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
Redefining Athlete Care: Dr. Tony Katakis on Injury Prevention and Boosting Physical Performance
Ever found yourself sidelined by an injury, wondering if there was a better way to train, recover, and prevent it from happening again? Tony Katakis, a sports chiropractor extraordinaire, joins us to unravel the complexities of physical performance and sports injury prevention. He brings to light his evolution from a football player plagued by injuries to a medical maverick who's redefining athlete care. Our enlightening conversation navigates through his approach to functional movement, the nuances of rehabilitation, and the critical balance between intense training and adequate rest.
As a high school athlete, I encountered a pivotal moment that shifted my entire perspective on health and recovery—kicking surgery to the curb in favor of a holistic approach that transformed my career. Tony and I dissect how this philosophy extends into the ethos of our practices, ensuring athletes are treated as whole beings rather than just a series of X-rays and MRIs. We explore the GRIP method, SFMA, DNS, and how a tailored regime of nutrition, sleep, and coaching contributes to a robust, injury-resistant physique. Our shared stories illustrate the power of chiropractic care, not only in treating injuries but in sculpting the future of sports medicine.
Wrapping up, we dive into the sophisticated world of sports science, where tools like Y-Balance and force plates serve as our compass for measuring and enhancing athletic prowess. We punctuate the discussion by underscoring the wisdom of preventive measures and the role of nutrition in fine-tuning performance engines. From the intricate dance of joint centration to the strategic use of supplements, Tony and I leave no stone unturned. I'm grateful for the insights shared and eagerly anticipate the rich knowledge yet to be uncovered in our ongoing quest for peak athletic health. Join us, as together, we tackle the art and science of keeping athletes in their prime.
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Hello everyone and welcome to yet another episode of the Art of Prevention podcast and, as always, I have a super special, amazing guest.
Speaker 1:And today I'm talking with Tony Katakis, who is a doctor of chiropractic, does a ton of rehab and active therapies with his patients, and his patients are wide ranging from super high level professional athletes that you might see on Sunday down to the high school athletes, to junior high kids and everything in between. So, tony, you were in school a little bit ahead of me when I was going through school and I wish we had hung out a little bit more. You know, but tell us a little bit more about yourself and your practice. You recently kind of rebranded or opened up the St Louis sports clinic and we were just talking about how man, I just love that name for a chiropractor clinic because we just all encompass like, oh, you need something for sports care, come to the sports clinic. I love that. So tell me about how you got into I know we're going to share your origin story and then how that came into being the sports chiropractor that you are today.
Speaker 2:Awesome. Yes, thank you, nick. It is a dream come true to be here with your brother. Yeah, I don't know. It's crazy to see, kind of down the line, how like minded we are and just wish that you know. Maybe at the time we would have spent a little bit more time cultivating that. It's kind of funny how these relationships come together.
Speaker 2:So I guess if I was to rewind and, you know, look back to where this whole thing started, when I was growing up, I was obsessed with football. My life revolved around football. Everything I thought about, everything I did, everything I wanted was related directly to football. I wanted to get a scholarship and play in college right, because everyone I looked up to that's what they did. And I went to a small town where that was kind of the thing when I was growing up and my time finally came and I had been putting everything into my journey as a football player. And then my sophomore year, I got moved up to varsity and I was playing and things were going well. The following year, my junior year, I was like, okay, things went well. Last year I got to turn it up, I got to go hard, I got to do everything I can to be able to play at the highest level. So I started training like an absolute psycho. I was doing everything I possibly could, which I thought at the time was the best thing I could have been doing. However, I was training like a psycho.
Speaker 2:It was preseason of my junior season of football. I was doing like Vertamax training and I was lifting and I was doing speed work on top of the practices for my team. So I was kind of doubling down, thinking that that's what you were supposed to do, and I will never forget what happened. So, first game of the season, I think I was healthy, everything was good, no problems. But it was going into the second game of the season, I was still trying to keep up with this insane training schedule during the week and then maybe recovering for a day or two prior to the game, thinking that that's how it worked and I would miraculously get all these crazy results and play at the best of my ability.
Speaker 2:Going into my second week of the season, I felt this pinch in my hip that I couldn't really shake and we were doing sprints at the end of practice and I started like galloping because I had this little limp and it was this pain in the front of my hip. I couldn't figure out what was going on. Coach saw me limp and they started barking at me, telling me to just sit out, and then they started looking at me and trying to figure out what was going on. They had no idea, so basically I ended up playing the season, took a bunch of NSAIDs and just kind of limped my way through the season. They called me the galloping ghost because I would just try to like I would do the whole season.
Speaker 2:I was good in the box, but the whole season that was week two and we played nine games because we didn't make playoffs that year. So there were seven more weeks of just misery and I abused NSAIDs to get through the season.
Speaker 1:And those are eventually non-sterile anti-inflammatories, ibuprofen, advil, things you can get over the counter, things that high schooler can get, and just start slamming. Sorry, I didn't mean to interrupt people.
Speaker 2:Tore up my gut, which is another side effect, another reason why I would not recommend that. So then I got through the season. But the first thing I did after the season because I didn't want to see a doctor during the season because they tell me to sit out. So after the season, first place I went was the ortho's office. The ortho looked at my hip, I don't know. He was with me for like two minutes after. I was in his office for two hours waiting and I don't know, scoured my hip for like a test or two and then said yep, you got tendonitis in your hip, you need to take a month off and take ibuprofen, which I had already been doing twice a day or three times a day. It was like every four hours. I was like okay, so that's all I do. Yeah, that's all you got to do. I'm gonna sit out and rest for a month. Okay, so I do what the doctor orders. I go home and I sit out for a month and I felt so stupid doing this. I'm like why? Like, there's nothing productive I can do in this time, I'm just supposed to sit here and wait and hope that it gets better. So it didn't surprise.
Speaker 2:And the next place I went was the specialist right. Everyone knows like in their area, in their town, in their state region, whatever there's like the guy you know he's the ortho, he is the king ortho of all orthos for this specialty. So there was the king ortho in all of Michigan and and, and I don't know, the upper Midwest for hips and he was at this hospital or whatever and you had to go see him. So my mom and I get in the car, drive all the way out there and I guess prior to seeing the doc, they had me come out, get CT scan, mri, all that, and so I was primed up, teed up, ready to go they, I go into the office, all my images are up and it's this whole fancy thing like this is the guy right and he comes in after again, spent probably two hours in the waiting room, barges in the room, says well, it looks like you got hip impingement and you know you're going to need surgery and I was going into my senior year at the time and again, still, football was life and he goes and you're probably going to need to be, probably going to need to say buy to football forever. You're going to be done playing football and I was like what you know I was at the time, it was the only thing I cared about.
Speaker 2:He sucked the oxygen out of my lungs and out of the room and I was like not play football. What do you mean not play football? He's like, well, it's really not that important, you know, you'll realize, and I'm like I got one goal. There's only one thing in life I really cared about at this point as a 16, 17 year old kid, and this guy just took it away from me. And so I remember just being lifeless the rest of the appointment. He just went pure, like you know, like the adults talk and sneak upy or whatever, and it's just like I don't think I heard a word after that.
Speaker 2:All I remember is I got in the car feeling terrible for myself, started busting down, crying in the car with my mom going all the way back home because it was like an hour and a half drive and I was just like I was completely robbed of all hope and life. And I remember just you know, feeling sorry for myself for like a week and I thought football was over for me. I thought my life was literally over, which sounds crazy, but at the time that's how it felt, like my world had just crashed in and everything was done. And so my mom luckily, she, she, she told me oh, we should probably try something else. We should try to maybe look for other alternatives.
Speaker 2:Now, at the time, the surgeon, the guy, the number one dude in the Midwest said well, you're not very symptomatic right now because I had been sitting out for three months. Hey, you're not really symptomatic right now. So we can't do surgery, because that's contraindicated, like we're not just going to do surgery if you're not symptomatic. So it was like well, what do we do? He's like well, when did your hip hurt last? And he's like, well, when I was running. He's like, well, go join the track team. And I was like what? Yeah, go join the track team and go run, and then, when you get hurt, just come on back and what a practice model that is.
Speaker 2:Oh my God. And when I look back I think how crazy this situation is. I'm like this dude had me join the track team so I could get hurt, so he could do surgery on me, so insurance would pay for it because, because I was symptomatic. And so I joined the track team. Right, because doctors orders right, oh my God. The first doctor told me to do nothing and take NSAIDs. The second guy, the guy, told me oh, you're not in pain right now. Go join the track team, get hurt so I can, so I can sink my teeth into you. And then so I joined the track team and I got home from practice one day and my mom's like, well, we're going to try this. This chiropractor down the road and I was like, mom, what are you doing? Like we're wasting time, we're going to, we're going to go to this guy like the, the, the.
Speaker 2:The guy, the surgeon, told me that I had no options and I needed surgery. What are we doing? She said, basically, you know, shut up and listen. So I I went and he was a straight Cairo at the time and he told me uh, basically, you know, hey, I can't fix your hip, but there's some, some areas above and below some stiff segments that I could help move better your foot, your, your, your pelvis, your your mid back, your TL junction, your T spine. There's some things I can do to potentially, uh, move better that might take pressure off your hip. That might make your hip move better so you don't have pain. And I said, all right, yeah, whatever.
Speaker 2:Now, at the same time I was also going to a facility and I called athletic Republic and Auburn Hills, michigan, and I was working with a guy who I guess by trade he was like an athletic trainer, but we were. We would do these like hour long therapy sessions, him and I and uh, and it was called a bridge program, um, uh, and that's exactly what it was. It was trying to bridge people from from injury to performance and he took me through just some like basic FMS and SFM a stuff. Back then it was awesome and and he, he's. But he said the same thing hey, uh, you know I can't tell you that I'm going to help your hip, but you know your, your ankle door deflection isn't the best. You know your, your hip range to motion overall could improve quite a bit. Your, your pelvic tilt is kind of kind of wonky. Your core is kind of kind of weak or whatever you're you. You don't move that well relatively speaking right and there's some things that you could work on, maybe move better with. So I said, okay, whatever, I did both of those things in parallel to one another and I never had hip pain again and I went on to play my senior year at high school and I had a great senior season and I got a scholarship and I ended up going in and went and played football in college.
Speaker 2:And it wasn't until that point where I was in college and I was playing football, where I looked back and I was trying to figure out what I was going to do with my life at the same time, and I looked back on that experience and I was like what a gift Someone gave me when I was completely out of hope, when I thought I had no options, when I had to just listen to the surgeon, when one told me just sit out and take ibuprofen and do nothing, while the other one told me you're not hurt right now, go run track so I can. I can eventually, you know, cut you open and and and shaved on your, your acetabulum or your femoral head right and and and after those, those, those consults had taken all the hope and all the dreams away from me. Someone else looked at me for more than just my anatomy, for more than just my hip structure, for more than just my image on a screen or or on an x-ray or whatever. And I, at this point, I've dedicated my life to looking at patients for more than just their anatomy, for more than just a piece of you know the picture, for more than just an MRI or even an MRI report or you know an x-ray, and I think some really great things, and I guess I'm, I'm, I'm.
Speaker 2:My story is a is a testament that there are great things that can happen if you just look, if you look above and below, if you, if you treat function, if you just help people move better and feel their bodies better. Surgery is not always the answer and, most importantly, rest in insets is not always the answer and it probably is never the answer. So I've dedicated my life to that right there, and so now, what I'm doing now is is, when I graduated school, I started my own practice here inside of a performance facility it's. It's a big 20,000 square foot gym, and and just recently we changed your name to St Louis Sports Clinic. It it's been me for about five years, but we just hired on two other chiropractors who are now starting their journey here as well. So there's three of us. St Louis Sports Clinic. We're inside of elite performance academy here in here in the Chesterfield Valley in Chesterfield, missouri.
Speaker 1:Oh, my God, amazing. There is so much more to that story than Ivan. I think I got the two minute, I got the one minute version of it. You know, and gosh, there's so much to unpack there. I mean, what a powerful story that. I mean.
Speaker 1:This is why, like, people become you know chiro's right, it's cause they go to the chiro, they get fixed up and it's like, oh man, now I've got this secret that I want to like tell everybody, you know. And I think what's really cool and really powerful is now you're doing what that ATC and what the chiro was doing, like looking at function for the function you know in the, you know joints and articulations and how they're moving, but also looking at the function as far as movements and things like that as well. Right, and you I mean I can see your you know certified strength and conditioning specialist plaque on the wall and I know that you've done a lot of continuing ed to help you facilitate that and get a lot of knowledge that you're now helping out a lot of students with as well, too, right.
Speaker 2:Right, right. So yeah, my favorite. Well, first of all, I think you and I probably share common ground here. Brett Winchester is my hero right, the goat.
Speaker 1:He is the goat.
Speaker 2:He's the goat. He taught me everything I know. Actually, he's the guy that when I was in school. He's the guy that really sparked hope and showed me that this style of practice working with athletes or treating function was a possibility and you can do more than just the bare minimum and just manipulate joints. No, no, no fault, like if that's your thing, that's your thing, but for me, I wanted to do a little bit more and work with athletes, and that guy was the guy that showed me the way.
Speaker 1:Yeah, still, he's going to be on at some point or just waiting, you know, kind of for the right time. But yeah, and now, working with athletes. You know, obviously we are often treating people for injuries, right, we see them after these injuries have occurred. But I'm sure that you know as well as I do we can, you know, see things that occurred in people with their movements, with their nutrition, with their sleep, with their coaching style, et cetera, that can predispose individuals to injuries.
Speaker 1:So you were an athlete and part of your origin story is like I was burning the candle at both ends. You know I was really doing way too much which I've been there with running, where it's like, oh yeah, I was going into the training room and I was doing three hours of like bird dippers and standing on a bozu ball and stuff like that and you know, wasn't a big bang for my buck, wasn't a great return on investment as far as like decreasing the prevalence of my injuries. But we have a lot of actionable items that are really easy, that can really reduce the risk of injury. If somebody's like an athlete or one of your athletes that's listening to this because I know you're going to make all your athletes listen to this. You know what stuff should they be doing in order to reduce their risk of injury Right?
Speaker 2:So there's kind of two categories of injury that I see from the non-traumatic variety right. So basically, training related injuries. There's the camp where maybe they're not doing enough and when I say not doing enough it's probably not what most people think it's not doing enough of the thing that is going to lead to breakdown later. So you have to expose yourself to the thing that you need to build tolerance towards. So, for the example of, like a hockey player, it's really hard on the hips, it's really hard on the groin, it's really hard on the ankles and the low back, and so it's common for people in the off season to be able to do that. And so it's really hard on the off season to focus on heavy lifting and potentially just running all the time or doing anything other than skating and not focusing on exposing the tissues or the movement patterns that they're going to be placed in throughout the season a whole lot in high volumes, not exposing themselves and building that tissue tolerance during the off season. So that's things like training the groin, training the outer hips In our world, strengthening the muscles around the joint so that there's balance around the joint, and hockey is one of those, those sports in particular. That's a lot of those players are predisposed to quote, unquote imbalances, because it can be very heavy on the groins, for example, and you need to be able to prepare all of the tissues around the joint, especially in the off season. So that's kind of the not doing enough. Make sure that you are doing a steady practice of movement, preparing your anatomy, preparing your tissues. If you're a runner, it'd probably be smart to do some lower leg and calf and Achilles work. It might be smart to do some patellar and quad tendon stuff, just to expose those tendons and expose that tissue to what the load is eventually going to be. On the other end, doing too much right this is I'm talking to who I was 15 years ago.
Speaker 2:Rest is a weapon, right, and doing too much is a thing, and so you have to listen to your body and you have to understand that you aren't going to get better by simply burning the candle on both ends or by doing three workouts in a day and doing that every day. It's not sustainable, and so you need to be sleeping really, really well. You also need to be dialing back instead of just doing everything because you saw it on Instagram or Tik Tok or YouTube. Instead of doing everything just for the sake of doing everything, because there's someone out there who's successful doing that thing, it doesn't mean it's right for you. And so maybe finding what are your weaknesses, what are your strengths, having a balanced program and just executing on the basics and that's things, like you know, not really working out for much more than maybe an hour and a half in a single day.
Speaker 2:You know you don't have to do three hours, you don't have to do two sessions of an hour and a half. You can. Simply, your body will adapt most likely better if you feed it that moderate variety and still you can crank up the intensity. But you just you don't need to do intensity and high volume at the same time. So that's something that I think I see most athletes get into. Trouble is when they press the volume button and the intensity volume too hard at the same time. Yeah, there's a time and a place for both. And if you up the volume you might have to down the intensity a little bit. And if you up the intensity, you just got to know that you need to up the volume, or sorry, down the volume, at that time too. So rest is a weapon. Obviously, sleep nutrition are huge, but don't get in your own way by thinking you have to do, you know more than what's necessary. Yeah, we want like Goldilocks principle, this right.
Speaker 1:Do you kids still learn? Like the Goldilocks principle, Like I don't know? Is that still a thing? That's right.
Speaker 2:Well, one more thing there, nick, that I guess I didn't mention. That's mostly for the youth athlete, but for the adult athlete, the one thing that these people struggle with is, you know, maybe they have some chronic issues in their shoulder, their back, they're growing, their ankle, whatever, and there's kind of two camps that you could fall into. You have two options in life. Right, health, life, whatever.
Speaker 2:It's an infinite game. You're always going to have to take care of your body and you know your shoulder pain or your back pain or your neck pain. It might never be a situation where one day it's just cake and ice cream or sunshine and rainbows. You might always have a little bit of low back pain or you might always have a little bit of shoulder pain, but I promise you that there is something that you can do to help your situation, to mitigate your symptoms, your pain, to improve your mobility and to improve your stability. And so, just like brushing your teeth and taking showers and working on your relationships and eating those are all infinite games, right, there's no end date. The end date is the day we stop breathing, basically. So between now and then, the game isn't to get from point A to point B and then everything will be solved. The point of the game is to never stop playing. Always take care of yourself, always look to get better, always look to grow. That's why we're in this situation in the first place.
Speaker 1:Oh man, that is just such true words. I mean, that's also what I know we're both fans of, like Peter Atia, and did you read his book Outlived?
Speaker 2:Not yet. I cannot wait. I need to make some time.
Speaker 1:Oh, I mean, you listen to his podcast and stuff like that. So you've got a. What he talks about in that book is the shift from medicine 2.0 to medicine 3.0. So we're in medicine 2.0 right now, which is like, oh, you're dying, you got to go to the hospital. Oh, we see this on your hip MRI, You're going to need surgery and you're never going to be able to play again.
Speaker 1:To now more of proactive health where, oh, you've got this little ache or pain. You need to go get that checked out. And we need to create a couple of things or instill a couple of movements or therapies that can keep this from becoming a huge issue down the line. So many people they're looking for that next greatest car or that next greatest house and that big down payment, and then it's like, oh, I got to spend this much to go to the chiropractor. Oh, you're just, you don't take my insurance that my company pays for. It's like, look, man, I'm trying to help you and you're like setting up these barriers for us to help each other out. And it's like, gosh, you can replace your car. You can replace every part of that car. If that car falls off a cliff, you just go get a different one, but you just can't do the same thing with the body. I mean, I don't care what you say Hip replacements are amazing, Knee replacements are amazing, Ankle not so much and shoulder not so much either. But no matter how far we get with those things, it's like we're given this one body and we need to take care of it.
Speaker 1:And I love what you talked about with weak points too. I had Alec Draglin on a couple of weeks ago and that's one of the things that we talked about, Like we're not fear mongering, we're not telling people like oh, you don't squat very well, oh, you know, it's really just, we could work on your squat. You know what's the driver behind you not being able to squat at all? Oh, do you have an ankle door sub flexion limitation? Do you have a hip flexion limitation? Do you get a pinch in the front of your hip like that, FAI?
Speaker 1:Are there some things that we can do on a daily basis as far as mobility and exercises and muscle activation et cetera, to improve that standard Absolutely? And I think that that's where I mean people like you and I are really coming into form these days. We can take those people that want to have a longer health span and those long healthy lives where they can do all the things that they want. And we can instill the practices like brushing your teeth, like taking a shower, oh, doing your hip mobility for five minutes a day. All those different things we can give to athletes, we can give to coaches to distill to their athletes, we can give it to the adult athlete, et cetera. What are some of the ways in which you find those weak points in some of your athletes?
Speaker 2:The main two movement assessments I use is number one. There's a technique called grip approach where they have a movement assessment, different manual therapies and a like corrective quote unquote movement strategy for the movement assessment right. I also love SFMA, right. I've used SFMA class classically for the last five years or so. It was the first thing I was really exposed to probably from a movement assessment lens probably seven, eight years now and love SFMA. I still use a ton of SFMA in my day to day and that's the selective functional movement assessment.
Speaker 2:That's Greg Cook, greg Rose, I believe, are the two main guys on that. But they break down every joint of the body and they tell you basically, if something is moving well within its quote unquote normal range or is it not. And if it is not, is it like a motor control function stability perspective, or is it a joint or soft tissue issue? So it could be a tight joint, it could be a tight soft tissue and we can identify those things. The grip approach is similar but different in a few ways.
Speaker 2:The grip approach is a way of looking at every single joint in the body and isolating the range of motion of that joint in all three planes of motion and having tests that are very standardized that allow you to assess that range of motion or that function right. So there's subjective components to it and there's qualitative components to it and there's objective subjective components to it where we're looking for a specific number to hit. We're on the subjective side or the qualitative side. We're looking more. So, when I raise my arm overhead, do I have to crank through extension of my lumbar spine to get there? Do I have to flare my rib cage and go through what Rich Olm described as the compression extension strategy to get my arms overhead? And so it's more than just the number, it's also how did we achieve that number? And that's where grip approach does a really good job.
Speaker 1:Bringing all that together and being, I guess, very specific with what we're looking at and what we're measuring, nice yeah, and I love the multifactorial approach Like these are all tools that we utilize to assess movement and look at how people are functioning with their physiology to get the performances that they want. And sometimes it can be as simple as oh yeah, when you're doing this movement, you just can't do it. You know, let's find out why you can't do it. There's our weak point, there's our starting point, and we're going to give you a couple of things to build from there so that then you're going to be less likely to get injured, because now you can distribute load across all of these articulations, so all of these articulations and all these joints and all these soft tissues, and you're not just loading one thing like the front of your hip or like when I was a runner with my Achilles. For a long time my Achilles heel was my Achilles. So you know that was nice and easy right, and I didn't know a lot of the stuff that I know now and that is taught by, like awesome mentors like Rich and Brett and all those guys. So it's been a pretty cool, transformative process and through that we're able to help hurt athletes but also help try and prevent some of these athletes and especially the recurrence of injuries. Now the best predictor of injury if you look at the research. Like you mentioned, sleep macronutrient intake, but previous injury.
Speaker 1:What would you tell somebody that's coming back from a previous injury? Because a lot of people think, well, I went to PT or I went to Cairo and I got out of pain and I'm good. I graduated from PT. You see people coming back from an ACL injury. I graduated PT and they'll use that nomenclature, so I'm good now. Then they end up in our offices a year or two later and they're like, yeah, I don't know what's going on. I might need to go and see my surgeon again. I graduated PT and did everything fine and now everything's been going good but my knee's starting to hurt again. Like what's going on and do I need to go talk to my surgeon again? What are your thoughts on that?
Speaker 2:Yeah, I think it goes back to that infinite game example. Like you graduated PT or whatever, but that does not mean that you stop taking care of your knee. That does not like. My low back hurts. That doesn't mean just one day I stopped doing things that are good for my low back, like it's like I brushed my teeth this morning. Therefore, my teeth are always clean. Like no, it doesn't work that way. So it's this infinite game.
Speaker 2:You always have to make these deposits. You always have to continuously take care and maintain and work with what you got, even if it's not ideal or perfect, or even if you're dealing with some sort of post-traumatic issue that's never going to be the same on an MRI or a diagnostic ultrasound, ever again. It does not matter. What matters is the fact that you keep on moving and that motion is the lotion, motion is life, rest is rest Right, and if you continue to just move the system, if you continue to maintain your movement, if you continue to keep that object in motion, in motion, you're going to be all right. The opposite is, it would be a recipe for disaster. Doing nothing, expecting to have done a little bit of work and yield life long, forever lasting results is unreasonable. And so that's really like. My advice to that person is, more so from a motivational perspective, like we need to get you on board with long-term, infinite care, or not care, but more so long-term maintenance, and that doesn't necessarily have to be with a provider. That's 100% on you, because that's your back, that's your hip, that's your ankle, that's your shoulder, and you can't give that or delegate that to anybody else. And so this is something that you these are the cards that you were dealt, and this is the game that you have to play.
Speaker 2:And so that just means the name of the game in this situation is just to keep on, keep it on, keep on moving, don't stop, because oftentimes, as you know, that's when a lot of the major issues take place, and when we're talking chronic pain, or just maybe that issue or that thing that we were dealing with leads to a poor movement, and so that poor movement can have a trickling down effect to other regions of the body when now, like, maybe I have this knee thing. Next thing, you know, my knee's not moving all that well and maybe it encourages me to do less, and then now my hip starts to hurt or my hip starts to break down Next thing. You know, 10, 15 years later it's possible to have some some degenerative process that was maybe accelerated because I stopped moving or because I stopped taking care of myself in the hip, and then you know who knows where else. So I think the the object of the game is just to keep on moving.
Speaker 2:Don't stop. Continuously take care of yourself. You're never done right. That's not how this game works. You're never done and it's not over until it's over. So just keep on moving. Motion is life.
Speaker 1:Oh yeah, and I totally agree. And I I am really fortunate with the patient population that I have out here in Simmer County, colorado, in that I get to see a lot of crazy athletes that are in their 60s, 70s, 80s. I mean we have people that are in their 70s that ski 100 days a year, you know, and it's like ridiculous. And one consistency between all those individuals is exactly what you said Movement and maintenance type care that they perform on a daily basis. They've made it a habit, like they've James cleared the heck out of that thing atomic habits, you know, and it's part of their daily practice to do some form of movement, some form of mobility, stretching, but also they're doing the thing as well, whether that be skiing, golfing, running, et cetera.
Speaker 1:So all of the people that I see that are super high, functioning later on in life and maybe they've had a couple of orthopedic injuries, like you know. Some of these people are, like you know, they've had an ACL terror. Or I mean one of the guys in my office, dr John. He's had both of his hips replaced and the dude can ski circles around me. I mean part of it's because I'm not a very good skier, but you know what I'm saying. Like he does daily practices that work the musculature around that hip. So then all of the neuromuscular coordination that he's gained with skiing for the last 50 years he can just still utilize every single day that he goes out on the ski hill, which he still teaches skiing too.
Speaker 1:So one theme also is like getting rid of the kind of next up mentality Amongst coaches and it's like yes, as a coach, you need to focus on the performance of your athletes, because that's why your paycheck's getting written, because you need to focus on getting the most out of that athlete in the short period of time that you have them, where that's four years for a high school kid, or four or five years at the collegiate level. But we also have to be thinking about that athlete as a whole person, with an entire lifespan, hopefully. What are some of the things and practices that coaches could or shouldn't still in their programming that looks at the big picture?
Speaker 2:I think the biggest thing would probably be just to start with a good assessment right. Nowhere you're, you're starting and from there you can gather a lot of the information or a lot of the tools that that you would have to to bring together for for whoever you're serving, whether it's an individual or for a team. I I think, if we are simply just kind of proceeding blindly without any sort of baseline, that that typically leads to poor results or, and sometimes and you know some situations potentially injury. We really fortunate here we have a group that they're called OE Baseball Academy, but they they have this really cool piece of intellectual property where they have these force plates through Hawken but they have this IP that they then pull the force plate data from Hawken and it goes to the cloud and they have a lot of different equations and formulas that break down their data and it's able to present this, this report that allows them to see what bucket maybe their athletes should be in. So they look at at four different metrics and and these are things I utilize with with a lot of my clients especially the more performance variety that the professional athletes or even advanced college athletes, that breaks it down into momentum, which is essentially a score, a very objective quantitative score, for how well they move their body relative to their body weight. Right, and there's a whole lot that goes into that equation, and it's not my intellectual property, so I don't have to do all the thinking behind the statistics and the math component. I just get to interpret the results.
Speaker 2:The second component that they utilize is fluidity. So that fluidity score basically assesses how well they move through range of motion, so how large is the range of motion and and how how well do they move within that range of motion that they do control. And then next would be strength. So strength is a an overall score, basically, of how much force is produced. And then, lastly, they look at power too, which is essentially a score that interprets force and speed at the same time. So we're looking to see how fast can you produce force, as opposed to just simply how much raw force you can produce. So then it's a really cool system that they have here and it's I've seen it prevent that injuries, or at least keep the number of injuries in, say, for example, in off-season training, block down, because they're able to train athletes based on their demands or their needs, you know, and, rather than everyone getting the same blanketed approach, they have a way of of treating the power athletes right.
Speaker 2:The power athletes in this situation have. They produce force really quickly, they produce force really well, but sometimes they lack the stability or the baseline strength to control it, and so they'll get, you know, weird injuries like hamstring strains or or Achilles injuries or, or you name it, and so there's there's a lot of different things that they're able to do to interpret that, say, you wanted to go more low tech. You don't need force plates that cost $10,000 and intellectual property that I'm not even sure if I'm supposed to be talking about. But you could incorporate easier things like I don't know, a y-balance assessment or even a movement screen like an fms or anything that you're going to be able to assess an athlete or or see whether or not an athlete is competent with their movement, and then go from there. I think in that situation a little goes a long way, where you can just pour into your athlete's ability to move and to move well, and it it also depends on the specific demands of the sport right. For the example of hockey hockey is such a unique sport with with a unique variety of demands, especially on the hips and the low back and the ankles and and all the things that go into skating, which is not a natural human movement. And so it's probably smart to prepare the hips and the ankles and the low back and the core and the pelvis for the, the unique demands of that sport. And so you know, if you're thinking football, maybe it's it's you know, preparing for the, the common things that a football player would deal with, like the, the next strength, the impact, you know, finding your ideal body weight too. It can be, can be big in a lot of situations. And then also, like if you are in a strength or power sport.
Speaker 2:Also recognize that there is a point of diminishing returns in terms of strength. Right, like, why in the world would we be loading up a thousand pounds and then somebody's back if their sport isn't lifting weights? Their sport is to go be an athlete and of course you need a baseline level of strength. You need a specific amount of strength to be effective at doing your thing or playing your sport. But there comes a point where there's diminishing returns, where the risk versus reward of loading up and we all see these videos in the springtime when high college athletes have been lifted in all summer, all winter, and they're preparing to enter spring ball. You see the videos of guys who are like you know, uh, maybe 200 pounds, squatting back, squatting like 650 pounds, and the whole team's just screaming around them. In that situation, yeah, that's, I mean, that's amazing and that's really cool and if that makes you proud, awesome.
Speaker 2:However, what's the risk reward in that situation? Is that 650 pounds on your back worth the risk that the reward of just your buddies being proud of you is? Is that? Is that worth potentially, yeah, an injury? Because, uh, there's a, there is a possibility that that load would be Uh too much for whatever your body's capable of handling, potentially, if it's like a one rep max situation. So things like that, uh, you know being smart with your, your testing, and and your testing doesn't always have to be one rep max, your testing doesn't always have to be you know, uh, those types of lifts where you really not, you're not gathering much information about how effective somebody is on the field. So, so why risk when there's very little reward?
Speaker 1:Oh man, so much to unpack actually. Uh, just went to a talk over the weekend that was taught by mike boil. Um, the, he's the strength and conditioning expert over at boston university. He's worked with the broons. He worked with the red socks in 2013 when they won the world series, and the dude kind of turned my world upside down for a little bit.
Speaker 1:I'm not gonna lie to you. He's like yeah, you know, I've got these professional football players and I told him they didn't have to back squat. And it's like, what you know? Like because in the pt world right now and in the kaira world that we live, and it's like Everyone has to back squat and everybody has to. You know like, load up the bar, you know, and all the stuff. And he's like, he's like why? Like what's the point of doing that? And they're like oh, to get off the toilet when you're 80, what 300 pound man is like on your back when you're trying to get off the toilet when you're 80, you know who who is. Who are you hugging while you're on the toilet trying to get up? You know like, what are you carrying while you're trying to get out of there? And I was like, well, gosh, dang it. That's a pretty dang good point. You know, like, and there is that diminishing return and it's like when we think about we have to start with why which is how he started his Talk like why are we doing this stuff in the gym?
Speaker 1:Oh, it's to get better at Football, hockey, whatever your sport is for me, like I do. You know some work with runners, so I wrote a PDF strength training for runners and it's like, yeah, like this should not detract too much from your running training. It should be additive to your running training. Like, how much of your stuff is just random Shit that you're doing? That is not actually making you a better runner. You know, and and sometimes you know people look at the Programming. They're like, oh, I want to do a lot more core stuff and it's like You're a runner, you know you like it. If you were like a hockey player or a snowboarder, like maybe, but you know it's like we've got core exercises in there. You don't necessarily need to be adding, kind of like previous Tony, you don't need to be adding all this other stuff, because it's like you're a busy person. You don't want to have to spend three hours in the gym doing all of your accessory work. When it's like we could do five or six exercises in a day, get it done within 45 minutes, because this is also not your main sport and we will get diminishing returns from Some of those high risk things like an 800 pound barbell back squat.
Speaker 1:Like If your goal is to be a strongman powerlifter and squat 800 pounds, that's what you got to do. You know, like you have to put up a barbell and you got to put a lot of weight on it because that's what the goal is. If you're a soccer player, you probably don't need to be able to do that and, honestly, it might detract from it because that's going to be a lot of weight and you're trying to be fat, you know. So, yeah, I'm just so on board with all of these, these points that you're talking about. I mean, when I had Taylor Primeraan One of my first episodes I think it was like my second or third episode Um, you know, he had an athlete that was going into their senior season.
Speaker 1:They were trying to get onto the board, hit these marks for the weightlifting you know their weightlifting things and they were going into a clean trying to get a big PR and then broke their wrist. It's like Nobody applauds when you limp out of the weight room. You know Like, maybe in the game where you're exposed to trauma and like these things that we can't really factor in like you know, people are, like you know, applauding and stuff like that and it's all cool and stuff. But I've been there where it's like, you know, nobody's applauding when you're out on a 10 mile run and then you have to walk the last five. You know Like there's no glory in getting hurt in training and we want to decrease the risks while we're in training so that we can perform at the highest levels, because if you're just going through these cycles of like injury, not injury, injury, not injury, like that's really not going to pay any dividends when you go out on the field later on.
Speaker 1:I think the stuff you've been saying about the goalie locks principle and like kind of hitting right in the middle Of that optimal dose Is where we need to all be, whether we're athletes or coaches athletes or coaches right, what other stuff do we have for like clinicians? So you talked about force plates. We talked about some movement assessments and things like that. We talked about some different approaches like SF, may and grip. What are the things we do for athletes, like in season, like are you giving them some nutritional advice and things like that? Is that kind of built into some of the stuff that you guys do?
Speaker 1:And I know this is like you know we've got nutritionists that do nutrition stuff. We've got, you know, coaches that should be talking about sleep, things like that. What kind of stuff do you do for interprevention for some of those athletes?
Speaker 2:I Definitely I'll touch base on, on things like, like nutrition and sleep. Those are the two primary pillars, primarily making sure from a nutrition perspective you know, did the nutrition meet the demands of their activity or their support? Are they eating enough protein? And, in some situations, if they're struggling with carbohydrate intake, like are they, are they bringing enough of that? And also Also from a supplementation perspective. We tend to hammer a lot of the basics here, like for athletes at least. We utilize a lot of thorn products within our clinic. I love their creatine supplement, I love their their Omega supplements. I think they have a super EPA supplement.
Speaker 1:I literally take.
Speaker 2:No, I love them. And then their daily greens is too. I mean, it's not necessarily required for an athlete, I think it's just a really good daily multi thorn, daily greens. And then we also, from a sleep perspective and a supplement perspective, we try to get people on magnesium, whether it's three, innate or bisglycinate, just to allow that carryover through the blood-brain barrier so that they're they're able to Utilize the the awesome components or properties of magnesium that help with sleep, which then would turn help with recovery and just down regulating the nervous system and getting the nervous system or into a pair of sympathetic states so we can repair and recover a little bit easier.
Speaker 2:A lot of my athletes wear wearables like, or rings and whoops sometimes those can be nice too Just to track patterns. Like you know, I think really my favorite thing about the ordering or the whoops say what you will, oh, about them. I know a lot of people have opinions. I won one for a long, long time. It taught me one thing that has changed my life forever and that is the effect of alcohol on recovery and sleep. And so it has made me, the whoops single-handedly made me Basically quit alcohol forever, or at least the abuse of alcohol. I don't think I've gone on a single been there since wearing a whoop, right like there that it just it really objectively tracks the, the risk and reward of Of going out and having a good night. So, of course, if I'm talking to my college athletes, where that's probably the most relevant, getting them to realize the effects or the, the detriments of alcohol, especially in season, just stay away from it. There's no point. Yeah, I get it, have a little fun here and there, but it really needs to be controlled and limited as much as you possibly can, because there's no benefit to that whatsoever for your performance.
Speaker 2:And then, I guess, other things for in season. You know, obviously we can't really account for trauma, that that tends to happen and we deal with it as as, as you know, it comes. But we we tend to see people in season baseball players are a good example. Baseball players, especially pitchers and I can't remember the exact statistic, but it's after a pitcher starts they lose x percentage of range of motion for up to like Three or five days or something like that. And so one of the things that we can do for a pitcher, a starting pitcher who goes and throws 80 pitches right One of the things that we can do for that person is really work on gaining that range of motion back in that recovery process. Things like soft tissue therapy and the medial elbow In the pec, in the lat around the upper trap, in the middle trap, and just getting the energy back and just getting the T spine moving and functioning from a chiropractic perspective, or a joint manipulation and joint movement health perspective. Making sure that the CT junction is springing and moving well, making sure that they have adequate T spine extension and rotation and TL junction extension. So all these things that a baseball player needs.
Speaker 2:We make sure from a mobility perspective we're maintaining those ranges of motion because, say, for example, if I'm throwing and I'm throwing too much or I'm I'm Overdoing it and I'm not fully recovering, and say I don't fully recover that range of motion in my glenocherminal joint back, internal or external rotation, right, what's eventually going to happen? You, it's possible that you end up transferring that force Through other joints, other segments above or below that segment that's lost its range of motion. So in the case of a glenochermal joint, it's really easy to imagine that if my shoulders not laying back as far and not Allowing me to lay back as far and drive back into external rotation in the late cocking phase of throwing, well then the elbow might have to go through a little bit more torsion force to then be able to perform the activity that I'm used to or I'm required to perform. So In that situation, in the in-season thrower who needs that full range of motion, that range of motion is everything and that very well Could be, potentially theoretically you can't say yes or no, but it could be Something that that helps somebody stay healthy and, if managed poorly, leads to maybe their detriment at some point, depending on what, what their utilization is throughout the season.
Speaker 2:The baseball player is really fun to work with from a clinical side because it is a fairly objective Process from from a range of motion perspective, also from a pitching and hitting perspective, they only do one thing. You know, like there's so much variability and soccer and in football and in Rugby and all these other sports and I know I'm speaking broadly to hitting and throwing a baseball I know that there's more than one pitch and that you know the ball the pitch comes in at at all different angles and speeds and velocities. But that's more of like a neurological game than it is a physical game right. So you need to be able to address those components, or those variables, and and adapt on your feet. We, and that's what makes great players great, but they're so. The reason I say that is because they're so fun to treat, because you know that in order to rotate well, you need to move well through your T-spin, you need to move well through your hips, you need to move well through, in the case of a pitcher, through your glenohumeral joint and your elbow needs to be stable and strong. So there is, there's so many things that we can do to optimize all of those variables up and down the kinetic chain and make sure that that person's not only moving at their best and potentially avoiding injury, but at the same time, performing at their best.
Speaker 2:And that's another component or another reason why I'll lean on sports data or sports science. In some special cases. This isn't practical for, like you know, every baseball player that walks through my office or every kid that plays football that walks through my office. But I will utilize before and after objective tests like, on a low-tech side of things, a y-balance, or I'll even I'll video a lot of movement my office. I do a lot of video on an iPad or pictures on an iPad to show Different patterns, different movements, different ranges of motion, stability, whatever. But sometimes too, will utilize those force plates and we'll see did you get better, did your output improve from the inputs that we provided? And if that's the case, then we know we have a recipe for success. And if the opposite is the case, we know we have to tweak something. And you know that that's kind of. I'll go through all that to try to hopefully meet the demands of the person in front of me or to To to give the person in front of me what they need.
Speaker 2:And and like I had mentioned earlier, from a movement perspective, I'm really looking mostly to the lens of grip approach. But secondary to grip approach, there are some really good special tests, primarily the breakouts in SFMA, that I think are awesome. From a hands-on perspective, I utilize a lot of motion palpation, see what joints are moving and what joints are not moving. Well, from a soft tissue perspective, just getting hands-on and appreciating tissue tension tone, you know from, as I'm in there and I'm moving around to join as it a soft tissue issue or is it a joint stiffness issue. There's so many different techniques that we could utilize to help open up soft tissue. So we provide all those inputs and then, lastly, in order for any of that maybe range of motion or mobility stuff that we just performed, in order for any of that to Actually stick, so that the player or the patient or the person client comes back the next week with any improvement or any any better Provide like they come back and they present any better. The only way that we can provide that is with Loading in that new range of motion is now training through that new range of motion and providing resistance and that your range of motion. And that's where I love the developmental kinesiology side of things. That's In basically an aesthetic hold. I think that's really where the DNS side of things is amazing.
Speaker 2:Dns Was, was probably the the primary thing I did in practice for at least three years before I found grip approach. It was the thing I studied in school. That's what I followed. Brett Winchester's every move to learn Was the DNS and it's life-changing right. But I kept finding myself doing the same three exercises for a shoulder case. Or I kept finding myself doing the same three exercises for a neck case. I kept finding myself doing the same three exercises for a hip case I'm like, well, there's got to be something, maybe a little bit more specific. I know, obviously in the beginning the first thing I'm trying to do is improve the ability that the patient or the Afflates ability to centrate a joint, right to provide equal muscle activation around a joint so that the joint is able to do what it's supposed to do.
Speaker 2:But if I wanted to assess those principles in all three planes of motion, because every joint moves in all three planes of motion, that's where I really started to dive into the grip side of things, where, that's where I think grip shines, it's taking those developmental kinesiology principles and moving them out of neutral.
Speaker 2:Once the person patient, athlete, client has shown competency in that basic joint centration, simple movement in developmental kinesiology, that's where, like now, I can bridge them away to more dynamic things, that that bleed into performance a little smoother, and that's where, like the grip approach, for for like a hip for example, there's an assessment for flexion, there's an assessment for extension, abduction, abduction, internal, external rotation, and I can pair an Exercise with maybe whatever that person needs help with or whatever they lack movement competency with.
Speaker 2:And so then I go beyond, just like the five months, seven months, sideline or High obliques or whatever, and I can, more so, move into a Movement that has those principles, but a movement that's a little bit more specific to what they need more of, and then I can load it a little bit more effectively also, which then, like, at some point, everybody's going to be on their feet and everyone's going to be holding Kettabels and loading and hip hinging, squatting, lunging, whatever, and then eventually get to the performance.
Speaker 2:But but when it comes to enhancing or Providing or improving somebody's Ability to stabilize a joint or segment, I'll start with the DNS world primarily in static ranges, with not a whole lot of men Managing or maintaining the basics, the foundations, the table stuff, and then the grip approach takes all of that Awesomeness and just puts it into three planes of motion. So For my clinicians out there, I I Personally I think it's an awesome tool. It's something that has completely changed the way I work with athletes and active people. It's allowed me to take the basics of stability and move it into all three planes much more effectively than than I was before.
Speaker 1:That's awesome, yeah, and I think DNS is really growing. I mean, you know, I'm a Homer for DNS as well and I think it's really growing. And I mean, like, rich is a Rich's strength training courses and stuff like that. Rich Olm, who was the first guest that I ever had on this podcast, I mean the stuff that he's doing with DNS strength training, oh, I think that you'd love it, because we're definitely moving into like that, that bridging the gap too. And go on, man, you got, we got to get you to Prague sometime too.
Speaker 2:Because I saw a bunch of people went this last summer. Right, it was this last summer.
Speaker 1:Yeah, yeah, and watching those cats like in their, in their true element, like in their hospital, doing it, I think, I think you'd be like, oh, these are working together even better than before. Yeah, yeah.
Speaker 1:All right, tony. So we're at just about an hour now and I like to end up you know, finish off all these episodes with like the same thing. And I always talk about Benjamin Franklin and the work he did starting the volunteer fire department in Philadelphia, and his famous quote is that an ounce of prevention is worth a pound of cure. Right, so we've talked about a ton of different things on this podcast, from different approaches to therapies, to load management, volume and intensity and the reciprocal relationship between those and a whole host of other things. But if we could distill this whole conversation into one little ounce, one little palatable nugget for people to take in, what would be your ounce of prevention for everybody listening?
Speaker 2:I think.
Speaker 2:I think it would be the concept that movement is better than no movement, right?
Speaker 2:So, rather than just blindly resting things when they don't feel right, or rather than just blindly resting in general, I think it's a really good idea to be more active in your recovery, a little bit more active in your day to day maintenance and realizing that the game ain't over when you quote unquote graduate from care.
Speaker 2:The game is over when it's over. The game is over when your life is done, and so, until that point, you have this thing, you have this body, you have these cards that you've been dealt, and it doesn't matter what those cards are. You have to continue to play them and you have to continue to take care and you have to continue to move, and movement is everything. So I see, the reason I say that I think that's so important is because so many people that come to my office are blindly resting an injury that they've had that they think is magically going to get better, when they don't realize that the way to actually improve or have longer lasting results, or or or to just live without whatever is holding them back, paying whatever is to expose, is to move, is to continue and not stop. So keep on keeping on.
Speaker 1:Oh man, we could just start up a whole another podcast right now with, like, oh, all those people coming in. I've been icing it and I don't know why it's not getting better. It's like, well, you know, maybe the ice isn't really helping out too much.
Speaker 1:You know A lot of our approaches have really changed and a lot of our theories around ice have changed and all this stuff. So, tony man, thank you so much for dedicating some time to come onto this podcast and share a lot of the information that you've gleaned from your personal experiences, as well as your experiences and clinical practice. Where can people find you? Where can people follow your stuff?
Speaker 2:Thank you, sir. Instagram is probably the most, I guess, used platform that I have at Dr Tony Katakis, so DRKNYKATAKIS. On that Dr Tony Katakis page I try to just share as much mobility movement stuff as I can. Oftentimes I'm organizing continuums and progressions and regressions of exercises in my own brain and just putting it out there publicly so I can kind of organize my own thoughts and sometimes people find it valuable and sometimes people don't and either are totally cool, because I can use that platform to basically organize some of my thinking.
Speaker 2:I also have the St Louis Sports Clinic page where we try to provide some content marketing or some content value to common conditions, maybe show what a type of treatment in our office looks like and then just try to provide as much value as we can. If you're a student and you're in St Louis, or maybe even if you wish to come to St Louis, come hang out, shadow, whatever get in touch with us there. That's probably the best way, because we have people who manage both that social media page and then my social media page as well. So just slide into those DMs and hopefully we can make something happen.
Speaker 1:Awesome, tony. Well, thanks so much, and I'm going to be picking your brain on a lot of things that we talked about before in the next couple of months.
Speaker 2:Thank you, sir. I appreciate you, Nick.
Speaker 1: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 education and entertainment purposes only. No patient 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, etc.