Managing Sports Injuries with Dr. Jonathan Kropf

John Boruk: [00:00:00] All right. Thanks for joining us on the podcast that focuses on the ever changing world of youth sports and athletics, and how we can do it a little bit better for everyone involved. I'm your host, John Bor. Thanks for being with us. We'd love it. As always, if you could subscribe to us on the podcast, you'll be notified every week when a new podcast is posted, and if you could give us a review, we would greatly appreciate that as well .

And if you've been a regular listener to this podcast, we try and take a different approach every single week from coaches to parents. We got personal trainers and I really like to emphasize the medical field when we can get somebody in that profession, we had concussion expert Dr.Vincent Schaller. He gave some extremely valuable advice as it pertains to brain injuries and how you treat those for athletes. And my guest today is going to bring a different side. He is essentially one of the leading experts when it comes to soft tissue injuries working with elite athletes, weekend [00:01:00] warriors, college athletes. You name it…Dr. Jonathan Kropf.

 Welcome to the show. How are you doing? Great to be here. Thank you for having me. Yeah. You essentially are a chiropractor, Correct? And that's one of the things that you do, but you deal with soft what you guys consider in the profession, soft tissue injury. So explain what goes into that, what that is and I guess more accurately what all it encompasses.

Dr. Jonathan Kropf: Sure. So what I noticed when I first was finishing grad school, that there was this big gap in treatment of treating these type of injuries. So you'd see athletes come in for tears, different things like that, which, very difficult to treat, you have to stabilize those. For treatment of soft tissue what we notice is okay, if it's not torn and you're not a surgical case, what do you do from. So [00:02:00] soft tissue by definition is, ligament. tendon, muscle, nerve and fascia. And oftentimes, there's modalities, ice or heat. But we know that there's deeper injuries than that. So what do you do to treat those? And that's where my career took me is learning these different techniques to specialize in the, advanced treatment of those injuries. Because I just saw this huge area with, where these injuries weren't being addressed. 

John Boruk: Just to give the listeners some background to Dr. Kropf currently the team chiropractor for Villanova University Athletics. Correct. So you've got some major responsibilities that you're dealing with in working with some of these athletes, especially as it pertains to basketball players, football players, track, 

Dr. Jonathan Kropf: Correct. We have a lot of different sports. At our school. So we see such a big variety. There's a lot [00:03:00] of things that trainers throw at us every week. So it gets you really good at learn assessing and treating these things on a fly because you're trying to get these kids ready to travel for a sporting event over the weekend.

So there's a lot of different things that they throw at us as far as soft tissue injuries.

John Boruk:  So what's the most common soft tissue injury? Is it, or is it different depending on the athlete and the sport that they play?

Dr. Jonathan Kropf: Very much different depending on what sport somebody specializes in. It could be, I, we treat shoulder injuries, muscle sprains, muscle strains a lot of overuse injuries which is, again, we see a lot of in use sports these days. And also you talk about how soft tissue can mechanically affect your back, your spine, how your, you know how those joints function and move. So that's where we marry the two things together. Yeah. So by tray, I'm a chiropractor. Yes. But it's how. The soft tissue negatively impact the joints themselves. [00:04:00] 

John Boruk: So when it comes to youth and kids and everybody says it takes your bones aren't fully developed until you get to your twenties. Is that also, does that, is that parallel with your soft tissue if for a kid it's not fully developed for youngsters as well who play sports?   

Dr. Jonathan Kropf: Absolutely. I'll give you a good example of that. So you hear a lot of these terms lately of people having core injuries, certain athletes, let's say soccer for example, or track. We see a lot of these kids that are doing high rep sports and they keep pulling the same muscles over and over again. And there's a deeper reason for that. When you see kids start to get into these grow spurts where they just grow rapidly, you see some kids, like my son, he was five three last March.

He's now five 11 and he is been complaining of some, tension in his, growing hamstring, stuff like that. So you'll see these kids grow so rapidly that their skeletal structure starts growing so [00:05:00] quickly, but their soft tissue hasn't caught up yet. So we're talking about lengthening of those soft tissues.

And a lot of kids will, complain of issues post practice where, they stretching just isn't enough. They just can't seem to get ahead of certain things. And a lot of that is is growth. It's because they're going through these quote unquote growth spurts, right?

John Boruk: Yeah. Whether it's growth spurts and some, I've got a kid on my son's hockey team, he's five 10. The rest of the kids are barely pushing five feet. It's unbelievable how he's hit this spur and it, he's the kid in the middle of the team photo. So when you do hit these growth spurts or you do hit puberty, what can you do to counter the growth in the soft tissue.

Dr. Jonathan Kropf: So I think it's for, from a, again, I have two kids myself that are both in puberty right now. And I think for coaches and parents to tie, first of all, identify what stage they're in and listen to their kids' signs and symptoms. So if [00:06:00] their kid's saying, Hey I'm tight, I'm feeling, uncomfortable after practice and it's not the normal type of, normal cramping you might get with gross spurs is looking out for certain things where you're starting to see the kid maybe limp a little bit.

Is there a gate change? Are they feeling discomfort just at rest in school? And those are the things you gotta talk to a practitioner about. All right let's take a look at it. Let's see how that soft tissue is lengthening. Let's see how flexible the kid. And it's not always about the flexibility of the tissue, it's how that muscle tissue lengthens and how pliable they are.

We're listening to the, one of the podcasts earlier with Jim Ferris about conditioning and you'll see, kids ignore these symptoms or parents might ignore those signs and symptoms and look at 'em and just oh, they're just going through a growth spurt. But also often times there could be a deeper overuse injury that's there. So really I just have, parents like try to look out for things like that. 

John Boruk: And piggybacking what you said and what Jim Ferris [00:07:00] had talked about is he sees this a lot with the overuse, the overexercising, that, when some of these young athletes just simply overdo it. And is that probably where a large proportion. The soft tissue injuries are coming from is just the overuse of these muscles and the overuse of these body parts.   

Dr. Jonathan Kropf: I think it all goes back to specialization. You've heard that term before, and you know you have certain sports like, gymnastics, tennis, hockey. The kids are starting pretty young and a lot of it is age based gymnast, they peak, in that early teens with their sport. But a lot of it is, some kids, they, and the parents, they focus so heavily on one sport and that specialization often leads to those overuse type of injuries where they're doing, they're just wrapping out on thing.

John Boruk: You're doing the same exercise over and over again. Not every muscle zone, not every soft tissue area is gonna get [00:08:00] worked accordingly. 

Dr. Jonathan Kropf: Correct. Yeah, Correct. We talk about cross sports skills, right? So specialization. When you see, let's talk about pro athletes for example. And they done a survey with division one athletes. 71% of division one athletes played multiple sports. Same with, I think NFL football players, 86% of them played multiple sports. So it's, when you. Give their bodies time to rest their soft tissue. Change the movement patterns, say going from maybe a soccer to, or a, a baseball to a basketball, for example.

You're working on coordination, you're working on offloading some of those soft tissues. To the point where they're not getting the tendonitis and the tendinopathies that, that we're seeing. So it's just giving those movement patterns, time to rest and moving to a different sport. And I think that's where we really see the kids benefit is they get all the games of, improving motor control and [00:09:00] coordination without the constant insult to that soft tissue in the one sport, just because they're repping and grooving those same movement patterns over and over again.

John Boruk: So what can we do to alleviate that? Are kids that are playing sports at a high level? Is it too many reps? Is it long too? The practices are too long. Is it too many games being played? Sometimes you play tournaments and you play four or five games within a tournament.

That's a lot. Correct. Yeah. You don't even expect that from, at a high school, collegiate level. We almost demand a lot. But when you see that, when you break it down, what is it? What is there is, or a direct contributor to these types of injuries. 

Dr. Jonathan Kropf: So when we're treating these injuries, so what we'll see is, let's say a hamstring pool, for example.

Like I just saw a young track athlete earlier, and [00:10:00] this track athletes actually is, secondary sport is soccer. So he's running constantly. And then they're also training for, distance running or middle distance running for his school. So what we'll see is we wanna make sure that these kids are also. First of all making sure that they are staying very pliable, doing what's called dynamic warmups pre, and listen, my kids that are super busy, it's not just running to the field and just going right in and start participating. Those warmups and stretches are so important to get those soft tissues pliable.

That's the first part of it, I think. And Jim was talking about too, about using Theraguns and the foam rollers and all those things to improve the pliability. We call it mashing. The tissue is just getting those soft tissues more pliable before, right before you start an event.

It's not something you might not wanna do after, you know a lot of people do, but you want to get those tissues more pliable and warmed up before the event. [00:11:00] So it's the prep. That starts meeting a lot around that same age. Most 9, 10, 11 year olds, they can just go out and start playing, right?

They warm up and they're good. But when you start hitting puberty and we're talking about having, the skeletal growth is so rapid, but in their soft tissue playing catch up, it's really just spending more time doing the dynamic warmup and the prepping for those events. And then once they're done for the day, it's making sure that they don't just run right to dough, do something else, making sure their buys have time to rest.

Cuz that's how it is now when you have, you might be playing on a travel team, you have a team for school, and they just go from one team to the next. And so I think the recovery time is so important for allowing them to repair their soft tissue. Cuz that's generally, again, where the cycle starts when we start seeing these soft tissue 

John Boruk: Injuries is it just as important, more important for the 11 to 19 year old athlete as it is [00:12:00] to the twenties and 30 year olds?

Dr. Jonathan Kropf: I would say once you start getting into the, the high school age eighth, ninth grade, when they really start hitting puberty, and these set those good habits for those athletes that might, excel in high school and in college, they really have to take care of their soft tissue.

So you, You should see in Villanova at any given point in the afternoon when tracks start their practice, kids scattered all over the floor using the Thera guns and the foam rollers, and they're rolling on the cross balls and they're just trying to get themselves pliable and warmed up so they can go out there and not injure themselves.

So they, a lot of 'em have had injuries or they're managing injuries I think it's just starting those habits earlier. But I think that the kids that we see at the earlier ages are the ones that are really specializing in just one sport. I think that's where we see the most soft tissue injuries for sure.

John Boruk: I've worked and interviewed and done a lot of things with professional athletes and I'd like to study what they [00:13:00] do in their offseason, cuz obviously when you get in season, it's very repetitive. You see the same thing over and over, but what are they doing off season? The one thing that I do.

That even before, engaging in an off season workout is they actually take the time to do certain stretches. And I know it sounds silly, kids just go out there and they just start playing, it's, pick up a basketball, just start shooting hoop or, Hey, pick up a baseball.

But if you could somehow just get your child into habitually even if it's I guess five minutes, right? How long? Hell, But five, 10 minutes just stretch out those, as you said, those ligaments, those tendons because it will go a long way. I know it's not something that's popular, but it is so important that's rarely emphasized.

Dr. Jonathan Kropf: Yeah. And you look at how we used to stretch when [00:14:00] we were kids, you'd do that, bend over, touch your toes for 10 seconds, We'd twist we'd and we literally would spend five minutes on that. But I feel like you know now since we know so much more about these injuries, I think, again, the best thing to do is have.

Make sure that the trainers, the parents, the coaching staff, everybody's on the same page knowing that, okay, hey listen, Jim or Jane, when they go to practice, they're always gonna be able to do these warmups. We're gonna take the extra time, not just rush, cuz we know they're all coming from either other sports or they're coming from school.

And you, when you, and in the off season you look at, to, to your question, it was, a lot of pro athletes, they won't even touch a baseball for months. They won't throw. They won't do anything. A lot of them will just go rest. They might play golf, they might do something completely different.

And when they really start getting serious about the, offseason conditioning, they go to places like, in, Arizona, Florida, and there's these, these conditioning centers that are built just specifically for cross training [00:15:00] and for their sport. Which kind of gets in another topic I'm really passionate about is just making sure kids do the right type of fitness for their.

I won't mention the college, but there was a college where I had a college athlete come home. Just a tremendous amount of low back pain. And she had a lot of issues with some of her core muscles. And she's a soccer player and division one soccer player. And I looked at her strength and conditioning program for the summer and she was doing the same.

Strength and conditioning work out that her football team was doing at the same college. It's, and this is a big time university, and she hurt her. She hurt herself. She had soft tissue injuries. She hurt her back. And I looked at this play and I was like, Why are you doing? This type of aggressive lifting when your sport doesn't require that, soccer's more of a finesse sport.

So I think it's, parents gotta step in too and say, Hey, time out. Let's make sure that they're doing the right type of lifts for their sport and not, doing a lot of heavy weights when their [00:16:00] sport doesn't require it. Football, wrestling, you're pushing all these big humans off you, right?

Yeah. Soccer's a finesse sport. Do you need to be doing, 300 pound deadlifts? No. So I think it's, also making sure that these kids are conditioning appropriately for their sport and at the right time. 

John Boruk: So I've been told that when you evaluate and you assess somebody's soft tissue injuries, you're able to hone in on, on that exact location and within two or three treatments you're able to course correct that area and they feel the world of difference. 

Dr. Jonathan Kropf: So I have to give all credit to Dr. Mike Leahy. He was somebody I trained with and he developed this technique called active release, and it's, I think it's what you're referring to so that, it's one of the main things I do when I'm at Villanova and it's called ART, right?

For short. A.R.T. For short, Yeah. Okay. What that teaches us to do is like you, you can use your hands to [00:17:00] feel where these irregularities are in somebody's soft tissue. Say for an example, somebody comes in with a shoulder problem and they're a tennis player. And it hurts when I do my forehand and and I'm like, Okay, do you do a two-handed backhand?

What's your forehand like? And you notice okay, we'll find these irregularities in the tissue depending on which movement hurts. So we find that area and it feels like a, it feels like it's bound up. It feels like a piece of leather. It feels gritty. And anybody that's had an injury like golf elbow or tennis elbow, they'll say, Hey, it feels spongier or it feels swollen here, but it also feels like there's grizzle in it.

Those are adhesions, right? So if people aren't familiar with that's, so what happens with overuse injuries that we see in a lot of sports is you'll have this cumulative injury to that muscle tissue. And we call it like an insult to the tissue, right? So if somebody's re out a lot, sports, like you'll say, they're repping out a lot of tennis strokes or [00:18:00] somebody who's a golfer or a pitcher for example, for shoulder.

So what'll happen that sometimes that friction and tension and pressure builds up in that muscle that has that, those little adhesions that build up. And what happens is that creates this inflammatory cycle and next thing that, that creates all this scar tissue that's basically changed their joint mechanics and is causing pain.

We have this, these newer techniques that go and we identify where those are and use our hands to break up that soft tissue tension. And it restores their normal range of motion. And it happens pretty quickly. And some people, it opens their eyes like how long have these things been there?

It's hard to say. It's hard to, hard question to answer. But if it's all about identifying where they are and then remove them the right way. 

John Boruk: So I'm pulling this off your website. Yes. ART. It is a state-of-the-art, soft tissue system, movement based massage technique that treats problems with muscles, tendons, ligaments nerves, all of that carpal tunnel, [00:19:00] shin splint, shoulder pain plantar fasciitis, headaches.

Back pain like headaches is directly tied to this. Cause my little guy complains of headaches and I tell him like, I think you need to drink more water, or whatever the case may be. 

Dr. Jonathan Kropf: But you, that's a good thing to do. Of course a lot of headaches, majority of them could be just dehydration. So in youth sports we see a lot of collision injuries. You hear a lot about, a lot of kids, have concuss. And what'll happen is we find a lot of times in their upper neck region, it's almost like having a bunch of car accidents. You talk about little football players, it's like having 10 car accidents a game sometimes.

And it gets worse as you get up into the upper levels, so you know, the collisions you'd see in hockey and even now we see in used sports like soccer, there's a lot more collision. Headers. That's why they've, I think they've outlawed some headers until a certain age is, because they develop these soft tissue injuries from that sort of whiplash [00:20:00] type of injury.

Now, some of that tension can build up in those muscles in your upper neck. And what we do is we can identify that we see it all the time at a collegiate level, almost all the trainers now they'll have me co-treat these kids with concussions, and you'll find all this leathery what we call fibrotic muscle tension in their upper neck.

So we start to remove those things with these techniques in these slow, methodical ways. And we do a few reps on it and almost always wow, that feel, I feel so much more range of motion and it really starts to cut down on their headaches cuz they get rid of all that, muscle tension and neural tension that they have in their upper neck.

John Boruk: So if there's a parent out there, a concerned parent where their child is saying, “Oh my God, I think my kid has a concussion, or he's complaining that he's got headache. This may not be a bad idea to at least start at this area before you, you take it to the point I gotta get a CAT scan, or I see a neurologist.

Why not start at this point, In a lot of ways. I think that [00:21:00] all the doctors would agree. It's all connected. It's just a matter of how you're gonna treat it.   

Dr. Jonathan Kropf: Correct. And our profession, as I'm a doctor. Chiropractic by trade, our profession evolved so much where now we have all these modern soft tissue techniques where it's not just, we treat the same, three things like neck pain, back painter, or headaches anymore like now.

So we use a combination of these things. Our clinic is one of those clinics that's known in the area, cuz we. All these new state-of-the-art soft tissue techniques, and that's what I feel like you have to marry the two and a lot for a lot of times kids, it's just treating the soft tissue.

We don't even need to incorporate some of the chiropractic treatments. So it's really, again, identifying where the tension is. Remove it in a safe, methodical manner, and sometimes that's all an athlete needs is that, I would say probably half my caseload, I was there yesterday at Villanova is, was soft tissue related.

Yes, I do some chiropractic treatment on 'em, but these techniques are just there's a whole [00:22:00] different way to approach these things from a functional standpoint. And this, those, this goes with all those different types of sports injuries we're seeing with youth athletes. 

John Boruk: The advance in medicine now, because when I think back to chiropractic medicine 25 years ago, I'm thinking adjustments, it's a back adjustment. Chiropractic, that's what it was. That was it. It has evolved so much. Where have we come for? When you look at injuries 25 years ago the remedy or the prognosis would've been to have surgery done to where now a non-surgical procedure is the way to go. 

Dr. Jonathan Kropf: And there's a lot of examples of that. So I know with knees they're trying to cut back on arthroscopies and so if you can identify where wear and tear is, and these things started at an earlier age too.

Some kids that have multiple knee injuries, we're seeing, we see a lot of post ACL, MCL in kids. And, it's, a lot of it is just, where. All this wear and tear and scar tissue build up [00:23:00] around joints. If you can eliminate some of that at an earlier age there's, you're gonna get a lot more miles out of that joint.

And that's, that's what all our patients tell us. We’ve been able to help some people avoid a hip replacement for maybe five six. Even seven or eight years by just removing some of the soft tissue tension. And I tell them, hey, listen, I'll be the first person to tell you're gonna need to go see your orthopaedist.

I think it's time to go get a joint replacement. By removing some of this soft tissue, you give that joint a lot more freedom of motion. Hey, you're gonna have a lot less pain. And then again, a lot less wear and tear on the joint surfaces. And that's what we'd like to do with kids too, is like, hey, if you can identify some.

If hip injuries are a good example, core injuries are a good example and for all the parents listening Hey, you know what core injuries are, if you might, there's especially common in soccer and hockey. And you see them, they start to get these chronic groin pools and groin tension, and a lot of that is okay.

You strain that muscle, [00:24:00] scar tissue starts filling in those gaps, and that becomes leathery. And so then they go out and practice and play and do games and might be six in a weekend. And. Then they next, Monday comes, they're going right back to school, they're doing the conditioning, whatever, so that soft tissue doesn't have a lot of time to recover.

So therefore it's like a strain and restrain type of situation. So what we try to do is we try to, remove all that strain, those adhesions that build up, and if we can do that, then again, that can take a lot of heat off of, the adjacent joint, like the hip joint for example. So if we can.

Remove those type of injuries before they start to really affect joint mechanics. Hey, maybe we can save somebody from, those, injuries like labral tears in the hip and things down the road. So it's really just, it's, this newer techniques to identify and treat those things before they become a huge problem or a surgical issue.

John Boruk: [00:25:00] Yeah, so if in my case, your case, we have kids that are actively playing sports and they're doing a lot of training, a lot of working out. But I don't want them to have a 35-year old body by the time they're 20 years old. Now, that's as much as I want them to be an optimal athlete and them to perform at their highest level. To me it's more important that they don't have, that their body is already at a point where it's breaking down as they're getting into their thirties and forties when nobody wants to see that. Yeah. So how can they be proactive in these early years so that's not the case. 

Dr. Jonathan Kropf: I had a whole discussion with a parent this morning about the same topic going back to this was a post-concussion athlete she's a gymnast and she had some extensive soft tissue issues in her [00:26:00] neck.

And you look at, all right, my kids, how many times you catch them on their phones and their head looks like it's gonna fall into their lap. Yeah. And I, we're driving in the car. My son had a baseball tournament last weekend and I just had to keep reaching over and just pushing his head back cuz he's leaning forward.

On top of sports, what we're starting to see is something, I call it tech neck. It's the iPad the laptop, the phone, and you see these, all these postural issues start with these kids, so that's that. That certainly doesn't help the situation. So you're seeing these kids have.

Have issues like that. And it's all, a lot of it's technology, but then, you know that they also might have the stressors from sports as well. That's, one of the things we try to focus on the right there in the neck area.   

John Boruk: I would think that you see probably more of those now than you did when you first started.  

Dr. Jonathan Kropf: A hundred percent, yes. That is absolutely true. And it's way more alarming than we have kids with migraine headaches coming in. At a rate we didn't see before. And [00:27:00] a lot of that has to do with weight of their backpack. And you got, looking at devices and I think really since the advent of the cell phone, we see a lot more of that now.

I see student athletes, they travel a lot on airplanes, buses and a lot of them are complaining, cuz they're doing work too, that, these student athletes they're doing, they're trying to cram in homework in between, on between road trips.

 Dr. Jonathan Kropf:. Absolutely. So I'm like, hey, shove your backpack or your sweatshirt behind you so you're sitting up straight, or make sure your laptop is sitting up higher. So it's all these little things that are cumulative for college and high school athletes and know, but it is it's happening more at an alarming rate. We're seeing these kids come in with, headaches, neck pain, migraines. Yeah. 

John Boruk: When I was a teenager going through this and I complained of soreness, the idea was to grab some icy hot or some Ben-Gay, and throw it on the area that felt sore and just rub it in and do you look at that and just [00:28:00] cringe now. 

Dr. Jonathan Kropf: It's funny. Yeah, cuz the gym I used to work out at, I used to go a certain time in the morning and some of the guys I was friends with, they're all like over 45 and you walk in, it smells like Ben Gay and Sav in there. So that's what our old remedy was. Ah, I just rubbed some of that stuff on there, and those things help you feel better. But, I think so, the science of soft tissue and all the research has evolved so much, especially over the last, even 10 or 15 years. So we treat these things so much different now at a, at a high school and a collegiate level.

And, and yeah, we have all these new muscle rubs and things like that. There's new one that comes out every week. One of the things we use a lot of is something that's old school is this magnesium. You remember your, my grandparents used say, Oh my soak and Epson salts, what does Epsom salts have? Has a lot of magnesium in it. So we're seeing a lot of these pro products like that, that have magnesium. So we, we have our athletes use a lot of that for repair and recovery. But I think. You're in the [00:29:00] advent of all this new technology like Theraguns and you have cryotherapy and all these different soft tissue recovery methods, recovery boots, you see those inflatable recovery boots, which basically help you push all that, gunk and fluid from an event or a marathon or whatever.

They, you flush that out and those are things people can now use at home. So there's just so much more we can do for ourselves and our kids to. Especially to, to post treat these soft tissues so they don't become a chronic injury. So a lot of times it's flushing that tissue out is a really important thing.

That's what Theraguns do. That's what foam rollers do. And that's what, again, going back to your question before was like, how can we help our kids and how can we help ourselves, treat these soft tissue injuries a little better? It's just being more proactive with them, not just rubbing something on it.

John Boruk: Yes. So you're essentially saying, do something. Beforehand then something reactionary, once the soreness [00:30:00] is already in there. 

Dr. Jonathan Kropf: Correct and a lot of it is, with young athletes, we want them to try to use their core or do the core warmups more than ever, So you know that, that term core is like a buzzword that's now evolved.

When you see kids doing like bear crawls and planks and these different thing, warmups, pre-game and pre-workout, what we're finding is these kids have way less soft tissue injuries, the more core they do. And when parents ask me, What can I do to help Jimmy or Jane prevent, a, an injury to these muscles, again, core, it's not just doing?

The old school exercises, the squats and the other things like that. It's really treating your core getting it as strong as possible and that really makes you more a more flexible athlete. It prevents a lot of injuries. So I, that's what we're stressing now is that kids warm up [00:31:00] their core.

And parents the same thing. You warm up before your workout. Do your core first, not last. We used never used to cash out at the end of a workout with sit-ups, yeah. 

John Boruk: So gimme two or three, just good core exercises that these athletes can do just to get that area warmed up, ready to go.

Dr. Jonathan Kropf: Absolutely. So I got this one. There was a trainer for the Minnesota Timber Wolves that we did some work over Covid. I was following, we had some of these podcasts on, and on social media was posting some of this. And it really, it's, his philosophy is his name is Quiche Sato and his it's keep it simple and you don't need a lot of fancy equipment.

We call it low tech. Warmups are low tech rehab, and it's as simple as just doing bear crawls on the floor and planks, you've heard planks know. Then planks are like the new sit up and if somebody could do those efficiently, [00:32:00] pre-workout, pre athletic event their core is gonna be very warmed up and they're gonna make themselves much more pliable and.

The standard stretching that we used to do, which is, stretch each body part for 10 seconds. We know now that's just not very effective. So you have these kids doing these functional movements like, there's, first they'll jog and then they'll, they'll do bear crawls and they do like the side steps and they do monster walks, which is like kicking your legs out in front and the lunge walks and all those movements help create more pliability in a tissue and they're warming your core up.

So we see those dynamic warmups just really prevent injuries and it's, I think there's 50% less injuries now because of just warming up the correct way. 

John Boruk: Yeah. I also see these high performance athletes, professional athletes warm up with those resistance bands. Absolutely. Yeah, those seem to be popular.  

Dr. Jonathan Kropf: So what they do is they create what's called an eccentric load. Tom [00:33:00] Brady's famous for this now, right? So he, everybody's like, How's he doing it at 46? I'm 46. And it hurts to get outta bed sometimes, right? But you look at this guy, how's he doing all this? I, And it's really because they're not letting, they're not letting 

John Boruk: Defensive linemen tackle 'em anymore?

Dr. Jonathan Kropf: So that helps always a big deal. Not having 350 pound humans on top of head. He does, they do a lot of these eccentric band exercises, which really are more lengthening the muscle and strengthening at the same time, versus just your standard, squat, bench press, bicep curl thing like that.

So what those do is they don't stress your joints nearly as much as the old school exercises. So using the resistance bands puts a less of a load. I think what we're seeing, you'll probably see less arthritic changes in a joint. You'll see better pliability to soft tissue and ultimately, less of these injuries that we, we typically see because of these 

John Boruk: New techniques and these, new soft tissue massage techniques [00:34:00] are we able to, or do you, how much do you work and try to alleviate arthritis, especially in middle, some of your middle aged patients. 

Dr. Jonathan Kropf: So our, I think, look at our demographics. We're pretty busy clinics, so we'll probably, if we have 350, 400 patients a week, we, most of those we'll see are like the 35 to 50 year old weekend warrior. And a lot of them are pre arthritic. Yes. They have this, the, we called soft tissue wear and tear issues.

. We're typically doing techniques to just, either we have instruments that are like, some of 'em are stainless steel or. to work out these adhesions that are, that we find around the joints. And once we do that, they're like, Wow, I feel like my joints are more pliable again, better circulation.

Again, that's, that comes back to being proactive and not reactive. So a lot of times, most of the cases, yes, we're gonna see that come in. Oh, hey, I was playing golf the other day and my knee got really sore, or I was at the gym doing exercises in my [00:35:00] shoulder, so that's usually gonna prompt somebody to come in.

But you know what we'll typically get, what we find with those is those wear and tear areas, they're easy to find, they're easy to spot with your hands. Like we, we get really hands on. We move the joint around. You can really feel those things. And then the techniques that we use, they, these things really respond well to improving pliability and range of motion.

And again that's, being proactive. If they waited maybe six months, two years and they still had the same injury, hey, maybe that's gonna turn into a tear. Or that's gonna turn into some accelerated arthritic issue. The last thing you wanna see is somebody down the road have to get a joint replacement.

But, it's, I think that, identification early is really important. And I think that a lot of people don't know that these things exist. These, there's this, like we were talking about it earlier, there's this big gap in treatment. If, let's say you, you're not, you don't have a tear you don't have a fracture.

But sometimes you'll get for [00:36:00] an ankle for example, you'll get put into a boot and a lot of people come in, I'm like, Oh, what happened? Did what? Did you break? What did you tear? And they're like nothing. I just, they put me in a boot for six weeks. I was like, Okay. So what's the plan when you get done?

Oh nothing. I'm just gonna go back and start trying to, run or play my sport again. Then we see atrophy, which is the muscles get weaker and we see a ton of these adhesions that have built up over time. So you. Way more likely to injure yourself after these injuries.

So instead of just waiting for the, those soft tissues to play catch up or heal, we wanna make sure we proactively get in there and clean up all, clean out, all that gunk and all that garbage break up, all those adhesions that are really holding those joints back or that are preventing those soft tissues from being pliable.

And this applies to pretty much every sport and almost every injury you've heard of, rotator. Golf elbow, tennis elbow, kids with those core injuries, hamstring pools, hip pointers or growing pools. [00:37:00] So I think that once, once you can identify, where the injury is and work it out, I think, the road recovery is a lot quicker than some people think it is.

John Boruk: And I, and a good example, and I don't know if I'm now venturing into orthopedics, but ACLS used to be a death sentence 25 years ago, you got an ACL injury, it was career. Now not only can it be repaired and restored to almost 100% mobility but instead of missing an entire season, sometimes now you see him coming back in season, which is amazing.

Everybody who lives in Philadelphia remembers Terrell Owens and the Super Bowl actually came back and played very effectively. But is that one of those areas where technology's now starting to catch up and it's not necessarily. A surgical procedure. It's something that, that can be healed naturally.

Because like I said, the technology and the and [00:38:00] the modern medicine as it applies to ACLs has come a long way

Dr. Jonathan Kropf:. Absolutely. And I think that has a lot to do with the sequence in which they handle the injury. It's not, a lot of times ACL, they'll wait about three weeks to four weeks to do the surgery.

And, some of these, like at Villanova we have fantastic PTs that work there in trainers and they're all so much more skilled and educated and how to manage these things. And instead of having someone. Immobilize for so long now they're really getting more proactive in, in as far as, getting those joints moving, working with the soft tissue really extensively to get it more pliable.

And therefore they can start strengthening and doing their sport specific activities much faster in a quicker timeline than they used to. So I think it's a matter of the skill of the surgeon, how they do the procedures now you know how good the PTs are and the trainers are at being proactive and really getting these, [00:39:00] these athletes and in, being more aggressive with it. And then also the soft tissue te techniques that we use, about four or five months post-surgical to, to break up the scar tissue and now they can really move forward much quicker without having to break through that.

If you ever see an old athlete that had an ACL like 20 years ago, they have, their knee almost looks arthritic. It's tight. They don't have full range of motion. It's rare that you see that these days. You see some of these athletes are nine months post ACL and they look fantastic.

They're running, they're starting to cut again. Athletes like Saquon Barkley came back and, with, tremendous amount of function he gets back. And these, it used to be that was a career, right? Career. Yes. Yeah. Now it's, I think it has to do with a lot of how they do this very specific sports conditioning too.

The core strength work they do the level of expertise of these great trainers and, athletic trainers and PTs that are working [00:40:00] with them. And then, you couple in all these new soft tissue techniques that we. , now you're, now you're cooking with gas.

Now you're getting back quicker, and safely too. It's not like these athletes are not ready to play, but they come back. Some of 'em are stronger than they used to be. And you can see they, they can play at pro sport for another four or five years or longer, yeah. I think it's just a matter of it's the procedure, the process. It is better. How long have you been at Villanova now? Let's see, it's been about almost seven years. Okay. Yeah. 

John Boruk: So you've been part of the national championships? 

Dr. Jonathan Kropf: Yeah Dr. Mike Duncan, who somebody I've known for a long time, we've had a referral relationship even prior to, but he's the head of sports medicine there.

He called me up it was actually shortly before they won the 2016 basketball championship and he said, how'd you like coming to work for us? We need somebody that's, that's doing this type of soft [00:41:00] tissue work that you do. And, it's been a great relationship and it comes down to, like I always say, it takes a village a lot of times to fix an athlete.

Treat an athlete because, so we have this great relationships with all the coaches, the trainers, sometimes the parents as well. And, so we have this very good collaborative team effort that we have there. And all credit, do you know, to the coaching staffs and the fantastic athletic trainers we work with there.

So we have this structure of how we treat everything. So they'll have me step in when. Somebody has some type of strain, sprain, whatever, and we're trying to, get rid of some of that scar issue and then the trainers can do their job, getting 'em more pliable again and sending 'em back on the field.

That's it's, again, I'm not the, I'm not the point guard all the time with these injuries. But it's, we're all working together, and that's, it's a collaborative effort. It [00:42:00] takes a village, and I like that.  

John Boruk: I like that analogy because, 20, 30 years ago, we were asking a handful of people, two or three people to be experts in nutrition and weightlifting and the cardio aspect.

We're asking them to almost be this multifaceted expert in all these things. And now, yourself. Somebody who's you're, an expert in soft tissue and we have somebody over here who is good with bones and a nutritionist. Now that these major universities have individual nutritionists and programs designed for certain positions, which is amazing.

And I used to not even blink an eye at the importance of yoga, but. Believe that yoga, as it certainly pertains to, to your area, is so critically important because it is stretching and getting the important balance and balance is so big in sports. If you don't have good balance, it's [00:43:00] really hard to be a good athlete.

But how all of that is, that is intertwined into really just maintaining, being, just a high, a high performance. So starting adolescent athletes out with doing things like very yoga specific poses and stretches.    

Dr. Jonathan Kropf:. Yeah. Balance and coordination. Those things carry on through the rest of your life.

If you wait till you're 65 and not very pliable, yoga's gonna be a little more difficult. Yeah. You could do it and you should. There's never a bad time to start it. But I feel like if those things are introduced at an early age, increasing balance and performance. And I know sometimes the guys reluctantly, like the, I know the basketball team they get up at really early in the morning and they're heading over to do yoga altogether as a team.

But, and that's done in the preseason. But these guys know, hey, they're making gains and flexibility, pliability, balance, [00:44:00] and their recovering from workouts. And that's what yoga is a great tool for is recovery from other workouts. It's the same thing with specializing with sports and I always talk about specialization in sports is not great cuz you want to diversify, almost like you diversify your portfolio, you wanna diversify your workouts.

 And that comes with, not just doing the same weight routine every day or every week. It's also it's recovering with yoga and Pilates and core workout. Cycling, running, and so if a runner, if somebody comes in and they have a soft tissue injury in my office, and I say what do you, That's one of the things I ask 'em, what do you do as your daily activities?

What's your exercise routine? If somebody just says, Oh, I'm a runner, and that's all they say. I'm like that's probably why they hurt themselves, because they're not doing yoga, they're not doing core, they're not doing enough weight training. [00:45:00] That cross training, we talked about cross sport motor conditioning and motor skills.

That's where the, that's where the big win is. That's where the benefits are, especially for youth athletes. That's why we don't want them to specialize. We say, we want you playing multiple sports because it's gonna improve balance and coordination and core strength and. Not just doing the same activity over and over again so you don't have that soft tissue injury built up cuz that that those tissues, if you're doing the same activity over and over again, there, it's not a matter of if it's when is it gonna get injured.

So that's where these things like yoga come in. And that's not only for, the youth athlete, that's for all of us. Yeah, It's diversifying your workouts, I feel like is probably the. Beneficial advice I can give to anyone diversifying your workouts.

John Boruk:. Limit the time on devices, electronic devices because of the strain that it puts on the neck. Implement core [00:46:00] muscle stretching. So if there's anything to take away, There you go. There's three good things to take away from this particular podcast that will go a long way, for the young kids out there, which is good. Absolutely. Yeah. Yeah. Dr. Jonathan Crop of the Sport and Science Center.

Did I say that right? Sport and Spine Wellness Center? How many athletes do you see a week? 

Dr. Jonathan Kropf: Ooh. Villanova is probably I have, I'll have 25 to 30 when I go there every week. But in the office it's, I look at everybody as an athlete.

So if you on my website, I think I have a quote about that is that, I look at everybody as an athlete. I don't care. What sport you're doing, how old you are. Anybody can act like an athlete and be an athlete. But I'd say, as far as collegiate, high school and youth athletes, we probably, in the clinic we probably see about anywhere from 50 to 60, those kids a week, on top of us.

Yeah. So it's just, and some of them are, [00:47:00] in season, and my primary goal is I need to keep you on the field safely, and I will, again, And it's again, coordinating that with the parents and making sure that they are doing everything they need to play safely. And how they, making sure they're treating their soft tissue correctly, doing the right home care.

So that that's my passion. It's just making sure that, athletes are playing safely in, they're doing the right recovery, and their parents also understand. They have to police that. So I'm just, it's all about communication between, and sometimes you have to call the coach too, but, to bring 'em all in and the trainer.

Yep. And but everybody's usually, when you get everybody on the same page, it's a wonderful thing. And it's all centered around that athlete. Yeah. Yeah. 

John Boruk: I think that it's just so important and so crucial because I think it's so easy to just get caught up in bones, concussions, and all this, because that's the stuff that's like the hammer hitting the nail over and over again.

But these. These are more prevalent. These are the more [00:48:00] prevalent injuries. These are the more, you know when you talk about shortness or you just talk about a strain here, these are all the soft tissue injuries that happen, and this is much more occurring and much more prevalent than anything.

I think that's out there. That's why I think it's important. So that's what keeps us busy. Yes. That keeps you busy. So thank you so much Dr. Kropf for coming in. John, thank you very much for having me. I appreciate it. It's good pleasure. We'll do it again. We like to always end the podcast with our encouraging words of thought and this week deciding not to take on difficult challenges is a choice, and usually it's one filled with regrets.

Unfortunately, you can't see how bad you'll feel about missed opportunities until they are long gone in your rear view. Take chances. Try hard stuff, fail often one way or another you're gonna ante up with effort or remorse, so you might as well pay the price and chase your dreams. All right, that's gonna do it for us.

Thanks for listening to Raising a Champion.