How To Test For The Undying Root Of Hip Flexor Tightness

Show Notes

In this episode, Dr. JJ dives into the often-overlooked but crucial topic of hip flexor tightness. She shares her expertise in identifying the root causes of persistent hip flexor issues, emphasizing the importance of a holistic approach to treatment. This episode is a must-watch for anyone seeking to understand and address their hip flexor tightness, offering practical tips and empowering knowledge for better health.

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What is The Dr. JJ Thomas Podcast?

Welcome to The Dr. JJ Thomas Podcast! Here I'll be talking all things physical therapy, raw and unplugged, giving you the unfiltered insights you've been searching for in your cash-based physical therapy business. If you're caught in the grind of the traditional model, swamped with paperwork, or feeling like you're not reaching your full potential as a physical therapist, this podcast was created just for you.

Dr. JJ Thomas: 00:00

I find when I teach that people often miss a piece of this test and that they just put this here and they just rank they just wrench that thing down. You really have to stabilize the opposite, As is before you let that knee come down. Because with all testing we know we have to standardize the test. If you don't standardize the test, then you don't really know if you're if you're making changes or not. Welcome to the doctor JJ Thomas podcast.

Dr. JJ Thomas: 00:31

Hey, everybody. Welcome to the doctor JJ Thomas podcast. I'm JJ Thomas. Happy to be here today. We have a special episode.

Dr. JJ Thomas: 00:39

My colleague and friend Jessica is here with me. She's gonna help me. We're gonna do a clinical episode that will help you clinicians. I'm always preaching like, if you want to get busy, get people better, get people better. So today's episode is going to give you some real clinical tools on addressing one particular area of dysfunction that we see often, is a hang up for therapists trying to get patients to break through pain and limitations.

Dr. JJ Thomas: 01:03

So today's episode is going to be for that patient that you have that is you constantly stretching the hip flexors, really limited in a hip flexor mobility, and you just can't seem to break through or make changes. So, we're going to talk about some clinical implications of number 1, why that can happen. Scenarios in that we often see clinically where that will happen. We're going to talk some Anatomy to help understand why that happens from, to begin with, and then we're going to talk some other theories that will help you understand how to break through that. So, we're going to get right into it with the anatomy.

Dr. JJ Thomas: 01:42

You're going to have access to this as well, but here's our body. What I want you to think about, think about the body anatomically and, and the importance of of all of the functions. Right? So we need we know that we in order to move efficiently, we need proper core stability patterns. Everyone's preaching that.

Dr. JJ Thomas: 02:00

Right? What does that actually mean? One of the things it means is that we have to have a strong foundation in the rib to pelvic area. We often find clinically that people who are chronically tight in their hip flexors are so because they're overusing, they're compensating using those hip flexors. And oftentimes, they're doing that because they don't have the strong foundational stability to anchor the pelvis to get that hip flexion off of.

Dr. JJ Thomas: 02:26

So, it's trying to compensate for a lack of motor control and stability usually in the midsection area that may be anterior, that may be posterior. So we're going to go through the anatomy first and then we're going to talk about, different, evaluation techniques that you can do to help highlight where you need to be, focusing your efforts on those patients. So it's important first that we consider the anatomy here, because structure meets function in our bodies. And as I said, a lot of times these hip flexor tightnesses, these chronic unrelenting hip flexor tightnesses are happening because they're not getting the foundational core stability that it needs from the proximal body either anterior, posterior, sometimes both. We're going to give you some tools to evaluate which ones, but first let's look at the anatomical players that we're talking about.

Dr. JJ Thomas: 03:11

Okay? So, here's the body and if we look at the abdominals here, external obliques are the first ones we're going to see. We know that by the nice, angle of the musculature. What I want to point out that not everyone appreciates is this muscle here, serratus anterior. Remember, serratus has these finger like attachments into the ribs and it's not a mistake, it's not by chance that these finger like attachments coincide with the attachments of the external obliques.

Dr. JJ Thomas: 03:38

So if I multi select here, you can see how they very seamlessly attach into each other. People often think of the importance of Serratus Anterior for shoulder stability. Am I wrong? I'm not wrong. Everyone thinks of shoulder of Serratus Anterior for shoulder stability, but they don't always think of its importance as it relates to abdominal stability, core muscle firing, core stability to stabilize the pelvis which with a stable pelvis, a hip will move cleanly on.

Dr. JJ Thomas: 04:05

Without a stable pelvis, that hip flexor is like Jesus, I'm trying so hard, I'm trying so hard. Can't do it. So, we have to take into consideration the importance of Serratus Anterior, from that aspect. Let's go a little deeper. I'm going to remove these muscles now, both of them, so we can see a little deeper.

Dr. JJ Thomas: 04:22

We all know about the importance of Rectus and how sometimes he can be he can be doing too much, but also, internal obliques and transversal abdominis. But I'm removing all of those temporarily so that we can highlight the iliopsoas because we all know that a lot of hip flexor tightness comes from iliopsoas. So I've highlighted here the iliacus and the psoas major, which together we know makes iliopsoas just to show that when we don't have the proper rib to pelvic connection in many of the patterns that we need movement wise, this hip flexor is going to try to drive that hip up. It's going to it's going to get overworked and it's going to get tired. So you can stretch that thing all you want, but if you don't fix the reason it got tight to begin with, you're going to keep stretching that thing and getting nowhere which is probably what's happening if if that's happening to you and your patients at this time.

Dr. JJ Thomas: 05:16

Some other quick things to just go over is remember I have to remove the fascia on this. Remember rectus femoris and how it attaches at the pelvis at the a I I s. So, it's also that muscle that's really important. We know that we check this when we do the Thomas test, and we're going to go through some little hints when we do Thomas testing, to give you other clues of like really which structures you might want to address. So those are the main players.

Dr. JJ Thomas: 05:42

One last anatomical thing is to remember that under the lats, under the traps, under all these muscles, under serratus posterior, these paraspinal muscles let me remove some more so we can see. Remember these paraspinal muscles, it's actually too much to show right now, but they go all the way from the sacrum up to the thoracic spine and they traverse, they scaffold all the way up to the head and neck. So if I were to keep climbing in that up there, we have, semispinalis, capitis, and servicis, and, longissimus. All of these muscles go basically scaffolding along each other from the tailbone to the head. That also becomes very important when we talk about core strategies for, for stability in the spine.

Dr. JJ Thomas: 06:27

If you don't have stability in the spine your hips are going to get overworked again and again and again. So, that's the anatomical viewpoint of that. Before we get into the special testing, I'm going to actually go one more step and talk to you about an ideal concept for efficient movement patterns. And what we often at Primal University, Primal Physical Therapy, what we like to consider when we're creating a, plan for our patients is an ideal or efficient movement pattern base. And what we can often refer to is the developmental sequencing of like when a child learns to move from 0 to 1 year of life, they have to go through distinct milestones.

Dr. JJ Thomas: 07:06

And so, our evaluation should consider that because we don't learn to walk by skipping steps, we can't really skip those steps. If you think about it, babies, they have their, they get head control, they get swallowing, and they get head control. And then we put them prone prop to get those spinal erectors that we talked about from the head all the way to the tailbone. We get them stable, and then only then do they start compressing using serratus anterior. And once they get compression and rib depression and approximation of the pelvis to the ribs, then they'll start to get hip mobility on top of that.

Dr. JJ Thomas: 07:39

That is my point. That's the pre crawl phase, the pre crawl phase, where as we learn to move developmentally, we first build our spinal erectors and our our posterior chain. Around the same time, soon after that, we build Serratus Anterior and Core Stabilizers Ventrally or Anteriorly, and then once we have that stable rib to pelvic connection, then we allow hip mobility on top of that. When we age and we start sitting in chairs more and we stop recruiting these patterns, that's when we lose them and that's when hip flexors get tired and cranky and start yelling at us and get tight. So, one of the first things we said that's important for efficient movement patterns, right, is that posterior chain, that that head control from the posterior chain aspect from head all the way to sacrum.

Dr. JJ Thomas: 08:27

And, if we don't have that then our pelvis is not going to be situated correctly to perform something like a squat. So, there's a test you can do to see how their posterior chain is affecting their ability to squat into their hips. So, for Jess, we're going to do this and I'm going to show you how to how to figure out if her posterior chain is involved in her, hip mobility or lack of mobility. So Jess, I'm going to have you stand with your feet hip width apart, just outside the hips actually. Great.

Dr. JJ Thomas: 08:52

Put your arms overhead and keep them straight. Good. Eyes forward. I want you to squat down as deep as you can with your feet flat and your chest upright. Good.

Dr. JJ Thomas: 09:00

Eyes forward. Awesome. So on Jess, we see that she loses some arm height here and her her torso drops a little bit. Could you face that way for me, Jess? And do the same thing so that the listeners can see.

Dr. JJ Thomas: 09:13

Great. See how our trunk comes forward. This is an SFMA test that I learned originally, and we're looking for the the tibia and the trunk angle to be the same. And and you see she loses that. So there's a potential that there may be a posterior chain deficit here.

Dr. JJ Thomas: 09:27

The way we're going to test it is I'm going to have you put your hands like this and I'm going to have you grab the band. Good. Arms straight, grab the whole band, yep, pull them back now. So I'm preemptively firing her posterior chain. Now, don't lean back pull back with those arms.

Dr. JJ Thomas: 09:42

Got it girl. Now, hold that tight while you squat, and eyes forward. Good job, and come back up. Let's do it this way so the listeners can see. Same thing, arms wide, pull back, and squat.

Dr. JJ Thomas: 09:59

She gets way further and her trunk is now in the same position parallel to her tibia which was ideal. So this is a classic example of how we can see that, if if we just looked at her squat without the band and then we tested her hip and it was tight, then we might have thought, okay, she has a hip flexor impingement issue, and we're going to stretch the heck out of it and target that, fine. That that'll help temporarily, but if we really wanna get her past that, we have to treat her posterior chain. And so that's a great test for that. So we're going to go through exercises at the end, but I'm going to show you a couple more tests because posterior chain is one aspect.

Dr. JJ Thomas: 10:38

There are also some other aspects that might be limiting her ability to hip flex or hip extend. And so we're going to go through those. So, that was the first test. The second test I like to do is just a basic hip, hip flexion passive range. Go ahead and lie on your back.

Dr. JJ Thomas: 10:56

So with this though, we're it's I say basic, but really it's basic with with purposeful intent. In that, we're going to check a very pure passive hip flexion, and I'm going to see how it feels. I'm going to see what that end feel is like just like we would with, go ahead and just relax, just like we would. And she is a little pinchy here. I feel it a little bit more on the adductors more than than, like, what, almost like a scour, but, she's definitely a little limited there.

Dr. JJ Thomas: 11:22

So just getting that impingy feeling, recognizing that if she has that impingement, phenomenon in here, she may be impinging from that rectus femoris attachment that goes to the IIS and basically pulls that pelvis forward and creates that impingement of the femur into the acetabulum. The rectus, I'm not sure if you guys are aware, but rectus femoris has fascial attachments into the hip capsule itself. So a lot of people with quote laborely symptoms or hip impingement symptoms, if you clear that Rectus Femoris with dry needling or other techniques, it'll often clear it it'll often clear it up. But don't stop there, if she has that, you've already identified the posterior chain deficit. If you don't treat that deficit, then she's gonna be in here incessantly, and that's not really what we wanna be doing.

Dr. JJ Thomas: 12:09

We wanna be able to giving give them the tools to to be better and not need us. So that's that. Also, recognize that if you do check that and they have this impingement type, symptom, the Faber test is also going to be an important one. I find when I teach that people often miss a piece of this test and that they just put this here and they just rank, they just wrench that thing down. You really have to stabilize the opposite ASIS before you let that knee come down.

Dr. JJ Thomas: 12:38

Because with all testing, we know we have to standardize the test. If you don't standardize the test, then you don't really know if you're if you're making changes or not. So in order to standardize the favor test, what you're gonna do is you're gonna take your palm your big surface area part of your palm, put it right on their ASIS firmly and deliberately with a straight arm, and then you're going to let this leg come down into favor. And as soon as you feel that hip wanting to come up on the opposite side, that's where you're gonna stop. So if you guys I'm gonna use this.

Dr. JJ Thomas: 13:10

I usually use that arm, but just so you guys can see, if I stabilize right there, that's all she has on this side. So this is my test retest. So we'll test retest, do a, do a an intervention and then test retest after. That's those 2. The last one I wanna show you guys is a a traditional Thomas test with a non traditional, flare.

Dr. JJ Thomas: 13:33

So for the Thomas test, we know that oftentimes we're doing I like to do this one supine personally, and we'll just do it off the side here. You normally, to be honest, I like to do it off the edge of the bed, but I'm not sure the camera view will get that. So we're just gonna do it right here. Just scoot over a little yeah. That's perfect.

Dr. JJ Thomas: 13:53

And then pull this knee all the way to your chest and lock it down. This is the number one piece that I that gets missed. You have to standardize how you have them lock this down. Some of my colleagues I know will say, well, I don't want her in a full posterior tilt. I want a neutral spine.

Dr. JJ Thomas: 14:07

And they'll like feel what they think is neutral and then they'll have them just hold it right there. That's fine. As long as your test retest is standardized, I'm fine with that. But it has to be at least a neutral spine or a posteriorly tilted spine to really see what's happening at the anterior hip. I tend to I tend to do a lot of things on the on the further end, so I like it in a posterior tilt because I really wanna highlight what's happening at that anterior hip.

Dr. JJ Thomas: 14:31

So Jess, you're gonna hold it just like that. I'm gonna get my stool, and then I'm gonna say hold this right here. And I'm gonna keep my hand there just to remind her that I want it there. And then we're gonna let this leg drop down and see what happens. And Jess has that classic.

Dr. JJ Thomas: 14:45

So what we're looking for here, the first thing you got that. The first thing we're looking at is how far does her hip drop down. So it doesn't get to 0. We want this at least to get to 0, meaning this would be 0. Right?

Dr. JJ Thomas: 14:57

Now the jeans might be limiting a little bit in her defense, but she's got some some significant hip tightness here. What I didn't show on the on the anatomy screen was the I'll come out of this a second for you, was the importance of the adductors in hip flexor impingement as well. Remember that adductors are also hip flexors, most of them, with the exception of abductor Magnus has a component that's a hip extender. But most of the adductors as are are strong hip flexors. So take that alongside the fact that many of us sit at work and we sit at home and we sit to eat and we sit and have coffee with our friends and we're sitting, sitting, sitting, and our hip flexors, including our adductors, are shortened.

Dr. JJ Thomas: 15:39

So now all of a sudden, we go to run on the soccer field or run on the lacrosse field or just run for life or, or reach up something in a cabinet where I'm extended, and our hip flexor is like, woah, Poppy. That is not right. I'm tight. I can't do that. So recognize that they're big players in the, in the the limitation of hip extension through the hip flexors as well.

Dr. JJ Thomas: 16:03

So let's go back to that position. We're gonna lock her down. Got it. Yes. Right there.

Dr. JJ Thomas: 16:08

So this was the first obvious the big rock as we say. This was the most obvious thing is this strong hip flexion pull. The other thing I like to mention here when I'm teaching is pay attention to what's happening at the distal at the knee. So, what you can do is you can actually use this position to tease out which muscles are limiting her the most. So this is a strong indication that iliopsoas potentially and and definitely the adductors here, which we also saw with Faber.

Dr. JJ Thomas: 16:37

So all these clinical checks are making sense and making a story that makes sense. But you can also look at how does the knee drop here. The her knee comes out, it kind of bows out a little bit. Like if I were to do this, see how it like there's some real tension here. That only, you know, the adductors don't attach at the knee.

Dr. JJ Thomas: 16:57

Well, other than gracilis, but gracilis isn't going to create that. But the rectus femoris does. So because this is past 90 degrees in it, I'm going to also suspect rectus femoris again. So our story is adding up again. Right?

Dr. JJ Thomas: 17:10

I felt the rectus femoris impingement, I felt the adductor impingement with hip flexion passive range. Those muscles did not like to shorten when I hip flexed her. Now, I'm checking here adductors don't like to lengthen and rectus femoris does not like does not like to lengthen as evidenced by this bowing phenomenon that's happening here. Now, the last thing I usually like to check during this Thomas test is how the TFL is doing. And honestly, Jess passes the TF TFL test clearly.

Dr. JJ Thomas: 17:39

So if they're tight in the TFL, they're going to have this, like, rotation moment here, where they're kind of bowing out into external rotation. So, just another thing to keep your eyes on when you're doing this test. Go ahead and sit up Jess. So, those are some of the clinical details that I like to bring when I'm teaching a large group. And so, I thought you know what we have this podcast avenue let's start getting you guys clinically on par with ways to really elevate your success with your patients.

Dr. JJ Thomas: 18:08

Those are the clinical tests. We're actually going to move to the mat now, and I'm going to show you how to integrate your findings with this, and with what we found with Jess into exercises that actually help move the needle for your patient's progress and get them past that hip flexor tightness. And beyond that to the point where they're actually stable and the hip flexors can have a break. They don't have to be compensating for the core stability patterns including the posterior chain anymore. Alright, welcome to the Primal Physical Therapy, Matt.

Dr. JJ Thomas: 18:35

We're going to go through some exercises to support the concepts that we just talked about in terms of getting your patient past that hip flexor tightness, through rebuilding stability patterns that are likely the the underlying culprit. So we talked already about the importance of that posterior chain, both for just overall core stability and especially stabilizing the pelvis to allow the hip to drive on. And so we saw that Jess, I'm gonna have you grab here. We saw this one already, but I'm gonna reiterate it. Widen your arms a little bit.

Dr. JJ Thomas: 19:05

I really like them to be like a y, arms are gonna be straight, pull it back. Patients will sometimes wanna lean. Don't let them lean, make them use the shoulder stabilizers and the posterior chain. So this isn't just stabilizing through, through low traps, but it's also creating spinal erector activation that preemptively is stabilizing the spine and pelvis so then she can squat down on it. And this is the exercise.

Dr. JJ Thomas: 19:29

Now, Jess has a tendency to look down, I would encourage them to look up. So, Jess, look at me while you do it. That a girl. That a girl. There it is.

Dr. JJ Thomas: 19:37

Now, why do I do that? Because the spinal erectors are linked to eye movement. Go back down again. So if she's looking down, she's not engaging those spinal erectors all the way up to her suboccipital region. So the small details matter.

Dr. JJ Thomas: 19:50

I preach it all the time. I promise you I'm not blowing smoke. It really matters and when you start to utilize every little cue like that, like, letting their eyes integrate to where their head is moving, it'll make the big difference in in your practice. So that's the first one. That's that posterior chain activation one.

Dr. JJ Thomas: 20:06

And just to reiterate, I started with that one because of developmental sequencing. Those 0 to 1 year of life milestones are really important for rebuilding foundational stability. And so, that posterior chain head control is one of those first milestones that we have to meet in order to move efficiently. And so, oftentimes we'll check that. Now, we're going to get on the ground.

Dr. JJ Thomas: 20:28

I'm going to show you one of my other favorite, exercises for core stability. Jess, I'll have you lie like right here, face down. Perfect. That's great. That's great.

Dr. JJ Thomas: 20:38

Yeah. She knows this one because we use it all the time. So this is, I we call this 3 months posture because essentially we're simulating 3 months posture. Jess is in sort of like a like a sphinxish pose right now. What I'm gonna do is I'm gonna help cue her to use her serratus anterior muscle to get that rib to pelvic connection that we've talked about previously and we talk about frequently.

Dr. JJ Thomas: 21:01

So I have her arms more in a plane of scapula position here because it's just a little bit more functional. We're trying to remember, we're trying to rebuild and restore those developmental patterns, like I said. So we're in the plane of scapula. I usually cue them to look between your thumbs. That's going to have her gaze, have her neck in slight flexion there, and from there we're going to push the floor away is the cue.

Dr. JJ Thomas: 21:24

Good. And then relax again. I want her I'm gonna move your hair just so they can see. I want her to use the cue push the floor away because I wanna get stir I wanna get mhmm. Good.

Dr. JJ Thomas: 21:34

And I don't want her to purposefully activate the abs. I actually want the stability pattern to start from the serratus anterior because of the anatomical connection I showed you. So, push the floor away. Now, she's doing it exactly how I want. That's right.

Dr. JJ Thomas: 21:49

Now from this position we're going to keep the head in neutral to start. Now slide one knee up towards your elbow, same side elbow. Don't look yet, I usually, I do, I give this one a lot where they look, but if somebody has a highly irritable neck, I'm glad you did that actually because it points out a difference. There are phases to this exercise. A lot of our patients are not in a highly irritable phase and we're giving them the one that Jess just did.

Dr. JJ Thomas: 22:12

But, if you have a neck patient with a highly irritable disc, for instance, you're gonna keep their neck in neutral. You're gonna you're gonna mo- you're gonna mobilize at, peripherally and stabilize centrally. So we would have her neck in just neutral here as the first phase of this progression and then slide the hip up as far as you can. Don't, yeah, keep pushing through the arms don't lose that, and then patients will find, oh my gosh I can't pull my If they have a hip deficit let's alternate sides. If they have a hip deficit, no, no, no.

Dr. JJ Thomas: 22:42

You're fine. Just do alternate legs. So if they have a hip deficit, they'll find it's difficult to slide that hip up because now you're asking your body to do it from a different stable base rather than compensating through the iliopsoas, rectus, femoris, and adductors. So now the progression of this is just go ahead and now keep your shoulders square so keep pushing the floor away as you look for your knee. Now, we're bringing in neck rotators, we're bringing in, anterior chain neck stabilizers, and we're asking the posterior chain to now adapt to that.

Dr. JJ Thomas: 23:15

So this is a really excellent exercise for integrating core stability patterns with with, stability requirements from the head to the tailbone and starting to get precursor hip mobility on top of that. It's really phenomenal. Give it a try yourself. You'll be surprised. It's way harder than you think in terms of actually doing it correctly, and you'll feel a good stretch on those obliques and also activation patterns.

Dr. JJ Thomas: 23:41

As soon as you do it, I think if you're doing it correctly, you'll feel the benefit to it. Yeah. Let's do one more exercise. Go ahead into quadripy position now. This last one is a very similar thing.

Dr. JJ Thomas: 23:53

We're going to encourage hip flexion mobility. So, avoiding that hip impingement symptom that we got with passive range by first asking her to stabilize the upper trunk through the arms. So let's actually turn sideways a little bit, the other way. Yeah, right there, right there. Maybe back.

Dr. JJ Thomas: 24:09

Yeah. Right there. Right there. Good. Okay.

Dr. JJ Thomas: 24:11

So for this, I'm going to have you spread fingers, elbows straight, stack shoulders over wrists. Okay? I also am going to ask her to roll your elbow pits forward, that's going to engage the cuff. So integrating everything from fingertips to the scapular stabilizers. And now, what you're going to do is push the floor away again.

Dr. JJ Thomas: 24:32

Yeah just there is good, and then I'm going to have you slide one knee up towards your elbow first, and then keep flexing till the hip, till the foot goes up. Now come back, see how she externally rotated there and kind of abducted. So I don't want that, I want a pure flexion moment. So instead, I'm gonna have you flex your toes and just touch your knee as you flex your toes. Push the floor away, flex the toes towards your nose.

Dr. JJ Thomas: 24:56

Mhmm. Now, if you can keep going on that path and abduct just a little bit, that's better. But see her heels not down, but I'm going to stop her right there. Because if she's going to go any further, she's going to compensate again and abduct and circumduct that leg. And we want to we want to build these patterns cleanly.

Dr. JJ Thomas: 25:13

Let's do the other side, Jess. So push through the knee, foot, only where you can comfortably. Good. And then come back. Keeping those shoulders stacked for stability patterns and then this one.

Dr. JJ Thomas: 25:24

Perfect. Way better. So she's keeping that in that knee and way better now, which is getting that pure hip flexion with a stable base underneath it or over top of it. That's enough. So that's it.

Dr. JJ Thomas: 25:36

I mean, that's the sequence of number 1, looking at your patients really from the standpoint of don't chase the pain. I mean, it's important to stretch hip flexors that are tight, but if you're stopping there there's a reason your patients aren't getting better. Because you really have to fix the underlying roots. The way to tease out how to fix that underlying root, we gave you a lot of great tools today. Use those evaluation and assessment tools we gave you with the squat, posterior chain activation, check, hip passive range of motion, be be deliberate with your test retest so that you know that what you're testing is actually, valid, And then, integrate that into a exercise that uses patterns that are familiar and important for core stability efficient movement.

Dr. JJ Thomas: 26:25

This was a lot of fun for me today. This is like this is my passion. This is really what I hope to share with all of you. This kind of thing is what we do all the time at primal university. We have our first big course coming up February 3rd 4th.

Dr. JJ Thomas: 26:36

We already have a lot of people signed up. I'm really excited. There's a few spots left, so if you wanna join in, feel free to sign up at primal university. It's actually primalhq.com, and, like and subscribe. If you can't make it to the course, just subscribe to our YouTube because we'll be doing these pretty frequently.

Dr. JJ Thomas: 26:54

Thanks again. Talk soon.