Ecological Dynamics with Dr. Cody Dimak

Discover the Ecological Approach, or Echo D, a revolutionary framework transforming rehab, coaching, and movement training. Move beyond one-size-fits-all protocols to tailor interventions for real-world complexity. This episode is your guide to agility, adaptability, and true patient-centered care. Join Cody Dimak, a leader in ecological dynamics, as he explains how focusing on environmental interactions can redefine outcomes. Learn to assess and modify individual constraints—task, environment, and person—to foster sustainable change. This episode is perfect for clinicians seeking a holistic, science-backed perspective. Challenge yourself to think beyond simplistic methods and embrace a nuanced understanding of motor learning and recovery. Whether you're early in your career or a seasoned expert, you'll gain actionable insights to transform your practice immediately.

Full Transcript

Beau Beard (00:00.19)

I'm gonna see you in week. Right? Miami. So what do you what are you teaching at Parker? This is also my first Parker seminar. So you better bring it. What are you teaching on?

Cody Dimak (00:02.972)

Formal. Yeah.

Mm-hmm.

Dude, that's crazy. That's wild. Wild Miami baby. I'm ready to roll.

Cody Dimak (00:23.423)

wow.

Yeah. I'm so I'm teaching it's gonna be a golf talk, specifically how to kind of improve force production characteristics and and build resilience against some of the forces that are applied to the low back during the golf swing. So it's it's tying in like kind of forces that are occurring in the low back and actually to produce power in the golf swing.

And then the strength and conditioning piece. So mine's like heavy, heavy S and C. you know. so they like they like when I do a golf talk in Miami for some reason. So they they like yeah, I'm like, all right, yeah. Bummer. Yeah. So

Beau Beard (01:04.414)

It's not all right.

Beau Beard (01:08.814)

Did you I know you to Mexico too, did you play some golf?

Cody Dimak (01:12.304)

I did we play PGA, River and Maya. It was awesome. It l every hole there was there's not one hole that's boring. It's they're all unique and they just get it's 'cause they have these what do they call them? These caverns, these caves with they have the have like the natural like the aqua fork huh? Zenote, that's what it is. Yeah. Yeah. Dude.

Beau Beard (01:17.164)

I can imagine.

Beau Beard (01:35.672)

Senote A cenote?

Yeah.

Cody Dimak (01:41.254)

They're all over the course. Yeah. I'll never forget this one hole. It's I think it was number sixteen, fifteen or sixteen. I can't I can't escaping me. Part three. We're playing, we're not even playing tits, we're playing blues. like in mid mid and into the win, par three, two thirty-five. And like you have like one slice that you can like land it short.

Beau Beard (01:54.62)

Beau Beard (02:07.542)

Yeah.

Cody Dimak (02:08.23)

Like a slice of land that you can like land it short if you're right. I mean it's water on the right and then like and then like just desert on the left essentially, like you know, and it's it's tough. Yeah. Eighty nine. Eighty nine, yeah, shot eighty nine, which is respectable for that course and rental clubs, the whole nine, right? So yeah, yeah.

Beau Beard (02:18.86)

You how'd you do? Okay.

Beau Beard (02:27.576)

Yeah.

Beau Beard (02:31.576)

We don't need any more excuses, Cody. Don't no, don't. Real clubs, I had to borrow shoes, so I forgot my pants. Yeah.

Cody Dimak (02:37.69)

I brought my shoes, yeah. I brought my shoes. I brought shoes. I learned my lesson. I brought shoes and I brought a dozen balls. I I learned I learned my lesson in Miami last year. So I played I played the course at at the the where we're staying. Rental clubs, except they're they were all regular shafts. So it was really it was a really 'cause I play X Diff and it that that's hard. If you play X Diff and you're gonna you know

Beau Beard (02:54.147)

Yeah.

Beau Beard (03:00.621)

Yeah.

Cody Dimak (03:06.16)

you then you go to regular. You really have to like I literally had to take my club face on my irons and like as address have them here. So when when it when it flexed it was square. It was it was wild. I think Yeah. Well his tempo but he's got like a magical tempo too, right? So but he I mean I was on the range in Miami last year in

Beau Beard (03:14.625)

Yeah.

Beau Beard (03:19.982)

I don't know. D shambeaux, it cannot move. It's regular it's gotta

Yeah. Yeah.

Cody Dimak (03:32.54)

This guy, the bunch of people, locals are warming up, people play the course all the time. And they're like, Hey, have you played here before? I was like, No. And they're like, just don't even pull driver out. Just leave it in the bag. I was like, What? Like, yeah, don't don't even pull it out. I was like, Okay. And he was like, Yeah, it's really tight and it's you think you can you're not gonna reach something and it's but it's gonna go. You'll reach it. I was like, All right. and then a separate guy.

Beau Beard (03:55.277)

Yeah.

Cody Dimak (03:59.898)

I was like about 20 minutes later, I was still in a range. Comes up, he's like, he was like, we just started chatting a little bit because he had like a LSU hat on on or whatever. And he's like, Do you play here? I was No. He goes, Yeah, don't even worry about your driver. Just keep it in the bag. He's like, Okay. What so what I do the first hole? I pull out driver and the drink. Like dead straight. I actually hit it well, and it just like it rolled into the water. So it's like, okay. So but it was so it's so tight.

Beau Beard (04:16.866)

Yeah.

Mm.

Beau Beard (04:26.883)

Yeah.

Cody Dimak (04:27.248)

Like at my in Miami, like here's the fairways here. You literally have like maybe three yards from the fairway to like the the the brush where you're not going in there and get your ball. It's gone. I brought six balls. Bo I was on my last ball teeing off him on the third hole.

Beau Beard (04:37.869)

Yeah.

Beau Beard (04:46.04)

I would have been yeah, same.

Cody Dimak (04:48.004)

And and so like I I was like I I was actually playing with another guy and I was like, I don't know what I'm gonna do. And like I I kind of like I told him like I teed off and finished the the third hole. I like, hey, I'm on my last ball. I had played it. If I happen to, you know, lose this, can I borrow one? He's like, Yeah, yeah, don't worry about it. And so 'cause he was from there. So he he had his his regular bag. And so I literally like I lost that ball on like number six and I started playing with his ball.

I played with his ball. I finished nine with his ball. So I went into the clubhouse and I bought a dozen and I was like, I severely underestimated this and they were like, Don't worry, it happens every day, all the time. I was like, All right

Beau Beard (05:32.27)

That you just see you like run and dive into a pond and you come up like you're like, Okay, I'm good.

Cody Dimak (05:36.294)

Yeah. Right. Yeah. Yeah. Yeah. Literally it. Yeah. So but I it turned around back at night, so it was good.

Beau Beard (05:41.454)

What a weird way, we can kind of dance that into what I wanted to talk to you about today is because we talked about like shoes and different clubs and you know all these things. And when you were here for DNS golf, back in January, you saw a book sitting on my desk, you came up to me like, what do you what have you been into? And it's kinda on a little not just in our world, but like an ecologic approach to just kind of thinking and that could be organizational and all that. But

Cody Dimak (05:50.298)

Mm.

Beau Beard (06:10.028)

Before we dive into this, because again, there's gonna people that what we're about ready to talk about, they're like, I've never even heard about this. So like we kinda have to approach it a little professorally, which is good because that's what you do. so can you just define maybe like a legit definition, but then also like a usable definition of what an ecologic approach in our world means of rehab and s and c and just treatment?

Cody Dimak (06:34.14)

Yeah. So the formal definition of let's say ecological dynamics or like in short, like echo D, 'cause it's kind of a mouthful, is basically it's what we could ecological psychology and dynamical systems theory if they came together and they had a baby, right? And those in its own have its own like kind of definitions too, right? dynamical systems theory is like the chaos theory, like all these variables can change what can happen essentially.

It's a bit more in depth than that, obviously. And ecological psychology is is the the the behavior of animals within their environment, right? And that's what psychology is, is actually a study of behavior, an animal's behavior within its environment. some people put mind in there, but I mean it's it's it's behavior, what's going on, right? So if those two came together and had a baby, we call it echo d.

And what that is from a formal definition standpoint is or like non-professor, if you will, to the lay or to the tri-six, if you will, in chiropractic school is what we do as practitioners is we try and change people's interaction with their environment. Right. And we don't tell them what to do, but what we do is we create a within a visit, let's say, with for what we do, we create a scenario or an environment to allow that person to discover what they

what's best for them given a particular scenario, right? And so now where does that, where does the manual therapy piece come in there, right? well, another term for echo D is a const is the constraints led approach. So it's a constraints hyphen led approach. And with those constraints led approach or Echo D, there's three constraints that interact with each other to produce some type of movement. It's the simplest way to do it, right? So you have the task that you're at being asked to do.

Beau Beard (08:00.547)

Mm-hmm.

Cody Dimak (08:27.302)

You have the environment for which that task is being performed, and then you have the individual within that environment performing the task, right? What we do a lot is well, cool thing is like you can never escape that. That is always present. Every single thing that we do in our life are those three things together. and the simplest form is those three things together producing syntax movement, right? So

Beau Beard (08:49.814)

Even if we're not aware of it, which most people like said they're maybe unaware of like this theory, but it it still exists and that's what we kinda like defining it, realizing it, just being aware it kind of changes your perception of it, and that's like the first step, right?

Cody Dimak (08:52.91)

Yeah.

Cody Dimak (09:03.546)

Yep. Yeah. And so, you know, when we as practitioners, as chiropractors or other manual therapists or even other, you know, any profession really, we see that maybe the the person's not able to carry out a particular task because it's a goal, or they have pain with the task, we need to identify what are the individual constraints that are limiting this person from performing the task. Right. And that's where your assessment course comes in, right? Finding that individual constraint that

Beau Beard (09:27.074)

Mm-hmm.

Cody Dimak (09:32.592)

We we need to work on to change how this person moves and interacts with their environment. And so that's what we do. So and how do we change those individual constraints? Well, that's up to you to determine. Like, is it something we need to like create mo mobility and do we need to do an exercise? Do we just need to literally just change the task and environment constraints to allow that person to discover a new movement? Like there's all these different variables and the different approaches to it, right? So it's it's it's not specific. It's very simple though.

Right. So you can make it really hard or you can keep it, you know, I'm from South Louisiana, so I like to keep things simple. Like you can make it really simple. Right. And so and then that's when we come to like an Echo D approach, in my opinion, this is kind of like the missing link when it comes to actually treating patients. Like I I you know, would you look at the statistics from a low back pain standpoint, the projections like in like eight hundred million when it gets to like twenty fifty or something like that.

Beau Beard (10:02.264)

Mm.

Cody Dimak (10:31.09)

From where it was like 600 and maybe 19 or 20 million in like 2020, what the hell are we doing? I don't think we have an intervention problem at all. I think we have an approach problem. And so our approaches are typically you know, have don't say they have a protocol, but like if you follow one approach, like it's or multiple approaches, that's great. But like we need to zoom out a little bit more and look at the grand scheme of things.

Beau Beard (10:37.55)

Mm-hmm.

Cody Dimak (10:58.086)

Right. What are the individual's goals and how are we approaching those goals? You know? And that's what Echo D does. It allows you to focus in on the individual and their specific goals, not your specific approach. Right. So you're you're agnostic to the the assessment process, you're agnostic to the intervention. Right. And that's like when we look at reap to performance, so you pull in all these, all these different modalities to approach the individual, but we need to have a foundation of like,

End goal. Like what's our like motor learning strategy that we're applying for this? And then and for me, I just there's there's nothing better than Echo D because it is nonlinear. You know what I mean? Life is nonlinear, learning's nonlinear, movement certainly nonlinear, regardless of what you know, some people want to, you know, say and lean on. You know, and so initially, like you say, it could be kind of daunting when you really start reading this stuff, but like it's like when you first start reading it, like, my gosh, there's

There's so much stuff. And there is, there's this new l new verbiage, new lingo you need to kind of learn. But then you have a moment of like, this is actually fairly simple. And if you keep it simple, it will always be simple. If you want to make it hard, it'll be hard. It's like biomechanics. Biomechanics is actually pretty simple. The math behind biomechanics is pretty difficult. But the applic yeah. Yeah. But the applic application of biomechanics is incredibly simple.

Beau Beard (12:03.694)

Mm-hmm.

Beau Beard (12:13.16)

Mm-hmm. Yeah. The verbiage and getting lost in the terminology.

Cody Dimak (12:24.018)

Especially if you keep it simple, right? So

Beau Beard (12:25.902)

When I think something to take off the shelf, because I know one thing I try to do is when we hear things and I can imagine somebody's conjecture, you know, it's all it would always be good to have an audience because you don't know what people are not picking up or what their thoughts are. So when somebody hears that giant, you know, there was the originally it was a twenty thirty, what the WHO, right? They're looking at basically muscle skeletal burden. I talk about this in my book, like what it was growing to, and they take everything into account, right? So we're talking

billions, but you look at back pain as you subset there and you're like, God, it's growing. And it's like, like you said, not an intervention problem, but also like people are wildly more unhealthy. So like now back pain becomes a factor within obviously this Melu. So we're not just saying like, we're still, you know, we're gonna be the thing. It's like, well, yeah, there's this other part of, as you said, the environment that's leading to maybe not changing the task, but changing the individual. So one thing

If you can, again, to try to make this as simple as possible, is there any way to give an example or a scenario of maybe somebody walking down the path of treatment that's not aware of this approach? Like you said, it's always happening, but they're not using it to guide them versus somebody that does. So somebody, you know, if we could, you know, walk the same patient into two different offices with the same complaint, how would those visits look a little bit different if somebody that's aware of this, you know,

theory or using this versus somebody that's not.

Cody Dimak (13:52.764)

Yeah. You know, I can use myself as an example actually as that treating provider, right? 'Cause like I if you walk in if I had an office right now and I had the same exact patient walk into my office now versus when I first started practicing in, you know, twenty twelve, it would be completely different. Right. And then this is a this is

I think I'm honestly that should be the case anyway, because we're learning, we're growing, we're always a different person the more we do it, right? But like I'm my my general approach changed, right? So like back in the twenty twelve, it was very biomechanical. I thought I considered biopsychosocial components, you know, a psychosocial components, you know, when I'm treating I have stories, many stories of that where I hit me in the face, I actually wasn't considering these things, you know, unbeknownst to me, you know. so what it would look like.

walk into my old office, right? It would be very biomechanical, very structural, very much of trying to perfect movement within the office, trying to get them to move a particular way. the whole concept of like motor and grams, which I don't believe anymore, because it's more dynamic than that, right? so the visit would look like, you know, come in, assess,

ideally like a really good history, a really good examination, and then trying to find the movement pattern to change with that person to decrease sensitivity. And then basically most of the treatments based off of pain. Right. Or painful audits, pretty much painful audits only, right? you're not having any pain. Okay. well, great. Let's let's get you back to you know, your normal activity, your release from care, right?

Beau Beard (15:40.994)

Yeah, yeah.

Cody Dimak (15:41.986)

I think where you're releasing them from care would be really important because if you're just letting them out in the wild, then we're gonna have bigger issues, right? We need to identify what are the capacity limitations for this individual, why they have the symptoms in the first place, right? And so if you're not the person in the office doing the capacity training, like a strength coach or a personal trainer, then you need to get them with one. Right. As opposed to now, if you would walk into my office now, pain would be important.

Right. That would be like a short term goal if we gotta put the fire out, essentially. Right. But we need to zoom out and ask the question, bigger question, why? And like, but everything, everything, everything is centered around the person's goals. Everything. And every intervention I choose is not only geared towards maybe a could be a painful audit, but you know, you would call it a functional audit, a movement thing that we would like to see maybe.

change or shift within their daily life, their ADLs, right? And so for me, I'm approaching that problem differently. I'm approaching that problem less about perfection of movement and trying to perfect it in the office and more about having the individual trying to search for a solution, me creating the structure, right? I can use a DNS exercise, I can use a a strength exercise, I can use a McGill exercise, right? But my intent behind it's changed.

So it's less about trying to perfect perfect the movement of that of that joint or that joint system and more about using the modality to change something bigger. Right. How can I shift their global movement or can I shift their ADLs by using these modalities, but being agnostic to what these modalities are are traditionally used for, you know? And so like when you zoom out, it's more, it's more individualized. And it's yeah.

Beau Beard (17:32.162)

Give an example of that, because I can again imagine somebody listening, like, wait a minute, like, so again, you what you just said, you and I get, but like use a a specific example where you're like, well, what's that mean to change to in particular? Because two questions here, and I think you'll hit both of them with an answer. A lot of the students or docs or whoever's listening to this, you know, when we think of DNS, the knock on DNS is the hyper specificity.

Cody Dimak (17:38.876)

Yeah. Yeah.

Beau Beard (17:56.204)

Right. They're like, we gotta be in this position, you gotta do it this way. That's not DNS if you do it like you're like, well, no, you can use DNS with the intent shift to make a global change. So how do we decipher that?

Cody Dimak (18:08.498)

So for me, one piece we bring up is like the concept of like actual motor learning and like when repet we're doing repetitions, what actually constitute as learning repetitions, right? What's our range, right? Does if you're between if you're between like eighty and a hundred percent of repetitions are perfect, it's too easy for the person. You're not learning, right? If you're below like fifty, you know, sixty to f below sixty or so, then you're not it's too hard, or then maybe they're gonna pick their scab, right? We want messy reps.

So between 60 to 80 percent of repetition should be kind of good reps. so knowing that that I didn't do that back then, like I do that now, right? But knowing that when we're trying to like let's say let's say somebody comes in, it's hard to use like a let's say an acute disc issue in the low back because that is like band aid, put the fire out, you know. Yeah, right. Let's say patellofermal pain syndrome, okay.

Beau Beard (18:58.412)

Yeah. It's already changing, yeah, everything we yeah.

Cody Dimak (19:06.814)

something where it's gonna be heavy exercise based. Okay. probably less in less MDT initially. You're probably not gonna do a lot of neurodynamics, right? But in your assessment, you're probably finding finding a lot around the hip, maybe a lot around the foot and ankle as well. You're definitely probably gonna find some core things. There's gonna be a load management piece to it, right? So a volume, accumulated volume for whatever task they're doing versus like what the what's required for the you know, for the what they're trying to achieve.

Beau Beard (19:09.688)

Mm-hmm.

Beau Beard (19:20.054)

Mm-hmm.

Cody Dimak (19:36.199)

You're gonna find stuff in the hip, specifically probably internal rotation stuff. You know, if they have a high degree of femoral neck antiversion, which we'd find like probably through Craig's tests, and you do like just a hip abduction, passive hip abduction, they have you suspect okay, maybe they're at 80 or 85 degrees. Okay, Cox of Valga is probably up there now too when we start looking at femoral acetabulated joint issues, right? Probably if they have 80, 85 degrees of hip abduction, that's one of the hospital Del Mar criteria. So we're probably looking at hypermobility potentially, right?

And so I'm gonna use like we know high degrees of femoral neck antiversion and cocks of valga is gonna change the moment arm of glute medius and glute maximus. So I know I'm gonna have to hit that really, really hard. And one of the best ways to hit that initially are some DNS exercises, some sideline exercises, right? So my approach previously was to be able to get them to have really good with with let's say a DNS sideline position.

Beau Beard (20:22.796)

Cody Dimak (20:34.844)

Get them to have really good movement of the pelvis up and over the femur, right? To start activating glutes and and whatnot to, and then eventually get into like a little a bridge-ish position with that and hit a really good frontal plane. And then transfer that over into like a loaded exercise, but like still still trying to like make sure that we're getting perfect movement over the the over the femur. Well now.

I want that I still want that initial stage of loading on the sideline position to start, you know, controlling that internal rotation essentially. But now I'll switch to a strength exercise where I know it's going to have a little bit quicker carryover. not having to end up, but it but if I'm doing that and I see that they don't have control, then I can regress to another thing. You know what mean? So I think the the the the willingness to progress to a loaded exercise and be a little bit more aggressive, if you will.

Beau Beard (21:13.847)

Mm-hmm.

Cody Dimak (21:30.78)

comes from the understanding that we are so complex and adaptable, which Echo D points out. You know, we're not these these machines where we have to like slowly progress. If you, you know, if you don't, you know, if you don't progress in a particular way, then you're not gonna then you'll never get here. No, that's not how it works. We can jump to here for some people. Some people we have to go jump back down here. You know, you know, your mileage may vary, if you will. So I think the the patello formal pain syndrome example is is a good one because you don't always have to coach

Perfect alignment of the limb. You know, if they have, you know, excessive more like antiversion and they have tibial torsion, you're not gonna get the knee to line up with the foot. It ain't happening, you know? So so, so so what are you doing? You know, I mean, where where where do we are we're gonna spend time trying to pull the knee? You know, we're doing our reactive neuromuscular training, trying to pull the knee in to get them the extra. That's good, but like how can we choose an exercise that's actually gonna create.

Beau Beard (22:11.586)

Yeah. Yeah.

Cody Dimak (22:29.498)

Real adaptation. Real adaptation long term, right? Again, there's nothing wrong with with all these other modalities and exercises. It's just I become agnostic to the to the to that process, but understand they're still incredibly valuable when it's the right time. You know.

Beau Beard (22:31.149)

Mm-hmm.

Beau Beard (22:46.594)

Mm-hmm.

When I think if I can add a little bit on the, you know, I'm about ready to become an instructor for DNS and it's it's something I've had to reconcile. It's like, like I don't want to go that far down the rabbit hole personally. It's like, well, the framework that you look at human movement and development of DNS, that's a power in it for me. It's like it gives me a really strong framework to be like, this, like you said, I may never get that, you know, anat

or anatomical and then functional anatomical alignment, but like I know what I'm working towards. And if I can't, then I'm like, okay, I have to do other things, right? To kind of offload or, you know, there's a capacity, or I might run into an issue repeatedly. I mean, that's a legitimate thing. People like in runners, if somebody has some structural limitations, you better tell them about that and you better be aware of that and realize that's part of that whole, you know, constraints led system. That is a constraint. Like there you go. Like

So it's not that you throw out these things and say, there's this whole new model that Dr. D Max segment. No, no, no. Everything fits in, but now the like you said, the intent in the map of Ecode kind of puts things into almost like categories. Like, yeah, you got to remove pain because that changes movement, right? So that that alters kind of behavior. And then when you start to look at it, you're like, like it almost kind of creates more of a playbook. Cause the problem we you and I probably see a lot of now is like, what tool am I using when and why?

Cody Dimak (23:50.801)

Really yeah.

Beau Beard (24:12.95)

And then you apply this like overlying framework and you're like, I could see why I'd use that here. And then how I could ahead here and then I fall back. But to be able to have that overlie, you already mentioned like an audit. What's an example or what's a scenario? You mentioned motor learning, but where what are signs I could progress somebody faster or I need to regress them?

rather than just like what we think of in terms of like the timetables of how long it takes to you know create muscle hypertrophy or ligaments changing or you know just off structure physiology, what are other things we could be looking at from a practitioner be like, I need to back up, I need to move ahead, challenge, you know, whatever it is.

Cody Dimak (24:51.442)

Mm-hmm.

Yeah. Well, I think one of the big things is like how are they how are they responding to their their you know hopefully getting to like normalized activities of daily living, right? What let me back up a little bit. I think the answer to your question is incredibly variable depending on who we're talking about. So are we you know, if we're talking about, you know, grandma Betty, who has like a training age of zero, maybe she walks, right?

Beau Beard (25:13.699)

Mm-hmm.

Cody Dimak (25:24.17)

versus I wouldn't even go weaken warrior. I would just say like grandma Betty, same age, who has a training age of like 70, right? Who's really active. She still lifts weights relatively often, right? Maybe she her training's trying to transition into like still some like small short box jumps to maintain power, right? But mostly like mobility and like some basic strength things that maybe have evolved to like hypertrophy type stuff, right?

Beau Beard (25:33.425)

Cody Dimak (25:53.159)

You're gonna take those those two individuals, same age, right? Same everything except training age and and capacity, right? You're gonna take a different approach with them, right? So, you know, if we have somebody with a training age of zero, we gotta find things that are actually tangible to measure, right? So what are they having trouble with? And then that's one of the things that we kind of lose as practitioners. We never really ask, like, you know, what is your pain not allowing you to do that you love to do? You know, and that that

Beau Beard (26:02.318)

Mm-hmm.

Cody Dimak (26:22.426)

And we answered that, we now have a goal. We have something that hopefully can be measured, right? And if that can't be measured, what are some of the components that we can train in that that allow us to be able to do those things? Like what are some of the characteristics of that activity that we could either measure or train to like start actually doing things, right? Is it walking to the mailbox? You know, I mean, like simple stuff like that, right? Versus like grandma Betty who trains, who's got a training age of 70.

Just like, you know, I I can't box jump on the 12-inch box now. I have to go down to the eight-inch box. All right, well, what is our power, you know, power? What are components of power? And now we can now you can be a little bit more aggressive with specific like strength exercises, let's say, right? So again, to kind of like with that, it's incredibly dependent on the person and the individual and like what pieces that we're trying to, you know, look at. But like from an actual regression standpoint or progression standpoint, I think.

Beau Beard (26:56.673)

Mm-hmm.

Cody Dimak (27:20.548)

One thing is like we start off, in my opinion, we start off incredibly too regressed with people. Incredibly too, like way too regressed. Like we think we need to go to the ground and then progress them through like two to three weeks of on the ground. and then then we progress them to like, you know, a different position. And then and by week six or hopefully not, right? By week six, we're finally standing and we're doing things like that. It's like, okay. I kind of

Beau Beard (27:32.397)

Yeah.

Cody Dimak (27:50.045)

How I approach it is like, I'm doesn't matter who I'm working with, I'm trying to get the person, if they're not training, I'm trying to get them training. I'm trying to get the strength coach. I'm trying to get them workout, right? Or personal trainer. Now, if I can get them with somebody who's a good match, then we're good, right? But if they're like, you know what, doc, I trust you, I want you to do it. Like, if you twist my arm, I'll do it for you. Right. So

Beau Beard (28:02.53)

And

Cody Dimak (28:15.548)

Keeping it simple, I'm looking at like the six like the the movement patterns, like hinge, squat, push, pull, carry, other, you know, lunge, those things, right? And then one movement you might be incredibly progressed, but the other movement you might be like really regressed, right? So let's say your squat is really bad, right? Like they can't they can't load squat for whatever reason, pain or whatever, but they can hinge, right? You know, one of the things we have a problem with in our profession is like seeing a weakness, and then we're like, we're working on the weakness.

Beau Beard (28:37.057)

Uh-huh.

Cody Dimak (28:43.462)

Bushek's netter has a great quote, you know, and he's if you know Bushek's you know Bushek's not, yeah, it's sprint coach rail issue, track and field coach rail issue. You know, if we only work on their weakness, then that in his case, the athlete is not going to get any better. In fact, they're gonna get worse, right? We wanna lean into their strengths and the weaknesses come along, right? It's kind of like a horse pulling a buggage, but it's a carriage rather, but it's with a bungee cord. So you work on the strengths and eventually that that weakness comes along.

And I use that in in like with the everyday person. If you f identify their weakness, but identify their strengths. And if you work on their strengths, the weaknesses come along faster. You're still working on the weaknesses, right? But you gotta lean into their strengths. And that was, you know, from a progression standpoint, I'm finding their strengths and I'm progressing their strengths as I've regressed their weakness, if you will. So in the same person, same visit, you may be progressed in some things.

But you also may be regressed and some other things. But again, that you zoom out, that's an ecological approach. That's a whole person approach, right? It's the end goal of getting this person to interact with their environment and their daily life in a different way. Cause the current way that they're doing it is not suited for them clearly because they're in your office. You know what I mean? Hopefully, that kind of like a dance around a little bit. Hopefully, I came back to the really important.

Beau Beard (29:43.853)

Yeah.

Beau Beard (30:03.63)

No, and there's two points there that one that I think needs highlighted all the time, especially again, you're you're teaching students. I interact with a lot of students just from, you know, what I do education-wise is when we even when you say, Hey, we're using this, you know, raising kind of we had to say their whole capacity, right? So the even then that weakness is even a little bit better. But now like what are all the reasons we would want to do that if we had to peel it back? Pain relief from just a general movement, you know, kind of

infiltration, there's an anti-inflammatory property to, you know, if we had them do more road, like there are reasons, right? But you might not, you might not have to like explain that to the patient, nor would you ever. But if you're aware of these things, so that's what I always try to get students to realize is like, why'd you pick that tool? Hopefully it's not just, well, I did McKinsey because they reported with back pain. Right. Like that will, you got to do that for a while.

But then if you're not thinking, why did that work with them? Why did it not work with them? What why how could I get this person out of pain without having to get them in my office? I mean, think of a virtual consult. Like these different scenarios will twist your arm to where you're like, I okay, manual therapy's out the window, what else could I do? But one thing I wanted to ask was if you had the grandma Betty that's you know, zero training age, to think this would be a common hurdle for a clinician to have to jump over the training age, grandma Betty wants to train. She's motivated to train already.

So there's two questions I want to ask you. So that that, you know, the non-training age person or that 70-year-old person that's, you know, not doing much, they're sedentary, whether that's pain-based or just lifestyle, how do we not leave them kind of undercapacitized? Right. So we get them to be able to walk to the mailbox. And maybe that's a thing they couldn't do. And maybe the clinician's like, I did the eco D thing. I did it. But then it's like,

Cody Dimak (31:39.495)

Mm-hmm.

Cody Dimak (31:53.852)

Yeah.

Beau Beard (31:54.86)

Well, wait a minute. Are we just setting them up for failure in the future because we didn't go far enough? And then second, if somebody's not gonna train, right, how do we move them further? Like, how do we like what do we do in that scenario? So, like how do we approach those people that aren't motivated? They have no, they're not gonna go to a gym, whether it's finance or whatever, like what are we doing with those people?

Cody Dimak (31:58.739)

Right. Right.

Cody Dimak (32:12.796)

Mm.

Cody Dimak (32:17.538)

really good question. I think we need to peel it back to our initial initial visit and the questions we ask before we even get to that point in in care, honestly. You know, one of the things that we need to start doing too is is ask our patients motivation to do certain activities and certain and certain things, right? So like what's your one of the things I used to ask patients is like, you know, you know, day one.

You know, it was like it wasn't like a formal question. It always always like kind of like flowed and wedged it into the the the conversation, right? It's like would you be interested in we're I would say, hey, we're gonna get to a part hopefully get to a point in care where we're doing great, you're doing amazing. and but the long term results, the true long term results are gonna be from you and your your health and your fitness. Would you be interested in me referring you to a strength coach or a personal trainer?

that's in your close to your area, that's a good match for you to like further along your health. And like I unless there were like I wouldn't do that with a referral from a coach or strength coach, right? But if they weren't seeing anybody, I don't I I'm having a hard time thinking of somebody who said no. I really am, right? now whether or not they follow through with that stuff, you know, at the time they're like, yeah. Like I'm not hard selling them and it's not something I'm getting kickback for.

Right. It's it's about them. It's about them. We need to start asking motivations to do things, right? And we can use that scale zero to 10. All right. Super simple. Like, what's your motivation to do some type of movement training or like you start using light weights or weights, right? On scale zero to ten. And let's say they say the answer that they give you after that question, I don't think people realize how important it is.

And it doesn't matter the number. It doesn't matter if it's two. It doesn't matter if it's seven, if it's ten. It doesn't matter the number. And you should never stop at the number, right? So the person's like, a three. Like, okay, Grandma Betty. I'm curious, why did you pick three and not two? What about that made you pick three and not two? Right? What about you that made you pick three and not four?

Cody Dimak (34:39.824)

And so what you start to do when you ask those questions, you start actually identifying the barriers that are truly holding them back, right? And if we never address those barriers that are truly holding them back, then there's nothing you and I can do from an actual, you know, trying to convince somebody's standpoint to go train and move, right? it's healthy for you, it's good for you. That doesn't matter to them, right? What if there are two because they have a situation at home where they have to be at home, right? They're taking care of somebody, right?

And then this is where the shift from patient-centered care. This is I've I've actually started moving away from patient-centered care. Bear with me here to person centered care. Person centered care is considered yeah, it's the same thing, but like but you're you're just considering freak out, but yeah. Yeah. You're you're you're considering all of the variables, not just the person in your office. You're considering all the environmental barriers, right? If we're gonna have a biopsychosocial.

Beau Beard (35:14.851)

Yeah.

Beau Beard (35:22.35)

Cody's getting ready to sell a new course. It's called

Cody Dimak (35:36.509)

practice, right? Considerations, if you will, which I did like fit right in with Echo D, by the way. That is, it is Echo D actually. If you kind of zoom out and you see the app, the actual instead of the the the general philosophical concept of bi biopsychosocial, that is echo d. The biosych, it is, it is within Echo D. It it it we can't avoid it. It it is, right? So that's what Echo D is. It's the actual intervention portion of that. Anyway, but

Beau Beard (35:39.406)

Mm-hmm.

Beau Beard (35:54.094)

Mm-hmm.

Cody Dimak (36:05.422)

I'm considering all the variables, right? Because if this person has things at home, right? Or if they have a his like, I don't know, making something up, right? Maybe their early husband, maybe grandma Betty's been widowed for for 60 years, right? And she never remarried. Maybe her husband, who passed away for whatever reason, was a big gym goer. And she didn't want to go to the gym because that made her think of him. Right? Holy smokes. Like that.

Beau Beard (36:30.99)

Mm-hmm.

Cody Dimak (36:34.842)

If you think about that, like that's that's one, it's incredibly sad, right? So let's acknowledge that, right? Two, I've just opened up a can of worms. Now I need to know if this if Grandma Betty has has seen anybody for this, right? Have they seen you know, psychologists or anything to kind of work through these things. And considering that, like, you know, generations before us.

usually did not see anybody, probably the answer is fairly low or is fair fairly high that it is no, right? They didn't see anybody for that. So it doesn't matter what you do from a motivation standpoint, you could be the best motivational speaker ever. If those components of this individual are not addressed, then can we actually get this person to to you know emerge as healthy as they can? You know what I mean? Because if we're doing whole person care, that's part of the whole person. It's not just neuromusculoskeletal.

Beau Beard (37:20.482)

Mm-hmm.

Cody Dimak (37:28.88)

The psychological component to this is going to be a have a direct impact on their ability or their desire to move more, to be more healthy. Those and and all the things that come with that, right? So I I think we it again, long way around to answer your question. It always comes back to our initial visit and getting their motivation for certain activities and find getting, but here's the deal: you, as a practitioner, cannot identify their barriers, their actual barriers. They

Have to identify their barriers. And if they identify their barriers, that's when change can potentially happen. If you place the barrier on them, change isn't going to happen. At least not in the way you think it's going to happen, right? But if they identify the barriers and there's some desire to change and some desire to want to do something different, then the motivation for that is incredibly significant and it's going to be stickier for long-term results.

So I I I think it it it always comes back to the initial piece of within our visit. And you know, unfortunately, I don't know how many how how much time you have for your initial visits. We back in we were in private practice in California, we had an hour, you know, and you know, and right now I don't know if an hour would be long enough. For what I know now, honestly, I'm just being honest. Like if I'm gonna be doing like long term health stuff with people, you know, it if somebody comes up with a raging disc issue, okay, yeah, it's gonna be.

Beau Beard (38:47.938)

Yeah. Yeah. Yeah.

Cody Dimak (38:58.0)

I'm not gonna I'm not spending like an hour and a half with them and you know talking about their long term goals when they're like, you know, sweating and crying on the table from like, you know, the you know, pain centralizing, right? No, I'm talking about your normal, you know, potentially MOI, probably not MOI, probably a work capacity issue, right? That those visits take longer, right? And if you're the long term piece of those things, it's imperative to get them to identify the barriers. Yeah, they have to.

Beau Beard (39:09.389)

Mm-hmm.

Beau Beard (39:25.238)

Yeah, when I think you need to call that questioning if they're interested in training, training curious. Like if somebody's bi curious, like, ooh, are you training curious? but yeah, when you said an hour might not be long enough, that's a big part of the art of assessment is you have to be efficient and effective. And that's like people a to get to our office they have to drive.

Cody Dimak (39:32.284)

Hmm. Yeah.

Beau Beard (39:49.154)

Then it's a time in our office and it's drive back. So like we had to take that into account because people you'll see somebody start looking at their watch. Now you like because they're like, dude, I gotta go, like I pick up my kid. That's where it starts with like your paperwork. It starts with your office. Like it starts with their portal into you. And as soon as like I tell everybody, it's like when I read somebody's paperwork, it's like playing roulette. I'm already either unbeknownst to me or you know, I try to, you know, gain awareness of like, I'm kind of thinking it's this based on what I read. medication interactions.

Like if your paperwork sucks, you're just making your job harder. You're just like, they got to do this because I they gotta fill it out and the hippos thing I got signed. No. You should have viable questions in there that you're like, I pulled data from that then you can go and you're getting a psychologic play there, right? You're making them answer it, and then you get to ask it again and you get to see if you get the same answer, but then you get to see if they extrapolate on it without you out. Like there's so many layers of this stuff that again, you can make really complex, but then you're like, What are you doing?

Cody Dimak (40:28.754)

Yes.

Cody Dimak (40:32.594)

Yes. Yes.

Yes.

Beau Beard (40:46.498)

You're making your time extremely efficient by accomplishing the goals you need to accomplish of getting them to define barriers, seeing what the where their motivation lies, where you need to help lead them, what the biggest constraint is. And then that, you know, like I I'll I have the quote, it'll go up here, I'll read it. What is it by Levitt, where it says basically your assessment should only confirm what you gather from your history. Your history starts.

The second you start reading about what they told you versus you didn't do any, you know, forethought to this case. You just walk in after your last visit, like, Hey, what's up, Dr. Beard? Good to meet you and then like start, like, my God, what a terrible visit. but one thing I wanted to

Cody Dimak (41:26.714)

I just started doing this stuff. Yeah. Yeah. But I can't I can't go sorry. just let me say real quick. I there's one I cannot agree with you more. I think one of the most underlooked pieces of an initial assessment is the actual paperwork that the patient fills out. you just the first front page, like the demographic piece. Like, you know how many people just don't even look at that?

They don't even look at like, okay, where's this person living? Right. And if you know your area, like and you look at the address, you're like, that's a rough part of that's a rough part of town. probably not gonna have that person go out for walks at night. That's gonna impact care, right? And then like if you don't look, widowed. You missed that whole, you know. But even like how they fill out those good questions too. Like how they do it. Like they just like they just leave it alone, they leave it blank, okay, we're gonna have to dig more. Is this a is this a a rush thing or is this like a

You is it the rush thing or is this just like a I don't want to tell you thing or I don't feel comfortable writing this down, you know.

Beau Beard (42:26.946)

Yeah. Yep. Yeah. We walk through that stuff and I tell I mean we pick up all sorts of stuff. Who referred them? You can see like how what, you know, social circle they run in. Yeah. All that stuff's wildly important. And I I mean I said weaponized talking to Ben Stevens. He's from Canada. He's like, weaponized, that's a really American term. I was like, well, you're just useful. Yeah. but one thing I wanted to ask when you're talking about, you know, they define their barriers for you. What about the I it's gonna occur.

Cody Dimak (42:35.516)

Yeah. Circle. Yeah.

Cody Dimak (42:44.786)

It's aggressive. Yeah.

Beau Beard (42:55.19)

What about those patients or that person that you pick up? You're like, God, that barrier, that constraint, they're either not willing to change, right? It's really hard for them to change. Maybe it's a lifestyle thing, you know, it's that time or whatever, that time in their life. And you're like, that is the thing that's either got you here, it's gonna keep you here. Like, what do we do in that scenario? Do we just wash our hands of that patient? Like, hey, I told you what I think needed to change. We're done, or

What and I could think of a specific scenario but we don't really need one. But what do we do with those people? 'Cause that's gonna happen where you're like, Yeah, this is the thing that's keeping you here or keeping you in pain or you know, XYZ.

Cody Dimak (43:33.531)

If you can get ahead of it, meaning like if you identify that and early in care and there's there's you s you know you still have some time for them to make a decision, right? We can try and try and apply like some like strategies like behavioral nudges, right? Where you're not telling them explicitly what to do, but you're prescribing scenarios or environments that and maybe giving them some parameters.

That hopefully allow them to make the choices themselves. You know what I mean? but some cases, like, and this this is this is for the seasoned practitioners are probably gonna be able to do that. They'll see it and get ahead of it earlier. The younger practitioners are gonna be so locked in on pain and so locked in on function because that's what they learned in school, you know, the a problem focused exam, like all these things, right? Which are important, but also there's more to patient care than that.

probably about 98% more to patient care than that. they're gonna get behind it. And those, those are gonna be the l life lessons and the learning, the learning experiences where they're gonna look back and say, I should have done something differently here. I should have, you know, gotten ahead of this in some way, shape, or form. Right. I think that for me, that would probably be the only way we can try and combat those things.

Cody Dimak (45:03.804)

Time and place, there early in practice, there were a few times where I was aggressive with the right person. Right. give you a specific scenario. patient was from Boston, didn't want to come to see which environmentally, there's nothing wrong with people from Boston. They're just very like there's nothing, right? They're they have a particular demeanor. Boston, New Jersey, New York, like that the

Beau Beard (45:30.2)

Right.

Cody Dimak (45:33.201)

That part of the country has a particular demeanor, right? They don't trust you until you prove yourself, essentially. Regardless of what people say to them. You still have to, you could have eight people telling that person, Hey, this this person's great. You got to go see them. Until they experience it themselves, they don't trust you. Right. And there's been multiple times with people from, you know, that just that culture, right? Or and it this, I have other experiences with other areas too, right? But like,

You handle them diff differently. You're a clinical chameleon. You're you're adjusting to the person in front of you. And there's been times where I'd had to look them in the eyes and be like, look, if you don't do this, right, and I'm not creating fear. It's like, look, you're gonna be fine, right? But if you want to hit the goals that you wanna hit, we have to make these changes. Right. And when they hear that, they're like, okay. All right, let's do it. Right. But you're not gonna tell, not everybody's gonna respond like that. You know what I mean? Somebody from from

Beau Beard (46:26.19)

Mm-hmm.

Cody Dimak (46:28.57)

you know, South Louisiana is like is gonna be like, okay. And then they're just gonna disappear. They'll never come back. You know what I mean? until that's somebody from California, they're like, okay. And then like they might they might do some of the stuff, but they might not. You know what I mean? So it's it it really depends on the individual where they're from, but that's you getting to learn them and adapting to their their you know, how they interact with the first visit. That's all it's an ex it's an exploration. You know, you're they're you they're they're learning about you, but

Beau Beard (46:53.688)

Mm-hmm.

Cody Dimak (46:58.118)

obviously you're learning about them, but like more importantly, they are learning about you. Like they're feeling you. They're they're getting information, you know, you're putting off information whether you know it or not. And it build building the trust and you gotta be you can't force things. so it's it's a it's a dance. It it's a dance, man. It you know unfortunately it's credibly incredibly dependent on the individual to try and get them to make some changes, you know.

Beau Beard (47:02.368)

no.

Beau Beard (47:12.654)

Mm-hmm.

Beau Beard (47:24.184)

Yeah.

One of the things that a quick story too on approaching different people, I mean the also the further you get into practice, the less, in my opinion, the less chameleon you have to play because things come off more authentic because your competency is higher, in my opinion. And I hope people understand what I'm saying here. You just understand things better. So in your own mind, and this is kind of the game, you don't under I'm being as truthful, you don't understand shit when you first got to school. I didn't, nobody

Cody Dimak (47:55.942)

Yeah. Right.

Beau Beard (47:56.66)

Because you just don't have enough context clinically to wrap all these theories and the science around you. You have nothing to tether it to. Now, some people a little bit better than others just based on life experience. But like once you get out, you're like, like you just understand stuff. So you may not be aggressive, but it can, I can seem very blunt and very cut to the chase. And I at first, when you don't understand things, that seems cocky. And I didn't understand that. I was just like,

Well, I'm gonna tell you what I think. Well, it seems like you're an ass. Now it just seems like, he knows what he's talking about. We had a guy, this is a couple of years ago now, and he came in and he initially came in for some musculoskeletal stuff, a couple visits in, he's like, I really just want to feel better. I want to start losing weight. Like, I'm, you know, he's in that midlife thing. He's telling you all the stuff. And like, okay, like, so we kind of said, Hey, you wanna do like a functional medicine visit.

Well, I even with him, I was like, I don't think we need labs and all that stuff. I think we just need to have a a sit-down and a talk and stuff like that. So that's what we did. And it's just to this day, there's three things about this case that like stand out. I of how you ask questions. I go, if zero to ten, how would you rate your diet? And he goes, taste or quality? And I was like, it's good. Okay. So you knew where he was going already, right? and then we go, Well, you know, how much alcohol do you drink? He goes, and you know.

Cody Dimak (49:07.248)

Ha ha ha. Wow. Yeah. We know we know we're working with. Yeah, yeah.

Beau Beard (49:17.41)

Couple drinks a night, one or two drinks a night, and then maybe a few more on the weekends. Okay, I'll take your word for that. Well then we get a couple more visits in where we're working on the muscoskeletal stuff. And now we're just following up on the funk med stuff. And he's getting frustrated. He goes, Dude, I'm, you know, I made the dietary changes, which, you know, whatever we're doing there. He goes, just I nothing's changed. I go, you know, did you cut back on some alcohol? He goes, Well, not really, because that's like the thing, you know, my wife and I like we don't have kids, you know, we're empty nesters. And I go, Okay, well, just give me the rundown on the last week.

I mean the dude crushed like 20 drinks on one Saturday, was drinking like half bottle of wine every night. And I was like, I go, Clinically, you're an alcoholic. Like clinically. I go, not my opinion, just clinically. And he was like, Wait, no, I'm not. And I mean, you saw like real quick, and I was like, you know, so for his goal, the constraint for him was calorically, I was like, dude, it ain't happening. But once you hit that hot button of me using that term.

Cody Dimak (49:55.676)

Yeah, yeah, yeah.

Cody Dimak (50:11.569)

Yeah, right.

Cody Dimak (50:17.328)

Mm. Yep. Yep.

Beau Beard (50:17.448)

Everything dissolved. And that was the guy that never showed up again. And that's on me because I was, but I I thought by calling him out, I was kind of highlighting. Whereas I should have been like, you know, maybe more. But I was just telling him, but again, the words you use, the scenario and time that you use certain words versus like, you know, like I wouldn't say to certain people, like, that dress looks terrible. Like, you've gained a few pounds. But like that might not that might be true. But how you use your language and how you use the environmental context matters a lot. But that's just a funny one that sticks out to me of like, yeah.

That was true, but probably not the right time or term to say it.

Cody Dimak (50:49.394)

You know, you you brought up you brought up so you said something you know earlier too that I was just I was thinking about towards the end of that story, which is hilarious by the way. in it in in its own way, right? I've had also had some experiences too calling people out and it didn't work out that that well. But you know, you you're right. I I agree with you. Early in practice, you are trying to be a clinical chameleon because you're trying to adapt to the person in front of you. And I think

Beau Beard (51:02.006)

Yeah.

Cody Dimak (51:19.162)

I think what happens as as you gain more experience and you're actually not just doing the same thing with every patient, you're appreciating the person in front of you. What happens is that I think you you yourself stop trying to be the clinical chameleon and all of a sudden everything around you, your office, your front office staff, literally the environment that you're in is the chameleon. And so when somebody comes in, they are adapting to your environment.

And that's why you can be a little bit more authentic, if you will. You're flexible, right? So like you'll have 10 people come in, but they're coming into the environment that they see comfortable with instead of you trying to adapt yourself to make them feel comfortable. You know, because you have your you, you know, you have your systems, you have the environment there, and then but you just see things differently, right? And so I think the range for which you're trying to make that person feel comfortable with gets more narrow because

not from like you're narrowing your thing, but you're narrowing to that individual much easier and they feel more comfortable easier too, right?

Beau Beard (52:22.414)

Well, if I could give one business tip to everybody listening, the more authentic you are with your marketing, the better or the easier that is gonna be. Because when you try to be this like vanilla gray, put the chiropractic sign on your like you're gonna get anybody and everybody, which is great because you need business, but then you're gonna realize, like, God, I'm having a lot of like, I'm really having to work hard to get like build rapport and things like that. And it's like, well, yeah, you're just kind of being this a la carte, like niche down the Kevin Callion.

Cody Dimak (52:27.889)

No.

Cody Dimak (52:35.847)

Yeah.

Cody Dimak (52:46.726)

Yeah. Yeah.

Yeah if you have a spine you know.

Beau Beard (52:53.666)

Yeah, like good, that's fine. Maybe if you're only with people for five minutes to Justin is fine, you don't have to do that because you're in and out so fast. Like the rapport happens over 60 visits and you have a Porsche. Cool. But that's not my model. But nothing wrong with that either. if we actually so if we peeled back a little bit, so we've talked about Eco D, we've kind of gone way out, right? It's the this big overlying kind of view of how we see things.

Cody Dimak (52:58.172)

Right. Yeah.

Cody Dimak (53:07.068)

Same. Yeah.

Beau Beard (53:19.33)

But also there's concentric circles of the same theory. If we use that specifically, just when we're talking about like rehab or exercise or S and C, can you just for people listening again, give us a specific example. So if we said we're working on somebody that can't hinge very well, right? Like say we have that, you know, 13-year-old kid that came in with some whatever back pain, maybe something else, and we're like, God, like that's that's what you think a hinge is, and how

Cody Dimak (53:38.172)

Yeah. Right.

Mm-hmm. Yeah.

Beau Beard (53:48.878)

How is it different to use that approach where we're like, this is a perfect hinge and this is how we're gonna do it versus we can get them to hinge using this approach? How's that work and what's that look like?

Cody Dimak (53:58.237)

Yeah. You know what's funny is like your the modality that you use and the exercises you use don't change. They worked for a reason. There's a reason why those things worked. You know what I mean? I think what it it, you know, like you said, shifting from like this is how you hinge, this is how we're gonna do it, versus like how do we apply an echo d or a little bit more flexible piece there is you find the right entry point for that person. Which gets go back to your assessment piece.

Beau Beard (54:09.326)

Mm-hmm.

Beau Beard (54:23.854)

Mm-hmm. Yeah.

Cody Dimak (54:28.55)

The goal is to find something that they can do that's comfortable, right? You find it, you find a good entry point. So when people have movement movements, right, there's a thing in Echo D called people get tripped up about it, but they're called attractor states, right? All an attractor state really is is a movement solution that you're drawn to, given a particular environment, right? or a task, right? So let's say, I mean, I have a

I have a background in in baseball. I was a power hitter in baseball, right? through high school. And power hitter. So you we were taught like elbows high, and then we're like, we're here, right? Well, when you start playing golf, that swing doesn't necessarily come in handy. that's what power fade, right? So aka a slice. So

Beau Beard (55:17.262)

So I gotta buy buy more bowls.

Cody Dimak (55:24.518)

The worst thing you can do is try and do the exact opposite. Right. Trying to like hit a draw. So I'm trying to keep the elbow tight in the back so it can and then like inside out, right? And that's it's the internal focus and that that whole thing, right? We don't even have to get into that. But like you so you're attracted to that particular movement solution, giving a rotational thing with an implement, like a a baton, whatever. so what you can do though is you can take what their solution is.

Beau Beard (55:28.238)

Mm-hmm.

Beau Beard (55:42.27)

Yeah.

Cody Dimak (55:54.331)

And then trying to get them to hone in on that solution, let's say for rotation for golf, let's say, trying to get them to learn how to use their strength, right, to the advantage. So you learn how to play the fade, right? Sometimes we have issues with like low, let's say acute low back issues. When they go to hinge, they can't hinge. They freeze the hips and they only flex through the low back, right? There's no hip hinge at all, right? Their squat is.

Beau Beard (56:07.288)

Mm-hmm.

Cody Dimak (56:20.11)

small knee bend. It's only it's only the shank coming forward, dorsiflexion, right? There's no, there's no like hips at all, right? Okay. That person is attracted to that movement for whatever reason, right? I need to ask the question, I need or answer the question, what is the individual constraint that's limiting this person from achieving a movement solution given this particular scenario, right? Is it because they are so they're splintered into so much flexion, right? That they can't they can't

literally can't use the hips, right? So are we are are we going to end up doing like some type of like clinician generated overpressure at L5S1 to have drive the extension, right? do they not have the ability from a neuromuscular standpoint to posterior weight shift through the hips? Do we have actual hip internal rotation flexion limitations? Is it bony? Is it soft tissue? is it a combination of

Beau Beard (56:51.042)

Option.

Cody Dimak (57:16.42)

Soft tissue, you know, we're not able to scour the put the hip and the posterior aspect of the acetabulum to be able to like load, you know, hips appropriately, right? I need to answer all these questions beforehand. Okay. Some of these things, I don't have to do things on the table. Some of them though, I could just jump to a hip hinge exercise. Which hip hinge exercise? What's the thing? Right. What's the thing I need to work on? Do I need to work on posterior weight shift? Do I need to regress them to a quadruped position and just have them start doing quad rocking?

Beau Beard (57:45.198)

Mm-hmm.

Cody Dimak (57:46.225)

Right. Do I need to put something on on the on their back so they learn that it doesn't if I rock back and this rolls off, you know, this isn't the best solution for me right now. Right? Do I need to put if if they freeze the hips and they flex with the low the trunk forward and it it bothers their low back, can I DNS would like scold me here with this, but can I put them in a door frame with a kettlebell holding behind their back so they push the weight back and then the

The the door frame keeps the torso upright for a bit. Just for initial, just initial stages of hinging. And then can I remove them from that? And then what does it look like? Because I'll tell you right now, what's gonna happen is if you keep forcing that extension, when you move them around, they're gonna drive into like hyper extension, right? But if I do a couple of reps where they kind of go into a little bit of extension initially, like two or three reps, and then I remove them from that, all you've done is you've kind of they're over here. We've done this. I want them here. So I'm okay kind of dancing the line with that a little bit.

And then and then but what does it look like when we actually start to actually load and hinge, right? It might be day one, we do a deadlift with. It might be, you know, month one, we do a deadlift. I I d I don't know. It's it really depends on where the person's at, right? But I guarantee you you can get to something loaded a lot sooner than you think, right? So from a hinge standpoint and an echo d standpoint with acute little back pain, those are some of the variables that I would consider. can I just go or can I just do isometric core exercise? And then all of a sudden they can hinge.

Beau Beard (58:49.39)

Mm-hmm.

Beau Beard (59:06.526)

Mm-hmm.

Beau Beard (59:13.901)

Right.

Cody Dimak (59:14.266)

So what was the low lying fruit there? Was was core. No. is it a stiffness thing? Is it a intrabound pressure thing? yeah. I don't know. do I need to know? Yeah.

Beau Beard (59:17.24)

Mm-hmm.

Beau Beard (59:26.358)

Well and that and the thing is you'll never and that's the tough thing we put up

Cody Dimak (59:29.05)

Right. Yeah. We so then Levit so Levit Levit has a quote as well. We operate at a level of acceptable uncertainty. Every day.

Beau Beard (59:35.958)

Yeah. Yeah. We put a bow on quickly, but that bow is what we've been saying in the offices, we pick a logic line, but it's always untrue. And that's maddening. Cause you're just like, This is the data that I gather. Cody might gather different data. I made this decision. You might make a different decision. We literally both get a person out of pain. They both regain a hip engine. They both go about their lives and we're like, How do we do different stuff? Welcome to Eco D. You have a highly you have a complex ad adaptive system. You have a human.

Cody Dimak (01:00:00.147)

Yeah.

Beau Beard (01:00:05.386)

And like I know that seems like, well, what the hell do we go learn all this stuff for? Where we have, you know, methods and protocols and techniques. To be honest with you, you learn how to do math. So then you can create your own formulas. And non-formulaic learning is the only way to go at the end of like in career, like you're getting outside of the box because you have to follow somebody's protocol. There's a reason you teach a class, right? Yeah, you we could say we're teaching this, but you still have to say, like, okay, in this scenario, we're gonna teach a hip hinge this way, or when the hip's stiff, we were, you know.

Cody Dimak (01:00:33.2)

Yeah. Yeah. But like considering context, right? It's that's the whole thing that's missing a lot when we're teaching these pr these pr these approaches is context. Cause usually like when you have a pro it's a yeah, you have like this, this, this, this linear thing. No, like context is completely nonlinear. Patient care is nonlinear because it drives incredible context, right? And that's what like with like yeah, it like go down a whole road of like technique and like approaches that way.

Beau Beard (01:00:34.988)

You have to do that eventually to break free of that. Yeah.

Beau Beard (01:00:43.928)

Yeah, which is a powerful.

Beau Beard (01:00:53.731)

Yeah.

Beau Beard (01:01:01.654)

Yeah. Well, you being in the education realm, is there anything that you would change, whether it's the overall framework of how we go about? You know, if we're talking about graduate level education within the musculoskeletal realm of, you know, physical therapy, physiotherapy, chiropractic, is there anything you'd change majorly, whether it's structure, certain classes, certain ideologies, where like we kind of get students or clinicians trapped.

in this way of thinking, then have to like break out. So instead of having to get trapped, how do we start off on the right path? Or what what will we do that different in your opinion?

Cody Dimak (01:01:36.427)

I think the overall approach of a program should have a foundation in something like Echo D and Motor Learning. you have a lot of programs that have like, you know, they have like departments or or centers within the school that try and teach you pedagog you know, pedagogy and like how people learn.

Beau Beard (01:01:48.142)

Mm-hmm.

Cody Dimak (01:02:02.748)

But I don't necessarily agree with some of the and I'm gonna say speaking about Parker itself, I'm talking about like other schools too, right? I don't necessarily agree, like cause they might have a linear approach. You know what I mean? And and I don't I don't agree is I just don't agree with that because that's not life. That's not patient care. Patient care is incredibly nonlinear, right? It's it's not it's never the same. Even if you're doing a protocol, it unfortunately it's never the same, right? So I think if you integrate something like Echo D, or just the basic principles in that, and every class is taught.

Beau Beard (01:02:24.397)

Mm-hmm.

Cody Dimak (01:02:32.762)

with the concepts of Echo D, considering the concepts of Echo D, and then considering even if you can't formally create context within your course, acknowledging that it requires context for certain interventions or certain assessments or our flow going this way, right? I think at the end of the day, what'll end up happening is you're creating, in the case, let's say chiropractic program, you're cons or even PT program, right? You're can you're making a whole a clinician who's whole, right?

Beau Beard (01:03:01.774)

Mm-hmm.

Cody Dimak (01:03:02.512)

you're providing a better, more considerate product, if you will, let's say as a school, to the public. You know, a more a prepared one, right? Now, if your if your program involves some type of skill, like in our case, it would be adjusting, right? If those things are taught in ways that promote motor learning, specifically utilizing let's say Echo D, right, you the learning piece, the performance, if you will, within practice,

Which is the difference between motor performance and motor learning, right? The performance piece in practice is gonna be shakier. It's not gonna look as good. But damn it, it's gonna look so much better, right? The longer you go on the program, more you practice, right? So that's the difference between motor learning and motor and motor performance, right? If in practice, we want people to perform in the in the game or in life, right? But when we're talking about practice, not Alan Ivan for practice, practice, man. That's it's equivalent like coaching skills.

Beau Beard (01:03:37.614)

Mm-hmm.

Cody Dimak (01:03:59.187)

For motor performance is equivalent to taking a brisket, putting salt and pepper on it and putting a pressure cooker. It'll be done in like an hour, hour and a half. You can eat it. You won't die, right? I don't know why you would want to, right? Or we can motor learn that brisket. We could take the brisket and show it all the love that we want, right? Give it all the stuff here. Nice cook it and cook it low and slow. The process takes longer, but damn it, that product at the end of that low and slow is so much better than putting the pressure cooker, right? So I think at the end, we need to think long term. What do we want?

Beau Beard (01:04:20.504)

Yeah.

Cody Dimak (01:04:29.254)

Are we do we want instant gratification, right, with what we're doing, right? Do we want perfection? Are we trying to teach people how to do things one way or do we trying to make people adaptable? Because Echo D focuses on adaptability to given other scenarios. And there's a lot of research about that. A lot of research, right? So at the end of the day, truly again to go back to your original question within any type of program ever, I think if you implement a foundation.

Beau Beard (01:04:31.779)

Mm-hmm.

Cody Dimak (01:04:57.894)

That everybody buys into, right? the funny thing is you don't have to change physically what you're doing very much anyway. The content doesn't really change. But the maybe how you deliver the content changes slightly, right? Because now you have a different frame of reference or different a different focus, if you will, of of goal or what you're trying to get them to achieve. But it's not as hard as you would think. It's actually incredibly easy.

It would just take a little bit education to those those instructors and like department heads and those types of things and get everybody bought in and it's it's to me, like I it's just it's just it just seems like so simple and so logical that it would like I don't know how we can't implement these things. You know what I mean? So

Beau Beard (01:05:43.566)

Right. When I was talking to Ben Stevens the other day, and he's like, it seems like a lot of us in the field that I I'm kind of colleagues and friends with are all landing on the same base material that we're interested in. And all I think it's just the fact that we're all in the same time domain of our careers with this information available. And it seems almost like, as h he and I were saying, like a philosophical shift, which is just an underpinning of why you're doing stuff, not like

Cody Dimak (01:06:02.597)

Yeah, that's good by yeah.

Beau Beard (01:06:11.566)

Chiropractic velocity of like innate, like like why are we doing the stuff we're doing? And then how does the intent and the why change a little bit of what we do? Not like you said, like maybe it changes 2% of what we're doing. But I think a really good take-home point, which you mentioned briefly, is let's, I mean, you're the student, you need, or the new doc, or even a you experienced doc, you're still gonna go learn methods and protocols. You're still gonna go take ART or dry needling or NBS.

Cody Dimak (01:06:37.605)

Absolutely.

Beau Beard (01:06:39.384)

I think a very key point here is to always kind of look at those through that triune of kind of the eco D and be like, what's the major focus of this method? For the most part, method we go to is what? It's focus on the individual, right? It's changing we would think that's the case. But then you starting to realize like, are they approaching it from the same philosophical underpinnings versus maybe they're like, no, this is the panacea, this tree, like that's not true.

Cody Dimak (01:06:49.745)

Bingo.

Cody Dimak (01:07:08.39)

Right. You yeah. Right. You're not gonna go down that rabbit hole essentially. When you hear that, that you're not gonna right. Yeah. What and what what's funny is like my elective that I created at at at Parker, the whole course is centered around is e is echo d and where do these these modalities fit within Echo D for the person. That's that's what my whole elective is actually about. whether or not the students like really lock in on that or not, it's up to them. But

Beau Beard (01:07:09.016)

For any sort of

Beau Beard (01:07:29.462)

Mm-hmm. Yeah.

Cody Dimak (01:07:38.585)

Most of them do because they're willing to take that elective, you know. yeah, I tell the students all the time, and I even say this, you know, when I lecture and stuff and seminars and stuff, it's if you have somebody, a technique or an approach who tells you in order for this intervention to to work, it has to be done this way or this protocol, it's not worth it. It's not gonna do it. It might work for somebody, but it's not gonna be applicable to the range that we're looking for.

Right. If you have an intervention from like an approach or a technique, and if it's worth anything, that approach or technique or some of the pieces of that, that modality or that intervention or that assess whatever is gonna work across a broader range given different context. You know what I mean? So, like if you have something, if you have a good product, I should be able to take something out of that product and be able to apply it to Echo D.

If I can't do that, then you have a problem with your product. This is that it's 'cause Echo D is inevitable. It's it's there whether we like to acknowledge it or not, right? But like if you're packaging like a specific technique and there's a protocol to that and you can't break that protocol, that's an issue. Run. Run as fast as you can and never look back at that, you know?

Beau Beard (01:08:51.48)

Yeah.

Beau Beard (01:08:55.544)

Yeah, 'cause basically they're trying to I mean, you'll see, I mean, we don't have to name names where a system is very complex, very overarching, and you're trying to overwrite. Cause again, all dynamic systems theory is saying is basically trying to d explain our world. That's what you know, what whatever verbiage you use, shallow wells, deep wells, attractor states, all it like all it's trying to explain is okay, why do we think things happen the way they do across all systems, right? It didn't start it

didn't come from our world, right? We adopted it. so I think that's important when somebody's like, I have this like, this is a new world, like terra firma, this tech is like, whoa. Where'd you come up with that and how where'd you get your so I I'm curious, are the students at Parker, are they gonna start calling you Dr. Echo D Mac? Or like that's what I

Cody Dimak (01:09:34.832)

Yeah, yeah.

Cody Dimak (01:09:44.967)

Ha ha ha that's nice. Yeah, we already have great nicknames. So like my wife and I. So it's Dr. Hemac Dr. She Mac. That's we have the Wi Macs. And so it's so that that's kind of lashed on quite a bit, but Dr. Echo D Mac, that is epic, Bo. And you know, and and I'm gonna steal that. No.

Beau Beard (01:09:51.33)

Yeah, yeah, yeah, yeah.

Which is hard to compete with, I'll agree. Yeah.

Beau Beard (01:10:07.672)

Yeah, I like it. So let's I'm gonna hashtag that. Let's start that after this episode.

Cody Dimak (01:10:13.53)

Do it. Yeah. And that that's that's actually gonna be a a hashtag handle I'm gonna continue to use from here forth. That's great, by the way. Did you win how long did it take you to come up with that?

Beau Beard (01:10:21.222)

It was on the it was in the first five minutes. I was like, dude, that's what I call this guy. I was like, Echo D, Dr. D? Yeah. as usual, your plethora of information, not just about brisket, but everything that you know matters beyond you know Texas food choices, but anything in this realm of if we're talking again this Echo D kind of model or you know lens.

Cody Dimak (01:10:31.158)

dude, that's great. That's amazing.

Beau Beard (01:10:52.172)

That you think gets misconstrued within our neuromusculoskeletal world where you're like, Yeah, I see people talking about it or trying to apply this aspect of it. Like, yeah, I just I don't think that's the case. because anything, not that this is new, I think it's just being talked about a lot more for a lot of reasons. And anything that kind of gets brought to the forefront, sometimes you're like, God, it's getting taken this way, or I'm seeing it applied this way, anything stick out to you?

Cody Dimak (01:11:04.326)

Yeah. Uh-huh.

Cody Dimak (01:11:17.666)

in the in the short period of time I have to think about that, the only thing I could think about is you know, when people look at like something like constraints led approach or echo D on the surface level and they don't really dive into it, they think that when you're coaching an exercise or coaching something, you're completely hands off and completely silent silent the whole time. And that is not the case. we do try to allow we're a little bit more

Willing to allow people to fail, right? But you have to use logic, right? So what if somebody has an acute disc issue and flexion's provocative, I'm not going to repeatedly try and do a hinge exercise or a deadlift where they're going in the flexion, they're picking their scab, right? We need to triage like what we're actually working on with, right? That decreasing decreasing their pain levels right now is going to get them to a place where they can explore more emotion eventually, right?

I'm not going to try and get them to explore something where they're they're in incredible amounts of pain. They just use like just it's stupid. That would be done, right? If you're good at choosing the appropriate exercise or activity, considering the individual in front of you, it will generally take less coaching, if you will, from the provider or from the coach, right? One of the things I tell students is if it takes you.

Beau Beard (01:12:22.968)

Yeah.

Cody Dimak (01:12:44.794)

Longer than 20 seconds to explain what you want the person to do in the exercise, the exercise is too hard. Impatient care. Impatient care. Right. It's not two two minutes to explain a side bridge is a problem. You know, there's something you need to regress them to, right? things change a little bit more when we start looking at like really complex skills. Like we're getting outside the office now. Now we're getting to actual motor learning of like like really like sports specific skills, if you will.

Beau Beard (01:12:51.566)

Mm-hmm.

Cody Dimak (01:13:14.642)

But even then, like if it's taken a long time to explain something, then is there something I can do that will either get them to utilize a movement pattern or a movement expression, if you will, or have the same force production characteristics that I want them to have in this other activity? All right. And what's crazy is that this activity has its constraint triangle of the task, environment, individual. But if I go do this thing to improve this thing, this thing has its own individual constraint.

Constraint triangle. Now I'm plugging in a different individual into the original. And that's the thing that kind of blows my mind with that. It's kind of inception for Echo D. but like thinking that it's completely hands-off, also thinking that it's it's it's free, like movement doesn't matter. That's not the case, right? When we look at when biomechanics truly, truly do matter, if we actually boil it down.

Beau Beard (01:13:49.08)

Yeah.

Cody Dimak (01:14:13.574)

Biomechanics really matter when there's high degrees of pain and we're working it's working on high performance. That's when those truly matter. I'm not saying that's only when I work on biomechanics. I'm saying that's when it actually really, really, really matters. Right. So if the person's in a lot of pain, we need to find the right exercise to have them explore, or maybe the the the when I say explore, maybe literally them exploring is me having them three month prone anchor and deep neck flexor.

Beau Beard (01:14:19.512)

Yeah. No.

Cody Dimak (01:14:42.64)

That's them exploring deep, you know, retraction. That's them exploring how to utilize deep neck flexors, how to utilize scapular stabilizers when they're coming up. That's how maybe that Yes. Right. That's the de exactly. That's the degrees of freedom that they can control and they can work within, right? So if we have a degree, if we just have a general approach, we didn't even talk about this today. A general approach of degrees of freedom. Right? If you can if you all you do is manage degrees of freedom.

Beau Beard (01:14:52.918)

Or not to use something that's like ripping away strategy. Yeah.

Beau Beard (01:15:08.172)

Mm-hmm.

Cody Dimak (01:15:12.9)

You're gonna get a lot done. Like a lot done, right? I can, you know, we talked about this in lecture Tuesday. There's some cases when it when we're in private practice, when I'm working with strongman competitors where we still needed to maintain a level of fitness that was really high while we're working on something that's fairly acute, right? What are you gonna do? Like you, like when you start having these variables that you have to consider here, like I can't say, okay, we gotta pull off on all this stuff when you have a competition in six weeks. No.

Beau Beard (01:15:14.563)

Yeah.

Beau Beard (01:15:31.96)

Yeah.

Beau Beard (01:15:40.183)

Mm-hmm.

Cody Dimak (01:15:41.157)

I need to find a regression for certain exercises that they can do that's not going to pick their scab, that's still going to work on the qualities that I want them to work on, but it's going to help them maintain the capacity that they need to perform. Right. I got to do that. Okay. So they can't pull from the floor, right? maybe this this event has them pulling from the floor like a bar, but like a deadlift, right? Well, they can do a rack pull, pain-free, as heavy as they can go. Shit, I'm gonna do that.

Beau Beard (01:16:04.12)

Mm-hmm.

Cody Dimak (01:16:08.176)

Now let me work on the stuff, the reason why they can't pull from the floor over here, and I'll I'll slowly increase the degrees of freedom for that. And then, you know, theoretically, ideally, we end up getting to the floor, right? Does it happen all the time? No. There's some setbacks, maybe some other events that are occurring within that same competition that are gonna be costly. That we don't have enough time to build capacity and those things, right? I mean, it's just kind of the nature of the sport in anyway, right? but yeah, like those, those, yeah, the the the considering the variables,

Degrees of freedom is a was one specific a key that we can use to not to not hopefully people don't think that they they're completely hands off. They don't say anything. and then hopefully they don't think echo D is like a just do whatever, move any way you want to. Cause it's not. it's not. It's it's we have a goal that we're trying to get people to do. and then we're trying to get them to use a different movement here.

And queuing, cueing is a form of task constraint for the better or for the worse, internal or external queuing. It's a form of task constraint, you know, regardless. so you are still queuing. You're still, you know, ideally, we'll use some type of analogy or external focus of attention to to drive motor learning, right? To drive discovery. But it's less about the explicit movement and more about pointing something out in the environment and having them come up with a solution themselves, ideally, and that and they can focus on.

Beau Beard (01:17:33.9)

Yeah. Well, I had a business plan for a rehab model. I'm gonna put it in the trash where it was kind of like a breakout room where I'm just watching with a camera and I just have all these different s setups and I just like every once I'm like I'd try the I'd try the lock on the closet over there. So I'm I'm gonna throw it away because you told me I can still be hands on. So I guess that's a bad idea. But the other thing that I just wanted to highlight before we jump off here is I think s

Cody Dimak (01:17:35.309)

Yeah.

Beau Beard (01:18:03.358)

One of the ways that clinicians and coaches get themselves in trouble, probably more clinicians here, is like you said, you're working with, you know, strength competitors, you know, power lifters, whether it's a runner, it's a whatever your sport that you say you specialize in. The way that you specialize in that sport, your understanding of the sport requirements from like movement, capacity, and all those things literally are what are your deciding points.

for your interventions, but also then, like you said, how to hedge around the constraints. Whereas people maybe don't, they think they understand stuff. And then they literally set people up for failure. Right. They literally because we're good at getting people out of pain. So that's the thing. Like we're all pretty good because we have all these things. Then you don't understand the highest level priorities or necessities. And then they go to that competition relatively pain-free and absolutely shit the bed or get hurt worse or XYZ.

So if you're gonna this is my takeaway is like if you're gonna specialize, you need to understand at the highest level, but that doesn't mean it needs to be like vomit the complexity of what you know on the person. Like you're just trying to get them to be like, let's keep moving forward without getting worse, hopefully getting better, whether that means function or pain change. And then also get you to perform and we don't set you up for injury. But what I see more often than not is the opposite. We get them out of pain, we set them up for a worse scenario down the road. And it's like that's that's so outside the realm of what we're supposed to be doing with these people.

Cody Dimak (01:19:28.146)

Totally. I I I wholeheartedly agree with you, buddy. you know, in in in in no. Yeah.

Beau Beard (01:19:28.514)

Yeah. All right, man.

And that's not easy. So I'm not saying like that's happened in year one of practice or even year two. But let's say you were a but let's say you were that athlete, you probably have like one of our good friends is a, you know, Olympic trials level level or hammer thrower. Like he probably has a really good understanding out the gate when he's going into grad school of that sport. Okay, well then he's gonna be able to apply it easier. Let's say you figure out, HIROCs is cool. Well, that's new. Like, okay, what are the constraints around that? What do they have to do? Like

Cody Dimak (01:19:38.129)

no, no, goodness gracious, no. No.

Cody Dimak (01:20:00.625)

Yeah. You have to do it, right? So if you've never like, you know, yeah. And that's what like one of the things I try and express to students too is like, you know, I'm not ignorant to the fact that so people I teach the two courses there. Like one is PT two, physiotherapy two, which is all the active exercise that everybody takes in the program, and then I have an elective. But in the formal course, I'm not ignorant to the fact that not everybody's gonna be doing this in practice, right? But you have to know it because you

Beau Beard (01:20:02.838)

Yeah.

Cody Dimak (01:20:29.852)

For pay person centered care, you have to refer to people who know what they're doing. And you need to know if they know what they're doing. You know what I mean? And we all agree, we make an agreement that movement and exercise is is is necessary. So everybody in the class agrees, right? Nobody says no, right? Just where do you fit in that continuum is it's totally up to you. I don't care. I mean whatever, right? As long as you're person centered care, you're not using f fear to drive for attention, like all the like the standard things, right? And movement is important for for being healthy. If we agree on that, we're good.

you don't need to know how to program for somebody. Like you don't need to write write a 12-week program, right? But you should be able to look at a program and say, That's it. That's why. Right? Like you it that's what you should be able to do, you know. And the best way to get good at that, though, is write yourself a program because you're gonna learn really fast that you have no idea what you're doing. You think you wrote a 45-minute workout, and then an hour and a half later,

Beau Beard (01:21:11.458)

Yeah. Yeah.

Cody Dimak (01:21:27.6)

You're doing your aerobic stuff and your grip is so toast from the workout here. You have and you programmed you know, a rower as part of your multimodal aerobic thing, and your grip's so toast that you're holding it with your wrist like this. Experience. You know? But when you start doing that, you start considering the variables that you're talking about and the sport or in the the workouts and those things, like you start thinking about okay, what's the cost in the spine? Right. So you're gonna do barbell deadlift and you're gonna do barbell bent over real.

Beau Beard (01:21:35.608)

Mm-hmm.

Beau Beard (01:21:48.013)

Mm-hmm.

Cody Dimak (01:21:57.287)

Good luck, buddy. you know, it's just, you know, there's nothing wrong with those two exercises, but if, you know, the capa if you're doing together and depending on the load that you're using for what and the repetitions you're using for for whichever one, right? you're gonna start challenging certain tissues capacity. And if you don't have the capacity in those tissues and you have a spike in workload for the capacity that you have, then that's when things happen, right? So again, it's not that one's bad or one or the other one's bad.

Beau Beard (01:22:14.638)

Mm-hmm.

Cody Dimak (01:22:27.056)

It could be bad. It could also not be bad. You could probably do both if the if the load and and volume and your capacity match those things, right? So there are variables to that. And considering those variables you're talking about, especially if you had gonna be very specific target market, knowing those things. And for me, my target market was actually was people who worked out and trained. Because we always kept them in a few exceptions. We always kept them in training. We they were always still able to work out because we just modified the program accordingly, right? But you're right, like if you're a runner, you want to treat runners, if you don't run.

I mean you don't have no you have no idea, right? It just you can't explore this stuff too. Like I know you've explored with foot contact. Like I know you've explored with volume. You know what I mean? I know you've explored with surfaces, right? That experience is invaluable. It's it's it's it's so invaluable, right? So so yeah, so I agree. Wholeheartedly.

Beau Beard (01:23:10.776)

Mm-hmm.

Beau Beard (01:23:16.302)

So for those people that aren't lucky enough to, you know, be in your elective course or see you speak at a seminar, what are some resources or books or things that you have really appreciated within this realm that people could go look up on their own to kind of get a foothold on this?

Cody Dimak (01:23:32.476)

Yeah, so my exposure to this was you know when back in co during covet, Liebinson was hosting Craig Liebenson was hope hosting some like webinars. Okay. And I jumped in on him and then he had Nick Winkleman on one time and I was a big huge Nick Winkleman fan from a queuing standpoint, Gabrielle Wolf stuff, you know, reading that for years. And then he asked he asked

Well, Lehmanson asked Winkleman if there was anybody who kind of like motivated him or like he looks up to he mentioned Rob Gray, who's a professor at Arizona State University. And so I wrote that down. I did that. And then man, listening to that, he's got a podcast called the Perception and Action Podcast. And and since then he's written he's written four books. I haven't read the fourth one yet, but I've read the first first three probably like six to eight times each.

Amazing. the there's a lot, a lot of podcast episodes, a lot to chew on. But you can go back and listen to like he revisits later in the later episodes, he revisits so like the a constraints led approach or echo d broken down, like in simplicity. And then they go into other topics that are really complicated, right? But I will tell you like the the one thing, if you're new to this, it can be kind of overwhelming trying to learn a new lingo.

And I will tell you that people within Echo D and Constraints Led Approach, they even argue against themselves on the definition of certain things, right? If you ignore all that stuff and you look at it how the general framework operates within what you do for your profession, it could be chiropractor, PT, strength coach, personal trainer, medical doctor, school, school therapist, literally anything, right?

It's it's for me it's it's life changing, honestly. And and to see that it's it was actually like seeing that book that you had there was like a a breath of fresh air because I I almost feel like I'm kinda out here floating in the abyss by myself. And to see one of my good friends in the profession learning that and le seeing that stuff and and and and kind of leaning towards that way as well is is is is a huge breath of fresh air and it actually warmed my heart, though. I tell it warmed my heart.

Cody Dimak (01:25:58.501)

Rob Gray, to answer your question. A D D's kicking in. Need more caffeine. Rob Gray was a was a huge influencer for me.

Beau Beard (01:25:58.83)

Yeah.

Beau Beard (01:26:08.218)

we'll put a link in there and then I'll put a link from my side just as a interesting side note. 'cause I've been interested in this. Like I did a talk on

Cody Dimak (01:26:17.33)

Yeah, I was gonna ask what's like what's drive driven use of that too. Yeah.

Beau Beard (01:26:21.314)

Well again, funny story. I think it was 2018. The Alabama High School Coach Association asked me to do talk. Terrible idea. I did one on chaos versus complexity. Yeah. I thought it was great because I was trying to take a very complex thing and say, you guys are doing this all day. Let's just think about these three things. Yeah, I think it was a bit much, but I got to research a lot of stuff, so it's good for me.

Cody Dimak (01:26:28.571)

Yeah.

Cody Dimak (01:26:32.6)

Ha

Cody Dimak (01:26:40.39)

Yeah. Yeah.

Beau Beard (01:26:45.1)

And then an article that came out, I think in 2022, but it talked about the preferred path of movement. It was talking about running. And it was really interesting to me because it was basically saying, like, good luck changing running gate because of all the stuff we just talked about when you focus on running gate rather than seeing what the constraint is and all. And I was like, that's like that's why nobody changes, but you can still have a pain change. Like all the so I'll put a link to that article because like that

Cody Dimak (01:27:05.02)

Mm.

Beau Beard (01:27:09.72)

Gives a really good primer of a specific movement. So you can be like, I could see how that would pan out. but book wise, honestly, a lot of it came from like, I have like I'm looking at exploring biomechanics. It's a lot of books on animal biomechanics. Because what they're looking at, like you said, when they look at how an animal moves, we look at a human move and we talk about the human moving. They look at where they're moving, they're looking at their habitat, their environment, why they develop their movements.

Right, why the vol can go through 100%. And it's like, yeah, we talk about how sitting changes, and we're like, Well, adaptation's occurring, adaptations isn't bad or good, it's just a thing, right? And then we contextualize it, and it's like, okay, why does that, you know, hawk have claws like that and move like that? And you're like, like that makes sense. And then we're like, Well, I can see why that person has like claws shit out of the ground and hinges like that, and it's like what they've their whole life, and you're

Cody Dimak (01:27:38.5)

Perce the perception and action coupling piece, yeah. Yeah.

Cody Dimak (01:27:50.194)

Thing yeah.

Beau Beard (01:28:04.75)

Well, okay, I'm not gonna give them different foot, but it gets back to exactly what we talked about for the past hour. So I'll put some links to some of the books that are a little off you know frame on principles of animal animal locomotion. I mean, these are high level stuff, but like it literally is talking about that, but it removes our our biases. So it's not human biomechanics, it's not talking about you know motor learning and the human movement aspects. I think sometimes that's good. So you're like, this is just a theory at large.

Cody Dimak (01:28:31.728)

Yeah, you know, and you know, I I do need to kind of go back and give some credit where credit's due as well. And and doubling over, thinking about that. Rob Gray was the one who really like made me how he framed it made me think about like, this is how I can actually apply this. The first time I ever heard something like this was is with dynamical systems theory or chaos theory, right? With Guido, Guido Van Risingham. Right. So he's been for years he's been on that train. Years, like going back to like, I don't even know how long, but like probably before I was even a chiropractor, right?

Beau Beard (01:28:56.302)

Yeah.

Cody Dimak (01:29:01.38)

And so, like he was actually the first one exposed that. I think just when I learned it from him, I wasn't right into it wasn't re I wasn't ready for it. You know what I mean? I wasn't mentally, I wasn't ready for that information. And so, like, but I'm I'm glad I stuck with it. You know what I mean? and then to give credit too, if you go back and read before Rehab of Spine Three came out, Rehabit of Spine Two was out, do you remember functional training handbook?

Beau Beard (01:29:07.694)

Yeah.

Beau Beard (01:29:26.35)

Mm-hmm.

Beau Beard (01:29:29.784)

Yep, yeah, I have the PDF on my iPad, yeah. Yep.

Cody Dimak (01:29:32.75)

Last chapter. I think it's the last chapter. Is Echo D. That's twenty four that's twenty yeah. Twenty fourteen. Yeah, that's right here. Yeah, right here. I think it's either last or second to last chapter. It's all echo d man. And I you know, I texted Craig and I was like, this stuff is like way ahead of the like way ahead of the game.

Beau Beard (01:29:37.056)

Is it? See if I can pull it up while we're on here without wasting too much time. You got it?

Beau Beard (01:29:51.982)

Well even you take that, also Anok is neuromechanics. but then you look at like the DNA like Pobble's textbook, which that's a who geez, it's like a walk across the globe in terms of like material, but they go through the different motor learning concepts and then they kind of say, Okay, the one that kind of holds the most water is this integrated, you know, basically systems theory. And that's again what they're talking about. And then they're like

Cody Dimak (01:30:06.866)

Mm-hmm.

Beau Beard (01:30:19.372)

That is in the first what that's the third chapter, I think, that book saying like you kind of gotta know where you're working from to move forward in the rest of the book. That's before any of the neurodevelopmental model or any of the DNS concepts. So again, it keeps showing up in all these places and anything that, like we said, becomes a logical underpinning for why you're doing things and like all these people that we respect, it would pay dividends to go learn about it and read about it and take courses or do whatever you can to kind of understand as best you could.

Cody Dimak (01:30:26.246)

Yeah.

Cody Dimak (01:30:39.666)

Mm-hmm. Yeah.

Cody Dimak (01:30:48.124)

Well that like did I think it correct me if I'm wrong, I think it might have been you who kinda told me this, but like you went to I think two years ago you went to Prague, right? come up with two years. Was it you who said that you made the observation that they did way less cueing or no cueing at all in the positions, but they kept changing positions until the person found the ability to create pressure, if you will. That would be

Beau Beard (01:31:13.004)

Yeah. Well the question was, so I don't know who asked it on the last day we had like a two hour QA, you know, everybody's just exhausted from a week. And somebody asked, What's your biggest pet peeve of like people teaching or talking about DNS when you talk about the prog school and like how you guys audiologically think about it? And they all literally look like everybody knew, like everybody in the room that was a prog PT like looked around, they're like, We got one for you. And they're like, You guys cue the snot out of intra abdominal pressure.

Cody Dimak (01:31:18.78)

Yeah.

Beau Beard (01:31:42.412)

They go, we rarely, if ever, cue it because we see it as a response to ideal, you know, centration, muscle synergy, ideal movement pattern. We're all like, these are now we're certified practitioners like, you just dropped that bomb on us after a decade of learning about this stuff. But there's

Cody Dimak (01:31:54.866)

Dude, that's yeah.

After a whole yeah. Yeah. Why isn't that why isn't that the beginning of every lecture? You know?

Beau Beard (01:32:06.338)

But what we're saying is they I think thought we knew it because it was a philosophical underpinning. Right. They the way they explain it, if you look at it, they explain it, but then they never say it that bluntly because they're like, You guys should have known that. And we're like, We didn't. We've been over here be like, Goo come on, pressure and

Cody Dimak (01:32:24.154)

Yeah. Well then that kind of like kiboshes the whole s like central governor theory too, you know, like from you know how how they're you know, how some of the content's being taught too, right? So it's you know, if the yeah, the I one and this is not necessarily against DNS per se, but it's like people's perception of DNS or their even their application of DNS, right? They think like the extra DNS exercise is gonna be the the end all be all, and that's it. That's all we gotta do.

Beau Beard (01:32:26.806)

Yeah.

Cody Dimak (01:32:53.614)

You know, you don't need to load, you don't need to actually exercise, like those things. You just add a band to a DNS exercise. I'm like, what? Look, it can be incredibly impactful, right? But like what are we doing? Like what's the actual angle? You know? Do you think you're changing function or you think you're trying to change function? But the long term change is gonna be it's gonna be movement, you know, it's gonna be movement, getting outside more, being in nature, loading, going for a walk, no headphones, no phone.

Like that stuff. That's the stuff that makes long term change, right? But maintaining power. Maintaining power. If you don't if you don't lose power, you never lose strength. You never lose strength, you never lose muscle mass. Everybody talks about sarcopenia, it's power penia. We gotta talk about power penia. We got you know, we gotta you maintain power. You gotta maintain if you never lose power, you never lose all these other stuff, right? Yeah. Chapter thirty five in chapter thirty five in in functional training handbook echo d twenty fourteen, I think.

Beau Beard (01:33:41.932)

Yep.

There you go. And that came out in that was 20. Yeah. Yeah. Yeah. We cover ground. Woo! We're here. I know. But it is a it's the conceptual framework that you that everybody, I would say everybody, we would hope everybody moves towards naturally. All we're trying to do, I hope, with podcasts like this and classes like your teaching, and I'm sure you always touch on this in your lectures now.

Cody Dimak (01:33:53.916)

Crazy. You know, twelve twelve years later it's like it's like still just mi Yeah, just yeah. That's wild.

Cody Dimak (01:34:16.198)

Every time. Yep. Mm-hmm.

Beau Beard (01:34:16.29)

You're trying to get people there sooner because the sooner you get there, the better clinician you you know become. And then the better clinician you are, the better you are, you know, of service to humanity. But the thing is that I would like to see is there are more clinicians talking about this because then the comments conversations are just deeper, they're better, and we all learn a little bit better. Cause now we do the communication platform becomes a kind of uniform base, more or less. And I think that's one thing our profession's been missing is one of the impetuses for art of assessment is like.

Cody Dimak (01:34:32.978)

Yep. Yeah.

Beau Beard (01:34:46.04)

Can we just kinda talk the same? Now we might do different stuff. Let's just kinda have the same conversation and then we can like go do our wacky. You can go, you know, I don't know, do eye drills. I might do some loading and this guy over here's gonna have, you know, sun their butthole. But we kind of all started in the same place. I don't know. We'll

Cody Dimak (01:34:49.35)

Yeah, yeah, yeah.

Cody Dimak (01:35:02.684)

Totally. Yeah, yeah. Yeah, no. No, that you're right. Every every s every time I not just in the coursework too in the program, but like every lecture, every seminar that I give, that's a foundational piece that we talk about. Now, whether or not it's the first thing we talk about is a is a different conversation because sometimes there's some things that need to be covered prior to that, like you know, some standards and stuff. But to like to before I move forward with any intervention, just about ever, you it's hard to not talk about it.

You know, especially if it's a weekend course, like it's it is coming up for sure. Just so we can like you said, we can have the same lingo and but we know the purpose behind the intervention that we're applying. It's not just to increase, you know, like to increase hip intern rotation. Yeah, okay, but why? Why are we wanting the hip interrotation increase? And then how do we get them to like keep that outside of the office? Right. So

Beau Beard (01:35:55.254)

No better way to end than on that of the why behind simple things, right? That then can become more and more complex and specialized. So I'll hold Cody's feet to the fire that he has to talk about it as talking parker. I'll report back to everybody. I'm sure he will at some point. But looking forward to seeing next week in Miami. you got anything else coming up? Are you doing it? What else you got going on the rest this year?

Cody Dimak (01:36:17.354)

I have I'm doing Tennessee Chiropractic Association's big event, the Southern Chiropractic Conference. I'm doing that. I'm doing like I think I have eight hours there. so that'll be fun. I think I might have something in Cali towards the end of the year. I gotta confirm that with Seb. but I had a couple of things with with Ben lined up and then British Chiropractic Association.

acts their CE requirements. So that kind of like threw a little monkey wrench in that. So also working with with Ben Stevens on some of the his his big mentorship thing that he's gonna he's rolling out there. So doing the low back portion of that. Well really strength and conditioning low back for low back stuff there. yeah a little plug for that yeah that's big

Beau Beard (01:36:59.096)

Yeah.

Beau Beard (01:37:06.176)

Little plug for Ben. He's he's doing I don't even know what it's called for sure. I don't think he does, but go follow Ben on social media. He's been talking about this mastermind that's gonna be a year long process. Cody's part of one of the specialty portions of the rehab. I'm gonna be one of the integration specialists. but it's anybody and everybody that you he's calling it the vengers that you look up to in this field, in my opinion that I think are at the top, are involved in some form or fashion. So I think it's

Cody Dimak (01:37:12.231)

Yeah.

Yeah. Yeah.

Beau Beard (01:37:35.98)

be a wildly important. I think it's gonna be very successful, but I also think it's gonna be something that sticks around and kind of starts to push some education around a little bit overall. So I'm excited about it. Yeah.

Cody Dimak (01:37:46.406)

Yeah, yeah. But other than that, that's that's what all it's plan right now. Looking for anybody who would like to host a low back loading strength and conditioning piece or a non contact ACL party. So it's a party, baby.

Beau Beard (01:38:00.952)

party. Like it. All right, man. Well thanks for doing this and see you next week.

Cody Dimak (01:38:07.1)

Yeah, brother. See ya man.