The Show Up Fitness Podcast

Shoulder Pain: Elevate Your Personal Training Business with Soft Tissue Screens & Techniques

• Chris Hitchko, CEO Show Up Fitness • Season 2 • Episode 194

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Join us in Las Vegas to address shoulder, hip, and low back pain by better understanding anatomy and the Biopsychosocial model of pain.

Shoulder pain leaving you feeling like a rusty old car? Join us as we explore a groundbreaking approach to understanding and managing pain in personal training, comparing the diagnostic process to that of a seasoned mechanic. We unravel the complexities of shoulder injuries, emphasizing the importance of working within the biopsychosocial model of pain and collaborating with medical professionals. Tune in to learn why trainers must expand their knowledge, gain hands-on experience, and collaborate with experts to overcome the dreaded imposter phenomenon.

Discover the intricate relationship between anatomy, psychology, and pain management as we challenge the notion that specific exercises are solely to blame for injuries. By examining factors such as stress, sleep, and form, we promote a holistic approach to movement and recovery. Listen as we discuss the impact of language on mindset, suggesting that using the term "discomfort" can foster a more positive recovery experience. With an emphasis on understanding anatomy beyond textbooks, we aim to provide trainers with the tools they need to effectively guide clients on their healing journey.

Ready to elevate your career in fitness? We discuss the importance of continuous education, networking, and building partnerships with healthcare professionals. Learn about lesser-known muscles like the serratus anterior and how they play a crucial role in shoulder health. We share advanced pain management techniques and actionable insights to boost confidence and competence in handling client discomfort. This episode is designed to inspire trainers to expand their expertise, overcome self-limiting beliefs, and set themselves apart in the competitive fitness industry.

Want to ask us a question? Email email info@showupfitness.com with the subject line PODCAST QUESTION to get your question answered live on the show!

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Speaker 1:

Welcome to the Show Up Fitness Podcast, where great personal trainers are made. We are changing the fitness industry, one qualified trainer at a time, with our in-person and online personal training certification. If you want to become an elite personal trainer, head on over to showupfitnesscom. Also, make sure to check out my book how to Become a Successful Personal Trainer. Don't forget to subscribe, rate and review. Have a great day and keep showing up.

Speaker 1:

Shoulder pain is complicated, but I'm gonna help you, help your clients, get out of shoulder pain, on today's podcast. Pain is multifactorial, but I want you to think of it from the eyes of a mechanic. If you were to go to a mechanic and you asked them can you fix my car? It depends. It depends on what the scenario is. What type of car is it? Do they specialize in that? When did it happen? How long has it been happening for? Talk to me more about what's going on. When did you first discover it? There's questions that go into it and, mind you, you first discover it. There's questions that go into it and, mind you, a mechanic goes through a very laborious trade school. Average trainer reads a textbook and in the textbooks you're not going to come across pain management. It's a whole giant area that is just missed. They teach you how to assess a little bit, not the business skills, not programming, and so trainers are confused because, guess what? You're going to come across clients on a daily basis who have shoulder pain, and that fear of not knowing how to help them creates that imposter phenomenon.

Speaker 1:

When we do our weekend seminars for our soft tissue mobilizations, I always ask who in here has a client who has shoulder pain? Everyone raises their hand. So imagine having that hypothetical client in front of you and not knowing what to do. Think of that mechanic. And they're just twiddling their thumbs. Maybe the confidence isn't flowing through their speech, so that person is not likely to invest in their services speech, so that person is not likely to invest in their services. But with mechanics they also know their lane and they can refer out to other specialists.

Speaker 1:

Unfortunately, trainers try to be a jack-of-all-trades. Let me show you this corrective exercise to fix your pain. It's way too simple. So today I'm really going to dissect what pain is, the biopsychosocial model of pain, the assessments that you can do as a trainer, how and when to refer out with specific conditions or injuries, and then what that session would look like. Hands down. The best way to learn about this stuff is at our hands-on learning seminars. Be in Las Vegas the end of February 28th and March 1st. We have our seminar schedule lined out for the year. We got some great bundles where you can get certified for life, pass any textbook certification within 30 days and get our certification all for $5.99. And we also have bundles where you can go to a seminar within the next 12 to 18 months and get our soft tissue and or nutrition certification.

Speaker 1:

If you want to become a successful personal trainer, hands-on learning is what you need to invest into. So let's take a step back. What is pain? It's multifactorial. With the mechanic, you can point at the serpentine belt or your tires missing. It's a little easier. The human body is very complex. We like to simplify it. It's a little easier. The human body is very complex, we like to simplify it. Social media is notorious for saying POV, fix back pain by doing this one exercise. I wish it was that easy. It's not, and that's why it's so important for you to better understand pain by having medical professionals on your team, such as a physical therapist, not just one. Get a bunch the more. The merrier Spend weeks at a time shadowing and interning and learning about different injuries.

Speaker 1:

Do you know what thoracic outlet syndrome is? Frozen shoulder or adhesive capsulitis? Is it freezing? Is it frozen? Is it dying? Where are we at in the process?

Speaker 1:

Does your client have a slap, tear or lesion? What is the labrum? What about a mid-shaft clavicle break? Is it in the medial part, the lateral part? There's three different types and grades. Is it a sprain? Is it a strain?

Speaker 1:

All of the injury information should be learned under the scope of a physical therapist. We should be working together. I'm not learning this stuff to diagnose or treat patients, no, but if a client were to come in, I have the knowledge, knowing that I can help you, I can screen you, I can eliminate red flags with these screens that we teach with our soft tissue. We are the only company that has a certification for personal trainers that allows for you to manually implement these techniques. Therapists can do certain ones and pretty much all of the ones out there a lot more aggressively because they're joint manipulations and so forth, but there's nothing out there for trainers that gives them the legal capabilities within our scope. I'm not talking about doing a Lachman's test on the knee or any external or internal rotation passive test, no, but we should be able to manipulate our client's soft tissue within reason to help them get out of pain, and that's what we teach you.

Speaker 1:

So to better understand pain, we have to take a look at the big picture, the biopsychosocial model of pain. With the mechanic, it's just the auto aspect yeah, there's parts that go into the car and so forth. But with the human body, as the car does not have a brain, it doesn't have the psychological aspect that we associate with pain. So, for example, I could be bench pressing and I hurt myself while I'm bench pressing the road to 315 in 2025. I'm going to hit that sucker again If I were to hurt myself and I didn't have the knowledge and whereabouts to understand why it'd be so easy to point a finger at the bench pressing. Bench pressing causes shoulder pain. Easy to point a finger at the bench pressing. Bench pressing causes shoulder pain, and that's not the case.

Speaker 1:

But the next time I go into the gym as I start feeling better, I'm probably going to choose another exercise, maybe a Smith machine or a pushup, and say things like I shouldn't lift weights, it's dangerous. I'm going to do more functional things, like a TRX press or on a BOSU ball, whatever it may be. My brain is accepting that those are safer, whereas bench pressing has more risk because I hurt myself. I'm not saying that's the case. There's risk for everything in life. Waking up, there's risk at living Walking to the gym, driving to work, walking to get your mail. There's risk in life but unfortunately, because of the fear-mongering that can take place, it's really easy to blame a certain exercise. Running is bad for your knees. Don't pick up stuff with a rounded back. You're going to hurt yourself.

Speaker 1:

That psychological aspect is really important and we do not address it. I'm not saying we're psychologists because we're not, but we all kind of make that joke as trainers that we're great at movement and assessing and helping your clients get the results. But most of the time we are like a therapist because we're helping answer heavy questions what is life, relationships, depression and so forth? We are the ones having those conversations with our clients. So it's like we are a psychologist in a certain degree. We are a therapist in a certain degree, but we need to know our scope and when do we need to refer out. So the biology aspect of the biopsychosocial model of pain is what's happening inside of that organism. Maybe they do have an AC sprain, maybe there's a contusion. There is an actual biological acute effect that is happening. We need to let it recover within the scope of the therapist. But if it's chronic, when do we refer out, and so forth? The psychology part is really, really important because if we just look at the injury as it is, we're not addressing that individual. And this bio-psycho-social model of pain goes into a lot of other areas as well Addiction pain management. What we're focusing on today how to help our clients get out of pain is super loaded because of the experience that individual has. Pain is super loaded because of the experience that individual has.

Speaker 1:

A lot of times I'll give that example of the person who was attacked by a dog when they were younger. They may go throughout their entire life labeling dogs as bad. Pit bulls are bad, they're going to hurt you, they're going to attack you because the experience that person has. I could be an expert dog handler and I could grab that person and say pit bulls are the best dogs in the world. Come over here, let me show you that experience that I have is completely different than them. They're going to be going through a significant different psychological experience than I have. It's not going to work. The single best way to help people be exposed to dogs if they've been attacked by a dog is to bring them into a room with a bunch of kids playing with puppies and there's a separation of glass so you can see it but you're not going to get hurt. There's absolutely zero chance for you to get attacked. And then, when that individual feels comfortable for you to get attacked, and then when that individual feels comfortable, they then communicate with the expert and say I am ready, I would like that kid to bring over that dog at this distance, so I feel comfortable. And then when that individual feels comfortable to pet the puppy, that's going to slowly start helping their exposure to the trauma they had in the past.

Speaker 1:

It's the same thing with pain and movement. If you hurt yourself on a bench press, the bench press didn't hurt you. You were probably hung over, you didn't sleep well, you were stressed. You don't know how to bench press properly. Maybe it was a different bench, maybe it was a different machine, a different gym, different time of day. So many factors go into that. But it's so easy just to say bench pressing is bad and so what we do is we label exercises as bad and we simplify it by saying get out of pain by doing this and it may help, because that's the low hanging fruit. There's positive hope in that solution. Knees over toe guy do these three exercises, knee pain is going to be gone For that person who has had and been struggling with knee pain for the last 10 years, they now see hope and they implement those exercises with a positive mindset. That's the psychological aspect. And they get out of pain. So they vouch for him and say Ben's awesome, he's the best trainer in the world. He helps all these people get out of pain. He's giving people hope.

Speaker 1:

Whereas the biomedical model they told you that you're screwed. You go get an x-ray and they tell you that you have degeneration, you have bone on bone, you shouldn't run anymore. The doctors, ironically, are overstepping their boundaries when it comes to movement because they don't have a background with it, as we do In the last part of this model. The societal aspect how do you go into that injury? Again, use that example with the knees over toes guy. You look at all of the comments. I felt better. He helped me. If you're carnivore, if you're keto, whatever it is fasting. Go into the comment section. This worked for me. This worked. I was able to reverse my PCOS or my autoimmune disease, my gut health, whatever you are beginning to believe, the psychology aspect is now pairing with the societal aspect bio, psycho, social, the society that you're involving yourself with. The environmental factors are huge. Now look at how most injuries are diagnosed.

Speaker 1:

You go to an emergency room or a doctor. The room is just awkward. There's a bunch of people who have terrible situations screaming, coughing. It's very white and bright. We don't have nice Kenny G classical music on or some country Alabama on the boom box, baby. No, it's scary shit and you have usually pretty unfriendly people bring you into a smaller room and they treat you like a number, not an individual. Doc comes in, they give you an x-ray, bunch of machines, all these sounds, and when they read it to you, maybe you get an MRI. You have this, that and this. Never do that. You're freaked out. You have no hope. That's what happened to me. I got an MRI on my low back. Chris, you should never run, jump squat, do any of that stuff again. Deadlifting's terrible for you. As I'm looking at a model on the table with a disc on the table, your disc's falling out. They use this stuff. It's very scary, so you get guarded. So now my movement is not going to be very positive. I'm going to be restricted Rightfully. So my brain is saying, hell, no, guard yourself, chris. You are a delicate snowflake, so that is probably the most important part of handling pain.

Speaker 1:

I don't call it pain, that's just what our clients will be referring it to. I use the word discomfort, so you're experiencing some shoulder discomfort. Great, that's awesome, and I use that vocabulary because it's positive. What do you mean, chris? How is that awesome? It'd be like you're driving on the freeway and you just loaded up some gas. You have a full tank of gas and your empty light now comes on. That's awesome because you know that you just filled up with gas. It's a sensory thing. Something's off. Let's go fix it. Let's go to the mechanic, tell them what happened. They're going to fix it. That's a great sign. You have shoulder pain. That's awesome.

Speaker 1:

I'm going to learn more about it when it happened. I'm going to do some shoulder screens, see if we can do some movement and some mobility, stability stuff, some soft tissue, if we can. That's great because I can refer out to my physical therapist. We have some of the best therapists in town Prehab guys, dr Waterbury, we together are going to find a solution for your shoulder discomfort. It's probably not going to be today. It could even get a little worse tomorrow, but over time we are detectives we are going to find a solution for you. I guarantee it. And I say that with confidence, with eye contact, and my clients go wow, thank you. So then I learn about their experience with their discomfort. That's all part of the assessment Asking the right questions when did it start? Where does it hurt? Now, what they don't know is my background, and that's what I'm going to go with you over.

Speaker 1:

First, because you need to understand the anatomy portion To do these screens. Yeah, we're going to talk about shoulder flexion, external rotation and so forth with the proper range of motion, but you need to understand the fundamentals, just like when I go to that mechanic or to that doctor. They have all of this schooling and learning that prepared them for that situation, to help you appropriately. Unfortunately, textbooks don't do that. Trainers deserve more than textbooks.

Speaker 1:

So we need to double down on anatomy, the skeletal system. That's where it begins 206 bones in the human body. There's the axial skeleton, there's the appendicular skeleton Stuff that is more fixed. Think of a car, an axle going through the car Appendicular. It's more freely moving.

Speaker 1:

When we look at the shoulder, it's one of the most mobile joints in the human body. It's a ball and socket, very similar to the hip joint, also a ball and socket, but the difference is the femur, the longest bone in the human body, goes into your pelvis, whereas the humerus, the second longest bone in the human body, upper body bone. It articulates with the clavicle, which is the most broken bone, or your collarbone and your scapula or your shoulder blade. Because of that mobility it's awesome, but the stability could be an issue and that great range of motion makes it more prone. It doesn't mean just because you have it, you're going to get shoulder pain. No it. It just means that's an option, just like when you drive faster, there may be an opportunity for you to wreck your car, whereas if you're going slower, having a faster car gives you the capabilities to use it if you choose to. I love my shoulder mobility, all this awesome range of motion, but I need to understand what it's capable of doing.

Speaker 1:

There are four joints the glenoid fossa, which is part of the scapula. Think of like a golf ball sitting on a tee. That's the glenoid fossa, articulates with the head of the humerus. Together that forms the glenohumeral joint, which has the greatest range of motion of the four joints. If you were to feel your clavicle and you go away which is referred to as distal and you feel the end of your scapula, they meet. It's like a wishbone. That's referred to as the acromioclavicular joint. The AC joint can get, like an AC sprain, different grades there, one not being that bad, two being worse than a one, three being the most severe. A sprain is to a ligament, a strain is to a muscle or tendon.

Speaker 1:

On the posterior side the scapula articulates with the thoracic region of the spine. We have a lot of range of motion in the mid part of the back, about 30 to 35 degrees. Each one of the vertebrae have about three degrees of range of motion there, one to 12. Let's do some math here. Come on tori. What do we got 36, roughly 30 to 35 degrees of rotation at the thoracic spine. So that's called the scapulothoracic joint. And on the anterior side we have the clavicle, the proximal aspect, articulating with the sternum. The sternum is your chest bone. If you had any older brothers, they'd pin you down and smack that sucker and hurt like holy hell.

Speaker 1:

That's the last of the four shoulder joints. We have the shoulder joint and the shoulder girdle. The girdle is not including the humerus, which is more freely moving. Think of a girdle back in the day. It's holding everything together, whereas the joint is going to be more freely movable. So those are the joints. We went over the skeletal names of the bones.

Speaker 1:

Now we got to look at the muscles 17 muscles of the scapula, starting with the rotator cuff supraspinatus Supra means above superior Infraspinatus. Supraspinatus supra means above superior infraspinatus. Teres minor subscapularis. That's the rotator cuff. Just helped the trainer get hired at Lifetime and I loved it because the manager quizzed her on rotator cuff anatomy and she said you know what? I don't actually know a hundred percent, but I'm fortunate because I'm going through the show fitness to get their CPT. And guess what? The manager said oh, I'm aware of Chris and what their certification is doing. That gave her the ability to get to that next interview, lifetime Equinox. They want trainers with their show fitness CPT because they're qualified and you're going to see more of these styles of interviews with managers and management at gyms because they're eliminating the textbooks which don't teach you that stuff. They don't stress the importance of anatomy, because to understand movement you have to have that foundation. So we got the rotator cuff.

Speaker 1:

Now we do the majors and minors. Terrace major, also referred to as the lats little helper, because it does everything the lats do within reason Rhomboid major, rhomboid minor, peck major and peck minor. We'll come back to the peck major here in a second. Then we have what I call the bromuscles, the deltoids, the biceps, brachii, triceps, brachii, trape, subsbrachii, trapezius one muscle, three parts, as are the deltoids one muscle, three parts anterior, lateral or medial and posterior. The pectorals major one muscle, three parts. We have the costal region, which is the lower, the sternal region, which is the middle, and then the clavicular region or, quote unquote, the upper pec. We have the latissimus dorsi dorsi, I think of a dorsal fin, very large back muscle. If you were to put your arm out in front of you, which is referred to as flexion, and you grab that meat and you touch that bone which is your scapula, that meat is the latissimus dorsi and the little helper, the teres major.

Speaker 1:

Then we have the three weird muscles that you probably haven't heard of. Some textbooks don't even have these muscles. Irony, behind that right we have the serratus anterior, also referred to as the boxer's muscle. Remember when Rocky fought the Russian? He came out and they're all jacked up. They had it serrated and their sides were all sizzled up, looked like serrated knives. Rocky and the Russian dude Dolph Lundgren look all jacked up. Those are their serratus muscles which protract the scapula.

Speaker 1:

Then we have the levator scapula and the last one is the coracobrachialis. A lot of muscles are named off of their orientation, the coracoid process of the scapula, coraco brachialis. Brachia means upper arm. The brachial artery is what we checked when we do blood pressure. Check out that previous podcast reviewing everything blood pressure, how to train people who have high blood pressure and the contraindications. So those are the 17 muscles I said we'll come back to the pec major because technically that is not a shoulder muscle, because it does not originate or insert into the scapula.

Speaker 1:

The omohyoid, technically, is the 17th, but we don't go to the gym and crush the omohyoid. It originates on the hyoid bone, which is a cool bone right below your jaw, which is called the mandible, and it's the only bone in the human body that doesn't connect to another bone. You may be thinking the patella, but the patella goes into and attaches to your tibia via that ligament, so that's a cool bone. So the omohyo technically is the 17th muscle. If you're ever on Cash Cab or who Wants to Be a Millionaire, they ask you which of the following is not a shoulder muscle? Technically, the pectralis major is not a shoulder muscle. Technically the pectoralis major is not. But what is Monday? Everyone Today, national Chest Day, international Chest Day. We're familiar with the chest being a shoulder muscle, so we incorporate that part of our certification. The pectoralis major is one of the 17 muscles.

Speaker 1:

Now we've checked off the 17 muscles. We got to look at the actions with the articulations of those muscles In the sagittal plane. Sagittal is referred to as an imaginary line bisecting the body into right and left halves, allowing for flexion and extension. We can go forward with the humerus, which is flexion, and we can come back behind, and that's extension. A swimmer, when their hand is above their head and they bring it towards their thigh, that is referred to as humeral extension.

Speaker 1:

We're making reference in the gym to the concentric actions. So when a muscle shortens, that's concentric. Typically when we want to breathe out, the easier portion is the eccentric. Now, in the frontal plane of motion, we have an imaginary line bisecting the body into anterior and posterior halves, allowing for a B-duction and a D-duction. And then we have five transverse actions. Transverse is an imaginary line bisecting the body into superior and inferior halves, allowing for a rotation. We have external rotation, also referred to as lateral rotation, medial, also referred to as internal rotation, horizontal adduction, like a chest fly, horizontal abduction, like a reverse fly, and then when we abduct our arm to 90 degrees and then we come in horizontally 30 degrees, that's referred to as scaption or the scapular plane of motion some people refer it to.

Speaker 1:

Now, when we're in the gym, we're not training planes of motion. But you need to understand this, to read journal articles, to have conversations with medical professionals, because if you're talking to a therapist and they say frontal or transverse or horizontal abduction, make sure not to actually rotate past 110 degrees. You need to be able to understand that professional. And that's where the line in the sand really is. Trainers don't have the confidence to have these conversations, so they just don't have them. That's the easier way to do it Just throw your head in the sand. It must not be happening, right? So we don't have these conversations.

Speaker 1:

Now you wonder why so many doctors, registered dietitians, therapists, massage therapists, chiropractors look at trainers as a joke. It's because we're not bridging the gap, we're not leveling ourselves up. They go through school. We read a freaking textbook and then we have the audacity to say that they're wrong. Oh, therapists don't know what they're doing. What's your background? An 800-page esoteric textbook, really? So can you imagine the frustration from that actual medical professional who has a career, they have a salary and they're respected, is getting lib from some dipshit trainer challenging their processes? We don't have the foundation, internships and so forth like they do.

Speaker 1:

A degree in kinesiology or biology, a three-year doctorate it's not easy to do. Now we can, you know, pick little holes in the education process to become a therapist all we want or a dietician. But trainers are not on the same level. So what you can do is put your ego aside and you initiate the conversation. You reach out to a therapist, you let them know you're going through a certification soft tissue mobilization or show-up fitness. They've linked up with some of the best therapists out there and one of the things that they have to do is intern under a physical therapist so I can learn more about conditions like thoracic outlet syndrome and what a rotator cuff tear looks like, what a slap lesion is, so I can build up my vocabulary to really know when I need to refer out to the therapist.

Speaker 1:

I'm not practicing outside of my scope. Doc, I'm sure you're aware that most trainers get some simple textbook NASA, mace, issa those are like the fast food companies you think of McDonald's, you think of those Super, super easy to get. The irony is 35% of people fail when they take these tests. It's crazy. One out of three. I'm not calling you an idiot or a dipshit, I'm just trying to help you look through a different lens.

Speaker 1:

People exercise more than they did 20, 30 years ago. They're going to gyms. We have a better, more positive gym experience today than we did 30 years ago. Now the barrier for entry to become a quote-unquote professional as a personal trainer has gone down. We're not leveling ourselves up as an industry. So the actual respected professionals look at us as jokes. So how you can get over that is bridge the gap and you let them know. Hey, doc, I'm sure you're aware that most trainers don't know much about anatomy. They're out there hurting people doing weird things to BOSU balls. It's a really fucky industry out there.

Speaker 1:

I'm not cussing in front of the doc, but what I'm doing right there is letting them know the frustration I'm sure they're experiencing. What I want to do is make sure that I'm assessing my clients appropriately and when there comes a condition that I can't help with, I refer out to you. I always stay in my lane. I know when I can help my clients, but I know when I need to refer out. I refer clients to our therapist all the time and I think it should be like a checkup, like going to the dentist. People are gonna be better off going to a physical therapist, who is the expert in pain management, once a month. Absolutely You're not gonna have an argument that, oh no, you're actually gonna be worse off going to a therapist once a month. Absolutely You're not going to have an argument that, oh no, you're actually going to be worse off going to a therapist once a month. Same thing like going to a psychologist. We should be doing that once a month. Get our brain cleaned out, get those cobwebs checked out, have those deep conversations. The psychology aspect plays a huge role in pain. So the better and bigger your team is, take a step back.

Speaker 1:

You are separating yourself from the frustration of the training industry. It's saturated? No, it's not. According to who? Ask that next trainer that tells you it's a saturated market. Ask them who's on their team. What's the name of your physical therapist, registered dietitian, massage therapist, psychologist and doctor? I'd love to chat with them. What do you mean? I don't have any of those Exactly, it's not saturated. It's saturated with textbook specializations that people throw in their bio. That makes them feel like they're special. I always make the joke the more acronyms after a trainer's name, the less qualified they are. It's a pissing contest for that. It's an armchair quarterback. Right there they're trying to make themselves feel special and we're all about that today All the trophy participation awards that everyone wants.

Speaker 1:

I got this certification, but if you've really been around, you look at that and you go, ooh yee, that's not good. I tell my clients first thing have you worked with a trainer in the past? Oh, yeah, probably have a NASM, an ACE, issa, something like that. Right? Oh, I'm sorry. I want to apologize on behalf on a lot of trainers out there because they don't have the background like I do. I'm not coming off as a cocky prick, I'm just being truthful. The average trainer reads a textbook. They go out there and they gain experience without supervision. I have a degree in kinesiology. I've had some of the best internships in the world as a strength coach.

Speaker 1:

I continue to learn from our partners physical therapists, doctors, registered dietitians I surround myself with the best. That's why I know I'm the best and today we're going to help you get out of this discomfort that you're experiencing. If it's not today, it's going to happen in the near future. So let's talk more about that. So that's just the anatomy portion. You need to know that to confidently be able to help the person in front of you when you go through the assessment.

Speaker 1:

So when they talk about the pain that they have, the four tests that I do, when the time comes, let's go out into the gym. Can you put your hands above your head? That's the first one. Flexion to 160 to 170 degrees, abduction about 180 degrees. That's what I'm testing there.

Speaker 1:

If they can get their hand above their head without any major limitations, that's checkpoint number one. Number two can you cross your arm and smell your armpit? If you can lift your elbow above the medial line, that's checkpoint number two. Good Number three can you put your hand behind your back and lift it off. If you can checkpoint number three and the last one's called a break test You're going to it's empty beer can test.

Speaker 1:

You're going to internally rotate and I do the non-affected arm first. So this is the healthy arm and I have them do the actual range of motion before I add any type of resistance. To show them what I'm looking for In the transverse plane. I'm going to give them a little bit of pressure. It's going to be an isometric contraction and then we do it on the affected arm and if it quote unquote breaks, they'll step away.

Speaker 1:

Oh ow, that really hurts. That's a bad sign. You know what? I don't feel comfortable taking you through today's shoulder upper body workout. I'm gonna have you meet with our therapist to take a deeper look and to see if this is something that we can work on or if we need to get an MRI. You're gonna get so much respect from that because you have a process. You're gonna come across little grimaces, grimaces are fine. It little grimaces, grimaces are fine.

Speaker 1:

It's the worst case where, if you look into the case examples that we have for the certification, there's people that cannot lift their hand above their head. That's probably a torn rotator cuff, specifically the supraspinatus. I'm not diagnosing it, but it's just an oh shit moment. That's not good, man. I'm sorry, but you should probably go get that checked out. You may have a torn rotator cuff labor issue, I don't know, I'm not getting in there. So let the expert check it out and, even better, go with them. Go to the doctor's appointment, go to the physical therapy appointment. Again, you're leveling yourself up because other trainers are not doing it.

Speaker 1:

I charge a lot of money here in Santa Monica. To my awareness, no trainer here in the greater LA area charges more than I do. And I had a client come to me who's worked with five other trainers and this is a referral from a high-end concierge medical facility and not a single one of those trainers went with him to his physical therapy appointment. I got the therapist's information. I sent them an email. We went out and had coffee.

Speaker 1:

Now that therapist knows that there's a qualified trainer they can refer people to, it just blows my mind that we're not taking that step. But then we're also frustrated that we're not making enough. Well, maybe if you invested in your education, you went to seminars, you learned from the best to become the best, you can then charge the most and so you don't have to be working 70 hours a week. You can turn your passion for fitness into career 100%. But it takes time and you need to build up your career capital with supervised experience and build your team. So once you screen the client, they're good to go. Now the value is really added as the qualified trainer because we get into the soft tissue.

Speaker 1:

There's five points around the shoulder that we're going to look at. We start with the lowest hanging fruit, which is typically the infraspinatus. We'll then go into the upper trapezius. We have the rhomboids, we have the pec minor and the adductor pollicis, which is your thumb fascia that we get into. You choose one of those.

Speaker 1:

Implement the soft tissue technique. You find a sensitive area, or, as I call it, the cuss word spot. You hold and they get to about a six or seven discomfort. A lot of times you're going to get them to say, oh shit, that's your spot. Hold big breath. Parasympathetic nervous system needs to kick in. So we're calming down the nervous system and this plays into chronic pain and central amplification. That's why we're doing this. We're calming the nervous system down.

Speaker 1:

This area is sensitive for a specific reason. It's that light on your dash that kicks on where you know something is off but you don't know exactly what. But you bring it to the mechanic. It's a sensory thing. It's the same thing with the body. It's probably a sensory thing. I eliminated the mechanical stuff by doing those screens.

Speaker 1:

Now let's implement these soft tissues. Breathe 30 seconds to a minute later, take your hand off. How's it feel? And more times than not, that's the low-hanging fruit that we need. Wow, holy crap. That feels significantly better. Sometimes it's just going to be like that definitely feels a little better, but still there. Great.

Speaker 1:

Implement another technique. We will do one to two techniques, one to two spots that are tender, and then we get into addressing the mobility issues, and then we get into stability issues and then we work out the old way of addressing this stuff, the textbook way. We're going to foam roll, we're going to stretch, we're going to activate, and then we're going to do an. We're going to foam roll, we're going to stretch, we're going to activate and then we're going to do an integrated movement, literally foam roll, static, stretch, isolate, and then you're going to do a stability, ball, squat, curl, press the new way, which has proven to be so much more effective.

Speaker 1:

You understand anatomy and movement. You have a team of physical therapists that you're working with and then you go through the assessment, the biopsychosocial model of pain. You're very positive in your interactions. You're not breathing down your client's neck with nasty-ass breath because that will have a negative impact on him. You're positive, you're engaging, you're delightful, your personality is shining, you're giving that person hope. You implement the screens to eliminate red flags and then do the soft tissue work. We're not mobilizing joints, we are not massage therapists, but we can, with this certification, implement these techniques. You release and then now we're going to address some deficits when it comes to mobility. You implement a few mobility drills. Maybe it's a controlled articular rotation or a CAR, maybe it's a PNF proprioceptive neuromuscular facilitation. You choose one or two of these drills to address the mobility aspect.

Speaker 1:

Then we implement some stability exercises which are going to build up that stability, because the shoulder joint specifically has a lot of range of motion, as I said earlier, and if we don't have full control, the brain can kind of throw on that guarding technique, that little light on your dash, saying uh, something's off. We don't have full range of motion control. Stability is an issue, so that can be causing the discomfort. So you choose one of the exercises. We have a ton on our platform. Prehab guys have a ton.

Speaker 1:

Implement slow, controlled, concentric. Slow, controlled, eccentric. The goal here isn't to go to volitional fatigue, it's not to overload the hell out of it. We're not focusing on optimization of hypertrophy. No, slow, controlled, eccentric three, four seconds. Hold isometrically three, four seconds, come back eccentrically three to four seconds. Control is the name of the game. Optimal range of motion, for example, on a bench press.

Speaker 1:

A lot of times people will hurt themselves because they restrict the range of motion and then under heavy load the weight speeds up the tissue and the capacity of the tissue isn't ready for it and you get injured. So then when you do a closed kinetic chain exercise like a push-up and you go through that full range of motion, slow and controlled, you're strengthening the connective tissue. That wasn't exposed prior. A lot of times it's a tissue capacity issue. I'm not saying all of the times issue, I'm not saying all of the times. So after the stability work, you then get into getting stronger with the movement patterns. That's based on their goals.

Speaker 1:

A lot of our clients are training full body. So we're going to do a squat, a hinge, a unilateral transitional pushing and pulling Under the transitional. We can jump, we can sprint, we can crawl, we can do carries, anti-rotation breathing drills. We're optimizing the organism by recruiting our type two muscle fibers volitionally that's the fatigue as fast and explosive as we can, power output and heavy as possible within the individual's capabilities. A beginner we don't go as heavy, we stick to about 10 to 15 reps. But as we progress we do things more explosively and we go heavier. That's how we build a better machine.

Speaker 1:

And when discomfort presents itself which it can from tissue capacity, from just having a bad night's sleep and you're lifting a load and you just have a little tweak, freak accident, it's not because of what you did there, it's just like a shitty day. You got a ticket, you woke up with a headache. It doesn't mean you're always gonna wake up with a headache, it's just a bad situation on that specific day. But you, as a qualified coach and trainer, can get your clients through it. So you implement the soft tissue specific to that area and you got to remember I'm giving you a very quick breakdown of this certification that we offer, which gets you 1.0 CEUs because it's more than 10 hours of content with case examples. You have to submit videos of you doing the screens to show that you're competent. You work with your therapist, you intern, you shadow, you build your team and you are going to be the expert in your town, your city, your state when it comes to helping clients get the results safely. It is within our scope to help our clients. If they come in with pain, you will know what you can help them with. If it's a red flag and you need to refer out, or if it's something within our scope, you have to have the certification with the insurance that allows for you to implement the soft tissues.

Speaker 1:

Now, if you choose not to do those, that's fine. You don't have to get the consent. Because you're choosing not to do those, that's fine. You don't have to get the consent because you're choosing not to do that. You can do just a car or PNF or static stretching or a certain exercise, and it may help. But the unfortunate thing with social media is then we broadcast out to the world that the reason you have low back pain is because you have a weak TVA, transverse abdominus, and that is false. Sure, you may have someone who has low back pain and by doing planks, their low back pain went away and by doing planks, their back pain went away. But it doesn't mean that planks will decrease low back pain. It's multifactorial.

Speaker 1:

There's so much that goes into this and, as a trainer, if you're at this fork like where do I go next in 2025? What do I want to really double down on? I need more clients. You got to take a step back and go. What are the gaps in my knowledge that I can optimize and learn more about? So my client, my knowledge that I can optimize and learn more about, so my clientele knows that I'm the expert and then have conversations with your clients while you're doing this. That's one of the most important things. I'm getting this soft tissue certification. I'm going to this seminar. Hell, you can offer a giveaway. You can do a weekend little lottery slash raffle. Your clients can then pay for you to go to these events.

Speaker 1:

Your self-limiting beliefs are what are holding you back from success as a personal trainer. If you use excuses like it's too expensive, you're not going to succeed in this field or any other one, because that's always going to be your limiting belief. I'm going to go back to school and I'm going to build up all this debt and get something that's more secure. This industry can be very secure if you get those streams of revenue by leveling up your knowledge, by surrounding yourself with a better team, you can then save and open up a gym and hire other trainers and therapists and you're the one hiring them. Look at the irony of that. That absolutely can happen and that's another stream of revenue for you as a trainer. We need to level up, get on that same level as therapists At least awareness for the muscles that we see on a daily basis 17 muscles around the shoulder, 20 of the lower body, 14 around the knee.

Speaker 1:

Start there by recognizing the names, how to pronounce them. Then get into the actions. What is happening with knee flexion, shoulder flexion, external, internal rotation, recognizing where there's limited range of motion and what could be causing that. So, as you build your confidence, other people in your area said by that you know that person's really sharp. They're more of like a therapist chiropractor because they're always doing soft tissue, quote, unquote, corrective stuff.

Speaker 1:

I just don't like the word corrective because you can just type in corrective exercise on Google. Why it's not an optimal term. I think Nick Tumaleno wrote a good article about it. It's almost looked down upon amongst physical therapists and when I say stuff like I'm a corrective exercise specialist therapists will look at me as, oh look, they're trying to overstep their boundaries. That trainer over there thinks they know what we do because we're not having the conversation. Even though it's not what you're saying, that's what's being interpreted.

Speaker 1:

So you need to go out there, get on Instagram lives, have posts with you and physical therapists and registered dietitians, because then you are in a different light. You're not fighting for space in the crowded social media spectrum right now, all smoke and mirrors. You are helping people get out of pain the most effective, efficient way, and you understand why. It's not just band, pull-aparts, cure shoulder pain. Why are you doing that? Why is this issue on this area more tonic than other issues? So when you get that thorough understanding, you go down that rabbit hole, your confidence builds up and then you're going to want to learn more and surround yourself with more quality medical professionals, and that's exactly how we're going to change the industry One qualified trainer at a time.

Speaker 1:

Reach out, ask questions about shoulder issues that you have. If I don't know, what should I do? But if I didn't, I then have the ability to go to our therapist and ask them for their medical expertise, and I do that all the time. I like to have fun and just piss people off on social media. But if a client comes in and something's a little off and I have an idea, I still record it, take a photo, send it to our therapist and usually within that session they'll get back to me. The very least by the next time that client comes in. I show them that conversation and what that does is it validates why they're working with me, working with this gym, this clinic, because as you get therapists on your team, you have a clinic. You are different than the whole clusterfuck of the industry. And this is stuff you can read about in my book when it comes out.

Speaker 1:

We have the tentative date. I submitted the last formatting adjustments. We're pegging February 1st. It's going to be a workbook style, so when you go to the seminars at Lifetime you will reference the book. It can help anyone pass those simple textbook certifications. We have a certification for life, which means in 30 days you will pass ACE, isa, nasm. If you can't get a refund, super, super easy. 35% of people fail. It's one out of three when they go that route by themselves.

Speaker 1:

When you go through a show up, we have a guarantee that you will pass. If you do fail, we repay for your test and on top of that, you get our show up in a CPT. Now that's going to level you up. You are now a qualified trainer. You're going to get interviews that you would not get with these other certifications. That's why we partner with Lifetime and can pridefully say we're the only company in the world that guarantees you an interview at Lifetime.

Speaker 1:

I will reach out to the right recruiter manager and if you check all the boxes you've gone through show up, you have your CPT. We will get you into the best gyms. As you can see, we've put more of a bias towards Lifetime. We still work with Equinox. We can get you hired there. We have some big calls in this next quarter growing the partnerships, getting trainers to level up, companies to level up, because we're sick and tired of not having the confidence to competently help people in a respected way. And that's who you are. You are a qualified personal trainer. Hopefully you found today's podcast slash YouTube helpful. What can we help you with If you want to become an elite, successful personal trainer? Dm us, instagram, social media. I will help you build that confidence so you can continue pursuing your passion for fitness. Have a great day, y'all, and keep showing up.