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The Show Up Fitness Podcast
Dr. Farnsworth Overcoming A Torn Achilles / Achilles Injuries
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Dr. Justin Farnsworth turns conventional wisdom about Achilles tendon injuries upside down in this eye-opening conversation about prevention, rehabilitation, and performance training. With recent high-profile NBA Achilles injuries making headlines, his practical, evidence-based approach offers a refreshing perspective for trainers and athletes alike.
"Anyone selling you an injury prevention program is a snake oil salesman," states Dr. Farnsworth, explaining that while we can't prevent injuries entirely, we can implement smart strategies to build resilience. Drawing on his 20 years of coaching experience and 13 years as a board-certified sports physical therapist, he breaks down the biomechanics of Achilles injuries and shares specific techniques for training the tendon properly.
The conversation explores why heavy eccentric training (true overload, not just controlled lowering) is crucial for tendon health, and why training the calf in fully lengthened positions might be your best protection against injury. Dr. Farnsworth challenges the outdated RICE protocol, explaining why compression and targeted isometrics often work better than ice, and why complete rest is usually counterproductive for healing.
For trainers working with injured clients, there's practical advice on rehabilitation timelines (typically 9-12 months for Achilles ruptures), the powerful benefits of contralateral training for the uninjured side, and how to safely program around pain. Perhaps most valuable is his three-part framework for Achilles health: mobility, strength in lengthened positions, and rate of force development through progressive plyometric training.
Whether you're a fitness professional or someone recovering from a tendon injury, this episode delivers actionable strategies to build stronger, more resilient bodies. Check out Dr. Farnsworth on Instagram @DrJustinFarnsworth or visit his "Programming Around Pain" course for
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I'm not a stickler on the oh my God, you iced it. You're a bad person. I generally haven't found it super useful. Iced is really helpful if someone has a lot of pain.
Speaker 2: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. Howdy everybody. Welcome back to the Show Up Fitness Podcast. Today we have Doc Farnsworth and he's going to educate us on the Achilles. How are we doing, doc?
Speaker 1:Hey man, I'm doing great. Thanks so much for having me.
Speaker 2:Well, thank you, I'm excited to get some of our instructors out to your in-person seminars. We're going to be out in Kentucky, new York, boston, tuxon in Arizona, and so where can people find your hands-on learning two-day seminars that you just started to do?
Speaker 1:Yeah, so the best place is actually through Instagram, so it's either my own Instagram at Dr Justin Farnsworth and there's a link to the course. The course is called Programming Around Pain. There is also an Instagram page for it at Programming Around Pain. Both of those have a link to a landing page that has all the courses laid out Two-day course a lot of hands-on, which I think every coach really benefits from, because we can all read textbooks all day, but textbooks aren't people.
Speaker 1:And really focusing in on good rehab is good training. Good training is good rehab. We all want to stay in our professional lanes whether it's me as clinician or maybe someone else as coach but realize we all have the same end goal and really helping give coaches usable tools around low back pain, hip pain, knee pain, shoulder pain kind of the big four that people complain about, I think, when they come to training. And then, using the experience I've had I've been a coach for 20 years, clinician, board certified in sports for 13. And I have taught the most in-person certification courses out of anyone since 2020, going two to three times a month for just about six years. So I've interfaced with a lot of coaches, a lot of rehab professionals have done it a while so I have a pretty good idea of, I think, what hits pretty well.
Speaker 2:I love that. I have a tendency to go off into rabbit holes, but I think that's so important for coaches to understand is that it doesn't just fall into your lap. You know, you put your work in, you earned your stripes. I mean six years grinding out like that, that's impressive.
Speaker 1:Yeah, I think. Unfortunately, we're in a day and age where you can scroll Instagram and we can perceive how someone like made it. And let's be at the end of the day, none of us ever make it Like it's. It's a continual grind, um, but no one gets there in six months Like. The only way you get there in six months is when the freaking lottery and then you can retire forever. The rest of us, it's just you. You get the best experiences with time in the field working with real people, and the longer I've done what I do, I can't tell you how much I think in-person education and experience with clients in real time is probably the lowest hanging fruit for everyone on just how to continually improve the skills. And, at the end of the day, when you improve your skills, you improve the life of the human you're working with, which is really the goal, I guess, why we all got into this in the first place.
Speaker 2:Nothing pisses me off more when I hear a new trainer and they say I'm just going to go out there and get experience and I'm like that's kind of okay, but you need to have supervised experience. You need to have someone telling you why are you doing this and the why behind it. There's no critical thought when you read an esoteric textbook and you can't ask any questions and so that the hands-on is absolutely the game changer.
Speaker 1:I agree. I'll tell you the best thing that ever happened to me in my career. When my wife and I as my girlfriend at the time started our physical therapy careers, we hopped in her car, we drove three days from New York to Tucson, arizona, and we took jobs. And the reason we took the jobs we did was we were promised mentorship. And nowadays, if you're a PT, you're promised mentorship and you end up seeing 60 patients a day and you don't get mentorship because you're too freaking tired.
Speaker 1:Back then, back in the day, like 13 years ago, I actually didn't treat my own patient for about four months. So I actually spent time with the owners of the practice and we treated their patients together for like four freaking months and I learned so much in that time frame. Yeah, did we get paid less than other jobs? Yeah, but the money or the resources I've made because of the knowledge I got early and often that first job forever shaped the trajectory of my career to the point where, if I had to go back in time, I would have paid to be there. So I think with coaching, training, rehab and it's all the same thing, finding a place where you can have actual, solid mentorship and feedback is so important because then you have a frame of reference, point of like where to start, and a lot of times the textbook doesn't really give you that. It gives you the here's a squat, there's only one way to do it, there's only one way to program it, and then, when all your clients can't do that, you're just like now what?
Speaker 2:That's so true and I think that it's so important for trainers to be able to know their scope, and that's why we're really big in working alongside with therapists. And so right now we have the NBA. We had Lillard go out, we had Tatum on Boston go out. And let's talk a little bit more about the Achilles and is that something? I know you get these charlatans online, so if you were to do my functional movement stuff over here, then we could have prevented that. But what are our thoughts on, to a certain degree, exercises that we can do to potentially prevent that injury? And let's go through the rehab process post.
Speaker 1:Yeah, I love that. So the first thing I think we have to realize anyone that's selling you an injury prevention program is a snake oil salesman. Here's why there is no such thing as injury prevention. We we can mitigate risk, we can reduce relative risk, but if you go watch high level sports, I can't prevent someone's knee falling into like LeBron's knee and tearing his ACL and so fast and you still see injuries and even kind of more comical than that for me.
Speaker 1:If you look at the nba, I mean over the past probably five to eight years, how much obsession has there been on load management? And you actually see guys getting hurt at a higher rate with all this obsession on load management, which in theory makes a lot of sense, but no one can actually verbalize what load management, even freaking, means. And you look back in the nineties and you have guys like freaking granted, no one is Michael Jordan except Michael Jordan but you look at like this, this party hard, go gamble, then freaking show up and drop 45 points and be totally fine. It's just it's interesting to see kind of the contrast past that. At the end of the day, yes, does load management matter? Probably Is there such a thing as it's not the load that breaks you down, it's the load you're not prepared for. Yes, but what does that actually mean? That's up in the clouds, no one can verbally tell you. It means specifically this with rest, reps, time, days off, travel time zone. There's all these variables that we have control over when you're a pro athlete and there's a lot of variables that you don't Like. You got to pick your parents wisely, for example, right when it comes to the Achilles tendon.
Speaker 1:If we look at the mechanism of injury for an Achilles tendon rupture, it's usually a high force and a very lengthened position. So when you go to the NFL, you watch Aaron Rodgers when he got tackled right and you look at that tackle and his hip was in extension. So his legs behind him, his heels off the ground, so it's a very lengthened position to gastro and then he gets a compressive force from the top down that drives his heel down. So when we think what might mechanically help the Achilles tendon, I would probably argue, with no research to support it outside of an anatomy and biomechanics textbook, that you have to be training people in a position that puts the calf at lengthened positions. What does that mean? Well, the calf, the gastroc specifically doesn't just cross the ankle, it crosses the knee, which means the position of the hip and therefore the knee probably matter just as much as the position of the ankle. So in practicality, what does that mean? Okay, let's just pretend a standing calf raise typical standing calf raise is going to lengthen the gastroc at the ankle, but with the knee being an extension. Cool, but you're not really getting much at the hip. Now imagine, there's this.
Speaker 1:I have a favorite exercise. It's called a leaning landmine calf raise. It's where you put the landmine on your shoulder and then you put your targeted hip behind you, so your hip is in extension, the knee is straight and then the ankle is all the way back here with the calf fully lengthened. And then you do calf raises from that position and I have left clients of mine who are squatting 400 pounds sore for days doing that with just the weight of the bar through their calf. So I think one of the first things we can do is can we train this thing in a lengthened spot? I think the second thing that we should be doing is heavy eccentric work. So we know pretty consistently heavy eccentrics do really well at making tendons more resilient to force. But I think too often what we do is we call something eccentric just because we control the eccentric versus what's actually eccentric, overload Two very different things.
Speaker 2:Love that, love that. And for those injuries I mean you're looking at what a minimum of a year. When would you give the clearance to start getting it? Because there's a whole thing with Aaron. You know he's going to come back in six months and that's just not realistic. What does that rehab process typically look like?
Speaker 1:So the uh, it all depends, um, it all depends on, uh, how much the Achilles was torn. Um, I believe they had this new I forget the name like the crossbridge protocol that Aaron actually underwent, which actually can accelerate how fast someone can come back. Um, you're going to have some other predisposing things like how healthy is the tissue? Most pro athletes don't smoke, but some regular people do so we generally know if you're a smoker you have type two diabetes. Those things slow down tissue healing. If you look in a textbook, you're going to see somewhere between like a six to nine, maybe 12 month timeframe in terms of a return. But at the end of the day we have to appreciate timeframes are just that, it's timeframes.
Speaker 1:I equate any surgery rehab to what we do with something like the ACL, for example. So if you look at the ACL literature, the ACL itself takes two years to heal period. But when are people going back to sports? Yes, nine months, 12 months, and we know as long as you wait, you know past 12 ish months you tend to do decently well and every month you wait past nine months or injury risk goes down by about 50%. But there's the criteria of well shit if you're at nine months and you're still weak, you can't jump on that leg. I don't really care what the time is you're showing me right now. You are not ready to go. So, generally speaking, we're going to sit right in around nine months, give or take.
Speaker 1:If you're 45 years old and you play adult rec league basketball you don't exercise that much it's probably going to take longer. If you are Kobe Bryant, if you're Andy, your life is dedicated around. Literally. My job is to recover from this thing as fast and as safe as possible. You can get there in six to nine months. I used to work in New York City. We had a gold medal winning Olympian who had an Achilles tendon rupture that we did his rehab with, and even him it took like six to seven months and once you know it, a couple of months back and you then, uh, went towards acl. So you know we do our best, uh, end of the day, biggest predictor of future injury is previous injury. So once you ring the bell, we just simply can't unring it.
Speaker 2:Unfortunately, yeah, that's, that's crazy. I didn't realize that that's. That's fascinating stuff right there. And so the rehab process. You're obviously me working with medical professionals such as yourself. What about some signs that we should be maybe concerned about? I know that I've done some long runs and my volume was way too high. I'm a meathead, so I just wanted to start running a bunch and my Achilles would start getting a little swollen. What happens with that? And are there things that we do, we want to push through that, like, yeah, I'm going to do these heavy eccentrics and really push through it, or you know what's that guideline look like?
Speaker 1:Yeah. So, generally speaking, I think when people hurt themselves, it's this idea too much, too soon, too often, after too little for too long. Hey, I haven't run. In five years I'm going to go run 10 miles. My Achilles hurts. Well, I guess running is bad for me. No, what? How you did it was probably bad for you, but running is awesome.
Speaker 1:Um, generally speaking, when it comes to pain, pain is such a it's a hard marker for telling us what's going on, because pain doesn't always equal tissue damage. There's actually some good research around the Achilles tendon where, if you actually let people work into pain a little bit, the long-term result is the same as if you didn't let them work in a paint at all, which in my mind, tells me cool, because if I can still work you out, we can stay fit, we can stay strong, right, all those components. Now, if I've got a client in front of me who's literally their Achilles tendon is thickened, it's hot, it's a hot tendon, well, we're probably not going to go play basketball that day. I wouldn't recommend it because there's the risk versus reward. But getting some loading through there is absolutely safe. When I say loading like there are things inside of a loading, parameters we can use to help make things feel better, for example, go slower. Number two use isometrics. Like, isometrics do some amazing things for tendons. So if you've got someone coming in with a hot tendon, we're not just going to like sit down and rest. That's probably the worst thing you could possibly do, because then we just decondition.
Speaker 1:You do want to put some load through the tendon. The easiest way to start that process is isometrics. So we know 90 seconds to 120 seconds of total time under tension accumulative. So you could break it up into 10 sets of nine seconds a piece, or it could be one straight set. We know that helps now shift the loading onto the right part of the tendon that tends to degrade when we have a long-term tendinopathy.
Speaker 1:Other really cool thing about isometrics is they have an analgesic effect.
Speaker 1:So when you do them it actually reduces pain and it can actually have a lasting effect for an hour inside of a training session. So if I'm a coach and I have someone that walks in and they got a hot tenant they're complaining about, I'm not going to diagnose it, I'm not going to tell them what they have, but I can selectively use safe exercise to help still get them inside of a training scenario and actually probably get a better result. Versus just like feeling a little bit anxious and maybe scared because we don't understand it super well and thinking I'm just going to leave it alone until it gets better and then it never gets better. Versus we have an opportunity to do the thing, like right here, right now, so that could look like a split squat hold with a calf raise. That could look like the Smith machine not unlocked just where it is, two-legged calf raise, like we're pushing against an immovable object, and we can hit a few sets of that right after our warmup before we get into an actual training session.
Speaker 2:I love that and still today. I had a client the other day. They came in and they were talking about their Achilles and they were saying I need to ice it. And I'm like, oh, that's about 20, 30 years old, but can you talk to us a little bit about the old school rice mentality and how that's probably not the best anymore.
Speaker 1:So I'm still back and forth on that. I see the whole ice and everyone will come out that the doc that came up with that has now come out and said that was the wrong thing to do, right? So here's what we know about blood flow. Okay, blood flow is good, especially for tendons which don't have a lot of them. That's why they heal so freaking slow. Your muscle has much more, uh, capillary density, so there's much more blood flow inside your tendons typically just don't. There are certain parts of the tendon that have less than others. So general, general recommendation to put ice on it. Probably not great. Now, is it going to be the death of your tendon? Also probably not, because what ends up happening is your body has this thing called homeostasis. It likes its baseline. So what you find when you put ice on someone which constricts right all the vasocompartments, right, so we have less blood flow. But guess what happens as soon as you take the ice off? You get vasodilation. You actually get an improvement in blood flow. So I'm not a stickler on the oh my God, you'll ice it. You're a bad person.
Speaker 1:I generally haven't found it super useful. Ice is really helpful if someone has a lot of pain. Honestly, it tends to work better than heat does. Heat's going to bump up those free nerve endings. Ice is going to turn them down and you really have to ice it a lot to really do anything. That's going to be a bad idea. So I generally don't recommend ice.
Speaker 1:I feel like the whole idea of police, which I forget what all those stand for. But it's like protect progressively, overload, elevate. I like those things better. So if I've got someone with swelling, I think what we can typically do a little compression works really well. So compression sock is really nice because that allows the lymphatic fluid to continue to drain. Maybe we elevate that thing up when we're watching TV, maybe we'll put a little heat on it to keep the perfusion moving, to keep blood flow moving through. And then I typically leave it at that and, by the way, still walk on it, still use it like progressively, load it.
Speaker 1:As soon as you shut it down, it actually heals worse, meaning like we're going to put you in a boot, put you on crutches, not let you put any weight on it. But again, let's be real, there's got to be a caveat to this because people want to like yell at medical professionals for being too conservative. There's got to be a caveat to this, because people want to like, yell at medical professionals for being too conservative. I've had some patients that are just idiots. They do too much and I'm like I'm actually going to put you back in the sling, because if you don't have the sling, you're going to do too much, and now I have a hot shoulder.
Speaker 1:The same thing for tendons of the foot. Like I have a couple of good friends of mine who are really good podiatrists and I was talking to them about booting up and, like some of them will still recommend, like you need to actually offload for one to two weeks, and if you don't offload it, I know you're going to make it worse because you, chris, you're going to go out and run 10 miles every day when I told you not to, so put the freaking boot on for two weeks. So there's all these nuances that people have to appreciate, but nuances don't make for good Instagram captions and headlines and interactions. So we always have to take a side, even though a lot of the answers tend to lie just a little bit in the middle.
Speaker 2:And I believe that there's some evidence to support from a business side, at least from a trainer. You have a client say they do blow out their Achilles. They may take that mindset where I'm just going to not exercise at all for six to nine months, but you could still train the good leg and there'll be some carryover right with how that injured leg is going to heal.
Speaker 1:Yeah, the contralateral strength training effect is a real thing. So we have these things called mirror neurons. I like to describe it as if you have kids. This is how your one and a half year old can mimic you without knowing that they're mimicking you. It's like the monkey see monkey do Right.
Speaker 1:So we know, when you train an uninjured side, you get a 50 percent strength benefit to the injured side.
Speaker 1:So this again, coach rehab professional, it's like we need to do the uninjured side in training and rehab and it's not like sit down and use the pink TheraBand for three sets of 10. It's like heavy work because it's going to not only help decondition the side that's still available if you just sit down, but it's also going to actually help straight train from the central nervous system, the other side. And then I'm also like, by the way, do you have two arms that still function? Do you have a heart that still functions? Can you, chris, with a blown out Achilles, sit on an airdyne pedal with one freaking leg and arms and still get a cardiovascular effect? So can we actually use your injury as a gift to get more fit on all the other things which, by the way, is going to help you come back better and faster and more resilient and probably not hurt yourself again, versus the scenario you mentioned, I'm going to spend nine months on the couch. If you spend nine months on the couch, shut down what deteriorates Everything.
Speaker 2:Exactly. I think it's a pretty cool case example right now with Dr Arash from the prehab guys, because he blew out his ACL and he's going through some prehab for his surgery, and so I'm sure it's pretty similar If I were to. Unfortunately, that's why I'm against playing sports with myself, because I'm getting old and I want to blow out my Achilles. I'm not playing pickleball, but if I were to blow it out, say today, when do you think I'd actually get surgery? It might be a month or so, right.
Speaker 1:So there's a little bit of debate around how quickly someone needs surgery after an Achilles tendon tear. So if you are a regular human who doesn't really care about getting back to sports in a really aggressive manner, some docs and depending on the quality of the tendon, how big it is, they'll actually just put you in a boot and just let the thing kind of scar down and heal itself without ever needing surgery. If you are Jason Tatum, you're getting it that night Right or the next day. Um, tendons ligaments are a little bit different. The ACL uh, typically there's no rush unless someone's super unstable. But you do have to restore. You need full knee bend, you need the swine to be minimal and you need to get their quad back, especially with the ACL. If you don't get full knee bend, people get that surgery and they come out really stiff and they have a hard time getting their knee bend back. So the ankle tendon, knee ligament it's a little bit different on when we make decisions on when to get it done, but both of those things actually aren't required to have surgery on.
Speaker 1:There's good evidence now. The ACL maybe heals, heals itself. Some people stay unstable, though. So then maybe they need it. And then what are their goals? If you just want to run in a straight line for the rest of your life, cool, you probably don't need it.
Speaker 1:Um, what concurrent injuries do they have? How's the meniscus, how's the mcl, things like that? If you want to like return to cutting and jumping, then you probably should get it done, but even then, there's never a guarantee that it's going to solve the problem. Achilles tendon, though I had a few patients of mine who I saw for other things, and they had an Achilles tendon tear that was old, and they actually just got booted up for a couple months and just let that thing heal, and they just ran it that way, and I believe someone can correct me on this. I believe the long term outcomes are nearly identical for regular people and when I say regular people, I'm talking non-professional athletes Like if you tear an Aaron Rodgers, you're going to get the surgery done, like it's just. That's the mindset of pro sports, right, and that's fine. For the rest of us, though, there's some good evidence that, at nine months to 12 months, the surgery route and the non-surgery route are actually pretty close to each other like close enough that it almost doesn't matter.
Speaker 2:Yeah, that's crazy. Now, what about progressions, with talking about the thickness of the Achilles? Would there be some things that we could potentially, preventatively, do like to incorporate, like plials? Would these be something to incorporate?
Speaker 1:So I think we need three big things when I think about the Achilles tendon. You need generally good mobility, like tissues that are pliable and to be able to be in lengthened positions and tolerate being there. So what does that look like? Like calf, mobility is kind of important. There's a really classic can you put your knee forward over your toe at about three and a half to four inches? If you can't, well, we have some mobility that we have to work on.
Speaker 1:Second, strength of the achilles tendon through, yeah, concentric, eccentric isos, but really he's eventually getting to a lengthened position. So, deficit calf work with an eccentric emphasis, first meaning we slow down the eccentric and then progressing to an actual eccentric overload, like smith machine deficit up on legs down, battling with four plates on each side, like that is true eccentric overload. A lot of people call stuff eccentric overload. It's not, it's just eccentric emphasis. And then, lastly, rate of force development the ability to not just to produce force but to be able to do it quickly. So not that everyone has to be an athlete, but everyone should train like an athlete, because the ability to produce force, rate of force development is more predictive of injury and your ability to function than maximal voluntary contraction, ie strength is. So both of those matter, but having some pliability at speed on the ankle is going to be important. So something like pogos I think are a great way to start, something like split exchanges, split exchange, leaps right, this whole kind of files plus program that we're seeing out there with light tier, ping tier, medium tier, deep tier, which just speaks to how much knee and hip bend am I getting? All the light tier, ping stuff tends to work really well because it's very calf dominant. So it's just files are awesome.
Speaker 1:I do them, my clients do them, they're great as primers inside of a training day is like the first thing before we get to a bigger lift. But the volume, how we do it, we know the medicine, exercise, we just have to get the dosage right. And for plios, I think for most people less really is more and spreading those hits out through the week is a way better than crushing someone with 100 plyo hits inside of one session. You know, even with pogos, because people go like yeah, I got someone. They can't even control the pogo position, like what do I do now? What about just a fast calf raise, drop up on two, quickly down on one, like that. That is the start of some sort of speed. It's not plyo, because we're not having the stretch shortening cycle, but it's still the idea of incorporating speed.
Speaker 1:So I think the value of a coach is being creative to find what can I do to get that person to start. The other thing that I really like inside of that is oscillations, so I can oscillate in a split squat and kind of calf raise without actually having to leave the floor and then accept force on the way back down, and then we can put a handhold, we can use a band to assist. There's lots of ways we could categorize and think but yes, those three things Get mobile, get strong and then have some pliability and the ability to produce force, especially at length in positions, and then you've done your job. And, by the way, shit still may hit the fan, sometimes stuff happens right, but you would have done the best that you can to make sure you're in the best position possible.
Speaker 2:In regards to the mobility, I believe it has to be a fine line, because if you do have an athlete and they need that stiffness for that maximal force production, are we going to reduce that force production by giving them that range of motion? So where do we draw that line where I was a triple jumper in high school and my left side is significantly less mobile? Now it's probably something I would want to work on, but when I was, you know, 18, 19, getting that mobility, what are the thoughts on trying to get there?
Speaker 1:Yeah, actually right. I think the general evidence just tells us the knee should be able to go over the toe to about three and a half to four inches. There's a specific tibial angle that I have to look up and it's dependent on how long your limb length is. But I'm just like put down the VHS tape it's four inches this way, one inch that way. If you don't know what that is, that makes you and I both feel ancient. Or just get a tape measure. Go. That makes you and I both feel ancient. Or just get a tape measure. Go to.
Speaker 1:A half kneel need a wall about three and a half to four inches. If you are an athlete, high-level athletes need around five inches. That's it. If you've got more than that excessively, you probably don't need to stretch the ankle. If you have less than that, you'll probably need to stretch the ankle a little bit. To my knowledge, there isn't any evidence that I've seen that talks about track athletes, high-level Olympians, and like yes, we do need to be stiff, but there's this interplay between stiff and loose enough. I don't think anyone's defined what that is, so I always tend to default to. What do we know about ankles? Well, ankles should be able to dorsiflex knee over toe at, and around three and a half to four inches in regular populations, at around five inches for everyone else who are high-level athletes, and if we can hit that mark then I'm cool with it.
Speaker 2:Okay, and so then, if you did have that athlete who's at maybe two and a half inches, what would be some of those mobility drills you like to incorporate?
Speaker 1:So when I do mobility I really like to think of mobility as two different things. First one is take the brakes off of the central nervous system first. So before we try to move the car you have to take the brake off the car. So something like a foam roll, lacrosse ball Shoot you could lacrosse ball the bottom of someone's foot, just tap into the whole nerves that run up the back of the cap. I don't really care. You use the TheraGun. If you're a PT and you want a dry needle and use cupping, I don't care. It all does the same thing Control, alt, delete for the central nervous system. That should be quick, maybe a minute, we know a minute foam roll. You're going to get improvement in range of motion.
Speaker 1:Then, secondarily to that, when it comes to the ankle, you really need to identify one of two things. Is the joint restricted? So tib, fib, talus. So the ankle is kind of built like this right Medial lateral malleoli talus. Here Some people have this A normal ankle. This will spread and rotate and allow this to happen. So knee over toe, knee back, knee over toe, knee back. So I need to identify is this happening or do they just have a lengthening issue up the backside of the calf. There's an easy way to do that have them drop their heel. You feel it on the front of the ankle, the back of the ankle. If it's the front, pinching, that's a joint restriction. If it's the back, that's usually soft tissue. When someone has joint restriction they will also have soft tissue restriction. If the joint doesn't move, the soft tissue is not moving. It just helps me delineate. They need to do a couple more things. So foam roll the calf on both of those people Easy If someone has a joint restriction, that's an easy.
Speaker 1:Put your own hand on your ankle, push backwards a little bit and drive that knee over the toe. You can self-mobilize and then we can do a basic calf stretch. I don't really care which one you do. I like the one on the wall with the hip in extension, versus just the calves going down on like the slant board because your hip's not getting an extension and we calves going down on like the slant board because your hip's not getting an extension and we need a little bit of hip extension to put the calf in a very lengthened position. So my bias is the extended position. If they don't have this pinchiness, then you simply just foam roll the calf, stretch the calf. But also inside your training, let's use deficits Like if we really want to improve mobility. Foam rolling and stretching will never do that. Foam rolling and stretching gives you a gap of time to now load when we can load. That's the glue that holds down the fact that we would foam roll and stretch in the first place.
Speaker 2:Now could you potentially get that same effect without the foam rolling and the stretching?
Speaker 1:You honestly, probably could I have a bias? I like a little. I mean, I'm a therapist, I'm a PT, we touch people. Um, I like warming up tissues, the return on investment in time. It's like two to three minutes of time, so it doesn't take very long, but there is no evidence that, like foam rolling, improves performance at all. It's just a a bias that people will say because they want to use it in their system and they want to like it has to fit inside the system so transparently. No, you don't have to do that at all.
Speaker 2:I think that's great to understand is that there's a lot of trainers and coaches out there that will take this to the extreme and they're doing a 30 minute warmup session to make sure everything's optimally activated and like is your client really paying you for that? The full role for actually 10 minutes, like you know, exactly as you said, a minute, you know, and you'll probably be good, and then move on to the next stuff.
Speaker 1:Yeah, a minute targeted on one thing. Pick one area. That's limited, that's going to limit what you're doing that day. Target that you don't move on, you know. So we don't need to stretch calf quad hamstring, move on, I love it. So we don't need to stretch calf quad hamstring, glute, t-spine, like no, find one thing, bullseye it. One shot, one kill. Just figure it out and do one thing both sides and move on.
Speaker 2:Love it. So this is a ton of gold nuggets in today's podcast from Doc.
Speaker 1:And where can people find you and follow you? So, instagram at Dr Justin Farnsworth just my name, spelled out, and then I'll have links to all the online stuff that I do. The courses will be running here coming in the fall, which will be a big launch for me. Again. The course itself is called Programming Around Pain.
Speaker 1:I'll tell you this whether you are a coach that's been doing this for six months or 10 years, you're going to learn stuff. That's what education is all about is even the courses I've taken and at this point I think I've taken everything. You go and you learn one or two new things. You're like I found a new way to think about that. One concept If you're new, sometimes taking education is like drinking from a fire hose and it's so much you're just like I'm not sure what I'm supposed to do and we'll dive this down and you can come away with a few takeaways and then you implement the takeaways and all of a sudden, you gain experience with those people, experience with those pain points, and that's how you build your educational kind of background.
Speaker 2:And if you want some badass coaching, you also offer some mentorship, right?
Speaker 1:Yeah, so I work predominantly with movement professionals, so this is rehab professionals coaches. I provide purely custom one-on-one coaching and programming that is purely custom, non-templated work. So I have I think one or two clients are probably taken here in the next couple of months. The other piece inside of that I offer that I don't think anyone else does is the education behind. So you and I were talking before this call. Like every client I have speaks to me, talks to me multiple times a week and I actually video record their entire block of training and provide as much insight education as I can. So the people that invest in themselves and in me can make that three to four X back downstream in the education to their clients. So not only is it people crushing their own training and programming, but it helps you learn how can I use these same principles for the people I work with every single day.
Speaker 2:That's invaluable. So that's awesome. Check him out and thank you for your time today, doc, and we're looking forward to getting out to one of your seminars and meeting in person.
Speaker 1:Awesome man. Thank you so much.
Speaker 2:Have a good one.