Common hip pain questions answered: back, glutes, leg length and more

Hey clinicians, before we start, I'm going to draw your attention to the premium version of the podcast that we have that we released back in January. It's going very well. It releases once a week and it's all the stuff that you care more about than some of the general conversation you might get in some of these free version podcasts. So it's about 15 minutes long. We do case presentations, all of the stuff that we tried, things that work, things that didn't work, and a little bit more specific to you and the things that you wish might be in there too. It's very affordable. You can quit at any time. There's a link in the description below.

Go check it out. You'll love it. Now onto the podcast. 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 guys, this is Sebastian with the Restoring Human Movement podcast. Thanks for joining the Movement Movement. If this is your first time on the show, welcome. You should go backwards into the archives as a release. And once every two weeks at the moment for about a 30 to 45 minute long format. This is for the general public to understand a little bit more about what's going on with your body. And maybe you get some tips and tricks about things that you could be doing, or maybe easy things and solutions and treatments that you maybe haven't thought of yet.

We're going to be covering hip pain today, and that would cover front and or back of the hip, as well as some other associated symptoms you might find with it too. We did other podcasts on the same topic. So again, go backwards in the podcast, subscribe to the channel, and you'll get more that actually come out to you. We have a dual version today. We have Dawne Costantino here. Hello. Dawne Costantino is, I'm going to go this way today with the mic. I always do this. Yeah. So let's see what the mic is. I apologize, everyone. We're trying to make it so that the mic and audio is the best because you ever go to a podcast and you're like, this audio sucks. Yes. So we're going to try not to do that. So we're going to ask each other question answer today as if we're doctor patient. And these are questions that we've kind of heard before from people. So we want to make sure that we cover as much ground as we possibly can about the topic of hips. So you guys won't have to go Google anything else. You'll just listen to this podcast over and over again. Dawne Costantino, do you want to be the doctor or patient first?

I'll be patient. Okay. All right, doc. So my back hurts too. Could it be related to my hip pain? Yeah. Are you talking about your low back, right? Yeah. Okay. Yeah, it could be. It's really common to have both. Do you think they're connected? Well, one came on first and then the other one came later. So I think it could be, but I don't know. You're the, you're the expert here. You're just here for my opinion. So which one came on first? Let's say the hip first. The hip came on first, the front or the back of the hip. I'm going to go back of the hip. Back of the hip came on first and then the back came. What's the back feel like? It's like, it's just sore all the time. Do they hurt at the same time? Sometimes. Then I'm going to say maybe. Okay. If they hurt at different times, then maybe not. Maybe they're different things. Uh, Dawne Costantino, as a, as a doctor, have you ever seen someone that actually their hip and back pain is different? No. Okay. I had to think about that one for a second. I'd probably agree with you too, but I, we were talking earlier about a couple of cases that we've been having trouble with. Right. Um, so I had one where the hip, uh, I believe he has arthritis of the hip and it is restricting his functionality, but, um, I think that lack of movement in the hip is creating his back to hurt, but you probably see it the other way sometimes.

Absolutely. I mean, sometimes you don't really know which one came on first, but most people want to know, like, is my hip creating my back or is my back creating my hip? It doesn't really matter. Um, we just need to figure out how to get rid of both. Okay. So how do you get rid of both? You come in and see us so we can figure some stuff out. Yeah. Okay. I like that. Uh, well, you know, the, um, yeah, I think back pain, especially when it's like low back or like a tight QL or a tight hip flexor or a tight, um, it's actually really common to have like the, um, what do you call this area? What do people call this area right there?

I call it the flank area. I don't really know. So as area, like, but superficial. So as not, so as, so it's almost like if you put like, it's almost like it wraps around to the lower groin area and that area is super common. And when that happens, sometimes they call this a sports hernia, but it's not, but it's not always the way you did that. I've been trying to work on theatricals. So it's perfect. So, um, I've noticed with the dog and even kids, if you're animated with them, they love it. Oh my gosh. Yes. Especially when your voice goes higher and they're like, I'm doing something right. Yeah. Yeah. Whatever we're doing, we're going to keep, they're like an instant feedback tool. Like I gotta, I gotta talk this more.

You can say like really bad things in a high voice and they love it still. Oh yeah. It never sounds bad. Do you want to take a, take a bath? Oh, I would love to see this relationship. Okay. So, uh, let's go with me as the asker of the question. So my foot feels numb. Is it my piriformis syndrome? It's possible. Can you enlighten me? I'm paying you for your opinion. Sure. So I'll start with talking about piriformis syndrome and kind of the idea behind it. As long as people know, piriformis syndrome usually is the concept of the sciatic nerve running either through it behind it. Um, but it's being compressed on by this muscle. So the sciatic nerve, um, supplies the entire lower limb into the foot and into the toes. Right. Um, so it's lower back of the limb. Yes. I guess we should say. Yes. Back side of the leg. Um, and so if it's depending on where your toe is numb and you know, that nerve being, uh, affected there, then yes, it could be the cause of it. But most of the time, what we notice is the piriformis muscle itself is not actually the true culprit. It's more of a secondary. It's tightening up for either protective reasons or it's pissed off because of something, a nerve related contributing to it, things like that. Um, so most of the time, numbness is a nerve thing. Where's that nerve being affected is the, is a, is a different question. So piriformis being the culprit there, not likely, but possible.

So, um, I know last time, the last podcast, you kind of, you kind of got going on the idea of sometimes you overhear people talking about how, well, I heard that my piriformis is one of those ones that actually splits in the nerves between it. I'm pretty sure this is my reason for numbness. Have you had numbness your entire life? No. Okay. So the nerve has not now all of a sudden split your piriformis and that's the issue. So that's what I usually like to ask is it, this is for some reason now it's pissed off and that's been your normal anatomy this entire time. So it's probably not the actual reason why. Okay. So anatomy, the differences of anatomy doesn't really dictate pain levels. I have, I have, I have different anatomy than most people. So that's why I'm in pain. Oh yes, exactly. No, not necessarily. Okay. That makes sense. Uh, so then on that same question then, so my foot does feel numb and my hip hurts. That's why I'm here. It's in the backside.

So what do you think? I think that we need to dive a little bit deeper and figure out, cause if we go digging around this piriformis or treatment like piriformis, we might be missing something here. Okay. What if it wraps around the front of my hip too, but also my foot's numb. It's not the backside just anymore. Now it's in the front, like that crease, you know, but my foot's also numb too. So I think that we probably got to look a little bit deeper again, just because there's other areas going on that are being affected as well. And what we're trying to get at here is what we see most of the time with piriformis, front of the hip, foot numbness, all that stuff. Got to look at the central source. I tell people this all the time. I feel myself zoning out a little bit because there's not inflections in your voice like you would do a puppy. Yeah. So I think probably the important part of there is at least the way I would kind of narrow this down is if you have numbness, let's say we're talking about only hip arthritis, impingement, labral tears, because I know there's a lot of reasons for hip pain. Although we talked about piriformis in this, if you have foot numbness, there's probably something else. Um, maybe, maybe you got to consider, I've heard people say, well, but I have diabetes too. Okay. So that's another wrinkle in this equation, but if you don't have diabetes, then maybe this is probably another spine related complaint, like numbness, change of sensation, stabbing type of stuff like that, or prickliness, pins and needles. That's kind of exclusive to nerve invest vasculature, right? Like there's not really, it's not really other, it's not like your hip flexor is going to refer pins and needles to your foot. Yeah, absolutely. It just doesn't happen. Well, on this topic though, if the thing is, is you've been getting treated for piriformis syndrome for some time now, and it hasn't been working, then, uh, we're missing a key component of looking at the central source. I tell people this all the time. We will be looking at the chief complaint and, uh, what's going on, but we're looking above and below as well. Cause if this has been going on this long, maybe that's what we're missing there. Maybe that's what we're missing there.

That's funny. I was going to say exactly that. Sorry. Oh my goodness. Dawne Costantino just got out of the room with the patient. She's probably just all talked out. I am honestly, my mind is still on her, so I will leave her in the other room. Uh, okay. Your turn to be the asker. All right. So doc, I was told I need to use my glutes more. Okay. Uh, you know, do you feel like you use your glutes a lot? Um, with some things, some exercises, maybe like what ones, maybe like squatting. Sometimes I do like, you feel both glutes or one glute. I feel like definitely one will activate more than the other, be more sore than the other. So this might be a, uh, kind of an off the wall question, but do you feel like you try to activate that glute? The other glute, the one that doesn't like focus on it more?

Yeah. Yeah. Like do you, are you mindful of it? Do you try to not necessarily know? Maybe if you talk to it more, maybe with an upward inflection to it, maybe if you said work blue, no. Um, so in, in the situation that you have at the, at this point, uh, maybe, yeah, you'd be might if you use the glute more, but there's a possibility that your glue is not functioning for some reason. Uh, and no matter how much you speak pleasantly to it, it probably won't help the matter. Um, people have the idea that maybe if they focus on using the glute more, it will work more, but that's rarely the case. Um, cause a lot of people try that and you've probably tried it maybe, or you guys on the listeners might have tried it already, but, um, it just doesn't seem to work, you know? And so there's other ways you can facilitate that glute to work a little bit better, which may help out your hip. Uh, I'd, I'd gamble and say it probably could. Um, but it might take a specific exercise coached a specific way. Like which ones? Yes. I got those. I was hoping you would ask. Like which ones doc? I want to know all the answers. Oh man. So have you had anyone ever come in who's just super happy?

Yes. Yeah. Aren't you in pain? Why are you so happy right now? Um, yeah, so there's, there's ones that we like that is, um, like a low diagonal sit is a really nice one. Um, there's a banded bridge, which is a really nice one. Um, but I really like if we're really trying to facilitate a single side, I like the sideways ones. Um, the, if you're, if you've already tried exercises, you might've been familiar with a clamshell, a clamshell. Now let's just flip that over. Like instead of using the band or the air as the resistance, we use the floor on the single spot. And most people put the band kind of around their knees, uh, which is fine. And so right where the air where the band would be, use that spot to push into the floor. Um, I find it works better. It's an isometric. We can narrow the, uh, focus a little bit more. And then the coaching cue we usually use is like, you'll put like a dollar bill or, you know, something of value underneath a section of their knee, which is actually important, which area, and you tell them to, to not let you take it. And so it changes the focus from more of a internal, like make your glute work, talk to it somehow and just be nice to it versus a task.

And usually tasks work better for getting the nervous system to kind of link up to that glute muscle again. That was a really good way to describe the diagnosis. It, uh, by the way, we have a YouTube video, I'm sure on this somewhere. I think we definitely do. Does anyone go to our YouTube channel that has over 500 videos all for free on it from here? I don't know. They should YouTube performance, performance, sports care, glute exercise. Uh, did that answer your question, patient? I think so. Okay. So yeah, maybe I would, uh, I mean, I think glute work is a very, um, it's a very useful thing, but, uh, to be honest with you, I feel like people do it poorly or at least not only say poorly, let's say inefficiently. It's not bad what they're doing.

It's just, it could be fine tuned and the results would probably reflect that. I think definitely people are learning that glutes and core are really, uh, important in a lot of these things, right? So they start to go do glutes and core that they see, I don't know, maybe from an Instagram influencer or something like that. It is glutes and core most of the time, a lot of times, but it's specific and individualized for you. Maybe it just needs to be a different one based off of what we see. Well, I know that you've said it before that like a lot of people can just get away with generalized glute and, um, workouts and then we never see them because it works. And this is kind of the phenomena of, you know, people doing general stuff just generally work sometimes, but when it doesn't work, you might have to fine tune that. Yeah. Good way to put it. Okay. Uh, I was told I need to tight, uh, stretch my tight hip flexor and I need to stretch more.

I got your attention though. Um, okay. So how long you've been stretching for? Have you tried this yet? Let me ask you that. Uh, the hip flexor. Uh, I've, I've, I've dabbled with it a little bit, you know, about five minutes a day. Uh, I like to stretch my hamstrings. That's just something I really was thinking that yoga attaining a great forward fold would help everything in life, including bank accounts and outlook and everything. Cause perfect yoga position to all that. But yeah, that's what I was doing. Okay. And when you, let's start with when you stretch your hip flexor, how's it feel? Uh, I think it feels better. It feels better afterwards. Okay.

When you stretch your hamstring, how does it feel? Uh, it feels better. Okay. Uh, just temporary relief though. You feel like you're always having to do this. Well, I haven't really been doing it too much, but I feel like daily so far I have to do it. Yeah. Okay. Um, I don't think there's anything wrong that as long as it's not making you worse while you're doing it or afterwards, I say you can give a little bit more time and see what happens, but if it's, you know, about three, four weeks now and it doesn't seem to be improving, maybe we need a little bit more than just a stretch. Okay. I'm okay with that. So stretch a little bit now, but if it doesn't work, then do a little bit different things. I don't think there's anything wrong with that. As long as it doesn't make you worse. Okay. Uh, your turn. I was told one leg is longer than the other. Well, let me show you something. I got this leg that's super long, but I don't have any hip pain. Can I show you that?

Do you really? No, I don't. No, I wish I did though. So I can show people demonstrate. Yeah. Like, look at that. Like, Oh my God, I went to this doctor and his leg was like one foot difference and his hip didn't hurt. It was amazing. Um, so yeah, I mean, I don't think it has as much to do with it as, as people have been told. Uh, I think it's something that's thrown around quite, uh, often. Uh, and I think, uh, you know, I was thinking about this the, the other day with, um, just the things that people have been told. I don't know if you've had anyone recently with this, but, um, I, I had one gentleman that he was told by, uh, one of his therapists that they just rubbed his back a little bit and they said, I think your kidneys aren't working. Yeah. I know your, her eyes wrote, uh, shook.

They shook. Um, so the point is like, so I asked him, I said, is your blood work all good? Yeah. Is your, your analysis good? Has your urologist said it's all good. Do you have any pain you go through and through? Do you have any blood? Do you have any pain with urination? And I'm like, well, everything else says you're probably good. So, but he was kind of hung up with this idea a little bit. And so be careful the words you tell people because they actually matter. And so one leg longer than another, if you tell someone that, or if you've been told that I know people hang on to that for a very long time. Uh, personally, I don't think it matters too much.

Um, if you, uh, and there's some research that I did put on the website a long time ago, but it's buried. Uh, I want to say like the rough amount was, I don't know, an inch or two after that, maybe it matters. But before that there's people walking around with, you know, different leg length all over the place and it doesn't really matter. So, um, the short answer is I wouldn't worry too much. Let's go through an exam and see what works for you. If it does matter, I'll bring it up later with him. We'll discuss how maybe we can remedy this, but I don't think it matters too much. Yeah. It's a different, um, technique that some chiros will use that they'll, they'll measure some leg lengths and, um, see what areas of the body will change that leg length that they're, uh, testing there. If that works for you and it seems to be working, then great. Continue.

Um, but I think telling people that they have a one leg that's longer than another almost makes it them feel helpless. Like, well, that's just my body now and I'm going to be in pain forever. And I just, I think that we could do better than that. Um, there's a lot of human error and measuring people's heels and length and all of that stuff. Um, if you're trying that route and it's not working for you and you think that your long leg is going to be a forever thing, try somewhere else. I don't think we should hang on to that. We had someone earlier that we discussed, uh, the possibility of there being arthritis in his hip. And so he did have pain in the front of the hip, the side, he had some down the thigh to a little pins and needles, which we mentioned earlier that pins and needles and things like that are going to be some spine related to. And so he did, uh, he said, well, what if I have arthritis? And I'm like, so what are you gonna do about it? And he's like, nothing can't do anything about it. And I said, then let's not cross that bridge yet. Let's not, I'm like, it doesn't, if you did have it, it's, it's probably not a lot. And so maybe we try some things that might be something you can do something about. Cause are you going to replace your hip? No. Cause I'm only 50 and it's not that bad. Okay. So don't, don't worry about it yet. You know, but the information itself of knowing probably won't, I mean, it wouldn't be okay. I did have, um, I did have a woman the other day. She came in full back and hip pain and she was very antalgic. And she, antalgic means like, then it's the hip flexor. She actually brought that up to me too. Um, antalgic means usually when you're in pain, your brain tries to get away from pain. So you start to lean to one side or the other side. So we started to address her antalgia, but as we went through her exam, we noticed she also had a knee thing going on from like an old accident that she didn't have any pain with. Um, and so as she gets up or as she lays on the table, she's completely fine.

She's not ontalgic. She doesn't have scoliosis that she thought she did. Her spine's completely fine. But when you look at her knee and her old accident, it started to bow inwards, which now has created a difference in leg length for her. There's no pain in the knee and there's no pain in the hip. And at this point she has no pain in her low back anymore either. After a few things of just strengthening around the area, she had true anatomical shift in the hips due to this thing that happened to her knee years and years and years ago. She's pain free though. So don't always hang your hat on that. Yeah, that's good. So I guess, uh, so you can be pain free if you have a leg length discrepancy in this case, an anatomical. Yeah, that's, that's cool. Uh, okay. Uh, I think, uh, one leg longer, you asked me that I'm my turn to ask you, uh, do you think I should be weight training for my hip? Yes. 100%. Really? Are you already? I don't like weight training.

Okay. Well, you made it, you made that too easy to make a challenge for you. I definitely have had people come in and they say they don't like to weight train. They don't want to put weights in the hands. They don't want to get big and bulky. We're not trying to make you power lifters here. Maybe we're just trying to figure out a way to, um, add some resistance to your body so that it is forced to adapt. And I can see Sebastian's face with the rebuttal right now. Um, I'll talk to some people about it and where their mind is at and their opinions on strength training. Um, it doesn't have to be something that has to be your entire life. Um, if there's other ways that you want to get exercise, that's fine. Let's just find a really basic level of, I hate this face that you're making right now. It's throwing me off. I'm curious to hear what you say, but yes, I think people should be strength training. We can find a way to make it good for you though. What? So, but I'm different. You don't understand. Ever since college, when I lift a weight, I just get massive. I'm different. I just get really muscular really quick. And I don't like that. What would you say to them then? You know, I've thought about this before and I'm like, I'm like, uh, and this is when I was lifting more. I don't do as much anymore, but I'm like, you're like insulting me like a little bit. You're going to start like, it's like, cause I'm like, do you know how often I lift, how hard I lift? And this is all I am, but you're, but you're just get massive.

So you define, you define all anatomical adaptation laws with, I mean, I don't bring it up to him like that. It's, I mean, it's kind of like a, I had a, uh, I had a friend, he had a gym. He, he made a good, good point. Uh, anytime someone will come in with that, with that problem, uh, he would say, look, at the end of a couple months, if you are too big, I'll give you your money back. And he never gave any money back after that. Cause no one complained. So, um, yeah, I don't know. It's a good way to put it. Yeah. I mean, I'm a firm believer in strength training. We've seen what it's done for people and we make it look different for everyone. To be honest, it doesn't have to be big, crazy weights in your hands, but I don't know. Most of the time, the people that come in here are open to it. I don't think I've ever had to figure out how to address somebody who's absolutely against it. Yeah, I haven't either. Like, I feel like it's, um, you know, the, like I can kind of consider like the, the rehab facility as like a, it's like a dojo, you know, like you don't necessarily go out and like, you know, throw people on the ground all the time, but if you're attacked, you know, the skillset and how to manage it. And so the weights is in some, for, for some people, it's just a simulation of weights that they would encounter at some point, uh, throughout the day in their life. Anyways. Um, sometimes the weights are big, sometimes they're big, heavy boxes.

Sometimes they're light boxes. Sometimes they're gigantic pieces of drywall. Um, we have different implements to, to create different scenarios for people. And rather than just set your hip out in the world and let it see, let's just see how it goes. Uh, sometimes it's better just to field test it within an area that you have control over. And then you just by chance get stronger. No, that is an absolutely good way to put it. We don't even need to use true weights. Let's not make it a kettlebell or a dumbbell or a barbell. Let's just, uh, I don't know, grab a, grab that sack out there and make it look like a kid. We'll just put a little, some eyes on it and just pick it up. Like it's a child, just like things like that. There was, so there was just one lady that came one time that she had a, she was, she did not like the, like she came in first and actually said, I think I'm in the wrong place. I said, why? She was like, I don't want to do any of this.

It was, uh, about 60, late sixties probably. And so, uh, so I sat down with her and I was like, so what don't you like about this? And she's like, well, I don't want to do those weights. I'm like, you don't have to. So I'm like, if we get to that point and I asked you to do something, just tell me no. And so she started coming. And so she did get to that point. She said, I don't want to do that. Cause I gave her a 15 pound weight to hold and just walk around with it. Cause the idea was to simulate. She actually said she would go to the store walking to bring her groceries back. And so, uh, I said, well, um, why this is to simulate that. And she's like, I don't want to do that. And I said, can you do something at home? She said, yeah, I can carry a bag of groceries. And so she was, she, I didn't tell her really how much the groceries probably weighed, but it was probably more than 15 pounds, but it seemed more benign and she was okay with doing it. So we just, I just didn't give her any weights in the office. I just told her to go home and carry her groceries home. Nice. Let's go ahead and go walk to the, do it. So it's got to make it important for people. Anyway, do we answer the question? Do you think should it be? Uh, yeah. Uh, you said, uh, probably, yes, but yes, you should strength train. We can find different ways to do it. And you tried to course me into doing it, even though I said, I get really big, really quickly.

And I don't like buying new clothes. It's all the, all the Labor Day sales are gone. So, uh, okay. So doc, I know no pain, no gain. I know no pain, no gain. So should I push through it? Oh no, I don't think you should. Uh, it's so you, have you been told that you need to push through it before? Uh, yes. Okay. Well, I think you say no and just make it hard on me, but, uh, I think there's this, there's this kind of notion that's obviously no pain, no gain has been around for a long time. Uh, uh, maybe let's reach, let's change this to no discomfort, no gain possibly. Um, or no effort, no pain or no, no effort, no gain maybe. So we do want to create some adaptation and some challenge for the body, but by no means should really, well, I'll say by no means, let's just say 95% of the time, any exercise that we give you should hurt your problem that you came in for should, should not, or should not hurt your problem that you came in for in any way, shape, or fashion. Meaning if we give you a squat to do for your hip and you're like, Oh yeah, I can feel it working my hip in the exact area where I came in for, we would change the exercise.

You don't push through it. We might scale that or modify it somehow or cue it differently, coach it differently to where you would then get an effortful experience, not a painful one. Yeah, that's a good way to put it. Most of the time we don't really want the area of complaint to be working all that much. So, um, I actually had a woman come in the other day and she's like, I've been going to PT for a while now and they give me a lot of gluten core exercises, but I always feel my hip pain when I'm doing them. And then when I'm done, it makes it worse. And I've just been told to push through it because once you build up the strength and the pain's just going to go away. And I just think that that's the wrong way to look at it. So most of the time, the exercises that we're doing in here, we're modifying so that, I mean, there's had times where people will come with sharp shooting pain in that area, but the exercise that we're choosing for them just feels like it's working that spot. Most of the time, I don't even really want that either.

I want other areas to be working because this thing's already overactive and pissed off. Yeah. What would you say to that? No, I would agree. Um, yeah, I think they want large, you should shoot for large areas of effort, not necessarily small focal spots. Like, cause most, I guess people do can come in for widespread stuff, but typically with hips, it's like my groin front of groin hip area hurts or my piriformis or something like that. It's not like, Oh, my entire glute hurts. Although they can have that kind of deep glute ache above on the crest sometimes. Um, but it should feel like large areas of glute working. Okay. Uh, we might make this the last one. Which one do you want of these three?

Oh wait, I got to ask you, huh? Oh no, no, no, no. I actually kind of like the, the, this one that's coming up next. This, this one. Okay. All right. You picked your question. Can you just work on my hip for me? Can that just, can that just make it feel better? I don't really want to do anything. Um, I like that cause I definitely have had people come in and out of here asking that before. Um, I'll do it for you. I don't mind. Uh, we can try that for a little bit if that's where your mind is at. Always meet people where they're at. So if coming in here means they're not willing to put in any work right now, they just want to see what I can do for them and they can walk out of here and maybe they're pain-free. We'll try it. Most of the time we don't see that that works though. And that's most other offices that you're walking into a lot of passive treatment, a lot of the doctor doing all the work for you. And it seems to be temporary relief. If you want to be reliant on me, then we're probably not going to work very well together because my ultimate goal is never see you again. Um, so let's figure out a way that we can get you to put in some work, but I'll try it for a little time being. Okay. Yeah. I think, um, I would, I'll split, I think I'd split this a little bit. If it's, if it's a acute pain or, or sub acute pain, like they keep had it for a few months or say it's in a, it's, it's like intermittent a little bit. And it's not just chronic pain. Like you've had this for 20 years type of thing. Uh, I think chronic pain might work a little bit better for, I'll work on it for you a little bit to kind of shake the rest loose. And then we're going to go right to the approach that you're talking about, Dawne Costantino, which is a little bit more of supportive. Um, cause we've talked a lot about a lot of supportive in this podcast already, but we haven't really talked about, uh, some of the value of managing the pain with some, uh, I'll work on it for you, but it's, I don't think either of us think it's a good long-term answer. Absolutely. Good way to put it. Uh, okay. So as we start to clean this up, um, maybe, Oh, how do they reach us? You're always good with that section. Okay. So we are, you know, if the information we've been giving you guys kind of jives with you and you want to know a little bit more about maybe working with us or how we can help you say this podcast is the first introduction to us that you've had. Um, we got YouTube, we got a website, check it out, see what we're about. If we're not in your area, then we also do virtual. Um, we've seen a lot of people have some crazy improvement doing some virtual sessions with us. So, um, we'd love to hear from you and we can talk and chat a little bit about how we can help. Yep. And, uh, any clinicians out there, as we mentioned, the beginning of the podcast, there is a premium version. I know this is all very general information, but, uh, it's intended to help, uh, the public. So we're going late public a little bit for a while here. If you want all the clinical, uh, descriptions of orthopedic tests and clinical reasoning and dah, dah, dah, dah, dah for case studies, like we cover that in the premium version. It's not very expensive. You can find it at the bottom of the podcast page player. Just click on the link and then you'll get access to a bunch of them. They release every Monday. Thanks for being part of the movement movement. I'll see you. We'll see you next time. Yeah.