How Poor Movement Creates Injuries and What to Change

This is session number 31 of the Performance Place Sports Care Podcast. I'm so ready. 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, it's Dr. Sebastian Gonzales again with Performance Place Sports Care Podcast, and we have a guest today. It is Cody Dimak. He's probably going to correct me, from Maximum Performance Chiropractic in Costa Mesa. And the reason why I brought Cody on is actually because I think he has a lot of good tips and tricks and good, easy ways to break down care and rehab and movements to people.

And we've met on a lot of occasions, and we're good friends now, and we meet and break down cases together and whatnot. And it seems like, so he's got a really, really good way of putting things together, and I think he treats people very, very well. So I trust his judgment on a lot of stuff. I am going to just ask him some questions and just let him kind of run with it. So, Cody, say hey. How's it going, everybody? Hey. Okay, so Cody, why don't you tell us a little bit about yourself? And I know you practice a little bit different than a lot of traditional chiropractors. Can you tell us how you got to be like that and, like, who influenced you along the way and so on?

Yeah. So, my name's Dr. Cody D-Mac. Like Sebastian Gonzales said, my practice is in Costa Mesa, California, Maximum Performance Chiropractic. My practice is very different than typical chiropractic practices in terms of we only do one-on-one time. Typical visit's about 30 minutes. And we integrate not just, like, one technique or anything like that, but we kind of structure our visits towards the patient. So, we create patient-centered care, whether that's, you know, if they need some, you know, they do need some mobility. So, we do some typical chiropractic adjustments or soft tissue treatments. But mostly, we do a lot of active rehabilitation and kind of finding what the patient needs.

So, he's looking at me right now and he's like, I know you're going to ask me what active rehabilitation is. But before I ask it, though, I know that people are probably wondering, like, well, why am I listening to this podcast and hearing, like, what am I getting out of this? And I think that, so, we're going to break down and go into the reason why movements are important, different types of treatments out there, which ones are the best for what type of case and so on. And I know we'll go into that, but tell me what active care is. So, active rehabilitation is, I think, my best way of putting it, I think, like, some potentially strength and conditioning, some corrective exercise and some traditional corrective exercise stuff, along with some spice from other strength coaches and that type of stuff and balled up into this little goodness of creating movement in people.

That was the most confusing thing I think you could have told me. But I know that the… Get people moving around. Okay. And your motto is basically movement is medicine. I read that. Is that trademarked, by the way? Yeah. It better be by the time this goes out, then. Yeah. I'd strongly suggest that. I don't know if I told you about it. I told you about my trademark initiative before. You did it, yeah. Yeah, we should really do that. But so you mainly, your style mainly roots in, like, how did you learn to treat people the way that you do or how do you decide what type of care someone needs? Well, I guess a little backstory is kind of warranted here.

I've always been interested in rehab and therapy, moving around and stuff, just from previous injuries in high school, stuff like that, going to physical therapy. And actually got talked in to go and visit a chiropractic school. And I saw that I can do some actual rehab with patients, not just passive care. But going through school, chiropractic school, I ended up having my third back surgery. And it kind of, like, led me to seek out information on how, one, to prevent it from having a fourth lumbar surgery. Also, how to prevent it from my patients. What kind did you have, anyways? First two surgeries were microdiscectomies.

And then the last surgery was an anterior approach lumbar fusion, L4-L5-S1. So with the, because I know that most people might wonder, well, I don't know what these big words are. So a microdiscectomy, it's pretty common. Yeah. They go in and they shave part of the disc that is protruding out or herniating out, potentially touching a nerve root. So I know that a lot of patients will come in and think this is an end-all cure to their back pain. Yeah. So what is your response to that? It's not. It happened for a reason. And that's part of the way we approach care is trying to find the movement issues, whether it's mobility or control mobility, that potentially cause that.

Because there's always a root to the problem. It's never just the site of pain. So something made that hurt. So whether that's the way somebody moves or whether that's poor training or poor advice in certain cases that needs to be addressed, no matter if you're going to have a surgery or not. So can you give me an example of, I know that I'm, I'm much better at explaining reasons for taking a certain approach with care when we actually break down and go into a certain case. Is there a certain case that you can think of right now off the top of your head? Obviously leaving names out of the, out of the, out of the, out of the whole podcast, but like just go into like how you feel the progression of their movements led to a need for a disc discectomy.

How I, if I feel like they should have had it or. Well, no, how, what's the progression of like getting to that point? Oh, getting to the point. Cause I know that we got the, the straw, the birth, the camel's back type of thing. Right. But what is the lead up process? Cause I don't think a lot of people understand that. Yeah. Well it, again, every, every person's different because people have different, um, different types of spines. And so I'm going to say the word morphology and you're not going to really know what I mean, but like people have disc, different, uh, disc shapes, uh, depending on your genetics.

Um, but certain people are more susceptible to disc herniations because of certain disc shapes. So, um, Dr. Stuart McGill, um, has done a lot of research on this and, um, he's shown that repetitive flexion, uh, bending forward, if you will, or bending forward. And then rotating to a side will actually in time, um, create a bulge and then, um, further along potentially create a disc herniation, um, to, uh, to one side or the other. Um, so I would say kind of bending forward, um, sitting, sitting in, in full spine, uh, flexion, if you will, uh, for long periods of time. And then going load that too, or, or loading, uh, you know, with weight, picking up heavy weight with poor form.

Um, I mean, it really, it really depends and, you know, we don't want to scare people from, you know, from moving. So, uh, we don't necessarily want to, um, you know, banish spine flexion totally, but, um, but it does need to be monitored in some cases. Well, I was, uh, actually I was talking to a guy the other day, um, that I was lifting with and I was actually kind of mentioning that same thing about, uh, so we only have a certain amount of, uh, flexion moments is the thing, right? Right. So you can only bend forward so many times before you blow something out and so on. And I told him, he's like, no, he's like, I'm like, yeah, yeah, really.

I'm like, I believe it. Yeah. But so his argument was like, you know, like we're going to make that incorrect movement many times. Why not just learn how to do it really well? Yeah. So is, I mean, I actually haven't even thought of it yet. Like, nor do I want someone to try that in my office and possibly blow something out in my office. But is there instances where you would condone doing something like that, like repetitive flexion, sit-ups, curl-ups? Um, I think it's within context. I mean, um, that you can do a curl-up or you can do a, uh, a crunch and, um, I believe not have a lot. It just depends on how much, how much motion you actually put in the spine.

So I think the, the, the trick is to do more of a, like a sternal crunch. So kind of where the rib cage comes down the front and have that moved down. So you are getting some anterior abs, but you're not putting the load, if you will, on the lumbar spine. Um, to answer your question, to answer any question. Um, again, I'm probably not going to do it in my office. I'm not going to load it because typically what I see in my, in my practice are people who, um, where flexion or bending forward does irritate them. It makes them worse and it makes their pain worse. And so we have to find, we have to find that and then kind of set, set a system based off of that.

Yeah. A lot of times I see that they, um, not to say I don't, I don't want to teach control with excessive motion forward and, or, uh, curling forward and extending backwards. But I kind of feel like they're doing that enough throughout the day. I don't know if I want to add any more to it. Yeah. Again, it depends on like, you know, their daily activities, you know, and how, and their postures, even if they're a desk jockey, you know, where their postures, when they are sitting down. So I saw actually that you guys did a video, by the way, uh, uh, Dr. Cody, uh, I know they don't like to be called Dr. Cody.

I'm going to call you Dr. Cody anyways. Don't ever do that again. Uh, so he, uh, actually they had, they have some YouTube videos out. Um, and I know one of them I saw was how to sit. Yeah. Can you explain how to sit? Oh yeah. That's actually pretty easy. Um, most of the chairs that we have, uh, in today's society kind of tilt back or if you will, they're, um, they're made to lean back and just kind of relax. Uh, if you're going to be sitting for a long time, it's probably, uh, best if you sit towards the edge of a chair and not sit up through the spine. So not, not extend through your spine, so to speak, or straighten up through the spine, but more so a roll through the hips.

So if you will, if you're kind of observing yourself and you're sitting with a round low back, um, you could take, put your hands on your pelvis and you could kind of tilt your pelvis forward just a little bit. And what that should do, if you do it correctly, it should kind of upright everything. So it, it's almost like a sprocket effect. If you will, you turn one sprocket and everything else follows up the chain and actually puts you in pretty good neck position also. So you're saying don't, don't pull with like a, like make a proud chest or anything. Yeah, no. Yeah. That's only going to cause some, some irritation from, cause you're starting to use prime movers as postural stabilizers and that kind of, that'll create some irritation.

Ooh, you're getting into some deep stuff now. Okay. So it's, uh, I might as well just go on, go on that route a little bit. So, uh, if, if anyone's heard, yeah, I don't know if this podcast is going to come out before the one I did on shoulders. Um, the three P's of the shoulders. Actually, I think that one's out already, but we talk about, um, rotator cuff muscles as, uh, humoral protectors. As well as there's, there's scapular stabilizers and there's movers, which would be the, um, the lat, the pec and so on. Yeah. Um, can you explain in the spine in regards to posture, which muscles would be, um, the ones that you really want to address in regards to issues of back pain and posture and so on?

Um, or you can take this a whole different way. I would actually, yeah, I would rather not because I think if we start to label muscles in the spine, then that's going to kind of, uh, direct people to thinking of, uh, low back pain as like a, a single driver, you know, as, as one muscle is really very reductionist in terms of, if we look at the global thing movement. Um, I think we should look at it more so of like, you know, how do people move through the hips? Um, do they have proper movement whenever they are executing lifts? Um, do they have adequate spine mobility and whether that's in the mid back and we call it the thoracic spine?

Um, or is that, uh, you know, or in the low back, even some people do need some mobility in the low back. So I, I would, um, I would veer away from identifying muscles because everything kind of depends on it, on, on other areas. Our little friend called regional interdependence. So wait, one more sign for regional interdependence. Okay. We got to get on this. So I don't know, but I don't know if everyone knows. So actually Cody's one of my, uh, bounce ideas off of guy. Once every couple of weeks we get beer and pizza and they just talk some stuff through. So I usually come away with something good and this is probably the one thing I'm going to get this time.

So regional interdependence. Yeah. Bring it. All right. So, um, so basically regional interdependence. Um, I believe if I have my sources correct, uh, originally, uh, came from Vladimir Yanda in Czech Republic and talked about the layered syndrome. Um, the same guy who, uh, who came up with lower cross syndrome or upper cross syndrome. Some people may have heard of that. Um, and basically what, what that means is, um, certain areas depend on other areas. So your low back depends on how your hips move or how your mid back moves. Your shoulder depends on how your mid back moves or how, um, how well your neck moves.

So everything, basically everything's connected through this, uh, through this chain. Oh, got it. I didn't, I haven't heard that term before, but I've heard the, the explanation. Yes. We usually it's, uh, the joint also knows the joint by joint approach. Yes. The more, the long winded one, the one that was supposedly written on a, a dining room napkin. It wasn't dive. It was a bar, bar napkin, a dive bar napkin. I'm sure there's peanut shells and vomit all over the floor. I hope not. Um, okay. So now we talked about like the, the importance of movement and so on. Um, is there a way to actually assess this at all?

Assess movement? Yeah. Totally. Um, and there's no one way. I mean, you know, you can assess movement right now by going to an airport or I don't know who goes to malls anymore, but going to a mall, just watching people move. Uh, you know, how they get out of the car, how do they pull the door open? How do they reach in their pocket for the money? How do they, what do they look like when they drop the quarter on the ground and they pick it up? Uh, that's, that's literally, that's assessing movement. But if we're looking at a clinical, um, clinical approach, uh, again, there's no one way. As long as you are assessing movement, you're not just looking at things statically, like traditionally in our, our profession, uh, you know, taking x-rays and basically, and solely treating off of the x-ray.

Um, which I don't think is a, is an optimal approach because that's not how we sit and that's not how our bodies are throughout the day. So, um, you know, there's many, many roads to roam, so to speak. It's the old saying, um, you know, but yeah, you have, you have to, in my opinion, you have to have a way of assessing movement, um, no matter what, you know, what your method is. So with, um, I always say at least with, like how much you're talking about, like going to the mall or like, like looking at people like when the student, because your assessment starts right when they walk in the door.

Immediately, yeah. And that, I always consider is like, what are your habits or what do you normally do? But I actually, we have a guy that comes in here that like he, I swear, every time he comes in, we have to reteach him how to do everything. And it's, it's like, he forgets, but when he like dials it in, his movements are not bad. Um, in regards to when you teach something and you are teaching that movement, is there ways to figure out how to learn if they're doing it well? Yeah. Uh, I think you, you just, you just figured out, you just said how to figure out if they're doing it well or not is, is, you know, what, what's the, uh, what do they come back with?

Right. What's the retention, uh, of that movement, you know, and how, if you're teaching somebody to move, there's certain ways you can, like you in the science has shown that there's specific ways that you should coach, especially if you're coaching or teaching a movement, there's certain things you should do, whether that's, you know, first thing you would do is try and change their environment and, um, and, and see if you can get the reaction that you want to get out of them, no matter what movement it is. It's, you know, um, I think it's called, it's the dynamic systems theory, Guido, Van Risen, uh, if you haven't looked at any of his stuff, definitely should, you should look into that.

Um, basically you want to control, you want to change the environment to try and get, uh, say, so you're trying to teach somebody to squat or, or, you know, or hinge. Um, you don't say a word, you just change their environment. So if you're trying to get somebody to squat, you know, changing the gravity, you can use like a TRX, right? So it kind of, you're able to sing back a little bit more. Um, now if you're going to use verbal coaching, uh, try not to use body parts because the brain doesn't see body parts. It sees, um, you know, it sees movements and pictures. So using analogies, metaphors, that type of stuff.

We, I mean, you've had coaches that have tried to explain something to you and you didn't get it, didn't get it. And then they were like, look, it's just like this. And then you're like, oh, cause they use some type of metaphor and analogy and it just clicks. Right. Um, those are the, those are the things that that's shown time and time again in science to actually help with retention. So, um, I think your number one, uh, the number one thing I do, I talk to trainers about when I do some workshops with personal trainers and strength coaches is like, are you having to say, you know, cue them again?

I'm like, oh, don't forget shoulders back because they're not retaining that. Right. And they keep having to say it. So you have to change something if you're, you know, I mean, you can only, you know, I like to tell them you should only say shoulders back so many times. It keeps, if it doesn't work anymore, change the cue, you know? Well, I wonder if the, um, I've always thought that with, I know there was cues that they gave me through, um, through sports in high school. So, and I don't know if I understood the importance of actually doing it versus, I mean, like, I mean, I did it cause I want to hit a baseball.

Right. I just wanted to make like, so I just remembered and I cycled through, squished the bug and backhand the ball. So, but when it comes to like exercise or rehab, I don't know if they, I mean, do they understand the importance? Like they must, if it, if it matters to them that much, why don't they retain it? At least like with sitting, how many cues do you use? Like three. Right. I mean, that is, surely this can't be that hard. I think the, in order for the, the connection for them to make it, if they, if they're going to retain it, you have to, you have to audit. So, I mean, you have to see what hurts, then they make the intervention and then retest.

Right. It's called a clinical audit process. So, um, you know, if somebody has pain with like, uh, in their knee with a squat, you do an intervention, even if you like, you're not quite getting it, so to speak, but then they kind of start to get it. And then you retest and the pain's less right then and there, that should create buy-in. Um, now again, how you taught the tests and what words you use and whatnot, those are important too, whether or not you're going to get the actual retention. So, when you're teaching people, I know that every time you go and teach people, uh, how to improve their movement or how you teach them some type of cues when they're going through your office to make it so their pain dissipates.

Is there a certain amount that you stick to or that like, do you show them one thing, two things, you wait till their brain is about to explode? I mean, like, is there, how do you gauge this? Yeah, there's definitely a limit because people only have so much attentional capacity. Um, and, and, you know, people are people and they get, they get busy or they get distracted. So if they, you know, we send them home, if you get, they get sent home with like a sheet of 15 things to do, chances are they're not going to do that. Uh, we try and max out at three to four, three to four things. If the person's really competent, we'll give them four.

So, um, uh, and that's not adding on every visit that's, that's changing if we do change. And what we try to be as specific as possible, the first go around. So we don't have to change too much in the beginning, uh, because we would like that to be the, the, uh, the prescription that we, uh, we give them. We want that to be the one that works period. Mm-hmm. You ever go through cases where you're like, oh, that first go around didn't work. I need to read, retract and start again. Oh, totally. Yeah. It happens. Unfortunately, it does happen. You know, we, we, we're human too. You know what I mean?

We're not perfect. So, um, we would like to think that, you know, we're, uh, we're pretty decent at, we'd like to think we're pretty good at, at assessing and trying to be as specific as possible. But we always miss something. Everybody always miss something. You know, even the top, top specialists in the world, they, they always miss something. You know, that's, that's why they call it practice, right? Yeah. No one ever wants to be the one that's practicing. Right, right. Yeah. They always want to hear like, yeah, I've seen this 5 billion times. Yeah. Um, well, you know, on that same note too, like, I don't think we ever talked about this, but like the amount of times that you, I know, I know I have people come in here, they get frustrated about, they've seen, been seen 30 times, 40 times to some other place.

And, you know, then also they come to some, they go to some guy who says, if I don't fix this in one time, then I don't want you to come back type of thing. Like how many times is, is good enough to know that you're going to have, they're going to have a good response. Cause we do have to backtrack a couple of times, you know? Yeah. I think, uh, if you're going to, if you have enough time in the first visit to do some type of intervention, which is ideal, you do at least a little bit of intervention, uh, the first time. Um, and there's improvement there. Then I think, I think the statistics say there's a 50%, um, um, um, chance of having, uh, intersession improvement or intersession like between sessions.

Oh God. So before the next session, there's going to be improvement. I think it's actually higher than 50%. It's pretty, pretty high actually. Um, I mean, we know within like the first three visits for sure, if we're going to, if we're going to make a really solid, uh, impact, especially in certain cases too. Um, you know, uh, we could, cause we're pretty, you know, your approach is always gonna be different for everybody, but there's certain like specific things that we know that something works really well for. And if there's, there's, uh, there's a pretty good change. If there's a change in discomfort and, and, uh, and objective findings.

So things that I find also, then we know that person, if they do their homework, obviously should fare fairly well. Um, you know, with, uh, you said, uh, so intersession improvements, is it, so it's pretty common to have improvements, but then a little relapse. Yeah. Depending on what it is. Yeah. You know, it's, we call it picking the scab. Um, so everybody's going to end up picking the scab. So they're going to go through some, they're going to do something that not everybody, but they potentially could do something that will irritate the painful area. Um, you know, whether it's shoulder, low back, knee, you know, there, there's a chance they're going to do something and it's totally fine.

Totally normal. That's what people, you know, just tell them, don't freak out. You're okay. You're not going to die. You know, just stick with it. And sure enough, I mean, about 99% they come around. Yeah. I don't know if I told you, I, up in the other room, I have, uh, uh, in my office, I have the rules of rehab. One of them is, uh, you're bound for a flare up, just, just handle it like, just, yeah, just, I'd say deal with it because it, because it's going to happen. It happens to everybody, you know, just hopefully if they know it and expect it in the beginning, they're not going to freak out and, and, and think is just the wrong thing and so on.

And yeah, I try and not let, you know, tell people that they're, they're might have a, uh, a relapse because, you know, I don't want to be like, they're living in fear, you know, but it's funny. Like two years ago, uh, I had somebody come in with a pretty typical low back disc, um, and responded really well just to, we call it video game position. So just kind of laying on your stomach, up on your elbows, like you're playing video games, you know, back in the day. And, uh, for some reason I said, you know what, you know, you're going to be fine probably in about a week that might flare up again.

Just do this, you know, do this exercise here, you know, we're doing and you're going to be okay. It'll calm down in less than a day. And sure enough, a week later, she had a flare up and it calmed down. I was like, did I just like nocebo this person? That'd just make her happen. The brain is powerful. It is powerful. Yeah, totally. Jedi mind trick. You will be fine. Hey, you know, actually, there was actually a guy, I don't know if I told you, like he was, uh, he had, he had an Achilles tendon issue and he was a young dude. Like he, he had a good job and everything. I think he was very confident in his, uh, ability to make money.

So I asked him one time that, cause he told me about all the things he couldn't do. And, and I'm like, if I, how much money would you pay me right now? If I could just, just touch your calf, just one finger, just touch it and it gets better. But it's a guaranteed 10 year guarantee that it's going to be better for 10 years. How much did you pay me? He's like, I'd pay you everything in my, in my bank right now. Wow. Yeah. I'm like, okay. Did you touch his calf? I, I, yeah, I did. I said, if this works, I want you to come back. You made the transfer money transfer first, right? Well, no, I think the touch was the money transfer.

Oh, good. He was bankrupt. Hey, he can, he can make more. He said, um, okay. So back on to, uh, actually what kind of conditions do you think work well to, when you improve movement? Um, I mean, I think any and all musculoskeletal issues. So issues dealing with muscles, bones, and joints, uh, aside from book broken bones. Um, but, uh, I think I believe almost everything can. Um, now there's obviously there's certain neurological conditions, um, where, you know, there, there need, we need to refer out, you know, um, but even some of those to some neurological conditions. Movement can't help, uh, you know, help the situation too.

So, well, so with, um, I know that I, I find it easier to explain to patients that lower extremity or, um, you know, foot, knee, ankle, hip, low back are a little bit easier to talk about movement. But when you talk about, let's just say you had a, uh, a contracture and a finger. Yeah. Like, how down like that route, when you get into wrist, fingers, elbows. Yeah. Non projectile throwing people, how do these come about? Like, uh, I know that the, uh, you got the, uh, repetitive stress injuries and so on. They go to work with work-related conditions. How would someone like that improve with movement?

Um, the caveat to improve with movement. Um, there's always going to be something that's probably inhibiting movement anywhere, whether it's mobility issue. Um, so, you know, when you start talking about specific things like in the hand, um, there's still probably something we call it up the chain. So further up the arm or into the mid back or something like that. That's kind of allowing things, basically the weakest link is going to break down. Um, so I, I think that needs to be taken care of before we even, uh, before we can start talking about movement. I mean, there's some cases too, where, you know, we create some, we create some decent stability in certain areas.

And then movement frees up too. So it works both ways. But, um, you know, it's tough. Those, those are, those are tough to call that thing. Case by case, obviously, um, is going to be how you approach it. Now, is there, I know you've gone through a lot of educational seminars and whatnot over the years. Uh, there, I just, in one of the prior podcasts, actually, there was a guy that who, he learned a bunch from different books that he read. Is there certain books or like self-educational tools that you recommend to people? I know you read a bunch. Um, I, I, I actually do better listening. Um, when I read, I tend to get a little distracted, uh, better, uh, better listening and talking and, and, and kind of going through stuff.

So, um, if I'm not taking seminars, I'll, I'll listen a lot to some podcasts. Uh, well, I'll listen to some lectures on YouTube or, uh, things like that. So, um, I do plenty. I don't know if you want specifics or anything. Well, I mean, I think, uh, I mean, I mean, I, I creep you on Facebook and Instagram all the time. So I know, I know where you're at. I'm tracking you. Yeah. Actually that credit card you use, you think that's just one of those newfangled chips, eh? Uh, but no, it's like, it really, is there any, is there anything good, uh, reference that you think like something easy a patient can besides this podcast, obviously, um, that they could learn from, because I think the big issue with patient compliance, I mean, I'm not blaming it on the patients, but they don't understand.

They've been fed all this other stuff that, gosh, I almost named off a bunch right now that I, I do, I don't, I try to say middle ground on these things, but, uh, I mean, you're right. I mean, Dr. Google will, we'll get you in trouble, you know, you know, well, Google and WebMD aren't actually the, uh, if there's, you know, musculoskeletal pain, um, pretty much everybody comes into me with a self-diagnosis from WebMD says they have six weeks to live too. So, you know, it's, it's, it's kind of tough, you know, and it's, it's hard to, um, to direct people to certain, certain, uh, avenues in terms of, uh, you know, treatment.

I think Craig Liebenson has a pretty good, um, pretty good, uh, Instagram to follow. His is very, usually very empowering and very, uh, um, movement. It's definitely movement related and active, active rehabilitation related. So getting people to move around and, and, and take, and be empowered and take control of their care. Um, I think, uh, you know, trying not to dive into, you know, fads or, or dogma, so to speak. Um, you know, if you have, if people asked you to be, if they, you know, you want to be a rep, and then you want to sell it, you know, sell their product and run. You don't want to be a rep?

Yeah. Um, know how you can make passive income. Yeah, that is the thing. That's the thing. Yeah. Um, yeah, I think I get, I got approached that a couple of times early on in practice. Yeah. They're scary. Yeah. Real scary. Especially when you got, uh, when you got loans to pay and everything. Oh my God. Yeah. Um, so I know that, I know that I always struggle with when people come in, since we're both chiropractors, uh, we get pigeonholed with the back, spinal, all that kind of stuff. And then I always joke with everybody that they ask if we do physical therapy and I say, no, but I'm like, if, if here's the thing, if I give you a squat, it's called physiotherapy.

If a physical therapist gives you a squat, it's called physical therapy. And if a trainer gives you a squat, it's called squat. So is there, is there certain things, questions that you think that people that are listening to this podcast that aren't anywhere close to us can ask the person who's going to apply their care, no matter what their credential or whatever, is there a few things that you think would be helpful to them, um, in screening someone who's going to do a good job with them? Yeah. Um, I think even they can, without even asking questions, they can kind of get an idea. Of, uh, what to expect.

I mean, the, in my, my opinion, the practitioner, whether it's physical therapist, chiropractor, um, should ask a couple of questions, which we ask at the end of every new patient, uh, history, you know, what are your fears and worries? So they need to know what you're afraid of and what you're worried about when you're, uh, you know, in terms of the ending of this. So also we ask, what are your goals? Cause if the practitioner doesn't know your, know the goals of the patient, then what there's potentially, there's no end in sight, you know? Uh, and we also ask, you know, what's, uh, what, what type of treatment do you expect to receive from us in here?

So that gets it all on a table right then and there, you know, I'm a chiropractor, but what are you expecting out of me? Are you expecting just to get adjusted? Or are you expecting like just rehabilitation? Are you expecting just soft tissue? So we, you know, there, there's an open line of communication right then and there. Um, and also, um, you know, we, uh, we ask, you know, what is your, in your mind, what are your expectations in terms of timeline to have, you know, their issue resolved? You know, we want to know realistically where they're at, you know, and in their head. So we know, um, I think questions that they can ask or also if, if, if, well, they don't even have to ask if the chiropractor tries to sell them a large package, I would say run.

Okay. Um, if the chiropractor or physical therapist doesn't put them through like a full body screen, even if it is just the wrist, even if it is just the elbow, I think a full, full body movement assessment is warranted. Um, those, those are little things where they don't even have to go out of the way. And, and feel uncomfortable and, and asking, you know, um, I think one thing is, um, uh, one question that can ask is like, what is your, you know, what is your goal for your patients? I mean, that would be a good one. You know, what do they want? Like, you know, I, I love it when patients ask me what do I want for my patients?

I'll tell them straight up and I'll be honest with them too. You know, they'll tell them, Hey, we want to get you better as fast as possible, you know, in a, in a way that things stick, you know, and it's not just a quick fix. Well, I know there's definitely a lot of people that come in for quick pick, quick fixes. Um, and I always really, I get a little alarm sometimes when I see that someone comes in definitely knowing what they want done. Oh yeah, yeah. It was a very, very, never, never do what they ask either. Ever. Yeah. Well, we, we've talked before about, I don't know if I told you I did a podcast on, uh, I think I called it, uh, death of, death of the technique.

So we, we had that conversation one time where all these different techniques and methods out there and then you go there and, you know, getting that technique or method. Um, but it's really just tool on tool chest. So you gotta do what's right for them. Yeah. It's, it's, it's hard when, you know, uh, it's almost better having a patient come in who's never been to a chiropractor before. So the expectations not specifically, um, you know, it's not set because there's, there's so many techniques in chiropractic. They're like, there's even more now. I know when I was in school, I think there was like over 250 or 300 or something like that.

And I, obviously there's more, we're only going to have more, you know, um, it's almost better not to have anybody, you know, I mean, it's almost better to have somebody who's not been to, uh, a chiropractor before, you know? And so it's, it's, it's, it's hard out there for a chiro, man. It kind of is. I always try to actually not tell anyone I am. Yeah. And I started using the term, uh, was it movement, uh, specialist. By the way, is there a credential that you have to have to be a movement specialist? Say it again. Is there a credential you have to have to be a movement specialist? No, no, I don't think so.

It's still a, it's still a, we can coin that right now. We could coin it. Yeah. Okay. So there's a date on this podcast, the record date. It's kind of like, like when you send yourself a mailed envelope with an idea and it, but never open it. Yeah. I think that works. I have notes on my phone, my iPhone and the nose portion that I haven't like opened since, since like two or three years ago, because I don't want the date to go out of the date. Just don't, just don't edit it. Just never edit it. No. I think you could screenshot it. Yeah. That's, that's touche. Oh, you can, well, you can email it to yourself unless I do it.

Screenshot it, email it, save it. Don't put it in your Yahoo account. Get hacked. No, I thought, no, I thought the cloud was getting hacked. Oh, was it? Wait, was Yahoo that hacked? No, Yahoo got hacked. Big time. Really? Yeah. Well, you, you strike me as someone who has a Hotmail account anyways. Yeah. It's got, it's got like my former age in it or something like that. Yeah. Something 16. Yeah. And it is attached to your MySpace page. Yeah. Still open. Still check it. Um, it's only bands that are, that are my friends now. Oh, on MySpace? Yeah. Is that still available? I think so. Yeah. I think I closed mine down.

Have you tried to log in? I don't even, I don't, I wouldn't even, I haven't been on there on the, on MySpace in probably two, three years. I think, uh. Cause I think I checked. I checked to see if it was open and I couldn't find it. So I guess it's closed. You know, the problem is that you tried to log in, which means that the next time someone looks, it's his last log in. It was like, it's like last week. I haven't been on in like six years, seven years. Yeah. Except for that one day where you checked it. I was like, Hey, let me check this. And I tried to log in. Yeah. I wonder if that old girlfriend contacted me on there.

Oh, no. Okay. So, uh, last couple of questions is that, um, that you're, you're really good with cues and whatnot and like getting people to be able to do motions easy. So I know that we talked about sitting, uh, and I know that you are more of a tactile hands on cue thing anyways, but is there a couple of things or life hacks you can give people right now? Like how to sit well, or, um, I'm sure they're probably driving or in an airplane or, I mean, they're probably sitting there right now. Yeah. What'd you got? Um, relax, let it all hang out. You thought they were just building up all of a sudden they're like, I'm going to rotate that cog wheel so hard right now.

Just relax. No, honestly. I mean, you know, people, people get tension in their, their upper shoulders and we call it the traps levator area, you know, so much. And, uh, especially driving or stress at work and stuff like that. The funny thing is that the stress alters our breathing patterns and the natural reactions that's kind of start stiffening up the tummy, you know, that type of thing. I think if people just kind of let, let everything hang out and they just kind of really relax. So obviously not letting it hang, like letting your tummy go and just falling in, like letting your spine slump, but just letting it relax.

You just open up so much more, um, you know, you open up the ability for the diaphragm to actually do its job, which is the breathe. And about 12 times out of 10, we get patients to just relax their stomach and the tension goes away in the neck. I did say 12 times out of 10 too. So, sorry to catch it. You see, you saw me staring into space. Like I'm thinking, I don't know if you can tell, but like, like partially doing like the hosting of the podcast, I'm like, Oh, I got to, okay. He's finishing an idea right now. I got to make sure I know we're going with this thing. Yeah. No, I think if people can actually just kind of learn how to let their tummy go, so if they're feeling tension in their neck or tension in their upper shoulders and they just relax everything.

Uh, so if they're driving and they have their seatbelt on, which hopefully you should, um, just let your stomach relax into the seatbelt that goes across your waist, you know, and you can just breathe quietly in through your nose into that, into that, make that tighter. Or if you're standing up or if you're sitting down, you feel it and you're wearing a belt, try and make your belt tighter whenever you breathe in. Not loud though. So nice and quiet. Why do people have belts around their stomach anyways? I don't like what? They're Italian. We're, yeah, where in the U.S. are we talking about this right now?

No, I'm not talking about around the belly button, actually. I'm talking about your regular waist. So they obviously wear it lower, but that's your target. Okay. So the distance is further away than what we want. And so creating the, the, the cue of distance, the further things are away, the better reaction you get. Hmm. Um, so just before we close as well, I think that you alluded to breathing as being an important thing. Is there, I'm sure you have a whole spiel. You tell patients the first few times about breathing and the importance of it and blah, blah, blah. Give it to me. Uh, breathing affects everything.

Carol Levitt, he was a Czech neurologist. Um, the guy was practicing up until he was 97 years old. Um, he said, he had the phrase, if breathing can't be normalized, the new other movement pattern can be. Essentially what that means is it doesn't matter how much, you know, you and I try and correct people's movement. Uh, if they're, if their breathing patterns are off in any way, things are just going to kind of keep resetting. So it's, it's, uh, poor breathing patterns just create so much, um, non-active tension. What I mean by that is like they're, people are not actively tensing up, but our brain perceives this, this threat that we can't breathe.

So it creates this protective tone in the body. Um, you know, time and time again, we've had people who can't touch their toes, get them breathing a little bit, tone relaxes and they can touch their toes. Um, so I think moving, you know, moving forward with, uh, the breathing, it's just, it has to change. And I think two of the, the two, two biggest things that, that get left behind, get left on the table in our profession and our profession being movement and therapists, not just chiropractors, but you were going to say specialists, were you? Yeah. Um, it might be coined somewhere. Yeah, maybe we don't know.

Um, our, our, uh, breathing. Okay. And the feet, those two things get left on the table all the time. Um, and they're probably two of the most important things in movement. Yeah. Our, our, our discipline seems to focus a lot on the spine, which obviously when you go deeper into the, the theory of, or the back history of, of chiropractic, there, there is merit to, you know, why they're doing that. Cause that's based upon the theory, you know, it's just a little different theory we're working with right now. Right. Yeah. So, um, all right. So we're approaching, we're around 40 minutes here. I can't believe I held eye contact unblinkingly with you for 40 minutes.

I told you I was going to give you 50 minutes uninterrupted eye contact. 50 minutes. Yeah. Oh, you want 10 more? Well, I'm, no, I'm going to continue even if we stop now. Okay. How was your day today? It was fantastic. Actually. Give me a good story. One good story. Um, I actually did a workshop for Equinox, uh, Huntington today on queuing on coaching. Really? Um, and at, towards the end of the, um, towards the end of the, uh, the two hour workshop we had, uh, I had one of the newer trainers come up and try and teach me how to, you know, teach me how to deadlift. And we just got through this whole thing of, you know, internal versus external queuing.

And, uh, how we don't want to use words like body parts internal, right? He told you to, uh, contract your peroneals. He did not. Your, uh, peroneals. But like he, he, he got up and he, like, he described the movement and every single word was like an internal cue. But then he goes, and he goes, Hey, would you like this? Would you like to use this kettlebell or that kettlebell? And I like stopped. I'm like, hang on. Are you asking, are you asking me? Or are you asking like the patient me that you're playing with? And he's like, no, I'm asking you. I was like, okay, time out. And I looked at it.

I was like, you have no idea what gold he just said. And it's like, he, he had no idea. Like he didn't know. So what he did is he gave me a choice. Right. So I have a choice. So I create, he created autonomy. Right. And so if we create autonomy in our meaning, like a choice in our patients or our athletes, or in their case, their clients, whatever they choose to do, they now know that they chose that and their attention and their focus is going to be on that task more than if it was just like, Hey, do this. So he didn't even know he did something really good, even though he was a coach, coached me poorly, you know?

So that was actually something pretty cool today. And I'm glad he said that too. Cause I was going to completely forget about that. I had like four minutes left and I was like, I didn't even touch on that topic. Oh, that was part of your list of talks with topics. It was, it was on there too. So it was like, it was gold. I was like, thank you. I told him, I was like, thanks for doing that. You, you, you, what were you going to like, what are other things that the trainers could ask? Like you want to touch my right or left bicep before you start? Well, we took, we did talk about muscle isolation a little bit.

Yeah. Is that, well, they still, they must still be doing that. I mean, it's for physique, right? Well, yeah. I mean, it's okay to get a couple of curls, you know, super set with some tries. Curls for the girls, tries for the guys. The big difference between you and I though, you use the thirties and I use the eighties for curls. Eighty what? Pounds. No, you don't. Each arms. Yeah. Let's see right now. Okay. Let's do it. I did five by three, uh, single arm bent over rows with 205 the other day. Single arm bent over rows? Yeah. Hmm. I don't believe that. It's a loadable dumbbell. I don't believe you went to the gym at all.

How much do you weigh again? I'll show you my check in. I think, yeah. Yeah. I bet you checked in there. I did. I'll check your MySpace. Mm-hmm. So, uh, I think I've been asking almost everybody this recently in the podcast. So, how tall are you and how much do you weigh? Six foot, 255. 255. Yeah. I usually have a really good game. I told you I'm good at guessing, uh, usually women's, uh, weights. Mm-hmm. I don't think I've had to guess 255, but I'm usually within about three pounds either way. Yeah. But it seems like my estimation of 200 pounds is really bad. So, I don't even, because I don't even know.

200 pounds is kind of skewed, right? Yeah, yeah. It's like, it's totally not even close. Like, I could be like, I could have said you're like 230. You're like, no, dude, I'm 255. I'm not even close. Yeah. That's fun. Well, what else you got? Um, because you got six more minutes. Six more minutes. Six more minutes, bro. You don't want me to start talking for six minutes. Just misery to everybody who's listening. Six minutes of pain. Well, before, okay, I'll tell you this. Before anyone ever tunes out because they realize, oh shoot, there's six minutes left of this. Yeah. We should, we should probably get Cody, uh, get his, uh, contact how to reach him in case you want to talk to him or just see him do 80 pound bicep curls in a preacher manner.

Um, no, no preacher. That's rough. Um, so you guys can follow me, uh, or my practice on Instagram, uh, at max perform Cairo. So M A X P E R F O R M C H I R O. Our Facebook is maximum performance chiropractic. And you'll see a picture of our logo. It's two little circles, sweet logo. Who made that anyways? Um, we actually had, um, somebody make it, uh, we did not make it. We had a graphic designer make it. Hmm. Fancy. Yeah. Um, well, cool. Um, what is your phone number there? Uh, seven one four nine seven nine three six seven two. Good deal. Um, yeah. I don't know if everyone knows actually Cody is probably the closest to a local competitor that I have, but, um, I, I want to have him in because I think he has a lot of knowledge that you guys can get.

And, um, um, I personally think there's enough people around that need help that we don't need to think of as competitors at all. So, um, I mean, how many miles away from you? Like 10 minutes, 15 minutes. Yeah. Maybe. Yeah. You live, you live like two blocks. Yeah. Pretty close. Yeah. Cool. Yeah. I wouldn't really consider it. Uh, I really wouldn't consider it competition though too, because I think like, you know, our, our sole goal for patients is to, is patient-centered care when we get people better. Right. Yeah. You know, and I've, I don't know if they've came, but I've, if I had no space in the schedule or if I was going to be gone, I've sent people to you.

I don't know if they came and you wouldn't tell me because it would break HIPAA, but. Oh no, I'd probably tell you. HIPAA's not listening. You didn't hear that. Yeah. I know. I, but the great thing is they probably signed that waiver. Name and birthday were left out. Yeah. But no, you can have them sign a waiver where you're like, you're allowed to co-manage and so on. Yeah. But no, I agree too. Like I would, I would, I would send people to you like if I was at a town or if this podcast took off, by the way, everyone's subscribing and everything. Cause I like working with people, but man, I like sharing knowledge a lot more.

Um, so yeah, I would love if everyone packed Cody's doors and I just ended up podcasting about every single thing that he has to say that I know he left out because he's on guarded first podcasting. This is your first podcast. Um, second podcast. What was your other one? Uh, it was on, uh, uh, Marianne and I were on the, the Dr. Bo show. So Bo, um, um, um, oh my God. Is that B-O-I? B-E-A-U. Oh, then I'm. Bo Beard. Jesus. Sorry. Yeah. He's in, uh, I think he's in Birmingham. He's in Alabama. Yeah. Um, they have a practice called Farm. It's actually really legit. Was it the P or an F? F. F-A-R-M.

Oh, good. I would have figured it was the farm. It's good. The P. No, no. They don't have a green plus sign on the front door. No, Bo's good. You haven't met Bo, have you? No, I don't think so. Yeah, it's good. Him and his wife, uh, his wife's alone. They're legit. Is he going to the, I, I'm going to go to the Perform Better seminar this, this. Which one? The summer beach? The, yeah, the, the three day one. Yeah, we're thinking about either doing that or we're thinking about going to Chicago. Mm-hmm. During that same time? Or is it, that's where they have you? Yeah, Chicago won. Yeah, Chicago performed better.

I'm sure they get a whole different- Nick Winkleman's going to be out there, so. They get a whole different speaker schedule, right? They do, yeah. Yeah. I don't think I've been in like, God, I think it's been about seven years or so. I just figured I wouldn't revisit that seminar for another, for like three, four years because it'd be the same ideas over and over again. Yeah, they're starting to, um, things are starting to change a little bit. So like, uh, you know, obviously you're going to have the same kind of similar talks with different, different topics. Mm-hmm. You know, Winkleman's talk every year is different.

Charlie Weingroff's talk every year is different. Levenson's is different every year. Mm-hmm. Um, Chicago looks like a really solid lineup. Mm-hmm. Long Beach looks good too. Mm-hmm. So hopefully we'd be able to, ideally we'd do both. Yeah. I, I just, I like that the, I like when they share new things. I don't care if they're wrong. Mm-hmm. I just want to hear something different. Yeah. Like at all. I feel like everyone falls in suit. Like they follow these big paradigms of like, um, you know, the techniques or, or screening methods for years and years and years and get really boring. Right. Um, okay.

Anything else you'd like to share? No, I think we're good. Cool. All right. Everyone say goodbye to Cody. It has actually been 49 minutes and 30 seconds. So you're almost 60 there. Um, cool. So everyone, thanks for tuning in for the podcast today. Again, uh, if you want to submit a question, go to P2, that is the number, sports is plural care.com. That is my website. Um, I have tons of free information on there with different types of conditions you might have. And so on. And like, I really, really want to share as much free information as I can so that everyone gets to go in and have a good educated conversation with their healthcare provider and not have to be educated on anatomy and why are we doing this?

Why don't we do that? And so I try to hit all that with there. So, um, if you guys want to leave a question for me on there, there is a speak pipe button right in the front and all the podcasts are listened to or listed there. You can access them at any time. So, um, again, P2 sports care and thank you for tuning in. Say bye, Cody. Bye. See ya.