Pulled Hamstring or Nerve Tightness: How to Tell and Rehab It

I'll do it and I'll say, okay, if I just do this, where's motion happening? You're like, you're back. What if I do it like this? Like, well, that's hip. Like, exactly. Does the hip, we have an anatomy lesson. Where is the hamstring attached? Does it go past the hip and up the back? And they're like, obviously it doesn't, right? But they might not know that. And so once they find that out, it kind of makes, it clicks a little bit more. You're listening to the Restoring Human Movement podcast, where movement experts discuss the latest evidence-based practices to help you and your clients move with mastery.

And now, your host, Dr. Sebastian Gonzales. Okay, everyone, it is Dr. Sebastian's also mic here, and we have a guest host today. Can you introduce yourself? This is Dr. Cody D-Mac. Oh, from number 105 and I think 31 as well. Yes, sir. Okay, so we got Cody a brand new mic today and headphones. So, it's going to sound like he's in studio. Yeah, but I'm not. I'm in Dallas. But actually, your studio could be the studio. My studio is not the studio. It's true. I don't think this is an official podcast, actually, until I name the studio. Or are you going to name it? I probably should. The hole. Well, which hole?

Okay, so the thing that we're going to go over today, and we're just going to go back and forth, football, is that I know that you probably have had people, just as I have, with hamstring tightness or hamstring tears or how to rehab a hamstring. And it's just kind of tightness considerations down to the leg. And I know I just had someone today where they're like, they put their palms all the way in the ground. They said, my hamstrings are always feeling tight, you know. So I think we can probably go down this as, for providers listening, they can kind of get some ideas of some clinical cases as well as what might or might not work.

And if your patient's listening, then probably this will help with some insight of maybe how you can get your thing corrected. Yeah, I think one thing, too, for the providers out there where you could go into this is, you know, just like you should approach every other problem, is not just looking at the site of symptoms, so to speak. So if somebody comes in with a hamstring, you've got to kind of look at it, take a step back and look at it from a bigger picture and realize that it may or may not be an actual hamstring thing. Right, right. And so as we get into that, we are going to cover probably a lot in this podcast.

It'll be about an hour. But before we do, do you know about the first story you've got to tell? Do you know about the stories, Cody? You know about my story or your story? Well, I do have a story, but I want to hear, do you need more time to develop your, you know what really grinds my gears? Oh, this story. You want to do this thing. Oh, okay. Yeah. Well, it's part of the trademarking. It's copyright. Oh, you want me first? Yeah, you first. Okay. By the way, if everyone's listening for the show notes on this, it's going to be 118. Just go to the website, ptsportscare.com, and 118, no hashtag, no pound, just 118.

I don't know. Like, I don't have anything really to complain about today, like Adam Carolla style. Wow. Yeah. But have you ever, I just started doing a book. I don't know if I told you. I'm doing a low back book. Yeah, yeah. That's right. And the audio version, I thought, you know what, if people are, maybe they won't read it. Maybe they're busy, and they're going to drive, and they've got to do audio. So, I was doing all this audio, and it is so damn hard to read your own damn words, verbatim. It's tough. Like popcorn, like in school, right? Mm-hmm. Yeah, it's hard. Did you play popcorn? I've only eaten the popcorn.

Yeah, that's a much better one than this one. But I'm starting to realize that as I'm editing this thing, I'll go through, and I'll find that I need to do things better. And there was a section where I was actually talking to you on there, and I was responding as you. And I realized, to make it realistic, I had to go and do a snip. I had to do a snip in it, and I said, first, it started with, so, what do you think about this? And then I changed it and said, Abra, what do you think about it? Very professional. It was the real deal. We were talking in a bar, so that's probably what I said. Maybe.

Okay. So, since you're co-hosting today, what grinds your gears before we get into it? Oh, my gosh. Probably one thing that grinds my gears is somebody driving less than the speed limit in the left lane. Mm-hmm. So, do you go around them, or do you go in front of them, next to them, and tell them about it? I tend to kind of wait to see if they're going to come to and get over, but they usually don't, so I'll pass them up in the middle lane, or the right lane, and I don't look over right then and there, but usually what ends up happening is they pull up to them, next to them, at a stoplight, and I kind of look at them a little crazy-eyed.

What do they usually look like? What kind of person are they? They're usually looking down at their cell phone. Oh. They're that person. You know, but at least, though, since they're texting when they're driving, they're doing it, they're being cautious and driving a slower death bullet. Right, but they're really being, you know, incognito in the left lane, you know? Right, right. Come on, come on. Yeah. Yeah, we definitely know that. There's a lot of text drivers here. I try to look around. I used to do something called boat mentality back in the day, and when you're on a boat, you look around and wave at people, they wave back, they're so friendly, and when you do it in a car, they think you're fucking crazy.

Yeah, they think you're crazy. They probably have hamstring tightness. They probably do. So, hamstring tightness. What is a good story that you have about a patient with hamstring tightness that can kind of lead us down a route here? Yeah, a patient. So, probably one of the more glaring cases that I've had in terms of patient encounter was a gentleman who's a very high-level strongman competitor, and he had been dealing with a hamstring issue for probably, you know, I don't know, maybe five to six years or something like that. Something pretty crazy. And it was just this really chronic thing, and I mean, he had all these soft tissue therapies done, and whether manual soft tissue stuff, instrument-assisted soft tissue, had a lot of things to try and address the hamstring tightness and discomfort.

And he had, he would, it actually transpired into, he would have kind of like a sharp pain in the hamstring only when he got to a certain percentage of his max in squat and deadlift. And when he would lay on his back, bring his thigh up into his chest and extend his knee. So, kind of stretching, like somebody would do to try and stretch the hamstring. But he always had these, maybe like a little creepy crawly thing down the hamstring, too. And he came in to me, I'm like, well, has anybody evaluated your low back? And he said no. And so, long story short, it ended up being some sciatic nerve irritation coming from the low back.

And I mean, slumps was positive. Straight leg raise really wasn't positive until we got to kind of really that, like almost 90 degrees and really dorsiflexion. And he would tuck his chin and he would get a, he would get a, a really good zinger down the, in the back of the hamstring, but it really inhibited his performance. And it, whenever he would go heavy on stones or he couldn't do heavy, uh, yoke carries really when he started loading heavy, he would get, he would just, his hamstring would shut him down. So, so kind of long story short, we, uh, we shut him down from all loading for quite a while to just to let things calm down.

Cause he had been continued loading this and his, and a big note here, his movement patterns were not very good. You know, if I, I know he would look at the, his, uh, old videos of just doing a rock pull from, you know, not even, not even at the knee, just above the knee. And it was just really, really bad. He had no lifter's wedge, fully rounded spine. And he was only, he was using his spine to, to drive hip extension essentially. So it just kind of repetitive trauma issue. And so the low lying fruit was shut him down and start re groove and moving patterns. We went McGill big three on them, started creating lifters wedge into the, uh, into the, um, physical industry strap.

So it's just that isometric, uh, lifter's wedge. And, uh, I mean, he's, he's back to full speed now and he's competing at a really high level and he's, he's doing really, really well. He's an animal. Nice. Uh, you actually went through a lot of stuff there. Uh, just, just, uh, to note on that too, the, for any clinicians listening, all the stuff that, uh, Cody might've said that you, if you don't know what it is, we actually just recently videotaped all this stuff. So it will be available. Uh, I'll let you guys know when it actually starts to appear as well. Um, so then did he, I'm just curious, like, cause I saw actually, I was watching someone on Instagram the other day, uh, a strong woman and she was just dumping at the spine like a lot.

And, uh, how do they get away with that? Like, how do they, do they usually feel okay and just have some minor hamstring tightness? Uh, no, usually strong men competitors are just wrecked. Uh, they feel wrecked. Their body's wrecked. Uh, they're always competing with injury. That's just, that's just part of the sport. That's what they, they say is just part of the sport. Uh, but they kind of, they're, they're really, they're almost, um, I mean, they're a different person in terms of mentality too. They're not, not your normal athlete. They're almost somebody like somebody would be in the military, um, in terms of, uh, they'll have nagging stuff.

Oh, they'll have like really extreme cases of pain, but their tolerance is much different than, uh, than other people, than general population. Um, but can I ask you, what was that, that strong woman doing? What, what, uh, what event? Um, there was, it was mainly, well, I just saw mainly the training and like, I don't like creeping people that long on Instagram. I'll kind of see, I'll, I'll go through the search and then I'll just see, oh, what's going on here? And, um, uh, she was just, she was dumping mainly with deadlift. Like the squat actually looked, it looked fairly good, but it was just, I always think it's interesting when they're, when they're wearing these belts and they continually just, just dump there like quickly.

Yeah. And it's a lot, and it's a lot of weight and it looks like when they finish, they feel like they're excited. Yeah. Well, I mean the, the, that's part of the thing too, is, is, is what this gentleman specifically was interrupting the cycle of, of bad lifting and, you know, saving, putting some money in his movement bank, so to speak, and save the, uh, the, the dumping in the low back for the very high maximal loads. Uh, unfortunately they, they being the strong men have to really, really load their body to prepare them for competition because it is a grind. It is a hardcore grind and it's intense.

Um, it's, it's, it's not for the normal person. That's for sure. But, um, you know, a lot of, a lot of, a lot of people, not just strong men, but power lifters and, and just some people in general, they're kind of hardheaded and they don't want to regress and take a step back and, and reevaluate their lifting form and how they, how they actually start accumulating load over time and on the body. And, um, and sometimes it's kind of like in Brian Carroll's situation, it's kind of takes a big injury to, to kind of slap you out of your own ego and, and reevaluate your approach to things. Yeah. I always wondered.

That's actually, that's what we had to do with this guy. And, and, uh, and he would tell you too, he had to kind of really step out and, and, and it was hard for him to trust me in the beginning because he had seen so many other people, you know, but he, he did. And, and, um, and he was, he'll tell you now, I mean, I'm sure he would tell you he's happy that he, he kind of took a step back and, and started from scratch. Cause he's lift, he's lifting way more now than he ever was before. Yeah. I don't think they can, they probably, I'm sure they're fairly hesitant cause it's, uh, it's probably taken them a long time to get where they're at.

And if they deload, they're going to think it's going to take forever too. Right. Um, so with hamstring stuff with them or with, so you mentioned that we were, the test that you did just, uh, clinicians out there probably know them like slumps tests and you did, you demonstrated like a straight leg raise. Uh, I was curious with the, with the toe going up, do you think that they can get away with doing the strongman competition if they were wearing high heeled shoes? To take them out of dorsiflexion? Yeah. That would solve all problems really. I mean, that, I mean, that'd be a talent to do the stone, the stones and stiletto, the stiletto stones.

They, I think that would make a good t-shirt stones and stilettos. So, so one thing with strongman is, is you can get a list of, uh, the events, but they're always going to throw a curve ball in there. So whether that's, uh, um, uh, they'll put a, a weight for, uh, an event, uh, and then the last minute they changed the weight to be something heavier. That would actually be really funny if they, they had stone stones, you know, progressive loading. And then it was like stiletto stones, you have to, you have to load in stilettos. Yeah. There was actually, I saw something recently put up a video of someone deadlifting in stilettos and they turned their ankle.

Yeah. I saw that. It's nasty. Yeah. Not smart. No. Well, it's, it's, it's for likes. Okay. It's for views. Uh, you know, actually, so we, we kind of talked a little bit about having hamstring tightness just from actually having a nerve based pain. But it's, it's funny. My experience, like I get a lot of people who are very convinced that they have a scar tissue or a need for some type of stretching locally there. And I was telling my story about like, I legitimately tore my hamstring, like it wasn't black and blue down my leg, but there was a focal spot of a bruise. Um, and I could feel the pop.

I actually looked around. I was sprinting to a ball playing outfield. Uh, and it was towards the fence, towards a warning track. And I remember like not knowing if I actually dove or if I fell. And I looked around cause I was looking for a second baseball that someone was playing a prank and actually hit me in the leg. And, and that's like incident where it's like, I don't know actually what created that one to, to become traumatized in the first place, but it was a definitive tear. Right. So in that case, I think, well, there's now there's a need for, uh, focal work there. As it, as the structure of the muscle or tendon muscle interface is actually, uh, compromised.

But in the one you mentioned, it's not. So the truth, so the truth plans will be a little bit different. Yeah. I mean, uh, you kind of, you kind of hit a, a, uh, part of the history there. That's somebody who has a true hamstring problem, uh, or a hamstring tear is, it's just like kind of like a tearing your Achilles. They, they feel like they were hit with something like some, they'll say. I felt like somebody hit me in the back of the calf with us, with a pipe or something. In your case, you felt like somebody hit your hamstring with another baseball or something like that. Right. Yeah. Here, it feels like a doing.

Yeah. So, uh, that, and the, the crazy thing is a lot of times when you have that non, uh, kind of that's hamstring tightness or the hamstring sensation, people think they pulled their hamstring, but there was no, no event. It just kind of came on out of nowhere. Uh, you probably didn't pull your hamstring, right? That's, that's probably some type of neurogenic, uh, uh, sensation that you're feeling. Um, but no, the, the loading is going to be much different and your assessment is going to be a little different, but you're still going to, at the end of the day, you're still going to go back to, okay.

Um, is the, is the, is your core working as well as it should be? You know, are you using your glutes like you're supposed to be? Because a lot of times when you have hamstring injury, it's because you're not using the primary hip extensor, which is the glutes, right? So you're trying to, you're trying to use the hamstring for, to drive your hip extension, uh, and, and track, track coaches and sprinting coaches will tell you if you there, you know, you're trying to claw the ground with your hamstring. It's, you're not going to be as efficient as you would be pushing the ground away using pure hip extension with, from the glutes.

Yeah, I agree. And, and I don't know my state before that actually. And a lot of times I'm sure a lot of people, they don't look unless they're in pain. Um, but I'm sure something set off, uh, that one was the right side. Um, I remember it cause it was the gas pedal. You know, the hardest thing is actually to drive. It's not being, it's not driving fast. It's being in traffic and letting your foot up off the gas. Yeah, that's funny. Yeah. I actually, I just, I just remember I had my left ACL done in college and they used my hamstring, uh, for the ACL graft. And, uh, I had more problems with my hamstring, um, you know, just for the, in that rehab.

So, I mean, once there's a, in that legitimate, uh, tear in the hamstring or as injury to the hamstring, it's, that's a, that's a bugger, man. That's a, that's a tough one. Right. And, uh, I don't know. Have you, did you ever play fantasy football back in the day? Uh, no, I'm not, I don't believe in fantasy football. Cause it's a fantasy. Yeah. Um, well there was, uh, there was Andre Johnson, which is always, uh, obvious higher receiver. And it's always like a dare. It's like, I think, should you, should you pick them? And you always know, since with that hamstring thing, it was always like, he's going to be out like four games.

Yeah. They're tough. They're really tough. Yeah. Well, you, you kind of hit a point to where, uh, excuse me, you hit a point just now where it's all these injuries that happen in professional sports and, you know, being in the field that we're in, I'm always like, man, I wonder if it actually is a hamstring or if it's, so I don't want to get, I don't know if you remember running back, uh, from used to be when the Rams were in St. Louis, um, uh, for, I'm blanking on his name right now, but he's him, his hamstring was always injured and come to find out. Oh, Steven Jackson, Steven Jackson. Yeah.

He had an S1. Yeah. He ended up having a microdiscectomy a couple of times, right? Or at least once. I'm not sure if he had a couple, uh, surgeries, but, but I mean, no, that was like a chronic, that was a disc. He was having disc symptoms in the hamstring. They kept rehabbing his hamstring. But to be fair about that, like, oh, I didn't, I never saw the rehab of it, but the, what the commentators say is the problem, you know, like Steven Jackson's out with a hamstring and then I think in the same timeframe, uh, uh, it was, uh, Arian Foster. I think he actually released an MRI of his blown out hammy.

So then you knew that one was kind of an actual hamstring issue. Yeah. Right. Well, I think, I think too, the, uh, there's other injuries that pop up like, uh, you know, like hip problems. There was a, there's a defensive back who's, who's the, an NFL, whose career was basically ruined because he had so many, he had a bunch of hip surgeries and it was like, did he really need the hip surgeries? Because he never got better after the surgery. Right. So you kind of take your step back and, and you know, as I do a lot of times the assessment isn't, there's no assessment. That's just based off of their treating based off of an image.

Um, I mean, you can probably, uh, back me up on this. I mean, I've had a ton of patients come in and they've had surgeries, uh, maybe for like a labrum in the, in the hip or labrum in the shoulder or something like that. And there was no improvement. And so when you do the assessment, it actually wasn't the labrum that was the cause of their discomfort where they have it. Right. Um, and also the, uh, and taking a different round of that actually is I have a lady right now that she has, uh, she has some neck pain with she's, she's golfing. So she's turned, her head is relatively turning with the swing.

And then, so she had a past 10 year old, uh, labor repair on her shoulder. So I would just come up and I would just kind of compact her shoulder together, just smash it together and have her move her head. And she's like, Oh mom, all my pain went away. And so I think it can also go the other route too, where now that you've had some type of compromise there or whatever created, maybe it's still there biomechanically. Now it's affecting other regions locally. Um, you know, uh, probably a point we should hit too, since we are talking about hamstrings, is that, so you mentioned the, uh, nerve based sciatic based, uh, back rooting type of hamstring tightness.

And I mentioned the actual tear, uh, MRIs and images, x-rays are going to probably be negative on both. MRIs are going to be negative on yours, not mine for the, for the hamstring. Ultrasound is going to be negative on yours, not mine. And then you're going to have an MRI finding in their spine and I might not. Right. So probably because people, they'll, I know a lot of times patients will kind of lean into that. Well, my, my image was negative. What the hell is it? Is it in my head and things like that? Right. So I know I see that as a, that's a, I've seen that the other way a lot too. I have a, I have a guy right now that he's very fixated on.

There's, there's a, there's a tendon issue in his foot or actually there's an issue with a tendon in his foot, but he's responding like a nerve based pain. So he's like, well, my, my foot, my ankle, I'm like, it's not, it's, it's, it's normal. That's normal down there for you. It's just not painful, but your thing is the other thing. So I think a lot of times it's hard for people to see past the image when it's presented to them. Yeah. I mean, that, that's, it kind of, that's our medical model though, right? It is very reductionist, reductionist, reductionist getting down to trying to find like the, find the thing that's wrong and, but have a picture of it, you know, and we can treat that.

Um, but I mean, the body doesn't always work that way. It doesn't play that way. Especially when you start getting into, uh, I mean, you ask people who study the brain and they're like, how's the brain work? And it's so complicated and they're not even, they're barely scratching the surface of how, you know, learning how things work truly, how we, how things are processed and, and pain. And when you start getting the pain too, it's like, man, open a whole nother can of worms, you know? Right. So I think to take home for that, the guy with the foot that's responding to some type of nerve, is it, is it more like a low back nerve thing or a peripheral nerve?

Um, he's, uh, giving him, uh, intra-abdominal pressure cueing reduces it. Wow. Yeah. So, I mean, you're going to be, so spine probably, right? Probably. I mean, we don't have any, I don't have any supporting image, but. No, but I mean, but your assessment and your approach to care is core based, um, technically kind of spine a little bit, uh, but, and it's changing what he's perceiving in the foot. Right. But, but obviously the image still shows the other thing, but probably, I mean, I'm sure it maybe has a contribution. We don't know. But, uh, actually I had a, I had a girl years ago that came in.

She was a, uh, she was a college runner and she had, uh, I was investigating for a stress reaction of a metatarsal head cause she had, she had foot pain right around the region. So I'm like, let's check it out. So we did an MRI and we found, uh, Achilles tendonitis and peroneal tendonitis and posterior tibial tendonitis. So all these tendonitis is all around. Right. And, uh, I was like, did any of these hurt? And she said, nope. And about two months later they did hurt. So, yeah. But the fracture was negative. Yeah. Just open up a whole nother can of worms there, huh? Right. Yeah. So, um, have you had, I'm sure you've had runners with hamstring problems, right?

Yeah, absolutely. What do you think about, um, is there a certain, uh, great exposure you would give them with running, um, uphill, downhill, flat surfaces, uh, sand types of shoes? Is there any considerations that you usually kind of target? I typically, um, in terms of types of shoes, it just makes sure they're kind of cycling through their shoes. Um, you know, if they're, if they're a distance runner, I'll have them either cycle through two or three pairs of shoes, um, and not just use the same one over and over again. Um, I don't go into too in depth of the shoe aspect of it. I actually, I give a little bit more focus attention to, um, uh, changing the pattern.

So I'll film them running just their, their normal, uh, their normal pace that they run at, uh, and the side view is, is the money shot, so to speak, because really get to see where the foot is landing in relation to their body. So I want their foot when their foot striking, I want the foot to be directly underneath their center of mass so they can propel themselves forward. Uh, most of the time what you'll see with the hamstrings issues is they're kind of casting out a little bit more and their foot contact is landing a little bit more in front of their center of mass. So they're having to try and use the hamstring to pull themselves forward.

And I mean, over time, they just kind of wear and tear it. Right. So my, uh, I actually treat them like a sprinter. So I, I give them sprinting drills, uh, for foot contact specifically. Um, and then I, my reintroduction into them running is doing sprint intervals. So they're having to, their tempo is much higher. They're having to push the ground away, so to speak, and propel themselves forward. And then when they're, we start transitioning them back into distance running, uh, hopefully that, you know, the idea is to have that, that carry over into their, their, uh, their running. So they're not just sloughing down the path.

So to speak, they're actually moving at a good tempo, uh, uh, you know, to help reduce some of the strain on the, on the hamstring and, and hopefully put more on the glute. Yeah. I actually, I do the same thing. I know we haven't really talked about this yet. Um, no, so sometimes I'll actually have them do, I'll have them do more plyometrics, high knees rolls, uh, uh, push the floor away, things like that. But also too, uh, I have some stairwell right up in my office, so I just haven't, uh, I haven't run stairs and I tell them to, to pound the nail into the stair. Yeah. I like that. Yeah. And it seems like it works well, but for hamstrings, I think they're a little hesitant to going quick.

So I just tell them about 75%, uh, sprint intervals and full recovery. Um, and if they, if they want to lollygag with like a far leg or something like that, then they could, they, they can do it, but I want some intentionful movements. Yeah. I mean, and, and if I'm working with individuals who has a strength coach, a personal trainer, I'm, I'm trying to get that personal trainer, training coach to hit the, hit the, uh, single leg glute pretty hard. So whether that's, uh, you know, some type of, uh, uh, or even like, uh, knee dominant exercise, right? So like a box step up or something like that, or eccentric, uh, box step down, uh, single leg dead lift with, uh, with not straight leg.

So with the slack in the knee, but an emphasis on the glute, uh, really trying to drive, uh, you know, hip extension through using the glute and not so much as the hamstring. Now, um, I don't think we talked about this yet either, but the, um, the reason I'm asking, or I want to go down this route is because if we have late public listening, I feel like with running populations, they're a little bit more, especially weekend warrior style. They're a little bit less apt to use strength training or have coaches or whatever like that, because they're just, um, my, my observation is that they, they just want to run.

They don't want to, they don't want to lift weights. They just want to run. So, um, I usually start them out with some type of, um, like double leg move, double leg, um, fundamental movements. And then I'll trick them into carrying shit and I'll tell them to get, get two Jansport backpacks, load them up with all the tools and random shit you don't use in your garage, walk them down the street about 50 yards, swing them between your legs and start doing some hinges and then get on the ground and do some planks, take a hand away. Tricking them into strength training, movement pattern stuff, right?

Pretty much. And I'm trying to, trying to get them some volume on it. Um, yeah, but I love, I love doing carries with them. Cause it's like, uh, one thing they seem to resonate really well with is that they've been told about hip drop. So that'll at least address some hip drop without really having to go into too many fancy terms with it. Hip drop, uh, specifically like a Trendelenburg is what you're talking about. Right, right. So when their belt line drops. Yeah. So, yeah. So the pelvis will be uneven, so to speak. And from a mechanic, so I was listening, something's going on out there. I don't know what it is.

Um, the, uh, yeah. And then from a, from a knee perspective, are we talking about going further down? Uh, then we have, uh, valgus or knee drop or a knee inward cave. And then we have all the biomechanical issues that go along with, uh, that. And then how can we really help? How can we really expect the hamstring to do its job well, even if the glute was doing its job well? Right. So. Well, it's, it's the, it's the devil pronation's fault. I hate pronation. I think we should get t-shirts made that say pronation, but horns on it. Ooh, or, or get a brewing company. And then that'll be like, you know how they have horny devil.

Yeah. We'll just say pronation. Ooh, we'll just make a bunch of biomechanical terms as the beers. Different beers. It's a good idea. Trademark. Um, no, but I think, I think you, you have the right idea and tricking them into doing some type of strength training. Uh, and that, that's basically what we'll end up doing in the offices, doing baseline fundamental movement patterns. Like, you know, like you said, more than likely they're not, um, they're, they're not used to just regular movement pattern stuff. They're just used to running. Right. And if, you know, you and you and I know that if all you do is one thing and you don't do anything to kind of offset the other things, uh, or the, to offset the one thing that you're doing constantly, uh, it's going to catch up to you in the end.

Well, I've definitely found that, um, by addressing some low hanging fruit in people and this, uh, let's, let's just say if a runner comes in and really loves to deadlift and they like to do, uh, pushups, then I find that adding something like a squat all of a sudden takes a lot of their shit away and they might have all these little, have all these little aches and pains and the hamstring and whatnot, but you start implementing like a movement, which is like the kind of the hole in their puzzle. And it seems like it addresses a lot of their concerns. Yeah. I mean, it's Dan John principle right there.

Right. So you want to improve somebody, uh, somebody's performance use, uh, in terms of carry on to the field. You look at their strength training program and do what they're not doing. So if they're not doing carries, give them carries. If they're not hinging hinge, they're not squatting squatting. Right. And it, but that, that, that's not, it's, that applies over to everybody. It literally, it doesn't have to be an athlete. It can be a general population. You know, if they're, and we, I think we covered this in the, um, uh, recording, um, over here, you know, it's, it's, you give them what they're not good at or you give them what they're, uh, you have, make them do something that they're not used to doing and they improve.

They get better. Right. Just over time and not, not over the course of don't, don't force it over one day, but then do it over time. Right. Graded exposure. Yep. So I always, I always ask them, so are you good at making any food? If you're not, then you should make me some or the floor is dirty here. When's the last time you vacuumed? But I like it. Yeah. You know, there's a, uh, I've been, I've been, I've been doing some glute primers by the way with some people. And so I'll have them on the ground on their back and I'll just act like the mini band, but I'll try to force them together. Right.

Force their knees together. So they've been, people have been struggling a little bit and they don't want to fight me. And so I just tell them if I, for the, for each person, I try to figure out what they are, what, something they really like or something that they're good at. And so when I force them together, like I'll usually, I'll say, Hey, I want a ham sandwich. Can you make me, if, if I put your knees together, I want you to make me a ham sandwich or I want a tomahawk steak or I'm going to take all the money out of your, out of your change compartment in your car. Yeah. I, I, I, I steal one from Dr. Mark Chang.

Um, and I say, I imagine you have a band around your knees and if you break that band, you get an unlimited debit card that doesn't expire. Is it a heavy band? It's a heavy band. Yeah. And that usually gets a, it gets the job done. Yeah. So. Well, I've been, I've been telling them with Sumo walks, if they break my band, then I, then I want them to buy me a steak. Ah, yeah. So, I mean, that, that brings up another point too, is that if they're breaking the band, they're doing a couple of things, either dragging on the ground so that the, the tempo is off, right. Or they're taking two biggest steps.

Right. So, well, I don't want them to do either. Correct. Cause those bands are, I mean, they're not, they're not that expensive, but they're not cheap either. Well, if you, if you're breaking one or two every day and ends up adding up a little bit. Dude, I told you this kid broke two bands the same, like within about 10 steps, you broke two bands. Take off the band. You're going to, you're going to get clamshells. Yeah. You're going to, you're going to do easy stuff here. Yeah. Okay. So we covered MRIs, positive, negative. We talked, we covered neurogenic based hamstring and actual hamstring tears.

Right. What else? With that, with, with that, so actual hamstring tear, you know, in terms of loading. So myself, I tend, I tend to start, you know, when we started loading, I started with a little bit more eccentric loading manually. Let's say we were now past the beginning phases of, of loading and hamstring. We're starting to get a little bit more dynamic. Do you start implementing any kind of neurodynamics into the, to the rehab? Yeah. I, I usually will have them do some type of like PNF style and then they can use the like ankle kind of movement to, I guess, slide some things through. But, but honestly, I don't really try to actually, we should back that up in case people don't know what neurodynamics were talking about like nerve flossing and whatnot.

Um, I, I truly try not to give them any more. I try to trick them into it by some type of warmup. Basically, uh, kind of backtrack even more on that, uh, nerve flossing. Basically what you would do is, uh, if you can imagine you have a, uh, a rubber band from the top of your head and it goes down the back of your neck, down your back, down your low back, across, uh, in your glute, down the back of your hamstring, all the way to the bottom of your foot, if you kick your, you're sitting down and you kick your knee out, you put tension on that rubber band. But if you extend your head, you just taking tension off of that.

So imagine you're flossing your teeth. You don't just tense the floss. You move the floss from one end and the other. Yeah, that's a good description. And also too, your teeth don't move when you're flossing. You have to have whatever kind of floss through stable. Stable. Bingo. So that's why I'll use the ankle a lot of times. I'll use the, the knee sometimes. We're talking about hamstring possibly actually, uh, that, or I guess lumbar spine too would probably work in there as well. Um, but I, I don't try to trick him into it. I think I've been screwing, or I try to trick him into it because I think I've been screwing up lately with, I, a lot of times through my exam, I'm troubleshooting, I'm trying to figure out data points on things.

So I'll try things. And then a couple of things will work. They're like, they're like, well, how many of those should I do? And I'm like, well, just do this one. They're like, what about the other ones? You know? And so they have this whole database of things they can try. And all of a sudden, a couple of weeks later, they're like, what, what, I forget all the things I should be doing. I'm like, just do the ones that work for you. So I'll try to just kind of change their warmup a little bit to integrate more of a neural slide and get some quote unquote flexibility back. Yeah. Do you use, do you use anything specific in that?

Um, in terms of flossing? Yeah. I'll floss just in case, uh, there, you know, and just, you know, it doesn't look like it. Do you have bacon this morning? I floss, I floss after every meal. Uh, but no, I, I'll floss them just to make sure there's no, uh, you know, just in case if there's any scar tissue starting to kind of build up, uh, that's close to any type of nerve. I don't want any, any, I want it to move well through there. So with a, with your disc people then, at what point, how would you, how would you figure out when is a good time to bring them into that straight leg raise? Hmm. Um, it depends.

I, that's, that's a, that's a tickle the dragon. It's, it's that, that is, yeah, you're tickling a dragon's tail, right? That's what McGill says with nerve flossing. Cause you can get, you might get away with it, but you might get burned. So it really does depend on, on where that person's at and their sensitivity. Uh, you know, if, if we can, um, if we can move them through a, uh, you know, through a range of motion that's pain free and they don't have any tension or tightness or anything like that, then we can play with that range. I don't like tensioning too much. I really don't. I think, uh, um, even though the theory, I think behind that would be to, to reassure the patient if they feel tension, they're kind of decreasing.

Uh, perceived threat. So maybe we're going a little bit psychosocial there, uh, just from a biomechanics standpoint though, I'm, I'm, I'm probably not going to move them into that, especially earlier on in the, uh, in their care. Yeah. I'll definitely, I'll wait like, I'll wait like three weeks or more like, and, uh, I kind of like, I noticed a lot of people get like this too though. What's that? I'm like a, I'm like a four week. Yeah. Week four maybe. Yeah. It's, uh, I know they'll start to ask really like soon too about like their, their flexibility and whatnot and it, which I'll tell them to stay away from it still until they start to if they become a little extension intolerant or I feel like their IVFs are closing, then I'll start to incorporate it more.

Yeah. Slide them a little bit. Yeah. I would, I would say I'd put a little bit more to my tensioner, so to speak on this on, on, um, disc patients are, uh, almost like a, are a deadlift essentially, uh, put more of a hip dominant deadlift. So not necessarily an RDL, uh, stiff legged, but just slack in the knees. So a little bit of tension back there, but I'm, I'm trying to load, I'm trying to load them. Yeah. I'm trying to load them as fast as possible. So then, um, as we can, let me, let me make sure to re I'll probably reframe that a little bit. So you're increasing the range of motion by adding load through a typical movement or an exercise.

Um, since, since usually I think you will, or at least I will, I'll dead, I'll do deadlifting from blocks or higher platforms. Will you then drop the weight a little bit and just do more of a therapeutic full range of motion to get more range from that? Not necessarily. I think, um, I would probably keep the same weight, but I would just start decreasing the height as long as they can, uh, they can maintain tension. And I know if I can get them just to lock into a, uh, a nice position at the bottom, do that a couple of times. And then I'll have them start lifting through that range of motion. And then we start increasing the degrees of freedom, allowing them to get a little bit, uh, uh, more range of motion through that.

Just to, I think we'll hit this a couple of times. I'll hit it different ways. And if you want to ask me to, you can, uh, so you're saying we're going to stretch the hamstring by not stretching the hamstring. We're going to do an, I do an exercise. Correct. What is the best way to stretch the adductor? Um, front planks, front planks, I just, I just, I just, I told you the story about how someone was trying to pin me down for this. Um, yeah, yeah. You just move deeper into the movement. I would unweight it at least for safety or at least body weight. Yeah. A squat. So do you think there's value to, uh, static stretching?

I think there's a time and place maybe. Yeah. Okay. Uh, how do you feel about doing some like PNF contract, relax, stretching, and then going into, uh, RDL? You down with that? Yeah, maybe. Yeah. Okay. Yeah. I mean, there's no bad exercise. There's right. Everybody's different. You never know when somebody, something's going to come up. You know, I, I, I never said I would do a posterior pelvic tilt. I said that, oh, excuse me. I said I would never do a posterior pelvic tilt and lo and behold, probably like, you know, year four in practice. I was like, man, I gotta, I gotta, I'm going to coach a posterior pelvic tilt here.

I can't believe this. And I did it and it worked. Right. But then I pulled them off of that as fast as possible. Cause that's what they needed at that, that point in time to get the outcome that I, that I needed. So, you never know. You have, you have no idea. How did you demonstrate that? Was it a Travolta move like, uh, like Boogie Nights? Is that Boogie Nights? Um, oh, when, with, uh, when, when they're in the little, uh, the class. Oh, you know, I, I, I'm, I'm thinking of the, I'm thinking of the, uh, the, the, the cover to the movie where he's really trying to flash that buckle. Mm-hmm. Oh.

A little different. Less weird. I don't know. I think that people really like those, those odd cues. Yeah. Well, it sticks in the head, right? Yeah. I'm trying to think of some, do you, you have any good cues lately? Um, for what? For anything. Yeah. Well, I, I do. Um, like I'll, I'll, I'll pull out a Dan John classic and I, I tell him, you know, if, if, if I can get underneath, so I'll have him go down for a low diagonal sit and, uh, emphasizing the knee support position. So, uh, and I tell them if I, uh, cause I'm working with students right now. Right. And so I'll tell them if I can get my hand under here, um, do you have, you have student loan forgiveness right here?

If I, if I can get my hand here, it's mine. Uh, that usually gets the job done. All right. I go to the Dan John classic. If I could get my hand under here, uh, you kill a puppy, you don't kill a puppy. And so that usually gets jumped up too. We have, uh, did I ever show you my Stanley shark? He's the, he's the office mascot. Oh, no. So there's a, uh, there's a bunch of stickers when my friend makes these stickers called Stanley shark. So everyone loves, a kid loves Stanley, Stanley shark. So there's all these stickers sitting up there from the kids come in. They take them, even adults take them.

So I'll put a, I'll put Stanley kind of in front of people like deadlifting that are like kind of peering out too far or too up and whatever. So I'll put Stanley in the correct spot and he's got these little beady eyes. And I say, you're in a staring contest with Stanley. If he, if you blink or you don't look at him, he's going to kill a Corgi because everyone loves Corgis. Yeah. I don't know. I don't know too many people who love Corgis actually. Well, they have Corgi days. Like I, no, I don't like Corgis cause they, they look very inefficient as for doing anything. Right. Yeah. But I got a question for you for the hamstring stuff here.

No. Um, perfect. Perfect. All right. Oh, that was it. Moving on. That was your answer. But no. Um, so you were talking about stack stretching earlier. How often are you, are you giving your distance runners ham, static hamstring stretching? I don't really give it honestly. Cause I feel like they're doing enough. Like they're doing it already. Like you look around a group of runners, like that are anywhere around the curb and there's like 15 of them, like a, like a bunch of crows on a, on a, on a pole, you know, all stretching their calves. So I don't, I don't bother. I like the, the low hanging fruit.

I would rather them do some type of like, um, some type of dynamic warmup, maybe get the hips going. Um, I, I, I tell a lot of the people that come in here that like, like, what do you do before you play baseball? I'm like, uh, I'm, I'm like, I do basically what we did right now. And they're like, well, what kind of stretching do you, do you do? I'm like, none. You know, I'm like, how do you get good for a baseball swing? You swing a bat in the batter's box, you know? So I usually don't give them much at all, but if they're down with it, if they want to keep it, they, they can have it. But I'm like, just add a couple of these things in here.

Yeah. We, I always have the, if it feels tight, talk with them. All right. If something feels tight, it means it doesn't need to be stretched. We need to take the opposite approach. So I, but I'll, I, but I don't try and pull them off of the stretch, static stretching, um, completely all the time. Depends on the person, uh, because, uh, you know, they read everywhere. And so I don't want, I don't want them to, to not listen to me on some other important things, you know? So I'll actually teach them how to stretch maybe a little bit more proficiently. So less low back and more hip. So instead of going, instead of going to touch their toe, uh, with their foot up on a chair, instead of touching their toe with their hand, try and touch their toe with their belly button.

So they're really uprighting through the spine and it's all hip. Right. And I, and I, I show them, I said, I'll do it. And I'll say, okay, if I just do this, where's most motion happening? You're like, you're back. What if I do it like this? Like, like, well, it's, that's hip. Like exactly. Does the hip, we have an anatomy lesson. Where is the hamstring attached? Does it go past the hip and up the back? And they're like, obviously, obviously it doesn't. Right. Um, but, but they might not know that. And so once they find that out, it kind of makes, it clicks a little bit more, but then we have the dynamic warmup talk.

We have the core stiffness talk, you know, and, and these are the things I want you to do before you actually go perform, before you go lift, before you go run. Um, and they see the benefits too, right? They, they, they, they see the carryover. So yeah, if they actually do this stuff, they all, it's almost a hundred percent. They see the carryover. Yeah. Um, but I think, I think you're right about not, it's probably not worth it to fight the battle on everything, on everybody just yet. Um, if you really, even if you think it's like terrible for them, maybe it's just better to implement what you think is, add what you think is needed first and then maybe, uh, nick off the things that are, you think are the triggers for them.

Yep. So I'm guessing that when you're telling them to, when you're correcting their hamstring stretching, you're correcting it because the way they're doing it is creating their hamstring tightness. It would probably, yes, it'd probably, it'd probably be a portion of it. Yeah. Okay. So you're, you're looking at their, you're looking at their triggers and you've, that is for someone who is probably a nerve based one, right? Correct. Okay. What about for someone who's a hamstring based one? Is there a, is there a certain, uh, is there any variation to give a talk that you would maybe give someone like that who's running on a Saturday and doesn't get paid for it?

Right. Well, I mean, you know, if it's a true hamstring injury and, uh, you don't want to be told, you don't want complete flexibility necessarily in a hamstring, but you don't also don't want total stiffness. So if there is some type of mobility thing that you have to do to kind of regain, uh, some, it may be, it's not necessarily mobility. It's just, maybe it's just making a little bit, the hamstring a little bit more supple and pliable. Um, and that, that may include some static stretching or, or even if it's a dynamic stretching or like a PNF type deal. Right. I still, I think still going over a, uh, a form of uprighting through the, keeping the spine and the relatively, uh, you know, their neutral position and having most of the motion happen about the hip.

But again, I mean, you got to keep going back to, okay, well, why did the hamstring pull in the first place? Do we need to be, is this what they need to be doing before they run? Do they need to be stretching or do they need to be working on more core stiffness and glute activity and working on hip extension? Mm-hmm. The, uh, I don't know if I told you, I wrote this massive article when I was, when I tore my hamstring, uh, legitimate tear, not, not, uh, feeling, feeling tight tear. Uh, and I was trying to look up some solid timelines of like recovery of like what is occurring when and when is a good time to start loading and blah, blah, blah.

Right. So I wrote this whole thing up and it was roughly about 21 days was the time was that there's a fiber cross bridge that, that occurs, which then has the ability to transfer load. Prior to that, it's just a jelly material and it really didn't have anything you can do much with it. So, and I was with a grade two, but, uh, so I kind of use that as, as a, as a entry point for conversation. It's like for, you know, after you get to that, after you, after you get the ability to, to, uh, transfer energy through that cross bridge now, now we need to do it. So, it's a way to kind of get them to start implementing some of the, uh, hinging movements that I wanted them to do, uh, without having to be too, too strict on a, on a, on a big conversation, a big dog and pony show about it, you know?

All right. Yeah. I, I, I just remembered something you mentioned about your hamstring injury earlier, um, about the, you had some, they weren't fully black and blue, but you did have some discoloration. Um, correct. So I had a patient who, uh, she was water skiing and she was kind of waiting for the boat to take off and the boat took off and it pulled her forward and she felt, she felt a pop, uh, in, in her like kind of glute hamstring area, kind of almost by the ischial tuberosity. So the sit bone, if you're, um, you know, uh, you know, general public, uh, general public out there listening. So, um, she came into me and was having this ischial tuberosity pain and she thought it was, she tore her hamstring.

I said, well, did you see any bruising in the hamstring? She said, no. And so I started palpating in the hamstring. There was no tenderness. There was no divot. There was nothing. Ischial tube wasn't tender. It was like, okay, well, let's do some, let's do some, some other tests. So I tested her for a disc and sure enough, uh, the pain went away with passive extension. So, uh, so even though she felt a pop in the area, uh, you got to think about too, what were some potential injury mechanisms? She was inflection when she got pulled forward. Right. So maybe it was a little, she, you know, kind of irritated the disc.

Um, but I think, you know, having that discoloration can give you a window into, okay, maybe there is some legitimate local tissue damage here, uh, as opposed to if someone's like, yeah, I pulled my hamstring and they're kind of grabbing, almost like grabbing their butt, but it's right where the hamstring inserts and you, you, you observe and there's, there's no discoloration. There's no, you can even, you know, do a hamstring strength test. There's no pain. There's full strength. It's like, uh, I don't know, you know? Yeah. And I know that, um, my discoloration actually, I didn't even find it myself cause it, I mean, it's behind you.

It's hard to see. And it wasn't, it wasn't enough to make the whole leg black and blue nor the foot. Sometimes it can happen. But, um, the, I was actually, I had someone given a massage to me and they found inner thigh high, kind of like around the like gluteal fold kind of area. And, uh, they're like, oh, there's a little bruise here. And, um, I hadn't had anyone mess with it prior to, I was just kind of giving it some time, which made me then kind of think when people come in with the possibility of a tear and they asked for tissue work on it and they want to beat the snot out of it, it creates the possibility that if they do bruise, then you muddy the water.

If they bruise because of you or because of the tear, or maybe not a tear at all. So I really try not to muddy that water anymore, just because it was really tough for me to even, for me to tell, because I couldn't just see the damn thing. So that was enlightening when I had that. Yeah. I think, uh, you know, there, there's so much information out there, whether it's good information or bad information, patients are in, are coming in with way more, um, uh, sometimes more knowledge, but also sometimes like their own diagnosis and they, on their own treatment and they think they know what they need.

Um, and I always told patients, I said, okay, that's fine. We'll consider that, but we're going to do, we're going to, I'm going to do my assessment and I'm going to let you know what I find and, and, you know, and, and what I think is going to be the best approach to treat this and work with this. Um, and, and we can talk options. And so you, and usually my, my exam and my history and my exam was the more, most comprehensive thing they've had. And by the end of the visit, usually I've had, I have them on board for whatever was actually going on as opposed to what they think they need. And, and that, but that takes a lot of, you know, communication and, and, and explaining to them what they need and what they think they need isn't necessarily going to be the best thing for them.

Yeah. So, um, on that note too, I've, I've been trying to make a good point with, with especially new patients to say like, I've, uh, you know, what are you concerned that you have? And they might say, well, hamstring tear and maybe this, maybe that, and so on. And then asking them like, you know, what do you, what do you want from me? Like, what do you, what are you looking for? And they'll tell you and throughout the time, I'll frame it a couple of times. I'm like, I just want you to, I want you to hear that I'm, I'm, I'm hearing that you want to, that you want this, this, and this, and that you think you have that, that, and that I'm going to screen all those out.

And I, if I feel like this is right for you at the time, I'll tell you, but if I don't suggest it, it's because I feel like it might be useful, not at all, or maybe later. And it's just different times for things like rest. You would only use it for like maybe five days, but you don't use it later. So there's times for these things. Right. So yeah, patient communication, always a good thing. We're starting to wrap up here. What do you, what else do you want to talk about, about hamstrings? Well, I think I just kind of brought up the ischial tube thing, the ischial tube discomfort. I, um, in chiropractic school, I was treating a couple of track athletes, uh, in the, in the clinic.

And this one guy in particular, he was a junior Olympian, but he missed his entire junior year with a hamstring injury. And so a kid came into me. I mean, this guy had huge hamstrings, huge glutes. His thighs were ginormous. There was no real pain. He didn't have pain on palpation. And so it was always kind of confused me. So me being the, the, the student that I was, I treated the hamstring. So we did a lot of eccentric loading. So we did a lot of manual eccentric loading, did a lot of Nordic hamstrings, a lot of Swiss ball, uh, eccentric hamstring, um, curls, and then progressed to some concentric stuff and just really, you know, went from eccentric all the way through to being more dynamic.

And, uh, he kind of kept having this issue, a tube thing come up. And then about, uh, halfway through the senior, senior track season, um, uh, started seeing the, uh, two other guys on the same, the four by one, uh, relay team. So two, uh, three out of the four that were on the four by one relay team were, uh, were coming in to see me and the other, the other two started getting issued to discomfort too. And I'm like, okay, what's going on here? So I started talking to the coach and say, Hey, what are you guys doing in terms of like, uh, your workouts? And he told me they're, they're sprinting workouts.

I said, okay, are you guys doing any, what are they doing strength and conditioning? It's like, oh, well, they're not really doing strength and conditioning. I said, okay, you guys don't do any other exercises. He said, well, we're doing, we do some core work at the end of the, at the end of a practice. It's like, Hey, what are you doing? It was like, oh, we're doing, uh, uh, sit ups, crunches, Russian twists, uh, reverse crunches, uh, reverse leg lifts. Uh, and it's like, it's all, it's all flexion based. I was like, okay, well, look, let's do this. Um, instead of doing this, this, and this, let's just plug these in here.

And I let them keep a couple of the other exercises. Cause I didn't want to totally, you know, say, Hey, you're, you're ruining your players, right. Or your athletes rather. Um, and so we, you know, it's just inputted some bird dogs and put it some front planks, uh, some soft planks, side planks, um, some rotational core stuff. And, um, and in the, in the office, I started doing a little bit more prone extension with the, uh, with, uh, the track athletes. And sure enough, the hamstring, uh, discomforts went away. Yeah. Uh, and, and I was like, and that, that, that to me, that was like, kind of like an eye opening, like, Holy, Holy moly.

You know, this is, uh, it's not always the, the local tissue, right. Right. They're having the pain. Well, and to you, you implemented the thing, the movement that was apparently not being, not happening, there was a lot of flexion. You, you had an extension. Right. So I think throwing that stuff in, I, I, you know, I can't help but think that all these, like, you know how, like you read about like the 10 most common ailments that people have and like back pain and it band and hamstring. And if there's that many of them, do you think we're missing something? Like people are missing something the way they're managing them?

Like not just clinicians, but people like. Yeah, absolutely. I mean, I think, I think a big part of it comes down to, um, just general activity. Uh, I think it's way more complicated than, than, um, we're not treating things well in terms of, uh, from our end. Right. I think, uh, there's more psychosocial things that play a bigger role in it. I think nutritional, uh, problems probably play a role in it, bigger role into it also. Um, cause I mean, I think we're getting worse at treating back pain. If I'm not mistaking, I think the statistics are getting, we're not, we're not, but there's so much more information out there is like how we're getting worse.

I don't think we're really connecting the dots in terms of promoting at just general activity. Uh, and for those weekend warriors, we're not promoting them. Um, we're trying to make them better at the, their, the thing that they're doing all the time on the weekends or just like, you know, but we're not, we're not managing the, the lack of load in other areas. We're not having them. Okay. You're going to run 10 miles this weekend. How about maybe a couple of times this week, go out for about an hour long walk or something like that, you know, just in managing that aspect of it. We're, we're becoming specialists.

Everyone's right. Everyone's really good at that one thing. Cause that's, they want to, they want to be an Olympic lifter or be a, can it, does anyone want to be a hits athlete? Yeah. Do they crossfit, right? They want to be an American ninja warrior. Yeah. No, I think, you know, you can, uh, and you and I are, are, we're, I guess in the field of chiropractic, we would be called sports chiropractors, so to speak. And I'm using air quotes, uh, but really we're just really good generalist, you know? And, and I think that's what we need to be as humans. We need to be good at a bunch of stuff. Um, not perfect at a bunch of stuff, but we just need to be relatively really decent at a lot of things.

Uh, and, and that kind of mitigates a lot of the, um, long-term load, so to speak on the body. If we're looking at, you know, endurance athletes, or if we're looking at, uh, strongman competitors, or we're looking at just the general population, um, doing, uh, playing golf, you know, once a weekend, we need to be doing something to kind of, uh, offset just that, that chronic load. Yeah, I agree. Um, this is completely a side idea, but I, I've been, I've been thinking about it this week. Tim, what'd you think? I've been telling people with elbow, shoulder, and hand conditions that they should only expect to have their thing completely go away by the time they develop three calluses and they feel like they want to file it.

Does that work? Uh, that, that's actually not, that's actually not bad. But, but I thought the disclaimer would be on that, that is that when you have someone already lifting, then that won't play. But deconditioned, yes. Yeah, absolutely. Deconditioned, I mean, you, you, um, you'd be amazed that you just start, like you said, upper extremity complaints, even neck complaints, right? Somebody's deconditioned, the first thing you do, if all you do is just have them start carrying stuff, they get better. Right. You work grip and grip, work grip and different variations, you know, and it's, they improve.

I don't know. There you go. Three grip rule. You heard it here first. Boom. Um, okay. So, uh, any last words you think on hamstring or hamstring, feeling of hamstring tightness or the actual hamstring tear? Yeah. I mean, for the practitioners out there, um, always consider a potential mechanism of injury. I know it sounds silly, but we can always, we can, uh, a lot of times we get caught in the, trying to get people in and out as fast as possible, you know, and, and, and just truly find out if there's an actual mechanism and not just take their word for it in terms of, uh, they have a hamstring pull.

Um, always look at it from the light. You got rule out of disc. Essentially, if there's some type of hamstring tightness, I mean, I think you're, you know, you're doing your due diligence by doing that. Um, and then, uh, just taking a full movement approach, not just working if there is legitimate hamstring injury, uh, like a tear or pull or something, um, you know, taking the approach of, uh, making sure the glutes online in terms of efficiency for, uh, for hip power, hip extension and core stiffness. Yep. Um, I think a couple of things I'll, I'll add, at least, uh, my general rules is that I've done, I've been bad at this in the past is that sometimes I'll get married to a diagnosis and I'll, I'll, I'll kind of go in thinking, oh, we're going to do this.

And like, you look at their paperwork and it's like, yeah, it's so going to be that. And then you get in, you're like, it doesn't look like that, but I want to fit it in that box. I still want to do it. Um, so that's, that's one thing. Um, but also too, is that, uh, when you do come to a diagnosis, I, I think it's more important to figure out what the body is asking for to reduce the pain and ask them to duplicate the pain somehow, and then try to reduce it. And it'll give a better insight of, of what we're looking to at least apply for doing a corrective exercise strategy or fill in the gaps of strength or so on.

Cause you can always do tissue work on it, but, um, that's, those are my two thoughts anyways. Yeah, I like it. Cool. Uh, so, uh, so to close out here, so we all, you always open up the show with a little negativity of, uh, grind your gears. What's something that you really, really, really do like that I like, um, uh, narrow me, narrow me down a little bit. Cause there's a lot of things I do like, I love pistachios. Okay. So, so pistachios, pistachios are there. They're, they're, they're great. Um, I don't know if you have you, I don't know if you've seen, my car and I, you know, was my car like that back in the day?

Yeah, there's pistachio shells everywhere. Right, right. And, uh, so. It's green dust. Is it green? No. No, but I'll, I'll have that, uh, that solo cup in the center console and I'll, I'll just, I'll start breaking them up and whatnot. And, uh, I started putting them in my lap, you know, and eating them that way. And, uh, and every once in a while I would get one that has no pistachio in it. So I'm kind of irritated. And then I'll find one that has no shell on it. I'm like, great. And I drop it. And there's this little section between the center console and where the seatbelt goes in that there's probably a good 20 solid pistachios in there that are just getting too waterlogged with moisture because it's moist here.

Is it moist there? Yeah. It's moisture. Moisture. Anyways, that's how you screw up a pistachio is get it wet, get it wet, get it moist. So you, you turned it back to a grinder gear. You turned it back to something like this is, this is, so this is something that I really like, I love going to a restaurant when you're obviously with, um, uh, you're not going to be on the same check. There's a couple, a couple of couples, you know, or there's obviously in, you know, we're in like mid thirties. Nobody's going to be like the dad picking up the check. Right. I love it. When a waiter or waitress asks, are you going to be on separate checks today?

Love that. Love it. You know, they didn't ask us. They didn't ask us when we went, right? Yeah. That lady that liked cornbread. Yeah, absolutely. She did. Yeah. I love that. And that's good. Have you been a waiter before, by the way? I haven't. No. It's the biggest pain in the ass to split a check. So when they ask, they're really good at their job or when they do it. I think it's just a system thing. I think if you don't have the system at the restaurant and make it easier, then that's, that's, that's the system problem. Yeah. Well, gosh, now you made it negative again. I didn't. You did. Never.

You're trying to, you're trying to flip the script here. Good stuff, though. I think we covered a lot of, a lot of good talking points today about the hamstring stuff. Right. Well, cool. Then I'll tell, I'll tell everyone how to find it and then, and then I'll.