We Didn't Plan This – The Podcast for People Who Ditched Their Five-Year Plan
Sep 5, 2026 · 29 min · 8 segments
Part 2 with Dr. Ruan Qing Zhao — Hyrox training, VO2 max, treating chronic pain in veterans, a brutal personal back-pain story, surviving exams on 3 hours of sleep, and advice for Singaporeans…
Ruan Qing ZhaoGuestIsaacHostFaithHostThen that actually brought an interesting thought to mind, which was you work with a lot of patients who I suppose have acute pain, chronic pain.
And I think before, I suppose before you go around shoving things into their spine, there's a lot of lifestyle factors and a lot of those other biomechanical factors that come into play as well.
And I think the other interesting factor is that they are all vets who've been through certain experiences.
So I'm actually quite interested in how this sort of lifestyle, exercise, movement, how do those come into play in your daily practice at all.
You would think that we would want to be as interventional as possible to make our lives interesting.
It's just like how surgeons always want to operate and how orthopedic surgeons will always see a fractured bone somewhere because that's what drives our interest.
But in the pain field, pain is a little more complex in the sense that it's obviously physiological.
It comes from the you know the pathology you know locally from the area where you know the issue is and at the same time you know a lot of it is mental right so um which is the reason why you know it's so complex it's difficult to measure pain you know it's difficult to treat pain um and you know the reason that pain requires like um multiple specialties to be involved or at the same time so you know believe it or not you know what i believe in is that you know Patients should probably, or hopefully, get the best outcome with the least invasive intervention.
Pain alone, with the strategic injections, and even with neuromodulation, is really hopefully to try to prevent them from having surgery, or to try to salvage the pain that's left over, unfortunately, from a spine surgery.
And what I like to tell my patients is that the best injections have a lifespan too, because that's just how long the steroids will last, which is four to five months.
You should move in a way where it's healthy for you and you should be able to build up the core muscle bulk so that wherever your pain is coming from, have the muscles take over the function of a joint, which is no longer there.
And the story is really that if you do that sufficiently, then you don't really need to rely on these four or five month injections from us anymore.
These veterans, unfortunately, they've been subjected to a lot of trauma, and it's both mental and physical.
And, you know, it's not only just cumulative, but, you know, they all kind of pile on top of each other, right? And exponentially, they become exponentially difficult to treat, you know, if one of them kind of lags behind.
I mean, I don't have the ability to take away the mental trauma or the PTSD.
But if we're able to downgrade your pain score from a nine to a seven or a six, and then have you take over the responsibility and continue to move, build your function, and hopefully never rely on us anymore, I think that's really the end goal, the objective.
I don't want to intervene on you and continue to put more and more devices into your bag.
Then that actually brought an interesting thought to mind, which was you work with a lot of patients who I suppose have acute pain, chronic pain.
And I think before, I suppose before you go around shoving things into their spine, there's a lot of lifestyle factors and a lot of those other biomechanical factors that come into play as well.
And I think the other interesting factor is that they are all vets who've been through certain experiences.
So I'm actually quite interested in how this sort of lifestyle, exercise, movement, how do those come into play in your daily practice at all.
You would think that we would want to be as interventional as possible to make our lives interesting.
It's just like how surgeons always want to operate and how orthopedic surgeons will always see a fractured bone somewhere because that's what drives our interest.
But in the pain field, pain is a little more complex in the sense that it's obviously physiological.
It comes from the you know the pathology you know locally from the area where you know the issue is and at the same time you know a lot of it is mental right so um which is the reason why you know it's so complex it's difficult to measure pain you know it's difficult to treat pain um and you know the reason that pain requires like um multiple specialties to be involved or at the same time so you know believe it or not you know what i believe in is that you know Patients should probably, or hopefully, get the best outcome with the least invasive intervention.
Pain alone, with the strategic injections, and even with neuromodulation, is really hopefully to try to prevent them from having surgery, or to try to salvage the pain that's left over, unfortunately, from a spine surgery.
And what I like to tell my patients is that the best injections have a lifespan too, because that's just how long the steroids will last, which is four to five months.
You should move in a way where it's healthy for you and you should be able to build up the core muscle bulk so that wherever your pain is coming from, have the muscles take over the function of a joint, which is no longer there.
And the story is really that if you do that sufficiently, then you don't really need to rely on these four or five month injections from us anymore.
These veterans, unfortunately, they've been subjected to a lot of trauma, and it's both mental and physical.
And, you know, it's not only just cumulative, but, you know, they all kind of pile on top of each other, right? And exponentially, they become exponentially difficult to treat, you know, if one of them kind of lags behind.
I mean, I don't have the ability to take away the mental trauma or the PTSD.
But if we're able to downgrade your pain score from a nine to a seven or a six, and then have you take over the responsibility and continue to move, build your function, and hopefully never rely on us anymore, I think that's really the end goal, the objective.
I don't want to intervene on you and continue to put more and more devices into your bag.
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