Mark Bell's Power Project - The Many Ways to Heal Chronic Pain - Mike Stella || MBPP Ep. 1008

Episode Date: November 13, 2023

In episode 1008, Mike Stella, Mark Bell, Nsima Inyang, and Andrew Zaragoza talk about how pain management isn't a one size fits all and how a good trainer will utilize many tools from different schools of thought. Follow Mike on IG: https://www.instagram.com/mikestella_atc/   Official Power Project Website: https://powerproject.live Join The Power Project Discord: https://discord.gg/yYzthQX5qN Subscribe to the Power Project Clips Channel: https://youtube.com/channel/UC5Df31rlDXm0EJAcKsq1SUw   Special perks for our listeners below! The Athletic/Casual Clothes we're wearing! 🕺 ➢ https://vuori.com/powerproject to automatically save 20% off your first order at Vuori!   💤 The Best Cooling Mattress in the GAME! 🛌 ➢ https://www.eightsleep.com/powerproject to automatically save $150 off the Pod Pro at 8 Sleep!   🥩 HIGH QUALITY PROTEIN! 🍖 ➢ https://goodlifeproteins.com/ Code POWERPROJECT to save up to 25% off your Build a Box ➢ Piedmontese Beef: https://www.CPBeef.com/ Use Code POWER at checkout for 25% off your order plus FREE 2-Day Shipping on orders of $150   Best STYLISH Barefoot Casual/Training Shoes! 👟 ➢https://www.vivobarefoot.com/us/powerproject to save 15% off Vivo Barefoot shoes!   🩸 Get your BLOODWORK Done! 🩸 ➢ https://marekhealth.com/PowerProject to receive 10% off our Panel, Check Up Panel or any custom panel!   Best 5 Finger Barefoot Shoes! 👟 ➢ https://Peluva.com/PowerProject Code POWERPROJECT15 to save 15% off Peluva Shoes!   Sleep Better and TAPE YOUR MOUTH (Comfortable Mouth Tape) 🤐 ➢ https://hostagetape.com/powerproject to receive a year supply of Hostage Tape and Nose Strips for less than $1 a night!   🥶 The Best Cold Plunge Money Can Buy 🥶 ➢ https://thecoldplunge.com/ Code POWERPROJECT to save $150!!   Self Explanatory 🍆 ➢ Enlarging Pumps (This really works): https://bit.ly/powerproject1 Pumps explained:      You Need Greens in your Life 🥦 ➢https://drinkag1.com/powerproject Receive a year supply of Vitamin D3+K2 & 5 Travel Packs!   ➢ https://withinyoubrand.com/ Code POWERPROJECT to save 15% off supplements!   ➢ https://markbellslingshot.com/ Code POWERPROJECT to save 15% off all gear and apparel!   Follow Mark Bell's Power Project Podcast ➢ https://www.PowerProject.live ➢ https://lnk.to/PowerProjectPodcast ➢ Insta: https://www.instagram.com/markbellspowerproject ➢ YouTube: https://www.youtube.com/markbellspowerproject   FOLLOW Mark Bell ➢ Instagram: https://www.instagram.com/marksmellybell ➢https://www.tiktok.com/@marksmellybell ➢ Facebook: https://www.facebook.com/MarkBellSuperTraining ➢ Twitter: https://twitter.com/marksmellybell   Follow Nsima Inyang ➢ https://www.breakthebar.com/learn-more ➢YouTube: https://www.youtube.com/c/NsimaInyang ➢Instagram: https://www.instagram.com/nsimainyang/?hl=en ➢TikTok: https://www.tiktok.com/@nsimayinyang?lang=en   Follow Andrew Zaragoza on all platforms ➢ https://direct.me/iamandrewz   #PowerProject #Podcast #MarkBell #FitnessPodcast #markbellspowerproject

When did this pain problem really start? You know, we look at like in the 50s, we had a lot of soldiers coming back from World War II. That's when a lot of money was being spent on, in the pharmaceutical industry, on solving the pain problem. How do you optimize the short-term healing so that you get the best long-term outcome? Pain is multifactorial.

Therefore, it can be modulated or you can mitigate pain by a lot of ways, including just having a conversation with someone. What percentage do you think of jujitsu athletes face low back pain? It's 100%. It's 100%? Basically, if you do jujitsu, you will get low back pain at some point. I think the FRC system lends itself really well to jujitsu athletes as a way to build capacities and ranges that would otherwise be vulnerable for you. builds capacities and ranges that would otherwise be vulnerable for you.

Power Project family, we've had some amazing guests on this podcast like Kurt Engel, Tom Segura, Andrew Hooperman, and we want to be able to have more amazing guests on this podcast and you can help it grow by leaving us a quick rating and review on Spotify and iTunes. If you're listening to the podcast, just go ahead and give us a review. Let us know how you dig it and help the podcast grow so we can keep growing with y'all and bring you amazing information. Enjoy the show. Well, you're usually pretty angry. Yeah, I just think people are just super specific. You know what I mean?

You got to like, you got to know. It's like kind of like going to church. You have to know all the rules. And like people come to Long Island. It's like, you don't know the rules. Like get out of the left lane if you're not going to drive fast. Because that's our lane, you know? So otherwise you're getting honked at. If you wait an extra 10 seconds at the red light, you're getting honked at.

If you're slow, you're going to – Listen, don't take it personal. It's just follow the fucking rules. These unwritten rules that we all have. Follow them. And if you don't know, now you know. I remember I went to a sandwich shop that I hadn't been to in a long time. I lived in California for, I don't know, like two or three years.

I went back to New York and went to this sandwich place that I used to go to all the time. And it, you know, it says order here. So you're saying they're real specific. And I was like, ah, he's like next. The second I had hesitation and I was like, what the, and then it happened like one more time. I'm like, damn it. I'm like, what's that? Uh, I lost my, uh, my quickness around here. Oh God. Now, now it's going to kill me. Cause you're from Poughkeepsie. Yeah, Poughkeepsie. What's the name of the sandwich spot? Do you remember?

Like Girardi's or something like that. Some Italian spot? Yeah, some Italian guy. I know exactly what you're talking about. Because we used to go there all the time. And yeah, they would just be like, if you didn't know what you wanted when you got to the front of the line, you went back to the line. Brutal.

Like, we don't have time for you to figure it out now that you've been waiting 20 minutes for a sandwich. So you're going to go back to the, you could think about it. There's like order here and pay here. And if you're in the wrong spot with the wrong thing, then they yell at you the whole time. At least we have thick skin from it, you know, develop a little thicker skin. Scars maybe. I wonder the New York life expectancy versus the rest of the United States.

Oh, it's definitely not a blues home. Probably like 62. Highly condensed pollution, angry people. I'm actually 18, guys. I just look like I'm 40. From my toxic upbringing, but it's all right. It's fine. It's details, details.

How long have you been investing a little bit more time and energy? You're mentioning you have kind of a bunch of cameras in your office and stuff. How long you been putting a little extra time and energy into the social media side of things to get the name out there and to get your message out there? It's, you know, it's really funny because you guys, like you reached out to me and just when I started getting back into it, I took like a six month, eight month break where I really wasn't posting much, you know, the last few years, probably around 2016, I read Gary V's book. Cause I was starting my own business. I was like, I want to get my message out there. Like I had some clients, people who knew me from the area, but I started producing

content, you know, and you know, for me, I'm an athletic trainer by trade, like an ATC. So it's very rare to see an athletic trainer in private practice. It's, you know, that's more common like PT Cairo to do that. So I'm kind of a trailblazer in my profession a little bit. So I was worried in the beginning of like how people would receive my contents. Like, oh, you're not a DPT, so we don't want to listen to what you have to say. And, you know, because at least on the healthcare side, maybe less so on the training side, but on the healthcare side of it, there's a lot of this, like, gerrymandering and like, oh, I'm better. You know, we're better because we have a doctorate and then you and this and that. But I started putting stuff out there and overwhelming, you know, response was positive.

So that gave me a little bit of like confidence to continue to do it. And then recently I expanded my, my business from like a thousand square feet to just under 5,000 square feet. So I'm like, I really got to start, you know, hitting this hard again. We added like a training, you know, we were just doing like the rehab side. Now we do the training side. So I wanted to put more stuff out. And one of my former athletes who we worked with for years,

he was like trying to get into videography stuff so I was like hey man like if you can help me get some more content while I'm just doing my thing instead of having it be as staged and then all of a sudden like the last like three months it's been insane so again all good stuff plenty of bad stuff too but I'll take it you know I'll take I'm here which is insane you know that's really cool how did you kind of get into all this stuff in the first place? The classic. I was a high-end lacrosse player in high school and kind of had the world in my hands, and then I tore my ACL, PCL, MCL, meniscus, tibial plateau fracture. All at one time?

Yeah. Oh, my God. The official diagnosis was fucked. That sounds brutal. So basically I dislocated the knee, and the lateral condyle fractured my femur. So it compressed my femur. That sounds brutal. I didn't make a decision, excuse me, because I didn't know where to go. You know, recruiting then was a little bit different. But, you know, long story short, Marist College was the last D1 school to offer me any scholarship.

Poughkeepsie in the house. Poughkeepsie, baby. And they happened to have an athletic training sports medicine program. So it just kind of worked out that way. But then the further I got into school and, like, learning about, like, rehab and training, I was like, all of this is bullshit because all of the gains that I made in my own rehab happened like with strength and conditioning, not necessarily like the rehab stuff I was doing. So after that, I just kind of was the guy that was always hurt, you know? And for me, that was like, it became like a bit of an identity crisis, I guess, because all of a sudden I went from this, you're the man you can, you're going to go play big time

D1 and for free, go to school for free. And now I can't even run down the field without being in pain. So it, you know, depression, anxiety, all those things start creeping into the equation. And then like I was, I was telling SEMA, like in my twenties, it was really out of a selfish motivation to figure out my own issues was like going to take all these con ed courses like i wasn't like partying or hanging out i was like spending every nickel i had and go into courses and and uh trying to learn as much as i could and then here we are like 20 years later so what i find exciting about like this sort of field i mean you're you're in a field where you're like you're responsible for kind of healing people in a way. Sure. People are coming to you with their problems, and you've got to try to figure out a way to solve them. So I find it all really interesting, and it can get weird. But it's like, how weird can it get before it's too weird? How do you decipher what's too weird?

What doesn't have enough science or information behind it? Because, I mean, sometimes, you know, somebody having a particular injury, maybe there's like other shit going on in their lives. And that has a lot to do with the pain that's registering on their body. But sometimes they legitimately just have a twisted ankle. Like a mechanical issue. Yeah. But it's not always like in their feels, you know, but how do you kind of decipher how you pick and select information that you're going to choose to start to implement into

your practice? I think what you're talking about is the difference between the science and the art. I think what you're talking about is the art of healthcare and the art of treating people. And again, early in my career, it was very like this, mechanical lens and I'm looking at structure and just like the classic stuff that we all look at. And then as I've learned more and more about the neuroscience side of this,

and like, there was this crux in like the late 2000s where we had kind of two schools of research coming out as far as like manual therapy goes. So I'm gonna kind of answer your question a little bit of a roundabout way, but I was really into manual therapy for my time at the university of florida like we were working with track and field athletes and you know basically tuning these dudes up before they would go run and we're hundreds of a second the difference between

winning and losing so my mindset then the mindset there in the sec was results by any means necessary period doesn't matter what the efficacy or the science or the research says. It's like, is this going to give our athletes a 1% edge legally, of course? We're going to do it. We're going to do it, right? So money is not an issue. You take your time with your athletes.

There's three athletic trainers for every team. Do what you got to do. So around the late 2000s, we started to see researchers looking at the biomechanics like the breaking strain of connective tissue and starting to realize, well, guess what? You know, connective tissue is a lot stronger than we thought it was. So we're not breaking stuff up with our hands or tools. But we did see people were getting better. So a lot of and then at the same time, that's when like the pain science stuff really started coming along.

And like understanding that pain is multifactorial therefore it can be modulated or you can mitigate pain by a lot of ways including just having a conversation with somebody so for me i was physical pain yeah just from a conversation there's um so you guys heard of like fibromyalgia or like chronic regional pain syndromes these are like catch-all diagnoses like they can't figure out like a structural biomarker for why you might have physical pain, they'll just diagnose you with fibro so they can put you on drugs. But the problem, so there was research, and I don't know the exact study,

but I'll see if I can find it for you guys. Looking at the correlation between people with early childhood trauma and then the manifestation of physical or idiopathic pain later in life. And there's a strong correlation. So people who are dealing with maybe more mental and emotional trauma or struggle, but their experience is still painful physically. So it's just so complicated and interwoven.

So the way that I do it with my clients is, like we were talking about earlier, is like, I'm just looking for the ROI. I'm looking for the return on their time investment. And that's why I love manual therapy. So for me in a 30 minute manual session, maybe it's just my opportunity to talk with somebody and like, let listen maybe more.

Maybe I just let them dump it out and get it off their chest. Cause I might be the first healthcare provider that actually listened to what they had to say about their own issue. So I try to like the old, you know, I forget who's, I think the quote is for us. Like, you know, we have two two ears and one mouth so that we can listen twice as much as we speak. So I try to incorporate that as much as I can. It's like, listen, why do you think you're in pain? All right, let's explore that a little bit while I'm doing some manual stuff, which is

also giving you the notion that, okay, something's happening. Somebody is taking care of my issue. Like I do have a big issue with therapists who think like, oh, okay, pain is from your brain, and so here's just your exercises. Here's a sheet of paper with homework to do. It's like, I can promise you a lot of people are not gonna get better doing that. Even if the exercises are great, they could be perfect for what they need,

but if they don't buy into the process, they're gonna struggle. And I think a little bit in the beginning, you know, our program, a lot of manual therapy in the beginning part, and then we kind of wean people off of us. And the goal is that you don't need treatment manually, or, hey, you get a twinge or a tickle or a little thing here and there, you already, we already have that line of care established, get right on the table, we'll take care of it. You know, so we're being a lot more proactive. But, you know, I think it

just depends on my early conversations with people, like what I think the carrot is. You know, some people, you know, somebody comes in with a binder full of all the doctors they've been to and all the scans they have. I'm just going to shut up and listen to them talk and let them get it out because they need that, right? That's like biopsychosocial part. And then for a lot of my clients who are athletes, a lot of their issues are rooted heavily in biomechanical stuff because, you know, they, be there taking care of the other things that are healthy.

You know, they're not obese, they're neurologically intact. Right. So in those situations, biomechanics play a much bigger role than the, you know, maybe like the middle aged person who's overweight,

who's stressed in their life, who's got a divorce happening. He's got kids that suck. Like that person's got maybe a lot more psychosocial issues and maybe exercise for them is just an outlet so it really just depends on on on the person and i think you know we were talking about this earlier is like the more you look at the research and you anchor to that which i do believe is something you should do that favors the group over the individuals at the outliers, right? So how do you help these people still?

It's like, oh, we're just going to throw the baby out with the bathwater and not help the outliers. So for me, I'm focused on what can I do with this individual human being to give them as much upside as possible. Just curious about the trend because you've worked with so many athletes. So what do you think you see as the physical trends that you see upon guys who, male and female athletes that move really well? Like when you see patients

and they end up having minimal issues, are there any through lines of like commonalities of what they do on a daily basis that you're like, oh, okay, I see you're doing this, this, and this. And this is something that a lot of these other top performers do too. Are there anything, is there anything like that? Absolutely.

I think, you know, there's always trends in relationships that we notice i think of my athletes like athletes that were multi-sport athletes when they were younger typically are better off in the long run okay you know they have more like so youth sports is effed right now man because it's like we right now what we're looking at is the most hyper specializedspecialized and under-prepared generation of athletes we've ever had. So there's a reason why kids participating in sports, that trend number has gone down over the last 20 years. But the rates of injuries have gone up. So it's like, whoa, what's happening?

And now we have way more single sport athletes than we ever had. I have 10- and 12-year-olds that are like, I'm a pitcher and that's all I do. It's like, like damn we're in trouble because because dad believes that if he can make johnny throw a little harder at 12 then he's going to get that look and he's going to go to vandy and he's going to get drafted and they're going to be millionaires you know and it's like well a the likelihood of that happening is extremely low and for some reason that seems to be a huge deal on the east coast it's a deal everywhere but

yeah in my area specifically you know what it is? Because there's a lot of rich people that have, they have a lot of time and money on their hands. And they think they could just throw money at the problem. And then they're playing for these youth organizations that are like, oh, if you play for my organization, we're going to get you the exposure. We're going to get you recruited and you're going to get a full ride. And then they just get hurt. And that's what happens. You know, and you got little kids doing nothing but baseball training or single sport training.

You know, certain sports lend itself a little bit better, like, you know, wrestling or like martial arts are very dynamic and like even basketball, very dynamic. Soccer is pretty dynamic. You know, you have your rooted skill sets that are there, but it's not like you're doing one movement over and over and over and over and over again. So, multi-sport athletes, I think think tend to do better. Another thing I've noticed, and I was talking about my staff at this about, about this recently was even when we've

had clients who like, we all go through periods in our life where like, we don't prioritize fitness, maybe, right. We take a backseat, maybe not you guys, but like, you know, I'm normal. So I do that sometimes, but, um, we're do that sometimes. We're abnormal. Right. We're okay with that. Yeah. In a good way. In a good way. I think people who have been in really good shape

at least once in their life, even if they've gotten away from it for a long period of time, tend to do better and faster if they get back to it. Or if they have an injury issue and we start with the rehab process and kind of bridge them into like a strength and conditioning or a training model, they do really well. The people that I see, and again, I don't

have, this is anecdotal, a hundred percent anecdotal. So the comment trolls looking for my evidence, there is none, but this is just an observation. Like I get a lot of clients too, who found fitness or athletics or sports later in life. Like, you know, we just had the New York city marathon was yesterday and plenty of people get into running later in life because it's something that they can do. And they have a lot of issues, you know, because they don't really have necessarily that really good base of a body awareness and, you know, kinesthetic awareness of where they are in space. And they also don't really have a whole lot of capacity to draw from. So maybe they do well with it in the beginning. And then they start to struggle as they progress to a certain point they reach that like point of

diminishing return but you know in terms of like biomechanics i think athletes with really good spine mobility and hip mobility are kind of like two big hallmarks that i look for and then obviously you could throw ankles and feet into that equation as well those are kind of like the big mobile zones that i look for as far as like general competency and movement um but again there's plenty of shades of gray in there too who uh moves better athletes or regular people who moves better what's better yeah i don't know that's the thing that we have to if we were to answer that we have to define what yeah i guess like who can get down in a squat easier who can do like a lunge easier like the people that you see and you ask them to do cars and stuff like that uh who's uh less wrecked the regular person or that's 100 even if they're in pain you know what i mean like we took in sema through some of the screens

and stuff today and he crushed them it's like dude man you're checking off all the boxes like you know you move really really well so again it's's always looking at, so even like the three of you guys, I took you through similar screens, but what we saw was three very different movement strategies to get that done. And all I'm doing is observing for maybe a possible linchpin or where, where could we maybe insert some specificity into this programming that has a, that's a small hinge that swings like a giant door for us. That's the big return on a small investment, right? So that's always kind of what I'm trying to key in on as far as like corrective exercise goes is like those opportunities to insert something very

specific with a specific outcome measure on the back end of that. And is there, do you, in your practice, have you found that there's a correlation between people's ability to move and pain? Or are those things not a big factor? Like someone can move really well, that doesn't mean that they're going to be necessarily absent of pain. I mean, listen, the pain conversation is a deep one. Because pain is something that every human being on this planet will experience at that point. It's a unifying factor of humanity. And it's a, it's a bio-evolutionary protective mechanism. It's survival mechanism. That's what it is. So there is no such thing as nobody

experiences pain. And I think, you know, when I, I wrote a course, um, I call it end of the ice age. It's a, it's a modern approach to caring for acute injuries, right? So we were talking to Andrew about his ankle and like why I've gotten away from some of those things. But I really went back as far as I could. Like, when did this pain problem really start? You know, we look at like in the 50s, we had a lot of soldiers coming back from World War II.

That's when a lot of money was being spent on in the pharmaceutical industry on solving the pain problem but it isn't a problem that we can solve so all we did is create fancier and more profitable ways to cover it up at the end of the day but again pain is a real experience it's you know we it's the it's your brains it's our brain's opinion of threat and that threat could be you know interpersonal it could be you know emotional mental could be just your belief systems are wired a little wrong or it could be a physical you know insult to tissue and trauma but when we look at a medical model we're assuming everything

has a structural basis like you go get that mri and then we put this mri up on the pedestal like it's like the panacea of health care but it's like, that's a 2D picture of 3D structure. That's a static photo of things that move dynamically, right? And it just shows us that it is that way, not why it is that way, right? So again, if you roll your ankle off the curb, it's like, we know the mechanism of injury, you know, and see me, you're a little, little back twinge, right? that's really hard to solve for because we don't really know the mechanism there is no one mechanism it's kind of a manifestation of multiple things we were talking about this idea that like our body remembers yeah it's like almost like is this an artifact of like those tweaks or or torques of yesteryear that are just kind of still present in your conscious experience. But this is kind of where I've really gone down like the neuroscience rabbit holes and trying to

understand people in pain because it's a really complicated thing. But, you know, the more you go down a neuroscience rabbit hole, it's like, well, our entire experience as human beings is like a movie that our brain is playing for us based off the sensory information it takes in via your touch, vision, hearing, things you've learned, things you've experienced, right? All of that is manifested and molded into what may or may not be your pain experience. So sometimes it's just give it some time, find ways to train around it, find ways to train through it. Other times it's, eh, this is something that we think could actually make things worse. So we might have to, you know, I'm never going to put an athlete in a position where they can hurt themselves worse, you know, by working through

something. So if I think like, Hey, more of this is going to be bad, which again, there's so many ways to modify people. Then I'll, I'll back down on whatever that sport or activity is, but I'm always trying to give somebody their sport if I can. So you've gotten your labs done, whether it's six months ago or a year ago, and you want to know where things are at, but you don't want to get a full panel again. That's why I've partnered with Merrick Health owned by Derek from More Plates, More Dates. And we have something called the Check It Panel. This is an affordable panel with 55 different labs that allow you to see all those different biomarkers. And you can get this channel every month or every two months, whatever frequency you like, but it'll give you all the specific labs that you want to

know so that you can make sure that you're moving in the right direction for your specific hormones. Andrew, how can they get their hands on it? Yes, that's over at merichhealth.com slash powerproject. And at checkout, enter promo code powerproject to save 10% off the Power Project panel, the checkup panel, or any individual lab that you select. Again, that's at merrickhealth.com slash Power Project, promo code Power Project at checkout. Links in the description

as well as the podcast show notes. With that being said, you said you made a course about how to like, I guess, analyze acute injury. What are the things that you want athletes to think about when they're assessing their own pain?

Because sometimes we talk about pain where we're just like, with some things, you don't want to avoid it. You don't want to stop moving into that range of motion. You don't want to totally neglect that. But like you mentioned, there are other types of injuries. Like if you rip a tendon or something, of course, you don't want to continue trying to move that thing around. Well, you can't, but like, you don't want to keep attacking that type of injury. Right. Right. So what are the concepts when it comes to analyzing your pain and knowing if you should be heading towards it, you should be, uh, trying to move it or if you should be avoiding it. It's tough. Right.

So there's like two buckets there. It's like the persistent pain or chronic pain person who's got pain for maybe unknown reasons for long periods of time, or maybe it's an old injury that just never started feeling better. Like, you know, sometimes we tweak something like, okay, you work through it and you give it a day or two and it's fine. Right. And then other times it doesn't do that. And it lingers. It's just sticking around forever. That's a different scenario than like an acute injury scenario. So like in my course, I'm really talking about how do you optimize the short-term healing so that you get the best long-term outcome?

That's my focus there. So it's a lot of cellular stuff and like, you know, obviously we can do like if you hurt your – like my left knee, blew it out. If I could go back 20 years and rehab myself, I'd have been doing heavy single leg work on my other side so that I don't atrophy as much. I'd have been training the rest of my body instead of just waiting for my knee to heal. There's all that time that was wasted in the first six, eight weeks that I was just kind of bending it back and forth because that's what I was told to do.

There was so many other opportunities there to make me a better athlete or to make my journey through that injury a lot better. So that's what I try to do with my athletes now. I think for athletes who are in pain, if you feel a pop, snap, crackle, something, and then it hurts and burns, you need to go see a doctor and get that shit figured out. Like, at least we got to know what we're dealing with at that point. You've got a muscle stream. Oh man, I felt it go. Like, we all know what that means. Like, Ooh, God. Yeah, that was, that was something, you know, know, we have to still respect the biology of the healing process. Like, we can't make that any faster than nature has already done for us, right? We can optimize it.

We can knock it in the way. So I think we have to just, what's a painful little, what's noise? What's noise for you and what's, like, super loud that you can't ignore, you know? So, like, maybe, like, think of it like that way, like a background noise, like we were talking about your lower back, that you can't ignore you know so like maybe like think of it like that way like a background noise like we were talking about your lower back and it doesn't prevent you from anything but you just you're aware of it there's something there some it whatever that it is you know i think that's really hard for a lot of athletes i think you know again there's also the culture of sports which is like don't be a bitch you know it's like how many guys

want to just shoot it up with cortisone and go out there, you know And you know and we and we were all sitting here watching like, you know, why do people tear their Achilles in the NFL? it's like well listen man, they're Professional athletes that's what they signed up for and they're shooting cortisone and stuff in there And you're gonna degrade some tissue and you're gonna have some problems So it just depends, you know, but I think just knowing your body listening to your body, you know, if you're like, Hey, I can't, I, uh, Dan, you're familiar with Dan John, love Dan John, his book, like, can you go? It's like knowing the difference between, can I go and maybe modify this and just kind of work around it? Or is this like,

I need to really kind of explore this and use the medical system for what it is to kind of figure out, is there something structural here that is risky to push through? Then once we get that information, we can then determine, oh, you got a small disc bulge. Guess what? Okay, we know what it is. We can kind of work around that and start to push you in other ways. But, you know, like, oh, you tore something.

You tore your freaking adductor off your pubic bone. Okay, now we got to maybe look at some different interventions, you know? I got two different diagnoses that I use. i don't know if that's a word diagnosis yeah no it's english it sucks diagnoses and uh one is something weird happened and the other one that i use is that's a two-weeker that's a two-weeker yeah yeah two weaker means it's really bad right Right. That's what that means. And then something weird happens, it's like, I don't know what happened.

Right. Something in my foot's weird today, I don't know what happened. Again, we're talking about a multivariate equation. There's so many variables in the pain equation. So it's just, okay, which knobs do we want to turn today? Maybe we've got to turn our intensity knob down. We turn the volume knob up a little bit because it's not bothering it as much.

Those are always, I always kind of like tell my athletes about the three knobs right intensity this is all dosage there's volume how much you do in a single workout let's say and there's frequency how often do you do that so you know in a competitive athlete if you're really well conditioned you can kind of have three knobs high at the same time but if you've got a little niggle or a little like a little nag or something like that that's bothering you. I heard you guys say it. Now it's been in my mind.

He's like, I had to get it out. I was waiting for my opportunity. It's like four or five podcasts in a row. I'm like, they keep bringing that back. I think it must be a Mark Bell Power Project thing. You get five bucks. Oh, shit. That's your card.

Maybe turn down one knob. Turn down one. Pick one. It depends on your sport. If you're a power lifter maybe that means in turn turning down your intensity knob a little bit adding some volume adding some or giving yourself more frequency this one bench workout skip one it's okay this next coming week don't do it that's frequency you just manipulated somebody's frequency knob and sometimes it's just a lot of what we see in athletic medicine. I call it athletic medicine.

It's just dosing issues. People just don't know how to dose movement, exercise, training and competition effectively. And that's, you know, maybe, maybe why guys like me have a job,

I guess, is how people do stuff a little bit more appropriately. But I try never to take stuff away completely. If I can avoid it, people get pissed. I've actually had one woman once get mad at me for not shutting her down from running. Because, yeah, she was like coming to me

looking for somebody to tell her, you need to stop. And I was not that guy. And she was not happy about it. You're like, my job is to try to get you back out there doing what you like. Yeah, I was like, are we misfiring on why we're here? Because, yeah, I thought you'd be happy about it. You're like, my job is to try to get you back out there doing what you like. Yeah, I was like, are we misfiring on why we're here? Because, yeah, I thought you'd be happy about that, but yeah.

Yeah, she was looking for her doctor's note, right? Probably. To try to get out of whatever it was that she was committed to. Yeah, I guess so. What do you think about a little bit of this voodoo flossing that Nsema's doing over here on her wrist? Yeah, are you a fan of that? Yeah, I mean, again, it's a, you know know there's some neurological mechanisms there compression feels nice you know it's a there's a reason we wear compression wraps or like for christ's sake we have like thunder shirts for dogs like

compression wraps for dogs you know what i mean like compression is a multi-billion dollar year industry because it feels good um but the cool part about flossing is the shearing component really what you're doing is you're shearing layers of tissue, and there's receptors in those layers of tissue that tell your brain information about where you are movement-wise. So some people, if you, you know, let's just say you had an old, like this was the case for me. I ended up having a saphenous nerve entrapment in my scar from my knee surgery,

so I had my knee reconstructed with a patella tendon graft. So what they do is they harvest the middle third of your patella tendon, graft it through your knee, and that's your ACL now, right? That's how they do that. Holy shit. Yeah, it's carpentry. How's it been? Listen, I have my good days and my bad days, but for the most part, for a catastrophic knee injury at 18 years old when I really didn't rehab it well, you know, I do everything I want to do, you know, but again,

it took me a lot of years of pain and anguish and not being able to do those things to figure out like, Oh wait, maybe hip mobility is important. You know, maybe I need to learn how to hinge a little better. Maybe just building capacity around this is kind of in not being afraid to push through a little bit of discomfort. You know, I think there's that nocebo effect of people like shouldn't be in pain. It's like, well, I think if I had had a little bit of a different mindset, I would have approached it a little bit of discomfort. You know, I think there's that nocebo effect of people like, shouldn't be in pain. It's like, well, I think if I had had a little bit of a different mindset,

I would have approached it a little bit differently. But yeah, I do most things and I don't have a problem. The shearing you were talking about for the voodoo floss. Yeah, the shearing, again, if you got an old scar like mine, you know, where the actual free nerve endings or the nerve endings are entrapped within that scar tissue, it's a great,

you ever see like somebody with a scar and like they go to move and it puckers down? That's basically because the scar doesn't just scar the tissue together. It scars down deep to the underlying layers. So like if you look at my skin move, right, there's end range of motion in every direction, but there is no specificity to that end range.

I can move my skin about an inch in any singular direction because my skin is anchored to my superficial fascia via these skin ligaments, right? Like connective tissue. And then there's a deeper fascia layer, which is kind of like the fascia that covers our muscles. Like the epimyseum or even like the periosteum or paratendon. These are like the fascial coatings of all of our internal underlyings.

And those are not only neurologically, they're innervated, but they're also... that's why like you bang your shin on something it hurts like hell so the bone doesn't have much neurological tissue to it but the skin around it absolutely does it's really sensitive right so that's what you're working on is that shearing mechanism so you know if you've got old scars sticky or poor interlayer glide flossing is a home run for that. So myofascial release, like what is actually happening there? I know some people get pissed about whether we're releasing anything or not. It just feels good. Yeah. What's in your brain? Yeah. What happens with some of that? And is it productive?

Man, you know, this is kind of where I'm very not PC on this topic, but I'll give you my take. The idea that we've been doing manual therapy for hundreds of years, you know, this isn't like a new thing humans have done. And if you, one of my favorite people to read, and she's a physiotherapist from Canada and also like a bit of a pain researcher in her own right, Diane Jacobs, she'll say like, you know, the evolution, the bioevolutionary processes for appreciating touch from another human are interwoven into human beings just because we're vertebrates. It's like if you look at primate species, they groom each other. And you can tell chimp hierarchy based on who grooms who. So it's part of their society.

And that's touch-based, right? So touch has a lot of's touch-based, right? So there, and touch has a lot of connotation to it, right? So just because manual, we're changing our lens, right? We used to think we were breaking stuff up, that we were lengthening muscles because what will happen is I work on you and I see increased range of motion. So the common sense way to, oh, okay, we must have lengthened something for that to happen. That's a purely mechanical view and Then we started realizing well shit We can't break stuff up because we measured it and that's not really possible right for me to like break up

Dense connective tissue like a tendon would take 2,000 pounds per square inch of force Which for context is like the equivalent of like the bite force of an alligator? Right so if you want if you took like a hunk of meat from costco right like a beef tenderloin and bit into raw meat as hard as you could what do you think would happen to your teeth uh rip them out probably right you break them all or bend a few or that's only 160 pounds is it still frozen or is it right because i feel like if it was raw you you'd probably get bit through. You could probably, you could probably, no, you're going to do some, I'm not saying you can't do damage.

I'm just saying like, you're going to bite through that thing clean in one shot? Probably no. Probably no. You know? Especially if it's like Chuck or like, you know, like something like that. But anyway, my point being is like your jaw, your bite strength of a human jaw is about 160 pounds of pressure. So think about like, if I bit you as hard as I could, I wouldn't even be coming as close. I wouldn't be coming close to the breaking strain of a tendon. So I'm not lengthening a tendon, but it still worked. So again, like, as I was talking about like that,

like in the late two thousands, there was this like inflection point of research in the pain science community. And like what we thought we were doing with manual therapy that produced, in my opinion, an entire generation of therapists who think manual therapy sucks and it's not worth their time and they'll just, which is fine because I do believe exercise can solve most of people's problems. But if manual therapy represents a turbo button, if I can change your brain's opinion in that tissue, I can promote some interlayer glide. I can promote some blood flow. We also know that even like with the tool, but any external force, we can stimulate

fibroblasts, which are the cells in our body that produce connective tissue to spit out connective tissue. The only way to do that is mechanical load, either internal load through training or external load, pressing on stuff. So there's plenty of reasons why you might want to do manual therapy. My unpopular opinion on why it doesn't, why people say it sucks or it's not necessary now is because it is a skill set that needs years to develop. And I think a lot of people just don't want to do it. And again, I'm coming from a totally different perspective. Like when I was at Florida, it was like every single one of those track athletes after practice

got on the table for treatment every single day. Not an option. But guess how many athletes we had hurt? Not very many. You know, we had, and we were at that time, 2008, 2009, we were number two in the nation. You know, you're talking about, we had like, I think it was like something like 14 Olympians on that track program, you know? Future gold medalists.

So these are high-end athletes. It's like, I just took that mindset and I applied it to everybody. That's kind of what I did. Let me ask you this. When it comes to like manual therapy, let's say someone, they've been going to somebody or even myofascial release,

if an individual finds that they're very, very sensitive to touch or pressure, what is that telling them? Because I remember when I got supple leopard back in like 2013, I started doing that stuff. I always find myself holding my breath. I always find I was super sensitive. But over the years, now it doesn't feel painful, right?

So is there, what's that telling them? If they're very sensitive in certain areas or almost everywhere so that's a really cool question so this is kind of how I try to differentiate it when I'm teaching this to clients is if you have a lack of flexibility right like I can't move you much passive range of motion the only thing that really hurts is to stretch it right but if I touch your muscles it it's not super sensitive in that way. But if you have something like protective tension, or we call it neurological tension. So one of the ways are, you know, we talk about pain

as a protective mechanism, but muscular tension or tone is also a protective mechanism, right? So your brain will lock you up. It's almost like a built-in immobilizer. It'll increase the tone. I call that juicy. You have juice running through that muscle. It's on right now. If you touch that same tissue, it's sensitive of it, is we're providing a sensory input to the brain. We're changing the brain's opinion of that tissue downstream, and we're manipulating the motor output. So it's a feedback loop. So if you have hypersensitivity to tissue, like muscle tissue shouldn't hurt to touch it. But if I push hard enough at a singular point, eventually it's going to be like, ouch. We call that pain pressure threshold. It's something we can measure, right?

You take a force dynamometer and we can measure how much until you get the ouch. We know that even light touch can increase or improve your pain pressure threshold. So even after a bout of manual therapy, the idea is now we've desensitized you to a certain extent. manual therapy, the idea is now we've desensitized you to a certain extent. And if I can, so let's just say there's a line where you cross that line and now you're painful. And if I can work on you and now I make that line a little higher, I raise the bar for your threshold of symptom experience. Now I can load you in that new window of threshold that we've created. So that's what I mean by like, can you get better without manual therapy? Sure. But if it's a turbo button, why the hell wouldn't you use it?

And a lot of people, for a lot of people, it's the time factor. Oh, I got to spend time with this person. But to speak to your point before Mark was like, how do how do I know which lever I want to pull with somebody? I have to spend time with them on some level and get to know this human being and have there be like, I trust Mike. I trust what his advice is, got my best interest in mind. Like, we're in this together now. And I think that is really the crux of the results that we're getting at the Movement Underground. It's like consistently people are getting better. We're the place that people come when they can't get better anywhere else. So we get all like the hard, tricky, weird, weird stuff. And I'm really proud of that. And honestly, it's because we listen. We listen to people. We take the time to use that manual therapy session as a way to educate them, as a way to encourage them, as a way to, hey, you're not broken. Like, you can overcome this. Like, we just got to push this a little harder. Like, you're safe here. Don't worry about it. And all of a sudden, you get people some momentum or a little bit like, Andrew, your knee.

Oh, man, my knee feels so much better. Dude, that is a huge win. Let's go move it now. Right now, we've just accelerated that. Let me wait a week process to today. And now we're doing something about it today versus waiting for it to not be painful. That's what I found with just myofascial release, just using stuff in the gym and just rolling on stuff. And you just end up exploring and you end up finding,'re like oh there's something there and then we've been doing a lot of stuff with cables and a lot of stuff with

uh different setups and you were showing me to kind of uh get that lower back to move a little bit more we've been practicing all kinds of different things in the gym where we're working on different movements maybe exaggerated movements maybe they're movements that were we were taught not to do you know when you lift you're taught like not to do certain things sure um specifically like when you're like bench pressing you know you would never quote unquote never um you know push your shoulder forward right and it's like well what's wrong with pushing your shoulder forward maybe that's a good function to have maybe it's a good option to be able to do that but maybe it's not a

great idea when you're trying to go for max weights that's exactly it it's the context right you know so like from a from a power lifting perspective big arch pinning the scaps back i've just shortened my travel distance and if we're talking about pure hypertrophy it's a lot more time under tension for pecs so from a pec development standpoint that's a perfectly rational strategy. But from like a movement perspective, it's like, well, your shoulder blade has to move on the rib cage. Why? Because it has to deliver the socket to the direction that your arm is facing so that there's socket behind the ball. Like if you look at, if you guys want to pull

it up, you can like a, an image of like a human shoulder from bone perspective, like our shoulder socket's hardly a socket. It's more like a golf tee. So the shoulder, the scapula's job is to position the tee in the direction that you want to reach. So like for my baseball players, if they, you know, and again, like when, even when I was growing up in like the 90s and the early 2000s,

when I was in high school playing sports and learning about training, a lot of the knowledge at the time came from the bodybuilding community. that's where the information was coming from right yeah so if you're looking at this image right now i mean it's not really showing us the socket per se but again the shoulder socket itself is very shallow it's not like a hip right and that gives us the ability for lots of degrees of freedom. So our shoulder, our glenohumeral joint is also inherently the most unstable joint in our body, but it's a give and a take. You get the mobility at the sacrifice of some of the, that's why we have more shoulder dislocations than hip dislocations. You know, the famous hip dislocation was like Bo Jackson, like dislocating his hip back in the day, but that's extremely rare. Yeah. There's a better image, right? You see that glenoid. It's really just a, it's a third of the size of the humeral head. Yeah. Oh, Jackson's right here. Oh man. What a

legend. That's awesome. He's on every show. I didn't even know what, I don't know if I noticed that, but I'm so glad I dropped that. He got a little upset that you said that. I'm sorry. It's a rare injury. You just don't see that. That. That's why there's not very many examples outside of car accidents that you would see a hip dislocation. We talked to countless guests on the podcast about the importance of strong, functional feet. And most people's feet don't function the way they should because of years of wearing narrow toe box shoes that over time weaken the feet and then actually don't allow the toes to function the way they should. Most shoes are casts and the toes don't move. That's why I've partnered with Paloova. Now, Paloovas are flat, wide, and have a five-finger design

so that whenever you wear the shoes, you're now getting the benefit of toe space. And that space that's being created through your toes is going to allow your feet to begin to function the way they should, literally all day long. You can wear these shoes while running. You can wear the shoes in the gym. You can wear the shoes while running. You can wear the shoes in the gym. You can wear the shoes while relaxing anywhere you want. You can wear Palooza's while getting the benefit of toe space. Andrew, how can they get it? Yes, that's over at Palooza.com slash power

project. That's P-E-L-U-V-A.com slash power project. And at checkout, enter promo code power project 15 to save 15% off your order. Again, paloova.com slash PowerProject. Links down in the description as well as the podcast show notes below. What do you think is maybe like what's responsible? What do you think is responsible for getting people quote unquote old? Making people feel old? What do you mean? I got to expand on that a little bit.

Making you feel old? Yeah, making people feel like when someone's like, oh, like they go to throw a football and they're like oh i can't throw it the way i used to or when they get up off of the couch yeah they get up on the couch the body's stiff or even just or even just not people that are necessarily old or feeling old but just the way the body feels in the morning right first wake up again i think you know in our bodies is history it's the history of your experience as a human, just like your traumas, your emotional issues, your upbringing, all that's programmed in there. Then there's your biomechanics and what you've trained your body to do over the

years. You know, like we were talking about you, it was like, well, why does my low back feel stiff in the morning? Well, you kind of lack some hip extension. So you're laying on your back and all that extension's happening at your spine. You're going up you're gonna feel that not because you're doing damage right so i use this analogy before it's like if i go ahead and do this right bend your finger back as far as you can are you doing damage to your knuckle no does it hurt no hold it like that for eight hours and see how it's gonna feel it's gonna feel stiff and shitty right part of that we actually there's a term for that we call it fascial creep right so? So this is this idea. So if we think about like our, and this, this whole thing about fascia, it's really confusing for people. So I'm going to try to

explain it verbally the best that I can. All of our connective tissues are made from the same basic sub components, right? Collagen, elastin, fibrin, you know, then our bones even are made of the same stuff, just more of the osseous versions of that. But from like a soft tissue perspective, our fascia kind of encapsulates all of our muscles. It's neurologically intact, but it also has contractile ability to it. Now, it's not like a bicep where it has like a fast twitch response. It's a slow contraction, more like your esophagus as it pushes food down into your stomach. So like if, for example, like, you know, I was up in Tahoe this weekend with my fiance and we just drove down here this morning.

So I'm a pretty limber, mobile guy. But like I get out of that car like everybody else and I'm like, oh man, I'm feeling a little stiff, right? Especially the tiny ass little rental car that they give you, you. And I'm like, Oh man, I'm feeling a little stiff, right? Especially the tiny ass little rental car that they give you. You know what I'm saying? But the idea is like you're in one position for a long period of time. It is more energy efficient for your body to just tighten up that fascial bag to hold you into that position than it is for your muscles to be active that whole time and hold you there. So a lot of this stuff comes down to conservation of energy, which again is rooted in bioevolution. It's like, don't spend energy you can't kill to

replace. Right? So these are all mechanisms. And again, like look at our lifestyles now as humans, you know, like human beings have been on this planet for a couple hundred thousand years, but in the last 200 years, we've changed the context of our bodies dramatically. You know? So like, um, when I was in grad school, I got, I worked with, uh, there was a student in the graduate department. He actually works at Harvard now. So when I was writing my end of the ice age course, I had reached out to him, you know, for permission to use some of his work in my course. And his whole doctoral research was the throwing shoulder. Like, so the theory forever was bipedalism was the catalyst for evolution. He was saying how being able to throw, hunt bigger food, have more calories, supports a bigger body, supports a bigger brain, have more babies.

That's the catalyst for evolution. He, you know, won some awards and some really cool. And he's, you know, he's the assistant director of anthropology at Harvard now. So it's a big deal. Um, so the point being is like, our bodies are meant for that. That's what we've evolved to be. The context we use ourselves now is like, we weren't meant to sit at a desk and type up TPS reports all day. Like that's just not. So people are feeling the strain of singular sedentary positions, which is why we're talking about movement variability being as like the antidote to a lot of the chronic pain and issues and health problems that we see. When you put it that way, it actually makes it amazing that we're not in more pain earlier. Right.

You know what I mean? Because like people don't really start talking that way until they're in their 40s or 50s. Yeah, until there's a need for it. I think you are starting to see some like teenagers do that though. Yeah, I agree. I mean, I don't know if on your table, but I mean, I know that I've seen quite a bit of like 17, 18, 19 year old kids. Happening earlier, yeah. Because a lot of times they're sticking in these postures.

Yeah. And they're not doing a lot of activity. You said there's less kids in sports now, so you're starting to see younger kids. Less kids in sports? I mean, drive past any park. Oh. Do you see anybody there playing,

like, just open free play? Like, when we were in elementary school, I remember me and, like, four or five of my buddies would play, like, these intense games of bumper tag, where it would be, like, full-on sprints across, like, open fields. And it was, like, life, and it was, like,-on sprints across like open fields and it was like life and it was like your social worth was completely dependent on how long you lasted in that game but i think

back to it now like you know knowing what i know about like biomechanics and movement and treatment and all this stuff and i'm like holy shit like that was that was why i was running a 4540 in high school i wasn't like a well-trained athlete. I just had been doing it every single day, full on sprints. And I just became a really good athlete. Like I wasn't even the best lacrosse player, like by all conventional standards, I was like mediocre at best, but I could just outrun a lot of people and make stuff happen with my legs. And that's obviously why the knee became a huge issue for me. It was like, okay, not as fast as I used to be. So what are some things you encourage some people to do when they're coming in and, uh, they're just getting banged up? Like, are you encouraging people to do, I know you said you

don't want to give people too much homework or you don't just want to send them off with homework. Uh, but I'm sure you encourage them to walk. I'm sure there's encouragement about sleep. Like, what are some of the, some of the pillars for you that you think are big time for people? I mean, the big three are always the case, right? Movement, nutrition, sleep. Those are the big three pillars. And then if you talk to, I know you guys talk to Huberman, you'll talk about light as a pillar, community or tribe as a pillar,

like having that social support system. So even part of what we're trying to do with the Movement Underground is be that social support system. So like even part of what we're trying to do with the movement underground is like, be that social support system for people. It's like, you can come here with all of your issues and we're going to embrace it and just work through whatever you got, you know? Um, so I think those are like the five pillars I would say of like good human health. I can't really disagree with guys like Huberman. I I'm like, yep, that's it. That's for sure. Like if you really root it down to what you need as a human being, you know, I'd argue touch is part of that too. You know, it's the only sense in our body that we really can't live

without. You know, you can live without your sight, you can live without your hearing, but you really can't live without touch. It's part of how our brains develop neurologically, even when we're young. And again, the research on this is ridiculously clear. If kids past, usually around the age three or four, don't get a lot of interaction with an adult touch, like loving touch, they are wired for violent crime. They're wired for drug addiction or substance abuse later in life. They're wired to be antisocial. So there's lots of far reaching, like ripple effect to not getting some of these things. Right. So, you know, um, I wrote an article for massage magazine years ago. They, they wanted me to write a commentary on why massage was important for youth athletes. And I guess they saw me as like an athletic trainer doing a lot

of manual therapy that I'd be a good fit. And what I actually wrote was like a like a satire piece i'm like the whole idea is like if you want your kids to be good at sports like touch them a lot like give them a rich sensory experience i'm like in a weird fucking way but like you know like there's a reason little kids want to wrestle with you they want to wrestle and rough and tumble they love that shit and it's partly because it's they're learning they're learning how to use their body and solve problems with their body. It's like I can't think of a better thing to do with a little kid than to give them that experience. And, yeah, that'll manifest through time. Again, at a certain point they might kick your ass, but that's okay.

Yeah. So, like, back, I don't know, I'll say a little bit over a year and a half ago when my back was like kind of controlling my life, my body was very protective of it. Sure. Right? Like anything that would come close to aggravating it, my body was like, don't avoid that, even without me thinking about it. But as my son was like starting to get a little bit bigger and he's starting to roll on the bed as he's asleep or something it's like oh i gotta like you know close the distance from where i'm at to go catch him boom i get there and i you know bend over catch him no big deal right what happened my back didn't hurt when i made all that

movement what the heck so like trippy yeah so like what um first off like what's going on there but also like you know if you were to tell me like like Andrew, you got to get some movement in your back. I'd be like, dude, my back is like, I can't, it's too painful. Like it's, it's protecting itself. How can somebody unlock, like, I guess I'll say exploration when it comes to movement in an area that hurts them. Okay. So we'll start with that one. And then I definitely want to answer that other question because it's a really cool question with some nuance to it.

But usually, again, this is kind of the classic PT answer that you'll get from a lot of us, which is like, you know, you want to explore that movement in non-painful ways. I like to use breath as part of that, right? So like if let's just say you were super biased, like flexion just freaking kills your back. I might put you on your back, right? And have you start to gradually flex your spine like those those peel-offs that we were working on earlier Get to the edge of that pain Just take a breath Right and then the cool thing about breath is like for the most part. It's a subconscious or unconscious movement, right?

You don't have to think about it You just breathe all day, but you can take over consciously whenever you want So we can take over that conscious pathway and use that as a tool to tell our nervous system like, hey, we're all right. We're cool. Like we own this position where there's no threat here. Right? So again, I think I love that quote is like, pain is your body's, your brain's request to change something, either in your internal environment or your immediate external environment. So change the context, breathe a little bit more into that, and then come out of it. What you'll notice is on subsequent reps, you're a little bit less sensitive, a little bit less sensitive, right? And then maybe we get to a

point where we start loading that, right? Load is like hitting the save button, right? So we're trying to show your system credible evidence of safety, right? And I think that's a really good way that like a conceptual way that you can look at it and apply that to like any joint really or any tissue on your body you know to speak to and this is like again the cool part about neuroscience and neurochemistry is like this is how we're wired right it's part of the reasons and again i love one of my favorite books ever sapiens have you ever read sapiens noel harari yeah freaking phenomenal awesome i mean it's it's an epic book to read because it's super super long and it's yeah but if you can get through it you can there's underpinnings there of like this idea that the social tribe like human beings were why are we

the dominant species because even though we like we just met each other today but like if i walked out on the street right now and somebody tried to mug me, it's like these mofos in here, I got a couple of brown belts in here coming out. They're going to save my ass, right? It's like there's something about it. It's like, oh, you know, you're part of our tribe. So to your son, like that's your son. Like there's nothing else on the planet in your brain's mind that matters more than him.

So you see threat there. There's no amount of threat internally in your body that's going to override that none now is there going to be collateral damage maybe but like it doesn't matter and like that you hear those stories all the time like somebody got trapped under a car and this you know four foot three woman picks up a car and like gets her kids out or crazy things like adrenaline's a hell of a drug man that's a hell of a drug right there but yeah it's probably a little bit of adrenaline, norepinephrine, right? Flood of dopamine and all those chemicals all at once and boom, you're like snatching them out of the air. But it's cool, right?

Sometimes even distracting people is a great way to get them to do something non-painful, right? So like maybe giving them something else to kind of focus their attention on and all of a sudden now you opened up a window that way. That's really the cool side about like, I think the neuroscience and the pain science, some people think that that made, it made the reason for not doing manual therapy stronger. And I think the opposite. I think that the pain science only makes the rational, the rationale for doing manual therapy stronger because it's like,

how else can we, I can affect somebody's psychological state because now I'm touching you physically. It's like, you're not ignoring me now. We're having a conversation, right? There's an interplay of touch that's happening at a subconscious level that your brain chemistry is working out. And then there's a social compartment to that as well. It's like, we're building some tribe there. We're building some relationship founded in like, I'm helping you. I'm helping you with the problem.

So that's always been my gripe with like the annual therapies, bullshit people. It's like, you are a throwing the baby out the bathwater and B you are like any other industry. It's like, if you, I was saying,

we were saying this before, it's like any other industry. If you hired a plumber to come to your house to fix your, your toilet and they handed you the step-by-step instructions printed off Google and they said, that'd be $500, please. Like you'd smack that person.

You'd be like, what the fuck? Like, that's bullshit. So like, you're going to come to me with a movement or a pain problem. I'm just going to give you a list of exercises. There's no actual exchange there. They could have Googled that. They could have watched Power Project YouTube

and found a lot of great information on how to fix their own stuff. Wink. But I think the manual therapy part represents the exchange. It's like, they come to me for a problem. Here's my attempt to helping you with it. And understanding that there's a lot more happening under the hood than just me rubbing some stuff. Oh, good. Andrew, the second part of your question with exploring the lower back, did you get that? Yeah, yeah. He answered that first. Oh, okay.

My bad. No, you're all good. I know. I talk a lot. I'm sorry. I missed it. That's my bad. We talk a lot on the show about the feet.

And would you mind kind of explaining, basically, if you could explain like the arch of the foot and maybe some of the information on where the support of the arch of the foot comes from. Right. And I know that there are some people that sometimes will try to put an arch support in there via something that you might put inside your shoe or something like that. That's what I described to me when I was younger.

And maybe it's not always a horrible idea but what what are some of your thoughts and like where like this arch uh you know what should should we have concern over like do we need an arch like a lot of people have flat feet right here people complain like i got a flat foot i can't do this or can't do that should they be focused on trying to even worry about something like that i mean again it really just depends on context but i do think you, you know, like, you know, one of the videos I think that you were referencing that I said is like, our feet are the only connection to the ground that we have.

Like, anything from an athletic standpoint, if you're talking about field sports or throwing a ball, is taking force from the ground and transmitting it through your body, right? Even like powerlifting, right? It's like, yes, you're picking up a bar against gravity, but you're pushing that amount of force through your feet into the ground, equal and opposite of the weight on the bar. That's how you're moving it. So it's probably pretty important, right?

And again, we've kind of taken this like, oh, we know arches are important. So let's put some shit under that arch to make an, and is there a time and a place for that? Probably. Absolutely. There's a time and a place for everything. You know, there's always a situation where maybe helping somebody feel that arch a little bit more through an external support might be warranted, but I don't think it's a good means to an end because like, for example, if, if I were to take a crazy person and wrap them in a straight jacket and throw them in a padded room, would you say that they get better or worse? Worse. Okay. So if I took your foot and put it in a straight jacket, orthotics, and then put it in a padded room, stability shoe, what's going to happen? That foot's going to get

worse because now it's relying on an external bracing or support mechanism. So if you look at the arch of our human foot, post-tib, toe flexors, all run through that like shin compartment, like on this inside part of our tibia, run back behind the medial malleolus into the middle or arch of our foot. So the whole idea is like all of the stuff that actually slings your arch up is upstream, right?

It's kind of like the suspension bridge, right? The bridge is supported not by the struts in the ground, but by the suspension? It's kind of like the suspension bridge, right? The bridge is supported not by the struts in the ground, but by the suspension. It's being hung. That's how our feet work. They're hung and then stabilized with the foot intrinsics once we're in that position. So people who have a flattened arch, again, there's lots of reasons that could happen. Every human is born with a flat arch. You'll see like little kids have flat feet, again, which is the argument for why they should be running around barefoot. That's how they're going to develop that neurosensory pathway to feel the ground. And then they're going to start to develop some

strength in their foot intrinsics and maintain the mobility of their toes and their heel, you know? So there's lots of moving parts in a foot. I mean, most of the bones, I mean, there's so many bones and ligaments in our feet. It's ridiculous. So many connections. But, you know, from some people don't feel the ground well, which is why maybe a textured insole might be a great thing for them. Just have more texture. That's why I love these Flux shoes that I'm wearing now. I have like a textured insole. There's research that'll say like a tech walking on texture can increase your nerve conduction velocity up to 40%. So even just like feeling the ground,

having more awareness. But yeah, I think a lot of people who have flattened feet struggle with lumbo pelvic control and also hip control. So what do they do? They use the arch of their foot as a way to find some range of motion that they're missing somewhere else. So I will steal range from that arch

to get around a lack of mobility somewhere else as a overall strategy, and then years down the line, then it becomes painful or irritated, because then it's like the finger example. Now it's ten years of not being able to get out of that position, and now it's hypersensitive. So that was kind of the genesis of, I never met a foot that a hip doesn't fix is like,

and people hate that. They get really pissed off, especially podiatrists. Why? Because they're only looking at feet, trying to find feet solutions to feet problems. It's like, well,

there's a whole lot more human than just your foot. But again, there's give and take, you know? So can you change that dramatically for somebody with a really flat foot? Their foot might never look different. But, like, so I recently have had a client, super flat feet, you know, super big lordotic curve,

lots of external rotation, so her duck footed. And we've been really working on kind of this foot-hip connection. And towards the end of the summer, she came in, she was like, so happy she was crying. And she shows me a picture of her footprint in the sand, she came in, she was like, so happy she was crying. And she shows me a picture of her footprint in the sand. And it looks like a footprint and not just like, like a giant, like wedge of sand being gone. So even though she still has a flat foot,

all of a sudden now there's actually some actual function tangibly changing there. And all of a sudden, oh, my knees don't hurt. My ankles don't hurt. My hips don't hurt anymore. there and all of a sudden oh my knees don't hurt my ankles don't hurt my hips don't hurt anymore so again are those causative of each other it's hard to say but certainly in that one case it's like it doesn't matter she got the results she was looking for she feels better she's more confident she's training so it's like i call that winning you know and with something like plantar fasciitis which you hear so many people talk about i'm sure that some of the pain could be registering and it could be coming from the bottom of the foot but you might want to look upstream absolutely i think if you're if you if you're treating one thing for two weeks and it's not getting any better it's not your problem

that's a good litmus test you know like if you're rolling your foot you're doing the foot stretches and you're doing the you know the toe grabs the foot stretches, and you're doing the, you know, the toe grabs and all that stuff, and you still have problems, that means you are not, you're shooting at the wrong target. You probably need to get another opinion. You know, and again, listen, we're all healthcare providers, you know, as healthcare providers,

we're all biased to our toolboxes, right? It's like, surgeons aren't bad people. They're good people, but their toolbox is surgery. So if you go to a surgeon enough times for advice, they're going to recommend surgery. But that's the toolbox that they have. You know, my toolbox is manual therapy and strength and conditioning. That's what I've used forever. And, you know, I think the combination of those two things has really helped me unlock results for people that maybe just one or the other weren't able to get on their own. unlock results for people that maybe just one or the other weren't able to get on their own. You are asleep for one third of your entire lifespan. You might be doing everything while you're working out, your nutrition, everything during the day to optimize things, but your sleep might not be where it could be. So that's why we partnered with Eight Sleep Mattresses, because the temperature of which you sleep at makes a big difference on your sleep quality. And Eight Sleep has all the metrics to make sure that your HRV, your bed temperature, all these things are moving you in the right direction. Eight Sleep has totally changed the

way that we approach and the way we sleep for the past three years now. Andrew, how can they check it out? Yes, that's over at eightsleep.com slash power project. And when you guys go there, you'll automatically save $150 off this amazing technology and the best sleep of your life. Again, 8sleep.com slash power project links in the description as well as the podcast show notes. On the strength conditioning side, a lot of power lifters listen to the show. And I don't want to specify on like the competitive power lifter, because if you're going to try to be super competitive, then you need to build a body that can do certain things, right? But a lot of people like powerlifting and they're potentially building a lot of adaptations that are great for powerlifting, but maybe aren't great for life and

movement. And I would assume that most people that like powerlifting would like to move through life without being in pain from what they're doing in the gym. So what are some practices that you think people should adapt maybe in the gym or outside what are some practices that you think people should adapt maybe in the gym or outside of the gym that can counteract the adaptations that they're making to become better lifters? And I'm saying this because working on Mark, he built an amazing adaptation with his back

to put 1,000 pounds on it. Right. But now it's something that has to be worked out. This is always the crux of this is where you really have to get to that person and ask him what their why is what is your why it's like i want to compete in powerlifting be the best in the world okay great that goal is going to come with cost there is no way around that so if somebody why do a lot of lifters like powerlifting because it's fun to chase the number it's fun to watch the number go up. It's fun to hit a PR, right? Because there's something, our brains are wired for progress. It's like the closer you get to a goal, the better you feel, right?

maybe weightlifting is an arbitrary goal, but in 2023, the gym is our activity. That is what people do to move. You know, it's not like it was a hundred thousand years ago when you were like, I got to go climb this tree to get me some figs. It's like, well, I can just open my fridge now, you know, and I don't have to do that. So we use the gym as entertainment. Yeah. I'd be dead. No, you probably wouldn't be. You probably wouldn't. I'd shake the tree or something. Right. You'd probably just fucking knock it down. Just tackle it.

So that's kind of where it's like, I think we have to communicate with people better of understanding the cost. There's a cost to everything. You've got to pay a price. Is the juice worth the squeeze? That's up to the person to determine that. That's not my job.

My job is to help them achieve the goal, whatever it is. To answer your question directly, I think building in some mobility work into that powerlifting program is a great idea just to, you know, get rid of the, if you don't use it, you lose it. But the idea is, is like neurologically in terms of physical adaptations is the more I funnel my goal to a very particular movement skill, the more I lose of the periphery. Right? So when you're training a 12-year-old kid,

the first six weeks, they'll make the biggest strength adaptations that they'll ever make in their life again. But physiologically speaking, from a tissue perspective, nothing's changed. They've maxed out their neurological output for that tissue. Then as long as there's calories and recovery and all that stuff, they'll start to upgrade

their hardware, right? So it's a software development first, then the hardware development comes after. So I think in Mark, in your case, there's certain hardware adaptations that you've made to power lifting that are they undoable? Maybe, maybe i don't nobody knows the answer to that but i think what you're also doing with your running is proving to people that it is possible to shift gears because you're doing two opposite ends of the spectrum right in terms of like maximum power versus maximum endurance but for the most part they're both sagittal plane dominant movements meaning you're moving front to back for most of it so at least you're still in your lane as far as capacities that you've developed If you're like, okay Mike, you know what powerlifting is great running is great, but I want to be a world competitive gymnast

I'm like, yeah, maybe those adaptations aren't there. No offense, bro. Yeah, I would hurt So again, there's maybe some of that that would be really tough or even like jujitsu might be tough I don't know if you roll or you like to do that or you've tried it, but you know, I do have a lot of jujitsu athletes who were bodybuilders back in the day that are, they shift gears and now they're struggling a little bit, you know, but again, not to say that they can't, it's just, you got to be patient. You got a program designed for the output that you're looking for, for the adaptations that you want to make and then be patient and work it and be consistent, just like everything else that we have to do to change our bodies. Right. So, um, there's no quick fix there, but you know, again, it's, I would say, you know, working on hip mobility, hip rotation

is a, is a good kind of panacea of general, good movement, good front to back or linear spine mobility is also a really, really good one to kind of focus on if you're just trying to like bulletproof yourself. But again, I think, you know on if you're just trying to like bulletproof yourself. But again, I think, you know, if you're powerlifting and that's the goal, those adaptations to your structure will come at the expense of being able to move in other ways. Can I ask you guys both a question? Yeah. Were you about to say something else on that one? No, no, no. Go ahead. Go.

I'm curious about your thoughts because I remember we kind of had this conversation with Stu McGill, and he mentioned when he was talking about, what's his name, Brian Carroll? That's right. The guy he worked with. He was talking about, like, obviously adaptations. If you're someone who's trying to be able to squat 900, 1,000 pounds, there's going to be a give and a take. But the thing I wonder is if you have the ability to maintain a strong, neutral spine with load on your back, why can't you have the ability to flex and extend

and laterally flex, right? Like, as long as you just maintain it. Because I think we've seen people who have had the ability to do that, but the thing is they just stopped doing the other shit. Right. I don't see why you can't just maintain light skills of doing the other shit while still improving

at your skill of being able to maintain position on a deadlift squat or bench. You know? Like, what are your thoughts on that? Well, again, there's... You can't get around the physiological adaptations part, right? So, like, one of the things that'll happen in powerlifters is your bones get denser and bigger. Mm-hmm. Right? So, like, you'll even see around the physiological adaptations part, right? So like one of the things that'll happen in powerlifters is your bones get denser and bigger, right? So like you'll even see on the vertebral bodies

in like an avid bodybuilder or powerlifter, like you kind of grow like these stalagmites around the bones, right? It's bony growth. And then the other part of that is your connective tissues become more densified and stiffer in their nature by default because that stiffness is a way to transmit force. So could you? Yeah, maybe. But I don't think you would achieve the upper ends of power if you were to.

It's kind of like the man who chases two rabbits catches none. That's kind of the crux of that problem is for most people, if they were taught these things younger, could they mitigate certain injuries or mobility deficits later in life? Yes, but I don't think that those people we would be setting world records in powerlifting. Okay.

You know, but that's any sport. You know, like you look at a baseball population. Like if you take a Cy Young baseball, or any, I take that back any baseball player who's achieved maybe like college baseball and you look at their humorous it's physically torqued like the humorous twists over time the socket of the glenoid actually starts to retrovert the actual socket orientation starts to rotate backwards as a result of all the external rotate rotation

stress there's stress did you say earlier is on like the elbow at that starts to rotate backwards as a result of all the external rotation stress. How much stress did you say earlier is on the elbow at that point or something? I think there's multiple studies on this, but from the general consensus is the average breaking strain for a UCL is about 80 newtons of force. In those videos, Dr. Chris Ahmad, who's the orthopedic surgeon for the Yankees, he's probably one of the most world-renowned elbow surgeons out there, but there's a picture of him taking a cadaver elbow just with his bare hands and just snapping

the UCL. Like, you know, the same way you would, you know, like bust a chicken wing open. It's like, holy shit, that was really easy. And he's like, no offense, Dr. Mond, again, great guy. You know, super, super good surgeon. He's a very slight of frame guy. So you're not talking

about mark bet busting or you busting something open you're talking about somebody who's not touching the pinnacle of strength and development i think he'd agree with that but you know the average fastball is like 85 mile an hour fast was 120 newtons of force on the elbow so valgus force so you would think theoretically speaking every time you threw a fastball you'd blow your elbow out but that doesn't happen because there's more to stability than just ligamentous strength, right? I believe this is it. Yeah. Yeah.

Pow, you know? And again, you know, it's— Now in slow motion. Let's watch it split, spiral apart. Yeah, I mean, it's super interesting, too. And it's like somebody asked me recently, I was like, you know, how do these Achilles, because all these Achilles things in the NFL right now, you know?

And obviously for the Jets fans out there, like, I mean, you know, the beginning of football season is really hard in New York, especially on Long Island, man. Like, a lot of people are like, the Jets, we're going to do it this year. And then it's just like, and it's over. But they're doing pretty good. They are doing pretty good, man. That's why it's a team sport. You've got to still play the games. But anyway, it's like,, and it's over. But they're doing pretty good. They are doing pretty good, man. That's why it's a team sport.

You got to still play the games. But anyway, it's like, how do these things just happen? Well, it's like, okay, for Aaron Rodgers, like, that's a really unfortunate, like, he's hung up in the ground. He's got external pressure. It's like bad position bang. But, like, you'll see athletes all the time where it's just like they're just doing something normally they always do. And boom, it just goes. So I don't know the reason why.

I think part of me and my brain is always kind of like imagine this idea of like resonance like you know like singers can break a glass with their voice because they match i think it's just the right amount of force at just the right angle it's gonna blow apart you know and like even like the goata guys are like oh no it's because ankle bone inside listen man i inside. It's like, listen, man, I'm like, I guarantee you there's somebody in that position who blew their freaking Achilles. I guarantee you. It just doesn't work like that.

What's goada? And then when he started talking, you're like, oh. Yeah, I know. Love you, Gary. You're my boy. No, listen, there's something to be learned in everything. We talked about like what what's the difference in all these different movement systems it's like they're

systems it's it's an it's an approach it every system has holes in it every system has holes in it where you could say oh here's somebody who doesn't fit your model that did really well or here's somebody who didn't fit your model who got who did fit your model that got hurt there's enough outliers out there for everybody to say, Oh, you know, we can always take our system and take our success stories and be like, yep, this is see, see how good I am. Yeah. It's like, those are the testimonials. Because again, if I put any, if I take 50 people and I put them in the same training

program, what you get is the standard distribution of probability. That's what you get. Some people get get. Some people get hurt. Most people kind of stay the same or maybe make a little progress or go a little bit backwards, but nothing substantial. And a small percentage of people got, got the result that they wanted. I got a theory. You're ready. Sure. I want to hear it. So I think a lot of people have started to train like more barefoot. And I think that that's a popular thing. However, I think when it comes to football, especially football, because you just, it's rare to like play the game, especially when you're really high level, when you're Aaron Rodgers, everything's in practice a little softer and things like that.

of times he's under that kind of stress is probably very low and in my opinion your foot stretches way more inside of a shoe than it does barefoot and you need to train inside your shoe or inside your cleat because anybody i mean i'm sure some people know what i'm talking about if you just roll to the side on your shoe you will stretch the shit out of the side of your foot out of your your shin if you go real far forward or if you had weight on you in aaron rogers case he's got someone bearing down on top of him and i think that the foot is is sliding and moving slightly inside of the shoe so i think that is part of the problem obviously it could be like the field and some people point to the turf and things like that but it's also professional football so shit happens that's why guys like me have a job i do think

that these guys need to train in their shoes and and figure out ways to mitigate it otherwise it's going to keep being i mean i don't disagree with you i mean there's so many very like everybody wants to point at the fields too i think that's a big thing but it's like okay well if we look at historically how these games have been played on grass versus turf okay so more turf now than there used to be right well guess what also used to be i work with one of my clients is uh stephen boyd he played for the detroit lions back in the 90s middle linebacker unbelievable dude he's like a long island legend but he's just a phenomenal human being um and he'll be the first to say he's, I wouldn't even sniff a sideline in today's NFL with the amount of athleticism.

I mean, you got guys that are 320 pounds running, four or five, four, four forties. Like that's insane. So guys are stronger. They're bigger. They're more powerful. They're moving faster. It's absolutely unreal.

You know, and I got to watch the SEC Florida Gators when a national, you know, on the sideline, like watching it you're like whoa this is like a whole nother level of athleticism that you know you think you're a good athlete in your hometown it's like no these dudes are legit specimens right but they're also statistical outliers because they're specimens yeah tim tebow's huge he's a huge dude you know how strong that dude is like those guys those gym workouts man like even that documentary they released really don't do it justice like they

would literally fucking kill those dudes but then every game was way easier you know what i mean to your point do we lose a little bit on the nfl maybe because like oh you've made it you're the best like we don't want to hurt you we don't there's a lot of like there's a lot of money and a lot of stuff on the line so everybody likes to like oh i don't want to hurt you. We don't, there's a lot of like, there's a lot of money and a lot of stuff on the line. So everybody likes to like, Oh, I don't want to make a decision. You know,

like a guy like me doesn't last as an athletic trainer in the NFL. Cause I have, I have too strong an opinion. You know what I mean? There's a lot of like, we don't want to do that. Cause it might, you know,

it could work, but it might not work, you know? So we don't want to have the might not happen. You know, they don't want your input on what they, what, how they're going to condition or any of that kind of stuff. Not to say that might not happen you know they don't want your input on uh what they what how they're going to condition or any of that kind of stuff not to say that i mean i'm using that as a

generic example there's really a lot of professional organizations that do it very very well but there's also a lot of organizations that the head guy has been there for 30 years he doesn't want to hear stuff that's not the wheelhouse that's been working for 30 years and maybe rightfully so again that's not my point my spot to say but the is, is like when you have a closed community of providers and the barrier for entry into that community is really hard, meaning like, Oh, you got to spend 20 years, not making any money to get into that position where you could be on the site, you know, like in that realm, it's, it's very difficult. So you tend to get like an echo chamber in my opinion of here's

what the surgeon says. We're just going to execute what the surgeon says. It's like, guess how many people that surgeon's rehabilitated? Exactly zero. Not saying they're not good people, but there's a big difference between, oh, you got to get your range of motion back and your strength back. Okay, that's a very broad statement. There's lots of ways to do that. Like what specifically are you going to do? So I guess it's kind of like why we all have to play nice in the sandbox together as healthcare providers and work together and realize that there's more commonality between the different professions than there are set differences. You know, we're all trying to help people feel better, move better, hopefully move more. What are some of your thoughts on, like, the spats that they they do in football where they tape the shoe and shit like that so we spat it a lot of the linemen

in Florida not because it helped their ankles but because we had to cover the logos because they weren't because Florida was a Nike school so they had to wear Nikes and a lot of the big boys didn't fit well into Nikes so we spat their cleats because they were Adidas cleats that we were spouting covering up the logos just drawing a check on the outside um that's been pretty much debunked in terms of like does it actually help your ankle stability probably not because to your point your foot can move inside that shoe so if you're going to tape an ankle you're better off taping an ankle but even then you're taping an ankle and after 30 40 minutes that ankle tape is

pretty loose just because it got wet so i think part of why athletes like it is the same reason you like that voodoo band. It's compression. It feels good. It feels like I'm supporting something. A really good ankle tape job will take away maybe that inversion moment so that you can train a little bit more confidently without risking flipping into that spot where you got hurt. Is that maybe a bad idea though, you think? or no, not really. You don't think, no, I think,

well, time and place, right? That's a protective strategy, which is a short term strategy. So I have to get around. I have to get you through practice. We're going to tape up your ankle,

get you through practice. Then we're going to go rehab this thing. That's what should happen. A lot of people just take, I'll just tape my ankle and listen, I'm guilty of that. I did that in college. Cause I remember I finally got cleared after my knee and I was, guilty of that i did that in college because i remember i finally got cleared

after my knee and i was it was like winter break i was at the local school and i was like playing wall ball i was just trying to get my feel back sprinting back and forth cutting hard like getting my stick skills back and what happened i was getting a little tired boom blew the ankle out golf like cute looked like a softball black and blue tore the ligaments and i show up to practice and i go to my athletic trainer i'm like yo scott i'm like you know i need you to tape this ankle and he's like what he looked at me he's like i'm not taping this thing he's like you can't play i'm like shut the fuck up and take my i'm not missing anymore but again i was 18 trying to play d1 lacrosse and like trying to like prove my spot you know know, true. I had to watch everybody play for all the fall ball.

I didn't get a chance to like do anything. And everybody's like, who the fuck is this guy? They were, um, but yeah, it didn't work out well. Not a good idea. Don't do that. Don't do that. As far as, uh, education for people who are like manual therapists, because you mentioned like Dan Jacobs mentioned anatomy trains.

Who else are like pieces of education or certs or things that you think those individuals should try to pay attention to or to broaden their knowledge? Because one thing is you have a very broad scope of knowledge that you can pull from. So what are your suggestions? I think I got better as a manual therapist as I got better as a strength coach or movement coach. strength coach or movement coach. I think partly, I think what you see is you get people who are hyper good at manual therapy, but they cannot prescribe exercise to go with that. So they're leaving results on the table. Conversely, you get the therapists out there who are like exercise fixes everything and they may be right. Fine. That's good. But they're leaving results on the table because they can't get you there faster. So I kind of in two different

portions of my career went really deep down the rabbit holes in both. And I think that's, you know, something that most more manual therapists should do is, you know, go, go shout. If you're a massage therapist or an athletic trainer, PT, that's really into manual therapy, go shadow or work with a really good strength and conditioning coach. Like I got, I was really lucky, man. I worked at the university of Florida, Matt Delancey, that dude, he really good strength and conditioning coach. Like, I got, I was really lucky, man. I worked at the University of Florida, Matt Delancey, that dude,

he's the strength and conditioning coach for all the Olympic teams, track and field, volleyball, swimming and diving, gymnastics. He's got more

national championship rings than he has fingers and toes to put him on. He's a, he was a, he almost, he qualified for world's strongest man

and then blew his bicep tendon out training. Fuck. Yeah, it sucked and it kind of like tookp tendon out training. Yeah, it sucked. And they kind of like took him out of it. But, you know, super strong dude, big believer in the powerlifting, traditional models of Olympic lifting for power development, but really was open-minded to a lot of other stuff.

And I got to work. He's like, hey, man, we're training at five in the morning. I know you don't have to be here, but if you want to come down and work with us, I'm like, I'm there. I was there i was like say less so i was in that weight room working with the athletes even though my job was the sports medicine side i embraced the opportunity to work with a really good strength coach i was at george washington for my graduate work i got to work with ben kenyon he's the strength and conditioning

coach for the 76ers now you know he's a i got to learn from really good strength and conditioning coaches while i was in my sports medicine kind of track. So I just saw the value in both, but systems to look at, I think, you know, um, really learning the neuroscience stuff, like the NOI, the neuro orthopedic Institute, they're out of Australia. It's probably some of the leading pain researchers on the planet currently. Um, really, there's a book that they wrote or released years ago called Explain Pain. You guys should check it out too. Phenomenal resource for really understanding complex pain science and being able to communicate it

in a simpler way and make people feel not broken. You know, the anatomy train stuff was just mind-blowing because it's just a different way to look at anatomy. You know, we all learn like muscle origin, insertion, action, blood supply, nerve supply, but really seeing kind of how these things connect together and how muscles attach to other muscles, essentially, and how we transmit force really...

I mean, again, like, if you look at some of these other systems, they're rooted in that. You're talking about, like, oh, these angles, and this is how you produce power. It's like, yeah, those are fascial slings, man. Just loading potential energy into tissue and uncoiling it into kinetic energy. Um, so those were great. I mean, I, I took a lot of, I think assessment is huge to being able to really dissect movement, um, from a global and more local approach. So like, you know, functional movement systems, great cook, love, great cook. The SFMA

was a huge course for me back in the day that I really got a lot out of like being able to kind of hey is this a software problem is this a hardware problem is this you know obviously i love the frc stuff huge fans of dr spina and what those guys are doing i think you know it's funny because people are like oh you got to check out these pails and rounds and i'm like yeah that's end range isometric so what about it i didn't really get it at first and then i was like okay it's just a system. But it's a beautifully well-designed system that they did for you. So guess what?

All my interns, all my employees, they all get sent to that course. Why? Because they built a beautiful system that helps. We all have to anchor to certain systems, you know, so that you can start to try to solve these problems. But I think what happens is you'll get a lot of clinicians that anchor to one system and that's the only system that they can execute.

And so I've kind of always found that a multi-systems approach is filling in the gaps, you know? So, you know, I think you hit a lot of the big ones. Again, I was a lot of influence by Eric Cressy and his work and all the T Nation stuff back in the day. I read a lot of influence by Eric Cressy and his work and all the T Nation stuff back in the day. I read a lot of that gentle core stuff, Eric Cressy, Mark Ripito, all the, the freaking goats, Craig Liebenson, you know, there's so much stuff out there. Obviously Stu McGill's work, you know, the big three he's, you know, he's a freaking goat in our industry. And again, even his system has holes in it and people will be like, see, it doesn't work. And it's like, dude, relax. It works for a lot of people and he's helped a lot of people get better so shut your mouth gotcha

yeah it seems like you're a fan of all of it almost right i mean it's just i love it all man there's a time and place for isometrics there's a time and place to concentrate on the eccentrics there's a time and place where somebody might go through a training phase where they might predominantly look like they're doing a lot of PT work. Maybe they're not doing a lot of heavy loading, and there's going to be a period of time where they maybe look like a power lifter or a bodybuilder. Just keep kind of shifting things around as needed. Absolutely.

And again, that's the art of coaching. That's the part we can't quantify or measure. And then as you get to these bigger systems coaching. That's the part we can't quantify or measure, you know? And then as you get to these bigger systems, and I think the part that like, you know, you guys have had some really great PTs on, you know, and that also like to play it safe. Well, the research says this, right? So they're taking the responsibility away from themselves saying, well, this is what the research says. It's like, no, I asked you what you thought, not what the research says.

You know, the research is there for us to interpret and apply when and where necessary. Right. So that's kind of where I'm like, man, just answer the question. But yeah, I agree with you. I think I've, I've gone down a lot of different rabbit holes in my career. And then the more I've done that, the more I've learned that there's a time and a place for everything. And I love Charlie Weingroff. Like he's another big influence on mine. And he, he says this really well, and I'm going to give him credit for it this time, but next time it's mine. But he says like all these systems,

keys on a key ring in your early in your career, gather lots of keys, but then you have to learn which keys unlock, which door. And that's the thing, right? FRC, I don't FRC everything.

It's a, Hey, here's wow. You really lack end range control. Let's mix a little bit of that in and see how you feel. Oh, Hey, here's, wow. You really lack in range control. Let's mix a little bit of that in and see how you feel. Oh, I feel better. Bingo. That doesn't mean FRC is an infallible system. It just means that I use that key for that particular door because it showed me upside for you based on my assessment, which is a blend of FRC. It's a blend of PRI. It's a blend of, um, SFMA. It's a blend of movement, uh, you know,

planar, planar mobility or the fascial anatomy model. So it's just like little bits of blends of everything together. It's like the Bruce Lee method. I just kind of amalgamated them all into our system or which I'm constantly changing, you know? So it's not even like I have one system that I've used forever. It's constantly evolving based on the things that we learn and all the new stuff that's out there. Let me ask you this. Um, I know you're jujitsu athletes aren't the only athletes you work with, but you've worked with quite a few now seeing the sport and what these athletes are, what they need to put their bodies through. Uh, what are the skills that you think that they need to be able to develop outside of the mat? Like awareness, as far as their body concerned, what are the skills that you think that they need to be able to develop outside of the mat? Like awareness as far as their body concerned, their ability to like breathe and

move their rib cage. What are things that you think that they should try to build if they're doing that sport? Because there's a lot of people that are getting into jujitsu now, and I think they end up getting surprised about the problems that they end up having or the lack of ability they end up having when they enter it. Right. You know, I'll ask you this question and maybe you can answer it for me. Okay. And then I'll answer the question. What is the incidence of low back pain in jujitsu? What percentage do you think of jujitsu athletes face low back pain?

Shit. I would say, I would say an upwards of 50%. It's a hundred percent. it's a hundred percent it's a hundred percent yeah the ibjjf they did a study or they sponsored a study looking at like the epidemiology of injuries in jiu-jitsu and it's like basically if you do jiu-jitsu you will get low back pain at some point like that's like it's not to say that you get you're doomed to that it's just super common based on the demands of the sport. I think the FRC system lends itself really well to jiu-jitsu athletes. I lean on that system a lot

as a way to build capacities and ranges that would otherwise be vulnerable for you. What do those guys do? What's FRC? FRC is Functional Range Conditioning. Another group of Canadian dudes that kind of built this model of the cars

and end range isometrics, end range liftoffs, end range holds. Like these are things that I was doing forever, but I didn't really have like a system behind it. So the whole premise is like, when it comes to movement, there's this, it's called Schmitt's schema. It's this idea, this was like a,

this was done by like the psychological community in the 70s, but this idea that When you do a particular movement your brain hangs on to Compartmentalized information about it so that it can put it together and use it for other things in the future So for example, if you're playing like tennis You're never going to have the exact same tennis hit Every time in a row the ball spins different the surface is different your angles are different like i got into surfing a few years back that was became my new like

movement thing i got really into because i sucked at it so badly yeah and i live on long island so i was living in long beach i was like oh grab my board go down the beach and just get my ass kicked by the waves but the idea is why do surfers talk about flow or like that they're just in the zone it's well there's a there's compartmentalized skills that you need for that balance proprioception some core strength hip mobility but you're never going to surf the same wave twice so it's completely new and novel for you every single time so we talk about like flow state is when you have a skill set that you're proficient in and you're pushing the boundary of that skill set within the context of sport or activity, but it's novel for you each time.

Musicians talk about it. Really good book. If you guys want to check it out, it's called Stealing Fire, Stephen Kotler. Yeah. Right. It's kind of like all this neuroscience of like flow state and that kind of stuff. Super interesting. But I think for jujitsu athletes specifically, it's, you know, there's the blend of your base strength and conditioning and your

joint mobility work to, to have capacity in different positions of a wide variety of nature. And it's nice because you can, now you can kind of compartmentalize it. Hey, I'm going to do really a shoulder mobility day and a hip mobility day. And I'll work on my spine mobility day. really a shoulder mobility day and a hip mobility day. And I work on my spine mobility day. Right. And then maybe, uh, accentuate that or accessorize that with your strength,

your traditional strength training type of movements, right. Building some, because at the end of the day, you know, part like, you know, your weight class,

you do well because how much of that is muscle versus fat? I mean, again, like for you as a, as an athlete, like probably stronger than a lot of the guys in your weight class, right? Because you've been training this way for a really long time. I would say that that's a competitive advantage. No. So, you know, again, when people like,

oh, bodybuilding, muscle, you know, powerlifting is not good. It's like, it's mass from a physics perspective, mass means power. You're going to be able to produce more power. So I think working and then working contextual situations with those skills, right? So that's where like a lot of guys will say, Hey, we're just drilling today in jujitsu. Yeah. You're working on maybe slower skills of movement to create motor plans for when that opportunity may arise. Boom. Now you have access to it and you can execute it. So as we all suck at stuff, when we first start, the more experience we get, the more data points our brain has of where we can potentially fit these things in to solve new problems in the future. So I just try to keep that in mind too.

And I'm like designing training programs for different athletes in different sports is where is this athlete today? Where do they want to go? And what do their sport demand of them? And where's their greatest return on investment right now? demand of them and what are what's where's their greatest return on investment right now how do i make them the best athlete in the next four week training block and the next four week training block and the next four week training block and that's to mark's point changing it up you might work on different skill sets at different times or even different parts of the year depending on when your seasons are so jiu-jitsu is tough because you guys compete like year-round basically

yeah you know i mean maybe there's the heavy like worlds and euros. It's like within a few months of each other. But for the most part, you got local meets and local competitions. It's a tough thing to do sometimes. So sometimes I'll be like, hey, listen, let's go through a three to four month off season. Yeah, you're rolling and you're doing your jiu-jitsu stuff, but let's really focus on the athletic development side of this. And then that's secondary.

Maybe this is a good advice for you, Andrew. It was like, you can't do it all and progress in all of the things simultaneously. You have to pick something. So I want to get really good at jujitsu. Okay, so maybe for three to four months, you're working on skill development as far as drilling goes

while you're saving that energy expenditure for the gym to maximize what your body can do. Now you can go back to jujitsu with a whole new skill set of how to solve those problems. And now then you're going to hit the wall with those skills and you're going to have to keep going back and forth. Well, I got to say those, what you said was beautifully said, because in jujitsu, you get into so many different ranges that are dynamic, that are not always the same with external loads and man's tough. But I started Jiu-Jitsu eight years ago. I was in more lower back pain.

I had more general pain. I did eight years ago than I do now. Now it's literally one tiny thing. But I have been able to develop strength, develop movement ability. And I don't want people to hear the thing about the lower back and say, okay, 100% of Jiu-Jitsu athletes have lower back pain.

I know, but the thing is, that doesn't have to be the a hundred percent of Jiu Jitsu athletes have lower back pain. I know. But like, the thing is, is like, that doesn't have to be the case, but you just have to put in the effort with your strength training and with the things you do outside of it so that you can have a resilient body for the sport. But a lot of people don't do that. I mean,

what's the incidence of injury in the NFL? A hundred percent. It's not if it's when that's it, you know, it's any again. And like, I know you guys have had a few shows recently on like the whole injury prevention thing. Can we prevent injuries?

Yeah, statistically speaking, we can't prevent injuries, but we can mitigate risk. Yes. But you have to know what you're training for, right? So it's like, great, the sport. Everybody wants to reverse engineer great athletes into, okay, this is what we have to do. But you're reverse engineering statistical outliers. How do you make Johnny do that? Who's Johnny?

I don't fucking know who Johnny is. Johnny's like the regular guy who works a desk job all day and then goes and rolls at night. Like we're the lucky ones, man. We get to do this stuff every day. This is what we do. So I always try to remember it's like this person has a whole other life outside of their athletic kind of like endeavors, we'll call them. And there's only so much energy that they can spend on these things. You know, so we, you know, for the regular person, the NARP, the guy who's like, I want to start doing jujitsu, you absolutely should.

Why? Because you're going to start to love movement again. You're going to start to want, there's going to be something for you to pursue excellence in there that's going to motivate you to do other things yeah call that winning yeah i had you know roughly two decades of lower back pain started jiu-jitsu a year ago and my back pain's never been better because you're moving more yeah and you're moving more dynamically absolutely you're exploring where you're limited but you're still part of 100 yeah because you have because he had it at some point maybe prerequisite i'd already had it so I can't get it again. Your grandfather. Yeah, my grandfather.

You've been vaccinated against a little back pain? Yeah. We'll test that theory. That's awesome. That was great. What are some things that people can do for back pain do you have like i know it probably varies so much because people can come to you and they had a car accident versus somebody has this or that but have you seen anything any common things with uh some injuries

that people run into because back pain is such a huge one oh man i mean you know back pain is like the panacea of medicine there's a million different causes a million different solutions big broad strokes correlations that i've noticed people have crap hip mobility and they ask their spine to do hip stuff and eventually you're gonna have a bad time that's just the way it is you know if you if you don't have good you know having good spine mobility and poor hip mobility still puts your back at the disadvantage, right? So you're going to have to lean on those other joint segments more. And each of our joints, the way that they're structured, has a particular set of skills that it's good at.

So yes, they can work together. Beautiful. That's what we want. But they also have to be able to disassociate, right? Can you disassociate your hip from your spine? That's the test that I took you through today. right? Can you disassociate your hip from your spine? That's the test that I took you through today. So when I'm looking at your standing hip car, I'm looking at how well do you manage single leg stance or an unstable position? How well do you, can you disassociate? Oh, you can't. Okay.

Let me help you clean that up. Let me give you more information. Now, can you do it still now? Okay. There's something mechanical here going on that we want to work on. I think hip mobility, I think again, like a lot of people who are, I see this a lot. I'll get like athletes that were college athletes get into the workforce. They're working in finance or a desk job. And then they start just doing general fitness. And all of a sudden they start like CrossFit, for example, and they start to have issues. It's like, okay, well you took your entire grow, you know, your entire lifespan growing up doing this one particular skill that's made

you asymmetrical. And now we're going to pile a lot of symmetrical bilateral load on top of that. So you, you're going to have some problems, man. And again, there's plenty of great CrossFit spots out there.

And like, let's give, let's give the devil his due. That's put more barbells in people's hands than any other sport ever did. So you got to, and I know you guys, you guys had them on recently, right?

So yeah yeah really cool but again how are we screening these people before we throw them into a chaos training we're not and most people get hurt because they don't know where they're at right now so like we blend functional fitness together with just a good assessment like let's just get a baseline of like where your current competencies are okay great now i know what you can do decently well we can build on that and we can work on in your programming the things that you don't do particularly well so that you're more well versed in all of it but i agree with you i think we can mitigate a lot of stuff um with a little bit more education a little bit

more time and a little bit more patience you know and just working on these things but a lot of people just want the quick fix what are some of your thoughts about uh ben patrick and knees over toes and some of the stuff you've seen from that because that's also another area that people are hurting in a lot because their knees are banged sure i would say again you know like um a lot of people i think give ben shit because he kind of like had this meteoric rise to being like in the public eye and the reason i love his stuff is like you can just see the passion spilling out of that guy how do you not get attracted to somebody who's just so he loves it passionate about what he's doing you know is his system the end all be all systems probably not they'll again as it goes on more and more

there'll be research that comes out that says oh this is bad and blah blah blah for the general population and and you know again to be fair we don't know about the people who tried atg and had worse knee pain those aren't people we're talking about is are those people out there i again no no shade thrown his direction because i think what i think his stuff is great you know and i'd be lying to you if 20 years into my career doing this, I didn't start incorporating some of that stuff. Cause I got a shitty knee too. That's surgically correct. And I was like, you know what? I have been avoiding my knee over my toes and I want to start exposing myself to that. But I also have a lot more background understanding of biomechanics and all of these things where I

can apply them in a way that's safe for me so that I can progress it. A lot of people who don't have that knowledge are leaning on the system, you know? And so what happens is they're going to follow that plan. What happens when the plan starts to deviate? What happens when it doesn't go according to the progressions that we're looking for? And again, I think he's solved for that in a lot of ways. And I think he's helped a lot of people be more confident or say i'm gonna do something and they download his program they buy it and they can stick to something and they get a result like yeah freaking awesome man and he's been able to monetize that and build a huge channel i'm fucking awesome good for him i love it i think it's great it's great to get a

lot of people to recognize you can solve your own problems. A hundred percent. And a lot of it could be solved through some movement, might be some activity that maybe you don't love doing, but, and also maybe addressing the fact that maybe, you know, possibly their knee pain or back pain is coming from not only like maybe faulty movement patterns, but maybe some weakness somewhere. Maybe there's an area that you just, and weakness is like, can sometimes be almost derogatory to somebody, but it doesn't have to necessarily be weak. It's just something that you haven't really worked on. Over the years, especially as I learned more about the pain sign stuff,

I became much more careful about my words. I don't call stuff weak. Yeah, you're new to this, rather than saying you're weak. Like, oh, your qu quads are super weak that's why your knees hurt right you know what information you're providing them you know i mean if like all your all you're like oh these are all negatives i always say like when i'm taking people through an assessment my assessment's 90 minutes like when people come see me and you know it's 90 minutes and they get a treatment with that 90 minutes too so it's usually about an hour of assessing about 20, 30 minutes of treatment.

And, you know, the whole time I'm like showing them all this biomechanics stuff. And I'm like, I want you to keep in mind that these are opportunities and not flaws. All this, all these things that I'm writing down that we're talking about that, oh my gosh, like I don't want people to feel so overwhelmed because there's a lot of information.

But I do that because this is nuanced shit. You know, this is complicated stuff and you have to have some, there has to be some base level of understanding for that client or that patient so that they have ownership and autonomy and the responsibility to do something about it. Because if I just give you a sheet of paper with no context, where's the, where's the exchange of responsibility? Where's the, I understand why I'm doing what I'm doing, right? The great Aldous Huxley would say, the person who understands their why can endure any how. So it's like a lot of us don't do that with our patients.

We don't understand their why because we didn't take the time to ask. And we didn't take the time to really assessing it didn't take the time to really assess and get to know them of where their linchpins are i call them linchpins for that reason because it's less scary and doesn't have so much of a derogatory term to it it's like oh your core is weak it's like well i know professional bodybuilders that are absolutely shredded that are strong as an ox that have instability in their core because strength and stability aren't the same thing but i'll say, your core is weak. You know, that's just from, and this is what happens when you get research

that people grab a hold of and they go, this is the reason, right? So there's some, the reason that came about, I think, I forget, I think it was like in the late 70s, early 80s, they did EMG or electromyogram studies. Like it's basically muscle activity, electric muscle activity of your abs in people

with low back pain and what they found is people with less emg activity of their abs had a higher incidence or correlation with low back pain so they said oh weak cores cause low backs so they took something that was correlated and we took and then we made it causative yeah but it's like hey how about this ready if you dump your pelvis forward and you put your abs in a crappy position, we were talking about this before muscles fire based on joint positions, period. So if you can't access different joint positions, you're not going to be able to have a mechanical advantage on those muscles. So your brain might just use other tissues. So if you're dumping your pelvis towards the spine and you're doing towards, towards the floor,

and you're doing hip thrust, you're like, man, my back is super pumped. It's like, that's cause that's your glutes now because your pelvic position is making the moment arm that your lumbar paraspinals have a better mechanical advantage than your ass does. So that's what you're going to use. And you're going to feel a pump and it's going to start to get, maybe get uncomfortable or maybe you start to lose some flexion capacity. So there's always these things.

But yeah, I think to your point, it's like, you just got to some flexion capacity. So, there's always these things. But yeah, I think, to your point, it's like you just gotta be careful with what you say. You know? And just try to... I try to give people... I try to like weave in the story of victory into the assessment. It's like, oh, you've succeeded despite this issue? Mm-hmm. What's gonna happen when we start cleaning it up a little?

I like that term too, cleaning it up. Mm-hmm. Because it's not like, oh my God, your house needs to be completely rebuilt. We just got to like clean some shit. We got to like, you know, tidy up the cabinets and get the floor a little cleaner. And all of a sudden that house is a whole lot better

than it was before. So obviously therapists need to be more careful with what they say, but how do you help the individual be more careful with what they say? Because I remember years ago, I had a meniscus surgery after soccer and I would just continue to tell myself because you know getting into squats for powerlifting there'd be a painful aspect to it there'd be a painful aspect to deep knee flexion and then i'll

i'll i'll just tell myself okay well my knees are like this for pretty much the rest of my life this is what i have to deal with i have bad knees started working on them started being more aware after meeting ben worked on them i can't tell where the issues are now. Like, like when we worked together, you're like, which needs you have surgery? And I had to look at the scars, but that was, I think one of the first shifts I had in the way I looked at all of the pain I had once I was able to fix that aspect. I was just like, okay, this lower back shit, all this other stuff I could fix. It's fixable, right? It's fixable. So the way I related to any type of pain became a very different thing. So how do you help the person

who's extremely negative when it comes to aspects of their pain? And for good reason, maybe they've had it for all their life or they've had it for as long as they can remember. But if they want to move forward, they have to relate to their pain differently. They have to verbalize it differently.

So how do you help them out? 100%. I mean, a lot of us have those self-fulfilling prophecies that we talk about, like how your self-talk can influence not only your psychological states, but your physical states also. Like there's this, even this research that suggests that somebody's posture is more indicative of their psychological state than of their actual anatomy.

You know, like, like think about it. Like if I walked in here, I was like, Hey guys, you guys ready to do some work today? You know what I mean? You'd be like, what the fuck? Fuck out of this power project, motherfucker. Um, sorry. Am I, I'm allowed to curse, right? Okay. Sorry. Too late. Um, so first off I'm a New Yorker, so I just call them out on it. Be like, that's, there's no room for that here. I will not, I will, I am not going to speak of you in that way. Therefore you will not speak of you in that way. Period. That's a rule here. We don't do that. Oh shit. Okay. Well, and then the other part of it is I just explain it to them. I think a lot of people just need that in understanding like, Hey, listen, you know, we got to reframe this a little bit, right? There's even, I was reading this research. It was, again, more psychological stuff, because that's just the rabbit holes I'm in right now. But looking at, like, people, I think I saw,

it was a soundbite on Instagram from Will X, you know, that podcast. Yeah, Chris. Chris. And it was, like, people who have just enough trauma in their life to be high achievers versus people who have too much trauma and they adopt like negative coping mechanisms like drugs or all those other things right

so it's kind of the whole but like what's the difference between those two people it's it's the framework it's the hey i learned something about it versus i this happened to me or it's the whole like it happened to me versus it happened for me. So I, again, I just, that's what I mean about, like, weaving in the victorious story. I weave in the story of the comeback. It's like, you're going to be a fucking monster. You, and like, I gave you guys those t-shirts, like, our whole mantra is like, be unbreakable. Be unbreakable doesn't mean that you're never going to have injury or pain or your low moments where you just can't cope. It, be unbreakable means that no matter what

fucking happens, you're not done. We come back, we go again, one more rep. We try another way. That's it. It's a mindset. It's a mindset. And I think part of, you know, the commercialization and the scalability of healthcare, what it's become is very impersonal, right? People are like, oh fuck, like I go to the doctor. It's like a horrible experience from beginning to end. It's, you know what I mean? It's like, oh, here's all the shit that's wrong with me, but nobody provides for you a solution, right? So I'm just trying to like, hey, here's what we found. Here are the solutions. Now people leave. It's like, wow, I don't, I know I had, they come in, they know they have issues. Like they wouldn't come to me otherwise. Like they know there's something up, but they leave with some kind of direction and i think that's part of the magic that happens it's like

now i have a way to pursue this and move forward whether they sign up with us or not how can people go see you i mean we're pretty easy to find on on social you know so you can find the clinic at the movement underground um you know you can find me at mike still underscore atc but you know you can text us our numbers on on the website so you can reach out. And if you're in our area, we'll certainly see in person and we do virtual stuff, too. And again, it's a little bit of blend of everything. So, you know, we try to really just get to know our people and our clients and give them tangible solutions or tangible ways of moving forward. And it doesn't always work 100%.

But again, it's find the big ROI, find the linchpin. So let's start working on that, and then we'll progress from there. What was the acronym you told me earlier? B-O... B-O-A-F. Both. Both. You said to do both, right?

Do both, man. It's not one or the other. All of this stuff is shades of gray. There's no one system. There's no one way to get out of pain. There's no the answer. It's just a pot of answers. So I just try to boil down that pot of answers to the things that I think are going to have the biggest outcome effect.

But I think even to answer your question again, I think the manual therapy part, helping people get an early win. Get a win early in the process. and that can help create a little momentum you know thanks for working on all of us appreciate oh man it was my pleasure this is this has been really cool you know i'm a huge fan of you guys and and what you're doing for our industry and being open-minded i think there's a lot of dogma and stuff out there and you guys are really showing everybody hey like have an open mind and let's have a conversation about this and i love long-form podcasts like this where we can really unpack some of these topics because 37 seconds on instagram is just not enough strength is never a weakness weakness never strength catch you guys later bye