Hip Flexors, Deep Hip Muscles and the Pelvic Floor

This is the Performance Place Sports Care Podcast, session number 37. Let Kunu be your instinct. Don't try to surf. Don't do it. The less you do, the more you do. Now pop up. Welcome to the Performance Place Sports Care Podcast, where you can learn about sports injury theory, rehab, diagnosis, and how to understand the doctor lingo you didn't understand at your appointment. And now, your host, Dr. Sebastian Gonzales. Hey, everyone. Thanks for joining me and our guests again at the Performance Place Sports Care Podcast, where you can go to get all your information on sports injuries, what the heck your doc was talking about, all the stuff that you really don't understand about your injury. I'm hoping you get it here. I'm hoping you get it from me. I'm hoping that I can digest it in an easier way than maybe you had at the office or the stuff that you've been reading online.

So, we actually have a guest today. And by the way, if you already heard the intro, I'm trying to do some stuff that very much is individualized to me. And if you know anything about me, if you know me well, you're going to know that one of my favorite actors is Paul Rudd. And I've had people say that basically I'm like a baby Paul Rudd because I look like Paul Rudd and act kind of weird like Paul Rudd. But I hope I'm not as socially awkward as Paul Rudd. But I thought I would do a little bit of a series opening where I just do some of my favorite parts of Paul Rudd movies. So, if you know which movie that was from, please hit me up on Twitter and maybe put hashtag performance HB Paul Rudd and put it down there.

Maybe do like a little quiz. So, if there's any Paul Rudd fans out there, this is the time and place to show your Paul Rudd love. So, yeah, we'll see what comes next on that. So, we're going to interview actually today Tim Fleischer. And Tim is someone that I met probably, gosh, I think back in 2010 maybe. So, it's been about seven years. Funny though, he's one of those types of guys that if you meet him like once or twice, automatically you want to talk to him again. He's an interesting, funny dude. He's very knowledgeable. And he's very well diverse in his education. So, just going through his rough bio here is that he has a master's of science.

He also teaches gross anatomy at the University of Texas. He's a massage therapist, but he mainly does massage therapists so he can just do manual therapies on people. So, I actually met him at an active release event in Hawaii years ago. So, in order to touch people and treat them, you have to have a massage or at least bare bones massage therapy license to do that. So, he does have that. He has a CSCS, which is a strength conditioning certification, which is one of the ones that I have as well. And he's actually an instructor for active release too. I don't know if he does it anymore, but he used to.

He does a ton of triathlons and he's also a bike fitter. And he's doing some very interesting research at the University of Texas as well. So, funny, which is a totally side thing that he does. He actually does some musculoskeletal ultrasound too, which is such a rare finding because, I mean, I could probably count on one hand how many people I know who do musculoskeletal ultrasound. It's a very rare type of skill set. So, this is Tim. I'm going to let you, I'm actually, I'm just going to go with the flow on him today in our interview. Because, funny, we had a little disconnect on what we're going to talk about today.

But, whenever we, whenever we talk, we have a lot of good conversation about stuff. So, probably what we're going to do here is we're going to see where the conversation goes. And I'm going to see what he has to drop. What kind of knowledge he has to drop and see what you guys can absorb. And I'll try to dissect away some of the technical terms that we might be using. So, consider it like we're sitting there, me and both, both him are having a drink at a bar. And then you're kind of listening over his shoulder and you're like, hey, he tapped me on the shoulder. You're like, what's he talking about?

So, I'll be like, oh, he's talking about this, this, that. So, let's try to make that the flow of today. We'll make it very conversational and see what the heck Tim is doing. It might not be an extremely long podcast today. But, yeah. Oh, one more thing. He's also a Stop Pilates instructor. So, gosh, this guy does a ton of stuff. So, Tim, why don't you come on and tell us what's going on? Hey. It's been a long time. Yeah. Yeah, I think the last time I saw you, I was in California. I forget what for. No, I think you were doing that bike fitting convention. In, like, Pomona or something? Yes. I was doing a certification for a triathlete bike fit called Fist through Slow Twitch.

Yes. So, you are, I know that, like, I told everybody a little bit about you already and kind of like your multi-facet, different education. You have a little bits and pieces of everything. But I thought that you'd be really good with speaking about, or we're going to target the endurance athlete world here and just kind of tell everyone about yourself a little bit and act like there's a triathlete over your shoulder. Okay. So, my name is Tim Fleischer. I live in Austin, Texas. I'm a PhD student at the University of Texas, and I teach at the University of Texas. So, I'm a PhD student in exercise science with particular interest in motor unit firing rates and deep muscle activation of the hip as it pertains to urinary continents in postnatal women.

And so, I work with some really big giants in the exercise science department. So, I get to just kind of sit and learn a ton from them. And then I work in the biology department as an anatomy teacher. I teach microscopic human and gross anatomy. So, I teach a lot of histology and a lot of just gross anatomy. And that's, you know, and I teach Pilates for a company called Stop Pilates. I fly around the world and train instructors. And I have a Pilates, a little Pilates set up in my living room, actually, down here on Lake Austin. And so, and I'm a sports massage therapist. So, I massage swimmers.

I was just up at the NCAA championships working on the Harvard men's team. And I worked on the women's team at Texas in the past and Iowa State. So, my whole thing is I kind of combined mind-body exercise, Pilates, massage, self-massage with, I love endurance training. And I live in an endurance town. I live right next to Deep Eddy Pool, right on Lake Austin. There's some great cycling around here. So, for fun, even though it's not my research, I tend to paddle around with people upstairs like Ed Coyle, who did a ton of research on Lance Armstrong way back in the day, and people who come from the Human Performance Lab.

And so, I coach a little bit with, I coach a few athletes in triathlon and cycling. And that's kind of what I do. So, they kind of tested you as being, like, a super freak then? Like, because your tan lines show that you really, you really are on the road a lot. My tan lines? Yeah, the powers are the powers in your tan lines, right? Yeah, the power is definitely not in my legs. It would really be in my tan lines. Yeah. And my receding hairline. Let's not forget that. Well, yeah. I can't really tell because you're always wearing, like, a hat or a beanie when I see you. Well, that's the cover of the truth.

Although, Brian Erlacher, man, I'll tell you what, man, they did magic. We're getting close to an implant there. Men out there, we are getting close. Wait, did they add, like, plugs or something? Just, like, little plugs? Well, you know, back in the Jeff Van Gundy days, back in the early, like, 2000s, like, it looked like somebody was just stapling hair in people's head. But now, I think that the stuff is starting to look pretty good. It's looking a little too fake, a little too perfect. But I think once they get it right, I mean, you know. Well, I've seen them do eyelashes on, they do eyelashes on girls.

Those things look like, they kind of look like caterpillars, you know. They look like real things. Yeah, see, we don't get that in Texas. I'm sure you get that out there in California, but in Texas, I don't know anything about that. I don't know. I've been to Austin. You probably have a lot of those things that just don't get as bushy. Oh, man, this place is great. You've got to come visit me. Yeah, I will. I mean, I think, I told you, the last time I've been there is for that bachelor party. We had a good time, but it was really quick. We didn't get to do extremely much. Yeah, I know it's hard to find water there.

That's the thing that we had the most. Well, we're getting some water back. We're getting some water back. Lake Travis, the puddle Travis is becoming a lake again. So, we just had some rain the other day. Oh, good. Well, so, I thought that everyone would learn probably a lot from, actually, you brought up the point that, so, you do Pilates or you instruct Pilates, but also, you have this absurd amount of education in biology and anatomy. So, is there a connection you can make between those two for some of the triathletes out there? Like, what is the reason for doing Pilates or doing core exercise?

And I know you alluded to the core and low back pain and so on. Yeah. Well, I think that there's probably a misconception with the core and what it is and how to strengthen it properly. So often, triathletes in particular, we like to go out and we like to hurt. We enjoy pain. I mean, that's just because we see benefit in it. Like, we see the reward after the pain. And so, we think that pain is good. And it's almost like, mind-body is almost like going out and doing a zone two run. You know, if you go out and do a zone two run, it can be kind of boring. You're like, what am I really accomplishing here?

Well, there's a lot you're accomplishing as far as muscle plasticity goes. And longer, slower runs are good at a low heart rate. Hold on. Before we go too far, explain zone two runs and muscle plasticity for me. Sure, sure, sure. So, zone two runs, I'm talking about, you know, if we're talking practically, it's kind of where you can still be conversational. So, you're not going so hard that you're, you know, you feel like you're working really hard. It's just a nice, leisurely pace. And, you know, heart rate is divided into zones. And typically, it's about five zones. Sometimes, it's seven. Most of the time, it's five.

And zone two would just be, you know, well below what you could hold for an hour without fatiguing drastically. So, what I'm talking about there is just a very easy kind of, you know, pace of running. And it doesn't feel like a lot of work, necessarily. So, you don't think a lot of good things are happening, but they actually are. So, if I can relate that to core training, a lot of times people are like, yeah, I got to work my abs. I got to do planks. You know, planking is the exercise for the past 20 years. People just love to plank, which is great. Yeah. Definitely has its benefits, but it's, it's a, you know, one thing that you need to realize is you're not moving when you're planking.

Yeah, yeah. It's a static one. I don't understand, like, I understand why people are doing planks, but like the absurd obsession with planks right now. It's just like, I don't get it. Why do you need to do a 30-minute plank? Yeah, you don't. And, and let, I mean, I think face, you know, it's like, you know, people joke about CrossFit. It starts in the gym and it ends on your Facebook page. I guess people want to show people that they can do it for 30 minutes, but I'll tell you, you're, you're probably killing your back and your hips. You know, it's all, it's like Robin Peter to pay Paul kind of deal.

Um, sorry for anybody out there who does CrossFit. I'm not coming down on it, but I heard that once and I thought it was funny. Well, I think that goes for, for anything, probably even the rides that you do, you're like, man, I hit zone two. I just want to tell everybody about it. Well, yeah, I mean, come on, the amount of times on my Instagram that somebody pops up doing a Pilates teaser, uh, you know, I, uh, you know, it's probably the same as somebody doing a burpee in CrossFit. So you're right. It exists with anything. At least you're not a wanderlust. I just can't tolerate how many wanderlust pop up on my feed.

Right, right. But the thing about it is, um, you know, when I teach, you know, I have actually, um, what is today? Tuesday. Yeah. This morning, uh, or today's Wednesday, yesterday morning, I have these, these ladies who come and see me at 6 30 AM. One of them's a doctor up here at Dell medical school and, uh, the other, uh, works on staff up at UT and they're both big time endurance athletes. So they like the long rides. They, they go to pedal hard, which is, you know, pedal hard is Lance Armstrong's bike shop. Like it's in the basement. It's like that CompuTrain center and they love to work. Well, when we, they got in here, I was like, look, it's about what you don't use.

It's not about what you do use. So I'm going to be telling you to back off, back off, back off in several positions. And I'll give you an example. Um, you know, in Pilates, we had this thing called a reformer and it has straps on it. Well, when you lift your legs, instead of thinking, lifting your legs, you want to say, don't lift your legs, relax your legs and let the straps bring them back to you. Um, and, and so that they don't pull up from their hip flexors, which tend to be dominant triathlete muscles and that they're working, uh, what's called eccentrically or lengthening under lengthening of the muscle under load through their hamstrings.

Um, and, uh, so I just cue them to relax and relax. Um, and, and, and that gets them into better patterns and get increases their range of motion and it allows them to use the muscles more efficiently. So, um, you know, so a lot of what I do with triathletes, it's let's get out of your hip flexors. Let's get out of your quads. Let's get out of your, you know, your neck. Let's get out of your six pack. Let's get into your transversus abdominis. Let's get into your internal oblique. Let's get into your glutes. Let's get into your medial hamstrings. How are we going to do it? Let's get into your abductors.

You know, the sides of the hips tend to be really weak on, on triathletes. That's why they get IT band syndrome so much. So we do that. And, um, man, with these ladies, you know, they come in and they're like, wow, I feel great. I feel like my body's brand new. I feel like I can go train for hours and I'm like, yeah, that's the idea here. You know, it's to make you more efficient. Yeah. So when they do something like that, then do you, do you end up seeing that they, so you're kind of like breaking up some of their dominant patterns and like, let's just say with a hip flexor, because I know that's super overused and everyone tries to stretch it and so on.

By the way, I did a whole video on it today. Um, the, I'm going to send you a link cause I know you like all those YouTube videos I put out. Oh, it's phenomenal what you've done with YouTube to make fun of you. And then I got on one of your, your hits for like a, so as stretching and had like 90,000 hits. And I'm like, what is I am in, why am I in education? That's funny that that one actually was one of the first ones. And I kind of want to take it down because I don't believe it's, it's so misleading that that that is like a fix or anything like, so actually this, this one today was going to be about 16 different ways to work with a tight hip flexor.

But then, you know, the first part is assessment and then assessing to see if it's too long or too short or if it needs to be addressed at all and then stabilize the trunk. Um, so I'm trying to trick them. Uh, yeah. So everybody, Tim used to make fun of me at the YouTube videos. Who did I did? Yeah, you did. Oh yeah. Yeah. It was great. Yeah. I get it. Get a text about some meathead making a YouTube video. Yeah. I'll make fun of you for it. I mean, come on. Um, yeah. And you have that thing where you won't even put a cell, you won't even show your face on social media, right? Uh, no. Well, I, I, I'm not on Facebook.

Um, and, uh, and, um, uh, see, I'm not on, uh, I'm on Instagram and I'm on Twitter, but like, um, I don't do a whole lot on social media. I should do more, but you know, I don't want to be like, you're really good at it. And, um, like, I don't want to seem like I'm like, check out my workout of the day or, you know, I don't even, you know, it's like, I don't know. I'm an academic like that where I'm like, ah, I don't know what I would do. Some people are really good at it. And like, I follow people, I love it, but I just don't feel like, uh, I don't know. I have anything to offer on social media.

I don't know. I think you get, I think you get a lot to offer. Like you can, you can even see, like, I don't know what the responsibility to this podcast, but like, these are things that like endurance athletes probably, maybe they knew, but like you'd be surprised at ones that like are starting out. They're like, Holy crap. Like I listened to that podcast and Tim knew, Tim knew the way, you know, like, and you could have shared this with a bunch of people if you shared on different forums. The one thing I would tell triathletes, I think one of the biggest things that triathletes need to work on is, uh, efficient pedal stroke.

Um, I was doing a bike fit on Friday, uh, and a lady came over and we were, you know, I was fitting her and I was like, um, you know, I was like, she was pedaling and she sounded pretty good, but I kept hearing this, this, you know, this kind of mashing of the pedals. And I was like, take, take one foot off and let me see a pedal with one leg. And it was the hardest thing for her to do. And I'm like, you gotta practice this. You gotta do one leg drills. You gotta get a set of rollers. You know, you gotta, you gotta get efficient with that pedal stroke. And you know, one of the things I, she's also a Pilates client of mine.

One of the things we work on is not pulling up on the pedal. Right. So it's like, you know, your hip flexors are going to get cooked in triathlon or, or cycling or running or swimming, you know, almost regardless of what you're doing. So it's like, okay, how do I back off these guys? Um, and one of the things that I found is if you do a typical Thomas test where you're doing, uh, you know, you do the leg drop over a, I don't know. Do you want to explain that? Yeah, it's, it's basically, yeah, you just take the, you're putting the patient on their back and then you're seeing if you, so you drop their leg to where it kind of dangles off the table.

And there's a certain range where you want it to be, um, kind of laying down easily without raising the back. And actually that was one of the assessments of the hip flexor length that I was, I had was going to have on one of those videos. Um, but for the most part, you want to fall within certain normal ranges, right? Right. Yeah. And so one of the things that I see, and I don't know if this fits into what you were talking about with your hip flexor length, but you'll see somebody jump down and, you know, you'll, you'll, you'll perform a Thomas test and you'll say, oh, they have a short hip flexor.

Yeah. We need to work on this. Well, I've, I mean, nine times out of 10, when I do that, what I'll do is I say, okay, this leg is not going further, uh, far enough. I don't actually assume it's a hip flexor. Or I think it possibly may be a malpositioned femur. And so what we'll do is I'm like, all right, let's get in a four point kneeling position. I want you to round your back. I want you to relax your hip flexors as much as you can. And then I want you to lean forward over your hand. So if you picture like rounding your back, kind of like a plank on your knees, um, you know, but keeping your background, leaning forward, barely over your hands, and then just lifting up one hand at a time, right back and forth.

And the goal is to pull your pubic bone right down in your pubic region to your nose so that you're using those lower abdominals and to not feel those hip flexors to relax your hip flexors. So I'll have my hands on the outside, on their hip flexors. And I'll just be like, relax this. Just use those lower abdominals as you lift your hands and they'll go back and forth. And then, you know, then after they finish doing that, like, so let's say 10 times on each hand, uh, by the way, that exercise is called puppies in the snow. Real cute, right? Yeah. So after they do puppies in the snow, um, we go back and retest and I kid you not, um, most of the time, most, most all of the time, I would say, um, their range increases.

And I mean, they passed the Thomas test. Yeah. Well, they even have two, like I've seen, uh, there was one video I wish I had, uh, had a link to it. It was, it was, I'm sure it can be redone. It's not a big deal what the link was, but they had a passive range of motion test for like a hamstring. They had someone on their back. They put the, someone else helped them up, see how far they went. And then they just let them go. And they're like, you know, go as far as you can on your own. So they contracted the abdominal wall and lo and behold, they had another three inches on it, you know? So it's true.

So it's like, it's like, do you really need to stretch a hip flexor? Maybe, maybe. I mean, I don't, I don't doubt that, you know, for some. Um, but I think it's like, man, do we need to reduce some tone in your hip flexors? And get those abdominals contributing more. Um, and with endurance athletes, especially triathlon, when they get off that bike, they start running, they go into that hyper extension of their low back and they do that Ironman shuffle and you're like, man, this could really help you. Um, but, but so, you know, like, um, I always put them in positions where they have to work hard.

Um, but it's different. It feels like what we do is Pilates feels totally different and Pilates style exercises feel totally different. It feels deep. And, um, and you know what I can, I guarantee them all. I'm like, when you get up and leave, leave this place, you're going to be moving way better than when you came in. And you're going to, you're going to feel it throughout your day. So I totally believe in it. And, um, I'm not, you know, I don't say that to be arrogant at all. I just believe in the system. I don't believe in my teaching necessarily. I think there's plenty of Pilates instructors who are much better than I am.

But, you know, I feel like I've learned some things that, that have, that other people have used that have worked. And, um, I just try to apply them to endurance training. Um, is puppies in the snow Pilates thing, or is that a separate, I don't think I've heard that one. It was start off like, well, it started off like a four point kneeling exercise in a neutral position, you know, like that, uh, they call it the swim prep, but it's also called bird dog, you know? Yeah. But with just the hands and, uh, it got the name puppies in the snow and Pilates, but it's not a Pilates exercise, so to speak.

It's more of a rehab exercise. Um, so yeah, so, so yeah, that's what it is. Um, but you know, I've seen people turn it into, you know, like a postural restoration Institute, Ron Haraska up there in Lincoln, Nebraska, they turn it into something where you round the back and then you start lifting the hands and that's brilliant because it makes you, uh, it's easier to inhibit your hip flexors in that position. There's a theory on that is that the, like, I always thought at least the, like the, the correlation with the trunk being stable or say you put them in a hip, by the way, hip flexion is rounding.

And I guess I, we should have talked about that before. I don't know if I told you, Tim, like the, uh, I, I, I've, I've, I never knew how many people didn't know what spinal flexion was. So I always kept to keep revisiting the back. Sorry. And you know, when I first heard spinal flexion and even rotation, like I was really confused. So I needed to do a better job defining my terms. So I apologize. It's okay. I'll, let's keep, I'll just keep stopping you. Cause we got one over, let's get some over our shoulder. Um, but I thought that the, so I, I always gave everyone, everyone the analogy of like, say I'm wearing roller roller skates and you are too.

When we're standing together and like we push, I, like I push you and then we both throw back equal, equal because equal and opposite reactions. Right. But if you were in shoes and I'm wearing roller buds and I push you, I move and vice versa the same thing. So the hip flexor attaches to the front side, uh, thoracic or, uh, lumbar spine. Yeah. And it also attaches to the femur or basically the hip. So we got to keep one stable if we're going to efficiently move. Right. And if you can't keep that trunk stable, then we're just getting sloppy. We're tuned. We're in two pairs of roller skates. So that's what I've always told people.

Um, I don't know if the analogy works or not. Yeah, I agree with that. You know, I think one thing that we need to, to do a better job of though, and you said it is like talk about talking about stability. I think this is why the plank took off to begin with is such a, a good exercise because it's like, it works on stability. And so the way we've traditionally defined it is you stay static, right? You're, there's no moving when you're truly stable. And so that's not true, right? There's, there's static stability and then there's, but there's dynamic stability, which is probably much more functional.

So how do you, how do you, how stable are you when you move? And, um, you know, it's like, well, how do I know? Um, well, you go to practitioners and you know, also it's how, how do you feel when you move, you know, tons of people have different movement strategies that work well. But if I see that you're bending over to tie your shoes and you're not bending your knees and flexing your hips, you're just rounding your lumbar. I'm going to tell you, you know, Hey, it's probably not an efficient strategy, right? Yeah. Right. But that's how they normally move. That's their habits. Cause they're sure, sure, sure.

Um, Oh, so what I was going to go back and ask you earlier was that, so once you've kind of, uh, engaged the deeper muscles and tried to disengage those larger dominant groups and patterns, how long does, is this a process that takes a long time to hold or does it stay for a period of time? Uh, that's a good question. And, you know, I think that, you know, I think it's probably a little different for everybody, but if you're, if you come in and you've never used your deep abs, like I've got a lady who, who comes in and she's never really felt, you know, you get this, this conversation, this conversation with folks and they're like, I just don't feel my abs.

And for me, I'm like, are you nuts? Are you crazy? Are you serious? Like, you know, for me, I always feel my abs. Um, and this was before I even did Pilates, like it was just, but I never felt my deep abs, never felt my deep abs. It was always superficial, but I still felt them. So, but some people don't connect with their, their core and not everybody connects with their core at all. Um, so, you know, we'll do things like put a balloon in their mouth and have them blow up a balloon. And it's amazing the amount of people who can't blow up a balloon when you ask them to, because you have to use your, your abs as respiratory muscles.

You know, one thing about the internal oblique and the transversus abdominis, which are deep abdominal muscles, you know, if you read about what they do, it'll say like rotation for the internal oblique flexion. It'll say stabilization for the transversus abdominis, but then it'll go dot, dot, dot AIDS enforced respiration, which means exhalation. So when you exhale, when you take a breath out, if you exhale long enough, your abdominals are going to turn on. And if you exhale really long, your abdominals are really going to start cooking those deep abdominals. So that's what I get people doing when they come in because those muscles attached to specific areas, particularly the deep transversus abdominals, it attaches to your low back region and can help stabilize your low back and protect your low back against injury.

And for, and I'll also say that with that, it will, if the stronger you are in those deep muscles, the more efficiently you will use your hip flexors for sure. For sure. I agree with that. So, so the people that get off the bike then, and they're just, they're doing the triathlete shuffle, if they then trained to, do they have to become aware of their deep abdominal muscles or is it just going to inherently just be in there after they've done some training for it? Uh, you know, you always train for body awareness, um, when it comes to mind body. So, you know, what I would tell triathletes is I'm like, yeah, I think I believe in lifting this, but you know, not, not for everybody, like, um, because it depends on your body type, I think.

Um, but I believe in lifting weights and I think that's good, but mind body, I think is so much, I think for the, for the money, mind body is way more beneficial for a triathlete because you need to stay light and you need to, you know, there's a power to weight ratio on that bike and in the run. Um, you know, meaning, you know, the more you weigh, the more power, the more effort you're going to have to put out, maybe not so much in swimming, right? But in the bike and in, and on the run, weight is a big deal. So it's like, well, how can I get strong and stay light? And I think mind body strengthens those muscles that don't necessarily hypertrophy a whole lot or get larger with load a whole lot, but they can turn on and they can protect you.

They sit very close to the joint when you're doing repetitive motion, like cycling, like running over and over and over. So I think, you know, a triathlete should really look at getting into either like a gyrotonic class or a Pilates class. Um, you know, to, to really strengthen themselves and then go out and do their volume, you know, swim, bike, run. Well, uh, so you said mind body a few times is that I actually haven't heard that term other than that place that tries to solicit me for their scheduling software. Oh yeah. What is a, so mind body is a, is it a theory or a categorization of exercises?

Yeah. So I guess it's more categorization of exercises. You know, I guess anything could be mind body. Uh, what it means is, you know, you really are focusing in on what you're doing. And, uh, you know, um, you know, you're just not pushing load. So anything could be mind body. I guess what I should say more to the point is I would say inhibitory exercise is what I'm a huge fan of. And that is, you know, when I cue my clients, it's usually not use this more, use this more. It's relax here and relax here. You don't need to use this muscle. You don't need to use this for this. And then I tell them to go.

There's a big difference in that. And, um, and, uh, so, you know, sometimes you get frustrated with me, but you know, like I said, at the end of the day, they get up and, uh, and they can move better. And, um, you know, it's because they were relaxing muscles they were dominant in, but not necessarily efficiently using. Yeah. So you, uh, actually I've, I've, I've never actually told people when I'm working with them to move stuff less, but it's kind of funny that you brought that up. But I think that, um, this is the first podcast where, so I do little intros into the podcast. Um, and I actually don't know which one hits which a lot of the time.

So, but I think this is the first one that has the Paul Rudd references. And I don't know if, have you seen, uh, forgetting Sarah Marshall. Oh yeah. Where he's doing the, the, that's the best. You're doing too much. You're doing too little. Yeah. Surfboard. Yeah. Don't, don't try to surf. Don't do it. Yeah. You know that, and that, that's true. That's so true. When you go into Pilates studio, sometimes they get so obsessed with deep. You know, one of the things when I go and train instructors, I tell them, I'm like, they still have to work out guys. It's like, you know, you can't like sit there and have them breathe the entire session when they're first starting out.

I'm like, let them mess up. Let them make mistakes, work them out. They came in for a workout. They should get worked out. Like if I show up for a workout and I don't feel like I've been worked out, I'm going to be mad. Well, is that, is that commonplace though? Cause I know you said they like to put that, they like to put the pain on. So is it would part of the resistance be that they're just not going in cause they don't feel the burn or. Well, I think it depends on who you go to. I mean, like you really need a seasoned person. You need an experienced person, somebody who understands your needs in particular triathletes.

Like, you know, as a triathlete, I tell you, I can really relate a lot better to the triathletes than I can with somebody who has, you know, um, so I have two extremes of clients. I have endurance athletes and then I have elderly, you know, I'm not old. I don't know what it's like to be old. Um, how old are you again? Um, well, I guess I'm a little old, 37. Well, you're looking for hair plugs. So, Hey, look, man, there's a guy in my high school district who was bald. He's old running the hundred meters and, uh, when Nero's high school, I saw him, he looked like he was 80, 18. So you can lose that hair at any age, but I'm telling you, I'm close to, to, to getting the plugs, man.

They're awesome. I don't know, man. I think they're kind of like lazy. Cause you probably got like one shot. Like your cornea is just, just, just thin enough. Like your scalp is just thin enough. Brian Urlacher looks like a stud. I tell my anatomy class, it's like 300 undergrads and I'm like every single time I get up to teach, you know, at the beginning of the semester, I'm like, Hey guys, it's getting close. We're getting close to hair plugs. So this, this bald head right here, you know, my friends are like, nah, man, you got the Jason straight, don't look, keep it going. And I'm like, I want to believe that, but that guy's way better looking than me.

So yeah, he just doesn't smile. That's his thing. You should just don't smile. Yeah. And steal cars and learn how to drive. Oh man. I was watching the mechanic part two or whatever last night. That guy's awesome. Wait, which one, which one were you watching? The one with Jessica Alba, who by the way is just terrific looking. Is that a current movie or is that like old Jessica Alba? I don't know. I don't know how old it is. I don't know what, how old she is now, but in the movie, she, she really does a fantastic job portraying a pretty woman. That is the hardest thing, isn't it? Yeah. Well, let's go back to like, uh, actually I, I didn't know what we were going to talk about today.

Cause we didn't, I guess we didn't talk or give a, any outline or anything, but I think you should be like, I've been, I've been doing actually the most boring podcasts are ones that I'm trying to teach mechanics of like, say a hip or like anatomy of a hip, just so we can get into like stuff like this and they're going to know what terminology we're talking about. I might just use you as the hip guy. You go after. Yeah. My whole PhD is on the hip. Okay. Tell me, tell me all about, tell me, tell me three things that people don't know about the hip that they need to know about. Um, well, so, so you have one, something about the hip is, uh, if you look at gluteals or if you look at butts, right?

Um, you were watching Jessica Alba movies. So I think. Oh man. Great gluteals. Um, she, uh, yeah, nevermind. So the, if you're looking at the hip, you have to understand that there are multiple layers. So you have the superficial layer, which is the layer on top, which would be your glute max. So when you go take a bar class or something like that, everybody wants a strong glute max. But beneath that you have, um, another layer and that's like your glute meds and glute men. And that's, that's a layer that has, you know, when you stand on one leg, these, these muscles primarily keep you from shifting too far one way or the other.

Um, but they also can do, you know, flexion and extension. So bring you forward and bring you back. And then beneath that, you have these deep muscles, six deep muscles. They call me your six deep rotators. And these muscles can wreak havoc on your hip or they can be very good for your hip. So when you talk about people with sciatic nerve entrapment, a lot of times that's the sciatic nerve getting pinched between two of these deep hip muscles in particular, the piriformis and the gemellus superior. Um, my research relies, uh, lies around the piriformis and how it functions in healthy individuals during a single leg stance, um, relative to how much they drop their hip and shift their spine.

So, um, so that's what I look at, but I would say that, that, you know, the deep hip muscles oftentimes, um, can take over and do too much work that the superficial muscles should be doing. So what you end up having is when you look at people, they go straight back to legs, right? They don't have a glute max. Um, and what they do have is really tight hip rotators. So when you look at them, it looks like they're eating their shorts with their butt almost. Um, I would say I was, and you know what, you can get exaggerated, uh, in a bar class. So be careful of turned out positions, working your, your gluteals.

Well, this is a bad thing to, if you have the eaten shorts appearance, it's a bad thing. It's a bad thing. And it's like, if you, I heard someone explain it once is like your butt should look like a triangle. It should not look like an upside down triangle. So the gluteals should flare out like a triangle at the bottom. But if you flip that upside down, the gluteals come inward and it looks like you're eating your shorts. So, um, with your gluteals. So you shouldn't have that look. So one of the things we work on when people come in is I work on strengthening that glute max and, um, and making sure that, that, you know, we're working on you know, we work on a lot of parallel position.

I don't do a whole lot of turnout. Um, I do a lot of internal rotation, a lot of parallel position. Um, internal just means rotating towards the middle. And I do a lot of side leg lifting. And you're talking about foot positions with internal and parallel. I'm talking about parallel with the hip. So femurs are parallel. Your big, big leg bones are parallel. And, um, yeah, so we do it like a lot of school. I'm a huge fan of squats. I think squats are the best. Um, so I try to teach my clients how to efficiently squat a lot. So what if they have that resistance of like, yeah, I got hurt one time squatting.

I can't, I can't do that. Well, you know, that's called a fear avoids belief. And I totally respect that. You know, I used to sprain my ankle all the time in high school, uh, playing basketball. And, uh, I wouldn't want to take a long step to the side because that's how I rolled my ankle. So I understand if people get hurt doing those things. So what we do is we break the squat up into areas where they're not necessarily doing a full squat. They're doing a partial squat so that they feel comfortable. And if they don't feel comfortable doing it, then I'll take them to another, uh, exercise where we can work on the same musculature, but not necessarily, you know, it doesn't have to be a squat.

Mm-hmm. You just take them to the, to the, uh, butt blaster, right? You take them straight into the gym, just glutes only. Oh, yeah. Yeah, yeah. We go, we go, we go with that, that outer thigh, that outer hip machine where you see people doing all sorts of funky stuff on it. Sitting down, you know, kicking the legs way out. Yeah. I've seen them do funky stuff on the Smith machines lately. Like I think I had like about a three month spurt in like a regular gym I've been in in years. They're doing some crazy stuff with those Smith machines. Yeah. Smith machines are great, right? People are just loving them, I guess.

I don't know. I see, I don't, I don't go to the gym, you know, you know, I go to the gym. Um, we have like five of them. And so my, my office is in the football stadium here at Texas. And so there's like five gyms in this building. And, uh, you know, you go in, I go in, I used to, uh, be a teaching assistant for personal trainers. So I'd go in there and see what people are doing. And, um, yeah, the Smith machine, they're all about it. All about it. Yeah. So, so, okay. So we've recapping, we don't want to eat the shorts and you want to train the glute max. You want to train the glute max. And the thing is, and one of the, the other thing I would say is that those, the deep muscles, the pelvic floor, which, um, your pelvic diaphragm is a very important group of muscles that helps, um, helps keep you continent.

Um, you know, it's highly correlated with the strength of your transverse abdominis and the mobility of your diaphragm, your, your respiratory muscle. Um, so we want strong pelvic floors. So a lot of what I do is teach people how to engage that properly. Well, your hip muscles in particular, your piriformis, which is what I'm looking at. It connects to the connective tissue of the pelvic floor. So the takeaway is you could have a pelvic floor issue that could be highly connected to your hip. So maybe some exercise, you should do some hip strengthening exercises for those deep muscles. If you're experiencing urinary incontinence or something like that.

Um, even if you're not, it doesn't mean you have a strong pelvic floor. Um, those deep hip muscles will help, uh, facilitate a stronger pelvic floor and also, um, probably can help strengthen those deep abdominal muscles and vice versa. So then those, those people that have like, uh, piriformis syndrome or gluteal tendonitis and sciatica, those would then, so there's a correlation between that and pelvic floor. There could be, I don't want to say there always is, but cause I'm not a doctor, but, but that's one thing I'm researching, right? Is I'm researching how connected this, this piriformis is to people with a low back pathology.

And, you know, with the research, it's interesting because, um, you can't just say low back pain, right? There's a million reasons for it. So you have to pick a subgroup of low back pain. So my subgroup I'm looking at is postpartum women with urinary incontinence. And, um, and so, but I'm, I'm collecting data on healthy subjects right now. So, so we'll see, we'll see if there's some sort of something there to it. Um, but the hypothesis is because of its connections, uh, you know, the piriformis is interesting because it connects to your femur, which is the long bone of your leg. It connects to that, that connective tissue of the called fascia of the pelvic floor.

It connects to your, uh, your sacral tubious ligament in the back, which is a ligament that connects to your hamstrings. So that it's part, you know, when triathletes feel that catch underneath this, the sits bones or the butt bone there, um, a lot of times that's a sacral tubious ligament being a little too tight. Um, and, uh, it also connects to your sacrum. So, um, a lot of connections for this one muscle, just like the boss down there. It just, it's got his hands in everything. It's like the mafia. Well, you would, you think so, but if you look at the literature, there's not a whole lot we know about it.

So I was like, Oh, I'll just do a PhD on this. So who knows when I'll finish, but, um, we'll see what, uh, we'll see what we find, but it definitely is an important muscle. And then, you know, the one thing I would definitely believe in is the hip is, is highly correlated. Um, your hip strength is highly correlated to the strength of your low back. Um, so whenever you do low back exercises, you should target the hip as well. I'm sure you, you, you did a bunch of other research on probably other pathology that piriformis is correlated to normally, I'm guessing, or else you wouldn't have picked it probably, right?

Well, I did my master's thesis on self massage. So I worked with a company called, uh, trigger point therapy products. Cause they were out of Austin and a guy named Cassie Phillips gave me a grant to, to do some research, um, on, on their products. So I looked at actually looked at the calf. Um, but clinically I was seeing a lot of people with issues, low back issues in the head, insanely weak hips. So I'm like, huh? So I started reading the literature and then I was like, huh, there's not a whole lot here on piriformis outside of diagnosing piriformis syndrome, which it could be anything. It could be a number of things.

Um, so I wanted to know more specifically what was going on with this muscle that people were talking about. So that's what I'm trying to do. Yeah. It's a big, it's a big buzz term. I know that, I mean, I don't know if people know exactly what it is or like the symptomatology, is that a word? Symptom patterns with it. Um, but yeah, no, I think it's an important thing. So I don't know when you're, when your research is, is it going to take like a year, three years, 10 years, you're going to have your hair still? Uh, yeah, no, I won't have any hair. I, you know, you know, my, my PhD has taken a long time.

Uh, but you know, I have, I have to have somebody who inserts needles that deep. I can't do it myself. So I have a, um, a guy who does prolo therapy in Austin, Dr. Brad Fullerton. He's working with me on my PhD to insert the actual needles into the muscle so we can record the activity of these muscles, um, and what they're doing. So he's brilliant. And so, um, I work with him and some other folks. It's kind of a big collaboration. So right now we're just collecting data. So I can't make any statements about what, what has happened because we just don't know. Um, but it should, you know, hopefully I'll get three papers out on it and, um, and, uh, you know, hopefully we add, add one sentence to the, the book of knowledge.

Yeah. The encyclopedia, no doubt. Yes. The encyclopedia. Yes. The, uh, you were talking about respiration earlier. Yes. Um, what do you think people need to know about respiration that they don't know? Uh, I think one thing is, is people assume that they're working their respiratory system by just going out and getting cardiovascular exercise. Um, so it's like, oh, you know, I need to go work my lungs. I'm going to go for a run or, you know, I'm going to go work hard. It's going to work my cardio respiratory system, which is true. But I think what you're going to see in the future. And I think if triathletes who are listening, want to get an edge, you could work possibly, you could possibly work your respiratory system by itself.

So how about you spend 15 minutes blowing up balloons or, you know, there's a, there's a tool out called the Spiro Tiger. That's a functional respiratory train trainer, um, that paces you with your breathing. What it does arguably is it increases the amount of air you can inhale and exhale outside of your cardiovascular fitness. So your heart and things like that. So just biases towards your lungs and, um, and that gas exchange and breathing more efficiently. You know, if you can direct your breath efficiently into the deep lungs, it's going to give you a good response and possibly it's going to help extend your run or help extend, you know, it's going to help you somehow in performance.

And a lot of people may say, yeah, right. That's a bunch of hocus pocus, but, but I've seen it and I've seen, I've seen the measurables on it. We actually had some students set up a, um, uh, project, a research project in a physiology laboratory looking at this. And it's amazing when people do respiratory fitness, what happens to the amount that they're able to inhale and exhale. Um, just, just in regards to volume or with gas exchange or both? Well, the assumption is gas exchange, but yes, with regards to volume. So we'll look at them with what's called a spirometer, which we'll measure that.

And, um, and it's like night and day it's night and day. So I'm a, I think that, that triathletes need to focus on respiratory fitness. I think that that's a, it takes 15, 20 minutes a day. It's not the most exciting thing in the world, but I'll tell you what, you're going to appreciate doing it when you get out there and, you know, you're able to breathe a lot better and you're able to go further. I think for the remainder of the podcast, everyone should just get a balloon and just breathe it up or blow it up and down for the remainder while they're listening to it. There's a free article online called the value of blowing up a balloon.

And, uh, you know, balloon gives you pressure, but you can even do it without pressure. Like you have to use your apps to blow a balloon, which is the argument. I pay $1.87 per 20 balloons at Walmart. They're the best. Um, but you know, like you could just breathe deeply. This is one thing, reason why yoga is great, right? It focuses on the breath and there's a lot to breathing that we just don't know about. More work needs to be done into breathing. Um, but you know, there's whole physical therapy, like systems that are set up around respiration, like I mentioned it earlier, Postural Restoration Institute out in Lincoln, Nebraska.

That's their whole thing. They're all about those balloons and getting intra-abdominal pressure through it. Um, so there seems to be something there, but I would say triathletes, if you want to focus on something additional and you want to see if it works, get into respiratory fitness, um, and, uh, start, uh, start working on your breathing. Yeah. I would imagine that if they were just only doing, um, like they were just crushing on the runs and bikes and stuff, I would imagine they would have more, uh, labored breathing. So it almost, it almost like probably offset unless you're really conditioned to pay attention to it.

Yeah. Well, the thing is, if you read running books, like a very famous running author, a guy by the name of Jack Daniels, great running, running coach. I mean, there's even sections in there where they're like, yeah, you need to focus on your breathing. And they talk about, you know, two, two breathing, like for every two steps you take an inhale for two steps you take an exhale. Um, so, and about exercising that, but they never go into real depth. Um, and I think a lot of that has to do is because we just don't know, but I think, you know, I think it, it, it, it, it's valuable to practice breathing and, and working on respiratory fitness because, you know, even when you're running, focusing in on your breath, um, you know, an efficient gas exchange is going to equal more energy, right?

I mean, um, you're going to be able to, um, produce more energy, uh, via oxidative processes. So, so it, I think it's a smart way to go. It's not the most exciting thing in the world. Um, but it works. Yeah. No, I, I, I, I'm on board with it. The, actually the, um, I've been interviewing other, uh, rehab experts and doctors and so on, um, on this podcast. And I can't tell you how many times breathing already came up and it's like, oh crap, we're talking about breathing again. And, you know, um, I mean, I like it. I do it here. I actually, I have a, I have a balloon animal that I could not blow up.

Actually. I think there's something, there's definitely something wrong in the balloon because I should have been able to do it, but I, I made a balloon dog and I have it sitting in the front office and people like, what's with the dog? And I'm like, well, it has good internal pressure. So it can stand, you know, but yeah, it comes up super, super often. Yeah. Well, yeah. And I think it's, it's, it's going to kind of be the trend, right? I think that, uh, it's, uh, you know, it's good too. I mean, the thing that I want to teach people to do with it though, is how to engage their pelvic floor properly.

So how do you lift your pelvic floor without gripping into it and without pushing down on it? You know, if you look at the, some of those CrossFit videos, the early ones, you see people like, you celebrating the fact that they're peeing themselves on stage during a squat, like it's some sort of badge of honor. And I'm like, man, that's a dysfunctional descended pelvic diaphragm. That's not good. Wait, was this men peeing or was this only, was this women peeing? No, women. Oh yeah. You know, it's like, what are you doing? Why are you celebrating that? It's not funny. You, you have a serious issue here.

You're incontinent because you're, you're pushing down on your pelvic floor to lift all that weight. You know, in Pilates, one of the major things is, you know, we want you to gently engage the pelvic floor, gently being the key word. And, and more than that, we want you to build awareness. You know, some, some moves may require a hundred percent pelvic floor engagement. Others may just require 20, but we want you to be aware of your pelvic floor. So, you know, in fact, guy I'm working with right now, he's a radio announcer for CBS sports. And he's, you know, he, he's got this big lung capacity.

Well, he's got a barrel chest too, and he can really inhale, but his exhalation really struggles. He fell on a fence post, uh, trying to get into his apartment because he left, he locked himself out. So he's climbing up his balcony, fell down, hit a post on his perineum, so on his pelvic floor. So I've been working with him with a pelvic floor PT for over a year now. And, um, and, but, you know, right now, you know, they, they have to work internally on him and that is not the most comfortable thing for him. But what I work on is teaching him awareness and how to lift that pelvic floor. And we're just now getting to the point where he can really feel his pelvic floor and he'll probably come back stronger than he was before as a result.

Um, but you know, uh, it, it's, um, you know, it's a, it's a big deal. Pelvic diaphragm is a big deal. 60% of women postpartum struggle with the urinary incontinence. And there's probably a ton of men who struggle with it as well, but just don't want to talk about it. So, um, so respiratory fitness can totally help with that, but you have to build the awareness in the right way. Yeah. Is there, is there certain cues that you give them when you're, uh, yeah, yeah, yeah, there is. I mean, like with guys, I'll say, imagine, you know, walking into the ocean water, uh, what is called the Pacific's pretty cold over there and you get to the bathing suit area and then all of a sudden it hits and you're like, Ooh, that's cold.

That's kind of a hundred percent pelvic floor engagement. I thought it just made you jump cause he didn't want to hit you. Yeah. But what if there's a wave coming? What if there's a wave? Are you still there? Yeah, I'm here. Okay. Yeah. What if there's a wave you can't get away from it? Yeah. You're going to be jumping inside too. And that's what you want to teach. So I say, okay, that's a hundred percent engagement. I'm like, can you do about, can we do about a fraction of that? You know? And so with, with every cue I give this one guy in particular, I'm like, okay, man, we're starting it off.

You start your exhale, lift up on that exhalation of gently on that pelvic floor. And then let's do this move, whatever the move may be. And, uh, that provides stability for his torso and then he can do his, his mobility through his extremities. Um, so it works. It totally works. Well, so in regards to dissection, I'm sure you've gotten into the pelvic floor area. Yep. Have you, have you found anything? I don't even think we went into the pelvic floor. We just kind of opened up the cavity and then we saw the intestines and whatnot, but we didn't dig around in there too much. Well, I think when you look at the pelvic diaphragm, I think one thing that you'll appreciate is the connection of the pelvic diaphragm, the levator ani muscles in particular, um, with the, the, the muscles, the adductors, um, you know, it's, it's tough to dissect them away.

You look at them, you're like, whoa, they're really connected. So, you know, a lot of the work we'll do is, is work through the adductors, um, uh, to connect the pelvic floor. The trick of it all though, is the hip flexors, uh, adductors can be hip flexors. So I rarely work, you know, I, I don't like having, I, I work the adductors in extension a lot. So with the leg in line with the rest of the body, pressing down on something, um, just because, you know, I, I want them to work the adductors as adductors, not hip flexors. Yeah. Makes sense. Um, gosh, I don't, I don't know. We're getting through so much stuff.

What is, uh, what else should we hit here? Is there any other pearls that you got to, uh, to go through? Man, I'll tell you what, like, uh, I don't know. I don't know. We can talk, we can talk again, man. Just that, you know, the one thing is, is if endurance athletes are listening, the one thing I would say is I think that, you know, like training all heart rate zones is necessary. I think doing a little bit of everything and, you know, doing some mind, body fitness, doing some, some hip training, some, some power lifting. I think power lifts are great for endurance athletes. Um, you know, all that stuff's necessary, but, but, uh, don't think that, that because it feels different, it's easier.

You're not getting a workout. When you show up for a Pilates class, you should leave feeling like you got worked out. Now that doesn't mean you should be hobbling out. It means that you should feel worked out. And when I tell people that when they leave, I say you should leave moving better than when you came and you should feel like you worked out, but I don't want you leaving broken where you're hobbling. Like you're so sore you're hobbling. You should be able to go do your endurance workout after seeing me, but you're going to do it much better. Yeah. Oh, I, I got a question. Cause this is the thing I get a bunch.

So definitely there's certain times, you know, during peak training times that they're going to say, I don't, I don't got time. I can't, I don't got time to do that stuff. Would you, would you rather them cut X amount of mileage out and then spend 30 minutes doing this other stuff? Do you think it would be more beneficial to them or do you think that they should just keep on the mileage? Uh, you know, sometimes they have to keep on the mileage. I mean, you know, you know, it depends on what they can do. Um, I, what I would say is it only takes 10 to 15 minutes. Like, that's what I ask. I'm like, can you, if it's cutting 10 to 15 minutes off their, their long runs to do this?

Yes, definitely do it. Um, you know, if it's a, you know, so I think that you just need to, you know, I give my clients two, three exercises. I'm like, do this before you run. Please just do these. Take you five minutes. And that, that stuff adds up. And, uh, the ones who do it really do well. Um, and so, um, so I would just suggest not necessarily cutting back on your, your volume or your training, but give it that five minutes to do, do some good work. You know, you can do good work in five minutes. Um, you can get the muscle fired up so it protects you during that run in five minutes. No question.

Yeah. I would imagine they can almost like just make a better warmup because I'm sure that not everyone's got a catered warmup. Yes, I agree. I agree for sure. Okay, cool. So we are getting through this. Have you, can you believe we've been talking for almost an hour? Yeah. I'm looking at my, my Skype and it says 59 minutes. Yeah. Well, that was before when we talked on the recording. I got 55 here. Yeah. Pardon me. Yeah. So then I want to know that. So how can people reach you or your Twitter handles and all that can adjust? Well, if you tweet me, I mean, I'll tweet, I'll get in touch with you, but you can email me.

My, my email is Tim.Fleischer. So Tim.Fleischer, that's F-L-E-I-S-H-E-R at gmail.com. I'm on the University of Texas Neuromuscular Physiology Lab website. And my website is www.timfleischer.com. And so, yeah, just if you got any questions or, you know, something I can clear up that, that wasn't clear or something you disagree with, you know, I'm a researcher, so we, we, we tend to be the most skeptical of people. So, uh, just reach out and, and I'll get back with you as soon as I can. I see your, uh, your website still has that Portuguese menu on it. Yeah. That Portuguese menu. I used to live in Brazil, so, so I had a Portuguese, Portuguese menu.

It hasn't been updated in the same amount of time. So. Yeah. I remember seeing this there, that article on there, I clicked on the, I was looking up a couple of things to talk about in the, in the news, there was that article of you and I can't read it to make fun, but I really want to. Oh, probably go for it. Right. I might learn Portuguese just for that reason. You should, you should let that motivate you to learn Portuguese. Right. Okay. So then I, let me close the show out here and then, uh, you just stay on and we'll talk at right after, but, um, anything else you want to add here before we close?

Uh, I really hope the Celtics beat, uh, the Cleveland Cavaliers tonight and I predict that the university of Virginia, my undergraduate alma mater will win the NCAA championship next year. Next year. Well, this is, this will definitely air before that, but you'll probably date the, date the broadcast, uh, by the other reference. Okay. Yeah. Um, okay, cool. So, um, everyone that was Tim Fleischer and, um, again, Fleischer is a F L E I S H E R. You can find him at timfleischer.com. And, uh, yeah, if you guys have more questions for me or if you want to hear certain types of experts, or if you want me to answer your personal questions, um, I'm open to that.

And actually had a friend today who he was on Skype with me and he's like, Hey, we should, we're talking about his hamstring. He's like, Oh, we should, what do you think about this? What do you want to think about that? It's been like two years since it's happened. And he wanted to do, he's like, why don't we just make this a broadcast? I'm like, that'd be a great idea. So if you've got a good story, I'm totally open to doing it because I think everyone learns from, um, each other in this, cause you will use the terminology that you can understand. I'll try to digest it down and explain it multiple different ways.

Kind of how me and Tim did here as well. So, um, if you want to drop a question, go to p2sportscare.com. Again, that's P is a letter, two is a number, sports is plural, care.com. Um, and any of the show notes on this, if you're, if Tim referenced anything, I will put them in the p2sportscare.com slash podcast section of the website. So go check that out. Um, but it was great having you and don't forget to go on iTunes and subscribe. It really, really, really helps me out because it's hard to market these things. And I just like doing content. So, um, help a brother out and just, uh, subscribe to it, share it with your friends and write a review.

Talk to you guys later. Thanks for joining us.