Episode #82 Why Elite Athletes Need Boundaries More Than Motivation

The most dangerous injury risk in sports medicine may not be the hit, the sprint, or the tackle. It may be constant stimulation, poor sleep, and athletes who never get a true reset. Dr. Pawen Dhokal and Dr. Dustin Glass break down why recovery starts long before game day and why the right habits can protect performance, focus, and longevity. Dr. Dhokal opens with a surprising reflection on birds, plants, and how everything around us seems to work in rhythm, then uses that idea to frame a bigger question: what happens when an athlete’s nervous system never gets a break? Dr. Glass adds the real-world perspective from working with athletes, teams, and families who are trying to manage phones, stress, and the pressure to always be on. You'll discover:

• Why today’s athlete may be under more amplified stress than the athletes of the 80s and 90s

• How social media, notifications, and morning phone use can quietly drain energy and recovery

• Why game-day routines like no phone, quiet mornings, and intentional silence can matter more than most people think

• How adults can model better boundaries for kids and young athletes

• Why being “off” by just a little can create the kind of dysfunction that leads to injury

The conversation also gets practical with a detailed sports medicine case involving a teenage elite diver who torqued her shoulder and triceps on a 10-meter entry. Dr. Glass walks through the mechanism, the tissue stress involved, and the treatment approach, while Dr. Dhokal adds his own biomechanical read on what likely happened and how to think through it.And then the episode takes a sharp turn into a timely fight breakdown, as the doctors analyze Conor McGregor’s injury, the balance clues that may have predicted trouble, and why elite athletes can still go down in a split second. It’s a reminder that pain is not the only sign of dysfunction, and that performance depends on more than just toughness.This one is for athletes, parents, coaches, clinicians, and anyone trying to understand what really drives recovery, injury prevention, and peak performance. If you care about sports medicine, biomechanics, or the mindset behind staying healthy under pressure, this episode delivers a lot to think about.

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Transcript

SPEAKER_01 0:00

And welcome back. This is the Second Opinion. We're a sports medicine podcast. I'm Dr. Dogan. I'm Dr. Glass. And we are back in effect. Dr. G, what is happening today?

SPEAKER_00 0:10

Not much. Got up early. Uh exercised, did my workout, big tall glass of water, creatine, took my protein, got my workout in. Then I uh took my dog for a walk, moose man.

SPEAKER_02 0:26

Yeah.

SPEAKER_00 0:32

So I let him go and um we have a real nice field out by my house. So um, yeah, so it's nice to I think on one of the other podcasts you talked about the birds uh, you know, chirping and stuff. And um, we live in a canyon kind of, so we can, you know, early, early morning we can hear the roosters crowing. Uh we got some farmland or uh some what would you say, not farm, like where you're from, but uh I don't know, canyon. Coppery fields yeah, we got we got the horse stables, we got the you know, canyon. So we hear coyotes all the time. It's really cool, you know. Towards the evening as the sun's setting, we hear the coyotes, and then in the morning we hear the roosters. So it's pretty cool. I I love it. I love living out here, but the morning birds chirping is a is great. So yeah, you mentioned that last time, and um, there's a great app that one of my patients put me onto. It was a study done by Cornell. So I think it's called I'll I'll send you the link. Actually, let me look it up. You you start talking, tell me last time you talked about the birds chirping and what that all meant. So tell let's tell our listeners about that real quick. And I'm gonna find this app because it's a really good app.

SPEAKER_01 1:39

Yeah, no worries. I was just mentioning that uh I read that the birds start chirping before the sun rises, right? So they start chirping like an hour, hour and a half before the sun rises. And I mean, I think we all maybe know that if we're just paying attention, but what I didn't realize was that the bird song actually the plants and trees hear the bird song, and it they found that it actually helps to open up like the flowers, not petals, but it helps open up the flowers for the day. Basically, it signals to the plants like it's time for pollination, sun's coming up soon, and so it kind of they're in communication, they're interconnected in this very unique way where the bird song the plants hear it, so to speak, and it affects them, you know. It has alerts them to like, okay, it's the day starting, let's I guess open up and be prepared for the the bees or the pollination or whatever is happening. Yeah, and so it's not something that like I was acutely aware of, and I just found that to be an interesting fact. It's like, oh, y'all animals and plants work in harmony, go figure.

SPEAKER_00 2:49

Right. It's like we kind of know, but when you actually hear the literature behind it and and it I mean, we are we know that we're all energy based, right? It's all frequency based. So that makes sense that the the frequency of the birds chirping, and they all have different, you know, they're communicating, they know what they're saying, they know what they're doing, but they have an influence on the on the plants. That's pretty cool. Plants and flops.

SPEAKER_01 3:12

I mean, I might have been a little hypoglycemic yesterday, but I came home from work. It was just a busy day, left early, you know, hour and say an hour and a half commute, and then worked the full day, had some hard cases, had some good results, had some reflection on the way home, but my commutes have been either creating content or calling people back. They've been very busy, you know. It uh it definitely didn't feel like downtime. But I got home the other day, I was like hungry, had stuff to do. Getting to my point, I walked in the backyard with the dog and I walked uh, you know, we have a bunch of fruit trees on the property, and one of them is like a delicate peach variety. It's called like a white peach, you know, it's kind of like like a nectarine almost, very soft, but it's a peach. Anyways, I went to the tree as I was walking the dog and was just kind of checking it out. I said I'm gonna pick one of these, and I picked the most delicious looking one, and it had some bird bites out of it, and I was like, ah, damn birds, like ah. So I threw that away, and then I picked another one, and I was gonna wash it off and take it inside, but I was hungry and it just felt so like perfectly soft and juicy. I was like just blew on it, like a little bit of dust never killed the armor, you know. And so, yeah, dude, I bit into it straight off the tree. It wasn't chilled, and I literally was like, oh my god, because it was like juice running down the arm. It was it wasn't, I like my fruit a little chilled, but it was like outside temperature, you know, but literally just pulled off the stem five seconds earlier. And when I say it was delicious beyond anything that you tasted in the grocery store, it's like for those people who only buy produce from the grocery store, go to a farmer's market and try that fruit. And even that fruit might be picked a few days ago. But like anybody can grow fruit. If you have a balcony, you can get a little potted thing and grow like Meyer lemons grow great in pots. Certain fruits grow really good in pots, and you can on a balcony, you can grow a blueberry bush. I just would encourage everybody to grow their own food in some way, even if it's one little lemon tree, one little blueberry bush, one little nectarine. Like there's some things that are pretty easy to grow that you it's hard to mess it up, really, you know? And yo, if you grow your own food and have it, I'm telling you, that is what a next level. I was like, I was just tripping out on like four months ago, this was just a barren tree with no leaves on it, and it was rainy and cold, and then I'm over here watering it a couple times a week, and then there's some little leaves that spring up, and then the leaves turn into a full tree of leaves, and then there's a little flower, and that flower turns into a nub, and that nub turns into a piece of little little little little baby almond looking thing, and then that turns into a delicious, fleshy, juicy peach. I was just like I said, I might have been hypoglycemic or something because I was really tripping out on nature and just like, man.

SPEAKER_00 6:01

Want me to leave you alone for a minute? I mean, you're what's that you want me to leave you alone for a minute? Yeah, right.

SPEAKER_01 6:08

Dude, I I was really tripping out on just like I can't believe how like just like the miracle of you know, you're put something in soil and look what sprouts, you know?

SPEAKER_00 6:18

Oh, you reflect.

SPEAKER_01 6:20

And well, that's there's an analogy there for sure in life, too.

SPEAKER_00 6:23

Let's bring it back full circle. I just want to and I love that, and I love that you have that experience with the farm, you know, farming background and all that. Um, because there is so many so many metaphors and analogy to life and sports. So we do talk a lot about that, and I love that. Uh but my I wanted to the app I wanted to tell you about because I want you to yeah, so you can because I do it all the time now. Um anytime I'm hearing some birds chirp, even out in my office or at home, but um it's called it's the Merlin app, so M-E-R-L-I-N.

SPEAKER_01 6:54

I'm writing it.

SPEAKER_00 6:55

Yeah, and one of my patients turned me on to it, and she's like in her 70s, 80s, you know, late 70s, and you know, you know, typical, you know, grandma type that wanted to, you know, share, you know, her bird chirping. And and at the time, I'm like, oh, that's cute, you know. Like, and then I did she made me download it at the office. So I'm like, okay, didn't think anything of it. Then one day I hear a lot of birds, so I'm like, I'm gonna try this thing. And you just put all you do is you hit play record, and it records the birds, and then it can pick up multiple birds chirping, and it will tell you exactly what bird it is, have a picture and then a full description, where it's from, native, and all this kind of information about you. Can save that information if you want it, like for the bird enthusiasts. But uh, but yeah, we have fun. I shared it with my parents, they have a great backyard with tons of birds coming in, they like it. It's a lot of fun. So I think you like it. Uh, and then you start picking up on some of their sounds. It's very accurate, like it's actually done to like it was based on some Cornell studies, so it was very accurate. But uh there's this kid on uh social media that uh has the talent of being able to do a lot of bird uh sounds, and so they actually and he's very good. He does it for his classes, and he does it, you know, and he's got this whole repertoire of birds that he can make sounds with. And so we should find a clip of him doing it on social media. But I came across a clip where his mom had the Merlin app open to see how accurate he was, and nice more than not, I think there was only one or two that it did not pick up, but other than that, they it all knew his. So talk about the talent of the human, you're right, and being all and we're all frequency based, so it's pretty cool. So, anyways, get the app, let me know what you think of it.

SPEAKER_01 8:38

So, but that well for sure, because I wandered off and there's different chirps. Like, what are those chirps? What kind of birds are those? Like, what is it? So I will nerd out and download that and then report back because we might have 15 species of birds, or we might just have 15 of one type of species, just you're cracking, yeah. You know, I'm not sure. Talking about different things, but anyways, yeah.

SPEAKER_00 8:58

So let's not bore our listeners anymore and show our age anymore, you know, like younger.

SPEAKER_01 9:10

Right. Well, hey, it's uh we cover all the things that come to mind, you know.

SPEAKER_00 9:13

Yeah, and plus it started off talking about frequencies, you know, and that the human body, the earth, everything's frequency-based. That's what it's all about.

SPEAKER_01 9:23

Well, actually, I'm glad you brought that up because I did have something I wanted to talk to you about on the side, but uh what better time to do it in front of our audience, I suppose? And it's about frequency and it's about injuries. And so I'll just pose the question to you. Do you think, I'll pose it this way, what are your thoughts on today's athlete and their stress level in comparison with the athlete from the late 90s? You know, you could make a stark contrast from like the Michael Jordan era athlete to the LeBron James era athlete. Meaning back then, maybe Jordan's gambling or off-the-court antics were pretty private. Nobody knew about anything. And these days, if you're an athlete, every movement is tracked basically, maybe voluntarily, because you're posting stuff, you know? But it makes me wonder and think about, I have some thoughts on it, but I wonder what your opinion is on the athlete's stress level these days compared to then and what impact, if any, that has on injuries and their mental.

SPEAKER_00 10:23

Yeah. And I know we talked we touched upon this on another podcast a couple couple weeks ago. Same kind of topic, but uh, you know, to discuss a little twist to that and give people a little more backstory on, you know, other things, or think about things a little differently than what we talked about on the last podcast about that. But I definitely think I think, you know, one, we gotta kind of define what stressors are, and but it's basically I like to look at what were the instead of comparing like did they have more stress or did we have more stress, I think it's stress is stress. And I think I like looking at what was going on during the times, like in the 80s and 90s and 70s, 80s and 90s. What were what was going on? What was what were the influences then and what are the influences now? You know, uh back then it was a different mentality, right? So what they would consider stressful, they played the game for the love of the game. They didn't get paid much, right? I'm talking about football, baseball, they didn't get paid much. So they were literally out there playing for the love of the game. So their stress level was different. You even look like there were way more fights during the games back then, you know. That's because they they literally loved the game and they didn't care about the repercussions of anything. It was they they were playing for their city, they were playing for the pride of the city, the pride of their team. They were, you know, that's what I was seeing different. Nowadays, it's so that me movement where it's all about the individual and where they're gonna be in the next year, where their contract is. Back then, everybody's contract sucked. So it wasn't about that. They all had other jobs, you know, a lot, you know, depending on what generation we're talking about, you know. So so I think things were just different and their their motives were different or their motivation was different to play. So I think I think the stressors were still there, but they had different outlets too, right? And nobody watching them. Like you said, in social media, they're the cameras on them at all time. You know, they can't go anywhere. They have to be hunkered down at home, they have to have private vacations, they have to have, they can't just live their life. So then they have to actually go perform. So you got stress at home, then you got stress, you know, at at the on the field or on the office. So I think it's just I think I think it's just to answer your question. I think nowadays, I think it's just more magnified. Everything just seems more magnified and amplified, which is unfortunate, because now we lose some of that purity of the game. Like you know, now it's like a video game. Every game we watching is like playing a video game. And they even talk about all the simulations and is it scripted and all that. Back then, you knew it wasn't scripted because you know, anything could happen at any moment, you know, and it was it was a real.

SPEAKER_01 13:15

You know, yeah, there's a lot more uh I don't want to say freestyle to it, you know, but like there is a lot more precision to today's sport, you know, a lot more uh at least it seems to me, uh specialized attention, specialized position, specialized. I feel like back in the day you could have been the QB and the punter and maybe gone out on defense if need be.

SPEAKER_00 13:42

It was Iron Man ball, you know. Again, it was a lot like, hey, we just got done playing in the playground, and now let's get paid a little money and entertain some people, right? You know, and a lot of them, because of the military, they were playing for their their you know, army or navy or whatever, and then they would come back home and play for their professional team, right? So it was they did play multiple positions, multiple sports.

SPEAKER_01 14:08

Yeah. Yeah, I I know we talked about this, so I won't, you know, spend more than a couple minutes on it today, but I've been really kicking around and pondering the effect of constant stimulation and the effect it has on the body, the effect it has on recovery, meaning like how does it affect your sleep if you're scrolling on the phone or you wake up in the morning and you're immediately stimulated by your phone, which I feel like that's most people. And I've been really curious about how that overstimulation and maybe low level of mental stress can wear on the body physically, and like if there's a relationship between that and lack of recovery or an increase in injuries, you know. So I don't have any hard data, just some deep thoughts on. I wonder if I could destimulate some of my athletes, what kind of effect that would have on their sleep and performance, you know? So that's it.

SPEAKER_00 15:07

Yeah, well, I so I picture like all this, all this, you know, the phone, the constant, like you said, there is just constant. I picture like having a radio on in the background where it's just static noise and it's just it's constant. We might not notice it, we might not be thinking about it, but at the end of the day, it's draining our our battery, right? And we don't know how good we could be because we feel like we're performing pretty darn good. But what if we can have that extra 1%, 10% because we didn't have that excess noise that really is insignificant, but it's significant, right? So that's the thing is yes, it we and there is literature out there. There are articles and research are there's people that are, you know, you know, I just listened to a podcast last night that they talked about this and and how how much it's influencing, but the key is how how how are you gonna get it out of the out of the norm, right? That's the problem. How are you gonna stop it? It comes down to discipline. You brought up the morning routine of first thing we do, the phone's literally next to us. When we were growing up, there was no phone, so we had alarm clocks, right? So you would hit the screws on the alarm clock, but you physically had to get up and do it. Uh so nowadays the phone, so most hopefully most people will turn it off or you know, put it on sleep mode so they don't get woken up. But you know, I have kids that are out of state, so my phone's on all the time. So at three in the morning, if I get a text, I can answer it, right? So I don't have that luxury, uh not even the luxury, because I don't mind doing it. I love being there for them, so I don't even think of it as a burden. I'm just saying where somebody else might think of that, oh, that sucks. No, I'm there for my kid, that doesn't matter. So, but you know, you it is something that's on, but but so I don't have that opportunity, but what I do do is first thing in the morning, I make the discipline of not even touching my phone. I'll look at it briefly to see if one of my daughters texted me or if there's anything urgent from a family member. And if it's not, I put it, I don't even put it away, and then I have about 30 minutes to an hour of no not connected at all. But it's a discipline, and it's not easy, especially when you start going because you're thinking, okay, well, what about a business email? What about this? Well, if I'm constantly thinking about other things, it's taking me away from other things. So again, I think of it as a battery, right? Yeah, I I only have so much energy and I gotta make sure I disperse it, but it's a discipline. Same thing, you know.

SPEAKER_01 17:34

It's but no, I think you're right, you're spot on, dude. I've been I made uh comment yesterday about if I was a balloon, this thing or person was like a needle that pierced my balloon, you know, and so it was like, is it a did my balloon pop? No, I'm still functioning. But that's an energy leak, that's an air leak. For certain things, like you need that. You may want that, you know, whether it's family or your job, like you might have like some, but you want to minimize the amount of little pinholes you have in your balloon because at the end of the day, you have too many pinholes, you're gonna be deflated, you know. And that is a thing that I think people have a lot of trouble with and struggle with. They don't realize just looking at the phone in the morning and seeing texts and notifications, even if you don't respond to them, you're just like, oh, I got seven texts and three are from my friends. Boom, you're already clunked over the head, dude. You're already cooked. Yep, things are already cascading in your body, hormones and it's a needle in your balloon.

SPEAKER_00 18:35

It's a needle in your balloon, you know?

SPEAKER_01 18:37

Like it's a slow burn. It's really great, I think, that you're intentional about it. And I would encourage adults and kids alike and athletes. In fact, I'll share one quick story about I'll just yeah, I'll just be honest about it. I thought it was very intentional and unique and a and an important part of last football season. My quarterback rider, his parents instilled kind of a rule with him of game days, no phone. So he'd get up in the morning. And in fact, I don't want to speak on it exactly. Like when he comes on or one of the other of his teammates come on, they can speak on it. But even like the friends who would come over to the house the day before the game, if they're having like an O-line meal, or you know, his house was kind of where a lot of people congregated. And after a certain time, if you're spending the night at 10 p.m., Kameh, God bless her, we'd go around with a basket. Hey, put your phones in here. It's 10 p.m. And they'd, you know, aw, like, uh, you know, and I was there working the first time, and I was like, oh, what's happening? Are they gonna be like, no? Not everybody. They were like used to it. Oh, we're at Ryder's house, it's 10, we're putting our phones away, we're off our phone. And you know what happened, Dustin? I'm working. And it went from everybody being on their phone, like kind of, yeah, yeah, yeah, looking up and just kind of half participating, you know, because they're the phones are gone. Dude, it was like a slumber party. Yeah, old school. We're hanging out, they're like, what are you doing there? Like, what's happening? We're chilling and talking, and then like I leave, and I'm just thinking, they're slumbering out, but they're like staying awake late, just staring at the ceiling, talking about the game tomorrow, making fun of each other, just not no distractions being present, you know.

SPEAKER_00 20:19

Yeah, that's huge.

SPEAKER_01 20:20

And I mentioned to the to his parents, like, I think that that's so important, and I I love that they instilled that kind of rule. And then for him as a QB, I was mentioning to him once early in the morning, like, hey, it's game day, let's dial in, don't let anything distract you today, blah, blah, blah, blah. And then pre-game, he shared with me, just so you know, um, like I'm not listening to rap music in the morning, like, I'm not listening, I'm like, no phone, no radio on the way to school. He had somebody that kind of spoke to him about these things, and he's intentional about how he spends his quiet time, and then he's like, Yeah, I'll listen to like maybe some classical or something to kind of and then like now we're pre-game, like now. I'm gonna hit the let me get fired up music. Because you do that at 8 a.m., I'm telling you, you're draining your battery. And I just thought it was so smart of him and his parents to instill those values and that importance. And so it's all young athletes, and you could speak on it with your daughters probably better than I could as an example. But you're if you're a young athlete, protecting your energy, especially on game days, is so important. The day before a game, hydrating, getting that good night's rest is so important. It doesn't feel like it. I'm operating off four and a half, five hours of sleep today, I got a full day. But I'm also not trying to read defenses while people are trying to knock my head off and I'm trying to be my sharpest. If I had to take the SAT today, if I was on Good Morning America, if I was, you know, I would make sure I got my seven, eight hours. Luckily, I can lean on my dope co host if I start to stutter too much. It's pretty low pressure over here, but for high performance. Sleep is so important. And what do you think of that routine? I didn't mean to speak so long on it, but what are your thoughts on that? And did you were you mindful of that with your daughters?

SPEAKER_00 22:08

Yeah, we were. We didn't have it as as much of a discipline, but like definitely dinner times, meal times at restaurants. We never had it. So that was our rule. Restaurants for the same purpose, be present. That's when all the the creativity comes out, right? That's one of the problems that they're saying. I mean, as as skillful as kids are nowadays on their iPhones and their phones, being able to create things.

SPEAKER_02 22:32

We got both our dogs wilding out right now.

SPEAKER_00 22:35

So so but but they're creative in a different way, right? But but when it comes to being able to think outside the box and think creatively, the biggest thing is that kids these days, um, I don't know, I don't want to be that guy. Kids these days, but what they're seeing is they don't know how to handle boredom, they don't know how to be bored, they don't know how to be sit in silence. Like as a whole, typically, if you put a kid without their phone in a room, like at a doctor's office, and they don't have that, because they've been since they were little babies handed that, they kind of freak out. They don't know what to do. So we were intentional at our our personal dinner table at home. If we were out at uh you know restaurants, if we had company over, it wasn't. They had to be even if they just sat on the couch listening, you know, when it was cut if it was friends and stuff, we let them do whatever. But with if it was company that we hadn't seen for a while, no, you sit here like we had to and listen to the adult conversations and be present, right? Yeah, and so we were intentional with that. I think knock on wood, uh, it appears my kids are a little more, you know, or in car rides. There that was another thing, car rides. How much did we learn as kids staring out the window, even if it was for two hours staring at signs going by in a freaking nowhere, right? You know, or we would play the sign game or the license plate game or something like that. So we would do that, you know. So we would do things like that with my kids. We would give them like windows, okay. For the next 20 minutes, you could be on your phone. So it was a special occasion, right? And then we would take it off, and then we would sing songs, we would, you know, do whatever, you know, maybe watch a movie on a DVD or something. But that was that was a special time, right? So I think it's super important, and and uh, you know, it's very hard. I know some kids, some of my patients just gave their kids cell phones, like in junior high or high school. If they a lot of times it's a safety thing where it's like, hey, you're spending the night or you're going down to San Diego, you're in a hotel, we do want you to have something. So a lot of the parents will have like restrictions on the phone or just a call and text phone only, no social media. And then then they'll have to wait till their like junior or their eighth grade year to get a phone or get the social media. So maybe it starts with Instagram, you know, or Snapchat or whatever, which there's a lot of problems with both of those. But can't just, in my opinion, just let them free in high school for the first time with that. You know, you gotta do a little slow, because it's like anything, you restrict it so much, then you know, not all kids, but a lot of kids will just want to jump right into it and go overboard, right? And we all know that with anything, human nature.

SPEAKER_01 25:24

It's tough when you're young and you're an adolescent to make your own boundaries. Here's the kid who's, I'm gonna go practice by myself. I'm gonna go, like I was probably the weirdo who's out there shooting hoops by myself, making my own games up or throwing the ball against the garage door because I didn't have somebody to play catch with, you know, and like rare is I saw a young man who was out on the hill practicing by himself, had a helmet on, and had, you know, just like regular workout gear. And this kid, Dustin, was probably 12. And man, if I felt like if I was a millionaire, I would want to like pull over and just break this kid off like a couple grand, you know, and just be like, I don't know what you need this for, give this to your parents. But like, I was just so proud of him. I don't even know who this kid was, but he was working by himself and I watched him up the hill, walk down. And I don't know this, but he was walking down, he had his hands on his waist and was like, bro, he was talking to himself, and he was like eight years old, and he went down and then back up again, and then back down, and then I watched him do five or six, and I said, This kid's out here by himself. Yeah, that's you're a special kid, you know.

SPEAKER_00 26:28

That's that's Walter Payton workout right there. I remember back in our day, you know, that's what Walter Payton did, ran hills, ran hills. So everybody wanted to do the Walter Payton workout. So I'm sure Dad or Grandpa said, Hey, this would be a good thing for you. Yeah. Yeah, so good for that kid. I've been I've had that same thought when I've seen kids do stuff like that, or you know, grinding it out there, putting in the time on their own. If I if I had the means or if I could, you know, like I'd love to take that kid under my wing and just like, you know, help him or coach or you know, yeah, you know, give him some money, whatever.

SPEAKER_01 27:00

But yeah, yeah. You know, it's cool. And if you're a college athlete or a high school athlete or a pro athlete, especially, you know the impact you have on young kids, especially if you're a professional athlete. But it's been unique being here at Folsom High School seeing these high school boys who are looked up to by kids in third grade, fourth grade, because they've there's like a feeder system and they're like, oh my God, you're the Folsom wide receiver, you're J-Mo, you're Rob, like you're a legend in these kids' eyes, you know. And then I've seen these high school kids give a little tip down, you know, like, hey, keep working, or yeah, if you want to be blah, blah, blah, blah, you gotta hit the books and you gotta. And that to me is like such great leadership, you know. It's like we forget sometimes that we are examples.

SPEAKER_02 27:44

Yeah.

SPEAKER_01 27:45

As parents, as adults, we're examples too. I was telling somebody in my family who was kind of getting on their kid about being on the phone. And why did my my cousin have to get off his phone to tell to tell his son to get off his phone? And I said, bro, what's going on right now? I'm not a parent, but we gotta be the example, you know? And so if we think about how hard it is for us to stop scrolling, imagine a kid, bro. Right. Like they don't stand a chance, they're still developing. So, as parents, if you don't lay that law down, it's like just giving free reign at Halloween to the candy. Of course they're gonna eat the whole bag. We ration that shit, right? It's like going through, pull out the candy with the needles. Here's four pieces for this week. Like, why wouldn't we do that with other things that are harmful? And I just I'd know it without knowing it, that in a few years at some point they're gonna be like, breaking news, no kid under five should use a device because it hinders their brain development. And we're gonna be like, Yeah, no shit, we were talking about that.

SPEAKER_00 28:44

Exactly.

SPEAKER_01 28:46

It's like the red lights and the cold lasers and the things we were talking about in Cairo school. That I remember family members and medical professionals were like, I remember one guy in particular was like, dude, red light does not help with anything. It's red light, it doesn't do anything for healing. You need to ice, you need to compress, you need to rest. And I was like, no, but they're the research, and they're like, Oh, your research that you learned in chiropractic school. It's like, well, I learned it in chiropractic school, but it's medical research, you knucklehead. You know? And now look, like now it's a whole industry, red light panels and this and that, and those are things that we were using 25 years ago. I remember having a discussion with you about KT tape when a pro team, I was taping up one of my athletes with KT tape, or I'll call it Kinesio tape, not brand name of rock tape or KT tape, but like I had a player come back and be like, hey P, I gotta take this off before I go into the facility because the team docs are like kind of making fun of me, like, oh, what is this tape you got on? You know, and two years later they were taping up everybody. I'm not claiming that we're ahead of the curve on everything, but it's just things are weird till they're mainstream, I guess.

SPEAKER_00 29:57

Yeah.

unknown 29:58

No.

SPEAKER_01 29:58

So that's why I like doing research and that's why I like our discussions, because I know you're on top of things like this all the time.

SPEAKER_00 30:03

Yeah. Well, we have to be with who we work with and the teams, and we have to have the cutting edge because they're gonna they're gonna want the edge. So we gotta figure out what's real, what's not, and be able to educate them on it too. A lot of times the teams, you know, the trainers will come to me and ask me my opinion on things because they know we do do that, you know, and we like research, and a lot of times they they get hit up with so many different companies hitting them up with, you know, everything that they they don't have time because they're in the middle of the season to stay up on it. So they'll ask me to do some research and that's how I learn a lot. And I I always tell my patients or anybody in the field, hey, if if you need help, you know, finding something or understanding something, if I don't have the answer, let me know, because that's how I'm gonna learn, right? And so I love doing a deep dive on something I've never heard of or whatnot. And uh even though you want to be the know-all and you know, and the be all, but it's also, you know, it's okay to say, hey, I'm not sure about that, but let me find out, or I know somebody that might know something, and then and I love doing that, you know, have no ego about it.

SPEAKER_01 31:05

I'm gonna mark that clip right there because that's an important point, not just in sports medicine or really in anything. People don't say I don't know anymore. I don't really hear that very often. I feel like you and I are some of the outliers that actually will be like, oh, actually, I don't know. Let me look that up. Because today's day and age, you can look it up, and also we can learn something together, you know? And I'm not the expert in everything, I'm very well versed in certain things for sure. Yeah, maybe one of the best in some areas, but certain areas, yo, well, let's learn this together. And thanks for bringing this to my attention. Yeah, I think that's the wonderful thing about the people that we treat is I like not knowing everything. I like it when something comes up during the day and I'm like, oh shoot. Yeah. Actually, I don't I have a feeling on this. Let me think this out. Okay, I have here's my thoughts. But let's let me ask my boy Dustin, he might have some other thoughts. Let me research it. I'm gonna put that on the thing, and when you come next week, we're gonna have a discussion about it. By the way, why don't you do a little research too? You can hit the World Wide Web and then tell me what you found, and then we have a wonderful discussion and we both learn.

SPEAKER_00 32:18

Yeah, I do that all the time. Yep. I do what you kind of said, like I say, this is my initial, I call it my knee-jerk reaction. This is my knee-jerk reaction on it. This is what I kind of have a feeling, but let me do and everything you just said. But I because it's okay, that's human, right? Instead of saying being the expert and then actually sending, you know, telling them bullshit, you know, just to make you look good.

SPEAKER_01 32:42

Yeah, it doesn't serve anybody. Yeah, you know, it doesn't serve anyone. Let me ask you something on a little side angle, Dustin. What do you think about a future where we're doing this podcast and we're doing some like real-time differential diagnosis because our guest is an athlete or a listener who has something that they've had trouble with and they haven't been able to resolve, or they just want to run something by us, and we have a third person here and we're kind of tag teaming what's going on with them because they're open, willing, and able to discuss whatever's going on with them on a podcast. Would that be something that would be interesting, you think, to people who listen, or do you think that's just like nerd stuff that we like?

SPEAKER_00 33:19

Yeah, I I think a little both, but no, I think it definitely would be interesting. Uh, and because that's kind of it'd be like taking uh it's I mean, it is telehealth medication, you know, it's telehealth. That's what we do when we do a telehealth uh meeting with somebody, we have those meetings, but I think um opening the door to other people, you know, for those that are willing, I think it they'd find it very helpful and then it's saying hi to he's like, I want to get I want to be diagnosed. Yeah, exactly. So but yeah, I think that I think and we've seen it on some reality shows like Dr. Pimple Popper or whatever, and uh those guys that did the breast augmentation and the the facelifts and all that, you know, that that's kind of what they did. They opened up, you know, on reality TV, you know, show what what what a consultation would look like, what their thought processes, what a treatment would look like, and then they would show the outcome, right? So I think there's definitely a place in our world where um I think there'd definitely be an interest.

SPEAKER_01 34:17

I think we should uh we should maybe try that one day.

SPEAKER_00 34:20

I think so. Yeah. One of our patients that we talk to and then say, hey, would you like to talk? And yeah.

SPEAKER_01 34:26

Because it would be nice to hear their perspective as a patient of something that they went through that we helped resolve, or maybe they're currently going through, and we can kind of ping pong it back and forth because there is synergy and discussion. And yeah, one of my favorite things is just to have a teammate like yourself to stimulate further thought and just kind of sift through whatever the clues are and figure it out, you know? It's like having a detective partner, you know.

SPEAKER_00 34:54

Well, that's kind of you know, we always talk, we started this podcast and we were always having these kind of conversations on the phone, right? And this is kind of how this podcast started about at one point during COVID. We're like, hey, why don't we just get this recorded so we have some? But the unique angle that we both had was we both worked with teams, right? But you worked on kind of the outside working in, and I worked on the inside working out, where I was in with the teams and the medical staff, and I was hired by the team, and you were hired by the players and but still part of the team, right? So we liked how and it I was talking to one of my patients the other day about this, is like we it was always the grass was always green on the other side. You would be like, Man, I wish I was in there in the locker room in the training room and doing the, you know, that would always be, man, I wish I was in the hotel rooms that after hours, you know, working on them and just doing the shit and being more personal with them. Because when I'm doing my stuff, so we always had this kind of you know, man, it'd be nice, but but um, but I think that's what's nice about this podcast when we actually do talk cases and stuff, is that we have basically the we come to the same outcomes but come from two different perspectives and we see it from two different ways. So I think patients would appreciate that too. So it's not just like two Kairos, two sports docs, two soft tissue practitioners. You know, we're actually, you know, yes, that's what we do, but we have external experiences that are unique to both of us.

SPEAKER_01 36:21

Yeah, that's what No, it gives it gives a different angle for sure, which your perspective has been really uh helpful, not just in this podcast, but just you know, take five years ago, ten years ago. I really do remember kind of feeling like I was less than because I wasn't the official kind of team guy. And it was helpful to hear your perspective on like, man, there's like limitations that I have because I can only be in a certain role and that's it. And like I want to do more, but unless I'm working with Kobe or my personal kind of clientele outside the team, it is difficult to really do anything outside of what they say is your lane. And I think I just wanted the free swag, you know. I think that's maybe I think maybe that's where that came from. But it was also maybe a little insecurity of, you know, am I good enough to be hired by the team or am I not? Like when I was younger, I kind of felt like, well, if I'm hired by a player, it's less than. And now I really look at it like it's uh it's like a big trust and a big blessing for somebody to go outside the team and say, Hey, I got my own person in addition to, you know. Yeah, I kind of have uh I really respected isn't the right word. I really appreciated that opportunity to work with individuals, but now I have a different level of appreciation, just being a little bit older, knowing what it means, you know, to be invited into somebody's home or to spend time after hours in a more casual setting without the guard of I'm in the facility, and you know, you can really get to know people on like a human level. That's all. Exactly. And I'd just rather have that than a professional working relationship, you know?

SPEAKER_02 38:01

Yeah.

SPEAKER_01 38:03

So yeah, no, it's it's interesting how our paths have been kind of parallel but different, and it's cool, dude. I think it'll be an awesome thing come this next Super Bowl. Like we both talked about being on like Radio Row and being able to take our show on the road a little bit and expand and interview more people and more guests. I mean, I think people would chip out if they saw our our black book or our contact list, you know. They'd probably be like, what the heck? How are you how are you not already like one of the most well-known people? But it's not we're not the cool people, we just know cool people.

SPEAKER_00 38:39

Yeah, and that's not that's not what we're doing it for because we know people that do have those names, and not not all of them, you know, that are well known out there in our field. And I'm not saying all of them, so I might get some hate on this, but there are a number of just like there's weeds in every garden, you know, there's a number of them that do it for the wrong reasons, in my opinion. They might help people, but they're out there for getting their name out there, and so they're reposting every little thing. They're, you know, they're they're and and I've had so many athletes come from doctors like that that say, hey man, I really liked what he did, but I can't handle, you know, there's no privacy, there's no this. I really appreciate that you're discreet and private. Nobody even knows I'm coming here. You know, yeah. And in my head, I'm like, I wish everybody knew you were coming here, it would help, you know, like you know, business-wise, right? But but you come full circle from a human side, you're like, I'd much rather have this connection and be that guy versus the other guy. Because that that comes across as a little scummy, a little scammy, a little in it for them, and you lose that, you know, that actual, what are we here for, right? And that's that's gonna be temporary, whereas relationships like we have are long term. You know, we have long term versus temporary. No, but you know, so I think that's important for students to realize too, because like you said, like in the beginning, you just want to have that, you know, you want to get in. You want to you want to get that mark, but you gotta also set your mark for long term and you got to know what that looks like and how to actually do that. So play it right from the beginning versus just for that short term. Now you can play it to where you can have some short-term gains to build on the long term, right? So I'm not saying completely abandon that. You gotta promote yourself too. Because if and Kobe wants to say, if you're not gonna promote yourself, who's going to? You know, like you gotta be, you gotta promote yourself, but you the way my thought process, you promote yourself by being so good they can't ignore you, right? That's one of my favorite quotes. Be so good they can't ignore you. So you don't have to say your name in the conversation.

unknown 40:44

Yeah.

SPEAKER_00 40:44

You're already doing your job, they know who you are, you know.

SPEAKER_01 40:47

So I've had a thought about sending uh like an Instagram friends message to a small group of people, you included. Just like an inner circle, I feel like uh I could use a little life update with some people that I haven't spoken with a while and just maybe an explanation of uh the time that I've been a little bit underground, just kind of uh rebuilding or grinding, you know. And the second part to that was just uh on the relationship tip, you know, because the people that we work with for a long time have now become friends and some of them family, and beyond the working relationship, there's another relationship, and you know it it's really meaningful or has been in the last year or two, and I'm sure for you too, you probably had people reach out to you at some point in time. And it's interesting when people hear your silence, you know, and those people who reach out when you're not reaching out are real ones, and it wasn't lost on me that some of those people were people that started out as professional relationships. Yeah. And it came full circle of like, man, I'm really it's not like I'm glad I didn't burn the bridge, but as a young doctor or as a a student who's listening, like you said, keeping the long term in mind is more important. Like, I promise, I mean, I don't know, I guess I'll ask you, you probably at some point in time were like, man, it'd be dope to have a Kobe jersey signed. It'd be dope to have him take a picture with me. And he would have gladly, I'm I'm certain of it, you know? Yeah, but you never did that, you know? And I for sure wanted an Antonio Gates jersey signed when I was a young doc and I'd see him in the elevator. Antonio, you were suited up every single time. This guy was suited in the elevator, Louis bag, Louis backpack, whatever his whole thing fitted, matching, cologne out. Ladies, he was smelling good, looking good, like shaved sharp. I mean, I wanted to be like, yo, AG, can I have your jersey after the game? Like, I would love it. It'd be cool to show my dad or show my never did it, dude. That shit would be hella, hella nerdy.

SPEAKER_02 42:57

Yeah.

SPEAKER_01 42:57

You can't do that, you know. But I'm just saying, as we're human too. Like we I had that thought, but really the overriding thought was I'm gonna respect this man. Single person, as soon as this elevator door opens, is going to be asking him for something, a picture, an autograph, this or that. I don't want to be in that category of a fan, you know? Yeah, I am a fan, I respect what you do, but I don't want to be so I just never did. And I'll tell you what, when he voluntarily gave me a jersey, bro, that shit was fire. It was like 10 years later, it was after he retired, maybe, you know. I think I think it was after he retired, but that thing was like more meaningful to me than if I had taken one to him and was like, It was wrong, I got this thing, you know. So I think you impressed that upon me as well. I don't know if that was all me, but I know we've had those discussions in the past of like, hey, we gotta keep this relationship professional, even though we kind of fan out too. Like Bro, Keenan scored three touchdowns on Thanksgiving against Dallas. Like, can I have that jersey, Keenan? I would love that jersey, bro.

SPEAKER_00 44:09

Like, I want to do it. Yeah. But yeah, no, it's it's true. Be respectful, you know, and they appreciate it. I can't tell you how many times, like we said, you know, they they just tell you how much, hey, really appreciate you, you know. And so that's nice, right? Or you get the hug from them, you know? That means a lot, you know. So that's that's that's where it's worth.

SPEAKER_02 44:31

Or that's yeah. That's what it's about.

SPEAKER_00 44:35

But I wanna I wanna uh kind of break our uh break pattern real quick. I I had a patient case, I just want to run by you before we run out of time. Please, please. Is that good? We got a good time. Yeah, let's talk about it. So um, so I have a diver, uh a young teenage uh die diver on the USA team, uh really you know, high level, going to a big D1 school as well. So, anyways, uh so my point with that is knows how to dive, knows what to do. But working through some stuff was on 10 meter the other day, and normally, you know, they enter the water in a certain way and then pull through, right? Well, something happened in her pike where you, you know, you come up. I'm not a diver, but I do know the movements. So the pike position, she came up and was it was off a little. So when she went to get out of the pike, her hands, instead of being, you know, overlaced, she dropped her wrist. Slight movement, just slight movement, not a big deal. I'm showing to the camera for those watching. So instead of hands together, kind of that pattern that we've seen divers enter the water, she just she overcompensated and grabbed her wrist. And then because what you're supposed to do once you hit the water is pull through it, okay? And you do like this ripping motion with your hands. But because her hand was cinched and she had to it torqued her whole side, and as she entered the water, and it really torked her whole uh shoulder on that one side to the point where that evening she couldn't even raise her shoulder to the side or to the front. So abduction or flexion, she couldn't move. But where the so the pain was in the shoulder and in the tricep because in that entry, which is common with divers, when they enter, they're using they're extending and using their triceps and lats. So comes in because she's got this big international, she's flying out of the country soon, and we got to get her ready and uh to compete. And uh so really raw. So the progression was shoulder and tricep, it was where the pain was. She had very limited mobility for one day, next day a little easier, she could raise it a little easier, but really sore. By the third day, shoulder pain was gone, but it was all in her tricep.

SPEAKER_02 46:54

Okay.

SPEAKER_00 46:55

Okay, but and by the time I saw her, she had full range of motion, uh just felt tight and a little off in her shoulder, but pain in the tricep. So, anyways, so that was kind of the uh, you know, with no prior injury or anything to either one, but it made and the she went back to diving just not from 10 meters, and she was able, but getting out of the pool was very difficult, like and you know, because you have to lift yourself up stuff. So, anyways, any thoughts on that? I know what I did and what I told her, but I just kind of any knee-jerk reaction to maybe possibilities or or you want me to tell you what I did, and then you have no let me talk, let me talk it out here real quick, just uh for the audience to kind of have a frame of reference or a thought process.

SPEAKER_01 47:42

One, you said 10 meters, yeah. So thirty feet. Yeah, so that's three stories. So nine point eight meters a second, gravity, velocity. I'm just doing some like physics that I didn't get, you know, an A plus in, but like do do do do do do do, I think that equals a lot of speed entering the water. And the impact, I don't know what that is pounds per square inch or anything like that, but it's significant, which makes sense that you would want to be as efficient when you enter the water versus smacking the water, right? So in that mechanism of hand on wrist, so can you, if you remember, was her left hand on her right wrist or vice versa?

SPEAKER_00 48:29

It was her right hand on her left wrist.

SPEAKER_01 48:31

And which triceps messed up her left one? Right one, the one that's on the right side. Yeah. So you're entering the water like this, wow. And you're trying to do this, now you're here.

SPEAKER_00 48:44

So left elbow, left elbow is straight like it always should be right with sliding bent. I got you.

SPEAKER_01 48:50

Yeah. So your tricep is an extension like you're doing dips. So you enter the water like this. For those who are not watching but listening, my right wrist, my right hand is on my left wrist. If both hands were fully extended in front of me, one hand on top of the other, as I dive, it would make sense because my hands are equally extended, that I could then do this kind of swimming motion and it would be equal. But with my right hand on my left wrist, my right elbows bent a little bit, my left arm's probably fully extended. And now when I go to I guess breaststroke, my left arm's fully extended. So that's all lats, chest, it's this motion. Whereas this here is a tricep extension motion. So I would say that that was probably the mechanism resistance in the water, where normally you're doing this, and you already have developed those muscles through thousands of reps of doing this, and now that same force that's all on the tricep versus the bigger muscle of the lat and the deltoid in the chest. That to me would be that would explain the strain or the pull on that tricep muscle. And so I'd try, you know, just unwind that whole arm if I'm being short about it, but if I'm being specific, tricep insertion, tricep origin, I'd hit the forearms because those are affected. I'd hit the deltoid, definitely the lats, definitely the pec, teres minor, merit major, you know, address all that. But for the tricep itself, I think that that probably got overloaded. It was probably, you know, extended, and then you contracted it as you straightened it, and that was uh probably an overload for that muscle in that quick movement. And so I would treat it conservatively like you would like a sprained ankle, you know, just try to flush it out, try to break up any crunchies, any adhesions, any like little blockages, I guess, in motion. And I'm sure you took it through the whole range, and that's how I would free it up, you know. Grassed in soft tissue, probably just straight hands-on is what I'd prefer in that moment. Find the tender area. And then, yeah, pimp mat, maybe some ARP wave or E stem. Um grasp in it if my hands didn't feel like it got enough. Yeah, I don't know. I know you have a shock wave. I don't know if you use that on it, perhaps. But how did you treat it? And what that that would be my initial thought of like, oh, that makes sense. That's why your triceps shot right now.

SPEAKER_00 51:19

Yeah, no, that's exactly that's exactly the thought process I went through. And your treatment plan was almost right on with everything that I did. So, so I I tested, so based on the history, which tells us 80-90% of what's going on, I had a really good inclination, just like what you did. I didn't have to test it, right? You just you didn't even test anything and you came up with a diagnosis or basically assessment and diagnosis. Same thing. I used, I then I went one step further because I was there and I could do an ortho exam. I did, I tested the different muscles, but I did test all the rotator cuff muscles to make sure I'm not missing anything on top of that. So all the rotator cuffs, the labrum, everything felt good and healthy. Bicep tendon felt healthy. So we were able to rule those things out. The tricep did have a palpable area where it was more dense, you know, so we could feel it. Didn't feel like a tear or anything. There was no bruising, swelling, anything, and it didn't have a divot, but it had like it was just a big hard knot, right? Right kind of in the tricep part.

SPEAKER_01 52:16

Where'd you feel that at? Was that like a pistol?

SPEAKER_00 52:19

Right in the belly, right there, yeah. Right in the yeah, right. In the horseshoe. Yep. So kind of got them all three, just kind of that whole that intersection, yep, right there. Put that away. Yeah. Looked like you got hit by a donkey, man. But um, yeah, so uh so basically did what you said. I started with soft tissue, found the area. I cleared out the anconius because of the entry, extension, and rotation, cleared out the anconius, and then I also um and it was tight, you know, that area. I didn't just clear it out, but beside checking side to side, and I checked everything both sides like we should, uh, and uh cleared out the anconius. That radial head was a little restricted and uh a little more posterior, so cleared that out. Um, and then went up the chain, cleared out her terries group, so uh because she was having that's where she was having a lot of the pain day before was the posterior side. So basically we're that, and if if you can picture where the tricep comes up, the terries comes across, and then the lat inserts right in the back there, right? So a lot of people get so I cleared the I cleared all three of those at the intersection there and um opened that up and then went and then finished with the belly, the tricep belly, and got on there and had her actively do it versus me passively doing it. I got on this and I started down at the elbow and worked up and we cleared out that and realigned the fibers and uh and then I finished with uh Mark Pro and uh PMF and uh red light. So just to kind of get that microcirculation going. And me and you like the PMF. We know PMF will last uh you know up to 12 hours of that microcirculation going. So I know when she's leaving, we're still getting tons of blood flow and oxygen to that compromise tissue. And then uh then um as she was leaving, she turned to me and she had two baggies and and I said, Do you want me to tape it? Because she brought her tape in and she's like, Yeah, do you mind? So we taped it up and uh and uh yeah, so and we got creative with the tape because she had taped it the day before, and uh she and I had never taped it quite like this, but I'm like, Hey, if you're liking that and you want to do that, and then I added my twist to it. Me and you are OG tapers back in the day when uh you know, like we were just talking about kinesiology tape was, you know, nobody was really doing it. So me and you have some OG techniques, and so I I did that and explained to her, but we taped it up real good. Uh it looked like a bionic arm, but she was happy and uh yeah, and then I gave her uh I re reinforced that we need to do a latch stretch, more of an open chain latch stretch. I don't want her to close it and and twist on it, so more of an open chain, no connection to anything. But as she reaches across her face and I push that hip away to get that hip insertion as well. And then um a tricep one that I like is I call it the Egyptian, where you put your for those that can watch, I put my hands together over my head and then I stand straight up, and the biceps should touch the ears. If they can't, that means there's a tricep restriction. So as you press up and you want to keep it, you don't want to be in front of your body, you want to have it pushing back over your spine, keeping your head straight. Biceps should come. That's a reflection on the tricep and lats. So keep the elbows back, elbows back, hand back, yep, and extend. So that's how I have a lot of my divers, a lot of my pitchers, a lot of my quarterbacks clear out their triceps and lats because as a throwing, they're using that tricep and lats. So we just do three pumps, three to five pumps before they even then do a dynamic stretch, doing it that way. So I those were the two main ones, and then the rotator cuff type chicken wing motions that I wanted her to remember. But, anyways, wanted to talk kind of quickly through it, and um, that was kind of what I saw and what I did.

SPEAKER_01 56:06

No, that that stretch is really uh effective as well because as you were talking, I was doing it myself, and I I did some tricep extensions just two days ago and did some pull-ups yesterday, and it's it's tight. Like I can feel that, like this feels comfortable. And I'm like, let me get that, and then like if you were behind me, you'd probably lock that out and get that even a little bit more.

SPEAKER_00 56:28

Like I can feel I can see your your elbows are in front of your like at your eye level, they should be at your ear level. So your elbows should stay at your ear level, not in front. Yeah, I'm tight, dude. Yeah, tight. So that's good though. You clear it out, right? So one of those things, like with my young athletes, they don't even realize it. They're like, oh, I'm fine, I'm throwing. They're throwing all day long, but look at we're short here, right? You gotta lengthen that and think of how much more range. The more length you get out of it, the more power and output and endurance. That's the thing I tell them. It's like I you don't you don't have to be like, I'm just talking about if you want more power out of it and more endurance, so you can last. So the fourth quarter is just as easy as the first quarter. You got to have length in that, you know. We're not talking stretch, we're just lengthening the tissue. Return it back to your norm, right?

SPEAKER_01 57:20

That's no, that's the clutch thing. You know, I had uh I listened to a clip by Tom Brady, and I meant to send it to you, but he was on a podcast and he was talking about his body coach, Alex Guerrero, and he had an adductor issue, and Tom was like, they want to do surgery on my adductor. They're like, Oh, it's tight. We're gonna go in and cut it, we're gonna do surgery. And he was a younger athlete. He somehow got in contact with Alex or had been working with him, and he called him. Alex, like, what are you talking about? Fly out here and I'll get that straight in three days. And the way Tom was talking, Tom, like he's my boy. The way seven-time world champion Mr. Brady was talking about it was it's like exactly what you and I would say, but it came from the goat's mouth. So I I think I reposted it because it's like you might not listen to me or my boy Dr. Glass, but you're probably gonna be all ears if the goat says it. And he was just like, Alex went in there and he explained it like, oh, your adapter's tight, it's shortened, it needs to have its full capacity to lengthen and it needs to have its full capacity to contract. And if it can't fully lengthen and it can't fully contract, you don't have that power in there. Plus, you're gonna be injured. So, yeah, you can go do the stuff. Yeah, it doesn't hurt. That doesn't mean you're optimally primed like a Ferrari that's totally balanced. You got a little wobble in that thing that needs to be corrected. And I used a bow and bow and arrow analogy yesterday with an athlete. Just simply that, like, if you have a bow and arrow and you get that full strength, that means you have that full velocity. But if you're only pulling that bow back halfway, you're not gonna have that velocity. And so, what's the difference between that and your hamstring? He was like, Oh, my hamstring's a little tight. Bro, I took him and he was like, Here. I'm like, you are an elite athlete, allegedly. You need to be 90 degrees. So I said, butt against the wall, feet up, and like, you know, he was still like this against the wall. And I said, we gotta shove that butt to where you're like this, feet 90 degrees, that's the goal. And so, just to your point, that was something that Tom was talking about about how important it is, and just the mechanics of well, how you prevent injuries is to make sure that muscle can totally lengthen and totally contract, and it's not just 90% lengthened and it contracts to 10%, not zero, you know. And so to you and I, it's pretty elementary. I think it's just and I hope more people start to look at it that way, because I still see people that correlate dysfunction only if they have pain. For the lead athlete, I'm telling you, you can have a lot of dysfunction without having any pain. Right. And in fact, you should go in to get assessed while you're not hurting to find out what things you can improve so you don't get hurt. And if I was a medical rapper, that'd be a ball.

SPEAKER_00 1:00:08

Let's put it to some music. I want to finish up with something relevant. I mean, we got a couple relevant things, but I I I want to talk as I think some listeners, just on our perspective, because this is second opinion, and yeah, but I don't know if you uh saw the um McGregor Holloway fight. Uh yeah. Yeah. So did you see it or saw our clips?

SPEAKER_01 1:00:29

Yeah, so I actually was watching it, so I saw it happen kind of live and uh beforehand, but what were you gonna say about it?

SPEAKER_00 1:00:36

Yeah, so I just um, you know, some it was I mean, he's got he's very controversial right now. So besides his human side and the other side, I'm just talking from an athlete. I felt bad from him from an athlete standpoint, from a yes, from a just competitor standpoint. That's what I felt bad for. Coming back from his 2021 broken leg, training hard, he wanted to perform and come out strong, right? And uh for him to have that moment and he had a game plan in his head, and as soon as it didn't go the way he wanted to, we saw what happened, right? And uh, but that's how quick it can happen. And he was in very good physical shape to the point to to let all our listeners know this is an elite athlete in the best shape, and he didn't make even contact, and he injured himself. So it can happen, you know.

SPEAKER_01 1:01:30

Yeah, you know, so you know we saw it in the Super Bowl with uh Greenlaw, I think it was on the 49ers right before halftime. He was bouncing on the sidelines and blew his Achilles, like what a freak thing. Same thing with McGregor. And you know, I had a thought if you and I were watching TV together, when he was stepping into the ring, he took off his sweats and took off his shoes, and he kind of stepped on his foot, stepped on his shoe to like, you know, take his shoe off one foot and then stepped on his shoe to take the other shoe off. You know how you kind of put your foot on the heel shoe, and then he took his sweats off. But what I noticed before he went in was as he was doing that movement, Dustin, he was stumbling, you know, like he went to take his shoe off and he kind of like lost his balance a little bit, and then he took his other shoe off, and I was like, oh, that's not very good balance, you know. Like he kind of like looked a little bit unstable, like he was on like a foam. So it was just a little mental thing where I was like, that didn't look like I'd expect him to be stoic and still, you know, and he was a little and then the other thing happened, and it just made me wonder, I'll never know, but I wonder if he was having something that felt abnormal to him prior to that flying kick that it looked like he just landed in a very awkward, unfortunate way, you know?

SPEAKER_00 1:02:41

Yeah. He was he was pretty adamant because people brought that up, and I think I watched the whole post commentary too, and they actually zoomed in on that and and talked about that and um about what you were just talking about. That little stutter step. Um so they they talked about that, and then the speculation was he came into it kind of injured already. Yeah, and he's been very adamant that he was not injured, he was fully go. But I saw that too, and he did do a little stutter, like um either something something was off on that, because it just didn't it didn't look right, but whether that was just he'd stepped on his pants a little weird or on it, you know, who knows? But it did look a little off, and it just didn't help that then he injured it, uh, because that could have happened and nothing happened, and we wouldn't have thought anything of it. But but these guys are always training hard, always feeling something. So in his mind, it might not have been anything, you know, but could have been significant from a biomechanical standpoint, right? To your point. So it could have been a biomechanical weak link in the area that he didn't take note of it because it wasn't necessarily a pain that he thought about pain, might have you know registered to his brain. Because it's I picture our bodies like uh we're a pilot going into the cockpit and we're pre pre-flight check. We have to go through all these checks and balances to make sure everything's ready for our flight, right? Well, that's our brains doing that constantly, checking every joint, and we got receptors everywhere, seeing what's working, what's not. So, you know, and it will give us feedback. And a lot of times as athletes, we ignore the feedbacks because it's not gonna help us in that moment. So there could have been something. But, anyways, I found it interesting because before the fight, I even just did I looked up the fight um between the two, wanting to know if they had ever fought together, what was the outcome. Okay back in 2013, that was the only other time they fought in 2013, and they both fought and um McGregor won. But in the second round of that fight, which I don't know if a lot of people know, he tore his ACL in that fight.

SPEAKER_02 1:04:38

Wow, I can do that.

SPEAKER_00 1:04:39

Okay, yeah. So in 2013, he tore his ACL in the fight. He finished the fight, but he had actually a terrible triad. He from what I read, he tore the meniscus and the collateral ligament as well in that 2013 fight. So it was just kind of really it was in the other leg, it was in the left leg. Um so, but it was just unfortunate that, and we don't know that I looked up this morning, they still haven't fully reported, like an actual report what the actual injury was, because he's got another fight that he's got a fight in, and so I don't think they want to report what the injury actually was, but he is going in for surgery, so it was definitely something significant. But the what the mechanism looked, it looked to me like ACL based on how you couldn't put weight bearing on it.

SPEAKER_02 1:05:25

Yeah.

SPEAKER_00 1:05:26

Because like like I've had meniscus injuries, you've had ACL injuries. I've had patients come in with ACL tears where they came in, they're like they walk in normal, they're like, I'm fine, nothing's wrong. But every time I go to bend or do this, my knee just gives out. Yeah. And that's and I've seen that multiple times. There's no pain. So a lot of people would dissociate, oh, you tore something, it's got to hurt like hell. Meniscus hurts like hell. It's like a pinch, like it's a different feel. Yes. You know, collateral is a different feel. Whereas ACL could give that give out. Like he didn't linse or anything, he just gave out. He was just giving out. He wanted to compete. He wanted to get back into it, but it would just give out. Like the light switch was turned off. So that that gives me the impression that it was more ACL than meniscus or collateral ligament. For sure. I do I do know a lot of the other medical people are saying that they speculate that it might have been meniscus or MCL based on the inward motion of it. But but the bait we his pain level and the way it just gave out tells me more ACL. What are your thoughts?

SPEAKER_01 1:06:30

Yeah, no, same thing. I mean, I I don't think those other people are wrong on the speculation. We're all speculating until we have an MRI, but like it, yeah, you look at the mechanism injury on slow-mo, there's like a you know, a lateral, the knee bows, you know, one way, and so you can deduce, like, okay, that's probably an area that has sustained damage. But what was telling to me, you know, at first it looked like he slipped on the kick, which is where he tore it on replay, and then he got back up and he's, you know, it looked as though he slipped again. It's like, well, is that Matt really wet? Is there blood on it? Is it dew? Like it just didn't make sense. He seemed like a brand new deer, you know. And then for me, what was telling where I was like, oh, that's his ACL before I saw the replay was the third time where he tried to step and then he kind of picked his knee up, and he looked just like, dude, that was too familiar, bro. That's like that. It is not there, you know. And you saw him, he was like, oh, like he kind of grimaced and he knew and he was hot. And the ref was like, it's a wrap. Like, that's it, you know. And it's like you can't, you literally can't. The only person that I know is you mentioned Conor McGregor, tore his in the last. So that is amazing that he continued that fight. I didn't know that. That's savage. And one. And one. I'll bring up Philip Rivers who played in an NFC AFC championship game with the torn ACL back with LT, and they lost that game. But he had a torn ACL, bro. He played quarterback.

SPEAKER_00 1:07:52

I don't know how you do that. When you backdrop like that and you know, backstep and then have to plant on that. No way.

SPEAKER_01 1:07:58

Phillips one of my favorite quarterbacks, and I don't know him personally, but just his cowboysm, his like down-to-earthness, his I don't cuss, his intensity. Like I just love so much about him. He's one of my favorite QBs just because of all that. And the amazing, you know?

SPEAKER_02 1:08:14

Yeah.

SPEAKER_01 1:08:14

But yeah, for Connor, getting back to the point, it's some people are like, oh, it's over and it's done. Listen, shut up.

SPEAKER_02 1:08:20

Yeah.

SPEAKER_01 1:08:21

Don't tip on, don't tell an athlete when they're done. Like you're on your couch sipping a coarse light. Like, shut up. Don't tell. I mean, you have your opinion. I don't I mean that, you know, yeah, in the biggest of ways, but like I hate it when people put limitations on other people, and I hate it even more when people tell athletes, like, oh, you're all the athletes I know and you know are already outliers. People sometimes tell me I'm delusional about stuff, and it's like, well, one, I've done things that people said I've never could do before. So once you've done that, like I've had a taste of the blood, like I know I can. So, like, you never have, don't tell me what I can do. But two, these guys are already in the 1%. They're already the elite of the elite. They've already beat the odds. You can't tell somebody who's beat the odds many times that they're not going to beat the odds again. Yeah.

SPEAKER_02 1:09:08

Right.

SPEAKER_01 1:09:08

And his tweet was like, I'm going to be back. And even if he doesn't win and he's not the same karma, dude, I respect him coming back after five years, being older, putting his reputation at stake, having a lot to risk. It's all downhill if you're a legend. That's a competitor. And for him to be like, I don't want to go out like that, I want to come back and at least compete. Even if I lose, I don't want to go out on an injury. I I can understand I want to compete and get beat versus go out on an injury. Bro, I hope he does come back. I hope he does fight again. And I'm not a huge commoner fan like that, but uh, I'm a fan of the comeback.

SPEAKER_00 1:09:45

Yeah, me too. Yeah. And talk about a comeback. So we've known people that break their uh fibula. You know, that's a pretty common bone, especially MMA, um, because like your opponent goes after that fibula and uh tries to break it to get the peronial nerve. Dude, broke both bones. Savage. That was five years ago, 2021, and he came back. So a guy that knows how to come back, that's one that's hard to break both bones.

SPEAKER_02 1:10:22

Yeah.

SPEAKER_00 1:10:22

You know, um, and so yeah, that was in his left as well. So his that whole left side, now he's got this right side issue. So but uh yeah, I think he'll come back. He's he's too pissed off to go out like that. There was so much riding on this, you know, and so much, you know a lot of hype. Yeah, hype that you know, he's not like that. He yeah, yeah.

SPEAKER_01 1:10:44

Well, it uh it remains to be seen like what his you know road to recovery looks like, but we'll follow it and bring it back up again.

SPEAKER_00 1:10:56

One last thing on that. Shout out to Holloway, because during that fight, he kept looking at the ref like he knew something was up, and he was like, I don't want to, you know, he could have just shut that off and just gone pound when he when McGregor was on his back vulnerable. He could have just taken advantage of that and made it a bloody scene. But he kept like, you know, what what should I do? I don't want to do this. So I I just thought that was really good sportsmanship, you know, you know, because at the end of the day, they are they are competitors, they are, but they are, you know, humans and friends, I'm sure, in some way, you know, not friends like buddies that but they respect each other. That's what I should say.

SPEAKER_01 1:11:34

Yeah, look, there's it's a rare breed, you know, whether you're in the NFL, you're in the NBA, you're a UFC fighter, like when you're in, you could be an emergency room doctor, like when you're in your with your people, your colleagues, there's a respect there for sure. And no, that's a great point on his sportsmanship, because he it's a savage sport and he could have been savage, you know, and really like and uh that was a class move on his part, you know, for sure. Yeah. Um well hey Dustin, I could continue with this for a while, but I have to be in Monterey in a few hours. It is kind of a go time for me, but I appreciate the time this morning and always a good discussion. We went a little bit long, but that happens just because we get caught up in combos. And uh yeah, I think we covered some good topics, and hopefully it was something that if someone's listening to it on a commute or while they're doing their homework or something, that they gain some some value. Um, I you probably should say this is the beginning or the middle and not the end only. But if you enjoyed this episode, share it with somebody. Please like or follow. We're trying to grow our audience and yeah, just reach more people and educate as many people as we can. So we do appreciate you listening. And uh, I know I've told you this before, Dustin, but every time we do this, it's one of the better parts of my day, one of the most fun parts of my week. And I look forward to the day where we can just do this every single day or full time. And uh yeah, it's been fun, dude. I'm gonna think about this conversation on my drive today.

SPEAKER_00 1:13:01

Yeah, I agree. Thank you for making time. Yeah. Appreciate it.

SPEAKER_01 1:13:04

No doubt. I think there's something I want to talk to you about on the personal side, but I'll hit you maybe on my drive back from Monterey tomorrow.

SPEAKER_00 1:13:10

Sounds good.

SPEAKER_01 1:13:11

We can catch up on that. But any last words or thoughts before you go?

SPEAKER_00 1:13:15

No, let's just let's get out there and make it a great day, huh, everybody?

SPEAKER_01 1:13:19

Yeah. I think uh somebody said to me a couple days ago, how'd you wake up this morning? And I said, uh, I was okay. I wasn't like super tired. I I probably could have used a little more sleep. There's a lot going on, you know, and we were kind of comparing notes about where we were at. And he goes, Oh no, how'd you wake up? And I said, Oh, just yeah, well rested. He goes, Were you happy or were you like sad? I go, Oh no, I was, I don't know, I was kind of like indifferent to be honest, you know? And he goes, Tomorrow, wake up excited and see what your day brings. And I said, Huh, all right, yeah, I probably should wake up excited, why not? I got my own practice, I'm gonna go see people I love. Like, yeah, I should be excited. Why am I not waking up with some enthusiasm? So I channeled some Jim Harbaugh and was like, I'm gonna wake up with some enthusiasm unknown to man, and like, which is another reason I like coach, he's always like just juiced up, you know? Yeah, and that energy is contagious, and so I did wake up a little excited the other day and tried to bring that to the people that I saw. So to you, I say, uh, be excited about your day, Dustin, and you know, share that energy with somebody today.

SPEAKER_00 1:14:25

Sounds good. Well do, bud. Thanks for the reminder.

SPEAKER_01 1:14:27

Yeah, all right, my brother. I appreciate you, bro, as always. Be safe when you're commuting to all our listeners. We appreciate you. We'll be back next week. And uh yeah, please share any comments or thoughts you have. Love to have discussions that are pertinent in the moment for things that are on your mind, or if we spurred some thought, share that with us. We could continue that as well. Yeah, one last time. Thank you, Dustin. Thank you to our listeners. This is a second opinion, we're a sports medicine podcast, and I'm Dr. Dokel. I'm Dr. Glass. And we will be with you guys soon. Everybody be safe, take care, try to brighten somebody's day, and we'll be back with you next week.