Hip and Shoulder Pain: Strategies for Joint Health and Injury Prevention with Dr. Gary Gray

In this episode of the Crackin’ Backs Podcast, we sit down with the legendary Dr. Gary Gray, a pioneer in functional biomechanics and rehabilitation. Known for his groundbreaking work in understanding joint health, Dr. Gray takes us through the intricate world of hip and shoulder pain.

We kick off by exploring what sparked Dr. Gray's interest in the hip, particularly the joint capsule, and delve into its critical role in movement and stability. Dr. Gray explains how to identify early signs of potential injuries, discussing whether these issues stem from overuse, poor biomechanics, direct trauma, or a combination of factors. We’ll tackle the biomechanical culprits behind common conditions like snapping hip, labral tears, and impingement syndrome, while also considering the impact of other injuries such as ankles and mid backs.

Prevention is key, and Dr. Gray shares his top recommendations for pre-play and post-play routines to keep your joints healthy. But what happens when an injury does occur? We discuss non-surgical and post-surgical treatment options, including whether surgery is the best route to recovery.

The conversation then shifts to shoulder health, where Dr. Gray outlines how to differentiate between joint-related issues and muscle injuries, such as those involving the rotator cuff or bicep tendon. He explains the importance of evaluating the surrounding structures, including the thoracic spine, clavicle, and neck, and provides insights on biomechanical issues that can lead to shoulder injuries. Dr. Gray also offers practical advice on warm-up, stabilization, and cool-down protocols to prevent shoulder injuries.

For anyone struggling with hip or shoulder pain, or for those interested in preventing these injuries, this episode is packed with actionable insights and expert advice from one of the leading voices in the field.

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Transcript

Dr. Spencer Baron: 0:00

Welcome to the Kraken bats Podcast. Today. We're joined by the renowned Dr Gary Gray from the gray Institute. We will explore the complexities of hip and shoulder pain. We'll uncover what makes these joints so critical, identify early signs of injury and discuss practical strategies for prevention and recovery, whether you're dealing with discomfort or aiming to just stay injury free. Dr Gray's expertise will guide you through the essential steps to keeping your body performing at its best. Let's get started.

Dr. Terry Weyman: 0:35

All right. Well, we're totally excited to have this man back, because it is football season, NFL season, and we got the fall sports going on. We've got the great Dr Gary Gray from the gray Institute online. And we're going to talk shoulder pain and hip pain, because everybody wants to talk about knee pain, but we're going to go to the shoulder and the knee and, I mean, shoulder and the hip, sorry. And some of the biggest issues are laboral tears, which is the joint of the shoulder and the joint of the of the hips. So you know what? Garrett, first off, thank you for coming back on the show, man, we so appreciate you having you taking the time out for us. No,

Dr. Gary Gray: 1:13

it's an honor. Really appreciate it. And I enjoyed the last time, and I'm confident I'm gonna enjoy this as well. So appreciate,

Dr. Terry Weyman: 1:20

I wouldn't go that far. But you know, thank you for at least giving us the opportunity to rise to your level a second time in row, because we usually hit it out, and then we'll see what we can do for the second half.

Dr. Spencer Baron: 1:33

Gary, let me ask you. Let me start by asking you what, first of all, a labrum from the layperson that listens to this podcast that doesn't know what it is. I think of it like a, like a washer on a faucet. You know, the labrum is that, that cartilagering, that's, there's five different types of meniscus like that, you know. And so if you can go ahead and elaborate on what we're going to be referring to a lot as the labrum, and why has that captivated you?

Dr. Gary Gray: 2:03

Yeah, I think that's a I love that description, because a lot of people, we talk about the capsule, we talk about the capsule ligaments, we talk about the labrum, and it gets a little confusing, but I love the idea what you just said, it's kind of like a rubber washer around the edge of the joint that seems to be the connective point of everything, kind of brings everything together, actually creates a little bit of a seal on the joint, especially in the hip, but it's, it's obviously the attachment helps the capsule and the ligaments attached to the bone. And has, obviously, because it's a little rubbery, has a little bit elasticity, but it has a point where it says, I can't deal with this anymore, and it tears, and we end up with a label, tear.

Dr. Spencer Baron: 2:49

Why? Why have you been so fascinated by those two areas, shoulder and the hip?

Dr. Gary Gray: 2:57

Well, I think it's because early on in my career, I miss so much. When you get old, you get more fascinated to saying, You know what? I think I missed this. Not only missed diagnosing a labral tear, but missed on how to prevent a labral tear. That's kind of that's little more of my passion. You know, it's getting a lot easier now to figure out if they have a labral tear, MRI Squirtle juice in them, and see if there's a leak on the washer. But I'm more excited about okay, if they do have it, what caused it? Because we've not we know that shoulder label tears aren't caused by the shoulder, and hip label tears aren't caused by the hip. So we we get excited to say, what, what Ha, what potentially happened, and can I potentially work with my athletes prior to having this and do my best to try to prevent it. We can't prevent it all, but I think, I think a great percentage of them are quite preventable once we understand the biomechanics of what happens

Dr. Spencer Baron: 4:03

the you know, it was interesting, because I'd say, oh my gosh, 1515, to 20 years ago, we had a quarterback at Miami Dolphins that was having hip pain, and it was also like converging into the the groin area. And I mean, everything was being done, and it wasn't until one of our athletic trainers was very astute, and he says, you know, let's do an MRI. And boom, it was the labrum. So you know, if you could share with us some of the presentation that a a patient might have with maybe a hip or, you know, I keep going back and forth, hip and shoulder, but, you know, but the joint capsule as well as you know, how do you would you make a determination? Joint capsule versus label? Well,

Dr. Gary Gray: 4:53

what's really fascinating? Let's start with the hip. The hip, it's. The hips power move to load. The musculature is going through internal rotation, and the big butt muscles and even the iliopsoas slowing that down, getting loaded and explode, going through flexion, obviously the big butt muscles and the hamstrings loading and helping explode. Of course, a deduction, the big hip muscles tensor and loading and explode. And so when our when our hip goes through flexion, adduction and internal rotation, that's a good thing, because that's how we load for throwing, that's how we load for running, that's how we load for anything. And when the when that motion, any of those three motions. And of course, they occur in a combination. When they occur, we have these huge muscles to decelerate it, and so there's like a safety net out there. In other words, it's really rare to go too past those three motions, and therefore you rarely hear about a posterior labor terror on a hip. And that's kind of a might scratch your head and go, that's funny. You're right. Most of them are in the front, right at 11 o'clock and one o'clock right in the groin area. And so I wonder why that is. And so when you look at the musculature, anatomy of the three opposite motions, hip extension, hip abduction and hip external rotation. You say, Okay, which EU muscles know how to decelerate that, and they're all real quiet. We call it the front butt syndrome. In other words, your front butt, if you look at it, ain't very big. And so we could all get naked if we wanted to, and look sideways in the mirror, and I go by golly, our back butt's bigger than our front butt. You know? I wonder if everybody else is like that? And the answer is, yeah, we rarely see somebody with a bigger front butt than a back butt. And the reason that is is because we're designed to create power. We're designed to resist gravity. We're designed to absorb shock and to take advantage of ground reaction, force and mass momentum in order to load those muscles to turn on Prop turn on proprioceptors. So we can do all the fun things we want to do. However, sometimes we have to do something very productive when we get extension out of that hip, when we get abduction out of that hip, and when we get external rotation out of the hip as indicated. There's a couple of muscles in the front hip that, if trained, can help us with that. But when you go and look at the labrum, and then you look at the capsule ligaments, they're aligned to decelerate those three motions, it's kind of cool when you look at, when you look at the anatomy of the hip and the labrum and the capsule and the ligaments. The muscles are designed to decelerate flexion, adduction, internal rotation, but the anatomy of the ligaments of the hip with the labrum are designed to decelerate extension and abduction and external rotation. But when you think about it, those three motions don't occur a lot because they're not gravity driven and they're not ground reaction force driven. However, when they occur, when we do a certain thing, and that's where we're seeing a lot of mechanism of injuries, we do a certain thing, and we have at least two, and usually three of those motions occurring together if we have not created an opportunity to teach the trunk and to teach the foot and some of the hip muscles to decelerate that, the next layer it's going to go to is the ligaments in the labrum. If they don't have the ability to decelerate that, something's going to tear, and your rubber washer's going to tear. You're going to get a tear of the labrum, and you're going to say, doggone it, I wonder if we could have prevented that, and that's kind of the million dollar question. I believe most of them are preventable. Now, I don't feel the same way about the shoulder. I think the shoulders at more risk because it has more mobility. The glenoid fossa is a lot, you know, shallower we do again, strangely enough, most of the labral tears are, you know, like a slap lesion. They're superior or anterior. Every once in a while, when somebody gets a repair, we see them in that weird looking thing where they have a do a poster repair. But you know, 95% we see like this because they did an anterior repair. So you got to ask yourself, Okay, wonder, how come? I wonder. And so we call it the front butt syndrome for the shoulder. We have a front butt here, not very much thing going on that's quite bony little peck here, going over and, you know, not a lot of excitement going on. But when I go back here and go, Oh, you know, I got some good poster deltoid going on, rhomboids. And, you know, so my back, my back, butt of my shoulder, seems to be designed to decelerate gravity again and decelerate and help me pick up things, rocks and stuff, and helps me do that. But when I get in that susceptible position, again of flexion and obviously external rotation, and in this case, more kind of an abduction, all of us. Sudden, we ask, what muscles can decelerate that? And obviously pitchers have to use that to load and explode. And if we don't have good elasticity and good what we call anterior stability, mobility with strength and stability, then all of a sudden it goes through the ability for the muscles to control it. It goes right into the capsule in the labrum, and the labrum gets torn. And so, you know, again, our passion is to say what, what is the mechanism of injury? Is there a common thread that we can see we we've we started? Well, there have been labrum tears for years, shoulders, we've been understanding them, at least during my 50 year career. We kind of, we've talked about them, but hip labor tears, we didn't start talking about them until about 1520, years ago, and I think they were out there. I just think we couldn't diagnose them, and we called it early arthritis, and then that led into a total hip and, you know, we called it all kinds of things, but we do know that that booger ached Right, right in the groin. And so now we get that classic they they go when I'm sitting and I stand up, boy, aches right there. I take a few steps, feels gunky. I walk a little more, doesn't feel too bad. They engage the muscles. They gain a little bit of control that the labrum should be controlling, but then when they kind of slow down or do more static things, it becomes more of a problem. Our eyes light up and go, have you had an MRI early on? It was interesting. I'm quote, unquote. I don't like this phrase, but it's a phrase people use. I'm just a physical therapist, so I'm not a radiologist, I'm not an orthopedic surgeon, but it doesn't take a Rhodes scholar to look at an MRI and see where it's leaking. And so we had, we had a document in case of 20 people who came to us that had classic labral symptoms. Now, the tough thing about labrum there's not really a clinical test that I know of that I can really take it and say, I think there's some instability there. If the even if they know most liberal tears, the athlete won't tell you when it happened, they don't know. It's kind of this slow fate. It's a small, little baby tear, no pain, and it tears a little more. And pretty soon they started having symptoms. So we would ask for the MRI. We'd throw the Mr. Up on our computer, and we could see it. We were cheating, because we know what we're looking for, but we look at 11 and one, and we see, bingo, we got a little bit of squirting going on. In other words, it's not holding it in there. So we call we actually, I have a specialist that I utilize in California, Dr Snivy, one of the best orthopedic surgeons in the world relative to labrums. And he's been kind enough to say, if I get an MRI, can I send it to you and take it'll take you two seconds to look at it and tell me if I'm right or not. And so a while back, radiologists didn't know how to read the labral terror. So we kind of had to do that for them, but now they do a great job now. Now we're pretty they know what to look for, and so it helps a lot to have that diagnostic, that diagnostic ability

Dr. Spencer Baron: 13:16

back to the hip regarding a common comment from patients would be snapping hip. What is that?

Dr. Gary Gray: 13:29

Well, it can be a lot of things. You can you can have a stable hip and still have something kind of snap. You get a little tendon that's taunt and it sneaks over the edge of a bone or edge of a rim, kind of the big snap, the big thud that we'll see with labral tears is somebody who has an advanced labral tear, that instability, where that washer isn't holding things in, and they literally get the hip loads because of gravity, ground reaction force. And then when they take a step, it unloads. But it doesn't unload smoothly. It unloads with a snap. You know, there's a quick movement so that a snap and all by itself, isn't, you know, a bad thing, because we got a lot of snap crack on, pops going on in us. But when it correlates to, like you indicated, something going on in the hip, and the achiness of the hip and that groin pain, or just a little higher than the groin. Then we go, Okay, we got maybe a little more instability here than we thought.

Dr. Spencer Baron: 14:27

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Dr. Terry Weyman: 14:40

now,

Dr. Spencer Baron: 14:44

you mentioned earlier that there really isn't any testing, any orthopedic tests for identifying a labral issue, but you know so often I see people the patient lay supine, and they. Take the leg and they do like all this passive range of motion thing. How do you feel about that? I think

Dr. Gary Gray: 15:05

it's great. I think I try everything. Yeah, I lay them supine, prone, sideline, upside down, wiggle it, just try to get an idea if there's a consistent area of pain, or if I can slide it a little bit and then compare to the other side, and it very probably is that I don't have the expertise on how to do that, but if somebody's doing that, and they can kind of get a positive correlation between what they find, I think that's great. They need to let us know what it is, though, because I just I'm not good at it, and I can't really differentiate it. I think once I had a person that I took and I did kind of a medial glide, what I tried to do is take the head of the femur and jam it through where I thought the labrum was torn by driving at the knee and driving at the trochanter. And in my mind, I felt I was getting a little more slippery going on there, you know, a little something gonna sneak into there. But then I went the other side, and I wasn't sure. So I think that's a difficult one, because the hip, intrinsically, is pretty stable, and when you get that, when you get that labral tear, muscles around the hip can can really protect it for a while, but then, man, you lose that intrinsic stability, and that thing starts wobbling back and forth. You get the early arthritis, and now you're in trouble, so an early diagnosis and get that baby repaired so you inhibit the arthritic changes, I think, is really key, and I'm seeing a big turnaround. I seen the orthopedic surgeons around here, and just even around the country, understand that much better, and they're doing just a great job. And then then the key then is just to understand, Okay, how did the labrum get torn? Because that's when I rehab somebody. I need to know that. So I've gone to some professional football teams, and I'll ask the strength coach, so tell me what your job is. What do you mean? What's your job? Well, I'm the strength and conditioning coach. I'm responsible for getting these guys stronger, faster, corner, meaner, tougher, great, perfect. That's That's your job. Then I'll ask, is part of your job while they're in in the in the weight room to create exercises to try to prevent labor tears. They kind of look at me and they go, I'll answer that for you, yes. Okay, that's your job. I don't have a labor tear now. I'm a $40 million a year athlete, and I'm going, I'm lifting weights, and so is your job to understand what I need to do to give me the least amount of chance to tear my labrum? And the answer is, yes. Can't deny that. And then the tough question is, I'll ask them to say, so what causes a labral terror, dead silence, and so it's hard to prevent something unless you know what caused same thing with ACL. I'll say, tell me what caused an ACL tear, because you can't prevent it unless you know what causes it. Same thing at the shoulder. So understanding the biomechanical mechanisms that let the labrum down at the hip and the shoulder are really critical to not only trying to prevent the silly things from happening, and designing programs that will really help the athlete. But then, if they do have rehab, and definitely surgery after rehab, our job is then to prevent it again. We're reading a lot now of labor tears re tearing, and so when you do the surgical repair, did you fix the cause. No, you just fix the symptom. You still don't know what caused it. And so another interesting thing that, and this is, this is, hopefully most of what I say is based a little bit on fact and truth and sound principles. But this one is a hypothesis. So take it as a hypothesis. I've seen a number of athletes with a labral tear in their right hip, and I find the cause in the left hip. In other words, I see the limitation the left hip that forced the right hip to do too much because the pelvis. And so you guys know that relationship, a lot of people don't. And so one of the things I do in rehab is to make sure, yeah, I know you had a surgery on your right hip, and I know what I gradually want to do to get that mobile and strong, but at the same time, I'm going to look at the left hip to make sure that wasn't the booger. Many times the foot is at fault. So I'm going to make sure. I'm going to look at the foot, and you guys nailed it last time we talked. The importance of the thoracic spine. The importance of the thoracic spine in preventing laboratories is huge. I mean, huge, huge. But very rarely will people like you guys do a great job connect the dots. And so we basically say, well, instead of playing a guessing game here, let's you know so so ask the strength coach. How much do you do? Where you drive the hip into extension with weights overhead behind you? How. Much do you do to drive the hip into abduction, and how much do you do to drive the hip into external rotation and more poorly? How do you how do you do all three together? What? What exercise will I do here? And they'll look at me says, we don't do anything like that. It's not in the strength and conditioning book. It's not in the you know, it's not in the playbook. And that's where we go. Hey, I think we can help you. Yeah, I'm glad we're here. I'm glad you invited us. But I think there's a, I think there's something that we could do together to give these kids a better opportunity to play the game they love and not get torn up. Is

Dr. Spencer Baron: 20:33

that where you, where you showed us those lunging type moves last time? Is that those that's, that's key. Okay, I love, yeah, that was a great recipe.

Dr. Gary Gray: 20:43

Yeah. What's really neat about that is what we showed you last time is kind of a single plane, 3d maps, yeah. So we took our lunge forward, took our hands up and back, good hip extension, and then we took our foot sideways and took our hands opposite. We got good hip abduction. And then we took our foot, did a same side rotational lunge, and took our hands. We got good external rotation, but we now have what's called 3d maps hybrid, which simply means it's the combination of all three of those motions. So it's interesting. As I'm getting older and older and older, I always kind of say, well, if I don't have a lot of time and I only have one exercise in the world to do. I can only do one exercise. I will do what we call our 3d maps, fascial exercise. Because what I what, what we can do is go through a motion that creates all three of those motions that are at risk of the hip, load them and explore them, and then come down and then load all three motions of the back, butt, which is flexion, adduction, internal rotation. So I'm getting all three motions of my thoracic spine. I'm getting all three motions of my hip. I'm getting all three motions my shoulder. So it's kind of like, you mean there's a movement that you can do to actually facilitate almost every joint in the body in all three planes of motion. The answer is yes, that's

Dr. Spencer Baron: 22:02

fantastic. I want to go. I know. I'm going to dig back a little bit deeper into our conversation about you mentioning that the most common injury to the hip labrum is anteriorly or in the front. And I do recall having in the past the maybe one or two times that I had patients that came in with a labral tear in the posterior region was because of a car accident. Very good they were in. And usually it's

Dr. Gary Gray: 22:29

got to be an external force the old dashboard you got it,

Dr. Spencer Baron: 22:33

yeah, fascinating. So how often would you be able to identify where there's two conditions where either the capsule has Invaginated into the joint because it's so loose that sometimes, you know traction and or you know some of the activities that you shared with us would help. And when would you also find a patient that maybe has, like osteophytes forming on the lip, on the anterior lip. So they, they say they can't even bring their their knee up to their chest when they're like supine,

Dr. Gary Gray: 23:07

you see, and it's a bite, it's a, it's a, it's a huge bite. The problem is, is that we can get the bite with the osteophyte, and we can get the bite because when we when we bring our leg up, we need this ability for the femur to kind of roll down in all three planes of motion, the other way, so we don't get that anterior impingement. Now you gotta, you got, if that's happening a lot, it's going to build an osteo fight. And now it's a big now you got a big problem, yeah, so now you've got this huge bind going on. And, like you say, if it's I think if I can do a little distraction and do a little glide, get a posterior glide, and do a little medial glide, and take a get just a pinch of external rotation and get them to actually have more flexion. Usually, I'm dealing with the labral capsular problem. Usually, by the time it's an osteo fight, I can't make it better, in other words, so I'll do a manual therapy, as you just properly discussed. And if I can kind of alleviate and they can get me more motion, and they don't have that infringement, then I go, okay, you know, we can work with this a little bit. I'm not as concerned is that you do have this big hunk of spur bone hanging out that's going to just beat on the anterior part of the of the femur between the acetabulum. So, but even then, I'm not always confident, you know? I just it's one of those where you use the sometimes the big question is, hey, looks like I have a labral tear? Do I have surgery or not? Okay, that's, that's, that's a question some people with a slight laboral tear, because they move and are very active. They do quite well, until they tear it a little more so whatever the initial mechanism was, now it. More susceptible. So early on, we kind of scratched our head and says, Well, maybe therapy and rehab will do it, but we're finding out, especially with active people, best thing to do is get that sucker fixed and then try to figure out what caused it, and then do great rehab on both hips, both feet and the thoracic spine. And they usually do pretty good. But to differentiate between the spur and no spur, for me, that's hard when

Dr. Spencer Baron: 25:26

you request an Well, at the point where you go, Hey, we need an MRI, I think the I should really start with saying that the art of the physical exam is lost. You know, obviously you're very conscientious, and you understand ranges of motion and muscle testing and biomechanics and everything, but, man, there's so many doctors that would just go straight to MRI. Oh, you got hip. Let's go. And I want to make that clear, because they've used MRI as a crutch as for their, I hate to say, their inefficient ability to perform a valuable hands on observational physical exam. Yep. Do you notice that?

Dr. Gary Gray: 26:08

Then orthopedic surgeons would admit that there's nobody, there's none of them are going to say that's not true. But then you, if you really you have an orthopedic surgeon who's a friend, and they're willing to just open up say, Do you know how to do a really good manual examination to differentiate, to see if you think they are MRI candidate or this could be something taken care of by a movement practitioner, and they'll be honest of it, no, we didn't learn that. You know we we just, we just know that if there's any suspicion, our job's easy. I get to go see the next patient, and meanwhile, this guy goes to the MRI, and then now somebody else is going to tell me what the problem is, where you know, what you all do is what I want to do. I want to understand it and see if they really need that. We can always do an MRI week from now. We can do an MRI a month from now, nothing's going to get a lot worse. You know, we rarely will somebody have a tear, and then we go, Oh, crap, we didn't do it quick enough, and now it's twice as big. Rarely happens. So we have time. And sometimes we'll have referrals and say, Hey, we're not really sure it's an MRI. It's a labor tear. It's kind of acting like one. We don't, haven't done an MRI yet. Could you, can you get this guy on a good exercise program to see if you can get better, and see if the eight goes away, and then if you do everything, what you consider right to facilitate healing in that area, and they still don't get better, then, okay, yeah, let's go do an MRI. I agree with you, 1,000%

Dr. Terry Weyman: 27:38

area. You mentioned that, you know, as Spence mentioned like an osteophyte. So we know that osteophytes are the body's reaction to abnormal stress. So, and we have a torn labrum, we know that's torn because of abnormal stress. So I'm not a big keen guy on personally, on surgery on labrums, because if you don't fix the cause of white or why this osteo fights there in the first place, you're not having success for a surgery. So Right? You know how and so many people get myopically focused on, well, there's a pinchment, or there's a osteo fight, there's a tear, let's strengthen the muscles around it. Well, a lot of people don't think about the feet. They don't think about the kinetic chain. How do you fix How do you use this osteophyte as a great diagnostic tool looking for the abnormal biomechanics and and how do you use the the where the tear is to look for abnormal biomechanics? How do you use these injuries as diagnostic tools to fix the problem

Dr. Spencer Baron: 28:40

we are. He also said he looks at the opposite hip to the good hip, right?

Dr. Terry Weyman: 28:44

So, so let's talk about the feet. Let's talk about how everything works with the hip. Yeah.

Dr. Gary Gray: 28:49

Well, what's interesting, and it's good kind of we're sticking with the hip capsule, because it's different in the labrum, different at the hip, than it is in the shoulder. What my again, sometimes when I say things I don't, kind of preface it with and this is my hypothesis, but this is my hypothesis. Okay, when we see athletes who have this problem, I always say, well, I need to look at you to try to figure out why. What's unique about you that you know you are not able to be a down lineman and handle your duties of protecting the quarterback, when all of a sudden you seem to get thrown back and rotated in this way. We got film where the offensive lineman will say, this is when I felt a something. You know, they don't say tear, but I felt something give in my hip. And again, we go. That's interesting. They were extended, abducted and externally rotated by the defensive lineman, and all of a sudden that went so, how much are you training yourself to help decelerate that? Well, most of the time, none. I'll ask them. Tell me what you're doing the training room. And they, you know, we just. Weren't aware of it. It's not It's nobody's fault. But the interesting thing is, when we see what, I think people who are susceptible to this, and as Dr Terry says, it's from abnormal stress, I think the lack of anterior capsule mobility leads to the lack of posterior capsular mobility, that when I then go through my flexion, it doesn't allow the posterior glide, and we get the impingement. So I rarely see what I would consider just a pure, what I would consider posterior capsular tightness. It's it's more common for me to see a dominant anterior capsular tightness, lack of extension, abduction, external rotation. But then, because it is that washer, well, if you if you make a washer smaller in the front, it's going to tighten up in the back too. So now the washer gets tight in the back. And now all the things I should normally be able to do, and that's, you know, squat down and flex. Now I don't have that normal roll and glide, and now I'm going to bind. And so as Dr Terry said, Well, should we maybe spend a little time on doing that before we jump to surgery? The answer to me is yes, if we can, if we can create that, because we know there's a lot of kids out there that have a label so they don't even know it. If we lined, if we lined a zillion people up, there'd be maybe a small little laboratory they're dealing well with. It hasn't got to the point where it aches and, you know, it makes it unstable. And so is there a more logical diagnostic process and then a more logical treatment process that we should be doing in some cases, not all cases, as opposed to I MRI surgery, you know? And the answer is yes, there should be. But the problem is, least myself included, very few of us understood what caused it. So it's really hard to treat it. If no one really sat our butt down and said, I think it's an anterior capsular tightness. It causes a posterior capsule tightness. I think it's an inability to decelerate extension, inability to decelerate abduction, inability decelerate external rotation. And if we can create mobility and stability. With those three motions, all of a sudden now we see posterior capsular loosening up, and now we get less to actually no impingement. And so it's interesting, they think of a balloon, you tighten up one part of the balloon, the other side is going to be tight too. And so we always think, well, how in the world do we get that posterior tightness. I think it's from gravity sitting all day long, like I'm doing right now. Everything's gunking in in my anterior hip, and I'm now susceptible, I think, to a labral tear. Do

Dr. Terry Weyman: 32:52

you ever see precursors to labral tears being maybe an ankle sprain, a thoracic sprain, or even maybe a glute sprain. Oh

Dr. Gary Gray: 33:02

yeah. In fact, I think he just hit the major three. So I did a little talk yesterday, just on low back pain, and just, I spent most of my time just talking about the glutes and the hip and how it relates to the low back and you guys taught us that you guys basically are the masters in that. And when I first started studying the foot, it intrigued me, because the foot, by design, is, is, is designed to actually create rotation in the hip, so when I walk my So Taylor joint, with E verts, has this bone on top, called the talus that let's, let's all kind of in our mind vision, and think of the right foot. So my right foot hits at the heel, and now it's going foot flat, gravity, ground reaction, force will ever my calcaneus automatically. There's not a, there's not a muscle that does that because of the shape of the subtalar joint that talus falls down and in, and the key is, falls down, but it rotates. And that's why they call the talus a torque converter, because it converts frontal plane torque into transfers plane torque and vice versa, top down transfers into frontal plane. So if we all stood up right now and just rolled our feet in and out, we'd see our body twist, and you'd go, that's weird. Yeah, I'm moving my foot through the frontal plane. Why am I? Why is my upper body dominating the transfers plane? Because that's a torque converter. And so when that foot hits and I go through that flexion, I want that internal rotation. And like you just said, Hmm, ankle sprain. Okay, somebody will come to us and say, got a little something going on my hip. Tell me more about what's going on. No big deal. Last year I had an ankle sprain. We go down there and we grab their sub Taylor joint, and it doesn't ever okay. That's so much. The two motions ankle sprains don't get back. The traditional inversion is eversion endorsed flexion. So if their foot's hitting the ground and the talus isn't falling down and in. They're going to get the flexion, they're going to get the adduction from gravity, but they're not going to get the corresponding internal rotation. That's setting it up for the impingement right there. So it's like, boy, before we jump to conclusions on what's happening at your hip, let's create some mobility in that subtalar joint and allow that torque converter to take your femur and rotate it so now you can get up and under the edge of the acetabulum and you're off to the races. Thoracic is fine. If like the motions, I'll stand up and again, obviously, without video, they're kind of, we have to kind of imagine what I'm doing here. But if I stand up and I basically take my right hand and I go back, if I don't have good thoracic extension, where's it going to go? Right to my hip. Okay, if I go over the top of my head in reference to my left hip, where, and I don't have good lateral flexion, where's that going to go? Right to the frontal plane of my left hip. And more importantly, if I do this, where I rotate, and I'm trying to get my hand right, hand to rotate right, and my thoracic spine doesn't give it to me. Guess where it's going to go, it's going to go right to the hip. And so we go, oh, that's a bad hip. And the thoracic spine, like you guys said last time, is up there, going, Oh, crap. Is my fault. You know, I'm the friend who let him down and and here, here's what really the thoracic spine saying, I hope and pray that somebody finds me, because if they don't find me, they're not fixing me, right? All right, you're still susceptible to the label terror.

Dr. Terry Weyman: 36:36

Yeah. You know, it's so funny, because when we have patients, and I'm sure you see us with hand injuries and wrist injuries, we spend so much time strengthening them post injury, yet when we have an ankle injury, we do a little bit of strengthening and balancing, and then we put them in soft shoes and arch supports, and we wonder why these feet get don't fix and then We wonder why they have ACLs and hip problems and mid back problems. So it's amazing how many people forget the feet and forget that whole kinetic chain and and all that.

Dr. Gary Gray: 37:10

I think we all forgot the feet. I know in school, when I reflect back on the feet, I remember it was the last chapter in anatomy and kinesiology book, and we only had a half a day, and the teacher said, Now, listen, there's not going to be a lot of questions on their state board. Memorize it has 26 bones, and that's you're good to go. And it's like, okay. But then I realized that when patients came to see me, most of them had feet on and I go, crap. I wonder what those two things are doing. And then I realized it's what we it's the only part of our body, the organ, that interacts with our environment every step we take. And then I go, Oh crap, oh crap. I wonder what it's doing. And then what I did is I look back to see what they told me was doing, and they told me what it was doing on a table. I'm not interested in I've never had anybody have an ACL tear while watching football on the couch. They just haven't come to me or sprained their ankle. So we started studying 50 years ago. What did it when the foot hits the ground? What changes? In fact, we did a course that's still out there. We started a course back in the late 70s, early 80s, called when the foot hits the ground, everything changes, everything how muscles function, how the foot functions. And like you said, Dr Terry, a lot of times we just forget about creating motions and reactions in the foot and ankle so it has the mobility and stability, so the knee doesn't have to take the hit, the hip doesn't have to take the hit. The low back doesn't have to take the hit, and the thoracic spine doesn't take the hit. That's why, years ago, they invented the batch board. The batch board is this weird shaped board that gives you proportional amounts of plantar flexion, DORS, flexion, inversion, Evers and AB and adduction with gravity and ground reaction force. So it's forcing all 12 muscles that send their tendons across the ankle and subtalar joint to do what it's supposed to do. But mostly it's saying with Gary's body weight on this thing, with wiggling like this, it's going to create strength in the foot and ankle, but then that strength is going to help stabilize the knee and the hip. And I need to declare this. I invented the bass board. So I don't want people go, Oh, cool. Go get a bass board so that you have to take that with a grain of

Dr. Terry Weyman: 39:27

salt. Yeah, that's phenomenal. I want to switch a little bit, while we have some time, to the other labrum on the upper the shoulder. We touch a little bit about it, but it's a structural different. You have a you have a ball and socket, and one's open, one's more close. Let's talk about the the complexity of the the shoulder label, because you talked about the shallower cup, and how we differentiate between a labral tear and bicep tendon, road tear cuff. Yeah.

Dr. Gary Gray: 39:59

Well. Now we're getting into where I've seen people do great diagnostics, clinical diagnostics, where they can kind of see, I think you got a long head biceps here. I think you got a little bit of superior labral tear, or I think you got a little bit of posterior instability. And, believe it or not, all of a sudden we do our test and and do some of our imaging, and they're correct, the as you indicated, the just the shape of this thing, and then things, what it needs to do in space is is huge, and it constantly puts it at a disadvantage. Now, just as Dr Spencer indicated that we're going to we're going to get a posterior tear in the hip. If we do, like, how often do we get a posterior cruciate ligament injury? Very rare. But if you get in a car and your tibia is jammed back up, we'll get it same thing. If I'm in a car and my fever gets jammed back, it'll go right through that posterior capsule the shoulder. Is kind of similar to that. When you get in certain things and they're doing where they get that posterior jam, you'll get that, but we still see, over the last 50 years, clinically, we see more things happening, superior and anterior. Strangely enough, did you what the thing the three motions that I just did for my hip are the exact three motions that put the shoulder at its most susceptibility. And so coincidence, I don't think so. And so again, I'll ask the strength coaches and physical therapists and athletic trainers and people that are designed to help make the shoulder nice and strong and stable, how much do you create deceleration with extension, or, excuse me, flexion, with overhead abduction and with same side rotation, and then all at the same time with some speed and with some weight. And they'll go, well, we don't we do these goofy rotator cuff exercises that we're not sure why we're doing them. Somebody told us to do that 50 years ago, and so we're still doing it. And then I, then I'll ask, Well, why would you want to make the scapula in sync with the pelvis and in sync with the feet, and therefore be in sync with the thoracic spine, to put the shoulder capsule at less of a risk. And again, if you don't know the connection, like you guys do, that's a foreign question to you. But again, if I don't have good thoracic motion, flexion, good hip extension right now, and good ankle dose flexion. Guess where it's going to go? Right to my shoulder. And same thing when I go through the frontal plane, if I don't have that good frontal plane motion of abduction of my hip and adduction of the hip, and lateral flexion of this and prone or E version of one foot, E version inversion another one. Where's that going to go? It's going to go right into my shoulder. And then, obviously the same thing with the transfers plane, which might even be more significant, so definitely more susceptible. The question is doing the right quote unquote shoulder exercises. I rarely, I'm not even sure if I have in the last 40 years, given anybody a shoulder exercise where, quote, unquote, they isolated the shoulder. I always integrate it with the scapula, talking to the thoracic spine and the rib cage, and them talking back to the scapula. And any, any really cool shoulder move. For instance, if I get up and I have a pickleball racket in my right hand and I'm doing a backhand, well, if you say to the shoulder what just happened there? The shoulder would say I did very little. My left hip did everything. So my left hip says I flexed, I adducted and I internal rotated, the thing we just talked about, all the muscles in my back butt are lengthened eccentrically. They're turned on by the proprioceptors. So now I just snap my pelvis and the arm goes, goes for the right and so I look it on my foot and go, Oh, cool. My foot has to do something too. My hip has to do something. I need both type one and type two motion to thoracic spine. I need this scapula to be able to load and explode. And if we allow those parts of the body to be successful, the shoulder gets a big smile in space and said, Man, you just took the risk of my laboratory down by a lot.

Dr. Spencer Baron: 44:08

Very good. Can we do you see frozen shoulder at all?

Dr. Gary Gray: 44:12

Yeah, yeah. We, we see him, Chris. We're kind of a last resort facility, you know, at the grassroot here we we have the blessed opportunity of seeing people who don't get better, and they wonder, wonder if the goo balls and Adrian can figure it out and and sometimes we can, sometimes we can't. So we'll get the ones where they'll come in and they have a frozen shoulder, and they've had it for a long time. So yeah, we get to see them. What

Dr. Spencer Baron: 44:38

do you do?

Dr. Gary Gray: 44:41

Wrists out of the pelvis and the scapula. We say that again. I shouldn't have said it that rude. I beat the piss out of the pelvis in the scapula. Yeah, and then and I let the humors be passive. Very typically, when I ask, what kind of what kind of therapy have you had? It's i. Been laying down. Everything's been stabilized. They're grabbing my humors and they're jamming me to try to get more motion. And the question you got to ask yourself is that, is that how it happens never okay. So why am I doing that now? Well, because I think I can get into the frozen shoulder better. Well, why don't we let the prop receptors do the work here. Why don't we? Why don't we put in the the six motions of the shoulder according to the hip and the thoracic spine and the feet? Why don't we put those together, and why don't I teach the body to use the hip to decrease the frozen shoulder, and then I just take it along for a ride. We call it functional man reaction. I try to reinforce with my hands, what happens in function and we and the reason we get to see so many of them is because it's not that we're smart anybody, but it's very successful because I'm using the foot, the hip, the other hip, the thoracic spine, the other shoulder, to treat the shoulder where most of the people have just been isolating that shoulder, to try to get rid of The frozen shoulder. So we cheat. It's called cheating, integrating the body in a chain reaction the way it was designed to and let that create the right mobility between the scapula and the thoracic spine to now create the mobility in the shoulder in order that my frozen shoulder goes away.

Dr. Terry Weyman: 46:16

Hey, Gary, can I interject? Because a lot I'll get these patients that they come in with adhesive capsulias, which is frozen shoulder, and they're like, Yeah, our doctor or our therapist said, Well, there's the three phases of it was it the freeze, the thaw. And I always forget the other one, because I just, I don't really pay attention, but they have the three phases, and they go, there's nothing you can do. It'll heal on its own. It could take anywhere from a month to a year. And they just let but you just brought up, you beat the piss, because they and then they'll go, oh, I beat the piss or cup there. They do air t they get in there, and they try and break up the capsule. And then they go, Well, if that doesn't work, we can do, put them under and do manipulation anesthesia. You're breaking up the piss of the opposite hip and leaving that alone. Can you go and does this work at all phases? Do you start this right away? I mean, does it so what's your what's your time frame?

Dr. Gary Gray: 47:15

Well, I'm weary of phases, because everybody's different. Yes, so I'm not a face. I'm not a real fan of phases. And you know, again, you have to be like, like you guys have any Yeah, be clinically savvy to ask some key questions. When did this start? What do you think happened? Do you even have an idea? Did it start slowly? Did it does it seem to get frozen quickly. Was it irritated? First, have you heard any other part of your body? Are you? Have you been trying to protect? I mean, just ask some questions to get at least give you a start, and then, based on the functionability, you go, Okay, do I believe this scapula slash humerus? We actually call it the peltrunularis, the pelvis and the trunk and the scapula and the humerus. If you put those sounds like a dinosaur, we call it the peltrus to keep trying, to keep us in mind, so we'll go after like, for instance, the three tough motions of a frozen shoulder. I internal rotation, I get to here. Okay, interesting enough. Frontal plane, getting the hand back is tough with adhesive capsulitis and over the top are tough. So both frontal planes are extremely tough. Transfers plane, internal here, that's kind of how they're holding themselves. So that's not a tough one. External rotation, that's that's a booger. Okay? Extension, a little bit of problem here. Flexion, huge problem. So when I when you just simply look at and I'm demonstrating my right hand moving, if I do a forehand in tennis, it's my same side hip that I need to pay attention to, because that's the guy that's going to let the pelvis rotate, let the thoracic spine and rib rotate, let the scapula get properly loaded. So I then can come through and hit a forehand, makes sense, because all you have to do is do it and see you see it, and then you go, Well, what about a backhand? Well, the backhand is the opposite side hip. Well, that's interesting. What about going from extension to flexion? It's the same side hip. Well, that's kind of weird. How about if I load and explode into abduction now it's the opposite side hip. So what we'll do is we'll say, Okay, go ahead and stand up for me. We'll get the pelvis going. Let's say I'm after abduction, and we get the pelvis going in the frontal plane. So now they're adducting into the right hip, but they start adducted left hip, and they load and explode. The scapula should follow where the pelvis goes, so the scapula will get loaded like the pelvis, and it'll explode up. That glenoid will come up, real nice. This humorous will go down, go oh yeah. This is what we do. And now we just create mobility there by creating the appropriate motion biomechanically that the shoulder was designed to do. If you give the shoulder back its authenticity, it's going. Come back 10 times quicker than laying them on a table and cranking them.

Dr. Spencer Baron: 50:05

Wow. Super good. So those are probably one of the most difficult conditions, and you just shed light on a completely different perspective on managing this frozen shoulder thing, because they're really tough, and if you look it up, it's the only condition that they say, to work through the pain, but it is, is a miserable way to do it that way versus the way you're just suggesting. So, believe

Dr. Gary Gray: 50:34

it or not, the rule I have with my patients doing it that way, because I did it the other way early on my career, and I look at him and say, this is going to hurt you a lot more. That's going to hurt me. And so, you know, here's a stick the squeeze on. I literally tell them, if I'm doing it right, you should have zero pain. Not only zero pain, but zero discomfort. If I get your body working in synergy, your butt's going to your butt's going to cure your shoulder problem long before I will. So, yeah, I'll feather it a little bit. I'll get a little bit of thoracic I'll take the scapula and play with it, and I'll feather the humerus a little bit. But it's rare that I put more than 20% force into the humerus, and mostly 80 to 90% force into the thoracic spine and the hips. It's rare that I have to, I have to create a driving of this. And then what's really cool is, once they achieve this new range of motion, if they kind of hold on to something, then they drive their pelvis in all three planes of motion. I get that distraction, and I get all three planes of motion, and they come back. And they've gained 20 degrees on their own. They've been stuck for four months, and now, within two days on their own, not not me doing it, they gain 20 degrees on their own because they're using the pelvis to create the mobility in the shoulder. They go, What in the world did you do to me? And I go, I didn't do anything to you. You're the one who did it. You should be proud of yourself. Now, I'll just, I'll teach you how to get the rest of it. But let's you know that's kind of that's where it gets fun when you empower them to do it themselves. And that's obviously a good adhesive capsule. Light is you want them to attack it a few times a day without pain. Pain is one of those things that pisses, you know, pisses everything off, and so this rebound effect of pain, I'm not sure that's the best, best treatment for a shoulder that doesn't want any pain. Carrie,

Dr. Spencer Baron: 52:25

what do you do other than motion, other than having the patient do their own biomechanics? Is there anything manually you do to maybe restore proper motion to the thoracic spine and ribs and all that, like a foam roll or something. What do you give them?

Dr. Gary Gray: 52:44

So as I explained to you before, early on in my career, I knew how stupid I was, and the bad news is how stupid I would continue to be, and therefore I snuck into all kinds of meetings, and a lot of them were chiropractic meetings. A lot of them were osteopathic meetings, and a lot of them were manual therapy meetings of therapy groups, North American mobilization, Australia, and everybody had their own thing. And I started scratching my head and going, Why is there different ways to achieve what we want to achieve, and that's the right motion that the right join at the right time and the right plane. And so we thought, so, well, wait a minute. Why does, why does my thoracic spine even move? Well, it moves because my eyes move, or my hands move, or my foot moves. It doesn't just go, Hey, look what I can do. You know, rarely does your thoracic spine say, Hey, I'm going to show off a little bit here and just do a wiggle and giggle. And so we take a look at that and go, Well, if I do this with my right hand, I'm getting right rotation. If I'm doing this, I'm getting left lateral flexion, and that could be with extension or flexion. So we'll literally go in there and reinforce that with our hands, we call it functional manual reaction. I This is, this is not hypothesis. This something I would argue quite adamantly. You can be a manual therapist and understand all your rules of manual therapy based on whatever certification you just passed, but if you don't know the biomechanics of human movement, I would contend you're not a manual therapist, because the whole idea of manual therapy is to reinforce normalized motion, nothing else, nothing more, nothing else. And so for instance, if you believe you can mobilize the SI joint, but you can't tell me what the SI joint does when I'm swinging a bat or walking or running in all three planes of motion, I'm not going to let you touch my SI joint. And same thing, if you can't tell me what the thoracic spine does like a golfer, thoracic spine is a big inhibitor of the golf swing and the number one cause of low back pain in golfers. So. If you can't tell me what it's supposed to do in rotation and lateral flexion, top down, and lateral flexion the other way, bottom up. And if you don't know that, then there's no way you'd be able to get in your hands on me and to reinforce that. And that's the beauty of what you all do. And hopefully what we do is, if we just let the body do it, it'll follow the path of least resistance, and they'll just reinforce a bad pattern of motion, and we're getting nowhere. So we got to get in there and snarl a little bit. We got to, we got to, you know, kind of get in there and move it a little bit, which is that's kind of exciting. But once we create that new mobility, then we got to be smart enough to teach them how to maintain that new mobility with strengthening and stability exercises. So I did that wrong for a number of years, early in my career. I get great mobility. I'm happy with it, and they leave to come back to worse. I'm going, well, crap. This is, this is, maybe I'm just doing the mobility things wrong and and then just logic says, Wait a minute. If you create new mobility, you better strengthen it, or it's going to be act as a hypermobile segment and an abnormal and it's going to basically respond by clamping down going the other way. So the beauty, I think, of what most of us now know, is based on years of mistakes. And I'm number one on that. I'll, I'll match anybody in any profession relative to how many mistakes I've made, and I'll kick their butt, they only come close to me, but I got to be smart enough at the age of 70 to go do I still want to continue to make those mistakes, or do what I like to learn more about how the human body really functions and what I'd like to do a better job. I've chosen the latter. Yeah,

Dr. Terry Weyman: 56:41

hey, Garrett, a lot of athletes like, brother calls that like something simple to go through with football season coming on, we get a lot, obviously, a lot of dislocations, you know, from the from receivers, the quarterbacks, linemen, you know, even linebackers going through rain, bass, grabbing their arms, throwing back. What's a good warm up to get the shoulder ready and stabilized, to reduce injuries. And what's a great couple exercises for a cool down before they hit the showers?

Dr. Gary Gray: 57:09

Yeah, well, you can go to the lions and see it live. I mean, our friend at the lions, she's done an amazing job, and the whole team has and when you look at their training and conditioning now, it's a lot different than traditional training conditioning. And so if you just said simply to me, what's an easy way to teach an athlete to least start a foundation of strength of their shoulders, I would go, well, we would do what we did 50 years ago. We would do the 3d shoulder matrix. And you'd say, well, what does that mean? Well, anytime you hear me say matrix, it's three planes of motion, and anytime you hear me say three planes of motion, it's both ends. And so if I was going to take just a bunch of young kids, let alone my high, high end profile NFL players, and say, if nothing else, when you do your overhead press, do me a favor, go forward with it and then go backwards with it. Now, as well as going up, go to the same side with it and then go to the opposite side, over the top of your head with it. Okay. Now, instead of going just straight up, open up and rotate with it and then cross over. So I just did a shoulder matrix. So if I asked my shoulder joints, just in my superior muscles in my shoulder, what did you do? They say we just did everything. Okay, that was easy. I just did all six things. And I think that's why, I think that's why, first of all, we were we've been successful over the last 50 years. But I think that was one of the first strategies we realized, if the body moves in three planes of motion, we better create exercises in three planes of motion. And therefore, years ago, we developed hundreds and hundreds of matrices. One of them is, as you guys mentioned, the lunge matrix. I just showed you, the shoulder matrix. We have, you name the activity, you name the body part, we have a matrix for it. And I think that's a neat way to get started. Now, what the lions then do is add movement of the legs. So they add the they add the lunge matrix with the shoulder matrix, what I call in sync and out of sync. So sometimes that's where the most of it, my body's going that way. I'm reaching for a ball this way. Oh, crap. Have I prepared for that? Most of the time is no, but they are preparing for that. So I would basically say, well, am I doing a a, basically an opposite a same side rotational at the same time, I'm doing an opposite side rotation with my foot. So my pelvis and my foot are going that way, but all of a sudden I made a cut, and the goofy quarterback threw it behind me a little bit. Okay? And so I don't go, Well, I'm not going to reach for it might hurt my shoulder. I'm going to go, boom, I'm going to reach with my lower body going one way, my upper body going the other way. Here's what our hope and prayer is that their body, their shoulder, the thoracic spine, their hips and feet and their neck go. Been there, done that. No problem. Catch the ball, bring. Mean, it's like nothing ever happened. But if you haven't trained in that, what we call transformational zone, or in those combined motions, to give you that, what we call abnormal movement, then there's a good chance for injury. So it's it's fun, it's just because you got to make it simple, at least for me, if I'm going to work out. And so teach me a little bit of lunge matrix. That's easy, all six directions. Teach me a little overhead matrix. Teach me to do them in the same plane. Teach me to do them opposite. Have a game with it. And now I got a party

Dr. Spencer Baron: 1:00:33

Gary. Those are great. And I'm so glad you left us with that, because that's something that people can start doing immediately, those kind of movements and entertaining those biomechanics, we're going to wrap up. But our usual rapid fire questions are now, there, you know, five of them. Yeah,

Dr. Gary Gray: 1:00:52

we had fun last time, didn't we? We did have a great I got to tell you, though he's sitting right next to me and and I had him listen to the podcast, and first thing he told me is, first of all, those guys are brilliant. They really listen, and they ask great questions. I said, Yeah, I know that's why I enjoyed it. And he got a smile on his face, and he says, and I was just happy. They asked me to be on the show. So you just so I just want to let you know that he wanted me to tell you, thank you. You're

Dr. Spencer Baron: 1:01:26

welcome. I want to show who he is real quick. Is he right there? Right yeah,

Dr. Gary Gray: 1:01:31

oh yeah. He's right here. He knew you guys were going to be on on here. So he goes. I need to watch these guys. They're good. I'll let you sit over there.

Dr. Terry Weyman: 1:01:40

Well, I could, we could say he should answer the rapid fire questions if you wanted to, but that's gonna be, I'm gonna be totally leave that one up to you, Doc, I'm

Dr. Gary Gray: 1:01:51

a normal voice. Now.

Dr. Spencer Baron: 1:01:54

Question number one, Gary, your secret to longevity.

Dr. Gary Gray: 1:02:02

I like that, because we've been talking a lot. Guess, the older you get, the more you start talking about that. You know, I didn't talk about longevity when I was 30. Yeah, those, those are just ones. You old people are going to die soon, right now. Good luck to them. Yeah, he's got, he brought it over here. So in case we, in case we do have to have it. It. And actually, this guy is 50 years old, so he's kind of been holding hold of the other pretty good. He looks good. Longevity is kind of defined in a bunch of different ways. But I think kind of the thought process now is, we I want to live quality longevity. I would rather live 70 years of quality life than 90 years of being beat up and can't do what I want. Now that sounds maybe a pinch more, but that's my own that's my own personal feeling. And so when we think of our world, the world we get to work with, and the people you get to work with, longevity is longevity is directly proportional to the ability to move. So funny, I did a study, not a study survey, of longevity clinics. So if you type in longevity clinics, they're all over the place, and they're popping up everywhere. And what I did is I did a number of things. I wrote down the names of all these and I think I got through 12 of them. Some of them had the word longevity in IT, health, wellness, well, being, all kinds of stuff like that. But it basically meant, live longer and have a more productive life. That's, you know. So then I wrote down what they promised so on the website what they're going to promise me for my longevity. Then I wrote down all the objective tests that they do to evaluate me to determine what I need to do to live longer and a healthier life. And then I wrote down all the things that they would teach me to do on my own so I could live longer. So I wrote it all down because I wanted to see what they're doing. The number one thing all of them were missing was movement. And at the end of the day, movement is king and queen, yes, because give me cancer and the ability to move any day. Okay, take cancer away from me, but don't give me the ability to move. I want the cancer back right now. You know, so it's like, and that's why I think what you guys are doing in the movement chiropractic world, especially you guys, way ahead of the game and preventative, you know, letting me come in and create the mobility in my joints so I can move better. You guys are way ahead of the curve there. Okay, what's going to happen is you guys are going to even be more significant, because people are going to realize, without movement, there's no longevity. Okay, I might live, you know, sit down in the front of a TV life for a while, but that's not, that's not pure longevity. So longevity is mobility and stability and a ton. Laughter, laughing at ourselves, not taking ourselves too important, understanding what ultimately we're living for. And I think just helping other people, and that's what you do every day. You guys wake up and go, Hey, I'm going to serve my patients and clients. And I think that creates a youthfulness that kind of keeps a lot of us going. So that was a long way to say. It's got to be, it's got to be giggling and moving.

Dr. Spencer Baron: 1:05:27

There you go. Very good. I think we're going to change the topic of rapid fire to

Dr. Gary Gray: 1:05:37

I think if anybody said I asked Gary a rapid fire question, they would just laugh their heads up,

Dr. Spencer Baron: 1:05:45

but you're so right, though. I heard recently, relationships and exercise, exercise being movement are the key to good relationships, obviously, are the key to longevity. Indisputably. Question number two, oh, boy. I feel this could be a big one.

Dr. Terry Weyman: 1:06:06

Gary. I do have to go to work sometime today, so you gotta keep these kind of rapid

Dr. Gary Gray: 1:06:13

perspective. I appreciate it very kind way to see. Okay, sure. Quicker.

Dr. Spencer Baron: 1:06:29

What's the cycle? What? What do you try to ask, What do you want to be remembered for?

Dr. Gary Gray: 1:06:39

Um, I'd like to be remembered for being a good friend, just being there when my I've been blessed with a lot of friends, I'm not sure I always am there for them. That's one of the things as I've getting older, I'd like to work harder on and I just want to be remembered as somebody who cared and and obviously I consider my patients and clients friends and my family friends. So I just, you know, we're all going to be forgotten in a number of years. That's, that's, you know, think about your great grandpa and tell me what color eyes he had. You don't know, so, but so if there's this small turn memory, I just hope that somebody would say, I think he, I think he, I think he was kind of goofy. I think he laughed a lot, but it seemed that he really cared for his friends,

Dr. Spencer Baron: 1:07:27

absolutely. That was good. Gary, what? What is your favorite exercise that you do every day?

Dr. Gary Gray: 1:07:36

That's easy. It's the, it's the 3d fashion matrix. What I'll do is I'll do the 3d maps initially to get all the planes done, and then I'll go through the whole diagonal with gradually try to increase the weights. And I just did 3d maps with some resistance going into and out of the transformational zone about an hour ago. So I want to do things that are effective and efficient, and so if I can get every joint and every muscle and every proprioceptor turned on in less than three minutes, that's what I'm doing, and that's what I do every day. I'm

Dr. Spencer Baron: 1:08:14

so curious, do you do it against resistance at

Dr. Gary Gray: 1:08:20

times? Yeah, I do with a viper at times. I do it with pulley at times. I do with ample photonic a bungee cord at times. I'll do it medicine balls at time. I'll do it with a core ball at times. So I like to mix it up.

Dr. Spencer Baron: 1:08:34

Question number four, the answer could be dangerous to your to your future in this, in your profession, what is your favorite NFL team?

Dr. Gary Gray: 1:08:45

Yeah, that's, that's a tough one.

Dr. Spencer Baron: 1:08:47

You don't have to answer on the grounds of incrimination. You know,

Dr. Gary Gray: 1:08:51

as you guys know, your experience in the NFL, these, these kids are amazing. Yeah? I mean, unless you get down on the field and see them flying around and hitting each other, you don't you can't TV, you can't appreciate it, and all that goes in behind the scenes, the chiropractors that work with the NFL teams, the therapists, the massage therapists, nutritionists, the athletic trainers, just all the people that are literally given their life to make somebody else look better. You know, saying, I think that's the beauty of it. And I gave a big talk to the athletic trainers for the NFL. I said, Listen, I just want to tell you, I admire you, because you spend your whole life giving everybody else the limelight, and you ask for none, and you work your butt off and you work hard hours. So yeah, I'm not going to answer that one, because we, we we're some NFL teams don't even know who we are. Some of them have invited us in and to speak and talk. We just want to be known as somebody that would help and so and I grew up. I grew up in Indiana, so and with a lot of people who like Michigan a little bit, a lot of people liked Ohio a lot. People like what's happening in Indiana. So I was a confused young boy. I didn't I wasn't the typical kid that wore the same outfit all the time. So I would say I'm pretty neutral.

Dr. Spencer Baron: 1:10:09

Well, that was, that was a safe answer, and the last answer, the last answer to or the last question. Best joke or story you tell someone to get them out of a funk. Best

Dr. Gary Gray: 1:10:21

Joker story, yeah, was it kind of depends who it is and what kind of language I'm allowed to use. Let's see, I usually, I usually try to come up with an authentic story based on what they just told me, that doesn't degrade me, but makes fun of me. In other words, if a patient or client comes in and they're telling me something's going on in their life, I try to internalize that, and I try to think, Okay, I don't want it to be about me, but based on what they just said, I can tell them kind of a funny thing that, that I did that didn't quite work out well to to at least get them to smile. And basically see the threshold of smiling, you know, see how, see how quickly with the behavioral driver, I can get them to go from I'm in a lot of pain and discomfort to, ho ho, you just made me laugh. So it's usually, it's usually not a key. It's usually different for everybody. And of course, being seven years old, you got all kinds of goofy stories, of goofy things that I've done. And so it's pretty easy to come up with something. So I just want to, I want us to become friends quick. And therefore I want to hear their heart, and I want them to hear my heart, and so I usually tell them a story that is a little bit personal, that just makes them laugh. Super

Dr. Spencer Baron: 1:11:49

good, Gary, it was a pleasure having you on the show again. I look forward to an honor. You bet.

Dr. Gary Gray: 1:11:54

No, it's none of your birthdays, is it? No, okay, because Donald was going to say happy birthday. But if it's nobody's birthday, then okay, okay, you can say bye, bye to him, bye, bye. Thank you guys. It's been an honor. You guys did an amazing job. Keep it up.

Unknown: 1:12:13

Thank you. Bye,

Dr. Gary Gray: 1:12:14

thank you.

Dr. Spencer Baron: 1:12:19

Thank you for listening to today's episode of The cracking backs podcast. We hope you enjoyed it. Make sure you follow us on Instagram at cracking backs podcast. Catch new episodes every Monday. See you next time you.