How to Help a Client When They Say They “Have Bad Knees”
CJ
Welcome back to Gymnazo podcast. I am your host, CJ Kobliska. And I have two awesome coaches here with me today we’re going to be breaking down knee pain and what to do about it when it pops up in a workout. And when somebody says they’ve got bad knees, what does that really mean? And how can we shift the conversation from things that are bad and things that are limiting and things that will prevent us from having access to a successful workout and successful lifestyle? With full full movement and fun and limiting our pain? You know, how do we how do we go about shifting that conversation and I’ve got Mitch here and Michael here to break down kind of their strategies on what they do when clients bring up they’ve got bad knees, or when they’re in a workout saying I can’t do this, I can’t do that, especially with lunges, squats, jumps balance, basically anything that involves legs.
Michael Hughes
Welcome to the Gymnazo podcast where you get to peek behind the curtains of what it takes to create and run a seven figure fitness facility that ranks in the top 5% of boutique fitness studios for revenue. But to be honest, that’s the least important thing about us. Founded by me, Michael Hughes, Gymnazo has created an ecosystem of services that blend performance with restoration techniques, and attracts top coaches to its facility hosted by its owners, Payton and myself, and our top coaches, this podcast shares our best practices on everything, from how to build a sustainable fitness business, to how to program for maximum results to how to build a hybrid training module that’s online. And in person. We have marketing secrets, movement, innovation, and breaking down trends in the industry. If you’re a fitness professional, or fitness business owner, this is where you learn how to sharpen your skills and to see maximum results.
CJ
So to kick off this conversation, I like to ask both of you, what do you think about? Or what do you say when a client says they have a bad knee or bad knees? What goes through your mind?
Mitch
I’ll leave this up to you first
Michael Hughes
deal. My first thought, I don’t say this is you’re thinking about it all wrong. You’re gonna have bad knees. If a bad ankle, a bad hip, a bad loading mechanics, you’re putting so much stress on that knee and the knee just says help me out a little bit. Help me out a little bit. So that’s what I say in my that’s what I think about, you know, it’s like, oh, yeah, so I mean to think what else is pissing off that knee to make it happen? Then my next My first question is, Tell me your story. Because it could be the opposite. It could be like No, literally, someone just literally crashed into my knee on a bike when I was a kid, or, you know, someone tackled me, slide tack mean soccer and blew my ACL, right there’s could be so there could be impact stories. So I really liked the story. Because that really shapes how I should think about even though my first thought is like, your nice, fine, it’s really something else. It’s, um, your knees hurt, right? But it’s not your knees fault. So questioning past history. That’s where I go first. That’s where I go first. But then, let’s say it’s non impact, I really want to see, I really want to see how that foot can go through supination prone and pronation appropriately, when it’s supination. When it’s behind the body, pronation was in front of the body. And I really want to see how those hips can really glide side to side and spin. That’s what that’s my first. So that’s what I really want.
CJ
a lot of things I want to unpack in there. Yeah. Match up yourself. What do you think about what do you see
Mitch
similar strategy? Definitely don’t impose anything on them at first, definitely just more suited ask questions, just to figure out a deeper, deeper dive in depth into like, what really is causing that issue? So I think I usually I just asked like, oh, like, have you had a surgery or something? Oh, you haven’t? Or you have? Because I feel like that tells you a lot, right? They’re like you have had surgery. So there’s some structural limitations or possible cause with that, or if it’s not, it’s like okay, it kind of goes Michaels route, looking above or below and seeing how well those two areas function the foot and ankle and then the hip. And then that’s that’s pretty much it. I think I kind of just leave it as a blank slate and just try and ask more questions to start narrowing the path down a little bit.
Michael Hughes
Yeah, people often say like, oh, I have a knee replacement. So expect XYZ. Now like, Well, wait a minute, like, tell me about your retraining of that. Yeah, they have a brand new part. The neuromuscular conductivity is like, I’m not because it’s gone. But it certainly hasn’t been trained in a long time if you waited so long to get a knee replacement. Right. So a lot of retraining, is kind of makes me excited. It’s like, oh, let me show you what we have. But you have to break through their mental barrier first of like, oh, this is the way it is. I got a knee replacement. I got about 10 years on it. Maybe 20 That’s what doctor says until I gotta get a another one. Like, wow, wait a minute, how can we put some more miles on those tires?
CJ
What goes into that story? It sounds like we’ve hit three things more structure first, like, what do we see in terms of the biomechanics of the foot, knee, ankle, and the hip and how its involved in the knee. We’re also looking at the story of their history of what the body’s been through, whether it be an injury, sports, types of training, no, nothing really happened. It just started becoming uncomfortable. And then also the internal story. What have they been told? What did the doctor shared with them? If they have got a replacement, or they have had some kind of surgery, meniscus or ligament, something that’s going going on inside of the knee? And maybe they just got it cleaned out? What are the stories that have been shared with them that they have now adopted as their own story? Yeah, and have they had an opportunity to change that story. Or to make it more thorough, I think a lot of people come in with limiting beliefs about how their knee can get better. And from what I’ve seen, all of us do is we don’t really address the knee right away, we say, okay, let’s check out the knee. But what we’re really looking at is above and below the knee, because the story the knee is currently living, may not be the full story.
Michael Hughes
It’s the truth. It’s true. And we’re going to talk about the thoracic spine, when we go to hip and foot. So often ik, obviously, it could be the thoracic spine, it could be shoulder it could be can be their neck, you know, they just can’t turn I mean, it’s really executed. So creative, all depends on the lifestyle of that person, the movement patterns that they go through, right, so frequently. You know, if you’re looking at I, it’s, I hate to say it like this, in such a complicated manner. But a truck driver could have a bad knee. Because the way they sit in their truck, because of pre positioned right in such a way. And that could literally affect movement patterns down as they’re unloading their truck. Because they got to climb that ramp, or whatever the case is, it can get so detailed, and so minuscule, but through repetition, rep after rep after rep, not like leg extension rep, but climbing a stair rep. So you’d really have to go deep in and people often say like, Okay, well, how did this happen? Well, it’s really hard for us to figure that out how it happened, we can understand where it’s coming from, but the long term story of the year after year after year, and there’s a number of things that could go wrong. Number of things.
CJ
Let’s take that that analogy of a truck, right? Not even analogies. An example really we people drive people travel, people sit at a desk. So let’s take that sitting position. And how might you unpack a lifestyle of sitting, but not just the sitting as the cause, but maybe something deeper, like a lack of counterbalancing that right? Or balancing it out? Say, alright, you’re sitting down, but also, it’s not bad to sit, we’re sitting down right now. But there’s something that we might do after or before, or recognize within ourselves because of a story of when we feel discomfort or pain. How might you help somebody? Or how do you currently help somebody understand that there is another story that can be told about knee pain, and we can dive deeper into our, our understanding of ourselves through our own movement, our own sensations? Where do you start shifting that conversation from? It’s not your knee? You don’t just tell them? You’re wrong. Right? You? That’s a That’s a horrible thing to do.
Michael Hughes
Than the last buck.
CJ
But so how would you start? Somebody comes in says, Listen, I sit for a living, I travel a lot. I have knee pain. My knees are bad. How can we begin to shift that to something more along the lines of, oh, this is why my knees hurt. And this is what I can do about it. I just need to do these things. What do you what do you start?
Michael Hughes
Okay, kick it off.
Mitch
Trying to find a little bit of success away from the knee. So they can try to find a little bit of success away from the knee that influences the knee. And I feel like that tends to kind of be like, oh, like like clicks in their brain like wait, you just form rolled my glute. And that help relieve the knee pressure or pain or whatever grab or zing whatever it may be they’re experiencing. And then they go, Oh, wait, maybe maybe this guy is onto something. And then diving into I think visuals tend to help really well. Just showing like, hey, look, XY and Z go here. And when you do this polls, and that’s why your knee doesn’t like that as a super simple way of putting it.
Michael Hughes
Yeah, we’re talking about the anatomy apps that we use on our cell phones or iPads. Yeah, huge. You can 360 rotated we can dive in deep and really show like this muscle literally has direct connection, right at least fashionably, which is obviously
CJ
3d for medical, for those that are listening that want to check that app out. Super helpful.
Michael Hughes
There’s several different ones to that just the major company. Yeah,
Mitch
I find that to be a big contributor into just winning them over in a sense of like, this is what I’m thinking and this is why and they can see the visual of it, and then you just kind of throw some sense strategies add on, and then they start to feel the relief, and then they start to kind of gain that trust with you.
Michael Hughes
I like the visual thing, like not many people know what the underneath of the hood of a car looks like. Right? They look, they don’t really open their hood of the car very, very infrequently. And if they do, it’s just a big plastic cover. I think we’re doing the same thing, like this is where your brake line pump is, and see where it goes like, oh, I can see how it’s the master cylinder not pressurizing into the back tires, like they would have no idea, the same thing, or your glute is a brake pedal for your knee at times, and if it’s not pumping, you know?
CJ
Or if you’re slamming the brake, right,
Michael Hughes
exactly, yeah, exactly. You know, but if they can see it, because there’s, you know, 800 plus different muscles. Fascia is lined in several different many layers within its own muscle tissue. Muscle fibers are the size of a human hair smaller. How many different muscle fibers you have? I mean, you know, I mean, you got three, two planes of motion to the cube 800. That’s a lot.
CJ
Everything’s connected. It’s all weave together. Yeah, exactly. Something if something’s in pain or discomfort, something, it’s like a check engine light, right? What are you gonna do when your check engine light comes on in your car? Yeah, but a little sticker over the top of that this day, that’s not happening. I just hear sounds right? I don’t mind. There we go. And that’s what we do with our body. If you’re looking at with your car, we could just go take it to the mechanic. But for whatever reason, with our bodies, many of us think we gotta go to the mechanic, which is the doctor, that’s the one place we got to take it. But how many different car shops are out there, how many different specialists are out there, how many different people can actually help you, and how many people think they’re helping you. But they’re, they’re having to do all these extra things, right? They’re gonna charge you extra, we gotta check this, check this, check this, check this, check this, and this may not even solve the issue. Like it becomes another narrative for ourselves when we’re in pain. Screw it, this is just how it is now. And that’s partially because those that we go to, may say, Listen to stop doing the thing that’s causing you pain. But for some people, that may be something you really enjoy doing like hiking, like just getting in another car, like going up and down the stairs into their house, like kicking a ball, like squat and down to do some yard work, like a lot of these things cause pain, and if somebody is telling us to stop doing it, and then have the authority, what does that do to us, right? As an individual who’s experiencing the pain, it’s like, well, I just kind of live with this the rest of my life, there’s nothing I can do about it.
Michael Hughes
Or it goes long as possible until the pain is so bad, that you can’t stand it then come in and get a knee replacement, like what what biological behavioral factors have you already preset into that body. So now they hold that same standard of life, post knee replacement.
CJ
And taking it back to the analogy of the car. If we don’t do anything about that check engine light, we go, we don’t take it in or we haven’t changed the oil or our tires haven’t been rotated. Those are all things that are going to cause more problems later down the road. And so if it’s not addressed, we don’t we just say I’m just gonna drive my car less. Okay, I’m not gonna take it on that four wheel adventure. Alright, I’m not gonna take it out in the winter in the rain, right? Well, now you’re not going anywhere. You can’t use what you’ve been given, or what you bought the vehicle. Right, right, your body. So So where do we go from here what Mitch has shared something about how he kind of helps to shift that narrative, which is through visuals and through experience, using an anatomy app, actually taking somebody through some foam rolling strategies and saying see how you feel, Oh, I am experiencing less pain. Maybe if I keep going down this route, I will find more success. One of the things if there is any more that we add in or that you add in to helping to shift that narrative? Yeah,
Michael Hughes
especially in a movement assessment, because you have to get that buy in as soon as possible. Because they’ve been living with it for if not months, years. You know, in the long term, something’s there. I wanna say the harder it is, but essentially, the harder it is to get it out of there. So tweaking in muscle groups is like an amazing way to get someone this idea like you can still move with less pain, or ideally, zero pain. So one of our movement assessments is afford lunch with both hands reaching overhead, if not post your the overhead which significantly turns off glutes, hamstrings, relative to turning on abdominals, quads as a primary decelerator of that nice, let me say that again, real quick. When you reach overhead, you’re asking the Front party for a body to slow down the knee on its lunge descent, versus when you reach forward or down you’re asking the posterior part of the body, glutes, hamstrings, to be the the brake pedal of the knee. So on one of the lunges we do is we reach forward or shimmy up and lunge forward and that can cause knee knee pain. So let’s just change our reach. And I’ll do that reach forward. How does the knee feel? Let’s say it still hurts. real bad. All right, reach forward and to the same side, spin the arms. See what happens? Oh, that hurts even more. Okay, I’m now learning that if I put more posterior chain more glutes more hamstrings, especially with that same side rotation, right foots both hands been right. And I really asked the posterior chain to add a lot of rotational t so and hurts even more, I get a story. I get told, okay, the glutes and hamstrings really don’t want to help out, or they can’t. Okay, let’s put a wedge underneath your foot and lunge up onto that dorsi flexed or up ramp. Would wedge hurts less? Okay, if it hurt more, I still get a story. So be based on their responses, I can change hand positions, foot positions, environmental positions, body positions to get to a that feels fine answer. I’ll find it, I’ll find it. If I don’t find it, then I then I start on the table. I mean, there’s always an answer. It’s there’s always a starting point. And the cool thing is that you can always tell them like you know, there’s not, you’re not going to tell me as a possibility that does not lead me to a starting point. They can’t say no to that. Because they can lay down, they may still have knee pain with the laying down the least I can capture the tissue to start there. So it’s really cool to not feel stuck in the beginning. Like I felt stuck halfway through like, Gosh, what’s my next move. But I still have an out. It’s called the rest of my team. Because you think about it differently, CJ, and you think about it differently, Mitch, like so it’s really cool to have not only the biomechanical possibilities, but the support possibility to think how what am I thinking about differently here, which How should I go about this? So
CJ
it’s really powerful, you bring up a point about searching for success. And it’s like the good, the better or the worse, right? Yeah. And you involve the athlete in that assessment. It’s not just do this, do this, do that. But hey, do this. And let me know what you experience. Many times, I think we haven’t been gifted the opportunity, or we haven’t given the opportunity ourselves to say, what do I sense when we once we have pain, we identify with that pain, and that’s who we are. And if we find a movement, that is not painful, we’re like, Nope, that’s not that must not be right. Like, it’s a weird thing that we go through that when especially working with people who have been in pain for long periods of time, that you ask them, Hey, does that hurt? And they said, No. But you get deeper and they say, No, it hurts all the time, right? It just doesn’t hurt worse. Like, okay, we were now getting to the bottom of what’s really going on here. It’s like we’re so identified with that discomfort and pain, which is not a negative thing. It’s just a part of our experience, that we think this is how it’s supposed to be. But what you what you had mentioned is that you’re searching for those positions of more success, you’re bringing variability, that’s not just variety, it’s got an intent behind it, whether you know it or not, in the beginning, you’re going to know it after they say that was worse, that was better. That’s the same. And we start to put together these puzzle pieces. That then the tough part is then relaying what we found, and not writing a story for our athlete, but helping them discover a new story for themselves a new narrative that there is something out there that is going to help me and I think I found it, or at least I found the path to get there right now. It’s not like oh, man, I feel better, I feel great. That’s a rare occasion that somebody is in chronic pain, or even acute pain, really. And then in an hour, they’re going to feel completely better. But there might be better. Yeah, when they came in
Michael Hughes
And that’s the hope. That’s the hope that they that they need. I say I’m looking for 50% better, if I can get 50% better in a stretch sequence of foam, rolling sequence, or all those put together, I know, through my empirical data that we’re going to figure this thing thing out, or at least we’re going to get to the next massive hurdle. And I always say this, and I maybe say it too, too much said my name is now Sherlock, your name is Alan Watson. And I can’t do my job without you telling me because I can’t feel what you feel. But I can see what you can’t feel. And that’s the really, that’s so you need to communicate to me a lot.
CJ
It’s very much a game of reflection. You see, you tell me what you feel. And we’re going to keep getting back to what we’re experiencing without maybe even figuring anything out. We’re just writing a more full story of what’s actually going on. And
Michael Hughes
we got a bunch of doors that we can open up. Because I’ve never said like, oh, I have one answer. It’s like I got I got option A, B, C, I can probably figure out D but I got at least three paths that I can go to to really open this thing up. And that’s the best part about it. When a doesn’t when they say no, it’s only about 25% reduce discomfort. Okay, not good. I didn’t really get the major artery that I’m going going for. So if I can get 50% better, then I’m I’m stoked.
Mitch
Yeah, I think that I think that’s subjective feedback is probably one of the most important thing Yeah, I mean, it’s it’s really interesting when you say like, because actually I stole it from yours. Straight up stole it from you were that the one to three scale where like one do you experience anything if you do you you can keep going to is you feel pain, but you’ll probably want to stop after a few more reps and threes basically just like no, like that was too much I don’t want to go anymore. And just even using that scale is is pretty powerful too. Because even if they experienced some type of knee pain with anterior lunge, just keep using that example. And it’s like, is it a one, two or three? It’s a one it’s like, is it really there? Because sometimes there’s Phantom Pains as well, because they’re so used to having pains in that area. And then it’s like, how do you differentiate between that and it’s, I think everything you said before we have tweaking in the arms, tweaking in the foot, adjusting all those things can help you kind of figure out a lot of those things.
CJ
And if we know anything about pain, it’s you could have something tremendously wrong internally physically, like by biologically that’s going on and experience zero pain. But you could have nothing wrong internally and be experiencing a shit ton of pain. Yeah, and you might have something going on, you kind of experience that mediocre pain, like there’s two sides of that spectrum. So when we’re addressing this pain, it’s it is very subjective. Everybody’s pain is different. If somebody’s got knee pain, the person next to him who’s got knee pain in the same knee in the same spot may be experienced entirely differently, because of what it may be inhibiting them from doing in their daily life, because it stopped them from doing something that they enjoy, because now it’s taking up all this mental real estate and they’re not able to focus on the other things that they really liked doing because their knee always hurts when they’re just sitting down. So I think I think where we can start to set a good background on how we see or view pain and how we address it and how we might shift that narrative. I think it’s important also to have a visual of when somebody experiences the pain, right? How often do we see knee pain pop up? I think I think it’s daily
Michael Hughes
I would say, yes,
CJ
knee pain does not mean injury, let’s get that clear knee pain means there’s somebody’s experiencing pain and discomfort that could be a sign of trauma going on internally, physically. It could be just something going on more mentally, emotionally. And we can’t necessarily say what exactly that is. But we can help to create that deeper story. So when, in what motions, what activities do we typically see somebody experiencing pain or sharing that this hurts me.
Michael Hughes
This morning, I just got done coaching a group session. And there’s a client who has chronically bad knees, and she’s in her 30s. And she shouldn’t be. And we’ve worked with her for a long time. She has a condition, a biological condition, that we’re not going to solve the knee problem, but working but we can biomechanically address it in the workouts. So she’s been working out with us. She actually told me as it’s kind of cool. Today’s my actually my anniversary for marriage. You know, it’s it’s kind of cool. She made it. I made it this far. But she was ironically she said, she said, Hey, Mike, I’ve been working out with you. You’re like the longest relationship in my life. Post my parents. I’m like, really? She’s like, Yeah, so, you know, anyways, she’s had knee pain the whole time. But she doesn’t experience it in the workouts, because we biomechanically adjusted every single workout since I mean, we’ve been working on it. Now she she goes through her motion patterns, and now she has less knee pain throughout her life. And we basically, she would just go to a hip hinge, and avoid knee flexion. Right. So now we go to knee flexion with massive hip flexion in her squats, and lunges and lunges look different. But we’ve taught her she’s taught us how that we can train her. And she’s up, she’s now pushing 1000 Plus workouts over the eight years that she’s been working out with us. And that’s pretty. So it’s pretty awesome to see how there’s a long story there. But it’s really awesome to see how someone how she’s now taught herself. We don’t I don’t even adjust her movements anymore. She does it automatically. And her lunges, her squats look a little bit different than everyone else’s.
CJ
I think it’s so important that you bring up too because on the outside perspective, you might think you’re doing that wrong.
Michael Hughes
It looks it looks different. I don’t know. But that doesn’t mean we shouldn’t be doing it. But that’s what she has to do it.
CJ
And that way has allowed her to sustain her fitness training journey. Still having discomfort, still experiencing some kind of pain, but not making it worse. In fact, making it a little bit better so that in everyday life, it’s not taking up as much mental estate, whether there’s something we can be doing that’s even better, I guess we’ll find out but at this point, we’re doing something that is sustainable, you’re doing something in terms of your coaching and cueing that is able to allow her to have a full healthy lifestyle that involves fitness and involves training that is enjoyable as opposed to a chore that is painful, uncomfortable, something that I don’t want to do I don’t look forward to but I have to do it
Michael Hughes
right and if Drew for eight years and still come still be coming back. You know it’s our it’s his it’s his reality that Some things you can’t solve, there’s no fixing, that really needs to happen. But a progression of of how you can go through life in a, in an awesome way the human body will degrade, it will stop moving at some point. But what’s the quality that you have as you go through it, and realize that we train that in a workout all the time, given people give us the opportunity to fitness is so weird because people just expect to work out in pain. When I have a new guest coming up, say, Hey, tell me how your body is done it. You know, it hips, ankle, I give them examples about this type of this. And they say I got a little pain, but I it’s just there. And I immediately say, if you have something bothering you in a workout, you need to bother me. That is the expectation that I this welcome to Gymnazo you must bother me. Don’t it’s not just should be there. And most the time, typically with a decision maker type of client, they’d like just give me the the nod, like appease me, okay. I know. And they don’t say anything. I go and bother them. How’s it feeling? How’s it feeling? And by Round Round, Round four of six rounds, they say, I kind of I don’t annoy them. But I’m on like, I’m here. Like, you know, it’s been bothering me. What motion pattern, give me the opportunity, you know, especially during a workout, why the clocks running, you’re feeling good. And most of the time, it’s just changing a simple angulation. From afford lunch to a lateral lunge. Or just from a straight forward lunge on flat floor to lunging onto a six inch box, just to give that knee that much less stress. Because the goal is to come to the next workout. It’s not to fix it, they just keep coming to workouts because movement good movement makes better movement. Worse movement makes even worse for movement. I mean, it’s so simple,
Mitch
but how often will even just watch that person when they tell you that? Because it’ll be like, Oh, my knee bothers me a little bit. And he started asking questions. And you can tell they’re getting annoyed that you asked him questions he you back off a little bit. Especially on like a first encounter type situation. And then you see him like, you know, two or three exercises in and just start watching him lunge or squat a little more gingerly, or run a little bit less speed. And then you go up to him, you approach them. And then you have the opportunity you have right there. And you’re like, Okay, try this. And they’re like mind blown.
Michael Hughes
Typically, yeah, they’re mind blown. Like, they almost don’t believe you know, this doesn’t happen all the time. Right? Sometimes you really have to search. That’s all I had to do, right? Yeah, but a simple toe in is simple. But just push your hips backwards. When you lunge forwards. Like that was another one today. Push your hips backwards and your launch forwards.
CJ
That’s actually quite a tough coordination. It intersects because you’ve got multiple drivers in a movement. Let’s let’s dive into that a little bit more. Talking about the motions, you provided some cool tweaks that takes away momentum or changes position changes the XYZ, like How far were you going and how high right? When else is it? Does it pop up? We know lunges, we know squats, we know what you say an image that somebody when they’re running around hopping around.
Michael Hughes
I rotational medicine ball throw. Yeah, that’s
CJ
a wild one too, because that’s the upper body core activities full body, but primarily upper body and core and then getting some knee discomfort.
Michael Hughes
Yeah, so is lateral facing a wall, the walls to your right side, 30 Minutes Ball to your right side, it’s pretty much the backswing of golf. And you throw that ball. And if that foot is pre positioned poorly or too much internally rotated to begin with, or whatever the case is, and your spine rotates to the right, your hips rotate to the right, and that knee rotates too far to the right, and your foot doesn’t move, that knee gets into an out of sync spin. Easy, easily paying opportunity there.
CJ
We see it as degrees of freedom to eight, you have joints that are all going to give a little bit and some that are going to give a lot more of a bit you got an ankle that will probably give you quite a bit a knee that depending on which direction can give you a little bit or a lot. Hips can always give you a lot in pretty much all directions. If you got some healthy hips. And they’re pretty mobile. You’ve got the lumbar spine that should stay pretty stiff. Yeah, you got the thoracic spine that typically should have quite a bit of availability at 12 pieces right there. That should tell you something about that part of your spine. You get the shoulders you get your elbows, you get your wrist. And I think where people run into discomforts, athletes run into discomforts, is just, it’s not even necessarily a position. It’s a lack of awareness of position. Because you should, as an athlete, as a human being be able to be in a position and complete a task without much discomfort. But for novel tasks, or things that are very complex, your body’s trying to pattern and coordinate a lot of different movements at specific degrees, that we’re not focusing on our ankle or knee or hip or spine or shoulders or elbows and our wrists. We’re thinking about doing the task at hand and so our bodies to self organize, to allow that task to occur. I think where we find a lot of successes coaches, not just us, but coaches in general is seeing all those pieces work together in harmony and coherently or working, not in harmony. Like there’s there’s a disharmony here, something is giving too much, something’s not giving enough. Or maybe everything’s giving way too much. And we’re just hyper mobile. So when you’re watching somebody’s movement, I mean, if you’re looking at something like a medicine ball throw, and somebody is experiencing knee pain, let’s say they’re throwing the ball to their right side, and they’re experiencing the left knee pain every time they throw, what’s a probable suspect, or maybe something that you can just shift in awareness that will allow them to do that motion successfully, maybe not fix their knee pain. But maybe that knee pain is just happening off of a freak incident, like they don’t even have knee pain. But this is the first time they’ve done a rotational throw. And now that knee hurts. What’s something that you might provide as a tweak, or what are you visioning, envisioning when you see somebody doing the right rotational throw and their left knee hurts?
Michael Hughes
Can we do like a roundtable just keep going round in a circle until we exhausted?
CJ
Let’s do it? Yeah. Let’s wind this thing out.
Mitch
I’ll look at the left knee and see if it valgus as well, because it tells me a lot about hip stability. Right there. hip strength, too.
CJ
So left knee may be caving in?
Mitch
Yeah, exactly.
CJ
What else might we see? We’ll come back around and I think give some tweaks. But
Michael Hughes
I want to see if the, if the foot goes through e-version, the left foot
CJ
connection through. I’m gonna see if a motion just a different joint
Mitch
Yeah, I’m looking for a bailout first to direct me.
CJ
So looking for bailout. So somebody caves in foot, maybe not taking enough pronation. Or maybe it’s holding back. Or he said, E version, pronation. Maybe their thoracic spine isn’t twisting at all. They’re all armed driven. So they’re really stiff up top and their arms are trying to do it all. Okay, and the bailout anywhere else?
Mitch
Lack of rotation from the hips, like just the inability to spin it around to get that ball to spin around. Yep. In conjunction with the spine.
CJ
Cool. What are a few tweaks? I think that addresses kind of lower the upper, the mid section? What are some tweaks that you might offer to if you see that knee caving in, and they’re getting that medial left knee pain? What might you offer as a tweak to just mitigate that pain, maybe not fix whatever’s going on. But to mitigate that discomfort?
Mitch
I’ll look at their stance, like, are they in a stance where the glutes are there to actually assist them? Or are they just in a more upright position where like, they’re just not really helping out. So I might even just put them in like a slightly flexed position at the knee and the hip just to load the glutes more, and then just have them go through the rotation, or emphasize a foot driving through the ground even more, and start using ground reaction forces. And for assistance in that exercise,
CJ
that’s a wild one too, because their feet are already touching the ground. But just by pushing your foot into the ground, right, that cue now they’ve got grounded stability, their feet are in contact with the ground versus they’re just trying to throw a ball, right? Their feet might be touching the ground, but are they actually communicating with the ground, right? So just adding some more flexion the hip turns the glutes on and read more load. And now pushing your feet in the ground. Now they’ve got some active tension. Connection. What else? Gosh,
Michael Hughes
that was a pretty wicked one, I’m gonna go super simple. pivot off that left foot, turning it in, whereas just let it just let it rotate like a baseball swing, let the back foot pivot. Don’t don’t keep it fixed.
CJ
What’s that facilitate? Why? Because that’s probably the easiest one,
Michael Hughes
right? Yeah, as he’s one, it basically removes any need for that knee to go through a valgus sink type of position, it should go through a valgus just going through probably too too much in this example. Yeah. So take it out of the equation. Literally let the toe pivot on the ground. So now that he rotates with the throw,
CJ
relatively, there’s no extra knee movement that’s actually in line with the foot side
Michael Hughes
of the knee is going to spin but it’s gonna spin in sync with the hips. What does that do?
CJ
So it takes away the knee pain. But now what does even facilitate me even more so
Michael Hughes
well, that we facility even more right hip rotation, more thoracic spine throw, just the whole the whole body’s now has more ability to rotate to the right. With this throw, we essentially took out the left abductors. I mean, simply put,
CJ
it’s everything spiraling together. Right, right, we can even combine the two, right? Now as we add more cues on top of this is maybe too much for somebody brand new, so maybe just doing just the pivot, just maybe just the foot pushing into the ground, right. But then you throw both of them in there. You get your right foot pushing into the ground, you get your left foot pushing in, but it’s pivoting. Now you might have influenced their power and now they feel like holy, although you’ve unlocked a beast in me, the ball should be louder against you. There you go. That sound tweak, sound tweak, what do you got? I would say let’s even just add a step. So if they’re lateral facing the wall, and I want to facilitate more rotation, maybe I’ll take their left foot and step across their body. So now that left leg is helping to decelerate ate, because it was planting that foot, it’s not having to stay back behind the the step through, now they’re putting their right hip into more internal rotation. And they’re going to force everything to go towards the wall. So at least if they have too much power, then they get the wall to stop them. But now they’re also taking away that valgus thing of the knee, and now allowing that foot to make good contact with the ground, it’s also allowing them to get more rotation. So if they’re getting that crazy knee discomfort, now they come across, it might be too much coordination, it might be that we’ve need to change something like, let’s face towards the wall
Michael Hughes
Right, just change your body position to the wall
CJ
instead of lateral facing, which creates a lot more rotation you forward face the wall and now throw from your hip, your knee is not going to be asked to go through as much decelerating with the abductor with the foot. With that right glute,
Michael Hughes
can you just give two tweaks in one turn. So
CJ
we’re gonna get started getting some more complex stuff right to fers. Now, anything else we might throw into that tweak?
Mitch
I’d be really interesting to even just put them onto like a cable machine and take the ball out of it, you take the fact that you have to toss something away from your arms and catches you take away that kind of spatial awareness aspect of it. And you just allow and just swing a handle across your body. And just tell them to just stay balanced between your two feet. And don’t let your weight shift from left to right.
CJ
Sounds to me like you’re taking away some of the momentum. Yeah,
Michael Hughes
exactly. Yep. The range of motion is going to be less. Exactly. And then what Yeah, exactly.
CJ
constant tension.
Michael Hughes
Yeah, I’m gonna go simple. Once again, let’s say both feet are, are parallel, excuse me, perpendicular to the wall, right, so you’re truly sideways facing the wall, left foot toe in 22 to 45 degrees. internally rotate left foot position. So now when you rotate, right and keep it there, and then now you throw to the right, you have so much more capacity, range of motion to actually rotate through that left hip, and the left knee, probably never even reached its end and range of motion.
CJ
Nice, beautiful, it’s gonna feel funky. Let’s go one more with this. I’ll try to keep it with one. Take the throw out of it, like Mitch said, but keep the medicine ball so that they’re still feel like they’re doing the activity, but you break it up into the parts, the load, the transition to the explode, and the finishing position. So if you’re going to launch that ball back, sometimes just that release and having to react, your body’s going to brace if you’re not used to throwing stuff and catching stuff, you’re gonna lock up and go God, some people don’t like throwing things. I don’t know, it’s weird. I love their own shit. It’s great. But some people don’t like doing that. So just by taking that same medicine ball, you take it to your hip, and you take it up to your right shoulder, and you take it down your left hip, take it to your right shoulder, and you start to just work that diagonal line. So now you’re starting to integrate your foot motion, ankle motion, your knee motion, hip motion, and your shoulder, thoracic spine, all working down the left, all coming up to the right. And once that pattern has been established, then maybe we go for a heavier weight. Or maybe we go faster. Or maybe we add a step. You don’t necessarily need to throw you just start adding in some more extra momentum. I think with the polling machine, that’s a great way to go about it. Because now you can start to up that weight and get that thing. That’s a fun one medicine ball, the weird one to have a knee pain in but it happens often. What about a typical activity like a lateral lunge, or a lateral shuffle, we get a lot of people popping up with lateral knee pain, medial knee pain on a side shuffle. Sometimes when we’re initiating that shuffle, so the acceleration, sometimes on the deceleration, and many times on the transition, when we stop, we’re fine. But it’s the in between that we’re kind of locked up. What maybe a tweak or something you’re looking at. Okay, just open it up, open the floor for this one. When somebody’s experiencing, let’s say right knee pain on a lateral shuffle both right and left, right and left lateral shuffle, right knee pain, push
Michael Hughes
and acceleration and deceleration. I’m ready to go. So when someone’s right lateral is shuffling. And it’s on landing. So when they foot, the right foot hits the ground, and they start to go the other way. And they start to go the opposite way. So or it’s just it’s just when the right foot hits the ground, and they’re ready to keep to keep going. Right. Right. But it’s so that it’s that first landing zone where they have to decelerate a little bit, right, we’re still keeping right moat, right momentum. So it’s not a hard deceleration. It’s just, it’s don’t fall on your butt DS celebration. I really want to look at like, what is the what is the lateral leg doing? You know, it ban TfL, glute medius lateral core. Is it really is it is it taking that absorption is it taking the shock? Are they’re very stiff on the upper side, you know, that’s what I’m kind of looking like are the legs super active in the upper body just kind of just blah. And then I want to know can if I put the right foot in front so I go to our xx lateral shuffle, which means right foot in front of the left. So it’s a split stance, lateral shuffle. Does that make it better? Does that make it worse? When I put the right foot in front, I’m asking the lateral right side to engage more, because it’s it’s more hip flexion. So therefore, it’s going to require those muscles to show up more, if they can show up more, probably going to reduce that pain. If it makes it worse, then I’ve got an answer that that lateral chain, that posterior lateral chain is easiest to bound down, not giving any motion, and I just asked to give it more and said, Fu, I’m sorry. So I’ll just go to a left foot in front, why the shuffle to the left, or to the right skewed to the right, you know, and that should, by definition, to combat that pain down. So that’s what that’s going right lateral. But if it’s on push off, I hope that same story solves the same problem with on one foot forward. Exactly. I hope it was sometimes it won’t do that. You know, but you’re hoping you can get one stone with two birds in the sense
CJ
to get one stone to bird that’s pretty cool. Don’t birds, it rocks.
Michael Hughes
I said that wrong. But you know, two birds with one stone, I love the podcast format.
CJ
Okay, that was great. So just started stance. And now we could really go into the intention, specific biomechanics, what’s going on. But in the moment when you’re coaching, just give them something that will mitigate some of that discomfort. And if it is switching your body position, if it is taking one foot forward, the other foot forward, whichever one feels better go with that one for the day. Now, when I was learning about coaching, physical training, I was told, Don’t go for what feels better go for what you’re trying to go after. Like the specific position. Like for bodybuilding, right, if you pronate your hand or supinate your hand, you’re gonna create a different bicep load. You don’t ask the client, which one feels better, you give them that. But when we’re talking about movement sake, and somebody’s just trying to travel back and forth, it’s simply about building a better experience and allowing your athlete to experience more success. Knowing that you want to be able to get them to a neutral stance inside shuffle without pain. But in a group workout, maybe don’t have time to address that full conversation. It may just be Hey, do this for me. Feels better go get it. Perfect, right? And then we’re having the conversation afterwards. Like, let’s get to the bottom of this. I think I know why that helped you. I think I can help you even further. Mitch, what do you see when you talk about like a lateral shuffle with that right knee pain? Or what you’re looking at
Mitch
a look at? How they just decelerate that knee pain. So when that foot hits the ground, like what does that hit? Do? Is that foot hitting really hard on the ground? Is it just slamming on the ground? Like you’re slapping the hand on the table? Or is it kind of like a cushion? Like when a car goes over at a speed bump or something? Does that just cushion that ground reaction force on there? And does it absorb it, because if it doesn’t absorb it, then you’re probably going to feel some some stuff in the knee. So it’s like I just try and teach them at first like when your foot hits the ground, try and land really softly and just sink, see your head back, for the most part. Because you can see like, I always will look at the knee like there’s a knee really drive forward, like excessively over the toes. Like not wrong, unintentionally. Maybe though, not not necessarily wrong. But if you’re experiencing knee pain and probably did an expression, it’s probably means you probably shouldn’t necessarily be doing it over and over and over again, if you continue to experience pain. So it’s kind of like CIPA hit back a little bit, get the muscles that Michael are just talking about to actually assist the knee unloading. And then that might even solve the other pain too. Because maybe, you know, maybe you’re having knee pain on the other side, too. Because the right knee was hurting for so long. Now the left one starting to do more.
CJ
Right? How often does that come up? Where? Oh, yeah, sometimes this knee sometimes it’s the other knee. It’s never both knees. But today, they both kind of ache a little bit. Yeah. And it’s like, sorry, Coach, I don’t really know which one’s hurting today. In fact, they don’t really hurt today. They hurt yesterday. But when I came in here, they know they’re not hurting anybody. Like that’s a wild thing that comes up too, because I’m like, this is a little acute pains, but they pop up often in switch knees. And it may tell us that there is something missing from their settling into the ground, right, that they’re not able to just slow down and feel they’re trying to do something too quickly.
Mitch
Yeah, I mean, I think about like a car. Like if you don’t have any shocks on a car, you continue to go over just bad roads all the time and go over speed bombs, like everything in that car is gonna start to loosen up and rattle. The driver experience is terrible because you’re feeling everything from the ground. And eventually that things are gonna start falling off, right? Yeah.
CJ
It’s one of my favorite tools to show this to be settling to the ground feels like it’s using a vibration plate. Instead of vibration plate and lock your knees out. You’re in, you read up to your eyes, your nose becomes itchy, your eyebrows are fluttering you’re like ah, and then you squat and like, Oh, my lower body is vibrating but my upper body feels very little. that simulates that chakra that ground reaction force when you’re hitting the ground. If we don’t have those shock absorbers like you were saying Mitch, is going to rattle the entire chain up the lumbar spine and now you got knee pain and back pain. And now you’re getting neck pain because you’re bracing your neck muscles and shoulder muscles. When you should just be letting you bodies sink and settle and slow down and feel the shock and drink to the feet to the hips. But not allowing yourself to brace so hard that you’re rattling the entire mechanism.
Michael Hughes
Yeah, it goes into this whole constant like flexor core while you do this move, and it’s like that, like, I get why they’re doing that they’re trying to get muscles to respond. But it’s, I think, you know, there’s better way, there’s a better way, let them respond by doing what they should you train them to respond, don’t force them
CJ
or even explain why we’re flexing the core. So because when you think about throwing something, as an athlete, you do flex, but you’re not consciously aware of it, you brace a little bit so that you can get the power everything’s just flaccid and loose, of course, it’d be like,
Michael Hughes
the other end of the spectrum, right?
CJ
You got to kind of squeeze a little bit. But if you’re just saying squeeze, squeeze, squeeze internally on somebody who’s just learning to move and to train, they’re gonna flex everything, and they’re gonna stay really braced. And wait a second. Let’s there’s a spectrum of this, you don’t get to flex 100% or 0%. Maybe just notice your breathing. Notice when you hit the ground? Are you still breathing? Notice when you hit the ground? Are you just trying to get exercise done? Or are you experiencing your legs working? Do you feel your feet, a lot of people are just so unaware of their feet, not because they don’t look at them, or they don’t know that feet. But because they’re locked away in really tight tennis shoes, and their side shuffling and they’re in a, they’re in a running shoe that’s designed to go forward. And now there’s nothing wrong with their knees, their feet are in chambers that do not allow them to pronate into absorb the shock. So now that the foots locked up, now the ankle in the knee or next, or the ankles, probably stiff in the shoe. So don’t tip over roll an ankle, the next thing is going to be the NIA, that knee is going to valgus Varus. It’s going to go all over the place. Or maybe just stay straight, because it doesn’t want to load up right. So there’s a lot of things to consider with movement. And I think we kind of got down to its momentum, its position. And then it’s essentially your, your direction, your distance and your your height. Where are you going with your movement and your matrix, your X, Y and Z axis, right. Any other movements we want to bring up in this one that are common news conference. I mean, we know squats we know lunges. But the people listening may want to know more about jumping
Michael Hughes
is like the jump box jumps kind of a staple drill in fitness, especially nowadays with you know hits style training. And there’s a lot going on with a jump because we don’t typically jump in our day to day life. A two foot takeoff to two foot land. It’s very rare. It’s very rare. But we do it maybe ad nauseam in some of our workouts hundreds of times, hundreds of times. So it’s really interesting how the body coordinates a jump we like to leap leaping is very common, excessively common. So how do you coordinate both muscle groups when you have acent asymmetrical tension in both legs? Because you sit funky you know driving a car. The legs are in different positions once tote open on the gas pedal once hanging out tucked in tight whatever the case is
CJ
or has you right calf was so overdeveloped? Oh no, no,
Michael Hughes
you know why you’re right glute constantly a little tighter than your left? I don’t know. Probably because the car design is a toe open car pisses me off. Come on people,
CJ
you know, damn cars, pedals,
Michael Hughes
you know? Hence why I like self driving cars so much. I’m just letting you know about that. You know,
CJ
so I like manual, you get to use both feet there. Yeah. So
Mitch
yeah,
CJ
we involved
Mitch
brought to you by Tesla.
Michael Hughes
So it’s to realize it that you know, when you squat, when it’s it’s a it’s an initial range of motion, squat to a jump, and then you got to decelerate that most often backwards. Because you jump on to something and then you jump off you jump posterior Li. And that’s how just, we could really break that down. But it’s a very, it’s a it’s a foreign thing for anyone over the age of about almost a five.
CJ
But it’s something we should all be doing the entire bit of our life, I would say so yeah, it’s an important skill to be able to, if you need to run, get away from something, get out of the way. If you’ve never done that, jumping, we’ll help you do that. Right. But at least we’ll help you do that. Right.
Michael Hughes
But in a bilateral stance, it’s it’s No, I’m just saying like it’s more for play than it is for an actual function. But I watch my awesome two year old he jumps all the time. He’s constantly jumping, any soft surface, he just starts jumping. So it’s like interesting to learn from it. I didn’t teach him that, you know, soft surface, he just starts bouncing. It’s fascinating. Seriously, every time at dinner, we have a little soft pads. He literally sees he’s done with eating food starts to jump in. I’m like, Man, I wish I could really do that right now. I’d break the bench, but do you just jump in? And I think it’s exploring the freedom of movement, the freedom of that. That constant like repetitive inertia, you know, feeling those Achilles those Achilles tendons in US Since taking that load, it’s almost a free and free energy. It’s really fun. It’s really fun. Obviously, that’s why it’s doing it’s fun. But to break that down in a 45 year old client, you know, and to say, why is their knee bothering because there’s so much going on from the calves, I mean, from a fascial, tightness to an inability to understand stacking of the body, to it’s just, it’s just a ability to, they just can’t jump backwards, they just don’t have the coordination to land it in a relatively extended position.
CJ
And I think we finally got a lot of things a lot of success is that we need to understand that if somebody is hurting in a lunch, somebody’s hurting in a shuffle if somebody is hurting in a jump, up or down. There’s progressions to that. There’s it’s not just a jump as a jump lunges, lunges, squats, and squats. Yeah, nicely said, there is other ways to squat. And we said we could change position, whatever. But let’s take let’s take the jump as like a high level progression, and say, Alright, jumping is hurting this person. Do we take away the jump and say, oh, let’s just not jump today? Or do we say something along the lines of? Well, instead of jumping in the air, let’s jump on the ground, where you’re literally just lifting your heels off the ground, and then having them come back down. So you squat, you come up and lift your heels, you squat, you come up and lift your heels. So it’s giving you the motion of coming up and coming down. You’re just taking away a lot of that ground reaction force. So that impact but also taking away that momentum, and things that go into making why that force may be tough to decelerate. So you take away the impact, you take away maybe some of the range of them having to land coming down and say, maybe we can add load into a squat. So now they’ve got to decelerate with a 10 pound sandbag on their chest. And that’s okay, I don’t feel any pain. So we have a progression up to a jump. Let’s now maybe we can do 20 pounds. The next week or the couple weeks later, they do in 30 pound squats. And they’re able to decelerate with no pain
Michael Hughes
up to a toe raise and back down. Exactly. Yeah,
CJ
I’ll bet if they take that weight off them, and then they go for a very small jump. Maybe the first five, they’re like, Oh, God, this is scary. But they’re like, wait a second, I’ve learned how to decelerate. It’s not that I can’t jump. It’s that I didn’t know how to land. A lunge, same thing, right? If you take it to a lateral lunge that somebody is getting knee pain, sure, you can change the angle of it. Sure, we can change the height of it, like you said, putting them up on a box. But we could also just pre position them into a lunge, and then have a move. Right? There’s a lot of ways I think that we all as coaches, consider the progressions, but we may not have the confidence to deliver this because this person doesn’t want to do it, or they’re afraid to do it.
Michael Hughes
Yeah. Or like it’s it’s an on off switch. You’re the jumper you don’t jump. Like so much of what we do. You know, we to us, there’s at least 10 different ways to tweak an activity. Right, we use the 10 off spatial essentials, we all learned from the gray Institute. And we’ve incorporated it into our training extensively. But we so cherish and hold off on tweaking one of those 10 It’s the action. Don’t change the action. That’s the last thing that you should change. If it’s a jump, keep the exact same movement pattern. But except just go up on toes come back on heels. You’re not changing the action. No, you’re changing the height, not the action. medicine ball. We didn’t change the the rotation Mitch didn’t change. He just changed the the modality. Like there’s so many things I want trainers to get from this podcast, don’t change the action, change the other nine. You don’t even know what the other nine is. That’s why should go into the NDMC course multi dimensional movement coaching course check it out, okay?
CJ
Because it makes plug.
Mitch
But then you also start going into what people have told them their whole life is like you can’t do this. Because you have an injury. Like how many times do people come to us? And they’re like, Oh, I was told I can’t run or I can’t launch? I can’t do this. And you’re like, Well, who told you that? And it’s someone that they have seen in the past that said, Oh, you will never do this again. And you’re like, why? Like, why now you have this fear. You have this block up and it’s like now you’re kind of fighting. It’s that. But it’s like we can get you to that point. For the most part to a better better point. But it’s like, yeah, how do you do it?
Michael Hughes
Now like that, yeah. And that progressional stance is really there’s so many different avenues. So it’s crazy
CJ
brings a point up yesterday, you had programmed a, an amazing workout for one of your clients coming in. But the timing is out. Here’s exercise. Here’s the five exercises we’re gonna do. Here’s the little restore shears you’re going to do and I have this whole game plan. The person comes in, shows up with knee pain, scratches your whole plan. What tell me more about that because I thought that was a cool transition because I saw the person moving at the end of the session. Enjoying enjoying the workout.
Michael Hughes
Yeah, we hit all five drills. Not as many times as I wanted to, but we hit all five drills. So first question is I always ask How you doing, personally, and then asked how you didn’t physically. And you do not ask a client that comes you enough times they’re gonna be real with you. It’s like, got my knee pains back. Hasn’t been there for a good three weeks. Yeah, he’s had knee pain, you would call it bone on bone. It’s not technically bone on bone, but it’s a bad knee. And yep, that’s great. When do you feel it does walking in here? Great. When the foots in front of you, or when the foots behind you when that knees in front of you, when you hit the ground or when you push off the ground. This is when I push off. Awesome. I know so much more about the potential muscle groups fascial lines that are influencing that knee negatively. And from there, I deduce I want to probable suspects another thing that we are taught right, there’s so many options, but there’s certainly ones that are more probable. So when after his quad and when after his his Lateral Quad was the tightest after some basic foam rolling palpation Lateral Quad was the tightest didn’t have time to do a whole movement assessment on him. But I did it I put him in that stride stance. And I had him just push off who gets me so I said what the probable says but we’re the biggest players quadricep hip flexors. biggest ones. Lateral Quad was just tender, just tender. When the muscles tender to me. It’s a dried up sponge. Just got back we just got back from a vacation. What’s your, what’s your sink was that sponge look like? deformed, crusty, rigid. You try to move that sponge, it resists you try to fold it in half. It doesn’t unfold, it stays folded, right? That’s not responsive. So I wanted to hydrate that muscle. How do you do that foam rolling? How do you foam roll? That’s a different podcast. But and I just went after that on the table, I got some soft tissue skills, I’m qualified to do that, when after it, loosened it up took about 15 minutes went to the cage or to stretch, put them in the exact same position that hurt him walking and drive his pelvis laterally significant stretch, significant stretch how to rotate his pelvis left and right significant stretch, especially rotating to his right is right and he was behind him. So it was a fun biomechanics of walking significant stretch, had him let go of the cage to the same stretch again. But he had a self control zone balance. So it started reteach tension, even in that stretching position, walked out of it. Three or four steps, ask him How’s it feeling? That’s gone. Let’s go to work. Took us 25 minutes, still had another 35 minutes of a workout left. When literally in the past, I would have just said, All right. Let’s go to DEF CON for let’s figure out how we can sit down this whole workout and do you know take it whatever the case is. So the cool thing is, not only did I get to go to my programming, but that client now says I’m going to bring up more things to my coach. Because he’s going to help me he’s going to challenge me with more stuff. I thought that was really, really awesome. And something that took me a long time to learn that don’t get freaked out, put an embrace it. In fact, it’s not to embrace it too much. To me, I embrace it, let’s just let’s really go after this really spend the whole session dialing that needs. Now let’s go to the workout. That’s what he’s here for. Gas was a great, that was a great case study. And I feel so good after work, got to give someone a workout, make them feel good and reduce a musculoskeletal dysfunction in one hour. What a cool session.
CJ
The beauty in that too, I think is when you get back to the training, you’ve relieved some discomfort. So now those reps of the program that you had dialed in, is going to make this person better, they’re gonna be stronger because they’re moving from a more functional place in their body. Things are relieved versus how many how often you show up to work out like how things just kind of hurt, I’m going to get through it today. And most time, that’s okay. But if you get something like that is like a knee or a lumbar spine, or like a deep shoulder pain, it’s probably going to feel a little bit worse if you just keep cranking on it and don’t address it. So it’s worth having that conversation of saying maybe we do need to take a whole hour Do you want to take this hour today just just to restore the leg? Or if you came in here to work out? Let’s see if we can get the restoration and then cricket.
Michael Hughes
And I did ask him I said I said do you want me to go after this knee and then see how much time we have left to go to the workout? That’s my first question. I gotta say say that I asked. What do you want to do about this? says let’s go for the scruff after the knee because this workouts either gonna make it worse or I’m going to still live with it once the workouts done so I’d like to get rid of it. So the cool thing is my probable suspect was correct. Now there has been times when my problems sector option A was not correct. And I underutilized. 25 minutes of an hour So I have to ask again, I have an option B told me to go after that one. But it’s all still learning. It’s all still that’s the theme. But yeah, you can’t you can’t expect perfection as you’re learning this, there has been times where I spent the entire sick, I went over 65 minutes, and I just didn’t get it where I want it to be. And you have to live with that choice. And your client has to live with that choice to. It’s not perfect. I’m not saying my tracker is not perfect, but it gets significantly better, every single day. So it’s all those coaches out there, you got to start trying, you gotta start trying. If you don’t have the information, it’s it’s out there, all three of us are not physical therapists, we do not have graduate degrees in any sort of form. We are trainers prove just know the human body very, very well.
CJ
Well, soon. Mitch, I have a question for you. I see you do this in your group sessions quite a bit about having conversations about discomfort or pain and even said before, like sometimes I’ll go over somebody I’ll check in check in and and then you wait for something to arise like they stepped down a little bit or they go a bit lighter, or they go slower. And that’s your time to open the conversation. How does a trainer How do you go about addressing this with with athletes? And then what’s the conversation like when you know, there’s something that you can dive deeper into to help them get out of that discomfort? Or maybe to make them more aware of what’s causing it?
Mitch
Do you want me to pick up on this? Right, right when they start to experience the knee pain?
CJ
Yeah, yeah. So you notice from across the room, like that person’s mood a little funky, and I bet their knees hurt. I’m gonna go check in with him. But
Mitch
so yeah, I’ll just do that same thing. I’ll be like, Hey, I just I’ll ask questions. I just always starts with a ton of questions. Hey, I noticed maybe you’re not going as fast as I saw you go on earlier, or lunging as deep or going as heavy? And then those you go, yeah, my knee starts to bother me or something like that. Oh, interesting. You know what, he’s literally just kind of just say it within the conversation like, Hey, what did you just try to lunging over there? or what have you tried that? Does that take it away? Oh, that’s great. Awesome.
CJ
seems so easy that way you put it like that
Mitch
I think it starts at the beginning, though, because I don’t try and impose anything on them at first. Because, you know, if you’re a new new person going into a facility, I think the last thing you want to do is trying to be sold on something. Like I’m just trying to experience this gym and workout and see what everybody’s been talking about, and see what everybody loves about this place. And if I go in there and try and sell them on like an exclusive or semi private or something like that, and be like, Oh, hey, you got to do paint, you need to do this, like, depending on who the person is in there. And the personality traits that I would like, that might just be a total turnoff. And then they even come back into the door. So one, it’s like, let me not be the salesperson right away, let me just be a good coach to first get you through this workout, the best you can. And if any hiccups along the way, like maybe start to experience knee pain, more knee pain, and I start to see moving a little bit differently. Well, then I’m gonna go in there and offer and be like, This is how I can help you. And I can help you because maybe this and this is going on with you. And if you stop here, it does x y&z of your body. And that’s why it feels better. And then they go through the workout, being able to push it like they wanted to push it originally. And then they come out of it going, Oh, wow, like cool, like that guy really show that he can help me without actually saying I can, he can help me. And then they’re gonna come back next session because one, their knee doesn’t hurt nearly as much as it could have, potentially. And they got a good workout, hopefully.
Michael Hughes
Yeah, there’s a lot of opportunity that you said, like, post workout, post workout, huge, huge, huge, you know, because you’ve given them something that at least route arouses their sense of curiosity. Like you’ve done something that no other coaches down, or at least that I’ve experienced. So you got the opportunity post cooldown, you walk up to them said, hey, you know, I just want to touch base with you, which I know, we all do. And that’s our opportunity to quote unquote, upsell, but what it really is, is offer an opportunity for that person to literally have an opportunity to take care of this issue versus just work around it. And the workouts we are, we’re going to work around it so you can have the complete workout. But what then, you know, is a warm up and cool down. gonna fix it. Sometimes it does. Not all the time, though, right? Sometimes it needs much, much more. So to walk up the person, you already have a little bit of ammunition in a positive way to be like, Okay, so this is what you experienced is the motion that you were doing. Here’s the motion that I gave you. Here’s my story, right? Here’s what I think is going to happen. And here’s what you can do about it. Option A, option B.
Mitch
I think one of the bigger things do is that post workout session, I think that’s actually probably one of the most important aspects of it, especially if you just take time away from the group. So once you get the whole group cooled down and warmed up and you just spend a few minutes with that person, just give them a little extra TLC and go just what you said. It’s like here’s some probable cause. says Now let’s put a little more focused intention, and maybe some more specific foam rolling and stretching or a movement pattern or something like that, that you know, you can help. And then you haven’t go retest, whatever they were doing. Just be like, hey, you know, does that feel better? If you do that? If they say yes, all right.
CJ
Yeah, the powers and the drip education is you said, Well, I can tell this person, I can help them without telling them, I’m going to help you. Because some people don’t want Nestle that help right off the bat, they just want to experience and they want to explore Is this the place for me and it that drip education in that warm up series, or even in the cooldown series that pre workout that post workout, it’s where a lot of times in that warm up, you know, somebody’s going to be experiencing discomfort, and it’s probably gonna be the knees, the back, think your body is warming up, it’s waking up, especially early in the morning. So that’s an opportunity, as soon as you say, hey, if this is bothering your back, this is bothering your knee, this is bothering you in this place. Here’s what could potentially be going on or try this. And just by offering that it’s the power of suggestion that I think is what builds that trust and that that confidence in I can help myself. And I just need to help people to help me help myself, as you offer that guidance saying, Have you tried this before because as movement practitioners as movement therapists, as coaches, as trainers, we see the body in a different light. And many athletes coming in, they don’t have that background knowledge of anatomy, physiology, and biomechanics and an application in a fitness setting. Maybe they have an initial, I know where my muscles are. But it’s not an connected web of understanding of my knee is connected to my butt is connected to my quad is connected to my calf is connected to him at the bottom of my foot is connected to my intention of what I’m trying to do. In the cooldown, specifically to or when we’re stretching and mobilizing. It’s kind of like putting yourself as a coach in the athlete’s body and saying, If I had this knee pain, when I’m doing this activity, how might I shift this for myself? How might I move my hips in a certain way to mobilize to then relieve that pressure discomfort at a knee or somewhere else? And I think that is the ultimate power is to be able to put yourself in those shoes and say, If I experienced this, what would I do about it? Or how might I explore this. And if we can offer that suggestion and that exploration in somebody takes that bait, and then they feel it. They’re like, Oh my gosh, what was that there’s an opportunity to now expand that to a deeper routine or practice that then solve the discomfort. But we were not our number one job isn’t always to solve and to fix, especially as group coaches or leading a circuit training, number one thing is to allow somebody to have a great experience and a fun time and to feel supported, and cared for. And so if you can, if somebody comes in and just wants to work out, they don’t want to fix the damn thing. Don’t fix the damn thing. But drip the education as we go along, announced it to a group announce it to everybody not listen to that person who doesn’t want that, that support yet, because they may have had lack of success from other practitioners and trainers that they don’t trust you now, but they’re giving you an opportunity to say, I want to have a good time I leave you’re having a good time, I’m going to come back. Now we start to build that rapport, that trust to open that conversation. Let’s let’s dive deeper and fix this thing.
Michael Hughes
That’s huge. I mean, literally, what you said is absolutely huge, you know, forcing someone to do something. If someone has that type of chronic of condition, and they’re still coming to a facility. You’re not the first facility that they’ve been to, you know, they are diehard on moving until that joint screams at them so bad that it messes up with their own psyche. And they’ve lived with it. And they’ve made a decision in their mind. This is what it is. And if you try to force it, yeah, that’s, that’s the whole. That’s the whole behavioral study that we spent a lot of a lot of time on, you have to win them over. You don’t force them, can’t force them. Sometimes it takes a long time. We got clients for years, finally get an opportunity to get that one on one session with them, but semi private with them.
CJ
I wish I would have done this years ago, right.
Michael Hughes
And that’s typically what they say. That’s typically what they say. But you can’t go back, you can always say great. Now if people started to beat themselves up like Ash know why it was in here. Here’s what it’s like, you’re here now. Can’t stop the past from you know, you can’t change Excuse me. We’re in the current and this what are you going to do about it? And then people get too excited. I want to change it tomorrow. It’s like that’s been here a long time. Hang in there. And we’re really teaching you to write with your non dominant hand. It’s going to feel awkward, and in fact, it feels awkward. Celebrate the awkwardness because that means you’re changing something that’s not your normal, which is good. It’s it’s a it’s a it’s a process. You know, we’re saying we in this pocket, we’ve said a lot of times oh just gone. Take a step back, you know we can remove a situational discomfort. But to solve the chronic drip is something that takes a lot more focus. But we still have to accomplish over and over again.
CJ
Well said, well said, well said, gentlemen, it was a pleasure talking to you guys about knee pain and what we do about it and always reflecting on our own practices and continuing to evolve the practice of working with people in pain in people who aren’t in pain, and just helping them move better, and essentially build the vitality and their life to thrive as long as possible. Any closing remarks, you want trainers to know people to know about about their knees about knee pain about how to how to bring this up with your trainer or even a trainer to bring it up with your with your athlete?
Michael Hughes
Biggest thing is asking questions. I think Mitch said that a lot like ask questions. And listen, listen, be of amazing listener. Because sometimes we talk too much, because want to spit out some information, or spit out the wrong information, or too quickly or step too far. So listen.
Mitch
Don’t think you have the answers already. Always be looking for more answers to be able to solve problems. I think, man, you know, I feel like I’ve gotten stuck in it, where you kind of get stuck in your own your own path of thought, got stuck into thinking my own path of thought and like this is these are my walls. And it’s like, Wait, hold on, like, get rid of these walls. Like there’s so much more out there. People are helped in so many different ways that I’ve never even thought of that I could learn from and bring into my own practice. So don’t be opposed to listening to other people, even if you may initially object on their, their train of thought or anything like that. Like, feel it out and, and learn if it’s the right thing or not.
CJ
Beautiful like though, I think, see what you see and know what they feel. Use your eyes and use yours. And you said listen, you can’t feel something for somebody, you can imagine what it feels like. But the best way to know is to ask and to ask him to give them permission to express discomfort. So many people feel like they complain when they’re talking about their pain. And they’ve set up for years and years and years. And they think that they’re just a broken record about their knee pain, but let them know that what they feel is entirely theirs. If it’s pain, it’s pain. If it’s discomfort, it’s discomfort. If it feels great, it feels great, those sensations, those feelings are real. But if we see something that they’re not feeling, this is an opportunity to bridge the gap in their experience in their movement. I think she’ll see in the next podcast. don’t enjoy seeing those knees.
Michael Hughes
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