Do Foam Rollers, Massage Guns & Stretching Actually Work? Dr. Jason Amstutz
Everything You've Been Told About Fascia Is Wrong? | Dr. Jason Amstutz Explains the Science
Is fascia really the missing link to chronic pain, poor mobility, and athletic performance—or has social media turned it into the most misunderstood tissue in the human body?
Every day, millions of people spend money on foam rollers, massage guns, stretching routines, scraping tools, and "fascia release" techniques. But what does the science actually say? Are these recovery tools helping your body...or are they simply treating symptoms while missing the bigger picture?
In this eye-opening episode of the Crackin' Backs Podcast, internationally recognized sports chiropractor, educator, and fascia expert Dr. Jason Amstutz challenges many of the beliefs surrounding fascia, movement, pain, recovery, and human performance.
You'll discover why the body may function more as a fluid communication system than a collection of isolated muscles and joints, why so many people continue to feel "tight" despite stretching every day, and how understanding fascia may completely change the way you think about injury prevention, rehabilitation, and movement.
In this episode:
✔ Why fascia is one of the most misunderstood tissues in medicine
✔ The biggest myths about fascia circulating on social media
✔ Do foam rollers, massage guns, scraping, and stretching actually work?
✔ Why your body feels tight—and what's really happening beneath the surface
✔ The relationship between fascia, fluid dynamics, and human movement
✔ Why pain doesn't always originate where you feel it
✔ Recovery strategies that actually deserve your time and money
✔ How elite athletes and healthcare professionals are rethinking movement and rehabilitation
Whether you're an athlete, physical therapist, chiropractor, massage therapist, personal trainer, physician, or someone simply looking for lasting answers to chronic pain, stiffness, mobility, and performance, this conversation will challenge your assumptions and give you a completely new perspective on how the human body works.
Learn More About Dr. Jason Amstutz
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We are two sports chiropractors, seeking knowledge from some of the best resources in the world of health. From our perspective, health is more than just “Crackin Backs” but a deep dive into physical, mental, and nutritional well-being philosophies.
Join us as we talk to some of the greatest minds and discover some of the most incredible gems you can use to maintain a higher level of health. Crackin Backs Podcast
SPEAKER_02
Every day millions of people foam roll, scrape, stretch, and buy gadgets that promise to release their fashion. But what if what if much of what we've been told isn't actually supported by science? Today we are separating facts from fiction, and welcome back to the show, Dr. Jason Amstutz. Thank you, doctors. Nice to see you both again. Same here, buddy. Hey Jason, let's start out by asking it. You know, if someone walked into your clinic after spending six months learning about fascia on Instagram, TikTok, whatever, what's the first thing that you would unteach them?
SPEAKER_00That's a great question. First thing I might unteach them is that we're only getting generally 50% of the equation of what the actual physiology of fascia is. And that's simply most models and most conversations and most techniques, both hands-on and also corrective exercise, are missing arguably the most important, which is the fluid. Like there is no biotensegree, there is no living fascia without the volume that is taken up by the interstitial fluid and other fluids of the body, period. So to look at this thing as a collagen-only, protein-only based connective tissue is literally 50% at best. And from a functionality perspective, I might even rate it 30%, the fibers portion.
SPEAKER_02So okay, so what was what is probably the most misunderstood thing about you know the this this tissue fascia that everybody talks about in the human body? Is is it is it something that you can narrow down because you hear about it all the time?
SPEAKER_00I mean, I think it's the s it's in the same vein of conversation. It's directly related to the fluid, the tissue, the tissue hydraulics. We are a pressurized hydraulic vessel from top to bottom, inside to outside. Every single component, not just the fascia, by the way, but we'll we'll stay with the fascia conversation since this is why I got invited. Um everything is based on the fluidity of the of the fill in the blank, the organ, the covering of the organ, i.e. fascia, all the vessels and how things move, how we how we are able to assimilate oxygen into our body, take it from the from the air around us and put it into our blood system, that has to pass through all these different layers of fascia. That is the most important piece, is the health of this tissue. And I think the biggest missing part is, and this is what I go around teaching, both hands-on techniques and otherwise, is how to respect this part of what we're already doing. This isn't something that we're like suddenly gonna now treat, um, but we just need a different lens, I believe, on how we can manipulate this body, whether it's an elbow, a wrist, a concussion. I mean, that the highest level, in my opinion, of understanding the the fluidic concepts and and constructs of the body has to do with concussion. It's not always a bunch of gray area damage. That damage comes from not taking out the trash because you're not sleeping and you have problems with the lymphatic exchange in the brain, which is called the gymph system, and or you're not getting enough arterial blood, or you have a backup in the drain system and you don't have enough draining of the venous system. And if you alter those pressures by just a little bit, plus you add the um cerebral spinal fluid pressures in there, we have a very, very sophisticated sense of what is normal and not normal. That's really what drives the concussion conversation. But again, what that's that's the up here understanding of the fluid dynamics of the body, but to bring it to the rest of the public, I think that's the the most important part is that has to be respected.
SPEAKER_02Is all fascia the same? Because we that you know we hear about fascia underneath the derma, the skin, the dermis, and then there's fascia and around the gut that we are hearing more about. Is there a difference?
SPEAKER_00Yes. I mean the class the sophisticated classification of fascia is now for this conversation, but there is all different classifications. This all comes from embryology. What portion and what part of embryology did this develop and where did it develop from? Because remember, we're we only start off as two two different cells, and we become an embryo, then that's all the majority of that is done in eight weeks. I mean, it takes it's nine months gestation or ten months gestation period, but most of that is a furthering of advancement of the brain and some other things, but all the parts have been there since the eight-week mark, and the point of that is simply to go from two to an embryo, and everything started with the same two cells and three layers, they all get intermixed and intermingled. So that's the embryological understanding, and that's an important piece, I think, for the further understanding of fascia for doctors and and things in our space. Um, but I think the the important piece of that for for um for this conversation is that yes, there are some superficial fascia. The superficial fascia can be in different areas, it's not just underneath the skin. That has one construct or feeling to it. But the rest of the fascia of the body, I mean, a ligament is fascia. This is another reason I want to, you know, some classific it's not the classification of fascia, that's the broad overlining or overhead uh bullet point, but then you have this whole entire list of these specialized tissues that all are fascia. Ligament, the tendon, the periosteum, the dura matter, the covering of the organs, etc. etc. So are they similar? Yes, they're similar, but some of them are thicker and denser and more elastin, and just like a ligament, like the the tissue has different pliabilities depending on if it's a deep ligament of the spine. You know, we know that those move, but they don't move quite as much as the you know the ulnar collateral ligament of the elbow as far as flexibility. And that's because not because that they're a different structure per per se, but because they have a different recipe of the same things. One of the types of collagen, you know, there's 24 different types of collagen in the body, and this gets mixed with water, which comes to the extracellular matrix, and then different different amounts of fibrin, different amounts of elastin, and this is what makes um the fascia.
SPEAKER_02So I I gotta ask you, wait, wait, you just said some something remarkable. For as much as we've been working on the body and understanding the science about it, how many different types of collagen marks?
SPEAKER_00There's at least 24 different types of collagen in the body. Really? Yeah, bio biochemically, histo histologically, yeah. That is true. And they all have different functions and they're found in different different parts of the of the collagen matrix of the fascia and other places. Yeah, it's not all the same. Very, very cool.
SPEAKER_02I bet most of our listeners and viewers didn't know about that. You know, especially with collagen being such a hot topic to to supplement your diet with nowadays, you know? Right, right. So what makes what okay. Here's probably uh a big question for most people wondering. There's so many different ways to work on fascia. What makes your approach so valuable and so unique? I mean, you know, we talked about I mentioned earlier, foam rolling is working on fascia. Deep t you go to the massage therapist and uh I'd like deep tissue massage, and then most guys go, all right, that's too much. That's too much.
SPEAKER_03Or they or they get their elbow in and they're digging their elbow in. Right. Right.
SPEAKER_00So okay, so as a nut in a nutshell, what makes this what makes this different is respecting the fluid. If I'm using my elbow or if I'm using a foam roller, I am not respecting for the most part the fluidic nature of that living tissue. And you don't have to take my word for it. And if you ask me for references and things, I mean you can scour books and all this other stuff, but I recommend that people get to a dissection. You guys need to come sometime with me to one of these dissections. So the body is untainted by chemicals and harsh preservatives formaldehyde and others. So you only have the clock is ticking because this tissue will rot in a short amount of time. So we take about anywhere from five to seven days, and you're working 12, 14 hours a day, and you only refrigerate the body. That will change your hands-on and your like understanding of fascia in one week. Because none of it is hard and beef jerky like or any of those things. It like literally responds not only to the heat and temperature of our hands, which has been known in the hands-on, you know, aspect of you know, the history of the world treating people like there's something that magical that happens with our hands. Part of that is the interaction of my energy with the actual tissue, and that can change the movement and the quality of the fascia via the water mainly. Not because I'm changing the fibrous part. Everybody wants to tear the fibrous part and open the fibrous part. But if you just took a little bit of extra time and and kind of manipulated the tissue as a system and you move the fluid better in there, that's what makes that's what takes the years off the athlete. A prime example of this right now is everything that you're seeing that's crazy with Christian McCaffrey's um training and what he's doing now at 31 years old. And everybody, you know, Instagram is like such a hilarious thing. But it's like you got people that always want to comment on other people's whatever they're doing. But the most important piece of that is, you know, this is a guy that's he's 20 years, his training age is 20 years at least. And if you got a training year, a training age of 20 years, you need to start morphing and adapting what you're doing to stay alive and stay in a game like that. He wouldn't do that from the time you're 17. He's already put in the time in the gym and all of the heavy lifting and all of the sprinting and all those things. Now he's trying to preserve, and now you see him moving more eloquently, and we all need to be doing that at some part of our training, re-education, um, part of our rehab. I mean, we take the ad we try to take advantage of every athlete that comes in post-surgically and re-mo revamp their entire body with the movement of the fluids better because that decreases the age of the tissue. It's not the number in the passport.
SPEAKER_02Somebody needs to uh do some work on Madonna. I don't know if you've seen her. She looks like she's gonna crumble on stage. Um I do I do have uh uh one one more question before Terry, I know you were gonna ask something, but you know, we talk we often talk about how uh uh adhesions occur, the muscles that are wrapped in their individual sheaths, and then you know, from from repetitive microtrauma or overuse, they start to adhere together. How how is that I mean is that considered fascia and the work you do? Is that part of what we try to do is make it move more smoothly?
SPEAKER_00Yes, but I think and then we're back to the same I'm gonna try to keep this steam for the next 50 minutes, and that is it's not just about the physical collagen sticking together, it's because of the lack of lubrication from the water and the hyaluronic acid in between the layers. So again, so lens one is we go when we try to strip these things from each other. Okay, I mean that's fine. I mean, that's part of the game, but the real game from my perspective and this other osteopathic model is if we just restored the fluidity in the interstitium of those layers, now they pr now they glide. So are they really stuck together in fibrose? I can tell you this from dissection. Um, one of the places that I've studied dissection with like a crazy anatomist is in Canada, at Queen's University in Kingston, Ontario. And before we even open the body, after saying a prayer and being very thankful for the for the ability to be able to be in that environment, right, with somebody who has passed, which is like just in and of itself another another thing. We go through and palpate this entire body, chiropractic, whatever, whatever your modality is, you go through and you make a long list. Oh, there's a big ankle fixation. This is the story I'll tell. There's a big ankle fixation. The woman at that time, that particular um um specimen was, I don't know, she was like early 80s. I don't remember if it caused a death. But anyway, you go around, she had a big, big restriction in her upper cervical, but her whatever ankle was like locked and not moving. So I think the normal the normal way of looking and viewing that would be, oh, it must be all, oh, she's eighty years old, she's got to have a bunch of arthritis in it, there's gotta be a bunch of fibrous adhesions, to your point, in this ankle. Well, fast forward, it takes two days or a day and a half at least, depending on how good you are, just to take the skin off. That's that's how important for this conversation the skin is and what we do to the skin, how important it is to the fascial body. Because it is adhered that much that it is a long, this is five, six people on a body. Not one. Because you can't just pull it off, it doesn't come off in sheets, you can barely get it off. Finger pads, bottoms of the feet, the places that we are highly, highly sensitive, you can it's it's like you can barely take you can barely separate it from the underlying because it's so embedded with these reticular fibers. Anyway, that's a different story. So we go on, we get we get to the day, whatever it was, and we finally get to the ankle and we open up the ankle, and they're literally in the tissue, whether it's the ligament, the tendon, in the area, there wasn't any signs of any like major gross, like scarring, kind of a you know, we had this scarring thing in our head, and these things are fibrosed and stuck together. There really wasn't a whole lot of evidence of that. And remember, with this with this kind of prepared body that's only refrigerated, you you can still see all the fluid in the tissue for the most part. Now it's drastically different than the day they died, but it's way different than what 99% of the world is dissected, I can tell you that. Um then you go to the joint aspect, and the joint, not a lot of arthritis or arthrosis, because technically a mechanical problem with the joint is not arthritis anyway, it's arthrosis, which means you know it's had some wear and tear over its life, right? Non-chemical based. And it's like the whole thing was shut together, the mortise and the subtailor, and that was it. So then we can actually do some of these techniques that we do on a live body to open up the space between the the tibio the between the tibia and the calcaneus, and between the calcaneus and the talus, and you can then re-palpate just right there on the dead person. I didn't scrape a thing, didn't scrape a thing, didn't rub a thing, and then the whole thing is like this pliable hind foot that you would expect to feel on an athlete. And that's because we drew the fluid, that's because we were able to move more of the fluid within that sticky joint complex, which is why the this type of conversation about pumping and other things related to the joint is why every chiropractor, in my opinion, should be going through this program because now you have the mastery of the adjustment, which is important when it's important, but sometimes you have to restore this fluidic nature to the joint, and that's what takes it to the next level, and they don't get another injury in four months on the same side. Part of that conversation.
SPEAKER_03So so those listening to us here, fluid, fluid, fluid, does that just mean I drink more water? Or how what does how do you how do you get this fluid into these joints and and and how and for this lay person doing is it a stretching thing? They drink more water, do they put creatine in the wire, they put electrolytes in the water? How do we get fluid into the systems?
SPEAKER_00How many questions are you gonna ask me at once, doc? I'm gonna throw them all at you because I know you can handle it. Okay, let's see if I can remember them all. Um the short answer is yes, of course. You gotta have water. You have to have high-quality water. Part of this conversation is the quality of the water that these athletes and we are drinking matters. Because in an ideal situation, we have an empty stomach and high-quality spring water, not even man-made. You know what I mean? Like that's how it goes, which is you can read about water and you there's all these water nerds on on Instagram, and the you know, the structured water and all that stuff is real. That's why we're supposed to be drinking live water because the water should constantly be moving. Anyway, empty stomach allows us to bring the water into our body, and then the majority of it doesn't, we don't need to digest water, right? We remember from just basic physiology, whether it's high school or chiropractic school, that the water moves freely for throughout the body, right? From areas of lower concentration of solute to higher concentrations of solute. So if we mix it with food, coffee, electrolytes, anything besides salt, now we have to get those things out of there, which requires the liver in a kind of a cleaning of the water. And that's a different process. That's more intracellular based. We want to be focused for this conversation on the extracellular water. The water that's in the cells, we die without that. This is not about that's not important, but you're talking to me about tissue health and hydraulics that I'm talking about. And that means we got to get the water, to your point, into the into this area. And how do we do that? We got to start with high quality water on an empty stomach. So, what does that mean? That's depending on where you're at on the water, like how much water you drink, that's first thing in the morning. I drink a liter with some regul, you know, high quality salt. That's it, no electrolytes, those are all chemicals. That requires a whole nother scrubbing and your liver use as well. Most people's livers are backed up, you know, for many reasons. Um and then an hour before my next meal when my empty when my stomach is completely empty, and so on and so forth. So that's the water, that's how we can manipulate the water to be best available for this interstitial fluid in space. Make sense?
SPEAKER_05Oh, yeah.
SPEAKER_00It's not rocket science, right? This is just physiology. So then the next question is how do we get it into these places, Doc? Well, depending on your age, uh, we won't even go age, we'll just say we have an 18-year-old male or female athlete, they eat high quality food. Don't forget the quality of our collagen and all these other things, depends on the quality of our food. That's another podcast with other people, but that's important, right? And then if you take that part that piece of it and they have no injuries and no previous problems, you move the water by doing all of these incredible movements that you see with all these different movement experts. And I'm not here to pump any of them, but gymnastica that you know Dr. Tim Brown likes so much. This Ido Portal is gaining a lot of a lot of notoriety and um more traction. He's been around forever. You have to move these joints through all of these different positions, that's the deepest conversation, as well as the more superficial pieces. So, could that be a proper myofascial stretch? Yes, but we use the stretch specifically for an issue we may have found with our hands or based on their previous injury of three times they've torn their left hamstring. We might be more specific with what we do versus a more global approach of moving the tissue because if we change the pressure in the in the joint or in the tissue itself, that's what moves the water. So you cannot neglect any movements in any direction. Again, this is a well-patient, well athlete, and that's how you maintain as much of this fluidity of the deepest joint, the facet capsule, the blah blah blah, the water and fluid, synovial fluid that's in the facet, that matters too. And that all comes through movements, which is why movement is medicine that's been around since Hippocrates. Movement is medicine.
SPEAKER_02I'm fascinated at the thought that back in high school in uh in the 70s and 80s, you weren't allowed to take a break to drink water during your wrestling practice or football outside or whatever it was. And the thought of that today is just corrupt. It's it's it's especially after what you're saying.
SPEAKER_00Right. Well, and you just saw in the World Cup, uh this is the first time I remember in the World Cup there being a water break.
SPEAKER_03Yeah, it they're do it it is the first time they've done hydration break. Uh huh. Is it?
SPEAKER_00Yeah, first time. But those guys know they know. No, they know.
SPEAKER_03Well, they also talked about uh that the reason they're doing it is you have football, you have all these other sports, they take timeouts and everybody runs out and gives them water. In soccer, there's no timeouts. So they're running for 45 minutes, sometimes 50 minutes without ever putting um fluid in. So people were like, oh, these guys are a bunch of wusses, they have need a hydration break. I'm like, and I and I flip back and go, look at every sport out there, basketball, football, and they all have timeouts, and that's when the the athlete trainers run out with water. So they don't have that. So they had to have that. Um let me talk about you talk about communication, uh, the cells are all communicating. And what do you think about like the fascial bounce or or stuff like that? What's some things that to get this hydration flowing and to increase the cellular communication besides just drinking water and having a therapist run their hands through?
SPEAKER_00Um well, I mean, I don't know what the fascial bounce is. I can imagine what it could be. Um but I mean, you know, that a lot of these things, see, the lymph system is part of this continuation of the water in your body. The water go gets into the interstitial tissue, and there's gonna be a question at the end of this, I'm gonna quiz you both. So you have water in the interstitium of all the tissue of the body, right? All the connective tissue fascia for this conversation. And then you have the lymph system, and then the lymph system empties back into the venous system, right? That is the flow of like much like the the movement of water of the earth, that's how the water moves in our body. It goes in here, it gets into my tissue, it goes into the lymph system, it becomes that water, same water moves into the lymph. That's why you don't want any stagnation anywhere in this process, because that's the start of disease. Anyway, that's another podcast. Um we have a lot of podcasts. So so that's an important piece, then it goes back into the into the um circulatory system. So the question is, because there's you know, fascia's a big word, and lymph, we've been hearding about lymph forever. What is the relationship in volume of water between the interstitial interstitium of the body, extracellular matrix for the scientists, and the lymph system? All the water outside of the cardiovascul outside of the the pulmonary or the cardiovascular system or how how much is in the how much is in the interstitium or how much is in the the lymph? Is it 50-50? Is it eighty-twenty? I have no idea. This is important for your this and then I'll answer your question, Doc.
SPEAKER_03I have no idea.
SPEAKER_00Just take a guess. Just take a guess.
SPEAKER_03I'm gonna go uh 80-20.
SPEAKER_00Which one? Ooh. Uh good try. Good try. 80-20. That's good. That's you totally take a guess. Throw out two numbers that add to 100.
SPEAKER_03Right. Well, you're throwing 50-50.
SPEAKER_0080-20. Hey, you're you're really close, but which one's the 80? That's the most important part of this conversation. Fluid. Yeah, the fluid in the interstitium. 85% of the volume is in the tissue. Only 15% of that water is now in the lymph, in the total network of the lymph system. So now you ask me a question: is this like bounding this fascial bounce? Is that like bounding on a trampoline?
SPEAKER_03No, you know how like uh uh Eric Goodman and Foundational Train, how they how they just do that loose bounce and they just go on their toes. That's why I call fascial bounce.
SPEAKER_00Okay, great. No, same thing. And that moves the water, but it mainly moves the water in the lymph system. Although they're interconnected. That's why it needs to be you have to change the angle of joints and the torsion of the tissues to really pressurize and depressurize. That's how we move the water most efficiently. Oh, okay. Because it's all that water is bound together. Like if I cut open a body, even of somebody who's alive, the water doesn't pour out of the interstitium. Why?
SPEAKER_05Oh, okay.
SPEAKER_00Why is it only blood on the floor? Why is there no water? Hey Doc, you just told us we're full of so much water, but there's no evidence of that. I saw somebody get their arm chopped off, but I didn't see any.
SPEAKER_03That's a good point.
SPEAKER_00That is great. That's because that water is all bound within the tissue and doesn't pour out of there. And that's through chemical bonds. That's why that's the importance of um um hyaluronic acid and other type of that that's what binds the water in the tissue. That's why it doesn't pour out of there. So you it has to be a little bit more sophisticated to move it in the tissue besides just bouncing. But if you know, being in water, water submersion helps move because you have a difference in pressure between your feet and your head. That's the real way to flush and to recover. This is what these athletes, if you look at all these outliers in all these different sports, and these outliers are mainly the best. If you ever have you seen anything on Instagram where you catch these guys at like away games and there there's people taking a video of them down in the pool. That's because that's how you recover your tissue. No kidding.
SPEAKER_03By by floating or just being in water?
SPEAKER_00Moving in water. I mean there's different there's money, but just moving in water because now we have this pressurized now we're changing the pressure in the in the fluid uh in the in our body, right? Because my toes are at six feet and my eyeballs are at one inch. That's a column of water. And that's a graduated, this is important, this is the graduated micrograduation, right? The higher I come in the water up my leg, the less pressure. That's how you can move the fluid out of a limb real fast. Not by squeezing the leg with these different cuffs and all these if different things. There's no graduation, there's no graduated scale in that. It's on off. That's okay for the blood system. That doesn't do a whole lot for the interstitium. Because all the water's bound together.
SPEAKER_03So if you don't have a pool, what's a good way to do it?
SPEAKER_00Well, then you're then you're certain hands-on, this pumping is to change the pressure at the joint to bring more fluid into the joint, especially if it's been lost because they've had a compressed ankle joint since they were 14 when they fill in the blank or whatever the old dry joint that you and I and and Dr. Barron feel, and every other chiropractor, the restriction that we feel of mobility in the joint, sometimes it's because, right? If the thing's too compressed, we're gonna use the weight-bearing joints, those are the easiest ones because they're constantly under load every single day, right? Talus, all of that. But the adjustment respects the fibrous portion.
SPEAKER_04My apologies.
SPEAKER_00Um the um the manipulation respects the fibrous portion in the immediacy, and that's like the neurologic and all the other cascades, and all of that neurologic mainly comes from the fascia, by the way. We need to get back to the neurology and why that needs to be discussed because that's all in the fascia. All the receptors for proprioception and awareness of the body are in the fascial system. Including the muscle spindle, anyway. Muscle spindle's not in the muscle. So sorry, I I got sidetracked. My daughter said a timer on my thing.
SPEAKER_02I do have a question though, on this terrible I mean about this. Um They often uh I've always heard that you know uh uh dehydration, even as uh uh can create a small but very critical shrinkage of the of the dura around the brain, and that could easily cause um you know awkwardness and and inability to balance and have uh you know uh a peak level of proprioception. But now you're talking about what dehydration can do to all the rest of the nervous system in the body.
SPEAKER_00And we're only talking about the afferent or uh the the afferent, remember the eighty the afferent is eighty percent of the information in the body is going to the brain. Only twenty percent is making us act. And all that comes, all that is embedded in these specialized fascial structures, which often gets missed, I think. And it's just that you just missed the page in the physiology book. Okay, we have all these receptors, the Pachinian and all, you know, the Meisner corpuscles, Bob, those are pressure sensors, but and all of these different change of length, right? Muscle spindle, Golgi tendon apparatus, but the page in between that is often missing is that where are those locators, where are those um receptors located? Some of them are self-evident, Golgi tendon organ. That's in the tendon. The tendon is fascia. Check. Muscle spindle. Uh-oh, doc, you just ran into a big one. It's like, no, I didn't. The the muscle spindle complex, which they don't truly understand exactly how it is, there's people that have some drawings and things, but it's in the fascia that wraps around the muscle fiber. It's not in the muscle. The muscle is yes or no. And I can and that and that question comes up all the time. Oh, why don't we more sophisticated with our training of the muscle? It's like, because the muscle's just on off. How many motor points in the longest muscle in the body? Longest muscle in the body is the hamstrings. How many motor points in the average human from distal to proximal end?
SPEAKER_04Two. Yeah, 2.8. That's it.
SPEAKER_00That's how smart the muscle is. Did you just guess that?
SPEAKER_03Oh fuck, I know. You know, I'm it's all in here, baby. It's all in here, baby. I would have never guessed that. Yeah, that's why you just sit back in Florida. Hey, I do have I do have a question before you lean in because you know you just talk about this. We we we're so focused on muscle and MRIs and CTs and all that. We're missing the big boat, aren't we?
SPEAKER_00100%, thousand percent. The big boat is right next door. It's what makes the it's what makes the muscle function from the perosteum, which is the skin of the bone, tendon. Then you have the aponeurosis and the wrapping of the fibers, great, but remember they all come back together as the other tendon. They're the it's all continuous to the other perosteum. That is the functional unit of the muscle, which means we have to respect each and every part of that if we want to build a well-oiled machine athlete that's resistant to you can't have a weak perosteum, or that'll create a problem. You can't have a weak tendon. There's a lot of research now on tendon training. I think we're headed in the right direction, but now we need to take that same construct and go, how would we train the muscle different from the tendon? We got a pretty good idea. And then what do we do about the perosteal connection? How do we make that more robust? Because I had an evolsion tear one time of my upper hamstring. You don't just keep doing leg curls for that.
SPEAKER_03You know, we have a machine called an in-body, and I've been focusing so much on the visceral fat and the and and the body fat, but I've also been starting to get really interested in the ratio of the ECW and the TCW, which is interstitial wire and versus the total body wire. And and the ratio should be between 3.36 and and 0.38. And it's it's amazing that you're seeing these athletes are really fit, but their their ratio is so far off, and they keep getting strains. Now it's starting to make a lot of sense.
SPEAKER_00Yes, and this goes right into the model of recovery and and and healing. Like we're not, you know, as much as we're trying to facilitate the healing, it really comes through the fluid being better adapted into those areas where they are stubborn. Those are the things you can still palpate after they tear their myotendinous junction of their hamstring or their fill-in-the-blank. You know how we still have those palpable places where you're like, man, this just doesn't feel quite right. The athlete hurts there, right? Like those that's the hydration principle of that tissue is what will change it on ultrasound. I mean, that's that's been proven. I had that um I had that experience early in my relationship with the 49ers, and they had a hamstring that wasn't healing on their timeline. I mean, these, you know, talk about numbers, right? They know exactly to the day when these guys should be back, give or take, right? Because they've done it so many times. And they called me in on a special console. I flew up there and went through my process of treating this fascia as a delicate, intricate, fluid-filled structure, nothing else, no tools, no nothing. Pump the joint above and below to make sure I pull on the whole entire chain, only to move the fluid. Not because it's like five weeks, six weeks, all the scarring's pretty much done, right? The only thing the tissue has to do now is adapt to stress and load, which they have all that handled. They know how to stress the, you know, they know how to stress the tissue in the gym, no problem. Multi-angle and all of that. So I leave and I get an I get an uh a note the next day that, hey, we wanted to show you something because you know I've been I had been probably consulting with them for two years and talking about the fluid. This is since like 2018 or 19. But you know, it's hard because you can't see it and can't feel it, right? It's like my information that I got from this crazy French osteopath and all this stuff, and then you can see it and dissection at times. Anyway, they did an ultrasound right before I walked in, and they had an area that was showing up in the hamstring that was not it was like a dark spot on there that they had been working on for two weeks, and they said right after I left they did another another ultrasound and it was gone because the tissue had been rehydrated.
SPEAKER_02Okay, hold on. We here's an elementary question, but I think it's a big one. We talk about fluids and moving them through the fascia and the body and the lymphatic system and all that, but how do you know if you're hydrated well enough? How how can the average person listening to this or or or watching identify whether they're hydrated properly or not?
SPEAKER_00That's a great question. And I'm constantly learning about this because I don't use all these metrics that these professional teams do. The highest level metrics that I have seen so far in professional sports, any idea what what sport it is? I mean, we're talking about down to the I think you may have drank too much water kind of people. Do you know what sport that is?
unknownBaseball.
SPEAKER_03I'm gonna go ultra ultra marathoners or ultra marathoners.
SPEAKER_00No, professional professional soccer where the biggest money is. They know every single they weigh these one way is to weigh yourself before and after. I mean, that's pretty that's not a that's a really simple area of understanding. A gallon of water weighs eight pounds, you weigh yourself before a competition, you weigh yourself after. That gives you a general idea of how much water you lost. Okay, it's not everybody in the audience is gonna do that. The color of your pee is still hard to beat.
SPEAKER_02That's the easiest.
SPEAKER_00You know what? That's that's still really I mean, as long as you're within some kind of a window and you're not abusing too much water, which leads to its own problems, and you're obviously not dark yellow and all those other things, that's at least a good idea of of understanding your hydration. The other one that we like to do, um, which is a little bit more poignant sometimes with the athlete, is when the athlete's face down and you take the the layer of skin on their lower back and I pull it away from the underlying superficial fascia. If it's stuck together and I can't get it to separate itself on some level, then that and it hurts them, and they know that when I know and understand that that's a sheer sign that they are pretty dry.
unknownWow.
SPEAKER_00Now there's other reasons for that not being super pliable, but that's an e that's kind of an easy, dirty one as well.
SPEAKER_03That's good.
SPEAKER_02The idea of um identifying how much hydration, I mean, there's also over hydration. You know, uh but that my real my my comment is to the lay people out there that you know the these the opportunity to do body composition analysis and all that is so contingent on several factors. You you know, whether you went to the bathroom beforehand, you know, you y you want to measure at the same time, no diuretics. Did you did you have a you know big lean piece of beef before you got measured, you know, because those all change things. But uh do you have a suggestion as to when the best time to identify uh your level of hydration or your body composition analysis, uh, you know, lean body mass, things like that?
SPEAKER_00You know, I don't really, honestly. That's not like a measurable that that I use on the regular. So I'm sure there's other ways besides the ones that, you know, have been presented to me or the ones that I've experienced in other places in other locker rooms, like right next to the urinal, there's those little colored things. Seriously, in some of these facilities, like hey, this means you need to drink another two liters. If your pea's this color, you need to do that. So no, I don't really have any more sophisticated data. It sounds like sounds like what um Dr. Terry was talking about could be interesting, especially if you can see the interstitial water on that type of an image.
SPEAKER_03I mean it's pretty cool. But I also have I'm gonna parlay off of what Spencer said. We we've had we see these people carry around their jugs of water, you know, everywhere. And we've had guests on their show going, it's just ridiculous. Just drink on an empty stomach. What's your thoughts on when you see all these people walk around? I mean, they come into my office and they put their big jug on uh on the on the thing. What's your thoughts? What's your thoughts on that?
SPEAKER_00I mean, I would I just want to know what's what's in the water, where they get their water from, what kind what kind of container it's in. You know what I mean? And then are they adding chemical-based electrolytes to it? Because now you're just taking in some other synthetic that needs to be processed by the liver.
unknownYeah.
SPEAKER_00The volume, we c everybody wants to argue about the volume and how much everybody wants to ask me how much water. It's like wherever you're at, your kidney has to respond to this. You can't just start drinking three liters of water tomorrow if you're at like a one-liter person, or or everybody says the same thing. Oh, I can't do this anymore, Doc. I spent the last seven days in the bathroom ten times. It's like your body has to adapt, and you can't like you can't overshoot the one liter by two more liters. The body has a really hard time adapting.
SPEAKER_02You you your idea of or uh our idea of uh color uh getting the uh chart, uh the P color chart. You know what was funny is that people I always tell I often tell people to go ahead and you know grab one of them online, you know, just print it out, put it, post it on your bathroom wall, and then they'll ask me, they go, is it the color coming out or the color when it hits the toilet water? And I go, well, I think it's the color coming out, I would imagine. Yeah, totally.
SPEAKER_05That's awesome.
SPEAKER_02They often um I now this is crazy, but I just heard this on Instagram, and that was the the concern of using a stainless steel decanter for water if you're have putting electrolytes in there or whatever, you know, or or even um you know flavoring it with lime or lemon because it leaches out the the the some of the toxic metals that are part of the stainless steel, whereas the point being is that glass would be best. Obviously, plastics, we have a big problem with that now that people are much more aware of.
SPEAKER_00But have you heard about that? I I mean yeah, the quality of metal, I mean that conversation has been going on for a long time because of the quality of metal that's changed in in the cars that are made. But you can use any kind of quality of stainless steel, and you either will have an issue. We all know that if you use stainless steel on certain parts of your car or a bolt, that never goes bad, right?
unknownYeah.
SPEAKER_00So if you gotta have high quality stainless, I think you're good. But I think what happened is that market got saturated by everybody wanting to get in the game, and then now you have like really, really that's an alloy. What you just described is an alloy, which is a mix. Like, yeah, who knows what they mixed it with?
unknownYeah, yeah.
SPEAKER_00That's a good question.
SPEAKER_01Interesting.
SPEAKER_00Go ahead, Terry.
SPEAKER_02Were you gonna say something else? No, no. Okay. So let me ask you you know there are uh thousands of these recovery tools. If someone only had 15 minutes a day to where you would have them invest their time, what tool would you you know, what do you like most? What do you suggest to the maybe?
SPEAKER_00This is for tissue this is for tissue health, connective tissue health, like this conversation specifically?
SPEAKER_02Yeah. Yeah. I mean, we talked about, you know, from everybody's foam rolling, but what would you suggest?
SPEAKER_00Aaron Powell I mean, foam rolling, that's been disproven like as far as like whether it has a f a a positive fascial hydraulic fluid effect 15 years ago. No, I'm not here to argue that. I'm just saying like that's like there's a whole other thing that's going on with with using a foam roller, which you know, you if you've talked to somebody that foam rolls on a regular basis and I say that, they're like, you must be insane. What are you talking about, doc? You know nothing. This thing makes me feel so good, and this and that. I'm like, okay, take it away for five days. I can't take it away for five days. I got I'm like, so is it really changing anything? Anyway. Um the question was, oh, if okay, so what can people use? I mean for recovery? I mean, I think people need to go to the basics. I think we get s if you want a true modality that moves water and has a change on the on the on the water of our body, it's PEMF. But who's gonna I mean, I don't know who's gonna buy the right and everybody's not gonna go out and buy a $60,000 proper PMF machine. So if we're not talking about like that kind of level of treating in this realm that we're talking about, I mean that's why swimming in a pool on your days off and not pounding this body into the ground is so important for recovery. The real basics hydration, sleep, grounding, like those are things that everybody wants to skip over and start doing methylene blue instead. It's like what is your what's the what's your gut status? Do you truly have a oh well, I don't really know. It's like, why do you not know? Everybody wants to go look at the hormones all the time, and it's like everything is is established from the quality of the gut, including the quality of our healing and our tissue. So why not go there first? Not last on the list.
SPEAKER_02I'm so glad you're the PMF for the lay people. Yeah. Were you gonna ask that, Terry, or no? No.
SPEAKER_03I was gonna I'll let's let that go for a second.
SPEAKER_02I want I want him to mention that. Yeah. PMF. Uh what is it and why for the lay people?
SPEAKER_00Sure. Pulsed electromagnetic frequency. All of this water has a charge, right? Everybody knows water has a charge. And then very specifically, if you get into other other studies of water itself, we have structured water, etc. That's highly, highly um charged water. That's what we're a living body, and what does it get charged by? It gets charged by our mitochondria. Mitochondria doesn't just create ATP for the cellular use for energy. It also, these are also little capacitors or batteries in our body, and we're you know, there's way more of those than there are cells. So if we want to take that model of understanding, then we use pulse to let electric uh electromagnetic frequency, and that helps change the dynamics of the charge of the body, which also helps with the fluid movement in the body. And we use it, we use it very specifically. I hurt my knee. People use PMF, right? Like that's I mean, again, not everybody, but I think that's the one that most physiologically and histologically sound that we know of on the regulator. There's a couple of others that I don't understand the technology as well that some of my some of my other mentors use, um, but I don't understand the technology enough to mention it.
SPEAKER_03That's a great explanation I never heard of before. Terry, go ahead. What were you gonna say? Yeah, I I love I love using my PMF machine. I we use it all the time, and but I didn't look at from that angle. So thank you for that. You know, uh and if another thing you mentioned is you mentioned going back to the basics, and then you mentioned methylene blue. I'm I get so tired of seeing all these doctors and these celebrities trying, oh my gosh, I had this drop it, or I did this, or I did I ran this, these IV fluids, and I'm zapping it with this before it goes in the system, and people are forgetting the basics.
SPEAKER_00Exactly.
SPEAKER_03And we get so on this fringe, and people are paying thousands of dollars for this fringe work, but they're not really going back to the basics of moving, going on the beach, which Spencer does every morning just walking the beach barefoot and and moving and and stuff like that. So thank you for that.
SPEAKER_00Yeah, you got it. I mean, I think that's the most overlooked part of every athlete's puzzle. Like, what are you eating? Yeah, you know, what are you eating? What kind of water are you drinking? How well are you sleeping, etc.?
SPEAKER_03Don't you think that that's what social media pre um preys on or prize on if uh pray not but prize on is all these little things and people always searching for that quick pill, that quick thing, and nobody really wants to put in the work to go back to basics.
SPEAKER_00You said it, Doc. That's exactly right. Like it's sunlight doesn't make anybody any money. Grounding yourself doesn't make anybody any money, taking your shoes off and walking around in your you know what I mean? Like these aren't big, these aren't big moneymakers, but this is how you have a foundational hormone system that functions right because melatonin is the master hormone.
SPEAKER_03Yeah. Yeah.
SPEAKER_00I mean, so if you have if you don't have that right, like then we have a whole other cascade of problems. Why is it why do we have so much low testosterone? That's definitely one of the one of the reasons.
SPEAKER_03I love nobody sleeps. Well, that's one thing I love about my partner. You'll see him on uh like Facebook and he posts all these pictures of the sunrise and on the beach. But what people aren't realizing, he's on the beach probably barefoot and he's starting his day in just such a healthy component. But they're looking at the picture, going, oh, that's a nice picture. But they're missing they're missing the big reason that that of why he's even out there. And so, you know, um, I think people need to go back and and save their money for the skills of the hands, but really focus on getting their getting their basics back. What are some morning for people like Spencer and myself, do I go out barefoot out on the grass and I do my fascial balance in the morning and all that? What's some other things that basics that people can do just to get off their ass, out of their away from the computer, out of the to start their day?
SPEAKER_00I mean, just going for a walk. I mean, there's so much research and data that, you know, I think last time I was on your podcast, if I'm not mistaken, I may have been dissing walking at the time because I didn't think it was enough of an exercise. But honestly, the more research and the things that I've read is like, hey, that is a fundamental basic, it's a it's a highly integrated movement pattern. Like you talk about left brain, right brain integration, walking and swinging your arms and legs in opposition, and all of these things that are part of developmental stuff. Like if we lose that, we have all kinds of issues that can happen with the body neuromuscularly and otherwise. So I think walking, no sunglasses. We wear sunglasses too much, and I don't think people would necessarily do it in the morning, but our eyes are are the main photoreceptor of the for the melanin for uh for the melanin in our skin. It's not the skin. If we blind ourselves from the sunlight going into our eyes, we'll all get a sunburn. Because your body has no idea how to throttle the melanin.
unknownInteresting.
SPEAKER_00That was that was done. That was some ex again, nobody likes to hear about experience. They want to hear about evidence-based research, which we'll keep waiting on all of it for this fascial conversation. Um, but it was a dermatologist in San Diego that noticed that he had a bunch of people that drive because of the you know, sales people, they all sit on the same side of the car, they all have the same challenges, and he noticed that he had these two different groups of people. Um one that was spent six hours a day driving in the same sunlight, you know, with or without tint, didn't really matter in this. And then the ones there was a big difference. There was ones that got cancer, and there was ones that didn't. You know what the number one variable was? Whether they wore sunglasses or not.
SPEAKER_05No kidding.
SPEAKER_00No kidding. So I blue-eyed, I've been wearing sunglasses my whole entire life. I came across this, I don't know, ten years ago. I don't really wear them anymore at all. And my the the skin and my ability to react to the sun in Southern California is that like a I don't get sunburned anymore.
SPEAKER_03No kidding.
SPEAKER_00I love sunglasses. You know what? They're nice, they're nice at times, but honestly, so that's part of the answer to why to get out early in the morning. It's because not only does that set the tone for the melatonin and our circadian rhythm, step one, but it also sets the tone of getting light in our eyes, which you know, if you look at all the ancient historical text of what people used to do, they did sun gazing for a reason. That's how you stimulate your penal gland. Wow. Wow, very cool.
SPEAKER_02Let me ask you about uh a basic issue that most people uh come to us with, and that is, hey doc, my hamstrings are tight or my low back is tight. Is it you know briefly explain what's actually happening that's tight and what can you know, again, people are foam rolling, but or or or trying to stretch. Is there a suggestion or can you first share what tight actually means to that person?
SPEAKER_00I mean I don't like to question the athlete or the patient that their sensation is not real, right? So if they feel like their hamstring is tight, I'm gonna take it at face value that it could be feeling tight to them. But the number one thing that I think gets skipped over in all of this evaluation process and even training an athlete or a non-athlete is, you know, in the terms of my last 14 years of studying osteopathy, we call it the gravity line, but we would call it your static posture. If that is disturbed by more than a little bit, meaning we have too much weight on the forward part of our foot instead of where the weight's supposed to be at, we have compensations for that anterior pelvic tilt, all the rest of it. So if that is a piece of the puzzle, that needs to be addressed and changed, or their hamstrings will be tight forever. And with that anterior pelvic tilt, which is a bad gravity line, that's when the whole gravity line, instead of being north and south lined up from my pelvis to my head, everything, you know, the trunk sometimes in these athletes and people is like forward of the pelvis, right? And when you take the weight forward of the pelvis, you mandatorily for the most part have to rotate the pelvis kind of falls more forward, right? We get a hyperlodosis in some people, etc. So I think if that's not being managed properly, which is a very simple way to fix that, is not to stretch the hamstring but the hamstring, but to shorten them. Because that's that will upright the pelvis even more. So that's the hamstring conversation. A tight back, I mean, that could be related to the same dysfunctional pattern of gravity line, but I also think that we don't have a lot of strategies in the professional sports world that or with our patients that create more space besides just sleeping at night. And the LDOA, which is, you know, my mentor, you know, Guy Voyer, and the osteopath from France that I started studying with in 2011, he is now most well known on Instagram and other places with his LDOA concept, which is a specific exercise for each and every disc and also the shoulder joints and also the hip joints to create space, to create space at night. And that could be another reason because most people get shorter and more compressed as we age because of gravity and running and jumping and all those things. And we don't take the time at most most locker rooms and PT places or um you know uh athletic training rooms of professional teams, nobody's trying to create more length in their spine very often. You know what I mean? And that's a one-way street. And if you keep compressing it, I'm sure it feels tight in a 60-year-old patient if you don't fight for it every day.
unknownYeah.
SPEAKER_00So that would be my guess on hamstring and low back tightness. That works.
SPEAKER_02Well, we are going to start our rapid fire questions. All right, here we go. So good luck to you and brief answers.
SPEAKER_00Brief answers. Okay. I'm gonna short the big thing.
SPEAKER_02I'm sure you have the answers to every one of them. Oh, boy. The big challenge is brief. Brief brevity.
SPEAKER_03Don't you like how he sets you up? You know, good luck. Yeah. Yeah, totally.
SPEAKER_01All right. Question number one. What is the biggest fascia myth?
SPEAKER_00The biggest fascia myth is that it's a bunch of fibrous things that that put us together and that it's an afterthought. It's not an afterthought. It it was part of the embryological process. That's how it got there. We didn't go back in and spray paint fascia. Like that's a very, very misunderstood part of it. It's not just this light stuff in between the layers. It's the ligaments, the tendons, the periosteum, the disc, the the intervertebral disc, the cartilage of the knee, the meniscus of the knee. That's all menisc that's all fascia. Specialized.
SPEAKER_02I like that. I like that because you kind of touched off on that earlier. Question number two. Most underrated daily habit.
SPEAKER_00Most underrated daily habits. I mean, starting your day off with good, clean, high-quality water on an empty stomach.
SPEAKER_02All right. There you go. I thought you were going to say sleep.
SPEAKER_05I mean, you can't go without that either.
unknownYeah.
SPEAKER_02Question number three. One thing everyone should do every morning.
SPEAKER_00Wake up with a positive attitude and remind yourself and be gracious for what you have and the places that you, you know, your life. I think that's what I try to empower and instill in my kids. That's cool.
SPEAKER_02We just went from a uh show that delves into the physical aspect of our programming to the mental, uh, emotional part. Because it's all connected.
SPEAKER_00You know, your fascial health will respond to your negative thoughts, your negative food choices, your negative everything. Stress is the number one killer of the fascia. That's a problem in this country.
SPEAKER_02That's great. Question number four. One discovery you're waiting for science to prove.
SPEAKER_00Waiting for science to prove. I'd like to see a better an I'd like to see a better like video or something, and this is probably needs to be done. I don't know if it's gonna be done by me, but just to give people this idea of how the water moves in the body. Like I think there's too many separate parts that you have to know and understand, and very quickly there's a drop-off of understanding, and then it's like, uh, what's he even talking about? And I think that literally needs to be it needs to be proven because it will up everybody's game and how we treat this human body.
SPEAKER_02Well, well, now with all the AI tools, I'm sure that someone's gonna come up with it if it's not you. A good video. Right? Right, right, totally. All right, last question, Doc. What's something you've learned about being human that has nothing to do with anatomy?
SPEAKER_00That has nothing to do with anatomy. I mean, I think my biggest life lesson today is probably truly understanding the perspective and emotions of another human. I've read a bunch of books on like empathy, and like that's a real thing that used to be part of our part of curriculum for kids is to teach them empathy. And I think there's too many people in this day and age where we're all so worried about ourselves, et cetera, that we don't take the time for those around us, let alone anybody else, to really truly understand where others may be at.
SPEAKER_02Yeah, especially in the world of healthcare. You know, right. Think of think of any oncologist who tells you your diagnosis. It's so they're so aloof about it, you know?
SPEAKER_00Right, right.
SPEAKER_02Yeah. So I agree, and thank you so much. That was really that was probably the best way to end the the show. Thank you for being on. Thank you guys. Thank you.
SPEAKER_03And just s for so uh share some empathy. You know, we're so glad that we've met you and you're part of our our little family here, and and it's just it's so fun to have brilliant minds that just can sit and have these conversations. So thank you for your time.
SPEAKER_00Oh, I appreciate it. Thank you very much. I'll see you guys soon.