Hey, everyone. What's going on? This is Dr. Chad Kuntz, and welcome back to "Prime Time." I'm stoked for this really three-part series, The Terrific Trio: Cupping, Needling, and Hands on Care. You know, I get so many questions about this. I figured, you know, let's go ahead and sit down and just discuss this during our podcast time so we can be as thorough as we need to. Because, like I said, these questions will continue to arise, especially when I'm practicing, people want to know what they're doing.
And to be honest with you, a little backstory, I've tried a little bit of almost everything throughout my years of practice. For instance, I've tried ultrasound, I've tried E Stim, I've tried the hot towels, the ice, the scraping, the lasers, and just the fancy massage tools. And, however, at the end of the day, I wasn't getting my results to get that long-term relief that they were looking for. They might have felt some relief, and they might have felt like things were helping.
But for me, it's really important that not only can we help that person experience no pain, how can we get that carry over in between appointments that tends to be a barrier sometimes for practitioners. I know that I've certainly ran through it, having a really hard time helping someone to continue to feel good in between appointments, and not only that, six months, nine months, a year, multiple years, to the point that they can continue to feel good. And really, there's a lot of things that go into that, you know, the awareness, their exercises that they're doing, a lot of things.
But from a hands-on perspective, I want to make sure that the modalities and the tools that I was doing during our quality time together was being incredibly useful. And just kind of preface, you know, and part of this three-part series, you know, these tools aren't technically for everyone. I think some of the greatest expression of art here is knowing who is a good candidate, how hard you want to apply it, how fast you apply it, as well as how often. It's kind of like an artist who's playing with the same tool like a paintbrush. You give several artists a paintbrush and you give them different colors. They can make something completely different out of those same tools.
And that's kind of the way I look at the tools that we're using here in terms of cupping, needling, and really the hands-on care. And I think there's so much content here. We're going to split this up today, we're going to just start to diving right into cupping, a little bit of the history and how I like to use it. And then next time, we'll get right into the dry needling, which will be fun.
So guys, cupping really goes back to 1500 BC. It was actually kind of claimed as a pseudoscience. Hippocrates was actually one to use that. I want to say that was around 400 BC.
And, you know, it just tells us that this thought process has been along with the humans for a long time. Traditionally, what is performed, it is static. So, in fact, I'm sure a lot of you remember Michael Phelps, when he was up on stage at the Olympics, he had those kind of circular bruises, you know. You could kind of see the bruises, you could see where they had applied the cupping. Now again, that's pretty traditional.
My typical style is very dynamic. Mine definitely is very unorthodox. It's unconventional. I would call mine more dynamic cupping because I like to move the cup with movement. And they're all different type of styles with cupping and especially in the dynamic set. You know, it's not just leaving it there and, "Hey, I'll be back for 20 minutes and come on back." That's the traditional style and that's where it's got more of pseudoscience.
I can tell you right now, I've had some incredible success with moving it around. And for me, it starts with interpreting the feeling with my hands, feeling the quality of tissue, discussing with the client, "How is that feeling?" Moving them around, making it tolerable. But we do know that there's going to be some form of discomfort there just because we're trying to make a mechanical change.
So what does dynamic cupping actually do for us? So I think a couple take on points here is that it absolutely helps improve blood flow, it can be great for swelling. I've definitely noted that.
One actually interesting area that's really helpful for swelling that I found is actually the inside the ankle, near the tibial posterior tendons. So as the...everyone knows where their inner ankle bone is, the medial malleoli, kind of just above that on the inside of your inner shin. And people can get swelling there. So if you've had like calf pain or ankle pain, that seems to be really helpful particularly for that area. But also, I'll get into a little bit later other areas, but I will also say swelling in the shoulder, that the cupping can be really helpful to open that up.
So it's great for some forms of lymphatic drainage, I think it's great for the immune system to kind of be more aware of what's going on there. Like if you're in pain, sometimes I use analogy your body puts up yellow tape around that area that says, "Don't go there." The cupping draws attention to the area. Kind of cuts the yellow tape and says, "Guys, we've got some work to do. Come back over here, I'll start cleaning it up." It's almost like your body didn't know what to do with that area because it was in pain, and therefore is in fear. So it can actually be great in the terms of creating attention towards areas that need adjustment.
It also is really great for adhesions, old scar tissue. So if you've had a surgery in your low back, or your knee, or your hip, and you've had that scar for 20 years, and no one's ever really worked on it, I wouldn't want to use that cup on that area. I would want to loosen it up. And yes, it may be uncomfortable. But what's honestly cool is, a lot of times, as I start to get in there, they're like, "Oh my God, that's my total knee joint pain." Or, "That's the ACL pain that I felt 20 years ago." And I'll be like, "Well, the reality is I'm just on your scar tissue. I'm actually on the portal where the surgery went in."
That's what we call the portal on those little scars that are present, those can hold a lot of pain. And sometimes they're the pain that you thought that was your, whatever, meniscus recovering or your labor, I mean, your rotator cuff recovering. But in fact, that can be a portal hidden in that scar tissue. So it takes some work to get in there.
And cupping is really nice because it helps you cover a lot of area. So one big area that I like to think of would be the lats. So these huge muscles that it connects to your shoulder, actually go all the way down into your, you know, thoracolumbar fascia on your low back. And so cupping can be great because it covers a lot of areas.
And not only does it kind of cover a lot of areas, they can actually help me detect what's going on. So I can literally feel kind of road bumps as I'm going through it or moguls and hills as I'm going through poor tissue quality.
And this might freak you out. But sometimes I can literally hear the tissue. There's like kind of a grinding and a grading effect. And it might feel like you're pinching, burning or a pulling sensation. But really what's happening is that you're just opening it up, creating more blood flow, and you're addressing mechanical malformations with your cupping as you open it up. And there are multiple layers to integumentary system, we're really trying to get down to the deeper layers where you actually have the wrinkles and the malformation on the tissue. So it does take some force to get down to that low of a layer rather than just superficial.
So I find myself quite aggressive, at least we'll work up into it so we can get into the deeper layers so that we can have more of that profound, long-lasting benefit. Sometimes people are quite sensitive early on. So we might have to just kind of work our way up into that for a few sessions. But we're working our way up into that so we can get into the deeper layers.
Something else just really cool about the tissue response is that the color and what it presents with after I do the cupping is actually indicative of the quality of the tissue. So let me just expound on that.
So if you have poorly acute light tissue. So if you've had a recent trauma or an injury, you'll actually yield higher histamine reactions. Most people know what histamines are, right? You can even get those with allergies at really the microbiological level, and your tissue can host that as well. So if I utilize cupping, let's say your forearm, and you've had a recent injury to that, your forearm will reflect a lot brighter, broken blood vessels opposed to healthy tissue. And that provides me some information.
In fact, the first time we do that, you might have significantly redness. So a lot of redness in that. And then it'll actually transform into a bruising and that might last 7 or 10 days. But as we go back into that and we keep working on it, and we keep working on it, you're going to notice that the redness starts to settle down. It becomes less red, becomes a little quieter, it becomes a little more focal as to the epicenter of your pain, right? So it also gives us some more information that way.
And as we keep working and working on it, hopefully, at the end of the day, which could be your plan of care, it's 12 weeks, we're working on it, what have you, all of a sudden, we just glide right over it, it doesn't leave any histamine response. Chances are, very strong chances, that you're feeling pain free at that point because you don't have that response.
Now conversely, on the chronic level, what's really interesting about what I find, like let's say it's the pec, you've had a tight pec and you've had shoulder pain for forever, and maybe even neck pain. Let's say I really like cup the pec. The first time I cup that, if it's been a chronic problem, you'll find like these smaller, circular purple nodules, like circular nodules. And just anecdotally speaking, okay, I really haven't done, all the ins and outs physiologically, but just anecdotally, I can relate that to chronic types of pain. It just feels like the blood is deoxygenated, it's just sitting in there, it's just gunky. And so you'll actually respond with those deep, darker purple nodules that will be the first few times that we start to work on it. It is linearly associated with pain when you have that.
So it'll be a little bit more uncomfortable when you first do it. You'll have more of those dark purple nodules. And they actually too will get better as we start to improve the tissue quality. And chances are, you're feeling a lot better at that point too.
Again, it's just fascinating to me that the healthy tissue will leave no markings at all. And that's usually when I'm looking at you and you go, "Yep, it feels good. We're at the same intensity as we were last time." And that's when people start to feel amazing.
There are different layers of intensity that I'll use with the cupping. I might start pretty soft, like I just call it level one. And I kind of just go up to grades of five-tiered system. Five would be the most that I can move. And that's where we're really getting into, again, the deeper, deeper layers.
So just kind of finishing up guys, if you've tried typical massage, you might have even tried traditional cupping or rolfing or just deep tissue massage or stone massage. Really any other type of hands on care that's out there or some forms of stretching and you're still having pain, cupping can be incredibly powerful. It can be incredibly powerful under the right circumstances with the right artist. Not all cupping is created the same.
So when people, if they were to come in and say, "Well, I've already tried cupping," I'm going to respect the fact that you said that, but I am not going to discount what my services could offer you because I know my experience and how all cupping is not created equal. The way you set up a client as you start to work into it, can be really powerful, right? So if I'm working on the inside your shoulder blades, because you're having pain down there, I'm not going to just only lay you on your stomach and work on that. Like, I might get you laying on your side, I might get you reaching with your arm, trying to get that shoulder blade to elevate and try to disconnect and dissociate from the spine to open that area up.
And that's where we can kind of uncover some crevices, some hidden gems, some gold mines that you wouldn't have otherwise found. In the glutes, which actually have been associated with forms a low back pain or hip pain, I will put your glute on stretch. I will have you pull, grab your hand onto your knee, pull the glute, open it up, while I'm doing cupping with you. There is a linear increase in somewhat of the discomfort when we do this. But it's because we're finally getting to the areas that have been needing to get uncovered for the longest period of time. So I would say common areas would be the pecs, the lats, on the shoulder blades, the neck, or the thigh.
So again, just to kind of cover that, if you've had shoulder pain, the pecs and the lats can be profound to help out with your shoulder pain, especially if you find yourself limited like reaching behind yourself. Like, if you're in the car, reach for the backseat or even just in your workouts you notice that you're generalizing more limit in your motion, that can be incredibly important. And then with shoulder pain, if you have pain like in the upper middle back inside the shoulder blades that can be a fantastic area for cupping as well.
Those who have tightness in the neck, the scalenes and the muscles on the side of your neck and the upper traps are a wonderful area. They do leave bruising, so around the neck, make sure you're not going out to a nice big dance or something like that if I'm cupping you because it will leave what looks like, I joke with my clients, hickey marks. So that's like somewhat of a limiting factor, right, because people don't always want to be walking around with hickey marks on their neck. But hey, if we can do it, it's been incredibly helpful because there's a lot of nerves around in that area and actually opening up the neural pathway through the muscles can help provide some immediate relief.
And the thigh is wonderful, especially right where the hip creases, where your hip flexors are. I'll put you on stretch first and then I'll do some strumming with that cupping. And again, that can be a tender area, but, man, that can really provide some really quick relief for hip pain or even back pain.
And just to kind of finish up because I know we've talked about a lot today, kind of a really cool take on point with the cupping is that it can provide relief like that. Not all tools that I have can provide relief that quickly. But under the right circumstances, with the right artist, with the right paintbrush, so to speak, you can find relief almost immediately.
Now, chances are we're gonna have to continue to work on the underlying root cause, we have to start adjusting your movement, start to adjust how you're sitting at work, walking, standing, but to feel that immediate relief and know that we changed it just like that is profound. And then I love seeing my clients' eyes, they light up and they say, "Holy cow. I feel so much looser, I feel lighter. That thing used to feel heavy." And that's kind of what you can expect under the impression of dynamic cupping. So everyone knows a lot.
If you have any additional questions like, "Is this the right thing for me?" You send a couple things that may have made sense, feel free to email me. Let's carry on the conversation. So shoot me an email at email@example.com. And let's see if that's something that would be the right fit for you. Again, we're located in the Charlotte area. Feel free to reach out to us. And as always, thank you for tuning in to "Prime Time."
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All right, everyone. Welcome back to Pr!me Time and I'm stoked to take on a pretty big topic today. We're going to talk about, "Have I Done Irreversible Wear and Tear Damage to My Body?" So this is a question I get asked a lot and it really puts people into a tough mindset and unfortunate mindset.
It puts them into fear. It puts people into the state where they all of a sudden don't even feel like themselves anymore. They don't think that they can get back to doing the things they love anymore because they've got this visualization in their mind of a quite horrid picture. Let's say it's in their shoulder joint. Just for a second, imagine if this was your shoulder, what you would paint the picture as as to what irreversible damage looks like.
I know if I think about that I view that the cartilage is kind of gone. I might feel some bone on bone in there. I might see a labral tear, it might be red due to inflammation and pain. And we don't really talk about this kind of stuff in terms of what we visualize that to look like.
But quite honestly, that's the way I would picture it. And you might have your own kind of story on it, or maybe you have had pain, or may have been told this and you've already pre-thought about it. But I think the big takeaway right now is, A, this puts people into fear. And we also have to, you know, discuss the truth. We have to be honest with ourselves. If there was a significant trauma, let's say you're skiing, and you've really landed hard, and let's say you tore your ACL, and MCL, and LCL, and you really did a good number to that.
But the question is, did you do irreversible damage? We've gotten so much better in even our surgeries, you know? Even though I'm one to help avoid people from surgeries as best as possible, surgeries have gotten a lot better. So, you know, let's say that person that tore those three ligaments, they go into surgery. It's not really like they've done irreversible damage.
On the research in that case, they might have a chance to have more arthritis in 10 years, but is arthritis irreversible wear and tear damage? As we get older, we're all heading toward the same space. I think we tend to neglect that sometimes. We have to be honest with ourselves.
We are all heading to the same spot, right? We don't really like to think about that. What that does mean is that there will be natural wear and tear into our bodies, which is shown in the forms of arthritis, shown in the forms of disc degeneration in our spines, maybe even disc bulges, natural cartilage loss. Those kind of things.
I still wouldn't call that irreversible damage. Now, I know that I can't reverse arthritis, okay? I know I can't reverse arthritis. I know I can't go in there and put more cartilage, more disc height in there. There are some promising signs to stem cells, which I think is probably the closest thing that we get.
But even then, I think most people would agree, you wouldn't go back on an MRI and see that there's increased space in there. So where does that leave us? Well, I think it goes back to, what are we able to do, still? Despite MRIs, CAT scans, and x-rays, previous trauma, what are we able to actually do?
I think for me, this boils back to trying to regenerate confidence in movement. I try to get my clients away from thinking about that irreversible damage. Because it...you know, I've just realized helping people get back to doing their thing, the things they love, is so much more than just the mechanics of it.
So much of it is in between the ears. So much of it is our mindset. So I find myself constantly battling clients who are coming from other health professionals. A lot of times it is their doctor and the doctor has told them, "Listen, you know, Judy, you've got significant irreversible wear and tear damage in your knee.You're 65, you're not getting any younger.You want to get back to walking three miles, but you're going to need a total knee."
And granted, there are times when the arthritis is so significant and osteoarthritis has really flared up to the point that maybe she does need it, but I'm going to say that that's lesser than more often. I think that more often than not, she's able to actually get back to doing the things she loves with really good care. And maybe it won't be overnight.
Maybe it'll take 12 weeks to 16 weeks, and she'll have to put work in, and maybe relearn how to walk, and do some stretching programs, and really start to strengthen her body, but to maximize her quality of life without going underneath the scope, because she's trying to regain the confidence in movement. And she's not going to just give in to the fact that just because she's been active all her life, that suddenly just all of a sudden she needs a total knee surgery.
In fact, in this case, I would strongly encourage her, if nothing else, to go through six to eight weeks of care. You could call that prehab if you needed to, if she ended up going into surgery, but to try to maximize her prognosis or ability to get better even following her surgery. So we use that as a 65-year-old, but that could be the case of having a significant knee surgery when you're 25.
I actually had a hip surgery when I was 23, right? And if I were told, "You've done irreversible damage just by having a surgery." And I was told that I'd never squat below 60 degrees again. What kind of mindset is that? What kind of a life can you live if you're shackled in fear all the time because you've been told by someone who you had a lot of trust with, right?
They've got their doctorate and they sat there and told you. They looked at the MRI, or CT scan, or x-ray and they looked at that diligently and they showed you the results and they say, "You've got irreversible damage. You can't get back to squatting, and lunging, and working out again." Those are really impactful moments for people, where you've really got their attention.
You're in pain, so you're sympathetic system's up, which just mean you're kind of in the fright or flight stage, right, where you're caught up in that moment. So you really record that well in your brain and you'll record that for maybe ever, honestly. I mean, I've had clients that have told me 20 years after their back surgery, or their hip surgery, or their knee surgery, and as I started to examine them, it's like, "All right, Lawrence, let's see you do your squats."
"Oh, I didn't tell you, Chad, but I had a back surgery 20 years ago and he told me I'd never squat again.He told me that I've done irreversible damage.I shouldn't do that." It's like, "Well, how have you been moving around on a daily basis then?How are you sitting down?Isn't sitting down into a standard, 18-inch chair a squat?" "Yeah, it is. It really is."
So my take-home point is irreversible wear and tear really invokes a lot of fear, and I tend to help try to get people back to being confident in movement as best as I can. We want to acknowledge if there is a point where someone may need that MRI to see how significant and severe their arthritis is. There may be a point where that comes, but more often than not, we're able to help people really maximize their quality of life without going underneath the scope because of just doing simple things the right way, you know, kind of relearning how to walk or relearning how to stand.
We catch ourselves doing these small daily micro traumatic things that eventually add up and compound themselves, and we start to walk way differently than we did even 10 years ago. So overall, I want people to continue to be more confident. I want doctors out there, and even just health professionals, to be more aware of how profound it is when we tell our clients and tell people that, "You've done irreversible damage in wear and tear."
We've got one life to live. I want everyone to really, you know, attempt, if nothing else, to do the things they love, to be as active as possible. You've only got one life to live, so let's shoot for the stars. That's my motto. So thank you guys so much for tuning in to our podcast and vlog today. If you guys have any other questions or topics of interest you'd like me to tackle, shoot it at firstname.lastname@example.org, that's email@example.com, just feel free to shoot me an email.
Until next time guys. Thank you so much. ♪ [music] ♪
Hey, everyone. Welcome back to Pr1me Time. We are on episode number 15, and we're going to discuss how to avoid joint pain when engaging in your strength training regimen. I think this is a great question, a great topic because I know, at least for me, I wanna be able to continue to train as long as I'm standing on this earth. I want to continue to be as strong as possible, I want to be resilient, I want to be preventing future injuries as they occur. I know that we're not invulnerable because we are humans and things will happen, but, we do wanna keep pain, as much as possible, out of the equation, specifically joint pain. So, first off, I think we have to think about the diagnosis. How do we know that it truly is joint pain? I have to bring that up just because of the speculation that the diagnostic imaging such as X-rays and MRIs have shown us.
And what I mean by that is, they're starting to see information that MRIs are revealing where people may have fluid in the joint, they may have degeneration in the joint, they may have even arthritis. And they'll come to find out that the people are asymptomatic, meaning, they don't feel any symptoms. So, I've also seen, when training with clients and working with clients, they'll identify as, "Oh, yeah, that's my shoulder joint, that's my labral pain, that's my elbow joint pain, injured that a long time ago." And we have to first kind of think about the question, how did you know that that pain is coming from your joint? Have you been properly assessed by a specialist to determine to what extent that is joint pain? How do you identify joint pain? Well, for me, it's pretty clear. If there's inflammation within the joint, there might be some swelling.
Swelling is a pretty good indication that the joint is not too happy, and we might be able to pretty confidently say, "Yeah, this is coming from your joint." A lot of times too, if I passively move that joint around and take it to end range, and if I feel maybe a firm end feel, which means it's got a little give to it and the client has pain, and if I know that there was no muscle guarding, meaning, they weren't consciously or even subconsciously contracting that muscle, and there was pain with it, that might be a pretty good indication that there is some joint pain in there as well. I do have to mention too that the myofascial system hosts a lot of pain, a lot of discomfort, and it's usually first noticed by my clients when I start palpating it, meaning, touching it. And I start kind of fishing around and hunting, so to speak, where their pain is truly coming from.
Let's take the shoulder, for example. Let's say they point at the front of their shoulder, and they go, "Yeah, that's where my labral pain is. I did have an MRI two years ago. I've been having that shoulder pain on and off with my weight training regimen for a few years, and my doctor told me that that's my labral pain." I go, "Okay. However, have you ever been assessed by a specialist, a musculo-skeletal specialist, that will take the time to observe, and analyze, and assess if that truly is labral pain?" Because if it truly is labral pain, from my background, they're gonna have some pretty painful, catching and clicking, and there are some things called clinical prediction rules that can even help paint us a better picture, a better guess, if you will, as to what's truly causing that pain. And with a cluster of symptoms and signs, we can usually get pretty close.
So, after you start assessing that, and start hunting and poking around, all of a sudden the client goes, "Oh my God, that's my labral pain." And I go, "Really? That's it?" And they'll say, "Sure." And all of a sudden I like look down and I'm pointing and I'm touching their anterior dome, or maybe if I got really deep, I'm touching their bicep tendon, which does have an insertion onto the labral, especially the lateral long head. So, when we discuss how we avoid joint pain in my weight training regimen, we have to be sure that we truly are diagnosing it as it truly is, which is within the joint.
Let's say we get past that. Let's say that we've given it the diagnosis, let's keep it easy and say that there's shoulder joint pain. Well, now we wanna know which specific tissues are affected. Most common, I would say, in the weight training population, which is what I work with quite often, the labrum is irritated. So, we now have to think about what the labrum does, what specific motions bother it, what put it kind of at jeopardy, and then we have to compare it to your weight training regimen. What exercises are you doing? Who taught you that form? How much weight are you doing? What's your repetition and set scheme? What are your rest breaks? How long have you been doing that form? How often do you provide yourself, excuse me, intermittent rest breaks, meaning, throughout your mesocycle, or your two to three-month-long program, how often are you giving yourself rest days? All right? Maybe a rest week. When is the last time you ever took a rest week off? See, you start to get into these questions and you start to get some of the answers that pop up right away.
For example, sometimes my clients will say, "Well, shoot, I've been doing that exercise for two or three years. In fact, I can't ever remember not doing it." So, you get some kind of aha moments like that when you ask those kinds of questions. Sometimes it's based off the form, all right? Sometimes people are excessively using their joint and they're not truly using their muscles. I can kind of see that when I analyze movement based upon how much weight they're using, the momentum strategies that they're using. Sometimes people kind of jerk up the weight, and if they're unable to do it in a nice, timely, concise manner, I feel like there's a little bit more of a risk to be put upon the joints. Even then though, with regards to U.S.A. weightlifting techniques, so when you get into snatches and clean and jerks, if you do that stuff well, with great technique, you're still not really even at jeopardy for joint pain.
You have to have great flexibility, stability, mobility. I've talked about that before in a previous episode in Pr1me Time. You just simply have to train for what you wanna do. And if you do that well, and if you have the prerequisites, there's a good chance that you're gonna be able to keep your joint pain at bay. So, you have to be kind of cognizant of that. And you also have to take ego pill sometimes. For example, I used to squat way more than I could ever handle. In grad school, I remember throwing four or five on the bar, kind of going halfway down, and I would probably cry if I saw myself doing that nowadays, because it was probably butt ugly. And guess what? I remember having some joint pain back then. I remember feeling it within the joints, and that ache and discomfort.
Well, I needed to kind of relearn how to squat quite honestly. I had to take that ego pill. And, believe it or not, I feel stronger, I feel like I look better than ever, and that's because I've dropped the weight significantly. I'm going through a full controlled range of motion, and I'm sticking to realistic repetition schemes. I'm also undulating my workout programs throughout the year, which really helps. So, I go for strength, I go for power, I back off, I go for volume. And this can all be specific based off whatever sport or whatever you're going after.
Lastly, there are certain exercises that just are great for your body. The one that I think you at least have to be cognizant about is when you do a pull-down and the pull-down goes behind your head. Certain exercises like that are doable, but, for the majority of the population that I see working out and the majority of the population that I treat, they are probably just not ready to handle it. In that case, that person probably needs a slightly regressed version, where he simply, or she simply brings the bar to their chest, where it puts their shoulders at a better position. If you lack range of motion for certain exercises, you can be susceptible to pain. One other exercise that comes to mind is that standing curl with your biceps when your arms are out to the side and you're bring in your hand towards your head. I mean, that kind of resembles a therapeutic assessment for a SLAP tear, which is a labrum tear.
So you can kind of make these relationships based off of movements and how we would go after and test that particular structure. And you can go, "Hey, that exercise in that test, that special test for that labrum, in this case, looks pretty similar." Yeah, there might be a correlation in terms of load, especially if you don't do it right. So, that's it, guys. That's it for Pr1me Time. Let me know what you think as always at firstname.lastname@example.org, and tell me how you avoid joint discomfort in your strength training program as well. I think it's a great topic. I'm interested to hear what you guys have to say as well. Thank you, as always, for tuning in to Pr1me Time.
Hey, everyone, what's going on? This is Dr. Chad Kuntz. You're back with Prime Time, and we are on episode number 14 already. We're going to discuss what's the difference between flexibility, stability, and mobility. This is a huge topic, and I think if you ask a multitude of different providers, you'll probably get a lot of different answers. The reason that this is so prudent is because it's literally integrated in everything, whether it's a clinical concept behind the way you're stretching, whether it's a clinical reasoning or rationale for the type of exercise you're trying to do to get out of pain, you're gonna find this a little bit everywhere. So, let's just break it down and then think about the application a little bit. Flexibility to me is a passive range of motion. Passive means, if I take my elbow and I bend it as much as I can, that's the flexibility of a joint.
Flexibility is really important as a provider because it gives me a lot of information. In the physical therapy rehab world, we'll call that an end feel. We'll call that an end feel because it tells us a lot of information. There's a lot of different types of classifications we may have, for example, if I try to bring that elbow and bend that all the way, and you say stop before I can even move that elbow all the way and you say stop because it hurts, we call that an empty end feel, not that you need to know that, but what it does do is provide us a lot of information and say "You know what? There's a lot of inflammation in that joint," or, "Something is really bothering you. I feel like I could have pulled you all the way, but you stopped me." Or perhaps assessing the flexibility of that joint, I can push you all the way and it's got a nice firm end feel, the joints are approximating appropriately. That feels great. You've got great flexibility in that joint. So, that's a little bit about flexibility.
What about stability? Well, hopefully, stability is a little bit more of a common ground answer, a little bit of an easier answer to decipher. Stability just means that you're able to have a nice co-contraction around that joint, and it's able to tolerate force appropriately, and you're able to do that without creating any more pain, and it's able to handle a sum of force or load to the joint. And stability, just a little bit of a quick side note, is probably one of the most important features that we need that is often undernourished. I think a lot of times we're trying to stretch quicker than we are to stabilize.
And then there's mobility. I like to think of mobility as a sum of both flexibility and stability. For example, when you're trying to get that shoulder into that full range of motion at the top of shoulder flexion, it needs to have great mobility, because, not only should I be able to have passively taken that shoulder joint up into that full range of motion, but I also need to be able to challenge its stability at that end range. And if you get both parts equated and working together, I think that's what yields beautiful range of motion.
Now, certain different types of thought processes will say that certain joints need one or the other. Maybe they'll say, shoulders need great flexibility, thoracic spine needs great flexibility, lumbar spine needs great stability, etc. In my clinical experience, I don't think it's that easy. I don't think it has to be brought down to that level of dichotomy. I don't think it has to be one or the other. I don't think our body is that simplistic. This body is an incredible machine, I will never stop learning about it, because it's always gonna be teaching me a few things as I work with my clients. Let's take a squat for example. I think, at the end of the day, you have to have this beautiful harmonious balance of mobility interspersed throughout the entire body. That takes into account that you have had requisite flexibility, and that you've done some stability training to help you get into that range of motion. The body really is connected, and it feels like the entire body kind of speaks to different parts of it to make it work so that you can do that new range of motion. We don't often think about it, but in that squat, heck, even parts of your shoulder blade, some completely non-irrelevant muscles up there are playing a role. And they feed off of each other.
So, in that squat, whatever work that your ankle is not doing, your knee is gonna try to make up for it, if that can't do it, your hip tries to make up for it, if that can't do it, your lower back tries to do it. And it kind of speaks to itself all the way up, all the way through. So, at the end of the day, I look to improve optimal mobility almost anywhere and everywhere I can. That means it has requisite stability, which is a really important differentiating factor than just saying I want it to be flexible. Just being flexible doesn't do a whole heck of a lot, because to me it means it's passive, in that you can't really control that. I think one problem that sort of throw my yogis underneath the bus here, but, I think one problem that yogis have sometimes is that they only achieve flexibility and they'll just passively pull themselves into positions, but no one is actually controlling that. And so sometimes we have to go back in and refrain that and say, "You know what, I need you to pull back on the level of flexibility you're going after, and I need you to stabilize there and let's teach you how to improve upon the mobility you have to get into that position."
So, I think that's where some different clinical beliefs and concepts come into how you're going to achieve that range of motion. But, at the end of the day, I think you need to be strong in somebody's end ranges of motion, but we need to intelligently progress into those ranges of motion. So that's just my quick thoughts on flexibility, stability, and mobility. I think this is a conversation that could go on a lot longer, but I wanna hear your thoughts. What are your thoughts on the differences and applications of flexibility, mobility, and stability? Why don't you email me at email@example.com. That's firstname.lastname@example.org. Let's hear more about this topic, who knows, maybe we'll have a part two based off of some of the conversations that you guys bring up. All right, guys. Thanks for tuning in.
Episode 12 | When Do You Really Need A Corticosteroid Shot For Your Pain?
"Hey, everyone, this is Dr. Chad Kuntz and welcome back to Prime Time. We are on Episode Number 12 where we're going to discuss, when do you really need a corticosteroid shot for your pain?
So if you've been in pain at one time or another when you ran into your general physician, your sports and or orthopedic doctor, the topic corticosteroid shots probably popped up at one time or another. And for most of us, we trust the doctor. They've done their homework. They've gone through all schooling and so if they suggest that we need one, we're usually on board. I'm just here to help give you guys a little bit more information and background on my personal clinical side of things having seen the effects of corticosteroid shots, and understanding now the timing in which you could best benefit from a corticosteroid shot. And perhaps some of this information can be super helpful for you guys at home.
So first we have to know what a corticosteroid shot is. A corticosteroid shot mimics cortisol. Cortisol is produced by the human body from the adrenal glands that sit just on top of the kidneys. Every morning, it's usually produced more so in the morning than any other time, however, should you be in a lot of stress in fight-or-flight, that's when cortisol is produced. So cortisol has very strong anti-inflammatory properties. That is most likely the main reason that it is favored in a corticosteroid shot. Because oftentimes if you're in pain, you have a lot of inflammation, so you need to fight chemistry with anti-chemistry, so to speak, and so, therefore, you knock out the inflammation with an anti-inflammatory effect. However, did you know that corticosteroids can actually start to weaken cartilage? They can actually degrade tissue that we're finding out now, most recently. Did you know that you're only supposed to have up to three of these performed, per year, in the entire body, because of their strong effects, strong negative side effects? They can actually promote muscle wasting and they can actually promote a decrease in bone density. In fact, if you have an excessive amount of cortisol for prolonged periods of time you can actually end up with osteoporosis, which is a severe weakening of the bones. In fact, it has also been shown to lead to something quite nasty called avascular necrosis most oftenly seen in the hip. And that's when the hip actually doesn't receive enough blood supply and that's not a good situation. So for all of these reasons, we have to be really more so mindful of when that corticosteroid shot is performed. Now, of course, if you have a corticosteroid shot every now and then, you're most likely at minimal risk for all those things I've just said. However, if you are a diabetic, do understand that this is gluconeogenic, and what that means is that it'll actually increase the amount of glucose in your bloodstream. So if you are monitoring that quite diligently, you would wanna know and monitor the amount of glucose that you have flowing through your serum or through your blood supply because you wanna make sure that doesn't get out of hand.
So when or who is the right candidate for these corticosteroid shots? Since there are so many side effects, why is it being performed so often? These are great questions. I'm here to kind of help you guys sift through it a little bit and kind of give you my personal take on this. I think one flaw of... this is more so even the healthcare system, is that we're just so reactive. We're so reactive and we jump to the most extreme resolution right away. And I think one example of that is a corticosteroid shot. Let's say I have developed right shoulder pain. It came out of nowhere, I'm not sure what's going on, I'm going to call it a 5 out of 10 pain but it's really you know bothering my quality of life, inhibiting my quality of life. It's making it tough for me to pick up my kids and it's making it tough for me to work. What do I do? Well, a lot of times I think right now in the population, we go right to our general physician. General physician goes, you know, you probably need to see an orthopedic doctor. They refer you out, they might do X-rays, which in my experience, most often doesn't really show anything. And then they suggest well we probably wanna, you know, not perform surgery right now but you would benefit from a corticosteroid shot. People undergo that process, okay? Now a lot of times, it does probably help but what is it really helping? It's probably helping the inflammation but it's not addressing the root cause. So now you've put yourself up for some severe side effects or possible side effects, and you haven't even addressed the root cause of it.
In fact, I had this sweet lady that had a corticosteroid shot performed for her knee didn't even know that she could receive care for it. And she had a severe reaction to it in the sense that it kind of gave her, if you guys are familiar with frozen shoulder, it pretty much gave her that in her knee, to the point that she couldn't even bend her knee and she had a huge autoimmune reaction to it. So all of a sudden, she had really high inflammatory levels and markers in her blood throughout her body. And she didn't even know that her knee could have been treated by someone and she could have foregone the corticosteroid shot. I'm sure you could imagine that made her quite unhappy.
So the point I'm trying to get to here is we need to address the root cause to figure out what the heck is causing that inflammation first. And knowing that these have such serious side effects, isn't it worth attempting conservative care for just 30 days to see if we can discover what the actual root cause is, which by the way you're gonna have to end up figuring out anyway? And seeing to what extent we can decrease that inflammation in that joint or in that muscle or in that tendon without a corticosteroid shot and save you all that worry.
So if you are in pain, and even though it's pretty significant, at a minimum, I would say find a practitioner that you trust. Find someone that can give you one on one care. I would prefer you to see someone with no techs, no aides, no assistants or anything like that, and to find a specialist, to find the best, okay. Find the best healthcare provider or providers that can give you the time of day to give you a good subjective history. Have a discussion what's going on because there might be actually something quite a simple answer there. You got a new job, you're doing something and moving a different way all the time. You began a workout program and maybe it's a certain movement that's just simply causing some inflammation because you're not doing it right. Yet you're gonna go to an extreme and get a corticosteroid shot when it could be like, you know, a quite simple fix in just 30 days. Isn't that worth it?
There are some cases, some cohorts of people, where corticosteroid shots have been shown to be maybe and arguably the most effective. The one that comes to my mind is a frozen shoulder. So a frozen shoulder, kind of an idiopathic meaning, unknown cause that's going on. There are some relationships like if you're a middle age female, if you're diabetic if you have thyroid problems, you might be more likely to have a frozen shoulder. So that kind of person might benefit from a corticosteroid shot sooner rather than later. But I wanna be honest. I'd still wanna identify her and give her a clinical diagnosis of frozen shoulder. And I'd still wanna see if she could benefit from our care for 30 days and within that 30-day timeframe to see what effect we could make changes on it. And guess what if we can't make changes in those 30 days let's go ahead and let's go through that corticosteroid shot. In fact, that's quite a common recipe for me anywhere in the body. If you have pain and it's just been stubborn, we can't get rid of it, well, sometimes you do need to take that firehose and put out the fire before you can begin with mechanical improvements.
So, guys, I hope that helps. That's a lot of information. Corticosteroid shots are talked about all the time. We wanna have a little bit more information about this. We wanna have a little bit more autonomy in our own pathway for our health. We wanna be educated so that we can make the best decisions in our journey throughout that point in time. And that was really the main purpose about this Prime Time session.
So thank you guys for tuning in. Feel free to email me any questions at email@example.com again that's firstname.lastname@example.org. Thank you, guys."
Episode 12 | When Do You Really Need A Corticosteroid Shot For Your Pain?
Physical Therapy | Ballantyne | Pr1me Movement
Episode 11 | How To Help Your Child Achieve A Collegiate Athletic Scholarship
Hey, everyone. Welcome back to "Prime Time." My name is Dr. Chad Kuntz. I'm the founder and owner of Prime Movement, and we are on episode number 11. We're going to discuss how to help your child achieve a collegiate athletic scholarship. So, let's be honest. We could probably spend days discussing this. We'll try to touch the surfaces of this, still cover a lot of the main content and to just kinda give you the framework.
If you have additional specific questions, as always, feel free to email me at email@example.com as if I don't know the information offhand, I will find you the specific details of this. Because when you start to think about a very young child trying to achieve a collegiate scholarship, there can be a lot of specific research-based guidelines out there which are very helpful to help you understand how much you can actually do when you're going through adolescence, when you're going through puberty, all these kinda nitty-gritty questions that need to be answered.
I'm happy to do this discussion too because I understand how much it costs to attend, and get, and achieve a really good collegiate education. So let's just do it a little bit smarter, guys, because I've seen already enough...a lot of kids getting hurt because they didn't have the right educational framework when growing up and kind of going through the process of trying to achieve that collegiate scholarship.
So, parents, when the kids are really young, and let's just use the example that you want them to be a stud golfer, and you want them to achieve a collegiate scholarship for golf. Let's start with that. So when they're really young, let's say two or three years old, get out in the yard and just model the movement, help them see it, watch it, and do that frequently. See if you could do that almost every day, even as little as 5 or 10 minutes. The kids are sponges, and they will pick it up. And they'll just see the way you're moving, and that will be a great start for them.
Let's scoot forward to the young ages of seven or eight. They're actually allowed to begin strength training. No, you're not going to stunt their growth. No, you're not going to damage their growth plates as long as it's done intelligently. So really intelligently can be simplified to meaning don't push them to do one rep maxes. Keep it fun, keep it light. I like to use a lot of bands in these type of kids just to learn the motion because really appropriate strength training is done when the person understands how to move that way and how to fire certain muscles.
So I think bands do a good job kind of helping the person learn to feel what muscles are being used. You can, of course, start to use some weight with this. Just remember you're not powerlifting or bodybuilding with this. They're just starting to learn how to move weight, okay? They're just starting to learn how to use their body to move a certain force. I do encourage bodyweight movements at this age, too.
From that age up until 16, we'll say, but don't think that's a hard fast rule. We want to be cross-training with them or hybrid-training if you will. So for our analogy, that's golfer, while we want them to have a majority of their time golfing, we also want them to have purposeful, nonconsecutive rest breaks from golf so that they can either do more strength training for their desired sport to help facilitate better movement in that sport. And also, they should be encouraging, or you should be encouraging them to do other sports, so basketball, baseball.
You don't have to become the most invested in those other sports because you have to realize, "What's the big picture of why I'm having my child play in this basketball season? Well, I want them to learn other concepts. I want them to learn how to work as a team of five. I want them to learn how to move their body in different ways to become more agile, to have better balance, to have better coordination. And then I'm gonna have them play baseball, and I'm gonna have them learn how to swing their hips and hit that ball in a slightly different way and yet still develop that eye-hand coordination since the ball's moving, and then I contact the ball and I swing that bat."
So you start to kind of depict and understand how these other sports can help your athlete do what they wanna do, even better. I would say it's pretty fair by the time they are 16 and moving forwards that they can start to really dial in that sport. And if you wanna go "year around," and what my "year around" means is that you still have purposeful rest breaks built into that program. But at the age of 16 and starting to move forwards, you guys can most likely do that. Again, I can't put an absolute hard on that, hard rule on the 16, just because everybody's a little different. People go through puberty a little bit differently, and you just have to kind of see where the athlete's at.
Lastly, to help your athlete achieve that collegiate scholarship, of course, you wanna get in front of them. And there's all these kinda other angles, but let's keep it mechanical. I want that athlete to be strong, I want that athlete to understand how to move, and I want them to have been exposed to offseason workout programs. And I'm not talking about just throwing any slew of exercises at them, I'm talking about them working with an expert to dial in proficient movements that help them with whatever they're doing.
A hockey player versus a golfer player versus a football player are all gonna need and have different needs in terms of the strength and power movement. Even within the game of football, if they wanna become an offensive lineman, that's gonna feel a lot different than quarterback in regards to what that strength training offseason program needs to look like.
So many parents get so caught up in having that child or athlete only play in the sport, and they neglect all the strength training. It's like they don't really understand the benefits that that appropriate strength training can do to catalyze progress. And it doesn't even have to take up that much time or your money. That's the best thing. A lot of people would happily spend thousands of dollars on equipment but never spend hundreds of dollars on teaching their athlete on how to properly move in a weight training work out.
You do wanna find someone the best. In my experience, you don't wanna necessarily teach them just the random base stuff, high-intensity aerobic training exercises. You want strength training. You want these kids to get strong. You do want them to develop muscle. And, of course, the specificity of their sport will decide some of this, but you can save the high-intensity boot camp stuff kind of for later. You want to dial them in with specific exercises for their end goal in mind.
If you do that purposeful two to three months span of only working out and then you gradually get them back into the sport, you will absolutely witness the difference. They will feel the difference. So, if you adhere to those concepts as they go through the ages, you'll have a better chance of helping them get that collegiate scholarship.
Like I said, guys, this conversation can really go a 1,000 different directions. So, if you have specific questions on the appropriate methods to help them progress in their yearly training...so if it's a baseball player, the specific angles and what pitches they can throw at what ages based of their tanner level, which decides whether, at puberty, it can decide what level of function and movement they can do. If they wanna become a USA weightlifter, there are specific guidelines on how many reps, and how much pounds, and when they can be a competitor.
So I didn't wanna cover all that today because that would be days' worth. So if you guys have any specific questions on that in your child's sport, I'd be happy to pull up the research, send you the information so we can make the best decision for your child, so that, most importantly, we can keep them healthy, keep them safe. Don't get them burnt out or injured before they even make it to that opportunity for their collegiate scholarship.
Thanks for tuning in to "Prime Time," guys. We'll see you next time.
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Episode 10 | A Perspective on Health Iphone Vs Health | Pr1me Time
Stem cells have gained a lot of attention lately and rightfully so. Listen in to this PR1me Time Episode to learn my personal experience having treated those who have undergone a stem cell orthopedic procedure.
Episode 9 | My Personal Experience With Stem Cell Procedures | Pr1me Time
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