This is a continuation of the rehab discussion from the last episode. The discourse concerning musculoskeletal rehabilitation principles continues with our esteemed host, Dr. Leo Kormanik, alongside the insightful contributions of massage therapist Zach Goulet and rehab specialist Cody Shields. A salient point of this dialogue is the intricate relationship between neurological recruitment patterns and the manifestation of pain in individuals with injuries such as meniscus tears. The discussion elucidates how improper muscle activation can exacerbate discomfort, leading to a cycle of pain and further injury. We emphasize the importance of understanding that the presence of an injury does not inevitably correlate with pain, but rather, it is the manner in which the body responds to that injury which dictates the experience of discomfort. Through dedicated rehabilitation and a focus on proper muscle coordination, we advocate for a paradigm shift in how individuals perceive and manage their injuries, ultimately fostering a more empowered approach to recovery. The profound intricacies of musculoskeletal rehabilitation principles are thoroughly explored in this enlightening dialogue featuring Dr. Leo Kormanik, Zach Goulet, and Cody Shields from Ohio Sports Rehab. The discussion is predicated upon the psychological and physiological ramifications of injuries, particularly focusing on the biomechanics of the knee following a meniscus tear. Cody Shields elucidates the neurological adaptations that occur post-injury, emphasizing how the body compensates through altered muscular recruitment patterns. He articulates the concept that pain is not inherently a consequence of the injury itself, but rather the result of inappropriate loading of the injured site. This perspective is pivotal as it reframes the approach to rehabilitation, suggesting that pain management can often be achieved through targeted rehabilitation exercises that focus on restoring proper muscle activation sequences. Further, the conversation delves into the psychological dimensions of injury acceptance and the identity many individuals adopt in association with their injuries. Zach Goulet raises pertinent questions regarding the societal and familial pressures that may reinforce a victim mentality, while Dr. Kormanik highlights the importance of fostering a proactive approach to rehabilitation. Collectively, they advocate for a paradigm shift where patients are encouraged to engage with their rehabilitation journey actively, thus facilitating a more profound understanding of their bodies and enhancing the efficacy of recovery protocols. The overarching theme emphasizes that rehabilitation is not merely a series of exercises, but a comprehensive journey that encompasses physical, psychological, and educational dimensions, ultimately leading to a more resilient individual. This episode serves as a critical resource for both practitioners and patients alike, challenging conventional notions of pain and recovery, and promoting a more nuanced understanding of musculoskeletal rehabilitation. By integrating these principles into practice, professionals can better support their patients in reclaiming their physical capabilities and fostering a healthier relationship with their bodies post-injury.

Takeaways:

1. Effective musculoskeletal rehabilitation hinges on understanding the intricate balance of muscle recruitment around an injury, fostering optimal healing without invasive procedures.
2. The psychological aspect of injuries can significantly influence a patient's approach to rehabilitation, often requiring careful navigation of their perceptions and expectations.
3. It is essential to educate patients that the presence of an injury, such as a meniscus tear, does not inherently equate to pain, but rather, inappropriate loading can exacerbate discomfort.
4. Successful rehabilitation often involves a multifaceted approach, including not only physical exercises but also addressing lifestyle and mental health factors that can impede recovery.
5. The concept of directional preference in spinal rehabilitation underscores the importance of identifying and utilizing the range of motion that minimizes discomfort for the patient.
6. Incorporating diverse movement patterns, such as Tai Chi or Pilates, can enhance recovery by stimulating underused muscle groups while providing a more engaging rehabilitation experience.

Foreign.

That does happen pretty often.

You could almost like see it in their eyes, like when they feel what they're supposed to feel.

Yeah, because like you just said, like, you know, it's like a flight flip up a switch and it doesn't happen all the time.

Like, obviously it takes a little bit of practice and sometimes some people pick it up.

Yeah.

You know, a lot quicker than others.

But it, it is pretty cool thing when you can just tell that they figured it out.

Yeah, you think of, like, that's kind of, you know, if we think of this, like we go, let's think of.

Let's think of like a meniscus tear in the knee and, you know, so let's just kind of flesh this out.

So you have a meniscus tear in the knee, whether it be medial, lateral, let's just say medial meniscus or the inside of the knee meniscus.

If once that tears, whether from trauma or overuse, however, it tears just that doesn't matter how it tore.

But say we have a meniscus tear neurologically, what that's done to the body is.

That's like.

Imagine that if you just like had a glass of water and you poured on a computer, like, you know, something's going to get wrecked, but you don't know what yet.

So, you know, from that point on, the brain's going to recruit the muscles around the knee different.

It's just going to, more times than not, it'll over recruit the inside hamstring tendons, and then it'll over recruit the IT band and the VLO or the outside quad muscle.

So when that's the case, when it over recruits those two regions, what they do is it pinches the joint together and creates actually more compression on the meniscus.

So the poor stability pattern now of the knee has actually thus created more of an injury, which is why it's a slippery slope.

Now you can fix that area even without touching the tear, without doing anything surgically.

And the way to think of this is once you decompress the joint, then now that buys space for the meniscus tear.

So the meniscus tear can like not be overloaded.

And the way to think of this is, is like imagine if you had like a hangnail.

And a hangnail doesn't hurt if it's just sitting there, but if you catch it on your shirt or you catch it on something, then it all of a sudden hurts.

So the meniscus tear can exist, but if you move the knee wrong, meaning you're not recruiting the right sequence of muscles, you're overactivating the medial hamstrings, you're over activating the wrong portions of the quad.

The next thing you know that that tear actually gets overloaded in the wrong way and it becomes painful.

So once you understand that, all you have to do is just not get the brain to do that and train them to activate the other muscles.

And then now the tear literally doesn't hurt, even though there is a tear there.

It's.

It's a crazy concept and it's.

It's why, like, you know, very few, you know, very few meniscus hairs go to surgery now, because we've all realized that you can rehab those out.

And that's the concept that the tear itself doesn't actually create pain, but it's the pressure on the tear.

So it's kind of like thinking of it like this.

Like you can have a broken arm and be in a cast and there's zero pain, but if you took the cast off and then the break wasn't fully healed and you took your arm and you bent it and put pressure along that brake, it's gonna hurt.

But it didn't hurt prior to that until you applied the wrong stimulus to the injured area.

So an area can be injured and doesn't have pain unless you load it in the wrong.

In the wrong vector.

So I think that's a really important concept because a lot of times when we get patients in, like when we tell them, like, yeah, you get some arthritis in the hip, or yeah, you got a labral tear, or yeah, you probably got a rot cuff tear, they start freaking out and it's like, no, join the club.

Like, it's just very common.

We just have to, like, offload the pressure of it.

And spinal specialists will speak in terms of like, directional preference of the spine.

Like, what is the range of motion that the spine prefers without pain?

So crazy, crazy stuff.

Do you think a acls are starting to go that way too?

I don't know.

Because it depends on the demands of the acl, Right.

You know, like, what you're going to do after that.

But I mean, there are some athletes that are just so darn strong that they don't necessarily need it.

If I know, you know, I think that's.

Yeah.

Gonna start seeing it maybe like, severity of ACL too, you know, so you

guys would know this better than me, but you guys do know people who have been running off of, like, a poor meniscus, like, whole careers, right?

Yeah.

So in like, including Myself.

So in those specific instances, do you think you, your brain is just so good at the coordination aspect of it?

It's just so good at distributing those forces and those loads.

So you're just able to get away with it?

Yeah, well, that was part of the rehab of it.

Yeah.

Yeah.

And then I'm an absolute hypocrite.

I'm completely lazy when it comes to rehab exercises.

And so, yeah, every now and again it'll still bother me.

Including this morning I woke up and just must have slept with my knees slightly angled.

Weird.

And it just was sore for the first couple hours of the shift.

And then, you know, I kind of just got the medial hamstring line to let go and try to walk it around, do a couple partial pistol squats, and just get the VMO to activate and it just kind of works its way out.

Simple as that.

So once you get, it's like, it's like with a lot of these rehab things, once you build the infrastructure, it's like getting a fire going.

Like, once you get a fire going, like you just toss a log in every now and again.

It's so easy, but it's so much work at the beginning.

But then once you get it going, you get it going.

And so it's like, with rehab, it's like, yeah, you gotta, like, relearn a lot of these behaviors.

But then, like, it's just so easy from that point on to just reactivate and re acclimate those muscles in the same way that like, once you learn how to ride a bike or learn how to play chopsticks, like, you could take a year off from doing both and then still come back to it.

Like, you learn, you actually learned that behavior.

And so rehab is the same thing.

It's like learning a language.

It's like learning how to ride a bike.

You're just training the right sequence of muscles and it should just be easy to just jump right into that.

Yeah.

Yeah, I agree.

Any other topics on this?

Any other questions?

I know we could keep heading a lot of wormhole.

Yeah, I mean, it's Again, I, I, I always find it fascinating to like, get somebody to buy into them because it is a lot of time and it's a lot of effort.

And I think a lot of people like the, the realm of like, performance and activity and not so much of like, singular focused rehab exercises, but to your point, and I think it's like, it's so important for people to understand this, is that like, if you put the work in, you don't have.

It's not going to take much time later on.

It's like, it's like learning how to meal prep.

It's like people always say how overwhelming it is to meal prep.

Like, I'm just spending all this time in the kitchen and then like a month later, like, I don't even think about it.

You know, I just like, cook up

some vegetables, throw it into a thing, and I'm good to go.

And it's like, yeah, yeah, because you spent the time doing it and you figured out what work and you figured out which ones were right for you and you were able to get it done.

And like, it's, it's just so many headaches.

For a lot of people that have certain types of injuries when they come in, it's just like, get back to the basics and stick to some of those basics from time to time.

Well, I also think this kind of.

You're alluding to like, the psychological aspect of an injury where some people just have this identity wrapped around an injury.

And you see this a lot.

Like, they'll go, oh, you know, I got a labral tear or yeah, you know, I got arthritis in my knee, so you know, whatever.

And then they just kind of accept it, like that's part of their identity.

But it would never be.

You would never do that in like a lot of other things.

If you're, you're relationship with your spouse, you'd never be like, yeah, you know, like, I'm just a jerk like that and I'm not gonna try to get any better or like, you know, like

that's just who I am.

Yeah, this is who I am.

I'm just gonna keep making all these really bad decisions.

Like, it's like, no, you're gonna just try to work on improving a lot of other regions of yourself and your life.

And like, that's like, you know, like, like trying to better yourself in all these avenues.

It's just smart and it's never too late.

You know, it's like, you know, I think like, that's why as, as you get an aging athlete, I think broadening, broadening your movement patterns is really critical.

Like, I'm a huge fan of doing something like crazy.

Like, you know, like if you're, if you're a runner that's like into your 40s and 50s, like doing something like Tai chi or rock climbing or Pilates or something that challenges you in a much different way.

I think that's just really smart and, you know, and it's just a way to Sort of wake up a lot of these different muscle groups safely without doing the boring rehab, if you will, because the demand of the activity itself just requires you to.

To stimulate all these other areas in unique ways.

Back to, like, the psychology aspect of it.

I'm kind of curious what you think about, like, when somebody says, like, oh, I just have arthritis, which is how it is, or, you know, my mom had bad hips, so I have bad hips.

Like, why do you think they.

Or why do you think people in that specific position are, like, accepting defeat?

Almost?

Like, do you think it's.

They just don't necessarily have the knowledge or the direction or the structure to kind of, like, teach them that.

That doesn't have to be that way.

Like, it just.

It's just so wild to me how people kind of just accept that's the reality and nothing's going to change it.

I can't do anything about it.

Yeah, I think that people, you know, this is kind of a weird way of putting it, but I think that people have a certain threshold of all the things that they're trying to work on.

What I mean by that is like, you know, like, like it.

It's kind of like, where are you willing to, like, what battles are you willing to take on?

Like, you know, if your kids are crazy at home, you have an average or subpar average or subpar marriage, you know, your parents are dying and you're afraid you're going to get cut from work or fired from work, you're probably not going to focus on rehab exercises.

You're just probably not, let's be honest.

But if your kids are out of the house, everything's great, you know, like, you have a wonderful relationship.

You're.

You feel fulfilled and you feel very positive about things.

Well, then you can be told that you have arthritis in the knee, and it goes, okay, well, that's fine.

I'll deal with it.

I'll kind of just manage.

It's kind of like in that same instance where, you know, if.

If it just was a crazy day and you're super busy, you're probably not getting to the dishes at the end of the day, but if you wake up on a Saturday and you don't have much things going throughout the day, you're probably going to do the dishes, like, you're going to do the little things.

So it just kind of depends on where that person's coming in at and, like, what battles they're willing to have.

And this is like.

This is another weird way of putting it, but it's no different.

Like if you drive down the street, you know, you can drive down a neighborhood and some houses, all the gutters are cleaned and all the panels are perfectly painted and the front yard is perfectly manicured.

And then the next house right next door, like their screens are tore out and there's trash in the front yard.

And now that person is clearly not in a state of mind to be able to tend to the, all the little things.

So I think it comes down to those people, when they come into the office, they just want us to fix it.

And then if there's some skin that we're requiring of them for home management, it's probably not going to happen or not going to happen at the level that we need it to.

And so it does put more demand on us as providers to get it better.

Which I'm okay with that challenge because I realize that everybody has lives and that's what they're hiring me to do.

And, and I'm not necessarily saying that rehab will fix everything, but because you do actually physically need to treat a lot of areas.

But I do let them know like their expectation of prognosis might be slightly different if there's no buy in on the, on the home management.

So.

Meaning instead of it taking two or three visits for me to fix your knee, it might take me five or six, but we'll get it done.

So that's, that's often the way I put it and I just have an honest conversation with people because, you know, I get six kids and the dishes don't get done every night.

So sometimes that happens.

I also, on top of that, I think it's, it might even be like reinforcement from people in their life that make them feel that way.

And I, I think a thing that I've noticed since I've like started to kind of work on myself in certain avenues in my own life is that I think a lot of people, including myself at one point where it's all in and all out, you're all in or you're all out.

And I've definitely have steered away from that and trying to just encourage people in my life that kind of feel that way of being like, no, it's okay, like you can you just go home?

Like if it's a busy day and you can't get to it, but you got a little bit of time, go for a five minute walk or like go, go do like read, read for 10 minutes.

Like it doesn't have to be.

You got to read a chapter or not.

You can just read for 10 minutes, it's fine.

If you're a slow reader, it's 10 minutes.

You're three pages in.

Stop there.

If that's your limit, that's your limit.

Like, it's okay.

And I found that just in my own life, like, taking that approach has made things feel less stressful and I feel more free.

And I actually feel more excited to do a lot of the things that I've been wanting to do in life where I don't feel like I gotta, like, follow a training plan of, like, mileage and, like, you know, I gotta do this type of sequence.

It's like, okay, well, today, you know, I'm a little tired.

I'm probably gonna do two miles when I get home.

You know, I wanted to do, like, on Fridays, I typically do 8 to 10.

But today I'm a little tired.

I'm gonna do 3 or 4.

That's better than not doing anything at all or forcing my way through that run and then possibly being burnout tomorrow or son.

It's like, no, I'm just gonna, like, scale it back a little bit.

And so I, like.

I think for some people in that regard, it's like they feel like they have these issues.

They feel like they have the arthritis so they can't do anything.

Or they feel like they have this thing, I can't do anything.

It's like, no, you can do something, but, like, it might not be to the level that you have to be, and that's okay.

But you can get there if we just start small and let the mind adapt and let the body just adapt slowly.

Yeah, it's a.

This is cool.

Cause, like, I think, you know, like, it's.

It's.

It's a very interesting thing.

So, like, if you look at an athlete, like, if you have an athlete and they are, you know, training for a marathon and they're two thirds through the training cycle and they get injured.

So they're relatively fit, they're eating well, they're sleeping well, things are moving in the right direction and you give them a diagnosis, they're much more willing to tackle it.

But if you take that same athlete and you get them at the beginning of the training cycle when they're not very fit, they're kind of trying to get out of some bad habits of eating bad and sleeping bad, and they're just starting to get built up and they don't have any wind in their sails, then it's probably.

They're probably not gonna, like, dig in fully with the Rehab, does that make sense?

So like, but if somebody has something that they're defending, some gains that they are defending, something that they feel valuable that they are defending, then that psychologically will help them because the brain is very goal oriented in that manner.

Like it, it wants to stay positive, it wants to stay in the right direction.

But if you're coming out of a bad cycle and then all of a sudden you get dinged, you're gonna go, oh, well, geez.

You know, you kind of throw your hands up and you're like, I guess this is just the way it is.

The other thing that's interesting too is like, you kind of have to meet the patient where the, where they're at.

Like, sometimes with patients, like they, like I said earlier, they will create an identity with it.

But this goes so far too, is like I was talking to this one patient the other day and she was like talking about her injury and she's like, I can't even mention my injury in my house because then my significant other will be like, oh, you want to deal with pain?

You know, you, you think you have a lot of pain.

I have this much pain in this area.

And then it kind of turned into this like arms race of pain where like somebody just can't, you know, necessarily.

Like the people just like hold on to their injuries and, and kind of just, that's just the way it is.

And this is just who I am instead of like.

So it just becomes this weird psychology of like that person is clearly not wanting to get better.

And they're using it now psychologically with their significant other, which is such a weird state of mind.

But it is so common for this to be the case.

I'm just laughing.

I just get, I, I have this picture right here that they're like pinching each other.

Like, is that painful?

Can you handle that?

Like cattle prodding each other?

Yeah, like, and then this will having happened even with siblings.

So say one sibling is really, really successful and then another one gets injured.

Well, they might lean into the injury a little bit more because now that's their out now that's their reason why they aren't as good as the other one.

And they're gonna, they're gonna use that as an identity to like let everybody know, like, oh no, I gotta, you know, I herniated a disc in my back and like, that's why I'm not as good as, you know, my sister or my brother.

And it's like, not true.

But that's just how they're What?

The lies that they're telling themselves.

Just kind of funny how it works.

I made a joke about a cattle prod.

Did you know that, like, the.

They're starting a ultra marathon done in central Ohio that's called the cattle prod, where it's like a.

It's like a five mile loop, and then when you drop out, you get cattle prodded.

No, you don't.

You get.

You get, like, shocked.

Yeah.

Wait, what is that?

One of our patients is putting it on.

What's the distance?

100?

No, you just keep going until.

Until you can't go anymore.

And so when you tap out, it's

like a last person standing.

Yeah.

I just love the running world right now.

What are we doing?

Like, it's just so wild.

Just coming up, some crazy stuff.

Cody, I think you should do that one.

Dude, I'd get.

I'd be tapping out so early.

Oh, jeez.

Would you.

If you had to tap out, would you go bare butt or would you go, like.

I don't know anything about a cattle prod.

I've.

I don't.

I think I heard bare.

But you'd go bare butt?

Yeah.

I mean, if.

Why barefoot?

Because it's like, it's the ultimate shame.

You've.

You dropped out of this race and now you have to pay the consequence.

Oh, my God.

Cattle broad prod right to bare butt.

I wonder.

Yeah, I don't know.

I don't even know how to answer that.

Yeah.

But it's just funny, the.

The randomness of the running world.

Why are runners so torturous to each other?

Like, why.

Like, how come, like, I'm sure we were all.

I mean, maybe not you, but maybe in football or something.

But like, how come at the end of the season we just, like, you know, we torture ourselves all season by, like, training, running, like, suffering then to compete at a high level.

And then at the end of the season, we, like Mountain Dew, eat all the crap that we can possibly eat and, like, gorge ourselves.

Well, it's delayed gratification.

I mean, I think runners are really good at delayed gratification.

But then, like, every time I.

Which is why runners make good lovers.

Actually, there's actually research on that.

But, like, I mean.

Yeah, I guess you could look at it that way too.

But, like, why do we.

Why do we like to just, like, just torture ourselves?

I don't understand it.

Well, we know.

I mean, like, we know, like in the workout, we're not, you know, necessarily after the exact feeling of the workout.

We're after the Feeling of accomplishment after it, you know, which is the ultimate delay, gratification.

And you know, that's the one guaranteed thing in running, is that it's going to hurt.

And so you have to have something carry you through.

But then it's also funny too, like we've talked about with type 2 pain.

Like, you don't remember the pain later.

No, no.

Like, you know.

You know it hurt, but you don't remember it.

Yeah, like, you can't, like, recall.

Like your brain is, like, void.

It's like, doesn't it can't.

Like, you could probably, like, remember the emotion of your first breakup or remember the emotion of, you know, the.

When you saw a loved one die or something, but you can't recall the pain and emotion necessary.

Or you can maybe recall the emotion, but not necessarily the pain of, like, finishing your first marathon.

Like, you just can't do it.

Like, there's a void there.

I think it's so fascinating.

It's like this cool defense mechanism of the body to make you do that again.

Well, do you think the.

The feeling of, like, euphoria you get afterwards just outweighs the pain so much that you just.

I think it's a feeling of accomplishment.

I think.

I think you just become very amnesic with it, and it's a survival mechanism because if you weren't amnesia to it, you wouldn't that journey again.

And that mattered 2,000, 3,000 years ago, because that means you would never go back out to war.

You would never go back out to fight, you know, or to find livestock, or you never go out to be a nomad again to find new land.

Like, you have to forget these challenges because there will be more challenges.

I actually think that's why that's the case.

It's kind of really deep, but.

Are you gonna do a marathon this year?

Marathon?

I know, I know you were talking about doing one.

I've been flirting with the idea of a half, but do it, dude.

I mean, a full is like a whole different beast.

No, it's not.

I mean, well, so.

So I guess my.

My view with that is like, finishing it versus, like, having a respectable time.

True, but what is respectable?

That's what I was gonna say.

Like, I guess if you have nothing to compare it to, just finishing would be step one.

But I don't know.

That's how I talk myself out of it sometimes.

But yeah, see, that's it.

That's.

I'll weigh those two ideas, and that's just.

I don't know which one Do I want to prioritize?

But, but who cares by what make, who's to say what is good or bad, right?

Myself.

True.

So, meaning, like, I mean like this

is where, this is where like you would have never done this.

You would.

If you would have done this with any other sport, then you would have never played football, you would have never golfed, you know, you would have never started volleyball.

Like, like every sport requires some entry point.

Yeah, for sure.

And that's the, that I guess the point I'm making is that that's the hard thing about running is that it's objective.

Yeah, for sure.

And then because you, you, you can say like, oh, I ran a XXX marathon.

Like I ran this time.

Well then now all of a sudden I'll go.

You can immediately be like, you can compare it, but like not all the other sports are the same way.

And so they don't have this like reality to it.

Yeah.

Like I was explaining this concept to my stepson where he did, he did a 400 meter time trial over the weekend and it was his first time ever doing the 400.

And he was so scared because he was worried he was not going to run as fast as his sister.

And he just like, dude, if that's the case, he's like, I'm never coming home.

Like, he's like him.

And he was so worried to like hat because it's like there's a reality to it.

Like either you're faster than your sister or you're not.

It's just that simple.

And so that's scary.

Yeah.

And luckily he was for his sake.

So he did come back home.

But yeah, I think that's what's funny about it.

But, but then again, it's like everybody in, in running knows that like, you know, that's not your main gig.

So like it doesn't really matter.

You know, it's also like thousands of people run these.

Yeah.

Nobody.

I don't ask any of my patients what their time is really.

I just, you know, it's like, oh yeah, that's cool you ran the marathon.

It's awesome.

Like, how'd you feel?

Like that's the cool thing, you know, I was like, how was it for you?

Like, how'd you feel?

Well, an effort is just like effort.

Like whether you run a five hour marathon or you run a, a two, a 218 marathon, effort is effort.

So like that person who ran the five hour marathon gave effort to their ability level to run that as running a 218 marathon.

You gave effort at your ability to run a 218 marathon.

So like it's not like, like, oh, slow piece of crap.

Like it's just like, no, it's awesome, dude.

Like, was that a PR for you?

Yeah, dude.

Like it was pr.

Like I trained hard for that.

It's awesome.

Like you put, I mean you went out there and you did it and you know, you fought through it and look at you, you're five hour marathoner.

That's.

I also think that's why ultras and trail races are more common.

Because.

Yeah, I agree.

There's no, there's no judgment in the same way.

Like, because you'll hear ultra marathoners talk about this.

I'm not bashing ultra marathoners by any means, but they'll go like if, like, oh, I ran, you know, trail 50K over the weekend.

And then they might talk about time, but most of the time they're really not talking about the time, the pacing of it.

And then they, they will often preface everything.

We're like, oh dude, it's way more money this year.

Like it was so like.

Or it was way, way hotter this year.

And it's like there's always something that takes away from the time.

It's like the mud or the heat or the cold or whatever.

Like there's some other thing that makes it so much worse that that's why the time is what it is.

30, 000?

Yeah.

So you can compare 30,00.

Whereas on the trail, like you can't do that.

It's not the same.

So I think that that's, that's the appeal of doing those off events versus your classic like Chicago Marathon or Boston Marathon or something that's very standardized.

Because there's just a kind of a hard nosed truth to those events.

I guess when I'm saying that then you should just do your first marathon on the trail.

I was gonna say the first or one of the good things about it is like if you've never done it, you're always going to get a pr, right?

Yeah, yeah.

First pr.

Yeah, but that sounds a lot more attainable.

But the trail is actually easier than the road though.

People, people will often not really think that like a road marathon hurts more than a trail marathon.

Like, no question.

Even though the trail marathon will take you longer, it hurts way less because you just can't run as hard.

And then you're not having the same foot strike over and over, so you're

just using more overall.

In a trail marathon, no two foot strikes are the same.

Yeah.

In a road marathon, 80% of your foot strikes are the exact same, and so you're going to overload the same area.

So it's just.

It's just about perturbations and distribution of load.

But they're fun.

I mean, New York City was so much fun.

Yeah.

So what'd you think?

Oh, it was a blast.

It was my first major.

It was.

It was my first, like, major road race that I've ever done.

I thought it went really smooth.

I had no issues, like, if people talk about using bathrooms when you're there in your corral, like, no issues.

Security again.

I mean, we had to go through security.

That was just.

That was a breeze.

I kind of made the police officer a little upset because I was like, 5:45 in the morning.

We had to put our, like, our stuff in these.

These containers for security.

And I just, like, put it in the container while she's holding it, like, this deck.

And she's like, now you're holding me up.

What are you doing?

I was like, oh, I'm sorry.

And she's like.

But other than that, it was awesome.

The crowd, Brooklyn was amazing.

They had, like, all sorts of different bands out there playing.

Crowd.

Crowd was loud.

You know, you go up the fdr, and you're kind of in, like, no man's land going over those bridges, and, like, no one's really out there.

There's construction workers getting to work and people, like, kind of, like, on the side, like, yelling down in.

But then you turn onto 42nd street, and then.

Yeah, you pass the Empire State Building, and it's just electric.

And then it kind of, like, fizzles out for a second, and then you turn on the Times Square, and it's just.

Just a line of people all the way up to Central Park.

Yeah, that's the.

So you go from Times Square to the finish.

You.

You go to Times Square?

Yeah.

Yeah.

So you got about two miles left from.

When you're Times Square.

Yeah, I mean, that's the only time that you run through Times Square in any.

The second time, or it's.

It's one of two times that it gets closed down.

What's the other time?

New Year's Eve.

New Year's Eve.

Wow.

That's so cool.

Yeah.

Yeah.

Yeah.

That's pretty awesome.

Yeah, it was.

It was.

It was neat.

Yeah.

30, 000 people.

It's a weird world.

Like.

Like, people were wearing, like, those, like, ppe, like, hazmat suits to stay warm.

Yeah.

And like, other, like, just random.

Random garb like, we ran with.

Yeah.

Boston's like that because, you know, the finish is not where the start is, so you have to so well.

And, like, as our corral, because I was in.

I was in corral A.

And so, like, these are, like, people that are shooting for faster times.

And there was a point where it was like a whirlpool of people just warming up in the corral.

And then there's this guy in the middle.

He's like.

He's like, if you guys are warming up, you got to get out of the crowd.

And it just got bigger.

Just warming up.

No one's listening.

And.

Yeah, it's.

It's a.

It's an interesting world.

Yeah.

No, the majors are awesome.

And.

Yeah.

You know, you probably have had over a million spectators there, and it's like.

Yeah, you can't reproduce that, man.

No, you can't.

It's like, it.

It doesn't like, even running it because I knew that this was going to be the case when I realized how many people were running it, it was like, you're always going to be with somebody.

Like, and it would be like five people would pass me, and then I'd pass five people, and then five people.

And it was just like this.

Yo, yo.

And it was like, wow.

There's always somebody to key off of.

There's always someone that is, like, putting in a kick.

There's.

It's like.

It's endless possibilities of, like, if you're in shape and you want a PR or like, run fast, you can if you want.

There's so much going on.

Yeah.

Would you ever do something like that?

You should.

A half marathon, like a big event like that?

Yeah.

I mean, I feel like that would probably be better than a smaller one.

Just feeding off the energy of the crowd.

And like, everything else, I feel like that would just amplify that much more and make it suck that much less.

Are you training right now for the adult track night?

Not specifically, but I probably should honestly include a little bit more sprinting.

Yeah.

My regimen.

But.

But I usually just wing that.

That's awesome.

All right, any other final topics here before we.

We cut loose?

All right, well, thanks, everybody, for listening.

This episode of the Mind Body Marathon and yeah, until next time.

Thanks for joining us and if you have any questions, comments, let us know.

All the best, Dr. Leo here.

If you want to catch me in another setting, be sure to check out my YouTube page, Running Rehab where you will find exercises on how to stay healthy with running, how to improve your running form, and a bunch of other tips and tricks on how to get over common injuries.

Dr. Leo here.

Be sure to check out my new book, Faster Without Fail, your guide to overcoming injuries and running faster than ever.

It is now available on Amazon.

You could read reviews on the Amazon.

You can check out what other people have said about it.

But basically if you want to revolutionize your running form and better understand how to stay injury free within the sport, this is your guide.

Feel free to reach out and let us know what you think of the book.

I would love to hear your feedback, but again please check it out on Amazon.

Faster Without Fail.

Appreciate it.

Sam.

Sa.

Ram.

Sa.