September 19 2024
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Welcome to the True Sports Physical Therapy Podcast with your host, Dr. Rosenblatt. Today, we sit down with NFL Hall of Fame Strength and Conditioning Coach, Kence Johnston. In this episode, Coach Johnston shares his wealth of experience working with top tier athletes and explores how the principles used to train and condition elite professionals.Professionals. Professionals can benefit everyone from the NFL to everyday athletes. This episode offers actionable insights on how to bring the best training, recovery, and health strategies to a wider audience. Whether you are a fitness professional coach or someone looking to optimize your health, this conversation is packed with valuable knowledge.Let's jump right in. Okay guys, you're in for a treat. Today's guest is. Kent Johnston. He recently wrote a book called a Ruka rebuild and restore your health, how to make the elite athlete model of health and wellness personal. So he takes the way elite athletes train and applies it so that it can be accessible to everyone, whether you're general population or whether you're an athlete in prep school or in college, this is a great one, but we dive way deeper than that.We get into how to measure and test someone applying for a job, how to measure whether they will be a great employee. He did a lot of hiring in the NFL, so he's great to talk about that. We also get into return to sport metrics and how he did that at the NFL level, and then just. Overall a wealth of knowledge.Kent has an awesome background. He first was an assistant coach at Northwestern State University, then went to northeast Louisiana University. He was there from 80 to 81, and then he arrived at University of Alabama. Was there from 1983 to 1986. Then he makes the jump to the NFL. He was the head strength coach.Tampa Bay Buccaneers for the Green Bay Packers with Brett fbe. Then the Seattle Seahawk. Later, he shows up with the Cleveland Browns as a strength coach. He then finishes out his career as the director of player wellness with the Carolina Panthers. And you're going to hear all about how he was in charge of their return to sport policy, return to play programming, and how he manages that entire career.It was a great conversation. I learned a tremendous amount. Go out and get his book. Listen to this. Listen to this conversation. Because while you'll, you'll hear tense Southern draw, he really gets to some gold nuggets throughout the entire conversation. So, enjoy the knowledge. I can't wait to hear from you guys.Let us know how we're doing. True Sports PT on Instagram. Give us your feedback. Leave us a five star review and enjoy this conversation. Welcome to the True Sports Physical Therapy Podcast. Thrilled to have Kent Johnston with us. Kent, welcome to the show. Yoni. It's great to be here. Um, it's great to hear my name pronounced properly.So I appreciate you doing your research. Um, Kent, you come highly recommended by the great, uh, media mogul, Colin Thompson. Colin gave me the, gave me your book, Aruka and So first of all, I was enticed by the title because I think it's of Hebrew descent. Am I wrong about that? You're correct. Okay. So, um, so Arruka deals with something near and dear to my heart, which is taking the model that exists in elite athletes.and applying it to the general population, to the lay person. And, and truthfully, your book was far more than what I anticipated because it wasn't just that it was such a deep dive on holistic health care. Uh, you pull from sources across the entire spectrum. So first of all, thanks for writing it. And second of all, I'm excited to get into it.Oh, that's very great. I'm excited to. Because unlike Colin, I read the book. You can read. That's fair. That's fair. I don't know if he can read. He can talk. I don't know if he can read. Um, I love him. He's a special person. Okay, so this vision of Aruka. So the book draws from health system used by elite athletes.And we apply it to the general population. Just elaborate for me on specific health management practices that differentiate the elite. Currently, elite athletes from the general population and how these principles can realistically be applied to the everyday person. Yeah, and I think that's probably the best question, Yoni, that could be asked.Thanks, Kane. We're off to a great start, dude. Yeah, we're good. So, I do believe that if I put everything into a nutshell, what it amounts to is being proactive. Thanks, dude. about your health management rather than react. And I think because of the 21st century culture we live in, most people have become reactive in how they approach their health care when, you know, you, you obviously, uh, Most people have a doctor.Some people don't. I've been amazed at the number of people that don't as I've gone out into communities since writing the book. But suffice it to say, elite athletes are very proactive in various areas that anybody, any of us, if you want to call us common people on the street, could utilize the same methods.And in ideology, but for some reason we've been rolled into this complacent attitude until we wait on something bad happening before we go and seek any health. So what I try to do in the book is highlight those areas of proaction and then encourage people to, to incorporate those in and create their own health management system.Yeah. Okay. So give me the lowest hanging fruit. If you're talking to the general population and right now you're talking to a podcast that hits sports physical therapists. And so as we educate our general population. If we're not dealing with the elite level athlete, give me some low hanging fruit where we can get a patient to start and how we can actually build buy in.I think it's such a big task when you say you're going to take control of your health, right? What, give me a few steps to get this population started. Well, yeah, I think there are some simple measures, uh, from nutritional elements to exercise elements to restoration elements. And let me just start with nutrition, Yoni.It, my wife, and I mentioned this in the book, I think she had a, uh, a revelatory acronym in her, her mind at one point, and she's a wellness orient. She's also been a hospice nurse, so she's seen both sides of the spectrum, so to speak. But she created an acronym in terms of people's nutrition, D. I. E. T. It stands for Discipline in Eating Things.Love it. And I think some of the low hanging fruit that we can encourage our clients with, and our friends and family members, Is, you know, number one, and we've all, we, we know this, but this really is low hanging fruit that you can point people to very readily. As much as possible, eliminate ultra processed foods from your diet.I hate to get simplistic, but tell me what a processed food is. Well, a processed food is a food that has been either bleached or treated with elements or had elements removed that are necessary for our health. in order to make that food a faster type of commodity that people can access and consume. And the most relevant food pyramid, in my opinion, and this is a sad statement, but I believe in it 100 percent, the most relevant food pyramid has nothing to do with Fruits and vegetables and nuts and meats and dairy products.And they're very important, obviously, because those are our sources. Uh, but it's what I, uh, it's the Nova food pyramid that was created by Brazilian researchers and it ranks our food based upon process. So I want to use an apple as an analogy. Sure. If you eat a raw apple, that's a level one, that that's a raw food as God created it and intended it to be consumed.If you eat an apple that's been sliced and diced and just with light preservatives and it's in a package form in your grocer, that's a level two. If you purchase applesauce, that's a level three. And if you drink apple juice, that is an ultra processed element that can be very harmful. So I think encouraging people to eliminate those things.You're approaching nutrition not from an energy and only caloric consideration point of view, which is important if people want to lose weight, but you're approaching nutrition from a health standpoint. And one of the things that we're about ready to roll out is our own version of how to make this work.And we have a 12 week challenge we're going to challenge people with. So. Okay, let's get proactive and let's get involved and let's get this thing as it should be. Not a fad diet, which we've all probably utilized, but they don't last. We all know that. Let's incorporate a mindset where maybe every now and then we do stumble and fall in it, but we get right back on the wagon.We know what to do. And it's just simple building blocks that equip people with the knowledge. In order to incorporate that. Yeah, I think that's, that's a great summation. That is a great poignant answer to how to take something super simple with a wide arching principle and apply it to everyday life. So I really appreciate the apple example, and I think you're dead on.I think like if we can get, you know, the buzzwords are clean food, um, that hasn't been processed, um, that that's a great start. If that's your nutritional concept, talk to me about exercise. Where do we start with exercise? That, I believe, you know, there are 10 types of exercise. And one of the things that I began studying actually back in the early nineties, I began, I was working for the Green Bay Packers, but I would run movement skill, mini camps for kids.And, uh, because I saw there in our society. There's a big gap between skill development and what we call physical fitness traits like power, speed, range of motion, uh, strength, obviously, endurance, all these things that are very vital. But if you stop and think about it from an exercise standpoint, Being powerful and strong and fast and coordinated is a total inert possession unless you can express that through a skill.And that's where we're really backward, I feel like, in our society. In fact, I haven't done this in, in, about three years. But the last survey I took, I could not find one universe in the United States that had a course on how to teach and evaluate movements. And so the reason I bring this up is I've worked for years, not only with elite athletes, but for younger athletes.And I can tell you working exclusively with a younger population and also with an adult population, Our current state of movement capability in the United States is we're retarded. We're retarded. It's a good, it's a good word. And, and, and I don't say that throwing stones at anybody because a lot of times that happens because nobody's been taught how to throw a prop or how to run.And I'm preaching to the choir here. I know. This is, uh, but when you relate all this back to exercise, even though there are 10 types of exercise, for instance, range of motion, coordinative exercises, strength, agility, exercises, power, uh, aquatic exercises, they're their own type. Irregardless, it's all about how do you move.And I think, Yoni, very strongly, and I base this not only on research that's coming out in these fields of neurogen, genesis, neurogenesis, neuroplasticity of the brain, uh, but also just working with kids who've had learning disabilities at, at young ages. And seeing the change that exposing them to movements that have been foreign to their central nervous system drives cognitive capabilities such as adaptability and the rapid processing of information or anticipatory skills and things of that nature.There is no doubt, undoubtedly a tie in between cognitive development. and between moving in patterns that our system is not accustomed to. And I think that's a key is we recognize, uh, working with people and getting them to exercise, just getting them to move and do what their body's not used to. Yeah, well, I mean, it makes total sense that if, if the driving engine of the entire thing is the brain and you are robbing that brain of exposure, or at least repetitions of the given movement patterns that the engine, the brain itself is going to suffer.So when you ask the brain to do other things, even if it's strictly cognitive, then it would become impaired. I'm also reminded of. Where we are as a society, you and I are sitting on this podcast and we're sitting at desks and our hips are sitting in 90 degrees. And while your life wasn't like this in my work life is not like this, a large part of American society, their entire life is this posture.And I'm in, in what, what happens to our movement development? How does that affect our cognitive? Um, capabilities, I'm reminded of, I went with, um, Israel baseball for the world baseball classic to South Korea. And we're driving through the hills of South Korea and I see an 80 year old South Korean man sitting ass to grass waiting for a bus, smoking a cigarette.And I'm like, there is no way in hell an American could get into that position at age 30, let alone at age 80. And that's so good. It's crazy. And how much our society, and by the way, that guy sitting there smoking a cigarette at age 80 is probably far healthier than the 30 year old investment banker who spends his entire day seated.And I think that gets lost. Yeah. Yeah. Um, okay. So, um, I think that that's really well put. And when you talk about exercising, so, so give me the prescriptive power like that, that you made the example of the Brazilian pyramid. What does that look like exercise wise? How do you get this gen pop to start to exercise?Well, I think that is the great challenge, obvious. And I think a lot of it, uh, sadly to say, we may have to resort to incentives. Okay. I hate to say that. And, uh, you know, I think we could all get on a whiteboard and bring up a lot of different things that might work. This current generation of young people in to more of a movement, uh, environment.But I think, I think what we have to do is really point to the fact, and you said this earlier when you gave your, uh, comments about the brain and how it's all interconnected, I think, uh, in, in terms of, of worldview.And again, I'm for everybody seeing things the way they want to see them in, in, in terms of a worldview, but I think this, this brain body response is largely the product of a left, pardon me, of evolutionary thought. And I've done a lot of studying on that. And again, I'm not saying that whatever a person wants, however they want to see the world, that's their business.But this body to brain response is, is taking it a little bit differently. It recognizes the ecosystem and the interdependency of the model we call humanity on all the interplays that occur. And so I think we've got to convince the general population of that. And, and, uh, like I do a lot of rehabilitation in terms of, I have worked so closely with great PTs over the years and athletic trainers and orthopedic surgeons.And when an athlete gets hurt or anybody gets hurt, it's a team process. Should be. It should be. And as you so aptly pointed out, Many times it's silo effort, and that's where we get into problems, but that's the kind of thing we need to provide. And our, especially our working class adults who have become, as you said, largely used to sitting in chairs and couch potatoes.Yep. Because of the 21st century affluence we'd all been afforded. We've got to Kind of join arms and say, look, you want to regain your health. You have to start moving. If you have the capability of doing that. Maybe you have to start in water, you know, and it, it really, I'm a big believer of this. Uh, and again, this is learned experience and also I think research you can point to.People have asked me what the most important type of exercise is to prepare. And but you know, most people in our country would say, well, it's cardiovascular exercise. And while I think it's hugely important, I think the cardiovascular health. As I'm sure you do in your audience, it's primarily the result of lifestyle and good nutritional practices.Uh, the most important type of exercise is global move. Yeah. It's, it's, it's maintaining movement through all three planes of motion. It doesn't require a lot of money. It, it, it, but it does require some knowledge and some teaching because unfortunately When we talked about this exercise dilemma we're in, and I would say it's more of a movement dilemma.people don't know how to move anymore. Yeah. Yeah. And I also think there's another layer there, which is consistency. Um, and, um, I guess drive or almost work ethic, whereas we're so used to having things at our fingertips and immediate responses and immediate gratification. Um, and, and we know that proper movement patterns, whether it be strength development, whether it be body composition or whatever, it takes time.And you need to allow the body to respond. So I think it's just another, um, hurdle you got to get over with your clientele, with your patients to understand and maybe give them different barriers. So you cannot start an exercise program, whatever it is, whether you're rehabbing a shoulder or general fitness and say.Your immediate goal is health but rather shorten that response time or shorten that incentive time where it's no. First, you're going to feel increased range of motion. Then, you're going, we're going to show you that you're gaining strength. Then, at the very end, you have gained some type of health or wellness.I think we gotta be smart about who's in front of us and what it is that makes it makes them tick. I think that's a very clear delineation between your elite athlete population. And who understands that, right? And gen pop that maybe doesn't. Um, but, but I think that's a great outline. Through sports, physical therapy is growing like wildfire.We've had 14 locations soon to be more. We are throughout the state of Maryland. We're in Pennsylvania, in Lebanon, in York, Pennsylvania, as well as in Delaware, in Newark and Wilmington, Delaware. Like I said, so many more practices to come and we always need outstanding sports, physical therapists. Our treatment style is unique.We are one on one with your athlete for 45 minutes. Every single session, you do the entire treatment, you do the entire evaluation, and they are in state of the art facilities where you have room to run, throw, and jump, and really get your athlete all the way back to on the field and better and stronger than they were.We also have outstanding salaries. Comp structures, bonus abilities, 401ks, as well as a very strong continuing education offering, including in house continuing education. And we're looking for you. Now is the time, as we are growing like crazy, just shoot your resume over to Yoni, Y O N I at TrueSportsPT, or shoot us a DM and we will get you back.We will get you in for our unique Tried and true interview process and really make a determination that this is the right place for you to grow your career and get your athletes better than ever. We can't wait to hear from you. Um, Ken, your, while your book is far reaching and talks about applying a lot of these principles to the general population, I want to dig into your NFL experience because it is Enormous and impressive.So you talked about a lot about what the NFL does really well in terms of being proactive. I know that's really organizational dependent from my experience. Some organizations are outstanding. Some are not. Tell me where you feel now that you're at the outside looking in like I am. What should they be doing better?What do they not do a good job of at that elite level? Well, I think they do a poor job. Let me start with what I think are big wheelhouses. I think they do a poor job of assessment. And what I say, pardon me, what I mean by that is simply this. When you're paying an individual 10 to 20 million dollars a year, You want to cover as many bases with their health as possible.And primarily, uh, a CBC and a basal metabolic assessment, serum assessment, urinalysis is what they do. for these athletes. There's no, for instance, food allergy testing. There's no testing in my wife is heaven. My wife is certified in functional blood chemistry interpretation, and she does that for for doctors and one of the big underlying toxicities that exist in the United States right now that's largely undetermined.is mold toxicity. For instance, one of the primary indicators of mold toxicity is joint pain that moves around the different areas of the body. It's it jumps around and, uh, it's assessments like these. These guys should be assessed for all of these markets. And so it would start there. I think we, the NFL could have done a much better job of that.And I brought that up. How'd that go? It, it, you know what? Well, we just didn't realize the cost of those. And I've gotten out since then. And because of what we do, we actually offer those tests. There's not hardly any cost. The problem is most doctors don't know how to interpret the results. Yeah, and I'm not throwing a stone at doctors, but they're just not taught that in medical school and it's kind of like nutrition.Now, many doctors know a lot about nutrition because few have been required to take a course. Uh, so I think you start with assessment and then I think there's a poor job and you referred to this earlier. of, uh, creating silos where the athletic training staff is over here and your performance staff is here and the medical staff is over here.And none of the three of them are tied in to where the right hand didn't know what the left hand's doing. How do you fix that? Because dude, I see that time and again. And I get athletes from all over the league. And it's, it's mind boggling how a doctor lives in one room and a PT's in another and never the two shall cross.So, so, if I gave you I bring you in. I'm the, I'm Steve Bishotti. I'm the owner of the Ravens and I'm bringing in Ken Johnston, who apparently has a wide breadth of knowledge. And I want you to set up my healthcare system, my performance model. What are you doing? Well, the first thing I do is, is obviously I would lay that plan out to you, the owner.And I would say, this is the way we need to go. And the reason primarily, which we could talk about for a long time, health in the 21st century is different than it was a hundred years ago for a number of reasons. It's fascinating to talk about that one plant, but then I would bring in everybody, the doctors, I would bring in the performance, the nutritionist, I'd bring in the equipment guy, you know, I would bring in the sports psychologist.And we would implement a plan that was largely integrative and this was, uh,this is the model you have to have a, in terms of medical, you have to have a plan that recognizes the strengths and weaknesses of modern or Western medicine. The strength and the weaknesses of Eastern medicine and the strength and the weaknesses of natural medicine, but you have to incorporate all three.And that was the biggest problem I had with a club, which I was the direct, uh, and, uh, and, and the pushback came from the side of modern and Western medicine, largely Yoni, It was an infringement on a power grid system that existed and, uh, there was no question. And I spoke with our team doctors about this.Hey, You're making medical decisions. I'm not a licensed medical practitioner. Same thing when I've worked with physical therapists. As a performance guy, and as a guy that understands movement, you tell me what this athlete can do, and what medical clearance they have, and I'm going to tell you what I'm going to do, and we're going to go start there.And I'm going to report back to you, and we're going to get this person back so much faster. Then what we would have, had we not taken that course, but, uh, and I would just say, look, if you can't adopt this integrative system, knowing that accountability still exists. And secondly, knowing that we do have to be concerned about the liability of our owner in the club.Yeah, that's legitimate concern. But if you cannot adopt this type mindset, then you got, you need to leave. You, you, you may be very qualified, but if you don't understand the efficacy and the validity of all the different wheelhouses and how we all have to work together, because how we manage this team concept is those who are stewarded with the pro, with the, uh, privilege, I would say.Of caring for these athletes, uh, you know, is going to be reflected in the locker room. Yep. If, if they see us as a whole, fortunately, that model we introduced with that team, the players said they'd never seen anything like it. And this was coming from guys that were 10, 11 year vets. And they loved the mob.So it can be done, but everybody's got to check their egos at the door. I was going to say, I was going to ask you what the biggest barrier to implementing that is. And you, it sounded like you just answered that with ego. Would you, would you say it's a dollars and cents issue or no? I think this is what I would say.I think it can be, I don't think it has to be because now that I know the cost of some of these assessments. And for instance, what we spoke to earlier, it's a drop in the buck. It's, it's, it's literally is, it's a drop in the bucket to the amount of monies that are spent. And so, uh, I don't want to entitle athletes.I always felt like they are, they, and they shouldn't be responsible and they should own it. If they're the ones that screw the thing up, and that happens. Sure. So, there is accountability and responsibility on both sides. But what I wanted to eliminate, and what I would still say is the most, is to eliminate it from the side of those who are stewarded with taking care and treating these players.Yeah. And it's crazy how often it's a barrier. What, what boggles my mind, I really, I haven't come to a solution to this, but I don't understand the, the role of sports physical therapy. Let's talk specific NFL where you'll have full rosters of 53 guys. Plus what is it? 10, 12, 15 practice squad guys, whatever it is you're, you're caring for 70 elite athletes, let's say, and you've got two sports PTS.On staff and, and you got one, one therapist juggling multiple rehabs and you have a lack of progression that's transpiring. This is at the highest level of sport. So, and all I hear is. Well, you know, it would be expensive to have, uh, five, six, seven physical therapists in there. And to my mind, I'm looking at it.I'm like, if you see this guy, one game, that's worth 600 grand or whatever. So, so what is the disconnect that the owners don't understand that it's actually a drop in the bucket? Or is it that the athletic trainer who's chief of sports medicine is, well, he's not an 80. And so it's an ego thing. I'm just dumbfounded by it.Well, I think a lot of it does get back to ego. Having said that, and I've said this for years, because many, as you would think, Yachty, some of my best friends in the world are athletic trainers and physical therapists. Yeah. Because I've had to work so close with those guys, and I see their heart for these guys.Yeah. I can tell you, and I'm not knocking, but a lot of times that doesn't exist upstairs with coaches and front office people. Yeah, and that's why the engine room of an organization in the NFL is the athletic training room, the equipment room and the performance room, because that's where the guys let their hair down and you have to be concerned about those players, but I think and I've said this for years.I think a model could be created in professional sports in which a lot of this could be contracted out. I don't even think that, because let's be honest, that's what they do right now at the medical. Not, you know, uh, most places that I've ever been, the only people getting paid were the general practitioner and the orthopedic.Surgeon. Everybody else was paid, but they were contract laborers that showed up. The neurologist, you know, you go right down the eye doc, the dentist, you know, so these guys, and it's different and different. Reena's but I think you could do that at the therapy yard. So I'm right there with you. It's crazy because the NFL, and I've said this a number of times on the podcast with various guests, and you're kind of making my point, which obviously makes me feel good.But the NFL solved this. With concussions, there was a tremendous amount of, um, uproar over the way guys were getting cleared for concussions. It led to millions and millions of dollars of lawsuits. And so what did the NFL say? They said, we're going to get a third party. We're going to get a third party that doesn't work for the team.It doesn't work for the player to clear these guys. And we're going to get a third party that doesn't work for the team. Why is the same principle? Not, not consistent when a guy's coming back from an ACL, if he has rehab, if he was operated on by the team doc, if he had a rehab expert who is employed by the team, where do their allegiances lie?It's not for the player. It's for the team. That's who's paying them. Right? And so why not? outsource that. And it's led to a number of interesting issues where a player will come see me. I will tell them what I think based upon what the player looks like. And they can go to the team doctor and they hear something totally different.Usually it's like, Hey, you're ready. You're ready for Sunday, where if this was contracted out, all of a sudden you start to peel away there where their allegiances are, right? It's an independent body. They're not conflicted. They're just going to give you the truth. What do you think about that? I think it's a great idea.And I think it's going to take an innovative owner that's willing to take that step. I think, and I think those guys are out there. I just think their focus is so global. Yeah, it's very wide. That, uh, concepts of innovation that could even potentially, as you pointed out earlier. Save the team money should be taken into consideration.And as we pointed out, it's already being done at, at, at certain levels. So I think. Maybe it's going to be the future. Uh, I always, and again, I think from a contract labor agreement standpoint, specifications could be clearly set forth that protected the club, even, uh, conduct issues by the practitioner, you know, so, uh, I think there's Obviously ways to do that in which it would be beneficial to players, but also beneficial to the club as well.Yeah. Okay. I want to, I want to dig into your role as return to play specialist or director. You did this from 2017 to 19. Where were you when you did this? Well, actually, uh, I started all the way back to 1987 and yeah, I'm not going to, I'm not going to tell you where I was in 1987. Please don't. Cause I might keel over.But I'm that old, but, uh, we had two athletic trainers. I was a strength and conditioning coach, so I would sit with the athletic trainer and we would decide what I was going to take the player out in the field. He can't, he can do this, he can't do that. I always work within those guidelines and for every year that I, there's only one club that I didn't manage a return to play at.And that was with the Chargers. And, uh, I worked for a guy, probably one of my best friends. But he said, No, this is our domain. We're gonna keep it here. He'd come and visit with me. But, uh, it's the only place I, and I respected that. That's, you know, he was a medical director. So, hey, he's the authority.That's the way it was. But I've really enjoyed that and, and, uh, I think, I think it's an enormous, uh,in my opinion, Yoni, it's the best way I know if there's a black hole that exists in the sports, the sandwich world right now, I believe it's returned, uh, because certainly rehabilitation. But I think a lot of it gets back to the educational systems that coaches, therapists, and ATs are exposed to. We don't break down movement well enough.We don't teach movement from a skill standpoint. And I believe there are twenty fives. And I'm working on this in a new book that I'm, I'm working on right there, 25, what I call fundamental athletic skills that anybody participating in fitness and athletics should, should acquire, because it gives you the ability to properly express how strong you are and how powerful.We're not taught those. And so I think that, if I may return to place standpoint, I think that's one reason it's remained devoid. I can say this. Sometimes it goes back to ego. Yeah. I want to be told what to do from a licensed medical therapist. I, that's not my jurisdiction, but I, by the same token, And I'm a little different because I've got a 30 year track record with this.I want for the medical licensed therapist to have the trust in me that I'm going to stay within those parameters. But also I'm going to get the job done on the field or on the court and things like that. So, I think again it gets back to the synergy that has to exist. And that performance clearance, medical clearance are two quite different things.Yeah. Yeah. And so, so when you held that position specifically later, um, in your career, because I think more, more technology was available, right? Correct. Um, what, what types of things were you doing? Um, say coming back from an ACL when you would say, yes, this guy is ready and gave you the confidence and the player confidence.And therefore, therefore the coaching staff confidence that. Indeed, this guy was 100 percent quote unquote, well, I can, I can list two or three things. The most important thing I should say for an acute injury, uh, is water. It was the use of water. Uh, I've developed nine different. progressive, I would say, modules.None of them involved utilizing an underwater treadmill, which is fine. And only one of them involves swimming. And so that it's this progression because God created water to be magic in a lot of different ways. And if you combine the hydrostatic pressure and the buoyancy, And the viscosity capabilities of water.I have seen athletes advance so much fast. Uh, and in fact, I've been hired a couple of times because with, uh, what was it, and again, I think sometimes we're right on, I think sometimes we're Throwing darts. If we say a guy has a grade one or two hamstring injury, I'd agree with that. Uh, but, uh, some of the medical staff, the doctor was saying, look, he's going to be out four to six weeks and we had him back on the field in two weeks.And they thought I was some kind of guru. I wasn't a guru. I was just using water. Anybody that knows me knows I'm not anything close to a goop. Not what I've heard. But, well, I'm just old now. What doesn't work? You know, what doesn't work you throw away. You say, okay, I made that mistake and I don't want to make it again.Or I've made it enough to know. I'm staying away from that, but I would say first and foremost, it's the use of water as an early onset to unfortunately, some people don't have access to it. And so I think that I think, uh, secondly. I think it is knowing when to layer things on, and I've created a model of return to play, and there's an alpha, a beta, and an omega stage, and of course the omega stage is the exit stage.Uh, as those of us that know the Greek alphabet know that's, that's kind of the last letter. So, but in each stage, we have to be very concerned about all the variables. Once we achieve a certain degree of kinetic linking, we have to be concerned about how we layer these variables, like what types of exercise of the 10 types of exercise What types of exercise are appropriate for an alpha stage?What types of ex, uh, pardon me, what planes of movement are appropriate? What surfaces are appropriate? What tempo? Is, is, are we at a walk tempo? Are we at a march tempo? Or are we at a jog tempo? You know, so knowing how to layer all these things in, and sequence them properly, knowing the athlete and knowing the type of injury you're dealing is very, very crucial.I think in terms of shortening that window, uh, of, of high performance and optimal performance. And getting that athlete back to where they can return to play, then return to competition. Yeah, I love that. I mean, that speaks to your ability to kind of like push fast forward on the rehab process. Um, why you were successful at decreasing those stays on rehab.Um, the IR or the IL, whatever they were, however they were, um, referring to it then. Um, and, and I think it gives us the sports PT, um, whether you're working in an elite athlete environment or you're working with gen pop other levers than we're really used to hearing. Like I like hearing you talk about, um, playing with different surfaces.playing with aquatics, playing with range, um, with planes of motion. It's far more than just reps and sets. Although, those are other levers that yes, and kind of understanding where you are along with cadence because I think that's crucial as well. Yes. Um and I and I see that kind of glossed over. What about all the way when you're at Omega?What kind of tests and trials were you putting athletes through? To say, yes, you are good to return to full competition. Well, when I was working with Christian Mccaff, and I've done a lot of work with Dan. Uh, who's most people who know about movement confinements have heard of Dan Path. He's excellent.He's one of my best friends. And, uh, so we bounce a lot of things off each other. I bounce more off him than he does off me. I don't believe that, but okay. But, but, uh, you know, Christian, when we first got to Carolina years ago, He had averaged 66 plays a game and running and the average number of reps per game for a running back in the NFL is 44.So when you tally that out over the season, we did, it was like he was paying three more games or something. And so, this syndrome had just gotten up with him. And he, his body broke down a little bit. Now he is such a gifted and copper wired athlete that he comes back very, very fast. But some of the things that I did with him, I had put together What I call an injury risk analysis.So this is the first assessment I would use. Finally, Ken, this is great. Tell me what the hell that is. Well, it's, we're going to roll that out here in about 30 days. It's, it's a video assessment because as you know, you only is everybody that's involved in what we do. Uh, you can, in gray cook, He's an old friend.When I was with the Seattle Seahawks, we were the first team he brought dysfunctional movement assessment. And I love him and I love what he did. But I think sometimes there are movement dysfunctions that show up in an athlete. When they begin to travel and increase the tempo or cadence, as you pointed out earlier, that you don't see when they're stationed.I think you need both, but the movement, I pardon me, the injury risk analysis. It's really five videos. We look at the athlete and they're moving, they're never max effort in anything they do. But what I'm looking for is 20 markers of movement dysfunction that can cause other injuries if they're not corrected.And we're talking about things like, are they, do they have a toe down landing? Are they over pronate? Are they supinate? Do they have abduction or adduction of the feet? Do they demonstrate valves? Uh, you know, do we have internal hip rotation external? While we're moving, and while we're moving through different planes, because again, And then, once that is graded, what's the corrective route to take with the athlete to eliminate And try to reverse those things.So that's one thing I would do and then in reference to what you were saying about assessments Yep, I would also I have different markers I use for instance If somebody's coming back from a hamstring Injury, and obviously unless that's a grade three, that's near the chronic exercise than an acute but the gold standard test that I use You Is basically a 60 yard shuttle, but done with a back.So they're going to backpedal five, splint five forward, backpedal 10, splint 10 forward, and then they're going to backward kick. So they're really going to extend the lower lever and reach back for the last 15, work their feet and then splint through. If they can do that, I know they're ready to go back and at least begin the competition.Yep. And then there's the standard test, like the y balance test, and all of these markers that we use that are very valid, that form a matrix of things we look at, so we can look at the different biomotor abilities. Yeah, that's awesome. Now, do you when you're dealing with a hamstring like that's a great example and I love the way you're forcing femur into let's call it hyper extension to make sure that he has a range of motion.Did you include cutting in any of that or change of direction? Yes. And what that look like? Well, I I'm big on uh and I get back to this brain. Uh I call these neurogenic athletic neurogenic exercises Yeah. I like cones early in rehab, but I like to move them to reactionary so that they're read to react into an audio or visual.Q. Q. Yeah. And, and so, uh, and sometimes they have to process and remember, they have to recognize patterns. So basically they're, they are change of direction and agility drills with those particular parameters governing how they're administered. Yeah. Well, I love that because that's what they see on the field, right?Exactly. And, and I think that's great. And I think, I love also your use of not just visual cues, but auditory cues, because. Athletes are using every sense we got when we're out there. Um, so, so I definitely see the value there. Um, that, that's, that's a great understanding. Now, were force plates in common use when you were still in the league?They, yes, and, and they were just coming back into, not back, but they were just becoming what I would say, uh, a mainstay. And, and how did you incorporate those into your offerings? Well, we would, we would, obviously, uh, we wanted to look at the different types of counter movement jumps, all the, but what I was more interested in, and, and again, before I say this, Yoni, I want to really underscore the biggest, and I'm saying something that we all know, but I think it's important we recall this, the biggest limitation any of us have is time.Time is our most valuable resource. And it's all about in that world, getting the biggest bang for the buck with the time you have of availability from the athlete. Yep. And it's always less than what you would like. And I'm sure that's true in the treatment world as well. Always. That that's, so having, you know,said those things. I was more interested in the discrepancies that existed between the right and left side. You know, I was talking to just about a week ago before we started this NFL season. I was talking to a club and they've had a number of calf injuries and they were telling me what they had done.And sometimes what we need to do is so simple. I think we try to get too creative, but I asked, I said, well, have you had your PT take a goniometer and see if there's a discrepancy in dorsiflexion on the right and left side? And, uh, the response was, well, no, we hadn't done that. I said, well, you can chase symptoms all day, but that could be potentially.a Answer to eliminate the root problem. Yep, if that does exist, so I'm again, I love force points, but sometimes we we neglect the most simple things That we should not lose sight of And, and I guess it's the difference between, it's the way I've been told this, this guy was talking to you. I said, look, we have so much knowledge.We are exposed to more knowledge than we can ever deal with. What we need is wisdom. What we need is the wisdom. To apply the right tool for the right job. And sometimes there's more than one tool we've got to use. We know that, but I think that's, we can't get lost because I think all of us have a tendency to do that.Yeah, there's no question. I mean, you, you see it even, even, um, I have this conversation a lot on the pod, like with the prevalence of social media, where, when I came out of school. I'm a little bit older than you, but when I came out of school, um, I couldn't find this performance information. Like I wanted to be a sports PT.I didn't, I didn't know where to start. I didn't know where to get the information. I would take books out of library, crap like that. Now it is the easiest thing in the world to find the answers to your question. The trick is, and the skill is what is good information. It's no longer that I need information.It's I need good information, right? And there's just so much information. so much out there on social, you got to be really careful. You have to be a really diligent reader. If there's one thing and I crappled my grad school a lot, but if there's one good thing that my grad school taught me was to be very discerning when reading through research, how to understand what is good research, how to understand then to your point, how to apply that research, I still remember going into.Um, I always screw it up whether it was a strike year or a walkout year with the NFL. I always say the wrong one. Whatever it was. What year was that? The most recent work stoppage? We had one in 83, 87, and then we had a holdout. Holdout. Holdout. 2010. Okay. So it was the holdout year. Yeah. See, I couldn't, I couldn't even give you the example of what I say wrong.So the holdout year. I walk in, all of a sudden you had all these athletic trainers and, um, physical therapists with nothing to do. Like they're in the building and there are no players. Right. So they decided to let some schmuck like me walk in. I had a meeting with them. I'm like. Hey, what's going on? What do you guys do here?And they point to this machine in the corner. They're like, that's our DARI system. It's a 150, 000 markerless motion capture machine. And I'm like, that is awesome. When do you use that? And they're like, yeah, we don't, we don't use it. What? Yes. What? So, so it's, it's a matter of like eat to know the tools you need to know the tools you have and then how to apply them, right?Um, and fast forward, like five, six years, they finally got a sports scientist in there that understood how to use it, but it was sitting there collecting dust forever. And, and so it's to your point, sometimes it's a really simple, but the bottom line is it's knowing how to use everything available to you and being discerning with the information that's coming towards you to see how is it applicable?By the way, if I was going to look at dorsiflexion, I wouldn't look at toe to wall instead of a goniometer just because it's functional. But how simple is that? It's just like, it's so simple. So, um, I appreciate the wisdom. I got one more question. Cause more so for my knowledge and my audience knowledge, you mentioned that a major gap in the way we offer, um, the services or a program or a system to the athlete is the eradication of ego.And I deal with this a lot when, when I'm building a clinic or I'm building a business, I'm looking for those who are egoless. My question to you is. How do I test for someone's ability to be a team player and to work without ego? That's a very, very good question. And it's a difficult question to answer because unfortunately, some people are just flat deceptive.But I think, I think a lot of it is If you have the privilege to know a lot of people, hiring people that have been recommended from people, you know, if you don't know that person going in, that certainly was very, very valuable to me. So I should be calling those references is what you're saying? Yes. Yes.Call references. But then I always like to just say, look. I want you to be totally transparent, and I'm talking about with the candidate for the job. I want you to be totally transparent. What are your goals? What do you want to accomplish, and what's important to you now that you have got this particular area that you're pursuing for a career?And I listened very intently to those answers, and that plus, this gets back to something that I think has vanished. What kind of work ethic does that people are, you know, are they too big, like if the cooler needs water, are they too big to go over there and put water in a cooler themselves? How do you test for that?I think you're dead right, but, but how do you test for that? Well, I think again, a lot of it is, uh, going back to what I said originally, and I think as you get older, I'm, you know, 68. And, and, but as you get older, you meet more and more people who have been in the industry. And I kind of made it a practice not to hire anybody from somebody I didn't know or had not spent time around, you know, and had not seen.And that may not sound fair. And again, I'm not saying it. Uh, people can take that and weigh it. It works for me. The times I have gotten in trouble, Yoni, with any hire I made is when I hired somebody cold turkey just looking at their resume. Yeah. I can say that unequivocally. I've been there. Every single time.And so, a lot of it, and I'm just going to be honest with you now, bud, and this is just my worldview, I just pray about it. Yeah. I say, and again, Lord, I say, Lord. I don't have the wisdom it takes to make this decision. Give me a gut feeling, lead me some, you know, and, and if I, sometimes I've gotten a good gut feeling, sometimes I had.Yeah. But, uh, you know, and sometimes I probably not in a position that the good Lord wanted to answer anything I was asking him anyway. Yeah. So I've definitely been there. So that being said, uh, you know, that's, that's what I did. That's what I found successful, but, uh, it's certainly difficult. And, you know, I want to add one more thing to that.The first year that I, when I came out of college, I didn't want to be anything other than a high school coach. And I can tell you, I never had any goals at all other than to be the best high school coach I could be. And over the period of years, uh, Yoni, I just met people. Yeah. I tried to work real hard, and I just met people.And they gave me opportunities and I tried to work hard and then some other door would open and they would give me opportunities. When I interview somebody that's just coming out of college and they tell me why I want to work in the NFL. Well, wait a minute. Most people need to be broken a little bit before they even have the opportunity.Or if that isn't, there's nothing really, barely intrinsic. If you want to help people, I can tell you if your goal is to make, uh, you know, young men and coach high school, you know, so, you know, a lot of it is what are their initial goals and what, and if they say, I want your job, I want to be the head performance guy at an NFL team.How do you take that? Uh, I can, I can sayit, it kind of shows me they're a little naive going in. Yeah. Doesn't necessarily mean they're bad folks. They're just naive. And I say, okay, were you willing? Because what I did, I didn't have a car. I made 200 a month when I was a graduate assistant in Alabama. Uh, I did. I had jobs on the side to make money to live off of.And every now and then I was Paul Bryant was the head coach. And then a guy came in Ray Perkins. Every now and then. I got called up to the AD's office. He'd open his drawer and give me a thousand dollars. Say, you're doing a good job. Well, heck, I'd have gone run through the wall for the guy after that.Yeah. The point I'm trying to make. You have to be willing to suffer. Yeah. And I think that's, uh, I think it's, I was going to say that that doesn't show up as much in this era, but I will say, I just interviewed a guy for a staff opening. Um, I was on the phone with him on Sunday. We did a phone screen. He's down in Florida.I'm in Maryland. Um, he's like, I'm really interested in the job. I'm like, okay, awesome. Let me know what you'd be around. It shoots me a text later that day. I'll be there Wednesday. I show up in the clinic Wednesday. He pulls up and I'm like, Hey, where'd you stay last night? You know, he's like, no, no, no. I, I just, I drove up from Florida.I'm like, I don't understand. But he's like, yeah, you know, it took 16 hours. I just timed it walks in in a suit, ready to roll. Bright eyed, bushy tailed. I said to him, where are you staying tonight? He's like, I'm not sure. I'll figure it out. I mean that it's still, it's still out there is my point. That's so good to hear.It's amazing. So good to hear. It's amazing. He got the job. I mean, Oh, it's awesome. Um, you guys quick pause and a quick shout out to this new master class that we just launched here at True Sports Physical Therapy. Myself and Doctor Tim Stone put together a master class of ACL Rehab and we call it from table.To turf and the reason we call it that is because it's going to teach you exactly how to get your athlete all the way from post op day one with the nitty gritty of regaining all of that range of motion with the tips and the tricks that we use here at True Sports Physiotherapy that gets our athletes better faster and stronger and that's early and then how do you progress that athlete all the way onto the field with a ball in their foot or stick in their hand or whatever their sport is and teach them How to accelerate, how to decel, how to change direction, all the mechanics that go in there, what drills do we use to get our athletes exactly where they need to be back on the field and even better than before injury and I want you to sign up for that class.Now, you can find it on our website. You can shoot us a direct. message and just say, hey, send me the course. It's right now on sale. So, make sure you sign up now. It is fully accredited to get you all of your continuing education hours. Sign up for the True Sports Master Class ACL from table to turf.Thanks guys. Okay. But as your buddies call you, I'm going to hit you with just a couple quick hitters. You and I have very different delivery styles, so you're going to keep this to one quick answer. You ready? Okay. In researching your book, Aruka, you went through millions of sources. I mean, I couldn't believe how many books you must have read for this.What was the best one?Oh, the best book that I read for a week, uh, probably I would give you an author. Elson Haas. Who was that guy? Who is that guy? He is an MD that is very integrative in his approaches. And he's written a number of books, uh, H A A S. Love it. I'm gonna add it to my list. You said enough. Who's the best athlete you have ever seen in person and you cannot say Christian McCaffrey.Uh, I think I just quickly athlete or football player athlete. Uh, Joe Delaney. Should I know Joe Delaney? Joe Delaney was drafted in 1980. By the Kansas City Chiefs. I coached him in college at Northwest Louisiana. He was the AFC player of the year. Rookie of the year. In the next offseason, he died saving two kids.Saved one, drowned trying to save the other. Oh my God. He's the best athlete you've ever seen. You work with Reggie White, you work with Brett Favre, you work with Kirshen McCaffrey, that dude's the best athlete. Because he was?Because he was not only copper wired. But he understood all the intrinsics he had to incorporate to become who he was. Went home every weekend and mowed his grandma's yogurt. I gotta look that guy up. He sounds like a hero. Okay, last one. The NFL organization that you know of that does, from a performance standpoint, everything Well, does it the best?Who does it the best?I think currently, currently, can I, can I give you a story if you have to, but yes, I'll take three Vikings. I would Vikings are money, dude. They are so good. Yes. Vikings, Texans. And then I would say, uh, that the guys had, uh, the 49ers, even though they've had some injuries, I think those guys try to do things the right way.I love that. Um, okay. Ken, I could talk to you. Forever, dude, we still have to cover the Hebrew name of your next book, cause I'm expecting it to be Hebrew. We still have to cover your trip to Israel. We got to cover that. That's, that's a whole nother conversation ever about that. Good. I'm glad to get some good publicity over there, but you, you've been awesome.I learned a tremendous amount going through a Ruka. So thank you for that. You've been a wealth of wisdom. So thank you for your time. Um, it's obviously much sought after. So thank you for sharing with me. Thank you for sharing with the audience. You've been awesome. Thank you. Tell me, tell everyone listening how they can find your stuff.What's the best way to do it? Well, if you want to look into a Ruka, the book, uh, it's on Amazon ARUKA Hebrew word for rebuild and restore. And then here within the next 30 days, we're launching a Ruka performance. And is that a performance. com? What is that? Yes, it is. Okay, awesome. Guys, go check it out. Um this guy's taught me a wealth of things.So, thank you so much, Kent. Thanks for listening, guys. Absolutely, man. A serious pleasure. Everyone, thanks for listening. Uh can't wait to hear your feedback. Bye bye bye bye.
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