Should you ICE an injury? Think about MEAT w/ Dr. TeBos

IG: dr_tebos Physical Therapist in Kentucky. 

Most people treat an ankle sprain like a simple checklist: rest, ice, wait, repeat. That advice can feel comforting and still be wrong for your recovery timeline.

We sit down with physical therapist Dr. TeBos to unpack what ice actually does in the body, why inflammation is a normal part of tissue healing, and how pain relief can sometimes compete with the adaptations you want. We get specific about when icing makes sense (especially in the first 24 to 48 hours for pain modulation) and when “icing it just to ice it” can slow the process by limiting blood flow and the cleanup work your body needs to do.

From there we move to a more useful model: MEAT (movement, exercise, analgesics, treatment). We talk about how to keep an injured area safely moving without overloading it, how compression and elevation can help when swelling blocks joint range of motion, and why post-surgery swelling can shut down muscle firing through arthrogenic inhibition. We also tackle the hot topics people argue about online: contrast therapy, ice baths after lifting, and the tradeoffs if hypertrophy is your goal.

Finally, we dig into why ankle sprains are often a proprioception and nerve problem, not just “loose ligaments,” and why boots can backfire by creating fast weakness and dulling the feedback you need to return to sport. We close with real talk on how trainers and physical therapists can collaborate better, and what a good referral relationship looks like.

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Transcript

Why Trainers And Therapists Differ

SPEAKER_00 0:00

Howdy, welcome back to the show of this podcast. Today we have Dr. Tabas. How are we doing today, sir? I'm doing great. I'm excited to be here. I think you're in Kentucky, Frankfurt. Yeah, uh proactive. Proactive. And we were having a great conversation prior to this. And I was saying that I think the the biggest perfect example of the difference between a trainer and a therapist is look at that anatomy. On the back, we have kind of generic 20 muscles, lower body. Back there, you got the deep, deep thoracic region there. You're getting into origins, insertions, nerve stuff. That is the difference between a therapist, qualified movement experts with prehab and rehab. And that's what we wanted to bring you on today to debunk some of the information out there. It's still being a run wild. Where talking to a client the other day, like, Oh, I sprained my ankle, I need to ice it. I'm like, uh, not that straightforward. Yeah. So the old school rice, rest, ice, compress, elevate, where are we at with that? And and let's dissect that a little bit more, pun intended.

SPEAKER_01 1:01

Yeah. So I think what we were talking about a little bit before is like everything tends to be black and white. People try to fall on like a very strict line of, oh, this is good, this is bad, they do everything a certain way. And I think ice kind of gets in the same way where people for a long time have iced everything. And you know, because it helps with pain, and it does, and that's not objectively wrong. But I think, like, you know, as what research has shown us, and logic is that it's not the best way to heal. And I think that kind of comes down to if you think about it very simply, is that it reduces inflammation. But the body, after an injury, inflammation is very much part of the healing process, and that has to happen. So I think that's where it's like it's not as simple as just ice it all the time, no matter what. Now, can I still be used? Yeah, but it's not the end all be all.

SPEAKER_00 2:00

I'm gonna put you on the spot bringing me back to my physiology days. Phagocytic cells, they go down there, clean up some cool shit, and then they bring it back. But the central pump is the lymphatic system. And so that's the whole thing. I always make a joke, you jump into cold water. Guys don't like doing that because everything shrinks up. So we get that vasodilation, and it's not optimizing for sorry, vasoconstriction. It's not optimizing for the healing process and getting it out and allowing for the optimal process.

When Ice Helps And When It Hurts

SPEAKER_01 2:29

Yeah, so it's like if you think about it, blood generically carries all those things that you're talking to the area, and it's also what carries all the waste product out after healing. So what ice does is it, like you said, it constricts all the blood vessels, which if you get into like um substance P and what causes pain, like you could put a lot of your uh NSAIDs in the same category, right? Like they inherently stop inflammation. Inflammation is what causes pain at the time, right? A lot of times. So you can ice can still be utilized, especially initially, to help mitigate some of that pain response. And it's usually what a lot of the research is showing is inside the first 24 to 48 hours, it's fine because it's it's helpful in reducing kind of that major inflammatory response and that'll help you to lower pain without needing to, you know, use NSADS or other things that are a little more extreme. So I would say there's still a value to ice initially, but what I wouldn't do is continue to ice it all the time just to ice it, you know, because you want you want a lot of that vasodilation after the constriction in order to enhance that healing response, that inflammatory response to keep blood moving through it. And that's where I think I mentioned in the post that you reached out to me is like instead of using rice as an acronym, using meat, which one of my um former teammates actually, uh Dr. Richher, who's also a great fellow on Instagram, uh, that's where I first heard it. And it's movements, um exercise are eccentrics, and then analgesics, and then treatment and therapy is kind of the best way to do, especially like ankle sprain is kind of the most common ice thing. And what what you mean by that is like the most important of the thing is to get it moving to keep blood flowing through an injured tissue. Now, you're not loading it super heavy, you're not doing the motion, but the more you can just keep the circulatory system moving everything through, that's gonna be really benefit, beneficial. Exercising is really good for the nervous system, and then and just continuing to load it, but then ice can fall under that analgesics department of like when you have a lot of pain, ice can still be utilized to lower that pain threshold. Does that make sense?

SPEAKER_00 4:55

And then absolutely, and that's I've I've been there where it's like it throbs so much, and sometimes I'm a little apprehensive of taking some non-steroidal anti-inflammatory. So I'll just like you know, it just feels better. But I you do still hear people say stuff about well, should I ice it for 10 minutes and then go into the you know steam room or the spa and then go back and forth for so would you suggest that with the first 48 hours?

MEAT Method Movement Over Immobilization

SPEAKER_01 5:18

Yeah, yeah. I think again, pain is kind of getting and severity is a big part of it too, right? Where like a lot of that contrast work is awesome, right? And I think you can kind of also that almost carries you into like full ice baths after workouts, you know, where some of that same response comes in where it's like, okay, what are you doing with a contrast bath where you're icing then heat, ice, and then heat, ice, then heat. Basically, what you're doing is you're dilating or constricting all the blood vessels, which is good because that reduces inflammation, reduces the belt pain, reduces nerve conduction, so it slows down the nerves, which therefore you feel less pain, so you feel a little more refreshed. But then when you go into warm water or just a warm area of sauna, then all of a sudden you're flushing the area and you're dilating all the vessels, and that's kind of helping to pump a lot of blood in. You're kind of going through that process, almost pumping in and out a lot of that fluid, which can be useful too. And I think even outside of injuries like post-workouts, that's a benefit. But on the flip side, if hypertrophy is your goal, you want that inflammatory response. I think that's also a missed thing, right? Like if you just go through and you've just been lifting super heavy and then you're like, oh, now I'm gonna go ice bath, well, that counters all that inflammatory response that you just spent your last hour creating. I think that's a part of it as well.

SPEAKER_00 6:48

And it's it's tricky because these are it's almost like stress we associate with a bad thing. Like stress is bad and stress isn't good, it's just a normal response. And there's good, there's bad stress, and it's the same thing with inflammation. But today we associate with like, oh, you're you have metabolic health issues, and oh, your gut's inflamed. You're like, well, do you even know what that means? Are you working with a doctor? Did you look at your levels? And yeah, it's just like a simple little tag word that people get excited about and they try to lower the inflammation, but it could be doing more harm than good in certain circumstances.

SPEAKER_01 7:18

Yeah, I think that's like uh, you know, you even think about that with exercise, like a sissy squat, right? Fantastic, because it stresses the patellar tendon. Now, is it gonna be the right movement for someone who's dealing with patellar tendinitis early on? No, maybe not, but maybe I'll just say maybe it depends, right? But it's like if you that's a good way, like yes, it's stressing that area. So that is how you build that resiliency, but it is stressing the area. That's part of how you, you know, the body you create adaptations to it. So you can look at inflammation and inflammatory response to an ankle sprain in the same way. Like, yes, it hurts, yes, it's not necessarily good at the time, but that's how the body is choosing to respond to the stressor of an injury is through the inflammatory process. That's not something that you want to stop. You want to enhance it and make it as comfortable as possible. You don't want to stop it where ice technically is slowing it down. But like we talked about, there's a time and a place, but the icing it just to ice it is slowing the process.

SPEAKER_00 8:24

And I think it can get confusing because you know Dr. Arash, not too long ago, he had an ACL um rehab. And I believe, don't quote me on this, Dr. Rosh, but after his surgery within a time frame, like they had a compression sleeve on them. And so, you know, the the mind may be thinking, well, if they're trying to work on inflammation there, well, why wouldn't you want to do something like that immediately with an injury? So, what's the thought process behind like you know having an ankle brace or some type of compression immediately after an injury?

Contrast Therapy And Hypertrophy Tradeoffs

SPEAKER_01 8:54

Yeah, so I think compression is really valuable, especially after like surgeries, because you get such a giant inflammatory response that you start restricting the joint, right? And so then you get into what's called artrogenic inhibition. And when that happens, because a joint doesn't move, then your muscles will shut down. So especially after like a knee injury, right? You don't, if you do not have full range of motion in your knee, your brain will not fire your quad to its full potential, it won't recruit the higher threshold motor units. So then you're losing strength and you're losing stability and power. And so that's where it's like, okay, getting the range of motion at that joint is critical. And when you're using compression over ice, is the compression doesn't necessarily slow down nerve conduction either.

unknown 9:37

Right.

SPEAKER_01 9:38

And you're kind of also trying to mitigate the amount of swelling. So a little bit of swelling is good, but a lot of swelling ends up causing more problems, right? And so and moving that swelling through, moving it in and out, which compression does a really good job of. That is helpful, you're still getting the inflammatory process there without the over-the-top protection mechanism that the brain does by massive swelling. Is it from uh why the brain does so much swelling? There is typically the brain doesn't know what the trauma was that happened at the knee, right? Or at the ankle, same process, but like let's say you snap your femur from an evolutionary standpoint. Your brain is not going to put power to the quad because of what it's not sure. Like, okay, if I walk on this, is the bone gonna lacerate the artery and nerve and then shut everything down, right? So it's gonna stop putting power to that leg for that reason, and then it's gonna blow up inflammatory-wise to add a layer of protection around it. Just from a your brain wants to survive. Yeah, your brain's main goal is survival. So, from an acute and traumatic standpoint, that's the brain's goal. What our job is, is to convince the brain, hey, we're okay, we need to heal, we need to get inflammation moving, right? Not eliminate it, which you're trying to do with ice in theory, comparing the two. You want to get it moving, but you don't necessarily want to eliminate it. But I often use ice after surgeries on a very regular basis, especially when it's more joint-specific, opposed to like an ankle sprain where yes, it's a joint, but it's almost more a lot of the times. Those ligaments on the outside, that's actually the inflammatory response. Where like a knee, it's like we gotta get the if the inflammation is holding up the range of motion, I want to get the inflammation out. But if the inflammation is not really stopping the range of motion, I'm not worried about it. That might be a good way to put it. If you can't move the joint, priority needs to be get removing the inflammation, in which using ice and compression is extremely valuable, and I use on a very regular basis. But if you can move the joint fully, there's no reason to do that unless you just like the feeling and you know it helps with pain, and that's gonna keep you off of drugs. Sweet. You know, that's a win too.

SPEAKER_00 11:57

But it's like the Goldilocks theory. You want to be right in that happy zone.

SPEAKER_01 12:01

Yeah, yeah, exactly. You're trying to find that right amount of movement where like, and I guess that's a good kind of how I differentiate a lot of times. It's like, do I get free motion at the joint? If I do, not gonna worry too much about that removing inflammation. But if that inflammation's holding up motion, then I want to do what I can to eliminate that that swelling, which typically I'll use compression and movement. You know, there's gravity is your best friend. You can elevate something that just helps move it, and then I'm gonna try to get as much movement as I can out of that joint to try to eliminate that swelling.

SPEAKER_00 12:36

So, on the topic of you're saying drugs, is there a time and place for NSAIDs, or what is the current evidence around that?

SPEAKER_01 12:43

One thing I tell a lot of patients, especially post-surger, but uh with bigger injuries, like even going into opioids, is like they gave them to you for a reason. And in my opinion, one of the most valuable things is you got to sleep at night. That's a big part of recovery. And a lot of people coming out of surgeries are like very acute injuries when they're struggling to sleep. If you can use one of these drugs to help you get a really good night's rest, I'd say that, you know, you're always trying to balance pros and cons. Right? There's never a simple, like all the right answer or all the wrong answer. You're always trying to balance that. And where if you're not sleeping and you can take what this call a painkiller that's gonna help you sleep, just very generally speaking, to me, that's always gonna be that's gonna end up in the net positive, right? But just taking them all the time because you don't like a little bit of discomfort, live with the discomfort, learn to love the discomfort and work through it. Don't take pain meds just to eliminate that. Are there any kind of a no?

SPEAKER_00 13:42

It makes perfect sense. I was just thinking, you know, we've had some sleep experts on here, and I was wondering, because you know, my you know, if you're from Kentucky, so you guys are known for your whiskey, and people will say, Oh, you know, I slept really good last night. I had seven shots. It's like, no, well, you blacked out, that's way different. That's not deep sleep. Yeah, and so with like NSAIDs, is there any ramifications from getting into deep sleep and REM?

SPEAKER_01 14:04

You know, that's I would have to look into the studies on that because I I'm sure that there are. But I would also simply argue that some sleep, even if it's not high quality sleep, is better than no sleep.

SPEAKER_00 14:18

Yeah.

Compression Swelling And Joint Motion

SPEAKER_01 14:19

You know what I mean? But I'm sure that there are, but I I don't know. I'd have to look into research, which would be an interesting study.

SPEAKER_00 14:25

Yeah, because you know, one of the things that we're prideful of with our certification is we're really big into networking with physical therapists. And so yeah, obviously, as competent qualified trainers, we're not doing range of motion tests and stuff with your clients. But if something were to come in, there's an acute injury over the weekend, that's just a great opportunity to reach out to your therapist and say, hey, you know, sprain, wanted to check it out, want to see, you know, what are your you know, any potential contraindications. I know, like I was thinking ankle sprain. Sometimes people will, it's very common, they'll go to the doc over the weekend and they'll take an x-ray, which obviously is not broken, then they'll throw them into a boot. And you know, it's it's tough because I'm just uh you know, we're just stupid trainers, and so our clients really put us in that high regard. So I remember one time there was a student, it was the same weekend, both of them sprained their ankle. One was doing a step up on a bench and it was unstable. She came down with 135, totally jacked her ankle up. And then the other one was playing softball, hit a ditch, and she got an x-ray, both fun. And I told her, you know, I'm not a therapist, I think you should go talk with one. But I worked at a lot of physical therapy clinics and I did a simple little hop test on her, and she was okay. I said, It's not broken, don't wear that boot. You need to get out there and start moving. And the irony behind, I know this is a very severe case, but the one who went into a boot, she later on had a clot, and she was out for like almost nine months.

SPEAKER_01 15:41

And so yeah, I mean, boots, in my opinion, are very rarely the answer. But in the same case as you, it's like I we have to deal as therapists, is like a lot of times MDs DOs, whoever they see, urgent care, they put them in a boot and then trying to convince people like, hey, this is not the best course of action. Like if you're able to walk with manageable pain and not significantly limping, then you're better off without a boot because you don't want to get weak. Like, and that weakness will happen drastically fast. If you immobilize something, you will get significantly weak. And another thing with ankle sprains is um there's a really high amount of nerve, nerve damage that happens, and that's often not talked about. So when it's your um perineal and palpiteal nerves, depending on the type and severity of ankle sprains. But if you're a grade two or grade three ankle sprain, I think grade three was uh nearly upper 90s in percent percentile, and grade two ankle sprains, which is the damage, the severity of the damage of the ligaments, it was like 87% have some sort of axonal damage to the nerve, which is impacting the proprioception to the foot. And then if you're gonna put that in a boot, not only are you gonna get weak, you're gonna damage the ability for that nerve's response to heal to regain that proprioception. So not only you're gonna be weak, but you're not gonna be firing into that foot adequately. So then when you do return to sports, even though you might be out of pain, now you don't have that feedback from the ground, and you're going to lead to more ankle injuries, inevitably. And that's that's a guarantee.

SPEAKER_00 17:28

And I love that because my brain was going down when I was at the University of Connecticut to Eric Cressy and Dr. Kramer and the team over there did a really cool study, unstable surface training with athletes and how it compromises force production. And you know, there's places out there like NASA who they're really big into stability where you hit it on the head right there. If there is an injury when it comes to the proprioceptive mechanics post-injury, there's there's huge benefit from that, but maybe not for gen pop if they don't have those injuries.

SPEAKER_01 17:57

Yeah. And there's even been a lot of studies interesting. Like I would say I wouldn't put a 100% faith in a lot of the stability studies because those are so many variables to have to manage. But stable surface stability training seems to be a little more effective from what I've been reading recently than unstable surface.

SPEAKER_00 18:17

Could you break that down a little bit more?

Pain Meds Sleep And Smart Tradeoffs

SPEAKER_01 18:19

Yeah, and I think it so like one thing I do a lot is I'll have someone in a plantar flex position at the ankle and then kind of flex at the knee, flex at the hip in a position that you would land, right, from a jump. Right. And then, like, can you hold, can you physically hold the position that you need to land in? Right? Are you not make sure you're not rolling to the outside of the foot, right? If you're rolling to the outside of the foot, you're kind of relying on the stability from the ligaments and the bones, opposed to being up in the big toe, stacking the knee. Then you're actually using the procreception from the muscles and the tendons to stabilize that ankle. And that, like, you'll see a lot of times when you put people in those more compromised, compromised positions of like and holding isometrics where they'll start to really start to shake in those fasciculations, which is that nervous system trying to relearn how to fire and hold in those positions. And I've found that that can be from a rehab standpoint and a performance standpoint, a more effective way than if you stick someone on a piece of foam or a bozo ball, which are great and they're not bad exercises. What some of the what you're doing is like you're teaching them how to balance, but you're using your hip, you're using your arms, your core, which isn't a bad thing if you're trying to train the central nervous system. So I'm not saying that's a bad way to train, but if you're trying to rehab an ankle injury, you're gonna be much better off putting that ankle in a position and making it hold that position of what it would be like a compromise situation, than trying to put it on an unstable surface and letting everything, letting your brain figure out how to stabilize using everything together. Not that that's bad, but if I'm trying to get an ankle back, I want to lean into a wall, put myself at a steep angle like I'm cutting, and then come up onto my big toe and lean into that, like I'm really trying to push to the inside of my foot there, so I'm not rolling to the outside edge in a cut. And you'll be shocked at how often, like, you raise that heel and push into a wall, and you push as hard as you can after an ankle injury. I mean, you'll start shaking quick.

SPEAKER_00 20:26

And that's just like that's how you fatigue. The the cliff notes on that for those that got lost, basically both your balls are fucking stupid. Uh, I'm just joking. Yeah, no, I mean, no, but I really appreciate that because it makes perfect sense, versus like you're optimizing the force production of the that area, and you can still get to an unstable environment, but you don't need to be on something as crazy as you know, one of these. No, you don't have to train that way.

SPEAKER_01 20:50

I don't want to make sure that they can get that the they can get in the right position to absorb force first, right? Like, can you internally rotate at the hip, flex at the knee, flex at the ankle while stabilizing in like a plantar flex position? And can you hold that? Once you can hold that, okay. Now let's progress into external rotation at the hip through the spine, you know, an extension at the knee and the ankle into triple extension. Can you hold that position? And once I can master those two positions, whether it's a knee injury, hip, ankle, once they master those two positions, then it's like, can I build the pattern to move them between it?

unknown 21:25

Right.

SPEAKER_01 21:25

A lot of times the brain will figure that out. And then once they can master that pattern, then I can start to load that pattern. And that's kind of how I treat any injury.

SPEAKER_00 21:35

I love it. I mean, my my brain position, I connect with that.

SPEAKER_01 21:38

If they can't hold the position, there's no point in loading it. You know what I mean? They can't even get in the position that you need them to be in.

SPEAKER_00 21:43

Yep. And so that's I think that's just so powerful with critical thought behind that because that's why again, when you have a therapist and you have this conversation, it's cool because it kind of connects the dots. Whereas you could watch someone who's Mr. Bosey Ball or whatever, and they see an exercise, oh, this is great for sprained ankles, and you're like, okay, I do it. Maybe the client feels a little better, but you don't know the why behind it. So then when you get that explanation, like, oh shit, that actually connects to exactly what you're saying. And then most importantly, like you said, then load it. And yeah, so that's the M E A A optimal. No, what was the A for the meat?

SPEAKER_01 22:15

Oh, that's analgesic. So like pain modulation, which is your icy hot, so whatever.

SPEAKER_00 22:20

But then the T would be treatment or therapy.

SPEAKER_01 22:24

Which yeah, more direct exercise, but which is this, you know, like that it would be in the treatment category of like, okay, can I put myself in the compromised positions and stress the tissues like we were talking about earlier? Like stress is a good thing as long as you're able to recover from it.

SPEAKER_00 22:41

So then two to go down a rabbit hole with that, would you do the same thing potentially with the mechanism for you know knee valgus if someone's recovering from an ECL or you would?

SPEAKER_01 22:52

Yep. Yeah, like a lot of any from the rib cage down, honestly, my treatment a lot of times looks very similar early on. Right? Like I'm it's it I get them in triple flexion, which is like force absorption, if you will. Like, how do you land from running or jumping? Right, you're internally rotated at your hip, you're flexed at your flex slightly at your knee. Everybody's gonna find that balance point a little different, like the amount of flexion. And then you're I always have them float the heel until they're but they're still flexed, relatively dorsiflex compared to full plan of flexion at the ankle. And then I have them move at the hip, right? Kind of do a hip airplane from that position, but holding an isometric at the knee and the ankle. Because it, like I said, if you can't hold that position, I have no reason to progress you from that point. Then I'll do the same thing into triple extension and I make sure their spine and hips rotate well through that whole thing. And then once they can hold those positions, then I start working, working my way through there. And that's the first part of rehab on almost every lower extremity for me. It looks like that. And then and I'll all my high neural exercises come first, and then I'll start to target, like, okay, let's say it was a you know, they have a deficit, a specific tissue deficit. I'll hit that at the end when you know they're already exhausted mentally and their nervous system's already exhausted, they're not gonna get any more value out of doing any higher complexity stuff, kind of the the fun stuff, if you will. Then it's like, okay, now I'm gonna isolate and I'm gonna do, let's say it was an ankle sprain in their perineal is really weak. Or I guess technically it's fibularis longest and brevest now, but you get my point, or it's like those are really weak. Okay, now I'm gonna do a little bit of e-version direct work there, or whatever it is, I'll put that direct, more isolation-based work at the very end of the treatment. Typically kind of how I structure that.

SPEAKER_00 24:51

And so you opened up a camo can of worms there with the fibularis as peronials. What why is why have we had that change?

SPEAKER_01 25:00

Uh I think as a what I was told in school, let me put it that way, is that they're trying to get away from uh old guys that named things after themselves to now naming it more uh based on anatomy. So they changed the names from your perineals to your babularis. So that was a doc who came over then. I that's what I was told. Okay, I could not verify that though.

Boots Nerve Damage And Proprioception

SPEAKER_00 25:27

I love it because some of the apps will have one, some of the other. If you go online, they'll call it like you know, perineal syndrome still.

SPEAKER_01 25:34

So it's just like yeah, I still call it perineal because then it's like I don't know, maybe because I'm old school at heart. Uh, but also like everybody knows what you're talking about if you say that. You know what I mean? And like you say fibularis, it's like, wait, are they talking about the bone? Are they talking about you know, so I don't know.

SPEAKER_00 25:51

So the last little thing I just wanted to chat about was, you know, with your success on social media, have you had trainers reaching out to you? And and what have those conversations been around if you have?

SPEAKER_01 26:02

Not as many trainers, it's been more other PTs and strangely from different countries, a lot more. I don't know why that is, but uh there's a couple trainers I talk to a lot around here locally, but it's been more PTs or a lot of uh PT students.

SPEAKER_00 26:21

Okay. Which kind of makes sense with a lot of most and so we are we're big into creating that network with with therapists and not to be that take, take, take mentality. Because even just the other day, I actually had a therapist reach out to me, and he it's from West Hollywood, and he's like, you know, I'm a therapist, and I would love for you to send me your your clients. And I didn't respond because I could tell it's AI, one, and it's like, you know, I don't know what type of therapist you are. You could be doing you know banded clams the entire workout. Like, you need to lead with something that is, you know, what's the why should I send my clients to you? And so, in the inverse with trainers reaching out to you, what would you like to see from a reach out? What would entice you to have a conversation with them if they wanted to potentially start sending you business and so forth?

SPEAKER_01 27:03

Yeah, I mean, to me, it's my goal is to always hand someone back off to a trainer, and that's like, and then with certain like you know, early on in a rehab, I might have certain restrictions, but like let's say someone has a lower body injury, I want them using upper body and doing everything there, and like that'd be insurance, like because we talked about like I'm still working in the insurance models for several different reasons, but like they're not gonna cover it if I'm like giving a whole bunch of art like upper body work to somebody. That's but one of the best things to keep someone mentally in it after an injury, in my opinion, is like still working on something, and that like to me, it's like that's perfect. Let's use a trainer, and then I start to phase out of you know, especially getting towards the return to sport. Like, I want them working with a trainer 99% of the time. And then I might just be able to add in, like, hey, this is doesn't feel right. Okay, hey, we look at this. Like, that's the goal, that is the ultimate goal is to like be as hands-off as possible.

SPEAKER_00 28:02

You mentioned prior to the podcast that you've worked with, you know, you're around at least strength coaches, and so is your mentality about trainers like, oh, you know, I'm I'm definitely pro-trainer because I know a lot of therapists that I've worked with, they're just kind of like they're the opposite, where they're like, trainers are fucking idiots. Why am I gonna send my clients and you're gonna go do some weird, you know, backflips with the boasty ball or whatever, and you're gonna get hurt? And so, what is the current, would you say, pulse of the therapy industry and the take on personal trainers from a professional standpoint?

Better Stability Training Without Gimmicks

SPEAKER_01 28:30

Yeah, I'd say I'm a little I have a different perspective than probably most in the therapy industry. Like my perspective is I really truly think I've learned I don't want to say more, but just as much from like strength coaches as other PTs. And the reason I say that is like I think it's because of passion, right? Like strength coaches that are good or what they do, they they got into it. They didn't get into it because they're gonna, you know, for the money. Like that, not at all, right? They got into it because they love what they're doing and they care about it and they're always trying to learn more, right? And that's I mean, that's the same reason I did PT. And so, like, from that perspective, like I think passion and care about what you do speaks way more than credentials, right? And you kind of get into the same like with chiropractors and athletic trainers, and uh everything in the generalized rehab world is like to me, it's not so much about the credential, it's like what is this person's passion? Do they care about what they're doing and do they want what's best for their patient client? And if that's the case, like I don't really care what their credentials are. Let's work together as best we can to make the results for whoever is in front of us, you know. Because like I've learned a ton from chiropractors, I've learned a ton from athletic trainers. I happen to be a physical therapist, but I don't think the PT profession is any better than a strength coach at Cairo, an AT. Like I wish it was more like we all work together as a system and kind of, yeah, everybody's got a little different strengths and weaknesses, but I'd say it's as much of an individual thing as it is a uh profession or title thing, in my opinion.

SPEAKER_00 30:06

I agree. And I think what happens is maybe we get when you I love that mentality, and just from having that conversation with you, I can tell that you're a smart cat, pun intended, going to you know, Kentucky. But you know, there's some therapists that uh, you know, they kind of gatekeep stuff. So it's like, you know, I went to work here in Santa Monica and they're doing some, oh, this is the newest training, some sweetest bullshit, and we put you in the ropes and blah blah blah. This is the only way to rehab. And I was just like, you know, I respect you. And I I didn't like I wasn't pugnacious or anything. I was just like, oh, cool. Yeah. In the back of my mind, I'm like, I this isn't someone who I'm gonna refer people to because this isn't like optimal loading and really trying to get them back into sport. And there's there's a lot, it's it's a spectrum. You know, you can have great trainers, you can have shitty trainers, you can have great therapists, you can have shitty therapists. It's just, you know, kind of reading out the the market to see where you align and make sure that you know personalities match up too, because you want to make sure that you can now see us having a beer and talking about life and sports, and you know, it's it's a lot easier for conversation.

SPEAKER_01 31:02

Yeah, yeah, no, and it's like I like when I like there's a trainer here that I work with a decent amount, and I like will tell them, like, hey, uh with this guy, this is what this is what I was seeing. Like, maybe try to do a little less of this or a little more of this type of thing. I won't tell them exactly, but like, I mean, they're plenty smart, they know what to do, and I'll just say, like, hey, this is what I'm seeing with them. You know, he's half the time with it, especially with athletes, like they go to multiple different people for a lot of different things. Like, you gotta learn how to work as a team, you know, because like they might see me because they want to do who knows what, or like dry needling or something like that. And then, you know, I'm gonna add a few things to it because I'm never just gonna do that. But, you know, I'm like, but then there's you know, they're working with this trainer today, and then maybe another trainer for you know, it's a running back, so he's doing like receiving stuff that day, and then lifting with somebody else and cutting with somebody else. So it's like having to try to. You know.

SPEAKER_00 32:07

Well, this was an awesome conversation, Doc. I really appreciate your time. Where can people find you on socials?

Working Together And Where To Follow

SPEAKER_01 32:12

Yeah, uh, Instagram's the main one at uh D R underscore T Boss T-E-B-O-S. And that's what um what I was telling you, just kind of starting to put a lot more out there on that. And then I do have a YouTube as well, which some I have a little bit more long form stuff that I'm working on, trying to get that same thing, Dr. underscore T Boss.

SPEAKER_00 32:31

So are you a whiskey drinker?

SPEAKER_01 32:34

I dabble, dabble. I got you know, I didn't really before I got into uh to Kentucky, but you kind of have to around here in a way.

SPEAKER_00 32:42

Well, I was gonna say, because we have some trainers out in the area. If they're gonna come, you know, reach out to you. I was gonna say, bring you some whiskey, but maybe you like donuts, maybe you like gift cards. Always, you know, shower your your therapist with gifts and let them know how awesome they are. So thank you for your time, doc.

SPEAKER_01 32:55

Yeah, that's been great. I really appreciate you having me on.

SPEAKER_00 32:59

All right, thank you.