Back to Performance – Athletic Training After Injury with Matthias Blankenburg

00:00:00: Hello and welcome to a new episode of Meditseen Direct, the medicine podcast.

00:00:04: Sometimes all it takes is one wrong step – attackle A landing after a sprint And suddenly everything comes to a standstill.

00:00:10: The ankle joint buckles A ligament tears Perhaps with a bony ligament tear For the body…a complex process begins at this moment Healing Load management in the long road back To performance.

00:00:21: But One crucial question arises again & Again Is it actually enough to be pain-free again or does the real work only begin afterwards?

00:00:29: Because between therapy and real resilience lies an area that is often underestimated.

00:00:35: Letic Training That's exactly what we're talking about!

00:00:38: My guest is someone who specializes in exactly this moment, The point at which rehabilitation becomes movement, trust & performance.

00:00:44: against Mathias Blankenberg Athletic Trainer Performance Coach & Founder of MYOS my own solution.

00:00:50: His approach not only treat structures, but look at the whole person with a view to movement, nervous system, stress and mindset.

00:00:57: Together we look at The Path after A Typical Sports Injury Today!

00:01:01: Hello & Welcome To Medicine Direct – THE MEDICINE PODCAST.

00:01:04: And I'm incredibly happy today because today We have a very, VERY SPECIAL AND A VERY GREAT GUEST HERE… UM… Matthias Blankenberg from the MYOS Athletic Training in Much, Much, MUCH MORE.

00:01:15: He will tell us more about it here in a moment and i'll say first... Matthias, hello, nice to Have you Here.

00:01:20: Thank you very much.

00:01:21: Thank you for the invitation today.

00:01:23: Mathias, many people think of physio when they think of rehab.

00:01:26: Why does the decisive part often only begin afterwards in athletic training?

00:01:30: Yes I'll say The first part of the Rehab is Of course um after acute injuries to look at the structure To treat the structure and the goal Is to get People moving again as quickly As possible And then to let the reconditioning i like to call it take place.

00:01:44: Mathias

00:01:45: now You've already told us a few things that i find really Very exciting and Really good.

00:01:50: Now pick us up at exactly this point.

00:01:52: How did that start for you?

00:01:54: how Did You actually come Up with the idea, it's Actually only been The case For a few years now That you do This on athletic training.

00:02:01: So Athletic Training Sounds like High Performance.

00:02:05: It is.

00:02:06: But of course we don't just have high performance athletes.

00:02:09: We also Have Patience Of everyday life and for me they are not Only people of Everyday Life but Also athletes of Everyday life.

00:02:15: Everyone has their own profile And Demands & Requirements in Everyday life and so for Us The difference between what we do with people is of course very, VERY BIT.

00:02:24: We differentiate very clearly but the claim to work with people IS THE SAME.

00:02:28: Um...the same goal namely to POOVEMENT IN THE FORGROUND and also TO WALK THROUGH LIFE WITHOUT COMPLAINTS AND HEALTHLY.

00:02:33: Mathias!

00:02:34: Why does the decisive part often start afterwards in athletic training?

00:02:38: Well

00:02:38: I'll say..The whole process upto the point-in time when we fully integrate someone back into everyday life i.e.with full performance & that can be the athlete but it can also be someone who simply experiences normal everyday life.

00:02:50: That's where it is decided whether everything that has been put before with all the interventions has also led to where you would like him or her.

00:02:56: And, I think that...that's a very, VERY decisive moment because when full performance is required and you still have any restrictions or any restrictions that limit the whole thing then your at point were just have yourself did everything that took place BEFORE THEN GO AS IT SHOULD'VE.

00:03:10: D- Now i come to it with such small critical question on the side Is this area in the system underestimated?

00:03:16: You

00:03:16: mean that, though.

00:03:16: The rehab...the first phase of rehab.

00:03:19: is it underestimated?

00:03:20: Um I don't know if you can say that in such a general way.

00:03:25: So i think the claim..The Claim IS THE SAME OTHON ON A PATIENT SIDE AND ON THE THERAPIST'S SIDE.

00:03:31: THAT THE GOAL IS TO COMPLETELY REINIGRATE SOMEONE BACK INTO THEIR EVERYDAY RUTINES.

00:03:35: That!

00:03:35: That is the basic

00:03:36: claim!!

00:03:37: I think the underestimation eyes and the fact that people are judged too much on the structural level And TOO MUCH ON FUNCTION the structure and too little on

00:04:12: answer from you, which he described really great.

00:04:15: Above all very honest also with the empathy that a therapist simply has them.

00:04:19: really great.

00:04:21: now we talked to bid in advance said him.

00:04:23: Which area are we going into so that?

00:04:25: We can take people with us and we set a bit will give The example of a athlete A footballer With an ankle injury with possibly bony ligament tear which is an injury in professional football or professional sports, but also in amateur sports and quite normally when going for a walk.

00:04:40: For the audio listeners we've described it a bit now-for the video viewers they see it in... In other words, injury patterns restrictions risks.

00:04:56: well The first point from me personally as always When I A patient or player who comes to our practice The first moment for me is always, how does the player get in the door?

00:05:08: Who IS

00:05:08: that?!

00:05:09: How does he get IN THE DOOR?

00:05:11: W what are his

00:05:11: habits??

00:05:12: What does it

00:05:12: radiate???

00:05:13: For ME, THAT'S ACTUALLY where the part of the examination or the anemnesis begins because I can see relatively quickly who i'm dealing with and HOW I CAN THEN START A CONVERSATION WITH HIM SLASH HER.

00:05:22: And the Anemnesus is the FIRST important factor FOR, let's say, the status quo admission and then also an ADVANCE, uh, for the clinical examination.

00:05:31: But it clearly defines how I assess someone and then talk to some one, that's a very important aspect.

00:05:37: Yes!

00:05:37: Now we have full professional with you.

00:05:40: Indeed at what point does rehab become real training?

00:05:43: And if could perhaps explain our listeners again beforehand What do understand as rehab in your field than is real training?

00:05:50: So for me the claim Is get somebody who comes with an injury back on move quickly.

00:05:54: i think you need to differentiate again.

00:05:57: It is important.

00:05:57: people Training then includes various aspects of the content structure and, And Structure.

00:06:03: But for me... The claim is to someone who has suffered something as quickly as possible.

00:06:07: Hey!

00:06:07: It's in Claim In & Uh Quotation Marks As far this ankle injury is concerned Just the foot and you have enough structures that lie above it That also have an influence on This little system.

00:06:17: but we can start very early On To load up here again and functionally give Something back into the System Of that Yes So that You get Back on your feet faster.

00:06:24: That Is point one.

00:06:29: You don't have to wait until it somehow feels like you can do something again down there, but I show you as a therapist exactly what you need and that Can start again very very early.

00:06:38: Thank

00:06:38: you Very much for explaining It so so well.

00:06:41: i think That's A bit understandable For everyone.

00:06:43: wow

00:06:44: um of course?

00:06:45: You Don't want To offend Anyone Too Much But i Think that the The biggest Difference Is that Physiotherapy Often um Takes Place too long on the bench On the Bench that you think small for too Long End.

00:06:55: Um don't exhaust enough of the possibilities that you want to, actually.

00:07:00: And I think that's where the biggest difference lies and that's a very important aspect for me but also from my team and that we develop individuality and approaches to solutions that can be developed on an individual basis.

00:07:20: And at an early stage, as I just mentioned, exercise can take place again!

00:07:24: i think thats what makes the biggest difference.

00:07:26: Now I come around a corner with next critical question Is this transition often made too?

00:07:30: Yes...I believe that ummm both therapists & those who are affected ummm don't trust themselves enough in such phases and maybe ummm get stuck in phases for TOO LONG.

00:07:40: There're so called phase models & rehabilitation processes Ummm which are tied to times, i.e days, weeks after operations or even conservative care and I think you have to get away from that of relying only on time.

00:07:52: um because there are also functional schemes in.

00:07:54: You can judge functions And I think That's where it diverges a bit.

00:07:58: sometimes It doesn't quite fit into Into the timeframe?

00:08:01: And then you may be A bit earlier than you Think you can do and that's why it's important for me that we assess Functions and Also The compliance Of the person who is doing.

00:08:08: it varies A lot.

00:08:09: some Are Earlier Because They Push A Lot Some are a little later because they don't really dare yet and I think this interaction in communication with uh, With the person is extremely important.

00:08:18: Think

00:08:19: so too.

00:08:19: And i would also like to say right away that exactly This transition That we have just talked about Is...I think Also very Very Important!

00:08:26: That The patient also says what he wants and how He wants it end But..he also participates Because you Have You Can't You can't lay your hand on It and then everything will be great again.

00:08:36: but There's always A Patient Story Involved.

00:08:38: Let's move On To The Next Phase Load Management.

00:08:42: That's a very, VERY important point.

00:08:45: How do you control the load?

00:08:47: specifically by feeling or with data?

00:08:49: Because that is now also very much associated with data!

00:08:53: Um... Can u- At the

00:08:54: end of day it makes sense to both.

00:08:57: Ah, on one hand Of course we record various parameters at certain points and these can be force parameters These can join angles Ranges of motion These side comparisons.

00:09:07: We also liked instrumental diagnostics to collect certain data but data isn't everything.

00:09:14: So, and that's where it's important to look.

00:09:16: Um... what's THAT?

00:09:17: What's the feedback from THE PERSON?

00:09:19: And that can vary from day-to-day!

00:09:21: I had already said earlier, such a rehab process is also A WAVE MOVEMENT.

00:09:24: No.. That's sometimes better.

00:09:26: That's SOMETIMES WORSE AND THAT'S WHY EVERY DAY IS ACTUALLY A VERY SMALL NEW ANAMENISIS FOR ME.

00:09:30: When The person comes in the door, first thing is ALWAYS.

00:09:34: How are you today?

00:09:35: HOW DO YOU FEEL?

00:09:36: WHAT DID YOU TAKE AWAY FROM YESTERDAY?

00:09:38: ARE YOU FEeling BETTER?

00:09:39: Are You Feeling Worse?

00:09:41: And thats Where Im Starting Anew.

00:09:42: Yes.

00:09:43: Not to overshoot the mark, not to wait too much but always hit a sweet spot.

00:09:47: that is optimal for this moment.

00:09:48: So our listeners can already see there are many small pieces of the puzzle But they have to mesh so that such training end especially in this phase.

00:09:56: load management at everything works perfectly.

00:09:58: Now let's get into performance buildup.

00:10:01: When does it

00:10:03: start?

00:10:04: I cant delineate it so clearly For me an athlete with an ankle injury who of course has extremely high demands on himself, back to what he actually does as quickly as possible.

00:10:14: And that's why I have to start this path with someone very…very clearly from the outset and a demand for performance increase or performance development or re-acquisition – whatever you wanna call it!

00:10:24: …and everything i do with the person from the first moment should serve to regain performance or improve it..And thats' why its for me, theres not that one moment where this cut is there.

00:10:34: Okay, now let's start with the performance.

00:10:36: But you also perform as well as possible within the scope of your possibilities-with the injury and highest level at which I want you to be.

00:10:42: I wished

00:10:42: for exactly this answer, Mathias!

00:10:44: And i am very, very grateful to you for it.

00:10:47: What do many people miss when they are finished in qu...

00:10:50: What do most people miss?

00:10:51: When their done?

00:10:51: yes So I think, so this one.

00:10:53: We have a moment where we've treated someone or led them back through this process This transfer back to the club.

00:10:59: And no, yes where?

00:11:00: Where do I stand now?

00:11:01: what happens if i come Back To The Club Now for example What did they Do To Me ?

00:11:05: What Can I Trust Myself To?

00:11:07: For this it is important that we bear the responsibility for ensuring That There Is A Good Handover and That The Departments In The Clubs Also Ensure That It Continues Seamlessly And Ensured That The Self-confidence & Confidence Of The Athlete Continues To Be Promoted That He Or She Is Physically And Physically Mentally As Always At The Same Point You Understand What I Mean So That there Is a Balance That he Doesn't Feel Physically Better Than He Is Mentally because he may not really yet, but he could.

00:11:30: But just as the other way around that He doesn't feel mentally stronger than his body actually allows Because these are always The moments where it can then come even to recurrences.

00:11:38: this is very well addressed.

00:11:39: I think It's a very very important topic and i'm also glad That in the last few months And years um more and more Is coming Just because you have Also addressed the topic of professional athletes no matter In which area now whether its football athletics handball or anything else.

00:11:54: Something is that they also say, yes so I'm healthy...or..I'M FINE NOW!

00:11:58: I'm back from all the physics…I'm recovered from athletics but my head isn't ready yet.

00:12:03: That's a very-very important point about this whole thing.

00:12:06: how far as The Head we have said the therapy was faster than THE HEAD can actually process?

00:12:11: THAT'S A VERY-VERY IMPORTANT POINT WHERE WE'LL CERTAINLY GO INTO MORE DETAIL ON ONE OR THE OTHER EPISODE.

00:12:17: Now thank god you've made.

00:12:21: We call the next steps a bit of professional sport as a laboratory.

00:12:25: A professional sport is like a high-performance laboratory.

00:12:27: actually, what?

00:12:28: Let's say can The normal patient who does not perform professionally in a club or In his area which he carries out athletically?

00:12:35: um learn from exactly these patients

00:12:38: the Normal patient of the professional I think the normal patient because you may Not be exposed to the same thing on a physical level but mentally He can.

00:12:45: Yes, Di I think there is.

00:12:47: There's the possibility that a normal patient can also learn from The Professional and their are great podcasts And they're all so great interviews From athletes who carry Their mindset to the outside world How They Can experience such rehab phases or Such extreme Phases from the very top.

00:13:00: I think you can Learn A lot there and Mindset moves the biggest Mathias.

00:13:04: Thank You Very Much That For The Answer.

00:13:07: Now We Come To You In Particular

00:13:09: MHM.

00:13:10: You Have A Very Special Approach.

00:13:12: You Could Say Now You could also call it individual, very structured.

00:13:18: Why are you convinced of your approach?

00:13:19: And take us a little bit into your approach again.

00:13:21: so summarized what we have already addressed again and again.

00:13:24: but- Mh!

00:13:25: Why am I convinced of my approach if i didn't have that?

00:13:28: If I didn't the power of persuasion in what im doing ,I don't think would be authentic.

00:13:32: That's why I believe Very much In What I do.

00:13:36: .And over time Of course It has become apparent.

00:13:39: The people We work with come to Us With the same conviction either because they have heard it from someone else or have experienced the same thing that others have already experienced with us and thus with conviction again.

00:13:49: So, Matt?

00:13:49: That's one thing!

00:13:50: What makes our approach special?

00:13:51: I think, um...that It is important to think far outside-the box And not only look at structures Or the injured areas But to look holistically At The person & To consider all aspects that can Have an influence on An injury OR On a physical system.

00:14:04: The teeth are extremely Important in the context of inflammation In the body Influence ON THE NERVOUS SYSTEM Influence on statics AND ALL THAT If you take all this on board in your ways of looking at things, is an absolute added value in the approach and then also... In dealing with people.

00:14:17: Um, And it makes more than sense from my point-of view to look and think three hundred six... Absolutely!

00:14:23: I thought The Approach was just quite good or the description quite Good With a Teeth.

00:14:27: There are actually currently German national players who have Also had their wisdom teeth extracted because the injury phases were simply too often Were Too frequent and Actually showed that It has become less.

00:14:37: I find it very interesting that you also address this again here.

00:14:40: Then You just said something, the change over time how you built The whole thing.

00:14:44: what has changed for you?

00:14:45: Over the years.

00:14:46: so you gain experience over the Years and i'm now i would call myself a an old hand A time i've had Now to gain Experience work with people mentor athletes on highest high lowest low.

00:14:58: i think That the experience of having the experience With someone accomplishing Something together or building something is the best And most important Thing.

00:15:06: No textbook can do that.

00:15:07: Oh, but I also had a moment where i changed my perspective in dealing with the body very much and That was the point when I realized that this biomechanical And this working with muscle structure and chains and so on...that This is not enough But there are other aspects Also play a role In that.

00:15:22: as the nervous system There's an institute C-Health, which is very much focused on the nervous system.

00:15:32: On...on brain areas.

00:15:34: On peripheral nerves.

00:15:35: On the central nervous system.

00:15:37: So it goes into neuroanatomy and neurofunctionality Which are very related to make connections between physical performance And from that moment I got to grips with it.

00:15:47: That's really an extremely complex end And versatile wayle with a matter It not easy do things but From there My mindset has clearly changed in how I look at things, How i approach them and how much our nervous system Has an influence on Our movement In our environment.

00:16:00: Absolutely!

00:16:01: You can also if you And I would recommend this Follow your social media channel.

00:16:05: Then you Can always see what changes there.

00:16:07: So This...you cant say that in general terms This & That has Changed over the years.

00:16:11: If you observe it a bit Now you have also communicated A- Two devices fly out A new one comes in.

00:16:17: Thats how It changes and I think thats Also The..this This key to the whole f**k move with time Too extremely, not too much device.

00:16:24: So mechanics data and so on but also body feel And finding this This middle ground is very Very crucial and I think that uh actually makes it very very special for you.

00:16:36: What are typical training mistakes?

00:16:37: where?

00:16:37: You say what do people do wrong?

00:16:39: intro

00:16:39: Do you mean in the cooperation of the therapists with the patients or the trainees?

00:16:43: them The

00:16:43: trainees themselves

00:16:52: are either not familiar enough with how they move and, where they move or overestimate them so.

00:16:57: So basically I think it's right that exercise is an elixir of life for all.

00:17:02: now It just depends on what environment do i move in?

00:17:05: What would we do in sports And what physical requirements Do i have and what can i contribute to doing what i do In a healthy way?

00:17:10: um and as you say You often see people walking without having a trained eye.

00:17:15: i Can judge oh A bit amateurish whether Whether it looks good Or Not and That starts With Footwear It continues with personal skills.

00:17:23: So what is the need?

00:17:24: What does the hip do, and I think that there's a lot of potential to add people a bit And show them say hey There are a few things That could be changed by external influences possibly By inserts or other tools but especially and i Think thats much more important for People The movement To coach them so they have A better understanding Of how They Do it.

00:17:45: Can

00:17:45: you take us in For a moment?

00:17:46: How do You train confidence In the body?

00:17:48: Thats

00:17:49: definitely a thing.

00:17:51: It's not in any textbook.

00:17:53: Its like that, I always say either you have it or don't.

00:17:56: Either You Have More Or You Have Less.

00:17:58: I Believe That You Have To Have A Feeling And Antenny For Work With Someone.

00:18:02: How to Talk To Someone How To Pick Someone Up and Getting Or Regaining Confidence In The Body Happens To Me Through A Lot Of Communication.

00:18:08: i Constantly Ask In Training how do u feel about her?

00:18:11: How Do U Feel About What We're Doing Right Now ?

00:18:13: I Depend a lot On Feedback.

00:18:14: Then I Notice Or Get Feedback That It Feels Good Or Doesn't Feel Good?

00:18:17: Ya Can I Be Progressive?

00:18:19: Do I Have To be Regressive?

00:18:20: I experience and look very, very closely and i think now have a very trained eye for how someone does something.

00:18:25: Does he radiate a sense of security in what he does?

00:18:28: Doesn't he raduate

00:18:28: it??

00:18:29: Does he want

00:18:30: more???

00:18:30: Does He Want

00:18:31: Less???

00:18:32: I Think It's Very, Very Important That At A Certain Point In Time You Go Back To The Injury And Confront People Again With What Actually Happened There In Trauma Management Take Place.

00:18:41: Can I Look at

00:18:41: What?,

00:18:42: What?

00:18:42: I Had A Player From the, from the Austrian, Um, From The Austrian League, He Toured His Cruciate Ligament And Couldn'T Look At What Happened Until He Was With Us.

00:18:49: And I think that's a very important part of rehabilitation, That you not only heal physically but also heal mentally to get the full performance back.

00:18:56: Thank You very much for taking us with you and all.

00:18:59: let's Get Back To Our Ankle For A Moment!

00:19:00: How would you treat an ankle joint?

00:19:02: i don't know...a torn ligament whatever?

00:19:04: why are certain exercises Important and what exactly do you train?

00:19:08: MHM

00:19:10: Well it's wow.

00:19:11: such a process has been a long time Of course so It always depends on The severity of the injury On the structure involved.

00:19:17: What happens in the body then?

00:19:19: I mean, at the beginning there is a phase of immobilizer immobilization.

00:19:22: This means that we have swelling We have redness Heat is generated So we everything in structure leads to body being signaled first.

00:19:30: Hey!

00:19:30: Something just happened down here.

00:19:32: That shouldn't happen.

00:19:33: Of course The whole thing is preceded by pain Is triggered by our nervous system and principle Pain processing And then Yes Then interventions started In the beginning.

00:19:43: You can do much with this structure.

00:19:45: That's the law In the begining.

00:19:47: it all about relieving the structure reducing the swelling, letting the inflammatory process that is there take place for the time being.

00:19:53: That's important!

00:19:54: I experience it again and again that people work with cold and a lot of cold as applied to logically reduce pain.

00:20:01: but of course that also has an influence on the inflammatory processes.

00:20:04: we need these inflammatory mediators Take Place Down There.

00:20:07: Thats why i have to be careful.

00:20:09: But Of Course i can go through structures above.

00:20:11: if its the ankle joint then theres very much little underneath.

00:20:15: but I can work on other structures that lead to the fact It's really not nice what you have there, but You can do a lot.

00:20:46: pair yourself for it and your foot for it.

00:20:48: Take back into the load fast.

00:20:49: one last sentence on this.

00:20:51: We Have A Really Great Piece Of Equipment Which Is An Anti-Gravity Treadmill And I Can Put People With An Acute Injury Back in Their Very Early.

00:20:57: Take Away Gravity Totally Relieve The Body And Slowly Start To Walk.

00:21:01: Feel Develop Dynamics Then Also Convey to The Person Hey!

00:21:04: It is...I can Yes..i can move.

00:21:08: i'm already walking again.

00:21:10: of course that does alot to you mentally

00:21:13: Absolutely.

00:21:14: You can also see that this is now being used more and more often at the centers.

00:21:19: I go

00:21:41: to Physiotraining Therapy and then get therapy.

00:21:47: Ah, i think it's important that we understand from our mindset um That prevention is the much more sensible way To do things to prevent injuries?

00:21:54: That's The basic approach!

00:21:55: I Think that people only invest intensively in their health When the child has already fallen into the well.

00:22:00: so And I think there Has to be a change that you proactively take care of It also financially.

00:22:05: That is simply part of finding ways to put your health preventively on a foundation with which I can carry out my everyday life or my sporting activity in a way that works well for as long as possible.

00:22:14: And i think th- So, uh... Four In terms of our Health Our healthcare system.

00:22:19: Already an aspect A Where I see weaknesses in In IN The System On the system side But also see weaknesses and the individual.

00:22:27: How do actually approach health?

00:22:28: Mathias Thank you very much For the open words and that You Also carried it Out THAT WAY!

00:22:32: And also showed It at the same time.

00:22:34: Okay, there may be a problem in the system but us problem can be solved and find a solution for that.

00:22:40: I think it's great.

00:22:41: now we have our category.

00:22:42: let's ask The professional towards the end three things you would give to every injured person about training

00:22:47: Every injured person okay?

00:22:51: So first of all my First recommendation is face this situation with full acceptance And don't look backwards But look forward.

00:22:58: that's That's the most important thing i think.

00:23:01: second Is Hide in people who will support you and coming back in the best possible way.

00:23:06: And these are not only therapists, but also the environment in which you move – family, friends, children etc.. That gives incredible strength!

00:23:13: And if your already back then do everything you can sure that what happened to you doesn't happen again if possible & make sure that you put your body on the pillars in the BEST POSSIBLE WAY ON YOUR OWN RESPONSIBILITY, INDEPENDENTLY AND WITH YOUR OWNE ROUTINES OR TO BE ABLEDORM.

00:23:25: Those're the three things I see.

00:23:29: the great description too.

00:23:32: And in the end, I say thank you very much for being a guest at MetaZine Direct today!

00:23:36: With

00:23:36: pleasure!!

00:23:37: I can only recommend to everyone, take a look at the website, check out the Instagram page... I can find everything in The Show Notes

00:23:45: too!!!

00:23:47: and if you liked the episode then leave us a like, five stars & so on and Say Thank You Very Much For Being A Guest Here Today!

00:23:53: I thank

00:23:54: you too, THANK YOU!

00:23:56: That was Meditseen Direct, THE MEDICAL PODCAST.

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