Latest / Motherhood Alliance Podcast / Stop Blaming Squats: Why Your Knees and Low Back Actually Hurt w/ Dr. Matt Buch | Total Pursuit PT
Transcript
- Andrea Renkas: Welcome back Dr. Matt. Matt Buch: Thank you, happy to be back. Andrea Renkas: we had a really interesting episode with you in this last one. So this is our second episode with you, we're going to be talking about, bulletproofing your knees, your back, just making sure that you're doing the right things when you're moving your body. And I think that this is going to be really insightful. If you guys haven't listened to the first episode with Dr. Matt, we talked a lot about his story. We also talked a lot about how stretching and rest aren't necessarily the best ways of going about ⁓ taking care of obviously doing it initially is great, but that's not long term. So you want to learn more about that definitely listen to that first episode. But in this episode, knees and back, ⁓ are those two areas such a huge problem for so many people, whether they're super active or, you know, not so much? Matt Buch: Yeah, so two very common things that we see in the clinic. I'll start with the knee and one thing that I think is really important to know about knees and why they can become such an issue is because knees are kind of dumb. They don't make, they don't, what I mean by that is they don't make a lot of decisions for themselves, okay? Britney: Hey everyone, we are Brit and Drea from motherhoodalliance.com and we are excited to welcome you to a four episode series with Dr. Matt Buch, a doctor of physical therapy, board certified orthopedic specialist, and the owner of total pursuit physical therapy and performance based out of De Pere, Wisconsin. Dr. Matt works with active people of all kinds from athletes who love to train hard to parents who simply want to run around with their kids without dealing with constant aches and pains. But what really sets him apart is his belief that pain isn't something you just live with. you Matt Buch: So they are heavily influenced by other areas of the body. for example, the knee basically like straightens ⁓ bends. That's all it does. Okay. If we really want to get into the weeds, there's a little bit of twist in there, ⁓ for our purposes, it straightens and it bends. The two joints that the knee ⁓ ⁓ by, the hip and the ankle on each side of the knee, they straighten, bend, Britney: So if you've ever been told to rest more, stretch more, or chalk it up to getting older, he is really passionate about challenging that mindset. His approach focuses on uncovering the root cause so that you can move better and feel stronger for the long haul. Dr. Matt creates customized treatment plans that often combine hands-on techniques like dry needling, cupping, and joint manipulation with strength training, movement coaching, and realistic habit shifts that actually fit your life. It's not just about getting you out of pain. It's about keeping you active long-term. Matt Buch: they rotate, they twist around, they go out to the side. There's way more movement and way more things that can go awry in those two joints. And usually what happens is anytime there's a problem either of those other two joints, the knee is gonna take the brunt of that force. ⁓ that's ⁓ main reason why the knee is such a common problem child for so many people. Britney: And outside the clinic, he's an avid bow hunter, climber, outdoor enthusiast, husband, and dad to two young boys. So he truly understands the value of being able to move well and keep up with the life that you love. Matt Buch: The back, let's specifically talk about the low back ⁓ I think low back pain is super ⁓ in culture and ⁓ in the that we see. Really same thing. The low back, ⁓ it bends forward, bends back. It does a little bit of rotation and side bending, but not a ton. Most of your other movements are coming again from your hips and then even up from your upper back. your shoulders, neck, everything else. So if doing full body movements, let's say like a, a hip class or like a bootcamp style class, and some of other areas in your bodies, your hips aren't rotating properly to, get down into a squat. your shoulders don't have enough mobility to, get a weight up overhead. Usually your low back is what's going to and compensate. for the lack of ability in these other parts of your body, which means that your low back is gonna become way overused or more than what its capacity is able to tolerate. And therefore we're gonna end up with some low back issues. Andrea Renkas: so if lot of people who especially are active, right, if they're having knee or back pain, should they stop those lunges and squats? What should they do if they're feeling that pain in those areas? Matt Buch: It really depends. I think ⁓ it's something that is, you know, a acute injury, and what I mean by that is something that's happened, yesterday, a couple days ago, and they're still just really recovering from, you know, an injury that just occurred. Yeah, absolutely. Resting, just kind of letting your body calm down. If there's any swelling involved, letting that calm down. definitely gonna be step number one. If this is something that's been going on for more than a week or two, then rest at this point is really not going to do a whole lot of good usually. Unfortunately, a lot of times people will start to avoid certain movements, like squats, things like that. And avoidance will generally just make things worse over time. Because in order to ⁓ reduce the amount of sensitivity in our tissues, we actually need to use those tissues in those movements to allow your body to adapt to that and allow your brain to realize that, okay, this isn't necessarily a dangerous thing. So when we don't exercise that, all of a sudden those tissues become more sensitive and then you go back, try and do squats or lunges, let's say a month later, and it hurts even worse and you're like, ⁓ crap. So better stop doing that again. And then two or three months later, you're like, all right, well, it's been enough time. Let's try it again. Well, that sensitivity has just continued to heighten. And now all of a sudden, your body is really sending these pain signals when it doesn't need to be. Andrea Renkas: We're always squatting, we're always we're lunging in different ways, whether that's to the sides or to the front, maybe not exactly what you would do in a hit class or a, you know, strength workout. But it's still those are natural movements. And if you're not doing that with weight in a gym or strengthening somehow, it's not gonna go well in real life. Matt Buch: Absolutely. I think that brings up another really good point ⁓ you to train your into ⁓ the types of positions, ⁓ movements, whatever it is that you're actually going be your body in real life. So for Have you ever heard don't your knees compass your toes when you're squatting? Andrea Renkas: Yeah, that used to be a really big thing and I know it's not anymore. Britney: Yeah, I... Yeah. Matt Buch: Yeah, exactly. might still be a good rule if you are doing a barbell squat with a lot of weight and you're doing an Olympic style lift that's very form regimented. Probably a idea to keep that good form. But if you're chasing kids around the yard, if you're backpedaling, if you're jumping up onto a during a HIIT workout, your knees are coming past your toes all the time. And so it doesn't really do you a lot of good to only train in that, you know, quote unquote perfect form when in real life you're going to be in all of these other types of positions. so what's really important for us ⁓ to figure out, okay, what movements, what positions is your body not tolerating? And then how do we systematically build up that tolerance to allow you to do the things that would normally cause pain. Britney: Yeah. So that's a really good point. ⁓ okay. So I'd love to get some like tangible that people can start doing in their homes. So ⁓ let's just say that somebody ⁓ they've experienced ⁓ back or knee pain on off, and just like, I feel like I'm just weak and weak. And so what should people be working on strengthening to make sure that the muscles around those areas are ready to handle the load that a regular workout or even everyday life would, would bring. Matt Buch: Totally. So take the back for example. ⁓ things that people will think about when, ⁓ know, okay, my back hurts, I need to start to build up strength ⁓ gonna be core strength, right? Which is totally correct. You want to build up core strength. ⁓ wanna build up good ⁓ strength. So starting, depending on where they're at in terms of their fitness level. They need to start at ⁓ a place that's going to be appropriate for them. So a lot of times I think people get themselves into trouble. They ⁓ up on YouTube, core for low back pain. And that may not match what their physical ability level is. It may not match the area that's actually weak for them. So what I would tell people if they are looking to start to build up that strength at is you want to start very low level and then just systematically build your tolerance up until you get to a point where you're feeling a little bit of your symptoms. So let's say we're talking about low back pain again, you know, three to four out of 10 and then work that exercise that kind of lists those symptoms just a little bit. Over the course of time, what you'll find is that the more you do that, all of a sudden those pain levels start to come back down. And then a certain exercise, say a dead bug, for example, you're laying on your back, you're kind of straightening one leg, one arm, back and forth. Maybe that used to cause a four out of 10 pain, what would call like, you know, just a ⁓ moderate Now all of a sudden is ⁓ pretty pain free. Cool. Now we want to advance that along again. And you just kind of keep pushing your body's tolerance a little bit. So complete pain avoidance is usually not going to be enough to change the way your body perceives pain and actually build up that pain tolerance, but also completely blowing through it and saying, all right, screw this, I'm just going to go for it. not quite right either. ⁓ we got to find our, what I would call like our Goldilocks parameters. ⁓ We to be just right. Same thing goes for the knee. If you that squats or lunges cause a lot of knee pain, maybe what we need to do is just start with a quarter squat or a quarter lunge. Do that for a week or two. Once pain level comes down, just continue to progress the depth. Where we come in is we're gonna into some of these other things, like we talked about the hip. the ankle, we're talking about the knee, figure out, you know, what's not moving correctly, what's weak, what we need to build up in order to prevent that stress ⁓ being pushed onto the knee. And then do that at the same time. Same thing with the back, ⁓ you know, out, okay, is it a shoulder issue that, you know, your shoulders aren't strong enough, they're not mobile enough, so your back is, you know, taking ⁓ the brunt the force every time you lift something overhead, whatever it is. We want to figure out how do we address those things as well so that along with just building up the tolerance at the area specifically, now we're taking a full body approach and really bulletproofing yourself. Britney: Yeah. Which I think is a really good point because as much as people don't want to take the time or spend the money, like seeing somebody like you, or even a personal trainer for just form evaluation would be really good because if also at the same time, if you don't know how to do a workout or your, your form is poor, you could just keep re-injuring yourself and, having somebody like you be able to pinpoint those ⁓ areas that could use strengthening or stretching. That's can be really key. I do want to talk a little bit about some high impact sports though, because things like CrossFit, things like HIIT workouts, things like running, especially Drea So background, I don't know if you really know this Dr. Matt, but Drea and I are personal trainers. So our whole background over the last 12 years has been, prenatal and postpartum personal training. And so we do have a background in this as well. so with the women that we've really worked with in the past and women as a whole in society, society puts a lot of pressure. on us to like be able to do the things that we did pre-pregnancy or jump back in and be able to perform at the same level that we did before. And so I think a lot of women, or even just look how we did before. And so a lot of women are turning to things like high intensity boot camps, CrossFit, maybe it's at home, HIIT workouts, maybe it's running and they're jumping back into these things before their body is really ready. But some of these are different. So I'd love for you to just kind of walk through if somebody is interested in getting involved in, let's just take specifically like CrossFit and HIIT, because we're going to have a whole episode on running. What are some things that they should make sure that they're doing first before they're jumping into those workouts? How do they make sure that they're ready? Matt Buch: Mm-hmm. Totally. So, so the first thing that they want to do, let's take CrossFit specifically. If they've never done it before, you definitely need to find a CrossFit coach. Every CrossFit gym in town has ⁓ coaches are all certified. And you to do a proper onboarding, ⁓ where they're to teach you the movement patterns. They're going to teach you how to do the different types of lifts that you're going to be doing during the class. That's priority number one, ⁓ first of all, you want to make sure that you're going to be able to effectively do the movements safely without bad form that's going to potentially cause a totally different injury. The other thing that is really important, especially ⁓ thinking of women, is really taking a long graded approach to get back into this. ⁓ I know it's, and I'm sure you guys have experienced this, you wanna get back to your pre-pregnancy fitness status as quickly as possible, right? Because you're like, man, I've done that, like, I know that I can do it. But we do just need to give the body time. to heal, we need to give the tissues the proper amount of time that they need to build that tolerance back up again. I think just really being, you know, graceful with yourself ⁓ about taking the time that's necessary for your body to actually heal ⁓ and adapt to getting back into ⁓ those patterns and those workouts is gonna be super important as well. Britney: What about, let's talk about warmups for these areas of the body as well as like recovery. So knowing that these are areas that especially people who are just getting back into fitness, they can be more injury prone. How much time do you typically spend on warming up these areas? Give us a couple of specific exercises to be doing and then let's talk about recovery too. Matt Buch: Yeah, warming up is like every athlete's least favorite thing to do. We'll ⁓ with that. But it's the most important thing. when we warm up, you should literally be warming up your entire body. Like you should be sweating by the time you're done with your warm up. Okay. It's not a couple quick like shoulder circles, a pigeon stretch, and then we're good to go. This should be a relatively Andrea Renkas: Thank Matt Buch: good amount of time that you're getting the blood flow going through your body, you're elevating your heart rate, you're breaking a sweat, your your tissues are prepared to do this high level activity. So if we're thinking about the knee, for example, we want to really make sure that that our hips are as warm as they can be. So doing some banded, you know, sidesteps, some monster walks. doing some walking lunges, maybe some resisted hip rotations, just to really get all of these muscles to fire on all cylinders and really get the blood pumping into these muscles that are going to support your knees as you're going into ⁓ squats, things like that. Same thing with the ankle, going through some double leg calf raises. single leg calf raises, some little ankle hops, just getting those light plyometric drills in to only elevate the heart rate, but also get ⁓ calves, your Achilles tendon, all of these other tissues ready actually take on load, get the blood flowing in there ⁓ so they're as safe as possible once you do actually start adding on weight ⁓ or speed, intensity, things like that if we're talking about more of a boot camp type workout. And then same thing with the upper back, know, make sure that, or excuse me, the lower back, make sure that your shoulders are really warm so that if you're doing any type of an overhead movement, you're not compensating with that lack of mobility in your shoulders ⁓ overarching your back and then placing all that stress through your low back. Making that your upper back muscles are ready to take on the load that you're doing. So really just getting all of the supporting structures around these areas. very warm. Like I said, you should be breathing heavy, your heart rate should be up and you should be sweating by the time you're done with your warm up. Britney: Drea and I have taught a lot of group fitness in the past, just kind of a simple way to think about it is basically do your workout, but maybe with no weights, like do it, like just going through the motions that you're about to go through just with no weights and maybe in a little bit slower, like, especially if you're going to do high impact, like do it in a low impact form. as well as I feel like with the lower back, a lot of people don't typically think about ⁓ those being worked. But if you're like a deadlift, people think, ⁓ this is for my hamstrings and my glutes. is so much your lower back too. And so ⁓ they don't necessarily think about warming up their low back, like they would one of the arm or leg muscles. And it is like going through the motions of what you're about to do ⁓ might be really helpful. Matt Buch: Absolutely. Yeah. Even, you know, thinking about a deadlift, like just taking an empty barbell, you know, doing some, some good mornings or doing them with a band, ⁓ going through some, Jefferson curls with lightweight, where you're just getting your back to, to fully arch and then fully extend going through that full range of motion, just to, to get those muscles working through their entire motion, ⁓ is going to bring a lot of blood flow into the muscles, which is going to help prime them to, be ready to accept that load. And it's also gonna get your nervous system ready to engage these muscles when it's necessary to protect your body with that good form. Britney: what are some good rules of thumb for recovery? you know, if somebody's doing low impact stuff, 20, 40, 48 hours, I think is kind of a good, um, and common rule, but specifically with these high impacts, like with CrossFit or with HIIT type workouts, where a lot of them are full body. How, how are you working recovery? How many workouts a week is kind of appropriate? us through your thoughts on that. Matt Buch: I want to start off by by saying that everybody's going to be a little bit different. ⁓ It's to completely depend ⁓ on person, what their fitness level is, what their load tolerance is, all of that stuff. so let's say we're talking about a high impact ⁓ crossfit style workout where we're doing, you know, full body. Generally speaking, you want to allow 48 hours of recovery between hitting these major muscle groups The nice thing about these types of workouts ⁓ generally you can do them five days a week as long as your body has the tolerance if you're varying the stimulus and varying the lift that you're doing. So example, I wouldn't recommend throwing 80 % one rep max deadlifts into your workout five days a week. your back's not going to like you very much by the time you get to the end of the week. But, you know, let's say you do a deadlift on Monday, you know, maybe you're doing more of a, different type of Olympic movement the next day. maybe you're doing more, you know, dumbbell type stuff Wednesday and you're just varying that stimulus. So it's definitely possible to, to work out five days a week, six days a week. I don't really ever recommend anybody works out seven days a week because I think you at least need a day of recovery to just allow your body to, to reset. But once again, it's, it's all about. Have you built up that, that tissue tolerance and that load tolerance? so if somebody who's just getting into fitness or just getting into a workout regimen, I would not recommend that they jump in five days a week, because their body's gonna. their system's gonna be a little bit shocked and they're gonna be feeling too great. So it's a matter of building that tolerance, if that makes sense. Britney: Yeah, it sure does. One last question for this episode that I think a lot of people are oftentimes wondering if they are sore from a workout, what are your hot tips for recovering from soreness the fastest? Matt Buch: Absolutely. So nutrition going to be going to be huge. You know, what's the the adage, know, muscle is torn down in the gym and it's rebuilt in the kitchen. So nutrition, you know, making sure that that you're getting enough protein ⁓ for your goals, sure that you're staying hydrated. Hydration is huge in terms of muscle recovery. Sleep hygiene massive. Most of us don't get enough sleep, at least as much we probably should. But ⁓ sleep a big factor as well. So nutrition, sleep, hydration, those are the ⁓ biggest components adequate recovery. Other things like sauna can be a awesome adjunct to it. You know, heat. Ice, I'm not big on ice unless it's an acute injury where you're dealing with swelling. some people have different opinions on that. That's, that's just mine. It depends on, depends on what your, what your goals are. So ⁓ if, if your goal to, you know, build muscle or hypertrophy, there's some evidence out there that says that, you know, doing an ice bath, bath post workout might not be the best option for that. Britney: What about ice baths, like right Matt Buch: because it's going to significantly inhibit that stimulus after the workout. that might be one thing to stay away from If you want to do an ice bath, in the morning, 24 to 48 hours after that workout, that can be totally appropriate. it helps with, energizing the body, waking things up. It can help with any areas of your body that might be a little bit inflamed, just kind of toning down that, that inflammation a little bit. That wouldn't really be a problem at all. Britney: All right. Any other tips for recovery before we close this one out? Matt Buch: I think the biggest thing honestly is just listen to your body. Most people know their bodies better than any health professional that they're going to talk to. And ⁓ in my clientele, like it's amazing what I can learn just by asking the right questions. And people will start to really kind of tell me everything that's going on that we need to figure out. you are very in tune with your body. listen to it, the amount of soreness you're feeling, the ⁓ fatigue that feeling, all of those things are just going to be, some cues that, you know, maybe you need a little bit of extra rest. ⁓ Or if you're at point where your body's feeling pretty good, you're feeling ready to go. That's a good indication that you can keep pushing a little bit. Britney: Thanks for sharing your tips for knees and low back. Cause I think there's a lot of people out there that struggle with this. So that's, that's really helpful. Are you on social media at all? Where could people follow you? Matt Buch: we are on social media. The ⁓ Instagram is total pursuit dot green Bay. So you follow for recovery tips, injury prevention tips, ⁓ we try put out a lot of stuff on there well. Britney: Cool. Awesome. Well, thanks for sharing this. do have two more episodes coming up. We are going to be talking about running and you may think a lot of it is similar to what we just talked about, but there's so much talk about running. So I'm excited that we're going to have an entire episode dedicated to that. And then in our last episode, we're going to be talking about dry needling. And I think that'll be really insightful. I'm excited to be able to ask you some questions because I've had it done myself, but I still don't understand the full science behind it. And so let's get nerdy in that episode. really excited about that. Matt Buch: Looking forward to it.