When Rehab Becomes Real Performance with Dan Braun

We sit down with Dr. Dan Braun to talk about training that actually moves the needle, from breaking plateaus with simple strength work to using isometrics with a real plan. We also dig into return-to-sport decisions, why rehab often stops at pain relief, and how sleep, breathing, and nutrition quietly decide your outcomes. 
• simplifying training with push-ups pull-ups and dips as repeatable anchors 
• using single-leg loading and tempo to train hard on low-readiness days 
• translating academic research into coaching language without losing the point 
• defining isometrics beyond trends including overcoming vs yielding 
• common isometric mistakes including random “sprinkling” without structure 
• go-to isometric exercises including flexed arm hangs and hip flexor holds 
• building a holistic base with nutrition sleep breathwork and travel routines 
• supplement routines with creatine electrolytes caffeine and comfort in the gym 
• shifting from solo clinician to multidisciplinary team for better rehab outcomes 
• bridging the gap from return-to-sport clearance to return to performance 
If you want to get your pre-workouts and your creatines, any other supplements, go to Perfect Sports, use the code AP15, save 15%. 

Transcript

Results Over Credentials

SPEAKER_01 0:00

I don't think people really care about how nice you are or how many letters you have after your last name or you know how whatever, how you dress, whatever. I don't think they care about any of these little things as much as they care about do they get the outcome that they're after. And if you deliver outcomes consistently, then people are going to flock to you in numbers because you can get the job done when they need it.

Breaking Plateaus With Simple Training

SPEAKER_00 0:26

You're the most decorated racquetball player in US history. World's strongest man from childhood passion to professional athlete. Eight-time Iron Man champion. So, what was it like making your debut in the NHL? What is your biggest piece of advice for the next generation of athletes? From underdogs to national champions. This is the athletes podcast where high performance individuals share their triumph to our lifeless to educate, entertain, and inspire the next generation of athletes. Here we go. This will be the 282nd episode of the Athletes Podcast, though. Dr. Dan Braun, welcome to the show. Been working on getting on for a few months now. Someone who I've been following specifically in the isometric space space, that is, and someone who I've been analyzing, observing you increase your dips and your pull-ups substantially over the past few months. Is that because of the isometrics, Dan? What's going on, Doc?

SPEAKER_01 1:24

You know, it's hard to say. I think you come to a certain spot where you're just willing to try anything when you've plateaued for a long time and definitely worked some isometrics into it and worked a lot of just hard styled training into it and just grinded out a few new PRs, which at the end of the day, that's what it's all about, right? You know, you hit a wall and you decide I gotta break this freaking thing down and find a way to keep moving forward. And that's what I did, you know. Outside of pull-ups and dips, I like to say I'm a very average lifter, but those are the two that people seem to struggle with. So I'm I'm thankful to be good at them.

SPEAKER_00 1:59

It's probably a good one to be able to showcase to people hey, if you just put in work on these two lists, you can still see incredible results. Dude, I look at your arms, even just over the past few months, I feel like they've gained a couple inches. Fact or fiction?

Smarter Leg Work With Single-Leg Loading

SPEAKER_01 2:13

I haven't measured, so I can't answer that. But I think ultimately, to your point, a lot of times people overcomplicate this fitness, performance, rehab, all three of these spaces when I tend to follow the simplest path forward. And ultimately, for me, when it comes to the upper body, I believe very strongly in a trio of exercises proposed by Bobby Maximus, phenomenal individual. I think he's out in Utah that way. But back when I was in college, I did kind of what he called his holy trinity it's push-ups, pull-ups, and dips. And if you get good at those three, everything else is a check. So lately, with me traveling a lot on the road, just all over the place, it's like I need the simplest form of fitness and performance enhancement for myself that allows me to feel good, move good, get about my day, but you know, do so in a timely manner. So push-ups, pull-ups, and dips have kind of been the magic RX lately for me. Legs are just overrated, eh? We train them. We do train them twice a week. You know, lunges are probably my go-to there lately. And I think having a really good structure to a leg workout can really change everything for someone. I think a lot of times we underload the leg, and I really like to load them up heavy on one leg. Uh, you know, I've got a history of some lower back stuff and just terrible hip mobility that way, which maybe genetics played a part in that. Maybe grad school and sitting at a computer for eight hours a day impacted that. Whatever it is, I just try and find a way to work around it, train around it, and continue to provide a good stimulus where we need.

SPEAKER_00 3:55

I feel like I've read some research recently that talked about the fact that you can get a pretty I should say a much bigger stimulus doing individual legs as opposed to loading both up at the same time because you have to go so much heavier. True.

Turning Research Into Plain Language

SPEAKER_01 4:10

So it's that classic it depends kind of answer. I think there's something very, very powerful, powerful and impactful about a heavy loaded double leg movement, right? I don't care if we're talking squat or deadlift or whatever pattern we're talking that way. I think if you load it on two legs heavy, there's good things that are come gonna come from that. I don't think you can just do single leg work, but lately for myself, you know, I kind of look at things in like ratios that way. And maybe traditionally I'm like 60-70% double leg and 30% single leg. Lately I've gone more 50-50 and I've pushed a little bit more in the single leg bucket. You know, it's like, hey, you know, we were on a flight, we were coming back from Phoenix, we were on the red eye back to North Carolina, and it's like, you know, I'm gonna train the next day, but I know I'm gonna feel terrible after four hours of sleep. So it's like I need to get an adaptation, but I I also know that if I jump under a bar with 405 on it, it's not gonna feel good, it's not gonna move good, it's not gonna look good. So that's when I'm like, hey, look, I can get a good training stimulus and adaptation from you know some lunges. Maybe we start 135, work up to 225, and we just get a little bit more of a single leg kind of stimulus in, right? Or maybe I go even lighter than that and I just adjust the tempo, or I play with some pauses, right? Like ultimately in training, everything has got a dial, and it just matters which one you turn up and which one you turn down and when you do that.

SPEAKER_00 5:41

Yeah, and you've obviously heard from what sounds like 500 plus people on Braun PR, Performance and Rehab, your personal podcast that you've been able to highlight, trainers, athletic therapists. I imagine, well, I know for a fact that you're a doctor of physical therapy. I threw on the tie to make sure I looked a little bit legit for this podcast episode. But more than anything, like through those conversations, you and I, both guys under 30 years old who are grinding in this podcast space, learning in the athletic world. You obviously have that academic knowledge behind it, but you're applying it physically as well. Another guy who I have worked with in the past and continue to try and get involved with prescript training, Jordan Shallow, similar space. He does not necessarily look like an academic, yet he will throw around words that 90% of the population will never be able to understand. How do you dissect and go from the academic world to then real life training and allow for people to understand that maybe through a podcast so that they can absorb that information instead of just going and pushing wait?

SPEAKER_01 6:46

Yeah, it's interesting because to your point, in academia, a lot of times we reward complexity. And I personally don't love that, right? We think the more complex something is and the more difficult it is, the better it is. When I could not disagree more, I like simple. So I'm always going to try and take the most complex, abstract idea you can think of and simplify it to the form that anyone can understand and comprehend without diluting the initial message. And that's where the magic really comes in, in my opinion. A lot of times people can simplify stuff, but the original message gets lost and it becomes a game of telephone, right? You hear something, but ultimately you hear what you want to hear instead of what you should be hearing. So for myself, I love analogies and I'm always learning new analogies from other people who are far smarter than I am that way. But we all play that same game of how do we take this ridiculous, complex thing that you just read about in a journal article and deliver that to your clientele who needs to be able to understand it, but they don't have a PhD and eight years of school behind them or whatever it is that way, right? Like, you know, they have a bachelor's or they have a master's, but maybe it's in engineering, maybe it's in business. It's not necessarily highly specialized in health and medicine that way. And on top of that, there's so many different misconceptions, I think, about health and medicine that way. I've heard all kinds of crazy things. I mean, everyone knows about the classic rotary cup instead of a rotator cuff. Just the other day, I had someone ask me if the QL, quadratus lumborum muscle in the back, was actually the, oh, what did he say? Quantum labrum, he said. And I was like, I've never heard that one before. I don't know where it came from, but in this information age, people are hearing a lot of different things now. So you ultimately are not just explaining things from your point of view and your rationale, but you're also potentially proving or debunking some of these other things that other people have heard as well. So I think ultimately the more clearly you can communicate with someone at a level that they can understand that does not dilute the initial message becomes the key, whether you're talking a podcast or working with a client or athlete in person, whatever the case is, I think it all comes back to that communication loop.

SPEAKER_00 9:22

Yeah, I think the communication is just the key to life at this point. I've heard that enough. It seems like a common theme throughout, whether it's podcasts on health, fitness, wellness, whatever the case may be. You also get the people that are like, oh, just go lift weight, go to the gym, push heavyweight, get stronger, and you're gonna develop a better physique, you're gonna develop a better body. I think of like a Jeff Nippard now out there in the world who is out there as the scientific lifter trying to optimize everything, get the best stimulus, maybe not the rough, tough metal barbell, just go out and rip plates off the floor. Do you find that it is tough to get people to adopt the academia at times, or do you, like you said, just dumb it down to a point where everyone can absorb it?

SPEAKER_01 10:08

I think it really varies because ultimately on the academic side, every study you read is probably going to end with the phrase more research is needed. So ultimately, even when we've done a ton of work and we've poured billions of dollars into research and understanding complex topics around health, performance, medicine, we still are not satisfied with where we're at, and we're still learning new things constantly, every single day. So ultimately, I think to a point, you need to understand the science, you need to stay up to date on the research as far as where are we at as a whole on our learning journey. But the art becomes how do you individualize that to the person in front of you? And that is not always the most scientifically correct way to train, right? If I have an athlete that I'm working with and maybe they have a catch-all diagnosis like jumpers knee, right? We've got patellotendinitis that we're dealing with. Well, maybe I go to the research and it says, hey, the Spanish squat is the best exercise for patellar tendinitis. Well, what if they can't do that? What if it's so painful or the form is just so atrocious that that exercise is not happening? And instead, I have them do a leg extension isometric, right? Kick forward, hold it. Don't move. Cool, easy. They can do that. Maybe that's number five on our list of best exercises for bateller tendinitis. But from my standpoint, if it's the exercise that they can do, I'm bumping that right to number one. I don't care about the ones that they can't do right now. We might get there eventually, but ultimately you have to keep the main thing the main thing at the end of the day.

Isometrics Explained Without Hype

SPEAKER_00 11:56

Hey, you mentioned isometrics. I mentioned at the beginning of this that's how you and I kind of initially got connected through Brad Thwarp ISOFit. I've got one sitting here. I'll pull on it occasionally if I don't have time to get in the gym, like we talked about, quick five-minute workouts. Are isometrics the most underrated tool in strength training right now?

SPEAKER_01 12:17

It's a it's an interesting question. I think isometrics are very trendy right now, but they've been around a long time. They're not brand new. I think for a while we kind of forgot about them and we overlooked them. And now it almost feels like we're kind of coming back to them. And I do use them a lot, but how I use them varies greatly. And I think there's a lot of different types of isometrics as well, which people typically break it up into overcoming and yielding. So overcoming being pushing or pulling into something that won't move, like a fixed bar or a strap or whatever, yielding being holding ISO. So I'm gonna put myself in this position, I'm gonna hang out there as long as I can. Maybe that's a wall sit, for example, right? Where it gets interesting is there's so many different offshoots of them EQIs, functional isometrics, ballistic isometrics, ISO catches and switches. There's almost like a new flavor every month, I like to say. And some of the things that we might have originally classified as holding isometric, like let's say the plank, for example, I personally think of that as more of a pushing ISO, because if you're doing a plank correctly, you should not be hanging out there for five, six, seven, eight minutes. It should be such an active push into the ground with the upper body and the lower body. Like everything should be tight, tense, and driving away as hard as you can that way. And to me, that's that's more of a push into something that won't move, like the ground, than it is a hold. So I think the world of isometrics is very vast. I think we've been doing them for a very long time. I think we're still learning and appreciating some of the different benefits that come with them, but ultimately, I don't think it is the one holy grail that, you know, I don't think you can only do isometrics. I think if you're an athlete, you still need to sprint, you still need to jump, you still need to lift and move weight and other variations and other capacities. And I know someone's gonna listen to that and say, well, you know, like I just all I do is ISOs and it works. Cool, great. If that works for you, that's great. But I've yet to really work with an athlete that I'm like, the only thing they can do is isometrics, period, and that's it for the rest of their life. The demands of sport go beyond just maintaining specific positions. How do you increase force development? How do you decrease force development when those positions are changing, right? It's not so much the rate at which is developed in that specific position, but the position itself, the angles are going to change literally in fractions of a second. So if I'm stable at this position, but I'm gonna move here in less than a second. Can I really say training here and training here is gonna cover all that area in between? Maybe it will, maybe it won't. I'd rather train some movement there than just stick it with isometrics myself. I think the more you work to cover all uh all bases, the less likely you are to miss something.

SPEAKER_00 15:25

What's the biggest mistake people make with isometric training?

SPEAKER_01 15:29

I think a lot of times people go in and they hear about it or they see something new online and they just sprinkle them everywhere and they don't really have a framework in mind or they don't have a periodization structure in mind, right? They just say, hey, look, like isometrics look great. So I'm just gonna start throwing them in everywhere. And I think ultimately you have to have a purpose for every action, so that way every action will have a result. So, you know, if you're looking at a specific problem within your team, let's go down this rabbit hole for a second. If we say, hey, look, working with a soccer team, a lot of groin injuries popping up. Yeah, where are we gonna work it with isometrics in? Okay, well, we'll start with maybe some Copenhagen side planks, and then we'll start with maybe a deep tier lateral lunge holding isometric, and then we'll do this. Okay, cool, great. Like there's a plan in place. It's not as it's not just, oh, well, isometrics are cool, so I'm gonna take these 10 and throw them into the program and hope something works. I think you have to be a little bit more sniper focused with them instead of shotgun focused.

SPEAKER_00 16:37

What's one X what's one exercise every athlete should be doing isometrically?

SPEAKER_01 16:44

So as you talked about before, in relation to the pull-ups that way, I love the pull-up. And I think if you can literally just do a flexed arm hang, which I know some people are gonna say is great, some people are gonna hate on, but personally, I love that vertical pulling pattern of the pull-up. And I think if you can literally start up top and then work your way down and just pause at different positions and hang out there a little bit, I think if you can to pull this from gymnastics a little bit, if you can do that in an L-sit, like an L sit chin up, I think that's also probably one of the best exercises for your upper half, right? We get a phenomenal core workout with that. We get a good hip flexor activation with that, and we work pretty much everything throughout the back and the arms as well. So I'm I'm a big fan of that one. The other one I'm a big, big fan of is for the lower half of the body. Like I said, history of some lower back stuff, just being dumb back in the day. So I love to work more of like a hip flexor, hip flexion strengthening type of thing. So for me, if I have difficulty getting into a deep squat, if I can literally bring one knee up as high as I can standing and just hold it, right? Like literally get that sucker as high as you can, as close to your chest as you can, and hang out there 20, 30, 40 seconds. You know, you you start to get a little shaky because it's like even just standing on one leg for that long, you know, you start to realize, hey, I got some work to do here. But getting into those positions that are traditionally a little bit more uncomfortable or tight or just difficult to get to, finding a way to get to them that is not difficult, that is not painful. To me, that's a huge win.

Travel Training Nutrition Sleep Breathing

SPEAKER_00 18:24

Yeah, I just spent my birthday weekend over on my family cabin watching some Canadian geese stand on one leg all weekend, and I was jealous because I couldn't do that while I was holding my isometrics. But without a gym, I was like, okay, I know that I can at least get some type of response when it comes to a stimulus for my muscles by incorporating some isometrics when I don't have access to my typical gym. How do you, again, in your travel incorporate this? How do you also layer in nutrition to this performance and rehab aspect? Because a lot of people think, oh, I'm gonna train well, that's all I need to do. And then after I'm done training, I can go eat, do whatever I want because I did my training and I should be good from there. How do you incorporate maybe a more holistic approach to this so that people also see the benefits of not only their training but what they're putting into their body afterwards?

SPEAKER_01 19:13

It's interesting because when I first started the podcast and when I first started my business, we actually had the word holistic in it because I was very, very off the deep end in college on the holistic lifestyle side of things that way. And I'm still very intrigued by it. I don't necessarily pursue it as much as I used to, but it's still an element of everything that I do. I like to say it's kind of the foundation that way, right? Like we look at, as you mentioned, nutrition, sleep. We ask about those things, stress management and so on that way. So for myself, from a nutrition standpoint, I'm very, very boring. I have done it almost the exact same way for at least since grad school. So going on about six, seven years now that way, which seems crazy to say. I love an intermittent fasting approach. It works for me. It does not work for everyone. I know there's research for it, research against it, but it has worked incredibly well for me. So when I train in the mornings, I'm always training in a fasted state, which I know, again, hot take because some people are gonna say, oh, well, there's research against that, or I tried it and that doesn't work for me. Everyone's different. It works really well for me. I like going in on an empty stomach because I don't have to worry about, like, you know, the digestive issues when you just slammed 50 grams of protein and all that sort of thing, right? So, anyways, keep it simple. We intermittent fast. We do a meal sometime between 10 and 1 p.m. is usually the first one of the day. And that always contains some type of protein. I personally love eggs, especially if it's close to that 10 a.m. mark, you know, four, five, six eggs, throw it in with an omelet, throw some different stuff in there, right? Potatoes and different things that way in college. I used to just scramble whatever leftovers I had from the night before in with eggs. So maybe it was chicken or whatever. It's just scramble it all together and it worked. Usually do some type of clean carb with that. I've loved uh sprouted grain bread lately, so I'll do that with like an organic peanut butter or something like that, and then Tremona yogurt. Shout out to my guy Atanas. I have that every day. So simple from a lunch standpoint, and then dinner. Lately been doing, I think they call it like the guy dinner or something. It's literally some type of protein and rice in a bowl. And then I season it differently or throw different things with it depending on the day. But it is that formula pretty much every day right now. If I'm traveling, it's a little more flexible. You know, we eat breakfast some days on the road because sometimes you just gotta eat when you can, right? So you control the controllable. As best you can and 80-20 it on the sleep side, I've finally learned through some help of guys like Rob Wilson, Harvey Martin, Andrew Hauser, Luke Way, I've started to pick up on the importance of breathing and breath work, and I've started to learn how to rev myself up or kind of pull myself down through breathing, which has been super, super helpful for sleep, because at the end of the day, I want to hit the pillow and I want to be out within minutes. Yep, the isocapnic trainer, that thing it will humble people. And it's amazing how much we've overlooked the breathing and breath work component. And I think ultimately if you have a good training regimen, if your nutrition is good, if you're sleeping and breathing good, if you've got those three covered, then odds are the stress management side of that equation is almost going to solve itself. Because speaking from experience, when I've had a night where I've slept three hours, I'm still trying to train hard, but I'm eating like crap. Everything is just like a red flag. Any little thing that goes wrong gets a very, very full throttle response versus when I can keep some of those things locked in, even the big deal things don't seem like as big of a deal, if that makes any sense.

SPEAKER_00 23:23

Makes all the sense in the world. I'm the exact same way. It's the biggest struggle if you don't get a good night's rest because it throws off the rest of your day. Uh shout out to Coach Luke Wei with uh ISOCavnic. It's an amazing tool. On a hockey fest is where I was first introduced to him. Uh, we did a little test there. And yeah, humbling is the least the easiest way to describe that outside. You also mentioned breathing. Do you do anything else like crazy at night from like optimization standpoint? I I asked this because I also got sent some VO2 mouth tape that I tape up my mouth at night with. People think it's crazy. I've probably been doing it for five, six years now, and I sleep amazing in comparison to when I don't have access to it. You do anything funky like that as well?

SPEAKER_01 24:05

Yeah, I've played with the mouth tape as well. And in the Biohackers Handbook, which came out a few years ago, they discussed temperature at night a lot, so I keep my room pretty cold. And they also discuss the influence of light, so I like my room dark. And when I travel, I have one of them, again, it looks dumb, but one of them masked things that goes over your eye so light doesn't come in. You know, the hotel we were in over the weekend that way, like it was very, very bright, even with the blinds closed and all the lights off. So having something like that, I was able to get a little over seven hours of sleep when normally it's like, man, when when you got light shining in on you all hours like that, it can be tough. So I think having little things like that provides a ton of value. I also think having a good pillow, having a good set of sheets and that sort of thing, like don't just go to your local department store and buy the cheapest one. Like it's not it's not freshman year of college anymore. It's like, hey, look, like there's certainly value in investing in something proper from a pillow standpoint, sheets and so on that way. So I think you know, actually buying the nice stuff can pay dividends in that regard.

SPEAKER_00 25:23

Yeah, you spend a third of your life doing it, so you might as well optimize it to be a good state in which you're gonna be doing that, right?

SPEAKER_01 25:29

Yeah, exactly. And I I've heard some people experimenting with different supplements around it too. I haven't done a whole lot of that myself yet. I know ZMA has talked about magnesium in different forms like magnesium, magnesium glycinate, I think it is. And there's different supplements like that out there. I I don't really dabble with any of those. The one thing I'm very big on is trying to stay clear of melatonin. I did use it a little bit in college, like sophomore junior year for different things. And I mean it worked, but I just I don't know. I feel like anything the body produces naturally on its own, I shouldn't be taking in synthetic forms.

Supplements Timing And The Placebo Edge

SPEAKER_00 26:12

That's an interesting take. The uh magnesium I definitely have taken. I use a glycinate. I thought I asked Dr. Peter Tierney, who used to work for Lululemon, now helps a rugby team over in the UK. He said bi glycinate, glyconate doesn't matter, but it does definitely help. I can confirm that. I'm tossing back some some perfect sports creatine. They're the sponsors of the Athletes Podcast. I got to give them a little show-to with my protein powder. I don't know. Are you dabbling with any other supplements like that? Like your creatine, your protein powders, what else?

SPEAKER_01 26:42

Yeah, so typically I have a uh pre-workout in the morning, just something zero calorie. I have that before I go to the gym or on my way to the gym. So I guess it's not like truly empty stomach, like there's about 200 milligrams of caffeine, but there's no caloric intake. So I have that, and then after the gym, I take a zero calorie electrolyte supplement with creatine, which I usually do somewhere between five and ten grams. I've been getting closer and closer to 10 lately. I think so. I think it helped play into some of the strength gains, but ultimately what I'm looking for more from it is some of the discussion around creatine monohydrate and the neuro and cognitive side of things that way. Is I want to be on when I need to be on. And if I can't flip the switch and be on from a neural standpoint, that's that's a problem. So I like the creatine for that.

SPEAKER_00 27:40

During why do you do the electrolyte and creatine after your workout? Sorry to interrupt you.

SPEAKER_01 27:46

No, you're good. So a lot of people have told me that they like electrolytes before or during. For whatever reason, for me, I like it afterwards. I've noticed if I'm doing a lift, if I'm just slamming straight water, I feel good and I feel great afterwards. If I start to mix other stuff in, and this is something I played around a lot with in college, is intra-workout type supplements that way. And they just never sat right with my stomach for whatever reason that way. Like I don't like leaving a gym feeling bloated or feeling gassy. Like, I want to leave the gym feeling good. So before workout, we get some source of caffeine. In the workout, it's nothing but water, and it's a lot of water. I usually bring through one of these 40-ounce things across the course of the workout. And then afterwards, electrolyte and creatine, and that works really, really well for me. And I feel great from it. I don't get bloated from it. So, as far as I'm concerned, that's my formula. But everyone's different. Some people are gonna feel better doing electrolyte stirring, some people are gonna feel better pairing creatine with protein. Some people are gonna say there's research that that creatine should be paired with a carb source or something. Like everyone is gonna find a different thing that works for them, and that is perfectly okay. This is just kind of what has worked for me lately, and I'm just gonna keep rocking with it until something changes.

SPEAKER_00 29:15

Yeah. I uh I've I've heard it's splitting hairs as far as when you're taking the creatine timing-wise, but uh now I'm similar to you on the 10 grams or closer to, so I'll go five before with my electrolytes and then five after with the protein. And now the big thing is making sure you don't mix your creatine with your pre-workout. That's the big you don't want creatine and caffeine because those ones. So PSA for those out there doing that. If you want to get your pre-workouts and your creatines, any other supplements, go to Perfect Sports. Uh use the code AP15, say 15%. But you were about to say something there, Dan. I saw it.

From Solo Expert To Team Operator

SPEAKER_01 29:48

Yeah, I mean, to your point, the the pre-workout and creatine narrative, it's it's gonna be different almost every year. Like, I feel like there's a lot of these things that just continue to change over and over and over again, right? Like, to your point, we're splitting hairs, right? Like one year eggs are bad for you, the next year everyone should eat eggs. Yeah, now don't take your creatine with your pre-workout. Next year it'll be fine, right? Like ultimately, I think if you feel good doing it and it's working for you, then we're we're on that, we're on the path that we need to be on. Because while we have a ton of research that suggests all this stuff is doing all these crazy good things and mechanisms in the body, the most effective thing at the end of the day is still a placebo. So if you believe that it's gonna do something, if you feel good, then do whatever it is that works for you. And I've heard of some people doing some crazy ridiculous things that, again, it doesn't necessarily align with what we think academically, but it works really, really well for them. And I'm not gonna knock something that's having the desired outcome.

SPEAKER_00 30:59

What's been the most paradigm shifting moment for you uh that you've experienced maybe when you were researching stuff growing up in school to now what you put out or do?

SPEAKER_01 31:09

Yeah, yeah, I think one of the biggest paradigm shifts for me is actually not necessarily just training or supplement, but more just overall how I operate on the day-to-day. When you graduate and you're announced as Dr. Daniel Brong, you walk across the stage, they mail you your doctor of physical therapy and all these different things. Like, you get this feeling that you can tackle the world and do anything. And within, for me, it was about four to six weeks of full-time clinical work. You hit this moment where you realize that you don't know as much as you need to, and not everything presents exactly like it does in the textbook. And sometimes you need help and you need to look in places that maybe weren't taught in school for help. You know, where I went to school, they did a couple multidisciplinary events, and they brought in orthos and pharmacist students and different things like that, which is great. But I ended up relying a lot more on strength coaches, on skill coaches, on athletic trainers and different individuals like that for help when we needed. And they always came in big time and delivered, right? Which is huge. But ultimately, it's that I I guess you could call it a Dunning-Kruger effect, but ultimately this shift that you think you can do everything yourself. You think you can be Superman. And then you start to realize that ultimately it takes a team, right? Athletes are all on teams. In order to get the outcomes that they want, a win, they need to work together and they need to be cohesive as one. So you, whether you're on the performance side, rehab side, whatever, also need that similar cohesiveness. You know, it's healthy to have respectful disagreements, differences of opinions, and push each other and challenge each other to think differently. But ultimately, you all need to find a way to work together in the best interest of the athlete. And I think once I started to shift towards that approach, and guys like Phil Pliski really helped me to adopt that, just conversations with him over and over again. It's like, how can I literally show up to the table and say, I'm here, here's what I can do. How can I help this person? Am I being called to captain the ship or am I being called to take more of a backseat role? And I need to be willing to play whatever role I'm being asked to play and do that to the best of my ability. And ultimately, as long as we get the outcome that we're after for the client or athlete that we're working with, mission is accomplished. It doesn't matter if I did 1% of the work or 100% of the work. If we all collectively got what we needed out of it and the athlete got where they needed to be, and everyone is satisfied, we're good.

SPEAKER_00 33:58

Yeah, and goal achieved. You mentioned Phil Pelisky, like who are some other individuals? I always give people some space to give others some flowers, maybe who inspired you or who got you into the space, or who you look at now and you admire the work that they do, or up-and-comers, for instance, even that you think are bright people to that we should look at.

SPEAKER_01 34:18

In school, when I was in school, Mike Lair, who was a professor of mine, was a very big influence on a lot of things that I did and really taught me the majority of what I know from an interventional standpoint. He is a wealth of knowledge and has done a ton of research on manual therapy, on regional interdependence, and has done some phenomenal research looking at populations of athletes that are often forgotten about, such as the female field hockey athlete. There's not a whole lot of research on elite field hockey athletes, but he's got a study out there looking at movement assessments and movement competencies in them. I think that's super fascinating stuff. Was also a big fan of Kelly Starrett and Brent Brookbush. I think the two both are phenomenal resources. Kelly, obviously, legend in the space, a lot of great books, a lot of great content. Brent, I love his platform and the way he breaks things down. If you want someone who does evidence-based correctly, he's my go-to guy. I mean, he he's he's challenging in some conversations because he's not afraid to question you a little bit and make you think like, you know, is this truly the right thing? But ultimately, that's how you get better. And I've started to kind of play that same game with myself different times. It's like, you know, almost conduct like a pre-mortem to your rehab program, right? Like, hey, what could cause this thing to fail and fall apart? What am I missing? Have I done enough of this? Why did I not address that? Like, literally just auditing yourself with a very fine-toothed comb. So I've certainly picked some stuff up from him on the S C side, Chipper Anderson, Nick Drano, Rob Nelson, Ashley Kowaleski, Tex McQuillan. I mean, the list could go on forever. Hauser, Harvey, I mentioned those guys before. I mean, it's really a like endless list at this point. And you ultimately become a product of the people around you. And I'm just incredibly thankful and fortunate to have been around some great people at the right times that way, and just hang around hang on and pick up some great things from conversations and different things with them that way.

Rehab Beyond Pain To Performance

SPEAKER_00 36:30

Yeah, selfishly, I asked that question for two reasons. One, because again, it gives you an opportunity to share who you've learned from, but also for me, it's like, hey, those are future podcast guests where I can reference the fact that you took inspiration from them. And then when we're going and getting the workout in down the road in North Carolina, going over to Duke, checking out their facilities, you know, we got stuff to refer back to. But I am curious, do you think most rehab programs today are actually preparing athletes for performance or just getting them out of pain?

SPEAKER_01 36:59

So the rehab model is different country to country. So if you're in the US, it's different than if you're in Canada, different than you're in Australia, wherever you're listening from, it's it's drastically different everywhere I've been. And even in the US, there's so much difference state to state, right? When I was up in New York finishing out my schooling that way on a clinical assignment, I believe the average reimbursement we were seeing per visit, don't quote me on this, was around 40 or 50 bucks. So for me to spend you know an hour with someone one-on-one and only get 40 or 50 bucks, you can't run a clinic that way. You can't keep the lights on, pay your employees what they want to be paid, include benefits and all that sort of thing. Unfortunately, the model forces you to see multiple to get by. In states like Maryland, where I practiced before, we had a much higher rate of reimbursement where we were, on average, in the$80 to$90 per visit range. So when you're almost double the other state, it becomes a lot easier to spend one-on-one time. So each state is drastically different. And ultimately, I think that insurance-based model is incredible for the older individual, we'll say 65-year-old with chronic lower back pain. They've had it for a long time, maybe longer than I've been alive. They haven't done a whole lot of movement, exercise activity, and that sort of thing. And getting them to someplace consistently where they do a structured program over and over and over again in conjunction with some simple modalities or manual therapy to help manage pain is a great thing for them. I think from an athlete standpoint, you can fall into that model and do pretty well in the phase one of your rehab, right? If you go to any PT clinic, most of them are pretty good at managing pain, inflammation, and restoring range of motion. So phase one, maybe even some phase two of rehab, is pretty well covered almost anywhere you go. Once you start to get into those phase three and four, when we get into more advanced strengthening techniques, once we start to enter return to sport and even differentiate between return to sport clearance and return to desired level of performance, that's where we start to split. And on one hand, I think that physical therapists are doing a phenomenal job of stepping into that space and trying to bridge the gap there. But on the other hand, I also see strength and conditioning coaches that are trying to specialize in that process of, hey, look, they've been discharged from traditional physical therapy. Now I can step in and progress them back with this model or progression or whatever that way myself as a strength coach. And I think ultimately both are valuable and both are right. I know people are not going to like hearing me say both are right because everyone wants you to pick a side. Oh, you're a PT, side with the PTs. Oh, you know, you love talking with strength coaches, side with the strength coaches. But I truly think this is a space where there's room for everyone at the table and everyone can be successful. So maybe the traditional PT model that only has the heaviest weight of a 20-pound kettlebell, maybe that's not the best for phase three and four ACL return to sport. But you know what? If that PT can see them once a week and work with a strength coach that's really well versed in that area, and together they teamwork, progress that athlete back to where they need to be, that's great, as far as I'm concerned, right? And on the flip side, if you're a PT that has the ability, has the equipment and knowledge to take that athlete from day one post-op all the way to return to performance, then do it. I think whatever approach you use is, again, righteous by me, as long as you get that outcome. Because in the world we live in, I don't think people really care about how nice you are or how many letters you have after your last name, or you know, how whatever, how you dress, whatever. I don't think they care about any of these little things as much as they care about do they get the outcome that they're after. And if you deliver outcomes consistently, then people are going to flock to you in numbers because you can get the job done when they need it.

SPEAKER_00 41:32

Yeah, that's truer. Words have never been spoken. Uh we're a results-based economy now at this point for sure. I am curious, what's something you see athletes do in rehab that actually slows their progress down?

SPEAKER_01 41:46

It's interesting. So when I was up in Maryland, we had a few athletes that, in my opinion, they just weren't getting as good as quick as I wanted them to. When going back to what we talked about before from a holistic standpoint and lifestyle standpoint, I think a lot of those variables kind of bled into it, right? You know, hey, college athlete, and maybe I'm rehabbing an ACL, right? Well, they still want to feel like a college athlete. So they might go out on the weekends and they might drink a little too much. They might not sleep that much different times, right? They might have stressful class schedules, you know. Like imagine if you're like a nursing major or something rigorous like that in undergrad. Like you're going to have to put in some more time to studying that way, and that can be stressful. Maybe nutrition slips. And, you know, I know no college athlete ever has had to just eat like a craft mac and cheese or something for dinner, but it's like stuff like that happens where it's like, you know, the caloric intake and the micro and macronutrient intake is not where it should be. The sleep is not where it should be. The stress is not where it should be. It becomes this death by a thousand paper cuts type of thing. And I think ultimately the ones that I see get the best outcomes are the ones that literally use that injury window as a chance to reset everything. It's like, hey, look, now is my time to step back, slow down, figure out what do I need to do different? What could have caused this to happen? Because everyone is going to tell you it's one thing. Oh, it's the turf. It's the cleats. It's because you didn't sleep well the night before. It's because of X. But ultimately, no one ever knows. And it's almost never just one thing. It's usually a combination of a lot of things. So for me, you know, knock on wood, if that happens to me, I use that as a time to step back and reassess everything, right? How have I been sleeping lately? How have I been eaten lately? What's my relationship with my family, my faith? Literally just go through everything. And then you start to kind of rebuild not just your knee or whatever you're rehabbing, but your entire life. And the athlete. That I've had do that, tell me that, hey, you know, during my ACL or this injury, it was the greatest thing to happen to me. And it it blows me away every time they say it because I'm like, I wouldn't wish that on anyone. And they're like, no, no, I don't want to go through it again. But because I did, I am a significantly better person for it. And I think that there's something about that and the human spirit, which not to get too philosophical, but it's like the obstacle that gets put in your path almost becomes the way forward in this case. And having the ability to do the difficult things, do them really well, and rise to the occasion can literally just redirect your life in places you never would have thought possible.

Return To Sport Testing And Risk

SPEAKER_00 44:43

Dude, I've thoroughly enjoyed this conversation. I'm feeling like we could riff here for hours. I know you do this for a living like I do, and we've talked to a lot of coaches, trainers, therapists. I am very grateful to have been able to spend an hour chatting with you here today. I do have a couple more questions, one more before staple that we ask every guest. But first, you mentioned that phase three, phase four, getting cleared for sport and then actually returning to sport. Is there a way that you get that okay to say, hey, this guy can or this guy or gal can go from yeah, being cleared to no, actually, you're ready to go full bore, get into a game again. Is there something, litmus test? What do you do?

SPEAKER_01 45:23

So this always becomes a very big multidisciplinary conversation. I think a lot of people want to be the one person that makes the decision. And if anything, I want to be as far from that as possible. I want to be one of 10 people that looked at you and said, Hey, you're good to go. So to me, that team becomes myself if there's an AT involved, if there's a strength coach involved, the ortho, the orthopedic PA, anyone on the orthopedic side that's involved. Was there someone from a mental health standpoint involved? Because I think we neglect the psychological return to sport component a lot. Sure. What's the skills coach seeing in practice? Like if they're practicing but not playing games, how do they look? How does their speed of play compare to what they were like before injury? And of course, the athlete, right? How does the athlete feel? What's their confidence level? Is there anything that they feel is kind of nagging almost, or it's not where it should be, you know, because maybe they tore their ACL, they're 10 months out, and he feels great. But you know what? My hamstrings bother me, or my hips bothering me. Well, to me, that's that's a little bit of a yellow flag. We got to slow down. So ultimately, you've got to pass the eye test, in my opinion, from every stakeholder involved, including yourself that way. And that's the hardest part I feel for athletes to literally look at themselves in the mirror and figure out, like, hey, am I good to go? Am I okay? Once you get past all the eye tests that way, obviously there's a few other things I like to include. I think everyone does the hop test at this point. I think everyone does multi-angle knee extension and flexion strength. I like 90 degrees and 60 degrees. If you have an isokinetic device, great. Everyone seems to do different speeds on it. I've seen 60, 180, and 300, I've seen 120 and 300, I've seen so many different combinations of two or three isokinetics, but ultimately have something that you're assessing. I liked using force plates a lot. So counter movement jump, isometric testing, squat jump, which amazes me how many athletes cannot do a squat jump, rebound jumps, which for that I'm just looking at the ground contact time as far as in-between jumps. Are they fast enough? Which I believe the cut is still 250 milliseconds, give or take. So are they even fast enough to do it? I don't necessarily care about 80% of the numbers. I just want to know can they even do that? And as you work through all this data, it's not just do it once and then never look at it again. It's how do I take all of this and piece it together to tell the full story, right? Like, how do I establish so many data points that I feel like we've covered everything that we need to and we didn't miss anything in this process. And that's an ever-evolving thing. And I don't think there's anyone out there that has every answer to that. But as of right now, I think if you're doing some hop testing, some force plate testing, some strength testing, psychological readiness, everyone passes the eye test, and then maybe as an added bonus, you throw in like a change of direction assessment, like a 505 or something like that. And all the while you're looking at movement quality, I think you're covering so many different things that the odds that you miss something is very slim.

SPEAKER_00 48:52

Yeah, Cole Hergod, the strength and conditioning coach for Trinity Western University, has a Sparta score. I don't know if you've seen that, but he combines a couple different testing metrics. Again, from a physical standpoint, but I love the way you layer in both as well the mindset and from every other angle, because you can't just look at physically. It might look good, might feel good, but like Kevin Durant came back and then injured himself again in that Toronto Raptors NBA finals. And, you know, maybe there were some opportunities to look at other angles other than just the physical readiness, right?

SPEAKER_01 49:23

It's always a risk-reward conversation with that as well, too, because there's always going to be times where it's like maybe we're not 100% ready, maybe we're only 80%, but it's now or never. And it's like, do we do we push the envelope? And sometimes those stories end very, very well. There was a high school quarterback that I worked with who had a surgery for his ACL in December and ended up back in the operating room in January for a washout procedure because the knee got infected. And that led to a two-week halt on everything PT related. Everything. We couldn't do anything. So by the time you pick up from that, it's like, okay, it's February, and we are literally starting from ground zero again. Oh, by the way, season starts in August, and he played a full season. Now, again, some people are gonna look at that and say, well, it wasn't nine months, it wasn't this, it wasn't that. Sure. But he got a great outcome and he lived to tell the tale without re-injury. So sometimes you're able to push the envelope and it goes really well. Sometimes it doesn't, but in that case, risk reward reward was high, risk was higher than we would have liked. But if that's your last chance to play the sport, then I I guarantee you 99% of athletes are gonna look at it and say, I'm gonna give it everything I've got and I'm gonna go out on a whatever note I can.

SPEAKER_00 51:00

Despite the fact that it may impact my body for the rest of my life, but who cares about that, right?

SPEAKER_01 51:04

Well, it's one of those things that I I think a lot of times people understand the risk, but to them the reward is greater. And even if the risk, you know, the unfortunate situation happens, to them they'd rather try and fail than never try, right? There's that man in the re arena concept, but to me it's just I tried and failed to me is a thousand times more of a person than someone who never even attempts it, right? To me, it's like you never know about that what if. I would rather die on my feet than never enter the arena myself. Again, opinion, everyone's gonna feel different on it. But for myself, I'm I'm all in on sending it if people feel comfortable. And as long as they know the inherent risks that come with that, as long as everyone is aware of what that worst case scenario could be. Yeah. If you're still comfortable with it, if everyone's still comfortable with it, then you know, again, team decision, it doesn't fall on one individual, it doesn't fall on just the AT saying this, or just the strength coach saying this. When you put it all together, what do we collectively feel?

Sweat More During Peace

SPEAKER_00 52:19

So Yeah, I laugh and I joke about it, but I I'm the same way. And if I was put in that position 10 times out of 10, I'm running through that wall and doing everything I can to play in that game, right? And it's just the fact of the matter when you're an athlete. Dr. Dan Bronn, the way we wrap up every episode, we ask our guests their biggest piece of advice for the next generation of athletes. And I'm sure you've got a couple doozies, but let's narrow it down to one.

SPEAKER_01 52:42

Biggest piece of advice for the next generation of athletes. This goes back to conversations and reading the book from my friend Nick Sedado. Is he talks a lot about, well, actually, the title of the book is Sweat More During Peace, Bleed Less During War. And he talks a lot about the times of peace, the times when things are good and you're comfortable, right? Like I'm currently sitting here, it's sunny and 75 degrees, I'm outside, pretty comfortable right now. Moments like this are when I should be working like an absolute dog to prepare for whenever the next moment I'm called the rise of the occasion is. You can't get too comfortable, you can't take your foot off the gas too far. Yeah, sure. There's conversations around balance and you know, relaxing and different things. And I think that's an element to it, but ultimately you still need to be pushing forward, even when things are comfortable, even when things you know a little bit easier that way, even when it's off season, even when it's the day after you just won the national championship, it becomes that question of how can I get a little bit better today? Even if you're not moving forward at the same pace that you were a week ago, you still have to find a way to move forward. So ultimately, I think as long as you follow that sweat more during peace, lead less during war philosophy, you really can't go wrong, at least on the work ethic component of getting stuff done.

SPEAKER_00 54:13

I love it, dude. Again, Ken, thank you enough for coming on this show. We'll look forward to getting down to the Carolinas getting a lift in. I got to work on my dips and my pull-ups for sure between now and then and the push-ups. But many thanks again for your time, insights, wisdom. Sure, the first time, but it won't be the last.

SPEAKER_01 54:30

Dave, I really appreciate the opportunity to chat with you today. Really love everything that you've been doing through the podcast and social media and that sort of thing that way. And just cannot wait to connect with you more, man.

SPEAKER_00 54:41

Yes, sir. Hey, if we ever have athletes who uh need support down there, we know who we're sending them to, you know.

SPEAKER_01 54:47

Absolutely appreciate it.