Barbell Shrugged - Lifting Heavy Again, Pelvic Dysfunction, Torn Meniscus, and Arthritis with Dr. Lance Einerson - Active Life Radio #1

Episode Date: July 12, 2019

Dr. Lance Einerson is a one on one coach on staff with Active Life. He is the go to staff member for clients who need help with breathing and bracing. His extensive experience as a breathwork specialist and a physical therapist makes him uniquely suited to help Active Life 1 on 1 clients utilize their superpower, breath.    What do you do when you have tried physical therapy for months and they keep telling you “You just can’t do that stuff anymore.”? That’s exactly what we were facing when with the client who we discuss on today’s episode. How did this mother of three go from having pelvic dysfunction, multiple knee surgeries, arthritis, and day to day pain, to hitting PRs on her olympic lifts? You’re going to have to listen to find out.    Minute Breakdown:   0-10 - Her pelvis hadn’t detached, but it had shifted. 11-20 - What was the first step to decreasing pain? 21-30 - How to breath through your sticking point. 31-40 - Collecting wins 41-50 - Managing load. Work with an Active Life Coach like Lance at activeliferx.com/shrugged Find Lance at @lance.einerson_dpt ------------------------------------------------------------------------------ Show notes: http://www.shruggedcollective.com/alr-lance ------------------------------------------------------------------------------ ► Subscribe to Shrugged Collective's Channel Here http://bit.ly/BarbellShruggedSubscribe 📲 🎧 Listen to the audio version on the Apple Podcast App or Stitcher for Android Here- http://bit.ly/BarbellShruggedApple http://bit.ly/BarbellShruggedStitcher Shrugged Collective is a network of fitness, health and performance shows that help people achieve their physical and mental health goals.  Usually in the gym, but outside as well. In 2012 they posted their first Barbell Shrugged podcast and have been putting out weekly free videos and podcasts ever since. Along the way we've created successful online coaching programs including The Shrugged Strength Challenge, The Muscle Gain Challenge, FLIGHT, Barbell Shredded, and Barbell Bikini. We're also dedicated to helping affiliate gym owners grow their businesses and better serve their members by providing owners tools and resources like the Barbell Business Podcast. Find Shrugged Collective and their flagship show Barbell Shrugged here: SUBSCRIBE ON ITUNES ► http://bit.ly/ShruggedCollectiveiTunes WEBSITE ► https://www.ShruggedCollective.com INSTAGRAM ► https://instagram.com/shruggedcollective FACEBOOK ► https://facebook.com/barbellshruggedpodcast TWITTER ► http://twitter.com/barbellshrugged

What's up, Shrugged Nation? Welcome to Active Life Shrugged. I'm Dr. Sean Pastuch. I'll be your host. And today's episode, the very first episode of Active Life Shrugged is with Active Life one-on-one coach, Dr. Lance Einerson. On this episode, we're going to take you through the inner workings of working with a client who wanted to be a weightlifter, but was also dealing with all kinds of issues related to pelvic dysfunction, knee arthritis, low back pain, and a mindset that was ready to rock, but a body that wouldn't follow. On this show, as you'll come to learn, we are bringing you both the side of the athlete and the side of the coach as to what it takes to get over the ailments that you and your friends are dealing with every single day when you

walk into the gym. We're going to help you get out of pain without going to the doctor or missing the gym by sharing the stories of our clients and how we've helped them with you. We might change some of the names, like in this episode, we changed the client's name to Sally. That's not the client's real name. But the stories are all going to be true. Not based on a true story, exactly true. So in this episode, if you can relate to somebody who's dealt with pelvic dysfunction, knee arthritis, low back pain, a mindset that won't quit, and a body that wanted to, you're going to love hearing about how this client got themselves back into competition

shape in under six months. Enjoy the show. So Lance Einerson, now Dr. Lance Einerson, congratulations on that. Thank you. Appreciate it. My pleasure. Yeah yeah so for those of you guys who don't know which would probably be all of you uh lance his email still doesn't have a doctor in front of it because he hadn't graduated physical therapy school when he started working for active life and now he has so it has to appropriately call you dr lance yeah i need to upgrade that email address. Yeah, we got to take care of that too. So as I talked to you guys about in the intro, Lance is both a staff member of ours who's been with us now for over a year and also is a breathing, bracing, and kind of like, I don't want to bastardize what it is, but a stress management specialist on our staff. And when I say stress management,

Lance is not getting on the phone with you and saying like, well, what are you thinking about right now? It sounds like it's cloudy. What about the clear water? That's not what I mean by stress management. What I mean by stress management is if you look at his Instagram account, you'll see videos of guys going off of huge jumps on motorcycles and bicycles and things like that. And it's what happens in the moment right before they fall. It's their ability to be able to suppress all of the natural response to that scary stimulus and calm their nervous system to be able to be cognitive in that moment. Yeah. Yeah. Can I, can I chip in there? No, no. Okay. All right. Well just, just keep, keep talking to him. That's cool. Whatever. Yeah.

I really liked this whole idea of, of that being like our human beingship, like our, almost like our ability to like as humans to leverage whatever situation we have, whether it's a good one or a bad one and to use the resources that we have at our disposal to come out on top and that i know that's that's the big thing that i really love about that whole conversation so what can you give an example of what you mean by that um yeah let me think about that for a second so let's say just like that example of um you know somebody like going off a big jump that one that i that comes to mind i posted a while ago

because this guy was he was just flying around this track and he went to um there's a big gap he was uh it was downhill mountain biking and he had the way that he hit the jump he was just supposed to clear it because it was a race but he ended up going backwards so basically like a backflip and it was an accident and so in that moment he had to be able to make the adjustments to like hey all right if i just decide to carry this through i might make it around but i might break my neck or do I bail right now really quick and maybe I wash out, maybe I break my leg, but for him to have the capacity to make that choice on the fly,

I mean, that's absolutely astounding. It just shows to me a lot of the, uh, I guess the capacity for human potential that there is, if we're willing to just kind of search for it. What decision did he make? Well, he didn't carry it through. Yeah, so he bailed. But the way that he bailed, and it's hard to describe this,

is that if he would have went a second earlier, his face would have not probably been attached to his skull anymore. But if he would have bailed later, then he could have, you know, broke his leg, maybe his neck kind of thing. But the way that he did it is he basically just washed out from away from his bike and he just kind of slid and he was fine. But it was just that perfect timing, that perfect decision-making process that, that I love. Yeah. And it's not something that he practiced. Yeah, no, probably not. So I think that one of the most valuable things that you bring to our team that we may get into a little bit today when we talk about the client

that we're going to discuss and the situation that she was in, maybe not, is the fact that so many of the things that people suffer from, while they're real, they're physically real, they are totally tied back into their own interpretation of them. You know, the emotional response to what's actually going on. Oh yeah, a hundred percent. I think the way I like to think of it as like a dysfunctional response. And I mean, the idea is like the person is like the person that's going through there they are the expert of what they're experiencing but that doesn't necessarily mean

that they're the expert at interpreting what that means and so like does that make sense yeah so so it's basically like we're both watching the same movie but we saw something totally different yeah yeah kind of it's just like um what's a what's a good example oh it's like somebody's like oh i hurt my knee squatting a couple years ago and now i just haven't squatted since and you know i'm just gonna i'm just going to avoid it because it causes pain and it's like all right is there actually something going on there like we can we can we can talk about this because you're experiencing the pain like there there's no question that that's what you're feeling but that doesn't mean something's broken that doesn't mean that you're broken it might just mean that

hey some tissues are sensitized or we just need to have a conversation about what's going on between your ears yeah this is the this is the person who's got knee pain who goes and gets an MRI and it comes back clean. And everyone's like, yeah, there's nothing wrong. Yeah, exactly. Something is wrong. It's just not coming up on the MRI. Oh, yeah. So what I want to talk about with you today specifically is I want to help Shrug Nation here get out of the kinds of pains that your client was dealing with, with Olympic weight

lifting. So let's, I didn't ask the client specifically if we could talk about her, so I don't want to use her real name. So let's call the client Sally. I like Sally. All right. So tell our audience a little bit about what sally was experiencing when she came to you please all right so uh sally had a few things going on uh if we just kind of start from the ground up i guess we can say uh she'd had some uh previous knee injuries to let's see it was her left knee that she'd had um meniscus repair a couple times, and that didn't go super great. She ended up getting arthritis in that knee, and so her range of motion there was garbage. She wasn't moving very well with the knee, getting some pain and stuff there. That ended up transmitting upstream.

She'd had a few kids, and she ended up with some legit pelvic instability. So the pubic symphysis was actually, it wasn't detached, but there was actually a shift, right? Like, so she could feel the shift. She could put herself into positions that where her pelvis came together in the front, that that was shifting and moving side to side and uh has she been to physical therapy already yeah yeah she had um and then she that kind of transmitted into a little bit of pelvic floor issues not like severe but a little bit uh with um some pain a little bit

incontinence and then also some um like hip and low back pain as well that was not constant, but was definitely related to activity. And she just felt like she was super unbalanced that that that left side that had had all of the injuries in the past was significantly weaker than the right. And so she was always compensating and her movement just wasn't, it wasn't great. You know, it was like, okay, it looks okay, but it's, it's not, it's not holding up to the demands that she wanted to place on her body to do the things she wanted to do. And she was a weightlifter. Yeah. Yeah. Yeah.

Okay. So I remember I met Sally in person and we were talking about what was going on with her. And she's like, do you think you guys could help me? I said, you know what? I think we probably could. And I have the perfect coach on my staff to do it because I just, I, I just, I literally said to her, let me see you take a deep breath. And she took a deep breath, shoulders went up, shoulders went back. And I was like, yeah, you're, you're stressed, you're breathing wrong. And the likelihood that you understand how to brace is low.

So why don't you take us through what happens next? Because Sally had been to physical therapy. She wanted to be a weightlifter. She wanted to do it competitively. She's two kids in the hole at this point. She owns her own business. And there's a lot of kind of fear, if you will, around how am I going to run a business in which I teach people how to live

better lives? If I can't get myself to living the kind of life that I want to live, where did you start with all the stuff that was going on? So where we started was really just the, like the, the low hanging fruit of, because like, you're totally right with the whole idea of like, I have this big thing going on and I need to be living it right to, to not be faking it, if you will. But generally speaking for me, like that's sometimes people can start there, but that's a, that's a big kind of scary thing to tackle for a lot of people. And so for her, we're literally where we started was just balancing

out some strength, right? Cause like I said, her left leg was, it was really weak compared to the right. And so she was compensating a lot. And so that, that was the win that we started with, if you will, you know, like that, that's what got the ball, the ball rolling. It's once we started to decrease the pain, decrease some of that, those asymmetries. And then we progressed into more of like the breathing stuff, more of the bracing to affect more parts of your life. And then, and then we just started having more conversations about what was important.

So first of all, do you think that the pelvic stuff, the stuff that was shifting around, was that due to the legs being disbalanced in terms of their strength? Or do you think that the legs being disbalanced in terms of strength was due to the pelvic stuff? Or was there no relationship? I think that the relationship was, like there's a moderate relationship, whether it's, you know, the chicken or the egg.

You know, I really can't say well what i do know was that in the past she'd had a lot of um like adjustments with like like leg length discrepancies you know kind of uh that kind of thing and when she stopped getting those not to say that those aren't useful in when they don't have their place but when she stopped having that intervention things started clearing up a ton and so it was it was a lot of like hey let's let's work on the movement and help you to better create force unilaterally and and improve your range of motion and then that started to clear it up, you know, quite a bit. Does that make sense?

Yeah, totally. Okay. So I was recently speaking with Matt Bruce. I don't know if you know Matt Bruce or not. Matt Bruce, for those of you who don't know, he is a world-class, well, was, he's retired, but he was a world-class weightlifter, top two or three guys in the U.S. for a long time. And he now owns Brute Strength.

And there's an athlete at Brute Strength who was dealing with some – she's young, and she gets a little back pain whenever she pulls off the floor. I watched her lift once, and I said, this girl has no idea how to brace. We had a teacher how to brace. And you mentioned early on that one of the things that you worked on with Sally, proverbial Sally, was bracing. I don't think a lot of coaches out there or a lot of people necessarily are adept at understanding if they're bracing properly or at coaching somebody to brace properly. So would you walk us through for someone out there who is let's say going to i mean i imagine it's the same how you coach it and how you do it so can you walk

us through kind of how somebody can learn to develop a brace yeah for sure um is it all right we gotta jump down a little bit of rabbit hole we'll surface and bring it together is that right yeah that's all right okay all right so i the reason i like to kind of jump down the rabbit hole with this a little bit is because it's a little bit counterintuitive because a lot of time when we think like all right we're gonna brace that means people think like all right i'm gonna take this huge breath i'm gonna be pressing against this belt that i have on to support my spine so that i can lift this big load because I'm not in a super advantageous position mechanically, but the weight is in front of my spine. So I have to, to create all of this pressure,

which is true, but we, where we miss a big part of this is that with our breathing, there's, there's more than just holding your breath okay because with our breathing that creates a uh how do i put it it's it's a it's a basically i like to call a proprioceptive highway to the your trunk basically to your nervous system like okay if i'm breathing then i get all of this information back from that part of my body, from that part of, you know, my spine, I'm protecting the spinal cord. There's a bunch of really important stuff there. And if my breathing is disrupted, my proprioception is also disrupted. And so if we're just packing everything that we possibly can into that area, that might work occasionally

for some sort of like one rep max thing. But if we're doing it all the time in training, it's disrupting the proprioceptive feedback to help us to actually know where we are in space, to be maintaining safe positions, and then also to be able to move dynamically when, you know, things aren't 100% perfect, because how many lifts are 100% perfect, especially, you know, when you know things aren't 100 perfect because how many lifts are 100 perfect especially you know when you're training or competing um for me all of them exactly right everybody else too they never get in poor positions ever right well so i think you hit on a key point here and i want to keep on going on it. And because I don't think that we got yet to how somebody actually practices and develops it. A lot of people think bracing is deep breath, hold, lift.

That's a great way to blow out a lung, but it's not a great way to brace. So how does somebody actually develop and practice the brace now that we know why it's important? Yeah, exactly. So with that whole proprioceptive thing I was talking about, we just have to incorporate the rest of your breathing cycle. Okay. Cause all of the, most people do is the inhale. That's a quarter of your breathing cycle. and that doesn't give you the feedback that you need or the pliability if you will to that lumbopelvic cylinder to keep your pelvic floor happy which we don't want that leaking and then you know everything else and so the way that you do this is first to practice in a gravity minimized position so that's usually hook lying, so lying on your back with your feet flat on the floor.

And to do that is to lift up into a bridge position and practice good breathing mechanics in that position. So that would – okay, go ahead. Just to reiterate, you're laying on your back. Your knees are bent. Your hips are bent. Your feet are flat on the floor. You're going to bridge your hips up in the air and practice diaphragmatic breathing yes but diaphragmatic breathing again kind of a mis no not a misnomer but people think about like all right i'm gonna diaphragmatic breathing i'm gonna stick my belly out right like that's a very

small part of it we want to expand circumferentially so all the way around the circle we want to expand in the front on the sides in the back that whole thing should be expanding and if it does the diaphragm doesn't actually move that much because of the greater surface area it just fills the entire you know thoracic cavity with air and from there what you're going to do is you want to be able to move dynamically and maintain that good mechanics while you're still exhaling. So as an example, right, so I lift up into that bridge position. I work on my breathing. I get that circumferential expansion. It's 100% dialed in.

Okay, we're good. Then what I like to see people do is lift up they get into that top position and i have them brace just like they're going to do to like a back squat right so they brace they kind of they bear down a little bit and instead of just having them crunch everything down and be you know compressing like they're going to crap their pants. We have them exhale about 10% as they drop their hips back down to the floor. And the idea there is that you're maintaining that intra-abdominal pressure with a slight exhale. So you still get all the proprioception and you're able to handle a load with, with that exhale, which cues your body, Hey, we're safe. We can, we can do everything that we want to do and everything that we need to do with all the information that we get back from here.

Will that only cue that you're safe if you're safe? Yeah, because if you're not, you're not going to be able to do it. But you're not going to get hurt. Right, right, right. Just bridging, right? Right. And that's why we practice this bridging and not under 300 pounds. Exactly.

So the next question is, okay, so let's say that I established the ability, and this kind of reminds me of the Shirley Sermon lower abdominal progressions. Have you heard of those before? No. So it's a hook lying position, and essentially this step zero is you slide one one leg out and then you slide it back while maintaining downward pressure with your multifidus into the floor. You slide the other one out and you slide it back. And then the next step is one leg goes out and touches and then slides back

to the leg goes out, touches and slides back and then out, touch, pull back, out, touch, pull back. And then they're both, they're passing each other in the air and it's, it's, it's not dissimilar gotcha um but there's no breath involved in that that's specific gotcha okay so now that someone let's just assume someone's able to do what you just described what's the next step have a stand up and do it with squat okay okay so like a lot of things with with the breathing stuff is that people are like, okay, they're looking for these really complicated sky. I have to breathe in for six seconds. I have to hold like this. I have to, you know, exhale this amount and then breathe in again and then

go. And it's like, we don't need to make it nearly that complicated because there's so much feedback already happening naturally from that part of your body, from your diaphragm. So if we get up and just have them get into like just like they're going to do an air squat and have them brace again okay get them set make sure they're in a good position all that good stuff and then just have them exhale again about 10 on the way down they go on the way down we're going nice and easy and slow with this they hit the bottom and then they come back up do they maintain only 10 out on the way back up or do they continue to exhale on the way up so we have two

options with that you can either have them maintain it which is usually what i start with people doing all right so i'll just have them do the 10 on the way down once they hit the bottom they come back up it was just with that same amount of air. The other, the other option that I will often have work with people is that they'll have 10% down. They'll hit the bottom. They start to come back up. And once they get past that kind of, uh, the break over point, that sticking point of where that would be in their squat, then they exhale another 10 ish percent on the way back up. ActiveLifeRx.com slash shrugged. You want to be a better coach. You want to help your clients better. You want to get out of pain, but you don't want to go to the doctor or miss the gym.

ActiveLifeRx.com slash shrugged. That's where you need to be. We'll see you when you get there. Turn pro. Here we go back to the episode. Understanding all of that. When I watch, I'm just, I'm going to extrapolate and guess. I would continue to do that for all different movements to make sure I can do the same thing

and all the movements I want to do it in, in the gym. For example, a deadlift, a shoulder press, wherever I need to brace. And then once I can do it with no load, I would start adding load. Is that correct? Yeah. So I will generally have people do it with no load, I would start adding load. Is that correct? Yeah. So I will generally have people do it with whatever movements we're working on. And then we'll do it with a tempo.

So we'll be like, all right, we're going to do six seconds down and three seconds up, you know, something like that. So we're focused on the eccentric and then we'll add the load. Okay. Got it. So it's essentially a linear progression of, can you maintain your brace as just like it would be for weight anyway? Exactly. Yep. So then what is the risk? And this might, I mean, we're off topic, but we might as well discuss it. What is the risk of somebody then like screaming on a lift? Cause it sounds to me based on what you just described,

when you scream, brace is gone. Yeah. In theory, right? We should be able to, not to scream, we should be able to brace while we're exhaling. That's, that's the big point with this is that if you can maintain your brace while you're losing that intra-abdominal air pressure, because you're, you're making up for it with an active contraction that you're essentially adjusting dynamically to what's going on under the load then that's that's exactly what we're looking for not saying you should necessarily scream out 10 of the screaming i'm talking about is when people just you know right off the ground it's. Maybe it's adaptive, man. I don't know. It could be. I don't know. So follow up question to that is now this person, you know, Sally is

able to brace. You are starting to level out left leg versus right leg. You started with left leg versus right leg. Why did you start with that instead of starting with the brace? It's a lot easier conversation to have. It's a lot. So it's, that's the whole thing of getting, getting a win that gets momentum going. And once that momentum's going, then you can dig into those other things that might be a little bit more, I put it more deep seated or things that are harder for people to wrap their minds around.

I think that's a great lesson for anybody out there who's a coach who wants to do things for their clients the way that we do things for ours is that you made an intentional decision to get this person an emotional win prior to loading this person up and all the things that you know they would need to do eventually. Yeah, yeah, exactly. I mean, it's, it doesn't matter if you have every single answer for somebody, you're like, all right, you have these seven things going on, I have seven solutions, and you're going to be stellar afterwards. If, if they don't have any buy in on the front end. If they're not willing to do the work and to trust that process, then I mean, who cares if you have all these answers?

They're not worth anything. Yeah. How much of that decision-making filter do you include in the breathwork immersion that you created for us? So that's a big part. A lot of it is, it has to do with making adjustments according to what the person is going after. So like what you're coaching them for. So if you're coaching somebody on performance, on the performance end, it's going to be entirely different than if you're working with somebody because their breathing patterns suck and they're experiencing pain, you know, as a result, right? So you have to be able to look that like, okay, this person is looking for X, Y, Z, instead of ABC. And I need to be able to build a bridge from where they're at to where they want to be. And if you're not able to do that, then again, the tool,

the tools are useless. So so that's that's part of the the overall conversation okay so i i didn't mean to get into talking about your breathwork course but somebody now that we're on it somebody who's gonna who would want to take that they're gonna learn about the decision making tree so that they don't just start somebody off on something that's high level that is not necessarily in their mental scope in the moment as a client. Yeah, yeah, exactly. It's the idea is that we, we do an assessment just like in the rest of the immersion work, you know, active life work that are classes that there are, we, we do an assessment, we break it down, see what the lowest hanging fruit is and work on a progression of getting

you know from here to there and making sure that it's the it's the right path and not just a path that makes sense okay got it back to sally she now has unilateral leg strength i imagine you're talking about step ups or lunging when we talk about that? Yeah. Yeah. Step ups and lunging. And I mean, it wasn't necessarily exactly for the leg, but then with like suitcase deadlifts and farmer's carries, that kind of thing. Rotational, anti-rotational. Yeah. Yeah.

Okay. So we balance all that out. Then we start working on the breath work. At what point in her progression did she start to notice okay i can do things without the pain i've been having forever um i would say it was about it was about a month and a half in there was a pretty good shift right yeah it was it and i think i think it goes, it's worth being said too, that Sally was one of the absolute most consistent clients that I've ever had that she was dialed in and knew what she wanted. And because she knew what she wanted and was willing to trust the process, that she dove in headfirst and was able to get results pretty quickly. Yeah. Sally's a savage. Oh yeah. I know Sally well. She's a savage. So she's about to have her third kid if she doesn't

already have it by the time this thing comes out. She definitely will have it by the time it comes out. Oh yeah. She'll know she better. That would be bad. A month and a half later um okay so six weeks here's the thing that i don't understand that i i'm hoping that you can help me with she was in physical therapy prior to all of this stuff happening with you she was cleared by her physical therapist essentially to exercise there's a lot of value in going to see a physical therapist when it's appropriate to go and see a physical therapist. What did they miss? I would say the big thing was just that they missed Sally.

They missed who she is and what she wanted to do. Because it doesn't matter if somebody scores a certain point thing on an outcome measure. It doesn't matter if they meet some criteria to be discharged from an insurance company, whatever, something like that. If, if they're not living the life that they want to be living, if they're not able to do the things that they want to do, then they need more assessment. They, there needs to be another conversation. And that conversation might be, Hey, I don't know how to help you, but somebody else does. And let's try and find that person. Um, but that, that's what I think that most people, most providers end up missing as, Hey, this is a person that has goals and dreams and things that they want to do with the rest of their life.

They don't just want to modify it to fit inside some box that some random person, like faceless bureaucracy made in the healthcare system. Right. Okay. A little bit of rant, sorry. No, sorry. There's also some advantage that we have when working with clients and being remote. Oh yeah. And it seems ridiculous to think that like, well, remote can't possibly have an advantage. Well, when you're in person, there's a level of emotion that you have to be able to handle the intensity of. That online gets automatically filtered through the digital system. And someone who's talking to you on the phone,

who's never hung out with you, who doesn't know your kids, or who hasn't seen you over and over and over again in person, spent an enormous amount of time with you, they almost have to take what you tell them as truth and try it without the opportunity to disagree, to second guess, because they're paying for it. They're not local. They don't have the time with you that they would have in person to ask you all of the second guess self-doubt questions.

So they just kind of have to try it. Yeah, a hundred percent. I agree. Actually that was one of the things when I started working for active life that I was a little bit hesitant about was being able to make the right, to make the connection on the right level with the people that I was working with to make sure that we were all that we were always on the same page and that we were always working towards the same goal and that everything was everything was kosher there but what I found was you know exactly what you're talking about is that these people that that we're working with

like they're committed to their goals and they're committed to getting to where they want to be and feeling the way that they want to feel. And so being remote, they have, they have to sit with it. They have to digest things and they have to go through it, them go through it themselves. And it's kind of like that whole idea of being like anti-fragile of like, just they're, they're not going to be avoiding it anymore and putting it on somebody else's plate to make 100 of the decisions rather they've got to be really present they have to be moving with a lot of intent and paying attention to what's going on with them and they can bring it up if necessary with us but if not that they they actually get

the uh to give themselves that pat on the back to get that notch in their own belt of like hey i made it through this like i can do this i'm stronger than i thought i was yeah part of the screening process for us and part of the reasons why i think it works almost every time we have a client is because part of what we screen for on the initial interview call is would this person be able to handle working remotely with somebody that's a part of the screening process and that's the picture that is yes that person has now gone and self-selected themselves at least twice because yes they are a good candidate to work with us remotely and they were they're prepared to spend thousands of dollars oh yeah that is a very unique person.

Yeah, it's somebody that's willing to have skin in the game. Yes. And that's probably the most powerful thing as far as working remotely. But generally speaking as well, if you're willing to have skin in the game, then the work you do is going to be significantly different than the person getting something for free. Yeah. Okay, so keep taking me through Sally's progression. First you teach her single leg, then you get to the breathing and bracing.

What's next? So there's a lot of the anti-rotational stuff. A lot of the, um, like single arm farmers carries overhead carries, uh, suitcase deadlifts, that sort of thing. Because what we wanted to do was balance the, it's not just that we were trying to balance the left leg and the right leg, but also the connections because all of that's going to be crossing the pelvis. Right?

So we want to make sure that her ability to create force on both sides and to brace was essentially equal so that when she's doing, you know, whatever thing that she's doing, that she doesn't have the her pubic synthesis rolling around and popping around. So that, that was, that part of the progression was probably the longest of like, cause it just, it takes a, it takes time to build that strength and it takes time to build those movement patterns and to make sure it's all dialed in.

And it can probably feel pretty boring where you're getting very, very small increases in weight, reps, decrease in rest, and weeks at a time of doing the same thing in a very similar way to the way you did it before and then at the end of a few weeks a couple months maybe you look back and you're like wow I'm a different person now oh yeah it's definitely not a sexy process but it's super effective I mean it's like all right are you paying for this program so that you can have something to post on Instagram are you paying for it because you're you're in it for the long haul and you're, you're going to be willing to go through that. Basically it's a fairly boring progression, but it, it pays huge dividends from, you know, most clients that have just been living their entire time in the gym, in their wheelhouse and they end up getting beat up. Yeah. We, you want life to be fairly boring. I mean, do you want times that it's not? But in general, if your life is not boring at all, you're living a risky life.

And more power to you if that's the kind of life you want to live. Generally speaking, if you take a big risk every single day, you still have like 23 hours and 59 minutes of non-risk time. Exactly. Okay. So was this all like at this point now, was she back to weightlifting or was it just straight up? Like you're only going to do single, like then you're only going to do breathing, embracing. Then you're only going to do, you know, the anti-rotational movement.

When does she get back to all of it or was it all kind of layered? It was, it was layered. So for the first part, it was, let me think. I want to get my timeline screwed up here. I want to say it was the first about month and a half. It was, we were just doing this stuff. Like she was, she was okay to be doing like some poles and stuff, um, like snatch and clean poles, that kind of thing. But that, that was about it for the first month and a half or so, if I remember right.

And then after that, we progressed back into like, all right, well, we're just, we're just working power, right? So you can, you can lift and, and you can, you know, you can do your weightlifting work for, cause you, you're wanting to be competitive. Like you can do that let's just keep it above parallel for now and as that strength improved and everything started to balance out then we just incrementally dosed it in and um she was also passing all the stuff that i was giving her onto her weightlifting coach which was being incorporated into like okay

make sure we're not getting too much volume and you know, that kind of thing. What was it about parallel and below parallel that had relevancy? Um, the big thing is because of the arthritis in her knee with the lack of range of motion that she was not able to maintain really good positions. Um, if she was going below parallel at least without without um like some sort of help like weightlifting shoes that sort of thing but we all we actually did work on the knee a little bit and got it it wasn't a hundred percent but we actually got a little bit more range of motion there and funny enough we incorporated some breath work with improving range of motion in her knee so that was, that was cool.

Well, I think what people need to understand is that breath work isn't foofy. If you're, if you picture your core trunk, midline, whatever you want to call it as a soda can, right? The top of the soda can is a diaphragm. The bottom is the pelvic floor. The front is the soda can is a diaphragm. The bottom is the pelvic floor. The front is the abs. The back is the paraspinal musculature and the, and then the posterior abdominal wall and the sides are going to be your obliques. If that's not sturdy, your knee can't do what it's supposed to do. Your ankle can't do it. Nothing can do what it's supposed to do your ankle can't do it nothing can do what it's supposed to do if the place where it would all break down breaks down yeah yeah exactly there's actually some

interesting studies that they did um they just had emg on people's pelvic floor and then they had to move around and they had so if somebody they were just i can't remember if they were seated or lying i can't one of those two but they had them just flex their elbow, and there was a response in the pelvic floor before the elbow flexed. So there was a bracing cascade, if you will, that was happening from somebody just flexing their elbow, not being loaded at all. That's wild. But on top of that, because we're just talking mechanics now like

that's that's essentially all all we're talking about but if if we layer on top of that the nervous system of of where we lie on the spectrum between sympathetic and parasympathetic so like fight or flight versus feed and breed of where we tell people which one's which okay so sympathetic would be fight or flight so that's you know everything's ramped up you're ready to go and then parasympathetic would be feed and breed so you're just chilling relaxing eating food that kind of thing where we sit on that spectrum also plays a huge role in the way that we respond so for her the with the breathing like her her bracing and stuff was pretty solid by the time we were working on, um, her knee. And what we were doing

is we were down regulating her system. So getting into that more parasympathetic state while we were working on the range of motion with her knee so that there wasn't some sort of kind of extraneous guarding that wasn't coming from something that was actually related to the knee and rather just, oh, no, I can't get in this position. And, you know, pulling back so that she wasn't able to work the range. What kind of expectations, if any, did you set with her about the knee before you started? This may or may not work. That was essentially the conversation because of what the diagnosis was. Like there's arthritis, there's bony changes in this.

But if we can tap into your nervous system and we can move through this really intentionally, then there's a chance that we can improve the range here. So let's get a shot. So I think the thing that people need to understand is that we didn't, you didn't go in and change the structure of our knee. What happens is if we can put somebody through a range of motion that was previously symptomatic and have it not be symptomatic because of the way that it's interpreted by the brain. And we can stack the deck by creating the appropriate neurological state

to induce that response. Then we can retrain the brain, because that's where pain comes from, to allow the joint to move in a way that previously was painful without that pain. Yeah, exactly. And the really cool thing about this is this builds on top of the whole tendinopathy discussion that is included with active life, like the coach's immersion, that the whole idea of it is that the dissensit,

we desensitize the range and we load it when we're treating tendinopathy. When we're tapping into the nervous system, we're doing the same thing. We're desensitizing and we're reorganizing. We're reorganizing those pathways. We're reorganizing the narrative. We're reorganizing that whole perception of the movement to just get that range back, to get the access back because it's the nervous system that usually locks us out of, you know, that thing that we're wanting to do.

Yeah. Now the crazy thing to me about Sally is that she was not avoiding training prior to working with you. She was doing all the things that she knew were beating her up because she could feel it. She could feel her pelvis moving. She could feel her knee. She could feel her low back. And emotionally, that stuff was beating the crap out of her. So when you started working with her, was there a requirement that she kind of back it down to start

and then build it back up? How did that work? Normally, yes. But she had made that commitment already. Uh, I was actually, I went back and I was looking at my notes from, from working with her and something that she said was along the lines of, I haven't been able to fix this thing on my own. I haven't made it a priority, but now it is a priority. And I basically accepted, I need to find an expert with someone to help me with this. And so that's why I'm here.

She had already made the commitment to make whatever changes to her training that needed to be made. It was that, that was a very easy conversation with her. It was like, Hey, after our assessment, this is what I see going on and this is what you need to avoid or modify, you know, et cetera, that sort of thing. And it's like, all right, done. That's, that's it. I will do what you tell me to do. That doesn't surprise me at all. So how long from starting with her to, um, I don't want to say completing because I know that she worked with you longer than that and i know that now she's having another baby she should probably be back in a few months to make sure so it's straight

um but in the mean in the meantime how long did it take you to help her from i'm in pain every time i lift weights to i can lift weights without pain and i can go heavier than I ever could before. Ooh, I want to say I would have to double check on this, but it would be five to six months. Okay. I would, I, yeah, I would have to double check on that, but I would say it was about five to six months. But the conversations that we were having at the beginning of when we started working was like, Hey, this, my pelvis feels weird. It feels like it's going to like shift and like pop apart.

Like something is not right. My knee hurts. I'm getting this issues up into my back. And then one of the last conversation, like coaching conversations that I had with her was more along the lines of how can I use my breath to better get myself focused so that I can perform at my best when I'm competing. So when I address the bar, how can I approach that? And so that shift was absolutely mind-blowing.

That was really cool. How long did she work with you total? It was like seven months. Okay. So she got herself to a place where she was comfortable and then it was like all right well i'm i want to just make sure for a month and then she was going to be on her way yeah yeah okay and are you still in contact with her at all yeah a little bit like on on instagram and stuff and i actually i interviewed her for my

podcast and screwed up the file so i I never actually got to post that. You can do it again. Oh yeah. Yeah. Good practice run. Yeah, exactly. And I know that since then she has sent at least, I want to say two clients and she tried to send a third and that third one said yes and then didn't end up signing up.

But nonetheless, she was extremely happy with the way you worked with her. So what advice do you have for the person out there who is like, look, that's all well and good. I'm just not trying to spend the money that it takes to work with Active Life to end up working with Lance. Maybe they have a physical therapist or a chiro, someone who's near them who they trust can help them. What kind of conversation do they need to have with that person? Let's answer that first. And then the second question will be the follow-up. What kind of things do they need to be doing themselves? Where can they access that progression, if you will? Gotcha. So I think the biggest conversation kind of goes back to that whole thing of like, what, what did Sally's physical therapist miss of like, going talking to their physical therapist or Cairo of like, do do you understand me? Do you actually understand the goals that I have, and the experiences that I want to have in my life? And can you help me get there? If you can help me get there, I want to know how.

I want you to tell me what you're going to do to help me to get to that position. Because if there's somebody that's there that they trust, that is actually able to do that, they can have that conversation. And they need to be willing to have that conversation because they're working with a person. They're not working with a number. They're not working with some automaton. It's like there are going to be these different factors that come in because this is an individual. And they need to be willing to have that conversation. And if they're not, then they need to find somebody else that is willing to have that conversation.

I'd like to add to that. One of my favorite things to teach people to do when I'm telling them that they need to go see somebody in person, right? Because we still send over 30% of people to somebody local because they're not a good candidate to work with us and they need a live, hands-on human being. I always tell them, ask the person who you're going to see after they tell you how they're going to help you, ask them, what are all of the reasons why that might not work? Like what are the potential obstacles between this thought and that reality? Okay. What do we do when that happens? And make sure that the person who you're looking to work with is prepared for a shift in their own practice a shift in their own strategy to solve the problem that you're dealing with because there's there's to me one of the common issues with the current

state of health care is that doctors have dogmas. And when I say doctors, I mean, chiros, physical therapists, acupuncture, anyone who is doing manual therapy or musculoskeletal healthcare, I'm calling them a doctor for this purpose. DPTs have their doctorate in physical therapy, chiropractors have their doctorate in chiropractic. That's where it comes from. So they have their dogmas and the chiropractor is like, well, we're going to adjust you three times a week for four to six weeks. Then we're going to back you down to twice a week for two to four weeks. Then once a week, say, okay, well,

what if I'm not feeling better in three weeks or four weeks or five weeks? What's the plan? Well, more, more. So more of the same thing. That doesn't sound like it makes any sense. But the same thing happens in the physical therapy Well, more, more. So more of the same thing. That doesn't sound like it makes any sense. But the same thing happens in the physical therapy clinic. Oh yeah. We're going to do these strengthening exercise. Okay. Well, what if, what if in four weeks it's not working? Is there a pivot plan? No, no, no. This is what we do. Okay. Wrong clinic. So what about the person now who

decides I want to go about this on my own? How do they know when it's time that it's too much? No more doing this on your own. When I think the big thing is like what the, the question often comes down of like, why would you not seek a professional to help you with this? Which often comes down to money right and then you have to ask yourself of okay does not spending the money on the professional helping me

to fix this problem help me afford something or can i afford not to ask the professional not to seek the help because you're either going to pay for it now or you're going to pay for it later most of the time right can you get i love the way you said that i would love a tangible example of can you afford not to have something now or does it allow you to does it allow you to afford something now that otherwise you couldn't have yeah so it's like okay let's say uh let's say you're you're working with us and it allow you to afford something now that otherwise you couldn't have? Yeah. So it's like, okay, let's say, let's say you're, you're working with us and it, and it's, you know, X amount for, for this, for this month. What, what are you buying? What, what's that thing that you are valuing now more than your ability to do the things that you want to do. Is it that you're getting Starbucks every morning?

It's not cheap, right? Is it that you're going out and partying? Or is it a legitimate thing of like, you know what, my kid wants to do jujitsu and I need to pay for it. You know what, that might be something that you are more committed to than getting your shoulder feeling better but you gotta realize you're gonna end up paying for it later as well

either way it's gonna be paid for yeah and either in a change in your activity exactly so it's an emotional payment or in physical monetary payment to help somebody get you better because now you can't sleep through the night. Yeah. And this is where, and we're getting, you know, this is way off topic for what we're discussing, but in the professional path, when we work with coaches, you know, a lot of coaches and gym owners are like, wow, that's, you know, what you're telling me to do is expensive.

It's expensive to work with you. It's expensive to work with me now that you've taught me to do this. And I'm going to tell people to pay this. And what if people can't afford it? My response is always, then it's, it's not important enough to them. There's a time at which, you know, if it was heart surgery, who can afford to drop a hundred thousand, $200,000 today? Everybody figures it out.

Heart surgery, you know so it's it's all a question of value and it's it's a rabbit hole of mindset that we can we can go down on that one but uh i think you did a great job talking about how we helped sally so how can people find you lance because i think that uh after hearing, they should be following you. You post awesome, I don't want to call them quotes, awesome tidbits. That's a shitty way to call them too. Awesome thought experiments for people to go through and to kind of think about what they're thinking about on your own Instagram page. And the stuff that you're doing on there, I think is very cool. And I want people to see it.

Where can they find you? So it's Lance.Enerson. It's E-I-N-E-R-S-O-N. I know it's not how it should be said, but that's how it goes. Underscore DPT. And so I'm really active on there. There's stuff almost every single day from those thought experiments to a little training tidbits, that kind of thing.

I love it. Well, we'll have you on again and we will talk next time. My thoughts are that next time when I talk to you, we'll talk about the guy who had been in pain for years, who finally decided to work with us because of recommendation of somebody else. And I think that you might find the story of how he met her really interesting and cool. All right. I'm down. All right. Thanks for coming on Lance. Okay. Awesome. Thank you so much. For the rest of you, Shrugged Nation, it's time to turn pro.

That's going to be a wrap for this episode of Active Life Radio on the Shrugged Collective Network. I hope you enjoyed it. If you did, please head to wherever you listen to podcasts Thank you. course. If you're looking to get more from us, whether it's coaching courses, one-on-one coaching from one of our staff members to help you get out of pain without going to the doctor or missing the gym, head to ActiveLifeRx.com slash shrugged. We'll see you there. Turn pro.