WEBVTT 1 00:00:03.799 --> 00:00:07.839 Welcome to Moving Conversations, a podcast for movement professionals, by 2 00:00:07.960 --> 00:00:11.240 movement professionals. If you coach, train, or teach movement, pilates 3 00:00:11.320 --> 00:00:14.119 or fitness, then this podcast is for you. With more 4 00:00:14.199 --> 00:00:16.600 than sixty years of experience and fitness and pilates, your 5 00:00:16.600 --> 00:00:19.199 host Brian Richie and North Saint John explored to science 6 00:00:19.199 --> 00:00:22.280 of human movement, diving deep into the backs, myths, and 7 00:00:22.559 --> 00:00:26.239 common misconceptions, hoping to spark thought and conversation about how 8 00:00:26.239 --> 00:00:29.800 we view fitness and movement. Now let's jump into Moving 9 00:00:29.839 --> 00:00:33.159 Conversations and welcome back to Moving Conversations. I'm Brian Richie 10 00:00:33.240 --> 00:00:35.479 joining me as always, there's Norris John. Morning, Nora. How 11 00:00:35.520 --> 00:00:35.799 you doing. 12 00:00:36.600 --> 00:00:37.600 I'm very well, Brian. 13 00:00:37.640 --> 00:00:39.600 How are you understand you're under a heat dome? 14 00:00:40.039 --> 00:00:43.240 Because oh my gosh, I just took a small little 15 00:00:43.240 --> 00:00:45.719 walk and from the time I left to the time 16 00:00:45.759 --> 00:00:49.359 I got back it was weltering. It must have went 17 00:00:49.479 --> 00:00:52.960 up five degrees. And we're supposed to get without heat 18 00:00:52.960 --> 00:00:55.920 index over one hundred to like one hundred and three. 19 00:00:56.000 --> 00:00:58.079 With heat index, they're expecting to be well over one 20 00:00:58.159 --> 00:01:02.560 hundred and ten, maybe hotter than that one fifteen. So 21 00:01:02.600 --> 00:01:04.879 we'll see things change here and there. But that's what 22 00:01:04.920 --> 00:01:06.840 they said yesterday's news, and I went, yeah, I'm not 23 00:01:06.920 --> 00:01:09.799 leaving the house. I'm gonna stay home. I'm gonna stay 24 00:01:09.840 --> 00:01:12.319 with the air conditioning on. I pray it doesn't break. 25 00:01:12.400 --> 00:01:12.519 You know. 26 00:01:12.599 --> 00:01:15.000 It's one of those things. It's just like, Okay, let's 27 00:01:15.040 --> 00:01:17.319 hope here. You know. 28 00:01:17.560 --> 00:01:20.319 I grew up in La right, So I always think 29 00:01:21.239 --> 00:01:23.319 that La greg Banilla was kind of funny because the 30 00:01:23.400 --> 00:01:26.519 summers could be pretty miserable, and when I was growing up, 31 00:01:26.599 --> 00:01:30.000 was also really smoggy, so I actually spent more time 32 00:01:30.040 --> 00:01:33.439 inside in the summer, like, rather than in the winter. 33 00:01:33.599 --> 00:01:35.920 So the whole thing about hibernating is like, oh no, no, 34 00:01:36.239 --> 00:01:39.280 I'm outside all winter and all fall and some of 35 00:01:39.319 --> 00:01:41.920 the spring, and then summer was like and you know, 36 00:01:42.000 --> 00:01:43.640 you go out, you do your thing, you come back 37 00:01:43.640 --> 00:01:46.519 in and you hang out until the heat wave goes away, 38 00:01:46.640 --> 00:01:50.400 which is just a backwards way of thinking about things. 39 00:01:51.040 --> 00:01:57.840 I've always wondered why my parents decided to move from Colorado, 40 00:01:57.959 --> 00:02:00.719 which was already warm in the summer, to Phoenix. 41 00:02:02.000 --> 00:02:05.560 Oh yes, and they must like heat, and no. 42 00:02:05.680 --> 00:02:08.479 The opposite, they really don't. It was just one of 43 00:02:08.479 --> 00:02:10.960 those weird things that air quality and all of that, 44 00:02:11.240 --> 00:02:14.080 it made sense to move there. Okay, I said, wait 45 00:02:14.080 --> 00:02:16.680 a minute, it's going to be one twenty one hundred 46 00:02:16.680 --> 00:02:20.439 and twenty degrees and maybe that's done a good day. 47 00:02:20.719 --> 00:02:22.680 I mean, people usually just go out first thing in 48 00:02:22.719 --> 00:02:24.639 the morning and then wait until the sun goes down. 49 00:02:24.759 --> 00:02:27.560 So I said, are you sure, Oh, we'll just stay 50 00:02:27.599 --> 00:02:30.120 inside those days. I'm thinking that's most of the year, 51 00:02:30.240 --> 00:02:30.560 isn't it. 52 00:02:30.599 --> 00:02:33.879 I was going to say, that's pretty much May two October. 53 00:02:33.960 --> 00:02:35.719 If I remember Phoenix. 54 00:02:35.879 --> 00:02:40.080 Yeah, exactly, exactly. I remember we were there for an 55 00:02:40.120 --> 00:02:45.520 event in beginning of April, and one day was beautiful. 56 00:02:45.719 --> 00:02:48.319 It had a little light overcast, it was gorgeous. The 57 00:02:48.360 --> 00:02:51.800 next day was already ninety degrees and I thought, oh 58 00:02:51.840 --> 00:02:54.599 my gosh, and it's April. I'm about to go back 59 00:02:54.639 --> 00:02:56.560 to the west or to the east coast, where it's 60 00:02:56.599 --> 00:03:00.599 going to be in the forties. How do you dan 61 00:03:00.919 --> 00:03:03.919 all that heat? And yeah, and we have the humidity 62 00:03:03.919 --> 00:03:06.520 here as well. So we're supposed to go to a 63 00:03:06.520 --> 00:03:08.960 baseball game Friday night, and I just said, you know what, No, 64 00:03:09.240 --> 00:03:13.039 I don't think so. My family doesn't do well with 65 00:03:13.039 --> 00:03:16.039 with you know, warm temperatures. I don't mind them nearly 66 00:03:16.080 --> 00:03:18.400 as much. I'm not comfortable, but I don't mind them. 67 00:03:18.599 --> 00:03:22.479 Rest of them are like, no, no, thank you, it's 68 00:03:22.520 --> 00:03:26.879 your wind blood exactly exactly. So I just said, it's 69 00:03:27.000 --> 00:03:29.960 it's not worth being miserable sitting there sweating, and just 70 00:03:30.159 --> 00:03:32.919 uh so it's like, nope, we'll stay inside, we'll rent 71 00:03:32.960 --> 00:03:36.120 a movie, we'll watch something. You know, well, we'll chill 72 00:03:36.120 --> 00:03:41.560 out because well, because there's nothing going on that we 73 00:03:41.599 --> 00:03:43.120 talked about that thinking, oh, what are we going to 74 00:03:43.199 --> 00:03:45.639 do this weekend? As little as possible. That's what we're 75 00:03:45.639 --> 00:03:48.639 going to do. The office work. I have a feeling, yeah, 76 00:03:48.639 --> 00:03:49.199 it's going. 77 00:03:49.039 --> 00:03:49.719 To be inside. 78 00:03:50.439 --> 00:03:50.639 Yeah. 79 00:03:50.639 --> 00:03:51.919 I have a little bit of an announcement. 80 00:03:51.960 --> 00:03:54.199 I actually have a website now nor a Saint John 81 00:03:55.599 --> 00:03:59.199 so and it includes everywhere I'm presenting and everything I'm doing. 82 00:03:59.199 --> 00:04:00.560 It also includes links to. 83 00:04:00.639 --> 00:04:03.800 Our show and all of our show, our past episode, 84 00:04:04.439 --> 00:04:05.759 a little a little document that. 85 00:04:05.680 --> 00:04:06.560 Has a lot of that in it. 86 00:04:06.840 --> 00:04:09.360 So if you're interested in that, feel free to come 87 00:04:09.759 --> 00:04:11.560 up or sign up for the being on my contact 88 00:04:11.560 --> 00:04:12.639 list or any of that kind of thing. 89 00:04:13.400 --> 00:04:16.480 Fantastic, fantastic, and do us a favor, hit the like 90 00:04:16.480 --> 00:04:19.279 and subscribe button. We really appreciate it. It helps the algorithm, 91 00:04:19.360 --> 00:04:22.000 whatever the heck that means, but what it basically does 92 00:04:22.160 --> 00:04:24.120 is help us to spread the word a little bit more, 93 00:04:24.199 --> 00:04:26.759 gets us out there to more people. It's always interesting. 94 00:04:26.800 --> 00:04:30.279 I get to see the analytics and some shows hit 95 00:04:30.399 --> 00:04:33.160 very well, others have a miss. So the more you 96 00:04:33.160 --> 00:04:36.680 can comment, the more you can like subscribe to all 97 00:04:36.720 --> 00:04:38.439 of those things. We really appreciate it because it does 98 00:04:38.480 --> 00:04:40.680 help us out a lot. Check out the YouTube page 99 00:04:40.759 --> 00:04:42.800 under my name Brian Ritchie and also check us out 100 00:04:42.839 --> 00:04:45.360 on Instagram at Moving Combos or you can email us 101 00:04:45.399 --> 00:04:50.199 at movingcompos at gmail dot com. So last couple of weeks, 102 00:04:50.639 --> 00:04:55.519 we've been talking about hip replacements primarily YEP, and the 103 00:04:55.600 --> 00:04:59.439 topic start came up a couple times. Yeah, yeah, no, 104 00:04:59.759 --> 00:05:02.600 was not just the rehabilitation aspect, but also the prehab 105 00:05:02.639 --> 00:05:06.000 of it. We spoke with like you said, Beth a 106 00:05:06.040 --> 00:05:10.120 couple of weeks ago and the topic came up about prehab, 107 00:05:10.160 --> 00:05:12.519 and it did last week, and I thought, why don't 108 00:05:12.519 --> 00:05:17.040 we sort of continue on with practical application of rehabilitating 109 00:05:17.240 --> 00:05:22.639 hips hip replacements, but also focus on the prehab because 110 00:05:22.639 --> 00:05:25.920 that's something that is really being shown to be more 111 00:05:25.920 --> 00:05:29.720 and more useful and more and more effective with our clients. 112 00:05:31.000 --> 00:05:32.920 And there's two key things I wanted to bring up 113 00:05:32.920 --> 00:05:33.279 about that. 114 00:05:34.360 --> 00:05:38.399 One is that oftentimes, and you know I both had that, 115 00:05:38.879 --> 00:05:41.680 I've both had that experience. Clients come in with hip 116 00:05:41.720 --> 00:05:45.920 problems and they're saying they are preparing for or considering 117 00:05:45.920 --> 00:05:50.199 a hip replacement, and then you work with them for 118 00:05:50.240 --> 00:05:54.240 a while and it turns out that really they were 119 00:05:54.439 --> 00:05:59.319 just deconditioned and that that essentially just exercise and movement 120 00:06:00.079 --> 00:06:03.160 were enough to move them out of enough pain to 121 00:06:03.360 --> 00:06:07.079 basically put off that hip replacement indefinitely or certainly for. 122 00:06:07.040 --> 00:06:08.120 A longer period of time. 123 00:06:08.600 --> 00:06:10.279 And as you know, you and I've both talked about, 124 00:06:10.279 --> 00:06:12.240 and it's certainly side of the show, the longer you 125 00:06:12.319 --> 00:06:15.600 put off those replacements to a certain extent, the better, 126 00:06:15.639 --> 00:06:18.079 because they don't last forever. If you've got somebody in 127 00:06:18.079 --> 00:06:20.639 their fifties or sixties who's thinking about a hip replacement, 128 00:06:22.040 --> 00:06:23.519 you know, you kind of do want to put that 129 00:06:23.639 --> 00:06:26.160 off if you can. Seventies and eighties in a little 130 00:06:26.160 --> 00:06:28.160 different but certainly fifties and sixties, you want to really 131 00:06:28.279 --> 00:06:32.160 give them the opportunity to make the changes and manage 132 00:06:32.199 --> 00:06:34.480 that pain a little bit differently through movement and strength, 133 00:06:35.000 --> 00:06:36.480 so they didn't have to have the HP replacement, or 134 00:06:36.560 --> 00:06:36.839 don't have. 135 00:06:36.879 --> 00:06:39.360 To have it so soon, and something to think about. 136 00:06:39.800 --> 00:06:42.439 I had a client come to me five six years ago, 137 00:06:42.639 --> 00:06:45.519 I think it was right around at the beginning of COVID, 138 00:06:45.600 --> 00:06:49.000 maybe middle of something like that, and came to me 139 00:06:49.079 --> 00:06:50.839 and said, I need a hip replacement. He's younger than 140 00:06:50.879 --> 00:06:54.480 I am, He's in his early forties. And I said, okay, 141 00:06:54.560 --> 00:06:57.839 and I'm trying to get out of him. Why could 142 00:06:57.879 --> 00:07:00.279 it be a structural issue. I've had a couple of 143 00:07:00.279 --> 00:07:02.680 people who need it because of structure. Sure, Okay, that's 144 00:07:02.720 --> 00:07:04.560 the only thing that's going to get them out of pain. Sure, 145 00:07:05.800 --> 00:07:07.920 I've had other I've had many dancers. I've had people 146 00:07:07.959 --> 00:07:11.040 who have had you know, large bouts of pread in 147 00:07:11.079 --> 00:07:14.680 his own there are reasons to have it. Sure, But 148 00:07:14.800 --> 00:07:16.800 I was trying to get that out of him, and 149 00:07:17.160 --> 00:07:19.319 finally he said, well, I was doing yoga and I 150 00:07:19.399 --> 00:07:21.680 was doing a real wide split sort of thing and 151 00:07:21.839 --> 00:07:24.360 leaning over trying to increase my range of motion because 152 00:07:24.360 --> 00:07:26.319 he had some back problems and was trying to do 153 00:07:26.439 --> 00:07:30.560 yoga to you know, supplement that and he said, in 154 00:07:30.600 --> 00:07:32.680 my hip began bothering me, and began bothering me, began 155 00:07:32.759 --> 00:07:34.560 bothering me, and he got worse and worse and worse, 156 00:07:34.879 --> 00:07:38.000 and he's he's a little bit of a hypochondriac, just 157 00:07:38.040 --> 00:07:41.279 a little bit, okay. He he tends to focus on 158 00:07:41.360 --> 00:07:44.240 these things. So he went to see a doctor. And 159 00:07:44.279 --> 00:07:46.839 the first thing the doctor said, oh, yep, it looks 160 00:07:46.879 --> 00:07:48.279 like you might have a label tear. I think we 161 00:07:48.319 --> 00:07:53.480 need to do a hip replacement. WHOA, that's that's a 162 00:07:53.519 --> 00:07:53.959 big jump. 163 00:07:54.199 --> 00:07:55.399 That's a big jump. 164 00:07:55.879 --> 00:07:58.439 That's that's a big Yeah, that's a big leap. And 165 00:07:58.519 --> 00:08:01.920 with the doctor in that way, yeah, he looked at 166 00:08:01.959 --> 00:08:04.279 the MRI and said, well, it's too big of a gap. 167 00:08:04.360 --> 00:08:06.439 It would it would basically they'd have to go in 168 00:08:06.560 --> 00:08:10.160 and just separate it and all of this. And I said, 169 00:08:10.920 --> 00:08:14.920 when is it scheduled? And we had I think three 170 00:08:15.040 --> 00:08:17.839 or four months, I believe, so. I think it was 171 00:08:17.879 --> 00:08:19.279 at August, and I think it was gonna be late 172 00:08:19.319 --> 00:08:22.480 December or something. I said, fine, give me three months. 173 00:08:23.279 --> 00:08:25.240 I said, you can cancel it at any time. You 174 00:08:25.319 --> 00:08:27.800 can always cancel that, but I got to make you 175 00:08:27.800 --> 00:08:31.120 as strong as possible. But let's see how close we 176 00:08:31.199 --> 00:08:33.039 can get you to pain free before that. And if 177 00:08:33.080 --> 00:08:35.279 we can, and you maybe can put it off until 178 00:08:35.279 --> 00:08:37.120 it starts bothering you again, maybe that'll give you an 179 00:08:37.159 --> 00:08:40.720 extra five years, ten years, whatever. And within a month 180 00:08:41.279 --> 00:08:44.120 his pain went from being in his mind a seven 181 00:08:44.600 --> 00:08:48.559 six seven to being a one. He barely noticed it, 182 00:08:49.600 --> 00:08:52.080 and then after a while he just said, yeah, I 183 00:08:52.080 --> 00:08:54.360 don't even think about it anymore. Should I still have 184 00:08:54.480 --> 00:08:57.600 the surgery? He asked me this, and I looked at 185 00:08:57.679 --> 00:08:59.919 him and I said, so, what are you trying to call? 186 00:09:00.639 --> 00:09:03.279 When he said, yeah, that's kind of what I'm thinking, 187 00:09:03.360 --> 00:09:06.879 I said, you can always call the doctor back. I said, 188 00:09:06.879 --> 00:09:10.080 trust me, he will book you. That's he felt bad. Oh, 189 00:09:10.200 --> 00:09:11.919 I made the appointment a long time ago. I said, 190 00:09:11.919 --> 00:09:15.320 trust me, he'll book it. I said, these touches a waiting. 191 00:09:15.120 --> 00:09:20.080 List, especially he was booking that far ahead exactly. He's not, 192 00:09:20.320 --> 00:09:22.279 it's not a problem. He can fill somebody in that 193 00:09:22.399 --> 00:09:23.440 spot and no problem. 194 00:09:23.519 --> 00:09:26.519 It'll heartbeat exactly. And so he put it off. And 195 00:09:26.679 --> 00:09:29.200 that was, like I say, years ago, five years ago, 196 00:09:29.320 --> 00:09:31.960 and he now, I mean, he graduated from me to 197 00:09:32.240 --> 00:09:34.240 just working out on his own. He checks in from 198 00:09:34.279 --> 00:09:37.399 time to time. But he's basically doing whatever he wants 199 00:09:38.080 --> 00:09:41.639 and doing fantastic and has no issues. Got to play, 200 00:09:41.960 --> 00:09:44.519 got back to playing softball and baseball again, sliding all 201 00:09:44.600 --> 00:09:48.159 sorts of things, and has no issues. So it can 202 00:09:48.320 --> 00:09:50.799 be done. And oftentimes it's just doing the right things 203 00:09:50.840 --> 00:09:53.679 and strengthening the right way to really see if we 204 00:09:53.759 --> 00:09:58.399 can get that the mechanics right and take pressure off 205 00:09:58.519 --> 00:10:02.000 of the area that may causing the issue, so it 206 00:10:02.120 --> 00:10:02.799 can be done. 207 00:10:04.519 --> 00:10:07.960 Yeah, I had a client who was a she was 208 00:10:08.039 --> 00:10:11.679 a hiker, like a professional guide for hiking up in 209 00:10:11.759 --> 00:10:14.240 the Sierras. And if you ever, any of you ever 210 00:10:14.279 --> 00:10:15.919 a hiking this airas a lot of times you're literally 211 00:10:15.919 --> 00:10:19.000 walking on granite. It's a pretty unforgiving surface. And then 212 00:10:19.039 --> 00:10:20.879 you've got, you know, a backpack on a twenty to 213 00:10:21.000 --> 00:10:23.159 forty pound to probably even higher because she's a guide, 214 00:10:23.360 --> 00:10:26.039 you know, fifty pounds backpack on, so it's a it's 215 00:10:26.080 --> 00:10:29.480 a lot of force. And her hips were killing her, 216 00:10:30.240 --> 00:10:32.399 both hips. Actually was kind of a lateral in her case. 217 00:10:33.120 --> 00:10:36.039 And then and she'd gone to a doctor. She's probably 218 00:10:36.120 --> 00:10:38.559 in her late forties, early fifties. She was not that 219 00:10:38.679 --> 00:10:41.039 old either, and they said, well, you know, we're thinking 220 00:10:41.039 --> 00:10:42.000 about a hip replacement. 221 00:10:42.720 --> 00:10:46.159 So it was interesting. In her case, it didn't take 222 00:10:46.320 --> 00:10:48.200 very long, Like like she came in. 223 00:10:48.919 --> 00:10:52.080 We just did footwork, feed in straps, a little bit 224 00:10:52.080 --> 00:10:55.639 of abduction adduction work, like nothing fancy at all. But 225 00:10:55.759 --> 00:10:57.200 she came in I think three times a week for 226 00:10:57.240 --> 00:10:59.080 about a month, and even after that month, like her 227 00:10:59.159 --> 00:11:02.120 pain was gone on. Then we kept working and I 228 00:11:02.159 --> 00:11:03.919 think this was in the winter, so she wasn't in 229 00:11:04.120 --> 00:11:06.639 her hiking season because she was afraid too that she'd 230 00:11:06.720 --> 00:11:08.440 have to like change her job. She couldn't do her 231 00:11:08.519 --> 00:11:10.679 job anymore, like it was a big, big, major life thing. 232 00:11:11.720 --> 00:11:13.679 So we had about three more months of just working, 233 00:11:14.080 --> 00:11:17.960 just getting her stronger, getting crew more resilient. Then when 234 00:11:18.000 --> 00:11:20.960 the next season came along, she was right back out there, 235 00:11:21.120 --> 00:11:24.000 able to hike, you know, fifteen twenty miles a day 236 00:11:24.159 --> 00:11:27.919 with a backpack on. And she put that off as 237 00:11:27.960 --> 00:11:30.840 far as I know, for years after that. So again 238 00:11:30.879 --> 00:11:33.279 these are two very positive experiences. 239 00:11:33.360 --> 00:11:35.720 You may not have the same thing out. 240 00:11:35.600 --> 00:11:38.120 There if you're teaching or if you have a hip issues, 241 00:11:38.639 --> 00:11:41.120 but it's something to know, especially if somebody hasn't done 242 00:11:41.120 --> 00:11:45.600 a lot of very specific hip stabilization and hip mobility 243 00:11:45.679 --> 00:11:47.519 training to kind of get things balanced. 244 00:11:48.360 --> 00:11:51.399 And I'm going to preface it by saying this, I 245 00:11:51.600 --> 00:11:54.000 had that client, but I also had sort of the 246 00:11:54.080 --> 00:11:58.360 opposite person. He was in his early fifties. He went 247 00:11:58.399 --> 00:12:00.879 in to get it for a hip replacement or to 248 00:12:01.200 --> 00:12:03.559 talk to a hip doctor because he was having anterior 249 00:12:03.639 --> 00:12:06.720 hip pain. And the doctor said, you need a hip replacement, 250 00:12:06.879 --> 00:12:09.440 and he said, I'm too young. No I no way, 251 00:12:09.559 --> 00:12:12.360 no way, no way. And I even looked at the 252 00:12:12.559 --> 00:12:16.240 X ray. He had a misshapen head of his femur. 253 00:12:17.080 --> 00:12:19.840 It was like an eight, and he had ground the 254 00:12:20.080 --> 00:12:22.600 center of the acid tabulum so that it was bone 255 00:12:22.600 --> 00:12:24.480 on bone. I mean, I looked at it and saw this, 256 00:12:24.639 --> 00:12:26.480 and I said, I'm sure that's what the doctor saw. 257 00:12:26.519 --> 00:12:28.919 Because I'm not a physician, so I'm thinking, I know 258 00:12:29.039 --> 00:12:31.080 that's what the doctor's looking at here. And I said, 259 00:12:31.120 --> 00:12:34.399 have you did he mention anything about a misshapen for 260 00:12:34.519 --> 00:12:36.399 more ahead. Again, I'm not going to give him any advice, 261 00:12:36.480 --> 00:12:38.679 but I saw it, and he said he said something 262 00:12:38.679 --> 00:12:41.480 about that, but no, I think there's something else. So 263 00:12:41.600 --> 00:12:44.159 he went to another physician who said, oh no, no, no, no, 264 00:12:44.440 --> 00:12:46.279 your hip pain is caused by your low back. You 265 00:12:46.360 --> 00:12:51.120 need to have a spinal fusion. Oh god, he chose 266 00:12:51.159 --> 00:12:54.720 to have a spinal fusion and he didn't need one. Yeah, 267 00:12:55.440 --> 00:12:57.440 I mean, and that was the whole thing is Was 268 00:12:57.519 --> 00:13:00.480 he having some nerve pain, yes, he and I said, 269 00:13:00.519 --> 00:13:03.399 please get a second or third opinion. But he so 270 00:13:03.600 --> 00:13:07.240 badly wanted to put off the hip issue that he 271 00:13:07.360 --> 00:13:08.799 immediately jumped to the spine. 272 00:13:09.679 --> 00:13:12.080 Yeah, of a final fusion and a hip replacement. 273 00:13:12.200 --> 00:13:14.320 Okay, that's and just not knowing what. 274 00:13:14.399 --> 00:13:15.159 The differences are. 275 00:13:15.960 --> 00:13:18.399 Yeah, And I mentioned that. I said, look, this is 276 00:13:18.519 --> 00:13:22.159 not something to just jump into lightly. And he he 277 00:13:22.279 --> 00:13:24.519 did it. I saw him afterwards, and it took a 278 00:13:24.600 --> 00:13:27.679 while to get him back into decent shape. But the 279 00:13:27.759 --> 00:13:31.200 hip pain never went away, and he went to doctor 280 00:13:31.240 --> 00:13:36.600 after doctor after doctor, ended up at Johns Hopkins. Maybe 281 00:13:36.679 --> 00:13:38.799 he ended up at male clinic. That's where he ended up, 282 00:13:38.799 --> 00:13:41.159 MAO clinic. The first thing they did was take a 283 00:13:41.200 --> 00:13:43.759 look and say, oh, you got an egg shaped femoral head. 284 00:13:44.639 --> 00:13:46.879 You just have worn down the cartilage. You need a 285 00:13:46.960 --> 00:13:51.759 hip replacement. I mean, it was that apparent. He he 286 00:13:51.879 --> 00:13:54.080 called me and said did you see that? And I said, 287 00:13:54.159 --> 00:13:57.159 so did your doctor? I said, I asked about that. 288 00:13:57.279 --> 00:13:59.559 He said, Oh, yeah, I guess so. I mean he 289 00:13:59.679 --> 00:14:02.720 really wanted to avoid that. And I don't know if 290 00:14:02.759 --> 00:14:05.519 it was just because of the fear of a hip replacement. 291 00:14:05.600 --> 00:14:09.159 Maybe he had a relative. I never drove that diet 292 00:14:09.559 --> 00:14:12.440 went that deep into the reason why. I'm sure there 293 00:14:12.559 --> 00:14:16.159 was a reason, but for him, that's what he needed, 294 00:14:16.679 --> 00:14:20.080 and had he had that done first, he probably could 295 00:14:20.080 --> 00:14:22.440 have put any spinal issue off for a long time 296 00:14:22.440 --> 00:14:26.240 because his core was very strong. He wasn't having issues 297 00:14:26.279 --> 00:14:28.879 with that. So there are some times in some cases, 298 00:14:28.879 --> 00:14:31.279 I've had a number of people who either threw like 299 00:14:31.360 --> 00:14:34.440 I say, drug interaction that their bones have just worn 300 00:14:34.519 --> 00:14:38.759 down severe osteoporosis. I've had a couple people who were 301 00:14:38.840 --> 00:14:45.000 severe bulimic and anarexik who became who basically wore down 302 00:14:45.039 --> 00:14:47.759 their bones to the point that they had very little 303 00:14:47.799 --> 00:14:50.320 in way of bone support and fractured their hip and 304 00:14:50.440 --> 00:14:52.799 needed to have the replacement. So I've seen a bunch 305 00:14:52.840 --> 00:14:56.320 of people who are younger who have needed it. Yeah, 306 00:14:56.600 --> 00:15:00.000 but my thought is, let's try the exercise first, because 307 00:15:00.000 --> 00:15:04.240 because some people have just never exercised property before, right, right, And. 308 00:15:04.240 --> 00:15:05.919 I think of one other clim I had who had 309 00:15:07.080 --> 00:15:10.399 rather see your hip dyspleasia, where you're just meaning that 310 00:15:10.480 --> 00:15:13.320 the femur and the acetabulum don't fit very well, or 311 00:15:13.320 --> 00:15:16.919 the acetabulum is very shallow, so it's just super unstable hips. 312 00:15:17.759 --> 00:15:20.639 And she had an april placement pretty early on, like 313 00:15:20.720 --> 00:15:23.360 I think in her late thirties, but she needed it, 314 00:15:23.519 --> 00:15:24.159 like there. 315 00:15:24.120 --> 00:15:27.399 Was nothing was free hips for not holding together without it. 316 00:15:28.360 --> 00:15:31.159 But that all being said, even with that, even when 317 00:15:31.360 --> 00:15:33.840 they need to do have surgery and that's the right 318 00:15:33.919 --> 00:15:36.639 thing and that's a good choice for them, then it's like, okay, 319 00:15:36.720 --> 00:15:40.240 so let's prepare them for that. And it's it's in 320 00:15:40.320 --> 00:15:42.559 some ways it's pretty basic. You want to get three 321 00:15:42.600 --> 00:15:44.639 dimensional strength around the hip, you want to get three 322 00:15:44.679 --> 00:15:46.759 dimension strength around the knee. You may want to work 323 00:15:46.799 --> 00:15:48.840 on gate, You certainly want to work on their core 324 00:15:50.360 --> 00:15:53.360 in order to just get them as strong and capable 325 00:15:53.399 --> 00:15:53.960 as possible. 326 00:15:54.720 --> 00:15:58.240 Yeah, I find that you said earlier with the word mechanics. 327 00:15:59.200 --> 00:16:01.600 There are some people by the way they stand their 328 00:16:01.639 --> 00:16:04.759 hips jut out and the femur heads are riding forward 329 00:16:04.799 --> 00:16:07.080 in the sockets slightly. And when we say forward, we're 330 00:16:07.120 --> 00:16:09.279 talking about millimeters. We're not talking about you know, a 331 00:16:09.399 --> 00:16:12.360 huge amount of slack we're talking about. It's just pushing forward, 332 00:16:12.879 --> 00:16:16.120 so maybe their hip isn't sitting as well as it should, 333 00:16:16.720 --> 00:16:20.679 and just getting them into proper positioning, getting them proper exercise. 334 00:16:21.240 --> 00:16:24.080 Something simple. I mean the exercise I started with that 335 00:16:24.240 --> 00:16:28.120 one gentleman, literally hands and knees. Let's just have him 336 00:16:28.159 --> 00:16:30.799 do hip circles on hands and knees, just tracing like 337 00:16:31.440 --> 00:16:35.919 a silver dollar and just let that leg hang for 338 00:16:36.039 --> 00:16:39.639 a moment, and then let's just start doing some simple circles, 339 00:16:39.679 --> 00:16:43.399 something simple. And again, what that was teaching was that 340 00:16:43.600 --> 00:16:45.279 the joint was going to have a little bit the 341 00:16:45.320 --> 00:16:48.600 weight was going to pull it slightly out, just slightly, 342 00:16:49.000 --> 00:16:51.279 so that he had greater range of motion, greater freedom, 343 00:16:51.320 --> 00:16:53.279 so we wouldn't be, you know, if there's any grinding, 344 00:16:53.679 --> 00:16:57.080 and just retraining how to do those movements. And he 345 00:16:57.120 --> 00:16:59.600 said that was one of the things that made such 346 00:16:59.639 --> 00:17:02.200 a huge difference, and it was something so simple and 347 00:17:02.320 --> 00:17:03.639 didn't really require money. 348 00:17:04.559 --> 00:17:06.440 Yeah, and for and for all my clients it's feet 349 00:17:06.480 --> 00:17:09.039 and straps, which is the same kind of deal. Feet 350 00:17:09.079 --> 00:17:12.000 and straps, Yeah, either on the reformer or on the 351 00:17:12.039 --> 00:17:16.400 trap table. And the one girl who was really prehabbing. Specifically, 352 00:17:16.559 --> 00:17:19.720 she was actually a forest ranger, so she was used 353 00:17:19.759 --> 00:17:22.440 to hiking a lot. So again, hiking seems to be 354 00:17:22.480 --> 00:17:25.119 a theme today. And for her, it was like, we 355 00:17:25.200 --> 00:17:28.359 would just go onto the trap table and do leg 356 00:17:28.480 --> 00:17:30.799 slides and I would have, you know, first we just 357 00:17:30.839 --> 00:17:33.640 do leg slides, and then I'd add a strap around 358 00:17:33.720 --> 00:17:35.960 her knee, uh, you know, going. 359 00:17:36.000 --> 00:17:38.119 Behind her so you had a little bit of resistance. 360 00:17:37.759 --> 00:17:39.759 Into her hand strings. And we do some leg slides, 361 00:17:39.759 --> 00:17:42.839 a little bit of resistance, we do some adduction, some abduction, 362 00:17:44.039 --> 00:17:45.279 and basically. 363 00:17:45.000 --> 00:17:46.599 We started with that and it ranged. 364 00:17:46.599 --> 00:17:48.839 It didn't hurt, and didn't didn't increase your symptoms anyway, 365 00:17:48.920 --> 00:17:51.720 not that didn't hurt, but didn't increase your symptoms. And 366 00:17:51.880 --> 00:17:53.960 that was you know, that's where we started. And then 367 00:17:54.000 --> 00:17:56.200 slowly built up to footwork and then slowly built up 368 00:17:56.200 --> 00:17:58.799 to feed and straps, you know, with more weight on 369 00:17:58.920 --> 00:18:03.079 the on the to the lever basically, and again she 370 00:18:03.319 --> 00:18:07.240 had much much, much improved response, and she didn't put 371 00:18:07.279 --> 00:18:09.519 off her hip replacement. But she had a much quicker 372 00:18:09.559 --> 00:18:10.920 recovery than I think she would have before. 373 00:18:11.759 --> 00:18:11.960 Yeah. 374 00:18:12.400 --> 00:18:16.079 Yeah, the thing I noticed that one of the rules 375 00:18:16.119 --> 00:18:18.680 I follow, especially when it comes to someone who's pre 376 00:18:18.799 --> 00:18:21.680 hip replacement or even pre knee replacement, when we're doing 377 00:18:21.759 --> 00:18:23.799 pre hab work or trying to see if they really 378 00:18:23.920 --> 00:18:26.519 need it or if they just need to exercise it properly. 379 00:18:27.160 --> 00:18:31.000 Is trying to deweaight the joint as much as I can. Okay, 380 00:18:31.279 --> 00:18:35.400 because standing often bothers them if they have a labor issue, 381 00:18:35.480 --> 00:18:38.200 it can be that it's pinching into the laborum, whatever 382 00:18:38.319 --> 00:18:40.359 it is, if they are bone on bone or whatever. 383 00:18:40.519 --> 00:18:43.759 Sometimes just getting the pressure off of it can really 384 00:18:44.000 --> 00:18:46.400 alleviate a lot of the discomfort. So trying to stay 385 00:18:46.440 --> 00:18:49.200 within that pain free range of motion, especially at the beginning, 386 00:18:49.880 --> 00:18:51.720 gives them, first of all, a lot of confidence that 387 00:18:51.799 --> 00:18:53.559 we're what we're doing is not going to hurt them 388 00:18:53.880 --> 00:18:56.640 because they've been in paint for a while. So just 389 00:18:57.559 --> 00:19:00.720 showing them, hey, this isn't going to bother too much. 390 00:19:00.759 --> 00:19:02.400 And if we find a range of motion that does, 391 00:19:02.559 --> 00:19:06.079 let's change the angle, because even something like clamshells forty 392 00:19:06.119 --> 00:19:08.359 five degrees from the hips may bother it, but ninety 393 00:19:08.480 --> 00:19:12.400 may not, or thirty may not. Sixty n find what 394 00:19:12.599 --> 00:19:15.160 doesn't hurt and train the heck out of that angle, 395 00:19:15.839 --> 00:19:20.319 and you can still gain strength, and again hands and knees, 396 00:19:20.519 --> 00:19:23.599 feet and straps, all of these sorts of things. Sometimes 397 00:19:23.680 --> 00:19:26.079 I would just have them stand on one block on 398 00:19:26.240 --> 00:19:29.079 a step or stare that I teach them to do 399 00:19:29.160 --> 00:19:32.279 at home, and much like doing a pendulum for the shoulder, 400 00:19:32.319 --> 00:19:32.839 where we. 401 00:19:32.960 --> 00:19:35.319