Navigating Pain and Fitness: Insights from Dr. Donald Mull

Welcome back to the Coach U Podcast! In today's episode, we have a special guest joining us: Dr. Donald Mull.

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Dr. Mull is here to share his insights and experiences on the current state of the medical system and the importance of collaboration in the health and fitness industry.

Dr. Mull starts by addressing the challenges of high demand and long wait times in the medical system. He believes that urgent care centers, while crucial for saving lives, often prioritize non-urgent cases and leave patients waiting. He advocates for the establishment of more accessible clinics and better reimbursements for healthcare services.

Collaboration and learning from others is a key theme in Dr. Mull's discussion. He emphasizes the importance of humility and being open to learning from professionals in different fields. By breaking down the silos that exist within the industry, professionals can avoid issues like under-dosing and injuries.

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In addition to his insights on collaboration, Dr. Mull touches on topics ranging from the importance of patient expertise in their own pain experiences to the need for a complete overhaul of the US healthcare system. He praises the US for its exceptional life-saving capabilities but acknowledges the system's shortcomings in preventive healthcare and chronic illness management.

Join us in this thought-provoking episode as we dive into the intricacies of the medical system, the importance of collaboration in the health and fitness industry, and the steps we can take to improve the well-being of individuals. Stay tuned for an enlightening conversation with Dr. Donald Mull on the Coach U Podcast.
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Please join the conversation!  Add comments or ask questions to start a discussion.

00:37 FPM seminars cater to unique health professionals.
05:04 Physical activity important for long-term health.
08:12 Learning from others, pushing industry forward.
10:54 Questioning basics, options, and leverage for health.
13:56 Low back pain cost rising despite advancements.
18:57 Options for pain relief: injections or surgery.
22:29 Guide, understand, provide positive experience, hit guidelines, reassure safety, avoid chronic illness, violate pain expectations.
25:33 Health care system needs holistic approach, empathy
28:31 US spends most on healthcare, worst outcomes.
30:10 Stop. Discipline can change life habits.
34:15 Following World Health Organization guidelines reduces pain.
39:12 Positive relationship with physical activity, expanding capabilities, enjoyment, positive health performances, important for those in pain, gamifying things, making it fun.
40:07 MRI not always necessary for precise treatment.
44:28 Gamification adapts to individual needs for maximum impact.
48:24 Meeting people where they're at, goal-oriented deconstruction. Strength and force for sports, varied approaches needed.
52:07 "Vaccination to decrease injury risk in athletes."
55:07 Trust people, be dumb, ask questions.
57:13 Jumping high, small hands hinder basketball dreams.

Donald Mull's Contact and Content Information 
https://linktr.ee/Kineticimpact

Transcript

Coach U: 0:18

Hey, what's up, everybody? Welcome to the coach u podcast. I'm your host coach U today. We're being joined by Dr. Donald Mull. What's up, Donald? How you doing, man?

Donald Mull: 0:27

Good, man. Thank you so much for having

Coach U: 0:28

me, dude. So glad you're joining us. We've had some cool conversations in the past and I met you in 2021, September 2021 at a small seminar. It was a very small group seminar here in Los Angeles, California, Santa Monica with Dr. Craig Liebenson and Dr. Ryan Chow, they led the group, First Principles of Movement. It was such a cool little group and we, it was like 22 of us, I think, and I loved it. What do you remember about that, that whole time?

Donald Mull: 0:56

Yeah, man, so I've been to quite a few of the the FPM seminars whether it be like assisting with Craig and Ryan or, or just attending and What I love about those it's all unique to and catered kind of towards the the group and audience man and it's always a group of a mix of ATCs, chiros, physical therapists, strength coaches, personal trainers, and what I remember most about that in particular was the roundtable. Kinda like round table discussions and, and see and hearing everybody's different niches and perspectives on how they work with people in the health and industry field. And then the collaboration and learning together and, and understanding the, the struggles that, that each profession has with working with humans and helping humans. And it was a really good, unique group, man. I loved, I loved Santa Monica.

Coach U: 1:47

Yeah, Santa Monica is pretty great, man. But you're not too far from Santa Monica. You're out in San Diego. Whereabouts exactly in San Diego are you?

Donald Mull: 1:55

Yeah, I'm in Northeast County. It's, it's technically 4S Ranch, a little small community outside of Poway, Escondido kind of like 40 minutes north of downtown.

Coach U: 2:05

Okay. Yeah, yeah. So you're right down there. Okay. And then that, that's where your your practice is. Can you tell us a little bit about your practice?

Donald Mull: 2:12

Yeah. So I started my practice right out of getting my doctorate in chiropractic. I got my undergrad in Kinesiology at University of La Verne, where I played football. That's kind of where it all started. Cause that's where my strength, I met my strength coach and he was like my second dad. And kind of where I knew I wanted to get into health care, went the EMP route, saw some deaths and was like, I need to have mad respect for first responders, but I want to, I want to help in the preventative world. So I looked into physical therapy in Cairo. I had never been to Cairo before, but I liked the ability to open access. Basically don't need MD referrals or anything like that. So long story short, met my business partner in school. We got along because we were just movement based. We were a little different in regards to our, to in comparison to our, our cohort. So we, we worked together really like throughout, throughout school. We started a practice on the corner of like a little strength conditioning facility, right on the turf, 2, 500 square feet, you have like seven independently contracted personal trainers and strength coaches that were just, and we just had two tables in the corner and we kind of grinded and started the business and grew from there. And now we kind of grew and we took over like a loft area and still had access to, to that that gym downstairs. We have like, now we have like a, a clinic gym hybrid. We see. A lot of general populations that just want to be physically active and realize like they've tried a lot of things and they want to be physically active, but something is getting in the way. So, it's not like we just treat low back, we treat all of it, the whole gamut and we see, we, we, our specialty is just helping people get back to being physically active and our main modality is exercise.

Coach U: 3:58

I love it, man. Well, I mean, they say do what you love and you won't work a day, right? So obviously there's a lot of work to be done. But you know, it's not just an easy road, but I will, you know, what, what, why do you love what you do?

Donald Mull: 4:12

Man, that's a good question. I, I, I think it's the, the ability to help guide somebody become stronger, the most, the strongest they've ever become. When they're the most vulnerable time in their life oftentimes people come to us and they're out there with them and they're super frustrated and, and we spend a lot of time with people. So sometimes like there's tears in the first consultation because it's a tough time for them. And then fast forward to. Two, three, six months down the road. And we're getting texts about the stuff that they're doing. Right. And you get it as a personal trainer, right? Because when you lift those physical limitations, it's not about bench pressing, I tell people all the time, like, yeah, it's cool that we can learn. Right. But like. When you pick up your kid and throw them in the pool and you don't have pain and you don't and you just realize that that's the first time you've done it in two years, that's powerful. And I think that's like the big reason. We know that we have an inactivity crisis in the Western civilization, United States, it's estimated that 16 percent of people meet the World Health Organization. Guide for physical activity, which is really not that much, it's 150 to 300 minutes of physical activity, moderate to vigorous cardio and, and two times a week resistance training. It's just really 30 minutes a day of huffing and puffing with a couple days of, of moving heavy objects. And not a lot of people get it. And I think for me, what I've realized, Is I can help people not only overcome these physical issues, but I can set them up with positive experiences that will set them up to have these tools for the rest of their life. Right. So they're less likely to die of these chronic illnesses. Right. The World Health Organization, they estimate that most people live 16 years of the end part of their lives with some sort of disability. So crazy. So it's, it's, that's incredibly powerful and my why is I watched my dad do it. He had a stroke at when I was nine years old and lived until I was 30. Right. So you do the math of how many years he lived in disability. It's, it's, I watched it firsthand. Right. So, so my why is, is I, I, I want to leverage my knowledge to help people live. Not just live longer, but stay young longer and, and, and really live quality life, but not just quantity of life. Right,

Coach U: 6:52

right. No, that's, that's the way you do it, man. That's where that's going to carry you. And people will feel that. And, you know, as a trainer, I've seen that. That when you're authentic and that people know that you care about them and their wellbeing, as opposed to just being a number coming in and out the door, it matters, it matters to them. And people can feel that and they know it's authentic. So I love that. You'd love that, man. You know, I love that. It's, it's been a personal thing for you too, because that's typically where we're going to get the best, most passionate work. So thank you for being that way with your work. So why do you think it's important? I want to go back a little bit to our seminar back in 2021. And why do you think it's important for coaches, trainers, and chiropractors, physical therapists, other health specialists to, you know, collaborate together, learn together, to be able to be open around each other and vulnerable.

Donald Mull: 7:39

I think, I think humility is important, right? I think the ability and the willingness to, to learn from other people will, is really the only way that this industry can grow. I think when we're too siloed in our, in our corners, we have this epidemic of physical therapists underdosing their clients. Or we have the, the boom and buff personal trainers that go super ham and, and their clients end up getting hurt because it's too fast, too soon, right? But if we learn from each other if we learn from the best strength conditioning coaches who get the best buy in for our programs, then physical therapists and chiropractors won't have this excuse of, oh, they're just not compliant, right? We'll learn from strength and conditioning coaches. They've been getting people to buy in for. Years for decades, right? They've been, they've been putting all this stuff and getting people to, to be physically active, right? And then vice versa. Strength coaches can learn from physical therapists and chiropractors in regards to like, oh, wow. When that happens, I gotta make sure that I gotta get them to see the right person and make sure that they're, they're good and they don't have any of these red flags that are life threatening or limb threatening. And I think if, if we just stay. With our blinders on, there's, there's no way we can learn from that. And I think I personally believe every interaction I have with any single human it's an opportunity to learn something from that person. Right. I, it's everybody has something that they could bring to the table. As long as I'm willing to listen and be open to it. And if it's useful information, I'm going to take it along with it. And I think that that's, I think that's how we push the industry forward because. In my personal opinion, I think we have a long ways to go and I think we have a lot of opportunity to, to gain allies with not only like our clients and patients, but also like the, our fellow colleagues in the industry.

Coach U: 9:32

I completely agree with that. And I mean, I did walk away with that whole experience as feeling, you know, as a trainer, not going, I didn't go to school for for exercise science. I went to school for broadcast journalism, hence all of this. Right. But you know, I, I put myself through all the studies. I've gone to seminars, I've talked to people. And that was the one thing that really stuck out to me was Everyone was open in that, and I learned from doctors, from chiropractors, from PTs, and strength coaches, and different, even in the training world, there's so many different specialties, even in the doctor's world, there's so many specialties, and so you can pull something from everybody. And that's something I'm, I'm glad that you're about as well, because, you know, I think nowadays, it's really easy to get into like a niche. It's so easy to be like, I'm all Kettlebell. I'm all X. I'm all Y. And it's like, why can't you just say like, I pulled this from Kettlebell World. I pulled this from X. I pulled this from Y. And you can utilize that and put it in your toolbox. You know, have that in your Calvary to be able to use later on. And so I'm, I'm so on board with you on that, man. Because I think being able to pull everything together to make your own arsenal is the best way to do it. And, and you're more versatile at that point.

Donald Mull: 10:39

I think that's important too. It's like a lot of people cling on to these techniques and, and they're very fatty and sexy and it makes for good posts. And yeah, like you can't, not everybody can use a barbell. Not everybody can use a kettlebell. Not everybody needs active release technique or all these clinical techniques, right? Like, There, there needs to be overlap in everything, and I think being a slave to a method puts the blinders on, and whenever, whenever I hear something that there's absolutes, I, I raise and I question, I become very skeptical because there's, the more I study the field of human performance and pain and pain, I, Just about human conditions. And the more I listened to very experienced individuals, the more I realized that A lot of the times, it's just the overlaps of people doing the basics really well who are very healthy, and there's so many ways to do it, and that's, that's my personal take home is, is, and that's encouraging to me because optionality is, is something that we can leverage in a very positive way and something that in my specialty, we've seen a lot of people who are concerned with pain is, is, is something that I think is, is very powerful. But it also on the human performance side, I think is very powerful, right? Because if you have an individual that's not comfortable, it doesn't like doing an exercise. Well, why are you doing the exercise? Yeah. Okay. If you know why you're doing the exercise. Okay. I got like 15 other options I can do to, to, to train that physical quality to get the outcome that we're looking for. Techniques aren't going to give you that methods aren't going to give you that. However, I think that you got to train within the box and master the box to be able to think outside of it. I do think that that's important. Like you can't just be like, I don't need any of this stuff about kinesiology, biomechanics, anatomy, all the hard stuff. You got to know that stuff and understand it, and then apply it in different ways, and I think that's the art of coaching, and the art of being a human, which I feel the clinicians aren't enough of, is just being a human. I'm just a dude that is going to do my best. I don't know everything, but I will tell you this and what I will promise you. I can't promise you being absolutely pain free. I can't promise you these elite fitness and performance goals, but I could promise you this. I will be in your corner and I will ride or die with you and I will figure out whatever I need to figure out and I'll support you. And methods don't teach you that.

Coach U: 13:28

You're talking there about chronic pain or pain in general. In other words, I want to shift to chronic pain a little bit more because, you know, it's something that. is prevalent in our world today. It's very prevalent, and I know it's probably because, yeah, we have more diagnoses and stuff. Sure. But the reality is that people deal with pain, whatever you want to call him. And I recently had a spat. You know that we talked about it on the phone. And you know, at the time we talked, and it probably was like three weeks, four weeks ago. And I was not in a good place mentally. I was, like, I just want to be able to walk without pain. It's like, how do you deal with it? And I really want to know how you deal with people who have chronic pain. What do you do, you know, you said be a human. I think that is number one. But, you know, what do you want people to know about chronic pain? And how do you help your patients with it?

Donald Mull: 14:15

It's a, it's a topic that, that could be an entire semester's worth of learning in and of itself. Right. And it's, and it's something that I think we're still learning so much about. And, and I think this is important to talk about because low back pain in particular is costing us billions of dollars, trillions of dollars, and we're not doing better at it. In the past 15 years, the cost continues to rise despite the advancements of technology that we have in regards to imaging and all the bells and whistles, all these fancy treatments and all this stuff. And why is it continue to get worse? One of the biggest things I think is that is important for people to realize is, is they are the expert. They, it's not the doctors that they are seeing, it's, it's them. Nobody experiences what they are experiencing other than them. Okay, so on day one, I make sure people know that, like they are the captain of this ship. I will do my best to help point two directions and see if we can take the best route and reroute when I think is best, but like they are the captain because they know and they are the experts of what they're experiencing. And the second thing is that you are not your diagnosis. I learned from Craig is don't let your biology become your biography. Just because you have a bulge this doesn't make you that bold. Yeah, right. I think that I think that's also important

Coach U: 15:46

What's crazy about that real quick? Is that I remember him talking about that and even as I was sitting there getting the MRI going over the MRI with the doctor Seeing that my disc was out so far there was fear that it's that sat in me and I work in the field So I can't even imagine people who don't really know about the body or have resources like I do

Donald Mull: 16:06

Yeah, and, and that fear has an effect on pain, right? Absolutely. that, that's another thing, I remember us having this conversation, I think, I think in, in regards to low back pain in general, I, I think there's a few things that I tell people that's important, right, and that I told you is, is that people have herniated discs and, and don't have any pain at all, right? And that doesn't mean that it's not coming, that, that you don't have pain in the, in the disc at all. What it does mean, though, is maybe there's hope that you can. You can have that disc herniation without any pain. And the second thing is that we know that disc herniation is healed. Actually, the worse the disc herniation, the better it heals. And so it's hopeful that it does heal without doing anything. And these studies were just 6, 3, months follow ups without really doing anything. And so, so time heals, right, for a lot of, a lot of things. That's hopeful that maybe it'll heal. Right. And then we know that a lot of things have an effect on pain, whether that be what, what you've experienced in the past, what you expect to happen in the future, what mood you're in, right, does that elicit fear, like you just said, probably going to elicit more of a heightened response. So what you eat, right? Do you get sleep? Like all these, these health things that we can help people with. That can move the needle a little bit if we have this conversation, it's a lot more reassuring, right? But, but let's imagine having somebody going into their urgent care because, they picked something up their back went out. Right now they're in the urgent care and you know, or the emergency room even better and it's really crowded and and it's and and they look over the right and they have somebody with a broken arm that's crying. They look over to the left there's a laceration wound that's just bleeding everywhere. And there's people running everywhere and they finally get back after two hours and they talked to the doctor for two minutes. They did x rays, and they said they're all good, and they gave them, some medication, and they, they told them that, Hey, if, if things don't get better, you're gonna need to see an orthopedic, and you may need to get surgery. Now, compare that with the conversation we just had. And let's say that it's exact same changes and exact same quote unquote diagnosis. Who may have the better outcome? Probably the previous one, right? And I think that's important. And the final thing I would say is expectations that there will be ups and downs. There will be flare ups. I think

Coach U: 18:39

that's a huge point. That's a big, big point. It's easy to forget that because pain is tough, man. Especially, I've never experienced pain like that before. That was another level, dude. It takes all of you just to be and to like, live. Without like thinking about the pain. So having the positive outlook and knowing, Hey, there are going to be ups and downs and you got to expect it. It is a really big point that I think more people need to know, but like you can't really set people up sometimes for the expectation of the down. Cause the down can sometimes be really rough

Donald Mull: 19:16

Yeah, absolutely. And I, and I try to do my best and I, and I try to let them know, like, listen, like. Like if there's like our options, if you're not getting better or if it's absolutely miserable, here are some options and there are options of cortisone injections or epidurals and pain management stuff like, yes, we have this preconceived, I think in my field, we have this preconceived notion that nobody wants to have surgery and nobody wants to have these medications like, yeah, most people don't, but some people just want to get out of pain, right? And if we look at studies like They, it, it, people have fairly good results who fail conservative care when they, when they have cortisone injections and and or epidurals. Right. And there's fairly good results there. Right. And I think the problem becomes that if people use them on a regular basis, right, like, yeah, I wouldn't, I wouldn't, I wouldn't be like, Hey, every three months you should, you should, you should take these shots. But like we. Yeah. If someone's in miserable pain, then we have to let them know that there's an option, right? But there will be down, right? And that's why I think it's on our end as clinicians, this is where I think the big things that, that our jobs are, it's listen without judgment and understand someone's story from top to bottom, right? Like, what

Coach U: 20:40

does that mean to you? Yeah,

Donald Mull: 20:42

like as Ted Lasso says. Be curious, not judgmental, right? So when somebody comes into to me, and the first thing I, I learned this from Peter O'Fallon is tell me your story, right? And I listen, because the, the average doctor, it takes 5 to 11 seconds For them to interrupt, because they want yes or no questions. Do you have numbness? What type of pain do you feel? Does it go down your leg? And it's this banter of just them leading the conversation. Imagine going on a date like that. How long would you last on that date? I'd be like, I'm out of here. So to me, it's just about listening. I shut up and listen. And I am... And then I ask open ended questions, like, what does that mean to you? Like, what, like, that question there was perfect. That's how it asks, like, what do you think is going on? Like, what does that mean to you? Because I want to know what they are experiencing. And what their understanding of that experience is. And then I can have a better idea of how I can help. Right and I have to be serious. And, and let them talk. Or else I'll never know and understand how I can help them. And help guide them. Right, and then the second part is validating what they experience. Right, like listening is one thing. Right, but I need to be able to validate like, and say like, I understand. I understand this is like frustrating. But whatever the emotions they're feeling, I want to make sure. They know I understand and that I truly believe them and and understand what they're going through to some degree. Yeah. I may, I may have never experienced it, but that, that alone goes a long way because a big issue that, that clients would come into me, their number one thing is I've never had anybody. that actually listened to me.

Coach U: 22:45

That alone is huge.

Donald Mull: 22:48

That's the only way that I can guide and direct and understand what we're going to do next. Right. And then, and then for me, what happens next is like, if I can provide a positive experience with movement, right. Cause that goes back to my wife. Like, I want to make sure that this person is confident enough to, if they're willing and have a good experience with it, to hit those, those. World Health Organization guidelines for physical activity and be healthy for the rest of their lives. Right? So they don't have to live the last 16 years of their life with disability or chronic illness. And then last but not least, I make sure, I reassure them that things are safe. Make, after I rule out all the red flag stuff, make sure they actually are safe. When they are ready though. And, and oftentimes that's after they feel movement and they feel safe and they've violated some of those expectations that something was going to be painful. Right. And then at the end of the day, I, I'm there to support them. Right. Like I pride myself on. Being there for them, you can text me, you can email me, like, let me know if you have any issues. I want to know real time feedback. The next time you come in here, I don't want you to be like, I don't really remember. Right? So like, I text people and I say, Hey, we did a lot of movement. How do you feel? Right? And I let them know that I'm like, there's support there. Yeah, that's a big part of being healthy. It's feeling a part of a community. And this is why one of our values at Kinetic Impact is family. That's our number one value, family. Because that's a big part of health. If you feel as though you're a part of a community, that is a massive sign of health. Just like not smoking, not drinking too much. Outside of being social, right? Because again, community, right? And then being physically active and not eating processed foods, right? Those are really the big five things of health, right? And community is huge, right? So to me, I think support is a massive massive components that we use to help people in chronic pain and, and who have been dealing with issues for a long period of time. Because it's a lonely thing to feel as though you can't do the things you want to do because your body is stopping you. Yeah,

Coach U: 25:11

no, it's tough, man. And, you know, being able to bring it back to them and revolving it around their life, checking in with them, making them feel part of that community. There's an aspect there of being seen, and being understood, and being heard, and all of those things are so important because you could feel alone during pain, you could feel alone during those times where you have the downs, and having someone check in on you, it could be the simplest thing, like a text like that, you know, like, Oh, wow. Someone's got my back like that is so big, so much bigger than I think people realize. Trainers can do the same thing. Doctors can do the same thing. Physical therapists, chiropractors. We are like everybody can check in. That's our job, right? It's not just one thing, right? We're not just we're not in this one category of whatever profession we're in. Part of that is what you said, the health. And I think that's, I'm so glad you said that because it is nice to be able to support people in more ways than just showing them how to squat and lunge and sprint. We talked a little bit about, you know, the healthcare system and. Not really taking the time to get to know the patient, the story, the background, and allowing those open ended questions to be answered or even asked in most cases. Why is it really important though for our healthcare system to start to implement these things? What big changes would you see happening if that were to take place?

Donald Mull: 26:30

That's a tough one. I think I'm a little cynical in this regard because I think there's probably too many vested interests to to make those big changes because there's essentially when you go in and you get treatment, right? There's billable units, right? And things like this is hard to bill. So at the end of the day, it's a, it's for profit, right? These hospitals are, most hospitals are for profit and insurance companies are private, so they got to, they have their bottom line too, right? They got to be able to make profit. They have to make sure that if they're public, they have to make sure their shareholders are healthy or I mean, sorry, happy. Right. So it. And this is what I think the biggest thing. I think if we want to make big changes in health care and make a bigger impact, I think there needs to be a non transactional relationships, and I think we need to value people over profit. Right? So, yeah, it's not going to make you a millionaire and or put you on Forbes Forbes 500 list. Like some of these insurance companies are, it's just not set up that way. Right. And I feel for the people that work in the medical system. And I feel for those clinicians, because they have to see so many people, they have to, there's no way it's set up for them to see a person. I see somebody for 60 to 90 minutes when I first on their first visit. There's just no way that the medical system is for set up to see people like that. Because the demand is too high. There's, there's too much volume there, right? There's too much need. You can't go into urgent care and see a doc for 60 minutes because they have people, they're saving people's lives. I think that there just needs to be more direct access to these types of clinics. And there needs to be better reimbursements for it, right? If, if there's not, there needs to be reimbursements based off of seeing people and whether it be for time or, or what it. There would have to be a complete overhaul of the medical system. And I think I'm a little cynical there and I hope there's a change. I do. I think it's going to be in my professional lifetime, probably not, but I think in order for it to change, there needs to be a priority into people over profit, right, right now we spend by far the most money out of all the top grossing GDP countries. By far the most money in health care and we have by far the worst outcome and a big difference there is how we run insurance and a privatization of insurances and all that stuff, right? But regardless, the outcomes in regards to health, health like lifespan expectancy and all that stuff that measures outcomes of health. Well, by far the worst, but we spend the most up there, right? So it's, it's, it's really tough. And I think, and I think if we're going to be really critical of ourselves, it's when we're really good at a lot of stuff, we're just not really good at, at helping people. with preventative health and helping people who have been dealing with stuff for a long period of time and preventing people from chronic illnesses and musculoskeletal disorders. And outside of that, we're great at saving people's lives. And I'm grateful for that. So it's

Coach U: 29:54

all the preventative stuff, right? Could we, could we argue that, as you were talking about earlier, consistent movement is gonna improve health. And not just like training in the gym, but, you know, movement in general, taking care of those five factors you talked about earlier, you know, as a trainer, as a coach, I try my hardest to inform people on ways that they can take care of themselves. And I do think that Sometimes it goes over their head and I don't, not because of the explanation, but because they're already dealing with so much other stuff in life. And the reality is making those changes is not simple. It's not easy. Everyone talks about it being simple and easy. Stop. Okay. Some things can be, and yes, it is a discipline thing. I think to an extent, but I also think it's a life thing and it's a life changing thing. It's a habitual thing that can over time change. And I think that's where I could argue trainers and coaches, chiropractors, physical therapists, everyone in the health, field who see patients and see clients, we can take part in this together by saying, Hey, I know, I know what's going on in life. Let's, let's work on maybe shifting and getting you into more of a habitual way to take care of yourself to prevent these things ahead of time. I can, we can argue that because that would say, well, now I'm not going to go to the doctor when I need to. You know, because I'm already at that point that I have to go. It's like if there was a life threatening thing, or obviously if there's, you know, God forbid something, you know, that you can't control like a cancer, possibly a mental disorder, we don't know those things necessarily, but I do think that being consistent in the messages that we're giving to our patients and our clients are going to be so helpful. And then building that, I want to say, confidence and being able to do that for themselves. Because it's not easy to do, and I'm in, I'm in the freaking world of it, you know what I mean? Like, even I have issues with it sometimes, and that's just life. That's just how life goes sometimes.

Donald Mull: 31:47

Oh, man. That, I mean, it's beautifully, you said it beautifully, right? I mean, confidence is a cornerstone of performance. If we, if... And if that person doesn't have this is why I prioritize I don't, I don't have like a templated stuff exam that I do with every single person. However, I have a checkmark of what we talked about what I do with every person, and one of them is create a positive experience with movement, because confidence is a cornerstone of performance. Right. And if that person doesn't have the confidence to do those things, then, and to be physically active, then it doesn't matter what. exercise routine I give them, like they're not, they're not confident to do it, right? You can write the best program in the world, but it doesn't matter if they don't do it. I think we're in the front line of defense, right? If, if we're going to be real strength coaches, and personal trainers, even, even more so because you guys see people that want, that want to be healthy it's on our shoulders to create that positive experience, I think there's a lot of barriers in fitness where it's like consumers think that everything needs to be perfect. I need to hit all these numbers like I'm a bodybuilder in order to be healthy, right? There's not a lot of people preaching to people that just 30 minutes of huffing and puffing a day or just going on a walk, right? Meeting people where they're at. And I think that's the biggest thing. If we can meet, if we can meet people where they're at and create a, an achievable plan that creates tangible hope. Then, then we're on to something then we can, okay, then maybe we can leverage this walk that gets you outside, that gets you away from the stressors, that helps you recover, right? Because now you're away from the emails, you're away from all the stuff that's providing all this stress and, and, and giving you this vicious cycle, which is causing all to be a portion of the cause of all the stuff that you're going through. Now we're on to something, right? And that's a part of it. It's easier than people think. And I think. We've seen this. The people that know the World Health Organization guidelines for physical activity, and I keep, I keep referencing this, not because it's a perfect number, it's just a reasonable, achievable number that we see a drop in chronic illnesses as a result of those who adhere to it, right? And those who know them, are much more likely to adhere to them, but how many clinicians know that I don't know the number off the top of my head, but it's not very high. And if they don't know it, they're not telling it to people, right? So, and then we know also that those who adhere to the World Health Organization guidelines are 2 times less likely to report pain of any kind. That one is, that one's done by Michael Ray and Paulie. He's a professor now in Virginia, but I could send you that one that last one about pain. It's a lot easier to get somebody to be physically active than to tell them to quit smoking if they're smoking we have numbers to prove that. But if we don't know the, the, the basics. As clinicians, then how are we expecting our society as a whole to become more active, right? How do we expect that 16 percent of people who actually adhere to the number to grow? Until we do that, I think, I think we're going to be, it's going to be a slow grow and this is why that's my North star. If I can get somebody to adhere to those, that's, that's, that's phenomenal outside of that, everything else is individualized.

Coach U: 35:41

I do think education,, is really important and it doesn't have to be, you don't have to know all sorts of anatomy and all sorts of exercises. I think it is an intimidating thing. It's something that I've been really passionate about when it is at like entry level stuff for people to work on at the gym, just to take care of themselves name at the gym. But like you said, go for a walk. And I think it is our job to, to, to tell these, to tell people these things, because if people don't know, they're going to be more intimidated because people walk into a gym some people that are in the gym are just in crazy good shape, right? But we also don't know that person's reality. And I think people need to understand that too, that first of all, that person's probably been working at this for years. Secondly, they may have way different goals and they probably have a completely different anatomy and physiology than you do. And like you said earlier, being able to tailor it to yourself and meet yourself where you are. It is so important., I have friends who are in the training world. I have friends who are in your world and you know, all in the health world. But I also have friends and family who Don't do any of this stuff. I always recommend people work with a professional, you know, get help at least for two, three months, get, get a rhythm down, get something to get you into a routine. Because I think that is more important than figuring out what the best exercise is for you. I think you need to figure out the routine of making it happen. And as you pointed out earlier, expect the ups and downs, there's going to be weeks that you're going to be just. You have so much energy, you're in a good mood and then the next week, Hey, you know something happened, you lost a sale. It meant you're not getting as much commission, whatever the case may be, life factors will happen. And understanding that the consistency is the number one thing, finding your routine. And then also something that makes you freaking happy. Do something that makes you freaking happy, man. Like if it means going and playing badminton or throwing a tennis ball against the wall, I taught one of my clients I gave my client three tennis balls and I was just like. Go, go outside and throw it against the wall and just try to catch it in the opposite hand. Just step with, you know, that doesn't, like, try to block it. Don't let it go past you. I don't need any objective outside of that. Just go throw a ball against the wall. She's a writer, and so getting her away, as you said earlier, away from the, the thoughts, the, the emails, the phone, anything that just gets you moving, get the blood flowing. That in itself is such a healthy thing. If your main objective is not to lose weight and not to, build muscle like a bodybuilder and you're not trying to run for a marathon, you're just trying to be someone who's a healthy person for yourself and your life and your lifestyle. Find out how to have fun. Find out how to make that part of your routine. And she loved it. I remember coming back the next week and she was like, I go out here all the time now. Like she's like two, three times a day. She'll go out there and you can imagine like that's probably more work than she was doing. That alone is a different style of movement that gets you in a flow in a different way. And also builds a little confidence too, because she's not an athletic person. So you can imagine like being able to accomplish something that you're not, I'm going to say good at, quote unquote good at, in comparison, whatever, to other people, but it's not something you're doing on a normal daily basis. And so being able to accomplish something like that, I think is so cool and it's key to building that healthy relationship with health, it's a really simple thing. Here's some tennis balls, go throw it against the wall, let it bounce if you want, try to block it. It's, it's the simplest things. It was our objective to get her heart rate to skyrocket and work on hit and work on all these, you know, different kinds of conditioning tools, no, no, it was to get her to move and to get her brain off of what work she was doing. That's it. Super simple.

Donald Mull: 39:31

There's a positive relationship with physical activity outside of the stuff that she would normally do. So not only is she expanding her, her broadband with, if you will of being physically capable, but she does it. Yeah. And I think that catapults for positive experiences and positive health performances in the future. And and I think that's important for those in pain too. And I think that, that sometimes it's an example of gamifying things, right? And and, and, and making it fun, right? If somebody can have a positive experience with doing a squat. In different ways when they had ankle pain before and and we can get them moving around and actually feel like they're working out their legs without even needing to squat and they had a good positive time. Perfect. That's, that's fantastic. Outside of let's get an MRI and see what tendon is, is quote unquote abnormal, right? Because again, we're not this bag of bones and tendons and, and ligaments, right? Right. We're beyond that. We're a living, breathing, understanding creatures that it's more complex than that. And that complexity brings optionality and for most, for the most part, most, I can't really think of very many conditions musculoskeletally that, that need, a very precise, treatment. For a precise diagnosis, and I think if you look at it that way, then you start to realize, Oh, is this MRI necessary? Is this now we have to defer to the context and make sure that you rule things out, but it's most often a a very specific quote unquote diagnosis and specific quote unquote treatment isn't really necessary.

Coach U: 41:30

What I want people to understand too about our conversation, specifically this topic is we know that this is not what we would do for an athlete, a high level athlete, or someone who had bodybuilding aspirations. Every single person's plan is going to look different I had my volleyball kids with my, so the volleyball team with the girls basketball team. And I had them do one of Craig's favorite, put a cone on your back, let's bear crawl, see who can knock off the cone. I put them on teams, I had teams of four all in the weight room, and they had color cones, and, you know, who was the last team standing. They, they did their bear crawls, they did it, but it wasn't because I told them to, it was like, hey, this is the objective, here's the game, go try it. And they had a great time. And there was smiles, and there was laughter. You should be having a smile and having that healthy, happy feeling about training. So what, what do you, what do you see when you work with your patients and you gamify things?

Donald Mull: 42:26

I think it comes back to the context let's say I have two different people come in. Both have an MRI and the picture is of their knee. And it's a meniscus injury. Let's use that because it's a very common condition. Injury, a meniscus and cartilage injury inside of the knee. Both of them have that. Am I going to treat this person the same? I don't know yet, now let's give you more information. One is a 20 year old who is a college student has a scholarship that is academic and does quite well. Stress levels are fairly low. It's the middle of semester. There's no tests coming up. There's no issues there. The other person is 32 years old, a single mom, and she has two kids and works three jobs. And,, doesn't have any training experience. Well, this person played a lot of, a lot of high school sports, the original person, the 20 year old played a lot of high school sports and actually had a personal trainer when they were 12 years old, all the way until they graduated. Am I going to treat this person the same? The answer is no. And I'm going to probably gamify to earn this person's trust, gamification for me is gaining trust, right? But if there is a lot of stress, stressors, fear, worry, concern, that's going to be my main priority. The soft stuff is going to be my main priority. And that's going to be my main goal. Now, if there is not a lot of fear, worry, concern, and they're open to doing a lot of stuff and exploring. Physical qualities become my main concern. So then I'm going to gamify based on the physical qualities I'm trying to develop. Let's say quad strength, right? Well, then I'm going to have a bear crawl where I may be holding a position where one leg is covered and there's a time test. Okay. Last week you had 25 seconds. You think you can beat that? Okay. We're going to hold for this amount of time because I'm just trying to develop the quad. Because there may have been a deficit. So there's, it's really dependent upon what I'm trying to achieve, right? I feel like gamification fantastic. But I think we have to look at, like, what you're trying to achieve in the specific context. Because this person, who has a lot of experience and may be very developed and understanding of what he, what soreness is, and doesn't have three kids to worry about and put, put food on the table for, and all the life stuff, right? I have to treat these people completely different. And that gamification is going to look massively different, right, for, for each individual based on what's going on with them. So my triage is, is this person concerned? Well, if they're concerned and worried and fearful, gamification for me is going to be geared toward making them more comfortable and having trust in their body. So it'll be minimal dose, very minimal dose because I don't want to create a fatigue response or a soreness response because that's going to drive fear, worry, concern. If that stuff isn't a worry and everything's all good, what physical attributes am I trying to develop? Is it a a specific muscle? Is it a pattern of movement? Is it conditioning? Is it shocks and springs and being able to move and cover ground and absorb forces and produce force? Then I can be like, okay, now let's create some games around this and gamify it. Because, because if we're just randomly doing gamifications, it becomes... Pretty risky, in my opinion, because you can lose trust because all these things are developed to provide positive results. Positive results is like a trust bank. And the second we lose trust, as you know, I've learned this from strength coaches. The second we lose trust, then we can't get the buy in that we need to get people to trust us. And that's fair. Right? Because it's on us to be, it's on us to guide, right? We're, we're, we are the ones that have experience in this world and they rely on our experience. So I think there always has to be a why behind the what. But again, I do think there's so much room for freedom, like we were talking about earlier. And at the end, like we got to prioritize the positive experience and the positive relationship with movement. Right. And if that, if that bucket is okay, then yeah, sure. Let's get specific. Let's get, let's see if that, that, that calcaneus is everting. Right. I'm down to, I'm down to get into the nitty gritty, but I think that that's not priority in most cases. I

Coach U: 47:32

like that. I like having the parameters on there because it is what's cool though is in each category. There is a way With each of these two scenarios There's a way to gamify and make it something that can build that buy in and trust But you do have to have the parameters you have to have your your boundaries. I want to go into returning to play. This is for everyone you know general population the people who aren't really necessarily focused on Athletic play, people who do play adult sports, right? And softball, tennis there's tons. Pickleball is a big thing now, you know, being being injured and then being able to get back to that. is difficult, you know, and strength is typically a thing that's like, Hey, this is what you need. You need to be strong, but when it comes to other things that are aspects of the games, cutting and sprinting and jumping and impact, like you said, you know, with the mom of three versus the college student who played a lot of sports early on and had a trainer, probably gonna treat em a little differently. So when it comes to these things, how do you prepare the body to go to the next level so you are getting back to play the way that you were? Yeah, I think there's

Donald Mull: 48:44

two big things. It's, it's again, meeting somebody where they're at, understanding where they're currently at, and then starting with the end in mind and deconstructing from the goal. If somebody's goal is a field sport or a really a team sport of any kind, it's very similar, especially with like the lower limb. I think you need to be able to have strength around the joint,, that is affected,, on both sides of the joint that is affected. And, and I think you need to be able to produce force vertically, horizontally. And laterally, and be able to change direction and I think that there's many ways that you can do that. I don't I don't I personally don't think that there's like a right or wrong test. I just think you need to cast a wide enough net. To get a good enough understanding where the areas are that that person needs to develop. This is normally like an acute injury, right? Like they roll their ankle and they're trying to get back and like stuff like that. So there's oftentimes less, psychological and sociological barriers and obstacles, not that there wouldn't be, but, it's, it's oftentimes like, Hey, I tore my hamstring or tore my ACL or I tore in baseball. I tore my UCL. It's really just developing those physical qualities. If we cast a wide enough net, we have a better understanding of like what needs to be done. Where I think the ball is dropped is this process when I see patients that come to me for ACL, not a lot of PT places are looking at this stuff. And if they do, they look at, they know the research that after nine months, there's every month after nine months, there's a decrease odds of retearing. So like, there's a general understanding there. I always see, but I hardly ever see it. a athlete come to me and say that they've done quad strength testing, hamstring strength testing, calf strength testing, vertical jumping, horizontal jumping, lateral jumping, and change, a change of direction. I don't care how you measure it. ACL research quite a bit. So if you just PubMed some stuff, you can figure out how, which ones that you want to combine and do. But you got to cast a wide enough net to understand which of those do you need to work on. And I think that is missing in the current PT. And I think that the lack of strength and conditioning knowledge, I'll go back to full circle here is a lot of PTs don't learn from strength coaches. A lot of the stuff that I'm learning about is from a strength coach or multiple strength coaches and PTs. But there's a lot, there's a lot of crossbreeding there. And I think, those, those developed, those, those qualities need to be developed, especially in an ACL and a hamstring, you got to be able to sprint, nothing in the weight room is going to expose an athlete to the stressors they get on the hamstring when they play more so than sprinting. There's nothing that can replicate that. So, so knowing how to, to slowly progress somebody would probably. The best to learn from, from people that are working with the fastest humans in the world and how they progress with them. Right. And those are strength coaches. Those aren't PTs. if we don't expose the athlete that has a hamstring injury to high speeds and sprinting, we're doing them a disservice that's that's as Dan Pfaft, like that's, that's vaccination, that's their vaccination to, to decrease the severity. or risk of injuring that hamstring. So if they, if they're in, in practice, if you're just telling them to return to practice, right? And then we put a GPS on them on a soccer player and they're hitting 15 miles an hour. And in the games, they're probably going to hit 17, 18 miles an hour, right? It's going to be faster. So if they're not hitting. 17, 18, 19, 20 miles an hour on a regular basis. They're not vaccinating themselves to reduce the risk of injury. Again, that's Dan Pfaft is, is a world renowned strength coach that has made athletes gold medalists. So I think learning from those is is massively important because in sports, what do you do? You sprint and then you walk and you recover and you then you sprint. So if you create this buffer, I think that's our job as both PTs. And if, and if the physical therapist don't have the means of doing this in regards to equipment or space or whatever it may be, I think if you're doing it, that athlete a disservice, if you don't have a relationship with the strength coach that you trust. Because that because this stuff to me, it's a no brainer, I think, I think if you're looking to get back to performance after an injury, I think you need to have these assessments that cast a wide net that gives you confidence because confidence is a cornerstone of performance. And if you, you really want to be confident, you know, that you check all these boxes that you're hitting 19 miles an hour. Multiple times, well then you'll probably be more likely to open up and go get that ball right and, and have confidence in it, right? Or if you have an a c l and, your right leg, that was, that was the surgery leg is now as strong or stronger than the, the left one that didn't have surgery in quad hamstringing, vertical jump, horizontal jump, lateral jump. You change the direction, you'd probably be a lot more confident. Yeah, but I don't see it. I don't see a lot of it in regards to suggestions from surgeons nor physical therapy clinics. And I'm hoping that that changes. I think it starts with the humility of, again, the health and fitness industry.

Coach U: 54:57

It's full circle, like you said earlier. It really is. I mean, that's, that's the whole idea, man. Which is a good segue into, I got two questions left for you, man. being able to keep up with the trends in the PT, the physical therapy world, the personal training world, the strength coach world, like. It just feels like we're bombarded with stuff daily and you go on Instagram and YouTube and everyone's got something to say. They have an exercise or this to show you for specific things. How do you keep up?

Donald Mull: 55:26

I learned this term from, from Lee Taft is like, have your board of directors, and have the people that you really trust and the people that elevate you. I really do my best to be the stupidest person in the room. Sometimes I don't have to try very hard, but but like, For me, like my mentors and a big one is Dr. Craig Levenson, who we talked about earlier. Dr. Ryan Chow. People that I can lean on and ask questions. And then not only them, I'm really close with, but people that I can ask questions and reach out to about specific stuff. Like if I wanted to help an explosive athlete, I'm going to, I'm going to reach out to Fred Duncan. If I want to, to help people, help somebody get. Program change of direction, I can reach out to at least half, like having people that you trust in certain areas that you can reach out to, I think is a big one. And then secondly, is I try to use my Twitter feed as, as like a morning newspaper, something that Craig, Craig kind of taught me is I tried to do my best to at least read an abstract of an article a day, if not like a full article a day. And something that Fred has pushed me on doing is writing a little bit more and trying to teach a little bit more. So like taking that stuff in and, and, and just writing for myself, not don't have a plan. Like I'm not like, it's not for SEO. It's not for this. It's just. Digesting a concept and writing it down to hopefully, for me to better understand it, but somebody else as well.

Coach U: 56:58

Yeah, writing is such a powerful tool, man. I like the idea of Twitter as your newspaper. That's pretty cool. I do enjoy learning in the morning. This is just a random question. Rapid fire here. What's been the toughest thing for you in your own health and fitness journey to get down,

Donald Mull: 57:15

I'm currently trying to dunk right now and it's It's been a year's journey. I Went on this journey because it's something I I wanted to do in my 30s that I haven't been able to do in my 20s How tall are you? I'm like 5 11 Okay, I could I could I could jump up and touch 10 foot 9 inches, but I have really small hands And I have a an issue with when the basketball gets in my hand. So I'm really close. But it's I am that, that client that has a lot going on in life. So I, it's, I, I'm not, I can't just dedicate my entire life to it, but it's tough. That's

Coach U: 57:57

fair. You'll be there. You're going to get, you keep the consistency going, man. You're going to get to that dunk. We'll be seeing you hopefully doing a windmill soon. Let me get up there floating. I want to see it, man. I want to see it. I got your link tree here. I'm going to make sure that that is put into the show notes. is there anything that you have going on that you want to share with folks or just let them know what you're working on and what you offer?

Donald Mull: 58:19

Nothing in particular, man. Just try to try to keep some information current on on our, our Instagram. So you can check that out. And our YouTube, you can check that out. And and also, too, if you want to just personally reach out to me, you always can. My email, like Donald Donaldmull1@gmail.com. That's my personal email if you guys, anybody has any questions? I'm game.

Coach U: 58:38

Yeah, Donald, definitely man, you, you, you hooked me up with,, some great information and you're definitely very helpful. We covered a lot today. I really appreciate your time and your knowledge. Hope you enjoy yourself, man. Thank you so much for joining us today on the coach U podcast,

Donald Mull: 58:51

man. Thank you so much. Thank you everybody for listening. I, I'm humbled, grateful, and can't thank you enough. Appreciate you, man.

Coach U: 59:00

We'll talk soon, though. Thanks, brother.

Donald Mull: 59:02

All right, brother. Have a good day.