Welcome And Why Injuries Happen

SPEAKER_00 0:00

So you're thinking about running, but not sure how to take the first step? My name is Brian Patterson, and I'm here to help. Welcome to Brian's RomPod. Hello and welcome back to Brian's RomPod, and it's me, your host, Brian Patterson, with some more hints and tips about running. Now, if ever you've picked up a niggle, which I'm sure most of you will ever have done, or had a frustrating injury, or just wondered how on earth you stay consistent with your running without constantly breaking down, then today today's episode is absolutely for you. I'm joined by today by Dr. Ben Baumgardner, a founder of Alpha Sports, who specializes in helping athletes build resilience, recover uh properly and perform at their best. What's really interesting about Ben is that his journey into this world actually started with his own injury frustrations and not getting the answers he needed and realizing that there had to be a better way to support athletes. Fast forward to today, and he's working with everyone from everyday runners right through to at least athletes. Um and in this episode, we're going to dive into what runners are getting wrong when it comes to injury, what multidisciplinary care actually means in plain English, and most importantly, what you can start doing right now to stay healthy, keep running, and enjoy it a whole lot more. So whether you're just starting out or trying to stay consistent week after week, this one's packed with a lot of practical takeaways. So let's get into it and welcome Ben to Brian's RomPod. I just thought I'd cover that for the audience for you. So um Ben, welcome to the podcast and thank you very much for agreeing to come onto the show.

Ben’s Business Mindset In Sport

SPEAKER_00 2:04

Um now, uh as I said in your uh your in the intro, is that uh just sort of take us back as of that, you were uh originally a business crowd. You didn't really come the traditional route into sports physiology, is that correct?

SPEAKER_03 2:20

That is correct. I found out pretty early on that I wanted to do sports chiropractic when I was about 15 years old from an injury that I had had. And then I realized that most of the medical providers that I had come across were honestly pretty terrible at the business side of it. And I knew I ultimately wanted to own and run my own practice with my wife. And so we decided, because we got married pretty young, we were both actually gonna go get business degrees from the university that was graduated from. That way we could have a leg up on that side and be able to actually operate a business well, not just treating patients well.

SPEAKER_00 2:59

Yeah. So it's like, you know, it's not just about being good at the special, the specialism, as it were, but also the the marketing side, the accounting side, that kind of thing.

SPEAKER_03 3:12

Very much so, yes. And I unfortunately love the accounting side. I love getting into Excel spreadsheet.

SPEAKER_02 3:18

All right.

SPEAKER_03 3:29

I am not one of them. I actually thoroughly enjoy the admin side as well as the trading position side.

SPEAKER_00 3:35

Now I know this is an audio podcast, and I know we do share some of uh the video on our social media, but I can see behind you that you do have a to-do list and on the top of it says monthly budget. So you do um uh you do put your uh uh you know, speak the truth as it were, in terms of liking, you know, the Rexel spreadsheets, that kind of thing.

SPEAKER_03 3:59

Oh, I definitely do. And that's my wife's handwriting, and those are things like make sure that we go over together just because I do it so often, I know exactly where it's at. I know where we're at every day of the month. Uh she is not in it as much as I am. She's a massage therapist, and so she is seeing clients as well. Yeah. So it's a reminder to us to actually sit down and meet to go through it with her so she knows where we're at.

SPEAKER_00 4:23

Right. Okay.

The Injury That Shaped His Career

SPEAKER_00 4:25

Now um just to sort of go back a little bit in high school, um, so were you did you did you kind of excel in any particular sports, or was was it just that you were very much into the sort of physiological side?

SPEAKER_03 4:42

I um I excelled decently well in football, uh American football, and excelled decently well in track.

SPEAKER_02 4:51

Yeah.

SPEAKER_03 4:51

Um I was at a small enough school to where if you were fast enough, yeah. And so I did. And I played football straight into basketball, straight into baseball, and then into track.

SPEAKER_02 5:01

Yeah.

SPEAKER_03 5:01

Um and it was when I was playing baseball and running track at the same time as when I actually had my injury. I was about 15 years old and I'd finally run a sub fifty quarter in the open four hundred. Oh, right. Um, that's pretty fast.

SPEAKER_00 5:16

Yeah.

SPEAKER_03 5:17

Felt great about it and I was like, sweet, this is awesome. Yeah. Um and then the very next week I had pulled my hip flexor playing baseball, trying to throw somebody out when they were stealing from second base to third base.

SPEAKER_02 5:29

Right.

SPEAKER_03 5:29

So that began this whole entire journey, I would call it. When I got injured, I went and saw a bunch of different types of sports physicians. I saw orthopedic surgeons, I saw physical therapists, I saw chiropractors, and all of them could collectively, they didn't do a great job. Right. It wasn't until we found a chiropractor that did a little bit more soft tissue than normal. He did some kinetio taping with me and he did a little bit more rehab just because he knew I wanted to run, and that was his background as well. And so I wanted to get back on the track and run as fast as I could. And he got me back to about 90% of my capacity.

SPEAKER_02 6:04

Right.

SPEAKER_03 6:04

Um, and but I had a blast while I was in the office with him. It never felt like I was doing any work. It felt like I was just hanging out with somebody and getting treatment at the same time, and I loved that. So at 15 years old, I decided I want to be a sports chiro. Um, I also found out how much he made, and I was like, that doesn't sound bad either. So, you know, sounds like a win-win right now.

SPEAKER_00 6:22

Yeah. It's funny you saying that, and I have interviewed, well, physiotherapists over here. And um, in a couple of cases I've interviewed them, it it has been that they've either been doing, let's say, one particular case, I interviewed someone who was a did martial arts and they got an injury. And it was the fact that when through the injury that he was learning about his body and also about it potentially being on an alternative career move. So it's funny how you know things sort of move you into different careers, into a particular career.

SPEAKER_03 7:01

Oh yeah. Yeah, I agree. They the experiences are what mold us.

SPEAKER_00 7:05

So yeah.

Underfueling And Repetitive Microtrauma

SPEAKER_00 7:06

So let's get into I mean, I my audience is predominantly sort of uh runners or people who are starting out on their journey in in running. So let's kind of get to the numb of it. What what do you think runners, in your opinion, because you work with them kind of on a daily basis, what what do you think runners get wrong about about injuries?

SPEAKER_03 7:28

Um, one of the things that I've learned probably about three years ago, we had a dietitian that was working in her office, and we found out very quickly that a lot of our long-distance runners, when they would start to get stress reactions or stress fractures, that that was actually an underfueling problem first and foremost.

SPEAKER_02 7:44

Oh, right.

SPEAKER_03 7:44

So we found out that if we're not consuming the correct amount of protein was the biggest one that we would find, that our athletes were not consuming enough protein. And because of that, your body would not be able to rebuild that bone structure as it's getting stressed.

SPEAKER_02 7:59

Interesting.

SPEAKER_03 8:06

What we have found is that 80% of our athletic injuries come from repetitive microtrauma. So doing the same thing over and over and over and over and over again, which is what leads to stress reactions or stress fractures. So that is one of the biggest things that I think runners don't realize is that if we're not consuming enough, if we're not fueling enough, because we are a Ferrari out on the highway, we need to be making sure that we're putting, you know, the top fuel into us, not uh junk food and making sure that we're getting the right amo amount of protein and carbs and fat into our diet.

SPEAKER_02 8:38

Yeah.

SPEAKER_03 8:38

So that we can actually repair. Because what we have found with Team USA, I work with Team USA track and field and I work with Team USA Bobsled, so spring and low runners. And what we have started saying is that it's not an over-training issue issue, it's an under-recovering issue. And under that umbrella of under-recovering is fueling properly, getting enough sleep, and then actually having a program that will stimulate you correctly. We also see that a lot of our runners will, especially if they're just getting into running, they will just go out and they'll just run as far as they can, as fast as they can. Right. As long as they can.

unknown 9:13

Yeah.

SPEAKER_03 9:14

That's a spiked increase in load. And that's the other time that we see injuries most of the time is when our body is not able to handle the load that we're putting on it. So a regular load that you're prepared for doesn't break you. It's a load that we're not prepared for that breaks you.

SPEAKER_00 9:28

So it's kind of a very fine balancing act in terms of uh diet, which you've talked about, sleep and obviously rest, and then obviously the training side.

Sleep Consistency For Real Recovery

SPEAKER_00 9:40

Yeah. So on the I mean, this on this on the sleep side, I mean, I know professional athletes tend to uh take rest periods rather than you've to you could t you'd tell me, um you're the expert, so that they may take rest periods uh twice during the during the day, and then intermittently then they would have various sessions within that day. So how could let's say someone who has works nine till five or eight plus hours go to the gym? How can they sort of improve on their sleep?

SPEAKER_03 10:13

Yeah, well, the biggest things we see when it comes to quality of sleep and improving that is going to be going to if we don't have the time like the professionals do when they're at a full job train in the middle of the day, and they can do a hard session in the morning, they can take rest, and then they can run and do another hard session in the evening if they're doing that kind of training cycle, is we need to make sure that we are as much as humanly possible going to bed at the same time every night, waking up at the same time every morning, and then we can get up actually eating breakfast, even if we don't like it. Yeah, even if it's just a quick little applesauce or it's some oats or it's uh some oatmeal, something, some yogurt, something that's gonna get our metabolic state kind of moving in the morning, will help to shift our circadian rhythm so that our body is ready and primed to go to bed at the same time every night. It's also ready and primed to wake up in the morning, every morning. So when your body is getting into that consistent cycle, you'll actually hit deep wave sleep, which is when we physically recover faster, and you'll hit cycles of that, which is one of the biggest things that we see, which is why I love like wearable devices. Like I wear a whoop.

SPEAKER_01 11:19

Right.

SPEAKER_03 11:20

A lot of people have horror reinnings and they have garments that track a lot of that stuff for us now, which is amazing to be able to see, like, okay, what what kind of consistency do we have in our sleep patterns? And I would say consistency is king when it comes to sleep patterns, and sleep is the number one ideal way to recover. Yeah. And I love to tell athletes that, hey, I'm gonna be your best advocate when it comes to being able to recover really, really well. But and at the end of the day, I tell them sleep trumps me every time. If you had to choose sleep or you had to choose me, I'm gonna tell you you need to go to sleep.

SPEAKER_02 11:54

Yeah.

SPEAKER_03 11:57

I really like to be, you know, out there doing a job.

SPEAKER_00 12:00

Yeah.

Strength Imbalances And The Four-Day Rule

SPEAKER_00 12:01

Can you I mean a thought just sort of occurred to me, can you predict in terms of when's your likelihood of a potential injury? Uh, if you get on the main, I mean I I had a um do dysmedius injury which I kind of struggled with last year, and it's you know, and I it was I I had to go to this particular video and get do strength training. But is there anything that I could have done prior to that that that could have given me signals that, you know, if I carried on training the way I'm I was training or running or that potentially, you know, my body's gonna, you know, either gonna shout at me and say, Well, look, if you carry on the way you're doing, then then you are gonna suffer the consequences.

SPEAKER_03 12:53

Yeah. We like to see, and we like to say that we want our runners doing some sort of strength training on the side in conjunction with running.

SPEAKER_02 13:01

Yeah.

SPEAKER_03 13:01

This is one of the reasons why for that, is the strength training that we like our athletes to do, especially when it comes to our runners, is we like them doing unilateral things or if they are um moving free weight around, which we like, we like them doing dumbbells or kettlebells, so it's the individual on each side, because then we can start to see like, okay, this side is getting stronger than this side, this side is having a harder time with this side, there's individual sides that we can look at. And then when we see that, we want to say, like, okay, we want to be able to stay within 10% side to side. Yes. And 10% we start to get that injury. Ideally, we're staying within 3% side to side. That's what all the research shows. Yeah. 3% is very, very nitpicky. So we just tell our people, like, listen, if we're having a hard time and we're struggling through X, Y, and Z, and we start seeing that, you know, we're able to do really, really well on this is a very basic example, but if I have two dumbbells and I'm bench pressing, and I know I can do 50 pounds on my right side and I can only do 40 pounds on my left side, that's a greater than 10% discrepancy. And I would say, okay, something is either not controlling or stabilizing correctly through my upper body, my left-hand side, I need to get that checked out. Yeah, because there's something going on through there. I also tell people that there's a difference between being hurt and being injured. We are hurt and it feels exactly the same as an injury. But an injury is gonna is going to have some sort of tissue damage, either hard and or soft tissue, meaning hard tissue is bone, soft tissue, fascia, muscle, tendons, ligaments. Um so the biggest difference in how we can kind of tell that the that I give all my athletes is if you do a really hard workout and the next day you wake up and you're really sore from that, you get that delayed onset of muscle soreness or DOMS. Yeah, that's totally fine. I don't want to see that last for four days.

SPEAKER_02 14:47

Right.

SPEAKER_03 14:48

So if it lasts the next day and then the second day after and then goes away, completely normal. You challenge yourself appropriately, and then your body was able to recover from that.

SPEAKER_02 14:56

Yeah.

SPEAKER_03 14:56

If I'm sore for the next day, the next day, next day three, and we still wake up with soreness on day four, that's when I start to say what we have seen and what we've experienced, we might have tweaked something at that point because the body doesn't naturally stay that sore unless this is the first time you've done that workout or this is the first time that you've done.

SPEAKER_02 15:16

Yes.

SPEAKER_03 15:16

But if you've done this before and all of a sudden it's keeping you sore longer than what you were normally used to, that's when we say, okay, let's go in and let's get that checked out. So my kids, I give them a three-day rule because kids can't really tell much. So I give them three days. And if they say that they hurt something, they have three days to stop complaining about it before I actually check them out.

SPEAKER_02 15:35

Right.

SPEAKER_03 15:35

So I figure if that's what I'm gonna do with my children, that's an easy rule of thumb that I can do with our athletes. I tell them store on day four to come in and check it out because typically it's it's just the easiest cutoff is that fourth. If we're still feeling it after that fourth day, then we might have overdone it. And if we overdid it, that is exceeding our capacity. And when we exceed our capacity, that's typically the load that can break us. Um and I say break us because that's just the easiest term, but it could be we sprained this ligament, we strained this muscle, we can persist that muscle a little bit more than what we intended to do. And so, therefore, my next couple training portions of my training cycle need to look a little bit differently so that we can keep, we can recover that aspect, recover from that stimulus, and still be able to perform and keep doing the things that we love to do. That's ultimately why we're here. If nobody cared about getting back to their athletic capabilities and being able to run or being able to lift or whatever else it is, I honestly wouldn't have a job. Yeah. Fine sitting in a chair doing nothing. But fortunately, and I love this, majority of us want to get out and do something athletic. And we want to be out there and we want to be either playing with kids or running because it increases endorphin and keplins and we feel good because of it, helps us to eat a little bit less good because we are burning it off. Yeah. Which is what a f I tell people that I work out as hard as I do so that I can eat the way that I eat.

SPEAKER_02 17:01

Yeah. Yeah.

SPEAKER_03 17:02

Because I'm not a professional athlete.

unknown 17:04

Yeah.

SPEAKER_03 17:04

And I just have to be able to beat my kids in all their sports. But everyone has different goals and we love to learn that so that we can say, like, okay, this is what is appropriate for you.

unknown 17:15

Yeah.

SPEAKER_03 17:15

If we're trying to be a weekend warrior, your training schedule should not look like a professional athlete's training schedule.

SPEAKER_01 17:20

Sure.

SPEAKER_00 17:20

Sure. Yeah. I mean, going on um what you what you said, I mean, there was a lot of uh gems there. So going on what you said earlier in terms of uh unilateral lifting, um, I noticed that when I do Bulgarian splits, n my left side is noticeably weaker than the right side. So even, you know, I think for anyone uh in the audience doing a particular exercise where you're having to to do one set of exercise where you had you're training one side compared to the other side, then you will notice that you will notice a difference, you know. And I know that's where it just so happens that that was where the left-hand side was where you know I got the injury. So yeah.

Multidisciplinary Care Without Turf Wars

SPEAKER_00 18:08

So now multi multi moving on is to on to multidisciplinary care. Can you sort of explain a little bit about that? I know it's probably more for, let's say, someone who has maybe on a professional level, but can you just give us a little bit of an insight into what that means, multidisciplinary care?

SPEAKER_03 18:30

Yeah. Um, so multidisciplinary care for us is having true different professions working towards the same goal. So we have in the US, we have physical therapists and we have chiropractors, and we have ATCs, athletic trainers.

SPEAKER_02 18:43

Right.

SPEAKER_03 18:43

All three of those look pretty similar to a physio. Yeah. I would say uh chiropractors are closer knit to like an osteo just because we manipulate joints a little bit differently. Um, but each one of those three professions is trained a little bit differently, and they're trained to look at issues a little bit differently. A physical therapist in the US is trained to look at uh strength and stability issues more so upfront. A chiropractor is trained to look more so at mobility issues straight off the bat. And then an athletic trainer is there honestly looking at like, okay, I'm the emergency medicine. What needs to happen right now to triage an athlete when they're doing something, get them back on the field very, very quickly. We love having all three of those aspects. And we actually love having dietetics, so dietitians in the clinic, and we love having sports psychologists in the clinic as well.

SPEAKER_02 19:31

Right.

SPEAKER_03 19:32

That, in my opinion, is the best makeup of professionals that you can have in on one team for a single athlete.

SPEAKER_02 19:40

Yeah.

SPEAKER_03 19:40

Because anytime that an athlete needs anything during their span of their athletic career, whether it's weekend worry or professional, you have somebody in your corner to be able to do that. And that's the reason that we love it. Because I earlier on in my career tried to be everything for athletes. I tried to do dietitians, I try to do psychologists, I try to do um T, Cairo, and ATL at the same time. And it just did not work well. Um, I would also say caveat that in the US, especially in the state of Texas where I live, yeah, physical therapists and chiropractors have almost the same scope of practice, meaning we can do the exact same thing danger. And so really good sports physical therapists and really good sports chiroids where I live will look almost identical to each other. So we have a ton of overlap. And a lot of people try to um what would I say? They try to mark their territory and say, no, only I can do this, or no, only I can do that. And in my opinion, as soon as we start saying no to something, we're no longer open-minded. As soon as we're no longer open-minded, we're gonna miss the ability to help that athlete be able to perform to the best of their ability. So that's why we love multidisciplinary care. And I got to witness this when I worked with FC Dallas, it's the Major League Soccer team in Dallas, Texas, okay, uh, here in the U.S. And so I worked with them for a season and I was able to go in twice a week and work on these athletes. And I had a physical therapist next to me, massage therapist next to me, an athletic trainer next to me, and we would all get together and we would watch an athlete go through a movement screen. And our movement screens were very basic. It was okay, we're gonna have you do a squat. Now we're gonna have you do a pistol squat so that we can see that unilateral side-to-side differences. And then we would all just sit there and we'd say, okay, now let's add this one little movement in. And all four of us would sit there and we'd look at them and we'd be like, What do you see? What do you see? What do you see? And then together we could game plan for that night. Yeah. And we're trying to overshadow somebody else, or we're trying to take somebody else's job away from them because we were all young and hungry, and we understood that hey, we're be working together, we're not trying to work over one another. Yeah.

SPEAKER_00 21:40

So that was You're working towards the same goal, as it were. Exactly.

SPEAKER_03 21:46

And you know, nobody was trying to have, you know, marking their territory the whole entire time. Yeah, and I've seen that try to be done at the Olympic level as well, like at our Olympic training centers, and it's just unfortunate. There's just so much policy that goes along.

SPEAKER_00 22:00

With an organization that's that big that they put is there politics like involved in su yeah.

SPEAKER_03 22:09

I mean, yeah. I I've been there when we had an athlete that dislocated their shoulder and we had an athletic trainer that's sitting there who's able to reduce it. And they were told no because the main doctor wasn't on site hospital instead of just being able to relocate it immediately right there because of policy. Um and the policies are there to make sure that dumb people don't do dumb things.

SPEAKER_02 22:34

Yeah.

SPEAKER_03 22:34

I was just happy in that all the people that were there and around us were very smart and just it's just unfortunate. You know, policies are made because people break things and do things that they're not supposed to do. And I get that at the same time, it's it makes our job harder. Yeah. So I've seen it done really well and I've seen it done pretty poorly. And that we try to make sure that we can do it really, really well in our clinic, which is why we like the multidisciplinary care. And when I go and I travel the world with Team USA, it's me as a chiropractor, massage therapist, athletic trainers, and physical therapists.

SPEAKER_01 23:04

Yeah.

SPEAKER_03 23:04

Almost on every single team that we go to. Um, I get to go to Brussels for a diamond league final later in this year. Yeah. And I'll be in Budapest for the ultimate championship for track and field later in this year. Yeah. We will have multiple of every one of those professions there. And so if that's what we're doing at the professional level, why not do that for all of our weekend warriors that come in here and are still running 20 something, 30-something, 40, 50 miles a week?

SPEAKER_00 23:27

Yeah. I mean, I'm reminded of how relevant that is because um my wife has been had um uh going through uh has has had breast breast cancer, and it was very much the same sort of setup and scenario in terms of that you when you when you go, you you have a team who is you have the consultant, you may have the radiotherapist, and you may have the nurse, you may have someone who's doing um you know the chemotherapy, and there's a team looking after the individual. So it's just exactly the same scenario, as it were.

SPEAKER_03 24:06

Yeah. And I mean that that is best practice, right?

SPEAKER_00 24:10

Right.

The Resilience Training Model Explained

SPEAKER_00 24:11

So in terms of you've coined this phrase, the resilience training model. Can you give me, you know, walk me through as to what that is?

SPEAKER_03 24:21

Yeah. So resiliency does not mean that an athlete will never experience pain or injury. I tell a lot of our young athletes as they're coming in as an athlete, you are basically just signing a waiver that things are gonna hurt. Yeah. Things are gonna feel bruised, things are gonna feel broken when they're not. Um, but it means building enough physical capacity to tolerate the predictable demands of that sport. So when we're building resiliency, we want the athlete to be able to absorb stress and to recover from it and to continue adapting in their sport. Um, one of the reasons we love multi-sport athletes is because they are stimulated in different ways and the demands of one sport to another sport to another sport are different. And those athletes tend to be more resilient because they are having different types of demand on there.

unknown 25:03

Right.

SPEAKER_03 25:03

So the goal is not simply just returning someone to where they were before an injury when an injury happens, but the goal is to help them become better prepared for what their sport will demand next. And so, like some of our, I would say like our main pillars of our resiliency training model are like understanding the demands. What does the athlete's sport and training actually require, identifying limitations, where does the athlete lack strength, mobility, control, workload tolerance, um, reducing irritability. So they we want to calm down the painful or overloaded tissues enough to begin productive training, which is where a lot of people skip that is getting the tissues to a point where they can actually start to have productive training. Building capacity is a huge one, improving strength and coordination and tissue tolerance. We do that way faster than a lot of our counterparts do here in the US. We load people very quickly because the research shows that the faster you load somebody, the faster they get back and the stronger that they are, the more time we spend with these tissues that are ready to accept load unloaded, the healing progress or the progression timeline kind of expands. And we don't like doing that because we like our athletes getting back to doing what they love as quickly as possible. And so another pillar is like reducing or reintroducing workload. So gradual exposure that the athlete needs. So like running volume is a great one, uh, speed of runs, heals on your runs, um, competition demands because everyone understands you're gonna put more into a competition, you're gonna have a little bit more cortisol, good cortisol, yeah. And so you're not necessarily gonna feel how your body actually feels until maybe after the race is done. So if somebody is doing a race every single weekend, we may be like, hey, let's just train for the next two, train through the next two or three weekend races. That way we can actually make sure the tissue tolerance is where we need it to be. And then we monitor and adjust, we watch how the athlete responds rather than building um a calendar and then just going by that. We love the ability to adapt and to adjust when we say, like, hey, you're progressing significantly faster than I thought you were going to. Let's ramp up progression.

SPEAKER_02 27:02

Right.

SPEAKER_03 27:03

Or not stimulating it the way that I want it to be stimulated. So we're going to change the exercise completely instead of blindly following what we thought was going to happen. We change our programs more often than we just run off of them. I can I'm thinking of athletes right now that we're treating, and I think there's one that I haven't had to change a program on. Right. All of the other we've had to change and adapt to some a little bit slower and some a little bit faster.

SPEAKER_00 27:27

So when you talk about change, are you talking about the progression in terms of the type of lifting they're doing, or are you talking about the type of, you know, a mixture of the aerobic and strength training they're doing? Or, you know, is there anything, you know, or mobility exercises it combination?

SPEAKER_03 27:46

All of the above, if we see that, hey, we're stimulating, we're getting a great stimulus, and the body's reacting the way that we want it to for this exercise. Let's just use your Bulgarian split squats as an example. Yeah. If we're going through with an athlete that has some sort of gluten weakness and they're not able to, you know, their gait is off because of that, and they're doing this whole circumduction thing where they're swinging around, they're overusing their hip flexors. Like, okay, well, we're gonna go through, we're gonna do some soft tissue, we're gonna release that hip flexor because it's overworked and it's relaxed. We're gonna go through the quads and everything through your rep film to make sure that it also relaxes. We're gonna strengthen up your glute and we're gonna strengthen up your hamstrings so that they fire correctly. Then we get into the exercises and we're doing the Bulgarian split squats, and we may that you may say, Hey, that felt really great, and I feel really activated right now. That's awesome. It's like, okay, sweet. Next time we're gonna do that, but now we're gonna put a little lateral deviation into your knee, meaning you're gonna have to drive as you bend down and put all that weight on that front leg. I'm gonna try to drive your knee inward, so you have to drive it outward, and you have to get even more connection with that glute made and really contract it. And if, say, we do that and they're like, ooh, that irritated it. Okay, I'm gonna take that stimulus away. We're gonna go back to the stimulus that was helping, and we're gonna take that one stimulus of me into your knee away, or they can say, like, hey, I felt great during the exercise, but I was sore for like four days after doing that in my glute. And I'm like, okay, that was too much. Felt good during it, but because we were sore for so long afterwards, we know that we overdid it. Your body worked harder to recover during that week, which means it's taking away from something else. Your body can really only focus on one thing at a time. Well, you want to make sure that it can focus on the thing that it needs to, and so much that the rest of your recovery kind of takes from it as well. And so that's how we would change things.

Smart Progressions And Return-To-Run Loading

SPEAKER_03 29:26

If it's okay, we ran um our not protocol, but our kind of our rule of thumb is when we are increasing our running when it comes to mileage or when it comes to speed, we're gonna say, okay, we're increasing, we're gonna start at 50% of wherever you you left off when you got entered. So if you're running 10 miles a week, yeah. We're starting at five miles in a week.

SPEAKER_02 29:46

Yeah.

SPEAKER_03 29:46

And if your longest run was only over two miles, we're starting at your longest is one mile right now. And we're gonna take that at a pace, it's gonna be at a conversation pace to make sure the tissues are ready to handle that. And typically we'll do that like on a treadmill or something in here because it's so short a time frame, and it's a controlled environment and we can see where it's at. Because we love to challenge in a controlled environment, which eventually we will challenge you greater than what you're gonna get challenged outside of an uncontrolled environment, meaning you're on the pitch or you are on a track or you were on some grass or some gravel or some concrete, whatever it is. So that's how we would kind of modify and change things, which is why we like having the length of appointments that we have in our clinic. We see people for an hour because we want to do so much soft tissue, we want to be able to do so much dry nadling and shockwave. And then when we stimulate and get into rehab, we want to be able to watch a lot of that rehab. So if we need to adjust, we can adjust.