Ep. #823: Dr. Aaron Horschig on Preventing and Fixing Pain and Injuries

Mike: Hey, and welcome. Welcome to another episode of Muscle for Life. I’m your host, Mike Matthews. Thank you for joining me today. And if you haven’t already, please take a moment to subscribe to the show so you don’t miss any of the new episodes. And so you help boost the rankings of the show in the various charts, which helps me because then other people can find my work more easily.

Okay? In this podcast, I interviewed Dr. Aaron Horsing about lifting injuries, how to prevent them, how to fix them, how to find out what’s wrong in the first place before you even try to fix it. Very important. And also how to manage pain, mild pain, acute pain, something that no matter how conscientious you are in the gym, no matter how careful you are with your technique and with your programming, you are going to experience at least now and again.

Throughout your lifting career, it is just inevitable that you are going to develop these little niggling issues, these little repetitive stress injuries. And if you know how to deal with them correctly, then they can be nothing more than maybe a little speed bump. And if you don’t know how to deal with them correctly, they can really get in the way of your progress.

And I wanted to get Aaron on the show to talk about this in particular because while I have talked about it, I’ve written about it, I’ve brought other people on the show to talk about it. Injury prevention and injury rehab and pain prevention and pain mitigation and elimination are complex topics and different people have different methodologies and different insights.

So I wanted to get errands, thoughts on his methodologies and his insights. And in case you are not familiar with him, he is the founder of Squat university.com. He has a doctorate in physical therapy and he has also been involved in Olympic weightlifting for over a decade as both a competitor and a coach.

So Aaron not only understands this stuff theoretically and academically, he understands it practically with his own body and working with many clients and patients over the years, which he continues to do. And Aaron also recently released a book that is getting rave reviews called Re. Milo, an interesting title.

He explains the title in the interview, but this book is all about fixing common weight, lifting injuries, whether it’s knee problems, back problems, shoulder problems, elbow problems, you name it, it’s in there. And Aaron put a lot of time into making the book very accessible to layman, which I really appreciate because that’s what I try to do with my work.

I am most interested in just clearly communicating things that work to everyday people who want to build muscle, lose fat and get healthy. And so Aaron has that same mindset in all of his work, which again, really resonates with. So if you wanna learn about going beyond just maybe popping pills and throwing on an ice pack, or maybe slathering on some icy hot to deal with pain or dysfunction or injury.

And if you wanna learn how to get at root causes, and not only get rid of the pain or dysfunction or injury, but get rid of what precipitated it, get rid of the circumstances that will cause it to occur again and again. Then this interview’s for you. Also, if you like what I am doing here on the podcast and elsewhere, definitely check out my sports nutrition company Legion, which thanks to the support of many people like you, is the leading brand of all natural sports supplements in the world.

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Head over to bi legion.com/mike. That’s B U Y L E G I n.com/mike. And just to show you how much I appreciate my podcast peeps, use the coupon code m ffl checkout and you will save 20% on your entire first order. Hey Aaron, thanks for taking time to do. 

Aaron: Mike, thank you so much for having me on. 

Mike: Yeah. I’m excited to, to talk to somebody who also writes writes books in the fitness space, and I love writing it. Many of us, yeah. 

Aaron: That’s very true. 

Mike: That’s very true. So first quickly and this is, this will be a good plug for the book, but I’m curious why the. 

Aaron: That’s a great question because a lot of people when they first hear rebuilding Milo, they’re like, Who the hell is Milo?

Yeah. It all comes down to the story, the fable story from ancient Greek times of Milo of cartoon. And most people who are in strength sports like weightlifting or power lifting, have heard of the old there’s this Milo magazine publication that would come out specifically highlighting different parts of strength sports, and they would have this poster on the wall.

But for those that have never heard of that before, Milo was an ancient Greek athlete, considered to be the best athlete of his time, multiple Olympians Olympias in the sport of wrestling. And there was this fd story that was attached to how he got so strong, which was that every single day as a young athlete, he.

Take this calf and put it on his shoulders and walk around and as the calf grew in size, so did his strength. Until one day he was literally hoisting a full grown bowl on top of his shoulders. And I think if you actually get into the story, he like walk down in the air, he like killed it and ate it in front of everyone in the Olympic stadium or something like that.

But basically the FD story set the precedent for how we understand modern day puritization, specifically in the idea of progressive overload, is how we gain strength. Now the idea is that as strength athletes, whether you’re a weightlifter, power lifter, CrossFitter a bodybuilder, we use this scientific principle to gain in performance gain, strength gain hypertrophy.

But just as much as there is science, there’s also this double edged sword is that we’re constantly butting up against, trying to get the best adaptations. And then sometimes we fall into. Having injuries, no one’s perfect. No one has perfect technique. No one has the perfect plan. We’re always trying to outdo ourself from last week and get one more rep, or put 10 more pounds on because that’s the athlete inside of us.

We’re always driving ourselves to become bigger and faster, stronger versions of ourself, and in doing so, we’re always finding these small injuries. In most strength sports or even, just people who are going to the gym because they like lifting, there’s never going to be a very high risk of traumatic injury.

You’re rarely going to see a torn ACL or just a very severe injury. However, there are these aches and pains that every single person suffers from, a sore elbow when bench pressing or your back starts to hurt every once in a while with deadlifts. And it’s not all the time, but these are things that happen.

Mike: And in today’s, my left forearm is a little bit pissed off these days. Yeah, a bit of biceps too.  

Aaron: There’s always Exactly, there’s always something going on. And I’ve experienced this myself. I started competing in the sport of Olympic weightlifting in 2005 and before that was even a gym rat.

I’ve always been. In this strength sport arena, and I know full and well, exactly what it feels like to have that knee pain hurt so bad two weeks prior to your competition. And just all these, thoughts of anxiety run through your head how are you gonna compete because you can’t even squat right now without tremendous knee pain.

And it’s something that everyone experiences that walks into the weight room well nowadays, we don’t always have the best information. For trying to fix those injuries. You can take the conventional route of going to a medical doctor who may or may not have any background at all in weight training.

And what is the common scenarios that you go to that person, you say, My back hurts from dead lifting. He says stop deadlift so much. That’s the reason you have back pain. Maybe they’ll give you some medicine, maybe a cortisone shot, tell you to rest, come back a couple weeks. If it’s better, you’re good.

If not let’s try another cortisone shot. Let’s go get an mri. We don’t approach things optimally from a medical standpoint by and large nowadays. You could do the other thing that a lot of people do is just ignore their pain and just keep on pushing. And what happens with that is we develop a lot of chronic issues because while maybe taking a little bit of deloading can help sometimes.

A lot of people will eventually return and have recurring injuries. So while the knee may feel better for a while, while every couple months comes back, starts bugging me again you can try to find a generic template on social media. There’s a lot of people nowadays that are selling like back pain or knee pain.

Do this. Yeah, quick fix and that, yeah, quick fixes. People love quick fixes because it promises what they want. They wanna get out of pain, but it doesn’t always deliver on that because as Dr. Stewart McGill, I know you’ve had on the show before, back pain is not homogenous. Basically this simple thing with any injury, there’s not this one size fits all approach to how you got injured.

So there can never be a one size fits all approach to getting out of injury. 

Mike: Yeah, I get asked a lot about little RSIs and unfortunately I know that’s the case. I wish I could just give them, It is easy if somebody says, Hey I want bigger biceps, here’s what I’m doing, What should I do? That’s pretty straightforward.

But yeah, if somebody I had some biceps tendonitis that I’ve been able to stave off, but I have to work at it to keep it from coming back. . And so people who will hear that on the podcast, or I’ve written about it, mentioned on social media, they’ll reach out, Oh I’m running into the same issue and unfortunately all I can say is in me.

Here, let me tell you. It was Subcap that was very tight. So getting that worked on helped. Couple of the little things helped, and that’s it. There were a couple trigger points. It’s hard to say exactly. Back on the scaps. Was it Infr? Was it Terry’s? Not exactly sure, but there was a trigger point in there, and by working on a couple of these trigger points, it actually just resolved.

And, but that may not work for you. And that’s, I and I understand like it’s not nice to hear that because it then they have to, you have to go hunting for, you don’t have to be necessarily groping around in the dark, but it is not as simple as go do 15 to 20 hard sets for your biceps every week and eat enough food and sleep enough, they’ll probably grow. 

Aaron: You know what I mean? Exactly. So basically the idea behind rebuilding Mylo was to provide that blueprint. That treasure map as far as like you said, to go digging. I want to give you that map to understand how to go about that process so that if you don’t have a good doctor, a good physical therapist, chiropractor, someone that can help you close to you.

I want to give you my approach to fixing injuries, which starts with a proper assessment so that you can find your individual reasons for developing injury. Now, this is nothing that I’ve marketed as my own. I’m only standing on the shoulders of giants who have come before me. So a lot of the back pain stuff is things that I have learned from Dr.

Stewart McGill. There’s shoulder stuff that I’ve learned from Mike Re there’s knee things that I’ve developed and learned from, Jill Cook or a lot of other great physical therapists and strength and conditioning coaches that, I’ve pulled all together and tried to create this one product that people can then use as a blueprint.

To take the first crack at fixing their injuries because despite what you’ll hear across social media or from some in the medical community, I don’t believe a lot of the aches and pains that we suffer from as athletes are severe medical issues. I think it’s just Kelly Starz said one time, You don’t need to call an electrician to change a light bulb in your house.

You should have the ability to do that yourself. With a lot of these things that we suffer from, they’re not traumatic injuries, so you should have the ability, the wherewithal to know how to navigate them. You just need the knowledge. And I think if you can be packaged and shown to someone in a way that they can understand it, then it can be empowering.

So the idea behind Rebuilding Mylo was to say inside all of us is this desire. To become a bigger, stronger, faster version of ourselves to use the principles that Mylo first showed us of progressive overload to reach our performance goals. Yet because that athlete inside us drives us so hard to push to become bigger, faster, and stronger, and then our body pushes back.

When we don’t listen to that biological set point of what we can tolerate at that time, we succumb to injuries. Let me help you with this book. Rebuild Yourself to become your own version of Mylo and have less injuries so you can enjoy doing what you love, which is for most people, lifting some big ass weight, getting in the gym, building their bodies to what they want.

That’s what we all love doing. So I want to be able to help people in that regard, get out of injuries. And that was what Rebuilding Mylo was all about. 

Mike: Can we talk about, I think we should talk a bit about injury prevention and treatment. Let’s start with prevention and I’m just gonna just give that to you and let you tell me where you’d want to go with that.

Are there some general principles regardless and know that the people you’re speaking to for the most part are, I would say like me, like lifestyle body builders. They’re not I may have some competitive athletes and some strength athletes in my orbit, but most of the people I would say are everyday people who may be in great shape, they have three to five hours a week to get in there and throw some weights around.

And they do, they want to get the most out of that time. And they are not though trying to squeeze every last ounce of performance at any cost necessarily. You know what I mean? Like I had mentioned before we started recording that. Fortunately I’ve not had any acute injuries and probably one of the reasons for that is I haven’t had to push myself as far as somebody who steps on.

A stage or who is competing in an event. So I’ve always been able to back off if something is bothering me, because I know I can just get back to it in a month. I’ll just go find a work around and not really worry about it. But that doesn’t work. Again, you mentioned if you have a meet now in three weeks and you’ve been working for six months for this one day and Yeah.

Aaron: So yeah. I think the first thing we have to understand is that we will never be able to completely prevent injuries from happening, but we can decrease and mitigate the risk of injuries really, and maybe the severity as well. Exactly, yeah. Especially when it comes down to the gym because we provide education on what to look for.

Now, there’s a few principles I think that if adhered to can very much so decrease the risk in when there is risk, decrease the severity of what does occur. And really that comes down to a few things. First things first is technique in learning, proper movement under load. So for example, if you’re learning the squat, if someone has never been taught how to squat and then they just go to the gym and they throw a bar on their back and their background’s like crazy as they go down on their knees, cave in, that’s suboptimal technique.

And obviously there’s a spectrum of what technique qualities are gonna look like, ranging from the most perfect squat from an Olympian to a very poor fr squat from, from someone who has never learned lifting before. Technique quality is a huge factor in how load is distributed. In the body in amongst different tissues.

And that sort of brings in our next part, which is load management. Now, load management and technique are basically the same discussion, but from different points of view. Load management can be thought of at first as how much weight are you lifting. It can also be thought of how you are moving, which mitigates how much load and on what parts of the tissues that load is being distributed to.

So for example, if someone is performing a deadlift, And they use good technique and they’re stiffening their core and they lift the bar from their ground and their back does not move excessively well. The body is going to very safely distribute loads amongst the spine. Amongst the muscles. It’s going to be handled much better than if someone were to pick that bar up and let their back just round like crazy off the ground.

And what I mean, round like crazy, I don’t mean like a an atlas stone lift. So someone that’s in world’s strongest man picking up the big stone in their back is rounded over the implement, but actually it’s moving. So they start off straight and as they pull the bar from the ground, the bar or the back moves, what that does is instantly we are shifting load, We are shifting stress from a very even distribution on the spine to being very vocalized or very localized on certain tissues.

Every tissue within the body has a certain set biological tipping point of capacity that it currently has. And if we overload certain tissues past a certain point, that’s what sparks injury. So that’s the big thing to understand is that when we lift with poor technique, we overload certain tissues, we isolate the load that we’re placing on them, and we increase the risk of tipping that biological set point of capacity.

Now, we also have to understand in the same conversation is how much weight are you lifting? Because let’s say a really strong athlete walks into the gym and they use poor form with very lightweight, are they at risk of injury? Probably very little because that athlete has built their capacity likely with their training over the years to handle and mitigate some of those forces.

So we have to have that discussion of where is that a leads in that person’s current capacity? So the biggest thing that we can understand is when we’re trying to mitigate injury is to use appropriate loads, build capacity slowly over time, whether, and then make sure that you’re using good techniques.

So listening to coaches, watching tutorials online of people that are teaching proper technique and then slowly progressing in load. What happens is that sometimes people get into the gym and they love lifting big weights and they keep on pushing weights and because they get the weight up, they believe they’re using adequate technique Though if you’re not doing that slowly progressing in load and using poor technique, you can risk overloading certain tissues in sparking the injury process.

So we have to have the both conversation as far as what type of technique are you using and what type of load. Cuz there’s a lot that goes into it. 

Mike: With technique. A tip that I can share that has helped me is to record yourself doing some of these exercises with your heavy, like your working sets.

I record all of my workouts cause I just post ’em on social media so people like to see it. But for people who don’t have to go through the rigmarole of doing that, I think it’s still useful. Occasionally to set. I have a little tripod thing for my phone, just with these little articulated arms.

You can just wrap it around something and pick, depending on the exercise, pick an angle that allows you to see what you wanna see. And what I’ve found with, I mean weightlifting, I’ve found this with golf and with golf even more so than weightlifting, that sometimes what you think you’re doing.

Is not what you’re doing. Yeah. So your perception of how you’re moving especially with weight lifting as you get deeper into a set and now you’re getting closer to failure and you have a lot of weight on your back, and you’re really just, all of your attention is on just driving through the floor and standing up and then you go look on camera and for example, and I, this is something I had to work on, that as the weights get heavier and I get deeper into sets, my knees would tend to, it wasn’t dramatic. It probably it wasn’t. Significantly increasing my risk of injury, but it was not optimal that I would notice that deeper into the set my knees would start to move inward and to fix that.

And I still have to do this now and again, this reminds me of golf where it took so many reps for me to learn how to what they call engulf, to shallow out the club, to swing it properly. Like when you get to the top of the back swing, what you have to do to swing it properly, it feels very odd.

You have to just do it again and again until finally it becomes normal. So I still have to do this in my squat is to, it feels like I’m forcing my knees past like I’m moving them outward. That’s how it feels on camera. Nope, they’re, they are dead still. They’re where they, and if I don’t do that, if I don’t try to force them outward, they tend to move a little bit inward.

So that’s something that has helped me. And you can do that with it it’s probably not necessary with machine exercises, , but certainly with free weight exercises where technique is very important, 

Aaron: I absolutely love filming my list and I will do so again with the tripod for all the lifting that I do.

And again, so I compete or did compete for over 11 years in Olympic weight lifting and still train Olympic weight lifting many times throughout the week now, just as I did when I was younger, just maybe not as frequently. So I’m constantly, even though I’ve been in the game now for many years, I’m still constantly watching my move.

Analyzing my sets during my rest periods and making sure that I’m seeing exactly what I wanna see. So if I do a set of squats, for example, I’ll film that camera sometimes from a direct side view, because what I wanna see is that barb track directly over the middle of my foot. That means the body’s imbalance and therefore capable of producing as efficient force of power.

And what sometimes you’ll see is that if you get a little off balance, and often the way in which people tend to default is to let that chest lean forward just a little too far. And what happens is the bar then starts tracking over the toes. So instantly you’re a little bit off balance. Now with lighter weight, often you can compensate and still get the weight back up.

What happens is that the way in which you practice turns into the way in which you’re gonna compete. What I mean by that is if a problem happens with lightweight and you don’t correct for it and work to get better and better at it, when you do go heavier, that same movement pattern is likely gonna get worse because it’s gonna be reinforced.

The way in which you’re training in that brain body connection called a motor pattern. So your body doesn’t necessarily work off of just, fire this muscle, fire that muscle. It stores the way in which you’re moving in these very specific manners in your brain called a motor pattern, and the way in which you are going to be moving.

Often strengthens or weakens whatever type of movement pattern you’re trying to create. So if you’re trying to squat and maintain your knees in proper alignment, like you said, if you do a squat and then you film yourself and whether or not it was good in your mind or not, then you can work to get better next time.

And then you can every so often get better and reinforce that proper movement pattern so that when you do go heavy for those few times, you’re gonna have a better chance of maintaining that style of technique because your body has reinforced it over and over again. It’s not just how strong those muscles can be, but whether or not your body can coordinate those muscles to have the exact same efficiency of the movement pattern at the heavier weights as.

Mike: I think that’s a reason to pay attention to warmup sets. That’s something that I a hundred percent agree as practice sets and whereas many people are a bit more sloppy in their warmup sets. I try to pay close attention cuz it’s easier to pay close attention to at least a few things in your form with lighter weights than it is with heavy weights.

And now you’re really going for it. And I’ve noticed that over time has helped, again, just seeing the feedback on video where I could notice, hey, my, my knees, they’re doing a little bit better now and there is the conscious effort that I’ve had to apply to it. But by focusing on that in particular in my warmup sets, for example, and just getting the feeling of what it.

Like to stand up with some force and keep my knees where they need to be, has translated to better squatting with heavy weights. 

Aaron: Definitely. I think every time you touch a barb bell or whatever weight you’re trying to lift, whether it’s a kele, a dumbbell you have a chance. To improve your movement quality.

And a lot of times people think that only their working sets are what are important, whereas I believe, just like you mentioned, the warmup sets are just as important, if not sometimes a little bit more important sometimes because you’re using them also as a last chance check to whether or not your body is moving as ly as possible before you start putting the bigger loads on.

So if you get under the bar for your first couple sets, you’re there not only to reinforce, All right, what am I doing? Let’s go through the exact same setup. Let’s get the bar in the back. Are my hands in the right spot? Am I bracing correctly? Where am I starting? Am I feeling the balance as I go through?

But you’re also checking yourself. All right, how do my hips feel? Do I feel symmetrical? Is my left hip may be a little bit tighter? Okay, what do I need to do? Let’s maybe sit and pause in the bottom squat position, drive the left hip out to the side, see if I can squeeze the glute and maybe take away that tightness.

Or whether or not, Hey, I also need to, before this next set, I’m gonna go do a set of ban joint mobilizations. I’m gonna use that as my last chance effort to self-analyze and see what do I need to do to basically make sure that these working sets are gonna be performed as optimally as possible.

So I definitely think the warmup sets are extremely important for reinforcing exactly the motor pattern that you want to see whenever you’re going to get heavier. 

Mike: Can you talk a little bit about the banded mobilization, the joint mobilization, and what you mean by that? I’m sure people are wondering, this is something that obviously many people have heard about and you had mentioned Kelly Starret previously.

One I guess it’s a bit of feedback, and it usually comes as a question that I’ve gotten regarding his becoming a supple leopard book is , It’s a lot of information and it’s impressive in that regard, but I’ve heard from many people over the years who they don’t really know what to do, though.

There are so many options for shoulders, for elbows, for knees, for the back and they just don’t know when they go in the gym. All right, what should I be doing and why? And so I’m just curious if you have a few simple, eh, Yeah, I’d say maybe like techniques that, that you could share with people like you just mentioned.

Like, all right you’re setting you’re getting set up for the squat. You’re noticing some tightness in how you might try to resolve that if simply like you said, Okay let’s pay attention to this. Let’s see if I can correct this just by forcing the correct movement pattern. But if that doesn’t work, Yeah.

Aaron: So first off, let me say that I love Kelly’s stuff. Kelly Star don’t mean that as a knock 

Mike: on his work at all. For sure. I’m just, saying, I’ve just heard it many times over the. 

Aaron: Yeah, so Kelly was one of the first to really talk about to mainstream, fitness people about banded joint mobilizations.

It’s something that physical therapists and physios across the world I’ve been doing for a couple decades. Usually we call them mobilizations with movement. In the idea is that we are trying to affect the joint, whereas with a traditional stretch, you’re more so looking at the muscles and the tissues that surround the joint.

The joints are extremely dense and thick as far as the connective tissue that goes around them. So in order to actually affect how the joint is moving, if there is a restriction in the way in which it’s moving is you have to get a very thick piece of of rubber, like a big rubber band or a monster band you may see at the gym.

For example, we always have to test and assess whether or not that’s even what unique. Because like you mentioned, someone could see an exercise on social media and they see it being enjoy mobilization. How do they know if they even need it? Because the last thing I want people to do is just throw a bunch of random crap at the wall and see if it feels good.

Mike: How a 30 minute mobility routine before they even start lifting.

Aaron: And they didn’t need to do any of it, exactly. That’s sometimes I’ll hear people say Qua University wants you to warm up for 45 minutes before you touch the bar. It’s, I’ve never said that at all. It’s always about doing exactly what your body needs in your warmup. So that, again, what’s our end goal?

It’s all about why our end goal is optimal movement, feeling good, moving well before you load it. So for example one of the reasons I will use a band joint mobilization is that a criterion by the way,

Mike: Sorry to interrupt, but is that so if you’re gonna squat and you’re doing your first warmup set and you feel good, is that a green light to move ahead?

Mike: My green light is basically always, I say generally again, I’m just trying to think with my average listener in mind, who loves to understand both the theoretical and the practical side of things. Who would love to go in the gym tomorrow and have one or two things that they remember Hey, oh, I can check that and, yeah, for sure.

Aaron:  I think the biggest thing I want people to understand is that if you’re not feeling pain free, if you’re not feeling great about the lift, you don’t often wanna load that lift. Okay? Because the more load you place on something that’s not feeling good, and I’m talking when I don’t, not feeling good, something’s achy.

Something’s just not feeling right, Like you’re not able to move. As far as your technique goes, it’s probably not a good idea that day to load the body because you’re going to increase your risk of injury when you’re not moving well. Now, the more seasoned an athlete is, Especially in the strength sports, the more you’ll have a better understanding of what sort of problems you can push through and what things you need to take a step back from.

That’s just the wisdom of being under the bar for a long time. But yeah, I’ll give an example. Let’s say you go to the gym and you’re doing your first couple squats and you have this like pinch or black sensation in the front side of the hip. As you go down, the deeper you go, it just feels really pinchy, blocky, sometimes painful.

Now, some people will say, Oh, it’s my hip flexer. It’s because it’s on the front side of your hip. Your hip Fluor is a very superficial muscle that is shortening actually as you go into a squat. So it’s not a often going to be the direct cause of any pain as you go into the bottom of a squat. Often what we see is that is more significant of a hip impingement, meaning the way in which the joint is moving.

As you go into a deep squat, the femur is moving in the socket in a way that is running in and creating that pinching in the front side of the socket as you go into a deep squat. Now, it could be due to a couple different things, but one of the helpful tools often is a banded joint mobilization for two reasons.

First off, what it does is help create a little bit more motion within the hip sock. You can perform it. And if for anyone that wants a visual of this, if you just YouTube Squat University, how to fix a hip Impingement, you can see this exact motion played out. But basically what we do is we distract the joint a little bit.

We give a little bit of pull on it with a heavy band, and then we create and work towards improving hip internal rotation for one part of it. And then we create also this neuromuscular reeducation, basically simply the way of saying we turn your butt muscles on a little bit better. With the external rotation.

So there’s different parts of the banded joint mobilization. One to aim to improve mobility. One to aim to teach the body how to keep that mobility. Basically, the idea is that we’re trying to create more freedom of movement, and the big thing is also test and retest. Once you’re done with the joint mobilization, see if it was worth anything.

You need to get down on the ground and perform a squad again. And C, did it actually change? Do I feel like I have more freedom of movement? Am I able to squat down and have less of that pinching paint? If so, all right. Now you just improved the issue that you. Now you’re free. If you’re feeling better. Now we can continues to load that pattern.

So the last thing we want to do is just continuing to push through pain. You always wanna listen to your body and that’s a process. It takes time. So if you’re very new to the gym, it’s something that is going to come with more reps and learning. And unfortunately, sometimes we learn these things. The hard way is that you push through something and the next date’s really achy.

But that’s part of the process. But the better you can learn to feel your body to know what things you can push through, what things you shouldn’t. And also in that case, what things can you do in the short term to mitigate and help your body feel a little bit better? A banded joint mobilization basically can be a very helpful tool when applied.

Correct. To improve mobility, give yourself access to a restricted problem to allow more freedom of movement. Sometimes, in certain cases, take pain away completely. 

Mike: Yeah. Something that I’ve said for a while is, and this is particularly to people who are newer to, to strength training, is if something hurts and you can’t resolve it, then find something else that you can do that doesn’t hurt.

That’s been my general advice. Yes. And I do that in my own training. , I’m willing to, Push through a little bit of discomfort okay, my, yeah, my, my left forearm is a little bit annoyed. And so now for the next probably month or so in I’m not doing any palms down pulling because that just aggravates it.

I’m doing neutral palm, palms facing, pulling, and I’m doing hammer curls instead of regular curls. And I’ve had this issue before. Unfortunately what triggers it is usually an overhead press where my, my, my forearms are not perfectly at a, they’re not that 90 degree. They’re a little bit in, and then when it gets to the bottom and it loads at the bottom, and eh, this has happened before, but I know, okay, then what I need to do is avoid the things that are causing pain.

Now, if I were to. Those even the hammer curls and any pulling whatsoever, it may get better a little bit faster, but I’m not really willing to do that. So I’m okay with the slower recovery. However, if something hurts, then and I can’t resolve it, what I’m doing is I’m finding an alternative exercise.

So if it were a back squat , it was just my knee is not liking it and I can’t resolve it, and I’ve had to do this before, then I’m gonna do a front squat. Does that feel good? All right, I’m gonna do that. Or I’m gonna grab the safety bar. Does that feel good? All right, then I’ll do that. 

Aaron: Yeah. I’m a big fan of the the slogan train, What you can train while you fix what you can fix. So in that scenario, if a back squat hurts, but you can front squat without pain, Okay, now we can front squat, but in the same sentence, we must understand why. Why does a back squat hurt? Because the idea of just avoiding an exercise in the short term, while it may allow some of the symptoms to decrease, You’re left not knowing why that problem even came in the first place, so that the next time you go to back squad, will it come back?

I don’t know. Oftentimes that’s why we see such high rates of reoccurring small aches and pains with people because they never are addressing the why. So that’s the goal with a lot of the content that I create for free every single day across every single social media platform, is the idea of saying, I want you to be empowered with some of its steps and tools and tests that I do constantly as a professional in a physical therapy setting.

I want you to be able to try some of these on your own so you can try to take a crack at. What’s that? Why? Because the idea of, Oh, I have knee pain. It hurts. still wanna train. All right here’s something you can do. RD yells, those feel good? Awesome. Go train rdl. You’re at least getting some post your chain activation.

You’re working your body that day, you’re blowing off some steam. Psychologically, you’re still gonna feel better because you’re not just staying away from the gym physically, you’re still building and maintaining some capacity because you’re still training your body. But then let’s also always try to get down to the cause, the root cause of problems.

Mike: And sometimes it just takes a little bit of testing, a little bit of time. But that’s where having the empowerment, good guidance in which is where your work comes in. 

Aaron: That’s what I’m trying to give to people is I want you to have that guidance, but I wanna try to speak to you in a way that you can understand, because again, most of us that are walking into the gym do not have a PhD in exercise physiology, a doctorate in physical therapy, a doctor in chiropractic.

They don’t understand necessarily all the high level science or the jargon.

Mike:  Jargon alone. A lot of the jargon kills me.

Aaron: Yeah, exactly. And that’s why one of the, you lose a lot of 

Mike: people right there because you really do, I, you could be trying to explain one concept to someone, and if you use the wrong words, if, let’s just say that they are committed to understanding what you just said or what you wrote.

You might be asking them to spend an hour on Wikipedia reading about things, then having to jump to the next one just to understand the 15. Specialized terms that you, with your peers, you throw ’em around like we’re just talking now. But for a layman, that can be a huge block to learning.

It can make the learning curve in very intimidating. 

Aaron: It’s extremely intimidating. And what happens is that if you’re not using language like that, you become less empowering for the individual because they’re not able to actually take control of the situation because they don’t know. They don’t understand.

And that’s where we need to come as fitness professionals, is teaching people on their level, not trying to talk down to them, because you could be the smartest person in the world, but if you can’t connect with someone and give them some knowledge to where they can then become empowered to take control of the situation, you’re not being effective at all in what you’re trying to do.

I would rather someone say, Hey, you were able to give me this piece of advice and that changed my life, rather than, Man, you’re the smartest person in the room. I don’t care to be that smartest person in the room. I wanna be the person that can make the most change in the room. So I’ll give you an example.

One of the common exercises in physical therapy. If I said the description like this, I want you to flex your hip to 15 degrees and then perform a unilateral abduction movement. Most people are like, I don’t know what you said, but if I said, Hey, I want you to hinge. I want you to stand on one leg, Hinge down, squat down a little bit, lean your chest for a little bit, Okay, Now kick out to the side.

You’ll be like, Oh, okay. This is a single leg kick out to the side. That makes sense. There you go. That right there. Alone, people are like, Okay, that I understand what you’re saying. I can become empowered to take control and do that exercise. So it’s the same thing with a lot of testing and protocols is it’s just we have to be able to teach people how to understand that, to do the most simple things.

How can you screen to understand if la stiffness. Is a part of your shoulder pain? Let’s try this simple test. And again, tho those are things that yes, I have in Rebuilding Mylo, but I give away for free every single day across every social media platform. So if people want to go and, squat university.com, I’ve got a ton of blogs.

They show all of these simple tests and measures and things that you can try on your own but are all written in a way that most people should be able to understand. 

Mike: Yeah. Yeah. And the benefit, I do the same thing I’ve written, I don’t even know now it, it might be. It might be close to 2 million words and just free articles, record podcasts.

Yeah. Pretty much probably everything that you learn in all of my books, it has been put out for free in one way or another. But a big benefit, of course, is a book, is you took the time to organize everything, to sift everything out and say, Okay, here are the key principles and here is the order in which they should be learned.

And then here is the what to do for each of these things. And it’s just in this one handy volume. Here you go. And that’s worth the 20 or $30 or even the book’s, $40. That’s well worth it completely.

Aaron: Great. 

Mike: If you like what I’m doing here on the podcast and elsewhere, definitely check out my sports nutrition company Legion, which thanks to the support of many people like you, is the leading brand of all natural sports supplements in the world.

And so let’s shift now and talk about treating injuries and something that I get asked about and something specifically people ask about is ice. Should I be icing my injuries and every day forever until it feels better? 

Aaron: I do not recommend ICE at all anymore. Now, this is actually something funny because I had a conversation with a patient of mine who’s probably about 12 weeks out of a knee scope procedure.

So they went in, removed a little scar tissue and cleaned up his meniscus, and he had seen another physical therapist for the first eight to 10 weeks. And he was talking to that physical therapist and physical therapist told him, Yeah, I mean you should be icing every single night. And even really, from here on out, if you’re your knee’s a little achy, once you’re done with the workout, you put some mic on it.

That is worst information. But it all comes down to education. We have to understand why are we doing these things? And a lot of it can be traced back years and years to just Misinformation in the way in which ICE was even intended to be u used in the first place. Originally if we go back in history, ice was used rarely in the medical world.

If anything, it was used with amputations. If you’re trying to sew someone’s finger back on, if you cut your finger off, you’re gonna put it on ice because it’s actually going to allow preservation of some of those cells so that the tissues can be sewn back together. It’s going to not allow a lot of cell death when you have something like that.

However, in 1978 doctor by the name of Gabe Merkin wrote a book called the Sports Medicine Book, in which he championed the idea of using ice as a method of treating acute e injuries and people. Now this know this nowadays as the Rice method, the rest Ice Compression Elevation Method. So if you sprained your ankle as you were a kid, what did people tell you to do?

Hey, put some ice on it. Elevate. Compress with a, tight sock, something like that. That’s the method to best treat injuries. Now I will say the one thing that ICE can be helpful for is to decrease pain. So if you are in a tremendous amount of pain, throw some mic on it. It’s not the worst thing in the world, but ice is actually not as beneficial as many of us think.

Now what ICE actually does is it slows and delays the healing process. And this is something that is validated by plenty of research. In fact, you will not find a single piece of research out there, scientific evidence that shows that ICE is beneficial in helps optimize the healing process at all, other than it helps decrease pain, which is in fact why Dr.

Gay Burkin, the person who coined the rice terminology in the early or later seventies, came out in the mid two thousands. And actually recanted his statement and he said, I was wrong about ice. And in fact, the use of ice with acute injuries delays the healing process, and we can be much more optimal in other ways.

So let’s talk about people wondering Yeah. 

Mike: Why is that? 

Aaron:  Yeah. Yeah. Let’s talk about it. So let’s say you sprain your ankle. When you sprain your ankle, there’s a couple things biologically that are happening. First, you have a lot of damage to certain tissues. In that area. Now what happens when you have damaged tissues is your body has this infl inflammation sort of spark that happens and you’re gonna have a lot of small cells called macrophages.

And they come to the area and their goal is to clean up, almost like PackMan. Their goal is to clean up and eat up all these damaged tissues and it cells that have happened because of the trauma. Now, as those macrophages come into the area, they also pull with them fluid. That’s the swelling that comes along with injury.

It’s just like a side effect of the inflammatory process. Now, when you have that swelling come into the joint, It is almost stiffening the joint because a lot of times what we do is we put ice on top and it just slows everything down. It traps the swelling within the area. Think about an injury like an accident that were to happen on a highway, and the macrophages and the white blood cells, the other ones, they come there, They’re like the cleanup crew.

They are the the fire department, the ambulance the tow truck. They’re there to come and clean everything up. If you ice. In area it is as if you’re putting up a roadblock and you’re just stopping everything from getting there. So you actually delay the proper healing process that is trying to take place.

Now, a lot of times people will say I don’t want swelling in my knee or my ankle will, I need to get the swelling out. Swelling is neither necessarily a good or a bad thing. It’s just a secondary side effect of the inflammatory process. The problem happens is when swelling accumulates around that area and anyone who’s had a sprained ankle knows exactly what this is like.

Mike: Yeah. I sprained my ankle years ago. Yeah, it was annoying. 

Aaron: The ankle just, it just blows up. Yeah. The reason swelling stays in an area is because we stop moving. They, they say movement is medicine. Whenever you have that, All the cleanup cells that are there to go and help spark the process of cleaning up the bad damaged tissues and regenerating a lot of the the injured tissues.

They all come to the area through the bloodstream, which is pumped through there by your heart. So you have this automatic generator that’s pumping the tissues or the different cells through that area. Unfortunately, swelling doesn’t move through our blood flow system in the exact same way. It actually travels through a totally different network of systems called your lymphatic system.

In your lymphatic system is completely passive, meaning that the only way any fluid moves through the pass or through the lymphatic system is through movement. So you have to have movement in order to remove swelling. If you have a sprained ankle and you prop your foot up, You don’t move it, you have no movement.

So that’s why swelling accumulates around the area. So if you’re putting a bag of ice on it, you’re actually trapping all that swelling that’s already accumulated there. You may stop more swelling from coming there, but the second you remove that, that ice pack swelling is going to come because it is following the cells that are trying to get into that area to clean up the damaged.

So what we would rather do is to try to move the injured area in a way that promotes a removal of that swelling, but not in a way that continues the damage. So for a sprained ankle, you may try to do some ankle circles, some ankle pumps. Try to do some movement that is relatively pain free if you cannot move at all because it’s just so painful.

You can use something like a neuromuscular electrical stimulation device that can help simulate muscle pump. And sometimes you guys may know these as like a Mark pro power dot a complex unit. Basically they attach electrodes to certain muscles, and this is, doesn’t hurt, but it’s sub fatiguing muscular contractions that create.

That pumping action to remove swelling. So when someone comes to me with an injury that has swelling, I don’t throw them on ice, I throw them on an MES device and be proactive at taking swelling out of that area, giving good blood flow to the area as well. So we’re optimizing the entire healing process without just slowing it down and trying to numb the area.

Mike: And what else can people do to treat? And I, we’re probably looking at repetitive stress injuries is gonna be the most common amongst , everyday weightlifters more serious stuff. Whenever people reach out to something more serious, I always recommend that they find someone, ideally like you, I say find a good physical therapist who ideally has worked with athletes like, I would say you would be the archetype of who I would send them to, but they may not, may be able to actually work with you, but ideally be a physical therapist who also is into weightlift and understands, but if it is just, hey, I had some biceps tendonitis that fortunately is mostly resolved. Like I said, I still have to work to keep it at bay. What are some other things that people can do and also before you answer that, let me just quickly comment on ice and I’m curious as to your thoughts.

Yeah, so when I was dealing. That biceps tendonitis. I did notice that. So where I would feel it is in the bi groove. . And the solution was I had to stop bench pressing. I could I could do chest flies from a low position. I believe I could do dips, but I stopped barbell pressing because that was just too, it aggravated it too much.

I stopped dumbbells for a bit as well, and then I was able to bring them back in with an elbows in position, gradually work toward, a nor normalcy. . However, I noticed that adding ice to the bi groove area, 15 to 20 minutes, a few times per day it did help. And I think I know why, but for people listening, I thought it just might be instructive to get your comments on, on.

Aaron: I’ll say there’s no doubt that ICE helps with pain. Yeah, ICE definitely can because it creates that numbing sensation. It decreases the pain that you’re sensing. So while in, that’s why ICE has been such a mainstay in the rehab and injury process for years and years, and there’s no doubt that saying, Hey, I’m putting ice on my shoulder.

Mike: It feels better for sure. It. Now what I may be, it may have just been coincidental that I was at the point where things were going to start working the way that they should. But I should have said this. What I, what it seemed to do is it seemed to help getting back to normal.

Like my shoulder felt, seemed to feel better in the gym when I was doing some of these movements and just testing. , cuz okay, so we’re over the more acute phase where I had to. I just made the mistake that, that probably most people listening have made where I just ignored it, where I was like, it’ll probably just go away and keep pressing, keep going.

Until I was like, All right, this is not going away. Yeah, it’s hurting to turn my head this way. It’s time to settle down. And so I got over that phase and I was clearly in the recovery phase and adding the ice. It did seem to speed that process up, but it may not have, it may have just been a placebo or it was just, it was gonna happen regardless.

Aaron: I will say often what wouldn’t be happening is that by icing you’re creating an environment where you’re not sensing that pain as much, so you’re more apt to actually work the body and perform exercises in a more pain free zone, which then can allow that healing, cuz that’s where the movement.

His medicine actually takes place. So it’s not that it’s a placebo completely. I think there actually is a reason for it is that you’re creating an environment where you’re not sensing the pain as much, so you’re allowing your body to move, and then that’s where the healing actually comes in. Now, I’ll say for anyone else, usually what I say in that instance is, Okay, instead of icing, because what could get better in five weeks, if we can shorten that up to two weeks, we can be more optimal.

We just have to take a little bit different approach of understanding, Hey, this movement creates a little bit of pain. This movement creates no pain, this movement creates a lot of pain. We then have to just be that much careful about choosing the right exercises so that we’re optimizing that healing process as best as possible.

So if you’re numbing yourself a little bit to some of the effects, Of exercise. Sometimes you can give yourself a little leeway with not having to be as precise with every single exercise. You’re still being positive in that movement is medicine. But you just have to be a little bit more precise if you’re not going tides.

And sometimes in doing that, in my experience, we can be more optimal in getting those results a little bit faster. 

Mike: And then how does that process look in terms of getting those results? So clearly movement is important and so again let’s think with some common repetitive stress injuries that weightlifters run into.

Aaron: I’m curious how do you generally approach even in your own body? I’m sure you run into these. The first thing we have to do is screen. We never assume, we always assess. And for example, I’ll give you a couple examples to, for people out there, knee pain is one of the most common things that we have in the gym.

And there’s a lot of different things that people will do to try to fix their knee pain. And oftentimes it is looking and trying to direct a treatment at the site of pain. And that is a very suboptimal way of going about things because often that is only where the symptoms are at the knees, basically like a hinge joint of a door.

And it is problems at the ankle and or hip that are often the cause of the pain at the knee. , that’s just where the symptoms are, but the problem lies elsewhere. So for example, while we wanna maybe take a step back from doing things that are creating pain, we then have to go about it in understanding why is the pain there in the first place?

What’s the cause? What screens can I do? So for example, I have a YouTube video called Four Tips for Knee Pain, and it just shows different screens that you can do on yourself to uncover, Hey, is this maybe a hip internal rotation restriction? Is this an issue in ankle mobility? Where’s the problem at?

Because as soon as you can uncover the problem, then you can start applying different exercises or different tools. to address the original cause and allow yourself to be that much better and more optimal in recovering back to a hundred percent. So that first step is what are we doing to address why the pain is there?

And a lot of times that’s, Hey, let’s stop doing that exact exercise. Let’s train what we can train, what we fix, what we can fix. But that next step then has to be what do I do about the pain? And the last thing we wanna do is just ignore it. We also don’t wanna just try to cover it up with. We want to ask ourselves, what can I do?

Or drugs. Or drugs, exactly. Cortisone is a big one that a lot of people get or ibuprofen or follow shacks advice and rub Icy hot all over it. , I’ve been there before too. I remember when I was in high school, I would take Icy Hot and just rub it all over my elbow before baseball practices sometimes.

I wasn’t addressing the why at all. 

Mike: Have I see hot on my forearm right now?

Aaron: You hear the commercials all the time, back pain, ile it right to leave will take your back pain away. Now there’s a time and a place for things like that to be able to give someone a little bit of relief.

I understand that. But the idea is that especially in the United States, we have become so enamored with fixing the symptoms that we have completely forgotten how to address cause. And we think that because we’re able to make our pain go away in the short term, that we fix the problem. So I don’t advise anyone to use things.

in the short term, like icy hot or pain medications or cortisone or things like that. Unless they have gotten to the point where they’re like, Hey, I’ve worked as a professional and they suggested I use this in the short term so that I can at least take a little bit of stress off that pain. But this is also what I’m doing.

I’m doing this, and this to address the costs, cuz that’s always my next question. Oh are you taking ibuprofen for your knee? Okay. Okay. What else are you doing? Tell me five things that you’re doing that are addressing the cause of your pain. Because if you can’t tell me what you’re actually doing to address why all you’re doing is covering it up and you’re creating a situation where this thing that could be solved in a couple weeks is now gonna be dragging out for a long.

And then eventually limiting you from doing the things that you like to do. If you like going to the gym and squatting, you’re not gonna be able to squat cuz you’re just having to just continue to take all this pain medication to cover up the symptoms cuz you never addressed the why in the first place.

Mike: And unfortunately, if it has gotten that far to where you are having to take pain medications to go squat it’s fair to assume it’s probably not gonna go away. And that’s why there’s professionals on its own. Not going to just magically resolve unfortunately.

Aaron: Exactly. And some things do.

Mike:  Yeah. Something like, you know this , I’ve had this little forearm thing, and it took about four weeks of doing exactly what I’m doing now, and then it was gone. And so that’s cool if that can happen. , but if this were something that were just getting worse and worse, then I wouldn’t have icy hot.

Maybe I’d have the ice chat, but I would be digging into it more. And I hope it just goes away again because these little things are annoying. But I’ve had to learn this lesson the hard way because I’ve made the mistake of being like, Eh, I’m probably okay. It’ll probably just go away until it does.

Aaron: Unfortunately, a lot of the lessons that we learned in the gym come the hard way. I’ve been there plenty of. 

Mike: Yep. And so then, okay, so we have the getting the finding what you can do, and then we have the assessing, which makes a lot of sense, getting at the root cause. And of course I mean you mentioned knee pain, elbow pain is calm and shoulder pain.

The back pain, right? And these are all. That are addressed in the book where you’re giving people, I’m sure information. I haven’t read the book yet. It’s on my, I read I follow a rotation of genres, and so some of them are, I have a work rotation and then I have a personal, and I just flip flop between them.

For my work, of course, one of the genres is health and fitness and your book is on the list. It’s, I appreciate it. And so I will get to it for sure. However I’m assuming that just given what you’ve shared here, that people, sure, we could go on for another three hours and you could break down, Okay, let’s talk about the shoulder.

Let’s talk about the different things that you can do. But, or they can just pick up the book and have that as again, a handy reference guide to go to for problems that they. Are having, or if somebody’s not having problems, what they can do to continue to not have problems for as long as possible.

Aaron: Yeah, that’s the reason I wrote it was to almost be like that if anyone’s into body building, the encyclopedia of body building from shorts, agger from back in the day, it’s something that, anyone that’s been in the gym that’s a staple book in the library. Yep. So that when you wanna pull it out and be like, Hey, I wanna really get my arms or my chest.

What do I need to do to go about that? I wanted this to be like the blueprint book that is on the shelf of any single person that walks into the weight room. Because you never know when something’s gonna pop up, a back injury, shoulder, elbows hurting. And I want this to be that first step that people can take.

To address this issue before it becomes something big, before they have to spend money to go to a professional, before they have to just continue to try to take pain medications and think it’ll go away. We can be better at these things. And I think it just comes with having the right resources. So for example, the first chapter is just on back pain.

So let’s say one day you go to the gym and you’re doing some squats or some deadlifts and back achy a little bit. All you have to do pull up the book. Chapter one, you learn about how back pain starts. You then are walked through a number of different tests and assessments so you can learn.

What your individual cause of your back pain is because there’s no one size fits all. And then based on what you find, it then walks you through an exact protocol of different exercises that you can do to rebuild and get out of that pain and get back to doing things a hundred percent. So there’s back pain, shoulder pain, knee pain, hip pain, basically every part of the body that you can think of.

It’s a reference guide, basically a tiny physical therapist in your pocket that you can then pull out at any time that you want. One of the analogies that I used earlier in the book was that when Apple was first making the first iPod, it was, the idea of having a thousand songs in your pocket or something like that, and it was revolutionary.

The idea behind Rebuilding Mylo is I wanted to have the entire access or library of how I approach physical therapy to help athletes who love being in the weight room. I wanted them to have instant access to how to maintain that love. and their body health for as long as they want. So that’s where, like we talked about before, you can go and find everything that I talk about online through blogs and videos and stuff like that.

But it’s that reference guide I smashed into one with direction, clear descriptions. Great treasure map as far as, how to take this step to this step. And some really cool looking pictures and graphics that the publisher was able to help me out with. 

Mike: I’m not surprised that it’s doing so well because there was a gap in the marketplace, so to speak.

And I knew that firsthand, having heard from so many people who were hoping that Starrett’s book would be that for them. But they just they couldn’t, they had trouble. Getting a prescriptive routine out of it for their problem. And again, that’s not to put down Kelly’s work at all. I’ve had him on the show and I, of course I admire everything that he has done.

But I just know having heard from so many people and so it people had, would ask. Over the last couple of years, I’ve been asked a number of times to do that book myself. And I’ve said, I honestly don’t know enough about it. I would have to find, I’d have to find somebody like you and I don’t know what I would really bring to it.

So coauthoring doesn’t really make sense. And so I would tell people like, I think somebody is going to do this book at some point. It’s just I couldn’t do it. I just, it would take way too much. It’d take years and years for me to learn enough to even get to a point where I could do it justice.

I’m really glad, and that’s the impression that I got from the book. I appreciate it. And then also reading reviews. I am not surprised it’s doing as well as it is, and I will not be surprised to see it continuing to do well. Hopefully it becomes a perennial bestseller. Just one of the, one of the.

Classics, one of the go-tos. Oh, you’re into weight lifting. And that’s what I’ve tried to do with my work. In, in trying to give people who are new, particularly people who are new to flexible dieting and the fundamentals of energy balance and the fundamentals of good training, of strength training.

Try to give them just that all in one reference. Guide that, to put it real simply, if you’re a guy and you’re looking to gain. 25 to maybe 35 pounds of muscle and the strength that comes with that, then bigger, leaner, stronger. I want that book to give you everything you need that if you want to go learn other stuff great, go learn other stuff.

But if you don’t, if you just want to know how, that’s what I just wanted how to do that. You just give me the program. You tell me how to eat, explain how it works, I’ll do it. That is that book. And for women, you could probably cut those numbers in about half or so. If a woman wants, and that’s in my experience, what many normal kind of everyday women, that’s the type of physique that a lot of these women would love to have.

They would love to gain maybe 15 to 20 pounds of muscle in the right places on their body. They would love to have a body fat percentage in the maybe low twenties, depending on how they wanna look. And that’s it. They look great and they’re happy, I, that your approach resonates a lot with me.

And so I’m looking forward to going through the book myself. And fortunately aside from this annoying, muscular issue, , I don’t have anything else to really, I might be able, I might be able to find something for my shoulder, although I worked with a physical therapist who he worked with a lot of baseball players, so he had seen a lot of shoulder stuff.

Yeah. And so we were able to pinpoint a few things. Yeah. But what is. Is obnoxious about my anatomy or physiology. Is it like this, Subscap is forever tight. I work with a massage therapist and she’s able to work it and we’re able to do what we need to do and, but these trigger points.

Aaron: They just seem to be baked into my cake. At this point I don’t know how to stop them from occurring. I know how to treat them now. . But that, that, I’m sure you have a lot of thoughts on that, that make for another discussion. Maybe it’d be interesting to see what the different screens in the shoulder chapter bring out.

Cause I’ll say this, a lot of times when we find muscles that are chronically stiff, tight, have those trigger points in them, there’s always a reason for it. Yeah. We just have to find out what that reason is. Now, there could be a number of things. Some sort of movement pattern is off a little bit

Mike: Yep.

Aaron: Sometimes it can be as interesting as your left hip is missing internal rotation, so when you do this specific motion, you end up creating overstressing that all the way up. Exactly. That’s why we see sometimes, like in baseball specifically we’ll see issues in that stride hip, the first hip that’s moving forward towards a for a pitcher and home play, how that can affect things all the way up.

In the hand and the way in which the ball is released. So that’s why we’re always, especially in the physical therapy world, we’re all about taking a step back from where the symptoms are and really screening the entire body to understand the connection. Because sometimes it is something completely elsewhere in the body that is not working as optimally as possible, that is actually leading to this chain of events that then sparks pain at another area of the.

Now again, it all comes down to screening and assessing and finding whether or not that is the case and whether or not is that just a tight hip or is that tight hip actually associated with the right shoulder? Because that’s where sort of the expertise the art versus the science of physical therapy can come in.

But that’s try, a little bit of the work that I tried to give out within this book so that you can try a lot of the tests on yourself and see well, what, other connection may there be so that you can work at addressing not only the specific symptoms but also the underlying cause.

Cause I’ll say a lot of times stiffness is a protective feature for the presence of instability. So oftentimes people will, in your case, in the front of your shoulder, but all a lot of times people will have it. Hip flexers, right? Hip flexers are always tight. They stretch and man, if they roll a ball on their hip flexers, it will light them up cuz there’s just a trigger point right in that area.

Why is it so tight? And oftentimes we find it’s because the body’s overlying on the hip flexors because of potential core stability. Or maybe their glutes aren’t optimally firing during certain motions. So the body is honing in on those hip flexers and becoming tight as a protective mechanism. So the second that we actually address the why, sometimes you don’t even have to address the symptoms anymore.

You won’t even have to stretch or do soft tissue work to the hip flux. And by addressing the why, let’s say it’s a glued coordination issue where maybe they’re not firing as well as possible in certain motions. All of a sudden the hip flexers aren’t tied anymore. They don’t have that stiffness because we’re allowing the body to move a little bit better.

Mike: So sometimes in the Subscap case, it’s because the body’s maybe not as stable as possible in other areas of the shoulder complex, which is the case on my right side. It’s been a while and I believe this happened twice the last time. I certainly remember one time, I believe it’s happened twice. It was heavy.

for me, dumbbell, overhead pressing, and it was at the top my and it was at the top. It’s been years. Regardless. At some point in the lift my shoulder it felt like it came a little bit out of place. And it wasn’t a bad acute injury, but I had to put the dumbbell down.

And then, and I believe it happened twice, and the second time it happened, there was some nerve impingement. I was like I’m done with heavy overhead, dumbbell pressing. And that was many years ago. When you were saying that, it actually reminded me, because that was probably 10 or 11 years ago, and I’ve never gone back to heavy overhead, dumbbell pressing I’m trying to remember, maybe I got to, to a hundred to 110 or so, something like that.

. I had the strength for it, but. Something happened there. And so what I’ve noticed with dumbbell pressing, I now just don’t go as heavy. Like I’ll do Arnold presses now because I can get I did sixties today for sets of six and had maybe one or two good reps left.

As opposed to having to try to load, If I’m gonna load heavy, then the barbell has always felt stable. . But I do still notice actually a little bit of, let’s just say my right shoulder, it yeah. Feels a little bit less stable and it just doesn’t feel as, it can’t move as nicely as my left shoulder, 

Aaron: Yep. So that, that feeling of not moving as nicely, that’s first off, you have to understand that’s a great thing, that you can feel that because you’re aware. Of the movement issue, and a lot of times people aren’t even aware, first of all, that they have that different side to side, but then that’s really where you would then attack with the proper exercises, whether that’s mobility, stability issue, which again, these are all outlined in the book, but underlying that, Why, And then addressing it with different exercises.

Maybe allowing you eventually to get to the point where you feel much stronger in that overhead position with less need for doing soft tissue work to the subscap again. And that’s the big reason is that there’s a time and a place for soft tissue work. For 

Mike: sure. Minimally. It feels good.

Aaron: It feels great. Yeah. And sometimes it’ll be that, that, Oh, this feels so good, but it’s a pain. Yeah. It’s gonna feel much better afterwards. Like I always tell people when they’re doing soft tissue work, pretend like you’re going to a mean massage therapist now to any massage therapist out there, I’m sorry for that.

But it’s the idea that when you get on a trigger point doesn’t feel great, it’s gonna hurt, but when you get off of it, you’re gonna feel that much better and that much more freedom of movement. The next question, just like I said before, with the ice, All right, you’re doing this and this what else are you doing?

Yeah. Is that any type of soft tissue work must always be followed with what else are you doing after to address? Why is that area so stiff in the first place? Yeah. So j just different things that I enjoy doing. That’ll be interesting to see your response to. I’m a big fan of things like Turkish get ups because the idea is that you’re moving your body through a wider range of motion and specifically stabilizing your arm eventually into that overhead positioning.

Mike: So it requires the body to really bring that strength stability, but also through a variety of motions and through high levels of mobility, which eventually is moving over. Yeah, I’m going to read the book and I will, once I’m through the shoulder area I’ll run through whatever screening is in there and maybe I can shoot you an email and let you know.

Yeah, for sure. Cuz I would be, yeah, I’m totally open to adding some some extra work into my routine. If it means that I can increase the stability and just make it move a little bit better, which, to your point, you’re absolutely right. I’m not doing anything else. I guess the only defense I have is it’s not a major issue.

Like it doesn’t get in the way of anything per se but it, it would be better to resolve it because if I don’t do anything about it now, eh, 10 years from now it may now just be chronically worse. then it’s, it, I’m sure it will be harder to resolve then than it would be now, so might as well do something about it now.

For sure. Anyway, this was a great discussion. I really enjoyed it. Yeah. And I would love to have you back again if you’re to do that for sure. And I’m sure we find I appreciate having me on. Yeah. Yeah. And again, the book is Rebuilding Milo, and anybody who I would say anybody listening who if you’re lifting weights a few hours per week and you’re fairly strong and you’re taking it at least a little bit, seriously, it sounds like it’s a fantastic book to add to the library and I look forward to going through it myself.

Aaron: I appreciate it. 

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