← Stronger with Don Saladino
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- [00:01]
Podcast Host/Announcer
5:00am I'm up with a crisp Celsius energy drink running 12 miles today. Grab a green juice, quick change and head to work. Meetings Workshops One more Celsius. No slowing down. Working late but obviously still meeting the girls for a little dancing. Celsius Live Fit. Go grab a cold refreshing Celsius at your local retailer or locate now@celsius.com this episode is brought to you by Peloton Break through the busiest time of year with the brand new Peloton Cross Training Tread plus. Powered by Peloton iq. With real time guidance and endless ways to move, you can personalize your workouts and train with confidence, helping you reach your goals in less time. Let yourself run, lift, sculpt, push and go explore the new peloton cross training tread +@1peloton.com hey everyone, in this next
- [00:51]
Don Saladino
episode of Stronger, I sit with one of my best friends, Dr. Charlie Weingroff. Charlie is one of the most unique individuals I know in the fitness and wellness space. I mean, he is a savant in physical therapy and strength and conditioning. I had the privilege of working with Charlie for over 12 years at my club drive 495 and I can't even begin to tell you how much I learned from him in reference to rehab and just keeping training simple. So many little nuggets that I took from him throughout the years. And in this episode we're going to talk about how training and rehab a lot of times is the exact same. Charlie goes into examples about the elbow and describes how X doesn't always mark the spot. Just because you have pain in your elbow d it doesn't mean that's the area that needs to be treated. So this is going to be a great episode for anyone that's dealing with pain or discomfort. I was actually the minister at Charlie's wedding, which is how close him and I are, so I know this isn't going to be the last time that we bring him on. But stay tuned for this episode because I know you're going to take a lot from it. The Stronger podcast would not be possible if it weren't for our incredible sponsors. Cozy Earth has been coming through for us and every single time I am blown away by their products. They just recently sent me their socks and their comforter. Now their essential socks. I would never think I love these, but again, Cozy Earth have proved me wrong. Cozy Earth Essential Socks are soft, breathable and thoughtfully cushioned with four versatile styles Calf, Quarter, ankle and no Show. Obsessed with these, I was always a no show person. But I now, yes, I have been wearing higher socks. I'm shocked because I never thought I would Cozy Earth again. Knocking it out of the park. Head to cozyearth.com and use my code stronger for up to 20% off. That's code stronger. S T R O N G E R for up to 20% off. And if you get a post purchase survey, be sure to mention you heard about Cozy Earth right here because I need more sheets. So please mention me so they know I'm doing a good job. If you don't mention me, I'm in trouble. Obsessed with this company Cozy Earth. Experience the craft behind the comfort and make every day feel intentional. Guys, thank you. I want to start with injury because I think people get injured and immediately it's this massive panic and I've been injured enough to know that it can be okay. Like it's there. What do you think? And we're. These are really broad strokes here and it's going to be difficult. But when someone gets injured, there's a process you wish you can jump into their head and have them operate and navigate the injury. Let's start. What is the step that you wish that they would follow step by step if someone gets hurt? Very broad.
- [03:38]
Dr. Charlie Weingroff
Yeah. But part of that broad nature is it's hard to dissociate from myself because the first thing I would ask somebody who, let's say if it was you or someone, somebody that has more than a middle up training age, hey, is it bad? And you kind of know if it's bad or not because then that sets off the real answers to this. So how does somebody even know if it's bad if you can't put any weight on one leg that has this injury of anywhere from your foot to your hip, the rules change a little bit.
- [04:14]
Don Saladino
When you say any weight, you mean literally.
- [04:16]
Dr. Charlie Weingroff
Like you literally can't put weight on your foot. Like you, if you put any weight
- [04:21]
Don Saladino
on your foot, like it's jarring, it's jarring.
- [04:23]
Dr. Charlie Weingroff
But even then, Don, I think you know what I'm saying. It's like I could walk cockeyed and I have an idea. But let's say there was a traumatic injury, you fell, you sprained your ankle, you got whacked with something and you literally can't put any weight through it. Sometimes that means maybe the first three miles you can, but then all of a sudden there's this magic time where you literally cannot. The question I would ask or hopefully get answered would be, is this life changing now you're kind of respecting a training age. So if the person then I think they know that answer now. Well, I can still do this, this and this. Okay, cool. That doesn't mean we don't need to put a plan together, but we also don't need to go to the ER or be very, very judicious. So. So that's the. Once we can get to that. So those answers, I don't know where. If you have a broken ankle when you can't put any weight through it whatsoever. Under, no wiggle, no weight shift, nothing, you can't hold onto something, it's still.
- [05:27]
Don Saladino
And you immediately know, by the way, this is what, where people can't disassociate when you're hurt, like really, truly hurt, you know, oh God, that was bad. Right? And I think people muffle that a little bit.
- [05:40]
Dr. Charlie Weingroff
Well, what's the movie? The program. Yeah, when James Kahn is at.
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Don Saladino
You heard of injured?
- [05:45]
Dr. Charlie Weingroff
Oh, you heard, are you injured? But again, that doesn't apply, you know. And no one should feel diminished because they don't have this language, they don't know how to make these translations. But if it's not that, well, you know, what do we do? Can you move in any degree of pain free motion? That's where rehab, physical therapy starts. That could even translate into more precise types of therapy where the science of how we recover from injuries and surgeries is far ahead from what even the best surgeons are still recommending. Now, I don't ever recommend that you go against what a surgeon is telling you. But not every physical therapist gets the same set of rules. When the surgeon knows the environment, the patient, athlete, the therapist involved, etc. Etc. So immobilizing when it's not this life changing thing is really very, very antagonistic to the best science.
- [06:42]
Don Saladino
So you just said not every therapist gets the same set of rules from the surgeon. But let's back up to a second. So the one problem with a lot of surgeons, I find is that they can maybe diagnose the problem or the fact that X might mark a spot on an injury. But then when it comes to physical therapy, it's with a lot. It's a little gray, like, oh, we'll go see this person. And I'm like, what do you, are you following? They don't have a team.
- [07:09]
Dr. Charlie Weingroff
I think it all starts with the reliance, the credibility, the expectation of excellence that we have from surgeons is just unfortunately just completely misguided and false. It's really disappointing because if I ask somebody what is your job? I'M this. Would you agree that there's good this. And it's just wild. Surgeons, they're good surgeons.
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Don Saladino
They're bad surgeons.
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Dr. Charlie Weingroff
Surgeons are allowed to suck. And just because you went to one that sucked is, is, is not a, you know. You didn't know. I, I t. You've heard me say this a million times. I'm probably not going to pay $1,500 for a flux capacitor. But I went to the dealer, you know, like, the dealer is supposed to be this. I went to the Jeep dealer. I bought my Jurassic Park Jeep to, to the dealer. And, and I'm still. It's still very possible that they could screw me because I don't know what they know. So no one's meant to feel. But you do have to expect that it's possible that the surgeon that you picked is horrible. Like, that has to be part of this train of thought. Just like a restaurant was horrible or just like, it can all be. So I think when just like other forms of very, very traditional and standardized healthcare, we, we should be using a resource rather than letting the resource use us. And a lot of the communication from less than elite surgeons or any type of physician or physical therapist, they are typically imposing their ethics on the patient. What they're good at is one set of things. They do surgery, they give medicine. But nowadays, largely because of the Internet, you and I could be just as good as they are at deciding medicine. We won't have the reps to decide when we should kind of zig and zag a little bit. But there's. And we also will never get the reps because we don't have a DEA number. But as far as learning biochemistry and learning pharmaceuticals, we could know everything that a doctor knows. There's no book we can't get. There's no information or studies that we can't get. But when they evaluate someone, they're like, you either need surgery or don't. And then of course, there's medicine, there's physical therapy, there's these nutrition. There's many, many things that they'll recommend, but they don't know how to do the things. So they can't be a leader. A leader of this. And this is kind of like now explaining what I do, even though my primary entry point is physical therapy or strength and conditioning. So I've already kind of broken a mold. But they don't. If you don't know enough of what you are delegating to, you're not a leader. The CEO is not as Good at cooking the books as the cfo, but he knows the CEO. He or she absolutely knows when that CFO should get fired. When we get audited and all hell breaks loose.
- [10:01]
Don Saladino
Sure.
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Dr. Charlie Weingroff
Doctors can't do that. Surgeons can't do that. So they can be a great surgeon. They can have brilliant hands, and they're creating as little damage as possible, but they may be good at nothing else. And that's likely. That. That's likely. I tell people there's always four things. You gotta pick a good surgeon. That ain't the easiest thing in the world, as we're describing.
- [10:21]
Don Saladino
Right.
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Dr. Charlie Weingroff
He or she has to have a good day. You have to pick a good physical therapist. That becomes even harder. Cause there's so many options. There's a cost that's recurring.
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Don Saladino
And people are typically going to physical therapists that are covered by insurance. Just say convenient just because it's convenient. I actually think it pushes you. The great physical therapists are the ones that aren't really collecting insurance. Or most of them are.
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Dr. Charlie Weingroff
Maybe most aren't. I want to, because I don't want to be like a complete barrier. I will only work with a physical therapist that accepts cash.
- [10:56]
Don Saladino
That's fair.
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Dr. Charlie Weingroff
There are great physical therapists that work for free. So you got to pick a good physical therapist, and then you got to do the work. And it is uncomfortable. It requires dedication. It requires effort. It's the actual opposite, where older folks that are so used to this type of healthcare service, you just go in and you get better. I have soon to be at least two, probably three NFL hall of Famers, but one is in right now. So he's older, and. And. And I'm behind him working on his shoulder. And. And he said, charlie, how come we didn't have people like you? When I was playing, I'm like, well, when your shoulder hurt, you put a needle in it.
- [11:37]
Don Saladino
Yeah, you got the needle.
- [11:38]
Dr. Charlie Weingroff
And. And when your shoulder didn't hurt, you put a needle in it. So he's like. And then obviously that type of conversation makes sense. You know, there's some relatability there with that type of person. But physical therapy is active. And now, of course. Like, what that physical therapy looks like? Oh, no, no. They gave me exercises. It has to be hard. Just like training. A lot of your audience is more in line with training, but as you know, my brand is the same. Like, training and rehab is the same thing. Anybody who thinks they're different, cross them off the list.
- [12:12]
Don Saladino
Sure.
- [12:13]
Dr. Charlie Weingroff
Including the surgeon. So when you say some, not every therapist gets the same. Sometimes I don't even get a protocol. But again, these are surgeons that you have more than even just a professional relationship with. And they'll be like, yeah, you know what to do. I'm like, send me it anyway. I want to make sure that we're not missing.
- [12:29]
Don Saladino
Yeah, I guess you want to cross your T's and diet.
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Dr. Charlie Weingroff
Always.
- [12:31]
Don Saladino
You want to crush it. But this almost. So one quick thing. There's a little bit of irony, right? Because we've all gone to a restaurant and had a bad meal.
- [12:38]
Dr. Charlie Weingroff
Sure.
- [12:39]
Don Saladino
Every single person. Yet we keep going back to restaurants. Right? Now, typically, someone goes to a physical therapist or a lot of people I have spoken to. And I'm basing this off of my community, which is thousands of people who don't have access to someone like you. And I'll ask them, well, what's going on with the need? You go to your pt? Yeah, I was in there for seven months, and they just couldn't figure it out. And you've heard this conversation.
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Dr. Charlie Weingroff
It didn't work.
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Don Saladino
Well, for me, that's almost like, well, it didn't work. Could have been a bad restaurant, could have been, you know, bad therapist. Call it what you. What you want. But rather than saying to myself, I'm going to get another opinion, people give up. And then I feel like that's when a lot of these problems start happening. You've been limping around on your right leg because of an. Of an ankle injury, and now you're feeling imbalances in that hip, and then you start developing back pain, and then that leads to something else. And it's this domino effect of issues where the reality is, any injury I've ever had for the last 14, 15 years, I would go to you first before the orthopedist, always, and say, what do we have to do? And you'd say, go to the orthopedist, or we can figure this out. And I, 10 out of 10 times, always trained around the injury. I never once. You never shut me down entirely because you knew I needed it mentally, I needed it physically. I could have broken my knees, my wrist. I could have busted my right arm. You're like. Like, work, Work your. My right arm. Work your left arm. Get on the air. On bike. Left arm. You always had me moving. And it was. Charlie was magic. So I want to talk about one. Let's start with the process you want someone to follow when they get injured. Do they go to the orthopedist, or should they go find someone like you to say this is the plan of attack. Because I almost feel like sometimes they need to see you first.
- [14:32]
Dr. Charlie Weingroff
It's. Well, first of all, we're back on the highway now.
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Don Saladino
Yeah, sure.
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Dr. Charlie Weingroff
I brought us back as a great podcast host. You brought us back on task, away from the ranting about terrible surgeons. The first person you should go to could be the physician. So I don't know. That absolutely has to be me, but it has to be someone who is going to consider every solution and also every solution in combination. Don, I do think this is. Whether it's now or in however long you're probably gonna need. You're probably gonna need a procedure. And I usually say that. I don't say.
- [15:05]
Don Saladino
I normally. Like, you told me this years ago, and I don't know if this has changed, but you said I normally only need a few sessions to be able to determine whether I can help someone or not.
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Dr. Charlie Weingroff
That's it.
- [15:15]
Don Saladino
And. And I. What frustrates me about most. Not. I don't want to generalize it. Some pts is that people are in there for six, seven, eight months, and it's just like they're getting a massage. They feel good in the moment, they're coming out of it, and there no real improvement.
- [15:31]
Dr. Charlie Weingroff
I would sell myself as saying, I have no idea where this lands, but I will come up with plan A. And if I can't do it in 60 figurative minutes, it was just because we didn't have enough time.
- [15:41]
Don Saladino
Sure.
- [15:42]
Dr. Charlie Weingroff
So that doesn't mean I help you. That doesn't mean I change your pain. It doesn't mean you run any faster. But I should know what's going on. And sometimes we need more information than what is available. So then. So the time stretches out and then here. So we create definition. I say we put a box around it or we. We put the frame. But it's. But every. But the picture has no color. It's only black and white. And then, okay, you need a surgeon to do red, you need this physical therapist to do green, et cetera, et cetera. That's. That's.
- [16:10]
Don Saladino
You know, what you. You've taught me so much in this category because I think about, you know, a line that I kind of. I think incorporated just from you. It's like X doesn't always mark the spot. And when someone is sitting there complaining about their elbow and suddenly, like, I may need to have surgery on my elbow, and then you come in and you're pointing out it's the shoulder.
- [16:27]
Dr. Charlie Weingroff
Yeah.
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Don Saladino
That just shows what a disconnect there is from an Educational standpoint.
- [16:32]
Dr. Charlie Weingroff
That's right.
- [16:32]
Don Saladino
That people just. It's not their job to know. They're not supposed to. It's not what they do for a living. They don't do what you do, they don't do what I do. So why would they know yet? I'm going to throw a really aggressive number out there. I've worked with you for how many years?
- [16:47]
Dr. Charlie Weingroff
October of 11.
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Don Saladino
Okay. So we're looking at right now 14 years. In 14 years, I would. I'm going to throw an aggressive percentage range out there, 60 to 70%. You're going to go, what does that mean? I would say you probably kept at least 60 to 70% of the people that came to you who are expecting to go into surgery out of surgery.
- [17:05]
Dr. Charlie Weingroff
Yeah, I think that's fair.
- [17:06]
Don Saladino
You think that's a fair number?
- [17:07]
Dr. Charlie Weingroff
I would. If I had to say, I'd probably say more. Probably.
- [17:09]
Don Saladino
So I'm downplaying that. So what I'm telling everyone is that they show up to Charlie, I need surgery, and Charlie would go, well, let's see. And the next thing you know, three months goes by and their trap bar deadlifting. Or they're doing farmer carries and they're out of pain. There's. That's scary to me. That's scary to me because it shows how many people out there are going to go under the needle or. I'm sorry, go under the knife.
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Dr. Charlie Weingroff
Yeah, yeah, yeah.
- [17:34]
Don Saladino
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- [18:38]
Dr. Charlie Weingroff
All right.
- [18:38]
Don Saladino
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Dr. Charlie Weingroff
That's how we go.
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Don Saladino
So I when you hear the term injury prevention.
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Dr. Charlie Weingroff
Yeah, yeah.
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Don Saladino
Which is something that's been thrown around a lot. You know, prehab injury a little bit different. What is your first response to injury prevention? Because people now, as they're aging, they want. They're focusing on resilience.
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Dr. Charlie Weingroff
Yeah. So what's your response for this conversation?
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Don Saladino
Sure.
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Dr. Charlie Weingroff
I think when we look at injury, obviously knees get torn up and muscles tear and bones break. So we start to think of those structures. But they're not the only structures. So number one, we would look at movement. So what your body is capable of doing at a very, very low level, if you can't do it passively, without any intensity, without any strength. I mean, I can't move your arm past here. Don't press that. Your odds are against you and even then, sometimes you'll make it look good. It's. I remember again, hopefully my stories are appropriate. I don't have the most mobile shoulders. I have traded that for bench pressing just under £600 back in the day. That's a trade that I made. I don't know that I was making it back then, but I always did well in the kettlebell certifications. And one of my mentors, Pavel Satselin, would say, ah, but Charlie, you'll see, because you are strong, that 24 kilo kettlebell is not very heavy for you, even though your shoulders probably would not indicate that they can do it. So that's what he sounds like. There's two types of Russian accent. I can't get my voice deeper.
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Don Saladino
No, no, no, that's what he sounds like.
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Dr. Charlie Weingroff
The other one I do better. But anyway, so it's always a combination. But what, what we should start to ask for injury limitation is like, tell me what you want to do. Because if you just want to walk around in a mall, I don't need joints that have to do a whole lot. That, that gets back to your question about or commentary on how to train. When you have a shoulder that's in a sling, which is usually a very necessary thing. Even in more contemporary rehabilitations from shoulder surgery, you still have another arm and two legs that you can train aggressively. As long as it doesn't hurt your shoulder, you're not breaking any rules. There's a whole system of communication that if you want to get into, we can do that. But that's one category, and that's where exercises and strength and joint mobility all live. But that's only what my mind, 25% of the. Of the system. I wouldn't even put strength in that category. In movement, can joints get into the right positions to absorb and adapt to stress for your activities? I don't know. You have to tell me what you want to do. You want to be an Olympic lifter. That's a dramatically different set of things than if you just want to walk around in a mall.
- [23:05]
Don Saladino
I'm going to throw another word at you right now. And again, I incorporated this line from you. I think we were working with golfers years ago. When I say years ago, I mean early on. All right. And I think we're looking at kinematic sequencing. We're looking at a golfer's torso rotation, and we're noticing that one half of the body naturally on a golfer is going to rotate way more than the other half. It was an amateur golfer and they said, oh, my God, I got to fix that. And you said, don't touch it. Yeah, that might be. That might. That might. Well, it wasn't. It wasn't an amateur golfer. It was Morgan Hoffman. And you said. He said, oh, my God. I mean, I remember it was Morgan Hoffman. He rotated to one side. And I'm allowed to talk about this. He rotated one side like Gumby, and the other side, he was unable to. And you said, don't touch it. That is probably what makes you great at what you do. Talk to me about asymmetries, because everyone. I can't tell you how many people reach out to me on social media. Well, my right arm could do this, and my left arm can. Or my right biceps a little bit bigger. My left arm's smaller. And talk to me about asymmetries.
- [24:06]
Dr. Charlie Weingroff
So the first thing we are going to hearken back to John Berardi. How's that working out for you? Because it's really. The answer is more in how do you use this allegedly asymmetrical environment versus that you actually have these two different things. So, for instance, if you have a dramatic asymmetry of some kind in your arms, what would I say? I would say don't use a barbell. Well, why? Well, because now that asymmetry has to get made up somewhere because your hands are tethered to the barbell, and I'm talking about pressing. Clearly, shoulders don't really get angry when they're down by their sides. Deadlifting. But I guess it could. Well, what would I do instead? Well, maybe I would press dumbbells or kettlebells. I don't know if this is going to show up on camera, but if. If this is my dumbbell. Okay, that's dramatic. Like, you can see that. But I bet if we go to the gym, we're going to see people that have no shoulder pain. They look the part, and they're handling 110s doing that. If they took a barbell, they would look like this now, but maybe their neck would get so.
- [25:13]
Don Saladino
So maybe one bar comes up, one end comes up.
- [25:15]
Dr. Charlie Weingroff
That's just. Now. Does it matter now? Do we have signi. I have a client. She fell off the stage. She's fantastic. You've crossed with her. She fell off the stage. Left hip was all jacked up, and it was a workers comp situation. I don't deal with that. But she. She. She. She has her people handle that, and she's like, they. They want to cut it off. I'm like, Well, I said, okay, about to say your name. This is how you're going to handle this. Between me and you, you will likely have to prove that this asymmetry, that 100% exists. Like, we have categorical proof that these. This is asymmetrical. But you know as well as I do that there's no limitation in your life because this is like a legal type of thing. So those are. That's what they're going to kind of ask. So if you want to play the game, that's on you. You're paying my bills separate. I don't. I advocate for you. I cannot say that that's always a good thing to be ethical or not. And she's certainly not going to do that. So. But. But we have to have very scientific information in terms of force plate, in terms of, you know, very valid and reliable strength tests, balance tests, to say that this asymmetry even exists, because you would never know by watching her, watching her train as a young lady in her 60s. So these asymmetries may not matter, but that's really. We're trying to be silly with. How's that working out for you? Like, do you have a problem? And then maybe you don't have a problem because you're picking exercises that fit in your box. It's when you don't, then you have a problem. And the bigger, I think, way to elucidate this is when you come back from injury, right? Not. Not so much. Do you feel great? You look the part. You're satisfied. No, I'm not satisfied. I would really like to do this. Well, then maybe the asymmetry matters. But it's when you recover from rehab and you do nonsense rehab that only gets you back to these basic standards that perhaps an insurance company would value. Then you're like, you either now have to pay or you just live with it. And that's when those asymmetries can become dramatic because you can still walk out of the office. You might be able to go up and down the stairs at an acceptable way, but you may not be able to do the things you did before. And all I would say is, your rehabilitation is incomplete. Nobody's garbage. It just. You just didn't get there yet. That's when it's.
- [27:34]
Don Saladino
I've almost never met anyone without an asymmetry.
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Dr. Charlie Weingroff
Well, like.
- [27:38]
Don Saladino
Like if you were to turn around and say, can you. Do you know any athlete or any human being that is 100%, perfectly, absolutely not?
- [27:44]
Dr. Charlie Weingroff
Because, for instance, there's. There's certain See, this is, this is a little bit dangerous, in my opinion. Truly dangerous, because there's brands that will take truths like what you're saying and what I'm about to say and then put the fear of life into you and then give you this nonsense.
- [27:59]
Don Saladino
Oh, like, like, like you're gonna, you're gonna, you're gonna get injured, but you
- [28:02]
Dr. Charlie Weingroff
have a heart on one side. This lung is different than this one. You know, like all these real, true things. This is how cults start. It's called the bookend effect. You start with something that's truthful, like incontrovertible. You finish with, oh, let me do these things and you'll be fine. That you believe them because they started with the truth. And, and then everything in the middle is complete foolishness. So no human is symmetrical. It's not possible because of our viscera is all different on each side to a point. There's a liver on one side, there's two kidneys, but there's only a pancreas over here. So that inherently changes how our thorax. All these things are very, very real and also incredibly irrelevant. Now what we need to do is establish a standard for how much asymmetry actually matters.
- [28:51]
Don Saladino
Right?
- [28:52]
Dr. Charlie Weingroff
But you can only do that when you answer what exercises you want to do. So if one hamstring goes like this and the other hamstring goes like this, that's a problem. That's the asymmetries that we're looking for. And obviously there are far more ethical commercial models. But you don't need a commercial model. Like, how's it working out for you? Do they look silly when they're walking? Well, then you run whatever systems that you want of what I suggested before. Movement, can the joints do it. Output strength, endurance, etc, readiness. How do you feel today? Because you might change how you feel tomorrow, but that wouldn't be this dramatic. Musculoskeletal asymmetry.
- [29:27]
Don Saladino
Yeah, but what about, I mean, if someone is asymmetrical and they're young and you're looking at them going, well, it's not a problem now, but it could potentially be a problem down the road. You know, that is something where it's. Well, how's it working out for you? Well, I'm 25. It's working out for me fine. It just, I, my, my right leg can do this and my left leg can only do this. And you're saying to yourself, well, it's not a problem now, but it could be a problem.
- [29:49]
Dr. Charlie Weingroff
Yeah. So, so again with that hyperbolic example, which is really the only way to really hit home with this, with this answer that matters. It doesn't matter that you're young. Now, I thought if you were going to ask about an asymmetry for a young person going through a growth spurt, now we have to kind of, there's a whole nother set of rules. When we, we have categorical proof that they're going through a growth spurt, there's going to be some movement challenges that we should not be using the same standards for. If there's no injury, if there's no pain.
- [30:17]
Don Saladino
Can you give me a little bit more on that?
- [30:18]
Dr. Charlie Weingroff
Okay, so. So let's just say growth spurt would suggest that the bones are longer than the soft tissues. Let's just say muscles, tendons, that can be a problem. Like so if I have this line and then the line that moves the line is the same, the proper length, there's no problem. But now if this gets longer, but I'm only here for my muscle, it gets pulled and stretched and stretched. Your brain doesn't like that. There's some. And it's really a shame that again, going back to what physicians would do, a non contemporary way would be in the lower body, if they pull too much at the Achilles and the heel or they pull too much in the knee, they call it a disease. And now any parent is going to go nuts when the doctor says their kid has a disease. The kid's knee hurts and now he has a disease. Now, more contemporary ways would not call it a disease, but all that is is because the muscle and the tendon is being stretched because the bone got longer. We probably should be modifying activity during those periods. But you don't jump off the. It's not even physical therapy. Don't stretch it. You're going to make it worse by stretching it. Because sometimes when something gets really, really long, the brain is like, I don't like that. I'm going to make it tighter so little Jimmy will stop using it. And indeed, you can peel bone away a little bit for where the tendon attaches. But that's a different standard of when somebody's going through growth spurts. How do we judge certain things? When you say young person, 25 year old, that's not considered young. And if it's in this dramatic, significant
- [31:56]
Don Saladino
difference, I mean, younger than me, because
- [31:59]
Dr. Charlie Weingroff
look, for instance, that person might actually look really, really good when they're dead. L. And then. But if their hips are different, that difference has to be made up somewhere so they're either using a 12 kilo kettlebell, wasting their time, or if they're using big wheels. That twist has to happen somewhere. And that's usually when a back becomes significantly acute, out of nowhere. Cause that person may not have pain, but that asymmetry mattered. And usually it can be changed quickly.
- [32:28]
Don Saladino
All right, so. So pain is typically. It's sending our brain a signal, right? I mean, pretty much. And we have heard about instances where someone might have been surgically repaired, corrected, but they're still feeling pain down the road. And I know you've gone through this a lot where people are coming to you and they say, I don't understand. I fixed this, but I'm still feeling it. What's wrong with me? How do you explain that so we can.
- [32:53]
Dr. Charlie Weingroff
There's. There's a number of ways. The one that continues to go back to what I think might help the most people is that the surgeon did something that was warranted to have surgery, but it wasn't your problem. If you have a trigger point in a muscle on the side of your hip and I stick my thumb there, it can cause pain down your leg. At which point there is a treatment approach. Maybe somebody believes in it, somebody doesn't, because everybody. Many ways to roam. That's your problem. And you never had an mri. But most of the time, like you're saying, where do you go first? Because that person gets treated one or two times and they're good to go, maybe in a great environment. But now the person goes to the doctor because it is absolutely 100% potentially correct that that pain down their leg is a problem somewhere around L5S1. And when they do the MRI, they show a herniated disc. And it's enough where that great surgeon thinks that they can repair it. So all of a sudden they do whatever back surgery they get and they still have pain down their leg because it was an incidental finding. That's why you have to have this very peripheral view of all these different things. So they have the exact same pain pattern, two completely different solutions. So they got back surgery where the surgeon wasn't trying to pay for their boat because it could have been the problem. But they never bothered to look at this other thing because they don't really know how to do a trigger point lidocaine inject, ultrasound injection with lidocaine just to see if it changes the pain. Because there's no nerve over on the side of your hip where the gluminimus is. So that's one. And there could be Dozens and hundreds of other contexts where whatever you thought was the solution was a good thing, but not for you. It wasn't your problem.
- [34:44]
Don Saladino
Right.
- [34:44]
Dr. Charlie Weingroff
You make sense. You access the solution that had nothing to do with your problem because somebody was incomplete in their evaluation. They were not as broad enough. I could argue if they were not as humble. So. And that can happen. Physical therapy. Physical therapists want to do exercises manual therapists want to do, manual surgeons want to do. That's why you need this. This team. And it's not. It's not normal. It's not normal to have that type of group of people where every tool is in there, and always the first person that they go to knows that the tools are there. Okay. Now, when it comes to pain, outside of that type of. One possible answer in this context, I think I could start right off by saying pain is an emotion. Pain is something that you either don't know what it is or. Or you think you know what it is. It has nothing to do with what it is. That would be, let's just say, 80, 20. If I smash your knee, it's going to hurt. There's a lot of, like, there's things that are part of this acute process that go to your brain and say, ow. Okay? That's the 20% chemical response. So, of course, that's a very real thing. The 80% is if you had no idea that a snake bit you because you were walking in the woods, you're gonna walk another 30ft, and then they're gonna have to call a medevac because you didn't know it didn't hurt. Charlie. I swear, I didn't even know it happened because months and years of hiking, you feel stuff brush up against you all the time, and your brain is like, when I feel this, under this set of circumstances, I believe this to be safe. And when the rattler got you, it didn't feel totally different because the environment was overwhelming, because your brain is shaped for certain environments to protect you. And that's really what pain is. That's a scary thing to tell somebody. Pain is in their head because the first thing they're going to interpret.
- [36:45]
Don Saladino
They don't want to hear that.
- [36:46]
Dr. Charlie Weingroff
Yeah, they're like.
- [36:46]
Don Saladino
A lot of times you don't want to hear that. They're not making this up.
- [36:48]
Dr. Charlie Weingroff
When I say that again, it's a podcast. I would not be communicating likely the same way to somebody who's in pain in front of me. But now, if you're in that situation long enough, there's now names. One thing we could call that is central sensitization, where everything is completely normal, and your new normal is pain. And we have to be very, very careful on what you do to communicate to that person or even modulate their pain. Because sometimes pain is how they introduce themselves to the world. To take away something that is fundamentally part of who they are is. Even though they say, I don't want pain, they do. Not because they want to be hurt, not because they're masochistic. It's because that's what pain science would typically indicate to us.
- [37:35]
Don Saladino
I want you to take me just to close this out a bit on a roadmap. And I don't want to say injury serious or not serious, because how someone's perceiving pain in the beginning. Like, you're in pain, but like what you said earlier in the movie, the program, are you injured or are you hurt? How would you advise someone to approach both? Someone's injured, meaning there's a real problem here, and someone's hurt, which means there's still a problem, but it's probably something you can navigate both most of the time. How would you. Let's start with the injury. What would be step one? From who do they go see to how do they go address it? And granted, there's going to be different outcomes and yada, yada, what is the goal at the end of the day? Let's start with serious injury.
- [38:16]
Dr. Charlie Weingroff
So, yeah, if you're injured, you can't put weight on it, you're crawling, you can't turn your head left, whatever. It's like something that your life is dramatically changed. You cannot do something that you absolutely would do at that time. Sure. Okay. You got to make a phone call, and who do you call? This gets tough. It has to be someone you trust. Like, who would I call if. If I wanted to go to the best Italian restaurant in the city? I might be wrong in who I call, but I still have to call somebody.
- [38:47]
Don Saladino
Sure.
- [38:48]
Dr. Charlie Weingroff
That could be 91 1. That could be Don, that could be Charlie. But you have to now activate the best expert process that you have. For the Italian restaurant.
- [38:58]
Don Saladino
For the Italian restaurant.
- [38:59]
Dr. Charlie Weingroff
So I know that's not the answer somebody wants because.
- [39:02]
Don Saladino
But I think it's the right one.
- [39:03]
Dr. Charlie Weingroff
Well, I do believe it to be right, because I'm saying it, but also. No, but. But also I think that when it comes to health, even training, which is not health, is something different. That's fitness. Health is different in semantics, that you have to just tell me what to do, and I'll do it. Okay. Go to the best option that you have. And then over time you'll learn that, you know what? Italian restaurant X ain't the spot. You didn't do the wrong thing. You did the best you could. So does that mean call a surgeon? It could be. Does that mean call the surgeon that I would call? Maybe they would be great. Does it mean go to the physical therapist down the street? Maybe. If that's the best that you have. So everything is so much in context. And I know it's hard because I have to believe whether they're listening to this or most people in general, they. Charlie, come on, man, just. I know you're really smart. I know you work. Just tell me what to do and I'll do it. I'm like, yo, it doesn't work like that. Go on social media like that and they'll tell you. And they'll only remind you of the six or seven out of ten where something good happened. But then they forget to tell you the three or four times where something really awful happened. The correct thing is make a phone call. And then when that is relatively under control and that process is in play, you got another leg, two arms, and you train your ass off. Just train intelligently. Right next time we talk about what is training intelligently. Because that ain't what. That isn't what people are doing. They're doing whatever.
- [40:37]
Don Saladino
So in closing, when a doctor turns around, says don't train, take off entirely, what would you tell someone? How would they approach that response? Do you listen to the doctor? Do you go see a physical therapist? You try and get more information?
- [40:50]
Dr. Charlie Weingroff
Yeah, I'm not going to give anybody permission to do something. And we're saying that, yeah, I would ask doc if am I okay to do bicep curls if it doesn't hurt my knee?
- [41:01]
Don Saladino
Because that's still going to give you response.
- [41:04]
Dr. Charlie Weingroff
Yeah, I'm being dramatic. Yeah, okay. And there's always good, better and best. But I think if there's value for this type of messages, it's ask questions, ask your doctor questions, nothing bad will happen. Maybe in the beginning you might be annoyed because if he or she doesn't answer the questions, then you need to move on. But that's not a bad thing. That means you didn't pick the right person. A physical therapist, an elite non physical therapist, I don't think is a problem because as long as you don't feel anything in your knee and you're not using your knee, I don't know why anybody would have they tell you not to? Yeah, like it's the same standards. Like, are you using good form and does it hurt? That's the standards of all types of training choices. We could argue on what form is. We could even argue what pain is because there are some things that pain is. Okay. Difficult is not the same as pain. Okay. But that's where. How do you start to unravel this nonsensical advice? You know, ask questions and build your case? I would say from a teaching standpoint, I gave you the reasons why you should keep training. And it's not like when, if you use a certain protocol that would develop hormones in your upper body. It's not like the hormones don't go to your lower body. They don't just stay here. There'll be more mitochondria up here than down here. But again, what can we do to accelerate this process? And then we talk about stim machines. All those other things then become a boost.
- [42:40]
Don Saladino
Yeah.
- [42:40]
Dr. Charlie Weingroff
And for those, there's good, better and best.
- [42:42]
Don Saladino
Yeah, of course.
- [42:43]
Dr. Charlie Weingroff
Well, I want to do cupping. How's that working out?
- [42:45]
Don Saladino
How's that work for you?
- [42:45]
Dr. Charlie Weingroff
Yeah, like it's all. There's always good, better and best. But that's where those processes that dominate commercial physical therapy and non stimulative exercise, you're now in a hole. And this is how you can kind of rationalize scientifically how to get out of it.
- [43:00]
Don Saladino
Well, this is going to have to be part one of like ten. All right, Charlie, thank you. It was brilliant. And Chris, let's fire some questions off because I want to get Charlie out of here. He's got a train to catch.
- [43:08]
Dr. Charlie Weingroff
All right, let's do it.
- [43:10]
Don Saladino
So the first question here is from Brian. Oh, I know him.
- [43:14]
Dr. Charlie Weingroff
Yeah, here we go.
- [43:15]
Don Saladino
I know Brian. Okay.
- [43:16]
Brian Lee
Hi, Donna, Charlie, this is Brian Lee from Chicago, Illinois. So I want to thank you very much for taking one of my questions here. This question is for Charlie. The question I have for Charlie is where do you see the field of physical therapy going in the next five to 10 years? Would it be more strength based or rehab based? So the reason why I'm asking this is that I'm employed at a facility that has physical therapy and I did just recently graduate last year with a physical therapist assistant license back in October of 2024. And since I'm there, they are not appointing me currently as a physical therapist assistant, but they have employed me there as a personal trainer, working with a group of people in semi private class sessions. So just want to get your thoughts on that. And Don, it's very good to see that you have this amazing podcast. I'm a huge fan of it. And it's also been awesome to meet you in person at the Athleanx Live event back in 2023. I hope to meet you again soon in the near future in person once again. And thank you, all of you guys, for what you do for this industry. And I can't wait to hear your answers to this question, especially for Charlie, and also give your input on this as well. Don.
- [44:27]
Don Saladino
I love it.
- [44:28]
Dr. Charlie Weingroff
All right, so Brian is asking, is it more this or this? The answer is yes, it's strength and rehab, because it's one thing. And when you can come and get one thing, not two things that happen in a sequence, not two things where people just seemingly try to work together. It's one thing where for X amount of minutes, someone's mobilizing your post surgical shoulder and, and then in that same session or week of advice, you're doing belt squats and pulling a sled and things of that nature. I think that'll continue to grow because that's where the results are. And I think more and more people are being willing to pay out of pocket because that type of environment likely is not the same, you know, stage, you know, if you will, for people that want to use insurance. So because you, you cannot have the trigger points and the mobilizations and the cracking necks and all these things. I think the future would be both. And someone like Brian, who is medically trained as a physical therapist assistant, holler at me, I might have a role for you because we need more medical providers that know at least one other thing so that they know which one is the priority. Or in this case, medical and fitness can typically be executed at the same time.
- [45:46]
Don Saladino
When I opened my first club in New York City, drive 495, I had a vision of kind of almost a PT driven model where strength and conditioning was a big part of the focal point, but the medical practitioner almost took the lead. So what I would always say to even Charlie is it's my name on the door, but you're the boss when it comes down to how a client, it might be moving or perceiving pain or whatever it might be. The second there was something jolting or jarring, Charlie became the. The boss. And that was a model that I really, I think we prided ourselves on in there. And I think, you know, even looking at how the gym floor looked and felt, it was more like a place where you pick up heavy stuff and you drop it. And when you walked in there and you saw people like Charlie running around, they were not, you know, there was a part where there was manual therapy going on, and then there was a part where they were picking up really heavy stuff. So I've always love that model, envision that model. And when we work together on that model, I feel like that's when I feel like we were almost like the first in the city to start incorporating.
- [46:49]
Dr. Charlie Weingroff
I think we've both been solicited for how do we. How do we do this over here kind of thing.
- [46:56]
Don Saladino
Awesome. All right. So, Charlie, first off, I mean, thank you. One, because I know your schedule is crazy. That's number one. Two, those of you out there who know Charlie and I, you know that we've been like this for a long time. So, I mean, yeah, you have no choice but to come on here again. So I really, I'm here, man. I'm grateful. I. I love you. I can't thank you enough.
- [47:14]
Dr. Charlie Weingroff
I never left the city. People think I left. Yeah, I live in Florida, but I still have multiple offices here.
- [47:19]
Don Saladino
I also listen, I also want to thank Christian Ponder, the owner of the Post, for hosting us here. Beautiful spot. Christian's been a gem. This place is just phenomenal. And guys, until next time, thanks again.
- [47:36]
Podcast Host/Announcer
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