When Old Dominion frontman Matthew Ramsey stepped onto the band's rehearsal stage a few weeks ago for their upcoming 54-date How Good is That world tour, he realized a familiar feeling was missing: fear.
"The stage is large, there are multiple levels, and I have to cover a lot of ground," he says. "But I don't worry, 'Is it going to hurt me to step down?' I'm not afraid anymore."
Pain was a near-constant companion for Ramsey after he suffered a series of injuries over the past seven years: torn cartilage in his hip in 2018 from leaping and jumping onstage; a broken rib and punctured lung in 2021 after falling from a 16-ft. ladder; a fractured pelvis in 2023 from rolling an ATV he was driving.
The injuries caused the band to postpone some concert dates, but despite the pain, Ramsey continued to perform -- at one point even borrowing Foo Fighter Dave Grohl's guitar "throne" (which Grohl used after breaking his leg in 2015), so he could play shows while sitting down.
"I would see him limping," says longtime friend songwriter Shane McAnally. "But he didn't complain. He would be out there on stage like, 'I've got to give them everything.'"
But as much as he tried, Ramsey felt like he was failing: "I wasn't able to give people what I felt they deserved."
The physical struggles took a toll on his mental health. "It was like opening the door for all these negative thoughts," he says. "I didn't feel like a fun person to be around -- I didn't want to be around myself."
Despite fronting country music's biggest band, with nine No. 1 singles and three platinum albums to their name, "I felt very lost," he says. "My dreams were coming true, and I wasn't able to feel them."
Ramsey's bandmates knew his body had taken a beating over the years, but for years, the singer kept his inner turmoil hidden.
"We were all seeing he was in chronic pain," Old Dominion bassist Geoff Sprung says. "But it wasn't as clear that he was struggling emotionally. He turned inward."
As one accident followed another, Ramsey's mindset darkened. "I felt like I was buried underground . . . and I couldn't get to the sunshine. I began to feel that I was a drag on everybody and maybe I shouldn't be around," he says. "It never got to the point of planning anything, but there was a nagging voice like, 'Everyone would be better off if you were not here.' And that's an awful place to be."
When friends and therapists suggested ketamine therapy, "I was so far down that I was like, 'F--- it. I'll try anything,' " Ramsey says.
Ketamine, a dissociative anesthetic, has been found to be effective for treatment-resistant depression. The therapy "changed everything," the singer says.
In 2023 he began a six-course treatment of one-hour sessions under the care of a doctor. "I was a little scared. I'd never done any recreational psychedelic drugs or anything. I was nervous," he says. "The first trip, I'll say, was pretty crazy, and you wind up being completely detached from anything. I was suddenly an outside observer of my own self."
The experience, "turns your brain off so your body can see how to heal and starts rewiring pathways to heal trauma," says Ramsey, who continues to receive monthly injections. "It was a gradual process of feeling able to be silly again and laugh and be in the moment."
But the injuries, and his depression, had taken a toll on his body.
"I fell into the worst shape that I've been in in my life," Ramsey says. "And started to show up during our shows. I was running out of breath. It was hard to sing. Everything that had broken was hurting, and I was exhausted after the show. I didn't like how I looked. I didn't like how I felt."
When the band began to make plans for an "epic" world tour for summer 2025, Ramsey panicked. "I thought, 'I cannot physically do that. There's no way.' I could barely do two shows in a row with two weeks off," he says. "That's when I started to go, 'I better rein this shit in.'"
So last November, he began working with a trainer and started working out three to four times each week. "It's brutal," he says of the routine. "I'm a person that hates working out. But I do like the results."
Earlier this year, he began working with a nutritionist as well, and since then, he has lost 15 lbs. of body fat. "I'm not looking to be a bodybuilder," he says. "I’m just looking to be as fit as I possibly can be so that I can handle the demands of the show."
Mission accomplished: "I can't remember the last time I've felt this strong," says Ramsey, 47. "I feel mentally strong too. I feel really, really, really great."
"My endurance is up, I'm sleeping better, and the shows are much easier," he says. "And I had to get all new clothes."
His family, including his two teen daughters, have noticed too: "They give me a hug and are like, 'There's less of you there!' "
For McAnally the changes in his friend have been profound. "It feels like the clouds have started to lift. He looks healthy, he looks happier," McAnally says. "It seems like his skin is fitting better than it used to."
Recently, Ramsey was with Old Dominion in the airport on their way back from the ACM Awards, where they had broken the record for consecutive group of the year wins with their eighth trophy, and Sprung noticed something different about his bandmate.
"We're getting off the plane, and normally he's the last one because he's been a little slower with all these injuries,. But I was walking to baggage claim and realized that he was past me. I was catching up with him!" Sprung says. "I don't know the last time I've had to catch up with Matthew in years. I was like, 'Bro, you're back. You're back!'”
Ramsey feels it too: “I came back to a me that I haven’t felt in decades. I’m able to feel the sun again.”