Craig Lindell: Can We Fix Physical Therapy?

I think that a lot of people that reach out to us are probably copying and pasting what they’re texting, and they’re sending it to 30 people. Here’s number one, they want to answer as soon as possible, and you can blame technology and social media for that.

Everything in life should be instant gratification, when the one thing in life that we cannot change is exercise and results and its delayed gratification. Rehab, getting out of pain and getting performance improvements, it’s hard work.

Welcome to the “BarBend Podcast,” where we talk to the smartest athletes, coaches and minds from around the world of strength. I’m your host, David Thomas Tao.

Today, I’m talking to Craig Lindell, a physical therapist and founding member of The Prehab Guys. After earning his degree as a Doctor of Physical Therapy from USC, Craig and two friends set out to re-think how people viewed and interacted with physical therapy.

Could they help more people perform better and feel better by working with them before injuries happened? Thus, The Prehab Guys was born. Success didn’t come overnight and The Prehab Guys owe a lot of the visibility to a massive social media following that’s grown over the last few years.

For reference, they have over half a million followers on Instagram alone. Proving that physical therapist and movement consultants can make waves on a platform more closely associated with fitness models and celebrities.

In this episode, Craig and I discuss the secrets to their success along with lessons they’ve learned about creating movement and prehab content that actually makes a difference.

Just a quick note, we’re incredible thankful you listen to the BarBend Podcast. If you haven’t already, be sure to leave a rating and review in your podcast app of choice. Every month we give away a big ole’ box full of BarBend swag to one of our listeners who leaves a rating and review.

Today I am talking to Craig Lindell. Better known as one third of The Prehab Guys online. An accomplished person in the fitness and wellness industry in his own right.

Craig, thanks so much for joining us today. I appreciate you taking the time.

Thanks for having me on today.

Well, you are known as one of the Prehab Guys as far as exposure to the most people online. I would love to get a little bit into your background in physical therapy, in movement, in fitness just to give our listeners that context as we dive deeper into the conversation.

If you wouldn’t mind, give us a little bit of your background and how you got involved in sports and physical therapy initially.

I was thinking about this in preparation for the podcast because I just had a patient yesterday, and I had a nice conversation with the parent, and they were like, “Wow, I wish I had this information when I was hurt.” It all goes back to this. As a teenager, I played soccer growing up my entire life.

I kept getting hurt as a teenager. I didn’t do my prep during the summer. I remember I got referred to physical therapy. The physical therapy that I had was very different than the physical therapy that I give to patients today.

It was very hands on in terms of using a lot of modalities, nothing in terms of prepping to get stronger, to getting back to soccer, to getting ready for the demands of soccer. Unfortunately, I never got back to soccer because I wasn’t listening to what the PTs were saying to do, but the fact is, what the PTs were saying to do wasn’t helping.

They were just saying rest or also ultrasound your quad. Honestly, what got me into physical therapy was, I wanted to help people get back for doing the things that they’d love to do, whether it be sports, lifting weights, or doing the things that they want to do on a daily basis without pain.

I grew up on the East Coast in New Jersey, then I went to Penn State for my undergrad. I studied Kines there. I was still very set on the physical therapy at that time. I got accepted to the University of Southern California. I drove all the way to Southern California. That’s where I met Mike and Arash.

That’s how we came up with the idea of The Prehab Guys. Fortunately, I’m in a setting where I had to work with teenagers now, who they play soccer. They play other sports. I give a very different type of physical therapy than the experience that I had. That’s the full circle right there.

That’s a great elevator pitch for your background. You kept it nice and tight. I really like how you bring up the idea of preparing to get back on the field or get back to the activities people love.

In my own experience in athletics for a long time, and especially when I was younger, when I was in college, I had the perception of physical therapy as this thing you did to play catch up to your injuries. You get injured. You go to physical therapy.

It’s all about trying to get you back to like not even 100 percent, like 85 percent, maybe 90 percent before you go out and beat yourself up again. I never thought of, in athletics, as physical therapy as movement as something that could prepare you to super compensate, that can prepare you to be at 100 percent or greater than your previous 100 percent.

Was there a moment in your education or in your physical therapy practice where that light bulb went off where you thought wait a minute, physical therapy movement can get people not back to just where they were previously or close to it but maybe even doing better and performing better?

Those are the conversations that Mike, Arash and I were having for the first year and a half of grad school. It’s that we would go on breaks or we would go out into the clinic or out into the community and we all had this great perception of what physical therapy was in class.

We’re learning all these new things and these techniques are ready to cure the world, like every single person in the world could benefit from physical therapy. Then we go out in the public, they’re, “So you do massage?” or “OK you help with this stuff?” The public perception of physical therapy is horrendous.

That’s what honestly led us to creating The Prehab Guys platform. It was to educate. We have to get the word about, or we have to get the word out about what physical therapy truly was and what it could do. That’s constantly what I’m teaching people in the clinic and what we’re trying to spread the good word online.

It’s that if something happens and you got injured, clearly your tissue capacity at your baseline was not optimal. Now you’re even below that because you’re injured and you’re not doing the things that you want on a daily basis. You’re getting deconditioned. We need to get you even better than where you were because clearly what you were at was suboptimal.

I love that it’s all about functional overreaching and creating super compensation so that when the person does go back to running, when they do go back to lifting weights they’re not going to fall on to this vicious cycle of getting hurt again and then going back to the PT just to get by and then you know what I mean.

Let’s talk about The Prehab Guys as a platform. What do you do for those who might not follow you all on Instagram? You have a huge social media reach for those of you who haven’t been to your website, what do you do? What services do you provide and maybe most importantly the back half of this question, what don’t you do?

Because I think that people go to folks and service providers in the fitness industry and they expect like a one-size-fits-all approach. “All my problems can be solved here.” People are too hesitant to ask when talking to coaches, physical therapists, anyone in fitness, “What don’t you do? Just so I know that.”

Honestly, no one has asked us that question before so I’m excited to answer this because it’ll be a little bit of self reflection in the meantime. In terms of what The Prehab Guys is, our elevator pitches The Prehab Guys is an online education platform that teaches people how to take control of their own health through knowledge, education and online physical therapy.

We want to be a one-stop-shop the prehab hub. If you want to learn more about sports and every single sport you want the most up-to-date information, the scores, the news, you’re going to go to ESPN. It’s just that there…

…or BarBend when you’re talking about strength sports.

Exactly. You go to BarBend for strength sports. You go to ESPN for football or soccer. We want to be the prehab hub in terms of how you can educate yourself about the human body and taking care of yourself from a physical aspect. Of course it’s going to drip over into a little bit of the psyche aspect as well because if you move well, you feel well.

That’s my opinion but that’s what we really do, we really educate. Constantly on all of our social media platforms on a daily basis we are educating and we’re providing value whether it be how to do an exercise, how to take care of a nagging knee pain, what you can do for your shoulders to make sure that you can do CrossFit without any issue. You name it, it’s really based on education.

That’s where our value comes into play. In terms of what we don’t do, at the moment if you were one to get physical therapy services by The Prehab Guys you’ve got to find Michael, Arash and Craig at three different physical therapy clinics. We still work part-time for different companies.

The three of us, we work Tuesdays and Thursdays and we see patients through health insurance and other mediums.

In terms of what we don’t do, I mean…this applies to all influencers and people on social media, you’re limited in what you can do online. Of course we’ve created products and we’re going to be creating more products where it’s these one-off programs to take care of your body.

If you want to prehab your shoulder, if you want to prehab your knee and you’re looking for something to augment and supplement what you do with your current training where you’re just looking for something to try to limit any possibility of your knees ever getting hurt, we have these one-off programs, we have articles and we have a ton of education.

I can’t even tell you the amount of content we have. It’s just almost four years worth of content. One thing that I can say is that we cannot guarantee that you will never get hurt. It requires…you have to be humble to say that. I had to be very honest and transparent.

Yes, our name is The Prehab Guys though we cannot guarantee 100 percent of the time that you’re not going to get hurt. If you’re not ever testing the waters, if you’re not ever pushing yourself and you’re not ever getting aches and pains then you’re not trying to achieve your full potential. I would leave it at that.

That’s the politician’s answer. No, I’m absolutely kidding. That’s important. It’s important for any service provider in fitness whether you’re a coach, whether you’re providing prehab services, whether you’re providing nutritional coaching, this is something that I was talking to Nick Shaw of Renaissance Periodization for a podcast recently.

Setting those expectations, what is possible what isn’t possible given time frames resources. If someone’s working 40, 50 hours a week at a desk job, they can still probably perform pretty well as an athlete but they’re not going to make progress as quickly as someone who is training full-time and who has all of the recovery resources and time to prioritize those in the world.

Setting those expectations with your clients is vitally important. What do you all do and maybe what could you improve on when it comes to setting those expectations and setting those boundaries?

I have to do this every single day in the clinic and even online. People email us, they message us and they comment on our content every single day 24 hours around the clock because people around the world are following us and they’re trying to get answers.

Unfortunately, a lot of people that reach out to us are probably copying and pasting what they’re texting and they’re sending it to 30 people because number one, they want to answer as soon as possible. You can blame technology and social media for that.

Everything in life should be instant gratification when the one thing in life that we cannot change is exercise, results and it’s delayed gratification. Rehab, getting out of pain and getting performance improvements, it’s hard work. You’ve got to be willing to put the work in. You’ve got to be willing to deal with some aches and pains in the middle of it and more importantly it just takes time.

In the clinic honestly, Adrian Peterson’s an amazing athlete but he screwed us as physical therapists when it comes to expectations after ACL rehab. Every single person that comes into the clinic, that had ACL surgery, day one, I’m setting those expectations and I’m being very transparent. Especially with the parents, too. It’s like, “Hey, this is like you when you’re going to get back to your sport.”

For an individual that hurt their shoulder lifting, it’s like, “Hey, this is going to take time. This is how it’s going to be. You’re not going to enjoy it. There’s going to be peaks and valleys. One day, it’s going to feel really good. The next day, you’re not going to like me, and you’re not going to want to come back.” I think being very transparent from the get go is going to lead us to the best results.

For most people, their expectations going into it influence what they want to do and what they want to believe. When I tell someone that, if they don’t like that answer, and they want to go somewhere else to get the answer that they want, I’m OK with that because it’s all about their expectations and what they’re going to get out of it.

What are some common misconceptions that athletes have about your work? When I say athletes, I want to specify strength athletes in particular. That’s what we write about at BarBend. We cover strength athletics, powerlifting, weightlifting, CrossFit, Strongman. A lot of these athletes are experienced. They’ve spent years building their base of strength and their movement patterns.

Sometimes, that creates a lot of preconceived notions and a lot of firmly held beliefs as to what they should be able to do and how they should move. What are some misconceptions you see experienced strength athletes bringing into the prehab and rehab process?

I would hope that these type of athletes don’t expect 100 percent of the time that prehab work is going to translate into increased 1RMs, getting much stronger, never experiencing a setback in their training or pain. It all comes back to specificity training. If you want to get better at a deadlifts and you want to be able to pick up a heavier weight, you got to practice picking up the heavier weight in that specific movement.

Nowadays on social media, you get these quick bites of 15, 20 seconds. “Hey, how to get out of pain, how to unlock your ankle, how to get deeper into your squat, your deadlift.” People are like, “All right. If I do this, I’m going to do it as long as the person did it in the video, and then I’m going to move exactly how they said they’re not going to be able to move, and my past four months of crappy training and periodization is just going to get wiped out the window because I did what this person did.”

It all comes back to people expect these very instant gratification results and it’s going to be like that. Unfortunately, it’s not.

You all have built a massive social media following through The Prehab Guys, specifically on Instagram. You mentioned earlier you have folks around the world following you, asking you questions. Whether that’s good, whether that’s annoying, whether they’re copying and pasting those questions and sending them to 10 different prehab outlets and specialists on social media.

How has producing content impacted your approach to working with clients, be it in person or remote?

That’s a great question. I want to reiterate people reach out with some crazy stuff. We get full MRI reports. We get full surgery reports. These people, they’re blasting out their information. They’re not worried about what this person finds out about you. Full medical history. You send that out to 30 people, it’s hard to get the answer and the result that you want.

Back to the specific question. How does creating content influence how I treat people in person and remotely? Both of them play off of one another. In person, I do patient care 18 hours a week, and I’m really glad that I do that, because it keeps me constantly grounded back to what I always wanted to do with physical therapy, and that’s working with people.

I feel like I’m a people person. I enjoy working with people. Working with people makes me happy as well as what makes me happy is trying to make other people happy. It all comes back to the content that I create so working with people in person helps give me ideas constantly with the content that I create online.

More importantly, it helps to keep me grounded because online, it can seem very superficial, and it can seem really easy to prehab your body and to get out of pain and to feel like you have everything figured out. It’s hard as hell. It’s really not that easy.

More importantly, I think some of the questions we get online and some of the comments, it’s like, “Wow! I didn’t even think of that.” Or, “Maybe that’s a question I need to ask my patient that I’m currently seeing.” Or, “Maybe this is something that I’m going to add to my repertoire of when I perform an evaluation.”

I love that I do both because they honestly complement one another.

What sort of content would you like to produce that you really haven’t explored yet? Or, that The Prehab Guys, or you individually haven’t really tested the waters with?

Now I think that’s a great question. I honestly had a call with a rep from a company where they have a really powerful platform. I don’t want to call it, “The billion dollar question,” but it’s the golden flask question, I guess you could call it.

It’s like, what’s the next brilliant idea? When we started this, it was just educating people. We never imagined it would be what it is today. Where I thought I would be out of school compared to now is a complete 180.

I’m just fortunate to be in this situation and to be educating a lot of people. I think what I want us to be able to create was something that I want us to be able to work on. It’s just solving the issue with healthcare. People don’t have access. Or, they do have access, they do have health insurance but they don’t even know how to use it.

They don’t even know how to navigate it. They don’t understand how it works. Creating the ultimate solution so that anyone in the world, no matter where they are, no matter what access to healthcare they have or not, that they’re getting the right information at the right time.

It’s that we’re working in that direction, and it comes down to time. I was backpacking in Peru in South America, and the time that people spend on work versus health, family, friends and not working, the balance is…it’s so much better balance outside of the US. I need to find more time.

I need to add eight more hours to the day. I hope to come back to you with a better answer for that.

If you figure that out, give me a heads up.

I have some interested investors for you and would like to partner on that idea.

Awesome.

Yeah.

I will definitely let you know.

Shoot me a text or email. I want to get in on the ground floor.

How was Peru, by the way? Did you go with…I asked because it seems like that’s the hot place to travel in the health and fitness industry now. After the CrossFit Games…We live streamed the CrossFit Games on BarBend. We worked with a lot of CrossFit Games athletes.

A big group of Australian CrossFit Games athletes went to Peru, literally right after the CrossFit Games, just quick turnaround the next day they arrived on the flight. It’s something where I’ve seen a lot of health and wellness influencers and personalities go hiking, camping.

Who did you go with? Why do you think right now so many folks in this industry are gravitating toward that particular part of the world?

My wife and I, we went…it was something that we had been planning for about a year. We went backpacking in Peru. We did it with this trekking group. There was five and a half days, a little over 60 miles, you finish them on Machu Picchu. That was amazing.

Why do I think a lot of people are navigating and trending towards Peru? Again, as great and as bad as social media can be one powerful, awesome thing is, it exposes us to beautiful places in the world.

We have to thank Instagram for finding these amazing places like Peru and other places that you see these photos. You’re like, “Wow, I have to go there.” As much as we want to be connected, for me, because I feel so connected that my phone is constantly listening to me and looking at me, “My wife and I, we wanted to go to Peru so that I could completely disconnect.”

I kept my phone and my backpack turned off for six days. I haven’t had my phone turned off for that long since I’ve had a cell phone, I guess. To be able to disconnect…we love being outside. We love mountains. We love hiking, that’s something that we’re passionate about. For me, the entire trip, I was like, “OK. I need to constantly be present. Since I’ve been back, I need to thank myself for doing that trip.”

What backpacking did for me is it reminds me of being present. I heard this on a podcast for an article one time, it’s like, “The new superpower is being able to single-task and be present.” It’s so easy to multitask and have your hands in so many different things. When I was hiking, if you weren’t present or you’re trying to multitask, you can slip off a trail, off the edge, you can slip on a rock, you can sprain your ankle. You’re in the middle of nowhere.

Being constantly present on that trip was something that I took for it. It’s benefiting me now with work. I just rambled, definitely, for sure. Peru is amazing. The food is epic. It’s beautiful, and it’s very affordable. I feel like that’s probably why everyone trends towards there.

I do want to say that I don’t have any hard travel data that says, “This many fitness influencers or this many people are going there.” That’s purely anecdotal…

…and coincident on for whatever they’re saying. I’ve talked to four different people on podcast recordings who have been like, “Yeah, I just got back from Peru,” and I’m like, “OK, wait a minute. What is this that people have to know each other, they have to be coordinating trips.” I do appreciate you sharing that experience.

It does speak to the power of presence and being in the mindset is something we hear about especially when it comes to coaching. Coaches who are challenged to, or challenge their athletes to be present in the moment. When they’re working out, when they’re training, when they’re mobilizing, when they’re doing prehab, don’t think about these 40 emails you have.

Don’t think about the appointments you have tomorrow. Can you be present in that moment and get more out of the limited time you have to improve your physical health and well-being? There’s an underrated mental component of that.

I wouldn’t doubt at that. Those athletes they’ve trained for who-knows-how-long and then they competed. They gave everything that they got, then, “Hey, why not go anywhere in the world. Away from their reality, and just reflect.” You experience a culture, you’re outside of your norm, and you’re present.

Then you get to reflect on what you did and what you’re currently doing. Peru sounds like a perfect idea for all urban athletes to go after competing. I would highly recommend it.

What do you think is still missing? To get back to our reality for a second.

What do you think is still missing in the world of fitness content?

Oh, man. That’s a really good question. Considering it’s one of those things where, if you want to watch a TV show, or you want to order food, and because there’s so many options with Netflix, Postmates or something, you can’t decide. It’s almost like you rather have less options and then it’s easier to make a decision. What’s missing from fitness and health? I don’t know.

There’s always a shift, right? It’s like the pendulum swings from pain science to “OK. You got to focus on this lift,” or “Here’s a method, the carnivore diet.” I don’t know, I’m just throwing random things out there, how there’s these huge shifts in social media about what you need to focus on. A lot of people are pouring out content about that topic versus vice versa.

I just feel as if there needs to be more transparency. It felt like I can speak on the rehab setting in this whole prehab setting and that group on social media. More videos of patients coming out and speaking about their experiences are actually watching a session. No one wants to do it because it’s boring, and it’s 30 to 60 minutes long. For strength athletes just watching a workout. Today social media is constantly highlights. That’s because we have poor crappy attention spans.

There just needs to be more of this authentic reality sessions of, “Hey, this is what it takes prepping for a Strongman competition. It’s a lot of work and there’s long periods of break. It sucks, it hurts. This is the prep that goes into my body before this is what I’m doing after.” I just don’t think people have the attention spans for it.

What do you think — and this is branching off of the previous question — what do you think is the next frontier in athletic performance recovery and Prehab? I’ve asked this question of about 10 different people and I’ve gotten around nine different answers.

Everyone thinks there’s something different right around the corner as far as what will become popular, useful and what’s really going to stick when it comes to improving and optimizing your performance. We see it start among the elite athletes first and then oftentimes these trends and these best practices then trickle down to the normal people like the rest of us. What do you think is next in that frontier?

The three of us are very fortunate because we get to teach a technique called Blood Flow Research and Training. The three of us who travel at least once a month and that’s a true pioneer. That’s at the front line of how we can improve performance, we can improve recovery.

It’s one of those very unique hacks where it’s legit and there’s a lot of science and research to support it. Getting BFR more readily available to the general population is something that should be at the forefront and is going to be at the forefront in my opinion.

Nowadays there’s so much hype about recovery like how instead of it being so passive to now it’s people are performing recovery. It’s a very active thing that people do. There’s all sorts of wearables coming out and different things to measure your recovery and how you can improve it.

We just need to keep messing around with how we can actually get the body to…the biggest thing is what’s the next big sleep App. Honestly, in my opinion the biggest thing is sleep. Can we get the same results of sleeping eight hours but do it with only saving four to six hours?

That’s the true hack because going back to what we talked about earlier, I don’t know if we’re going to be able to add more time to a day. Can we spend less of the day doing other things that are so passive like sleeping? I don’t know what that is going to take. Then it all comes back to education and awareness. The more that people…there’s all sorts of great things out there.

We just need to have the information more readily accessible to the average person. It all comes back to professional athletes is easy to rehab. It’s so really hard work but you have unlimited resources. You’re getting paid to do it. It’s easier for that person to rehab and to get stronger compared to someone else.

Those are a few things, I’m excited to see what comes out with BFR evidence. I’m excited strength coaches are making a big push in this day and their role is expanding and their knowledge is constantly getting more and more respect from other health care practitioners and the general population versus just thinking all they know is how to lift weights and teach people how to lift weights.

I love it. I absolutely love it. Craig, I really appreciate you taking the time to chat today. Where can folks stay up to date with the work you’re doing along with the latest updates from The Prehab Guys?

You’re going to find us at theprehabguys.com. Really where we started was Instagram, so you can find us on all social media platforms Instagram, Facebook, YouTube and Twitter. Those are all great places that find us.

I would say if you’re really looking for more information just head to our website and then check out the body map. That’s honestly if you have no idea what to do, where to go, go inside the body map on our website on a body part you’re interested in learning more about…

…then we have programs, we have videos, we have articles. That’s the best place to start.

Awesome. Craig, thank you so much for joining us today. Looking forward to seeing what’s next for you and the rest of The Prehab Guys, really appreciate your time.

Awesome thank you so much.