Let’s move on to being overweight and how much a role that plays in chronic pain I’d imagine a lot… Yeah, it can, just because you’re carrying all this extra weight and putting a little bit more stress on the bones and that’s just gonna affect some other things especially like when you are overweight and you have obesity generally that comes in conjunction with metabolic disease right so sometimes when you have obesity and you have that you have hypertension and you have type 2 diabetes and you have something now I’m not saying that everybody does but that can definitely be something that exasperates your pain because at that point you’re changing some of the hormonal responses we talked about cortisol earlier and cortisol how would a stress hormone it has a bunch of other different like functions in terms of your body being able to utilize like blood sugar for instance right so it’s definitely something that can consider because with exercise it can it can make things a little complicated with that kind of population. Do your patients tend to lose weight once they start working with you? -Yeah, they do because they’re been more active than they were before so without even trying sometimes they start losing weight I’ve seen people I don’t work any physical therapy offices but I’ve seen people in a physical therapy office start physical therapy and then come out with a little bit of weight loss you know the waist is a little slimmer their arthritis is down then they don’t want to leave as well then the problem is they become dependent on physical therapy they’re just like ‘hey, Diana, can you book me for a session on Friday?’