Ep. 39 | Dr. Mike Voight on Common Golf Injuries, Hip Mobility, Physical Therapy, and Advice for Aspiring Professionals

Dr. Mike Voight joins us on this episode.

Dr. Voight is a tenured professor with Belmont University's School of Physical Therapy and an Adjunct Associate Professor in the Vanderbilt University School of Medicine. He has worked with a number of teams in the NFL and NBA, and consulted with various teams in the MLB, NHL, and the MLS.

In this episode, we learn more about the most common injuries in golfers and how to prevent them; the importance of hip mobility within the body and golf swing; the progression of physical therapy and training in golf; and advice for aspiring Golf Coaches and Physical Therapists.

Follow us on Instagram: @urbangolfperformance
Follow Mac: @mactoddlife
Follow Leo: @leo_ugp
Website: urbangolfperformance.com

Follow us on Instagram: @urbangolfperformance
Follow Mac: @mactoddlife
Follow Leo: @leo_ugp
Website: urbangolfperformance.com

Transcript

Mike 0:00

I might add is that some people just think we can go in, I can lift weights, I can get stronger. And we can probably talk about examples of that going on in the tour, but get stronger, do things and forget that eclectic approach. And what happens that I see going on much more common today than it was five years ago, even. Is the analogy I use. Is it a lot, a lot of these golfers, particularly the younger guys, they're putting Ferrari engines into a Volkswagen frame and they're generating so much power, but you're overpowering the system. And eventually that, that car is going to break down. If you don't, if you don't, if you don't fix the frame or do something like that, or harness that power a little better, you're going to see it. And I can see it in our 3d assessments or various things in these big hitters, what they're doing and the million dollar question. Now they start to have problems and we get them that the elite golfers are so in tune with their body, they're going to come ask questions before they get complete breakdown, but they're on a slippery slope going down that by the time I see them, perhaps things are happening already and we'll try to shore them up a little bit and allow them to play or to continue to play, maybe tweak their programs. But it, I think that the big difference in kind of getting to your question was, I think they're just some golfers are getting almost too powerful.

Leo 1:27

Welcome to the urban golf podcast. This is Leah Rooney and this week it's a special episode and I say that almost every time, but it is a special episode. I have our director of recovery at UDP. Manny Garcia, join us for this conversation because we have a sports medicine giant on. We talked to Dr. Mike Voight and Mike is one of those individuals that have done everything. And I don't know really what to say. Other than that, he has been one of the top PTs and educators and clinicians in the world for the past decades. And so he's worked with the NFL, the MLB, the NHL, the MLS, the PGA tour, multiple Olympic teams. In addition to being a professor at Belmont university in Nashville, in addition to being a scientists, executing studies, usually PTs and other professionals will do one of these things. He's done all of them at the same time all the time. So if there's a um, greatest of all time, he might be at the top of that list in the PT world. And he's just an amazing person. Really, really awesome to talk to because he's experienced it all. He was one of the early contributors to the Titleist performance Institute. He's still on the board there and he's focused a lot on golf in his career. So he knows a lot about the hip. He alone knows a lot about the golf swing in general. And so we're getting to, you know, what are the most important things for any golfer to focus on when it comes to the body and how physical therapy is actually used for performance at the highest level and not just for pain an injury. And I had Manny on, because I know man, who is a big fan of and it was just uh, you know, a pleasure to talk to someone who has done. Everything at the highest level, but it's so humble and really in line with our core values here at you know, really feeling like the more he learns, the less he feels like he knows. And having that beginner's mindset, it's just uh, something that we try to live by here at UDP. So talking to Mike was an honor, and we're getting into a lot of different subjects. So if you're a golf coach or a golfer, PT or a trainer, this is a great episode and I hope you all enjoy it. Well, it's an honor to have you on the show, Dr. Mike voids.

Mike 4:22

Hey, thanks for having me guys. It's good to meet you and Leo there and Manny. It's good to be with you today.

Leo 4:27

Yeah. Uh, When we, when Matt and I talked about this talk Monday was, you know, looking into your background and you older didn't know, you knew you obviously, but he was like, Hey, Mike has 84 pages on his CV. Am I underperforming? W what's going on here? So my first question is, you know, You're kind of the Tom Brady of the PT world. How, how did that happen? And usually when you know, people do great things, there's a really strong intrinsic driver behind all that. What is that strong, intrinsic motivation in you?

Mike 5:03

Yeah, that's actually a great question. Thanks for even bringing it up. I think the one piece of that for Manny go back and look close at that the pages I've probably had it like in six spaces between snow

Manny 5:13

singles,

Mike 5:15

single space. I put a lot of papers in between the academics here at the universities they look at. I think that that's people always ask me and I, and I think it's, it's true of work in general. It's that old line you know, love what you do and you'll never work a day in your life. And that's, that's, that's my life right now. I love what I do. I love working with golfers. I love getting up. I there's days. I know peoples, they, they get on me and say, how could you possibly be that upbeat if I raced to get to work in the morning? Cause I love doing things and it's the chase of answers. You know, Leo said, what's your intrinsic driver. It's if you get to the part where you think, you know, everything, I probably, as the older I get, I realize, I don't know hardly anything. But not ask a lot of questions and I think that's part of it. So when you look at there's sort of two parts to your, to your question, it's always asking why. Going down that road and trying to find the answers. And there's a lot of things we don't have answers to. So that's, that's there, but it's that the chase that's good. And then the other part, I would say this for people listening. So they're younger are getting started in this cause sometimes they think it's like, how do you even get into some of these things? Is that I, when I was early in my career, I volunteered for everything. I went to stuff. I didn't even know what I was volunteering for sometimes. And, and there, I will tell you this, and if you volunteer for different sports or you do things, you better know something about that sport. cause think about it. I use this analogy a lot of times I was with the um, uh, was the Olympic trials for figure skating. I hadn't don't really know a whole lot about bigger skating trust me. And I had a well-known figure skater come in and said they'd hurt their ankle doing a triple toe loop. And I could've sat there and said, well, what the heck is a triple two? But have I did that? I know what's the downside is they're going to look at me and go. You don't know anything. I might've been the best person in the world for that ankle, but they're going to say you don't know anything about that because you don't even know what a triple toe. So I do have to fake it real quick, but you better go do your homework. Soon as I leave that room, I'm on I'm reading figure skating books. I got a coach at triple toe loop, so I knew what it was. So I, it was back to volunteering, I think, for a lot of things. And then doors just open. Yeah. When you do that, when you're not looking for anything, it's really the quest for the knowledge of the experience. And that's what got me in to various things that didn't, and I think there's an element of luck along the way. But as you guys were talking about the career-wise, you know, I've worked in the NBA, I've worked in the NFL primaries jobs. I've done four different Olympic games working with the USA things that I've been all over the world with various sports federations and very, been very fortunate in that regard. I think what we're talking about today was one of the funnest things I do is working with golfers. Is because there, and I do a lot with PGA and I do recreational, but the PGA guys, I like because they're piecemeal workers. If they don't play, they're not making money. Oh, unless there's some really big endorsements, I guess you could be laying up in a hospital, it's still have endorsements, but most of them, if you don't play it, I'm making money. I like that. Although, when you get to those levels of sports, the drivers with them are still up there too. So we have it on the team sports. I think they're there. People are pretty eager to play and that's my clinical practice and we can get into it involves 50%. Well, 50% of what I do and see he is elite athletes. And I specialize now in hip winning, come back around to that in the background. Here's the clinic, the hip clinic, but we see a 90% of my patients that I see don't even live in Tennessee. And about 20% don't live in the United States. And again, I said about 50% are at the elite. What I call lead or Olympic level. Professional or elite level athlete. So it's kind of just do what you love and it just snowballs. It just keeps snowballing over time. Yeah.

Leo 8:51

And how, what's your background in golf? Like how did you get involved in golf? And how come you, you, you work so much with golfers.

Mike 8:58

Very interesting. So really the way I got into golf, I'd been around it and I'd seen some golfers with injuries, but I'm going to be honest. I didn't know a whole lot about golf and Leo you're going to die because there's a golfer yourself doing this because of the other sports that I'd been around. I had access to golf courses all over the country when basketball traveler do things and they say, Oh, do you want to go play? You want to go to pebble beach? You want to go do this? And I'm not a golfer, so I didn't go. And so then I finally, when I was in academia said, you're not going to try to take this up. But then I realized back to my figure skating analogy don't ever let these guys see me, sweetness, you see a swing your club. Cause they're going to know I could throw a ball almost bred that I could hit it. And then through They've been in 2000, two-ish batting in there. That's where I met Greg Rose and Dave Phillips with Tyler's performance Institute. And they took me under her wing as a medical person and was advising them. And I've mentioned you guys before, but I became a sponge with them and I just spent time not being a golf coach. I don't pertain to do that. I know a lot about the golf swing and I started studying that and studying the interaction between physical limitations and what would happen to a swing ball with that. And along those lines, I, my famous, my, my favorite story was working with Lance Gill. He and I kind of at the time, and Dave Phillips was a golf coach. I don't know what prompted this, but Greg Rose and the people said they had a lot of players they're working with and they said, Hey we got a guy that's looking for somebody to work with them. Okay. And this was pre majors, but Pauric Harrington. And Patrick was like 170 fifth in the world and at the time, and so we started working with Pauric on screens and fitness and solving some physical limitations he has. And then the rest was kind of history. He went from one 75 to three and three majors in two years with that, I'm not going to say we did it. He did a lot of he's a workaholic uh, works really, really hard on his game and did a lot of things. He just had to have a little direction with his team around him. So that's kinda how I got into it. And from there, it was a love, became a real passion, learning more and more about it. And again, Not that other athletes are not fun to be around or have the best attitude, golfers have great attitudes and they're just great people to be around. So I kind of drifted into that mold a little more. Yeah.

Leo 11:20

Especially when you know, Patrick, he didn't, he, when one of the British opens, he won, he had like a slight wrist issue. I remember. And he was kind of not, didn't put as much pressure on himself and he felt like it was helping him that week.

Mike 11:34

Yeah, that's exactly right. I won't say anything negative, but sometimes you can overthink things as you're well aware and, and Pauric analyzes everything. Uh, But he's great at what he does with that. And he was able to put that in the back of his mind and not dwell on that and focus on the good, and actually he had a, he and the coaching staff had a great game plan for him and you're right. He wanted on 17 and 18 that particular British open, but you're exactly right. Your memory is perfect on that.

Leo 12:03

That's awesome.

Manny 12:03

And I have a question like you said uh, your, your course caseload's, you know, a lot of elite athletes, about 50% of it is lead athletes including golfers. And uh, what would, what would you say makes golfers unique, you know, compared to the other elite athletes that you work with? Like, what characteristics do you see that the others don't have?

Mike 12:23

Yeah, I would say I'm not going to say it's different. I'm going to, but I'm going to preface it a little bit about the types of things I see. Golfers are basically a rotatory sport. We work in the transverse plane. So, so, but if you think of a rotatory sport, two quick ones off the top of my head that would come into mind, baseball that's rotatory and hockey for a large part can be rotatory as well, a little bit what they do. And I'm sure there's others. We thought about it in my I've been very fortunate again, sometimes the right place, right time. But I work with that. A hip surgeon that would be considered one of the fathers of hip arthroscopy and one of the top sports dot sports hip guys in the country. And there's several of them and they all work well together. We all know each other, we all do things well. So a lot of the people are coming in and I think the difference is, and what I'm starting to see some changes is that, and it kind of fits into humanity and perhaps with recovery and the training is that. And I can't tell if it's cause and effect, but what makes you unique is golfers. If we go back into pre 1998 ish 96, seven, eight, really? There was only a handful of people that trained for golf. I mean, there wasn't very many people, even at the pro level would really jump into that whole training aspect of it. What really, I think, started to change it or gave that big shift towards Trey obviously was tired when he came on the scene and everybody was trying to emulate what they did well, what ended up happening is a lot of people got into training and doing things, and here's what I liken it to happen. It's it's, that's where you, your approach is really good. Manny, we've talked before about how the whole group there and how you do an eclectic approach, a holistic approach to golfers, which is the right way to do it. I might add is that some people just think we can go in, I can lift weights, I can get stronger. And we can probably talk about examples of that going on in the tour, but get stronger, do things and forget that eclectic approach. And what happens that I see going on much more common today than it was five years ago, even. Is the analogy I use. Is it a lot, a lot of these golfers, particularly the younger guys, they're putting Ferrari engines into a Volkswagen frame and they're generating so much power, but you're overpowering the system. And eventually that, that car is going to break down. If you don't, if you don't, if you don't fix the frame or do something like that, or harness that power a little better, you're going to see it. And I can see it in our 3d assessments or various things in these big hitters, what they're doing and the million dollar question. Now they start to have problems and we get them that the elite golfers are so in tune with their body, they're going to come ask questions before they get complete breakdown, but they're on a slippery slope going down that by the time I see them, perhaps things are happening already and we'll try to shore them up a little bit and allow them to play or to continue to play, maybe tweak their programs. But it, I think that the big difference in kind of getting to your question was, I think they're just some golfers are getting almost too powerful. Yeah, that's really interesting sport for that rotational sport. Yeah.

Leo 15:27

We talk a lot about force when we educate is it's hard to actually feel just how much, how many, how strong the forces are in the golf swing, you know, swing uh, you know, whatever, 120 miles per hour. That's, that's a lot of, you know, over a hundred pounds of force in one direction, but it happens like that. So peep, we don't feel it. We actually don't feel it. And the force is pulling us and we have to, resist that force in the opposite direction. You know, speaking of hips, what do you see as the most common issue? Cause you know, everybody knows, we sit mostly now in the modern world and the hips are supposed to be mobile, but they're not always mobile. and we talk about hips a lot, you know, because it's what we do every day. What is the most common issue that you see just everyday golfers? In terms of the hip,

Mike 16:18

that's easy. I, this, you could almost retire on this one for me. That's gonna be easy. It's, it's either one of two things and they're interrelated, muscle imbalance and lack of range of motion and lack of range of motion. Doesn't have to mean that there's something boney caused it, that they need surgery. It could, they could have capsule limitations. I'll tell you the story. You, you, you said the right thing that we're looking for, and we go back to this whole concept of joints, or if you really think of joints as a whole joints are either designed to be mobile joints. Produce a lot of mobility do things, or they're generally designed to be stable. In example, hinge joints like a knee, a knee should be stable when we do it and elbows should be stable. And the body just the way were developed. The good Lord developed is that generally their inner interlaced, although we can come up with some, you know, they change between like stability, mobility, stability, mobility, and the body. There are certain activities that could change depending on the activity you're doing, but it generally stays that way. So for example, people can relate to this that are listing today. Hips are designed to be really mobile. If I go up to my next layer in our human body, we have our lumbar pelvic area. Okay. The lay term core, our core should be stable. Everybody should have a good core. The next thing up the chain, we should have good mobility in our thoracic spine. That's where we're going to get rotation with the golf swing. Our scapulas should be nice and stable against the thorax or glenohumeral joint, a ball and socket like a hip should be mobile. Here's what I see happening. A lot of times. People come in and it's amazing and it doesn't matter. And it's what makes us even more amazing to me is that the golfers, these elite golfers or the other thing I might add in Nashville that I get to do a little bit, this fun is I also work in the entertainment industry. So I see a lot of entertainers come in and I call myself in that regard has nothing to do with medicine. I'm a matchmaker. So when I say I'm a matchmaker, most of my entertainers that come in, they think they ought to be on the PGA tour. Cause they play on all these pro-ams. They think they're really good, but it's kind of funny. A lot of the golfers, I see, think that'd be a front man and a band singing and playing guitar. So I just say, y'all get together and you, you can figure it out, but I've got examples on both sides. Doesn't really matter. I had a I'll use that entertainer had a guy that's a Grammy award winning entertainer. He came in boggles my mind, but I'm going to say to you three year history of blow back pain. These guys have resources. They've got resources. So it's not like they couldn't get care. This person, a lot of these guys, just like our PGA tour players, they have rehab and recovery people with them on the road every day. So they're getting treated five, six, seven days a week. So here, I'm looking at this guy thinking, wait a second, you've been treated five days a week for three years. And it's progressively getting worse. I said, your low back, something's wrong here. I mean, just in my mind, I'm thinking. And of course, just like you guys do, you're going to ask a client on an intake. What is it you do for working out well, these guys will pull out their little booklet and show me everything. And some of these guys golfers, or this, this particular client, I'm thinking of how to add an exercise program for the core. That was probably as good as anywhere you could see. Yeah. If we could, if we could write some paragraphs around it and bundle left, we could sell it on Amazon, have a best seller. I mean, it was like 89 exercises and, and of course the first thing I thought when I saw it was nobody does these ex nobody's going to do 89 dang exercises person did. I mean, he could tell him, tell me what 47 is. You know, the guy, he could rattle off all these exercises. So we did an assessment on him and here's the crazy thing. As I started looking at him at his hips, he had five degrees of internal rotation, bilaterally, five degrees we should have for golf. What should I be? We are as a bare minimum. We like 30, but 45. Some of the, the pros have more net. He had five. So every time he tried to rotate the hips, we're moving well, what's going to happen. It's supposed to be a mobile joint. It's gonna make the next joint. To the point where he can't, it's going to be unstable. And so he could do those exercise for the next five years. It's not going to solve his problem. And with the hardest part with these people are when I see them. And we obviously do this every day. The hardest part is they're going come to you and say, Hey, my hips don't even hurt. Why, why, why are you looking at my hips? My hips don't hurt. And you'd come back and say, Hey, your hips don't hurt. Cause they're not doing anything. Not even working. Of course they don't hurt with that. And in this particular guy, we went from over the course of two or three weeks, we went from five degrees and I think there is a threshold there, but he went to 15 or 20 degrees of internal rotation. And all of a sudden his pain went away. I never touched his low back. There was a well-known guy and a PGA tour right now, the exact same thing. And we had that same story with him. And then all of a sudden, about two or three days into treatment, the guy says, do you think that's why I'm also having left knee pain? We're working as low back pain, but you know what, if the hip isn't work, those forces are gonna be attenuated above and below the joint. Of course, that's why your left knee is hurting. So back to your question, range of motion is huge that they don't do the right things just because our lifestyles were seated where we're generally our secondary golfers are notorious for that uh, secondary. And then I try to just get out and play so between, so we lose our range of motion, but one of the things we that goes with that hand in hand is muscle imbalance. So we do a lot of manual work for getting hip range of motion back and then glute medius, glute max, a big power drivers that they're, they're the King and queen of your golf swing, generating the power. We'll come back and work on those. Because what generally happens is when the range of motion goes down, we've done research, looking at this range of motion goes down, or there's something in the hip causing pain. The first thing that's going to happen is that glutamine is going to start to shut down. Well, if you need that to stabilize and you need that certainly to trans it's the transmission for your golf swing, no wonder you're going to have problems. So back to your long way to get there, but it's, it would definitely be hip range of motion and then muscle imbalance around that.

Manny 22:21

Yeah. And I th I think the concept of regional interdependence, I think you've had a lot to do with that. You know, filtering its way through the profession and the profession getting better. Do you, do you think the profession is um, is doing a much better job at, at really getting down to the true issue? Or are we still in the dark in certain, in certain realms as far as solving chronic problems?

Mike 22:41

Yeah. Yeah. That's a great question. I talk with my colleagues about that a lot. I think we're still, I hate to say it, Manny. I think we're still a little bit in the dark ages and I think we're moving in the right direction, but it's going to slow. And the reason we're doing that, quite honestly, you guys think outside the box, you guys have embraced. The, the total approach, how to do it. The problem in medicine is that in medicine, we still take a mile myopic approach to healthcare and that's how it's taught. And fortunately it is good. And that's where it's going to change because we be the schools doing this. But what I mean by that myopic approach to the region, regional dependence you talk about is person comes in much like the entertainer or the golfers, and they have low back pain. Well, what do we do? Blinders, come on. And I focused that cause that's how you're taught. It hurts here. It will. Therefore that must be where my problem is. And the kids graduating today, they know all kinds of special tests and manual techniques and they can examine all they want. But if the problem is somewhere else and that's just the weak link in the chain, they're not going to get better. And that's why you actually hit on the right word. That's why a lot of these problems that exist are going to become chronic problems. Big. Most anybody today can get somebody out of acute pain. Or the queue problem, but that doesn't mean they're going to, they're going to be, if they don't come back, it doesn't mean you made them better. They just, probably some people are smart enough to figure it out. I want to go back there then maybe I'll find somebody else who knows what they're doing. But typically that is the, you hit the nail on the head. I think we're better than we were. But I think it's a, it's a slow process to educate. I

Leo 24:14

think it's so interesting that, that we haven't come a little bit further along because you know, the, you know, if you're talking about the hip and for people that are listening that are just regular golfers, like, you know, just how important, for example, internal hip rotation is for any rotational athlete and, and your story. We see the, about the, the Grammy award winner. We see every single day and they always come in and they go, well, I have, you know, the Clippers you know, trainer and I'm going to this guy and this guy. And then, you know what we've started to do instead of saying, well, it doesn't seem like you're getting the results. We just say, okay, how do you work on internal hip rotation? And we have them show what they're doing and they'll do a glute bridge, you know? Um, So yeah, so like, yeah, you know, and, and these, this is like, this has been around forever. I mean, the how, how limited internal hip rotation is correlated with back pain, especially in golfers. And so how is it that trainers? I mean, we're talking about PTs here, but not even trainers are aware of how to work on this and ensure that, that each rotational athlete have proper, proper hip mechanics and proper hip mobility,

Mike 25:37

you know, that I see along those lines. Cause I know you're exactly right. You guys deal with it every day and know to look for it and. It's sometimes shocking to me that in professional sports, they don't look forward as like you'd mentioned a team, but they don't always look for the same thing. The other thing along that line that we see sometimes is And I wouldn't say it's necessarily common, but it's not, they're not going to be uncommon to say is that, and I'm starting to actually see this a little bit more in golfers and we see it in baseball as well. The younger, the kids, we, we, I talked earlier about how they're getting strong. They're getting stronger. The younger, these kids develop power. At least when those growth plates are open, we're starting to see a little bit more of what we'd call it. Um, The anteversion or a retro version torsional changes their femur. And if you have that, torsional change. And you have a retroverted hip you're, you're not going to get internal rotation all the way. I mean, it's going to be a bony block now. It doesn't mean you don't have a big arc of movement. It's just occurs in a different part of the clock face. We've kind of known this phenomenon. Manny is not as in baseball for years it's shoulder, it's the same concept. We're starting to see more at the hip and the younger kids. And so one of the things that really bothers me along that same line that you two are talking about is let's say by chance, somebody did look for range of motion saw, Oh, you've got limited internal hip rotation. Good first step, but they need to do at least one quick little screen to see, do they have retro version or anteverted hip? If they're a retroverted and now you put them on a stretching program or a program to work on that you're going to destroy that hip joint. You'll destroy that hip to it. Now they're going to surgery over time. It won't happen that day. It'll happen over weeks, months, maybe a year to get to it. Whereas. If you like what you guys do at your place. Cause you've got that holistic approach. You can recognize it and say, yeah, they've got a Craig's test. They're retroverted hip. Now the next thing I would do, that's why I think the beauty of your system is great. The next thing I would do is work with my golf pro and say, Hey we've got this fixed deformity. I'm not going to change it. Surgery is not going to change it. What can we do to work around? What's a workaround, it's in your wheelhouse. Now golf coach should do that and say, okay, obviously the easy one there, here's the little trick for your viewers and the listeners of this today. Just watch and laptops. We love it. So I love watching golf on weekends. I'll watch. So I go to a lot of tournaments, but sometimes when they have the, the Connico swim camp, but they had the camera on the golfers, looking close, watch some of our guys what they do when they step up to hit. And I'll give you the example on our retroverted hip. Particularly it was. I've got them on both sides. I mean, sometimes it's a trail leg, sometimes the lead leg, but lead leg is going to be more pronounced that w or they've learned to compensate other ways. But watch what some of the guys will do. They'll just step in. They get, they do their, they do their imagery. They look down those golf where they want, they hit the shot. They come up, they get set up. Everything's looking good at that very last minute before pulling the trigger, that foot flares out where that lead put out 45. And I'll tell you where the problem is. It seems easy, but it's not as easy as it I'm going to sound because if I flare that foot out 45 degrees, if you think about it, I just gave you 45 degrees of internal rotation. The problem is is for some of these guys, it's not as easy as it looks. And I know you guys have, as soon as it's over, you're gonna stand up and try it out. And you probably already, I know Leo talk about golf and coaching. You already know what a gift, but when you set up on your target line and a golfer does that, and then you flare that front foot 45 degrees, it looks like everything's going left. And then you start playing with your hands and your head and your eyes are telling you different things. You're still set up on the swing plane, where you want to be. It's just your foot change that one position, but it looks like your name and way left now where they, so you've got it. So some of the guys we try to tell them to do is at that last minute before pulling that trigger, flare it, and don't look just flare the foot, do not look at it because they're going to try to go get handsy and try to fix it with that. But yeah, I, I think that those are, again, that hip is like, you're saying Leo that is vital to the game of golf. And it's also vital. If you want to talk about people, we see. The corollary to it. We see, I talk about Lee. He had been a golfer. It's the lead hip and a pitcher as well. We see lots of major league baseball, pitchers come in the exact same injuries for some weight. We don't see it as much. You think it's the same in batters, but you don't see it as much in batters because they on the dirt at home plate, their foot will flare out when they start their swing. So they don't act, they don't actually post into it like a golfer sets up or when a pitcher's strides out and plants their foot there. That foot is now fixed. And they're going to pivot over the top of it. It's the same mechanism of injury. So the hip is vital, as you said,

Manny 30:23

I have a question about you know, rates of injury in, in golf instruction. Obviously, you know, TPIs has been around for awhile and I feel the, the different parts of the industry are starting to work together a lot closer, but golf injury is still just so prevalent, especially with golf instruction. Do you, have you seen, you know a positive change in injury rates since TPI has been on the map and, and progressing through the profession?

Mike 30:48

That's a great question, Manny and I, I'm not sure I'm going to answer it with my heart first. And then my head second, I think with my heart first, I'd say that yes, that those that have embraced a system and it doesn't have to be a hundred percent the TPI system. I mean, with you guys, you integrate eclectic the best of the best and do it, then have a system and are working with people and get them on that holistic approach to golf. I would have to think that the instant rate. Is going down and people can play golf longer and they can play more rounds of golf per week if they want to do I have to think that's true. I'm not sure that I see that. And I'm talking about recreational golfers now that do that. And so I, I, I think anecdotally, I've seen some of that. Some of the data I've seen doesn't necessarily support it, but the problem we run into, and I know you have mentioned this before we got on the air is that the, we don't really even know at this day and age is for a sport. That's so many people around the world play. We don't really have a good handle on how many people are getting injured or what the injury rate is or the types of injuries. And, and it's also different PGA players, the LPGA players, they have a different injury rate. For and for different reasons than the recreational golfer does. So, one of the things I mentioned to you that we just started last year, 2020, and even with the pandemic, we still were able to a lot of people golf during the pandemic. So we were able to get some pilot data done, but with the international Olympic committee, basically, and the international golf Federation, we've started a project to look at it. It's a three-pronged project, but it's the first step of the project is what is the real incident of golf injuries uh, worldwide. And we've started a project there's 10 countries involved. We're gathering data on just anybody. It's not the elite golfer. And uh, that's what we've eliminated tour players. And, and we've eliminated children at this point in time. Cause different things could occur. So it's just the adult golfer and we're gathering data. And with a pilot, we developed an app. We can collect data and find out who is, what does the typical golfer look like? How much golf do they play? Per week or month what warmups they do, what exercise they do, are they in fitness? They do other things. And from that they report every week, if they've had an injury or what type of injury or any illness that prevented them from playing golf. And we're going to monitor that. And now in 21, 2021, we're gathering where we will be in the process, just started gathering lots of data on this worldwide, hopefully to get a better snapshot of where are we in 2021 with instant rate and what types of injuries the ultimate goal is from this is if we now say this is what a typical types of injuries that a typical golfer gets, it goes back to what Leo asks me at the very beginning, that the million dollar question that drove my career, why, why are they getting hurt? Why are they having these things? And it could be instruction, or it could be physical limitations. It could be all kinds of things. So what we're going to try to do is step two of this is Either use a TPI type of screen or some sort of a physical screen to run these people through and start correlating physical characteristics to perhaps what they do with golf, with the ultimate goal being, if you can figure out that there are changes or limitations to uh, a person playing golf that then maybe we could come up with a an intervention strategy. It might be working with you guys on a fitness plan. They probably should be doing anyway or it might be in conjunction with a five to seven minute warmup pre pre-round a golf that would target those specific muscles, muscles slash joints that we know are prone to injury and a golf match or a golf game. So that's kind of where it's going. So back to your question is I think it's gone down. But we're also, we see the world like you do Manny. We see it through our own eyes. You your clients. And I think you could look at your clients and say, cause you're in touch with them on a regular basis. Leo's in touch with them on a regular basis. You know what they're doing? They're coming back, they're coming back because they're successful. So, you know, they're doing well. It's all those people that aren't doing it. So when you say, what is the incidence rate? I think if in the world that we live in, the three of us, I think we see it going down in the big picture. It goes back to kind of that whole thing with where are we at that regional interdependence? I'm not sure all golf pros fully embrace it. I'm not sure they all get it. You, you know, as well as I, there are golf coaches out there that believe there's only one way to swing a golf club and you're going to learn my way. And that's my way only. And you're going to figure out a way to do it. Even if it's going to hurt you, you're going to make your body do this swing. Whereas, you know, I think there's a thousand ways to swing a club and we can go down that road with there's only one efficient way, but there's a lot of ways that you see them. And I tell people, coaches that all the time, cause some coaches will tell me no there isn't and I'll say, well, I'm gonna tell you right now, Why don't you go back and look at Jim Furich swing a little bit, cause I'm sure that doesn't fit your model swing picture, but that's pretty darn successful. So I'm going to tell you right now, there's probably multiple ways, but I think, I think the rate will go down, but we're actually in the middle of a study right now, worldwide to try to get that incident rate. I

Leo 35:55

think what the issue is too is at the highest level, unfortunately, it's still not happening. So, I had a conversation with you know, to me as a top five coach uh, you know, really well, Mike. And when I asked him just, really how many coaches on tour do you feel like really understands the body well enough to, to coach with this physical awareness uh, mindset as a coach. And he said too, so he can only put his name behind two people. And all of golf that really understands that to the level where, you know, they're coaching with that in mind and can communicate with a trainer, can communicate with the physio. And so I think if it, the day happens at the, at the, at the top level you know, more than 50% of the time, I think is where you're going to see a lot of change because for us, it's, you know, working with a lot of um, typical, regular golfers. It's, it's a, it's, it's, it's a challenge to explain it, right, because Manny might come into a golf session and they look at men and they think he's a PT. He should be working. He should only work with me if I'm injured or, in pain. But actually he might come in and look at it. Feet mechanics kind of the tires of that car analogy, right? Because the tires might be costing the transmission to work really poorly. And so, so that's, I think what we believe is kind of the future of, of is actually having a recovery specialist and trainers working in performance uh, not just in pain and injury.

Mike 37:29

I, I wished I could pull something up on my screen and show you Leo uh, Manny, you know it, but there's a good friend of mine. Mike Reinold. I'm from the Boston area and he's he's actually in spring training right now with the Chicago white Sox, but he worked at the red Sox, big baseball guy. And he's writing an editorial for the international journalist sports physical therapy this month. And I was running for precedent for president. He's going to be great cause he's kind of trying to bring things back to a, if he wins. Uh, But I, I highly endorse him to let's let's get back to what our roots are and you're gonna like this Leo, the title of his uh, his editorial for the journal this month is coming up. I'll make sure you get a copy of it, but he says physical therapists are trained the wrong way, or we're trained. We're not trained to look at the right thing. We're trained to look at function, but we probably ought to be looking at performance. That's bigger. That's a bigger picture to look at. Not just, Oh, well, I can lift my arm up overhead or function functional, this that we need. That's the theme of his little editorial, but performance is the answer. So when you say that Leo, that's exactly right when somebody comes to Manny and they're thinking, well, yeah, he'd worked with injury and does which he could do, but do it. The real answer is just getting somebody back to function. Isn't going to solve the problem. It's about performance.

Leo 38:43

Yeah. Because that's where the injury is actually happened as well. So you can catch it early. And I assume that it's not the running for president in, in, in a PT setting, is that

Mike 38:56

at that with the Academy of sports, physical therapy. So with the American physical therapies we have an Academy of sports, physical therapists, and there's an election starting in April. So I encourage people to vote for Mike Ronald, but he's uh, he's bringing it back saying we've kind of lost maybe our vision, a little bit of what is we should be doing. And he's not saying don't do research or do other things like this. We need to give back to try to restore, not just function, but bring people back to the highest level of performance because you're right. That's where they get hurt. Yeah. That get you the baseline, but that's not where people are functioning at baseline. They're fluxing up at this level with performance.

Manny 39:34

And I think you, you mentioned something too about, you know, acute injuries, most often acute injuries resolve on their own. Right. But if, if there's a a reoccurring mechanism, just like the golf swing, especially when you put, a schema or a thought behind how their body is supposed to move, and then you put physical limitations that acute injury is going to come back. Right. It's just a matter of time. Right. Right. Yep. And, and my question is, is, is, you know, you've been in academia for a very long time. Have you seen a a change in academia towards looking at. You know, human movement, human potential in a greater sense, versus just looking at, you know, the local tissue area that's injured. And, and how, how can we continue to move that forward in the profession?

Mike 40:15

I actually think that's a great question. And I think this one I've been kind of a naysayer to your question so far, Maddie, what'd you say I'm living this and I actually think we're making strides that we're doing better. And, and let me tell you what's happened with this one and I've been fortunate to be involved a little bit for you Leo in the American physical therapy association. So that's our national organization. They, they, and I'll get, I'll make a real quick to your answer because the answer is, yes, it's getting better. They did a survey and this has been probably five to six years ago. And kind of to your point, Leo they surveyed external people to our profession, physical therapy profession. And the question basically was variation of this. What is it that a physical therapist does. What was it, but they did physicians, nurses, physician assistants. They did other people as well as patients. And the answer they got her back was quite alarming. It wasn't what they thought at all. They basically got quick answers, like, Oh, a physical therapist uses an ultrasound machine. A physical therapist makes me walk and parallel bar helps me walk. They, they do stretching exercises, but all the answers, if you think about it could be summarized as tools that a physical therapist would use, not what they do. Now. I'm going to flip it around a little bit. If I changed that question and said, what is it that a dentist does? Well you'd know right away, they deal with teeth, teeth in the mouth. What is it that a cardiologist does? The first thing that comes to your mind? When I say, what does a cardiologist do? Wasn't they used a stethoscope. They have a blood pressure cuff. That's, that's not what you thought they do with the cardiac system. What is it that your neurologist does? Oh, they do reflexes. No, that people have a pretty good idea. All these professions, physical therapy has a huge identity crisis about what it was. So the, the, this time, the board of directors and the elected officials said we need to rebrand the identity. And the quick version is that the ELA, the five second elevator spiel is what is the physical therapist? Does physical therapists are experts in human movement. We're experts in movement. That's what we do well. Okay. That's real easy to say and give you a little one sentence, vision statement. That's what we do. If you really believe that, then you got to go to the next step. Well, actually two steps. The next two steps. If I believe that movement's important, then the next logical question I would say is how do you assess movement? Well, that's what you guys are already doing in your business. That's what you guys do. And when people, you take new clients on what you don't look at a joint use, look at total body what they're doing with movement. And then once you could identify movement patterns, turns that are dysfunctional, then this is the harder question. What's the most, what's the best or optimal way to restore proper movement patterns. Well, again, that's what you guys do every day with your clients is your identified and fixing. So the fact that at the national level, that has been pushed out, that they want to do it. And this is at all levels of physical therapy. It's not just musculoskeletal, it's POM, everybody's buying off on this. Uh, We'll see it start to change. I think that driver, the ultimate driver of this, and fortunately we don't have to live in this world every day is I think it's going to be insurance industries uh, that is going to drive it because right now insurance says, well, let's movement. How do I, I'm not reimbursing that. I'll reimburse you. If you have a ligament tear, A written versus a torn meniscus, but they don't understand it yet. So there's a, there's a paradigm shift of education, but the good news is people like yourselves are working with clients and people from the ground up. And the top is bringing it down top down, trying to educate and, and the, the there's three stakeholders that really have to buy off on this. And the one that's the hardest, the one that, where we work with, but the stakeholders are going to be researchers. Well, that's going to, that's already changing. So some of the big, not that it evolves us with golf per se, but, and IAH or big grant giving organizations, they now will ask when you apply for money, how is this going to affect the human movement system? The new, sort of the new buzz word education, that's going to be important. Education's the easiest one to change. And the reason it's easy to change, you just change the accreditation standards of PT schools say you have to teach this in your program. So that's being done or has been done. I think most schools are gravitating towards that. And then as the clinicians are out there, and unfortunately that's the 95th percentile, it's already the practicing clinician. So we have to change their mindset and that's going to be a slow process, but where I think it's going to change, it will be the insurance industry, because if they're not getting reimbursed for the stuff that's not working, they're going to have to change the way they practice. So I think so I think we're a lot further along on that one, when you asked me than the other ones, we've, we've sort of hit on.

Leo 44:50

That's good.

Manny 44:51

That's awesome.

Leo 44:51

I kind of want to shift gears here a little bit. you know, we talked about golf coaches and, you know, we have almost, I think, 18 full-time golf coaches now, which is crazy. And what would you tell them? A coach that doesn't necessarily have a background in anatomy or understanding of the body. Like what's the best and easiest way to get, get started, you know, to understand mechanics, to understand the body, how it works, because I think that can be, there's a reason why the coaches aren't doing it. I think it's because it's intimidating. It's, you know, kind of starting over. Well, what would be your advice to a golf coach that wants to kind of learn more?

Mike 45:33

Yeah. That, well, two parts. One is to your question. I think you hit the nail right on the head. That is the issue. Leo is exactly what you said. It's in, they're intimidated by it. Good, but I'm going to tell it to me. If you came up to me, Leo, and as a, as a great golfer that you are and started talking to me about golf swing and some of the swing mechanics I'm going to be in, we wait to get into a deep discussion about risk mechanics and I'm going to get lost. So I'm intimidated by you. So we've got to lift that barrier down a little bit, and I try to do it is when I talk to golf coaches, I don't want to overwhelm them with everything I know about a shoulder or rotator cuff. I'll just talk about basics and cause I don't have to convince you. I'm not, I'm not out there to convince that golf coach that I'm good at what I do or anything like that. It's all about the client. It's all about what we can do this client. So I just speak in sort of very generic, try to, and I know this sounds bad, but I can't think of a better phrase to use right now. I try to dumb down the anatomy a little bit and talk, but I don't make up anatomy. I'm going to use the right things, but I don't have to get into every little detail about how muscle works and where it inserts and the innovations and all that. Just sort of talk them about that way. And then I might even. To, to ease my golf pros, but sometimes I don't know the answer to this. I'll ask them a question about a muscle. And I say, how do you think that knowing that the muscle, let me share the muscle, does this, how does that affect the golf swing? How do you see that affecting a golf swing? Because that's what I'm kind of interested in. And I put it back on them and then they start the wheels, start turning a little bit with it and you start building that working relationship. But if I come in there and try to think that I know everything about a golf, which I've known golf swing and the anatomy I've lost that golf coach, they're not going to talk to me about anything. So I try to keep it on a very collegial level where we learn from each other and I let them know. I'll tell them on the onset, I'm here to learn from you. I want to learn. I want to watch a lesson. I'm not here to critique you. I want to learn from your lessons because that physical therapists need there's a lot more of that. We need to learn as physical therapists about it, working with the golf pros. I think they're better in tune to what's going on than we give them credit for in a lot of cases. Yeah, so it's about that develop. So I didn't give a great answer, but it's that collegial, developing that collegial relationship, unfortunately egos oftentimes will get in the way with that. And that actually is you brought up Leo earlier. I think that's the issue on the PGA tour to a little bit with that, but that attitude's going to change. Cause it, cause what happens is somebody else is going to get into your system like you guys have, and they're going to have success, which they already are, and word is going to travel like wildfire. And you're going to get to a point where you guys are getting there. Hey, I can't take on more clients. We don't know what to do at a great problem because you're doing the right thing.

Leo 48:17

I feel like TBI is still the best resource to get started it, you know, because there's a lot of these tour player or tour coaches have gone through TPI, but they're not necessarily. Continuing that that path, is it still, you know, the, the best way to, to get started, do you think,

Mike 48:34

and I, again, I'm going to give disclaimer to everybody listening. I work with TPI. I teach in the medical track with TPI. I don't own TPI. I'm not a stockholder and timeless. And so I, so when I say this, I, I can give it a little bit of discerning. I actually think they're, they're the best approach globally to get into the game of golf and work the game of golf. And I'll tell you what, what impressed me the most is I've been to, I've been to most of the systems that are out there and have analyzed them. And there's good in all of them. There's little pearls. You can draw from all of them, but it's when you start getting into the Hocus Pocus side of things. And the thing that always impressed me with Titlest was, and TPI with Dave Phillips and Greg Rose is that they were open source. Back to my drive. The why I'd ask questions about the hip and how much they said, look, we don't have time to look at the hip, but I'll tell you what, you know, we have 12,000 3d scans. You want to go pull our database and pull them out and look at them, have at it, you hear that here's all the data go minded if you want. So they were, they've always been open source to me. Like nothing was hidden. That there's the thing. And they'll tell me if they don't know something, well, let's go figure it out. So I think one of the things, I think, where the problem is is it's a lot of people early on went through the TPI program and maybe still today went through it. And, but I don't think they went into it, not talking about it and everybody, but a small percentage that are not open-minded. So they learned it. But so. And I'm all about like you guys, you know, I know you pull that eclectic the best of the best and can rationalize your vows when we look at it. But even though a lot of those people have gone through the TPI program, if you go out on tour and I'm, I'm out there quite a bit different events, I never see anybody going through it. I don't see people, you know, doing prevention or rechecking a screen. I rarely if ever see that, where people are doing that. There's the guys that Leo knows. Yeah. You were talking about you and Manny that said, yeah, there's two them are there. I see them doing it, but I don't see the other guys doing it. And the same thing with the trainers, there's a lot of trainers on the road that we're, it's a small group. We all know each other they're out there doing it. They don't all embrace it. Some of them have their own little spin off things. They do some good, some bad. And I think again, without getting into real specifics, I think that's where ma Leo, you were saying, look at what's going on with the PGA tour. You've got some big name players coming down with injuries and some of the injuries they're starting to have, or. This past year that we've seen with injuries are, or two years, really for that matter. They're, they're kind of overused related. They're not, they didn't just step on a rake or twist their ankle or do something get hurt. The things that were developed for other reasons that they ended up.

Leo 51:19

I just got to say before I hand it over to Manny, isn't it amazing. I mean, this sport, you play, you play this sport or the club in your hands and the club is attached to your body So you would think logically that the body matters and, am, I might sound crazy, but I know all these coaches that coaches the best players in the world, and they don't think that that's a a given. Correct. And, and so therefore when we get players come into our facilities, And we have tour players. We have top five players in the world and things like that as well. And they kind of understand it because they've seen it a little bit more, but, but we have to have that conversation, you know, like, Hey, you know, you're holding the club with your body. So the body actually matters in your performance. And there's a lot of resistance still to this day.

Mike 52:11

Yeah. I was going to say, I don't generally in my world and again, hip injuries part of the body, I call it the transmission of that club to the body. The way a lot of these guys on tour get to us is through their agents. It's not coming from their coaches. It's not coming from the other people crazy. And so the agents, because we see them from other sports, so the agent will say, Hey, can you so-and-so is going to come in and see it. And so now we have to have that discussion and you're, you're dancing on very thin ice, oftentimes because I know who those coaches are. And I know as soon as you say something, that's going back that, I mean, after write up detailed reports and. Great tactical tap though, what you say? Because I don't always say what I want to say. It does put it that way, but you can maybe make baby steps maybe if, as long as we're going forward a little way, but I've seen some crazy training techniques being done with at least one group that's out there and look at the players. They're having some crazy injuries too.

Manny 53:13

And I think that's why I'm so excited about, you know, where going. Um, Obviously this company has been very successful and it's going to continue to be successful, but the way that the culture works now, the way the teams work together, I think is, is the best it's ever been in Leo. Obviously you can, you can say otherwise, but I think, I think the teams in the departments are working so much closer than ever before and. Uh, I think, I think you said when it, when it comes to, you know, what the, how to resolve a lot of these issues with egos and personalities is really making it about our client. And, you know, our process is pretty sophisticated, but at the same time, it's very simple, right? Our process is making the client as good at golf as they can and do it in a safe way. Right. Do what's best for the client. And sometimes that, that involves a coach saying, Hey, you know, it's not a swing issue at this point. We need to understand your body. We need to get you feeling better, moving better before we can move forwards. And I think when you have so many different perspectives, so many coaches, so many professionals, I think when you center it around a client, right. And a lot of these egos can kind of hopefully go away when it comes to the. The recovery side, you know, it's, it's crazy to hear that as a lot of coaches still, especially at the higher realms, that that don't understand the body. And we're, we're bringing on young coaches who are getting very intense reps, understanding biomechanics, understanding the body. And we're starting to see some pretty, pretty significant changes as far as reducing injury. Do you have any advice for new PTs coming into this situation or this company and, and working in this industry with other

Mike 55:00

professors, I'll give you two, as I was thinking of a phrase, I like to use a lot of times, Manny, that you were talking about the company and how you guys work, and I've sort of touted the limited, I've sort of seen from Nashville, what's going on in Los Angeles or the orange County area with your company. And as it's growing, it's you sort of have that a three-step process. And what I mean by that three things that make. Give you this successes that you guys are seeing as a company, it's the people, and you said two of them, and I'll give you the third one, which goes, it's a logical extension people process and outcomes. I said, you guys have great people in your system. Okay. Well, that's good. You even said off air, we talked, but you just brought it up here. You have a process and you've been perfecting your process, or I kind of liken it this way. You've heard us talk before you have a system that works for you because where people get in problems, golf pros, especially is when you deviate from the system. I mean, stick to your system with what you're doing, trust your system. There's going to work. And by trust that, then you have outcomes. Well, that's all your clients. I mean, you know what your clients are doing, your, your pros when your system are doing that. So to a young person, what I would say. Is a couple things. And, and again, I don't know how the company is sort of set up with this, but go and observe, go learn from people with, as observed, take the classes and don't, don't, don't try to reinvent the wheel, go learn from the best. That's what I've done. I mean, I say Latin go, I want to go see what they do. I work in hip. I'm very fortunate that with hip surgeons and some of the others that I know a lot of these people have been all over the world, seeing other surgeons, what they do or other places and pull the best of the best from it. So I would find some as a young clinician is volunteer and observed, but latch onto a company that has a system, a proven system, and learn dismiss them because it won't work otherwise. And, and if you think you're an Island or you think, you know everything and step out, it's not going to work it. We know that's not going to work time again. People think it will. And that's, that's basically in your world. It's all your team or that way, it doesn't matter. We have to be talking about a therapist now, or it could be a trainer or even fitness it less. They have that whole team around him with the client being the center or the analogy we use all the time is the formula one, or I'll use Southern phrase here, NASCAR. So we have our NASCAR teams with it. You have drivers that are really good, but Hey, the driver is only as good as that car they're sitting inside. And you guys that work on that car they're specialists all the way around there. We've got tire changers, we've got engine guys. We have the gas guy, whatever, all those guys have a role on the team. And if they're all working together, that driver has success. Same in golf. You guys got a multitude of, of specialties as a multidisciplinary approach to the game of golf, which is how it should be reality. It is most of the people that are successful on PGA tour. That's how they work. They may not have that. I can tell you for a fact, that's how they work. Now. Granted, there's some rogue people within those teams, but there isn't a single guy out there that I know that only has one person giving them advice where you run into problems is when you get conflicting advice. And that does happen. You guys don't have that issue because you have guys that don't have egos and you can work well as a team and blend. But I think that would be my advice to people is for young people to go find that system and get involved with people that have, have that proven track record. That's where you're going to learn and then check your ego at the door. Yeah. Yeah. Well, and be a sponge. Exactly.

Leo 58:32

Two things to kind of wrap up here. We're running out of time. I'm realizing that we could go on forever. One, we should probably do w we'd love to do another episode, just talking about the hip. But secondly, you know, I've done this a lot where we go to a charity tournament and we're involved somehow. you sit a full day on one hall and me, both me and Mandy have done this and you look at 140 players tee off on the same hole for nine, 10 hours. That's probably the most powerful thing that, that I, that I think you can do to understand the golf swing and the physical and how much the physical limitations affect the golf swing because 140 players that are, you know, mostly just regular golfers. Every single golf swing is determined by their physical makeup and mostly hardware. I would say a hardware issues and every, almost every single one of them think it's a software issue, meaning they don't think it's the body. That's making them come over the top and slice it 50 yards every single time. They think that they need to work on the software, work on technique and the, you know, basically creating better motor learning in their brain so that, you know, update the software. So if you take those 140 players and you can only prescribe three things, what, you know, and, and I did this Arlene, my career, I created the big three. We call it the big three. It's basically hip T spine, an X factor. As you know, if I had a thousand golfers, I would prescribe that in a program. What would those three things be for you?

Mike 1:00:12

It's funny. Can we just play that back? Just go back and go back last 30 seconds. Yeah. We went, mine's going to be exactly the same thing or variation of it. Hip T spine and interaction of the two I'll put core, I'll flip it up to core, but it is X factors. What you're basically we're doing a hundred percent would say, that's it. And then, and then it's that mobility stability within, but most people have the mobility restrictions, the young kids we work with, maybe their stability, but, but most of them are that. So I'm going to say exactly that hip T spine X factor core, whatever you want to call it. The rubber band in between. Those are my big ones right there. Oh, great. One of the things you said that was great back to Mandy's question with this great piece of advice again, for the young people, I was just thinking what you said, and I hadn't even thought of it in that realm. A lot of times I'll tell students like this week, we're talking about gate, we're doing stuff in orthopedics, foot and ankle stuff. And I tell people it's funny, how parallel does parallels with Leo. I tell them, you know, this weekend, go to the mall, just sit on a bench at the mall and watch people walk. And you're going to see all kinds of strange things with people's gait and how they do stuff and just start, but pay attention to what you're looking at. I couldn't think of a better piece of ice to the Leo said, if you want to learn a little bit about the golf swing and do it go to these events and just sit there on that tee box and watch just watch people. That's exactly right. And you're going to see all kinds of things.

Leo 1:01:36

You can't walk away thinking that they all need better golf instruction. It's just not, that's not what you think about because it's all these injured bodies pain, you know, they're, they're you know, you can just hear it and see it. It's so clear in front of you.

Mike 1:01:52

Let me tell you this, Leo, I've got one for you though, that when you come to Nashville and business yeah. And I'll make it quick, but I can, I'll give you one example where it's probably more, so they need some instruction and in Nashville, lots of the entertainers have golf outings, golf tournaments in there for charities and do those things like you're saying, but the perception years ago it could be 25 years ago was that it was a male dominated activity. So all of these guys on music row would go to their golfing, but females were always left out and weren't included. So one of the guys on music growth and several years ago started an event it's called the women of music row golf tournament. And it's only for women it's one day a year. And they they're now in all of these tournaments, they can play, there's no gender issue, but they have one just for the women in August and they come out and then they spit. And basically they get a day off of work with, this is what it ends up being. You go sit on the tee box there and watch that one deal. You might have a little bit different approach on that one. No, not a hundred percent. The way we make it for it's fun for them. So they try to join the game of golf. We have what we call shots sabers. So every, every tee box has a. A reasonably good golfer on it and it's all for charity. So the women, most of them they're just out to socialize so they can step out of the tee box and give you a dollar or$5 if their tee shot for them and then go chase it. But I'm laughing when you said, for some reason, that's in the back of my mindset. I do know one where they might need to

Leo 1:03:19

touch. I hear that a lot too. And the industry is like, you know, only focused on the, but that's not, that's not really not the case. Right? The key is to work on all of it at the same time. That's where you know, that's why we have it under the same roof, because it becomes so much more powerful when the team is also communicating and are actually incentivized to work together. Like the, the tour players. Unfortunately they have PT co coach and Trent, they're not necessarily incentivized to communicate very much. And then, so it actually becomes a little bit scattered in the, in the, in the, in the development.

Mike 1:03:58

No. What you're saying is exactly right. I would say this for your, your people now and why that system works really well. Again, if we go it alone, two things are going to happen. If, if I'm a golf pro and I go along and I'm trying to teach you something, maybe it's my swing or my way of doing it, or this that, what you're ultimately going to do is potentially set that person up for an overused type of injury. If their body can't handle it. On the other hand, if Manny and I take a client and I start changing your shoulder range of motion, your hip range of motion or whatever. And I don't talk to the golf pro and let them know what we're working on at the same time. Now we're going to start doing compensations. They're gonna start swinging at different. Ultimately can lead to injury again as well by themselves. You may get lucky and it, and there will people that just ride as the top. Naturally, they're good athletes by large. It doesn't work your approach where you work it together and you use another buzzword, which is a whole nother topic. Is. You've kind of writing the program as you go. And the longer I go independently, you start to write new motor patterns in the brain. And unfortunately we don't know enough about it with this, but I can tell you that in many cases, if I do something and you start to compensate in your brain for a new golf swing, we may never be able to change that once you write a new pattern. So I'd rather work with I've had, I can tell a player and we've Amanda, you've probably heard it level three, and I can say it cause it's not a HIPAA violation. Everybody knows you had a problem. Did it, but there was a day at Titlest. Phil Jacobson came in having hip problems, He was having hip problems, but he came in and he was losing distance. He was losing distance off the tee and Greg Rose didn't do a full assessment on him right there and said, well, let's get a 3d assessment on you. Let's see what's going on. And we looked at the data, the curbs that he had and his hips. Weren't moving that much. And so the question to him is what's going on with your hip and he's Oh, but this was this was in the summer sometime in summer, late summer. And was uh, Oh, this is right. Yeah. We've got arthritic changes in my hip. I'm going to get a total hip in November. I'm just going to play it on out. And we both all looked at each other and said, no, you're going to get a total hip next week. We can get you in tomorrow. And he's like, no, I'll give you a 10 million reasons why I'm not going to do it tomorrow. But you had all kinds of appearance money. And while we came up and said, we is, we might be able, that might, you might be able to play it out, but I can't guarantee you that when this is done, you're still going to play golf because you're going to develop all kinds of compensations right now that we may never get on done. Let's fix the problem and get your swing back. And I think it was maybe 10 days later, you had a total hip done, but there's a reason you're saying you developed some of these compensations without that team approach. You could make some things that may never undo.

Leo 1:06:41

So, so some of the takeaways that I'm getting is. You know, I'm just thinking of now about regular golfers and golfers that are listening and golf coach is actually, maybe the place to start is the big three's the hip T spine and the relationship between the two. And that's a, that's a simple place to start and that covers most of it. Right. And so, so that, that's what I would recommend if you're a golfer and you don't know what we're talking about right now is go see a professional and, and start working on the hips and the T spine and the hip. Because if that functions well, then your golf coach can help you in a better way

Mike 1:07:23

if those function well, I, and I'm, I'm trying to think of a number. I don't want to throw a number out there cause somebody will hang on whatever number we say, but we could all say probably would, all three of us would agree. You fix those two things or straighten that out and get it working. Well, I bet 95% of the other stuff goes away. And they're just the extension, the shoulder in the armored extent and club or the extension, what you did for your pelvis and your thorax. Yeah. So I don't think the rest of follows along. Yes. There's a fine tuning to that. We'd want to look at those are your, you want to change your game right now? Go with your big three and you'll change the game. cause you know, for sure you, you address I'll change one thing. It doesn't mean you're putting is probably going to get any better Tia from tee to green. Your game is a lot better. If you take care of those two or three things.

Leo 1:08:09

That's right. That's right. Well, this was a, this is, it was awesome. And thank you so much for taking the time. And like I said, I hope we get to talk again sometime soon and we have so much to talk about,

Mike 1:08:21

love to do it. Anytime guys, I'd love to help out.

Manny 1:08:24

Thank you, Dr.