The Project: Health Wellness and Psychology

Joe Camoratto ( @dr.joe.dpt ) Discusses: Wod Prep, Physical Therapy for Athletes, Pain and its Symptoms, CrossFit and the Hidden Benefits Behind the Crazy Movements, The Dangers of Over Thinking Posture, Lower Back Pain and It’s Causes

December 07, 2020 Mahdi Al Oun, Meg Guthmiller, Joe Camoratto Season 1 Episode 211
The Project: Health Wellness and Psychology
Joe Camoratto ( @dr.joe.dpt ) Discusses: Wod Prep, Physical Therapy for Athletes, Pain and its Symptoms, CrossFit and the Hidden Benefits Behind the Crazy Movements, The Dangers of Over Thinking Posture, Lower Back Pain and It’s Causes
The Project: Health Wellness and Psychology
Joe Camoratto ( @dr.joe.dpt ) Discusses: Wod Prep, Physical Therapy for Athletes, Pain and its Symptoms, CrossFit and the Hidden Benefits Behind the Crazy Movements, The Dangers of Over Thinking Posture, Lower Back Pain and It’s Causes
Dec 07, 2020 Season 1 Episode 211
Mahdi Al Oun, Meg Guthmiller, Joe Camoratto

In this episode Dr.Joe discuss the benefits and drawbacks of CrossFit for the average persons.

Breaks down the truth about posture and how over doing it may lead to more injuries. 

He also talks about athletes and their genetic makeup that leases them to be the 1% of the 1%! 

we also dive deep into back pain and it’s fixes along with powerlifting and how squats and deadlifts can help your body feel younger! 

Support the show (

Show Notes Transcript

In this episode Dr.Joe discuss the benefits and drawbacks of CrossFit for the average persons.

Breaks down the truth about posture and how over doing it may lead to more injuries. 

He also talks about athletes and their genetic makeup that leases them to be the 1% of the 1%! 

we also dive deep into back pain and it’s fixes along with powerlifting and how squats and deadlifts can help your body feel younger! 

Support the show (

Unknown 0:00
You are now listening to the project quake project quake project where we stop at nothing to bring you the right backs on health, fitness and psychology, featuring some of the world's most experienced professionals. So you can learn and play with your hosts make dirty, and maybe

Unknown 0:21
I'm an athlete I was born to just I love to compete. I love to go balls to the wall. And for someone to say, Oh, I don't really think you can do that anymore. It's just like, Dude, seriously, like, I want to do this. I was 15 needed my knees replaced. What are you telling me,

Unknown 0:35
I suffered from that quite bad. As in the hospital for about eight days, you know, a lot of fear of going back in and getting injured. And also, you know, coaches being like, Don't go too hard. Now you're more susceptible to getting it again. And it's like, oh, shit, like now I can't do anything anymore.

Unknown 0:48
We certainly don't want you to rest well, we want to do is try to find it an entry point to continue to train. If your knee hurts when you're squatting, what we need to do first is take weight off the bar until you can go through a full range of motion. If you're not able to do that, we need to adjust the range of motion to a you can do a close variation to a competition squat. If you cannot find a variation of a squad that you can do without hurting your knee to transition to a front squat transition to a safety bar squat. What do you want to do is take a few steps back from that variation of that lift that gives you trouble train there. And so your symptoms let up and then slowly test to go back into that.

Unknown 1:24
All this and more in today's episode. Hey, everybody. Welcome to this episode of the project. And Meg's here Meg's back. Hey,

Unknown 1:32
I'm back. Yeah, we

Unknown 1:33
haven't jammed in a while. And we have a very special guest on today. And do you want to try his name? Or should I fuck it up?

Unknown 1:41
I want to hear you try to give it a go. And then I can correct it.

Unknown 1:44
Dr. Joe kamisato like the booze amaretto. Right, right. There. Yeah, there you go. He explained to before the show, Dr. Joe, you've got a PhD, and you're a badass in the weight room. I just saw your grand man dead lifting 505. That's a pretty good lift. I mean, that's definitely well more than I collect. Obviously, you're a power lifter. And what really intrigues me and I was telling Meg is that you also have your CrossFit level one at the same time. So to see a physiotherapist going into powerlifting or CrossFit, I'd say two sports with the most injuries either you're trying to make a lot of money or you're trying to make a lot of sense of what people are doing these days.

Unknown 2:25
Yeah, yeah. So one correction before it gets going. I don't have a PhD I have a DPT. Okay, which is a Doctor of Physical Therapy. I don't want anybody out there thinking that I'm claiming a PhD that I haven't worked for definitely don't have one of those not smart enough for that.

Unknown 2:39
Apologies, Doctor you're still a doctor man. I

Unknown 2:41
mean, Doctor it's funny because all the different education levels as far as like doctors in different fields, they all get weird like there's doctor chiropractors or doctor physical therapy, but you know, in different countries, there's not doctor physical therapy. And so it's you know, not a problem at all. It just gets a little wonky.

Unknown 2:57
You come to quite people, right Ms. If they have a master's degree in front of their name here really All right, yeah. Did you get people that if they have a doctorate they will get doctor on their credit card? No shit. I've heard jokes of professors here in quake and called on planes, you know, because they have doctor listed on their name. So you know that people think they're a doctor doc. It's happened to me before? Yeah,

Unknown 3:19
I prefer to go by Joe. Honestly, anymore. jacker. Joe, Dr. Joe is totally fine. But yeah, Joe. So yeah, it's definitely been a transition from the old physical therapist way that that we learned as far as what I do. Now, currently, I'm working with WOD prep, I don't know if you guys know, Benji lossky. He is the head of WOD prep, as well as TJ dipalma. They are a programming and one on one coaching team. And so I'm one of the coaches as well as part of the rehab team with CJ. As far as WOD. Prep goes one of our core things WOD prep masters, so 35 and up which kind of hits on what we're going to be talking about today, as far as training through aging, which everybody is doing. A lot of people get offended when I talk about that their aging, it's like, well, you know, what else are you going to do? You can go backwards or not, not do anything else better than the alternative? But yeah, I'm currently training powerlifting good bit trying to compete this year, haven't picked a federation to go into and think of the usapl but we'll see. And then the CrossFit thing, after I, you know, was kind of making my way out of the clinical and the, you know, classic clinic setting as far as khaki and Apolo and having 20 patients a day, I started talking with CJ also the movement doctor on Instagram and he was like, Hey, man, I want you to come work with me. And so I was like, Alright, well, I don't know thing about CrossFit. So I should probably dive in, you know, headfirst into this whole world and so got my level one out of New Orleans. I trained CrossFit for probably eight months. I'm six foot three and 250 so I don't know if you guys know that the

Unknown 4:54
way for you.

Unknown 4:57
Even a little bit.

Unknown 4:58
Oh, come on, look at for koski man Like, Becca, Big Boy, right? Look, if you're Josh Bridges, you're screwed man cuz I'm like five, seven, and there's shit that I struggle on don't put me on a rower.

Unknown 5:09
I love her Oh, actually, I love her. I love the air bike, the wall balls, definitely for me, but I can't do pull ups for anything, you can't do any sort of body weight for repetition. So that whole thing kind of fell through my wife and I moved up to New Jersey. And so now I'm doing remote work with wide prep. And so definitely stepped away from the clinical role as far as a physical therapist goes, although I do still integrate the whole background as far as that in my current lifters with wide prep. But it's funny that you mentioned that powerlifting CrossFit have a high injury rate, because actually the exact opposite. If we look at what we deem is like strength sports, which is powerlifting, CrossFit, strongman weightlifting, and the Highland Games all have the lowest injury rates as far as per 1000 hours of exposure to activity and competition, because there's two things that we really have a great hold on as far as injury risk reduction, which is being strong and load management. And so those two things are kind of worked into the sport as it as a construct. And so those two things kind of have all these injuries very low. Now, as far as why that is, I think that it also comes into there's no other people trying to murder you on the field, because there is no field and so that kind of plays a big role in it. There's not really too many dynamic movements outside of maybe strongman and Olympic weightlifting. But yeah, I think that can also kind of plays into what we're going to be talking about today, which is like preconceived notions with quote unquote, like barbell training and, and heavy training, which is definitely interesting. I mean, some people will say, don't call it the deadlift, because it sounds scary. What do you mean?

Unknown 6:48
Sounds badass avant, I know, we're gonna get a lot into Yeah, more of like the the pain and the CrossFit and that type of stuff. But I you touched on it a little bit. And so I kind of want to circle back to that is what you learned in physical therapy school and how that's different to what you understand now, because I'll be honest, I, a physical therapist, I feel are incredibly boxed in, in a lot of methods. I see that in approach to like, you know, rehab and pain, and it's almost anybody I can guarantee with them walking away with an injury, I know what, you know, they're going to be prescribed in some ways. And so I'm curious of what you learned in physical therapy school, and how that's different for what you understand now being exposed to all these different outlets. And maybe, yeah, advice of anybody who is looking at PT school.

Unknown 7:31
So as far as going into PT school, I had already been like a strength supporter, I guess. And so I feel like I was biased going in to not thinking that physical therapy had like enough of a stimulus to create, like, physiologic changes, which is how I started out. So I think I was kind of on one end of the spectrum going in. As far as what we learned in physical therapy school, we learned to be technicians, right. You would assume a technician would be somebody who knows your car really well. They know what the torque specs of, you know, the head bolts on your car, they know what sort of weight oil to put in your car. We learned to be technicians, we have two semesters of anatomy, two semesters physiology, we have, you know, an incredible amount of neuro and all these things that create this ability to have what they call X ray vision, right? When you have somebody standing in front of you, they say their shoulder hurts, you can use your quote unquote, X ray vision to look and see and remember what their anatomy is. So that you can try and infer or make this kind of cause and effect relationship based on what you understand to be in that area. The problem becomes when we talk about the complex experience of pain is that it's certainly is not just based on that cause and effect, like this is the structure this is its status, and this is what you should feel. And so I think that the biggest change that I've had undergone, and thankfully undergone since going out of PT school is that they don't have that fixer mentality anymore. I don't fix people, I don't tell them that they're broken. I don't understand that. If somebody has degeneration in their knee that they should feel something and nor do I tell them that because of the complex interactions that occur to present people with pain. Pain is a is a subjective individual experience that now how to understand it based on the updated model of pain. The biopsychosocial model has many different factors that come into play as far as what can contribute to what people are feeling, right? Because I don't know what you guys are feeling. I don't you know, you don't know what I feel when I have pain. And the ability for you to understand somebody else's pain is limited by the ability of them to explain it. Right. And so that I think is the biggest change that has happened since school. And it makes things a lot more confusing, but also frees me up from that box that you were talking about. Because As far as like, if we're looking at what's called a biomedical model of pain, right, which is this cause and effect that has been going on for thousands of years, I stick my hand on a hot pan and hurts because my flesh is burning, right. And it doesn't take into account the context of watching your hand go onto that pan that you know is hot, the prior experience that you've burned yourself before people telling you, which is like a social interaction of not touching hot things like all of these things that come into play, when we consider subjective events. And so when we kind of go in that cause and effect model, we can open ourselves up to a lot of these things that we see in current rehab, which is like, posture has a huge effect on what you're feeling. And you should avoid different postures, or you should avoid moving this way. Or you should, if you're feeling pain, not do X, Y, and Z. And so all of these things are kind of rooted in this model of, there's so many ways to fuck yourself up that you should make sure that you are in this kind of movement, jail or box that you're kind of walking on eggshells, so that you don't hurt yourself. But it wouldn't make sense that we're so able to do all these different movements, like run into each other at high speeds with you know, people that are upwards of 300 pounds and be relatively fine. I mean, I'm not gonna say that, you know, football players are fine, but they're okay. We wouldn't be able to put a bar back and, and squat and upwards of 1000 pounds for those elite athletes without crumbling underneath that if we were to subscribe to these kind of narratives that we are fragile and easily, easily breakable.

Unknown 11:35
I love that.

Unknown 11:36
I know I've just said it on the show. And I've always said it that athletes are the best at cheating their bodies, especially baseball players, I mean, to throw at the speeds that they throw, you can't tell a baseball player, especially a pitcher, fix your posture, you know, you can't have your shoulder going forward, dude, that's gonna fuck him up. I honestly think, you know, I had some elbow issues. And then my physical therapist was like, Oh, it's because your posture sucks. So I did all the postural exercises and the whole, fucking bring my shoulders back and everything. And to this day, I could swear that that was probably the source of my shoulder pain afterwards, rather than fixing the problem, because I wasn't really working on the muscular development of the muscles that I was overusing. I was trying to force this position that just wasn't working. And you know, you said it right there with the athletes. I mean, if you tell an athlete or an elite athlete, football player or basketball player, for instance, oh, you know, your right foot is, you know, caving? Well, maybe that's why he's elite. Maybe that's just how he's built. And, you know, I mean, what would you say to that, where you hear these newbie trainers and these newbie physical therapists that are like, Oh, my God, you know, did you see? Do you see his knees caving, when he was squatting? All that's so bad for them? And then they go and correct it. And I'm assuming some of them get injured after that, because they weren't meant to do it in the first place. What's your take on that?

Unknown 13:01
So I guess there's a couple ways that we can look at that sort of thing. There's definitely issue as far as where these notions are coming from, right. There's a big move. Now, as far as the physical therapy community to try and change accreditations at school, right, there's certain things that they have to teach you. And it's not the fault of the new PT for using what they learned in school. And so there, there certainly is a move to try and create this new environment. And I'm, I'm gonna plug the level up initiative here, which is a free four month mentorship for new grads to try and almost de educate and re educate them on different ways of critical thinking, growth mindset and communication skills so that they can, you know, we can look at all these accreditation issues in the face and be like, Listen, this is just what they're learning. And it's what they're going to learn until something changes. So let's intervene as soon as possible to try and change the trajectory of how they understand their interactions with their patients, right. And the clients. As far as the changing of elite athletes, it's tough because for your example of when you're throwing, while you're doing these things that are attempting to change your posture, you're likely not training at the same intensity that you were before, right? And so that we have taken into consideration that you're going to be detraining and deconditioning, which is part of load management, which is probably one of the bigger reasons why you're having trouble in the first place, right? You didn't manage the load well enough, you probably have some sort of spike, you pitch too much. You threw too many days in a row, whatever sort of load management issue that you had, and then you have the symptoms Come on. So they're like Alright, let's do less for the significant of time was trying to intervene on your posture, which are not intense exercises, right. I mean, you probably are using a band to pull apart and squeeze your scabs together. While you should have been just modifying your activity a little bit to wait for your symptoms to let up and then go back into Your activity. And so not only are you d training, but you have an authority figure in the medical community, somebody who you trust and are going to, to try and take into account your rehab process telling you that there's some way that you're not doing something, right. And if you do it like that, again, that you're going to hurt yourself again. And so we have this concept of what's called the nocebo effect, right, which is the opposite side of the coin of the placebo effect, which is a negative outcome based on a negative expectation. And so again, it's playing into the nuance of movement variation, and the subjective experience as well as injury because if you have what's called a kinesia, phobia, or a fear of a movement, you're more likely to injure yourself. And so there's definitely a few different nuances to the scenario that you're presenting in that not only are you deconditioning, which is not a great idea when your plan after your symptoms led up is to just go back to what you're doing before, right? Which is not what you're currently adapted for. And then you have your authority figure telling you, yeah, man, if you like, throw a curveball, you're gonna snap your super space, right, which is probably not accurate, but probably not going to open you up to having a good expectation and belief about what's going to happen when you throw a curveball. And so those are the things that I kind of think about when I hear that sort of scenario.

Unknown 16:20
Yeah, I think the language is huge around that of setting up that expectation of what's possible with somebody and I can see a lot of people shut down and feel afraid to ever go back to doing anything or that's where, you know, especially when I'm talking in the aging aspect, because I've worked with a lot of I call them golden areas, and these are my people in their retirement home. And, you know, the fear of falling and it's because they're constantly reminded you're old, you're frail things break easy, you're gonna fall, you know, and don't do that you're too old now. And that just has the worst impact for quality of life. start bleeding, and oh, sorry.

Unknown 16:52
Yeah, I was just gonna say it wasn't for me. It wasn't a curveball was a knuckleball that fucked my forearm up. Like, that's why I went in there because my extensors? Yeah, it was my extensors because when I, I would tense up my knuckles, and it was one physical therapist. He was my cousin's friend. He explained this to me years later, after all the damage had been done. He's like, dude, well, if you'd done something you were never used to doing. And you know, you're stressing out those extensors that go into here. Obviously, it's going to lead to forearm pain. And they're like, they just missed the boat. You know, like I got treated for a brachialis issue. When he was explaining it to me. I was like two that actually kind of makes more sense, because the only thing I had done differently was throw knuckleball. And like that was it? Yeah, that was the only thing I had done differently. And you know, I was 35 or 34 thrown a knuckleball. I had no business doing it anyway. So. But do you think athletes the perception of pain has changed over the last hundred years. And athletes are more prone to injury because of that perception? Because I mean, let's take a baseball player because that's the sport I know the most or any sport. They didn't go down with injuries as much as you see it now. Okay, we could say it's volume and load. But if you look at Sandy Koufax, he was pitching like five days a week, you know, those guys in the 20s 30s 40s and 50s. were throwing hard, fast balls three, four or five times a week. And they didn't have the elbow issues, the shoulder issues that we're seeing pop up with athletes nowadays. So what would you attribute most of that to? And I agree with you load can be a contributing factor. But do you think perception of pain is a contributing factor? Also?

Unknown 18:29
Yes. I think that in the scenario that we're talking about, obviously, I haven't played baseball a long time, and I'm no commentator, has the perception of pain changed? Um, I think that maybe with recent sports, there's more of an ability to train at a higher level more frequently. Because what we know about exercise physiology better. There's maybe more games that are being played on though, is that accurate? Is there more like is there more volume and frequency that's going on? Or no,

Unknown 18:58
not really? No, I mean, I mean, pitchers are definitely pitching less. Now in baseball, they used to go nine innings or eight innings now they go six innings or five innings? I mean it's ridiculous how baby and I say baby because you know I was in 90s kid and it was eat nails pitch vinegar, shoot lightning bolts out of your ass, you know, like that. That was the motto and mag I'm assuming and swimming. It was kind of like that back in the day for you. You know,

Unknown 19:23
it was always Yeah, build up as many yards as possible. There's a lot of like tendinitis shoulder issues as always build up, build up and then you taper off which was interesting because once I got into college, we did the least amount of yards. We never spent more than an hour and a half in the pool. And most of the time was spent weightlifting, running rock climbing bodies, yoga, doing other things. And everybody's performance went way up and injuries went way down for our team. So here's what's on top of my head, which is a certain reason driving over medicalization. So I'm thinking that with new technology and with new ability to intervene on maybe a more precise scale, there's more maybe not understanding what there's more of an impetus to attempt to intervene on things in an earlier phase because we can detect them sooner. I mean, that might be one way that maybe not pain perception is changing currently. Because I don't know if that would change, because it's kind of up to the person. But maybe we're just better at detecting changes at an earlier rate now, and so that we're intervening sooner. Does that kind of make sense?

Unknown 20:33
I mean, there's a lot of like, I know, it's for college athletics. And either there was a lot of resources anyway, for recovery. I think there was definitely more of a focus on that versus obviously at the high school level. But on the college level, there's a lot more, yeah, resources for recovery. And so I think that, to that point, there probably is more in awareness of what might be more preventative, I guess, measures in place that I guess that would kind of speak to the opposite side of what Maddie is talking about.

Unknown 21:00
I mean, it could be like a culture shift as well. And that people are more focused on longevity. And so they're maybe they're trying to get ahead of things more often. And maybe back when you're referring to as far as that scenario, they were just like, let's go balls the wall right now. And, you know, the next guy will come up once this guy's done, you know, replace them. But yeah, I don't know. I don't know the answer to that question is,

Unknown 21:22
I think everyone's boggled by it, especially in the MLB. Cuz like, the good pitchers are, you know, every sport Yeah, in this day and age, like athletes are good for years or three years, then they have like three or four years of like, you know, injuries, reoccurring. And, yes, it could be overused. But I like what you said earlier about medical technology and its advancements. And you alluded to this a little bit earlier, do you think that we go in for an X ray, for instance, and then the doctor is like, Oh, yeah, you got bone fragments all up in here. And then I start thinking, Oh, shit, I got bone fragments, fuck, and then I go throw the next day. And I'm like, or I go kick a soccer ball the next day in my knee, and I'm like, Oh, my God, my knee hurts so much more. And I take myself out. And that just that perception builds up.

Unknown 22:04
Yeah, that's really huge. And again, it kind of gets into this, like aging sort of mentality. And it's the same thing as far as the nocebo effect and managing a patients or clients expectations and beliefs about the scenario. As far as current, when I do interviews with new clients are new patients, one of my biggest questions is what do you think is going on? What have you been told? And what do you think will fix it? Right? Because this type of what's called motivational interviewing or meeting the person where they're at, is going to be huge, as far as trying not to be this like, paternal like authority figure that's just like, here's what you have to do, because I said it and it must be right. And so managing the expectations and beliefs of the person in front of you can really have a huge effect on what direction the care goes. Because if their understanding is based on what their primary care manager told them through an X ray that may or may not have been necessary, was ordered Anyway, you know, that can play a huge role in their, their can easier phobia, their understanding of their current status as far as their joint integre goes. And yeah, I mean, those things can play a huge role. And imaging is actually a huge problem when it comes to detecting these, or we call it normative aging changes, right? We're biological creatures, we degenerate as we age, but that does not mean that we increase the sentience that we feel based on those degenerative processes just because they're happening.

Unknown 23:33
That makes sense. Now, I'm 30 almost said, I'm 35 I'm 37. So I'm a Master's athlete, and I always use the term, man, I'm old, you know, I'm getting too old for this shit. I use it as an excuse. Because if I suck one day, I can just say, Look, I'm 37 man. Yeah, like me doing a WOD. Like, it's alright. It's all good. I can get away with that shit. But I had a 29 year old in a wad with me. He wanted to He's like, Yeah, let's do this together, whatever. And he's like, Oh, my back hurts. And I'm like, dude, when I was 29, like, I don't know, like, I didn't really have that much pain. It was only when I hit 30 for that maintenance period. That's when I was like, Yeah, I tore my left labor on tour my right labor room. And now even at that, I still went and did a triathlon with a torn labor them and I you know, essentially, during the triathlon, it didn't hurt, you know, it was only later on, but when I actually tore it the month before that, oh my god, I woke up at two o'clock in the morning and it felt like someone was stabbing a knife through my arm. And they gave me a shot and quite mag knows this about Kuwait. You know, just so you know, quite an Islamic country. We don't have a lot of drugs in the hospital. We don't take vikan and we don't have that stuff. Like they'll give you two panadol you're on your way. And I don't know what they gave me a shot, but it didn't feel like anything strong. And I think it was the security of they gave me a shot of something and it made me feel good. I went sleep and the pain was The next day, but it was nowhere near as bad as you know how it was the night off? Sure. So

Unknown 25:05
that's definitely a testament to what we call contextual effects. Right? you as a person who's experiencing this alarming enough event to take you into a medical provider is receiving, quote, unquote, direct intervention directly in the spot that you're having pain at. And so whether or not the stuff that they injected into you had some sort of physiologic mechanism to progress the situation, you got something that was shot directly into the air that you're having problem with, by an authority figure in the medical field. And that's exactly what you were expecting to get. And that's what you were expecting to help. And so not taking any consideration that possibly what they injected into, you had some sort of mechanism to increase your progress in decreasing your symptoms. But all these other things are kind of at play as far as the context of the situation as well. And I think that the problem with a lot of the interventions that we see is that those contextual effects are not taken into consideration when trying to figure out why is this person feeling better, right, because there's a ton of different ways that you can feel better, that have nothing to do with what's currently going on as far as the physiologic status or biologic status of your body. And so whether or not that injection that they gave you was a corticosteroid was some sort of hyaluronic acid was some sort of, you know, Sham, they just put ceiling in there. There's numerous studies on just that, you know, people have similar outcomes when we do a sham and injection into different areas. And so there's a certain ability to forget that we're as scientists and as you know, doctors of our practice, we need to understand the mechanisms and what's called the efficacy and not the effectiveness. While that's still important, the advocacy is what exactly is the mechanism of what this is doing, what this intervention is doing. And not so much the effectiveness of well, it made them feel better,

Unknown 26:56
I guess, when would you suggest having maybe some of those, like, imaging things done? Or you know what I mean? Like how, because it can paint a picture, right? I'm broken Oh, shit on the neck and change everything going for. So I guess what, how do you know when that's necessary? Or what's the way to kind of coach around that? I

Unknown 27:14
guess, with those results of like, Who do they need to see next? So as far as the conversation of when, let's take the low back, for example, right? The Lancet is a very prominent heavy hitter as far as scientific journals go. In 2018, they put out a four part series on the the low back by the Lancet, and they basically looked at, like, low back pain is, you know, 85% of the global population has low back pain at one time or another. I think that's like 57 million people at one time, don't quote me on that. But I think that that's what they said. And their recommendation was one to 4% of low back pain patients, or patients with low back pain will have some sort of red flag or something that advances their need for more medicine, right? When to get low back pain imaging is when you suspect one of those one to 4%, whether that be a space occupying lesion, which is a tumor, a cancer, a fracture, or if there's signs of, you know, something horrible happening, which is like loss of bowel, bladder, loss of motor control, severe unrelenting pain, all these things that are like, okay, maybe we should like something needs to happen, or else this person is going to severely devolve in their presentation. But outside of that, it really doesn't paint a great picture. And as we were saying before, it actually doesn't really help to make the situation any better. Because with aging past 20 years old, these things just happen. We get discriminations we get and play changes, we get for set hypertrophy, we get annular tears, all of these things occur once we get past the age of 20 in the low back. And if we're looking at the cervical spine of the neck, it happens after the age of nine. And so all of these are asymptomatic, which means that they don't have associated symptoms with them. And so if we're looking for, we need to, and if we're looking meaning if we get some sort of imaging, what we need to do is make sure that we're not doing what's called a post hoc fallacy, meaning that we're looking at something we find something, and then we associate what the person is feeling with what we found, right? Because unless we have some sort of start image based on, you know, a study, like, hey, let's get a low back image before you go and play, you know, go into this, why'd they get pain, you do an end image and they compare the two of those and the end is different than the beginning, then we can say, Okay, this was what caused this happening. But if we don't have that beginning, like baseline, who's to say that the symptoms that you're feeling come from what they find in the imaging, it could have been there as it was before and you're just coincidentally having pain in that area. And so the stuff that you guys are talking about as far as that that issue is harmful languages that we are unable to kind of have connected to and it's much more harmful as far as keeping people from doing the things that they love keeping them from training at a moderate intensity and having their disability go up and their quality of life go down. Like, why would you expose somebody to something like that, when you could just monitor their symptoms for six to 12 weeks and have them train at a modified pace? Again, I mean, it's much more nuanced. There's a CI or cover your ass sort of thing that happens as far as trying, you know, you don't want to miss anything. Yeah, I'm sure that the understanding of those people who are able to order images, they might understand that the prevalence of things that need imaging are much higher. And there might be a drive from management to get more imaging. And there's a whole host of things that can happen that can have that happen. So yeah, I don't know. I can't remember the real question is, how did I know?

Unknown 30:53
Yeah, that's because I've always been skeptical of things like especially a slipped disc, right? You know, like everybody has one at one point, maybe another, like, fairly, they're more common than we think. And I always think about that with the imaging and things. Especially if you're laying down right like I'm I'm like, Well, now that's not the position that your spine is typically in. And so I just, you know, the accuracy of that I've always been interested in I've just, you know, the relevancy of when in also just getting that image, like we talked about what that does it psychologically,

Unknown 31:20
if I could tack something on to the imaging thing? Yeah, there's this understanding that the image is like a solid picture of what's going on, right? A lot of people are like, let's just look right, that will be the ultimate answer. But we need to consider that just like every other medical provider, as far as their own bias, radiologists all also have their own bias. And those people that are looking at the images have a bias based on their education, what they've seen before and who they're surrounded by, to name a few. And we actually have a really interesting study that had a participant who was going to get imaging for low back pain, go to 10 different radiology centers in the New York area and got like 30 different diagnoses, and none of them were the same. And so there's this trust that once we get the picture, we'll know exactly what's going on, right, that kind of old school cause and effect, hope and mentality that I can find a technician that will know me as good as possible so that they can fix me. And the problem again, becomes that one, it's that's a way outdated in a harmful way to look at it into, it might not be exact representation or an exact interpretation based on the radiologist, you get the area that you're in the culture that surrounds that sort of medical community that the person is in. So there's a whole host of like, holes that I can, unfortunately can poke in this in this process of trying to get a benefit out of imaging. Again, that's not to say that there's no use of it whatsoever. But we need to really be careful as to what we tell patients that are coming in hoping that you're going to be as helpful and knowledgeable as you can, you know,

Unknown 32:59
yeah. Funny story about imaging, though, me and Meg met on a forum because I posted my X ray. And she had responded, because I had a physical therapist tell me I couldn't basically couldn't lift weights again. Oh, my God. Yeah. That was funny, though. But it's just based on the imaging. It's, it's an interesting topic. And like over in the States, it's different for you guys over there. I mean, is it still a sales key or not? Really?

Unknown 33:26
I am less in that space, too. I mean, obviously, there's different reimbursements for different things as far as insurance goes. But I am less inclined to understand the comment on whether that's still a sales tactic. I mean, I'm sure that you probably get more money for doing something than doing nothing, right. If I ran the medical world, I'd have a lot more training and education as the first line, you know, tactic, but I don't think that education really reimburses very well. And so I'll say yes, I'm sure that something gets more money than nothing. So and we have to consider like, what's the repercussion of getting that something, right? If you get an image, and it shows something, the next step is to do something about that something that you see on the image, right, whether that's an injection, whether that's a referral to neurosurgery, whether that's for orthopedics, whether that's a referral, physical therapy, whether that's, you know, there's a whole host of things that kind of marched down this path of now we found something as a physician or as a provider, I can't just do nothing about that something now that I've seen it. Yeah,

Unknown 34:34
I think the biggest shift after myself, like coming back from injuries I've had so we're talking CrossFit rhabdo I'm sure you've been tuned into and I suffered from that quite bad. I was in the hospital for about eight days, wearing ck levels went up over 30,000 but do you talk about like, you know, a lot of fear of going back and getting injured and also, you know, coaches being like, Don't go too hard. Now you're more susceptible to getting it again. And it's like, oh, shit, like now. I can't do anything. thing anymore. And a host of all kinds of other things that started happening was, I think, a big shock to the immune system as well. And you know, joints starting to hurt more and this and that. And the biggest shift for me was understand the importance I think it's what you're saying going into, you know, physical therapy school is just understanding a lot of times our pain I think, is a cry for more stability and strengthen and ERISA understanding the importance of strength training, but I had a coach and a teacher was a movement specialist, ido portal method I've talked about a little bit before, I don't know if you know, you know, and, you know, through his teachings was, you know, pain is information. And that was just a big shift, I think that I needed in order to get back into my body and figure out, you know, what can be the remedy going forward and attaching less to like, you know, those images or maybe some of those previous issues that happen in sport, and whether that's, you know, competition or longevity, it helped me on both sides of understands. That's often I know, Maddie, when I reached out to you, and you had your X ray shown on there, and you were told you can never do anything. Again, I was very much on the side of like, I don't believe that. Like, I think there's still something you can do. Yeah,

Unknown 36:03
I was freaking out. I was totally freaking out. And yeah, you know, like, I knew enough about fitness. But again, coming from an authority figure, like a doctor and physiotherapist. It's like, holy shit. And I'm an athlete, I was born to just I love to compete. I love to go balls to the wall. And for someone to say, Oh, I don't really think you can do that anymore. It's just like, Dude, seriously, like, I wanted to do this till I was devastated. I was like, I want to do massage 50 I needed my knees replaced. What are you telling me? I'm only you know, 35 at the time, but Meg, you know, we had a conversation on the side. And she's like, Yeah, you got nothing to worry about a couple people said the same thing. And I was like, Alright, I'm going back to squat next week, I don't give a shit. So speaking of lower back pain, I wanted to circle back to this real quick, we had a guest previously on the show. And he talked about lower back pain and the perceptions of that. And you had a few things that you disagreed with, which is cool. We love to bring in both perspectives on the show, and whether you had something to disagree with that. I said, also, I'd love to hear it. I'm always open to feedback. And I'm sure if you're an open minded person, you'd always be open to feedback. So what did you sort of disagree with? What did you like? And not like? I'm really curious about that. Because you're a lot younger than that.

Unknown 37:17
I am 28.

Unknown 37:18
So you know, yeah, you're a lot younger. And I truly believe age does play a factor. I think younger people sort of get the freshest information out there, versus someone that gets set in their ways when they're in their mid 40s to early 50s.

Unknown 37:33
Yeah. And we actually see that that exact thing reflected in the physician community that people who come out of school sooner have better information, more up to date things and yeah, so as far as low back pain goes, extremely complex, multifactorial, we don't have a great grasp on what causes it. And we don't have a great grasp on what helps it. And anybody who says otherwise is, I mean, I don't mean to put anybody under but there's so many different tracks that you can go down, you can go down the core stability track, right, quote, unquote, you need to make sure your spine is stable, so it doesn't move and accurately, you can go down the jelly donut track, which is you know, you're squishing your jelly out of your donut.

Unknown 38:24
donut squishes the jelly donut. Oh, is that like try to imitate taking a crap or something like that? Never heard that before? I'm gonna be honest with you. But

Unknown 38:34
yeah, sorry, man. You can go down the degeneration track, there's so many different like fingers to point, right? There's so many different threads that you can pull out as far as things that people have tried to grasp on to to find that one weird trick that nobody else has found, right. And when people are very loud about that one weird thing that they found, they usually have some sort of monetary involvement and teaching that right. And so as far as low back pain goes, we see that people with like heavy manual labor jobs, people who have depression, anxiety, people who don't have great, they don't enjoy their jobs very well. And to name a few again, the society and culture that exists in your activity level. All these things play a role in the extreme complexity of low back pain. And none of the things that were mentioned the Lancet, which is again, a great resource for low back pain understanding, mentioned that your disc was squeezing out the back or that, you know, the muscles around your spine weren't strong enough. There's a lot of things that we attempt to grab on to, to make understanding these complex processes easier for us. Right? It would be way easier for me to tell somebody to never bend over with around back again, and have them magically stopping and pain right I would much rather do that than try and sit here and talk with somebody in front of me who's desperate. And try to tell them, it's more complicated than that you need to trust the process, we need to wait like 12 weeks, three months, sometimes upwards of a year or more for these symptoms to, to relax and resolve because there's not that one thing that we need to intervene on. And like I was saying before, there's a whole host of ways that people can feel better and actually created an hour long presentation about this very topic feeling better, because it can really disguise and trick our cognitive processes. in understanding what exactly is going on. When we input an intervention, there's an output of feeling better. And that is a positive feedback loop for us to understand that what we did must have intervened or what we thought it was. And so that's must be what their problem was, right? I dug my fingers into there, so as in their inner hip, and they felt better afterwards. So it must have been that there. So as was was super tight, you know, forgetting that you have to go through so we can as fat three walls of AB muscle, intestines, visceral fat, all to get to the so as and so if you dig through a lot of shit to

Unknown 41:11
get in there, once you get that released, like once someone gets to it, it's like, I mean, I don't know if it might have been a mental thing. But I had one physical therapist get in there. And I'm gonna be very blunt Meg's like our poop expert, I had the best shape of my life the next day. So I don't know if it had anything to do that. But like, they dug real deep. They're like, yeah, we release your so as I was like, Alright, and then literally, like, I felt like a million bucks like, Sure. So I don't know if that's a placebo effect. But

Unknown 41:43
people are quick to get frustrated when when we say that things are a placebo effect, right? They feel cheated. They feel like what they got was fake. A feel like you didn't feel what I felt. And so you don't know what you're talking about. All of these are very complex conversations that need to be had, is the placebo effect bad? No, can we remove you from the placebo effect, unlikely because the placebo effect we can call contextual effects again, which is you exist in a situation within a society within a structure of beliefs about what's going on. And so we cannot remove you from that. But it's just difficult to, again, assign a cause and effect relationship when we exist in all those contexts that this is exactly and the only thing that made you feel better. And so I would never say that something goes on somebody's head because everything's on your head, right? Your perception is yes,

Unknown 42:38
it's fine. If you say it's all your head, I'll be I'll be totally cool. That answer I'll give you I'll

Unknown 42:42
do it again, then people think they're crazy. And that's not what we're saying either, you know, but there's a lot of complexities when it comes to this cause and effect and correlation type and contributing factors type thing. Now, as far as some of the things that I mentioned earlier, as far as the low back thing goes, the jelly doughnut thing has been super prevalent, right? You have this annulus fibrosis, and this Nicolas pulposus, which is the quote unquote, jelly inside of the doughnut of the disc, yes, we get disc herniations we get seek restorations, we get detachments of that with aging and with different types of activity. But again, we have to kind of remove ourselves from that understanding that because this happened, you must feel symptoms, because we have people and very large populations of people that have that structural change without the symptoms that accompany it. And so it's like, Where's the line? Right? And we also have to think about that, that no cebo effect that harmful language that we talked about before, if I tell you that your jellies shooting out the back, what are you not going to do anymore, right bend over, and you're not going to be able to deadlift anymore, you're not gonna be able to hang clean anymore, all these things that improve your quality of life, because you're able to better do your activities of daily living, you're able to feel more robust, more self confident your self efficacy goes through the roof. And you know, your quality of life is improved. Because with increased muscular force with increased lean body mass, your morbidity mortality decreases, right? It's it just is this whole, like long line of shit that happens when we kind of try to give very specific answers to a very complex systems. You know what I mean? And it's like, instead of doing that, just say, I don't know, I don't know. But let's train, you know, because once you cross over and you squeeze the toothpaste out of the tube, it's very hard to get it back. And it's very hard to unring the bell once you've done it. And so instead of saying, Yeah, your spine is unstable. Let's just say hey, let's just go deadlift, it'll, it'll strengthen your low back, right? And there's a very upsetting paper called The, the, I can't think of it. It's about physicians words, but One of the most extreme examples in that about low back pain is that a woman was told that her low back pain was caused to instability. And she unfortunately had an abortion because she didn't think that her spine could tolerate the load that was going to come on with increased weight of pregnancy. And I mean, yes, it's an extreme, but, I mean, this happens. And so it's tough to, to sit here and say, Yeah, I can make these really robust claims without any evidence. And just with trying to make sense of this complex system, which also doesn't usually work out. That's a bummer. I'm sorry.

Unknown 45:34
Yeah, I mean, shit on my parade, dude. I'm just messing with you. Now let's dive deep into your powerlifting physical therapist, so you know your shit when it comes to physical therapy. You know your shit when it comes to powerlifting and CrossFit. Now, what are some of the most common ailments you see power lifters go through? And some of the easy fixes that they can really kind of tweak so that you know it won't happen to them? I mean, my my wife is a power lifter Go figure. And she snapped her alma, by back squatting, which I didn't even know is a thing for power lifters. Yeah, she was going to she did a 315 walkout she was going to re rack it or I think it snapped on was on her back. And she has a metal rod right here. And she has a metal rod and this bone, and it just a totally snap. Like it was the grossest thing I've ever seen in my life, you know, and she didn't pass out because she didn't look at it. She didn't cry until she did look at it. I just want everybody to know that. Now. That's because she's a low bar squatter. But what are some of the biggest annulments or some of the tips, you can give powerlifters to sort of fortify whatever they're doing, you know, their guys, their knees cave, we talked about that. That's just part of their process. There are guys that you know, shoot their knees out there, guys, that round a little bit where we heard before was don't round your back when you deadlift don't round your back, when now it's like a little rounding is okay, you know, it's if you're strong in that position. So what would you say to help these power lifters fortify their longevity going forward and you know, increased strength.

Unknown 47:07
So as far as most common, right, it's not that far off from what the quote unquote general population feels right? People get short pain with adventuring, they get elbow pain with benching they get elbow pain with our squatting, low back pain while that deadlifting knee pain while they're squatting, I mean, all these things that the general population gets, you know, powerlifters get as a as a. And ironically, last night, I was squatting, I was doing pin squats, and I tweaked my upper back, you know, go figure. I don't know how you do that. But it's not the first time that has happened. But as far as tips go, we certainly don't want you to rest, right? If something comes up, you have some sort of acute change in your symptoms, you have some sort of injury, so to speak, what we want to do is try to find an entry point to continue to train, right. If your knee hurts when you're squatting, what we need to do first is take weight off the bar until you can go through a full range of motion, where it doesn't hurt anymore. If you're not able to do that, we need to adjust the range of motion till you can do a close variation to a competition squat. So that you can continue to train that variation. If you cannot find a variation of a squat that you can do without hurting your knee, transition to a front squat transition to a safety bar squat transition to a leg press if you have to box step up to similar variation, right. And all the while trying to stay as close as you can to your goal of whether it be a competition lifts, right, your squat, your bench or deadlift. If you're doing strength, lifting your overhead press, what you want to do is take as few steps back from that variation, or that lift that gives you trouble, train there until your symptoms let up and then slowly test to go back into that. I mean, it's not rocket science, but without the understanding of I guess the pain and rehab process that, you know, the three of us might have, it can be very scary, right? If you're under the understanding that your knee or your meniscus is blowing out, right. And that's what your symptoms are telling you. It can be very fearful to try and continue to do that with just a little bit less weight. And so as far as my best advice powerlifters go, is to try to take as few steps away from that goal lift. And it's okay, if you do right, not everything happens right now. If we're in it for the long haul, then training at lower intensities is going to be fine. As long as you're still training. You're not resting and you're building a good relationship with the lifts in that if you have pain, you're not totally avoiding that lift because what sort of relationship does that build with that lift? And what relationship does that build with the pain that you're feeling? I'm more than okay with people training with pain as long as they're able to tolerate it, right? Because if we make that kind of divorce of the pain is caused for some sort of structural change, then there's not that like, I'm going to make it worse if I continue to train and pain and so if i The pain is tolerable, and they're not afraid of it. Right? I'm totally fine with them training with that, as long as they're not like a masochist. And they're like, yeah, 10 out of 10 is totally fine by me know, my asshole blown out, I can keep doing it, it's totally fine. So there is some ebb and flow as far as being a coach and, and being okay with that. But what we don't want to do is say you need to train with zero pain, right? Because the intensity goes, Yeah, all the way down, because for the most part, people are able to train for the most part, you don't have to do that. Right? We have studies that say that we have similar outcomes when people train with and without pain, right? But the intensity is able to stay higher when they train with tolerable amounts of pain. And so they're kind of what we're talking about when you were talking about your shoulder, that detraining effect doesn't happen as large, right? And so they're able to get back into their regular training, better, they have a better relationship with that rehab process, they have, hopefully more self efficacy or ability to handle that on their own if it happens again. And so I think that that would be my best advice is to, don't freak out. Take a couple steps back. It's okay. If you're not training, you know, balsa wall right now. And even even for weeks, months, all that is fine, as long as you're still training and you're doing as best as you can. Because the alternative seems to be that let's just stop and wait. Right? It doesn't build that good. Really, yeah, that doesn't build like a relationship, you d train, it's harder to get back into it afterwards. If you're not training, you have a sedentary lifestyle, there's risk associated with taking that on, especially as you get into, you know, past 40 5060. You don't have the ability to be sedentary for months or years on end, because, you know, it's not good. Yeah. As far as longevity goes, or

Unknown 51:54
trying to reduce the risk, wondering question before you move into that, yeah, this is based off a post I saw you post earlier, and I really applaud you for this. I saw you doing some overhead presses. I mean, dude, yeah, I told Meg, I was like, Fuck, I wish I could do that shit. You know, I mean, my overhead press ain't bad. But I'm not hitting Oh, 235 or 205. Or, you know, like, I'll get up there. But here's my question. I see a lot of power lifters and this drives me fucking insane. All they do is benchpress deadlift, and squat. And I understand it's your sport. And if you want to get really good at something, you do it repetitively. But you're not going to get fucking stronger by doing just three movements. In my opinion, my personal opinion, when I wanted to boost up my benchpress by, you know, 15 kilos or 20 kilos, I started doing an incline bench press, because I sucked at it. Once I got really good at that. My benchpress went up like 20 kilos, sure, and squatting. You know, I can squat 400 pounds now. And I attribute that because I started to do more front squats, more squat variations, unilateral training, and my biggest knock on CrossFit is there's no twisting. In CrossFit. There's no, you know, side to side movements. That Yeah, there's no rotational shift. That's my biggest knock on CrossFit. Otherwise, I think it's done amazing things for all sports in the fitness field. Yeah, but what's your take on the power lifters that are like, No, no, no, you got to, you know, just squat, volume loading, German volume, all that shit, and not doing some of the accessory work that is needed?

Unknown 53:26
I think my answer for this would have been different a year ago,

Unknown 53:29
what would your answer have been a year ago? I'm curious.

Unknown 53:31
I answer a year

Unknown 53:32
ago, man, I'm really curious. Oh, that's

Unknown 53:34
totally fine. So my answer a year ago might have been if you want to be good at powerlifting. You have to do, right, these specific things, right? squat bench dead all the time. And if we're playing on like a specificity, right, specific adaptation to impose demands of said principle, you need to practice like you compete, right? My change now is that you can do whatever you want, because you're an adult, I guess. And I don't really care as long as the end outcome is okay. Now, I'll say this program is way more complex than I thought it was a year ago. And so my answers now, I don't know if you guys know, like, Dunning Kruger effect. But like, I'm in the valley of despair as far as like learning a lot of stuff and not understanding that you just need to squat bench and deadlift to get better at those things. Yeah, and my understanding now is one, you can do it everyone, I don't care. If you want to get better squat bench deadlift, you should probably do those in some sort of capacity. But I also understand now that exercise variation and training in different rep ranges, RPS different variations are is a good way to expose yourself to different movements that you might be better at as far as changing your competition lifts as well as exposing you to just more training stimulus, right if you squat bench and deadlift, more training. Most is going to be a few squat bench drills and then incline press as well, because that is going to help, at least in some capacity have some sort of transfer over into a bench press, right, because you're doing some sort of horizontal pressing, whether it's a little bit more vertical than the bench press, it's still not nothing. And so I think that maybe more volume will help with that overall goal of increasing your benchpress. And then we have to kind of consider as far as like, I don't wanna say anabolic resistance, but like becoming resistant to a certain stimulus, I guess a good example would be perfume, right? You go into a room and somebody sprays perfume, you smell it really hard when you first get in there. And then after you're in there for a little bit, you don't smell it anymore. I think that that would be kind of a you know, you've kind of run out, so to speak a variation, and then you leave the room, you do incline press for a while you go back to the bench press, and then you have that similar reaction to to that stimulus again, because you haven't done it a while you haven't adapted to that. As far as the overhead press goes, I'm really good at overhead press. And so I enjoy doing it. I mean, for honestly, it's just fun to do for me. And so that's why I do it. I've always been good at overhead press, I have no idea why. And I'm not going to stop to ask questions. And so I'm on a road to a bodyweight overhead squat, which, you know, is fun. And so why do I put that in there as a power lifter, because I want to do it I want to do and I'm gonna do it, and you can't tell me otherwise. But to those people that just do squat bench and deadlift, I don't think that they're necessarily wrong, because there's many different ways to skin a cat. And I'm more so appreciate, like what reactive Training Systems is doing as far as like an emerging strategy or like a weekly reaction to how the lifter does in that week, rather than, like, top down like, this is what you're gonna do for six weeks, no matter what sort of thing. And I think that that kind of plays into the more looseness of how I coach now, rather than maybe the this is what you're going to do. And this is what will work because these are the lifts sort of mentality. Does that makes sense?

Unknown 57:07
No, I make sense. And I mean, like the elite athletes, the elite power lifters, they can do whatever the fuck they want to do, because they do have that genetic, you know, they're the 1% of the 1%. But, you know, Billy over at friggin Gold's Gym, like, who's just doing those three movements like, dude, you might need a little variation and variation will help for a novice, in my opinion. That's just my personal opinion. And, you know, trial and error for like, 20 years.

Unknown 57:34
Yeah, I mean, you want to expose yourself to a wide array of moving, right, because my mom, for example, I train her in my garage gym along with my dad, and she doesn't like doing the power lifts, which, you know, makes me sad, but what are we going to do not train, you know, so, we do things with the med ball and the slam ball and the dumbbells in the box. And we're still doing resistance training at a moderate intensity, which is what, you know, the Activity Guidelines for Americans recommends two to three days a week. And so like, just because she doesn't like the variations that I like, doesn't mean that we can't find something that she does. And that ability to be flexible and to find different ways to move and, and load is great. I mean, if you kind of consider exercise, or training in certain ways as like, just based on how the equipment is built, right, like we squat bench and deadlift, because bars are long and straight. And that's just how they've evolved over time. You could do anything as far as exercise goes, and you know, CrossFit, right? You guys do anything that can be objectively measured, that can come out of that, quote, unquote, hopper. And so if that includes swimming, and then air biking, and then doing a husa, fell stone carry, like, those are just ways that training has been evolved around a certain implement, and it can really be whatever you need it to be as far as what tickles your fancy,

Unknown 58:55
I do want to touch on on shift gears just a little bit to the work that you did with the Air Force. You're a civilian contractor, and you help them in getting mission ready.

Unknown 59:04
And that's like, we were talking I think, like kind of in terms of what we've been talking about a little bit on the competition side, but a lot of like general health and wellness is too but getting someone like mission ready. I just kind of want to hear like a little bit about like, pain and strain training and your work in that realm of obviously, I don't want to say like higher stakes, but like kind of.

Unknown 59:25
Sure. Yeah. So I really liked working with the Air Force. I did it in two, I did it in three separate occasions. So I did it at Travis Air Force Base out in California for about eight months. And then I did it in two different stints in Biloxi Mississippi at keesler Air Force Base. The interesting and fun part about working with the Air Force is one there's no insurance, right? They use traquair. And so I don't have to Bill anything. It's great. There's no pressure from you know, there's no like you can't do manual therapy and neuromuscular re Ed along with resistance training and the same thing because we're not gotta pay out for that, you know, it's like, I can do whatever I want. And I can act as a person who has no, or at least limited external pressure to shape my practice, which is great. They need to be able to deploy, they need to be able to sprint 100 yards, they need to be able to exist in an austere environment, they need to be able to do those things. I can't exactly remember all of the like this. criteria are, but it's funny, there's a kind of perception that people in the military are different than everybody else. And I would say that, in some cases, that's true. And others, they're just regular people that were, you know, the Air Force stuff and have the same ailments that we have, the only thing that's different is that they need to be ready for what's called a physical fitness test or a PT test every year, and that they have to do push ups sit ups running in a waist circumference measurement. And so what we usually get is people who, in like a week are needing to do that, and they've done push ups every hour on the hour for the last week and haven't been eating anything. So that their waist measuring come in, and they've been running. So they basically try to cram everything in for like a month before. They're, you know, test. And so we have a spike and load and lack of adaptation and symptoms. And, you know, and so as far as trying to that, it's just basic load management and reassurance and education. Now, if we wanted to get into like, quote, unquote, like special operators, I have worked with what's called combat control trainees, which is, it's always funny talking about special operators, because it's like the army of the Air Force, I guess, hopefully, my Air Force friends don't scoff at that. But they are the ones that are helping, they're usually attached to like an army unit, as far as their ability to communicate with planes to use maps to help in aid. As far as tactical situations go, they train at an extremely high level, they have a two year pipeline that has no pause button. And if they pause, they're out. They have different PT testing standards, they have to do like pull ups, and they have to weigh far run, they have to drag people they have to do swimming and holding their breath and stuff like that. And as far as rehab goes for them, you can basically try and scotch tape them together while they fall through this pipeline. and hope for the best really, because I have contexts in like the early pipeline as far as pts go, and pts go. And my best recommendation to them is try and get them as strong as possible and robust as possible, because they really need it because there's no break for two years. If they make it through that, then that's great, but for the most part they don't. And that's kind of what they're looking for, right? You don't want somebody who has some sort of physical ailment that they're not able to perform in a austere environment in a deployed situation and fail. Unfortunately, that's kind of what they're looking for. They want that person who has that, that selection that goes to that selection process that doesn't fail that is able to really perform under that situation. But you really, it's tough, because you need to shift your thinking away from the long term and more towards How can I get this person through the week? Right? How can I get this person's foot who has a fracture? Because they've been rucking for, you know, 30 miles yesterday? How can I get them to do it again tomorrow without putting them on pause. Because as soon as they get on pause for like, more than three days, they're out. And for those people that choose to go through that pipeline and choose to do that, and they've self selected themselves to be that type of person who needs that to happen, right? It's not like you and me where it's like, if this doesn't happen, it's fine, right? I'll go and do underwater basket weaving, they're like, I need to have this happen, because I need to serve my country I need to perform at a high level. And if I can't, I'm going to be not in a good way. I think that is a better perception from the general public as far as the military goes and rehab. But for everybody else, they're just regular people that that go in, they work on a computer or they work with people or they are mechanics on planes, and they have regular complaints. Like like you and I do not matter though.

Unknown 1:04:16
Like Yeah, right. Like, get some good perspective on you know, just what our body's capable of. And then also just where do we need to be drawing that line of putting our talkies? For sure. Like, what what am I doing this for like that you brought up you know, the relationship between movements as well, to be honest, again, what is your relationship to this? If you hate doing it? Why are you doing it?

Unknown 1:04:36
That's why I hate friggin CrossFit. I hate that shit. Oh, no, I do it every day you love as Joe would say, I'm a masochist. I just love putting myself through pain. It's my turn on. It's crazy, because I don't think I've said that on the show before. That's the

Unknown 1:04:49
first thing gets turned on. No, I'm just joking it. If you look at like CrossFit memes, they're all about hating life. Why am I doing this and it's it's such a funny relationship with training. Like I do squat bench deadlift, overhead press, I do a barbell row. Sometimes I have an air bike, but I don't hate any of it.

Unknown 1:05:11
I love it. I

Unknown 1:05:12
look, it's my release. At the end of the day. I love getting to it, I now that it's colder weather, here's 30 degrees outside, I don't sweat anymore. It's great. I could never get behind the I'm never going to get better at this because it's always going to be harder, sort of, you know, I mean, I just, and for me, it just doesn't click but that doesn't mean it doesn't click for you. And as long as you're again training and enjoying and you're able to do that for decades, you know, go for it.

Unknown 1:05:37
Yeah, I love this shit. I love feeling like I'm gonna puke after every workout. Great.

Unknown 1:05:42
It's the best feeling in the world. not totally your thing, man. Whatever tickles

Unknown 1:05:45
your fancy. No, but but I honestly I work a shit job. Like I work behind a desk. It's boring. It's mundane. CrossFit is my, it's my release. It's sort of when I get to be who I want to be so sure, I love it, man. I mean, CrossFit fun.

Unknown 1:06:01
I like the novelty of CrossFit. I like I'm like humanity in that I feel like I'm pretty good at a host of things. I'm just not amazing at any one thing. And so CrossFit gave me the opportunity to walk in excel at a random thing that we were doing, like, you know, power cleans or snatch or something like that, or Atlas stone walker or farmer carrier, you know, a mile run, which I'm not very good at. But it that novelty and that exposure to a lot of things was both the good part of the bad part. I thought about CrossFit because it was fun, right? social environment, you're doing different things every day, but I didn't feel like there was any like, rhyme or reason. And that was a big like, thing for me because I was like, what are we doing here? You know,

Unknown 1:06:49
if you have a good coach, though, and I honestly like I have I'm lucky I'm blessed with a pretty smart coach. Like the guy's very smart. And he's great at programming in my opinion. He got me to a point that I'd never thought I would get through yummy to a bodyweight snatch and Meg talked about, you know, when she was chasing in CrossFit, and I never understood it until I hit 90 kilos. And I was like, shit, I just, that's my own bodyweight. That's awesome. Some people say, All right, now what for me now it's like, Fuck, I want to hit 100 kg. You know, like, that's, I want to bump up those 10 kilos, like a clean and jerk, I never thought I'd get to, you know, 225 I got to 225. And it's like, Alright, let me get to 120 kilos. Now it's, I want to hit 300 it you know, before the age of 40. Like, that's my goal with a clean and jerk. So that'll be rad. Dude, if I do that, I swear to God, I'm gonna fucking take off all my clothes and streak wherever the fuck I am. And I'm gonna go full monty, just like straight through the gym, and excitement. yet.

Unknown 1:07:55
Now that I'm working with WOD prep, I'm learning a lot more about programming for the CrossFit athlete. And it does make a lot more sense. Now that may be the place that I was at before. As far as understanding I just didn't understand what was going on. Because it is, now that I understand the structure better. It does make more sense. And so yeah,

Unknown 1:08:13
yeah, it's a big piece.

Unknown 1:08:14
So how is WOD prep? And can you break it down? For some of our listeners? I know, we have CrossFit listeners too, on the show and boot camp listeners and everything. To me, it's all kind of the same sometimes. But how is WOD prep? You guys do great things in terms of movement and getting ready. And, you know, can you talk a little bit about the programming

Unknown 1:08:33
Yeah, so and I hope that I don't do any disservice I've been with them for about two weeks. now. I'll say we moved from the movement doctor, which was CJ and I as far as pain and rehab over to WOD prep, but why PrEP is basically I want to say like a performance assistance service for that like regular crossfitter there's a lot of different courses as far as getting double unders getting muscle ups, perfecting your snatch, trying to be better at endurance type athletics and then we have one on one coaching as well. As far as trying to pay for you know, just you and I talking about programming doing something very unique for yourself and kind of changing as far as the nuances that present themselves as far as a as a unique Independent Lifter. The think that the WOD prep masters is a fantastic group, the over 35 which is exactly you know, the population that I love working with those people that were told by everybody else to like just just slow down and die already, you know, and so it's very much fun to see people doing Olympic lifts in their 60s and and see people doing muscle ups in their 50s and that sort of thing. And so, yeah, the WOD PrEP is fun. And I don't know if I did a great job there

Unknown 1:09:46
when you hit 35 to like about 4550 that's when you get man strength. All right, that's when you get a different kind of strength

Unknown 1:09:52
sided pull 800

Unknown 1:09:55
pounds everybody out there like you get a different kind of strength at my age. I don't know if it's because I have a kid But you know when I was 18 is like I can't wait to get man strength you get that different level of strength and megs heard me talk to you. You've heard me talk about this all the time, but it's different. Yeah, you know, I mean, wait

Unknown 1:10:11
to get there,

Unknown 1:10:11
y'all you get there, dude, you get it. If you're pulling like 600 now or 500. Now, if you stay consistent till you're 35 it's a different level of strength and it just think shit changes for five or six years, but that is just downhill from what I heard. Do.

Unknown 1:10:27
You guys, do you know Dave Rick's David Rick's not kids. He's a powerlifter from the States. He's 61. And he does charity events. And he squatted 705 for a triple dam the other day, which is crazy. seems to be getting stronger as he gets older, which gives me a lot of hope. Oh, yeah. I mean, yeah, I don't know. I'm hoping to, to squat 460 this year at 28. And he's tripling 705 at 61. And so again, it gives me hope that things will work out. He's really he's got super old man strength.

Unknown 1:11:05
That's a dude for anything past. I mean, back in the day, back in my day, when you know, in the early 2000s, mid 2000s. If you were hitting 400 you're like almost in that elite category. The advanced now 400 like the average, I'm like, no weights, the average, like the average to what it's, you know,

Unknown 1:11:23
it's funny, it's always funny to hear you talk about CrossFit Maddie because I know you. I was in CrossFit in 2006 I was there 2006 to 2011 So way back in the day, anyone those numbers you talked about were massive and it's the same thing like swimming time. So I look at like the pool times of what I did in college and now high schoolers are doing it and it's kind of exhausting but but, but it's just funny to hear. Yeah, their perspectives on the newness like I think because Joe you just got your level one in the last year.

Unknown 1:11:50
Yes. last couple years. Yep.

Unknown 1:11:52
It's just fascinating to me to like find that people are like just getting into it or just getting started with it because I was there at the the baby phase, when like the kipping pull up was as crazy as we got and now there's like movements I'm just like, what the hell is going on? Yeah,

Unknown 1:12:07
I mean, I hope to continue to see like genetic freaks because isn't that the point of like high level athletics is to put as many people as you can through that selection process to see who's really good at it who's enjoys who enjoys it and who can compete and and push into that pain cave as hard as possible because then you see like, Matt Fraser tea to me, which is my you know, shallow understanding of who's good at CrossFit.

Unknown 1:12:31
I don't even like watching the games anymore to be honest with you like until they retire. I'm not gonna watch that shit anymore. You know who's gonna win? You know, it's it's kind of like, you get the cereal box when you're a kid and had the surprise toy in there. There ain't no surprise with you know, Matt Frazier and Tia Claire to me like it's not there. So yeah, yeah, there's no no surprise to it, like no bubblegum or anything. The cereal box. I'm good on my side. Meg, you got any more questions?

Unknown 1:12:59
Now I could talk to you all day, I'm sure on more things with pain and everything. But we can always bring it back for another round. Because I think yes, it's good information and is WOD prep, where you want to leave people to to be able to, you know, connect and work with you or what we're gonna leave people.

Unknown 1:13:14
So CGI are the rehab team on at WOD prep. You can find us as far as pain and injury risk reduction work and coaching at wide prep. I wouldn't mind throw my Instagram out there. Dr. Joe DPT, and we have a training through pain Facebook group, where we do every other week live q&a as far as answering people's questions, trying to give out as best advice as we can to those people for free. And so I think that that's a great resource as well to find me, but those three things, I think would be best.

Unknown 1:13:47
Amazing. Well, if

Unknown 1:13:48
they're not on Twitter,

Unknown 1:13:51
only Trump's on Twitter.

Unknown 1:13:53
Nothing bad happening on there. Right.

Unknown 1:13:56
Awesome, man. Thanks for coming on the show. Really appreciate it. To the listeners. We're definitely gonna bring you back and you know, it would be awesome. If you did come back. I hope I didn't run you off. I told you a story how I ran a couple people have

Unknown 1:14:08
a great time. I'll always rant on any platform that I can get on and I had a great time as well. I hope to come back. Love it man. Thanks, Joe. Thank you.

Unknown 1:14:18
Thanks for listening to this episode. If you enjoyed it, please head over to iTunes to subscribe rate and leave a review. You can also find us on Instagram at the project Kuwait. Thank you and join us next time

Transcribed by