Strength and Conditioning Benefits for Aches and Pains

He was a really good case. I think he's a really good type of case. It'd be nice to see, like, if someone was to, like, walk into your practice and say, well, what are you guys going to do on day one? I don't know. Well, shit, I might have you do 135 from blocks, because that's basically what happened. That ended up what happened. You're listening to the Restoring Human Movement podcast, where movement experts discuss the latest evidence-based practices to help you and your clients move with mastery. And now, your host, Dr. Sebastian Gonzales. Hey, everyone. This is Dr. Sebastian Gonzales, your host with the Restoring Human Movement podcast.

Thanks for joining the movement movement. We also have the co-host, Dr. Cody D-Mack. How's it going, everybody? What's up? You got a new microphone over there. I do. I had it last time, I think. Yeah, but a new stand, new setup, though. So it's a little bit more hands-free. So it's a little bit better. Yeah, I think you look better this time, too. For some reason, that microphone made your haircut look better. Ah, yeah. Yeah, I changed the settings on my headphones, too. So it maybe changed the shape of my head. Oh, do you end up having like the, I can see yours, they both kind of cut across the top around the alfalfa would be.

Do you have a cut in after you're done? I do. It's okay. Good. So what we're going to cover this time is, let's see what the, what was the title I made here? It was General Strength Conditioning Recommendations for, I know what we were talking about, conditions that will tolerate loading, I think. Hold on. Let me look this thing up. I'm not prepared. The, okay, the title was Strength Conditioning Benefits for Aches and Pains and just kind of presenting the, just some thoughts or thought-provoking things that will get patients as well as clinicians to think about loading their patients and ways to frame the loading process and resistance training so the person actually wants to do it.

So, I mean, it's really common for people not wanting to load anything once they get injured, you know, and so like a very common, the common thought process is that old rice, you know. Yeah. Have they, they've gotten away from that now, I think, right? Some people still use it, but I think, I don't think they necessarily understand that, you know, you know, general movement's good too, but sometimes actually loading the tissue itself is a, is, can be therapeutic. Mm-hmm. It is very therapeutic. And I know that with, hopefully, if the scheduling goes well, last week, people would have already heard me interview Guido, and he would have talked about Attractor States, probably.

Yeah. Yeah, definitely. Guido's amazing, man. He's awesome. Yeah. I started off the introduction with, on the written part, is, why is Guido a badass? I don't think you have enough time for that. Yeah. He's just a badass, man. He is so good at what he does, and he speaks, you know, he's so good at presenting, too. He has material, and it's just, comes across so clean. It's awesome. Yeah. He's great. Now, I guess before we start here, then, are you aware that actually today is the release date to the book that I put out, that actually you are in it, too? Yeah. I saw the copy you sent over. It was good.

Thanks for the ball cap tip there. Yeah. You didn't get the print version yet. I think those are still coming. They should be ready now. The release date is January 16th is when this is going to release. Awesome. That's awesome, man. Yeah. So- I can't believe I said what I said in there, though. Wait. Do you remember saying that, or no? No, I don't remember. I think I remember you asking me that question. I don't believe it was 15%. I was totally pulling your chain, you know? I know. While I was sitting there, I was like, hmm, okay. What else? Is he being serious, or is he- So, everyone, in case- So, I'll back up a little bit.

So, the book is basically called I Will Beat Back Pain, and it's kind of a precursor intervention book for when you want someone to actually read a good book or go into therapy, like read McGill's Back Mechanic or some of the McKinsey work. Like, sometimes they just don't do it. So, what Cody's mentioning is that there's a section in there where it was kind of like we were drinking beers at the bar. I remember we were at Pizza Lounge. I think we were in your little corner spot at the bar because you like to harass the bartenders. And I think we had a bunch of beers. Go ahead. In a good way. Yeah.

They were all friends. We knew everybody there, so. Well, they were male bartenders, too. You didn't know what's the rest of the- It was a nice restaurant just to give the lowdown to everybody. It wasn't a hole-in-a-wall bar or dark bar or anything like that. It was actually a really good place. Yeah, definitely not scabies there. Nope. Yeah, so then I eventually asked you. I think we were talking about cases that worked and didn't work. And I was like, how much do you think you know about back pain that I- How much do you know that I know about back pain? Or what's the percentage of things that I know?

And you said 15%. And I was like, motherfucker. Wait a minute. What do we got to learn here? I maybe said 50 or something like that. Just to pull your chain. But it got the wheels turning, though, right? Yeah. Yeah, I dug it around into some things. And so some of the things that- Just for context here, I'm really not that cocky or anything like that. You know, actually, funny. So Brennan has been coming in, right? And so me and Ali have been talking with Brennan. And I would just like to pull his chain every once in a while. So right now we have this game called Cocky or Confident. So he'll ask a question, and then I'll use to say something, and it's just kind of like, well, that was cocky.

I'm like, well, was it confident? We don't know. There's a fine line there. Yeah, yeah. You dance the line. Yeah. Well, so in that book, then, we go through the story of later on, I end up having a back issue. That was years later. And I went to you as the one that managed it. And it kind of goes through the story of the mental foundation you have to build to be able to let rehab stick. Because back pain, like, mentally fucks people up. Yeah. Not me inclusive, too. So yeah, that's that book. Yeah. Yeah, I know. No, I mean, I think the kind of mental approach or the kind of the, I guess now, you know, people call it motivational interviewing approach that the practitioner should participate into with the patient and letting them know they can beat the condition, you know, is kind of overlooked.

You know, a lot of people take too much of a straight biomechanic approach, but a lot of people don't take any biomechanic approach at all either. So I think there's a line you kind of dance between the two, you know? Mm-hmm. You know, in the just kind of framing things, like I was thinking about how to figure out how to relay to people that there is that beginning interventional part, that mental part that you kind of have to play the line with. It also, too, with there's that barrier that people seem to not want to do the things suggested to them for whatever reason, their bias, their fears, whatever the hell it is.

Yeah. And I was thinking of physics. I was thinking inertia and friction. We can push them, but they don't tend to roll. Mm-hmm. So, and I was thinking that with the book, the book is intended to reduce friction, but someone has to push the book on them. Right. So, buy it for your spouse. I like it. Yeah. It's a good stocking stuffer for next year. Oh, it is. Totally. Yeah. We're past that now. Maybe for Valentine's Day. Oh, I think I'm losing you right now. Valentine's Day. Yeah. There you go. Yeah. Honey, I love you. You can be back pain. You know what you could do? Valentine's Day, you can include McGill's study on back positions or spine positions with sex, with coilus.

But you can actually bring on Natalie Sudorkowicz, who did that, who actually, that was her study. And she, have you met Natalie? No. She's awesome. She's fantastic. So, her and Carrie Tull, they've created a company called, it's named Red. And they're, I mean, obviously, they're based out of Canada, but they host a lot of seminars. So, they've hosted, like McGill's, the McGill Summit, they hosted the McGill Summit. So, they do a really good job at hosting seminars, too. Oh, cool. No, never met them. I've never been to Canada. I've been to Canada one time. Yeah, we've been to, well, Marianne, my wife, has been to Calgary to assist Craig Liebenson.

And both her and I have been to Vancouver multiple times to assist Craig Liebenson up there, too. And that's what, Red hosted Craig up there. They let you into Canada, huh? They did. So, why are you here? It's a business and pleasure. Well, so, let's get into strength conditioning, then, I think. Let me start out with, I know that when, like, my experience with exposing some of my patients to, I guess, just picking up a weight in general. Because I know I had a lady recently, she's 85, and she came in, and I wanted her to do a little bit of carrying work, you know? Because she's going to have to encounter groceries and whatnot.

And she's like, I don't want to pick that up. And I only gave her a 10-pounder, and she kept giving it back, you know? And then she took two-pounders, eventually, and she started walking with those and started swinging them. And I was thinking, swinging them, you're probably subjecting yourself to a lot more force than this 10-pound carry. But either way, she was hesitant of it. So, I think the stereotype with picking up a weight is that it's an exercise. It's not an implement to improve the person's ability to move weight through life. Yeah. Yeah, I think, you know, people need to understand that, you know, human body is a very robust thing, you know?

And it's not some fragile flower. And actually, loading it is very beneficial. You're not going to create any change or adaptation at all unless you apply stress. And, you know, that external load or that implement is the stress, and it can create a positive change. Too little is not good, and too much is not good. So, there is a sweet spot, you know? And just kind of moving people towards the middle of that spectrum in terms of loading tissues is kind of our idea. And that's what we were trying to do with rehab, right? Before we hand them off to the strength and conditioning coach. Yeah. And I think at least most people are very familiar with the idea that, especially of a certain age, they're probably thinking osteoporosis, you know, things of that nature.

And their doctors at least said, hey, you take these vitamins and then start doing weight-bearing exercise and pick up a weight every once in a while. Yeah. And when you say the adaptation of tissues, that's inclusive of bone, tendon, ligament, carlids, and a lot of things, even nervous system, right? Right. So, is there a certain conversation you have with people when they're hesitant of actually picking up a weight? Well, I think, you know, educating them on, you know, that we're not going to ask them to pick up. If they've never picked up a weight before, it's been a long time, or they're old and they're afraid, you know, letting them, reassuring them that we're not going to pick up 200 pounds.

You know, this is not something that's going to break them down, letting them know this is actually going to be good in the long run. They should not have discomfort when they do certain, you know, if we start to do certain loads, you know, and for them to communicate with us and let them know that we're there if there needs to be any help. Yeah, yeah, and I think actually that's a good point with making sure that they are aware that when you say pick up a weight, you're not talking about making them into an Olympic weightlifter or a powerlifter. Not at all. And I know that there is, like, is there a general recommendation do you give people in regards to, like, are you, like, what is a good long-term goal for you just as a human being to be able to, like, move certain types of weights?

Well, I think it totally depends on the person's goals and also the person's training age, you know. So, I mean, if you have somebody who has literally never lifted weights before ever, then I don't think your goal for them, and they're in, you know, they're in their 60s or something like that. I don't think your goal for them necessarily is going to be very high load, you know, just getting, just getting, you know, once you hit, start to get the 60 range, 60 years old, just building, you know, building muscles in, through hypertrophy training is very, very beneficial for longevity. So, I think the goals may change a little bit, you know.

Now, if you have somebody who started training when they were, you know, a teenager, and they've kept training all the way through, you know, and now they're 60, you're going to have very different exercises, different loads for that person, but it's still centered around their goals and what they're trying to do. Mm-hmm. Yeah, I totally agree. And I tell people that probably, like, one of the main reasons why I think that I'm in business is actually when there's big peaks in their loading or their mileage or whatever they want to call their exercise or their high-intensity training. Those big peaks that they have are just a little bit more risky than I would want them to because I think they're in a bigger rush to get to their fitness goals or whatever it might be rather than just taking a good long-term approach.

Right. So, yeah, there's no shortcuts to that, right? You know, if we're talking about just kind of trying to keep things healthy, so to speak, just tissues in terms of not overloading them if they're some type of endurance athlete or even if, you know, even if they're like a bodybuilder and their programming is kind of poor and they don't allow for adequate rest periods, they're going to start to have issues and it's going to really – it'll hinder their training. Yeah. Just my observation with, like – I don't know if it's just me or the people that I follow on social media. It's just a bunch of Cairo meatheads lifting weights and stuff.

But I feel like there's a push for people to get people into Olympic barbell lifting is – what do you think about that? I mean, again, it depends. You know, what's the person's training age? Has the person ever done it before? You know, if you have a 45-year-old male who's never done Olympic lifting before and he has really, really bad – like just kind of worn out shoulders, bad T-spine, I don't think – I think certain parts of Olympic weightlifting can be very beneficial. But looking back on the goals, you know, are they trying to be an Olympic lifter or are they participating in a sport that could benefit from Olympic weightlifting?

Are you trying to use the Olympic lifting as a metabolic conditioning exercise? Then that's a problem, too, because it's not really meant for that. So, again, it kind of totally depends, you know, I mean, you know, what kind of person do you think – do you have in mind? Yeah, yeah. I was just kind of curious with – by the way, I would consider myself a meathead, so don't take offense to that. But there's – by the way, I was thinking, too, that with the – imagine like there's the – like I've had a lot of people come in with like – so I'll have them carry kettlebells. I'll have them hold on to barbells.

I'll hold on to these objects that have like nice round handles sometimes. And there's a couple times where I've told them, you know what you should do? Just go to your garage, pick up that old Jansport backpack, a couple of them that I know you don't use and you had since high school. And since it has a lifetime warranty, you're never going to get rid of it. And fill it up with a bunch of shit in your garage you don't actually use and walk around the neighborhood with it. And they're like, well, why shouldn't I just – maybe I'll just buy a kettlebell. I'm like, you want to pay $1.70 a pound for a kettlebell when realistically in life it's never going to have a nice round handle like that.

Like it's always – you're always picking up random shit like you're just coming up the stairs from Costco carrying two boxes and then like a jug of milk, you know? Well, that was part of my training is when I would move the kettlebells around my office is I would put the 24 kilo around my – wrap my index finger around that and then the 20 kilo around my middle finger. I'm kidding. I thought you were going to say you would bear hug one like a baby's head and the other one you would – Yeah, stack them all in the hand and start pressing them. No, I think creating a little bit of variability like that's important also.

And the fitness industry has swung really far towards variability in implements. So whether that's a kettlebell, sandbag, bands, barbell, dumbbell, you name it, it's out there, right? So it's a good thing. Also, we can't deny the basics. You can't move too far from what definitely works. But the variability is something that's important. It's just like people who – distance runners, one of the things you might give them is like you're in Huntington Beach, you might tell them, hey, take your shoes off, your socks off, just go walk in the beach nice and slow just so they get some different feedback coming up through their feet into their nervous system.

You know, just that alone might be therapeutic to them. On that same note, what do you think about lifting gloves? I'm not a lifting glove guy, but I mean, you know, but let's be – you know, if you're – what if you're a hand model? Right. Well, yeah, but do you ever see – do you ever see hand models go like this palm to the camera? They're usually the other way. They usually are, but you never know what type of shoot you're going to get as a hand model. You're right. There's – I think there's a good niche market for selling weightlifting gloves to hand models. Yeah. Well, I was just curious because of the feedback, the affirm feedback, but – Yeah.

I know I have a friend who grew up in Boston, and he didn't have much money as a kid, and he would have a little cellar over there. And he'd go downstairs with all of his buddies, and they didn't have much money. So he was just like lifting all of the rusty like iron there was that he could find. But for the most part, he had a lot of center blocks. So he'd just be pressing center blocks. That's cool. That's like – that's easy shit. Like, I don't know if you ever made an anchor out of concrete. Right. That's the easy way. Yeah, yeah, that's the easy way, yeah. Really? I have. They don't work very well because they don't grab the bottom of the leg too well.

You just use anchors. Yeah. Well, those sand – have you – damn. It depends on the bottom, okay? You can get those like claw-looking ones. You get the wedge ones. If you have a variable bottom leg, you need different types of anchors, really. Everything was in the bayou or surrounding swamp areas where I'm from, south Louisiana. So we just use an anchor. So you would – so we just use something that would hook to a Cajun? No. Wait, what do you call the crocodiles? Are they Cajuns? The crocodiles? I thought the – What? No, there's alligators down there. Wait a minute. Wait. So one salt and – There's no crocodiles down there.

So the – I'm talking about the water? The brackish water? Okay. Educate me on crocodiles versus alligators. I don't know what you're talking about right now. They're just – they're different. So they have a different – the nose is shaped differently and the teeth are different. You have those round – the ones that look like double rainbows, right? Yeah. I mean, it's a little bit more wider and round at the end. The crocodile is a little bit more narrow. It's not like an inverse parabola? No. Like a high slope parabola? No. Back to loading. So is there any times where you would – if someone walked in just – we should actually probably get into a little bit more case presentation, I guess.

But is there any times where someone would walk in where you're like, I'm not going to use loading on this person right now of any type? I mean, yeah. Yeah. What if you suspect something's broken? Okay. You know, that's a pretty clear, you know, obvious answer. But I mean, I don't know. You know, if there's no red flag, so to speak, and then, you know, you're not suspecting some type of fracture, you know, or some gross ligament or joint instability, then, I mean, I think loading at the right time, right place, in the right way may be beneficial and or not necessarily take away their pain, but could be fairly therapeutic in the long run.

I tend to think if there's – I feel like there's an acute first aid process there. I won't necessarily load them yet, but if they're kind of the tail end of that, I might try with some attractor state stuff. But if it flares them up, then I'll retract real quickly. Right, right. So, you know, I'm with you on that too, you know, and – but I also look at, you know, maybe it's non-load on the tissue that's irritated, but can we load somewhere else to take off some stress of that area? You know, a great – yeah, a great example of that, you know, somebody who come in with right knee pain, whether that's kind of, you know, kind of patellar tendon and or kind of just some medial knee pain, and you put them through a squat and looking at them from the front, they're shifting into the right side.

And maybe their knee is coming in the valgus, maybe it's not coming in the valgus, but they have pain with that. But there's an obvious shift to the side. So, looking at – taking a step back and say, okay, what does making this person shift into the side of pain? So, you look at the pain that – I mean, excuse me, you look at the side that doesn't hurt, that's not in pain. So, maybe you do an evaluation and let's say they have some left hip thing going on, whether that's decreased range of motion or you're suspecting that they're not – the brain's not wanting to use that side for some reason. You might put them through an exercise to what, you know, increase the attractor state in the glute on the left side, not the right side, on the left side.

And then you re-squat them and now they're more symmetrical in the squat and the pain's gone away in the right knee. But all you've done is you increase the attractor state on the opposite side and change the movement pattern. And so, the one area is not being overloaded. So, we didn't load necessarily the tissue that's irritated, but we've loaded something else. And so, you've loaded the patient and you get – now they have an exercise they can take it home. Yeah. And also, too, I think that if they're – like in that situation, if they're loading the side of the complaint and they're offloading the other, then if we're going to take this person in a good long-term direction, we have to equal that out anyways.

So, you might as well just start hitting it now. Yep. I always like to consider like – so, at least working with like the right corrective exercise or in the right dosage for that person at that time. And I think that if you can find that, which sometimes takes me three, four times to figure out what exercise works. And if I have a reset on them, it's nice. Yeah. But once you do that, you can make a good change in about a minute or so. And then how long it sticks is a whole different story. Yeah. I mean, I think – well, with the – it's a great point in terms of it sticking, you know. So, a lot of people do exercises that fire up their glutes or fire up specific muscle groups.

I mean, you have to load that with some type of load in hopes that we have some carryover in the long term. So, people will get their glutes fired up, you know, if they do some band walks, but then they don't really do anything. And so, you know, it would – if your goal for that exercise, those band walks is to strengthen the glutes, you're not strengthening the glutes, you're just increasing the attractor state in the muscle group. But if you load that with a deadlift or a single-A deadlift, some type of load in a pattern, ideally that, you know, A, it makes the exercise a little bit more efficient with some increased attractor state in the area, and B, we have some carryover for longevity in terms of strength.

So, then considering that same – okay, it's probably easy to fall down this knee case a little bit. So, imagine we have that same case and we did increase the – I always say supportive system, supportive areas, and it helps reduce the symptoms. If we can get them to some type of loaded movements, is it fair to say that that knee person, we might hinge them or deadlift them? And you said single leg, deadlift them. Maybe have them carry. Yeah. Maybe have them do a pull. Squat might be higher risk. Yeah. Maybe. But what type of squat? You know, maybe you go – if they have pain in the bilateral squat, maybe you go to a split squat and you only have them do like a quarter split squat and you expose to them that they don't have any discomfort and you go back to the bilateral squat.

I think it kind of totally depends. There's this – like you said, it may take you two to three visits to find the things, the exercises, so to speak. But, I mean, also it's exposing to that person what patterns don't hurt and trying to find the ones that they're afraid to do and then giving them variations or regressions on those exercises to load those tissues and then take a step back and say, hey, we just loaded these tissues that you're scared of loading in this pattern. Do you want to try and load this pattern now? And some take you up on that. Some of them don't. But the ones who do take it up on it, you know, they don't always – they're not always pain-free when they load those, but most of the time it's less discomfort.

Yeah. Especially when you kind of – you pull the curtain back. You're like, hey, surprise, we loaded the things that you're afraid to load. Yeah. No, I totally agree. I think that when loading them too, it's nice to have patients to have a little bit of understanding of that. Just because it's painful to squat doesn't mean we can't go a percentage of that depth and go as much as you can and then slowly expose yourself to it or maybe expose yourself to that same range in a quad rock tabletop position or some type of regression. Absolutely. But yeah. So yeah, I think that's a good recap on the new thing there.

But yeah, I think you were telling me earlier before we came on that you had a really good example of when load became therapeutic for a patient. Yeah. There's actually – there was a lady last night. There was – she was kind of fun. She came in and she had left-sided upper trap, I guess you would say, tightness or not, as she said, and also some mid-back stuff. It was more of like a sensation of tightness in the area? She couldn't really validate that or not, but she can show me movements that were provocative like a partial push-up. Granted, her push-up was – the form being taught was not what I would have wanted.

Well, actually, she was like this. Yeah. She was like – Elbows were really far out. Yeah. Probably. She actually had her index fingers pointed inward. So it was interesting. So we cleaned that up a little bit. She still had some provocative symptoms and also the area around the – what's this area called right there? There's – I know there's a gully there that actually has a name. Yeah. I don't remember it, to be honest with you. It kind of was. So everybody knows, he's pointing just medial to the humerus, the anterior portion of the humerus. It's like kind of where the pec minor ties into the corcoid.

Right. So she did say she had some pec minor pain. And then upon further questioning, we figured out it was actually like a zapping, numbing type of sensation. So – but either way though. So I wanted to see first if we can supply some type of load to the area. Because in testing, I had – she had problems with moving her neck. So moving her neck to that side, tilting, and also looking up were painful. So I had her with that same arm, same side arm that she was tilting to and had problems with. I just had her – I said, push me away. You know, lock the elbow out and push me away. Move the head again.

Let's just see how you feel. And she's like, oh, it feels better. And I'm like, cool, great. So then I had her push her elbow into me, elbows by the side, and I had pushed down towards the table really hard. And I said, how does that feel? And she said, oh, my God, it's better. What is this, some type of shitty voodoo? You know? And so I took her out into the floor area, and we did some attractor state stuff with the middle trap, lower trap. I first tried like serratus type of like an aggressive pushing position because she led me down the route of a push-up. That one was kind of iffy. But when we did lower trap, middle trap, she sat up and she's like, I'm purring like a kitten.

This is so good. So I didn't have to – I didn't do any manual therapy with her in that case. I might later, but that was the instant where actually she – I think her belief system changed it. She's like, I had no idea we're going to do this today. And I had her sweating on the ground. It only took about a minute and a half to get her to that point. But now she just has to stick it a little bit. And then we did a carry after that. We did 16 kilos per hand – I'm sorry, 12 kilos per hand. And she was hesitant, and she was talking during which, and so I increased it. And then she stopped talking. And then she felt fine after that.

So then at that point, I can relate to her trainer that I'm like, she's responding well to carries. She's responding well to some type of lower middle trap type of thing. And let's just carry on with that and just see what else reveals itself as we unmuddy the water. Yeah. That was my case. No, that's great. I mean, I think, you know, a lot of times patients don't realize that, you know, loading too will be therapeutic to that. They're expecting – I think we've talked about this before. You know, they're expecting come in for you to only put your hands on them and do some type of soft tissue, you know, massage, ART, or some type of instrument-assisted soft tissue and maybe adjust them, you know.

But, you know, they don't understand that our goal is to try and find things that they can do at home to, you know, to create some independence from us. You know, terrible business model. But, you know, in terms of patient care, it's optimal. Yeah, yeah. And I think as long as we – I always try to make sure that I understand what you hear that, like you said, you had upper trap knots and so on because they will probably believe that then beating the snot out of it would be a good first approach to it. And so I say, look, let's try this other stuff first. But we can still do that other stuff later and we could.

But these are things that you're showing me that – like in the exam, you can see it. If you do some type of dynamic test or loading in the exam, you'll see if it makes a change or not. And then you can probably see, too, with low risk where you can start loading this person. Yeah. Just curious, did you have her do any type of overhead pressing? Did I have her do overhead pressing? Yeah. I didn't because usually I'll ask them, like, what can duplicate your symptoms? And whatever they go to that they can consistently create, I'll use that as the measurement outcome tool. I could go overhead with it, but at that point, I didn't see any point yet.

She did have it flare up in the gym with overhead pressing, she said. Yeah. Did you do any shock locks, neurodynamic stuff for extremely? I did not there yet. Actually, she came in about 30 minutes late and I had to get to what I needed to get to. So I started with some type of – I started with neuro-ortho compression, decompression testing of the cervical spine, which it bared fruit, but then also holding the blade holding the blade together and stabilizing the blade seemed like it was bearing more fruit. So I just went that route and I'll probably change routes next time. Oh, yeah. I was just curious to see if she had some – if you had some positive neurodynamic testing and then overhead press, she was having some lateral translation of the cervical – of the head towards the side she was pressing.

So I was thinking that actually when I was testing her, but the thing I was – I was doing myotome testing, right? And so she did the C5, this one, the bicep one, and she immediately went like this, right? And so I said, just stop right there. I'm going to go get my phone. We're going to do a video. And she did the other side and it was fine. With pushing, it was fine. But she – I found enough to where I thought I could make an impression and make a difference in what she was trying. And then next time I would go through more. I don't know. Personally, I like to – I just tell them straight up. I'm like, look, I'm learning about you as a story and I can only get through so much today.

I'm a speed reader. So let's go through more next time. Yeah. A lot of times there's – well, there's more to it, right, than just the presentation that they're presenting with or the issue they're presenting with, you know? So there's – I mean, you don't know what they – you don't know the stress level at their job or family at home and stuff, you know? There's so many more factors to the person itself, right? Yeah. And it'll sound like probably like a shitty type of business scheme. But I think the best thing that we could do the first time is if we feel confident we can work with this person and improve them, you got to get them to come back.

Right. Because if they don't come back, you can't help them. Right. Do you have a good case about loading? I know you talked about the knee. I do. Yeah, the knee. I have another good one to have. An upper extremity one also is having somebody who we suspected they had some type of cervical disc issue. They were having some radiculopathy. I mean, everything was pointing to a disc. You know, kind of coughing, sneezing. Digerine's triad, so to speak, was positive. Orthotesting, neurotesting was positive. So – but they were – the pain in their arm they were having was kind of over the deltoid and into the lateral forearm.

So exercise-wise, it was like, okay, well – and I tested their grip, not with a diana neumometer, but just had them squeeze my – I had put my fingers in their hands and had them squeeze. Oh, I thought you hadn't – I always thought you had them squeeze your thighs for some reason. Creepy like stuff. No, they can't fit a wear on my thighs. My thighs are too big, too much muscle. Anyway, and on the side that was – he was having the pain, he just wasn't squeezing as hard as the other side. So I brought him into the rehab area, and I had a CLX band. I didn't have a cable machine, but I have a CLX band, and I put a baseball in one of the loops.

And what I did was I had him grab half of the baseball with his fingers together, anchoring the thumb first, and then going pinky ring middle index. So almost kind of – if you take your hand and you kind of bite your thumb and your fingertips together. You're doing like a – you look like a crane. You look like a little crane tip, so everyone knows. Yeah. And so he only has half the baseball. So it actually – what it ends up doing is you're not – if the baseball is not in your palm, it's really half the baseball is inside the fingers and half is out. And I had him just put it in – unloaded in terms of the CLX band, put his arm in a road position like he would pull for a standing row, and I had him back up.

So it just loaded the fingertips and the hand in that finished row position, and he cashed out really quick. I mean, the ball started sliding out immediately. And so long story short, it kind of started building up to – he got more and more endurance, started having him row and then retest. And the sensation in his arm went away. So all the pain and discomfort in his arm completely went away. We didn't do anything with the neck. All we did was increase, I guess, the brains – I guess the attractor state, so to speak, with the pincer grip. And I mean, I should have had a dynamometer so I could give you some data, but I had him squeeze again.

It was – and to me, it was obvious that he – and he felt like he was able to squeeze a little bit more too. So it was a great instance of that. So we went a grip route with this guy, and we did some McKinsey chin – you know, some retractions, some neck retractions. Yeah. That was a one-day thing you're talking about. There was – are we talking about progressive or just one day? No, that was one day. That was – that was – that was – basically, I was first visit. I used that as an audit to see if that was going to be the thing. Because in his exam – we did a movement exam, too, and nothing really was pointing towards any other big things.

And he even did a cervical breakout, SFMA. And, you know, so it's the motor control stuff in the cervical – the lower cervical. So that's why we kind of went a little bit more McKinsey route. And, you know, if he did have some type of disc, you know, that whole McKinsey thing for a disc. So then with something like that, I don't know if the listeners will probably think, well, crap, I don't want to load this person too early. What if I do? Like, how do I know? So in a case like that, did you have some type of reassurance that you're like, I'm not going to hurt this person? Yeah, well, that case specifically, they were okay with doing it because it wasn't their neck.

They weren't really – it was just like a measly little band and a baseball. So they didn't really know where I was going with the whole thing. And I told them what we're doing. I just told them – I just told them and said, hey, we're going to do something for your grip right here. And to them, their – I'm putting air quotes – weak grip, so to speak, wasn't necessarily related to their neck. They didn't know why they didn't squeeze harder on that side. Did you even tell them or no? Tell them what? Did you tell them – did you even do – Oh, did I point it out to them whenever I noticed, whenever he's – Did you mention the neck as being a – as a correlating factor or did they just – you know, like people, like, no matter how much you tell them about the neck or whatever it is, they're like, well, my wrist.

And you're like, well, it's not your wrist. Yeah, well, he came in and he is – he like – I mean, just like most patients, they come in with their differential diagnosis, right, or their diagnosis. This guy came in with his differential. He was like, I don't know if it's my shoulder or maybe even it's my neck, you know. And he tried to do his research before he came in. But so towards the end, I was like, yeah, I'm pretty sure it's coming from your neck. We're going to do this, this, and this moving forward. And I want to see you again – I want you to do this until I see you again next week. And, you know, it got better pretty quickly.

I mean, most of the people that came in, you know, they weren't on long treatment plans or anything like that. And so they would do their homework, you know. They're paying for it out of pocket. They're going to do their homework. Yeah. Oh, yeah. You had the cash practice. So people – they should do their things. They don't always, though. They don't always, but most of the part they do. Most, yeah. Did – can you give me an example of a case that you perhaps – because that was a light loading one. How about one where you – where someone – a bystander might think, holy shit, you're doing that with an injured person.

Yes. Well, I mean, I can count – I mean, I can't even begin to count how many times I've loaded lumbar – where we suspect a lumbar disc and either a deadlift or an isometric lifter's wedge, you know. I mean, it's a – it's an in-visit progression. We don't immediately go to it, so to speak. But, I mean, I'm sure that you've had this, too. People barely walking in, and we suspect there's some type of lumbar disc, and we progress them in a 30-minute visit from barely being able to walk to lifting weight off of a platform or lifting weight off of a box. You know, that's an easy example. You know, actually, for everyone that – I don't know if this will be live by the time this podcast goes.

I doubt it. But there – so I flew out to see Cody recently in Dallas, and we did a whole video series on flexion intolerant back pain strength conditioning, basically. We went over the squat, the hinge, the carry, progressions of all of them, as well as horizontal pull. And we didn't do push, but that was my bad. But, anyways, this is going to be part of a CE course that we're putting on, an online CE course that I'm part of. I'm doing ethics with Ben Ramos. Philip Snell, Greg Lehman, and James Vacker Seville is going to be on there, as well. It's all flexion intolerant pain. But the reason I bring it up is because the person that we use as a model, he actually was a real case.

Like, he – we hadn't seen him before. You hadn't seen him before. No, no, I haven't treated – I had never met him before in my life, didn't treat him, didn't – yeah. So, you're going to see through – just talk about that a little bit with – because I know that we took him through – you loaded him pretty good. Like, I remember that when we went into the goblet squats, you were doing a double rack, and I think you said, go over there and pick up those 62s. Pounds, by the way. I'm American. Pounds. And you were going to load him up with two of those, and that was – so that's basically on day one of exposure to this guy.

Yeah, so the gentleman, I mean, he has been dealing with a low back disc issue, I believe. It was confirmed, an MRI, and he had taken some time off of lifting. He's an Olympic lifter, not necessarily competing, but that's just what he does, and he's a coach also. He's a strength coach. So, we started to – I asked him before we started, and this was off air, and I said, hey – I asked him a bunch of questions, his background, what has he been doing for his rehab and treatment and whatnot, and he did not start deadlifting, did not start really squatting. He started the front squat a little bit, but it was very light, I think, with maybe tens on the bar.

So, everything was pretty raw from get-go, and I didn't tell him beforehand and say, hey, I want you to do this, and then we hit record. It was all just there. Do this and see what happens, and then coach from there. And I think that was the idea, is being able to coach those individuals, taking them from somebody who's maybe competent in lifting, like this guy was, but still have some movement pattern issues to somebody who's really has never lifted before, and be able to coach them in those lifts. And it's just positions and patterns, you know? Yeah, I think that was a – he was a really good case.

He's the – I think he's a really good type of case that it'd be nice to see, like, if someone was to, like, walk into your practice and say, well, what are you guys going to do on day one? I don't know. Well, shit, I might have you do 135 from blocks, because that's basically what happened. That ended up what happened. Yeah, the guy's an animal. I mean, he ended up doing really well. He handled everything well. And I've seen him a couple times in passing since the recording, and I haven't told you this, and he feels amazing. He's starting to actually turn up the intensity on his training now, and he's using those techniques that we talked about in the recording.

He said he's never felt more locked in, and the weight's never felt more lighter than it has before by creating the tension through the grip and the floor, and then thinking about breaking the bar and everything. He said it's working really well for him. Yeah. Well, nice. He was cool. Like, he was a good – definitely a good sport with – because we were recording for a bit. Yeah. And I just – I know that one of the things is a precursor that we had in there, which I know that you teach before you introduce people to heavier weights, at least, and I do as well, is hand contact and wedging. And in that course, we go through that, and I remember actually – it was funny when – because I've been from the admin side of putting all these videos together with Greggs and Phils and so on, and like, so I – like, we were sitting there watching football and editing yours, and yours were damn entertaining.

Like, watching you show the lobster claw grip to this guy, I'm like, I can't believe I'm watching a 10-minute video on grip. It is important, you know. It is important. And it could be if you get to a certain level in terms of competition, whether that's power lifting, strength and conditioning, you know, strongman competition, that can be the determining factor whether or not you hit the weight you want, you hit the lift you want, or – it's important. It is important. Yeah. So if any of you guys are hesitant of showing loading, especially barbell lifting, and to your patients, that course is going to be amazing.

It's one of a kind so far. I've never seen anything like it, at least from a CE perspective. But just to retract a little bit, because we talked about that he was an Olympic lifter, we can clearly use those techniques with normal people, right? Okay. Correct. Yeah. You don't have to be an Olympic lifter. You don't have to be a power lifter. You don't have to be somebody who works out for a living. I mean, the general population, the same exact thing. The same thing I go over with my strongman competitors or power lifters, I do the same material with my general population, because in the long run, it's all about creating tension, you know, and being able to manipulate your tension, control your nervous system, knowing when to contract and when to be able to relax.

I was really surprised by when the, since he was an Olympic lifting coach, that the grip was so inspiring to him and that wedging was so like, it was like a crazy, like he said, he was totally locked in. So it was clearly something that he was lacking in his movements and especially if he's coaching it. I can only imagine how many people like, I can't tell you how many times, like, actually it came from Guido's workshop and went straight over to a friend's house afterwards and they, we got all crazy watching football and so on. I said, lay on the ground, let's do some of this shit. And so we're just, just yelling, screaming at him.

And because they go, they go to CrossFit over here locally. And since then I have stopped going to that gym because I have my own and they're like, they're like, I love when you come over because you always like, well, I'll tell them how to wedge in the floor. I'll say, go in your garage and go grab a, go grab a bar. Let's fucking do this thing. And so they start using it. Like, I don't know how many beers they have, but they probably start, they start using it right away and they love it. Yeah, it's good stuff. I mean, and I tell this to, especially, you know, I tell this to everybody, you know, we're going to go over this, these, these, uh, tensioner techniques and how to, you know, create pretension before you actually start to create tension into the lift.

Um, we're going to do that, uh, in the beginning, whenever we're rehabbing, and we may do that whenever we're starting to warm up with, uh, you know, an empty bar or lightweight, but when you start going high maximal loads, you're not going to be thinking about all this stuff. You know, this, these are things to think about and do, uh, in the beginning. And then we want them to transition over. I want it to be, uh, uh, unconscious competence at that, at that point, you know? Mm-hmm. Um, just to, just to make sure I, I finish up on this. If you guys are interested in that CE course, it will be available year after year.

Um, I'll put a link in the show notes and, uh, in the, and in your media player, you'll find a little link right there. It might not be live yet because we're still in the process of developing all of the, um, all the content and getting approved through the schools. So you can always do 12 hours on there. That's there's four hours of documentation as well as history taking, which everybody needs, uh, as well as two hours of, uh, ethics, which by the way, me, when me and Ben did it, holy shit, it was, it was tough. It was so, so hard. Ethics, ethics is tough to make interesting, man. Yeah. Well, I mean, so we went over case presentations of, you know, people, um, the, uh, NCMIC, but it was, it was every time, like we went through about three cases and we're like, okay, we need to go eat.

Uh, I, I don't want to touch person ever again because I'm scared to death. That's true, man. So you're talking about CEs for that course. Is that, uh, chiropractic CEs or are there any other CEs or no? No, those are just, they're going to be chiropractic for now and, uh, I know that, um, we'd spoken to, uh, Stuart McGill about taking, uh, about doing some stuff on there as well. Kind of the, uh, uh, yeah. So, so Philip might, and then I don't know if it's, it's, it's, it's truly going to happen or not yet, but he might interview, uh, Stu on some of the stuff he's observed through his, uh, adventures with working with people and just wasn't enough to publish really.

So they might spend a 12 hour C on that. And I, the reason I bring it up is because he's like, Hey, make it, make it available for PTs too. We're like, I don't think we can do all, like I can't do all that, you know, like you might as well just focus on chiropractors first and then maybe expand later. Expand a little bit. Yeah. Good idea. Um, so back on, back on strength conditioning then with, um, is there any easy recommendations that, that you usually use and give to people? Um, cause I definitely have some, some of my own, but what you got? Uh, tricking, I think about tricking them into doing something.

Yeah. I, I usually, I'll trick them in the office and, and just to basically let, show them that they can do the things that they, they need to do in terms of personal training and strength conditioning. Honestly, I, I kinda, I, I have a frank conversation with patients, uh, and just my, my personality, I guess when I, when I speak with patients, uh, I can, I'm not necessarily firm, but I'm also, you know, I, I, I'm completely honest with them. You know, I tell them like, look, in terms of long-term, you know, benefit for you, it's not in my office. It's not coming in here and let me work with you once a week or once a month, whatever you think you need.

It's really getting with this person who can manage, uh, you know, manage this part of your, uh, your activity, uh, properly, you know, and if you have a good personal trainer or a strength coach, then they're going to teach you also. And then hopefully they create in some independence in that way too, in the long run, if you have the right person. Well, I always thought the best way to prevent further problems is to squeeze the DMAC thymometer. Yeah, that's, that's, that's tough, man. Dent my thighs, dent my thighs. Yeah, crush my thigh. Yeah. Leave your fingerprints in my skin. Yeah. We'll be breaking hands, man.

That's not good. Right. Um, yeah, I've been trying to trick a couple of people into, uh, the, the people who like, like the robotic movements, like the, uh, they like to lift, you know, I'll tell them to do something different, do some like, um, crawl around the ground, act like an animal, act like a kid, things like that. So some type of variability. Um, well, I think, I think you had a, uh, kind of the Dan John principle right there, right? You basically, if you want to improve performance or if you want to, you want to help get people better, you find a thing that they're not doing and you do it.

And he uses the example of a strength conditioning for like a basketball team. You know, if you look at their program and they're, they're not doing carry, uh, they're not doing carries, you do carries and their performance improves. They get stronger, they jump higher, you know? So, uh, you do that for the general population too. You take a step back and look at this person and this is for rehab and this is to start moving towards performance. Also, it's what are they not doing? What are they doing too much of? What are they not doing? Let's kind of move some of that attention away from what they're doing too much and move it more towards what they're not doing and things, things generally improve.

Yeah. And I think a lot of times they'll tell you the things they, they are good at and they like. Absolutely. Yeah. And then when you further investigate, it's like, what are you not good at? And, uh, yeah, let's work on that today. And then they hate you. It's amazing. Well, I mean, we're, we're, we're a part of that too, right? So, I mean, you know, the things that you're not very good at and you know, the things that you should be doing in your strength and conditioning. And if you don't do them, you feel fine, but when you do them, you feel better. Like for me, when I do long carries, not necessarily heavy carries, that's easy for me.

It's just long duration carries. I hate them. But man, I feel good. I feel good. I feel good for days after that too. You know, it's, it's crazy. Are we talking briefcase or are we talking farmer? Farmers. Yeah. Farmers carry. She needed a second kid and make them heavy. Yeah. Well, I get just dynamic load, carry up here and you know. Oh, you're doing a mixed carry now. Yeah. Mixing up a little bit, but no, not even like really heavy, just kind of light, but just long, long carries. I feel great. Yeah. I feel great. You know, just to, just, just to recap on this too. I know that it's, it's sometimes it's easy to overlook.

So yeah, you carry a stroller or are those, what are they called? Bassinets? Strollers? What are those? No, those aren't strollers. Car seat. Whatever the thing with the handle is. So that's a, that's a, that's a carry. How much do babies weigh? That depends. How much, how much does your baby weigh with that car seat? With the car seat? Probably close to 25, 30 pounds. Do you carry a baby satchel backpack? I don't. Do you carry a fanny pack? I don't. No, we split the load. So the wife will carry the bag, I'll carry the child. So I guess when you guys eventually travel and fly, are you still coming out here on the, are you going to make that New Year's party?

Yeah, that's, that's the plan right now. So, okay. So you should take a video of you rolling your luggage, carrying a baby, pushing a stroller and a backpack. Well, the baby would, the baby would be in the stroller. Well, you definitely have, you'd probably have a backpack and a. You're trying to create too much variability right now. Okay. Well, I would think it's fun. I think it's funny when people say they got hurt, like carrying their luggage or putting the luggage in the overhead bin. Yeah. Practice on carrying something, roll it, shit, go to the grocery store instead of pushing the cart.

Can you pull it sometimes or something, you know? It's actually good. Yeah. The problem is I've done that, it clips your Achilles. It doesn't, doesn't work well for that. Pull it on the side with a fingertip pull. I do that. Yeah. I'll push it on the side here and I'll just guide it. Maybe if you walk a little, little bit more like a cartoon character with a little scuffly steps, like that won't happen. Or just, just, just, uh, just make noise when I walk, eh, eh, eh, eh, kind of clear, clear room, everybody separates. Oh, I know you're talking about you'd breathe over someone's shoulder when you're in line waiting to pay.

You know, you know what we didn't do? We didn't, we didn't do the store at the beginning, actually. I know. I'm actually kind of happy about it. You didn't start this thing off with some negativity. It's good, good stuff. This is going to be a good one. Well, no, no, no, let's do it. No, we can't, no, we can't, we can't do it without, we got to do something. Well, since you're the co-host, you can pose the question then. Yeah. What, uh, what is something that you actually love to do, Seb? I like barbecuing tomahawk steaks. Tomahawk steaks. I knew you were going to say that a bit. You know, so what's, so what, so what's your, what's your grill time on that?

How long do you heat the grill? What type of grill do you use? So, um, I use the grill in my garage, which has an infrared top. I don't know what that means. I think it was a sales point. I didn't buy it. Propane? Propane, yeah. That's, that's propane, yeah. So I do an indirect, indirect sear, but I actually follow the hashtag tomahawk on Instagram. It's one of the only two things I follow. Um, but, so I'm surprised. So I'm, I'm looking at these people doing these massive, like two, two and a half pound steaks, right? And they just like, they do it like caveman open fire style. I saw one dude throw it in the, literally throw it in the ash and he pulled it out and it looked phenomenal.

But, so I'm afraid to ruin a steak right now, but the reverse sear, about 45 minutes, flip five minutes a side or so, keep it real low, by the way, the least manly way to make a tomahawk steak is with a meat thermometer. Terrible. So I won't. So you can, you can take out the word tomahawk steak and just censor the word steak. No. Okay. So, so I got this friend who like, he just got a new smoker and everything and she showed me this app he can control with. I'm like, this is the least manly thing that you've ever showed me in your life. Um, but, but any, but anyways, uh, after that we'll do. A straight sear.

But I saw people were flipping over their cast iron skillets and throwing butter on there and doing the sear right on the flat surface. So I can't wait to do, we're going to have, we're going to have tomahawks on New Year's. Yeah. It'll be good. It'll be a good day. Oh my God. I can't wait. That's the best thing. So, so what do you like? Um, I actually, um, so my, uh, my mom this past, uh, uh, right before Thanksgiving actually taught me how to make her gumbo. So I, uh, I learned actually how to make gumbo and it is awesome. And it's so fun. It's good. I love cooking. Love to cook. Uh, and the roux takes so long, uh, it takes so much attention and focus.

It's, uh, it's pretty incredible. You have to, you have to stir it constantly for anywhere from 45 minutes to an hour and a half or longer. It kind of depends on how, how low the heat is or, and yeah, so it's awesome. So is there a secret family recipe that you got access to finally? There is. Yeah, there is. Did, uh, what is roux? Is it the soup? No, the roux is the, is basically what makes the base of the, uh, um, uh, so you, so you, have you seen gumbo before? Um, I've seen, it's like a, it's like a soupy. So you see how it's, how it's kind of dark? Oh wait, I thought that was that other thing where they throw all these sea creatures in there and then when people eat them, they get really messy and it's in this little cauldron.

Um, no. I'm going to look up gumbo right now. Go ahead. So no, so the roux is the, the roux is basically the base of the, um, uh, what is, what is, um, I don't know how to explain it. It look, it kind of looks like, uh, like a reddish, like, no. Okay. I'm gonna look at more images then. You get the wrong thing. Put Louisiana gumbo. It's like the sauce. Louisiana. Lou. Yeah. Lou. How do you spell Louisiana? Oh. Yeah. It's like a red sauce. It looks like you had like, well, how, what color is it? It's, it's either brown or really, really dark, dark brown. I don't know, man. Looks pretty, looks like, looks like there's just a bunch of like shelled animals in a red sauce.

Uh, you were on the wrong website, buddy. Anyway, I love cooking gumbo. So. Okay. I love gumbo and strength and conditioning. So when, when, uh, you come over for New Year's, do I need to go find all of these? Send me that recipe and I'll go buy all the stuff and you cook gumbo. I'll, I'll cook a tomahawk. Okay. Sounds good. Um, anything you'd like to cover strength conditioning wise? No, I think, I think it's pretty straightforward, uh, in terms of what we do in practice is, is it introduce people to the basics? Uh, and, and, you know, we may do some programming to introduce, uh, kind of load, uh, uh, tolerance to load, uh, and empowerment, uh, create, uh, some, uh, you know, patient independence and whatnot, and then, and transition them to, with somebody who, uh, who you can communicate with.

That's very, very, very important. Mm-hmm. Uh, I would probably just add, don't, don't be afraid to add some weights to your patients. Um, just make sure that you earn their trust and then go at their own pace, but they're, they're not fragile. I don't, I honestly don't think babies are fragile either. Neither pregnant mothers. That's a whole different story. But, uh, don't treat them like they're fragile because they'll also probably start adapting that principle. Um, and I think last thing on closing is then, uh, again, if you're interested, this is the release date for that book. So, I literally wrote this thing for a damn year.

Yeah, congrats, buddy. Well, thank you. Um, I, so if you guys are interested, it's on Amazon. I put it in three different types of medias. There is an eKindle format, which if you like staring the screen and burn your eyes, that's cool. That's your thing. Uh, there's print version, which I'd strongly suggest because there's written areas in there and there's audio. So, you can hear it like my sexy voice like this, but, um, it's intended not for you guys to buy for yourself. If you have a back problem, it's for you to buy for your damn spouse or your friend or your mom to give them the inertia nudge.

And then hopefully the book will create a friction reduction. I like it. Good stuff, man. Yeah, man. Uh, as always, it's good, uh, co-hosting your show with you. Oh yeah. This is, uh, this is so much easier and you have more to add. Yeah. What do you, what do you want to talk about next time? I don't know. Let's, uh, let's, let's brainstorm there. Okay. It'll probably be a couple of weeks before you come on again then. Um, yeah, but we'll capture a picture gumbo and tomahawks. A real gumbo. I don't know what you're looking at. Awesome. All right. Good stuff, son. Cool. All right, everybody. Uh, talk to you next week and, um, leave people better how you found them and always date an Eagle Scout.

What do you got, Cody? We'll close it on that. He just like sank away from the mic. See you guys next week.