Greg Rose, DC - Assessment is Gold

Summary

In this conversation, Dr. Beau and Greg Rose discuss various topics related to movement and injury. They touch on the alternating joint hypothesis, the three pathways of injury (trauma, insidious onset pain, and altered motor control), and the importance of hands-on palpation and manual therapy in treatment. They also discuss the potential for a TPI-like model for screening and coaching runners. Overall, they emphasize the importance of understanding movement and addressing both mobility and stability issues in order to prevent and treat injuries. Running as a sport requires highly trained skills, just like pitching in baseball. Any movement can be turned into a sports skill with the right boundaries, technique, and rules. Running can be a skill, especially in sprinting and distance running, where training plays a significant role. However, the challenge lies in maintaining proper form and technique over long distances. Shoe fitting is crucial in running, as it should match an individual's physical abilities and needs. Force plates have revolutionized training by allowing coaches to understand and evaluate athletes' movements and exercises. Guidance devices, like RNT, can be helpful in teaching proper movement patterns, but it's essential to transition to performing without the device to ensure transferability. Motor learning drills should be practiced with variety, high conscious level participation, and sufficient time to strengthen tissues and make individuals more resilient. The decision to transition from motor learning to strengthening is a coaching decision based on trust and proficiency in performing the desired movement pattern. In this part of the conversation, Greg Rose and Dr. Beau discuss the concept of advantageous asymmetries in sports. They talk about how certain asymmetries can be beneficial for athletes in specific sports, such as golf and baseball. They also touch on the topic of normal movement patterns and how they can differ among athletes. Additionally, they discuss the importance of force production and how it affects performance. They mention the idea of the 'big brake theory,' which suggests that an athlete's ability to decelerate is crucial for acceleration. Finally, they mention ongoing research and development in the field of movement analysis, including the exploration of top-tier movements for assessing wrist and foot mechanics.

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Chapters

00:00 Introduction and Background

02:01 Understanding the Alternating Joint Hypothesis

03:17 New Chapter 3

09:03 The Three Pathways of Injury

24:47 Applying the SFMA Model to Running

26:08 Coaching Runners from a Skill Standpoint

26:15 Is Running a Skill or a Natural Human Movement?

28:16 The Importance of Training and Technique in Sports Skills

30:21 The Role of Genetics in Athletic Performance

33:30 The Significance of Proper Shoe Fitting

37:02 The Insights Provided by Force Plates in Analyzing Movement Patterns

46:49 The Value of Feedback and Guidance Devices in Motor Learning

49:28 The Combination of Guidance and Practice in Motor Learning

51:55 Making Informed Decisions in Progressing from Motor Learning to Strengthening

52:20 Motor Learning and Repetitions

52:51 Advantageous Asymmetries in Sports Performance

56:29 Ankle Mobility and Running Performance

57:35 The Role of Force in Sports Performance

59:04 Training the Non-Dominant Side of the Body

01:01:31 Future Developments in Movement Assessment

01:13:37 FARM Cast Outro.mp4

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Dr. Beau (00:00)

or even.

Greg Rose (00:01)

I'm here probably 60 % of the time and then California probably I'd say 30 % of the time and then the other 10 % traveling all around. You know what I mean? Yeah.

Dr. Beau (00:15)

Yeah. Wow. Why Arkansas? Do you have family there? Does your wife have family?

Greg Rose (00:21)

This is my wife's whole family is from here. She was born and raised there. We got a killer property and we have 80 acres here. We have our own river. You can paddle board and fly fish. I mean, we grow most of our own food. It's like adult camp here. It's awesome. Yeah.

Dr. Beau (00:24)

Okay, gotcha.

wow.

Yeah, sounds terrible. Well, I'm already recording because I hate like missing stuff. So we're just going to kind of dive in. But I just, I appreciate being on here. I know obviously you're busy traveling around and working with everybody. But for those that don't know, I can't imagine if you're in our field, you don't know who Greg Rose is, but I ran into Greg at the, what the ACRB rehab symposium a couple of weeks ago, gave a great talk that I got to sit in on.

And during that talk, as most of us do, that are kind of, you know, nerds in the seminar realm, like a bunch of questions came up and I asked, I think I asked the most questions during your entire talk. but I didn't want to take over. So there were a lot of things like perfect format would be podcast to bring you back on and just ask more things that I was kind of curious about. so I'm going to jump right in if your game. I don't know. Yeah.

Greg Rose (01:22)

Yeah.

Let's do it. Thanks for having me. Cool.

Dr. Beau (01:30)

and again, I'll give a little bio on Greg, but again, I just, he's not a newbie in our field. So if you don't know who he is, Google Greg Rose and you'll find out really quick. the big, the first thing I wanted to jump off on, because I think it's going to set up the rest of the conversation was you brought up again, which I've heard you talk about. I've known about for a long time is the alternating joint hypothesis, which Mike Boyle, Greg Cook, you know, mobile stable joints. My question is, and.

Greg Rose (01:38)

Ha ha ha ha.

Good.

Yep.

Dr. Beau (02:00)

I don't want this to be like, hey, we say different stuff when we're in different crowds talk. That's not what I'm trying to get after here. But is that, is that a rule or is that a heuristic? And what I mean by that is, is it something you live and die by or is it something it's like, hey, when you're kind of new and you're learning things, it's a good, it's a good rule of thumb. Or if we had different level of professionals, it plays better for, you know, maybe the coach.

Greg Rose (02:06)

.

Dr. Beau (02:26)

versus the medical professional just because we operate at different levels of information. Like we're all just operating at different levels. What's your take on that?

Greg Rose (02:34)

Okay. Yeah. So I well this is a loaded topic, but I would say that

this is our 99 % rule, right? So I would say nothing's 100%, right? But like you said, I think this is a very gross oversimplification to understand how the body would prefer to move. Let's put it that way, or was designed to move. And we always say that, you know, certain joints were designed to be very mobile. Those are the joints like the ankle, the hip, the shoulder, the thoracic spine, the wrist, because if you look at the joint,

angles and you look at the orientations and you look at the space of the design of the joint it's meant to move in all three planes pretty freely right so you know like your ankle can move in every direction your wrist can move in every direction but then there are certain joints that are designed to move in one plane of motion right like your lumbar spine you know I always say lumbar spine it better be mobile like you better be able to move your lumbar spine now in our joint by joint approach we call it a stable joint right what that means is that

Dr. Beau (03:29)

Mm -hmm.

Greg Rose (03:36)

it's very mobile in one direction. I think a lot of people think stable joint, though, and they just go, that doesn't move. I mean, the last thing in the world I'd want is your lumbar spine not to move, right? But what we want the lumbar spine to do is move in the axis that it was designed to move in, right? It was designed to flex and extend. When you try to twist and side bend from your lumbar spine, a lot of bad stuff happens, right? So I think, basically, I think the number one thing people, they argue about, like, should that be stable? Should that be mobile?

Every joint in your body is mobile. That's why they call it a joint. It's supposed to move. Our philosophy is more of three -plane versus one -plane joints. And so what we say, and when you think of it that way, it's pretty much the 99 % rule. It's kind of like, all right, your knee was primarily designed to flex and extend. Can it rotate? Yeah, it can get up to almost 20 degrees, depending on if the knees flexed or extended. And can it side bend? Yeah, but do I really want it to side bend? Probably not. You know what I mean?

I think in my way of thinking about this is I always try and make the path of least resistance through your mobile joints. If your mobile joints are restricted, the body tries to take the path of least resistance. Well, a restricted mobile joint is not the path of least resistance. So it tries to go through a stable joint. When a stable joint tries to become a mobile joint, which it can 100%, we tend to get bad stuff happen.

Dr. Beau (04:47)

Mm -hmm.

Mm -hmm.

Yeah, and I bring that up because again, you're creating a, it's almost like creating a recipe with treatment. You create some sort of schema so people can better understand how something works that's extremely complex because it gets argued, you see it in social media and all over the place, this whole, I don't know how long this concept's been around that people are like, well, every joint's supposed to be mobile and then it gets kind of misconstrued or taken out of context.

Greg Rose (05:28)

I think this is that word stable. Like when we say mobile stable, mobile stable, I think when they use that word stable, I think people might think of that as immobile.

Dr. Beau (05:38)

Yeah, well, it gets into the neutral spine, you know, misrepresentation and things like that. Again, I'm not saying like you and I are on the same team, like, we're against all those other people and we know what we're talking about. But the misconstruing, I think, literally just comes down to people wanting to argue. I think if you literally sat down in the same room, we'd be saying the same stuff.

Greg Rose (05:57)

Sorry, I got my doctor. But I actually think, I actually think there's all there's, it's terminology is first and foremost. I think when people, when you really sit down and listen to them, you kind of go, wait a minute, you're saying the same thing I'm saying. They just don't realize it. And, and then sometimes I think they start arguing over is what's more important, strength training or stretching. And if I'm going like strength training versus stretching is not the mobile stable car. Those are two totally different conversations, right? Like if I want to improve your mobility, I can use strength training, right? That, that

Dr. Beau (06:05)

Yeah.

Greg Rose (06:27)

We're not talking about like what's more important, stretching or strength training. I see a lot of people confuse that and I'm like, well, you're not even speaking about the same topic, right?

Dr. Beau (06:37)

What a way do you feel like, cause a lot of what you and Greg Cook and the whole FMS, SMA kind of team have done is tried to simplify things, right? Create screens, create assessments. And sometimes I think the simplification actually gets a lot of pushback because it seems over simplified. And then people are like, well, that's not how it is. And you're like, yeah, we know.

Greg Rose (06:57)

Yeah, I mean, I think, I think, you know, it's kind of like, I believe everybody prefers. This is just my personal bias to be talked to like third grade. Right. So I, I don't want to be talked like, like I'm an idiot, but I just want, please make it simple. Like, don't, you know, like the MRI is for the doctor. You don't hand the MRI to the patient and go, here you go. You look at it. You've got, had a lot of education to read it. And then you try and explain to them in third grade, what's going on. It's the same thing here. And I feel like.

you know people sometimes like me and your screen is it's so basic like there's so many more than we're like it's not basic enough like we're trying to make it simple

Dr. Beau (07:32)

Yeah, which it is important. And again, I think I was telling people in the crowd while I was listening to your talk of, you know, why I thought you were such a good teacher is how, you know, analogy stories and simplification and simplification for the purpose of understanding, not just to dumb it down. but that's tough. I mean, you're literally taking the most complex thing in the known world, the human and trying to like make it more understandable within the realm of, you know, a professional setting. something else that you brought up during that talk.

Greg Rose (07:48)

Yeah.

Dr. Beau (08:02)

was you talked about this, and I don't wanna, I'll let you tee this up, but you talked about the three pathways in injury, right? And I think you brought up a coach from, what was it, soccer? Or yeah, or yeah.

Greg Rose (08:12)

Ireland. Yeah, Liam Hennessy, one of the best physical therapists on the planet. Yeah. Yeah, so you know, when we were doing our advisory board at TPI, right, we have advisory boards on, so at Titleist, we have advisory boards for coaches, we have advisory boards for fitness professionals, and we have a medical advisory board.

And when we got that medical advisory board, me being young and naive, I said, I want to make a difference like everybody does, right? And I want to do something special here. And I remember saying to Gray, at the time, Gray Cook was on that board, along with a bunch of other smart men and women. And I said, hey, you've got your functional movement screen, right? That's for healthy people. But you always say, if someone's in pain, it can alter the FMS. And it's really not designed for people in pain. I'm like, we should create a pain one, right? And he said that.

I always say I felt like I was talking to Henry Ford. He was like, you know, actually I've been I've been actually working on one and I always say he showed me the backbone of the SFMA. I always feel like we got in the car, we drove and I'm like, this is amazing. Now halfway down the road the tires fell off and the engine blew up, but I was like, that's a cool idea, but it needs some work. So we went and basically made it our journey to let's perfect this screen. And I took a bunch of these smart men and women

on the advisory board and I said I want you guys to help us do this right and I said you know I want to be able to come up with a movement screen that can predict injury

Little or predict us the the cause of injury right better than any other movement screen on the planet because I always say You know their source and cause right so if your knee hurts That's the source of pain, but the cause could be your neck right it could be anything so we're like could be coming with a movement screen that could identify the true cause of the source of your pain and This very smart man Liam Hennessy said to all of us He said you know Greg if you're gonna come up with a movement screen and and you want it to be the

on the planet, you really need to understand the mechanism of injuries that can happen. And I'm like, well, I think we're pretty good at that. And he said, I don't think you are. And I go, what do you mean? And he goes, so I think this is the problem in medicine. And this is probably 2005, maybe? He goes, Greg, I think we can put all injuries into three buckets. He goes, the first bucket would be trauma. So obviously, if somebody punches me in the face, I know where the injury came from. It was a fist hitting me in the face.

And he said, are you good at diagnosing a trauma? I said, yeah. So if somebody gets a trauma, I can see where the swelling, the pain is, right? Let's say you twist your ankle. Ankle swells, so the trauma creates the pain.

And then I could see how they alter the way they walk because the injury created the altered movement. And he said, I agree with you. I think you guys are good at trauma. He goes, there's a second way to get injured. The second way to get injured is insidious onset pain. He goes, what if you didn't sprain your ankle, but you just started walking and your ankle had pain? I think we've all experienced this. Insidious onset pain. I don't know why it hurts. I don't remember doing anything, but it just hurts.

Dr. Beau (11:05)

Mm -hmm.

Greg Rose (11:22)

He said, are you good at diagnosing insidious onset pain? I was like, well, it's not as easy as trauma, right? But I was like, you know.

I can track dermatomes. I can evaluate the joint. I think I can still figure out why the joint's hurting. I go, when you get insidious onset pain, it alters the way you move. I understand why you're moving weird. And then because you're moving weird, it can lead to bigger traumas because you're not used to walking this way. And I go, it's so related, but yes, I think we can diagnose that. He said, good. He goes, now there's a third category of all musculoskeletal injuries. And he said, that's basically altered motor control.

He goes, in other words, have you ever woken up where you just weren't walking the same? Maybe you slept on a different bed. You ate some different food. Maybe you worked out in a gym that you haven't been out before. And we've all experienced that too. Let's say you're traveling. And you get up and you're just like, man, I just feel stiff today. So now when you feel altered,

you don't usually do nothing, you usually just walk it off, right? You just alter the way you move. So this altered motor control, it's altering the way I move, so I'm moving weird. Because I'm moving weird, I'm vulnerable because I'm not used to doing this, and that can create trauma, which can create pain.

Dr. Beau (12:23)

Mm -hmm.

Greg Rose (12:37)

We all agree that those are the three mechanisms. Trauma, insidious onset pain, or altered motor control. And then he said, are you good at diagnosing altered motor control before it's a problem? And I said, no, that's the problem. And he's like, so he goes, you need to understand, though. He goes, I'm not even sure if we know what normal is.

But we need to know what normal is before we can identify abnormal. But we all know this is probably the leading cause of musculoskeletal pain is some type of altered motor pattern is happening before the trauma or the injuries happening. And he said, you know, this is going to be a tough journey. This is what Liam said to us. And we all in our young cocky stage said, you know, hey, I think enough smart minds around us, I think we could we could knock this out in six months. Well, that was 2005. You know, I would tell you that we're virtually

Dr. Beau (13:25)

Mm -hmm.

Greg Rose (13:28)

almost 20 years into this and we're still not done by the way but the SFMA has come a long way and it's it's pretty pretty impressive but our whole goal was to try and do what Liam said become the best at identifying altered motor control because we know it's probably the number one cause of musculoskeletal injury in humans.

Dr. Beau (13:47)

Well, and that was, I mean, you and I didn't, you know, we went to the dinner, you know, that Saturday that we were in Florida and I was kind of giving you the 50 cent version of what I was going to talk about on Sunday. But this was kind of, you know, this is a question. This isn't, I an answer or anything. But as more research has come out and in particular people like Phil Snell and Justin Dean have started kind of elucidating some of this and, you know, this goes out back to Diane Jacobs. And I mean, people talk about this forever.

There's the three mechanisms. I mean, trauma, let's remove that. We get that one for sure. Obviously, I don't want to put words in your mouth, but I think you just said it. Like the SMA and that tool is very much focused on altered motor control. We go after the dysfunctional non -painfuls and try to let things change, right? Permeate through as we focus on those. My, kind of what I was bringing to topic was, there's a lot of evidence showing that sensitization in the periphery can occur without altered motor control.

Greg Rose (14:31)

Yep.

Dr. Beau (14:45)

It can just happen with normal movements, right? Without aberrations and then we can get into the whole, are there bad biomechanics and good biomechanics, which I think I kind of know where you'd lean on that one. But then that leads to the question of, well, there's two questions. Are there times when you're actually treating pain to not let the compensation come through? And how do you pick that up in the screening process or the assessment process?

hey, I think this is insidious onset pain and we know that that will change motor control or alter motor output. And then the other one is, well, how often is that happening? And like you said, you know, the SMA mindset is, hey, we think alter motor control is driving the majority of the pain that we're seeing outside of trauma. And again, I don't know. I'm just looking at both sides. I mean, I've, yeah.

Greg Rose (15:31)

Let me just say real quick. I believe in all three categories. I do believe there is pain generation without altered motor control first. Like I said, I don't think it's the most common, but it doesn't even matter. If we have the debate on what's the most common, who cares where all three are possible? You have to be good at all three of them. I'm not sure if your question was, do I believe that there's a...

Dr. Beau (15:59)

No, I guess because again, I agree that all three and again, I think it would be hard to determine the, what is the biggest swath. But my thing is if we have a real trauma, we can, that's easy to pick up. We had an on -field assessment, right? Your sideline care, ultra motor control. You guys literally built in my opinion, the best tool for sussing that out. Well, then is it, Hey, it's a exclusionary criteria. You went through all this and then this is what you're left with. Then is that how it's treated or is there some other way? And that's kind of what I was presenting in

Greg Rose (16:00)

Yeah.

Yeah.

That's it.

Cool.

Dr. Beau (16:28)

I was just presenting the evidence, not necessarily the best tool, because I don't know if there is a best tool.

Greg Rose (16:34)

Here's what I'll say about it, and this is in no way the correct answer to your question. But if you had somebody in pain and you did a top -tier S -symphoma and it was clear, everything's red, then I would say all terminal control is not your source or not your cause here. So I'd go. Now with that said, it's very rare to see somebody who passes all those, but that doesn't mean they can't have both, too.

And then it gets to that chicken or the egg like if somebody came in did it start with insidious and now they have the alternate motor control because I don't know when I got them after right so you know the question is is how long can somebody have this descent or this pain pattern and not show alternate patterns I think you'd have to get them fresh like I think it would

Dr. Beau (17:10)

Right, yeah.

Yeah, and I think it's almost immediate. I mean, look at an ankle sprain and we know it's like literally a scissorhap.

Greg Rose (17:29)

Yeah, that's probably it. But I'm just saying like, like if you said, Hey, what if there's a bunch of people who don't have altered motor control, but they have these problems with Pamir? I'm like, how long could they have those problems and not alter their motor control? I don't know. I don't know if that exists. It sounds like a unicorn to me, but I, maybe, maybe we get them fresh. You know what I mean?

Dr. Beau (17:47)

Yeah. Well, that tees up this next part. So again, maybe it is just exclusionary. You're like, man, we've went through this. It doesn't fit the categories and now we're jumping over here. This stage in your career. So you said 2005 was the first like kind of epiphany moment with the Espanay of Gray showing you that. So almost two decades later.

Greg Rose (18:07)

Yeah.

Dr. Beau (18:12)

Are you, if we walk in and I shadow you for a day, you know, treating golf and stuff, is it just like the playbook of SMA? Is it strict? You're running top tier to full breakouts or if we watch Gray grows like how the hell did he get there? Cause you're jumping around now because you're allowed to break the model.

Greg Rose (18:29)

Remember, if you're in SFMA, I apologize now. I'm the jerk who made the flow charts, right? So I'm the engineer of the group. So I like flow charts. And when I create those systems, I do not deviate, right? So I just feel like I've...

You want to say experience allows you to jump, but experience can make you make a mistake by jumping too. So I think if somebody walks in, first of all, if somebody comes into TPI, comes in to see me, if they have pain in any form or fashion, we're doing top tier, so we immediately break out. Now if they don't have pain, that's a different story, we're going a different route. But if they have pain, we're running the rule book. That's the way I do it. So some people are surprised. We have people shout at me all the time, and they're like, I thought you'd do something totally different than you teach in your class.

Dr. Beau (18:53)

Great. Yeah.

Greg Rose (19:18)

I'm like, no, we actually do exactly that.

Dr. Beau (19:20)

Which is refreshing, it's gotta be, because I'm sure that exists out there within the teaching and seminar world. So I did ask you this question, we didn't get to talk on it too much, that if you get to the end of the SMA, outside of a motor control issue, like an SMCD or whatever the most current terminology is, you basically get down to like a tissue disorder dysfunction or a joint disorder, which comes down to hands -on palpation, which I heard you.

Greg Rose (19:44)

It's either you get mobility or stability. And if you've got a mobility problem, it could be joint or tissue. Yeah.

Dr. Beau (19:51)

Yeah. So for those, you know, maybe students, new docs, even people that have been in practice for a while, there's a, I don't know how big a wave is it is. It can seem bigger than maybe it is due to social media, but there's a big wave of, Hey, we can be totally hands off of treatment. We can do an assessment. We can go through load management protocols. So let's say somebody uses an SFMA and they get down to the area via breakout that they think there's a problem.

how important is hands -on palpation, and then we could take that into actual manual therapy if that's necessitated based on exam.

Greg Rose (20:30)

I mean, this is gonna show my biases now, but you know, I feel like...

that one of our weapons is our manual therapy skills, right? So I feel like I always, I always, I know we have rules on whether it's tissue or joint, but when I get my hands on it, I can kind of start to really tell, you know, and this is where experience comes in, like, no, that feels like the joints are shifted or no, that feels actually like more tissue. And, and I feel like I always say mobility problems are like brick walls, right? You want to knock down that brick wall. Now exercise can

be a hammer and chisel and you can knock that wall down but sometimes you're like just give me some TNT right that that's manual there that's that's what we do right so I'm like if I can just blow the wall down in one visit and then keep and have the exercises keep the wall down I'm going speed I just feel like

Clients, as we all know, humans want the easy button, right? I mean, if, you know, this is why people take medications and pills and so on, they just want the easy button. And I'm going, you know, I'm pretty much the easy button. You're the easy button. If you lay down on my table, I don't know how much easier that gets, right? We can kind of knock this loose. Now, I always say, you can't be lazy. You're going to have to try and keep that wall down and I'll show you the drills and stuff to do that. And if I can't get the whole wall down, you're going to have to help me with these exercises, perpetuate this. So a lot of times it's a teamwork approach, but

Now, there's nothing wrong, like if you're not licensed to do manual therapy, hammer and chisel works too. Like, let's, there's nothing, let's keep going, let's knock the thing down, and there are some amazing exercises. Now, I'd say with a little caveat, this is why SFMA differentiates mobility from stability. If it's an SMCD or stability problem, well, I'm going to, I don't know what to mobilize. There's no, definition, there is no mobility problem.

Dr. Beau (22:20)

So in like you guys going back to the whiteboard ever, have you ever thought about going further into helping people determine, you know, joint versus tissue just beyond, because I mean, when I got taught the class, maybe it's different now. I mean, you guys were like, well, you got to figure that out with hands. Have you went further?

Greg Rose (22:32)

We did it.

So now? Yeah, in our level 2 SFMA, we have an entire diagnostic algorithm now where we go through and we try and give you the signs differentiating. Like, I'll give you a couple. So the big signs we would say between tissue and joint. So joints tend to be, I call it equal opportunity employers. They restrict multiple points, right? So if a joint's restricted, let's say your hip flexion is restricted, but everything else is clear. Not saying that can't be joint, but that you more thought that there was a higher chance it's tibia.

whereas hip flexion is restricted, hip intro rotation is restricted, and hip extension is restricted, I'm starting to lean more towards the joint, it's probably restricted. So joints tend to go multiple planes, tissue tends to go single plane, but once again, I can show you tissue that restricts multiple planes, so you gotta get in there and palpate. And then the second most obvious would be when you're taking a joint, like if I'm flexing my elbow, right?

where you feel the tightness. If it's on the contractile side, there's not many tissues that get restricted on the contractile side. That's usually a joint block.

Or if it's on the elongating side, you feel something tightening up, that's usually not joint, that's usually more tissue, right? So if I feel something on the elongating side and only one plane of restriction, I'm pretty confident I'm dealing with a fascia or a tissue or some type of connective tissue. If I got multiple planes, it's on the contractile side, I'm going, yeah, it smells like joint to me, right? So we kind of go through, we show an accessory joint palpations. If it's restricted, we always like the palpate joint first, because if the joint's

not clear, it's kind of even hard to get to the tissue tension, right? So we do accessory playing. In our level 2 SMA, we teach in our online classes and live classes how to do those palpations. And then we do a tissue evaluation that we really took from Mike Leahy at ART. I helped him teach the diagnostic track for ART. And it's a tissue palpation.

find where the links tension are. So yeah, we do kind of, I think we do now help you get to that local biomechanical testing.

Dr. Beau (24:40)

Yeah. Yeah. Cause you basically just left us out to fend off the wolves. Yeah. You're just like, better be good. no, I figured that was coming, but you know, we were fairly early in the game. so now getting more, I'm interested in all this stuff. And now like, I have questions that I've literally had since I took SMA almost a decade ago now. obviously the TPI, you know, SMA medical model has been wildly successful with golf and tennis and baseball, rotary sports.

Greg Rose (24:43)

I left it in you forever.

Dr. Beau (25:10)

The Sfma and FMS are based on neurodevelopmental models. He talked about that a little bit in Florida. When we look at running, right, because I'm in running both from personal, what I like to do, but also who I treat, it's kind of at the top of the neurodevelopmental model, right? Like nobody teaches you how to run, but for some reason there's a lot of gate training and gate retraining and all that. So I'd love to pick your brain on, first of all, do you think,

Greg Rose (25:26)

you

Thank you.

Okay.

Dr. Beau (25:40)

that a model like a TPI model of screening specific for running as a sport could work. I know it's a broad question.

Greg Rose (25:46)

I have no doubt. I'm 1000%.

Dr. Beau (25:53)

Okay. So here's my next question then. So I, I've thought about this for years, actually put a pitch into Brooks about the Brooks running Institute, trying to steal everything that you ever put out there and say, Hey, there's this TPI thing. And the pushback I kept getting from people in the field that work with running is well, you know, running is the thing that's not learned. And then there's a, there's two diverging paths, right? It's basically, if you look at dynamic systems theory, right? You have a tractor states and

Greg Rose (26:03)

I think it would be great. It would be great.

Dr. Beau (26:21)

how a joint can move or what's allowed or not allowed is gonna drive something. And then you have this whole gate retraining that you can see people, you can change via cadence and stride length and all these different mechanisms. I don't know how much you've worked with runners. I'm sure just from being a biomechanics nerd, you could dive into this, but I know where I stand. I just wanna kinda hear what you think. If you think that model can work, you just said yes. Well then.

Do you think that we should be or could be coaching runners from a skill standpoint, just like a golfer? Because I asked the question during your talk of.

Greg Rose (26:53)

I can't even believe that's a question.

Dr. Beau (26:55)

Well, in the, but if you look at the, if you look at the research again and you look at the highest level people in the field, there is not a concise, you know, one side or the other. It's, it's literally split in the middle.

Greg Rose (27:06)

That's crazy to me. So it's like I can use this analogy anywhere. Like if I said, you know, throwing's not trained. It's just something that humans can do with time. Right. OK.

But pitching is a skill of throwing that is highly trained. So I agree. Running, humans can run. That does not mean you're going to go beat Usain Bolt. That's a very highly trained sprint is a very highly trained. So is that what we're talking about? Running as a sport? Are we talking about this?

Dr. Beau (27:24)

Mm -hmm.

Yeah, both sprint and distance can get some different, you know, ideologies. I get that. But yeah, just running as a sport. Yeah.

Greg Rose (27:47)

Yes, you know, it's kind of like, you know, I always feel like when you're young, you learn basic human movements, the fundamentals, fundamental movement skills, right? So throwing, you know, running, sliding, hopping, all those things. And those have no, there's no objective. It's just, you know, throw that way, right?

When you put it into the framework of this is a baseball game, you have to stand on a mound 60 feet, six inches away. You have to hit into a certain zone over here and you have to fool a hitter over there. It now becomes a barely highly trained skill. And there is no way anybody's going to tell me that you can't train pitching, right? From, from throwing, right? Those are two different, even if it was, I'm a hunter, I'm going to throw spears. There is an artwork that's passed down from generation to generation on how to do these things. Right? So to me, any movement of course,

Dr. Beau (28:22)

Mm -hmm.

Greg Rose (28:40)

your humans learn how to do these movements. But any movement can be turned into a sports skill, right? If you put the boundaries, the technique, there's rules, guideline, anything that has that, now all of a sudden motor learning becomes an appropriate thing, right?

Dr. Beau (28:43)

Mm -hmm.

Greg Rose (28:55)

And I've spent many hours watching coaches improve people's running. Just because biomechanics is sometimes opposite of what you believe. What do you think? You think, I should do this until somebody really highly trained and skilled tries something new and different, learns something, until that information is because it's not intuitive. It's not natural to pitch like that.

You know, if I sit in, I guess, different tracks, different terrain change all these things. But to your question is running a skill, it depends on if this is a sport. If it's sprinting the 200 meter, if it's hurdle, those are sports. Those are 1 ,000 % training, right?

Do I agree all humans can just learn how to run on their own? Yes. Will some be faster than others? Yes. They might get luckier. But if I train somebody how to sprint based on our biomechanical information, they'll beat all of them.

Dr. Beau (29:57)

What about, does it change at all for distance running? Let's say we get a marathoner.

Greg Rose (30:01)

1000 % it's still a skill

Dr. Beau (30:03)

The reason I ask that is, so if you look again at dynamic systems theory applied to running, what they've seen, especially as they study more ultra marathoners, is people, they slip into this attractor state regardless of coaching. And they see this shifting that they've seen, basically they did a study at Western States where they just put basically Dartfish -esque technology on people and watch what happened to their gate and they saw people gate shift.

So they would go to more pendular gait, kind of a double stride. So they're almost like speed walking to running. And they would do it normally to basically probably offload tissues and metabolically efficient. And then coaches took that data and started coaching people to basically gate shift throughout an ultramarathon to change their gait consciously. So you talked a lot about motor learning concepts in your talk, which that's where I wanted to go with this. Cause now it gets very interesting to me that, okay, for sure I agree. We can coach the skill of running.

Greg Rose (30:53)

Thank you.

Thank you.

Dr. Beau (31:00)

But then you see the longer somebody runs based on metabolic demands and then also biomechanical efficiency, like what you can do for muscular endurance and how the joint moves, that people tend to fall back into the same old pattern, that old book, as you would say, right? At a certain distance and then it gets really hard. Do you think that's, you know, just another training like echelon they have to kind of work on or like, do you think that's just like, God, that's a really hard thing to change, which I get it's hard to change. That's motor learning.

Greg Rose (31:29)

I guess what I'm trying to say is I would find it really hard to believe that if I took the top three ultra marathon runners in history and I put them in front of a young ultra marathon that they couldn't teach them anything. Do you agree with that?

Dr. Beau (31:46)

Yeah, I agree. Yeah, and again, I agree, but again, there's no absolutes. I think we'd agree on that as well. If you looked at the top, yeah.

Greg Rose (31:54)

Yeah. Let me say something about genetics. Okay. So you always say like, you know, we always say, you know,

Working hard beats genetics when genetics doesn't work hard, right? But if genetics work hard, it's hard to beat, right? So there are maybe some freaks who are just born with all the knowledge, all the wisdom of wherever they got it, and coaches just need to get out of their way, right? I am sure we can come up with examples of that. But I am also 1 ,000 % sure that is not the majority. That is the extreme minority.

Dr. Beau (32:09)

Yeah.

Greg Rose (32:30)

And I'm going, I don't know if I'd like, if I want my kid to win the Super Bowl as the quarterback, I don't know if I want to just go, I just hope they got the genetics where I, we've seen you can train a quarterback. You know what I mean? Yeah. Now again, might be one of those, like you said, like, you know, I,

Dr. Beau (32:42)

Yeah, yeah.

Greg Rose (32:48)

I don't want to be so naive to say, like, I just, I can't imagine that you being the best at a sport and to be the best in the sport, you just need nothing. Just, just no previous information, no coaching, just keep people away from you and you'd win. I, I'd have to see a lot of evidence of that. You know what I mean?

Dr. Beau (33:07)

Well, the other interesting thing is, is when you look at the differences in people's gait based on anthropometric measures and male versus female and where, what sports they play growing up, what distance they ran growing up and how they got into the sport of whether it's marathon, ultra marathon, you know, the Olympic trials are going on right now. I, what I see in running is that it's not a TPI approach of there's a million swings for a million golfers. It's there's running gait.

and then that has to permeate across. I think that's the problem in my opinion of how running is trained as a skill is it's very put in a box. And I get that there's.

Greg Rose (33:43)

Well, let me tell you, I'm gonna give you the secret sauce here. This is, you know, people always ask like, so you said not a TPI model. Well, let me explain to you what a TPI model is. Like how we, because we like that we've done this for softball, we've done this for baseball, we've done this for tennis. Actually, I'm building one for quarterbacks right now with Jordan Palmer. And we've got, I built one for US lacrosse, we never launched it, but we got like, I feel like you can do this for any sport.

Dr. Beau (33:54)

Mm -hmm.

Mm -hmm.

Greg Rose (34:09)

Here's maybe the difference and maybe they'll understand my philosophy. I believe that if you take any sport, let's take running, right? And you take the top 20 minds in biomechanics or coaching, put them in a room. And I said, okay, guys, let's all agree on what's the best way to run. How's that gonna go? Is that gonna be smooth or is that gonna be like World War V?

Dr. Beau (34:32)

In running, I'd say it'd be fairly smooth if you took the top 20, but it.

Greg Rose (34:36)

So I'll talk to the top 20 coaches in the world. I'm talking about the top 20 coaches in the world. Coaches, not players, like the coaches, and say, can we all agree on this is the best way that you should run?

Dr. Beau (34:47)

I think there'd be a little bit of strife, but I think largely everybody agrees.

Greg Rose (34:50)

Okay, okay. Well, that would be very unique because usually there's lots of like different techniques and stuff in there. Normally, like, how did that go like?

Dr. Beau (34:54)

Yeah. How people train, I think would be the point of conjecture and running. Yeah. Yeah.

Greg Rose (35:00)

I'm not even there yet, it's just more of agreeing on what running should look like. Normally what we find, like if I said, let's take 20 baseball pitching coaches, put them in a room and say, okay, what's the best way to pitch? We're gonna have a debate, right? They're gonna have a hundred thousand percent. Because you and I both know there's a million ways to pitch, right? So they're all right and they're all wrong, right? So what we never do is we never say, here's how you run.

Here's how you golf. You'll never, if you come to TPI, we will not tell you how to swing a golf club. What we do instead is we do the complete opposite. We all go, could we agree on the most fundamental biomechanics that people shouldn't do? So we go, you know,

Okay, when you swing, should you move towards the golf ball during your swing? Coaches will say, no, you shouldn't do that. You lose space, like in baseball you get jammed up, you can't hit an inside pit. Okay, we agree you shouldn't do that. Should you start with your upper body first, and so your lower body, that's called over the top. Every coach says, no, you shouldn't do that either. Now if I said, how should you start? That's not our philosophy. All we're saying is we agree on these certain

Dr. Beau (35:47)

I don't know.

Mm -hmm.

Greg Rose (36:11)

Fundamentals that shouldn't we shouldn't see so what we do is we we go through and we we interview for years like two three years Tons of coaches and we get down to a point where we go Okay, we came up these 15 things that every coach agrees with right so like we call it like in golf We have the big 15 right in baseball pitching. We have the big 12, right? The big 15 are the 15 most common Characteristics that every coach on the planet that we've talked to would say yeah, of course you shouldn't do that, right?

So once we show you, like, here's all the things you shouldn't do, people go, now I know what to do. I'm like, well, first of all, I didn't tell you what to do. I just told you you shouldn't do these things, right? And then what we do is we say, you know, it's interesting. A lot of people do these things, right? A lot of people do these things. And we go, why? Why do people do these things that we all agree you shouldn't do? Well, one of the reasons people do things is because that's the only physical thing they can do. They don't have ability. So we said, is there a way for us to do a physical assessment, to screen somebody?

And see if they can't do this, they're probably going to do one of those 15 things. So to answer your, to go back to your running, like if I was going to go after marathon or ultra marathon or something that mattered, I would sit down instead of trying to figure out, okay, what's the best way to run? Like, can we all agree on, here's the things you shouldn't do, right? Maybe a coach gave him the wrong information. And if you, if you can agree on all the things that you see people do wrong, you've got a potential to come up with a screen.

Dr. Beau (37:21)

Mm -hmm.

you

I mean, I teach, we basically have seven parameters that come from all of the gait analysis research from the most detrimental to the least detrimental.

Greg Rose (37:40)

That make sense?

And can you do a physical screen and predict if they're going to do this? And you're already happy.

Dr. Beau (37:55)

For sure, I basically came up with mishmash. And my thing is, I guess I'll kind of eat my words from before. I think what happens is, which I think this happens in all sports and why you guys are successful. So let me back up. I think coaches and trainers try to get people to run a certain way without seeing the physical limitation, which creates the problem, which in essence, now we have a non -implement sport, right? And the body is the thing.

And yet we just kind of say, we don't want to have overstriding or a tibial inclination angle of this much. And we don't look at, can their ankle even do that? And then we create a problem by trying to idealize the running. And I think that's the crux.

Greg Rose (38:33)

I'm gonna date myself, but Patrick Swayze said, don't put baby in a box, right? We don't do that, right? If you're saying everybody's gotta swing like this, I totally disagree. Yep. Yep.

Dr. Beau (38:38)

Yeah.

Yeah.

Yeah. So, well, that answers that for the running, which again, I figured that would be the answer. My thing would be...

Greg Rose (38:56)

And by the way, I'm willing to learn if I'm wrong, I'm all ears. Yeah.

Dr. Beau (38:58)

No, no, no. I mean, when I put, when I pitched this to Brooks, I literally said, well, per Gregor's story, Titus wanted to sell more golf balls. I'm sure you want to sell more shoes. Like let's go. I think the thing is, and yeah, maybe in golf, what would be your take on shoes get looked at as a fix or a, an implement to change running, right? More of a drop, a catalyzing, you know, forward propulsion, more cushion, a carbon plate.

Greg Rose (39:08)

Yeah.

Dr. Beau (39:27)

So now the thing that you're selling is supposed to change the mechanics. If I change the mechanics, does it negate what shoe I wear? And I know that's maybe a harder question to answer, but like if I, let's say Titleist now sells golf clubs for a specific type of swing. Does that change what you guys do?

Greg Rose (39:41)

Well, I think maybe I'm thinking of this a little differently, is I would say, based on your physical abilities, right? Let's say you've got somebody who's got great ankle mobility, and then you've got somebody who's got horrible ankle mobility. Would you put them in a different shoe? Then the shoe matters, and the type of fitting matters, right? Based on their physical weight. So I agree, 1 ,000%, right? Like if somebody's got no mobility,

I probably want a shoe that's as mobile as possible. Somebody's got no stability, I probably want a shoe that's stable. So I feel like people think of shoe fitting as in like, okay, size and last and volume over there. I'm going, you know, you and I are both going, how can we assist the human, right? So first thing I need to know is what the human can do and then try and match a shoe to that. So I feel like it...

If like, you know, I'm going to take golf, right? Because we obviously we.

Dr. Beau (40:41)

Well, Footjoy did this for a while, didn't they? Yeah.

Greg Rose (40:43)

I'm gonna take off because we own foot joy, right? So we do we we evaluate we're big on shoe fitting with our players and what we do, you know, we we actually I helped design a shoe called the project way back for foot joy was the most mobile shoe in golf at one point But we have the most stable shoe right all the way down to the most mobile shoe We tried to create a suite of different ones because that's how we were fitting We were basically first of all, we would go in and we would Evaluate their mobility stability. We would look at the lower extremity for sure and if they we would put them in three buckets

It's very mobile, very stable, a tweener somewhere in the middle, right? One of those. And we had shoes that we had preferences. Like if somebody had no mobility, we had the very, we call them the happy feet, mobile shoes, trying to give them mobility. And if somebody had no stability, we had the platform stability shoes and then just normal somewhere in the middle, right? Like a drag for us. And basically we would then go and we would try and figure out what's the best last, you know, one of the things that people don't understand about shoes is that as we get older, most people's feet actually get smaller.

and wider. Like, you know, if I say I'm an 11 and I try an 11 because I was 11 when I was 12 years old and I just haven't tested it ever since. And I just go in and I say 11 and it feels tight. I usually ask for 11 and a half. We're actually a 10 and a half wide is probably what you need. So people come in with the wrong size shoes and the left foot and the right foot sometimes aren't the same size. I mean, there's so much to that that I think is ignored in the world of professional sports that when you get the right fit on there, they go like, God, like I can use the ground better. Like the ground reaction force.

on force plates are different when you actually fit them properly.

Dr. Beau (42:16)

Yeah. What would be your take? I didn't plan on asking this, but just because again, I agree with matching, you know, foot architecture and ability to the shoe during performance. What about in practice? Does it change with footwork because you have this whole, you know, a minimalist shoe movement to strengthen the foot. And we could also say, well, if you have a, you know, a really rigid foot versus a very mobile foot, you could still use stability to train either one of those. Would you change what you're doing with that? I'm assuming yes.

Greg Rose (42:40)

Hello? Hello?

Yeah, I mean it depends on what the goal is, right? You know, I'm always like, you know, in training we try all kinds of stuff and then in performance we're gonna go with what we think is gonna perform the best right now. Right?

Dr. Beau (42:55)

Yeah. How much, so you brought up the story during your talk also of asking Mark Blackburn if he had to pick one tool to use the rest of his life, it would basically be force plates. Force plate treadmills have been huge, bilateral force plate treadmill has been huge for gait analysis for the past two decades, floor treadmills. How much has that changed what

Greg Rose (43:07)

Yep.

Dr. Beau (43:21)

you do in terms of working with a golfer in terms of working on their body, but also golf as a skill.

Greg Rose (43:28)

Force flights have changed the way I look at players and train players more than any device in the last 10 years, right? Like I said, I feel like force flights have done two things. Number one, they allow me to literally step inside my player's body and try and feel what it feels like to do what they do. Like just think about, imagine if you had a sprinter and you're like, I can't figure it out, but I can I just step in your body real quick and just run the race in your body. You'd be like, as a coach, you'd be like,

I didn't realize you were doing this, right? I'm always like, I always want to step inside my athlete's body and feel like, hey, what are you doing? And I, before we used to look at 3D or 2D video and it would show us like, okay, their hands are here at the top. So we'd put our hands there at the top and we go.

Okay, I think you're doing this. But not knowing that there's 400 different ways to put your hands in there at the top, right? And how you put your hands over there can be, can dramatically change the feel. And that's what we get from the force plates. It's how you move, right? I can see, are you pushing forward or to the side? Are you going vertical? Are you twisting? Are you torquing? Like we can see all those things. And then the second piece, so first of all, it allows me to get a better understanding of what my athlete's doing. And then secondly, and probably the more important thing is I started evaluating our exercises.

right in our drills and I'm going, do they match what the athlete's doing from a force production on the ground? And I can tell you right now, about half the stuff I used to give people, it wasn't even close. Right. And I'm like, you know, we used to go like, I can't believe that doesn't transfer. Like that seems like such a cool drill or transfer. And then we got the first plane and I'm like, no, I know I doesn't transfer. Actually, it's potentially negative. Like it's completely different the way they're creating force. So, so now, you know, we started, we went down this pathway about three years ago going, I got to take every exercise, get them on the force blades and I can start mapping out the exercises.

I'm like, this is gonna be amazing, right? So I start taking medicine ball drills and I'm going through and I remember I had one athlete and we went through like 30 drills and I was like, this is awesome. So I took the 30 drills and I'm like, all right, this one's more of a frontal plane torque. This one's more of a lateral. And I was like, all right, we gotta do some more. And I was like, you know what? Let me grab another athlete. Let me just make sure that that's what those, like at the next seven, 30 exercises. And he did them completely differently. And I was like, damn, okay, that was dumb. Like everybody doesn't do exercises the same either.

right? But now I can at least see when I give somebody an exercise, are they doing it the way that they do it when they swing, so that we transfer. That's just been game changer.

Dr. Beau (45:53)

Do you go that in depth with each player now of like if you're giving them correctives or something that you put them on the force plate to see if it's actually getting what you want?

Greg Rose (46:01)

We've always done this under 3D just to make sure that their sequence is like their way they're transferring energy But now I can see how they start their power to see if it's the same way and then does it transfer through their body I always feel like man anything you do on a regular basis throughout the day if you're just like I'm just gonna practice my backswing in my office, you know

man, it better be perfect, right? So I'm like, you can measure that now to see if it's actually perfect and we can go keep doing that. Or I can't tell how many players come in. I'm like, let me see the drills you've been working on. And I'm like, don't ever do that drill again. Like that's actually part of your problem.

Dr. Beau (46:33)

Well, I thought the two best slides in your entire talk in Florida were just the bullet points of motor learning and then feedback of like summarizing. Cause that's, and you could kind of tell within the crowd there, like that was, I wouldn't say mind blowing, but like there were people that maybe have never heard that, but also definitely weren't adhering to it just based on the questions and the pushback. And I think it's very interesting.

My one question there is, and this is just kind of a fun question, I guess. So you talked about basically using an aid, right? Some sort of device or something for feedback. So where does something like R &T fit into that? Cause you were kind of bristling against like a feedback. So if I use, you know, and you like, you said there's a time and place for it for sure. R &T were using a band obviously to direct traffic into the, you know, the mistake. So how's that fit into that whole?

Greg Rose (47:08)

Thanks.

RNT, the fancy name for that we call challenge feedback. There's facilitated feedback, challenge feedback. So any type of feedback, right, to me does one major thing, right? It helps the athlete do the motion properly, right?

Dr. Beau (47:47)

Mm -hmm.

Greg Rose (47:47)

That does not mean they know how they learn doing that, right? It helps them do the motion properly. Now once you get them to do the motion properly, you can now start the motor learning process and teaching them how to learn how to do that and how to remember to do that. So guidance devices I think are great, like reactive neuromuscular training, RNT, to go, that's what it feels like to do that properly? You go, yeah, that's what it feels like. Now what does that feel like? Now you ask the athlete and the athlete goes, man, so when you were pulling me to the right, I was trying to prevent myself. So as I turn,

I felt I felt more like in my groin where I usually feel on the outside of my head perfect Okay, as soon as you have that feel we can take a feel we can't take form form doesn't work We can take a feel and we can create a motor pattern now, right? So it's like a you know create this book on the shelf in your brain and once you have that feel we can go into all the research that shows you how to do this but now you need to go to do it without the guides device because No, we're not gonna be pulling on them in their doll swing So they have to be able to reproduce that feel but they needed to know what the field felt

like in the first place. That's where guidance devices come in. The problem is that so many people just practice with guidance device and they never let them know. So they never really actually took the next step to see could I do it without the guidance device. And that's really important. So I think the motor learning world for a while was like get rid of guidance devices because it wasn't transferring. But I'm going okay just because it didn't transfer doesn't mean it's not a good device. Maybe we're just not using it properly right. So anytime you do RNT you do any of these things you can do this with a patient or as a client. I think the

Dr. Beau (48:58)

Mm -hmm.

Greg Rose (49:17)

The RNT entire goal is to reproduce a normal pattern and give you the feel. Once you have that, get rid of it and try and reproduce it.

Dr. Beau (49:27)

In your world, this probably isn't a huge issue because you're dealing with extremely high level athletes and you even said you're playing above the pain line most of the time. So for somebody that's in clinical practice, whatever you want to call them, the loving term that I've actually heard come from the TPI world was a motor moron, whoever said it first. But let's say we have somebody that's not kinesthetically graced. You're right. So now how much like,

Greg Rose (49:48)

That's the norm, by the way. Yeah.

Dr. Beau (49:54)

does that change? Obviously you have a high level athlete, like they may need like literally like four reps with some sort of RNT and I got it and then you remove it versus somebody literally you think they got it and then they come back in and it's abysmal again. Like how do you.

Greg Rose (50:05)

We've all experienced that person where you do the RNT, it looks great, it's so different than what they normally do and you go, can you feel that? And they go, I don't feel a difference, right? That's a motor morgue. They're like, you're like, dude, it's like.

the amount of movements like reduced by 12 inches and they're like, I just can't feel it. So if they, if you have that person, I, in my personal opinion, you can't move on. You have to try and keep doing more guidance devices, more things, because until they can feel it, they're not going to change because they tell the difference between the old pattern and new pattern. So I feel like this is probably, like I said, the norm is that usually you have to try two, three, four or five different things until they go, no, that felt different. I can feel something there. And you go, now where did you feel it? Right. And it's going to surprise you because out of their mouth,

doesn't matter as long as they can feel the difference. And then like I said, take the RNT away and say, OK, show me what you were doing before and now show me the new feel and see if they can do it without it. If they can, then you can do without it. If they can't, we're going right back to the guidance device.

Dr. Beau (51:04)

I think I saw the most people sit upright in their chair when you asked how we program motor learning drills at home. And there were a couple of answers and then you're like, it's like if we did 10 minutes of work with a bunch of variety, high conscious level participation, I don't think that happens. I think the hard, okay. So I think that was a great piece of information, absolutely fantastic.

then you said, you know, there is the strengthening side. Like, yeah, now we gotta, you know, print that pattern, we got it, and you gotta strengthen tissues, make people more resilient. Is there, just like you have helped people in SMA level two determine, you know, joint versus tissue, how do you help clinicians determine when can you make that jump? Okay, how do you know it's a proficient pattern and how we can go into training it, you know, in the gym setting?

Greg Rose (51:54)

Yeah, I think this is this is a coaching decision, right? So this is just what this is what

Bill Belichick would have done with Tom Brady making a coaching decision you're doing with your patient, right? Going, number one, do I trust them to do this at home on their own, right? And then number two is, is it at the point where I don't even have to say anymore, they're just kind of doing it, right? Or they'll say, I don't even feel it anymore. And you're like, let me check. And you're like, what's, cause actually now it looks kind of good. That's when I shift into, okay, hopefully, cause our goal is for it to become automatic. I don't want you to have to think about it, right? So that we could just do strengthening on there. So to me, that's a game changer.

day coaching decision. Pretty obvious though. It's usually pretty obvious.

Dr. Beau (52:36)

Okay, you also mentioned, yeah, and again, I would say, but I think sometimes you see one or two things. People perpetuate motor learning concepts, whether they're doing it right or wrong, through the entire rehab trial of care, or it's right to strengthening in the face of the motor plan not being idealized or as good as it could be, or offloading the sensitized tissue.

Greg Rose (52:44)

Sometimes it's not.

Yeah, I think that's a good point too is that, you know, a lot of times you're like, we got to build a new motor pattern and you don't realize that they actually have the pattern or they just built a bad one on top of it. And most people like within a minute or two don't need motor learning. They just need they just need repetitions now or strengthening. Right. And

Dr. Beau (53:09)

Yeah.

Greg Rose (53:18)

Again, that doesn't surprise me either sometimes. I'm like, you know, it seems like maybe if they say, you know, I used to do that when I was 14. And then somebody told me, OK, then we're not building a new motor. I just got to remind you.

Dr. Beau (53:27)

Mm -hmm.

Yeah. You talked about, and I've heard you talk about it before of normal, normal aberrations movement or normal dysfunctional non -painfuls with certain athletes, right? Whether it's a unilateral athlete. Do you think that those are, and let's just use golf as one, and then I want to kind of ask about running, but let's use.

Greg Rose (53:49)

It's like you're talking advantageous asymmetries type of thing. Yeah.

Dr. Beau (53:52)

That was my question. Like, are they advantageous or are they just normal asymmetries?

Greg Rose (53:58)

Okay, well I definitely believe in advantageous asymmetries for certain sports, right? I've fallen by countless hours of like like okay like If I take a Well, let's do Captain obvious a baseball pitcher, right? You know, their total arc should be normal, right? But it better be shifted to external like they better have

Dr. Beau (54:16)

in

Yeah.

Greg Rose (54:23)

two three or I don't like three ones but they should have a two three on the FMS shoulder or else you know we have a station at the NFL Combine right and if you know anything about football combines the pre -combine training people try and make the athletes

perfect the combine scores, right? It's like, I want to get the best. So they're like, we're going to nail a 21 on the FMS, you know? So we get all the data for the teams. And I can't tell you how many times teams have said to me like, hey, I got this quarterback and they got a 21. I'm going to quarterback out of 21. I wouldn't draft them. Like that's, that is not normal for a quarterback. If you tell me their shoulders balanced, I'm like that, that either they're not throwing it off or somebody did the test wrong. That's, that's messed up. Right? So I feel like there are like,

you know, how you get these asymmetries is important, but I think there are, there are, you know, to me there's, I call it, I hope this makes sense, like in FMS we call it the, or.

Okay, like let's say you want to win the Masters. We call it the jacket bracket. You know, if you want to win the gold medal, we call it the medal bracket, right? If you're going to be a, you want to win the gold medal in table tennis, right? Pretty confident you need to be between a 15 and a 17 on the FMS. And I can show you how you need to be able to do that. Now to keep you in that 15 to 17, there are certain advantageous asymmetries that we feel help you in the sport. Now, stay there. You don't try and make these asymmetries in training, right?

Dr. Beau (55:34)

Mm -hmm.

Mm -hmm.

Greg Rose (55:52)

It's just you practice so much it develops these So we always say like your goal. Here's the cool thing for you and me the guys in the pit crew, right? We're trying to balance them like we should be treating you trying to bounce it But your volume of practice shouldn't let us win, right? So that if we got the good ratio of treatment to practice you'll stay in that bracket, right? Now if we treat you too much and you're not practicing enough All of a sudden you start going above your bracket, right? If you're practicing so much, but you're not getting enough treatment You'll start to drop below your bracket and keeping them in that bracket is is

Dr. Beau (55:55)

happens. Yeah.

Right.

Greg Rose (56:22)

you know is is quite the challenge but that's that's kinda how I look at those advantageous asymmetries.

Dr. Beau (56:27)

Yeah, which I would 100 % agree with that. And again, if we, and I know you, what'd you say you have something like over 5 million data points within, is it multiple sports or just golf?

Greg Rose (56:34)

Yeah. We had multiple sports, whole Olympics. Yeah.

Dr. Beau (56:38)

Okay. So when we look at running, the two big, this got into a big social media thing a couple of weeks ago that, you know, it's normal for runners not to be able to touch their toes and then obviously deep squat because ankle mobility issues. So here's my question. Obviously that's normal amongst that population, but then you can very quickly look at data on not being able to touch your toes and the correlation to low back pain, even though people want to say there isn't one there a hundred percent is. So again, now we're.

how do you reconcile, you know, now you're working with a major pattern, like just a flexion pattern, somebody were saying, Hey, it's normal, you can't do it. And then you're like, well, man, there's all of this information saying that if you can't touch your toes, there's a much higher risk of low back pain. So again, I know we're trying to balance them, but where, cause I know we're tuning athletes and you need some stiffness, especially depending on what sport you're playing. Like, is that just again, game time decision? What's the phenotype of the person in front of you or are, are there certain things that you're like,

God, I know that's advantageous, but like, could we get more, a better flexion pattern, you just control the end ranges better. Like, are there certain things you're like, we don't like that, even though it's normal in that population.

Greg Rose (57:44)

Yeah.

Yeah, normally, I'm trying to think in my mind, normally they're advantageous asymmetries. Like right toe touch is better than left toe touch. Versus bilateral can't touch the toes, right? Those are usually not advantageous. There's not a lot of those, right? So.

Dr. Beau (58:00)

Yeah, like a curve runner in 200. Use the Usain Bolt, yeah.

Greg Rose (58:13)

You know, again, like you just said, the curve runner, I could see one side potentially being stiffer than the other side. But in general, most professional athletes are way more mobile than non -professional athletes.

Dr. Beau (58:26)

100 and that that was my argument if you look at the bell curve professional marathoners are Super mobile you and I wouldn't think they were until you look at the data and you're like, they can sit in a full deep squat and touch their toes and

Greg Rose (58:34)

Yeah.

I mean, look at Olympic lifters. I mean, people think, the weights, I mean, they're probably the third most flexible athletes in the Olympics. They've got to get under the bar. They don't get the bar with their head. So I think that,

people go, they're tight compared to who? Like compared to the most flexible person in that sport or compared to normal humans? Because normal humans are the ones that are tight. These athletes are not. I'm like, and people say, you know, John Rahm, you know, on the PGA tour, he's on the Liv tour now. John Rahm, he's a big guy. He doesn't have a big backswing. He must be tight. I'm like, actually, he's one of the most flexible guys. He learned to play from a short swing, right? That's just how I learned, right? I'm like always to blab these people.

Dr. Beau (58:53)

Yeah.

Greg Rose (59:19)

who challenges something you need to test more professional athletes.

Dr. Beau (59:24)

No, that's a really good point about the population comparisons like that. I was actually talking about

Greg Rose (59:30)

Yeah, because I hate it when they say, really fast athletes have to have tension and have to be tight. And I'm like, now you're telling this kid who has no flexibility that he should be tight. That is not what they're talking about. Like that is that's lack of mobility. They're talking about tissue tension. That is totally different. Yeah.

Dr. Beau (59:40)

100%.

Yeah.

Yeah, the ankle dorsiflexion debate within running is a huge, just, I think, misconstrued. Like, I think you're hitting the nail on the head and I think people just normalize things that can lead to injury.

Greg Rose (59:57)

I think things that are hard to produce, like if you find somebody who's got tight ankle dorsiflexion and you don't know your stuff, it can be very challenging for the medical practitioner to improve that. When they don't have the skills, most people don't go, I need to learn the skills. They go, it must not be that important. I see that a lot. So don't, yep.

Dr. Beau (1:00:16)

Yeah, yeah, normalize it. I was talking with a golfer in here the other day, which it's a different scenario when it's a club golfer. He was like, basically he wanted to know why I thought he needed to increase the amount of rotation and swing, right? Because he had basically a stability motor control dysfunction. And I was like, you don't want to play it in ranges and all this stuff. Trying to explain it to him.

And he goes, was that what pro golfers do? So I just kind of had a question come to mind when you brought up John Rahm, right? So if, because I heard you say what, force applied over longer times or more force applied is how you're going to get more distance out of the ball, basically. So if you have a John Rahm that has more in the, you know, bank in terms of range of motion, why not maximize it? And you're like, well, he's doing great. So don't change it. But is there ever like an injury prevention mechanism where you're like, well, he doesn't have to create as much force now if he can go further.

into it as long as he's not running up against that physiologic barrier.

Greg Rose (1:01:12)

Sure. Yeah. Yeah, so John's a great example of this. I mean, John was born with club foot on his right foot. So his ankle is pretty much fused. I mean, you can't really use his ankle. And the more he rotates, the more he goes unstable on that backside. Right. So he grew up playing high line and these little short change direction sports. And in a way, I'm like, this is perfect, man. Like you were not taking you beyond your physical range of motion. Now you have them. You have the range of motions.

Dr. Beau (1:01:19)

Mm -hmm.

Greg Rose (1:01:40)

Like we said, there's three ways to develop power, right? You apply more force, you move your hands faster, or you apply that force and velocity for more time. A longer backswing gives you more time to apply that force and velocity, but I'm like, John Rahm is like the size of you and me combined, but he's huge, right? I'm like, he's got so much force and velocity, I don't even know if he needs more time. Like he doesn't. So if he took a bigger backswing, could he hit farther? The scary answer is, yeah, he probably could. He doesn't need to, he's still one of the longest hitters out there. But I think what he's done is he stayed in

Dr. Beau (1:01:47)

Mm -hmm.

Yeah.

Greg Rose (1:02:10)

inside his physical abilities.

Dr. Beau (1:02:13)

Yeah, so you've created that barrier. Well, kind of the last two questions I ask everybody on this podcast, you can take it wherever you want, keep it in the professional realm if you want. But what is one thing that for a very long time or for a long time you held to be true that you completely changed your mind on? They're just like, I shift.

Greg Rose (1:02:32)

I think we talked about it. Force, man. Like the force, I'm telling you, like, there are, you know, throughout my career, there's countless examples. Like in SFMA, we talk about proprioception. We used to think everybody had proprioceptive problems. Now we think it's more mobility problems. But I think force has completely changed the way we look at players to the point where,

I agree with Mark Blackburn, like if I was only going to have one tool going forward it would be a force plate and assuming that the drill looks good does not mean they're creating force the same way they do in their sport. To me I'm like, wow it looks perfect, they have to be doing it right. I just don't believe that anymore. So that's probably where I would go with that question.

Dr. Beau (1:03:13)

Mm -hmm.

Is the only proxy for that, like, cause you said you're putting, you know, athletes on force plates for exercises. So let's say we have a clinician or a golf coach that doesn't have force plates. Is there any proxy besides feel for making sure that like, if it looks good, because like you said, form, isn't the thing we want to fall back on.

Greg Rose (1:03:36)

Yeah, I mean I think you know it's kind of like you know I don't have an MRI machine, but I've learned a lot from MRIs right so force plates the same way like I think don't be like I don't have it so I can't do this no we've learned so much from it that I think you said it though you know if you're trying to get something to transfer Please don't look at like that looks like a golf swing so that exercise must work right. I don't care if it looks golfy

What's more important is does it feel like your golf swing, right? If it feels like your golf swing, we're probably getting some benefits. If the exercise feels totally different than when you're doing the sport, I'm not sure if we're using our time appropriately, let's say maximizing our practice.

Dr. Beau (1:04:17)

I remember Charlie Weingroth's talk at World Golf Fitness Summit. I don't know what year it was, golfish, that everything, if it looked golfish, you go, that's great. And like trying to get away from that. Well, real quick, you had mentioned that, you know, another one was maybe the proprioception versus, you know, now, can you just touch on that for a second?

Greg Rose (1:04:23)

Yeah. Yeah. Yeah. Yeah.

Yeah.

Yeah, so you know, I think, how old are you, Bo? OK, so I've got almost 15 years on you. So when I was going through school, and maybe it's the same when you were going through school, everybody had a proprioceptive problem, right?

Dr. Beau (1:04:40)

40.

It was pretty much the same.

Greg Rose (1:04:53)

Yeah, that's kind of what we were taught. Like everybody had a personal. And then I started looking at a lot of the, you know, I'm thinking golf, we got to have speed balance. And we started looking at all these unstable surfaces. You know, you have the air, X pads and you have the balance on stuff. And the research is coming out really clear that it was very poor transfer. We're like, this is crazy. Like you think that if we work on unstable surfaces, it would transfer really well. But I wasn't seeing the transfer either. And the research was saying it doesn't transfer.

Now when we started SFMA, we got to Single Leg Stance. And I told you we had a bunch of smart people there. I grabbed Dr. Mike Voight from Belmont Therapy. His doctorate was in proprioception. I said, Mike, you are going to help me do Single Leg Stance. And Mike, with his Southern accent, was like, no problem, Greg. He goes, we'll knock this out first. This will be easy. It took us three years to do that. I keep blaming on him. I say, Mike, you must be slow. But basically, our paradigm is wrong. We felt like everybody started with proprioception.

trying to do Perception.

Now it's like so captain obvious, right? Like you said, a fundamental switch. It's, you know, how do mechanoreceptors, proprioceptors, how do they work? Right? When a joint moves, it stimulates the mechanoreceptor and pressure changes in, can stimulate this. Right? So to say when you sprain your ankle, you damage your proprioceptors and now you have no stability. It makes way more sense that when you sprain your ankle, you lost mobility and you're not stimulating it anymore. Because what we've found now is that if I just give you your mobility back, it's amazing. The proprioceptors are working now.

Right like I don't think they were ever damaged. It's just they weren't getting the proper input, right? So we flipped our entire thought we were like like you said rule out by exception We said let's check first to see make sure there's not a vestibular problem, right? And then if there's no vestibular problem, let's just make sure that you've got the appropriate core control mobility Let's just make sure you've got ankle mobility him like because if you don't have those Let's just break that loose first and see if all of a sudden your balance approves because 95 % of people improve now when you do that, right? But

If your vestibular is good, you don't have any core, hip, spine stability or ankle mobility problems, then we're going to go, okay, then you probably do have proprioceptive problems. Based on our millions of data right now, that's less than 6 % of the population. I've been going through school, I thought it was 96 % of the population.

Dr. Beau (1:07:08)

Yeah.

You needed like eight BOSU balls and yeah, blindfolds and everything else. Well, the flip side of that question is what is something that you hold to be true or you're just like, I think this is the way it is, but there's no data to support it yet. And I'm gonna hold you to a different candle that you can't use something that you have data on from TPI that has been released.

Greg Rose (1:07:15)

Red.

think about that. Okay, big break theory. Now this is something Tom House and I, Tom House, one of the best coaches in the baseball football world.

We have a philosophy we call the big brake theory, which is that you will only accelerate as fast as your brakes can decelerate you. So we're going, if I'm in a car, I don't want to go so fast where my brakes don't work anymore because I'm in trouble.

So we feel like the body puts an internal governor on you. So this is why we're really adamant. And there's tons of people that call us wrong. And again, the evidence we have, I say no evidence. I think the evidence is, what's the word, non -conclusive yet.

People say, should you waste time training the opposite side of the body? We always say, I feel like it's a huge value to train the opposite side, not only because the biggest, fastest athletes in the world have some type of history of non -dominant side training. It's scary, the volume on there. But I feel like the best way to train your breaks is to...

to go explosive in the non -dominant side, right? So we do lots of non -dominant side, like for your sprinters, I would have them run backwards. Do you do that with your guys now?

Dr. Beau (1:09:01)

Yeah, and I mean, a lot of this, you know, you're a big mentor to me, even though, you know, this first time we've kind of talked privately, but I still remember, you know, I think you brought the example up of who are the fastest people in the NFL. It's usually cornerbacks. Now, is that because they run backwards or just that's the position they fell into? Nobody older now, but it's a good, it's a good correlation to make, you know.

Greg Rose (1:09:13)

Yeah.

Yeah.

Yeah, yeah, it's like, you know, if I go through like.

you know, the fastest swingers on the PGA Tour, you know, like they were left handed in this sport, now they compete in this sport in long drive. If I go to baseball, like there's always this like, man, I didn't think about it. But yeah, I did this when I was young. I did this left handed or blah, blah, blah. And now I do this. Like I know coaches now like in baseball and softball that if you're a right handed thrower and left handed hitter, they'll draft you. If not, they won't even draft you because the data is so overwhelming that but no one in the research can prove that that's a

Dr. Beau (1:09:32)

you

Greg Rose (1:09:54)

And there's some very, very smart people that say it's BS. But I can tell you right now, every one of my athletes is training non -dominant side.

Dr. Beau (1:10:02)

Well, and I think if you take it out of rotary sports, so if you look at, you know, Trent Nestler, I guess he's probably the biggest influence on ACL, you know, research that we probably have. I mean, looking at how people decelerate, right? Rolling through the ankle instead of breaking on the toes, but also like just how they decelerate. and I mean, that's probably, it's one of the best, like, you know, return to play criteria, but also risk assessments you can do for ACL. So I think there is a lot of evidence in that realm.

Greg Rose (1:10:19)

Yeah.

Yes.

Yeah, but again, I think a lot of people will tell you it's inconclusive right now on the big break theory, but I'm doing it no matter what, to answer your question.

Dr. Beau (1:10:38)

And again, you don't have to obviously release any, you know, clandestine secrets, but is there anything you've always kind of said what if you come to a TPI or SFMA seminar and something's not new, that's kind of on you guys. So what's on the horizon? What's coming out in the next few years? Anything big?

Greg Rose (1:10:54)

I'll tell you something about that. I was pretty excited about it. We had a very, very smart gentleman from the Johns Hopkins organization come to one of our SFMAs. And one of the challenges why we have not put wrist and hand in the SFMA yet is we can come up with a top tier. I think he showed me a top tier for wrist that might work. So we still don't have foot, wrist, and TMJ. And we've been working on those. And it's the top tier that's the limiting piece here. It sounds weird, but that's for another podcast.

I think you might see a risk breakout in top tier coming for estimate at some point. I told you I'm hoping that we'll be launching a couple other sports, quarterback certification, and then we're working on all of our level twos in baseball and softball now too. And then I would say our tools, our apps, the things that complement us is something that we've been spending a lot of time on. But I love, like what you said, running. If you want to take a running one to the world, dude, call me.

I'm in. I love doing new sports and doing that stuff. Everybody calls me the juice extractor. You give me the 20 smartest people in running, we will extract the juice from their brain and come up with a screen.

Dr. Beau (1:12:07)

Well, and that's, I asked the question during your talk of, cause you said, you know, one of the big, two of the big pieces is hand TMJ and then foot and wrist for gymnastics, which is, you know, what my wife specializes in is a nightmare. I mean, that's like one of the biggest plagues in gymnastics and I know in golf, it's also up there for kind of a killer of careers. Is there, I know you said you might have one for wrist. Are you guys actively working on foot and ankle a little bit more, or is that something that's just kind of back burner?

Greg Rose (1:12:33)

What's kind of weird is like we know how to break out the foot. It's more if I said what's the top tier movement that identifies altered foot mechanics? That's where it gets complicated because you're like is there one movement that I can do to see if there's all things in the wrist and foot or in the TMJ and I'm like...

Dr. Beau (1:12:37)

Yeah.

Gotcha.

Yeah.

Greg Rose (1:12:54)

I think TMJ might be a little easier, but the foot and hand had been challenging. But like I said, a very smart person showed me something a couple months ago and I was like, man, that actually, that might be it right there. Yeah, it's weird. Like I said, we have breakouts. So I know like your foot's a problem. I think I know how to break out your foot, but I'd like to have a top tier to make it fit into the model. You know what I mean? Yeah.

Dr. Beau (1:13:13)

Mm -hmm.

Yeah, well hey, I'm always excited and I keep tabs on you guys obviously and it's been a few years for us since I've been to a TPI or SMA so I'll make sure I head to one if it comes around earlier, we'll host one here in Nashville, Birmingham soon but before we jump off any last.

Greg Rose (1:13:27)

in.

Are you in Nashville or Birmingham? Where are you at?

Dr. Beau (1:13:36)

I'm in Birmingham, but we just started an education company where we're hosting in Nashville just because it's easier to, it's more fun. People want to go to Nashville. It's easier to fly into the Birmingham. So we're doing a lot more in there. Yeah. Yeah. we're actually heading or heading away from you, but we'll be heading up towards, we go through Arkansas on the way up to Missouri. which I didn't realize it's like fly fishing Mecca in North Arkansas.

Greg Rose (1:13:45)

Well, actually, you're a little far from me here in Little Rock. Yeah.

big time. It's like, have you been there before?

Dr. Beau (1:14:02)

Yeah, I saw a trout. Yeah, I saw a trout on the water tower, wherever I was. I was like, and then I started looking into it and yeah, it's amazing.

Greg Rose (1:14:08)

Beautiful area. Cool. Awesome. Well, thanks for having me, Beau. Appreciate it.

Dr. Beau (1:14:12)

Absolutely, Greg. Thank you so much. And yeah, hopefully I'll see you again soon and get to talk with you a little bit more. All right, man. Take care.

Greg Rose (1:14:17)

Sounds good. See you then. Yeah, bye.