Dynamic Dialogue with Danny Matranga - 32 - Dr. Brandon Baranzini: Scoliosis, Elbow Pain + More!

Episode Date: May 18, 2020

This episode is all about common upper body issues lifters and fitness hobbyists may have to navigate across a training career. In this episode, we sit down with Dr. Brandon Baranzini and chat spine, shoulder, elbows and more!Brandon Baranzini, DPT, CSCS, CPT has extensive experience in both physical therapy and strength and conditioning realms. Beginning his career as a Division II collegiate athlete, playing Men’s Baseball for Santa Rosa Junior College and Sonoma State University, Brandon discovered his love for physical fitness and training, as well as his innate ability to network and form strong social relationships. This unique combination of talents soon led Brandon to become one of the top certified strength and conditioning coaches in Sonoma County. Brandon soon expanded into the world of physical therapy in order to further advance his knowledge and mastery of the musculoskeletal system and dedicate his life to helping others achieve optimal health. Moreover, Brandon’s special interest lies in combining the worlds of personal training and physical therapy in order to foster lifelong health and a more universal fitness model.Follow Dr. Baranzini HERE!---Thanks For Listening!---RESOURCES/COACHING: I am all about education and that is not limited to this podcast! Feel free to grab a FREE guide (Nutrition, Training, Macros, Etc!) HERE! Interested in Working With Coach Danny and His One-On-One Coaching Team? Click HERE! Want To Have YOUR Question Answered On an Upcoming Episode of DYNAMIC DIALOGUE? You Can Submit It HERE!Want to Support The Podcast AND Get in Better Shape? Grab a Program HERE!----SOCIAL LINKS: Follow Coach Danny on INSTAGRAMFollow Coach Danny on TwitterFollow Coach Danny on FacebookGet More In-Depth Articles Written By Yours’ Truly HERE!-----TIMESTAMPS: Support the Show.

Guys, welcome to the Dynamic Dialogue Podcast. I'm your host, Danny Matrenga, and today we're sitting down with my longtime friend, Dr. Brandon Baranzini, CSCS. Brandon is a physical therapist by trade, but spent years as a strength and conditioning coach and personal trainer prior to making the leap to therapy or the therapeutic space. The kind of merging of those two backgrounds, right? That strength and conditioning, athletic and personal training space with the medicinal and therapeutic space really give him a great ability to distill

some of these common problems we're going to talk about. And we're talking about really, really common upper body issues that are a lot of lifters and fitness enthusiasts face. So again, like I said, Brandon is someone who I'm very close with. We were roommates in college. We worked together at a box gym for years as trainers. Somebody who I have tremendous amount of respect for in this space. I very much encourage you to give him a follow after listening to today's episode. But again, here we go.

A nice sit down talking all things upper body with Dr. Brandon Baranzini. So Brandon, man, how is it going? Hey, I'm doing good, Danny. Thanks for having me on. I'm excited to be here and to talk a little bit more about upper extremity issues that could be occurring with strength training realm. Yeah, that's what we're all about here. So I really wanted to bring Brandon on because I'm one, I'm not a physical therapist. I've seen a lot of the issues we'll probably talk about today

with my clients. I get a lot of messages about some of the issues we'll probably talk about today through Instagram, but I don't know a ton about them. I about today through Instagram, but I don't know a ton about him. I know what I see, but I don't know how to treat him. I don't know how to define them. I don't know the advice to give. So what I wanted to do is I wanted to reach out to Brandon and actually have a discussion around some of the most common upper extremity, upper trunk issues that he sees in clinic and that he's seen in his time as a trainer. So for those of you who don't know, Brandon actually spent a considerable amount of time working with me. We actually worked in the same gym for years as trainers before Brandon

actually went on to get his doctorate in physical therapy degree. So he's very familiar with what these look like in the gym setting, not just in a clinical setting. So he's very familiar with what these look like in the gym setting, not just in a clinical setting. So I'll let him talk a little bit about his journey from coaching into physical therapy, and then we'll kind of get right into talking about upper extremity, common upper body lifter problems. Thanks, Danny. So initially, you know, I played division two collegiate baseball. And after my career, I started lifting and getting really involved in weight training, right. And then, you know, I happened to meet you, and you convinced me I needed to become a personal trainer. And at first, I didn't know if, you know, that was the right move for me, but thank God I listened to you and you helped me develop. Right. And, you know, like he speak, with personal training and working with,

you know, hundreds of clients previously. And it only has helped my physical therapy education thus far. And I think it's awarded me a certain respect and know-how in terms of patient relations and building rapport and managing people from a humane perspective, right? Like we all want to have, you know, good dialogue and great communication, be understood, right? And I think personal training is a great realm to kind of hone those skills. Yeah, I think I couldn't agree more. And I think one of the reasons you'll be incredibly successful as your career continues and one of the reasons you've had so much early success is that a lot of the barriers people run into with their

rehabilitative process are related to not feeling like they're connected to the practitioner. And the skill set that you developed as a trainer has helped you connect really, really well in clinic settings, in coaching settings, and that's only going to make a bigger, bigger difference as you continue to help people from that healing standpoint, because they're exponentially more receptive when they connect with people. So without further ado, let's talk a little bit about upper extremity issues. For those of you who don't know, the term extremity essentially just means limbs or anything dangling off your axial skeleton, like your arms, your legs, or anything dangling off your axial skeleton, like your arms, your legs.

And the trunk refers to basically everything above the hips, from your hips to your collarbones, that upper body, that torso portion. And for lifters, there's a lot of common problems that we will see time and time again. Or there's a lot of, I don't want to call them abnormalities, but there's a lot of unique things that can happen that can impact your lifting. So if you had to narrow it down to say three or four big things you see a lot that are either impacting someone's performance, that might be a dysfunction related to overuse, just stuff you see with lifters that impact them.

What would be those kind of three or four big things and then maybe i'll just ask you some questions and we'll pick them apart yep that sounds wonderful um you know when it comes down to the upper extremity it's quite unique in meaning that you know the shoulder joints have a lot of range of motion that we can move through like the ball and socket joint has so many different motions that it can go. And that makes it a very unique thing to treat. And then it also makes it a very unique thing to, you know, be perceptive to injuries, right? So, you know, I've gotten a lot of questions about scoliosis lately. And so that's something I want to talk

to you today about and kind of go over like what it is, you know, how to manage it and what can maybe cause it. Right. And I'm sure you've trained, you can talk to multiple clients that you've trained to have had scoliosis. Yeah. It's a lot more common than I originally thought when I first learned about scoliosis, I thought that it was essentially like I would, anybody who I saw that was bent to the left or the right, like, oh, that guy's got scoliosis. But realistically, what I guess I could say I didn't know was that it's quite common. It can affect all the different spinal regions. And there's a variety of different curvatures that can occur. And so, you know, I guess the first question is what exactly is

scoliosis? And for those who are lifting with scoliosis, are there any considerations that they might take given that they have an atypical structure of such an important region like the spine? Sure. So simply put, scoliosis is a lateral curve of the spine. And so if you're looking at someone from the back, this is how we assess in physical therapy. We'll have them bend over and touch your toes. And it's very easily seen, you know, the spine going into more of like an S curve as opposed to, you know, straight linear up and down. And so typically what we see is this curvature is more found in your like mid back to low back region. Okay. And this is most commonly occurring, you know, in adolescence.

Right. But once you reach skeletal maturity or once your bones stop growing, so to speak, typically the severity or degree of scoliosis or degree of curvature, it stops, right? It stops right there. So it becomes kind of fixed in adulthood. I think the thing that my mind goes to immediately is when I think of weightlifters and the activities that they do, a lot of them involve transmitting forces up and down the spine. And from my understanding of anatomy, the spine is structured in a way to transmit those forces effectively and safely from top to bottom, from bottom to top. So for example, if I have a barbell

on my back and I'm doing squats, my vertebrae are stacked in a way that they can transmit those forces safely up and down my spine. If I'm doing a deadlift, thee are stacked in a way that they can transmit those forces safely up and down my spine. If I'm doing a deadlift, the same is happening in a different direction. What's going on for somebody who, like you said, has a lateral curvature in their spine? Are they still able to transmit those forces safely? Should they be a little bit more precautious about spinal loading? And then maybe expand on that if there's anything else you've seen in practice? Yeah, so I would say, you know, 100% hands down, those with scoliosis should be able to lift and resistance train effectively without concern.

Now, this is totally dependent on the severity of the curvature, right? So if you have a really, really great degree of, you know, scoliosis or curvature within the spine, then this is something that I would highly recommend you going to see a healthcare professional to make sure the movements you're doing are safe and effective for your body type. are safe and effective for your body type. However, you know, I've trained a client before PT school who had a pretty severe scoliotic curve. And, you know, she got this when she was, you know, in adolescence, but then it stopped progressing. And, you know, she was an older adult, you know, mid 60s. And she had been doing just fine. And we were doing, you know, squats and deadlifts and a lot of hip hinge type movements. And she was totally okay, right? Now, she did go to a physical therapist and a chiropractor and, you know, she did acupuncture and all these therapeutic modalities to help her feel her best. But in general, depending on the severity of scoliosis, you should totally be safe to do resistance training. I think that's great for a lot of

people who are probably aware that their spine plays a big role in force production and stabilization, but they don't know, hey, can I really load this thing up? Because as far as I'm concerned, everybody my whole life has told me my spine's bent all out of shape. So that's really, really a big thing. Now, from a clinical standpoint, if somebody is listening to this and saying, man, you know, I have scoliosis, I want to give myself the best chance at training for a really long time at having a productive training career at that as well. Are there types of rehabilitative work or is there any strengthening work, particularly

for people with scoliosis that you see show up commonly in clinic that are effective treatment or training modalities for just reinforcing stability through the spine? Yeah. So I think one of the most important things to do for someone who has scoliosis is to work on breathing exercises. And this is because if you think about a spine with a lateral curvature and you think about how the rib cage is supposed to open up as we breathe, we inhale, our lungs expand, our rib cage moves open to accommodate that movement. Well, with a lateral curvature in the spine, this can impede that function. So having, you know, a set foundation of breathing exercises can help maintain expansion of the rib cage and expansion

of those overly taut muscles due to that lateral curvature. And this can help the longevity of your resistance training career. And not only that, but functional activities and making sure you're able to play with your kids and grandchildren, et cetera, you know, for as long as possible. And then additionally, I always want to implement a strengthening program. And, you know, for those of you who may have like a minor scoliotic curve and are still heavy weightlifters, that's totally fine. All I'm saying is just start to emphasize, you know, specific trunk and pelvic musculature in order to support the spine, right? In order to support the stability of the spine. And what muscles would be of particular importance for not just people with scoliosis, but anybody looking to increase that spinal stability?

Yeah. So you're looking at like the posterior chain musculature, right? So the spinal extensors, because sometimes we have those who have a scoliotic curve, but then they also have a rotational component. So it actually causes their torso to rotate a little bit and to make sure that we're, you know, we can combat the progression of that rotation. We want to make sure we have those strong spinal extensors to hold us back and, you know, taught in a proper postural position as well as, you know, strengthening the glutes and hamstrings and all those strong, powerful posterior chain muscles in order to best support the spine. I like that. Last question before we move on from scoliosis. Is there any utility in unilateral training for this population,

particularly because that translation of the spine might be either more left or more right? Is this a population that you think should experiment with unilateral training, particularly for upper body work? Yeah, you know, if you want to get, you know, a little bit deeper into the minutiae of training, specifically for scoliosis, you could say that you want to do unilateral training on the side that is lengthened or weaker in order to pull the spine back in that direction. You want to stretch the opposite side, but you don't have to get that complicated while you're doing this. Right. So your body is going to best, you know, stabilize the spine as it sees fit.

OK, so it's not something that you can necessarily fix. Right. But we just want to decrease the progression of this curve, especially if you're adolescent, you know, but if you're an adult, it should be like, it's not going to get worse and it's not going to get that much better in terms of degree of severity. However, unilateral training is super beneficial for everyone, not only scoliotic, those with a scoliotic curve. But additionally, I want to talk about one other thing related to scoliosis, and that's the difference between what's called idiopathic scoliosis, which just means, you know, we're not sure why it, you know, came about and non-structural scoliosis, which is a curve that actually can be reduced with changing positions. And so this is something that

is actually a really easy fix, especially for those who are personal training. And, you know, you have a client come in with you, like, you look, it looks like they're kind of like walking with a antalgic gait pattern, or they're having a little bit of pain right with their gait and it looks like that you know one hip's higher than the other which then can cause like a lateral curvature and so this is non-structural and so all this means is it could be due to a leg length discrepancy or one leg is longer than the other or you know maybe they're wearing down their shoe a little bit more on one side. And then this causes kind of a lateral curvature in the low back.

And so this can easily be corrected by just measuring their legs and making sure they're the same length. Hey guys, just wanted to take a quick second to say thanks so much for listening to the podcast. And if you're finding value, it would mean the world to me if you would share it on your social media. Simply screenshot whatever platform you're listening to and share the episode

to your Instagram story or share it to Facebook. But be sure to tag me so I can say thanks and we can chat it up about what you liked and how I can continue to improve. Thanks so much for supporting the podcast and enjoy the rest of the episode. That's really, really good. And I think that's a good place to stop given that, you know, it kind of covers all the different types of scoliosis that people might be seeing or dealing with, but it also gives them some action items and some training tips and a little bit of confidence too, because one of the things I've heard a lot from this population is there's a pretty noticeable lack of confidence and there's a lot of fear around the fact that my spine appears to be atypical and how is that going to impact my training? So a lot of really positive stuff here, but moving away from the

spine and more towards those extremities, there's a few particular issues that I see a lot. And I'm wondering which ones you see the most in practice. The ones that I tend to see the most, and you can let me know if this is the same for you, but I see a lot of stuff with lifters happening at the elbow. And do you see the same stuff in clinic? And if you do, what do you tend to see? Yeah, so when we're talking about the elbow joint, I would say the most common two things that we typically see is a tennis elbow and golfer's elbow. And so tennis elbows relating to the lateral elbow or the part of the elbow on

the outside there and golfer's elbow is on the inside, right? But if we're talking about those two, tennis elbow is more common than the latter, right? So lateral epicondylalgia, or also known, or typically known as epicondylitis is tennis elbow. And so epicondylitis, all that means is it's an irritation or an inflammation. Itis means inflammation of the lateral elbow tendon extensors, right? And so, what we're looking at here is actually there isn't much evidence to state that inflammation is happening, okay? And so, the best terminology for is lateral epigondal algebra, which is just lateral elbow pain. Okay. And so what happens is you have your wrist extensor musculature. So if you were to extend your wrist, you move your wrist back and up the muscles on your forearm, they insert at the elbow there. And so you have this degenerative change happening at the tendon where it inserts

on the elbow. Okay. And this is known as tennis elbow. And so what can occur is when you overuse this tendon or you have a repetitive overuse injury of the wrist extensor tendon, you can have irritation at this spot causing a bunch of pain and swelling and sensitivity with this motion. Yeah. And I think when you talk about even just explaining for everybody to move their wrist back and up and you realize like, oh man, that's actually a movement I do a lot when I'm lifting weights. Even though it's been coined tennis elbow and it's predominantly born from that type of activity, from the tennis type of activity, these are movements and overuse things that could get replicated a lot in weightlifting. And so given that we see this so much in that population, what are some good techniques or tactics that you

could utilize to hopefully manage if you're dealing with these epicondylitis? That's a tough one. Yeah, I was actually of the school of thought that it was just epicondylitis, but it appears that's changed for the better. What are some techniques you can use to manage this? Because as somebody who's dealt with elbow pain, it's incredibly debilitating for a lifter. Yeah. So with lateral epicanthalalgia, you want to make sure that you're including an eccentric wrist extension exercise. Okay. So let me break that down. So if you're to lift your wrist up and back, and then you provide a little bit of force with your other hand, pushing your wrist down, that's an eccentric motion for that

musculature. And so the evidence states that we want to include this type of exercise for this tendon because then it can best recover and repair from those degenerative repetitive motions that we were making it undergo, right? So first off, we want to make sure we have eccentric wrist extensor exercises in place. Additionally, what I'll do in clinic is I'll do scraping or you can take a spoon or a soup ladle or whatever, put some lotion on the elbow joint. And then all you're going to do is scrape in a parallel manner to your forearm, right at the spot where it's a little tender. And this is okay if it gets red, it may even have a little bit of bruising. We don't want to go for much, but that's

totally normal. And you do this for about five to 10 minutes. And then this is just thought of as realigning those collagen fibers within the tendon. And then you can include some other exercises for the wrist, such as wrist flexion exercises, wrist extension exercises. And then really the sky's the limit from there. But basically, I would recommend a little bit of scraping or massage. You can even do massage with your fingertips going perpendicular to the forearm there, which is called cross friction massage. And then just make sure you're doing that eccentric motion that I described before. I love it. I think for a lot

of people who are training and dealing with this stuff, those are all super actionable and they really require little to no expertise or equipment to just hopefully manage this and make it something that at least creates the ability for them to get some training effect. So tell me a little bit about the other side of the elbow. That's for the lateral aspect of the elbow, correct? And so now we're talking about the medial aspect. So if you were looking straight down at your arm and your palm is up, the lateral part of your elbow is going to be on the outside. The medial part is going to be on the inside. So tennis elbow is lateral. Golfer's elbow is medial. Yep, correct. And are we dealing with the same type of treatment or what are we doing if we have that

medial elbow pain? Yeah. So when it comes down to golfer's elbow, it's, it's coined the term for the same motion that you do when you take a golf club and you swing it. Right. And so it's the same idea, except for now it's a repetitive wrist flexion injury. Okay. And so, whereas with lateral epicondylalgia or tennis elbow, this is more common with like mouse work, repetitive mouse work or repetitive, you know, laying in bed doing iPhone or iPad movements with the fingers. or iPad movements with the fingers, you know, golfer's elbow is going to be more flexion, right? And so this can be anything from, you know, actually golfing to any other motion that's going to combine a lot of wrist flexion, repetitive wrist flexion. And everything I said before regarding lateral epicondylalgia goes for medial. It just comes down to making sure you are eliminating those activities that are particularly aggravating and then slowly ramping up your return to these activities.

I like that. So there is one more, and this is one that I've dealt with a lot. And I think anybody who's ever thrown anything has dealt with a lot. And it actually takes place smack dab in the middle of these two. And it is right in that pit of your elbow. And that's traditional biceps tendonitis. So I see this a lot. I've dealt with this a lot.

What is it? What causes it? And then again, down that same same wavelength what are some of the things that people can do to manage it yeah so bicipital tendonitis can happen you know in the elbow but it's more commonly occurring up in the shoulder region at the insertion um on the scapula there so the bicipital tendonitis is an inflammation of the long head of the biceps. And so the long head of the biceps comes up the humerus and inserts on the scapula there. And so this is the reason why we get a lot of irritation with overhead athletic type of movement. So

when our arm is up throwing a ball or we're spiking a volleyball or anything that requires overhead movement, the bicep tendon goes through a small space in the shoulder called this subacromial space. And so it's going under the acromion, which is the portion of the shoulder blade. And that, you know, it's right above the humerus. Okay, so imagine a small tendon going through this small space. And when you elevate your arm up overhead, you decrease this space. And then if you do it over and over and over again, this tendon can become inflamed and then you can have irritation of the tendon and then the space can decrease even more. And so to give you a little bit of a background,

I experienced a flare up of bicipital tendonitis in my throwing shoulder when I played collegiate baseball. And so, this was a really nagging injury that would, you know, come and go, but it really required, you know, tedious, consistent work in order to get it to be eliminated. And, you know, at a collegiate level, when you're required to go do something overhead multiple times every single day, every single hour, you know, it's a hard thing to manage. But you totally can manage it with a little bit of consistent, you know, attention to detail. And so with repetitive overhead activity, you want to make sure that you can eliminate or taper down some of this activity as much as possible. For me, I couldn't do so, right? I was playing to have a starting position, right? And so for me, it involved going and seeking help. So I went to athletic trainer's

room. They gave me ice. They did massage. We did a lot of scapular retraction and postural exercises, which will open up that little space and give the tendon more room to move. And so all of these things can be super beneficial when you're having a acute bout of bicipital tendonitis. So that would be what we call proximal bicipital tendonitis correct it's a little bit closer to the midline or upper how do we classify that because both of them are common with lifters but i've also seen a lot down towards that lower portion of the elbow where that bicep kind of inserts on the other side yeah and so they're both termed bicipital tendonitis. You can say it's proximal if it's up in the shoulder or distal if it's in the elbow.

But typically in clinic, I'm going to see a lot more proximal just because we're going to see a lot more overhead athletes. Now in a weightlifting setting, of course, you'll see more at the elbow because you're crushing those bicep curls. And that's totally, totally like, you know, acceptable as well. But if it's at the elbow, it's going to be even simpler to treat because the tendon isn't going through this small space. And so what you're going to want to do is obviously taper back some of those bicep curls. I know if it's summer, it may be hard to do and that's okay. But taper back icing can help with some of that pain um

you can do similar things like scraping like i said before taking a spoon with some lotion you can do massage and then um i would also say work on the triceps give the triceps some love give some um some rest and recovery to your biceps and then it should be good to go yeah and so let's let's wrap it up here. We've talked about the spine a little bit with scoliosis. We've addressed the humerus quite a bit with the two different types of, uh, biceps tendonitis, as well as those particular issues at the elbow laterally immediately, but we wouldn't be doing the upper extremity service if we didn't talk about the shoulder uh you know what what are the most let's just pick one what's the most common shoulder issue you see a lot in clinic uh what causes it and then again just in general we can go even more general what are some things people

can do to mitigate long-term uh shoulder issues or to help keep that joint that is so mobile and is so important functioning optimally? Yeah. So, the first thing that comes to mind when we're talking about the shoulder and we're talking about, you know, traumatic injuries, especially in, you know, a younger population is a shoulder dislocation. Okay. So a glenohumeral anterior dislocation is the most common of these. And that means the humeral head in your upper arm is dislocating forward. Okay. And this most commonly occurs when your elbow and shoulder are up in a position overhead. Like when you're going for a rebound with a basketball or when you're going to, you know, spike a volleyball or when you have, you know, whatever

you're, could be playing spike ball, you know, and you have an external blow at the hand and it moves your hand backwards and then you get a lot of anterior translation of your shoulder joint and a dislocation can occur. This is more so going to be happening in a younger population, you know, around 18 to 25 years of age. Those who are more active, also those who have hypermobile joints. Okay. I know all about that. Yeah, yeah. You do have hypermobile joints. Okay. I know all about that. Yeah, yeah. You do have hypermobile joints being a gymnast at a young age. But we can help with stability of these joints.

And so we want to focus on stabilizing the shoulder joint with the musculature surrounding the joint complex. joint with the musculature surrounding the joint complex. And so with these athletes, I'm focusing on the rotator cuff muscles, the four muscles that stabilize the shoulder there. I'm focusing on the rhomboids that help stabilize the scapula. I'm focusing on all these other joints that connect at the shoulder in order to enhance stability. But I also want to focus on doing these things in a manner that is particular to the sport or activity that, you know, this could occur with. Another thing is when you experience a dislocation, you have a general laxity or looseness of these ligaments and of these tendons that occurs. And we want to make sure that it doesn't happen again. And in doing so, you have to train these stabilizing muscles and

you have to strengthen them because you are, we do know that you are at a higher risk of reoccurrence if you have dislocated your shoulder before. I love that. And it's interesting because I had Joe Grinstein on and he was a mentee of the great Eric Cressy, who anybody who's ever played baseball or ever done anything related to their shoulder in baseball knows who Eric Cressy is. Eric is the guy when it comes to training baseball players. And he said almost all of the same things that you just said, particularly related to taking care of the shoulder in the long run, not just for overhead athletics, but also for lifters. So I think that that was a really good way to circle the wagons and just to kind of, again, address some of these really common movement dysfunctions, perhaps common overuse-related injuries, common skeletal abnormalities, whatever the heck you want to call them. I see them a lot with clients in the gym.

I see them a lot when I'm just examining people. If you have a coach's eye, you kind of see these things. But there's a lot here that people can do and utilize to help these things go away or at least manage them across a training career, which is really, really important. So for anybody who made it this far, who liked what you had to say, Brandon, where can they find you? How can they keep up with you? And if they have any questions, can they reach out? Yeah, of course. So most commonly, I will be most readily available on Instagram and you can find me at Zini, Z-I-N-I,

physio. And I'd be happy to answer any individual or specific questions that you guys may have. You know, send me a message. I try to get back to all of you as quickly as possible. And I look forward to talking to you on that platform. And I want to say thank you to Danny for having me on. I appreciate it. And I look forward to doing this again in the future. Yeah. You know, my, my goal here is to have you on relatively regularly as more questions arise around just taking care of the body, taking care of your training career. I'm all about longevity. I want to create a community with the podcast where people are encouraged to

either work through sticking points or just be active across the lifespan. And I think that combining the avenues of fitness and physical therapy is a really great way to do that. They're both emerging fields. And I think that continuing to have you on is a no brainer, man. So thanks so much. Everybody give him a follow again at Zini Physio. That's going to be the best place to find him. And a lot of things coming in the future between the two of us, I can tell you that. So stay tuned and have a good one. It's going to be the best place to find him. And a lot of things coming in the future between the two of us. I can tell you that.

So stay tuned and have a good one. So everybody, that's it for today. Again, thank you so much to Dr. Baranzini for coming on and talking about, again, really common issues that affect a lot of lifters, a lot of fitness enthusiasts, even just gen pop individuals. These are really, really common things. And I think having a better understanding of how it is they impact the body are really, really valuable tools. Be sure to give Brandon a follow on Instagram. His handle again is at Zini Physio, and we'll be sure to have him on again soon. If you took anything of

value from this episode, I strongly, strongly encourage you to share it. It would mean the world to me. I would appreciate it. I hope you have a fantastic day. Continue to learn. Be sponges. Go out there. Make the world a better place.

Make it a healthier place. Have a good one, guys.