Shoulder Pain From Snatches and Overhead Lifts

This is session number 48 of the Performance Place Sports Care Podcast. Welcome to the Performance Place Sports Care Podcast, where you can learn about sports injury theory, rehab, diagnosis, and how to understand the doctor lingo you didn't understand at your appointment. And now, your host, Dr. Sebastian Gonzales. Hey, everybody. It's Dr. Sebastian Gonzales again with this is the Performance Place Sports Care Podcast. And if you've been following along and listening to all these sounds of the 80s and 90s, and I think the last one is 90s, and I'll give you one second. I'll give you five seconds to figure out what that one was.

Three, four, five. Okay, so it was actually Home Improvement, and I actually never grew up watching Home Improvement, but I know the sound. I know the sound they have at the end, and that's Tim Allen coming on, and it reminded me of my childhood. And I know that Home Improvement was on for a lot of seasons. I think it was, what, eight, nine, ten, God, maybe 15 seasons by how much JTT grew up. But, again, I never really watched it. I watched the show after it. So I watched Mary Were Children, and I was probably watching around, I think, probably the age of 10, 12, something like that. And I know it's probably not what most people would have let their kids watch, and I loved it.

It was amazing. And I still to this day, if I see that Mary Were Children is on and I get references of Al Bundy, it's amazing. I mean, I'm pretty sure Al Bundy was America's hero. So he was my hero anyways. But it's interesting to see all these characters actually go from there and do other things, like Peggy Bundy became the, she was with the wife on Sons of Anarchy. So I just can't see these characters as anything else. So I grew up on that so much. So anyways, I thought it would be fun to add that in. So today the podcast topic is overhead shoulder injuries, so I guess in lifters who lift overhead.

And we're going to have a guest on today. We're going to have Dr. Scott Mills. And Dr. Scott Mills actually has a podcast himself. And this morning before we did this podcast, I was just binge listening to them. And I sort of heard a couple of them about a month or so back, but these ones I was just binging them. And I want to see what else he had. And he had some really good videos on YouTube, but his podcasts were amazing. And so his podcast, by the way, is called Full Body Fix Radio. I'm sure he'll tell us about it on the interview here. But this is going to be the first time that I'm really interviewing someone who usually is the interviewer too.

And I've actually only done one podcast, no, two podcast interviews since I started this. And it almost kind of feels like you're speaking in front of a bunch of people, which I usually don't have a problem with. But I like to make it so everyone on the interview side feels comfortable like, you know, playing, basically playing tennis, kind of like hitting the ball back and forth so they don't have to think of all the answers. But it's going to be interesting how this one goes because I'm sure he's usually used to answer or asking the questions rather than answer them as much. Although I know he's been on some other podcasts as well.

So Dr. Scott Mills practices in San Francisco. Again, his email is so his website is fullbodyfix.com and he'll tell you all about it. But we're going to go into some stuff today, some shoulder mobility for overhead lifters, some ways that you guys can assess if you should even be doing a snatch or if there's other things you should be doing instead. And just kind of brainstorming some things you can do in regards to shoulder mobility as well as shoulder stabilization and just the concepts around shoulder injuries in overhead lifters. So I know it's a really, really popular thing that happens in people who I don't want to say just CrossFitters, but Olympic lifters get it too.

So I'd say a strong majority of the things that people like this get is lower back, shoulders, and hip conditions. So here we go. Without further ado, I'm stuttering today, eh? This is going to be Dr. Scott Mills. So Dr. Scott, come on on. Hi. Well, thanks for having me on the show, Doc. Yeah, good having you. I told everybody I listened to, I was binge listening to a couple of your podcasts this morning. I heard that you did one with, there was a guy, it was a doc, it was on the, was it Rhode Island, who you guys were talking about shoulder cases, kettlebells, I think. So actually, well, I told everybody we're talking about lifting and overhead injuries today.

I guess I should start with that, right? That's the topic of the day, I guess. That is the topic. Already we've jumped off topic. So tell us about yourself and what's your experience with working with people who lift overhead and shoulder conditions and so on. Sure. Well, I'm a sports chiropractor, and basically all that really means is I work with and try to work with mostly folks who are at least active. They don't necessarily have to be elite athletes. My practice is actually in a gym here in San Francisco. I would say 95% of the people I see are engaged in some sort of regular physical activity.

My background is in exercise physiology. That's my master's degree. And I started out in life actually as a collegiate certified athletic trainer. So I did that for about six years. So I've really been in and around just athletic endeavors, both as a participant, I'm an athlete myself, and also now, obviously, as a practitioner. I've been doing that for seven years as a chiropractor and about 15 years overall. So, yeah, definitely working with a lot of folks, and interestingly enough, I think when people think chiropractic, oftentimes they think spine pain, neck pain, low back pain, car accidents, that sort of thing.

But to be honest, shoulder pain is probably the number two thing I see in my practice, probably second only to low back pain. So do you find that there's a – and is there a correlation between – because I know everyone thinks like spine issues when you think chiropractor, but do you specifically work only with the shoulder in those cases, or is there a correlation in other areas? Yeah, I take a – definitely a holistic approach, do a really thorough exam on the first visit with a patient. So I'm looking at their full functional range of motion because as we'll get into probably later with – especially in my lifting population, something like, for example, the Olympic lift like a snatch is one of the most challenging things you can do to a shoulder, but really it's a whole body exercise.

So I want to know, does that person have poor ankle range of motion that might be throwing things off all the way up in the shoulder during that lift? So, no, it's definitely a full body approach and look at the whole system, do a good functional evaluation, and then kind of hone in on that local complaint and see why exactly it is. And what I basically describe my approach is, is root cause analysis, and this is a term I stole from my dad. What did your dad do? Yeah, so he's just a Mr. Fix-It, and that guy can fix literally anything. We just are in different planes. He works with machines and I work with men.

But he used to always talk about root cause analysis, like whether he's fixing a lawnmower or trying to figure out what's going on with a car. What's the root cause of the problem? Trace back the – get away from the symptoms, but trace those back to whatever is causing that issue. And that's definitely the case with specifically shoulder issues. There's usually always some other components going on, whether it's, you know, thoracic or mid-back rigidity, whether it's, you know, poor ankle range motion, hip problems, stability in the core, you name it. It could be anything. So when you guys were like – when you guys were putting up a Christmas tree, it was like tilting to the side and your dad's like, huh, son, what do you think?

What's the root cause analysis on something like this? Oh, yeah, definitely. The joke in my family is there's the right way to do something and then there's the Mills way, which is really the actual right way to do things. It sounds good. I think the major thing that my dad told me at least was start a website. And he's a dentist and he has no ability to even type an email. And I don't know how he came to that conclusion, but it was a good idea. He's like, I think this web thing is going to be big. You should probably get into that. Yeah, what's this interweb thing? I see you guys – you kids are like looking at this computer and hearing – watching stuff come through on Napster.

This must be interesting to you. Yeah. Okay, so you mentioned a couple of things in regards to like ankle and like T-spine rigidity in regards to snatching. And I'm guessing the people listening to this are going to know what a snatch is. But can you describe a snatch and why these things are correlated with that? Sure. Yeah, well, I always use a snatch because I do work with a lot of CrossFit athletes and it's probably one of the most challenging positions, especially for modern man to get into. And basically what it is, taking the bar from the ground – a full-length bar from ground to overhead in one motion.

And you usually do it with a wider grip than most people would expect. And these are the lifts you see Olympic standards being judged on. So there's the snatch and then there's the clean and jerk, which is more of the narrow grip, which you go ground to shoulder and then shoulder to overhead. But in the snatch position, it's very challenging because it really does tax the whole system. You have to be able to basically fully squat under the bar with the bar over your head. And most people can't do that even without any weight over their head, let alone in a loaded position. So, yeah, a lot of things can go wrong, whether, like I said, it's poor ankle mobility or stability, whether it's poor motor control in your glutes, overactive hip flexors, you name it.

Lots of things can go wrong. So if someone's having shoulder pain with snatching and we don't know – I mean, they're probably just troubleshooting on their own realistically. That's what probably a lot of people start with. What's a couple things they can look for and, you know, not necessarily improve their snatch, but maybe think this is something that we're going to – maybe that they're going to look at? Yeah, there's definitely a couple things that people can do just for a quick check. I mean, one is can you get into just a body weight regular squat position to full depth, which means at least, you know, hip crease below parallel.

So that would be kind of number one. Can you do that? If the answer is no, you can stop there. You shouldn't be snatching, at least not full. Number two is, you know, you can do a simple ankle range motion check. The one I use in the office is standing – facing a wall, put your foot up against the wall, and then lean your knee into the wall. If you can do that, then take a step back a few inches and try again. And you go and – if you can get to about five inches with your toe away from the wall and your knee still touching, that means you have good dorsiflexion or basically that ankle range motion you would need to get into a full depth squat.

So there's two there. I would check a quick shoulder range motion test, which would be something as simple as a scratch test. And this is where you basically try to touch your shoulder blades behind your back. And you can kind of do it really quickly with both arms. So if you were doing this with the right arm, you'd reach behind the back, touching the left shoulder blade, while you take your left arm behind your back low and try to touch the right shoulder blade. And then reverse. I know it's an audio medium, but hopefully people can rewind and try that again. I'm watching you do it. I think we've got a left shoulder pathology going on right now.

My left's a little tighter than my right. You seem to lean that way. And basically what you're looking for is symmetry there and the ability, obviously, to move through a decent range of motion, get pretty close to the scapular or the shoulder blade, but also symmetry. So what I see in my evaluations a lot of times, just like you noticed in me, we usually have one shoulder that moves a little bit better than the other. And if you multiply that times repetition times load, you could be setting yourself up for some trouble. So let's just say someone has done all that right now. They were listening.

They rewound a couple of times and they checked all that and they're like, oh, this is normal. I have all this. I can do it. I can do all this. I still have shoulder pain. What's that? Yeah, there is. This is where you and I come in. And it's one of the things that I always am really cautious and always constantly reminding people. You know, I do a lot of work online for those people who don't know or aren't familiar with my work. You know, I go by the online handle Full Body Fix. And so I'm always showing stuff, videos online, on Instagram, et cetera. I have a program I sell to folks specifically, you know, for all different types of issues and injuries.

But the reality is you can't replace the professional in your life. And I always encourage people to find a good professional. So when you've kind of exhausted some basic, you know, self-evaluation, self-care, you've been mashing a lacrosse ball into your shoulder and I'm not surprised, it still hurts. It's time to go see a professional. And this is where I do recommend folks like yourself, like the kind of work that I do, which is, you know, performance-based care, which we can get in there, do a root cause analysis, figure out what the root cause of the problem is and find out what that is. And in my case and in shoulders, about 80, I'd say, I'd say 80 is conservative.

Eight out of 10 cases, I see a shoulder pain. There's usually an issue with the subscapularis muscle. And we can talk about that if you want. Yeah, we can. Gosh, I was going to ask you something else in the middle of there, but I thought I forgot about it. I'll come back to it, I'm sure. Sure. So, I mean, basically, this is a big, most people have heard of the rotator cuff, although a lot of times it gets mispronounced as like rotor cuff or something. But the rotator cuff is a combination of four muscles that basically stabilize and do some motor control in the shoulder. And the subscapularis muscle is the big, powerful internal rotator that kind of sits on the underside of your scapula, thus subscapula, subscapularis, or your shoulder blade.

So it's basically between your shoulder blade and your ribs, if you can kind of visualize that. And the way we access and test this muscle is by basically reaching our thumbs into your armpit. So you can palpate the muscle there. And really, most of the time when I check shoulder pain, there is a problem with the subscap. So whether it's got a soft tissue adhesion where it's sort of glued to surrounding tissue, whether it's the lat or teres, or it's just overactive, or it's forgotten how to fire. So lots of things can go wrong with this muscle. And one of the best ways to treat it is with active release technique.

It's one of the techniques I know you specialize in, something I've been doing and been full certified in since 2005. And go in there and just a few visits, release that muscle. And sure enough, the pain in the shoulder starts dissipating because the biomechanics have been fixed. You know, I was thinking back, actually, 2000, I think that was around, I went to, that was when I started to, we'd probably been to a seminar together. We just didn't know about it. It's possible, though. Most of mine were on the East Coast. So if you've always been here, I don't think I've made too many trucks out here.

Oh, really? No, I was mainly out here. I did one in Boston like about three years, two years ago, I think. Oh, my God. Like, I haven't been on the East Coast and had to wake up that early for a seminar before. I don't think I'm going to go back, man. Nah, that's tough. So I know that a lot of patients probably ask you then, so say you're feeling into the subscap, and they're like, do you feel something? Does it feel abnormal? How can we know? It does. The best way I describe it is, I kind of mentioned this when I was talking about it, but almost like glue. A soft tissue adhesion basically decreases relative motion in between soft tissues.

And just a layperson's term, if you think about the way glue works, it sort of sticks to everything. And that's kind of what these soft tissue adhesions feel like to me anyway. And, of course, after we've been doing it for 10-plus years, you start getting, I don't know, just a sense for when muscle tissue is normal and when it's not normal. And so it could feel kind of boggy, it could feel kind of dense, just not like normal muscle tissue. And then the cool part about active release technique is as you're palpating that muscle and putting it from a shortened position, a shortened muscle contracted position, through its lengthened position, you can actually feel what's happening with the tissue, with the muscle, and seeing if it's actually passing through that range of motion, or if it's kind of shutting down and closing off that range of motion.

And one other thing, while I'm kind of on this vein, is a lot of people have pain in the top of their shoulder and have been given maybe a shoulder impingement syndrome diagnosis. That almost always is not the area of the problem. So that tendon on the top of your shoulder that's being impinged is called supraspinatus, and that's usually the symptom, not the cause. And that's when I do tend to look at the subscapularis, release that, and get the pressure off the top of the shoulder where the pain is. But yet again, you see so many people just kind of like treating the area of the pain. And this goes for providers who don't know this information either.

They'll do ultrasound or E-STEM on top of the shoulder to try to kill the inflammation or pain, but never get to the root cause of the problem. Yeah, and I think it's what we kind of find, too, with like shoulder or subacromial bursitis or the irritation to the fluid sac. I mean, it's just – I mean, you find it with rotator cuff tears, tendonitis, labial tears. I mean, it's always there. You know, it's just a secondary cause, you know. Yep. I was going to tell you that when people ask me what it feels like, I always tell them it feels really stinky. Stinky? Because it's in their armpit. I don't know if you said stinky or sticky.

Yeah, no, it feels really stinky. What have you been doing today? Yeah, that sounds about right. So, the subscap then, since we're on that route, is what other types of shoulder conditions have you correlated – like, when you treat like the subscap and you make it normal again, what other types of conditions actually improve with this? Right. So, I mentioned shoulder impingement. That's probably number one for sure. I mean, definitely in my lifting athletes, they get that superior top-of-the-shoulder pain that's usually, like I said, eight times out of ten, a subscap issue. Rotator cuff sprain or strain or tendonitis or even subacromial bursitis, like you mentioned, which is basically that inflammation of the bursa sac in that area.

I definitely see this translate, though, down the chain or up the chain, downstream, upstream, if you're familiar with that kind of language from Kelly Sturette. But basically, you can get some upper extremity type of tendonitis, depending on the type of activity you're doing. So, if that big stabilizing muscle under the shoulder blade that's, you know, kind of really designed to stabilize the shoulder, especially in overhead reaching, is not firing well, you could actually get some translated biomechanical tension down the chain and maybe get something like bicipital tendonitis. I've definitely seen that happen, you know, if you're doing, like, a lot of pull-ups, for example.

Yeah, that's probably a good list to start with, anyway. Neck problems, actually. I've seen quite a bit of neck pain because, again, if your shoulder girdle, you've got to think about that whole thing as part of the biomechanical chain. If that's not moving well, if you're getting rigidity or just a lack of stability in that joint, it's going to translate somewhere else, and that could go right to the neck as well. Yeah. I've seen – I actually watched some of your nerve flossing stuff today, too, and I'm sure you can get some of that. I saw the median nerve. I didn't see – I didn't get through – you had a radial one in there?

Was there – I don't have those ones up there, not on YouTube. Only medial? I just only put the medial one up, yeah. Yeah, that was a good one. Was it the dinosaur arm? T-Rex. Very descriptive. I'm sure people will get that part. Yeah. Okay, so you were talking a little bit about bicipital tendonitis then. I know that this is probably going into a larger biomechanical type of conversation, but then how could biceps pain be correlated to the subscap or shoulder conditions? Because I know that – I mean, it probably makes sense to us, but I want to make sure everyone kind of gets an idea of we're not blowing smoke.

Yeah, I think the most common way I kind of think about this is just from the pull-up position. I think a lot of – it's a pretty common exercise, whether you're doing maybe lat pull-downs or assisted pull-ups or bodyweight pull-ups. That's a repetitive motion overhead, but you're pulling. And one of the things that – in that position, the subscap really's responsibility is to kind of hold the head of your arm bone, your humerus, kind of down and away from the joint so that you can reach up overhead. If the subscap's not firing, your shoulder's not going to move freely in that position. If that happens, the force has to be translated somewhere.

And so then maybe you start pulling more with your other muscles. You're not able to maybe engage the lats, the tears, and other scapular retractors. You start engaging more biceps, and then all of a sudden you kind of get that pain at the front of your shoulder right where the biceps actually originates. I like it. In regards to then – let's just say – because all these things are – these conditions that you're working on, I imagine that the ones that are improving, they're not major, major tears, right? Correct. Okay. So what level then are we – like if people are listening, they're thinking, well, this type of correction will work for me except if I have X, Y, and Z.

Yeah, I mean, obviously, I've referred folks out for imaging that I suspect have maybe a significant partial or full tear of muscle tissue. Although, interestingly, I don't know if you saw this report, Doc, but there was a new kind of meta-analysis report, and I don't have the details in front of me to give you the exact literature on it. But they did a study of rotator cuff injury and compared conservative rehab, even in full tears, to surgery, and the results were pretty much the same. Yeah. I believe that. Actually, if you have it, you want to email it to me? I'll look it up. I'll grab it, and we can get a link maybe in the show notes or something.

But I saw that kind of come through, and I was like, oh, I kind of bookmarked it to read the whole thing, never got a chance to. I was like, oh, that's interesting. Because, you know, it's sort of one of those things where you're like, well, if it's torn, it needs surgery. I think it depends on the activity and also the level of athlete because, obviously, if you're Cole Hamels, a professional major league pitcher, then, yeah, you need your rotator cuff fully intact. But, you know, maybe if your goal is pain-free, full-range motion, you know, full strength to your ability, there's a good chance the conservative approach and rehab and strengthening the areas around it could actually work.

But, again, I don't want to get outside of scope of practice. I'm definitely not going to speak for surgeons since I am not one. But, yeah, I think it's always worth knowing what the problem is regardless. So, you know, get some imaging, whether it's a diagnostic ultrasound or MRI, and kind of see if there's something more going on there. I can't really think of anything other than that, other than maybe progressive neurologic deficit, which just basically means a consistent loss of muscle strength and or feeling in your extremities. If that's happening, definitely go see a doctor. But, yeah, for the most part, a lot of these things can be addressed with conservative care and rehabilitation.

Yeah. I don't think I – or I haven't told you. I don't know if you saw it on any of the other podcasts or anything. But the – actually, my mom actually had a really – she had a fully – I don't want to lose my words right here. But her super spina is basically blown off and pulled back. So completely pulled back. And she came in, actually, to my office one day. And we were – I was with a sonographer, and we were just learning how to do musculoskeletal ultrasound. Or I was. He was good. So that was at the time years and years ago. And she was picking on my dog. And I knew she had a partial tear already from, like, a past MRI she had.

I was like, why don't we just take a look at this? I want to see what a partial looks like. So we look at it. She's completely gone, like I said. She had no pain. She had full range of motion. Yeah. Until we – I really isolated down the subscat – or the – sorry, the supra. It was completely normal. So with what you're saying, again, like, with – it really depends on what the person needs to do or wants to do. Yeah. I mean, that was one of those cases where, I mean, she's not in pain, like, especially with her being my mom. I was like, I don't – if it makes her worse, am I going to hear about this for a long time?

Like, because it's definitely a possibility. Yeah, probably. Yeah. She came out better from it, but she had it repaired. Yeah. So since we're on this route of thinking then, so with people doing overhead lifting, snatches, and so on, is there a certain point in time where you're like, look, this is, like, this is not going to work for you based upon what you have? Do you direct them to something new? Yeah. Because I know you're – what's the hashtag? Does your doc even lift? Yeah, does your doc even lift? Yeah. Yeah, I started saying that basically because I just – I got honestly overwhelmed with patients coming in who had been to other providers and had been told, well, you can never do X, Y, Z again.

And I was kind of like, well, I mean, does your doctor even lift? Like, do they even know what that means when you're telling somebody who loves working out or loves playing tennis or loves running that their injury now is a prognosis for never doing that activity again? So I think approaching kind of the mental side of rehab is definitely part of it. But, yeah, I mean, there definitely are times where we need to modify activity, take the insult away from that area. But for the most part, I mean, honestly, I'd say a good 80% of my patients were working through whatever problem they have during activity.

So they're able to continue to do things, you know, outside of obviously, like, really acute stuff. We're giving people active, corrective exercise, and they're able to continue feeling like they're engaging in the activities they like to do without, you know, continuing to make it a problem. But I think to kind of take your question and sort of flip it on its head a little bit, the bigger issue I see, especially in functional fitness, is folks that don't have full range of motion nor full ability to stabilize or motor control over their joints jump into loaded activity that they shouldn't be doing until they can acquire those skills.

So what I mean is, you know, for example, that snatch position that we're talking about, it's one of the most challenging things you can possibly do, especially if you're loading it. Well, what should you do? Well, first, you should do the range of motion test that I want to walk you through. Then put yourself, get yourself a PVC pipe, basically zero weight, but put your arms out wide and put yourself into that overhead squat position. Now, can you do that pain-free? Okay, you know, then let's take an empty barbell. Can you do that in an overhead squat position? Okay, can you power snatch it without the full squat component?

If at some point you get to the no point where things are like your form is really, you know, getting out of whack and your coach notices that, they should be able to step in and say, okay, this is where we stop. You're going to drill at this load or you're going to work on this range of motion deficit or you're going to work on this stability deficit until we can safely do this position. I think that's the kind of component that is missing in a lot of group classes is that kind of individualized one-on-one evaluation, which is kind of where I see, you know, myself as kind of the interim saying, okay, well, you're starting this new activity.

Why don't you come in and let me do a functional evaluation of how you move and give you some advice on things you should be doing and maybe you shouldn't be doing at this point in time? Yeah, I think it is more common in group fitness for sure. And, I mean, so how many times, like, when they come in does it take for them to really understand their capacity within group and be able to, like, hold back a little bit, especially on the movements that they don't have control over or they don't have movement that they can tolerate, you know? Well, that's the thing. I think that the evaluation component is kind of completely missing from my perspective for the most part.

I mean, there's definitely some places that, you know, require a functional movement assessment before you start a group class. But for the most part, you know, they kind of just, here's the workout of the day and let's go. And maybe here's, oh, you can't do that. Well, let's put a band on it for your pull-ups or whatever. But I think we need a little bit more individualized attention, you know, especially for beginners so they do know their capacity and what they should be doing and what they shouldn't be doing. But, yeah, I mean, it's definitely a tough balance. But as far as, you know, working with folks who are maybe already engaged in some sort of fitness that they're enjoying, I don't tend to say stop.

I tend to say, well, let's do this also instead of or alongside and try to give them some different options. Yeah. So when people, let's just say, because we went back to that, let's go back to that part where you said, here's a PVC pipe. Let's go through the movement. Let's see what you have. And say that takes them, say 10 minutes? You want to say 10 minutes? 15 minutes to do? Sure. Part of the hour they have for their workout. And they come back and they say, Doc, Doc, I'm really frustrated because I'm not getting my sweat on. I'm not getting my workout. I need my workout. What do I do? So what do you tell them?

Because I know that's why they're going. They want to lose weight. There's some type of reason, you know. Well, you can develop quite a workout without really ever picking up a barbell or putting yourself in a compromised position. That's what I would tell them. Just do a bunch of burpees. I mean, you'll get your sweat on in a hurry and it's not dangerous. But the other part of it is honestly, and what I see a lot and why a lot of people I think do get hurt, is they let ego dictate their workout instead of letting basically their coach or their practitioner work with them to determine what's an appropriate, you know, load for that day.

They let ego dictate load. That's when you're going to get hurt. I see that all the time. It's why I really didn't get hurt doing CrossFit when I started five or six years ago. You know, I was already a practitioner. I understood the body. I depend on my body to make a living. I was not going to get hurt. So I spent many, you know, many classes with a PVC pipe right next to, you know, experienced female CrossFitter who was completely just crushing this workout. And yeah, of course, it feels like a little bit weird when I have, you know, no weight on my PVC pipe. But I knew that that was the stage I was in and I had to do the work of learning the form before adding the load.

And it worked. Yeah. So it was like a good, it was mainly like an ego check. And you said, look, this is where, this is why I have to do this. And, uh, in that kind of stuff, right? Yeah, for sure. Okay. Um, so I heard women's RX is still RX. Yes, yes, it is. How's your, how's your snatch now? I'm terrible by the way. Cause I don't, I, I decided that a long time ago that snatching is not something I really care about, nor am I going to get paid to be a professional athlete. So I decided to clean and that's it. Yeah. How long did it take you to get yours going? Um, yeah, I mean, it's definitely, oh, it was a long journey to be honest.

Um, my goal was always to be able to snatch my body weight and I cleared that, uh, and then some probably I'd say two and a half years into CrossFit. So I hit 205, although to be completely honest, I haven't snatched over 185 since, uh, I'm kind of like you, I sort of like really appreciate the movement, but I realized that there's no way I'm ever going to get to a weight that it's meaningful. I'm not a competitive CrossFitter. I do everything I do. I do for, for health and enjoyment. And, uh, yeah, that's kind of where I stopped with that. But yeah. Can you imagine like getting up to like, you got up to your PR and like, you talked to it's like two years, you get to your PR and you're like, Hey, this is why I snatch and someone's like, ah, and they just disregard it.

And it was like, here's your work. Cause it's not impressive still. Yeah. It's still not that great. Yeah. I was always thinking about like, with like, we're talking about like functional movements of like, you know, squatting, deadlifting, and they're all being used in everyday life and functional fitness and blah, blah, blah. Right. And I was thinking about the overhead squat really. Yeah. And I was thinking about how to get something over your head. If you're moving, if you're moving from one, from one spot in San Francisco to the other and you have a box, would you ever snatch it up? And when it's to the top, would you ever squat it down to put it up again?

Yeah. No. Like, like what an arrogant person where it's like, you know, I'm moving, forget it. I'm going to snatch it. Then I'm going to squat it too. Maybe like a really light lamp. Yeah. I know. Right. You'd be the like least productive mover on the block. Like just doing extra squats for no reason. Yeah. I definitely, uh, it was kind of funny you mentioned that though, because actually we had a big box of, uh, I think it was like outdoor patio furniture delivered to the house. And, uh, I was busy all day yesterday with patients. So my wife went and she's like texting me. She's like, I have, this thing weighs 150 pounds.

I'm tire flipping it into the garage. I was like, Oh, by the way, there's a piece of glass in there. Yeah. But she's like, talk about functional movement. She's, she did. She like moved that box here, didn't there? I mean, she's also a super avid athlete and very strong. So it was, it was kind of fun to see, but yeah, for sure. I don't know how functional, uh, tire flipping, well, ground overhead snatching is. I'd say tire flipping is fairly, fairly functional. Yeah. I always thought that like, uh, like actually today, actually, um, earlier. So I don't know if I told you I have a, I have a coffee roasting business.

Oh, okay. No, you didn't say that. Okay. So this is, uh, so my partner is actually, he's a, he's a CrossFit coach and he can, he can deadlift like five 50 and he's a strong dude. Um, just like a beast of a man. So when we ended up picking up buckets of coffee, like some of them, like one of them today was a trash can of basically 60 pounds of roasted coffee. So we're taking it out of the car and he just pulls it out and he starts like, he has to straddle it to walk it in. And I'm like, you just basically sumo that is what I'm like, now you're, you're sumo walking, but you're being so stubborn.

Why don't you just ask me to help you? We can both farmer carry it in or suitcase carry it. Nice. The functional fitness of it all. Um, okay. Back on the shoulders then. Sure. Okay. So shoulder mobility tips. I know you have some YouTube videos out there, but people always talk about shoulder mobility as well as stabilization and all that stuff. Give me two tips for each. Yeah. So for mobility, uh, I do, I do kind of lean toward the subscap release. It's not definitely not anywhere near as good as you're going to get from your active release technique provider. But, you know, basically it's just a banded kind of overhead, um, stretch just to kind of allow some freedom of motion in that overhead motion.

And, and part of it honestly is just kind of feedback. So people can feel the difference between sides. I do have people do it bilaterally, even if they're only having pain on one side. And typically that'll help kind of, well, it helps a couple of things. It helps their shoulder range of motion, but also helps them say, oh yeah, I really notice the difference between when it's actually moving and or firing, um, versus when it's not. So that one you can definitely find on the YouTube channel, a quick link to that for anybody listening who wants to just jump to it is the number two minute fix videos.com.

That'll actually take you right to the channel. Oh, I thought for some reason you're going to be able to have the slash two W Y Z. Yeah. Let me give you the bit.ly link. Uh, no, no. Yeah. Um, yeah. We'll have a link on the podcast. No, that's right. You can see that. Um, and the other one, I actually really, I see tons and I'm sure this is probably for most people, I see tons of desk workers. Um, I'm tending to give them a lot of, you know, sort of peck or chest opening drills as well. I do see a correlation between those two kind of, you know, having the, the shoulder being pulled anterior or forward rounded shoulders, uh, which is, you know, obviously going to be an overactive or tight quote unquote peck, uh, or chest muscles.

So I do, uh, teach people how to do those as well, whether it's just kind of a door jam stretch where you're sort of, you know, have your arms out and leaning into a door, um, or even doing some contract relax where you're sort of firing those, um, scapular retractors, bringing your arm behind your back sort of straight up to the side and also up kind of overhead and behind. Uh, and that kind of helps, um, just helps relax the peck while you're trying to stretch it instead of just trying to force it into a lengthened position. How long do people typically use these for? Like how many, how many seconds they hold it and like how many times a day?

Yeah. I think with the subscap, uh, release, I say basically like three sets of, uh, 10 second holds. So it ends up being, you know, not too long. And then with, uh, active isolated, related stretching or contract relax on the pec, same kind of thing. You're, you're only contracting for a few seconds and you only need to do them, you know, maybe three rounds of 10 reps as well. So it's not, not too, uh, prohibitive. So if someone were to do these, then how long should they expect until they feel like, Oh, that's different. I feel better. I, it's a tough question to answer because honestly, I look at these as more maintenance and it's part of a companion to your work with a provider.

Uh, if that glue is in there, if the soft tissue adhesion that we talked about is in there, uh, it doesn't really matter how much you stretch. It's really not going to, you're not going to get the full benefit. You might get some of it, but you're not going to get the full release of that tissue or lengthening that tissue. If there's a, if there's an adhesion there. So I think it's working with a practitioner and looking at it like, um, kind of like regular hygiene, if you will, like brushing your teeth or flossing is for your oral hygiene. Think about your body, body biomechanics as kind of a daily maintenance tool.

And so what I do is I typically, I kind of have a whole, whole history of low back pain, which we don't have to talk about. Um, I'm currently not in any pain. I haven't been for years, but I had a, I had a history before going to chiropractic college. And so one of the things I do is it just every, every time before I'm working out, which is usually five days a week, I go through a little bit of a low back mobility stability protocol. And I look at that as, as just kind of a daily habit thing. But I'd say if people are doing this for a month, you know, three to five days for a month and they're not seeing any improvement and you haven't been to a practitioner, it's time to go see somebody.

Yeah. I agree with that. I just thought I'd ask you cause I know that people are probably wondering it, but, uh, yeah, sure. Yeah. I always tell people if, if they are like, if they've worked out and they're not so in the rest of their body anymore, but they still feel one certain spot and it's been about a week and they've done mash work and stretching and all this isn't going to get better. They should probably go see somebody cause yeah, cause it can be really simple in the beginning, but the longer they wait, the worse it's going to get. Absolutely. You go ahead. Yeah. And then on the stability side of things and, and honestly, uh, doc, I, I, I lean towards stability over mobility work anyway, I, if I, if I had a patient to do one of the two, I would do stability.

I'd say, let's do scapular retraction work. So that would be pulling your shoulder blades back together to get some motor control firing, opening up that chest. You kind of get killed two birds with one stone there. And then as far as some shoulder health drills for stability, I really like single, uh, dumbbell or kettlebell overhead walking, like literally just take a good solid weight for whatever you feel like that load is put your arm up over your head with that weight and just walk around as long as it's not too painful. If you're in acute pain, obviously don't do that yet. Um, yeah, they can't reach above their head.

They're like, yeah, I'm going to do this. Um, but once you're kind of in that sort of rehab zone where you're, you know, you're out of acute pain, that's one I really like. And then other one I really like is single arm high pull. Uh, so it's a little bit hard to describe, but basically taking a weight and pulling it straight up and kind of toward your shoulder, almost so you're, if your palm is facing your chest, your, uh, film should be shoulder height. And if you do those, uh, you can do them fairly light to start. That's a really good shoulder stability exercise. And most people are super deficient in that range of motion.

So you look like you're starting a lawnmower. Is that a good point? Yeah, it's like kind of like a lawnmower pull exactly, but upright. Okay. Yeah. I like those too. The, um, yeah, I would agree with you. I, I used to start with stabilization and I like, I like doing like actual release and tissue work and stuff, but realistically, I want to be able to see if I can change it from a, a movement standpoint first. And then we just work on the tidbits at the end. Um, I'm always surprised the amount of times people just get better and they're like, oh man, that's, that's David Copperfield stuff right there.

It's like, what'd you do? Well, no, you did it. You stabilize your shoulder. Yeah. Cairo voodoo. Yeah. It's always good. The, uh, did you ever have a class by the way in school? There was, uh, we had one, uh, gosh, what it was called? It was, um, I want to say it was a techniques based class. So it was one where they brought in people, uh, doctors of different techniques of all different realms in the chiropractic realm though, every week. And you'd see different things like we'd see a hole in one doctor. We'd see one that had this, this, this is where I'm bringing it up. He had a little thing on his belt and he kept, he kept touching it.

It was like, he'd swirl it up and then they'd touch you. Oh no, I don't know anything about that. That's weird. I, I don't know. I kept calling it a swirly, but, uh, but honestly, God, actually during that class, we would leave and play ping pong in the student center. So I'm not well-versed in other types of techniques, but we heard about it after class. We're like, Oh, they're like, Oh man, you missed the swirly. Ah, I really wanted to hear about that. Um, okay. So, uh, actually, so we're about 40 minutes in the podcast and I, how tired are you? Because you're used to 30 minutes segments, aren't you?

I'll go as long as whatever I, I mean, I do my own show at 30 minutes, full body fix radio for those of you guys listening. Uh, but I'm also used to editing my wife's podcast, which has been an hour, uh, every week for five years. So I'm, I'm used to longer shows. Do you, do you, uh, do you, Oh, so, Oh yeah. So I guess we got to say what's your wife's podcast. Oh yeah. So Diane Sanfilippo, you can follow her at Diane Sanfilippo.com. Um, but, uh, the, the podcast is the balance bites podcast, the award winning balance bites podcast. How do you get an award winning by the way? Yeah. Well, she got her and her podcast partner, Liz Wolf, they, uh, they've won now two years in a row or three years in a row.

I can't remember best, uh, podcasts, uh, from paleo magazine. So they do that every year at paleo effects at the big conference there in Austin, Texas. Okay. I was just making sure it wasn't a, uh, you ever, you ever, I don't know if you have a place in San Francisco around there that has like the world, the locally, locally, world's famous best pastrami. Yeah. We have one of those down here in sunset beach and this is world's famous, but it's like painted on a wall. It's like they were hell bent on like, we're not losing this title, but I don't think there's not even a freeway really that goes directly to there.

So I doubt, I doubt they were, they're world famous. So by the way, everyone, that's bricks. It's sunset. It's in a sunset beach, California. We'll work for pastrami. They do have pretty good pastrami and beer on tap though. Um, so then, uh, tell us a little bit about your podcast. Cause there's not too many doctors, educators actually out there. And I mean, why did you actually start doing it? Cause I mean, cause you're, you got good information here and you know, you can easily spend your time treating people. Yeah. Uh, the why is a couple of different reasons. I mean, one of my, I feel like my missions as a doctor is also as an educator.

Um, I believe doctor means teacher and I think, is it Latin? I don't even remember. But, um, I think part of it is I just got frustrated with all the misinformation swirling around these days, um, part of the blessing and curse of the age of the internet or information age is anyone can say anything and they may or may not know what the heck they're talking about. So I felt kind of like, this is my chance to bust myths, uh, to break through misconceptions about, you know, fitness and movement and, and just how, what are the, really the best practices for getting people better and back to doing the things they love.

So yeah, full body fixed radio sort of stemmed out of that passion of mine just to teach people and clarify information. I do kind of like a movement myth buster segment often. Um, I have professionals like yourself come on and talk about whatever they're most passionate about and get people equipped with good information. So it's part of, you know, a bigger mission of mine with fullbodyfix.com and also the program, uh, that we've referenced as far as, you know, having a video resource of, of just quality information for people to access, uh, and just kind of cut through the junk and get right to the heart of the matter about what, uh, what works and how to help people eliminate pain and improve the way they move.

Yeah, that's good. The, have you, if you're like me, I I've already learned so much from other people. Other people. Oh yeah. So what are the top three things you think that you've learned or at least the top one from someone else? Yeah, I think pastrami, uh, other than the world's best pastrami sandwich. I think, uh, you know, I had an awesome show. One of my favorites, probably, I hate to single anybody out cause all my guests are fantastic, but, um, Dr. Jonathan Chung, who's an upper cervical doc. He came on, I think it was like episode three or four. It's just somebody I've known in the, in the community for a while.

He's down in Florida, uh, with a practice, but he actually, he didn't really talk that much about chiropractic outside of his, his area of interest is concussion rehab. And, um, and just some of the stuff they're, you know, utilizing with chiropractic technique, but also, you know, all sorts of interesting measures like heart rate variability. And I'm still learning myself. I don't even know if I can speak eloquently like you did about it, but you can definitely check out that show of, you know, concussion rehab, I think is one of those sciences that is really just at its infancy. And they're learning so much every day about, you know, what is the really best practices for, for head injury recovery.

Uh, and it's super important, super, uh, um, just current information that people need to be working on and need to, need to seek because of how much trouble folks are having, you know, later on in life from these cumulative trauma, uh, brain injuries. Yeah. There's, um, I, I interviewed a guy that, um, and actually when I went through school and we probably went through the first or the, through the same type of, uh, learning process because we started with, you know, do manual therapies and everything. And, uh, so I started talking to some people that did functional neurology and was he doing the same thing?

Yeah. It's kind of an offshoot of that, like Carrick's work and stuff like that. I definitely, I've learned some of that as well myself. I think it's fascinating. Yeah. It's, I almost feel like it's digging so far down the rabbit hole. Um, I just kind of want to cover part of the rabbit hole up cause I, I partially don't think, yeah, well you could, you could like learn so much where you get, you get paralyzed by, oh crap, am I doing anything right? But, um, I think for those cases, I think I'm just going to refer those out. I think it's important to know, you know, you're as a practitioner, what you're most passionate about, because otherwise your patients can sense that energy.

If you're either lost, confused or disinterested, they're going to know. And that's one of the things I learned from one of my mentors and Dr. Russ Ebbets back in New York chiropractic college, you know, when he was there, he, he, I was having trouble sort of deciding what route to go. And he said, pick something. It's sort of like very matter of fact mentoring, which is just basically like what lights you up? What are you most passionate about? And head that direction. Cause you can't be all things to all people as much as a practitioners like ourselves who are engaged in this, um, profession of helping other people's.

We, we always want to feel like we're the answer. The best thing I think you can be as a practitioner to know when you're not the right person for the job. Yeah, I totally agree. Yeah. There, there's nothing worse than having someone hang around in the office and treating them and you, you can't really do much for them. I mean, it's, it's dishonest. It's not helping them at all. And you know, there's someone else who can treat them better, you know, the longer I've been in practice, the quicker I am to send people to other profession. Professionals because you learn that very quickly. It's not good for them.

It's not good for you. Yeah. I had this one, I had this one person one time. I won't go, I won't make the two, the details too specific, but, um, but, uh, I had to immediately within like five minutes or less of the test. And I'm like, I'm like, we have to go get something that you need to go somewhere else. And it wasn't a personality thing or anything, but it was mainly just exam findings. And they, they really, really wanted me to do one type of treatment with them. And I'm like, I can't, I can't, I can't, it won't help you. It was, it was, I was having to force them out the door almost to get them to the right care.

It was, it was really, it was kind of funny, but, uh, hopefully in the longterm people understand the benefit that you didn't, you gave them, but it's, that's not on you. Yeah. He didn't, I don't think he liked me at the time, but, but I thought I did the right thing. Um, what is the second thing that you learned in, in, on the podcast? Yeah. Um, Hmm. You know what? I did a whole series in the month of May. I did kind of a month of mom series and two out of four of the people I interviewed there made a special emphasis, um, in regards to kind of pre postnatal, uh, kind of fitness and rehab as far as, you know, moms who have, uh, are either getting ready to deliver to deliver or have delivered, um, really place a large focus and emphasis on the importance of learning how to breathe properly, not just like the kind of classic or stereotypical Lamaze breathing thing, but actually really learn how to use their entire quote unquote core to, um, to actually breathe.

And, and I sort of, it triggered something in me because I noticed a lot of patients and you've probably seen this too in your own practice, really are most of our society breathes wrong. We don't use our abdomen. We don't use, you know, our big kind of control muscles. We actually breathe from our chest and that can actually throw a lot of things off from a neurologic perspective and create some, all kinds of havoc, uh, from a biomechanical system. So I thought it was just interesting that, you know, independently two people in that sort of specialty brought up the same point and it kind of made me, uh, want to focus a little bit more on that with my folks too.

Yeah, that is, uh, actually it's funny. I, I have had probably four people independently also have the same thing on the podcast. They just, they start talking about breathing and, uh, diaphragmatic breathing and all that stuff. And, um, I actually had a patient two days ago, uh, you're on video, so you're the only one who could see me, but he comes in with a, he says, I got a labral tear on a frozen shoulder. And, uh, he, he looks at me and he's like, it hurts when I breathe. Uh, are you still there? Sorry. Yeah. Okay. So, uh, I, I said, okay, can you demonstrate for me? And he goes like this.

So for all that you can't see, I basically just shrugged my shoulders when I was breathing and, and I, and I was like, so that hurts right there. And he's like, yeah. And I'm like, can you, can you, uh, I'm like, I want you to look in the mirror. So I showed him, he didn't, he didn't get it at the first glance either. And I said, you know, your shoulders don't have to move when you breathe and he just couldn't stop it. So finally we stopped it and he's like, Hey, my shoulder's better, but then it still hurt when he shrugged, which until it made total sense. Sure. Yeah. Um, okay. So let's, let's recap thing.

Cause we're coming to the end here then. And so you said there's three things that we need to make sure that you can, that they can do to be able to snatch, uh, ankle range of motion. You said T-spine rigidity and some type of emergency in San Francisco streets. Yeah. I'm sorry about that. Welcome to home podcasting. Uh, the last one is reach a reach test. So, uh, anything else you want to add to those? Yeah. I think we, we kind of mentioned, uh, yeah, hip range of motion or being able to basically squat to at least a parallel, uh, in a stable position. That'd be the fourth one. Okay, good. Um, do you have videos on any of these?

We can, I don't really break down Olympic movements or for fitness movements in general. No. Uh, are you going to plan to maybe shirtless or something? Yeah. Just drive up traffic real quick there. Uh, no, I, I feel like I, not like a stay in your lane kind of person, but it's just kind of not my focus. Uh, so I tend to break stuff down, I think a little bit, uh, just from a different perspective, but, uh, I might have someone on and kind of do like a guest post like that. Um, but yeah. Okay. Well, uh, well definitely, uh, if you have anyone real soon, just let me know. Um, and lastly, how can everyone reach out and we talked about a few times on you have an Instagram.

Yeah. As far as contacting me, uh, my favorite social platform is Instagram. That's just at full body fix. I am active on Twitter. Same handle. Uh, full body fix is also on Facebook. It's just facebook.com slash full body fix. Uh, and full body fix.com. Look at that. Um, so yeah, that's just definitely, I've kind of geared everything toward that. The podcast, as I mentioned, is full body fix radio. And then if people want some additional help or care, I do have my, uh, premium product, which is a video rehab program. Um, I basically cover 21 protocols over a hundred exercises and really kind of break it down part by part.

Uh, so there's a whole series, uh, on the upper extremity. So shoulder, uh, elbow, wrist, uh, long track nerve issues. So carpal tunnel type syndrome that's in one group. Then I have a, my midliner spine, which is, you know, neck pain, low back pain, mid back pain, sciatica, uh, sacroiliac pain. And then there's a lower extremity module, which is, you know, kind of your hip mobility, stability, uh, knee pain, ankle rehab, et cetera. So there's, there's lots of good information there. If people want to get on that, uh, they can just go to full body fix.com and click program. Yeah. I saw the, uh, the YouTube had a couple of teaser videos.

Yeah. If you want to just get the free stuff, go to the YouTube channel, two minute fix videos.com. You can, uh, you can see me basically doing the, you know, short versions of, of the stuff. So you get an idea of what, what you're looking at. Yeah. Cool. Um, anything else you want to add before we close on it? No, I just really appreciate the opportunity to be on the show. Looking forward to having, uh, doing the reciprocal thing. Have you on, come talk about whatever you're passionate about. I've only, I've only been the interviewee a couple of times and I'm not going to lie. Like I was pitter patter, like the first time, like, but the, but the guy was really good at like, you know, engaging conversation till it made it easier.

But I forget how hard it is on that end. Cause you're like, uh, uh, I don't know the answer to this one. Um, okay. Well, one last question then before I close the show, um, why, what happened to, you couldn't get Scott Mills or I'm sorry, Sean Mills.com you had to put a Scott, Oh, Scottie Mills.com. You know why? Do you know why? That's a good story actually. Yes. So Scott Mills, not the most extravagant and cool name in the world, but it is the name of a, uh, famous, I think it's BBC one, uh, DJ from back in the day. And he, uh, he owned it. So yeah, I don't actually, I don't actually even use that site really anymore, but yeah, for a long time, I mean, blog site was drscottamills.com.

So, so when you, when you're about to like make a YouTube channel before you went to, to full body fix, were you like, I'm going to call this the real Scott Mills should have done that screw you DJ. Yeah. I got the real one before you did. Yeah. Okay. Uh, so just hold on right here. We'll, we'll talk for a few minutes after, but let me close the podcast. Okay. Sure. Okay. Run. That was Dr. Scott Mills. He's in San Francisco. Again, if you're around there, you should go in and see him. He knows a lot, a lot of stuff. So, uh, like he said, if you've been working on like doing foam rolling and mash work and stuff all in and around the shoulder and you still got stuff going on, then you should probably go in and get someone's help as well.

So listen to his podcast. I listened to a few this morning. They're 30 minutes. They're really, really good information. Um, uh, yeah, they, I, there was one actually I listened to. We were talking about, it was talking about, um, a, uh, shoulder condition that had a nerve root entrapment and it was basically a caller or a patient's question and he kind of troubleshoot it for her. So that was really, really cool. If you're looking for the show notes, it is on p2sportscare.com slash podcast. And just go through, check out all Dr. Scott's, uh, links and information and all of his YouTube videos.

He's got a lot of really good stuff out there. Lastly, if you have not listened to this on iTunes yet, you really, really need to. And that's the only spot to subscribe all the other stuff. If you're listening to someone on someone else's website, which they've embedded because they've been a guest go through to the iTunes, help me out and, uh, put a review on there and thumbs up and share with friends. So I'll talk to you guys soon and see you later.