Strength Coach Collective

Dr. Zach Long: Why Athletes Get Injured (And How to Prevent It)

• twobrainbusiness@gmail.com • Season 1 • Episode 30

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In this episode, Kenny Markwardt sits down with Dr. Zach Long—a board-certified sports physical therapist who believes injured athletes should use the gym, not leave it.

Long, aka “The Barbell Physio,” explains when coaches should modify training versus refer out and how trainers can build relationships with the right medical professionals. He also offers practical tips for training athletes through pain and injury.

The pair discuss what separates quality gyms from mediocre ones, from optimal coach-to-athlete ratios to common programming mistakes.

Long also tackles coaching misconceptions such as “never lift overhead” and “don't squat below 90 degrees,” explaining why these myths can cause more harm than good.

Check out the full conversation for actionable strategies you can use to keep your athletes training safely through injuries and setbacks.

Links

Strength Coach Collective

2:46 - Good versus bad gyms

5:18 - Common programming mistakes

21:55 - When should coaches refer out?

33:31 - Preventing injuries for beginners

42:52 - Debunking fitness myths

SPEAKER_01:

My guest today believes that when you're injured, you should use the gym, not leave the gym. And I could not agree more. Meet Dr. Zach Long, or the barbell physio, as he's also known, board-certified sports PT, CrossFit coach, and the guy who keeps athletes lifting when others prescribe rest. He leads the clinical management of the fitness athlete seminars and heads onward physical therapy, blending barbells with rehab science. In this episode, he'll show you how to manage pain, prevent injury, and keep PRs rolling. Welcome to the Strength Coach Collective, a podcast brought to you by Two Brain Business. We are here to help the strength and conditioning coaching community by bringing you a wide range of experts in the field. Join our group at strengthcoachcollective.com. For today's episode, I'm your host, Kenny Marquardt. Zach, thanks for coming, man. This will be great. Excited to chat. Let's jump right in. I think we're going to have a lot to unpack. So I'm going to cut the fluff and just ask you, let's tell me your background. Tell me, tell me how you got to where you are now, and then give us a little bit of an elaboration on that.

SPEAKER_00:

All right. Um, I guess I started out in the strength and conditioning world, wanting to work with a football player specifically, um, as a student at university of North Carolina worked for the football team strength program for a couple of years, worked for some high schools and, While I enjoyed it, I could tell it was not like the thing I wanted to do forever. Stumbled into physical therapy, went to PT school, and a lot of PT is really boring, so I didn't really exactly love where I started out, but I got really fortunate early on in my career that I got exposed to CrossFit. To be honest with you, early on was like a mild CrossFit hater of it. just didn't see how it could do all the things that it claims. And we now know both from what we see in gyms and what we see in research that it does do all the things that it claims. Um, But just got lucky, like got hooked up with some folks at CrossFit Journal, wrote some articles for CrossFit Journal early on as I was kind of dabbling into CrossFit and then ended up at a really good gym. And when you're at a good gym where you really see what the methodology should be and how it's run, it's easy to fall in love with. And so that's kind of been my passion for the last 12 years of my life has been kind of figuring out how to leverage my skills and knowledge in the physical therapy space with helping Crossfitters and powerlifters and Olympic weightlifters perform better, get out of pain, et cetera.

SPEAKER_01:

And with coaching as well, like trying to help coaches do the same kind of thing? Yes. Yeah, yeah. Yeah, so you said something real, like I think it's acknowledged from time to time, but like what makes a good gym versus not a good gym? Like what was that experience for you compared to what it could be negatively?

SPEAKER_00:

There's a lot of different things. I mean, I think one of the big things is, and this is also shown in the research, is the number of athletes there are per coach. So research has shown that more athletes to coach results in more injuries. So if you're going to a gym that has 20 or 25 athletes to one coach, I've even coached in that situation myself. And I can tell you when I was coaching those classes, everybody did not get a little bit of attention that day. especially when a new person showed up or a couple of new people showed up to one class. You just are running around trying to do the absolute best you can. So that's probably the first thing I look at in terms of the quality of a gym. is is that ratio next i want to see coaches that are doing things to to develop their their skill set so if everybody just has their you know cfl1 i mean that's great that everybody has that but i want to see somebody that's that's moved on and has taken other courses both inside and outside of the crossfit world to understand that stuff a little bit more and then finally the programming programming in the crossfit space is really really tough I think there are very few people that are exceptionally good at programming CrossFit. There are a lot of great people that can write you an amazing powerlifting program or bodybuilding program, but it is so easy in the CrossFit space to over-program certain elements to over-program volume to where you're beating people up, it's challenging. I won't write CrossFit programming. I will critique your CrossFit program, but don't ask me to write it from scratch because I just can't do it. We

SPEAKER_01:

just had this debate in my staff meeting literally yesterday. It was like, We're bringing up a lot of the points you mentioned. It's very difficult to do, very easy to point out the holes or point out the overprescription of volume or whatever. I mean, there's a litany of things that can go south. And the collaboration at the end of it, like, well, what are we going to do about it? What do we do? So in any case, yeah, it's a moving target. They can be hard to do really, really well. So, yeah. You know, as far as, like, the overarching– goal of it i would say and you can disagree if you want but like it's we're trying to make people well-rounded athletes and athletes for everyday life yeah so in terms of that like how what is like again i don't want to go too deep in the programming hole because it's uh hard to do but like what do you see is like over over prescribed and maybe under prescribed in that avenue

SPEAKER_00:

over prescribed for sure is probably going to be your your rig based volume

SPEAKER_02:

It

SPEAKER_00:

is easy to have muscle-ups and kipping pull-ups and toes-to-bars all in the same week. And so you've got three days where you're doing a heavy upper body pulling exercise with a lot of lat engagement, high dynamic skill work. That's probably the number one thing I see over programmed. Number two is going to be the squat pattern in most gyms. And then under-programmed, I'm probably going to, this is going to sound weird, but I'm going to say it's strength-based rig work. You don't see enough people that are out there programming five by five weighted pull-ups and exercises like that to build that gymnastics base that's going to save so many people's shoulders long-term. I also think a lot of gyms should incorporate a little bit more bodybuilding into their CrossFit style programming for a number of different reasons. But let's take, since we've already talked about rig-based volume a lot, I'm a huge believer that lat strength is not only going to improve your rig-based performance, but is going to result in significantly less shoulder injuries. Because when you're doing all of those movements, the lats not only pull you over the bar, but they slow down your deceleration when you're coming down. So athletes that can kip but don't have amazing lat strength can put more stress on their shoulder. So I'd love to see that you're doing those high-level gymnastics movements, You're doing some strict pull-ups, but I'd love to see some bodybuilding-style work on people's laps at times as well.

SPEAKER_01:

Yeah, I think that was a big– I'm not sure actually where it came from or if it was direct from the top across it or not, but it was kind of like bodybuilding got a big, bad rap initially. It was like that was kind of the thing. It was like, hey, stop doing these bodybuilding-type movements and start doing all this full-body, multi-joint compound exercise for everything. But I think that for a lot of the reasons I've stayed uninjured, relatively uninjured in the sport and participation in CrossFit is because I did a buttload of bodybuilding beforehand. And so I think I built up a lot of connective tissue and requisite strength to be able to do the things that I was able to do. You know, what's, again, it's hard to make some exact recommendations here, but like in terms of that, what are some more additional bodybuilding type stuff? You know, I know you mentioned lat pulldowns, some more specific strength type work, but what would you wish more people did? Uh, for accessory or maybe main joint or sorry, main lifts and their strength work. Sorry. Bodybuilding wise. Yeah.

SPEAKER_00:

Bodybuilding last. Yeah. Yeah. Yeah. Lats. Number one, quads and glutes are going to kind of be tied for number two for, for CrossFit athletes, in my opinion. And then I'd probably do a little bit of extra dealt work as well, because that's going to help improve your overall upper body pressing strength. I think a lot of people should also consider bodybuilding work. If you're the athlete that's been in CrossFit for forever. And you've noticed that over the last two or three years, you've not set any PRs. Well, you're probably way the exact same. And you've optimized your technique and your neuromuscular efficiency on something like your back slot. And now the only way you're going to get stronger is if you put a little bit more muscle mass on. And sometimes that requires a little bit more bodybuilding specific work. That could be accessory stuff on the side. That could also be taking a couple months off of CrossFit and just saying, hey, I'm going to do three months of bodybuilding. increase my caloric intake, I'm really shocked when people take time off of CrossFit, how little CrossFit fitness they lose. And they jump back in, and they are really quickly back to where they are. And if you look at, like, if you look at games athletes, this is a great example of this. Most of them are a heck of a lot more jacked than you and I are, Kenny. And they're also a lot stronger. There's a pretty strong correlation there to the fact that they're bigger and more jacked than we are and stronger than we are. I'm just, I'm not actually seeing you with your shirt off. Not if I get a podcast. So they've got more muscle mass, but if you also look at a lot of their training, and this isn't true for everybody, but a lot of high-level CrossFit athletes aren't CrossFitting year-round. They're kind of really working on their specific weaknesses. So if they're an athlete that comes from a high endurance background, they may spend huge blocks of their off-season doing strength and bodybuilding work. If they're coming from an Olympic weightlifting background where they have the strength, you might see them do tons and tons of just conditioning-specific work and less CrossFit ones. I'm not saying that's what it should be in a group setting. Because if I take 100 general population people, no, I'm not saying that they should all necessarily be doing bodybuilding. If you've got three or four days a week, and that's all the time you have, I think that the general CrossFit methodology is probably your best bang for your buck in terms of a whole group. When you look at a whole group of people... Some of them, by following this generic CrossFit programming, are going to miss out on bringing up their weaknesses. So while we're trying to develop a well-rounded athlete, if you come in very biased in what your previous background is, generic programming will help your weaknesses a little bit, but sometimes it takes fully attacking those general weaknesses to get to where you're actually well-rounded.

SPEAKER_01:

Yeah, I've seen the exact same thing. Again, I think one of those things where it was– CrossFit kind of became this anti-periodization or anti-seasonality. It was like, okay, just general fitness every day. But I think that got taken a little bit too extreme. I find that for intermediate people, it seems to work pretty decent to become pretty intermediate. But the beginner, probably more bodybuilding type stuff, a little slower to build that requisite strength. And the advanced, to slow down and focus on some of those weakness things too. If we're going to define it by seasons. So we kind of skipped over this, but I think it'd be worth going back. Can you define bodybuilding for everybody real quick? Like what that would look like? Sets, reps, rest, you know, just kind of how they could focus on that better.

SPEAKER_00:

Bodybuilding would be just training with the emphasis on improving the size of muscles from a how do you do it perspective perspective. you're gonna find a ton of different thoughts out there. But really, one of the things we now know is that a very wide range of reps will create a hypertrophy effect as long as you're working at pretty high levels of intensity. So you could be doing sets of four to six where you're one to two reps shy of failure, or you can do sets of 20 or 30 repetitions. As long as you're getting close to failure, they're gonna create a hypertrophy effect. takes time under tension not time under tension is not the correct word it takes mechanical tension on muscles to really stimulate that hypertrophy response so think of exercises where you're often feeling a bit more of a stretch in the muscle and a lot more tension as you perform the movement so a great example of that would be a deadlift it's a phenomenal exercise when you fail a deadlift you don't usually sit back and think man my hamstrings just got blown up at the end of that set or my glutes were burned you just like i just couldn't lift it anymore but if you do a set of romanian deadlifts or stiff-legged deadlifts or seated hamstring curls and you go to you can't lift weight anymore you were going to say i was limited by this muscle because that exercise just tends to have more mechanical tension on the muscle and therefore that's why you don't see bodybuilders deadlifting. You see bodybuilders doing RDLs and seated hamstring curls because you get more mechanical tension on the muscle. So we're looking for mechanical tension. We're looking across a wide range of reps will work for this. And in general, the research tends to show that more volume has a better hypertrophy effect as well. With that in mind, if you're trying to bring up a specific body part, then you want to kind of think of what exercises can I tolerate the most volume in? So, you know, if we're talking RDLs versus deadlifts, not only are RDLs better from a mechanical tension perspective, But if I made you do 10 sets of deadlifts to failure in a week, Kenny, or 10 sets of RDLs to failure in a week, which are you going to choose if you want to survive outside of the gym? You choose RDLs. If you wanted to take that another step further, and I said, well, 10 is a lowish volume for a hypertrophy effect on a muscle group. I want you to hit 20 sets a week to crush your hamstrings. You're not going to do RDLs. You're going to choose hamstring curls because they just let you accumulate more volume on the muscle with less overall fatigue so that you can still recover. So I tend to, with CrossFit athletes that we're talking about, bodybuilding with on specific muscle groups. I'm really thinking through what muscles get the most mechanical tension, what exercises create the most mechanical tension with the least amount of fatigue, especially if they're going to continue to cross it while we add in a little bit of bodybuilding accessory work.

SPEAKER_01:

You corrected yourself on something that I would like to explore a little bit more. You said time under tension and then backtracked and went to a different direction under, what did you say, muscular tension?

UNKNOWN:

Yeah.

SPEAKER_01:

Mechanical tension. Mechanical tension. Sorry. Yeah. What's, where's the, what was the difference there for you? So

SPEAKER_00:

we used to really think that lifting a weight slower, which we would calculate as the time under tension would have a greater hypertrophy effect. But over the last five years or so, the research has tended to lean a little bit away from time under tension being super important. So you could take a weight that, If we're doing a dumbbell bench press, we could do a five-second lower, a pause in the bottom, and then press up nice and slow. Or we could do a controlled but faster descent and a controlled but faster concentric contraction, and we're probably going to create pretty much the same hypertrophy response. I've just been in the game so long. Sometimes I still say time under tension when I mean mechanical tension.

SPEAKER_01:

Yeah, no, I mean, that's kind of what I've looked to as well. You know, Charles Baldwin type stuff and, like, doing the– a factor of volume as a quantity of time under tension was kind of how I was brought up to. So I was just curious on the vernacular

SPEAKER_00:

there. Speaking of polyclin, like that's probably my favorite hypertrophy protocol is his shock method.

SPEAKER_01:

Yeah.

SPEAKER_00:

So there are hypothesized and there's a little debate about this, but three different contributors to muscle hypertrophy and that's mechanical tension, which most people agree is the most important muscle damage and and metabolic stress. And the shock methods, goals according to Poliquin, is to hit all three of those by doing a set of six, followed by a set of 12, followed by a set of 25. So a great example of that for the lats that I really program this quite a bit would be like six weighted chin-ups, hop off the bar, In 15 seconds or rest, move to doing a set of 12, some version of a row that's a little bit lighter, but you're still getting really close to failure on that set of 12. And then do a set of straight arm band pull downs. So we get three different exercises back to back that hit the lats.

SPEAKER_01:

Yeah, that hit the lats and you're not just doing... whatever the math is on the total of pull-ups. I think exactly what you just said in terms of the consideration between the Romanian deadlift and the hamstring curl in terms of the ability to tolerate the volume on that. Yeah, love it. Okay, cool. Let's transition a little bit because I think this is a topic near and dear to me. like where you see yourself, like how you're viewing this as a clinician or physical therapist versus how you see this as a, as a strength and conditioning coach and like how that, where that continuum begins ends, if it does, like how that, how that looks to you.

SPEAKER_00:

So I think of most injuries as we've asked a tissue to do more than it was prepared for. Now, the preparedness can mean a lot of different things, can be impacted by a lot of different things, but if this is a tissue's baseline level of fitness, your performance training is trying to raise that baseline level of fitness to a higher level. When you're injured, that baseline level becomes lower because those tissues have been broken down enough that they can no longer tolerate the volume, intensity, et cetera, that it used to be able to. Our rehab goal is to build you back up to baseline so that you can then continue to build it bigger, stronger, whatever our goal is there. So it is a continuum, but I think far too often, from a rehab perspective, we're like, okay, this was previous strength of that muscle, got injured, it went down here, let's strengthen it back up to baseline, we're done with rehab. And that's a problem because this baseline level of fitness that that tissue had wasn't enough for it to tolerate what you were asking it to do. And so it got injured. So we want to raise that up supposed to use like a bank account analogy here. If you have a thousand dollars in your bank account and you get a bill for$1,200, you go in debt. You don't want to just pay it back and get out of debt and back to a balance of zero. You want to get to where you have$1,000,$10,000,$100,000 in the bank so you have more of a buffer against injuries happening in the future.

SPEAKER_01:

What does that look like? Again, we're going to have to talk pretty broadly, but how can you... extrapolate that down for what that might look like practically for a coach or for somebody who's leading somebody through their fitness journey and they continue to do that or they witness it for the first time, how do they not do it again?

SPEAKER_00:

Let's say an athlete's having shoulder pain with rig-based gymnastic skills. Prior to getting injured, they could do six chest-to-bar pull-ups with good form. Well, as we're going through their rehab for their rotator cuff strain, we're strengthening up that rotator cuff while we're also trying to build some lat strength simultaneously. Well, I don't wanna stop when they're back to doing 10 pain-free chest-to-bar pull-ups. We're gonna try to get that up to 10 chest-to-bar pull-ups and 12 chest-to-bar pull-ups or six with a 25-pound weight on their body.

SPEAKER_01:

So increasing that, so... From the perspective of a coach who doesn't have the qualifications to perform rehabilitation or make, oh my gosh, what's the word I'm looking for here? Diagnosis. How does that look for us? How does it look for somebody without the letters after the name? I

SPEAKER_00:

think that's when somebody is returning after an injury. especially if it's a more serious one, let's look at their previous benchmarks. If they've got videos of their previous squat and you can pick apart any faults, see what those faults or issues that they had that may have contributed to that injury, let's really attack those and attack those past when they are back at full steam. So if that person found that their squat pain got better with lots of rehab exercises that built up their quad strength, It's great that they're back in CrossFit doing every squat variation that they want, but let's figure out towards the end of the rehab, what were the quad exercises that were still crushing the quad, still making them feel like they were working really hard, and let's find ways to continue to progress that at a volume that's high enough that it's still driving, quads getting bigger, stronger, whatever, but not so high that it's impacting with them being back in the gym doing the full thing that they want to be doing in the gym.

SPEAKER_02:

Got

SPEAKER_00:

it. If we go back to like CrossFit level one guy, this is your sickness, wellness, fitness continuum. But from a rehab perspective, like you don't want to get to where your blood pressure is just 120 over 80 or your resting heart rate 60. If we can get that even better, more buffer against getting super sick long term. Yep. If I could make one thing be a required read for every medical professional out there, it would be the sickness, wellness, fitness continuum. if every medical provider in the world could understand that concept, the world would be a lot better off.

SPEAKER_01:

Yeah. Where does that line, where do those designations at? Like, so again, as an example for somebody in a gym, if they're managing an athlete who is, you know, they have an ache or a pain, like at what point, where do we go? You know what I mean? Like everybody's got their, little things like I find it very rare that somebody comes in with a clean slate, joint or tissue wise, where does that end where we get to work perform our stuff and we refer them out like, you know, I think we do such a we always talk about Oh, we can scale anything we can do whatever, like at what point are we saying okay, time to go see somebody else.

SPEAKER_00:

Yeah, so there's not like a set defined thing here, but overall, like your job as a coach is to scale and modify around that individual's needs so that you can keep them in the gym working on the bigger picture of their overall health and fitness. Your interventions aren't usually going to be aimed at treating specific pathologies. So if somebody comes in, I think even though, even if you know that this is an athlete that has patellar tendinopathy, You might give them similar exercises, but your goal with giving them similar exercises is probably to diagnose and treat that patellar tendinopathy. So one question that I ask a ton of people when I see somebody at the gym and they're like, hey, I'm dealing with this. Should I come see you? I'm like, you think it's a tweak or you think it's an injury? Because so often you just get working out, something feels off that day, you've got to modify to a different version of the workout, but you're like, this is not an injury. This is something that I know is going to be gone in a week. Well, we don't need to jump and go to your primary care physician or orthopedic surgeon or a PT for a tweak. When you do something like, that ain't a one-weeker. That is something that I can't figure out. It's not getting better overnight. after a little period of time, or you immediately do it, you know, Oh, something's screwed up. Then that's when you kind of want to go have somebody check it out.

SPEAKER_01:

Okay. Yeah. I find that less of a discussion with, well, it's maybe a different discussion with athletes or experienced athletes, you know, they can go either way. Sometimes people just plow through for way too long of a period of time, but on the flip side of that, the general population are people who are new to fitness and, I find that to be a challenging conversation to navigate what's, you know, is it hurt or is it pain? What does this look like? Because they don't have experience with it. They don't know what it's like to kind of play through. Your newer

SPEAKER_00:

athletes are also going to get injured more. And that's been shown in one research study, and I'm sorry I can't quote who the author is here, but there was a research study on CrossFit athletes, and they found that new CrossFit athletes had, I think it was like 8.9 injuries per 1,000 training hours, and most every other study out there shows injury rates in CrossFit around three per 1,000 training hours, so a decent bit more. And they did two things with that. Number one, they said, well, if any of these injuries are linked to a previous injury, let's get rid of that. And then we saw injury rates go back down to normal. But to me, that really just screams that this is somebody, if they're newer to CrossFit or any form of exercise, those tissues just aren't used to being loaded. And your tendons and joints tend to like a steady amount of volume. And so if they're not used to getting loaded, when you start loading them, even though we all know that that's good for them long term, you can expect some aches and tweaks to come up. And so the best thing you can do for that athlete is modify around that injury. Just become really skilled in that as a coach so that that person that's finally made the decision to come into the gym doesn't pause their membership or doesn't cancel their membership and never step back in the gym again. So you've got to be modified. be good at modifying. And then you need to have a great connection of somebody that you know that really understands what you do inside of your gym, but has the right medical license to help rehab that injury when they actually need to be seen. You don't want them going to somebody that says, oh, your knees are killing you when you squat right now. You're 250 pounds and you are 100 pounds overweight, but we should take a month off from the gym right now. They're missing the bigger picture when they make that recommendation. So Be good at modifying. Have somebody good in your corner to help you out there.

SPEAKER_01:

Yeah, I can't tell you how many times I've seen that where somebody has a tweak or whatever, something pretty minor, speak to their medical professional, and that person tells them to never exercise again. Or, like, that's just, you know, they should never squat down or bend over again. So how do you start that conversation as a coach or as a gym owner? Like, how do you start that relationship? Or find the right person to be able to refer out? Because I do find that most people, like, they hear the word CrossFit. Most practitioners hear the word CrossFit, and they still, like, they're just, like, kind of allergic to it. And they won't really explore it further. So where do you suggest people start to come to find somebody like you in their town or wherever to... move that further. Uh,

SPEAKER_00:

well, shameless plug here, honored physical therapy. We've got clinics in, uh, 31 cities around the country right now. And all of those people are very fitness forward. Like all of our clinicians are people that are getting after it on a daily basis in the gym or on the track or something like that. But Really, I think you can learn a lot by going to a clinic's social media pages. If you go to a clinic's social media page and you don't see that they've got somebody that they posted from their clinic running a half marathon in a couple weeks. And they're giving you a little insight into Amanda's training session and also what she's doing from a prehab perspective as a runner. And you don't see that their other therapist, Jimmy, just did a CrossFit competition. They're not showing that stuff on their social media page. That's like a, this is probably not the right place for me. The other thing I really like to look for is when I go to a clinic's website, I want to see that people like the people that walk into your gym are all over their website. But I also think that there are a lot of medical professionals out there that like to say that they treat everything. So they will talk about how, you know, I'll help your grandma who's having fall risk. I'll help you as a CrossFit athlete. I'll help the overhead pitching athlete. You know, I'd rather, if I'm looking in a city where I won't know anybody and I'm pulling up a couple of websites, I want to see the place that says, you know what we do? We treat runners, crossfitters, powerlifters, and Olympic weightlifters. That's our skill set. Because I know that person has developed the time to understand squat and deadlift mechanics, that knows how to analyze your running technique, that understands what total volume of working out somebody can tolerate and helping them slowly move back in that. And they're usually also, when they're that dedicated to a specific area, also very willing to say when they don't know some stuff. And so they'd be more likely to call you up, Kenny, and say, you know, I think this and this is going on with this person's back, but I also don't know enough about this movement that he says bothers his back at the gym. Give me some insight into that and tell me like, what this Zimbabwe split squat is, Kenny. Can you explain that to me, what the demands of it are, and see if that helps me understand why that might be bothering them.

SPEAKER_01:

Yeah. And what about the conversation where somebody's already got a pre-existing relationship with either a physical therapist or a... a doctor and that person tells them that, let's say, you know, the thing I referenced before, they say, you can't like, you got to stop doing this. So that's going to, you're going to get hurt in there. You're going to do that. Like, and they cease altogether. So they come back to you and say, Hey, look, my doctor told me I got to stop doing this altogether. Like, what's, what is that? Cause again, I, it's, you kind of get into this like war of the worlds where I'm saying, Hey, this is what I think. Hey, he, that he or she said, this is what they think. Where do we get, you know, what does that look like? And how do you have that conversation in a productive manner?

SPEAKER_00:

Yeah. So, I mean, when you hear that, like the hair on the back of your neck sticks up and you want to start attacking, like, hey, that doctor is so dumb. They are so out of date. Like, why in the hell are they telling you that? But when you come at it like that, you're going to invalidate everything that that person has worked on. And it doesn't destroy their trust with that person. It more destroys their trust with you when you do that. So I prefer to just ask weird questions and then say nothing like, well, That's interesting. I've seen a lot of different research out there. Did your doctor tell you why specifically your knee can't do that? And just ask questions like that that are very open-ended, and usually they say no. And I'm like, okay, well, why don't we try today doing this squat variation? It's going to put your knee in a slightly different position. I see that's going really well. And they've been told, you know, you shouldn't squat again. And I know that they should squat full range of motion with whatever knee issue they have. But maybe I meet them in the middle for a handful of weeks where we're doing box squats to a limited range of motion. And I can prove that as I coach it with appropriate cues, volume, intensity, and that doesn't exacerbate stuff. Then I say, you've been doing so well with that box squat and your knees actually feeling a little bit better. Why don't we do some back squats? Or why don't we do... some split squats, do a little bit more range of motion and just try little tiny steps for it. You're never going to win that battle in like one 10 minute conversation. That battle is won over five sessions, five months, five years.

SPEAKER_01:

Yeah, totally. And I'd love to hear your insight on this. What my experience has been is that a lot of coaches kind of back off without, without some experimentation in movement patterns to say, Hey, let's try this instead, or let's look at this as an, in a different way. And they kind of just back off. But like, I think there's a lot of what your education is for coaches, but like, let's talk about that. Like how people can experiment and play and play with different movement patterns as a coach to, uh, to modify scale or just keep moving.

SPEAKER_00:

One of the best things I think I've ever done to help me myself out clinically. And as a coach is to just schedule like a weekly, a 30 minute play session in the gym. Where I don't have anything that I'm specifically training for that day. But I said, all right, let's go mess around with some different knee things. And I pull out a resistance band and I do some split squats where the band's pulling my knee one direction and I see what does that feel like? Where does it change the load to? And then I'll put the band placing a different direction. put my heel on a plate. And I just play around with different exercises, different setups, torso position, knee positions, and just feel on myself how that impacts what joints and muscles I feel being loaded. And that's been amazing for me to help translate that to my actual clients.

SPEAKER_01:

So there's

SPEAKER_00:

more self-experimentation. One of my biggest pet peeves in the rehab world is rehab providers that don't exercise themselves. It's like, how can you then tell somebody what an exercise should feel like or what training two reps shy of failure feels like if you've never lifted anything more than a pink dumbbell.

SPEAKER_01:

Yeah. Yeah, for sure. Something I want to revisit is the just kind of where beginners tend to get more injuries than others. How do we program better for them in a group, even if it's in a group setting? What does that look like in a way that we can Success. Cause I think a lot of gyms are doing onboarding now. Like they do on ramps, they do some sort of like prerequisite classes or sessions with a new person, but I tend to find that's not quite nearly enough. Like, what does that, what do you recommend there for, uh, an accumulation of volume as somebody who's getting started? I

SPEAKER_00:

think a lot of times we think through what's the optimal dosage. And we know that somebody that goes in the gym five days a week, is probably gonna be fitter than somebody that goes in the gym three days a week. And so when somebody wants to join the gym, we think, oh, we should start giving them the optimal dosage of five. That's gonna be best for improving their overall fitness. Well, the minimal effective dose there is maybe three days a week. And because they've been doing nothing, going three days a week is a huge improvement in their health and performance with less risk of them getting injured because it's less overall volume than them going five days a week. So maybe we just think of starting people out with less overall working out. Do three days a week for a month or two, then take it to four days a week. And then if they want more, take it to five days a week. But don't feel like you gotta jump in and have everything perfect day one. If you go back to like CrossFit's level one course, Mechanic Consistency Intensity. So you could also program a lot more of their volume of different things to be working on mechanics over the weight on the bar. And so you're controlling the overall volume a little bit more with that setup. They're still getting fitter. They're still moving their body, but that's going to potentially lead to a few less tweaks.

SPEAKER_01:

Yeah. How do you solve the conundrum where people are in a group? Like it's, I think it's way easier as an individual or to work with an individual and talk them through those things, but so frequently they get in a a group setting, even if it's a small group and they look in the lane next to them and they see somebody doing a thing and they think, okay, well, this is what the norm is. And so I'm going to do that. Like how, as far as like setting expectations for people or like coaching them through that stuff, even with it or when they're in a group, like how, what's your, what's your take and perspective on that?

SPEAKER_00:

So I'm not in a situation where like somebody is coming to me as, um, you know, as their coach and I'm talking to them about this in the gym. So when I have these conversations, it's a little bit easier because it's me treating new gym member that just tweaked their knee. I'm treating their knee pain, and I have an hour-long session with them. They're two weeks into their fitness journey here, and I have a long time where I can talk to them about it. So I have this much easier than anybody that's listening that owns a CrossFit gym or coaches at a CrossFit gym. But for me, a lot of times, I'm just saying something like, know imagine taking a you go to your doctor you've got this weird medical condition and they want to figure out what's going on they never start you at the maximal dose of medication they always start you at a lower dose and if that lower dose works and you don't get negative side effects they might increase it but if we start you at the highest dose we don't have anywhere to go from there yeah sometimes if they're really uh If they seem like they got a good sense of humor, you can joke about this like it's cocaine. Like, we're not going to start out doing all the coke. We can start out with just a little bit. I'm not endorsing doing cocaine.

SPEAKER_01:

All right. I know what we're going to have for the show highlights. This will be great.

SPEAKER_00:

Oh, man. Did I just change the podcast rating? You have to rate this one.

SPEAKER_01:

Yeah, perfect. No, I love it. This will be great. One takeaway I want everyone to hear from this is that. How about assessments? Like, Do you find that there's anything that's worthwhile as an assessment to do from a coaching perspective with a newer athlete that will help us have them present with things that we all need to work around as they get going? Aside from the norm, you know, aside from basic strength type stuff.

SPEAKER_00:

If I owned a CrossFit gym right now, and I was to come up with the perfect assessment for the new CrossFit athlete, it would be saying, all right, today's workout is we're doing six sets of two back squats. My assessment is let me see your air squat. That's it. I'm not laying them on the ground and testing their hip mobility and their ankle mobility and doing all of these things. I'm saying, let me see your air squat. Does that look good? Great. Let's put an empty barbell on your back. Let's progress that up a little bit. Does that not look good? Can I coach it or cue it to be a little bit better? If I can't, then I have to make a decision on do I want to actually break out some of those joints? And usually for me, the answer there would be no. That instead, I'm just going to say, cool, here's the best we can do with solid technique. Let's put a little bit of weight on. You won't be surprised, but most people would be surprised when you see somebody that doesn't have great mechanics day one, and you think that they're super stiff, and you just spend two or three months training them through the best range of motion they can train through, how much that range of motion gets better without you doing extra mobility work. I think we don't need to create huge barriers to exercise by having a lot of people, especially new athletes, do a lot of testing and assessments. Now, if somebody came to me and they said, Zach, I've been crossfitting for five years and my performance is held back by these two things. Would I jump into some testing and assessment of that? yes because i need to get a little bit more information for that specific athlete on what's going to actually help push their performance forward but i think newer people let's not create a huge barrier to entry i mean i i would screen out you do whatever the the health questionnaire is that tries to catch heart conditions and things like that just from a liability perspective and protecting them from the bad bad stuff but a couple weeks ago i had a local uh training business reach out to me and they showed me their assessment for all of their new athletes and kenny it was three pages long like they looked at the squat they looked at ankle mobility they looked at knee flexion they looked at hip internal rotation external rotation if their hips were anti or retroverted and they got all of this information and i asked one question after you walked me through this whole questionnaire i was like what if this stuff changes your decision making and what you do workout number one

SPEAKER_02:

and

SPEAKER_00:

he didn't have an answer for me And I said, then it sounds like a not valid test to use. I said it nicer than that, but it doesn't sound like that gives you valuable information. I just want to see the person squat.

SPEAKER_01:

Yeah.

SPEAKER_00:

Have them squat for four weeks. If that squat still isn't to the depth standard that you want, then maybe do some assessment on some stuff. Early on, let's just get people moving. That's the bigger problem this world has right now is that they're not moving and they're unhealthy, not that they lack five degrees of hip internal rotation.

SPEAKER_01:

I'm actually very guilty of what you just said. It was many, many years ago, but I had... I was like, all right, listen, we're going to get a goniometer out and check out everybody and see what– and then I was like, well, I don't know what to do with this information. I have stacks and stacks of papers with measurements with no clue on what to do with it or if it matters to anybody. There's no patterns that made any sense. So, yeah, I get it. But I think the passion is there for all of us. Like we just want to keep people out of pain. We want to keep people coming back to the gym because, like you said, that's the most important thing of all is they just keep coming.

SPEAKER_00:

What I always think with that is– You know, we're thinking there of, okay, let's say I train a thousand athletes. If I test all of this stuff out, maybe I'll prevent five injuries. That'd be cool. Yes, it would be. But also, when you do all of these tests and somebody's hearing you say, wow, your hip external rotation sucks and your thoracic mobility is bad and, you know, your blah, blah, blah is going on. And they hear this hit list of all the things that are wrong with your body does not place little seeds in their head that some stuff aren't right or moving appropriately. And literally, we might be making more than five injuries happen because of that. I can't prove that, but that's something that I think about a lot, is how often do our words and things we do with very good intentions create the exact opposite effect of what we want.

SPEAKER_01:

Yeah. I don't know where, I think there's maybe an ego facet for me where I was like, I just want to show everybody how much I know and how much like more intention I'm going to have about this. And I'm trying. And I really, like you said, I don't think I solved any problems. I just probably made everybody's lives harder and probably intimidated more people than I did help anybody. So yeah.

SPEAKER_00:

Been there,

SPEAKER_01:

done that. Yeah. Right.

SPEAKER_00:

I'm so glad that I can't go back and watch myself as a 24 year old clinician. I would punch myself.

SPEAKER_01:

Yeah, the only thing that helps me with is helping newer coaches be like, listen, you can't do this worse than I did. You'll be fine. Just keep going. Everything's great. You're doing a great job. Just keep moving forward. There's no way you're as bad as I was ever. Can you address a couple of things that I've heard from... orthopedic surgeons, from other PTs. There's a couple standards or a couple of universalities that they like to throw around, one of which I think the most predominant one is lifting things over your head. I'm sure you know what I'm referencing here where they say you should never lift anything directly over your head. Where does that come from? What should we be doing about it? You know what I mean?

SPEAKER_00:

Yeah, I have no idea where it comes from other than Yeah, I have no idea where it comes from. I tend to think like if the body wasn't supposed to do something, we wouldn't have that range of motion. Yeah. So like, you know, I believe that we were created by God. I don't think God would have put our shoulder in a position where it can move all the way overhead if he didn't want us to be able to do that. Or if you're, you know, more from an evolution perspective, like humans haven't evolved to this part in our evolution where we have that much range of motion. if there wasn't some valuable survival reason why we have it. The same thing with low background. So many people are like, we should never let the low background. Well, then why can the low background? It would have been evolutionarily gotten rid of thousands of years ago if there wasn't some value in your spine being able to round forward. So let's not move around like we're a tin man.

SPEAKER_01:

Are there any other ones that are worth addressing that you can think of? I'm trying to come up with a couple of the other ones. The overhead one. I

SPEAKER_00:

don't hear the overhead one near as much as I hear that you should never let your back round or that you should not squat past 90 degrees.

SPEAKER_01:

Yeah.

SPEAKER_00:

Squat past 90 degrees is probably the one I hear the most of because I treat more hip, knee, and shoulder injuries than anything else.

SPEAKER_01:

Yeah. That one... that one's a pretty like as soon as i hear that one i kind of know that that practitioner is not somebody i want anybody ever talking to again

SPEAKER_00:

we're pretty out of date and that's pretty well established in research that actually squatting to 90 degrees is where the forces on your kneecap are actually the highest yeah so it's asking you to go down slow down stop and reverse direction at the range of motion that's the most force so then you have to make a decision if that's the the worst place from a load on the joint perspective Do I want to squat above that or do I want to squat below that? Well, if you're squatting above that and you're doing these little quarter squats, the amount of weight that you have to put in your body to create a tough stimulus goes through the roof. You're going to become, you know, the bro at Gold's Gym that has his self-cut tank top. You know, the one where like his necks are hanging outside of the tank top. I was wearing that earlier. He walks out of the squat rack with five plates on each side and he does his little like barely unlocking his knees and standing him up. Well, he just threw the compressive forces through his spine, through the roof versus if he put 185 or 225 in the bar and squatted that all the way to his hamstrings, touching his calves, he would get the same relative level of effort with significantly less compressive forces through his body. Training through more range of motion tends to be better from a hypertrophy perspective and tends to have better translation to your strength through full range of motion than partial reps do. So I think more benefits with less risk by training through max range of motion.

SPEAKER_01:

Yeah, totally. And that's a very well publicized study. I mean, and there's been several, but there was a big one. I can't think of it right now, but anyways, accessible.

SPEAKER_00:

It may have been Fry Smith and Schilling that did that study. I can't remember who did past 90, who did the big one.

SPEAKER_01:

Yeah. All right. Well, good. That makes two of us. Let's talk about what you do. Let's talk about what you provide for coaches and how you're helping the industry here. What do you give us?

SPEAKER_00:

So I have a couple of different businesses. So from a rehab perspective, Onward Physical Therapy, we've got locations around the country that are all fitness for physical therapists that want to keep people in the gym. We believe that you should, when you're injured, use the gym, not leave the gym to get through your injury. So OnwardPhysicalTherapy.com is that. For athletes, PerformancePlusProgramming.com. We've got different accessory programs to help the fitness athlete out. So if you're trying to learn your first bar muscle-up and you've got solid vertical pulling strength, but you just can't figure that technique out, we've got a program for that. We've got a program for improving your hip mobility if that's what's limiting your squat. But then on all of my websites, thebarbellphysio.com, performanceplusprogramming.com, and my YouTube channels, I love putting out content that helps people understand this stuff more. So I probably have... between those websites, ones I've written for CrossFit and CrossFit Journal. I've got 300 articles out there that cover everything we talked about and then more in a little bit more nerdy depth to help people understand it more.

SPEAKER_01:

Beautiful. And you're doing seminars too, correct?

SPEAKER_00:

Yeah. So I teach for a company called the Institute of Clinical Excellence. We teach courses to rehab providers. So we think that more physical therapists, chiropractors, athletic trainers should understand the mechanics of a squat and deadlift and be able to look at a gym's across the gym's programming and say, yeah, this is a gym that's that's programming in a way that I want to send my new members to. Versus this one is a gym that is programming from like a maximize your performance perspective. And maybe I don't want to send that person that's brand new to CrossFit to this one. They should go here better. So we want them to be really educated on all of that stuff.

SPEAKER_01:

Wonderful. You listed a bunch of stuff there, but where's the best place for someone to consume all of your content that you're providing for us?

SPEAKER_00:

I'd probably say go to the barbell physio.com and then, um, you'll find all sorts of places and they're there to sign up for my email newsletter and whatever the best piece of content that I've made that week, wherever I put that out, I send it out every Friday. So that's the best way to find the newest stuff.

SPEAKER_01:

Fantastic. All right, Zach, thanks for doing this, man. I appreciate it a ton. Uh, thanks very much.

SPEAKER_00:

Enjoyed it.

SPEAKER_01:

Yeah. All right. We'll talk to you soon. As always, thank you for listening, and don't forget you can join our group at strengthcoachcollective.com.