Single-Leg Strength: Why Unilateral Training Catches Weakness Bilateral Hides

[0:00] Jason: Hey Kathy, quick question. If someone came into your clinic and said, “I can back squat 315, but I literally cannot stand on one leg for 10 seconds without looking like a baby deer on ice,” what would you tell them? Kathy: I’d tell them their squat’s a lie, and their body’s been writing checks their stabilizers cannot cash. Jason: See, that’s the thing. Every gym bro out there is chasing these bilateral PRs, posting their squat numbers on Instagram, and meanwhile, they’ve got like a 15% strength difference between their legs, and they

[0:31] don’t even know about it because the barbell lets them cheat. So, your strong leg is doing all the work, and your weak leg is just along for the ride, like a freeloading roommate. Kathy: And then they come see us when something finally breaks. Jason: Exactly. So, today we’re talking about why unilateral exercises — the single-leg, single-arm stuff that everyone skips because it’s so hard, and you can’t post impressive numbers — might actually be the most important training that you’re not doing. This is the PTCH.

[1:02] What happens when a chiropractor and a physical therapist get together to make a health and wellness podcast? Kathy: But chiropractors and physical therapists don’t like each other. Jason: Oh, think again. Kathy: I’m Dr. Kathy Lynch, physical therapist who likes to help people move and get stronger. Jason: I’m Dr. Jason Young, an evidence-based chiropractor who uses humor just as much as adjustments to help people get better. Kathy: Welcome to the PTCH Podcast. Jason: Remember, there’s no I in PTCH. Ah, we’re back. It’s the PTCH Podcast. Welcome. I’m Dr. Kathy: And I’m Dr. Kathy Lynch.

[1:32] Jason: And we are the co-hosts of the PTCH Podcast. Kathy: That’s this podcast. Jason: That’s us. We’re here. Kathy: Yes, uh-huh. So, if you didn’t know that and you got lost, welcome. Let’s get lost together for the next little bit. Jason: Yeah. Little update on the podcast — podcast is strong. Kathy: Yes. Jason: Solid. We’re doing so well. Kathy: Very. Jason: And thank you to the people who’ve been leaving comments and questions. Although I do want to call out one person. So, our episode about the Wolverine stack — remember that peptide? Kathy: Yeah, it

[2:02] was really fun, because on YouTube we got a comment from somebody who chastised us. Kathy: Ooh. Jason: Yeah, for being very poor researchers. Yeah, because they said that there is plenty of evidence out of Eastern Europe of human trials. Yeah, there isn’t. Kathy: Did you pull those up? Jason: Yeah, there isn’t. I mean, just so people know, we do homework before this. This is like a

[2:32] part-time job. We have decades of experience, and we actually crack open a book or read a study or something like that. We are not just making stuff up here. We are not Instagram. Kathy: We are not Instagram. Did they send you the link to them? Jason: No, no. And I posted later and I said, “Well, it’s been X number of days and I’m still waiting for those studies. So, if you’re out there and you have these studies that show that we clearly don’t do our

[3:02] homework, send them in, because I’d love to see them.” Kathy: Yeah. Jason: You know what’s probably happened? He probably had to charter a flight to Eastern Croatia so that he could recover the files from the lab that is underneath somebody’s barn where the human trials were done. Kathy: Yes. Jason: Right next to all their graves. Kathy: Jason: Anyhow. Hey, so should we jump into this poorly researched episode?

[3:32] Kathy: Should we drop a little pseudoscience? Jason: I know nothing about unilateral exercise. Kathy: You don’t? Okay. Well, this episode was your idea. You’re like, “Jason, let’s do this.” So, tell me — what are we talking about today, Kathy? Kathy: Well, I’ll shout out the New York Times. I actually think their health and fitness articles are usually pretty good. And so this one that I read — yeah. Jason: Some days ago. Kathy: Yeah. Yeah, I can’t remember when I saw it first.

[4:02] A number of days ago. Jason: Yes. Kathy: Was about the value of unilateral exercises and balance. And so I thought that this would be a good topic to talk about. We could bunk or debunk some of those things. Jason: Bunking. Kathy: And I think we’re going to bunk a lot of this, because it was actually a really good article. Also, they interviewed some PTs, so you know. Jason: Not biased. Kathy: Oh, no, I’m not biased at all. Jason: Now, this is kind of right up your alley, huh? Kathy: Yeah.

[4:32] Kathy: Yep. Jason: I’ll tell you, I’ve got beef with symmetry. Have I shared this before? Kathy: No, but I want to hear it, because I agree that we don’t have to be symmetrical. Jason: Yeah — symmetry. Kathy: Symmetry. Jason: Symmetry is overrated, and it drives me a little nuts at work. I don’t know if when people go to the PT they’re talking about this, but oh my gosh — I don’t care about your leg length. I

[5:02] don’t — Kathy: you were telling them that, and then they were coming to tell me that you told them that. Jason: If I’m mad at you, I’ll tell somebody to go to Encore Physical Therapy, tell Kathy that you have a 0.5 mm leg length difference and I need her to fix it. Kathy: Been wearing a heel lift for 25 years. Jason: Yeah. So, here’s the thing with the leg length thing in chiropractic — I’m just going to step on this soapbox, then I’m going to step off so that you can

[5:32] drop some science on this. There are systems out there where chiropractors are measuring leg length to see if they’re even, and supposedly if they’re even, that means that your spine is aligned and you feel fine. And one of the reasons this is such a popular thing is that it’s highly reproducible. Like, somebody could have a leg length difference, they can come see me, they can go see you, they’re going to have that leg length difference, and so on and so on and so

[6:02] on. Even Raul can nail this, okay? Raul, do you need a job? Like, is the engineering thing working out good here? Kathy: Jason: Classic. Thanks for not making the O. Anyway, Kathy: Jason: but yeah, so it’s highly reproducible, so people like it. You can do an adjustment, and there will be some change, but you can do a lot of things — in our videos, you can hop on one leg, and there will be some change. And the problem is that it’s not clinically correlated with anything.

[6:32] Jason: Right. And so, you can look at whatever studies you want, there is — there’s not a good clinical correlation between “my legs are off this much” and how your back feels, or how you’re moving, or anything like that. Now, there are some exceptions, like if you have a really significant difference, like, you know, an inch or something like that, or you have an anatomical leg length difference, where you actually have one that’s a little bit longer. Kathy: That is possible. Jason: Yeah, then you might want to do some stuff. Kathy: Yeah. Jason: But for the most part, the body adapts well,

[7:03] and stop coming to me about your symmetry. The body’s not supposed to look the same on one side or the other. Like, do you take four bites with your right hand, and then switch to your left for another four? Like, do you drive on — do you have a British car and an American car, so that you can even things out? Are you sleeping on different sides of the bed? Kathy: Yeah. Jason: No. Kathy: Yeah. We swap every night. Jason: Yeah, killing me. Killing me. So, anyway, I’m done. Kathy: Okay. Jason: I’m done. Kathy: Well, I’ll add to that, too. Again, we agree on this. I learned in school that the lungs —

[7:36] Jason: Mhm. Kathy: — the right lung has three lobes. Jason: What? Kathy: Uh-huh. And the left has two. Jason: That’s poor design. Kathy: Why is that? Because the heart’s over there. Jason: Yeah. Who else tells us that? Robin Pester? Kathy: Yes. Because you breathe differently Jason: Mhm. Kathy: with two lobes versus three lobes. Jason: Yeah. So remember that. Kathy: We’re not going to be symmetrical. Jason: We are not symmetrical. Kathy: No. Jason: It’s not the goal. Kathy: No. Jason: Yeah. Kathy: No. Well, strength — we would like to be close. Right? Jason: Definitely. Kathy: Yes. Jason: Yes. In most cases, I’d even say.

[8:06] Kathy: I mean, I’m thinking of exceptions. It’s baseball season. Jason: Yeah. Kathy: Right? If you’re a pitcher in baseball and you’re symmetrical, it’s because you suck. You’re not a good pitcher. Yeah, you’re not very good at pitching. Like, if you are a pitcher, you should be overdeveloped on one side. Hands down. And so, I should be able to look at your back and tell you if you’re a lefty or a righty. And if I can’t, you should — I don’t know. Jason: Not be — you should be a swimmer. Yeah. Kathy: I don’t know. Jason: If you watch professional tennis, too, the arm that they serve with,

[8:38] Jason: way bigger. Men’s and women’s. You can just see it. So, that doesn’t necessarily make the case for what we’re going to talk about today. Kathy: No. But I just — I feel — Jason: What are we talking about? Kathy: better now that I got that off my chest. So, Jason: Yeah, we’re not saying that you have to be 100% symmetrical in everything. It’s just not going to happen. Kathy: Yeah. I think it’s one of the concerns though that people have whenever they’re like, “I don’t want to do unilateral exercise.” And for people who don’t know what unilateral means, it means just one side, right? Doing one side or

[9:10] the other. So, you can get a straight bar and you can curl that bar, or you can get dumbbells and you can curl one side at a time. So, that’s the difference between a unilateral exercise and a bilateral exercise. Jason: Yeah. I would say this — I really like the — I loved the article because of many things, but this is — I have to say this is kind of like my —

[9:40] — not a weapon. I don’t know about wielding weapons. I just — Kathy: Your secret weapon. Jason: Yeah, it’s something I pull out with patients who think they’re strong. Kathy: Wand. Jason: My secret wand. Kathy: Your magical fairy dust. Jason: Yeah, I don’t know. Kathy: The trick up your sleeve. Jason: Not a weapon. I’m not out there to slay my patients. Kathy: Yeah, but you’re wearing a top hat, right? While you’re doing PT? You are wearing a top hat. Jason: On Wednesdays. Kathy: Now you’re wearing a top

[10:10] hat now. Jason: Come to Encore Physical Therapy where they all wear top hats. PT so good, you’re going to want more. Kathy: More hats. Jason: More hats, yeah. More rabbits. I’m sorry. I totally sidetracked. Kathy: It’s okay. People come in, you know, with knee pain, ankle pain, foot pain, shoulder pain, and they’re like, “Why does my right knee hurt more than my left knee?” And so I’ll go to the testing, and then when I ask them to do single leg exercise, single arm — you know, single leg heel

[10:41] raise, things like that — they can’t do it. The one I use a lot, especially with foot pain and ankle pain, is the single leg heel raise. Jason: Yeah. Kathy: And so they’ll start with a double leg — Jason: So describe that. Kathy: People call them calf raises, but Jason: Okay. Kathy: I like to call them heel raises because — Jason: Stand up on your tippy toes. Kathy: Stand up on your tippy toes. Jason: And then you get a cookie out of the cookie jar. Kathy: Yeah, exactly. Jason: Mhm. Kathy: And so I’ll have them do a double leg heel raise to start. Feels great. And then I have them do the uninvolved foot. Like, “Okay.

[11:11] Kathy: Yeah, I can do that. I can do 12 of those.” Jason: I can do 15. This is easy. Let’s try the other leg. Oh. Oh. Kathy: Jason: Oh, I didn’t know that. Yeah, that’s probably why you’re having more foot pain, plantar fasciitis. Kathy: Yeah. You may be having hip pain because your calf muscle on that side isn’t as strong. So, usually in PT what I am doing is we’ll start bilateral if people need it, but I’m trying to progress people to single leg.

[11:41] For that reason — I think you mentioned it — in the open, the strong leg is going to — I’m talking about lower body — the strong leg in this sense will take over and do most of the work, more than the other leg — the Jason: the — Kathy: the weaker leg. So, this is personal to me because I had surgery that we’ve all talked about many times now, back in the ’90s, and my left quad —

[12:11] still is not as strong as my right one. Yes. So, I will say that my least favorite exercise is a single leg — is a split squat or reverse lunge because when I try to do it on my left side versus my right side, it’s so much harder. Yeah. And that pretty much means I need to do more.

Jason: Totally.

Kathy: Yeah.

Jason: Well, and you ever have this happen? Like you’re working with somebody and they’re like, oh, I’ve been having pain in my — in my right knee, and then like you work with

[12:41] them some and then like they come back the next time and they’re like, wouldn’t you know it, the pain moved from my right knee over to my left knee.

Kathy:

Jason: It’s like — that’s a concept that drives me nuts, because it’s not like the pain is just crawling around inside —

Kathy: Looking for a spot.

Jason: It’s like a little mouse or something like that. It’s like — it’s like the little worm in RFK’s brain.

Kathy:

Jason: It’s just like traveling. It’s just traveling all throughout your body. Where will it end up next?

Kathy: Where are we now?

Jason: But I think — I think that that phenomenon

[13:11] of people feeling symptoms move, I think it has to do with this relationship where you could have a strong side and a weak side. And so, as you start to strengthen a side that maybe was challenged, you — you — you might feel things move, which — maybe I should just quit prescribing people exercise on one side. I don’t know. But I mean, do you see that sometimes where people get symptoms that move around just because —

Kathy: Yeah.

Jason: Yeah, just as they — as they improve?

Kathy: Mhm.

[13:41] Or as they change? I don’t know if they’re improving. I don’t know.

Kathy: Well, I mean, if you’re just working one leg, and all of a sudden, oh, now my right knee feels great, but guess what? Now my left knee doesn’t. Oh.

Jason: Mhm.

Kathy: Because we haven’t really been working that out. If you come to Encore, we’re doing both.

Jason: Both. So, you never see the patient going away the right way.

Kathy:

Jason: Well, and I’ll tell you this, like if you want to talk about the value of a single leg exercise. So, when like Austin had to get his ACL, like I was just like — I was thanking God every day

[14:12] that he had been to see you, because especially those first few days when it’s just so inflamed, the single most important skill in that kid’s toolbox is being able to do a pistol squat.

Kathy: Oh, yeah.

Jason: Right?

Kathy: With the other leg.

Jason: Yes.

Kathy: Yes.

Jason: Yes, absolutely, because otherwise, like you can’t get into the shower, you can’t, you know, get onto the toilet or anything like that. You have to be able to pistol squat. Well, you don’t have to. It’s just your life’s going to suck

[14:42] Kathy: Yes.

Jason: if you can’t.

Kathy: You’re rolling off the couch.

Jason: Yeah. Well, and you — you don’t always — like he’s fortunate that he had some runway up to that, but you don’t know. Like you could go out and you could bust your knee or your ankle tomorrow, and now you’re in pistol squat country.

Kathy: Yeah.

Jason: Yeah.

Kathy: But if you’re not ready,

Jason: Yeah.

Kathy: I don’t know what to tell you.

Jason: So, there is — there are some stats that we found. So, most people do have —

Kathy: Most people do have 10 to 15% strength

[15:12] asymmetry between limbs.

Jason: This is bad.

Kathy: No, it isn’t, actually. But over 15% correlates with significantly increased injury risk in athletic populations.

Jason: So, as long as I’m not athletic —

Kathy: It doesn’t matter.

Jason: I’m fine.

Kathy: I’m kidding.

Jason:

Kathy: That just means that that’s who they studied it in.

Jason: Yeah.

Kathy: Okay.

Jason:

Kathy: Exactly. It was the athletic population. So, I think that what we find — that

[15:42] people have these strength differences and you can go about your life and never notice.

Jason: Mhm.

Kathy: You know, that you have this strength difference. But, you know, if you’re an active hiker, biker — I had somebody in today who’s having knee pain and going downstairs, going downhill bothers his knee more than the other. And I actually did this test and I did a single leg squat to the table and he did it on his right leg. I was

[16:12] like, you know, challenging, but okay. Did it on his left. He had a really hard time getting — like you’re talking about that pistol squat — getting up off the table with his left leg, and he just kind of looked at me. I said, “That looks a little harder, you know?” And he’s like, “Yeah, it’s a lot harder.” I was like, “Well, that could be a good indication of why you’re having left knee pain and not right knee pain.”

Jason: Can I give you a little marketing tip?

Kathy:

Jason: I love it. We love it. Next

[16:42] time you have a situation like that where he looks at you and he’s like, “Oh my gosh, what is this?” That’s when you look at him, maybe put a hand on his shoulder and say, “Welcome to Encore Physical —”

Kathy:

Jason: We’ve got you.

Kathy: Got you.

Jason: Right? We’ve got you.

Kathy: We just solved all your problems.

Jason: Yes. Hey, you’re in the right place, buddy.

Kathy:

Jason: It’s going to be okay. You know, maybe — maybe like slide over the box of tissues. Here you go. Here you go. Ow. Hey, this is a safe place for you.

Kathy: I see this every day.

[17:12] Jason: Just kidding. Drop and give me 50.

Kathy:

Jason: With two legs? No, with one leg.

Kathy: You know where I see the asymmetry affect people? There are two places I see it where the strength difference causes pain for people. One is plantar fasciitis.

Jason: Mhm.

Kathy: There — for whatever reason sometimes we don’t — we don’t really know the source, but one

[17:42] calf — one gastroc muscle, one calf muscle — is weaker than the other. And the other one I see is in the hip, that lateral — that side hip pain.

Jason: Yeah.

Kathy: I see this in women a lot. Women over 40 a lot. That side — I call them the side glutes — the gluteus medius and the minimus are the glutes that are on the side of your hip, because they control how the pelvis moves in — one of these — in this plane of motion, the front of the pelvis.

Jason: Your sexy walk.

Kathy: Exactly. Exactly.

[18:12] Yeah. Robin calls it sassy. When you’re sassy. Boom. Boom. Yes. Shake with those fries, right? That’s true. That’s when you know your glute medius isn’t working that great if you got a little hitch in your giddy up on one side, but not on the other side. I’ve got one of those. Yeah. Yeah, I’ve got one of those. Yeah. Old leg injury and, you know, it rehabs to a point, but yeah, every time I do — like if I’m doing like hip

[18:42] airplanes or something like that, I still have to mentally be like, “Let’s lock that in.” Don’t let that hip get sexy. You got to keep it — Well, it’s already sexy. Like, how do you — It’s so sexy. Dial it in. Yeah, I know. Yeah, it’s like for everybody else’s benefit.

Kathy: Yeah, the glute medius is really important in stabilizing the pelvis when you walk.

Jason: Totally. Yeah, and so when you do get the little sashay —

Kathy: Mhm.

Jason: — when you’re walking, it can kind of

[19:13] cause a little bit of friction, a little bit of extra stress out on the side of your hips. And so —

Kathy: And I guess it’s not a move that you should never make. We don’t want to discourage people from doing it. Like Julia Roberts in Pretty Woman —

Jason: Do it. Don’t do it all day long.

Kathy: But we want you to do it under control, right? You should be doing it on purpose, not because you can’t control your — right?

Jason: Exactly. Exactly. So, I’ll usually have a test to check that too, and I’ll compare between the two legs. But

[19:44] that’s also where balance comes in, right? With the glute medius — walking is basically jumping from leg to leg.

Kathy: Yes. Right? And so when you’re in a single leg stance, the glute medius keeps that pelvis level. When I say — I don’t know how to describe “level” for people who are listening.

Jason: No, that’s pretty good. Level, as in not tilted.

Kathy: Not tilted. Yeah, and — so the pelvis, I think it’s helpful to think of the pelvis as a bowl.

Jason: Mhm. Yeah.

Kathy: Which this might horrify Carrie Boysen,

[20:15] she might agree, right? But if you think of it as a bowl, and if you have that bowl, you can dump it out forward.

Jason: Yep.

Kathy: You can dump it out backwards. So, forward would be your anterior tilt — that’s kind of like your booty pop —

Jason: Yes. Booty pop.

Kathy: — backwards would be like if you’re tucking your pelvis underneath you.

Jason: Yes.

Kathy: But then you have your side to side, right? You can dump something out the side. And so I think that’s what you’re talking about in terms of that tilt.

Jason: Yeah. So when you’re standing on one leg,

[20:45] and it happens for a millisecond every time you walk, that glute medius keeps that pelvis level as you’re on one leg. And so if one glute medius is not as strong as the other, then you get that shift — the little sashay

Kathy: Yes.

Jason: — we’re talking about. So when the glute medius is not as strong, balance can suffer as well. So

[21:15] balance — people’s balance — the factors that come into balance are a couple of things. One, your vestibular system, which we could do another

Kathy: Yeah.

Jason: — podcast about that. We should.

Kathy: Yeah, we should. Get like an ENT in here or something like that, or —

Jason: — vestibular therapist.

Kathy: Vestibular therapist, yes. Mhm.

Jason: I did a rotation at a vestibular clinic when I was in school. I loved it.

Kathy: Yeah.

Jason: Yeah, it was fascinating. So anyway, vestibular system, your

[21:45] somatosensory — your input, your sensory system — so what you feel,

Kathy: your joints and nerves and

Jason: Mhm.

Kathy: all that kind of stuff.

Jason: Mhm. And then actually your visual system all plays into balance. So as humans we tend to use our eyes for balance. And so that’s why when I ask you to close your eyes and balance on one foot, it’s a lot harder because you don’t have that reference point with your eyes.

Kathy: No. To keep your balance.

Jason: And people should try this. Like, stand on one leg

[22:16] and you can’t cheat though. Like, you can’t have one leg touching the other leg. You also have to have your hip over your knee over your ankle. And just stand there on one leg for as long as you can. Do it barefoot — it’s probably better. And then do that again but with your eyes closed.

Kathy: Yeah.

Jason: Good luck going 10 seconds if you have a deficit.

Kathy: It’s a big difference.

Jason: It’s — yeah. So all those things come into play.

Kathy: Yeah. Yeah. Well, and from a practical standpoint, can we talk about how important this

[22:48] is, especially for people as they get older? Like, man, I’ve had a couple of patients who we’ve had to have really serious conversations about — your legs don’t work. You’re going to fall, right? Whether because of sarcopenia —

Jason: Mhm. It would be great if we did a whole episode on that.

Kathy: Yeah. Oh wait, we did.

Jason: Good episode. Yes. Yes. Go back and look at the early episodes. Sarcopenia — or these balance mechanisms start to break down. And man, I’ve seen somebody who’s

[23:19] had pretty significant head injuries.

Kathy: Mhm.

Jason: I had a patient today who has this leg injury, and they’re asking, “What do I need to do to get better?” It was the side of the leg.

Kathy: Mhm.

Jason: And they’re like, “What do I need to do to get better? Like, are you going to be able to get me better by the end of this?”

Kathy: Mhm.

Jason: And it’s like, “Yeah, you need to exercise this. Like, you’ve got to strengthen that muscle.” Well, even though it’s injured? Especially because it’s

[23:49] injured, right? You’ve got to put it under some tension, an appropriate amount of load. Well, what does that look like? Well, let me show you — we could do some squats or some lunges, some side lunges. “Oh, I couldn’t even do those before I got injured.” And that —

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[25:22] Jason: Full circle.

Kathy: Yes.

Jason: And here we are.

Kathy: That is how you got injured is because you can’t do those things. And so, any of these things you find difficult, it’s because you’ve got to do.

Jason: Mhm. Mhm.

Kathy: I whispered for emphasis.

Jason: To make sure people — wait, what did he say? And then they rewind it.

Kathy: Yeah, that’s right.

Jason: I should start saying things backwards, too.

Kathy: Please do.

Jason: Because then when they rewind it, yeah, we don’t — no, this isn’t the old days.

Kathy: Nobody’s listening to this on their

[25:53] reel-to-reel.

Jason: Oh, right. No.

Kathy: No.

Jason: No. Cassette tapes are dead.

Kathy: I’m sorry. Go ahead.

Jason: Continue. Teach us.

Kathy: Okay. So, let’s talk about some of our favorite unilateral exercises.

Jason: And these are two of our favorite unilateral exercises. When I’m feeling sad.

[26:24] So, I already mentioned my least favorite, but also most favorite to prescribe.

Kathy: Oh, well, let me see if I was paying attention. The single leg heel raise?

Jason: That one.

Kathy: And the one that I hate to do that I need to do more.

Jason: The single leg burpee.

Kathy: That sounds good.

Jason: That would be —

Kathy: Is it the single leg squat?

Jason: It’s the split squat or reverse lunge.

[26:56] Kathy: They’re so hard.

Jason: Yeah.

Kathy: They’re so hard. Forward lunge, my knee doesn’t love that one. But reverse lunge or split squat, you know, Bulgarian split squat.

Jason: Yeah.

Kathy: That one tells the truth.

Jason: Yeah, well, and I think it’s different for different people. I actually love those.

Kathy: You do? Yeah.

Jason: I love the Bulgarian split squats. Yeah, I — but I think it’s just because I don’t know, maybe my legs are built for it. Maybe I use that more. I don’t know what it is. But there’s some people that

[27:26] absolutely loathe that. Like I remember Laura Lee, she was on, she was like —

Kathy: Yeah.

Jason: It’s like it’s not that big of a deal, right? But, yeah, so those are good examples of them.

Kathy: Yeah.

Jason: I don’t know. How do we — this is hard because some people are listening to this and it’s like, how do we describe all these to you?

Kathy: Yeah.

Jason: I don’t know. Maybe —

Kathy: Yeah, so let’s just — the split squat in general without the Bulgarian part of it.

Jason: Okay. The American split squat.

[27:57] Kathy: The American —

Jason: Proceed.

Kathy: Well —

Jason: The freedom squat.

Kathy: The way we start at Helix, if you haven’t done split squats before, we’ll start with your knee on the ground. And then you have one knee on the ground, your other foot is in front, and your feet are hip-width apart —

Jason: So it’s kind of like you’re taking a knee as a coach is going to talk to you.

Kathy: Yes, and maybe this is why I don’t like them.

Jason: Because it takes me back to my Catholic roots.

Kathy: Yeah.

[28:27] Genuflecting.

Jason: Somebody saying, “Listen, Lynch.”

Kathy: Going into confession.

Jason: Yeah.

Kathy: Bless me, Father, for I have sinned.

Jason: Your sinful glutes.

Kathy: Yeah, so think of — if you are Catholic and you genuflect, that’s a split squat. One knee to the ground, stand up without the use of your arms.

Jason: Okay.

Kathy: Okay? You can’t use the pew.

Jason: Oh, no.

[28:57] So, you’re saying the Catholics have a huge advantage whenever it comes to leg strength.

Kathy: 100%.

Jason: I think that there are studies that support that, yeah. Uh-huh.

Kathy:

Jason: The control group was non-Catholics.

Kathy: Non-Catholics.

Jason: Uh-huh.

Kathy: I heard the Pentecostals have a real leg up on cardio, though.

Jason: Oh.

Kathy: Oh my goodness. Okay, how did we get off on that train? Anyway —

Jason: My — the one I hate to do the most is the split squat, but the one I most

[29:27] love to prescribe is the split squat or reverse lunge.

Kathy: So, just to get that straight, kind of take a knee, step the other one forward, and then I’m just going from that position standing up.

Jason: Stand up.

Kathy: Standing up.

Jason: Stand up and then back down. Bring that knee straight back down.

Kathy: Okay.

Jason: And stand back up.

Kathy: Three sets of 10.

Jason: Let’s go.

Kathy: All right.

Jason: And so, that’s one leg at a time, but should you do both?

Kathy: Yeah, then you switch.

Jason: But what if one side isn’t as strong as

[29:57] the other, Kathy? Shouldn’t you just stay on your strong side?

Kathy: Just keep going with one leg.

Jason: Just the strong side.

Kathy: Let the other one wither and die.

Jason: You know what that reminds me of? Did you ever see that movie Lady in the Water?

Kathy: No.

Jason: Oh my gosh, it’s M. Night Shyamalan. I don’t know how to say his name.

Kathy: Yeah.

Jason: Yeah, and Paul Giamatti and —

Kathy: Woman in the Water something. Is it Lady —

Jason: It’s Lady in the Water. Yeah.

Kathy: Okay.

Jason: Yeah, and she’s like in the swimming pool or whatever. Paul Giamatti is like the super for this apartment complex. They got all these

[30:28] weird people in there. They have this one guy who he’s just doing this experiment. He just does curls all day with one weight. Kathy: With one arm. Jason: With — oh, yeah, with one arm. Not one — it is one weight, and yeah. And so he walks around and he’s got this one normal arm and he’s got this one arm that is just huge. It’s so weird and funny. I love that movie. Most people hate it. They’re like, this is his worst movie ever. I think it’s such a great story. Anyway, Kathy: Okay. Two thumbs up. On my to-do list

[30:58] now. Jason: Yes. Kathy: I guess if I’m looking for something. Jason: But yeah, go watch that and you’ll see there’s this dude in the apartment complex and he just has this one huge arm. It’s grotesque. Kathy: Jason: My second favorite, you already nailed it, is the single leg heel raise. Kathy: Yes. Jason: I call that my plantar fasciitis prevention program. Kathy: Ooh, I like that. Jason: Mhm. PPP. Kathy: Yeah. Jason: PFPP. Kathy: Pif-pup-pup. That’s how you say it. Right. Jason: Yeah. The

[31:28] Kathy: I’m on the pif-pup-pup-pup. Jason: Kathy: Yeah, for foot pain. Jason: That’s right. Anybody, especially after a surgery — even if it’s a hip or knee surgery — I go after single leg heel raise, because likely if you haven’t been bearing weight through that leg, that gastroc muscle is Kathy: It’s going to need some work. Jason: Yes, and that muscle is imperative.

[32:00] It’s a must-have in order to walk. Kathy: Yeah. Jason: Yeah. How do you get your heel off the ground? Kathy: Yeah, you cannot toe off if you don’t have a good gastroc. You can — Jason: You can toe off. You can’t heel off. Kathy: Jason: Thank you. Right. You can’t push off using your toes. Yes. Kathy: I know what you meant. Jason: Goodness gracious. Yeah. Kathy: Toe off. Yeah, you just — Jason: Don’t tell Robin I made that mistake. Kathy: I won’t. She will try not to listen to this episode. Jason: Yes. Which will be easy for her. Kathy: Jason: Cuz she’s not listening to most of them. Kathy: She’s too busy learning more to teach

[32:32] us. So that’s my second favorite. And also just — that muscle doesn’t get trained enough, I don’t think. And so I’ll throw that in usually with any kind of lower body rehab that I’m doing. Do you have — well, you already told us your favorite one is the split squat. Kathy: I like the Bulgarian split squat. I think — I don’t know. I think it’s fun because there’s like a seat involved, right?

[33:04] Let’s see. Okay, so here’s one that is a little more dynamic. Jason: Mhm. Kathy: I like speed skaters. Jason: Oh, yeah. Kathy: Yeah, where you’re kind of jumping side to side. Jason: Those are good. Kathy: That’s a really good one. And probably one of my other favorites is the hip airplanes. Jason: Oh, yeah. Kathy: Yeah, which I love hip airplanes because even though it’s a unilateral exercise

[33:35] where — boy, this is going to be impossible to describe. Just go Google hip airplanes, you’ll see it. Jason: You’re standing on one leg. Kathy: On one leg, your arms are kind of out like an airplane, your — Jason: And you bend over. Kathy: Yeah, and you’re bent over at the waist. You have one leg that’s straight out behind you and you’re trying to kind of rotate that back leg so that the toe is pointing up towards the — Google it. But I love that one because even though it’s a unilateral exercise, it’s really working both sides. So,

[34:05] your up side and your support side are both working. And my legs just feel phenomenal after that. Yeah. Jason: And you — I mean, you can use weight with it, but you can do body weight on that and still — Kathy: It’s just like — it’s enough just to keep this guy off the ground, right? It’s a really good balance one. It’s good for strength. And I’ve seen people do it with exercise bands attached. Jason: Oh, yeah. That’s advanced. Kathy: Yeah. Jason: That’s next level. Kathy: Yeah, it’s a great one, though.

[34:35] Jason: Okay, what about upper body? Single arm upper body Kathy: Mhm. Jason: exercise. So, there’s your typical — I like the overhead press with a dumbbell. Kathy: One arm at a time. Jason: One arm at a time. Kathy: Yeah. Jason: Yeah, just like — I like the dumbbell Kathy: Yeah. Jason: bicep curl, clearly, right? Kathy: It’s a must. Jason: It is a must, for sure.

[35:06] But the other one — this one’s a little bit more dynamic, too — is plank with a shoulder tap. So, you’re planking Kathy: yeah. Jason: and then you’re tapping your shoulder. So, for a second or two, you are on one arm. Kathy: Yeah. Jason: Yeah. And that can really, again, expose which side is stronger than the other. Kathy: Well, and that’s a good one, too, because that’s not just an upper body exercise. It’s also — you have to have good control of your glutes and the

[35:39] muscles in your abdomen in order to be able to pull that one off. I like that one. Jason: Mhm. Kathy: I like a good kettlebell swing. Jason: Oh. Kathy: Like a one-arm kettlebell swing. Jason: Swing. Kathy: Yes, cuz I think it’s fun. It’s nice and dynamic. It trains you well for like starting the lawn mower, which — you know, give it 5, 6 years, nobody’s going to know what you’re talking about when you say starting the lawn mower. Everybody’s switching over to electric and it’s like, oh, I push a button. Nobody’s going to have that core

[36:09] memory of trying to pull that cord. Jason: going to have any muscles left. Kathy: I hope not. Jason: I’m just kidding. Kathy: Jason: Cuz everything’s just so easy. Kathy: Yeah. So, a good kettlebell swing — I like that. It’s fun. Jason: It’s dynamic and it’s — it’s kind of weird to say, but it’s almost even like a little bit of a stretch while you’re doing strengthening, cuz you’re resisting the weight of that kettlebell as it’s

[36:39] swinging, so. Kathy: Mhm. Jason: I like that. You can do double-arm kettlebell swings, but single arm I think is really valuable too. Kathy: Yeah, it’s definitely an advanced movement and skill for sure. Okay. So, moving on. Let’s see. Jason: Where are we on the agenda? Kathy: Do we have any questions we need to — talking points we need to go over? I’ve talked about this before,

[37:10] especially with ACL rehab. And your son will be able to — you know, he’s heard me lecture him over and over and over and over how strong we need to keep — we need to work that one leg. There is a — where is the — I have a study that I read. Sorry, I don’t have this up. It was a study. Oh wait, here it is. Cross over —

[37:40] crossover. Cross education of strength. So there’s this theory that if you work the strong side, your other side will get stronger as well without actually doing the exercise, because it’s more of a neuromuscular — Kathy: Yes, integration. Jason: — integration than it is necessarily the actual physical movement. Kathy: Yeah, because we’ve talked about this before, where a part of getting stronger — the first part of getting stronger — is actually not

[38:11] building bigger muscles, it’s recruiting more muscle fibers neurologically. Jason: Right. Kathy: And so, as I am moving — I mean, well, you could think about the dominant hand thing, right? Jason: Yeah. Kathy: So whenever I sign my name with my right hand, I’m also training my left hand to sign the name, because that just gets built into your brain. So if I break my hand and now I need to start signing with my left, I’m not starting at square zero where it’s like I don’t know how to write anything.

[38:42] Those skills for writing are in my left hand even though I never use my left hand for it. So it’s the same kind of thing for other limbs, too. The hand is kind of a weird example because this is a high-dexterity thing. But if you’re doing something that’s lower dexterity, like a hip movement, if you’re training hip movement on one side, you’re also training hip movement on the other side. It’s not like your left side’s like, “I’m just going to take the day off. I don’t know what’s going on.”

[39:13] Kathy: I’ll be here on the couch. Jason: Yeah, yeah, yeah. I don’t want to know. La la la la la. No, it’s paying attention and it’s learning, and they’re all fed by the same nervous system, same spinal cord, same brain. Kathy: Was it Michael Jordan or Kobe Bryant that — Jason: Was good at basketball? Kathy: — was one of them. I can’t remember which one it was. Jason: Shot left-handed free throws. Kathy: Yes. Jason: Which one was it? I can’t remember which one it was. Kathy: Jordan was the one who used to close his eyes and shoot free throws. Jason: I want to say it was

[39:43] Jordan. Kathy: Okay, was it then — maybe Kobe — it was the left-handed — Jason: I don’t know. Was that the game? Is that the game? Well, Jordan definitely closed his eyes and shot. Kathy: Yes. Jason: But I think I want to say it was Jordan that shot the left-handed free throw, too. Kathy: Yeah, same idea. I’m sure he didn’t spend tons of time shooting with his left hand. Jason: Yeah. Kathy: It’s just that he had shot so many times with his right that the left is like, “I could probably do this better than most people with my left.” Jason: Totally. Totally, right? Well, and when you’re coaching kids, like does anybody

[40:13] on your basketball team get away with only being able to dribble with one hand? Kathy: They try. Jason: Okay. Kathy: Jason: So we have special drills for that. Kathy: Yeah. And it’s — when I was coaching volleyball, you know, it’s like you need to be able to hit with your left hand and your right hand. Yes, you’re mostly hitting with one or the other. Jason: Right. Kathy: But there’s going to be sometimes when maybe a set goes out too far, and do we just let that point go away, or if there’s a way that we can

[40:44] finish, we finish. And so, yeah. Jason: Yeah, let’s get it with the left hand, for sure. Kathy: I’m Googling your Kobe Bryant–Michael Jordan thing. Yeah. It was Kobe Bryant. Jason: Kobe. Okay. Kathy: Kobe Bryant famously shot a free throw left-handed after tearing his right rotator cuff on January 21st, 2015 against the New Orleans Pelicans. Jason: Wow. Kathy: Stayed in the game, made one of two left-handed jump hooks,

[41:15] free throws, and even hit a left-handed turnaround shot, demonstrating his legendary Mamba mentality. Jason: That guy is a legend. Kathy: Yes, absolutely. Jason: Yeah, just — Kathy: the background of that. That he tore his rotator cuff and still played. Jason: 100% committed. Kathy: And then it says — so the Practice Habit says Kobe often practiced left-handed shots during training to improve his off-hand skills. Jason: Okay, so he did practice. Kathy: It’s still his off-hand, you know?

[41:45] But yeah, so there is no wasted rehab, I guess I would say, from that standpoint. Jason: Well, do you have the game — Kathy: My goodness. I went a little — if you go a little bit deeper — Jason: 1999, he was recovering from a broken hand and shot left-handed. Kathy: Left-handed. My goodness, this guy. Jason: What an animal. What an animal. Oh, so you’re saying that you like to play a game. Kathy: All right. Jason: Game.

[42:15] Kathy: Jason: All right, I call this game in honor of the fact that we’re talking about unilateral exercise. There can only be one. Kathy: Oh, okay. Here we go. Jason: So these are going to be questions where the answers themselves clearly involve one — like maybe the word, the number, something that means one. Okay? Does that make sense? All right, here we go. Number one. Actually no, we’re going to start at number 10. We’re going to count it down to one. Kathy: Okay. Jason: All right, let’s see.

[42:46] Okay. The common English phrase about leadership — which number is used in the expression, “You can’t be blank of many, you have to be blank of one,” emphasizing focused responsibility? Kathy: One of one? Jason: Very good. Kathy: Great, look at me. Jason: That’s so difficult. Okay. In Roman numerals, what is the symbol that represents one?

[43:20] Kathy: In Roman numerals — like, how do I explain that — but it’s an I. Jason: It is an I, very good. The capital I. Kathy: It looks like a capital I. Jason: Okay, in the Star Wars saga, Anakin Skywalker is a character who is prophesied to be what — who will bring balance to the Force? Kathy: Obi-Wan Kenobi. Jason: No, that’s Obi-Wan, but — Kathy: One. Jason: He was supposed to be

[43:50] Kathy: the one. Jason: Yeah, the close. Obi-Wan says, “You were supposed to be the Kathy: one.” Jason: Raul, what’s the answer? I see you over there mouthing it. The chosen one. You were supposed to be the chosen one. Kathy: Supposed to be the chosen one. Jason: Yes. Kathy: Okay. Jason: Okay. Kathy: Dang, I thought I had that one. Jason: Yes, in J.R.R. Tolkien’s Lord of the Rings, there’s a legendary object that is the subject of the book. What is

[44:20] the singular object called? Kathy: One ring. Jason: The one ring is correct. Good job. Kathy: Look at me. Jason: Okay, all right. In the sci-fi film The Matrix, which character’s name is literally an anagram of the word “one” and matches his role as the one in the story’s prophecy? Kathy: Am I just naming the character’s name?

[44:50] Jason: Yeah. Kathy: I have no idea. Jason: It’s an anagram of the word “one.” Kathy: Okay. Jason: It’s only three letters there. Kathy: Oh, anagram of the word — Jason: I’m going to give you a clue. It’s not Eon. Kathy: I was going to say Eno. Jason: Or Eno. Kathy: Eon, you already said it’s not Eon. Jason: Oney. Kathy: And it’s not Oney. Jason: Noey. Kathy: It’s not Noey. Jason: Neo. Kathy: Neo is correct.

[45:20] Jason: Boy, that took a long time. Kathy: Yeah, yeah. Jason: On first try. Kathy: Okay, in mathematics, what is the only positive integer that is neither a prime nor a composite, making it the only uniquely stand-alone number? Jason: One. Kathy: That is one, that is correct. Very good. On. So, if we’re looking at the scoreboard, and we’re trying to rank you, I think that you came in first. You’re number one. Good job.

[45:50] Jason: I’m number one. Kathy: All right, take homes. Jason: Okay. Take homes. Unilateral exercise will expose weakness, and there’s no place to hide. Kathy: There’s no place to hide. Yes, I like that. You can run, but you can’t hide. Jason: That’s right. Kathy: When we’re asking you to run on one leg. Jason: You look like a triple jumper. Kathy: Okay, my take home number one, I’m

[46:21] going to go back and I’m going to watch Lady in the Water because I just really enjoy that movie. It is so good. I love it. Like the whole thing is like a fairy tale and yeah, it’s just excellent. Let’s see, my other take home. Well, I definitely need to get back into some of my favorite exercises. I’m glad that you brought them up because it’s like, ooh, yeah, I do like these and I need to do it more often, because I can tell a substantial difference when I do it. I don’t know if PTs are like chiropractors where it’s like,

[46:53] it’s very easy to give good advice all day. Jason: Aw. Kathy: But then at the end of the day, it’s like I’m done dealing with that good advice. I’m not going to do it for myself. Jason: Now, why would I do that? Kathy: Yeah, yeah, so I probably need to take a little bit of my own medicine. Jason: I hear that. Kathy: So. Jason: I hear that. Kathy: Could we shout out to sponsors real quick? Jason: Please. Kathy: Sponsoring this episode. Anyway, yeah. Oh, I think we talked about Encore Physical Therapy. Jason: Yeah, that. Kathy: That’s a darn good physical therapy clinic. If you are in the Corvallis,

[47:24] Lebanon, Albany, Philomath, Jason: Philomath, Kathy: Jefferson, Turner, Jason: Alsea, Kathy: Alsea, Adair Village, Jason: Monmouth, Kathy: Oh, yeah. Jason: If you want to get — hey, and it’s North Corvallis. So Monmouth is not that far away. Right? If you’re in Eugene, just stay there. Enjoy your stinky city. Kathy: Jason: But everybody else, invite to come on down to Encore Physical Therapy. Quality, quality physical — Kathy: High quality. Jason: Mm-hm. Kathy: Yes. Jason: And oh, you guys actually — you got a new

[47:55] got a new PT. Tell us real quickly about — Kathy: Nathan Smith. Jason: All-time great guy. Kathy: Yes. Jason: Everybody loves Nate. Kathy: Yes. Jason: But also 19-time Ironman finisher. Kathy: That’s insane. Jason: Bro. Kathy: Insane. Jason: Yeah. Kathy: Yeah, I actually sent an endurance athlete over specifically to talk to him, so Jason: Excellent. Kathy: Yeah, because I don’t understand that level of psychopathy. Jason: Commitment. No. Kathy: Oh, you got

[48:25] Jason: commitment. Kathy: Yeah, and Nate and him will probably just vibe. Jason: Yes. Kathy: That’s really good. Jason: Yeah. Kathy: And then we have another sponsor. Jason: Body of Kathy: Body of Health Jason: Health. Kathy: Yeah, Health is the best. Jason: Yeah. So, it’s just a little family chiropractic clinic. Kathy: It’s a pretty good place. Jason: Just — Kathy: Come see the Young family. Jason: One short mile away from On Course Physical Therapy, so yes. Kathy: Great vibes. Great vibes at Body of Health. Jason: Yes, because I mean, if you can’t have science, you might as well have vibes.

[48:57] Jason: If you can’t laugh at yourself, I mean, come on, guys. No. Um, I think there is one more important thing that we need to get to, and that is there’s no I in pitch. Kathy: