The Show Up Fitness Podcast

Hip Pain Explained: FAI w/ DPT Coleman

• Chris Hitchko, CEO Show Up Fitness • Season 3 • Episode 231

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Doc Coleman, a physical therapist specializing in athletic rehabilitation, takes us deep into the misunderstood world of hip pain—specifically femoral acetabular impingement (FAI). This condition affects countless young athletes but is frequently misdiagnosed as simple IT band tightness or dismissed because of the misconception that hip problems only affect older adults.

With surgical precision, Doc Coleman breaks down the anatomy of hip impingement, explaining how bony buildups on either the femur (cam) or pelvis (pincer) create friction that can damage the labrum. The telltale signs are unmistakable once you know what to look for: C-shaped pain wrapping around the hip, pinching sensations during deep flexion, catching feelings during normal activities like walking, and discomfort with prolonged sitting.

For fitness professionals, this episode serves as an essential field guide to navigating hip pain in clients. Doc Coleman offers clear guidance on which movements to modify, which mobility exercises actually help, and most importantly—when to refer out to a physical therapist. His approach emphasizes that conservative management through targeted mobility work and glute strengthening can be effective, but only if you're seeing improvement within 6-8 weeks.

Perhaps the most valuable takeaway is Doc's passionate plea for greater collaboration between trainers and physical therapists. "We're not trying to take clients from you," he emphasizes. "I want to get them better and back to you as quickly as possible." This partnership approach benefits everyone, especially clients who receive comprehensive care tailored to their specific needs.

Whether you're a fitness professional working with clients experiencing hip pain or someone dealing with that mysterious catching sensation yourself, this episode provides clarity on a condition that's frequently misunderstood and mismanaged. Connect with Doc Coleman on Instagram at Coleman PT Performan

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. Howdy everybody. Welcome back to the Trail Fitness Podcast. Today we're here with Doc Coleman. He has his coast-to-coast physical therapy. He's going to be out in Long Island, but we met in the greater San Diego area this big hunk. He knows everything when it comes to physical therapy. So thanks for taking the time today, doc.

Speaker 2:

Yeah, of course. Thanks for having me.

Speaker 1:

And so we just want to chat a little bit about that issue. We had a client who came in and they had some FAI and we wanted to kind of dissect that from a pathology standpoint and what's in the scope of a trainer, and then maybe learn some exercises and stuff that would be appropriate and when we would maybe need to refer out to the professional, like yourself.

Speaker 2:

Yeah, yeah, fai, or femoral acetabular impingement super common, super common in younger athletes as well. I think people think that hip issues are just something for older people. And no, I'm too old to have hip problems. But FAI, in particular, and when it kind of seeps into the labrum, are definitely a younger, you know, 17 to 35 year old population type injury. So, um, you know, it's definitely not something where it's. You want to ignore it because you're having hip pain and you're like I'm not old, I don't shouldn't have head pain. Um, so yeah, and it's, and there's definitely a slippery slope between conservative and surgical approaches too. So happy to kind of dive in and clear some of the muddiness.

Speaker 1:

I know we like to simplify stuff today and the client. First thing she said was oh, it's my tight IT band. And I was like, well, did someone actually tell you that, or were we looking on Instagram? Where are we coming up with that terminology? And so is there a way to? Obviously trainers wouldn't do this, but is there clear cut symptoms that someone would present? That would be FAI. And then what could we do with that?

Speaker 2:

Yeah, I would say it's a wide, wide variety. I would say the people that I see mostly are young athletes. So I would say, um, painful flexion, you know painful deep flexion, deep squats, um, single leg stuff like lunging, you know, and typically it's it's, it's deep, it's anterior, you know it's across the front. Or people will describe this kind of C-shaped pain where they kind of grab their hip from the side and they kind of wrap their hand around Right. So a lot of times it's, it's a symptom location, but um, so that C-shaped kind of around the hip, particularly in the anterior or the front part, pinching, blocking sensations, pain with prolonged driving, prolonged sitting where they're flexed and it's prolonged in that position.

Speaker 2:

Senses of instability, you know, if you feel like that hip catches or locks, those aren't great symptoms. We love Going downstairs. If you feel like that hip catches or locks, those aren't great symptoms. We love Going downstairs. If you feel like, yeah, I just want to when I'm lowering myself on that leg, I just want to grab onto that railing, I don't feel very, very strong and secure. Those are kind of like the yellowy flags that we hear from people as far as like the IT band goes. Yeah, I mean that's going to contribute to that kind of that lateral C shape area, but you probably won't have a lot of those symptoms I just mentioned with with something in the soft tissue like that.

Speaker 1:

Yeah. So I have definitely heard clients talk before like when I'm walking, it like catches, and I've always been told like, oh, that's not a good sign, is that we're not diagnosing? But is that like a labral tear or is maybe a little, because in the shoulder you get your slap tear? Is it kind of similar in the sense in the hip? It's like maybe there's a little lesion or something there that needs to get an MRI. Or what would be your recommendation for a trainer who has that client who comes in? They say, yeah, it's common. I'm walking throughout the day and I get like this little hiccup and like I can't move my leg forward and that's like, ooh, that's not good. Huh, yeah, I don't love that.

Speaker 2:

I don't love that. That kind of mechanical catch again could be a few other things right, you could have that internal snapping hip, that, that psoas and that hip flexor kind of rolling over that, that bony prominence in your hip. So it doesn't always have to be a red flag, but yeah, anything where it's mechanical and it's a clunk or a catch, especially with something normal like a walk, a sit to stand, you know, a transfer from a chair or out of the car, those are definitely signs where you want to refer out.

Speaker 1:

And you get the blame of the psoas. Everyone likes to point a finger and say, oh, it's your psoas, you got to release it. And then they're doing some crazy barbell into your you know inguinal ligament right there. That's a little aggressive. But what would be some suggestions when it comes to soft tissue stuff that you would want to maybe to try if you don't have that catching stuff?

Speaker 2:

Yeah, I mean, try it. You know what I mean. Like you're, it's you, you, you have to have more than one trick, though, right? So if you are having this, like I just worked out, and it's very acute and I feel this hip pain and it's catching, what the heck is going on, yeah, hop in there, get the, so right, and you know, kind of, get the lacrosse ball, get into your tfl and the side of your glute, um, and it should be a quick fix, right? So if you, if you're doing the quick fix and it's not a quick fix, then then that's not the problem, right? So, you know, it's, I'm totally fine with people hopping on a film roller or the so-right, but you know, um, there are lots of other things that can be contributing to the pain, and, and that's just one of them. So, by all means, try it. But, um, yeah, there's definitely other mechanical issues going on that that you want to dive into too.

Speaker 1:

And to really break down the actual diagnosis of impingement. What is that referring to? Because you know, I know there's space in the shoulder, but is there actually like, is it ligament, is it capsule, is it? You know what's going on there.

Speaker 2:

Typically it's bony. So what will? What will happen is, um, I always compare it to like, you know, your, your body responds to stress, friction, right, so, and the hip is robust, it's constantly kind of made to to brace impact. You're doing deep squats and it's rolling and it's it's being compressed by big muscles like psoas and glute. Um, so it's response.

Speaker 2:

You know, any, any area in your body is is either going to blister, it's going to callus right, Just like your foot right. So why, why do I develop a blister on my big toe on one side and a callus on my other foot? I don't know, but the callus kind of idea is that I is that friction creates the, the bone to start to calcify and build up to make it a bit more strong and secure from all the friction. Right now it doesn't quite know that when you go into this, this hyper flexion and rotation to positions, if I've got this bony buildup around that femoral head and femoral neck, I'm going to create more pressure and more impingement into that articulation and what typically can happen is you can have that bony buildup.

Speaker 2:

We call them either cam impingements, when they're built up on the femur, or a pincer impingement when they're built up around the pelvis. You can have those and live a perfectly normal life, and that's kind of where you'll hear this conservative approach kind of style. But what can happen is if you get this perfect recipe of that's happening and I live a life that does it a lot and my sport requires it a lot and I start to get micro tearing into the cartilage and the labrum that secures the hip, that's when you're going to create pain and compression and even instability in the hip. So that's kind of when you get this perfect recipe of a bony buildup creating micro tearing to a typically strong structure and when that integrity is disrupted, you're going to have problems.

Speaker 1:

And so is it actually like calcification, so they need to go in there and like surgically, like laser it off and stuff like that.

Speaker 2:

Oh, yeah, yeah, they'll do, um, they'll do what's called an osteotomy. Well, they're going, they'll, they'll. They'll usually arthroscopically three little incisions kind of like in the front side of your hip, but go in there, they'll repair the labrum. So it does peel off and fray quite a bit. So they got to kind of reattach and so, um, but if you, if you do that and then you get someone through rehab, well, guess what? They still have that big bony buildup. So when you get to those late phases of rehab, they're going to re-tear again. So what they'll do is they'll, they'll go in and they'll shave, they'll do that osteotomy or that, that bone shaving which is typically the a lot of the painful part of the surgery. And then that's when they're they're trying to kind of restructure and shave that hip. So now it's got room to articulate and breathe and it protects that new repair.

Speaker 1:

And so are there things that we could potentially be doing and let's not talk about the surgical aspect, but prior and not saying that they need surgery, but it's like, are there distractions or things that we can do to maybe open up the hip, so then movement can like re-engineer the optimal, you know neuromuscular control, so that we can avoid that?

Speaker 2:

Oh for sure. Yeah, I would say you know we love the banded hip mobs. You know you hop in that big, thick kind of rogue resistance band and and you know, from there you can do a lot of things, things I love to kind of get into a deep lunge and, you know, pry the hip open and close into er and ir rotations. Um, you can definitely like. You know anytime that you, from a conservative standpoint, anytime you're bringing the hip into multiple planes of motion. So before this podcast, you and I talked about the 90-90 position, right. So I know we're kind of getting ahead of ourselves, but you know, that's kind of when you'll feel like if I'm flexing this hip and I'm driving it a bit more towards midline or towards my armpit, there is like a little bit of, as you can see, like a bit of a rotational component there, Right. So you know, typically people will say like this feels pinchy, that feels great though, Right, when I can open it up and get that femoral head away from my acetabulum. So I always say that the biggest thing for people who are dealing with this pain is is listen to it, live within that constraint, right. So you know that that 90, 90 position, flexion, internal rotation right. So you can do flexion and find comfortable positions and you can do internal rotation into comfortable ways. That's still very nourishing for the hip. So if you're feeling that kind of bony block, you know, listen to it. If you a position and you're like what am I doing? Right now I'm in a, I'm switching from flexion and rotation but and I'm feeling that anterior c-shaped pain, get out of it, okay, right, there's plenty of other ways to mobilize the hip than that specific drill, even though it looks and feels cool sometimes. So that would be the biggest thing.

Speaker 2:

And then from there there opening up the glute, getting the TFL and your glute kind of opened up so it's less compressive for that cam and pinchment. And then the biggest thing is just getting that glute nice and strong, whether it's hip thrust, banded bridge, comfortable ways where you can kind of just feel the glutes activation stabilizing posteriorly. A lot of times it alleviates even immediately that that pinching and that compression you feel in the front of the hip. It's just one of those things. Yeah, it's, we just know it's referred to. The cam is the, is the version where it's? It's. It's typically kind of in that space between the, the femoral neck and the femoral head. So that's kind of where you know. This is where my acetabulum sits here and I start to rotate. I'm going to get all that friction in through that cam impingement. Can you kind of coach?

Speaker 1:

me through. If that internal rotation is irritated, is there a point when you want to have a little bit of discomfort, or is that completely? Stay away from that? Work more on just the external part until it feels better and then maybe in the future we can get deeper into that range of motion. Yeah, I would avoid it.

Speaker 2:

I think I think, uh, and like that's and you know me right, like I'm, I'm very much like no, we're going to, we're going to push it through, we're going to get you through this and we're going to work, and you know, and a lot of times it's just like no, you just need created exposure to just like back off. Do it this way. No, I would. I would say, when it comes to these issues, like we're talking about how complicated it is. Um, you just don't really know exactly what's happening in there, sometimes until it's too late. So oftentimes, by the time you start to feel a symptom, the damage is done.

Speaker 2:

The reason you're feeling a symptom isn't because there's a bony buildup. It's because of the steps it took to get to there. So, and because I've seen so many hip labrum injuries and I've seen so many pre-op and post-op and look up the research the outcomes are not phenomenal for these surgeries. Um, it's one of those things where I'm just not cavalier, but you know, it's very much like nah, stay out of it. You know there's a better way to do it. If you want to open the hip up, like, we'll find an avenue that like does the targeted movement that doesn't bring you into that compression, not demonizing internal rotation, I am just demonizing dynamic, multi-planar movements that you might be doing in a yoga or Pilates class that you feel a pinch and I'm just not as okay with that pinch as I am in, maybe, like, say, someone's ankle or their shoulder, with a range of motion. Because of that reason it's a robust joint that when it's talking to you, when that light pops up on the dashboard, you want to listen to it.

Speaker 1:

Exactly so. If you're listening to this and maybe you do the 90-90 because you think it's a cure-all for everything and that internal rotation irritates you, listen to your body and so if we were to look at a squat, say and I have a client right now that when she does squat past parallels she feels that pinching in there. So the suggestion I said is just limit your range of motion and then work on some of these banded mobility drills and then could we say that maybe in the future she might be able to get down. You can maybe try it with like a goblet variation with lighter load, but don't always try.

Speaker 1:

It's always fun to the pain when people but they'll get down, like oh yeah, it's right there. Like stop doing that, don't keep on going into that discomfort. You know, let's let's get the brain to recognize that maybe we need to work on our squat mechanic a little bit and work on these drills and then in the future, a couple of weeks from now, we can try it again. But let's not keep on going into that and it's pissed off for a reason. Listen to your body.

Speaker 2:

Yeah, exactly, I think that's a perfect example of like, what we like what we do here. Right, that someone comes in with that complaint deep squat lunge. That complaint, deep squat lunge, pinching compression right, it's like, well, let me. Part of our evaluation process is well, let's get on a table. I'm going to put you through these things that you know that we test the labor and we test the hip flexor, this and that, and if everything's actually, that's great, this is really good to. Range of motion is really good. No compression here. Let me see your squat. Okay, let's try this and this and this. Now, how does it feel a little bit better? Great, here's how we do it, right. So it's.

Speaker 2:

It's more than just like, oh, like, I have pain. Here's a stretch. Right, there's a, there's an avenue that pushes us in a specific direction. So that game plan that you just mentioned is perfect, right, like. If it's just something where it's like today it feels stiff, well then, yes, you know, grab onto the rig and sink into a deep squat, hold it for a few seconds, do some squat pauses. Yeah, it feels way more open now, great, right.

Speaker 2:

But if it's a chronic thing, if you know that, like over the last X, many years. It hurts when I get into hyper reflection of a deep squat or even months. Listen to that. You know that's. That's not like an, like an I'm having a bad day type of symptom. That's a structural thing that you want to dive into. And, yeah, you might have that kind of avenue where it's like, oh, it's actually maybe a little bit pinchy, but you know it might not be as bad. As you're ready for an operating table, let's try some of these drills. And over a three to eight week span, I want to see it open up and get a bit deeper, right. So I think that approach is is perfect and again, like there's just always have that that kind of feel where it's like these are my modification, this is my workaround. You know I can avoid it for a little bit. It should get better. If it doesn't, it's no longer. It's no longer in your realm of scope. Right, and see a professional.

Speaker 1:

And what is that timeframe? For it doesn't get better. My client comes in. You know you have some resources. We've gone to like the prehab guys page and I was looking at that like they're doing some airplane variations on there and it's like frontal plane stability, so maybe that helps with the socket and stuff. When would you, as the trainer, be like okay, it's been a, is it a week? Is it a month? What? What is that timeframe If they're implementing some of these, these quote unquote correctives that it's not getting better, that you want to refer out?

Speaker 2:

Yeah, I think you know, at that point you're you're not diving into the pathology, you're diving into correctives, right, like you're trying to, you're opening up the capsule, you're you're you're strengthening the glute, you're accessing more hip internal rotation in a more comfortable plane where the hip airplane is a great, a great drill.

Speaker 2:

Um, relatively quickly, you know what I mean Like six to eight weeks, right, cause, again, like you're not, you're not trying to fix the, the pathology, you're trying to. You might have a known pathology and if the, you know if you can improve strength and range of motion and flexibility, like, how long does that take? Right, if you give me good, you give me good six to eight or eight to 10 ish weeks, I should be able to make a physiological change in some of these, this healthier tissue, right. So now, from there, you know that's, that's what you want to see, like improvement, perfect and and progressions are different and that's different for everybody. But you know you, you want to have something objective, like a deep squat, that you're able to test. Right, have a corrective or something you're going to implement and then retest If it's not better than you're on the wrong track, right. So you know it's, it's always about listening to it right Now.

Speaker 1:

do you like to progress? I know it's probably a case by case, but do you like to progress more off of reps and volume or intensity? So let's say you come in and those airplanes are working, they feel a little better. Are we going to want to put a band on there? Or do you want to do more sets and more volume?

Speaker 2:

Yeah, I like to keep it a bit more like fun with my clients too. So like if I'm doing, if I'm doing one drill for like I'll probably progress duration and duration first, just to make sure, like that specific tissue tolerance, keeping it simple for the neuromuscular system, system is is just adapting to something that's measurable, right. So if I can do it for 10 seconds, I can do it for 20 seconds. I'm progressing well, seconds, I'm progressing well right. Then once I add a band, that's gonna that switch kind of changes and I'm gonna revert back a little bit.

Speaker 2:

For me in my practice I'm kind of that way and like I I probably won't just make the same drill a little bit harder, I'll probably implement like a new drill that was like hey, remember that hip airplane? Well, guess what? Now we're gonna do this like 3d, with a band around your chest, lunge where we're now we're adding flexion and rotation into that system, right. So and that, and I think that's just, that's literally just. You know, that's that's the beauty of, of what we do is every person, every clinician and coach and trainers, has their own little unique flavor to the, to the science, and that's where the art and the science kind of meet.

Speaker 2:

So so, personally, I'm like a I'm more of like a duration intensity progressor, and then, when we're ready for to work for a little bit of a revamp, I'll probably make the system, you know, work a little bit harder in a different way, cause, again, I'm my goal a little different than than maybe you or a fitness professional. I'm trying to get you the hell out of here. You know what I mean. Like I'm I only want to see my people for for 10 weeks, 12 weeks, maybe even shorter, right. I want to get them back to you where you can work with them on a 12 week, a 16 week, 24 week periodization block, right. So so, for our goals are also a little bit different too, right.

Speaker 1:

And I think that's what's great about the process that we have is I'm a great trainer, but when it comes to that stuff I have a couple of little tricks and if those tricks don't work, I refer out pretty quickly within a couple of sessions to go get it. Cause it's just you're expediting the process, where I know that the trainers can get their ego and they're thinking well then, let me try it for the next six to eight weeks. And you got to remember why we got into this to help people. And if the couple correctives that you're implementing aren't working, then you can make the process go a lot faster, because the therapist is the expert with pain management and getting them out of there, and then you communicate with them.

Speaker 1:

You implement it, because it's kind of like throwing shit on the wall If you try to just throw a bunch of exercises and you don't really know why you're doing it, because now maybe you're doing too many exercises, which I think is obviously it's a tissue capacity thing. But you have, you know, a banded distraction with flexion. You do the banded one with external rotation. What is that point where maybe it's a little too much? Is it usually suggested one or two exercises? You know, eight to 10 reps or so, or what are the recommendations there?

Speaker 2:

Yeah, for something like that I'll. I'll probably I'll try to do a little bit more of a longer duration. I'll probably do like three 20 second holds. You know, I think with a lot of soft tissue, you know your goal is is maybe around a hundred seconds. Okay, it's like you know that's that's like kind of like a you know there's lots of research kind of you know kind of the barriers from that. But, like for my, my patients who are dealing with pain, my goal is to work them towards a hundred seconds. That's kind of like where lasting change will occur. So, like you know, that could be 10, 10 second holds, that could be five 20 second holds, right? So I think the longer you do anything, the more you're going to peak into a disruption of tissue, right? So if you're like, oh yeah, do a pec stretch for three 45 second holds, Well, guess what you take someone with, like a bicep injury. That's going to really hurt them, right? So, same, same idea here. Like you know, you want to build them up, but they also have to have an entry point into pain, right? So I think that's a big difference between what we do, whereas I only people who are in pain walk through my office, right, so of course I'm going to give someone a TheraBand or you know some, some stretching first, right so? So for me we're starting people off on a very different spectrum, you and I, right so that's always. My goal is a hundred seconds. How can I kind of get them there Once they can tolerate three, four, 30 to 40 second holds. That tissue is doing pretty darn good, right, so that's usually my prescription for those types of things.

Speaker 2:

And to go back, to go back before about kind of what you said, you know how long should, if I'm doing these workarounds, how long should it take Right now, these hip labral issues and fais are these are sometimes like months in order for those to kind of heal the?

Speaker 2:

The six to eight is kind of what you're you're mentioning now, where it's like, if there's nothing wrong with me, how long should it take to get better right, like, like that's kind of what you want to see.

Speaker 2:

So it should be quick, right, even for the, for the, for the coaches out there, like if you're doing something and you're your athletes been in this workaround phase for months, like they're officially getting worse right, like if you're not progressing, they're getting weaker, right, so you know, that's that's the biggest thing for my athletes too is like, oh yeah, like I, I just, you know, I, I just do dumbbell, chest presses instead of the barbell hurts me.

Speaker 2:

It's like, well, well, guess, guess what, like, if the getting the barbell bench press is a goal of yours, like you've been getting weaker for the last six months, like it's just you know where you can't press at all, so as you back exercises, it's like, well, now you're just very imbalanced. Like we can't just live in one, you know, in one plane going posterior, right. So so for the fitness professionals out there, that's kind of is a good thing is like what you can do, what you can provide in terms of workarounds and well, I fixed that person up, it wasn't their labor, it was just their glute or their tfl. It's like that should be quick, right.

Speaker 1:

It's like, once they're in that phase of of not normal pattern programming, get them out and refer them out quickly, you know that's one of the things we're really great at is connecting with therapists and so for maybe, a trainer that hasn't gone through our certification. What would be a nice way for a trainer to reach out to you and basically say that I got a client who we're not diagnosing it, but there's some hip issues. Can I refer them into you and can I shadow a session? What would a professional reach out look like for?

Speaker 2:

you Text or a DM. Honestly, we're so open to that. I've had dozens of PT students fitness. A bunch of your students have come in to shadow me and pick my brain. So that's what we want. We want to communicate with the people who are on the front lines, like coaches at classes or personal trainers. That's what we want. We want to communicate with the people who are on the front lines, like coach you know, coaches at classes or personal trainers, like you know. That that's what we want. We want to be able to collaborate. Like we're not trying to, not try to take them from you. You know what I mean. Like it's like I just said before, like it's very much like I want to get them back out and and even from a business standpoint, get, get out and tell your friends about me, right. Like, like nobody wins if, if I take them from you and they live in rehab forever, right? So I think just this, you know this, this duality of like, trying to make sure that we're on the same team. I think that's the biggest thing too.

Speaker 2:

And and I was unlike a lot of PTs, I was a personal trainer for years before I was a PT. I've been there, I've been the. I've been the personal trainer where I'm doing upper body work and someone's like yeah, you know, last week's shoulder day kind of busted me up. I'm actually still a little sore from it. I'm like, okay, let's modify. You know what I mean.

Speaker 2:

And like I look back at that time, 10, 12 years ago, and I'm like, what were you doing? You were so worried about keeping that client that you, you, you, you did a disservice to them. You know like, and that's me. I can literally look back at myself and say that. So there's I'm sure there's lots of trainers out there saying the same thing, like now, on this end of it, like I wish I had a Instagram and a and a, an open PT. That was like, oh yeah, the guy, he's a strength guy, he kind of gets what I do. So we're out there, just reach out to us, communicate with us. And you know like, no PT is going to be gatekeeping in that sense of like trying to take your client. You know it could be a good relationship and I think you and I have proven that.

Speaker 1:

I think it's unfortunate because, you know, when we do our seminars, you and I have proven that. I think it's unfortunate because when we do our seminars, I always ask there's 30 trainers here, how many of you have a physical therapist who you could reach out to right now and get some feedback? And it's always zero hands. And that's unfortunate because it's only going to make you more credible. It's going to be a nice little referral network that you have and if you're going to go pick a doc's brain, bring him some goodies. If you're going to go shadow, doc, what do you like? Do you like cookies? Do you like whiskey? What are some things that you like, doc?

Speaker 2:

Both cookies and whiskey. Yeah, I would say that.

Speaker 1:

There you go, and that's only just going to be the little cherry on top. But go that extra step because it doesn't happen very much. You don't have a lot, don't be? You know? You know making the session about you. You're just there with a pen and paper taking some notes, maybe ask some questions later. Hey doc, can I take you to happy hour to kind of pick your brain on why we did that?

Speaker 2:

It's my treat, you're just going to gain so much credibility in that professional's eyes, where, unfortunately, a lot of trainers don't have that professional outlook because we're hurting people. Yeah, yeah, I would agree I think early in my career I can definitely speak on that to where people we're getting hurt in the gym, right, I mean you're which is something I talk about with my clients a lot too Like you're doing something extraordinary. You're a one percenter if you're in the gym four days a week, right. So there's a very thin line between helping and hurting, right. So like it's, yeah, there is bad programming, right. So if you're doing due diligence to be more learned in your skill and in your art, then I'm talking to you, right, and if you're not, then I'm not talking to you, right. So you know it's not, it's not a problem to get hurt, it's a. It's a problem to not listen and to and to not have an outlet and someone to reach out to. So I think on my end yeah, it was a little bit skeptical for me to kind of be like oh, wow, like another person hurt at a gym, you know, at discharge, I'm going to be like you know what? Here's your band workout and here's this and that, here's how you're not going to get hurt again. Well, that's not a good game plan either.

Speaker 2:

Right, and that was kind of me in network and I don't have the accessibility and the network that I had, that I do now, right, so now I go to these gyms, I do kind of what you're saying trainers should do. I go to to studios and I go to to. You know, I have class pass, I take these classes, I network with the trainers at orange theory and this and that. And when I get a client in here, that's like, yeah, you know, like I'm I'm a big time runner, but I I don't know anything about strength training and you know I I'm wanting to train for half marathon. That's not my job. My job's over. Go to Tempo, go downtown in Little Italy and check out Tempo and these trainers that are there. They're freaking great run coaches. It's like I want to get back into bodybuilding. Here's a trainer at the compound that I love. It's like I've made the network myself. So come talk to us. We want to have the network of people to talk to.

Speaker 1:

There's a common question that I would get from trainers is how do you look at the or navigate the PT realm of finding a therapist? That's maybe more pro movement, because there are some it's not to knock therapists, but there may be some that see 15 patients in an hour and so the, the, the client clinical experience may not be optimal. So is there. I know that you have a background in sports. You work with athletes. That's usually what I look for is like does someone have some type of uh, it's not an internship. What's the next one you guys do after you get your DPT?

Speaker 2:

You can do what's called a residency, you know, and you can get what's called um, your OCS, your um orth, your orthopedic clinical specialist, which kind of just makes you a bit more up-to-date on current research and application of best practices. Unfortunately, there isn't really that exists. You have to do your homework. The OCS is great but, just like anything else, you can have initials next to your name and suck Right, so you know it's just a test, right, so you can pass a test and study hard and work hard to get the OCS. But doesn't it make you a good clinician to athletes Right? So, first and foremost, I would say I think Instagram has been great. That's what I use Instagram for is to you know it's. It's not to show me, it's to show my athletes right. So my athletes in here, who do I work with, what's their injury and what do I do to fix it. I think people see that and they they go. That's me. I can do that. That's what I want to get back to doing and that's been great.

Speaker 2:

If that, if whatever you're doing isn't showing, say, your doc refers you to blank physical therapy because it's in network and it's closest to your zip code. That's how that works. To be honest with you, they don't know who they're sending you to. That's just the way that that works. So you have to do your homework. Go, go there and check it out. Walk in. They're going to say can I help you? And you say, hey, you know, I got referred here for physical therapy. Do you have an appointment today? No, I just want to come check it out. It's like, okay, that's weird. No one ever does that. But from a PT standpoint, I might see you and go can I help you? I'm looking to do PT here. Come on in, I'll show you around. This is our gym, it's our clinic, it's our cable machine. You know, here's my card. I can chat with you later. That would happen once in a blue moon. But that person I maybe. I never saw them again and that's because I wasn't the. I wasn't there. They're cut. You know what I mean. That's fine, right.

Speaker 2:

So call, ask them how many ACLs do you treat a day? You know how many? How many hip labral repairs have you seen in your in your career? I can say I've. I've treated hundreds. That's very, very rare.

Speaker 2:

Hip labrums that, to get back onto on topic, are a very rare thing to treat because they're often misdiagnosed, they're very you know, it's, it's very much as like a conservative management thing for a while and and they're tricky, right. So for for a PT to, to seeing a couple dozen is a ton, you know. So you know you have to ask the question. You have to know, you know, and hopefully the PT is being honest. But if you walk in and you're a 24 year old, former collegiate basketball player dealing with a nagging patellar tendon issue and you still want to hoop, and you walk in and it's just nothing but treatment tables and bands and Mildred and Frank and Henry on the table hanging out getting stretched and doing ultrasound probably not going to be good for you, right. So you know it. Just, it sounds like common sense, but do your due diligence. It's, it's a serious thing and it's, it's expensive. So you better be in the right spot.

Speaker 1:

That's probably some of the best advice I've ever heard. So now at least trainers have a good avenue to start to find some qualified PTs that you can link up with, and it can be a really fruitful relationship, like we've shown here. So where can people find you, doc? You?

Speaker 2:

can find me on Instagram. You can find me on YouTube Coleman PT Performance. We have our own business here in San Diego, coast to Coast Physical Therapy, with Teresa Berg. She's my co-owner. Right now we're in San Diego and, as Chris mentioned, I'll be moving back to the East Coast in a couple of weeks. We'll be setting up shop in somewhere on the East Coast, either New York, new Jersey or Pennsylvania. So follow me on Instagram. I'll be sharing that journey across the country and how we set this business up. But, um, right now, in the in the San Diego area, you can work with myself or Teresa. Um, I also do some virtual work, so shoot me a DM. Um, very accessible there. Uh, either on that page or my my business page coast to coast PT.

Speaker 1:

Love it, doc. Thank you for your time today and we'll be chatting with you soon.

Speaker 2:

Thanks guys, Appreciate it man.