WEBVTT
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Today's episode is brought to you by the premium content subscribers on the golf intervention substack.
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Welcome back to the Golf Intervention Podcast.
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have a special guest on the show tonight, Dr.
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Andy Royalty.
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He is a Doctor Physical therapy and the founder of the Royal Treatment Therapy and Performance.
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And I will say, Andy, if your last name is Royalty and you're a physical therapist, you have to name it the royal treatment, you have to, like you had no other choice, right
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when I came up with the name, I was like, I, I ran the name different names of, you know, businesses by one of my good buddies who's a physical therapist.
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And, I was like, it's way too corny to do the royal treatment.
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He's like, no, that's perfect.
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It's perfect because you're, you know, you're last name and you're, you're going above and beyond for, for your clients.
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So yeah, that's kind of
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Oh, love it.
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out.
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You do treatment.
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So it's like, I, I just don't see how it could be anything else.
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I think you per picked the perfect name for your, for your establishment there.
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And Andy is, located here in the Greater Richmond area also where I am.
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So we have.
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Some clients who, who work with both of us.
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And, uh, we go to the same church.
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If you're watching this on the YouTube, you'll see the chapel hat that I've got on.
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So, um, anyway, a very, very good physical therapist and trainer and we're excited to have'em on.
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And really, the reason that we're having him on is because.
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I wanted to have a discussion around golf and pain.
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I think it's one of those things that people don't talk about, right?
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Especially on our end.
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And I mentioned this on the podcast to Rob before, I feel like people will just straight up lie to us in a like, Hey, tell me about your shoulder.
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Hey, something going on with that hip.
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And they'll be like, Nope.
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And I, and again, I don't think they're lying by the way.
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I think that they're trying hard to.
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Sort of ignore the pain, right?
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And so they have to have this mental place of like, ah, it doesn't bother me.
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It doesn't bother me.
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but we all know that golf performance is definitely affected when we have pain.
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And pain is gonna come from somewhere, right?
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And so I wanna say that there's, there's ways that we can address it, right?
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If you go see a, a person who's very smart and good at what they do, like Andy,, we.
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As golf instructors are not going to be fixing your pain in the golf lesson necessarily.
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Maybe with some golf swing stuff that we see.
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But if you need to get work, you're gonna go see a specialist.
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So we are glad to have you on Doc and really I think that,, a couple questions I had for you to start with before we get into pain discussion is if you go on and you look at his website, which I'll link in the show notes, you'll see he is at a golf course.
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Right.
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He's at,, independence Golf Club, which is
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Oh, cool.
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Public facility here in Midlothian, which is a greater kind of greater Richmond area, and the host of the state open in Virginia.
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so golf is central to your practice.
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So has it all, have you always been a golfer?
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Have you always wanted to be.
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A physical therapist and a and a trainer that was working with golfers.
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And tell me, the origin story of Andy Royalty here.
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Thank you Eric and Rob for having me on it.
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It's an honor.
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I appreciate it.
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Uh, but yeah, I mean, uh, I was pretty much a, a baseball player growing up and then it was through a couple shoulder injuries where I got into physical therapy.
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And then, uh, I've been a physical therapist since 2014, and then before that I was an athletic trainer.
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over 11 years I've been a pt.
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And it wasn't until, you know, we moved up here in 2020, um, with my wife, uh, two kids and a pregnant wife.
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And, and so we decided that, I was like, I'm just gonna start my own thing, because I wasn't with the way.
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Traditional physical therapy was going with a therapist, seeing, you know, 20 patients in a day, not really being able to give great care.
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And so it was a matter of me just being really passionate about, uh, golf.
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And I, I picked up golf, uh, my sophomore year of college, and that's where I, you know, got, got the golf bug.
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And, and so we had a, a course called Motor Learning in School.
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Uh, that was all about neurology and how the brain controls the body, and so one of the projects we had to do.
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Was be able to teach one of our classmates a skill that they were not used to doing.
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And so I had to teach the golf swing to of, uh, one of my classmates
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Nice.
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went over the steps on how we taught that.
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It was really, where it kind of started for me.
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And then.
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When I had golfers come into the clinic, when I was working down in Greenville, South Carolina, uh, I used to get super excited.
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Like I was just like, I couldn't wait for them to come in and me be able to work with'em.
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They wanted to get back to golf and that's where I was like, gosh, this doesn't even feel like a job to me because I'm teaching somebody how to get back into a sport that they love and they're motivated, they're gonna do everything you tell them.
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They tend to be much more motivated to get better.
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Uh, and so that's where I found that like.
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These people were gonna meet me, you know, halfway.
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I was gonna give them all I had and they were gonna work as hard as they could to get back to the sport that they loved.
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And that's kind of where it started.
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And, and I just, I mean, honestly, like every day that I, you know, 65% of the people we work with play golf.
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And so just being able to work with those people is.
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It's honestly like it's a dream.
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Being able to help golfers get back to playing golf, pain free, that is, that is like my passion and I love doing it.
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So that's kind of where it all started.
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And I mean, it's just been one patient after the other, and other people telling other people.
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It's just been really neat how, you know, we came into contact with each other, Eric was just, you know, a matter of just working with people in the Richmond area and, you know, word of mouth spreading.
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So it's been, it's been awesome.
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I love it.
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What percentage of your clientele is more athletic training versus physical therapy?
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say because we have, I would say it's 50 50 within the 65% of the golfers that we see.
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So 50% are golfers that are dealing with some type of pain, and they want to just be able to play like.
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whole 13 without their back killing them.
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Uh, and then you've got another half which don't have any injuries.
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They are just in a position where they're losing distance, they're getting older, they know they're losing flexibility.
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They need, they know they need to do something to essentially get their bodies in shape to be able to hit the golf ball further or just be able to maintain the distance that they have.
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So.
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say it's 50 50 as far as the, the golfers that we work with.
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That's super cool.
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It's, it's fun too.
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I know on our side with the teaching end, like Rob and I do.
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It's fun when people come in and they want to, they really want to do better, right?
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They're, they're, they're coming to see you in that sense.
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'cause they're like, Hey, here I am and I wanna do better.
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And so much of our teaching is kind of like, Hey, I'm actually doing worse than I used to and I just need you to help fix me up a little bit.
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So there's the fix me part of it.
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And then there's the long term growth part of it, right?
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Which is super cool.
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And, uh, through my years in Richmond, it's been 20, almost 20 years in Richmond, I've worked with a bunch of different trainers and physical therapists that I've come to know at the country club away from the country club.
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And that team approach to coaching is, I think, so important, you know, that we could kind of communicate with one another like you sent me,, a voice, uh, note about a student that we both work with some of the stuff that he was dealing with.
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And, um, and, you know, we can communicate back and forth about things like that.
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And I think that's really.
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It's almost imperative to have that team of people that you can really communicate with.
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Do you find that golf professionals that you've been communicated with are open to you being a consultant on their students' performance, or is it a little more closed minded or do you get kind of a mix of things?
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are definitely open to it because they really enjoy what they're doing.
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They, they want to be able to provide the best.
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Lesson to the client that they're working with.
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I think others are so overwhelmed with but then they have the administrative tasks of the, you know, running the golf shop.
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They've just got so much on their plate.
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Yeah.
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the last, the last thing they want to do is or answer a text or, or do something extra beyond what they're currently doing.
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I mean, lot of these, these PGA pros, they're, they're putting in more than 40 hours a week and,
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Oh yeah.
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know, they're, they're getting a little, they're getting spread thin.
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And so I that.
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And so I'm, I try to say, Hey, like, I'm here for you if you want to bounce ideas off of me.
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And in summer, open and willing to, to chat.
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And Eric, you're one of those people that, that I love being able to hear from and just being able to bounce ideas, um, back and forth.
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So, uh, so yes, it is.
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It is sometimes challenging, but.
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Uh, you can only just be there for them if they want to be accepting of wanting to discuss, you know, some of the challenges and physical limitations that some of their students are having.
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Then, uh, some, because, you know, some of these instructors as they're working with their, their students, you know, they're, they're telling'em, Hey, you know, I need you to turn a little bit more into the backswing, or, I want, I want your hands to, you know, not get as steep, but.
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In all reality, they may be dealing with some type of flexibility limitation that just doesn't allow them to get into that correct position.
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And so just being able to communicate with the PGA instructor on those limitations can a lot of times allow them to work around them or just know that, hey, maybe we can work on a few other things while they're improving that flexibility or they're working on it over these next couple weeks.
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So it just gives them a better understanding of how they can work around some of those limitations and, and ultimately.
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Is gonna help the student, you know, long term and, and be able to provide, you know, the best instruction that you can during those lessons.
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Does that make sense?
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Yes.
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That makes great sense.
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Thank you.
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And that, turns me to my next question here.
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So everybody, no matter what, wants to hit the ball farther, right?
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They want to hit the ball a lot longer.
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And I think that as soon as they think that in their mind, they're jumping to how fast can I swing the club?
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You know, there's also.
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A launching of the ball element to it that I think we can accomplish in lessons that are way easier than just swinging and hitting it harder.
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But also when you take on club head speed as an improvement, there's some real considerations there.
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Are there not Andy,'cause I think that if, if the body isn't really ready to take that on, can't that be really detrimental and potentially even leading to injury in a way that's really gonna set the player back.
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Where do you see him from that standpoint?
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Right.
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Yeah, I, I think that in regards to, there's so many ways to hit the ball further.
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So I mean, there's people that can, they can have the same exact swing speed, but still hit the ball further.
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I mean, a matter of just hitting it more on, the center of the club face is gonna allow for you to have a better smash factor, which is gonna lead to more ball speed.
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Um, there's things you guys can do by having them shallow out the club a little bit more, change the angle of attack, decrease spin rate.
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So there's a lot of things that.
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That, that you guys can do on your end to be able to help them hit the ball further.
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And then there's other things that, you know, we can do from a physical therapy, uh, training perspective, uh, where we can essentially get their body moving a little bit more efficiently so that they can increase the swing speed.
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Um, so I think it's kind of multifaceted when it comes to.
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People wanting to increase swing speed and there's the hot topic of speed sticks and, you know, super speed protocol, the stack system.
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And I think those are good and people can get more swing speed by using those things.
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But oftentimes what can happen is if they don't have the adequate flexibility, the adequate strength, uh, to be able to contain, uh, be able to handle that speed Can, you know, uh.
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Result from that.
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So that's something that we've seen before too, where people have come to us when they said, Hey, I've been doing speed training and I, you know, pulled something in my back when I was, you know, you know, level three trying to really push it.
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Uh, and that's where we kind of have to sit back and say, Hey, like you're, we gotta take it a few steps down and really focus on flexibility first before we start really implementing the speed training.
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Uh, but I don't want to get too much into a, down into a can of worms yet.
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Uh, but yes, I.
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I see that pretty often.
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Like you said, yet we are definitely going down the, the, into the can of worms, just not yet.
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I, I have a quick Um, so.
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Have y'all, um,'cause I know y'all have had some other physical therapists on, on the podcast.
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you, have y'all, um, Rob, especially, have y'all worked with other physical therapists, uh, or, uh, personal trainers that have, uh, your students have been working with, that you guys have been open to, like discussing things
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Mm-hmm.
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For sure.
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Yeah.
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I've had at least three now, um, that I've kind of cycled through.
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Um, and then now it's to the point to where if they need help.
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Um, Dr.
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Michael k, he's a, he's a physical therapist out in.
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Uh, west Coast, uh, working with Tony Greco and Chris Walkie, um, and they've got an awesome online program that I'll, I'll send students to.
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That's, that's the limit, that's the limitations of what I've, what I've found.
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And, and, uh, I, I trust Dr.
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Mike with, um, my education and kind of what I do with my students on a daily basis.
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Um, so I have no, uh, no hesitation to, to send my students his way as well, so.
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So now I want to get into pain, pain itself.
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I know there's a couple different types of pain.
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I'm not an expert in this, obviously, that's why we're having you on the show today.
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But, from my understanding, there's acute pain and there's chronic pain.
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What is the difference between acute and chronic pain?
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How do you address'em differently?
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What about the understanding of how that works and affects the person?
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And how does someone like you take that on to help alleviate whatever type of pain they have and put'em on a track to being a pain-free person in life?
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And golfer also.
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Absolutely.
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Yeah.
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So you have acute pain, which is essentially pain that's been lasting less than six months.
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So once somebody's been dealing with pain for longer than six months, it becomes chronic.
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And so, uh, acute pain can be anywhere from, uh, an event that occurred where they just.
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They have been hitting off of a mat, uh, and taking a lot of swings and a lot of wedges, and they're somebody that takes, you know, more, more of a deep divot.
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Uh, and they end up with, you know, one swing and boom, my elbow's been killing me
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Hmm.
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of like an acute event.
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Uh, but then you get people that been like, yeah, I've been dealing with this back pain, uh, for about a couple months now.
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It's still considered acute and it's just, it.
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I don't remember doing a specific thing that caused it.
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It just kind of came on gradually.
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with those people, I mean, uh.
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We find that if somebody's been dealing with symptoms less than six months, the chances of them getting better are fairly, pretty quick as far as timeline goes.
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Uh, somebody that's been dealing with symptoms for a while, uh, we have found that it's very interesting that.
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Because you get people that are like, oh, I've been dealing with back pain for 20 plus years, and it's like, okay, like what's exactly going on here?
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And we've, we've found that there's, um, Adrian Lowe is a PhD, uh, neuroscientist, that, that studies pain.
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And, uh, and he, they found that tissue healing takes about a year for tissues to heal.
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so, so why is somebody having pain past one year?
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And the question becomes is, is the, is.
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Is, is the tissue still injured and that's why they're having pain.
00:16:43.340 --> 00:16:54.230
But what they found is that that neurological signal, uh, in the body, you know, telling the brain that there's a threat, uh, going on in the body, which is like the pain system, uh, the
00:16:54.235 --> 00:16:54.316
Hmm.
00:16:54.590 --> 00:17:00.200
system going off, they found that these people, their were healed, but they were still having pain.
00:17:00.200 --> 00:17:01.309
It was more of a.
00:17:01.419 --> 00:17:03.279
Neurological, uh,
00:17:03.285 --> 00:17:03.505
Wow.
00:17:03.610 --> 00:17:05.740
that feedback loop was going so long.
00:17:05.740 --> 00:17:13.089
And so those are the down with and say, Hey, like, you know, it takes about a year for those tissues to heal and you're dealing with symptoms greater than a year.
00:17:14.359 --> 00:17:36.980
This is, uh, that's where you try to educate them and there's like a little graph, I'll draw people on like a whiteboard and kind of explain to them that we have to do exercises and things that are gonna help decrease that sensitivity of the brain and, and, and limit that sensitivity to where they can start to do activities and exercises that don't set that alarm system off.
00:17:37.069 --> 00:17:39.319
Um, and that's how you tap into the system.
00:17:39.589 --> 00:17:41.144
Uh, but those are, that's kind of.
00:17:41.970 --> 00:17:54.539
pain in a nutshell, but when it comes to working with people that are dealing with symptoms like less than a year or less than six months, usually what we're doing with those people is are trying to figure out like, okay, where's the pain coming from?
00:17:54.569 --> 00:17:56.279
Is this like a muscular problem?
00:17:56.279 --> 00:17:58.829
Is this like a, a tendon problem?
00:17:59.099 --> 00:18:01.500
Uh, is this a ligament problem?
00:18:02.390 --> 00:18:08.779
Um, tendons is what connects muscles to bone and ligaments is what connects bone to bone.
00:18:09.019 --> 00:18:09.380
Okay?
00:18:09.710 --> 00:18:20.480
And so people can be dealing with, with pain and it could be, you know, bone related or one of those soft tissue structure, uh, soft tissue structures that's causing the discomfort.
00:18:20.660 --> 00:18:24.619
And so really when I evaluate somebody, I figure out, okay, where's the pain coming from?
00:18:24.619 --> 00:18:26.269
So we'll do like special tests.
00:18:26.299 --> 00:18:27.410
We'll try to figure out.
00:18:27.765 --> 00:18:30.704
We'll palpate, we'll figure out like where's the pain coming from?
00:18:30.704 --> 00:18:34.575
The second thing we want to figure out is like, what is the underlying problem here?
00:18:34.575 --> 00:18:36.555
Like, why did this happen in the first place?
00:18:36.944 --> 00:18:42.734
Is it because of poor range of motion, or is it because of weakness around that area that.
00:18:42.934 --> 00:18:46.654
That is causing, uh, you're not able to control that joint very well.
00:18:46.654 --> 00:18:49.384
So you're putting too much stress in that area.
00:18:49.384 --> 00:18:53.765
So therefore you start to overload the tissues, which then leads to injury.
00:18:54.095 --> 00:18:57.244
Uh, so those are the things that we try to figure out during our exam.
00:18:57.634 --> 00:19:06.154
Um, and, but for example, most often, if we're dealing with somebody with low back pain, some of the things that we see with those people are.
00:19:07.174 --> 00:19:14.974
When the golf swing end, it's a, it's a violently rotational movement, and so you need to rotate through the hips.
00:19:14.974 --> 00:19:26.825
You need to rotate through the mid back, and oftentimes what happens is end up rotating too much through their lumbar spine, which is like the lower back.
00:19:26.884 --> 00:19:30.454
And that lower back isn't really made to rotate very much.
00:19:30.454 --> 00:19:34.894
There is a little bit of rotation involved in the biomechanics of the the golf swing.
00:19:35.099 --> 00:19:41.039
But most of the rotation occurs through that upper mid back and through the hips.
00:19:41.039 --> 00:19:49.019
And if somebody's tight through the hips and or through the mid back, their body's gonna try to get it through that lower back.
00:19:49.019 --> 00:19:51.750
And that's where a lot of issues can occur.
00:19:51.990 --> 00:19:54.930
So oftentimes when I'm seeing somebody with low back pain.
00:19:55.775 --> 00:19:59.375
Usually the first thing we're checking is like, how's their hip mobility?
00:19:59.375 --> 00:20:01.535
How is their thoracic spine mobility?
00:20:01.535 --> 00:20:11.255
And oftentimes they're stiff in both areas and so not so most physical therapists, they're gonna want to treat the low back, which I think is really good.
00:20:11.494 --> 00:20:20.884
But if you don't fix the underlying problem to why this happened in the first place, they're gonna end up going and playing multiple rounds and being like, gosh, my back flared up again.
00:20:20.884 --> 00:20:21.515
What the heck?
00:20:21.515 --> 00:20:22.565
What's going on here?
00:20:22.894 --> 00:20:24.184
So with those people.
00:20:24.545 --> 00:20:29.464
We'll do things well, I kind of separate it into three phases when I work with clients.