S05E103 - Beyond RICE: Modern Approaches to Athletic Healing with Kayla Andrews

The way we've been taught to treat athletic injuries could be completely wrong. In this eye-opening conversation with certified athletic trainer Kayla Andrews @kay__wellness, we challenge the decades-old RICE protocol (rest, ice, compression, elevation) that has dominated injury management since 1978.

Kayla reveals why immediate, extensive icing might actually impede your body's natural healing processes and how complete rest can lead to longer recovery times and poorer outcomes. Instead, she introduces modern recovery frameworks like MEAT, PEACE, and LOVE that emphasize appropriate early movement, controlled loading, and allowing the inflammatory response to do its critical work in tissue repair.

What's particularly fascinating is how counterintuitive some of this advice feels. We've been conditioned to think that an injury means stopping all activity, icing constantly, and taking anti-inflammatories around the clock. Yet Kayla explains why this approach may be robbing our bodies of the signals and resources they need to heal properly. 

Through practical examples of ankle sprains, hamstring pulls, and shoulder injuries, we explore what "appropriate movement" really means - finding that sweet spot where discomfort is tolerable but movement is possible. Kayla also shares valuable insights about compression (never sleep with it!), the power of mindset in recovery, and why working your uninjured side can dramatically benefit your injured side.

Whether you're an athlete, coach, or someone who occasionally tweaks something at the gym, this conversation will transform how you approach injury management. Listen now to learn why "movement is medicine" and how you can take a more active, effective role in your own recovery process.

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Episode Transcript

Sam Rhee (00:04):
Welcome back to another episode of Botox and
Burpees.
I'm here with my very specialguest, kayla Andrews.
We are going to talk todayabout debunking outdated acute
injury recovery methods.
I know a lot of people havetalked about rice and that's
what I've always learned and,almost more recently, have
realized that rest icecompression elevation may not be

(00:28):
the best thing for all theinjuries that I've sustained
over these years and I sustaineda whole bunch, and so we have a
talk today about some of thesenew protocols, what people
should be doing if they'vesprained something or hurt
something, and I have with meprobably the person that I know

(00:52):
who have seen more of thesetypes of injuries than anybody
else in an acute setting, andthat's Kayla Andrews.
Welcome, kayla Andrews.

Kayla Andrews (00:56):
Thanks for having me.

Sam Rhee (00:57):
All right, tell me a little bit about yourself, kayla
, and what you do in terms ofyour experience with acute
injuries.

Kayla Andrews (01:04):
So my name is Kayla Andrews.
I'm a certified athletictrainer.
I work at a high school, so Iwork at the Hackley School.
It's in Tarrytown.
This is year six, I believe.

Sam Rhee (01:16):
Wow.

Kayla Andrews (01:16):
Yeah, year six Been athletic trainer for seven
years, and so I work withanywhere from seventh grade to
up to 12th grade.
I have collegiate experience.
I used to work at a college andthen, obviously as a student, I
started in a collegiate setting.
So I'm also a CrossFit coach atCrossFit Bison, which is

(01:41):
awesome.
I'm also a nutritionist, so Ihave my master's degree in
nutrition and dietetics so Iintegrate that into my job as
well.
I have some clients on the side, the whole K wellness business
on the side, which I like tointegrate, both that mobility
and preventative aspect of justtreatment and nutrition as well.

Sam Rhee (02:06):
So how does someone get a hold of you?
What's your Instagram handle,by the way?

Kayla Andrews (02:08):
Oh, I'm really bad at Instagram, but it is
kwellness.
You can find me there, is itkwellness?
I'm pretty sure it's that I'm abad business person, but yeah,
you can find me there.
And then kwellnessnutrition ismy email.
If you wanted to email me atgmailcom, you can also do that,

(02:30):
and then just text me.

Sam Rhee (02:32):
That's awesome.
So I mean my personalexperience with injuries have
all been ones that I'vesustained myself, and I think
I've done just about everythingin the 11 years of CrossFit that
I've been an athlete.
I've done my shoulders, myhamstring, my ankles, my wrists,
and I've never really learned.

(02:53):
But I haven't really seenpeople very often Maybe one or
two times in my life have I seensomeone for low back or
something like that, for lowback or something like that.
And so a lot of us, when wesprain an ankle, when we pull a
hamstring, when we, you know,feel our shoulder give out a
little bit, we think we knowwhat we're doing, but maybe

(03:15):
there are ways that we have beenmanaging ourselves that have
actually slowed down how werecover, and so what I want to
do here is talk about how weused to sort of manage injuries
like this and then how theremight be newer ways of doing
this which might be more helpful, especially acutely.

(03:36):
And just as a reminder, this isnot medical advice.
I'm not telling anyone what todo per se.
This is mostly anecdotal andalso our own experience and
discussion.
Obviously, you should see yourown medical provider and if you
have any questions you need toseek professional treatment, but
this might just give peoplemore of an interest and then

(03:57):
maybe they can start figuringout some of this stuff on their
own.
Have you ever injured yourselfduring doing anything?

Kayla Andrews (04:03):
Yeah, it's more the tweaks and aches.
There's never been like a.
I've never had like a surgery,but I have problem spots like a
handstand push up my strain, myupper trap.
And it's, you know,debilitating.
You're like this, you can'tmove your neck.
I think it stems from like wayback in high school.

(04:24):
I did it while I was dancing,kind of did a flip and landed on
my neck and then it's been likea problem spot since.
But, um, here and there alittle bit banged up, um a
little bit of like from theupper trap going to my mid back.
Um, every now and then that'llget a little tight, but um,
never anything surgical.

Sam Rhee (04:45):
Yeah, that's a blessing.
Same for me too.
So let's talk a little bitabout rice first, and, as I
mentioned, it's rice ice restice, not rice rest ice
compression and elevation, andthis was actually a protocol
developed in 1978 by Dr GabeMerkin, and this is sort of how
I've actually managed prettymuch everything I've dealt with.

(05:06):
When did you realize, or thatrice wasn't necessarily the way
to treat every sprain or acute,you know, athletic injury that
you might have seen right away?

Kayla Andrews (05:18):
Actually, they started to introduce it in my
last year of college, so that'swhen my professors were really
taking on to this new.
Like hey, this doctor, GabeMerkin, came out and said I was
wrong.
Ice is actually not the thingto do.
Rice is not the best protocol.

(05:40):
It actually impedes the healingprocess in some ways.
So it actually impedes thehealing process in some ways.
So, yeah, we startedimplementing this in college.
So for me it was an opportunityto, before I even started
practicing, start using some ofthese techniques that are a
little more healing promoting.

Sam Rhee (06:01):
So yeah, I guess seven years ago, seven years ago now,
I still see people at the gym,though, who who'd follow this
pretty consistently in terms oflike rest, so maybe they tweak
their hamstring so they won't goto the gym for like a week
until they feel like it's thepain is almost completely gone
away, or for a shoulder or forsomething else, and I think that

(06:25):
that was the thing that, um,why I wanted to talk about it?
Cause I saw so many people atour gym.
They tweak something and thenthey don't do anything for
literally like four or five days, and that's something that, um,
I'm sure that you, with yourstudents, uh, and your other
athletes, sort of poo-pooed atthis point.
How hard is it to get peoplebecause you know sometimes they

(06:45):
don't really feel awesome rightafterwards to like say, okay,
now let's try doing somethingrather than nothing.

Kayla Andrews (06:52):
Right, how hard is it to get the athletes to
come in and do it?
I mean, some, it depends on theathlete.
Some people are like I need todo something right away, I need
to fix this, I need this to gofaster.
And then some people shy awaybecause they're in pain, and I

(07:13):
think that's one of the biggestdownfalls of this whole.
Rest ice compression elevationis that we've really as like a
profession, and it was very wellunderstood that we want to make
the patient or the person ascomfortable as possible.
Right, take the pain away.

Sam Rhee (07:31):
Right.

Kayla Andrews (07:31):
Get rid of all their pain, flood them with
NSAIDs, flood them with ice, soit kind of numbs the area and
make them as comfortable aspossible.
But at the end of the day, theinjury process is not a
comfortable process and there'sgoing to be some pain involved,
especially within that firstmonth or first couple weeks.

(07:52):
So what I try to do to get themto come in is talk to them
about a plan and about what toexpect and why you're feeling
this way, so they have someautonomy to say, okay, well, I
can control this.
Just sitting on the couch anddoing nothing, watching Netflix
and sobbing over your hamstringstrain, won't be the solution.

(08:15):
There is absolute benefit tomovement versus just sitting and
in place and doing nothing.
Even just going over likeknowing the inflammatory process
, like some of those likescience-y words and like
breaking them down, could evenbe a helpful start to allow some
people to like realize what'sgoing on.

(08:37):
So if you wanted to break thatdown, we could do that.

Sam Rhee (08:39):
Right.
So yeah, I mean, the firstthing is is I think one of the
things that we don't do properlyand I've seen this even in my
patients post-op for not evenjust athletic injuries but just
other operations when I'moperating is they want tobs it.
So the thing that we've learned, and you can comment on it, is

(09:01):
that they say trainers shouldsay only use ice for the first
hours of pain relief, maybe sixhours or so after the injury,
and no more for than about 10minutes at a time, and it's
really to help reduce pain.
But, like you talked about, wedon't want to remove all of the

(09:26):
inflammation, inflammatoryprocesses that are happening,
because that's actually part ofthe recovery process right,
absolutely, yeah.

Kayla Andrews (09:32):
So to go back on your like, when to use ice
within that, first I say justhour of injury.
I shorten it, I try to shortenit as much as possible, and a
lot of times I'm seeing athleteson field and it's to the point
where they can't walk.
They're in a lot of pain, souncomfortable that we need to

(09:52):
numb the area.
So that's where I'm like okay,10 minutes of ice only at a time
, and then if it starts to feelbetter after that, let's ditch
it as soon as possible starts tofeel better after that, let's
ditch it as soon as possible.
So it's no more 20 minutes on,40 minutes off for days and days

(10:14):
and days out of injury.
It's all right the first day ifyou can't tolerate it.
It's better than using NSAIDs,it's better than using some of
the anti-inflammatories andrelying on them, because that
can also be a slippery slope.
So if we can get them to iceinstead in place of that,
temporarily for the first day,then okay, that's when I'll say,
I'll quote unquote allow it.
We also don't want to add heatwithin that first 48 hours

(10:40):
because they're still goingthrough an inflammatory phase or
the initial phase of thehealing injury.
So all of that blood flow isgoing to that area.
So he is just going toexacerbate that a little bit
more.
And so that's where the termlike walk it off, like the old
school method of, you know, rubsome dirt on it, is kind of

(11:03):
coming back.
There's a more eloquent way, anelevated way of doing that, but
movement, which we'll get to,is going to be the key at some
point.

Sam Rhee (11:14):
Yeah, let's get to that.
So the first protocol acronym Iheard of was MEAT, which is
crazy, m-e-a-t, which stands formovement, exercise, analgesics
and treatment.
And so you talked aboutmovement.
So I read and this was mostlyfrom a Wall Street Journal

(11:35):
article gentle, pain-freemovement as soon as possible to
maintain range of motion andmuscle activation.
So what does that look like?
What does that mean exactly?

Kayla Andrews (11:43):
So it means a lot of different things depending
upon the scenario.
Let's take an ankle sprain, forexample.
Someone rolls their ankle orfalls, twists their ankle off a
box or on the athletic field andthey're swollen, they're puffy
but maybe they can bear someweight.
But it hurts and they feelbetter with it propped up, but

(12:08):
they can move it, it's notbroken.
Or maybe we ruled out afracture already.
They got an x-ray, we know it'snot broken.
That movement could literallylook like ankle pumps, meaning
pointing your ankle down,flexing it up, making it turn in
, turn out, inversion, eversionor going in circles.
Okay, really basic way ofmovement.

(12:29):
It could also mean an isometriccontraction.
So you're squeezing the muscle,letting it relax.
You're creating some sort ofblood flow to the area by using
external load or internal load.
So internal load being youcontracting your muscle.
External load could mean somesort of massage technique,

(12:51):
instrument, assisted technique,some sort of load in that way.
But whatever you currently haverange of motion wise, that's
relatively pain free.
I'm okay with discomfort.
You're going to beuncomfortable within these few
days, maybe even month of injury.
But if it's not excruciatingpain, use it all right, or else

(13:13):
you're going to lose it.

Sam Rhee (13:14):
How about analgesics?
So that was movement, the M Aanalgesics?
So they do say to use someanti-inflammatories but not to
block it entirely.
It's really to manage the painso you can stay active.
What is that, like you saidline where you're sort of

(13:35):
keeping that pain at bay so youcan maybe do some of these
isometrics or gentle range ofmotion type exercises but you're
not like knocked out.
Yeah.

Kayla Andrews (13:46):
That line is really going to be athlete
specific, it's going to bedependent upon the person, and a
lot of times what I'll ask themis are you looking for the most
pain-free treatment?
Are you looking for the mosteffective long-term treatment?
And some of that is going to bea little bit of discomfort, but

(14:06):
if it's sharp shooting pain,they're wincing, they're unable
to perform the treatment orthey're getting worse after the
treatment.
Or if the next day they wake upsuper sore, more swollen, more
stiff, those might be red flagsof you overdid it at that point.

(14:28):
And more stiff, those might bered flags of you overdid it at
that point but going back to,like, the analgesic part, I
think just knowing some of those, like the reasons why this is
where it could be controversial,Like some people like to use
them, some people don't.
But the healing process is a.
The inflammation process isreally a normal part of the

(14:48):
healing process.
It's a necessary part of thehealing process.
At Cookie Cutter Way we havethree phases the inflammatory
phase, which is day zero, whenthe injury happens to day six,
Um, and that's when you know,you see that redness swelling,
um, you see the, the pain, um,the four cardinal signs of

(15:13):
injury, Um, and I'm missing oneredness swelling pain.
It'll come back to me at somepoint.
Heat, that's the other one.
Um, some point heat, that's theother one, but you have.
So it's a normal part of theprocess and we want that process
to happen.
Initially because you have allof these, these molecules, these

(15:35):
cytokines, these macrophages,these, these fancy terms that
they come in and they start torepair the tissue Tissues don't
understand that once they startto heal, like in the
fibroblastic phase, they startto heal in this pattern that's

(15:56):
disorganized, it's kind of likea webbed net and we need some
sort of external load orexternal force to align those
fibers to let them know like,hey, we need to prevent that
scar tissue formation, but if weflood the area or if we flood
your body with analgesics oranti-inflammatories or a lot of

(16:19):
drugs, that process gets impeded.

Sam Rhee (16:23):
It gets blocked off.
Yeah, it's almost like there isevidence, for example, that
ibuprofen and otheranti-inflammatories can impair
muscle growth, because musclegrowth are basically micro tears
in the muscle and then you'regetting an inflammatory process
and then you're getting therebuild and it's on a greater
level.
When you have an injury likethis, you're getting a rebuild

(16:45):
due to that inflammatory process.
So if you're using a lot ofanti-inflammatories, it stands
to reason.
Same with ice or anything else.
It sort of knocks down thatprocess.
I mean, in my experience forinjuries I've never really used
anything more than ibuprofen andI really hate trying to.
I hate using it.

(17:05):
I will use it because it makesme feel honestly really good,
but maybe only for a couple ofdays.
Tops, what other drugs oranti-inflammatories have you
seen used in addition to, say,just Tylenol and Advil Meloxicam
is a big one, oh wow.

Kayla Andrews (17:23):
Yeah, meloxicam is a really big one right now.
You know a lot of providersthat at least I like.
Within my circle I've seenproviders basically every
athlete who walked into theiroffice walked out with Meloxicam
.

Sam Rhee (17:39):
Oh, wow.

Kayla Andrews (17:40):
Like regardless of the injury.
And yeah, I don't think there'sa one-size-fits-all, I don't
think that just oneanti-inflammatory drug is the
solution to the problem.
I think it could be, like Isaid, limiting their long-term
progress.

Sam Rhee (18:00):
So we got the MEA Movement Exercise Analytics
Treatment.
So articles I've read suggestthat you can get more targeted
treatments, say maybe from aphysical therapist or an
athletic trainer, like jointmobilization, soft tissue
massage, acupuncture, guidedexercises.
What are the kind of thingsthat you've seen athletes do in

(18:23):
terms of their treatment thatseem to help for these type of
injuries?

Kayla Andrews (18:27):
Well treatment sessions would be like going
back to the range of motion.
So let's say we get them on anexercise bike, some sort of low
grade exercise, get the heartpumping.
It's not very fancy, it's notpainful.
We need to get blood flow toall of your body.
Instead of just heating andlocalizing that one area.

(18:48):
I think the best way is to getblood moving with some sort of
general exercise that they'reable to tolerate.
And then we move into some ofthe soft tissue work.
I like soft tissue work or somesort of manual therapy, because
work.
I like soft tissue work or somesort of manual therapy because
I think one.
It's a good time for you toconnect with your athlete or

(19:09):
your patient and not everyone,but most people respond well to
physical touch.
In some way.
It's that like okay, it reducesmy pain, whether you're pushing
the swelling out or not, Istill think that it allows that
physical touch.
It feels so good, like why dowe foam roll?
We're not necessarily breakingup scar tissue, but it provides

(19:32):
an opportunity or a window foryou to get more work done.
So some sort of manual therapy.
I like instrument-assisted softtissue mobilization.
I like just good old, usingyour hands, some sort of cupping
that could also be beneficialthings that I don't typically,
or I don't do something like dryneedling or acupuncture, like

(19:56):
you said, some of those, they'reall tools or pieces to the
puzzle.
There's no one thing that'sgoing about two more protocols
here.

Sam Rhee (20:24):
Peace and love, which I thought were so hilarious,
because peace is for theimmediate aftermath after an
injury and then love is thelonger-term rehab.
So let's break those down alittle bit.
Peace, which is usually aprotocol you would do for the
first one to three days postinjury.
Again, these are not like crazyconcepts.

(20:45):
They actually make sense.
You told me you actually do allthese things, but you didn't
know like they had these crazylittle acronyms.

Kayla Andrews (20:52):
Peace and love baby, that's right.

Sam Rhee (20:54):
But I guess if you haven't really heard of them,
then it might just help like jogthe memory a little bit just to
know what these acronyms are.
It does for me.
So the first one piece, p.
So the whole acronym is protect, elevate, avoid,
anti-inflammatory,anti-inflammatories, compression

(21:14):
and education.
That's the piece.
So let's break it down realquick.
P, protect, shield the injuryin the very early phase.
That means avoiding movementsthat cause sharp pain for one to
three days, but not totalinactivity.
So what does that really mean?
To do some, but not too much.

Kayla Andrews (21:32):
To do some without doing too much, and
avoiding total inactivity is thekey here, and I'm going to keep
beating a dead horse.
It depends on the injury and ifyou have, let's say, pain-free
range of motion and it's passive, there's no weight involved and
you can let's take yourshoulder, for example lift your

(21:55):
shoulder over your head, it'snot painful, I can do it.
A little bit of discomfort Okay, awesome, let's run with that.
Then we can maybe move to thenext step of figuring out what
is painful and what is notpainful.
It's going to take a little bitof teetering back and forth.
In this same phase we could alsointroduce things like maybe

(22:17):
it's band work to that shoulderinjury, some light load, but for
the most part I would say it'sa safe bet to start on loaded
first.
Once you check those box andall the ranges of motion,
mobility work instead of justsitting and stretching like a
classic sit and reach for like atweaked hamstring.

(22:39):
We want to avoid juststretching in prolonged
positions for a prolonged periodof time because you just
overstretched your muscle so youdon't want to stretch it more
because at that point it doesn'tneed it More.
So the range of motion that youhave, that's relatively
pain-free, use it.

Sam Rhee (22:58):
And this is important because I think and I've
actually done this where I'veinjured it and then I've tried
to say, oh, I got to keep usingit and I pushed it too much.
So we will actually break downthree of the most common
scenarios.
I think that most people see iseither an ankle sprain,
hamstring sprain or a shouldersprain.
We'll break those down after wego through these protocols and

(23:21):
sort of kind of figure out whatthat means in terms of motion,
because I've done exactly thatthing Hamstring hurts yeah, let
me keep stretching it, and youknow, because that's what I'm
supposed to do.

Kayla Andrews (23:33):
So we don't want 10 out of 10 pain Like that's
what we're trying to avoid.

Sam Rhee (23:37):
Or even five, I know I don't.

Kayla Andrews (23:39):
I don't love that scale because it's so different
.
Like with athletes, I'm likeall right, what's your pain
level?
Like one to ten.
Ten is bear eating your leg off, like unbearable, like hospital
.

Sam Rhee (23:51):
Yeah.

Kayla Andrews (23:51):
Like I want to be around.
You know one to four, one tofive.
It's dependent upon what theyhow you know the athlete.

Sam Rhee (24:00):
That's right.
If they're telling the truth,too, that's right.
We got some wikis at our gym soI could figure out who's what
there.
So protect, elevate, and thatto me still makes sense.
Obviously, like when you aresitting, for whatever reason,
you keep that injured limb aboveyour heart level.
Try to get that fluid andswelling to come down a little

(24:21):
bit.

Kayla Andrews (24:22):
Yeah, let the gravity do the work.
Pull that swelling down and outof the area as much as you can.
It might be temporary for thetime that you're elevating, but
any bit counts.
It's better than just keepingthe limb below the heart or not
doing it.

Sam Rhee (24:37):
It's really hard.
I mean I've had ankle sprainsand then I've had to stand for
six hours, right.
So I mean I've had anklesprains and then I've had to
stand for six hours and right.
So I mean and we'll talk aboutthat in a second because that's
the C part, but let's talk aboutso that's PE Protect, elevate,
avoid, avoid anti-inflammatory.
So this is similar to what wetalked about in terms of not

(24:59):
popping high dose ibuprofen orconstant icing.
Let's just let the inflammatoryprocess go, not to the point
where, like you said, beareating, leg off pain, but a dull
roar, but let the recoveryprocess happen yes, absolutely.

Kayla Andrews (25:18):
I kind of added to that anti-inflammatory
response before, but I agreewith this full-heartedly.
I think it's hard to watch someof our athletes, especially
it's baseball season, so this isfresh in my mind.
And and um, you have the.
They're like Skittles.
It's like pouring the, pouringthe jar of ibuprofen, and down

(25:41):
the hatch and off to practice.
They go, and it crushes my souland they know it too, so it's.

Sam Rhee (25:47):
It's whatever they got to do to be on the field it's
terrible, and I've only I'veseen this at our gym too, where
I've seen some of our olderathletes like I take 600 of
advil every time before I cometo the gym and I I'm like that's
how long Months and I'm likenot a great idea.
It bothers me.

(26:07):
That bothers me a lot at ourgym.
And then also anyone who takesan energy drink every time they
work out.
Yes, Like before they work out.
I'm like probably not a greatidea.

Kayla Andrews (26:20):
Yes, I have my reasoning on that.
I want to know yours.

Sam Rhee (26:25):
Mying is, when you get addicted to the, you become
dependent on the caffeine or youbecome tolerant to the caffeine
.
So whatever bump you might havegotten, it doesn't really bump
you anymore.
You need increasing doses toget that same bump and then at
that point it also is nothelpful.
It jacks up your heart rate.
There are all sorts of otherthings in most energy drinks

(26:47):
which are probably not good foryou in the long term, and it's
expensive too, and it also itbecomes a part of your routine,
which I don't think younecessarily need.
I remember we talked about thison a podcast about dopamine
hits and getting motivated forworkouts, and if you need to get

(27:08):
motivated by a workout bychugging that Celsius, well, now
you've started associatingworking out with chugging a
Celsius, and I think that's bad.

Kayla Andrews (27:16):
Yes.

Sam Rhee (27:17):
What is your motivation or thought behind it?

Kayla Andrews (27:19):
Yes to all of those.
And also if you're trying tomake your heart rate peak
mid-workout.
If you've already elevated yourheart rate, let's say I don't
know, right before your WOD oryour workout or your competition
, and you've now elevated it.
Maybe it's 200 milligrams ofcaffeine plus your typical

(27:41):
energy drink's around 200.
Yeah, you've already startedthe workout with your heart rate
elevated.
It's like this little mountain.
You've already climbed thatchart.
So now you're going to peak toosoon.
So then you hit that wall.
You're forced to rest earlier,or you're forced to come off the
field earlier to let your heartrate come down because you

(28:01):
didn't let it peak, naturally.

Sam Rhee (28:02):
Right.

Kayla Andrews (28:03):
So that's one of my biggest reasons.
I mean, I work with theadolescent population.
I actually had a student.
It's hard to tell if it'sactually from the energy drink
or not, we'll never know, buttheir heart rate was.
Supposedly they had an energydrink beforehand.
Their heart rate was in the 240.

(28:24):
Oh my God, and climbing oh myGod, 275.
This is when I called theambulance.

Sam Rhee (28:30):
Yeah, this is where I had to send them to the hospital
, absolutely.
I mean that's a heart ratethat's going to send them into
an arrhythmia.

Kayla Andrews (28:36):
Yes, and it did, and that's where you don't
really know if they had othermedical history too.
But where?
You don't really know if theyhad other medical history too,
but at the same time it's hardto say, well, that could have
been a factor.

Sam Rhee (28:46):
I'm sure it probably was.
That's a very, very likelyfactor.
I mean, it's a really goodpoint.
I will say I've worn my heartrate monitor and I know I don't
need it because I know I feellike I'm about to have a heart
attack if I'm in the 180s.
I just know it, because I knowI feel like I'm about to have a
heart attack if I'm in the 180s.
Like I just know it, I'm like,all right, heart attack, feeling

(29:06):
I'm in the 180s.
So most days I can keep it intothe 160.
Something maybe pops into the170.
That's just sort of where I sitfor these high intensity
workouts, yeah.
But like, I know, like, and soI mean I think younger people,
athletes, have more tolerancefor those higher heart rates,
which is why they feel like theycan take these energy drinks.

(29:29):
But, like you said, there arelimits and once you start
pushing them that can getextremely dangerous.

Kayla Andrews (29:35):
Yep.

Sam Rhee (29:37):
So P-E-A-C compressed compression.
I really do, really believe incompression, especially.
I remember I jumped off I wasdoing toes to bar and I jumped
off the rig and I had a littlemat like a six inch riser and I

(29:57):
came off of it like I just hitit off the edge and both my
ankles like twisted on it andfor probably about six weeks I
had to wear, while I wasstanding at work, like really
tight compression because if Ididn't my feet would swell and
look like you know, oh my god,so uh.

(30:18):
I wish I could have just satthere and elevated all day, but
like if you can't you, you haveto live your.

Kayla Andrews (30:23):
You're a surgeon.
You have to live your life.

Sam Rhee (30:25):
So what do you think about?
How do you compress?
What are your favorite ways of,you know, putting compression
on for people?

Kayla Andrews (30:31):
I go back and forth with compression.
Some people I find the, ifthey're in acute phase or an
acute type injury, like theyroll their ankle and they're
super swollen.
Some athletes actually respondpoorly to it.
They feel like it makes them inmore pain.
So it might have actuallyreduced some of the swelling but

(30:52):
they're in more pain because ofit.
So the following day I can'tget as much done.
There could be other factors inplaying a role into that as well
.
And then I've seen it go theopposite way, way where they
really like that feeling ofcompression and if we're we're
squeezing like the swelling outof that area and we're trying to
push the swelling up and out toallow for a decrease in

(31:15):
swelling in return, allow for adecrease in pain.
Um, I, that's also fine too, Ithink I I use it.
So I use sometimes I'll use acompression wrap, but I'm kind
of I'm trying to get away fromit actually, because I'm getting
better results without it.
It's just letting that naturalhealing process take place.

(31:36):
But different forms ofcompression I really like the
Normatec boots.
I know we'll touch on toolslater using that for recovery,
for the lymph to move throughoutyour legs, or they have that

(32:07):
for upper body as well could bebeneficial.
Things like knee sleeves I knowpeople really love them.

Sam Rhee (32:15):
I was about to ask you about that, because they don't
have any acute injury, they justlike wearing them.

Kayla Andrews (32:20):
Right.
So I'm never going to say, hey,you can't squat with your knee
sleeves on, but at the same time, there is some sort of
dependency there and if we canuse it or use your body without
depending on the form ofcompression or the form of
support, that would be the ideal.
If you're going for like thesemax lifts, where you're putting

(32:43):
your body at risk, and you'remore gearing towards the side of
sport, then I'm like hands-on.
But if you're training all thetime with your compression
sleeves, I think you shouldprobably re-evaluate why you
need them.
Is it a psychological thing oris it like a?
No, I need this because itdecreases my pain and increases
my range of motion.
A lot of times I think itdecreases range of motion just

(33:06):
because they're in the way.
Maybe I'll feel differently asI'm aging into my 30s, but
that's my scientific take onthem is it's one of those use
them sometimes.
I don't think they're the worstthing in the world, but I also
think that going without them isalso beneficial I think it

(33:27):
depends on the reason.

Sam Rhee (33:28):
I agree with everything you said, um, one of
the things I have seen arepeople have structural issues,
um like real knee instabilitythat they can't control because
of a damaged meniscus or someother issue, and, you know, torn
ac ACL in the past.
So they're literally using thatcompression to limit
instability, which is limitingmobility and limiting range of

(33:50):
motion.
If that's the reason, then byall means use it.
If you're using it not becausethere is some sort of, you know,
pure structural problem, uh,psychological um.

Kayla Andrews (34:06):
Strength deficit.
Yes, you have to work on itwithout the sleeve.

Sam Rhee (34:09):
Then that's an issue because that's like a weight
belt.
So for me, you use a weightbelt to increase your core um
strength because you're pushingagainst something and knee
sleeves have been tested andstudied and they do take strain
off of your knee and you knowthe connective tissue and your
muscles around the knee, and sousing it for everything is a

(34:34):
problem, just like if I seesomeone who's using a weight
belt for everything, includingtheir warmups, you know.
Then I'm like, okay, there'sagain.
If there's a structural problem, I understand, but if you're
doing it because that, just likeyou said, provides a

(34:55):
psychological crutch, you'reactually reducing your body's
ability to adapt and getstronger because you're using
this thing to take the load offfor you, and that's that's a
problem.

Kayla Andrews (35:02):
Absolutely yeah.
One last thing aboutcompression If you do injure
yourself and you get maybe youwent to an urgent care and they
wrapped you in that compressionbandage do not sleep with it.
Our healing process themajority of it happens at night,
when we sleep right, our deeprecovery.
So if you're sleeping with it,it's actually restricting blood

(35:24):
flow.
We want healthy blood flow inthat area.
Throughout the night we'repropped up, our legs are up,
we're not standing like we arethroughout the day.
So that's the number one thingI tell my athletes if I'm using
it is don't sleep with it.
Use it tomorrow, you can put itback on, but you will impede
the healing or delay thatrecovery process.

Sam Rhee (35:45):
That's a really good point.
Yeah, I didn't even realize it,but you're right, People might
be sleeping with theircompression and that's an issue.
And then the last one is E,which is educate, which is
basically again lettingprofessionals help you in terms
of guiding your treatment, whichis why they have people like
you.
They're paying people like youto help them with that.

(36:06):
So that's peace Protect,elevate, avoid,
anti-inflammatories arise,compression, education, Love,
peace and love.
So love is the day three andonward, where you're guiding
recovery in the subacute orchronic phase of your injury.
And the first part of love isload starting to reintroduce

(36:26):
load or stress to the tissuegradually.
So you mentioned some of thesemethods which I really love.
Touch on it a little bit morein terms of like.
What does that mean in terms ofstressing out that tissue?

Kayla Andrews (36:39):
Right Load is we kind of touched on it with.
Load really happens in two waysit's the internal loading, with
you making it work and youcontracting it, and then that
external load, so internal forceand external force.
External force could be themanual therapy, the massage,

(37:02):
maybe that's in a company withthe strengthening exercises.
Like I said, those fibers don'treally know how to heal until
you apply load.
Okay, especially thefibroblasts.
That's what I'm talking about isthey respond to load, and
that's why it's so important, sothey can heal in an organized

(37:24):
fashion, and that's why, ifyou've ever been to a PT clinic
right, I'm not a physicaltherapist, but we do a lot of
that corrective exercise in theathletic training room, and
that's the boring three sets of10 of I don't know quad sets or
doing some sort of single legwork.
If they're progressed to thatpoint, it looks like some of the

(37:47):
bodybuild work that you do inthe gym just loaded, either with
no weight or loaded a littlebit differently, or in
conjunction with right, youstart them on the table and
you're manually loading throughsome sort of massage.
I think it's a component to it.
Most of all, though, the loadhas to be done, and should be

(38:12):
done with you moving your body.
That is the moneymaker, that isthe end-all, be-all is you have
to.
Once you get to that phase ofthat strengthening type exercise
, it's really important to do.

Sam Rhee (38:28):
I think you know I was just thinking Cooper Flagg,
who's a basketball player onDuke's team we're not going to
talk about.
I didn't want to bring it up.
I know I didn't want to bringit up but it did make me think
because he did roll his ankle ina game during the ACC
tournament and it was a prettybad roll, like it was a lateral

(38:49):
buckle and all that and a lot ofwhat.
And actually I do know theorthopedic surgeon who helped
him through that rehab, nedAmendola, who's the head of Duke
Sports Medicine.
I interviewed him a while backon one of my podcasts but he's a
really awesome dude.
But they were talking about howhis rehab went and some of it

(39:12):
was like forced play testing tosee what his jump and you know
what load, what felt appropriatefor him.
So I think at the very highestlevel of sports medicine now,
these guys are measuring, youknow very scientifically, what
kind of load they can place onthese injured tissues, what that
looks like is it symmetric tothe other side, how that
movement pattern is going.

(39:32):
So definitely that's a hugepart of it.

Kayla Andrews (39:38):
You just triggered a thought that I love
to do is training the other sidethe uninjured side.
There's benefit, there's scienceand research behind.
If you can't move your rightankle, you should be training
your left ankle and your leftleg.
Let's say it's immobilized.
Let's get your body moving insome other way because that is
going to translate over.
It's going to translate in somecapacity because if you go up

(40:01):
the kinetic chain into your knee, into your hip core stability,
if the areas above and below itare stronger, that's going to
translate to better outcomes foryour long-term healing.

Sam Rhee (40:12):
Absolutely, and it's a little counterintuitive, like
why would working on my rightshoulder help my injured left
shoulder?
But there is really goodevidence and I've heard that
time and time again frommultiple providers, so that was
an L load O I love is reallygood evidence and I've heard
that time and time again frommultiple providers, so that was
a load.
Oh, I love this one OptimismBelieve in your healing.
A positive mindset has shown toimprove rehab outcomes.

(40:34):
Do you believe in that?

Kayla Andrews (40:45):
Absolutely.
What we say as cliniciansmatter so much.
You can really pave the way.
This is an opportunity for youto get better and stronger.
This injury, it's anunfortunate opportunity, but use
it in a way that you're goingto come out better on the
outside, on the other side, andwhen you start to see because I
see athletes every day, I havedaily contact with them and you
can really change the course oftheir mindset and if your mental

(41:06):
health and your mindset aroundthe injury is just a little bit
lighter, they can start to seethe light at the end of the
tunnel.
Because it's really hard whenyou're sidelined and you don't
have any sense of purposesometimes is how people feel or
they can't do what they actuallylove to do, or in an adult
situation it's really hard to bea parent, be a mom, a dad and

(41:30):
run around, or you can't runaround and it's crushing you
because you can't be how younormally would with your kids.
So optimism I think just thewhole psychological component,
it really does matter.
And I think interacting andreally getting to know that
person and what drives them andhow they tick is super important

(41:52):
.
Because if you can give themlittle personalized like hey,
you know, let's do this at theend of our session or go home,
let's make a plan so it's clearon how to progress, I think it
makes the world a difference.
Yeah.

Sam Rhee (42:09):
I agree a thousand percent.
I know I've had rehabs where Iwas very down for whatever
reason a lot of externalcircumstances and others where I
, like you said, I got littlesmall wins or there was the
support from people around me.
And it's hard because some ofthese recoveries, especially at
my age, it can take six weeks,three months and you despair

(42:31):
like am I ever going to be whereI was?
And I think remembering thatmindset matters is important.
It might not.
That might not just make youfeel good suddenly matters is
important.
It might not, that might notjust make you feel good suddenly
, but you know, over time,thinking about that can can help

(42:54):
.

Kayla Andrews (42:54):
There's a way to go to go about it.
You don't have to be like a rahrah, here we go.
Cheerleader, it's be empathetic.
That is a huge part of this.
Listen to what they're tellingyou.

Sam Rhee (43:03):
And be disciplined, stick to your plan.
If you're the one that'sinjured, you have to not give up
.
You have to say listen.
Maybe I feel really down rightnow, but I'm going to trust in
the process and let me see wherethis goes.
And once you start seeing somebecause almost everyone will see
it that makes such a difference.
It reminds me of Tom Keeter.

(43:24):
He had a heart attack at thegym.
He was told some prettydepressing news and he was down,
but once he started to see somereal improvement and recovery,
it made such a world ofdifference to him.
I see him at the gym.

(43:46):
He's such an awesome guy, andso there are so many ups and
downs to any of these types ofprocesses, but yeah, having that
O really really does help.

Kayla Andrews (43:56):
Shout out to Tom.

Sam Rhee (43:57):
Yeah.

Kayla Andrews (43:57):
He goes.
Yeah, I mean, I'm just happy tobe here and just like having
that mindset.

Sam Rhee (44:01):
Oh my God that gratitude that I see is of him
being able to do all the thingshe does, and he does a lot.

Kayla Andrews (44:07):
I know he does.
He's really busy, he's awesome,he's crushing it.
Yeah, totally agree on thatpoint, though Good.

Sam Rhee (44:14):
Vascularization, so get the blood pumping with safe
cardio.
So you mentioned this a littlebit.
With the bike, I see a lot ofother people doing some sort of
aerobic activity and I thinkthis is overlooked by a lot of
our members at our gym.
So if they hurt their backthey're doing nothing, or their

(44:34):
shoulder.
And then I see a few people whothat has happened and if they
hurt their shoulder maybethey'll do C2 bike.
They'll come in and they'lljust do C2 bike and it kills
them because everyone else iswadding, but they're at least
getting their aerobicconditioning in, and so this is
something I think I've beenterrible at, but I think it's

(44:56):
something that bears repeating.

Kayla Andrews (44:59):
Oh yeah, totally agree on this.
A lot of times I'm starting myrehab sessions with athletes on
the bike go warm up some way.
Um, sometimes that's the onlything that they can do in in a
situation where maybe you're byyourself and you're not
receiving treatment yet, or it'snot that bad, but coming in,
getting on the c2 bike will makea difference.

(45:20):
Getting on, if it's your lowerbody and you can't use the C2
bike, using the ski, using therower, if you can, totally 100%,
your lymphatic system starts topump, which is your lymphatic
system, carries nutrients anddelivers nutrients and fluids

(45:44):
around your body, and that'salso moving with your blood.
So you're circulating yourblood from your heart and your
lymphatic system, which isremoving waste from that injured
area or that beat up area.
If you're not quite injured,and it's only going to make it
better, especially if it's notthat bear eating the leg off

(46:06):
pain.

Sam Rhee (46:07):
You know this reminds me of Katie Miller because she's
had like an arm issue or elbowissue.
But she would still come in andshe would scale the workout and
modify it.
Where she didn't have to usethat arm or sometimes it was
just not her shoulder, she would.
You know, she would dodeadlifts instead of a clean or
a shoulder to overhead and herrecovery, I am convinced, was

(46:35):
accelerated by a tremendousamount, One because her mindset,
but two, she was so dedicatedat just finding ways to move
without worrying or, you know,risking injury to her arm.
Sorry.

Kayla Andrews (46:50):
Absolutely.
Katie Miller and Matt Aquino ohyes, both of them.

Sam Rhee (46:55):
They are just grinding my hero.

Kayla Andrews (46:58):
Yes, Both of them .
They would come in day afterday and just grind and get after
it and change and modify overand over and over again.
Sometimes it'd be a completelydifferent workout and they'd
still show up and I thinkthey're better because of it.
I am like blown away by math'sprogress.

Sam Rhee (47:15):
Dude, the guy crushed the open.

Kayla Andrews (47:17):
Crushed it.

Sam Rhee (47:18):
And I think a couple years ago he had back surgery.
He had a blown bicep or no pec.

Kayla Andrews (47:24):
Yes.

Sam Rhee (47:24):
So this guy is the epitome of being able to, like
you said, mindset, recover, keepmoving.
I've known people who've hadboth just one of those and never
were the same people again everafter that, because they gave
up.
They gave up.
And so he's inspiration to mein terms of like if, if anything

(47:46):
like that were to happen.
Neither of us have had surgeryfor injuries, right, but if we
did like, I'd be picking hisbrain all day about like how he
felt, how he approached it, howI managed it, and a lot of that
is humility, it's not having anego, it's like not caring, like
what other people think whenyou're at the gym.
And then I just saw him at theOpen and I was just like holy

(48:07):
cow, this guy is better, likehe's better now than he was
probably in his prime.
I don't know, it was amazing.

Kayla Andrews (48:13):
So awesome.

Sam Rhee (48:13):
Yeah, exercise.
So L-O-V-E.
Again, this is really about astructured exercise program to
rebuild your strength andflexibility.
Again, this is really experts.
You could almost put expert inhere as well.
Unless you chat GPT, you're notgoing to really develop your

(48:35):
own structured exercise programunless you're a trained athletic
trainer.
These things can be helpful.
What kind of programs do youdevelop?
Like, suppose you had, I don'tknow, you probably have people,
um, I don't know, pick a sportand like, what kind of
structured exercise programs doyou, you know, work?

Kayla Andrews (48:55):
with uh for them so let's say it's a soccer
player, lower body hip flexor isa big one, just because the
repetitive volume of which theyhave contact with the ball and
how much they run Exerciseprogram like in a whole set like
an ACL.
I mean, we talk about hipflexor but ACL, like prevention
programs, do exist.

(49:15):
So that's all about prevention.
But even just like let's getthem on like a hip flexor
protocol.
Or with our long distancerunners we have a shin splint
protocol, like where they havepain in the front of their shin,
like that anterior tib painjust from running, and I mean

(49:37):
those are all more preventativetype protocols where we're
they're a little bit moreblanket, where we can implement
them right away, um to liketheir warm-ups.
We've done that with like a lotof band work type exercises.
It's a lot of single leg workum, a lot of a lot of calf work,
um.
But in terms of like theexercise portion, I'm reading

(50:00):
this and the motion is lotionbaby.
I said this.
Try saying that in front of agroup of teenage boys.
It does not go well.

Sam Rhee (50:11):
I can only imagine the giggles and the off-color
comments you would get by sayingsomething like that, but it is
so true though, so does thatanswer your?
Yes, yes, yes.
Exercise protocols.

Kayla Andrews (50:23):
That's more on the preventative side, because I
don't really it's hard to givea protocol.
There are certain protocols for, like, an ankle rehab, but none
of them are cookie cutter.
I try not to give cookie cutterlike classic rehab programs
just because everyone is sodifferent.

Sam Rhee (50:41):
That's so true Because everyone is so different.
That's so true.
I was going to go throughscenarios, but I will say if you
are interested in what you know, say what you might think about
doing for an ankle sprain or ahamstring sprain or a shoulder
sprain.
Let us know, send us a message.
We can go through that with you.
Just what we, you know what,like you said, cookie cutter

(51:04):
type of protocols might be.
Obviously there's a lot therethat can be very honed in and
specific for those types ofinjuries.
I've had all of them and I wasreading the suggestions and I
was like, oh, I did none ofthese things About.
The only thing I did do waswith the shoulders, was the
crossover symmetry.

Kayla Andrews (51:20):
Yeah, huge.

Sam Rhee (51:22):
Yeah, and they're basically bands that you do a
number of exercises with, uh,and I have to say that, you know
, I was literally like almostfrozen, like I had to keep my
shoulder in one position which Icould actually operate with,
because you don't really needthat much.
Yeah, you don't need too muchshoulder for a lot of stuff,

(51:44):
like if you can keep like aslong as I didn't have to bring
it up, which I don't foroperating, if I could bring it
forward and back, I was good.
Like there's no outside, likechicken wing motion, for Do you
tell your?

Kayla Andrews (51:54):
patients, this no .

Sam Rhee (51:58):
But I will say I'm good.
I'm good.
I will say there were some dayswhere I really had to build up
for some of my surgery just tomake sure I could do everything
that I needed to do.
But the thing that got me goingthe fastest in terms of
recovery, which I was soskeptical about, was crossover
symmetry.

Kayla Andrews (52:13):
I know I mean.
Someone that comes to mindwho's been consistent with that
is Karen.

Sam Rhee (52:18):
Yes, every day yes.

Kayla Andrews (52:20):
Every day she has a shoulder thing going on and
she just she kept at it.
She's like I see her in theback warming up, coming in early
, whether it's 5, 10, 15 minutesearly, getting back, and if you
have no idea what to do, thegreat thing about those is that
that shows you.
Yeah, you can literally read itstep by step there's a card yep
, and you don't have to do allof them.

(52:40):
But if you do two to three setsof 10 of, maybe you're doing
just.
I'm going to pick these fourexercises and however long they
take me, I'm going to get themdone before class or after class
.
I think before is morebeneficial because it'll warm
you up for class.

Sam Rhee (52:55):
It's really bad.
I hate seeing her because itjust reminds me of how I'm not
doing them and it makes me feelterrible.
It's like when you see someonewho's really good and you know
you're not good and you're justlike and, and happens every day,
so I know that's why I feelterrible every time I say I'm
like, oh there, she is beingreally good and protecting her

(53:16):
shoulders when I'm not.

Kayla Andrews (53:17):
Screw you, Karen.

Sam Rhee (53:20):
But I will say that it just reminds me.
I will say that it just remindsme and you know what it reminds
me of is that I hated doingthem, even when I realized there
was real benefit.
It's just so tedious.
So there is a special mindsetfor people that you just have to
do it.
And I will say, once I wasreally regular about it, it was

(53:42):
easier to do.
Really regular about it, it waseasier to do.
But once you have that acuteinjury and you're going through
that, I think the hardest thingto do is to do it on a regular
basis, because you don'tnecessarily see it that first
day or even the second day.
It takes like a week, two weeks, three weeks and then suddenly
you're like whoa, this is like Ifeel so much better with this,
yeah.

Kayla Andrews (54:00):
It's like weight loss or saving money.
It's like you don't see theprogress at first and that's
where people give up.
Yeah.

Sam Rhee (54:06):
All right, this just re-motivated me to go back and
do my cross.

Kayla Andrews (54:09):
I'll be there with you.

Sam Rhee (54:11):
So and I have no excuse I'm there.
I could certainly get there 10minutes early and certainly on
the days I coach, I couldcertainly be doing plenty of
that after I coach.
So that's one tool.
What are other tools that youlike to use for your recovery or
in terms of you or others, interms of what you like to do for
them?

Kayla Andrews (54:32):
Tools, again, they're tools, they're all
pieces of the puzzle.
There's no one thing that'sgoing to be the end, all be all.
I really like I mentioned itbefore instrument-assisted soft
tissue mobilization.
Some sort of physical touch andjust even light touch can be
beneficial.
You're not necessarily breakingup scar tissue but you are

(54:54):
stimulating that lymphaticsystem, pushing that fluid in
and out of the area.
Other tools I like.
I like the Normatec boots.
I think they're a tool.

Sam Rhee (55:07):
I love those.

Kayla Andrews (55:08):
Yeah, they're just, you know, they feel good,
they feel nice, and there isscience behind lymphatic system
Crossover symmetry for sure.
Other tools the body is ourbiggest tool, so I tend to be
number one.
Move your body well throughspace.

Sam Rhee (55:27):
How about something like K-Tape?

Kayla Andrews (55:28):
Oh, kt Tape, so I don't do a ton of it.
I'm not certified in it, like Iknow how to vaguely do some of
the tapings, but I don't use ita ton.
I think there is a good timeand a place, just because it
provides that sensory feedbackto the body and it's also not
necessarily supporting the joint, but it's more so going back to

(55:50):
the lymph system, taking someof that fluid and pushing it
elsewhere.

Sam Rhee (55:56):
What do you think about?
You said you don't like usingheat in the acute phase but,
what do you think about heatother times?

Kayla Andrews (56:04):
Awesome, Love it.
So acute phase, like the first48 hours, I tend to shy away
from heat for various differentthings that are really swollen.
But if it's just like oh, Itweak my neck and it's a little
sore, apply heat sooner than 48hours, that's okay.
But yeah, after that, 24 to 48hour period, love it.

(56:25):
Whether it's a hot pack or somesort of hot bath, Epsom salt
bath, sauna, that would also bebeneficial.
It gets blood flow flowing inshort terms.
So if you think about goingback to the ice and heat
discussion, If you bury an acuteinjury in ice it's like that

(56:48):
classic ice bag your athletictrainer comes and wraps it on
and then you're walking out likea mummy because you can't move
your knee.
Your blood vessel.
What does ice do?
It vasoconstricts.
So it vasoconstricts the bloodvessel and if you're doing that
for long periods of time, you'renot allowing the fluid to enter
into that healing space or thatinjury.

(57:12):
You're constricting it.
So what heat does in theopposite is it vasodilates.
You're allowing more healthyblood flow and more nutrients to
flow in and out of that area,and then you're pairing that
with your manual therapy andthen your exercises and really
completing the rehab sessionafter that.

Sam Rhee (57:33):
I mean, this is outside what we're talking about
, but what's your take on icebaths in general?

Kayla Andrews (57:38):
Do you?

Sam Rhee (57:38):
like them, do you do them?

Kayla Andrews (57:39):
So ice baths, I say great, but it's really a
different thing than icing aninjury.
Some people love them, somepeople hate them, and I'll talk
about when to use them and whoshould be using them.
But it's different than thatclassic ice wrap it on really
tight.
It's more of a hormonal effectand more of a systemic

(58:04):
biological effect and it'sputting you in a controlled
stressful state so then you canthen endure more stress at a
later time.
So if that makes sense withsomeone like a CrossFitter I
mean, there's multiple thingsthat do this.
Exercise is one of them.

(58:24):
When we work out really hard,it's also producing endorphins
and hormones, a systemicreaction in our body.
But extreme cold and extremehot can also do this.
So for the athlete who is usingit for short periods of time
three minutes at a time at areally cold temperature Awesome,
great mental benefits, great,more recovery type benefits.

(58:49):
It's not the same as bearing aninjury for ice for 10 minutes
at a time.
Got it when to use.
What was I going to say?
The person that should not beusing it.
If you're already a reallystressed out individual, that's
me Not like your daily stress oflike work and like I have to
eat well and I have to walk thedog.

(59:10):
It's like that's.
We all have those things.

Sam Rhee (59:12):
OK.

Kayla Andrews (59:12):
But if you are the athlete who's already at
their tipping point you'realready, your cup is full and
you get into any sort of stressSometimes it could be good, good
, good or bad stress and that'sjust going to send you over the
edge then that's the athlete.
I would say hey, we don't needto apply any more stress in this
point.
We need to do things thatactually feel good um, if you're

(59:36):
already adrenaline depleted,yes, yeah, okay yes, that's
where I would shy away, becausethen you get those like really
bad reactions out of getting outof the cold tub.
But if you're, you know,regulated, I would say, then
have at it.
Do I do them?
I have done them.
I live in an apartment rightnow so I think they would be

(59:58):
really mad if I set up my icebath around my balcony.
I like the way I feel when I doit, but I don't get to do it
all the time.

Sam Rhee (01:00:06):
Got it All right.
So I think we've covered mostof the topics in terms of new
ways to recover.
I just wanted to throw outthere this is all basically
self-management.
For pretty minor injuries, youshould seek professional
evaluation, obviously, if youthink there's a bad injury I

(01:00:29):
mean, loud pops can't bearweight something that is like a
severe tear or a fracture, likeyou got to go see somebody right
away.
Have you seen patients orathletes where it wasn't getting
any better after like five daysa week and you're like this is
not sort of going the right way,absolutely.

Kayla Andrews (01:00:48):
All the time it happens all the time.
For me that's where I refer out.
Looking at it, by now I knowlike, yes, I'm referring that
right away or I'm going to wait.
Sometimes the two week markwith some of the chronic type
things that have been lingeringfor a period of time, maybe it's
like months, or it's been onand off for years and I'm like,

(01:01:09):
all right, well, let's if we canjust treat it for two weeks and
let's see how it goes.
But if I can't get you to budgeor improve at all, I'm
referring you out.
But if you're, yeah, dave, thatone week period of an acute type
injury it's about one week totwo weeks is my time frame.
And if I'm not seeing any trendupward, definitely going to

(01:01:32):
refer you to a doctor or aspecialist or somebody that
needs that I can't give youanswers for.
Or if you're in that positionand deciding that for yourself,
definitely the inability to bearweight, it's really swollen,
it's not getting any better.
At least seek advice.
Like, yes, go seek some advice,go get some professional help,

(01:01:56):
because I'm sure you will notregret it.

Sam Rhee (01:01:58):
I think the other thing is and I've seen this a
lot is someone who keepsre-injuring a certain thing,
like I've known, like peoplewhose back are they're
constantly getting re-aggravated, like after the third or fourth
time of you know doing a heavycleaning, oh man, I just got
laid out again and I couldn'tcome back to the gym for you

(01:02:19):
know two weeks Like get, even ifyou can recover from it.
I think there's something therethat you got to like address
and and think there's somethingthere that you got to like
address and unfortunatelythere's so many warning signs
that we don't always pick up on.
I had to get burnt a bunch oftimes before.
I was like which is easier saidthan done can make a huge
difference, absolutely.
Any other takeaways at thispoint for us, kayla, in terms of

(01:02:57):
Move it.

Kayla Andrews (01:02:59):
Move your body Movement is medicine, move it
often.
Move it.
Your body movement is medicine.
Um move it often, move it.
You know, I think one thing wedidn't touch upon is like the
nutrition component, with injuryum feeding yourself.
Well, yeah, there are.
That could be a whole nothertopic oh yeah like hey, like
every single athlete, I see likeI'm talking about nutrition
with them and what they can do.

(01:03:19):
There's certain things um herbs, more non-traditional things
that are anti-inflammatory, so Ithink eating is a huge
component into that.

Sam Rhee (01:03:30):
A lot of people take turmeric every day.

Kayla Andrews (01:03:32):
Yes, turmeric.
I was just going to say thatMake sure it has some sort of
black pepper with the turmeric,because that's what makes it
more bioavailable in our body.

Sam Rhee (01:03:40):
Interesting.

Kayla Andrews (01:03:40):
If you're doing supplements, they usually have
it in there.
If you're cooking with it, makesure you're adding some cracked

(01:04:10):
black pepper.
Tart cherry juice has beenresearched so, especially if
you're a surgical athlete.
These are the things thatinflammatory process, Things
like garlic, ginger there's onethat's escaping my mind but all
of the different types of thingsthat you can easily add in.
People don't always think ofthem because it's like, well,
what's that going to do?
I'm like, well, did you try ityet?
At least give it a try.

Sam Rhee (01:04:25):
Right right, right, right right.

Kayla Andrews (01:04:26):
So making sure you're adequately hydrated as
well is a huge component.
Seek medical advice and helpsooner rather than later, and
then stop icing every singleinjury.
I'm going to shout out one ofmy athletic trainers that I
really admire.

(01:04:46):
His name's Mike Stella, and hehas a course called End of the
Ice Age.
It is so great.
It's really not that expensive,and if you're just a lay person
wanting to learn more about whyice and is not the answer
anymore, head over to his page.
It's the Movement Undergroundand go learn.

Sam Rhee (01:05:06):
I love that.
Just remember those protocols.
Meet peace and love.
Keep that early mobility.
Keep a super positive attitude.
Kayla, it's been such apleasure.
Everyone can reach you atkwellness on Instagram.

Kayla Andrews (01:05:22):
Yeah, I'm pretty sure that's what it's called.
If you don't know, just emailthis podcast and I'll let you
know.

Sam Rhee (01:05:28):
Thank you again, and I really appreciate it, taylor.

Kayla Andrews (01:05:30):
Thanks, Sam.