Low back pain and pars stress fractures in young gymnasts

You know, I went through it. I was 13 when I had my parse fracture and they put me, not only did they say four months without gymnastics, so I missed my season. I missed being around my friends. They took me completely out of the gym. So those were my friends. Sounds really sad. I didn't have friends at school. Those were my, those were my friends. My coaches, I spent more with, I spent just as much time with my coaches as I did my parents at that point in life. 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, it's Dr. Sebastian Gonzales with the Restoring Human Movement, Restoring Human Movement podcast. I will get that right one time. I don't know why I picked a tongue twister for the podcast title. Anyways, the interview is going to be today with Dr. Sloan Beard. She is a chiropractor who works mainly with gymnastics or gymnast in Birmingham, Alabama. And she has some online content, videos, courses, and so on. So she can really spread her mission of decreasing extension-based problems or extension-based issues, pathology, PARS fractures, and so on within the gymnastics community amongst a bunch of other things. So I think you're really going to get a lot from this interview today. If you are a clinician, you're going to learn how to communicate well with your patients because she actually, it's interesting. I don't get this feedback a lot from people. I don't get this conversation a lot from people. Is that she identified that who these patients are, these 12-year-old girls, is that they're athletes. That's their identity. So she has to address the possibility that these people are losing their identity as they get an injury and they're out for three to four months if need be. So it's an interesting part you'll probably get from her. Also too, she's going to tell you some stuff on how to reduce extension-based lower back pain. And we go into some fun stories such as urinals and urinal biscuits and elephants. Those are all going to be really fun. If you're a gymnast, you're going to get a lot from this and just realizing that it's actually help for people just like you. And these problems are really common, says Dr. Sloan. And there's solutions for you with this. You don't have to do gymnastics in excruciating pain. There might be a little bit of pain, but there is solutions for you out there. Now before we go too far with this, let's do a little bit of a personal corner with me. And then we're going to go straight in the interview with Dr. Sloan Beard.

So I was making an observation recently about garbage, trash, stuff that like you see in the gutter. And I was thinking, who the hell litters anymore? And I know that no one really enforces that $10,000 fee or $50 million fee they have for littering, but I feel like I really think they should. And when I look around, I'm trying to think, who the hell is littering? Because I can't, I can't recall the last time that I actually walk in a dog, I left any dog crap. Just pick up your dog crap. But I don't remember the last time I actually littered unless something flew out of my car when I was driving. I'm like, I can't stop on the freeway. I pick up every single thing. And I wonder who the hell is littering? So I look around and look at the quality of the litter. And one thing I really see is cigarettes. And the other thing I see is fast food, Coke cans, and so on. It's like wrappers from McDonald's and whatnot. And the first thing is the cigarettes, because I have one friend who smokes, and he doesn't smoke that often, but we're out in the garage, and he's barbecuing, and he liked his cigarette up. You know, he's sitting there just like, I can just imagine his face right now. He's so excited about this one cigarette. Or he's smoking, smoking, smoking, throws it on the ground, wiggles his little foot on it, put it out, and then walks away. I said, what are you doing?

And he's like, well, I'm just putting the cigarette out. I'm like, no, no, no, you littered. I'm like, grab that. He's like, no, I'm not gonna pick it up. So I go over and grab it and put it back in his hand. And he throws it back on the ground again. So we did this about five, six times or so. And finally, I threw it down his pants. I had to basically wrestle him down and throw it down his pants. And I was like, what? I'm like, I understand you're putting your cigarette out responsibly. But is there a thing that it's like certain things are okay to litter just because it's like, that's a fire hazard. So I think I'll throw it in the asphalt. I mean, look at this other litter.

You look at the fast food containers. I'm thinking who? Doritos bags, McDonald's, KFC, all these things. It's like, you look down, you're like, who is eating these things? And I was thinking, I never really see, I never really see health food wrappers. I don't, well, I guess you can see apple cores and bananas and stuff like that. But I don't really see like Whole Foods bags flying around. I don't really see all these healthy option bags flying around, which makes me consider that are the people that don't care about their body as much because they put junk food in, are they also the ones that don't care about the environment? Are they the ones that litter externally? So you see beer cans, beer bottles, vodka bottles, cigarettes, fast food containers. I mean, like, is this the type of person here? I'm just kind of curious. So just making the observation. That's all I really have to say on that. Okay, everyone, then we're going to start the interview here with Dr. Sloan. Is it beard or beer?

Oh, I've never heard that pronunciation, but I'll take it. Well, it's not really spelled like beard, is it? Yeah, B-E-A-R-D, like facial hair. Okay, shit, I just don't know English then. But if you want to call it beer. Well, so Bo's name doesn't look like, like Bo, I imagine B-O, not B-E-A. Oh, because he gets fancy. Yeah, B-E-A-U. Why did he get so fancy? I don't know. If he was, if he were extra fancy, they'd add an X on that and go ahead and make that Cajun. Ooh, that's kind of like a Van Damme. Jean-Claude? Oh, there you go. Yeah. So if we want to drop the D on the end of beard, we can go ahead and do that.

Oh, I like it so much. I don't think, I don't think down here in the South, that'll go over well. Really? Why not? I don't know. It might get a little confusing with the dialect here. I'm from the South, I can say those things. I can joke. Oh, yeah. I do the same thing about, I'm mixed ethnicity, so I'm like white and Mexican, so I can make jokes on both sides. Yeah. You, what is it called with a comedian when they have a, I don't know, you just have a large pool to grab from, I guess. Right, right. There's definitely many pools that I wish I was part of, but I think I'll another lifetime. Okay, so I thought we'd have you on then just to frame things, just the audience is, there's a lot of young clinicians and DCs, PTs, ATCs, exercise science people that come on. So let's do a couple nice things for them, but also too, if gymnasts end up on here, I don't know how many gymnasts are my listenership, but so we'll, let's act like one of those is over our shoulder if we say something technical. Does that sound good?

Yeah, so I need to explain like what a Tkachif is. I think you gotta, I think you gotta explain, yeah, I think you gotta explain that right now to me. They're just, they're just certain skills in gymnastics. I always wondered, I know a little bit more with dance, there's like, I think all the terms are all French based? Mm-hmm, mm-hmm, like coupe, passe, uh, what is a leap? Uh, relevé? Oh, battement, I think is a kick. I should know those things. Relevé, that's a good one. Yeah, I don't know what that is. You stand on your tiptoes. Oh, yeah. I, I feel like those, these are the only sports where like we, as, as Americans or English, we just have no idea what the hell they're even doing unless we've been part of it. Like baseball, they all make sense to me.

Yeah, well, most, oh, I, I can't say most, most little girls, but a lot of little girls grow up in ballet, so they, they learn a few things from a young age, but ballet, ballet, uh, ballet words translate over into gymnastics quite a bit, so. Okay. Is there tumbling words, by the way? Back handspring, flick, flack, if you will. Flick, flack? Mm-hmm. Bounders, roundoffs, those are tumbling words. Okay. I think that you could figure out what a back handspring is, though. Oh, yeah, yeah. Well, I, I think that's the only hashtag I follow on Instagram. Hashtag back handspring? Yeah. Hashtag, uh, fit fam after that?

Fit fam, yeah. So, uh, can you explain to everybody what you're all about? Ooh, what's, what's Sloan Beard's all about, or what Gymnast Fix is? Tell, tell me about what Sloan Beard's all about, and then tell me why Gymnast Fix, Gymnast Fix even exists. Yeah, Sloan Beard is all about movement. Like, you move to stay alive. Uh, but Gymnast Fix is about moving better as a gymnast to be able to stay within the sport. So, I'm, uh, probably, as you introduced, a doctor of chiropractic, and then I'm a master's in sports science and rehab. So, I blended those two things together, and then I, uh, tacked on my experience as a previous gymnast, and I hybrid everything together to create opportunities and options for gymnasts in regards to sports injury, prehab, as well as rehab.

Um, so I grew up a gymnast. I started just before I turned three, and I like to say I retired from the sport. I don't like the word quit. I retired, um, in my junior year of college. So, I had the opportunity to compete for Ball State University for a few years, which I am oh so grateful for. Uh, I was always like the little engine that could. Like, I probably shouldn't have, uh, been an NCAA gymnast, but I had coaches that believed in me and fought for me, and I fought for myself. So, I competed a few years in college, and then when I got done with that, um, I moved on to grad school, which was my chiropractic and my master's programs, and then started practice right out of school.

And within a year or two of practice, I realized that there was this opportunity to reach the gymnastics community, um, an opportunity that wasn't there for myself as a gymnast. And so, I'm trying to fill in some gaps for gymnastics with, uh, what I learned in school and what I learned with my patients on a day-to-day basis here in the, here in the practice. So, when you were, um, I know reading into your story a little bit, so you, I guess you, you said you're filling the hole of PARS issues in gymnastics mainly, or was there other, other parts? Yes. Well, my hope is down the road that we can, we can tackle a broad spectrum of, I hate to even use the word issue, but, um, I love that word, aspects, issues within gymnastics, uh, as it pertains to the body, the psyche, uh, coaching, even, um, gymnastics is a bit of an antiquated sport coaches and gymnastics and not all, I don't want this to be targeted all, all coaches, but a lot of coaches, they use techniques that were successful in the past.

So, like, like any sport, it worked for one athlete, it must work for all. And those, those techniques have rolled over from decade to decade to decade. And in fact, you'll notice in USAG or in the spotlight right now, the United States gymnastics is really being criticized right now, um, for a multitude of things. Everything from, uh, horrific sexual, sexual abuse to, um, mental abuse to poor, poor training. Um, so I hope that gymnastics can tackle multiple aspects of gymnastics, but for currently right now, we're tackling, uh, the PARS issue that you mentioned, um, in more layman's terms, low back pain.

So low back pain is by far the number one complaint I hear from my gymnasts, uh, inside my practice and from coaches that I talked to around the country. And it's, it's the most pesky, can't get rid of, can't work themselves out of most common complaint. And so there are so many options to prevent it from occurring, but then there's so many options to rid it once it's happened. And, um, I just want to offer those options. They're not being utilized yet. And it's always been a mindset of gymnastics that back pain is just a part of the sport. You know, when you think of a gymnast, when you, when you close your eyes and you picture like if an image of a gymnast, what are they doing?

They're doing a backbend. Yeah. They're doing like a back walk over with their leg in this beautiful acrobatic split. Well, gymnastics is a lot of bending. It's a lot of extension over and over and over again. And that takes a toll. You and I know, you know, as a practitioner, you know, you know, the low back, you know, as good as any of any practitioner out there and you know what extension can do to it, especially at a young age. So take a prepubescent female gymnast that's extending for 30 hours of their week, what that does to the low back. So, so in gymnastics, we've just always assumed that that was just a necessary evil.

Like, Oh, you got a bad card. You got back pain. I guess you're going to have to deal with it. I was that gymnast at 13. I had back pain for months. I think it, I think it was about eight months, eight months of back pain before a doctor actually finally diagnosed me with a parts fracture, which hate to throw out the word fracture, but I was told numerous times, Hey, you just find a different sport or you're going to have to suck it up. If you want to do gymnastics. In fact, the night before I was diagnosed, I, my mom and I had a conversation and I'm crying. I was like, mom, I can't go to practice tomorrow.

I can't do four hours of practice with this feeling like it feels. And she, and she said, and I love my mom to death, but she said, Sloan, if you're going to do this, you're just going to have to deal with it. This is a part of it. And I'm, and it doesn't have to be a part of it. And so I want to change the thought process and the culture of gymnastics as it pertains to low back health. So short of the long, yes, I'm working on low back issues in gymnastics. Well, so just, just for everyone, just to clarify, so PARS issues or what was your, what was your translational thing for issues? Aspects?

Aspects. Yeah. I don't know if it works in my case. Okay. So here's why I don't like the word issue is because I'm talking to a 13 year old and they don't want to hear, Oh, you have issues because I work with 13 year olds that are always searching for perfection in the sport of gymnastics. You start with a 10 and they slowly deduct from there. It's a sport of perfection. They're always seeking that. And so if I use negative words, they take them so personally. That's interesting. So we can figure out a different word than issue. I usually, I usually use it for like, uh, like to say, say someone's asking about their, their tendinopathy or a quality of a tendon or whatever the heck it is.

It's like they want to gravitate to like how bad it is. I'm like, well, it's just a little issue. So yeah, I'm, I'm just building up from a zero really. Cause they think they're just torn up. Um, so just explain the ranges of pars, injuries, aspects. Yeah. So the pars intarticularis is a posterior element of the lumbar spine, and it's really affected when someone extends backwards. So they do that bridging position or say a back walkover. Most people, most clinicians out there are going to know what a back walkover is or a back, back bend. And so when you arch backwards, you're influencing that parse area.

And if you do that at a certain number of times over a certain period of time, you can develop what's called, um, stress reaction or, or even before a stress reaction, bony edema. So the bone starts to respond, it becomes swollen. If you don't catch that during that swelling period, and you continue extending and putting force through that element, you develop what's called a stress reaction where that bone starts to weaken. It starts to react. Um, and then eventually it, it can fissure creating that stress fracture. Uh, if one side of the spine, um, fractures, then you have a, what's called a spondylolisis.

If both sides fracture, you get what's called a spondylolisthesis. Uh, my goal is we enter interject well before that period happens, because that's not typically with a gymnast. That's not like you go to practice on Tuesday and then Wednesday you have a spondylolisthesis. It's, you go to practice in September, your back kind of aches. October, it may get a little worse. Then you have season. And by March, April, you get an MRI. Then you have spondylolisthesis. So you have, you have this, this period of time that you can interject. Okay. So you said something earlier there that the finite amount of times or it sounded like what I read that as is, is there too much volume at a certain time?

Yes. And unfortunately we don't have that quantified. Think of a pitch count for a little leaguer. They have a number that they can throw repetitively before they're pulled. We have extension counts for gymnasts or extension moments. So every time your lumbar spine extends, it should tick. And then it extends again. There's another tick mark. There's another one. Well, if we practice four to six hours a day, and some of my girls practice upwards of eight, they may have two different practice, you know, bouts during the day that equal eight hours a day, you know, five or six days a week. That extension count is very, very high.

We don't have that quantified yet of what is safe. I don't think we ever will, not with, you know, how much it may vary from an 11-year-old to a 13-year-old. And I think it depends a lot on, you know, when puberty is achieved, how much strength training is going along with it, when do they start gymnastics, are they a little bit later introductory into the sport versus earlier. So it's going to be impossible to label, okay, this amount is safe for one athlete, or this amount is safe for across the board. I think what should be really looked at is practice volume and at what age. So I see very high volume gymnastics at young ages, and that is because we have this mindset in gymnastics that we have to develop high-level skills before puberty.

Why is that? And so we rush and rush and rush and train little tiny bodies to get to a level of gymnastics so then when their body changes and they grow and their center of mass changes and their lever sizes change, that now they have the skill base. Because in theory, it's much easier to learn a skill, a smaller gymnast than a larger gymnast. I thought that it was kind of like when you taught someone, I heard this about like baseball. So all these guys were having their kids hitting lessons really early before puberty, and then eventually the kids hit puberty and they look like baby giraffes swinging baseball bats again.

So they lose the skill set and they have to learn it again. So I kind of thought it was a waste of money. So you're saying that learning it early is better. I'm saying that's the thought process. Okay. I think that thought process needs to change. I believe that if we hold off and develop really strong foundations and fundamentals early, and we develop very strong athletes, a strong core foundation, mobile yet strong hips and shoulders, and we train that and then allow their bodies to change, then we can add in skill specific or sports specific skill training after that. So again, this works in the Nadia Comaneci time.

Do you know Nadia Comaneci's trivia time? I feel like I've heard the first name, the last name, but I would never be able to recognize. Comaneci is the way it looks. So she was in an Olympic. Is there an accident? I don't think so. Just season eyes. Anywho, she was an Olympic gold medalist, gosh, in the 70s, I believe, and with the Corollis. Do you know who Bella Corolli is? Is that the one on the Disney movie? No. Wow. We are. So they were the head coaches and the heads of the United States gymnastics team starting in the 90s, and they just recently retired. Marta, he retired several years ago, and then Marta, his wife, took it over.

This was her last set of Olympics, this past summer Olympics, and she retired. And they had the ranch down in Texas, which is where they held their national training camps for the United States gymnastics teams and programs. Well, now they're being investigated. But the United States gymnastics really mirrored their protocols and their thought processes that they brought over from Romania. And so it worked in the 70s to push teeny tiny, you know, bodies to this point. And so then it worked in the 80s, and then we mimicked it in the 90s and the 2000s. And it's just not – there's more flaws in it than positives now.

If you look at our last Olympic team, they're much older. There's some in their 20s versus our 96 Olympic team. They were 16, 17 years old. So I think that the sport is changing to peak at a later age for women, but it's still – just because it's changing in that direction doesn't mean that everyone trains that way. So back to kind of the original point, I think that the low backs are really threatened in the PARS region due to early training, early volume of training. So how would you, in the gymnastics fix, what have you done to kind of offset this constant triggering or – I'm guessing you built a supportive system.

Yeah. So I had several patients come into my clinic, several gymnasts, with that complaint. And so you start to see a pattern, and you start to work with them on how to work on some anti-extension work, utilizing the diaphragm a bit more. I'll go into that in a second of what really my rehab focuses on. But after starting to see the pattern in here, in the large numbers, and I would get – people would reach out to me from other states asking, how can we replicate what you're doing in Birmingham? Because we can't make it to Birmingham, but my daughter's back hurts. So I realized I needed to make this accessible for others not in my town that I treat in.

And so with Gymnast Fix, it's kind of organically grown into this online platform where I have online courses now that gymnasts can log into and follow a series of rehab movements, whether they're movements or exercises, different kinds of stretches, strength training drills. And they perform these protocols for like six to ten weeks trying to change their movement pattern so that they can spare their low back more during extension movements. So they can reach that online, and they don't have to be here. Have you gotten any coaches to sign on it and love it or hate it for any reason? Yes. So I work closely with a handful of coaches that have really opened themselves up to some critique and some suggestion and some partnership.

I think that they are excellent coaches for so many reasons, and one being that they're willing to learn. Now I have other coaches that are very shut off to it. They don't – they're not interested in learning. I'm sure. They do it well. They do it right. But the coaches that I do work with, they've been so receptive, and they've seen a drastic reduction in low back pain in their programs. That's not to say it's completely gone. Gymnastics is a brutal sport that – I hate the words injury prevention because I'm not going to prevent low back pain, but I can reduce it. We can reduce it through these movement changes.

So the coaches that I do work with are rock star coaches and super receptive to learning a bit more about biomechanics and how they can utilize biomechanics to their advantage rather than just sticking to what they've always been taught. So explain anti-extension again. Yeah. So your body extends. That's a God-given movement that we should be able to do. But we have actions within the body that help reduce the impact on certain joints while we extend. Same thing for flexion. You know, we should bend over and be able to touch our toes, but I'm sure you have several patients that are very scared to bend over and touch their toes or bending over and grabbing their socks, put them in the ER, right?

So certain ranges of motion we're supposed to be able to achieve, but sometimes they can feel threatening. So in gymnastics, gymnasts are put into tiny little leotards and they're told to present very big. They're given certain instructions like have a very proud chest, look up towards the ceiling, raise your chest up towards the ceiling. And what do you know as a practitioner, if you're told to bring your chest up and you're in a very small leotard, what do you think a 16-year-old girl is going to do? Well, they're definitely not going to make a big belly. They're going to get real thin, huh?

Yes. They're going to draw that belly button all the way in. They're going to suck in and they're going to pump up their chest because that's the coveted position of a gymnast is this drawn-in slim, slim waist. So you and I both know and practitioners out there know that that is completely devastating to the stability of the lumbar spine. So if we're doing that for hours a day and then we're told to extend with tons of force, do you know when a gymnast impacts the ground, when they impact the spring floor, not even like a hard floor, but when they impact the ground, a spring floor, they can absorb up to 17.2 times their body weight and then they're sucking in at the same time.

So that's destabilizing the spine. So when we go through those normal ranges of motion, our body doesn't have the protective mechanisms in play to protect itself. So I'm guessing it's just riding on the facets probably. Absolutely. So I see in young girls 12, 13, facet arthropathy already. Really? Damn. Yes. Uh, it's, and, and, you know, I'd probably see it younger if I actually had images of younger gymnasts. Um, so the very first thing that we work on, if I'm with a gymnast, it doesn't matter if they're like Sloan, I sprained my big toe or I have headaches or my shoulder hurts when I do casts or even my low back hurts.

The very first thing we do is assess diaphragmatic breathing, um, because it is so foreign to a gymnast. They're always sucking in. They're always drawing in their, their, their, um, holding themselves in that small position or that hollow position inside that leotard. They're scared to let their body relax through their midsection like that. From, from a, from like a, a patient communication standpoint. So when they walk in, they're like, well, I turned my ankle and you're like, we're going to work. I'm breathing. How do you have this conversation with them to, to make them not knee jerk? Like I'm out of here.

This place sucks. Do we have 30 more minutes? But it's a long conversation. And, and you know, I, I, it's not like I neglect the ankle. We definitely, we definitely pay attention to the ankle if they're coming in with an inversion sprain. Uh, but while they're rehabbing the ankle, they might as well get some recognition of the core going, you know, they've got the time to spend on it might as well. And, and, you know, uh, distal stability or distal, uh, ability comes from central stability, right? So, um, a vulnerability within the ankle can definitely be influenced by a vulnerability at the low back.

So I try to explain to them that the most foundational or most fundamental thing that I can teach them is how to utilize their diaphragm, how to stabilize their look. Uh, so when they walk out, yes, they may have some, some rock tape on their ankle, but they also have some diaphragm drills and some, um, anterior core drills to go home and do from me. Well, I saw one of your videos, I think it was ankle pales, pales and rails. Uh, I mean, you kind of trick them in that way too. Uh, so do you, you ever just, do you just kind of start with like, Hey, I want you to lay face down and just do all this breathing work, breathing and four, blah, blah, blah.

And then, Hey, here's some tape for ankle. Or do you blend them more often? No, they're definitely hybrided. They're definitely, um, blended together. And also that gymnast, most gymnasts I work with want to have a collegiate career or want to have an elite career. And they know that this isn't the only time that they're going to face injury. So every injury we look at is with like the glass half full. This is an opportunity. This isn't a sideline. Like this isn't, this isn't an, Oh man, I'm going to miss the first meet of the season. No, this is a blessing. This is you getting to take time that you can now make your ankle stronger.

And we can look at other parts of your movement and other parts of your body and bulletproof those. This is a, this is a, a window of time that we're gifted to focus on how to make your core a bit more stable, even if that wasn't the issue that you walked in to me with, because I know that if I focus on that, it's going to optimize their performance as well as reduce injury potential in the future. Good. So if they have a 10, 10 more years of gymnastics, let me help them out with those 10 years. If I, even if I can't get them to, you know, do their floor routine the next day on that ankle. Yeah.

You're doing more for it. The long play. The, uh, completely game. One, one way I've been able to, to equate the torso stiffness to, to, uh, motor control of the extremities is I'll usually just, I'll stand them in the middle of the room, like no matter what injury they have. And I tell them, like I put my hand in theirs and I said, I'll give you a dollar if you can, if you can push me over without using your belly. And then, so they're like, yeah, I can't do that. So then, then I'm like, oh, your ankles and feet and knees and everything works the same way. So that's what's worked well for me.

Um, I may try that. It's, it seemed it's, I've never given up a dollar, but there was, there was, there was one guy where like he was, I had him, I screwed up, I had him on the ground. So he was on his back. And then so he used the floor as, as the stability point to brace. Yeah. I'm like, Hmm, I'm not going to give this dollar yet. Let's have you seated. I guess I'll prove to them, uh, that they can increase their flexibility by utilizing their diaphragm. I mean, that's an, that's an easy, easy test, you know, test, test a single leg raise or hamstring flexibility. And then with a big inhale through the chest and it's going to be much more limited than a diaphragmatic breath.

Then they'll realize, oh my gosh, my leg goes so much further. And so that means gymnastics can be, can be a lot less, um, it can, it can have a lot less effort behind it. So if you're trying to do a split leap, you don't have to try nearly as hard if you have more hamstring flexibility. Yeah, that's a, that's a good point actually with, uh, you've heard the concept of buy-in. Yeah. So that's a really good buy-in point. And I know that from, I didn't realize the value of buy-in for a very long time. And now I'll start to model my first appointment around. Like I, I know what I want to know to help this person, but they're not going to come back unless we do a buy-in point.

Absolutely. Yeah. That is definitely been a learning point of mine as well. I'm sure you and I probably practice pretty similarly. And so we're not necessarily looking at, you know, pain relief right away. We're like big picture. Let's look at the big picture. And I've had to rein myself back in quite a bit and be like, no, like people want to feel good, you know? So I've had to really focus on, you know, pain management in the beginning, making, making light of what the long-term goals are. You know what, I've never had this happen with a gymnast. I've had this happen many times with, with other populations, but that their long-term goal, their goals doesn't even have to be long-term goals.

Their goals don't align with my goals. So then it's not, it might not be a good fit or I have to change my way of thinking, but a gymnast is always on board for looking out for their next 10 years. The, the weekend warrior is not always on board for that. Yeah. They, they, I find the weekend warrior usually, they usually pick up their, their sport because of a secondary level goal, like a weight loss or something like that. But, uh, I like that your, your target market is exactly you. Oh, thank you. It's so, when I'm with a 13 year old, it is like, what does it, this is a, this is something the 13 year old would write on Instagram.

It is life. Well, I know all the fields. It is life. Oh, it is so wonderful. I, it's, I beam, like you can see me via zoom right now. Like it is just completely where I'm meant to be is working with those gymnasts. I can be goofy. I don't have to, you know, use my doctor talk. I can be relaxed. I can sit on the ground with them. I can take my shoes off. I just, I love that patient base. It's a good thing too, that since you're not, how old are you? You're not very old. I'm 30. I turned 30 last month. So, so you won't, you won't deal with the, uh, you're a little too young to help me type of thing because you're good.

You're always going to be old. Yeah. I don't deal with that whatsoever. I'm, and I'm, you know, I have credibility with them because I did gymnastics and because I can speak the lingo. Like I can say those words like to Kachef and Sukahara and your Chanko, which make you go cross-eyed, right? I can speak those things and I can ask them, Hey, how bars go today? And they're like, good. I did, I did bails. I did some shoot overs. I made my connection, you know, they can say those things to me or they can say, you know, my shoulder felt tight during my pirouette, but not during my kip. And I know what they're talking about.

So that gains me some credibility with them. But at the same time, I'm so glad that we really didn't have like cell phones and a lot of video and like YouTube when I was young, their age, because the gymnasts I work with now are light years ahead of anything I ever did gymnastics wise. So they look at me like, Oh my gosh, she did college gymnastics. But my 13 year olds, they're better than what you were, thank me in gymnastics nowadays. Yeah. So I have some credibility with them, but, um, I'm glad that there's no evidence of how much better at gymnastics they are than I was. Right. We had, uh, like back, back in the day when I think I was like probably 12 or so, 11, 12.

So there was a local skate shop. And so we're like, Hey, we want to get sponsored by this local skate shop so we can get free shit. And so we're like, what do we got to do? And they're like, well, you got to provide a video. And so we probably have provided some videos and I thought they were okay. And then we'd watch all these other videos of people doing stuff. We're like, well, it's pretty damn good. And you see the shit now. It's like, there is no way, no way. Yeah. I'm so glad I did gymnastics in the decade that I did compared to now these, these girls. Now, I don't know if you catch any on, on TV or not, but, uh, us classics just happened, which is a big national meet.

Simone Biles came back. She reappeared. I'm not sure if you're familiar, but maybe some of your listenership is. Well, we'll see. We're going to really see how many people fall, uh, USA gymnastics now. You're not going to, you're going to have a lot of, um, skips this week. Um, but anyways, so us classics was on and I was just blown away. Like these are human beings performing the skills that they're performing. It's, it's mind blowing what gymnast in 2018 can do. Well, I've, it's interesting, like from, I'm more familiar with dance. And so I've learned that some of the simplest movements for the dancer is the best for the audience.

And like all the small nuances, like, like, oh, well their, their lines weren't good. And it's like, how the hell do you see that? You know, but like that split looks really good. And they're like, that's the easiest thing in the world. I don't know if they have that in gymnastics too, but you probably look at it from a different, Ooh, I think I'm losing you. Do you hear me, Sloan? Yeah, you just came back. Okay. Um, I'm guessing in the world in gymnastics, you kind of look at it differently when you're watching someone. You're like, God, that's a really technical and good. Yeah, I probably have a different lens looking at it than say Bo does my husband.

Um, I can still admire the, the skill level, but I am looking at amplitude and, and lines and, uh, momentum. And, you know, during a bar set, you know, do they keep, they keep momentum and do they have any kind of pauses and stuff that maybe you or him wouldn't pick up on? I would definitely grade them down from a 10 to a nine at that point. Too many pauses. Oh, well, you would know, you would know. Um, so earlier off there, you mentioned, I think a couple of good talking points. The, I think we get this in a lot of sports. I'm sure a lot in gymnastics is they're scared to go to someone who's going to tell them to stop or just suck it up.

So how do you kind of mitigate that? And actually, how do people, when they come to you, if they come to you, how do they, how do you relay that actually you won't be that person for them? Well, yeah. So two reasons that I've, I think that people are going to be scared to go to a physician right now, uh, in as a gymnast, one, they're going to be told you're missing out on season or you need to take four to six weeks off. I mean, that's the classic protocol, right? Oh, your ankle hurts take four to six weeks off rest. And a lot of practitioners that don't know that are unfamiliar with the sport of gymnastics will say, no, you can't go to the gym.

Well, as, as a former gymnast, I know that if they go to the gym and even if they can't use their ankle or their low back, there's so many other things that they can accomplish during their time period at the gym. Um, so I never take them outside of the gym unless I truly think it's needed for their psyche at that moment, but there's so much they can accomplish, uh, on other events or, you know, rehab wise. And it's just good for them to be around that sport and around their teammates. So I keep them in the gym. So I make that very clear up front that that is not my intention. My intention is not to take them away from the sport.

But like I said to you earlier, I start off every appointment with a gymnast with, I tell them, Hey, give me, name me three things about you that have nothing to do with gymnastics and nothing to do with the injury that you're coming to me with. And most of the time I get crickets. I mean, they sit there and they kind of twiddle their thumbs and they look over at mom or dad and they don't, they don't, they don't know what to say to me. And I tell them like we have all day, I could, I could sit that whole hour appointment sitting there waiting for them to tell me three things about them because them recognizing that they have more about them than just gymnastics is more important than any rehab I can give them.

Um, so I'm once that, once we go through that, I make it very clear to them that my goal with them is to keep them in gymnastics. I don't want to take them from that sport because at 13 and you're a gymnast, you identify completely as a gymnast. That's all, you know, most competitive gymnasts have been doing it for years. I mean, I started before I even turned three and I did it until I was 2021. I mean that you are nothing but gymnastics. And so they're so scared. You're going to take that away. So we discuss, Hey, that's not going anywhere. I have your, I have to keep you safe, but at the same time, I know what you're, what you need and want.

So I work with them on that level. Now, another, another reason that individuals are having a hard time seeking out, um, medical advice right now is unfortunately the scenario that came about this past year in the media, uh, with certain medical practitioners taking advantage of their athletes. Um, and so there's a fear aspect to practitioners right now. Uh, so I can see that they don't want to go to a provider, not wanting to set themselves up for that. Am I making, am I getting myself, am I making myself clear with that? Do you know where I'm going with this? I can guess, but honestly, I don't have cable TV, so I don't, I don't have a lot of, that's why I don't know all these gymnasts, by the way.

I'm going to start sending you videos. I'm going to start tagging you on, on Instagram, like, look at this, check this scale out. Look at this girl. She's Mary Poppins. That's her name. So I'm, um, I'm, I'm, I'm specifically referring to the Larry Nassar, uh, situation where he abused physically and sexually abused hundreds of athletes over the last two and a half decades. Only gymnastics or is there, he just got, it was, there were other sports. There were definitely other sports. He worked for Michigan state university. So there are other sports within Michigan, some like softball swimming. Um, and then other people would bring their athletes to him as well, but he worked for the United States gymnastics.

So he was, he was the team provider. So anyone that was on the national team had to see him and he became their, their friend, their escape. He, he, he kind of, he groomed them into thinking that he was helping them. Uh, so that's out there. I don't, parents may be shielding their 12 year olds from finding out about this, but they're going to. And so that I know I have a, I have a few girls, I've seen a few girls that have been affected by this, that are very nervous of putting their health into the hands of someone of authority like that. So back to your original question, you know, uh, or a statement about people being, or gymnasts being nervous about seeking out medical advice.

One, they don't want to be taken away from the entire thing that they identify themselves as. And two, what's been in the limelight, the spotlight over the last year and a half has been a medical provider that worked for United States gymnastics that worked for USOC for the Olympic, uh, group. He took advantage of gymnast after gymnast, athlete after athlete for two and a half decades. Well, I would, I would imagine from, I mean, you're, you're female. I would imagine the threat would be down. Yes. Maybe. I, I, I hope that it is, um, you can't just assume all the time that it, that it is. But, um, I think that I present myself in a non-threatening way.

Uh, I think that maybe that there's an advantage to that because I am a female, um, that right now in the sport that needs to change so drastically, um, within the culture, uh, that me being a female can be a positive, uh, direction or a positive, uh, within medical care within this sport. Um, now we just got to stop you from being a chiropractor because that, that takes, that brings the threat about again. Yeah. Oh man. Uh, that my threat level just went through the roof. Yeah. Scary, crazy chiro. Yeah. Yeah, yeah. Um, yeah, I, it's, what, so what you said earlier with the, like the identity thing actually.

So I just, I've been writing some content and one of them is a, it's a lumbar spine book. And so I wrote the story that I had. I had an injury in high school, uh, no parse fracture. I actually, they did check that for me. Thank God. And, um, I eventually had one in August again. And this time it was interesting that, I mean, I had the opportunity and knowledge to kind of internalize and digest the mechanics of it. Yeah. But I still. Maybe, maybe a good and a bad thing. I, I know. So actually, actually, um, I actually went to Cody as, as my care provider and Brennan. Smart choice. Yeah. Right. Well, and he was around the corner is a good deal.

So, so he helped me through that because there's obviously some fear avoidance things and so on. But, uh, I actually took the first two weeks of my own rehab and wrote like a diary of it and even did an audio version and I'm proofreading the thing right now. And I'm, there's a lot of questions of like, okay, so you can't play. So I still play baseball on the weekends and I've always been athletic. I can do pretty much anything and I'm basically Superman. Yes. And so, but I couldn't really do that anymore. So the odd, the audio on that is like, I'm listening to it. I'm like, man, I was depressed as shit.

And I questioned like the identity version because it's like, if this is who you are and this is what you've been for like the last handful of years and what the hell are you now? And then what's your purpose in life. So I do think it's a really important part for sure. Yeah. You know, I went through it. I was 13 when, um, I had my parse fracture and they put me, not only did they say four months without gymnastics. So I missed my season. I missed being around my friends. They took me completely out of the gym. So those were my friends. Sounds really sad. I didn't have friends at school. Those were my, those were my friends.

My coaches, I spent more with, I spent just as much time with my coaches as I did my parents at that point in life for me now for me now to connect with my, with my other 13 year olds. Because when I sit there, they're across the room from me or next to me and it's like looking at me. And so it's like, I have to reassure them that there's so much more to them than that injury because they will become depressed. And you know, you know, as much as I do, especially with your experience that the way your mindset is during that time completely influences healing. So I'm not just doing it so that they're happy.

I'm doing it so that they heal faster. Yeah. Definitely big parts. And I think, uh, definitely missing parts in a lot of, like I, I missed that part for a very long time and I think I actually do, I could do a way better job of it now. I have this whole like line item thing when patients come in, I'm like, okay, what is the biggest thing holding you back from your care? Um, just kind of, just trying to break in through the barriers. And every time I look at my sheet, I'm like, damn, I didn't ask that question. Yeah. I miss that. Yeah. We're all human, aren't we? Yeah. Well, it's just, it's uncomfortable to me sometimes because I, I don't know.

I, maybe I'm in a rush to do the problem solving part, but I forget about the person sometimes. You're probably a lot like my husband. So, uh, uh, my husband, Beau and I practice together and we, even though we tell people we're like the same doctor, as far as training goes, we, we practice very differently, um, on the patient interaction side. I'm like the feel good fluff and give me like, are you a hugger? And I'll go in for the hug. Right. And he's like, let's get down to business. He's that problem solver. You know, he's got to figure out X, Y, Z, he's got the gears going and I'm like, let's sit back.

Let's talk for a while. You know? So I think if you like put us together, it would be, um, a pretty, a pretty, uh, good practitioner. But I, I definitely miss a lot on those, those, that bulleted list of what I need to go through on that first visit. So we're both human. So you did mention on the street then what was, uh, Beau's pickup line? Oh my gosh. Well, I will say this. He said his first line to me, his first sentence to me ever when we first met, um, uh, delayed our dating for several years. Oh really? It didn't go that well, huh? No, I'm kidding. I'm kidding. We were friends for the first couple of years and started dating probably our, I guess, last year and a half of school.

So, you know, school is, uh, just under just shy of four years and we decided, Hey, let's give this thing a try, maybe a year plus left of school. Um, but so we sat down at orientation for, for grad school and he knew some people in class and I, I was very, I didn't know anyone. It was my first day there. And so I sat down in the second row just off to the left cause I didn't want to be dead center in the, in the middle, you know, but I wanted to be a good student. So second row and then behind me was this like, and I was all by myself. I was in the whole row all by myself. And then there was this group of guys behind me that all knew each other and we're friends and I'm terrified.

I'm sitting there. I'm so nervous. And so he reaches out and taps me on the shoulder. He's like, Hey, what's your name? And I say, Sloan. And before he ever even introduces himself, he goes, ah, your name was on the urinal. I just peed in. Was, was it actually the name of the porcelain or is it the, the urinal biscuit? Have, I don't think Sloan makes urinal biscuits. I could be wrong. I guess, I guess I don't look at too many urinal biscuits in my life. But have you, you've never seen Sloan plumbing, like Sloan sinks and Sloan toilets. You're going to see them everywhere now. No, I, I, I have.

There's a lot of Bemis out there. I've seen a lot of Bemis and American Standard. American Standard. I'm, I'm a snob. It better be Sloan. You know, if I'm, if I'm going to use it, it's got to be Sloan. Is Sloan, wait, do you have Sloan toilets in your clinic right now? We should. It's a good point. Or at least, maybe a sticker, put a sticker right over American Standard. Take this American Standard. Yeah. I actually think those, like, I don't, I don't know about the toilet biscuits as being like a great thing, but it's always a battle to, to, to break them. You want to be the one, but then they have.

I can't say I've had that experience. Oh, it's amazing. You, you like to walk out of the bathroom like, yes, got it. I did it. But there's those piss mats too, which are like the, they got little arms on them all over it. They're like, what would they equate to? They're like a shag rug in there, but they disperse the splashback. Amazing. I can, I can see how that'd be really helpful for you. It's great. And they have that B in there. And they what? There's the B. Have you heard about the B? No. I don't know if Sloan makes B's on, on their urinals. There's a B. So there's, there's a B in there.

There's nothing but white porcelain and there's a B. It's a, it's point. To aim at. I, well, I don't know if they meant it as that or if they actually, cause I think they put it there to minimize, that's the point of minimal splashback. Like a letter B or like the, the insect. Insect. Bumblebee. And so, so maybe if you hit that spot, like according to physics, you're going to have less splashback. I think it depends on how tall the pisser is. Now, are you referring to the individual or to the urinal? Oh, well, they're probably both. Maybe if we had an elevating descending urinal and we know that.

There's a business model. Yeah, it's always at your shoulder height as being optimal height for minimal splashback on the, on the B. I bet you there's some research lying within that statement about like, you know, um, less stress on the lumbar spine, according to urinal height. You can, you can roll with this. Well, I think though, if we're going to actually go down that route, you have to make a footprint too, because they might, they might lean in, extend, and then you're going to have to train them. I've never heard that from a patient. I've never had anyone come in and say, I threw my back, you know, the whole quote, I threw my back out peeing in a urinal, but I've heard, I threw my back out using the toilet.

So. Well, I bet those people though, that if they did throw their back out using a urinal, they'd probably be one of those ones that puts their hands on the wall. Absolutely. Disgusting. Where were we? Oh, somewhere in between parts, fractures, uh, uneven bars and urinals. Hmm. Gosh, you should really listen to the whole show. So gymnastic, back on gymnastics fix, then the, it's a video based program. Yeah. So the videos, they're tutorials. So to make sure that the gymnast knows what the exercises are, there's pictures, there's detailed descriptions, there's bullet points, and then there's video.

So it kind of cover all bases that, Hey, you should be able to tackle this exercise that I'm sending you. What's, what do you find the success rate of people getting the right position and tension on a video versus in person? Yeah. In person is higher. I have to say I, in person is definitely optimal, but it's not realistic for everyone. Like I'm working with a girl right now in, uh, Okinawa. There's no way that I'm going to be able to put my hands on her and make sure that she's, you know, getting proper intra-abdominal pressure. So we try our best through video and through feedback, you know, if they have any questions, they're welcome to reach out.

I check in with them every, every two weeks or so to make sure that everything's going well. Um, and then there's a lot of repetition. So it's not like one and done, like, Oh, you do this on Tuesday and let's hope that you got it right. It's repetitive over and over again. And it build, the program builds on itself weekly. Uh, so it's really hard to build on an inaccurate exercise. So I hear back from them quite a bit if they feel like they're not getting, getting it right. So on the video, when you're doing that with them, or when you're doing the feedback with them, what are you looking for to see if they're doing it right?

And what are you looking for, or what type of cueing can you give them verbally to make it better? So while in the video tutorials, I'm talking through it quite a bit. I'm giving them ways that they can challenge themselves. So I'm just going to think of something really simple right now. Um, so think of just a very easy, uh, dead bug position. So on their back, I'll instruct them, Hey, put a towel underneath your thoracolumbar junction. Of course, with them, I won't call it the thoracolumbar junction. And then I'll challenge them. I'll say, Hey, put your hand on the side and try to pull that towel out as you disassociate and move your hips.

Um, and so that gives them a little bit of a challenge and that gives them their own biofeedback to tell if they're doing it correctly or not. Or I can use like the webbing of their hand to place around their stomach to make sure that they're getting pressurized breathing within their hands. Um, so there's cues within the video to help themselves out. But then feedback email wise, um, will be very similar to that. Every once in a while, if we need to get on a virtual session and just make sure that they're doing it right, we can do that. Um, every program that I have starts and ends with a virtual assessment to make sure that they're in the right program.

And if in that assessment, I notice, Hey, you know what? I want to tweak something. I want to individualize this just a little bit. I'll go ahead and suggest that. And we can work, um, a little bit more individual basis. If I see something alarming, do you, so the, the first fundamental exercises that you have to do, how long is that process until you actually add upon it? Oh, a week. So six days of movement. So let's say they start the program on a Sunday. That's when I suggest Sunday, they learn their exercises. They learn their movements. So they go through, they read, they watch videos, they practice, but they don't have to perform anything as far as repetition or time goes.

Then, pardon me. Then on Monday, they start their, their programming. So Monday they start Tuesday. They repeat Wednesday. They repeat and Monday through Monday through Saturday. That first week is the same every day. And they're developing those fundamentals. Then the following Sunday, they start week two. That's when they start to build on those fundamentals. So the very first exercise in any program is diaphragmatic breathing. So we don't build on that. We're not standing them up and having them go through, you know, single leg deadlifts until they're well into the program. How, how many weeks do you think until they get to foot on ground?

So I have a couple of different courses. So I've got three, three individual courses. One is directed at improving hip extension. One is directed at improving thoracic extension. And one is in directed at improving shoulder flexion, which you and I both know. If you improve those areas of the body, your entire overall global extension pattern improves. So then I have a collective comprehensive program that targets all three of those. And that one's much longer. And it's a, it's a little bit more, um, uh, step, uh, stepwise. Um, so that's for someone that has both shoulder flexion issue and hip extension issue.

So it might be a little bit longer down the road for that comprehensive program. But say we're just looking at the hip extension program, they're going foot to ground on week three, four. So from a, just from earlier when you, when you said that Q in person is definitely better. So how long did it take you personally to, to, to feel good about putting a video out when you're like, Oh, I know I could do better. Yeah. So this is tough. This was tough for me. Uh, in fact, uh, I had a conversation with, uh, two of people, people who I consider big mentors of mine, uh, Dr. Philip Snell and Dr. uh, Steven Cabo Bianco, uh, excuse me.

I call him Capo. How do you pronounce his last name? Do you know Cabo Bianco? Uh, I just, I just do Capo. Capo. There we go. Um, I had a conversation with them over dinner back in February at R2P and I told them my hesitancies, how I was really nervous about making this, um, a program that's extendable outside of one-on-one with me because I couldn't control the variables. I couldn't control the scenario and through their encouragement, they, they basically told me it was a shame if I didn't do this because I had the intention behind it and I had the knowledge behind it and the experience that if it were going to help 80 out of a hundred gymnast, that's better than helping the eight that could actually get one-on-one with me.

So it may not be a hundred percent successful because it's not one-on-one, but it's going to have a very high success rate compared to not doing it at all. So it was tough. It was hard, but, um, I want to help as many gymnasts as I can. And I can't do that being behind four walls here in Birmingham, Alabama. Right. Just a, just a bigger cause. Yeah. Uh, so you don't have to answer this one, but I'm, I'm curious and I know I've gotten the, I've gotten the, I've had this conversation with a lot of people and it seems like a lot of people don't know the answer or they don't have a definitive answer.

Yeah. So how do you get around the fact that we can't really examine them if we're recommending or are we recommending? Someone told me that like, well, I'm showing exercises and I'm like, well, you're kind of like, I thought we were of the degree where we're supposed to know, so we can't ignore. Someone else said, well, I'm a fitness coach. And I said, nah, you're a clinician. Yes. So, so there's definitely legalities behind that. And so there are a lot of clauses and whatnot that I have written. Disclaimers everywhere. Yes. Um, the way that I look at it is I'm not treating pathology. I'm not hands on.

So if someone in California is doing this, I'm not treating a spondylolisis. I'm, I'm influencing their movement pattern through exercise and movement. Uh, so that's where you get around the, I guess the legality of it. Um, now there are some, there, there have been times where I talked to people and we do the initial assessment and I'm like, you know what, this isn't the path for you. I need you to find a provider locally. And we stop it there because I don't think that improving their hip extension is going to, you know, take away, take away X, Y, Z. I, but that is, yeah, that is my answer to that.

That is a tough one. And you knew that and you set me up for that. So, yes. Well, I'll tell you my, my experience with it. Cause I, I mean, we did, I did phone calls and consults for a little bit. And then, um, I had a, I have a friend and he's in Texas and, and he, we, we talk about this stuff and he's like, why are you doing that stuff? And I'm like, well, why not? We're just helping more people and whatnot. And he's like, yeah, but he's like, why kind of lose everything that you, that you have based upon, like, you're trying to venture into something else. He's like, you got good stuff going for you there.

And I'm like, well, I, I don't know. I like to think of it as it should be okay if I'm directing them to information. And there was a guy that called from Britain one time and, and he, he was very good at playing the game. I say, look, I direct with him. I'm like, I, I don't know if this is the right legal advice or not, but I'm like, I'm like, if I told you about the story of Hansel and Gretel and I told them, I told you that they got burned up in that oven is the moral of the story. Don't go in an oven in a stranger's house that you don't know. You know? So if we do it more of like a, like, Hey, here's like a theoretical model.

Like, how is this any different than someone picking up McGill's book and reading about lumbar spine disorders, but to, to mitigate that risk even more. So I don't do phone calls consults really anymore, but, uh, I would rather do a digital model like you are videos. And that is literally a book and this is how it's a revealing what you do in your clinic. And I think that's okay, but we have a shit ton of disclaimers too. I've spent thousands of dollars on disclaimers. So it is a tough one. I feel I, and to go back to something that you said a minute ago, I have a great thing going here. As far as the farm goes, my clinic, my sports chiropractic clinic here in Birmingham, Alabama, I have a wonderful thing going here and it can provide for me and it can fulfill me for the rest of my, my professional career.

But I truly feel like I have been prepped for a different purpose. I have been prepped my life, um, to serve the gymnastics community and to serve these, these teenagers, these preteens that have this love and this drive for the sport, but don't have answers. And so my best way to do that and to reach as many as I can is through an online platform. I did it for several years here and here in Birmingham as a clinician in a, in a clinic space. And I have girls that travel outside the state to see me, but they're minimal. Like, in fact, today, when we get done with this, I have a girl that's coming in from North Carolina.

I think they're driving like eight hours for an appointment. Um, that's so unrealistic for everyone else. Um, so I just, I feel, I feel like I have this obligation to serve gymnasts and if it is a little bit of risk and if it, and if it downgrades my level of physician because it's online based, I'm okay with that. At the end of the day, I don't need Dr. Sloan Beard to be big. I want improving extension and gymnastics and decreasing the rate of pars fractures to be big. Um, so it is, I was very hesitant at first to start it, but, um, I really, I feel very called to this path. Yeah. Good. I know it'll, I know it'll work out.

I feel like when the intention's there and the intention's good, it's, it's going to work out. And I think people can see that. Um. Thank you for that. Yeah. But it, but it is, it is a hard, it's a hard thing. Um, I actually thought about this before with, cause I feel like there's enough PTs, chiros on Instagram showing themselves lifting weights and saying they do online consults. Why don't we just hire one single bad-ass attorney to figure this out? Like you just get like a thousand chiropractors and then pay, you know, $10,000 figured out. I'm in it. I'm in. So you, me, that starts with two.

I think we can find several others. Yeah. I think the only hangup would be a difference of state. Mm-hmm. I just really, I base it on is I'm not, I'm not treating. So that's how it crosses state lines. Yeah. I never tell definitives for sure, but I'm, I'm definitely directing you to all the content that I wrote. Cause I don't, uh, I know what's on it and I know you'll probably get good information from it, but I, I don't know your case. And like you said, what's the difference between that and them reading a textbook or reading, reading, um, oh. No, Kelly Starrett's supple leopard, you know, every crossfitter that comes in here, they feel like they can manage their own shoulder problem because they read Kelly Starrett's book, which is a great book and it's great resource.

And I, and I want you, if you're an athlete, if you, if what is Bill Bowerman's quote, if you have a body, you're an athlete, if you have a body, you better know the manual, like read, learn about it, take care of yourself. But I don't think what you or I are doing online is any different than someone picking up a textbook. Yeah. Right. Um, that's going to be your, it's going to be your quote for this is, uh, if you have a body, own the manual, know the manual. There we go. I like it. Uh, what did, what did, what did we not cover so far that we need to about gymnastics? I don't know gymnastics, I don't know gymnastics too well, but I know I, oh, we didn't cover diaphragm, diaphragmatic breathing or pelvic and thoracic diaphragm.

Cause I don't even actually quite honest with you. I don't think a lot of, I didn't know about that for, for many years and the importance of it. So I would have, my interns don't know. I, oh, really? They don't. Well, so I'm, I think it's school based and I'm not going to pigeonhole any certain school, but they, and they have their job at the schools are to get you through the testing really. Right. So, yeah, that's not on the board. Which is, you know, 10 plus years behind anyway. Right. So, um, explain, explain the purpose of that with anti-extension. Yeah. So I was super fortunate where I went to Logan University, little shout out there, um, where we had Dr. Brett Winchester.

You're familiar with Brett. I think you've had Brett on the pod before, right? Uh, he's phenomenal. I had him every Thursday for three hours and it was so amazing. Our last trimester of school. Uh, and so he really hit home the use of the diaphragm, the thoracic diaphragm, and then how it related to the pelvic diaphragm and how to utilize that to create intra-abdominal pressure, thus creating lumbar spine stability. Uh, so I had that from schooling. And when we started practice, it seemed to be a very foreign subject to anyone, other clinicians in the area to patients. And at first it was a very hard thing to get across to patients.

It still can be with certain patient bases, like teaching them, oh, we're going to work on your thoracic diaphragm. And they're like, how's this going to help me pick up my kid? Um, so I, I use, um, I use, uh, like a physio ball or like a beach ball to help create, um, visual demonstration form, especially for my gymnast. You think of, um, pressure within a ball, being able to bounce and distribute energy within a ball. And so that relates to a gymnast. Um, if you think of a tumbling pass, if you think of a tumbling pass, what are you looking at? What are you looking at? Oh, no. Our lights are flickering.

It might be storming outside our lights always flicker. So I'm really hoping that we stay connected here. I thought the moth man maybe appeared in your room. No, you see the flickering lights. I'm really crossing my fingers that we don't lose wifi here. Um, but if you think of a tumbling pass, you think of bounding elements, you think of back handspring, back handspring into a flip series. So they have to generate energy and they have to keep that energy going. Uh, so if you think of a ball, if you bounce a ball, it continues to bounce, right? So it keeps that energy within it. But if you deflate it, if you poke a hole in that ball, you lose energy as it bounces.

It's, it drastically slows down. It loses that energy from point A to point B. So that is a really good image for a gymnast or a coach to understand is if you can continue to keep pressure within the abdomen, you can continue force throughout force and amplitude throughout that tumbling pass. You want the last skill in a tumbling pass to be the most dynamic and explosive. Well, if in your round off, you lose pressure, they keep flickering. Yeah. If you lose pressure early on in your tumbling pass, your last skill is going to be your least dynamic. So back to the diaphragm, um, we were, we were taught in school.

Um, and so I've utilized that throughout practice. That's when I get the most success with patients is the ones that really get that concept and that we can apply that concept into rehab. Um, and, and gymnasts seem to do really well with it once they can physically feel it. Um, I'll tell you an example about me, um, in, in Dr. Winchester's course, uh, when we first laid down and we were investigating this whole new idea of supine diaphragmatic breath, um, I had nearly an anxiety attack in class. I could not let my abdomen expand because I grew up in a leotard. I grew up sucked in for 20 something years of my life.

And as a female, I have a little bit of vanity. I was told by coaches early on that I was too big. I was too fat to be a gymnast, not to, you know, don't feel bad for me. I'm, I'm, I'm over it, but I was, I mean, heck my nickname. Oh my gosh. I'm not to get off subject here, but my nickname in gymnastics when I was young was Slanyonic. So I had Russian coaches and they told me, Hey, um, in Russian, your, your name Sloan means Slanyonic. It translates to Slanyonic. So for years of my life, I went by Slanyonic by my coaches. All right. I was also told by those same coaches, Hey, you're too big to be a gymnast.

If you wanted to be a great gymnast, you wouldn't eat bread. I mean, I was always a very big gymnast. Um, Slanyonic turns out it means baby elephant, nothing to do with Sloan. And so I was a baby elephant as a gymnast. And so that's what I correlated myself as is this like thicker gymnast that could never lose enough weight. And so I had this just sucked in mentality. I, so in, so fast forward, I'm in class, I'm trying to learn how to use my diaphragm and contract diaphragm, push down into my abdomen, inflate my lower abs. And I couldn't do it. And I would, I would almost have anxiety over it.

Uh, so it took me probably a full year to even be able to get into that breath pattern. All right. Fast forward to me in my clinic today, I have several athletes that lay down that won't let their stomach go. They like will not just relax and breathe, uh, abdominally, if you will. Um, so that's the first place that we have to start with them. Um, again, like whether I'm treating their big toe or their shoulder, they're learning how to breathe better, uh, because no matter, it's going to help their big toe and their shoulder. Absolutely. But it's going to help them in gymnastics. So how many of your passwords are slenoic?

Slenoic? You're like, shit, I got to change them all right now. Thank you. Thanks. Well, most of them require, you know, like letters and characters. So if you can figure those out, you're welcome to my email. Well, slenoic, uh, 88. Yeah, there you go. You did math really well. Well, you had a nice round 30. Uh, oh, I, I, I find, I find the need to blend to uh, two topics she said into a couple jokes. Okay. Since she talked about urinals and now Russian too. Oh, yes. So, and actually this is a true story. So I was in my, I was in my office and so I had this employee that like, she loved, she loved to tell jokes and she was good at them.

I don't know where she got them all, but she said, she said, hey, if you're in the bathroom and you were a nationality, what would you be? Can I ruin the punchline? You can, cause I got a second follow-up. I know the second follow-up. No, I, European. European, yeah. So then on the fly, I told her, ooh, I got one. Okay. You're in the bathroom, you're going, you're in the bathroom and someone's waiting on you. What nationality are you then? Russian. You're, yeah, you're Russian. And then, so later on that night, I told that joke again and someone said, you stole that joke. I'm like, no, I didn't.

That's my joke. I made that shit up. Yeah. And she said, no, Ellen told it today. You took it from Ellen. I'm like, Ellen stole my fucking joke. At least you're, like, she may not have stole it, but like, you're, at least you're on the same level as Ellen now. Right, right. Oops, wait a minute. Is there going to be gymnasts listening to this? I just cussed. It's okay. I guarantee you that most of the coaches do as well. Okay. Yeah, yeah. Me and Ellen, Ellen, call me. So. If you need a rider, let me know. Yeah, if you need a rider for the rest of it. I don't know who your rider is, but we really don't know.

Okay, I have a follow-up to that joke. You got a third? Holy shit. Okay. So, you're done using the bathroom. You're washing your hands and you walk out. What are you? For some reason, I want to say Ugandan, but I don't. That's a good one. You're Finnish. Oh. They both work. Shit. Okay. I wish we could come up this on a fly. Yeah, we need a fourth one. Well, something surrounding. You're in the bathroom and they have after-bathroom mints and you walk out. You're Swedish. No. That is not up to Ellen's level. Ellen just fired you before she hired you. They all sit around on a couch and make these jokes all day, I'm sure.

Like, I just needed a little bit more time. Yeah. Okay. So, as we start to come into, we've been on for an hour and 10 minutes. Is there anything that you want to cover? And we definitely have to let people know how to find you. No. I think this was fantastic. I teach several times a year to different gymnastics coach groups, to parents and whatnot. And I kind of come in and I say, hey, heads up, I could talk about this stuff for days. And I have 60 minutes or I have two hours. And so, I kind of get frantic. I just go, go, go, go, go, because I feel like I could talk forever. But, so I could sit on here for the next couple hours.

I can't, unfortunately. I have to go. But this has been fantastic. I've thoroughly enjoyed it. Thank you so, so much. Yeah, it was fun. How can, is it gymnasticsfix.com? www, you know, the traditional W's there, .gymnastfix.com. Gymnast. So, not gymnastics, gymnastfix. Why not gymnastics? Was it taken? You know, I'm just going to come up with this right now because I'm not sure I ever thought about that. But I want it to feel very personalized to the gymnast. Okay. I do want to have an impact on the sport, but I really want to impact the individual. I can tell you thought about that. You almost pulled the trigger on multiple URLs.

You thought about it for weeks. And then they can find me on Instagram at gymnastfix. That's my handle, as well as on Facebook. I do also have a closed group to just parents on Facebook that I get on, and I can offer different suggestions weekly of just how to care for their athlete in a little bit more intentional manner. If people want to join that, just reach out to me. Is there, most people that have online content have some type of giveaway through an email campaign. Do you have that? Clickbait. Wait, clickbait? No. I do. Lead magnet. What's a lead magnet? I don't like to call it clickbait, but...

Clickbait's like it's the thumbnails. We do have an email campaign that gives out a lot of great resources. Resources that pertain to hydration cheat sheets. So making sure that your gymnast stays hydrated. And there's a few more tips to that than just drink water. There's a nutrition cheat sheet out there. There's a sleep cheat sheet. There's a recover better cheat sheet. So all of these are free resources for gymnasts and for parents. And I also have several videos that are geared towards gymnasts as well as to coaches. So how to improve landing techniques to save the knees as well as the low back.

How to start your gymnast on some intra-abdominal pressure drills. So if people are interested in that, they can enroll in that campaign by just going to my website and then giving us their email in the interested or in the pop-up box. And if you want to be treated by you, Birmingham, Alabama. Got it. Okay. So thanks for being on. Thank you so much for having me. Yeah, it was good. Cool. Great. Thank you so much for that interview, Dr. Sloan. Everyone, if you're looking for the show notes on that, go to p2sportscare.com. And we are now having a pretty good search function. And it's drawn up a pretty good list of curated content.

So if you just go through and put in Sloan, S-L-O-A-N, I guarantee she's probably the only Sloan that I'm going to interview in a very long time. That's probably the easiest way. Or whatever media player you have right now, iTunes, Google Play, whatever the hell else, Stitcher. I don't know what else there is for podcasting. Maybe I should get on that pretty soon marketing-wise. Anyways, there'll be a link in there. So just go through. It'll take you directly to the show notes and all the links and correlated stuff that we would have talked about. You can find her website and contact information on there as well.

As you can tell, it's really hard to do product promotion as well as be a good clinician and digest content in a simple way, but still kind of be respected by your peers. You got to digest it down for your patients because it's there. We're meeting them on their level. So Dr. Sloan has done an amazing job at that. So even if you are not going to, even if you're not a gymnast, go through and just observe if you're a clinic or if you're a clinician, go through and observe the way she's presenting her material because it's great. It's amazing. Not everyone can do that. It's an art form. So go through and check it out.

Review the show for me and I will talk to you guys next week. Lead people better than how you found them. See you soon.