How to Eliminate Pain, Heal Faster, and Perform Better - With Dan Swinscoe

26:47Maybe there's some scar tissue there that now because workload got a little heavier, the scar tissue was there and previously you were adapted with that just fine. But now because you've been spending 12 hours a day in a chair that maybe now you no longer can overcome both of those two little imperfections where before you could. I had a lady I'll never forget I couldn't tell your name if my life depended on it but I remember her story so well I was having her see me what I was expecting to be her last visit she was doing great I gave her some time on her own check back with me in three weeks or a month or whatever it was and this was that day and she came in and she was a mess and I it blew me away that she was hurting so bad and I'm like did you you know I'm running through all the questions of all the things right that we knew were problematic for you and I'm like and I just threw it out there like what about stress and then all of a sudden her face changed i'm like oh do you remember something she goes my mom died last week so um stress is a pain amplifier i've seen that over and over and over again so for the person who maybe they had something a long time ago if there's those you know mental emotional as much as we want to say mind and body are separate they 100 % are not um and so maybe something like that you know there's there's always a reason though my favorite reason for someone coming in is to tell me there's no reason because that means I have to sleuth and

28:05Shawn Stevenson:the sleuthing is the fun part right yeah so you're you're a body detective man exactly this is an important point and thank you so much for this every single person listening please remember this how impactful stress can be on our biology right we tend to think that it's this is calorie free, it's invisible, and it doesn't really affect us like that. But we know every single part of our physiology can be impacted by stress. For sure. With that being said, maybe the site again, that of that old injury, maybe it's a back injury that happened, maybe it's a knee injury, maybe it's the shoulder, but you're experiencing some life stress, or maybe again, maybe it's not an acute thing, maybe it's just a chronic buildup of things that just went unprocessed, these nociceptors, right, that we have in our tissues that transmit pain, it can literally kind of activate.

29:01Shawn Stevenson:It's like a channel that can activate and express pain. One of the things that we know today is that psychological stress can increase inflammation in the body. Amazing. In a myriad of ways. And so again, we might be in a situation where we're chasing, if nothing happened, I didn't do anything, but why am I in pain? And having the investigation capacity, get your pink panther on and look into your body. And to be honest, what's going on in my life? Like, am I experiencing a buildup of stress or am I not processing things? Am I moving too quickly? Am I not moving enough? You've got to be your own detective.

29:36Yeah. You just reminded me of another person I worked out that long ago that we were helping recover from back pain and we were starting to get deadlifts going a little bit heavy. And he's like, Hey, you know, I'm kind of feeling that in my back. I'm like, what does feeling that mean? What does that mean? And basically what described is muscular effort, right? But he, that his brain is very sensitive to stress going through that part of him. And I think it was just sending his brain a little check engine light. That's the example I use sometimes. I said, well, your form was perfect. You have any pain during, but now your back's just sensitive.

30:07Yeah. I said, that's probably what that is. And he goes, you feel confident about that? I said, yeah, do you? He goes, I think so. And we kept going. How's your back? I'm fine. It's just, sometimes the nervous system just checks in and says hello, right? And you just have to sometimes use reasoning about like, okay, you're under some load here, but you're managing it perfectly. I think anybody who understands how to deadlift would look at this person's form and say that that's really good form. And they didn't feel anything anywhere they weren't supposed to at the time. But obviously when you deadlift, your back muscles work, right?

30:37That's a good thing. But if in the past, whenever his muscles had that contraction, maybe it was from a straining kind of experienced something. I said, you know, just if you feel good about it, I feel good about it. I'm not worried about you here. If you're willing to keep going, let's keep going. And he just felt better and better and better as he went. Awesome. Yeah.

30:52Shawn Stevenson:All right. If you could, and the thing is, since we don't have somebody who's a patient right in front of you, that's dealing with a very specific issue, this is kind of holistic. We're looking at overall insights, right? And so somebody's recovering from an injury, right? They experienced an injury, they come to see you, I don't want to put a label on it, but I guess, again, we got to kind of use an example. But maybe, again, it's a lumbar issue. Okay. The reason I'm thinking about this, Joe Montana. All right. I just watched a Joe Montana documentary, which was fantastic. I haven't seen it. I'm going to have to go find it.

31:29Shawn Stevenson:I think it's on the Peacock. There's so many apps, by the way. Right. I know. It's so well done. And there was a game where he felt something during the game, ended up being a disc injury. and he had back surgery like almost immediately and the prognosis was he'd be out for the rest of the season we'll just say like this was like week two all right and there was no rush but in his mind there was because he knew who was on the bench behind him right exactly good that guy he came back seven weeks later i don't remember that but that's weeks i had no idea yeah it's something like that you know he was art white and the san francisco spine institute were the people as I recall, that took care of him.

32:10And they're kind of the beginnings of what we understand as stabilization exercises. Now that was kind of ground zero. Come on. You see this? Yeah, there you go.

32:20Shawn Stevenson:So early on, he was very low. He was very depressed. He didn't want to, right? He was afraid and also he was apprehensive to do stuff. And somebody challenged him to like, if you say you want to do this, do it. Right. And then you see like clips of him training in the pool. Ah, there you go. Right. Being able to build that confidence. And again, long story short, him coming back from this back surgery seven weeks later is insane. Yeah. But it was possible because not only that, he came back and he performed at a high level. For sure. Right. Yeah. And so with that being said, what are some of the principles when you have a patient that's coming in, they're lacking confidence, they're afraid, like you just mentioned your guy doing the dead lifts, what are some of the steps that you're taking to build their body back and also to build their confidence back?

33:12Give you a couple examples. The person who walks in crooked, like you feel sorry for them to have to get in their car, get to you, get out of the car and physically get to, because you can see every movement is just agonizing for them. some basically Stu McGill oriented training of you use the same principles we would use in training like for powerlifting like to lock your lats and spread the floor when you squat and things like that if you're in agonizing back pain I say hey Sean are you expecting your back to hurt when you stand up out of that chair yeah and let's say you're not a weightlifter and you're you know you program computers for a living or you sell widgets or whatever and you don't know you don't know those cues that are really common in the world of weightlifting.

33:56I say, okay, here's what I want you to do. I want you to try to pull your arms down like this. Can you do that? And you do that. You see, you feel how that makes things tight? Yeah. Now, as you sit up, do that as hard as you can. How's your pain? Is that better or not? And we just start doing cue after cue after cue of bracing from lat, abs, glutes, frontal plane, glutes, transverse plane. We do whatever we need to do till he gets up and goes, oh my gosh, that didn't hurt. And I a hundred percent expect to have him say, oh my gosh, it didn't hurt or way, way, way better. And so when I get that and I say, okay, now we didn't change anything about your spine, but we just gave you a little bit of external support.

34:33And I'm not saying you're going to live your life this way, but right now when it's agony to get in and out of the car, it must've been agony to get dressed, agony to get off the toilet. Daily life is very painful for you right now. This is how you get through daily life. And then I teach them how to hinge so they can use the sink, you know, wash their face, contact lenses, all that sort of stuff. And so for my people who are like the worst of the worst, I just treat them those principles. I don't measure their range of motion because it's going to suck. I mean, you can see them from 20 feet away that these people can't move without pain.

35:04I'll do a quick neural screen because I want to know if they got any weakness, if they've got any sensory loss, if the reflexes are gone. But that's really the only true evaluation I do with them. For people who are really miserable, I allow them to make day-to-day life their rehab. I teach them how to get in and out of a chair, how to roll out of bed, all of those things without the pain. And I use as examples, if I have a bruise on my arm and I hit it and then I hit it again and again and again and again, my arm is going to become so sensitive that I hardly have to touch it and it's going to hurt like hell.

35:35And I know if I glance on my arm, that's not harming me. But I also know that tissue got so sensitive that even the tiniest bit of force freaking hurts, right? And when you can explain it to them like that, now when you lock your lats or do whatever technique I taught them, whatever one works for them, I said, that's one more time you didn't hurt the bruise. And if you can go all day hitting that bruise 20 fewer times, that bruise can go away. And then as you no longer have to be so deliberate and so careful with these little movements, then we just really get rocking. and that's how I would take that person to give them confidence because I now just gave them the skill where they can do the things that before were agonizing and now are immediately way, way, way better.

36:21That's a big deal. And so I like doing that with them. For the people who are like, yeah, my back hurts. I don't feel like doing, you know, I'm not going to the gym now or I just go and I walk on the treadmill. I don't lift or, you know, those kinds of people where their back pain is an annoyance but not an impediment to life. If they didn't tell me the back hurt, it wouldn't be obvious. Those are the people where I ask a lot of questions. That's where I'm concerned about. Does your big toe move well enough? Did you break your ankle 10 years ago? You know, any of those sorts of things, because it all connects and works its way up the chain.

36:51And when people fill out, like, our, our, you know, every place you go, fill out the little form, right? The little, tell me about your past medical history. Well, what I've come to learn is you fill out what you think is relevant. You don't want to fill out that form. When I'm there, I don't want to fill out that form. So I don't trust that you filled out everything I want to know. So I'll look at that form and say, oh, you had ACL surgery in high school and you take a statin or something. I don't know. I shouldn't say that because that's an old separate can of worms, but whatever. You know something about, yep, and that's all your medical history.

37:21Okay. And then what I do is I start the feet and I start asking, so how are your feet? Do your big toes move well? Do you have any plantar fasciitis? Wear orthotics? Oh yeah, I've got orthotics. Oh, who gave them to you? Oh, so and so. What for? I have plantar fasciitis. Do you still have it? No. You still wear the orthotics? Yeah. Think you need them? I don't know. All right. How are your ankles? Ever sprained them? Play basketball? And I just work my way up. And when you start at the feet and work your way up, I just do that so I don't forget something, right? And so for me, it's ground up to make life simple on me.

37:48So I forget. But when you ask very specific symptoms about people, you realize, you know, they said that they had an ACL surgery and that was it, but you find lots of other stuff so often. And that's what I love about my practice in Arizona now is I've got more time than what I heads is I no longer take insurance. So I don't need to interrupt you to get to kind of the chase. I'll let you tell your story. And then I'm asking even more. And the value to that is, is remarkable. And so now when I know that you've got bad feet and you've been wearing orthotics all the time, that lets me know how you and gravity are starting to interact with one another, you know, ask about your shoes and, and you just work your way up.

38:25And so if you've got back pain and the person that you're seeing only asks you questions about your back and, you know, only gives you exercises that look like they're just for your back. There might be more out there and just recognizing that things from far away can make a difference to where your pain is. There's a guy, his name is Carl Leavitt, looks like Carol Lewitt, but it's pronounced Carl Leavitt. He who treats the side of pain is often lost. And I like using that quote a lot, not to say that you can't or you shouldn't, but boy, if you only look where they tell you it hurts right here and you only look right there, you're going to miss stuff without question.

39:02So just being able to take the time and branch out and ask a lot of questions and investigate movement and recognizing how things should work together. And when they don't, oftentimes that's your source. Yeah. But there's always a reason. Yes. Yes.

39:16Shawn Stevenson:There's always a reason. And very often it's not the reason you think it is. Right. Yeah. You know, this gets me thinking about Dr. Ellen Langer. One of her labels is like the mother of mindfulness. You know, she's run more experiments on the power of the human mind affecting your physiology, affecting your biology than anybody. And also all of her incredible students have gone on to create all these incredible studies as well, like Alia Crum out of Stanford. But I'm saying that to say that the most important part of this is your mind. And that's one of the things, the emphasis on therapy part with physical therapy, because one of the things that you did for me was to reestablish my confidence.

40:02Shawn Stevenson:And it happened so quickly because I was super uncomfortable doing a very simple act, right? Just, he was like, touch your, go ahead and touch your toes. I was like, whoa, whoa, whoa, whoa, whoa, whoa. I know my spine looks great now, but you know, I just, I don't want to, I don't want to irritate anything. Everything's going so well. I was afraid. Hyper protective. Yep. Right. And once I did it, it just was like, wow, I did it. Like, but just you giving the cue. And also there was a patience that you had for me that I can't really explain. Like you, you said, you made me confident that I can try.

40:42Shawn Stevenson:Right. And it was okay if I, if it didn't go the way that I I didn't want it to go. But also it reminded me too that I was, again, I was looking for pain. I was looking for a problem rather than like, yo, I feel really good right now. Right. It's been a significant amount of time. I'm doing all these other activities, but I'm afraid to do this simple act right now. And so can you talk a little bit about that, about helping people to reestablish that confidence? Yeah. Yeah. You just reminded me of whether you think you can or whether you think you can't you're right right um it just yeah i mean there's nothing wrong with bending over and touching your toes i mean we can argue all day if you want to do that under load um i'm a i wouldn't do that guy but you know i know you can train for right you can train for anything um you know the people out there over the minutia of something like a jefferson curl or whatever but um for that typical person um bend over and touch your toes if it causes you pain then you know you You can bend over to some degree and then just have to figure why can't you get further than that?

41:47You know, it's generally speaking, no load, no injury, right? And so you shouldn't be afraid to move your own body through space, especially when you do it slowly and carefully. The body usually will whisper before it screams. So if you go slowly and you start to get some signal, what I'll tell people, if the pain is small and it's acceptable to you, whatever that means, because it's yours, not anyone else's. So nobody else's opinion matters. But if it's acceptable to you, breathe your way through it and see if it doesn't get a little less on an exhale. And then go a little further. It'll probably talk to you again.

42:23Well, you breathe again and you might get a little bit further. And then just come out of it every so often and just kind of make friends. There's more than one way to touch your toes. You can try it in standing. You can try it in sitting. I had a guy one time coming to see me for his back. It was kind of fun with him. Ask him to bend over his toes. his toes. He got somewhere past his knee, not very far, you know, obviously didn't go very far. And I said, what do you feel? He goes, my hamstrings are really tight. How often do you stretch them? Every day. For how long? Years. I guess you don't need to stretch them then.

42:54What are you talking about? They're tight as hell. You just told me you stretch them every day for years. If years of stretching every day didn't get the job done, I'm not so sure another day is going to make a difference for you. And he wasn't able to get that. And I said, so I took a gamble, but it worked. I said, sit on the floor with your legs in front of you. And he went out, touched his toes without a problem. I'm like, do you realize what you just did? No, what? I'm like, dude, you just touched your toes. You just told me you couldn't do that because your hamstrings are tight. Wait a minute.

43:22Right. And it was so funny because it was, he just didn't even get it. I'm like, so when you're upright standing, your brain is afraid you're going to fall on your face because you're not shifting weight effectively. But when you're sitting on the floor with your legs long in front of you, that concern is gone. So you were able to demonstrate the flexibility that you actually have. You can't demonstrate that in standing, but that ain't a flexibility problem. That's your brain saying, whoa, whoa, whoa, whoa, pulling on those hamstrings back there. We don't trust you. So it created a perception of threat.

43:51And if a threat is perceived, it may as well be real because you act the same way. You know, now that I live in Phoenix, I'll use the example, if we go for a walk and there's a stick on the ground and I think it's a rattlesnake, I'm jumping as if it's a rattlesnake. It was never a threat to me, but I sure as hell thought it was, right? And so even if something has no chance of harming me, if I believe it will, I'm going to act accordingly. So sometimes when, especially if the original injury was a flexion-oriented activity, we've all got a little PTSD for that plane of motion, right? So sometimes you just have to help people get it in a different way.

44:25But I have every expectation. It's a norm, right? I use an example sometimes, you know, if you don't graduate from high school, you may very well have a wonderful life. You just made it harder on yourself. If you can't touch your toes, you can still have a wonderful life. You're just making it harder on yourself. It's a norm for a reason. And so let's look to establish that norm.

44:43Shawn Stevenson:Yeah. Yeah. You mentioned this a little bit earlier, but a protective response. Right. And so often, and this is one of the things that I wanted to ask you about. when we have that protective response, we tend to treat it like an injury, like I'm injured, something is seriously wrong. And you advocate for us to treat it like a protective response. Yeah. We use the term muscle guarding, muscle guarding, your body's doing this for a reason. Let's investigate why versus putting all of our chips in, like you have a severe injury because that is very likely going to make that process of getting well so much longer.

45:20Shawn Stevenson:For sure. Without question. Yeah. You're kind of validating your own fears. So what do we do instead? Baby steps, right? So, you know, depending on the level of confidence of the person and level of disability by their pain, you know, you can think what plane of movement feels like it's okay to you. What plane of movement is the scariest? We're going to get there eventually, but why pound or square peg and around hole on day one? Right. So, um, also depends where are we on the journey for this person too. Right. But, um, if someone comes to see me, and they have a history of a lot of pain, but not a lot of damage per se.

45:55You know, with my job, I'm going to compare your active movement relative to your passive. So let's say you are in agony and you can't, like you just touch your toes because it's so common. You can't touch your toes at all. You stand and you're like, oh my God, oh my God, oh my God. Like you just, you know, a lot of questioning whether or not this is a bad idea and everything. I'm like, okay, okay. We don't have to do any more than that. Why don't you lay on this table for a minute? And then I can bend their knee towards their chest. Well, that means their hip is capable of flexing. You know, maybe I can bring a straight leg raise up.

46:24Well, there's your hamstring flexibility when there's no load on it. Compare the other sides. And then if I can do that, I say, check this out. What? Because they're just laying there kind of zoning out. Most people don't pay too much attention. And I bring their leg up to a 90 degree angle with a straight leg, which requires a lot of hamstring flexibility, right? I said, look what your hamstring can actually do. Oh, really? That's good. I didn't think I could do that. Oh, right. And then you do the other side. And then, so then all of a sudden Now they see that the parts are okay if you separate them out and I move it for them.

46:54And when I say, you know, if your hamstring didn't have the flexibility, not only would you not touch your toes, but I'm not able to do this either. Right? And so you just start finding different ways by looking at passive movement versus active. And same thing if people like say they can't twist. Oh gosh, I can't twist. That really hurts. And you know, you see it all over the face. There's a lot of apprehension. They kind of give it a go because I asked them to, but then you put them on a table and you can roll them all the way around a corner. and I say, you recognize what we're doing here, right?

47:21Like if you're on the table and I do it for you, you actually rotate pretty well. It's just when you're standing, you can't. And when you start explaining them to that, you say, okay, can we think of this more as a software problem less than a hardware problem? And that's usually when the confidence and they start kind of, oh, you're connecting some dots for me a little bit here, right? And then you just challenge them in a way that doesn't feel scary to them, whatever that is. And I'll bring it all the way back to just diaphragmatic breathing if I have to. and then we'll build it up from there.

47:48But you just regress to the level of their comfort and progress back out from there. But you can always do that. If you grew up anything like me,

47:56Shawn Stevenson:you had your fair share of candy bars. Nestle Crunch, Snickers. Milky Way was my top joint. Butterfinger, when that came out, that was crazy. Bart Simpson was the mascot, all right? These candy bars were undeniable. These and many others. And so when I was trying to get healthier, I pivoted away from eating these childish candy bars. And I'm going to eat these cereal bars, right? I'm going to have these very mature cereal bars from like the Quaker folks and from Kellogg's. This is a much healthier choice. But little did I know or understand at the time, we're looking at sometimes equal amounts of sugar, highly refined, ultra processed.

48:42Shawn Stevenson:now they're these quote cereal bars or these food bars that are these ultra processed forms of trickery now the thing is the convenience factor is real having that bar on the go is such a valuable thing in today's kind of fast-paced world but is there anybody doing it right? Is there anybody who are utilizing whole foods ingredients and making sure that the bars actually taste good? Well, the food bars that I always keep on hand, that I travel with, that I even keep here in the studio for my team and for my guests, not only does it have eight plus organic superfoods and collagen rich, 100 % grass fed bone broth protein, there are no added sugars or sugar alcohols and four delicious flavors including red velvet, lemon meringue, dark chocolate chip, and apple cinnamon.

49:47Shawn Stevenson:Flavors that are reminiscent of the vibes that I was looking for, that I grew up with, but without all of the ultra processed ingredients. These are the superfood bars from Paleo Valley. Go to paleovalley.com forward slash model right now and you're going to get 15 % off their incredible superfood bars. And on top of all that, you're going to get 15 % off storewide. They've got some of the very best supplements in the world as well, including their essential C formula, their turmeric complex. These are supplements that I use on a regular basis. no binders no fillers no nefarious stuff just the very best ingredients possible head over to paleo valley.com forward slash model that's p-a-l-e-o-v-a-l-l-e-y.com forward slash model for 15 off and now back to the show so one of the big takeaways already for everybody is and this is going to be Captain Obvious is to do what we can.

50:50Shawn Stevenson:For sure. To do what we can. And we're going to be shocked oftentimes when we put our bodies into different positions, how we can do things that we can't do when we're in other positions. For sure. Right. And so again, then that's going to give you some feedback, but that this is a protective response and your body's like, when you're in this position, I don't feel comfortable letting you do that thing. Right. Right. And I wanted to ask you and just circle back a little bit when somebody, and I don't know if there's any data on this, I kind of do, but of course you do. When somebody is dealing with, we'll just say an injury on one side of the body, right?

51:29Shawn Stevenson:So it's one of their legs is injured or one of their arms, one of their shoulders. Is there any benefit to training the other side of the body yeah absolutely dealing with that yeah so let's say my shoulder surgery i'm in a sling not allowed to do anything well if it's my shoulder i still got shoulder blade right i still might have some spine and i can ride a bike i could press and pull it's where i think you're probably going with i think you know the left side of your brain takes care of the right side of your body and vice versa and there's some small amount single digit percent i don't remember the number anymore.

52:04It goes back a very long time from PT school, but it's 7, 8, 9%, something like that. So if I'm, say, for my shoulder, I'm doing a one-arm bench press and I'm working hard, it won't work with a light load. It has to be a challenging load. So I've got a challenging load, like say 5RM or something of that nature. There's going to be so much effort for my 5RM here that there's going to be a little bit of crossover there. So the brain is communicating to those same muscles, even though it's in a sling and I'm not doing anything. And interestingly enough, with visualization, that's a big piece to have people say, Hey, I know your arm can't move, but I want you to do this.

52:44And while we're pressing at this in your mind, you're seeing both arms do that bench press, or I know you just had back surgery. You can't, you can't move, but in your mind, I want to see you walking as gracefully as you ever have, or you, I want you to see you swing in the golf club with the best swing you've ever had. And because when you start envisioning those things, the parts of the brain that make it actually happen are coming to life. And so we want to take advantage of that. So anything you can do like that, again, doing nothing is never your best move. Never say never, but very, very seldomly.

53:13And I hope no one ever listening to this is in that position, but by and large, there's almost always something you can do. And, you know, if you've got one leg in a cast, like you're, you know, leg pressing or whatever you can do, try to get a pistol squat, something like that, there will be some benefit of doing that. It's not huge, but it's better than nothing. And that's what you got when you're doing nothing.

53:31Shawn Stevenson:Oh, man, this is so good. Thank you for bringing this up. You don't know this, but we actually, as of this recording, the episode is out, but we just did an episode. She's Nike's first mental fitness coach. And we talked about visualization, the power of visualization. There's good data on that. It's so much, man. It's so much, whether we're talking about performance with Olympic athletes, you know, improving three-point percentage with collegiate athletes and free throws and all this stuff by visualizing, but also accelerating healing is another really powerful domain. And you said the words, which is when you are visualizing your brain in many ways, it doesn't know the difference between us doing the thing in the world and thinking about the thing, those circuits are running, right?

54:21Shawn Stevenson:And so if you want to engage those circuits and kind of wake things up, it's such a powerful tool. Yeah. Particularly if you're laying there, you know, you got crutches, your legs in a cast or a brace or what have you, what else you got? Yep. Right. You know, so work on a diaphragmatic breathing pattern, do a lot of visualization. But, you know, so many of the things that are factors in performance are also factors in rehab. So, you know, the same that I learned from Stu McGill when he's talking about, you know, the same cues you would give a power lifter to lift, you know, hundreds of pounds.

54:50you give to this sweet person in front of you that is on the edge of tears just trying to do the most simple movement. It's a powerful tool. You mentioned breathing a couple of times. Why? What do you mean by diaphragmatic breathing? Diaphragm is a muscle. And if we are breathing diaphragmatically as we're supposed to be, it's the first domino. You're a kid and you stack dominoes and you get this big long trail of dominoes through the house. You tip one over and then all of them go. Diaphragmatic breathing is the first domino to lots and lots of stuff. Musculoskeletally, it's how your core is quote, quote, on without you having to think about it.

55:29So if you were going to pick up something heavy, you know what you're doing, you'd brace, right? But what about when you open a door that you thought was unlocked and it turns out it was locked and it gives you that jar or anything that happens that's unexpectedly? Well, if you didn't have the brace on in the first place, then that's going to jar you. And that might not feel so great, right? So when we breathe diaphragmatically, diaphragm is a muscle that's shaped like this when it's at rest, like so. And... Same like what for people listening? Oh, sorry. Like a dome or like an umbrella, if you will.

56:00And when you inhale, it goes inferiorly down towards your pelvis, okay? And so when I inhale, it does that. And it's very elastic. So exhale is generally effortless with relaxed breathing. Obviously, you can force air out if you choose, but it's elastic. So when the muscle relaxes, it just shoots right back up. Now, when I inhale and it goes downward towards my pelvis, the bottom of the pelvis has a muscle group that looks a whole lot like your diaphragm upside down. That's referred to as a group called the pelvic floor. And so when I breathe and my diaphragm is moving inferiorly, now it's pushing all of the abdominal contents onto that pelvic floor like a hammock and that creates a little gentle stretch.

56:39Well what does every muscle do reflexively when you stretch it? It contracts. So now the act of breathing just made my pelvic floor turn on but my body doesn't just go that direction when I inhale with my diaphragm. It expands all the way around. So my entire waistband expands and it moves inferiorly. So the inferior travel gets the automatic stretch out of my pelvic floor but my innermost abdominal, innermost lower back muscles, the multifity and the transverse abdominis, if you care about the name, it doesn't really matter though. Those get stretched and those contract. So the very act of breathing with my diaphragm makes the top, the bottom, the front, and the back of the cylindrical thing we all call the core these days, contract.

57:20So if I breathe diaphragmatically, I have a little bit of stability at all times. And the average person breathes like 22 ,000 times a day. So if 22 ,000 times a day, we have core muscle contraction, that's a nice little safety net. And it's not huge, but it's something. I always tell, what if I gave you 22 ,000 pennies? Oh, that's nice. Every day. Well, that's not a bad little lottery ticket right there, right? So even though it's only a small amount, it's a small amount times 22 ,000 every day with zero effort on your part. And a lot of times people lose their diaphragmatic pattern. They're breathing up here and that's referred do is an apical pattern, breathing into the apices of the lungs, inefficient.

58:00And it tells your brain you're in fight or flight mode, fight or flight versus rest and digest. Right. And so what do you think muscle tone does when you're in fight or flight mode? I don't know why my neck is hurting. Right. And so they feed themselves that way. So we talk breathing pattern all day long at our office. And so if you breathe well with your diaphragm, you're giving musculoskeletal support for your core. If you breathe well through your diaphragm, you don't have to use all these muscles up here to substitute, which leads to stiffness of your neck, shoulder, headache, all sorts of things like that.

58:33And so say you hurt your back and now you're stressed because it was scary. It was painful. You have questions about what you may or may not be able to do. Maybe there's time off of work, all those other things. And now you're stressed. Now how are you breathing? Right? So people tend to breathe up here when they're stressed. Just like a kid. I'll use an example. if one of my kids fell on skin, they're needed to be, dad, dad, dad, right? You know, that's the reenie. Calm down, honey. It's going to be okay. And they get back down diaphragmatic again. Well, sometimes if you've had something big enough, especially if it's emotional, if it scared the crap out of them, like a car accident, something like that, that's emotional, right?

59:09And they just stay up here and they don't reestablish a good diaphragmatic pattern. So when you do that for folks, not only do they start to loosen up up here, they don't feel all of that. They get less sympathetic, more parasympathetic. They start establishing some core. They stop feeling so fragile to do stuff. It's remarkable. It's the thing that nobody wants to talk about. I always have to be really careful when I introduce it because I know these people are going, oh my God, I can't believe I'm paying for this. And you talk to them about breathing. But once they kind of get it, it's remarkable and they're very thankful we took the time to do that.

59:41Can breathing well help you to heal faster? I don't know if you, I'm Captain Literal, so I don't know if you mean the word healing as well as as deliberate or what's the word as specifically as i do i wouldn't say necessarily help you heal faster but feel better without question yeah without question so breathing well can help us to reduce pain without question okay yeah i mean remember lamar's breathing back in the day right yeah so and there's a reason they taught ladies to breathe that way right it's and i mean think of a yoga practice or something like that anything that's involved breathing you've got

1:00:16Shawn Stevenson:more tolerance to tie it to the potential to heal faster i would imagine that the body is in a more restorative or healing environment is created when we're breathing well versus i mean it certainly won't be worse yeah yeah um you might you may very well be right i just when i think of healing i think of like in a petri dish kind of environment right so you have a cut and you know the cascade of inflammation and healing and all that i don't know how much that would change but it might but definitely your perception of the pain and the disability from whatever injury you had will be lessened for sure.

1:00:50Okay. Yeah.

1:00:51Shawn Stevenson:We've got this interesting thing happening right now. And a lot of trainers, a lot of armchair experts are chiming in on all the injuries that are taking place in the NBA specifically, right? And so there have been a number of severe injuries, especially like the last couple of years, right? a lot of severe knee injuries, a lot of Achilles injuries, like, you know, superstar players are like just getting taken out. And so there's been a conversation like, why is this happening now? Because it has gone up, we'll just say 50, 80 % versus the 90s or whatever. And again, these are not exact numbers, but it has gone up significantly.

1:01:37Shawn Stevenson:And my question is, why? Why? I've got you here because one of the theories is that it's because the kids are playing too much basketball. They're specializing when they're young. The AAU circuit and they're just playing basketball year round. And it's just like too much load on these kids. And it's just accelerating the time when something breaks down. Yeah, that was my going to be. I'll tell you, I don't know. I'd love to be able to tell you that I know. that would be my first guess. And for what it's worth, I'm a baseball and golf guy, so I'm aware of NBA basketball. And I know the storylines you're talking about.

1:02:21If I had to guess, I think that's it. That certainly seems to be the issue with elbow injuries and MLB. If you are a parent of a kid who has some athletic prowess, understand the only kids that get hurt are the kids that are good because they're the only ones that coaches want to overuse, right? If you suck, the coach is not going to be pressured to keep you in the game too long, right? So, you know, God bless the kid at the end of the bench. But I always tell people, and I've been in the kid coaching realm in the past, the most important thing for a kid to do when they're playing a sport, whatever it is, is having a fun that they want to play the next year.

1:02:56Because I don't care if your kid, you know, is 20 and 10, you know, double, double, whatever. However, if he's like, this kind of sucks, dad, I think I want to try lacrosse or something, you know, go to a different sport, then you failed the kid. I mean, nothing wrong with lacrosse. But I mean, when it becomes a job before it's a job, that's a problem to me. And so I think that when you see immature bodies that have school all day and then they've got practice and then they've got their specialized, like, you know, maybe they have a dribbling coach, a shooting coach, whatever. You know, in baseball, they've got a pitching coach, a hitting coach, and then they do conditioning.

1:03:31And then like kids have got every moment of their day programmed and scheduled, be there, be there, be there. And these are children, right? I mean, like the stress level is significant on them. I think if you want to create, let me back up, I'm sorry, I'm wandering a little bit. I can tell you with clarity from my training through Titleist that if you want to create the best fill-in-the-blank sport star, the best way to do that is to create a multi-sport star until they're about 16 years old. The kids who play multiple sports train multiple movement patterns. They train with multiple different types of stressors going through their body.

1:04:10just imagine that not only are you as an adult say you know i was telling you know the the pro players play less and they have more of a pitch count than your kid um and he's still growing and developing right you've just you have to diversify like you diversify a stock portfolio so you're not at risk by everything being in one thing if all you do is play basketball and run and jump and cut and run and jump and cut and run and jump and cut is there any wonder that the lower extremity soft tissues are wearing out at a younger age, right? But imagine that basketball player also played baseball in the spring instead of summer or instead of AAU basketball, whatever, or played AAU but not their school team.

1:04:51Or you just find some other thing for the kid to do until about 16. But that's kind of the line in the sand with the exception of tennis and gymnastics, where you're rewarded at a younger level, at elite levels. But the multi-sport athlete becomes the best athlete. And so my two cents on that would be create a multi-sport athlete. And then if you've got a kid that wants to be great at basketball and I'm making this number up, but let's say he's got 30 hours a week involved in basketball, maybe some of that could be in the gym as opposed to being on the court. And when I say gym, I mean the fitness gym, not the basketball gymnasium, but working on the ability to handle loads and stressors and to be around a different an adult too, right?

1:05:33You know, because in youth sports, they're being, um, how they think about things is being shaped by that coach. And so being exposed to other qualified coaches in other realms can sometimes be useful for perspective on them. That's great.

1:05:49Shawn Stevenson:Great advice. Weight room strong, real world vulnerable. There you go. This is something that you're talking about as well. and we need to be educated about. It's awesome that people are getting in the weight room now. There's a surge. There's a movement and intention around that. And we don't want to put all of our eggs in the basket of just being weight room strong. For sure. I'm glad you brought that up. Talk about that a little bit. Yeah, thank you. This is one of my pet peeves. So I just remind people, it's a three-dimensional world we live in. And so you need to be able to handle forces that are forward, backward, side to side, and rotational, and usually all at the same time, right?

1:06:26And your child who you're paying to be trained by somebody, if they're training them like a bodybuilder where you isolate one muscle and bodybuilding is a sport in and of itself, take your clothes off and pose for a judge, that's a sport. And if you isolate one muscle, one exercise, one muscle, that's a bodybuilding mindset. And that's fine. But that does not carry over to athletics where there's acceleration, deceleration, multiple joints working together and in all three planes of motion at the same time. So there has to be some level of functional training in what they do if you want carry over to a functional activity like running and cutting and throwing and hitting and, you know, all the things that sports are.

1:07:06And you don't get that from back squat and you don't get that from a bench press. And I'm not saying those are bad exercises. I'm saying that if I want the squat to carry over to fill in the blank sport, maybe I'm not going to have a bilateral symmetrical grip on a bar with a bilateral symmetrical stance. Because I'll never be in those positions and have loads like that. I'm definitely going to squat, but maybe I would have more of a split squat. Or maybe I'd have more of a single leg squat. Or maybe there's so many variations. And when you see the people that often run the youth conditioning programs, you have all the kids doing the same stuff.

1:07:42And, you know, the most common say was probably football, right? And so if you're the guard and I'm the kicker, why would we have the same needs, right? And if you're a senior and I'm a freshman, why are we doing the same exercises? Because you've been through this for four years now and this is all brand new to me. Do you really want me doing a power clean? I don't know. I've had kids with wrist injuries from power cleans because they didn't know what the hell they were doing. And the football coach had the kids max. Now, what could go wrong in a testosterone-laden high school football weight room with all your buddies around you and you put an extra plate on each side and you're like, go, right?

1:08:24You know, um, that's cool. If the kid can lift more weight, but if you can clean a certain amount, that still doesn't mean you can make a tackle. It still doesn't necessarily mean you can cut on a dime and make change. Right? So, um, the training of these kids do has to involve all three planes of motion has to involve arm working through core to opposite leg. Cause that's how they're going to run. No one walks like same arm, same leg, right? No one hops two feet at a time when they walk into a room or across a court, across football field. So you have to have exercises that somehow mimic those tasks.

1:09:00And then you get carryover because carryover is movement, plane, speed specific. And so if I'm lifting super heavy, cool, there's value in that to some degree. But if the only way I ever work on a squat is a barbell back squat, you're going to get beat by other kids that are moving more athletically than that.

1:09:16Shawn Stevenson:This is important for all of us. Of course, with our kids, but we might not see ourselves as a quote athlete, but you are a life athlete. Yeah. And again, getting weight room strong, that's great, that's awesome. But we need to make sure that we're training to be able to be adaptable in this three-dimensional real world out here. Right. Where life doesn't come at you in a push-pull, you know, everything's kind of symmetrical. Right. Like almost never. Yeah. And so with that being said, and we're getting close and closing here, but I want to get some tips on some things that, and I know it's tough.

1:09:51Shawn Stevenson:I know it's tough. You know a lot. Um, but what would you say are three exercises that you think that all of us should be utilizing or doing on a regular basis? Oh man. Um, well I'm going to, can I, I'm going to be a politician. I'm going to dodge your question to give you the answer that, that fits my brain better than what you asked for. Fundamental human movements are hinges, squats, lunges, push and pull, right? And if you want to call it carry a movement, if you want to call it walking. So if I'm going to be exercising, I need to be thinking that I need to do push and pull somehow, right?

1:10:30And it can be horizontal or vertical, preferably both because both matter, right? If all I ever do is train here, the time I need to be up here, I'm not prepared. so I'm going to have some amount of push and pull I'm going to have some sort of forward backward lunge that is something like you know hey let's all go hiking it'll be fun and you haven't done lunges in 100 years you've just done bilateral squats in the gym and now you're stepping downhill over and over again for miles on end how are those knees going to feel versus the person who's prepared for those deceleration forces by doing lunges as an example so if you just understand that those are sort of considered fundamental human movements.

1:11:06So if you are a human, you've got to somehow address those patterns. So I'm not saying you can't barbell back squat, but I'm saying if that's the only way you do it versus say a kettlebell front squat versus a split squat versus a single leg squat. You know, I have people just try to sit down, stand up from a chair, one leg, right? But what everybody should do is like, I don't know who everybody is, right? So what's appropriate for you and me and the next person are probably all going to be a little bit different because of our individual likes and dislikes, what we have access to. If all you have is a band and I'm telling you to use a kettlebell, that doesn't work, right?

1:11:41Or vice versa. So if you just think about the fundamental patterns in your exercises, just make sure that sometimes you squat, sometimes you hinge, sometimes you lunge, sometimes you have push and pull both horizontal as well as vertical, and sometimes you pick something up and move it around. That'd be a carry if you want to call that or a walk right so if those are blended into what you do what you do will be pretty complete doesn't have to be every workout but learn if you look every week and say okay i'll give you twice a week for half an hour rock on week and without question get all of those patterns in twice a week half hour and that's pretty manageable got it got it i knew he's gonna

1:12:18Shawn Stevenson:skate around it but you know you're giving us the real stuff you know so what i'm gonna do instead I'm gonna throw out a form of exercise. And in, I was gonna say one sentence or less, but maybe two, maybe two. Bounding. For who? I knew it. Let's talk about bounding. Bounding is when you take off on one leg and land on the other. So that means that leg that you're landing on flies through the air and lands with a force greater than body weight. If that leg's not ready for that, That's an injury waiting for a place to happen. So for this person, bounding's awesome. For that person, bounding is stupid because you're gonna hurt them.

1:13:01Love it, but just kind of depends

1:13:03Shawn Stevenson:on what you're ready for. What about bounding for the majority of people, but like a diet bounding, all right? All right. I mean like hopping from one leg to the next, like in place almost. Yeah, absolutely. Yeah, so basically kind of like, almost like jogging in place, becoming, you know, yeah, absolutely. Cause that, that's your ability to use the elastic energy in your tissues, um, which makes you athletic, right? I think everybody, you know, the, uh, shout out Cliff Harsky, be able, be adaptable, be athletic. So to me, that means you can not just do the thing, but you can do the thing in different ways and you can do the thing in different ways where you might also add another thing on it, like, um, bounding, right?

1:13:49So can you balance on one leg, okay? Then can you lunge? Okay, can you hop in place? Okay, then can you hop from this foot to that foot? That would be kind of the evolution of be able, be adaptable, be athletic.

1:14:01Shawn Stevenson:Okay. Two leg jumping. Two leg jumping. And you got two cents is max. 100%. I'll have, you know, LOL used to stand for a little old lady. I'll have an LOL in the office and say you've got carpet like there where there's two tones and we're getting her up and moving again, I will hold her hand and I'll say, I want you to jump from the blue to the gray. And she'll be looking at me like I'm crazy and kind of bounce a little bit and move just a little bit. That's two-legged jumping, right? But power is the number one thing we lose as we age. It's not our flexibility. It's not our strength. We lose everything as we age, but we lose power the most.

1:14:39And so you have to be able to train power no matter who you are. You just have to bring it to a level appropriate for you, but absolutely. Walking. Of course. Yeah. I mean, a lot of people, even if they're in that person with exaggerating back pain, how long can you walk for? It's bad. Two minutes. All right. Can you give me like a 60 to 90 second bout every hour? Okay. Right.

1:15:00Shawn Stevenson:And then you build. What would you say to the person who's experiencing pain right now? They just experienced an injury and they're in pain and they want to get back to doing the things that they love, what would you say to that person? Odds are in your favor, you're going to make it that don't let how you feel right now go beyond right now. Cause it's really easy. I've been there with my own injuries to think, Oh, this is how it is now. And then it's a slippery slope, but it's highly unlikely if you're hurting, that you're still going to be hurting. And if you need to find another person to seek care from, you seek care from someone else.

1:15:41And if that person strikes out, you seek care from someone else. In the world we live in, in the United States, if you don't get better, you are a chronic pain patient. And you may have just been let down by a system that doesn't allow very smart people to have enough time to think or to think outside of a protocol that you may not fit very well in. I've had that happen with me personally. Be your own advocate, expect to get better. And if you're not getting better, keep looking because more than likely you're going to be okay.

1:16:15Shawn Stevenson:I love it. That's all I got for you, man. Right on. So rich, man. Thank you so much for sharing your insights. Thanks for having me. Is there any where the people can connect with you? Again, you work with people remotely, which is what you did for me. Where can people get in touch with you, follow you, you know, get more education, all that good stuff, but also contact you and your team. Yeah, sure. So t2wclinic.com is my clinic's website. I've got a YouTube channel with a lot of what we described there, all free, obviously. If you want a course from me, I've got a couple that are at fixyourfunction.com.

1:16:49It's a nice place to go and you can see some things you can get. I'll put a model discount code when I get home. so you guys can get a discount uh your listeners get a discount but those are the places to find me instagram at dan swinsko okay so the code it would be model i'll just put it model yeah okay

1:17:06Shawn Stevenson:and create a discount awesome well again man i kind of shared a little bit with the guys before you came in that you've been instrumental for me you were there for me when i was just uncertain when this was 2020 right sports injury everything was going so well i just turned my book in and I get a really bad sports injury and going through the process of getting well, I was grateful. Again, I had the imaging and the physician that looked at it, he was just going on about how good my spine looked, all this muscle tissue. He was just like standing there like, I was like, yeah, yeah, that's me. But why am I in so much pain?

1:17:45Shawn Stevenson:Why am I hurting? And there was this one spot where I was compromised and being able to, of course, just get out of pain, of course, but then to restore my confidence and my mobility and my movement, I didn't just get back. I got better. I got better. I was doing more than I'd done for years. I was exploring more of my capabilities and I was proactively challenging myself when I kind of went into autopilot, which you don't, you don't know that you're doing it, you know, with the things that you're comfortable with and excelling at. And we pushed you out of that comfort zone little by little. That's right.

1:18:23Shawn Stevenson:And just got me, got me playing more, really focusing on play and, but also qualifying myself to be able to do those things. And so I appreciate you so much, man. You're, you're great at what you do. You're world-class at what you do. Thank you very much. Yeah. Thank you so much, man. Thanks. Appreciate it. The one and only Dan Swinscoe. Thank you so much for tuning into this episode today. Again, bookmark this episode. Keep the insights in mind, but also when you need that reminder about your capacity to heal, you need some insights and tips on accelerating your recovery, stacking conditions in your favor, come back to this episode again.

1:19:03Shawn Stevenson:And of course, follow Dan on social media and definitely check out his YouTube channel. He's always sharing incredible insights. You could see the exercises, especially when it comes to exercises and physical therapy. It's always great to be able to visually see what the educator, what the teacher, what the trainer is talking about. And he shares a plethora of incredible exercises and things to think about as well in our training. And I'm a big fan of prehabilitation, not just rehab, but prehab, training our bodies, getting these inputs with some very skill-driven exercises so that we can stack conditions in our favor and make sure that our bodies are prepared to do the things that we want to do.

1:19:47Shawn Stevenson:We've got some amazing masterclasses and world-class guests coming your way very, very soon. So make sure to stay tuned. Take care, have an amazing day, and I'll talk with you soon. And for more after the show, make sure to head over to themodelhealthshow.com. That's where you can find all of the show notes. You can find transcriptions, videos for each episode. And if you've got a comment, you can leave me a comment there as well. And please make sure to head over to iTunes and leave us a rating to let everybody know that the show is awesome. And I appreciate that so much. And take care. I promise to keep giving you more powerful, empowering, great content to help you transform your life.

1:20:22Shawn Stevenson:Thanks for tuning in.

1:20:38Thank you.