• Misbah Haque

Intentionally Building Trust w/ Dr. Sean Pastuch

Dr. Sean from Performance CareRx is back on the show! The first half of this episode was very tactical and technical. We reflect on the Open workouts, benefits of carrying, and ideal ratios for general fitness programming. There’s even a protocol for Knee Tendinosis that some of you might find useful. Without a doubt, the light bulb moment in this episode lies around the concept of building trust with your athletes. Whether you are a coach or athlete, hang tight and take notes. I have a strong feeling you’re going to walk away with something actionable from this one.


Show Notes:

  • (4:30) - Reflecting on the Open workouts

  • (8:50) - The role of your ego and mindset during the Open

  • (11:40) - Why Dumbbells in the Open is a great leap forward

  • (15:24) - Ideal ratios for general fitness programming throughout the week

  • (19:46) - Suitcase Carry vs Waiter’s Carry

  • (24:28) - Getting creative with Farmer’s Handles and why you need to get a pair

  • (25:28) - Sandbag Carry

  • (27:30) - Farmer’s Carry

  • (30:06) - Overhead Hold Test

  • (34:50) - What’s happening when your body is shaking

  • (36:14) - Building trust with athletes

  • (46:04) - Affirmations

  • (54:50) - Tendinitis vs Tendinosis

  • (58:55) - A protocol to follow for Knee Tendinosis

  • (1:05:48) - The Active Life Podcast

Resources we may have talked about:

  • Farmer’s Handles

  • Start With Why

  • Daring Greatly

  • The Active Life Podcast

  • Active Life Coach’s Program (Use “Airborne Coach” to get 10% off)

How you can connect with Sean:



(00:00:00):


Hey, this is Dr. Shawn with the active life and you were listening to the airborne mind show.


(00:00:35):


Hey guys, Misbah Haque here. Thank you so much for joining me today. And welcome back to the show. Before we get started. Two things that I would love for you to check out. Number one is all the training resources that we have up@theairbornemind.com, which is the home base. If you head over there, check out what is most relevant to you right now, and sign up for the newsletter. Number two, please head over to iTunes and leave a five star review. It only takes you a couple of minutes and I would love to hear what you think good or bad helps me out with the rankings helps me get more people on the show. And yeah, if you've loved what we've been putting out so far and you want to keep seeing more of it, I would love to hear your thoughts. So once again, head over to iTunes and leave a review.



(00:01:15):


Now today's podcast episode is brought to you by audible.com. If you enjoy psychology, if you enjoy learning about how the brain works, how we think, how we process and organize information. I think you're going to enjoy this book that was recommended to me by a D cashew it's called mindset by Carol Dweck. I don't know what took me so long to get to this one. I've heard many other people talk about this as well. But yeah, super fascinating. If you enjoy learning more about your brain and how you think and how you work. So if you want to head over to the airborne mind.com forward slash reading list, you can grab a free audio book and 30 day free trial there as well. So today, Dr. Sean from performance care RX is back on the show. Last time he was on, I believe it was episode 11 and 12.



(00:02:02):


We got into a ton of tactical information. If you are somebody who's experiencing any types of aches and pains, hips, knees, shoulders, ankles, lower back, highly recommend that you go revisit those episodes because they give away so many tools and tricks that you can start applying pretty much right away. In this episode, we talk about, you know, the open workouts. We talk about what Dr. Shawn has been up to since the last time around. They've been doing workshops all across the nation, helping coaches in person and remotely. I actually went through their coaches program for the lower body assessments and got a ton of value out of that one. They have a podcast that just dropped on iTunes to make sure that you go subscribe to that. It is the active life podcast where they're going to be talking to a ton of people, way smarter than me.



(00:02:51):


And so I'm excited to dig into that. If you are somebody who's a coach and you are looking to learn more about the shoulders and want to join the coaches program to get your athletes ready for Murph. And obviously beyond that as well, we dig into the details in this episode, but he was nice enough to give us a discount code for airborne mind, readers and listeners. If you are planning on joining it is airborne coach for 10% off. So a I R B O R N E, coach C O a C H. So definitely go check that out. If that sounds interesting to you. But with that being said, I'll let you get to the episode. Hope you take away something from this one and more importantly, hope you do something with it. Dr. Shawn, welcome back to the show.



(00:03:34):


Thank you, Ms. But I love being on the show. Yeah.


(00:03:36):


I I always love having people back on because you were on for episode 10 and 11. And so, you know, it's been like 20, you know, 23 episodes or so four months or something like that. So a lot happens in that time and I've been keeping tabs with you guys. You have a lot going on. So how's everything been going with you? How's life.



(00:03:55):


Life is good. Life is busy. I have Jeremy has, as you know, I mean at the time when, when we recorded last time, he had a four plus year old and an infant. Now we has still an infant is a little bit, they are who moves around a lot more. So he's busier. And his daughter is older and more active. Of course I have a two year old who at the time was just sitting in a corner crawling a little bit. Now she's up and running around the house and talking in full sentences. And my wife is due to have another baby in about a month and a half. So a lot going on. Yes. Thank you.



(00:04:30):


So tell me a little bit about the how you feel about the open season. This year's open season, we saw more dumbbells. We saw some unilateral movements and things like that. How did the open season go for you? What were your initial thoughts kind of going through the workouts week by week?


(00:04:45):


Yeah, so the open season, that is a loaded question. There's a lot, there's a lot to that question. Speaking personally I have not been keeping myself in the best shape over the last year and that's not something I'm proud of. Right. It's something I tell people to do as I do. And as I say so I need to do better. But I have been waking up early working out on my own the last few months to try to get myself back into the groove a little bit. But as far as personally goes, I did better than I anticipated doing. I was still able to snatch some weights that I didn't think I'd be able to snatch, which was cool. I did not do 17.5 because that was a rough week. I didn't sleep much and I didn't want to throw myself into heavy deadlifts on no sleep. So I did not do 17.5, but I felt pretty good about one through four. I'm sorry. Five was not the deadliest. That was four. Yeah. I didn't do the thrusters one.


(00:05:42):


Gotcha. in terms of kind of comparing it to previous open workouts any, any initial thoughts you guys were doing a pretty cool series where you were giving out warmups and things like that for each workout. And you have a very cool series now that you were kind of wrapping up on why you sucked during each open workout. So tell me a little bit about your thoughts when we kind of look back at previous years, workouts.


(00:06:04):


It was why you might have sucked, like, because some people didn't, but you know what, the open is interesting right. In that I feel like, unless if you finished top 20, you think you did terrible right there, there are some people who are like, Oh, I moved up by a hundred spots and they're happy about that. And that's cool. But for the most part, people, for some reason, seem disappointed with how they did in the open, right? It's like as if he could control the other 300,000 people who were working out at the same time, what they were doing every day and their gyms and, you know, in preparation I loved this year's open. I loved that there were dumbbells involved. I loved that there were, you know, unilateral movements involved for me. That was very cool. I still have a little bit of a problem with the, the mental approach to the open, which is everybody can do it.


(00:06:52):


It's universally scalable. And it's what CrossFit's all about. So if you go to a CrossFit gym, you need to do it. By the way, we have squat snatches in the open when orthopedically, that's not really scalable for some people. But now to have the psyche of, I need to do this, I'm not cool. I'm not a CrossFit, or if I don't do it, but it's not so good for my head. So my low back, cause I don't have that range of motion. I never do it in the gym during the year. Screw it. It's the open I'm going to do it. And then they get hurt. So that for me was the one little if I had to nitpick this year, but otherwise I loved it.



(00:07:27):


Yeah, me too. It's a tricky thing. Right? Because every year the level of competition is going up and up and we see that not only at the regionals and the games level, but in the open as well, like we've got more complex skills and movements and the envelope is constantly being pushed little by little it's, it's a tricky, it's a tricky topic to get into.


(00:07:46):


I feel like they need to keep pushing it because the thing is, you know, in 2010, 2011, I did my first open and you know, I couldn't snatch 135 pounds. Not at all. I'm the second workout was snatching and I had to get, you know what, no, that was in 2012 and get my years mixed up, man. But, but the point is that, you know, back then seven minutes of burpees was, was a great workout. And I still wouldn't be now, but people have evolved past that as, as a measuring stick, you know, it's now it's okay. We can do complex skills in the open because the bottom 15% have been exposed to this. I think that they need to keep on pushing that envelope forward. It's just, it becomes less inclusive even though they have the scale division.



(00:08:30):


Yeah. I agree with you. How, how has kind of, you know, the athletes that you guys have been working with and, you know, getting them back to living daily life and resolving, you know, shoulder pain, knee pain, hip pain have you noticed any change in their attitude and mindset approaching the open?



(00:08:51):


We try to impart a mindset change before they approach open, right? So depending on who we're talking about, if you're talking about the elite athlete, the guy or the girl who's going to go to the CrossFit games, most likely we're not usually their primary coach, right? So that person has somebody else who they're working with, whether it's, you know, a brute strength coach or Nick feller over brute strength, my casual brute strength, or, you know, CJ Martin from Invictus. We, we don't necessarily work with those coaches, but we work with those athletes. And what we do is we give them our little piece. And when we're working with an athlete at that level, who has a coach at that level, and I don't know why I said CJ Martin, we don't have any of his athletes in particular, just name that came to mind.



(00:09:38):


But when I'm working with an athlete who has a coach, who's that involved in their program, we tried to let their coach take control over that, but we don't discuss so much of the mindset going into the workout. It's with the athletes who don't have that coach who is necessarily paying attention to their mindset or who don't have a coach at all, who will start discussing with them. You know, what are you thinking about? Why are you thinking about that instead of how does, what you're thinking about make you feel right? But we, we are much, much better suited staying in our lane, which is making sure they can.


(00:10:17):


Absolutely something I've, I've noticed, at least in our gym here is people who are coming back from injury. It's like you have a new, new perspective because your level of gratitude is now you've kind of lowered it, right? Because you got used to doing all these movements and you were going gung-ho and, and you know, just kind of in a sense, maybe beating up your body in some ways. And then when you get hurt weather, or you start to get aches and pains, you start to notice like, Whoa, I can't, you know, I can't raise my arm over my head anymore, or I get pain getting out of my car and things like that. So I feel like you start to appreciate what your body is capable of a little bit more. And that's been really interesting to see, you know, those people you know, approaching the open with a bit of a smarter mindset.



(00:11:04):


I think that depends on where you are and who you're looking at. It's also the people who were like, Oh, it hurts when I do this, but it's the open. Right. Okay. And you know, no, as far as I'm concerned, it's just, you know, March 16th. Yeah. It's, it's, it's not anything different. It's, it's still your body doesn't know the Dave Castro said, you need to do this this week. It just knows it can't do it, you know, not right now. So I think it depends, it depends on how well checked a person's ego is how well they're going to be able to handle that.



(00:11:39):


So tell me a little bit about the dumbbell snatch workout, right? Why, why might have we have sucked during that workout? There were some unilateral movements going on there and it's just something different. Like we've definitely it, you know, day to day, maybe in your class wads, but it's the first time it was in the open. And it was really interesting to see there was a lot of volume. So what were your thoughts on that?



(00:12:02):


Well, the thing, you know, if you watched our, why you suck, why you might've sucked video one of the things that we talked about was that not only was it a unilateral exercise, but it was also what's called the transverse plane exercise, meaning that you were forced to rotate, right. By reaching down when the single arm in between your legs and grabbing heavy objects on the floor, throwing it over your head, you're basically asked to twist, right? It's not huge, but there's a little bit of twisting. There's a little bit of resisting rotation there as well. And what we find is that most athletes in the CrossFit space, who we work with are not well exposed to that. They're if you're doing it in the gym, it's, it's once every two or three months, right. They're not coming in and banging out suitcase delish for the single arm, doing single arm carries you know, doing single arm snatches. I mean, we have people doing single on deadlifts from a Sumo position all the time. So for us it was like, Oh great. Our athletes can to hold them really well to this because we're not prepping them for CrossFit. We're prepping them for life. And in life, you need to be anti rotational and rotational in CrossFit, typically in the past, you didn't really need to be. So for us, that was like a, this is awesome. As far as we're concerned, CrossFit is moving the envelope forward to a health standpoint as well.



(00:13:21):


You can also I feel like with something like that, you can notice, you know, which side is weaker. Like I was coaching a class the other day and we had dumbbell thrusters, which I swore was going to show up for 17.5, but it didn't. But you can see with something like dumbbell thrusters, if somebody left arm is significantly weaker and they're going to press overhead. Like, I, I can think of one gentleman right now who the right arms flying up there and the left arm is like this, right. Just halfway. And that's like, you know, whether you like, without getting into details, that's definitely something that needs to be addressed in some way, shape or form. And so I feel like the dumbbells are able to expose some of that a little bit better. What do you think?



(00:14:00):


Yes. There's that, and there's, there's also the idea of we're gyms. We should have dumbbells, you know, and, and I, I was absolutely guilty of the contrary. Right. And, and my, one of my head coaches, his name is Robin Maloney. He was, he's been with us now for about a year and three months and very short into his tenure. He's like, Hey, I'm going to buy dumbbells for this gym because we need dumbbells. I was like why, what do you know? No. So he bought them and I was like, listen, I'm not going to let you pay for these. I paid him back for the dumbbells. Now our gym has dumbbells and he was right. You know, like the gym needs, we're a gym, right. Another friend of mine telling me bride Owens cost at five, one six, and I was, we were back and forth complaining about, you know, just, just having the conversation about affiliate owners and how are they going to manage this?



(00:14:55):


Do you have a small gym? Or you will need, you don't have any dumbbells now you need to go out and buy them. And he's like, yeah, just, just say out loud, you know, I have to buy dumbbells from my gym and a complaining way and see if anyone gives you any sympathy. And I was like, yeah, it's true. It's a hundred percent true. So when the opens came out, we went out and bought three more, three more pair of all of the weights that we needed and we were perfectly well-stocked. So I love that CrossFit is starting to evolve in your life.



(00:15:23):


I totally agree with you. Could you touch on some things that maybe people could do to include more of that rotation or that the transverse plane into their training, maybe it's in their warmups, maybe it's in their cooldowns. But when we think of even, you know, when we see the dumbbells being utilized in the open, a lot of it is there's this element of explosiveness and, and, and you're under a timed pressure and things like that, but maybe walking away from that and doing something that's a little more focused and controlled. What are some things that kind of come to mind for you that people could benefit from?



(00:15:59):


Well, let's, let's start with, with the idea of why it's important, right? Because the number one cause of lumbar disc injury. So our lower back disc, which is the, basically the little shock absorber in between the bones, the number one way that you can injure that is with coupled flection and rotation. What that means is basically doing a dumbbell snatch, if you lose your spinal position, right? So if you lose your spinal position, if you saw people rounding their back and reaching down to the ground and just kind of ripping up that person is at risk of injuring their lumbar disc. So this, this starts with the idea of being able to preserve the proper position. So that doesn't happen, right? So we have to start there and then we go to the affiliate owner, or whoever's writing the programming for the gym, because as much as we're talking to athletes, now they're not going to be able to walk into their gym necessarily like, Hey, I want to do this program.



(00:16:54):


It wouldn't be advisable for them to do that. Right. So I think that when, when you're an affiliate owner or you're a coach and you're writing a program, you need to be considering quality days, you know, just general strength days general conditioning date. It doesn't need to be walking into the gym, do a strength, do a skill, do a gymnastics segment, do a workout. You know, it could just be, let's work on this until we're good at it. And then we're going to do a workout, including it. Right. so one of the things that we recommend often is that people carry at least twice a week, right? And when we say carry it doesn't, we don't really care. What kind of carry could be an overhead carry. It could be a yoke walk, could be a farmer's carry two arms, one arm, sandbag carry.



(00:17:46):


We just want you moving an object from point a to point B twice a week. And the reason we say twice a week is because most people are squatting three times a week at minimum. Unhinging three times a week. Ideally that's the lineup, squat and hinge three carry, push, and pull twice ground to shoulder or ground to overhead ones. That's how often we want to see people loading things. So as long as those ratios are in line, we're good. We like to see those different kinds of movements done both in prep work. So we'll have people will go out and do a heavy carry to start their day, right. And say warm up. And we get them warmed up. There's no go warm yourself up, but warm up like this, right. And then grab 40% of your one rep max deadlift with a single arm and take it for a walk as far as you can take it rest until you're fresh.



(00:18:39):


And do it again. And repeat five times on each side or six times on each side, right? You don't start that way, but you start a little bit later. And the nice thing about that for a programmer is that's a very low skill movement. And when I say that there are purists out there who are cringing. They're like, it's not low skill to carry heavy object from point a to point B. I respect that. Not I'm not minimizing that, right. What I'm saying is that for a CrossFit gym, giving somebody a farmers' handle and saying, keep your core braced, try to lean into the weight as opposed to away from the weight and take it for a walk there's less to do than there is when you're teaching someone how to snatch. There's less to look for from a CrossFit coach's perspective, right? And people are typically going to be safer doing that in the margins of good versus great than they are a snatch or a clean and jerk, or even a kipping pull up or a muscle. So building those into the beginning of classes as a high CNS load, relatively low skill is a great way to get people started.



(00:19:45):


So could you dig into the suitcase carry, which you just talked about holding a farmer's hand or a kettlebell out by your side one arm and then a waiter's carry, which would be like a front rack position on one side what's going on in those two movements, what's kinda different about them. What are we kind of targeting there?



(00:20:05):


So if you, if you're listening and you're, and you're trying to figure out what the difference is, a suitcase carry would be literally what it looks like. You, you, you grab a suitcase, you pick it up and you walk with it. You're going to be able to have to handle a very heavy load in that position, right? As long as you can grip it, you can handle a pretty heavy load. In fact, we'd like to say that people should be able to carry 55, 0% of their one rep max deadlift for about 10 meters. That's the goal, right? More people believe it or not can do that. Then carry out 50% of their 10 rep max dead lift for a hundred meters, which we also want to see you be able to do because the time when there's tension just isn't had, we grab something heavy, we let go pretty quick.



(00:20:47):


So this case, Carrie is going to be the way it's pulling down towards the ground. It wants to pull your body towards it. So you kind of have to lean away, even though you're not leaning away, right? Your body is having to keep you upright by keeping everything on the opposite side, turned off waiters carry is similar, except the weight is higher. It's up by your shoulder. Think about a front rack position with a kettlebell or within dumbbell, right? That's a waiter's position. Now we'll have two differences. That way being higher, the center of gravity is different. It's going to function as a heavier load, right? So it wants to pull you down. It's going to compress on your ribs, make it harder for you to breathe. And it's also going to require some active shoulder, you know, L elevation's the wrong word, but some active shoulder flexion and abduction to keep the weight where it needs to be. So your shoulder becomes much more intentionally involved in the movement. So typically people can't move as much in a waiter's carry as they can in a suitcase carry, but we program both.



(00:21:50):


Okay. So what would you recommend for, you know, gyms that don't have farmers handles yet? Yeah.


(00:21:59):


But you know what it's it's, I don't mean to interrupt. I mean, I do mean some drugs to you, but I don't mean to offend you by interrupting you, you know? And we, we get it all the time. It's Oh, well, my gym doesn't have farmer's handles. So can I just use a heavy dumbbell? Yeah. You know, but my gym, my gym doesn't have a bar belt. Can I just use an actual bar loaded up? Have you, it's not the same. Right. You know, it's a farmers handle is an inexpensive piece of equipment in terms of in the scope of what you need for your gym. Right. You can get a farmer's handle for where you can get a 45 pound bumper plate for maybe even a pair of them. Right. and they don't take up a lot of room, put some hooks on the wall and you can hang three to four sets of farmers handles. If you're only having people use one at a time. No, for a single long farmer's carry, they're more versatile for you to use than an assault bike or a rower, which costs a thousand dollars a piece. Right.



(00:22:56):


Yeah. I like multiple. I like how you gave the, a percentages because that gives people some context as to you said, what 50% of your deadlift for 10 meters.


(00:23:08):


So take whatever you can dead lift. And let's say, for example, you can deadlift 200 pounds for 10 reps, divide that in half, you should be able to carry that for 10 reps. And for us, one rep is 10 meters. Got it. Right. So if you can double the 400 pounds for one rep, you should be able to carry 200 pounds in a single hand for 10 meters or one rep.


(00:23:31):


Got it. So you don't, you don't really want to be afraid to load this movement up since it's somewhat low scale. And if you let's say for now, in the meantime that you don't have the farmers' handles, you want to be kind of leaning towards the heaviest that you can handle. Maybe it's a 75 pound kettlebell that you guys have, or maybe it's a 70 pound dumbbell.



(00:23:51):


Yeah. The, the problem with the kettlebell and the dumbbell is that people will grab a kettlebell and have to basically swing it away from their body. Right. Cause there's that, there's a big circle at the bottom, the big sphere at the bottom. And the issue with the dumbbell is that it's weighted so close to your hand that it actually feels much heavier than a farmer's handle with the same weight on got it. Right. And so it makes it really difficult. It becomes more of a grip exercise than it does a shoulder and torso exercise when you're using the dumbbell and that kind of defeats our purpose.



(00:24:24):


Okay. And I guess when you, cause you can also take that farmers handle and you can go overhead for an overhead carry. Right.


(00:24:30):


We have people use the FA so that's a really good point. Right? Cause a lot of people are like, I don't want to buy farmers' handles and just carry with them. That's what's the point there's so non-personal what are you talking about? So we have people use farmer's handles for everything from suitcase carries, you know, one arm carries two arm carries two waiters carries, right? Cause if they need to go heavy, that's a better way than a dumbbell or a kettlebell to right. Overhead carries when they need to go heavy. We have them do suitcase downloads with them so they can set them up on one side of their body, stand up on a riser. And now you're doing a download from the floor. That's anti rotational. We have people doing in place of a hex bar deadlift, right? If you, if you want to be able to have people do a deadlift it's from the sides where they're better loaded, they can have more weight. Now you have essentially a hex bar only it's they're unilaterally loaded. So at, and I'm sure there's other variations that I'm not even mentioning, but they're much more versatile than they appear when you just look at them for what they seem to be used for.



(00:25:27):


Mm. I think you know, in the next year, hopefully we'll be seeing more and more box owners purchasing that. And we finally hear a God sandbags, which I'm excited about and messed around with them the other day. Could you tell us with maybe something like sandbag carries what's going on there?


(00:25:43):


So what's going on there? You know, it's funny, you know, Jeremy and I were making a joke because he moved and I moved within a few months of each other and we're like, we should just write a workout called moving day. That's, you know, carrying objects, you know, from place to place and then doing step ups with them for, you know, 13 to 16 reps, low step up, I mean go back and just do it again. Right. because that's what, that's what life is, you know? So what is the sandbag carry doing for you? It's it's doing that. You're having to stay on tension while you move from place to place. And when you're moving, one of the things that people don't necessarily realize is that you're mostly on one leg, right? So now it's, it's a single leg exercise, which means that you're having to balance from lateral stability to rotational stability, to sagittal stability, you have to make sure you're not falling in any direction.



(00:26:43):


Right. And now all of a sudden you're squeezing this heavy bag in front of you like a bear hug, it's pressing on your diaphragm. You can't breathe. Right. There's the, this is where the mindset of stuff comes into it. Right. But there's the opportunity to panic, right. And just start breathing really heavy and to have to put that half to put down and have to put down, you don't have to put it down. Right. Relax your breathing. You're going to have to be more comfortable with shallow breathing because you can't get that big diaphragmatic breath because the sandbag is pressing on your diaphragm. Right. So it's just, it's a really versatile way. It's not a versatile way. It's, it's it, it's an exercise that has a versatile effect to the person using it. Right. It's not only just a hard and heavy thing to do, but it also can play mind games with you, which I think is very cool.



(00:27:29):


Yeah. I think you guys mentioned this last time you were on the show, but FA farmers caries at some point and correct me if I'm wrong here can be used to improve ankle dorsiflexion.


(00:27:46):


Yeah. But, but we're talking about that in a can. Got it. Okay. Right. It's it's, it's, it's, it's not, we, we wouldn't prescribe heavy. Farmer's carries to improve your ankle range of motion, you know, it's, it's just that the, the, the thought process behind that is that you're going to be better at farmer's carries if your ankles move well. Okay. So if you're doing, farmer's carries, your body is probably going to make some adjustments along the way, right. Hopefully enough, but unlikely enough by themselves with farmer's carries there's other stuff that needs to be done in conjunction with that.


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