February 21, 2023 • 47 mins
One of the areas of physical therapy that people tend to struggle with most is the later stages and return to sport progressions. Advanced strength and conditioning concepts are not commonly taught in physical therapy school, so are still and area that many PT’s can improve.
In this episode, I talk with my friend Dan Lorenz about how to get started learning and applying the principles of strength and conditioning to our physical therapy practices.
Plus, we talk at the end about blood flow restriction training and how we are both using BFR in our practices.
Full show notes: https://mikereinold.com/integrating-performance-training-and-physical-therapy-with-dan-lorenz
Click Here to View My Online CoursesFull show notes: https://mikereinold.com/integrating-performance-training-and-physical-therapy-with-dan-lorenz
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
On this episode of the sportsphysical therapy podcast, I'm
joined by Dan Lorens.
Dan's the director of sportsmedicine at Lawrence Memorial
hospital in ortho, Kansas inLawrence, Kansas, and also
teaches for his con ed company.
Ortho athletic education does anexpert at many things but one
area that he's really passionateabout is strength and
conditioning and how thatrelates to late stage rehab and
(00:22):
return to play we talk aboutthat and an update on how we're
using bfr in our practice all inthis episode
Mike (00:40):
Hey, Dan, welcome to the podcast.
Thanks so much for joining ustoday,
Dan (00:43):
Mr.
President, great to be here,man.
Mike (00:46):
Wow.
that still, that still feltweird,
Dan (00:50):
Yeah.
Good to see you, Mike.
How are you man?
Mike (00:53):
I'm doing great.
You know, and appreciate youtaking time doing this.
Um, you know, for thoselistening that don't understand,
I mean, this is like six 30 inthe morning right now for Dan
before work.
Um, but this is, you know, the,the type of character that Dan
is that, you know, is alwayswilling to share and all that
great stuff that he does online.
So, um, really appreciate youtaking time outta your, your
(01:14):
personal day to, to join us thismorning.
Dan (01:16):
Mike, thank you for asking me.
I really appreciate it.
You got a lot of great peoplethat have been on here already,
and I know you have a lot ofother people you could have
asked, so.
Mike (01:23):
No, no, this is, I, I've been waiting for this one for a
while.
I wanted to make sure we hadsome time to do this.
Um, there's, there's so manythings that we can talk about.
So Dan and I are friends, we'veknown each other for, for a
bunch of years now.
Um, and, you know, we geek outabout some things online and,
and through text messages andstuff when we see each other in
person.
But, um, I what I think what Iwanted to focus on for the, the,
(01:44):
the sake of the podcast for nowis this background that you have
in this area that I know you'resuper passionate about and
you've been building out on thelater stages of rehab and even
performance training to anextent too.
Right?
Um, you, uh, you're, you know,the past, uh, sig leader, um, in
the sports academy of the a pta,the American, uh, Academy of
Sports Physical Therapy.
(02:04):
You were the sig leader for thesports performance sig.
Um, did you start that sig bythe.
Dan (02:09):
I did.
Yeah.
Mike (02:10):
Nice.
So you were the, the founder,right?
We'll call that, We'll call youthe, the, the, the originator of
that sig.
So, you know, I know you'vealways been interested in this
sort of thing.
Um, for me, this is an area thatI see so many PTs struggle and I
know that so many of thestudents that we have coming
through our place at Champion.
Have so many questions about whydo you think we're at a point
(02:33):
right now in physical therapywhere the later stages of rehab
in, in training in general justseems so daunting to so many
people?
Dan (02:42):
Uh, I would say that I think the biggest problem there
is that in school we, we justdon't get it.
They.
As generalists, you know, youhave to, you have to treat
everything when they're tryingto prepare you for being an
acute therapist or work peds orgeneral ortho.
And, and I do believe that partof the later stage, uh, stuff
is, uh, is something I have toacquire either on your own or
(03:02):
through continuing ed.
Uh, you know, I think part of itis that we don't, um, it's so
highly specialized, uh, at, atthat later, those terminal
phases, and so we just don't getit.
I think in.
Mike (03:15):
Yeah.
And I, I think that makes sense,right?
And I don't think that'snecessarily a slight towards
school.
I know you're not saying that.
I know we don't think that way.
There's just so much that a PTstudent needs to learn.
Um, so I don't, I mean, so what,what do you recommend then?
So when you have people askingfor advice, maybe they're
already.
In PT school right now, andthey're saying, Wow, my
(03:38):
curriculum just doesn't haveenough of strength and
conditioning principles or, or,or high level late orthopedic
sports type type rehab things.
Where do you tell people to getstarted?
Like what do you, what do yourecommend they do?
Dan (03:51):
I think studying for the CSCs exam, you don't necessarily
have to take it, but I mean,studying for it isn't a bad idea
cuz you'll get at least somefoundational knowledge, uh,
about those concepts andprinciples.
I think.
Even being an NSCA member, Imean, they have a couple
different articles, or excuseme, a couple different journals.
We get a lot of, they have somereally good information in
those.
(04:11):
There's tons of strengthconditioning courses out there.
I think, uh, you know, evenhanging out in a local weight
room, like a uni, like maybe acommunity college or, you know,
if you have access to auniversity where you could just
volunteer and, uh, put, put sometime in here and they're like,
I.
Uh, you know, to loading weightsor wiping chalk off bars or
whatever, just to, just to pickup some things.
(04:32):
I think those are probably someof the better ways to do it.
There's a lot of good con, Imean, heck, the, the Academy has
the sports performanceenhancement sig, so you get some
good information there,especially with the mobilized
platform and things.
So just through engagement ofpeople that are already doing
it.
Mike (04:46):
I like that.
So, so let's do this.
Walk me through your historythen, because I think you
started to elude it a littlebit, but you know what, You're
in PT school, right?
Obviously you have a, um, almostlike a personal, uh, uh, area
that you want to pursue herewith strength and conditioning.
You know, you enjoy that sort ofstuff yourself, you train
yourself.
Um, what did you do to putyourself here to, to really
(05:08):
grasp this, this concept?
Dan (05:10):
You know, how many people do you know in sports pt, uh,
went into this because theyplayed sports and they got an
injury themselves, right?
So that, that happened with me.
You know, I, um, I broke my legin high school playing football
and wanted be a PT from, fromthere on.
Well, same thing with thestrength editioning piece.
Uh, I started power lifting inseventh grade, um, and uh,
(05:31):
really just kind of became a gymrat from.
And in early, like undergrad andthings like that, I was going to
a lot of strength conditioningcourses.
Uh, I spent a lot of time just,uh, uh, again, like just kind of
volunteering and, and shadowingand in some different weight
rooms at the collegiate setting.
So I, I learned a lot there.
And, uh, like I said, it's justalways been an interest area of
(05:51):
mine and, and, uh, the fact thatyou can kind of merge PT and
strengthen dishing in thoselater phases, it's just, it's
served me well, cuz I, I reallydid understand those concepts of
loading and progressingexercises and, and, uh,
regressing and lateralizingexercises, those kinds of
things.
So it, I think that's probablywhat got me to this point.
Mike (06:11):
And I like the way you, you said you put yourself out
there a little bit, right?
And it's really, really hard.
You, you, you mentioned twothings and um, I really like
these two points.
One was, you know, the CSCs wasessentially in, in, even if you
don't take the test, but youmight as well take the test,
but, um, is understanding theconcepts of strength and condit.
(06:33):
Right.
So that's almost, that's thetextbook, that's the classroom
style, right?
That's that's learning theprinciples and the physiology of
strength and conditioning.
I think that's a great start,and what I like about that is
you could do that veryasynchronously, right?
You can wake up early in schooland read a chapter a day.
Right.
If you really wanted to or youknow, do that in between
(06:57):
classes, right?
You can, You can take time toasynchronously, asynchronously,
start learning the concept ofdrinking conditioning.
But then what you did though isyou did the practical
application too.
And I think that's the hard partthat sometimes students don't
realize right now is that it'snot just about reading, it's and
understanding thing and evenwatching.
You know, social media, YouTube,reading people's blogs.
(07:19):
It's also about applying it.
So I like how you went out thereand you volunteered.
Um, where did you go?
Did you say, Was it college highschool?
Like what, what, how'd that goabout?
Like how did you know people?
Like how'd you get your, yourfeet in the door there?
Dan (07:33):
Uh, asking questions, like, Hey, I'm really interested in
this.
Like, I may went to a guy'scourse.
Um, or some somebody's courseand just said, Hey, uh, you
know, I really like this aspectof things.
You know, sometime in the summerwhen I'm back, can I come up
like an hour, uh, an hour or twoon a certain day of the week and
just make it throughout thesummer and, and hang out a
little bit and just observe.
(07:53):
And like I said, I, I can be arunner for some things.
I just, I just wanna learn, youknow, and, and showing that
passion.
So there was a few universitiesback home in Illinois.
Spend some time with.
And um, again, you just do a fewhours here and there over the
course of a couple years duringthe summer, you accumulate a lot
of knowledge, you know, So Ithink that helped me out a lot.
No question.
Mike (08:12):
Yeah, and I wonder too, if I was in your shoes back then
and I wanted to get specializedin one specific area, I think
what you could do now is youcould reach out to some local
universities that are near youand maybe let's say for example,
my case, just reach out to thestrength coach that's in charge
of baseball and say, Hey, I wantto come help.
(08:32):
I wanna come volunteer, be yourassistant, um, you know, just be
an extra set of hands in theweight room.
Um, and then, like you said,it's only a few hours a week,
right?
Because that's all that, youknow, baseball gets access to
the weight room at a lot ofuniversities, right?
But you can really be nice and,and and strict with that and
also develop a relationshipwith.
The train coach, the team,probably everybody else over
(08:53):
time, like I, I, I think that's,that's one area that I think
people don't understand is youcan, you can get very specific
with who you want to try tovolunteer with as well.
Dan (09:02):
You can, and, and like, you know, it's all about
relationships, Mike, you know,they gotta know you.
They gotta like, and they gottatrust you, right?
And you just, those things taketime to build.
And, um, I.
I always, I get this question alot.
I spoke in a meeting not toolong ago.
I had a couple students ask me,and I'm like, you know, I, I
always encourage students, or ifyou're trying to get into this,
a lot of times, you know, PTstudents or early, early
(09:23):
professional PTs always likegoing into those environments
and kind of showing off whatthey know.
And it's like, remember you'regoing in their turf.
You know, uh uh, you gotta, youknow, can kinda keep your mouth
shut and your ears open.
You know, like, uh, you're thereto learn.
You're there to absorb, andyou're the one that has to be
there.
They didn't ask you necessarily.
Right.
So, I think it's important thatyou have some humility when you
go to those environments thatyou don't know everything.
You might learn a thing or two,you might see some things you
(09:45):
don't like, but you kind of putthose in the catalog just, well,
I wouldn't do that.
Right.
Um, you know, but also, again, Ithink athletic trainers too.
That helped me out a lot.
I was an undergrad athletictrainer.
I learned a.
From our athletic trainingcolleagues and I got'em dual
credentialed.
And um, I know there's alwaysbeen a turf war, unfortunately,
between those two professions,you know, for a long time now.
Uh, there's, there's definitelya responsibility on both sides
(10:05):
to be shared there, but, uh, Ilearned a lot, you know, in the
late stage stuff.
Cause again, they, they just do,do it better I think in some
capacities,
Mike (10:13):
That's actually a really good point too is, is is
volunteering a little bit withathletic training staff too.
Cuz you're right cuz they do alot of that in-house, late stage
rehab themselves too.
Um, it's not just the strengthand conditioning room.
I like that.
Dan (10:24):
And they're, and then they're twice understaffed.
Like, show me an athletictraining staff that's fully
staffed where they're notoverburdened with, uh, having to
cover multiple sports or, youknow, uh, or, or just too many
athletes for the amount of handsthey have.
I mean, they, they love to help,you know, So, uh, I, I think
that's a, that's an excellentway, uh, to kind of work
yourself into.
Mike (10:44):
Yeah, I'm, I'm really glad you brought up that concept too,
about going in there and nottrying to impress people.
Um, Right.
And I, I think sometimes, youknow, it depends on your
personality, right?
But sometimes people go in thereand their way of impressing
people is to try to get you tothink that they know a lot,
right?
When that's not.
Really the path to impressinglike a strength coach that's
(11:06):
been doing it for 20 years, andyou're in PT school right now,
you're gonna impress us byputting your head down and
grinding, right?
Dan (11:13):
Exactly.
Mike (11:14):
get you, get dirt, get your hands dirty, get on the
floor, get out there and coach,and get out there and be a good
member of the team, right?
It's not about what you.
Not about showing everybody, youknow, that's not how you're
gonna get a job, you know, ifit's two people there and, and
one's the, the one's alwaystrying to show everyone how
smart they are and the otherone's that just puts their head
down and works.
Um, that's probably the personthat's gonna get that, that job
(11:37):
when there's an opening in thefuture.
Right.
Dan (11:39):
No question.
Mike (11:40):
Yeah.
So, alright.
So here's what I was thinkingwhile you were telling me this
story a little bit.
So walk me through, you've beenpower lifting since middle
school, you said, right?
So, which is, which is awesome.
What's your, what's yourdeadlift pr by the way, We'll
get off topic for a second.
Dan (11:53):
Oh man.
Oh gosh.
Uh, that's a long time ago,Mike.
I, I don't, gosh, I don't evenremember.
I, I haven't done it.
I, I mean, I still, I stilldeadlift heavy.
Um, but oh my gosh.
Uh, this is probably earlycollege.
I was around, I wanna say 4 85,500, I think,
Mike (12:12):
Adam boy, and what, what's heavy now?
Cause now you're, you're old,right?
You're an old guy, but, Right.
Dan (12:17):
Yeah.
Old with old, with wearing anunloader brace on one knee, cuz
like, I've had four operationsand yeah.
Uh, no, I usually, uh, I stilldo sets of four to five, you
know, just
Mike (12:30):
good for you.
Dan (12:30):
think it's, I think it's good for us to pick up heavy
things every now and then justfor.
Mike (12:34):
Yeah.
Dan (12:35):
you're gonna have to do it eventually, at some point in
your day to day life, picking upa heavy box of Christmas lights
or something here pretty soon.
So it's good that you've, It'sgood that you've been there
before, right?
Mike (12:44):
What kind of Christmas lights do you guys have at the
Loren's house?
That's so heavy.
No, I I I love that.
So here's what I was thinkingwhen you were telling me about
that.
So how, what was going throughyour head when you were an ortho
class in school, like sophomoreyear at college and you're doing
like, There had been exerciseswith people like, what, what,
(13:05):
what was going through your headas somebody that was comfortable
in the weight room that knowshow to load people and just,
just sees like the complete lackof loading that sometimes
happens in pt.
What, what was going throughyour head?
Dan (13:18):
I tell you what, I had some sympathy for my colleagues in
class that were just feverishlywriting notes on some of this
stuff.
And having been a studentathletic trainer, I had already
been exposed to a lot of it.
That really, really helped.
I mean, I, I really, that partof PT school I sailed through
because I really understoodthose concepts very, very well.
Um, I think.
I think some of it with the why,why so many therapists struggle
(13:41):
is just, there's just, I thinkthey, they put this fear in the
back of your head that if youput another plate on the bar or
another couple stacks in the legpress that the ACL's just gonna
explode or something.
Or you know that, you know thatthat total knee that you just
had, I mean, you're just gonnaruin it if you go, If you go a
little too heavy, like I'm notcertainly advocating to be
reckless, but on the flip side,I think they just put this fear
like, you know, protect thehealing, protect the healing.
(14:02):
And you know, uh, all those, allthose things they say, you know,
don't do, don't do squats withthe knee over the toes because
of compression.
Don't open chain knee extensioncuz of compressive forces of
patella for oral joint.
They're so high and people freakout and they never do those
things.
You know what I mean?
Like I, there's just thisirrational fear that I, I think
that I was noticing that peoplehad.
So having, uh, that, thatstrength editioning background,
(14:25):
uh, You, you just learn.
You, you, you know it.
The easy stuff, the early phasestuff is easy, and I think most
people just hit a roadblock andhaving the later stage stuff
just made my programs, uh, morecomprehensive and, and well
round.
Mike (14:38):
That's awesome.
And, and I I what we try toteach our students here when we
have these discussions, cuzthey'll come in with the same
thing and be like, well, youknow, everybody on Instagram now
they're, they're, you know,they're debating knees over toes
or open connection kneeextension.
And I'm like, You have tounderstand this knees over, toes
open, connection ne all thesethings, they do increase stress.
You have to just, you have tounderstand it increases stress,
(15:00):
but that increase in stressisn't always bad.
It isn't always disadvantageous.
Sometimes it's actuallyadvantageous, right?
So it's, you try to like tellpeople, don't get caught up in,
you know, these false conflictsonline that are, you know, just
attention draws and justunderstand it's the same thing.
Do.
Throw weight a ball as abaseball player.
Okay, go nuts.
It's more stressful, but we justhave to talk about how to apply
(15:23):
that stress as as best as wecan.
Right?
And and you're right.
The PT world was just full offear and it was just like, if
you do this, your knee's gonnaexplode.
If that knee goes over your toejust one centimeter, the
surgery's gonna fail.
Right?
you're just
Dan (15:39):
there is man,
Mike (15:40):
you
Dan (15:40):
there is.
Mike (15:41):
It's crazy, but you just draw a graph like, look, here's
stress over range emotion.
You see like, sure.
When your knee goes over yourtoe, does the stress go up a
little bit.
Sure.
But you know the world's notgonna end.
Right.
And, And that's a good way ofdoing it.
But do you think you werecomfortable because you yourself
had a training age at that time,you were comfortable in the gym,
you've moved weights, right?
(16:02):
You've had loads on your ownbody.
Do you think that was a big partof why you, you felt that you
were more comfortable doingthese sorts of.
Dan (16:10):
That's a good question.
Um, I think I maybe, uh, I thinkI just had a, a good idea of
periodization and progression.
I grew up, you know, I start,when I got started, you know, we
would, you know, this is anearly high school or, or as I
was beginning my training, likewe, we, the workout would be on
the board and, you know, we'dhave a set of 10, a set of
(16:32):
eight, two sets of six, andmaybe a set of four.
And you went up a little biteach time.
And it was all based ontechnique and form and, uh,
Gosh, Mike, that's a, that's agood thought.
Probably.
Probably, yeah.
I'd say yeah, probably just acomfort level with, again, I've
watched people lift and I, Icould, I could pick up technique
or if you were unloading oneside or shifting your weight or
(16:55):
those kind of things.
Like I just had a, a keen eyefor it, I think, and that helped
out a lot.
Mike (16:59):
And you had experience.
So not only did you do thatyourself and felt it, but you
also did it with all yourteammates and your friends
probably in high school, andnone of them blew out their
knees by adding a plate or bygoing a centimeter past their
toes.
Right.
You know, like, so I think, Ithink you saw, like when you,
when you get to um, you know,maybe being a little bit too
conservative at times you'relike, Well wait a minute, I've
(17:20):
been doing this for years andyou know, my knee's fine.
Right?
Like, you know, like that'sgotta be part.
Dan (17:26):
I think this circles back to the original or the first
question you asked today about,you know, PT school stuff.
Cuz remember sometimes load forour patients is sitting up in
bed and they teach you thatstuff.
You know, again, they're tryingto teach, teach you in school to
take care of traumatic braininjury, acute care where people
have been, you know, bedriddenfor weeks.
And like I said, sitting up andgoing to the, uh, going to the
(17:49):
bathroom, walking 10 feet islike a maximal attempt for them.
So I think they're more worried.
That you'll get that late stageACL stuff down the road.
We gotta worry about gettingpeople home and you know, living
independently again.
And I, I think a lot of time isspent on that stuff and not so
much on the, you know, the laterstage.
Mike (18:08):
Right.
Yeah.
And, and I, I, I, I didn't meanto come across earlier as
pooping on yellow theand, by the
Dan (18:13):
No, no, no, no, no.
I didn't take it that way atall.
And nobody else should either.
Nobody else should either.
No, no.
I don't think that's it at all.
But it's, But what it is, is, isnot, um, the yellow TheraBand is
that, you know, don't, when youwrite down, you know, external
rotation and you just write acheck mark in all your treatment
logs, like, did you change thereps?
Did you change the load?
Did you change rest, period.
(18:34):
That's the piece.
I think that where a lot oftherapists struggle, um, it,
yeah, that's the part for.
Mike (18:40):
I, All right, so I, I'm gonna try to summarize what we
talked about so far, because Iactually think this has turned
out to be a really cool, uh,episode for people looking to
get into this.
So let's, let's go through it.
Step one, I think you're a PTstudent or even a, an early
career professional that's juststarting to think about these
things.
I think step one is get booksmart.
Right.
I like that.
It's easy to do.
(19:00):
You can do it in your own time.
Grab the CSCs book, startstudying for the test.
You might as well write andbecome book smart, but all of
that is useless if you don'tapply it.
So you gotta get your foot inthe door somewhere.
Either volunteer, uh, go to alocal university.
Now there are so many privatefacilities like mine that are
out there that you can, you cancome.
(19:21):
We have strength andconditioning internship.
At Champion where we designed itfor future strength coaches,
right?
And exercise FS students tocome.
And I will say half of ourpeople tend to be PT students or
new grads that are just wannalearn and immerse themselves for
three months a semester as acoach on the floor.
(19:41):
So you learn somebody's system,but then you're also out there
performing and you're doing it.
So you gotta get, so get book.
Get in the weight room somehowwhere you can do this.
And then I do think you gotta,you gotta go through these
programs yourself a little bit.
And I don't think that'smandatory.
Not everybody can, right?
Some people don't have thephysical abilities to do that,
but do as much as you can sothat way you can experience it a
(20:01):
little bit.
If, if you have the ability, Ithink that will do wonders for
your understanding of some ofthose things.
Right.
Um, what do you think was, wasthat a, was that a, was that a
cool summary?
Dan (20:10):
great summary.
A hundred.
Mike (20:12):
I, I thought that, I thought, I think, I just think
that is a, that's a really goodroadmap for, for somebody to
follow and, and, and, and Ithink you're gonna be a much,
much better PT because of it.
Dan (20:22):
And you have to train somebody.
You know, I, I, I talk a lot oftimes with students about, Oh,
should I take this CSCs?
Like, well, You'll study for itand probably pass it.
I think you have a lot moreknowledge than, uh, from PT
school and stuff to, to studyfor a little and take that test.
I mean, there are probably somegym based thing, like, you know,
gym design stuff that you mightstruggle with, but I, I would
say you might have the css, butcan you really train anybody?
(20:45):
Can you, You know, So that's whyI said, take your 14 year old
kid that you're seeing forTendonopathy and get him on a,
you know, good like total bodystrengthening.
Teach'em how to hinge, teach'emhow to squat.
You know, can, can you coach thehinge, Can you coach the squat?
You know, like those arefundamental.
Foundational concepts that weshould know how to do.
And the bottom line is, it'skind of our job because somebody
(21:07):
in a few years, when that kidgets to high school, somebody's
gonna put a bar in that kid'sback or put'em underneath a
bench and they're, they're notgonna have any foundation.
And we have a tremendousopportunity to do that.
Like I said, you can almost use,in a sense, you can kind of use
your, you use your patience as,as lab rats in a way to kind of
tinker with progressions andloading and, and actually
training someone.
Mike (21:26):
Right.
Right.
I love that.
And I, I would still say at thispoint in this person's career,
right, you're, I think you'restill technically a technician
with all this sort of thingswhere you're still just bringing
people through the paces with,with what you understand.
You haven't evolved yet to be acoach until you have some
experience underneath your beltworking with people where you
can say, Oh, if this happens,I'm gonna pivot this way.
(21:48):
Uh, I'm gonna regress this, I'mgonna lateralize this, I'm gonna
progress this.
Um, to me that's coaching and.
Coachings also the ability toconnect with the person, right?
When we get into some softskills, now that's a, that's a
whole nother podcastconversation, right?
Dan (22:01):
yeah, it is for sure.
It.
Mike (22:03):
there's, there's, there's so much that goes into it.
It's more than just justknowing.
So you get book smarts, you gottechnical smarts, and then to
me, I think you get those, youknow, to be a great coach, you
have to be able to connect withpeople in and understand when to
pivot.
I think that's, that's, that'simportant too.
Dan (22:18):
No question.
Yeah.
And, and that the soft skillspiece, I mean, you can work on
it, but sometimes as they say,it's hard to make a zebra change
its stripes.
So, know, uh, you know thatMike, Mike, you know that
there's people that, you know,you went to PT school with that,
you know, maybe they were, youknow, had the.
Had a 7.0 gpa, but you know,they couldn't talk to a
doorknob, so it's like, but, butthere's, and there's other
(22:39):
people.
Let's face it, there's otherpeople that may not have been
the, the, the bookish type orthe real book smart types, but
man, they could, they could worka room and they knew people.
And I would take, again, havingbeen a private practice owner, I
would take the, the ladder anyday, uh, the people skill piece
because I can teach you how toprogress and load.
But if, if people don't likeyou, if you're just not a warm,
engaging person, good.
Mike (23:00):
I like it.
So.
Alright.
How does a sports pt or even,you know, northo pt, I guess
too, um, how do they apply theseconcepts to the later stages of
rehab and returning somebody tosport?
Right.
Cause I think this is an areawe, we, um, we need to get
better at in physical therapy.
Again, don't get me wrong, Ithink sometimes we blame
ourselves a little bit, but youjust talked about you get an 18
(23:22):
year old kid that just touredtheir ACL playing football
that's never lifted a weightbefore in his life.
I'm pretty sure at six monthshe's gonna be weak because he
was weak at zero months or hewas weak at negative one months.
Right.
Like I, I, I think that's partof it too, but like, how do you
take these concepts and how doyou apply'em to the later stages
of.
Dan (23:40):
Well, first off, I think it's, it's screening for
appropriateness like is.
Done.
And whenever I teach, anybodythat's heard me speak before,
one of the concepts I I alwaysstart with, uh, when I teach is,
is rehab done?
Um, because obviously when wegot people going back with 65%
quad strength or.
Or what have you that rehab'snot done.
(24:01):
So I think starting there, Ithink you, they have to have
requisite the requisite mobilityand exercise technique to do
what you want'em to do.
Like you might want'em to do aback squat, you know, or a front
squat.
But do they even have thetechnique?
Like, that's why I said the cofamiliarizing yourself with
these basic concepts.
Uh, cuz again, my, my programsare, are painfully boring.
We, we push, we pull.
Mike (24:23):
right, right.
Dan (24:24):
and can you, can you, can you teach a front squat?
Do you know what a good frontsquat looks like?
Do you know why?
If it does, does, If it doesn'tlook right, why does it not look
right?
So I, I think starting there andthen, um, Uh, from the
progression standpoint, it, it'slike anything else.
I mean, I, I think this is wherethat the whole periodization
idea comes in a little bit.
You know, you gotta get afoundation first, and then you
continue to build, buildstrength, and then eventually
(24:45):
you start to, um, move, movelighter things fast, right?
Appropriate.
And then, then you work on speedtowards the end.
So, um, I, That's where yougotta start.
I can start with the basics.
Do they, Is rehab done and then.
Whatever, basically, whatever.
As I've said this before too,like whatever factor is
(25:06):
contributing to their lack ofpower, that's what you have to
focus on.
And it might be an ankle doorsof flexion restriction.
They can't squat because of it,so if they can't squat, they
can't get their legs strong andthen they therefore can't work
on explosiveness.
So that's your job is to pick upthe impairment that's limiting
their ability to be powerful.
Mike (25:22):
Right.
And when in doubt, just startgetting them strong.
And I think things will, willstart to click over time is you,
you have to be able to load, Youhave to be able to increase
that, that over time.
And then, then I think thingswill appear right.
I think, you know, if this isyour first ACL that you're
working with, past six months,you're working on their
strength, you're trying to get'em going, I, I think you're
gonna notice.
Oh wow.
(25:42):
They're agility, they're runningmechanics, those sorts of
things.
They're all gonna improve asstrength improves.
Right?
It's almost a limiting factor.
Dan (25:50):
I'll give you an example real quick.
This literally happened Friday,so I have a, uh, we have a, we
have a residency program now,sports BT residency, and I was,
uh, kind of mentoring with myresident and we had a patient,
she's a college basketballplayer and really no training
history coming in.
And we, we started trap bardeadlift the other day.
She's, uh, kind of a later stageacl and, um, you know, I, I had
(26:13):
her, uh, I think she had likeprobably one 15 on the.
And I said, because we werestill trying to establish a load
for her, and she did six, likesix reps, and I said, zero to 10
on difficulty scale, like 10.
And she saw it was about aneight and it didn't look like
our heart rate got past resting.
And I'm, and I said, Yeah.
I said, We're gonna go, we'regonna go up, we're gonna go up
20 pounds.
(26:34):
Uh, so we went up, we went up 20pounds, so roughly 20% for where
she was at.
And we did it again and stilldidn't look so good.
So I, I went up another 20%.
And then I felt like I kind ofsaw that last rep where there
was a little bit of strain andI'm like, Okay, we got a good,
we got a good, a good weighthere.
So I, I think part of it too isjust, is it's okay to tinker.
You might go through five or sixsets of dumbbells, or you may
(26:56):
have to change weights six orseven times before you find that
sweet spot.
That truly is where they shouldbe today.
Cause I, You don't wanna wastereps.
I mean, why would you lift inthree weeks, which you can lift.
Mike (27:07):
And, and I hope everybody noticed right there.
So that was, that was Dan beinga coach, right?
So remember the, what I talkedabout earlier about technician
versus coach, right?
So the technician would showsomebody how to deadlift, show
them, show them the technique,tell'em how to, how to cue it
through it and perform the task.
The coach within Dan determinedthat that was not the
appropriate load.
There wasn't enough intent fromthe athlete that's next level
(27:29):
stuff.
And you can't do that withoutexperience, right?
You can't do that without repsdoing that.
So, you know, that's, that'sthat coaching muscle that you
have.
Dan (27:36):
And that circles back to our discussion earlier about my
comfort level, the lifting.
Give me a comfort level withthis and Yeah, it did.
Because you saw when somebody,you know, we used to always say
like, Oh man, that was a toy.
You gotta put some weight on thebar.
You know, like, And then, so forher that weight was a toy.
We gotta put some weight on thebar where you see that effort.
Or maybe you see that there's,they struggle with that last rep
(27:57):
or two, you know, like that.
That's a good spot to be.
And I think the challenge forus, like I said, is, It's hard
to base a lot of ourprogressions on one RM because
those are unhealthy people.
Right.
So it's effort, scale.
I mean, you, I mean, there's alot of different ways to kind of
measure that.
You know, when you have somebodywith no training history, you
gotta kind of read your patient,which is really hard to do, you
know?
Uh, that that's a, that's achallenge for us.
(28:18):
That's why I said, I think withthe recovering patient, that
first time he put somebody inthe leg press, M pfl
reconstruction, you know, uh,what, what weight is okay to
start with.
And, um, I probably, I would saymany, many, many therapists,
both, uh, uh, new ones andseasoned ones, struggle with
this.
Mike (28:38):
And I think you actually did an amazing job actually
teaching that athlete as well.
Right?
So that was part of that processthere is you taught her intent a
little bit and what really is aneight outta 10.
And you know, I, I, I don't, I,I, I don't, I don't, that
doesn't get lost with me is thatsometimes with these people, we
have to teach them intent.
(28:58):
And that's a big component ofour strength and conditioning
principles that we do atChampion here.
Is that a lot of.
Kids, right?
We do sports performance withkids.
Um, one of the things we have toteach them is intent and how
that isn't always, um, you know,your, your eight outta 10 effort
isn't always what you think itis.
So, um, awesome stuff.
So, um, alright.
So one other question related tothis for me in my mind is you
(29:20):
have experience with this bothas a private practice owner as
well as working in big like megacorporations and hospital
systems, right?
Um, how do you, how do you dothese later stages of rehab in
this insurance based.
Dan (29:34):
Oh, good question.
Cause that's affecting all ofus.
Uh, well, a, a couple things.
So one, um, I think you have tokind of reverse engineering on
how many visits you have and howmany you're projecting that you
probably are gonna.
So typically if I'm runningoutta visits, uh, I start to
space'em out a little bit more.
Uh, I provide, I provide a lotof programming, like I write
stuff out and give themsomething to do.
(29:56):
And that comes back to coachingagain, like when you teach them
how to, you know, I write outlike, here here's five or six,
you know, quad based exercises,and I make sure that they're pro
tech, uh, uh, proficient intheir technique.
So writing out a program is, isdefinitely one way for.
To, but keep it simple.
You know, pick, pick four, fiveexercises that you know they can
execute.
You gotta find out what resourcethey have access to.
(30:17):
So that's one way.
The other one is, is that it'salways helpful to have some sort
of a step down program.
And we had at our, at our, uh,where I'm at now, called Final
Hurdle, where rehab was kind ofdone or the money ran out, but
rehab wasn't done.
You know, so we, we had a.
Uh, we worked with our, ourstrength coach would, we'd kind
of give him a summary and, andhe would address, uh, whatever
remaining deficits there were.
(30:38):
So that'll help for sure, uh,having something like that.
Um, but it's one of those thingstoo.
Talking to your physicians,talking to the family, letting
people know ahead of time, like,you know, day one postop, you
might start trying to plan forthis.
Now we're gonna have to dosomething late stage.
And you might work with peoplejust to just say, Hey look, I
got, here's what our, here'swhat our rates are.
(30:58):
I, I can do 30 minutes so thatyou can do 30 minutes of the one
on one time.
And then they can work out ontheir own.
You know, they're within youreyesight.
You can still supervise, but uh,you know, you can help work with
their financial situation.
Cause we obviously now in ourcurrent state like that, that's
a big.
Mike (31:14):
Right.
Yeah, no, I, I think that makessense.
And, um, collaborating.
I think sometimes too with, witha nice solid gym that's near
you, maybe that have a strengthcoach
Dan (31:24):
Forgot to, forgot to mention that.
Mike (31:25):
Yeah, I mean, just like go out there and spend some time
there.
Maybe, like, maybe you need toactually go there and spend time
there.
I think that's important.
Like, and actually, you know,talk to those people, um, you
know, and, and not just referpeople there, but let them
become part of your network.
Like that would be amazing.
Dan (31:40):
it is.
That, that, that was really oneof the main ways I, I built my
practices is that there was a, alocal gym.
He actually got started when I.
And I really kind of cold calledhim, just stop by, said hello,
and I'm down the street.
And it just evolved into a greatrelationship.
In fact, my son trains therenow.
So, um, you know, I mean, no,it's, it's, it's great.
And, and, but again, bouncingideas off each other, building a
(32:01):
collaborative model, you know,uh, if they don't need to be in
therapy and they don't need tobe with you, then call that
strength coach and say, Look,just don't do these things for
the next two, three weeks.
Do these things instead.
I mean, that, that's how it's.
Mike (32:14):
Awesome.
I love it.
That's awesome.
All right, one other topic Iwanted to hit about real quick
with us here.
You and I, uh, we put togetheran online course on blood flow
restriction training, which Ithink is kind of related to this
conversation, Right.
Um, you know, and how we dothat.
Um, you know, as a PT that'sworking in this environment, um,
how are you currently using BFRin your.
(32:35):
Because I do think a lot ofpeople are thinking this.
A lot of people want to gothrough this and you know how we
use bfr, but like what are, whatare some of the main reasons why
you start whipping out BFR forpeople?
Dan (32:46):
I still say for me, the over overwhelming majority,
probably 95% or greater, is justquad strengthen atrophy at
postop knee.
I, I think it's really, reallygreat for that.
I particularly like it for, youknow, I got a lot of folks right
now with car restorationprocedures, some that had a,
some that had a car restorationprocedure and a fulkerson that's
like dropping a nuke on thequad.
(33:06):
So, I mean, yeah, I mean, it'sway worse than any ACL I've ever
had.
I mean, those, those people, Imean, they're often restricted
for 12 weeks from, you know,closed chain loading.
So, uh, those are the, are arethe folks that are, are still
very active but have terribleknees.
Like this guy
Mike (33:21):
right.
Dan (33:22):
I do it myself.
Like it's not shamelessself-promotion, but you know,
my, I have one knee.
It's just trash.
It's just trash.
So I mean, it really helps thosefolks out.
I do, I don't use it.
We've talked about this.
I don't use it much in the upperbody except for my big athletes
that have pec tend and tears,uh, to get that atrophy back or
like, you know, I had a, andactually I've been publishing
this case study very soon in Ijs b t about a strong man
(33:44):
competitor I had that had adistal biceps rupture.
So, uh, I did it with him.
Um, you know, I, I can't say,you know, as you know, Mike,
there's no studies that reallysay don't do it, or that it's,
you know, uh, I, I'm just.
Other than those cases that Isuggested, like we've talked
before, I don't have a problemgetting folks strong or getting
strong in the upper body.
(34:05):
I think the legs are a littledifferent because of that quad
atrophy after surgery.
So that, that's the, that's themain reason I'm using it.
I'm not using it yet fortendinopathy.
We might, down the road, there'sbeen a couple studies to show
that it helps with healthytendons.
But you know, I've even talkedto the, the tendon experts, you
know, at different times.
You know, Chris Segger and JillCook and asked him about, This
(34:25):
and, and they're like, Yeah, I'mnot really on board yet with the
whole tendinopathy thing and bfr maybe down the road it will
be.
Um, I think right, right nowthose are the probably the main
ones for me.
Mike (34:34):
I, I, I feel like I completely agree by the way,
it's, it's, it's a no brainer toperform in all these lower
extremity things where westruggle to get strength.
Um, I just, I, you know, Idefinitely, I don't, I don't do
it much in the upper body.
I don't think anybody atChampion does maybe Dan Pope a
little bit, um, with some of hisathletes, cuz he has different,
like, weightlifting type, youknow, backgrounds, fitness
athletes.
(34:54):
Uh, but I think we agree.
We, one, I'm not seeingoverwhelming benefit, but two,
like, I don't know.
I don't, I have no problemgetting the cuff strong.
I don.
You know, having to do that is,is hard.
I mean, I, you know, we make aliving off that.
Um, you know, to theTendonopathy concept.
I just wonder if, um, you know,it allows us to load the tendon
(35:15):
more, or is it really just thatyou did an exercise for 75 reps?
Right.
Which we wouldn't normally do.
You know, say you're working onlateral epicondylitis and you're
doing some risk extens, Realbasic, right?
We normally do two to three setsof 10, right?
But with bfr we're doing 30, 15.
15, 15 a lot of times, right?
That's the standard protocol outthere nowadays.
(35:35):
Um, is it helpful just becausewe did 75 reps
Dan (35:39):
I don't know, man.
I, I, I do, I wrestled itbecause as you know, the two
main things that tendons likeare tension and load,
Mike (35:45):
load,
Dan (35:46):
not doing, you're not doing, you're not doing a whole
lot of.
And the 10, the tensions there alittle, I suppose.
Cause it's, you know, the amountof reps you're doing.
It's just not my, it's just notmy first go-to.
I'm not sure what to say.
Like it's certainly an option.
You know, take Patel pain likethere, you know, hip and quad
strengthening first.
I mean, do you go down the roadof, of taping?
Well, maybe, but that's like,you know, five, six down the
(36:08):
road on my list.
That's kind of how I feel rightnow about tendinopathies and,
and again, maybe, maybe I'll beproven wrong here in, in, in,
in, in the near future.
But on the flip side, I'm alsogetting really good results with
isometrics to get the pain downand then going either heavy,
slow, or eccentrically based.
To get'em better.
And I got 20 years of a hugeend.
(36:28):
Uh, where, where that, that'shelped.
Mike (36:31):
Yeah, that's actually a good point.
Like you, that's not an areawhere you think you even need
it, which is, which is prettyhelpful in there.
Uh, that, that was the firstthing we talked about at
Champion as a staff when we weretalking about starting using BFR
a little bit more, uh, you know,several years ago now at this
point.
And I think we all said, Well,well wait a minute.
If we're not loading the tendon,maybe this is good for strength,
(36:51):
but what's the long termramifications of doing all these
exercises with less load on thetendon?
Um, and it was definitelysomething we, you know, we were,
we.
We thought about.
I'll leave it at that.
Dan (37:02):
I've always said, uh, and I even wrote a, a clinical
viewpoint piece in I G S P T onthis like, definite room for
optimism.
And you should be looking atthis, no question, you know, but
pump the brakes like you shouldnot replace.
Traditional loading methods.
You, you know, it's an adjunct,it's a supplement, it's a
whatever word you want to use,but it should not be, it should
(37:24):
not be a replacement.
Um, you know, and just remembera lot of the stuff that they
talk about with bfr, all theseamazing benefits with hormones
and things like that.
We get that with normal trainingtoo,
Mike (37:34):
Right.
Dan (37:35):
Like there's not just this, uh, it doesn't stop when you,
you, you deflate the cuff, so tospeak.
Mike (37:41):
Ex.
Exactly.
Dan (37:42):
think it's important.
Remember that too.
A lot of those benefits happenwith our traditional training
methods,
Mike (37:46):
right.
But for the right person at theright time, that has an
inability to load, but wants toget some of the benefit, it's a
no brainer.
It just, it just seems obvious.
Dan (37:54):
right?
For sure.
Mike (37:56):
I love it.
Right?
And so this is why you need tocheck out Dan and I's Course, by
the way, uh, because you know,it's our personal experience.
It's how we use it and you know,we teach you that, right?
We teach you how we use it andwhy we use it, right?
Not just some, some, you know,random stuff.
It, it's more of a, you know,clinical application concept as
well as all the signs.
So, um, yeah, check that out.
Dan and I, you know, put a lotof work into that.
(38:17):
Dans the mastermind behind that.
So I'm, I'm super appreciativeof all that.
But, um, you know, if you wannacheck that out, that's just mike
round.com/bfr.
You can head to that course,but, um, Dan, before I let you
go, we'd like to end with a highfive.
Still calling it that, eventhough everybody makes fun of
it.
But, uh, the high five, fivequick questions, five quick
answers at the end, um, just tokinda learn a little bit more
(38:38):
about you.
But number one, what are you,what is Dan Lorenz currently
doing right now for your ownConEd or professional develop?
Dan (38:47):
This has never really stopped for me, but I, I read
incessantly.
I think that's the first thing.
I think, you know, that I do astaff journal club.
Um, I'm constantly postingarticles on, on social media,
uh, or at least on Twitter.
I don't do much else other thanthat.
But, uh, it all starts withreading.
Um, uh, I think preparation forall my teaching.
Uh, you know, cuz if you'reteaching something, you really
(39:08):
gotta be on your game and yougotta know, you gotta know the
material.
So I think that indirectlythrough teaching, uh, I, I, I
get a lot of, uh, stuff there.
Um, I'm signing up here very,very soon.
Actually, this week I'm gonnatake, uh, uh, Derek Hanson speed
course.
Mike (39:22):
Oh, nice.
Yeah,
Dan (39:23):
Yeah, I wanna take that.
Uh, again, that's just somelater stage stuff that you
really gotta kind of spend sometime with and, and he's probably
one of the best in the field atit.
So, uh, he has a, a speedcourse.
I'm, I'm gonna, I think I'mgonna delve into that.
And I think for me too, I thinkpart of it is, you know, I have
all this new technology I neverhad before.
So like we have force platesnow, a ice connect device.
Like we've had these things forabout a year and for 20 years I
(39:45):
never got those things.
I didn't have the band.
What was the point of, of, uh,knowing what the, the latest on
force plate technology is whenyou don't get to use it, so,
Right.
Why would, why would you fillyour brain with that stuff when
you have access season?
So again, I'm, I'm a, I admit,I'm, I feel like a new grad in a
way.
Excuse me.
Learning, learning how to usethe ice kinetic device with
speeds, you know, um, what we'relooking at in the force plate
(40:07):
and stuff.
So, uh, that, that's been kindof fun, um, because again, it's
new, it's, it's cool technologyand it's really, um, changed
how, frankly changed how Ipractice.
So,
Mike (40:16):
Awesome.
Always growing.
I like it.
Well, I know you're a littlestubborn, but I'm just kidding.
But, uh, what's one thing that,that you've recently changed
your mind about?
Dan (40:25):
I would say evolved last couple years.
I think more the open chain kneeextension stuff.
I mean, I think you and I cameup about the same time in PT
school and I mean, if, if you,uh, you know, if, if you did
open chain knee extensions afteran acl, I mean, man, that that
was, that was grounds for, uh,Being arrested.
Being arrested and thrown in,thrown in the go log, right?
So, uh, I think that's changed abit.
(40:45):
I've certainly gone been moreprogressive there.
Uh, I've also, um, also sloweddown my cuffs considerably
rotator cuff repairs.
I say that all the time.
Uh, and I think too, it's beenkind of good on uh, uh, helping
out tens a lot is theisometrics.
You know, I, I've been usingthose a ton for pain.
You know, I have a, a highschool, uh, wide receiver.
I mean, who was, he came to seeme constant proximal hamstring
(41:08):
tendinopathy, like pain.
It hurt all the time.
Sitting in class doing nothing.
He was on isometrics for twodays and his pain went away to
only when he ran at practice.
I mean, there, there'sdefinitely something there.
I mean, we weren't reallytalking about this 20 years ago.
It was kind of go right.
Right.
To eccentric or something likethat.
So I would say that those areprobably three off the top of my
head that, um, have, I'veevolved on a bit.
Mike (41:30):
Yeah.
That's awesome.
And, and I agree.
Follow Dan on Twitter, by theway, because you, you do share
what you're reading, um, quite abit.
Like one of the, one of themost, you know, um, Twitter
accounts that I follow, like,like you, you do share all these
articles you're reading with alittle comment.
So it's always cool to see that.
So, um, you know, definitelyfollow Dan for that.
Um, what's your favorite pieceof advice that you give your
students or your new residentnow?
Dan (41:53):
Be an expert at the basics, Uh, no question.
Uh, the careful with the socialmedia fads and those kind of
things.
Uh, know what you're measuring,you know, uh, get an algorithm
base for progression foreverything.
Uh, test, test people.
Uh, you know, again, myresident, you know, he had a
(42:14):
patient not too long ago and,um, I was like, you know, he
mentioned about strength.
I'm like, Well, did you test it?
You
Mike (42:19):
Right.
Dan (42:20):
the Dino's right there, man.
You know what I mean?
Not to, but again, we, Iliterally say it with him every
mentoring session, like there'san opportunity to say being
expert at the.
And like I said, you don't haveto have this crazy exercise that
nobody's ever seen before thatthe main guy in Instagram is
doing.
Like, can they squat, can theyhinge?
You know, push, pull, hinge, uh,carry.
(42:42):
Like it really is that simple.
It really is.
You don't have to, but peoplewanna do the like, well there's
gotta be a different exerciseother than sideline external
rotation.
There's a reason why we've beendoing it since it's don a time
because it works.
Mike (42:53):
Right, exactly.
Dan (42:55):
so yeah,
Mike (42:56):
and,
Dan (42:56):
I, No question.
That's the biggest advice Igive.
Mike (42:59):
And, and I hate to break it to everybody, but you know
that person on Instagram that'sdoing all those crazy things,
even for them, that's 1% of whatthey're probably doing.
But that's just what they chooseto show you, right?
They're not showing you the minisquat that they're doing.
That progresses to a, a partialsquat, which progresses to a
deep squat, which progresses tothe load that, cuz that's really
(43:19):
boring on Instagram.
right?
like you know?
So, uh, good point.
Dan (43:23):
I think the other thing too is just, you know, find the
experts in whatever, whateverarea it is, and, and read their
stuff, go to the meetings, youknow, whether it's, uh, Amsc or
going to CSM and listening tothose people speak.
I mean, that's where you have achance to interact and engage
and, you know, we have somereally great people in our
profession that'll spend sometime with you if you just, if
you just reach out.
So use the resources around ittoo, for.
Mike (43:44):
Yeah, I agree with that.
You know, our, our sportsperformance thing that you
started is, has done such agreat job building community,
um, you know, within, you know,that shared interest, which I
think is really neat.
So again, find that group ofpeople that you can geek out
with.
I think that's, that's fun too.
So, um, Awesome.
What's coming up next for you,Dan?
Dan (44:03):
Uh, actually this week I'm really excited.
I'm coming out to your neck ofthe woods.
Actually, I was asked to be apart of, Yeah, I am.
I was asked to be part of this,um, this bridge Enhanced or bio.
Against ACL reconstruction wherethey're, you know, they take
the, basically trying to getthat naturally they're redoing
the protocol and I was asked tobe on a panel to make that
happen, uh, or to be a part ofputting that together.
So, um, yeah, I'm really excitedabout that.
(44:25):
I leave here in a few days forthat and it's just, uh, there's
a meeting, uh, it's about sixhour meeting round table with
some orthopedic surgeons and I'mnot quite sure who else is on
the.
The pt, you know, staff orfaculty for this.
But I'm really looking forwardto that.
Um, I'm, I'm continuing toteach.
I, uh, I, I put some, I, I justput my performance enhancement
course online.
I'm probably gonna do a few moreof those as well.
Um, you know, so that's, again,I put more of'em online, I
(44:48):
should say.
Um, That's, that's probablymostly what's, what's next for
me.
Um, but I think, uh, just from apersonal standpoint, you know,
just trying to trying to work onhow to be a first grade
basketball coach and just, just,just sharpen, just sharpening
the acts as a dad and husbandand father.
So, yeah.
Mike (45:05):
I, I, I, I'd be lying if I, if I said that, I, I haven't
gone to YouTube to look up likethe rules of field hockey and
lacrosse and all these sports.
I didn't play growing up withkids, so
Dan (45:16):
right?
No, that's exactly right.
So,
Mike (45:19):
That's awesome.
Um, and, and what's your websiteagain?
I'm gonna put, this is gonna bein the show notes for everybody,
but your website where you havethese courses and everything
where.
Dan (45:26):
It's Ortho athletic edu.com.
Um, yeah, that's where, that'swhere all those are.
And like I said, I typically do,uh, four different courses just
cuz it's the stuff I like, thestuff I emphasize the most.
But I certainly have cateredcourses specifically what folks
want.
So, and I do enjoy doing it.
I, I much prefer live ratherthan online.
Uh, there's, uh, I think it'sjust better to do.
(45:48):
I'm a little more animated inperson and I can demo more
stuff, so, but no, I, I, I doenjoy for.
Mike (45:54):
There's the gap for online, but you know, you need
in person as well.
I completely agree with that.
So that's awesome.
So awesome.
Well, Dan, this was amazing.
Thank you so much for takingtime out to do this, uh, sharing
all this great knowledge withyou.
Uh, hope to talk to you again ina future episode.
Thanks so much.
Dan (46:10):
Likewise, Mike, thanks for having me.
On this episode of the sportsphysical therapy podcast, I'm
joined by Dan Lorens.
Dan's the director of sportsmedicine at Lawrence Memorial
hospital in ortho, Kansas inLawrence, Kansas, and also
teaches for his con ed company.
Ortho athletic education does anexpert at many things but one
area that he's really passionateabout is strength and
conditioning and how thatrelates to late stage rehab and
(00:22):
return to play we talk aboutthat and an update on how we're
using bfr in our practice all inthis episode
Mike (00:40):
Hey, Dan, welcome to the podcast.
Thanks so much for joining ustoday,
Dan (00:43):
Mr.
President, great to be here,man.
Mike (00:46):
Wow.
that still, that still feltweird,
Dan (00:50):
Yeah.
Good to see you, Mike.
How are you man?
Mike (00:53):
I'm doing great.
You know, and appreciate youtaking time doing this.
Um, you know, for thoselistening that don't understand,
I mean, this is like six 30 inthe morning right now for Dan
before work.
Um, but this is, you know, the,the type of character that Dan
is that, you know, is alwayswilling to share and all that
great stuff that he does online.
So, um, really appreciate youtaking time outta your, your
(01:14):
personal day to, to join us thismorning.
Dan (01:16):
Mike, thank you for asking me.
I really appreciate it.
You got a lot of great peoplethat have been on here already,
and I know you have a lot ofother people you could have
asked, so.
Mike (01:23):
No, no, this is, I, I've been waiting for this one for a
while.
I wanted to make sure we hadsome time to do this.
Um, there's, there's so manythings that we can talk about.
So Dan and I are friends, we'veknown each other for, for a
bunch of years now.
Um, and, you know, we geek outabout some things online and,
and through text messages andstuff when we see each other in
person.
But, um, I what I think what Iwanted to focus on for the, the,
(01:44):
the sake of the podcast for nowis this background that you have
in this area that I know you'resuper passionate about and
you've been building out on thelater stages of rehab and even
performance training to anextent too.
Right?
Um, you, uh, you're, you know,the past, uh, sig leader, um, in
the sports academy of the a pta,the American, uh, Academy of
Sports Physical Therapy.
(02:04):
You were the sig leader for thesports performance sig.
Um, did you start that sig bythe.
Dan (02:09):
I did.
Yeah.
Mike (02:10):
Nice.
So you were the, the founder,right?
We'll call that, We'll call youthe, the, the, the originator of
that sig.
So, you know, I know you'vealways been interested in this
sort of thing.
Um, for me, this is an area thatI see so many PTs struggle and I
know that so many of thestudents that we have coming
through our place at Champion.
Have so many questions about whydo you think we're at a point
(02:33):
right now in physical therapywhere the later stages of rehab
in, in training in general justseems so daunting to so many
people?
Dan (02:42):
Uh, I would say that I think the biggest problem there
is that in school we, we justdon't get it.
They.
As generalists, you know, youhave to, you have to treat
everything when they're tryingto prepare you for being an
acute therapist or work peds orgeneral ortho.
And, and I do believe that partof the later stage, uh, stuff
is, uh, is something I have toacquire either on your own or
(03:02):
through continuing ed.
Uh, you know, I think part of itis that we don't, um, it's so
highly specialized, uh, at, atthat later, those terminal
phases, and so we just don't getit.
I think in.
Mike (03:15):
Yeah.
And I, I think that makes sense,right?
And I don't think that'snecessarily a slight towards
school.
I know you're not saying that.
I know we don't think that way.
There's just so much that a PTstudent needs to learn.
Um, so I don't, I mean, so what,what do you recommend then?
So when you have people askingfor advice, maybe they're
already.
In PT school right now, andthey're saying, Wow, my
(03:38):
curriculum just doesn't haveenough of strength and
conditioning principles or, or,or high level late orthopedic
sports type type rehab things.
Where do you tell people to getstarted?
Like what do you, what do yourecommend they do?
Dan (03:51):
I think studying for the CSCs exam, you don't necessarily
have to take it, but I mean,studying for it isn't a bad idea
cuz you'll get at least somefoundational knowledge, uh,
about those concepts andprinciples.
I think.
Even being an NSCA member, Imean, they have a couple
different articles, or excuseme, a couple different journals.
We get a lot of, they have somereally good information in
those.
(04:11):
There's tons of strengthconditioning courses out there.
I think, uh, you know, evenhanging out in a local weight
room, like a uni, like maybe acommunity college or, you know,
if you have access to auniversity where you could just
volunteer and, uh, put, put sometime in here and they're like,
I.
Uh, you know, to loading weightsor wiping chalk off bars or
whatever, just to, just to pickup some things.
(04:32):
I think those are probably someof the better ways to do it.
There's a lot of good con, Imean, heck, the, the Academy has
the sports performanceenhancement sig, so you get some
good information there,especially with the mobilized
platform and things.
So just through engagement ofpeople that are already doing
it.
Mike (04:46):
I like that.
So, so let's do this.
Walk me through your historythen, because I think you
started to elude it a littlebit, but you know what, You're
in PT school, right?
Obviously you have a, um, almostlike a personal, uh, uh, area
that you want to pursue herewith strength and conditioning.
You know, you enjoy that sort ofstuff yourself, you train
yourself.
Um, what did you do to putyourself here to, to really
(05:08):
grasp this, this concept?
Dan (05:10):
You know, how many people do you know in sports pt, uh,
went into this because theyplayed sports and they got an
injury themselves, right?
So that, that happened with me.
You know, I, um, I broke my legin high school playing football
and wanted be a PT from, fromthere on.
Well, same thing with thestrength editioning piece.
Uh, I started power lifting inseventh grade, um, and uh,
(05:31):
really just kind of became a gymrat from.
And in early, like undergrad andthings like that, I was going to
a lot of strength conditioningcourses.
Uh, I spent a lot of time just,uh, uh, again, like just kind of
volunteering and, and shadowingand in some different weight
rooms at the collegiate setting.
So I, I learned a lot there.
And, uh, like I said, it's justalways been an interest area of
(05:51):
mine and, and, uh, the fact thatyou can kind of merge PT and
strengthen dishing in thoselater phases, it's just, it's
served me well, cuz I, I reallydid understand those concepts of
loading and progressingexercises and, and, uh,
regressing and lateralizingexercises, those kinds of
things.
So it, I think that's probablywhat got me to this point.
Mike (06:11):
And I like the way you, you said you put yourself out
there a little bit, right?
And it's really, really hard.
You, you, you mentioned twothings and um, I really like
these two points.
One was, you know, the CSCs wasessentially in, in, even if you
don't take the test, but youmight as well take the test,
but, um, is understanding theconcepts of strength and condit.
(06:33):
Right.
So that's almost, that's thetextbook, that's the classroom
style, right?
That's that's learning theprinciples and the physiology of
strength and conditioning.
I think that's a great start,and what I like about that is
you could do that veryasynchronously, right?
You can wake up early in schooland read a chapter a day.
Right.
If you really wanted to or youknow, do that in between
(06:57):
classes, right?
You can, You can take time toasynchronously, asynchronously,
start learning the concept ofdrinking conditioning.
But then what you did though isyou did the practical
application too.
And I think that's the hard partthat sometimes students don't
realize right now is that it'snot just about reading, it's and
understanding thing and evenwatching.
You know, social media, YouTube,reading people's blogs.
(07:19):
It's also about applying it.
So I like how you went out thereand you volunteered.
Um, where did you go?
Did you say, Was it college highschool?
Like what, what, how'd that goabout?
Like how did you know people?
Like how'd you get your, yourfeet in the door there?
Dan (07:33):
Uh, asking questions, like, Hey, I'm really interested in
this.
Like, I may went to a guy'scourse.
Um, or some somebody's courseand just said, Hey, uh, you
know, I really like this aspectof things.
You know, sometime in the summerwhen I'm back, can I come up
like an hour, uh, an hour or twoon a certain day of the week and
just make it throughout thesummer and, and hang out a
little bit and just observe.
(07:53):
And like I said, I, I can be arunner for some things.
I just, I just wanna learn, youknow, and, and showing that
passion.
So there was a few universitiesback home in Illinois.
Spend some time with.
And um, again, you just do a fewhours here and there over the
course of a couple years duringthe summer, you accumulate a lot
of knowledge, you know, So Ithink that helped me out a lot.
No question.
Mike (08:12):
Yeah, and I wonder too, if I was in your shoes back then
and I wanted to get specializedin one specific area, I think
what you could do now is youcould reach out to some local
universities that are near youand maybe let's say for example,
my case, just reach out to thestrength coach that's in charge
of baseball and say, Hey, I wantto come help.
(08:32):
I wanna come volunteer, be yourassistant, um, you know, just be
an extra set of hands in theweight room.
Um, and then, like you said,it's only a few hours a week,
right?
Because that's all that, youknow, baseball gets access to
the weight room at a lot ofuniversities, right?
But you can really be nice and,and and strict with that and
also develop a relationshipwith.
The train coach, the team,probably everybody else over
(08:53):
time, like I, I, I think that's,that's one area that I think
people don't understand is youcan, you can get very specific
with who you want to try tovolunteer with as well.
Dan (09:02):
You can, and, and like, you know, it's all about
relationships, Mike, you know,they gotta know you.
They gotta like, and they gottatrust you, right?
And you just, those things taketime to build.
And, um, I.
I always, I get this question alot.
I spoke in a meeting not toolong ago.
I had a couple students ask me,and I'm like, you know, I, I
always encourage students, or ifyou're trying to get into this,
a lot of times, you know, PTstudents or early, early
(09:23):
professional PTs always likegoing into those environments
and kind of showing off whatthey know.
And it's like, remember you'regoing in their turf.
You know, uh uh, you gotta, youknow, can kinda keep your mouth
shut and your ears open.
You know, like, uh, you're thereto learn.
You're there to absorb, andyou're the one that has to be
there.
They didn't ask you necessarily.
Right.
So, I think it's important thatyou have some humility when you
go to those environments thatyou don't know everything.
You might learn a thing or two,you might see some things you
(09:45):
don't like, but you kind of putthose in the catalog just, well,
I wouldn't do that.
Right.
Um, you know, but also, again, Ithink athletic trainers too.
That helped me out a lot.
I was an undergrad athletictrainer.
I learned a.
From our athletic trainingcolleagues and I got'em dual
credentialed.
And um, I know there's alwaysbeen a turf war, unfortunately,
between those two professions,you know, for a long time now.
Uh, there's, there's definitelya responsibility on both sides
(10:05):
to be shared there, but, uh, Ilearned a lot, you know, in the
late stage stuff.
Cause again, they, they just do,do it better I think in some
capacities,
Mike (10:13):
That's actually a really good point too is, is is
volunteering a little bit withathletic training staff too.
Cuz you're right cuz they do alot of that in-house, late stage
rehab themselves too.
Um, it's not just the strengthand conditioning room.
I like that.
Dan (10:24):
And they're, and then they're twice understaffed.
Like, show me an athletictraining staff that's fully
staffed where they're notoverburdened with, uh, having to
cover multiple sports or, youknow, uh, or, or just too many
athletes for the amount of handsthey have.
I mean, they, they love to help,you know, So, uh, I, I think
that's a, that's an excellentway, uh, to kind of work
yourself into.
Mike (10:44):
Yeah, I'm, I'm really glad you brought up that concept too,
about going in there and nottrying to impress people.
Um, Right.
And I, I think sometimes, youknow, it depends on your
personality, right?
But sometimes people go in thereand their way of impressing
people is to try to get you tothink that they know a lot,
right?
When that's not.
Really the path to impressinglike a strength coach that's
(11:06):
been doing it for 20 years, andyou're in PT school right now,
you're gonna impress us byputting your head down and
grinding, right?
Dan (11:13):
Exactly.
Mike (11:14):
get you, get dirt, get your hands dirty, get on the
floor, get out there and coach,and get out there and be a good
member of the team, right?
It's not about what you.
Not about showing everybody, youknow, that's not how you're
gonna get a job, you know, ifit's two people there and, and
one's the, the one's alwaystrying to show everyone how
smart they are and the otherone's that just puts their head
down and works.
Um, that's probably the personthat's gonna get that, that job
(11:37):
when there's an opening in thefuture.
Right.
Dan (11:39):
No question.
Mike (11:40):
Yeah.
So, alright.
So here's what I was thinkingwhile you were telling me this
story a little bit.
So walk me through, you've beenpower lifting since middle
school, you said, right?
So, which is, which is awesome.
What's your, what's yourdeadlift pr by the way, We'll
get off topic for a second.
Dan (11:53):
Oh man.
Oh gosh.
Uh, that's a long time ago,Mike.
I, I don't, gosh, I don't evenremember.
I, I haven't done it.
I, I mean, I still, I stilldeadlift heavy.
Um, but oh my gosh.
Uh, this is probably earlycollege.
I was around, I wanna say 4 85,500, I think,
Mike (12:12):
Adam boy, and what, what's heavy now?
Cause now you're, you're old,right?
You're an old guy, but, Right.
Dan (12:17):
Yeah.
Old with old, with wearing anunloader brace on one knee, cuz
like, I've had four operationsand yeah.
Uh, no, I usually, uh, I stilldo sets of four to five, you
know, just
Mike (12:30):
good for you.
Dan (12:30):
think it's, I think it's good for us to pick up heavy
things every now and then justfor.
Mike (12:34):
Yeah.
Dan (12:35):
you're gonna have to do it eventually, at some point in
your day to day life, picking upa heavy box of Christmas lights
or something here pretty soon.
So it's good that you've, It'sgood that you've been there
before, right?
Mike (12:44):
What kind of Christmas lights do you guys have at the
Loren's house?
That's so heavy.
No, I I I love that.
So here's what I was thinkingwhen you were telling me about
that.
So how, what was going throughyour head when you were an ortho
class in school, like sophomoreyear at college and you're doing
like, There had been exerciseswith people like, what, what,
(13:05):
what was going through your headas somebody that was comfortable
in the weight room that knowshow to load people and just,
just sees like the complete lackof loading that sometimes
happens in pt.
What, what was going throughyour head?
Dan (13:18):
I tell you what, I had some sympathy for my colleagues in
class that were just feverishlywriting notes on some of this
stuff.
And having been a studentathletic trainer, I had already
been exposed to a lot of it.
That really, really helped.
I mean, I, I really, that partof PT school I sailed through
because I really understoodthose concepts very, very well.
Um, I think.
I think some of it with the why,why so many therapists struggle
(13:41):
is just, there's just, I thinkthey, they put this fear in the
back of your head that if youput another plate on the bar or
another couple stacks in the legpress that the ACL's just gonna
explode or something.
Or you know that, you know thatthat total knee that you just
had, I mean, you're just gonnaruin it if you go, If you go a
little too heavy, like I'm notcertainly advocating to be
reckless, but on the flip side,I think they just put this fear
like, you know, protect thehealing, protect the healing.
(14:02):
And you know, uh, all those, allthose things they say, you know,
don't do, don't do squats withthe knee over the toes because
of compression.
Don't open chain knee extensioncuz of compressive forces of
patella for oral joint.
They're so high and people freakout and they never do those
things.
You know what I mean?
Like I, there's just thisirrational fear that I, I think
that I was noticing that peoplehad.
So having, uh, that, thatstrength editioning background,
(14:25):
uh, You, you just learn.
You, you, you know it.
The easy stuff, the early phasestuff is easy, and I think most
people just hit a roadblock andhaving the later stage stuff
just made my programs, uh, morecomprehensive and, and well
round.
Mike (14:38):
That's awesome.
And, and I I what we try toteach our students here when we
have these discussions, cuzthey'll come in with the same
thing and be like, well, youknow, everybody on Instagram now
they're, they're, you know,they're debating knees over toes
or open connection kneeextension.
And I'm like, You have tounderstand this knees over, toes
open, connection ne all thesethings, they do increase stress.
You have to just, you have tounderstand it increases stress,
(15:00):
but that increase in stressisn't always bad.
It isn't always disadvantageous.
Sometimes it's actuallyadvantageous, right?
So it's, you try to like tellpeople, don't get caught up in,
you know, these false conflictsonline that are, you know, just
attention draws and justunderstand it's the same thing.
Do.
Throw weight a ball as abaseball player.
Okay, go nuts.
It's more stressful, but we justhave to talk about how to apply
(15:23):
that stress as as best as wecan.
Right?
And and you're right.
The PT world was just full offear and it was just like, if
you do this, your knee's gonnaexplode.
If that knee goes over your toejust one centimeter, the
surgery's gonna fail.
Right?
you're just
Dan (15:39):
there is man,
Mike (15:40):
you
Dan (15:40):
there is.
Mike (15:41):
It's crazy, but you just draw a graph like, look, here's
stress over range emotion.
You see like, sure.
When your knee goes over yourtoe, does the stress go up a
little bit.
Sure.
But you know the world's notgonna end.
Right.
And, And that's a good way ofdoing it.
But do you think you werecomfortable because you yourself
had a training age at that time,you were comfortable in the gym,
you've moved weights, right?
(16:02):
You've had loads on your ownbody.
Do you think that was a big partof why you, you felt that you
were more comfortable doingthese sorts of.
Dan (16:10):
That's a good question.
Um, I think I maybe, uh, I thinkI just had a, a good idea of
periodization and progression.
I grew up, you know, I start,when I got started, you know, we
would, you know, this is anearly high school or, or as I
was beginning my training, likewe, we, the workout would be on
the board and, you know, we'dhave a set of 10, a set of
(16:32):
eight, two sets of six, andmaybe a set of four.
And you went up a little biteach time.
And it was all based ontechnique and form and, uh,
Gosh, Mike, that's a, that's agood thought.
Probably.
Probably, yeah.
I'd say yeah, probably just acomfort level with, again, I've
watched people lift and I, Icould, I could pick up technique
or if you were unloading oneside or shifting your weight or
(16:55):
those kind of things.
Like I just had a, a keen eyefor it, I think, and that helped
out a lot.
Mike (16:59):
And you had experience.
So not only did you do thatyourself and felt it, but you
also did it with all yourteammates and your friends
probably in high school, andnone of them blew out their
knees by adding a plate or bygoing a centimeter past their
toes.
Right.
You know, like, so I think, Ithink you saw, like when you,
when you get to um, you know,maybe being a little bit too
conservative at times you'relike, Well wait a minute, I've
(17:20):
been doing this for years andyou know, my knee's fine.
Right?
Like, you know, like that'sgotta be part.
Dan (17:26):
I think this circles back to the original or the first
question you asked today about,you know, PT school stuff.
Cuz remember sometimes load forour patients is sitting up in
bed and they teach you thatstuff.
You know, again, they're tryingto teach, teach you in school to
take care of traumatic braininjury, acute care where people
have been, you know, bedriddenfor weeks.
And like I said, sitting up andgoing to the, uh, going to the
(17:49):
bathroom, walking 10 feet islike a maximal attempt for them.
So I think they're more worried.
That you'll get that late stageACL stuff down the road.
We gotta worry about gettingpeople home and you know, living
independently again.
And I, I think a lot of time isspent on that stuff and not so
much on the, you know, the laterstage.
Mike (18:08):
Right.
Yeah.
And, and I, I, I, I didn't meanto come across earlier as
pooping on yellow theand, by the
Dan (18:13):
No, no, no, no, no.
I didn't take it that way atall.
And nobody else should either.
Nobody else should either.
No, no.
I don't think that's it at all.
But it's, But what it is, is, isnot, um, the yellow TheraBand is
that, you know, don't, when youwrite down, you know, external
rotation and you just write acheck mark in all your treatment
logs, like, did you change thereps?
Did you change the load?
Did you change rest, period.
(18:34):
That's the piece.
I think that where a lot oftherapists struggle, um, it,
yeah, that's the part for.
Mike (18:40):
I, All right, so I, I'm gonna try to summarize what we
talked about so far, because Iactually think this has turned
out to be a really cool, uh,episode for people looking to
get into this.
So let's, let's go through it.
Step one, I think you're a PTstudent or even a, an early
career professional that's juststarting to think about these
things.
I think step one is get booksmart.
Right.
I like that.
It's easy to do.
(19:00):
You can do it in your own time.
Grab the CSCs book, startstudying for the test.
You might as well write andbecome book smart, but all of
that is useless if you don'tapply it.
So you gotta get your foot inthe door somewhere.
Either volunteer, uh, go to alocal university.
Now there are so many privatefacilities like mine that are
out there that you can, you cancome.
(19:21):
We have strength andconditioning internship.
At Champion where we designed itfor future strength coaches,
right?
And exercise FS students tocome.
And I will say half of ourpeople tend to be PT students or
new grads that are just wannalearn and immerse themselves for
three months a semester as acoach on the floor.
(19:41):
So you learn somebody's system,but then you're also out there
performing and you're doing it.
So you gotta get, so get book.
Get in the weight room somehowwhere you can do this.
And then I do think you gotta,you gotta go through these
programs yourself a little bit.
And I don't think that'smandatory.
Not everybody can, right?
Some people don't have thephysical abilities to do that,
but do as much as you can sothat way you can experience it a
(20:01):
little bit.
If, if you have the ability, Ithink that will do wonders for
your understanding of some ofthose things.
Right.
Um, what do you think was, wasthat a, was that a, was that a
cool summary?
Dan (20:10):
great summary.
A hundred.
Mike (20:12):
I, I thought that, I thought, I think, I just think
that is a, that's a really goodroadmap for, for somebody to
follow and, and, and, and Ithink you're gonna be a much,
much better PT because of it.
Dan (20:22):
And you have to train somebody.
You know, I, I, I talk a lot oftimes with students about, Oh,
should I take this CSCs?
Like, well, You'll study for itand probably pass it.
I think you have a lot moreknowledge than, uh, from PT
school and stuff to, to studyfor a little and take that test.
I mean, there are probably somegym based thing, like, you know,
gym design stuff that you mightstruggle with, but I, I would
say you might have the css, butcan you really train anybody?
(20:45):
Can you, You know, So that's whyI said, take your 14 year old
kid that you're seeing forTendonopathy and get him on a,
you know, good like total bodystrengthening.
Teach'em how to hinge, teach'emhow to squat.
You know, can, can you coach thehinge, Can you coach the squat?
You know, like those arefundamental.
Foundational concepts that weshould know how to do.
And the bottom line is, it'skind of our job because somebody
(21:07):
in a few years, when that kidgets to high school, somebody's
gonna put a bar in that kid'sback or put'em underneath a
bench and they're, they're notgonna have any foundation.
And we have a tremendousopportunity to do that.
Like I said, you can almost use,in a sense, you can kind of use
your, you use your patience as,as lab rats in a way to kind of
tinker with progressions andloading and, and actually
training someone.
Mike (21:26):
Right.
Right.
I love that.
And I, I would still say at thispoint in this person's career,
right, you're, I think you'restill technically a technician
with all this sort of thingswhere you're still just bringing
people through the paces with,with what you understand.
You haven't evolved yet to be acoach until you have some
experience underneath your beltworking with people where you
can say, Oh, if this happens,I'm gonna pivot this way.
(21:48):
Uh, I'm gonna regress this, I'mgonna lateralize this, I'm gonna
progress this.
Um, to me that's coaching and.
Coachings also the ability toconnect with the person, right?
When we get into some softskills, now that's a, that's a
whole nother podcastconversation, right?
Dan (22:01):
yeah, it is for sure.
It.
Mike (22:03):
there's, there's, there's so much that goes into it.
It's more than just justknowing.
So you get book smarts, you gottechnical smarts, and then to
me, I think you get those, youknow, to be a great coach, you
have to be able to connect withpeople in and understand when to
pivot.
I think that's, that's, that'simportant too.
Dan (22:18):
No question.
Yeah.
And, and that the soft skillspiece, I mean, you can work on
it, but sometimes as they say,it's hard to make a zebra change
its stripes.
So, know, uh, you know thatMike, Mike, you know that
there's people that, you know,you went to PT school with that,
you know, maybe they were, youknow, had the.
Had a 7.0 gpa, but you know,they couldn't talk to a
doorknob, so it's like, but, butthere's, and there's other
(22:39):
people.
Let's face it, there's otherpeople that may not have been
the, the, the bookish type orthe real book smart types, but
man, they could, they could worka room and they knew people.
And I would take, again, havingbeen a private practice owner, I
would take the, the ladder anyday, uh, the people skill piece
because I can teach you how toprogress and load.
But if, if people don't likeyou, if you're just not a warm,
engaging person, good.
Mike (23:00):
I like it.
So.
Alright.
How does a sports pt or even,you know, northo pt, I guess
too, um, how do they apply theseconcepts to the later stages of
rehab and returning somebody tosport?
Right.
Cause I think this is an areawe, we, um, we need to get
better at in physical therapy.
Again, don't get me wrong, Ithink sometimes we blame
ourselves a little bit, but youjust talked about you get an 18
(23:22):
year old kid that just touredtheir ACL playing football
that's never lifted a weightbefore in his life.
I'm pretty sure at six monthshe's gonna be weak because he
was weak at zero months or hewas weak at negative one months.
Right.
Like I, I, I think that's partof it too, but like, how do you
take these concepts and how doyou apply'em to the later stages
of.
Dan (23:40):
Well, first off, I think it's, it's screening for
appropriateness like is.
Done.
And whenever I teach, anybodythat's heard me speak before,
one of the concepts I I alwaysstart with, uh, when I teach is,
is rehab done?
Um, because obviously when wegot people going back with 65%
quad strength or.
Or what have you that rehab'snot done.
(24:01):
So I think starting there, Ithink you, they have to have
requisite the requisite mobilityand exercise technique to do
what you want'em to do.
Like you might want'em to do aback squat, you know, or a front
squat.
But do they even have thetechnique?
Like, that's why I said the cofamiliarizing yourself with
these basic concepts.
Uh, cuz again, my, my programsare, are painfully boring.
We, we push, we pull.
Mike (24:23):
right, right.
Dan (24:24):
and can you, can you, can you teach a front squat?
Do you know what a good frontsquat looks like?
Do you know why?
If it does, does, If it doesn'tlook right, why does it not look
right?
So I, I think starting there andthen, um, Uh, from the
progression standpoint, it, it'slike anything else.
I mean, I, I think this is wherethat the whole periodization
idea comes in a little bit.
You know, you gotta get afoundation first, and then you
continue to build, buildstrength, and then eventually
(24:45):
you start to, um, move, movelighter things fast, right?
Appropriate.
And then, then you work on speedtowards the end.
So, um, I, That's where yougotta start.
I can start with the basics.
Do they, Is rehab done and then.
Whatever, basically, whatever.
As I've said this before too,like whatever factor is
(25:06):
contributing to their lack ofpower, that's what you have to
focus on.
And it might be an ankle doorsof flexion restriction.
They can't squat because of it,so if they can't squat, they
can't get their legs strong andthen they therefore can't work
on explosiveness.
So that's your job is to pick upthe impairment that's limiting
their ability to be powerful.
Mike (25:22):
Right.
And when in doubt, just startgetting them strong.
And I think things will, willstart to click over time is you,
you have to be able to load, Youhave to be able to increase
that, that over time.
And then, then I think thingswill appear right.
I think, you know, if this isyour first ACL that you're
working with, past six months,you're working on their
strength, you're trying to get'em going, I, I think you're
gonna notice.
Oh wow.
(25:42):
They're agility, they're runningmechanics, those sorts of
things.
They're all gonna improve asstrength improves.
Right?
It's almost a limiting factor.
Dan (25:50):
I'll give you an example real quick.
This literally happened Friday,so I have a, uh, we have a, we
have a residency program now,sports BT residency, and I was,
uh, kind of mentoring with myresident and we had a patient,
she's a college basketballplayer and really no training
history coming in.
And we, we started trap bardeadlift the other day.
She's, uh, kind of a later stageacl and, um, you know, I, I had
(26:13):
her, uh, I think she had likeprobably one 15 on the.
And I said, because we werestill trying to establish a load
for her, and she did six, likesix reps, and I said, zero to 10
on difficulty scale, like 10.
And she saw it was about aneight and it didn't look like
our heart rate got past resting.
And I'm, and I said, Yeah.
I said, We're gonna go, we'regonna go up, we're gonna go up
20 pounds.
(26:34):
Uh, so we went up, we went up 20pounds, so roughly 20% for where
she was at.
And we did it again and stilldidn't look so good.
So I, I went up another 20%.
And then I felt like I kind ofsaw that last rep where there
was a little bit of strain andI'm like, Okay, we got a good,
we got a good, a good weighthere.
So I, I think part of it too isjust, is it's okay to tinker.
You might go through five or sixsets of dumbbells, or you may
(26:56):
have to change weights six orseven times before you find that
sweet spot.
That truly is where they shouldbe today.
Cause I, You don't wanna wastereps.
I mean, why would you lift inthree weeks, which you can lift.
Mike (27:07):
And, and I hope everybody noticed right there.
So that was, that was Dan beinga coach, right?
So remember the, what I talkedabout earlier about technician
versus coach, right?
So the technician would showsomebody how to deadlift, show
them, show them the technique,tell'em how to, how to cue it
through it and perform the task.
The coach within Dan determinedthat that was not the
appropriate load.
There wasn't enough intent fromthe athlete that's next level
(27:29):
stuff.
And you can't do that withoutexperience, right?
You can't do that without repsdoing that.
So, you know, that's, that'sthat coaching muscle that you
have.
Dan (27:36):
And that circles back to our discussion earlier about my
comfort level, the lifting.
Give me a comfort level withthis and Yeah, it did.
Because you saw when somebody,you know, we used to always say
like, Oh man, that was a toy.
You gotta put some weight on thebar.
You know, like, And then, so forher that weight was a toy.
We gotta put some weight on thebar where you see that effort.
Or maybe you see that there's,they struggle with that last rep
(27:57):
or two, you know, like that.
That's a good spot to be.
And I think the challenge forus, like I said, is, It's hard
to base a lot of ourprogressions on one RM because
those are unhealthy people.
Right.
So it's effort, scale.
I mean, you, I mean, there's alot of different ways to kind of
measure that.
You know, when you have somebodywith no training history, you
gotta kind of read your patient,which is really hard to do, you
know?
Uh, that that's a, that's achallenge for us.
(28:18):
That's why I said, I think withthe recovering patient, that
first time he put somebody inthe leg press, M pfl
reconstruction, you know, uh,what, what weight is okay to
start with.
And, um, I probably, I would saymany, many, many therapists,
both, uh, uh, new ones andseasoned ones, struggle with
this.
Mike (28:38):
And I think you actually did an amazing job actually
teaching that athlete as well.
Right?
So that was part of that processthere is you taught her intent a
little bit and what really is aneight outta 10.
And you know, I, I, I don't, I,I, I don't, I don't, that
doesn't get lost with me is thatsometimes with these people, we
have to teach them intent.
(28:58):
And that's a big component ofour strength and conditioning
principles that we do atChampion here.
Is that a lot of.
Kids, right?
We do sports performance withkids.
Um, one of the things we have toteach them is intent and how
that isn't always, um, you know,your, your eight outta 10 effort
isn't always what you think itis.
So, um, awesome stuff.
So, um, alright.
So one other question related tothis for me in my mind is you
(29:20):
have experience with this bothas a private practice owner as
well as working in big like megacorporations and hospital
systems, right?
Um, how do you, how do you dothese later stages of rehab in
this insurance based.
Dan (29:34):
Oh, good question.
Cause that's affecting all ofus.
Uh, well, a, a couple things.
So one, um, I think you have tokind of reverse engineering on
how many visits you have and howmany you're projecting that you
probably are gonna.
So typically if I'm runningoutta visits, uh, I start to
space'em out a little bit more.
Uh, I provide, I provide a lotof programming, like I write
stuff out and give themsomething to do.
(29:56):
And that comes back to coachingagain, like when you teach them
how to, you know, I write outlike, here here's five or six,
you know, quad based exercises,and I make sure that they're pro
tech, uh, uh, proficient intheir technique.
So writing out a program is, isdefinitely one way for.
To, but keep it simple.
You know, pick, pick four, fiveexercises that you know they can
execute.
You gotta find out what resourcethey have access to.
(30:17):
So that's one way.
The other one is, is that it'salways helpful to have some sort
of a step down program.
And we had at our, at our, uh,where I'm at now, called Final
Hurdle, where rehab was kind ofdone or the money ran out, but
rehab wasn't done.
You know, so we, we had a.
Uh, we worked with our, ourstrength coach would, we'd kind
of give him a summary and, andhe would address, uh, whatever
remaining deficits there were.
(30:38):
So that'll help for sure, uh,having something like that.
Um, but it's one of those thingstoo.
Talking to your physicians,talking to the family, letting
people know ahead of time, like,you know, day one postop, you
might start trying to plan forthis.
Now we're gonna have to dosomething late stage.
And you might work with peoplejust to just say, Hey look, I
got, here's what our, here'swhat our rates are.
(30:58):
I, I can do 30 minutes so thatyou can do 30 minutes of the one
on one time.
And then they can work out ontheir own.
You know, they're within youreyesight.
You can still supervise, but uh,you know, you can help work with
their financial situation.
Cause we obviously now in ourcurrent state like that, that's
a big.
Mike (31:14):
Right.
Yeah, no, I, I think that makessense.
And, um, collaborating.
I think sometimes too with, witha nice solid gym that's near
you, maybe that have a strengthcoach
Dan (31:24):
Forgot to, forgot to mention that.
Mike (31:25):
Yeah, I mean, just like go out there and spend some time
there.
Maybe, like, maybe you need toactually go there and spend time
there.
I think that's important.
Like, and actually, you know,talk to those people, um, you
know, and, and not just referpeople there, but let them
become part of your network.
Like that would be amazing.
Dan (31:40):
it is.
That, that, that was really oneof the main ways I, I built my
practices is that there was a, alocal gym.
He actually got started when I.
And I really kind of cold calledhim, just stop by, said hello,
and I'm down the street.
And it just evolved into a greatrelationship.
In fact, my son trains therenow.
So, um, you know, I mean, no,it's, it's, it's great.
And, and, but again, bouncingideas off each other, building a
(32:01):
collaborative model, you know,uh, if they don't need to be in
therapy and they don't need tobe with you, then call that
strength coach and say, Look,just don't do these things for
the next two, three weeks.
Do these things instead.
I mean, that, that's how it's.
Mike (32:14):
Awesome.
I love it.
That's awesome.
All right, one other topic Iwanted to hit about real quick
with us here.
You and I, uh, we put togetheran online course on blood flow
restriction training, which Ithink is kind of related to this
conversation, Right.
Um, you know, and how we dothat.
Um, you know, as a PT that'sworking in this environment, um,
how are you currently using BFRin your.
(32:35):
Because I do think a lot ofpeople are thinking this.
A lot of people want to gothrough this and you know how we
use bfr, but like what are, whatare some of the main reasons why
you start whipping out BFR forpeople?
Dan (32:46):
I still say for me, the over overwhelming majority,
probably 95% or greater, is justquad strengthen atrophy at
postop knee.
I, I think it's really, reallygreat for that.
I particularly like it for, youknow, I got a lot of folks right
now with car restorationprocedures, some that had a,
some that had a car restorationprocedure and a fulkerson that's
like dropping a nuke on thequad.
(33:06):
So, I mean, yeah, I mean, it'sway worse than any ACL I've ever
had.
I mean, those, those people, Imean, they're often restricted
for 12 weeks from, you know,closed chain loading.
So, uh, those are the, are arethe folks that are, are still
very active but have terribleknees.
Like this guy
Mike (33:21):
right.
Dan (33:22):
I do it myself.
Like it's not shamelessself-promotion, but you know,
my, I have one knee.
It's just trash.
It's just trash.
So I mean, it really helps thosefolks out.
I do, I don't use it.
We've talked about this.
I don't use it much in the upperbody except for my big athletes
that have pec tend and tears,uh, to get that atrophy back or
like, you know, I had a, andactually I've been publishing
this case study very soon in Ijs b t about a strong man
(33:44):
competitor I had that had adistal biceps rupture.
So, uh, I did it with him.
Um, you know, I, I can't say,you know, as you know, Mike,
there's no studies that reallysay don't do it, or that it's,
you know, uh, I, I'm just.
Other than those cases that Isuggested, like we've talked
before, I don't have a problemgetting folks strong or getting
strong in the upper body.
(34:05):
I think the legs are a littledifferent because of that quad
atrophy after surgery.
So that, that's the, that's themain reason I'm using it.
I'm not using it yet fortendinopathy.
We might, down the road, there'sbeen a couple studies to show
that it helps with healthytendons.
But you know, I've even talkedto the, the tendon experts, you
know, at different times.
You know, Chris Segger and JillCook and asked him about, This
(34:25):
and, and they're like, Yeah, I'mnot really on board yet with the
whole tendinopathy thing and bfr maybe down the road it will
be.
Um, I think right, right nowthose are the probably the main
ones for me.
Mike (34:34):
I, I, I feel like I completely agree by the way,
it's, it's, it's a no brainer toperform in all these lower
extremity things where westruggle to get strength.
Um, I just, I, you know, Idefinitely, I don't, I don't do
it much in the upper body.
I don't think anybody atChampion does maybe Dan Pope a
little bit, um, with some of hisathletes, cuz he has different,
like, weightlifting type, youknow, backgrounds, fitness
athletes.
(34:54):
Uh, but I think we agree.
We, one, I'm not seeingoverwhelming benefit, but two,
like, I don't know.
I don't, I have no problemgetting the cuff strong.
I don.
You know, having to do that is,is hard.
I mean, I, you know, we make aliving off that.
Um, you know, to theTendonopathy concept.
I just wonder if, um, you know,it allows us to load the tendon
(35:15):
more, or is it really just thatyou did an exercise for 75 reps?
Right.
Which we wouldn't normally do.
You know, say you're working onlateral epicondylitis and you're
doing some risk extens, Realbasic, right?
We normally do two to three setsof 10, right?
But with bfr we're doing 30, 15.
15, 15 a lot of times, right?
That's the standard protocol outthere nowadays.
(35:35):
Um, is it helpful just becausewe did 75 reps
Dan (35:39):
I don't know, man.
I, I, I do, I wrestled itbecause as you know, the two
main things that tendons likeare tension and load,
Mike (35:45):
load,
Dan (35:46):
not doing, you're not doing, you're not doing a whole
lot of.
And the 10, the tensions there alittle, I suppose.
Cause it's, you know, the amountof reps you're doing.
It's just not my, it's just notmy first go-to.
I'm not sure what to say.
Like it's certainly an option.
You know, take Patel pain likethere, you know, hip and quad
strengthening first.
I mean, do you go down the roadof, of taping?
Well, maybe, but that's like,you know, five, six down the
(36:08):
road on my list.
That's kind of how I feel rightnow about tendinopathies and,
and again, maybe, maybe I'll beproven wrong here in, in, in,
in, in the near future.
But on the flip side, I'm alsogetting really good results with
isometrics to get the pain downand then going either heavy,
slow, or eccentrically based.
To get'em better.
And I got 20 years of a hugeend.
(36:28):
Uh, where, where that, that'shelped.
Mike (36:31):
Yeah, that's actually a good point.
Like you, that's not an areawhere you think you even need
it, which is, which is prettyhelpful in there.
Uh, that, that was the firstthing we talked about at
Champion as a staff when we weretalking about starting using BFR
a little bit more, uh, you know,several years ago now at this
point.
And I think we all said, Well,well wait a minute.
If we're not loading the tendon,maybe this is good for strength,
(36:51):
but what's the long termramifications of doing all these
exercises with less load on thetendon?
Um, and it was definitelysomething we, you know, we were,
we.
We thought about.
I'll leave it at that.
Dan (37:02):
I've always said, uh, and I even wrote a, a clinical
viewpoint piece in I G S P T onthis like, definite room for
optimism.
And you should be looking atthis, no question, you know, but
pump the brakes like you shouldnot replace.
Traditional loading methods.
You, you know, it's an adjunct,it's a supplement, it's a
whatever word you want to use,but it should not be, it should
(37:24):
not be a replacement.
Um, you know, and just remembera lot of the stuff that they
talk about with bfr, all theseamazing benefits with hormones
and things like that.
We get that with normal trainingtoo,
Mike (37:34):
Right.
Dan (37:35):
Like there's not just this, uh, it doesn't stop when you,
you, you deflate the cuff, so tospeak.
Mike (37:41):
Ex.
Exactly.
Dan (37:42):
think it's important.
Remember that too.
A lot of those benefits happenwith our traditional training
methods,
Mike (37:46):
right.
But for the right person at theright time, that has an
inability to load, but wants toget some of the benefit, it's a
no brainer.
It just, it just seems obvious.
Dan (37:54):
right?
For sure.
Mike (37:56):
I love it.
Right?
And so this is why you need tocheck out Dan and I's Course, by
the way, uh, because you know,it's our personal experience.
It's how we use it and you know,we teach you that, right?
We teach you how we use it andwhy we use it, right?
Not just some, some, you know,random stuff.
It, it's more of a, you know,clinical application concept as
well as all the signs.
So, um, yeah, check that out.
Dan and I, you know, put a lotof work into that.
(38:17):
Dans the mastermind behind that.
So I'm, I'm super appreciativeof all that.
But, um, you know, if you wannacheck that out, that's just mike
round.com/bfr.
You can head to that course,but, um, Dan, before I let you
go, we'd like to end with a highfive.
Still calling it that, eventhough everybody makes fun of
it.
But, uh, the high five, fivequick questions, five quick
answers at the end, um, just tokinda learn a little bit more
(38:38):
about you.
But number one, what are you,what is Dan Lorenz currently
doing right now for your ownConEd or professional develop?
Dan (38:47):
This has never really stopped for me, but I, I read
incessantly.
I think that's the first thing.
I think, you know, that I do astaff journal club.
Um, I'm constantly postingarticles on, on social media,
uh, or at least on Twitter.
I don't do much else other thanthat.
But, uh, it all starts withreading.
Um, uh, I think preparation forall my teaching.
Uh, you know, cuz if you'reteaching something, you really
(39:08):
gotta be on your game and yougotta know, you gotta know the
material.
So I think that indirectlythrough teaching, uh, I, I, I
get a lot of, uh, stuff there.
Um, I'm signing up here very,very soon.
Actually, this week I'm gonnatake, uh, uh, Derek Hanson speed
course.
Mike (39:22):
Oh, nice.
Yeah,
Dan (39:23):
Yeah, I wanna take that.
Uh, again, that's just somelater stage stuff that you
really gotta kind of spend sometime with and, and he's probably
one of the best in the field atit.
So, uh, he has a, a speedcourse.
I'm, I'm gonna, I think I'mgonna delve into that.
And I think for me too, I thinkpart of it is, you know, I have
all this new technology I neverhad before.
So like we have force platesnow, a ice connect device.
Like we've had these things forabout a year and for 20 years I
(39:45):
never got those things.
I didn't have the band.
What was the point of, of, uh,knowing what the, the latest on
force plate technology is whenyou don't get to use it, so,
Right.
Why would, why would you fillyour brain with that stuff when
you have access season?
So again, I'm, I'm a, I admit,I'm, I feel like a new grad in a
way.
Excuse me.
Learning, learning how to usethe ice kinetic device with
speeds, you know, um, what we'relooking at in the force plate
(40:07):
and stuff.
So, uh, that, that's been kindof fun, um, because again, it's
new, it's, it's cool technologyand it's really, um, changed
how, frankly changed how Ipractice.
So,
Mike (40:16):
Awesome.
Always growing.
I like it.
Well, I know you're a littlestubborn, but I'm just kidding.
But, uh, what's one thing that,that you've recently changed
your mind about?
Dan (40:25):
I would say evolved last couple years.
I think more the open chain kneeextension stuff.
I mean, I think you and I cameup about the same time in PT
school and I mean, if, if you,uh, you know, if, if you did
open chain knee extensions afteran acl, I mean, man, that that
was, that was grounds for, uh,Being arrested.
Being arrested and thrown in,thrown in the go log, right?
So, uh, I think that's changed abit.
(40:45):
I've certainly gone been moreprogressive there.
Uh, I've also, um, also sloweddown my cuffs considerably
rotator cuff repairs.
I say that all the time.
Uh, and I think too, it's beenkind of good on uh, uh, helping
out tens a lot is theisometrics.
You know, I, I've been usingthose a ton for pain.
You know, I have a, a highschool, uh, wide receiver.
I mean, who was, he came to seeme constant proximal hamstring
(41:08):
tendinopathy, like pain.
It hurt all the time.
Sitting in class doing nothing.
He was on isometrics for twodays and his pain went away to
only when he ran at practice.
I mean, there, there'sdefinitely something there.
I mean, we weren't reallytalking about this 20 years ago.
It was kind of go right.
Right.
To eccentric or something likethat.
So I would say that those areprobably three off the top of my
head that, um, have, I'veevolved on a bit.
Mike (41:30):
Yeah.
That's awesome.
And, and I agree.
Follow Dan on Twitter, by theway, because you, you do share
what you're reading, um, quite abit.
Like one of the, one of themost, you know, um, Twitter
accounts that I follow, like,like you, you do share all these
articles you're reading with alittle comment.
So it's always cool to see that.
So, um, you know, definitelyfollow Dan for that.
Um, what's your favorite pieceof advice that you give your
students or your new residentnow?
Dan (41:53):
Be an expert at the basics, Uh, no question.
Uh, the careful with the socialmedia fads and those kind of
things.
Uh, know what you're measuring,you know, uh, get an algorithm
base for progression foreverything.
Uh, test, test people.
Uh, you know, again, myresident, you know, he had a
(42:14):
patient not too long ago and,um, I was like, you know, he
mentioned about strength.
I'm like, Well, did you test it?
You
Mike (42:19):
Right.
Dan (42:20):
the Dino's right there, man.
You know what I mean?
Not to, but again, we, Iliterally say it with him every
mentoring session, like there'san opportunity to say being
expert at the.
And like I said, you don't haveto have this crazy exercise that
nobody's ever seen before thatthe main guy in Instagram is
doing.
Like, can they squat, can theyhinge?
You know, push, pull, hinge, uh,carry.
(42:42):
Like it really is that simple.
It really is.
You don't have to, but peoplewanna do the like, well there's
gotta be a different exerciseother than sideline external
rotation.
There's a reason why we've beendoing it since it's don a time
because it works.
Mike (42:53):
Right, exactly.
Dan (42:55):
so yeah,
Mike (42:56):
and,
Dan (42:56):
I, No question.
That's the biggest advice Igive.
Mike (42:59):
And, and I hate to break it to everybody, but you know
that person on Instagram that'sdoing all those crazy things,
even for them, that's 1% of whatthey're probably doing.
But that's just what they chooseto show you, right?
They're not showing you the minisquat that they're doing.
That progresses to a, a partialsquat, which progresses to a
deep squat, which progresses tothe load that, cuz that's really
(43:19):
boring on Instagram.
right?
like you know?
So, uh, good point.
Dan (43:23):
I think the other thing too is just, you know, find the
experts in whatever, whateverarea it is, and, and read their
stuff, go to the meetings, youknow, whether it's, uh, Amsc or
going to CSM and listening tothose people speak.
I mean, that's where you have achance to interact and engage
and, you know, we have somereally great people in our
profession that'll spend sometime with you if you just, if
you just reach out.
So use the resources around ittoo, for.
Mike (43:44):
Yeah, I agree with that.
You know, our, our sportsperformance thing that you
started is, has done such agreat job building community,
um, you know, within, you know,that shared interest, which I
think is really neat.
So again, find that group ofpeople that you can geek out
with.
I think that's, that's fun too.
So, um, Awesome.
What's coming up next for you,Dan?
Dan (44:03):
Uh, actually this week I'm really excited.
I'm coming out to your neck ofthe woods.
Actually, I was asked to be apart of, Yeah, I am.
I was asked to be part of this,um, this bridge Enhanced or bio.
Against ACL reconstruction wherethey're, you know, they take
the, basically trying to getthat naturally they're redoing
the protocol and I was asked tobe on a panel to make that
happen, uh, or to be a part ofputting that together.
So, um, yeah, I'm really excitedabout that.
(44:25):
I leave here in a few days forthat and it's just, uh, there's
a meeting, uh, it's about sixhour meeting round table with
some orthopedic surgeons and I'mnot quite sure who else is on
the.
The pt, you know, staff orfaculty for this.
But I'm really looking forwardto that.
Um, I'm, I'm continuing toteach.
I, uh, I, I put some, I, I justput my performance enhancement
course online.
I'm probably gonna do a few moreof those as well.
Um, you know, so that's, again,I put more of'em online, I
(44:48):
should say.
Um, That's, that's probablymostly what's, what's next for
me.
Um, but I think, uh, just from apersonal standpoint, you know,
just trying to trying to work onhow to be a first grade
basketball coach and just, just,just sharpen, just sharpening
the acts as a dad and husbandand father.
So, yeah.
Mike (45:05):
I, I, I, I'd be lying if I, if I said that, I, I haven't
gone to YouTube to look up likethe rules of field hockey and
lacrosse and all these sports.
I didn't play growing up withkids, so
Dan (45:16):
right?
No, that's exactly right.
So,
Mike (45:19):
That's awesome.
Um, and, and what's your websiteagain?
I'm gonna put, this is gonna bein the show notes for everybody,
but your website where you havethese courses and everything
where.
Dan (45:26):
It's Ortho athletic edu.com.
Um, yeah, that's where, that'swhere all those are.
And like I said, I typically do,uh, four different courses just
cuz it's the stuff I like, thestuff I emphasize the most.
But I certainly have cateredcourses specifically what folks
want.
So, and I do enjoy doing it.
I, I much prefer live ratherthan online.
Uh, there's, uh, I think it'sjust better to do.
(45:48):
I'm a little more animated inperson and I can demo more
stuff, so, but no, I, I, I doenjoy for.
Mike (45:54):
There's the gap for online, but you know, you need
in person as well.
I completely agree with that.
So that's awesome.
So awesome.
Well, Dan, this was amazing.
Thank you so much for takingtime out to do this, uh, sharing
all this great knowledge withyou.
Uh, hope to talk to you again ina future episode.
Thanks so much.
Dan (46:10):
Likewise, Mike, thanks for having me.
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