PODCAST EPISODE 9: INJURY PREVENTION

  • By U.S. Navy SEAL + SWCC Scout Team
    Posted June 20, 2018
 

00:00:02:05

The only easy day was yesterday. (Intro)

In training, when you push yourself to the limits there is always a risk of injury. In the special operations field this is even further magnified. Today we speak about the fundamentals of fitness and injury prevention with expert Don Kessler, a man from the highest levels of competition. He is on the ground every day helping Special Warfare trainees perform their best and has some solid advice. Let’s get started.

00:00:43

DF: Thanks for taking the time to sit down with us and speak about what you do for NSW. First, let’s talk a little bit about you for a minute, 40 plus years of physical fitness background with athletes varying from high school students to Olympians. What do you think uniquely qualifies you for your specialized position that you have at NSW?

00:01:10

DK: Well, I started out as a hospital corpsman after getting my master’s degree in physical education, and this was during the Vietnam time, and I eventually got stationed at the US Naval Academy and working as a hospital corpsman there. I moved into athletic training as my profession, but I had years of experience in the military going into that, and I loved it so much that I decided I was getting out of the military to continue on in athletic training. So, I went through, again, working in high schools, colleges. I worked at the Olympics, I worked with US Soccer, so there were many different variations I went to, and when the time came to retire from college athletics, I didn’t feel like I should stop. And so, I contacted some people in the NSW community that I knew and said, “I think I could be some help or benefit to them,” and they said, “We agree.” They thought that my experiences would be able to help teach some of these people some of the things that we do in athletics but also that we should treat the NSW people as Division 1 or professional athletes.

00:02:17

DF: How does the training that you do now specialize from the typical sports medicine that you’ve seen earlier in your career?

00:02:25

DK: My job in the medical side of BUDS training is that I’m to do the functional rehabilitation. So, we have three physical therapists that work with us that will work with the initial part of an injury, and I’m to functionally get them back into full action. They call it the BRIGS program, taking you from the very simple things of coming out of an injury or post-op and getting you back to able to do the obstacle course. So, that’s what my job is, it’s unique among any of the programs that we have in that I have to know what are the things that they ask of the students, both SEAL and SWCC, to make it through the training. And so, my functional rehabilitation is built towards what do you need to do to pass, or what do you need to do to pass through Hell Week or the tour.

00:03:21

DF: So, it is very similar to a lot of other athletic training, you just, a different kind of endgame, so to speak, in terms of what their capabilities need to be?

00:03:30

DK: It’s, like with any sport, and as I used to tell the students that I would have as athletic training students, that you have to look at the team you’re working with and know what is required of them in each thing and even watch people coach them and decide if I’m going to rehab them, what am I doing specifically for that sport. If it’s a thrower, if it’s a swimmer, if it’s a runner, I need to know specific things I need to do to get them back to full rehabilitation. And so, what I did was spend about two months just watching what they did in training and say, “All right, when I go to do my rehab, these are the things that I’m going to need to incorporate in the functional training to get them back to full 100%.

00:04:19

DF: Is there differences because of the loading that these guys are under a lot of times with heavy packs? It seems like to me that that’s one of the differences between training for a marathon or another body weight endurance sport versus the types of things that these operators do. They carry a lot of gear. Would you say that that’s accurate?

00:04:39

DK: In the, in the early phases of training, the heavy gear is just moved from one place to another. It’s not something that they’re really training with. They will eventually step it up and move it up, and they get later phases, but most of the problems we run into are things that involve endurance, whether it’s a run, whether it’s a swim, whether it’s an obstacle course, and we have to get them ready to be able to handle those and repeat those over and over and over again.

00:05:09

DF: Do you see that the injuries that you typically see are, like you just mentioned, are a result from maybe a too sudden of an increase of exercise volume?

00:05:19

DK: I would say there’s certainly an increase in volume. Some people come in trained too much for it already, and any addition that is made to their training puts them over the edge. The people who are peaking slowly have less problems, and that’s what BUDS prep does, and that’s what BO does, is to try to peak you and bring you along slowly, so most of that works fairly well. Many people come in way over trained and become stale as they say in athletics, and therefore, start on the downslope even though they’re going to slowly start increasing what they had been doing.

00:05:57

DF: So, I think it would be helpful if maybe you kind of unpacked that a little bit, talking about the progression of the scale or intensity. You’re talking kind of about peaking in terms, do you mean condition or wear on the body? Can you maybe unpack that a little bit?

00:06:14

DK: I would say more than anything else from the injury wise, it’s the wear on the body. On the physical therapy side, 60% of the injuries that we see on a daily basis are stress fractures, 60% are stress fractures, and so we have to slowly build them up, and if they do get a stress fracture, we have to again start at ground zero and build that up slowly. So, that’s what I mean by that. With the prep students, they start them doing a little bit of running and try to increase that as time goes along and try to make it go faster. When they get to here, again, in basic orientation, again, it starts a little bit slow, trying to show you what you’re doing and doing it once in a while and then start increasing it as you get into first phase. You will then have everything thrown at you every day, and then when you get to Hell Week, it runs on 24 hours a day. So, it peaks, the progression does. That gives them the ability, if you’re doing this right, to be able to handle that peak, but some people come in too high already, or they try to do extra beyond what is needed to be at that phase, and then it’s too much for them when they add more.

00:07:29

DF: I see what you’re saying. So, is there a difference between what the SWCC recruits are seeing versus the SEAL recruits in this process?

00:07:38

DK: The SWCC and SEAL will start prep together and do everything the same in prep. They will do BO together, and then after BO, they will break off into their branches. The BCT that the SWCC people do will be a little bit modified. They won’t be doing quite the much as, quite as much quantity, but they will still be doing the same things that the SEAL people are doing. So, again, it’s the same exact training. They keep right on up until they break out, and then there’s just a slight variation as to the quantity that’s done.

00:08:13

DF: You’ve mentioned the term BO a couple times. Can you tell us about that, what that is, what that means?

00:08:17

DK: BO is Basic Orientation. So, when the students come from prep in Great Lakes they are, all start out in Basic Orientation, and it’s a slow process of trying to learn what is required of them on a daily basis for their swims, for their runs, for the obstacle course, for their barracks inspection, personal inspection. It’s a watered down advance part of what’s going to happen in Hell Week or the tour or any other phase, and so they slowly as the weeks go by will increase the intensity of what they’re doing and the quantity of what they’re doing.

00:08:57

DF: Okay, let’s roll back maybe a few weeks or months in this kind of process. I’d imagine part of the reason why your voice would be so helpful here is being able to have these recruits hear you before they arrive and go through this orientation process. This is I think the kind of the jewel of being able to talk to you. What do you think these recruits should not do when they’re preparing for their PSTs before they even arrive?

00:09:28

DK: I would have to say it’s almost like getting ready for a track meet. You don’t want to be training for a marathon to be able to do a one-mile race, and the same thing goes with preparing to go to basic training and then to go to prep and then to go to BO. If you’re trying to do the amount quantity wise and the intensity that you’re going to need further down the road, you’re going to break down beforehand. So, it’s important to remember there are requirements to pass the PST. Shoot for what you need to do to be prepared for those requirements and not worry about what you need to do to get through Hell Week in that the amount of mileage you need to put in, the amount of lifting you need to put in or the amount of swimming you need to be in is nowhere near the amount that you’re going to need later, but you need to be able to do well at what you’re going to do at a lower level, but by being prepared to doing something at upper level won’t necessarily make you better and may break you down when you get to that upper level.

00:10:31

DF: I think that’s a really important distinction to make because we’ve talked with a number of people through this process, and there’s a sense of continued reflection on the documents and the guides that have been well-vetted and written for recruits through this process. I think that there’s a tendency, especially coming from a very high performing collegiate background, all these people are athletes, to want to push, want to push, want to be the best, want to be the top, and I’m hearing that continuously don’t push to the point where you’re hitting your limits. Follow the measured approach, the crawl, walk, run approach that’s kind of been echoed by a few different people, so it’s good to hear that from you, too. It seems like the guides that are available for people and the training programs that are available for people are designed for your success. They’re not necessarily for the lowest people on the rung to be able to get through. There is a measured approach for a reason, and it’s not only just to get people in the right condition but to prevent long-term injury.

00:11:39

DK: Absolutely right. The people that I end up seeing for medical treatment are usually those people who’ve pushed too hard. And that’s why I was brought in because they felt that in the past, if you were dropped because of medical reasons, many times you were left by the wayside and never really could get back into what was going on. And they found that many of these people were some of the best athletes that they had, and they just over trained or had a freak accident and got an injury. And what we wanted to do is take that out and say, “Hey, we want people like that. We want people who will push themselves, but let’s give them a framework to work in,” and rather, instead of just going crazy doing a lot to say, “Here’s the measured amount you need to do to get better,” and that’s what we have honed over the years to say, “I know exactly what it takes for you to have a fracture to get back to running full, and I know how many weeks it takes, I know how much intensity I have to do it each one, and if you add more to that, you’re probably going to get injured again.” And I’ve seen it time and time again. As it is with the people who have followed the pattern, and I’ll just say with stress fractures, we’ve dealt with stress fractures. I’ve had 148 guys I’ve used the Altered G, which is gravity assisted running, and of those people, all of them have passed. Only six people were reinjured, which is about 4%, and the history with stress fractures is if you’ve had one, it’s the best predictor of getting another one, and you have a 40% chance of being reinjured if you’ve had a stress fracture. So, we’ve been able to hone that down to about 4%, which is amazing. I’m going off on lectures at colleges and universities to talk about that, to try to help them with what we’re doing, but that’s what we’re saying. We have done this, we have seen this, we have a measured approach as how much to do, and the word we try to get out to you beforehand is don’t wait to get hurt to do this measured amount. Do the measured amount beforehand so we can bring you along gradually through the training throughout the cycle.

00:13:47

DF: So, for the people that don’t have a world-class rehab facility whenever they’re in the earlier stages of training, is there anything you can say to them about comparing the type of pain that’s causing injury versus the pain of, of your muscles burning? Can you speak to that a little bit?

00:14:04

DK: Well, again, looking at most of…DF: Like when to stop I guess…DK: Mostly people have had, are athletes of some sort, whether they’re swimmers or water polo players, ice hockey players. They have an idea from high school training or college training about what I need to do to get in shape, and there is that, you know, soreness when you start getting in shape, but after that, it never should be a real soreness. You should say, “Hey, I got a good workout,” but you never should be getting sore that the next day, “Oh, I don’t think I can do it.” If you’re doing that, and you’re getting more sore each day, then you’re already start over training, and that’s one of the best things that we’re trying to say is that, yes, there should be a breakdown, but there also has to be recovery. You just can’t keep pushing every day although you can do running one day, swimming a day, biking a day, almost like a triathlete and say, “Hey, that will get me there. It gives different parts of my body a chance to take off, but I’m still working towards the end,” and that’s the approach we push with the patients who are already injured, but certainly it’s necessary for the people who are just starting out.

00:15:13

DF: Right. So let’s say you’re earlier, you’re earlier on in this process, maybe you’re six months into training for your PST, and maybe you sustain an ankle injury, or you, you determine that you maybe might have stress fractures. I’d imagine it’s very important and even more so later on in the process to be able to maintain your engine, your cardiovascular capability through an injury. Is there anything you could recommend to people that might be “nursing” an injury early in this process to be able to keep their fitness level up instead of just drowning out?

00:15:45

DK: Absolutely. We always keep the conditioning. When we have somebody who is injured, and again, we’ll use stress fractures as an example because it’s one of the most prevalent injuries that we see, those people even if they are injured and are on crutches, they are working out, and their workout for aerobically will be sitting in the seat and doing an upper body arm bike, or they’ll be swimming. And eventually if they’re off crutches, we may have them biking and changing the speeds and resistance and things like that, so they’re constantly doing aerobic conditioning, and then we will eventually take them along to what the phases of running is concerned. But if they had an upper body injury with swimming say or the obstacle course, again, they’re on the bike, and they’re pedaling away, or if they can run, they will run, so they’re constantly keep their aerobic base going all the time, but we have to work to the specifics to what their injuries are and rehab that injury and then incorporate that into their fitness once they’re capable of doing it.

00:16:50

DF: Yeah, so it seems like a little bit of that can be done with common sense on your own if you’re in the early stages of this training process; do something that you can do and try to keep the intensity level going.

00:17:01

DK: Absolutely, except for the one machine that we have is gravity specific, everything else is something that you could have in the basement of your house, a bicycle, medicine ball, some dumbbells. There is nothing that I use in the rehab that involves anything complicated at all and have stations set up that people will be doing squats, or they’ll be doing lunges, or they’ll be doing hamstring curls. They will be doing planks, they will be doing sit ups, dips, pull ups. There’s constantly things they can do that involve no special equipment at all, and that’s what we try to teach them, is that you don’t need to have big heavy weights of 400 pounds to be able to get through this. You need to move your body weight and be able to push that through what is required of you.

00:17:49

DF: So, maybe if you could be the voice in a young recruits ear who sees these really “macho” characters who are almost beyond super human doing things that people would love to be able to do with their bodies. They’re strong people obviously. There’s a focus on strength that I think maybe is a little misplayed. I think a lot of the most successful candidates are endurance athletes like I’ve heard from other people. Maybe you could maybe summarize a little bit about that kind of philosophy that people have like they need to be the strongest people on the block to be able to make it through this program. Is that true, or maybe you could give us some information there.

00:18:24

DK: I would say the eight years that I’ve been here, there are certainly many SEAL operators who are pretty big, strong, intense but not to the numbers that you see on movies or TV shows now, that the average guy would be able to do what he has to do, is an endurance athlete. And I had an operator one time tell me he needs to be able to carry our heaviest weapon ten miles; he doesn’t have to carry ten weapons one mile. So, they don’t need to be that big and that strong to do it. They have to be big enough and strong enough to move things and move themselves with heavy backpacks and stuff, but the heavier they are themselves, the more chance they have of injury and the more difficulty they will have trying to get over the obstacle course or trying to make 4-mile runs. So, they have to get strength, but, again, more than anything else, they need endurance. The activities they call for and are posed the most strain on are going to be the tour and Hell Week, and it’s difficult to make it through if you’re too big.

00:19:33

DF: So, I guess maybe if you could be the word of wisdom for these young people to kind of instill some discipline into them on maybe self-reflection of what really is needed to get through. What kind of advice would you give to people in terms of taking a look at themselves and seeing what should be, you know, their goals and such in terms of their physical fitness?

00:19:56

DK: I think their goals should be what their PST is first, what do they need to do to pass the PST and do well. Do you need to be really strong, have a heavy bench press or a squat to do it? I don’t think so, and that is the first objective they have, they need to pass that and do well with it, which is going to include speed and endurance and some strength, but it’s not going to be an over amount of any one of those. As they move further down the line in the training, they’re going to ask more of them, and the more of it will be more endurance than it will be strength, so be very careful of not trying to do too much of one, thinking it will carry over into one of the other fields of swimming or endurance running knowing that that is one of the many measures. And so, what happens with push-ups after a while at Hell Week especially? I tell them, “The only time you really need neck exercise is when you get to Hell Week,” The strength that you’re going to need is on the obstacle course, climbing over that, doing the climb up the tower and things like that, and that’s what I put in my training is what, what are parts, some parts of the obstacle course because that’s something I know you’re going to have to do outside. Let’s make sure that you have the strength and the endurance to do it in here, and then I’ll let you go to the obstacle course and do one obstacle. How’d you do with that? And we move them along like that, so, you know, none of it is involved that, “Hey, I need to get your bench press up or your hand clean up,” or anything like that. I don’t do any of that at all. We work on muscles that are not even shown in most strength things. They’re shown mostly in rehab because that’s what’s injured as opposed to your shoulder, gluts, hamstrings, things that people, it’s not glorified, they don’t see it, but when a SEAL breaks down, a SEAL instructor breaks down, those are the things that happen, and we say to him, “Wow, if you had done this way back when, you probably wouldn’t need this shoulder operation as a 30-year old operator,” you know. Pitt was involved in some big studies there, and they looked at all the injuries that the SEALS had, and I saw, well, a lot of these are the same as what these guys are getting in our training. If I show them this now, hopefully, it’ll carry through their career that they’ll do that twice a week and be able to keep from being, you know, inoperable kind of cause we take care of the SEAL and SWCC instructors, too, and the injuries that they have, which are much worse now because they’re inoperable condition are the same exact things that the kids get other than stress fractures. Most of the guys have gotten smart enough to either not run much anymore, or they know exactly how much they need to run to do what they need to do, you know, but that’s, that’s what we look at and see.

00:22:41

DF: Are there any, we mentioned stress fractures, are there any other major issues that you see with people coming “off the street” when they enter into BUDS that you would like to maybe kind of nip in the bud or along the lines in the, in the guide that you would like to address?

00:22:56

DK: I would say shoulder and back are two big things, and the shoulder is rotator cuff. Very few people do much with it. They really only think of it with a throwing injury, but the rotator cuff is very important in all the things that you do because it stabilizes your shoulder before you do any exercise. And it’s not shown in a weight room as an exercise that’s going to make you look big and strong because it’s three tiny little muscles that are underneath the deltoids that nobody sees, but if they go, and they always go first because they’re very small and very weak, then you can’t do anything else, or you’ll dislocate your shoulder, you’ll tear your labrum, and it can all be prevented by doing some rotator cuff exercises, and they are simple exercises. We call them the T, where you take dumbbells, light dumbbells, and lift them in the front and the side and the back, external rotation exercise, where you’re lying on your side and bring your arm up, and one exercise for the supraspinatus, which is called the empty can. And those exercises are done as a preventative thing, but they are the base if you don’t have a good rotator cuff, you have difficulty in the obstacle course, boats overhead, logs overhead, all those things, but also in bench pressing. Every year in football, when springtime will come around, and everybody’s trying to do their maximum weights, I would have football players with shoulder injuries, and most of it was rotator cuff from trying to bench press and build up those muscles but do nothing for the rotator cuff. And I would just back off on how much they were lifting, work on the rotator cuff, and they’d get better, and then we could increase their weights. So, it’s important to keep that as a basis all the time to have a strong rotator cuff. And it’s not more than 15 pounds that’s needed. I mean it’s a very lightweight that anybody can have in their basement to do, four simple exercises for strengthening for that.

The other is the back, one of the most common injuries, not only in our environment but in society in general, and people will want to do all kinds of exercises that involve bending over and twisting and lifting, which are the worst things that you can do for your back. People who have disc injuries, people who have stress fractures of their back are usually from bending over and lifting something without getting your feet underneath you, almost like a squat, to pick it up. And so, if you do those as exercise as prevention, you’re actually doing the worst thing you could do because that’s what injures you. So, it’s more important to do the tiny little muscles that are around the spine that you can strengthen just by doing planks, and you can do a front plank and a side plank and a back plank and all variations. You can do it for time. There are all kinds of ways you can do it, but those strengthen the core muscles around your spine, and then you can start doing sit-ups and extensions, only if your core is strong, and those simple things, which involve 15 pounds at the most and/or your body weight will prevent most of the other injuries that we see.

00:26:08

DF: So, focus a little bit more on some of the less glamorous exercises it seems in support of the bigger body parts and muscle groups. That’s a very good point. I think a lot of people totally miss on. How many times have we seen people in the gym doing curls and doing bench press, and these are the “strong” guys in the gym, and then the next thing you know, right, they’re on crutches or the shoulder is…

00:26:33

DK: So, basically we’ve started kind of from the top, and we’re working our way down by talking what I just did about shoulder and then the core. The next would be your legs, which would be most of the people spend it doing squats or lunges or something that’s going to be working on their quads and do very little for their glutes and their hamstrings. And again, it should be a balance. There should be a balance of the percentage of strength from your quads to your hamstrings, and we see this with problems with hip injuries later on, and again, just like the shoulder, we may see it as a strain of the muscles in the hip, or we may see it as a labral tear, which, again, is cartilage in the hip just like in the shoulder, or we may see it that you may have sciatica and nerve problems, things like that because of poor position now because your quads are so much more dominant than your hamstrings. And so, again, I’ve seen this with all sports throughout high school and college, was the emphasis was on, “I need to have this strong quads,” and, yes, you do, but if the ratio becomes such that you have a 5 to 1 ratio in many cases, let’s say you could squat 500 pounds, I’m sure we could hardly find anybody that could curl 100 pounds with their hamstrings. So, again, that’s why I say it’s a 5 to 1 ratio. And when you workout, I mean when I’m running and doing something explosive, that ratio has to be 1 to 1. If my quad strength is five times what my hamstrings strength is, where do you think the injury is going to happen? And where do we see this in the NFL and baseball? What is the major injury you see that they say, “Oh,” it’s hamstring, and no one understands why, why we have it. Well, I can tell you, if your leg is extending with a 500-pound force, and you only have a 100-pound force to slow it down, to keep it from hyperextending, after a while, it’s either going to fatigue, or it’s going to be overcome by that strength.

So, that’s what we need to think about, is, yes, you need to do the quad work, but remember there’s a balance of front to back, and everything we do. When the shoulders, what I talked about, yes, you can do bench press, but you also have to do the posterior part of your shoulders. Here, yes, you can do squats and lunges, but you have to remember I have to do some hip extension work. I have to do some hamstring curls to try to balance it out and get the ratio better. This can even prevent some things like the runner’s knee because, again, you’re so quad dominated that in a true running form, you should be more glute-dominated. And if we get those stronger and get that explosion, it’s supposed to be the biggest, strongest muscle in your body. Well, there’s a reason for that cause it’s supposed to be one that explodes to drive you forward, and so, you want to strengthen those glutes and strengthen the hamstrings, to balance. If you don’t, you’ll have knee problems, so we see that also.

00:29:24

DF: So, in terms of maybe the lower extremities, you know, ankle, knees and such, a lot of that seems to be just volume of training, right, wear and tear, or is there any preventative maintenance that can be done there?

00:29:34

DK: There is preventative maintenance, and, again, if you look at many athletes, from their knees down, they haven’t done anything. They may do some calf raises, you know, and that’s usually common. If they’re straight leg calf raises, then they got a barbell, and their shoulders, or they have leg press, and they put their feet out there, and that’s all they do. And that’s good in most cases, but in reality, it only really helps the gastroc, right, and there are two muscles that are in the lower leg that are combined, and that’s the gastroc and soleus. And the soleus attaches below the knee, and so you actually have to do the exercise bent legged also. So, we teach that, yes, you’re going to do the straight leg, but you also need to be seated with a weight on your thighs and do calf raises that way so you involve the soleus. And the soleus is really the muscle that you use more for running because your knee should be slightly bent as you’re running. You really don’t get to full extension of your leg until at the very last push off, okay, so you need that soleus in there. Most people don’t do that at all and also with their stretching. They don’t do a stretch. They may do the straight-legged stretch, but they won’t do it with a bent knee, and you need to stretch one straight-legged and one bent because, again, there are attachments above and below the knee.

But not only just those because, again, now we’ve overemphasized the back of the leg, we haven’t done anything to the front or the side, and that’s, again, where we see a lot of problems with a stress related problem, is that the anterior portion where your anterior tib is lifts your foot up and toes. Well, when we’re running in soft sand, there’s a lot of that going on, and they have difficulty with boots even lifting that up high enough to get over it, and so they start using that a lot, so you need to do some anterior tib raises. And again, it’s not a lot of weight. It’s 1,000 foot strikes per mile, so you need something you can do a lot of repetitions with. Now, I can’t tell somebody, “Go out and do 1,000 reps of that,” but you need something with resistance, whether it’s your hand, whether it’s a towel, whether it’s a band and get sets of 20, sets of 50 that you’re doing that motion.

And so, we get to the ankle, instability when we are running in soft sand or on the beach, and you step in something, you have to have the ability to be able to handle all the different directions cause your ankle is going to do it. So, that means you have to do an inversion and eversion, and again, if you use your towel, your hand or, again, a resistance band and go through those motions and use your peroneus longus, use your posterior tib muscle. Those are muscles that, again, we don’t require any extra equipment, we don’t require any more time, any more resistance. It’s just a matter of getting those repetitions in. And the last thing I’d say is that one of the exercises I have to do with our stress fracture guys is to just throw a towel out on the floor and curl it up with your feet, just like you’d be curling up with your hands and your toes because the muscles that flex your toes are running up the inside of your leg, and they also support your arch, and so if I strengthen those and get those used to repetitions, that will make it so that I might not have as much difficulty running in soft sand in boots and also prevent plantar fasciitis, too, so I mean there are, you know, we’ve basically gone from the shoulders down, a lot of simple little exercises that balance out things that you’re already doing. Those are the preventative things that we see are neglected, and they end up being the things that get injured.

00:33:06

DF: I think that’s a really good summary. One thing that I think would be helpful if you covered, and my guess is that the reason why a lot of these bigger muscle group movements are predominately focused on and a lot, like you said, football strength, whatever, because they’re, they’re impressive numbers, and they’re measurable, where it’s like a lot more difficult to maybe do some of that type of measurement with like the exercise you mentioned about curling a towel with your feet. What ways can people measure these types of movements really simply? Maybe you could talk to that a little bit.

00:33:38

DK: I’m one who really believes in using objective measurements in the lifting that we do. I want to know exactly how much somebody is lifting and what they need to be as I feel over 46 years of doing this, knowing it takes this amount of strength to be able to prevent that as a rotator cuff. If in an athlete you can’t do 15 pounds, you’re probably going to have problems. So, I know that if I’m starting with five, I know where I need to get to and can make those progressions. And some of these exercises, it’s difficult to do that, and that’s why we ask for repetitions instead, but you can even push that a little bit, and, again, trying to get as objective as possible say with a towel curl exercise. You, again, start out and make it easy, and you’re doing 50 of them, then put a book on it, build it up, and if that gets easy, put your boots on it and pull it in, or put a cement block or something on there that makes it more difficult. But again, with all the lower leg injuries, we are saying, “You are going to do 1,000 foot strikes per mile. During some of this training, you’re going to be running six to ten miles a day, so you need to prepare yourself for that.” Now, again, I’m not asking that you do 1,000 to 6,000, but you need to be doing sets of 20, sets of 30 so that your body at least knows what to do, and you can start strengthening those muscles.

00:35:01

DF: Great. A lot, we talk this being a lot about endurance, a lot about body weight, so, and you’ve mentioned that there’s not a tremendous amount of equipment that’s required for you to be able to hit your PST number and come into BUDS, and we talked about endurance being very important. Can you talk a little bit about footwear? I think there’s some trends out there for barefoot style running shoes and or running barefoot in sand, all this kind of stuff. What…

00:35:26

DK: But they won’t have that option when they get there. They will just be boots. There’s no, and the boots that they get were the ones that everybody’s issued. We can’t even change the style of the boot until after they’re into second phase. So, the footwear that they’re going to wear, I would tell them not to train in that, in that it’ll, it’ll throw off their mechanics, and it’s more important to have good mechanics and run properly, and I would say more, more towards the barefoot in that you’ll have a better style, and then as you add shoes, as you add boots, your body will adapt to that, but I certainly don’t recommend people going barefoot who haven’t run barefoot before. Again, with anything, you add a new exercise, it’s a shock to your body, and, again, I want to add steps of how many repetitions or how many days a week I do that, and it’s a matter of adjusting for your body to the stresses and new stresses that you’re adding to it. So, it’s kind of unique in that I’ve been doing it for about six years watching, you know, these guys run, and we’ve got all these stress fractures. And again, it’s probably best, again, to get them early or to get them up at prep, and I’m not moving to Chicago I can tell you that right now. I moved from New Jersey here 13 years ago, and there was a reason, but, you know, when I was trying to get them ready, they had to be able to pass their 4-mile run or 3-mile run. And so, I knew I not only had to get them back in condition, but they had a definitive line, as you said. It didn’t matter about push-ups, pull ups, sit-ups. They had to pass their 4-mile run. If they didn’t pass it, you know, no matter what we did rehab, they were out, so I’m going like, “How do I make them most efficient?” I know this post stress fracture guys, I know that they’ve got to wear the boots, I know it doesn’t matter if I put an orthotic in it or not, it’s going to be in the ocean, wet and sandy, you know, that’s not going to happen, that I know that they’re going to be running on the beach, high tide or low tide. I know they’re going to be wearing those pants, and I know it’s always a 4-mile run, and I know what the time is, 32 minutes and then 31, then 30. So, how do I know that when I’m teaching them to get back to running I’m making them the most efficient that I can? They’re broken for whatever reason. How do I know that if I do this and make them better they can?

So, at that time, a tour group came through, Alberto Salazar. I don’t know if anybody’s familiar with him at all. Alberto is the coach of the Oregon Project for Nike and has taken US and the world’s best distance runners and worked with them, and Alberto was coming through, and it just was timely that I’m about that same time scratching my head, going, you know, I can get the limp out of somebody, I can make them stronger, but is this the best they can be with what they have? And so, I posed that to him, and I said, “You know, I don’t really know that, and, again, having worked athletics for over 40 years, that a distance coach has ever said, ‘Well, this is the best way to run. You know, this is the most efficient way.’” And he goes, “Well, I coached that.” “We’d never beat the Kenyans if we didn’t take care of everything, including technique and diet and sleep,” I said, “Wow, I’d love to learn it.” He goes, “Come on up and see.” So, I went up to Nike at his invitation, And he, the first thing he did, he sat me in front of a computer and said, “Watch these high speed films,” and then talked me through what they were doing, and then he showed me footplate films of how the foot was landing. And then we went to the treadmill and had Galen Rupp. I don’t know if you know Galen is the ten-time 10,000 meter champ of the US and silver medalist in the 10,000 meters in London and only the second time he ever ran the marathon got the bronze medal in the last Olympics. So, you go, not a bad runner. I guess he’s done something right with him, and he’s coached him since he was in high school. And so, he had Galen on the treadmill and went absolutely, you know, “Here’s what he’s doing, here’s what I’m watching, here’s what I’m coaching, here’s what I’m trying,” and it was like some of the things were just like, “Wow, I’ve never seen that, never known that.” And so, that night, I stayed up there for three nights, I’m a runner myself. I’ve been running for over 50 years and tried, you know, one of the things on myself, you know, and it’s like, “Wow, that feels a lot better,” you know, it’s like, “Wow.” The next day tried, you know, something different, and I kept feeling better with it.

00:39:46

DK: And so, I get back, and I started doing research on the medical side to say, “All right, if I’m more efficient to make me faster, does that make me have less injuries?” and so, started looking at each thing on research wise. I went through about 200 research articles and said when you break them down individually, yes, they do. And so, started putting it together, and so I started teaching my guys who had stress fractures, and the first thing I remembered was an ice hockey player from Brown University had bilateral stress fractures. And you watch him run on the treadmill, and you went, “Oh, my God, he looks like he’s still ice skating,” you know, it’s like one of these all over the place. Had trouble passing his 4-mile run, and so started doing what I call the FASTER program, and he got better. He even said to me, like, “My legs would always get tight as soon as I started running, my shins would, and I don’t feel that at all.” It’s like, “Oh, that was a good sign,” and so eventually he got, got out in running, he ended up passing and going through Hell Week and everything else. He said he knocked three minutes off his 4-mile time and now is on the teams on the east coast, and he’s been there for a couple years cause he’s been doing this for about two and a half years.

And Alberto posed the question to me, what kind of sports background did it come from? I said I had never really looked at that and started looking at it, and as you would think with stress fractures, it was swimmers, water polo players, ice hockey players, and we always used to say it was bone density, and yet we do bone density tests and calcium tests and vitamin D, and everybody would be within normal limits. But you look at these guys and watch them run to evaluate the first time, and you went, “Oh, my gosh. No one’s ever shown you how to run because you didn’t need it to be a good swimmer, and you didn’t need it to be a good ice hockey player, but you’re not a good runner.” So, I found out keeping track again over all this time, over 75% of the guys who got stress fractures are from sports that are non-running sports. And, you know, I already named it. If you were a soccer player, football player, lacrosse player, you could still get it, and most of the time it was from over training. I actually film the guys for 15 seconds from the side and 15 from the back and watch the running mechanics, and then we sit down from the app and go over each of the six things and have had great success with it, and the whole point is, again, not over training. When I start training them back again, I don’t ever let them even do a 4-mile run. They do intervals where they’re doing 30-second intervals, short recovery and do that for three miles maybe, or they’re doing minute intervals that we’re trying to build up their strength and their aerobic capacity but not trying to just do mindless miles, and that’s what I see kids do, is to get ready for the PST or to get ready for the 4-mile run, “I’m going to run 8 to 10 miles a day, and, therefore, it’ll be easier.” Yes, it’ll be easier, but you won’t necessarily be faster because you never worked on the mechanics, and you never worked on the speed and power that you need to do to be faster. If you didn’t use more muscle fibers to go faster, you can’t go faster. I don’t care if you ran 20 miles. You’re not going to be a fast miler if you didn’t do speed work to be that fast, you know, and so that’s what we try to teach.

00:42:57

DF: So, all just, as a wrap up…(DK: It’s much too long!) DF: No no, I think you touched on a very important part…

00:43:02

DK: It’s where I got to rebirth at 68 years old to say, “Wow, you know, this is something that’s untouched. Why, why?”

00:43:09

DF: Yeah, just cause you learned how to run when you were a kid didn’t mean you learned the best way to run.

00:43:12

DK: And actually the command saw that 100% of the guys that I was working with were passing the 4-mile run. I said, “Well, it’s better than the rest,” and we had guys who weren’t injured and weren’t passing the 4-mile run, and they asked me to work with those guys for a while, and all of them passed, again, just doing simple mechanics and doing shorter distance but faster and a short recovery in between, intervals as such, and, you know, everybody made it. So, again, something that should be pushed earlier to say, “Hey, don’t just go out and do mindless miles. Do some intensity, get some short recovery so that you’re still pushing the heart, and do that intensity again, and you’ll do a lot better than just doing multiple miles of, you know, slow, easy jog,” yeah.

00:44:01

DF: So, in summary, if you had the ear of somebody who’s going to be entering in this process, in 15 seconds, what would be the quick elevator pitch to this kid that’s going to enter the process?

00:44:14

DK: I’d say balance, front to back, quads to hams, shoulder, and endurance. Think of, yes, I need strength, but I need to be able to do it multiple times for a long period of time. And so, it’s more important to have that endurance factor to get through the early part of our training. Later on as they become a SEAL, it becomes specific, but right now, they need to be able to make it through the training, and the training involves endurance.

00:44:40

DF: Are there any resources available to these potential candidates to prevent this type of injury?

00:44:44

DK: Online, there’s the physical training guide, and there are also some rehabilitation exercises that are shown on videos that they should be able to understand and be able to apply all these techniques.

00:44:58

DF: Well, we’re out of time. Thank you so much for joining us. It’s been really, really helpful.

00:45:02

DK: Good.

00:45:04

DF: Find out more at SEALSWCC.com, and join us again for the next NSW podcast