Brodie Has PHT Again!! + Answering Your Questions

On today's episode I'm answering all of your PhD questions. Welcome to the podcast that gives you the most up-to-date evidence-based information on PhD rehab. My name is Brody, I am an online physio, but I've also managed to overcome my own battle with PhD in the past, and now I've made my mission to give you all the resources you need to overcome this condition yourself. So with that, let's dive into today's episode. Welcome back, thanks to everyone who submitted their PhD questions. As I think I did last Q&A, I decided just to ask the people that are on my PhD email list and plenty have come in, enough content for the next several episodes. So sorry if I don't get to answer your question, but I want to start off with something a little bit differently and give you an update on me, give you an update on my current PhD, because for the first time in several years now, the PhD is the worst as being, and so I want to give you a rundown on exactly what's happened, and my PhD journey up until this day, what I'm doing about it, I was, I mean, an houring, whether I talk about it at all, but I thought, yes, it's probably important that I do talk about it, so that you know that we're in together and give you a bit of an update on what's been happening with me, but maybe you can learn a few things based on what I'm testing out, and I initially thought, well, maybe I'll talk about it in a couple of weeks to see what my progress has been, because right now it's right in the weeds of it, but I think I'll give you an update now, and then who knows, maybe when my next episode's released in a couple of weeks, I'll have a bit of an update for you, and then after that, I'll get to answering the questions that you've submitted. If you're not familiar, yes, I have had PhD, I've had it on both sides, and started when I transitioned from running marathons and going into triathlons, so no issues during the marathon, it was kind of just a big volume build, not a lot of speed, and handled that quite nicely, well, my hamstrings did a lot of other parts of my body didn't handle marathon training, but yeah, it was that transition to sprint distance triathlons where I had to run faster, I started on the bike, doing a lot of speed sessions on the bike, doing a lot of like, I remember doing a hard swim, and then getting out of the ocean and jumping on my bike, and my upper hamstring just felt so tight, and I guess sore, didn't really think much of it until it just persisted and persisted and persisted, and then I'm like, okay, and I eventually realised probably something serious going on, but by that stage, it was very, very hard to manage from there, and I'll sort of, I guess getting to the triathlons and managing it, okay, but pain persisted, pain persisted beyond my couple of years of triathlons into my just recreational running, and I just remember, you know, it being quite sore at work, as a physio, I had to lean over the plinth to like massage people and do manual therapies, and just leaning over the bed, was really causing some irritation, I just remembered driving home from work, most days into squirming in my chair, driving home, and it was only a 10-minute drive, but by the end of the day, it was just really annoying, and I think all in all, I think I had it for a couple of years, sure, Ebt and Flo didn't got to a stage where I noticed it, but didn't really disrupt my day-to-day life or physical activity, and so I was okay with it, but just ignored it until I learnt more about it, and then like, you know, if it's been persisted for so long, I think I should probably do something about it, try to do more research on it, so this was even well before the podcast days, I think the transition from marathon to triathlons was about 10 years ago, but I had it for, I don't know, maybe two or three years, and then managed to do the right things, managed to do the strength training, managed to reign in my general strength training, and yeah, I would be confident in saying I've had five years or so of it, you know, me pretty much saying I don't have PhD, for me to say I don't have PhD means there's been a long time me pushing my limits and not having symptoms, and so the strength routine that I went through up until this point, I mean like, even just last month, my strength routine, I do strength training twice a week, they do involve deadlifts, they do involve hamstring curls, at this stage, my deadlifts were, my warmup set was one set of six at 90 kilos, I did two sets of six at 110 kilos, and then I would do one set of five at 120 kilos, so for you North Americans, that's 265 pounds, so I'm getting close to for my heavy set about, getting close to double my body weight, I'm not a heavy person, I'm only 78, well typically 78, I'll talk about that a second, and I guess from last year I was performing, I was pretty happy with how I was performing, I was doing some good running, some good workouts, I've done two high rocks races, and got through those without any PhD hindrances, I would say I've had minor, I'll call them reminders in the past, like I have had gone on long haul flights, and I have done some pretty hard workouts, and then sat for a long period of time, and if those combinations kind of aligned, I would be squirming a little bit for like half a day, but then back to normal the next day, so there's always in the back of my mind, okay, you've had PhD in the past, but you're strong, you're all sensible with your training, and that just seemed to just not be bothering me for years, and I guess that's my typical view when someone asks like how long or when can I truly say I have overcome PhD, or how long does it take for me to no longer have this for the rest of my life, and I've answered this several times on the podcast, but my general philosophy is we can get you to the stage where yes, you're symptom free, yes, you're performing at your best, yes, you're very happy with symptoms, but like with any injury, not just PhD, there's always going to be a subtle reminder there, if you decide to push things, if you decide to do things that aren't sensible, if you, if certain things align where you fly internationally, run a marathon and fly back, like the combination of those things are natural and can't really prepare for, and maybe just maybe there's some reminders there that hey, remember you had PhD, there might be a little ache there, I think that just exists and you're back within a day or two, symptoms are gone within a day or two and you're just back into training uninterrupted like nothing ever happened, I think that's a common experience that we should expect, but yet hopefully you're okay with that particular outcome, if you decide to push your limits, if someone said you know what Brody, I'm just okay running three days a week, five Ks, slow pace, I just enjoy getting out nature, I don't really want to push myself, I don't have any big ambitions, then yeah, definitely your standards and your goals should be and will be symptom free, remain symptom free, to never return, but a lot of us listening, want to continue pushing elements, push our standards, run farther, further, faster, harder, longer, all that sort of stuff, and so yeah, let's expect some minor hiccups or reminders, I'll call them, whenever we decide to push that, okay fast forward to today, and again, I'm like how much of the story do I share, if you're a listener of this podcast, I'll count you as like a part of my inner circle, so for you who do or don't know, I have a daughter, she's two and a bit, absolutely, love her my life, my partner and I have been going through IVF for our second child, which has been going on for about, well unsuccessfully, for about a year now, and it's been brought to the attention of our fertility doctor, IVF doctor, that maybe I should try going on testosterone therapy, not necessarily like directly testosterone, it's a hormone that I inject or medicine that I inject to trick the body into thinking that I need to produce more testosterone, therefore it does it indirectly, and so I'll get to why this matter's in a second, so I've been on that for about five, six weeks, and my god, I, the weights that I was lifting and was close to my max now just feels like nothing, it has been astounding, let's just say for my chest press, so for good, yeah, my max has been about 80 kilos, and I do about sets of five, six, seven ish reps, I should say, and so you know, that's my bodyweight, which is, I'm pretty happy with, but I just never can push that I tried 82 and a half a few months ago before this testosterone stuff and I actually dropped the weight, dropped the bar on my chest because I just couldn't lift it up and I had to roll it off me. So this is how close I'm getting to my max and I do this at home without anyone supervising me so it's not the smartest thing in the world. But I like a few weeks ago went to 85 and was surprised I could finish a set of four and then I finished a set of six a week later and then I went to 87 and a half and just last few days ago I was lifting 90 kilos. I did a set of six which I'll surprise I could do and that even felt like I could do more and so this is it that's how profound this has been and this has been reflected in here we go my hamstring curls just felt light so I just went heavier my deadlifts felt light started to go heavier and I think that's what really poked the tendon a bit too much. My deadlifts increased and so over the subsequent weeks all leading up to this I went from 120 kilos to 130 kilos and two sets of six for that and like you know it was challenging but doing it and didn't think about my hamstring at all didn't think oh your PhD is going to return if you aren't sensible like I feel like they were sensible progressions but as proof is in the pudding probably not because now my very very gradual ache is starting to come on and I would say probably had like a seven day lag in terms of increasing the deadlifts and a feeling fine feeling fine the next day they're going for a run maybe running about three days in a row hamstring getting a bit tight then maybe did my hamstring curls that felt fine then maybe doing another heavy workout and getting some like tightness in both upper hamstrings which is like normal typical for me but maybe slightly more bothersome and then I continue to run that being quite slow a bit more awareness and all of a sudden I'm like all right something's going on here and it became more obvious sitting at work sitting at like towards the end of the day I definitely was starting to feel noticeable discomfort in my upper hamstrings that I don't really get and I'm like okay some sort of overloads going on here so it wasn't as direct as increase my deadlifts bang the next day I was sore sitting it was just like this accumulation over seven to ten days I would say to the point where I'm like okay I should start taking this more seriously so started adjusting the dials doing what I recommend for everyone I went down in my deadlifts I think I dropped from 130 kilos to like somewhere in the 90 to 100s I stopped doing hamstring curls that seemed to be I don't know I just do want to risk that I was doing single leg three sets of six each side and it was 15 kilos which doesn't sound like a lot but based on my bench attachment and the weights that I put on and like the fork room it sort of creates it's quite well it's obviously challenging for me and so I just decided to give that a break for now it was very hard to modify those I think I will go back to doing them soon double leg instead of single leg and just seeing how that plays out but I'll update you more on that in a second and I just continued so I adjusted my deadlifts and just kept still kept with my running just really really slow my pace my typical slow pace is six minutes a six minute per kilometer pace so it's like a ten minute per mile pace ish and my faster running is somewhere in the four 30s four something like that so quite a discrepancy so I keep my slow running really slow but with the hamstring in mind and even my calves like last two weeks ago I started getting calf cramps and it doesn't usually happen and I was doing this slow slow healy run I'm like wonder why I went on to the scales and I've put on like five kilos I don't look any different in terms of like weight but for the last couple of weeks I've been time ago for and I feel like I look bigger like my frame looks bigger and she mentioned that like yeah my profile I look like a different person and obviously the testosterone is kicking in but I'm just heavier slightly heavier and I didn't I never really weigh myself but decided to weigh myself the other day and I've just been 80 68 kilos consistently for the last two years despite trying to put on muscle for high rocks I really wanted to bulk up and like add some strength and add some muscle because that was like my weakest link so I tried I tried hard to put on muscle I really couldn't do it and then yeah keeping the train the same keep my diet the same and then just going this testosterone I've shot up and I've I now weigh 73 and a half so I've put on five and a half kilos it might have been gradual it might have been sudden I have no idea because I don't weigh myself but that's probably taken a toll on my calves me being five and a half kilos heavier and running and running like that being slow but up and down hills probably why my calves decided to give way but now controlling that and so my runs have been like six and a half minutes per kilometer when just trying to ease into things and last Thursday I did a five K run symptom free my hamstrings were perfectly fine the next day completely fine but last Friday was my deadlift day and I have a half day working and I had to sit for four hours on calls and just after that four hours of sitting I was just really achy and I did my dead lifts I did 90 kilos so what my warm-up set is and I did half range of movement which up until this point they've all been four range of movement so I made a significant shift to adjust that and just the rest of the day just really saw the worst has been since I can remember and I'm like man I'm still I'm making these adjustments last night's run was completely fine I think it's a sitting there it's sort of for whatever reason right now sitting is the main trigger those four hours of sitting in the morning it started off revealed itself in sitting the week prior and so now I'm thinking that it's particularly this vulnerability that I need to modify right now and trying to stay as active as possible so I'm like all right now it's time to be serious let's I've tried taking it's a subtle approach which is sort of what I recommend we don't want to take big overholes and say let's shut everything down for two weeks now we just make subtle adjustments just until we find our sweet spot but even though subtle adjustments I'm still not finding my sweet spot and so I went back on isometrics last Friday when I had my quite bad day my isometric of choices what we could call a long lever a single leg long lever bridge and I might have done too many of them I've probably done three sets of 10 seconds and I would have done them every three hours or so which I thought was fine and the next day this is where it gets more complex that's Saturday I work out with this incredible like knee pain like it seems like it is distal hamstring pain up around the side of my knee which is either from the volume of the isometrics I've done to me that I'm not used to or I did try one isometric long lever wells so like twisting or like rotating my foot in and out just to see if I could find a point where it was a bit more painful and then I could load that tendon in a little bit more of a painful position to then get a bit more of an analgesic which I haven't done before and I like to experiment on myself just to see if something is really good that I sort of have insight for and then can maybe help my clients maybe it was that but man this this knee pain right now like I'm waking up in the mornings and it's like a five out of ten pain to walk I'm like limping and this is going on well Saturday Sunday Monday it's kind of like day two day three now it's not getting any better and so that's why I'm definitely not doing my hamstring curls at the moment but hey I'm doing what I can yesterday I did a pretty intense workout I did the ski yoga I did wall balls with a half squat and I did a sled push and I did the rower and everything seems to be okay with that and I was pretty intense workout so still trying to keep as fit and as active as I possibly can just before recording I did my regular sets of squats maybe did three quarter range of movement rather than full do my usual chin ups do my usual dips and tonight I'll probably do some cardio that will involve like the ski yoga and a rower so still staying as active as I possibly can I'm icing my icing my knee this is how bad it's getting I'm actually putting a nice back on which I hardly ever do but it's just so sore but let's see if that resolves hopefully that resolves because then I can get back into running I'll pull you know if this knee wasn't an issue then I'd probably continue running but my action plan is I'm taking a D-load week I usually take a D-load week once every every fifth week so I build up for four weeks and I take a D-load build up for four weeks take a D-load and right now I'm on to week three and I'm like oh let me just take a D-load and bring that D-load week early earlier. It makes me feel a bit better about not running and yeah if this week I feel better then I'll just go into my build next week. Yep trying to do as much cardio as possible just keep it light because it is a D-load week. Keep the cross training going if symptoms provide. Might still ice. I don't know but I'll definitely have to ult my sitting. I'll be standing. I do have a sit stand desk which I haven't used the standing function in a year but I'll use that strategically. I'll still sit but sit within my tolerance. I'll use a cushion which again I haven't done in several years but that's a part of my game plan for the next couple of days at least and the rebuild. So like I said at the start of this recording I don't have any success yet. I wish in a couple of weeks I do have some positive things to report on. No doubt I'll keep you updated though but there are my thoughts. This is the thinking process that's going through my brain and we'll see what comes of it. So let's get through I know recovery from PhD has never been simpler. If you've been struggling with this condition and you're not sure what to do next I've put together something to help. LinkedIn the show notes is a 30 second question air literally just six multiple choice questions and based on your answers I'll point you towards the most effective next step for your situation because over the years I've created a range of resources from free education to structured self-guided programs all the way up to working with me directly all of which are aimed to strip away the mountain of misinformation about recovering from this diagnosis and taking out all the guesswork that leaves people like you overwhelmed. If that sounds helpful don't wait until the end of this episode. Click on the link in the show notes now and I'll guide you from there. We're in terms of recording. We're about 20 minutes in. Okay so we'll get through a couple of questions and what do we start with? The first question that came in was from Chuck. So first come first served with me answering these questions. So Chuck says do you believe it is more effective to use isometrics versus eccentric exercises as the research is shown? Okay so isometrics are an exercise that is a load and hold in one position exercise rather than an eccentric which loads up the hamstrings as the hamstring lengthens. So an isometric would be an isometric bridge so you just hold the bridge hamstrings are loaded you're not moving. Whereas like an eccentric classic eccentric is like your Nordic drop where you are lowering your body down the hamstrings are getting longer and longer and longer as they are being activated or recruited at the same time. And so 10 20 years ago isometrics were all the craze for tendon opathies because they created this really nice analgesic effect. Ebony Rio had a really nice paper on the effects of tendon tendon pain with isometrics and so you know it caught fire everyone jumped on isometrics everyone saying how good they were how effective they were but there wasn't necessarily a study done looking at other loading it was just a study looking at isometrics in their effects. And so it wasn't until later that they actually brought out isometrics versus concentric eccentric exercises and they showed when it came to analgesic it was pretty much the same like had the same effect. And so I guess the difference being that the concentric eccentric are more functional. We don't want to train the muscle just to hold a particular position stay in that position for a long period of time. No we want it to be functional because we need to bend over our gap stairs as we return to running we need to return to sport we need to return to picking things up and like you know functional tasks. And so Chuck you mentioned eccentric so I would probably add in their concentrics as well. I think the concentric is just as important as the eccentric they when done and load correctly they all seem to have this analgesic effect but it's only the concentrics and the eccentric that have that carry over for function. What is more effective look the isometrics for me I think are more effective at symptom relief that's as my personal benefit and inside which is why come last Friday when I'm like alright this is quite painful I decide to start doing a whole bunch of isometrics. But I wouldn't do that for very long as soon as my symptoms calm down I would personally ditch the isometrics and start doing the concentric stuff or do what I naturally have been doing. I mean for years I haven't done isometrics I've just been sticking to my deadlifts curls lunges those sorts of things and squats. But it's their own I know I have in the past been quite critical of isometrics and quite critical of bridges but I have since slightly changed my view on things I do think you know bridges do have their place isometrics have their place so the concentrics and eccentric I wouldn't just do isometrics I think that's where people go wrong they stick to isometrics and they never progress I'll get to that a bit later. But why not do a bit of everything and see what really works for you see what moves the needle see what gets you towards the goals that you have and if you do you find yourself particularly stuck. If you have been on isometrics for a long time you haven't considered concentrics or eccentric maybe we delve into them safely conservatively and then build up and see if you start noticing improvements. Thanks for your question Chuck the next one comes in from Rose who says I have a case of chronic pH tea I play tennis and continued playing until the pain during a match was no longer tolerable and MRI showed a three centimeter attraction of one of my tendons. Because my case was chronic my sports doctor said he would not operate and prescribed PT. I've been doing PT for a solid six months and was just released to return to tennis. My question is will I ever be the same? Well I'm glad I talked about my expectations when it comes to a full recovery of pH tea because my answer would kind of be similar when it comes to will I ever be the same? Yes you will get to a point where there's fully functioning. I don't know how much to how much relevance to hold to the three centimeter attraction. I think context is required at this stage. I think if it's slowly developed over time if it's slowly gotten worse and worse and then it shows a degenerative tendon that has a three centimeter attraction. I think that's less concerning than someone who was playing tennis. They lunged for a ball felt the popping out behind string. A bit of bruising, a lot of pain, some dysfunction. They get a MRI and that shows a three centimeter attraction. The context matters I think but in this case based on Rose what you've described does seem like it has been that chronic gradual onset type of stuff. So will you return to the same? Most likely I would say based on the information I have. But it'd be helpful to know how much improvement you've made in this six months of PT. I'd like to know why exercises were done, how much progression you've made, how systematic it's been, how effective it has been. Have you been doing six months of the best exercises, the best progressions and you've made 20% improvement, or have you done the best exercises, the best progressions and you've made a 90% improvement? Have you had a really shoddy rehab that I would shun away from? But you've still made 50% improvement. These are like the things good data points to know like hey, there's still so much potential here because you haven't really done a really effective rehab and yet you're making this improvement. You have so much potential to grow from here. I think I'll add on top of this. It does require a good dedicated rehab that factors in the tennis technique, the requirements, the loading. So we're talking about as you are ready to do so, graduating towards like lunges, heavy lunges, fast lunges, side lunges, sprints, changing direction, all that are sensible and gradual. But that's going to help you build and build and build and feel more confident, more powerful, more strength, more capacity to not only get to where you were playing tennis before, but even beyond that, like you can get to a point where you do strength and conditioning so that your body is equipped well before the onset of PhD. So yes, definitely a lot of potential. I would say to wrap it up, you should make a full return despite retraction seen on an MRI. I won't say you will. I can't say that with the information I'm given, but most likely, hope that helps. Next question comes in from Debbie, who says, "I'm 12 weeks hamstring tear, no surgery, conjoined tendon, 2.7 centimetres, and semi-membranoisus, 7.1 centimetres retracted." I should probably say, retraction is when the tendon kind of pulls away from the attachment and the retraction is the hair far away. It's pulling and Debbie asks what are the best exercises to prevent ray injury? Okay. So obviously with all these questions, it's going to be so frustrating for the listener to hear out, but more information would be helpful. I'd like to know sort of like what movements or tasks like functionally, how much you're struggling, Debbie, what deficits you have that being range or strength or power, those sort of things to assign you the right exercises really. What do you want to return to? Are you returning to sport, running, sitting, like driving? I don't know. I'd say for the most part, to actually give you an answer, a better tailored advice would be a bit more helpful, but I don't think there's anything wrong with just going back to the basics. I think if symptoms behave like P-H-T and it hasn't been like this really severe case that requires surgery, if they've decided to treat it conservatively, we still follow the same principles as P-H-T. We assign the same exercises. The time frames might be different. How conservative we are. We might need to start with a lower starting point and progress a bit slower than typical, but essentially what these exercises designed to do is restore strength and function of the hamstring. Whether you have a tear, whether you have surgery or not surgery, whether you've had P-H-T for 10 years or 5 months or 5 weeks, it's all about, "Okay, let's try to safely and sensibly restore strength and function to this unit," that then permeates into the joint above, the joint below, and functionally return you back to what we need to return you back to. That is typically starting off maybe with bridges, then some hamstring curls, some stepups, some deadlifts, but they're all at an appropriate level that you're ready for. If you're not ready for stepups or curls or deadlifts, then we just do some bridges. We might just do some light isometric hamstring curls. We might just do some walking. Get out there and do 5 to 10 minutes of walking, based on the level of function that might be an appropriate starting point. But I think the same direction, philosophy, approach would be the same as a typical P-H-T patient. But like I say, the starting points might be different. How quickly your progress might be different, but the same principles of play, we're listening to your body, we're letting your symptoms guide what's appropriate and what isn't appropriate. And typically, little bit of discomfort is okay. We usually keep from a pain level under 4 during an activity, which then resolves. Unless by the next morning everything should be completely resolved, back to baseline, back to your most settled state. And it's okay if there's a little bit discomfort during, okay if there's a little bit discomfort afterwards, but it needs to be back to its most settled state the following day. If we follow those and progress a little bit more, pay attention to symptoms, progress a little bit more, pay attention to symptoms. I think it's hard to go wrong. Hope that helps you Debbie. The next question I've got coming in is from Jane, who says, "Thanks for the opportunity. I have chronic P-H-T. I've been suffering for 10 years. Whenever I ride my electric bike with pedal assist or ride as a passenger on a Harley in brackets with a great cushion, I get very sore during and after. And at the top of my muscles, just below the butt crease, feels like a finger has hard pressure on that area, most uncomfortable. I've done years of isometrics, but continue with flare ups as above. Any tips to make past times more enjoyable would be greatly appreciated." Okay, Jane, thanks for your question and your information. Just a question, maybe you fall into that category of someone who continues to do isometrics and hasn't yet progressed into the more functional stuff like the deadlift, step-ups, curls, lunges, whatever have you that helps meet the demands of what we need to return the tendon to. So, I would say, if that is you, tip number one would be to gradually and sensibly progress beyond the isometrics because you're creating a ceiling for yourself in terms of your potential to rehab if you're only doing your isometrics. And then we want to add exercises that sort of cross over to meet the demands of the task. If it's cycling and sitting on a Harley, like that's compression of the tendon when you sit and I don't know what sitting is normally like. I don't know what driving in a car is like for you. If it is the Harley, it might be the vibration that's actually a stimulus that triggers it. If it's on the bike, it might be the pedal stroke rather than the sitting itself. I don't know. But exercises that encourage compression would be deadlifts, would be weighted step-ups. And so, if you, let's say you can only tolerate 20 pound deadlifts, but then over six months, we get to 80 pound deadlifts. You're obviously tolerating more compression and therefore we'll have more tolerance to tolerate compression, which is sitting, which is cycling, all those sorts of things. And that step-up action is kind of like that pedal stroke action. So if you're doing step-ups with five pounds and eventually progress to step-ups with 50 pounds, you can better tolerate a pedal stroke and therefore have greater capacity to do more and more and more. If sitting is an issue, then maybe we look at improving your sitting tolerance. Maybe we look at outside of the cycling and the Harley sitting. We look at actually like sitting, your day-to-day sitting in a standard chair and see what you can tolerate and then have a sit-stand strategy or have some other changes in your sitting environment so that we can go 20 minutes of sitting, 10 minutes of standing or walking or some sort of sitting variation, then back to 20 minutes of sitting and then as the weeks go on, we're doing 30 minutes, 45 minutes, 60 minutes of sitting and we're just building up your sitting tolerance as symptoms allow. That might be something. But another element worth considering is taking those specific tasks and then giving you smaller bouts of exposure so that you can tolerate it in the future. This might not be that practical for the Harley standpoint but for an electric bike, you say that I'm very sort during the bike and I'm very sort after. I would say, okay, let's build up your strength a little bit but let's try on the bike pedaling for five minutes. Let's maybe get an indoor trainer where we set it up and only do five minutes on the bike and if that's tolerated, amazing. We can do that every day or every second day and then eventually progress to eight minutes, 10 minutes, 15, 20 minutes and that gives the body a chance to adapt to the conditions that you're giving it. It recognizes the stimulus of pedaling on a bike. It then says, hmm, that's an interesting stimulus. Let me adapt to that. If you do it more often, that's more opportunities in the week to adapt to those conditions. Then we can tolerate slightly more, slightly more, slightly more and then we're very systematically training you to tolerate those things while concurrently working alongside your strength training, building up your step ups, building up your squats, building up your lunges or whatever is appropriate for you. Would seemingly lead you on a more successful path based on the path that you're currently on. But I don't know where your access to a Harley is like, but five minutes on the Harley, a couple of times a week, progress it out to eventually get to what you want to do. It might not be that practical, but if you can put that into practice, then happy days. All right. So probably too much about me, but hopefully these questions did help you. Time will tell, let me jump on and hit the microphone again, hit record in another couple of weeks and let you know about me and we'll answer more of your questions. If you are looking for more PHT resources, then check out my website link in the show notes. There, you will find my free PHT five day course, other online content and ways you can personally connect with me, including a free 20 minute injury chat to discuss your current rehab and any tweaks you might need to make. While done, you're taking an active role in your rehab, find the sneak to content like this and together we can start ticking off all of your rehab goals and finally overcome your PHT.