Strength training the acute low back and beyond

I think we've talked about this, too, and in order to, like, I believe, I think you asked me one time, you asked me, like, what do I think is, what does somebody need to be good at, like, kind of seeing movement and good at movement? I mean, you got to, in my opinion, you have to have a really good knowledge of anatomy because you have to be able to, if you know where stuff is and you watch movement, you're like, they're hinging excessively at C5 when they go into extension. They, early lumbar flex, when they're going to touch their toes, you're able to pick things out. 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, everybody, welcome. It's Dr. Sebastian Gonzales, your host for the Restoring Human Movement podcast. Thanks for joining the Movement Movement. Today, we have an extra special guest. We have a co-host, Dr. Cody D. Mack? How's it going, Seb? Hey, good. So, Cody lost his microphone in the move, so now he's on a headset. Yeah, it's not as clear, and I don't hear you as clear. You need all the help with your voice, so. I'm going to make sure that, on this video part, I'm going to make lots of hand gestures so you see that I'm still talking. So, then, I thought we're going to do, we'll do co-host style a little bit today, and so everyone knows, I guess I should, I'll introduce the podcast.

You haven't been listening to this podcast before. It's basically blending the line communication with doctor, patient, and us two doctors kind of talking. Imagine we're having two beers, probably two West Coast IPAs from Green Flash. You can sponsor the podcast if you'd like, and there's a CPA next to us listening, and he's like, I don't know what the heck you guys are talking about. So, we're trying to clean that up a little bit. In addition, when we're speaking to our patients, ideally, we should have this nice general communication anyways, and so, we'll try to make it like that today. But, today is the part five of five series, where we're talking with the presenters from the Pro Chiro Online CE platform, which Cody was nice to be on.

And, he went over a really cool section, which was introduction of loading with flexion intolerant spines. And so, if you guys haven't seen it yet, there is a 10-minute snippet, which is completely free on Pro Chiro, which you guys can access and check it out. If you don't like it, then just spit it out. No big deal. And so, we'll cover, like, a lot of the stuff that we went through today on that anyways, right? Yep. Cool. Before we start, since I know you love the introduction section, would you like to pose the question? Since everyone wants to know about their host and co-host. Pose the question.

Yeah, because you don't want me to do a rant. I know that. Oh. No. No, yeah. Say so. Well, like, lately, you've been doing a good job of not, you know, saying negative things, but just telling people a little bit about yourself. You know, you've told them various stories. So, is there another story that you'd like to tell? A good story. I can tell you that I started gutting the, we have a 1930 hot rod, me and my dad. It's a 1934-mile, eh? I've seen those pictures, yeah. Yeah. And so, we started gutting it. One of my patients is a welder, and now he's a good friend. And so, we traded that out a little bit, and so we started taking the old wiring out of it.

And I realize now that all of a sudden there's really good wiring, like the little nice braided cables and stuff. And so, it's going to be pretty. And so, that's my project for the next probably couple months. Yeah, that's what, say, how long is that going to take until you finish it? Dude, I've had it since I was 15. Like, I've had it. Yeah. So, my mom, like, so she started setting up, like. A couple of months. Yeah. Well, so it has an engine, it has a transmission, it has wheels, it has everything except for, like, the mechanics of putting it actually together. So, we're close. But my mom started doing, like, garage sale items, like, out there.

And so, she has tables just lined up, and she's, because the car hasn't moved in 20 years, you know. So, now we started moving her crap around. Then, so then you've got to tell us a story about Mr. D-Mac that everyone needs to know to know a little bit more about the D-Mac. Yeah. Well, let's see. Wow. There's so many. I don't know where to start. Tell me the one about football that you remember as, like, the greatest moment, Al Bundy-style, four touchdowns, six touchdowns in a single game. I actually told this story the other day. It wasn't very glorious, but it was my freshman year of high school.

I think it was probably, like, maybe the third or fourth game of the season. And they put me in on kickoff team. And so, I'm running down on kickoff team, and I got ear-holed. So, basically, I didn't see the guy coming, and he ear-holed me. And my feet went over my head. I, you know, I hit the back of my head on the turf and everything. But when I got up, I looked up. The guy with the ball was running, like, right at me. So, I just laid him out. And that was the story of the first and last time I ever got an ear-holed. Do you make sure that you knew where everyone else... Never happened again through college or nothing.

Is that why you have... You said you have the wide linebacker vision is because you don't want to get an ear-holed again? That's part of it, right? Well, you need it, you know. You've got to see the blocks coming down, so... Yeah. Well, good. Now we're nails yet. So, let's go on to the topic then today, because we were talking the other day about just loading. And I think we had a podcast before, which was at number 122, I think, where we kind of introduced the idea of loading and how to use it for actually rehab. Not just rehab. Let's just say treatment, because I think people forget that actually you can use loading protocols to make people feel better than you could with manual tissue work, with adjusting, with, I mean, in these cases.

And so, we got a question on that one, which came from a listener. They said, what is loading? How would you describe loading, to sum up that podcast? I would say loading is, you know, some people would say loading is only with, like, a type of implement, like a barbell, kettlebell, dumbbell, band, or something like that. And I think, technically, that's, like, the definition of loading, but even, like, starting to introduce patterns, to me, is kind of like a subcategory of loading, because now we're starting to load tissues or areas of the body that should be loading more. So, in the case of, like, a flexion intolerant low back, generally people don't move well through the hips.

You know, not everybody is like that, but most of the flexion intolerant issues are kind of a subcomponent of that, so to speak, would be core loading through the hips. And so, when we start to, if you start to deadlift or squat with those individuals, they're going to dump, move excessively and not well, excessively through the low back and not that well through the hips. So, loading would be with weight, technically. Right. But you still have to kind of clean, you still have to clean up some patterns before then. But you want to try and get to loading as fast as possible, you know, and as safe as possible.

Well, that's one of the things on, with that, when we went through, I forget the actual part of that workshop that we did, or sorry, the loading process with that one guy. But one of the phrases he said, okay, we're going to pattern this, and now we want to load it as fast as possible. Ideally, in the same session, I'm assuming, for you. Yeah, especially if we're doing, like, if you do some type of manual therapy, too, right? So, if you're doing some type of manual therapy in terms of, like, adjusting, manual mobilization, soft tissue, it's really good if you kind of try and, you know, use the terms or the catchphrase to kind of seal that newfound mobility by load.

And basically, what you're doing is just telling the nervous system that, hey, I've given you this potential new range of motion. Here's some load. Now you have to control it. And the idea is that we get better carryover with those mobility solutions. But, I mean, also, in terms of patterning it before we load it, you know, you can't just pattern something and hope it sticks around. You know, it's the same principle as, like, we're patterning something, now let's load it to try and seal that in the brain, so to speak. Make that normal. So, for some reason, then, I didn't hear in there that, so we talked about implements.

The floor could be used as loading. Gravity could be used as loading. Yeah. Well, you can start, you know, we can get into the whole topic of wedging, which you've talked about extensively, I believe, either on the podcast or some YouTube stuff, right? So, you know, basically putting stress on the body where it has to stop or resist or transfer motion would, I guess, theoretically be the definition of loading. Mm-hmm. The, and, again, I think to classify or just to frame stuff well for everybody, when we're talking about loading and the use of resistance training or whatever we might be using to make a change in somebody and make improvements to how they feel, we're probably going to, like, I tend to stay away from the concepts of manual therapy with adjusting and other types of, many types of manual therapy.

I mean, for that regard, when I'm talking about it, because it's a whole different thing. And so, I classify those a little bit more as, like, pain modification or pain modulation, which is appropriate at times, but it's not always needed. And I know that the interns that come in to see me, they're like, well, why did you choose to load this one person and this other one you didn't? I'm like, well, that was an acute radiculopathy, and, like, they could barely move. And so, I mean, if they were more of subacute or chronic or, like, it tended to, like, it was painful when they walked in, but when they sat down, it's better.

Then there's fluctuations, and there's maybe entry points, you know? So, I think that I want to make sure to frame that for everybody is that, I mean, I believe that we can use loading with almost everybody that comes in unless they're lit. Even then, you can probably use it some, right? Some type of variation of it, right? Yeah, absolutely. And it's all very scalable. Well, I mean, like, yeah, absolutely. We had one instance today where a new patient walked in, and she obviously had a low back disc issue going on in the history, mechanism of injury, and everything. It just fit within that realm.

So, we just went straight to in-range loading or starting to introduce in-range loading, which decreased leg pain drastically. And then she was walking around all stiff, and so I was like, okay, well, let's go for a walk. And just moving around walking like that, you see the look on her face just kind of light up. You know, walking technically is load, right? So, we're controlling how far you walk, how long you walk, whose distance, whose volume. And so, it's not necessarily the load that one would think of in the weight room, but still you're putting stress on the body or distributing stress on the body where it should go.

You know, the other day I was, or weeks ago, someone emailed me. There's this whole, I don't want to say algorithm, but it was like this big block of text about phases of when to deal with, like, tendons in a certain way, and then that, and this, and that. And I'm like, do you agree with this? I'm like, yeah, it looks good, but, you know, I feel like man steps on tack. Man removes tack from foot, starts limping. Three days later, he starts to need to eat, and he starts walking in slowly putting weight on foot. You know, it's like, I don't know if we need to make this stuff super complicated, and I understand that, you know, the science says that these things happen during certain time periods.

But I believe in, like, the, like, you're just looking at this elephant in the room thing. This person stepped in a tack, like, three years ago, and they have not introduced load into that foot. Like, there's something kind of odd to me on that. And so, you just start to introduce load into that foot. All of a sudden, their back issues go away, right? Yeah. So, I don't know. Just have a thought. I'm on a tangent in there. Sorry, man. No, it's all good. I like it. Yeah. Tangente. Is that a tangent in Spanish? No. Or is that just a type of fruit? It's a tangent in the restoring human movement. So, when do you think then, let's go over a couple case, maybe, presentations, because I know that everyone's probably had seen, if they've gone through and taken that module, at least of yours.

By the way, you can buy Cody's independently, in case you just want to learn more about loading. When do you think loading is appropriate with, say, an acute radiculopathy, numbness in the foot, positive SLRs, positive slumps test? Do you think there's any loading that's appropriate, maybe, in a person like this? Yeah. I think the thing you have to clear is, are we able to get into a hip hinge without increasing some of the peripheral symptoms? So, I think you're not going to take the individual who's having, you know, radiculopathy symptoms and numbness and tingling, radiating, you know, into the leg and putting them through a hip hinge.

And there's, either their pain's getting worse or it hasn't changed, right? So, we're not necessarily going to load, like, a deadlift or a hip hinge patterning in that scenario. I think the priority becomes, you know, centralization in that, at that standpoint. So, trying to bring the symptoms away from the limb into the low back. And now, when we start to, you know, we start to get more, just low back pain, then I think the game changes a little bit. We can start being, you know, if we start getting a little bit better control, lumbopelvic control in that hip hinge pattern, you know, we can start talking about, you know, truly loading that person.

Okay. And... I think it's more like a priority thing, you know? It's like, the leg pain's going to be a harmful hurt. The back pain's just going to be a hurt, hurt, right? Yeah. So, it's a good point. And definitely, I think that the game does change a lot when you've reduced the radicular symptoms, or at least they come above the knee, and they become more, especially transient, controlled. There's a safety net in play. The person can control their symptoms. Then we can start introducing more. And then, does abdominal bracing decrease some of that symptoms when they go into that hip hinge? Right.

You know what I mean? Or, like, you know, changing the angle, doing, you know, using some analogies, or changing the environment to try and have movement come out, so to speak. And if the symptoms aren't increasing, then, I mean, why not? Right. Obviously, your repetition, sorry to keep interrupting you, your repetition range is going to be much lower. It's not going to be three sets of ten. It's not going to be 15 reps. You know what I mean? You may do one or two reps. See how we're doing? Reset here. Okay, let's reset. Yeah, I think, so I think what you said there, Zing, is important, is that just because it's not reducing their symptoms doesn't mean it's wrong.

It just, it's still okay. It's like a yellow flag in there. But if it increases their symptoms, then that's a no-go. Yeah. You know, and with that, it's either, you know, either that's the wrong exercise for them at that point in time, or, you know, they may just not, they might not be doing exactly what you want them to. They might want them to do in that exercise. So, like, for instance, I had a, again, today, I had a bunch of low back discs. Wait, you worked today? Yeah, lumbar discs. Yeah, I was. I was all day. Bro, it's July 5th. Yeah, man. Pool doesn't shut down. No, but we had a bunch of low back discs today, and one of them, you know, he was kind of lit up.

He was having symptoms down past the knee, and extension totally took it away. But he had, he just could not move through the hips at all. So we tried working some hip hinging, and it just didn't, it wasn't working out. So we audibled, and we worked hip hinge a little, a bit more cleverly. We put him in quadruped rocking, and started rocking him, teaching him control of the pelvis as he starts to go into, like, the squat, so to speak, which is basically an unloaded hip hinge, you know, and decrease. And then he actually felt really good with that, and so, so that was his homework. That turned, so that turned into his hip hinging homework.

So let's explore that a little bit, because I think these are important things, and we'll circle back on this whole concept later. What else could you have picked in that? Because I know we're going to talk about toolbox here in a couple minutes, probably. What's another option? I probably could have had him sit down on the edge of a, edge of a table that's raised up fairly high, so he doesn't have to come out of a deep squat. And so we decreased the range of motion that he has to actually hip hinge into, because on the freestanding hip hinge, trying to lock his hands into his thighs and kind of anti-shrug, that McGill anti-shrug to create some stiffness in the torso, even with the abdominal brace, he could not, he could not hip hinge.

It was all, it was all torso flexion. And so it didn't matter what cue I gave him, didn't, you know, and I'm not going to sit here and try 500 different cues. You know, after the third or fourth cue, and he's still not getting it, I'm changing the exercise. You know, he's obviously uncomfortable, so we're going to, he immediately went to unload it. Now, I could, potentially could have taken him from that point, and like I said, kind of move him to where he's sitting on the edge of a, of a, of a table or a raised chair, and start working on creating tension and then standing up from, from that.

But, but again, that's not a deep, not a deep squat position. I mean, it's literally, you know, maybe, I don't even know how to explain it, it's just hardly, hardly any hip flexion at all, you know. And so maybe go, you know, kind of, instead of working from the top down, kind of go bottom up a little bit from that. Yeah, I think the, it, the sense you change, I know I do, I do this too, and there's been a couple cases over the last year or so. I, I, I swear I look like a dog who got all of his toys out and just never cleaned up the floor because I couldn't find, like, you kept finding, like, I was like, I'm like, I clearly hip hinging helps this girl, but I can't figure out something that is getting her to feel better, or it keeps increasing symptoms.

And so I kept on that track, but then, long story short with this person is, so this lady didn't come back. And I think there's a good value in, in having a couple go-to exercises to really hammer that point in, and then knowing when to, to jump ship and scale back, because if they lose trust in you, then they're not coming back anyways. And so you jump ship on that one to get another one in, right? Yep. Now, I've had that happen to me, too. I thought, I was treating a lady, and I thought she was having, in the exam, she was, she was having some glute pain. She had some, she had positive slumps and positive SLR and braggarts on that same side.

And so we treated it like a low back disc, but in the hip exam, we found that she was having some hip issues also. So we were actually doing some exercises for the hip itself, and then, and then doing some core stuff. And she wasn't very compliant with her home care anyway, so she kind of fell off. And then she made it a point about three years later to show up in the office, tell me that I should, I should check the hips because she ended up having hip replacement surgery. I was like, okay, yeah, you're right, you got it, okay. Was she, was she, did, was there sign, was there degeneration actually in there, or like, like, actually, like, bony, like, obstruction?

I didn't feel, I didn't feel that. There was a little bit of it, I mean, she had decent internal rotation, you know, but there was a, I mean, it was hard infield on the internal rotation, but it wasn't, wasn't like I start to internal rotate and at five degrees, I'm, I can't go any farther, you know? Like, it worked, it just wasn't working. Yeah, yeah, it just wasn't, correct, yeah, exactly. It's a great clip of it. It chose not to work at that moment. But I think, but like, but I think to kind of drive home that point is, you know, just because, since you, if you're not making the gains that you think you should be making, and especially the patient things that they should be making, you probably miss something in the assessment.

Or there's other factors, right? It's more psychosocial factors and things that we need to consider in those individuals. There was, there was a student that, they, I'll tell a story about this, I think it's, I think it's relevant. He contacted me and he was asking about a shoulder person. And so they were treating him for a, they were rehabbing him for a shoulder. And he basically told me stuff that he was doing and it sounded good, you know? And I think logically, when we have someone who is supposed to respond to this shoulder rehab program, and if it's a good, well-rounded, deliberate program that is instructed well, there's no ifs, ands, or buts about it, they should respond.

If they're not responding, you probably missed something in your exam. And lo and behold, they hadn't screened out really cervical involvement. And so I think that, I think there's a very high success rate with using, using loading strategies and having a tool belt, which is, that honestly makes a, honest to God, change with these people. Not just like, hey, this looks like it might work. Maybe try this for three weeks. Like, it shouldn't be that sheet of paper, try these things forever type of approach. Like, it should make a definitive change. Right. Yeah, no, the same thing. A student came to me asking me some tips for helping this patient with plantar fasciitis and same side low back pain.

And I started asking some more questions and more thorough questions in terms of patient presentation. When does it hurt, et cetera. You know, the foot pain didn't really change. The back pain never really was, it wasn't as intense as the foot pain and the foot pain was never really as intense as the back pain. So it was like, have you done any, any extension and range extension for the low back and see if the foot pain, you know, lessens? And we're like, no. So we did that. And then lo and behold, the foot pain went away. So it wasn't, it wasn't so much as, um, you know, two separate issues as, you know, you got to clear upstream, you know, and, you know, and I, we showed him some, some cool stuff from, uh, from Shacklock's Neurodynamics.

We did the, uh, the, the three different biases and straight leg raise and, and sure enough, like some of the, you know, they, they made a difference in what she felt. Right. So it's really interesting. Yeah. I, um, I don't know if I told you, I had a case recently that I didn't get on topic, but I had a case. It was a, it was a heel pain case. Did I tell you this one? And so, so she rolled in and she's, uh, she has heel pain that, uh, heels, Achilles, kind of like inner arch pain for, it's been a while. So she, there's a stairwell by my office and, and so I was like, how can you, I didn't, I really didn't light her up too much on exam much at all.

And so actually I take it back. She had a positive SLR. And so she goes out, goes out on the, um, the stairwell and so she says, I feel it when I stretch my calf. And so she's looking down at it and I say, look up. And she's like, oh, in a way. And so we did, we did openers and contralateral sliders on her and that, that cleared it all up after about two weeks. But yeah, that was, that was a fun one. Well, that's, that's one thing that, you know, you start to learn too, when you start to dive into like courses like Michael Shacklock's and Phillips and those courses, you know, you, you, if you're not looking for like before, I'll tell you, you know, Shacklock's course is absolute game changer.

Period. Um, you know, so many pesky things that you have trouble, you know, working on like medial epicondylitis, lateral epicondylitis, like they are not clearing it up with, you know, your, what usually clears it up with shoulder cases, you know, uh, you know, heel pain stuff, you know, all the, those neurodynamic tests, man. I mean, you nail it every time and just, you know, when in doubt, just test for neuro, you know, as well, I tell the students, um, over at Parker, you know, I say, look, when you're formulating a differential diagnosis, consider two things after you've rolled out red flags, right.

Consider what are the tissues in that area that could be really irritated and what could be referring there, whether that's nerve root or peripheral nerve. And if, and if you think about it and you rule it out, you'll never miss it. You know what I mean? Yeah. I, I totally agree. I think that it's funny. We come from, you know, we have the chiropractic profession that we're all based upon nerve stuff. And then we forget about how much nerve stuff can create a thing in this, you know? Um, but I know it's a little bit of a different way than when we started out with our profession probably, but either way, I think it's important.

Um, now I think this might be a cool game then. Let's do this. So, um, we, me and Cody actually, we, uh, he can't, he flew out and we recorded a module too, which won't be released by the time this podcast goes on, but it's on, it's on upper extremity or upper quarter loading. Um, and I think we did a better job this time and he had a good idea of creating a toolbox. Um, and just like how you kind of heard him earlier with, um, I asked, what else could you have used? There is no one single magic exercise, but there are ones that when you're trying to do something and get a certain effect out of the person, you can, you can, you can do it many different ways.

Um, and so in this one, uh, he recorded a lot of tools for that, but, um, why don't we play a game? Why don't we go through a case, a case presentation, and then we'll, we'll dissect this different ways and see what else might work. Uh, we'll, we'll, we'll try lower extremity stuff. Okay. You want, you want me to make one up first? Uh, sure. Yeah. Okay. Um, let's go with, let's go with medial knee pain while running. No trauma. Um, uh, there's a valgus collapse in the foot or a loss of, um, it's dynamic though. Open chain. You can kind of see like they both look symmetrical. Um, no real low back pain, uh, but it's in the inner part right under the patella.

Area, um, and on and off for years. Tempo. What's that? Tempo. What's my tempo? Their speed. No, their speed. Running. Mm. That's what I would probably look at first. Okay. Honestly. So we're going to go with it. We're going to go with a 12 minute mile. So slow. Can they run faster? I mean, they can if they're chased by a lion. But honestly, if I'm, you know, aside from, I can, we can go biomechanics, you know, and I can like, we can look at like glute stuff and, and foot, you know, kind of glute hip or, excuse me, um, hip, knee, foot exercises, which we'll dive into here in a second, I guess we'll get into it.

Um, one of the biggest things is, you know, I think actually you and Greg Lehman talked about it. Um, yeah, this was actually not the same case. I just made one up on a fly, but yeah, it was kind of funny. Um, honestly, every time I have a patient has pain running, record them running, uh, specifically try and get that side view right when they're crossing the camera. Um, so we can see where, you know, you know, what's the, um, where's the foot strike, you know, and just, uh, you know, observing the speed, right. Um, and can they run faster? Like he's, you know, I think you said, you just, can you run faster?

But when we're introducing people back into distance running, we actually haven't trained sprint intervals, you know, if the sprinting doesn't hurt, then we're going to start building up, try and build up fitness and, uh, to the point to where we can actually have a faster tempo and of running. Uh, so we're not kind of sloughing down the pavement or along the trail, you know? So, but kind of rewinding a little bit. You don't want to go straight to, straight to, uh, being a running coach then, huh? No, no, no, we're not going to get into sprint mechanics stuff. So, um, but I, I agree, I agree with that though.

I actually teach people, teach runners how to try and, you know, how to sprint, try and teach them. I actually do sprinting drills with them. A lot of wall marches, a lot of, uh, um, various, uh, you know, wall, uh, wall drills for sprinting and then, uh, start introducing, uh, truly like just running. So, uh, well, I think we can jump into this then. Why do you, why do you go that route? Well, actually, do you give them anything else first? Uh, and if not, let's, let's focus on this. And why do you give them the, a wall mount marching? Uh, the wall mount, wall marching because it teaches a, uh, a more forward lean and kind of, uh, and triple extension through the, uh, the hip, knee and the ankle or not.

Yeah. So, okay. I thought you were going to say, uh, I w I was looking to, uh, improve, uh, uh, foot loading through, uh, dorsiflexion. No, I'm not really worried about, I'm going to harp on the, sorry, I was thinking toe. Oh, okay. Yeah. Through great toe extension. No, it's part of it. Right. So you're getting, you're getting extension and, and, uh, but that's a part of the assessment too. And so that goes back to like some of the, maybe the biomechanical things that we're working on, um, you know, we can, we can try and go down these various rabbit holes of, uh, what came first to chicken or the egg in terms of, uh, is the foot pronating because of, um, uh, because of poor glute functions or vice versa, or is it because we don't have good transverse arch activity in the foot?

Is that because we don't have great toe extension? Blah, blah, blah. It doesn't matter. We're going to have to address everything, uh, almost all of it anyway. Right. And so, you know, we'll start to get, you know, we look at hip issues. We look at, uh, just kind of foot loading. We look at, you know, uh, toe mobility, um, just kind of general foot activity. You know, do they have a dead foot? Do we have to kind of wake up, maybe give them some, uh, some foot homework and whatnot. There's a, there's a lot of pieces of the puzzle, uh, and everybody's kind of different. That's why you kind of, I guess you got to know to look for the stuff too, you know, instead of just skipping a quad sets and, uh, and, and, uh, you know, straight leg raises to try and activate VMO.

Yeah. So that's actually what I was going to ask. So you didn't go to a knee specific exercise. Usually, usually if there's pain in the knee, it's not the knee's problem. Usually. Right. Especially if we're going, if we're going valgus collapse, you look at Chris Power's work, um, uh, DPT out of, uh, LA, you know, he's like the Stuart McGill of knees. Right. And so his work has shown is, you know, a lot when the foot's in contact with the ground, usually what's, uh, not a lot, what's, if the knee's going to valgus, uh, the femur is going into flexion, adduction and internal rotation. The exact opposite of that is the glute max function, extension, abduction, external rotation.

So really the foot's in contact with the ground. It's the eccentric control of glute max that, uh, is potentially, um, uh, not, not allowing that femur to stay, uh, in a relatively, well, there's no one good position, but a good position, uh, that, you know, that pain is from valgus collapse. We don't even know if it is from valgus collapse. Right. So, but the thing is, is like, you know, you have to have good foot loading too, in order for glute max to be as, as efficient as you would like it to be. Right. And so for this, for this person, go ahead. No. So, I mean, but like, you know, we could get into all this biomechanical stuff too, and we're not going to bog the patient down with telling them all this stuff.

You know, we need to know this stuff as practitioners, but we're not going to tell the patient you and vomit information at them. Right. You just say, Hey, we're going to do these exercises to kind of help your sprinting form or help you, uh, improve your sprinting or your running. All right. Right. And so they may ask the question, why, why, why, why you don't want to necessarily bog them down with all this potentially things that they might, you know, perceive as pathological, but you need to know this as a practitioner. Mm-hmm. And so let's, let's just say with that, with that person, I noticed then, so we didn't stick knee focal on that, although you, so loading of the knee, um, and exercises, when you are loading the glute and hip and everything and foot, you're actually loading the knee as well.

Right. But it's just, it's just not, it's not isolation, right? It's isolation through integration. So we may have like a quad focus, we may have a, uh, hip focus, but we're integrating in some type of pattern or position that, uh, that, um, that, you know, loads multiple joints. Well, and so you didn't go through isolation of the glute med nor the foot. Correct. So you just, you challenged the entire limb or the system. That's the goal, right? Anything that, you know, Craig Levinson talks about this all the time is you want to try and find the hardest thing they can do well. And usually they can do more than a clamshell.

And so, um, just scaling back, cause I know that I'm trying to pick this apart for, for listeners is that when is a clamshell appropriate? Um, one time, one time that is very appropriate is if you're, you know, you, you have some legitimate neurological nerve root weakness and there's atrophy and there's hardly any activity. Um, let's say you have 80 year old, um, and grandmother who's got some serious stenosis. Um, and, um, um, they may have had surgery or they're on their way to surgery and like, there's just no glute activity at all. I think that's very appropriate. Um, you know, maybe, maybe coming out of hip surgery, uh, that's probably a, uh, appropriate time as well.

Um, but, but, but if somebody, you know, they're relatively healthy, um, you know, they, they're, they're pretty active already, you know, they run, they, you know, they, they maybe play softball, they play pickup basketball. Um, we're probably not going to start them on something that's, um, that low on the movement totem pole. There's, there's other exercises we can do to facilitate the musculature that may integrate other muscles into it as well. Right. So I agree. I just want to play devil's advocate with it. No, I like it. Cause I think, so something, we, we talk about this off air is that I think it's an, it is important to realize and keep hammering this home that, um, corrective exercise is not the end all.

Like they should not be doing this forever. They shouldn't be doing clamshells or bird dogs or isolated stuff forever. Even while, uh, um, um, while marching, like the goal is to get them into some type of resistance training to simulate, in my opinion, simulate life. Cause load, load is life and they're going to be doing it anyways. So you might as well just get them really good at it. That's it. Yeah. Um, and so in your, in your opinion or what you've seen from, uh, docs at a school, I can tell you my opinion. I'll tell you my opinion first is, um, they're familiar with the exercise, some of the, some of the corrective exercises, but they don't know when to use them.

They don't know how to change that. Let's just say if we gave someone a clamshell, they don't know how they're like, this person has back pain with a clamshell. So I'm not going to do clamshell. It's like, well, maybe you change, like, can you have them stiffen up their body a little bit? Oh, the back pain went away. And so I think they need to better learn how to implement these movements or loads with people with the problems rather than just ditching them completely. Cause they might be an easy win there. Um, and they just have to have a keen eye for it. Um, but in my experience, a lot of them don't have that, which I'm not blaming them for it, but neither do a lot of seasoned docs either.

It's true. And so we default to our passive care. Absolutely. Well, it's easy, right? Passive care is easy. Like doing soft tissues, it's, it's, you know, it's not easy on the body, right? But like literally, like, you know, I'm not saying everybody does this or I'm not saying that most, uh, most people do this, but like it, it's really easy for some, for you to start doing soft tissue and you just kind of blank out. You know what I mean? You just go totally like mind is like elsewhere. You're thinking about what you're going to have for dinner, right? But you can do that doing soft tissue. You can't do that during exercise or coaching a movement or looking at, uh, uh, evaluating movement or assessing movement rather, right?

You just can't do it. You have to, you have to be on all the time. And that's why, you know, you have a, you know, in your practice, if you have a day, that's like 12 patients, that's a long day. And that is, I hope that it's openers and sliders. That's it. Yeah. We'll pass it here. No, um, no, but I mean, I think we've talked about this too. And in order to, like, I believe, I think you asked me one time, you asked me like, what do I think is, uh, what's, what does somebody need to be good at? Like kind of seeing movement and good at movement. I mean, you gotta, in my opinion, you have to have a really good knowledge of anatomy because you have to be able to, if you know where stuff is and you watch them move it and you're like, they're hinging excessively at C5 when they go into extension, they early lumbar flex when they're going to touch their, their toes, you're able to pick things out.

And so repeatedly I'll, I'll, I'll ask the student, did you see that? Like, it was like, to me, it's glaringly obvious. And they're like, Whoa, what? Like, I don't see it. It's because they don't have a repetition. Right. And I think that, you know, getting the clinic and that's why I hammer, I'm like, look, every time they come in, do part of the movement assessment, do it. The more reps you can get, the more you're going to see, the better you're going to be at seeing things. You know, when you start to do corrective exercises, if they start to have pain with exercise, you're not going to totally audible immediately from that, but you'll probably be able to give them one focus or one cue on a thing and completely change the outcome to that exercise.

Right. Yeah. It's really, um, I've noticed that, well, so the interns that are with me right now, like I told them that I feel like my responsibility to them is, is that they walk away with like the, I don't want to say all the tools in toolbox, but like the ones that tend to work for certain cases and they need to be really good at, at coaching the person out of, out of the symptom. Um, and, and, and it's challenging because people like, even, even when we're working, like when I'm working with them, it's like, okay, you got them to feel the area that needed to be, to be loaded, but that person didn't have an ambient symptom.

And then when you get one where it's like, oh, my other knee hurts with this, you're like, oh, okay. Uh, I, I don't know what to do now. You know, like they, they can, I remember this one guy came in one time and he said about this guy, he came one time, he had the, he had the oddest, um, responses to orthopedic exams. Like I wouldn't work with his knees. Like my left pinky hurts. And I'm like, oh, I don't, I don't know. I don't know how they're related. I don't even know how to take that. But if you do that with a loaded exercise, it's like, oh, I'm just going to ditch this thing. You know, if you don't know what you're looking to, um, improve in their, in their position or movement, you know?

Yeah. It's kind of like when you're doing slumps on somebody and, and when you, you, you passively extend their knee, the, um, bilateral pinky start getting numb. And then when you put the knee down, it gets away. Yeah. Or the first time you find a downward sliding dysfunction, you're like, it got better. Yeah. Wait, what? Yeah. So, what's, so, uh, what's another, what's another case you want to go over? Well, we'll stick lower extremity. Yeah. So, I think, uh, so what about person who comes in with, um, with, uh, maybe they have Achilles pain, not necessarily heel pain, but kind of like the case that you have, uh, before.

What if they do have a legitimate, like kind of Achilles tendon, almost up the insertion, but along the Achilles tendon. Hmm. Okay. Especially, specifically the medial portion. Medial. Ruin medial. Uh, well, uh, I would, I'd screen neuro out first. Probably. So, I'd, I'd check slumps SLR, all that jazz and see. Um, and, uh, I probably had a, a, a bad, I do a bad job of this, I think now, but I think, oh man, it's going to be so easy. Let's just do openers. And, uh, and, uh, and sometimes it goes away, but I'd probably ask the person if I couldn't find much on the exams and they're just very high function, I'd say, look, show me what hurts, you know, sometimes they'll show you the weirdest stuff and I tell them, look, you can pick anything except for a stretch.

Yeah. And so, let's just say they picked, um, what do you want them to pick since you made this case up? Uh, uh, um, let's say, uh, walking upstairs. Walking upstairs. Okay. So, I'd take them to stairwell, let them pick and say, look, just remember how this feels. Okay. We're going to come back and test this again. And so, usually I'll go through, in my exam, I'll go through intersegmental flexion, extension of the spine, rotation, squatting, and usually like some type of star excursion test, uh, Y test, I think is what FMS start taking it as. And so, I'll just look at a glaring to see with that.

Um, if I anything, find anything on neuro, if I see them offloading a certain side, I'll just pick like a, like say they're loading. It's not uncommon to be loading on the side of complaint. And so, uh, I'll just challenge the other side and then just see. Um, and so, usually what I'll do for introduction of loading onto the other side, let's say, or, um, by the way, it's, they could be offloading on that side, but if it's an inappropriate amount of time for offloading, like attack analogy, I'll still load it. Um, but if it makes sense where they stepped on attack the other day, I'm not going to force them to.

So, uh, usually I'll, I'll, I'll go through a low diagonal set first. Um, on what side? Uh, whatever side they're offloading. Um, and so I don't, I don't, and by, and by offloading, cause there's some students out there that don't know what you mean by offloading. You step on a tack, you take load off that foot. And so I think the body's protective mechanism of, of protecting that area that has like the tack, um, is to take weight off. And, and we don't teach people to limp. They just limp, you know? And what if, uh, what if you put this patient, let's say it's their right, uh, Achilles that's bothering them.

What if you put them through a bilateral squat and they shift into the right? Um, so that they're, they're not giving their body or they're not giving that tendon probably the proper healing time or the, or the load has exceeded the repair time. And, and so, um, I, I would, I would give them the theory of there's a possibility that you, so your body's showing me what it's doing as a habit currently. And so if I were to punch you a bunch in the arm, at some point, like real light punches, at some point you're going to bruise up and I'm going to keep punching you. Right. And it's not really fair to say I need to address that area local, uh, uh, directly.

I can just stop the punching. Uh, and in this case, we just, um, we just offload the area and I'm not saying bed rest. I give them a little more of a loading base correction. In this case, a low diagonal sit, um, single leg already, uh, single leg, uh, dead, a dead lifting opposite side bias first, probably. And then go retest. And if they feel better, then I stick to that. And then usually I'll tell them like, look, these, this, this one or two is your exercise that I want you to do as a, as a, as a medication. Um, I give them the example of like a, uh, antibiotics since they're all pretty familiar with that.

I'm going to give you one antibiotic pill today, but you have to take the rest of them for the next five days and you got to do it yourself. And the cumulative dosage should have an overall effect. If it doesn't have the effect, I picked the wrong medication for you or you didn't take it. And so we just kind of see more collecting data points with that. And so I'll just give them a couple of those things. And if it, if it produced a, I like personally, I like 50% change on whatever they picked or more, but if they say 30, I stick with it. Um, and so that's probably where I'd take that, but other options of exercises would be, I've done a hydrant on that.

I've done a quadruped hydrant. Yeah. I've done a, uh, a single leg bridge and I'll, I'll almost sit on them, you know? Um, sometimes I call it a shitty clamshell where I put them into like a clamshell position, but then they can pop off the floor, uh, rotate them in a little bit. So they have internal rotation. Okay. Um, because sometimes with kind of like off of a oblique set or low diagonal set. Yeah. Sometimes they just can't let that back leg go. And so I'll put it in front, you know? And so lots of options of things to try or rotational squat works, you know, but, but I don't want to teach it right now.

That's hard. Yeah. So there's, but we can, I think I can get a response out of all of these some way or another and it won't take any more than five minutes and that person will feel better. And I will not do a tissue work approach on that person. If I find that's a productive outcome. Right. And I think, so, you know, we've talked about this plenty, but like you said, there's probably some new listeners on here. You know, what's the significance of that? If you taking that exercise approach and within five minutes, potentially, you know, trying to attempt to offload the stress in that area and allowing, giving them an exercise to take home and, uh, and for the time being avoid a soft tissue work.

What's the point of avoiding the tough, tough, tough tissue for that time? Um, well, you know, I always, I always tell people that like, cause usually they have past history of things they've tried and I mean, really, really rarely. You're going to get somebody who's, who's not tried a thing. Um, and I say, what do you tried? And they said, well, I tried tissue work and stretching and adjustments and icing and resting and lacrosse ball and every, they tried all that stuff. And then I say, look, I'll be honest with you. If it was going to work, it would have worked, but if it didn't work, let's try something different.

And like, I'm not opposed to like, I'm like, look, if you came in for tissue work, like I will do it if needed, but let's try this first, you know, allow me to do my job. And, uh, I'm like, if this was going to work, I explained this with people with nerve stuff. I'm like, or if you do like an opener and their leg pain or so their leg pain goes away or their foot pain or goes away and they're concerned it's an ankle in this case. And I said, look, if this, if this was an Achilles tendonitis, it was like swollen, boggy, all that stuff. This wouldn't work, but it did. Right. So work with me on this, you know?

But that's the reason I don't want to muddy the water with doing more, you know? More of the same. Mm-hmm. No, yeah, I totally agree. So in that then same example, what are some other tools that you could have used? In this, in this, uh, the Achilles? He's either loading the side of complaint of the Achilles. Yeah, well, I always look at the contralateral hip first. Um, and that's the easiest. It's like kind of low lying fruit, right? So if they have some, you know, poor internal rotation on that side, um, I'm attacking that first. Uh, same with like knee. Like if somebody has knee pain, uh, hip pain, low back pain, but they're shifting into the side of discomfort, then I'm going to look at the contralateral hip.

And usually it's, usually it's the hip. And if it's not the hip, it's probably foot and ankle or somewhere along that other side. To me, it's just the brain telling them, telling their body that they can't, you know, if their right side hurts, even though that right side hurts to move into, which they probably, they probably don't move into it because they don't move, right? Because every time they move, it hurts. You know what I mean? So we're looking at the other side, the contralateral limb, uh, and then nine times out of 10, you're going to find something on that side that doesn't hurt. That's not moving as well as it should.

Uh, and by, you know, whether that we clear that up with manual therapy or we clear that up, usually it's with an exercise and then load, load that and then retest. Like you said, usually that clears up the side that's painful. So let me, let me clean that up a little bit here, I think. So we're going to, we're going to load the opposite side with some type of, you'd pick a, a oblique sit probably, right? Right. And then you turn rotation issues in the hip. Yeah. It's a go-to load, like a low diagonal sit. Okay. So we retest that walking upstairs. They feel better. You immediately follow it up by getting out of the corrective exercise and you would load them in, in now a, uh, a foot on ground movement.

Yeah. It depends on their balance. Right. So, um, I'm going to, I'm going to do an exercise to try and stress that intern, the internal rotation and flexion of the hip. So it may be something as a, as simple as like a, uh, kind of just like a split stance working on a, like a sprinter split stance, not like a split squat, but more of a push off split stance. Kind of like the Koichi's H step pattern, I believe he called it. H step. Um, is that like, is that a popular dance down there in Texas? No, no, no. Tokyo. Um, no, but, um, but you know, getting them to load into the hip, uh, and specifically flexion and having the, having the, almost like a single leg pattern.

So the, the femur is very, uh, rather close to midline. And then we could maybe potentially progress them to like a single leg deadlift if they have the balance or a variation of the single bed deadlift. Even if it's like a, like a door jam, they're holding onto the door jam or holding onto a squat rig or something like that. And they're just grooving that single leg pattern, you know, and there's no pain. Maybe we can, uh, with, with some support going to a hip airplane, maybe. I mean, we have all these options and there's, there's, there's, there's the, the, the options are endless. You know, probably an important part.

I don't know if someone's probably thinking this something to decide is, well, what if the hip impingement pain on that side? Yeah. And so that's where the low diagonal set comes in. There's different things you can do in that position, uh, specifically with traction of the, of the down pelvis. And so even though we're rotating the pelvis on top of the femur, uh, into relative hip internal rotation, the traction actually will decrease and desensitize occasionally, uh, some of that sensitivity in the front of the hip. Now we're not trying to go through bone. You know what I mean? That's not the idea, but, you know, even with bony impingement, you can, you know, potentially you can desensitize what they feel as pain there by cleverly loading them.

Yeah, I, I can, I can test it. I can be a testament to that. It does work. Um, and if, and if anyone's struggling with, with, uh, treating people with hip impingement, I think it's a driver for symptoms. Like it's really, it's not too hard. It's really not too hard. You just have to have, uh, the tools, the appropriate tools, loading tools, if they're not responding to passive care. Um, but also too on that, uh, so hip impingement, it clears out partially with slight posterior tilt to the pelvis. They found that on, uh, radiological studies. So there's, you can cue them into probably a slight posterior tilt if they're not opposed to it, you know?

Well, I think, um, one in particular when they're in split stance, right? And so like, if you're worried about posterior tilting, let's say they, they have, uh, the patient has like some low back disc issues and, um, and flexion is, is the thing that picks their scab, uh, you might not want to do like a bilateral posterior pelvic tilt, right? But what if you go, you know, you go, uh, one side, like in a kind of half kneeling stance and start doing like a pelvic tilt or something like that, a slight pelvic tilt and the, and closing, uh, opening up a little bit more room for hip flexion. I imagine you kind of doing that.

Like when you're just like when the coach was, was talking to you, you just half kneeling, doing pelvic tilt. Yes, coach. Like when you do these, you guys, maybe you guys did that in Eagle Scouts. I don't know. I never did that in football. Take, take a knee boys. Let's do some pelvic tilts. Eagle Scouts thing. I don't know. No, Eagle Scouts, like, no, I don't think we, there was no huddle. If we did have this, uh, it was in Boy Scouts. You had this huddle up circle, like say the scout law. There was that, that was that exit. In baseball, you had to take a knee and the coach would take like our coach anyways, like he took his foot and he would just go swipe on the, on the dirt, you know, back and forth and look down at his foot.

Yeah. As he's just reaming us. He's smooth in the dirt, but he's over the line too. So he's just smooth in the line. He's like spitting his chew out and he's kind of like rubbing, rolling dirt over his spit. Yeah. He's basically just rolling that spit. Yeah, that, uh, spit globule in the, in the brick dust. Yeah. So, so, um, as we, as we start to close this one out then, since we're about 50 something minutes in, um, is there, I, I think, I feel like it's every time we talk on this podcast, it's, it's, it's going down the route of loading and I, I, I don't know any other way to say this, but, uh, maybe you'll make it nicer.

Is that I think that people really practitioners of many different types and I, I've got, I sucked at it years ago. I really did suck at it. We need to get better. Like we're really good at passive care, loading and corrective strategies and getting them out of the corrective strategy is very lacking in our profession. And just because you lift a barbell doesn't mean that you know how to cue these things on people either. They're different and they're different animals. Totally different. Yep. Yeah. No, I don't, I think you said that nicely. I don't think that was bad, but I, I, I, I agree a hundred percent though.

I, I, I think, uh, you know, if we can improve as a profession in terms of chiropractic profession and other professions, like you said, can, can improve in this as well. Um, it's, it's knowing when to, when to apply load, which is, and not being afraid to, and knowing when to, to pull what card, you know, when to apply this exercise, you know, what should I follow up before this? What should I, what should I pick for this? Right. And you want to, basically you want to go, what's the best risk reward and the, uh, the exercise and the, the, the thing that can give you the, uh, you can use minimal effective dosage on and have the biggest bang for your buck.

I, I agree. There's a, there, it, I don't, I think one barrier for people when they're, when they're thinking about adding a corrective or active component in their practice is they think it's going to take too long. It doesn't take long at all. No, it doesn't. Like we can make a, I'm, I will see what you say. I can make a definitive change on somebody with a corrective strategy, with a loading strategy, with the, even like, like old symptoms. I'm like, let's leave ridiculous opties out of it, out of it. Um, as long as they're willing to, I can make a definitive change in the last less than five minutes.

If we've done our due diligence on our assessment. Yes. Right. Yeah. We'll take the exam and history out of that. Yeah. Right. No, I mean, if we've done our, we've done what we were supposed to do on our history and our examination, that we're going to be really, um, really pinpoint on what are, what we're going to attack in terms of exercise. And I agree, we can make a, uh, I mean, sometimes even less, right? I mean, sometimes you might do one or two reps of something, uh, and then completely and make a huge change. Yeah. I want, uh, one, one student was having, um, his patient, when he would go to multi-segmental flexion and extension, uh, especially multi-segmental flexion, he had some bright hip pain.

And I said, okay, anterior hip pain. I said, okay, well, let's, let's do this here. Uh, I said, where was the pelvic shift? He said, to the right. I said, okay, I'll tell you what, let's load. Uh, I want you to do left side bridge, just left side, uh, 80% rate of perceived exertion, 10 seconds on one to two seconds off. And I mean, 80%. I want him to barely, barely have anything in the tank. He goes, okay. And he did it and pain completely went away. It didn't take many reps. It was like maybe six or six or seven reps. Uh, but that alone is, you know, it's under like three minutes, you know what I mean?

And so then he retested toe touch and it was completely gone. It felt great. The shift was gone too. So now the brain perceives that it can, it thinks it can load the left side and it does load the left side more and offloads that right hip. So to speak, kind of like how we were talking earlier. And so our exercise choice in that, and that was, was a core stiffener. Yep. You know? Yep. And that, and that's just, now the person does that as homework and we have to reverse engineer a process. Yeah. Adaptive process. That's it. And just manage, manage, manage load through tissue, you know, and do that.

Like you said, by offloading, but also, you know, and that's something that Tim Gabbitt talks about in terms of, we need to know when the patients come in, we need to know kind of what they're coming in with. We need to know, um, where they want to be, you know, what are their goals and where, where does their capacity need to be? So to speak, and we need to know how much time we have to get there, you know, because if, you know, if we have somebody who wants to run a marathon, the longest they've ever written, uh, ran before was 5k and the marathons in four weeks. That's usually when they come in and they don't, they don't strength train.

So it's like, uh, you know, I don't know if we're going to get there, but then again, you might have somebody walk through the door, you know, and, and their, uh, their current capacity is, is either really close or maybe even right at what's required and, uh, for their goals. And they have 12 weeks before they, they have to, uh, before they compete. And then that's like the golden goose right there. That's the optimal scenario. And you hardly have to do anything. You know, you just kind of give them a little bit and, and it pushes them, uh, to where they need to be. So yeah, you know, consider all that stuff too.

And we're, we're starting talking about exercise choice, the biggest bang for your buck and are things actually realistic? Mm hmm. Yeah, I agree. That's the, uh, I guess the, uh, the art of coaching loading. Also, yeah, there you go. Also, uh, kind of have a thing for, for loading too, because, you know, you can, um, you know, we can, you know, do our manual therapy, soft tissue adjusting and whatnot, and then attribute all of their success to, to that one thing. And we, we, we as practitioners kind of build up like all of my manual therapy skills, you know what I mean? I kind of, I think it kind of turns me off.

I don't, I don't really like that. Yeah. I think, you know, with the loading aspect, you're giving patient independence, you're creating, uh, you know, you're telling the patient that they're, they have an active role in their healthcare and solving their problem. And so, you know, you're going to get better patient compliance, in my opinion, and they're going to refer more people to you. Yeah. I think they, um, I mean, there's obviously some people who are not willing to do the work, but you know, when they're doing the, willing to do the work, it's, it's kind of like you were part of a team that did it, you know, and, uh, it is very important.

And it's, they come back with questions and, uh, you know, and they're, they're, they're, they're usually pretty surprised by, you know, how something very simple could, could make a big change in them and how they have control over their symptoms, you know? So it's a good, it's a big deal. And, uh, but yeah. All right. So, so as we start to finish then, I know we talked, it was like 10 minutes ago we did that, that, uh, uh, I'm going to let everyone know where to find, um, more of your content. And so Cody's stuff specifically right now, he's exclusively on Pro Chiro Online CE. This is the only spot where you can ever learn anything about Cody because he has not written his book yet, which he's talked about before, but, um, still trying to find that personal time for, uh, after having, after having a baby, huh?

Yeah. It's kind of tough, hard to come by. So, yeah. So the, the, the interns that have, I've shared, um, all of your videos with the interns, they just think it's amazing. Um, so everybody, please go over there and check it out. It's, you do get CEs if you are a chiropractor, but, but honestly, it's not like, I don't even care about the CEs. Like I've, I've gone to many courses so far, like Shaq Locke's course and, um, you don't, you don't get any CEs and you still burn a bunch of money. How many courses, yeah. How many courses I've taken and haven't gotten continued education from it. It's crazy.

Yeah. We've had, uh, we've had trainers already by, uh, your course. They don't get a CE for it. So. Oh, nice. Yeah. And so please everyone go to, go over there and just check it out. Again, if you don't like it, you're not getting CEs, just like, just tell us how to improve it. Like I, I haven't spoken to partners about any return policy, but for the most part, uh, you go, you go through there. You're not gonna be disappointed. Like I, I would, I would lay my hat on that. So pro power online CE and, uh, Cody, uh, leave people better than how you found them. And if you're dating, dating Eagle Scout.

What do you got as an exit? Are you dating? I can find an Eagle Scout for you. No, no. I'm in, I have two loves right now. My wife and my daughter. So I'm good. Okay. Well, we'll see y'all next time. See y'all.