Function Trumps Pain, Records Being Broken, and the Teams’ Upcoming Adventures: Week in Review 41

In this conversation, the team discusses various personal updates, including training for upcoming races and the challenges of live streaming. They delve into the latest trends in track and field performance, highlighting recent record-breaking achievements. The discussion also covers clinical cases, providing insights into patient care and treatment strategies. Additionally, the host reviews recent research articles related to fascia and its role in health and performance, emphasizing the importance of understanding the underlying mechanisms of treatment.

Links to articles discussed:

Fascia as a regulatory system in health and disease

https://pmc.ncbi.nlm.nih.gov/articles/PMC11346343/

Uphill Treadmill Running and Joint Mobilization Improve Dynamic Stability and Ankle Dorsiflexion Range of Motion in Young Adults With Chronic Ankle Instability: A Four-Arm Randomized Controlled Trial

https://pubmed.ncbi.nlm.nih.gov/39304079/

Transcript

Beau Beard (00:00.142)

with my parents. Like a live call? Yeah. Oh, a meeting.

Beau Beard (00:16.076)

Whoa, it's like showing you typing on the note as you're doing it. All right, mic's up because we're live recording, doing all that. So while you're typing stuff, you somehow got to make it entertaining for everybody else. Let me see if I can figure this YouTube stream. look at that. Looks absolutely abysmal. So it's a little delay. Cool. I'm not going to click on it. Well, let's see actually.

If I can mute this and then that way I can pay attention if there's a chat. All right, so this is our first attempt at, back up here in a sec. First attempt at streaming live, it looks abysmal from what I can see, so we'll see how this turns out and we'll pay attention to the chat. It looks like there is a 10 second delay, maybe.

But either way, if you have a question, you can put it in on the Riverside chat if you had the link to that, which I just posted on Instagram. But I'm going to try to make these little more interactive if we have viewer questions and then we've changed the format of the week interview. It's fun to talk all nerdy and talk clinical cases and stuff like that. But I think like five people listen and one of those people is Tyler Lindburner.

So if you're listening and you have a question on the live chat, chime in. We appreciate you listening. But we're going to change format up a little bit. So first things first, it's kind of anything exciting going on with you guys? Maybe don't get too personal. I mean, we don't even know about like, you know, an impressive bowel movement or being evicted. Well, that's, that's off in the future a bit. Have you guys found any place to live? No, waiting on my tax return. I'm waiting on Alex to get his tax return.

Pre-approval, all that jazz. So you're still trying to buy a house? Yeah. And I'm trying to rent from the guy who's trying to buy a house. Oh, so you're going to be, oh look, you already have an investment property. Yeah. OK. Our third option is moving to England, Yep. OK. Finding somebody else. Oh, with Evan? No, Evan's moving to England. third option is moving. I thought you said your third option is moving to England. was like, that's a, OK. 2025 has been off to a hot start. rent one, or move to England. There's a lot going on in 2025. Yeah, remove from a house, buy a house.

Beau Beard (02:44.334)

Not sure when he's going to buy a house. Let's see. Other roommate. sure if we're getting approved for a house. Other person's moving to England. Yeah. So it's been sweet. That's fun. I had a stomach bug earlier this week. Yeah. Absolutely torched me. That's pretty exciting. cold going on. Everybody's dropping like flies. I was sick last week, but we have kids, so we have a better

Y'all bring the stuff here. There's no stomach coming from us. crap he had. Yeah. That was church group right there for you. was. Anything else? So I got hot and heavy on the, posted all of it and I followed it for the first eight weeks to a tee, but trained for the Mount Chi Ha 50K, which is Saturday. Also it was snowing in like 19 degrees this morning. So I hope that changed a little bit before Saturday.

Yeah. but my motivation kind of tipped off around week nine. mainly just, kind of, well, not, not kind of, don't like running 26 miles on a Saturday. So, I didn't follow the plan to a T after eight weeks. What was funny was we went to dinner with the Toshas. So if you're from Birmingham, you know,

David and Mary Jo Tosh are basically the people that are responsible for growing the trail running scene in Birmingham. They hold the Southeastern trail series, blood rock 100, the Lake Martin 100. Now the Southern States, 100 and 200. And we were at dinner with them and Travis Grappo who owns Oak house, shout out Oak house came up and we were talking about that. goes, oh yeah, yeah, yeah. You're like me, you're 280 HD. You can only do a six to eight week block training, like lead up. There's no way you can do a like.

12 to 14 week, goes, I've had the same thing happen over and over. I was like, yeah, maybe that's a good point. So, um, and then I kind of decided around that nine week mark that I didn't want to do the race. And I mean, I was signed up from before I did the 14 week training block, but then Sloan was kind of jabbing at me a little bit and I decided I might as well do it. So yeah, Saturday I'll be doing that. The goal was sub five hours. I think the goal is now just, uh, I don't know.

Beau Beard (04:58.016)

Race myself not other people because then I'll blow up if I because it's some fast looks like some fast people signed up so we'll see but on the next week interview in two weeks, I'll give an update on that race and see how it went. Nothing else really going on. got I guess from my end. got my my triathlon season. I guess finally is going to start when that certain hopefully hopefully. Yeah, so I got a bike fit yesterday for my tri bike. It was sweet. yeah. Shout out bike link and Hoover. Yeah, that was Joe.

is a man. looked at me and I got on there and he goes, he started asking me like everything that was like painful on this bike, which I basically bought it from a friend and I just like, you know, this thing will do and just like hopped on it, sort of riding and it feels abysmal when I rode it. It's fast, but it feels abysmal. So I did like a sprint try last summer, still didn't like get it fit. So it's been like, I guess a year since I've had the bike or close to it. And even though it,

felt abysmal to Seth, he was still crushing me the one and only time I rode with you, which I was on a road bike and you're on a tri bike. So yeah, there's that. But yeah, he got on there and I thought the bike, it kind of like helped me a little bit, guess, learn a little bit about...

the actual positioning of the tri bike, cause the bike itself is a little big for me. Like I, I'm like five eight. So like a good bike fit for me for a tri bike should be between like 52 and 52 centimeters for like bike frame. this is like a 56. So I'm like riding on the cusp of it being like a little too big. So I had hearing that I had the seat kind of lowered as far down as I could, like the seat post itself. And he's like, yeah, you're actually pretty cramped on this thing. And I was like, I'm actually cramped on this. I was like, I feel like.

feel like it's a little big for me so I don't feel like I can like toe off as well like I guess in the bottom of my pedal stroke. And he's like, no, he's like, you my hips were like pretty uncomfortable on that thing. So he actually raised my seat and moved me forward. And once he did that, I felt like a whole lot more like open It makes sense for Tri-Bike because I'm just pushing back. Yeah, because he's like, you know, the whole goal of this thing is not to be comfortable.

Beau Beard (07:04.884)

It's to make the, it's to make it's to become less fertile as your basically pudendum gets crushed. He just like, it's, he goes, it's to make the run suck less. So, but anyways, we, we moved everything around a little bit, like move my seat up, move my, move my seat forward. and went out back and like, he's like, I want you to actually like put this thing in like big gear. So he goes, right now you're not, you're not cranking down on it. And he goes that, that bite can chew up some ground.

because he's like, have big cranks on there. And it felt like incredible. was like, I could push, I could push in big power for a long time. So when's your first race? So I've got to do Athlon with the Vulcan Tri Club March 1st. So that's next weekend. Yeah. So was nice. Nice time for a stomach bug. So wait, what in the do Athlon, your? It's a mile run. It'll be a 17.3 mile bike and then a mile run. And then that's all at Oak Mountain. So the bike will be hilly. Yeah.

So there's no rhythm at Oak Mountain. If you ever come to Oak Mountain, you're like, hey, I want to like get into a groove. Don't. It's fantastic for strength, but it's not like a beautiful. Yeah. And then they've got a practice triathlon in April, April 19th with the club that I'll probably do. There's supposed to be like a sprint try option. And I think this was supposed be a longer option if you want to do your longer races. But that is three weeks out from my 70.3.

So I'm just gonna do the sprint try, just like a gear up. Where's that at? Which one? That sprint. The sprint, it's gonna be at Oak Mountain as well. So it'll be in the lake and then it'll probably be, if I had to take a guess, out to like Lunger Lake area and back from the beach. And then- And you landed on which half Ironman? I'm gonna do 70.3 golf cause- sub-cancelled and all that. Yeah, so the reason I say like earlier that I was like my season's gonna finally begin, last year I actually built You've been training for 15 years at this point with no race.

But I built up last year, I did a sprint in Tennessee, and I think it was June. And then I had two other races set up that we were gonna do in July. Me and you were gonna do one in Guntersville. You were gonna do at Half Ironman before that. You were gonna do it in the late spring of 2014. I was gonna do Chattanooga. Yeah, so there was lot of having to shift.

Beau Beard (09:31.054)

Last year was like my first real year being in practice, trying to figure out timing of different things. We went to a couple seminars early in the year where we traveled out of town. I was like, I just can't go three weekends in a row and then go out of town again for a half Ironman. CCSP thing too. CCSP. We were supposed to do Mountain Lakes in Guntersville. Me and Bo were. Not in Gold Lakes, Mountain Lakes.

And then you were out of town like six weeks in a row and you're like, can't, I can't do another weekend out of town. I got COVID the week of Buster Britain in August. And then September came around and I was like, well, at least I'm still signed up for my half Ironman in Augusta. And as I did that, Hurricane Helene decided to make an appearance.

And basically just like smoked all of Augusta, which I actually packed my parents drove down They picked me up and we were at my house and I just went back inside to like go to the bathroom before we like hopped on the road because we had like, know, four hours to Augusta and As I was in there came up mom goes. Hey, did you get the email? They just canceled the race So like I was like seconds away from being on the road heading there. We still go. Yeah, at least I didn't go

So yeah, then didn't get a refund, but we got to change whatever race we wanted to move it around to. So I chose Gulf Coast. So yeah, it should be interesting. It's an ocean swim, which that's kind of dicey. It's like me sharks and jellyfish. And then, which I guess I've never swam in the ocean, so I really don't know how far down you can see in like pretty clear salt water. Yeah, I don't know how far they'll have you down. The further you go out, I mean.

Yeah, but I you have sandbars for a while. Yeah, I don't think I'd want to see. And then yeah, it should be a flat bike, flat run. It's just gonna be pretty warm. There's no shade. And what's the date on that again? May 10th. All right, so we got a lot of stuff. I might do exterior again. I'll train for it. just, there's a lot of stuff going on that weekend and I still don't know how much, I mean, we're gonna be involved, but I might be doing a lot. So then I just, I don't know.

Beau Beard (11:50.286)

I'd like to do it again for sure. The big thing is I I still, told myself after this race, after the 50 K that I was going to get a membership at the Y and swim while it still cold. It's, it would be very hard for me to get to the Y early enough and still get here and do stuff. Like, I don't know. They open at five. Yeah. I'm here at 6 AM on early days getting work done. And then the thought of getting back in that lake like three times a week and swimming.

With the E. coli. That doesn't bother me. It ain't hot. It's it's thought of driving 30 minutes out to Oak Mountain, swimming in the lake. Then I feel like I want to do some sort of small break like run or bike with it. And then there's two hours and then I mean, it's time. So it takes time. Um, I'm going to train, but maybe not as much as I did last year. Uh, if you swam any, you would swim more than you did last year. No, I swam quite a bit leading up to it, but I only signed up three weeks before. Right. So I swam a lot in three weeks. Right.

So if I got three months ahead of it, I started well, March, April, May, two and a He basically trained to fatigue. And then said, I'm gold. Whoa. Let's get out there and survive. So that's kind of the happenings in here. Like events, you've hit how many Tuesday night runs now? man, since the first week. first week January, like six. So we've been doing Tuesday night runs, track shack and us.

have partnered together to do runs at Veterans Park, a three and a six mile option, three and five mile option every time. we're brainstorming on how to create a summer series with some giveaways and things like that, that will be based on attendance. So if you're listening, start showing up so you can put your name in the app for maybe some stuff, Adirond or at the end of the year, we're still working on that. So I don't want to announce too much. what else? We'll be at a couple of races.

Working some stuff. So we got the wine 10 K the first week in March or that Saturday, March 1st, think, right? Uh, rump shaker, which is March 22nd, Saturday. Where's that at? It is downtown regions part. It starts at regions field and finishes there. So we'll be doing our normal song and dance stretching, soft tissue recovery, healing, you know, the crippled, um, don't show up in a wheelchair and expect miracles. That's not going to happen. Uh,

Beau Beard (14:14.702)

I think that's it for events. The barn burner, way off in June. Yeah. 10 K and a half marathon. So it's always been a five and 11 mile, which was odd. And I think it'll be easier to market with those distances, but also, I it just should be better races. Cause you mean it's easier to train for something that, you know, you're already kind of maybe in the mix for. I think that's it. Anything else event wise? I don't think so. Seminar coming up in Nashville, first week in April.

Running retreat running treats same weekend. So Jonathan Croy, what's the company with this company called finish line? He's doing a three-day running retreat Friday Saturday Sunday Sunday. Yeah, Alex is doing a talk Friday night and then leading the hike Sunday morning and then they also have Corey Waltering which if you don't know that is I don't know if he runs for North Face anymore it might Ultra endurance athlete that ran for North Face. He was on the

eco-challenge that was last televised on Amazon. Um, he's been on a couple other, he was on a, another endurance show that we watched. can't remember what it was. Uh, yeah, he's a, he's a cool guy. Uh, pretty funny. I don't, he's the keynote speaker one day. then he got Trey from zombie trail races, Carrie Morgan from cadence running, cadence run coaching. Who else?

Yeah. One more speaker. Yeah. Yeah. It'll be good. Um, it's a whole weekend, full running and education, fun stuff. And if you know Jonathan, you know, it's going to be a good event. So yeah, I think that's it. So let's move over to, well, before we off events and happening, this isn't personal to us or the farm, but what in the is going on in track and field craziness. If anybody's been following our social media posts on Thursdays, um, these guys, you got one coming out today. I'm assuming, right?

Yes, but it won't be actually track related. forgot I made the video, but I haven't posted it. Yeah. So in the last two weeks or so, give or take, it's a, there have been, I think six world records broken in the men's on the men's side, at least there was like a race walk up in there that I, I don't know what it was, but I saw that it was of the six. don't keep up with that. No, it's, it's impressive that you can.

Beau Beard (16:39.338)

stick your issue, your iliac crest in your armpit, but, and walk with two feet on the ground, but supposedly, yeah, supposedly. I did see some guy ran like five or ran, sorry, walked five 24 for a mile recently. And that broke a record by like 10 seconds or so. no way two feet on the ground. Right. That no way. I don't know. your legs be 10 feet long. There's a side. Yeah. So

Starting, guess, shortest to longest, you had the men's mile. This is indoor season, so there'll be different records for the indoor and outdoor track seasons. Men's record in the indoor mile was originally broken at the Millrose games by American Yara Negus. I ran 3.46.6 amongst a huge crowd of other countries' records. The guy who got second was an American, also would have broken the world record. It was just a fast race overall.

really cool because the same day American Grant Fisher broke the American record in the men's 3k running 722 and also another race where you had fast competition so him and Cole Hawker went to the line Cole Hawker also broke the previous record but it was you know obviously Fisher leaned him at the line however five days later after Nagoose broke the

Indoor mile record, Jakob Ingebrigtsen soloed a 3.45 one. Indoor mile. Now he had a pacer, but he won the race by like eight seconds. again, I think he's got some good competition this year, but there's a clear division between him and the rest of the field, at least over in the European side. And then in...

Six days after Grant Fisher broke the indoor world record for the 3K, he breaks the indoor world record for the 5K running 1244. Took a substantial amount of time off the American record. Just really cool to see him run two world records in a matter of a week. He was a guy that graduated high school at the same time and he ran sub four minutes for the mile in high school. Everybody's like, hey, this guy's gonna be it. And he had a great collegiate career, but just won his first Olympic medals.

Beau Beard (19:00.974)

this past year, two bronze medals in the five K and 10 K. So for him to break world records is, you know, he's kind of taking the next step. And then after that, the next day you had on the road, Jacob Kipley Mo from Uganda broke the world record in the men's half marathon, his own world record. Crushed the world record by 50 seconds, 56 minutes, 42 seconds, which is for 19 a mile. That's he, I saw the splits.

per 5K, average 5K would be $13.25, but his, so two $26.50s for 10Ks, his 5K from 10K to 15K was $12.57.

Beau Beard (19:46.305)

That's 407 a mile, 1257. And he won by over two minutes and the dude's 25. Like he got started on the road racing very young, didn't really do much on the track. He has run some, but you would think, oh, you know, why doesn't he run? Surely he would break a world record on the track in the 10K, which I think he could, but he likes running on the road. So what do we think is going on?

Yeah, there was a really funny satirical post put out, I think, by Grant Fisher, because he's sponsored by Nike, and in the picture after the 3K or the 5K, it was him. Are you good, Dawford? We're having some technical, not so technical difficulties. There's a post that he put out of Post Race, and he's holding his spike.

Right. And all I said in the caption was it's got to be the shoes and which everybody's been discussing as that's the big differentiator in the last few years of these super shoes or carbon plated, different foam shoes on the road. see that playing a bigger role. they were originally designed for the marathon. And you think about if you increase efficiency in a shoe and then you get to do that for the course of one to two hours, that's going to have a bigger effect than in a three K seven and a half minute race.

And when we were racing in high school, there were spikes that had carbon fiber plates and release carbon fiber in the sole of shoe. So I think he was making fun of the fact that you guys think that has to do with the shoe, right? not that all of these people are now pushing each other really, you know, to the next level. And you think about, a similar effect whenever Roger Bannister breaks four minutes in the mile, nobody thought it was possible. Then after he does it X number of people very soon after that record.

broke four minutes in the mile. And three weeks ago when we saw Ethan Strand run 348 for the mile, two seconds faster than the NCAA record in that race at Milrose games, you had a collegian run 348, Gary Martin from Virginia. You had an 18 year old from Australia, Cam Myers run 347.2 taking six seconds off of his previous U 20 world record. Um, and like all of those guys,

Beau Beard (22:15.02)

would have been like the top six or seven of the race were now the top six or seven world all time. So you get in the right race with the right people and all it takes is for everybody to be pushing each other and think that, well, he did it so I could, there's a chance I could do it. There's also that guy from Adam State that he ran like 736 and

This is his vision to his division to his time would have been NCAA all time leading for D1 and D2 coming into the season. But currently he sits like six or seventh on the like all time instead of late list just because you've had six or seven other guys faster than him this season. And that previous record was from 2023. So that record was set last indoor season. Which if you also think about, we've talked about this just being involved, you know, somewhat in the high school cross country scene and track and field like.

four or five years ago, you just like in our state, you just saw this like boom where it was like, what's going on? Like you guys were even telling me like the times that kids are running now, like you, you guys wouldn't have even been like in the mix with most of those guys or, you know, records that were broke were not even like, you know, worthy of like top 20, you know, when you guys were there. So like, maybe that's just the matriculation now where four or five years later, you see people coming up out of those ranks of whatever that move was.

So that's what I'm always just trying to like think like, yeah, it could be a Roger Bannister moment. Sure. Cause all of this got broke right then, but it's like, obviously people have to be better to be able to do that with the psychological push. it's like, has something changed? The only thing that I could say that has really changed has been, well, I'd say maybe two major things. Footwear that you're training in, which David Roche talked about this quite a bit on his podcast of which we, think I was talking to you about training and

carbon plate to choose versus not for speed work. And we looked at both sides of it, right? So if you train in them, David Rocha's take is training them all the time when you're doing speed work, you know, interval, fart look stuff, because you're going to be able to have a higher output in an easier effort, right? So you can actually, the workload goes up, even though you don't get banged up and energy, you know, like energy efficiencies up your kind of retort was, well, I want to have to work harder both from a mechanical standpoint, right?

Beau Beard (24:33.496)

but also an energy standpoint when I'm training. then if I put on the shoes, then it's easier. I kind of think of it like, so when I was in high school is when like parachute training became really big for like sprinting, both being pulled, you know, drag and being pulled. So it's kind of like, well, you know, which one's better downhill running, you know, for sprint training, things like that. Like we know all this, you know, may have an effect. So my thought was maybe people are adapting to this footwear that they're training in, right? So the output's getting higher.

then there are wearing it. So it's almost like you just kind of have like a, like a bionic human. They've gotten used to that footwear because we know it changes mechanics because we've talked about, you know, the stress fracture run up with a different mechanical load. So that's one thought. The other one is I think there's a hell of a lot more, just more cross training occurring in the running population, but also much better. So it's like, there was always a, if you looked at, you know, high school runners, collegiate runners, cross training was doing planks and pushups and stuff like that.

then they ran a bunch and now you're like, I think in particular in college, we realized like, you can't do that. But also it can't be hand me down strength conditioning programs from other sports just to make them do something. So as you get more specific, maybe people get better there, but that doesn't probably explain people coming from other countries. And I don't, you know, I don't know how all that stuff follows, but there's gotta be something going on there. That's a big shift. And besides just a mental, I think it's, there's a mental part there for sure. My other thing is

you weigh in both options of like, wanna work harder mechanically versus using the shoes and it helps your efficiency so you work, I guess. Not work less, but it's a little bit easier. To me it's like, does it matter? Because if you're able to run a faster pace and an easier effort, do you not just adjust the times down a little bit so now effort's higher? if you ran 5.15s, now you're actually running a 5. You're running like 5.05s.

Right. Repetitively. Like, does that even matter? Like at that point, you're still getting the same effort. I guess if you were using RPE is your natural. Yeah. The only thing that I see that being a difference in is just how they view other people running that time. If they see that, this felt that easy. And I ran five fives versus running five 15s and feeling the same effort. If they go, well, if that felt that easy at five five, I can race at four 50 and be better. then your whole race strategy changes based on like relative. Yeah.

Beau Beard (26:59.352)

perceived effort. Yeah. I don't know. There's a lot of stuff and what, so I brought that up to Travis Grappo too. Cause I mean, he's a huge running nerd. I mean, huge. And he was like, bio carb. I mean, that's just first thing he says, bio carb. It's all it is. He goes, took it once and like best run I've ever had. was like, So also I think nutrient like in the strength and conditioning energy. And they're probably drinking. Did we ever drink electrolytes in high school? I barely drink them now.

Which there's a whole debate on that of, okay, how did people perform at a high level before we had any of that stuff? Right? Cause it's not like people weren't doing amazing things. And then we think we have to have all these things, but then you do think about something like, you know, a company like Morton's coming around and I mean, it literally does change, you know, pH balances and your ability to shuttle things. Like it said, there's that now I don't, we'd have to look at how many of those athletes are actually using that stuff. I doubt it's actually that many. I don't

be interesting. lot of them are using that, other drink, the ketone IQ. Yeah. Which that again, we get into the mental, the big one there besides recovery, cause they've found most of the research looks at the recovery from an endurance standpoint is coming at taking it after right. And your ability to basically not have to utilize glycogen and glucose for like brain, right? Cause that's 20 % of that and taking it after you're able to shuttle, you know, things into the periphery. And then I'd say for longer bouts, which

maybe the half marathon gets into that, it's a lot of that central governor's theory of like, it just, it's easier because you have that, which maybe if you pop up a four or five K and you're all lit up or neurologically stimulated, maybe it is easier. don't know. Um, I wanted to get some of those for the straights I'm this weekend, but I just, haven't, maybe I will probably crap my pants or something if I've never taken them. expensive too. Yeah, it's come down a lot though. So I was looking at it's like 20 bucks a shot, isn't it? Uh, no, that's for the like,

I think it's like four or five bucks a shot. Oh, okay. It used to be $125 a shot. So you just come in three vials when they first came out three vials that were the little like immune booster size shot things and it was $125 for those three. They're not for a shot for those three. Yeah. Yeah. So yeah, it's come down, but we'll keep, mean, obviously Alex has been putting out posts every Thursday. It's a lot of track and field stuff. So follow along on that. But I mean, we're always, you know, we're talking with runners constantly in here because

Beau Beard (29:21.506)

people in the amateur ranks of running want to want to lean on nutrition and shoes and stuff harder than they should because that allows them to put in the same effort and expect something better. But at the end of the day, it's still effort based in terms of training. So I shouldn't expect much difference in this 50 K after falling after falling off after eight weeks. But the last time we've also put in a dedicated eight weeks of training is probably when you and I were trained for a five K. So yeah.

it still should be better than it would have been if I was just doing nothing. Let's kind of jump over to just interesting cases. So if you guys have any just fallen at any point, like I said, we used to do a very deep clinical dive on like one or two cases and that was fun for us and our, know, crony friends, but I think we all get a little bit more out of it. If we just kind of highlight some interesting stuff in here, things that were different. And again, if you have any questions about this, you can always.

you know, post in the comments of this video or send me an email. But one of them was a woman came in, she's in her early sixties and was having bilateral shoulder pain and she does private training at a local gym here and basically just said, I can't do anything. My right shoulder's worse than my left, but I can't do anything cause my shoulders are killing me. And then my right shoulder in particular is killing me at night. So in our clinic and anybody's clinic that, you know, knows their head from their ass, both shoulders are hurting you. We're like, it's

probably not your shoulders. maybe there's something going on with the right shoulder, but then it's still gotta be something central if it's both. And that doesn't mean necessarily like you have a neck issue. It could be how you're operating around your, you know, around your rib cage and your scapula thoracic joints. So with her, at first I was just, she was like, well, I'm not really doing anything with my shoulders because it was just bothering me so much. Okay, let's just not do that for a week.

So we take her through some tests and like we can recreate neck pain on her right side. So that's kind of positive for an orthopedic test, but like she has almost zero rotation through her thoracic spine. I mean, she's a little bit kyphos and then she literally is telling me that her low back hurts if she just walks for a long time. So she's just stuck in extension cause she's flexing her mid back, but like every visit with her, I've had to talk her back into the fact that it's her mid back, even though her shoulders aren't bothering, cause she's not doing anything, which I should all like, I try to tell her like, if you can do stuff in your day to day,

Beau Beard (31:40.302)

and it's not bothering you besides when you went in there and like did presses and lateral raises that should tell you you don't have a shoulder injury because you can do day to day stuff. So I'm just want to throw that case out there because I'm a lot sure a lot of people, maybe not a lot of people have, you know, both shoulders bugging them, but if your shoulder or whatever is only bothering you during a, a hard challenge, you go on and bench press and you're like, my shoulder bugs me then, but it doesn't bother me any other time. You probably don't have an injury. It's probably either how you're bench pressing.

It's how you have to move around your shoulder when you're bench pressing because of how something else doesn't work or doesn't integrate or sync up. So I want to highlight these cases for almost patient, not just education, but so like you kind of arm yourself if you're working with somebody or you're Googling stuff, they go like, that doesn't really make sense. If you, again, trying to logically break down like why would both my shoulders hurt? Why would they only hurt when I do this instead of just Googling?

shoulder pain, you're going to get rotator cuff tear, labrum tear, and then you just, you're just down this pathology rabbit hole. So I wanted to highlight that one from just a pure functional case. I have no clue if she's actually better because we can't reproduce any pain in her shoulders on orthopedic tests. They move fine. She's very mobile. We can recreate neck pain. I sent her home with retractions and her neck got worse. And I was like, perfect. Like you have a neck problem. Obviously that doesn't mean that's like going to solve all of her shoulder woes. Cause there's probably a big like,

how you do things around your mid back once we even get your mid back moving, but it's just solely get your mid back moving and kind of see how things go. another shoulder case. So this guy has had bilateral shoulder problems, but he had a left shoulder problem a long time ago. Now he came in with a right shoulder problem. this guy, so he used to come in with a little piece of paper and it would tell me all of his warmup drills, all of his exercises, and he'd just go over every visit, even though it was hadn't changed since the last visit.

And then he get done, goes, what do think about that? And I just, I kind of got the point. was like, yeah, it's good. Cause I just, whatever I said, it's not going to change. Now it changes cause he's we've had success, but this guy wanted to see how much, how many times he could do 185 barbell bench press and his right shoulder started bothering him. We had told him with his other shoulder, which he had a legitimate labrum tear diagnosed on him or I, and we said it was nonsurgical and we got him over that without surgery. So that's why this success came in and he came in, he's like, got the same thing.

Beau Beard (34:07.148)

same thing on the shoulder started her bench press. I was like, well, let's check it out. It was not the same thing. I think he has my like a probably grade two, you know, whatever you want to call it, tendonopathy strain of his super spinae, this very specific testing that shows that hurts with, you know, putting a shirt on in the arcs that we would expect like the first 15 degrees and then up top and then coming down, he gets that big like catch. So I want to bring this one up because when I tested his shoulder the very first day,

he would have pain with some of our classic orthopedic tests, right? So like your arm at 90 degrees, external rotation zero, empty can, which is supraspinatus test, know, kind of moving from that labral shear test from the pronator position to the supinator position, that caused pain, you know, pushing hurt, but he was like, that was worse, but he had no loss of strength. like functionally it's like clean, but like he has pain with almost everything with his shoulder. So we've taught, obviously you guys know this, we talk a lot about.

what the orthopedic test is doing. It's testing integrity of a tendon, a ligament, you know, the labrum, whatever you want to say. So I explained that to him and I'm glad I did because he came in the second time and he's like, I just don't think I'm doing any better. We test everything. He has less, less of those tests are painful, right? So it came down to just empty can, none of the pain was going from pronation supination, but he's saying it's the same. I'm like, no, it's not like it's functionally improving your, I know your pain's the same.

You know, so let's just, I think we should keep going because he's kind of worried. Do I need them or I also know comes in the third time he's like, I had, you know, some good days, but I had some days where it was worse. like, we don't want you to go. I tried dumbbell bench press and like started with twenties and then 25s and 35s and got 45s. And he's like, I couldn't do it. I was like, how many sets? He's like five sets. was like, So you did something you haven't done. You did the thing that hurt it before. we go in and test them and nothing hurts. Right. So.

Like, and he's like, yeah, but he goes, if I put them a shirt, like I'll get a catch. And so then I, then you try to explain, okay, functionally your shoulders doing better, but now your strategies around how you did stuff. And literally if he just thought about not elevating his shoulder while I did this stuff is way better. So if you think you're super spinae, this always explained to people, it's a little muscle and tendon that's going to live right under your AC joint. And it's like a butter knife on a rope. If you get into this elevated position, that's, you know, basically a secondary shoulder impingement. And I was like,

Beau Beard (36:33.368)

I'm not saying you got to do that all the time, but watch how it changes when you're just cognizant about your shoulders working. A good, another good point for people to think about of how do I determine the difference between what an image says, what I Google and am I actually having progression if I'm at a PT, a chiro, or just trying to get over something myself? Cause now I'm, I'm always, we're always telling people to test stuff. Hey, now you go try a dip, right? I told him, Hey, I don't want you to try to

just dumbbell bench press again, I'd like you to try to do a pushup beyond, you know, like on a parallel or a box or something and see if you can get into shoulder extension without your shoulder just going to this elevated position because he tried one and he's like, that hurts. But his shoulder was up in his ear. And I go, can you try to just think about that? And he did, he's like, it doesn't hurt. was like, again, that's maybe that's not what we do, but we can use as a test, right? So if you just drop yourself in to that movement a couple of times before you go do your workout, cause he's going to keep doing this stuff and your shoulder hurts.

maybe you shouldn't do those other things. So it's a preemptive test, then knowing him, he'll probably start doing pushups from parallettes and that's fine. Cause I explained to him, that's a closed chain movement. It's a little easier to work around and stuff like that. So that was interesting. That's actually, had a Peggy, the gym she's either the post coming out today or it's coming out this week about one of the gym goers who she would do a single arm row. And she said she had

upper trap, you know, shoulder pain doing the single arm row and Peggy videoed her doing the row and you see the first rep where Peggy says, okay, I want you to row this weight and pull the weight to your back pocket. She does that. No shoulder elevation. Then she doesn't tell her anything on the second rep. She immediately goes to shoulder elevation, see your upper trap pull and she goes, yeah, that hurt my shoulder. That's the exact same thing. So it's, and you know, I, I don't think I did. I did a post about it. I should do a,

video on like motor learning and coaching like the best way, you know, so if we get somebody that has like a bad rep, a painful rep, we don't highlight the bad rep and be like, see elevator shoulder because the whole reason somebody does that is because that was a good way to operate. It got him out of pain. It allowed him to move their shoulder into a position they couldn't. So now to highlight the bad and say, well, don't do that. You have to

Beau Beard (38:51.362)

they may not even be aware of how to do the other strategy. Hence when she didn't have any coaching, she just went to a position that created pain, which seems not logical. Like why would you create pain? Right? You'd be like, she, you think she'd do it the non painful way repeatedly if we just showed her how to do that. But like your brain is gets set in a pattern. There's no reason to like dig itself out of that rut. So that is literally like a motor learning strategy that, you know, keeps you in a pain pattern without maybe an injury. So that's again, I tell people all the time, it's the reason we have a job.

We're trying to not just say, that's a bad rep. Let's do it this way. And then try to be like, why is that so hard for them to do or why can't they conceptualize that or what can't they feel or whatever? Maybe they can't move around something. Maybe they're mid-back stiff. So it's hard to retract and depress their shoulder blade. don't know. But that's our job is to figure out is there a why? Maybe it's not, maybe it's just coaching, right? It's technique. Okay, then we can coach them, but it's not just, that was a bad rep. Let's keep our shoulders back. And then pretty soon they're like, well, I'm having pain even doing that. And they're like, well, I should have assessed stuff a little more.

Yeah, that was a part of the discussion for her, at least when she was asking, you what, could I do to tell her that or how would I, or how would I word something on the caption about that? So instead of saying that the shoulder elevating was a bad rep, say that the other one might be more efficient because your shoulder, your upper trap is going to elevate your, your upper traps doing what it should elevate your elevates your shoulder blade. But if you're trying to pull away to buy your side, your shoulders blade shouldn't have to go up. That's counterproductive for where you're bringing the weight.

And if the lats can extend the shoulder blade or extend your shoulder, then that would be what you want to use more. in that position. So, and again, trying to like weaponize people with logic, like you can, why would you do this? If it's not the best way to pull away. That's a question that yeah, you could ask with that guitar. That's why having somebody look at you and be like, God, yeah, you really, maybe your shoulder can extend. Yeah. And that's, that is literally our first job is like,

can you do the movement or do you just, you choosing not to do the movement, you know, subconsciously. then, then you can make a dividing point of like, that's a complete coach Peggy job. Like she needs to coach you up on this, get you to, you know, pick that pattern up, eventually make that a subconscious motor pattern or dude, we got to work on your shoulder or you do and get it moving different. And then this gets a whole lot easier and there might not even need to be a reason to coach it. So I wish more people understood that because it was just a gaping hole of,

Beau Beard (41:16.248)

Well, if I think about it like this, it doesn't hurt. And then they wonder why they have to consistently think about that all the time. And you're just not hitting that, like, you know, putting the cart before the horse type deal. this one's just a little bit different. It's just one of those that you're like, whatever somebody I've seen forever. And I was seeing her for, she was basically having mid or like pain just inside her shoulder blade. Her right shoulder is just chronically elevated. I'm talking like, literally you cannot pull it down. She's hanging off all this stuff, mainly through like brachial plexus tension.

Um, I saw her like four or five times and it really wasn't changing. She was having her eating pain down her arm and we'd get that to go away, come back like two or three or two or three days after a visit. Well, I didn't know. She just went to a PT that's like really close to her house and she came in. hadn't seen her for a month. She came in and she goes, well, that was, uh, that was my first rib. And I was like, Oh, okay. Um, and both 10 years ago, it have been like, no, no. Um, and I was like, Oh, okay. And she goes, yeah. So the PT just, you know,

I saw him twice a week for like four weeks and I go, well, how is it? She goes, I don't even think that my arm is still like pretty bad. Like I've been here and I was like, so what'd they have you doing? And she goes, well, some flossing. Well, she didn't say flossing. She goes this, right? So I'm showing you like a median nerve flossing thing. Um, and then he, she was like, yeah, they just pushed on my, you know, around my pack and kind of a lot of soft tissue. So I was like, okay, but it's better. So whatever in her terms, I just point that out to not say like, oh, I was right. They're wrong. What we're going to do is different. It's just,

the confidence with which you say something. Again, that person was like, yeah, it's first rib. And she's like, oh, whereas I was like, yeah, I think you're, know, brachial plexus has a lot like that doesn't, she doesn't know clue what I'm saying, but like she even said that she went home and Googled her first rib and like she had, it's all picture of it. So now she has an image of it in her head. So I should have done a better job with her because I've seen her for so long. I just kind of figured like, no, she's not going to just go off to PT land and do some weird stuff. So.

The interesting thing with her is from the clinical side, her first rib moves awesome, right? So from a joint standpoint, but in our world, if somebody has like brachial plexus tension, if we take them through a flossing maneuver, we'd be like, that's kind of a no-go for right now. We got to like detention it. And that's what I was trying to do with her with like some DNS and exercise the whole time. So just kind of interesting that she's like, you have to do this, which is probably the soft tissue that they were doing, just getting stuff moving. Cause it's a giant like brachial plexus nerve entrapment.

Beau Beard (43:43.234)

around there. But it still goes back to strategy. Like, why is this? mean, she literally lives like this. So she walked in and just like, why should you do that? Tough one. But at the end of our visit, she has like a 20 gallon purse and she just throws it on that shoulder and she's hanging out like that. Can you just not do that? I go, hate to be that person, but just don't do that. She goes, it's so hard. I go, you're literally doing this to hold that purse up. She goes, I know. So again, I'm not saying that causes it, but it doesn't help anything. So, but I bring that one up of confidence of delivering a

for a patient and a clinician, if you deliver something confidently, it doesn't mean you're right, right? That you just get buy-in, but a patient realized just because somebody delivers something confidently does not mean that they're right. So you gotta play both sides of that. Interesting one from my standpoint on the clinician side, a person that a good friend of ours, we all ran a half marathon a couple of weekends ago. During the half marathon, her left knee started killing her in particular on the downhills to the point where she's probably the fastest woman in our group. And she came in close to the last woman.

Cause it was bothering her so bad, but post-race she could flex it fully, do a squat, all this stuff wouldn't bother her. She goes, it just seemed like it was impact. And she's had a history of low back stuff. So she came in the other day. She's like, my knee is still bothering me. And she goes, I was, they went to the Daytona 500 and she goes onto the way to Daytona. They drove. She goes, my whole leg was just like going numb and tingling all the way down to the, basically medial arch of my foot. okay. she goes, that's better. And it's just kind of like above my knee, like in my hamstring now. I go, okay, let's check it out.

positive slump test on that side, both for, guess you'd say positive or positive a better neurodynamic test. So like lack range motion or ankle compared to the left, but then also like straight leg raise is positive. slump just by itself and no like neurodynamic is not really positive, but then her quad had a bunch of trigger points and Vassus lateralis and you know, through rectus and just like twitches all get out and I go, okay, so

your back's not bothering at all. You got this kind of ridiculous stuff. Your knee is the big complaint. Let's just treat your low back and the nerve and just kind of see what happens to the quad. Cause I think that's causing the knee stuff. All those trigger points went away and we didn't touch your quad. So I point that out again for us, cause we're always talking about an audit. So that is a perfect functional audit of a trigger point that isn't even technically, yeah, it's kind of, obviously it's limbo sacral plexus. So obviously all those nerves converge at some point.

Beau Beard (46:09.678)

But if we thought if somebody came in sometimes we just think oh, it's sciatic nerve and then you're a quad or for some reason we like Splice those out. Well, it can't be that. Yeah, which is your low back I mean l2 3l4 like back is getting compressed snot for whatever reason And we didn't do that much work on her low back. It was like getting her sciatic nerve moving soft tissue some Openers on that side and I mean gone in terms of trigger point now will they come back she goes and runs will come I don't know

pointing that out again of we know a lot of lower extremity pain is derived from your low back and that doesn't always mean like neurologic, ridiculous stuff, right? Those muscles might be getting more neurologic output because your back is kind of angry and you have signals coming in and out and it's kind of just like everything gets a little chaotic and you just bombard muscles based on you are doing work, you're on a downhill and now that muscle just like has to turn on all the way because it doesn't have like a good throttle.

So it's like zero or a hundred and that's kind of what a trigger point is. again, I'll have a follow up next time on her for sure. And just kind of say like, yeah, like working on her back is kind of the thing that helped her knee the most or maybe it didn't, but no positive or speed tests on her knee, no swelling, no point tenors on her knee. So you gotta be like, okay, there's something else going on here. So I that was interesting for sure. I'll skip this one because we're running out of time, but

one more, guy that I've seen forever came in the other day and he, switched careers completely and he's in his fifties, moved to building homes. And he said he was flipping over a countertop, like a Formica countertop and felt a pop in his elbow and had extreme pain. But he's like, I kept working and he goes about three hours later, he goes, I literally couldn't like pick up a hammer with my left arm. no swelling or anything that day. But he goes like the next day I woke up, he's like, I couldn't like move my arm.

No bruising, no anything like that. So he comes in and he has a brace on that elbow, like a Velcro brace. Said he's been taken ibuprofen, still been working, but there's things he can't do. And takes off that brace, giant pocket of swelling on the inside of his like distal bicep and just kind of look at it, test city as pain with all ranges of motion that are resisted, right? So like 45, 90, 135, uh, elbow flexion, but he isn't giving up ground on any of that.

Beau Beard (48:31.488)

I bring this up because I just put out that video on, you know, is it a nerve injury or is it a strain and like how easy it can be to diagnose a strain. If somebody has swelling, you had some sort of soft tissue injury like that amount of swelling. I mean, it's pretty diffused in a focal pocket. he's not able to do things. It got really bad a couple hours later, right? So obviously strain, not rupture, also didn't have recoil, but he's in an age category where being very sure that like,

what grade that strain is because this guy could get out of pain in two weeks. He goes and flips another countertop and just absolutely ruptures bicep off the tendon and you know, has like the neck tie roll up off a cartoon into his shoulder. So he's very like, what should, what can I do? What should I do? Cause he's like a small crew cause he's just doing this, you home building on his own. but I bring that up about the diagnosis thing, right? Because was it a tendon? Is it a muscle strain? Where's it at? What grade is it?

So with him, based on how it tested, like you can almost unequivocally say like musculatindinous junction, like a one plus, you know, strain of the long head of your biceps. Why that matters. I mean, now your rehab is super specific to, okay, it's about a week old. he did say that it was getting better and then he touched a hot wire and yanked his arm back and he goes, that sent me through the roof. So fast twitch stuff with a muscle strain is going to drive it crazy. Just like if you come back after hamstring strain and

everything's good and then you take off to sprint. You're like, Oh, get to you again. So I had to like paint a picture of him and like, okay, I'm to give it three visits. And if we don't see, you know, really good progress or if it goes backwards, you do some at work, you know, catch something we might get an MRI just to protect this guy. So he doesn't, I if he's built in homes, that's his livelihood now. And he ruptures advice. He's out for like, you know, minimum eight weeks, if not longer. Um, so the guy wouldn't be able to work. He also doesn't have disability insurance because it's small business that he just started.

So taking all of that in is a good management piece of like, I'm not just going to fly off the rail and be like, I think it's a mild strain. Let's just kind of start loading it like very specific on the angles. So we're playing in that 135 cause long head pronation versus supination matters because of where he actually feels the most kind of tenderness when he's loading it, right? Cause you're going to change how much you like break your radialis and short head versus long head using dry need only to create a pro inflammatory things. It's weak old.

Beau Beard (50:53.388)

So all that comes into play, which it could be wildly different if he comes in the day of I'm not sticking needles in the thing. I'm probably not loading it day of it's a, know, grade one plus strain. I'm going to keep it moving, get the edema out of there. So again, being diagnostically accurate for a clinician top notch, but for a patient, you deserve that amount of accuracy. So your treatment is very specific. So you, don't get knocked out of work, but also I could have this guy.

doing things pain free in two weeks. But then I told him right then and there, I was like, you're going to have to be cognizant of not just flipping a countertop over when you're out of pain because it is a strain. And that's hard if you're out of, know, say we make a mistake and he has no swelling or like, I think it's just a nerve or something. And he flips a countertop in two weeks. He's out of pain and ruptures. I mean, that's on you, you know? So again, the swelling helped. were certain things that kind of pointed that out, but yeah.

you ever think, because he didn't have any weakness, right, when you were doing any of the... He wasn't buckling. mean, he said the, and again, you take their history into account, he was like, I couldn't lift stuff. But then he had also told me over the week, he had gotten better. So that's where I'm like, grade one, one plus. Yeah. Right. Also, he didn't know any swelling. So if I have a tendon that you keep using because he's doing construction.

It's going to get pissed off. So that's why I was like, okay, that also sounds like a mild strain that you're just not able to let it heal because you got to do stuff. Um, so yeah, I mean, we, so in the treatment, we dry-needled it for a pro-inflammatory cascade. Um, I taped it up to try to draw the edema out of there back up towards his, you know, axilla, uh, went through isometric loading and I said, Hey, we're just going to do two to three days of isometric and then probably move into like eccentric stuff. Cause I think we need to cause it's grade one.

But I need you to go home and make sure it responds well and also see which angle is kind of the worst, but in a good way. Like where do you feel it the most where by the end of those four to five sets, you're like, Oh, that's achy. And it was that 135 because we did one round of it in here next time. Cause it'll be a little further outside of the acute window. We'll do some BFR and you know, maybe go through eccentric loading with that stuff and just push them a little bit harder. So like I said, I think in four visits, I can get that guy like going and then he's going to have to continually load it, you know,

Beau Beard (53:10.03)

the next couple of weeks specifically. But I said, you could use stuff at work and go up to countertop and just do an isometric for 45 seconds. It doesn't have to be a band or a rope or, you know, it be a saw or something. So we can make stuff up. yeah, when you were deciding whether it was a strain or not in the first, what was telling you that the swelling was coming from, um, the Muscogee tendinous junction versus it being neurogenic. just where

So again, where your pain is. So when we test them up here, he has no pain at all. Right. So the lever, so you just work your way down, just like when you do. So we have a hamstring strain, right? Somebody's on their stomach. You're to start them at, you know, maybe less than 90. So maybe 45, depending on their range of motion, but 90, 135, 160. And you're thinking you're working your way down the hamstring, but also like the further you get out with some people, the higher they'll present with pain up towards their shoulder too.

because the lever's at its longest and you're just, in my opinion, you're working further out from the muscle belly. So if everybody listening or watching, if you just take your bicep and squeeze it as hard as you possibly can in a ball, you're gonna literally probably almost cramp like in your bicep, right? But if I had you hold something for the longest time in a straight arm, you're probably going to feel strain like for most people down in your elbow, right? Just cause we're not doing a lever with our shoulder. The other thing was when I tested them, so we found out that

And I'm saying a big arc of flexion, right? So maybe this 150 degrees, I don't know. Um, the higher I got him, the better it got some more use his shoulder. Right. So the more he's up here, right? Offloading this, like he's like, yeah, that's, I don't really have anything. So was like, okay, that seems like it's deep in there. I don't think it's on his bone, right? Just cause of how it's acting and things like that. He's also 50. So becomes less likely with that injury. He felt a pop. What's that mean? Maybe something.

But that's also the most susceptible area of a muscle if we don't think it's a tendon injury and the way it's acting doesn't sound very Tendon either it got better in a week, right? If he's like dude, I can't do anything and I mean you might pull a trigger on an MRI even if somebody's coming in there and they're full range motion mild pain They're not buckling but you're like say it's blown up like a balloon and you know stuff like that But yeah, so that again that would be my strong assumption. All right, so that also tells me where I'm needling but that's also

Beau Beard (55:30.542)

when I'm palpating, right, I palpate on like head of the radius and stuff like that, like there's nothing you move up and you're like, oh, it's kind of in that, you know, junction and how big that junction is a little bit different on everybody. Yeah, kind of a little bit of that. Let's move on while we still got 10 minutes or so to some research articles. Do you guys get a chance to look at these at all? No. These are just interesting. We're not going to like get in the weeds. We'll put links to these in the show notes here.

One that I thought was interesting, this came out in what, just two weeks ago, week ago? It just says February. published in September, released in this journal in February. It says uphill treadmill running and joint mobilization, improved dynamic stability and ankle dorsiflexion, range of motion in young adults with chronic ankle instability, a randomized controlled trial. So, Wayne Norton would be happy.

I just thought it was interesting because they're literally using, it was either a standalone running groups. You're running on a treadmill uphill for this is three to four or three times a week for four weeks, 20 minute running sessions. Or you, well, let me read through it. So participants were randomly assigned to four groups combined uphill running and joint mobilization. The joint mobilization was like grade four. So it's just joint mobs, uphill running alone.

joint mobilization alone and a control group. people that had restrictions that they did nothing with, the uphill running with the joint mobilization and uphill running groups is 20 minute running sessions, three times a week for four weeks. And then they used a wide balance test cause they're trying to look at chronic ankle instability, the Cumberland ankle instability tool, which is a, I don't think that awesome. And then weight bearing lunch tests. So that's, you know,

not too far off like a Gary great type thing, not non weight bearing angle, dorsiflexion degree using Goniometer. So reading through this, the biggest group that showed response, which again, if we, the most input was the people that are getting joint mobilizations and running uphill. But when you read through kind of the methods and the outcomes here, because it says the uphill running and joint mobilization superior to either intervention alone with a success rate of 1.5 times.

Beau Beard (57:53.966)

1.55 times greater than just uphill running But when you look at the uphill running versus with the joint mobilization like they're kind of the same So this is I was just talking to Seth about it It's not confusing. I think I understand why but like I run a lot of trails and there's always a lot of hills But there's also not maybe 20 minutes of a hill right at the same incline in a controlled scenario But I know a lot of people that do a lot of like

long, slow hiking, running where they are doing either heel repeats or they'd be doing enough. They're going slow enough. Like they're putting in more time than that. And I, I don't want to say I guarantee you their ankle mobility is not improving and the chronic ankle instability tests are not improving in those people. So just thought it was interesting that, you know, what is the mechanism there? Again, we know that joint mobilization from like a grade four grade three,

you know, if somebody's doing it for you, you're doing on your own, like, yeah, you're going to improve a little bit of input, but like how much is that actually going to change if you have a joint restriction or tissue? I don't think a whole lot, right? It gives you more feedback. So the ankle instability stuff makes sense. The Y balance test and stuff like that. The dorsiflexion, that was interesting thing to me. That's you saw it was almost the same, whether you got joint mobs or running. So then it's the uphill running that's the factor, right? Cause the joint mobs are helping the stability tests.

So one of the harder things in my opinion to change is ankle dorsiflexion, right? We, you did a undergrad research study on breathing and ankle dorsiflexion cause we were just curious. We're constantly leading ourselves back to an ankle that's like, probably causing a lot of this, but also that's a long road to walk or will it change at all or should we focus on it because it's hard to change. So it would really be a, I guess a smack in the face if it was like, I should just have everybody.

either walking or running on a treadmill, you know, 20 minutes, three times a week, and that would actually improve their ankle mobility better than anything. So I just wanted to point this out in terms of like, I don't know, I don't know, you'd have to understand the mechanisms better. Also, if you looked at the amount of load that that is a 60 minutes, you know, total, that's not a ton, right? But if we looked at like Keith Barr's work for like a tendon, what I was kind of looking at is right. after about, you know,

Beau Beard (01:00:13.134)

two to five minutes that tendon stops kind of having to recoil. So now you're going past that point. If I keep working it, maybe if you had a stiff area of a tendon, just like he says, you have to load the tendon enough to allow the portion that won't load to evacuate fluid, but also get tensilely loaded. Maybe that's what's happening is you like, basically you lose that recoil ability, the tendon. then as you keep walking uphill, you're like,

maybe pulling on that portion that's not stretching or fascia or whatever I'm going to say. Um, cause again, this isn't people that have Achilles tendonitis, but if we had, if I had to guess why a lot of people have stiff ankles, you've had massive adaptation around your, the end of your gastrocnemius soleus group and that's what's, you know, stopping you. So I think about one of our patients, a young guy that used to play tennis and now trail runs that has less than zero degrees of dorsiflexion. Like he is in the negatives by maybe four degrees.

what would happen if I gave this to him? Because I've told him forever that like you have to change this because that's a cause of some of your back pain and he had a hip surgery and then he has knee problems. So I just be curious and he would be probably somebody that would do it, right? But it would be out on a hill on a trail. So yeah, it was just kind of interesting to think about with those people that you're like, I need them to change it. Maybe you're like, come do this. I don't know. What do you guys think? I think it would suck. It would suck. minutes, three times a week. the grade was 5%.

Yeah, that's Yeah, dude, that's not a let me make sure on that grade dude. Those are some fears runners Yeah, 20 minutes straight hill at 5 % You're probably talking That's 200 280 for a heart rate. It's David Roche ledville training right there on his I'd be a max heart rate for at least 17 of those minutes. It's probably two mile plus hill. Oh, yeah You'd be be grinding I Could see why something changed you either you you literally had to

I'll put in the show notes to grade or I'll put the whole article in there. Um, it's downloading right now, so I don't want to take the time. The other article that I thought was kind of interesting just because I've been going on a little more deep dive, um, into fascia land, which every once in a while just kind of pops up with, you know, interesting stuff and people want to blame all our woes on it or that you can fix everything by the focus. Um, not gout. I was going to talk about gout.

Beau Beard (01:02:36.974)

That was another thing with that patient with the elbow problem. but was an article that came out August of last year called fascist regulatory system and health and disease. So again, the article is almost looking at it as like the, the end all be all. But what was interesting or I thought was interesting is this concept and they literally call it the watchman of the Kim, like the ability of fashion communicate. And we knew that fashion.

could communicate or was communicating faster than neuronal communication, right? So like as fast as your neuron can fire, which is different for, you know, you know, a C fiber versus like an a fiber and things like that, but like how fast those can communicate somehow things were happening faster than that. So then it came down to basically testing both the electrical gradient and piezoelectric gradient of fashion. They kind of found out like, Ooh, fascia is communicating this. Still people don't understand how that's why even some people are thinking there's some sort of

quantum entanglement with fascia, which gets wild. But this is also saying now they think like immune regulation is coming from fascia communication. So if we thought about like where lymphatics live, you kind of like start to, I guess, like use logic to be like, yeah, it can make sense. I bring that up because I just maybe think of somebody like Kelly Sturrett or Perry Nicholson. So one of Perry Nicholson's biggest things is like, you know, lymphatic mojo, which I took that class is pretty interesting.

And then, you know, if you're getting like a lymphatic massage, like he even said in that class, like it's the pressure usually of like a nickel on your skin. Like it's nothing. then you think about Tim Brown, if anybody knows who Tim Brown is, he's been, the sports medicine director of the world surf league for like 20 years. he is recently kind of coined his own method called SPRT soft tissue. So SPRT was specific positional relocation taping. So he's like the godfather of like Kinesio tape.

but he does these like super light strokes over an area, which he says is based on Wilson's law, right? So whatever nerves innervate a joint, innervate the surrounding musculature, right? I think that's Wilson's law. That's a long way back. So he's saying that if you gently work on the periphery that you'll like joint restrictions and things get better, right?

Beau Beard (01:04:56.684)

I just bring this up because it's a good thought piece. So if you're clinician listening, you need to read stuff like this. And this gets back into the art of assessment course of having these good base of your pyramid of core sciences, a good filter to be able to read stuff like this. Look at somebody like Perry Nicholson or Kelly Stratt. Kelly Stratt's huge in, you know, lymphatics, getting fluid out, flushing it both for the proprioceptive, mechanoreceptive response. Once you have that fluid out of there, but also just like healing rates go through the roof. Tim Brown.

I mean, before it changed to the move in advocate, like, you know, Steve couple Bianco was the fashion doc, like all of these things kind of tie in. again, I don't think it's an all be all, but like trying to conceptualize the way that you treat things and not just going in, you know, with a hammer and like, you know, from the treatment standpoint of bypassing these things. And I think that's where you can appreciate like, well, different tissues and different nerves and different structures respond to different amounts of pressure.

different amounts of load, like the running study. So always thinking about not just like, I'm working on joint stuff, right? Why would the joint be restricted? Why is, why does this guy still have swelling a week later? But the more you think about this stuff, the better condition you're gonna be in. they're just being like, I'm gonna get swelling out and Kelly Surrett says, wrap it in a voodoo floss band and move it and I'm pushing fluid out. That doesn't really help you to just do what somebody else says, even though it might work. You gotta be like, why does that work?

Why doesn't it work on some people and it does work on other people? So again, read this article if you get a chance, just interesting. Obviously there's a ton of research on fashion coming out all the time, but I have a whole folder on that. But I'll be doing a video on the Myofascial Meridian crossover with acupuncture here pretty soon because I didn't realize it was something, I didn't know that quite a while ago, I blanked on the researcher's name, they took...

Trevell and Simon's work and overlay that with acupuncture meridians and they redid the study because it was originally like a 75 % overlap. They redid it. It's like an 81.5 % overlap and myofascial trigger points and their referral points and then, um, acupuncture meridians. So again, why does that matter? Because we're, I'm big on learning referrals and things like that. So then if you're like, well, a lot of these acupuncture points are trigger points.

Beau Beard (01:07:15.488)

And then just like our motor index points guy, you're like, if I treat in a chain, I have a bigger effect on a trigger point. Like again, you're trying to hone your skills. You're like, I don't just stick a needle in a tight muscle. You're trying to be better than that and just, you know, play around too. So you can get creative. Be like, I'm going to do every, you know, acupuncture points, three points away from this trigger point and then the coinciding trigger points. a lot of your acupuncture points are trigger points.

Right? And then you think acrobatics points are holes, right, or vacancies. So then you'd be like, well, what is that? Well, that's where fascia is going to intersect. So those are the envelopes. So I don't know. It's something to think about. And like I said, I'm digging through some research. I'll do a video. Just kind of my thoughts. I know a lot of people talked about this, but yeah, that's what I'm interested in right now. Any comments on the watchman of the fascia?

None, So go look up if you haven't. Tim Brown, SPRT Therapy is doing live Instagram stuff like once a month. You can get an invite to that. We'll put links to these articles. If you have any questions, whether you're a patient or a doc about anything we talked about or anything in the future, let us know and we had such a massive live chat. It'll be impossible to get to all these questions over here, so we'll do our best and I guess we'll see y'all next time.

Right? Yep. See ya.