Interview with Dr. Drew Timmermans

Discussion Details: Join Dr. Brigham Woods of Polaris PT & Wellness as he sits down with Dr. Drew Timmermans of Regenerative Performance to explore the cutting edge of regenerative medicine. From PRP and stem cells to patient-centered care and pain science, this conversation breaks down how innovation and empathy are transforming musculoskeletal treatment.

Benefits of Watching: Learn what PRP, stem cells, peptides, and exosomes actually do — and what’s hype versus what’s proven.

Address of Guests Business: 726 N Greenfield Road, Suite 101, Gilbert, AZ 85234

Dr. Drew Timmermans: Thank you, man. It is good to be here.

Dr. Drew Timmermans: I thought I clicked out on you. That’s gonna We’ll maybe edit that out and post. Oh, anyway.

Dr. Brigham Woods: Yeah. Sorry, man. Thanks for being here.

Dr. Drew Timmermans: Yeah. Yeah. Good to be here. In fact, yeah, you know, it’s funny. I was just at your clinic two days ago. Was that two days ago? Was that yesterday? No, it’s two days ago. Uh two days ago. Yep. Thought you lost your laptop. And it was super.

Dr. Brigham Woods: Yeah, dude. It’s been that kind of week. When you like the inside of my backpack, I know we’re getting off topic here, but like 10 seconds in and we’re already off. Perfect. This is my case. Yeah. This is the inside of my backpack.

Dr. Drew Timmermans: Oh yeah, that’s camo for sure.

Dr. Brigham Woods: Yeah. So I look it in there. I’m like, I left it there. And then I went back and looked again and it’s Yeah, it’s there. I’m It’s why I don’t do surgery. So, oh, we left the tool in there. Um anyway, so yeah, I mean I think a lot of people understand like people have heard of regenerative medicine, people have heard about stem cells and you know uh peptides are kind of having a moment right now especially uh BPC 157 like a TV500 and then obviously GLP ones, right?

Dr. Drew Timmermans: Yeah. Yeah. Yeah.

Dr. Brigham Woods: Oh, for sure. like those are all having a moment and then PRP kind of more I mean PRP’s been around for 15 20 years but it’s really starting to people are kind of coming around to the idea of it and so I think people have an idea of what regenerative medicine is but like what would you say regenerative medicine is?

Dr. Drew Timmermans: Yeah. So I think at its core regenerative medicine is just using different injections of various substances to try to stimulate the body to have a healing response. Right? So we get injured, we tear a rotator cuff, we roll our ankle, our body has a healing response. It starts with inflammation, then we get proliferation of cells and then we get remodeling of that tissue. And so regenerative medicine is just capitalizing on that and using different methods to stimulate the body to go through that process without having a whole new injury that it has to recover from. And so instead of having this like dip in like you know tissue damage and stuff and then rebounding to you know a baseline it’s like oh we have no new injury but we stimulate a healing response and so you can add on to your baseline. So various ways that we do that, but that’s kind of like the core of regenerative medicine.

Dr. Brigham Woods: And when you say no to injury, you’re talking about like surgery, right?

Dr. Drew Timmermans: Yeah. Surgery or even, you know, it’s just like you you didn’t just reinjure your ankle to get that healing response. We just went in and injected some PRP or something like that.

Dr. Brigham Woods: And and I think, you know, I think you would probably agree there is a time and a place for surgery. Maybe you wouldn’t agree. I don’t know. I think you know there sometimes there is a time and a place for surgery but but but I think people don’t understand that you are causing a whole new series of trauma when you go have a surgery. Yes. If you tear your ACL in half and you want to go back and play a sport and you kind ACL is kind of important. Yep. So you know you have to go have a surgery you just created a whole series of other injuries that you need to also try to recover from.

Dr. Drew Timmermans: Yep. 100%. Um,

Dr. Brigham Woods: Which again, if surgery is the option, that’s it’s a it’s an option. Um, but I think that’s an interesting idea of like, hey, we got this injury. We can actually really beef up your your body’s own response to healing and and go that way without having to do another injury.

Dr. Drew Timmermans: Yeah. Yeah. And and that’s what we’re trying to do.

Dr. Brigham Woods: That’s awesome, man. Um, so what initially then I mean because yeah, we’re not you’re not making X-Men, but what really drew you to that specialty? Like was there a personal moment or a mentor? Like how did you get into this world of regenerative medicine?

Dr. Drew Timmermans: Yeah, so it all actually started with my own back injury. So in uh let’s see, 2012, I was in a car accident um on the highway up in Canada where I’m from and uh I I was relatively okay. I had to throw that in there. a little.

Dr. Brigham Woods: No, I know. But you know, we we would never know that you were from here. Never. Never.

Dr. Drew Timmermans: Sorry. Um, and so I was relatively fine after that accident, but at that time I was still competitive in track and field. I was a middle distance sprinter. And so probably about two weeks…

Dr. Brigham Woods: Canadian national champion, by the way.

Dr. Drew Timmermans: Appreciate that. Yeah. Uh, two weeks later was in the gym squatting and uh tweaked my back, right? And it was Paul Quinn’s good old 369 protocol. I don’t know if you’re… Oh, brutal. So, it’s towards the end of the kind of the third round of those and uh and I felt a little tweak in my back. Okay. And you know, I it was two or three days and I was okay and and back at everything. So then about two weeks later, I’m running repeat 800s and on my second last 800, we had eight of them to do. This This was the seventh, which you should never do anyway.

Dr. Brigham Woods: I mean, 800 sucks. 800 is a diabolical is a diabolical distance.

Dr. Drew Timmermans: Yeah, I loved the 600. The 600 was like my my most It’s an indoor event, so you don’t see it like outdoor Olympics and stuff, but I loved the 600, but that extra 200 meters is death. Complete death. Yeah. Um, but I I literally felt my discs herniate. It’s the weirdest feeling, but felt them herniate. Uh, and the next day just woke up and like severe pain down my leg, severe intense back pain. Ended up getting an MRI a few months later because it’s up in Canada, so you know, you they’re not going to do anything right away, right? Uh, and I herniated 45 and 51. So from there, I did physical therapy, rehab, um I worked with a European osteopath, a bunch of stuff, and it got me out of the acute stuff, but I was still left with this nagging low back pain that would radiate down uh towards my foot, and it was just kind of 24/7. It was always there, worse when I was sitting for long periods and all this stuff. So, I end up uh moving from Canada to Arizona for med school in September of 2013. Still have back pain. And then in uh at some point in 2014, I think it was like March or April or something like that, I went to a sports medicine conference out in Florida, no this is 2015, sorry, it was 2015 because it was two years later. Um, so I go to a sports medicine conference in my second year and at the conference and like I had heard of like prolotherapy and PRP. Uh, my cousin was an elite gymnast and so she had PRP injections for an adductor strain that she had from a guy up in Toronto who like was the doc who did PRP on like all the Olympians in Canada. Like he was the guy to go to, right? So I knew of it but like I just knew of it, right? So, at the conference and and learning about Prolo and PRP and so there’s a doc there, he’s he’s out in Texas. He’s a fantastic doc, but uh during one of the breakout sessions, he’s like, “Hey, anybody got like a lingering injury, you know, and we’ll ultrasound it and we’ll we’ll see what we find in my hands up there, right? Because no one can really figure out why I have this pain.” So he diagnosed me uh with exam and ultrasound with uh a tear in my ilial lumbar ligament. So that’s one of the ligaments in your low back that connects your spine to your pelvis. And uh and a tear in the uh the lower lat fascia. So your thral lumbar fascia. Yeah. And so uh later that day he was like, “Hey, tomorrow we’re doing some PRP demos. Come find me and we’ll do PRP on you for these things.” I’m like, “Sweet. Yeah, totally.” So, next day I get PRP at the conference and uh

Dr. Brigham Woods: real quick. It doesn’t have to be your blood.

Dr. Drew Timmermans: Uh, no, it does have to be your blood.

Dr. Brigham Woods: So, my blood. So, they pulled your blood.

Dr. Drew Timmermans: Yeah. Pulled my blood.

Dr. Brigham Woods: Right there.

Dr. Drew Timmermans: Yep. Did it all right there at the conference. Okay. Y uh and so, uh, three months later, for the first time in two years, I was like 100% painfree. And so it was that moment that I was just like, “Holy cow.” Like that process of first figuring out the diagnosis on why I was actually in pain. Yeah. And then the PRP injections, I was like, “This is exactly what I want to do for the rest of my life and how I want to help people.”

Dr. Brigham Woods: So I mean, should an MRI have picked that up?

Dr. Drew Timmermans: Uh, no. Uh, MRIs are not great at picking up fascial injuries. So, that’s one thing that gets missed quite a bit. Yeah. Um, as I’ve gotten further into practice, there actually are quite a bit of fascial injuries that do show up on an MRI. The radiologists don’t talk about it. So, I pick them up on an MRI, but the radiologist doesn’t.

Dr. Brigham Woods: Well, because a lot of the like I start talking about fascia with people and there’s a certain subset of healthcare professionals that instantly go, “Nah, BS. We’re not talking about that. Yeah, that’s not a thing.” But that’s crazy. That’s great. I mean, I’ve seen it like I’ve I’ve now had too many experience with fascia stuff and what I can do with it that makes me go, “Yeah, there’s more to it than just you you can’t dismiss it.”

Dr. Drew Timmermans: Yeah. And and again, I think you just go back to basic anatomy and physiology. If something has nerve endings in it that transmit pain signals, that structure can become painful. For sure. 100%. And there’s so much so many nerve endings in fascia. Yeah. For for pain.

Dr. Brigham Woods: Well, and and I was listening to somebody else talk about that whole idea of like why that like we use percussion, right? Like I use like a lacrosse ball some heavy percussion on stuff is that I think what you call the P po pole electric effect where like all the fascia is interconnected. So if we can affect it here, it spreads out and communicates with the rest. So yeah.

Dr. Drew Timmermans: Yeah. Fascia is a a big communication network for sure. It just it the the the forces don’t get transmitted in ways that like people can measure well. Yeah. And it also like spans long distances. It’s complex, complicated. So I mean we are just scratching the surface when it comes to fascia and how important it is for the biotensgrity model and everything that we do.

Dr. Brigham Woods: Yeah. Um, so within that was like when it had personal meaning for you and when like, hey, this is this is how I’m going to pursue this. So when did it become I don’t know if it has any deeper meaning than that, but did is there a point where you’re like this was important to me, but you realized it had deeper meaning beyond just fixing yourself and for other people.

Dr. Drew Timmermans: Oh yeah. In that in that moment like, you know, and again that moment is over a three-month period, right? Because it’s from injection to really being back in the gym three months later and being like, holy cow, yeah, I am, you know, I’m back squatting and doing the things that I couldn’t do before. Uh, and so that three-month process was just like great for me, but it was just like, this is how I want to help people. Yeah.

Dr. Brigham Woods: And to that end, is there a I know I mean you’ve been doing what you said 10 years now.

Dr. Drew Timmermans: Yeah.

Dr. Brigham Woods: Is there in that I mean sure there’s tons, but is there one person in particular that kind of stands out to you is like the success story?

Dr. Drew Timmermans: Dude. I have these stories freaking every every month at this point. Like, you know, I I think the big ones like I had a lady, uh, let’s see, this was probably about almost 6 months ago now where she’s uh endstage arthritis. She uh was told she needs a knee replacement. Uh, didn’t want to go through a knee replacement just because of, you know, her personal beliefs about what she wanted to do for her health.

Dr. Brigham Woods: Are we thinking about the same person?

Dr. Drew Timmermans: Uh, no, actually that’s one of them I’m thinking of, but this is another one.

Dr. Brigham Woods: Okay.

Dr. Drew Timmermans: Yeah. Yeah. And uh and and she had actually, and we’ll I’m sure we’ll get into this discussion later, but she went to one of those seminars on stem cell therapy and the the company was going to come to her kitchen and inject stem cells into her knee joint. And so and she is a a friend of my wife’s aunt and so my wife’s aunt found out about this and was like, “Do not do that. Yeah. Go talk to my niece’s husband and actually get something that’s real,” right? Um and so, uh so she was up in Montana. She came down for treatment and 3 months later, I mean, she is able to do what she wants to do in life. She doesn’t need a knee replacement. Now, her joints not regenerated, right? But she doesn’t have the pain that forced her to go to the doctors for them to say, “You need a knee replacement.” And so those things just happen on a regular basis at this point.

Dr. Brigham Woods: Well, yeah. And it’s funny because I was like, you were starting to talk. I’m like, this sounds an awfully familiar, right? Because I’m working with somebody that came from and I had always known that you had like I had always known that you did this and that like it was good. It was successful because I’ve seen a bunch of your patients, but this one was the one where I was like, “Holy cow.” Because I’ve seen most everybody that I’ve kind of interfaced with hasn’t been super super super like bad. They’ve been pretty bad. Yeah. And maybe that’s because they’ve I get to them after you’ve done your done your thing. But this this woman I was just like this she couldn’t she was like missing 20 degrees of knee flexion and like could only bend to like 115.

Dr. Drew Timmermans: And no lateral meniscus.

Dr. Brigham Woods: Yeah. And no lateral meniscus. And now she’s able to achieve zero and get to 140 degrees of knee flexion. She’s walking around with little to almost no pain. She I think she had no pain, she said yes on on when we saw her the other day. And uh yeah, just ready to get back to to training and working hard and and and she’s not particularly young either. Like no, she was going to get a knee replacement.

Dr. Brigham Woods: And so like for me that was the one where I was like this you can take somebody like that and turn it around into this. This is legit. Yeah. Like I was I always knew it was legit but then it was too legit to quit. Like that’s an old person’s joke for um so anyway like so the practice I mean you you co-founded the practice with your wife.

Dr. Drew Timmermans: Yep.

Dr. Brigham Woods: Um I guess what are some of the core values that you have that have shaped your approach to patient care to your practice and how you interface with with patients?

Dr. Drew Timmermans: Yeah, I think, you know, I think one of the the most important things that we have really stuck to that has the biggest impact, and this applies to my side of the practice which I only do orthopedics uh and and pain and my wife’s side of the practice where she handles everything else, is we we treat the the patient that is suffering and we respect their symptoms. And what I mean by that is there is so much dismissal in the conventional medical world. You’ve got shoulder pain and the doc says there’s nothing wrong on your MRI. It’s all in your head. And it’s like you do a physical exam for even a basic one for eight minutes and you’re like I know exactly why you’re having pain and here’s our solution to it. And then we do that treatment and their world has changed. And then so on my wife’s side, she deals a lot with like chronic infections, complex chronic disease, you know, these these situations where again the conventional system is just like, yeah, your CBC is good. So there’s nothing wrong with you. These symptoms are all in your head. Go see a psychiatrist. And it’s like, no, there is a reason that these things are happening. Yes, the psychosocial component of the biocschosocial model is real, but our experience has shown us that it’s not the biological model in in some patients and the psychosocial model in other patients. It’s the biocschosocial model. And all three of those pieces play into it to some degree. Some people it’s high biological, low psychosocial. Other people it’s high psychosocial, but they’re still biological. Like all three of these are always at play. And so it’s just listening to the patient and believing the symptoms that they have and trying to figure out why they’re having those symptoms to help them as opposed to just being like it’s all in your head.

Dr. Brigham Woods: Yeah. No, for sure. And and I think I’ve I’ve yet to come across somebody who just purely had pain they made up 100%. Now, now when you’re distressed, pain becomes exacerbated. And things become a bigger deal. But yeah, oftentimes were you distressed because you had pain or were you already, you know what I mean? Yeah. And so, yeah. No, I think that’s great. You have to respect people’s pain because a lot of times, yeah, they do go, “Hey, uh, yeah, there’s nothing on your MRI. Sorry, dude.” Or or they don’t even do MRIs. There’s nothing on your X-ray, so there’s no reason for you to have pain.

Dr. Drew Timmermans: Yeah. And I tell people all the time because like we get a lot of like, “Hey, you know, you’re you’re they come in and they think they’ve been given a death sentence. They’re like, “I’ve got herniated discs. There’s nothing we can do.” And I’m like, “Yes, so does so does the whole…”

Dr. Brigham Woods: “I’ll never squat again.” I’m like, “Did you go to the bathroom this morning?” You squatted.

Dr. Drew Timmermans: Yeah. Sit down on that chair.

Dr. Brigham Woods: Yeah. But also like you realize that like the overwhelming majority of the population is walking around with herniated discs or bulging discs and not everybody’s dealing with pain. Like like anatomy is in some cases anatomy does mean pain, but it also doesn’t mean pain. Right.

Dr. Drew Timmermans: Pain is correct. Pain is just a request for change. Yep.

Dr. Brigham Woods: Yeah. And and it’s interesting on that point. I’ll make a comment that sometimes I see that pendulum go too far. Yeah. Meaning that a doc will say, “Yeah, you’ve got herniated discs and you’ve got back pain, but everybody has herniated discs, so that can’t be causing your back pain.” It’s like, no, that logical f that’s a logical fallacy that doesn’t track.

Dr. Drew Timmermans: Yeah. In this case, they probably are causing your back pain. If somebody else is, they’re probably not, but in this case, they are. And we need to address that. And and you know this, the only way you can know that is if you load the tissues.

Dr. Brigham Woods: Yep.

Dr. Drew Timmermans: Right. You load that disc however you’re going to load it. And if it causes their pain, I mean, you’ve got your answer as long as you’re ruling out other things. If it doesn’t and no matter what you do to load that disc, it doesn’t cause their pain, then that disc herniation is incidental and it don’t matter, right? Yeah. You’ve got to be able to look at the each thing, each piece of the anatomy and go, “Yeah, figure out how to load it and go, is that it?” If that is, then it is.

Dr. Brigham Woods: So, no, I think um I think that’s absolutely correct, man. Um, and so for you, I mean obviously clinical outcomes, you want great clinical outcomes that that is a standard of like, hey, did we do our job or not? But what for you then also within that plays into outside of clinical outcomes, what else plays into giving exceptional care to you?

Dr. Drew Timmermans: You know, so we are we’re not a high volume clinic and we have strategically chosen to be that way. Um because we want to make sure that, you know, and there’s also plenty of research out there that shows that patients get better when there’s a stronger therapeutic relationship, right? And I don’t want to discount that if somebody gets an extra 10% improvement from a procedure because we took the time with them and we sat with them and we listened to their story and we actually cared for them as a human. Love it. I’m all for that. Right. I don’t want to discount that. And so um so you know we spend a lot of time with patients where, you know, we don’t I don’t see 10 15 patients in a day. Uh, you know, I see three to five patients in a day, which shocked me.

Dr. Brigham Woods: That’s it. I mean, it surprised me yesterday or a couple days ago when I came to shadow and hang out and you were like, “Yeah, we’re going to be here 8:30. We’re starting 8:30. We’re done at 5:30.” And I think we saw five people all day.

Dr. Drew Timmermans: Yep. Yeah.

Dr. Brigham Woods: Which which is phenomenal because it was really There were a couple things that I noticed. Number one like your intake with like we had the there was a new one new patient several two, right?

Dr. Drew Timmermans: Uh yeah yeah yeah.

Dr. Brigham Woods: And each of those were two hours, which was f- like unbelievable to be able to take two hours with somebody. And even at the end of two hours, what I thought was really cool was, you know, you’re sitting there and you go, “Is there anything like,” and it’s supposed to be the end of their appointment and you’re just like, and and and I knew you meant it. Like if they needed something else, you were going to stick it. Yeah. And they were like, “Is there anything else that I can do for you today?” Yeah. And I think that’s I So, yeah. I mean, you just you you said it, but also I watched you live it. So, yeah, I appreciate that. That’s a really cool thing, man. Um, and so with the people that you guys see, who do you what conditions or cases do you most frequently see? Like what’s your sort of…

Dr. Drew Timmermans: Yeah. So, so number one for me is the low back. And and I think part of that is just because that’s what I talk about the most online just because I have personal experience with that. You know, I’ve never really had knee pain. I’ve had shoulder pain. I’ve had neck pain. Uh I’ve never really had knee pain, but like back has been the number one thing for me over the last 10 years of my own life. Uh and so the low back is is the mo and I also love the low back. The low back there’s just something about it that like it clicks for my brain. I am really good at it. I love the procedures for it. We get fantastic outcomes and so low back is probably number one. Uh then number two is knees just because, you know, 98% of the population has knee issues, right? Uh and then and then cervical spine is is third.

Dr. Brigham Woods: Yeah. And so, um, I guess what would be interesting is for you, what are a few early like because I think a lot of the times you end up with people after they’ve sort of ignored something for a while or they’ve maybe necessarily kicked the can down the road, then they tried to go see some other people and it progressed to a point where like then you get called in. Um, what are some of the like what do you put a couple early warning signs that someone shouldn’t ignore that like maybe should prompt a visit?

Dr. Drew Timmermans: Yeah, I mean I think when it’s really good question. Um I think the you know the first signs that your pain is starting to affect your daytoday, right? Cuz we can have some discomfort or something like that, a little stiffness in the morning, but you can still do everything that you want to do. Sure. Now, arguably if that persists for several months, probably good to go, you know, get that checked out to get ahead of it. But the first sign that you’re like, “Oh, I’m not playing. I’m not going as hard in pickle ball as I want to because this knee is bugging me…” or, oh, I’ve got to I I I’ve had to stop doing overhead press because the shoulder’s not just feel it’s feeling a little wonky when I do it.” Like that is when I think people should be like, I need to do something about this now. So that way it’s not 3 years down the road and then we’re trying to make up for that that lost time and that lost movement.

Dr. Brigham Woods: Yeah. No, I agree. I think Yeah. I tell people like people think of injuries as like something that is they broke something or they had this nasty sprain. And I go, “No, an injury is when you start affecting your life and you start trying to figure out and make choices about how you’re going to do things.” Like if you’re like, “Hey, I’m going to sit down to put on my shoes every day now instead of standing up, right?” Like, or I can’t do that anymore because of pain, we might need to take a visit.

Dr. Drew Timmermans: Yeah. Yeah. And I would say uh 95% of the patients I see are that latter category. It’s not the oh I fell and tweaked my ankle or you know I was hitting a serve in tennis and I felt my shoulder you know blow out or something like that. It’s like hey I had an injury 12 years ago and it’s just slowly gotten worse over the last 12 years.

Dr. Brigham Woods: Right. Yeah. No I I I agree. Um so we talked we at the beginning we kind of mentioned regenerative medicine. So, I had to define it. I mean, I kind of have what I see as some of the misunderstandings, but what do you see or what do people often misunderstand about regenerative medicine or PRP, stem cells, that kind of stuff?

Dr. Drew Timmermans: Oh, big question. Um, all right. So, I’d say first thing is that um people just assume that the let’s say I’ll use knee arthritis as an example, right? Right. So, you’ve got knee osteoarthritis, you get an X-ray, doctor says you’re bone on bone or whatever.

Dr. Brigham Woods: Um, he’s an 80-year-old.

Dr. Drew Timmermans: Yeah. Yes. Uh, no cartilage left. And then I show on ultrasound. I’m like, there’s your cartilage. You still have some. Yeah. Um, but they just assume that they just need an injection inside the joint. Uh, whether it’s PRP, stem cell therapy, prolotherapy, doesn’t matter. They just assume that like, oh, you just go inside the joint because arthritis is, you know, loss of cartilage. Sure. Um, and most of the time that’s not the full picture.

Dr. Brigham Woods: I’m going to be honest, that’s what I thought it was when they’re like, “Hey, we’re doing a PRP injection for arthritis or we’re doing a stem cell injection for arthritis.” I was like, “Oh, cool. They just go in and because that’s that’s what I’m accustomed to as far as like how most PRP I feel like is done, how most cortisone shot and those kinds of injections, SinBisk, that kind of stuff is done.”

Dr. Drew Timmermans: Yeah. And and I will say that is probably still the most common way it is done. It’s the it’s the subpar suboptimal way in in my experience. Right. And I think part of it is because you’ve had a lot of uh a lot of doctors who are transitioning from cortisone and hyaluronic acid over to PRP. And so they’re just taking the old model of well we just put it inside the joint and then they transition it over to PRP and go well we’re just going to put it inside the joint. Yeah. But a lot of the times there are structures outside the joint. So the medial collateral ligament, infropatella branch of the sophinus nerve, your coronary ligaments which attach your meniscus down onto your tibia. All of those things can be painful and sometimes that’s actually causing more of the pain in our in knee osteoarthritis than the actual arthritis itself. Yeah. And so the the misconception is you just got to put it inside the joint and that’s it. When in reality you need a good physical exam to determine which structures are contributing to pain because the success of the treatment is almost 100% dependent on an accurate diagnosis. Yeah. And a lot of doctors don’t talk about that because if if a patient fails PRP, the doctor doesn’t want to take responsibility for that. They want to blame the patient. Oh, you didn’t do your physical therapy. You didn’t, you know, you’re just a non-responder or or whatever else when most of the time it’s no, you just you didn’t inject into the structure that’s actually causing the pain. Yeah. Right. If you’ve got rattling going on in your car and the mechanic just goes, “Oh, yeah, it’s probably your alternator and changed out your alternator, but it wasn’t your alternator,” you’re still going to have rattling in the car. Yeah. And the same thing applies to chronic pain and these types of injections. Um, so that’s the big one. Uh well that that’s a big one. Yeah. I think the biggest one is just the whole misconception on stem cell therapy.

Dr. Brigham Woods: Yeah. Tell me about that.

Dr. Drew Timmermans: So um where do I start? Okay. So, in the United States, the FDA has pretty clear guidelines on the fact that you cannot take cells from another human and inject them into a different human because they determine that to be a drug. Now, I don’t I I don’t agree that it it that it should be labeled as a drug. Okay? I think there needs to be some form of regulation because there is serious risk that can happen if you get bad actors coming in and not doing proper sterility testing, not making sure that the, you know, there’s not contaminants or viruses or other things that can get transmitted from one person to another person, right? The same way that, you know, if someone’s in the hospital and gets a blood transfusion, there’s a regulatory body to make sure that everything is safe as excuse me as possible.

Dr. Brigham Woods: But not heart prisoners in some third world country.

Dr. Drew Timmermans: Right. But that blood is not a drug. Right. Right. But they want to take the the stem cells in a vial and call those drugs. Okay. And and and the landscape there is shifting a little bit, but that’s currently where it’s at right now. And so the the there’s been a lot of companies who have actually been shut down by the FDA because they are saying we have stem cells in this product and then they’re selling it to doctors but that’s in violation with the FDA. Now the other layer to that is there have been several research studies that have been done on those products and the the last good really good one that was done that I’m aware of at least was I think 2019 where they took so there’s a university that did this study so they’re not affiliated with any of the products right that’s very important there’s no bias here but they looked at all six of the top products that were being sold in the US at that time and not a single one of them even contained living stem cells at the time that they would have been injected into the patient. So patients are paying for stem cell therapy and they’re not even getting living stem cells.

Dr. Brigham Woods: Well, yeah, I mean dead stem cells don’t do anything, right?

Dr. Drew Timmermans: Correct. They do not. Now, there are still uh growth factors and a few other components of the extracellular matrix and collagen that are in those. And so, patients can still see benefit, but it’s way overpriced for what you’re actually getting.

Dr. Brigham Woods: Yeah.

Dr. Drew Timmermans: And so, so for that, so the FDA is for the most part okay with what are called autologous stem cell therapy. That means it comes from you.

Dr. Brigham Woods: Yeah.

Dr. Drew Timmermans: So if, you know, on our mutual patient, we took her fat and her bone marrow which both contain stem cells and processed those and reinjected those back into her in the same procedure. Yeah. And and that’s how we can do stem cell therapy. So that is one of the biggest misconceptions I think out there is people think that they can just go to a doc, get stem cells in a vial and get that injected. Now that is coming. There are products that are in development and in phase two and phase three clinical trials that once those get approved, we will then be able to use them. But as of right now, you know, September 2025, that’s not the case.

Dr. Brigham Woods: And then tell me because you were telling I thought it was super interesting. You were telling me about what we could what you’re able to do or how you can actually multiply stem cells for people.

Dr. Drew Timmermans: Yeah. So um there’s something called the federal right to try act which essentially says that if a patient has a uh debilitating condition and they have uh failed some form of conservative care. So an example is a patient has knee osteoarthritis. They’ve done NSAIDs. So they’ve done medication management. They’ve done physical therapy. Maybe they’ve done a cortisone injection or hyaluronic acid and they’re still having symptoms. They can then apply for the right to try act which allows them to have access to a drug that is in the pipeline. So it’s past phase one uh safety trials. So the FDA has said yes, we approve that this is safe, but we don’t know if it’s efficacious yet because they’re going through phase two and phase three clinical trials. And so there’s a a lab in California uh that we’ve partnered with where they their product has gone through phase one clinical trials. So FDA has given that stamp of approval. And so we can take a patient’s fat, we can send it off to the lab and they can culture expand it. So they can take a 100,000 cells and they can turn it into a 100 million cells. And then the patient has the right to request those back under this federal right to try act where we can then treat them with their own expanded stem cells as part of this federal right to try in order to help them with whatever debilitating condition that they have.

Dr. Brigham Woods: That’s awesome, man. So, when you do stem cell stuff with people, do they generally just need one bout of it or do people often need more bouts of of stem cell therapy?

Dr. Drew Timmermans: Uh it’s a great question and it kind of depends on the nature of the injury. So if somebody has a degenerative condition over their lifetime, they are probably going to need more than one treatment. Okay? Right? And so somebody has endstage knee osteoarthritis, they get a stem cell procedure, they might have really fantastic relief for three years, five years, sometimes even out 10, 15 years. Yeah. But a lot of patients in general at some point will probably need another treatment because the degeneration process is still occurring. Okay? Right? Someone who has, let’s say, they’re playing pickle ball and they tear the rotator cuff and they have pain and they don’t want to undergo surgery or they’re not it’s not bad enough that they need surgery. They don’t want to do steroids because the risk associated with steroids and we do a stem cell procedure. That’s a patient that’s more likely to kind of just need one treatment. Okay. Uh because again, it was more of like an acute traumatic thing. Now, I will say they’re still at risk for reinjury because as you know, once you’ve had an injury, that tissue is different.

Dr. Brigham Woods: Sure.

Dr. Drew Timmermans: It’s never it’s never the same. So, you’re more at risk. And also, what movement mechanics led them to be in that position in the first place, right? And so as long as we are and and and you know this because we refer patients over to you, but we’re bullish about physical therapy. Yeah.

Dr. Brigham Woods: I I tell patients that these injections are going to get you out of the pain hole, but what turns this from lasting from three years to a lifetime is physical therapy. Hands down, physical therapy. And I I appreciate that because I think what we do is invaluable. But again, it we’re not the cure all end all beall. And it’s been really cool to see how well your patients do versus some other patients who who maybe didn’t get stem cells or PRP or you know and just they’re just coming straight straight to us.

Dr. Drew Timmermans: Yeah. Yeah. It’s a it’s a different beast. Yeah.

Dr. Brigham Woods: Yeah. It’s a different animal together. So what so I guess my next question would be is how do you decide between stem cells, PRP, or is it always in conjunction together or do you ever just do some PRP, some stem cell?

Dr. Drew Timmermans: Yeah. So um every there there’s one exception but almost every single time we do a stem cell procedure so either with bone marrow or adipose tissue we add PRP into it. Okay. So there there’s good evidence that shows that a high dose of platelets will actually help to activate those stem cells that are present in either bone marrow or adipose tissue. And so that always gets paired together. The one exception is we’ve had a Jehovah’s Witness patient over the years.

Dr. Brigham Woods: Sure.

Dr. Drew Timmermans: Uh and they’re they you know their beliefs is they don’t want to use any blood products.

Dr. Brigham Woods: Oh is that Jehovah? Okay.

Dr. Drew Timmermans: Yes, that is. Yeah. And so uh in that case we just use the the fat derived stem cells and we did not pair it with PRP. Sure. Um but you know uh when we do PRP if like the patient’s choosing to do PRP um or if we recommend PRP obviously you know we’re not going to add stem cells under that because they’re just choosing to do PRP. But so the the decision so uh I’m I’m very research driven when we have that research. Um, obviously we don’t have a lot of research for a lot of different conditions and so sometimes we have to extrapolate and I’m always transparent with my patients on hey we have this study that shows us this but these things we don’t have research for we can try to pull from this but I’m being very clear we don’t have a research trial on this but um the the one area that I think has that I’ll mention is so patients with knee osteoarthritis so there is a research study that was done in France where the surgeon where he was actually the first doc in the world to do bone marrow stem cell therapy for an orthopedic condition. Okay. He did it for um uh at first it was um non-healing fractures and then it was uh avascular necrosis of the hip. So he had the idea that when you do a stem cell procedure for knee osteoarthritis because cartilage heals from the inside out, it starts that healing starts in the bone and works outwards to the cartilage. He did a study where he took a a goodsized group of patients. He did bone marrow stem cell therapy inside the joint only in half of them and in the other half he just did it in the bone underneath the cartilage. So it’s called a subchondrial or an intraosseous injection. And then he obviously tracked pain and all that type of stuff. But the biggest thing that he was looking at was does this actually change the rate of a person getting a knee replacement.

Dr. Brigham Woods: Yeah.

Dr. Drew Timmermans: Because it if it changes the rate of getting a knee replacement that that’s huge. Okay. So the study lasted 15 years which is like that’s unheard of these days, right? In terms of how long a research study is going to go on. So 15-year study and the patients who got a intraarticular so inside the joint only stem cell procedure 70% of them moved on to a knee replacement within that 15 years.

Dr. Brigham Woods: Yeah. I’m not I’m not I’m not taking those odds to Vegas.

Dr. Drew Timmermans: Right. Right. It’s still better than not doing anything for sure. But but still 70% of them needed a knee replacement. The patients who had the intraosseous injection, 20% of them needed a knee replacement over 15 years.

Dr. Brigham Woods: Yeah. I I’m putting my savings on black.

Dr. Drew Timmermans: Yep. So, in a situation like that, if a patient comes to me and says, “Doc, you know what? What can I what’s the best thing I can do to avoid a knee replacement?” It’s that 100% hands down. Now, not everybody can afford that, right? So that so the second decision maker outside of of research and clinical experience is finances because these things aren’t covered by insurance and so patients have to invest their hard-earned money into this. And so if a procedure like that is going to cost, let’s say 15 $18,000 and somebody goes, “Okay, that’s not something I I can do.” Then we just scale it back. We go, okay, well the step down from that is this. The step down from that is this. And then we work to figure out what works in their budget. Yeah, but some people go, “Yep, like it’s so important to me to do the best thing possible to avoid this knee replacement.” And so, yes, I will reallocate my resources to invest in my knee, my health, and go through that for sure.

Dr. Brigham Woods: Um, well, I think it’s Yeah, that’s that’s that’s great. And I appreciate I figured at some point finances I mean, same thing with us, right? Like finances always is is part of the equation and you just kind of have to and and whether or not and there is truly the situation where people just can’t afford it or there’s the situation where it’s just not that worth it to them. Yep. And that’s that’s okay too. So stem cells, now I’ve heard people talk a lot about exosomes.

Dr. Drew Timmermans: Mhm.

Dr. Brigham Woods: Are those what’s the difference between kind of stem cells and or are they the same thing?

Dr. Drew Timmermans: No. Yeah. So, they’re different. So, um exosomes are basically a little packet of information that a and there there’s different types of cells in the bodies that will send out exosomes. Exosomes are not unique to stem cells. White blood cells send out exosomes. Platelets actually can uh send out exosomes. Like lots of different cells can send out exosomes. But in the regenerative medicine space, when you talk about exosomes, it’s almost always coming from stem cells. Although there are some ways that you can get the exosomes from platelets and and use that. Um, but basically there these little packets of information that the cells will send out to tell other cells how to heal, how to respond. It’s one of their kind of communication systems. But exosomes fall into that drug category that we talked about earlier from the FDA. So as of right now, there are no approved exosome products in the US for an orthopedic condition. And so we, you know, again, companies and clinics that are using that are at risk, right? There’s still a lot of places out there who will say, uh, either they don’t believe it’s a risk or they just go, I don’t care that it’s a risk. And to each their own, you know, everyone gets to decide how risky they want to be with their medical license. I have I’ve chosen to take the safer path and not risk my license. And so we used to use exosomes quite a bit prior to the FDA saying, “Hey, these are drugs.” Yeah. Um, and they worked really well. I I still think it pales in comparison to using a stem cell because again the stem cell is fascinating in that the stem cell actually senses the environment that it’s in and then decides what exosomes and information to send out.

Dr. Brigham Woods: Interesting.

Dr. Drew Timmermans: Whereas the exosomes have been created in a lab where they stress the stem cell in a particular way to get it to release that info. But that’s not that may not be the signaling the best signaling that it needs once it’s inside this patient versus that patient. And so that’s why I still think, you know, true cellular therapy is going to be better. Now, one area that I am excited for for when some of these products get approved and I can use them is I’ve had quite a bit of patients that are just medically too frail to undergo a bone marrow aspiration or a mini lipo aspiration to get the fat or the bone marrow. And and that would be a great place for me to say, “Hey, we actually have something that’s off the shelf that we can use.” Yeah, it’s probably not as good, but you can’t go through a procedure medically anyways. So, like it’s a moot point. Yeah. Let’s go for what we can do.

Dr. Brigham Woods: Yeah. And then, you know, it was interesting to me. Everybody’s heard about PRP and I mean, I’m in this space somewhat, you know, the orthopedic space and I had never heard of PPP. And you were like, “Yeah, we do PP.” And I’m like, “Wait, what? What? What is P?” So, and maybe I just maybe I’m out of the loop, but I don’t it’s the first time I’d ever heard of PPP. So, explain a little bit about like what that is and why you use it and how you use it.

Dr. Drew Timmermans: Yeah. So, uh so when we take blood for our PRP processing, right, we take blood, we spin it down in a centrifuge that concentrates the red blood cells to the bottom and we get rid of those. Then the other part of blood is your plasma, right? So blood is basically just is red blood cells and plasma. So then we take that plasma and we spin it again and that takes all the platelets and it and it packs them to the bottom and then we take that little bottom portion. So now we have plasma that is rich in platelets. That’s where that’s where the name platelet-rich plasma comes from. Right? But then we have all this other plasma that does not really have a lot of platelets in it because they’ve all been packed to the bottom. And so that is platelet poor plasma.

Dr. Brigham Woods: Gotcha.

Dr. Drew Timmermans: And so within the plasma there is still a lot of really great growth factors that are present that can be uh useful in certain situations. So probably the the best use of platelet poor plasma is actually going to be in muscle injuries. Okay. So uh hamstring tendon tear uh the the patient we saw together the other day had a a pec tear. So when you put it inside the muscle, it will actually help recover that muscle better than platelet-rich plasma will. And part of that is the research shows us that platelet-rich plasma can actually stimulate a bit of the scar tissue uh inside muscles whereas the platelet poor plasma doesn’t. And so we actually get we just get better healing. And so inside muscles is probably the number one area that we’re going to use platelet poor plasma.

Dr. Brigham Woods: And so, you know, I mean, typical typical muscle injury six to eight, you’re looking at like six to eight weeks, right, to heal. Does does how much does PPP speed that up?

Dr. Drew Timmermans: Um, quite a bit. So, if you look at like return to play in like professional athletes, some of these athletes with PPP are back in like 14 to 21 days, like two two to three weeks. So again, for the average person, like if someone comes in with a like again a recreational pickle baller comes in and they just strained their hamstring. Yeah. And and it’s two weeks in, I’m going to be like, “Hey, go to physical therapy.” Sure. Your body 85% of the time is going to take care of this. We don’t need to do anything. Right. Because there’s nothing on the line, right? You’ve got you’ve got a a an NFL lineman where every game he misses is a huge deal. Like, yeah, you’re gonna do something to shave three weeks off of their return to play.

Dr. Brigham Woods: Well, I mean, anytime you hear about like a guy, a skilled physician getting a hamstring strain, that guy’s out forever. Yeah. So, yeah, if you can speed that up with PPP, that’s great. Yeah. Um, so here’s something, I guess. So, you people listening to this, they they’ve kind of looked at you, kind of looked at your social media because you are also amazing at putting out content. I wish I had that gift. Um, but if they’re hesitant or unsure about reaching out, what do you what would you like them to know?

Dr. Drew Timmermans: Oh, good question. Um, what do I want them to know? Uh, so here’s what I’ll say is there are there are a lot of really great physicians across the country who practice very similar to me, right? There. But sadly, we are few and far between. We’re the 5%. 95% of the stuff out there is rushed appointments. It’s barely any physical exam. It’s not proper platelet dosing. It’s not good technique with injection or it’s palpation guided, so there’s no imaging and things like that. So, you know, if someone’s looking locally, you want to make sure you’re you’re doing your research. I have a bunch of videos online on YouTube kind of covering, you know, what you’re looking for and that type of stuff. Um, if someone is interested in working with me, I do free discovery calls. So, we’ll hop on the phone for 15 minutes. We’ll kind of see if we’re a good fit for each other. I’ll walk through how it would work, even if you’re out of state or out of country. Um, we have quite a bit of patients who who travel to to come work with me. And so we’ve got that dialed in, which is rare for a physician to take 15 minutes to jump on the phone and see if you’re a fit for his practice.

Dr. Brigham Woods: Yeah.

Dr. Drew Timmermans: So very rare, but but it’s so important because I think it just helps. Well, two things. One, it’s my vetting to make sure I think I can help this person. Yeah. Right. Because I I’ve had some patients who get on a call and I go, “Look, this type of condition like I like the results are not good even with what we do.” So like go explore this avenue or you know I’ll have someone who tries to get on my schedule for something I don’t even treat, right? And so it’s a vetting process for me but it also uh helps reassure the patient that hey, you know, at least this is something that we work with we can help with and makes them more comfortable to travel.

Dr. Brigham Woods: Yeah I think it’s great. Um, and so if somebody does want to get in touch with your office, what is the best way for someone to get in touch with your office or book a visit? What’s the easiest way?

Dr. Drew Timmermans: Yeah, so on our website, regenerativeperformance.com, uh we’ve got a link there that you can just either call us and chat with my front desk staff or there’s a a calendar link to just directly book the uh the 15-minute call.

Dr. Brigham Woods: It’s great, man. Yeah. Um and then for a first-time patient, what should they expect with an initial appointment with you?

Dr. Drew Timmermans: Yeah. So, most appointments are between an hour and a half to two hours. Um usually it’s we’ll talk in depth for about 30 to 45 minutes depending on the complexity of the case because there’s a lot of things that I will learn for that’s going to guide my physical exam, guide my review of imaging and things like that during that talking portion. Uh then it’s a really hands-on physical exam. Um it is it’s extremely in-depth. Uh you know because again we’re try if I’m going to put a needle in somebody I really need to understand which structures are painful. So we’ll do that. Then depending on the region of the body we may do a a diagnostic ultrasound evaluation. So, I’m a certified musculoskeletal sonographer and so we can go ahead and if it’s a shoulder, it’s a knee, uh, an ankle, whatever, we’ll we’ll do a diagnostic scan because ultrasound will show us some things that are better than an MRI would. There’s still a lot of situations where an MRI is going to be better than an ultrasound, but a lot of times both of these things together are crucial. Um, and then from there we’ll, you know, just discuss different treatment options and figure out what the the right approach is for that patient.

Dr. Brigham Woods: Yeah. No, and it was great. I watched it firsthand. Like it was it was cool. Two hours with somebody and you nailed you’re like, “All right, this is this is the plan. This is what we got. This is how it’s going to go.” Um, and then any you have any kind of final thoughts for somebody silently struggling with like low back pain who isn’t sure where to start?

Dr. Drew Timmermans: I mean there is uh I mean I I always got to shout out Kelly Starrett. I mean the dude you know him.

Dr. Brigham Woods: I was just there with him.

Dr. Drew Timmermans: Yeah. Dude’s a wizard. He has so much fant like there is there’s so much good stuff out there on YouTube, but there’s also so much crap out there on YouTube. Um, and so, you know, if someone is not ready to dip their toes in for like something one-on-one with somebody, you know, anything Kelly Starrett Posts is fantastic. You know, the McGill method is also fantastic. I’m I’m I’m a huge McGill guy. Um, I’m not a purist McGill guy, right? It’s but it’s there’s a lot of really great things like almost every single back pain patient is going to be recommended the McGill Big Three. Like, and I’ll tell you this right now, there’s a lot of PTs that talk a lot of crap about the Big Three that it’s outdated. It’s, you know, and I’m like, except, you know what? It’s like Novocane. Give us some time, it’ll work. Like, I like I use it all the time with our low back patients and it’s it’s great.

Dr. Brigham Woods: Yeah. And and and it’s so research driven. There’s been there’s no other, you know, um, researcher in the world who has like studied so much exercise with EMGs to actually like have a scientific approach to which core exercises you should do for stabilization. Everyone else, oh no, you should everyone needs to do this because like I thought of it and it sounds great and it worked for me. Yeah. Okay.

Dr. Drew Timmermans: Yeah. Well, and and even Like back to the Kelly Starrett thing, the he all of his people with low back get breath work, get breathing 100%. Because it’s a really really great way to start getting some some motion in the spine without movement, but also to help your nervous system, get your diaphragm active, get some of those stabilizing structures active and and teach your nervous system like, “Hey, it’s okay. We can calm down a little bit.” Just looking for some of those things, you’re right, I think are awesome for people.

Dr. Brigham Woods: And I think one of the things I really liked about Kelly is he did a video a while back on the Big Three and his take on it. Yeah. And what the thing he adjusted was, hey, when you’re doing them, breathe. Yeah.

Dr. Drew Timmermans: And I was just like, brilliant. Yeah. Yeah. It just it’s it’s the cherry on top of an already awesome Sunday.

Dr. Brigham Woods: Yeah. Well, dude, I I know you’re busy. I know we, you know, booked an hour for this thing and so I just I really appreciate you being here. I learned a ton from, you know, I’ I’ve been doing this a long my thing a long time, you know, but it’s I love going and learning from other people. So, I learned a ton from you. I learned a ton from you every time we talk, man. So, I appreciate you being here and yeah, if anybody who wants to get in touch, make sure that you go check out the website and get in touch. But, thank you again, Dr. Timmermans, for being here, man.

Dr. Drew Timmermans: Thanks, Dr. Woods. Appreciate it.

Dr. Brigham Woods: So, appreciate it, dude. That was awesome.