Dave Fevre on Isokinetics, Testing, and the Human Side of Performance | Season One, Episode One

Recuper, Perform, Excel What do those words really mean in a world where injury, recovery and performance are forever evolving? It's time to find out with the Performance and Rehabilitation Podcasts from Kiko Health. In our very first season, before the whistle, we're exploring how preseason testing and assessment shaped the outcomes long before the action starts. From I-Synch-Connected Data to On-The-Ground Insights, we're speaking to experts who prepare teams and individuals to move, perform and recover at their best. Let's get into it. Okay, so first of all, we have Dave Fever with us today. Probably needs no introduction to many people out there, but a little bit of background on Dave. Long history in rugby league, through Lee, Wiggins and Great Britain rugby league. Even into football then we managed to unite, had Blackburn Rovers and then there's quite a few more clubs on the list of their Dave, Chelsea, Lester, Solford, Barrow, Man City. But most recently, England 11 for soccer aid. So first of all, how are you feeling after the weekend? It was a great time to be involved in that as well. It was a brilliant experience and it was obviously controlled a lot by the media and how it ran with the Ferrari TV and everything else. But you see, you're never too old to learn an experience, something new and it was looking after the players was easy in terms of the footballers, but again, getting used to working with the actors and the singers and all that sort of thing. But they were all brilliant. Everybody was both from the staff and both the players, everybody was really responsive and it was a really good four days. I really enjoyed it and the people I worked with were excellent Gary Lewin and Colin Lewin and then the Rustymassers, Laura, Emma, Steve and John Green and what I've been the doc Matt. It was really good because they were, it was basically a Southern medical team plus me. So that's how it basically panned out. So I think I was the butt of the jokes most of the time, but never mind. I held my own, I think. No, good and obviously going a little back step back in time for you to be back in the dugout or traffic. Yes. The word vehicles are calculated. It was 26 years from when I last sat in that seat. You chose the same seat? No, no. I went in on purpose just to say, look, this is the seat I used to sit in. I used to obviously sit in the other dugout or I was a blackboard, but it was a bit surreal and being in the whole dressing room, that's the other thing that was surreal as well. But it was brilliant. It was great. It was nice. And again, I, it costed the way the structure of this coaching team set up. My job was to do the warmups as well. So I ended up probably doing more than I would have done my much day for you now. So, um, so it was good mate. No, it was good. So rolling back the years, if taking the warm up as well, that takes me a lot of time. I just thought you see it would, I think I did it for three days and really. In fact, on the second day, I had to do both teams at the same time within the size of a penalty box area for 40 players. So that was the first. Like you say, still learning Dave. Still learning mate. Colt with 40 players in a penalty box and see if you can go with it. Well, no, it's fun. Now, fantastic. Look, this is, this is obviously a great thing for me. I've been used to guest on this day because I like to the start of my career. And those of you might not know this out there that Dave gave me. Probably my first opportunity as a student in March 2000. Wow. Yeah, we're showing both our ages there. And then I was fortunate enough to come and enjoy Blackburn in the summer, the following summer sort of preseason there later in that year. So yeah, to have you on, Dave, is a great thing for me personally. You've taught me a lot about things through my career. A great mentor to me from the start. So no, just so much appreciated. That'll probably not a problem. So I guess going back for yourself and Dave, and again, I'm sure with the number of things that you've done in the past, people might have a bit of an insight into it. But how do you fall on the decision to go into the world of physio? I want to be a PE teacher, to be honest, and didn't get the grades. Web to love for and that that time when you went to love for you all attended in your England track seats, whatever. I played for North of England. And when I got there, I realized I got little chance because everybody else had England or their country on their blazers and I had North of England. And there's a, as I didn't get in and I didn't want to go to love for it. I couldn't go to Carnegie and I didn't want that. I either wanted to love for or nothing. I didn't get to love for us. So I decided to have to change tack. And at that time there were many male physios around and I was into my sport. So I thought, well, let's go for it and see what happens. My mum and dad just said, look, do what you think is right and go it that way and that's the way I did it early, John. And not look back since? Not at all. Never would for one minute would I want to change. And the worst thing now is that when you go on conferences and you speak and then I meet the 21-20, I met a young MRI student on the Sunday at the game, he came up to me just to have a word. And I said to her, I said, I said, they're mostly put, I wish I was your age to start. And because I enjoy it so much, I still love it now. It's not something I've never seen myself packing in. But I said to her, I was jealous of her being at her age and still looking at just starting on that road. So that enthusiasm hopefully shows in the way you work and that's until I lose that and I'll keep doing it. With that in mind then, I guess what is on the agenda at the moment? What's on the schedule moving for a few days? Obviously, I was just mentioned in the environment in Socarade. I know recently you did a presentation offering in Finland. I've got a few more international ones coming up. I've got Denmark coming up and I've got to see my FAS stuff with the rugby league stuff coming up. And at the rest of the time, it depends on what happens on my mobile in the next five minutes, ten minutes one hour. And it's a nice way to be in a way. You're not sitting by your phone, but if you don't get any phone calls, I'll just do, I've got plenty of other things to do. I'll just wait for that and see what comes along. And I quite like that ability to be able to do what I want when I want, which is great. And then if somebody rings me, says, can you come and do a year or six months or a month or a week, then I'll go and do it. If it's what I want to do. So it's a great stage in my career to be doing it there now. I thought probably eight years ago, and I left Blackburn, I thought probably within the year or two, then it would start to be that I wouldn't be relevant and ironically my phone never been busy during the last eight years. And it ever was when I was working full time in football. So who knows what's going to come up in the next few weeks, months, days, whatever? Look, that's amazing in the sense because I've just recently come out of full time football. Obviously, you know that, but the listeners might not. And even today, and I sort of felt the same way coming out thinking, well, what's going to be next? What I'm going to do? I'm going to fill it. Here we are. We never thought you and I'd be sat in there necessarily doing this. But we did chat about that. And I said to you, so I'd love to go with it. You can do it and you tickle the boxes at home and you can do all that. It's easy for me. My kids have grown up, but I think, but I think in that situation, we've worked so hard over the years and you've been controlled by what the club's patterns have been. Now you're very tired of what you can do. And now you, by being it this way, as long as you've enough work to play the bills, then you can go whichever direction you want to go. So I would encourage anybody, but it's having that bravery to go out there and move it onto the next level. I only did it once my kids had all gone through a yearning. And once they'd all gone through a yearning, then it was just a matter of well. It's time for us to start doing what we want to do. And then just letting the job take its roles it goes. But for yourself, then Dave, like going forward, like you say, the election in present day, whatever comes across, but you've still got that passion for their hands on stuff as well as the teaching and lecturing. That's the where I see myself as a clinician. And people try and slot me into roles and if it's not clinically based, then I'm not interested. So it's something that just sits behind the desk and sort of supervises where people go away. BCDI, I want to be part of that team that's going outside and doing the outdoor rehab and doing the pitch side trauma. Obviously we're doing the teaching for Atmiff and I'm off. They're not obviously a little bit different, but in that situation, that's the way my career has always been. And I think it's very easy to get older just to start to move into a more administrative role and that does not float my bow. And do you think that's changed over time? From me personally or? Just in general in the world of sport, I mean, when I remember starting off as a young, just leaving university, there was yourself, some great clinicians at Blackburner was I joined Paul at the Philbatti, Nick Broad, who was there obviously a couple of days a week. Compare in that setup. And then you mentioned the changes in this sort of movement upwards into a potentially more organizational role. How do you see that the dynamics of elite sport have changed over your career? You probably did it without even thinking about it and it was part and parcel of it. Now we've got a job title for it. And it's a matter of now we've got now got performance based approach. We've got a rehabilitation based approach. We've got a matchday, you know, physio based approach as well. So the job's been split and dissected and a bit like you're saying there, one would start it out. It was a matter of having two physios, one soft tissue, no fitness coach. That was part of our remit, that was part of our job. We had a doctor two days a week, we were lucky. So I think the numbers now have obviously changed. I mean, one of the clubs I've been into in the last couple of years, we had we had 16 medical practitioners on the first thing without the doctors included in there. So you've got numbers and numbers of people. And I think the other thing that's changed a lot really, John, is that number of people now that actually a lot of club lower down the chain that basically are filling the positions as required by the F.A. So they see right, we need two physios and they will try and get young physios, no disrespect to that, but it's on the basis that financially it's not going to cost them as much money. And there's been a massive drive that way towards bringing in and ticking the boxes for the F.A. requirements of having one at-mif physio or one charted physio based. But regardless of the experience, it's been the youngest staff that's coming because it's easier and cheaper to employ them. The polymer is then it backfires because when an injury starts to go o'r rwy'n amser, o'rän o'r mwy'n amser ymdwi'r gweithio. Yn maen nhw'n amser. A'r mwyn, mae'r gweithio ar yma, mae'r gweithio yn amser. Mae'r gweithio yn amser. well being their mental health side, the support systems they're having place. So can you see it? Why, like you say, there's not many people of even staff staying one place for a long period of time, but probably more so, the players stay in one place for the unless time. So, yeah, there's becoming an increasing thing where players might have their own support system and own medical team and own fitness team around them. How have you found the changes in that over the years away from, I guess, club based to normal, I think in that situation, it's certainly my experience with several of the clubs I've worked at in the last few years. That's that's obviously been there. I think it's a matter of trust between the two parties. You know, it's here to stay. It's not something you're going to get rid of. But at the same time, it's it's having that it's developing that relationship with the players and go, look, we understand that that's going to happen. You want to do it here and there. Just be honest with us, just be up front, tell us what's going on. You know, we're happy to relay the same information back to the other parties. What in that situation? You know, there's a line between keeping everything storm about what you're doing rehab wise and what you're doing training wise. You know, I can remember a player at Blackburn. It wasn't blackburn. We never had any of that issue. But I remember one player telling me he was going to have a master come round and stay at his house and I went, it's not a problem. Thanks for being so honest. You know, if you want to do soft tissue massage stuff when you're at home with your family, I get that. And that was it. He's on the expense. And I think you would have got to move with that situation. It might not be what we want, but it's something that's there and how we develop it and how we move on is fine. I think eventually the year hope that in time, as you get to know the players better and certainly one of the clubs I've worked at. I just found a common goal to get on with the player and once you get on with the player within a few weeks to start to come to go, look, my physio and Italy wants me to do this, but I'm not that keen. What do you think? Can I follow what you want to do it? And it's getting that divide into it and going, get it, totally get it. I understand where you're coming from. And that's the important thing. And I think the other issue is dealing with big players is really important and understanding that the end of the day, they all want to be out on the pitch. So soon you can get them out on the pitch. Then it's a position they want to be in because they know they are in a stronger position than you. But then you've got to be able to think how you incorporate that with their injury and then convince them that you know what, you do know what you're doing. If you try and fight it, I think you'll end up making it worse. Yeah. And I think I think there's a player that you and I both work with independently at certain times in our careers and it reminds me of an example that you've just said there of, of with them and going, look, you know, I normally manage it. My injury's in this way. And you know, he was an overseas player and, you know, I want to go back home and see the people that I normally see. Well, no worries, you know, if we'll come with you, if you need us, no, no, I have to go on my own. That's the way it works and this. But being open and getting those relationships and having that communication to go, look, we support you. It's no problem. Let us know what goes on. So we can maybe replicate your needs here. And I think the that open collaboration to support the athletes, probably the, the key bit and might say, but we've all been there in the past where it's been a bit of a secret. You've been to see someone and no one says anything and no one knows anything. And I think that's probably what makes for a difficult or a more awkward management of a, a bit poor. I think you're right. And I think I mean, don't forget the year when I started, basically, there was a, there was a professional respect for your other colleagues. And I think that unfortunately is dwindled. You know, I get agents ring you mean it about seeing players at old. And I go, that's fine. Just get the fizzy on the dot from the club to give me a ring. And the, no, no, no, we want to do it with that. I said, you'll find somebody but you won't get day favorite doing it. Because that's the way I've been brought up. And I'm not going to change now. It's too late in my career to change. I'm with me. I've done it, I've done it and spoken to clubs and just say, look, I've been asked this, you know, but is your player? I don't need to speak to you. You're quite happy. And quite often when you have those conversations, people go, oh, no, we'd really appreciate your input or your, or what I think it comes back to that, you know, I, and we keep going back to this. The theme of I was guided in my career by, by you, if that makes sense. Yeah. I learned those things from you. And obviously, you're all not bringing of what's right and wrong through your family. And just that mutual respect, you know, professional courtesy is probably the demands of the sport, I think, maybe have taken a little bit that way where people do have the power to do what they want to do. I think, I think you're right. And I think, I think it's the way the profession has gone a little bit, which is a shame. You know, everybody's trying to, I know everybody's got to an 11 and I get that, but you don't need to stamp people in the back. I think that's wrong. I don't, I don't like it. And, you know, I listen to people and, you know, we all know people that do that. That's their choice. But, you know, it drops my respect and that degree where like, if that would ever happen, I'm sure it does happen without me knowing, but, but in that situation, it's not something I ever want to do. So, no, no, you've got to stick to your, I guess, look, a couple of different questions, then I guess biggest challenges, if you like, I mean, you've had a few over the years, and I guess then maybe biggest achievement, you've done some, you know, which might have been when you've been in sport, but like you said, when you left Blackburn, you probably are thought in your mind that, well, you know, I don't know what's coming next. You've had some great things. So I guess, let's start with like some of the most challenging things, I guess, or just an example where that we can maybe share with other people or situations you've had to deal with. Let's go with that one first. I think in terms of rehab, I think the important thing every injury is a challenge, whether it be a hematoma, right, the way through to a full blown ACL or something more. See it. I think the important thing is to know your role in your rehab pathway. You know, sometimes you've got to lead the individual. Sometimes you need to work alongside them. And other times you basically just steer them in the right direction. And it's knowing when to apply those appropriate moments to do it. So I think from a rehab point of view, you know, people sort of go out. Some of the jobs I've been in the last few years about what's the pressure like that? I never feel pressure. It's not a pressure. It's a challenge. And that's up to me to ticket. And if I haven't got the ability to sort that out, and I've not got the ability to look in the mirror, if things aren't going well, is it me? Is it something I've done? Is it something that players doing away from from that side of it? And then if that piece of the jigsaw doesn't fit, it's then trying to find the right piece that does fit in order to move it on. So I think from that point, you know, what? You know, in terms of us giving that question in terms of the injuries, I don't really feel anything there has changed in terms of the way I've done things and the way I've I've pilar out my rehabilitation. I think in terms of doing my lecturing, that's definitely been challenged. Probably my hardest challenge, I think in terms of election was when I got us to do the Oxford Union. And I thought it was a microtate. I thought I thought we were some of the lives of the club winding me up. And I had to go to my father in law to find out and he looked at anyway, and all this is genuine. And without boring the listeners to everything that goes through, I spent six months preparing for this. And it was what a 12 minute lecture, but I wanted to do it. I always lecture without notes and prompt cards and things like that. But I wanted to do it. And I watched various people from world leaders who done it from Barack Obama through to Nigel Farage. And again, you don't agree. By the way, that Nigel Farage could hold the audience for phenomenal. And I watched what he did. And I thought, you know, a lot, if I could copy that in terms of the way I did it, then it would be brilliant. So I did spend ages looking at that. It's funny, but I'll interrupt you because my my most recent gift from someone sort of another layer, a neighbor of mine, in fact, who works in business. You know, she's very, very high up in the corporate world. And I'd spoke to her about the discussions of things that from my own career, what we're going into. And the bookshed with Jamie was, was how to have to develop your presentation skills for those who've got no time, honestly, starting to read it and like you say, looking at people, whether you, whether you, you know, like them as a person, or you haven't opinion or whatever, for people to do the things they've done, and we'll have the same on players, you know, people have opinion on a player and we'll go, that's totally wrong, because we know that player. But everyone has some element of skill or, you know, something that makes them different and stands out that if you can steal a little bit and put it into yourself, but it made me laugh because that's literally just the book that the subordinates that I've got around for me. You know, you can see that. Like, that mean the only books I ever read are geographers. Likewise. I guess you might see sort of here, the Iron Meer day, but literally, it's just it's literally autobiographies. That's all it's on the books. And the ones that I found the most helpful for my lecturing, the comedians, because the comedians, if they get the first job wrong, it's, it's never going to work. And I've taken a lot of help from using those as books to make me think, you know, I need to get this delivery right. This has got to be spot on and and having that that side of it. So, so that was probably my biggest challenge. And the way the day pans out for those people have never done it at Oxford Union, you're giving a student for a couple of days to look after it's like you go for really, they take your round and then there's a whole procession of events that go on in the day and the evening before you go into it. And there's a guy that was speaking at the same time as me and he'd done no preparation. And we sat next to each other at dinner. And he went to me, what do you think I should say? I just tell him his story because he story was a brilliant story. And he stood up and ironically, you get a 10 minute bell to warn you there's only two minutes left. And your hand is on a central wooden box that Winston Churchill gave to Oxford Union. And the idea is that Winston Churchill spirit goes through your arm and it makes you speak better and so on. That's that's tradition. And he stood there and as soon as the bell went at 10 minutes, he sat down, he couldn't cope with it anymore, but he did really well. And I run a person on the other side of the argument that I was after was a journalist and I thought to myself, I thought, wow, this is I'm up against two journalists and some new works around the international. This is going to be difficult. The journalist stood up and ready's 12 minute lecture off a piece of paper. And I know my wife was watching and she knew that I was buzzing about that because I just thought, that's brilliant because I know that I'm going to do 12 minutes. I know my facts are right. I know my jokes, where they're going to fit in. And I'm going to do without any script whatsoever. So the idea was to them when you're and it was such a good thing. I remember watching Robbie Williams do Neb with this video and when you watch him afterwards he talks about the the low after you've spoken and I totally understand that because I remember and I listened to what he said about that and I thought as soon as I've come off lecture and even now when any lectures I do you do get this little bit of a dip because you've spent so much time preparing for it. And I guess I if I can compare and you've you've done the same thing and look to be honest because those are listening I end up in rugby league probably on your say so to pass to go down I don't know if you recall in life day. I do have that but yeah yeah. Get yourself into rugby league and what the greatest experience but for those that don't know is a physio rugby league doesn't stop if you go on the pitch and that buzz that involvement in the game whereas you know football someone goes down everything stops. Yeah you got one you do your bit there's no sort of like you say it's funny because we've done it so often I don't feel any pressure with that and people might say what you've you know you've been at the stadiums that you and I both worked at and you think yeah doesn't it that you don't batten either about it. In the game live when you're in there rugby league and you're in what a great feeling and again I've not know when near them as much um lecture in our presentations and look that might come in time for me but I can see that but a performer like Robbie Williams coming through and yeah I've been in that sense too. I can see how he must about coming off the stage there without that six months work. I was tempted to mention it to him yesterday but I never really get the off chance yesterday I was going to say you've led me to do what I do so anyway it never happened but um but but I think in that situation those sort of things are what and that that's probably I would say that's my most challenge. I just thought of another one now as we're chatting because that I've never ever been nervous about a job and I've got a job to do the man city. WSL team to go and help there they only had one physio and I can remember getting up early to driving to Manchester and remember sent him a wife or would I can feel nervous about this because I was going into a different sport with a different gender obviously in terms of what's there and I remember going in and when I got there and I found out which players I was looking after which were all Lioness bass players and I remember sitting down at Jack's home in the first map right just put me straight on ABCD leagues I wanted to clear the air and the girls were brilliant I absolutely loved my four months it's one of the most enjoyable jobs I've had and it only came to an end because I ended up having to do four I was driving the day which was 10 hours work four I was driving seven days away um I'd only signed for four months but the things I learned and I found now doing the atmosphere of people respected because you worked at lower level you've worked at WSL I think it makes a big difference in terms of of where that really is but that was that was a challenge you know and I learned a lot of things working in the women's game that I wouldn't learn in the men's game so I've got a lot to thank the WSL for but I guess from an achievement point if you as well you know like that that was a challenge and we mentioned achievements too but you probably within the same breath some of those are amazing achievements as well you think you never have the same chance then something like Socorro it comes along and you go well it's another challenge and you go it's you know what I mean it's it never stops coming up you know I remember doing my first after dinner speech and it was the first it was a challenge and and you're doing these sort of things and so it's great in a way because that gives you that enthusiasm that bus still so so I that's why I enjoy it so I guess along the journey then there's going to be things that you know tools that you've worked with you know things that you've consistently used throughout your career if you like they'll support and guide your practices you go so I guess think about that's the objective data and things that you've you know we discussed about the change in that other time you know what you know one thing you you taught me from the onset was the use of isoconetics and as well as that or we can talk about that but as well as that other things that have guided you I guess or you've or you'd be a things that you'd turn to to support your practice now what sort of things can you give people a bit of an insight into how you work and rest of it some of you all know that my mentor was a guy called Dennis Wright and Dennis was very old school and he's his attitude was anything with a three pin pull gone isn't worth having and I work with Dennis in the real belay and I just started using isoconetics and I remember getting a book by George Davis given to me probably within the first year started using it and I took it we were on an away trip set a challenge cook final Dennis and I was sharing the room and I went in the room and I'd take I brought the book down me just started reading it and it's it's a really thick book probably four five hundred pages Dennis looked across and Dennis at that stage would have been in his sixties and he said what you got there Dave I still don't know it's a book about asking that I said you won't like it it's got a three pin pull on it and he went no no no not for me I can't believe you read it and then I then went with the lad to go and play snooker in the afternoon it's traditional at Wiggand to go and play snooker on the day before the cook fan so I went Dennis didn't want to come I came back he'd line on the bed he's up to page 40 anyway he never told me he was exercise and and from somebody with my mentor and he taught me about exercise he could tell there was a little seal of approval and at that stage I was very fortunate to be in a job where my day was controlled by me so where I worked at Fairfield and St Helens it was a rehab unit that basically I'd been given cat blanchum we had one brought in my job was to look after Rubelied players from all over the country so Yorkshire, Lancashire the most of the lad's lived in Lancashire and then came to Fairfield for the rehab so even the london's were playing at Leeds or Castleford or that type of thing on top of St Helens and I was at Wiggand at the time so we had a catchment area there we had the industries like Feynman we had so we got a contract with the fibergate, similar size london's to the rugby league players and we started using the IKD incorporated into the gym so it was always in the gym it was always you know you'd have eight and nine london at once want to be on the IKD I'd be supervising the whole lot and running the IKD at the same time and that went on five six days a week and the amount of positive stuff we got out of it you know you got the rugby league players who obviously want to work hard and you could quantify that for them in terms of visual stuff and numerical stuff the fibergate fibergate used to basically discharge people who had an untiery cruciate ligament injury and there was the word I was up surgery if they had surgery they were automatically kicked out the fibergate and if they didn't have surgery they didn't really have a concentrated tool to work out whether they could carry on working so the basic thing was that they came in for like final medical report so we do the tests send them to them and put a report with a goal up his legs trends really good this is what he can do functionally and this is where we're at and decisions then were made on a visual and a number judgment I remember one of the can remember the last name like Steve Payne who the Feynman and E came and he went you know what Dave I'll accept it if they show me that my legs aren't strong enough and I've got to dip in that graph on my numbers not good left to right leg I'll accept what's there if they're going to tell me just off somebody's opinion 10 minutes listening to me then I'm not and you're thinking that's absolutely right and what the costs are of retrain and the fireman was phenomenal so building from that that's when I started to bring it into sport obviously I was looking up to get the man you job after that brought it in there so I did that six years and probably a lot of people listening to this will have seen the Roy King video then smashing the machine that there's me there with a mustache and everywhere I go now it's either been on TikTok or Instagram and everybody goes is that you and I go yeah yeah again recently if you just release that one yourself again Dave just let's all come into the clubs I'm working out and they're going to go yeah yeah and I think you know you do take somebody like that particular play we just mentioned for him he needed that goal he needed that drive needed that was numbers he needed that was graph to make him realize you know that video that's out there was was 15 months after his injury and he was back playing then it was just a matter of our our process of res testing him and the biggest problem I think for a lot of practitioners in that scenario is that you need time to learn how to use it you need to learn how to read the data and if you don't you'll misread it and then you'll make false representation so a lot of my work now is people send me the data because players are all over the world now it's easy for the physio to get them tested send me the data I look report on it and just come back to it so I've had plays for Italy I've had Australian players male female I get all sorts of stuff sent to me that can you just write a report for us and that's the beauty of it that's fantastic and that's something obviously I wasn't aware of either that's I mean that's great and obviously like that's still obviously a key part of your practice and thinking yeah go and currently go forward and I think the important thing of John is that it is very important but it's part of the jigsaw it's not you know what I don't want people where I go and do IKD look so this is part of my rehabilitation it's not the beyond end alive I always think I hate seeing an IKD machine in a in a separate room because the players see it as a torture chamber for me it's got to be in the gym it's got to be sitting amongst the other the other tools we've got and then you incorporate it in you know you've seen it a black thing where we did it where we had players would go out and do outdoor rehab 20 minutes late the coming do a set on there then go back out again just to keep topping it up and keep that muscle firing so the ways you use it I think you know being at one of the Premier League clubs in the last couple of years we've been using BFR blood flow restrictions alongside it and I I would always do the test myself before the player so when we brought it into this club I went right I'm going to do it on my own leg first and some of the lads came watching me and I look and honestly it was so hard the work but the next day I had no muscle soreness nothing in there but I said well I've done it and it certainly not made my legs any worse so let's go with it and it made a massive difference but it's funny that you mentioned that and I'll always do the same with the players, I think when you put things out in front of them, whether that be functional, rehab, whether that be things in the gym, it's always important for clinicians to have an understanding of what that feels like. I've worked with staff for my staff that I've had in the past and you go, "Gorning, I have a goal, show us what I can't do that." Well, if you can't do it or show it, how do you want someone else to do it? And I appreciate that we're not elite athletes, but I think you've got to have an understanding of the feel of what something feels like before you ask others to do. I mean, we mentioned IKD and there's probably a little bit of bias in the podcast in that sense of worried, but there are other things as well, Dave. I mentioned BFR, there are other things that you sort of maybe come into your sort of toolboxes you like of things that you'll use more often now than you maybe used to. I've always liked the use of early rehab in a Sampak, which is great if you've got that available. I do go big now on TRX and using TRX at a really early stage of rehab. You know, that ability to look at that my official chain from lower limb pelvic up a limb and incorporating that rather than isolating stuff. And certainly, the lands I've worked with in the last five or six years are probably back that up in terms of what I said. So I'm a big, and the thing about the TRX is that you can take it away with you. You can go outside and do it. You can do it inside. You can use it as a functional tool. You can use it where you're using it with a ball. So that's a lot of positive for me and that side of it. I do like that. And that's one of my main things. Pools always been a big thing for me as well. We underutilise the pool. I think a lot of the time you know what it was like at Blackburn. We used to have an 815 session for the lads. And if they turned up at 816, we didn't let them in. We'd locked them out. You see on the set, the ability of respect for what we do. So I think that's a big thing as well in terms of what I do in terms of using the pool, whether it be our robotly or injury based. And sometimes just a bit of recreation just to give it that alternative. And I think the other thing as well that I do like to do is like certainly with a long turn rehabs is trying to have one day a week where they do something completely different. You know, when I was down at a club in London, I sat lads out and I went to the upbox hill. And I remember one of the young players turning it all and he turned up and he just come in his training gear. And he went, oh no, I've got some new gear to go out on it. And he opened the back of his car, took out a brand new pair of white trainers and took labels off tops and no, well, in a minute, we're going out 15, 20 mile walk here. And after about five mile, he would never walked as far as us before. But it was, we had a map. We had to find our way along certain routes. And it was scrambling. It was, it was just a change and we did that quite often. So I guess bringing some of those bits in, like those other bits and I guess reverting back to basics in that sense of what we were going out for a walk. I remember taking a lab mountain biking and I know you've done the same. You know, we were fortunate enough to end up over in the States and taking a, taking a boy mountain biking up in Portland Oregon through the mountains. It was amazing. It wasn't probably on a page of rehab that maybe got sent by a orthopedic consultant somewhere. But you know, amazing. So I guess is the sort of the next little bit of this is to say, you know, any myth or method in the madness. There are sort of some things that you see in social media, you know, is, is it, is it, is it, is it? Is there so many things that are pulled? Is it some things that you sort of look at, I think, I'm not sure about that one. Or is it some things that you think of that? That looks great. I've not really, I don't have much experience in that. My biggest bug bow at the moment is this massive reliance on isometric measurement. I get it for some bits. I get it for, or players who for teague do suddenly have lower isometric strength and adopters. I get it. I totally understand that. You know, you found a meister runner that comes around the last bend and he's got nothing left in his wreck family. So we'll see he relies on it. And if players are fatigued, they will run in that tend to two. And I get that. I just get a little bit irritated by this. When we take a whole body profile isometric and you're telling me there's a 10% drop in his, I mean, I mentioned tens of fascia louder before. I was probably a bit of a facetious there. But in terms of the muscles that are not really directly involved, I think we've got to be a little bit careful what we read. And again, that worries me. You know, asymmetrics, yeah, we do use asymmetric and football because we're blocking pieces, we're holding players off that asymmetric sense important. And we had asymmetric when I first trained. That's what you did in your maximum protection and your mother protection phases are real. You never did it at any of the stage. So to use that as your actual tool to decide if a player's training or not training, I just, I think we need to make a bigger picture. And I've just seen it a few times now where, yeah, yeah, he's not ready to this. The other thing I see that is a little bit, people are trying to tick off numbers very early and somebody's rehab. At the end of the day for the loves, if you can do that with a ball, you need to get a ball involved. I've had a recent experience in the last 12 months where a player has come back, he's gone out to do outdoor rehab, he's gone out for six, seven weeks and this particular day I was asked to look after him and I went, you know what, let's get a ball out, you know what, and he sort of looked at me and went, you're joking. And I just used a video that I've just been in Finland and I showed some videos of a player doing this particular drill after five minutes and doing it after an hour. And the difference in the play visually was frightening. And at the end of the day, you didn't need numbers. You didn't, the people in the audience could see, the difference between him at 10 minutes into the session, him at 50, his ability to control the ball as a centrum in the field player. And he went, that's the first time I've touched the ball in five months of rehab. And you're thinking that's not right. But there's a definite, I think again, we've got other professions jumping into our outdoor rehab stuff and we're happy to let it go. And for me, that's our application of anatomy and injury profile. And it's probably the best in terms of for the individual. So she only we should be controlling that. And I find there's a reluctance now to want to do the outdoor rehab amongst physios and it's, it's, it's, it frightens me. It really frightens me that that's going to be disappearing. Yeah. And I think the studios, it's probably one thing that we don't maybe do very well is protect our role and profession, you know, and I think that's probably with the increase number of staff and increase specializations of roles that maybe yeah, I think you're right. I think the other book bear is though that we dug a little pit for ourselves though because we want to diverge off, we want to do ultrasound and do diagnostics off the ultrasound. You know, I work with doctors who are far better than me will it and will be far better than me as long as I live on reading ultrasound scans. Why do I just refer them to the fill butties, the Duncan Robertsons, the Amit Panou de the world and they were, why am I getting involved when I'm not good enough at my own job, you know, we want to do injection therapy, we want to do okay, somebody wants to say that's fine, but at least get your own house in order as a physio and do that size. I just, there's still things to learn, you know, I'm still looking at stuff and every day I'm learning like going, yeah, these are better things into better that. So do I have time to ultrasound diagnosis? I have no adult and there's people far better than me, all I've got to do is refer it, that's the easiest option. Yeah, no, no, I agree, I guess one part of this podcast day is to bring, bring obviously the continuity and the theme between, you know, guests and you guys. So one of our other guests has kindly created a question for you. Yes, I did see this on this list, this is going to be interesting. To be fair, I guess we may have been, we've got to over it a little bit in the things we've, things we've gone through. I think his mindset was a bit more about testing an objective day. So, so how is the testing process changed from when you started doing screen and testing to today? And again, do you feel that they're a bit more focused on the data rather than the player in front of them? And I think we might have touches on these so far already. I'm going to give you a little case. I had the last year where I went into a club and I was at, I went on the academy for the first week just to get to know the a lot of the club and everything else and we've got young physios and the doc said, would you do it? I went, yeah, I got to a little and I knew the doc on the academy and he said, could you do some CPD? Yeah. And so I've turned to the younger members of staff to look what CPD do you want. And they went, could you do an assessment? And I was like, you are joking. Surely you've got nothing you're locker to do that. And I just, you know, I look at that and I think wow, that, that itself is, you know, and I've got people there, the same people telling me that they know I have to set an IKD up and I said, a lot, I'm not being rude but can you show me how to do it? And I watched them within a minute and doing it. I went, no, no, no, no, no, you, you, you, if you set up positions not right, your data is going to be wrong. So don't even go there, but they felt within themselves that they could do it. And you know, and I just thought, you've just not had any training on it and you probably watched somebody do a knee and think, I can copy it. I remember another club I worked at, went in and there was a young, a category of physiode doing it. And it was so far, the axis of movement was completely nowhere near the knee. And the leg, the length of the animal was so far up the she had, it was just not, and I went, no, no, no, don't ever put yourself in that position because you get a injury somebody. You know, and once you, once you injure somebody on the IKD, the whole club will never use it again, right? A senior player at the same club who died, he'd seen somebody get injured due to bad clinician management of the thing. It wasn't the player's fault. It was somebody tried to do something too soon and basically irritated it. And then none of the players will use it. So I think, I think that's the important thing is that it's, it's not knowing and knowing, you know, it rather than trying to fill people you do know how to do it. And I think in terms of, of that data management, like you say, we were already touched on that really in terms of where we are, you know, I think, I think we've just got to try and make sure we get the right balance. I think there's two bigger shifts now to data. where it was going back maybe a few years ago it was too much linked to MRI and we've now gone away from our clinical assessment and you've heard me say before is that you know clinical assessment is a dying art and people it's too easy to have an MRI. If you're a club at a club who's got an MRI how many times are going to knock on the dock and have an MRI it's only next door and the diagnosis doesn't get done. You don't learn about the athlete through an MRI you learn about the severity of injury. Now many times do we get false positives you know you MRI are hit 66% of players from retillatious research have got a labelled tear but it's never been clinically a problem to them so what are we gaining out by knowing that there's an actual labelled tear that's given them no clinical significance whatsoever so we've just got to be careful I think. And finally then Dave just from you a takeaway ending this conversation with a sort of a key piece of advice from you to sort of people should be doing more of less of you know things better cut back on different things in the sense of what they're delivering so for rehab and performance. Yeah I think I think I take away from me is that you're working in the best job that's possible if you stay true to yourself and you work hard and you do it the job will give you rewards the job will give you the benefits and it was the best job in the world working in football and not just football but in general I think you know I've worked in rugby league and there's other sports opportunities you know I've worked either season in cricket which was brilliant and I think in that situation is that you've got to keep that passion if you're a physio that's not enjoying your job then you're in the wrong job because it is the best job of all you know and in that situation it's what you make of it if you haven't got that every day you come in you need to have energy and enthusiasm and if you haven't got that for the job or for the rehab process or for where you are then it's difficult you're not doing the job right and that's you know at the end of the day that's I mean I know what you're like in terms of that enthusiasm you know that's the important it gets a lot of people through and it never be too proud that you still learn and I know from my point of view as a tutor that on the F8 stuff my knowledge now picture side is far better than when I first took the area course, remote course and so on. I think after it's 13 times as a delegate when I looked and I know far more now in the last five or six years because I've learnt off better practitioners than me I've learnt off paramedics and A&E and it's the same physio you just got to tap into the people that are there and then buy into that fact if you do that then that will send you a long way and don't be too afraid but it's also about ability to reflect if you if you don't recognise the injured tissue is more fragile than normal tissue you will irritate things by what you give them and it's having that you know what I've pushed into are you know people aren't trained if you've not worked privately or in the NHS and you've not worked with people who are not athletes you've got to realise that they can't take the same amount of load as an athlete count so an athletic load is obviously really high an untrained but fit person is just below that an endangered tissue is you know you can only change it by about 44% in terms of the latest research so so you've got to be careful you loaded it's got to be a lot slower with an injured tissue even with an athlete even if the athlete's trying to push you don't be pushed too quickly to gradually make that better and then just constantly reassess just everyday reassess not just not just the actual physical side of not just the biochemistry in the biomechanics but you know asking the player are you happy we where we're going now we're going in the right direction is it ticking the box for you because if they just follow what you do that's not important you know I've had so many players question me in many ways but you've got to have an ability to come up with an answer you know and if you come up with an answer and there's no you wouldn't do this unadmitted for a jump but if you say well I might do this or I might no no no no you go one way of the other you can make yourself you might make a mistake but you go this is what we're doing this is where we're going not maybe or if you say maybe or I might put oxygen on a player when he's out of the head and you really know you don't you put it on it's the same with rehab this is where we're going if he's if it becomes irritable is it you or is it what the player's done away from the training ground and we've all that scenarios where it might be us it might be the player's gone out and done something a bit stupid and I'm sure we could throw about a dozen examples in which you take another podcast really so we know each other too well for that one yeah well look Dave thanks ever so much I mean some amazing thoughts into your career background what you're doing your thoughts of where things are at the moment for me like say it's been great just well actually I've been to been out a chat for one hour without anyone anywhere exactly whenever that time doing that's a novelty in itself so look thanks ever so much Dave appreciate and thanks ever so much for your time not worries thank you so that's it for this episode of recover perform excel thank you for listening if you took something useful from today's conversation share it with your team your colleagues or anyone on the rehab and performance gym you can subscribe and find all episodes on Spotify Apple Podcasts and it keycohealth.com and if you've got a myth to bust or a method to share reach out we'd love to hear from you until next time keep moving forward