The Dylan Gemelli Podcast - Episode #127 Featuring Will Harlow! INDEPENDENCE FOR LIFE! The world's most well known and respected MASTER Level Physiotherapist! Specializing in physiotherapy for over 50's!

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Starting point is 00:00:58 50 trace minerals along with being SCA certified and having no additives or preservatives. If you want a clean coffee that is single origin and designed with your health in mind, then Danger Coffee is your answer. Use my link in the description and Code Dillon. That's Code Dillon. That's Code Dillon. D-Y-L-A-N to save 10% off your next order today. All right, everybody, welcome back to the Dylan Jameli podcast. We have a phenomenal guest today, and thankfully we're able to get this recording in. I had a little incident yesterday where I was in the emergency room, and he was good enough and kind enough to meet me back here the following day, and so we are about to tear it up for my man

Starting point is 00:01:44 here. He is someone that you have probably heard of, but if you haven't, he's a specialist physiotherapist. He's a Sunday Times bestselling author. He's a YouTube creator and he founded H.T. Physio in 2018. Now, he's built one of the UK's most trusted physiotherapy practices. He's got 900 and actually more than 900 five-star reviews. He's got over two million people following him. all over. His YouTube channel is amazing. He is amazing. And I've had the pleasure of talking with him quite a bit. And I'm so excited to introduce you to him. He's got a new book coming out we're going to talk about as well. So my friends, welcome Will Harlow. Thank you so much, Dylan. That's such a wonderful introduction. It's an honor to be here. Well, my man, thank you again for getting here

Starting point is 00:02:37 with me. I know yesterday wasn't ideal, but we made it work. And I'm just, I'm thrilled to be able to talk to you. and I'm also thrilled to be able to share you with the world. Thank you so much. Yeah, I'm really looking forward to diving in. So one of the things, because I hit it off with you immediately when we talked, and I didn't really know you at all when I got introduced to you, and you speak my language in such a variety of ways with health and fitness and wellness. So, you know, since you're in the UK is probably one of the reasons that I haven't followed

Starting point is 00:03:09 you more closely, but now that I have, your work is amazing. I want to get into your focus. So tell me first a little bit about your group of people that you work with, because you kind of have a structured way that you go about it. So I'd like to talk about your group and then why you've selected this group of people to work with. Yeah, so I'm a physiotherapist, as you say, or a physical therapist for you guys in the US. And my special interest area is in people over the age of 50. And this is a group of people that are just chronicians.

Starting point is 00:03:42 under-served by just about everyone. And it became very clear to me really early in my career that we were doing this group of people such a disservice because people who are over 50 are often told that your problems that you've got are just due to your age. There's nothing that can be done. You're going to get stiffer. You're going to get weaker. You're going to have pain and there isn't anything that you can do about it. And that's just not true. And when I discovered this, it was almost like a purpose or a calling was kind of awakened in me that I had to do something about this because I've had the training, I've had the experience, I know that I have the tools to help these people. And when I just saw some of the transformations that it was possible to get

Starting point is 00:04:26 for even people who've been told that nothing can be done, that really just drove me forward. But I mean, I'm jumping ahead because I didn't start off wanting to work with people in this age group. I, like many of my contemporaries, a young guy who studies physiotherapy, were really interested in sports. So my whole life, I thought that the big thing for me would be to go and work in professional sport. And my sport's always been football or soccer for you guys. I was obsessed with it when I was growing up. And I thought, I'm going to be a physio so I can help football players get back onto the football pitch. And when I graduated university, I got a massive stroke of luck.

Starting point is 00:05:05 I got introduced to the head doctor from the football club that I'd supported as a child. And I called him and I said, have you got any jobs available? And he said, well, actually, as a matter of facts, we're looking for a physio right now. Can you come for an interview? Huge stroke of luck. Got the interview, got the job, went into this job which I thought was going to be my dream. And within a few months, I realized actually this is not what I thought it was going to be. I'm not cracked up for this.

Starting point is 00:05:33 I'm a terrible personality fit for this role. And it was almost like I had a quarter-life crisis really early in my career because this thing I'd trained for for so long, I just didn't, I just realized it wasn't where I was supposed to be. So I left. And while I was trying to figure out what to do, that was when I went into the National Health Service, which is our big kind of corporate healthcare system in the UK.

Starting point is 00:05:59 I thought, I'll just be here for three months where I try and figure out what's going on and what I want to do next. And I worked there for a couple of months. And I was treating mostly people over the age of 50 who were referred by their GP or by their consultant. And I look back on that couple of months and I thought, you know what, this is the most fun I've had in years. I'm helping people to walk again. I'm helping people to get out of pain who've had arthritis and have suffered for years. I'm helping people to rebuild their strength and to rebuild their muscle mass. And I'm seeing these transformations that I didn't even think was possible from my own training. So that kind of introduced me to the passion that I'm into today, which is helping these older people. But I knew that the NHS

Starting point is 00:06:42 wasn't the right setting. And I knew that, you know, we were restricted to seeing people two or three times. Then we had to discharge them to make space for someone else. So that's when I decided to leave and set up my own practice. But from day one, I said, I'm going to specialize in helping people over 50. That's all we're going to serve. So we quite actively pushed anyone who was younger away and we said, no, no, we're just here for the older population. We're just here for the people who've been told that nothing can be done. And really the business took off super fast because I think it just filled a gap that no one else was filling. There was just nothing out there for these people. Word quickly got around. I started creating content online, originally just to help my patients that were coming in. But that started to reach a wider and wider audience and just the whole thing snowballed. So, Really, as we've grown, the mission has stayed the same. It's to help this underserved group of people to move better and to live longer, healthier lives. But now, because of the reach we've got, that we've really expanded that.

Starting point is 00:07:43 And my mission now is to impact the lives of 100 million people over the age of 50 before I can rest, really. What do you say to people that will go around with the mindset of, well, I'm getting older, so it's inevitable. and how inevitable is the declines that people like to talk about and how preventable is it truly? There's such an interesting question. The first thing I'd say to anyone who thinks that is it's not your fault because that's exactly what you're told by society. That's probably what you've been told by your doctor.

Starting point is 00:08:17 It's probably what you've been told by your friends or your family. And when you've been told it five, six, seven times, most people just go, well, I guess I'm just going to have to accept it. But now we know for a fact that getting weaker, losing muscle mass, getting stiff joints, even problems like arthritis and osteoporosis, many of these problems are more down to disuse and deconditioning than they are to age. These problems don't just come because you've crossed a particular birthday. They start slowly and it's usually because we change our activity levels with age. But the good news is we can reverse that. We can put strategies into place to reverse these things. And we can't deny that aging exists. Like aging is definitely a thing and your cells

Starting point is 00:09:04 do change with time. But many of the things that people blame on age are simply not that at all. It's because our activity has changed or we're just not fulfilling the needs that the body has. Do you think that some of that too is diet related in terms of some of the aches and pains, the added inflammation. A hundred percent. A diet is vital. It's one of really the core pillars of longevity. And I know you talk a lot about diet on your show here, Dylan.

Starting point is 00:09:33 But we know that people who have blamed age for muscle loss and weakness are often under-eating protein as an example. And that's one of the big reasons why they're losing muscle mass and they're losing strength. It's not because they're getting older. It's because the diet's not dialed in. And then the same thing for inflammation, you know, If they're eating a diet which is pro-inflammatory and they're driving up that global inflammation,

Starting point is 00:09:56 that can cause all of these problems that we assume are just age-related. But in fact, it's just because we're not doing the right things for our body. You know, one of the things, because I've been a major athlete and person involved in athletics, a great deal of my life. And one of the things that I've always said and gone back to is you train smarter, not harder. You learn more and gain more wisdom, which actually allows you to be better as you age, because you're more reckless when you're younger. And in the reality of things,

Starting point is 00:10:24 your biggest and best gains start to come in your 30s, 40s, and even 50s. And sometimes even 60s, if you know what you're doing, if you love your body, if you feed it what it needs, if you train it the right way, I think that people become so enthralled

Starting point is 00:10:39 and overtraining, misunderstanding diet, eating whatever they want, not sleeping well, not doing blood panels, then they start to degrade over time. And I think that the key, He is really doing everything wiser and understanding the importance of rest as opposed to

Starting point is 00:10:55 beating yourself up and letting yourself recover and looking more playing the long game as opposed to this like short-tracked mind. I totally agree. I think that you touched on something really important there about rest and the demands of our body for rest and recovery do change with age. So that's one of the things that does change as we get older. Now it means that We probably are wise if we start to put a little bit more time in between our workout sessions as we age. But what I think people misread that as is, oh, because I'm older, I shouldn't push as hard now. I shouldn't exercise as hard. I shouldn't challenge my body as much.

Starting point is 00:11:36 That's actually not true at all. The body needs the stimulus to stay strong and to keep building muscle. And as you say, if you keep giving it that stimulus, provided you're giving it ample rest and recovery, some people can see the best gains of their lives in their 40s and 50s, not just in their teens and their 20s. Yeah, I agree 100%. Like I said, I've seen it so much. I have been a victim of overtraining and not realizing the value of rest. My best results have come.

Starting point is 00:12:05 I'm always going to train hard, but it's like get in, do it, and then learn how to recover both physically and mentally. Because if you don't have that off switch mentally, your hormones are out of alignment. you're going to have more problems and you're never going to really get fully healthy or hormonally balanced or anything else. So structurally, when you're looking at it, and I'm sure you have to deal with this, and that's where I'm wondering, do you often have to talk to people about some of their stresses, like their everyday stresses and things like that? Or do you kind of just focus on, you know, the physio side of things?

Starting point is 00:12:40 Or do you find that it's necessary to at least talk to some people, learn about them and help them to de-stress as well? It's absolutely vital. And there's three Ss actually which all kind of fall under this umbrella that we address with people. So we've got stress, as you say, because chronic stress drives up inflammation and that can basically undo all of the good work that you do. The second thing is sleep. And this dials into that same thing again. If you're not sleeping well, you're not recovering well.

Starting point is 00:13:09 So you're not bouncing back from exercises you should do. And then the third thing, and this is the one that people always ignore, but it's so. important as we get older and that's social, being social and having connection with friends, family, just people that you enjoy spending time with has been associated with a longer life and a healthier life. And in fact, isolation, particularly in older people, is actually more harmful to health than smoking 10 cigarettes a day. And there's really robust data on that to show that the lonelier you are, honestly, the shorter your life is going to be. So we try and help people not just with the physio aspect, but with managing stress because we know that affects

Starting point is 00:13:50 recovery, helping them with sleep with simple tactics to improve that, and then bringing people together, that social connection part is vital as well. So for you, because since you're in a pretty strict age bracket, then I want to talk first about the physical side and then maybe the hormonal side. What are some of the most common problems that you see more prevalent? I'm sure you see it all. But I mean, what are some of the more prevalent problems you see? Like, is it back pain? Is it knee pain? Like, what is it that you see the most of?

Starting point is 00:14:22 Yeah, we see loads of back pain and knee pain. And I actually did an analysis once on the clinic. And it was completely neck and neck for numbers of back pain and knee pain. There are most common issues that we see from a musculoskeletal point of view. Now, most people who have these problems, these back pains, knee pains, even like hips and shoulders, they come to us and they say, I think it's just arthritis, right? And everyone's heard of this term arthritis, which is the wearing down of carcelage in the joints. But I would say that at least 80% of these joint pains that come in, people with joint pain,

Starting point is 00:14:55 the pain is driven by something called their mechanics. Okay. And mechanics are the way your joint moves. And people who have joint pain often say, well, it's because my carstage is gone, but they don't realize that the muscles around that joint have become weak. certain muscles have become tight other muscles are not doing their job so there's imbalances everywhere and it's all of those mechanical problems that are causing the pain not the fact that there's arthritis in that joint and we know this is true not just from my practice but in the data there's some amazing

Starting point is 00:15:28 research to show that about 80% of people who don't have pain will have some kind of arthritic changes on a scan so it can't just be the arthritis that's causing the pain it's usually these mechanical factors that are the bigger driver. And again, that's really good news because it means that if we fix those mechanical problems, people's pain often reduces significantly. And that's how we have people coming into the clinic all the time who start off saying, well, my doctor told me, I'm going to need a new knee within the next two or three years. We put them through a program that fixes their weakness and reduces the stiffness and the tightness. And within 12 weeks, they're saying, my knee doesn't hurt anymore. It's like a miracle. But it's not a miracle. It's just because they

Starting point is 00:16:10 fix those mechanical problems. So that is a huge issue we see. Another big issue we see, and I'm sure you talk at length about this, Dillens, your audience, is sarcopenia, which is muscle loss with age. And this is an insidious problem, and this is something that people don't realize this has happened often until it's too late. And after the age of 30, most people lose muscle mass as a rate of between 3 and 8% per decade if they don't do anything about it. Then after the age of 60, that accelerates rapidly. Many people have heard that stat, but what people don't realize is that along with that 8% muscle loss, your strength reduces about three times faster. So that's terrifying, because you could quite feasibly lose 25% of your strength each decade after the age of about 60.

Starting point is 00:17:00 But again, this is for people that don't do anything about it. And the good news is sarcopenia is largely reversible and it's also preventable if you start early enough. Even for people who feel like they're quite a long way gone, strength can be rebuilt, muscle can be rebuilt well into your 80s and your 90s, and that is backed up by the evidence. Yeah, sarcopenia is a major problem and it can be fatal. And I don't think a lot of people understand that, especially when they're trying to lose weight and they're sacrificing muscle along with weight loss.

Starting point is 00:17:33 And that's a topic I want to get into you with a little. later about glp1 use and things of other like weight loss mechanisms that people do and they don't realize the outcomes on these things yeah so given that that's such a problem and it's a disaster with what happens considering like bone degradation you know tendon and joint problems that are going to creep up and become a big issue what is your method of getting people to to notice that one and then how do you fix it for people is it supplement is it supplemented? Is it diet related? Is it multiple things?

Starting point is 00:18:08 Because for me, I always go to creatine as something everybody should be taken. Not that that's the total answer, but it's a, you know, there's a cumulative approach and that's one of the key supplements that I personally do. So just wondering about your methods and thoughts. Yeah, 100%. And I like to take the 80-20 approach when it comes to muscle and strength. And for me, the 20% that gives you the 80% of the results is resistance training.

Starting point is 00:18:35 and protein intake. So I like to tell people that if you don't have any kind of strength training practice, the best time to start would have been yesterday. The second best time is today. And I think people are often quite intimidated by this because they think if I've got to start a strength training plan, does that mean I have to join a gym? Does that mean I have to go and pick up heavy weights in front of the big guys who are working out in front of the mirror? You know, I'm a 65 year old lady. I don't want to do that. But the truth is, you don't need a gym membership because you can start this kind of stuff from the comfort of your own home with absolutely minimal equipment. And most of the people who come to see me, we start them off with just some body weight exercises just to get that confidence

Starting point is 00:19:19 building, just to get that baseline of strength before we start to bring in equipment. And if someone's just wanting to get started, I like to give them something called the 3-2-1 approach, which really, really resonated with the people I help because it's so easy and it makes strength training not a full-time job. And the way the 3-2-1 approach works is you're going to pick three exercises and these three exercises are going to be compound movements. So movements that work multiple muscle groups and move multiple joints. You're going to do each of those exercises for three sets right up until the point where you feel like it's tough to do any more repetitions. And then you're going to do that routine twice a week. So that's the two part. And then the one part of the three to one is each week

Starting point is 00:20:07 that you do it, you're going to try and progress just one variable. So the one variable might be one extra repetition per set. It might be one extra pound of weight if you're moving weights. It could be just slowing the movement down and improving the technique just ever so slightly each time you do it. And that satisfies the progressive overload principle, which is how we need. to just slowly, gently make things harder when it comes to strength training if we want to move forward and not hit plateaus. So that's where I start people off. Yeah, one of the things that people tend to do is like get very regimented and they don't do anything to shock their body and they kind of fall into this doing the same thing forever and then they actually go backwards.

Starting point is 00:20:52 They revert away from what they're doing. So I think when you're structuring something, it's so important to keep mixing things up, putting in like eccentric movement, and different things to shock the body a little bit, changing rep ranges, changing, you know, whether we're going high rep, low weight, or, you know, lower volume, higher, higher weights and things like that.

Starting point is 00:21:13 Do you kind of do something like that similarly? A hundred percent. I have a rule that you should change up your routine every eight to 12 weeks. Yeah. So I tell people that about eight to 12 weeks is the time where you're going to probably start to feel a bit bored,

Starting point is 00:21:27 but the body also adapts very fast. Like your body is an added. adaptation machine. It will change very quickly to what you throw at it. If you throw it the same thing every day, eventually it says, well, we're used to this. We don't need to change very much anymore. So eight to 12 weeks for me is the sweet spot. And that might be where you go from doing low reps to high reps or vice versa or go from doing, you know, faster repetitions to very slow eccentrics, like heavy eccentrics. That works really well. The thing about strength training is all of these techniques work, but you just can't get stuck in one particular box for too long, otherwise it

Starting point is 00:22:01 starts to plateau. So as you say, you know, changing it regularly is key. My wife comes to me every six to eight weeks and tells me it's time. Yeah, so I got to go through it and restructure for her. So my own coaching in my own house, but it's good, you know, because you pass that understanding on and you do become a little bored too. And you know what happens when you do that. Your workouts aren't as good either. You're not pushing yourself. You're kind of just, I don't know, it's real easy in life when you get regimented to just kind of, I hate to say go through the motions, but that's kind of what you do, you know, and you just don't get the same kind of push or the same kind of effort or efficacy out of it. And I think it's important to continuously mix things up

Starting point is 00:22:45 and keep it fun, keep it exciting, and challenge yourself a little bit. Couldn't agree, So what about supplement-wise? Do you have things that you put? Because at 50 you do like anything else, you got to be more cautious about what you're taking. You got to be more aware of a lot of different things. I'm always very, I've always been conservative with anybody that I personally work with in terms of what I'm doing and testing on them.

Starting point is 00:23:10 But what about you? Are there certain ones that, let's say that you have that are more like staples and then things that you're willing to push the envelope along if people are more advanced already? Or what's your thought process there? Yeah, so I would say my philosophy is kind of split. So there's the core that I recommend to most people if they have the goals of building muscle, strength, maintaining mobility.

Starting point is 00:23:34 And then the other part of my philosophy is this test first and then treat what you find approach. Now, many of the people who come to see me, they're over 50. We live in the UK, so it's colder, there isn't that much sun. They come in and they say, I feel really tired, I'm fatigued, I'm weak, I don't know what's going on. And I look at them, I say, I don't think this is just muscle loss. I wonder if you've got something like a vitamin D deficiency, which is super common in Caucasians and in the Western Hemisphere as well.

Starting point is 00:24:04 Yeah. Now, you can just take a vitamin D supplement and many people do, but a more efficient way is to get a blood test done first to check if you're actually deficient and then to treat that deficiency. Similarly, iron, magnesium, all of these things can be tested for. And then if you are deficient, that's when you want to top up those levels. So that's one half of my philosophy. The other half is that I like to tell people on a protein basis to try and shoot for 1.6 grams of protein intake per kilogram of body weight per day. And I think it's great that the guidelines, the government guidelines for you guys in the US

Starting point is 00:24:44 have recently changed to kind of match that recommendation. So if people are struggling to include that much protein in their diet, then I would often recommend a way protein supplement or something similar, which is a really convenient way to top up those levels. Now, the other supplement I look at quite closely and I think has tons of evidence and is pretty safe is, as you say, creating. from creatine monohydrate 3 to 5 grams per day, provided you had the sign off from your doctor, seems to be really good for improving strength and muscle mass alongside resistance training.

Starting point is 00:25:20 It doesn't do it on its own. You can't just take the supplement and grow muscle. You have to give it the right stimulus, but it's an amplifier. So that's really effective too. So those are really the core ones that I look at and then correcting those deficiencies when we find them. Yeah.

Starting point is 00:25:35 And creatine's got, well, it's shown, have cognitive benefits too, which as you age is vital as we know. So it's it's multitudes of things. I mean, it is literally the most proven supplement, you know, that you could really take. So I've had great success, but confidence in that as well. So I'm glad that you have that as well. So when you're looking at diet, because we've, we've said now multiple times the importance of protein. And look, I say this question lightly because everybody's different. Everybody needs something a little different, but let's just look at a broad spectrum when you're structuring diet for people as the age. How are you prioritizing nutrients, carbs, fats, proteins, generally. It's a great question.

Starting point is 00:26:22 I think you've touched on a really important point there is that different things work for different people. And some people will find that a higher fat diet is better. Some people will find that a lower fat diet, higher carbohydrates, is better. Now, a couple of general principles. So we've touched on protein, which is a big one. Another one is I tell people to prioritize whole food sources where possible. Yes. So trying to reduce highly processed foods. We know these are bad for inflammation.

Starting point is 00:26:49 We know these don't do anything really for, you know, on a micronutrient level for us. So let's try and get our nutrients from whole food sources where possible. Now another thing I like to tell people to do is to take what I call an energy diary. Now, an energy diary is not just counting calories, it's counting how you feel throughout the day after a certain pattern of eating. So it's like, well, how do I feel if I eat eggs for breakfast versus if I eat porridge for breakfast? One of those might give me a crash around midday, whereas the other one I might feel pretty steady throughout the day. Now, if you've noticed a pattern like that, that's a great clue that that one that keeps you steady is a really good food

Starting point is 00:27:32 for you and you should include more of it. Whereas those ones that give you big peaks and then huge crashes are probably not doing wonders for your blood sugar and are probably not going to be very productive when it comes to getting the most out of exercise or indeed for living longer and living healthier. So tell people to keep a seven-day energy diary when they're just getting started. You know, how do you feel at various points throughout the day and then map that against what you had for those meals and then use that as a starting point for what to keep and then what to get rid of? So I love it. Okay. So let's talk some hormones a little bit here. Look, as we age, those get a little bit more difficult to keep in line. And as, as you know, as I do as well, as a man, we have a certain decline after the age of 30, testosterone and growth hormone being the two top ones that are going to probably affect us the most. What, aside from those two, what else do you find seem to be things that you consistently run into that are on the decline or things that may be?

Starting point is 00:28:35 men aren't aware of that they need to be aware of at that age? Yeah, I think that it's such an important point. The hormonal changes that we go through are, I would say, still underdiscust in the healthcare world. And it's interesting, because when I came to the US a couple of weeks ago, it's much more of a open conversation over there with you guys than it is here. Now, if I have a gentleman who comes into the clinic and he's in his 60s or his 70s, it's actually very rare for one of them to bring up the topic of testosterone with me, or to even realize that those levels decline with time, and that that is something that could be affecting his recovery,

Starting point is 00:29:20 it could be affecting his strength, it could be affecting his sleep and his muscle mass. So it's also one of those things that you have to broach with caution, because some people, I mean, it's a very personal decision as to whether you want to get your levels tested and treated too. So I'll always start off with just raising the conversation with someone and just saying, you know, is this something you've considered having a look at? And if it is, then it might be worth getting, you know, a test done just to see where you are. Now, if someone comes to me and they say,

Starting point is 00:29:50 do you know, I feel like my testosterone levels or even growth hormone have dropped. I don't feel the same. I'm thinking about going on TRT or something like that. I'll often tell people to try and get the fundamentals right for a period of 12 weeks before they turn to a pharmacological intervention. The fundamentals are making sure you're training, making sure you're getting enough movement each day, fixing your sleep, and then dialing in some of those diet factors that we spoke about before, before you go on to any kind of medication. Because some people I find, if they get their resistance training sorted, they sleep better, they increase their protein intake, and they start moving around throughout the day,

Starting point is 00:30:32 many of the symptoms that they thought were testosterone deficiency actually start to ease. So they can improve their health without having to rely on an exogenous hormone just by making those simple tweaks. So that's where I look first. For women, I feel like women have been done a massive disservice by that one study, you know, 20 years ago

Starting point is 00:30:55 that almost misrepresented what HR does for a woman in terms of risk of cancer. It knocks that entire group of people out of the picture of having the proper treatment for estrogen deficiency, which is obviously what happens after menopause. And it really, really delayed many women getting the help they needed. And I'm really glad that now the conversation is coming back to saying, actually, HRT does not seem to be as dangerous as what we thought and could be a real lifeline for many women coming through. But, you know, I'm not a hormone specialist, so I don't have these conversations as frequently as possibly you do dealing with people. But it's so vital. And if people are feeling like they're not themselves,

Starting point is 00:31:39 their recovery slowed down, they're losing more muscle mass than they really should be. And they're just not responding to exercise in the way that they should be, then these are all definitely important conversations to have. Yeah. And women especially have gotten just. Well, beyond what you said too, there's this strong misconception that women have misunderstanding the importance of testosterone in their lives and then balancing progesterone, testosterone, and estrogen. And likewise, with a lot of men, aside from bodybuilders, they're not too well in tune with the balance of testosterone to estrogen. And there's a lot going on there. But what I like that you said that I have been the biggest advocate for is just because you have low testosterone, doesn't

Starting point is 00:32:23 mean you necessarily need to jump on TRT. There's a lot of factors that you brought up some good ones through the training but the diet the rest the sleep the recovery and then there's also you can look through a blood panel and if you're you know doing your job you're looking for potential issues that are tying up testosterone or causing it to be low and trying to fix those first you've got things like SHBG that kind of thing if that rises that it's binding testosterone you know there's many things that can impact it and i think one of the problems especially here in the UK, is that someone gets a blood panel done. The doctors often only look at one number, which is total testosterone,

Starting point is 00:33:02 which is only a very small part of the puzzle. So it's also what are your levels of sex hormone binding globulum, what's your free testosterone, what's your albumin? You know, all of these things are impactful to how a person feels, not just that one number. It's much more complex than it's often dressed up to be. Well, and that's it. And that's that just one mindset approach.

Starting point is 00:33:26 And it's a lack of digging. I hate the term idiopathic or people that they just do this like surface level structure where they don't dig or even know or understand. So it's important to really like exhaust options before going to that ultimate route. And look, I'm a, I'm the biggest TRT advocate on the planet when needed, you know. And that's the problem is everybody. wants a solution right away in a quick fix without trying to actually go to the core of the problem. And I'm assuming the way that you teach people is more of a longer approach and try to cover

Starting point is 00:34:02 all the bases first before going that last route. No, 100%. I think if you can treat something naturally, it's almost always better to do it that way, unless there's a reason for you not to. I mean, the fundamentals are just, they're the fundamentals for a reason because they work really well. So as we touched on training, and diet and sleep, like these things, you have to get those things in line before considering something more serious like a medical intervention in my mind, because that means that, you know, you've really maximized what your body can already do, which is what I think everyone should be shooting for. Yeah, 100%. I couldn't agree more. So let's talk about GLP ones a little bit

Starting point is 00:34:44 because I think that it has become so polarizing for a variety of ways. I'm finding more negatives as time has gone on with them. But I'm curious how often you run into that with people in that age bracket. They're wanting to do it or already doing it. Yeah. And do you know what? This is something that really surprised me

Starting point is 00:35:04 in the last few months because I have obviously my own patience. I see less patience now because of what I'm doing is really targeting this big audience online. We've got our in-person practice. So much of the feedback I get from our live patients is through my other physios. And in a meeting one day, I said to them, I was like, how many people are you treating that are on these GLP?

Starting point is 00:35:30 And the girls who are treating them were like, honestly, I think it's probably about 10, 15% of the people coming in are telling us that they're on these drugs. And I had no idea. I thought it was going to be, oh, we've seen one or two. It's loads. So I'm not surprised because obviously they're sold as these miracle drugs that help people to lose weight. tend to look better in inverted commerce. And for some people, they are genuinely life-saving. You know, people who are diabetic, people who are extremely obese,

Starting point is 00:35:59 have had incredible benefits from these drugs and have often kept people alive. Now, there's a big difference from taking GLP-1s when you're obese and taking GLP-1s because you want to lose the last five pounds, so you're ready for the summer. Yeah. And I think that one of the problems with GOP-1s is they're very effective. they do work for weight loss, but what weight are you actually losing? Because weight loss is not necessarily a good thing. And now there was a very interesting study that came out a couple of weeks ago

Starting point is 00:36:31 to show that around 40% of the weight lost is actually muscle, not fat, which for me is a catastrophe. Because the people who are in their 50s and 60s and taking GLP ones and losing 40% worth of muscle, how difficult do you think it's going to be for those people to get that muscle back? Super tough. And these people are not necessarily the ones that are experienced with the resistance training. Maybe they don't know how to eat to maintain or build muscle. So for those people, when they lose that muscle, it's often gone forever. And we know that muscle is an independent organ.

Starting point is 00:37:09 It's like your longevity organ, your muscle is. The more muscle you have, quite literally the longer you live, the healthy you are, the less likely you are to have diabetes. in cardiovascular disease and dementia and depression and all of these things are independently associated with less muscle, making them more likely. So I think people have to be super careful. And it's almost like be careful what you wish for because you'll definitely lose weight with these drugs. But if it's that wrong kind of weight, then you could get something a lot worse than what you bargain for. Now, people that are on gLP ones, if they do push their resistance training

Starting point is 00:37:48 and they do eat protein, you can absolutely mitigate those effects of muscle loss. So the rules don't change. It's just like the process is sped up with these drugs rather than when you're off them. The rules are the same. If you eat protein and your resistance train, you can take these drugs and minimize muscle loss, but you just have to be very careful. Yeah, 100%.

Starting point is 00:38:13 And that's where I was actually going to go. So you beat me to it. But the thing is, here's my issue, Will, and I've learned and I put some content on about how these actually age you quicker that we're finding the aging acceleration in them over time because it's speeding things up internally, especially cellularly. But beyond that, it's I have, here's where I have the problem more than anything is we're taking a solution here for weight loss when these were supposed to be diabetic drugs. And I'm all about having secondary, you know, benefits to things like Jardians, for example, diabetic drug. You can use it for heart failure. Great. That's awesome.

Starting point is 00:38:52 But then there's side effects that you're getting from the Jardians as a non-diabetic user. And you might be getting the benefits of the heart failure part of it. But then you're creating other problems by taking it. Well, same here. You're creating more problems for yourself by taking it for its unintended purpose. And the biggest problem that I have is you have to remember, the mechanism here is we're shutting off our mind and telling yourself you're not hungry anymore. Okay.

Starting point is 00:39:18 So what do you think happens when you start taking it again? Then what? Then where does our mind go? Well, it remembers that you're hungry, right? And if you don't follow what you just said about getting enough protein intake while you're on it, you've lost weight, but you've lost muscle. And when you gain the weight back, guess what? It's not muscle you're gaining back, right?

Starting point is 00:39:41 it's all fat so that's another big problem you end up being worse off than when you started because eventually you're going to have to stop taking these you're not i don't care what anybody tells you about you you take these forever that is not true and it's indicative by the studies i can show and prove by the results so that's why i don't like the dependency on these in any way shape or form and it's all about data that you see over time and real life data and that's what I'm transitioning to that. For you, you know,

Starting point is 00:40:11 there's things that I'm sure you go against the grain. Don't you find that it's more important for real life data with you have thousands and thousands of patients over years by now, I'm sure. Don't you find that what you get data-wise by that is much more efficient than a study that got put out? I mean, 100%. And it's wonderful when your real-life experience matches up with, what the data says, but as we know, the data is often five, ten years behind what you see in the practice. So I think it's very, very important to go off lived experience as well as the evidence base. And if we often find something that works super well in the clinic and it's like

Starting point is 00:40:57 there is just no papers on it because, you know, no one's studied it. It doesn't mean we shouldn't use it because it's still within our scope of physiotherapy practice. You know, it might be a certain exercise approach that's not backed up by science for something, but we've found it works with this pocket of people. We're going to keep using it. So I totally agree, like having your own data is super important. And it's almost your responsibility to collect that data and to collate it over time when you are seeing, you know, the volume of people that we do.

Starting point is 00:41:26 And that's been one of our most valuable assets over time. I love it. Here's a question for you, I think, would be curious. First of all, how long have you had your practice? So I started it in 2018, but I've been practicing for 10 years total. We really went, well, I went full time, like really all in in 2020. And, you know, I was seeing 60, 70 patients per week when it was just me. And then when the online thing took off, it was like there was just so much demand that I had a choice.

Starting point is 00:42:03 I could either grow this enormous in-person practice, or I could keep the in-person practice quite small and quite intimate and really high quality and then put more effort into reaching people online and really trying to spread the message. So I did that kind of hybrid model where we've got a very small practice. We have three full-time physios alongside me that treat patients. They're all hand-trained by me. We look at every patient case together as a group. We spend a lot of time training the clinicians because we want that quality to be much better than anything else that people can get. And then I've put a lot of effort into speaking to people online, reaching people online, and just trying to impact more people.

Starting point is 00:42:43 How many thousands of people do you think you've seen or coached by now? Well, in our practice, we've got roughly 1,500 active patient cases. That's in person. And then in my online program, I've got more than 2,500 people in there as well. And we speak to them daily. and it's less kind of intimate because it's done virtually, it's done online. Yeah. But we're speaking to those people every day and we're building the programs based on their

Starting point is 00:43:11 feedback and what they need and they tell us their stories. We get everyone who joins to drop in a reflection of their journey up to this point. And again, we've got that data. It's like, right, these are the biggest problems people are dealing with. Let's build something that helps them overcome that issue. and make it as easy as possible. So, yeah, I just love what I do. I'm so, so blessed. I'm so lucky. And that's not to mention, you know, the five or six million views on YouTube we get every month. Yeah. The hundreds of comments and people just saying, like, that they've used my stuff and

Starting point is 00:43:48 they've got some kind of change. It just boggles the mind. Like, I can't get my head around it sometimes. It's very overwhelming, you know, to have this kind of, this kind of reach. But I feel With this reach comes great responsibility. So my main thing is to just not let people down and to just always try and give them what I believe is truly going to help them. I'm going to correct you on something you just said. There's no luck involved on any of this.

Starting point is 00:44:14 They've never been lucky. You've been blessed like you said the whole time and you were given a responsibility by God and you're doing it to the highest extent and level. So there is no luck there, my friend. I have to correct you. This is all you listening to what you were supposed to do and then implementing and being such a good heart and soul and doing it.

Starting point is 00:44:32 So I never want you to think you were lucky because you are not. You are just doing what you were intended to do and doing it the right way. And it's appreciated, man. I really appreciate that. I really believe that people have some kind of purpose. This is something I've been toying with for a while. I feel like all of us have got a purpose or a calling. And I think it's super sad when people don't necessarily find theirs.

Starting point is 00:44:58 but this was something that just was almost like thrust upon me. And people say like, oh, when did you find your passion? I don't know if it's a passion. It was more a calling. It was like I had no choice but to do this. And then I was given this wonderful opportunity when, you know, there was just so much attention online. And I thought, I'm in such a good position now to help the people that have put their trust

Starting point is 00:45:21 into me so far. And that, you know, that responsibility kind of weighs heavy sometimes, but it's all So the thing that gets me out of bed is the thing that drives me and, you know, get stronger with each passing month. So, you know, I'm very blessed. You know what I've found is, yes, you are right that the responsibility is heavy. But once you realize the purpose and you start to do it and you start to feel it, it doesn't become heavy anymore.

Starting point is 00:45:52 It becomes fun and it becomes like this sense of reality that, wow. people need me and listen somebody has something within them where somebody needs them somehow or some way sometimes it's really big on the surface and sometimes it may not seem like that in the moment but it is but the weight it becomes less and less and less and the joy and what you do becomes more and more and more so while the the responsibility and the burden is there it's not a heavy one anymore you know what i mean it's like it's very light and it's just it's like super fulfilling when you become so purposeful and it's for everybody else. It's not you. Your win out of this is that you're changing people's lives and helping them and you're making that impact. And I know,

Starting point is 00:46:40 I know how it feels and I know what you get is people coming to you thanking you for fixing their life. And that's priceless, dude. Like, yes, we all want to make a lot of money because we need to survive. But it's like, when has it come to the point where the motive behind this is like doing what you do and it's not because you dude you become rich in multitudes of ways money being one of them when you're doing good work it just happens but when you chase it or let that dominate you you find that it's not good it doesn't even feel you know yeah i i totally agree i think that it's yeah it's a funny one because people do come to me and they're like thank you for what you've done like you've you've you've changed my life you've impacted my life and i always catch myself thinking like

Starting point is 00:47:24 i didn't do anything i just put this information out there you did it. You were the one that got out of bed and you did the exercises. You stuck to it for three months. You can't give me all the credit. It's not me. It was you. So always try and bring it back to them because that also is it's not empowering to say that, you know, everything that you've got is because I told you how to do it. That's not a good message. Now, the person who actually put that stuff into action needs to know that it was their effort that was the thing that made the difference. If anything, just being generous to me,

Starting point is 00:47:59 I was just a capable guide. That's all I've ever done. But, you know, you were instilling hope into people, though, brother. That's what it is and teaching them, and then it's up to them from there. True. Yeah, I like that. So it's a team effort,

Starting point is 00:48:15 and you're leading the way. And that's so, so powerful, my friend. It really is. Thank you very much. I appreciate that. Yeah, no, it means a lot. So let's take a look at your new book because I want to kind of tell people what your first book was and what it was about and how we're transitioning now into the new chapter, so to speak, where you're writing. Yeah, definitely. So I wrote my first book, which came out two years ago was called Thriving Beyond 50. And to be honest, thriving beyond 50 is like a manual. So I wrote a hundred,

Starting point is 00:48:51 111 chapters in there about the different problems that we see in the practice. So it wasn't really designed to be read cover to cover. You were supposed to pick it up, find the chapter that relates to the problem you've got, read that chapter, implement it and hopefully get better. And people loved it. But this new book, it's got a more important mission. So it's called independence for life. and it is all about giving people the tools and the strategies they need to actually stay independent for as long as they can. And I define independence as being able to do what you want, when you want, for as long as you want, without needing to ask for help from someone else unless you want it. I like it. Now, I wrote this book for two different people and it's the same

Starting point is 00:49:37 two different people that I used to see in the clinic all the time. So the first group of people that this book is for. Are the people that have been told by their doctor that it's just your age, there's nothing you can do, you can expect to feel weaker and have more pain and lose muscle as you get older. And these people are often in quite a state when they come to see me. But the first thing I'll try and do is give them hope that something can be done. I've seen people in your position so many times before and more often than not, the end result is positive if you have the right strategies and if you can stick to them. So I put everything I know about how to fix these problems, how to reverse the effects of, in brackets, aging, and I put them all in one place

Starting point is 00:50:24 in easy to consume chapters so people know the bare minimum they have to do to actually get that great result. Then the second type of person I wrote this for is the person who's probably listening to all the podcasts, they're watching all the YouTube videos, they've already read all the books. So they're doing a lot for their health, but they feel overwhelmed. There's just so much online. You know, one expert tells them to do one thing, another expert tells them to do something else. And they kind of don't really know who to believe. So I wanted to give these people the science-backed data and approaches that actually work so they can stop wasting time on the things that don't and start just implementing the things that do. I love it, man. That's what people need.

Starting point is 00:51:07 people, if you read comments and are looking for, you know, what are the biggest concerns people have? If you sift through the BS, and I'm sure you get a ton of comments having the amount of following you have, what I find is the number one thing that people have a problem with is confusion. Is that what you're seeing to? I 100% agree. Confusion overwhelm. It's not knowing what to do and having so many options and not knowing which one is best. for their circumstances.

Starting point is 00:51:39 Yes. We both touched on this, and it's nailing down what's right for each person. And that's the key to being a teacher, is explaining to people, it's not just your way. That's an example. It's fine. But what I find, I'm curious just to what you find, is that too many people, it's like, it's my way or no way. What, this happened to me, so it has to happen to everybody.

Starting point is 00:52:02 And that's not really fair. It's good to say and provide experiences, but I don't think it's fair. to like pigeonhole everything into one blanket like statement or ideology. I just, I just can't get behind it. Yeah, I 100% agree. It's one of the reasons why in the book there's more than 100 exercises in there

Starting point is 00:52:21 is because there's no one exercise that's right for everyone. So when I was putting this book together, I was like, well, I'm going to have to give everyone at least something they can do, which is why there's so much in it. But you're absolutely right. Like everyone needs their own path.

Starting point is 00:52:36 and there are general principles that everyone can benefit from. But within those principles, there's a lot of wiggle room. And what works for you with your diet or your exercise might not work for me with my diet and my exercise. So if we can teach people the principles and give them the tools to actually build their own structure, I think that's the most powerful thing we can do. Yeah, because I mean, you get multitudes of injuries that could have occurred from who knows what, that you have to structurally figure out and then come up with some sort of solution. And I'm sure it's not ever always the same.

Starting point is 00:53:10 No. And when you see two people with knee arthritis, which you think, oh, surely that's quite standard, well, two different people are going to have two completely different rehab programs because one person might have weak hips, whereas the other one's got strong hips. That person might have really tight calves. That one's calves are okay. So it's going to be completely different, even if you've got the same injury. So yeah, absolutely. Everyone needs something different. And, you know, I always try and give people the tools to help them work out what's going to work for them before they invest loads of time and effort in doing the wrong thing. So simple tests to discover simple strategies that are going to work for you. That's kind of my motto.

Starting point is 00:53:52 Absolutely. I love that. So I got one more question for you. I'm very curious about it. So a lot of people that are in, you know, have your kind of practice have different modalities. they really believe in, whether it's PEMF or whatever, you know, there's different types of things. Are there any things that you really kind of get behind that you like to utilize for people? Do you know what? We're very low tech in my practice. We very much stick to the fundamentals of appropriate loading, more movement, and adequate recovery as our pillars, if you like. We do like shockwave therapy for tissues that are stubborn and won't.

Starting point is 00:54:31 heal. So for tendon problems and issues like plantophaseitis, we use shockwave for those injuries. But to be honest, we're very low tech. And one of the reasons I think that approach resonates is because the stuff we give people to do is always stuff they can do at home. And I'm not saying these extra modalities are useless because absolutely they do work and there's lots of evidence for various things that people have in their practices. But my philosophy has always been, I don't want people to be reliant on having to come to us to get treatment. I want them to have the tools to be able to continue their stuff at home. So if we ever bring something in to the clinic, we always think super carefully about is this going to make our patients reliant on us? And if it is, we probably

Starting point is 00:55:14 aren't going to bring it in. We just want to give people the tools to be able to do it on their own. I love that. Last question I have for you, and I'm not asking you to throw stones or anything of the sword or bad mouth any like, and I hate to even use. this word is traditional medicine, because I think what is termed traditional is non-traditional if you think about it, but that's a different topic. Do you try to get people to not be reliant on things like ibuprofen, you know, pain killers or whatever it is that they're taking, you know, because I really can't stand a lot of the medications that people take for pain or anti-inflammation. Do you work to try to get people off of those, or what's your thought there?

Starting point is 00:55:54 Yeah, definitely. And that's actually one of the biggest things that brings people to us. is they're tired of taking painkillers. They've been taking these painkillers for so long that they can feel the side effects. They don't feel well when they take them, but they're relying on them because if they don't take them, the pain is so bad. So they're often looking for an alternative,

Starting point is 00:56:15 a solution to coming off these painkillers when they come to see us. So absolutely, we will always try and help people to come off these painkillers in a safe way. Now, I don't think painkillers are always bad, Sometimes they can be good for getting people over, you know, temporary problems and helping people to still move when it's impossible otherwise. But you're absolutely right.

Starting point is 00:56:40 You know, these anti-inflammatories especially, they have many unwanted effects that people aren't always conscious of, especially the ones that we think are mild anti-inflammatories like ibuprofen. It actually can be quite harmful to the stomach and other processes in the body as well. and people don't realize that. So yeah, I'm not anti-pain killers, but I treat them with caution. And absolutely, the quicker we can get people off them, the better. Yeah, they're quick hits for me. Like, it's get, use it very, very, very lightly

Starting point is 00:57:11 just for specific things and just get away from it, you know? Yeah. Because alternately, you're just band-aiding a wound and you're actually just delaying the inevitable and making it worse because you're tricking your body into thinking something's okay when it's not, you're creating more problems. Yeah, totally.

Starting point is 00:57:26 agree. So, and that's why I don't like cortisone shots and all these things that people take and do because it's just, it's causing me more a problem. Yeah, the cortisone shots especially. So there's, there's evidence to show that, you know, one shot is often okay. But when you start to go past two and three, you start to weaken the tissue. And sometimes that weakening of the tissue is not reversible. So you get fatty infiltrates that will come into your tendons. And once they're there, it's very hard to get rid of them. And people who come in and they, say, oh, I've had, you know, five shots in my shoulder, instantly I'm thinking, wow, I am worried about your rotator cuff. I wonder what that course is sewn over time has done.

Starting point is 00:58:08 So, again, if we can help people avoid needing them, that is brilliant. We certainly do not send people for them unless it's a last resort. And again, sometimes they can be helpful, but we're super selective as to who we recommend those two. Yeah, I'm with you. I did one in my shoulder and honestly like it was getting me through workouts and then I quickly realized man you just made this thing way worse because then when it wore off it was just I don't even want to you that's a whole other podcast to talk about so will tell everybody where to follow you and I'll link all of this where to get your new book when your book is releasing because this is exciting man like this is a big time for you yeah thank you so much so the book is independence for life it comes out on

Starting point is 00:58:55 May the 26th worldwide and you can get it from all major booksellers. So just type in Independence for Life and you can find it. Willharlow.com is my website. That's kind of my hub where you can find everything else about me from there. So that's got, you know, the clinic, the YouTube channel, the books, the online program, all of that is there. But my main content hub is YouTube. So if you just search Will Harlow on YouTube, you'll find all of my content.

Starting point is 00:59:20 We've got more than 700 videos, all 100% free to just let people, you know, figure out what's wrong with them and treat it safely at home. I love it, man. I love, I told you this multiple times. I think the world of you. I love what you do. I think your heart is made of gold. And I just appreciate people like you that have a voice, give people hope and show that there are a lot of good people out there trying to do a lot of good things. So it's greatly appreciated, brother. Thank you so much for having me, Dylan. And likewise to you, like I can tell, your heart is in such a good place with what you're doing. So yeah, I really, really appreciate you having me on. It's been a great chat. Well, people are going to see this book. They're going to

Starting point is 01:00:01 see more of you. And I'm just excited to share you, brother. So all right, everybody, that wraps up another one. Get out, get Will's book. Check out his website. Go visit him and stay tuned for plenty more to come. Dylan Jameli and Will Harlow signing off.

The Dylan Gemelli Podcast - Episode #127 Featuring Will Harlow! INDEPENDENCE FOR LIFE! The world's most well known and respected MASTER Level Physiotherapist! Specializing in physiotherapy for over 50's!

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