Strength Training for Dancers With Hip Pain and Labral Tears

With dancers, it's like you have a lot of things that are demanded upon you with the choreography. You might as well have a lot of options. And I guess this probably simplest analogy is if I only knew one edge of like a piano, if I only knew the left side of the piano, but you asked me to play Mozart, I can't. But if I knew both sides, then I have capability of doing a lot of things. But if you're only exploring that one side, you're only getting only certain spots of what your capacity is. 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.

Hey, it's Dr. Sebastian Gonzales, your host for the Restoring Human Movement podcast. Thanks for joining the movement. Movement. This is your first time on the show. You have missed a lot. It's about 197 episodes. 96. 196 you've missed out on. So, please go back in the archives. There's some amazing content back there. And just as I mention probably every episode is that I'm thankful for the podcast because it's really improved my clinical skills and communication skills over time. And I'm hoping that you guys follow along the journey with me. So, this podcast is mainly intended for clinicians, but it is very patient-friendly, too, via hopefully going over some easy communication.

It's kind of like we're all at a bar just having a beer, and I decided to get a barley wine, and you decided to get a mead. And our buddy, who is a—he makes hats for a living. He makes those amazing, stretchy-fit hats that somehow, like, they decided that they didn't really need any, like, five and seven-eighths anymore. He decided to get a margarita. So, we're all just hanging out at the bar just talking about patient care, but he fully understands what's going on because we're communicating in a common language. That's what the podcast is about. So, also, if this is your first time on the podcast, I do share a little bit of a short story about myself before we start here.

Just so you guys understand who your host is and hopefully like me, this podcast is actually a section of the Beyond the Point podcast. And so, I was interviewed by Allie from the Beyond the Point podcast, who has a podcast for dancers. So, it's point with an E on the end. Very clever, huh? So, I thought I would share with you guys, because I think it went pretty well. First, we're going to get into the short story, and then we'll get right into the podcast. So, I don't know if you guys have air conditionings in your house or not, but air conditionings, holy shit. Like, there was, I want to say back when I was finally, when I was about 34, we got our first air conditioning unit, at least in my place.

And so, it's this little tiny space one. It, you know, fits in the window. It's got a long tube out of it and stuff. But it's, for $300, like, that thing is legit. And so, you know you made it in life. When you can turn the, you can turn the temperature down about two degrees and say, you know what, it's 71 in here. It's way too hot to sleep. I'm going to get it at 69. And so, that's when we became, that when I started to realize that I made it in life. When I can turn it down two degrees to get comfortable, even though we live in California. So, that's my life. Now into the show. Hello, Sebastian Gonzales.

Thanks for coming on. Yeah. Glad to be here. Or actually, I don't know yet. I don't know if it'll be a pleasure yet. Everyone always says that at the beginning and it's like, hmm, you don't know that yet. Yeah. Sebastian Gonzales, Sebastian, has a podcast himself. So, he's very used to this atmosphere and being interviewed slash interviewing people. Yeah. I think it's harder to be the interview person. The interview with someone's done is hard as actually making up the answers. Yeah, it is. That's why conversation is always better. Yeah, it is easier, I think, to be the one that's directing the conversation a little bit.

But, I brought you on today because, as you guys heard, if you listened to last week's podcast, I was talking about my injury and what happened after I figured out that I was actually injured and I accepted it. I had spent two years doing things that didn't really work. And I referred to a sports medicine doctor that assisted me and Sebastian Gonzales is him. So, we now work in the same office. We share space and we get the chance or I get the chance to learn from him and watch as he works with athletes and all different genres of people. And he has had the pleasure of watching me work with dancers.

So, I think that that's been interesting for you to see some of the differences between other athletes and dancers. Yeah. It's, yeah, I would, I mean, I always classify them as like bendy athletes because it's like the, the, the expectations you have for like, let's just say a sprinting athlete, baseball, soccer, you know, like a much, much different than it's like, how much do you want, range of motion do you want a hip to have versus you guys where it's like, oh, you really, you want to, you want to do that, huh? Okay. This takes a little bit more, takes a little bit more gusto. So, it's different, definitely different.

Yeah. It does have a lot of differences and it's been very educational for me to have these conversations with you about what the expectation is. And I, I've appreciated it and I think it's funny when you're like, so why do they want to do that? Why does their foot want to look that way? Why do they want to be able to stand on one leg with their other leg by their head? And it's really made me think about why do we want that besides the aesthetic look of it? But what really is the goal? And I think that that has really propelled me over the last years into questioning more of how we train, uh, because as it was more, why are we doing this?

Not just, yeah, this is what we do. I had to dive. Well, you know, like I remember we had talked about before that like we talked about lines, you know, informing me about lines and I'm like, what, why, why do you, why do you want Oh, cause it looks good. I'm like, yeah, but they move on stage well without that. Maybe I don't have a keen eye for it, but it's like they can do an amazing thing, but they have to have a line as well. And so we had talked about like, cause a lot of times with knee issues and hip ones and back ones, we, we get people to use their hips a little bit. And, uh, I had asked one dancer to said, can you just, you know, like sit back, like you're going to sit into it like a tar, tall barstool is called a hip hinge, where it's a hip dominant movement, which is helpful to offload certain areas.

Then you reinstall whatever room they want. And they're just so resistant to it. And I'm just like, what's going on here? They're like, Oh, well, it's, it's the way it's kind of, it doesn't make the aesthetic line. And I'm like, well, this seems silly. This whole thing's silly. Like, why don't we just get the person to feel better? And then you can do what you want. But it's, it's, I don't know, at least for me, and this goes for many, dancers are, they're the artists, you know, like, so they might not have had that exposure to those other things yet, which is kind of confusing to me sometimes because with a lot of the other sports, even golf was, golf was really far on the list for a while.

They just, I think it was seven, eight years ago, they finally decided that, you know, we're going to be like the other athletes and actually do some strength training. Um, every Olympic athlete, every Olympic sport, curlers do it. I mean, yeah, that's true. Yeah. Can you imagine like doing that little brush thing like that hard, you know, and they have to go into a split lunge like that and hold it so still. How was that? Like, I mean, I understand why they strength train, but I mean, there was, there's certain sports that are just, they're just behind is all, um, I'm sure they'll catch up. Sorry, tangent.

Yeah, no, and they will. And you guys at this point have heard me say that the dance world is behind. It's starting to catch up. I'm happy to see a couple of things popping up here and there. Um, but as we, as we have been working in the same office and having these conversations conversations and then having my own aha moments, uh, this has been a huge driver for this stage in my life and working with dancers. And when I saw such a big difference with the dancers, when I started adding in strength work and last week, I said that you were the one who said to me, Ali, why are you not training your dancers in the thing that helped you the most with your own injury?

And I think I said to you, well, you know, we don't want them to bulk. And you're like, well, why are you're, that's not going to happen. As we talked about last week on the podcast, you'd have to be in the gym working so hard hours and hours and hours with heavy, heavy, heavy weights. And I'm proof that that didn't happen. So when I got called on my own stuff and was like, oh, you're right. I hesitantly started adding it in with dancers and all of a sudden their balances got better. Their placement got better. Everything against what had been taught to me in the dance world. And I had gone back into that dancer brain when I looked at someone else's body.

Uh, now I get, have dancers that we do certain strength movements and then we work on placement from a different approach than tucking the pelvis under and their eyes. I have video after video that, well, it just happens time after time that they look in the mirror and you can see their eyes get big. I think you've seen me do that. And you're, you've asked me like, what are you doing with them that they're so excited about? Yeah, I don't, I don't quite get, maybe I don't say good, maybe I don't see it. Um, but you know, like with, with adding in strength, like, I don't know if this would be a good analogy or not, but, um, I'll first start with, I guess, strength and mobility adds, um, it adds to a movement library.

Or like a, uh, uh, movement strategy options. And so an example might be where I remember I had a computer monitor in my hand one time. And so it was big, it was expensive and I dropped my keys. And so I looked down and I was like, am I going to put this computer monitor down? No, I'm just going to slide down and get them. And so I slid down doing what we call a small knee bend, which is, you know, not a good squat. But it worked and it worked because the human body is pretty magnificent and you have a lot of movement options. So, um, if you don't have the strength to do that, they say, say my quads were weak.

I couldn't do that. Or if I had a knee injury, I couldn't do that. And so basically strength and a strength loss and injuries, um, or just, um, well, I guess be, um, uh, not doing certain things. It robs you of your movement strategies and with dancers, it's like you have a lot of things that are demanded upon you with the choreography. You might as well have a lot of options. Um, and I guess this probably simplest analogy is if I only knew one edge of like a, like a piano, if I only knew the left side of the piano, but you asked me to play Mozart, I can't. But if I knew both sides, then I have capability of doing a lot of things.

But if you're only exploring that one side, you're only getting only certain spots of what your capacity is. Yeah, I think that's a really great way to say it. And now there's no company in the world that doesn't do a wider variety of rep. Even our classical ballet companies are doing some type of contemporary work, which means that they have to use different types of movement. They have to use the other side of the piano. Uh, so if you look at it just even that way, even in the dance world, you're no longer required to just be able to do ballet. You have to be able to do a wide range, wide range of movement.

And that wide range of movement takes more strength in some ways than just being able to do a demi-plié in first. So having that full piano of movement is really, really beneficial when we're looking at being in a dance world, but it being in a company or whatever you're doing. I know you had mentioned before about, um, you, you said there was a period of time when you're Instagram where you're going to post good movers versus just good ballet or whatever. And like, I would, I would imagine like good movers just, I mean, so I'll back up. I think I've seen like three ballets and the only, really the only people I was really impressed with.

So I was like, I was like, wow, they move so strong, you know? And, uh, that was, that was Vitor. Vitor is the man. I said, I want to dance like Vitor. And, um, but he was just so strong and I, I, I, I know that you'd mentioned that's like, it's like a, you said more masculine dance versus feminine dance, but I don't know. I was just impressed by the, by the ability. Yeah. Well, and you know, Vitor Luis is, uh, an ex principal from San Francisco ballet. Um, if you listened to the podcast with Brennan Gassabia, that is his brother-in-law now. So we're just tying all the pieces together here. And we actually talked about Sebastian Gonzales in that episode about how impressed you were when we went to the Nutcracker for the first time, uh, or you had your first experience.

But I remember that you had seen, you had seen, you know, these younger dancers who are coming into the office and, um, I had showed you certain videos or things of dancers. And when you saw Vitor perform, I know, I, I saw the, the knowledge and the respect for what they have to do go up because what, when a student does a coupé jeté and they land loudly, you're like, okay. And then you watched Vitor do it and you're like, holy crap. How did he do that? Yeah. Well, even like his rebound too, I'm sure that other principals have it too. But so with running, we have, um, there's, there's quite a bit of, uh, research, which they've, they've been going on and on about like what presents, prevents running injuries and so on.

And so one thing is, um, uh, less ground contact time, meaning like you're on the ground for, I'm going to make big numbers. Say you're on the ground for three seconds between a jump versus a split second. And, um, the people who have the lower contact time actually have less injuries. Um, and Vitor is like, right. Versus clop, clop, clop. So, um, and I know it's a skill building thing, I'm sure, but, but the ability to rebound from the floor and create tension through that leg to then propel himself into, uh, the other jump, whatever thing it was. Um, it's, it's, it's, it's not only powerful and impressive, but it's actually sparing his body.

Yeah. The jumping is a, is a big thing. I think we can look at, um, I love the analogy of, uh, a ball that if the ball is full of air, like a basketball, it bounces really well. It spends, as you're just saying, very little amount of time on the ground. The rebound is good and it can continue to go. If the ball is flat and you throw it down to the floor, it goes, that's like a, that's like jumping without straight, uh, strength and tension in your body. Uh, and when we see that with like little kids, if you can imagine them like trying to jump off of the floor, they're like a wet noodle, you know, they're not like a, they're not hugging you.

Uh, it's like when you try to pick up a sleeping kid versus a kid that jumps into your arms, when they jump into your arms, they've created tension in their body so that they're, they're holding themselves in an aspect and it's much easier to hold them. Um, I think that same thing applies to jumping and for dancers, when we're trying, when we're trying to do certain aspects of jumping without having trained in these other ways, as we were saying, we haven't hit the other side of the piano. We're just kind of fighting against ourselves. Yeah, there, yeah, there's, there's, there's, there's, there's, there's those skills that are needed.

And I know that when we work with people with, with injuries, um, a lot of times we have to work on a lot of, uh, let's just say if I have someone with, with a back issue and they say, well, I want to go back into doing burpees again, you picked actually seemingly, it seems very mundane. It's like everyone can do a burpee because it's body weight and you can do it at home and it doesn't like everybody can do it actually the requirements for something like a burpee, it far exceeds something like a God, like a heavy goblet squat. And so these people, a lot of times they'll, they'll want, or actually, I guess they won't know in this case, I think it's, it's unknowing that there's other requirements that they could, that they should do ahead of time.

Um, and it'll actually make them feel honestly a lot better than just doing solely the burpees. Yeah. So I have a, I have a dancer who comes in, who's a teacher and she's been working with me for probably a year and she's, I love having her in and she really, uh, takes in and then passes on to her kids and she comes back and she'll, she always reports to me and says, okay, so my kids were doing Rondajams and their rib cage was all over the place and they were like wiggly worms. So I had them get down on the floor and we did a plank like we talked about, not a plank that we do in the dance studio, but a plank that we talked about where all they could do was hold it for 10 seconds.

And she says, Allie, they stood up, they did a Rondajam and their spine was right in the middle. There was no wiggling and wobbling. And all I did was have them do a plank for 10 seconds. I'm like, and I'm like, I know I'm smiling ear to ear cause I'm like, I know there's so many things that don't look like dance that if you do them, dance gets better. Yeah. And you know, um, I don't know if you just had a thought. I just, I don't sound trained dancers, but if you're trying to keep tension between jumps, something like a really good call external cues, it's the way your body reacts to the environment.

Like if I were to throw a volleyball at your legs and it was dirty, you'd probably jump, right? I don't have to tell you to jump, but jump rope, skipping rope like that. Those are, that's especially quicker. Like that's a lot of high tension between jumps versus being, what'd you call them? Noodles? Yeah. I actually, so when I start working with dancers and I have them jump rope for the first time, uh, it's kind of funny cause they, they jumped, they try to jump so high and so slow and you can just see it's so much effort for them to jump rope. And I'm like, is that how you jump rope as a kid?

And they're like, I don't know. They don't know. So I have to, I have to cue them to jump faster, smaller jumps and just let the jump rope pass underneath them. And what they don't realize that we're doing is exactly what you said. We're training their tension, but it's because they're like that, that ball without the air and they're trying to jump like a dancer instead of just jump rope, just jump rope. And then when you do that, your petite allegro gets easier because you're jumping quick and you're like the blown up ball, not the wet soggy ball. Yeah. I think it's, yeah, there's a lot of, there's a lot of fun things you can do with people that will build skills and, uh, some of them don't take that long.

I'm sure that within a single session they improve that, you know? Um, but yeah, what do we, what do you want to talk about today? I don't even think we've even started anything. Oh, that's kind of just the intro. Uh, well, after last week sharing what we had, uh, what we had gone through you and I together, as I came to you, I know that it had been two years of me going to different chiropractors, acupuncture, uh, different deep tissue. I did laser for my hip cause I had that labrum tear and you kept saying to me, I think, I think you need to squat. And I was so hesitant to squat and you said, I think you need to hold a weight.

And I was like, no, I can't. My dancer brain was freaking out. Um, probably the experience more traumatizing to you than it was to me. I probably just did a fleeting like, yeah, you should do that. Yeah. You, you probably were. And it probably stuck with me for my entire life and will in a good way now, but, uh, yeah, that's probably true. Um, so when you, when I came to you, I had imaging, I had doctors, I had surgeons that had told me I was going to have three, two surgeries and a hip replacement by the time I was 30. Um, and you had come and said, I think we can do something with this. I think, uh, well, am I allowed to share all this stuff?

Yeah. Um, yeah, I think, um, yeah, in the beginning we tried a bunch of tissue work, just like, I'm like, I can do better tissue work than you got. And that didn't go. Yeah. Cause you're good at ART. Yeah. That was your, kind of your specialty back in the day. Yeah. And that was, I mean, I think there's a time and place for all that stuff, but, um, on like kind of like pushing onward and upward with, with your thing is, uh, if it doesn't have a lasting response in like two weeks, three weeks, then something's probably missing. And that's usually what I go back to with a lot of like, even I had, I had a case today.

She had a, she had a short, she had a shoulder and she had a sloppy shoulder. She actually dislocated it. Um, and she had, she had some pain. Um, and I saw her a couple of times and so she's gotten better, but there's still something there. And so we, we did a, a single remedy and she's like, oh shit. Like she can put her arm like all the way between her shoulder blades after that with no pain. Um, and I guess my point is that there are some very simple remedies to have people do based upon the injury pathology or problem they have, but it's hard for them to see. Cause I even looked up Dr. Google today cause I was doing a video of something and it was, it was like, it was actually on hip impingement actually.

And it said, what is the most effective treatments of hip impingement? If you guys can look this up, you'll probably see it. It'll be rest. Number one. Number two was don't do that, which basically don't do the range of motion that, that irritates it. Um, there was exercises, which is extremely general answer. And then there was over the counter, over the counter pain medication. And yeah. And that's the, so that's what people are looking up. And like my whole video that I made today was, I understand you guys are looking this up and this is what you think everything is, but this is not even close.

So, I mean, probably the closest thing in there is don't do that and exercise, um, or specific exercise. But if you feel like you've tried everything, you probably haven't. And Allie had not tried everything either. Um, we did a diagnostic ultrasound, which, um, if you're talking about imaging options, I know that probably a lot of you have thought about this. X-rays won't show that much. They'll show angles and whatnot, but it's, it's extremely not useful for most hip impingement cases or labral cases. A labrum is a soft tissue. It's actually over in gasket of the hip. And, um, I, I've never been in a cadaver lab where they've done it, but if you just, if you pull it out, it goes, right.

It's so hard in there. It's so sticky in there that it actually, um, it, it keeps it like nice and compact because your entire body frame sits upon two of those joints. Um, but imaging to look at, look at a labrum, even an MRI is not useful. You need an arthrogram, which requires dye injection, which is pretty darn expensive. And I had a patient that did this one time and they said that was the most painful thing I've ever done in my life. It turns out she didn't even have a hip problem. She had a, she had a nerve problem and it wasn't even needed. But either way, we did an ultrasound because all the other stuff was, um, so musculoskeletal ultrasound.

If you have a really good technician, you can see stuff. And so the sonographer that we used, um, he, he was very honest. She said, look, I like, I, you can't always see labral tears in there, but she clearly has one. And so you can do an MRI with, with, with dye if you want to, it'll just confirm that she has one is all, but I can clearly see it. Um, so with that being said, Allie had a structural pathology or she had, um, structural abnormality or tissue disruption. Okay. Tissue disruption. The example is if I tore a muscle and it bled, there's a gap in there. That's tissue disruption. It doesn't mean you're going to hurt forever.

It just means that the tissue has been irritated or spread. I don't want to say damaged because again, you won't, it'll function perfectly fine later based upon the, the, based upon the ability, uh, the, the, the degree, but yours was pretty big. You can squat deep as you want to now. And, um, even to the splits. So, but, um, the, the more structural damage you have or the more tissue disruption you have, the harder it is, is all. And so I think everyone that has to be aware that number one, that if you see an imaging finding of a impingement or a labral fraying or a, they're going to scare you when they say tear, a lot of times it's just incidental findings.

I had a pretty, pretty sure a labral tear plus an acetabular fracture from baseball. I have no pain whatsoever. And you play baseball weekly. Weekly. Yeah. So, and I can still sprint. That was, I think when that one happened, it was about. Four years ago, I was, I, I ended up, I was jumping for a ball and I landed on my left hip and I twisted over the hip and I felt right. Immediately started limping after the next three innings and I couldn't sprint anymore. I mean, I was, I was lame for about three months after that. Um, but it got better and I don't have any real problems anymore. So I think the, the thing I want, I think everyone should understand is that you're going to see things on images, which do not mean that they are the problem.

I don't know how many people I've had with positive imaging findings who have, who those imaging findings have nothing to do with the way they feel at all. Um, I've had people with MRIs of their back that it says they have a herniation in their, in the, in a disc. They don't have pain whatsoever. I have people that I remember this one guy, he was really confused by the whole thing. He had a negative MRI and he, he's like, he's excruciating pain. I'm like, well, why do you think that is? He's like, I don't know. I'm confused. What could it be? I'm like, well, imaging is just a picture in time. And most of the time when they take the image, you're in a position of comfort anyways, like laying on your back.

So I think that's the first thing. And so you're, you had a positive image. Not everybody does. The second thing is, is that everybody, there's a progression of getting into a labral tear, which is typically correct me if I'm wrong. You could remember times where that hip felt bad before it felt really bad, right? Yeah. So there's a hip impingement or groin pain is usually a precursor to, and it's extremely reducible. There's no, I don't, I don't know a hip impingement case over the last two, three years. I've had to refer out even for a medication injection or anything extreme. Go ahead. You can stop me if you want to.

No, I was just going to say that as I, as I've become more knowledgeable and understanding more of what you're talking about, I also find that when dancers come in, because it's very common, they come in and say they have a hip impingement or pinchy hips. That's how people like to say it in dance world. But there's, it's very easy for me to make a change in them. So if I can make a change, you can make a major change. Yeah. They're, they're using it that hard. I love having hips. Actually, I love having hips with people who are compliant and they listen. Oh, I guess I'll put it that way. Cause if you're convinced that your hip thing is because you're damaged, you're the hardest case in the book because to get you to do the thing and not feel like you're broken is the hardest part.

People are the hardest part of their recovery. It's not the process. It's them understanding and understand the process, understand what their, what their requirements are, what their work has to be. Um, and I know with you, so we did get on the squatting route, but I think it's important to realize, uh, important to, to probably preface this first sometimes, or a lot of people when they have hip impingement or labral tears, they can't squat. And so I couldn't squat. It was barely a hover. Yeah. You did like a quarter squat or something. Yeah. And so it wasn't pretty. We, so we had to, we had to get some things protected first before you squat.

So some of those things might be a specific corrective exercise. I think in this case, we loaded the hip, the, the outer hip, the glutes. We did some glute primers and things like that. And then we explore the, the hip range of motion out of gravity. Um, correct me if I'm wrong. I think, I don't recall anymore. You couldn't squat while you were actually standing, but doing a quad rock exercise, you can go through full range. Uh, I could go through more range. So quad rock would be on your hands and knees, rocking forward and back, uh, with a straight spine. And I could, I could go through much more range that way.

I think I couldn't go to the full, but it was pretty, pretty significant. Yeah. And so I think it's like, that's an enlightening thing for a lot of people to find out. And if anyone is dealing with a hip thing right now, um, if you try to squat into a chair, which is about pair, about parallel to most people, and then you get on the ground and you rock down into like a frog position and you feel it feels normal. That means there's nothing really too bad with the hip. It just means you can't control your body through gravity. And so we have to build up some support systems in there and then get you to pattern through the movement and then load the movement.

Um, so usually I'll have people, and I think that we did this too, is we, we tackled the hip hinge. We did a variety of a deadlift, not. Which I had never done before either. Yeah. You scared me when you said deadlift. Well, you know, I don't know why they name it deadlift. Let's just call this, pick up a heavy thing of dog food. Yeah. Okay. Cause it basically, when you pick up a kid, if you're not doing the underarm scoop, if you just, well, maybe not a kid, um, if you pick up a box, you're probably deadlifting. Um, if you're scooping up a kid, you're going to probably be squatting and that would bother most people's groin if they're having a groin thing and they're groin sensitive.

But deadlifting, it actually requires a little, it's more hip, uh, it, there's more hip protection. And so usually, and I remember at a guy like this, this was a knee case. This was, it was a fun case. Um, there's five basic, have you talked about the five movements? I'm not sure if I've talked about it on, on the podcast. So there's, there's five basic movement patterns, which we can load through exercise. And so the body is basically one unit here. If you have on Dan, John, I'm sure that you guys will go over this a little bit, but the body is one unit and actually doing a pushup can help your hip.

It helps support your hip because there's tension throughout the abdominal area, as well as other things happening. A pullup can help your hip. Now I had a guy before that he had knee pain and so it hurt him to squat. We're just going to squat to a bench. And so he, he like, we have a good relationship. He's like, oh man, I don't know what's going on with his knee and knee. And I was like, man, we only got like 30 minutes here. I'll tell you what, why don't we deadlift first to, by the way, he, um, he was about 60. I had him deadlift roughly about 35, 40 pounds from a block. Okay. Stuff he's going to navigate throughout life.

So we weren't like crushing him or anything. Um, I had him do a pull and a push in a carry, a loaded carry, which is, um, I had him carry like a 25, 30 pound weight in one hand. He came back and he squatted to the bench again. He's like, oh my God, it didn't hurt anymore. And so at that point I realized how supportive the other movements are. The body is one unit. Granted, you can say I'm going to work on my hip flexors today, but you're not going to isolate a thing. You might as well just link these muscles up in, in the fashions they do. Like, like when you, when you grab what, I don't know what, uh, um, if you were to run, do you tell your knee to bend and your hip to extend?

No, it's, they work together. The body works together. So when programming stuff for you, obviously we look to see if, as are you surgical case or not? And it looked like you weren't and also you didn't want to, um, you could have done an injection, but we found that there was positions where it wasn't painful. If there's, I guess I should address this too. People tend to think through thing is inflammation. Okay. Have you ever had like, um, have you ever had, uh, a rash on your skin or let's just say a sunburn, a sunburn? Does it ever fluctuate with where you're at? What position you're in? If you're in or out of the sun, does it ever change how it feels?

No, it's always a sunburn. Yeah. It's just, it's sunburn until it cools down. And inflammation is kind of the same way. If you imagine like how it feels throughout the day, whether you're sitting, standing, walking, running, jumping, whatever, it's a straight line. Right. But when people have undulations, it's like, oh, it's worse when I sit, but better when I walk. Like these are undulations or you find zeros. These are extremely easy rehab cases. But if you're not experiencing a change, it's because you're trying, number one, you're trying the wrong thing. By the way, uh, home care does not always count as good care.

I know a lot of people try it on their own, which I got no problem with, but don't expect the same results all the time. Um, and the, and the second thing is you might've found, and I mean this in the nicest way, you might've found someone that doesn't know what they're doing. Um, I don't know what I'm doing with a lot of things. And I try to be brutally honest with my patients about it. If you don't have a good change in like two weeks, uh, meaning a reduction of symptoms by 50%, not restored full function, but do you feel 50% better with normal activities a day living, then we're on the right path.

But if it's going on and this is still not changed, I chose the wrong thing. You're doing the wrong thing. I'm not the right fit for you. Or maybe this is some type of intervention that you need something more advanced. Um, but I think being brutally honest with people about that and if you really, whatever you guys are trying right now, if it hasn't been working, it's probably not going to work. Yeah, that's, that's exactly what I, I think what got me to try a different way with you. Uh, cause I had been going for two years and I saw minimal, minimal results. Um, and I realized I had to just change my frame of mind because I was still trying to rehab like a dancer and it just wasn't working.

But as you were saying, you were talking about how a pull-up can help the hip, how a push-up can help the hip when we're looking at the full body as one piece and that they support each other. I was just talking to a dancer today and that was a big question is, uh, we were talking about my new strength program. Uh, she asked, which is a great question. What muscles are we going to work on? All of them. Yes. I was like all of them. And she told me her specific ailment that she wanted to work on. And I was like, listen, I'm going to be honest because I want you to feel great about being in this strength program.

Your one problem is not a solution of I'll do this one exercise. It's how we look at the whole body. And that's exactly what you're going to find in my program. So you can't come in to me and say, oh, I want my posture to be better with my shoulders and not expect that we're not going to look at the whole body because I, I think the posture is the great example, especially for a little bit, if we're adults, we all know like, oh, I don't stand up as straight as I used to, or I sit over my computer or whatever. And I just, I always think it's a great example when it's like, well, how long have you've been trying to pull your shoulders back?

And you're like, oh, for 20 years, my whole life, I've been trying to pull my shoulders back. Has your posture improved? No, not really. Ah, because we're not attacking it from the right place. Like we have to look at how the whole body supports. And when that happens, we saw, we see much quicker, longer lasting results. And that's what was missing for me was that full body approach. Not just the, ah, my hip flexor, ah, my pinchy, uh, it was, oh, I guess I, I do need to look at the rest of how my body supports. And that's part of my, um, my daily practice now is how the, how I set up my torso for the day.

Uh, it's super important for my hip health. If I don't keep up on my, my torso strength, if you've been doing my core workouts, you'll know what I'm talking about or my quote core. I, then I know down the road, I'm going to start feeling my hip stuff come back because I've lost the support and the balance there. Yeah. And I think that it's probably important to classify that, like say with you, um, you have, again, I'll revert back to a structural deformity. Um, once the deformity happens, then we have, it's, it's, you're swimming upstream a little bit. It's not like you can't feel good and you can't do a lot of good things, but it takes work.

And, and I'm, I remember, uh, I was at the bank one time and the teller was like, oh, I, she looked at my account and she's like, oh, cool, uh, sports care, right? Yeah. Great. She's like, I had an ACL injury before. I said, cool. Well, how'd your rehab go? She's like, I'm all done. I'm like, oh dear, you're never done. Like, because you had a repair. And so it's different than having like hip impingement is not a structural deformity. A labral tear is, or, or fraying. And I might change my opinion over the years, probably on this. I might have to rewind the talk yet. Oh, we all reserve our right to, to educate more.

So, but yeah. But if you have a tear, say you have your plantar fascia, you only have half of it. You got to expect that there's going to be, uh, there's going to be some flare ups here and there, but it doesn't mean you're destined to be disabled. Um, just do something about it. Like be empowered about it. Like, like, like I know I've had disc herniations. I've had a rotator cuff tendonitis. I've had two hamstring tears, um, and, um, oblique strain. I've had all this junk. I don't feel any problems whatsoever. And tomorrow I plan on actually towing a car. I'm going to walk with a car behind me.

That's going to be my fun workout. We're going to try that. Yeah. Cause that's, cause that's good glute work. Yeah. So you have seen some of my dancers at this point, uh, that have had some hip things that just aren't quite getting back to a hundred percent. What do you see with them and what are some like common threads of exercises or things to focus on that you see with some of these dancers with hip issues? Um, after usually I'll do an eval just to see, to take a, like to gather the data we say before I make a wild guess. But, um, some commonalities are that, you know, it's funny that some dancers will, they'll actually say you have a right hip problem.

When you have them squat, they'll actually put more weight into the right leg. Is that normally what you see happen? Are you saying that's different as a dancer? Well, no, it just doesn't make any logical sense. And let's just go down the logic route with this. Cause it, cause this does happen actually quite a bit. Um, so let's just say if you, your right leg hurts, your right hip hurts, why would you put more weight on it? It doesn't make any logical sense. So you could be overloading it because of an old problem. And sometimes when you get on the question round of these people, it's like, you ever hurt yourself?

Nope. You sure? Well, there was one time I had left, left ankle. I had a left ankle turn or, you know, things like that. Um, and so they'll hurt the other side sometimes, and then they'll acquire a new movement strategy or a new compensation, which then leads into more demand and, uh, force on that right hip. Um, and so in that case, this would, it'll seem kind of obscure, but we load the left hip and the right hip gets better and it can happen within a single session. Um, I did have that one with a, a heptathlete one time had that and she was just like, what the heck? Like, yeah, the bull, you're drifting off this other side.

So why don't we just see what happens? You know, um, the other thing that we do a lot of too is we, we work the backside or the glutes. And so I've seen you use the banded bridge quite a few times. Um, there's also a kind of a reachy exercise of the accordions that tend to work pretty well. And I think it's, it's really, uh, those recommendations are based upon, uh, really if the person is coach, extremely coachable or not. Like the banded bridge is hard to mess up for most people, but funny, like you see a lot of the, like I've noticed the more work I work with people on the floor and give them a, give them a suggestion, the more information you get about what their underlying thing is.

And so some people, you have them do a banded bridge and they say, ah, my hamstrings, you know, it's like, oh, okay. You're, you're a hamstring dominant person when the hamstring is really an accessory hip extender. The glute max is the engine. And so this exercise is for your predominantly your glute max and you're, you're picking up all the weaker, smaller muscles. So that's one. I have to jump in. Cause I think that's really important for dancers to hear. And I want to kind of say that again. Um, we, as dancers are taught to be afraid of having glute muscles were told to always tuck under our pelvis and it shuts off the glutes and it puts changes the hip, the way the hip is sitting and the structure.

And, um, we, we have been taught to have a certain aesthetic, the way our body looks the way some ballerina down a hundred plus years ago, like had great strong glute muscles that were really small. And so we decided, oh, everybody's body is like that. And that's not to say that you have to have big glutes to have strong glutes, but mechanically anatomically, you're saying hamstrings can't be dominant. The glutes have to be the driver, the engine. And as an athlete, that's really important that if you're jumping, if you're moving forward in space or any direction, um, that we have that balanced ratio.

So when a dancer has not done glute work and not to the, I promise most dancers haven't done the, the, uh, push to the level that you demand of your glute work, uh, we're not, we don't have the right balance. So this is a really great example to me tying into dancers, uh, of where it's not about having big glute muscles. It is about making sure that they're doing their job and that you're not recruiting other muscles for whatever you want to do as a dancer, that jeté, that pirouette, that extension. Yeah. And, and yeah, the hip is the main or the glute is the main extender. It's the main engine.

I would, all my patients, I call it the engine, um, for the shoulder, it's, it's going to be the lat and the pec is one, two. So there's, there's groups around the body, which are kind of like the engine, especially you're in the ball socket joints. And so, um, I guess the first note is that you're right. Yeah. You don't need to have a big, big glute to have a strong hip. Um, there's tons of very small, petite, lean people who are extremely powerful. And then based upon, you know, what, what, what God and your parents gave you, you might have a bigger booty just happens, you know, but it doesn't mean you should try to like get it to go away.

It's just what you got, but make it function. Well, for God's sake, um, you're going to have it, you might as well have it working for you. Yeah. Might as well work. Um, I mean, shoot, you know, again, you, you try to drag a car, um, or walk up a hill, try not to use your glute. You'll, I guarantee you'll get a hamstring spasm. Um, and, and also something too, which I know that we'll go back into the other exercises too, but, um, there, there's, there's common patterns we see with like pathology or injury. And there's going to be some research articles, which will not validate this, but let's say we're talking about majority of them or it's like, so we'll read through like research papers and just kind of look and see, Oh, I wonder what's going on.

And so, you know, there's ones that quote other ones and so on. And, but for the most part, if we say we're talking about shoulder, it's like, Oh, the, like we're talking about, uh, rotator cuff, uh, injuries, or we're talking about, um, subacromial or pin pinchment of the shoulder. And you see that, well, these muscles are on and these muscles are quote unquote off or dormant or underutilized. It's like over and over again. It's like, Huh? Okay. Why don't we massage those ones that are always on and then strengthen up those ones that are always off? Like it makes logical sense. And then we see with the hip, the same thing applies like the glutes typically quote unquote off.

It's not off. It's just not, it's just not tip top shape. You see the low back muscles be very on and very helping. And you see the hamstrings very on and helping. And you see these common patterns throughout the rest of the body, um, that, uh, you see them across the knee and the foot and the shoulder and the neck and so on. You see them all over the place. Um, so you might as well just go with what logically has been observed. You know, it's been observed. Um, everybody's a little bit different, but you might as well just go with, with that. I think it's your best bang for buck. But again, back on that thing where everybody kind of looks up Dr. Google and what Dr. Google says is, you know what?

Ignore all that. I just want you to kill the pain or they'll say, you know what? I just want you to only rub out those ones that are always on. And so with the hip, rather than thinking about like, let's say we're talking about hip flexors, rather than rubbing out the ones that are on, don't think of those ones as being overused, overuse injuries. Think of the, think of it as an injury of underutilization. You're not letting the other things do their job. And so it's the squeaky wheel gets the oil in this case. And you know, if you stop oiling it, I don't want to guarantee you, but I'm pretty sure you get better a lot sooner than you would if you only did one, like only tissue work or TLC to that one thing.

Yeah. Yeah, for sure. That sounds very right. And, or it just sounds very accurate. And, uh, I think that that's one of the things that's happening in the dance world right now is that we are not utilizing that logical sense of what smarter people than us have observed. Uh, we're just sticking with what's being passed down. And as you said, with like what's turned on and generally in the hip for in or not turned on, you said low back is turned on. Hamstrings are turned on. Dancers. Does that sound familiar? Your teacher saying lift from the back of your leg and tuck your pelvis under. And you feel like, I don't know if that's what you guys thought, but that's exactly what I thought is you said that I was like, oh my gosh, low back is like fired on completely.

And then the teachers are telling you to lift from your hamstring, which I don't know how you do that. Uh, so it's, you just described dance in, as you described what's turned on and turned off in dance, uh, in hip injuries generally. Well, if you guys look at lower, don't, don't look at how to solve this, but look up lower cross syndrome. And then if you have shoulder neck issues, look at upper cross syndrome. And basically all the things that say they're quote unquote on is, um, they're going to be, they're called, they're called tonic muscles or, um, the ones that are off are called phasic.

And, um, I, I was writing something up a year or so back and just with these general observation theories. And, uh, someone asked me finally, they said, is this validate with research? I said, well, you're right. I'm going to ask somebody. So I asked a PhD about like, I'm like, is it okay to use stuff in sports medicine that is not validated with research? He's like, he's like, they've never done it in this one might be misquoted. He's like, they've never done a research article on any 13 year old volleyball players. Do they get treated? He's like, most of the stuff that you guys are going to do is actually based upon theory and it's not proven because it takes too long to prove.

And so certainly go off general observation, but if you're not getting where you're supposed to be going, then stop, you know, and don't go against the grain. Like flexibility, like stretching, static stretching is completely against the grain. Passive stretching. Over and over and over again, it shows that people can't jump as high. People get slower and it doesn't stick. And so if me as a healthcare provider suggesting that for the reason for a performance would be subpar and against the grain. However, if I need to do that passive stretch for one specific reason, say like a post-op knee, then yes, like there's certain circumstances for everything, but it's for the most part, if it's against the grain, don't do it for most people unless there's a real good reason.

Yeah. Well, you just keep coming back to the, you should see results in your change in your body in a few weeks, maybe not a hundred percent, but our bodies are resilient. They're meant to, they're meant to want to feel better and to keep us at that level. So when you have the right information, change happens. And if you've been doing something longer and you're seeing minimal slash no results and they're not sticking, it's time to find something else. And that's, that's where I was at. Well, you know what, one thing too, I don't think we hit on this. We did hit it with the 15 year old boys and weight training, but most of the time when people are dealing with a hip thing, like I'm going to call, I call them things because once you start labeling them as like a tear, like all of a sudden people, oh my God, I won't get better.

Right. If you're dealing with it, it's probably your first time through it. And I've seen it a bunch. You've seen it a bunch, Allie. And, and so we, we might sound like know-it-alls, but think of it like grandmother saying, oh, like I've seen this a lot. You know, it's called case recognition. It's like, oh, we've seen this. We know what we should be trying, but every, nearly every single person, or let's say every single person, their first time doing something is going to try their own stuff and they're going to try a lot of things that don't work. And there's nothing wrong with that because there's a lot of hip conditions that will get better by not doing anything extravagant like we're talking about.

But the insanity is trying the same thing over and over again and expecting different stuff and just sticking to your guns with that. That is the crazy part. So please, if you're, that is you, please listen to these words of advice. But if this is your first time, sure, stretch it out. Like it might go away. You know, they do. I know they do. No, I'm laughing at the stretch it out. Well, I mean, you think about nature's way of like, I wonder if people like rub their legs sometimes, people limp. Nature's way, like people, this is, this is therapeutic for some reason. If it's loud, you cover your ears.

There's things that naturally occur, which will work in a lot of cases. But if they don't work, you need to start thinking outside the box and don't stick to your guns on those things. Yeah. Yeah, totally. Totally. And you know, we do. You're right. 10, 12 years ago, I did what I wanted. Yeah, you sure did. I sure did. How much money did you pay doing all this stuff? Yeah. I know I told Sebastian Gonzales that I figured out in one year, in one year, I probably paid over 20 grand for care. And I don't know where I got that money. I don't know. I don't know either. So just to let you guys know too, good care is not always extremely expensive long term.

I think the last hip case I had that was a dancer, to get them back into dance again without really, like it was about 90%, 95% resolution over the course of two months maybe. Um, they paid under $700. Yep. So it's, it's higher price per, per interaction, but you do, you do the work, you get better. If you don't do the work, you're going to pay for babysitting. Um, but 20 grand is, that's ridiculous. Um, I hope no one ever has to pay that amount. Like you shouldn't have to pay more than a couple thousand dollars unless you get super surgical, you know? Yeah. But just do good work in the beginning and do your research about who you're going to work with or stretch it out.

We're saying that jokingly, by the way. Uh, yeah, no, it is. And I, you know, that, that extreme amount and that knowledge, um, wasn't wasted on me. So, uh, it's, you know, if you've been following me for however long, uh, I think this last, you know, a few weeks of being at home and having, uh, Instagram take over basically everyone's lives and we're doing everything through Instagram as dancers right now, it's given a lot of people a chance to, I think, listen to what I'm saying, how I'm saying things, what I'm saying as they're listening to are doing workouts with me. And, uh, the, what I'm sharing comes from 10 plus years of research and from my own experience and wishing if I could go back, actually at this point, I wouldn't change anything because, because of that, I, I am where I am today and I do what I do and I work with who I work with.

Uh, but yeah, I wish I didn't have to have spent that money. I wish I hadn't spent two years on at an eight or nine on the pain scale. You know, I, I look back and I can, I can say, yeah, I wish I had done that differently. So, um, I've been talking to a lot of dancers lately as they've been reaching out about my strength program for the year and what it entails and if they're right for it. Um, I've had quite a few people actually reach out about labrum tears. And I think that that's because, you know, that's what I shared last week on the podcast and, um, whatever that, you know, whatever drew them in, but I've had to, you know, say to them like, okay, so I'm not saying this as I'm not saying this as a trainer.

I'm not saying this as someone who has a program. I'm saying this as your dancer friend. I'm going to be friend right now. It's taking too long. You need to find something else to do. Like, don't be me. You're, you're nine months into this. Don't be me. Stop right now and let's find something else. And they're like, Oh really? And I'm like, again, not saying that as, as a trainer, I'm saying that as Allie, the professional dancer that lost her career and wished I had somebody, I wish I had Sebastian when it happened. I wish that somebody had told me that there was a better way than what I was doing.

So I've actually, that's actually happened. I've had these conversations for the last two weeks, quite a bit today. I had two of them. Um, so, you know, it's, it's, it's sad when I hear their frustration cause I like, I can feel it so deeply, but at the same time, I'm like, no, there's so much hope. And that goes for so many injuries that we're seeing in the dance world. I'm like, nope, there's so much hope. You just haven't found the right answer. Yeah. Well, it takes, uh, it takes an active listening, uh, on their part to really, and to be able to absorb the stuff in. Um, I've told, I've told, I don't know how many people with back pain and hip stuff and oblique stuff.

Like I get email, I get emails weekly from people randomly seeing, you know, my stories and so on of, of recovery. And honestly, they don't listen, you know, and, uh, or they don't take, they don't take the advice given. Um, you know, sometimes they want a quick fix. There is no quick fix. There's, there's no good long-term quick fix. Um, and, and so I think they just have to, to be ready to, to listen and accept the information because I remember I had one guy on my phone, like, this is probably the only person I ever recall in recent history that he, he actually took me up on, um, what, what I'm, what I, what I say to sometimes people on the phone.

And so he had, he had something like he explained his case. He had a back, um, but he had back pain. He explained his case and, uh, he asked how much and I told him and he's like, ah, I'm not, I'm not going to waste any more money on this. And I said, hold on. You know, I'm like, look, one sec. I want you to know, I'm not trying to get you to come in right now. I'm trying to talk to you as a human. What you're doing right now is not working. Give me a chance or give someone else a chance. But I'm telling you right now, what you're doing is not going to work for you. That's it. And I hung up and that's it.

He called back an hour later and he scheduled an appointment. Um, two weeks later after seeing him, he calls me and he says, uh, he's, I want to thank you. I didn't tell you at the time, but I was actually, I was going to have surgery the day following I met you. And so he had, uh, uh, like a 75% resolution of symptoms within, within two weeks, just by doing three exercises. So people don't always listen, which is a very sad thing. I wish they would just listen a little bit and consider their options. Um, and I mean this out of frustration because it's, we, I'm in the profession to help people and people don't always want to hear the suggestions you give.

I don't know why, but anyways. Yeah. Well, I think, uh, I think that when it's not, we've somehow come up with a society that's just so instant and just wants to be pampered. To be honest, like if you said to a stranger or I don't know, I will say me, if you said to be like, would you like to do 30 squats or get a massage? Probably. They're probably going to say, I'd rather get a massage, right? Like I'd rather I'm stressed. I, I already do so much. I don't know. I think I'd rather not have a stranger touch me. Yes. I can see you saying that, but just in general, uh, just in general, I think when we look at what's like, what the general person is feeling in the world, it's like, huh, well, you're telling me that maybe I could feel better if I get deep tissue and you're telling me I have to do some work.

Yeah. Okay. Which one do I want to choose? But the results are completely different. They're night and day. They're long lasting versus massage feels good in the moment. Well, they can be quick though, too. And I think people forget that and they, and they think, oh, I don't want to, I just want a quick fix. It's like your, your resolution of your symptoms and actually return to your dance can be quicker and cheaper, but you got to work than it would to do X, Y, and Z. And by the way, I'm not bashing. I've done tissue work for a very long time and I think it's important and even adjusting because I'm a chiropractor by trade.

Um, I have a friend who made it, he made a good quote, a good doctor knows when to, when to do something and when not to do something. It's not just sticking everybody with the same thing. And so, but, but they can get a quick resolution by doing the stuff that we're talking about. It just takes a little bit of effort for a couple minutes. It's like less than an hour of total work out of your life over a couple of weeks. Yeah. Well, and for dancers, they put so much effort and time into their training and we're talking most dancers, I would say would spend three to five hours a day doing something.

And then when you get more into your career or trying to get more advanced, you're spending sometimes 10, 12 hours a day. It's like you're working so hard. There's such easy solutions that will make your day feel so much better and that your results will be so much better when you add 15 minutes of strength training in and you stop looking like a dancer, stop moving like a dancer for that 15 minutes. And, and be open to the A equals B, not, we're going to go around the path here. So, um, it's, it's crazy. I think, I think you can put this on my gravestone now. Um, it's, uh, I always, I usually tell people that they're like, I'm like, oh, well, this is, this is simple.

And they're like, oh, this is hard. I said, I said, it's simple, not easy. Yeah. So it takes effort, but the resolution of most groin, low back and, and knee stuff is really simple. Just put a little effort in, like you need some guidance, but put some effort in and you'll get there sooner than you think. It's simple, not easy. If it was easy, everyone would do it. That's right. Yep. Well, thank you so much, Sebastian Gonzales for coming on. Allie, thanks for having me on the show. That was a good time. Uh, we always have good communication on the podcast. We should just do more of those. So, uh, everyone go to the podcast notes to get a link to Allie show, or you can just simply search on any of your iTunes or podcast players beyond the point E because it's a point like dance point.

There's an E on the end beyond the point podcast. And you'll hear, um, she has, uh, a handful, quite a handful of episodes in there. So, um, really good content. She puts a lot of thought and effort into it, and she's had some good interviews on there as well, not just mine. So, thanks for being part of the movement, and I'll see you guys next time.