How to Actually Think About Pain and Rehab With David Grey

even if like I've never played American football for example, but I feel like if you gave me five minutes and told me about this guy's position and what he needs to be able to do, I could design some kind of late stage session. Other American football coaches might not agree with it, but from my point of view I'd be like I'm stressing his body in these particular ways and he's going to get an adaptation from that. So I feel like, and I don't think I'm special by the way, I think that's just if you just understand sport, if you've played a bit in sport, if you've seen a bit of sport, you can do that. This week on the YohkumStrecht podcast, we got the chance to talk with the legend David Gray of David Gray Rehab. If you're in the field of human performance, you've definitely seen him online or more than likely use one of his programs to help keep it back on your feet. Throughout the episode, he talks about the fluidity that practitioners need when dealing with athletes, the different stages of returning to play, and some other awesome insights from his years of working with athletes at all levels of sport. As always, thank you for listening and enjoy the episode. Before we dive into today's episode, I want to tell you about the YohkumStrecht Insider. The Insider is an online training platform that takes everything we talk about on this podcast, better movement, smarter training, and actually enjoying the process, and turns it into something you can live in breathe. Our goal is simple, create better movers who feel stronger, more capable, and more confident in their bodies. We do that through a holistic approach that includes everything from spreading and lifting to mobility and spinal movements. Inside the Insider, we run several distinct programs. Building better movers for foundational athletic developments, a dedicated Olympic lifting program, the GIT Yohk series for pushing strength and physique, and washed up movers for the players who want to keep training hard without beating themselves into the ground. We also offer focused options like a vertical jump program and at home training so you're never forced into a one-size-fits-all plan. You're not just getting a program, you're getting full access to our app. With video demos, progress tracking, a community discord, and direct communication with the YohkumStrecht coach. Plus our 30-page nutrition and lifestyle guideline covering how we eat, train, and build habits with our athletes. If you want to make training fun again, use code podcast25@checkout for 25% off your first program. Hope to see you there. Boom. I'm a coach. Welcome to podcast. Excited to have you here? Thanks Austin. Great to be here. I'm looking forward to the chat. Yeah, I was going to say I was just telling you the first time I tried your stuff. I think I had heard you on Jules Smith's podcast. He's a good friend of the podcast. It was a while ago, though, because I was still in my old gym. It had to be like 2019, maybe 2020. I think it was with lower body basics, your first ebook you put out. Yeah. I put that out in 2020, about six months into COVID. Funnily enough, I taught I had missed a book. Everyone was releasing online stuff. I had done a couple of webinars at that stage, but everyone's releasing online programs, things you can do at home. I was probably six months in, and I was like, "I'm too late to this," which is funny, thinking six years later now that I definitely wasn't too late. But Jules had me on. Probably couldn't be 2019 first. That was big for my career at the time, because Jules was and is the guy. That was big for my confidence. Also, I think Jules passed on a little bit of his authority onto me as a guest. It's so funny. I remember the first time Jules asked me to come on the podcast. I remember listening to your podcast when I was just getting started. It's kind of cool. The right-of-passage, going on the Jules fly podcast is the Jules. You're an OG if you're listening to the podcast. But I remember trying some of these out. It makes sense that I was during COVID too, because it was probably why I was trying all this different shit out. I didn't really have an injury. I was just interested in all this stuff that I could dive into. It was probably because I was bored as fuck at home and didn't have anything better to do. I remember trying some of your exercises. It was the first time I found myself getting properly wrecked without a 500 pound barbell on my body. I was like, "Dude, what are you doing to me?" It was really cool to just look at that way of training. Maybe the barbell isn't the answer a little bit more. You have enough of that stimulus going in. Maybe there's just some of these weak points that you can look at. Maybe that could better your training. Regardless of if it's those specific exercises or not, it was that philosophy. It was a good little seed planted in that philosophy of there are different ways to train. There are different ways to look at it. I would like to know, how did you come up with some of these things? How did you think about some of these things? I really want to dive into that approach because you have a high variation in a lot of your exercises. It looks like at least on your Instagram page and a lot of the e-books that you have. It's just not high variation in like you're just throwing shit at the wall. It's creative solutions to a problem, but that are queued in a very strict way. It's this balance of lots of variation with a constraint around it so that you're not just becoming a movement yogi, which I can definitely see. People just throwing things at the wall and nothing really sticking. How did you come to that approach? Good question. I had a lot of good teachers and mentors and people to learn from along the way, which is definitely one. Another part is definitely throwing shit at the wall like you just say. Something's stiff and something's don't, but I think a lot of it comes back to not using variation for variations, say, it comes back to understanding the difference between variety and variability in how we move. I think that's very, very important and I think people get those two words mixed up and they think that they're the same thing. I think that, okay, if I just program with a lot of variety, that's going to lead to someone expressing movement variability. In healthy, good movers, that might be the case, but when you work and rehab, that's not the case at all because if someone has a knee problem that they don't want to bend their knee, it doesn't matter. You can even go all the way down into putting in a front loaded squat variation with a wedge under their heels. They'll still find a way to not bend that knee or to not load it and it might even look like they are loading it and they are bending it, but suddenly you look at over the course of six months or 12 months and that quad because they have a patellar tendon up and that quad might have still atrophied. Even if it looks like they're demonstrating variability and their bending at a certain joint and loading, the nervous system is still very sneaky about where it puts load and how it directs load. For me, variety is great and it's cool and I see you doing a lot of variety just messing around with boys. It's getting them to have. there's a task there. Let's see how they complete the task, but when we have someone that is injured or is in pain, it's important to also recognize that there's a good chance they will still find a way to get the task done without demonstrating variability at a particular joint. So that's where sometimes, yes, we can have a lot of cues. Our not many cues just one or two very important cues that get someone to move in a particular way that actually demonstrates variability at a joint to get that certain area to load. So that comes back to accuracy with how we move. We need to be able to move. If I say I want you to bend your knee, you have to. I'm going to make sure that you bend your knee and then you're going to have to load certain tissues around your knee or your hamstring or your calf or whatever it is. So it's all comes back to that. Movement accuracy piece, variability and variability within the program and how all of that fits in. Dude, it's funny you mentioned that with the knee because you see it a lot. We have a lot of guys kind of like the stiff backs, like they'll come in like back pain this type of thing. It doesn't matter what back variations you put them in. They move it in the same way. Like they have the same spot locked up until you bring like awareness and like get them to move that spot and like they'll find, especially the better athletes, they'll find a way around moving that like part of their spine that is like locked up and stiff. They're like see I completed the task way into totally different way. Like they just found a way to like get like I think a back bridge is another cool one. Like you'll see seven different athletes do seven different back bridges in a totally different way and it's like are we doing the thing that we want to do or they just find a different way and sometimes again sometimes they're right with the athlete finding a different way. But if it's like a like you said if you have an athlete with the knee pain or have an athlete like with a locked up back it's like am I am I actually opening up their back with that exercise or they're just finding a way to get into their shoulders and like muscle it up and be a tricep warrior on that back bridge. It's kind of give me a good little there. But they also maybe think are like this random thought but are better athletes kind of sometimes harder to rehab than with you because they are master compensators like that was one thing I was thinking about like do you have to pay attention a little bit more to somebody that is like an elite level athlete and when you get them I'm sure they're a hyper responder. So it's like a harder to rehab is weird because once you get them I'm sure they hyper respond and they heal faster and they do that type of thing but do they compensate in ways or it's like god damn dude like I really have to pay attention to see how you're doing that because you're so good at compensating. Yeah I think so I don't know if they're harder to rehab but they can certainly compensate better right um but then again everyone can compensate really well like anyone someone breaks their ankle they're still gonna find a way to walk right it they're just they're just not going to using that ankle particularly well. There's not going to be a lot of joint excursion, so I think everyone will compensate to the level that they can already move to to complete a task. And the example that I like to use is Toiger Woods because he has like one of the most contrasting bodies from before his big car accident, not his most recent one, before he smashed his leg up. And then afterwards where he had a completely different body, he couldn't his issue after he had his massive car crash and smashed his leg up was not hitting the golf ball anymore. His issue was actually being able to walk around the golf course. So he was still playing unbelievable golf, but he couldn't play for four days straight because he couldn't walk that much. But so if you imagine his swing before he had that accident afterwards, he obviously was using a lot less of his leg that one leg. He wasn't really bending his knee hip or ankle as he was hitting that ball, but he was still able to hit it pretty much as far after that accident and as accurately because the the skill itself wasn't banger knee, banger hip, banger ankle and then swing the club and hit the ball. The skill is just connect the driver or whatever club with the ball at this velocity, at this direction and and get as close to the hold as possible. That was the skill. So his body still had that skill in it. It just had to organize differently around that. So better athletes can they're just compensating just as well to the level of their movement before if that makes sense. So are they harder to rehab? I don't know. There's like there's some areas that they are, some areas that they aren't. The areas that they are harder to rehab or maybe it's easier to say where they aren't yet. Like you already mentioned, they pick up things really quickly. So once they get it, they get it. But it's a little bit harder to get them together in the beginning, you know. And sometimes you don't need to. Sometimes it's fine. They're just not going to, they're not going to change her. They move and they don't need to. And that's I think where the argument in their world often comes in around what do you need to change and what do you not need to change? What is quality movement? What is there? They're just moving the way they move to best get the job done. And I don't envy people in the SNC world trying to answer that question. But in the rehab world, it's a little bit easier because they're usually already injured or already in a lot of pain when they come and see us. So we can make that decision a little bit easier. Right? Okay, this strategy isn't really working anymore and we're going to make some changes to it. So, so yeah, for us, it's not that hard to decide what we're going to change. But first, someone who's working with a healthy athlete and it looks like they move in a weird funky way. I'd probably just leave them do it, you know. That's funny because I was going to say the exact opposite. I was going to say I don't envy your way of doing it because you have an injury. You have something that happens and then you have to figure out, okay, is like at least in my world, I would like to hear your thought process. Like it would stress the fuck out of me of like, okay, they're an elite level athlete. The way that they move to become an elite level athlete is the way they move, you know what I mean? But now they're having the injury. So what do I fix? Right? Like that would stress me out way more than working with the healthy athlete where it's like, okay, we're seeing some of these things, but like, yeah, that answer, man, because that's really what I really do like your approach. Like you're you seem like like almost like a Mr. Miyagi, like we're using all of our tools, we're using everything to go forward with this without like swearing by anything. But yeah, dude, those answers have to like, what tool do you use with somebody that is that elite? Like working with, working with somebody that's in pain, that's maybe just like a gen pop person, we're getting them out of pain, but it's like they don't have these weird things that, but is that weird thing what makes them elite? You know what I mean? Do I fix that? Do I not? Like what is your approach there, man? That would stress me out. I think I think you, I don't know, maybe it's just coming from a strength coach, but I feel like you definitely have it harder than us. I think, I think right, I've learned this many years ago, six or seven years ago, I got to work with a couple of elite power lifters, like some of the strongest people in the world. And I started to get asked questions from people in the circle around like, okay, are you going to do some stretching and mobility work with them? Because obviously them being super stiff is one of the things that makes them elite. You don't want them to be floppier, bendy. And I was like, this is such a, this is a question that everyone loves to ask in our industry, right? Everyone is like, oh, how do you decide how much to do because you don't want to change their strategy? And the realization I came to is I can't fucking change that strategy no matter what, you know, like it's still, it's not going to change. So they're not going to all of a sudden I do a bit of stretching and they open up all of this range of motion in their hip. It's simply not going to happen. So that's probably a good thing for us because we can just, we can just dip our toe in and start to work on different areas. And it will just, it will just incrementally improve a little bit. Maybe there's a little bit of range or maybe they just, maybe there's no more range to be had and maybe they just feel a little bit better because again, they're moving with a little bit more variety, our little bit more variability. So we don't have to have too much of a god complex with it where it's like, I'm going to change this thing, you know, this is the thing that caused their injury. We just, we can just start to work on things and it will be incremental improvements and and that's how that's how society works as well. We're looking for we do want fast progress in society. Everyone wants to everything everybody, everything in our in our society, hopefully can progress fast and improve fast, but it still should be incremental. It shouldn't be I go from this system here to now we have implemented this system up here and we've skipped the 50 or 100 steps. No, we still want fast progress, but it should be just incremented where we get a chance to see along the way if that's working far them. So I and if it's actually making it better or worse, so that's really how I need that at its body is going to work because you're not going to change 110 or hundreds of thousands of repetitions, you know, in the in the space of a week. You're just going to make very small changes. That's funny because it kind of drew my brain to the thought process of you always have this like fast twitchy athlete that always says like, I don't want to lift weights because I don't want to get too bulky. I want to put on too much muscle. It's like dude, do you know how hard it is to put on too much muscle? Like that's not going to happen, but yeah, then we we look at it on the other end and we don't really see it as the same thing of like, yeah, you're probably not going to become too mobile or too like too loose off of this one exercise that we're doing a week. Yeah, it's not going to happen. Obviously, acutely you could do something stupid where you, you know, you fatigue them too much before they go out and train or play or you do something stupid, but that's not a that's more of a training how you plan your training session rather than anything else. One of the things that I really like that you talk about is kind of like the constraint let approach to and I think Tiger Woods is a good example like using that there is pain can be a constraint. I think a lot of times and just like simple things like your strength levels can be a constraint. Your ability to move in very basic movement patterns can be a constraint and I think a lot of times when it gets to the constraint let approach, we get super complex right away. We like get really into the agility, the on the field stuff, the really like like we have to figure out this person's there, the perception reactions like all that type of thing and without ignoring some of the the first things or and not even that it's a first thing but like you can do them concurrently and I think a lot of times we throw out the very basic the very things that are in front of us where you have an athlete that like you're in knee is a big one where they can't get into these positions at all focusing on some of this other stuff maybe escaping a few steps to get there, but I really like that you do bring up like it is a constraint. It is something that can hold this athlete back and maybe we don't have to go full complex right away. We can focus on some of these simpler things right away and then hopefully that solves some of their problems. Yeah I think that's really really important you'll see that in the in the Boyer Mechanics world right where people will talk about okay this athlete isn't bending their knee and what do we need to okay what does knee flexion what is it in the clothes chain what what is that composed of right we're going to have knee flexion we need to have tibial internal rotation maybe we're going to have a foot pronation we're going to have hip adduction hip flexion blah blah blah blah blah so you can keep going on the chain and then they start to work on all of these mechanics of how to bend my knee hands up I do that as well right and we'll start to look at where these joints aren't moving and so on but so often someone just isn't bending your knee because their knee is sore and if you can just help their knee to not be sore then they would demonstrate all of this nice tensegrary this nice kinetic chain movement where all the joint coupling that you want to see so they're just finding ways to not do that because they're they're in pain and we think that they're in pain because they're not moving in this way but actually it's still the way around they're not moving in this way because they're in pain and that's such an important distinction and such a more important flip for any coach or any coach It's a really flipped your mindset into that second one that they said that they're probably not moving this way. I'm just talking about if they have pain, but they're probably not moving this way because they have pain. They're not in pain because they're not moving that way. I like that. That's a good way to look at it. And then tying that into something else I've heard you say that I actually have not heard a lot of people talk about is how feeling better with an exercise can be a trap with that exercise. How do you balance that with, "Okay, is it step one we get our athletes out of pain?" Then we adapt to go actually stimulate to fix the problem. What's that approach? Because I've never heard that. A lot of the world is talking about getting the athlete out of pain right away because obviously that is a big important piece. But you've also mentioned that that can be a trap as well. Or your stuck on certain exercises that maybe aren't stimulating you to the level that you need to stimulate to heal or adapt or cause adaptation. That you need to cause adaptation to kind of fix this thing long term so you're not in pain long term and you have some of these things fixed. What's your approach there? Yeah, I'll give you an example of where that might be applicable. So if we think about Achilles tendonopathy, for example. We can choose exercises that potentially give us an analgesic effect which is where it's kind of a phenomenon where we might get between 30 minutes and 60 minutes of pain reduction or even pain free a lot of the time. So everyone knows this. Anyone who trains they feel like it's basically a warm up effect where you're tendon or you're joint sex to feel warm and it starts to feel better. It's a little bit more common that you feel an analgesic effect in a tendon. Sometimes when a joint is a little bit more tricky where actually it might feel worse as you go on but a lot of the time we're tendon you're going to feel a bit better as you get a little bit more warm. Not all of the time definite. So people start to feel this right they start to feel this and maybe they'll go far. Some kind of calf raise or isometric if they have a bad Achilles tendonopathy and that makes them feel just good enough to be able to get through the next training session or practice on the field or whatever. And I've felt fallen into this trap and I've probably worked with hundreds or maybe even thousands of athletes across our whole team that have fallen into this trap. It's very it happens every single day in our clinic. And they get to a good enough point and it feels good enough that they keep doing this exercise at the same intensity all of the time. Now you can get rid of Achilles tendonopathy. I'm not saying that you need to do any one particular thing to get rid of it right. You don't necessarily need to build tendon stiffness. You don't necessarily need to do heavy calf raises. You don't necessarily need to do anything. Maybe it will go away. Maybe it's a metal ball of problem. Maybe it's a load management problem. Whatever. But we typically try and take the approach that okay. We take a functional approach where pain is a little bit unpredictable. We're going to manage your load and we're going to make sure that you're you're doing your prep work well. You're doing your gym work well. You're doing your field work well. You're recovering all of those things. Along the way we know that there's certain ways that we can train and do your calf raises that will help us build more tendon stiffness. This doesn't automatically mean that you're going to be out of pain, but nothing does. So we may as well try and build tendon stiffness while we try and work on helping you get reduced the pain. And in my experience a lot of the time it happens together. If we want to build tendon stiffness, we know that we need a certain amount of strain through the tendon. And to get relatively high levels of strain through the tendon if we're taking a kill easier. We need to train in a more dorsiflexed position because that's where the calves are going to be strongest. And that's where we can use the most load. So we can start to load up very, very heavy and get into a stretch position of a calf raise and work kind of from neutral to a stretch position. And over time if we use heavy enough loads we will we will start to improve our tendons Achilles tendon stiffness. If you don't take that approach and if you just take approach to I just always want to feel a little better and I fall into this trap of getting this analgesic effect. Then what you might do is you might just train in plant reflection where you're at the top of a calf raise. You feel a strong contraction in your calves, you're getting warm and all of this stuff and you're getting just good enough to get through that training session. And that exercise in and of itself, if we just chose on one day training the top of the calf raise versus the bottom of the calf raise might not change very much your how your pain feels on that day. Both of them might produce the same analgesic effect. But over the course of probably 12 weeks is probably the best study that's been done over the course of 12 weeks. If you do all of your calf raises in plant reflection, the top of the calf raise, then you're going to be loading it too late and you won't experience any increases in tendons stiffness versus being in the bottom half of that calf raise and being able to go much heavier. So that's why I think it's a trap and we need to be careful with short medium and long term goals, short term do whatever you can't get people out of pain, but medium term and long term. We actually want to produce a training effect and make sure that we're getting stronger and we're opening up joints and ways we want to do and we're starting to help people move better ultimately. Yeah, that's awesome and being able to do both at the same time too. Like you said, you mentioned pain is unpredictable. I know I think it was on Tim Riley's podcast. They were talking about like pain scales and you're like, that's not really how you look at it. You try not to hyper focus on the pain. What is the approach there? Is that a psychological thing? Because I can see this in the PT sector where if when you said this, this just made me think of like if everything I do is I ask you, how does that feel like pain lies out of scale. Then you're relating every movement to pain. Is that like a thought process there? Like what are you looking at with pain, especially when a lot of people's issue is like they relate everything to pain because pain is so prevalent. Like it's so when you are in pain, like when I heard it in my desk, like it's nice to talk about, but it's like when you're in that pain, do nothing else matters. Like everything just feels like whatever I can do to get out of that pain, it's as fast as possible. Like it feels like the world is ending in that movement. You can't do what you want to do. How do you like, how do you work like with that as like a PT as somebody that is guiding somebody through pain? How do you help them get out of those thought processes and those traps of pain, especially when it is like you said it is unpredictable where maybe we're doing we're two weeks we're good and then they have a flare up and they're like everything's wrong. That's everything. Like what's your process like? Good question. I don't know how good an answer I have because I think so much it depends honestly like some some you might meet a client who is just completely ignoring their pain and just playing ahead and that can work for some people, but other people they just end up completely in addition to absolutely screwed, you know. But someone else is like so obsessed with their pain and they can't think of anything else. So I think you have to be quite fluid. We just released a knee program, which is a DIY program and in that I did include a pain scale in that. And that's because I'm not there to work with people and I just included that I was like okay if you're in this zone, which is three or ten or three or three out of ten are less and you're training away and you're getting stronger and you're moving through the phases and you're meeting or exit criteria, then I'm happy. If it starts to go to four or five or the 10 that's like okay, we need to probably take a step back here and anything about that is like red flag you're going way too much here. So I think pain skills can be helpful, but I do see clinicians falling into the trap of overdoing it within a session. So within a session itself, you don't have to ask someone every 30 seconds, how is your knee or how is your back or how is your foot and that is literally what is happening all over the world. It is one of the most common things. So what we try and say what we try and do first is always educate people around their pain. Like help just help them understand what's going on. That's the most important thing by far. You mentioned about flare ups happening and you start to free guilt and all this stuff. We always address that from the start. We always address that in session warning. We say, there flare up. There's a good chance that at some stage, there might be a flare up. We're going to do everything we can to avoid that, but that's that might happen. And we'll draw out a graph and we'll help them understand if you wake up in a few weeks time and you feel so good and we're working on a plan. And I'm saying, I don't need, I'm not letting you run until we get to until we take off these 10 boxes or five boxes or whatever. You say, if you wake up in three weeks time and your pain is gone and you just go for a run because you feel good, then don't do that. Right. But also if you wake up and you feel like absolute shit and now you think all of my progress is gone. Also don't freak out there. So let's just try and stay level headed with it and stay logical with it and stick to the plan. So I think that's really important and what will happen often is in the kind of physio world, physios are very afraid of flare ups because the client will come back and blame them and say, you gave me this plan and now I had a massive flare up and You know, you cause this to happen to me and they suddenly lose a client and you know They might get a bad review and all of that stuff So I think addressing it from the beginning there Their their problem there is they're fucking up from day one because they're trying to They're trying to sell them says as the Messiah that can fix all of the pain and then suddenly when pain is back or is worse That that that that curtain just falls down and it all trust is gone So addressing it from day one and saying there will be ups and downs along the way and We need to make this training decisions and rehab decisions together So that and we need to understand we're gonna push this much and And then when a flare-up does happen the client isn't gonna freak out at you There they might be upset. They might be whatever but they're not gonna freak out at you because they say look We both knew that this could happen. It's gonna take couple of days to settle down And it will will be back on the horse again So I think most of the issues come from not addressing the big elephants in the room from day one and trying to pretend you're the You're the Messiah. I could talk about that all day. There's so many different honestly There's so many different ways and the psychology of pain. It just It's there's so much to go into it's really really important and Dealing I want to know your answer to this because it's something like I know I struggled with as a young strength coach Even and I'm not even working with a hurt population I'm working with decently healthy athletes most of the time especially when I was in a college sector We had a whole like PT at sector working with us So it took away some of the emotional part of it But how like how do you deal psychologically with that as a PT with all of the emotions that do come around pain when somebody does come to you With those like even if you do address it like hopefully it's it's cleaned up You also like you're gonna have to deal with some like a shitload of emotions of people struggling with not being able to move the way They want to move especially elite level athletes. Is it just a rep game of like hey? I've done this so many times just just bear with me like deal with me there like have you learned a process to be able to deal with that stress Because I know that's something a lot of young stroke coaches a lot of young PT's will be when they start It's like man your first time you have an injured athlete your first time you have somebody freaking out about something You got to wear that as a coach you like fuck I messed everything up. I did everything wrong What's happening? How do I fix this right away? What's that process like for you? I don't think it ever gets that much easier to really honestly I got a big at least either big at least in Ireland I've already a Lee footballer Come back from ACO He played his first game three days ago he came off the bench in his first game and I gave it I kind of released him back to his team about three weeks ago and I would have liked him to have probably probably an extra month of higher training With with his team before he needed to play the game, but his team picked up Five injuries to important players in the week before the game So he had instead of having six seven maybe eight weeks of training with him He got three weeks of training and then he texted me saying I'm playing this weekend and I was watching the game and he came off the bench and I was like I was just watching it true For I was just watching I could barely watch I was squinting at the television every time the ball came near him, but he was okay, but That doesn't mean he like everyone will be okay. There will be injuries and it's It's just shit. It's just I was one of our other physios up in We've not a clinic in the north of Ireland now and we were literally sitting beside you You're about to film a video for you for for YouTube and the camera their video out with our press play on the camera and She just got a tap phone was on the table and she got a text in one of her clients like her her best client and the lead at least Broke his ankle in the training session that day Completely she was rehabbing him like completely separate thing. She was rehabbing like hamstring Recurrent hamstrings, but I think someone fell on them or something like that broke his ankle and she just She felt like she was gonna get sick like and she's a very experienced practitioner So it's never gonna get easier, especially when you put so much Time and work and effort and you really care about like these people, you know, I think When it's when you do work with go to athletes, it's it's so much harder It genuinely is so much harder because that's their career at stake their lives at stake and you feel Terrible when you see an injury happen. It's so much worse than Someone who it's terrible when it happens to anyone, but when it's someone's career on the line It's fucking terrible It's like so stressful sometimes you're like god damn dude One of the one of the things with the lead level athletes is that two sides of things in you You brought up both sides of these people where it's like you have the meat head that pushes through pain And you have the hyper aware athlete and it seems like elite level athletes are one or the other The the reason they're elite is cuz they're hyper aware and they like know their body in space They know like I'm sure you've worked with all hundreds hundreds of athletes like this where it's like they are They are so in tune with their body to the point where like how do like what and then you Have the meat head like me where it's like they just they push through for so long It's like how did you tell me that was an rp6 when like I just saw you move that bar at a point one like that is not an rp6 bro Do you have a do you have like different systems when you're working with those type of athletes to where like the hyper aware person You're trying to get them to understand It's okay in some sense and like we need to push through some of these things and like giving them Fields and giving them drills to do that and the meat head we're trying to draw them a little bit more internal To become aware of that like do you do you think about that when you're working with these athletes? I think about it um I think everyone thinks about it whether they we're all just we're all human beings are always measuring Other human beings what whether you know it or not weird. That's what we're all doing You're measuring the person in the coffee shop. You're it doesn't mean you're judging them But you're you're you're always saucing people that you're you're always picking up on all these kind of social cues So you can't not do that when you're working with someone and you just start to see patterns of marriage over time and It's just it just it just depends on the person honestly. There's no there's no right or wrong. I've worked with Elite athletes who are earning millions and millions and millions of dollars every year and they're so neurotic about everything To the point that Like I'm trying to figure out how much I can say here like to the point That Or not lead for example if you're doing Something with him He won't mention Achilles is the word he will not like you can't use the word Achilles and he's never having Achilles injury But he's seeing people have Achilles injuries in his sport and if you say the word Achilles is like we don't use that word I'm like who's we's like me and they're you Don't use that word. I'm like it's just your it's a body part but he associates it with an injury so it's like no that word doesn't exist so I don't know what like you just go along with it You're like funny. I won't use that word so you know So I don't know it. I honestly don't know you just go you just go along with it You just you just do whatever you can to avoid with the person and you're gonna find out the way how you can help them You just have to they just have to trust your first Yeah, absolutely. That's a good that's a good boy. Everyone is completely different you meet some But you work with the level guys like I think the reason a lot of these guys are so elite is they're so different Like they're so different in so many different ways. You're like That's the thing that like makes you difference on the field as well It's almost like the in body the way that they play and it's got it's kind of a fun little fun little journey there One of the things I like that you do with your athletes as well is like more of the late stage And I think a lot of times it's like these athletes work in so many different sectors where it's like okay They have their clinic PT guy and then when like the clinic super close super like Constraint stuff is done then they go straight to like their speed guy or they go straight to their strength guy Or maybe they have a speed guy and a strength guy like it's all siloed out One of the cool things I have I've seen with you is like you kind of try to encompass it all I'm sure that you have athletes that they have their guy and it's kind of annoying to like be able to do that But what's that process like of like getting them to the field and now you're working on like It's a little bit more reactive. It's a little bit more perceptive like like what's it? What's the process of building those things out because that's totally different than like the clinic stuff where it's very Closed and very like one-on-one and are you are you building out some of the small side of games to like get them into some of these environments I see you working with these athletes on the field and like building out some of these things and the cool process of like From okay, we're reacting to a cone and cutting getting used to that to now we're reacting to a human to maybe now we're reacting to multiple humans Like what's that process like for you? I love that it's my favorite thing if I could only coach Wanting it would be late stage Because it's just fun you're just outside with people And it's just fun and I love sport. I've always loved sport. I love all kinds of sports So I think understanding sport helps you with that as well even if like I've never played American football for example But I feel like if you gave me five minutes and told me about this guy's position and what he needs to be able to do. I could design some kind of late stage session. Other American football coaches might not agree with it, but from my point of view, I'm stressing his body in these particular ways and he's going to get an adaptation from that. So I feel like, and I don't think I'm special, by the way, I think that's just, if you just understand sport, if you've played a bit of sport, if you've seen a bit of sport, you can do that, you know, because they're not that different. You have to be at the sprint and change direction and slam on the brakes and so they're not that different. I think the guy thing, having the speed guy and the strength guy and all the different guys, that's such an American thing. It's such an American thing. That's why when you see us doing a rehab, you're like, are these guys our team are doing everything? That's because the guy isn't in Ireland. We just don't do that. That's nice. That's nice dude. Especially like, you have like draft guys, dude. They'll have footwork guys. They'll have route guys. They'll have speed guys. They'll have strength guys. Like it's all, and then you'll have the massage guy and then you'll have the dry needle guy. It's crazy. That's funny. That's just an American thing as well going through. Maybe that's just a money thing where there's so much to go around. They got so much somewhere. Yeah, you have, number one, they have so much money. And number two, there's so much money at stake that they're just showing money at the problems. Like if how many guys can I get, they can maybe help me, you know? Or as I love being able to take an athlete from day one and bring them all the way back to the field. And do we do everything with it now within our team, we have different people who are maybe a bit better at certain things. So like we have certain people in our team that might be a bit better at manual therapy, certain people that might be better at whatever coaching, coaching a speed session or whatever, but we're all kind of on the same page. So we try to what makes, I think what makes us successful at late stage rehab is what happens in the early and mid stage in particular. We have patterns that we break there on that are not special patterns or anything like that, but we think about having walking patterns in the gym, you can do this in the gym or outside, walking patterns, lunging patterns, skipping patterns, shuffling patterns, acceleration patterns, deceleration patterns and change your direction patterns. So we have all those patterns, we have buckets of exercises within every single one of those things that I just named out. And as soon as someone can safely complete lunging patterns and this is lunging with balls overhead, with twisting with a stick with maybe with a water bag, lunging in different directions, walking patterns where you're doing hip locked drills, you're walking your stepping over hurdles, deceleration patterns, where you just have a one step decel with a band pulling you in or someone pushes you off a box, acceleration patterns and so on and so on. As soon as anyone can do one of those exercises or one of those patterns, they're doing it. So we're not waiting until they're on the field, we're not just doing, okay, you're doing a typical rehab program now in let's say good rehab, particularly good rehab program now looks a lot like we'll do a warm up, we'll do some plyometrics and then we'll do your strength work and we have we will do the same thing, we'll do a warm up, we'll do some plyometrics, maybe some overcoming or some metrics and then we're straight into our patterns, even if they're not able to run yet, we're doing walking pattern, running pattern, skipping pattern, shuffling patterns. So they're getting all of this kind of almost microdosing these little movements, they're not very intense movements, but they're sensory rich movements and there's a lot of variety in them and you can do a lot of them. If you think about doing if you have an ankle issue and you think about doing or a Achilles issue or whatever and you think, okay, I'm going to do some ployos today. People always say the old, how right this is, I don't know, but people would say you can do eight between 80 and 120 plyometrics contacts in a day, right? I don't know, that's just a number that seems to be thrown out there, right? I don't know how correct that is, but that's the number that seems to be thrown out there, that's even for healthy athletes that number is thrown out there. If you get people skipping on a track for a 15 meter or 20 meter track and skipping and doing little shuffling patterns and little dribbles and all of these things, you could get 500, you could get a thousand contacts in there that don't feel stressful at all and I am moving in that direction with our rehab a lot over the last few years is like really getting as many contacts and we try and what I always say to our coaches is we try to get volume true variety. So if we can have 10 different patterns where they're doing each one for 10 meters and then we repeat that four times or something like that, that's going to give us 500, 600 contacts rather than just doing three sets of 10 synchronic pogos, you know? So I don't even know where that answer went positive. That's how I think about getting people prepared for an eight stage rehab. It really happens in the mid stage. And with this late stage stuff because I've heard I have a background with a lot of the guys from like Emergence, Michael's Wafel, I've seen do a lot of videos on this where it's like the difference between an athlete cutting and he's not working with rehab guys, but an athlete cutting off a cone versus an athlete cutting reacting to somebody and just like the different positions. I would love to know like somebody like with your biomechanical background where you, I mean you're starting with people like I've seen you start with people like we're working with their foot, we're working with like toes and you're building them all the way up into that position where like now it's reacting. There's so much more information. What is your thought process when it comes to like the perception acts and cycle when it comes to rehab and like their ability to okay now we can do it in a closed drill versus like like what have you, what have you seen when you add in somebody else and when somebody with like your many, this many reps in this like world where now they have to start perceiving information. Do they start to move different, do some athletes pick it up really quick, some athletes struggle with it like what's your thought process in adding in more of that information after we get past the point of where okay you're structurally good in a lot of these close things and now we got to bring you to more of an open environment. What's your thought process there? I don't, it's really tricky. I know, I know the guy that you're on about emerges is it? Yeah, I'm losing to see how they have like Sean, you just go to Tyler, you're a bunch of those guys. Yeah, yeah, there's a guy on Instagram that does like really cool stuff, but he has like all his kids are always racing. I have to say I can't think of his name like Jeremy Frish maybe? Not Jeremy Frish, no, no, he's got, he's got to, I think he's one, maybe he's one of those emergent skis. I love that. I think that is, that's the end of the rehab process, Revy, you know, is well obviously they need to be reintroduced back into sport and team practice and so on. That's the end of the rehab process, but that's that part that they're doing there most of the time where they're getting someone to react to someone else, that's the practice missed. So the question I think boils down to because it's the same in the sprint world, can you actually change here? Someone moves. I think that's that's the question are when you throw them into a chaotic environment like this, are they just going to go back to doing what they always did? I think I think you can change your people move. I definitely do. I think that I think that it's silly for people to say that we can't do that, especially if you, if you get a chance to rehab someone for three months, you can put on a bit of muscle in three months. That's going to change your move just because you're stronger and you can access certain positions. So it's always this like, it's always this people always kind of almost strong man of where it's, oh, it needs to be, oh, you're not going to be able to hold your pelvis in a perfectly neutral position when you go on sprint. So why are you doing it in drills? Okay, maybe, right? But maybe, maybe it will be in a slightly different position when you're going sprint. I don't know, but I think the easier answer here is, yeah, put on a bit of muscle will change your someone moves. Pulling a hamstring will change your someone moves. Putting an eye patch on will change your someone moves. It's easy to change your someone moves, you know? So yes, I think we can change our people move and mostly what they need at a certain point is reps of those drills that you're describing and that will change your someone moves. They will figure out how to do it more efficiently and more effectively. They will win the race and they will do it in a way that cost them the least amount of energy. And that's what we're looking for, efficient and effective moveers. And it's very hard to describe or say what is the one thing that made the biggest change, but we just need to expose them to those things and people will move better. I read them. Yeah, absolutely. Now somebody coming from the prehab or the rehab kind of sector versus somebody in the strengthening sector that's listening to this podcast where you hear prehab talked about a lot. What is your thought process around prehab? What is your thought process around implementing a lot of the things that you do to maybe keep them out of a PT room? Like what's the total thought process of how do we get better at hopefully not having an injured athlete in the first place? Is it implementing some of these things in the first place? Are what's your done rehabbing an athlete? Do you go back to like training an athlete? What's your what's your process there? And maybe if that's is not how you guys work because you guys are a rehab sector. I'm sure the education process is like that a bunch. Like I'm sure when you're speaking to a lot of these teams, they're not asking the main question is probably, how do we keep our athletes out of this room, rather than how do we fix them? Like what's going to your thought process there? So I think rehab is just good training. And I think then if it brings up a bigger question around what you see as good training. And what I see as good training, particularly what I think people are sometimes missing is that piece that we spoke about in the very beginning around accurate movement. If we're trying to load a certain tissue, then we need to load it. And that doesn't need to be fancy, by the way. That's like, that could be as simple as saying, you're not loading your squad in a squad. So we need to give you two sets of three reps of a leg extension as an accessory once a week. That's what I mean by accurate movement. It's not like now you're actually bending your knee and loading your squad, accurate loading. And we end up with a lot of clients that stay on board with us in a legacy program after they've come back from injury and we just trained them. And it just looks the same as their rehab pretty much. You know, their late stage rehab, it just the training just looks the same and they just like it. So they just keep training with us. So I don't think we need to think about injury prevention too much in that way. What you can, right? It probably doesn't matter. If you think about undue this far injury prevention or undue this far performance, it's just good training. And it can achieve both of those things to a certain degree. The only time I would really use the word prehab is literally when someone is going to be going in for a surgery. So there they have ACL surgery scheduled for a month's time. No, you better be doing a fucking prehab. You know, so that the surgery goes well and the rehab will go well. So I just don't use that word, to be honest. It's like the Achilles, we don't talk about that word. (laughing) But it is funny, dude. It's like even rehab though, it's like when it gets the prehab rehab, like that's why I kind of asked that question 'cause I was wondering if you trained people after 'cause they seemed like your late stage is just good training. It seems like that's just a good, well-rounded program there. I was wondering if you just keep training people 'cause when it gets the prehab rehab, it seems like so many coaches. We had this in the college sector. We were Division III for the first two years that I was there. So when we were Division III, we didn't have as structured as a strength conditioning program. So every sport kind of had a different one. And the soccer team at that time had this like prehab specialist. They hired their own strength coach as a prehab specialist. But all of their training, dude, was a miniband. Like it was all of their training. That was their strength coach, was clamshell walks, like boot, like, and it was all prehab. Like it was their whole strength conditioning program was ACL prevention without ever lifting away, without ever doing anything. And it was crazy. I'm like, I feel like we just get that stuff so backwards when we put different labels on it for some reason. Like it's such a weird thing. And but then it's like a commoditized label, like saying you're a prehab specialist, saying you're a rehab specialist in the Americas anyways. Like this state, it's like, it's that you get paid way more than saying you're a strength conditioning person. And it's like, it's shitty your training that you're paying more for. That is probably actually gonna lead to more injuries. It's crazy. - Yeah, yeah, the problem there is, it's literally that worse. It's literally the worst prehab. It just put people into a box and then that's how the training became. So yeah, sometimes words don't matter. Sometimes they do. - Absolutely. When you talk about accurate training, one of the things that I would like to hear your thought process on is, let's say you have a college trained conditioning coach that has 50 to 60 athletes they're working with, right? What like are there ways to make their training more accurate with that many people that they're working with? Like is it just looking at like somebody that has an underdeveloped VMO and being like, okay, you're in the VMO box. We gotta start like building up these quads. We gotta start doing this. We're gonna add in extra sets. Maybe it's the same thing with the hamstrings. Like what is some like, are there other big key indicators where maybe the training isn't as accurate as you'd like it to be with that many athletes with not very many coaches looking at it? - Yeah, that's a good question. 'Cause we, I'm well aware that we have the loaduring, the privilege of almost always working one on one with athletes. And that's more my perspective is always coming from. But we do work with teams where they have groups of athletes and big groups of athletes. So it's tricky. It comes back to, it comes back to defining what you want from each session and each program, whatever you wanna break it down, each cycle, whatever you wanna break it down. What are the adaptations that you want to occur? And I think that that's where people make a mistake. Is there not hyper clear on what the, what are the adaptations I want here? And yes, you can, because we can kind of throw in words about strength and power and we can kind of, we can kind of hide behind some of those words sometimes because it's like, oh, I'll get a bit of everything. But no, let's be very clear. At least when we're rehabbing athletes, and if I say to one of our coaches, I always want them to be able to answer me in this way. If I look at one of their sessions, I want them to have programs that they've written for an athlete. And I say, what are you doing that exercise? I don't want them to come back to me and say, well, that exercise, I can improve dorsiflexion, calf strength, reduced pain, and whatever, increased tendance stiffness. Even though a certain exercise might potentially be able to do all of those things, I want you to be able to look at that exercise and say, the one reason, the main reason I'm doing this is for this. And I think that clarity, I've been able to stand over that when you look at a program, each exercise is there for a reason, and each exercise, what is the adaptation I want to cause? So that is the most important thing when it comes to accurate training. It's just understanding what you're writing down for people to do and then being clear on it. So that, like, again, it goes back to the calf, for example, I gave you earlier, if we're doing a calf raise far increasing tendance stiffness and calf strength, then we need to make sure it's heavy enough, and we need to be in a dorsiflex position. We're not just doing a calf raise far doing a calf raise, you know what I mean? Because then we're not going to get the adaptation. So that's the number one, be clear. I saw an NFL team that I was with this year, not that long ago, do it quite well, but it just grouped that leads into, I think they put it as like key resilient sites. So they had these five athletes need a little bit of more hip and groin work. These ones need a little bit more work around their knee. These ones need a little bit more work around their ankle. And then for, so they had, there's the main program for the day, and then they had it bucketed. So each of you, five guys here, there's your two accessories that you need to finish with, you guys, there's your two, you guys, there's your two and so on. And I just thought, I thought, I really liked that. I thought that that seemed to work, as far as I could see, it seemed to work really really well, and it just allows people to be more accurate and more targeted, and you don't have to have 50 programs or 60 programs. You still have one program, just with a couple of different options at the end for different people. Yeah, absolutely dude. And that's something that I talk to a lot of people when we do like consulting over programming. It's like, when they see the high variability or variation in our programs, they're like, how do I, how do I do all this? Like, how do I get everything in there? It's like, it's so easy once you have the actual thing that you want to get done figured out. Because then you can plug and play whatever you want to like, okay, you know your goal. You know your goal. You have like, I break it down and like, this left side is the stimulus, is the goal stimulus that we want out of there. How can we get that goal stimulus done? It's cool to hear you talk about that because it makes sense now that like all of the variation you have that you see in your program. It makes sense because now it's just like, hey, I'm trying to build whatever. Let's say it's a lunge pattern. We can do that in multiple different ways and it gives you the freedom to do that and allow your athletes to explore some of those things. And I think a lot of people, they start with, I need to do this exercise or I need to do this thing and they have no idea why and they're like, how the fuck do I do all of these things that I see everybody doing? I have no, and you get totally lost. And it's almost like you need to constrain yourself first to allow yourself to have that freedom in their back end. - Exactly man, exactly. And that comes back to as well as that when people ask, how do I get better at coaching and exercise? It comes down to, even in that, I always start with, well, okay, you can coach a hip-inch. You're terrible at coaching someone to do a hip-inch, right? Hawaii, Hawaii, are you doing it? What do you want their body to show you during a hip-inch? And they can't explain that usually. They'll say, oh, I want their chest, they're back to stay straight and their chest go to the floor. And that's not a good answer. You're looking for a pelvis to travel backwards in space and you're looking for a whatever. But it's a hip-inch. It's the name is in the exercise and you've started to talk about their chest already. Also, that. That's when you're coaching an exercise, you have to be so clear what do you want to happen? And then you can just give like one cue and it's gonna work. Rather than searching, what's the best cue? Stop searching for the best cue. You don't even know what you're doing it. - Yeah, that's pretty good. It's also funny, like the better athletes that you work with too, it's so insane. When you are clear in the instruction of what you wanna get done, how fast they pick these things up to, dude, it is insane. They talk about like these 12 progressions for an RDL. I'm like, have you ever worked with a good Division 1 athlete and given them like an actual clear objective on what they wanna do and watched how fast they pick it up? So our school, the college that I worked at, went from the Division 3 level to the Division 1 level. So we had Division 3 guys in our room at the same time that we brought in our first freshman class, the Division 1 guys. And like these clear cut cues for Division 1 guys, they would look at me day one in something that I would take like two to three weeks for a Division 3 guy to learn and be like, like this coach. I'm like, yes, dude, like that. I can't, like you figured that problem out instantly. It is wild watching those high level adapters figure out problems like that. - Yeah, and then some people go and call athletes dumb. They say, you know, that does my head in. They say, at least, you know, that's the thing, like athletes are, or they're dumb. You don't explain anything to them because they're dumb. They won't get it. They just go on to feel and they're amazing. Bullshit. They can learn all of these skills so much faster and understand them so much faster than most of us can. They're not dumb. They might not have given a shit about English class or maths class. That's just 'cause they could have easily learned that too. They just didn't care about it. - Dude, and it's like the thing is, the one thing I noticed, I was like, maybe you would notice this too. It's like, it's almost like these really, really high level athletes, they talk in a way, they sound high when they're talking about movement. But it's like, it's almost like the way they talk about movement is like, they have a PhD level in movements to where they are saying things, most mortal humans cannot understand because they don't feel it that way. They don't understand it that way. And they think that person's dumb. It's like, no, you don't understand it. Something like, I've been learning like the baseball swing and working my way up through baseball. And like, I've worked my way to like a decently high level in the swing, building it up. When I started in the swing, I would look at guys that were really good at swinging and I would ask them advice, I would ask them for things. They would tell me things, I'm like, these guys are dumbasses. Like, they're just really good at this. Like, they're stupid. And now I get to the stuff, I'm like, no, oh my God, I was the dumbass, quite obviously, 'cause I sucked at it and they did it. They knew something, I did it. They had a feel that I just could not even get my body to like, it's like reading a different language. And I was telling them they were stupid. Well, they were speaking, fluent Spanish to me that I just couldn't understand. I'm like, you're an idiot. I'm like, no, guys, like, it's been such an, like the skill acquisition sector, there's been such an eye opener in that regard to, no, these guys just are like such masters of that language that they are speaking something that you just can't understand. And then on the back end, instead of looking at it as like, we can't understand it, we write it off as they're stupid. It's wild. - It's wild. - Yeah, it's cool to know. - Absolutely, dude. Well, I appreciate you taking the time out of your day to come and rip this podcast with me. It's a long overdue. You're one of the few legends we haven't had on the podcast yet. So I appreciate you doing this with us. - Thank you, Austin. I'm definitely not one of the few legends, but I really appreciate you having me on and you're killing that man. So keep doing a great job. - Appreciate you. Thank you guys for listening. Keep chopping wood. Fuck yeah, dude. To stay updated on future podcast guests, keep chopping wood.