Pain, Your Brain & Whole-Athlete Physiotherapy —with Erwin Seguia of Match Fit Performance - EP132

When you feel pain, your brain is trying to tell you something. And a good physiotherapist can help you interpret that message. But pain doesn’t always mean tissue damage, and an elite physio will look at biomechanics as well as any external factors that might impact your pain experience or the recovery process.

Erwin Seguia serves as the Cofounder and CEO of Match Fit Performance, a sports performance, rehabilitation and physical therapy practice based in New York City. He is a Board-Certified Physical Therapist, the Sports Director for the New York Empire, and the Secondary Physiotherapist for Gotham Knights Rugby. Erwin is passionate about soccer and enjoys CrossFit and Olympic weightlifting, and as a physio, he has experience with rugby, endurance sports, Ultimate Frisbee, soccer, golf, CrossFit, powerlifting and dance.

On this episode of Ali Fitness, Erwin joins us to discuss how Match Fit differs from traditional physical therapy, explaining why the team only uses manual therapy when absolutely necessary. He walks us through the concept of progressive load and describes the way physiotherapy should help athletes move MORE—without aggravating an injury. Listen in as Erwin busts common myths around muscle tightness, manual therapy, and glute activation—and learn about the major role our brain plays in the pain experience!

Topics Covered

[1:10] How Match Fit differs from traditional physical therapy

• Goes beyond biomechanical cause for complete picture
• Explore external factors that contribute to experience (i.e.: sleep, nutrition, stress)

[4:26] Why Erwin recommends seeing a physiotherapist first

• Capable of diagnosing musculoskeletal injuries
• Refer to MD, cardiologist, etc. when necessary
• Easily accessible through direct access in US

[7:29] Why match fit only uses manual therapy when absolutely necessary

• Damages client’s self-efficacy to depend on touch
• Use only to change pain experience, follow up with movement
• Literature suggests MUCH force necessary to deform tissue

[16:54] Erwin’s insight around the pain experience

• Pain = brain’s way of communicating with us
• Interpret message with specificity (e.g.: sharp, stabbing, burning, etc.)

[23:40] Erwin’s approach to reducing the threat in our brain

• Leverage manual therapy as intervention
• Similar movement in position feel less threatened
• Take through questioning process to determine external factors

[27:09] How Match Fit uses the concept of progressive load

• Bodies resilient, get stronger with gradual exposure to increased load
• Tissue adapts without being at risk or setting off pain alarm

[29:40] Erwin’s thoughts around athletes who push too hard too fast

• Ask body to push redline consistently (e.g.: CrossFit)
• Injury part of learning experience to understand limits

[31:24] Why a PT should partner with a physiotherapist

• Powerful duo when focus on mutual client
• Operate from abundance mindset

[35:13] Resisting physiotherapy because you don’t want to stop working out

• Goal to help client move more without aggravating injury
• Maintain conditioning, stay involved in sport-specific activities

[40:38] The myth around learning to ‘turn on your glutes’

• Term gluteal amnesia coined by Stuart McGill (linked to lower back pain)
• Use different semantics, e.g.: input in spine + hips vs. activate

[45:51] Erwin’s take on cyclists who drive force with glutes to avoid hip flexor pain

• Discuss volume of cycling and how often
• Address load management or hip flexor strength issue

[48:35] The myth around muscle tightness

• Input in closest joint usually alleviates tightness
• Usually indicates core stability or strength issue

[52:32] The myth around kinesiology tape and wrapping

• Ultimately won’t prevent tissue damage
• Placebo effect changes what brain feels

[55:02] Erwin’s top tip for Ali Fitness listeners

• Good training program worthless without adequate recovery

Learn More About Erwin Seguia

Match Fit Performance

MFPX on Instagram

MFPX on Twitter

MFPX on Facebook

MFPX on YouTube

Resources

Jill Cook’s Study on Tendinopathy + the Brain

Dr. Stuart McGill

RockTape Class Action Lawsuit