Episode 8: Building A Bigger Bucket

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• Joe Gambino
• Joe LaVacca

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Summary:
In this episode, Joe Gambino and Joe LaVacca discuss how to help someone tolerate more stress and build resilience in their body. They emphasize the importance of desensitizing the system and reducing pain to allow for more stress tolerance. They also discuss the concept of the 'bucket analogy,' where the body can only tolerate a certain amount of stress before it overflows. 

They highlight the role of trust, patience, and problem-solving in helping clients who have struggled with pain for a long time. They also emphasize the importance of being a guide and facilitator rather than a fixer.

Takeaways
1. Desensitizing the system and reducing pain are important for building stress tolerance and resilience in the body.
2. The 'bucket analogy' helps explain how the body can only tolerate a certain amount of stress before it overflows.
3. Trust, patience, and problem-solving are key qualities in helping clients who have struggled with pain for a long time.
4. Being a guide and facilitator, rather than a fixer, is important in the client-provider relationship.
5. Building trust and confidence in the client's own body is crucial for long-term progress and resilience.

Transcript

Joe Gambino (00:01)
Welcome back to the Beyond Pain podcast. I am one of your co -hosts, Joe Gambino. You can find me on Instagram at joegambinodpt and your other lovely, beautiful co -host, Joe Lavaca. He's sitting somewhat across from me at strengthinmotion underscore PT. Well, we're, you know, we've got screens now. Feel free to reach out to us. We love having conversations with anyone who interacts with any of our content. So please do so.

Joe LaVacca (00:16)
Hello, hello. So much.

Joe Gambino (00:31)
You can do that on Instagram. There's also an application form in the show notes So if you are interested in working with us, you can fill that out and one of us will get back to you and we can have a conversation that way And you can also watch this show on YouTube cups of Joe's underscore PT and we do have an Instagram account for the podcast simply beyond pain podcast on Instagram and That's it. And I was just telling Joe right before this started that

I'm a little tired from the week, little recovery from Mexico is still happening. Hopefully your day is going better than mine. I was telling him I attempted to make myself a cake up before the show and did not change out the cartridge. So I just poured it out and gave up on it. Here we are. Here we are today. We could have that. There'd probably be a couple of episodes on that one.

Joe LaVacca (01:19)
Dude, that's a different podcast about what happened in Mexico.

That's gonna have to be an extra so that'll be that'll be the subscription only service.

Joe Gambino (01:29)
But I will the Subscribe to us will give you access but yeah, I mean the footnotes for that is there's just way too much tequila So I feel better. I'm just like I'm just mentally not fully fully ready for life. So

Joe LaVacca (01:44)
Yeah, well that's okay, that's okay.

Well, and did you have a time zone shift? Was it an hour or something? Yeah, well, I don't know. Sometimes, depending on what you read and what you believe, an hour shift, it takes a week to recover from. I don't know. I've never really felt that. I mean, flying out to Colorado back and forth so much now, I guess for eight or nine years, I feel like I settle into a groove. My watch tells me a different story when I'm out here, though, which is always interesting. But like you just said, it's always context. Like, you know, court and I, when we get together,

Joe Gambino (01:53)
There's only an hour. Yeah, it's not bad.

Joe LaVacca (02:19)
It's like, hey, let's go grab a cocktail after work. Let's go grab a beer after work. And, you know, that's not probably something I'm doing regularly in the city. So, yeah, I can feel a little bit of the fuzz today. You know, we had a great day yesterday. We had our first guest ever on the podcast. So there's lots of reasons to celebrate. So Courtney, I did a little celebrating last night and. It was just a good good night, and then that leads to some tough mornings, but I'm here and ready to rock. And so are you. So what are we talking about today, dude?

Joe Gambino (02:34)
That's right.

Yes. And this is, this thing, that was actually a perfect joke because it kind of pushes us right into today's episode. So this is episode nine, episode eight was Tyler. I thought it was a great conversation that we had with him and there were, times where we started to talk about, you know, capacity and kind of how we bring somebody back to, you know, whatever their fitness level is or whatever it is that they're looking to accomplish with their bodies. Right. so.

I'm kind of going to, they're just, you know, it almost feels like a somewhat of a continuation, but I'm going to throw this question to you. And I'm curious to how you think about things, but I think you even mentioned it in like two episodes ago where, you know, a question that people have for us, right? Is how long does this process take or how can we even help them? So the question for you is when it comes to actually helping somebody tolerate more stress, how do you think about that?

Joe LaVacca (03:46)
Yeah, I think that, you know, it goes without saying first, it's always an individual level. The person who has been training and maybe accustomed to delivering stress to their body, we can probably always push a little bit more. Let's keep the conversation to probably my more typical client who comes in with fear, comes in with avoidance strategies, very hesitant to...

You know, pick up load. I mean, let alone move. If I can convince them that movement is good by starting things, you know, very stability based, like just on the table, you know, can we start just moving and wiggling on your back, on your stomach? Then can we take that up to hands and knees? Then can we take that up to like a tall kneeling position and then all the way up to standing? So there's always remnants in my thought process and that.

remnant there is probably what I took from SFMA, right, like just starting in these like, what they would say is like a four by four matrix, increase the stability demands throughout the position, but you can still do any motion you want in a prone or supine position, or a quadruped position. So if it's sensitivity to movement, that's kind of where I'll start them, I'll break that movement down into pieces. You know, back pain is common, everyone can kind of relate to that. So let's just say,

if they're apprehensive or having a lot of sensitivity to forward bending, I might start the process on the table just with like some knees to chest. Keep that lever arm short. Alright, so knees are going to be bent, then maybe gradually increase the lever arm by having the leg go out a little bit wider. And then maybe have them start to do like a little curl up or a little roll up there. And then just kind of keep gradually building off of that that can kind of go to like some

more specific cat cow drills again with their legs in different positions. And then maybe just gradually sitting and flexing forward before we go up to something like standing. Right. Now, if it's more from a weight perspective, this is where I'll typically just play with body weight. Right. If we're doing like some lower body tasks, like I want them to maybe think about squatting or dead lifting. I'll ask them their body weight and I'll typically take like

25 % of that, right? And usually the number is fairly small and I'm like, hey, if we took a quarter of your body weight and put it on the floor, do you think you would be comfortable lifting this weight or kind of manipulating this weight in some way, shape or form? Sometimes that answer is no, right? And I'm pretty respectful of that. And then I usually will just say, okay, well, what weight would you think you're kind of comfortable with? And then people say something like five pounds, 10 pounds, whatever. And okay, fine. Let's...

build up to then a quarter of your body weight if we can. Here's five pounds, just lift this off the floor. And we can maybe talk about just some easy things in terms of form and technique. And then that five pounds, build a little bit of confidence, builds them up to 10, and then maybe we kind of gradually go up to 25 % of their body weight. The fun thing lately I have been doing is thanks to the TIN deck. Do you have a TIN deck in your clinic, Joe?

Joe Gambino (07:02)
I do not, because I don't have a clinic. Yes.

Joe LaVacca (07:03)
Or, you do a lot of virtual, you do a lot of virtual. So I'll actually put them, I'll rig something up on the Tindak, right? Like just maybe like a handle, bring them over to the cable column, and I'll just have them pull on that thing, right? And a Tindak is essentially a force reader, right? So it can read in pounds, it can read in all these different units of measurement. And then people will pull, and I'll tell them, just pull your safest, you know, whatever you feel comfortable with. You know, they give a little tug.

And I'm like, okay, what do you think the force you just put into this, you know, device was? I think they'll always underestimate it's like 10 pounds, 20 pounds. And then I turn the camera around, I turn my phone around, because the phone will actually give me an output. And it's like 90 something pounds, 100 in this pounds. And they're like, wow, I didn't even know I was putting that much force, you know, into into the movement. And then I say, okay, what do you think about that when you've been now using 10 pound weights in the gym, or you and your trainer have been really under loading?

the areas, it seems like you can tolerate a lot more stress. And then it sort of proves it to them. But that's only like within the clinic. So I guess knowing that you're more virtual now, or really only virtual, how are you doing some sort of like prove it stuff or progression stuff for people in the virtual space?

Joe Gambino (08:21)
So there's a couple of things that I like. I think it kind of always comes down to whenever someone's in pain, looking to get back to something like first step is like desensitizing the system. I bring in now pain building confidence because it's true. I mean, there's a lot of people that come through that are very unsure that they can take the next step. I've had people who have had a conversation with me and they've like, yeah, this has been going on for years. I've seen so many people and,

The biggest part about making a decision to even work with me is just to be like, yeah, this is actually possible for me to get better, right? Like that's the hurdle that ends up happening more often than not. So, you know, I agree kind of like that, that initial part to building a more resilient body is desensitizing the system because pain will ultimately kind of affect things. And when, if we can't get somebody completely out of pain, then they need to, I mean, we need to reduce it as best as we can so that this way they can.

Joe LaVacca (08:55)
Mm. Sure.

Joe Gambino (09:18)
start to load it and start to kind of push through. But in this environment, it's more of a, I think every episode so far, we've touched on the pain guidelines that I have. So it's asynchronous, my communication with whoever I'm working with, right? It's more often than not happening on like a direct call with somebody. It's like, go do this and then let me know how you feel. And then based off of that, we either hop on a call to talk about it or we navigate it through like, you know, sending each other videos back and forth or messaging. So.

That's kind of how we do it. And I think what I like about the environment is that it teaches people to have more control over it too, right? Because they're doing it on their own. They're kind of by themselves and have to come back to me as like the soundboard. And as long as they're comfortable being in an environment, you know, they're able to do it and navigate it. And then come to me where I just give them advice and they go back and do it on their own, right? It's very, it creates like an independency for them, right? Because they're not relying on me in a clinic to be like,

can I do this, can I do that, right? They start to learn to explore on their own and come back to me. And now we kind of, you know, it's the backend kind of coaching that we kind of do to navigate some of the uncertainties, right? And that's, it's more of me helping give them permission in a sense to keep pushing or keep loading, right? I had somebody I'm working with and he's trying to get back to playing tennis and our, for, you know, we're maybe about our eighth weekend, I think at this point.

Joe LaVacca (10:30)
Mm.

Joe Gambino (10:41)
And he's having, you know, like he gets sore after some of our sessions, but he's slowly tolerating more and more stress. Like I could push him a little bit harder and he can push himself a little bit harder and just got him back on to like, you know, just hitting balls, like very, very gentle. He's very cautious. He's like, I felt my Achilles, I felt my knee, I felt my wrist, but I felt really good doing it. Right. So we're building this like confidence slowly to kind of get him out and doing more. And if we didn't start this journey, I don't even think he would have been remotely close to even thinking he could.

Joe LaVacca (11:02)
Yeah.

Joe Gambino (11:10)
that right so there's a lot of these like and he's one of those people that getting on the like to make the decision was hard because he's seen so many people and he's worked with a lot of people and he's knowledgeable he's you know working to be you know he has a certification to be a trainer he just doesn't feel confident his body to go out and coach people at this point so you know he's knowledgeable on all that front and like the decision for him was like like

Joe LaVacca (11:27)
Mm -hmm.

Joe Gambino (11:33)
is something actually going to work. Can I even take that next step forward? And it's slow, right? It's happening. And each time we talk, each session that he does, right, it's more and more confidence. I think that's exactly what you're moving to. Like, how do we start to build this trust in your body to even feel like you can start to push the, you know, your body a little bit more.

Joe LaVacca (11:53)
Yeah, that permission word I think is huge that you use, right? Because I think sometimes the biggest thing that I can do for someone is just tell them it's okay to move and it's okay to load and it's okay to do the things that they're avoiding. And sometimes I feel like that kind of is a cop out, but then people leave so relieved and kind of tell me I didn't know that I was even allowed to do this. You know, my...

Joe Gambino (12:21)
Mm -hmm.

Joe LaVacca (12:21)
My doctor may have told me to avoid everything, things that I've maybe seen or read, or my neighbor, my family member, they all told me, stay away from pain, eliminate pain. And I think that, again, there's probably certain times where we just maybe want to chill out. And I think that goes into this whole idea of the cup of stress and the rehab buckets. And I know these were some things that we talked to Tyler about a little bit yesterday, like you said. Now,

When we're then building all these sort of like things with capacity and giving people permission to move. And, you know, I was just kind of given one example of just some progressions or regressions that we can use there, but there's so many more. There's tempo and there's the apparatus of the weight. There is positions. There's the environment in which we're performing those things. I mean, when you're thinking about these buckets, do you...

Explain the bucket analogy to people is that is that something that you use a lot when? Early in the phase of rehab or is that something you bring in later on? Because that's a common analogy in our space now, and I and I really like it I think it makes a lot of sense, but I'm just trying to think of like when do you incorporate? That into your progressions with movements

Joe Gambino (13:37)
Yeah, I use the analogy when it comes to people who are dealing with pain and more so like if they have the questions around like how does all this stuff work, right? Like I don't, you know, education comes in a lot of different forms of fashion and it just like, the way I educate just comes within the context of how we're interacting and you know.

I get pretty deep with people as far as like how things are affecting their lives, right? Like before I even start to work with somebody, I ask like, I've had people tell me like, nobody has ever asked me questions like this before. So I feel like that's like a surprising, right? Because as people who are helping people with pain in the medical profession, even as a fitness coaches, right? Like, we should be trying to figure out like how you can only help somebody when you know how it's either impacting their life and what they want to accomplish, right? Like you can't otherwise like you're just throwing stuff at the wall. But.

If I do the bucket analogy for people who don't know and I do use it often in education is that you can imagine all the stresses in life and you know, your body can only tolerate so much stress and that can be physical, that can be emotional, that can be a number of different forms, right? And if we were to put all the stress and that stress was water, that bucket is your capacity. You know, once the bucket is completely full,

And that water would then overflow. That would be at that point, right? Like your body's going to have a hard time recovering, pain could happen, things like that. So the one, two things that we can do to help someone kind of get out of pain is either A, reduce the stress, right? Whether that's from a load, like taking painful things out. If it's mental health, right? Getting help from the mental health perspective, things that can help remove water from the bucket, that's going to allow you to tolerate more stress overall. And then there are things from a movement perspective we can do that's going to help

The size of your bucket so you can just put more stuff in it, right? So that's in essence, you know kind of like building that bigger cup That's how we can start to allow somebody to maybe they sell the same pain level, but they can do more activities right it Oftentimes right like we have people who come in like I have pain so I stopped doing X Y and Z and then three months later they're saying well I have I had pain when I when I did this and I'm like well you had pain and it's like

barely anything and you're still going to the gym and you're still doing X, Y, and Z. And last time you told me this, you had to sit on the couch for three days. Right? So it's like a very different type of pain. Right? And that's what we're talking about is we're building these bigger buckets. Your body can tolerate more stuff. That is the essence, right? Saying that you're even though you still have pain, right? You're significantly more resilient. And I find always the hardest part with people navigating pains because it's so internal. You always feel it. It's hard to almost like escape from it, especially when you've been dealing with it for a long time and you have to go back and look at these like,

Joe LaVacca (16:04)
Yeah. Right.

Joe Gambino (16:27)
Well, what can I do now that I couldn't do in the past? And those are the hints that start to tell you that even though there's pain here, we're still taking 100 steps forward, and we're well on the way. And how do we start to figure out the nuances?

Joe LaVacca (16:41)
Yeah, the thing I've been adding to the sort of like bucket analogy is the bottom of the bucket. And a lot of people, you know, when they come in, especially if they work with other providers, and that analogy being so common and useful, and I think easy for people to relate to, they're like, Yeah, I've heard of the bucket stuff. And, you know, I've been doing the mental health thing, I've been doing the breathing, I've been doing my zone two runs, you know,

all these things that might take water out, as you said, and then simultaneously build up the bigger cup. And they're like, well, and you know, I still don't understand why, you know, I'm still stuck. And then that's when I just kind of point to the bottom of the bucket. I'm like, look, we can be taking things out and building things up, but if you don't have a bottom of the bucket, nothing's going to be retained, right? And then you can't progress the way that you're thinking, because every time you go to move the bucket, what, everything falls out and then you have to sort of like start all over again.

So I think we are the bottom of the bucket, right? Like the coaching and the programming are the bottom. And the person that we're trying to fill up or build is the cup itself. And the analogy works for me in two ways because it kind of puts us at the bottom, right? Of this hierarchy, you know, and like the person is above us and we're trying to build the life of that person. But I think that that's why when people are always maybe, you know,

scouring around the internet and thinking like, well, I can just ask Chachi BT like what's a good running program? What's a good this? What's a good that? And that's all good and well. But then what are you going to do if and when the cup overflows again? Or what are you going to try to do when you want to transition into something else? All right. That's where programming and I think coaching and maybe even those chats, as you were mentioning before, like in between sessions and after sessions is so valuable because it starts to really build that education.

Joe Gambino (18:33)
Mm.

Joe LaVacca (18:36)
So yeah, I kind of consider myself now the bottom of the bucket in the best way possible.

Joe Gambino (18:42)
I have a hard, well, what I would think is a hard question for you. So, you know, I always start to think about like,

you know, think back, like, okay, if I'm, you know, the way I kind of go about things and what I'm doing, what makes it effective, right? You know, if I have, you know, I've had people who've seen many providers and then, you know, they come to me and all of a sudden I can help them, right? I don't feel like I do anything special, right? It's almost like hard because...

Joe LaVacca (19:14)
Mm -hmm.

Joe Gambino (19:17)
I don't know if like the things I do, they're just like I have my system, it seems normal. And I like, I would just assume that everybody does things in a similar light. Like maybe different, like everyone's a little different, but not too far off. So I have a hard time like pinpointing, like this is, you know, why I think someone's more successful with me than they were with somebody else. So I want to throw that question to you is like, what do you think about what you do that can help somebody who's really struggled with pain, who has struggled with.

providers in the past and like why do you think you maybe get through to them or help them get to the next level?

You are the philosopher, so I think you might have an answer to this.

Joe LaVacca (19:58)
I lost you for one second there.

Could you repeat the last part of your? Yeah, just the last part of your question I didn't hear.

Joe Gambino (20:02)
Where'd you lose me?

So the question really is, is what do you think makes you or gives you the ability or what do you think is the quality that helps you help a client who is really struggled with pain for a long period of time or with other providers? And I feel like you might be able to have a good answer because you are the philosopher of the group. So I'm hoping.

Joe LaVacca (20:29)
It's not going to be the answer that you're hoping for. I really just think it's patience. I've come to a point in my career working with people where you're not going to outpatience me. And I think because of that, I am prepared for anything. And my expectation is, well, you're going to come...

Joe Gambino (20:31)
You

Joe LaVacca (20:59)
We're going to work together and you will get better. Like in eight weeks, in 12 weeks, in 16 weeks, however long you decide to stay, you will be stronger. You will be smarter. You will be more conditioned than the day we started together. I can guarantee you that. What makes it different now, and I think the reason why I'm able to help more people and maybe more consistently, is when these down days happen, I expect them.

You know, and I think younger, when I was a younger clinician, those would really throw me off just as much as they would throw off patients. You know, we were doing so well. man. And then we had this pain come back. Dang. I think I try everything all over again. You know, like that clearly that plan didn't work. We're now knowing the natural, you know, history of things, knowing the prognosis of things. I think we sort of are trying to build people.

into the best versions of themselves now, rather than recreate who they were in the past, right? And I think that's what really to me rehab has shifted to. So being prepared for the bad and then being patient and waiting for the good, I think is probably the biggest thing that people will tell me I do a little bit differently. Because, and I'll give you an example that happened to me last week.

We were I was working with a client who's had back pain when we met it was December He could barely put on his shoes. Okay, fine. We go through our program. He's working hard. He's working out now four or five days a week He's really crushing it. He just became a member of the 200 pound squat club, right like two weeks ago That was the highest he's ever gone to things are things are rolling man. Things are rolling then

you know, with our little next phase of programming, I'm like, well, you know what you're doing so good, but you know, I want to kind of build the bottom base of your, your squat just a little bit more. I think we can work on that a little bit. So let's do some pauses. We're going to like, you know, de -load the bar by like 25, 30%. So it'll feel pretty light. And then I want you to just kind of like, just take a two second pause in the bottom and you know, first set goes perfect. No problems. Second set. He stands up grabbing that same spot in his back and.

Immediately I knew what happened and I'm just waiting for him to talk to me and he's like, yeah, that whole spasm I felt back in December is back. And I'm like, okay, take me through it. What are you feeling? And just very calmly, and this is sort of the thing where when I'm teaching, I think the biggest advice I give to clinicians a lot of the time is remove your emotion. Because if you can remove your emotion, you can begin to think,

clearly and help this person problem solve because they already have too many emotions. Right. And then really that's going to shut down a lot of their ability to think clearly. So you have to react stone -faced. Right. If he popped up out of that squat, I usually kind of wait for their reactions, but I'm not selling it. And if they're happy, I'm like, then I grabbed the smile. I do the fist pump, little high five. I'm like, there we go. But I'm always waiting for them first. All right. To see what happens.

So I asked him point blank, we'd go through a couple tests. I'm like, what would you have done if I wasn't here with you? And I loved his answer, because I think this is like the accumulation. He's like, well, you've taught me enough where I think I would have just taken some weight off the bar, and then tried it again. And then if I didn't, I probably would have just skipped this exercise and went on to the next one. And I was like, dude, that is absolutely perfect. That's exactly what I would have coached you to do.

If you text me or you called me and you're at the gym, I would have told you the exact same thing. Let's reduce intensity. Let's try again. If not, let's move on and still get a good workout in. And then he stayed. We got a great workout. Shirts, porn, sweat, you know, at the end of it. And he was like, I'm really glad I did that. Now, flash forward to a day later, I check in on him. He's like, dude, it's even hard getting out of bed. And I'm like, all right, what's the plan? And he's like, going for a walk.

I'm going to keep it low aerobic. I'm going to just stay moving, find things that make me feel good as opposed to staying in bed for three weeks like I would have done in December. All right. And then that's it. It was just patience. Right. I didn't rewrite his program that day. I didn't tell him to stop doing things the rest of the week. He knew enough. I was also aware that a flare was bound to happen. You know, statistically they are happening to 80 to 90 percent of people and it's during the course or during the early phases of rehab. So.

I think the advice I'd give to clients and clinicians is just stay the course, remain patient. And I think that's the biggest shift in my practice. But what about you? I mean, that's not like really a sexy answer. It wasn't like, yeah, I took this course, I developed a system. It was just like being patient.

Joe Gambino (26:06)
Yeah, yes. No, I like that. And I think that that, you know, is part of that, like, you know, being that sound board for them, right? Like you need to be able to be here, right? And be understanding of kind of what's going on and how can you start to navigate kind of all those things that go around and help them realize that they're still confident in your body. Because I'm like, you know, those are the times where I think flare ups happen the most, right?

They started to feel better. You start to push it and then all of a sudden flare up happens, right? Because you exceed right with that that bucket But I think that's a great thing because if you're feeling willing to like go push your body right with or without me being there That is a sign that you're making good progress and you're gonna take a couple steps back But we need then right we need to figure it out Hopefully recovery is usually faster than it's been in the past and then get you back on track and just get your ride back to where you were and then beyond that But I that's it I think

what people and what I've been told is just like me being able to like, you know, if someone's like, I'm like up here, right? Cause they're stressed and I've, you know, all this stuff that's kind of going on and I'm sitting back in my chair and I'm processing it and I'm just talking to them, right? And like, okay, asking them more questions and getting deeper and helping them make decisions as well. Not just like, you know, I think I don't freak out and I try to change the program. I change it if it's necessary. And then I try to help them, you know, I just,

Joe LaVacca (27:07)
Yeah, so you just have to figure out where you're going.

Mm -hmm.

Joe Gambino (27:34)
So there's a conversation at that point, right? And see where that ends up taking us. So, you know, maybe that is it. Maybe it is some special magic in my programming. I don't know. But I just always have found that it's like, I just don't know, right? What is the, it's hard to pinpoint, right? Like what it is. And I've had people ask me like, why can you help me versus somebody else? And I'm like.

I don't know, I mean, basically, I think maybe the thing that I do is just have that trust with somebody, right? From the way our first interactions all the way through, which is a trust, it's the soundboard, it's being calm, cool and collected and just being able to guide them. But who knows, I just figured I'd ask where your mind was there. Because I feel like that's always, you know, what makes me, and also, yeah, go ahead.

Joe LaVacca (28:17)
Well, I think that you...

Trust is huge. I mean, and outcomes, I mean, we have enough data now to suggest that alliance and trust within the patient provider relationship enhances outcomes. So you don't have to write like this unbelievable program. You can give the same program that another PT or healthcare provider gave that client, but just do it with that background of trust and

under that guidance of like maybe empathy and compassion where, you know, that's what I just heard from you too. And it kind of echoed my sentiment that I usually would tell clinicians too is like, you know, remove yourself from that painful reaction or the painful experience, right? Just go back into deductive reasoning, go back to being a scientist, right? And you can still express concern.

without overreacting. And now having, you know, a child like you, like, you know, that's relatively young. I'm sure if she's anything like Avery, she was falling a lot, slamming things, you know, teetering off the edge of kitchen counters and things like that. But when she falls, you know, typically again, it's always our reaction that will scare them.

Joe Gambino (29:23)
Mm -hmm.

Hmm.

Joe LaVacca (29:51)
And if we come running over and we're like, my God, are you okay? I'll pick them up like, you know, rubbing the spot, right? I think it shows them, hey, like that was bad, right? Like I am fragile. Like, no, if I fall, something really bad could happen to me. And then what would happen if daddy wasn't there, right? So it's the same thing with the clients, right? When they have pain, you know, being able to empathize, but then also then switching that into sort of like a,

separate compassion and just saying, let's problem solve this together. This is expected. This is what was going to happen. And let me ask you these few questions and then tell me what we think about after those types of questions. And when people have those little flares or painful experiences and they're in front of me, again, I could have ran over to him and be like, dude, all right, cool. No more squats today. We're shutting it down.

Let's go. Let's just rub on that back. Let's do some breath work, you know, and look I'd be prepared to do that if the pain became unbearable, but at the same time I want to relay to clients that I'm not afraid of pain, right? And neither do you have to be and just because you had a little bit of setback today We still have a new floor, right? Because we're we're six months removed from where we started right and in our floor back then was you being able to put shoes on?

Right now our floor is, you know, 200 pound pause squats that we can build up to. And at the same time, you're like you said, you know, when these clients are having some some reactions, their ability to just continue to move forward, you know, lateralize, pick something else. And that in and of itself is empowering because look, I don't know what your training was like this week, but you're still recovering from Mexico. I imagine that wasn't like, you know, PR city.

And you probably wouldn't even put yourself through that knowing how you were feeling, getting back on track with sleep and recovering. And I do the same thing here. Hey, I either have it sometimes with the altitude change and the time zone change, and then sometimes I don't. But it's just about meeting yourself where you're at, knowing to progress, and then having us there as coaches and guides to facilitate that process.

Joe Gambino (31:49)
Correct.

I really, I really liked that. I was going to ask one more question, but I think maybe to wrap it up, I will say this and think about like, you know, my fitness cat going back on here, right? So we have somebody who squatting 200 pounds, right? And you're like, well, let's bring it back to some positive, right? Cause we want to develop some specific tissue adaptations here, right? If somebody in a deloaded situation with some pause squats, we're putting some extra, you know, like we're really making them have to force and control and.

Load right some of these like not end range right but the bottom of their squat and something pops up Well, what do we think is going to happen if we never did that right? But now you decide let's go try to 15 to 25 to 35, right? You're you're you're missing some of that foundational stuff too, right? So you challenge them in a specific way you had this outcome and now you know, okay Well, you know, maybe there was something here right that still needs to be worked on tweaked on too. It's not just like

the Alliance, right? There are still mechanical things that happen and now you can kind of fine tune this and work on these qualities at the same time, right? So we put all these things together and I think that's where, you know, maybe that's where the sweet spot is, right? We have all this kind of like therapeutic Alliance, right? We have the trust, we know how to navigate pain, right? And that's part of it. But then we also understand what's kind of going on here from a movement perspective, right? We both, you know, we both train, we both work hard, we both had pain, we both had a navigated, we've worked with, I don't even know how many people.

Joe LaVacca (33:07)
Right.

Joe Gambino (33:34)
up until this point. And we, you know, like once you know that stuff, right? Like now we can be, I think a little bit more specific, right? And say, okay, when this happens, right? Like now we know for the next time we're coming, right? We need to build up these qualities to make sure we can continue on that journey and beyond it. So I think I'll leave it there. Any, any final thoughts, Joe? All right.

Joe LaVacca (33:54)
It's a good wrap -up point. No, it's a good wrap -up point. I think, well said, my friend, well said.

Joe Gambino (34:00)
Thank you. I think there's a between last episode and this one, I think there's two themes that keep popping up. It's like, don't try to fix it, right? We need to be the guide, right? We're not the fixers. And the second one just left my mind. So I'm going to, you know, I'll leave it there, which is maybe one takeaway from it.

Joe LaVacca (34:16)
Well, maybe, well, maybe I'll fill in the second one for you. Is that, you know, those, those alliances in the work that you put in the beginning, right? Gives you money in the bank and flexibility when the bad times pop up that this person in front of you is still going to trust you. Right? So when we can say like, like you said, like, you know what? Like there is still something right? That.

I saw at the bottom of the squat at 200 pounds that I didn't see at 195, where I was like, hey, you know what? This would probably be a good time to deload and back off and work on something. And then lo and behold, maybe there was something to work on there. And then now, again, my ability to say, hey, look, I was expecting this. We know that this is going to happen. And then now because we have that trust and alliance, but here's how we're going to move it forward. Now we know exactly what we need to work on again. And that's cool. And that could set us up for the next six, eight weeks.

Joe Gambino (35:11)
And I would say it's not just the trust that like we're there, right? To help kind of navigate this stuff and the trust in us, but also the trust in themselves, right? Like this is a flare up and you're going to process whatever you're feeling, right? But then thinking it through and knowing, okay, I'm in a better place and I can continue on my journey. And I think that's the more important thing, right? Because if they don't have the trust, right, that they can do it and kind of continue to get better in this flare up, just a flip in the journey. I think then there's a whole lot more that kind of needs to be.

done for that person, right? Because in order for them to be independent, be on their own, right? They need to be able to make that mental switch to being able to trust their body that they're gonna be able to get back and then be able to continue to push. All right, Joey Boy. Well, I thought that was a great conversation. Listeners, I hope you thought the same. Joe, I love you. Listeners, I love you. And if you made it this far in the episode, it's to listen and extra love for you. Till next time.

Joe LaVacca (35:54)
Sure. All right. That's.

Dude, I do. I love you.

Have a good one.