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James Cerbie

Helping you own your health, wealth, performance and happiness.

Ep 113: Engineering Knee Health and Performance with David Grey

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Knees are a tricky subject, especially when dealing with pain. We tend to look at the knee joint entirely wrong, which results in the knee being completely mismanaged. A lot of the time, people are so quick to blame the knee, but in almost all cases, itā€™s not the kneeā€™s fault. Joining me on the show this week is David Grey. I wanted to have David on the podcast again to break down knee pain and determine what some of the underlying drivers are (usually the hip, foot, and/or ankle).

Itā€™s important for us to start looking upstream or downstream of the knee because the majority of pain tends to sneak in through the muscles above and below the joint. Listen in as David unpacks the big rocks of knee health and performance so you can stay pain-free and perform at your best.

What You’ll Learn in this Episode:

  • [03:50] Intro to David Grey
  • [06:45] The gap that was missing in pain-free training
  • [08:15] Commonalities in those seeking help for knee-pain
  • [09:01] Key things David looks for when assessing someoneā€™s pain
  • [13:10] Common rocks missing with respect to the knee
  • [15:46] Why most people with knee pain arenā€™t doing single leg work
  • [21:34] The inability to contract efficiently
  • [24:39] Ways to build buy-in with breathing drills
  • [25:24] The second quickest way to assess knee pain
  • [27:14] Knee issues and the struggle to get the shin to travel forward and backwards in space
  • [28:45] How little movement most people have in their shins
  • [30:58] The purpose behind basic, non-sexy exercises
  • [31:53] Why you need exposure to single leg work
  • [36:44] Where and when you need extension to take place
  • [38:05] Understanding muscle activity and the importance of relaxing
  • [45:28] Where to find David Grey
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James Cerbie: Totally on point. I need to up my game. Your background is substantially better.

David Grey: We just redid this recently. So we’re in a new gym and my clinic is only twelve months old, old at this stage, but the clinic, I redid this wall. So it’s just this wall that looks like that. And I have shelves and stuff and all that stuff there. I saw a guy on I just kept recording video and there were shadows behind me and stuff. And I had a white wall and I saw this guy, Noah Kagan. I think he’s on YouTube and he did a video on his home office. So it’s like the home office or the home setup of a 100 million dollar CEO because that’s what he is. And the video is in his home office. And he had his home YouTube studio. And he said, I just walk in, I sit down and I press play and everything is set up. And he has a Google home and he just says, hey, Google, turn on the studio and he’s able to sit down and record the video. And I was like, I would love that because I have so much resistance. I want to record videos, but like, sitting down, getting the light set up, putting the camera, blah, blah, blah, blah, blah.

It just wrecks my head. So I just did this. I have my tripod there and I just moved my computer out of the way and pressed play, and that’s all I do. And it looks way better now. And it’s much easier for me to make videos.

James Cerbie: Nice, dude. I like it.

David Grey: Yeah.

James Cerbie: I need to do a total overhaul here on this room. I’ve bounced around in the house a couple of times. Now it seems like settling and painting stuff and actually upping my background game a little bit here. But dude. David, thank you so much for coming on the podcast. You’ve done this once before, but people tend to maybe not know who you are. Can you give them a quick rundown on who you are, what you do, all that fun jazz. And then we’ll dive in and talk a little bit about the need today. I think we’re talking about knee pain. That’s just something that I feel has become more and more prevalent and popular.

Intro to David Grey

David Grey: Yeah. It’s been popular for me for a long time because I had knee issues for so long. So that’s kind of why I’m in this business in the first place. People will hear my voice is a bit raspy today. So I had a rough weekend and a rough week. Background One thing I haven’t done in a while is actually background talking about myself on the podcast. Basically, at the moment, I work with people in the rehab world, pain and performance worlds, and we kind of help bridge the gap between those worlds for people. And sometimes then we just continue to train athletes after they’re done with that rehab process. Sometimes they stay on with us, but most of the time we just pass them elsewhere or get them back to their sport or back to their recreational athletes, back to wherever they want to be. And I’m fairly confident and comfortable in that nation. I don’t need to go into, like, a direct post up world or too far into the performance world or anything like that. I’m pretty comfortable in the niche that we do with rehab and that’s kind of where we’ve been for a while now.

My original story was just a frustrated athlete who kept getting injured. Lots of knee issues and Achilles issues and hip issues and all of this stuff. I just kind of went and tried to figure it out. Basically got some pretty terrible advice over the years from people who are supposed to be some of the best in the business. And looking back, probably it’s disappointing the things I got told, but that was where the industry was probably at the time, and people were probably doing their best. As hard as I’ve kind of gotten over, I’ve gotten the chip off my shoulder about it, but they were probably doing their best, but it just wasn’t great advice I was being given at the time. So I kind of traveled the world and just went around and did all different things and learned from different people and lots of really smart people. And then that kind of led us to where we are at the moment. And we do a mix of a lot of online work. We have some programs, then we do online consultations, and then we have a membership site and yes, some one on one working people as well.

And I train a few athletes longer term, but I don’t really have much space to take on many others. So we’ve a little bit of a team around us now and everything is going pretty well. And here I am talking to you.

James Cerbie: I like it. That’s good. That’s a good pitch.

David Grey: Thank you.

James Cerbie: Yeah. It’s funny, actually. We have such a similar story there, because the reason I got into this originally is because I just don’t like the traditional or at least the strength and conditioning model that I got taken through as an athlete. Really let me down and tell me because it was just chronic injuries like multiple back injuries, joint issues, shoulder issues, and I was just looking at this framework. I’m sitting there saying, there’s got to be a better way to do this. I should be able to train and be strong and jacked fast and powerful explosives, like all that stuff that you want as a field sport athlete without just chronically being broken down all the time. There’s a gap, there’s something missing. It’s like that essentially sent me on a decade plus long journey. It’s like going to work with Eric Cressey up in Boston. Go work with Mike Robertson, work with Bill Hartman, all these people. So I’m just trying to absorb as much as I can from them along the way. It seems like you guys are doing things very differently than the other 95% of the population that I was exposed to. So I need to figure out what you guys are doing.

But I know today we want to kind of talk and focus more on the knee because for whatever reason, maybe the ā€œknees over toes guy.ā€ He went on Joe Rogan. God knows how many downloads his podcast gets.

David Grey: Not as many as you.

James Cerbie: Yeah, I’m sure Joe texts me all the time, dude, how can I up my podcast game to be like, you know, it’s just got to put in a little bit more work. But we’ve been getting a big influx of questions around the room, and we talked about this a little bit off air to where I always feel so bad for the knee joint because it gets so much blame and criticism and focus when in reality it’s not like the knee’s fault per se because it’s only listening to what’s happening above and below it. We got to look at the foot and ankle and we got to look up the hip because those are the things that are going to dictate what’s happening at this, more or less like a hinge joint. Right. And so what I would love to kind of chat about here, if we think about if you want to call it knee health or knee performance with your experience, what are some of the biggest rocks that you see kind of go awry? Like when people come to you with knee pain, what are some commonalities obviously there’s going to be specific situations and it’s just like there’s always an individualized component to it.

But I think that there is usually a generic 80% that tends to kind of be common amongst a larger population.

Key Things David Looks for When Assessing Someoneā€™s Pain

David Grey: Yeah, there is, I suppose, because there are different types of knee pain and different types. And even when you categorize the different types of pain, still no one’s experience is the same because no one’s experience at least we don’t know if it’s the same because how do you describe pain? It’s such a hard thing to even describe in the first place. So how do you know? Excuse me, what I’m describing is the same as what you’re describing. So that’s a very difficult thing. That’s the hard thing in the world of pain. So what I say is eight out of ten, you might say it’s a two out of ten pain. What I might say is a dull pain, you might say is a sharp pain. We just don’t have good language to describe this. The good thing is, for me, at least with most injuries, most issues in the body, I’m not particularly interested in the pain itself. And the biggest thing I’m looking for, and this is different with everyone is their story. So, like how you got here in the first place, what are the big things that happened in your life along the way that led you not to be too serious about it, but like, what led you to being here with me at this point?

What was your training history? What other injuries have you had along the way? And basically you’re looking for some little pieces of information that say, okay, here are some things that stand out to me. You tore your hamstring or you tore your calf and then you went back to playing sport and three months later you have this chronic knee pain that hasn’t gone away now in the last twelve months. So straight away you’re probably starting to think, okay, maybe these tissues aren’t doing such a good job there and we need to re-educate them, strengthen them again and start to rebuild that. So that could be one thing. Another person could have broken their ankle. Another person, another person could have sounded weird, but they could have had some dietary issues going on in the gut or something like that at the time. And their whole body just tends to stop as a result. And they’ve lost a lot of fluidity and movement around the rib cage and the pelvis and the femur and all this stuff as a result. Another person, they had plantar fasciitis or they stubbed their toe or something like that.

And that changes how they roll through the Fort in the gait cycle. There’s a million things. Sometimes it could be just habits, like they literally came in touch with a trainer who told them that they always needed to squeeze their glutes when they do everything. And that just kind of closed off the back of the hip and the posterior capsule and there’s no ability to get that flexion through the hips. And when you’re starting to miss that, then you’re just kind of being pushed forward all the time and you’re missing a lot of good stuff that should happen in the gym and when you go for a run or anything like that. So there’s so many things. But for me, the key thing is just trying to find what’s missing in someone. And if you have that mindset towards looking at any injury, what’s missing, what’s missing, what are they not doing? Well here, then that’s quite an empowering thing because you’re suddenly taken away from right here is the knee joint itself versus what’s all the rest of the body doing, what’s going on in their training. It might just lead you to the answer, might be just looking at someone’s program and saying you’re actually not doing any calf work here whatsoever.

And you just put in whatever ten or 20 sets of mixes seated and standing, half raises every week and suddenly knee pain is gone. So I’m just interested in what’s missing and we can dive into what’s commonly missing, if you like, but that’s where my starting point is, at least.

James Cerbie: Yeah, I think that is a really good background and framework to keep in mind. We talked about this a little bit off there, too. Like podcasts are so hard because there is such an individualized angel list. Every human has such a unique story that got them to the point they’re at now. And then we’re trying to put out information here that 1000 people can listen to and just generically kind of like can hopefully find something that’s going to be helpful, they can implement on their own. And then it’s one of those, well, if this generic stuff doesn’t help you, then maybe you can talk to us, because then we need to actually dive into you. But the pain realm in itself is such a complex world, right. The sensation of pain is incredibly nuanced. It’s not as simple as I think a lot of people try to make it out to be. I think if people listening are interested, there’s a phenomenal book on this realm called Explain Paying by David Butler.

David Grey: Mosey.

James Cerbie: Just that book in itself, which is so well written, they do such a good job for drawing it’s at least like a nice small step in the direction we need to appreciate how much is going on here and just to experience the sensation of patience. But yes, what I would love to do is we can talk about what are some of the big rock common things you see missing with respect to health or performance or whatever language.

Common Rocks Missing with Respect to the Knee

David Grey: Okay. So usually there is some element of loading involved, right? So we’re just going to take that off the table first, because at least people who are listening to your podcast, like they probably have done some training in their life. Right. They’re probably not a granny just sitting on the couch. So they’ve done some amount of training. So there’s usually some elements of loading involved where if they just have a bit of pain, but it’s why they’re doing an activity. If they just sit on the couch, they might be sore, but it’s still because I’ve been doing activity. I’ve been pushing myself every single day. If I just sat on the couch for a month and didn’t do any hard training, maybe my pain would go away. For some people it wouldn’t, but maybe it would, or at least it would be a lot less. So there will be some elements of load, but we’re just going to take that off the table. Where I would start with is just like I would start with any other person. I would just look at the range of motion. So it’d be looking at the hips, the pelvis, the feet, what the femur can do, the resting position of the bones here, and then the movement availability of the bones.

So that would be like passive and active range of motion that’s what I’m looking at. Then I’m also looking at kind of a low tolerance type of thing and the ability of the tissues posteriorly to contract synergistically together. So you might see people using one of my exercises, which is a foam roller bridge. That’s kind of a treatment and an assessment, to be honest. So you can put someone into a foam roller bridge, which is basically a liner back. Put your feet on the foam roller, the arches of your feet, or you can go on the ball of your foot. Let’s hook your pelvis, lift your hips off the floor. Your knees are a little bit bent, and you just stay in that kind of longer lever bridge, which is not a straight knee with a slightly bent knee. And you’re pressing down through the ball of the foot or the arch of the foot, depending on the person. And you’re just kind of trying to actively plant reflections down into that foam roller. What that’s going to do is get the foot to be active, the ankle to be active, the coleus and the gastric and the distal hamstrings.

And then you’re going to get some proximal hamstring and just a little bit of glue, and you won’t get too much back extensors. If the back stays nice and low, you don’t want to go up to too high. So you’re basically assessing by doing that to someone, and then you want to see them be able to go on to a single leg and hold it for at least 30 or 45 seconds. Most people with knee pain can’t do that. To be fair, most people can’t do it at all in the first place anyway. So they’re just not strong enough. But most people certainly have knee pain, they just can’t do it at all. Like they go into a single leg and they’re gone. Whether that’s an inhibition thing because of the pain, maybe some of that is definitely part of it. But a lot of the time they’re just not strong enough there. And some people will ask the question, and it’s a fair question as to why. Okay, is it a strength thing purely and maybe not, because a lot of these people can go and do a lying hamstring car and then a load of calf raises and that won’t they’ll be really strong in each of those exercises individually.

But as soon as they try and get these muscles to contract, synergistically and co-activate together, they don’t have any ability to do that. That is interesting to me, because when we go and walk and when we run, these muscles have to contract together to help to stabilize the knee in place, particularly in running. You want to see more oscillators around the knee joint when the foot hits the floor and you don’t really see much change in knee angle at all. Actually, when we go for a run, if you look at a video of any good runner, any good sprinter. The knee is pretty much in a noisy metric contraction. The muscles around the knee are pretty much in noisy metric contraction, particularly like you’re looking at gastroc, median, lateral, distal hamstrings and the quads. And that then allows the hip muscles to get more of an active hip extension from things like Max and stuff like that to push us forward. When people can’t do that, they’re not strong enough or they can’t coordinate those tissues well enough. You see, like a slightly wobbly you might not even see it, but either they’ll sink down into their knee too much, so they go down into too much knee flexion, or else their knee straightens back too soon.

Key Things David Looks for When Assessing Someoneā€™s Pain

Either way, it’s kind of the same issue, which is the energy is not being transferred around the lamb effectively and efficiently. And so maybe the knee joint is just getting kind of beaten up a little bit as a result. Because if you look at the anatomy that’s set up around there and you look at the tissues and you try and understand the architecture of these muscles, then you’ll see biarticular muscles. So reefing is crossing there, the gastroc hamstrings, these kind of long tendons where you see that, you can see, okay, these are designed to transfer energy from the hip down to the foot. They’re kind of designed to pass the energy through the knee joint. The knee joint is there, but we want a lot of and I don’t like the word, but I’m going to use it anyway, is stability. We want a lot of stability there. So that’s something that I will check very quickly or straight away with someone. You can just use an exercise like that. And when you see that, okay, the target here is 40, 45 seconds, at least 30 seconds. And they literally can’t do 5 seconds, not at all.

Then that’s probably my first place that I will go to. And even if that’s not what caused the issue, the root cause, which I don’t even like what you’re getting using those words because we don’t even know we never know what the root cause actually is when it comes to pain. That type of giving people that feeling of those tissues contracting together seems to give their brain some kind of sense of maybe it is stability where it’s like, okay, we have muscles here that we can use and we can stabilize the knee. And it does make you wonder because a lot of the time people stand up, they go for a walk and they feel better. And yeah, maybe they’ve warmed up a little bit, but they feel better the next day again. And every day they do it, they feel a bit better and a bit better and a bit better. And it makes you wonder about why, because in two days it’s not fast enough to build strength. So two days we need a couple of months to really be able to build any significant amount of strength in these tissues. So it’s more of a neural patterning thing, I think, where you’re starting to rebuild this connection between these tissues and this inter and intramuscular coordination.

So that kind of coordination between the tissues, I think, is not the biggest thing necessarily, but the biggest thing initially is to check off with someone and start to give them back to them. And I do see massive changes there. So I’ll stop that soliloquio there for a second before I keep going further.

The Inability to Contract Efficiently 

James Cerbie: No, yeah. It’s really interesting to see, I think, the difference in context for people where they have a hard time getting the positioning and coordination. It’s just like by changing context, it totally changes their capacity to actually coordinate contractions and essentially Orient themselves to space appropriately. Right. Because you can take someone that deadlifts 500, I know that you’re strong. You can’t deadlift 500 unless you have some juice in your life. But then we change the environment and we have you do the exercise that you’re describing or even like a really watered down version. It’s like a 99 deg on a wall and it’s just like we’re all over the place. It’s like you get them to kind of like, all right, reach your butt pockets, reach your knees up to the ceiling, and they kind of finally get a little bit of the posterior tilt, kind of get those ribs coming down a little bit and they start shaking like crazy. Right. I don’t know, it’s weird, right. Because it’s not really like a strength thing. It’s just they have a really hard time getting into that position and then managing that position. Right, exactly.

David Grey: It’s a position. It’s a sensing foam roller bridge that has a lot more strength involved than that stuff. But you see the same in that stuff. It’s a tissue that seems to be unable to have an inability to contract efficiently in that joint position and that joint angle. Some people will push the agenda on the power lifters where it’s like, oh, you can’t even do this bridge and you think you’re strong and they are like lifting a shit on a weight. They are strong. Do not get that twisted. They are strong. A lot stronger than the person who’s probably saying that, definitely a lot stronger than me. So it is a position specific thing, but it also does maybe show, like, you’re probably missing something here. And it goes back to the exact thing that I said at the start when I find something that I think is missing, not a random thing, which is like anyone can find any weakness. Frc does this. It frustrates me a little bit where it’s like, you see FRC trainers. I don’t want to be a knock on FRC. I think some of that stuff is good, but it’s like, I put you into the most shortened position in your hamstring and I ask you to pull your heels to your boss in the most shortened position and you get a cramp.

And I use that as proof that you are really weak in this angle. And you should train that joint angle. I don’t mean it like that. Anyone can find any easy way to prove to someone, oh, if you put your elbow in this position and I push on it, you’re weak there. So you should train that way. I’m talking about meaningful positions here. Meaningful joint angles. Meaningful. Like, not extreme end ranges, just ranges that you should, I think, have some ability to get into and get some contractions there.

James Cerbie: Yeah, I think that’s such a good point. Right. Because it’s not that hard to sit around, like try to poke someone and just tear them apart. Whether it’s a movement realm or there’s a programming realm, it’s not hard for me to throw the government at you. Look at all these things you suck at. Like, here are the issues that we need to fix. I think we have this co-contraction thing right in that. Single leg or double leg foam roller bridges are a really great diagnostic that people do for themselves at home. I’m sure you have a YouTube video or on your Instagram. I’ve seen that exercise literally all over the place. Granted, you’re probably going to find like 37 other people doing it that have just taken it from you. So you’ll be able to find it. Just Google, like a single leg foam roller bridge, I’m sure. But definitely one worth. One using a kind of a self-assessment, self-diagnostic on yourself, and then two, something that’s highly worth putting into training, even if it’s something that you do in the back end. If you warm up every day just so you get more repetitions with it, you can do it at the end of a lift.

It’s great to prep right before you go running, obviously. So that’s kind of a big rock. Big bucket number one. What would another big thing be?

The Second Quickest Way to Assess Knee Pain

David Grey: Yeah, that’s a big one. And it’s an easy win. That’s why it’s such an easy win. And you know what? Some clients, sometimes you have to work hard to convince clients that this is why, especially with the breathing stuff. I spoke with this on our membership site the other day, like ways to build body in with the breathing stuff. Sometimes you have to be really smart and sneaky and sneak it in the former on a bridge. You don’t have to be sneaky. I’ve never had to be sneaky. It doesn’t matter if it’s an Olympic athlete, professional rugby player, an NFL player, or a 50 year old woman, a six year old woman, or a seven year old woman who’s never ran before. You do a foam roller bridge, they feel those muscles contracting, and then you say you feel that you need to get better at this and they’re like, I agree. There is no questioning. There is no buyer needed. Right? It’s done. Simple as that. The next big thing or a couple of big things is definitely looking at the hips, definitely looking at the feet. But the quickest, the second quickest win after a foam roller type of thing, bridge type of thing is looking at the movement of the shin.

How Little Movement Most People Have in Their Shins

I talk about this constantly on Instagram. People kind of think they understand sometimes what I’m saying, and they try to do it and stuff like that. I’m not so sure. But we look at the Shin and we look at how the shin travels forward and backwards in space and rotates in space. Such a big deal. Now you can go and this is like a plus for the FRC stuff. They do like kneecaps, where they do like tibial rotations and stuff like that in the open chain. I think that stuff can be really nice as both an assessment and a treatment. If you have someone with a really cranky knee joint and they don’t even want to really load onto it, they can’t even walk up the stairs or anything like that. Give them some knee cars and just open chains to build rotations, it would make them feel a lot better. And it will also bring some awareness there and just get some movement in there. That’s also an assessment. Can you actually get some rotation in your Shin and then seeing where the shin angle is in space when they go and move and do these, do whatever movements?

That’s a really big deal. We basically want to see someone that can transition through the gait cycle, which you can equate to a lot of exercises in the gym. Some people like to do that. Some people hate that. I find it to be quite useful to be able to understand that and basically, excuse me, break it down into three phases of the gait cycle is the easiest way. I think kind of more of a heel strike midstance and then toe off. And the easiest way to think about those three phases of gait is seeing a negative chain angle and then you’re moving towards that more vertical chain and a positive shin angle. That’s what you’re going to see as you pass through the gait  cycle. So a lot of the time with a knee issue, people are struggling to get that Shin to travel forward and backwards in space, which couples with the rotation that you’re talking about then in the tibial rotation stuff. So this is why the knees over toes, guys stuff can work for some people and can feel quite good for some people, I think it’s much less about building VMO strength and this magical muscle that he talks about.

I think it’s much more that they’re just actually bringing the joint true range of motion now. It’s also why half the people get better when they do a program like that, and half the people end up with worse knee pain or never had any pain, and then they have knee pain because you’re bringing the joint into extreme ranges of motion, and you need to do that in a smart, progressive way. And that’s not to say he doesn’t do that. It’s just some people that do the program won’t do that. They won’t listen or whatever. I don’t know the program, but looking at the machine angles and looking at how people what movements people do when they do their squat, for instance, like, do they just kind of sit down, sit back into a hinge, and the shin just stops at a certain point and the hips have to keep going or something like that? Looking at when they go for their walk, are they actually able to transition their shin forward and back in space like that? And that couples then with what’s happening at the foot, because if you’re able to transition the chin forward and back positive and negative shin angle, you’re going to see a rotation and you’re going to see pronation and supination at the force.

If the shin doesn’t actually move that much, which you would be surprised how you would be, but a lot of people would be surprised how little people actually know how little movement they actually get from there, then you’re not going to see much movement at the feet. You’re going to see feet that are locked up, even in more pronation or supernatural. But it doesn’t matter. The answer is they’re not moving at their true range of motion. So that’s where I would go now. Why is that happening? Maybe that is an issue that’s happening more approximately. So I’m really locked up at the rib cage and all of that has to travel out of this city from there. It does in my mind. There’s no doubt about that. But whether we have to wait and clean up all of that stuff approximately, like clean up the ribcage, clean up the pelvis. I do it with clients because I think I would be robbing them of just feeling better in their body if I didn’t. But I don’t wait until I’m not an approximate distilled guy. I just go to where I feel like I need to go to get the biggest improvements in the fastest way possible.

So I think going after that shin and teaching it to move negative to positive, external to internal rotation, supination to pronation at the foot just changes people’s whole feeling of their whole lower body and their knee very quickly if you do it in a smart way. And some of that work paired with something like the foam roller bridge. So the foam roller bridge can be cool because it almost desensitizes the knee joint where I do a couple of sets of it, and it’s like I’ve just burned the hamstring tension into my brain. And now it’s taken some sensation away from the anterior knee. Now I’m able to just transition that knee joint. Whether it’s a step up, whether it’s just a kind of a knee forward and back motion, whether it’s a squat variation, whether it’s a step down, it doesn’t matter. I’m just looking for that Shin movement and that experience of the arches can load and unload again.

The Purpose Behind Basic, Non-Sexy Exercises

James Cerbie: Yeah, I really like that. Some exercises in that realm, this is where you take basic exercise exercises, say like a lunge or a step up or a step down. And the exercises may not look sexy, may not look fancy, but these are the things that are going on underneath the hood when we’re prescribing these exercises. There is a real reason that I’m giving you this Besides just, hey, dude, let’s get bigger quads and bigger ass. I want to actually see this tibia move through space. If I give you a split squat or a lunge variation, that lead leg tibia is going to have to move through space. I can have you go forward. I can have you go over first. We can do step ups, we can do step downs. There’s so many ways there to actually start getting that thing moving in space. And then obviously, the nice part about that is you can’t do that without tying in what’s going on at the foot also. Right. Those exercises have been a really nice big catch all, which is why we use them all the time, which is why I think most people listening to this at some point in time when they’re training, we talk about this all the time.

Why You Need Exposure to Single Leg Work

You need to get on one leg, you need to do unilateral activity. That’s not to say you need to take out your big guns, squat, bench, deadlift, et cetera. But there needs to be repetitive or at least exposure throughout your program to unilateral activity, because that is what’s going to actually translate better to what’s going on when you’re on one leg in space performing gait for other things along those lines.

David Grey: Yeah, exactly. The phone, roller bridge and stuff like that. That’s promoting again, I hate the word but like stability. You’re thinking on the stability side of it because you’re talking there about synergies. You’re talking about not co-contractions in that exercise, but you’re thinking that might transfer over to co-contractions of the agonist and the antagonist. When they go for a run, then the shin work, you’re talking more relative motion. So you’re trying to increase the motion at the joint. So they’re kind of doing the opposite of each other. But the funny thing is they complement each other so well because it can desensitize an area and then actually have a chance now to move through more range of motion so they can really help well with each other, even though in theory they’re doing the opposite things. Moving the heel bone is something that people don’t talk about a lot. It should because it should couple with that Shin movement as well. Like, if you look at the calcaneus and everything is just basically stacked up above that, you will find it hard to move your shin around in space if that heel bone doesn’t move at all.

It should move more than most people think it can. And it sounds kind of like an arbitrary thing, but sometimes it’s hard to describe this stuff on a podcast. And until people actually feel this stuff, it’s hard for them to understand how important or how good this stuff can feel. But actually getting that Shin to move forward and rotate and get the heel bone to move on the floor, for it to move on the floor, you need to have it actually heavy on the floor. First of all, I’m not a guy who’s always some of the people who come from the PRI world, everything is true to heels. True to heels, true to heels. I’m not like that. I don’t agree with that. I think some of the time that’s important. But it is definitely important to get some weight in the heels and be able to especially get like that version and inversion of the heel. You’re going to start to unlock a lot of movement at the hips and at the knee and the foot if you can do that. So that is important. Giving people an understanding of where I can get that pressure is really important.

With regards to the co-contractions, what you’re going to see is people, the further forward I get in the gait cycle, the more everything locks up, right? So earlier in the gate cycle, I have more room for movement earlier in the gait cycle. So there’s just a little bit more room for wiggle through my joints. Okay, the further I get forward, the more everything needs to stiffen up. So if you think about trying to think about, say, I’m doing a sumo wrestler with a big guy, right? If I’m leaning into him and I’m trying to push him backwards, I’m going to be on a very rigid foot behind me. Both feet are probably going to be a very rigid lockdown my knee joints, I don’t want it to move. I don’t want my hips to move. I just want to put force into the ground and try to put that force into him and push him back. If I’m on a spaghetti foot at that stage, it’s not going to work. If my foot is flapping around, if my knee is flapping around, if my hip is flapping around, the force is being dispersed at my joints and not going from the floor into him.

So if you think about that, that’s a toe off position and everything starts to lock up because it needs to push and propel myself forward. If you take it back to midstance and then you take it back to earlier stance, I have more options to further back in the gate cycle I come. So when you see knees like that that are very cranky all the time, very little movement, hips that have very little movement, they are probably more forward and are probably trying to push against the sumo wrestler all the time. They’re in that proportion all the time. We can bring them back, which might require doing some ribcage work, doing some pelvis work, mostly more than any of that stuff. I just see I just try and give them an experience in an exercise in a simple knee forward and back exercise or a lunge or something that they can start with a negative Shin angle. So the knee starts from behind the ankle and then it can transition forward again. You see, like ā€œKnees Over Toes Guyā€, I don’t think he invented a split squat for doing split squats and stuff like that.

Really nice exercise. I think that’s probably why these things are helping people.

James Cerbie: Yeah. I think like the sumo example there in that end of phase of gait is really getting interesting because really what we’re describing there is extension. When you’re a tower, we’re essentially at some level systemic extension, extension at the foot extension, knee extension at the hip, extension all the way up the chain. And that’s where we need that extension to take place. Right. You need extension if you want to be able to generate force and be powerful. That’s why I hate when people get so dogmatic, people attacking extension like it’s evil. It’s only a bad thing if you can’t manage it and get out of it. Like if you’re just perpetually, as you mentioned, if you’re always pushing against the sumo wrestler, if you’re always able to air quote this one, always extended, always propelling forward in space and you can’t get out of that, that’s when we start to run into some issues.

David Grey: Yeah.

James Cerbie: But that’s kind of how I think about it.

Where and When You Need Extension to Take Place

David Grey: Yeah. I said this somewhere else recently. I valued extensions so much that I don’t want you to be there already so you can move there. And that’s all I talk about. When I talk about extension, I don’t care how much extension you are in. I just want you to be able to get into extension. That’s it. So I don’t know why. How much is too much. I just need you to have some room to go there. So to have some room to go there, I need you to have some room to come out of there. That’s all. Just enough variability. When I think of extension, I think of just co-contractions everywhere. So the whole body around the spine, the ankles, the knees, the hips, co contractions everywhere. This is what you see in people who have lost a lot of movement is co contractions everywhere, and we need to get rid of them. There’s just muscle activity everywhere. You cannot relax. So relaxing is so important. Telling people to relax is probably not the greatest thing to do. But some of the time I think the breathing work just works to get someone lined on the floor.

Not necessarily because I’m doing all this funny ribcage stuff. Just because they get a chance to chill out and settle down and their spine gets a chance to kind of fall into the floor or whatever. So just relaxing, taking away that chronic tension on the agonist and the antagonist at the same time and just having a chance to take joints to a range of motion. Again, take muscles to a range of motion. These things don’t have to be super complicated, super complex. Just give people what they don’t have.

James Cerbie: Yeah, a couple. It’s hard to extend on something that’s already extended. Right. We gotta get you a little bit of flexion so you have something to extend into. And then I think that point there about the Co contraction is so important because just conceptually, if the body doesn’t feel safe in space, whatever you want to call it, the only real tactic and strategy it has is to essentially fire every muscle it has around that joint to try to stabilize it again, that word comes up again. But to try to stabilize that joint. Right. So we have to somehow give an input or a signal to make sure that the brain essentially pertains itself to being safe in space. So we can get those muscles just to cool down a little bit and give us some room to actually start to play and learn and just kind of reprogram. If you want to use that language in terms of how we Orient ourselves or space as we move, then I think that’s the third big point there. And this is like a theme that comes up all the time. That’s why I like doing podcasts, because you talk about so many different things.

You kind of get these Nuggets and beans that come up all the time. Again, it came up when we talked with Ty Terrel and a few others, this idea of trying to fill the empty bucket for the person that’s in front of you. What’s the empty bucket? Find that thing and fill that thing. Because if I can fill your empty bucket, if you can fill your own empty bucket, that’s going to give you your biggest ROI return on time investment. And that’s maybe where the true value of a coach comes in, because the coach finds the empty bucket really fast and knows how to feel it when you try to do it on yourself. It’s kind of like a shotgun approach. So it’ll probably work for some of you. It probably won’t work for all of you.

David Grey: Yeah, exactly. If you’re willing to put aside your ego, which can be hard and not like we want to be really fancy sometimes and say, I have all the answers and stuff. If you just look at someone’s training program sometimes and just what is missing in there? What have you not done for so long or even better? What are you just doing way too much of, let’s just strip that back a little bit. I don’t want to change too much. I don’t want to change 100 things all at the same time because I want to have a clue what worked. Let’s just take out whatever variation you’re doing and try this variation instead. Like I said earlier, let’s put in some of your calf work instead. Let’s give you a couple of foam roller bridges before you go and squat and see if that helps. Maybe I can give you two or three sets of a breathing exercise. Some people are saying you don’t have time to do that. There’s an obesity epidemic in the world. Don’t do breathing exercises. I’m sorry. You have two minutes to do a breathing exercise. If it makes someone feel better and moves through a range of motion, you have time to do it.

The bigger issue for the obesity epidemic is if people get in chronic pain and they can’t train anymore or they feel like they can’t train anymore. Let’s keep people healthy and look at things from a longer term point of view. Other people what’s funny, which is almost like a rehab professional, it’s a little bit contradictory to my thought process. Right, because I’m always looking for evidence and proof that you’re ready to move on to the next stage. I’m very aggressive with my rehab, with people. Very aggressive. But I always need proof that you’re ready to move on. So I won’t get someone to run until they can prove to me that they can do some kind of plyometrics, some kind of continuous hopping type of thing. I’m not alone in that. That’s a very common type of thing. But other people would just go for, okay, you can do one and a half times body weight back squat. Now you’re ready to run. I don’t see any correlation or any link between those two movements whatsoever. So I am always looking for proof. I want proof to know that you can move from this stage to this stage to this stage to this stage.

And I’m very systematic with that. But sometimes what’s weird is someone can have knee pain and they can go and start to do plyometrics, and it seems like that can be the tonic that they need for whatever reason. I don’t know. But maybe it’s because especially if it’s more extensive plyometrics and Pogo hops and stuff like this, maybe it’s because it’s ours to stimulate the ankle and get the foot. You’re not thinking about getting off the floor as fast as possible and shorter contact times. Maybe you’re just allowing them to feel that floor. The foot is able to yield a little bit. It’s not just all, but overcome, overcome, overcome. And you start to train this ankle. You start to train this calf, you start to train the contractions around the knee joint. But the key thing is they’re getting a chance to relax in the air and they’re preparing for contact. They’re making contact. They’re off the ground again. That can help, but that could also flare the life out of someone. It’s not something I would just throw someone into, but I have seen this weird stuff helping. So sometimes there is no necessarily rhyme or reason for this stuff.

But again, maybe it is like, okay, they were just missing these kinds of polymeric types of contacts in their training and their body just appreciated this kind of faster lengthening and shortening of the tissues and the pretension. And actually I would just call it more reflexive movement. That’s why they appreciate a more reflective movement, a movement where I didn’t have to think about anything. I was just doing it and my body was organizing. So that can be really cool. But I wouldn’t suggest people just throw people with knee pain into that straight away. You should have at least some proof that they feel like they’re ready for that, unless you like to take chances with our clients, which I wouldn’t be a big fan of.

James Cerbie: David, this has been fantastic. This has been such a fantastic conversation. Really glad that we got to get you on here to do this. I think there’s a lot of nuggets and takeaways for people listening, which is always one of the hardest things in the podcast is trying to not keep it 100% theoretical and give them something to walk away with. Like go do the foam roller bridge. If you take anything away from this episode, I think with all the stuff we talked about, the easiest thing for you to go do for yourself is that foam roller. Try it on two legs or two legs. Easy. Try it on one leg. You know, have something at least to start pointing in the direction of both assessment and training for people that have listened here and really enjoyed the episode would like to come find you and what you do and look more about you. Where can they do that?

Where to Find David Grey

David Grey: Yeah. And go and do the foam roller bridge. And I don’t want to make it into like this is the exercise, this type of thing. Just for an example, just feel something, right. They can find me best places, probably Instagram, David Gray, Rehab, and if they like my stuff there, I will sell them all our stuff from there. But we have a membership site where we talk about movement and I do a couple of videos every week and break down different things for people. And we have some programs and stuff there which I think could definitely help with a lot of people’s knee pain. So Lower Body Basics is one that I think 8000 people have done now. And to be honest, I don’t want to be like a catch all this will help everyone. It probably won’t but it will help a lot of people and everyone learns something from it so that’s definitely a good place to go with knee pain. Basically I put it together, I was like when I couldn’t take on any more clients, it was like, okay here’s the things that I would probably do with most of my clients and I’d like them to be good at all this stuff even before they came to see me and in most cases they’re not.

So that’s where they can go. Excuse me, my voice is going, that’s where they can go and check some of that work out and thank you very much, James, I appreciate it. I think you’re doing a great job man with everything and I really enjoyed the chat as always and I’m looking forward to catching up again soon.

James Cerbie: Appreciate it, man. Everybody listening, thank you as always for tuning in. Have an absolutely beautiful rest of your week, family. Talk soon, bye.

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