Strength training by age, youth lifting guidelines and warm-ups

This is session number 54 of the Performance Place Sports Care Podcast. Cool story, Hansel. Welcome to the Performance Place Sports Care Podcast, where you can learn about sports injury theory, rehab, diagnosis, and how to understand the doctor lingo you didn't understand at your appointment. And now, your host, Dr. Sebastian Gonzales. Hey, everybody. Thanks for joining me. I'm Dr. Sebastian Gonzales from the Performance Place Sports Care Podcast. And this is going to be a podcast with only me today. Sadly, I know that everyone seems to really like the people that are interviewed. And I thought I would go over just some generalized topics that I've been asked over the past couple weeks.

And some of them are really, really good. So I thought I don't know if we can designate an entire podcast to them without the back and forth debate of someone being on the other side. But I thought I would just hit on them at least now, since I did get some questions on them. And I thought it was going to be important to get a podcast out about the topics, since they were pretty prevalent at the time. So first off, if you guys have not listened on iTunes yet, if you're listening on someone else's website, please go through all the way to iTunes and rate the show. Subscribe to the show. And I'm really grateful when you guys do, because I like hearing feedback.

And that's what this whole thing is really about. I need to make sure that I'm talking about the things that you guys really care about. Because if you don't care about these topics, I'm just farting into the wind, really. So I really want to talk about what things you guys care about. So please rate the show as much as you can. I'm open to constructive criticism at any point in my life. I'm always looking to get better and hope everybody else is, too. So, again, thanks for everybody for being listeners to the show so far. I hope you've gotten good information from it, from all the experts. And, gosh, I mean, we're—I'm already over 50 episodes now.

Like, I'm so astounded already. And I see so many other great podcasts out there giving out great information, too. I was barely introduced to podcasts probably about, I want to say, a year and a half, two years ago. I mean, it was a whole new thing for me. As soon as I started flying a lot more, I wanted to listen to podcasts. So I thought the stuff we'd go over today is, number one, we'll go over age-related corrections. Or giving treatment plans or exercise programs based upon the age of the person. I'll go into each one all on its own, by the way. Also, too, strength training for youth athletes, especially I was asked for dancers.

I didn't know that they absolutely crushed these young athletes sometimes. And, I mean, I don't have a lot of experience in working with dancers. But from what I hear, it was pretty extreme what they're doing with some of them. So I thought I would speak to what the guidelines are on that. Next, I thought we'd go into the concept of injury versus pain. Because that was definitely brought up in my office this week. Miscommunication and just having misunderstanding or different terminology as patients, athletes, and clinicians. And if we have time, I'm going to go into some warm-up concepts. So let's start first with age-related conditions because this was brought up actually just the other day in my office.

I was talking to a trainer who she mainly works with. She's really, really concerned about geriatric populations or baby boomers. So when we were talking about ages, I mean, I told her that, I mean, I know someone who's 85 years old. And when you ask her, like, what did you do for exercise when you're growing up? And she said, I never sweat in my life, you know. And it's interesting because think about what we can get this person to do from a rehab standpoint or even an exercise standpoint. Like, if the goal is to get them to move better at 85, to be able to get themselves off the ground, be able to get themselves into, like, the bathroom, bathe themselves, you know, get them out of a wheelchair.

All these things are, I think, things that can really be combated early on in life, especially when we consider strength training. And I just saw a stat the other day, I think it was from Harvard Health, actually. So they were talking about the average American, average American male, at least at this standpoint, around 30 years old, will lose half of their bone or half of their muscle density or volume by the age of, I think it was 80 or so. And I think when it was about a quarter around, I think, the age of 65 or 70. So, I mean, losing half your muscle mass and basically half of your functionality around that age is pretty disabling, I think.

So, I would think an easy solution is you just build some of it back. Just these people that can't get off the ground, put them on the ground and make them get back up. I think Dan John gave that very simple analogy of a daily activity they can't do. Just make them do it and they'll get better at it. But the problem is, is the mindset, I think, here. Because just think about this person's mindset. Around 85, she hasn't done anything sweating-wise throughout her entire life. How can we possibly convince her that doing this stuff is important? It's going to be a completely foreign topic, you know, to her.

And I was talking to this trainer and saying, well, like, look, if you told me, because this trainer grew up around the time frame, I think it was, with aerobics, step aerobics, and so on. And I said, if you told me that, you know, when I'm 70 years old and I've been lifting, I've been running, doing triathlon, and so on. And around 70 years old or so, I need to have some type of exercise program, and you tell me that it's going to be step aerobics, I might lose my mind. You know, like, nothing in my life experience has been even close to that. I don't like it. I'm not familiar with it. I didn't do it, probably because, I mean, over the course, I didn't think it was going to be fun.

But also, too, I can think of a lot of other things that I thought would be more important to me. And not to say anything's wrong with step aerobics, because I'm sure it was, it's helpful for a lot of people, but I just never had any experience with it. In contrast, though, if you told me, look, 70 or 80 years old, look, we're going to, remember when you used to deadlift and run and squat? I'll be like, yeah, yeah, that was, you know, good times. Like, I used to be able to do X amount of weight and so on. I'll be like, great, cool. So here's what we're going to do. I'm going to have you deadlift a little bit, and then we're going to do, let's just say the new concept at the time is step aerobics.

You know, I might be a little bit more open to that, just because I've already been sold on the idea of deadlifting, because it's been what I've been doing my entire life, right? You got to give a little bit to take a little bit, I think, in this, and if I'm going to give a little bit in regards to, like, me being a patient or listening to that person or listening to the trainer or the doctor, that step aerobics is going to be, you know, my end all, then I'm probably going to listen a little bit more if you include something like deadlifting. At least kind of bait me in a little bit, just the bait and switch, right?

So we were talking about, you know, these baby boomers and what we can possibly do to get them to realize they need to start, you know, adding mobility, stabilization, lifting, all this type of stuff. It's like the main thinking process with, like, fitness and health. You know, like, we're back into kettlebells and barbells and stuff, but these people didn't have any experience with that, you know? So the only outliers, maybe, we're talking about outliers, actually. She talked about Jack LaLanne, and she said he was somebody who was just a complete outlier in that time. And you can't just say, well, like, look, Joe, I know you're 65 years old.

Do you want to be like Jack LaLanne? Look at him. Look at him at this age, you know? Like, I don't know how old Jack LaLanne is, by the way, but I know he's in and around that time frame. But it's impossible. I mean, like, it's not going to happen. Like, I'm never going to look like a 60—Joe's never going to look at 65 years old. He's never going to look like Jack LaLanne. He's never going to function like Jack LaLanne because he hasn't been doing all this other stuff his entire life, nor is it important to him, okay? And you're going back on, like, what I feel with if I was that age, and you told me that step aerobics was going to be my end all, and you're like, look, go look at Jane Fonda.

Look what she's been doing with step aerobics all these years. And I'd be like, I don't really care. I don't want to be like Jane Fonda, you know? So I think individualizing these people's exercise or treatment plans to bathe them in a little bit and then give them what is needed. And I'm not saying what we need now is going to be better than what, you know, we might suggest later on. You know, like, step aerobics at the time was awesome. Adjustments in regards to treatment, I think it was back in the 80s or 90s, was awesome. And now everyone's moving forward and adding better and better stuff, I think.

But also, too, I mean, I remember the first time I saw the concept of crawling and rolling, I thought, this is, no, get out of here, you know? Like, I remember going to the seminar thinking, if I give someone crawling that comes into my office with a knee injury, they might just walk out. And I was a little embarrassed, actually, to add it. And I see the value now. And I actually recommend it a bit. But the thing is that you have to bathe them in a little bit. And whatever they come in asking for, sometimes you have to give it. And the same thing goes with fitness or exercise. So, I mean, I would imagine that when I get older, since I'm 30-something now, 35, I would imagine that I'm going to have a thought process that, you know, I did lift a lot.

I did sweat a lot. So, they're going to have to convince me probably that maybe it's not bone density, maybe it's not muscle. It's probably going to be a movement-related issue. So, if they tell me that I'm not strong and I can still do more than, you know, some of the other, like, say I could do more than my dad at his age, saying that I'm not strong is not going to work for me in my head anyways, you know? So, it's going to be interesting to see what comes from there. But I think in regards to the current baby boomers, I think we have to give them something that they've already been accustomed to and then add in small other parts of other types of theories, kettlebells, dumbbells, barbells, whatever it might be.

Or even bands and so on. So, it could be basically anything, but we're just talking about the theoretical psychology of it. So, I think that's all we're going to have on that topic, at least for now. But if you guys want to chime in on that, feel free to leave a comment on, let's go on Instagram or Twitter or Twitter. I'm going to try to be a little bit more active on Twitter. And those, my handles are the same thing. So, it's Performance HB. And I will do my very best, at least, be on Twitter the day of the release of these podcasts, which is Wednesday morning. All the way probably until, like, the afternoon.

I don't know about you guys, but it's really hard for me to want to keep looking at social media. I love Instagram because I like looking at pictures. But all of the little links and tags and hashtags on Twitter drives me crazy because they don't look like anything. They look like little bits of, you know, like a half paragraph. I don't know how many characters you get in there, but it drives me a little insane. So, I'll try to be on Twitter around them, but if you really want to get a hold of me, Instagram is the quickest way. I look at it multiple times a day, even on days where we don't release here.

So, the next thing I thought I'd go into since it was brought up to me that youth dancers are being loaded excessively or, I don't know, what was it? It was that they were being strength trained until failure, I think. And I forget the exact age that we were discussing, but I remember hearing it and thinking, I don't think I would have trained the kids that way. And here's the reason why, and I'll bring up a standpoint of the American College of Sports Medicine in a second here. But, like, I'm all for kids doing some strength training, and it all has to be really, really good form because we're molding athletes at that point.

You know, like, they probably haven't hit puberty yet, depending upon the age, and there's a difference of, I mean, people hit puberty during different ages, too. But, I mean, they're, like, long and lanky at that time. They can't control their bodies. They're kind of like baby giraffes, you know. They're kind of growing. Their legs are all disproportional and so on. And so, a lot of times you have to teach for them even more so later. So, I usually don't take them into complete failure when I work with kids of this age group. And it doesn't really matter of which sport we're talking about because my mindset is we're looking to create better movements during that period of time.

And loading can come later. And it's definitely going to come later with things like high school football. Even some of the other sports in high school are getting a little bit more attention in the weight room. So, they're going to get some work done in the weight room anyways. But we need to really produce quality movements because in those settings, they're not going to get a ton of one-on-one unless they're paying outside of their program for it. But I usually suggest people, especially around that age, go more towards, like, 70% or 80% of max capacity. And what I mean by that is if you can do 10 reps of body weight or if you can get them to hold a kettlebell as a goblet squat, if it looks like they're going to fail at reps 9 and 10, then stop them at 7 or 8.

And the reason for this is because if you've listened, actually, to the other podcasts that we've done on some of the neurological system or functional neurology, we're talking about neuroplasticity. And you can create a really, really good neurological pathway or a really, really good firing pattern or movement pattern or whatever we want to call it. But we can also create bad ones, too. So, at that age group, the worst thing we could possibly do is create bad habits, knee cave, forward rounding of the torso or the trunk. And a lot of times, these kids are pretty resilient. They won't have a lot of injuries with it other than, like, tendon issues because they're growing.

And also, too, we're loading maybe one side more than another when they don't have good form. But for the most part, they usually bounce back. But in regards to long-term, the long-term better benefit is I think we need to focus on form. And it's going to be really creative. And this is why I don't love working with kids for this reason is because they have really short attention spans. And I'm a grinder for form. I just love to just dish out really good form. And, like, all the yellow people, like, they do their last rep. They put the kettlebell or barbell down poorly, and I just yell at them.

I say, what are you doing? You know, like, since when is the last rep that I count the last movement you do well? You know, this is life. Don't hurt yourself putting a weight down from doing 10 good reps. So, I usually keep people around that 70%, 80% range, especially in that age group. So, when we look at the American College of Sports Medicine, by the way, this is a public thing you can read. I forget their last standpoint, and I'll see if I can pull it up here really quick. I don't see a date on it. Oh, here we go. It looks like they've changed it as of 2017. So, this is pretty current here.

So, you can read the entire thing on your own, but I'll just do some major points. So, all youth strength training programs should be closely supervised by knowledgeable professionals with an understanding of uniqueness of children and have sound comprehension of youth strength training guidelines. So, my takeaway on that portion is make sure that whether it be the coach, whether it be the instructor, the dance instructor, whether it be the strength conditioning coach, I mean, because they're different. I mean, I don't expect my high school baseball coach, which I never saw him squat in my life.

I mean, maybe he did, but he didn't do it every day, and he didn't teach it every day. So, I would imagine his ability to teach good form was probably less than the strength conditioning coach that was working with the football team. So, make sure you have someone who really is a stickler with form. It's important in regards to neuroplasticity, and that's mainly on how your kid's movements develop. So, don't undercut that. And if your kid has really bad form and he's working in a group, you need to get him to someone with one-on-one. And you have to stress to the kid how important it is to have good form because it's not a joke.

You know, if they're going to be moving their body, especially under load, they need to make sure they have really good form. Knee injuries, back injuries, hamstring ones all come from this type of thing. And a lot of times you can see it. There's warning signs of this. The next part says, although there's not one optimal combination of sets and repetitions for all children and adolescents, one to three sets of six to 15 repetitions performed two to three times a week of non-consecutive days have been found to be reasonable. So, basically what that means is don't gas your kids out day after day.

Keep the reps a little bit higher. And, I mean, you can work them in like a little circuit, you know, of two or three times and so on. This should probably take about 20 minutes or so. Usually the rep schemes, if you guys don't understand that, the higher the reps, the lower the weight, basically. So, if we have one rep, then we are looking at pretty high weight. If we're looking at 15, it is pretty low in comparison to what, I mean, you can almost like time it out and say do a minute of work. And, say you're having them do air squats or lunges, a lot of times just so we go out into that higher rep range right there as well.

So, I typically program like that. The next paragraph says, Begin with one or two sets of 10 to 15 reps on several upper and lower body exercises that focus on major muscle groups will allow room for progress to be made. So, what they're talking about here is they want to have you do complex movements. And, I do see this in the further paragraph. Complex movements are mainly squatting, dead lifting, or in the kid's case, probably more so with like a hip hinge. Just teaching them to use their hips or their backside. Carries, probably even handstands are okay. Pushing and pulling. Pulling can be a couple different types of vectors.

You can do forward pulls. You can do upright, which is like your vertical loading, which is going to be a pull-up. So, they can do all this type of stuff. And, actually, it's funny. You see like kids in gymnastics. I mean, these kids can do more pull-ups than a lot of adults can. So, I think it's important to keep that, you know, throughout their entire life if we can. So, next it says, youth with strength training experience may progress to 2 to 4 sets of 6 to 12. So, they drop the repetition with heavier weight provided progression is based upon technique competency. So, that's not just if your athlete moves weight well and around the 15th rep, he's like, you know what?

I can do a lot more weight. Don't have to wait just because they're asking to. Make sure that all of their movements are on point. And, if you don't know how quality movement is, they need to get them to somebody who knows it. And, actually, you know, this is actually probably a good point, too, is that I can't tell you how many people I've had come into the office who are weekend warriors. I've had crossfitters, I've had runners, triathletes, tennis players. A lot of people don't know how to squat or deadlift. And, a lot of times, I actually start them out with, I give them the full floor to use whatever they want to.

I said, look, show me or teach me your best squat. And, I just want to see that they can do it. I want to give them the benefit of the doubt. I don't want to re-teach something they already know. So, if they know it, they know it. But, it's surprising a lot of people don't. They don't know what a squat's called. They don't know how to set their hips back. They do it very shallow. I mean, there's a lot of things that I would expect parents to probably not even know to teach their kids. So, I think we need to have a professional up in here. Next is, and this is especially important for youth to perform multi-joint exercises.

Example is squatting or complex exercises. This is weight lifting, example weight lifting, due to the complex nature of these movements. So, don't focus on just single joint stuff. Don't teach your kids bicep curls and lat raises and seated calf raises. So, these are the type of things you'll find in, like, larger gyms, 24-hour fitness and so on, which they have limited areas for racks with barbells and kettlebells a lot of times very much lacking. You can do a lot of stuff with dumbbells. And, you can do a lot of things body weight. But, a lot of the machine-based things are also their single joint approach.

Or, a lot of the traditional stuff, at least that I actually, I don't want to say a lot of machines are joint specific or single joint stuff. Because, there are ones that are pushing, pulling, all that kind of stuff. But, I personally use them a lot because I see a lot more value in doing free weights. But, I remember that when I was growing up, I had my gym experience where I would just basically go with two friends. We go over to, God, where did we go? It was an old powerhouse gym over in, it was in Fountain Valley. I remember we did that and it was, I mean, I just, I thought we'd get dropped off, actually.

Like, we might have been not even old enough to drive yet. But, we went over there and we just messed around, you know. Like, we did bicep curls, we ran the rack, we did stuff because we wanted to look big, you know, like, and strong because we were high school boys. So, that's what we did. And, you know, looking back on what is needed for, you know, youth weight training or youth resistance training, I think we didn't do the right thing. But, luckily, I grew to a hefty 5'7", so it didn't stunt my growth and I didn't have any injuries, right? So, a lot of times we look for not only injuries for tendons, but there's always a possibility of growth plate fractures if you load them a little bit too much.

So, I think that's the major fear. I would say if you have a kid and if you have a dancer who is getting, actually, I don't want to pin a hole dancers. That was just where I got the idea from. But, if you're a kid just being work till failure on heavier weights or barbells or dumbbells or kettlebells, I mean, I would really, you know, ask the coach or ask the trainer who, you know, just tell them your concerns. And, I'm not there, so I can't tell you that they're doing it completely wrong because your kid might have solid form, just absolutely solid form. But, a lot of times, and I notice this even with me, is that when I hit my single rep max, my one rep max or two rep max, they're not pretty.

And, that's kind of how, you know, it's like a, it's a true one rep when form degrades. And, I mean, I still have a video of my one rep max deadlift, and it was pretty. I think it was pretty. I mean, I actually bent down afterwards to take a sip of coffee. I wasn't gassed at all. I didn't get dizzy. You know, I didn't feel lightheaded. So, I mean, I think there was a lot more in the tank. So, just make sure that your kids have proper form throughout, and I think that is where we're going to leave that one. I will put the link to the American College of Sports Medicine standpoint on youth strength training on the podcast notes.

So, that's p2sportscare.com slash podcast, but really, you can probably search that as well, and it pops up pretty readily. I think they update it pretty frequently as well. And, I mean, I do agree with those recommendations. There's, I don't think there's any need to just make your kid jacked out of his mind, you know, at a young age. And, afterward, in regards to productivity as well, realistically, when their growth plates have closed and they have a little bit more hormones raising in there, I think they're going to make better gains anyways. So, it's a better use of their time just to make them be aware of their body movements, make them into real athletes.

Let them kick soccer balls, let them throw baseballs, let them, you know, run around and play tag and stuff. I mean, these are the things that make better athletes later on. Next, we're going to go into the concept of injury versus pain. And, the reason why I wanted to bring this one up is because I had a new patient that came in a week ago. So, this patient came in, he had a shoulder injury, or I would say shoulder injury. So, I asked him when, you know, when this injury happened. And, he said, I'm not injured. I said, so why are you here? And, he said, well, my shoulder hurts. I said, okay, so I think we have to clarify.

I'm like, did you slip and fall? Did you land on it? Did you, you know, hurt it in any way? And, he's like, well, it just started hurting after, I forget what the story was. I think it was, he was playing tennis, I think. But, it was a big spurt of it. It was a lot of the activity, I remember. It was more so than he'd done a buildup to. So, it was a big spike in activity. So, I, again, I questioned him. I'm like, so, you, you don't have an injury? And, he said, no, I just, I just have, you know, this discomfort and pain right here. How do we get rid of it? And, I started thinking about just the people or the patients, the athletes, misunderstanding of our terminology of injury.

Now, we have a couple different terms that we throw around typically. There's traumatic injury, which is slip and fall. Someone punches you, you know, in regards to the shoulder, you fall on the outstretched hand, it gets dislocated, things like that. Those are traumatic injuries where there's a single traumatic incident that creates pain almost immediately or at least that same day or second day. Those are things that it's funny that patients, I think, they gravitate towards the idea of injury with trauma. Now, when we say, again, injury, we also mean the possibility of an overuse injury or a movement disorder, an overuse injury.

And, by the way, if you guys haven't listened to already, there was a whole podcast I did on types of muscle injuries. And, this kind of goes into that realm as well. So, when we talk about overuse injuries, let's just say, actually, a delayed onset muscle soreness is kind of in this range. Say I had you do a bunch of push-ups and your chest started to hurt, your pec started to hurt, your shoulder was sore, and so on. Like, this is technically an overuse injury because it is a large amount of work that you put upon a muscle or a joint or a tendon. It wasn't accustomed for it. It wasn't ready for it.

It wasn't conditioned for it. So, it developed some small inflammatory reaction. Now, a lot of people use the term overuse injury as a tendonitis, just generally speaking. And, a lot of runners will say that an overuse injury is something that happens over many repetitions, such as runner's knee, IT band syndrome, Achilles tendonitis, hamstring injuries, they call them overuse. And, they use the term overuse mainly because they're talking about non-trauma or non-injury. Overuse injury is like a subset, they say. I would beg to differ on this a little bit because, actually, there's a lot of times you can see movement disorders, I believe, as the major cause of these, quote-unquote, overuse injuries.

Again, I'm using the second term, or second definition of overuse injuries, not the first that I mentioned right there, or for delayed onset muscle soreness. So, movement disorders can load a tissue or a side excessively. And, let's just say we're talking about jumping and an Achilles tendon issue. Now, let's talk about a knee issue. I think that's a little bit easier. Let's say jumper's knee. So, let's just say we have someone doing box jumps, depth jumps, a lot of plyometric drills where they have to land on one leg or two legs and they rebound and jump back off. So, ideally, we had them do the same amount of hops, two-legged hops, the same amount of hops on one, on the right leg, on the left leg.

So, they did the same amount of volume throughout. The next day, or the next week, they start developing knee pain on the kneecap on the right side. Let's just call it, quote-unquote, jumper's knee. So, was that an overuse condition or was that a movement disorder-related condition? And I'd say it was a movement disorder mainly because the reps were the same. Your body weight's the same. The knee was in good health before. So, why didn't the other knee also become overused is my devil's advocate on that. I think a lot of times that the movement disorders, which can be instabilities, they can be loading one side excessively.

Or I guess in the knee, we call it occult instability because it's unstable enough to create an increased workload for the tendons, muscles around the area to stabilize the joint. But you can't really notice it on tests like Drar's test, Lockman, Valgus, and Varus testing, which are mainly for like the ligaments and major structures of the knee. So, I would consider them more of movement disorders than overuse injuries. But either way, going back to that patient, I think it's important to realize the difference of definitions or terminology that we use. So, when you go into your doctor's office, if they ask you about an injury, they're probably talking about pain, discomfort, tightness, lack of use, things of that nature.

It's not always trauma. The reason why we ask about trauma specifically is because we want to see if it's a possibility of a fracture, a contusion, if there is a possibility of joint instability or a large-scale joint instability. So, we're looking to see, we're looking to find the correct diagnosis. So, oftentimes we'll use the word trauma. But the word injury, it mainly means the reason why you're in or if you've had another similar condition like it. So, if I were asked, like, have you ever had an injury on your knee? And it currently doesn't hurt right now. That can mean any tendon injury, any ache, pain, swelling, boo-boo, even impact the knee where you fell on it.

So, this is all things that we're looking for to help you get to the right diagnosis and also to improve your treatment plan. Because like I said, if we're looking for trauma and there's a possibility of a fracture, then we need to make sure we rule out that fracture before we go further to recommend the right thing. Lastly, the topic we're going to go into is warm-ups. And the reason why I wanted to go into this is because I try to write and give some topics and input to different organizations, websites, guest writing. And there was something on bodybuilding.com that they said, hey, do you want to give some input on some things?

So, I thought, yeah, let's give this a go. So, I don't know if it's going to be posted or not or if it's going to be even used. But I spent some time this morning really writing this thing out. So, I thought I would just share with everybody because a lot of times writing really helps me get to the bottom of my thoughts and organize things better for you guys to understand. So, with warm-ups, the major question they wanted to ask was, how much time should we really dedicate to a warm-up or a cool-down? But I kind of focused more so on warm-ups. So, I said from a sports medicine standpoint or point of view, warm-ups can really just take as long as they need to.

You know, there's no set time. It's mainly designed so it improves your body's ability to do the workout during that session or during that bout. So, sometimes it takes people 15 minutes. Sometimes it takes them 45. It depends on what type of athlete you're talking about. I think track athletes, I thought it takes them about like almost an hour to warm-up sometimes. If you talk about someone who just rolled into the local CrossFit gym, they're going to say 10 to 15 minutes. If you talk to someone who's had been into my clinic, who has a shoulder condition, but also a hip one, it's probably going to take them 20 to 30 because we're looking at getting different things or getting different goals done.

Because if the workout for that person, for the shoulder one, say we're going to do pushing or pulling or even deadlifting, they might, or overhead jerks, let's just say jerks. That's something we want to stabilize the shoulder and really work on the stabilization standpoint or the stabilization point in the core as well as breathing to make it so that shoulder has the best possibility to function in the jerk. We also want to work on mid-back and neck movement, scapulothoracic stabilization and all that kind of good jazz. So there's a lot of goals to hit and a warm-up when done well or programmed well, it's really, really individualized the person's past history.

So warming up before lift should address a couple of the following things. So number one is you want to be able to get the blood moving, and the reason for getting the blood moving is we want to be able to affect elasticity, and I'll go into all this on its own right. The next is we want to make sure that we are preparing for the movement within the exercise. Next, we want to make sure that we stabilize areas that need stabilization, such as the feet, knees, back, and shoulder girdle. That's just a couple of them. Mobilization, you want to make sure that it's within the areas that need to be mobile to accomplish the movement they were asking for.

So ankles, hips, thoracic spine, glenohemeral joints, or actual shoulder joints proper, as well as the neck are a couple of areas that I typically highlight. So getting the blood moving, like I said, is we're mainly looking to increase our exertion beyond conversation rate. This really gets the blood moving, the heart pumps it all to the peripheral tissues, the tendons, the muscles, the joints, and it makes it so we decrease our injury risk by basically increasing elasticity. Another important thing too, and the reason why I said beyond conversation rate, is that if you listened to the podcast on BDNF that we had with Dr. Michael Lovitch, I know after we were done with the podcast, he informed me, you said my name wrong.

I'm like, well, shoot, I don't think we can go back. So, Mike, if you're listening to this, I'm going to apologize again. But yeah, I have a hard time saying your last name. So anyways, you should all listen to that podcast because it is a really, really interesting one on brain-derived neurotrophic factor, BDNF. So he was saying one of the best ways in regards to exercise to increase our BDNF excretion is to go beyond conversation rate. And the reason why we want this is because we're improving neuroplasticity. And neuroplasticity is the ability of the neurological system to increase synapsis within a pathway.

So if we're looking to improve a movement pattern or a habit or some type of thing in the neurological pathway, then we want to increase the amount of BDNF, at least for that period of time. By the way, if you don't understand all of this, you should really listen to that entire podcast. I'll put it in the show notes. But it's really going to be easy to find if you go into p2sportscare.com slash podcast. So BDNF, mainly you want, or that will increase excretion when we are getting above conversation rate for about three to five minutes. And that will help us through our workout, especially through our preparation of movement.

Now, the preparation of movement concept I was talking about is pretty simple. So if you're deadlifting today, then you want to be able to work on the hip hinging movement within your warmup. And that can be good mornings, Romanian deadlifts or RDLs, sumo deadlift. I mean, these are all things that can help out with movements and really retrain the brain how to use the body during that movement during the actual workout. So you can also, too, increase the amount of weight as you start to go into your lifting as well. I tend to do this. I'll start the movement unloaded or lightly loaded, and then I'll start to move up a little bit in weight just to make sure that I'm still getting my form about me and that I'm still working on improving that movement.

Next, we're looking at stabilization. And again, the stabilization is within areas where you want stabilization to occur. Some of the body has areas that really require a high amount of stabilization to really have good high quality movement. It's hard to move well if you don't have good areas of stabilization. So high quality movement is really required first before we build strength, power, speed, endurance. And these are all the things that you want. I mean, you think about it. Like, if you don't know how to run and you sprint, your sprinting is not always optimal and it's not always pretty.

And a lot of times, it's better if we improve the mechanics of running before we send you all out. And especially if we send you all out for an extended period of time. So like I said, high quality movement, strength, power, speed, and endurance, it's kind of in that order. Arguably, we can interchange a couple of them. But it's also based upon your past injuries. So you might want to stabilize an area more so in your warm-up because you've had a past injury. And that's really the beauty of individualizing warm-ups for people. You have to be able to know their past history. You have to know which joints have occult instabilities.

I mean, like I said before, with the knee conditions, how do we know? I mean, how do we know that that jumper's knee in that past example was not from the knee just not stabilizing well? And that's a definite possibility or we have to look above or below it and so on. So there's a lot of individualization, like I said. Lastly, mobility, just like stabilization, mobilization and warm-ups can be individualized. And a lot of times, stabilization and mobilization, as well as the combination of movement prep and getting the blood moving, this can all be done within a handful of movements. And this is actually, I mean, one of the ones I really like to do is a low sweep.

It's part of a Turkish get-up series or a half get-up series because it really does a lot of this stuff. I mean, it requires you to activate your core. It requires hip extension, hip internal external rotation. The shoulder has to be packed. I mean, there's a lot of things that we need as well as thoracic spine rotation to get into these positions. So it doesn't have to be like 30 different exercises for warm-ups. You just have to know which ones are working best for what we're needing to mobilize, stabilize, as well as preparation of movement. Getting the blood moving, I mean, shoot, you can throw someone on a rower and let them row beyond conversation pace for three to five minutes and you're set with that a lot of times.

But obviously, if the person had a terrible form of rowing and a back injury, then you don't want them doing that either. So there are definitely small nuances that would take some of these categories out or would interchange exercises based upon the person's individual condition. But for the most part, understand that warming up has its purpose. It doesn't have a set amount of time. It has to be individualized to you and your injuries in the past. So that's it for the topics on these. If you want to access the show notes, we have p2sportscare.com slash podcast where you can access all the show notes and anything I referenced on this podcast or any of the other podcasts.

If you have questions you want to send in, I really do want to hear about it. And I mean, I can only make up so much content that I think is important to you. But realistically, I mean, like I've actually had this before. I was talking about rat carries and I did a video on rat carries and I had to retract a little bit because I realized that I didn't spend enough time on how to rack a kettlebell. It seems like a very simple thing to some people, but other people need help with that. So there's no dumb questions. Email me. You can send them to info at p2sportscare.com or you just go straight to the website and there's a whole contact form on there as well.

Or there's actually the voicemail button, which I did include on the front page of the site. And you get a minute and a half, just you'll get your voice on the actual podcast. So I'll include your question. And keep in mind, these are all suggestions for generalized health and sports medicine information. I can't really give direct as much as I really want to. There's healthcare laws in place to protect me from suggesting to people like you, if I haven't examined you yet. I mean, realistically, you think about it, you got to have an exam. I mean, I've actually had some patients that on the surface, they didn't look like they had any serious conditions.

And they did. They really did. And I had to refer them out. And thankfully, they got to the specialist and they're okay now. So you can't guess that kind of stuff. There's outliers. And there's the reason why WebMD has that type of, you know, the scary stuff on it. And I know everyone jokes about it. Like, oh, I went on WebMD and I think that I have a brain tumor. But I mean, it could be. The reason why it's on there is because it happened to somebody, so it has to be included on there if it's going to be severely comprehensive. Okay. Um, I think now that hopefully, hopefully, uh, this, I'm going to record this podcast before the Kickstarter actually ends for the four-step healthy back system.

I'm hoping that it funded. Um, I really want some, uh, a series of, I don't want to say self-help, but prevention of injuries, uh, daily rituals. I want these types of products to be made and I don't see a lot of them out there. So I thought I'd take it upon myself to do it. Um, I think that I'm hoping, I'm hoping that if this actually came to fruition, that you can find this program, the four-step healthy back pro program on the resource page. I think that's where I'm going to put it. So ptsupportsk.com slash resource. I haven't decided yet whether I'm going to give the ebook out for free and, um, have people charged for the, uh, accountability pamphlets, the workbooks, and the exercise library.

Um, cause I believe that information should really be free. Uh, and I try to give a lot of good free information out there. And that's why I have this podcast, but the best of the best stuff I think should be paid for. And not just cause I have to make a living, but also too, there there's, there's the concept of skin in the game. And I really do believe it. If you don't pay for something, you don't use it. You don't value it. And I, I paid for an online course. Uh, I paid a grand for it. I really used it. I was seriously on there five to six hours a week easily. And their stuff, their videos were amazing.

But I can tell you from personal experience that if I don't have skin in the game, I don't do it. And I don't want that to happen with you guys. I want you guys to be able to succeed with this four, four step healthy back system or any other program that I end up creating for you guys as an education and daily rituals. So I will talk to you guys soon. Don't forget to subscribe and thank you. Thank you again for listening. Thanks for sharing. And I will talk to you guys soon. See you later.