Timestamp Speaker Transcript
00:00:02.04 Tony Fowler And we're rolling.
00:00:04.86 Taylor Kruse Welcome back to the Cruise Elite Podcast. What's up Tony?
00:00:08.63 Tony Fowler What's up Taylor?
00:00:10.19 Taylor Kruse How are you?
00:00:10.31 Tony Fowler I've got a question for you.
00:00:11.48 Taylor Kruse Yeah.
00:00:13.91 Tony Fowler Is there a sport or a more traditional training modality that you feel like utilizes the most kind of applied neuro just naturally?
00:00:30.77 Taylor Kruse Hmm. Man that's tough. i don't I don't know. Well so my my mind immediately goes to sports that are incredibly reactive that require like really really good vision and vestibular skills.
00:00:55.25 Tony Fowler It's like paddle sports or something.
00:00:55.26 Taylor Kruse So...
00:00:57.23 Tony Fowler Yeah.
00:00:57.94 Taylor Kruse Like yeah so like racket right? Is that what you mean?
00:01:00.63 Tony Fowler Yeah.
00:01:00.70 Taylor Kruse Like a racket?
00:01:01.31 Tony Fowler Sure.
00:01:01.34 Taylor Kruse Yeah yeah so racket-type sports for sure could could certainly fit in there.
00:01:01.62 Tony Fowler Yeah.
00:01:06.28 Taylor Kruse So could like any type of combative sport but you know especially where there's striking.
00:01:12.12 Tony Fowler sure yeah
00:01:15.22 Taylor Kruse And then also racing sports like alpine ski racing um racing cars
00:01:24.55 Tony Fowler Mm-hmm.
00:01:24.95 Taylor Kruse It's kind of an interesting one to think about but I mean that uses i mean if you don't have a good visual system you can't do that. Like it's just literally that. Like it's it's interesting because there's a lot of sports where if you don't have a great visual system you can compensate for it because of the high level of proprioception that is needed. So like for me thinking about myself as an athlete
00:01:49.05 Taylor Kruse You know I do reasonably well with wrestling and jujitsu and like there's a high level of proprioception that's needed for those types of sports.
00:01:58.31 Tony Fowler Right. Mm-hmm.
00:01:59.22 Taylor Kruse And I don't have the best vision. Like i've i I wear corrective lenses. i' I've been working through different visual deficits since the time I started learning that you could have a visual deficit.
00:02:12.57 Taylor Kruse And I still have some of those things present in terms of like my visual system is there I have like stamina issues related to my eyes.
00:02:24.38 Taylor Kruse And you know going back to as long as I can remember really like being in school and stuff and you know you're told you have whatever learning challenges and stuff. A lot of times that is you're being told that but you actually have vision issues. In my case I had vision issues.
00:02:43.61 Taylor Kruse I was not good at ball sports growing up. it was They were very frustrating for me and I avoided them. And I transitioned into wrestling and it was like amazing for me because instead of needing to worry about you know balls flying at me and lots of different players on the field and kind of that was very chaotic for me I was able to...
00:03:07.48 Taylor Kruse have my threats right in front of me.
00:03:09.58 Tony Fowler Yeah.
00:03:09.59 Taylor Kruse And then I could put my hands on a person grab them and use my proprioception which was really good. And it kind of made up for the fact that I didn't have excellent visual skills.
00:03:20.82 Taylor Kruse So there's definitely it's it's cool to run the activities through the filter.
00:03:25.75 Tony Fowler yeah
00:03:26.20 Taylor Kruse You know what I mean? But yeah for first for me it's like okay I immediately think of of sports that require excellent vision and some of those racing sports really come to mind. Anything that's very reactive.
00:03:40.82 Taylor Kruse and And you're reacting based on visual input.
00:03:45.27 Tony Fowler Visual input. um Also visibular input right? If you're changing direction quickly you're cutting even like the the force of a turn on a racetrack or skiing yeah.
00:03:49.46 Taylor Kruse Yeah exactly.
00:03:57.11 Taylor Kruse Totally.
00:03:57.48 Tony Fowler ski yeah
00:03:58.46 Taylor Kruse yeah Yeah right. with like With skiing you have to be really accurate in terms of the line that you take.
00:03:59.23 Tony Fowler Mm-hmm.
00:04:03.74 Taylor Kruse so And you have so many different forces working against you right because of the speed that you're traveling. And then of course you've got ground reaction forces happening from a uneven surface right as ah as an alpine ski racer.
00:04:12.73 Tony Fowler Mm-hmm.
00:04:20.98 Taylor Kruse there's a lot to deal with that you you don't really know those things exist if you have not experienced that kind of activity. But yeah without a good vestibular system it's going to be hard to calculate you know how are you going to approach your turn let's say and deal with all of those forces at the same time you're dealing with gravity.
00:04:46.01 Taylor Kruse and And that's really what the vestibular system is. It's like a compass that helps you understand where you are in space which way you're going and how to deal with gravity.
00:04:55.96 Tony Fowler Yeah. Yeah that's really cool. Thank you for humoring me. um I think it's great that you you know you're thinking about like all the sensory stimulus and then you're thinking about reacting to it and thinking about movement.
00:05:08.73 Tony Fowler And it's like these are all the things that you're training to just tie everything together and make your brain function better.
00:05:17.14 Taylor Kruse Yeah yeah.
00:05:17.24 Tony Fowler So yeah you can kind of reverse engineer it almost.
00:05:18.45 Taylor Kruse Yeah you know what's... Totally totally. and And I do this a lot. I just kind of run things through my filter in my mind as I'm thinking of you know seeing different sports and stuff. One of the funny things that I picked up on was that there are a lot of great martial artists particularly jujitsu jujitsu practitioners when I watch jujitsu that wear glasses.
00:05:41.19 Tony Fowler Mm-hmm.
00:05:41.62 Taylor Kruse and And some of them wear like pretty darn thick glasses. And when I see that I'm like oh my gosh. Like this guy's literally blind without his without his glasses.
00:05:51.59 Tony Fowler Mm-hmm.
00:05:52.44 Taylor Kruse Those things are so thick and yet and yet this person I'm actually thinking of is one of the best if not the best at least in his weight category in the world.
00:06:03.61 Tony Fowler a
00:06:04.02 Taylor Kruse And when he doesn't have his glasses on he's like squinting and can't even see the scoreboard. And i'm I'm sort of chuckling to myself. I'm like that's that's funny. Like jujitsu is so proprioceptive.
00:06:17.78 Taylor Kruse And certainly a good visual system helps you because jujitsu is all about pattern recognition.
00:06:21.14 Tony Fowler Right. Mm-hmm.
00:06:24.54 Taylor Kruse But if you don't have great a great visual system to recognize those patterns you're doing it with sense right? Tactile sense. And yeah so it's just interesting. you know it It goes to show you that even high-level athletes depending on their sport and the requirements for it can have these different um limiting senses if you will but then make up for it drastically with other things that they're really good at.
00:06:51.61 Tony Fowler Yeah. I think at the the highest levels it's almost like your anatomy and maybe perhaps neuroanatomy uh selects you for the sport and not the other way around.
00:07:01.71 Taylor Kruse Mm yeah right.
00:07:02.24 Tony Fowler Right. It's like you look at like uh ah the speed skaters and they all have a very similar body type. And you look at like marathon runners and they all have a similar body body type and it's you know football players.
00:07:11.80 Taylor Kruse Right.
00:07:13.72 Tony Fowler And it's like oh yeah these people are all like it's like they're designed for this specific mix of attributes.
00:07:17.08 Taylor Kruse Yeah.
00:07:20.15 Taylor Kruse Right. Right and the sport can literally like you can reach a point where your career is basically coming to an end because you are missing one of the most important features that is needed neurologically for a sport.
00:07:35.32 Tony Fowler Mm-hmm.
00:07:35.45 Taylor Kruse And that's and that's in a a lot of times that's what we're experiencing when our athletic careers kind of come to an end. A sort of you know non you know non-professional athletes and but you'll even see it at at the higher levels.
00:07:48.75 Tony Fowler Mm-hmm.
00:07:49.02 Taylor Kruse you know someone who's really trying to make it right? They're trying to make it they're really close they're on the heels of the best. And they just they need that extra advantage and they're missing fundamental things that the highest level athletes have.
00:08:03.74 Taylor Kruse A lot of it comes down to what's going on with your eyes.
00:08:03.85 Tony Fowler Mm-hmm.
00:08:07.64 Tony Fowler Mm hmm. You know I always thought that the stereotype of jujitsu jujitsu practitioners being um kind of like more cerebral and like you know it's it's because it's like chess you know it's like they're they're they're making a move and you're making a counter move and they're making a counter counter move.
00:08:26.94 Tony Fowler And you're thinking about these patterns and all that.
00:08:27.26 Taylor Kruse Right.
00:08:29.42 Tony Fowler It turns out we think they're smart just because they all wear glasses.
00:08:32.50 Taylor Kruse yeah Yeah. Yep.
00:08:37.50 Tony Fowler ah Nice man. Well we've got a pretty good episode queued up today. um You know a couple episodes back you mentioned this thing called the eight levels.
00:08:49.30 Taylor Kruse Right.
00:08:50.78 Tony Fowler And I'm just sort of um excited to get into it because in all of the hours of neuro that we've discussed on here we haven't really talked about that.
00:08:57.29 Taylor Kruse Yeah.
00:09:02.71 Tony Fowler And it seems like It seems kind of like the key ingredient to diagnosing someone's potential neuro issues right?
00:09:15.41 Taylor Kruse right
00:09:16.98 Tony Fowler um So yeah I thought we would do a full episode on the eight levels and just have you walk us through that process kind of at a high level. And then you know I'll pepper you with questions when i see something that I think we could drill down on.
00:09:31.13 Taylor Kruse Nice.
00:09:33.69 Taylor Kruse Yeah yeah it sounds great. So yeah this is this is big for you know the health and movement professionals and certainly our students who are going to listen to this because the eight levels
00:09:45.30 Taylor Kruse is the framework that our entire curriculum is based around.
00:09:50.81 Tony Fowler Mm-hmm.
00:09:51.13 Taylor Kruse um It is literally the anatomy that supports all of the basic lessons that we teach. So for example one of the things I teach at fundamental level like in our free master class is this idea that the nervous system does three things.
00:10:09.27 Taylor Kruse It takes in information from the outside world. It then decides what the information means. And this is sort of the processing part. And then decides what it's going to do with that information. And then the third part there is the um the actual outcome of that which is the output.
00:10:27.80 Taylor Kruse So there's input decision-making output. And this is the loop that we're always talking about that's very fundamental in terms of the human nervous system. Like this is what... the human nervous system is designed to do. Take in the information from the outside world figure out what it means what to do with it and then create an output. And you know the outputs can be so many different things. We're usually talking about those outputs as movement right or pain right because those are the two things that come up the most in terms of people's goals right is is improving their quality of movement and decreasing the pain that they experience. But there's lots of other things that kind of fall under the umbrella of output. You could put almost anything in there.
00:11:11.42 Taylor Kruse It could be more specific qualities of movement whether it's stability or balance. It could also be things like blood pressure. It could even be things like anxiety or depression. So there's lots of possibilities there.
00:11:26.81 Taylor Kruse But you've got this basic lesson that we're constantly teaching this input-decision-making-output loop. And the eight levels... is literally the anatomy that supports that right?
00:11:39.21 Tony Fowler Thank you.
00:11:40.30 Taylor Kruse Because it's much more complex than input decision-making output. So this is something that we're bringing up a lot you know to our our students especially in our advanced course because the eight levels is...
00:11:57.03 Taylor Kruse essentially a thinking model. And I want to make sure people know like I did not create it. Like it's not this is neuroanatomy. And to be honest in sort of doing some research on where it originally came from there's it's a little blurry at the moment as far as like who gets credit for designing this idea. Because I think it originated as the seven levels.
00:12:23.58 Tony Fowler Mm-hmm.
00:12:24.06 Taylor Kruse And people have sort of taken it and created their own interpretation of it. And the interpretation that I was exposed to was from early on in my Z Health education. And Dr. Cobb who is the creator of Z Health had taken it kind of put his spin or interpretation on it and it kind of evolved into what is the eight levels. And so that's kind of where my experience in education comes is the eight levels. And I think that this idea of the eight levels has pretty strong roots just coming from the functional neurology world which is essentially where applied neurology happens under this name functional neurology at more of a clinical level right? This is literally a a doctorate kind of program that you could that you could pursue if you wanted to go that direction. So we get a lot of our inspiration ideas and ideas
00:13:22.01 Taylor Kruse you know and tool sets coming from the research that's happening in functional neurology. So we've got this eight levels that informs everything that we do. And it essentially is showing us where things can go right and where things can go wrong in the human nervous system.
00:13:42.30 Taylor Kruse And we can essentially use it as a thinking model or a filter to try to figure out What is the highest priority areas to target with any given concern be it you know for us a movement problem or a pain issue?
00:14:02.90 Tony Fowler Mm-hmm.
00:14:04.10 Taylor Kruse There's going to be eight levels to every movement problem. there's going to be eight levels to every pain problem. And that's why this is so interesting is because we typically look at least the industry typically looks at a pain issue very in a very isolated nature right? Your knee hurts must be a mechanical problem with the knee.
00:14:29.84 Taylor Kruse That's basically as far as anyone goes. Like when you look at everything and sure there's plenty of people out there and different methodologies that go further than that. But realistically as a whole when you look at the whole industry if your knee hurts you're going to get told that you have a mechanical problem with your knee.
00:14:48.47 Taylor Kruse And Knowing that movement comes from the brain and knowing that pain is a construct of the brain we have to know how to think deeper.
00:14:59.96 Taylor Kruse And the eight levels allows us to do that. So here are the eight levels okay? And we'll kind of break it down a little bit more from here. But this all begins at what would be considered the receptor level.
00:15:14.58 Taylor Kruse So if literally if you were writing down these eight levels on a piece of paper the first one would be receptor. And receptor just kind of give like really brief overview of of each of the levels. But with receptors you can think about what's happening we'll we'll I think we'll keep it at the skin level to keep it to keep it simple.
00:15:35.45 Tony Fowler Mm-hmm.
00:15:37.29 Taylor Kruse There's other receptors. mean you could you could call the eyes receptors right? You could call the vestibular system receptors and and they are right? They have receptors but to keep it kind of simple we're gonna think about what's happening at the receptor level as what is happening at the level of the tissue.
00:15:54.68 Taylor Kruse So think about the skin right? um And we can think about tendons and ligaments and nerve fibers that live deep within the joint capsules.
00:16:06.39 Taylor Kruse But receptors are nerve endings okay? That's what they are. They're nerve endings. And we need to be able to test the function the health and function of those nerve endings.
00:16:18.42 Taylor Kruse Because that is one of the primary ways that you're sensing the world right? right the external world. It's also a primary way that you're understanding what's happening mechanically as you move like the proprioception.
00:16:33.85 Taylor Kruse Those nerve endings become sensitized by different kinds of mechanical force as you move be it nerve endings at the skin level the connective tissues joints ligaments tendons okay?
00:16:51.68 Taylor Kruse So that's receptor.
00:16:52.37 Tony Fowler It's like touch or movement you know?
00:16:54.01 Taylor Kruse Yeah yeah.
00:16:54.78 Tony Fowler Yeah.
00:16:55.46 Taylor Kruse And it can be it's different types of touch right? And that's why we have tools to test these different receptor types.
00:17:02.34 Tony Fowler Right.
00:17:02.67 Taylor Kruse So we just did an episode on the neurology of touch. Right? And we talked pretty in a pretty detailed way about assessing the skin and assessing these receptors and how we have to do that in different ways because there are different types of receptors that sense different sensations. There's also different spinal tracks in which that specific information travels along.
00:17:29.18 Taylor Kruse So we we need to know the differences so that we can test the different receptors which essentially is also partly a way to be testing those spinal tracks.
00:17:39.35 Taylor Kruse So that's like when we talked about the difference between testing warm and cool sensations and crude touch and even uncomfortable things like the pinprick test that we discussed where you're kind of stabbing somebody's skin and creating a little bit of discomfort.
00:17:39.46 Tony Fowler Right.
00:17:59.26 Taylor Kruse We talked about those sensations. We also talked about like light touch and two-point discrimination and even vibration. So the reason we have those categories of testing is because we're looking at different receptors and we're also testing the different spinal tracks.
00:18:14.26 Taylor Kruse So that's receptor level. The next level up would be a peripheral nerve. okay So all that information that's coming in from the tissues via those nerve fibers has to have a way to travel.
00:18:31.90 Taylor Kruse And that's where our peripheral nerves come into play. So we need to be able to test the receptor test the peripheral nerves and as you go deeper into peripheral nerves you learn which nerves supply which muscles and which nerves supply which parts of the skin And we sometimes we will have ah both sensory and motor nerves.
00:18:57.37 Taylor Kruse So that means a peripheral nerve supplies both muscles so for movement and then also a certain portion of the skin for sensation.
00:19:09.37 Taylor Kruse Some nerves are motor only. Some nerves are sensory only. only And then we have the combination. Yeah.
00:19:17.40 Tony Fowler So with peripheral nerves ah just kind of as like a working definition these wouldn't be spinal nerves. These would be like smaller nerves that are outside like in the limbs or in the fingers or in the.
00:19:28.92 Taylor Kruse Yeah i think think in the limbs. Yeah and and I guess they're not they're not even small right?
00:19:30.94 Tony Fowler Yeah. Okay.
00:19:33.65 Taylor Kruse Because think about think about like the sciatic nerve. right So the sciatic nerve and then its branches right because it'll branch off as you get further away from the midline.
00:19:38.43 Tony Fowler Hmm.
00:19:46.49 Taylor Kruse okay That's pretty big nerve. So yeah just think think um in the periphery in the limbs is is where our yeah kind of where we're zooming in will me when we say peripheral nerve.
00:19:54.33 Tony Fowler Got it.
00:20:00.06 Taylor Kruse and yeah And so we have tools for
00:20:00.15 Tony Fowler got it
00:20:03.86 Taylor Kruse Assessing peripheral nerves right? And in some of those sensory tools that we already discussed are part of the assessment for a peripheral nerve. For example if I do a sensory test on the bottom of somebody's foot and I compare sensation on the right foot versus the left foot like okay client can you feel this versus this?
00:20:26.13 Taylor Kruse And then they tell me hmm you know what?
00:20:26.32 Tony Fowler Mm-hmm. Mm-hmm.
00:20:28.15 Taylor Kruse On the left bottom side of my foot It felt a little dull. It didn't feel the same as when you swiped the brush on my um my right foot.
00:20:38.87 Taylor Kruse And so that's a ah sensory test that is telling you that they have decreased sensation on the left side. Technically that could be happening because there is a peripheral nerve issue.
00:20:51.61 Taylor Kruse So it's you could be thinking about it through just receptors but then you can advance your thinking by going what's the next level up? ah I wonder if they're having a problem with a peripheral nerve.
00:21:02.23 Taylor Kruse And then you think about well where am I finding the sensory deficit? And if you look at a little map that you can Google up on peripheral nerve distributions
00:21:13.27 Taylor Kruse both motor ones and sensory ones you can see nice color-coded graphics that show you that the bottom portion of the foot the sole of the foot would be supplied by the tibial branch of the sciatic nerve.
00:21:27.48 Taylor Kruse So in knowing that you're running a sensory test on the bottom of the foot that might make you think about the tibial nerve. So if there's a a nerve issue peripheral nerve issue perhaps that sensory problem is a reflection of that.
00:21:43.09 Taylor Kruse right So that's one one idea you know behind the thinking with peripheral nerves. Of course we can have other issues going on with peripheral nerves like um actual and entrapment of the nerve itself right where maybe nerves are not...
00:21:57.77 Tony Fowler Mm-hmm.
00:22:00.70 Taylor Kruse gliding appropriately through underlying tissues or there's been an injury of some kind at some point and there's restriction at the level of the nerve or maybe it's just a perceived thing right? Maybe it's literally just perceived by the brain that that there is some kind of issue going on with the nerve.
00:22:22.46 Taylor Kruse So all the more reason to know how to test each of the peripheral nerves that we can target because that gives us again a lot of information because those are like little highways little roadways back to the spinal cord.
00:22:32.34 Tony Fowler Yeah.
00:22:38.23 Tony Fowler So I imagine this conversation will come there. This question will sort of come up at every jump in the levels. But let's say like someone has ah some sort of pain or issue at the bottom of their foot.
00:22:52.59 Taylor Kruse Yep.
00:22:54.78 Tony Fowler How would you know that it's peripheral that there might be a peripheral issue versus a receptor issue at the bottom of the foot?
00:23:04.31 Taylor Kruse Sure. You would go by history and you would go by testing. And that's typically how we approach everything.
00:23:07.63 Tony Fowler Yeah.
00:23:09.19 Taylor Kruse So let's say the person actually has had an injury you know that has affected the bottom of their foot.
00:23:13.34 Tony Fowler Mm-hmm.
00:23:15.89 Taylor Kruse That certainly would give us some insight into why they might have receptor issue there. um Maybe they've had a long-term pain in that area from like plantar fasciitis.
00:23:29.75 Tony Fowler Mm-hmm.
00:23:30.14 Taylor Kruse and perhaps that area has become very nociceptively active because they've been in chronic pain for three years four years five years right? And and maybe that nociception is needs some assistance in terms of kind of being turned down if you will.
00:23:48.66 Taylor Kruse So people will tell you things in their history that will help you fast track what might be going on in terms of the eight levels. They'll give you kind of keywords which is why we're we talk a lot of history in our courses because you have to know how to hear those things and then kind of translate them.
00:24:06.97 Taylor Kruse Because you know the client client uses their own words and you you kind of have to translate a little bit. But yeah so it's always going to be history and testing. And so that might history will always prompt your testing.
00:24:19.61 Taylor Kruse So somebody might tell you those things and you go you know what I should probably test the bottom of your foot. And then maybe you start figuring out more nuanced things about those receptors. Like well it it appears that they don't have any sensory issues with two-point discrimination and light touch but...
00:24:40.66 Taylor Kruse I am seeing that they're having a little bit of a challenging time with this pinprick test. And that information is again coming back to those like specific sensations that tell you information about specific specific sensory pathways.
00:25:00.25 Taylor Kruse Now you're starting to get more clues as to what pathway actually has the existing issue from a sensory perspective yeah.
00:25:07.61 Tony Fowler Mm-hmm. And from a high level you're kind of never sure until you run a battery of tests like this right?
00:25:17.14 Taylor Kruse Yeah in and let me say this. This is important. I'm never sure ever. Like ever okay?
00:25:23.77 Tony Fowler Yeah.
00:25:23.97 Taylor Kruse So um it's it's fun to so tell people you're sure. You know like I could tell people I'm sure but but the truth is I'm i'm never sure.
00:25:29.28 Tony Fowler Mm-hmm.
00:25:34.30 Taylor Kruse i'm Everything that we do at this level is based on function. we We look at we listen to a person's history and we run tests and then we see what the outcome of that is. and And that's really all we can do right? Because I don't have technology that goes deep enough you know for me to understand what's really happening structurally in a person's brain.
00:25:57.46 Taylor Kruse I don't know what's happening long-term as we even provide training what's happening structurally. I'm okay with that. i don't I don't need to know basically. But I but i need to be...
00:26:11.54 Taylor Kruse accurate enough with my interpretation of history and assessments to make the right training decisions and then get people doing the right stuff. And and it's always there their functional outcomes right? And their experience and how they're moving through the world and how they're feeling that to me really is the ultimate right? It's like okay um this is this is really the goal right?
00:26:37.02 Taylor Kruse So we've covered receptor we've covered peripheral nerve and now the next one is spinal cord. So we said that whatever happens at the level of the tissue be it a sensation that's happening on the skin or some sort of proprioceptive activity that you know our our brain's getting information from
00:27:00.76 Taylor Kruse mechanically what's happening in a joint as we move. That information sensitizes these nerve fibers. Then that information travels a peripheral nerve and kind of the first checkpoint on its way to the brain or I should say yeah it's a checkpoint right? It's the spinal cord.
00:27:19.48 Taylor Kruse because all those peripheral nerves originate from different levels of the spinal cord. So this is an important one because we want all sensory input that's coming in from the outside world to get to the right places in the time that it has to.
00:27:41.37 Taylor Kruse And we don't want any interruptions along the way.
00:27:43.99 Tony Fowler Mm-hmm.
00:27:44.02 Taylor Kruse right We want a smooth transfer of information. So once information sensory input arrives at the spinal cord it begins to ascend the spinal cord on its way to the brain.
00:28:00.66 Taylor Kruse And this is where we have to look at the spinal cord itself Now peripheral nerve testing will give us some information about the spinal cord because we can look at specific peripheral nerves and we can understand where they originate.
00:28:19.16 Taylor Kruse And so perhaps somebody tells us something about their history like I've had a disc herniation which is pretty common to hear from people. whatever spinal cord injury you know people might talk about or maybe I've just had back pain for on and off for a long time.
00:28:38.46 Taylor Kruse And when someone gives you that kind of a history finding you have to be thinking about the spinal cord because think about it as like a kink in the hose right?
00:28:50.49 Taylor Kruse We can't have a kink in the hose. So just a spinal cord mobility problem could actually interfere with incoming sensory input.
00:29:02.01 Taylor Kruse And a lot of people have a history of spinal cord issues or just in general mobility problems of the spinal cord. So this actually builds a case for why just general practice of spinal cord mobility is actually a really healthy thing.
00:29:18.07 Taylor Kruse um You know the the fitness industry is catching on right to needing a mobile spine. They don't talk about it in this way. They talk about it as well you got to be able to move your spine because the spine is designed to articulate right in a very you know sophisticated way we might say.
00:29:40.34 Taylor Kruse Well to bring it you know several steps further because of those nerves originating in the spinal cord and there's other nerves there too like you mentioned spinal cord um or spinal nerves right?
00:29:55.96 Taylor Kruse Everything in the middle of the body right? I mean different...
00:30:01.24 Tony Fowler All your organs and all that.
00:30:02.42 Taylor Kruse Your organs different areas of the trunk and the thorax right? I mean the middle of the body is where all the important stuff is right? And and that's important from a survival perspective.
00:30:14.84 Taylor Kruse When the spinal cord doesn't move well it's not a good thing. It's also very telling that what lives beneath it might not be as healthy as it could be because you can actually have organ issues right?
00:30:29.17 Taylor Kruse long-term that develop or at least express themselves as tight muscles. We have reflexes or reflexive responses from when an organ is in some distress that the muscles that surround that area and the connective tissues can also express that distress which might ah lead to mobility issues in the midline of the body.
00:30:53.66 Taylor Kruse Well
00:30:53.72 Tony Fowler This is what you called like a referral pain referral or.
00:30:56.98 Taylor Kruse Well yes. So there's there's pain referral. um And then there's also these kind of visceral type reflexes that along the same lines that as a pain referral impact just mobility alone.
00:30:59.72 Tony Fowler hmm.
00:31:11.32 Taylor Kruse Whether it's got to the point of being more nociceptive where you feel pain that's one thing. People are at least familiar with the idea that You know one of the signs of somebody that's having a heart attack is ah it's left side I believe left side pain of the radiating down the arm right? That's what we mean with viscerally viscerally referred pain. And there are viscerally referred areas all along the midline of the body.
00:31:43.67 Taylor Kruse And actually it even extends out of the midline. And and there's there's many philosophies on this. and Lots of connections but the ones that we primarily think about are the midline ones.
00:31:54.90 Tony Fowler Mm-hmm. Mm-hmm. Mm-hmm.
00:31:55.54 Taylor Kruse So sort of a different topic altogether but this idea that being able to move the middle of your body and when we look at the joints that exist there it's the spinal cord and the ribcage need to be able to move. I mean how about your spinal cord and its mobility and your ribcage and its mobility just for breathing?
00:32:17.50 Taylor Kruse If you can't move if your ribs don't move well because of longstanding mobility issues of the spinal cord or just trunk that's gonna present some problems right? if If your breathing is impacted and you can't breathe optimally. and So back to kind of this idea that ah all sensory input coming in from the periphery is gonna arrive at the spinal cord begin to send up it on its way to the brain.
00:32:46.62 Taylor Kruse We want to make sure the spinal cord's healthy from a mobility standpoint for sure. We also have spinal cord reflexes or what are referred to as deep tendon reflexes.
00:32:58.67 Taylor Kruse We've talked a little bit about that. In past episodes that's when you you know you're a kid and you're at the doctor's office you're your leg's on the table the doctor bonks your knee with a reflex hammer and your leg jumps off the table by itself.
00:33:13.21 Taylor Kruse Those reflexes we have them all over the body with different muscles at these tendinous junctions where if you tap those tendon areas there will be a reflexive response to the muscle. and And that reflex is very much involving the spinal cord.
00:33:30.71 Taylor Kruse it kind of works on an arc like a big loop from you know that tendon all the way back to the spinal cord. And if the reflex doesn't work or it is dysfunctional in a way that it is moving too much right? You can have a reflex that is too responsive. one that's non-responsive.
00:33:54.29 Taylor Kruse You kind of want to strike a balance in the middle where the reflex works. But then after the limb moves You know there might be a swing or two of the limb but then it calms down.
00:34:05.62 Taylor Kruse And when those reflexes are not working appropriately it is technically telling us that there may be some integrity issues of the spinal cord.
00:34:15.56 Tony Fowler Mm-hmm.
00:34:15.67 Taylor Kruse So for example if if you have a relatively serious spinal cord injury and you go... to the doctor and you end up working with a neurologist or something they will likely test your tendon reflexes to see do they still work the way that they're supposed to?
00:34:34.46 Taylor Kruse um And that is because those reflexes are so involved with the spinal cord. So you could have old disc injuries that have impacted your tendon reflexes and perhaps they don't work you know anymore. And I've seen that quite a bit actually.
00:34:53.88 Taylor Kruse So moving on now as we get closer to the brain that sensory input is traveling towards the brain and now we have the cerebellum.
00:35:05.37 Taylor Kruse So we did ah recent episode. What the heck was the name of it? Something about complex movement.
00:35:12.44 Tony Fowler Yeah complex movement training and the cerebellum.
00:35:14.36 Taylor Kruse Yeah.
00:35:17.66 Taylor Kruse Yeah. And we talked about... this little brain that lives underneath the big brain and how one of its major roles is to help us with more complex types of movement tasks. Pretty interesting brain area. We spend a great deal of time talking about it and training it in our courses.
00:35:41.27 Taylor Kruse There's different kind of subdivisions in our eight levels of actually all of this stuff. The cerebellum
00:35:47.41 Tony Fowler Of course yeah.
00:35:49.30 Taylor Kruse cerebellum can be broken up into the spinal cerebellum the cerebro cerebellum and the vestibulocerebellum. um And those names have a lot to do with where certain anatomical areas are when we dive a little bit deeper.
00:36:09.88 Taylor Kruse Like for example vestibulocerebellum what does that tell you? Well it tells you that the vestibular system and the cerebellum are essentially cross-talking a lot.
00:36:22.51 Tony Fowler Mm-hmm. Mm-hmm.
00:36:22.73 Taylor Kruse right? And that the cerebellum is actually very much involved in similar qualities that the vestibular system helps us with like balance right? so um but but for our purposes you know be thinking about coordination be thinking about accuracy of movement be thinking about balance right?
00:36:48.44 Taylor Kruse And um You know when we test that we test the cerebellum we have a whole cerebellar flow of assessments that are kind of rhythm-based coordination assessments like tapping your hand really fast or kind of doing a piano playing motion with your fingers to you know as quickly as you can.
00:37:13.27 Taylor Kruse or tapping your foot or what we call hip pendulums which is like a a rapid internal-external rotation of the hip. We have other assessments that kind of bring us a little bit closer to the midline of the cerebellum where we're testing more balance such as a Romberg style assessment where you might set up your client in a narrow stance feet together and then have them close their eyes.
00:37:40.63 Taylor Kruse Or you set them up in a tandem stance which is one foot in front of the other as if you're standing on a line and then you have them close their eyes. The idea being can you balance there for 20 to 30 seconds without any visual input?
00:37:53.78 Taylor Kruse and what's happening posturally with sway. Our listeners can try that. if you If you get into a tandem stance like you're standing on a line without cheating and rotating your feet out like a duck you want them to be pointed forwards
00:38:09.11 Taylor Kruse you just stand upright relax your arms take a deep breath and then kind of close your eyes and time yourself. you know Can you maintain your balance? And as a coach watching this happen we'd be looking for different signs of postural sway like swaying to the right or swaying to the left maybe circular sway.
00:38:30.87 Taylor Kruse you know They all tell us things about what might be happening with the cerebellum. So
00:38:36.19 Tony Fowler Mm-hmm.
00:38:37.82 Taylor Kruse Very very important structure to consider for accuracy balance and coordination.
00:38:45.94 Taylor Kruse Moving up from there we are at the brainstem. We've talked quite a bit about the brainstem in past episodes. The brainstem is where all the reflexive stuff happens. It's kind of a very primitive subcortical right subcortical region.
00:39:06.23 Taylor Kruse We talk about the pontomedullary reticular formation. Okay that's that's what we mean here. And this one is a huge target for us as movement coaches because this is where reflexive stabilization comes from.
00:39:21.59 Taylor Kruse This is where autonomics come from. You can think about blood pressure even has a great deal to do with what's happening at the level of the brainstem. it's It's a big one. And for example if you if you have a right ankle that seems to be chronically unstable because you've sprained it 10 times in the past you've developed this kind of stability problem.
00:39:50.58 Taylor Kruse Well like we said mechanically like the the fitness industry wants to say well maybe you need a stronger ankle. and you've done all the strength work done all the mobility work but your ankle still feels wobbly and not supporting you when you go hiking kind of jumping up this eight levels as we would kind of be looking at all these things we might arrive at the brainstem and go oh yeah you know what?
00:40:06.25 Tony Fowler Mm-hmm.
00:40:15.00 Taylor Kruse This is starting to look and sound like a reflexive stabilization problem. So perhaps we need to work at the level of the brainstem to work on that right ankle stability.
00:40:27.34 Taylor Kruse Posture comes in here too. Brainstem is is very much involved in global posture and muscle tone. So any posture issue whether it's bilateral or unilateral we'd be thinking about the brainstem for sure.
00:40:41.86 Taylor Kruse Mm-hmm.
00:40:43.29 Tony Fowler So a question about um anatomy. Thus far we've been kind of working from the outside and in and up into the brain. So you know from like the skin tissue level to the peripheral nerve into the spine up the spine into the brain.
00:40:56.01 Taylor Kruse Mm-hmm.
00:40:59.29 Tony Fowler um This is where my anatomy gets really fuzzy right? is Is the brainstem is the cerebellum between the spine and the brainstem?
00:41:10.39 Taylor Kruse The cerebellum is so if you kind of think about that stereotypical image of the brain where you have the large cortex on top right?
00:41:17.73 Tony Fowler Mm-hmm.
00:41:23.48 Taylor Kruse that is That's where the lobes are right? And we'll get to the lobes. Underneath that is another little brain.
00:41:33.94 Taylor Kruse it almost resembles the same shape as the large cortex but it's more compact and a little bit more it's a little rounder right?
00:41:37.27 Tony Fowler Mm-hmm.
00:41:44.13 Tony Fowler Mm-hmm.
00:41:44.79 Taylor Kruse That's the cerebellum. And if you were to move just it's it's kind of Across and down from there you have the brain stem.
00:41:55.32 Tony Fowler Mm-hmm. Mm-hmm.
00:41:56.79 Taylor Kruse All right all these structures are relatively close to each other but literally the stem like the stem on a flower right? You can think about like the flower portion of the flower portion is like the cortex and literally the stem that is beneath that in in this anatomy it's it's the same right?
00:42:19.93 Taylor Kruse That's literally the brain stem.
00:42:22.42 Tony Fowler So that's sort of what I'm what i'm wondering is um in my mind the brainstem would come first in the order here if we're working our way in and up.
00:42:33.59 Tony Fowler I always sort of imagine the brainstem sort of like attaching to the top of the spine almost as it comes up.
00:42:33.69 Taylor Kruse Yeah.
00:42:37.50 Taylor Kruse Sure sure.
00:42:38.55 Tony Fowler So I'm just curious what what the thought process is on the order from here on out now that we're in the brain um or does it it actually matter?
00:42:44.57 Taylor Kruse Yeah.
00:42:49.05 Taylor Kruse Yeah. Yeah. i As far as that order goes yeah I don't have anything special to go. This is exactly why that that order is decided with this.
00:42:57.91 Tony Fowler okay
00:43:02.20 Taylor Kruse I mean there's going to be Yeah it's it's it's hard to say. I mean ah so a lot all of our movement the pathways that exist for movement um a lot of them have to do with the brainstem as well.
00:43:18.04 Taylor Kruse So...
00:43:18.20 Tony Fowler Right.
00:43:20.12 Taylor Kruse Yeah it's tricky because there's information going both directions right? It's not only information going to the brain right? So we've got like ascending information but then we've got exiting information too
00:43:35.29 Tony Fowler okay
00:43:35.67 Taylor Kruse right So it's kind of a two-way street. yeah but so So there's going to be you know stuff traveling in both directions in regard to the cerebellum and the brainstem.
00:43:47.96 Taylor Kruse But yeah again I don't i don't have like a perfect like a good explanation of being like oh this is exactly why.
00:43:50.50 Tony Fowler Yeah I was just curious if yep yep.
00:43:55.00 Taylor Kruse So brainstem think subcortical think reflexive. And then we we are now at the thalamus again subcortical. so And this is an interesting one.
00:44:06.63 Taylor Kruse this is The thalamus is an area where so much so much information goes here. It's actually difficult to talk about it in some kind of isolated way because it's it does so much.
00:44:20.22 Taylor Kruse But you know for the sake of our learning and the way that
00:44:20.34 Tony Fowler Sure.
00:44:24.79 Taylor Kruse or the our ability to to work with it in some ways you know I'm gonna describe it in a pretty simplistic way compared to what it actually does but you can you can think about the thalamus as a switchboard operator between what is sometimes referred to as the old brain and the new brain.
00:44:42.78 Taylor Kruse So old brain being like subcortical new brain being the big cortex okay? People have different different names for that.
00:44:53.11 Taylor Kruse First brain second brain i think I've heard it as...
00:44:57.70 Tony Fowler Your lizard brain I've heard.
00:44:58.69 Taylor Kruse Lizard brain and then lizard brain and what is the one to represent like executive functions?
00:44:59.51 Tony Fowler yeah
00:45:06.18 Taylor Kruse Lizard brain and it's on the tip of my tongue. I'm not sure but you get the idea right? So the lizard brain being like the subcortical stuff. So the the thalamus acts as a switchboard operator between these two areas subcortical and then what is cortical?
00:45:25.34 Taylor Kruse And switchboard operator meaning a lot of sensory input goes here and then the thalamus is involved in the process of deciding how much of that sensory input is able to pass on to the cortex because not all of it needs to right? So there has to be some kind of filtering mechanism or switchboard operator to figure out what's important to allow to pass versus what is not and this is where the conversation around pain becomes pretty interesting because nociception is essentially it's coming from the periphery or you know the tissues and it's not it's not a it's not pain at that point right? We don't have pain pathways.
00:46:18.04 Taylor Kruse So what we have are pathways or nociceptive input that essentially is input that has been tagged with this idea that it could be dangerous.
00:46:31.10 Taylor Kruse right So the thalamus is involved in tagging it as potentially dangerous stimuli and then we'll be involved in the process of saying all right I'm gonna let this through i'm gonna let it go on to the cortex or it doesn't really seem as that important.
00:46:48.24 Taylor Kruse I'm going to squash it here so not as much moves on or and or none moves on to the cortex. And this is a big deal with pain because anything that moves on to the cortex then has more weight I guess you might say in terms of it becoming a pain experience.
00:47:09.37 Taylor Kruse And so much is involved in pain right? And the cortex will be heavily involved in kind constructing a pain experience and Gosh so much. Your beliefs you know cultural factors upbringing ah memory what happened last time um your kind of predictions of what might happen in the future. i mean it's it's endless. There's so many things right?
00:47:40.50 Taylor Kruse So imagine if all nociceptive input made it to the brain because we're experiencing nociception all the time. constantly actually if all of it made it to the brain that would not be good right?
00:47:55.81 Taylor Kruse we We need the important things to make it to the brain but we also have to have a good filter for it that kind of helps us understand what is appropriate
00:48:00.74 Tony Fowler Mm-hmm.
00:48:08.47 Taylor Kruse right What is appropriate to have to allow through to potentially create a pain experience versus what isn't? And so this this gets into some really interesting topics like thalamic conditioning which is kind of a fancy way to say that anything that we do that is difficult that has some level of discomfort that is associated with it
00:48:33.24 Taylor Kruse is thalamic conditioning. So if you whatever you've learned in your lifetime that caused pain maybe you're an endurance athlete and you you push yourself to that red line it's technically painful right?
00:48:46.91 Tony Fowler Mm-hmm.
00:48:47.13 Taylor Kruse If you've ever done something in your cardiovascular fitness is challenged as much as it can be like that is also kind of a form of pain. right Not pain like ow I hit my my big toe with a hammer but it's uncomfortable.
00:49:02.74 Taylor Kruse and And so is a lot of of you know things that come from sports. like We talked about jujitsu at the beginning of this. episode jujitsu has a lot of nociception involved with it.
00:49:15.61 Taylor Kruse I mean people are people are creating enormous amounts of pressure on your on your abdomen on your chest. there They're torquing your joints. They're putting you in different submissions. There's pain that that comes with that.
00:49:30.74 Taylor Kruse And you could run so many types of sports through the filter and kind of be like yeah this one has a lot of nociception.
00:49:35.45 Tony Fowler Mm-hmm.
00:49:38.10 Taylor Kruse um and And the point being is that your ability to deal with that and filter it at an appropriate level involves the thalamus right? And your experiences leading up to that have a lot to do with it. Like if you try one of those sports for the first time and it causes you a lot of discomfort you are more likely to quit if you don't have practice experiencing that discomfort.
00:50:05.79 Taylor Kruse It's like if you've ever jumped in a cold plunge or something.
00:50:09.78 Tony Fowler Yeah I was thinking about that.
00:50:10.30 Taylor Kruse right There's people who are practiced at that and there's people who are not practiced at that. And if you're not practiced at that you're likely going to quit sooner than somebody who is practiced because they have trained their thalamus to understand that What's okay right? What's actually dangerous versus somebody who doesn't have that that ability to filter it and understand it all yet but they could with thalamic conditioning which means do more of the thing that causes the discomfort and you will adapt to it right? So there's a lot though with the thalamus. So um lots of so pain's a big one there.
00:50:51.67 Taylor Kruse um Just overall sensory inputs typically like in a... when we look at history with the thalamus we we might we might associate several different kinds of sensory deficits at this happening.
00:51:10.49 Taylor Kruse um Like let's say someone's leg you test someone's leg and they're showing you very large areas where there is both a dorsal column and a spinothalamic sensory loss.
00:51:24.47 Taylor Kruse right That means you found issues in both of the tracts that we assess. and And it's contralateral meaning opposite side of the body. That may be a history finding for the thalamus. A lot of sensory input will go to the thalamus.
00:51:40.02 Taylor Kruse It even involves motor control. um And an interesting one is like navigation challenges is something we think about with the thalamus ah at least from a training perspective because there's some level of like right left discrimination.
00:51:55.35 Tony Fowler Interesting.
00:51:55.54 Taylor Kruse that the thalamus is involved in and you'll find that in the cortex too in certain areas. But yeah so knowing your left knowing your right and um navigation challenges because you have to essentially solve what in my mind is like a movement problem when you're navigating something. So think like an obstacle course.
00:52:19.29 Tony Fowler Mm-hmm.
00:52:19.96 Taylor Kruse you have to You have to have good right-left discrimination in order to create motor plans and understand them to navigate something that is challenging.
00:52:30.55 Taylor Kruse okay So that kind of fits in there. So does overall coordination. We call it bone rhythm. So being able to for example squat without any coordination issues happening. We want the ankle the knee and the hip to share the load and help one another out with good quality coordination.
00:52:51.74 Taylor Kruse And if there happens to be multiple large areas of the body that have some kind of sensory loss happening which again might be that thalamic history finding then something like squatting with good bone rhythm is going to be very very difficult.
00:53:07.03 Taylor Kruse Because with without the ability to sense then we have what is simplified as a blurry map.
00:53:07.28 Tony Fowler Mm-hmm.
00:53:15.61 Taylor Kruse right it's ah it's um It's a mapping problem. So interesting things to think about there. um People who have had concussions the thalamus is a I think it's hard for I don't know if going use the right words but it is susceptible I guess.
00:53:31.64 Taylor Kruse to some some problems post-concussion. Yeah so chronic pain. Okay this is probably the most important one for our listeners.
00:53:45.24 Taylor Kruse any Anyone who has been in chronic pain for a long period of time and you can no longer associate it with tissue damage right? there is no history of tissue trauma and you just have chronic pain. i mean we see that all the time. Back pain.
00:54:01.85 Tony Fowler Mm-hmm.
00:54:02.17 Taylor Kruse Do know people out there have back pain with no back injury? Probably back pain is probably gosh maybe back and neck right?
00:54:13.37 Taylor Kruse Most of the time when people come to me and they describe back pain neck pain and we start getting into it they don't have an injury mechanism for that. They're like yeah it just developed.
00:54:25.53 Taylor Kruse right And so that's chronic pain right pain you've had for a long time. Well thinking about what I had mentioned with the thalamus as being a switchboard operator you actually can get better at experiencing chronic pain.
00:54:42.33 Taylor Kruse And that's problematic. It's a survival mechanism I guess you might say. So A lot of times people who have been in carotic pain for a long time have essentially become better at it and their thalamus is kind of call it sensitized in a way where that nociception that should be getting squashed or turned down is not.
00:55:12.86 Taylor Kruse And instead all the pain signaling or I shouldn't even call it that all the nociception is continuing on through. And these people also are very sensitive with pain issues. Like they do some stuff for a pain problem and maybe it feels better but then they have an experience whether they're conscious of it or not because a lot of sensory input is unconscious.
00:55:37.45 Taylor Kruse And the overwhelming amount of sensory input that arrives at the thalamus triggers it to go back to that hypersensitized state. And so now you've you've done something that actually helped you but then you are kind of reset to being oversensitized again and your pain comes back because maybe you've been dealing with thalamic issues for a ah long time.
00:56:00.25 Taylor Kruse So your thalamus has become better at essentially letting pain through which is not good right? So that's a big one and that's why The number one like the first line tool for helping somebody with chronic pain is educating them about what chronic pain is and where it actually comes from.
00:56:22.94 Taylor Kruse This will always be the best tool. And almost nobody in this world who's in chronic pain knows what pain is. Think about that. They don't know.
00:56:35.29 Taylor Kruse Do you know how frightening that is? right That's why most people associate chronic pain with internal damage of some kind. And that's not how it works.
00:56:46.84 Taylor Kruse You can't just because you're in chronic pain it does not mean you have problems. It doesn't mean you have it doesn't mean you're broken. It doesn't mean you've got anatomy that's um broken. doesn't mean you have trauma.
00:57:02.62 Taylor Kruse And that's that's why it's important to learn about what what it is where it comes from because that alone is actually thalamic training.
00:57:12.25 Tony Fowler Yeah.
00:57:12.76 Taylor Kruse you just were educated about what pain is and where it comes from. And that can help kind of inhibit some of those responses that we talked about which is why we're always encouraging our students to get comfortable with the pain education conversation right?
00:57:35.58 Taylor Kruse Because almost no one goes to physical therapy and learns what pain is. and And when a doctor presents you with their opinion or an um MRI right? And every you're there because something hurts.
00:57:52.02 Taylor Kruse Nobody tells you what pain is and where it comes from. And nobody tells you that you could experience pain and not actually have damage. And you know it's a different it's it's a rabbit hole of a conversation in itself but the problem with that is it it changes your thinking right?
00:58:09.14 Taylor Kruse it changes your thinking to kind of more catastrophizing the issue. Like I must have that pain because I must have that problem. And sometimes that's not the case.
00:58:23.45 Taylor Kruse So
00:58:24.79 Tony Fowler And that added stress and anxiety may also raise your threat levels globally and and create that pain or reinforce that pain.
00:58:28.06 Taylor Kruse yes 100%. hundred percent
00:58:34.20 Taylor Kruse right And the pain experience involves so many other things.
00:58:38.10 Tony Fowler Right.
00:58:38.14 Taylor Kruse right So that that elevated level of stress certainly can help you be in pain longer.
00:58:45.12 Tony Fowler Yeah. So we're at level six I believe. um
00:58:49.27 Taylor Kruse Yeah so we move... Yep so six seven... Yeah exactly. So...
00:58:52.57 Tony Fowler Yeah and and just real quick a ah question.
00:58:55.10 Taylor Kruse Yeah.
00:58:55.76 Tony Fowler um you know With the the thalamus being the switchboard operator right and it's letting ah you know nociception through or not
00:59:02.26 Taylor Kruse Mm-hmm.
00:59:07.32 Tony Fowler um you might have something going on with the peripheral nerve. You might have an entrapment or something and also have a thalamic issue.
00:59:14.19 Taylor Kruse Yep.
00:59:21.37 Taylor Kruse Exactly.
00:59:21.94 Tony Fowler that is either caused by it or reinforcing it. So at any point in these levels like it's it's not necessarily you might find a test that says oh well this points to the thalamus but it might not be definitive in that way.
00:59:36.98 Taylor Kruse It might not be definitive.
00:59:37.51 Tony Fowler And vice versa you might find something that says oh i think I think I've got something going on with this peripheral nerve but that doesn't rule out that you also have a thalamic issue. Hmm.
00:59:46.17 Taylor Kruse ah Exactly almost nobody has one problem. right So so that's that's a good thing to bring up. And maybe after we go through these levels because we're almost there now we could run something through a filter to kind of help people understand that like ah like a pain issue.
01:00:04.18 Taylor Kruse right
01:00:04.29 Tony Fowler Fun fun I love that.
01:00:05.08 Taylor Kruse yeah Yeah so next one here is the insula. So we have an entire podcast episode technically on the insula
01:00:14.20 Tony Fowler Look at us we've done so much.
01:00:15.51 Taylor Kruse Yeah yeah it's good. um the The insula is the home of interoception okay? And this this idea of interoception is actually getting popular now. There's been you know there's ah there's a movement happening for sure. People are are getting involved with learning about interoception which is basically your sense for your internal body right is a way to describe it. um Your body goes through a lot of functions.
01:00:48.39 Taylor Kruse Your interpretation of what they mean requires you to have accurate interoception. So for example if your stomach growls you know your stomach growled because you've learned that and you have that interoceptive sense that helps you understand what it is and what does it mean okay? If you really concentrate really hard and maybe you interlock your fingers
01:01:15.86 Taylor Kruse and you close your eyes and you just kind of body scan most people they have reasonably good interoception can pick up on their pulse.
01:01:27.35 Taylor Kruse right It's actually a neat little exercise to do and you can do it with different body areas. So I could say okay interlock your fingers relax breathe focus your attention on your hands. Can you feel your pulse through your fingers?
01:01:42.87 Taylor Kruse And then maybe we could bring our attention to a different body part and you'd be amazed.
01:01:46.24 Tony Fowler Mm-hmm.
01:01:46.72 Taylor Kruse You can get a point to a point where as a person's interoception starts to increase in the moment from bringing more bringing more awareness to their internal body as you go through this people are like oh my gosh I can feel my heartbeat in my face right? And and that's not something you're aware of when you're not focusing on it.
01:02:10.01 Taylor Kruse Right? Breathing is the same. We are not aware of our breathing when we're just going about our daily tasks. At least we don't want to be.
01:02:21.03 Tony Fowler Mm-hmm.
01:02:21.18 Taylor Kruse Some people are because their introception has become sensitized to the point where they're focusing a lot on their internal body. This is very distracting for people.
01:02:33.29 Taylor Kruse It's not fun when you are over aware of your own heartbeat. we see that people become over-aware of certain areas in the midline of the body from usually long-standing insular issues. So if you're over-aware of your breathing some people are over-aware of their core function.
01:02:52.63 Taylor Kruse Some people are over-aware of like their pelvic floor function. um but But on the the other side of that coin is like a hypo-awareness like people having zero map for their core.
01:03:05.62 Taylor Kruse zero map for their scapula zero map for their pelvic floor function right? Zero map for their breathing kind of goes both ways.
01:03:16.47 Taylor Kruse But again the the point being interoception has to do with basically the middle of the body the internal you know aspects of it. You could carry the conversation into organ function because One of the cranial nerves that we talk a lot about in regard to interoception is the vagus nerve which we have an episode on.
01:03:38.14 Taylor Kruse um And the vagus nerve is the is the nerve that is sending all of this interoceptive input to the insula which I should say and don't think I mentioned yet is a part of the cortex.
01:03:56.09 Taylor Kruse And if you think about the stereotypical image of the brain you can't actually see the insular cortex because it is inside of... that structure. So if you were to kind of peel back the temporal lobe and look at what's underneath it you would then see the insular lobe right? So um kind of has not gotten the attention it deserves over the years because it's been hidden and and now is known as the the fifth lobe. And people are talking a lot more about it now because it is so important for for interoception.
01:04:33.27 Tony Fowler I think it's so interesting that the The part of the brain that is nested inside of itself is the part of the brain that is focused on understanding the sensations inside of your body.
01:04:45.62 Taylor Kruse Totally.
01:04:46.32 Tony Fowler It's just really interesting how that worked. Yeah.
01:04:48.09 Taylor Kruse the The actual like yeah the way the anatomy like where the anatomy lands in terms of its location and then what it does it's always there's so many so many interesting connections to that that.
01:04:55.13 Tony Fowler Yeah.
01:04:58.87 Taylor Kruse The really interesting part about the insula I mean there's so many interesting things that it does but the insular cortex essentially will it's a home of you know
01:05:11.09 Taylor Kruse It's like an information hub really. there's There's visual input going there there's auditory input there's tactile sensory input going there and even vestibular input goes there.
01:05:13.16 Tony Fowler Mm-hmm.
01:05:24.57 Taylor Kruse And it's so it's ah it's like an integration hub and one of its primary roles is to tag things with emotional content value.
01:05:38.71 Taylor Kruse Right so when you are being touched what does this mean on an emotional level? um It also is involved in like emotional and physical groundedness.
01:05:50.52 Taylor Kruse So literally your stability but also your emotional stability. Lots of interesting things.
01:05:57.46 Tony Fowler Yeah that is super interesting.
01:05:58.90 Taylor Kruse Yeah yeah.
01:05:59.02 Tony Fowler Yeah.
01:05:59.90 Taylor Kruse it's So there's a very high emotional um part you know content with any you know any of the insular stuff. And it's it's ah it's a fascinating one.
01:06:14.07 Taylor Kruse um especially if It's especially fascinating to train all the vagus nerve stuff that people are getting into all the breathing stuff even even understanding like sense of self better.
01:06:28.63 Taylor Kruse ah asking yourself how do I feel after a meal right? Like really dialing into your own internal sense to kind of ask yourself how do I feel right now? Some people are good at telling you how they feel. Some people are not good at it right?
01:06:44.60 Taylor Kruse it's it's the It's the insula that's very much involved in in distinguishing your emotions. So moving on now to the other lobes right? We're kind of at the...
01:06:58.65 Taylor Kruse At the top this is the eighth level but it's divided up right? Because there are four other lobes that haven't been discussed that just fall under the umbrella of the lobes. So we've got the occipital lobe which is thought of as the home for visual processing even though that's not entirely true because there are so many brain areas that are involved in visual processing but the occipital lobe is highlighted for that.
01:07:25.78 Taylor Kruse Then there's the parietal lobe. which is usually highlighted as an area where sensory processing occurs and is involved in spatial awareness and orientation.
01:07:39.16 Taylor Kruse So knowing where you are in space. For example one of the history findings for the parietal lobe is do you bump into things a lot?
01:07:48.07 Tony Fowler Mm-hmm.
01:07:48.63 Taylor Kruse my wife is that person. She's like how did I how did i get these this like she has a bruise forget on what side but like she'll have bruise on her hip
01:07:51.37 Tony Fowler Yep.
01:07:59.64 Taylor Kruse like all the time just like comes and goes. She's like I guess I bumped into stuff again. And that's a finding for the parietal lobe. So it's like spatial orientation. We then have the temporal lobe which again we we zoom in we we say okay it does this but it it does so much.
01:08:19.78 Taylor Kruse But the temporal lobe is known for like memory and sound processing like the auditory cortex is in the the temporal lobe.
01:08:32.54 Taylor Kruse And the frontal lobe is next. The frontal lobe's one we talk about all the time because it is where voluntary movement is initiated from and it is where your executive functions live.
01:08:44.73 Taylor Kruse right So attention and planning all that stuff coming from the frontal lobe. So yeah occipital parietal temporal frontal is kind of at the top there.
01:08:57.11 Taylor Kruse And that is the entire eight levels. so Let me just kind of list them out. So we started with receptor. We then went peripheral nerve then spinal cord then cerebellum then the brainstem the thalamus
01:09:14.04 Taylor Kruse So we're still subcortical and now we're about to make the jump to the cortex the insular cortex followed by the lobes occipital parietal temporal and frontal.
01:09:18.03 Tony Fowler Mm-hmm.
01:09:25.46 Taylor Kruse And so every goal that you have whether it's getting out of pain improving quality of movement or you are running a diagnosis that you have of a pain issue or something
01:09:41.34 Taylor Kruse Whatever your goal is you can run it through this filter and the eight levels becomes a thinking model that you can use to address the problem because you might have different levels involved in the issue kind of like what you were getting at Tony where people can have more than one problem right?
01:10:00.73 Tony Fowler Mm-hmm.
01:10:01.70 Taylor Kruse And and that's that's important to know. You can have a preexisting thing that is now kind of colliding with something else. and And now what appears to be maybe one issue might not be right? Because there's going to be other factors from in terms of brain function being affected by other things.
01:10:27.06 Taylor Kruse So let's let's give people an idea kind of running something through a filter here.
01:10:33.05 Tony Fowler Yeah. I'm curious what your example problem might be.
01:10:38.04 Taylor Kruse Yeah so ah let's let's just go like sciatica. People ask me about sciatica all the time. I think it's a good one because it's goingnna be it's going to have the first five or so at at least four levels of the eight levels are usually the easiest for people to understand at first because they can kind of visualize it better especially if our listeners don't yet have experience like with some of these other neuro tools.
01:10:42.56 Tony Fowler Okay.
01:10:53.92 Tony Fowler Mm-hmm.
01:11:04.82 Taylor Kruse at least receptor peripheral nerve spinal cord makes a lot of sense if you're still sort of thinking mechanically but then we got to make the jump to thinking more neurologically right with global function as we start to get into the cerebellum the brainstem the thalamus and the lobes.
01:11:11.32 Tony Fowler Yeah.
01:11:18.82 Taylor Kruse But you can imagine this. So let's say the client has sciatica and they're complaining of left side you know symptoms radiating discomfort down the all the way down to the calves or even the bottom surface of the foot you know if we're calling that sciatica.
01:11:41.62 Taylor Kruse We would run that through the eight levels filter and immediately go okay you got to ask yourself questions right? So think about that first receptor category. You could ask yourself is there a problem with sensation?
01:11:57.81 Taylor Kruse That's the first question you would ask yourself with somebody who has sciatica.
01:12:02.01 Tony Fowler Right. Mm-hmm.
01:12:03.03 Taylor Kruse And you only know the answer to that by talking to them and asking them questions and then by following up with sensory testing. Otherwise you don't know the answer to that.
01:12:13.72 Taylor Kruse So you might say to the person hey do you have sensation issues? And they might go well I don't know. What would that feel like? Do you have any hypersensitivity on that side of your body? Well there they might say well yeah my pain.
01:12:28.34 Taylor Kruse OK well that is technically a sensation issue. Do you have any sensation issues like when you put your sock on? They're like no not that I notice.
01:12:39.00 Taylor Kruse Well you still have to test. So that's when you run your sensory tests. Now if you if you're thinking about well where do I run the test? This person is telling me they have pain from their glutes all the way down to their their foot.
01:12:54.01 Taylor Kruse Well you might then use your eight levels model again and hmm well let me start with the foot with sensory testing particularly the bottom of the foot.
01:13:05.91 Taylor Kruse because I'm starting to think about the sciatic nerve and the tibial branch based on where they're having their symptoms.
01:13:11.61 Tony Fowler Right.
01:13:15.26 Taylor Kruse So you do sensory testing on different areas associated with the tibial nerve so different skin areas which would be the bottom surface of the foot also the heel and some of the gastroc.
01:13:29.46 Taylor Kruse And so you might do your sensory test and you might go oh that's weird. They or actually that's not weird. You might go that's exactly what I expected.
01:13:35.61 Tony Fowler Yeah.
01:13:38.01 Tony Fowler yeah
01:13:38.07 Taylor Kruse They actually have a problem sensing vibration let's say on their left calf and their left heel compared to the right. And so in your notes you're writing down sensory loss dorsal column sensation vibration.
01:13:55.38 Taylor Kruse And that's important to know because that's a sensory problem. Now there are now consequences to having a sensory problem. And those consequences are the next seven levels.
01:14:06.65 Taylor Kruse Because think about information traveling the levels eventually arriving at the cortex.
01:14:08.80 Tony Fowler Right. Yeah.
01:14:13.46 Taylor Kruse So is it a receptor problem primarily? We don't really know. So we still have to consider the next seven levels. So then in your thinking you might go okay
01:14:26.42 Taylor Kruse I found an area where they have a known sensory deficit but I still have to think about the peripheral nerve because they're telling me they have sciatic-like symptoms.
01:14:38.26 Taylor Kruse So I'm thinking that tibial branch I'm thinking you know the the trunk of the sciatic nerve. And maybe I took a history or I definitely took a history.
01:14:49.65 Taylor Kruse That's important. And in a conversation you learned that they actually do have a preexisting sacral injury from whenever.
01:15:00.92 Taylor Kruse And maybe they tell you what that is and you go oh okay. I definitely have to test the nerve because of where it originates. They've actually had a problem there.
01:15:12.20 Tony Fowler Mm-hmm.
01:15:12.85 Taylor Kruse We'll come back to that because as we continue up what's that? Well that's the spinal cord. Okay so tracing it back. I'm testing now the peripheral nerves that I might be concerned with. i've I've got lots of tools to do that. Sensation is one of them. Our neuromechanic exercises is another form.
01:15:31.06 Taylor Kruse So all the tensioning slacking sliding of nerves all right I've gotta figure out like is this nerve having difficulty moving right? You get the idea. Maybe there's an entrapment.
01:15:43.64 Taylor Kruse um Maybe it's just become kind of hypersensitized from the pain issue for so long but maybe actually I got to continue my thinking because maybe it's actually primarily a spinal cord issue right? And so we're climbing the ladder here. Is there any issues with the spinal cord? So I got the history that there is and now I'm going to test mobility.
01:16:06.87 Taylor Kruse Just starting out really simple. Can this person move their spine? Can they move their pelvis? what does What is their sacrum doing when they walk right? From a mobility perspective I've got to consider that. And I might also do some sensory testing in that area.
01:16:26.10 Taylor Kruse um you know as ah And I might even test deep tendon reflexes right? So now I'm back kind of working distally where I'm tapping a tendon hammer on their Achilles or their hamstrings.
01:16:39.72 Taylor Kruse Do their tendon reflexes work yes or no? right Those are all things running through my head when I arrive at the spinal cord level in our thinking.
01:16:47.21 Tony Fowler Mm-hmm.
01:16:49.75 Taylor Kruse And as we continue up right we get to the cerebellum. Well this person's been been in pain for a long time. They've had a history of a spinal cord issue. Do you think their coordination has been affected? Yeah because they've moved differently for a long period of time.
01:17:04.41 Taylor Kruse The consequence to moving differently or not as much at all could be that you now have a cerebellar deficit because you're not doing as much movement with that side and you're not doing as much complicated movement with that side you have what's called now an input problem if you know what i mean because you're moving less so maybe we find that using some of our cerebellar training through our joint mobilizations
01:17:28.55 Tony Fowler Mm-hmm.
01:17:36.12 Taylor Kruse which are complex nonlinear in nature meaning they're circular right? Those are great ways to train the cerebellum. Maybe we find that you need some of that work along the lower body um you know knee circles and ankle tilts and you know different mobility drills for the foot whatever it might be the hip the spine right? We might have to do pelvic tilt series and learn how to you know move those areas better.
01:18:03.80 Taylor Kruse and And all that could be you know You could think about it as not only just general proprioceptive work but cerebellar training. And continuing up with the brainstem there could be brainstem consequences to this input problem.
01:18:20.09 Taylor Kruse There could be stability issues. There could be muscle tone issues. I should have said that too for the cerebellum because the cerebellum is involved in muscle tone particularly like midline and proximal muscle to muscle tone particularly extensors.
01:18:25.84 Tony Fowler Mm-hmm. Mm-hmm. Mm-hmm.
01:18:35.86 Taylor Kruse So with like sciatica people are going to be telling you about their hamstrings and their gastrocs. And a lot of times people develop atrophy in those muscles and weakness. And again we might think cerebellum but we might also think the brainstem because of its role in stability and its role in muscle tone.
01:18:58.52 Taylor Kruse Moving up you know thinking about um the thalamus chronic pain for a long time right? Maybe an oversensitized issue.
01:19:09.37 Taylor Kruse Maybe this person has learned to live with sciatica for a long period of time right? and they've just gotten better at it. And they've actually reorganized their thinking around their pain issue.
01:19:20.06 Taylor Kruse People do this all the time right? They've been in pain for a long time and they start to believe they're fragile. You don't want to believe you're fragile because if you believe you're fragile you are. That's literally what it comes down to. So being in pain for a long time changes us psychologically and whatever story we tell ourselves is what we end up believing right? So that that thalamic conditioning piece where you need to learn about what pain is where does it come from right? That's really important.
01:19:52.60 Taylor Kruse And then through a training process right? you are essentially teaching the thalamus what is safe and what is not. that's That's kind of the training process there which is super important.
01:20:07.00 Taylor Kruse So perhaps we are adding different types of sensation to the mobility drills. Maybe it's even multiple sensations at once.
01:20:18.33 Taylor Kruse Sometimes we have to take a ah sensation that is perceived as very safe and stack it with one that is not. So someone has trouble moving their knee because they've been in pain for a long time.
01:20:30.33 Taylor Kruse We vibrate the knee but we also put a cold pack on it. Or we put a cold pack on the calf. We put vibration on the knee right? And we're using kind of dual sensations.
01:20:41.50 Taylor Kruse Sometimes this can be very effective for training that needs to happen at the thalamic level.
01:20:46.84 Tony Fowler interesting
01:20:46.87 Taylor Kruse And we're working on coordination of the movement itself. So it's it's yeah and we're educating them right? There's that thalamic piece. So yeah all that you know thinking like that with the thalamus and then um you know the main question there being like issues with long-term chronic pain. Does this person have a history right?
01:21:09.88 Taylor Kruse Moving up to the insula. So this is interesting. I mean like we talked about you can have other issues that are involved. I mean I could have given another issue example for all of these levels but the insula is a good one because like for example let's imagine that the same person who's experiencing sciatica is also telling you in a history that they've had longstanding gut issues.
01:21:37.82 Taylor Kruse whatever that might be digestive sensitivities difficulties just digesting certain foods certain foods make them sensitized or maybe they just know they have like a ah diagnosed like gut issue they're working on their gut health there's so many things there.
01:21:40.40 Tony Fowler Mm-hmm.
01:21:54.20 Taylor Kruse those types of internal threats will create internal threat right? And the insula. The insula could be involved now. um And remember the insula helps tag different sensory inputs with emotion.
01:22:13.97 Taylor Kruse And let's say you have some preexisting internal health issues like gut issues that can actually exacerbate other things.
01:22:25.11 Taylor Kruse And sciatica is actually a good example of that because of where the nerve roots come from at the level of the sacrum.
01:22:25.43 Tony Fowler Sure.
01:22:35.03 Taylor Kruse a lot of times you can have like gut sensitivities or gut inflammation that increases symptoms simply because of things living close to each other and sharing nociception and kind of similar to that conversation we had on like viscerally referred pain right?
01:22:57.58 Tony Fowler Mm-hmm.
01:22:58.44 Taylor Kruse So maybe there's a preexisting internal threat that's now actually kind of helping to exacerbate an issue and make it more chronic and keep it sticking around for longer.
01:23:11.35 Taylor Kruse So an example of that is you know can we can we work on the insula? Can we work on these gut issues by yes targeting the insula but also doing what we need to do for gut health?
01:23:23.64 Taylor Kruse And might we see sciatic symptoms decrease because of that? And that that's an and that's absolutely a possibility.
01:23:29.56 Tony Fowler Mm-hmm.
01:23:31.13 Taylor Kruse So yeah there's a lot of ways to kind of take it as far as how would the insular cortex be involved but that's one idea. And then as we go up into the remaining lobes I mean there's so many ways you could take this.
01:23:45.70 Taylor Kruse Let's say someone has a preexisting hearing problem okay? They've had hearing issue on one side their whole life. So we're talking about left-sided sciatica. Let's say that we found a lot of stability issues on that side of the body.
01:23:59.83 Taylor Kruse And then the person in history says yeah I actually don't have good hearing on my left side. And if you know your cranial nerves and you you know you're kind of thinking about your pathways you might immediately go oh interesting.
01:24:12.50 Taylor Kruse I should consider that because I know that if I can do some stuff to stimulate the cochlear nerve through sound stimulus or even vestibular stimulus on that side of the body I can affect muscle tone on that side of the body.
01:24:29.34 Taylor Kruse So that's an example of another pre-existing thing that could then be also kind of wrapped up in some of the tone issues that someone might be having on that side of the body. So yeah maybe we're now bringing in other aspects of training these systems to affect the one that we are most focused on.
01:24:49.72 Taylor Kruse That would also kind of bring our attention to like the temporal lobe because of the auditory processing component. man we could we could essentially affect muscle tone by working with those other lobes too.
01:25:05.54 Taylor Kruse I mean we go vision for the occipital lobe.
01:25:06.04 Tony Fowler Yeah vision drills or yeah.
01:25:09.40 Taylor Kruse We go other types of sensory um processing for the parietal lobe. um We've got We could go um just general movement but also working in cognitive loads for the for the frontal lobe.
01:25:29.27 Tony Fowler Mm-hmm.
01:25:29.74 Taylor Kruse There's so many things right? And this is just where it gets cool because it's like oh neurology really does show you holistic health. Right and it takes the woo-woo out of like well you have sciatica and you're pointing to the burning pain in your calf but we might actually do something with your eyes or your sound processing that could impact that.
01:25:56.85 Taylor Kruse Right which is wild but that's that's what applied neuro is. you're you're You're thinking about all systems and you're testing them to see like what is their influence on on this thing.
01:26:08.85 Taylor Kruse so Yeah there's so many other tools right that we didn't even talk about but it's it's a different conversation right because you've got this eight levels and then you've got these subcategories of each of the eight levels right?
01:26:22.05 Tony Fowler Right.
01:26:22.74 Taylor Kruse But then you've also got your toolbox and your toolbox can be divided up so that you understand your tools and where they fit in in terms of the eight levels and sometimes there's overlap you know like a vestibular drill right?
01:26:25.27 Tony Fowler Right.
01:26:36.85 Taylor Kruse right A vestibular drill is going to be stimulating for cranial nerve eight. Well as soon as we stimulate cranial nerve eight we're now talking about the brainstem because that's where it originates.
01:26:47.86 Taylor Kruse But a vestibular system also speaks a vestibular drill also speaks to the cerebellum.
01:26:53.56 Tony Fowler Mm-hmm.
01:26:54.26 Taylor Kruse right So we can affect the cerebellum through that. And so there's a lot of carryover right a lot of kind of crossover with the tools. And you know some of our tools are like maybe more targeted towards a specific area and others are kind of more broad.
01:27:12.30 Taylor Kruse It's really neat to think about it that way.
01:27:16.06 Tony Fowler Yeah it's really cool to hear this this framework. I feel like it's a almost a culmination of two years of podcasting. you know It's like we've talked so much about the tools and about specific brain areas or you know it's like we've done kind of a lot of the the more siloed aspects of it.
01:27:24.82 Taylor Kruse Yeah.
01:27:39.51 Taylor Kruse Right.
01:27:39.77 Tony Fowler And so that this to me is so powerful because it's It's how do we apply all of that knowledge in a systematic way so that when you encounter a problem you're not lost and you're not just throwing stuff at the wall which couldve you know you can get there that way too right?
01:27:48.34 Taylor Kruse That's it.
01:27:57.88 Taylor Kruse Yeah.
01:27:57.98 Tony Fowler But this this will speed you up because now you're thinking you know from from n to out from out to n you know what are the different things that could be affecting the sciatic problem?
01:28:02.49 Taylor Kruse Yep.
01:28:09.66 Taylor Kruse Yeah this is this is also a really good thinking model to have when you run into challenges like just tricky clients where you've you've done some good stuff but you you feel like you're falling short.
01:28:21.14 Taylor Kruse Many times I've just had to take a step back from thinking about what I'm doing with a client and and really literally write down the eight levels and sort of just start jotting down some history things that kind of go with each of the levels and then ask myself those questions like okay have i have I worked enough with peripheral nerves? Have I really evaluated their spinal cord thoroughly? Have I evaluated these receptors thoroughly? Am I missing a body area? Am I missing certain sensations? Because you can't do it all at once. You never can. If you tested a client and did everything we know how to do you would never actually get to training.
01:28:57.22 Tony Fowler Right.
01:28:57.46 Taylor Kruse Because there's so many things and you have to be careful of that early on when you're learning this stuff because the tendency is to want to do all the sophisticated stuff.
01:28:57.72 Tony Fowler Mm-hmm.
01:29:06.78 Taylor Kruse I always tell people because this comes up a lot in our community. They're like man there's so many options. What do I do? And I'm like yes there are. And you know that's okay always revert back to movement.
01:29:18.62 Taylor Kruse like Always go back to movement as a starting point because you can get so much done with that. And then as you you know begin to kind of pick your levels that you're going to assess you can only do so much at once.
01:29:32.05 Tony Fowler Yeah. Mm-hmm.
01:29:32.50 Taylor Kruse So you might decide like with a client in a session you're going to do some sensory testing on their feet right? And you're going to also look at some neuromechanics for peripheral nerves. And that's all you have time for in that moment. And that's that's where it begins. And then you kind of see where that takes you and how they're assessing. And then that might then prompt you to think about other levels as you as you work through it.
01:29:58.10 Tony Fowler Yeah this also seems to me like a great framework to revisit when considering stacking.
01:30:04.89 Taylor Kruse Big time.
01:30:05.02 Tony Fowler um you know when When we've talked about stacking before it always seems kind of like oh we've got we've got a clue that points to this and a clue that points to that.
01:30:13.62 Taylor Kruse Yes.
01:30:14.39 Tony Fowler Well now you can take these eight levels and say okay well I have a clue that points to one thing. Let me look at the other levels and see if there's something else that might coincide.
01:30:21.91 Taylor Kruse Exactly. Exactly.
01:30:25.27 Tony Fowler And and you can you can you know try to design a stack based on that. That's really cool.
01:30:30.10 Taylor Kruse i I find myself doing that a lot actually. That's a good thought. And I also use it sometimes again trying to be more time efficient because you can't do it all. I sometimes will think about what drills have given me the best results with somebody and I will use that to lead me into the eight levels. Like sometimes I'm i'm doing this stuff and then I have to take a step back and I go well what have I actually done? And I start kind of jotting it down and I'm like wow I've actually done a lot of work in the frontal lobe.
01:31:04.98 Taylor Kruse And they continue.
01:31:05.55 Tony Fowler Didn't even think about it that way though.
01:31:06.22 Taylor Kruse yeah they Yeah I didn't think about it that way.
01:31:07.15 Tony Fowler Yeah.
01:31:08.90 Taylor Kruse And I have like all this stuff listed that kind of falls into the frontal lobe category of training. And I might say to myself man they they assess so well to frontal lobe stimulus.
01:31:19.51 Taylor Kruse and And that's important for me to know so I can give myself permission to keep going with that. I can also use it for improving underperforming so systems.
01:31:30.71 Taylor Kruse So once I kind of know what they're already good at and what they're well maybe it's what they're already good at but it's also what are they assessing really well with? I can lean on that.
01:31:42.17 Taylor Kruse And then maybe I find other areas where they're more challenged and they seem to have more issues. And I'm building a stack like you said I can take what's good and I can stack it with what's bad.
01:31:55.26 Taylor Kruse and And that is a really good tactic for you know re-education for the brain and the nervous system and reducing threat while you deliver what is technically a threatening stimulus and teach somebody how to deal with it better.
01:32:12.25 Taylor Kruse So it's it's it's cool like how many different directions you can come from with the eight levels.
01:32:22.84 Tony Fowler Yeah. um I feel like this is the kind of episode i would want to listen to more than once.
01:32:29.66 Taylor Kruse Yeah and I think well I know some of our students will listen to it multiple times. I'm kind of excited to see what they think of it because we don't really get a chance to break it down like this right?
01:32:34.57 Tony Fowler Yeah.
01:32:41.09 Taylor Kruse For an hour and a half on the eight levels. It it sort of comes up in little chunks within our conversations within our curriculum.
01:32:44.52 Tony Fowler Mm-hmm.
01:32:47.70 Tony Fowler Mm-hmm.
01:32:49.34 Taylor Kruse So this is going to be good.
01:32:51.86 Tony Fowler Yeah yeah amazing. Any final thoughts on the eight levels maybe and on applying the eight levels yourself perhaps?
01:33:04.06 Taylor Kruse just to you know let people know that you know there's a lot as you've heard and experienced there's a lot more to any issue than just a mechanical the mechanical nature of it.
01:33:17.82 Taylor Kruse this This model or think this thinking model does not throw biomechanics out.
01:33:22.72 Tony Fowler Great.
01:33:22.73 Taylor Kruse We'll never throw that out but instead it makes biomechanics neuro biomechanics. And so if you're a ah health and movement professional that is really interested in building your skillset and really understanding holistic health and how everything sort of fits together
01:33:40.50 Taylor Kruse This is a great model to do it. This is the best model that I have found. And it it continues to help me advance past that just typical you know stereotypical thinking about ah about a pain issue just being mechanical and Yeah it allows you to really flow through the different levels and and understand your tool set better.
01:34:02.46 Taylor Kruse Because I feel like there's a lot of practitioners out there that do great work and they still don't even understand the mechanisms of why the things that they're doing that do work why they're actually working.
01:34:14.39 Tony Fowler Mm-hmm.
01:34:14.65 Taylor Kruse Because you you have to understand the eight levels to be able to run the techniques through those filters. and And then once you do that it it helps you do even greater things with the tool sets that you have.
01:34:28.15 Taylor Kruse right And um then of course if you want to even build a tool set out and understand more of the neuro tools that that we're teaching then you can just get involved in our courses. which I should mention um at this point people should know that we we do not have at least I should I'm saying this with 90% certainty anyway we don't have any public enrollments happening for the rest of this year for 2026. And what that means public is that
01:34:55.46 Taylor Kruse You're not going to see me on Instagram or YouTube or something saying hey by the way we have an enrollment coming and you can get involved in it.
01:35:01.20 Tony Fowler Mm-hmm. Mm-hmm.
01:35:01.79 Taylor Kruse But we will we will have private enrollment. And if you are interested in getting involved in our courses we will be running private enrollments. But it is critical that you guys get on our email list so that you can know about those private enrollments when they happen.
01:35:20.41 Taylor Kruse So if you are in fact interested make sure that you get on the email list and ah you can actually go to our website or visit the link you know in the in the show notes to put yourself on the wait list for the courses. And then in doing that you will get emails when we do an enrollment. And we are considering the idea of actually doing a private email list only enrollment in May.
01:35:43.70 Taylor Kruse So keep that in your back pocket if you're excited to get involved.
01:35:49.12 Tony Fowler Awesome.
01:35:50.51 Taylor Kruse All right. Well that's it for today. I hope you guys enjoyed this episode. This has been one we've been talking about for a bit or we knew we had to do it and well here it is and i like it. I'm glad. i like where it went and we'll be able to talk more about the eight levels in the future and now that our listeners will kind of have this under their belt I think it's going to help you understand some of the previous episodes that we've done.
01:36:15.35 Taylor Kruse and at least think about them in a different way. Maybe maybe even go back and listen to some of them and and experience them in ah in a little bit different way using this framework or model.
01:36:27.10 Taylor Kruse Thanks everybody for listening. We will be back soon.
