Latest / Wits & Weights | Strength & Fat Loss Over 40 / Pain-Free Knees, Low Back, and Shoulders for Training LONGEVITY (Dr. John Rusin) | Ep 388

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Pain-Free Knees, Low Back, and Shoulders for Training LONGEVITY (Dr. John Rusin) | Ep 388 · Wits & Weights | Strength & Fat Loss Over 40

• 0:01
  Philip Pape: If you've been pushing through knee pain, nursing a cranky low back, or avoiding certain lifts because your shoulders complain, you need this episode.
• 0:10
  Philip Pape: My guest today reveals why these three areas fail together, not separately, and how most training advice makes the problem worse.
• 0:18
  Philip Pape: You'll discover why stability in one area affects pain in another, how to modify movements without abandoning your goals, and what actually builds resilience instead of just managing symptoms.
• 0:29
  Philip Pape: Stop choosing between results and pain-free training when you can have both.
• 0:34
  Philip Pape: Welcome to Wits and Weights, the show that helps you build a strong, healthy physique using evidence, engineering, and efficiency.
• 0:50
  Philip Pape: I'm your host, Philip Pape, and today we're discussing why the joints that handle some of the most load, your knees, your low back, your shoulders, tend to get beat up and how you can achieve a pain-free approach to your training and movement.
• 1:05
  Philip Pape: My guest today is Dr.
• 1:06
  Philip Pape: John Russin, a physical therapist and strength coach who's worked with everyone.
• 1:10
  Philip Pape: He's worked with athletes from the MLB to the NFL to the Olympics, powerlifting, endurance sports.
• 1:15
  Philip Pape: He founded the pain-free performance specialist certification, which has certified thousands of coaches and clinicians since 2018.
• 1:23
  Philip Pape: He is the author of the new book, Pain Free Performance, which I've had the pleasure to read myself.
• 1:28
  Philip Pape: And he was even named a top 50 health and fitness expert by Men's Health.
• 1:32
  Philip Pape: Today, you're going to learn from John why your body, especially the hips, the shoulders, the core, tends to thrive as a system, how to modify movements without abandoning those precious strength goals that we all have.
• 1:45
  Philip Pape: What actually builds joint resilience versus just treating symptoms and how to progress and still train hard?
• 1:51
  Philip Pape: Train hard.
• 1:52
  Philip Pape: We want to train hard while staying healthy.
• 1:54
  Philip Pape: Whether you're currently dealing with pain or want to prevent it before it starts, listen up to the entire episode because John is about to drop some wisdom when it comes to training longevity.
• 2:04
  Philip Pape: John, welcome to the show.
• 2:05
  Philip Pape: Phillip, that was one hell of an intro.
• 2:08
  Philip Pape: I appreciate it and I'm absolutely buttered up.
• 2:10
  Philip Pape: All right.
• 2:11
  Philip Pape: You're psyched.
• 2:11
  Philip Pape: You're psyched.
• 2:12
  Philip Pape: That's what we want to do here.
• 2:13
  Philip Pape: We want to talk about how to stay healthy.
• 2:15
  Philip Pape: We got a bunch of lifters listening in.
• 2:17
  Philip Pape: We have a bunch of people that want to lift.
• 2:19
  Philip Pape: We might have an 80-year-old grandmothers who were just told that if they don't start lifting, they're going to be in a convalescent home.
• 2:24
  Philip Pape: You know, we've got everybody who needs to get healthy and fit.
• 2:27
  Philip Pape: And I want to start with thinking about the body as a system and what you call the pillar, kind of the hips through the core to the shoulders and why that's so important.
• 2:37
  Philip Pape: I know, I know when I'm doing my deadlift, why it's important, but really I want to understand the big context here.
• 2:41
  Philip Pape: Let's start there.
• 2:43
  Dr. John Rusin: There's this big misconception when it comes to strength training or health and longevity training today that we just have to get isolated strength.
• 2:50
  Dr. John Rusin: You get isolated strength at your abs for lower back pain, isolated strength at your biceps to look better, isolated strength and hypertrophy at the butt if you want to fill out your genes.
• 2:59
  Dr. John Rusin: But that's not how the body is engineered to move.
• 3:02
  Dr. John Rusin: And it's definitely not engineered to function.
• 3:05
  Dr. John Rusin: What it is engineered to do is an integrated movement model, which is central lines of tension and stability, which puts us in the best possible position to stay healthy and also optimize performance.
• 3:17
  Dr. John Rusin: And we get at that central line of tension with something called the pillar, which is essentially the shoulders, the hips, and the core working synergistically together to give us the best possible result, no matter what the goal set is.
• 3:30
  Philip Pape: Okay, cool.
• 3:31
  Philip Pape: Okay, so you're you're one of those guys that gives nice, concise statements.
• 3:33
  Philip Pape: I could tell you've been on a million podcasts.
• 3:35
  Philip Pape: I love it.
• 3:36
  Philip Pape: Okay, so so a center line of tension, central line of tension.
• 3:41
  Philip Pape: I think that's great, especially the word tension because it it reminds me of various queuing protocols with, you know, whether just today I was doing T bar rows.
• 3:50
  Philip Pape: I don't know if you saw it on Instagram.
• 3:52
  Philip Pape: Not sure if I'm prop holding the proper line of tension, but that's kind of what I think about.
• 3:56
  Dr. John Rusin: I thought you were Arnold.
• 3:57
  Dr. John Rusin: I had it wrong.
• 3:58
  Dr. John Rusin: That's right.
• 3:59
  Philip Pape: Yeah, actually, you're supposed to have a little rounding on that one.
• 4:02
  Philip Pape: But, you know, so let's talk about that a little bit more.
• 4:04
  Philip Pape: When we say the central line of tension, are we are we talking about the context of everyday movement as we're walking around thinking about our posture and such?
• 4:13
  Philip Pape: Are we applying this specifically to protocols in training, protocols in rehab?
• 4:17
  Philip Pape: Like where does it apply practically?
• 4:19
  Dr. John Rusin: Well, for my clients and my athletes that I've worked with, the first skill that I try to teach them and at least have them hone in on some sort of requisite skill and connectivity of the pillar complex is being able to teach breathing and bracing.
• 4:33
  Dr. John Rusin: You know, breathing and bracing is super unsexy.
• 4:36
  Dr. John Rusin: The fact that we're sitting here talking about it on a podcast means that, wow, it must be important because that's the last thing that people want to do in their training.
• 4:44
  Dr. John Rusin: But we get it wrong when it comes to breathing and bracing.
• 4:46
  Dr. John Rusin: Specifically for pillar bracing, we never connect the ball and socket base joints to the spine.
• 4:52
  Dr. John Rusin: Every time we hear, hey, if you want to protect your spine while strength training, especially going heavy, brace the core, use your core, get your abs tight, all these cues, but they're incomplete because without managing the shoulder joint, which is the most mobile joint in the body, and then the hip joints, which are the second most mobile joints in the body, we never have that central line of stability.
• 5:14
  Dr. John Rusin: We essentially just have a little bit of tension through musculature that cannot connect to the ground, it cannot connect to weights, it cannot connect to your human movement system.
• 5:23
  Dr. John Rusin: So simply by going through and connecting these three integral areas, we give ourselves a superpower to be able to create internal tension, meaning that mask much musculature can create tension to be able to stabilize and centrate, essentially get those joints into optimal positions in order to function, but also in order to not take the wear and tear of your strength training, no matter the movement or the exercise.
• 5:47
  Dr. John Rusin: And instead, we direct that force and we direct that load right into the key musculature or the movement patterns that we want them to.
• 5:54
  Philip Pape: Yeah, and that that's definitely speaks to me from a physical perspective of creating that solid end-to-end system of transferring load.
• 6:01
  Philip Pape: When I think of physics and biomechanics, I'm a very nerdy engineering guy.
• 6:04
  Philip Pape: And our listeners are as well.
• 6:06
  Philip Pape: So they do love this stuff.
• 6:07
  Philip Pape: They do find it sexy, by the way, breathing and embracing.
• 6:09
  Philip Pape: Okay.
• 6:10
  Philip Pape: Love it.
• 6:10
  Philip Pape: So I'm kind of jumping around my notes here, but I guess when it comes to breathing and embracing, is there a universal set of steps that could apply to anything anytime you need to do this?
• 6:21
  Philip Pape: You know, we hear terms like intraabdominal pressure.
• 6:23
  Philip Pape: We talk about using lifting belts sometimes versus not when training.
• 6:26
  Philip Pape: Um, I know there are misconceptions when I see someone squat and they're like breathing out as they come up instead of holding the breath and things like that.
• 6:34
  Philip Pape: Yeah.
• 6:34
  Philip Pape: But are there are the universal tips somebody could take away, whatever they go and do in the gym next week, that they could apply?
• 6:40
  Dr. John Rusin: So the first thing that we need to do is have that connection point, be able to create tension around the shoulders, then the hips, then breathe in, brace around the core, and have this central line of tension.
• 6:52
  Dr. John Rusin: But from there, many times people come to me and they go, Oh, yeah, I know how to brace.
• 6:56
  Dr. John Rusin: Well, why are you visiting me with lower back pain and chronic shoulders that don't move immobile and are causing you pain on bench press?
• 7:03
  Dr. John Rusin: It's a matter of being able to actually take the activity at hand and brace the tension to that activity in a smart and common sense way.
• 7:12
  Dr. John Rusin: You know, the way that we're gonna deadlift for a one repetition max is far different than the way that we are gonna go in for a 25 rep goblet squat.
• 7:21
  Dr. John Rusin: We need to be able to have a dimmer switch on our tension and our overall bracing strategy.
• 7:26
  Dr. John Rusin: And that will be polar opposite for what our breathing is.
• 7:30
  Dr. John Rusin: So, breathing and bracing need to go together.
• 7:32
  Dr. John Rusin: It's like peanut butter and jelly.
• 7:34
  Dr. John Rusin: When you're going for a one RM deadlift, of course, we want to be able to brace maximally.
• 7:38
  Dr. John Rusin: We want to hold our breath and we want to move that load because we don't want a whole lot of moving parts as load-centric loading is going to be the focus.
• 7:47
  Dr. John Rusin: But as soon as we actually have to take in oxygen in order to survive a set or into survive our lives, we need to be able to make our pillar tight, be able to have common form and technique that holds up against the stress.
• 8:02
  Dr. John Rusin: But we also need to make sure that we have oxygenation that does happen indeed.
• 8:07
  Dr. John Rusin: So we go through different breathing and bracing strategies.
• 8:09
  Dr. John Rusin: Essentially, as load goes up, your breathing capacity goes down.
• 8:13
  Dr. John Rusin: As load goes down, your breathing ability goes up.
• 8:16
  Dr. John Rusin: And it's all about minimal effective brace in order to keep optimal mechanics.
• 8:22
  Philip Pape: Great.
• 8:22
  Philip Pape: So effectively, there's I'm picturing an inverse set of curves, somewhat like a spectrum between full bracing, fully holding your breath because the load is near maximal, all the way to more of a work capacity, endurance, you need the oxygenation.
• 8:37
  Philip Pape: So you, you know, the you don't need to brace to that extent.
• 8:40
  Philip Pape: In fact, it could be counterproductive, which reminds me of my front squats this week, you know, whereas doing sets of 10 to 15, very different experience where you're getting a little bit winded versus sets of three to five on a back squat or something.
• 8:53
  Philip Pape: So actually, I remember in your book, guys, anybody watching the YouTube, I was joking, that's kind of a tome coffee table reference book in all the best ways.
• 9:00
  Philip Pape: His new book, Pink Free Performance, because I did read through this and I do, I do appreciate how you go over very specific context for each of these.
• 9:08
  Philip Pape: You know, you have like ladders, you have different level types of movements and rep ranges where you breathe in different ways.
• 9:13
  Philip Pape: So we don't have to go through all of that on the show today, but I do want listeners to understand that context matters and the breathing embracing matters.
• 9:20
  Philip Pape: What I want to get into next, John, is training hard.
• 9:24
  Philip Pape: I think you said in the book something like training pain-free doesn't mean training easy.
• 9:27
  Philip Pape: It's it's training in ways that make you resilient without breaking you down.
• 9:32
  Philip Pape: And a lot of people here modify for pain.
• 9:35
  Philip Pape: I've got pain, I'm rehabbing this and that, and I'm gonna take it easier.
• 9:38
  Philip Pape: I'm gonna go light.
• 9:38
  Philip Pape: And unfortunately, a lot of doctors give advice that they don't specify what they mean, which side tangent, by the way.
• 9:45
  Philip Pape: My my mother-in-law, her doctor just said, you need to start lifting now and heavier the better, or you're gonna be in a nursing home before long.
• 9:51
  Philip Pape: So I appreciated a doctor saying that.
• 9:53
  Philip Pape: But uh, what's the relationship between like training hard and training smart, if that's the terms we want to use?
• 10:00
  Philip Pape: You know what I mean?
• 10:01
  Dr. John Rusin: Our industry has had a pendulum swing, I think, over the last decade or two.
• 10:05
  Dr. John Rusin: We went from, hey, just go out and kill yourself in the 60s, 70s, 80s, up until the 90s, hypertrophy at all costs, big lifts for strength and muscle building.
• 10:15
  Dr. John Rusin: Don't warm up, don't worry about anything.
• 10:17
  Dr. John Rusin: It's all gonna be good as long as you're as big as humanly possible.
• 10:21
  Dr. John Rusin: And then I think like late 90s into the 2000s, we got into this like quote unquote functional training trend.
• 10:27
  Dr. John Rusin: And everyone wanted to become a physical therapist.
• 10:30
  Dr. John Rusin: Everyone wanted to be a corrective exercise specialist.
• 10:33
  Dr. John Rusin: And all of a sudden, strength coaches and personal trainers were doing pseudo-physical therapy on the floor of the gym.
• 10:39
  Dr. John Rusin: And we forgot to actually train for the physical capacities that give us that health and longevity, strength, muscle, cardio and endurance, all these things that are heavy hitters.
• 10:49
  Dr. John Rusin: And at pain-free performance, we are the middle ground on almost every single thing because I've been at high performance athletics and sports, I've been in physical therapy, uh, working with people that are out of surgery or having market pain responses.
• 11:04
  Dr. John Rusin: And I do believe that halfway between many of these extremist polarizing swings is going to be the right approach for many.
• 11:12
  Dr. John Rusin: But really, what it means is that we need to be training as hard as possible in a concentrated and a focused way.
• 11:19
  Dr. John Rusin: And we need a standardized system in order to just do all the right things that we need to be doing for our health longevity orthopedically and systemically.
• 11:28
  Dr. John Rusin: But more so, we need to be avoiding the wrong things because it's avoiding the wrong things that actually push us forward in terms of our momentum decade by decade.
• 11:38
  Philip Pape: And what are those wrong things?
• 11:39
  Philip Pape: What are those wrong things, John?
• 11:41
  Dr. John Rusin: Wrong things, man.
• 11:42
  Dr. John Rusin: There's a laundry list of these wrong things.
• 11:45
  Dr. John Rusin: But I think the number one thing that people tend to neglect is their well-roundedness in terms of just being a functional human being.
• 11:53
  Dr. John Rusin: Like I do believe that there are things that every single human, no matter if you're a child all the way up into an active ager, should be able to do with your body in terms of their movement patterns.
• 12:03
  Dr. John Rusin: But I also believe that there are physical capacities and characteristics that need to be able to be trained and maintained for a lifetime if we are gonna indeed thrive.
• 12:12
  Dr. John Rusin: And many times we don't have that mindset when it comes to our training.
• 12:16
  Dr. John Rusin: We have, hey, I am a hobbyist.
• 12:18
  Dr. John Rusin: I'm only interested in this one thing, and I'm gonna deep dive into this one thing until it breaks me down, burns me out, or leaves me with an injury that I have to then take a break from.
• 12:29
  Dr. John Rusin: We call that the planned meathead deload.
• 12:32
  Dr. John Rusin: We want to avoid all of these things and just simply be a little bit more well-rounded in our training so we can have the ability to be pain-free, not suffer injuries, but also just function more normally in our lives, being able to do things with physical autonomy that we were meant to do.
• 12:48
  Philip Pape: Physical autonomy.
• 12:49
  Philip Pape: I love that.
• 12:50
  Philip Pape: Yeah.
• 12:50
  Philip Pape: Seriously, man.
• 12:51
  Philip Pape: This lack of well-roundedness, we're all guilty of it, myself included.
• 12:54
  Philip Pape: Some of it comes from time, right?
• 12:56
  Philip Pape: Like, how can I do all the things?
• 12:58
  Philip Pape: Some of it comes from, you know, passion where you get into something and you go all hog wild in it.
• 13:03
  Philip Pape: Some comes from the dogma in the industry, I think, where the different camps say, like, this is all you just need strength.
• 13:09
  Philip Pape: That's all you need.
• 13:09
  Philip Pape: You know, like you don't, which, and and I've come from some of that.
• 13:12
  Philip Pape: And the more I get exposed to these things and talk to guys like you, the more I start to integrate all this.
• 13:17
  Philip Pape: But what I want to be careful of, because I could see it happening if you like, if you read your book and you have these train strength training or you have these training templates at the end and there's different days per week, different levels of experience, it can seem overwhelming if you've never done all of that.
• 13:31
  Philip Pape: You're like, oh my God, I gotta do the warm-ups and I gotta do the foam rolling, I have to do this and that, the other.
• 13:36
  Philip Pape: Where do you meet people in the middle when they're starting from that mindset?
• 13:40
  Dr. John Rusin: I think at the entry point is important.
• 13:43
  Dr. John Rusin: Like people are gonna have different entry points into the industry.
• 13:45
  Dr. John Rusin: Maybe cardio is your entry point, maybe doing a progressive powerlifting program is your entry point.
• 13:51
  Dr. John Rusin: But if you train long enough, you're going to be humbled.
• 13:56
  Dr. John Rusin: It is not a matter of if, it's a matter of when.
• 13:59
  Dr. John Rusin: And that humbling usually happens through injuries.
• 14:02
  Dr. John Rusin: It happens through performance plateaus.
• 14:05
  Dr. John Rusin: You can't quite get what you used to get.
• 14:06
  Dr. John Rusin: And then all of a sudden, people make the mistake of going, hey, you know what?
• 14:10
  Dr. John Rusin: I'm dogmatic.
• 14:11
  Dr. John Rusin: I believe in this one thing.
• 14:12
  Dr. John Rusin: What's the fix to this one thing?
• 14:15
  Dr. John Rusin: I'm gonna double down on this one thing instead of maybe going right or left of that one thing.
• 14:20
  Dr. John Rusin: Maybe if you're super into powerlifting, moving a little bit of hypertrophy and mobility will probably do you some good.
• 14:25
  Dr. John Rusin: If you're a cardio bunny, actually going into some functional strength training is probably the thing that you need.
• 14:31
  Dr. John Rusin: The rule of opposites definitely applies when it comes to hobbying inside of our industry.
• 14:36
  Dr. John Rusin: And I think that over time, people are pushed to become more well-rounded if they want to continue to do the thing that they love to do, which is training.
• 14:45
  Dr. John Rusin: I know that clients that I work with and many of my athletes, they're not worried about just training today.
• 14:51
  Dr. John Rusin: They love this.
• 14:52
  Dr. John Rusin: They are doing it every day because it's become part of them.
• 14:55
  Dr. John Rusin: And they want to make sure that they can do it into their 40s, 50s, 60s, 70s, and beyond.
• 15:00
  Dr. John Rusin: And that doesn't happen by changing what you're doing at 70 when you're all broken down and hurt.
• 15:06
  Dr. John Rusin: It it changes with what you decide to do today, just little by little, to be able to incorporate base things that, again, we should be able to do.
• 15:15
  Philip Pape: And I like the lateral.
• 15:16
  Philip Pape: You mentioned lateral, I think in the previous response, but the the, because I think of lateral thinking, like getting out of the box, same thing, physically lateral, which means start from where you are today and then branch out.
• 15:26
  Philip Pape: And it reminds me of some guys I follow who I'm actually running some of their programs for that very reason, like Jeffrey Verity Schofield.
• 15:33
  Philip Pape: You know, he'll throw in cardio two days a week to his training programs.
• 15:37
  Philip Pape: And it's like, it's in there.
• 15:38
  Philip Pape: So if you're a lifter who's used to following programs, you're like, cardio's in there.
• 15:41
  Philip Pape: I'm just gonna do it.
• 15:42
  Philip Pape: It kind of gets you to do it.
• 15:44
  Philip Pape: Or Brian Borstein, who's into more of the, I guess, the high rocks kind of level of a little bit more elite hybrid athleticism, Cody McBroom.
• 15:52
  Philip Pape: We had Chris Gethin on the show.
• 15:53
  Philip Pape: I think his episode's come coming out right before yours.
• 15:55
  Philip Pape: And I think it's important because for a while, I personally was in the like the starting strength world, and there's a lot of value there for sure.
• 16:02
  Philip Pape: I mean, I credit that with a lot of strength development.
• 16:05
  Philip Pape: But then there is looking down on a con condescension against, you know, anything else, right?
• 16:10
  Philip Pape: Like, you know, and I talk bad about CrossFit sometimes, but only from the perspective of when people do it, you know, have bad form and they're slamming out reps and they're getting injured, you know, there's something to be said for that.
• 16:21
  Philip Pape: So with this context, then going back to the pillar, maybe that's where we can start.
• 16:27
  Philip Pape: And we talk about like referred pain and why people have injury and why people have pain.
• 16:32
  Philip Pape: Is this a compensation thing going on that's important to understand?
• 16:35
  Philip Pape: Or where do we start breaking this down?
• 16:38
  Dr. John Rusin: I think 30 years ago, when you look at the greater body of evidence and research, and then you look at professionalized education within the universities, spent way too many years there.
• 16:47
  Dr. John Rusin: We thought that this pain thing was just a pure mechanical approach to movement.
• 16:52
  Dr. John Rusin: Hey, if you move in this way, you will have pain and you will get injured.
• 16:57
  Dr. John Rusin: And today that's laughable.
• 17:00
  Dr. John Rusin: You're just like, what?
• 17:01
  Dr. John Rusin: You know, like a biomechanics course showed me how to be pain-free for life.
• 17:05
  Dr. John Rusin: If that was true, we wouldn't be dealing with the chronic pain and injury cycle that we are currently seeing amongst our active population today here in America.
• 17:14
  Dr. John Rusin: So I think that pain is definitely a more complex conversation that we need to be having.
• 17:19
  Dr. John Rusin: But calling it what it is, I think the first line of being able to write yourself is being able to move well.
• 17:26
  Dr. John Rusin: And what moving well essentially means is moving well for your body, your particular body, your limb lengths, your joint types, your body size, and being able to take that and look at your skill set and be able to customize your positions and know very well that not everyone is going to look exactly the same way as they squat.
• 17:46
  Dr. John Rusin: Not everyone is going to be able to deadlift from the same height with a neutral spine.
• 17:51
  Dr. John Rusin: And not every running mechanic is going to be the same gate locomotion cycle.
• 17:56
  Dr. John Rusin: We are unique beings.
• 17:57
  Dr. John Rusin: And I feel like in every other aspect of the industry today, everything's so unique, the functional health cycle of unique blood testing, so we can get on supplements and drugs.
• 18:06
  Dr. John Rusin: And then it comes to strength training, starting strength, squat like this, overhead press like this, bench like this, deadlift like this.
• 18:13
  Dr. John Rusin: That's a great starting point.
• 18:15
  Dr. John Rusin: And I'm so happy that there is a strength emphasis coming into our industry today.
• 18:20
  Dr. John Rusin: But strength is more than just three or four cookie cutter textbook exercises.
• 18:27
  Dr. John Rusin: Strength is a physical characteristic, strength is not a specific exercise.
• 18:33
  Dr. John Rusin: And just having the epiphany of making that realization is huge for people's long-term health.
• 18:39
  Philip Pape: So when it comes to moving well for your body, then what I know some people will interpret that as okay, a squat's gonna look massively different.
• 18:50
  Philip Pape: And I have to, where am I trying to go with this?
• 18:52
  Philip Pape: People always go kind of to the extreme of this.
• 18:54
  Philip Pape: And I think I think what you're saying is because of your anthropometry, because the angles are different, the principles you're trying to adhere to, which are universal, like I don't know, vertical bar path or efficient movement, yes, are going to translate to a different, you know, different angles between the hinge points or something like that, right?
• 19:10
  Philip Pape: So maybe elaborate on that, thinking about the squat specifically.
• 19:15
  Philip Pape: How does that how should someone be thinking about this when they're they hear this episode?
• 19:18
  Philip Pape: They're like, okay, I'm finally going to start squatting, and now I want to practice in my living room without a bar.
• 19:24
  Philip Pape: You know, what are they thinking here?
• 19:26
  Dr. John Rusin: It's cool because over the last 10 years, a pain-free performance specialist certification has certified over 20,000 personal trainers, strength coaches, physical therapists, and physicians in person in two-day certification courses.
• 19:39
  Dr. John Rusin: So, in that amount of people, you see a lot of different movement.
• 19:43
  Dr. John Rusin: And you not only see a lot of different movement from people, you see it from experts in movement, people that know their shit, people that have been training their entire lives, people that do this for a living.
• 19:52
  Dr. John Rusin: And I think when we first started running the certification, the squat was the first movement pattern that we were like, I know that there's some diversity in the squat pattern in terms of identifying somebody's most optimal squat pattern, but wow, after 10 years, the diversity that we see weekend to weekend in terms of our certification courses is absolutely wild.
• 20:14
  Dr. John Rusin: But this is where people tend to go wrong right off the bat.
• 20:17
  Dr. John Rusin: They go, okay, squat, only a barbell on your back, low bar position, and I'm gonna go feet shoulder width apart, and I'm gonna toe out slightly, I'm gonna look down at the ground, and I'm only gonna go to parallel because that's how real men squat.
• 20:32
  Dr. John Rusin: And it's like, no, hold on a second.
• 20:34
  Dr. John Rusin: You know, we've seen this with definitely a lot of the avatars that go through some of our screening and assessment protocols for the squat.
• 20:42
  Dr. John Rusin: So we're either trapped into, hey, I've been hurt from the squat before, therefore I'm gonna modify my movement patterns.
• 20:48
  Dr. John Rusin: And it usually turns into I'm too wide, big base of support, very low little range of motion, and kind of the parking break on the system.
• 20:56
  Dr. John Rusin: Or on the opposite direction, we see that people are like, hey, I've squatted this way for my entire life.
• 21:02
  Dr. John Rusin: Maybe I've developed it with a coach over time, and this is going to be a specific squat exercise for maybe a barbell sport goal.
• 21:10
  Dr. John Rusin: And neither of those are going to be optimal because again, we're talking about the squat pattern itself.
• 21:15
  Dr. John Rusin: When I say squat pattern versus squat exercise, I'm talking about somebody taking a shit into a hole in the most opportune position possible with joints stacked, centrated hips, angulation at the knees that makes sense, looking at ankle mobility, looking at spinal position and neutrality, and being able to organize the shoulders over the hips.
• 21:38
  Dr. John Rusin: And all of a sudden you're like, oh, okay, that is the squat pattern.
• 21:42
  Dr. John Rusin: But many people deactivate that squat pattern in chasing only exercises.
• 21:46
  Dr. John Rusin: So we tend to see that there are a couple key variables in people's squats.
• 21:51
  Dr. John Rusin: Yes, the stance is going to be wider or more narrow, the foot ABduction position is going to be out or in.
• 21:58
  Dr. John Rusin: And then we're going to see the knee is going to be forward or more vertical shin.
• 22:02
  Dr. John Rusin: And then we're going to see the torso angle is also going to be more forward or more erect.
• 22:07
  Dr. John Rusin: And then the thing that usually gets lost, because what I just described is very sagittal, plane and unidimensional.
• 22:13
  Dr. John Rusin: What gets lost is hey, what's underneath the skin?
• 22:17
  Dr. John Rusin: You know, what's underneath that glute?
• 22:19
  Dr. John Rusin: What is the hip type actually look like?
• 22:21
  Dr. John Rusin: Because that's where we tend to see the most amount of success in unlocking people's ranges of motion, getting them out of pain at their knees, at their hips, at their lower back, and being able to actually be strong and stable in their best squat position.
• 22:35
  Dr. John Rusin: And this is something that we go through in the pain-free performance book and also the certification course called the hip quadrant test.
• 22:41
  Dr. John Rusin: Essentially, we are able to type your hip in a matter of one to two minutes.
• 22:45
  Dr. John Rusin: You can even do it on yourself from the protocols in the book to be able to look at where you should actually be at the bottom of your squat and what the glass ceiling is for you to be able to get in this position and be able to build a skill set up so you can get into that position under load.
• 23:00
  Dr. John Rusin: And then the goal from there is to be able to train and maintain that at least one time per week in your programming forever.
• 23:06
  Dr. John Rusin: And then the other two or three times per week that you're doing a bilateral squat pattern, go into specialty, go in for some different muscular targeting, go in for some load capacity work at partial ranges.
• 23:17
  Dr. John Rusin: You know, the sky's the limit in terms of diversity.
• 23:19
  Dr. John Rusin: But what people are missing is that they're not doing the foundational pattern.
• 23:23
  Dr. John Rusin: And instead, they're only doing the partial pattern with specific goal sets, losing the pattern in its essence itself.
• 23:30
  Philip Pape: Yeah, what you talk about again in the book, and I'm happy to promote this book only because, guys, if you if you check this out, whether you get the digital or physical when it comes out, there's a lot of progression and context and building from essentially nothing up the ladder, not just with what John mentioned, range of motion and your own biomechanics, but also the types of movements and making it as accessible as possible and kind of working your way up.
• 23:57
  Philip Pape: Like I could see myself on those different spectra where, okay, right here I'm close to the top.
• 24:02
  Philip Pape: I'm pretty confident.
• 24:04
  Philip Pape: Here I would probably step back a bit and work my way up.
• 24:07
  Philip Pape: And then you also mentioned targeting different muscle groups and things like that.
• 24:10
  Philip Pape: You know, I've had Andy Baker on the program several times.
• 24:13
  Philip Pape: I love Andy because he he came from the starting strength world, but then has branched out and realized the importance of variety effectively, not for its own sake, but because of what you just mentioned.
• 24:24
  Philip Pape: And we had a whole discussion about squatting and ultimately the million ways you could squat and different types of exercises.
• 24:30
  Philip Pape: It's not really about that, right?
• 24:32
  Philip Pape: It's achieving the right movement pattern.
• 24:34
  Philip Pape: And look, if you have the right movement pattern and you progress over time, you're gonna get massive results, whatever squat patterns you decide to do.
• 24:41
  Philip Pape: And a lot of that comes down to what's fun to you and what do you want to train with too, right?
• 24:45
  Philip Pape: So anyway, I don't know where I'm going with all that, other than to say it makes sense to be methodical about this, whether it's buying your book, reaching out, going to YouTube, listening to podcasts, practicing thinking, being mindful.
• 24:58
  Philip Pape: Let me ask you, John, when you're in the gym and you're training, do you listen to music or do you think with your thoughts?
• 25:03
  Philip Pape: How do you, how are you mindful about your listeners?
• 25:05
  Dr. John Rusin: I've been uh quote unquote raw dogging my sessions lately.
• 25:07
  Dr. John Rusin: I know that was a popular term of like guys going on a transatlantic flight and not listening or watching anything, but that's what I've been doing.
• 25:14
  Dr. John Rusin: But I follow my own programming.
• 25:16
  Dr. John Rusin: I go inside of the Unbreakable app and I subscribe to it just like every one of my other members does.
• 25:20
  Dr. John Rusin: And I find liberation in that because I know I'm gonna be getting the diversity of movement patterning that I need.
• 25:26
  Dr. John Rusin: I get the distribution of volume throughout the patterns and the exercise selection that I need.
• 25:30
  Dr. John Rusin: And I also kind of have the same goals as everybody else.
• 25:33
  Dr. John Rusin: You know, nearing 40, being a dad that coaches baseball and basketball, you know, being a husband and a business owner, I got 60 minutes to hit it.
• 25:40
  Dr. John Rusin: And I know that I need to be focused.
• 25:42
  Dr. John Rusin: I need to be on rest periods.
• 25:43
  Dr. John Rusin: I have different key performance indicators, strength movements that I'm chasing, but I also want to have that feel of moving well, being mobile, and also like tapping into an athletic potential, even at my age, where I never want to lose track of athleticism and power.
• 26:00
  Dr. John Rusin: So, like the programming that I do right now, I stay very focused in on it because I just follow the app and I do exactly that.
• 26:07
  Dr. John Rusin: And then I track it.
• 26:08
  Dr. John Rusin: And there's a reason that that works for accountability and just staying on track because today it's super easy to go to Instagram and lose 10 minutes between a set.
• 26:17
  Dr. John Rusin: And it's definitely easy to program hop while you're doing an actual program just because of all of the very superficial resources that we have at our fingertips.
• 26:26
  Philip Pape: Yeah, so raw dogging it, following a program, making judicious use of your rest periods and not getting distracted while you lift.
• 26:35
  Philip Pape: And I can raise my hand being guilty of that sometimes, where I'm like, okay, I'm an entrepreneur and I'm losing weights.
• 26:40
  Philip Pape: Go, do both at the same time, you know?
• 26:42
  Philip Pape: But uh, so okay, maybe roping back a little bit to the framing of this episode on pain, specifically where people get a lot of the pain, which is low back or shoulders or knees.
• 26:55
  Philip Pape: Maybe, maybe looking at the low back, that comes up a lot.
• 26:57
  Philip Pape: Low back fatigue, low back pain.
• 26:59
  Philip Pape: And then sadly, a lot of people just have something go, something pop, have to have a surgery.
• 27:04
  Philip Pape: I know someone, she's a power lifter.
• 27:06
  Philip Pape: I've always thought she's she's lifted great and and she's been competitive and she had to have a microdyskectomy recently, but she also got a lot into running and rowing, which she hadn't adapted to as much as her lifting.
• 27:17
  Philip Pape: So who knows where the issue was?
• 27:19
  Philip Pape: People are like, what do I do?
• 27:20
  Philip Pape: Where do they start thinking about protecting?
• 27:23
  Philip Pape: I even like the word protecting sometimes because it sounds like too much in a shell, like safety, but basically fortifying back.
• 27:31
  Dr. John Rusin: Two patterns that are going to be super back intensive and also back sparing are going to be the hip hinge pattern and the single leg pattern.
• 27:38
  Dr. John Rusin: We call it the lung at pain-free performance.
• 27:41
  Dr. John Rusin: But when it comes to knee pain, when it comes to lower back pain and really shoulder pain, those are going to be the big three in our industry today.
• 27:48
  Dr. John Rusin: Like we have to have a good foundation of biomechanics.
• 27:52
  Dr. John Rusin: Like we've already talked about the foundations of finding your unique biomechanics that work for you.
• 27:57
  Dr. John Rusin: But I didn't add the next layer to this, which is once you find your unique biomechanics, cool, that's your central line on a spectrum.
• 28:06
  Dr. John Rusin: Be able to add diversity and range of motion and different muscular targeting and different rep ranges and different rep speeds and all these different methods and modalities that we can start throwing on the system strategically over time, not all in one single training week, is going to be the recipe for long-term success.
• 28:23
  Dr. John Rusin: But with the lower back specifically, I tend to see that people neglect the hip hinge pattern because they go, I've hurt myself deadlifting before.
• 28:34
  Dr. John Rusin: Well, what's a deadlift to you?
• 28:35
  Dr. John Rusin: Well, it's a conventional stance with a barbell on the ground, of course.
• 28:39
  Dr. John Rusin: And I am hoisting that thing up at all costs.
• 28:43
  Dr. John Rusin: And in our research at pain-free performance, we've seen that people are unable to keep a neutral zone of spinal neutrality 93% of the time when doing a conventional barbell deadlift off the ground.
• 28:57
  Dr. John Rusin: And this is out of a more pure hip hinge pattern.
• 29:00
  Dr. John Rusin: So essentially what happens to people is that they think this arbitrary exercise is the be-all end-all of everything.
• 29:06
  Dr. John Rusin: But what if you're one of the 93% that can't even access that bar off the ground?
• 29:11
  Dr. John Rusin: You're going to be doing one of two things.
• 29:13
  Dr. John Rusin: You're going to be using mechanics from the squat, pushing your knees forward, rounding your lower back, dumping your pelvis in order to get yourself wedged into that position.
• 29:22
  Dr. John Rusin: Or you're going to be going through and putting undue stress directly on the spine, being able to try to force in a hip hinge that you simply don't maybe have the range of motion or the mobility or the hip structure to be able to achieve.
• 29:37
  Dr. John Rusin: And there's very rarely a time where we bring somebody right from, hey, you had pain, hey, you had an injury.
• 29:44
  Dr. John Rusin: Let's go right back to picking something up off the ground.
• 29:47
  Dr. John Rusin: Many times this is the pattern that is in dire need of a rebuild because people have not just pain and injury backgrounds mechanically, but it really fucks with your mind.
• 29:58
  Dr. John Rusin: When you blow out Your back and it is deteriorating to your lifestyle, not just your training, but your lifestyle, you're going to think again before you go back in and train that, or you're just going to be lost and able to really take the most out of the highest yielding movement pattern that we have.
• 30:15
  Dr. John Rusin: But I would say about 40 to 50% of people today attempting to strength train are neglecting, if not disusing fully the hip hinge and the deadlift.
• 30:26
  Dr. John Rusin: And this is really problematic because we say that it is the most injurious movement pattern, but it is also the movement pattern that will protect the most.
• 30:35
  Dr. John Rusin: So where do we go on this yin and yang?
• 30:38
  Dr. John Rusin: And it's back to a strategic rebuild of trying to put the pieces together stronger and healthier and more customized to your specific needs.
• 30:46
  Philip Pape: The yin and yang is a great way to describe it because I sometimes have trouble communicating to people that a deadlift done wrong could hurt you, and a deadlift done right could save you, right?
• 30:56
  Philip Pape: It's the same principle.
• 30:57
  Philip Pape: And of course, and you called it the highest yielding movement pattern we have, which again, I I strongly I love the deadlift.
• 31:04
  Philip Pape: Personally, I love it.
• 31:04
  Philip Pape: I think my body is built for it way more than the squat, and that could just be an excuse not to get my squat up.
• 31:09
  Philip Pape: But it is, it is a fun lift.
• 31:11
  Philip Pape: When you said the, I think you said the safe zone around the line of neutrality.
• 31:15
  Philip Pape: Uh, in your book, in your book, you have diagrams showing, for example, somebody hinged over and you have this zone with different colors, and there's that safe zone and then the buffer zone.
• 31:23
  Philip Pape: And it's it's quite liberal.
• 31:24
  Philip Pape: It's not like you have to be super afraid that it's just this rock solid line.
• 31:28
  Philip Pape: And once you go out, spring your back falls apart.
• 31:31
  Philip Pape: But you said 93% of people can naturally stay or have trouble staying.
• 31:40
  Dr. John Rusin: They are unable to access the bar for a conventional deadlift with spine neutrality.
• 31:44
  Dr. John Rusin: But the interesting thing in that section of pain-free performance about the neutral zone of stability of tension around the spine is that there are many different factors.
• 31:53
  Dr. John Rusin: It's not just a biomechanical model.
• 31:55
  Dr. John Rusin: Our zone of neutrality goes out and it comes back in based on your preparation at hand, based on your skill, based on your sleep cycles, based on your past injury history, based on your training loads and volumes, based on an exercise being a mismatch for your unique biomechanics versus something that actually is a good match for you.
• 32:16
  Dr. John Rusin: There are many different variables that actually affect your neutral line of tension and your zone of neutrality.
• 32:23
  Dr. John Rusin: And this is something that I was super proud of in the book because I haven't heard a whole lot of people talk about this before.
• 32:28
  Dr. John Rusin: They're so they're so black and white when it comes to spine neutral at all costs.
• 32:32
  Dr. John Rusin: You know, you hear the kettlebell community going perfect spine neutral while kettlebell swinging.
• 32:37
  Dr. John Rusin: What do you mean?
• 32:38
  Dr. John Rusin: There's 17 to 24 degrees of spinal flexion at the bottom of a kettlebell swing, even in perfect quote unquote execution.
• 32:45
  Dr. John Rusin: So, what are we really talking about here?
• 32:47
  Dr. John Rusin: What we want to be able to mitigate the risk away from is having rapid force, eccentric flexion of the spine under load.
• 32:57
  Dr. John Rusin: What that essentially means is like, hey, you're out fishing, you got a fish on the line, the line goes like this, it bends the line and it bends your hook, and all of a sudden you're like, whoa, okay, I got that fish.
• 33:08
  Dr. John Rusin: But you don't want to do that to your spine.
• 33:10
  Dr. John Rusin: That is something that when we do see injuries, they can happen in many different types of ways.
• 33:17
  Dr. John Rusin: But I tend to see the injuries happen specifically on the hip hinge pattern with that rapid force, eccentric moment as we're coming up out of the hole off the ground.
• 33:26
  Dr. John Rusin: Usually that first like two to five inches off the ground is where people tend to lose their central line of stability.
• 33:32
  Dr. John Rusin: They lose their spinal tension, they lose that zone of neutrality, and they end up, if they are having all those other factors line up correctly, unfortunate for them, they end up with an ache, pain, injury, flare-up, whatever you want to call it.
• 33:46
  Philip Pape: Okay, that's really important.
• 33:47
  Philip Pape: So we want to avoid rapid force, eccentric flexion on the spine.
• 33:51
  Philip Pape: Is that dumbing it down rounded back?
• 33:54
  Dr. John Rusin: When you're quick pulling rounding of the back.
• 33:56
  Dr. John Rusin: And it's usually going to be anywhere from like the lower back or the L and S spine.
• 34:02
  Dr. John Rusin: That is where the vast majority of these are going to happen.
• 34:04
  Dr. John Rusin: There's a natural fulcruming point that happens in the lower lumbar spine.
• 34:08
  Dr. John Rusin: And that is something that is, again, natural, but we don't want to be loading it and we don't want to be losing that line of tension, especially under load.
• 34:18
  Dr. John Rusin: And I think that as like injurious as that may sound, this is really easy to avoid with what we started with, with just being able to brace and breathe properly.
• 34:27
  Philip Pape: Brace.
• 34:28
  Philip Pape: Yep, for sure.
• 34:29
  Philip Pape: Yeah.
• 34:29
  Philip Pape: So L4, L5, S1 is where you hear a lot of these injuries and issues.
• 34:33
  Philip Pape: And if you look at the spine, you can kind of see that S shape occur around there.
• 34:38
  Philip Pape: But you also mentioned that it moves with your adaptation, with your recovery capacity.
• 34:43
  Philip Pape: And I get attest to this.
• 34:44
  Philip Pape: We talk about, you know, the differences between fat loss and when you're not in a deficit, when you train of being even more attentive, not that you shouldn't always be, but that you're more susceptible to some of these things because of the fatigue and the recovery capacity.
• 34:57
  Philip Pape: I know personally when I get distracted or I go in and I try to be, you know, do an ego lift, right?
• 35:03
  Philip Pape: You kind of get the same thing.
• 35:04
  Philip Pape: So the adaptation I wanted to ask about because you hear a lot of criticism or hot takes on Instagram.
• 35:09
  Philip Pape: You know, look at this guy who can deadlift 900 pounds, but look at that rounded back.
• 35:13
  Philip Pape: That's awful.
• 35:13
  Philip Pape: And I'm like, okay, he's adapted to that and he's doing it and he hasn't injured himself, but is he about to snap his back?
• 35:19
  Philip Pape: Like, what are we talking about?
• 35:21
  Dr. John Rusin: Taking these people that are absolute beasts, probably a world record holder has been deadlifting for 20 or 30 years at this point.
• 35:27
  Dr. John Rusin: There's really no huge young guns in the game.
• 35:30
  Dr. John Rusin: They've been able to again adapt and stress the system in a strategic way, extraordinarily strategic way, in order to again go at a specific goal for a sport, which is totally different than lifting for health and longevity.
• 35:44
  Dr. John Rusin: But I have personal clients that I work with that you would look at their deadlift form and be like, oh, he just hoisted 950 and he had a rounded and kyphotic spine at the thoracic.
• 35:57
  Dr. John Rusin: And then maybe he's probably even rounding at the lumbar spine.
• 36:00
  Dr. John Rusin: But the big difference between that rounding setup for these guys that are absolute anomalies, if I'm just calling it out, is that they never get pulled into deeper flexion rapidly.
• 36:10
  Dr. John Rusin: They maintain that flexion point and they don't have a net positive flexion point at the spine.
• 36:18
  Dr. John Rusin: I think that's the big differentiation factor.
• 36:21
  Dr. John Rusin: That, and they've done deadlifting so much volume with so much intricate technique work that they are masters of this specific skill out of this specific position.
• 36:32
  Dr. John Rusin: And their body has normalized it in terms of the way that they have callused their system.
• 36:38
  Philip Pape: Yeah.
• 36:38
  Philip Pape: Yeah.
• 36:39
  Philip Pape: The the speed at which the angle changes and the force gets applied is a direct function of the maximum force that's getting applied, right?
• 36:47
  Philip Pape: F equals MA.
• 36:48
  Philip Pape: I think about discussions I've had recently with lifting buddy of mine, how much we love pauses these days.
• 36:54
  Philip Pape: You know, we're both in our 40s and we like pausing at the bottom of a lot of our movements.
• 36:57
  Philip Pape: Take out the stretch reflex, only because sometimes that is where you're prone to have those high levels of force from the stretch.
• 37:04
  Philip Pape: Not that it can't be also beneficial and you can build the resilience and adaptation, but it's it's what came to my mind.
• 37:09
  Dr. John Rusin: Anytime that you take a movement pattern, whatever movement pattern it is, squat bench, deadlift, whatever, and you take it to its X amount of available range of motion, and then you play and you dabble between compensatory range of motion and an authentic range of motion, you're in this intermediate range where all of a sudden you don't have the active stability neurologically or mechanically that you probably should have.
• 37:32
  Dr. John Rusin: And you're using compensation, whether that be momentum, whether that be using like the tendoosseous junctions to be like rebound and ramp up out of a squat.
• 37:41
  Dr. John Rusin: Whatever it may be, those are things that maybe not line up well for your long-term health.
• 37:48
  Dr. John Rusin: You know, people are always like, oh, well, what do you think about the butt wink in a squat?
• 37:51
  Dr. John Rusin: Like, I hate it.
• 37:52
  Dr. John Rusin: Like if your goal is to feel awesome and just like be jacked at 45, like probably the butt wink has no place in your programming.
• 37:59
  Dr. John Rusin: But if you're gonna go to the CrossFit games at 45 and try to compete for a medal, like that's a totally different story.
• 38:04
  Dr. John Rusin: So there's always two sides of the coin, but I do believe that anytime that we can be a master of our movement and then we can dominate a movement and then diversify that movement little by little to be able to add variance.
• 38:17
  Dr. John Rusin: And that is gonna be a more well-rounded spectrum of the human movement system.
• 38:22
  Philip Pape: For sure.
• 38:22
  Philip Pape: Yeah, no, I I love that.
• 38:24
  Philip Pape: And you also mentioned the lunge when we talk about the hip and shoulders and the that pillar.
• 38:28
  Philip Pape: And it's funny because I just I just started a new cycle of a program that does have walking lunges in there, which I like, but I also they also have one and a half walking lunges, which I like quad burners, right?
• 38:39
  Philip Pape: You go go down, go down, come up halfway.
• 38:42
  Philip Pape: You know what it is.
• 38:43
  Philip Pape: Just explain for the listener.
• 38:44
  Philip Pape: Go all the way down, come up halfway, go back down.
• 38:46
  Philip Pape: So you've just like use the lengthened position without relieving much tension, and then come back up into the walk.
• 38:51
  Philip Pape: And you'll find you can't do nearly as many of those as the full as the single walks.
• 38:55
  Philip Pape: But where does the where does the lunge fit in here?
• 38:57
  Philip Pape: Because it is one of your six.
• 38:59
  Dr. John Rusin: The lunge is the most detrained.
• 39:01
  Dr. John Rusin: You know, the hip hinge, nobody wants to do.
• 39:04
  Dr. John Rusin: Yeah.
• 39:05
  Dr. John Rusin: Ignore our ignore.
• 39:06
  Dr. John Rusin: Uh Dave Tate, an ex-client of mine and a mentor of mine, said it best when I was working with him at Elite FTS.
• 39:12
  Dr. John Rusin: He goes, John, this sucks.
• 39:14
  Dr. John Rusin: I had him doing split squats.
• 39:16
  Dr. John Rusin: He goes, This sucks because it's half the amount of weight and it's twice as hard.
• 39:20
  Dr. John Rusin: And I'm like, man, you just said it.
• 39:21
  Dr. John Rusin: You just said it.
• 39:22
  Dr. John Rusin: And that line is right in the book, too.
• 39:23
  Dr. John Rusin: But when it comes to the lunge, I think it's misunderstood and it's also neglected because it's going to be hard every single time.
• 39:30
  Dr. John Rusin: Uh, unilateral-based lower body work is going to be very demanding in terms of the muscular system, the stabilization system, the neurological system, and the sympathetic system is really going to be heightened up because the balance component to it.
• 39:43
  Dr. John Rusin: But I think just from the mechanics alone, it differentiates itself.
• 39:47
  Dr. John Rusin: It's not just a squat on one leg.
• 39:49
  Dr. John Rusin: It's not just a hip hinge on one leg.
• 39:52
  Dr. John Rusin: It actually is its own distinct pattern.
• 39:55
  Dr. John Rusin: So the lunge pattern has all the best properties from the squat, which is associated with a positive shin angle, a knee forward uh position, and be able to have quadricep dominance.
• 40:06
  Dr. John Rusin: And then also it's a hip hinge at the hips that integrates hamstrings and glutes and lower back.
• 40:11
  Dr. John Rusin: So we actually have maximal amount of load capacity in single leg with many of these patterns, like the Bulgarian split squat, walking lunges, that feel natural to the body as well, because when we function on single leg, that is where we spend 85 plus percent of our movement lives on.
• 40:30
  Dr. John Rusin: You know, we're not functioning in our daily life doing bilateral positions at the squat or at the hinge.
• 40:36
  Dr. John Rusin: We are definitely maneuvering in asymmetrical lower body stances.
• 40:40
  Dr. John Rusin: So this is one that I tend to put the most amount of volume distribution in for almost everybody I'm working with.
• 40:47
  Dr. John Rusin: Probably the highest with athletes, the second highest with like the 35, 40 plus population, and then the third highest amongst people that want to get super strong unconventionally, usually coming from more of a barbell background.
• 41:01
  Dr. John Rusin: But usually with a lower body day, we're distributing anywhere from 50 to 70% of total volume in asymmetrical lower body stances, which is essentially our lunch pattern from pain-free performance.
• 41:12
  Philip Pape: Okay, yeah.
• 41:12
  Philip Pape: And that is definitely higher than the traditional most people would see.
• 41:15
  Philip Pape: Oh, yeah.
• 41:16
  Philip Pape: Um, and it sounds brutal, but I get it because reverse lunges, I don't know if you put step-ups in there, but to me, those are hard too.
• 41:23
  Philip Pape: And, you know, what split squats, we all there's there's memes galore about split squats, you know, being the worst of the worst, right?
• 41:30
  Philip Pape: But again, we have to change our mindset and think like how beneficial that is.
• 41:34
  Philip Pape: I mean, you mentioned stability and balance and everything.
• 41:36
  Philip Pape: It's like raise your hand if you're listening and you've tried a walking lunge and you like, you know, are just trying to stay up straight, let alone with a bar on your back, if you're not doing dumbbells.
• 41:45
  Philip Pape: So yeah, I thought that was interesting because a lot of people reduce the movement patterns to exclude that.
• 41:51
  Philip Pape: And I think it I I am coming around to your way of thinking here.
• 41:54
  Philip Pape: I think it's really cool.
• 41:56
  Dr. John Rusin: Yeah, like just going over the years, chasing like we we call it functional meat head.
• 42:00
  Dr. John Rusin: Functional meat head is we're gonna take some like easy-ish exercise, something that you'd see in physical therapy, and we're gonna push it to the absolute limits.
• 42:07
  Dr. John Rusin: The chase over the last like five years or so has been Bulgarian split squat five RMs.
• 42:12
  Dr. John Rusin: How heavy could you possibly go out of different loading positions?
• 42:15
  Dr. John Rusin: I've gotten it to the 150s in each hand for five reps down to the side, and I've also goblet Bulgarian split squat 190 pounds in front of the body for five reps.
• 42:26
  Dr. John Rusin: So when you do things like that, you're like, man, that doesn't sound fun.
• 42:29
  Dr. John Rusin: But you learn a lot about the body's natural stability points and where we can actually maximize strength recruitment from in those particular patterns.
• 42:38
  Dr. John Rusin: Knee forward position plus the hip hinge is gonna be strong, it's gonna be stable, and it's also gonna be able to be able to mitigate risk of knee pain long term because we get into the deep knee flexion, and it's gonna be able to spare the spine because we are on an asymmetrical stance at the lower body, and essentially our pelvis can rotate in opposite directions, and the stability factor is far different than in the bilateral counterpart.
• 43:02
  Dr. John Rusin: So when you think about doing stuff like that, you're like, yeah, this is where this pattern makes sense.
• 43:06
  Dr. John Rusin: If you're just setting up for a Bulgarian split squat for a set of five with a 10-pound dumbbell, and you're like, oh, this seems easy.
• 43:12
  Dr. John Rusin: I can keep a vertical shin, I can put my knee forward, I can do whatever I want.
• 43:16
  Dr. John Rusin: That's fine.
• 43:17
  Dr. John Rusin: But when you actually push things to absolute maximal load or maximal challenge, your body will find its natural, natural writing mechanism, put you in a strong and stable position.
• 43:27
  Dr. John Rusin: And the thing I want people to take away from that statement is where you are most stable is probably where you're gonna be the strongest.
• 43:33
  Dr. John Rusin: And where you are the most stable and the strongest is where you're likely to be the safest.
• 43:38
  Philip Pape: Right.
• 43:38
  Philip Pape: Got it.
• 43:38
  Philip Pape: Okay.
• 43:39
  Philip Pape: Yeah.
• 43:39
  Philip Pape: And so again, we have to train hard, is also part of the uh part of the equation.
• 43:43
  Philip Pape: And that was a good segue to knee pain because you mentioned the knee flexion and how this supports the knee.
• 43:49
  Philip Pape: We talked about Pateller, you know, the tracking and the knees forward.
• 43:52
  Philip Pape: There's a lot of, I'll call it mythology around that because people will reduce the, you know, form check to, oh, your knee's traveling too far forward, not thinking about the system.
• 44:02
  Philip Pape: So, what are your thoughts on that?
• 44:03
  Philip Pape: And in general, knee pain, maybe the use of knee sleeves, like the whole ball of wax.
• 44:08
  Dr. John Rusin: One of the biggest mistakes that people will make if they have that generalized chronic front-sided knee pain is that all of a sudden they'll go and Google it and they'll be like, oh, I need a knees over toes program.
• 44:19
  Dr. John Rusin: I need to be forcing my knee forward in the most biomechanically disadvantageous position possible while it's hot, while it's hurting.
• 44:27
  Dr. John Rusin: And sissy squats.
• 44:28
  Dr. John Rusin: Yeah, yeah, sissy squats.
• 44:30
  Dr. John Rusin: Uh, there's a bunch of different exercise variants with that.
• 44:33
  Dr. John Rusin: But that's the opposite thing of what we would recommend that pain-free performance.
• 44:36
  Dr. John Rusin: If you are dealing with hot knee issues, like, hey, this thing actively hurts right now and it's been kicking my ass for a number of weeks, if not months.
• 44:45
  Dr. John Rusin: That's the time where we pull back and we actually back down into some simple biomechanics.
• 44:50
  Dr. John Rusin: If we can manage where the knee is relative to the ankle, that is going to take the distribution of our loading through our body and it's going to put it onto different key musculature into different patterns in different ways.
• 45:01
  Dr. John Rusin: So the more vertical we can keep the shim, the more the posterior chain is going to be involved.
• 45:06
  Dr. John Rusin: Hamstrings and glutes, if we can get stronger at both of those places, that is going to be putting us in a nice position long term to have pain-free knees.
• 45:14
  Dr. John Rusin: But we don't want to just stay there because I think many times people just end up staying there.
• 45:18
  Dr. John Rusin: Their squats are vertical shins, their lunges are vertical shins, everything that they're doing is vertical shins.
• 45:24
  Dr. John Rusin: And guess what?
• 45:25
  Dr. John Rusin: When we walk, we don't have a vertical shin.
• 45:27
  Dr. John Rusin: When we run, when we sprint, when we change the direction and being an athlete, there is never a vertical shin.
• 45:32
  Dr. John Rusin: There's a knee forward position and there's a dominancy of being on the toes versus the heels.
• 45:37
  Dr. John Rusin: And that's something that we need to grade and scale back into.
• 45:40
  Dr. John Rusin: But naturally, we need to be moving back into a more knees over toes position in a graded and concentrated way, maybe week by week, program by program, and being able to have access to that because long term, that is going to be huge.
• 45:55
  Dr. John Rusin: But going back to just like being able to get your knees healthy, managing that knees over toes position is going to be huge.
• 46:00
  Dr. John Rusin: Strengthening the posterior chain that actually supports the stable line of tension from the knee is going to be huge.
• 46:07
  Dr. John Rusin: So hamstring work, ton.
• 46:09
  Dr. John Rusin: I see that super neglected.
• 46:11
  Dr. John Rusin: And then gluten, hamstring work together.
• 46:13
  Dr. John Rusin: That posterior chain emphasis is going to be one of the best things that we can do for our knees.
• 46:18
  Dr. John Rusin: Once we do that, then we can start to scale some of the stress back in with novel positions of the knee actually translating forward.
• 46:27
  Jerry: Hey, you just wanted to give a shout out to Phillip.
• 46:30
  Jerry: I personally worked with Phillip for about eight months, and I lost a total of 33 pounds of scale weight and about five inches off my waist.
• 46:38
  Jerry: Two things I really enjoy about working with Philip is number one, he's really taken the time to develop uh a deep expertise in nutrition and also resistance training.
• 46:48
  Jerry: So he has that depth if you want to go deep on the Yes with Philip.
• 46:52
  Jerry: But if also if you want to just kind of get some instruction and more practical advice and a plan on what you need to do, he can pull back and communicate at that level.
• 47:02
  Jerry: Also, he is a lifter himself, so he's very familiar with the performance and body composition goals that most lifters have.
• 47:10
  Jerry: And also, Philip is trained in engineering, so he has some very efficient systems set up to make the coaching experience very easy and very efficient.
• 47:19
  Jerry: And you can really track your results and you will have real data when you're done working with Philip and also have access to some tools likely that you can continue to use.
• 47:29
  Jerry: If all that sounds interesting to you, Philip, like all good coaches, has a ton of free information out there and really encourage you to see if he may be able to help you out.
• 47:38
  Jerry: So thanks again, Philip.
• 47:40
  Philip Pape: Cool.
• 47:40
  Philip Pape: Yeah, gluten hamstring work.
• 47:42
  Philip Pape: Everyone loves that, especially the ladies.
• 47:44
  Philip Pape: Hamstring work is is definitely fun because there's there's ways to isolate it both with extension and flexion.
• 47:50
  Philip Pape: And I know I've been doing length and partial RDLs lately, and those can be brutal because you can some people can overload them, some people actually find them heavy, heavier.
• 47:57
  Philip Pape: It's kind of kind of interesting how that works between individuals.
• 48:00
  Philip Pape: What are your favorite hamstring movements?
• 48:02
  Dr. John Rusin: RDL is gonna always gonna be the king.
• 48:04
  Dr. John Rusin: I would argue that the RDL, if you're to do one exercise for the rest of your life, probably has the highest yield.
• 48:09
  Dr. John Rusin: You get that stretch on the hams, you get the flex on the glutes at the top, you're able to have mobile full range of motion down through the posterior chain, and you're able to have a connectivity through your upper body.
• 48:19
  Dr. John Rusin: Like it is awesome.
• 48:21
  Dr. John Rusin: And it also gives us the ability to train the core and the spinal position at an isometric.
• 48:26
  Dr. John Rusin: Like it is a super high yield.
• 48:28
  Dr. John Rusin: But I'm a big fan of hamstring isolation work as well.
• 48:31
  Dr. John Rusin: Like, not always going to be jumping into the machines doing a machine circuit like it's global gym.
• 48:37
  Dr. John Rusin: But when you go to seated and line hamstring curl machines, those are two of the only machines that I will routinely be able to program in because there's really nothing else like them in terms of open chain mechanics at the hamstrings that will be far different in terms of the mechanics and the properties of the joints and the stabilization patterns than standing on two feet and doing something like an RDL or a split squat with a hinge emphasis or something that lengthens out the hamstrings.
• 49:03
  Dr. John Rusin: But really, we like to also have diversity in terms of our tool sets there.
• 49:07
  Dr. John Rusin: Anytime that we can get sliders out, anytime that we can get suspension, bandwork, that is gonna be huge for hamstrings.
• 49:14
  Dr. John Rusin: And remember, the hamstrings aren't just one muscle.
• 49:17
  Dr. John Rusin: The hamstrings are hamstrings, and then we have adductor groups of the hamstrings as well.
• 49:22
  Dr. John Rusin: So anytime that we can get out into the lateral planes of motion, that is gonna act for hamstring stabilization at the hip down into the knee even more.
• 49:29
  Dr. John Rusin: So you really can't go wrong having big, strong, meaty hamstrings because they're not only aesthetically pleasing, but they are so functional for almost every goal, whether it be trying to mitigate low back pain, being able to bring up your glute hypertrophy, or just protect your knees long term.
• 49:48
  Philip Pape: And they make your legs look good.
• 49:49
  Philip Pape: Uh, let me tell you, because it's like the triceps of the legs, right?
• 49:53
  Philip Pape: You know, people think it's the biceps, it's the triceps that make your arms look big.
• 49:57
  Philip Pape: But uh no, that it's funny you mentioned the sliders and stuff.
• 49:59
  Philip Pape: Because I, again, I used to do CrossFit and they had the rollers and stuff.
• 50:02
  Philip Pape: My my daughter's doing a little physical therapy for her.
• 50:05
  Philip Pape: She dislocated her knee not long ago.
• 50:07
  Philip Pape: And they're like, Dad, have you ever heard of sitting in a chair and pulling with your legs?
• 50:10
  Philip Pape: I'm like, Yeah, I bet that hurt that you feel that in hamstrings, don't you?
• 50:13
  Philip Pape: Because, you know, it's just even doing that, it's you can see how weak you are sometimes when you do those.
• 50:18
  Philip Pape: Uh, that movement, which is more like the leg curl type movement.
• 50:21
  Philip Pape: I know we're getting low on time.
• 50:23
  Philip Pape: I did want to talk about the shoulders, honestly, because I personally have had rotator cuff surgery.
• 50:28
  Philip Pape: There's probably a lot of things I could have done different myself over the years.
• 50:30
  Philip Pape: I am where I am, but it's a very epidemic thing among lifters who are older, bar none.
• 50:36
  Philip Pape: I mean, shoulder issues all over the place.
• 50:38
  Philip Pape: Some people avoid overhead pressing altogether.
• 50:40
  Philip Pape: Some people are in, you know, shortened range of motions, using the pausing, using having to vary up their grip and width and all this.
• 50:46
  Philip Pape: Um, trust me, I know.
• 50:47
  Philip Pape: So when it comes to the shoulder pain, are there, again, movement pattern issues that people are doing too much?
• 50:55
  Philip Pape: Or is it trying to go too hard on overhead doing it the wrong way?
• 50:58
  Philip Pape: Like, where does all this come from?
• 51:00
  Dr. John Rusin: We have an obsession with the mirrored muscles.
• 51:02
  Dr. John Rusin: I think it's as simple as that.
• 51:03
  Dr. John Rusin: The mirror muscles are gonna be your abs, they're gonna be your biceps, and of course, the chest.
• 51:08
  Dr. John Rusin: And if you're not training chest on Monday, are you really strain training?
• 51:11
  Dr. John Rusin: And as funny and as stupid as that sounds, if you go in and watch any single gym across the world as I've been to, you're gonna see that the bench press is the number one exercise for every male in that gym on any given day.
• 51:26
  Dr. John Rusin: And all of a sudden, you go years, if not decades, of overtraining the push and neglecting the backside of the body with the pull pattern.
• 51:32
  Dr. John Rusin: And we tend to run into some problems, especially now because we are so glued to handheld technology with our phones, we're on our computers, we're sedentary more than ever before.
• 51:42
  Dr. John Rusin: And we have a bigger need to actually reverse these sedentary postures with the pull patterns that put us into extension, external rotation, and AB duction at the shoulders.
• 51:52
  Dr. John Rusin: And this is the opposite of what most people are training.
• 51:55
  Dr. John Rusin: One of the first things that I do with clients is that I audit their volumes.
• 51:58
  Dr. John Rusin: I audit their volumes across squat hinge, lunge, push, pull, and carry patterns.
• 52:02
  Dr. John Rusin: And when it comes to the upper body pushes and pulls, if I see anything that's under like a two to one ratio between pull and push, I'm like, yeah, that's the first thing that we're gonna go after here is we're gonna redistribute the volume to put more volume on the backside of the body in terms of rowing and pull downs and push-ups and direct lat work.
• 52:21
  Dr. John Rusin: And then we're going to probably keep the volume about the same or pull it back a little bit in terms of your push pattern.
• 52:27
  Dr. John Rusin: And the push pattern is gonna be more diversified than just the barbell bench press on a flat or if you're functional, going up to a 45 degree angle.
• 52:35
  Dr. John Rusin: And that tends to really be humbling for most people because they go, oh shit, you know, I need more face pulls, I need more rows, I need more unilateral work in the pull pattern.
• 52:45
  Dr. John Rusin: And I need to be able to diversify away from just the barbell.
• 52:49
  Dr. John Rusin: I love barbell bench pressing, and I would say 60 to 70% of my clients will barbell bench press.
• 52:55
  Dr. John Rusin: But we also are training many different uh ways in terms of landmine pressing and dumbbell pressing and working with bands and having kettlebells.
• 53:05
  Dr. John Rusin: And there's so many different ways to be able to train the push pattern.
• 53:08
  Dr. John Rusin: And the easiest one is the most accessible to everybody, is simply doing push-ups in a closed chain, getting your hands on the ground and allowing your shoulder blades to actually start moving again.
• 53:18
  Dr. John Rusin: That is going to most likely be the pattern where we start the rebuild process from if you're dealing with shoulder pain and past injuries.
• 53:26
  Philip Pape: So much wisdom here, guys, if you're listening.
• 53:28
  Philip Pape: I mean, I'm just like smiling inside, John, because a lot of what you're saying, I've had to learn through hard knocks.
• 53:34
  Philip Pape: And I, you know, I'm not saying I know everything you know, but it just resonates so hard with me because for me personally, for anyone listening who's been following my shoulder rehab journey, you know, things things got kind of acted up about a year after my surgery and things started to take a turn with bursitis and issues like that.
• 53:50
  Philip Pape: And I'm still working through, but a lot of the advice I got and talking to guys like you, not you, but guys like you, were trying to do more pulling movements and try to really strengthen the back part of the upper body.
• 54:02
  Philip Pape: And, you know, just today I was doing neutral grip pull downs and T-bar rows, and like I'm really getting into more of that.
• 54:07
  Philip Pape: I like that two to one ratio because it's a nice prescriptive way to think about it, where you, you know, if you're doing six movements, then four of them should be pulls rather than pushes.
• 54:17
  Philip Pape: And what are what are your thoughts on like barbell rows and yeah, let's, you know, movements like that that have other translation to the posterior.
• 54:27
  Philip Pape: Do you find them even more effective?
• 54:28
  Philip Pape: Or can they be kind of limiting because of the weight?
• 54:31
  Philip Pape: Like, what are your thoughts?
• 54:32
  Dr. John Rusin: I program almost everything.
• 54:33
  Dr. John Rusin: I do not program traditional barbell bent over rows.
• 54:37
  Philip Pape: I saw that in your book.
• 54:37
  Philip Pape: I saw that in your book.
• 54:38
  Philip Pape: I wanted to ask about it.
• 54:39
  Dr. John Rusin: One of the reasons that I don't is not that I think everyone's gonna be injured first time that they do it.
• 54:44
  Dr. John Rusin: That's not the way the body works.
• 54:45
  Dr. John Rusin: But I do think that it's just not the best way in order to train the back directly.
• 54:50
  Dr. John Rusin: When we're thinking about holding a hip hinge, we just mentioned that a lot of people have trouble hip hinging in general, but now I'm gonna ask you to hold it for 30 to 60 seconds in a hard isometric and not give up the position whatsoever.
• 55:03
  Dr. John Rusin: And then I'm gonna put your hands in a fixed position on a barbell in an arbitrary distance apart, and I'm not gonna allow natural rotation to happen at the hands nor the shoulders.
• 55:13
  Dr. John Rusin: And then I'm gonna put it into a bilateral stance that is gonna be dependent on your lower back position and you staying upright.
• 55:19
  Dr. John Rusin: And then I'm gonna put max load on because anytime we see a barbell, it's like, how much can we load up on this thing?
• 55:25
  Dr. John Rusin: And many times it just turns into a sloppy movement, it turns into half rep ranges of motion, a lot of momentum being used, a lot of the recruitments happening at the lower back versus the musculature of the upper back and the lats where we really want to target.
• 55:39
  Dr. John Rusin: And it's something that there's just like so many other awesome variations that we could possibly go into for muscle, for strength, for resilience building of positions, that it just doesn't make a whole lot of sense for me.
• 55:53
  Dr. John Rusin: I will absolutely use positions and I will use different variances of bent over rows, whether it be single arm, whether it be supported, whether it be chest supported.
• 56:02
  Dr. John Rusin: There's a lot of different ways to do it.
• 56:05
  Dr. John Rusin: But the standard barbell bent over row, I know this seems like sacrilegious to many people listening, but that's just not a high risk-to-reward exercise for a vast majority of people for shoulder health and for lower back health.
• 56:18
  Philip Pape: Yeah, I wanted to ask because I saw that in there and I don't totally disagree.
• 56:21
  Philip Pape: I mean, I've spent years trying to follow people like Alex Bromley, for example, who takes it very seriously on how to do the position and making sure you're up above the ground so that you could properly get in the form and everything.
• 56:33
  Philip Pape: And then guys who, you know, are like, Loyal, let's use the easy car, let's easy bar, let's increase our angle and let's do power versions of that so that you go to a dead stop.
• 56:42
  Philip Pape: There's lots of things.
• 56:43
  Philip Pape: And maybe there are some other benefits like the isometrics, but you get that from deadlifting as well.
• 56:48
  Philip Pape: So I hear you, man.
• 56:50
  Philip Pape: And I personally have really started to enjoy like T-bar rows and cable rows and things like that, and really feeling it hit those spots more directly.
• 56:59
  Philip Pape: But teach his own, obviously, if you can progress safely and do it and you want to do it, we're not saying not to.
• 57:04
  Philip Pape: As we wrap up, and we're a couple minutes past, apologize.
• 57:07
  Philip Pape: Is there anything else you wish I had asked?
• 57:09
  Philip Pape: I know there's a lot we didn't get to, but in this context of just pain-free with those key joints, anything we didn't cover that's on your mind?
• 57:16
  Dr. John Rusin: I think that as we get older and as we have more mileage on our system, we will all be pushed to be able to evolve and change so we can continue to do what we love to do.
• 57:25
  Dr. John Rusin: And you said something that really resonated with me.
• 57:27
  Dr. John Rusin: It was like, yeah, I had to gain this wisdom because I had shoulder pain.
• 57:31
  Dr. John Rusin: I had to go into surgery, I had all these injuries over the years, but I love training and clearly we do.
• 57:36
  Dr. John Rusin: But I think pain-free performance is a 600-page resource on things that I have made mistakes with, things that I've been mentored by, and the system that you could simply run to plug and play a pain-free performance model that simply keeps you healthy and works for your body uniquely.
• 57:53
  Dr. John Rusin: We don't have to give up what we love to do.
• 57:56
  Dr. John Rusin: I would never tell anyone that.
• 57:58
  Dr. John Rusin: Leave that to the doctors and the poor physical therapists out there.
• 58:01
  Dr. John Rusin: What we want to do is be able to line you up to do what you want to do forever, but it does take a little bit more concentrated work and a smarter system to achieve that.
• 58:09
  Philip Pape: A smarter system to do what you love to do forever.
• 58:11
  Philip Pape: Love it, John.
• 58:12
  Philip Pape: All right.
• 58:13
  Philip Pape: On that note, where do you want people to find you besides?
• 58:15
  Philip Pape: I'm going to promote it for you again.
• 58:16
  Philip Pape: Pain free performance, the book.
• 58:18
  Philip Pape: I think it's still available for pre-order because it doesn't come out till, well, around when this episode comes out.
• 58:22
  Philip Pape: So look look it up.
• 58:23
  Philip Pape: We'll include the link to that.
• 58:25
  Philip Pape: Uh, any anything else where you want them to reach you, John?
• 58:28
  Dr. John Rusin: Any social media is at Dr.
• 58:30
  Dr. John Rusin: John Russin on Instagram, on Facebook, also on YouTube.
• 58:34
  Dr. John Rusin: And you can check out our websites over at painfree training.com and also drjonrusson.com.
• 58:41
  Philip Pape: All right, we'll include those links and uh the handles in the show notes.
• 58:45
  Philip Pape: Thank you, Dr.
• 58:46
  Philip Pape: John Russin.
• 58:46
  Philip Pape: It's been a pleasure.
• 58:47
  Philip Pape: Really, this was even better than I expected.
• 58:49
  Philip Pape: I expected a great conversation, but we really covered a lot of unique, helpful areas for the listener, and uh, they're gonna love it.
• 58:55
  Philip Pape: Take home some good action from this.
• 58:56
  Philip Pape: So thank you so much, John.
• 58:57
  Dr. John Rusin: Thank you so much for having me.
• 58:58
  Dr. John Rusin: This was fun.