The Peter Attia Drive - #365 ‒ Training for longevity: A roundtable on building strength, preventing injury, meeting protein needs, guidance for women and youth athletes, and more | Gabrielle Lyon, Mike Boyle, Jeff Cavaliere

Episode Date: September 22, 2025

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter In this special episode of The Drive, Peter hosts a strength an...d conditioning roundtable with three experts in the field—Gabrielle Lyon, Jeff Cavaliere, and Mike Boyle. Together they explore why maintaining muscle mass, strength, and power is essential for healthspan and longevity, and examine how resistance training supports metabolic resilience and injury prevention across the lifespan. The conversation covers practical strategies for getting started and staying consistent, the importance of a protein-centered diet tailored to age and activity level, and approaches to resistance training for peri- and post-menopausal women—including tendon care and optimal programming. They debate single-leg training versus heavy bilateral lifts, share knee-friendly lower-body options, and highlight exercises that belong in the “graveyard” due to poor risk-reward ratios. Finally, the group discusses youth sports specialization, emphasizing the long-term value of variety for developing lifelong athletes. We discuss: Personal career journeys and philosophies of each guest that shaped their approaches to strength, conditioning, and lifelong health [3:30]; Why so few people engage in resistance training despite its proven health benefits [8:30]; Mike’s low-stress, high-consistency method for training beginners to resistance training [18:45]; How resistance training enhances metabolic health and body composition even in lean, highly active endurance athletes [25:30]; The dominant role of nutrition in shaping physique and achieving low body fat, the synergistic effect of resistance training, and the unrealistic expectations about muscle growth and fat loss [28:30]; Why Jeff advocates for five meals a day, and why meal timing matters less than overall protein intake and caloric consistency [38:00]; Optimizing protein for every stage of life: quality, quantity, and guidelines for diverse diets and body types [44:15]; The advantages of unilateral lower-body training over heavy bilateral lifts: impact on strength, athleticism, recovery, and functional movement [51:45]; Rethinking heavy squats and deadlifts: risk-reward, aging bodies, and the case for reverse lunges and other single-leg alternatives [1:01:15]; Adapting with age: Gabrielle on injuries, hip dysplasia, and the shift to smarter training [1:10:15]; Exercises that belong in the “iron graveyard”: unnecessarily risky exercises and their safer alternatives [1:19:15]; The downside of early sports specialization in children and the long-term benefits of encouraging kids to play multiple sports [1:25:00]; Advice for preventing an Achilles injury: calf strength, ankle mobility, and listening to pain signals [1:33:15]; Shoulder pain: how to keep training the upper body when shoulder pain limits pressing movements [1:40:45]; Effective strength training strategies for women before, during, and after the menopausal transition [1:43:15]; Best practices for strength training and athletic development in children, and the pitfalls of early sports specialization [1:50:30]; How to foster healthy habits and an interest in fitness beyond playing sports [2:00:00]; Something each guest has changed their mind about in the last five years [2:04:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

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Starting point is 00:00:00 Hey, everyone. Welcome to the Drive podcast. I'm your host, Peter Attia. This podcast, my website, and my weekly newsletter all focus on the goal of translating the science of longevity into something accessible for everyone. Our goal is to provide the best content in health and wellness, and we've established a great team of analysts to make happen. It is extremely important to me to provide all of this content without relying on paid ads. To do this, our work is made entirely possible by our members, and in return, we offer exclusive member-only content and benefits above and beyond what is available for free. If you want to take your knowledge of this space to the next level, it's our goal to ensure members get back much more than the price of the subscription. If you want to learn more about the benefits of our premium membership, head over to peteratia.m.d.com forward slash subscribe.
Starting point is 00:01:04 Welcome to a special episode of The Drive, another round table conversation devoted this time entirely to strengthen conditioning. My guest this week are Dr. Gabrielle Lyon, a fellowship trained physician in geriatrics and nutritional sciences, founder of muscle-centric medicine and author of The New York Times, bestseller Forever Strong. She runs a clinical practice in Houston, and continues to publish research on skeletal muscle health and metabolism. Jeff Cavalier, a physical therapist and former head strength coach and physical therapist for the New York Mets, who parlayed that experience into his incredibly popular YouTube channel using an injury-smart approach to make athletic training accessible to literally millions. And Mike Boyle, a pioneering
Starting point is 00:01:50 strength and conditioning coach now in his 43rd year. Mike popularized NFL Combine Training in the 1980s and spent the 1990s with the Boston Bruins and opened the first for-profit strength and conditioning facilities in the U.S. He was also part of one of the Boston Red Sox championship winning team. In this episode, we discussed the critical importance of strength training for longevity, how muscle mass strength and power protect health span as we age. The participation gap in strength training and why closing it is crucial for lifelong health, injury prevention, metabolic resilience, plus the barriers that keep most people from getting started and staying consistent, the importance of building a protein-centered diet, how age, activity,
Starting point is 00:02:30 and metabolic health drive how much protein and carbohydrate each individual really needs. Resistance training across Perry and post-menopause, including tendon care strategies and why good programming matters. Single-leg training versus heavy back squats and deadlifts, the risk-reward calculus that led Mike to swap most bilateral lifts for unilateral work. reverse lunge mechanics and other knee-friendly lower body substitutes that still let you load heavy and grow stronger the exercise graveyard why unsupported chest flies cuban presses and other classics may be more risk than reward and what you should be doing instead early sport specialization myth for kids why variety in sports at a young age is still valuable and necessary to becoming a lifelong athlete
Starting point is 00:03:19 So without further delay, please enjoy this roundtable conversation with Dr. Gabrielle, Lyon, Mike Boyle, and Jeff Cavalier. Lady and gentlemen, thank you so much for all making the trip out to Austin. Been looking forward to this one for a while. As some listeners might know, this is our second version of a roundtable. But unlike the first one where I had interviewed the three guests multiple times previously, and they were very familiar to the audience. All three of you are people whose work I'm very familiar with, but I've never had the privilege of sitting down with you one-on-one.
Starting point is 00:03:57 And as much as I would have loved to have done that first, I think it would have stood in the way of doing this today. So before we jump into what we're about to talk about today, which is all things related to resistance training, I want to just ask each of you to maybe give the non-bio version of who you are and as such why I think you're a great part of this. Let's start with you, Gabriel. Certainly.
Starting point is 00:04:18 My name is Dr. Gabriel Lyon. and I'm a fellowship-trained physician in geriatrics and nutritional sciences. I did my fellowship at Washoe, and at the time, I was very reluctant to doing geriatrics because it can be a very arduous and sad experience, but I was fascinated by the nutritional research side. There was a moment we were working on a study looking at body composition and brain function, and I really took to one of the participants, and I imaged her brain, and at her mid-50s, she looked like the beginning of an Alzheimer's brain. And in that moment, muscle-centric medicine, which is the concept that I practice and founded
Starting point is 00:04:57 was born. And it's really that skeletal muscle is the focal point of all our health and wellness. I'm an author, wrote a New York Times bestseller called Forever Strong. I continue to do research and work within the space. And you see patients. I do see patients. I do see patients. We actually just submitted a paper that got accepted for publication on sexual function, the relationship between sexual function muscle mass. Okay, cool. Mike. Michael Boyle, I'm a coach. I've been a coach. This is my 43rd year actually coaching. I was lucky enough to bounce right out of college and into a college job. I started out as an athletic trainer
Starting point is 00:05:35 when you said to be immodest, I think I invented training for the NFL Combine, at least as a book that says I did invent training for the NFL Combine in the 80s. I worked in the NHL for the Boston Bruins in the 90s from 90 to 99 while I worked at BU because strength coaches were basically part-timers at that point. I worked at BU for 30-something years opened a business for profit, strength and conditioning, probably the first one in the United States in 1997. And then in 2012, I left BU where I've kind of always had more than one job. And I jumped over to the Red Sox for two years and was able to get a World Series ring out of the Red Sox in two years and then realized that that was not very conducive with being a what I really want to be a good father and a good husband and was like,
Starting point is 00:06:19 okay, I'm done with pro sports. So now I coach still, coach my son and his friends. I have a son in place called lacrosse. I'm still actually functioning as a personal trainer, I guess, in some cases and as a strength and conditioning coach in some cases. So I'm more than anything, just a practitioner. And what type of clients do you see now? What's the range? The range is 11 to in their 80s. That's our client range. We don't take kids till they're 11 because we really don't want them in the gym before that. And we'll take him as old as we can get them, but I think the oldest right now is 89. That's actually my son's pediatrician just turned 89 and retired last year, believe it or not. Dr. Leader had still been working all those times. We have a couple three-generation
Starting point is 00:06:58 families of which he's one. We have him, we have his kids, and we have his kids' kids, kids that are all training in the same space. Good. There are a lot of things I want to talk about that are embedded in there, so we'll come back to it. Jeff. Jeff Cavaliers, so I'm a physical therapist by trade, moved out of the clinic at an early stage. Got a great opportunity to work in that role for the New York Mets, which was a dream country for me because I was a diehard Met fan growing up, presented the dream job. And from there, piggybacked into how could I continue this education of athletes on a broader platform? Was well aware of the power of the internet at that time. So I started a YouTube channel, which by luck beyond just my family members subscribing early
Starting point is 00:07:39 on, I got a few others that did along the way, and it piggybacked that into a broader message, which was, okay, now it's not just about training athletes and empowering athletes, but how do I empower people who want to be more athletic, feel more athletic, move more athletically in daily life, not just in where they're getting a pay to paycheck. So that became my mission, really, from that point. Now, beyond having to sort of maintain a certain level of consistency because I want to practice what I preach, I also have two young boys. I started late. I'm 40 years old. I have twins. And now I feel like I got to make sure I can keep up with them when they're ready to have me be able to run and play. So I have a lot of motivation to keep doing
Starting point is 00:08:18 what I'm doing and stay in the shape I am. But I believe that it requires having an understanding of injury, training around injuries, because no matter what, as we get older, things do start to break down. And I think you have to have strategies to be able to push through that and train around that. And I think that's where my big strength is as a PT to provide that background to help people do that more readily. Okay. Let's start with a question that probably has an answer, although I actually am a bit embarrassed to say I don't know the answer. So I'm wondering if one of you guys do. Do we have a sense of what percentage of people in the United States do not practice resistance training?
Starting point is 00:08:52 Well, we know that 50% of Americans are not training or doing any kind of exercise. From the research that I've read up until recently, it's probably 70% do not meet. the criteria for both activities. 70% in total then, or you think it's 70% of people who are doing some form of exercise? I believe that it is 70% of people in total. Got it. I can't even fact check that. I mean, that's hard for me to imagine, but I can believe it.
Starting point is 00:09:20 I think it's lower if you're talking about resistance training because we were talking about you would say lower than 30% would do resistance training then? Yeah, because I think 20% of people belong to a gym. If we look at home gym stats aren't very good in terms of people, the home gym person who actually has one and uses it is probably more unicorny than we think they are. And so if you start looking at that number, 20% have a membership, 50% of those people use it, which now brings us down to only 10% of people in the United States are actually in a gym. And then you look at that and say what percentage of them are resistance training? Maybe now we're down to 5% because you see a lot more
Starting point is 00:09:54 hamster wheel people who are just walking on a treadmill or walking on a stair climber or whatever it is. So I would think the numbers are pretty low. We spoke a little bit about this, but we have digital statistics that actually show people who have signed up to train with our programs, let's say either be at home or at the gym, the percentage of people that make it through our programs is only 20% and that's very high industry standard. That's twice the industry standard for digital. Right, right, which is usually like 10% or so. So those are people who showed the commitment, made a purchase, put their hard-earned dollars behind it, have everything they need, I would think in terms of the tools and sets and reps and what's supposed to be done
Starting point is 00:10:31 and only 10% will finish a program. So that's a pretty remarkable statement on why people can't. I think there's a lot more of a desire to do things, but the ability to actually follow through is where I think we're having a hardest time. So it might be then, Gabriel, your stat is 70% of 50, be the reciprocal of that, 30% of 50, 15. It might be that our range is somewhere from 5% to 15%
Starting point is 00:10:54 if I were going to sort of triangulate between these three data points. That's kind of a hard thing to digest if you're asking the question And I've never been shy about my thesis, which is of all the pillars that we have to embark on improving our health, whether it be changing our nutrition, improving our sleep, taking the medications and supplements that can be actually quite important. I just don't see any evidence that anything trumps exercise, just purely from an actual lifespan perspective and from the standpoint of reducing the risk of chronic disease. When you then layer in the benefits it has on quality of life, I mean, it's just sort of a no-brainer. So what do you think, Mike, I'm going to start with you because you've been at this the longest. What do you think explains the disconnect between the fact that we have this incredible tool that will lengthen your life, improve the quality of your life, make you look and feel better, and yet five, 10, at most 15% of people engage in it. What are the barriers? I think the biggest barrier is just life, lifestyle, kids, jobs, people thinking, you really have to commit to, is it? Is it
Starting point is 00:12:01 getting there early? Is it going there after work? Whatever it is, it's adding hours to your day. I think that's probably the biggest barrier. In some ways, I guess that's economic. People don't have the economic freedom to say, hey, I can devote. That's why I laugh sometimes when I hear people talking about hours per week of exercise and hours per week of cardio, I just kind of snicker in terms of if I can get someone to do two hours a week, so I like your guideline more of, I think you said 75 hard minutes. And I'm like, 75 hard minutes now is realistic. But even 150 minutes, some of the guidelines are crazy. And then there's a lack of awareness. You don't know you're losing the battle until it's too late. That's what we see in our business. We see people coming in and you think,
Starting point is 00:12:40 wow, thank God you got here now at 50. Thank God you got here now at 55 because the end for you was going to be bad. I'm not saying this to flout of you. I've been following you for a while. And you're getting the message out in a way that it hasn't gotten out before because the message before was geeky or nichey or whatever it was, but it wasn't this, hey, this is really good for you. And this is going to make you live longer and live better. It's double bonus, right? You want to live longer, but who wants a long, shitty life? Excuse me, I don't know if we're not supposed to swear.
Starting point is 00:13:10 We swear, don't swear. Okay, good, okay. But do you know what I mean? Versus looking at it and saying, hey, I would like to live longer. And Jeff and I talked about this, I've experienced 50 to 65, and trust me, it's not fun. The decline is rapid and the decline is significant. And I think if people, like, if you don't wake up by the time you're 50, you're going to be in real trouble by the time you're 65.
Starting point is 00:13:31 Gabriel, how much of a difference do you see between men and women on this front? Not from this standpoint, not from the economic standpoint, but from some other barrier to entry. Do you see differences between men and women who are new to resistance training? I do. And the first thing that I want to say is you're absolutely right. There's nothing more important for maintaining health and wellness than taking care of muscle health, whether it's strength training, mobility, resistance, but skeletal muscle health
Starting point is 00:13:57 is really what we're talking about. Where is the disconnect from men versus women or people in general? Part of it is cultural. We live in a society of comfort. It's very easy to take the escalator or take an elevator. When it comes to nutrition, we all have to eat, but we don't all have to move. I literally could sit at my house, order my groceries, Amazon Prime, everything, and I never had to take more than 300 steps. For women, typically strength and strength training, has not been the focus. And we know that. I mean, even just from a standpoint of walking to the gym, you're starting to see it more. I really do feel like we are on the precipice of women recognizing the importance of strength and muscle, especially with new conversations around menopause and more potent conversations. But they're busy. And the other aspect of that is there are self-imposed limitations. A woman would look at a 40-pound weight and go, I can't lift that. But she would look at a 40-pound toddler and go, I'm going to lift that, and then I'm going to carry my groceries.
Starting point is 00:15:02 I got it. And that's really where I think that we can change the disconnect is re-educating the importance of muscle and then also changing the cultural conversation. Obviously, you're really fit. Has resistance training always been something you have enjoyed? Did you grow up doing it or was something you kind of came to in your 20s or beyond? I grew up doing it. By the time I was five, I was riding 10 miles on a with the conversation around children, if we teach them good habits now, then we don't have to have them spend a lifetime outgrowing old habits because we're not raising children. We're raising adults. And yes, I have always trained. So I'm in the same boat, and I suspect that's true for all of us. And so one of the challenges that I know I have that's a bit of a blind spot
Starting point is 00:15:48 is when I'm talking to patients are perhaps representative of the real world, which is people who are like, I don't enjoy the feeling. I'm sure you've all heard this. I don't like the feeling of lifting weights. It hurts. I don't like that. I can't tell you how many times I've heard that. And I appreciate the honesty, but I can't relate. And it's hard when you can't actually relate to what your patient is saying. I can relate when they complain about having to watch what they eat, because that's a struggle I would have. But I truly can't relate to that. So do you think that that's a function of having started early? Or do you think that there are literally just, just as we have people with different eye colors and different heights, there are truly differences in genetic hardwiring
Starting point is 00:16:33 that would speak to an individual's appetite for that kind of discomfort? I actually think it's the latter. I think there are some people who are more inclined to enjoy that type of stress. It doesn't matter how much I run. I do not enjoy the stress of running. I don't enjoy how I feel. I don't enjoy the feeling I get in my lungs when I'm sucking for air. I'll do it. because I know I have to, there's no enjoyability about that. Training hard and lifting weights and pushing myself to the utmost level of effort, that's always been something I actually kind of enjoy. And I think that it can be learned, though, you can get better at it, just like I can learn the discipline to continue to push and run when I don't want to. So after doing it
Starting point is 00:17:12 for a while, when you start to see results, the results actually might become motivating enough to go like, well, there is a tradeoff here. I'm seeing the tradeoff. And I think that's what when we were talking about before, about people, the start being the thing that's stopping people is that the perceived level of what they're going to have to do is usually bigger than what they have to do. I've mentioned before, you can build a great body on six exercises, literally. The row, squat, deadlift, bench, pull up, curl, done. You've got everything you need. You don't have to complicate it. If you keep trying to get stronger at those exercises, now you might get bored to tears, but you can build the prerequisite foundation to get a better body.
Starting point is 00:17:49 but people want sometimes to complicate it in their heads so that they have an easier out because it makes it a little easier to say, yeah, I don't have time for all that. We liken it to, I've known a few people in my life who've wanted to start businesses. And they're like, I got this great idea and they're gung-holy, they want to do it.
Starting point is 00:18:06 And then they get caught up in. I don't know if I should set up an LLC or if I should do it as a corporation. I want to get my business cards. I can't figure out my logo. Right? They're doing all that stuff. And they never take the step
Starting point is 00:18:17 of actually just starting what their service is going to be. And they never get going. And I think people do the same thing in terms of fitness. They make it bigger and they make the commitment larger so that they can almost have a safe landing spot to be like, yeah, I'm just going to get it going. So it's our job to educate them as to how simple it can actually be, simple being what you need to do.
Starting point is 00:18:37 But I think the commitment to actually showing up and doing it, that's hard. Mike, what percentage of the people that walk into your gym are coming to resistance training for the first time? I'd say 50, if I was guessing. Some of them were high school athletes and have some basic relationship with strength training. What percentage of them are approaching intelligence strength training for the first time?
Starting point is 00:19:00 100%. So most of them are coming. We're going to party like it's 1999. People come in and they kind of look at us like, what are you doing? And I think that's where, when you were talking about people saying the discomfort, my first thing would be like, what discomfort? There shouldn't be any discomfort.
Starting point is 00:19:13 If you come in and start working with us, My whole goal I say to somebody, you should get out of bed the next day and be like, I think I worked out. I felt, okay, I always tell everybody, everything's gauged and if you get up in the morning and you're crippled, I suck. I did a really bad job. You should not be uncomfortable at all. This is slow and steady wins the race, one percent better, however we want to look at it.
Starting point is 00:19:32 And if we can just layer, like I always think, I'm a big attendance guy. If I can get you to show up two days a week for a year, you'll be remarkably different. And you might not have ever had balls to the wall or go to failure. We would have done none of that, zero. And yet, you would look at somebody and think, wow, like, if you came into our place, everybody looks younger than they do. I am 100% certain, not just of the longevity benefit, but about the physical change that people undergo.
Starting point is 00:20:00 Because I'll just show you people and say, yeah, that guy's an 80-year-old, two-time cancer survivor, and people would be like, yes? And I'm like, yep, they look different. And they all look different. They all look younger. Again, what is that? Is it hormonal? I don't, I mean, not a scientist.
Starting point is 00:20:14 I know that it works and I know that it doesn't have to be hard and it doesn't have to be uncomfortable. So let's talk about an example of somebody that walks in. So somebody walks in, they're 50 years old. Let's pick a male to start with. But we're going to do many case studies today, I think, because that's how people I think can sort of connect. My goal is to make sure everybody listening to this can identify with a person, theoretical
Starting point is 00:20:33 person we're going to talk about. So 50-year-old guy comes in. He's done a little bit of the trade at his health for wealth thing. He's been working himself to death. He's had some health scare. He went to the doctor's office and they told him, your blood pressure is really high or there's something going on. Or he's just sort of confronted his own mortality. He's lost a parent. That's a big wake up call for somebody in their 50s.
Starting point is 00:20:52 Played sports in high school. That was about it. So doesn't really do much of anything now. And somehow has landed himself in your gym. Maybe he saw Jeff on Instagram and he was like, that guy looks incredible. I got to do something. What he's doing sounds cool. So how do you interview this guy, how do you find out what his goals are, and then how do you create that show up attendance pattern that's going to make sure he can give you a year of whatever it is two days a week? The show up attendance pattern is a big thing, and that's, is a really good book called Never Lose a Customer Again. We approach our business much more like a restaurant. Unreasonable Hospitality, I think, is the Will Gradar book, and we try to train our coaches. We refer to them,
Starting point is 00:21:33 coaches more than trainers, way more in the customer service skill, because we realize that we want to get the person to come back. That's the goal. Get them to come back. Get them to get through the first workout and come back. We don't interview people a lot. I don't talk to people about their goals. I look at, I think your goal is to not be the sad sack of shit that you are right now, unfortunately, and we just want to get you going. So it's like, just get them on the conveyor belt and carry them through. This is the one thing, and one of the things I wrote in my notes, that CrossFit did well. They created community. You need to create community where people are comfortable. One of the problems that we had was people would say, I can't go there. It's all
Starting point is 00:22:07 athletes because they come in and, you know, just from a marketing standpoint, there's jerseys all over the place. And it looks like a place where athletes train, but 65% of our business are people like us. But just getting them to be comfortable in that environment and getting them to show up again. When we tell everybody, if you've got new people in your group, you should text them that day and you should text them the next day. How was it? How did you feel this morning? We're trying to build a relationship because it's relationship marketing. No like, trust, all the things that you read about, get them to know you like, you, trust you, want to come back, want to be part of it. And then we can take care of the training part, but the training part to me is relatively easy. It's the getting
Starting point is 00:22:42 that person to be consistent and to come. And all I call them check the box clients. I just want check the box clients. If you check the box, which means I got to Mike Boyles twice this week, you will get better. You will feel better. Say a little bit about the programming. The programming for us, very assembly lineish. I always talk about the idea that it's a recipe and not a menu. So no one gets to pick what they want to do. You come in, this is how the cake is made. in this order. This is what you get. Don't like it. Go someplace else. You know, go to Planet Fitness. You can make your own cake. You want to come here. You do it the way we do it. Everybody form rolls. Everybody stretches. Everybody does their mobility work. Everybody does dynamic
Starting point is 00:23:20 warm-up. Everybody throws medicine balls. Everybody does some sort of power training. Plyometrics, not really actually, some sort of jump training. Then they'll go and they'll lift. The lift takes 36 minutes and then they'll go and they'll do some type of conditioning work and we'll start really really again really easy try to give them something that's very achievable don't get them particularly tired and then boom out the door they're in and out in an hour hour door to door yep okay 36 minutes of that is the actual resistance training but obviously everything that's leading up to it and on the back of it is i mean that's clearly training as well right right i think honestly for the older client more important we always talk about the first 15 minutes is more important
Starting point is 00:23:58 getting people to roll, to stretch, to start to deal with their tissue limitations, because most everybody that comes in has something. No one comes in healthy. No one comes in and thinks, so I have nothing that hurts. Progress is made by advancing weight, advancing reps, advancing sets, jumping higher. Mostly by advancing weight. I mean, if you're going to look at it the simplest way, it's just try to get them, because again, females, right, you're just trying to get them to engage in progressive resistance. I always think what someone said, I've been doing the five-pound dumbbells for the last year. I'm like, oh, you only wasted like 50. weeks. Our thing is just get them to pick up something that's a little heavier. We try to figure
Starting point is 00:24:33 out ways, could be isometrics, could be eccentrics. We try to vary it because with our adult clients, we're in the entertainment business a little bit in terms of we've got to keep it interesting. Like you said, you can do six exercises, but we have to figure out of there 14 different versions of those six exercises that we can do to keep somebody not thinking they're doing the same thing over and over again. If we get one complaint, it might be that we do the same exercises a lot. It's kind of like, yeah, because we do the good ones. but our adults don't touch a barbell. Okay, I was going to ask you, are there any things that are off limits?
Starting point is 00:25:03 They don't barbell bench press, they don't barbell deadlift, they don't barbell squat. No one squats anyway. That's another whole conversation, but almost all of our lower body stuff is unilateral. We'll do goblet squats, basic stuff with people that are really deconditioned because we need them to be capable with two legs before they're going to be capable on one leg, but people were really smart and really safe. And I think that's what you want to be if you want to keep people coming back. I think you can be really smart and not be really safe and you can be really safe and not be really
Starting point is 00:25:30 good. The midground is where we want to operate. So Gabriel, what's the biggest thing you're thinking about when a patient is in your practice? And they're coming along well on many of the other lifestyle adjustments. Let's just assume this is a person who's a lifelong cardio rat. So they love to run. They run two marathons a year. They've been running forever. They've got some nagging injuries, though. As you know, a runner, especially a female runner, the probability that her proximal hamstring isn't just torn up is pretty low, especially if she's had kids. So now her pelvis is tilted a little bit. How do you make the case to her? Because she's lean. Doesn't need to lose weight, as though that's the thing that matters. How are you making the case to her that this
Starting point is 00:26:15 muscle-centric approach matters? Well, she's going to want to be active her whole life. And the healthy her skeletal muscle mass is. There seems to be somewhat of a disconnect. People talk about strength and then disassociate it from mass. But I believe, you know, and I have patients like this in the practice that are very lean, have always been runners, but we'll see their glucose creep up. We will see an increase in visceral fat. That can be course corrected by addressing skeletal muscle mass. when you just think about if this woman, I'm thinking about one patient in particular, she's around 60, she runs 100 miles. She's an ultra. Her body composition was not nearly as good as it is now just by adding in two days a week of resistance training. We added in two days a week. We pulled back on some of the mileage. She's able to move more weight. I mean, in this girl, hey Sharon, she listens to your podcast, as a matter of fact. She is incredible. By pulling back her training and increasing her weights and being very specific about, obviously, I don't program, but we work with coaches that program.
Starting point is 00:27:27 By changing up the movement patterns, she was able to really increase her lower body strength, but also improve her labs, improve her fasting insulin, her glucose, and her triglysteroids. And so do you think that that's purely a function of having a larger reservoir to put the glucose into? or do you think that it also speaks to the insulin sensitivity? Does it even make sense to try to disentangle those two? I think that the larger reservoir is important for a number of reasons. The metabolic component of muscle, as we all know, muscle is the primary side for glucose metabolism, also free fatty acids at rest. However, it enables her to have more dietary flexibility. Because when we think about nutritional sciences and we think about triglycerides, insulin, glucose,
Starting point is 00:28:14 what we're really looking at is the health of skeletal muscle. Metabolic syndrome, the markers of metabolic syndrome are the markers of healthy skeletal muscle. Does it her activity improve insulin sensitivity? Yes, but her running is she's going to be very insulin sensitive as is. But it's really that metabolic component of having healthy skeletal muscle mass from what I believe. So, Jeff, you're working with people a lot of times at the opposite end of the spectrum. people are coming to you often because they want to have 7% body fat.
Starting point is 00:28:47 And it might be that they're an actor and they're about to do a role where they kind of have to look a certain way. Alternatively, it might be an athlete who probably doesn't need to be at 7% body fat but might want to be at 7% body fat. So you're kind of dealing with the other end of the spectrum. Is it safe to say that these people that are coming to you are so long on motivation that that's not really an issue anymore? When your goal start to become 7% body fat, I'm assuming that you're probably not
Starting point is 00:29:13 35 or 40 with aspirations to be there. These guys are usually coming in 12, 13, 14, 15% body fat, desires to want to get leaner for whatever those reasons, like you said, whether it be a role or I always tell the athletes, they have to be very conscientious of not falling in love with what they see in the mirror because ultimately they're not getting paid to look that way unless they're, I mentioned sometimes we work with WWE athletes who do get paid to look a certain way and perform at a certain level, but the people that have to be conscientious of what level of biofat they are so that they have a certain role, I mean, they are usually pretty good at being able to dial in. They've oftentimes done this multiple times before, too,
Starting point is 00:29:53 so they've done this and had a history of being able to get down there. They just don't have ability to sustain it. I think that it's always going to be achieved through nutrition. That level of look is a nutritional consistency. It has nothing to do with training. It has nothing to do with exercise you're doing, doesn't matter what split you're following, it doesn't matter any of that. All you have to do is be able to remain very consistent with nutrition. And the level that you're able to get down to is just a reflection of how many sacrifices you're willing to make. You want to still drink a couple times a week? That's fine. You're going to have to bump it up a notch or two. Because you really need to be able to make some cuts. Now, I do not believe, I don't do it myself. I do not make sacrifices to
Starting point is 00:30:33 to the point where I'm eating boiled chicken and broccoli, steamed broccoli. I don't do that. I eat meals that are good meals. You saw what I eat. I can eat a meal that anybody else can eat. But I'm very disciplined and not straying from those meals. And so your ability to kind of stay that way is going to determine how low you're able to get and how low you're able to stay. I always say if you're eating, let's say five times a day and that's a seven-day week, it's 35 meals. If you can stay 90% or above, you don't have to be perfect. If you could stay 90% or above on those meals, you're looking at three meals in a week that aren't perfect. Now, I'm not saying to go hog wild and go down to Buffalo Wild Wings and start eating everything you can't, saying that
Starting point is 00:31:11 they just aren't perfect meals. Your body almost completely ignores those. It just overlooks it. You keep going and the consistency overrides that and you're able to get to levels that you weren't able to achieve before. But people can't sustain it because either they make it too difficult or, as I said, it is actually difficult because getting yourself to the gym, for one hour, five times a week, two times a week, whatever that might be, even the 36 minutes. That's one level of commitment. It's what you do in the other 23 hours of the day that determines your look because that is the nutritional responsibility that a lot of us don't have the ability to manage well. How well do you think that's understood? I mean, I'd say that for all of you.
Starting point is 00:31:52 This is a question for everyone. When someone looks at a person and says, look at that man, look at that woman, look at how jacked they are, do you think that the average person of appreciates the role of nutrition in that? Or do you think most of them assume that person must be spending 12 hours a week lifting weights? And sorry to jump in, but it's such a sore spot for me. People always think exercise first. In my experience, they always think exercise first to the point where I have people that will say to me, if they see my abs or something, they'll say, oh, what exercise did you do for that? You know, they pat there. Usually it's big belly that they're patting. It's not an exercise. I did less of this exercise. I did the reverse curl. Fewer sets of
Starting point is 00:32:32 that more of these, pushing yourself away from the table. No, I don't think they have an appreciation for it at all. Their instinct tells them it's exercise, this movement. Would you guys share that sentiment? I would totally agree. And what's so fascinating is the data supports also the synergistic effect of resistance, training, activity, and a calorie control diet, which people could connect the dots that it is not simply training. But to be fair, training is the most potent stimulus to muscle, but you cannot, what do they say? You cannot out-train a bad diet. That's true. I feel like you could when you were 14. When I was 14, I did train six hours a day. I mean, I was running 13, 15 miles every morning before my workouts. And all I did was eat, but I was like
Starting point is 00:33:24 a garbage disposal. Breakfast was a bowl, not a bowl, a box of fruit loops in a large Tupperware bowl. You could put the whole box in the, it just didn't matter. But something changes when you're 20 and you can't do that anymore. When you're 13 and younger, you're very anabolic. The balance between what drives muscle changes as we age. When you're young, you're very driven by insulin. For example, my daughter, who is five, she could have five grams of protein. She doesn't need to have a meal threshold of 30 to get an anabolic response.
Starting point is 00:33:55 Because when you are younger and you are still growing, you're very anabolic. After you are done growing, you want to shift from the insulin usage to the stimulus, which then now exercise becomes much more important. Oh, I want to talk about that. So I'm going to come right back to that, but I want to hear Mike's point on nutrition and then come back to that because that's actually a very interesting question. I think about it in a simpler sense. We go from being extremely active to extremely sedentary.
Starting point is 00:34:24 Suddenly you get into your 20s and you get a job and you're commuting and maybe 10 hours. You might be sitting on your ass. 10 hours a day, every day. And then you might go to a bar with your friends after. And I don't think people sense the shift. They think our problem is that the shift is happening and then people don't pick up on it until it's too late. Suddenly you look down at yourself and think, oh, my God, what happened? I gained 40 pounds and I'm in horrible shape and I'm completely sedentary. Then they think, oh, I have to do something about this, but then they tend to revert back to whatever information they might have had and think about what's your relationship with exercise in high school. If
Starting point is 00:35:00 you're not an athlete, you have a terrible relationship with exercise in high school because it's something that you made to do. It's not fun. He probably don't understand strength training. You go to the gym. I saw a great presentation one time at a seminar. I forget someone did it in New York and they brought in. They said, I'm going to bring in the most important person in fitness. And they brought in a woman who was a member and had her do a half hour talk. And she talked about just having the money to join the gym and learning how to train. She said, I followed this pretty girl who seemed to know all the machines around. She said, and I would stay like two machines behind her. So she didn't realize that I was following her, but I would watch what she did. And then
Starting point is 00:35:34 she'd move two more machines, and then I'd do what she did. And then you just realize, like, this is how people are learning. We all learned to exercise somewhere along the way. Somebody created kind of that initial imprint on us. And most people's initial imprint is really bad. What I learned to do when I was in my teens was just moronic in terms of the way I would look at it now. I would tell everybody. And that's why I say. The reason I say the things that I say is because I've done everything conceivably wrong that you can do, and I have all the orthopedic maladies to show for it. What do you guys do?
Starting point is 00:36:07 Do you guys have nutritionists in your business that also help people when they're also trying to lose weight in addition to improve strength and other metrics? We've tried a whole bunch of different ideas, and none of them have ever really stuck, to be honest. We still have another one going right now. One of the guys that works for us is trying to do nutritional consults. And truthfully, we've never found one that we felt real. really was sticky that a lot of people would do it, but we deal in the most basic nutritional
Starting point is 00:36:33 information that we can with people in terms of, hey, we want you to hydrate better. We want you to eat more protein. That's why I said, that's why your message is great. Like your book is perfect. It's like, okay, if we can just get people to eat, not even more protein, never mind eat protein. We still have people say, what's protein? Adults who don't really even understand.
Starting point is 00:36:51 Again, we're so sometimes up here and then realizing that our consumer is somewhere, even our intelligent consumer, is way down here with these. incredible, you said disconnect, I had disconnect written down, incredible disconnects, incredible misconceptions. I have women, well, I don't want to start lifting because I don't want to get too big and I'm kind of like, trust me, buddy, that is not what we're worried about right now. I'm still trying. Right, exactly. You're trying like, hell, and you're up whatever, 125 pounds or something like that. 10. 110? You're killing you, but you know what I mean? You're killing yourself in the gym to build muscle. It's not easy to do. It's not easy to do for anybody.
Starting point is 00:37:23 It's not easy to do for males. But we see too much steroid use. And then we see too much. responders, like you look at NFL guys. I mean, I think there's people that are way higher responder levels than other people. And I think we look at responders or we look at, like, when I was a kid coming up, I was looking at people taking drugs, but I didn't know they were taking drugs. I thought I could look like, I can remember, I'd go to bodybuilding shows. I can remember looking at Boyer Co. I'm thinking, I can look like that. And Frank Zane, I can look like that. And then suddenly in my 20s realizing that these guys were taking drugs and that was why they looked like that. But I spent years frustrated. Why don't I look that good? I'm doing all the
Starting point is 00:37:57 right stuff. So I think that's why these things are good, trying to get people to see reality, I guess. Jeff, you talked a minute ago about five meals a day. Double click on that a little bit. Most people think, I thought I'm only supposed to have three meals a day or sometimes just one if I'm intermittently fasting. So talk about the five meals per day. I know a lot of people that are intermittent fast and actually do well with that. The thing that I think why more people do better with more frequent meals is simply because they tend to get hungry throughout the day and they don't have good management of hunger and then they're for portion control and they don't have willpower to sort of wait to that next meal. If they are hungry in the mid-morning and they have
Starting point is 00:38:38 nothing pre-planned or prepared for a snack, they'll just go into the kitchen at work and just start picking and grazing and that's where a lot of the calories throughout the day are consumed, not in those three main meals, but in the grazing that happens because they can't make it to the next meal. So I just found that it's been easier, especially from the athletic world, these guys want to fuel more often, so they want something in between their main meals. But in the world of just the regular individual who wants to be more disciplined with their nutrition, it's easier to actually program in to additional snacks, nothing big, but just snacks in between that I always think should still focus and center around a protein, because again, I believe that protein should be the cornerstone of every one of our meals and snacks because we don't get enough. that's enough just to keep somebody, A, probably more metabolically stable to get to the next meal, but also it starts to teach them the willpower to do it. So if you're sitting there, you ate breakfast is 8 o'clock, and then now your next meal is at, let's say, 12 or 1230, when it's 10 o'clock,
Starting point is 00:39:41 if you get hungry and you have a snack there, you don't have to get through four hours of willpower that you don't have right now to get to that lunchtime. You only have to get through two hours. And of those two hours, you weren't hungry the whole time anyway, only the last half hour. So you're teaching yourself willpower over the course of an hour and a half. I actually have dropped back a little bit to where I'm not necessarily doing five meals in a day. Now I'll maybe do four, but I have easy willpower. Walk me through a day in the life for you. Not on a day when you're here and traveling. So you're at home. Your first meal is what time? It depends on weekend or not, but usually 7.38 o'clock. And what is that meal? Usually it's oatmeal, egg whites. My oatmeal, we call
Starting point is 00:40:19 pumpkin oatmeal. Like it's oatmeal, it's walnuts, it's flinda brown sugar or brown sugar if you don't care about the calories in it. Whip cream, put whipped cream on top. Pumpkin I mix inside it. It's good. Like it tastes good and it's something that I actually enjoy. If it wasn't, I could never just eat boiled oatmeal for the rest of my life. And then egg whites because you're just trying to cut the calories? You want the protein without the total calorie of the egg? Yeah, although I'll mix in like just at the hotel here, I'll eat eggs, just the prepared eggs because they're there. Because I have my egg whites and I keep them frozen egg whites. I don't have, like I don't want to start cracking full eggs to put it into. I'm a little bit simplistic when it comes to my nutrition because I know
Starting point is 00:40:55 what works for me, but I have no problem with mixing one or two full eggs. I think you should, people should. And then I'll have milk with that or I'll have protein shake along with that. So they're not small meals either. That will take me through now I'll actually go to lunchtime. In the past, I would have another small snack. I'd have some pretzels and jerky or something. like just again some protein and then some carbohydrates then i'll go to lunch time at lunch i'll have either it's funny because i'll either have a grill chicken wrap with vegetables and yogurt that would be my preferred meal some fruit that would be my preferred meal or i'll have cereal because i am still a cereal addict and we have lots of cereal choices but i try not to choose the cinnamon toast crunch
Starting point is 00:41:38 that my son prefers and i'll have something else but i'll have cereal and yogurt how much protein are you getting in that meal then? I'll have usually protein shake there too. So I have my protein shake. That's 30 grams plus the yogurt, another eight to 12 grams. And then in the cereal, a little bit more milk too. So I get enough protein from the meal. It's just a little bit less preferential in terms of where the carbs come from. I don't really get crazy about the carbs. I just try to pick lower sugar carbs. I try to be a little bit more selective when it comes to that. And then you do an afternoon snack around three? Then afternoon snack would be the same type of thing as whatever the first was, I like jerky, so I'll have some jerky, just pick at it. And again, some type of
Starting point is 00:42:18 crunchy food, just like a pretzel. It would be easy for me to have a handful of pretzels. Then I will have my dinner. Well, actually, before that, I have another protein shake after I train. So if I train. And you train in the afternoon, typically? Randomly, I'll train at five before I finish up work, randomly. But most often than that, I wind up having my shake, and then I'll go train at night, like late, late, late at night. I think we have an input into the sleep issue. We do have input into the sleep issue. But I'm not having it.
Starting point is 00:42:46 I could fall right asleep after my dinner. The issue for me is that when I get home, my kids have been waiting to see me all day. I make myself available to them. We play, we run, we go on the pool, whatever it might be. And then they go to bed a little bit late. We have a busy household, so four dogs. It gets a lot to put everybody down. But they go to bed around 9, 9.30.
Starting point is 00:43:06 And then when I finally get to the gym, it could be 10.30. So now I'll go and I'll train. I don't like to train on full stuff. stomach. I hate the feeling. So I'll opt to have my dinner afterwards, but that does mean that the dinner could come at 11.30, sometimes even 12 o'clock at night. And that is not recommended for everybody listening, but like I also do think I could dispel the myth, though. I do not believe in the don't eat after six at all. I don't believe in that at all. Your body, especially if you're carrying a good amount of muscle, which is why we want to, can utilize those calories, can utilize
Starting point is 00:43:37 that protein, can utilize those carbs throughout the day, provide whenever they do come in, And I don't think that just magically eating after six is the death knell to having low body fat. That's not part of my equation. The only part of the equation for me is I could get, like, it's a little late in the day to be eating there. Yeah, it might be impacting your sleep more than anything else. It's clearly not impacting your fuel partitioning. No, and I've been blessed to have the ability to hit the pillow and fall asleep
Starting point is 00:44:01 within minutes and stay asleep because I don't sleep very long. I sleep five, six hours, five to six hours, but my quality of sleep is usually very high. I don't wake up. I don't wake up at all. I wake up when the time to wake up in the morning. So I want to kind of go back to what you were talking about a second ago because it opened the door towards protein in kids. But before we do that, maybe just for people listening who have been maybe not paying attention to some of this stuff, we've all been talking about elsewhere around protein consumption. What type of guidance are you giving your patients on protein? Is there any difference between men and women? And are you differentiating it based on age?
Starting point is 00:44:37 Age, yes. Men and women, no. When we talk about protein, typically. we talk about one thing, but it's 20 different amino acids, nine of which are essential. We actually eat for those nine essentials. There is a lot of nuance around protein in general. Each of those amino acids do something different. For example, Lusine, which is I know our favorite amino acid, is critical for muscle, for muscle protein synthesis, but something like three-nein is important for mucin production in the gut. I suppose I should start with why are we eating protein? we need about 250 grams a day. We recycle, much of that, we don't eat that. A portion of that,
Starting point is 00:45:18 probably the largest portion, maybe 75% of that goes towards visceral tissue for turnover and maintenance. Maybe 25% of that goes to muscle. But we have to continue to get these essential amino acids so that we can maintain rebuilding and repairing, which the efficiency of that changes as we age. Anabolic resistance, protein efficiency decreases. That is one reason why we need dietary protein just to maintain the tissue integrity and the structure. Women and men do not need at this time from what we know in the literature a different amount of protein is not sex specific. It's body weight specific. The minimum amount of protein I would ever recommend would be 100 grams at a minimum. men or women, that would be the starting place. Because if you are, say, a 115 pound woman and you are
Starting point is 00:46:11 following the RDA at 0.8 grams per KG, what is that? Forty-five grams of protein or so. That's not enough. Part of the failure there is that we have to recognize protein is different amino acids. And so when we talk about muscle health, we need to get enough leucine to support muscle health. And And that is probably the recommendation is two to three grams a day. It's probably for optimal health around eight or nine. How do you get folks to think about that? Because now all of a sudden you get into dramatic differences in terms of protein source. I don't really think we should go down the PDCAS pathway necessarily for everybody today. But just in terms of understanding that foods are created different. So you can look at an ingredient label of something that says
Starting point is 00:46:53 30 grams of protein. You can look at another thing that says 30 grams of protein, but they don't list out the amino acids. They don't tell you that this one has more lucine or more methionine and this one doesn't. But there are certain themes that we know. We know that dairy-derived protein, beef-derived protein, and egg-derived protein seem to have the highest amount of the right amino acids, or let's just say the more important amino acids. So when you're saying to that person, hey, I want you to eat a minimum of 100 grams per day, does it come with the caveat of assuming you're getting your protein sources here? What you're pointing out is protein quality.
Starting point is 00:47:31 There are plant sources of protein and there are animal sources of protein. And just from hard-fast biological numbers, we consider a high-quality protein to be eggs and dairy, fish, chicken, any of the animal source proteins. The lower-quality proteins would come from plants. When we educate our patients in the practice, we have them choose. and we really don't focus on plant proteins as a source of protein. While they do have amino acids and certainly a combination is wonderful, we like to focus on plant foods for fiber. Let's say we take out soy, but we really want to focus on high quality animal source foods because, listen,
Starting point is 00:48:11 it makes up, let's say makes up 30% of our diet, nearly 100% of our calcium, our bioavailable iron and zinc, selenium, come from these animal-based foods. And while we talk about Protein, we should also talk about nutrient quality. Whether someone decides to get their protein from plants or animals, it isn't just about protein. It is also about those nutrients of concern. For women, like bioavailable iron, for kids, bioavailable iron, nutrients that primarily come from animal sources. I just think are really important. And again, nothing wrong with plant-based proteins, but we eat plants for fiber and phytonutrients. Presumably you have some patients as I do who are vegetarians, and in some cases it's ethical, religious, whatever
Starting point is 00:48:57 the reason is. What are some of the things that, and let's go one step further and let's go, most vegetarians will at least be able to consume the dairy portion. But if you have someone who's vegan and who is purely looking at animal sources of protein, how much of an uphill battle is that? The challenge is the carbohydrate consumption. So I was listening to what Jeff was saying and he was absolutely right. You were saying that you have maybe 100 grams of carbs and you have no problem with it. I mean, you probably calculated it in your head, but yeah, I can do that, yeah. For someone like him who is super active, he is able to dispose of those carbohydrates, but a normal person, our carbohydrate threshold, if you calculate the disposal from skeletal muscle,
Starting point is 00:49:35 organ systems, it is not much. It is about 40 grams in a two-hour period. Anything above, say, 40 or 50 grams in a non-exercising adult will result in a robust insulin response. We do not want that. We do not want to be utilizing insulin to help support glucose. We want to use activity or have the health of our skeletal muscle be able to balance that. And I suppose what we're talking about is carbohydrates. And unless you are highly active like you are, then we also have to think about the carb portion of this. And designing a diet, typically for us, we think a lot about a one-to-one ratio of protein to carbs at a meal depending. Yeah, which is, let me think about that in myself. That's pretty tough. You have to be pretty deliberate about withholding carbohydrates. I
Starting point is 00:50:24 mean, I'm probably eating a gram of protein per pound of body weight, so it's not like I'm skimping on protein. But you're metabolically healthy. And that goes back to this hierarchy of how we determine protein. I think you have a longer leash if you're active. Absolutely. When we make protein decisions in the practice when we're designing a diet, it's age, it's activity, and it's metabolic health. If you are metabolically healthy, then you can tolerate, there's no problem. herbs aren't the enemy. But once we find out someone is metabolically unhealthy, which you can see from blood work, you don't change your protein amount. Because as you restrict calories, you keep protein the same or higher because you must protect lean tissue. And also, it's better. I mean, we've
Starting point is 00:51:05 seen this in the data. What about overweight patients? Let's say you have a patient who's, let's say it's a man, 250 pounds. And I know we're going to talk about body fat, because I'm actually super interested in what you have to say about that. But let's just assume you do a DEXA on this guy. You don't need to do a Dexa, by the way. You can look at him. You know this guy's carrying way too much fat. But the Dexa just gives you some numbers. The guy's 40% body fat. So when you're trying to tell him how much protein to eat, are you doing it based on an ideal body weight? Or are you doing it based on his 250 pounds that he's carrying around? His target body weight. Okay. So you're going to say, I'm targeting for you 16% body fat. Let's calculate how much lean tissue you have. What would be your ideal body weight at 16% body fat? And that's what we're going to target you at. Yeah. Okay. I want to totally pivot and talk about something that you already brought up, Mike, and this speaks to how these roundtables get totally messy because I am not done with nutrition.
Starting point is 00:51:57 I want to come back to it. But I don't want to forget this idea of unilateral lower extremity training. So this is a topic that's near and dear to my heart. So I grew up, and apologies for people in the audience who've heard me talk about this, but this is just context for you. I grew up, powerlifting was one of the things I did on the side. It actually wasn't a sport. I mean, boxing was my life, but I became hooked on being in the gym.
Starting point is 00:52:16 and the gym I belonged to was a dungeon. It was an old man dungeon, two stories underground with no windows. And I didn't realize how lucky I was at the time, but this happened to be like the powerlifting epicenter. So you basically just had a bunch of middle-aged men who were machines. Everybody could bench press two times their body weight, squat, three times their body weight, deadlift, four times their body weight. That's what I grew up doing.
Starting point is 00:52:40 I was like, we bench, we squat, we deadlift, and we do it really, really heavy. Not surprisingly, over time, I started to get injured. I injured my back by the time I was in medical school and kind of decided, I don't know if this is worth the risk anymore. Like I don't really see that I need to have four plates on my back squatting anymore. And almost through necessity, had to discover single leg training. So I want you to say more about that experience. Help somebody, because I have patients who really can't believe that you can achieve optimal lower body, hypertrophy without a barbell on your back or without picking a barbell up off the floor. Yeah, which is amazing. Same background as you, I got into competitive powerlifting in college because I was no longer an athlete and I was looking for an outlet and it was like, okay, I'm good at lifting weights. So started competing in powerlifting, started hurting myself, back problem, shoulder surgery,
Starting point is 00:53:35 athletic training background, get to college as a strength coach, start to see the same things. I've got athletes with back problems. Everybody's back problem seems to come down to one thing. back squatting. Every kid. During one deadlift, we were the old school like squat bench power clean because that was the football mentality at that time. But the people with back pain, it always related right back to back squat. We started to look at that and think, okay, if we're doing something that we know is hurting 20% of our population, should we continue to do that?
Starting point is 00:54:03 For a while, we had to because the football coaches mandated it. But when I got to the point where I was kind of fully in control, I said, we're not going to do this anymore. And then we went the unilateral route. Sorry, when you say football coaches, are you saying even at the level of the NFL? At every level, the football coaches, they want to know how many guys can bench press 400 pounds and how many guys can squad 500 pounds. It's still a very old school mentality. It's getting better. NFL level is getting much better. Is the bench still in the combine for anyone but a quarterback? Everybody's still benching and still benching in 225 as a strength test. They do an endurance test for strength. We could talk about the foolishness of the
Starting point is 00:54:35 combine too, but that's another. The same combine that you helped develop. The same combine that I help train people for. Yes. I always tell people it's like getting a copy of the SAT and all you got to do is cheat. You got to practice the event. Practice the questions. You know the answers, practice. You'll get good at it. We developed that thought process. But we started going just down this unilateral rabbit hole. But then you start getting into the biggest thing that people have to understand is when you get into the bilateral deficit research, you're stronger on one leg. You have more strength capability on one leg than you do on two. It's so interesting, sorry to interrupt you, Mike. It's so interesting how difficult it is to appreciate that when you're not doing
Starting point is 00:55:09 unilateral exercises. People don't try it, and then it's very dogma oriented because we've all grown up around the squat poems and all these things about, you know, King of all lifts and all this bullshit that people spout, and I'm always spouting the anti of that. But the reality is we started seeing when we first started testing is what happened was one of my assistants, this guy, Jeff Oliver, who's been at Holy Cross for 25 years, said to me, if we could test one-legged strength, would you stop squatting? And I was like, yes. So then we said, okay, let's try to figure out how we test. So we started making up these half-assed one-leg squat test, you know, doing rep maxes in different split-squot variations and things. But when we did it, the results blew us
Starting point is 00:55:48 away in terms of... The difference between sides blew you away? No, the ability to be stronger than we were, or as strong as we were bilaterally blew us away. So we had guys, the first year I did it with my hockey team, 2000, maybe six or seven somewhere in there. Everybody could split squat what they could front squat. Same amount. So if I did a back split squat test, Everybody that could back split squat 300 pounds was a 300-pound front squatter. Everybody that could back split squad project out to a 400-pound max was a 400 front squad. Right across the board, it was exactly dead even, one leg to two legs.
Starting point is 00:56:21 And then people would say, that's because they're using their back. Like, they were trying to come up with all these rationales for why it wasn't. But the numbers were just glaring. Then we went to a split-squat test, and we had one kid who did 240 pounds for 20 reps, which, you know, if you bilateral did out, it's 480 for 20. He's a 200-pound hockey player, 190 pounds. hockey player. The numbers started to smack us in the face a little bit. And then you start looking at the bilateral. Like, you look at the grip strength research, bilateral deficit. Right
Starting point is 00:56:47 hand plus left hand will be more than combined two hand. He's done it with leg extension. They've done it with a bunch of different things. And what they realize, I think this is my own theory, but we neurologically know that we are unilateral. If I said to you, try to dunk a basketball, I'm going to guarantee you right hand. I'm going to jump off one foot. You're going to jump off your left foot. You're going to hold the ball in your right hand. Everybody here is going to do it except 10% of us are lefty, so 10% of us are going to grab it in our left hand. But everybody knows, if I say to you throw a baseball, I always say to somebody, if I say throw a baseball, everybody knows how to throw it.
Starting point is 00:57:17 If I say throw two baseballs, somebody would think, I'm not really sure how I'm supposed to do this right now. We understand neurology and then we deny it when we start strength training because we want to deny it. And I think it's actually limiting. I think I've said to people, I think I spent a lot of time probably making people less athletic. You think that you did that in the past? In the past, yes, because we had some of our super elite NFL wide receiver type guys would be very resistant to really heavy back squats and
Starting point is 00:57:45 deadlifts and things like that. And they would always say, were like cats. I don't like it. I don't like it. It makes my back start. I don't feel right. And what you realize is you were probably dampening their nervous system a little bit because the analogy I always use, if you think like the mountain, the guy from Game of Thrones. He was an Icelandic basketball player, decent, mid-level Icelandic basketball player. When he became one of the world strongest men, he was a worst basketball player. And I can remember, I used to go to powerlifting meets and I'd look at the powerlifting meets and I would be like, nobody here looks athletic. No one. And then I'd go to an Olympic lifting meet and I'd be like, ooh, these cats are athletic. They can jump and they can sprint
Starting point is 00:58:18 and they've got big traps and big asses. So they looked more like what I wanted my athletes to look like. Whereas power lifting, it was sort of like a semi-mobile refrigerator imitation, you know, just people lumbering and even little people lumbering around. A little people lumbered just as bad as the big people. And then you go to a track meet and go watch the sprints and the jumps and you're like, wait, that's what I want. That's what I'm trying to get everybody too. So I became a big Charlie Francis guy in the 90s. You start looking at this and saying, okay, let's look at how the fastest people in the world, the people that jumped the highest in the world, what are they doing for training? And again, you started to see more unilateral work, unilateral plier work, unilateral
Starting point is 00:58:54 plire work, unilateral strength work. So it was sort of this rabbit hole that I just went down and never came back from. It's interesting. Charlie Francis, of course, a lot of people will sort of just have a negative thought associated with him because of the association with Ben Johnson, but I don't think a lot of people realize his coaching genius. Can you say a little bit more about Charlie, who sadly passed away, I think due to cancer, kind of young, right? Yeah, kind of young. Luckily, one of the guys I said, someone said, anybody you never met in the field that you would have liked to have met. And I said, yeah, I wish I had met him at that time. But when you think about he developed world-class printers in Canada, almost all of them from Toronto, greater Toronto area.
Starting point is 00:59:33 The probability of doing that is really, really low. And so you think, and he was so far ahead of his time. If you read Charlie Francis' training system right now, it was originally published as Charlie Francis training system. Then after he got in trouble, they republished it as training for speed. So it's the same book. You can just get it on the internet. But he's talking about recovery, regeneration, massage. This book was written in the 80s. You would read it right now and think, my God, this thing was written a month ago. He was using words that I hadn't even seen yet. It was the first time I encountered even the word.
Starting point is 01:00:02 That's what we started to do massage work with our athletes. That's where we started foam rolling because we realized we can't get massage done for every single athlete, but we can get everybody to foam roll. And he was always talking about tissue quality and tissue resets. And they would bring therapists to training camps that they were doing. And it was so forward thinking. I mean, imagine. because now, well, 45 years ago, right, I guess, 35 years ago, whatever it was.
Starting point is 01:00:25 It was a long time ago, and he was so far ahead of the field, frighteningly, to the point where it's still encouraged people to read his stuff now. I started reading. I read everything he wrote. I read Speed Trap, which was more about what had happened to them in the process. And then I read this, Angela Sajenko, who was one of his sprinter, just wrote a book. I read that book. I just read every thing I could consume about Charlie Francis to see, you know, is there another
Starting point is 01:00:47 little nugget of something that I'm missing? I guess from the track and field thing, I never looked back. I never looked and said, I don't care what power lifters are doing. I don't really, I care what Olympic lifters are doing. I really athletically, and then we started to look at rehab, and we realized that from a rehab standpoint, it was all unilateral, and it was all what they were calling functional, and it was all what they were calling closed chain. And suddenly, to me, it all made sense.
Starting point is 01:01:09 It all came together for me at that point in time. So we've been doing that for 30 years. So, Jeff, in your world training people the way you are, what are the exceptions to those rules for you? When are the times when you're saying, or are you saying, no, I still see that the risk-reward trade-off for someone in a certain position is there for a barbell back squat or a sumo deadlift or something like that? How do you think about that? I think that there's always the argument of, see, a lot of times, especially in Mike's world, too, when people come to him, they've already learned bad. mechanics for squats. So they're bad squatters when they come to them. So they're already demonstrating habits that are going to totally break down their body by continue to just pile
Starting point is 01:01:54 more and more weight on. I think when you can intervene with somebody in an early age and teach them biomechanically how to squat better, which Mike and I have discussed before at length, it's not easy to really dissect that lift. It's a complicated lift. There's a lot of moving parts. So you have to be willing to spend a lot of time with that person to teach them from the ground up. In those instances when you can, I think you could probably teach somebody how to squat more safely. That doesn't take away the fact that if you can do it and not have to load that way, and especially as we talk about the aging population, then the benefits might still outweigh the risks in terms of it's just better to single leg squat. But I think that you can probably teach that
Starting point is 01:02:32 lift, but you have to be willing to teach that person to either unlearn the bad things that they've already learned or if they're starting out early, learn how to do it more properly. And you could do it in stages too. You can, by squatting to a box, you can biomechanically fix a lot of people's issues because having the target or the safety net behind them is enough to sort of get them to actually move in a better way. But you don't want to train that way without ultimately going to a freestanding squat if they're going to be ultimately playing sports and needing to do something like,
Starting point is 01:03:02 let's say, an offensive lineman coming off the line. But again, I'm actually in Mike's camp in terms of the value of single-a training. We do so much single-a-training with athletes. X because I believe that it's not just the unloading that we get from the single leg squat. It's just, as Mike said, how we're wired, how we're actually preferred to move. And I took some shit along the way because anytime you pick up a leg from the ground, it's functional training. And then all of a sudden, that was a cool thing at one time.
Starting point is 01:03:30 It's not a cool thing anymore. But you do pick up your leg. And yes, that's functional for a reason. So I think doing lunging and step-ups, we built a whole program with the Mets around step-ups and lunging because we knew how important that was. And then again, we did other forms of bilateral lifting. We would do trap bar deadlifting to clean up some of the issues that people had. I always say that if you want to learn how to squat, take a dumbbell, hold it between your hands or a kettlebell and just let the dumbbell the weight go straight down to the ground. It will put you
Starting point is 01:04:00 biomechanically in almost a perfect position because you're just letting the weight drop straight down in your center of mass. That's a great tool for teaching what it's supposed to feel like. But when you then go put the bar in their back, as soon as they don't have thoracic mobility, all the things that they're lacking start to change that dramatically. You think it's the same exercise because you're going straight up and down,
Starting point is 01:04:18 but it's a very different exercise because now when your hands are up and again, thoracic extension is more required. They don't have that and the whole system gets thrown out of whack. So it's done, it's still done in certain circumstances and you're always going to still encounter people who, I don't know, Mike,
Starting point is 01:04:33 you might just tell them to go to a different gym, but there's going to be people who will insist that they still have to squat and they want to learn how to do it and do it more safely. And I think having the willingness or the ability to still coach them through that is important. But because of guys like Mike and because hopefully stuff that I talk about, people are less reliant on those as the only things that they can do. I'm a little conflicted, less so now, but I think up until about 18 months ago I was still squatting and deadlifting regularly, though with much less weight. I was
Starting point is 01:05:03 never going below five reps and frankly targeting eight to 12 most of the time. And my rash Chanel for it was the following. I viewed it as an amazing audit of my chain. So I filmed every set. So I have a tripod in the gym. My phone would sit on it. From the warm up set to the last set, every set was filmed and my recovery was watching the video. The truth of the matter is, despite that, about one in every eight workouts, I just screwed something up. And I would spend the next four days in pain. And I'd be sitting in the shower, running hot water on my back, was it anything catastrophic? No, not at all. I got my erectors just flared up. It wasn't the end of the world. But what it said to me was people watching us might be offended by the statement, but I'm getting
Starting point is 01:05:48 old. I'm getting old. You look great for 25. Come on. As I think all of us would agree, the name of the game when you're old is never getting out of the game. There's nothing more devastating. It's one thing to get injured when you're 20. You're going to be back. But if a 55 year old, never mind a 70-year-old. If a 55-year-old has to take a year off because of some devastating injury, it's really difficult to come back. And so I very sadly decided that the risk that I was going to do something dumb. Actually, I'll tell you the straw that broke the camels back. I used to do a lot of tire flipping. So I used to have this 450 pound tire. And my absolute favorite activity was there were different games you would play. So you would love the gamification
Starting point is 01:06:30 of it, right? It's like, how many times could you flip it? How long did it take you to flip it 25 times or something like that. And so when I moved to Austin, I didn't have my tire because it was out in San Diego. So, of course, I had my assistant call and find a guy who could find the closest tire to 450 pounds. We found one that was 407 pounds. The guy delivered, he's like, what the hell do you want this thing for? I start flipping it again. And my friend, who's a really awesome PT, was watching me and he goes, have you ever hurt yourself doing that? And I said, never. He goes, you are in a remarkable amount of lumbar flexion right now. And I would just be careful. The lumbar spine does not like to be in this position when it is that loaded. And I was like, you know, he's right. I can absolutely
Starting point is 01:07:07 see how under fatigue I could just do something too much. Sorry for the ramble, but the point was I basically decided as much as I love this exercise, as much as it's a great audit. I'm learning. I love the idea of critiquing my form between sets. I just decided the risk reward tradeoff wasn't there for me. Do you think that's a mistake? Do you think that I should have stuck with it and made other modifications? Because you have these options, I don't think there's a compromise and the benefits you're getting
Starting point is 01:07:36 from single-layed training. Like I said, there's probably more benefits that you're getting from that. I'm right in that same boat with you. I spent probably from 35 to 45. I have bad knees. That probably comes from my flat feet, but wanting so badly to not have to squat
Starting point is 01:07:53 because every time I did, we'd kill. My knees the next day would be horrifyingly in pain. and my low back would ultimately wind up taking on that same brunt. I know exactly the same spot you're talking about. But yet, I kept telling myself, but you have to squat. You have to squat. It's just what we do.
Starting point is 01:08:10 We have to squat. So I would try to get past the point of the things that were bothering me, and then I would ultimately go back under the bar and squat again. Until I, through watching Mike and others, said, it's not a requirement to get what I'm trying to get out of it. I'm trying to hypertrophy my legs. I'm trying to get stronger hips. I'm trying to stay injury-free.
Starting point is 01:08:27 and so my favorite exercise at that point became a reverse lunge. So I'll do it with a barbell or I'll do it with dumbbells. Honestly, it's a little easier with the barbell because I don't have to worry about the grip of holding the dumbbells. So reverse lunge,
Starting point is 01:08:39 meaning you're starting in a standing position and you're doing a step back. Step backward, step backward. I've seen a great video on this where you emphasize how wide you're stepping out. That's the thing, and this is where some of the functional training stuff comes up. Oh, it's a balanced exercise.
Starting point is 01:08:53 That's a bad, it's not a strength exercise. It's a balanced exercise. It's not a balanced exercise. If you can't keep your feet wide enough, all you have to do is just step back and out, you'll maintain a wide enough base where you still have support. And then it's a strength exercise.
Starting point is 01:09:04 I remember where I was when I watched that video of you, and I went to the gym that day, and I was like, I've never thought about taking a wider stance. I mean, I added 40 pounds. Right. My second big tip on that exercise is, as you go down, I call it like screwing yourself into place, but you're really not.
Starting point is 01:09:21 You just take a little bit of a rotation towards the front leg. So you're just taking your torso, So you take it a little bit over the front leg. It will basically stabilize that front leg a little bit more. And again, with enough contact, I think when we're doing those reverse split situations, it's about 75% on the front leg or so. Yeah, about.
Starting point is 01:09:38 Yeah. So, I mean, you're still got 25% going back on that back leg. And that's enough to support you and make sure that you're not falling all over the place. That is my favorite way. And I recommend people all the time to do that. Lunging forward is fine, but people that have knee issues like myself, that doesn't feel too good either. So it's like, why not do it this way because this is a safer way that has less orthopedic
Starting point is 01:09:59 issues for people, being pretty heavy again, if you're going to use a barbell there too. So that's my favorite substitute. And since I learned that there were other things I can do and not compromise, whatever it was that I was chasing at the time, I have since backed away from that. You can ask Jesse every now and then I'll go back and try again. And inevitably, in a few days, things start clicking on my hip or things that didn't pop or click before. I do believe that there's a path away from that. For you, before I want to talk about your patience, but personally, because we're all telling personal stories, what have you changed in
Starting point is 01:10:31 your training, resistance training specifically as you've aged, as you've increased wisdom, whatever the case might be? I wish I could say I get less hurt. Before we started the podcast, I said that I had a right torn hamstring. Proximal or distal? It is proximal and quad femme, which is very unusual. Glute Mead and Gluteman. I love to overachieve. I thought it was a great idea about eight years ago to keep up with my husband, who my husband was a former seal who's now at Baylor. I thought we would do a 50-hour event. And I was not physically capable or prepared to do that. It's just another Tuesday for him. And I tore my left hamstring on a sprint. Since that time, I think that it changed my ability to squat. I kept going back to the squat. I am not able to do that at all now,
Starting point is 01:11:25 but that changed probably, I don't know, six months ago. I stopped squatting six months ago. I also found out that I hip dysplasia. All of these injuries, all of these patterns, which, you know, as I think as someone who is listening or watching this, if something doesn't feel right, you talk about taking that wide step back. If someone is doing something that people will say, okay, this is a squat pattern, but it doesn't feel right to you. I had been squatting in a much too narrow position for someone that has hip dysplasia. And so I ground out my hip. I'm somewhat stubborn for those people that know me. I just kept doing it because I believe that we should squat. Needless to say, I'm now in a position where I am doing only single leg movements and really trying to
Starting point is 01:12:07 pull back, probably be doing some PRP for this now, new injury. And I say that all about, someone in a roundabout way that as we age, like you said, Peter, the worst thing that you can do is stop. And I think about Doug Patton-Jones' work, the Catabolic Crisis Model. This isn't a catapult crisis, but a catapult crisis model is when you're off the table, you lose muscle mass and strength rapidly. And that continues per decade. So my training has changed dramatically. I do more high intensity on, say, the bike or the airdine versus any kind of long, slow, steady state, which I would love to get back into and then also the lifts. So you're able to do high intensity stuff on a bike with a high hamstring tear? Well, this is new. This new tear just
Starting point is 01:12:52 happened. I got my MRI back two days ago. Got it. I won't be able to. When you're recovered, so let's just say we're sitting here in nine months. I'll be recovered before then. All right, very well. When you're recovered, how is it going to change what you do going forward and how will that impact what you modify in terms of your patients? Because I think all of us are practitioners here, and therefore we're students. We do a lot of self-experimenting. We make a lot of mistakes on ourselves that gets us curious about what's the lesson here? How do I make sure that my client, my patient, doesn't make the same mistakes? What are you going to change and how is it going to impact what you tell patients? Definitely, it doesn't have to be these big lifts. We don't
Starting point is 01:13:33 all have to squat. And for me personally, having to deal with that, prior to injuring my hamstring, just recently, I was starting to do more unilateral work. And I will go back and also just being much more particular about form. I think as lifelong exercisers, we can compensate a lot. People that are somewhat athletic compensate very well. I think I have to hold myself to a much higher standard. Otherwise, I know I will continue to get injured. And also I want to add in more zone too. It's so funny you say that I remember a trainer and I can't remember who it was, but he was showing me videos of some incredible athletes doing workouts. And he was just pointing out all of the horrible mistakes they were making. And he goes, they're not great athletes because of how they're
Starting point is 01:14:20 training. They can get away with training that way because they are such great athletes. How much did you see that, Mike, when you were training pros? I literally just wrote down the better the athlete, the better the compensator. That was a note that I just wrote. Masters of compensation is what we used to call. Yeah, I used to look at these guys and think, like, my God, it's amazing what they can get away with at that level. But I want to go back to the adult because it's really funny to the squat thing because I wrote an article one time
Starting point is 01:14:42 and I forget what I called it, but it was basically about slamming your hand in a car door. I said if you substituted slamming your hand in a car door for squatting and then had the same conversation with yourself saying, hey, I just hurt my hand.
Starting point is 01:14:52 I slammed it in the car door and I can't wait to my fingers heel up because I'm going to go back and slam my hand in the car door, right? That's what you'd be saying to me in the shower every eighth workout. But we've all done that. Exactly.
Starting point is 01:15:02 And that's why I wrote the article because people do it all time. And you just realize that if you just, and that's where being rational and substituting something really stupid. Although in fairness, the analogy is more like this. The analogy is, I love slamming the car door because I love the noise. But I like to also reach in the car when I'm doing it. And normally it's fine. But on every eighth slam, oh.
Starting point is 01:15:25 I might edit the article for that and say, okay, even if it was only every eighth time you did it, would you go back and slam the car door eight more times? You wouldn't. you would be like, no, that's absolutely stupid. The risk, reward doesn't work. But for some reason, squatting has such a visceral attachment in strength and conditioning. That's why I mean, people, you should go look at some of the old YouTube comments about me, the things people were saying about me were unbelievable.
Starting point is 01:15:48 You know, and I was kind of like, just telling me. It's religious, right? It's religious. It's absolutely religious. An exercise like the clean doesn't have that type of religion because I think functionally, again, everyone can relate to the squat. The squat is something we do every day, every time we get out of a challenge. chair every time we go to the bathroom. So I think there's the attachment. But your point, Jeff,
Starting point is 01:16:07 sorry to interrupt, is a very good one, which is people are confusing a goblet squat or effectively a sumo deadlift with a goblet, which is, it's all the same hip hinge. They're confusing that with this. This is the unnatural part, I think. We teach everybody to gobble squat. We teach everybody to sumo deadlift. But I always tell everybody in people like, well, you know, you got to be able to go to the bathroom. I won't use the indelicate. And I said, yes, but you're not going to piggyback someone in and take a shit. Like, that's not how it's going to work. You don't have to be able to do that. Like, in order to be able to use the bathroom, you only need to be able to bodyweight squat. So once you can bodyweight squat, you're good. Let's do unilateral stuff for loading, because
Starting point is 01:16:46 and this is where we get into, adults versus athletes. Like I always people say, what's an adult, what's an athlete? I'm like, an adult has a job that does not involve playing sports. And I was doing this presentation for Perform Bad. I was writing it up one of the things is, you know, pickleball players aren't athletes. People that are adult recreational athletes, They're not athletes, because if they get hurt, like you said, you get hurt at 50 or 60, it's really debilitating. You don't heal. Even the rate of healing, you're seeing that now.
Starting point is 01:17:11 The rate of healing is totally different. I look at my son and his friends, they'll get hurt. And two days later, they'll be like, I'm fine. And I look at them and think, I'd be six months crippled if I did what you did. And people don't see, I always say life is this gradual transition of filet mignon to beef jerky, right? And I'm in the beef jerky stage of life, firmly in the beef jerky stage of life. I'm thinking I'm in a New York strip at the moment, just getting a little firmer. But you know, you think like you're getting crustier and a little bit more salinated and just you're not what you used to be.
Starting point is 01:17:42 And I actually post the thing on my Instagram. They say the number one cause of injury in old men is thinking they are young men. And that's why when you get to should they squat, should they do it? I always say no because I wrote down ego. The problem with that is when you start letting people do these things, you then have to become the ringmaster in the circus. So for us, we just eliminate the events. Like, nope, we're not doing those events because I'm not going to be able to figure out,
Starting point is 01:18:06 well, you can squat and deadlift. You can't squat and deadlift. You can, it's like, no. If nobody squats in deadlift's in our adult program, then we're just better off. And again, by professional athletes, I had one guy in the Red Sox who squatted, insisted to me after I really fought with everybody about it,
Starting point is 01:18:22 every single guy except one. What position? Pitcher. A pitcher. Like a real, you don't get John Lester. He was a, I mean, looks like a linebacker. like Brian Ehrlicher. He was like, no, I have to do this. The rest of the guys were like, oh, I'll do the whatever. I'll do split squats. I'll do whatever you want me to do.
Starting point is 01:18:37 But in that situation, I was like, okay. Our college kids, we have to squat, so if you came and someone came in the gym that day, they got to squat and they were like, oh my God, like, there's a defector in our midst here. And I was like, no, he has to squat. He's got to go back to college. He's got to go to his college, weight room, and his college program. Those kids squat, because we want them to be able to go back to school and be able to participate in the program the way they're supposed to participate. I feel like people don't, appreciate the nuance of what you're saying. I feel like it can easily be turned into Mike thinks no one should squat. And what you're saying is, no, there's a threshold. There's a risk-reward
Starting point is 01:19:10 trade-off. I completely agree with you, this idea, like, if you're not getting paid to play a sport, you have to reconsider how you're treating that sport. It's also not as if the alternatives are sacrifices in terms of what they're delivering. That is the problem. Like I always talk about people get on me because I have what I call the Iron Graveyard. There's a few exercises that just belong in there. And one of them for me is the upright row. It's a garbage exercise. You could tell me, no, there's no bad exercises.
Starting point is 01:19:37 That's a bad exercise. Talk about it. So the upright row is done the way that old school taught how to do the lift. You hold the barbell and you lift it up here up under your chin. Your elbows are much higher than your wrists are. You've got lots of weight usually on the exercise. So fully pushing your arms down to the internal rotation. The funny thing about that is that position is literally the time.
Starting point is 01:19:56 test as a physical therapist that we would put somebody in to try to see if they have impingement in their shoulder. We would put them in this position, push down if it gets a lot of pain in there, likely something's getting pinch, super spinaidus tendon, something. Why am I doing that exercise? When? Not because I dislike the exercise. I never got hurt on it. I never did. I've did it for years. I've done it for 40 years. There's always the outliers like we talked about before. But when I can just simply tell you, I just want you to drop your elbows lower than your wrist. I want you to do something called a high pull. I want you to go this way. But doing that, now instead of internally rotating the shoulder, I'm externally rotating the shoulder. I'm still working my
Starting point is 01:20:29 delts. I'm still working my traps. I get zero sacrifice of what I'm trying to do the exercise for in the first place and I eliminate the part that I don't like that I don't care if you haven't gotten hurt this time, but ultimately doing it over and over and over again can potentially cause a problem down the road, even just the potential of it. I'm not saying that you can't get injured on any exercise you can, but on this exercise, I'm lowering the risk and not sacrificing the benefit. I think when Mike talks about squatting, the fact is, if you can do something, something that's giving you a better or even equal benefit. And it takes away some of those downsides to the exercise, especially as the population who's performing it is less appropriate
Starting point is 01:21:08 to be performing the exercise and more appropriate to be doing the alternative. What's the whole point? It makes me think about how do we re-educate people? Because we've all suffered from these narratives of you have to squat, you have to deadlift, and it's just similar to nutrition. Do you think that there's a way, if I can ask, do you think there's a way that we re-educate getting to our youth potentially so the younger that we can educate, the less likely we're going to have adults in their 50s having to have serious injuries? And then, Mike, you wouldn't have to have this conversation about no more squatting. No, I think we're doing it right now, actually. I mean, these things are really, the ability to mass produce this and to have people hear it and see it
Starting point is 01:21:50 is something that we weren't really able to do before. I talked about the fact, when I was a coming up, I had to wait for the new strength and health to come out to the newsstand. I mean, I waited. I visited the newsstand daily. We lived by these magazines. I loved it. I waited for Strength and Health and Iron Man, I would walk into the store and I would say, those magazines come in, the guy would be like, nope, they're not in yet, because that was our only connection to the training world. And now you think you've got 14 million subscribers or something like that on YouTube. And I had someone asked one time to say, what's the greatest thing you've seen, or the greatest change in strength and conditioning? And I was like, the computer.
Starting point is 01:22:24 And they were like, what do you mean? I was like, there was no computer. Such a good point. So you start thinking, we've got this ability now, podcasts, YouTube. We can educate people, but our problem is that we copy dumb people. There's too many dummies on the internet and not enough people. I've taken a little bit more in my old age to kind of calling out the bullshit. Sometimes I'll just say on Twitter, that's a bad take.
Starting point is 01:22:46 Because if you don't, then people get to establish themselves as experts. Because this is the loudest voice situation now in terms of who's going to, influence and now there's a lot of AI like if you look at Twitter's got all these AI things going that are showing people and sometimes I'll just write total garbage and I'll just click and send the reply because I'm like it's total garbage this is shit you shouldn't be on the internet shouldn't be anywhere so but I'm going to be that I guess I'm going to probably we need that I'm getting close to the grumpy old man stage like when your grandfather would say inappropriate things at meals I'm like I'm inches away Jeff give us a couple more things in the graveyard
Starting point is 01:23:22 Cuban press for the same reason, which is when the elbows can, you know, the arms come down and then press from there. It's kind of an unnecessary adaptation that we don't need. What else I'll still have in the graveyard? The chest fly. I put the unsupported bench fly in the graveyard simply because of my history working with pitchers and knowing how susceptible the shoulder capsule can become from chronic overstretching, and then we apply a load in that position at the same time. And even our as a fly machine would be safer because you're not low. Much safer. And we'll do a floorfly. The floorfly, we're getting the eccentric overload. Matter of fact, the benefit of a floor fly is that you're going to have the safety net of about
Starting point is 01:24:00 here on the floor and I could use a heavier weight. But if I'm doing the exercise because I like the eccentric overload I get on it, I can actually apply a little bit more weight, a little bit more eccentric stress to the chest because the benefit of the exercise is the stretch of the exercise. So I can apply a heavier load but in a much safer. And again, my shoulders aren't going to be vulnerable there too. But again, because it's an Arnold favorite and it's an Arnold classic, and I believe he tore his peck once on the fly. So it's like was his favorite, but he did have repercussions for him too. It's not something that I believe you can't reproduce the benefits of in other ways. Again, nothing is in my graveyard that doesn't have an alternative that's equally
Starting point is 01:24:40 good. The only reason why I would ever throw an exercise into that category is because there's something that could be done that just eliminate some of that risk that's just as good in terms of and what it's supposed to deliver. So yeah, I mean, it's not an extensive graveyard, but people are very vocal about their favorites when one finds their way into that graveyard. And you have to sort of explain your way out of it. I want to talk a little bit about kids. So I have three kids. They all love playing sports. One of them in particular has taken a real love of baseball, the youngest. So he just turned eight about a month ago. I grew up never playing baseball. It wasn't a sport that was particularly popular where I grew up. I have to say, I have become obsessed with baseball.
Starting point is 01:25:19 I can really fully understand how people can get obsessed with this sport. It's not just the numbers and the data. There's so much art in nuance in learning about all these different pitches and how they hold the ball and all the kind of stuff. Okay. But we live in a world now, it seems, where coaches want kids to specialize earlier and earlier. And I was a little bit surprised at the end of his seven-year-old. They're playing three seasons a year, by the way, in baseball right now.
Starting point is 01:25:48 So you've got fall ball, spring ball, there's this little summer ball tournament. And the kids are playing one position now. Most of the kids have a coach, a coach outside of, like a position coach outside of the team. My intuition is that just doesn't make sense. Tell me what you guys think of that. Do you have a soapbox available for me to jump up on? One, I always say follow the money. If you look at most of these people that are telling you that kids need year-round sports,
Starting point is 01:26:18 are people who are making their living from year-round sports. If you look at what most professional athletes are doing, they're not doing that with their kids. If you look at what most coaches are doing, they're not doing that with their kids. What you usually find is some entrepreneur who has developed Joe's baseball, and he needs income year-round
Starting point is 01:26:36 because he doesn't have Joe's baseball and lacrosse. He just says Joe's baseball. So as a result, they start telling you, they start giving you that early specialization myth, like, hey, you've got to get started early, and if you get started early, you do better, and if you get senior, I just saw somebody, Twitter the other day, somebody said, scouting starts now at 10U.
Starting point is 01:26:53 This was a woman who runs a softball development program. I said, no, that's absolutely bad information. They start using words like development and exposure. The reality is if you said I have an 8-year-old who really likes baseball, the number one thing I would tell you is make him do something else besides baseball. My daughter was a full scholarship ice hockey player, a very, very good played a year in the Women's Professional League. You had a scholarship when she was 15 years old.
Starting point is 01:27:16 I didn't let her play in a summer tournament until she was 13. And people would say all the time, can Michaela play in this tournament? Can she play in that tournament? I'm like, nope. And they were like, what's she doing? She said, she's going to go to the lake. She's going to water ski. She's going to be on the swim team.
Starting point is 01:27:28 She took up diving one summer because they needed a diver, and she became the U-12 diver because the guy started throwing herself off the diving board and said, oh, she's fearless. I'll teach you to dive. And I was like, how many hours will you take her for? And he's like, oh, a couple hours a week. I was like, awesome. We made her do that. We made her play soccer.
Starting point is 01:27:44 She did judo. She was state judo champion when she was 12. The kids that are better athletes do better in the long run, you end up with as a whole early succeeder phenomenon that we deal with. And early success generally they won the genetic Olympics. They generally tend to be from groups that develop earlier. And they will tend to be ahead when they, for us, from in my years, it was the Greeks and the Italian kids. They always matured. They were the ones that were shaving in junior high school. And they were much better in junior high at football than the rest of us were because they weighed 180 pounds and we weighed 130 pounds. You just look at that and think that's not going to have any bearing on the end. You have to look, this is the literal marathon versus sprint argument in
Starting point is 01:28:24 terms of you've got to look at this and think, no, this is a developmental marathon. And the kids who sample tend to do better. Like your kid loves baseball now, but you don't necessarily know that that will be my son loved hockey. He's playing calls lacrosse. He was playing baseball and lacrosse at the same time. And do you feel this way even if the kid is themselves wanting to play all the Would you sort of force the kid? Yeah, I forced my daughter. My daughter was hockey only. She was, that's all I want to do.
Starting point is 01:28:49 And I said, I don't care. So she was not thrilled about the idea that you weren't letting her play in a summer tournament. Angry at times with me. Fights about why can't I do this because she knew she could go and be the best player. And I said, I don't care for you the best player when you're 12.
Starting point is 01:29:02 I care for you the best player when you're 18. Being the best player at 12, I'm not getting any ego gratification by going to this tournament and realizing that you made the 12-year-old All-Stars or something like that. So yeah, we had fights. fights about soccer. I made a player of U-14-year-s soccer. And the specialization thing, I always think
Starting point is 01:29:20 up to 12 broadest sampling possible. The more things they can possibly do, the better, because we're trying to develop general athletic attributes. You'll see the kids in hockey that played soccer because they're kids that can pick up pucks in their feet. My son picked up lacrosse really fast because he played baseball and he played hockey and he understood the whole idea, oh, we score, there's a net, I can catch things, extended. All that stuff made perfect sense to him when he went to lacrosse and lacrosse ended up coming together but if you weren't sampling you don't know you just think i always say this is a terrible analogy but i'm going to use it anyway i said if your son came to you and said i really like cocaine at this point it's the only thing that i want to do you would be like
Starting point is 01:29:56 no we're not going to do that right but suddenly because you have to do a little hair right exactly i mean i would like you to drink a few years you don't mean if you substitute that for baseball i like absurd analogies but i think there you see the absurdity of that and you think Yeah, you love baseball. That's great. But you should learn to swim. And you really should learn to do some sort of sport that involves your feet. You know, you should play soccer. I think kids should do some sort of combative sport is really good for kids because you should learn what it's like. The instructors when my daughter was doing judo were Rhonda Rousey and Kayla Harrison. What are the odds that you go to the best judo school in America that is 15 minutes from your house? And that's who's teaching the classes in judo. So my daughter can still say that, you know, she was taught by Bronda Rousey and Kayla Harrison. Having to go out on a mat and fight another kid, he fights the word, I guess, is really good for a 12-year-old girl.
Starting point is 01:30:51 And that feeling I remember her looking at me the first time, like, sorry, I can't come out. Like, you're on your own, you better figure it out. And she did. Sampling is the key. And specialization, if we can think of the worst possible thing you can do for your kid, it is to let them specialize,
Starting point is 01:31:04 even if it gets to the point where they think, Dad, I don't like you. You're mean. You're not a good person because you're not letting me do what I want to do. You've got to look at them and think, that's why I'm the parent. That's why I'm in charge. Soap blocks down. I'll let someone else talk. I will say that our kids are both in gymnastics and jujitsu. My daughter hates jujitsu, and she excels in
Starting point is 01:31:24 gymnastics. And we chose gymnastics because it allows for her fine motor skills, all of this development very young, and also the development of her musculature. She loves it. And we know that the healthier, fitter, and more active these kids are, the greater their metabolic health as adults is. But to your point, what we see is, I think in the U.S. we see a lot more injuries than in other places because of this always having a season. And from a standpoint of longevity, definitely, again, make our kids do the same thing. I don't know why we haven't stopped and questioned it a little bit sooner because it's not like injury rates are going down. So we're playing more and getting injured more. That's what we've seen across all levels of sport. Mike and I
Starting point is 01:32:09 were discussing the Achilles tendons and the rash of Achilles tendon injuries, or at least it seems to be in prominent players. But a lot of it has to go back to the repetitions and the mileage. And one thing that Mike brought up that I thought was really interesting was the way the style that the game is played now, let's say basketball, there's so much more because it's really come down, chuck up a three, go down, check up a three, come down, there's a lot less of that inside game going on. The game is faster and they run more. And there's a lot more mileage. How many miles extra, was it? 200 more miles a year per team.
Starting point is 01:32:41 Right, because of just the way the style of the game has played, and they're not all linear miles. They're start, stop, stop, start, stop. So there's a lot of cumulative stress on the Achilles tendon doing that. Again, on top of the fact that as teenagers, they were playing all year long too, not like it used to be when Larry Bird was playing when he played his season and he probably went home and did something completely different, just shot around a little bit. So we need to start looking at these extensive seasons and these.
Starting point is 01:33:08 multiple seasons per year because it's not changing. It's not helping. If it was helping, we wouldn't have all these athletes being injured. Things are worse now than they've ever been. Say more about the Achilles. That is the injury I personally fear the most at this point because I play with my kids a ton. So it's usually soccer and baseball that we're playing. And especially with soccer, I'm always worried, is this going to be the day when despite all of the training I do, despite all the jumping, despite all the multilateral training, I'm always doing. I don't know what it is. I think I've just seen so many of them. It's the injury that keeps me up at night. I'm just literally diving for a soccer ball and ping. It's the beef jerky
Starting point is 01:33:50 injury. What is the protocol? How do you think about maximizing the odds of survival? Rolling and stretching one. I'm a huge foam roll and stretch person. I think everybody should be rolling. Everybody should be stretching. Everybody should be doing. Sifically, you're talking about the soleus. You're talking about rolling all the way down onto the tendon. Yeah. Okay, so you're talking about calf. Calf, and then doing, you know, just ankle mobility work, basic ankle rocks. And then now it's really interesting because this is we talk about dogma.
Starting point is 01:34:18 All of a sudden, the front foot elevated stuff is becoming popular. And when you think about from a preventative standpoint, it makes perfect sense. We were always told that you have to have your whole foot on the ground. Like that's the correct technique. When you say front foot elevated, do you mean like toe on a plate? Yeah, like toe on a plate kind of thing. But initially when I first thought that, I was like, I don't get it. And then a physical therapist friend in mind, David Gray, was like, yeah, well, if you want to get your foot engaged and you want to get your gastrock engaged, it just makes sense to put your foot on there.
Starting point is 01:34:45 And that's where some of the stuff, it always goes back to when I wrote functional training for sports and they asked me to define it. I said, functional training is training that makes sense when you think about things. So that's why when you're talking about flies, like flies don't make any sense to me. I said, unless you're a professional face slapper, I don't know why you would do flies. Still probably better on the peck deck. We don't do that. Like, I look and think I don't know why you would do that. Maybe if you went to a universal. Florida, like if there are certain things where you might be required to perform that action. But from a hypertrophy standpoint, there's a lot of reasons to do it. There's something you must be getting out of that movement that you can't get out of that movement. Yeah, well, I mean,
Starting point is 01:35:20 you look at the amount of abduction that you're getting. So any press, any dip, any push up, it's all limited to about this range of motion. But if I can actually open it up even further and get more stretched, we know the benefit hypertrophy-wise of applying stretch to a muscle. But that's an exercise where you are also entertaining end range shoulder mobility and then again excess stress on the anterior capsule so like so it's like if you're a bodybuilder if you're in certain sports where the aesthetic matters right it could be the difference between first and second place if you're a competitive bodybuilder but but it's not my world and I think that at least educating people about what those risks might be is at least an important first step to have in a discussion
Starting point is 01:35:59 of whether they should do it or not and again if I can provide an alternative for them where I think you could get additional benefits without the risk, then why do it? What else do you think is important in the playbook of minimizing the risk of the Achilles injury? When Mike said mobility, I think ankle mobility is something that no one pays attention to their ankles. We don't try to mobilize our ankles at all. I think that tight calves are common in people and they don't really ever address them.
Starting point is 01:36:24 And it all starts at the ground. Everything starts at the ground. If you have any compensation, if you lack ankle mobility, your knee is going to pay the price for sure because the knee, I always say the knee is like that consequential joint in between the hip and the foot. And it's just reacting to what's happening above and below. And the poor knee, my knees in particular, like they got beat up and they never really were to blame. All they were trying to do is just hinge back and forth and they couldn't do a good job because they were being betrayed by flat feet and weak hips. But I think if people pay more attention to strengthening their
Starting point is 01:36:55 hips and to mobilizing their ankles, you can feed that chain up and down. And if your calf isn't tight or if your ankle is more mobile, then there's less of that tension being placed down through the tendon itself. You're already doing it, taking a step forward in terms of decreasing your risk of actually snapping that thing. And in terms of strengthening the calf, do we think the soleus or the gastroch plays a greater role? Do you need both? Do you need to have both knee bent and knee straight? We always focus on both. A lot of people will always talk about the gastroch specific strengthening with the knee straight, just because it's the one that gives you the better contraction, but I don't care about that. I care about making sure that all the muscles in the body
Starting point is 01:37:36 are strengthened. So we'll do equal amounts of seated versus standing in cap raises. So if you're doing three sets in a day of standing, you're doing three sets seated as well. So every time we program cap training, it's seated and standing together. I don't think one versus the other is more responsible for the tears. I think as a group together, our ankles are lacking mobility. And because the ankles are lack of mobility, we've talked about like in sleeping. In sleeping at night, your feet are down, if you keep those blankets tight at the end of your bed, they're down quite a bit. And you're spending six, seven, eight hours in that position. You're not doing yourself any favor in terms of encouraging mobility at the ankle and flexibility through your cabs. So we need to be much more
Starting point is 01:38:16 aware of those areas and do more work towards that. And again, that's more work that people have to do. And when you're talking about from the very beginning when we're saying, what do I have to do to be in shape or what do I have to do? Sometimes you have to own little mini parts of your program because specific to you, they're important. So for you, you, this big fear of that Achilles tendon tear, which I'm right there with you. I think it's a devastating injury that will take you out for quite a while. That would be part of your program that you have to add another five minutes of mobility work for your ankle and do that three, four times a week to make sure that you're doing something about it. That starts to add up and people
Starting point is 01:38:50 start making choices and their choices. I'm cutting all the little stuff because that's not going to really, no one's going to see my ankle development. I want to see my arms or my chest or something, so we're going to do more work there. But when you make those decisions to cut those little parts of the program, those are the ones that usually keep you injury-free. Speaking of single-leg, the difference between doing calf raises with two feet versus single-leg, that was one of the most profound eye-openerers for me was the difference in strength and how much less weight you could do one leg at a time.
Starting point is 01:39:22 It's not half the weight. There's some sort of interesting compensation when you're doing it two legs at a time. We started adding that back into our adult program. put calf work in and then suddenly we started thinking, I remember trying to do some calf raises and I was so sore and I thought, my God. But again, you realize it's kind of a use it or lose it scenario where if you're no longer sprinting and jumping, then that flexibility, the mobility of that complex and the ability of that thing to absorb force. But the other two things, one, avoid doing it if your calves are sore because if you look at both Tatum and Halberton
Starting point is 01:39:54 had previous calf strains that they were playing with, ended up with Achilles tendon tears. sometimes, I'm a meme guy. There was a great meme yesterday, and the guy said, the doctor was like, how much does that hurt? And he said, oh, the usual amount. And the doctor said, the usual amount is zero. So you've got to be able to look at that and realize that it shouldn't hurt at all. If you're thinking, oh, my calves, my shins, they're sore. That's indicating to you that you were doing something that wasn't kind, and that now you've
Starting point is 01:40:20 got to give that enough time to recover so that that's not sore anymore. And I think sometimes we get into the kind of hard guy stuff. I tell everybody, I wrote an article one time called Does It Hurd? And I said, it's all about the idea that does it hurt is a yes, no question. If I ask you, does it hurt, you can only answer yes or no. And any equivocation is yes. Well, after I warm up, yes. Or only yes.
Starting point is 01:40:41 And I always do that with people. When they start qualifying, I'm like, yeah, that's yes. How much does it hurt? Benchpress, after I warm up, it doesn't hurt at all. That means it hurts. But you're using that then as a sign that says, I need to understand why it hurts. It's not, you don't train. It's we need to figure out what's going wrong.
Starting point is 01:40:56 What's your movement pattern? And figure out what Jeff was alluding to, like, you know, upright rows and rotator cuff. Like, what is it that's making your shoulder sore? What's the movement that's aggravating? For some people, like, we find that standing, you know, people, it's functional. Standing cable pressing is the one thing that everybody can do that doesn't hurt. So if we have people with shoulder pain, they're standing cable press because it's the one thing they can do that doesn't hurt. And I don't care whether people think functional, non-functional.
Starting point is 01:41:22 You can label it any way you want to label it. But I just know I can get you to press pain free. goal. That's my goal all the time. I want to be able, you can look at me and say, I can do that and it doesn't hurt at all. Then I think, okay, we can build off that. What people don't understand, too, is that it's okay to go through periods of restriction to a single movement like that, a standing cable press, to actually allow the shoulder to heal to a point where you actually could get back to doing other variants of the press if that was your desire. I told you a story myself where I had a, I have a labrum tear, and I had an inability to do any type of pressing. I had
Starting point is 01:41:56 to restrict myself simply to a variation of a crossover that wasn't even a pure crossover, but just something that I could do where I could actually pull in a little bit and then cross over my body, because that was the only thing I could do pain free, but I could still work my chest in a way that allowed me to do something. I also knew that I could do something completely different, like I could horizontal row. By doing that, I'm getting shoulder movement in a way that was different. It's almost like the specialization in sport, not just doing all chest up, but trying to actually attack the chest through a different way by still looking at the shoulder joint. And I would do a lot, a lot of rowing, which probably was good just posturally
Starting point is 01:42:32 to balance out some of the imbalance I had in the shoulder, but also to just give me more joint range of motion in the shoulder. I'm getting all this extension. But the combination of those two things got me to a point where my shoulder doesn't, knock on wood now, but my shoulder doesn't hurt. I can actually be able to go and go back to pressing, again, in a smart way with dumbbells. I don't barbell bench press, but I do it with dumbbells. And I have none of the pain that I had years ago when that was going on. So it's okay to understand that this is a long game and you might want to take a step back and stay with the exercises that don't cause pain and allow yourself a chance to be actively mobile to still recover at the same time. Instead of sitting on the
Starting point is 01:43:15 sidelines, like you said, it's just not a preferred choice. That's not going to turn out well. sort of pivot and talk a little bit about strength training women across the transition from perimenopause into menopause. Do you have any experience with that? I'm guessing you do. Mike, you must just by the fact that they're coming in your, so start with you, Gabriel. What are you noticing as the most important things as women are making the transition from perimenopause straight on into menopause? The first thing is don't wait until they start to feel that their body composition is changing. The bitter they are. going into perimenopause and menopause, the better they're going to be both metabolically
Starting point is 01:43:53 and just activities of daily life, everything. Those women seem to suffer much less. When hormones are changing, I think what I end up seeing is that maybe sleep is poor. One of the signs of menopause is this frozen shoulder. So if someone is a candidate for HRT, we do certainly believe in that or menopause therapy. When it comes to training, in the literature, I haven't seen huge evidence or a variation evidence that good training, it's not sex specific. There is not something specific for women that needs to happen rather than following good foundational principles of strength training, hypertrophy, and cardiovascular activity. So you don't say, hey, now that you're making this transition, we have to alter your periodization or change.
Starting point is 01:44:44 the amount of time you're spending doing one form of training, say cardio versus resistance or even the number of reps you would do. We're not changing any of that stuff. I don't. One of the things that we do look at, though, is if they are at risk for injury for tendons or joints, we do see that that changes. But then once we treat them, I do not see a reason to change. Good programming is good programming. Progressive stimulus is progressive stimulus. No, it was great because when I read your book, it was very reinforcing for me because where I'm getting that question more and more now, from our female clients just because of people like you who are talking about it more, people are more comfortable than talking to us about it. It's exactly that. It always comes back
Starting point is 01:45:23 to strength and conditioning. Get stronger, get in better shape, get them to challenge themselves more with weights and not be content. Females are very, there's an ego component that's absent in females that is very present in males. Like males will look at, you know, if I looked at what Jeff did, I might think, oh, I'm going to try that. Females just don't have that. They're just very internally driven, and sometimes that will cause them to underachieve in the weight room because they're not worried about being top dog. They're not worried about who lifted the most weight. It just isn't. Makes them better snipers, you know. I believe it. It makes them better clients. I would do nothing. I have a lot of really elite females that are great hockey players and lacrosse players and stuff,
Starting point is 01:46:00 and they're the best people to train by far because they don't have a lot of the extra baggage sometimes that the guys have. They're just way more compliant. They just listen to what you say. They don't argue with you. They don't worry about what Jeff is doing. But encouraging them to continually get stronger. And we would look at it as conditioning versus cardiovascular work. That's just kind of how we always used the term. But pushing them to do more intervals, pushing them to do, I want more aggressive intervals. So you might call it a VO2 max workout, but I want to get that. Like I love the Andy Galpin's idea. Like Andy Galpin's thing was like, hey, you just want to get your heart rate up really high once a week. I think that's a really good concept. And starting to just get people to
Starting point is 01:46:38 think, hey, get your heart rate up. Where a heart rate monitor. Don't be afraid to push your heart rate to X, whatever that is, and don't be afraid to be out of breath or get off the bike and feel like you want to lay on the floor kind of thing, because we're a big assault bike, Airdine people. I think it's the most efficient way to hit your cardiovascular system with what I would call no orthopedic cost. Like, I can kill you on the bike, and nothing bad is going to happen. Even like you were saying with the hamstring, I'm going to bet you can be able to bite
Starting point is 01:47:04 with that hamstring. I'm plenty on trying it later today. And then you'll be perfectly fine because you're not weight-bearing and you're not getting a lot of aggressive hip extension and a lot of aggressive hip flexion and you can probably torture yourself on there for a long time without having any negative effects. But the biggest thing, like I said, with women is just getting them over that. I'm going to get big so I don't push myself kind of thing. And so it's funny, I film a lot of my women and ask them to talk about how much they weigh and how much weight they haven't gained. So I have two of the best lacrosse attackers on
Starting point is 01:47:32 our U.S. team that are in their mid-20s now. And they've been here for five years and they've gained no weight. They're stronger, they're faster, but females gaining lean mass is really difficult. You have to really be a super responder. And usually I always say apples end up like apples, oranges end up like oranges. It's not like suddenly one day the apple is going to wake up and the next day are going to be an orange. If you're an ectomorph, you will get the occasional really mesomorphic female where you do think, oh, wow, she really does respond to weights, but they're rare. They're super rare.
Starting point is 01:48:01 So, Jeff, what about you? What are you seeing in women specifically that you're training, especially during that transition through menopause. As Gabriel pointed out, the training specifics are pretty much the same. What applies what is good smart training for men is equally applicable to women. The only thing that I would say from a PT standpoint, biomechanically, there are some differences in terms of something called the cue angle, the angle of the hip of the femur coming down to the knee. It does create a lot more valgus at the knee for women than it does for men. So I think you just have to be aware of those things. So when you're doing certain activities, you want to
Starting point is 01:48:36 be able to coach better in terms of being aware of positioning. So like the tendency for a lot of women when they jump is to land in a much more valgus knee state, which could put more and more stress. We're not fearful of them blowing out in a training session. But as we talked about before, that cumulative stress of every time you land, you're getting more and more stress on the MCL or the ACL. That would be something that you'd want to coach around and make them aware of because you could strengthen that. You could work on biomechanically improving those things, put a band around their knees and have them jump that way and land that way. They're learning how to activate their abductors and their hip. That is probably something that isn't even really
Starting point is 01:49:12 a requirement. All men can benefit from that, but it's not an additional requirement because we're not dealing with the same biomechanical angles. Also, because of hormones, women will have more laxity of hormones at different times of the month that will make them susceptible to different stresses. I think you just have to be aware of the education side of it and coaching through that. But as far as the exercises, the programming, we also found that women just tend to be much stronger than men in terms of their output, pound for pound. And given the differences in sex, they're able to proportionally push more weight, especially with their lower body, than men can. Much stronger have you found that, too? Mike, the women are incredibly strong in terms of
Starting point is 01:49:52 their output and strength comparative to men. I haven't really thought about it in terms of pound for pound. The one thing we found is that they're much stronger in their upper body than they think they are. That's the one thing that we've seen is that we've got women doing weighted chins with 45 pounds for five. What? Wow. 45 for seven is the best I've seen. 45 pounds wrapped around her waist and she's doing seven chin-ups. Alex Carpenter, who's one of our... How many men can do that? In our gym, we really emphasize it. Most of ours. Wow. Sons did 90 for two the other day. He weighs 180. A bunch of kids in his team. We really push pulling. We push pulling. That doesn't sound right, but we emphasize pulling. We like to push pulling. I'm leading the league in redundancy.
Starting point is 01:50:31 I want to come back to something you said at the outset. Mike, you were talking about kids. The youngest you train is 11. You drew a hard line in the sand. How come? I always say I don't want to be in the childhood stealing business. And I think there's some people in our industry that are in the childhood stealing business. I think kids should be kids and they don't need a strength and conditioning coach when they're 7, 8, 9, 10 years old.
Starting point is 01:50:52 They probably need a playground and a bike and a swing set and a slide. There's a lot of things that kids can be doing that are way more fun than being in my gym. So we actually drew the line at 12 initially, but the sports brackets are 11-12. So when we realized that we drew the line at 12, people then started coming and wanted to bring a team, and suddenly it was kind of like, well, we'll take Peter, but Jeff can't come because he's 11. So eventually we kind of bumped it down, and then we just resisted bumping it down more. Because I don't want to run a kind of program.
Starting point is 01:51:22 I don't want people running around. I don't want birthday parties. That's not what I'm looking to do. So we just said 11. And I think at 11, you're going into middle school, you can start to understand that there may be some commitment involved in terms of, hey, if I want to make a team, I'm going to probably have to learn to work at this thing and I'm going to have to learn to train. And it's a very good if you kind of look at long-term athletic development models that 11-12 is a good learn to train age to get kids in and get them kind of oriented to, hey, here's how you do the exercises. And we're very learned to train oriented at that stage. I tell our coaches all the time, I don't care if any of these kids get stronger. I could care less. I really care. that they're good lifters. If they've been here 10 weeks and by the end, I can look at them and think, wow, they can gobble squad and they can sumo deadlift and they can do a clean and they can do a chin up and they can do a pushup, then mission accomplished. I mean, all of that is fantastic,
Starting point is 01:52:11 right? And again, it still flies in the face of what many people would think, which is, oh my God, an 11-year-old lifting weights that's going to stunt their growth, Mike, aren't you crazy? I literally wrote that down. It's funny. That was in my notes in the beginning, but the misconception stuff. We're still dealing with the stunted growth thing. And you brought up New York Times, but New York Times did an article where they tried to pull the string on that. Where did the stunted growth thing come from? And it actually came from a study. The only study they could find was was on Japanese forced child labor. The kids who were forced into child labor tended to be smaller than their age-matched peers. Who were malnourished. Right, exactly, malnourished and not working
Starting point is 01:52:45 at eight in a factory. But yeah, you still have doctors. They talk about growth plate stuff. There's no growth plate damage evidence. There's none of those things are there. And then you talk about gymnastics. Gabrielle. I always tell people, figure, skating and gymnastics are 10,000 times more aggressive than anything that we would do in the gym. I'll get myself in trouble, but I always say organized child abuse, right? I mean, it's not even good for kids when you look at what they're trying to do with these young bodies because you need, I always think you need little people that rotate. And that's the key to those sports. You look at that and then you think, what we're doing in the gym, okay, hold 10 pounds, squat up
Starting point is 01:53:18 and down, and that's going to be bad for you, but spin around three times and land is okay. That's physics denying, science denying, where you look and think, no, I can show you the physics of that is way, way worse. So what are the things, and this is a question for all of you because you all have kids. So we haven't pushed any of our kids. Our daughter just decided at some point she wanted to start lifting weight, so that was great. But our boys kind of like to come in the gym with us, and we just sort of play goofy games with them. So I know you're friends with Jock and Leif, and they have this fun little card game that they play where you, have you seen this game? So it's basically like you designate what's a spade, what's a heart, what's a diamond, etc.
Starting point is 01:53:56 Like you pick an exercise. Like this is a pushup, this is a burpee, this is a sit up. And then obviously if you flip it and you get a 10 of that thing, you do 10 of them. If you get a 7, you do 7 of them, and then blah, blah. Usually they'll just come in the gym with us and play that game. And this is the problem with boys. They want to one up each other. So once one of them goblets squats this amount of weight, the next guy wants to go to the
Starting point is 01:54:15 heavier kettlebell and the next guy wants to go to the heavy kettlebell. And actually, I do get a little worried because I see their form deteriorate. They go into what I call turtleback. So they go from lumbar extension, they start getting into lumbar flexion, and I'm like, guys, enough. What advice would you have for trying to help little boys who want to start lifting, but you just want them to develop the form? It's really funny because if you were to ask them to jump onto something or to even to walk upstairs two steps at a time, their form usually is going to look quite good when it's just a naturally occurring activity that they're doing. in their life. When you then say, hey, let's do this as an exercise, let's do something called a step up where we step up onto a box. So let's even do a pushup. The pushup, if they were to
Starting point is 01:54:59 get themselves off the floor, it would probably look a lot prettier than it does when they ask them to do a pushup. Their asses up in the air. Their shoulders are wide. They're kind of moving in all different kinds of segments. So to me, it's this disconnect. It's not that they lack the athletic skills or the strength to do what it is you're asking them to do. They lack the awareness of what it is you're asking them to do. When it's packaged as an exercise, they're sort of like, I'm not really sure what that is. So it's our responsibility to kind of make it seem easy to understand and tell them where they're supposed to be feeling it. The number one question that people ask when they were starting out an exercise program, not just kids,
Starting point is 01:55:35 anybody, when they do an exercise, surprisingly, this is what we all do and we are so passionate about it. What am I supposed to work? What am I feeling here? When am I supposed to feel this? And to me, I'm like, well, where do you feel it? They want to know. Because they want to know where, okay, because if I'm not feeling it there, what do I have to do to feel it there? Kids need to learn the proper form and biomechanics of how to do the exercise. Again, I think they possess a lot more athletic skill and natural abilities than we give them credit for. And when we just have them start doing exercises, it breaks down. So take the time, do the exercises right. Who cares about the weight that's in their hand first? Start with body weight. And then have them learn the mechanics of that. As I said before, with that little drop squat, the drop squat is where they can actually add weight and learn better than it could be if they were trying to learn a body weight squat. In this case, that actual implement would assist them in learning how to do it properly because it's going to take their center mass straight down. So the form is everything when it comes to kids.
Starting point is 01:56:32 And when we've worked with kids in the 11 to 12 year old bracket, that's what we try to focus on is learn the movement, go slow. Don't speed through it. Go slow. Speed is something that usually breaks down in any attempt at good form. So learn the movements and then we could always speed them up and we could always add weight. But if you don't learn the form, you're going to basically set up a foundation that's going to ultimately crack, especially if they get away with that for 13 years and now they're 20s. And then really now that competition starts to kick in and competing with your buddies and then things get really ugly.
Starting point is 01:57:03 And are either of you guys doing sports specific training for these 12 year olds? For example, if you got a 12 year old who's a pitcher versus a 12 year old who's a basketball player, are you having them do different exercises? Nothing. I always say sports specific training is bullshit. It's absolutely nonsense. Baseball is sports specific training. Like if you want to go get better at baseball, then go play baseball. If you come to the weight room, I've trained guys in every major professional sport and it's at most 80, 20, probably 90, 10. 90% of what we do is the same 10% of what we do is different. And that 10% is totally irrelevant to a 8, 9, 10, 11, 12-year-old, it makes absolutely no difference. That's really counterintuitive. I would thought that, I mean, God, if you're a pitcher,
Starting point is 01:57:45 you've got to be taking more care of the rotator cuff than maybe the guy who's the hockey player, for example. Right. That would be the 10%. Literally, like the 10% with baseball would be that shoulder care stuff that you might not really worry about with your hockey players or your football players. That's where your difference in programming would be like that one spot, rotator cuff. But with kids, like I always look at it, I think you shouldn't be a pitcher. You're not a pitcher. You're a baseball player. And you might end up being a catcher. You might end up being a shortstop. Because And Nomar Garcia-Paro, Nomar Garcia-Paro went to Georgia Tech
Starting point is 01:58:14 and tried to kick on the football team. Yeah, and he loved soccer. He married me a ham. He's a huge soccer fan. He told me one time, I used to train him. He said, I would absolutely be playing soccer if I didn't live in the United States,
Starting point is 01:58:25 he said, but I realized the best use of my athleticism was Major League Baseball, and that playing in the MLS would never have given me the type of career that I would have had in Major League Baseball. But most every great athlete that I've seen was a great multi-sport athlete, but we've got this self-fulfilling
Starting point is 01:58:40 prophecy now of specialization, where people can now point, and they'll point to Tiger Woods or somebody and say, oh, Tiger Woods specialize. And it's like, you can find me one specialist, I can find you a thousand generalists who all have achieved. But you'll continue to use the specialist as the example, because that's what you want to believe. We as achievement-oriented people, for you to be a great doctor, for you to be a great doctor, for you to be great at YouTube, that's what you've got to do. Kids, it's the polar opposite. For them to be great at something down the road, they probably need this super broad-based skill set, the base of the pyramid versus the height of the pyramid, the bigger the base, the larger the height. You know, if you build
Starting point is 01:59:17 an obelisk out of the gate, you're probably not going to accomplish much. You mentioned Carl Crawford, like, he didn't get those scholarship offers for three different sports because he started playing at 18 or 17. He obviously was playing all those sports at a young age and developing all those athletic skills to where he could select the one that was most appropriate for him, either financially Or, and he was just the best, some of this is genetic lottery. Carl Crawford could do a standing backflip at 230 pounds. He's still the most athletic person I've ever seen, but he would have been that in any number of sports.
Starting point is 01:59:49 I don't think, you know, it's just the fact that he chose baseball, and that's what's interesting in terms of people say, oh, you look at the Europeans, they specialize in soccer, and it's like, yeah, because they don't have the choices that we have over here. We've got a lot of opportunities that maybe aren't present in other countries, so people will cherry pick because they want to support their thesis. But to me, the more important thing is virtually no kid is going to be a professional athlete. My interest is in how do you use the interest in sports first to fuel the spark that says lifelong activity is an important pillar of health. Second, how do I make sure that when you are done playing sports, which for most people is the end
Starting point is 02:00:29 of high school, then there's a narrow subset that'll say, well, actually, it's the end of college. And then there's virtually nobody who's playing sports after that. Because to your point, pickleball with your buddies on Sunday, that ain't sports. So we all stopped playing sports pretty young, and yet we are going to need to train for the rest of our lives. I think that's the thing that I'm still trying to better understand is how do we use youth sports as a tool to set you up to be an athlete for life where the sport changes to life? I think that's the difference in terms of using it to teach life lessons. They say sports can build character or can build characters. Do you have to use it to build the kid's character?
Starting point is 02:01:11 And sometimes that may be saying, you're not just going to get what you want. I get it that you just like baseball. But we're going to play soccer in the spring because we think you need to be exposed to more things. And the kid learns that lesson because sometimes they just learn this micro focus really early on. And then later on when they don't achieve, they think, oh, I wish I'd done more things. I wish I'd sampled more. I wish I'd explored more. I think it's looking at the real body of evidence versus looking at the evidence that's presented to you by the person who's trying to get your money, which is what usually happens now. The issue, I think, though, is that where we're
Starting point is 02:01:44 going off track is that the coaches and the parents of these children are over-emphasizing the importance of what it is, they're actually competing in to the point where, why do you think we have you simply because of money that we have all these additional leagues throughout the year, but it's also because everyone thinks their kid's going to be a pro. They're not. And they don't want their kid to be left behind. That too. And it's all these social pressures behind this. That is what's feeding the problems that we see and also taking away from the fact that this is introducing lifelong habits to them to the point where it's degenerating something that should be very positive into something that becomes at worst destructive. You're overdoing something
Starting point is 02:02:22 and you're actually a lot of times also making a lot of these kids hate athletics by the time their 17, 18, 19. That's another issue, which is, I can't tell you the number of people I met who grew up collegiate swimming, who cannot stand swimming. And it's such a shame because swimming is, while it's not good for bone density, it's pretty much good for everything else. So by itself, I would say it's not the only exercise you should do, but boy, if I think about, if there's one exercise I could insert into everybody's life, it would be some amount of swimming. Somebody who swam through high school in college, they're like, I could never do it again. It was my best sport. I went to the first swimming meeting at Springfield College. Coach, I still remember, Red Sylvia,
Starting point is 02:02:59 famous Division III coach. The first words out of his mouth were the first practice is at, and I was thinking, he's talking per day here, right? They're swimming twice a day. They're swimming before school and after school. And I sat politely through the whole meeting like this and nodded and went to the football meeting and tried out for freshman football because I was like, there is no way I'm going in the pool twice a day. It was the end of my swimming career. And I'd now terrible shoulders. I can't stand swimming because it hurts. when you're talking about becoming a lifelong athlete. For us, so again, our kids are four and five. They train with us. They might not be doing the same lifts, but we let them play with a kettlebell, pick things up, put them down, and we let them run. We let them do things that they would physically be able to do without a lot of queuing. And as I just think about some of the data on tendon health, we know that the earlier people start, the better and more resilient those tendons are because they're not starting later in life, not getting injured. And I just think, again, it's just a great place to start, the earlier, the better, which is a bit counterintuitive because we've heard all of this information of how kids shouldn't lift weights or train.
Starting point is 02:04:04 And maybe it's not a standardized training program. They're in there, they're doing stuff with us, like every day. If you think back to the last five years, you're obviously all in a constant state of learning. Is there something you have changed your mind on? Something significant that you've changed your mind on and not just changed your mind on, but it's changed the way you behave. the way you help other people. I'll start with you, Gabriel. This is a big one. I don't think body fat percentage is nearly as important as we think it is. I think that it is going to be somewhat of an outdated metric. I believe that intermuscular adipose tissue, this eye mat, is going to be
Starting point is 02:04:43 much more predictive of disease. And this came from, I interviewed on my podcast, Melanie Cree. We were talking about PCOS. And I'm thinking, metabolic PCOS, what is the body fat percentage that's going to change the outcome. And she looks like to me, she goes, Gabrielle, has nothing to do with body 5%. It had to do with their intermuscular adipose tissue. And that, I think, is going to be an upcoming theme. It's much more specific to insulin resistance and these metabolic outcomes that we care about. And commercially, obviously, it can be measured quite easily with CT scans and with MRIs.
Starting point is 02:05:19 To my knowledge, it's very difficult for Dexa to approximate it. That's right. Is ultrasound viable? Obviously, you wouldn't be able to get whole body, but you could sample the quads. Yes. That would probably be the canary in the coal mine as if you're accumulating muscle in your quads. Yes. And I think it's also very difficult.
Starting point is 02:05:33 I guess we're accumulating fat in quads, yeah. Very difficult to test. MRI seems to be where a lot of the data is. We're not there to measure it. But this is something that I think we are going to see so much more of. And we're all focused on a muscle-centric approach. And for the last 50 years, it's been all about obesity. And this is the same thing.
Starting point is 02:05:52 It's almost that we're looking where it's obvious, but it doesn't mean that that's where it's effective. I really agree with you, actually, and I think pharmacologically for what it's worth, I think that's the next frontier. So I think what the GLP-1 agonists have done over the past five years with the introduction of the third and fourth generations of those drugs, the first two were largely failures, but because of how successful the third and fourth generations were, we're really at a point where I think people can see that you can address the crisis of overabundance from a nutrition
Starting point is 02:06:24 standpoint. But what people realize, the new problem that is yet to be undressed is sarcopenia. When I'm looking at what's at the leading edge in the frontier of biotech right now, it's all around antisarcopenia drugs. Now, of course, we have another great drug that works against sarcopenia. It involves holding iron and eating certain types of foods. But, if where billions of dollars are being invested is any indication of what people realize is the next frontier, I think people are waking up to the idea that it's not enough to solve the adiposity problem. You must address the sarcopenic problem. Yes, I couldn't agree more. What about you, Mike? What have you changed your mind on? I'm glad you gave me a head start to think about this.
Starting point is 02:07:10 You know, some digestive health. I had a bowel resection done nine months ago. So they took a foot of my calling out. And I realized, I actually did a really good presentation for our staff called You Don't Know Shit, because I think that's the most neglected area of health right now because we don't want to talk about it. It's uncomfortable. Until you experience it firsthand, you don't realize how important fiber is, how important water is. Chronic dehydration seems like a, oh, it's a big deal, but it's really not a big deal, but it suddenly is a big deal. I liken it to, it's like you have a dumpster, your whole life that's out in the back of your house, and it just gets emptied all the time. And then suddenly one day you realize they can't empty the dumpster
Starting point is 02:07:48 anymore. Like, I'm in trouble. And that's us. Like, we're worried about our muscular system. We're right about our nervous system. We're worried about our endocrine system. And our digestive system is just this thing that's supposed to be this dependable system that's just going to take care of us forever. And then suddenly in our 50s and 60s, it starts to fail. And we don't want to talk about it. Like, I was in the hospital. I was sick. And then the guy was like, this is a major surgery. We've got to take foot of your colon out and put you back together again. I won't go into the gory specifics, but it made me realize that, I mean, I take a fiber supplement all the time. I put fiber in my shakes all the time now.
Starting point is 02:08:19 I look at how much fiber is in everything that I eat now. But you start about protein numbers. Look at the fiber numbers. People are way more fiber deficient than protein deficient, but they're going to suffer the effects way down the road, and it'll be too late for them to realize. So if I would say to anybody, I'd be like, drink more water, eat more fiber because you don't want a ball resection. What about you, Jeff?
Starting point is 02:08:40 Breaking the rules, I have a couple. but personally I think I have two twin nine-year-old boys and so in the last five years they've gone from four to nine which for a dad is the phase where mom was definitely the favorite for the first four years and then I sort of step in and become the fun guy so I've realized through their interactivity with me number one to appreciate things I didn't appreciate before in the first half of my adult life I was so focused on professionally achieving whatever I could whether be working for the Mets or then starting this business and really going all hours of the night
Starting point is 02:09:13 to try to build the business. Not that I just still don't do that, but I really have learned to better prioritize my time with my kids to the point where it's difficult for me to make travels out to do podcasts because I really try to be around them and I've learned to appreciate because they're on the spectrum, I've learned to appreciate their wins every day. So it's like, wow, I don't take anything for granted.
Starting point is 02:09:33 That's a thing that I am so grateful for that I've been able to benefit from because if I think if the situation was different, I probably would just continue to work, work, work the way I did. But I think from a professional standpoint, kind of oddly, one of the things that I think is really overlooked is balance training. And I think that it's an area that people are going to probably have to spend a little bit more time focusing on because, like we just talked about digestive health,
Starting point is 02:09:56 like it's another one of those things that's going to get worse as you get older for a number of reasons. Number one, your reaction times will get worse. Number two, your proprioceptive sense is going to get worse, which is essentially your sense of body position. Number three, your strength is going to get worse, as we talked about inevitably decade by decade. When we consider what all that leads to ultimately falling,
Starting point is 02:10:19 we talked about these fears. I don't have the fear of falling right now. I'm sure if you don't have the fear of falling right now, we have the Achilles tendon stage right now, but 20 years from now, 30 years from now, our biggest fear should be falling because when you do, you're likely going to live a pretty difficult end of your life, and it might lead to a much faster end of life.
Starting point is 02:10:37 I think that actually training balance is another one of those things that's going to have to get kind of sectioned into that five minutes of extra work that you're going to want to have to do for yourself. And the most important thing when you're training your balance, even if it's just simple standing on one leg and drawing an alphabet with your other foot, is to close your eyes. Because I think that when you don't close your eyes, you're actually one-dimentially creating an environment that's not actually what we're going to face. Most people fall in the dark because they don't have that visual feedback to correct.
Starting point is 02:11:06 By the time you send that signal down to your ankle to make an adaptation, it's too late. If our reaction times are delayed too, it's going to be even worse. So it's just a thing that I think people that are already older should start working on because as a skill, you can improve it. And as somebody who is looking down the line here and seeing things changed, including my eyesight, which used to be so perfect up close, that changes, I know all these things are happening under the hood. Making a dedicated effort is something I think people should probably invest some time into
Starting point is 02:11:33 because it's well worth the investment for that. long range safety. I think the theme here is, I think we would all agree in the gravitational pull of aging, despite the fact of what some of the popular biohackers might have you believe, none of us are getting out of this alive. I would bet each of us can remember what it was like, what it was like to be 10 years younger, regardless of whatever age we are today. But this idea, if I could take what you're all saying and impart one thing to a listener, it would be you do have a choice at the rate at which this glider is going to come down. The glider will come down. Gravity always wins. But you can train to reduce the rate of decline. You can train to reduce the rate of
Starting point is 02:12:18 decline. It won't happen by accident. The training you have to do has to be specific. It's not obvious or intuitive that you should do some of these exercises. A lot of the things that you guys have talked about today are exercises I just love. The front foot on a plate, on a 45 pound plate, putting the front foot up there, going into a lunge, taking a plate, and doing little twists. The amount of stress that that puts on the pro preceptive capacity of that front foot is insane. What a dumb-looking, unsexy exercise that never shows up in the mirror, and yet, what a phenomenal exercise. I'm with you 100% on all of these sorts of balance drills with eyes shut. They're frustrating. It is frustrating to be on one foot with your eyes shut.
Starting point is 02:13:00 Third layers turn your head when you're doing that. Oh my God. The way you feel and you don't want to do things you suck at, but you kind of have to do this. I don't know. I just hope that people realize that ignoring it won't make it less likely. It's a relatively small price to pay. You're not asking people to be in the gym 12 hours a week. Last I checked, some of us choose to be in the gym or exercise 12 hours a week, but that's probably because we're weird and we do that just like other people might enjoy watching TV. But yeah, if someone could give two great hours a week? It breaks my heart that there are people who don't do it for whatever reason, for whatever belief system that says it's too late or it's too hard or I'll do it tomorrow. So guys, I really, really appreciate this. I don't know where the time went because we didn't actually cover a single thing I had written down, which is okay because I had good stuff written down, but I thought we talked about good stuff. So I'm incredibly grateful for all of you making the trip out here. I only wish we had another three hours, although we'd have to take another bathroom break or something. So thank you all for coming. Thank you. Thank you. A pleasure, honestly.
Starting point is 02:14:10 Thank you for listening to this week's episode of The Drive. Head over to peteratia md.com forward slash show notes if you want to dig deeper into this episode. You can also find me on YouTube, Instagram and Twitter, all with the handle Peter Atea M.D. You can also leave us review on Apple podcasts or whatever podcast player you use. This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Starting point is 02:14:58 Users should not disregard or delay in obtaining medical advice from any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. Finally, I take all conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit peteratia-md.com forward slash about where I keep an up-to-date and active list of all disclosures.

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