Art of Prevention
Our mission is to decrease the prevalence of preventable injuries and athletes therein optimizing performance by decreasing the time that our athletes spend benched due to injury. We are going to distill information and practices from experts in the field of injury prevention. High level coaches and top performing athletes. We believe this information should be accessible to everyone so that we can reduce the rates of preventable injuries.
Art of Prevention
Strength Training for Runners: Myth Busting and Optimal Protocols
Discover the truth behind strength training for runners as we bust the myths that could be slowing you down. We'll explore how hitting the weights can actually elevate your running game without the bulk. This episode is your ticket to understanding the intricate dance of muscle metabolism and how it can be optimized for endurance.
Prepare to revolutionize your running routine with our comprehensive eight-week strength training program, detailed in a handy PDF from theartofpreventionorg, designed specifically for runners seeking to improve performance and economy. Frank Shorter's legendary 1972 Olympic Marathon is just one example of how these principles lead to real-world triumphs. Get ready to make significant strides in your runs with the science-backed insights and expert advice we're sharing today.
Strength Training for Runners PDF:
https://www.artofprevention.org/store/p/strength-training-for-runners
If you have listened to this podcast for any length of time you know that strength training is crucial for runners. However a major obstacle for many runners is not know what to do once they get to the weight room. This PDF seeks to change that. It will arm you with the tools you need to effectively strength train to get the most out of your runs.
use code PODCAST for a 20% discount at checkout at artofprevention.org/runners
Hello everyone and welcome to yet another episode of the Art of Prevention podcast. Today I will be doing a solo episode in which I dive specifically into a topic that has permeated many of the conversations that have been on this podcast before, and this topic has specifically permeated many of the conversations regarding endurance athletes, specifically runners. So today we are going to be talking about strength training, or resistance training, for runners and the running population. There are a lot of myths that surround strength training and specifically strength training for endurance athletes. So today we are going to be doing a little bit of myth debunking and we are going to talk about some of the previous and somewhat outdated notions that some individuals will propagate for runners. And from this establishment of outdated notions surrounding strength training for runners, we will go into more optimal programming and optimal styles of training when we are talking about strength training, specifically in resistance training, specifically to the running population, and we will also go into many of the new found benefits of optimal strength training programming for runners. Now I will say one of the biggest obstacles for runners going into the weight room and resistance training is that they simply don't really know exactly what to do. We know about running training. We know going for a run and we know intervals and things like that. But then when we go to the strength training or the gym and we see all this iron and barbells and things, that we can become a little bit overwhelmed with all of this new information, new techniques, new set and rep schemes, etc. So I have actually created a resource for runners that want to get the benefits of strength training, and that resource can be found on ArtofPreventionorg. If you go to sports and then runners, at the very bottom of that page you will see the PDF Strength Training for Runners, and today I will be diving into many of the topics that are explained in much greater detail in that PDF. And along with that PDF is eight weeks of sample programming that you can utilize, along with the principles that we are going to talk about today, as well as the principles located within that PDF that can enhance your running performance and also reduce your risk of running injury.
Speaker 1:So let's get started with our first myth and this is probably the most pervasive myth that I have found which is that strength training will increase the mass and weight of individuals that are performing it. Now, obviously, strength training can be done in such a manner that will increase hypertrophy, ie the enlargement of muscles that are worked in their sets and reps and things like that. And indeed many individuals do go to the gym with the sole intent of gaining muscle mass, and that's not always a bad thing. However, when we look at the running population and endurance athlete population, as well as people like climbers and gymnasts and actually weight class athletes, we have to be able to figure out a way to improve strength without increasing weight or mass to a significant degree. And if you ask somebody who has gone to the gym with the sole intent of hypertrophy or muscle enlargement and mass gains, if you will, that'll be the first to tell you. This is not the easiest thing in the world, actually, and when it comes to runners, it is even more difficult to lay on the pounds when we're going to the gym, and this is due to many factors. But for runners, this is actually something that can work to our advantage, so we can go to the gym and we can increase our strength, our power and even our running economy without significant increases in our weight.
Speaker 1:And there are actually systematic reviews and studies, many, many studies that actually support this notion. So if you look at the systematic review that was published by Black Grove et al in 2018, they literally looked at many studies of resistance training in endurance population, specifically runners. They found, in 18 studies that did various amounts of time with resistance training in runners, that no one actually increased in mass, and there was actually one study one single study, out of the studies that they looked at that found an increase in mass and that increase was by 2%. So if you have a 100-pound high school runner and they do a strength training program, they may increase their mass by literally 2%. So there'll be 102 pounds by the end of that resistance training program, which is big whoop. I mean they're going to grow to a much larger degree just in the length of their bones and mass related to this, more so than increases in muscle mass.
Speaker 1:Now, when I was in college, I did have a friend that when he was in high school and he was training, they were doing a lot of work in the weight room and they were running and he actually did get large increases in muscle mass. However, when I asked what was the nature of your training when you were training for your cross-country races and their coach had them doing basically training like a sprinter, so they would do very, very low mileage I think 20 to 25 miles per week or something like that, and it was mostly interval work of 200 meters or 400 meters. So in that scenario, if someone is training like a sprinter and doing very low mileage and only high intensity interval training, then one could increase muscle mass. However, if we look at the types of training that is going to benefit runners specifically ie a little bit of a higher volume, some anaerobic threshold work as well as some anaerobic intervals then we have competing interests within our metabolic pathways for increasing weight versus increasing endurance performance. So the pathway that improves or increases our weight would be the mTOR pathway, and this is one of the signaling pathways for the enlargement and hypertrophy of muscles. However, there is a separate pathway that is a more endurance-oriented pathway, and this is the PGC1-alpha pathway, and these two pathways will compete. One is trying to enlarge our muscle tissues and one of them is trying to increase the efficiency of our muscle tissues.
Speaker 1:However, if we prioritize our endurance training which the point of this entire episode and podcast and the point of strength training is not to replace endurance training and replace running. The point of it is to be an adjunct to make running and running training more effective. So if we are prioritizing our endurance training, running a sufficient mileage per week, as well as performing threshold runs, long runs, etc. Then we're going to out. These endurance tasks are going to outweigh and prioritize be prioritized over the mTOR pathway and the pathway associated with muscular gains in size. However, this also goes and coincides with the previous notion that the strength of a muscle was only associated with its cross-sectional area, ie its size. So previously we used to think only about the size of muscles in terms of weights.
Speaker 1:However, if we look at bodybuilders, many bodybuilders have extraordinarily large muscles. However, they're not going to be as strong as an Olympic weightlifter in a lower weight class and neither are they going to be stronger than a strongman competitor. Obviously, their physiques are quite different and you'll see there's definitely some difference in the tone and definition of musculature between a bodybuilder and a weight class Olympic weightlifter and a strongman. However, if they went toe-to-toe in a strength comparison, those strongmen and those Olympic weightlifters would win every single time. And that's because we can train, we can have resistance strain in such a manner that prioritizes hypertrophy as well as strength gains. So we can strength train to try and increase cross-sectional area. But we can also strength train in such a manner that we can increase recruitment of motor units, thus increasing recruitment of muscle fibers, and thus we can get neurological gains in strength.
Speaker 1:So neurologically-based gains in strength and if we look at somebody with a really low training age in the weight room, these are actually the majority of our strength training gains. Within the first six weeks, or even 12 weeks, I mean, you'll see massive improvements in weightlifting personal records of individuals as they begin a weight training program. However, they will have very, very little I mean like less than 1% increases in the actual size of muscles, and this is regardless of if they're endurance athletes or just strength training individuals. And this is because our neurological system coordinates activity and coordinates muscle movement a lot more quickly than our physiology can adapt and create more muscle size and muscle strength. So when we are strength training for runners, we don't necessarily need to increase the size of the muscles in order to increase strength and thus increase running economy. And this is a nice segue into our second myth that runners should perform high reps or high repetitions with low weights when they're strength training. And this is an absolute fallacy when we look at the actual physiology of how we get stronger without getting larger.
Speaker 1:So one thing that I mentioned a few minutes ago was motor unit recruitment. So a motor unit recruitment, a motor unit is a peripheral nerve, so a nerve that's coming from your spinal cord, from your brain and all of the motor fibers that it innervates. So if we recruit more motor units, we recruit larger motor units. Then we are able to produce more force on an object or in a given movement, and one of the big ideas with strength training is to train our bodies to recruit more motor units. So there are differences between things like a maximum voluntary contraction and a maximum involuntary contraction. A maximum voluntary contraction is the maximum amount of contraction and the maximum amount of motor units that I can utilize and recruit when I'm performing a task. The maximum involuntary amount would be if I set two electrodes on something like my thigh and then I cranked those electrodes up all the way, thus making my musculature contract. That would be a maximum involuntary contraction, because I'm not voluntarily doing the work. I'm using an external source to create that muscle contraction, ie those electrodes. So obviously we're not going to be hooking up our runners or hooking up ourselves to those electrodes in our training.
Speaker 1:We want to be able to volitionally or voluntarily recruit those motor units and you'd be surprised at the differences in motor unit recruitment and how much this can change in individuals. Basically, we're not reaching our full potential in our motor unit recruitment if we are untrained. And untrained athletes are only able to recruit approximately 50 to 60% of their motor units, and this is because we have central governors in our central nervous system that don't allow us to recruit all of our motor fibers at once. If we recruited all of our motor fibers and motor units at once all the time, then we would tear and we would injure our motor fibers much more often than we do. So we have these central governors and safety valves within our central nervous system that will limit the amount of motor units that we can recruit. However, oftentimes these safety valves are on a little bit too tight. So that's that 50 to 60% range and with training we can actually improve our motor unit recruitment, specifically of larger motor fibers, especially in the running population, to go up to 60, 70, even 80%. So we can really improve the recruitment of motor units.
Speaker 1:And recruitment of motor units also has a lot to do with the types of muscle twitch fibers that we are recruiting. So if we're performing solely endurance tasks, we are much more likely to recruit our type one or our slow twitch muscle fibers. These muscle fibers are smaller but they are very dense and very rich with mitochondria, which are organelles that produce energy within our cells. These have a great capacity to utilize oxygen and produce ATP, our adenosine triphosphate, which is the energy currency of our cells, which is produced by those mitochondria. However, these slow twitch muscle fibers are quite small and they aren't able to produce a lot of force, but they can produce low amounts of force for a very long period of time, which is why they're called slow twitch muscle fibers, and these are the ones that we are predominantly recruiting when we are running slow speeds as well as if we are running long durations.
Speaker 1:Now, on the opposite end of the spectrum, we have fast twitch muscle fibers. These fast twitch muscle fibers have subdivisions, such as fast twitch, type 2x and type 2a, but we're not going to get into that. That's beyond the scope of this episode. But these fast twitch muscle fibers are much larger. They have a much higher capacity to produce force. However, they have a much lower mitochondrial density. They have a much lower capacity for oxygen utilization. Thus they can't work for as long a period of time, however, when we are running at above a threshold pace.
Speaker 1:So if we're running in a race or we're doing a fast interval, we can't solely rely on those slow twitch muscle fibers, unless you just want us to run slow all the time. Obviously, that's not going to be the point of running and racing. And if we look at the extraordinary times that are being put up nowadays in high school, in the NCAA or in professional track events, long distance runners and middle distance runners really have to have the capacity for very fast sprinting at the end of all of their races. Even if you're a 10,000 meter runner, you still have to be able to close the last 400 meters of that 10K race in 55 seconds if you're going to think about winning that race. So even for our long distance runners, it's not just about having great slow twitch muscle fibers, but also about being able to sprint in order to finish a race quickly if you're going to want to finish and cross that finish line first.
Speaker 1:So how are we going to increase motor unit recruitment? Well, high repetitions with low amounts of weight isn't something that's going to be beneficial in increasing the recruitment of larger motor units. It's actually just going to create this system where we only recruit the motor units that we already know and we already utilize on a day-to-day basis. The only way to recruit larger motor units is with progressive overload training. So we have to recruit and we have to utilize loads that are at a much higher percentage of our one-rep max and at a much higher RPE or rating of perceived exertion, if we're going to get these neurological changes and strength changes necessary to improve things like running economy, which, if we go back to that Black Grove et al article, that systematic review, they found that running economy alterations in association with strength training and weeks, you know, a proper standardized training program with a lot of overload, with dynamic exercises, with plyometrics, can improve running economy at faster speeds on average by 4%, which is a massive gain, especially if we're looking at the longer events. And improvements in running economy don't only enhance our racing performance but they're going to enhance all of our training performances as well. So our improvements in running economy will make us better runners, especially at those faster speeds. It's going to make our training more effective, which is then also going to make our racing more effective as well.
Speaker 1:So back to sets and rep schemes. Previously we would say to runners oh, you want to stick to 12 to 15 repetitions per set so that you can work on muscular endurance. But, as stated previously, this is something that's only going to facilitate the utilization and recruitment of previously utilized motor units. So we actually want to really decrease the number of sets and the number of repetitions that we're performing. We can actually increase the number of sets, but really we want to focus on a lower number of repetitions at a much higher RPE and a much higher percentage of our one rep max, and this is what's going to necessitate the recruitment of larger motor units. So, literally going down to three sets of three to five repetitions a really great podcast with Andrew Huberman talking about strength training protocols really talked about the decreasing in our number of repetitions and a good rule of thumb, if you will, would be three to five reps, three to five sets, and this was with Professor Andy Galpin, who's a professor of muscle physiology at Fullerton University in California.
Speaker 1:So runners can utilize these lower rep schemes and there are multiple benefits associated with these lower rep schemes. One of the major benefits is, of course, the motor unit recruitment. But the second major benefit for runners, and something that we actually hinted at earlier, was that it won't actually increase fatigue to the same amount as those higher rep schemes. So if I'm looking to increase someone's fatigue a ton, I would actually have them perform many, many sets of many high repetitions and I would have them perform those sets and reps all the way to failure, and this is really going to lead to a lot of central fatigue, so fatigue in the central nervous system as well as peripheral fatigue within the individual muscles and the peripheral nerves. Now, if we really decrease the number of sets down to three to seven repetitions per set, we're going to be doing quite a bit less work, but we're going to be recruiting more motor units and leading to less fatigue because less work is being done.
Speaker 1:If we think about this with running, think about why we might get much more tired, or why we do get much more tired with something like a five mile run versus five strides. If I do five 100 meter strides, I'm working at a much higher percentage of my maximal speed. However, because that stride is much shorter than that five mile run, I'm going to have significantly less fatigue as a result of those five strides. And this same concept we can apply to the weight room. So we don't want to go into the weight room and significantly increase our fatigue to the point where it's going to affect our running volume and running training. Now, at the onset of a strength training program, we will need to modify the amount of running mileage and volume that we're doing, because this new type of training is going to be a stressor to the system. So we don't want to add a bunch of volume with a new stressor like weight training. However, as stated previously, the benefits will far outweigh the small decreases in running volume that we were initially going to have to do. So if we decrease that rep scheme down to three to five or six repetitions per set, we can improve our motor unit recruitment while also decreasing the amount of fatigue from that workout. And we can even decrease the number of sets down to two to three sets per working muscle group or per exercise, especially if we have multiple exercises that work the same muscle groups. And this can be really beneficial so that we can keep our concurrent training with running and incorporate great strength training, which is going to improve our running economy, motor unit recruitment and even the capacity of many of our tissues, such as our tendons, ligaments and contractile tissue like our musculature.
Speaker 1:Let's move on to the next facet that I've already alluded to multiple times that running can improve, and that is our running economy. And I would say one of the best examples of where running economy shines is the story of Frank Shorter in the 1972 Olympic Marathon. So oftentimes runners will get hung up on the VO2 max as a predictor of running performance. However, the VO2 max, or the volume of oxygen consumption that one is able to utilize, the volume of oxygen that one is able to utilize as they breathe in versus what they exhale this is a very limited factor associated with running performance. It's something that we can moderately improve. However, we're going to be seeing significant variability and differences at very high levels of running performance. So you can be someone that consumes a large amount of oxygen while still being a very slow runner. On the flip side, you can be a very efficient runner who also runs very fast and performs very well, and Frank Shorter is someone that does just that. So Frank Shorter has a good VO2 max, don't get me wrong. 71 was his VO2 max score. However, if we look at Frank Shorter's VO2 max versus the other competitors in his race, such as Carol Lismont and Kenny Moore, another American long distance runner, we would see, on paper those two individuals should outperform him. Based on the VO2 max equation alone, kenny Moore's VO2 max was 74.2, 3 percentage points higher than Frank Shorter's. However, if you look at the results of the 1972 marathon, you see Frank Shorter handedly won this race and was a full 30 seconds to a minute ahead of Carol Lismont. And the reason was Frank Shorter has a much better running economy. He has a much higher efficiency when he's running relative to those other individuals.
Speaker 1:A metaphor for a car would be like a Hummer or a Humvee can consume a large amount of gasoline, but that doesn't mean that it's able to cover a large amount of distance efficiently and in a quick manner. So if we're looking to win a race, you wouldn't necessarily want to take a Humvee to the starting line. You wouldn't want to look at who consumes the most gasoline. You want us to look at who goes across the finish line first. So a very different vehicle would be much more beneficial in going across that finish line and it's going to consume less gasoline or, if we're talking about runners much less oxygen.
Speaker 1:So, as I spoke earlier, I mentioned that in that Black Grove et al article and there are multiple articles that have also looked at this. I just like the Black Grove article because it's a systematic review, so it's looking at about 20 to 25 articles and it's assessing different types of training programs and different variables and factors associated with resistance training for runners. So in that article they found between 4 and 8% improvements in running economy, especially at those higher speeds. So VO2 Max has a limitation for most individuals and, yes, much of our training is going to be regarding VO2 Max training, but we can also improve the efficiency of our running with something like strength training. So now let's move on to what does an optimal strength training program look like? And if you're unsure of exercises and sets and reps and things like that, you can always go onto theartofpreventionorg and look at that PDF. I've got a fairly low cost for individuals because I'm not trying to rob anybody of tons of money or anything like that, but I would like for people to have access to the principles associated with strength training as well as examples that they can utilize for strength training practices.
Speaker 1:So beginning a strength training program is all about familiarizing oneself with specific movements. Some of the best exercises that runners can do are actually compound lifts that incorporate full body movements such as a squat, whether that be a barbell back squat or a front squat or, if you're just getting started, even something like a goblet squat can be very beneficial for you as you begin your weight training journey. Then we also want to incorporate things that do actually look a little bit like running, so some things that incorporate single leg lifts, like a Bulgarian split squat or a split squat, back squat, and then we can do other safe measures of lifting, such as, like a trap bar deadlift, and we can do traditional deadlifts if you're familiar with that exercise, etc. And there are many more exercises in the PDF that I created if you want to check that out as well. So in the first three to four weeks we want to familiarize ourselves with our exercises and probably work at a moderate to easy RPE or rating of perceived exertion. So we don't want to go into the gym and max out our lifts in the first week, because these are the things that if we have poor biomechanics or if we have poor lifting strategies, this is how we could get injured quickly. So we obviously don't want to get injured in a strength training program and if you're someone who is new to strength training or new to lifting, maybe beneficial to get the guidance of someone like a personal trainer or a sports physical therapist or a sport or rehab chiropractor someone who can look at your biomechanics and ensure that you're utilizing optimal mechanics when you are performing these exercises. And also looking at other resources on things like YouTube etc. Can be helpful when you are familiarizing yourselves with these movements. Now, once an individual is familiarized with specific movements, now we can start decreasing the number of repetitions per set down to something like a rep scheme of three to five repetitions and three sets or so at a much higher RPE and at much higher percentages of one rep max. So after three to four weeks we can go down to five repetitions, but we may go up to an RPE or reading of perceived exertion to a five to seven out of ten and then after subsequent weeks we can work even further down to two or three repetitions per set and we can really increase that reading of perceived exertion to eight to nine of ten. And this is really going to facilitate motor unit recruitment and it's going to facilitate the neurological improvements in strength without significantly increasing the mass associated with strength gains. Now, after we've done a good job of laying down a foundation as far as strength so the ability to just move an object or the ability to recruit motor units Next, something that has been associated with significant improvements in running economy, as well as other important factors like bone mineral density and connective tissue properties, are plyometric exercises, and this is moving oneself or moving one's weight quickly.
Speaker 1:So these are jumping drills, hopping drills, single leg bounding drills, etc. And with these, if we look at the amount of force that's generated, force equals mass times acceleration. So instead of increasing the amount of weight that we are moving, we are increasing the other aspect of the force equation, which is acceleration, so we can really increase acceleration, thus placing more load on those connective tissues, so that then they will have proper stimulus necessary to adapt. Now this should be done on top of the foundation that was already set by the previous weeks of strength training, so that we can increase the capacity of our tissues before we start moving those tissues and start applying very fast loads through those tissues. So plyometrics are typically done with very, very light loads, typically began with just body weight, hops or body weight, you know, single leg hops, etc. Or bounding drills, long strides, things like that and typically when we're looking at high velocity movements, we never really go up to high percentages of a one rep max. It's beyond the scope of this specific podcast, but sometimes people will work up to maybe 30% of a one rep max if they're doing something like a dumbbell, squat, jump or something like that. So really, really low weights here, but the focus is on acceleration and explosiveness, and this also improves coordination in the form of motor unit recruitment, so we can work our way up to things like plyometrics.
Speaker 1:The last thing that I would like to talk about in regard to strength training for runners is all of the other benefits to the human being that is doing that strength training. So we have to remember we aren't just runners, we aren't just cyclists, we aren't just triathletes. We are human beings and thus we are susceptible to the maladies of being a human being, especially those maladies that occur later in life that may significantly affect our lifespan and our health span or ability to have an optimal lifestyle for as long as possible, and some of the things that do interfere with this would be things like low bone mineral density and low muscle cross-sectional area. So with a good strength training program we can retain large amounts of cross-sectional area and we can improve and mitigate the losses of bone mineral density as we age. So if someone is a runner, and solely a runner, and they do not do any strength training later on in life, that person is going to be really at a deficit as their bone mineral density begins to decline, especially after the ages of 40 to 45. We have natural declines in our bone mineral density as we decline due to alterations in hormonal density in that time of life. Our bone mineral density peaks around ages of 18 to 20, moving up into our late 20s, maybe even early 30s. So we want to make the peak in our bone mineral density as high as possible.
Speaker 1:And, contrary to popular belief, running is not a properly osteogenic exercise, meaning that running is not the best way to stimulate bone growth and bone mineralization, ie the deposition of minerals within those bones, which is going to improve its resilience over time. So the best way to improve bone mineral density is actually through resistance training. The osteoblasts and the bone cells that are responsive to a specific type of exercise actually lose responsiveness after about 10 to 20 minutes of the same stimulus being applied over and over. And if we think about running, running is literally the same stimulus being applied over and over and over again. So if we're thinking about a 20 mile run, you may have a good stimulus to those bone cells For about two, maybe three miles and then there's a significant drop off in the responsiveness of those cells to running, that monotonous, similar activation of musculature and that similar stress to bones. However, if we think about the optimal strength training that we can incorporate for runners, this can really provide a lot of load to bone in a short period of time and we can do multiple exercises which can stress bones in multiple ways. In this manner and in this way we can really stimulate bone cells to turn over and lay down a ton of bone mineral density and this can really help with staving off many of the maladies that individuals face later on in life, such as osteopenia and osteoporosis, as well as if we're trying to lay down bone mineral density to stave off things like stress fractures and stress reactions, which are a discordance between the bone building and the bone losses that are associated with activity. Strength training is really the way to go and even plyometric training even an older individual strength training and plyometrics training has been shown to improve bone mineral density. So if you're a coach or an athlete or a clinician, I want you to think of your runners not just as runners, but as human beings that are subject to these later on maladies and are subject to these things that can really affect our bone tissue as well as our muscle tissue and affect our lifespan and health span. If we think about the global picture of that individual's life, and if we want to maximize someone's health span and if we want to maximize even just their running performance, resistance training and strength training is one of the best adjuncts that we can do to do that. Thus concludes my rant, if you will, on strength training for runners.
Speaker 1:Thank you for listening to the end of this episode. Let me know if you have any questions regarding anything in this episode or if you'd like to hear more about this episode In this episode or if you'd like more information on strength training for runners. As stated previously, we do have that PDF available on theartofpreventionorg. Now, this is a PDF that is a general PDF and not specific to one individual, so bear that in mind when you're going through some of the programming located within that PDF and keep in mind that there are many coaches and many clinicians etc. That can really help you, guide you through the process of getting into strength training as an adjunctive training program that can really enhance one's running performance as well as hopefully enhance your health span.
Speaker 1:I'm Nick Hedges with the Art of Prevention and thank you so much for listening today. I hope that you enjoyed this episode of the Art of Prevention podcast. If you did enjoy and or benefit from some of the information in this podcast, please be sure to like, subscribe and share this podcast, or please give us a five star review on any platform that you find podcasts. One thing to note that this podcast is for educational purposes. No Dr Patient relationship is formed and if you are having any difficulty, pain, discomfort, etc. With any of the movements or ideas described within this podcast, please seek the help of a qualified and board certified medical professional, such as your medical doctor or a sports chiropractor, physical therapist. And if you are having any difficulty, pain, discomfort, etc. Please be sure to like, share this podcast. And if you are having any difficulty, pain, discomfort, etc. Please seek the help of a qualified and board certified medical professional, such as your medical doctor or a sports chiropractor, physical therapist, etc.