Q&A: Deadlift Advice, Pain Remedies, Balancing Training Load, Managing PHT & Back Pain

On today's episode I'm answering all of your PhD questions. Welcome to the podcast that gives you the most up-to-date evidence-based information on PhD rehab. My name is Brody, I am an online physio, but I've also managed to overcome my own battle with PhD in the past, and now I've made my mission to give you all the resources you need to overcome this condition yourself. So with that, let's dive into today's episode. Welcome back, rehabbers. I went through my email list to ask the question about a week ago now for your PhD questions and got a flood of questions coming in, and I thought it'd only be fair just to answer these on a first-come first-served basis, but with such a large volume of questions, what I think I'll try to do, which I haven't really done on previous podcasts is answer. The first ones with a lot of detail or to my usual satisfactory amount, and then if we have time, I'll just do a couple of rapid-fire questions to some in here, and whoever asks a question if they weren't too happy with a quick rapid question. The other alternative was me just not answering the question at all, so hopefully I could be as useful and as helpful as I can, but yes, we'll split this into a two-parter. So the questions, the start of the questions, I guess, for the next episode were the ones who did manage to get it early, so I will still be quite detailed with the first questions of the next episode, but just pulled some questions at the end from a few last-minute questions that were submitted to answer those quickly. And so without further ado, let's dive in. I've got the list of the questions here, and we'll just scroll up back to the top. And the first one came in from Martha, who says, "Our deadlifts good for strengthening once the pain is settled down. What type and what range of movement, what weight, etc. For context, my symptoms are okay when running, but hamstrings are very tight from sitting." Okay, happy to help you out, Martha. This, the deadlift type of action based on the hinge pattern and based on how you move, is pretty much the only, well not the only, but the most effective exercise I can think of, the targets the upper hamstring. It tensions and stimulates and strengthens the proximal part of the hamstring as it attaches to the sit bone, i.e. targeting the tendon that we want to target. And so with it being such a specifically targeted exercise, it does make it the best. I've mentioned this on the podcast before, but if we get the dosage wrong, that's why it can flare up. The same reason why it's so beneficial is the same way it can be so detrimental, the only difference is being the dosage. And so a lot of people, a lot of success stories that we've had on the podcast and a lot of injury tests that I jump on, they detail, listen to your podcast, her deadlifts were important, started doing some deadlifts, I was flared up for days, and I'm too scared to go back to them. And that is just a clear sign of yes, when we do deadlifts and we get the dosage off, it will over stimulate that tendon, it will surpass its threshold and can get symptomatic. But that's why we typically start conservatively, usually way more conservative than you ever would have thought of. I only rein the risk of underloating you initially, but once there is no flare up, then we slowly, patiently, systematically progress, progress, progress until we eventually hit a good sweet spot of what stimulates the tendon, that nice middle ground of enough stimulation to trigger adaptation and it'd be challenging enough for the tendon to grow. Yet, it's not so challenging that it irritates and irritates the next day. And so yeah, it's all about finding that middle ground. What type of deadlift do we do? Some people opt for like a stiff, legged deadlift, which I don't typically like, I think it's too, it's a bit tougher to progress through like range and weight. It's very hard to do a very heavy stiff, legged deadlift. It puts a lot of strain on the lower back as well. But your traditional deadlift has a fair amount of knee bend if you just want to Google deadlift and look at what most of the people look like. That's, there's a lot of knee bend, but the shins themselves remain vertical. So that's usually what I adopt for. I also adopt for starting that movement at the top. So picking up the barbell from like a weight rack machine so that you're not picking it up off the floor, particularly a full range of motion deadlifts are irritating for you. We have the option of putting the bar onto a rack so that when we pick it up, we're already at the top of our movement. And then doing a deadlift as far down as we're comfortable going, we now can manipulate the range of movement. And that could be half range of movement, which I would consider is sort of just past the knees. And one quarter range of movement would stay just above the knees. Three quarter range of movement, I'll say it's been going about halfway down the shin. And that's typically where if someone really struggles with range of movement, they haven't done a lot of deadlifts before, we can just progress, patiently progress up to three quarters range. And we don't need to go any further. Additionally, I guess we don't need to and we can just go heavier from the three quarter range unless you like doing a full range of movement deadlift. I mean, I do full range of movement deadlifts. I've been doing them for years and find that's okay for me. But if you recall, my flare up last year, I reduced that range of movement just because I know that range can be particularly sensitive or the PhD can be sensitive to deadlift range of movement. So the question about your part of your question, Martha, about the weight does get a bit more nuanced because it just depends how strong you are and how much the tendon can tolerate. And then that goes back that ties into frequency. So let's dive into that through trial and error. You want to start conservatively with a lighter weight than you probably think is that sweet spot. And I have an intuitive sense of where your sweet spot is. Let's just go lighter than that. Why not and try that a couple of times and then progress. Pending what weight we set along once we find your sweet spot. We can then so yes, allocate in the weight will depend on symptoms. We start conservatively and symptoms are okay and then we slowly bump up, bump up, bump up and symptoms are okay. Then we just continue progress in the weight. If we do a weight and symptoms increase the next morning, we know that that's a bit too much, then we back off a little bit and we just stay there for a couple of weeks. We can just hone in on that spot. So that's how we find the weight. We usually just based on symptoms. We also fall back on sort of is your technique okay? Can you go through that movement with good quality? What's your grip strength like and all those things, but just assuming that's all in check. And then based on how heavy that is, based on how physically demanding and how much exertion and efforts you're putting into that weight, we then assign the frequency. So if your symptoms flare up after 30 pounds, we drop back down to 25 pounds and that's okay. And then we continue doing deadlifts from there. That's not a lot, that's not very taxing on the body. It's sensitive for the tendon, but the rest of the body doesn't really need a lot of time to recover. So based on that, we could do that once a day or once every second day. But as you progress and you get heavier and heavier and heavier and it progresses to 200 pounds, we can't do that every day because your body will struggle to recover and your tendon needs that nice ebb and flow of challenging the tendon yet having enough recovery on the back end to have this tendon turn over and adapt. And so that's when the frequency needs to taper off. So that as we go through these ebbs and flows, it may have might be three to four times a week or deadlifts might be three to four times a week. Tapering off to three, tapering off to two and maybe just simmering down at two. I think if you're still rehabbing this tendon twice a week of heavy lifting is a good frequency just to fall back on. But if you're doing really, really light deadlifts and say Brody says twice a week and you're only lifting 25 pounds twice a week, it's probably not frequent enough. That's where the nuance comes in. Okay, next question comes in from Bob who says, "I am into my seventh month of hamstring issues. I've had six sessions of shockwave. I've started massages, tried acupuncture and now I'm doing physical therapy. Early PT's said it was my back disagreeing with the doctors. There was no collaboration or accountability at the University of Michigan Medical Centre. My first thing was never mentioned. My primary focus is to stop waking up to pain early in the morning around about 4.30am. My hamstring is tight. My morning ritual is ice, heat and either walking or using the Nordic Cross Trainers Skier exercise. Within about two hours, the discomfort is tolerable, only to move to my butt once I've been sitting. How do I relieve this morning pain? Okay, sorry to hear about this whole scenario, Bob, I'll try to help you out as best I can. And it is a tough one to answer because a lot more context is probably required. I'd love to know what was happening up around the time of this hamstring issue going on. It seems based on your symptoms that, or based on what you've written, that symptoms are mostly in the hamstring muscle itself. But you know, you say you've had hamstring issues and you say you're hamstring is tight and you say it's only once I start sitting that it travels upwards more towards a sit bone glute butt area. So yeah, is it pH tea? I'm not too sure. Like I said, I'd love to know the onset. I'd love to know the results of some diagnostic tests. Sometimes we do is like a heel press test where you stand, you're taking a fact outside, try to slip your shoe off with the other foot by sort of digging your heel back into the toes of the opposite foot and see if that elicit symptoms. A heel press test is another one that we do where you sort of lie on your back, you have your knees and hips bent at 90 degrees and your heels are sort of resting on a chair or a table or something like that. And then you just push your heel down directly down. We don't lift the hips up into a bridge position. We just constantly just try to press our heels as hard down as we can into that surface. See if that elicit symptoms. And yeah, if the onset of pain, what was happening around the time of these symptoms match pH tea, i.e., if you're running and doing some speed work, if you're running further, running heels, or if you're sitting longer, or if you're doing a lot of dead lifts or a high-powered kind of gym class, all of these are pretty consistent. Excessive hamstring stretching around that time could also be indicative, but like if the onset matches pH tea, plus it's quite localized to the cipron area, plus if there are reproduction of your symptoms with these diagnostic tests, we can then sort of delineate or have confidence in saying it's likely to be pH tea. But if your pt thinks it might have been lower back origin, that makes me suspect that there may be overlapping symptoms or your current presentation doesn't exactly align with pH tea. And so yeah, maybe there is something else going on that we need to investigate further. So that's why context matters. You mentioned that loading was never mentioned, like have you started loading and if so, what has the tendon response been? Because if we're still a bit unsure of a diagnosis, one thing we can do is say, okay, let's move forward with the assumption or with a theory, a hypothesis that it is pH tea. Let's test it out for several weeks and see if it starts behaving like a tendon. Because if we treat it like a tendon, it doesn't behave like a tendon, it might not be a tendon, but vice versa. If it behaves like a tendon, then we're getting better. I hate this head in this direction. So I would start loading if you haven't already, because that could alleviate the pain. Tendons do have sometimes not all time an analgesic effect. So when you load the tendon and it gets warmed up, sometimes that can provide some pain relief and we would expect that for tendon opces if the exercise is done appropriately. So that's where some people might do some long leave of bridges or might do that heel press, like I mentioned, and hold that for 10 seconds as a form of an analgesic or just, you know, one quarter range of movement deadlifts with moderate weight. These are also things that we can do and to see other things that I can think of to try to help you out, apart from doing say isometrics or loading based exercises. From a mechanical standpoint, it would be modifying like anything else that's going on outside of your exercises that we know loads tendons. So maybe modifying your sitting. If you modify your sitting on a particular day, the next morning does it feel better? Do we reduce the speed of your walking or the speed or volume of the skier that you're using? If we do that, does that change your morning symptoms? Do we change your sleeping posture? If we do, does that change symptoms? Like all of these are mechanical adjustments that we can make to see if there is a change in how you're perceiving your pain. But then there's also like the pain sensitization side of things. If you are in a lot of pain, there are ways we can sort of calm down the nervous system in the moment to see if that does help make the mornings more bearable and you can get through your day and tolerating something more. So calming down the pain signals, i.e. calming down the nervous system might be doing some deep breathing exercises. So you know, finding something that's more distraction or something that's more joyful rather than focusing on the pain or the pain just being all encompassing every morning, all morning and really struggling because hypervigilance is something that really is to someone's detriment when it comes to recovery. If they wake up and they think about their pain, they notice their pain, they rate to their pain, they move every step that they take, they think about their pain. That's very unhelpful when it comes to recovery. We call that hypervigilance. And so we tried to move away from that if we noticed that as a particular flag and say, okay, let's try distraction. Let's try calling a friend or talking to a friend or listening to an engaging audiobook or just finding some enjoyment. So like if you go for a walk and instead of walking by yourself and thinking about your pain the whole time, how about, you know, listen to music, listen to meditation, guided meditation track, listen to a body scan track. So not only we're walking and getting some exercise and getting some getting some air in our lungs and getting some sunshine, we're also listening to a body scan where we're paying attention to what they talk about in that track instead of focusing on the hamstring. So there's a combination of movement, fresh air, but also distraction and also maybe enjoyment. Maybe you're listening to a guided deep breathing meditation track as well and calming down the nervous system that way. And just see, to see as a trial, does that calm down your pain? And if it does, then these are some pain, relief modalities that we can start using. So just a few tips there, I hope. Recovery from PhD has never been simpler. If you've been struggling with this condition and you not sure what to do next, I've put together something to help. LinkedIn, the show notes is a 30-second questionnaire, literally just six multiple choice questions and based on your answers, I'll point you towards the most effective next step for your situation. Because over the years, I've created a range of resources from free education to structured self-guided programs, all the way up to working with me directly, all of which are aimed to strip away the mountain of misinformation about recovering from this diagnosis and taking out all the guesswork that leaves people like you overwhelmed. If that sounds helpful, don't wait until the end of this episode. Click on the link in the show notes now and I'll guide you from there. That helps you out, Bob. Okay, Roman is the next question to come in and says, "I have a bit of a meta question. I've successfully rehabbed Medial Epicondylitis. Some people might recognize that as golfers, although I've managed to rehab that by myself, but now I'm plagued by hamstring and hip flexor issues, probably also tendonopathy. I wonder what working with a physiotherapist is like. Based on my knowledge, it's all about appropriate load and imaging is not very useful. That means PT can only work based on the feelings of perceived pain of the patient." Okay, it is a bit of a meta question, so I'm happy to best try to describe this as I can. I suppose I should start by saying that all physios are different based on where they are in the world, they have different training approaches, different experiences, different treatment philosophies, you know, all physios have different personalities. You get some good physios, you get some bad physios. Same thing, you can get some good chiro's, get some bad chiro's, good surgeons, bad surgeons, like it's not just industry specific or profession specific. So everyone's approach and experience and will be different because everyone has different, you know, I guess, like I say, experiences and ways they like to go about things. But I would say let me try to answer this as typically as I can, so typically an in-person physio. Day one, they do a subjective assessment where they sit you down, hopefully exchange some pleasantries and talk about what we say subjective is just more like question and answer this sort of stuff. It's more like what was happening around the time of your pain, what are your current symptoms, what it irritates, what eases your symptoms, what injuries have you had in the past, what goals do you want to work on, like all those sort of questions to try to give us some data about what might be going on, what might be a roadmap moving forward. They also do objective tests, they follow on with doing some what we call like maybe special tests or or diagnostic tests or like them watching you. move through space, do strength tests, mobility tests, length tests, like all those other things, just to again gather more data. And then based on all of that, they sort of have a look at their findings and they, so they educate, they say this is what we think is going on, this potential hypothesis, this is the components that might match the symptoms that you're going through. And then they go through what they think might be the best course of treatment, that might be exercise prescription, so giving some rehab exercises to do at the gym or at home, but also education about the injury and that can help the client understand a lot about what really irritates, what modifications they might need to do, education about day-to-day modifications, so like we see someone with PhD, okay, this is how we can modify your sitting or your driving or your sleeping posture or something just to help things. Education about the injury, sort of like stretching is okay, just don't overstretch, exercise is okay, just don't overexercise, just follow symptoms, I guess symptom management and interpreting your symptoms is also a part of that education side of things. Roman, you mentioned that our imaging is not very useful. I would say it is useful in certain contexts like we are trained at trying to identify red flags if something is serious and something needs to be investigated to which we do prompt scans, MRIs, X-rays and those sort of things just to roll out something sinister or serious. But yeah, we're trained to identify movement patterns or compensations or any kinetic chain weaknesses or mobility issues and see if there's anything else that needs to be addressed, it's not just the local site. And then we're also trained in manual therapies, we're trained in massage, trigger point release, some physios are trained in dry needling if they've had extra training. Massage, like I said, shockwave, that's probably additional training and other methods like taping, mobilisation, joint mobilisations, all these things are within our wheelhouse. And so, yeah, not just, I guess, load management and exercise prescription, but we sort of pick what's appropriate for what. And then after that, there's usually some casual follow-ups, sometimes I guess on average weekly follow-ups to discuss how the past week has been, discuss changing symptoms, things going well, maybe adjustment or progression of your exercises. And then as the weeks go on, and as you get better, hopefully less manual therapy is sort of less needed. But more towards the empowering, independent exercise therapy side of things, and then hopefully sessions with the physio become less frequent as you require them less often. I would say, yeah, that's a pretty typical experience, I'd hope. For me, like if people are familiar with me, I am 100% based online, I'm an online health professional and help people. I do have my own subjective forms that I have people fill out before we start working together. I also have some objective forms where people do some tests at home themselves and then document how symptoms are. But, you know, where I feel like the same sort of overlapping advice with in-person would be around education, be around exercise prescription. I get people, I send people videos of certain exercises I want them to do, they send me videos back of them doing the exercise, so I can make sure the technique is done. And what's well within my wheelhouse and bread and butter, I do this day in day out is just weekly structure, coming up with your rehab program. How does your rehab exercises fit in with your cardio, fit in with your day-to-day work life and family life and other commitments and just then, I guess, what differentiates me from what a traditional like all physio would be would be on call communication. So I am just constantly messaging my clients, they're constantly messaging me throughout the week, any changing symptoms or questions or uncertainties or pop-up. We are just in direct communication via WhatsApp just to make sure rehab stays on track rather than just waiting a week to see your next physio appointment and then giving them an update of how the past week has been and then they're sort of playing catch up from there. But yeah, I guess my limitations are I don't provide manual therapies obviously being online, but most of the clients that I see are tendon opacies and tend opacies don't really require a lot of manual therapy, especially if it's in the chronic nature. And so I guess that's sort of what differentiates my physio experience from someone who might be an in-person physio. Verena or Verena, submit her question and says hi Brody, thanks for your hard work, your series already helped me a lot. I've had a hamstring tendon opacy for one year, but it took four to five months to figure it out, i.e. awaiting doctors appointments. Now unfortunately, physiotherapy has not been a big help. So I'm still struggling, either with too much strength training and increasing problems afterwards or problems without any training. But I'm unable to find the balance between enough weight to strengthen my damaged muscle, but not too much to over stimulate it. I also have the feeling the problems increase as pain sometimes moves down to my heel. Do you have any advice for me? Okay, thanks for your question. I think I'll answer this in two directions. One is like, okay, let's assume it is PhD, but there are a few things that sort of make me think that it might not be or at least something else going on. So let's start the question by just assuming that it is PhD. So struggling with the balance between loading it with exercise training or strength training and risking an increase in symptoms or once you have an increase in symptoms tapering off and stopping and resting and not giving it the stimulation that needs. And so what I would say is if you're really struggling with that too and fro and that balance to start with one exercise, one exercise at a time and let's just see if we can find the sweet spot for that rather than doing three to four exercises and then feeling flat up and then struggling to work out the dosage from there. So we're just really stripping everything back, getting everything really dialed in. And yes, I talk about all the time, but probably the deadlift would be the one exercise I would include if I had to include just one exercise. And so hopefully you've got the equipment required for this, but let's just use your deadlift as an example. Let's do say three sets of eight. Let's do half range of motion. So you start at the top and we're dropping the weights down. We're doing a nice deadlift hinge pattern and we're just going to move the weights or your hands or the bar just below the knees and then come up from there. That would be what I would consider half range of movement. And let's start at a conservative weight. Whatever that is for you, I don't know. Let's just say it's 20 pounds. So start with that. That's probably still enough to stimulate the tendon, but let's just see the response. And if there's no noticeable increase in symptoms, let's just bump it up from there. We can just slowly increase by five or 10 pounds each time. Let's just see how you feel afterwards. Let's see how you feel the next day. If that's okay, we can continue building. If you do that dosage and it does irritate your symptoms, hey, let's go to a quarter range of movement. Let's just keep everything above the knees and reassess how we're going from there. And my guess is you're going to be tolerating that quite well. Then once we bump it up and we try it several times, we then just gain some confidence as to where your sweet spot is. Then we can choose to either progress that deadlift or we choose to layer in another exercise, which might be a hamstring curl. Let's start conservatively. Let's build upon that. And not a lot of people need to be this diligent, but for some clients, they're particularly sensitive to loading. And they do need this very diligent, very patient, very systematic way of going about it, which might seem tedious right now. But after several weeks of experimentation, you then have a fairly decent, predictable, confident exercise routine that you can then execute. I'd also add on top of that. If you do a deadlift or you do progress something or you do trial out and exercise, we want to make sure that we keep all other variables as consistent as possible outside of your strength training. So don't progress your running. Hopefully it's a day where you're not doing a lot of sitting or like an excessive amount of sitting above what you typically do. Because if you do in their symptoms that increase the next day, we can't just straight away just blame the deadlifts. It could be the deadlifts, but it could also be that you sat in a meeting for three hours, which a meeting only goes typically goes for an hour. Or you were stuck in traffic and had to drive, you know, 45 minutes more than usual. So we want to make sure that if there is a flare up and those things are outside of the normal, then we do want to pay attention to that. Also like your sleep, if you had a poor night sleep or if you've had increased stress or if you're just coming on with a cold or an illness, this also sparks pain signals. And so if some of these things are happening around the time of an increase in symptoms, and you did your delus today before, it might not be the delus, might be something else that's influencing or magnifying the pain signals. Okay, so that's if it's PhD, but you sort of mentioned the pain can sometimes radiate down to the heel, that is not consistent with PhD, either you have PhD and something else is going on on top of that or this is something else entirely. And so like I mentioned before, we can treat it like PhD and see if there's improvement, we can use the treatment approach as kind of a diagnostic tool in a way. But if we treat it like a PhD, it's still not getting better, it's not behaving like a tendon and this still is radiating symptoms down to the heel, we need to investigate further. Is there something to do with lower back or this some psych nerve involvement or something else is going on? So yes, if you're still not seeing any improvement in your being super super diligent, then potentially looking at a second opinion, getting other options there. Okay, let's cover off some quick fire questions, which weren't going to be answered, 'cause this is too far at the bottom of my list, but I just pulled up a few just to give some quick guidance. First one comes from Susan who says, "Hi, Rowdy, I've been doing rehab with PT for nearly six months. We initially did deadlifts twice a week, but recently changed to once a week as I was wondering if twice a week was causing more pain and symptoms. Is it advisable to do more than one session of deadlifts a week or does a very personal person?" Okay, I say in general, rehab twice a week, it will suffice. Once your symptoms are like symptom-free, and you're returned back to the spots that you enjoy and there's not a lot of symptoms, I would say once a week is appropriate, just for like that maintenance phase. Once a week during rehab is probably not frequent enough. You can test, go ahead, test once a week if you want right now and see if it settles, but you only need to test that out for one to two weeks. Symptoms haven't settled in one to two weeks and that's not the deadlifts, you can probably reintroduce it again, maybe and symptoms stay the same. But if you do reduce the deadlifts and it does settle down your symptoms, I would suggest maybe doing one heavy session per week or what your typical deadlift is now. And then one moderate session later in the week, where you're still doing the deadlifts, the tendon still getting the adaptation, yet it's just not as stimulating. That could be the same weight with less range of movement or it could be the same range of movement with less weight. The tendon will still get that trigger to adapt, but it's just not as challenging and therefore you're not as sore but you're still getting that frequency. And who knows, maybe you could do a third session of lighter. We do know sometimes with athletes, we have a low or we sort of do a high day, followed by a light day, followed by a moderate day, followed by rest. We go high and low, moderate rest, high and low, moderate rest on repeat so that the tendon gets plenty of stimulation, plenty of frequency, but yet just a better Evan flow of recovery rather than just going heavy, heavy, heavy, five to six days a week. So you could do something similar. Dana asks, I am in my mid-40s, active my whole life. I've got exercise physiology for a career, love running, mountain biking, hand salam, water skiing. I've been fighting with PhD for years since learning from you. I've started loading it heavily and it was doing the best it had for years. Well done, Dana. I then went on a trip to Iceland in November, 2025. So long flight and no running or lifting there and it's been painful since then, so annoying. I just got back to lifting heavy and hurt my back four days ago. I am so nervous about the PhD pain coming back just for taking a little bit off to help my back heal. So any advice would be great. Sorry to hear about your scenario, Dana. I would say that like you can do some, like try to find some moderate loading with other exercises that doesn't really affect the lower back, 'cause yes, the dead lifts are a exercise that does stimulate the lower back while also stimulating the hamstring. My O2s can be sort of Nordic hip dips. So someone can look at this. So if someone's familiar with a Nordic drop where you sort of anchor your ankles in position while you're kneeling and then you just drop your whole entire body, the lower your entire body, keeping everything from your knees to your shoulders like completely straight. What I like to do is have your knees bent at 90 degrees so you're still in that upright kneeling position. But then you just dip forward at the hips rather than the whole body going forward and then come back up and sort of like a dipping bird, drinking bird sort of action. While keeping your thighs completely vertical does give a nice stimulation to the upper hamstring, but it is a little bit of a lower back but probably not as much as like a deadlift. And so you can try that. You can try heal digs like lying on your back. Have your hips and knees bent at 90/90 and have your heels on a chair or a table or a bench. There's pushing your heels down, not coming up into a bridge, but just pushing them down similar to like that diagnostic test I was talking about earlier. And just holding that, holding that for 10 seconds, 15 seconds. You might want to like rise your hips like one inch off the ground and just hold that position. And if that's not challenging enough you can get a dumbbell and put that on. So it's like a lot of load through the upper hamstring but just not a lot of stimulation for the lower back. You can also do your pronamption curls. Pronamption curls shouldn't really be that stimulating for the lower back, but we'll strengthen up the mid belly hamstring area. So yeah, our job as a physio is to look at all the complexities and multiple factors that are going on, trying to modify an exercise program to still be proactive, but consider everything else that's going on 'cause we will typically provide exercises for someone, but people have different goals, people have different sensitivities, aggravating factors, different injuries. We work with PhD with people who also have planifactious or low back pain or a glute tendon opathy. And it's our job just to consider all those things and come up with the best exercises that are right for you. So there's just a few exercises there. All right, next episode we're going to be answering the remainder of your questions. So look forward to bringing those and hopefully you've learned a lot today. If you are looking for more PhD resources, then check out my website link in the show notes. There you will find my free PhD five day course, other online content and ways you could personally connect with me, including a free 20 minute injury chat to discuss your current rehab and any tweaks you might need to make. Well done for taking an active role in your rehab, find the seek to content like this. And together we can start ticking off all of your rehab goals and finally overcome your PhD.