Corrective Exercise Selection and Dosage: The Attractor State Approach

And that's a whole other topic, is stiffness, which is one of my new interests now. Issues stiffness. What is this? You know, muscle spasm is too much stiffness. Muscle inhibition is not enough stiffness. What's enough? In a weightlifter like a Chris Duffin that helped using this attractor state concept as well, his back extensors are just massively stiff when he's training and or competing. And that's causing discomfort. And by basically using the attractor state concept on him and making him stiffer in his rectus abdominis, he noticed an immediate change in a more relaxed erector spinae muscle group.

And thereby, because of that, he can do more repetitions. He can do more sets. And eventually, of course, his volume of load goes up and the vice performance increases. 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. It's Dr. Sebastian Zalz again with the Restoring Human Movement podcast. Thanks for joining the movement. Movement. As you can see, I had a guest on today in the interview with Guido van Rysingen. There's Ys and Ss in there.

So don't blame me if I can't say his name correctly. But I met Guido at a workshop. Guido was presenting on the dynamic system theory as well as the use of, I guess he didn't want to call it corrective exercise. But I'd venture to say that we're actually working on how do you use effective or corrective exercise that actually works quickly and produces a really good result. Like, quicker than you would think any corrective exercise would. So he had some really great cueing in there. But also, too, it's kind of like picking the correct medication for the problem and doing it in the correct dosage.

So he was really great at actually picking people that, and I will probably share some of these videos if he's okay with it, on social media and correlated to this podcast. But there were some where he was really, really soft with the person and cueing them just enough because you can see that they were a little bit afraid of the movement. And other people, they were more chronic condition, and he was reading his subject or reading the patient extremely well, and he was just yelling and screaming at him. Either way, though, he produced really amazing results, and I would not be inflating this number.

But usage of what he showed has dramatically changed my practice easily tenfold. It's amazing information. So sadly, though, there's not a lot of stuff out there on Guido. And if you search around for information, he does have a couple papers out. But also, too, in the limelight, you'll probably only find one podcast, at least at this point in time, and he did it with Kabuki Strength or Chris Duffin on the Kabuki Strength podcast. So there's a lot of great things to share. And as you hear a couple times throughout this podcast, I say there should be more Guido in this world. So he's going to have a lot of information to share to health care providers as well as patients.

We'll get some great storytelling in here. Now, before we actually get to the content, I wanted to share with you some excitement that I actually had in my personal and clinical life is that I've been writing a book for a very long time. I think I mentioned it a couple times. And there's been ins and outs of it. It used to be part of a course, and I realized that I needed to split it up because, as you see, even with speaking with Guido today, you see that people have different entry points, and they have fear avoidance, and they have chronic pain. The pain is very complex. So sometimes I think we need to address it from a motivational standpoint or framing it well with the people.

So this book actually I created is called I Will Beat Back Pain. And the subtitling is setting up a winning mental attitude for recovery because half the time the battle is just not – the battle is that people don't accept help or they're afraid or they have pride or whatever it might be. So the idea that I have with this book, which it's releasing next week is why I'm bringing it up, next week on the Wednesday of the podcast it's releasing, I would really like husbands or wives to buy it for their spouses because oftentimes people with pain, they're depressed, they don't want to talk about it, they don't want to do anything about it, and it's frustrating.

So I would really like the spouses or loved ones of people who know people with problems just to buy it for them and just see what happens. It's a very cheap read. It's under $20 for different varieties. We have Audible, Kindle, and Print. And it might just change your life. So please check that out. I'll put links in the show notes. Now I'll share your personal story and then we'll get right on to Guido. So I think if you've been following along, you probably realize that I do like cooking. I like barbecuing and I like steaks. And I especially like the most obnoxious and ostentatious, most showy of the steaks you can possibly get.

It's called a tomahawk steak. And I think though, actually, so there's ribeye, there's bone-in ribeye, and then there's tomahawk, and then there's a cowboy, I think. And the cowboy one, at least the ones that we've got in Arizona, they're like the rib bone is, it looks like a legit tomahawk, like you're going to chop wood with a thing. And at the very end is a piece of meat called the tomahawk. So anyways, we started getting excited and we started cooking these tomahawk steaks. And the first one I ever did was last year around the 4th of July. I did it on the 4th of July. It was great. And so I cooked this thing up.

We got so excited. We didn't just say tomahawk. Well, because people are saying like, what kind of steak is that? I said, it's a tomahawk. I'm like, what's a tomahawk? I said, it's a tomahawk. And eventually we started just yelling, just getting excited about meat, saying tomahawk. And someone would be like, what are you doing? I said, cooking a tomahawk. So I get excited about steaks, especially tomahawks. Anyways, cook a tomahawk sometimes. Surprisingly, they're, I want to say about 25 bucks over at Costco, 13 bucks a pound, 14 bucks a pound. You go to Albertson's, they'll probably run you about 20 bucks a pound.

But they're about two and a half inches thick. Amazing. And if you think it's too much meat for you, have some friends over. I mean, I think we have one, two and a half pound tomahawk feeds about three to four people, unless they're pigging out. So if you're looking to go get a good steak, get a tomahawk. So great. Let's get into the content. All right, everybody. Welcome on Guido, the major, the major, major Guido, the major guest. Guido Rice, or Guido Van Riesingen. Riesingen? Correct. That was a really, I heard the one with Chris Duffin. And I thought, holy shit, they have a hard time saying his name, too.

I'm glad I'm not the only one. Here's the funny part. My wife's last name is Adams. Is it really? I should have taken hers. Yeah. Probably should have. I've actually been talking about this podcast, leading into it, and I know we're recording it way earlier than it's going to be released, but I planned a lot of things around it because I thought your content would be extremely valuable for people to learn, clinicians and patients. So I thought we'd go over some attractor state stuff if that's cool. Yeah, that's great. Okay. First, since you do have an interesting lead-in story, why don't you tell everyone a little bit about yourself and just how you got to be, what you're doing?

It's kind of a long story. I'm an old dude. I'm going to celebrate my 60th really soon. But basically, my mom was a nurse and always been interested in medicine. Originally from Belgium. I got fascinated by science since I was in high school and got in the military. There was still a draft in those days and I became a medic for commandos or special forces. Worked in a military hospital in Brussels. But I think the most interesting part about myself is that at a relatively late age, I think I was about 17 years old, I watched a baseball movie on TV about the Negro League. And although I've been always involved in sports and played a variety of sports, I actually was a premature baby and almost didn't make it.

I was in an incubator for like two months. And we had quite a revolutionary pediatric doctor and he basically told my mom and dad that I had to get involved in sports and move and I would never develop all that fun stuff. I was actually anemic until I was about 16 years old and my draft got postponed by two years because I was too skinny when I showed up. Until I finally was able to convince them that I could pass their physical requirements, you know, like 50 push-ups and 15 pull-ups and all that fun stuff. And actually the funny part is, although they thought I was not military material, I then eventually worked with our so-called special forces commandos.

And basically had to go through the rigors of that training and then, you know, was in charge of their health as a medic. But anyhow, once I saw that movie, although I had no clue about the game of baseball, I just totally fell in love with it. And that summer I was a leader of a scout group and one of the kids had a baseball glove and a ball and I basically asked him, what the heck did he get this from? And Lord behold, in my hometown, Antwerp, Belgium, there were several baseball teams. And basically I just threw myself on to that. While I was studying in nursing school, it became apparent that I just didn't have the time to practice.

And of course I got into the game quite late and even though I had to put a glove on my left hand and all that fun stuff. And I started taking care of their injuries. And I started corresponding with Dr. Job, which was then the top leading orthopedic surgeon in the U.S., probably the world, dealing with baseball injuries. And he thought it was fascinating that some guy from Belgium was interested in baseball injuries and sent me a book and several articles. And for those of the young listeners here, these are the days that you have to write letters. There was no email and all that stuff. You still have the letters from Dr. Job about the whole correspondence?

I doubted that I still have that stuff. But anyhow, studying the stuff that he gave me and analyzing similar sports, throwing sports like javelin and looking at track and field, running. And I basically started looking at baseball from the perspective that, hey, these are just athletes running around, throwing things, catching things. There's got to be a way for me to analyze this game. And I basically wrote a manual, and I still have a copy of that, of, I don't know, about 30 pages or so, on baseball injuries and baseball conditioning. And started applying that. So basically, my role on our baseball team became so-called athletic trainer.

And then I actually became their strength coach. We won seven Belgian titles in a row and went to the European tournaments. And then I'm fast-forwarding this story here. But I met a guy from the Mariners in Paris during the European tournament. And we talked for maybe 15 minutes. And this guy basically changed my life. Gary Thompson still lives in Seattle. And we've been close friends ever since. I was able to persuade my wife that there was a unique opportunity for us to go to Seattle. We flew to Seattle. We had no clue where the hell I was. I was, you know, I had to go to the library and open up an atlas.

And I'd say, oh, my God, there's this town on the West Coast in the United States. Did you spin the globe and everything and just watch? Yeah. Those were the days. There was no Internet. I mean, it probably was, but it wasn't accessible to the public. And we basically came to Seattle. I had an audition with their head athletic trainer, Rick Griffin, who retired last year, by the way. And gave him a copy of this little manual. And that same night, he called me in our hotel room and said, hey, I think you've got, you know, you've got some information. You've got some good stuff in there. Why don't you come over to the kingdom?

And, you know, I stayed there for about 10 days. It was the off season. And my whole world just changed literally overnight. And those 10 days changed everything. And after 10 days, my wife and I had to go fly back home. And Rick basically said, listen, I think you've got some phenomenal potential. I can help you. I'm a graduate from the University of Oregon. So is my assistant athletic trainer. And it's the best master's program in athletic training. And you should go there. So we got a rental car and we drove to Eugene. And literally almost, you know, six, seven months later, we sold everything we had.

We moved to Eugene, Oregon. I got a dual master's there. I was lucky enough the first summer that a short-season A-ball team had a job opening. And I couldn't believe it. They gave me the job after an interview. And so basically, I got my feet into professional baseball. Then graduated, went to the Rangers, Texas Rangers, the Florida State League, got promoted to AA. Then I got to the Orioles, got promoted to AAA, and became their medical coordinator. So I basically lived a dream. In retrospect, though, I kept learning and my family grew. I had two kids. And, you know, I had to be home. I had to be a dad instead of being on the road, be gone all the time.

So I took a job at Oregon State University and really enjoyed that. Being back in the academic world was really inspiring to me. And the last, let's see, year and a half, I've been basically running workshops, clinics on my own. Spent a lot of time in Southeast Asia, predominantly China, Seoul, and also Japan. At the same time doing workshops in the U.S., in Europe, and so forth. So that's kind of that. Yeah. Well, I think the first question is, was the beer good in Seattle when you came over? Do you think this is crap? This is a pivotal factor in my move? Well, we're talking 30, I think 31 years ago.

The beer was pretty shitty. The weather sucked. It rained all the time. You must have really liked baseball then. Right. But, you know, it's just something I had to do and see if I was up to the par. And, yeah, it just changed our life for the better. And we're happy here. We're all American citizens now. Our son actually served in the military. He was active in Iraq. He was also in Afghanistan. He's got multiple decorations. And, yeah, we're good old Americans now, I guess. Nice. And the beer got better. Yeah, I know. It finally caught up, didn't it? I don't think I was ever actually, well, I guess I was alive when beer was worse.

But it's always been pretty good when I've been drinking. I guess I should, the reason why I wanted you really on as well is like, so when I went to your workshop, and I think I mentioned in the introduction that I went to your workshop, and Ben really just convinced me. I was like, who's this Guido guy? And he's like, you're not going to find anything really on the internet about him. You're not going to find anything on really social media. You just need to trust me and come. And I was like, well, what is it? And I read the whole thing with dynamic systems theory and all this stuff. And I was like, this is a lot of wording to me.

Can you clean this up? He's like, it changed my practice a hundredfold. Just come. And I said, okay, I will. And he was right. Like, all the stuff that we went through was, like, as I would classify it, would be like, you know how you go to PT and people say, like, well, I was doing three months of PT. Nothing worked. Your stuff, it was like the correct dosage and application of the correct exercise to do the thing within a minute or so. And then whether it stuck or not was a different story. But I found that very intriguing. And I never really saw corrective exercise in that light before. So that's the attractor state.

Would that be fairly – you can clean that up if you'd like to. No, I really appreciate the comments. Yeah, so do you want me to explain kind of what this attractor state concept is all about? Yeah, please do. And then also, too, if you could give me some examples because if we have people listening, I want to make sure that they're familiar of how to apply it. Sure, sure. So while I was at Oregon State University, I developed a concept there called kinetic integrations. And it basically is kind of my starting child of workshops and lectures, et cetera, et cetera. As I was doing that, I wanted to come up with a methodology to either A, resolve injury, either mostly actually chronic, and or improve performance that was based on a neurologic level.

So I started studying more and more the principles of neuroscience. About, I would say, 10 years ago or so, maybe a little bit longer, I started noticing that young practitioners, practitioners around me, and also students, started hanging their head a little bit too much onto the functional movement screen. And I don't mean that negatively, but they were misinterpreting that information and its methods. And I started seeing more and more and more people saying things like, you know, if you had a knee injury and your knee caves in, that's all bad, and then you've got to do this and this and this.

And if your FMS score is not that, that means it's abnormal and you've got to do that and that. And it perpetuated itself into the performance world where people were starting to say things like, if you don't squat like this, you don't deadlift like that, then it's wrong and you're going to blow a disc in your back, et cetera, et cetera. Well, through the years dealing with athletic populations of a variety of levels and non-athletic populations, of course, I noticed, you know, as yourself, that you see a variety of movement patterns, not necessarily them being bad. So, in my response to, you know, young practitioners and students saying these things, I started doing a review of literature on what is movement, et cetera, et cetera.

And I pretty much accidentally then ran into movement, the concept of movement variability. And I have a workshop on that as well, you know, what is movement variability, what's good, what's not. And then delving into that a little bit more, I ran into a concept called a dynamic systems theory. So, basically, the dynamic systems theory, per definition, it would say something like this. It's a system of elements that change over time. So, that basically means that within the dynamic systems theory concept, if you change the environment, for example, the floor where your athlete or your patient is moving on, then also their movement pattern can change.

We, as clinicians often focus on the part of the dynamic systems theory part, including manipulating the body. So, mobilizations, manipulations, et cetera, et cetera. So, there's different ways to change movement through this dynamic systems theory concept. And then I ran into the concept of attractor state, which in a simplified way, it means that our central nervous system is attracted to use specific muscles, restrict range of motion in specific joints associated to performance and injury. And as an example, if you're looking at the difference between sprinters and long distance runners, and you look at their quadriceps hamstring ratio, then the literature will show you that the sprinter is predominantly, the ratio is in favor of the hamstring muscle group.

So, they use basically more of their hamstrings than their quadriceps. And in the long distance runner, it's actually the opposite. You know, purely because of their position, they're standing a lot straighter and so forth. Of course, they're running a lot slower, too. So, their quadriceps is being used more in favor than the hamstring. And through my years that I was at the University of Oregon and being exposed to track there, we already way back, I mean, we're talking 30-something years ago, part of our rehabilitation was analyzing quadriceps hamstring ratios. We had isokinetic equipment. Of course, we had the data on healthy runners.

And then if one of our injured runners got back into running, then we would use that data to at least approximate, let's say, 90% of that ratio before we allowed them to race again. Well, the attractor state concept just made total sense to me that performance, specific performance, is creating central nervous system attractions. So, the pitcher in baseball will, over the season, have a decrease in shoulder internal rotation and horizontal adduction. And if you then look at the injuries in baseball pitchers, you often then see that attraction. So, they have a lack of internal rotation. They have a lack of horizontal adduction.

And if you resolve that with mobilizations, then often their symptoms will dissolve. So, their impingement goes away, for example, and or their velocity of throwing goes back up to where it's supposed to be. Then, if you look at injury perspectives, let's say knee pain. In my practice, I noticed years ago that people with knee pain often exhibit a lack of hip forward flexion. So, they could have an anterior hip impingement problem, lack of tereo curl joints, mobility, lacking mobility in their ankle to move appropriately. And, of course, then later on, the research has shown lack of enough stiffness.

I don't like to use the word strength necessarily. Lack of enough stiffness in the hip abductors, glute medius minimus, et cetera, et cetera. So, it got apparent to me and, of course, other people as well that if you have an injury or you perform at a certain level that our central nervous system gets attracted to lack of range of motion, for example, changing quadriceps hamstring ratios, for example, and so forth. In the last, I would say, 15 years, more and more research actually shows that my concept of attractor state totally makes sense. And so, indeed, it can become really, really simple and convenient and not time-consuming to evaluate somebody from the attractor state concept, then mobilize whatever needs to be mobilized, and then suddenly, you know, see a tremendous change in either their symptoms or their performance level.

And that doesn't only work with baseball pitchers, injured individuals, but also some individuals that are interested to perform at a higher level. So, another example was a hurdler from Peru. This is probably six, seven years ago that I saw. She was competing in Eugene at the pre-Olympic trials, 16 years old. And she goes and she goes and see a local athletic trainer. She complains of some diffused hip discomfort and basically mobilization and adding some neurodynamics to it dissolved her symptoms immediately. Then giving her specific attractor state stiffening exercises, which in her case was stiffening up her back extensors, also her glutes.

She ran a faster run the next day that she'd ever ran before, continued doing my exercises. A week later, she went to Brazil and broke her own personal record again. And to make a long story short, this young lady, unfortunately I can't disclose her name, but went to the Olympics and competed and became the fastest hurdler in her event in the whole South American continent. Now, these are just, you know, some examples, obviously, but as a clinician, I've been using this concept for over 15 years and the results are phenomenal. So, just to go a little bit deeper into one of those examples, the hurdlers, I think it's a simpler one because you mentioned three parts there.

You said there is a, you mobilized something, you did neurodynamics, and then you gave her some stiffness work for her extensors and her gluteal region. Yeah, I know that we're going to tangent off a little bit to talk about neurodynamics, but can you explain how that correlated to what she had going on there? Well, first of all, I am a huge fan of the concept of neurodynamics. While I was working for the Baltimore Orioles, we had an Australian pitcher who was in a minor league system. So, I was the medical coordinator basically in charge of all the rehab. And part of my responsibility was also to return athletes to full competition after their injury got dissolved.

We had an Australian pitcher, he was a lefty, he dove for a ball and basically had this massive nerve root problem to where he basically almost lost complete function of his brachial plexus. So, his grip strength in spring training was about 180 pounds. And when I saw him three days after his injury, he could barely squeeze 28 pounds. So, he had massive loss of motor function, also sensory function. Now, this young man was a big prospect for our organization and there was a lot of money pumped into him. And basically, the owner of the Baltimore Orioles, which was then Peter Angelos, called me and said, we have at least a three-year contract on this young man.

I really don't care what you need to do, but he needs to come back. You know, we're having a huge investment in this young man. At that point, this is 1996, I believe, yeah. David Butler, in his book on neurodynamics, was published in English and I got my hands on it through actually an English physiotherapist that I worked with in a clinic while I was in the minor leagues. You know, baseball, you don't have a full-time job. So, in the off-season, I would work in a clinic. She didn't know much about therapeutic exercise. I didn't know anything about neurodynamics and I got really interested in this concept.

So, I was able to persuade the owner of the Orioles for me to fly to Australia. And I spent basically 10 days with David Butler in his clinic. I immediately noticed that his population was chronic pain and that my population was not, working with top athletes. And I basically made some changes around the techniques that I think are more productive for athletic populations. And then later on, it became a big, big part of my evaluation. So, part of this young lady's evaluation noticed that she had a positive SLIM test for tibial nerve bias. And I basically did neuromobilizations on her, improving her range of motion and by her stride, jumping over this hurdle.

And basically, by using the neurodynamics concept, you can also then immediately change that attractor state. That was the plucking? You went plucking on it? Well, I did not use plucking in those days yet. I used more of a gentler approach and then progressed it with her, probably about three, four years after that, to a more aggressive approach, which is almost a neural manipulation. So, it's a fast, trusting maneuver. Plucking, I developed, you know, later on in my career as I started noticing that the skin area around these nerves that are not moving appropriately, according to the neurodynamic concept, was incredibly stiff.

And then my interest in fascia came all into play in this and so forth. So, yeah, for years I just called it plucking because you literally, rhythmically, relatively quickly pull on the skin. You probably really good at the bass guitar. Yeah, yeah. You know, sometimes as a clinician, you just kind of, you know, try some things out. And this has been a big part of my success as a practitioner. And I've helped numerous athletes and non-athletes with this stuff. But basically, it's all still based on this attractor state concept. And then reading more and more on dynamic systems theory and central nervous system, in my opinion, when we have an injury, it's basically a threat to the system.

The central nervous system is going to attract itself to protect itself. And these protective mechanisms are pretty much predictable. That's the crazy part. So, it's like knee pain, here's the history, and so forth. This and that and that has been tried already. Do an evaluation to rule out specific trauma or potential, in my scenario as an athletic trainer, red flags refer to a physician. But most people that I've dealt with over, you know, more than 30 years as an athletic trainer, I don't see that much of a real trauma in my athletes. There's an insult to the system, but damage done? No, not really.

So, I would say, although our training is often based on traumatology in the acute phase, let's say you're covering a football game and two athletes run into each other, the majority of the patients that we deal with are not having a trauma where there is a fracture or a dislocation or whatever. But they're having a pain state, and in the days that I went to college, we were so focusing on damage and tissue healing phases and so forth. And it was basically a traditional medical model. And we're more and more and more stepping away from that, and more and more athletic trainers and other clinicians are moving away from the traditional concept of it's damaged and we need to protect this area.

No, no, no. People need to move. And so, this whole dynamic system theory and attractor state concept has just been a major help for myself and especially for my patient populations. So, with that hurler then, after you did some neurodynamic stuff, then describe what the stiffness work was in the regions of interest. Because I just want to make sure that the listeners can kind of unveil the secret in there, you know. Because after going to your workshop, you see that it's like, to me it looked like, almost like when we're biasing movements, it looked like we're going a little bit back to old school Arnold, but it seemed to work, you know.

So, can you kind of paint a picture for everybody of what that looked like, at least in her case? Yeah, sure. So, again, to kind of sum that up, young lady, high-level hurdler from Peru, 16 years old, has been having some, I can't remember if it was right or left, I think it was left anterior hip discomfort. And her coach started noticing that when she jumps over the hurdle, that her stride is basically shortening. And so, there's a change in her performance level. And she has a hard time continuing to compete at her level. So, upon evaluation, was anterior hip impingement. Number one, knee was completely clear, ankle was completely clear.

And then, I'm also a big fan of observation. So, observing the young lady when she's in her sports bra, you know, I noticed immediately that lumbar spine, erector spinae and stabilizer area around L5, L4, L3 was pretty much, was poor. And some of the literature shows infiltration. And some of the literature shows infiltration of fat in multifidus inhibition or low back pain states. And then, I also noticed that when I did her, what I call a reverse slump test. So, my slump test is not the traditional slump test. I kind of reverse it. And over the years, I've noticed that doing this reverse slump makes it a lot easier for me to control them when I assess their slump test because these are often large individuals.

They're either tall or they're very muscular. And the traditional slump test just, you know, didn't really work out for me too well. And so, using this reverse slump test system, I noticed that, you know, immediately that she had a positive slump test with a tibial nerve bias. Reverse slump? I can't wait to see a video of a reverse slump test. For some reason, it makes me think like you're sitting on the person. No, no, no. No, for those that are listening that are familiar with the slump test, it's basically reversing the process. What I mean by that is that I put their ankle in neutral to begin with.

So, they get on the treatment table in a slump test position. And the last thing I move is actually their head and cervical spine and deflection. It allows me to control a lot better where their body is in space. And having practiced with the traditional slump test and this reverse slump test, I haven't noticed a difference in the end result when I treat them and or evaluate them. So, maybe we don't need to follow specifically this, you know, let's call it the traditional or most common slump test protocol. But, who knows, right? I mean, we don't have any research on it. But it's just years of working with us as a practitioner and then seeing that it really didn't make any difference between the traditional slump test position and this so-called, what I call, reverse slump test position.

Sorry, I tangented you. I'll have to send you a little video on it. So, basically, that test was positive. Then, I palpated the area around the tibial nerve where she was mostly complaining of tightness and restriction. And over the years, I've noticed that the areas of restriction is often very stiff. So, the muscle or muscle group in that area often exhibits a higher level of stiffness. I use a machine called a myotone, which is kind of like a, almost looks like a gun. And it measures tissue stiffness. And it just gives me an objective measurement of the amount of stiffness in that tissue. And then, after treatment, I measure it again to see if that stiffness decreases.

Now, upon palpation, you see it, you feel it right away that there is a difference. But once I got introduced to this myotone piece, I wanted to see if I could have it objectively measured, and it can. And that's a whole other topic, is stiffness, which is one of my new interests now, is stiffness. What is this, you know? Muscle spasm is too much stiffness. Muscle inhibition is not enough stiffness. What's enough? In a weightlifter, like a Chris Duffin, that helped using this attractor state concept as well, his back extensors is just massively stiff when he's training and or competing. And that's causing discomfort.

And by basically using the attractor state concept on him and making him stiffer in his rectus abdominis, he noticed an immediate change and a more relaxed erector spinae muscle group. And by because of that, he can do more repetitions, he can do more sets, and eventually, of course, his volume of load goes up and thereby his performance increases. So this whole concept around attractor state doesn't only work for, let's call it injury or pain or restriction because of an injury, but it could also affect performance quite well. I remember I saw Cody was using some on someone's hamstring one time.

I was shadowing him because as he moved his practice or as he moved to Dallas, I took all of his patients, so I wanted to shadow a bit. And a lady came in with some knee problems, and he assessed a little bit and stuff and lay face down on the table, and he just – it almost looked like he was just ripping her hamstring in half, just keep going and going and going, kind of how he did in the seminar. And she stood up, and she's like, wow, that feels a lot better. You know, I know she had an injury with that, but it was interesting to see how quickly that could work in some situations. Yeah, based on this dynamic systems theory in a attractor state, our central nervous system is constantly, let's call it, recalibrating, right?

It's resetting itself consistently based on these three major factors, body, the tasks of what you make them do, and then the environmental input. And so there is no – in my opinion, there is no steady state in our central nervous system. It's constantly recalibrating and looking at what is important to pay attention to. And so, I mean, I can talk for this for hours, but, you know, attentional state is a big factor there, too. What do they pay attention to? Because the brain has a limited capacity to do tasks or member tasks and so forth. So things like muscle memory don't really exist. These are all just, you know, concepts that we like to use, but they're really – you know, they don't make any sense from a central nervous system and a neurologic standpoint.

I'm guessing people just say them because the – it's patients are familiar with hearing it, you know? You know, and you're absolutely right. I often tell practitioners that, hey, we need two language systems, a language where we communicate amongst each other, right? And that should be more scientific-based and use the right terminology. And then I understand that we need to have a language that we communicate with our clients and our patients. But I see more and more that the patient language becomes the practitioner's language even when they talk among each other, like muscle memory. You know, our brain doesn't have a brain, so there is no memory.

It's the same thing with my paper on the myth of proprioception. You know, standing on one foot improves the proprioception, really. So that was a two-year project with one of my students, Dean Kim, who's now in Canada. He's a kinesiotherapist. While I was at Oregon State University, he was interested in finding a topic for a paper. And I said, well, you know, I've been doing some research on balance versus proprioception. Why don't we do something together? Actually, I've got to tell you that this summer, the NSCA National Conference in Washington, D.C., has invited me last week to present on this concept, you know, what is really proprioception.

And so, yeah, I think we need to be careful what we use as professionals in our language versus when we talk to our patients. Yeah, that'll be interesting if your presentation and the concept spreads or if, like, I know probably the trainers and coaches are going to get it and clinicians will get it. But then if you propose it to a patient, it's like getting them away from grandma wisdom and stretching and bed rest, you know, for two months at a time. And I wonder how quickly it'll integrate into actual patient or athlete life, you know? Right. Well, maybe I'm fortunate that in probably in the last 20 years of my career, I kind of see problem cases, you know?

So clinicians are sending me their patients that they're struggling with. So I think those patients are often already motivated to listen to a different concept. And that's often what I tell them the moment to basically sit down in my office where I say, listen, you know, you've tried the, let's call it the traditional approach. You've not had success. This, what I'm going to do with you and what I'm going to look for is something totally different. And actually, there's very few patients that would balk on that scenario. And they're all ears. And then especially if I give them some examples, so they see me for, let's say, low back pain, they start saying, yeah, that's exactly what happens to me.

And that's what I keep, or they say something like, this is why I've been telling my doctor or whoever before, but nobody's listening. I mean, yeah, what you're telling me makes absolutely sense because that's what I am experiencing. So I think it's the way it is explained to the patient that makes the biggest impact. And often my first visit, which is typically 40 minutes or so, so the initial evaluation, I would say I probably talk for 30 minutes. I can believe that. Just trying to explain them, what am I going to do? And why it's so important that they are compliant with their home exercises and so forth.

And it often involves a lot of drawing. In chronic pain, I often then go online and show them a video on graded motor imagery retraining, for example, how chronic pain, part of it is not the body. It's, again, this recalibration of our central nervous system and how it affects our daily activities, et cetera, et cetera. So a lot of it is, I would say, education. And then like you saw the examples and what we did in San Diego during the workshop, they're simple. I mean, you know, there's nothing hocus pocus. There is no special equipment most of the time that you need. It does not involve any modalities.

So it's something that people can easily control. It takes maximum five minutes. They can do on their own. So I'd like to keep it as simple as possible with the least amount of, you know, let's say equipment that involves a lot of bells and whistles. Yeah. It was really easy. And just one of my observations was that I kept thinking when you, like, the areas that we were seemingly doing stiffness stuff with consistently, it was like the phasic groupings versus the tonic. And so I think back to like, well, what have I done in the past clinically to help people out? And it's like, well, I've given them some of these things, but I haven't done it at the intensity and looked for the, because I think back to Ben, not like, not like you just do Bigfoot Ben, but Despicable Me Ben.

They had the crevasse, the Grand Canyon between the shoulder blades when deadlifting. And we have that video of you just like screaming at him to get his, to get his rhomboids going. And then instantaneously after, it was like you'd thrown a bunch of sand inside the Grand Canyon and he filled it up. But it was intense, I guess, is my point. And I'm always, in the past, I've thought my patients are extremely fragile, you know, and you can really challenge them and you make a big result how you did. Yeah. Now, of course, in the examples that we did there in San Diego, you know, they're basically two big guys that lift weights and can handle me screaming at them.

But, yeah. But on the flip side, when you worked with Allie, though, you changed tones very, very quickly. And I think when you saw that, is it when you see the people who are tentative, you'll change tones and dream a little differently, right? Yes, absolutely. Yeah. If I see people with chronic pain, they're fearful. They have a, what I call, an avoidance problem. So they're afraid to step downstairs without holding on to the handrail or whatever. So they have this fear factor. And actually, I'm going to give you another little example associated with that. Probably 12 years ago or so, I saw a ex-professional ballet dancer, a female, who was in her free time, was skateboarding.

She fell and tore her ACL. Looking at the surgery notes and the MRIs, et cetera, it looked like a pretty simple procedure, meaning there was no chondral defect and all that stuff. Rehab apparently went well until she had to reproduce the maneuvers she did as a professional dancer. Now, I'm not familiar with all the names of ballet, you know, jumps that they're doing. We can mix them up. Yeah, but anyhow, one of those jumps where they're up in the air, their legs are kind of spread out. I don't know. I can't remember what it was called, but she could not reproduce. So the career basically was over, right?

This is several years after the ACL surgery. She's now a ballet instructor for kids. And even years after this ACL surgery, no pain, there's really no structural limitation for her to perform. She noticed that she still could not perform this jump, right? She's scared. And every time she tried, it looked absolutely horrendous, and she would be afraid to lose her balance when she landed on the floor, et cetera, et cetera. And basically, based on this dynamic systems theory, if people come back from pain, and especially if it's chronic and or traumatic, their visual field has changed. So what that means is this.

A lot of our patients that stand on, let's say, a plyo box, and when they look down, it feels to them as if the distance between standing on the box and landing on the floor is large. Like they literally – one of them actually said, it feels like I'm jumping off a building. Oh, really? Yeah, and they're only about, you know, let's say four and a half to five feet off the ground. I mean, it's not like I'm making them jump off, you know, a second forward window or something. So that's also why in planes the windows are very small. Crazy, right? I mean, wouldn't it be attractive if you fly in a plane, fly over some mountains or something, and that the wall, where the windows are, it's actually all glass.

I mean, wouldn't that be cool? I think we need to talk to Boeing. It sounds like a really cool concept, right? What companies like Boeing have experienced is that when that plane now makes a turn, people freak out. So although they know this is glass, I'm not going to fall. When that visual field changes, you panic. So the windows are small for a real purpose. Now, related to this young lady, all I did was I asked her, number one, how did it feel like before your injury when you did that jump? And she basically said, it felt like I was flying. And I said, okay, now I want you to think about that concept.

I want you to fly. Now, the second thing I now did to change the attractor state, and it's based on science, is I made her look through her fist. So you make a fist, and you still allow a small hole in it, and I basically made her close one eye and look through that hole, and we did a couple of jumps like that. So it changes the visual field. It's like the small window in the plane. So suddenly now, she started noticing, she tells me, oh, my goodness, I'm less afraid to jump off this box. We're still not doing this ballet jump, but I'm making her stand and ply a box, and I'm making her taller and taller while she's jumping off.

So I made her repeat 17 times, I want you to fly, I want you to fly, I want you to fly. And then we basically went into a larger room without space enough outside of my office. And I said, now show me how you fly. And bingo, she did that jump, fearless, landed appropriately, and cried her freaking eyeballs out. You guys still trade Christmas cards? I'm sure she's really happy. Oh, yeah. She, seven years of fear and change in movement pattern in an ex-professional ballet dancer who should have had no problem with this whatsoever. So the attractor state concept is not just purely physical. It actually involves also our mental state.

And some of the research has shown in people with chronic pain in general, there's actually a change in where myelin protein is being laid down on neural connections within the brain associated with movement. I mean, so we're talking our brain is changing when we have pain, and especially if it's chronic, and if these attractor states that our central nervous system is restoring, is using inappropriately, it actually becomes somewhat of a structural change within the brain. So it becomes tougher and tougher and tougher to get out of that inappropriate attractor state, let's call it. But the beauty is that you can change it.

You know, the brain is incredibly plastic, as we know. And for the longest time, we thought making changes within the brain would take weeks of practice and all this other stuff. No, it doesn't. Based on this dynamic systems theory concept in attractor state, for example, if I step out of my apartment, out of my house, and it has been freezing outside, and I suddenly slip, I didn't have to learn to not fall on my face. I resolve immediately to an attractor state that has no learning whatsoever. Does that make sense? Yeah. So a lot of the things we do are, let's call it, are reflexive, right? There's no learning involved.

And if we look at babies, for example, we don't need to teach our little kids to roll over or sit up or whatever. Actually, some evidence shows that if we would, you know, learn, teach them to walk, for example, that would often not be productive. Related to that, some people believe now we have to go through these developmental phases, so we're all messed up. Well, my wife and I travel quite extensively. This summer, actually, we spent two weeks in Kazakhstan. We did some horseback riding there and some climbing and stuff. So we always are interested in going to parts of the world that are not so touristy, northern Myanmar, for example, small islands in the Philippines, et cetera, et cetera.

You see a lot of these populations, including some of the Apaches here in Arizona on the reservations, their children never crawl. They pick them off the ground. They carry them. And often it's because of environmental reasons, snakes, scorpions, dirty floor, et cetera, et cetera. So these children do not go through our so-called classic developmental phases, which I think is all white Caucasian biased, by the way. Interesting. So they stand, they walk, and they're absolutely fine. Go to the Copper Cannon, the Tua Mujadas, you know, the long-distance runners, right? We were there about 12 years ago.

It's the same thing. Their children don't crawl. They're actually wrapped up. They swaddle them? I'm sorry? They swaddle them? They wrap them up like a burrito? Yeah, absolutely. Yeah. So how do you think all this comes together then? Because I know that probably some of the clinicians are thinking, well, you just blew my mind with that. What do you mean we don't have to crawl? What do you think is happening there? Well, I think based on this dynamic systems theory and based on these cultural practices, you can see that our central nervous system has a tremendous amount of plasticity to learn, for example, to walk and then later on to run.

And that we not necessarily have to go through these different phases. You gave some good examples, I think, in the workshop where you were talking about a treadmill and teaching someone how to run. And I think, what was your thing? Movement will emerge? Yeah. This is a study. It's actually been duplicated a couple of times. So if you put, let's say, five people on a treadmill and you rig that treadmill up to a scenario where the factor of their leg length is not – it's all the same. That basically means the treadmill's speed is adjusted to their foot strike. So a person is six foot five, another person is five foot three.

When their foot strikes the treadmill, it's exactly at the same time. So the speed is adjusted to their leg length. So if you now gradually increase the speed of those five treadmills, blind studies, so they don't see what's happening, they don't see a speed increase. If you only feel it, at exactly the same time, these five individuals will change their movement pattern from walking to jogging. And then if you then, after a couple of minutes, decrease the speed at exactly the same time, they will change from jogging to walking. Some studies have been done with swimmers as well where you basically put them in a pool where you can control the speed of the water coming towards them.

And you will see that their freestyle technique will change exactly at the same time. And so based on this dynamic systems theory, it basically means that you change the environment in this scenario, the treadmill speed or the resistance of the water, and movement changes. And it makes total sense if you tell people that, right? Yeah, yeah. Nobody stands next to you and next to that treadmill says, hey, it's time for you to start jogging now and you're going to fall on your face. Well, I think a lot of us are accustomed to breaking down movements for people with multiple steps and making it a little bit more complicated than it needs to be.

And, you know, like a simple thing like that seems like, holy shit, we can get people to run just like that. I think your cueing is great. I do like your—I was sitting there with Cody when you told him how to put—how to get MJ to push off the floor. Uh-huh. The distal cueing. Yeah. But I don't know. I was thinking before with, like, old people, I would just put—I would restructure houses. I would make it so their kitchen and restrooms are all upstairs. Just make them walk up the stairs. Yeah. When are you going to do a seminar again? I know Ben is—I don't know. Have you and Ben worked out anything yet?

Yes. I talked to Ben, and there's two potential dates in April. As far as I remember, I think it's the 24th. We haven't completely decided yet what I'm bringing in and so forth, but it might be proprioception. There's also an interest in kind of the way I do neurodynamics, including then the plucking technique. And Dennis and I have been talking about this for over a year now, what a similarity there is between his technique and mine. And actually, we've been kind of chit-chatting around how we could potentially do some work together, but we'll just kind of see how that evolves from there. But, yeah, the plan is that I would come back in 2019 to San Diego twice.

It might be, again, the same workshop, because there's some talk now on Facebook and so forth where people are sharing some of the information they learn in the workshop. So we might see a bigger crowd next time. Otherwise, I have a variety of other workshops. One of them is called Training the Senses, which was the last one I did at Perform Better last year, which was very well attended. So it's kind of a split off, again, from the attractor state concept. You know, can we augment our senses? Because ultimately, our central nervous system makes a decision based on the sensory information that comes in.

Well, is it possible that we can either bias our central nervous system to pay attention to one sense versus another? And what would be the consequences of that? If you're familiar with Nick Winkleman's work on cueing, for example, Nick is an ex-student of mine, probably one of the most brilliant students I've ever worked with. He basically has made a career out of cues. You know, what we say matters is a paper that everybody should read. Because it translates immediately into our patient population as also our performance population. And so by having the brain focus, the attentional focus to shift from an internal cue using body parts to an external cue, external, more performance-driven cue, movement changes, even in the elite.

And those of you that are not familiar with this concept, Gabrielle Wolf from UNLV has basically spent her whole career looking at research associated with cueing. And this is just the tip of the iceberg. We're starting to learn more and more and more about how can we influence our central nervous system and how it changes behavior. And then in behavior in our scenario would be our patients that come and see us to get help, as also our athletic populations that seek us for improving their performance. By the way, I'm going to, for everyone listening, I'm going to put some links into the show notes for a couple of these things.

I'll put what we say matters in there, your proprioception paper, which I'll find the Exos video of you doing some stuff, and a link to your seminars. I was telling Ben and Cody that the world needs more Guido. So whatever you present on, I would go to, and I brought a few people to that last workshop in San Diego. Like Jeremy flew from New Jersey. Chris didn't know what he was coming for. He just said, I'm going to go because you said it's good. And then, so everyone that went thought, holy shit, this just blew my fucking mind. Well, I really appreciate that. Yeah. I think we do need a lot more Guido.

And so if people are considering doing this workshop or not, by the way, I get nothing from this. But it will change your practice. So go find a Guido workshop. I'll put the links on the show notes for that. Anything you'd like to add, Guido? How can everyone reach you? I'm sorry? How can everyone reach you if they're looking to talk to you? Well, considering I'm spending a lot of time now in China and Korea and also Japan, probably the best thing is either contact me by email, which is safe recovery, one word, Guido, at gmail.com. Just go to Facebook and find me on Facebook or my professional Facebook page called Kinetic Integrations.

And just send me a message. Phone is kind of tough because, you know, being international, so that's probably the best way to do it. I also want to say that I have a workshop planned in Portland, Oregon, on the Attractor State. This is in a personal training facility, so the majority of the population will be performance-driven individuals. And so the workshop will also be geared towards that. And that's on kineticintegrations.com as an advertisement. What else? I got something else going on in January. This should release on January, I think, like 9th. Oh, perfect. Yeah. That's okay. Awesome.

Anything you'd like to add? There is a podcast that Chris Duffin did on me as well, so I think if you just Google my name, it'll pop up. Because he was flabbergasted by this Attractor State concept I did with him, and it made a huge difference for him. So he said, hey, more people need to know about this. So I think about a year ago, after I saw him at Exos, he did a podcast on me. Okay. Yeah, I did hear that one. Actually, so before I usually go in and interview people or talk to them on air, I go through and try to get through all their content. So I've read nearly all your papers, and I was looking on podcasts, and I'd like to hear what you've already spoken about.

And Chris Duffins was the only one I could find, and then so I'm going to stick with my statement. We need more Guido. So if we can get Guido on more podcasts, I think it's going to be a better rehab world. Yeah, I'm horrible about self-advertisement. You need to get on that. You can't let Nick have all the propaganda. Nick is doing some amazing things there in Ireland, as you probably know. He makes me very proud. He's like my second son. But yeah, the reason I do this now is I've stepped back quite a bit as a clinician because I'm 60 years old. I want to leave something behind, and I want more and more people to know about these concepts so they can apply them and help more people.

Yeah, I definitely, as I've learned, we only have so much time to learn and disseminate information, and I know for a while, like I've been in practice about 10 years, so for the first bit I was working on information, and then I started realizing that as interns started coming in, they didn't know some of the stuff that I knew. And I'm like, well, maybe a podcast or articles or videos. But then when you start doing that, you forget to learn stuff, so it's hard to do both. Yeah, I'm one of those fortunate people. It's a blessing and a curse where my hobby is also my job. So there is not a day that passes by without me reading.

But like you said, it's one of my quotes in my office. It says, so much to learn, so little time. Right. You seem to just upload it like the Matrix, man. Well, right on. Well, thanks for coming on. Just hang on after I stop this, and we'll just chat for a second. Sound good? Sounds good. All right. Thanks so much for this opportunity. Yeah, yeah. This is going to be your second podcast, right? Yeah. I'm so honored to be the second. Cool. Thanks so much, Guido, for being on. I enjoyed the conversation on and off air. So, amazing. I'll be talking to you real soon. For all of you who are looking for Guido, again, I will put the links in the show notes.

And hopefully very soon, and we talked a little bit off air with his presence on podcasts. I'm hoping that he gets to more podcasts. So we set up a little bit of a strategy to get him more well-known on podcasts. Because I'd love to say mine's the most popular podcast and has the best reach. But realistically, there's ones that are more popular. So let's get him on to some of those other podcasts. And if you listeners know people who have amazing podcasts, and you know them personally, and you enjoyed Guido's content, let's get more Guido in this world. Because Guido, he's a good dude. He's got good shit to share.

And by using his strategies, if you go to his workshops, you're going to improve your patients quicker. It's crazy. It's crazy how well it works. And I think that's all we have for just today. Again, if you have a spouse with back pain, please direct them to the book. It'll be releasing next week on Audible, Kindle, and print. If you've already read it, and you were part of that soft release, please provide me with some feedback. Actually, sorry, take it back. Not feedback, because at the current point, the book will not change. Okay? It will not change. What I'm looking for is a review. How did it affect your life?

How did it affect the person you gave it to's life? That's what I'm looking for. And that'll help me with promoting it and helping out with sharing it to more people. Let's get rid of back pain. Okay? It's been around long enough. This is bullshit here. So, as always, leave people better than how you found them. And if you're dating, date an Eagle Scout. See you later.