 In this episode of Mind Pump, the world's top ranked fitness health and entertainment podcast, we talk all about knee pain, you know, about a quarter of Americans suffer from chronic knee pain. If you're listening to this episode, you're probably one of those people. So in this episode, we give you solutions, not band-aids, but rather solutions, how you can fix your knee pain. Now, we talk a lot about a lot of different things, talk about stability and strength. In particular, we spend a lot of time about talking about mobility, in particular, hip, ankle, and foot mobility. When those joints aren't working the way they should, it places a lot of stress on the knee, which is not quite as dynamic as those particular joints. So a lot of knee pain comes from issues in the hips, ankles, and feet. Now, we do mention in this podcast a webinar that we did a while ago where Adam goes through and teaches, he actually instructs some of his favorite hip, ankle, and foot mobility exercises. So if you're listening to this episode and you're here as referring to those movements, I highly recommend you go to maps, excuse me, primeprowebinar.com, so that's primeprowebinar.com, and you can watch Adam teach you how to do some of these movements, apply them on yourself, and you probably will find that your knee pain will feel a lot better. We also talked about systemic inflammation in this episode, and we mentioned gut health. Some things you can do to improve your gut health, you can drink or take supplements that contain prebiotics or compounds that help heal and protect the gut. One of our favorite products is Olipop. This is a company that we're sponsored by. Now Olipop makes sodas, no joke, these are sodas that remind you of some of your favorite sodas when you were a kid. They have like five grams of sugar, very, very low calories, they're naturally sweetened, but they contain compounds that are prebiotics, they feed the healthy bacteria in your gut. 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So one of the, I think, I would say the number one question that we got during that webinar was people asking, what about the knee? What about the knee? You guys, you guys talk about the ankle, you talk about the hips, shoulders, back, neck, all these other things, but you guys didn't talk about the knee. And I've been meaning to get with you guys and do an episode where we talk a little bit more in depth about knee pain and how to address that, how to prevent that, or how to fix that, and people that are either dealing with it or want to prevent potentially having it. It's probably the second most common chronic pain issue that people suffer from, probably second to back. Back pain is super common. Knee pain is also super common. And I would say that when I would train clients, I'd say a majority of them would say that they had some form of knee pain. Yeah, or bad knees, right? How often do you hear that one? Bad knees was a big one. That was the limiting factor when you're trying to do any exercise. They would always bring that up. First, like I feel this pain in my knees, so I don't want to go down too far. Or, you know, I don't want to do that move left to right. I don't want to do that because then I feel my knees and hurts. Yeah, one of the big things to understand about joint pain, I think first you want to kind of understand the function of that joint because it helps you understand what may be going on. Now before we get into that, I think it's important to distinguish between acute pain and chronic pain. Acute pain is the kind of pain you get from an injury or injured. Something is torn or bruised or you hurt yourself. So if you have knee pain because you twisted your knee last week, that would be considered acute pain. Chronic pain is the kind of pain that you just have all the time. Yeah, my knees bother me from time to time. Or if I sit down for a long period of time, my knees hurt. Or if it's cold outside, my knees hurt. Or if I run or walk too much. Every time I do this, my knees hurt. And so it's just something you deal with all the time. And the reason why that's important to distinguish is because acute pain is typically solved with healing. So okay, your knees hurt, let's heal for a second. Or if there's torn ligaments and things that require surgery, then get surgery and they can help fix that. But chronic pain isn't fixed by sitting around and allowing something to heal. I know that sometimes can temporarily relieve the pain. So if you have chronic pain every time you walk or every time you stand for a long period of time or sit for long periods of time, the fix isn't to rest your knees because you're not solving the root cause. The fix is to figure out why you have this chronic issue in the first place. And by the way, chronic issues can show up on imaging like MRIs where you go to the doctor and the doctor says, oh, you have, for example, conglomalacia going on, which is underneath the kneecap. The cartilage looks a little frayed or, oh, it looks like you have inflammation here on this part of your knee. And yes, you can look at those things and say, okay, that's causing some of my pain. But something caused that to happen. And fixing what's causing that is going to fix the problem, not curing just the byproduct. For example, they could go in and shave off some of the kneecap and say, now we fix the conglomalacia. It'll come back if you don't solve the problem. I think that's an important distinction. I think that people still have that because if you go to the doctor's office, they're going to try and prescribe you things that are going to give you some relief. And it's like this immediate thing that you're going to feel and experience. And people are still drawn to that mentality to be able to go into either a chiropractic office or a doctor's office. And they want to get that relief for their injury or whatever they feel is something that they can solve. But really, chronic pain is a totally different subject matter in terms of how we treat that. Well, most if not all of this is caused because the knee is not tracking properly. I mean, the knee is a floating joint that's held together by these four major ligaments. And if it is tracking properly, you shouldn't have any chronic pain. But when you start to get this chronic pain, it's because it's not tracking properly, right? Because because of the knee is a bit of a complex hinge joint. It's called a synovial joint, not to get too complex. But essentially, the knees movement does two things. It either flexes or extends, right? So if you look at your knee right now, there's only two things that the knee can do. You can straighten your leg out, or you can bend your leg all the way back. That's it. That's all the knee does. Now what's happening in the joint, a little more complex, you have your kneecap that floats on top of the knee and helps with that particular part of the knee movement from flexing and extending. But the knee doesn't bend laterally. If your knee bends laterally, you've got a big problem. You pour some stuff, right? It doesn't hyperextend. It doesn't bend in the opposite direction. And it doesn't twist. It doesn't rotate, right? All it does is straighten out or bend. And all the ligaments and things that surround the knee joint are designed to keep it from moving in any other direction. So in other words, there are ligaments that prevent the knee from bending sideways. There's ligaments that prevent the knee from hyperextending or bending backwards. And there are there's tissue that prevents the knee from twisting at the joint. So all that stuff is put in there to keep it so that it only moves by straightening or by bending. And now here's where the problem happens when those ligaments and the knee itself is placed under strain outside of what it's supposed to do. So if the knee is supposed to straighten and bend, but because you have issues in other parts of your body, and we can think of the joints that are closest to the knee, like the ankle and the hip, when those aren't moving the way that they're supposed to, now those ligaments need to support the joint prevent the knee from bending in the way it's not supposed to prevent it from twisting because it's not supposed to twist or the kneecap which is supposed to track nicely on the knee every time you bend and flex. If other joints in your body is not doing what it's supposed to, now it's going to track a little bit to the left, a little bit to the right. It's going to wear itself out and cause a lot of these problems. So oftentimes the things that solve knee pain are things that solve issues somewhere else. Oftentimes it's working on other parts of the body to get the knee just to work the way it's supposed to because it is a big joint. It can handle a lot of work, but if it doesn't move properly over time, you're just going to have this chronic pain. Now it goes even deeper than that because I think that's the first step is understanding that and many people that suffer from chronic knee pain, if they've had it long enough, have figured out there's certain remedies that tend to help it or alleviate it. And I think as a young trainer, this was the direction that I moved in because I didn't have a full understanding and grasp of where the root cause was. I knew things that were causing some of the issue and so even I would lean clients towards things like foam rolling and massage to relieve all the tight muscles that were around the knee that was maybe pulling on or causing some of this pain, but what I didn't realize I wasn't doing my clients a real favor because I wasn't really addressing the root cause. I was giving them a band aid. Totally. It's like you're banging your head on the wall, your head hurts, so you're going to take ibuprofen, but you keep banging your head on the wall. Yeah, and that's the same analogy when I was playing football and I would get in from when I was smashing into somebody else and I would get this headache and it was this ringing headache. I could get temporary relief by just squeezing certain areas of my hand really hard and it just sent a different signal away from that really loud signal that was telling me my head is pounding and it's hurting. So there's ways to sort of divert and take that attention away from that signal, but are you really changing, healing and addressing the root of the issue itself? No, think about this way. This is an example I've used many times, but think about the way that a sliding glass door tracks on a track. If you've ever installed a sliding glass door, if you look down at a sliding glass door, you see that there's a track that the door has to run across every time you open it and close it and if it's balanced properly, that track isn't going to have a lot of wear and tear on it. Now if the sliding glass door is offset just a little bit, now it's pushing a little bit in one direction and it's sliding on that track. It's grinding. It starts to grind and it starts to chip away or fray that track and starts to cause problems. Now what you can do is you can add more WD-40 and more grease to it and that might prevent it from grinding right now, but over time it's going to still grind and cause problems. Instead, what you should do is figure out why it's not lined up. Oh, let me fix this sliding glass door, let me line this up so it doesn't grind and now this track is going to last a very, very long time. Well, in a little bit, to thinking of the knee, and I like the analogy of the sliding glass door in the track, but also too, like there's two points. So two competing points. There's one there, an ankle and one at the hip. And so depending on where your feet are aligned is also what's going to determine two. The hip allows for that rotation. The more I keep the toes and my hips kind of going in the same direction, the less stress I'm going to put on my knee. So when they start to compete with each other, that's going to create that torsion where that torsion goes is right there and it's weak point in the knee. To give you an example of that, female athletes are at risk of tearing their ACL, I don't know how many times more than male athletes. It's far more common in female athletes and a large part of that has to do with the angle at which their femur, the top of the leg attached to the hips, because women tend to have wider pelvises, slightly wider hips, and the femur comes down in at the knee. So it's a stronger angle, therefore placing more stress on the knee, therefore making them more susceptible to tears. So it's just giving an example of what is moving around the knee that tends to cause lots of issue. But you can definitely throw band-aids on it, right? You can take pain killers, which reduce inflammation in the body over time that actually contributes to more knee degeneration or joint degeneration, because the inflammatory signaling process is an important signaling process that tells the body to heal and when you block it full stop or effectively with a drug like ibuprofen or a leaf, for example, naproxen, then you're not just alleviating the pain because you reduced inflammation, but you're also limiting the signal. And so the joint doesn't heal like it did before. So what they've done studies on athletes that take NSAIDs regularly and they find that the joints get worse faster. And then the other reason why it gets the joints get worse faster is because you've blocked, now that you, now that it doesn't feel as bad to move terribly, you move even more terribly and you cause more problems. This can be said for things like knee sleeves or knee wraps. I was going to talk about those as being like this external stability. And so you're providing this, this false sense of stability and security where you do have that when the sleeve is on, but when it's off, it becomes even more susceptible to being able to stabilize properly and being open for injury. Right. There's also that your knee is designed or evolved to handle a certain amount of load when you're doing certain movements. And then other joints and the muscles attached to those joints are designed to handle a certain amount of load. So I'll make up some arbitrary numbers, but let's say you're going into a squat and the muscles and the knee joint itself is designed to handle maybe let's say 30 or 40% of that load. The rest of the load is distributed between the hips, the ankle, and maybe your back. Well, let's say your hips are really weak. Well, that doesn't mean you're not going to squat. It just means your body's going to transfer some of the load to some of the other joints. So weakness or imbalances then can place more of a stress on the knee joint, but it's not the knee joint itself. It's the fact that other parts of your body aren't doing what they're supposed to. So now you're moving around with more stress on your knee than it's prepared to handle long term. So you continue to develop problems. The analogy that comes to mind when I think of that point that you're talking about is, you know, you can have these door hinges, you know, built and to sustain these swinging the closing and opening of a door of a really heavy wood door. And it could last a lifetime of swinging open completely fine. And then if I were to take somebody our size 150, 200, 300 pounds and hang them on the, let them hang on the edge of the door and do that. How long do you think that door tracks without eventually breaking or bending or bowing to the point where it can't close and open? Well, those hinges are designed for a certain amount of weight or a certain amount of work. And the joints, the joints work that way as well. So I think we're making a pretty good case for the fact that most chronic knee pain has less to do with the knee and more to do with the things around it and how the knee is working itself. And if you address those, you solve tremendous problems. I mean, it reminds me of a story of, you know, I towards the back half of my career, I had a lot of clients that were physicians. My studio, I used to own a studio that was next to a hospital. And I remember one lady in particular loved her. She became one of my favorite people. She was a general surgeon, very intelligent lady. She came in to hire me. And when we did the assessment, I said, do you have any areas of pain and any exercises you can't do? And whatever she said, Oh, I have knee pain. I can't squat. I can't lunge. I can't do anything beyond, you know, even I can't even get down to 90 degrees. So those are the things we have to avoid. So I asked her, I said, okay, now why is that? Who told you that? She said, Oh, my friend is an orthopedic surgeon. And he said, don't do lunges. Don't do squats because you have bad knees. Now I took that information knowing what I know about how we can strengthen other parts of the body and whatever. I thought, okay, we're going to take this slow. But I knew in myself like I felt like I had with all my other clients, we're probably going to see a lot of your knee pain go away. Sure enough, into our training and correcting some of these issues. Six months later, this woman was doing full squats, full lunges, no knee pain, no knee pain anymore. I didn't change her knee joint. The knee joint stayed the same. It was how she moved and the stress that was being placed on the knee that changed. She didn't lose any weight. It wasn't anything like that. It was literally had everything to do with her movement and solving those root cause issues in his six month period. Somebody who had chronic knee pain for years who was told don't do these exercises was not only able to do those exercises, but no longer had pain doing them. Well, this is so common that more than one in four people suffer from chronic knee pain and the unfortunate part is exactly what you just said. They get told that they have bad knees. I don't know how many times I had to overcome that objection of squatting, lunging, deadlifting, doing any of these movements that I knew were so beneficial to my clients, but because they were told by some doctor or some surgeon that they have bad knees, they avoided doing all these movements. But the reality of it, it really is, and this kind of goes back to the point that Justin was making in our first point in addressing knee pain, is the stability in the hip and the ankles. I think that's the number one root cause from this is that you either have unstable hips or unstable ankles or like most people, both. Both of those areas are unstable and because they're unstable, it puts all the stress around all the ligaments that are supporting the knee. That's right. So think about it this way. So you get the hip, it rotates, it moves laterally, it flexes, it extends. It's a very dynamic joint. If that's not stable, if I take a sideways step or I step up onto something and my hip is not stable, well, my knee now wants to bend in that direction. What's holding it there? All those ligaments. And those ligaments have, you know, if you keep doing that, it's got a short shelf life and you start to cause problems. So step number one is to become stable in your hips, in your ankles, in your feet, and in your body. How do you become stable? You become stable with slow, purposeful, balanced stability type exercises. This is very important. It's literally lateral movements, slow and stable, control. Make sure the knee isn't taking the brunt of the load that it's coming to the hips and the ankles, strengthening. Some of these muscles that maybe not these big gross motor movement type muscles, but rather these muscles that stabilize the joints. This is where mobility work is insane. This is phenomenal for this kind of stuff. Exercises like 90-90 or modified 90-90s and exercises for ankle mobility. Those help build stability in those joints so that the knee ligaments don't have to give you all the stability you need. Well, this is also where the tools that I think we've even bashed on this show, because I think we got out of control with them like your bosu balls and foam pads and stability exercises actually have a tremendous amount of value. I think that the fitness community went over the top with it when it got popular, and then it became this thing that we did with every single client, even if they didn't have any hip or ankle issues. But I do see tremendous value with stepping up to a balance or a lunge to a balance or putting one of your feet on a foam pad or a bosu ball to create instability while you're training for this specific issue. If you're somebody that has issues with your knee and it's because you lack stability in the hip and the ankle, this is where it does make sense for that client. Well, and too, I think we kind of briefly went over posture and anatomical posture. Really, we start with that to assess where your comfortable stance is. How you stand, how you sit, how you do things is going to determine where all the stress goes, and to be able to understand or at least start to work on immediately where you see deficiencies. So if I see that my foot just automatically wants to rotate all the way out just to gain that stability, that's a sign for me if it wants to do the opposite of that. And my knees want to come in to just keep my stance in an upright position. These are all things to pay attention to, to then bring in to address and add mobility exercises, add things to make it more comfortable so that your body will properly stabilize. Here's a simple stability exercise. You take your shoes and socks off so your bare foot and stand in front of a mirror and then balance on one foot and pay attention to what happens to your leg. Is your foot collapsing? Is it turning out or does it facing straight? Is your knee turning in a little bit or turning out a little bit? What's happening with your hip? Did you have to shift your weight dramatically to be able to balance? Can you even balance? So the idea with this exercise is to stand barefoot facing forward, keep everything perfectly aligned, keep the foot active all the way up throughout the entire body, and then balance with that perfect position until that position breaks down a little bit. Either you lose your balance, your foot collapses, something turns, pause, rest, and then try again. What you're trying to do with stability is you're essentially trying to connect to all these other muscles to give your body that stability that it needs so that your knee joint doesn't have to give you all the stability that you need. Did we ever shoot on YouTube? Do we ever shoot the Miguel planes? Do you know if we did? They're in our program, but no. No, we didn't shoot that on YouTube. That's something we should shoot. That was one of my, was so one of my favorite moves to address stability in both the ankle and the hip is to do what you said Sal, strip down to bare feet, balance on one leg, and then do these Miguel planes. I think you address both the hip and the ankle stability in a situation like this. Absolutely. It makes a big difference. Go ahead. Oh, I was just going to say too, in terms of like the planar movement, like I know that people are pretty familiar with left to right, you know, lateral and sagittal front and back, but you know, in terms of the rotation and finding stability, that's a little more challenging. And so one thing why we pay attention so much to where the feet are pointed is because I want to see if I'm rotating now at the hip, my entire leg. I want to see if my foot and my toes can travel with that in unison. So that way I'm not now competing like I was trying to explain earlier where my toes might be in a different position as I'm trying to stabilize where my hips still going. That's going to cause problems. Totally. Here's the next one. And this one is a really big one. It was my favorite way to surprise a client with immediate pain relief. And that was just to get them stronger, just to get them stronger overall, but in the right way. Okay. So if I see someone with chronic knee pain, what I'm going to do is I'm going to focus on getting their hips stronger, and I'm going to focus on getting their feet and their ankles stronger. And just by doing exercises that strengthen those areas, oftentimes they would notice less knee pain. I'll give you a great example. Here's a good example. A hip bridge off the floor without any weight, keeping everything in line and in balance, and just pressing up and squeezing the glutes and activating the glutes and strengthening the hips. That simple exercise with somebody who has knee pain, just doing that on a consistent basis, having them then move throughout the day and find that, wow, my knees don't hurt as much. Why? Your hips are stronger and now they're taking less of the load that's happening on the knee. This is why balance strength is so important, right? So when I say get stronger, it doesn't mean go jump into a bunch of leg exercises because if your knee joint is handling a lot of the load and you don't address the other joints that need to get stronger and you just go work out your whole lower body, what may end up happening is you just continue with that strength ratio. So everything gets stronger, but your knees are still handling that much more of a load. Well, the muscle supports that. I remember, man, when I had my, I tore my ACL and my MCL and I remember when I went and saw the surgeon and I remember talking to him like, it's so weird. I can walk around, I can do it. And he was attributing that to all the muscle that I had developed in my legs. He's like, if you did not have all this muscle, you would feel all over the place without those ligaments. He goes, but the fact that you've developed so much muscle around the knee, it's actually helping support that. And it doesn't feel like you've done as much damage as you really have. I'll show you the MRI. You've got all this damage that you've done, but you don't feel it the same way as somebody who is deconditioned because that they rely so much on those ligaments to help them because they don't have the muscle to support. That's how important getting stronger and building muscle around the knee is and keeping yourself from getting bad knee pain. Oh yeah. Knee pain in deconditioned people is because they're not strong. That happens all the time. And I know it sounds counter, right? Like you don't work out. You haven't worked out in a while and you're like, my knees hurt. And then you hear a trainer say, well, we need to work out your legs. Like, well, that's going to make my knees hurt even more. How are we going to do that? Now, if you do it the right way, everything gets stronger, knees no longer hurt because the muscles really do support and protect the joints. It's like if you have a strong back and a strong core, you're not going to get so much back pain. Well, I mean, we have bigger muscles for a reason. Like our glutes are one of the biggest muscles in our body and we need to give them more work. I mean, that's what they're designed for. And so to put all that responsibility on the stabilizing muscles around the knees is, you know, something that inevitably it's just going to wear and tear and it's not designed to take up all the brunt of the force. Yeah. So let's go with the next one, which is, you know, we're talking about getting stronger, getting stable. But let's talk about the joints that are that, you know, most often contribute to knee pain. One of them is the hip. If you lack hip mobility and hip strength, you will almost almost guaranteed to have knee pain. You're almost guaranteed to maybe even have back pain. Because remember the hip, it connects to the back as well as to the femur, which goes down to the knee. And like I said earlier, the hip joint is very, very versatile. I can, if I, if you put your leg out straight and front, if you sit down and you twist your foot to the right, you twist your foot to the left, you bring your leg out to the side like you do the splits, you bring it across your body. That's the hip that's doing all of that. The knee only does, it only bends and straightens out. That's about it. Have you ever done that as just an exercise with a client and how challenging it is? You sit them on the floor like that and do all those movements you just said. It'll light most people up. That's always a sign too that you're neglecting not addressing that. If just sitting on the floor with your legs out in front of you and then doing the movements, you just talk about elevate, elevate the heel up off the ground, rotate to the left, rotate to the right, kick it all the way out to the side and come back and literally just the weight of your leg will cramp you up. You know that's an area that you're neglecting and if you're neglecting that and that's unstable and that's weak, you have to understand that that has been directly causing stress in the knee. Totally. And it's funny too because this is a big one for advanced athletes or lifters, you know, that they, they have such poor connection to their hip joint or to the muscles that control the hip joint. They don't even realize it. Like you'll get, you know, you'll get one of, this happened to me. In fact, I went to Dr. Brink. He put me in a position and he said, okay, rotate and lift your foot up. So I rotated. So my hip had to, the muscles around my hip had to twist and rotate so that I could lift my foot up and I could barely get my foot up off the floor off of this position called 90 90 barely. And I said, and he goes, can you go any higher? I said, no, no, my, my, my joint doesn't move any further. And he grabs my foot and literally lifts it up and brings my foot next to my head. Now he was highlighting that my joint had way more movement than I could control. It felt like you detached my leg. The capacity was there. It didn't hurt. Nothing was preventing me from doing that aside from the fact that I didn't have the strength and the mobility to control that range of motion. What do you think's happening in my knee as a result of that? So hip mobility is extremely important, strengthening the hips through its fullest ranges of motion, connecting to those ranges of motion, which include rotating in both directions. One's called internal rotation, one's called external rotation, getting your leg to come out like you're going to do the splits, getting your leg to go behind you, like you're doing a backwards kick, having your leg go in front of you and across your body. All those include, involve muscles of the hips. And if those muscles aren't able just to do that, you're going to cause a lot of problems. And we did some really good, you know, Adam did a really, really good mobility class. I think it's called what was it called, PrimeProWebinar.com? Yeah. So PrimeProWebinar.com, it's a free class. And he actually takes people through a couple hip mobility exercises. Very easy to practice, but they're phenomenal at improving connection and mobility in the hips. And I would say a good 30 to 40% of people get just incredible results just from working on this alone, just the hips alone. And then they're able to twerk, explain that. Exactly. And that's just this right here. The next one covers, I think, everybody else, right? I think when you're looking at the hip or you look at the ankle and the feet, this is a big one because all, I'd say, most people have very, very poor connection, especially to their feet because we wear shoes all the time. And our feet have a lot of muscles that do certain functions in them. And because we wear shoes all the time or we wear heels all the time or shoes with really strong structure of them, those muscles are just weak and they don't do much. And so now we're walking on stilts almost. Oh, man. I just remember when I would come back from the off season and come back to football, I just remember when I would start getting into running and so I was trying to build up my endurance initially, I would gain all this weight and then now I have to go try to cut it, cut down and get back in shape. And my feet were so flat I would run and stomp everywhere I went. My entire foot would just stomp. And the gain of weight was definitely a factor, but I just not working on my foot strength, my forefoot, getting my heels up off the ground and then also just the overall function of my toes and my ankles, that was just not even a consideration. It was just lift weights and get as big as possible. This is the biggest contention I have with my family right now with my son. So now that he's starting to walk around and so he tromps around all over the place, now I want him barefoot like 99% of the time. The only time I throw shoes on him is to match an outfit, take a picture, look cool while he's in his car seat or some shit. But the rest of the time, as soon as we get somewhere, I strip his shoes right off and all of my family are like, oh my God, there's rocks and he's going to hurt his feet, put shoes on him, put shoes on him and I'm constantly going back and forth with him and trying to explain this right here because I didn't understand how important this is. And I see it and I don't know if it's now being a father. And so I look at other kids and how they walk and they move and it's crazy that you start to see it that early. You can see kids that when parents right away have a child, they throw shoes on them all the time and they literally learn to walk with shoes on. Imagine trying to write cursive with snow gloves on. That's literally what you're trying to ask the feet to articulate and control and to be able to grip the floor and to stabilize the ankle really well. But yet you've put snow gloves on them the entire time you've ever been using them. And imagine how difficult that would be. So this is an area that I struggle with with my family grasping how important it is that he walks around barefoot and touches the dirt and feels the grass. It limits the responsibility of the foot in how to react to certain situations in the environment and our shoes. We tried to make it easier. We tried to make running more comfortable. We tried to make activities more comfortable so everything supported. But we lose then the ability to be able to navigate in that and have strength and control in our feet. Yeah, no in the ankles too. Especially because most shoes have some type of a heel on them. Even men's shoes when you look at the type of tennis shoes or sneakers that we wear. There's always a little bit more of a rise. Typically a little bit more of a rise in the heel than there is in the forefoot. And what that's doing is that's compensating for ankle mobility or lack of ankle mobility. And then because you're always walking in them it trains that your body kind of forms to that. Now this doesn't necessarily mean take your shoes off and socks off and now it's going to fix all your problems. It's not going to work that way. You've already developed these patterns. Your body already moves this way. But what you can do is play special focus on ankle mobility exercises. One movement in particular. Combat stretch. Very easy to do. We've got videos on our YouTube channel. I believe Adam goes through some ankle mobility. This is the single biggest thing that allowed me to be able to get into a squat deeper than 90 degrees. The first thing I addressed was hips in the 90-90 and having good stability and strength in my hips I knew was important. But it wasn't until and you referred Dr. Brink already. I mean this was this is what he did for me and he showed me the breakdown in my ankle mobility. And this is especially true. This is true in everybody but this is especially true in those of you that have long limbs if you're taller. You have to have the ability for your knees to track over your toes comfortably. And if you can't do that the limiting factor is your ankle mobility and it is not something that you're stuck with with the rest of your life. You can improve it tremendously. Oh tremendously. I mean and this was what was keeping me from breaking 90 degrees was my knee would track to right about to my toes and then I'd feel stress in my knees and so then I would stop the squat. That's as deep as I'm going because any deeper than that and I feel that. And part of that is our fault too was trainers. I mean we were taught this way most all certifications especially you know two decades ago would teach trainers to teach their clients to not break 90 degrees. And they would teach us to do that for safety reasons because most clients couldn't get their knees to track further over their toes without having direct stress right on the knee. And so instead of just saying oh I can't squat past 90 degrees because I have bad knees or my you know ankles won't allow me work on the ankle mobility so it then will allow your knees. I mean I gained a good five to six inches. That's a huge difference in the ability for my knees to track over my toes to allow the hips to drop down into the squat. Did you address any ankle mobility in the Prime Pro? Oh yeah that's where I start with. Oh good so in that webinar it's free and you know the reason why I'm pointing in that direction is because you want to do these movements properly. Once you understand them they're easy to do but you might need instructions. It's very hard to explain on a podcast right. You might need some instruction. You need some visuals. Watch visuals and how Adam does it. He teaches a phenomenal class on it. It's free and you go on there and you'll learn some of these things that we're talking about. And literally I don't honestly you don't even need to go any further than that. Most people listening if you have knee issues watch that webinar and he does the hip mobility and the ankle mobility. He also does some shoulder stuff on there if I recall correctly. And just do that and practice that every single day and then you can see what happens with the knees. And the ankle stuff is one that people miss all the time. I mean hip one isn't that popular but at least they see some people work on that. Ankle and foot nobody talks about. But that's like I said earlier. I bet you 30% of people with knee pain comes from the hips. 70% probably comes from the feet and ankle. It's actually a bigger cause of knee pain. And since you're bringing up the webinar if you watch it I do put emphasis on this but if you don't watch it and you decide to just go look up the combat stretch or the 90-90 and do this on your own it's so important that the intent that you do it with. So you don't just do it like a passive stretch. You don't just sit in a position. You don't just sit in a position and like you would stretch like a passive type of stretch. It's a very active exercise. So when I am doing like the combat stretch and I'm driving my knee over my toes to the in range of motion I'm trying to connect. I'm trying to squeeze. I'm trying to intensify that position. I'm not just moving to that position and then stopping because if you do that you're not going to gain the greater range of motion. It should be something so active that if you spend 10-15 minutes doing you will heat up. You'll break a sweat from doing this and you'll see in the webinar I'm sweating by halfway through this because even though I'm doing like a mobility drill or what looks like stretches for most people it's not. It's an active exercise and movement that I'm performing and there is an intent and intensity behind it in order to gain that new range of motion. 100%. Now the last one really has to do more with inflammation in the whole body. Now this can be a problem and can cause knee pain but typically you also notice other parts of the body that hurt as well. If you have systemic inflammation if you're just in an inflamed state which we can talk about you know in a second what causes that not only will you notice knee pain but you'll notice overall stiffness throughout the whole body. So things just generally hurt because your inflammatory system of the body is out of balance okay and and real quick the inflammatory system of the body is an important system of the body. If you eliminate it you get joint breakdown, tissue breakdown, very dangerous. If it goes too far in the other direction same thing. Joint breakdown and things start to get pretty bad. You want inflammatory system that's balanced and if it's out of whack it can definitely cause problems. One of the main causes of systemic inflammation is lack of sleep. In fact one night of poor sleep typically can be measured by measuring someone's inflammatory markers. Sleep is extremely important at helping your body regulate its its own natural systems of inflammation. So prioritizing you know seven to eight hours every night don't eat about an hour before bed, an hour before bed make sure you have all the lights turned down maybe wear blue light blocking glasses make sure your room is is blacked out and you take that you know seriously you go to bed an hour after everything's winded down you're relaxed maybe drink some chamomile tea and get good sleep because lack of sleep even in the healthiest person can cause inflammation to go in the wrong direction. Yeah I also think too of inflammation like how some of my clients it would show up as you know like swelling and fluid and things like that you're going to notice in your knees that right away is like okay how am I going to deal with this and like you know how was your sleep and also nutrition is one of those factors that you have to take into account what you're eating and putting in your body that you're you might be reacting to that might also you know open up any part of your body that is already fighting things within is going to really exaggerate that you're going to feel that even more. Oh yeah if you eat something if you eat anything that causes any gastro distress so it could be as simple as like flatulence like oh every time I eat this I get lots of gas or bloating or stomach pain definitely constipation or loose stool if you eat anything that causes gastro distress you are causing a your inflammatory system to ramp up a little bit every single time you do that now if you do that every single day which a lot of people do you know heartburn is another one I know people that deal with heartburn every single day and they just take tums or roll aids every single day it's just what they do I know people who you know they have constant gastro issues and this is just how I am oh this is without really paying attention to what foods is causing that and that can be very individual by the way for some people it could be some foods for other people it can be other foods but if you are constantly having gastro issues regularly you are giving yourself a higher than than a healthy level of inflammation of the body it does compound and it does cause more pain. Well to Justin's point about fluid being sent to these areas too okay so I had bursitis in my hips and what happens is if your your knee or your ankle isn't tracking properly then the the body receives that as a signal that there could be pain in that area and so it sends fluid there fluid there to help it out and then it builds up in these sacs and then it causes all this systemic inflammation and so that was something that just was mind-boggling to me is that oh here I am this exercise guy I work out but then why do I have all this bursitis in my hip and it was because I lacked the mobility the stability and the strength in my hips and so my hips were not tracking properly my body then thinks that there's an injury or something going on there so it then sends fluid to that area to help protect the joints in that area which just ends up causing all this pain so when you have things like bursitis or you have fluid being sent to joints the body is recognizing it as if it's injured and it's trying to help you yeah it's trying to medicate it by sending all that which is just causing even more pain and the inability to move properly and the the way to fix it is not to avoid it and stay away from it it's to actually address the mobility the stability and the strength in that joint to alleviate that problem right now let's let's to go back to diet here's another one this is very common if your fatty acid profile is way out of balance if you eat lots of vegetable oils or processed vegetable oils if you're not getting enough omega threes or healthy fats because the the fatty acids are help are part of what make the inflammatory system work if those are out of balance you can have more inflammation sometimes people can actually supplement with fish oil and notice a reduction in overall inflammation other times it needs to be a little bit more dramatic where they have to change their diet maybe cut out some dairy or definitely eliminate those those vegetable oils like corn oil soybean oil those processed you know vegetable oils get those out of the diet replace them with things like olive oils avocado oils butters you know healthy fats animal fats ghee from from you know from well sourced uh sources and they start to notice their inflammatory system starts to balance out and they start to feel a little bit better to that point so do you see value in things like prebiotics and probiotics to to help people with their gut because if it helps their gut for sure because poor gut health is going to make you feel inflamed everywhere and that can even show up as anxiety and in a bad mood uh high inflammation if you've ever had a fever or a mild fever and you feel just kind of crummy and you're taking anti-inflammatory all of a sudden you feel so much better that's kind of what happens right your your inflammatory inflammation is a little high you feel just kind of crummy overall you bring it down from healing your gut and those things can be a part of a of a gut healing process other supplements um turmeric uh can be a good supplement that could reduce inflammation ginger is another supplement that can help with inflammation now one of the problems with uh with those supplements however is they don't replace a good diet or good sleep or good stress management but you did make a very good point adam you know making sure you consume things that promote good gut health tends to reduce inflammation overall in the body um you know things with prebiotics or things that contain compounds like slippery elm for example uh marshmallow root these are things that help keep the gut healthy because the gut definitely can cause inflammatory uh signals to rise um and oftentimes it's from you know poor poor gut health look mind pump is recorded on videos as well as audio come check us out on youtube you can find us there you can also find us on any podcast platform uh we're also on instagram if you want to find us directly you can find uh dug at mind pump dug justin at mind pump justin me at mind pump salin adam at mind pump adam the first step of overcoming anxiety is is recognizing that it's self-inflicted um which you know and i don't know if it's this generation or this time that we're going through right now but a lot of this is like we're always pointing at the things that are happening to us but it's us who allows ourselves to feel anxious