Behind the Bluff
Uncover best practices to participate in life on your terms. Every week, hosts Jeff Ford and Kendra Till guide listeners with short conversations on trending wellness topics and share interviews with passionate wellness professionals, our private club leaders, and additional subject matter experts offering valuable tips. Each episode conclusion includes Healthy Momentum, five minutes of inspiration to help you reflect and live differently. Subscribe now and discover the keys to living your greatest active lifestyle.
Behind the Bluff
Soft Tissue 101 | Dr. Gray Stahlman
We map the soft tissue system that drives movement—muscles, tendons, ligaments, fascia, and scar tissue—and explain how each heals. The through-line is durability: balance training, recovery, and mobility to prevent overuse, reduce pain, and move well longer.
• defining soft tissue and why it fails
• muscles as motors and why they heal faster
• tendons as ropes, tendonitis vs tendinosis
• ligaments as stabilizers and why sprains linger
• scar tissue as the body’s patch and its limits
• fascia’s role in glide and how adhesions form
• eccentric loading for tendinopathy
• rest, ice then heat, and smart progressions
• balance across strength, cardio, mobility, stability
• aging, microtrauma, and building durability
• programs to prioritize restore, mobility, and stretch
• teaser for part two on mobilization and therapies
Please hang around with me for a few more minutes and get some healthy momentum for the rest of your week
Are you ready to live an active lifestyle? Welcome to Behind the Bluff, where we believe every moment of your life is an opportunity to pursue wellness on your terms. So here's where we're at today. Every step, stretch, or lift we make depends on soft tissue, muscles, tendons, ligaments, and the elusive term that you have been hearing about fascia. Most of the time, we don't notice them. And it's typically once something goes wrong that we start to pay attention. So today we're kicking off a three-part series on soft tissue health with orthopedic surgeon and palmetal bluff member, Dr. Gray Stallman. In this first episode, we'll cover the basics, more of an education behind muscles, tendons, ligaments, and fascia. And then what we're gonna dig into is the what do I do with this information? How do I make an impact in my routines? Our concept today is how do they work and really just digging into the evidence behind why taking care of them matters. Grey. It's so great to have you here.
SPEAKER_01:Thanks, Jeff. Good to be here.
SPEAKER_00:Yeah. I've been looking forward to this. We've been talking about providing more of the education behind these terms that get thrown around in a fitness setting.
SPEAKER_01:Well, I think that's a really important thing. Uh people throw these terms around. Uh people are told scary words uh by doctors or practitioners, and they don't really know what they're trying to understand. And I think a basic understanding of anatomy, physiology, and whatnot really can help us to understand why a problem is and what we can do to try to fix that problem.
SPEAKER_00:Absolutely. It goes a long way in designing a lifestyle that keeps us durable and bulletproof.
SPEAKER_01:Yeah, I don't want to be a preachy scientist, but I think uh good basic knowledge is always helpful to start rather than uh uh sitting there scratching your head wondering what the heck the coach just said.
SPEAKER_00:Yeah, yeah, I'm with you. So I'd love for you to give us a big picture overview of what we mean by soft tissue in the body and why it matters for our movement and health.
SPEAKER_01:So soft tissue health is important to us because more often than not, in the muscoskeletal system, your body, um, it's the soft tissues that give us problems. So you've heard of tendinitis, you've heard of muscle strains, you've heard of ligament tears. Um, those are the things that knock people out of activity. Um, it's not very common to see a broken bone uh in a sports activity. You certainly can.
SPEAKER_00:But that's a rarity.
SPEAKER_01:But that's far less common than a tendinitis or an inflammation. And so inflammation really affects the soft tissues of the skeletal system rather than the bones. Um, so there are basically four major soft tissues in the body, and one that I'm gonna throw in that's important in all of those. So the the top four are muscles, tendons, ligaments, and fascia. And then the fifth one is scar tissue. And scar tissue is a soft tissue, but it's really a healing tissue. It's not a function tissue. Um, so let's start with muscles because they're the biggest um real estate in the body.
SPEAKER_00:Yes, and I would say most people love training their muscles and trying to improve not only how they look, but from a bone density perspective, they're told all the time we've got to keep our muscles strong.
SPEAKER_01:Absolutely. Well, the muscles are the motors of the body. The muscles are um the structures that help us to move. Without muscle, we couldn't move. Um, muscles contract and relax. Muscles can't push. So we have muscles on both sides of our body, the front and the back, as well as the sides, because the muscles have to contract to make a joint move, but then the opposite muscles have to contract to undo that joint movement. So if you bend your knee, you're you're contracting the hamstrings in the back of your thigh. If you're extending your knee, straightening it out, you're contracting the quadriceps muscles, the muscles in the front of the thigh. The quadriceps muscles don't push the joint straighter, they pull uh to make it bend or straight.
SPEAKER_00:Yeah, so any movement from a joint requires the contraction of muscles.
SPEAKER_01:That's correct. That's correct.
SPEAKER_00:Now, what makes muscles unique compared to the other soft tissues?
SPEAKER_01:That's a great question. Um, they actually are active, they contract, they they are made up of cells, fibers, that uh uh when stimulated uh can shorten and they can shorten in a in a in an easy, simple way, or they can shorten in a very rapid, aggressive way, depending on how many fibers are contracting. So a uh uh a power move, say a box jump, when you're jumping up, your quadriceps contract to straighten your legs, your knees out to get you up over on the box. Um that hard contraction means you've recruited a lot of those fibers to contract. If it's a squat down, slow, easy like an eccentric. That's correct. You're not you're you're not you're not contracting those fibers nearly as hard or as many. Um so the most important thing of all the four soft tissues that we're talking about is uh is is the differences are the elasticity, how mobile those tissues are, and what's their healing potential. And their healing potential is a hundred percent relied upon their blood supply. So muscles heal really pretty well pretty quickly.
SPEAKER_00:Much faster than the other soft tissues we're discussing.
SPEAKER_01:Absolutely, because they have a really good blood supply. Um, if you can imagine bruising of a muscle, you get the black and blue um uh of the muscle, the swelling of the muscle.
SPEAKER_00:Which is a great sign. That's what we want to welcome.
SPEAKER_01:That's exactly right. And uh uh that injury repair is is mediated by how much blood flow there is to the to the uh tissues. Uh so muscles have a high potential of healing. Um muscles are very elastic. They are they can stretch, they can actually overstretch to a point and not be injured. They can return back to their normal length. The muscle strain is an overstretch of the muscle. So those fibers then start tearing or they start becoming injured, and that's where you develop uh pain, limited mobility, and whatnot after it after an overstretch injury.
SPEAKER_00:Graham, in your description of the overstretch, does that mean that it's been a repetitive overuse of an activity or a movement that someone's done to cause that in the muscle? More commonly, yes, although it can also be an acute injury. Like a sprint, hundred meter sprint, and then I pull my hamstring.
SPEAKER_01:Okay, like I did at the first bluff athalon. Yes, sir. Pretty common that one. That's exactly right. It it's the abrupt onset of force that causes that overstretch because the muscle is trying to contract and you're pulling against that contraction force.
SPEAKER_00:Understood. Let's switch gears and go to tendons. They are what I know as the bridge between muscles and bones. What makes them prone to overuse injuries?
SPEAKER_01:Uh, you're your your description is actually very accurate. Um, consider a rope and pulley system. Uh, you've got something that's a motor that's pulling the rope to lift a weight toward a pulley, right? So the motor is the muscle, the rope is the tendon. So tendons attach muscle to bone on each end. So a must a blob of muscle is attached to a bone on one end and then attached to a bone on the other end.
SPEAKER_00:Muscle cannot be on bone unless the tendon is attaching.
SPEAKER_01:That's correct. That's the attachment points. Um by virtue of the fact that you want an efficient pulling, tendons don't stretch well. They're very stiff, uh, they're not flexible. Um, but that improves the efficiency of the pulling motion. Uh you can you don't want to lose energy in the system by allowing the tendon to stretch while you're trying to pull that rope on the pulley. And so they're very stiff, they're very tough, but they don't have a great blood supply. The blood supply in the tendons really comes from where it attaches to the bone, so the ends of the tendon, or where it attaches to the muscle. There's very little blood supply in the middle of the tendon. And that's the key to why tendon injuries occur. Um, most common tendon injury in our population here is probably tennis elbow. That's a tendonitis, an inflammation of where the muscles of your forearm that extend your wrist, that allow you to drive your wrist back, um, attaches to the elbow bone. Okay. Um, it starts with inflammation, irritation, so that's a tendonitis. And then as time goes on, as repetitive overuse or repetitive use occurs, constant or chronic inflammation occurs, and you develop deterioration of the tendon itself, uh, and that's called tendinosis, uh, or in some uh circles tendinopathy. Uh, but both of the all three of those terms are related to tendon irritation or tendon damage.
SPEAKER_00:Yeah, that's great clarity, Gray, because tendonitis is more inflammation and tendinosis is more deterioration is more deterioration. I've I haven't heard it in such a simplified manner. I think that's helpful because oftentimes it is more the latter, it's inflammation, and we're typically not giving it time to recover, and we're continuing with that repetitive motion that caused it in the first place, and the muscles around that elbow, for example, not being strengthened in the direction over time to handle the load the person's putting on it.
SPEAKER_01:That is correct. Um, also, the the muscles can be essentially overtrained, so they're stronger than the tendons themselves are able to tolerate. Interesting. And so it's kind of a fine balance. And so you're right. So let's go back to our tennis elbow um story. Um, it almost always starts with uh a new activity um or new level of activity. Um, you get some irritation, inflammation, some tiny injury to the tendon where it attaches to the bone or where the tendon attaches to the muscle at the elbow. But we play through it. Ah, it's just sore. It's fine. We keep playing through it, keep playing through it. Days come to weeks, weeks come to months, and now you've had three months of, my God, I can't pick up my tennis racket because my elbow hurts so bad. It's become uh it's gone from tendinitis, inflammation, which typically gets better in a few days, to tendinosis or tendinopathy, which is chronic irritation, inflammation, and now deterioration of that tendon. And so they're treated in different ways. If you can get at it early, tendinitis, if you rest it, ice it, gentle massage, stretch, that type of thing, um, you can get rid of a tendinitis pretty quickly. Once it sets in, it takes a lot longer to get better because there's not a great blood supply. And so it takes a lot more work, a lot longer of rest versus a muscle. And versus a muscle, definitely. Okay. Um, so the tendons are the pull are the ropes, the muscles are the motors, and then the third tissue is the ligament, and the ligament is basically um built similarly to the tendon. It's made out of a tissue called collagen, a protein called collagen. Uh, it's a tough fibrous tissue with its fibers oriented in specific directions to what the purpose of a ligament is is to make a joint stable, to restrict motion of a joint. It holds things together. Um so, for example, the ligaments of the ankle keep your shin bone, your tibia, from shifting around on your foot.
SPEAKER_00:Staying neutral to your toes, for example.
SPEAKER_01:Exactly. But an ankle sprain is actually a pull or tear of the tendon, uh, sorry, the ligament that is structurally supporting the ankle. So it's pushed it further than it was designed to go, and it tears those fibers.
SPEAKER_00:And could it also be another example? I'm going out for a run and my ankle gives out, I roll it. That's a ligament issue a lot of the time.
SPEAKER_01:Typically a ligament. Okay. And it can be a simple stretch of the ligament. Again, like tendons, ligaments don't have a whole lot of elasticity. Uh so it can stretch it, it can push those or pull those tissues further than they were designed to go. Or it can be a frank tear where some of the fibers or all of the fibers tear. And so there's degrees of ankle sprain. Mild ankle sprains are typically stretch. Uh, severe ankle sprains are typically tears.
SPEAKER_00:I'm also hearing that this relates to the knee. We hear about this a lot. MCL, ACL, PCL, and ACL is like the worst of the three, right?
SPEAKER_01:Well, they it depends. Um, so L means ligament. So anterior accruciate ligament, medial collateral ligament, posterior accruciate ligament, that's what those uh acronyms stand for. Um, but they are holding the thigh bone and shin bone together. They're keeping them from moving further than they were designed to go. So if anybody is a football fan this last weekend, Tyreek Hill dislocated his knee. Oh, for the season. Out for maybe his career. Oh no. And in some situations, a injury like that can actually, I've seen people lose their leg because it causes a blood vessel injury that's or a nerve injury below the knee. But basically, he tore probably the medial collateral ligament, which is on the inside of the knee, keeping the knee from wagging outward, the anterior cruciate ligament, which is the main stabilizer between the two bones, and the posterior cruciate ligament. So he probably did all three. Tore all three. Most likely. Most likely. And he may also have had a fracture in there, too. That's a common um added bonus. Um, I don't think he had a blood vessel or nerve injury because of the the he's gone through his surgery and whatnot. So that's unlikely. But that's a devastating injury. Yeah. And certainly season ending, certainly six months to a year of recovery, and may very well be a uh career-ending injury for somebody who's an elite athlete like that.
SPEAKER_00:And most of our listeners are not elite professional NFL players. The the importance here is understanding that ligaments versus tendons and muscles are take a lot longer to heal.
SPEAKER_01:That's correct. And they often require um more uh aggressive immobilization. You want to you because if a if a ligament heals and it's essentially more stretched out than it used to be.
SPEAKER_00:And maybe the fiber's not going in the direction they're supposed to be.
SPEAKER_01:That's correct. Um, it can lead to what we call instability of the ankle. Uh uh, more motion than the or of any joint, more motion of the joint than it's designed to tolerate.
SPEAKER_00:Great. I'm tracking that a lot because you you see and hear a lot of the time when someone's injured a ligament that it at times reoccurs.
SPEAKER_01:Absolutely. So classic example is rolling your ankle playing basketball. Um, you turn your ankle, you tear the fibers in your ankle, you let it heal, but it's looser than it used to be. It's easier to turn the ankle again because the joint moves more than it was designed to. Uh, and so again, ligaments suffer the same problem that tendons do, is they have a poor blood supply. So they don't heal very well. Um the healing process is the the fifth tissue, which is scar tissue, which is just basically fibrous tissue that connects things together, it's essentially a patch. Um, the trouble with scar tissue is it has essentially no flexibility and essentially no uh strength. You can pull scar tissue apart pretty easily. And so when if you have an injury to a ligament or a tendon or a big tear in a muscle, and you've got a big chunk of heeled, they're still connected, but they're connected by scar tissue, those tissues are much weaker than they were originally. And so it's easier to have problems such as recurrent injury or persisting pain after an injury like that. So many times, uh depending on the structure, many times the treatment for uh ligament injury, stability injury, is surgery to uh repair those tissues so they're as tightly bound together as possible, so there's minimal amount of scar tissue involved in the healing process, so that joint isn't loose, like it, we don't want it to be loose.
SPEAKER_00:Um that's great to understand because I've never fully understood scar tissue. It's one of those things that people often say to me, you know, more when I was in a training set setting of, oh, I got all this scar tissue built up. And by understanding that when we have surgery, we want to mitigate the amount of scar tissue buildup and create more stability, say from uh a ligament hair, makes a lot of sense and is very helpful to have that context.
SPEAKER_01:Yeah, the the surgery side of things, we're actually trying to coerce the body into doing acting like we want it to. We know it's gonna heal with scar tissue. We want to kind of direct that activity so that we can minimize the scar tissue, or at least the scar tissue is in a an effective range of mobility for the for the various parts. Um, if you if you've ever seen somebody who's been badly burned and their skin is that meshwork kind of tough, uh friable looking, uh uh easily damaged, easily scratched tissue, that's what scar tissue is. Um none of the body tissues except bone and liver heal with their own tissue. So bone can heal with bone, liver can heal with liver. Everything else heals with scar tissue. And so in the skeletal system, in order to maximize function after an injury, sometimes we have to do surgery to try to restore that connection and minimize the scar tissue effect of that. The scar tissue that you talk about in the shoulder, for example, I've got a lot of scar tissue in my shoulder. Most of the time it's not actually true scar tissue. It's inflamed tissue that's gotten stuck down. So, for example, a rotator cuff muscle group in your shoulder that's been repetitively irritated, there's lots of inflammation. That tissue inside the joint gets stiff and sticky and kind of restricts range of motion. But the easiest way for practitioners in particular uh to describe that to people is oh, there's scar tissue in there. It's not actually scar tissue, but uh it acts in a similar way. It doesn't allow mobility like it's supposed to occur.
SPEAKER_00:Yeah. That's a great transition because each of us out there, we've got something a bit sticky in the body. And more education around one of the tissues we haven't talked spoken about, which is quite abundant in our body, fascia. It's a buzzword. We know that regardless of if it's scar tissue or fascia, there's there's got to be some interrelated play there. So I'd love for you to explain what really is fascia and why it is important.
SPEAKER_01:That's a great question. And even in medical school and residency, there was always kind of this mysterious fascia question. Fascia is actually real. Um, fascia is a is a connective tissue. It's a soft tissue in the body that attaches various pieces together. It looks different in different parts of the body. There's a lot of fascia, for example, right underneath the skin in the layer of fat. Uh, there's fascia around your organs in your belly. There's fascia that surrounds the muscle tissue. Think of it this way: uh fascia kind of creates an internal structure to your body. If you didn't have any fascia, all of your muscles, your fat, your skin, your organs would sink down toward your feet due to gravity. So you'd be this oompa loompa um looking, you know, nothing on top and everything around your ankles. So what the fascia does is hold things in place against gravity. It also allows uh the internal structures to pull against one another. It uh additionally, around the muscle bellies. So think of a steak. Steak is all your meat in your in your uh grocery store is muscle tissue, uh, whether it's chicken, fish, beef. Um, that's what muscle looks like. And um fascia covers the muscle so that the other tissues can slide by the muscle. So the muscle can contract and relax, and it doesn't get stuck down to the other tissues.
SPEAKER_00:That that's good imagery. I've always, when I first started learning about fascia, I I go back to a chicken breast example, the white film of the chicken breast is the fascia.
SPEAKER_01:That's exactly right. And um fascia is the bugaboo of your world and our world as as um aging active individuals, because as fascia gets irritated, fascia gets injured, fascia gets inflamed, the inflammation causes the fascia to uh stick together. So that sliding mobility, that that uh uh pliability of the tissues decreases. And so we'll often hear physical therapists or massage therapists in particular uh talk about fascia and sticky of your fascia, and we need to mobilize the tissues, primarily when we're mobile, and we're gonna talk a lot about this in part two, because that's really an important new feet, new er field of health, wellness, and fitness.
SPEAKER_00:Yeah, of self-care. That's more important than stretching. We're gonna say that right now.
SPEAKER_01:Absolutely. No doubt, no doubt, no question, and hard stop. Uh, but mobilization of those tissues helped you to become more pliable, more flexible, more durable, and more versatile. Um, if we help take care of those tissues in particular. So I'm really excited actually to talk about part two because um that's that's information that frankly, in many cases, did not exist in my training um and has really come about in the last couple of decades. Yeah.
SPEAKER_00:Absolutely. Setting the stage with what these soft tissues are and understanding them better and then practicality of how do we take care of them. What I have always referred to, and I want to get your take on this, Gray, adhesions in the body. When we refer to taking care of our fascia, some folks will use the terminology, I'm trying to smooth out the adhesions and restore those sliding surfaces, surfaces. Could you speak to that? Sure.
SPEAKER_01:So I think that really comes down to the uh inflammation effect of the fascia. If irritated or damaged fascia occurs, the first body healing process is inflammation. That's actually a natural, normal, and important process in the body. You have to have inflammation in order to heal.
SPEAKER_00:We shouldn't be scared of it.
SPEAKER_01:No, no, no. And in fact, if we piled on the anti-inflammatory medications too soon after a mild injury, you would feel better, but you actually hamper the recovery. And so it's important to balance that. The adhesions are really those sticky spots that I talked about where you have inflammation that occurs as the inflammation either continues or resolves. Those soft tissues, the fascia and the surrounding area that the fascia attaches to, can get stuck down to one another. And so you get these uh uh knots in the trigger points.
SPEAKER_00:We've heard that language before.
SPEAKER_01:Trigger points are a couple of different things. Trigger points are fascia related, but they're also muscle-related. They're actually they can be areas of localized contraction that hasn't released in the muscle. So it's kind of like a ball of spasm. But over time, trigger points can then, which creates inflammation, trigger points can then become chronic. They kind of get scarred down or adhese together, and the mobility within the muscle is compromised. Uh so uh our soft tissue mobilization techniques that we're gonna talk about, and again, we're gonna keep pitching this because it's an important topic in not only maintenance, but recovery as well, um, is to try to alleviate those sticky areas, those areas of either acute or chronic inflammation, uh, to smooth out that mobility, to improve that uh that uh range of motion. Yeah.
SPEAKER_00:And the goal is having a plan around that and prioritizing it. We before we started the conversation on air today, I was just trying to pick your brain of how do we get more people to take care of their fascia? How do we get folks doing less of the cardio, the strength, which is all important, but balance that out with this injury prevention component. I think it's a game changer if we as a community can get connected to the importance of this.
SPEAKER_01:Oh, I think without question, I think that we would have a lot fewer visits to the physical therapist and the doctor if people maintain their system. I mean, you change the oil in your car, you change you add air to your car tires, you need to do that to your body systems as well. And it's really the soft tissue system that we're talking about. Uh muscle stretching and pliability, uh, fascia, uh, mobilization. Uh, these types of things can help reduce the occurrence of injury or repetitive use discomfort. Uh, it doesn't even have to be an injury, it's just an overuse type of problem. It can make you more durable, but it can also help you recover faster from an injury.
SPEAKER_00:Great point. And improve your performance with whatever activity you're doing.
SPEAKER_01:Absolutely. So all of all of one thing never makes any sense. So strength training seven days a week doesn't give your body time to recover. And in fact, as you well know, you know, your gains in strength training occur when you recover, not while you're doing the the activity. You're actually injuring your body. It's controlled injury of the body uh in strength training. And the and the recovery is the is the place where you make your gains.
SPEAKER_00:From a personal perspective, until I stopped strength training six, seven days a week, that's when I actually started to see progress personally. And that took time for me to realize as someone even in the field that that proper balance is essential to progress.
SPEAKER_01:I think the balance is actually uh very important. Same thing goes with, you know, uh endurance athletes. Um now there are some bodies that are built to tolerate, you know, running a marathon every day. There are just some people like that. The 99% of the people, you need recovery, you need rest, you need balance. And so running every day is not good for your body. Not at all. Uh, I think it it promotes, um, and we saw it in the 90s and 2000s with the the marathon craze, how many repetitive use injuries occurred, mostly to soft tissues, uh uh because of the volume of uh activities. That's not to say that working toward a higher volume is necessarily bad, but you need a balance of strength or resistance training, flexibility and tissue mobilization, and um balance um uh to help you with your endurance. Well, and you and and the last thing, frankly, is you need your body needs rest. Yeah. You need to recover.
SPEAKER_00:Well, I'm looking forward to part two because we're going to get practical with what that can look like in your week and specifically the big, what I would consider the important areas of your body to continually pay attention to taking care of fascia and from the perspective of other therapies that Gray's going to share more on. Now, healing and adaptation. I want to kind of put a bow on injury prevention here and have a full understanding of factors that help or hinder soft tissue healing. You touched on it a bit. Is there a difference between how muscles versus tendons and ligaments recover? Yes.
SPEAKER_01:I think recovery for ligament injuries, that's kind of the easy one because they're the stiffest and they're the most restrictive tissues. Recovery for that really relies on not overstressing those tissues. They need to rest. They need to uh take time to heal. So uh stretching, for example, a ligament injury is very actually can be very detrimental to its healing because if you stretch it and keep stretching the ligament injury, it can heal too long. And now your your your joint restriction is not appropriate. Uh so ligament stretching is not really uh a practice we would advise. Muscular stretching, a little bit different. There's a bigger blood supply, they're big bulky tissues. Um, stretching and uh mobilization as part of the healing process in many cases is appropriate and and helpful. If it's a full tear of the muscle, where you really have to rely on the tissue fibers to heal back together, then restriction of mobility uh for a short time is appropriate. Now the tendons are kind of the in-betweeners. Um tendons actually do um heal better with certain types of mobility. Um there are a couple of tendons that are uh very important that you can't really mobilize right away. For example, if you if somebody cuts their forearm, their wrist, and all the little leaders, the tendons that are running in your wrist that make your fingers bend, cut them in two. Stretching those things is not a good idea. Those things need to be surgically repaired and kept quiet so the scar tissue is at a minimum. And then we gently and uh functionally bring people back to mobility and strength over time as those tissues toughen up.
SPEAKER_00:So an occupational therapist would intervene at that time.
SPEAKER_01:But for example, the tennis elbow, the tendinitis of the muscle tissues at the outside of the elbow, they actually benefit from, because it's not torn in two, uh, they actually benefit from particularly eccentric strength training. Ecentric means that the muscle contracts and relaxes under load, correct?
SPEAKER_00:Yes.
SPEAKER_01:Yeah. So for example, um at the elbow, think about cocking your wrist up and then slowly allowing it with weight, and then slowly allowing it to fall down to cocked down. Um, that's an eccentric load. Um, and that can actually help those tendons heal. Putting a little bit of force on those tendons uh allows them to uh have the stimulus to bring that soft tissue, fibrous scar tissue in there to heal, and the blood supply brings those growth factors and whatnot in there to um heal it more quickly. So a balance for most tendon injuries is um some degree of mobilization immobilization, some rest, and some degree of mobilization, of movement.
SPEAKER_00:And the best way for someone if they have an injury and they're unsure of an it of it, whether it's tendon-related, ligament related, muscular, what's the best approach? Like as someone who has been through a few injuries and as a doctor, what are the first steps someone should take?
SPEAKER_01:Well, let's kind of look at it this way. Um, there's kind of a a subset of those injuries that really you should probably have it looked at. If it was an acute trauma, you rolled your ankle and your foot's still cockeyed in in one direction, it's not lined up on your foot. You can't walk on it. That probably needs to be evaluated because you have to look for things like fracture or true ligament tears that need more rapid immobilization. But in general, in our population, it's a it's a repetitive use problem. So I went out and played two hours of tennis and my elbows kind of sore. Um, not I had a specific injury, like I fell on my elbow. Um, most of the time that can be managed with a couple of things. One is patience. Um, one is taking it easy, not going back out on the tennis court until it feels better. Give it some rest. Um attacking the acute inflammation, the acute injury, the acute discomfort with uh some mild anti-inflammatory, typically ice, um, is very appropriate. So people always talk about heat and ice. What do you use first? In general, if it's a if it's a new type of pain, a new injury, uh uh overuse problem, ice is the way to go because that reduces swelling and reduces inflammation. Uh that for the first few days. Then heat after that, because heat helps promote blood flow. And so blood flow is how the healing process occurs. So anti-inflammation for the discomfort and the swelling, and then heat for the blood flow.
SPEAKER_00:Great recommendations. And to riff off of that, we shouldn't be icing every day of the week because of activity. If we're icing months on end, there's a deeper problem that needs to be addressed.
SPEAKER_01:I think so. And it's probably a combination of factors. It's probably a combination of older, um, less pliable tissues, plus technique is very um key to reporting.
SPEAKER_00:Let's get to the root of why the injury and inflammation is occurring in the first place.
SPEAKER_01:That's right. And then the last thing is the what are the other tissues doing? In tendons, that's the most common type of problem we have, tendinitis. Um, the muscles do play a role. The muscles are pulling on those tendons because they attach to the bone through the tendon. And so using things like physical therapy to appropriately uh reintroduce muscular contraction and and and strength training while we're recovering, while we're being patient, um, is probably the most important thing.
SPEAKER_00:Yeah, helps tremendously making sure that we have a pinpoint of coming back from one of these issues that we've had for a long time in a manner where it's not going to return years later.
SPEAKER_01:Yeah. And you you in a perfect world. Right. And you can't relate to this because you're not there yet. But when you, you know, as you turn into the 50s and 60s, um, all of my colleagues will tell you that things start hurting every single day, and it's a random thing. One day my knee hurts, the next day my back hurts. Why is that? Well, there's a whole process that's been going on for decades, which is the degeneration, the aging process, and the effect of accumulation of micro trauma. Um, and so we don't heal, we don't recover as quickly as we used to because our tissues aren't as durable, as viable as they used to be. Um and we've just got this baggage of uh accumulated microtrauma. And so it's it's frustrating when you get to our age group, uh, but it shouldn't be demoralizing that you know, something hurts every single day because you know the next day something else will hurt. Uh and mystery of why is that. So I've always told people don't get too worked up about, you know, niggling discomfort that comes and goes here and there. It's just gonna happen. How you minimize that is with the things we've talked about, the the preemptive uh strengthening mobility, flexibility, stability. Stability, right? Yeah, those are the things that are really gonna help us live uh uh a more satisfactory life than than than it would be. Uh you know, you got to remember so many of us are are now we have the time, we're no longer working, we don't have family at home. We're wanting to stay durable. We're we're ascribing to the Peter Atia um outlive prospect of exercise is the most important we have. That's exactly right. Yeah. Uh the trouble is we've accumulated a lot of baggage. For example, a sedentary lifestyle. Uh no one should expect to go from zero to a hundred and not have some at minimum discomfort. Uh more so, you know, inability simply because um the desire's there. Yeah. So we have to balance that a little bit.
SPEAKER_00:It's a great perspective and excellent empathy and understanding for for all of us to be aware of that baggage and not to dismiss that when we do get older, things will feel a little bit different. And there's a ton of hope to ensure from your end that you create routines that allow you to participate in life on your terms. All right. With that, I think we're at the end of our time today, together, Gray. I want to thank you so much for educating us, and I'm looking forward to episode number two. Any final thoughts?
SPEAKER_01:I think you could stand this program up to anywhere across the country as far as um cutting edge, revolutionary mindset toward overall fitness, wellness, health, and and um satisfaction in life.
SPEAKER_00:Oh, we appreciate that, Greg. We're we're always learning, always trying to get better, and just grateful to do it with the teammates we have here, this amazing property, the amazing members. Uh, it is it is a gift, and it's fun to be able to wake up each morning uh knowing not only you're after making a difference in people's lives, but actually seeing it take effect and seeing it take root. It couldn't be more gratifying for our entire team.
SPEAKER_01:You couldn't do it without the support of your bosses uh and your budget. And um, I hope that it's it continues to be seen as a pillar of this community. Because it really is. It's really it's really unique, it crosses all boundaries. It it you know it affects golfers, pickleballers, uh, horse people, um, you know, gym rats.
SPEAKER_00:Every member who wants to get involved.
SPEAKER_01:Anybody who's sentient and upright, um, I think it's really it it has offers something for everybody. And so um I would encourage everybody, don't get wound up on the names of classes or um go out there, experiment, test the boundaries because the the offerings continue to evolve. We were talking about that earlier. Um uh I would highly recommend following this conversation that you look out for the the restore and or mobility and or stretch classes types of uh programs that you're gonna be offering, uh, because I think that's gonna be really helpful in the in the vast majority of our cases of attack in life.
SPEAKER_00:Absolutely. And I'm excited about part two next week, where we're gonna be continuing this conversation with the discussion focused around mobilization, stretching techniques, the specifics of the how and what to do, as well as alternative therapies such as stem cells and PRP. Until that time, please hang around with me for a few more minutes and get some healthy momentum for the rest of your week. My grandmother recently fell and she broke her ribs. And frankly, she hasn't been the same since my grandfather passed away this past May. When I uh call her up on the phone, she she sounds different. She's frustrated with how long the healing of her ribs is taking, and you can feel this sense of sadness that she has inside of her because her husband's no longer beside her. It's been hard to hear, honestly, because I'm used to speaking with my grandmother and it being an upbeat conversation, and it's made me think a lot about time, energy, and what really matters. And I've been thinking about it because there's going to come a time for all of us when we realize we spent far too much time on things that didn't really matter, and that includes how we treat our bodies, pushing hard, staying busy, but not slowing down to stretch, move, or recover. Sometimes it takes a tough season or a reminder to bring us back to what's important. I think an acute injury can do that a lot of the time for each of us. And when it comes to my Grammy's journey, that has been the reminder for me on a personal level. She reminds me that life moves fast and time is something we don't get back. Her season of slowing down has shown me how much of our lives are built on what we choose to give our energy to. And that includes the simple things that keep us moving well, like a few minutes of stretching, mobility, or just breathing. Because taking care of your body is spending time on what matters most. So as you head into this week, think about this. What moments are you missing by being too busy? What would enough look like for you? And if you only had time for one great thing next week, what would it be? We try to, but we can't do everything. We can only do the things that truly matter. Let's not just be busy but intentional. Let's take care of the body we've been given, and let's spend our time where it counts. Because in the end, that's what matters. So this week, take five minutes for you. Stretch, move, breathe, give your body the same attention you give everything else that matters. Because when you move well, you're gonna live well. That's a wrap on this week's episode of Behind the Bluff. I want to thank you for taking the time to listen in with myself and Dr. Gray Stallman. We're looking forward to continuing this conversation next week. Until then, remember to actively participate in life on your terms.
