E65 | Trevor Rappa Interviewed on the Speed and Power Podcast
Resilient's Trevor Rappa was recently interviewed on the Speed and Power Podcast by hosts Jason Heairheller and Ryan Heickert. If you like this episode be sure to check out the rest their podcast has to offer here.
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Episode Transcription: Welcome to the Function and Strength, Speed, and Power podcast. I'm Jason. Along with Ryan, we're going to talk about all things, strength and conditioning related to improving on-field speed and power for your athletes. Along with our own unique ideas, we will be bringing you professionals in the field to talk about their own skillset, to get athletes faster. All right. So we have Trevor Rappa here, Trevor, welcome to the podcast. Thanks for having me on guys. Really appreciate it. So I wanted to bring you on, particularly because you're a performance coach, but you're also a physical therapist. So the first thing I wanted to kind of get into was how having that background in performance has an effect on what you do on the therapy side of things. So I'm pretty fortunate with my business partners. Like we all were shrimp coaches prior to going to PT school. And I think that's made a profound impact on just our treatment style in general. Um, so we kinda know when people have a goal, we know like the end stage to get to any goal is typically something kind of more on the training end of the spectrum, rather than towards the rehab end of the spectrum. And I think for us, we have, um, We kind of have the skillsets to be able from our PT background and the performance background to take somebody from an acute post-op case to getting them back on the field. Um, so kind of being able to run that whole spectrum from the first day post-op surgery to getting them actually back on the field and being, being competitive in their sport has really been huge for us. And even, not even just with athletes, but with some of the gen pop people that we see, like, you know, fitness is so huge for everybody, whether they're. Um, dealing with an injury or not. So we know how to safely coach and safely progress and safety program for people that are dealing with various aches and pains. So I think it's, it's been huge for us in terms of kind of separating us from some of the other more traditional physical therapists that are out there. And people really are kind of seeking more of the performance end of things. Cause they, if somebody's goal is just to be able to walk a flight of stairs without pain. That's great. But most of the people we see have some sort of higher level activity that they're shooting for, whether it's. You know, being a weekend warrior and playing tennis or playing pickup basketball with their kids or something like that. So, um, it's really just helped us understand how we can take people from where they currently are and get them to their goal safely. That's great. So I wonder like when you guys are getting a new patient and you're kind of discussing things like when do the PT goals and. And the performance goals begin and I'm sure they blend and they kind of meld together. Um, I just wonder like how you guys might talk through that, you know, like you're saying with the other business partners, as you're maybe seeing certain cases ACL's and different things like that. I honestly like don't my, myself and I can't speak for them, but I don't really see a difference oftentimes between the two, because. People come to typically people come to physical there because they have some sort of preparement or some sort of pain or some sort of limitation that they're dealing with. That's stopping them from doing what they want to be able to do. And if that goal is performance related, like they want to be able to, you know, do a 5k without pain. They want to be able to, like I said, go play tennis without being whatever it is. It's kind of the same thing. That's performance and it's rehab. Like if there's no real separation between the two, like they're coming to physical therapy because of what they're dealing with, but ultimately we need to give them some sort of an intervention and that's going to help them achieve their goal. Even if it is more quote, unquote performance, like those examples I just gave, um, But for us, it's kind of trying to take a look at like, is there actually something going on from a dysfunction standpoint, that's not letting them do what they want to be able to do, or they just like, not fit enough to be able to go and do what they want to do. Like a good example of that is I had somebody who was a couple of years ago. He's like he was an older guy kind of middle-aged and he's like every six months I start playing tennis again and I pull my calf. And then I stopped for six months and then I go play tennis again. And then I pulled my calf and it's been going on for like six years. And I'm like, okay, that's great. And it's like, nothing's wrong with your calf? You just don't do anything that is even close to the stress you're gonna encounter in tennis. So our sessions were like low-level plyometrics and then progressing plyometrics and then doing some easy change of direction stuff like nothing super high level, but it's getting him more used to the stress. That's good that he's going to be in Conrad when he actually goes and plays tennis. So he came to me with, you know, a pain or dysfunction or an impairment, but his goal was definitely more performance related. It wasn't like, I want to be able to go and, you know, walk up the stairs without pain. He wanted to go and be able to play tennis one to two nights a week and not post calf every time. And after a few weeks of just doing some easy progressions, which is much, you know, it's the same thing as a strength coach does in terms of your kind of GPP phase plyometric, that's all we did. And he felt great after that. So again, it's hard to kind of have like the distinction between. Rehab and performance, depending on what the person's goal is. I think that's the right answer when you're doing your job correctly. You know what I mean? And appreciate that, you know, I probably gonna throw some people under the bus and like, that's not really my. My intention, you know what I mean? But I think that's probably a bigger issue and you can probably speak on that. Um, but like for an example is, you know, we, we work with a lot of hockey players and even youth hockey players. And, uh, we had one of our players recently, I don't know to what extent, but how to a severe enough hamstring pole that it was almost like an, a pop, the Situs. It was, you know what I mean? And he was, he was. Sat down for like four to six weeks. And he's like, Hey coach, like I'm, I'm clear. And I said, awesome. I said, do you have anything from your PT? You know what you've been doing? And he's like, no, no, no, no. Like I I'm cleared. I said, well, what was your return to play protocol four to six weeks of rest. And then he went and played a game that weekend. And it, it blows my mind that, you know, we're allowing athletes or even weekend warriors or people to. Do things like this still when I feel like we know better. Um, I guess my, my question here is like, I'm not trying to generalize. All PTs are all taken ATCs they're all straight and coaches, but. Where are we, where's the disconnect here and getting these return to play protocols, even if it's just for a weekend warrior and an athlete. I think a lot of that comes down to under, and that's why the performance coach like your initial question, Jason, I think is so important because it's like as a, as a sport coach, especially if you're programming for an athlete, like you're performing a needs analysis of what that person has to be able to do down the line, whether it's, you know, Whether they're in the middle of the season, whether they're in an off season, it doesn't really matter where it is. Like you're trying to understand like what they need to be able to do. Um, and with what you're talking about, Ryan, it's when people don't understand like the stresses and the velocities and the speeds and the forces that people are going to be encountering in their sport. Um, it's hard to kind of like start at that level and backtrack to currently where they are and people, you, you backtrack to where they are because it's like, Oh, they can sprint right now. Uh, and then you go all the way down to like, well, it kind of hurts when they're walking around, so I'm just gonna have them, so shut them down and do nothing. But then once you have them shut down and they no longer have pain during like normal day-to-day function, then there's no progression back to the level of support that we actually have to be able to get to. Because again, I think people don't. Understand how to progress from like, like what's easier than walking. It's like, uh, how about some double leg plyometrics? What's a little bit harder than that. How about skipping? It's harder than that. How about some single, like plyometrics? Okay. What's harder than that. How about a heel sprint? Okay. Or, or your progression, and just being able to kind of grade the stresses and have graded exposure back the level of. Of what they need to be able to do. So what happens is people get comfortable in day-to-day function without testing it out, if you will. And. Getting back to what they are going to actually be able to have to do on, on the sport. Sorry, on the court, around the field. Like for myself, I pulled my hamstring, like all the time. It was from my sophomore year, my junior of high school through, I finished playing college football. Like every preseason I pulled my hamstring and I would pull it like multiple times because that's what it was. It was like you would pull a, you would get a soft tissue injury. You would rest would go on the bike. You would jock a little bit. And then it's like, well, that's good. Now we'll go back on the field and try to go full speed, but it's like, I hadn't experienced like 50%, 60%, 70%, 80%, 90%. Like you have to experience, I think all of the levels, whether it's for a short time or for a long period of time before you're actually able to withstand the stresses that you're gonna have on the field. I think something that's interesting right now is looking at all the injuries in the NFL, after all of these players, haven't practiced with their teams, you know, and who knows really what they've been doing. And it's like, what's the best way to prevent hamstring strains is, you know, you sprint and you have a, you follow a good sprint program. And I think it. The phrase, do no harm when people hear that they almost take it to the side of where you have to almost be too easy on the athlete where I think it almost has to go the other way. You have to challenge them in the positions that they need to be in. Um, you need to challenge, you know, their strengths. You need to challenge single leg strength. And can you just kind of talk about the concept of. Do no harm and how that kind of plays into what you do. And I know it kind of goes along with what you said already. Yeah. Yeah. I mean, the do no harm, like phrase is obviously something we're all kind of striving to follow all the time. Like nobody wants an athlete to get hurt, especially like on their watch. Like. I would say within like the, within the, uh, individual training session, like do no harm is 100% my number one goal. Right? Like, I don't want to like do something. That's basically like, don't do something that's irresponsible. That's going to get them hurt. You have to understand their current fitness level and what they can handle right now and then progress it from there. But you're totally right. That I think the do no harm things just means like, don't let them have pain and don't get them to them uncomfortable. So we don't push them that hard. Um, Because it's the same example of what Ryan just talked about is like, if you have somebody who has had a hamstring injury and it hasn't done anything for four, six weeks and then gets back on the field, correct. You did not do any harm to them during that four to six weeks. So like, that's good, but did you really do your job and prepare them to be able to get back on the field and. A be safe and not like, not have a high risk of reinjury. And in that case, like, definitely not because you didn't prepare them adequately for the stresses that they're going to be having to deal with in a sport. Um, so yeah, like do no harm to me just means like, don't be, you're responsible. One of the things that we talked about recently was, um, you know, it's like you watch somebody like, like for me, the stuff that I do from a return to play standpoint with, with my athletes probably looks. Crazy to like some PTs who, who, you know, they're, they're discharged testing. It's just like a three like hop or sorry, a single leg, triple hop test. But we're doing like open skill, reactive things change, you know, an actual agility drills that may look risky, but it's not risky. It's not risky if you've had the appropriate progression to those activities. And, um, You know, like that, that balance of risk reward with whatever intervention we're choosing is always on our mind with everything that we choose during a session and like throughout the progression of, of, of care for a client or an athlete. Um, but like what's what a later stage activity has. Low risk has low risk high reward at that point in time. But if we chose that same activity and use it three months earlier, it's probably high risk, low reward at that point in time. So. As we, as the person adapts to what we're doing and it becoming more competent and we're seeing the physical qualities that they need for the stuff that we're going to do later on like the risk reward, flips and things become less risky and we get more reward, but we're ultimately pushing them. To be able to handle the stress of what they're going to be able to do in sport. Because again, we don't want to harm them, but, um, if we're not putting them in positions that are stressful and least challenging them and getting them to be able to get them prepared for the sport, then we're really not adequately preparing them. And like what doesn't care about doing harm as like the sport and your opponents, like your points, don't care if they're doing harm to you. So if we're not preparing them to be able to handle some of that, then we're probably not doing a good enough job. And you mentioned kind of rehearse first reactive drills, and that that's going to kind of lead me into my next question. And Ryan, I actually had this conversation today and we're kind of talking about our, our model of speed and power development and we consider. You know, speed training to be an actual skill. And we consider linking movement patterns to be like our end goal. And we want people to do that well. And then, you know, we, we look at the movement patterns and we see like, alright, do they have the ability to do this? Well, and then, you know, you kind of give them the drill. And in the case of even like physical therapy, or even as we're training, it's almost like a corrective exercise to get them. Where they want to go. So at what point do you go from kind of the, the rehearse drill to the reactive drill? Is it like when. They are, I don't, I don't know a better term for this, but like a good mover. Like they, they hit some check marks and then you kind of go into that stuff. Or do you kind of introduce some very low level reactive stuff? Just like, you know, on my clap, do this or something like that. Yeah. I think your last statement there is exactly kind of personally, what I do with people is, um, You know, always making sure that they have like the requisite, um, physiologic qualities beforehand, like they're strong enough. They have enough plasticity, they have enough just work capacity and fitness before we're doing things that are kind of harder like a chick, you know, rehearse drills. Um, but even as I'm doing rehearse drills, like. I do, I will always kind of be pairing that with some, some sort of reactive component to it, but I'm just going to limit how much of that chaotic open skills stuff I'm kind of doing with them. So we've been with like a, like rehearse drill, like I'll have them just emphasize some sort of. Um, reactive component. Cause how they move reactively is always different versus not right. Like change of direction. And agility are two different things because agility has that cognitive component to it where they can't predict what they're going to do when they can't preplan, how they're going to navigate like this, these cones set up that we have. Um, so. I'll do, like I said, like, go on my plan or something like that. If I think it's a really easy way, just to start introducing a reactive component where they're kind of getting out of their own head about what they're going to be doing next. Um, and as you said, as they become whatever your criteria is for like good enough at those skills, then again, the next progression is. Increasing the complexity of it. Sorry, increasing the complexity of it and, uh, taking away some of the constraints that they're dealing with during these drills. So, um, I think cold, uh, closed drills are a great way to get people again from a coach's standpoint, too. It helps us know what we're looking for. So I think that's a great way to kind of begin to train your coaches. I, in terms of. Um, doing, doing closed grills allows us to know about like, okay, they're going to do a hip turn at this point in time. Right. They're going to do a rotational cut here. They're going to do a lateral cut here. So you can kind of predict what's going to happen and see if what the athlete does matches our model of movement in our head, which allows us to kind of have an intervention. But once they kind of meet that model of movement with these closed drills, then we can start making it more reactive and seeing how they can, um, seeing how they are actually, um, Moving from a strategy standpoint where they can't predetermine what they're going to do, because athletes, when they predetermined what they're going to do, when they know the path they're going to move differently than they do in an open skill kind of actual agility where they're reacting to some sort of stimulus. Yeah, absolutely. Right. And then I think part of what you're saying there is like what the close drills also is. It's a great, it's a great way for us to coach. I dunno, I'm going to use this term again, skill, right. So we know what it should look like. Right. We know what we want it to look like. And then we can kind of sit back and watch that it's like a curve treadmill. So instead of having them run 40, 50 yards down the field, we're right there. Being able to see this drill in real time. Um, and we have an idea and, you know, I know Jason uses, uh, a lot of close drills and has really good stuff. Success with that and leading them to that open drill, right. Using it as a way to teach motor learning also. Right. If we, yes, they are going to move differently when they know when, and they don't know, we started to kind of blend those together and get bits and pieces of that and slowly, you know, open it up and let them go. Yeah, I totally agree. I think, you know, um, Like the close drills are great for the predictability of it from, from a coaching standpoint, like, you know, like how many cuts you're gonna get off of a right leg versus the left leg. You can you're, you're, you're really, um, like in a good way kind of constricting what the athlete can actually do. You're you're controlling, you know, by having your cones only three yards apart versus eight, like at three yards, you know, they're not going to be able to be getting to the same velocities that they would have if they were going to eight yards. So there's so many things that we can control and manipulate to like. To keep the intensity and the intent very high with close drills while you said still practicing skills. Cause I agree. I think like all of the movement patterns that athletes do in sports, like those are skills and closed. Closed loop. Uh, rehearsals are great way to practice those skills. Um, but ultimately you have to be able to get them to do that in a reactive situation to have it actually become like a set from like a motor learning standpoint to have that become more innate and more natural for them. If that is an issue for them in the first place. Right. I say that because most athletes, when you have them, If they're doing some sort of reactive open, new drill right away, they're going to do a lot of things. Right. But closed drills, help them kind of fine tune certain things. If, if, if that's what needs to be done, I want to bring up something that just drives me crazy. And it is the footwear of kids that come into the gym now. So, you know, we've had kids actually like sit down and be like, buy a pair of like these sneakers, you know, like court shoes or something like that. So yeah. I'm curious how you kind of address that or work around that, because I know like if someone's sliding all over the place in their shoe and they have, you know, a very kind of like, almost like a sock on their foot, it's going to change the way they move a little bit. So how do you kind of figure out, like, right. Are they doing that because that's, what's natural to them? Are they doing that? Because. Otherwise they'd be running on the side of their shoe. Yeah. I mean, the shoe thing is a hundred percent, right? Like so many kids. I even my, I mean, I talked to kids about that all the time. If they come in for a session and we have to do plyometrics, or we have to do some sort of change direction, agility stuff, and they're wearing like, Some of those like running shoes that makes it our socks and they're have like three inches of foam on the bottom and they're just slipping and sliding and you see their, their foot like try to stop, but then it kind of just like rolls off the side of the shoe. Um, I, I honestly, like I won't do, if, if I see somebody in those shoes, like I honestly just won't do some of the stuff that I was intending to do that day. If, if. Cause I know, like for me, again, from a risk reward standpoint, I'm like the Kmart rolled her ankle. If they're going at an intensity, that's high enough. And I'm trying to have them do up, you know, a really far like rotational cuts or something like that. So I might just get those things and then spend more time on like linear activities cause where there's just less demand in the frontal and transverse plane standpoint. Um, but yeah, like I. I always ask him, like, do you have a pair of like basketball shoes? Or do you have like soccer tertiary? Was that your plan or do you have 10, like actual the sport of tennis shoes or something like that? And I'll have those kids just bring those in because yeah, there's just like certain things that I just will not have people do during a session with me. If they're just not run the appropriate footwear, like that's kind of stupid, I think to a certain degree, it's maybe a little bit extreme on my part. Um, but I think it really can make a big difference in terms of, of how somebody is going to be interacting with the ground and, uh, you know, Again, three inches of foam that they can't really, there's no stiffness. And they're just not getting that the rebound from the ground that they normally would and just a better pair of sneakers. Oh, for sure. And I, I hate, like you said, kind of going into a session and then changing what I'm doing, because I don't want them to roll their ankle. But then at the same time, I'm like, um, I'm not preparing them. Like I want to prepare them, you know, and I hated that. Something like sneakers can have an effect like that. I, I I'm, uh, I've a very serious sneaker obsession. Uh, and I have like, like nineties basketball, sneakers and Jordans and all sorts of stuff. But then I also, I like, I'm constantly kind of buying like different sneakers that test out. So I have like, Four different pairs of like tennis sneakers or tennis shoes at our, at our gym in Jersey that like, if a kid's going to fit it on, I'll be like, yeah, put these on, like, I'm not having you were around in those, those frees that, you know, don't have, don't even have shoelaces. It's like, we're just not doing that today. Right. And it even goes back to your point earlier of like an open-close drill, there are going to move different. So it's almost hard for you to even coach what ability are they lacking? Because you don't know cause they're moving differently because they can feel that they're at a role, the rank, or they can feel that, you know, they're slipping and sliding. So it's like the injury part, but then it doesn't even allow you to properly assess. What their actual ability is in a movement pattern. Yeah, for sure. It's like, you're not going to get the effects that you're looking for. It's like, why am I going to do, why am I going to do this thing with you? If I know we're not going to get the effect that I'm intending for it, it's like, we'll just do something else. That's maybe going to have a better bang for our buck this day. I did want to talk about gait patterns and I've kind of heard other people. And really, I don't, I don't know enough about gate to say whether this is true or not, but ultimately like. Your gate is what leads to like the best movement. And unless like you're taking care of your feet and your feet are working properly, like nothing up the chain is going to work. Do you think that's true or do you think it's kind of like if your hips don't move properly or the way they should, then it's going to affect like downstream? Or do you think it's just like both? I would say it's definitely both. Oh, like straight up. Like I think anytime people make a blanket statement, like, Oh, it's always the hip affecting the knee and the foot, or always a foot effect in the name of the, the hip. It's like, we have no idea. Like, we're just, if we're being totally honest, like we have no idea. And people are just kind of saying blanket statements. Cause it's sounds good. And it's good for social media and all that kind of stuff. Um, but again, like I I've seen cases with both. I've seen people where their foot affects their hip and their knee and their hip affects down the chain. Cause biomechanically like. For us, what we always teach is like proximal orientation dictates distal performance. So it's like, if somebody's in a really hard, like anterior pelvic tilt or extension pattern, whatever word you want to use, doesn't matter. It's like they're going to be, you know, orientation wise, it puts their feet into pronation and puts more weight kind of on their toes with changes, how their foot's interacting with the ground. Um, I think for myself, what I always coach, especially when it comes to like the, um, agility and change of direction stuff is I just coach balance. I, I want people being able to, uh, have, have equal, relatively equal contact, kind of heel to toe. Cause if it's somebody up on their toe, they have less surface area. They're going to be more unstable. Their center of mass is pushed forward. They're not going to be able to find as good of a push off angle. Like there's all these kinds of. Things that happen when you get somebody started off in a really bad position. Um, so I always want people to feel kind of balanced on their feet. Um, if we're doing something more lateral, I want people to be able to feel that inside edge of their foot, cause that typically orients their need to a better position relative to their foot and their hip to move laterally. Um, but yeah, like kind of the answer. So the first part of the question, like the hip definitely can affect down the chain and the foot up the chain and, you know, S. We, we rarely do things, um, without footwear, meaning like we rarely do things. Um, We rarely do things that are of high intensity without footwear. Like if you're sprinting without shoes, like you're not really sprinting, like you're, you're not going to go at the same velocity that you normally would. If you were wearing shoes, if you're changed doing change of direction stuff barefoot, like you're not going to go in, you're going to move differently barefoot than you would without it. Um, so I do do some stuff with shoes or socks off just, wasn't kind of get an idea of like how somebody trying to move. Like, are they always trying to keep their heel off the ground? Are they do they accessibly like slap the feet into the floor? Can they not control probation? Um, just to get an understanding of like how they're moving. Another thing that I do see a lot is, is you'll see people that. Instead of being able to get like authentic Dorsey flection kind of coming from like the talus rolling, rolling in the ankle, you'll see them kind of get a lot more like low ankle toe extensors kicking on. So they get back to their toes, the flare toes to flail up. That's little hard for me to say toes, the flail up the kind of clear the foot from the ground, rather than getting the actual talus kind of moving into true, authentic Dorsey flection. So those are people that like, they have this, they have a ton of calf tone. They have a ton of like, Or foot's kind of overly supinated typically, and their toes are, are flailed vertically as they kind of come up in into a jump. So we're not getting Dorsey flection occurring at the ankle. They're doing this compensatory kind of motion at the toe. So, um, I think there is definitely value in getting people's shoes off and kind of assessing how they move. But I don't think there's any place though. I have have, if you're trying to get like the best quality of speed or change reckoned or agility, probably not going to get the best thing with, uh, Having done it without shoes on. I don't know if I've heard Landau talk about that exact thing with the foot that you had just mentioned. And, you know, I know he goes through like, as soon as someone sees him, their shoes are off and he's kind of looking at their foot to see like how it's even capable of moving. Yeah. Are there certain things within the foot that you're like, this is what. Uh, I don't want to say like a good athlete versus a bad athlete, but, um, um, I don't really know a better term, but something that you always see from better athletes in terms of their feet versus someone who is probably not as explosive, I would S. Uh, again with like a generalization, I would say no, like I've seen people with like the, one of the best athletes that I work with, like have complete like flippers for his feet, but still has like actual good, like ankle dorsiflexion range of motion still has great knee and hip mobility. Like the kid just moves super, super well. So I think people can kind of compensate like in and out of everything. I think the hard part is determining like, If that is the limiting factor, because it's so easy for us to find something that is quote unquote, like non-optimal, or, or not ideal. And try to say, like, fixing this one thing that's going to cause this cascade of events and everything to get better. That's just rarely the case. Um, but yeah, like I think when it comes to the feet stuff, sometimes it's like, Again, trying to determine, like, is that the limiting function? Sorry. Is that filming factor? Is it low functioning or is it dysfunctional? That's a term reuses that I love that I think really just makes these, that kind of concept, like, like hit home. It's like, just because something is limited doesn't mean it's dysfunctional just because you like, like, somebody could not have a lot of ankle dorsiflexion, but it doesn't mean that they're dysfunctional. Like. They can just be low functioning. They can just not have great and go dorsi, flection, and then we can do something to improve that range of motion. If it's like truly dysfunctional, then maybe they should go into PT. And even for us, if something's like truly, truly dysfunctional, like then we send it off to an orthopedic surgeon or something. If it's something actually structurally wrong, that's causing these limitations. Yeah, no, that's great. And so for us, you know, we, we do a lot of, I would say early warmup, you know, three to five minutes with no shoes on, uh, we started, you know, we'll do slammed board and how them do different angles and get up under the, on the inside of the edge, onto the ball of foot, um, level maybe progress from double to single. And we've had a lot of success with this, but I do wonder how much is it because of. Our clientele. We see a lot of swimmers and we see a lot of hockey players. And part of the reason we do so much of that is our hockey players always being in that hockey scape. And they're, they're very limited and kind of locked down and we do a lot of change your direction and speed work in the off season. So we need to prepare them. To do what we're going to ask them to do. And we find that like at first, when we were doing a lot of, so a lot of shin splints and ankle injuries, and once we started taking that time to just kind of let them move freely without our shoe on and kind of build up some strength and then even with our, our swimmers. And I think it might have to do with them always being in the water and having that. That kind of planning or reflection and like, you know, with no gravity that even they had a lot of success just doing basic holds without a shoe on. Um, so I, I do wonder if a lot of that for us, our success is just come from who we're seeing. I would say the success with that just comes from good programming. Like, like, you know, like that's the kind of stuff that I love to do with my athletes too. I think like those though, um, lower intensity, you know, moderate up to moderate volume, low eat, you know, uh, like low amplitude plyometrics, barefoot are huge for people, especially because people like a shoe can hide. Or I'm sorry, I shoe can make your foot interact differently with the ground. Um, like an example of that is like, when I work with a runner who, if they have like a really bad heel strike and a super easy way to get them to knock heel strike is to happen. Like do tempo runs on my turf without their shoes on, because you're not going to jam your heel into the ground. If you don't have two inches of foam, you know, protecting your heel. So all of a sudden their overstride is completely changed just because. Of of how they're kind of trying to interact with the ground. So, and I think that also helps them, you know, helps their intrinsic foot muscles. Just get a little bit more adaptation under stress a little bit more. And I think there is definitely a huge upside to doing some of those easier activities barefoot, just to get people moving differently. I think. So much of from the PT side that we do is just, we're trying to expose people to the things that they don't normally do. Um, we're we always talk about variability and we're trying to like increase the different things that they can do and just give them more variability, um, which doesn't necessarily need to be like. Any one specific thing. It's like, we're doing a bunch of different things that are just different than what they do. So like, for example, when we see like powerlifters, it's like, we're not always like working on their squats sometimes it's like, you just let's throw in some different accessory work like split squats. Cause you just don't ever split squat. It just changes it, the loading pattern pattern a little bit and makes them move slightly differently. And can just give them a little bit. You know, stresses them in different ways than what their traditional, what their, what their sport does or what they kind of typically do on their own right now at the end, that kind of aligns with. Our model. So at the top of our model is, is performance. And then it kind of branches off into a broad focus in a narrow focus. And that narrow focus is when a client comes in and they have expectations of what a training session is going to be. We have to somewhat meet those needs. Right. And then we also then look at like, what sports. You know, take some fitness testing or like some KPIs and where do we need to kind of get better? That's like our narrow focus, right? And then our broad focus is just long-term athletic development. And that's where a lot of this barefoot stuff comes in for kind of warmup is we're going to try to expose them to as much as we possibly can. And then especially early on with them, we're going to expose it as much as we can of things that they definitely don't do. Right. So again, I'll go back to hockey. We're going to do as much post steer chain work as we can, when we first see them, you know what I mean? And I think just having that model, and then once we kind of get through that model, then it kind of meets back with more of our principles based in force production, velocity, and then moving on to quality. Right. Yeah. I'm like, like, you know, me, Greg and Doug kind of talk about this stuff. Like we got to like make them human first. Like let's give them just the human capabilities that they should be able to do, like covering all of the basic movement patterns of squat hit, you know, hip dominant down or whatever words you want to use. Push pull vertical, horizontal carry. Anti-rotation just getting people to be able to do kind of all the things with a relative relative competence, because I think that's you just like you see, you see young athletes who. Are being trained, like they're older athletes and they don't have even close to the, to the foundation that those older athletes do when they're doing like, you know, uh, like VBT or something when it's just it's like that kid can't it's like, like, or they're like they're, um, you know, doing like an Olympic lift things like the kid can't do 20 kilo. Kettlebell deadlift. It's like, why, why are we doing that kind of stuff? Like he has so much other stuff he should be able to do just as like a young athlete that I'm not going to worry about some of that other stuff. Yeah. It's like, why are we having somebody sprint? If they can't like appropriately skip and March and hop and do some of those just basic things that are the foundation for those higher level activities. Right. And kind of goes back to like, no, sorry. I was gonna say, I kind of just plays into exactly what we were talking about with someone the other day is like, So much of this, especially early on is all motor learning, right? You'd be surprised at how much you can get by asking them to skip, you know what I mean, basic poles, whatever you want to call it, hip hinge, all that basic stuff. Um, and again, I don't think it has to go back to as far as it was where people were, you know, maybe getting too far down. Physical therapy who pull as performance coaches. Right. I don't think we need to go that far back. Um, and we don't need to have these young kids training, like they're pros either. And I think you're right on point with them. I really, I really like what you just said there too, of like going too far down away from. From like what they kind of need to be able to do. Like, that's something that I think we're seeing a lot more of is people are trying to like differentiate themselves, like in the industry, whether it is more like the rehab side or more performance side, um, you see people that like try to go, they try to get it down to like this one root cause of what's going on. And if you fix this one, itty bitty tiny thing, like you're going to see these dramatic changes in performance, but. It's like, if you, like, when you think, I think it's always about like the said principle, right? It's like, you have to do what you wanted, what you want to get better at. You have to do something that is that thing or something pretty close to it to get better at it. So it's like, you know, if somebody, we always kind of go back to like our orthopedic ringing, true emotion tests. If that's one of, it's our baseline assessment for pretty much everybody that walks in the door for us and it's like, If somebody doesn't have some of those normal ranges of motion, whether it's, you know, like hip internal patient or hip extension or whatever, like we're gonna get them those ranges of motion. But then I can't expect, like, just because someone's hip extension range of motion improved that like they're going to run two tenths faster when they go. And you know, if they haven't like done a sprint progression or if they haven't done something, that's like actually going to get them better at what they need to be able to do. Like. Yes, maybe from a variability standpoint, giving them more of those ranges of motion and the requisites that they need is super important. And we want to do that stuff, but ultimately like if we just then let them, people left to their own devices and we're not coaching them, then that's the kind of like, like what you're saying, like, you go too far down the PT rabbit hole, or you're doing stuff that's like too low level. And, um, you're not really causing any sort of adaptation. It's more of a motor learning standpoint, which is huge. And motor learning is super important, but ultimately like. Like that's part of strength. Training is motor learning, but that's also like getting strong or it's also skill acquisition. There's so many pieces that kind of go into it. Right? Can we take like one little thing that we think is gonna, uh, change just the whole system? It's like, if this system was that sensitive, that'd be a bad thing. That'd be a terrible thing. If like one little intervention completely changed the entire system and the person was that fragile, that like. One little intervention was just going to like completely change how they perform. Like that would be a terrible, terrible thing. So I think when people kind of preach that, that's what they're doing. It's like if we take a step back, that's not a good thing at all. I always think of progressions in terms of, instead of always getting harder or getting easier, it just has to be different. You know, you can just take a hop and instead of just, you know, hopping forward, You hop to the side, or instead of hopping to the side, you hop at an angle, you know, it's not making it harder, it's just making it different. And I think, especially when we've talked about long-term athletic development, that has to kind of be the idea. And then once you've kind of maxed out all of those, then go into the next progression. Yeah, absolutely. I think like, you know, like variation is necessary for. For, um, at a patient, right? Like you're going to get, you're going to get used to the same type of stimulus all the time. And then it's no longer going to cost you to adapt. You've got to vary it up and like, Simple things like that. Just changing the angles, changing the directions, changing, you know, like left, left. Right, right, right. Or something, you know what I mean? Just some sort of little tweak can, can be enough that it challenges the person, whether it's even if it's not necessarily physiologically or, but it's challenging them, challenging them cognitively to kind of figure out how to do the task. I think there's. Huge value. And in that of just like these little mixed ups and honestly, like from a coaching standpoint, like it keeps things fun for us. Like it's, so it's boring trying to coach the exact same thing all the time. Like they're still, you're still giving them the same type of stimulus that we're looking for, but like it's fun. It's fun, coaching something new. And it's one scene trying to see somebody trying to, you know, do something that's new. That's not like too far off from what you've already been doing, where you're. Just kind of changing, uh, what the stimulus they're actually receiving is right. And you're kind of building a movement library for them also, right. Because as we get into sport and we talk reaction and we talk a lot about this, a lot of times, if you're thinking it's already too late, Right. Like it's already happened. So exposing these athletes, and again, I'm saying athletes, it could be anyone but exposing people to as many different scenarios as possible. And they're building up that memory bank and their body's like, Oh, I've seen this before. Or we've been here before and they don't have to necessarily slow down and think about it. They can just move through it, I think is a huge key that I think people sometimes miss. When they're building a program and they get worried too much about too much variety cause they want to get really good at one thing, I think there needs to be some of the weekend, like you said, don't have to travel too far off that path, but just a little bit, each way I think plays dividends in the, I would, you know, I think that ideas is, um, like super important, especially for like, Kind of like what I think kind of we're all referring to is like the more like the actual movement type of stuff, like, like giving them the variation with that is super important. And it does kind of create that, that library that you're talking about. Um, But then it's like, then you see people who like, are kind of almost doing that sometimes with like the shrink standpoint of things where it's like every week, it's like a different strength routine. It's like, that's not actually going to get you stronger. Like, I'm sorry if you're, you know, it's, it's a trap bar deadlift thing, and then changing up for different type of hinge pattern. I'm in another one the next week, the next week, the next week. It's like, you're not going to be getting good enough from a skill standpoint to be able to perform that competently. And you're not going to be able to. Um, like really get them stronger if strength is the goal with that activity. So it's like there's a time and a place for sticking with it. And just being kind of giving people the same thing over and over and over. And there's also a time like, especially with like, like low-level plant metrics. I think there's a great place to introduce variation and create that, that, um, you know, movement literacy for, especially for younger kids and even, you know, like older athletes who are so used to just doing the same thing over and over being so stuck in like, The type of movements, they're doing their sport all the time. Like getting people just to do different things. Um, it has so much value. I'm gonna, uh, ask a question about something kind of totally different here, but I think Lee had mentioned that you did it now. It's something I have no experience in, but I'm always super curious about blood flow restriction training. Is that something you've done? Yes. Yeah. So we, uh, we do blood flow restriction portraying at our spot in Jersey. Um, it's awesome. Like, like I think there's, there's so much value in it from a, um, like, especially so typically like it's, it's used with somebody who's post-doc who's post-surgical who. Like needs to maintain strength. It's a great way to like decrease the amount of ads for feed that they're occurring. So what it does is basically like cuts off oxygen from getting to whatever tissue you're kind of, you know, basically it's either like at your shoulder, it's at the top of your thigh, so cuts down off oxygen to the rest of the limb. So you create a toxic environment to kind of stimulate the type two fibers that are actually like your strength fibers versus. You're type one fibers, which are obviously like, you know, basically there or use oxygen. Um, so it's a great way to when somebody can't actually strength, train, and can't stimulate those, those types of strength fibers, if you will, it's a great way to, um, stimulate those fibers without having the mechanical load, because they can't actually do it. So like, we use it a ton with, with people who are coming off of a surgery, but then I'll also use it when people come in, if they're like just their legs are trashed from. Hard workout or something like that. It's a great way to keep saying great. Right. It's really useful to, uh, help them kind of recover because again, you're not sore from VFR, which is one of the cool things about it because you're not doing anything that's actually heavy and truly stressful on your body. You just get a really good autonomic response to it that kind of can help stimulate healing without having the stress from, you know, heavy, heavy lifting. That's super interesting something. Yeah, I've always kind of wanted to try, but never. Yeah, did it. And I, I never had an anything around my leg or anything like that. Yeah. The Jersey your what will drive it? It's fun. It's it's I always tell people, you know, I always give people a little pep talk before we do it. Cause I'm like a super uncomfortable, so like get ready for that. I always tell them, it feels like. You know, when you were in sports and you're doing like a bunch of suicides of gassers or something, or your coaches, you know, pissed off at you for it because everybody messed up a practice and it just having, you run like nonstop where your legs feel like they're about to explode. They're so small and they can't move. And like, would your lungs feel the same way? So you kind of get that same feeling with the legs, but not the lungs. So the strength protocol is 30 reps of whatever exercise, a 32nd break, 15 reps, 32nd break, 15 reps, 32nd break, 15 reps. Um, So people always think like during that rest break, they're like, it's going to go away. Like, you know, you stop, you stop squatting for 30 seconds. You lakes like momentarily, feel a little bit better before you squat again. But because there's no oxygen going to it, it just feels terrible, like kind of the entire time. But then once you take it off, it's like 30 seconds later, a minute later, you're like, Oh my legs feel incredible. So it's, it's, it's a really cool feeling. Like it's almost seems like voodoo kind of at first, but then once you do it, it's like, Oh yeah. Um, I'm bought in. So with that, does the equipment matter? Like I know that there's some different name brands out there. Um, I'm not sure what you use. The only one that I've heard of and I've had experience with is I think be strong. Um, The, the Delphi unit. Cause that's the as well when we bought it. And I don't know if that's changed since that was the only like medically approved device. So like for us, like we have to use the medically approved device. I have no idea about like some of the ones that you see online. People, just a little tourniquets themselves like ours or ours actually have like a real blood pressure cuff that. Basically when you put it on you turn it on and it finds the person's blood pressure. So only includes up to a certain percentage. So for your upper body only includes up to 50% for the lower body includes up to 80%. Cause you don't want to over occlude somebody for too long of. We do some pretty damn serious damage. Um, but yeah, so those are the ones that we use are like the medically approved device. It's Delphi unit. It's the ones that are orange recovery system is the, is the course that we took him. It's I recommend it for anybody that's interested in whether they a shrimp coach or a PT. Um, or like rehab professional. It's a great course. The, they do a great job of kind of going into the physiology behind it much more than I kind of just didn't this little rant, but, uh, yeah, it's super useful and I definitely recommend it as a, like, even if you're going to buy the units, it's kind of a really useful tool to kind of understand what it does and understand the physiology behind, like why it works. Now my, my wife's a PT. Ryan's, wife's an ATC. So if an athlete comes to us with an injury, we always say, go see the professional, but the reality is some of them say, I don't want to do that. And I'm not going to do that. I'm going to rehab with you guys. All right. So. If, you know, we're seeing like hamstring strains, you know, ankle sprains, just simple stuff like that. What would your advice be to a strength coach that is kind of in charge of like rehabbing, even if they've said go see the professional, but the kid still comes in. I think that's, you know, like if, if trainers and trend coaches and, you know, I would just say fitness professionals in general. Always had to refer out every single time. Uh, they had a client complaint complaint of like some sort of like, or pain it's like, you would never see anybody ever. Right? Like people always have kind of something going on usually. So that's almost like unrealistic. Um, but again, I think that a concept of that low functioning and versus dysfunctional comes to play in, in this kind of scenario. It's like, how can you determine that? What they're, what what's going on is. Like a low functioning issue or is it a dysfunctional issue? Like if they, um, you know, like an ankle sprain, that's not a big deal. It's like, you're going to like progress them. Appropriately with different plyometrics and understanding like how you're supposed to, how you're going to be stressing the ankle to get it back to what it needs to be able to do. Eventually it's the same thing with, with like, uh, a hamstring strain. Um, it's like, I would say it's almost hard for me to answer that question because I am a PT. I'm like, yeah, I don't know what I should. I'm like, send them, send them to PT, but I totally get that. Like kids, sometimes I not do it. Like I don't care. I always think like, like the answer is, is, um, kind of convincing them that. If they really do need to go to PT, convincing them that like you can still train and you can still do stuff. Like, I think that's one of the reasons we have a great rapport with like the coaches and trainers that refer clients to us is that like, we never tell people to stop training. Like we rarely, rarely, rarely tell people to completely shut down and stop doing whatever it's like, we will find a way for you to be able to modify things, to be able to continue to do what you want to do. Um, so I think like hopefully trying to educate them on that was almost kind of your. If you're what would be your best case scenario, if they are really like, hell bent on like, not going to PT, but they actually do need that. It's funny earlier this summer, like as soon as we opened, there was a kid and he was like four months post-op ACL. And his dad's like, nah, trust me. It's good. And we're weird to send them away. It's like, what, what are you doing? You know, you still have range of motion issues. You you're clearly not even walking. Right. You know, so yeah. Like began on his first day. Right. That's, that's, that's a different, you know, like that's a completely different scenario that, that then like, you know, somebody having a hamstring issue or like an ankle it's like, yeah, whatever. Like it's probably going to get okay. If they're doing things that are appropriate and they're not just, you know, doing something, that's actually irresponsible at the current moment, but. That kind of stuff happens all the time where, whether it's, you know, the PD didn't adequately, adequately prepare them, or they've been discharged when they probably shouldn't have been discharged or maybe they run out of insurance visits or there's so many different reasons that those kinds of things happen, which is super, super unfortunate for the client. And it puts the coaches in, in, in a, in a tough scenario because it's like, You know, one of the things that we talked about is like, understanding your skillset. It's like, if you don't have, and this is not like a knock on anybody, but it's like, if you don't have the skillset to be able to deal with somebody who is coming in, limping coming in with range of motion issues and all that kind of stuff, it's like, yeah, you're probably not the one to be prepared for them. And it's like the same thing from, from a PT standpoint. Like, just because. You are the medical person and you've gotten somebody the range of motion. They have like, you know, decent, they didn't have limited asymmetry and, you know, kind of a typical PT check marks doesn't mean that like, you know how to get them ready to return to sport. So like they should then be sent to a strength, performance specialists like yourself. So it's like, there's this. There's this in-between zone that, you know, who's kind of handling the care from that typical discharge from PT, which is like three to four months, we ensure to have your full range of motion and all that kind of stuff to whatever the timeline is to actually get back on the field. It's like, who's kind of handling that bubble because that's, that's what happens is like, go there. They're not ready for strengthened conditioner. They're not ready to like, for like actual good training yet, but they get sent to somebody like you. And it's like, if, if you. If you don't have the model to be able to do it, like maybe that person needs one-on-one care and it's just your model. Doesn't allow you to provide that. Like, that's a tough situation for coaches to be in. So I just feel bad when that kind of stuff happens to coaches. Cause it's like something somewhere in this line of communication, whether it was, you know, the doctor, the ATC, the physical therapist, whatever it was like, somebody kind of something was miscommunicated and the person is not ready for whatever. Somebody thinks that they're ready for. Right. And I just think there's, there's so much pressure for these young athletes to perform. Right. And like get back and play and you know, and like we're talking like long-term athletic development. Like no one cares if you're the best 12 year old. Right. But that mindset is out there and that's a hard mindset to break. You don't even like 14, 15, 16 trying to explain to them, like, don't rush this. You don't want this to follow you. You know what I mean? For the next few years? Um, it just hard, cause there's just so much pressure. Uh, I think they put on themselves, but maybe from parents, from coaches, from scout, for whatever that they feel like they just want to bypass it. And as soon as it's like, yeah, you're cleared. Right. Even though they may not be clear to what, to the extent they think they are. Right. It just it's just go. Right? Yeah. I think that's, you know, that's the hard part of like, Athletics and kind of the new world where everybody is playing sports 12 months out of the year, they don't really have an off season and they're, don't really get time to be a kid and just kind of, you know, like enjoy the sport. It's like if you're, if you're 12 years old and it does happen like 12 years old and you're rushing back. For a game or something. It's like, something is like out of whack, like the priorities are just kind of mixed up. It's like, you should be having fun. You should be feeling good. You shouldn't be battling through injuries as a 12 year old. It's like, take some time off, you know, enjoy life. Like go ride a bike, go throw a ball around the backyard with your friends. And it's like, that should be part of your rehab. Then it's just like being a kid again, rather than making things. So. So regimented for these, for these young athletes and that kind of, I think that kind of goes for everybody. It's like the rushing back to be competitive right away. It's like there's a time and a place that that's absolutely the case. Like I have an athlete who she's trying to, she was coming off an ACL. It was trying to get back for her senior year of soccer. She's not planning on playing in college, but she's like, I am playing my senior year. It's like, Cool. Like what I want more time. Absolutely. But I'm gonna do everything I possibly can to make sure she's confident and can be competitive on the field when she get back, when she, when she gets back to her sport. Um, so it's like, you know, there's a time and a place to kind of push things, but then you have to know when to like reassess the entire situation and be like, yeah, we don't need to, you know, get Tommy back on the field for his, you know, 12 and 12 U baseball game this weekend. I think it's great. What you're doing, what Doug and Greg are also doing with, uh, resilient. What is next for you guys as a group and kind of the model you have where you are blending, this like therapy and also performance side to it. And then also just for yourself personally, um, for us, it's growing the practice more, um, like we, we have two locations, so we're in Manhattan and then we're also in Chatham, New Jersey and we had just signed a lease for, um, our new space in Manhattan right before the quarantine kind of hit and stuff. So the timing of that wasn't necessarily ideal, but we're back on the other side of doing well again. So it's really trying to. Grow like the clinical side of things and continue just to help more people in the areas that we are in Manhattan and New Jersey. Um, but also from an education standpoint, we love talking with other professionals and just sharing what we do with people. We want to be as open and honest and authentic as we possibly can and, and share like the things that we actually do. Cause there's so many discussions. About like theories and the best way to do this and the best way to do that. And, but without like sharing case studies or like what it is you actually do on a day-to-day basis. So we're trying to create education, um, you know, content that it's kind of biased towards that of like, like no frills. Like this is truly honest. This is how we practice. This is how we assess this is how we coach, this is how we, we, um, kind of look at things and just share what we do, because I think having that kind of. Honesty. And that openness is kind of great for the professional, because I think there's a lot of like infighting between people that's just completely unnecessary and trying to like, look like I'm smarter than you and all that kind of stuff, which is that's another topic that just kind of irritates me. Um, but yeah, but like just trying to create more education content, that's, that's authentic and real. And it's like not saying that this is the best way to do things. This is how we do things. And like, like take it or leave it, like no issue, but we just want to share what we've. What is it that we do? So personally, one of the things that I'm doing is I'm creating a course for creating our next online course, which is going to be, um, turned to sport with an S with a focus on acceleration and agility. And just going through how we progress somebody from, you know, low-level plyometrics into actual agility drills. Like, like we were kind of talking about here. That's awesome. So where can people like find out about, um, I guess where can people reach you? What's your website? Can you give that info? Oh, to, uh, resilient performance.com. We have our first course online actually, which is resilient movement foundations. And we actually wanted to say, uh, we have a 10% off promo code for people listening to this podcast. If they just put in the promo code podcast, we get 10% off of that course. And that's our introduction reports. That's just kind of like. Uh, general strength and conditioning. Like how, how do we coach basic movements? How do you want basic movements that look like? And then we're always reachable on social media @resilientppt is our handle on pretty much everything. Um, personally, my email is [email protected] So I, again, I love talking to people and kind of sharing what we do. So everybody has questions, like feel free to reach out. I'm always happy to hop on a call or do a zoom or do something. How to get to know people and hear about what you do and share what we do. Awesome. Well, thank you so much for coming on. Yeah. Thanks for having me guys. I appreciate this is fun. Awesome. Thanks Trevor. Thanks for listening.
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