Working with Fitness Athletes and Low Back Pain with Dan Pope - Episode 19

Working with fitness athletes is becoming a huge new focus for sports physical therapy. 

One of the leading experts on the topic is Dan Pope, from FitnessPainFree.com. 

In this episode of The Sports Physical Therapy Podcast, Dan talks about working with fitness athletes, including knowing when to back off or push through certain injuries and how to return back to the gym.  We also talk specifically about low back pain in these athletes.

Full show notes: https://mikereinold.com/working-with-fitness-athletes-and-low-back-pain

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Transcript

Introduction: 0:34

On this episode of the sports physical therapy podcast, I'm joined by Dan Pope. Dan is the owner of fitness painfree.com. And one of the leading experts in working with fitness athletes. He's also a PT with me at champion PT and performance. So I get to see this firsthand every day. He truly is the best. And this episode, we're going to talk about working with the fitness athlete in some detail, specific to low back pain.

Mike: 1:09

Hey, Dan, welcome to the podcast. Thanks so much for joining us today.

Dan: 1:13

Thanks for having Mike. This is big. I am very excited. Glad to be here.

Mike: 1:16

I'm, I'm excited to, I mean, obviously, you know, we're, we're good friends. We work together all the time. So, um, I think this will be a really fun conversation, but, um, I mean, you know, Dan, this is Dan Pope, everyone, Dan Pope fitness, painfree.com. I mean, this is to me the guru. Right. But, um, I, I, you know, you're one of the trendsetters, you're one of the, the, the first people to kind of really, uh, put a little bit of focus. Of their career towards the fitness athlete, uh, which I, I, I think you've done an amazing job on, I feel like everybody wants to do this nowadays, right? I shouldn't say everybody, you know, like you can't talk in absolutes, but like, there's so many people that have interest now in working with fitness athletes and CrossFit and, you know, opening up a PT practice in a gym and all these things like this, this is so hot right now, but you're one of the rare people that have not only done it, but you're teaching it. Right. You have amazing resource on your website, your courses. Probably some of the best courses I've ever seen and taken just in terms of top notch with the content, but, um, you know, how'd you get how'd you get started in this sort of thing with the fitness athlete and your passion and stuff. Why don't you tell a little bit about, about that before we dig into the, the beef of this episode?

Dan: 2:27

Yeah, first and foremost. Thank you so much for all this compliments. That's amazing coming from you. I, uh, I've kind of learned my foundation is built on your teaching, Mike, so I'm just gonna regurgitate everything that you've, uh, taught me over the past 10 years now.

Mike: 2:39

Perfect. Yeah, that's the whole point of this podcast just to regurgitate all my biases. So this is perfect. So great. So

Dan: 2:44

it. Echo chamber. Right. It's good.

Mike: 2:47

perfect,

Dan: 2:48

Um, it's funny what you said, because you know, my origin story is not so original anymore because there's so many people are currently doing this, but, uh, I'm a meathead. I always say that I love fitness. You know, I was the weirdo that was reading about west side barbell and bringing in like old rusty chain. For my dad's farm because I had read about dynamic effort training and how they use chains. So I'm dragging like one chain that probably weighs like 13 pounds and one that probably weighs like 27 going inside a commercial gym with these rusty things, drag cement, or dragging rust on the floor, you know, being an idiot, putting like one chain that's too heavy on one side and the other side is too light, but still doing it. Right. Um, and that's the thing I've always been super passionate about fitness nutrition. And, uh, so I went to school for that. You know, I did exercise science, which was, you know, a clear passion for me and I loved it. And then the next step for me was personal training. And what I was finding with my clients is that they would get hurt. And I would say the majority and I feel pretty strongly about this. And it's a big part of what I teach on a regular basis with my courses is that majority of people I was working with have an orthopedic issue of some sort, right. Might not be immediately painful that day, but they have a history of knee pain. They have a history of low back pain every once in a while their neck pain flares up. And if you're a personal trainer, you're going to deal with this, whether you like it or not. Right. And it's probably gonna happen on your first day at work. It's a huge problem. Um, and we're not really taught how to deal with this. As, you know, re or excuse me, healthcare or, um, fitness providers, you know? Um, and that's a big problem because you're seeing it all the time. And I think the, the answer is generally like, go talk to your doctor or go talk to a physical therapist. Um, and at the time that's kind of what I said, and I didn't wanna try to rehab and step outside of my boundaries. So I'd refer out to local PTs and the PTs I was referring to at the time would just. To my patient. Of course, you got hurt. You shouldn't be deadlifting or you shouldn't be doing kettlebell swings, or you shouldn't be doing bench press and you in my head, I was like, this is a terrible relationship. A because I would lose a lot of clients cause I'm trying to actually get'em better. And I'm, I'm saying to a, you know, physical therapist and they're, they're saying it's my fault. Right. You know, but B it doesn't make any sense. You know, why is exercise with all these positives gonna be bad for all of your joints? Right? It didn't make any

Mike: 5:08

right.

Dan: 5:09

So, you know, it just, it led me down the pathway of figuring this out myself. Really. I was like, well, what do I need to do to be very good at helping these folks with pain, probably physical therapy school. Those are the folks that do it every single day of their life. I probably need to go down this pathway. And over the course of time, I found really good mentors. This is from a fitness perspective, you know, both with guys like, uh, the, the folks at power monkey, fitness guys, like Dave ranty, uh, Chad Vaughn. I had a ton of mentors at the time. Um, both of these guys were kind of in person. Like power monkey, fitness, but also, you know, initially remote from folks like yourself, you know, like the Mike Ronalds of the world, they're putting out really good information about sports, physical therapy that wasn't really, you know, the same as let's say, rehab of the weightlifter, but you can apply a lot of the same concepts. Right. And over the course of the time, I, I just really try to carve out my niche as the guy that helps folks that wanna get back to fitness. Right.

Mike: 6:04

Right. That's awesome.

Dan: 6:06

you know, I've been a, a knucklehead my entire life in terms of training. I love it. So, I mean, I did strong man for four or five years, my life. And then I kind of went over to CrossFit and competed for seven or eight years. I, my coach CrossFit for a long time. Um, and I loved working with those folks is what I was passionate about. I saw a big niche because you know, these people were not being served well by the healthcare community. So that's where I really started to dive. Um, and I cared greatly about being good at it. So I went absolutely bananas in terms of ConEd and doing whatever I had to do to try to be as good as I could for these folks. So

Mike: 6:39

Which was

Dan: 6:40

now I'm here I champion trying and do the same thing.

Mike: 6:42

well, and I think that's what, you know, originally when we first met you and we first drawn you. I mean, I knew of you from, you know, the internet beforehand. I mean, your website's like a gym, right? I mean, it's, it's, it's super focused on the fitness athlete, getting people back into the gym, um, even enhancing their performance in the gym too. But you know, for me, I'm focused more on the other things. Um, It's such a gem out there for this new, um, kinda wave of physical therapists that are interested in working with the fitness athlete, uh, that I think is topnotch. I've seen everybody over the years with this content, and I think a lot of people wanna do it. A lot of people say they do it. A lot of people show that they may do it on the cinema Graham a little bit, but you're literally doing it. And educating people, how you're doing it to me, you're the market leader for this sort of stuff. So, uh, you know, you're my resource, you're the person I've learned so much about this. It's a niche, right? Like you said, it even a sport physical therapist, if you're an astute sport, physical therapist, you're. Still not necessarily good at getting the fitness athlete back into the gym, even if it's not competitive, even if it's just recreational, we're still not good at it. Why, why do you think that is? Where is the huge disconnect? And, you know, what's your advice to like an early career professional that loves this stuff, but just doesn't know where to go.

Dan: 7:58

Well, thanks again. You know, this is, uh, this is awesome. I feel like I'm just gonna like cut up all these clips. You tell me how good I am, you know, and post all over my sight.

Mike: 8:07

You're welcome to be fun.

Dan: 8:09

Yeah. Well, I, I think it's just, it's a different sport, right. And there's very different demands, you know? And I think one place, I think, you know, clinicians get a little bit confused. We'll talk about, let's say like a throwing shoulder, which you know, a ton about, and you're, you're pioneer with that. Right. So there's a lot of, you know, information about balance in the front and the back of the shoulder, which I still think is important for let's say, Olympic weightlifter or powerlifter. Right. But if you think about throwing a ball, use a specific set of muscles to accelerate the ball, and then a specific set of muscles to decelerate your arm after you've released the ball. Right. And if you can accelerate the ball really, really well, but you can't decelerate things. Well then maybe you end up with injuries of some of the structures that need to decelerate the ball or structures that get damaged. If those muscles aren't strong enough right now, if you compare that to a bench press, right. Bench press is, is just very different in the sense that it's a, it's a one rep max, which is kind of like throwing two. It's just that you're using more load and a bench press and it's slow. And a ball is obviously much lighter. Right. You're doing it once, right? It's not like you're, you're throwing however many times over the course of a game of course, of season. So that's very different. But think about a bench, press the muscles that decelerate the bar are the same ones that accelerate the ball or ball bar, excuse me, bar as well. So just in the, in that sense, I don't think that all of the principles that are applied to a thrower can be applied to some of the bench presses, right? Because you end up seeing physical therapists that are looking at a bench press or shoulder, and they might be looking at things like GERD, right. Total arc, maybe if they're a little bit more informed and they're trying to treat a bench press or shoulder, just like they would've throw her shoulder. And it. Completely different, you know, and there are a lot of similarities and I know I'm making this, you know, argument of like, they're completely different. They are a lot of similar things you would do from a rehab perspective, but it's just not the same. Right. And if you don't know these things as a sports PT, it can be a little bit gray in terms of treatment. And the other part is that as a sports PT, you might not know about how the training year goes, right? You might not know the differences in federations, and you might not know that you have to pause your bench press. You might not know how much, like rest time you have in between, you know, attempts when you're at a power lifting meet. There's so many little nuances that go into preparing an athlete for something like that. That you probably wouldn't know unless you're kind of in the trenches with it. So I agree with you. You can be very, very good as a sports PT, but if you don't understand the athlete and what they're trying to get back to, sometimes you get a lost, you know,

Mike: 10:39

Yeah. And I wonder if like, you know, traditionally in sports PTs, you know, there's a lot of us were athletes growing up. We enjoyed sports. We, we probably had some specific sports that we liked more than others. And that's what we were trying to focus on as professionals. Now I wonder if it's just the same thing, right? It's just that, you know, if. You don't have a training age and you haven't been involved in the gym. You don't understand the lifts, especially with CrossFit, right too, just because, you know, Olympic lifts and some of the skill work, those are, they're not unique. I shouldn't say unique, but they're, they're not the most common things you see people doing at planet fitness. Right. So, you know, this is. It's just an area that I think a lot of PTs aren't familiar with because they haven't personally done it themselves. Right. And maybe that's what we're seeing now is we're, we're seeing, you know, the age of strength and conditioning kind of improve. And now the PTs are more interested than when they were younger in students. And now they're, they're trying to, to bridge that gap, but, um, you know, I, I just think it's interesting. I mean, if, if you're an early career professional and you know, you, you wanna get with the fitness athlete. What's the first thing you tell'em to do? Like what, how, how, like, do you tell'em like, look, you gotta get in the gym and, and be part of that yourself, or is that important? Or what, what, what do you tell people?

Dan: 11:48

Yeah. So I think that, um, that is one of the absolute, most important things that you can do. And fortunately, as I've kind of mentored more and more people they're already doing that because they just love it. But I think getting to the gym, like you said, so if you're not already training yourself, you need to train yourself and you probably need to be pretty specific to whatever kind of population you wanna be serving. Because, as you said, previously, going into the gym and lifting weights and doing like a typical body building or kind of recreational program is very different than CrossFit, right? So when we're trying to even do research on these things, it's like, we're looking at Olympic weight lifting and we're looking at CrossFit, we're looking at body building and we're trying to figure out which injuries are most common. They're very, very different, right? So I do think that being, you know, specific about your niche is gonna be important then getting really, really involved in that niche. Right? So for me, I knew that I would be a better, uh, clinician. So physical therapist, if I coached, if I competed, if I really gotten the weeds with the people I was trying to help. Right. Um, and that's a big thing to talk about. I mean, that's a huge marketing thing, but you gotta know the problems, you know, if you really wanna help someone, but if you're not in the trenches to learn about the problems, probably not able to fully help folks. And if you're experiencing this yourself, I think that's one of the best ways to do it, you know? Um, unfortunately, and I, I'm actually trying to change this with a lot of my education, but, you know, P I, I'm not trying to hate on PT schools. I feel like I've gotten to hot water recently with some of my statements right. On social media, just because

Mike: 13:09

I know you're like one of the nicest guys. I know you're one of the nicest guys. I know. I mean, I can't imagine you got into hot water on anything, but

Dan: 13:15

yeah, yeah. Right. Um, I think one of the, the troublesome things is that in PT school, you're trying to teach a student so many different things, right? An exercise technique is, is not at the top of list, right? You're trying to teach about medical red flags pathologies. You have to prepare people for an exam that's coming up. But I think that the students that are coming outta PT school are not prepared. And they'll tell you that they won't really understand exercise fully. And if they do it's because they have a personal training background because they've spent some years actually training others. Right. Which is super helpful. And, uh, I think the other thing that we don't really have knowledge wise is the idea of progress.

Mike: 13:50

right.

Dan: 13:51

if you have patella femoral pain, where do I start and how does that change for person a versus person B and how do I advance over the course of time? Right. So I think the exercise technique, exercise, selection, and then progressions regressions. We don't really get a ton of information about in PT school. And obviously that's when I'm devoting my entire career towards, right. Obviously taking my courses, if you really wanna learn more, right. Or just listen to a ton of the free stuff I put on a regular basis. Um, but I think focusing on training others, And trying to learn how to progress and regress, uh, based on their pain problems is gonna be super important. And I think that your kind of foundation of treatment, if you are going to be the person who works in fitness should be fitness based exercises. Uh, and I would say that that's also reflective what the medical literature says too. So if you're giving people, I don't know, lunges for knee pain, you're probably doing a good job of evidence based care for knee pain,

Mike: 14:43

Yeah. Is it that simple?

Dan: 14:46

Yeah, I hate to say it, but kinda.

Mike: 14:49

I, I mean, it kind of makes sense, right? If, if you're naive and you don't understand the process of training and you don't understand strength and conditioning, especially the subtleties of the niches, like. Power lifting and Olympic lifting and, and skill work. I mean then yeah. If somebody comes to you with back pain, you're probably gonna say don't deadlift because you don't know otherwise. Right. You probably don't understand the concept of deadlifting enough. You assume everybody's doing it poorly and it's just bad for you, but you also don't understand the subtleties of. Okay, well, how do I regress this? How do I get person back to it? How do I transition them back to that activity they love, right. Maybe, maybe that's where the disconnect is, is they're just naive. So instead of saying, well, yeah, let's, let's take a step back. Let's work on it. Let's work through this and then let's progress you back. It's uh, don't do it because we're nervous. Right? Is that, is that part of the issue you think.

Dan: 15:38

I think that's a huge part of the issue, you know? Um, and you have two ends of the coin, right? And I think as a new grad, it it's a little bit challenging because you've got some of the folks on one in the spectrum. And I think I kind lie in this a little bit, although I try to be in the middle. Cause I think that's where the truth is saying the deadlifts are gonna help your low back pain. Right. I. Then you have people on the opposite of the spectrum. A lot of times this is a surge. I'm not trying to hate on surgeons in any way, but you know, surgeons and some healthcare providers saying never deadlift. That's why you hurt your back in the first place. Right. And we know the answer kind of relies somewhere in the middle and it's, it's pretty clear if you look at, let's say chronic low back pain, there's several studies now, you know, there's two that I, I kind of like bookmarks. I knew we were gonna be talking about this today. Um, but both in 2015, and these were like really illuminating for. It was from, uh, ASA at all. And they were looking at high load lifting, which is basically dead lifting versus motor control exercises. And another one from Welch at all in 2015. And they're just looking at free weight training, right? So lower body strength training, and it was effective for reducing low back pain at a similar rate as other types of treatments that we have for low back pain. So we know. Yeah, these exercises can actually be beneficial for low back pain, but don't, you know, kid yourself, you're, you're at risk for hurting your low back. If you're pushing the envelope in power lifting. Right? So the answer clearly lies somewhere in the middle. It's not like deadlift and squats can't cause any problem they do. And it's very clear. We have research to show that, but they can also be used as a tool to help people in pain. So, like you said, there's, there's probably has to be some sort of intermediate and that's gonna vary a lot based on the person. Um, I ended up stealing an idea from a guy's name is Michael Raiffe. He's done a lot of research with Emeral pain, alls good laughters um, battel or, um, planet fasciitis, I think, but he had a pretty cool, um, presentation when sports Congress, this was years ago. But he was talking about these things called modification ladders. And he was studying folks that had Patel femoral pain. And basically he was allowing them some activities that were tolerable well tolerated. And he would just kind of work his way up the ladder as people got better and better. So it wasn't like, okay, yeah. Patel, femoral pain, do this, you know, set of exercises for eight weeks and then we'll see the effect. It was okay, let's start you here. And we'll ramp up based on how well you're progressing and he had great results. So I've basically taken that model and stolen it directly from them. And I apply it to pretty much every pain problem in the gym. Right. So if you have lower back pain and we're trying to a improve your fitness and keep working towards your fitness goals, which I think is a really important thing that PT should think more about as opposed just getting anti pain, but also reducing your pain. If we pick the right modification, we're probably accomplishing both of those goals. So maybe we can't pull singles off the floor cuz your back is hurting, but maybe we can do a trap bar deadlift with a tempo and get away with training the same muscles. Right. So you're still kind of working towards your fitness goals, although you're not lifting max loads and you're actually rehabilitating the spine at the same exact time.

Mike: 18:36

Right. Exactly.

Dan: 18:37

exactly. So whenever we can do two birds with one stone. Great. And the other thing is that you're. Helping out that patient. Cause most folks are coming to you because they wanna keep deadlift. Right. And if you can be like, Hey man, you can.

Mike: 18:50

Right.

Dan: 18:51

That's awesome. That's that's your patient's gonna really like that. Right. I've never met a patient who was like, you know what? I don't think I wanna deal anymore. know? It's like, whoa,

Mike: 18:59

I have

Dan: 19:00

Yeah, there is a couple. Right. But when people want to deadlift and you tell them, like you still can and they're like, well, I don't think so. That's rare. Right? They usually want to keep doing it if they're coming to see you, but.

Mike: 19:09

Right. That's a differentiator too. And I think that's what, what I think with some experience that good PTs understand that. Right. And I always tell the story. Right. You know, with Kevin, I, you know, I show after Kevin, I always tell. But like when I had him, you know, take a look at my low back pain, you know, one of his first things is like, I should golf less and I'm like, no, no, no, no, no. I'm coming to see you to help me golf more. Right. Like, so it's, and that's what the fitness athletes are doing. They're coming to see you, especially the ones that don't have mega injuries that are just coming you for the maintenance. In the ongoing care and stuff they're doing that just like any other athlete would use you to help them continue with their hobby or their sport, or, you know, their passion, the thing they're doing. I think people need to think about that. Right. And sometimes we get caught up in being dictators. Right. We think that like, we're in charge of what the person does. We're not, we're we're concierge for their life. Right. And we give recommendations and try to help them do the things they need or they want to do. And I think, I think that's a big mental differentiator, right?

Dan: 20:31

Yeah, for sure. You know, um, that's one of the things I it's really nice because you know, you already said this, but I work a champion. It's an out network provider. It's kind of a cash based system and we get to help people, however, they want to be helped. Right. And I understand there's limits to this. So if you're an insurance based model and you, you know, start talking about deadlift and someone can't get, you know, can't go to the gym. Right. The insurance company doesn't care. Right. That someone can't deadlift because they're low back pain. So I get it right. But in the model that we are at, it's awesome. Because I ask a lot about goals, right. And the goal isn't always, you know, it, I, the goal is oftentimes like, yeah, I can keep on exercising and my back hurts, you know, but is this the best for my long term health? Right. I'd rather not hurt. And the other thing is like, I wanna compete and I wanna do well with my competition. Am I causing more damage? You know, is there a smarter way of doing this? And that's a whole different conversation than someone comes in because they have like searing pain on the back of their leg and they just wanna get outta pain. Right. Um, and live their life on a regular basis. So we're blessed to be able to focus on someone's goals, right. And not have the boundaries or restrictions of, you know, what insurance thinks that we should be doing, you know?

Mike: 21:40

Yeah, that's huge for the, for these athletes. So, um, well, we, we've talked about a little bit about low back pain. I, I do I wanna talk specifically about that with you a little bit in this podcast, because I think it's a big talk topic in the fitness athletes, and I think you're a good person to talk. Um, talk to you about this. And I think this will apply to a lot of sports too, not just the fitness athlete, but I think it's a good model. Um, if you wanna learn about, you know, hip knee, shoulder, that sort of stuff, you want fitness pain, free.com, dance courses. We'll teach you everything about those things. But for this episode back pain, right? We're gonna talk about back pain. It seems like to me, low back pain is one of the common things we see. I don't know if it's the most common, maybe, you know, but it's one of the most common things like we see a ton of fitness athletes that have low back pain. Why do you think that is.

Dan: 22:25

Yeah. Good question. Um, I guess to, you know, go back on your first question, like yes. Low back pain is probably. One of the most expensive things that, you know, human beings pay for out of everything. It's like the number one healthcare cost out there beats out like the top five killers. Right? Uh, it's it's a huge problem. Um, but it's funny. And we talked about this previously. It's like a lot of these sports rehab experts. They're, they're like knee and shoulder, right. And maybe hip hips getting a little more popular right now, but low back's like, nah, man, we're not touching that thing. Um, but if you look at the literature for, and it varies, right, because when I say fitness athlete, That's not really fair because Olympic weight lifting again, very different than power lifting different than strong man.

Mike: 23:06

Yeah, it's

Dan: 23:07

It's hard to say that all of these, yeah. There's a lot of nuances between the different sports, but if you start looking through that literature, the top three injuries are generally going to be low back shoulder and knee. And then low back pops up as number one, the most generally, and this is more in power lifting strong man. And I think it's just reflection of the lifts. You'll see. Right? I mean, pitchers get shoulder elbow problems because they're pitching, that makes total sense. Right? You see hamstring injuries obviously. Cause they have to run bases and that type of thing. But for powerlifters, it's low back pain. Why? Because they're squatting heavy and they're, deadlifting heavy and where's the stress there. The low back takes a lot of stress, right? So it's usually the top three most injured area and oftentimes is at the very top. Right. So it is very, very common. Right. And I think that the type of injury you see is specific. Although we don't have great research to show that, right. There's a study by, I think it was fares at all in 2020. And they're looking at adolescent weightlift. right. Which is, again, adolescent weightlifters is a different population than the general person training. It. It's hard to extrapolate this to everyone. Right. Um, but they were saying that disc pathology makes up almost 50% of all the injuries and the rest of injuries were low back strained, which means to me that they didn't do a great job of like trying to parse what the injuries were and the way they defined the injury was basically. Yeah. Was it radiating or not radiating? Right. So if you have a disc injury or ridiculous back pain, um, you don't always have radiating pain, right? That could be part of it. And if you have non radial back pain or non disc related pain, Doesn't mean that you can't have radiant pain either. Um, but I do think there is something about that position of loaded flexion. Right? So I don't know. I'm sure you've seen this multiple times. Right. And it flies in the face of what you may see in social media. Cause everyone talks about how, you know, loaded flexion is not a problem. Um, then why do I hear people all the time that hurt themselves in the bottom of squat, bottom of deadlift. Right? Um, and it might not be load deflection. It might just be a lot of load in that position that against gets people. Hurt right into hot water. Uh, but if you think about where people are getting hurt, it's generally the bottom of the squat coming up outta the bottom of the squat, usually, or starting to pick the weight off the floor, right. Is when they start to feel that pain. And that can be ridiculous nature. So, or could be something that's mechanical. Uh, even in McGill's original research when he was bending pig spine. So we'd either compress pig, spines, or he would compress and flex at the same time, he created a bunch of different types of injuries. So disc pathology, that was one of the main ones. That's one. We always hear. The other one is vertebral and plate fractures. Right. Which is a common one that you, you never hear about really. And the other type of injury that he created, which kind of flies in the face. What we're taught in school is Spady injuries. So he created Spady fractures spondylothesis um, and I've actually heard this, I've heard some folks that were squatting really heavy, try to come outta the hole. They feel a shift or pop in their back. They fall to the platform, right? They go to the emergency room, usually. It get some imaging or does it show, oh, you have a spondylothesis right. You know it, so I do think that you create a variety of different injuries, but the mechanism's kind of similar it's overload in that position. Right. Where people get in hot water.

Mike: 26:12

Yeah. Makes

Dan: 26:12

there's a lot of that position in all of those sports.

Mike: 26:15

And for some reason, like, people love saying stuff like, oh, you know, you know, weight lifting's back, you shouldn't deadlift is bad for your back. That's that's you can't do that. Right. But every other sport out there, we accept all these crazy risks. Right? Like you play football you're, you know, it's, it's, it's just accepted that you'll tear your ACL. You're Achilles. You get a concussion, you ski, you're gonna tear ACL, you know, you pitch, you're gonna tear your Tommy, John, that. Perfectly accepted in society, but you shouldn't work out because you might hurt your back. right. Like it's kind,

Dan: 26:43

know.

Mike: 26:43

it's, it's kind of weird how people think of it that way. But, um, so you, you started talking about this with low back pain and, and I wanna chase the cells bit because I think the, the. A lot of young clinicians and I was in this boat. So I could talk from experience here. I, I think low back pain is just such a broad, generic term that it's daunting because you don't know what that means like, and you just said, you just described a handful of completely different. You know, diagnoses that you could have that would all be classified as low back pain. Um, you know, how do you differentiate between somebody that's literally just like their muscles are sore or they have, you know, muscular strain or even like overload, like, you know, your, your muscular soreness versus an actual pathology. Is this, you know, how often do you see the two and, and how does, how does your brain, you know, go in different directions depending on what you.

Dan: 27:34

Yeah, for sure. I think a lot of it is dictated by how much training the person has under the belt. So them knowing kind of what's okay. Soreness and what's maybe too much. Right. Um, and then it's also very different basically individual cause some folks will say, yeah, my back's a little sore and you ask'em to touch your toes. And they've got so much pain. They, they can't even get past like, I don't know, 50% or something like that. And some folks are like, yeah, I can't even touch my toes. I'm so sore. Like, can't go up the stairs. And like, literally it's like, that's doms and that's just because you had a good session. Right. So there's some parsing that comes out. Yeah, I think the other thing from a competitive perspective, a lot of top level competitors, it's funny. Cause I've had the opportunity to work with some high level folks. Right. And they'll come up to me and they're like, you know what? I've been feeling really good recently. It's been a really good training year. And as we start through the evaluation, they're like, yeah, my shoulder hurts when I do this. My knee hurts when I do that, my low back hurts when I touch my toes. I'm like, they've got all of these maybe orthopedic issues, but they only mean classify that as an injury in any way, you

Mike: 28:30

Right. Yeah.

Dan: 28:31

I think the other part is that there is a certain level of. Yeah, there's a certain level of acceptance for these things, right? So if you're like peeking for power lifting meat and your shoulder doesn't hurt and your back is not hurting a little bit, it's kind of like, whoa, are you pushing the envelope enough? So I think a lot of folks just accept this as part of the sport, but I also think that there is inherent risk with this. Um, I did read a cool study recently, um, and it was called do niggles matter and it was on, um, soccer players. Right? So football anywhere else in the United. I forget the author. So I apologize for that. But what they were looking at is that they were looking at non-time lost injuries. So basically an injury that's not bad enough to take you away from your sport. Right. And we see this a lot, so something hurts, but you just train through it. Right. And they were trying to see does having one of these injuries and they kind of label that as a, a niggle. Does that turn into a worse injury. So does this non-time loss injury increase your risk of a time loss injury, where now you're outta your sport? And it was by a lot, it was a very significant, you know, difference. Right. So if you had some sort of injury you're playing through your risk went way up, you know, I, I don't want to quote this study incorrectly, but it was something around five times. It was a lot of risk, right? It was is greater than. Acute to chronic workload ratio. So there's another really common, you know, term that we know that that can increase your risk of injury. If you kind of do something you're not prepared for your risk goes up, well, if you have this injury, right, that's not that bad, it really does increase your risk of two things. So that injury getting worse, but also an injury elsewhere. Right? And that's what the paper showed. And this is soccer players. And this has been my entire life. I'm trying to extrapolate research from one population to the population, wanna work. But I just exercise caution with folks because if they are having one of these, like, oh, it's painful, but it's not that bad. That's on my radar.

Mike: 30:15

Mm-hmm

Dan: 30:16

So I have people kind of continue training regularly, trying to be a little bit smarter, maybe with the decisions they make from like an RPE perspective or just how heavy they're going or how many sets they use dial back slightly. And then as this pain goes away, we can start to ramp up again. Um, but I just try to use that as an educational tool for folks. And you know, this is a whole nother, you know, ball of wax, but it depends very highly on the person's psychology. You get some people where they have, if they have the slightest injury, they think they have to stop everything. And you have people that on the opposite end of the spectrum. They don't care about their pain at all. Right. And they blow through it all the time and they get themselves in the hot water for that same reason. So, unfortunately, I don't think there's a, you know, black and white answer. You have to kind of read the person that's in front of you, figure out what kind of injury they're truly dealing with, or if it's actual soreness and then give information and try to educate them based on what they're dealing with.

Mike: 31:06

Yeah, and I, I don't get me wrong. I think, you know, we say soreness, but like that is also that could limit you. Right. So it's not, you know, sometimes it's just late onset muscle soreness, sometimes it is overuse, right? So it is an excessive use of the muscle. And you have a bit of a muscle strain type injury. Um, what do you think, like what's, if somebody comes to you as a fitness athlete with low back pain, like how many times do you think it's just simply muscular versus one of the big other ones? And I don't wanna oversimplify this, but let's say, you know, neurogenic, you know, so like disc stenosis, like nerve root or even OSUs like play, uh, you know, spy type thing. Like what do you think the percentages of those you see in your practice are.

Dan: 31:47

Yeah, for sure. So that, that paper that I was talking about earlier by ASA. Um, they, you know, said it was close to 50% people had radiating symptoms and they classify that as a disc issue. Right. Which we know that's not perfect. And I think the general population, ridiculous issues are around 5% of all pain. Um, I always tell clinicians just to keep in mind that we're biased as physical therapists cuz we see the bad injuries. Right. We don't see all the little things that pop up. Um, when I was a CrossFit coach for years, It was funny, cuz people always ask me about how to work with a given population. And we just gave the answer. Basically, you just get involved in that community. I would coach, you know, a couple times, uh, in a given night and then afterwards I would try to work out and I got to the point where I couldn't even work out. It was ridiculous. Cuz so many people would come up to me afterwards and ask me about. You know, I got this injury, what do I do? I got this going on. And my very vanilla, you know, answer to everyone was like, all right, well, let's kind of back off of what is bugging you currently. All right. And as you start to feel better, slowly ramp back into those things. And if it's not getting better in a couple weeks, come see me. And what happens is that the large majority of people get better. I think that's pretty consistent with what you see in the medical literature, cuz most people are gonna have their, their symptoms are gonna go mostly away in the first. Let's say four to six weeks. Right. And I don't think that's the type of person that we see as physical therapists. We see those kind of outliers that. Haven't gotten better over the course of time. So I think the large majority of injuries that you'll see, I don't even know if you wanna label an injury, but pain problems. Right. You know, there's a lot of folks that get super heated about that research because the definition of an injury is so gray and changes from study to study. But large majority of these things are probably pretty minor and they get better really quickly. Um, I think the thing that's challenging is that we don't, we're not always sure what that structure is. That's injured. And even in, let's say disc pathology, and there's a huge spectrum of different types of injuries to the disc, right. A large majority of those are even getting better in about four weeks. Right. So I would say the majority of injuries, maybe more muscular nature, maybe some sort of irritation to a joint, but even the ones that kind of masquerade as more sinister, right. Um, like disc pathology, they tend to get better pretty quickly as well. Right. So I would say the majority are pretty. I don't know, minor. And the ones we tend to see are probably the minor ones that kind of extended out for a longer period of time, maybe because of poor decisions or because the irritation was worth. Uh, but even then I, I, I would say that ridiculous low back pain is a lot lower. Um, but I also do believe, and this is my own opinion that ridiculous low back pain is a little bit more common in the weight lifting athlete than in the average population, even just working at champion. Right. We see a lot of kind of extension rotation based spotty injuries. That's far and away, the most common, low back injury that we see. Uh, do we see some disc stuff for sure. You know, but far less, I think in the weight lifting population, you know, disc path. Is more common than a general population, but also in a sporting population as we normally think of it.

Mike: 34:49

Yeah, that makes sense. And, and again, it's just, it's the, it's the cost of doing business, right? You you're just putting more stress in the area. So, you know, it is what it is. But going back to what you said earlier, I mean, hopefully these minor things, we work on, we address early and they don't. Develop into major things. Maybe like maybe we can make a difference. Right. Um, how about this for, you know, I think the million dollar question for you. I think this would be a good one, but, um, I think this is one where some people are really good at this. Some people are really bad at this, but how do you know when it's okay to help somebody train through.

Dan: 35:23

God.

Mike: 35:24

like, like ju just modify their, their, their workloads or regress them versus saying like, you know what? You actually do need to stop deadlift for example, like, like, like what's the thought part? Like what's the algorithm in your head on how you determine that for some people.

Dan: 35:40

Yeah, well, two things, right? So one, I just always wanna make sure I rule out red flags, you know, um, you just wanna make sure there's no call Aquinas syndrome, you know, set paraesthesia bowel and bladder, right. Myelopathy type stuff. Cause I do think that's really important, you know? And it also sets people's minds at ease because when you have low back pain, especially like disc pathology, you know, and really it's not just disc pathology, but it rocks your life. Right. You know, oftentimes these folks get injured and they're laying down on the floor for hours and they basically have to be, you know, carried by friends or put on a stretcher. Like it's, it's incredibly dramatic, you know? And I don't mean that in a way to poke fun at this. I mean, it's it rocks your world and it's super painful and it sucks. So I

Mike: 36:23

We've seen it. We we've all done it. Right. We've seen people do it. We've carried people and

Dan: 36:27

Yeah. Yeah. You know, we've

Mike: 36:29

you know. Yeah. Right. I mean, yeah. It's, it's terrible. And then they do magically get better, but yeah, no, absolutely.

Dan: 36:35

yeah. So I think it's, it's twofold, right? So you have to respect the person what they're going through. Right. But you also have to, you know, just let'em know, like, Hey, there's no medical red flags here. We can kind of continue. Right. But that being said, and I tell this to my patients. I think it's important to set these expectations that this process is very experimental. So I tell folks, we're gonna try to get a good idea of what you tolerate today and what you Don. But the other part is that text me, let me know. We schedule more frequent visits up front because we wanna make sure that we're kind of hitting the nail right on the head. And if we're screwing up, we wanna change this soon. Right. So you don't make that person worse. Um, but I get a lot of information from the subjective. So when you sit down, you ask questions about how they got hurt. So if that person got hurt in the bottom of a squat, I'm automatically thinking like you gotta be a little cautious in the bottom of a squat. Right. So they're gonna give you a little bit information,

Mike: 37:24

right. I love how, like, just everything you've said so far is just like, when you say it, you're like, yeah. That's like, that makes perfect sense.

Dan: 37:33

I don't know, man. I had a professor Dr. Keres in, uh, my undergrad or my graduate and he was great. And it was funny cuz some people would get mad at him because he simplified things so much that it almost was like he was talking to you as a two year old. You know what I mean? Now that I have a two year old, I know what that feels like or seems like,

Mike: 37:50

well, I, I mean, social. And social media just is confusing people all the time. Cuz they're like, no, no, no, you can squat for back pain. And you're like, right. But if the if being all the way in the bottom is what's causing. Yeah, exactly. I hear you. All right. Sorry. Keep going. I apologize.

Dan: 38:04

no worries.

Mike: 38:05

thought that was great.

Dan: 38:06

Yeah, exactly. But, you know, it's, it's like, okay. I, I'm probably gonna have to be careful with squatting. This person hurt their spine in a position of kind of flexion as well as compression. So dead lifts are probably gonna be one of those things. Right. Um, so you get an idea based on their subjective. And that kind of goes into your objective testing. Right? So now you're actually testing the squat. What does an unloaded squat look like? Right. And I think this is oftentimes where people get into trouble with weight. Lifters is because basically they can squat doesn't really hurt that bad they can launch and movement looks pretty good. Right. And then oftentimes they're subjective complaints are like, yeah, I can kind of squat. But when I get. 50 60, 70% of my one rep max. That's when I have to stop. That's when my technique falls apart. And that's where I think clinicians are like, well, I'm not sure what to do because all of my special tests are negative. Right. All of my testing, you look good. Like I'm not even sure how to progress this person. And you will see people along the entire spectrum. So what I do is I test them day one, right. We go out in the gym and we just try a variety of movements. Right. Uh, oftentimes I. Program for them. Um, one of the things that I recommend folks do, and a lot of this does come down to experience, but as you see more of these folks that have low back pain, make a template, you know, like, oh, I have a template for weightlifters and low back pain. And week one is this week two, is this the exercise I try? Um, what I do is that if I have weightlifter that comes with low back pain, I already have an idea of what they tolerate don't tolerate. I can just grab a chunk of that template, go out in the gym and start trying things, right? Like, well, I, I think that we can probably. Like a high handle trap bar deadlift, cuz it sounds like for you, you're not tolerating, tolerating heavy loads of reps from the floor. But if we alter this a little bit, maybe we can tolerate that load. Right? So we're changing your, your trunk position. We're pulling a little higher from the floor. We're not flexing the spine quite as much. Um, we change the moment arm, which is the physics things to basically, if you're doing a trap bar deadlift, there's a little less stress on the spine because now your knee's actually doing a little bit more work. So we're dialing down the stress, but we're still allowing someone to train heavy. And I'll go try that in the gym. Like, oh, how is trap bar deadlift going? Oh, it feels good. All right. Let's use that as your modification for the deadlift and then give you a bunch of accessory exercise to strengthen the things that we think are important to get back to deadlift. Right. And oftentimes people can't tolerate anything. Right? So I go into the gym hoping that we can find something that goes well. Right. And usually my bottom of the barrel exercise for trying to train the deadlift as a hip. And for a lot of folks, they have so much pain that's not happening.

Mike: 40:31

Right.

Dan: 40:31

If you have that patient that just kind of limped off the platform and is just now able to get in the car and drive to the physical therapy clinic, cuz their back is killing them. I'm not dead lifting with them. We're not deadlift. We're not squatting. Right?

Mike: 40:42

Dan, everybody should do deadlifts. They're amazing. You should do it right.

Dan: 40:45

Yeah. So what we do is I tell them, let's get back to the bar. Here's three 15. I I'm just kidding. I don't do that. Um,

Mike: 40:53

Well, you know, I, I wanna point out this to, to people listening right now. Cause I think this is an important concept here is that Dan's he's not going in and just saying don't deadlift or deadlift. What he's saying, I'm gonna manipulate. The load I'm gonna manipulate the compressive force. Right. Did you pick up when he said that? Right? I'm gonna, so you have to understand the biomechanics of these things. So you can say, all right, you're this is a compressive force type injury, for example, I'm just making it up. And I, what I wanna do is I wanna regress the compressive loads, right? I mean, that's a lot different than just saying, like, Do or do not do one exercise. Right? So I, I think that's a key part. And I think that's, you know, when you go through, you know, the educational process and things like dance courses, you see these things, but that's the key here. It's not saying you can, or can't do an exercise. It's, let's manipulate the variables that go into those exercises. And that's exactly what we do in every other sport. Right. You break down, you know, running sprinting, jumping and stuff of football. We break. Throwing, you know, to its pieces, it's the same thing. So, uh, that was, that was, that was really, uh, you know, cool what you were just saying there, Dan. So I really, uh, you know, appreciated that one, so sorry. I just, I wanted to make that point, cause I thought that was awesome.

Dan: 42:01

Oh, thanks, man. I, I think that a lot of ways there are tasks. I mean, Stu McGill's done a good job of this. I I'd recommend a newer. If you haven't picked up a copy of, you know, Stuart Gill's books, he's got a bunch of'em at this point and we're all very good, but he talks about some of the special tasks you can use to try to parse out what's going on. So we'll have you sit at the end of the table, extend the spine, and then apply over pressure by squeezing your back right by holding onto the sides of the table. So you can see if it's kind of like compression and extension issue, you can do the same thing for spinal flexion. So think about slumping over and then pulling your, your back into the table to see if you're having someone who's kind of intolerant to flexion as well as compression. He also has a test where you go up on your toes when you're standing and drop your heels to see if's more of a straight compression element. So he's kind of looking for vertebral PL fractures with this type of issue. So you do, there are a lot of tools you can try. Um, but I do feel pretty strongly. You know, people are gonna be in certain places in the rehab along a giant spectrum. So you're gonna see the folks that are basically in a wheelchair coming through the door. Cause they're back is I've literally had patients that have had that, that just can't tolerate like standing cause it's, it hurts so bad. And then you have folks that come in they're like, everything feels great until I get to let's say a three rep max. And I think the rehab that you apply is gonna be very, very different based on the person that you're presented with.

Mike: 43:20

That makes sense. So I think the other big topic then for this type of athlete that people struggle with again, is, okay. What does a return to training program look like? Right. I, I think that's another area. Maybe it's just lack of experience or creativity in that area, but right. So you have the person low back pain there you've regressed them. You're you're working it. How do you get them back to where they were? Any, any nuggets or pearls that you can share with people on how to build those types of programs?

Dan: 43:48

Yeah, for sure. You know, that's, that's a really good point, right? Because it, you know, when I was trying to figure out what's the best kind of program for my weightlifters, the first place I looked was in the medical literature. Right. To see if there's much right. And I gotta be honest. There's not a lot for rehabilitation of lifters, which is a little unfortunate. But if you start to bar from other sports, other pathologies, as well as the low back, um, one of the strategies you'll see pretty often is that people will do physical therapy, right? So three times a week-ish then they'll have a home exercise program they do on their off days. Right? So usually my foundation principle is some sort of loading three times per week. Right? Then I have some easier exercises on your off days. So maybe some basic core strengthening on your off days. Whereas we do some actual loading three days per week. Right. And the other piece I think about is where does this athlete want to get to? So I ask a lot of questions about, and sometimes this is so far removed from the patient's mind, cuz they've been in pain for so long. Right. Um, but I ask like, what does a traditional trained split look like for you? Cuz that's where we need to be. So we think about where the endpoint. We figure out where we're at currently, and we just give them the most similar program to where they wanna be, that respects that healing injury, and also optimizes the rehabilitation. So for me, three days per week, worth of loading, we're usually squatting one to two times a week and deadlifting usually once per week. So the hardest variation that people can tolerate well, And, you know, in terms of what's okay. From a pain perspective, it that's very gray. I'm taking most of this research from chronic low back pain papers where they use a lot of, does this feel tolerable? The patient says yes, then they continue strength training. Uh, when you compare strength training with pain versus not having pain, when you exercise, it seems like the two get better at a similar. So I I'm barring a term from Chris Johnson here, but I'm, I'm pretty cavalier in terms of loading people. Just because if I am creating some pain, I don't think it's gonna change their long term outcome and it might actually improve their short term outcome. So I'm okay with pushing into a little bit of pain. Again, it depends a little bit on the pathology. If someone has some disc related pathology or they have a history history of frequent recurrences, right. And I know that we have to be a little slower, then I'll probably end up being a little bit less cavalier, right? Not push quite as much, but to go back to we're talking about squat usually twice a week, deadlift once a week, and then some sort of strength training three times per week, and the strength training exercises I choose are based on what that person wants to get back. So that movement that got'em into hot water in the first place is usually a squat or a deadlift. So the accessory exercise I'm choosing, we like to have a well rounded program for the core, let's say, but I put a lot of emphasis on, let's say the glutes, the spinal extensors, I'm doing a lot of, let's say 45, 3 back extensions, G HD back extensions. Good mornings remaining deadlift variations, a lot of single legged strength training that focuses on the Glu. Spinal rectors, all the musculature that's gonna be needed for their sport. Right. Kind of similar to like a baseball athlete. They're gonna need to train the posterior cuff for deceleration. They're gonna treat, you know, the front of the cuff, a lap to accelerate the ball. I'm thinking about all that stuff. Right. But I'm also thinking about. What's gonna be good for their long term health too. Right? So once you return,'em back to a given program, let's make sure that program's actually smart. Right. And you know, I'm, I'm kind of moving ahead and I'm just kind of going based my thoughts. So I apologize now I covered, you know, finished that one question, but I think that's super relevant for folks, right? If you're taking someone that got hurt in a gym environment, that's not. There's a chance they're gonna get hurt again. Right. And I think that folks need to know that. So I do a lot of education for folks about what's maybe reasonable for them, and what's kind of reasonable for most folks in getting back to the gym. And it's twofold, right? So we need to come up with a long strategy for loading the list that gave someone trouble in the first place. Right. Um, and we also need to create, I say an insurance policy. So let's get some extra strength on board in those areas that are more at risk, right? It's the same thing as doing Nordic for, you know, soccer players. Cause you know, that hamstring is likely to get injured. Right. Uh, for those folks, the low back is likely to get injured, you know, in a power lifter, let's strengthen the crap at a low back. And here's the other piece strengthen your low back is gonna make you stronger too. It's gonna improve your lift. It's gonna probably reduce your injury rate. Although I haven't seen your research on that yet. Mostly because the research hasn't been done, but you know, it makes sense. We're trying to be logical about a return.

Mike: 48:08

Yeah, that's awesome. And, and clearly you can see, this is a huge topic, right? I don't think this podcast is gonna do this topic any justice. Right. But as you can see, it's the tip of the iceberg, but there's a ton of nuances that you have to learn that goes into this. So, um, You know, obviously fitness pain free is a great place to start head over to there. Uh, Dan, before we end, I like ending with the high five. So five quick questions, five quick answers that show a little bit about what your brain's doing right now. First big question. Ready? Uh, what are you currently reading and working on for your own professional development?

Dan: 48:42

Yeah. So I, I, I don't know if people know about this about me, but I, I really like business a lot. I think it's a really kind of cool, interesting

Mike: 48:51

Business and, and bananas. Dan loves

Dan: 48:53

I am a big banana fan. I eat 10, 12 bananas per day.

Mike: 48:57

he's

Dan: 48:58

calmed down on bananas. I'm trying not to get diabetes. So,

Mike: 49:02

sorry. So bus business, sorry.

Dan: 49:05

Yeah, I I'm kind of, I just finished a book by a guy's name is Alex from mosey. Um, I think it's called a hundred million dollar offer, but it's like a dollar on Kindle. So if you wanna check it out, definitely recommend that. Um, I think it's important as physical therapists and, and for anyone just to learn some nuances behind business. So I'm constantly reading either business improvement, marketing, or physical therapy related content, usually, or health and wellness. Cuz I, I love that too, but.

Mike: 49:31

I like it. I think we're similar with that. Nice. Uh, well, based on all this stuff, what's one thing that you've recently changed your mind about

Dan: 49:39

Hmm. Yeah, this is a tough one, you know, and I, I would say that this is kind of. I don't know. I think it's, it's solid advice for folks, but it it's, it's something that's changed over the course of the past few years. You know, when I started as a clinician, it's, it's tough because there's so much information out there. Right. And the common advice is to learn as much as you can. And I think that's decent advice. But in a lot of ways, I think that's actually, you know, bad advice because it's it's way too overwhelming. And the problem is that you don't have a solid foundation, you know, to compare these different types of treatments. And like our social media landscape is so polarized at this point that I think for the new grad, it's hard because you may read something by one expert to completely contradicts what another expert is saying. And what happened to me is I would kind of flip. Up all the time on my treatments. And I don't think that's a good thing. Right. So I've actually kind of, yeah. Streamlined my learning more recently and I've done it because I think it makes me a better clinician cuz back in the day I used to just read everything. Right. I would treat, you know, concussion, TMJ, plant fasciitis, you know, I, I try to do everything and I was interested in it. But in the day I don't think that it was the best way for me to help people around. So I've really tried to streamline my learning process in the past few years. And that's one of the things I continue to do. That's a little bit different than what I used to.

Mike: 51:01

I love it. What's your number one piece of advice that you like to give students at champion?

Dan: 51:07

Yeah. So one of the ones I like a lot, um, is to come up with some goals that you wanna accomplish. And usually this is with your physical therapy career. But I think it's it's with your life too. And I think people should constantly have some sort of a barometer on, are they working towards what they feel is meaningful in their life and constantly reflecting on that. Um, good example is social media right now, because I think a lot of students just have pressure. To do social media, right? Because their, their favorite mentors are doing it. Right. They're like, I need to start this. I need to start posting more. I need to start getting out there. Right. And I think a lot of ways that is good advice, but the other part is like, does that reflect any of your goals in life? And do you have any goals for your physical therapy career? Right. Because maybe social media is the right way for you. It's just that maybe you have to be a little more specific about the way you apply. And maybe social media, isn't the most important thing for you right now. Maybe you need to focus on other things. So I have students kind of sit back and reflect on what they want in their career because it's brand new. It's very exciting. Right? It's kind of cool to sit down like where you wanna be in five years, 10 years, you wanna be in a sports clinic, you wanna be an orthopedic clinic. Do you wanna be in a cash based thing? Right. Um, do you be run a, run your own business? You wanna make educational products? Do you wanna. You know, market towards the professional. Do you wanna market towards the average person, right? Is there a niche that you like, and then once you have like an idea of where you want to go, then we can start saying, okay, let's come up with a plan, but I think too many folks are trying to come up with a plan and they don't actually have, you know, a, a solid foundation of what their goals are. So then they're just like a, a ship that's in the middle, the ocean, that's just kind of blown around in all different directions. There's no destination, right?

Mike: 52:44

I love that. I think that's, that's great too. Cuz we see, I think a lot of the, uh, issues that we're having with lack of, uh, you know, even self confidence in their skill set and stuff, I think probably comes back down to that too. Right. They're just, they're just all over the place of what they're being exposed to. So, um, awesome. What's uh, what's coming next for you up next for you, Dan.

Dan: 53:03

Yeah. So biggest thing that's happened right now. And I have no idea when you're gonna be launching this podcast, but,

Mike: 53:07

Me neither.

Dan: 53:08

Yeah. I, I, I have, uh, my certification, which is basically, you know, to borrow one of your terms, a career accelerated, or excuse me, career accelerator. So basically, we're just trying to get you up to the place where I am in the shortest period of time. It's around three months to get through everything. Uh, what's new this month is this certification now has online mentoring options. So we're kind of trying to mimic residency and, or kind of fellowship programs with the style of education. Uh, and that's actually gonna be out in the next, let's say around four weeks or so kind of, depending on when this, uh, is launched,

Mike: 53:39

Yeah, exactly.

Dan: 53:40

Yeah. I mean, the certification gets launched every six months, so it's not like you're gonna, you know, lose access to it. But that's my next thing. And I'm really excited about it. So more information to come.

Mike: 53:49

Yeah. That's a good one. I like that. Um, alright. Well, how do they learn more about you, Dan? How can they find out about that certification, your courses, even yourself on social media, what's the best place to find you?

Dan: 53:59

Yeah, absolute best place is to go to my website and then to sign up for the newsletter. I have a weekly newsletter. It kind of ups updates you on all the best content that I'm releasing, which is an absolute, you know, boatload. It's kind of crazy how much time and effort I'm putting into this right

Mike: 54:11

It really

Dan: 54:12

but I think it's super valuable.

Mike: 54:14

yeah. It's, it's

Dan: 54:15

gonna level up your. Thank you. Yeah. So it's gonna make you a better coach, better clinician, and it's weekly. So we'll get, send you, um, an email every Sunday, uh, but you can also find me on all the social media. Uh, biggest one is Instagram, but YouTube. I'm really pushing a lot, a lot of great content there. I'm also on TikTok and Twitter and Facebook, but it's not quite as good, but you can find me anywhere. Fitness, pain, free.

Mike: 54:35

that's pretty good. Yeah. Fitness painfree.com. I'll put some links in, uh, the show notes, but, uh, thanks again, Dan. Really appreciate that. That was an awesome episode. And just thanks for sharing all your wealth of experience with the fitness athlete.

Dan: 54:47

Thank you for having me. This is, uh, it's pretty cool. It's pretty surreal for me to be on a podcast. It's funny, cuz like I've been on the, the ask Mike rhino podcast for how many years now? Like five

Mike: 54:55

I was like six right.

Dan: 54:57

Yeah. I was so nervous for this one. For some reason, I feel like it was so different. oh my God, you're gonna be on a podcast with Mike rhino, but you really are one of my biggest mentors, you know, both from the standpoint of being a clinician, but also a business person marking all that stuff. I've learned a tremendous amount for, from you. I think it's, um, super valuable aspect that people don't realize. Um, how successful you've been, not just as a clinician, but as you know, let's say a career professional, right? You've done a lot of really cool things that I think others can learn from you. Um, but they don't think about that typically when they think of Mike Reynold. So.

Mike: 55:29

Yeah. Well, and, and thanks for you for doing the same thing. I mean, you're putting yourself out there and helping mentor other people. And I think you said it really well when you talked about your certification, but it's all about helping the next person get where we got but faster. So that way they can get ahead of us. Right. And they can, they can leap frog us down the road. So, um, awesome stuff. Thanks again, Dan. Appreciate it.