Raw Transcript: Dr. Joe Damiani and Coach Chong Xie on Chronic Pain from Fascia Perspective Part 1

[music] [music] Why don't you kind of kick it off? How did you get into this? How did you get into fascia training? >> It's really a long journey. It has been 10 years now. So when we first started really it's when we were working with athlete, everybody does squat, deadlift, right? However, what we see is that some people when they do squat, they do not recruit their glutes or core the same way as some elite level athletes. >> Okay? >> So, for example, elite level athlete may be doing a squat and uh you know, they're recruiting because we look at EMG, they're recruiting a lot of the glutes and the core, but average athlete, for example, they don't do that. Some people very quad dominant when they squat down the very little reading in the glutes but a lot on the quads >> and lower back. At that time it was like it was a very big challenge. So to solve this we we really have to look at what is missing. And also what what we found out earlier on is that there are athlete who are very athletic but they're very skinny. They're very lanky. >> Mhm. and they do poorly on the weights. So some athlete they can dunk the ball at 5'9 but you ask them to do a 135 lb squat they can't do it. This is something that we were very curious about and we wanted to find out what is actually powering these elite level athletes and at the time we actually had a opportunity to study Cardor Xani who is a founder of modern dunk shows. So he started dunk shows in in France. We sent him a EMG suit. Uh it's called EMG suit. It was a startup company. So that suit is it's a surface level EMG but he can measure you know what muscle groups being used. >> Okay. >> So when he started using it we were noticing he was using a lot of glutes even standing and walking but this amount of glutes activation was not seen in average people. So that was our kind of light bulb moment. What is actually causing that? And uh that's how we started to look into the foot because when he was growing up, he actually he didn't have the necessary economic means to to have fancy shoes. So he he was always grew up barefooted and he did everything barefooted. He was jumping barefooted at at at his prime. He had a 50-in vertical >> even even though he didn't have any any big muscular mass, but he was dunking. He was doing a 360 one leg dump from almost from the free throw line. That was that was just how crazy athletic he was. Uh but of course we we wanted to understand that that's how we look into the the fascia perspective because we wanted to know if there's any benefit in any connection that's happening from the planter fascia which we we all know on the bottom of the foot >> connects all the way to the glutes and the rest of the body right >> and and I'm happy to say that there is a very strong neurological fascial connection that can be enhanced from the foot to the glutes. Right. So you guys were so your hypothesis at the time was that he was having that his fascial connection he was essentially it was very integrated within the body so that he was able to not just planter flex or push his foot down but he was able to connect that with extending the knee and extending the hip but in his case he was by because to extend the knee you're going to use the glutes predominantly I mean the quad quadriceps to extend the hip you're going predominantly use the glutes. Um, but so when someone is just bending down and coming back up at first sight, you don't really know is it because of the ankle mechanism, the knee or the hip. But in like as you guys dug deeper into it, you saw that he integrated everything and really dominantly use the glutes more than someone who would not be able to achieve that same vertical. >> So what is also very important to understand is for example doing a let's say we do a standard box jump, right? having someone just jump on the box. Now the the more goose dominant individual will use the fascial connection. For example, when they jump off, their heel is already suspended. So they kind of doing that triple extension automatically without being coached. Now the people who are more quad dominant, they don't have this necessary connection. They dorsif flex much more in their ankles and then they use much more quad to jump on the box. So the difference is if you understand what you're looking for is huge. But if you don't know what you look for, you you can't see it. You just think, okay, yeah, this person jumping on the box. But from an EMG perspective, it's completely different. >> So we we wanted to understand why this is. And and the question becomes, can we turn somebody who is quad dominant into somebody who is more goose dominant? Mhm. >> And then this is where we we actually joined a organization called the fascial research society with many doctors from the US and from Germany, from Italy, from Canada, from Brazil and they all contribute to the knowledge of fascia science through either through dissections and research. >> Mhm. So when we had our research, we really we were very interested in this footto gloo connection and how can we achieve this elevated amount of connection and how can we use utilize this to help people with chronic pain. That's that's where we really specialize in and currently we're doing clinical trials. We're trying to understand can we in 12 weeks address chronic ankle instability and also improve performance without any type of weightlifting and the result well the pre preliminary result is very good we haven't finished the study we should have the study done by the year end but the result is is very good >> so so basically is the theory with that then that basically by not being able to finally control the movements of the ankle, you're essentially leaving performance on the table that doesn't even require additional strength training or speed training or agility training. It's just the natural tendencies have more efficiency in them, but you're not no you're not utilizing the full efficiency of it. So average people unfortunately from what we understand now >> because we as as average people we we develop our body with the existence of the shoe. >> So we're constantly dampening the neurological stimulation to the plantar fascia. Therefore we do not develop from the neurological fascial perspective. So the foot to goose connection is not fully developed. When we are talking about elite level athletes especially you know you look at you know LeBron James you look at Pacquiao you look at all the elite level athletes today they really have a very high level enhanced level of photog connection. So, I know you were just talking about chronic pain and injury. At some point during your research, were you finding that the people who did not optimize or utilize these these functions properly would not only not perform to their fullest, but they would be more prone to injury because of overuse and dominance in certain areas. >> Yes. I mean, the I think currently the mainstream understanding and the term we use quite often is overuse injury. or or some muscles are very tight, shortened, stuck in a shortened state. >> But without truly understand the architecture, the real anatomy with fascia integration involved, you really just give a incomplete explanation of what's going on. The way that I found your work is, you know, you were talking about fascia. That is very very important from a muscular perspective. every fiber because I did my dissection at Stanford. When we look at the human body from dissection point of view, every muscle fiber is encapsulated by fascia, >> right? >> And there are multiple layers to the finest detail of your muscle fiber. Now the muscle fiber, if you remove the fascia, the muscle itself is like mush. It it it doesn't really have too much strength. But with the fascia integration, it gives shape. It gives strength. And we also know from tinsel strength study for example fascia in the fascia ladder on the leg is up to 276 mega pascal but the muscle if you just pull it by itself without fascia is only 0.5 megapascal. So there's a huge level of difference. So what that means is that on the physical level strength level the fascia plays enormous amount of role. So you probably heard of, you know, like when elite athletes are airborne, when they land, when they change direction, the force can be up to seven times body weight, nine times body weight. But if you look at the gym numbers, when people are lifting weights, at the most they lift two time body weight, three times body weight. Now, what is actually handling the rest of that 6x body weight? >> That is your fascia. That is your connective tissue, >> right? your ability to absorb that, >> right? And it redistribute properly, >> right? Because athletic movements are complete compound total body movement. So you need a complete system to actually absorb those forces properly and which is like almost the same reason why the spine has its natural curve. If you relied on one hinging joint to absorb all force, that joint would be busted and painful. Now when you look at the spine, it has a beautiful architecture where it can actually absorb force because of the natural curves and the fascia is just an extended effect of that throughout the entire body. Exactly. And the fascia it's so intricate. The way that we started to understand more about fascia is Is that