#148| What Is The Best Way To Treat a Muscle Strain?

[MUSIC] Thank you for tuning in with us today. We are discussing one of the most common injuries that happens, a muscle and a tendon strain. We look to answer what is the difference between strain and strain, what causes muscle and tendon strains, what are the best ways to prevent strains? If an injury does happen, what should our initial steps be to kick off the healing process? What role does blood flow restriction play? And why the heck was it banned in New York State? It's a great episode to help you take control of your movement system. Hope you enjoy. Today's show is sponsored by the Prehab app. This is not just an app, but a solution. You have the opportunity to take care of your rehab, prehab fitness, and performance needs all from the palm of your hand. The app is available for download on the app store for both Android and iPhone users. Also, a seven day free trial is available. Don't wait. Start taking control of your movement health today. The Prehab Audio Experience will give you the knowledge to take control of your health. Learn how to optimize performance and tune up your movement system using the right information at the right time. Prehabers, welcome back to the Prehab Audio Experience. This is your host, Dylan Caswell. We wanted to start today's show by first thanking you. Thank you for the reviews and for writing into us and letting us know what you want to learn about on the show. We read every review that's posted on Apple, every email, every comment that comes through. Today, we're going to be answering one that's been coming in more and more. Today's episode is going to focus on differentiating two words that are commonly thought to be interchangeable. Although they share some similarities, they are different. Similar to a donkey versus a mule, a butter versus margarine, or a jam versus jelly. Yes, they are different. Today, we're going to be discussing the difference between a strain and a sprain. But more importantly, how you can take control of your healing when a muscle strain does occur. Dr. Kregland-Delsman teaching on this topic across the world for the past few years. And today, he's on the show to teach us. Kreg, thanks for joining us today, man. How do all the places you've taught this topic on? What's been your favorite location so far? That's a good question. I mean, immediately, one spot comes the choice. And it was at Nike Headquarters. It was super cool. I got to teach back-to-back days on Saturday and Sunday. I got to do an in-service with some physicians, with some sports scientists from the NFL and NBA, as well as a team of physical therapists from the NBA team. So that was a super special experience. I also got to meet like a previous Penn State quarterback, which is super cool because I was heading back to my alma mater Penn State the following weekends. And then in addition, the Saturday that I was there, the break-to happened. I don't think that's the right phrase, but it was basically running a full marathon under two hours. And that was prior to me beginning my whole running experience, but to like be at Nike Headquarters, the day that that happens was pretty special. So a very vivid memory of that entire weekend. Yeah, that's amazing. And I mean, if you can teach there with that amount of pressure, I mean, you're going to do this podcast a lot as just today. So thanks for joining us. And we'll start off with defining the difference between a muscle strain and then a type of sprain injury. So a sprain refers to a ligament injury. So when we have an ankle sprain, that's a ligament that becomes injured. A ligament, something that connects the bone to the bone. So again, with an ankle sprain, it tends to be the anterior, tailor-fibral ligament that's sprained, but again, that's a sprain with a P. What we're going to focus on today is a strain. So with a T, and that happens not to ligaments, but that happens to muscles and tendons. Tendons connect the muscle to the bone. And an easy way that you can think of this is strain. It has a T in it and so does tendon. So strain happens to the muscle and the tendon. And with that being said, strain's going to happen just to the tendon itself, the muscle belly or the area where the tendon and the muscle connect, called the Muscle Tendons Junction, where this tends to be the most common point of injury. We see muscle strains happen all the time. And especially now, as summer is underway, a lot of athletes are starting to prep for their fall season. So football preseason, camps are starting to come underway. A lot of soccer athletes are starting to get in condition for the fall. Maybe they're playing in the summer, but a lot of athletes are starting to get in season shape. And preseason starts to get ready for the regular season. And this tends to be where we start to see a lot of muscle strains. So Craig, I want to pass it over to you. And the first question that we have is, what are the top causes of a muscle strain? The top causes of a muscle strain, as simple as possible, is just going to be too much mechanical stress. So whether it is something that is happening, e-centricly, you're trying to slow down the movements, you're going through a really big range motion, something is happening fast. If there is too much mechanical stress that your muscle cannot handle, remember, like the bare, the simple definition of a muscle strain is going to be a tear. Like, that is the one more definition. Think strain with a T, tearing of the muscle fibers. Muscle fibers, they contract, they relax. Think of them as like ropes. When there is a tear in that rope, you are experiencing a muscle strain. And simply put, when there's too much force, it can cause a tear. Yeah, absolutely. And I want to touch on this point a little bit because we look at mechanical strain and it's, we're performing or we're trying to do too much, we're putting too much demand on top of capacity, that may not be built yet. And we can build that up and start to prevent it. But we also need to look at the internal load. What is going on in that athlete's mindset? What's going on in their brain? Because that's going to change the way that that feed forward mechanism inside their brain works. And a lot of data is showing that athletes will become injured and have muscle strains when they have higher life perceived stress events. So there's a training aspect to it to load it mechanically where these tendons and muscles can withstand the forces that you're putting upon them. And then there's also the aspect of how is this person doing as an athlete, how they doing as a human, what's going on in their life, what are their stress levels. And how do we start to tailor that to make sure that they're performing to the best that they can. So with that question, the next one that we ask is, well, can muscle strains be prevented? And what we see a lot of times is that these things can really be prevented with good programs. When we look at the NFL, a lot of people tend to think that the number one injury is concussion or head injury. In reality, the number one injury is a hamstring tear, a hamstring muscle strain. But what the NFL has learned is that with strength and conditioning coaches, with athletic trainers with PT's, that when they do a really good prevention program, and they build up this muscle to be able to withstand the forces, the muscle strains, they don't go away completely, but they decrease a ton. They are able to play longer into the season, not as many players on the team are having these injuries. So these things can definitely be prevented. And I think that's what gets it so excited is that there's a lot of things that are out of our control. There's a lot of things that are within our control. And this is something that is within our control. We can take control of this to become the athletes that we want to be, to become the people that we want to be. So, Craig, the next question I have is that as much as we try to prevent them, and when we look at the logo of pre-hab, I want to point this out, this is the reason that there's brackets around the pee and not a full circle, is that because we realize that prevention is not going to be 100% successful. But it can be successful, but it's not able to be 100% successful because of all the variables that a person goes through in a day and a week and a month and a year. But once an injury does happen, how do we kick off that healing process? What are the first things that we should do? So, one thing you experience in muscle strain, the challenging part is that it's painful. It hurts. Going about your life, trying to move, you have to contract muscles. And since we're talking about hamstring strains, you know, we talked about strains, we defined it in one word, it's a tear. And strains and strains, they have different grades of tears. And it's typically your grade one, grade two, grade three. If we're talking about a hamstring strain, a grade one, your hamstring grabs, when you're sprinting, it's pretty sore, it's pretty tight. But you likely probably don't have any pain with walking. Whereas a grade two, there's a solid chance that, hey, maybe you heard a pop, it's really sore, it's really tight. Maybe there's even some bruising, and you definitely feel it with walking. And then grade three is maybe you ripped it right off the bone. And it's not good. It's definitely bruised. It's really painful. Had a serious hamstring injury. Regardless, when we're talking about rehabbing a muscle strain, we want to get the body moving. Living in Los Angeles, this is the way that I describe it to people all the time. So say that you strain your hamstring. You're trying to get back to soccer as fast as possible. Your body is trying to heal itself as fast as possible. So when you normally actually. exercise and you're doing hamstring exercises, you are actually causing micro tears of the muscle. Like that's very normal. Under normal healthy conditions, our body is able to adapt to that stress and pose on the muscle and then as long as you're feeding your body and you're giving it adequate time to recover, your body is going to regenerate muscle tissue and the muscle is going to get stronger, it's going to get bigger and those muscle fibers are going to become more resilient to the stress that you just imposed on it. That's why repeated exposure to exercises and movements, they get easier and your body gets stronger. Now, say that you tear your hamstring. Well, now your body is going to try to heal as fast as possible because it doesn't care what kind of tissue it's going to lay down. It's a matter of it's going to go in the fight or flight mode, it's going to go into survival mode and we just need to heal this issue as fast as possible. I brought up the Los Angeles thing because if you, I mean, Los Angeles has a reputation for terrible traffic. Well, Los Angeles to San Diego, if there's no traffic, you can get there in an hour, 45 minutes, hour and a half if you're going pretty fast, but on average, let's say two hours, taking the five freeway. So, you're normally exercising, you're working out, well, guess what, your body's constantly taking the five from LA to San Diego, we're hitting the gym and then we're recovering. We're going down to the gym, we're coming back, recovering. Now, what if you strain your hamstring? Well, the five is the easiest way to get from LA to San Diego, you're on cruise control, it's highway miles, it's efficient, you're regenerating muscle. But think of a muscle strain like causing a traffic jam on the five. The five is the best way to take because it's going to lay down the best muscle tissue possible. It's promoting a hundred percent muscle regeneration. But when there's a strain, now there's a giant traffic jam on the five, it can take five hours or six hours to get from LA to San Diego, but your body's like, hey, we need to heal and we need to get the San Diego as fast as possible. Now you're going to take side-trees, now you're going to take all these random highways and these random roads. And the good thing about that is it gets your body healed as fast as possible. The problem is all those side-trees and all those other freeways are actually promoting scar tissue formation. This is a big problem with muscle strain rehab because scar tissue is not as good contractile tissue like muscle tissue is. And that's a big problem with muscle strains, especially a hamstring because you want that quality muscle tissue so that you can get your full hamstring flexibility. If anyone is ever strained to muscle, especially their hamstring, when they try to stretch their hamstring, it feels tighter. It doesn't have the same flexibility, it doesn't have the same pliability. It just feels stiffer compared to the other side. And that's probably you are feeling the stiffness from the scar tissue, from connected tissue that has scarred down. I mean I wish it were we're gonna try to keep it as simple as possible. But the reality is when you strain the hamstring is a perfect example. It's never just a muscle tissue that get hurt. That gets hurt. You have to think there's connected tissue in the area that gets hurt. There's neurovascular tissue in the area that gets hurt, especially if you're doing with the grade two, it bruises. You know, you're talking about active inflammation, swelling, those neurovascular structures, they have the heel as well, the connected tissue, it has the heel as well. And it probably doesn't heal with the same proper quality tissue just like the muscle does it. So all of that leads to this crappy situation in that area that now your hamstring on one side is going to feel different than the hamstring on the other side. So going back to the question, what do we do? Well, we need the move because there's a lot of great science and evidence to support that, hey, the more that you can move, the more that you can activate and use that muscle within pain tolerance, the more that you are going to promote muscle regeneration pathways. Versus if you just sit around, you do nothing. Oh, you're showing your hamstring, Dr. tells you the rest, you need to get up even if it's painful, you need to walk out that door, and you need to find someone that's going to work with you. Tell people all the time, muscle strain rehab, it sucks, it's painful. But if you're able to do it, you can find ways to do it. You're going to be promoting more muscle regeneration. And that's overseeing in a literature more and more, especially hamstring rehab. It's like, hey, work within pain threshold tolerance, it's actually going to help with preventative risk factors related to hamstring strains. It may not increase time to return the play, but at least you're helping with preventable modifiable risk factors. And then in addition, work on flexibility, work through that range of motion. We want to restore that range of motion as fast as possible, even if it's painful. Because otherwise, we're going to lose out on that flexibility. And that's what gets athletes in trouble, keeps them in the injury cycle because guess what, the knee bone is connected to the hip bone, which is connected to the low backbone. And if your hamstring doesn't have flexibility, where, well, you're going to be putting stress in strain somewhere else. And then that's how the vicious cycle begins. Yeah, great point. And Craig, you reminded me of this conference. I was at a few summers ago. The speaker was sharing a story that his dad shared with him and his dad grew up in Africa. He also grew up in Africa, but then moved over to America, but he was talking about the difference between a bowl and a cow. And what he was saying is that when a storm is coming, that the bowl will walk towards the storm, and it will stand there, and it will take on the forces of the storm, where the cow on the other hand runs away from the storm. But what ends up happening is as the cow starts running away from the storm, they actually prolong their suffering in the storm. The bowl goes into the storm. And because it goes into it and it faces it head on, it limits the amount of suffering. And it's the same thing with a muscle strain. You have to be willing to lean into it a little bit in the beginning. And that's going to overall decrease the amount of suffering that you need to have from this injury. As Craig was saying, to sum up those points that we need to limit the distractions and the distractions with muscle strains tend to be anything that's passive. You know, we did a podcast on the truth about icing. And what happens when we rest what happens when we put ice on this area? We've done podcasts talking about ultrasound and other passive interventions that, you know, these are distractions. We need movement. The way that the muscle is going to heal us through this process called mechanical transduction and mechanical transduction doesn't happen without movement. We need to make sure that that we're moving. And if you are suffering from a muscle strain, hop on our website, Tommy Mandela wrote a phenomenal article on the pain monitoring scale that we use with with every client, every patient that we work with that can help you guide of how much pain is too much pain. How much is it where I should be pushing a little bit more? And then how should my body be responding to that? And you can use that and you can jump into one of our programs and really start to take care of yourself with active things. And I think that's one of the biggest responses we get from people that go through our programs is they're like, wow, I've done all these other things. I've done ultrasound, I've done shockwave, I've done infrared, I've done all these things, but moving has made me feel better than I've ever felt before. And if we can take care of this early, we don't need to spend a ton of time regenerating tissue because it never degenerated in the first place. And kind of last point here to sum up some this up is that, you know, when we look at hamstring injury. So I mentioned in the beginning that the NFL, the number one injury is hamstring issues, especially in skill players, the biceps form, ours tends to be the number one thing that's injured. These players in most teams, they go instantly into movement. They strain at that day, they're back in the locker room doing isometrics. If they can tolerate it, they're getting out of treadmill. They're doing light hamstring exercises, but they're moving this area. And they're ready to go within seven to 10 days, but people hold them out for two weeks because the likelihood of injury is higher at that two week mark. So in order to be safe, because of how many millions of dollars these players are being paid, they prolong it to about two and a half to three weeks before that player can come back. But they're ready to go within seven to 10 days because they limited the distractions. They did what they needed to do to get this moving and by using the cano-transduction for that healing process. So I love that analogy of driving a San Diego and being on the highway versus going off and having to go through all these side roads, get to the destination that you want to be in the quickest, most effective, safest way to make that happen. So Craig, another question that people might be asking is, well, why else does early movement matter? And one thing that I think you do a great job on talking about in the course is that if you don't use it, you lose it and the disuse atrophy that happens. So let's dive into that a little bit of let's say hypothetically, I have this muscle strain. I'm not moving it early. I'm a little fearful to move it. I'm afraid I'm going to tear it more. I'm afraid I'm going to damage it. And I'm just not okay with moving it. So I decide I'm going to go complete rest for four months or four weeks. Four months would be a lot, but it happens, but let's say it's four It's a month of rest. What are the repercussions of that? Yeah, I mean, if you don't use it, you're going to lose it. Like that phrase is always going to hold true. You heard it growing up and that phrase is not going anywhere, especially when we're talking about muscle strains. So the problem is, number one, before we've been talking about the repercussions, it's like, I think if you can set expectations with your patients and clients now or even yourself that, hey, if you strain a muscle, rehabbing it is going to hurt and that's okay. If it hurts, good. It means that you're actually targeting the tissue and it means that you're using it. Like, think about the injury. You tear a muscle. So using that muscle is probably going to hurt, but letting yourself know that, hey, work with him, whatever you can tolerate, and it's not going to cause extra damage, as long as you're not going crazy with it, and just microdose it. You know, it's, I think, where the expectations get messed up or where people feel like they can't do anything is because they're trying to compare to what they were doing prior. And it's like, hey, you're not going to be able to do as much as you were doing prior, but you need to do something and you have to do a daily. And if you microdose it, you work with your tolerance, it's going to get better every single day and it's going to heal. So setting that expectations will really help with having successful muscle strain rehab. Now, going back to the repercussions, like we said, if you don't use it, you'll lose it. Muscle is so metabolically taxing to maintain and keep on your body. Like, literally, the number one thing that your body is going to give up is muscle, because it's expensive as crap to keep it on the body. It's like very expensive real estate. Well, what's the, what is the most expensive thing that I can get rid of first that your body is thinking about? It's going to be muscle because the brain is more important. That's going to come first in your organs and everything else is going to come second. So muscle is at the crap end of the stick. And that's going to go because it's just too expensive to maintain. In order to maintain muscle, there's two simple things that you can do. You're either going to get quality protein ingestion with amino acid as well. And quality protein is going to have quality amino acids in it. And then secondly, it's going to be stress. And that stress is resistant training. So as long as you're doing those two things, you're going to be promoting this anabolic state of body. We can call it this anabolic building. You're promoting muscle protein synthesis. So if we have the light switch, the light switches on and we're promoting growing muscle and maintaining muscle. So the only way to do that is you're reading really good or you're doing resistance training. You're moving it. You're using it. Now if you rest for four weeks, well, the light switch is turned off. Now you're going to be in this catabolic, this breaking down environment. Muscle protein breakdown is going to be the only thing that's happening. And you're going to be only promoting and dealing with anabolic resistance. So just like people with diabetes, they deal with insulin resistance where their body's natural insulin is in working as well. We'll think when you strain a muscle, you're not exercising. You're going to be dealing with anabolic resistance. So it's actually going to be harder to be growing that muscle because you're only promoting the pathways that are breaking down muscle and parting ways with muscle. So what's the problem with that? Well, muscle size is going to decrease. Muscle strength is going to decrease. And because of that, the amount of force that you can create that your muscles can output is going to decrease. And because of that, now the amount of mechanical stress and force that your body can handle is going to decrease. Trying to keep physics as simple as possible. Pressure is just force divided by area. Well, think of area as your muscle. So if your muscle shrinks, and you're still trying to do and lift the same amount of force, the pressure is going to be higher. What this pressure or what this pressure or QA2 in terms of feelings is going to feel like more pressure. It's going to feel like more discomfort. It's going to hurt. It's going to feel like your muscle has to work that much harder. And this is where the person rests after straining a muscle, they try to get back to exercising. They're trying to do hamstring exercises and all their feeling is a crazy amount of pressure or tension and stress and their hamstrings are on their knee joint or on their hip joint. And they're wondering what has happened, what's going on. Well, the muscle is smaller. It's just physics. Yeah, I want to go back a little bit because I know we live in a society where people hear if something is good, then more of it must be better. And I was looking through a human podcast, some of their comments when they release one on the importance of light and how light affects circadian rhythms. One person commented on there and was asking, well, if light's good for us, would it be best if I went out in the morning and I stared directly at the sunlight? The response was, no, don't do that. That's too much. You've went too far with this. And I know people listening, they might be thinking, okay, if it's a muscle strain, then pain is good. So if I create more pain, then that means that my rehab is better. And it's like a vitamin. You want to take the right amount of it. And if you take too much of it, it becomes detrimental. If you don't take it at all and you're not getting it from other sources, it becomes detrimental. So it's finding that that right amount. And again, I would reference that article that Tommy wrote, but it tends to be what we use is two points on the pain scale. And yes, the pain scale is subjective. But let's say I strain my hamstring and I have a three out of 10 pain. I start exercising and it goes up to a four out of 10. Okay, gonna keep going. It gets up to a five out of 10. I'm gonna keep going, but maybe I'm a little bit more cautious. All right, now it gets up to a six out of 10. All right, I'm gonna start to shut it down, take a rest break and see what happens. You know, in that sornus, it might last through the next day. But by the time I get to the next day, I should be back to baseline level or improved from what I did that previous day. And if that's not the case, then that's a sign that, hey, we did a little bit too much. Need to dial it down a little bit and then build it back up again. So that two points on the pain scale tends to be with the research points to, tends to be what's safe. I know there's some rugby athletes I've worked with where it's like, hey, okay, we want to create a little bit of pain. And they're like, oh, I'm really good at that. Let me go sprint as hard as I can and go hit a sled. And it's like, their pain went from a two out of 10 to an eight out of 10. And it's like, man, that's way too much. Like at that point, we're doing more tissue damage and not giving the body the opportunity to heal. So it definitely comes with that caveat of it being the right amount, but the takeaway being with a muscle strain, you know, we do want some discomfort that helps the healing process. Now on the other side of this, if it's like a neural type of issue, like a cervical radiculopathy or sciatica type pain, you know, in most cases, we're not going to want to create more pain. That's just going to further person up and it's not going to get to the healing process. So as Craig was mentioning in the beginning, it's not just the muscle. It's the neurovascular bondol cardiovascular system. So we have to be sure that it is a muscle strain. And then once it is a muscle strain, we can start loading it and creating that pressure on there. Craig, what I wanted to ask you is a lot of the field is moving towards blood flow restriction in these early phases. Just because you can get a little bit more metabolic stress, you can get more growth hormone, more IGF1 floating around, which is going to kick off that healing process. And kind of a side note here, you know, BFR recently in New York State has been, they put out a statement saying physical therapists cannot use blood flow restriction. And just kind of a quick caveat that, you know, if you are a physical therapist and you're in New York State or you're in a state where this is happening, that you're writing into your state government and you're asking questions and you're trying to advocate for it because when people asked for the meeting minutes of why this was banned, the only thing that New York State gave out was names of people that were in the meeting, but they didn't give out anything formal as far as like what evidence was used to say that this should be banned. They just decided that that it should be banned and it might be because the name sounds scary. But Craig and I were talking before the recording of how much of a disservice that is to people because blood flow restriction is showing really great promise for people, especially if they're having muscular atrophy. And let's say they have to be in bedrass, well, BFR can help maintain some muscle mass. And then when people are moving at light intensities, using BFR can help to get that strengthening effect. So we can get people back to what they want to do quicker by using this thing. So it's kind of irritating and, you know, it kind of upsets us that they just banned that without even discussing the evidence they're going into it further. So kind of quick, quick caveat there, but Craig, I'm going to pass it over to you. And let's talk about blood flow restriction and how you would use that for a muscle strain. Would you use it right after the injury begins? Do you wait a certain time before using it? Yeah, great question. And the BFR thing getting shut down in New York is scary. And that's a shame. We've been teaching BFR for over three years now with smart We've been very fortunate to get exposed to this modality early on. And every time I teach I truly say that this should become the standard of care for injuries like muscle strains for post-operative care, and for any acute pain that is related to a loading problem. So everyone definitely needs to stand up and speak out because this could turn into a slippery slope and people could just be using the state of New York as an example. And BFR has completely changed how we rehab patients and clients. I mean, we have extra sets of BFR that if someone's going to benefit from it, we give it out to them. And then people are going home with BFR. That's how much we value in. That's how much we believe in it. And on the topic of muscle strains, remember, it's the definition of a tear. So it's going to hurt if you're using that muscle, trying to rehab it. And going back to your side note earlier, the key word is microdose. Don't overdose with muscle rehab. You have to microdose daily. Now, why BFR is so good with muscle strains is because everything that we spoke about earlier, the more that you use it, the more that you move it, the more that you're going to be promoting muscle regeneration. Well, BFR is only going to exaggerate that response. And that is because BFR is going to promote muscle protein synthesis. It's going to promote the muscle getting bigger and promote the muscle getting stronger. And there's plenty of evidence and science to support that, hey, if you actually use BFR, it's actually going to inhibit something called myocent. And myocent is something that's going to make muscles disappear in atrophy. Myocent is actually part of the TGF scar, TGF beta scar tissue family. So the more that we use BFR, the more that we're actually going to be shutting down scar tissue pathways. So like I said, think of BFR, it's basically, it's the cops as well as the cleanup crew coming to the five freeway to de-conjess the traffic and open things up. Whereas TGF scar tissue pathways, it's all those side streets. It's all those different roads that you're trying to take to get to San Diego's fastest possible. It's appealing. It's attractive because it's going to potentially get you to San Diego as fast as possible, but grind it out and stay on the five freeway. It's going to be uncomfortable. You're stuck in traffic. It's uncomfortable. It doesn't feel great, but it's going to help repair muscle tissue as fast as possible. And the coolest part about BFR is that it actually has this analgesic effect, meaning that it's going to decrease pain. So, Dylan, you brought up earlier, hey, NFL guys, they heard their hamstring. They're back in the locker room doing stuff right away. I strained my hamstring sprinting within 30 minutes. I was doing BFR. And I did BFR every single day for eight days within a 10-day period, micro dosing, doing what I can, tolerating the pain that I could. And as long as my pain diminished and resolved within 24 hours, as long as my range of motion wasn't getting worse, it wasn't a swelling or stiffness. I knew that I was doing a good amount of micro dosing, and I was back to jogging at like day 11. So, it's an awesome piece of equipment. It's an excellent modality. There's literally nothing better when it comes to muscle strain rehab. All the athletes that I work with, they ever strain something, whatever it may be, any previous person that I've worked with, that tweaked something, they are literally texting me and trying to get in the same day or the next day and wanting the Dupy F-R. Because it hurts so good. That's awesome. So, I'm a Kansas City Chiefs fan, and I promise the story is going somewhere. But for my 30th birthday, we went out to Kansas City, saw the Chiefs first at Cowboys, first time going to Kansas City, first time going to Arrowhead, and it was just a phenomenal experience. But I had a group of my buddies. It was after the game, it was that next Monday. We went down to the park, we're playing football, we're playing two on two in the all-time quarterback, and one of my buddies, you know, the first time that he was really sprinting around like that in a while, and kind of tweaked his upper hamstring. The best part about it, he's also a PT. So, he tweaked it on the field, and instead of the normal response of laying down and all crap, this sucks. You know, he got down on the ground, started doing single leg bridges, and he said, "Okay, I can tolerate that." So, it started doing some single leg RDLs and said, "Oh, okay, that hurts a little bit." All right, let's do some hip hinges, do some hip hinges. Okay, that feels okay. I kind of kept progressing, but you know, he was like, "Hey, I can't run anymore. I can't tolerate a single leg RDL, so I'm not going to keep playing this game." But then we were a little worried because this flight cup getting delayed, and by the time that he landed for his layover, he had to get off the plane and sprint to get to his next gate. So, he went from three hours of complete sitting to then getting up and having to run, and do that. So, that was kind of like, you know, he was able to do it, and he didn't have further injury. But the reason that we believe he was able to do that was because he started moving it right away. Like, as soon as the injury happened, he dropped down, started doing bridging, started doing RDLs, but he took care of it very early on. But, yeah, I mean, those points are great, Greg. Is there any advice that you want to leave the listeners with? Oh, I want to keep it simple. Like I said, move it or lose it, microdose it, and set clear expectations. Know that muscle strain rehab is going to hurt, but that's okay because that means that you're using it. Get help if you need it, and try BFR. If you can get access to it, we sell the cups on the shop on our website. The three of us still teach courses from time to time. What's great is smart tools. They now have technology where you can buy the product right off the shelf. And if you're the average person, you have no PT education, whatever it may be, you can still use this stuff. And it's great. And yeah, I mean, our programs are a great way to help build you up microdose movements, get you back to what you need to do. We got hamstring programs. You name it. So hope you enjoyed it. Hope you listen to it. And if you're ever in LA or California driving to and from LA, the same Diego, I suggest doing it very early in the morning or at nights. And definitely check Google Maps because if there's an accident on the five, it's pretty bad. Awesome episode. We're crag on strains. Let's go over the key takeaways. Key takeaway number one, limit the distractions in the healing process. Stay on the main route. Key takeaway number two, with muscle strains, it is okay to lean into it a bit. Just make sure that you're using the pain scale as a guide to find the right intensity. Key takeaway number three, movement, movement, decompgest and cleans up the route. Do not be afraid to move. And if you are, seek out a professional that can help give you the guidance that you need to reach the outcome that you want. Prehabers, thank you for listening. And as we say to the beginning for sending in episode suggestions, thank you for the reviews on Apple. We've been seeing a bit more come in. Thank you for taking the time to do that and help more people discover this podcast. If you know someone that would benefit from learning more about muscle strains, please share this episode with them. All right. We'll talk soon. [BLANK_AUDIO]