What an Oblique Strain Feels Like and How to Rehab It

With my oblique strain, I was not able to do a ton of things. I mean, I literally found out that first week that I used my core doing all of the things that I typically do, like putting on shoes, getting into a car, even pushing the pedal down in the car was painful. Sitting up, rolling over, leaning to one side, I couldn't run, I couldn't laugh. 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 guys, it's Dr. Sebastian Gonzales, and that was a section of my solo podcast today all about oblique strains or oblique muscle strains, and it is a topic that I know very, very close to my heart, because I've had it close to my chest, I guess, because I've had it before.

So, before we actually get into all that information, I want to make sure that you guys do know that you're on the brand new Restoring Human Movement podcast, the Restoring Human Movement podcast. We've changed from, the old branding was Performance Play Sports Care podcast, but I thought this would be more indicative to the people actually listening. So, I want to make sure that all the healthcare providers, the movement providers out there, that actually you guys are sharing these with your clients, if they're more of the basic information, and the one today is actually going to be much easier to share with the general public, because I'm going to be using some more common terminology.

I won't be interviewing anybody who is a expert, and we don't have to have the, it won't be complicated information. So, share this with your people who have oblique strains, and probably sports hernias too, because it's very similar. These injuries are very similar in regards to how they affect the person. Now, some of the topics I'm going to hit today is what it felt like to have my oblique strain, and what I did to rule in and rule out other types of things surrounding the possible reason for the abdominal pain, and some of the things I did. I did a rough timeline, and actually, right after I had this injury, I had an article that I wrote, because just like a lot of the injuries that I have, I really don't, I don't want to forget about it, you know, it's just something that, it's funny with pain, you just kind of forget about it after it's gone as quick as it came there.

So, I want to make sure that all of my experiences are still helpful to all you guys. If you guys are looking for the show notes on this, go to p2sportscare.com, put in the search function, oblique strain, and it's going to pop up probably the article that I have on the oblique strain, as well as the podcast transcripts, transcription for this one right here. Now, just as on all the new episodes of the podcast, I'm not going to be doing the introduction of little parts about me, but I'll do a small short story. So, I don't think I did this one already, but since we're going to be talking about baseball today, there was actually in high school where, so I played center field in high school, and right around along the outfield wall, there was this, you know, that's where the grass kind of stops, because all the outfield fences have, I mean, they're not just chain link usually, usually they have some type of meshing in it or something, so it basically deadens the sun.

So, right below it, there's usually not a lot of grass, and it's kind of semi-shaded, it's just, it's not out in the sun all day, but it's in the sun enough. So, what I thought I would do is I went out in the middle of the night, went out there and dug a hole, a little tiny hole, and I put some strawberry plants there. So, it was in the, almost in the gap in left center field, so I go out there and I would take water from the dugout, kind of, in my mouth, out there in the outfield, and I water it. And throughout the season, I'd check to see, make sure my strawberries were growing and so on, and I think a couple of the guys heard that I had a strawberry plant growing out there, because some of the strawberries were starting to disappear, but also, too, it obviously wasn't protected.

Maybe some rats got it, I don't know. But there were some small strawberries there by the end, and I'm sure that plant is no longer there. But, that was when I started growing strawberries in the baseball field. Now, I want to thank you guys, first and foremost, before I talk about the oblique strains, that thank you for spending the time to listen to my podcast so far, and thanks for sharing it. It really does help me out. I think it helps a lot of people out, too, and I'm hoping that this information, I know that a couple of the interns that have come through my office have told me that this information has been very helpful to them.

So, I'm hoping that we all get more from learning from all these other, I don't know how much I have to share, but all these other people I have on, they're amazing. So, listen to those interviewed ones there, but thank you so much for sharing and listening to my podcast. Now, the oblique strain, I have not done a podcast on this yet, but I did do the article, I did do a video, and again, there was a reason why I did, because I didn't want to forget about it. The oblique strain overall, like an oblique muscle strain, which you see in baseball, you'll see a 15-day DL. I feel for these people, like it is, it's a terrible injury, and I remember when I had it, it was, I mean, I had to eventually tape it just because I felt like my guts were going to fall out.

Movements that you don't even know that you use your abdominal for, all of a sudden become very, very real to you, and it did to me. I mean, there were things like sneezing, which was terrible, bending over to tie my shoes, opening doors. I mean, these are all things where it's like, holy crap, I use my core for this? I had no idea, you know? So what I've found, at least I've had some people come in with this, is they usually don't like a certain type of lean and a certain type of turn. So the ability to resist that, I think, is what the magic is going to come with to prevent these things from coming back.

But the pages I've written on this and the videos I've gotten on this, it's very interesting because they're ranking really well on Google and search. So if you go through and you type up oblique strain and find, you're probably going to find mine first, second, or third. And actually, I'm kind of curious, go ahead and do that. Because I get a lot of emails from people and I feel really bad because these people's stories are really, they're very detailed. I mean, there's details in there that you can't make up. I mean, they're not fabricating these things. These are things that, these are real life stories.

And I feel really bad because I can't really help them, you know? And I say that in a way that I'm legally bound and I cannot help them. And I wish these people lived closer because I know how bad this injury really feels. And it, I mean, I literally thought, I'm not going to play baseball again. I wonder if this is ever going to get better. I think my guts are going to fall out, you know? It's ways on your mind all the time. And it does get better, especially over the first week or so. At least it did for me. But it lingers for a while. And you really wonder, like, especially if your identity is tied to any type of sporting or physical activity.

It's really tough. So I get emails from these people and I can't help, but I feel for you. And the one thing that I think that, and we did have a big disclaimer written up recently for all the online books and manuals that I'm creating, just specifically for this purpose is because I can't really help these people one-on-one. And if you have an oblique strain, I want to let you know that I do want to help. But at the same time, I can't guide you one-on-one because that establishes what we call a doctor-patient relationship. And I haven't examined you. That's just the way it is. And this goes for any healthcare person.

They can't really help you and guide you specifically unless they've seen you. Yeah, because there could be a lot of things that, in presentation, need to be addressed. So what I've done is actually, and I'm pretty much done with this course, there's an oblique strain. I called it Oblique Strains as Managed at Performance Plays the First Eight Weeks. And it's a bunch of videos of the exercises as well as the theory behind why I would include certain types of things. I actually started off with breathing and breathing mechanics. And I talked to my friend about this, and I said, I better frame this really well because I think the lay public is not going to understand why I would say breathing is going to be important in the first eight weeks of their rehab.

And I kind of came to the conclusion after, so one of my friends had a baby, and she had a C-section, and she couldn't do anything. Like, so her back hurt, her leg hurt, so she had nerve-related pain down the leg. And I think of all the stuff that I would have usually given a person like this, because I don't see a lot of people who are just from having a baby or had an abdominal, I don't want to say always a surgery, but when there's been some type of trauma to the abdominal wall, you kind of got to give it a little bit of first aid and time to heal up. So I couldn't give her all the stuff I used to give her.

So I thought, what is she going to do anyways, and how can we improve it? Well, she's going to be sitting better, probably, for her, for that back case, and she probably could be sleeping better positionally. But for the most part, she's going to be breathing and walking, and probably leaning and picking stuff up. So how can we get this to become better? So I thought with oblique strains, starting with breathing is something they're going to do already. And it's a very, very close relationship from the abdominal wall to breathing in a diaphragm, pelvic floor, and internal pressure. So that's kind of where I started with that, and just building the person as the area has a time to repair itself.

Now, I am going to go into my story, but I want to frame that for everybody, because what I did in my story, or in my rehab, was actually different. And this is how I kind of found to manage hamstring conditions, too, is I found out what I did, and I did research along the way, and I figured out where I probably could have improved it. Because I'm not going to get it right the first time, but I am going to figure out things that definitely don't help me, or that my body doesn't respond to. And obviously, everybody's very different. But I find that breathing and stabilization of the torso is actually the thing where I probably should have started within the first week, and certainly within the first couple days.

But I did take the first aid approach, which I'm proud that I did myself that time, because you got to let the area heal up. And that's just kind of how it goes. You tear the skin, you tear a muscle, you sprain something, you got to give Mother Nature a little bit of time to heal it up. And after that, we can do a little bit more with it. When the abdominal area is affected, we really can't do a lot. And there's a lot of things that really hurt. And with my oblique strain, I was not able to do a ton of things. I mean, I literally found out that first week that I used my core doing all of the things that I typically do, like putting on shoes, getting into a car, even pushing the pedal down in the car was painful.

Sitting up, rolling over, leaning to one side. I couldn't run. I couldn't laugh. I couldn't sneeze. In fact, sneezing almost took me to the ground. And actually, it did. I remember actually, I was on my stairwell, and I sneezed, and I felt like all of my, or some of my intestines were coming out of that area. Now, for me, it was on the left side, kind of right around the margin where the obliques or the abdominal wall and searched into the rib cage. So at the time, I wasn't really sure if it was a rib fracture or if it was an abdominal strain. But even going number two was painful, but sneezing especially, I mean, it scared me to death for a while.

I was thinking, don't get sick, don't get sick, don't get sick. Because if I had to sneeze again, I might just lose my innards. And so actually, before I sneezed, after that, I actually put my hand over the area where the injury was firmly and then sneezed and it actually helped out, maybe it decreased rib expansion for all I know. But I actually doctored up a tape job based upon that. And you can see that throughout my page, which I will link into the show notes as well. And I did one of these on a soccer player the other day, actually, too. Surprisingly, it works because what you notice with oblique strains, or at least what I did, was that I couldn't turn, well, I definitely couldn't tilt away.

So it was passive range of motion tilting away from the side, which was a problem. So if it was on my left, I couldn't tilt right. But also there's a rotational component. I'm pretty sure I couldn't rotate to the right as well. So I doctored that tape job up to really limit that. And I did the same thing on that girl this week. She was a soccer player. And it just reminds me of that I haven't done a ton of these tape jobs. But every time I do them, I think, man, I wish I would videotape this thing so everyone can see. Because I used this tape job for at least a week. And I think it saved my ass when I jumped on a plane and went to San Francisco.

And I was thinking, don't get sick. Don't get sick on the airplane. Don't sneeze. And I know that it, I have this thing about airplanes where, you know, like, I must get into my head that after I jump on a plane and get to the place, I get sick. And maybe it is in my head. I don't know. But I went to Italy over the 2018 early part. And I got sick in Italy. So who knows? Maybe it's me wishing upon myself. But either way, I see there's a lot of people struggling out there and not being able to know either how to manage this from a clinical standpoint or just patients thinking, I don't know what the hell this is and what to do.

And like I said before, we can't really manage those people. But I can do a write-up as we manage it at our place so I can tell you the things that we're doing and how I manage my own even through my story. And if you are reading it as if you're reading a Mark Twain movie and you realize don't drink stump water, then I'm hoping you get that from it and you go to see someone who can help you implement something like that. When that is complete, I'll leave it in the show notes too. But I actually sustained mine during playing baseball. And I was in right field at the time. It was the first inning or second inning.

I remember it was very early on in the game. And I'm the type of player who doesn't really want balls to get by him. I like diving. I actually, when I was in high school, actually, we did diving practice, me and a couple friends. You know, it was just a fun skill. It feels good to get it and especially the balls are a little bit out of reach. So this one in particular, it was over my head to my right and it tailed away. It was going towards the right field line. So I took a slight bad angle on it and I had to jump and turn, glove hand. I'm right-handed, so it was a left hand going over my shoulder.

And I had to actually, I actually landed on my back and I caught the ball. But the overextending and rotating and arching of the back, I think, strained the area. It wasn't the impact. It was actually the catch, being up in the air like that. So I'll go into a little bit why I think that was a problem for me in the first place. I don't think I conditioned well as one part, but I think there's a pressure issue on another. But, I mean, if you look throughout even Major League Baseball, you'll see people are on a 15-day DL with these things. I mean, it's not an easy injury because you can't do a lot of things and you also can't do a lot of training around it.

And let's just say you have a rotator cuff condition. You can do leg work, you know. You can pull a sled. You can do stuff like that. But you can't really do that with an oblique injury and you're kind of like, you know, stale right there. So the things that I actually did to be able to have a little bit of control was, number one, I needed to get a right diagnosis with it. And everything inside me told me it was the oblique because it wasn't the impact. It was the stretch of it or the abdominal wall, rather, because we didn't know at the time what muscle it was. But I thought maybe it's a rib, you know.

And I've heard stories of people having, we call them soap bubbly lesions or just expansive lesions on the rib where it just makes the rib fragile. And it breaks with things like sneezing and jumping and so on. So those aren't, I mean, you don't want to have one of those. So I actually went, when I realized what I could do for it, I went and got a musculoskeletal ultrasound from a friend, Mike Jabilon. I went over to his house and he's one of the best sonographers that I know. And he checked it out and we checked along the rib and I really wish we had the images of it. There was a podcast that I did actually where I was talking to him about it.

And I don't think either one of us has the images anymore, but I think it would have been interesting to see for you guys. So we eventually found out it was, there was no injury to the rib. It was just the margin of the, where the muscle meets the rib. So I knew that I just had to kind of manage it like a musculoskeletal injury and just make sure to give it a little bit of time to heal its gap up a little bit and like that. So I took about three weeks roughly and, um, you know, actually let me retract a little bit because I remember more about that game. I mean, that was, this was probably like, gosh, if I look back at when I wrote the article, it was probably about like 2014, maybe 2013.

You know, I think it was long. I think it was, well, I was on the nationals. So, uh, yeah, I had, had to be less than five years ago. Um, but I remember actually that was the, the incident in the beginning was, um, during the, it was the hint of it with the extension or the arching, but eventually it was on a base. It was on a swing that it happened about in the seventh inning. And that's when I felt the pop and intense pain. And, uh, actually I remember that at bat. Um, I was just kind of hoping to God he would throw balls cause I didn't want to swing anymore. But then at a certain point you can't really step out of the box and just trade out like you're going to mean out.

So I was thinking if I can hang in there for a, um, uh, a walk, then I'd be okay. Then I would get a pinch runner. Um, or I could just, uh, bunt the ball or at least fake a bunt and psych him out. And then I would be on base and that would be it. So I really didn't have a good idea of, um, of what this injury was when I was playing. And I remember going on the side of the dugout after that, just almost make myself sick thinking about it. Like, I don't know what this thing is, but, um, almost every movement hurts it. So, uh, I need to figure this thing out. And I took the rest of that game off right there.

Um, so after we found out that it was, uh, actually, you know, the oblique injury by the musculoskeletal ultrasound, um, I did feel a lot better, but I felt a lot better about it. I wasn't happy about it. And I kept thinking, like, why did this happen? You know, why, why did this happen to me? Um, what could I have done to prevent this thing? What do I need to do now, um, to get it to improve? And that's something I, uh, I don't always do with all my injuries because it takes me a second to really sit, let it sit in and think about it from a logical way. I'm thinking, what can I do right now? Like, this, this happened to me.

It already happened. I can't do anything else about it. It happened. What can I do to make it better? So, at that point, that's when I implemented that tape afterwards. And, uh, you'll see the picture of it. I used Leuco tape, uh, which is a non-stretchy tape in it. So, restricted my movement. Um, I'm not going to say things like the stretchy tapes like KT and rock tape and all that stuff and aren't going to work. But, at the same time, um, I need to restrict movement and more of a structural tape is what I opted for. So, Leuco tape is very, very sticky to itself. It does not give at all. Um, and you need to have a cover roll under it.

So, I had a cover roll. And I remember thinking about the fifth day or so, uh, after you even shower with it. And, like, it gets a little, little soggy under there. And it starts to dry. And it kind of toughens and so on. And I, I thought my skin was about, like, probably rotting underneath it, honestly. Um, eventually, when I did take it off, about five days after, um, I took a, I took a shower and then took it off after. So, I wouldn't have, uh, ripping my skin off, basically. Because some people have a reaction to that or they take it off before the shower. Um, the skin was fine, which is great.

Um, so, about three weeks later or so, um, I started into some light training. And I probably would have done this very different, uh, now, now that I think I know better. Um, but that's why I'm, I'm still growing as a clinician, probably just like everybody else. Um, but back then, what I did was, I'm going to read this off this, uh, website. So, my first workout was an isometric abdominal workout as a warm-up. Concept 2 rowing at 50% effort for 1,000 meters. Uh, barbell hip thrusters, 65 pounds for reps. I just kind of went to whatever reps I felt like. There was no goal in this. I was not in a CrossFit workout or anything.

I did Bulgarian split squats at 26 pounds for reps. And then front squat, 85 pounds for reps. So, I didn't have pain with this, which is great. But I still had pain with sneezing. I think it's an important thing there. So, I really wasn't, uh, healed up. Um, but I was good enough to where if I held a certain position, I was okay. Probably looking back now, and what I wrote up in part of this, um, uh, oblique program is that I, I still think back of what I could give, uh, my friend's wife, we, after she had a C-section, um, she was, she was, uh, weeks after. And, and I don't know much about C-sections, but I do know that it's, it's a slicing of the abdominal wall.

So, you have to be very careful to not, I mean, you can't tear that thing apart, right? So, what I thought was that why is one area stretching in the abdominal area when the, uh, why did it have to overwork? And why was it, um, fragile to that? And so, now I go to the concept of intra-abdominal pressure, really, is was my water bolus compressed enough and secure enough with the arching or extension of the back to protect against the musculature having to do excessive work? So, at this point, I'd say my answer is no, and that's why I think actually breathing is probably one of the easiest things we can give people in the beginning.

Um, so, uh, the reason I say this is because breathing, um, happens via function of the diaphragm. The diaphragm has to depress to secondarily, um, create stabilization for the, for the abdominal area around the spine, um, which then helps out with making it so the abdominal wall, as well as, uh, muscles crossing this area don't really have to work that much or work as much anyways too. So, I believe sports hernias are the same reason too. So, anytime I find someone now who has an oblique strain, I think intra-abdominal pressure first, since they can't really do anything, we think, well, what are they going to do anyways?

Well, they're going to breathe, right? So, we might as well just do high quality breathing in different positions. Um, before we actually do isometric move or isometric exercise, uh, the last person that I had come in, uh, that soccer player. So, we worked on breathing mechanics. We worked on it in a face down position. We worked on it in a frog position. And then we got into, I was just checking. I want to see what else she could do. Could she do, um, uh, lateral wedging? She could on one side, but not the other. It lit her up. Um, so it was too early for her on that. Um, and consider the safety of those movements typically is, I mean, they're isometric non-movement contractions.

They, if you can hold position and not overload the area, I think you think you should be fine. Um, but it's just too early for some people at some points. So, people with oblique injuries, I usually, uh, and sports hernias, I, I'd say, let pain be your guide on it. And I certainly did. I, I tested things on, on the third week and I, I did some isometric work, but I, but I would have stopped if it was painful. I did hip thruster stuff, which requires some abdominal bracing. Um, but the weight wasn't really heavy and I didn't blow through pain. So, I think that's the most important part on, on the early rehab is that makes you making sure that the pressure is adequate.

Um, because we're going to be breathing anyways. I mean, if I'm spending three weeks not doing anything, I might as well be damn good at breathing. And so, that's kind of like where the oblique strain program is going to, uh, really starts with us. Um, and then it gets an isometric contractions and then, uh, ball socket disassociation, which is going to be movements of the hip in different ranges while we still keep the torso, uh, stiff or stiff enough to where we don't create symptoms. Obviously, there's a lot more beyond that. Um, but at the same time, we, um, these are very fresh cases. They're, they're up into eight weeks or so.

So, we just be, got to be very careful with them. Now, for me and my personal one, um, I, the next step I took was really around the fifth week where I started swimming. And I thought swimming would be cool because it was, it's basically, so, water resistance. I'm going through movements. There's some rotation, some extension because my, uh, or, uh, lumbar extension because my form is not that great. And I also started to use the TRX Rip Trainer, um, which is more of an isometric hold. And I didn't go through the ballistic movements of it. I just basically just held positions to see if I can get it to, um, stimulate different slings of the abdominal wall as well as the back side.

So, I might do this differently now, but the TRX Rip Trainer wasn't bad in that case. So, uh, it was a little uncomfortable at the time in the first few laps that, um, I recall, but it dissipated. Um, I wouldn't necessarily work through pain again. I probably would have just gone to a kickboard or something and probably put a noodle under, under my, uh, belly to make it so I wasn't arching and stressing that area. Uh, around the sixth week, I swang a bat again. Um, and if you've never had an oblique injury, you wouldn't understand, or even a back injury, you wouldn't understand this quite as much, but a lot of people have it with different injuries as they are scared to death of the thing that created it.

And, um, I, I would not imagine, I was so afraid to swing the bat, um, it was, I mean, I was just going to slap the ball, literally. Like, I did not want anyone to pitch inside. I did not want to miss the ball, and I just wanted to, um, just kind of go through the movements, you know. Um, but it was, it was, it was startling. It was really scary. Um, but I was okay, and, um, there was not a lot of discomfort. It was just more of getting your reps in. So, there is a concept, if you are, are an athlete, um, a competitive one, that you have to make sure that the, um, training of the individual doesn't go down with the injury as well.

Uh, meaning if it takes, you know, uh, five weeks of rest for an injury to recover, whatever that might be, it doesn't mean we always rest the individual. So, still doing skill work is important. So, even standing in the box and seeing pitches, and maybe bunting probably would have been okay for me there. I didn't necessarily need to be, uh, hitting, um, but, you know how it goes. You always want to try a little bit more than you can. Uh, around the ninth week, I kind of decided I wasn't really going to have an oblique strain again. Um, so I started adding rotation and lateral movements into my training because I realized that, um, over that winter time before the season started, like, I was really just doing sagittal plane movements, bilateral sagittal plane movements, front squats, back squats, deadlifts, cleans, and so on.

Um, but I really wasn't challenging my body's ability to anti-rotate or anti-extend. Um, looking, looking back, I definitely should have, and so at that point, I started to implement a little bit better, and that's kind of, um, the progression where I, I like, where I like to have people in my office do that. Um, I find that a lot of times their, their training is a little bit subpar, and especially if you have someone like a weekend warrior like myself, like, I don't spend the winter time, uh, hitting balls or, or throwing for that matter, and I probably should be at least spending a little bit more time, you know.

So, um, that is, that's the basis of my injury from an oblique strain point of view. Um, just recapping on some things that I probably are, um, uh, that I'm probably going to put into the program is, again, breathing is king on this stuff. And, uh, if you've heard all my other podcasts or a lot of the other podcasts, we've dipped into things like intra-abdominal pressure and breathing mechanics or proper breathing for, um, abdominal wall, for pelvic floor, for the diaphragm, um, for muscles that cross. And it's, it's been brought up by a lot of different people unsolicited. And, and I like to say that I, my interviews are ideally not very, I don't want to lead the questioning series too much.

I will, I will dig in a little bit more, but I try not to lead someone into saying, uh, hey, what's the answer to that? Yes. Is it yes? You know, and they say yes. And it's that, you know, like, oh, I knew it. Um, I try not to do that a lot. I try not to do it at all really. Um, but these people kept bringing pressure up, you know, breathing up. And it's, it's really interesting to see that a lot of times the public will, they, they don't see this and rightfully so because, um, hip conditions, knee conditions, um, there's a lot of peripheral conditions that can be improved with better, uh, midline stabilization and proper breathing is just one of the fundamental aspects of it.

Um, I remember a, uh, friend in school that he, he told me he was going to a breathing seminar back in 09 or, uh, 2010 and I thought that's nuts. You know, that's, I, I, I don't know if I can sell the idea to patients. I don't believe in enough myself. Um, but I do, I really do now. Um, and just to understand the diaphragm, uh, there is a section I have on a low back page. If you search low back on my, on my site, it'll pop up. Um, there's a section on breathing and the, the main breathing function is obviously to get oxygen, oxygen in and no one's going to refute that. Um, at least not that I know of, I certainly wouldn't because the, the function of breathing is to get CO2 or sorry, to get oxygen.

CO2 comes with the two. Um, it's to get oxygen. All right. But also it creates secondary effects. It's kind of like, um, when you, when you look overhead, when you look up, your eyes go up there, but also to your neck, um, art, uh, extends. It's just a secondary effect. You know, um, when you lean forward into the balls of your feet, your body follows, follows it. Secondary effects. Now breathing, um, the primary function of breathing of getting air in, it depresses the diaphragm downward, almost like a parachute. Uh, and it is kind of like a parachute shape, uh, muscle. And then on the bottom under it is a fluid cavity, almost like a water balloon.

So when you compress a water balloon, I did have a patient, uh, who described it in a really easy way. I said, what happens when you compress a water balloon? He says, you keep, you pancake it. So you pancakes out the sides, which then stabilizes, um, almost like a bike tube. I think Dan John put it that way best is when you inflate a bike tube, it has the ability to, so to provide support. But if you don't inflate it properly, uh, or if it's underinflated, then it's not going to, uh, supply the support. So with oblique strains or sports hernias, we kind of the same thing. It's just these muscles of around the abdominal area, the torso, um, they're, I think they're mainly issues of pressure primarily.

And it doesn't always start that the person is gasping for air or they, um, uh, they have a breathing disorder like that you can actually qualify such as COPD or emphysema or something like that. They, they, they basically just have a lot of times, um, I don't know how to put it. Um, you can visually see it. They have hills and valleys and craters and, um, diastasis and, or splitting the abdominal wall, or they try to be excessively skinny. These are just all signs that their breathing mechanics can improve. And, um, Brian Carroll actually put it a good way, uh, in regards to, um, doing the McGill big three.

Anyways, he, he, he said it was like a bank account and I believe breathing is the same way. Cause I have people come in and they're like, well, I don't know how I'm supposed to learn how to breathe. I breathe all the time and I just can't remember it all the time. I said, well, you don't have to remember it all the time. Let's just put in some good reps. And if you think of it like a bank account, you have to make deposits before you make withdrawals. So the more good reps we put in to breathing, the more withdrawals of terrible breath we can take. And at some point you're going to, it's going to catch.

It's going to remember. It's kind of like when you have a morning habit, you've been trying to, uh, get down and, uh, you know, make it a habit. It's, you might forget a couple of days here and there, but the more and more you do it, the more and more it sticks. Um, but I think that's the easiest way to think about it. Make good deposits, make good breaths, check in frequently throughout the day. Um, the, the tools I put into this program that I'm going to make, uh, for everyone to kind of see how we manage these things. Uh, there's, I had a patient that came in recently that we're, so we did a face down breathing on the ground and he said, uh, so I had him do it before we did a couple other things.

And he's like, do I have to keep doing this at home? Do I have to keep starting with this? And I said, well, I'm, I'm like, it's not a bad idea in the beginning, you know, like what does it take? Like 30 seconds, you know? And, um, he said, well, am I going to have to keep doing this? And I said, well, no, I don't think you have to keep doing it. And I'm like, it's kind of like calculus and, and, um, addition, you know, it's like, well, maybe algebra and addition anyways. I'm like, once you know the basic addition math, I'm like, you don't have to refresh it every time you go and do algebra. It's just, you know, it's a starting block and you're, you're learning it right now.

So why not just put some reps in? It's not going to really hurt. So three weeks of really putting the reps in is, I think, going to put these people in a really good place. And, um, injuries are, they're not always a bad thing. I mean, they're a bad thing if, if they leave you maimed and disabled and so on. But a lot of times, uh, I think when your body just speaks to you like that, it's kind of like just a wake up call, you know, cause there's a lot of other terrible things that could have happened at least to me with that. Um, and it's just a sign that I needed to improve on certain things. So just some takeaways on things that I kind of went through in this podcast already to make sure, cause I know there was a lot of storytelling is number one, to get an area to repair itself.

If you think about a scar, you can't start moving the skin all around and stuff and you probably can't rub at it and so on. So, uh, when you have an oblique strain and at least a confirmed one, it's an area that has to repair itself and it takes a little bit of time. And I always tell people, you can't really increase this healing time, but you can delay it by doing the, by doing a bunch of things wrong. And I would rather have people do things right. Kind of like, um, I was usually analogy of a Jenga game. So the Jenga tower, if it's all stacked up really well and you can literally stand on it and it's not a problem.

I mean, you can be balancing a cup of water in your nose and you're probably still good. But as soon as you start taking a couple of blocks out, uh, or at least shifting them and, uh, kind of stacking them poorly, then it starts to get hairy really quickly. And when you're repairing there, it's kind of the same thing. And if you think about that scab again, that scar, just put a bandaid on it. Or if you get a cut, you suture it and you don't like wiggle it around. You don't move the joint a ton. You might move it later on, but in the beginning phase, you might not do that. So when it comes to things that we're going to be doing already with an oblique strain, you're going to be breathing, you're going to be sitting, you're going to be standing, walking, maybe pushing a stroller and in my friend's case.

And, uh, so improving the posture and all these, and also, um, improving mechanics of how you move at least your own body is really not a bad thing. So in the first week, what I really give people is a lot of breathing stuff and a lot of coaching into how to move their body. Now in the, in the eight week manual, I, I, I just realized maybe I should add something. So maybe I'll put things of how to stand, sit and walk. I don't know yet, um, be, but I, I, but I already did add breathing stuff in the first week. And what I use, what I'm going to add later, usually in the second week is more stimulation to the actual abdominal wall in different planes of movement, the frontal, the transverse, the sagittal plane, and so on.

And then we want to actually improve the hip motion as well. So ball and socket dissociation. And then we start to work on ground contacts or foot contact. And these are weeks and weeks in advance. And I had someone ask before, they were kind of proofreading this for me. They're like, so how come there's not different exercises every week? I'm like, well, didn't you can, you need to build stuff before you move on to something else. So some of the weeks are just, they, they take a little bit of time. It takes time to build that stuff. It's not an aggressive process. Learn to trust the process. So what I might do with this though, I just, I need to talk to my advisor on this is I would like to give everyone the first week of it for free, um, or at least a severely discounted rate because this is going to be a thing that's sold.

Um, I, I'd love to say I can give everything away for free, but I, uh, I have a saying that if I invite you over for dinner, steak, lobster, and so on, it doesn't mean I have to give you my house. So I'm, I'm glad to give a lot of things away, but at the same time I do need to make a living as well. So, um, I might give away the text, um, just to frame it kind of like this podcast as well as the first week, but I got to talk to him. If you're interested in that, go to my website, type up oblique, and there's going to be a email opt-in. Just put your email in there and then you're going to, uh, if, if there is something on the other side of that, um, I'm 90% sure there will be, then, uh, it's going to come through that format right there.

And if you're open to getting the rest of the book, then you can, and you'll be prompted to do so through that email campaign as well. Um, I won't spam you. I won't send you junk. It's all going to be oblique or sports hernia stuff. I promise. So, um, I do plan on making some mini courses too, by the way, and this is a tangent a little bit just because I do have a lot of friends and people from different places that ask like, Hey, I got this back issue. I have this hip issue. I have this knee one. What do I do? And I'm like, well, that is a great question. Can you go on my website and just type up or search knee?

And they're like, well, I looked at it and I don't know where to start. And I'm like, okay. So this is, um, I want to help, but at the same time, I can't, I, I, I can't literally spend this much time with this many people. Um, I would go bankrupt. And I did have a friend come in and we did a video shoot. So she supplied me with some video and, um, we looked at her knee and it was an hour and a half almost, actually it was almost two hours we spent. And she's like, I can't believe this took this long. She's like, I feel, I want to pay you something. I'm like, no, no, no. You gave, you gave me your time and you were willing to be on camera and you signed, you signed your, uh, your healthcare law away basically.

So I can share this a little bit. So this is fine. But you made a good point is that I don't think a lot of people understand that management of these conditions and recommending the correct things that comes with eval. Um, and obviously, um, I mean, I, I think, uh, I've, I've heard a couple of people say this is that we do similar things with a lot of different types of cases with minor tweaks. So I want to, I want to make sure that when I'm writing these things, uh, especially those mini courses that are going to be available, they're going to be, uh, probably about a week, maybe two week mini courses.

They're going to be on the things that I generally work with certain types of cases, but obviously I can't, um, modify those. Um, but I'm hoping it helps a lot of people and I'm hoping it helps a lot of people very quickly because these, these people that reach out to me, I really do want to help. But at the same time, like I would love to answer every single email and phone call that comes in, but I literally can't do that. Um, so if you guys want any of the knowledge that I have on certain topics, please go through those avenues. Um, and let me know how can, uh, how I can improve them actually.

So I think that's going to be the end of this podcast here. So again, this is going to be, uh, show notes on p2sportscare.com, uh, look up oblique strain or oblique podcast, and you're going to find it. I think this is going to be episode 97. So I think if you took a look up podcast 97, you'll find that as well. Lastly, if you're a healthcare provider, especially ones that are barely out of school, um, and you like all this information, please visit the website and listen to all the podcasts because, um, I had one of my interns, he, he texted me on the blue and he said, everything on your site is literally what all these students need, what all, uh, all of us students need.

Um, so I was, I was really happy you said that. Um, a lot of people I've interviewed have been amazing and they're people that I learned, I've learned a lot from, and I put all that information out there so I can remember, but also too, so other people can learn too. Um, and so if you go on that website, young providers, um, I guess, I don't want to say, I don't want to say young, young or inexperienced because I'm still learning too. So, um, but yeah, if you feel like you want to learn some more for rehab and corrective exercise and how to manage human movement, restoring human movement, then go ahead and go on there, um, and just search whatever you think.

Most of the, uh, audio and video stuff are intended for people just like you. A lot of the text and less transcription are intended for a lot of lay public. It's just the way they're written. So find as many of the verbal and visual things as you possibly can. There is a store in there for stuff like posters and manuals that I've written for clinical reasoning. Posters are mainly for patient education, but I've, I've created a lot of things to scratch my own itch. And these are things I wish I had the first year in clinic. So I made them really affordable for you guys. So please go through there.

Um, I made them with you guys in mind. Lastly is make sure to treat each other, uh, really, really well and leave each other better than how you found them. Eagle Scouts rule. Talk to you soon.