The Ultimate Human with Gary Brecka - 280. Will Harlow: STOP Losing Muscle After 50 (Do This Instead)

Episode Date: June 29, 2026

A 30-second test with nothing but a chair can tell you whether you'll be independent or dependent at 80. Most people score lower than they expect and don't find out until something goes wrong. Here's ...the stat that stopped me cold: for older adults, the hip often breaks before the fall. The bone gives out first. The fall is what happens next. And most doctors never mention it. UK physiotherapist Will Harlow breaks down why your knee pain usually isn't coming from your knee, how even people in their 90s rebuilt leg strength by 175% in eight weeks, and the one movement test that predicts your longevity better than most bloodwork panels. CLICK HERE TO BECOME GARY’S VIP!: https://bit.ly/4ai0Xwg  Get Will Harlow’s book, “Independence for Life: The Complete Guide to Building Strength and Regaining Mobility Beyond 50”: https://bit.ly/4vRGg3T  Connect with Will Harlow Website: https://bit.ly/4eo7AzK  YouTube: https://bit.ly/44gEttm   Instagram: https://bit.ly/4xB9Lst   Facebook: https://bit.ly/3S5wblx   TikTok: https://bit.ly/3SM9TFr   LinkedIn: https://bit.ly/4uLXsaf   Thank you to our partners A-GAME: “ULTIMATE15” FOR 15% OFF: http://bit.ly/4kek1ij  AION: “ULTIMATE10” FOR 10% OFF: https://bit.ly/4h6KHAD  AIRES: "ULTIMATE20 " FOR 20% OFF: https://bit.ly/4a3Duze   BAJA GOLD: "ULTIMATE10" FOR 10% OFF: https://bit.ly/3WSBqUa  BODYHEALTH: “ULTIMATE20” FOR 20% OFF: http://bit.ly/4e5IjsV  COLD LIFE: THE ULTIMATE HUMAN PLUNGE: https://bit.ly/4eULUKp  CYMBIOTIKA: "ULTIMATE10" FOR 10% OFF: https://bit.ly/4tjyluP  GENETIC METHYLATION TEST (UK ONLY): https://bit.ly/48QJJrk  GENETIC TEST (USA ONLY): ⁠https://bit.ly/3Yg1Uk9  GOPUFF: GET YOUR FAVORITE SNACK!: https://bit.ly/4obIFDC  H2TAB: “ULTIMATE10” FOR 10% OFF: https://bit.ly/4hMNdgg  HEALF: 10% OFF YOUR ORDER: https://bit.ly/41HJg6S  PEPTUAL: “TUH10” FOR 10% OFF: https://bit.ly/4mKxgcn  SNOOZE: LET’S GET TO SLEEP!: https://bit.ly/4pt1T6V  WHOOP: JOIN & GET 1 FREE MONTH!: https://bit.ly/3VQ0nzW  Watch  the “Ultimate Human Podcast” every Tuesday & Thursday at 9AM EST: YouTube: https://bit.ly/3RPQYX8 Podcasts: https://bit.ly/3RQftU0 Connect with Gary Brecka Instagram: https://bit.ly/3RPpnFs TikTok: https://bit.ly/4coJ8foX: https://bit.ly/3Opc8tf Facebook: https://bit.ly/464VA1H LinkedIn: https://bit.ly/4hH7Ri2 Website: https://bit.ly/4eLDbdU Merch: https://bit.ly/4aBpOM1 Newsletter: https://bit.ly/47ejrws Ask Gary: https://bit.ly/3PEAJuG Timestamps 00:00 - Intro of Show  01:21 - Gary's intro of Will Harlow  03:11 - From pro sport to the NHS mill  05:22 - Why we wrongly normalize aging  06:32 - Leaving to build his own clinic  08:32 - Why pain returns after treatment  10:46 - Fear of movement and neural inhibition  14:51 - The four pillars of independence  17:06 - Exercise snacks explained  18:17 - Sciatica causes and home fixes  25:22 - Biomechanics and mechanical pain  30:50 - The sit-stand longevity test  35:09 - Falls, hip fractures, and bone health  37:36 - Muscle mass and all-cause mortality  38:30 - Building strength in your 90s  43:51 - The mind-muscle connection  47:43 - Writing Independence for Life  51:07 - What it means to be an Ultimate Human Disclaimer: This podcast is for informational purposes only and does not provide medical advice. It is not intended for diagnosing or treating any health condition. Always consult a licensed healthcare professional before making health or wellness decisions.  Gary Brecka is the owner of Ultimate Human, LLC which operates The Ultimate Human podcast and promotes certain third-party products used by Gary Brecka in his personal health and wellness protocols and daily life and for which Ultimate Human LLC and / or Gary Brecka directly or indirectly holds an economic interest or receives compensation.  Accordingly, statements made by Gary Brecka and others (including on The Ultimate Human podcast) may be considered promotional in nature. Learn more about your ad choices. Visit megaphone.fm/adchoices

Transcript
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Starting point is 00:00:00 We almost look at people who've got these age-related problems and say, well, what do you expect? You know, you're 60, you're 70. Everyone's suffering with this. And the worst part is, when people are told that so many times, they believe it. It normalizes this culture of group suffrage. And when it seems normal in your peer group, you just accept it as a consequence of aging. We think that people only lose independence in their 80s and 90s, and we just don't think about it. It's one of those things we take for granted that we start to lose a lot earlier than we
Starting point is 00:00:30 realize. Independence truly is freedom. As we get older, one of the measures of independence is do you need help with the activities of daily living? The four pillars of independence, as I call them, are mobility, strength, so how strong you are, but also how much muscle mass you have on your body, balance. And then the fourth pillar is skeletal health. The age-related muscle wasting, it's more rapidly, I think, than people realize. Muscle mass throughout the entire body is an independent predictor of longevity. How important is it for people that are trying to build strength? but in older ages, to return that strength. Do you have them draw their attention to those muscles?
Starting point is 00:01:02 Do you find that that helps? So what I tend to do with people now, and this is something people can do at home, is... Hey, guys, welcome back to the Ultimate Human Podcast. I'm your host, human biologist, Gary Brecker, where we go down the road of everything, anti-aging, biohacking, longevity, and everything in between. And today's guest, all the way from the United Kingdom,
Starting point is 00:01:35 physiotherapist that I'm actually greatly interested in running this podcast with, decided at one moment, point in his life that the patients that he was caring for that were leaving his clinic without pain were going home and the pain was starting to return. And he wanted to find a solution to how people could care for themselves outside of the clinic and make a material difference on the trajectory of their life. And this has to do with musculoskeletal pain and movement and your posture and so many things that are overlooked by modern medicine. And we're starting to treat those symptoms that actually have a chronic underlying condition that can be fixed so you can put them permanently in
Starting point is 00:02:12 your rear view mirror. So welcome to the podcast, Will Harlow. Thank you, Gary. That's very kind. Yeah, I'm super excited about today. And as always, we usually start running a podcast before the podcast starts. But we had a great conversation before the podcast started. But I wonder if you might just give a little context to my listeners, because you're working at NHS as a physiotherapist. And having a great deal of success with the patients that you were hands on with that could come into the clinic and actually receive treatment and guidance. But at some point you noticed that when they would leave, those gains would go away. And it was the chronic condition was coming back. Yes.
Starting point is 00:02:54 And I believe that the people that are the most driven purposeful, like passionate and impactful are the people that are solving problems. And so that seems to be the problem that you solved. 100%. So give us a little context around that. Yeah, so I was in the NHS at one point, but I actually started in professional sport. And it was a funny trajectory for me, really, because I spent my whole childhood growing up thinking,
Starting point is 00:03:24 I want to work in professional sport. I don't care what I do. I just want to be in and around the clubs and the players. And I was also really interested in the human body as well, like yourself. So when I heard about this thing called physiotherapy, I thought, great, this is going to tick both boxes. I'm going to be able to help people with their bodies whilst also working in professional sport.
Starting point is 00:03:45 So I was locked on this idea of working in professional football, soccer, as you guys say. And I went right through University of this goal, came out the other side, and I got an inn with a local football club, which just so happened to be the club that I supported my whole childhood. Oh, man. Yeah, so dream come true.
Starting point is 00:04:03 Got an interview, got the job, got in there. And within about three to six months, I was looking around thinking, this is not what I want to do at all. I'm in the wrong place. It just was a bad character fit for me, a bad fit for, you know, the environment. I didn't really like the culture.
Starting point is 00:04:21 And it was almost like the world was coming crashing down for me because I thought, I've trained my whole life for this. I've got no plan B. What on earth am I going to do now? But I took the chance and left. And while I was trying to figure things out, that's when I went into the NHS. Oh, okay.
Starting point is 00:04:37 And when I was in the NHS, we were in this big kind of corporate mill-like clinic. I was seeing 15 patients a day. They were all referred from their primary care physician. And about 90% of them were people over 50. I never really worked with this pocket of people before. So I've seen people with knee-artagn. Careful, I'm over 50, dude. So don't come out as too hard.
Starting point is 00:04:57 I would never dream of it. People with knee pain, people with back pain, sciatica, all of these things. and from my training, I knew I could help these people, and I started to see these wonderful transformations. I was just giving people basic advice, telling them what they needed to do, coaching them through it, and then watching the outcomes.
Starting point is 00:05:17 And I look back about three months into the process and thought, this is the most fun I've ever had. Yeah. So it was at that moment I knew this is what I was destined to do. And I don't know about in the US, but in the UK, there's a huge problem in terms of the attitude we have towards aging. Oh, no question. We almost look at people who've got these age-related problems in inverted commas and say,
Starting point is 00:05:39 well, what do you expect? You know, you're 60, you're 70. Everyone's suffering with this. Yeah. And I knew from my training. Normalizes it. Yeah. I know.
Starting point is 00:05:47 And the worst part is when people are told that so many times, they believe it. And they go, well, the doctor said, this is it. So I guess this is just life now. Yeah. But seeing people improve, I knew that there was something here. And I knew the demand for it was massive. The NHS wasn't the right environment for me to take it further. We were very much constrained by how often we could see people and what we could do.
Starting point is 00:06:12 I remember being given a 2.5 session average cap. That's how many times you're allowed to see people before you have to get rid of them and bring someone else. 2.5? Yeah. We were marked only on our session average. Oh my gosh. Yeah. Wow.
Starting point is 00:06:28 Because you've got to make room for someone else. Yeah, yeah, because it's just a mill. Exactly. Yeah. So I knew that wasn't the right setting. So I didn't know anywhere else that was offering this kind of help for older people. So I decided to start it myself. So I left and I set up my own clinic and it just, it really took off.
Starting point is 00:06:46 Because I think the message just resonated straight away that, you know, you're not just destined to suffer like this forever. There's a lot we can do. You just haven't had the right guidance yet. Yeah. So that's how it started. You know, I think too, you know, with aging just in general, what happens is as we move through life, right? Like my kids are in their 20s, early 20s to late 20s, all their friends are getting married, right?
Starting point is 00:07:09 So like every weekend there's another marriage. And then, you know, as they're emerging from that, it's like now everybody's having babies. And in my age demographic and then I look at my parents, it's like everybody has similar ailments and issues going on. So it's very normal. It's like, well, you're on blood pressure medication. So am I.
Starting point is 00:07:31 What do you take? Oh, I take? I take a beta blogger. Hey, we all take it, you know, and, you know, my knees hurt all the time, so does my back. I'm, I wake up, I can barely move. Yeah, neither can I. It's like, it normalizes this,
Starting point is 00:07:43 it's sort of this culture of group suffrage, right? And when it seems normal in your peer group, you just accept it as a consequence of aging. Yeah. And I would argue the same thing that you're arguing, they're not consequences of aging at all. It's just not having the tools, to put these things in your rearview mirror.
Starting point is 00:08:05 Absolutely. And so you started your own clinic, but at some point you started to notice that people were also, you're making these major strides in the clinic, but afterwards, they're sort of post-care, where they were left to their own devices, they started to slip backwards.
Starting point is 00:08:23 Yeah, 100%. Which led to you doing this online. Yes, right? Definitely. And so talk a little bit about that transition. Yeah, for sure. So I think looking back, and bearing in mind I was very early in my career here, so when I just started, I was very much still focused on pain. Like, what's the problem this person's got that's causing pain? Great. Once you figured it out, let's fix it. Once the pain's gone, we'll send
Starting point is 00:08:49 them on their way. As you say, they were coming back. And I was like, well, why is this person's knee pain come back? You know, I've fixed the problem. But I hadn't fixed it because there were deeper, rooted things that we hadn't yet addressed. Now, through seeing this many times, I decided that one of the better ways I could help people to avoid this cycle, of almost boom, bust, get better, then get worse again, was to give them things to do in between their sessions
Starting point is 00:09:15 and after they leave me. And one of the best ways to deliver that was via video. Right. So I started putting these videos out initially just to help my patients. And I've seen a lot of your videos. You're like your rotary videos, your glute strength videos, your shoulder mobility videos. And they're very easy to follow.
Starting point is 00:09:34 I mean, they're simple routines and you're very specific about different ailments. And having gone to chiropractic college and having a pretty fundamental understanding of anatomy, you know, they make extraordinarily good sense, you know, because when the biomechanics get off, the pain shows up. Yeah.
Starting point is 00:09:54 And we think the pain is, you know, the shoulder pain is because something happened to my shoulder, the biomechanics sort of led to that repetitive use issue. Yeah, definitely. And I always try and strip things back to the most fundamental basics of movement. Because I never think of myself as a smart guy. I'm like, I have to see something work for me to understand it. Yeah.
Starting point is 00:10:14 And I figure that a lot of people like that approach as well. They just want something very simple, like a really simple explanation, and then one thing they can do to fix that problem. And I think that was probably the approach that really propelled the channel to get so many millions of views. But really the mission hasn't changed from there. It's still like give people something very easy that they can do and don't overcomplicate it, strip it back to basics, figure out what has gone wrong,
Starting point is 00:10:43 and then a simple strategy to try and improve it. I love that. You talk about the fear of movement sometimes being as bad as the injury itself. Yes. What do you mean by that, the fear of movement? Yeah. So let's go back to pass. science for a minute, okay? Because this is really, really important. We used to think that when
Starting point is 00:11:03 someone was in pain, that was because there was a tissue that was damaged. And the only reason someone can have pain is because there's some element of damage there. Right. We now know that's not true. We now know that there are many things that can cause pain. And there are studies showing that people who have been through an MRI scanner without pain are just as likely to have some of these injuries in an adversity commas as people who do have pain. So there must be some missing pieces to the puzzle that we hadn't figured out. Now, one of these is a fear of movement. And fear of movement is something that triggers muscle spasms. It tightens everything up. It restricts the movements of your joints. And it's primarily driven by what's going on in the neural circuitry. So like neural
Starting point is 00:11:51 inhibition. Exactly. And that drives pain up even more. So I had many people come into the practice who didn't have any obvious injury, but they still had a lot of pain. And a lot of that was because they were so afraid to move from something having gone wrong a while ago that that was now the primary driver of pain. Ah. So figuring out what's causing that fear of movement
Starting point is 00:12:13 and then slowly unpicking it can have dramatic effects for people that have suffered with this kind of mechanical pain for a very long time. Listen, there's what I share on this podcast and then there's what I share with my inner circle. If you've been following me for a while, you know how I hold nothing back here. But my VIP community, that's where the real magic happens. Picture this. You're struggling with energy crashes, brain fog, or just feeling like you're not operating at your peak, and you don't know where to get real answers.
Starting point is 00:12:41 But here's what really sets this apart. You're not just getting my insights. When I have incredible guests on the podcast, VIP members get to submit questions for a private podcast segment. So that world-renowned expert we just interviewed, you get exclusive access to their podcast. knowledge tailored to your specific situation. This section is under the private podcast section in the ultimate human community. And speaking of exclusive, you're getting my personal protocols, the exact tools I use for water fasting, gut optimization, and morning routines that have taken me decades to perfect. This isn't theory. This is what works in the real world. The community
Starting point is 00:13:14 launches challenges throughout the year where you get direct access to me and my network of experts. It's like having a personal health advisory board for less than $100 a month. Your health is your wealth, and this investment pays dividends for life. Join the VIP community at the UltimateHuman.com forward slash VIP and step into your ultimate potential. Now let's get back to the Ultimate Human podcast. You know, what's interesting is I interviewed a sports psychiatrist a long time ago, and he said one of the challenges in, especially in professional athletics,
Starting point is 00:13:45 very high level athletic performance, when an athlete gets injured, is very often they start to see themselves as an injured person. Yes. And the brain subconsciously will guard through this process called neural inhibition, different limbs from engaging in certain movement planes because it doesn't realize that the injury is over
Starting point is 00:14:12 and it's safe to move again. And so very often he was like, you know, it would throw their biomechanics off, even though there was anatomically nothing wrong with them. They had healed from surgery, trauma, you know, whatever it was. Yeah. And you talk about these four pillars of independence. And I wonder if you'd lay those out because, you know,
Starting point is 00:14:37 that seems to me a good foundation for us to start with, you know, independence truly is freedom. You know, as we get older, one of the measures of independence is, do you need help with the activities of daily living? Yeah. And starting early is the cure for that. 100%. And I define independence as being able to do what you want, when you want, for as long as you want,
Starting point is 00:15:01 without needing help from someone else unless you want it. And independence is one of those funny things where we think that people only lose independence in their 80s and 90s, and we just don't think about it. It's one of those things we take for granted that we start to lose a lot earlier than we realize. So when I was thinking about... what actually influences independence. I looked back at the patients I've treated and tried to think,
Starting point is 00:15:28 well, what were the reasons that those people had lost independence to begin with? And it came down to these four things. And the four pillars of independence, as I call them, are mobility, so how well you can move your joints, strength, so how strong you are, but also how much muscle mass you have on your body.
Starting point is 00:15:46 I'm sure we can talk about muscle later, but it's one of the most important things for your health. I would agree with that, yeah. Balance, so how well you can stay on your feet is the third pillar. And then the fourth pillar is skeletal health. So I define that as the health of your joints. So what's going on inside the joints and the health of your bones as well. So avoiding things like osteoporosis and osteopenia,
Starting point is 00:16:08 because those lead to a big loss in independence for many of the people that I've treated, even if the other pillars are intact. So I see these four pillars, almost like the four legs of a table. Yeah. So you need all four to have a sturdy table. If you knock one away, the table's wobbly at best. If you lose two, the table's on the floor.
Starting point is 00:16:28 Right. So that's how I see it. Yeah. And some of your solutions I find really fascinatingly simple if they're done, you know, consistently, right? Like brushing your teeth on one foot, you know? And so standing barefoot and brushing your teeth on one foot, just to get that one minute of extra. of foot stability and like, you know, calling your attention to your balance while you're doing
Starting point is 00:16:54 something else. You know, things that I feel like everybody could incorporate into their lifestyle relatively easily. Yeah. And so how much of it is under our control? So much of it. And the thing you're referring to, Gary, there is something I call exercise snacks. Yeah. Now exercise snacks, I think it's just worth bringing this to everyone. Yeah. It's short bursts of movement or exercise. Typically, 30 to 60 seconds that you do in otherwise dead time throughout the day. So the classic time to do it, as you say, is standing on one leg whilst brushing your teeth to work on your balance. You don't need to work on your balance in an exercise snack. You could work on your strength, you could work on your mobility, you can even work on your bone health.
Starting point is 00:17:38 So what I tell people to do is to pick the one thing they want to improve and then build almost an exercise snack regime around that one attribute. That's cool. And you can rotate the exercises is you choose, but if you have a clear goal, like, let's say you wanted to build up some strength in your upper body, you might do a 30-second exercise snack of wall press-ups, and then you might have a resistance band loops around the door, so next time you walk past it, you do 30 seconds of rows. And before long, you are going to start building up that attribute. And the research really supports this as well. This is not just like some, you know, little thing that you can do that might or might not work. This is really evidence-based. You know, it's fascinating to me, too,
Starting point is 00:18:19 I think we've been trained to think that exercise happens in one duration burst, you know, 45 minutes or an hour every day at the same time and then it's done. Yeah. Where, you know, you're saying, hey, even if you have a really busy lifestyle and you have a lot going on, you have these moments throughout the day where you could just draw attention to whatever it is that you want to focus on. Yeah. I've got to ask you about sciatica.
Starting point is 00:18:46 Sure. because, you know, growing up and having graduated from chiropractic college, you know, there's so many people suffer from this. And it can be, excuse me, debilitating and get progressively worse. Yeah. And it's one of those things that draws people's attention away from everything else. It's sort of subconsciously on your mind if you have it. By the grace of God, I've never, never suffered from it, but I know people that have had really chronic sciatica and it's debilitating. Yeah, absolutely.
Starting point is 00:19:12 And eventually it can even lead to, like, atrophy and, you know, other things. Yeah. But what would be some of your go-toes people could do at home, let's say, for sciatica? Syatica is such an interesting one. It's actually one of my special interest areas. Really? Oh, awesome, dude. I'm glad I asked then.
Starting point is 00:19:30 And in a real cruel twist of irony, a couple of years ago, I had it myself. I picked up a nasty bout of it from a deadlift where I just wasn't concentrating. I rounded my spine too much, picking up this heavy way. I just got back from a long holiday without any weight training and was anxious to get back into it. Yeah. So it was a typical case, you know, rushing in, no warm up, bad technique. Bang, I felt this pain down the back of my leg.
Starting point is 00:19:56 And like any good physio, I thought, I've pulled my hamstring. Yeah. Of course I hadn't. Yeah. It was probably a disc injury. Yeah. And that really brought it home for me because I've been helping people with this problem for so long
Starting point is 00:20:08 without ever having suffered myself. And then having that pain for three, four months, having the numb foot, worrying if it was ever going to get better, that really brought it home as to how debilitating this can be. So it kind of renewed my interest in helping people with it. So there are lots of different ways to treat sciatica because there are lots of different things that can cause it. The most common cause is an issue with one of the discs in the spine,
Starting point is 00:20:36 so a disc bulge or a herniation. But really anything that presses on one of the nerve roots or irritates one of the nerve roots in the lower part of the spine can cause sciatica. So it could be a disc, it could be a joint, it could be a muscle that traps it, it could just be general inflammation. And sometimes there's sciatica and we have no idea what's caused it.
Starting point is 00:20:58 There's no diagnosis there, the person just has the pain. So once upon a time I used to try and treat sciatica based on what the tissue was that was causing it. But then I realized that was an oversimplification. So the person needs to treat. as a whole, not as an injury, if that makes sense. So what I tend to do with people now who have it, and this is something people can do at home,
Starting point is 00:21:21 is most sciatica is linked to movements of the spine, okay? About 90%. If you move your spine in a certain direction, it's either going to make it better, or it's going to make it worse, or it's going to do nothing. So the first thing I would recommend people do is find out what those movements are for them. So it might be that if you bend forwards,
Starting point is 00:21:39 that sciatica gets worse. So now you know, okay, so when I flex, that aggravates it. So what you need to do then is for a moment, until it starts to improve, try and avoid doing lots of those flexed positions. Because with any nerve pain, this is not a no pain, no gain thing. It's a total opposite.
Starting point is 00:21:59 You have to avoid the thing that's causing the pain, avoid it increases the inflammation, and the problem goes on for longer. Right. So once you found the thing to avoid, you make sure you take note of that, Now you're going to test the other movements. And chances are you'll find one
Starting point is 00:22:14 that makes it feel maybe slightly better. And that is your almost golden movement. You're going to keep coming back to that, almost as an exercise snack again, going back to that concept, keep repeating it. And what people often find is the pain starts to reduce when they do that. So this really helps in the early phases.
Starting point is 00:22:34 Once that pain is under control, we then want to start rebuilding strength around the area. because it doesn't take long after having an injury like sciatica or that pain in your leg for strength to start to reduce. So true. And with it mobility and with it confidence. Yeah. So strengthening the glutes up, strengthening the core, strengthening the spine itself, absolutely vital for anyone who's been through this. But you have to start by knocking that pain down a few notches first because otherwise everything aggravates it. Another good evidence-based thing is walking. Walking can really help to reduce and control the pain of sciatica's for as much of that as you can,
Starting point is 00:23:12 and just avoiding things that cause pain. And sometimes those things are unusual. I know for me that when I had that pain, if I slightly leant one way, it really hurt. But if I leant right the way down, no problems. So I avoided any exercises where I was slightly leaning forward. So anything with weight on my back that caused me to come forward slightly, avoid.
Starting point is 00:23:35 But then other exercises, even things like the leg press, people typically think you should avoid with sciatica, that was fine for me. So it's very individual. Okay. So avoid what hurts, do more of what doesn't, keep moving and rebuild that strength. Do you find that most sciatica, even chronic sciatica, goes away over time if you do that? Yeah, most of the time. If you're following a good plan and it's designed to help you reduce pain, restore mobility,
Starting point is 00:24:06 and rebuild strength, 90% of cases get better. Wow. And I think people's perception of it is skewed because we all hear about the awful cases that are there all the time and didn't get better. That's probably only about 10% of cases. And then there are people who have recurrent sciatica, which is quite common.
Starting point is 00:24:28 But again, I would argue that most people where it's recurrent, they haven't fully regained mobility or rebuilt strength. they often wait until the pain goes away, then they just jump straight back into doing what they were doing before. And there's still that underlying problem that might not be causing pain now, but it's leaving them vulnerable to a re-injury later.
Starting point is 00:24:47 So I'm sure that when you were at NHS and a lot in your clinic, you were seeing a lot of post-surgical or post-traumatic recovery, like where people had some kind of specific incident, and then it led to the need for rehabilitation. But what percentage of people are, or how often did you see like repetitive use injuries or people that had prolonged poor posture over time? And now it's just starting to manifest
Starting point is 00:25:15 and you have to correct that. Because I think, you know, the too little attention is paid to biomechanics. 100% agree. You know, I've talked about this before, you know, every professional golf coach would rather start somebody swinging a golf club from day one,
Starting point is 00:25:34 rather than unlearn somebody who's been swinging a golf club wrong for 20 years. Takes twice as long. Right, it tastes twice as long. Because those neural patterns are ingrained. And I think, you know, the way that those neural patterns get ingrained, you know, when your posture is off or your gait is off, and now it's starting to manifest pain. And people think, oh, man, my hip is starting to go.
Starting point is 00:25:56 And it's like, well, you're just starting to feel it. It's really been going for a long time. Yeah. So how do you restore, like, like, what is good biomechanics and how do we restore that overall? It's a really good question. And as I've moved through my career, I've come to the conclusion that probably 80% of the cases
Starting point is 00:26:17 that I treat in the clinic are what I would call mechanical problems. It's a mechanical pain. We used to think, as I said, everything that caused pain is an injury. Now we know that you can have pain in the absence of injury and you can have an injury in the absence of pain. So the actual injury itself is a poor predictor of how much a person is going to suffer. We even see this with people with almost no castelage left in their joints.
Starting point is 00:26:43 You put them through an x-ray machine for another reason. You say, how does your knee? Does it hurt? And they're like, no, you're bone on bone. But they don't have pain. Yeah. And the reason they don't have pain, I would argue, is that their mechanics were still pretty good around that knee. So there wasn't stress going through the joint as much.
Starting point is 00:27:02 as someone else who did have the pain. Right. So in answer to your question, biomechanics are so important. And when I look at someone's joint, and I'm looking at the biomechanics and how to fix it, it often starts with the muscles. So I'll look at what those muscles are doing to protect that joint.
Starting point is 00:27:20 Because your muscles are like your joints bodyguards. Yeah. That's their job. Their job is to reduce stress and strain on the joint tissue itself. Okay, because we've got cartilage in our joints, and it does a pretty damn good job. but it's not designed to take the entire weight of the body every time you move.
Starting point is 00:27:37 You need the muscles to take some of that weight as well. Right. And if they're not doing their job, that's often the first place I would start. And then we also want to look beyond that joint itself. So this is absolutely classic, and we were speaking about this before we came in. Yeah. You mentioned having a foot problem, and then before long, your back starts to hurt. Yeah.
Starting point is 00:27:57 Well, there probably wasn't an injury in your spine causing the pain, but the mechanics lower down were having an influence on the mechanics higher up. Is that making sense? Making so much sense. I mean, because I have flat feet, and on my left foot I have a really collapsed arch. I mean, it's flat on the ground.
Starting point is 00:28:17 And I noticed, you know, as that arch collapsed, I would get a little medial knee pain and I would get some lateral hip pain and low back pain. So common. And eventually it worked its way up to my shoulder. And finally, I've gone through corrective. I had a really good physio that you just met, by the way, he happened to be here working with my wife, Dr. Evan,
Starting point is 00:28:37 and doing all the, like, boring stuff that I didn't want to do, like ban rotations and holding a, you know, a five-pound and then a 10-pound weight and externally rotating and, you know, just re-strengthening the rotator cuff and really what he attempted to convince me of in the beginning and what I'm now convinced of is just I was anatomically, just not in the right position. You know, in my case, my shoulder had just come forward. And posture was terrible.
Starting point is 00:29:07 And so that anterior bicep just never healed. Yeah. And as soon as I strengthen the rotator cuff, they're just time and consistency with these exercises. I'm back to no pain. Pull-ups, overhead exercises, you know, everything. You've just demonstrated the magic of fixing those mechanics. Yeah.
Starting point is 00:29:25 So you've taken the stress off that bicep tendon by strengthening, presumably the muscles at the back of the shoulder girdle. And that's allowed it to move in the way it was designed. And then, hey, presto, the body starts to heal. Yeah. So this is how we kick off healing by fixing those mechanics. Putting the right biomechanics back in place so the body can do what was meant to do. The body wants to heal.
Starting point is 00:29:48 Yeah. It wants to work with you. It's not trying to work against you. Yeah. But it needs the right conditions to do so. And the right inputs. One of my favorite biohacks outside of breathwork by far is, mineral salts, Baja Gold Sea Salt. It's got all of the trace minerals that the body needs.
Starting point is 00:30:03 You know, most of us are not just protein deficient, meaning amino acid deficient or fatty acid deficient. We are mineral deficient. So a quarter teaspoon of this in water first thing in the morning will make sure that you get all of the essential minerals that you need. It tastes amazing. In fact, I made a steak today. I actually made a grass fed steak with grass fed butter, and I put just mushrooms and a little bit of rosemary and I sprinkled Baja Gold Sea salt all over the top. Try it. It'll be your new favorite for cooking too. It's the chef. cheapest and one of my favorite biohacks, I don't know, a 15 or $20 bag of this will probably last to five years. It's literally the world's best biohacking secret. Now let's get back to the
Starting point is 00:30:37 Ultimate Human podcast. So you also have, which I'm really curious about, a great predictor of longevity, the simple sit-stand test. Yes. I want to do it. I'm hoping that I don't embarrass myself. And it's basically in a 30-second time frame. What the number of times you can sit and stand and sit and stand to a full standing position. Yes. And you cross your arms, right? That's right.
Starting point is 00:31:07 No arms allowed. Yeah. With arms allowed. So you sort of rock forward, stand up. Sit down, rock forward, stand up. And there's evidence that the number of times that you can do that in 30 seconds is a predictor for, you know, mortality and longevity. Yes, absolutely.
Starting point is 00:31:22 I would actually heavily agree with you on that. Can we do that during the pod? Can we fire it up? Can we do it? Okay. Hopefully this goes well or we'll just have to cut this right out of the podcast. All right, and I have a weighted vest on,
Starting point is 00:31:40 so I'm going to take the weight of vest off, right? I'm wearing a seven-pound high on weighted vest. Let me give myself every possible advantage here. Is this chair good for it? To be honest, you would want a nice, firm chair normally but we can make do we can make do let's let's bring the firm chair up here yeah um pull this bad actor back right there that one would be perfect okay because then i could always blame it on the chair if i yeah you need escape i got it in case this goes wrong yeah yeah yeah
Starting point is 00:32:13 that would have had who should have actually that would be good actually okay so yeah i'm just gonna yeah yeah yeah so we're practice first so you want to be sat on the edge of the chair okay so you're gonna come up all the way up that's it and then all the way down to a full sit and then straight back up again, but there's no pauses. So we're going to do it as many times as you can in 30 seconds. Many times that can in 30 seconds? Yeah, so we're going for rapid movement. Okay.
Starting point is 00:32:37 Okay. Should I time it? You got a timer? Yeah, I got a timer. Okay, so I'd start sitting. Yeah, so we start sitting. And the first, number one is when your bum touches the seat again, and then you just keep going.
Starting point is 00:32:49 Okay. I'll tell you when to start. I don't get one for standing up? No. Oh, dude, that's... He's got an up and down is one. Okay. Yeah.
Starting point is 00:32:55 Okay. All right. Ready? I'll give you a countdown. So you're going to go on go. All right. Three, two, one. Go. Keep going, Gary. This is phenomenal. And stop. I'll give you that last one as well. 29? Yeah. Amazing. Is that good? That's a very strong score. Yes. The older bit human. How old are you, Gary?
Starting point is 00:33:40 55. Okay. You're in elite territory of that. Yes. Dude, elite territory. You smashed it. Clip that, put it everywhere. So for your age, anything above 20, is really strong. Really? And that might surprise you, right? Because you did that quite easily.
Starting point is 00:33:55 Anything about, yeah. All right, hold on. Let me get the other chair back. Catch my breath. Good, good. Yeah, yeah. You smashed it. Yeah.
Starting point is 00:34:09 Elite territory. You got that, right? I mean, that's, audio is clear. Smashed it. Oh, that's awesome. Yeah, so anything above 20 for people between 50 and 60 is very strong. Wow.
Starting point is 00:34:22 But this is on like population average, right? So obviously this is tens of thousands of people. So that gives you an idea of how low probably the real average is. Right. So anything below 15 at your age would be a little bit concerned. Anything below 12 is deeply concerning. Okay. Now the numbers that you should hit are different for each age group.
Starting point is 00:34:46 So each age group's got its own and each gender as well. Right. Okay. But I would say, I would argue that any age below 12 is probably, And there's some pretty robust data to show that anyone who can't hit more than 12 of those in 30 seconds have about a 2x risk of falls in the next year. Which is the greatest risk for... Which is the greatest risk.
Starting point is 00:35:08 In older ages, yeah. Absolutely. So with falls, they cost your healthcare system $50 billion a year. Really? It's massive. Falls? Yeah, just falls. In the elderly.
Starting point is 00:35:20 And many people who fall, who are over 65, will fracture their hip. And the scary stat there is that one in three of those people will die within the next 12 months. Wow. So it's terrifying. We actually used to call that in the mortality space the triad of death. Yeah. We had a nickname for it. Oh, wow.
Starting point is 00:35:38 These hip fractures. And what was super interesting was when we really look deep into the data, very often, the hip breaks and then they fall. Oh, interesting. The fall wasn't always causing the fracture. Like, they'd be so osteoporotic or osteopinic that the femoral neck would break and that would cause the fall. So instead of the fall causing the fracture, the fracture caused the fall. I've never gone across that. I mean, that's probably happened lots of times without me realizing.
Starting point is 00:36:08 Yeah, grandma's standing there at the sink, you know, washing dishes and crack the hip breaks and she just falls. And sometimes the family member will say, well, why did she fall? You know, I was watching her. She was just standing at the sink, washing dishes. and she just bang, hit the floor. And then they would realize, yeah, the femoral neck broke because this skeletal system had gotten so weak. They couldn't even support itself.
Starting point is 00:36:31 That's a great. So let's talk about, first of all, everybody needs to do this. Try it. It's such a good test. See if you can beat 20, would I get 29? You got to be 29. But if someone is in that 12 or under category or 12 to 15 category,
Starting point is 00:36:48 what's that a wake-up call to say, you got to start doing X? So it is primarily a measure of your leg strength, and specifically quads and glutes. And I call these your independence muscles. Because if you've got strong quads and strong glutes, you're just much better overall in terms of your mobility. You've got less chance of an injury
Starting point is 00:37:08 when you step down from a height, which is one of the key risk points as we age. Ah, not being able to hold your own weight and just stepping down from a curve, stepping off a bus, stepping downstairs. It is a double risk there because, A, your muscle's lengthening as you control, so you're more likely to lose that control, but also you're on an elevated height. So if you do lose control and you fall, the stakes are higher.
Starting point is 00:37:32 Right. So having strong quads and glutes prevents some of that risk. Okay. Now, it also means if you've got less than 12, chances are you've also got poor muscle mass in your legs. And we know that muscle mass throughout the entire body is an independent predictor of longevity. And the more muscle mass we have, the healthier we are, the longer we live. It's just as simple as that. And for every 10% decrease in a mark of muscle mass index,
Starting point is 00:38:00 so how much muscle you have on your body, there's an 11% increase in your all-caused mortality risk. Wow. So for every 10% you lose, it's an 11% increase risk. Wow. So not good. But the thing that's fascinating is this is within our control. So like if you are one of those people that hit 12 or less or 15,
Starting point is 00:38:22 or less, that's your wake-up call to change it. You're not stuck. No, absolutely not. And there's so much you can do. Yeah. So many simple exercises will help you build up the strength in those key muscles. But what I want to just address really quickly is there's probably some people who tried that test and they're feeling pretty hopeless.
Starting point is 00:38:42 The research shows that you can make incredible improvements at any age. And on the flight on the way over here, I read a new paper that came out just the other day, which said that a group of nursing home residents, so these were people in their 90s and older, were put through an eight-week quad-strengthening program. And in that eight weeks, they improved their strength by 175%. Oh, my gosh. 175% in a 90-plus-year-old age in America. In eight weeks, which is not long at all. Now, for those people, I have no doubt that was life-changing because they can start walking around again, they can probably get in and out of chairs again independently, can make a huge difference to them. So what this proves is that
Starting point is 00:39:33 it's not too late at any age. You can make improvements. And another bit of great news is that when you first start working on your strength, we typically see improvements within as little as two weeks. It's not because you can build muscle mass in that time, because you can't. But you build up those neural connections again, and that happens fast. So your body learns these movement patterns quickly. So within two weeks, there's a meaningful change in what you can functionally do, but you just have to get started and you just have to stick to it. Because I notice, you know, in older ages, the first sign is people will start pressing on their knees or they'll start grabbing the chair to get up or they'll pull themselves up somehow. Hence the crossed arms, right? So you're fully independent,
Starting point is 00:40:17 and no assistance. Both of my parents are at that stage now, and I have them working with the physio actually to try to improve that strength. Because, you know, once you're in bed and the bed's up high and there's not much that you need to do to stand up and you kind of shuffle around all day
Starting point is 00:40:36 and then go back into bed, you're not really... That strength is leaving fast. Sarkapenia in older ages is more rapid than age-related muscle wasting. It's more rapid than, I think, than people realize. Definitely. And we used to define psychoponia just as a loss of muscle mass. But now we define it as well as a loss of strength and function. So there's multiple things happening at the same time. And even though muscle mass and strength are very closely linked, they're not the same thing. So you lose muscle mass over the age of 30 at about a rate of 3 to 8% per decade if you do nothing about it.
Starting point is 00:41:13 Right. So if you're just not strength training, you're going through your normal daily life. Even if we're walking to work, right? You're still declining a muscle mass. What was really astounding to me was looking at some of these sagittal plane views through the quads. You know, where it looks like they just chopped straight through a quad.
Starting point is 00:41:32 You can see the femur in the center. And then the muscle, you know, going out almost looks like it's touching the skin. And then five years later, you see more fat on the border. And 10 years later, more fat, 20 years later, 30 years later. And the muscle almost seems to be,
Starting point is 00:41:47 like melting into the bone. And sometimes it looked like their circumference shrank a little bit, but not that much. It was just replaced with fatty tissue. Yeah, yeah. And you can see the fatty infiltrates inside the quads themselves as well. So inside the muscle. But have you seen the same cross-sectional
Starting point is 00:42:04 studies with Masters athletes that are still going into their 60s, 70s, 80s? These guys have got muscle that looks very similar to many people in their 30s and 40s. Right. It's because they're using them all the time. Right. So they avoided these changes that we used to think were inevitable because they're using it, not losing it. Yeah. So let's say that someone is at home and tries this sit-stand exercise, doesn't have the wherewithal to go to a physio. Where would you start? Would you start by just
Starting point is 00:42:32 repeating that exercise or where would you start? The simplest place would be to repeat it. But if they're, you know, if they're in pain or they got a really low score or they just couldn't do it, they had to use their hands. We might need to even wind it back a step further. So from that position, which, by the way, is where I find many of my patients when they first meet me. They often can't get out of a chair without help. We might start with some seated exercises, so just getting the quads going,
Starting point is 00:42:57 add some weight to the ankles, so you're getting the quads going like that. You might get them in bed and doing a straight leg raise against a resistance band. So non-weight-bearing exercises, but still building up the quads. Once you can get to that position
Starting point is 00:43:11 where you can get in and out of a chair, that's a great thing to practice. But then we want to progress that pretty quickly as well. So then we start to add a weight in, so a goblet squat from a sit to stand position. Exactly. I hate those. I do them, but I hate them. They're savage, but they work really well. Has me doing them. Yeah. They're great. And then you get rid of the chair and you have them doing squats without the chair if they can handle that as well. Right. And there's just so many ways to progress and make things tougher over time. I like to keep things simple. I have a rule of just one
Starting point is 00:43:39 progression at a time. So you either increase the reps, you increase the weight, or you change the technique, but not at the same time. Right. And then over time, that's how we get that progressive overload that actually rebuilds the muscle. And it really helps them focus on those nerve pathways. You know, I've had like Chris Bumstead, you know, what was the six or maybe even eight-time Mr. Olympian? Yeah, incredible. Eight-time Mr. Olympian, I think. And he talks a lot about the muscle mind connection and the difference between sort of mindlessly working out and pushing weight and and thinking about the muscle contraction, being very present for that muscle contraction, you know, just having your brain and your muscle seemingly connected during that exercise.
Starting point is 00:44:27 How important is it for people that are trying to build strength outside of somebody who's trying to get super athleticism or, you know, become a bodybuilder? But in older ages, to return that strength, do you have them draw their attention to those muscles? Do you find that that helps? Oh, 100%. And what I would say is it's fascinating how many of the techniques we use now with the older population originated in the bodybuilding world. Oh, really? Yeah, it's amazing. And this is one of them. So the mind muscle connection we used to think of as just for guys that are trying to get
Starting point is 00:45:00 huge. But it works just as well for older people that are trying to build some strength back up in their quads, right? Yeah. And there's evidence to show that it isn't just what your muscle itself can do that produces the contraction, it's how well neurally you can connect to it. Yeah. That's very well established. And just concentrating on it is a way to improve it 20, 30 percent, just like that. Yeah. Wow. Just having that presence of mind to do it, definitely. So I try and avoid telling people to do exercises absentmindedly while watching TV. Right. I think they deserve the full attention, especially if we're just doing, you know, a minute to two minutes worth of work at a time. Right. Everyone can put down what they're doing and just focus on that thing because you get so much out of it.
Starting point is 00:45:44 Yeah. You know, I noticed that the chiro physio that's working with my father will have him do it in front of a mirror sometimes. Oh, it works so well. Right. So he can see like what side he's leaning to and, you know, visually corrected. And I think probably at the same time, that visualization going back into the muscle in real time and that real time feedback. And Chris talks about that too, you know, working out in the mirror. And people think, oh, you're just trying to be your vein.
Starting point is 00:46:11 You just want to watch your muscles flex. But just to make sure that they're symmetric and also it just has your mind lock into, okay, we're working on our shoulders now and really drawing your attention to that. Yeah. So, hey guys, let me tell you about one of my favorite new hydration drinks. Now, this is for distance athletes, hits cardio exercises, people that sweat a lot or exercise intensely. An A game is a hydration drink. It has eight essential vitamins.
Starting point is 00:46:37 it has all of the electrolytes, the entire suite of B vitamins. Before you freak out and read that it has 21 grams of sugar, which it does, the sugar is coming from natural cane sugar and honey, my preferred mechanisms for getting glucose into the blood during intense exercise. It also has natural flavors, but these natural flavors don't come from bacterial fermentation. They actually come from real citrus fruits, and the color is from vegetable juice, not artificial dies. So next time you're looking for a great hydration drink and you're exercising intensely, A-game
Starting point is 00:47:07 is your choice. Now let's get back to the Ultimate Human podcast. So the main reason why people were coming to you was for pain, either post-surgical recovery or for pain that had become chronic. On your site, do you have the exercises that we just talked about? Can somebody go to your, join your membership program and actually get some of these exercises for them to do at home? Yeah, the membership program is about putting it into structure for people, but you don't need to join the membership to get them. I've got it all on my YouTube channel. All broken down for people.
Starting point is 00:47:43 Yeah, I've watched a bunch of them. I've watched a bunch of them. They make perfectly good sense. So what was the impetus for now wanting to put this into a book? It's a great question. And when I was thinking about how I could best help people, because this is where the motivation comes from, I want to reach 100 million people over 50 and actually impact. their lives meaningfully in some way. And the first book I released... Oh, you've impacted mine. So that's 99 million, 9,000 or 99,000 you have to go.
Starting point is 00:48:14 Thank you. I'll put your name down. I'll give you one. Yeah. Yeah. So the first book, I got so many messages from people saying what an impact it had had. So I knew that a book was a great vehicle for that. And I recognized that there were two types of people who were coming into my clinic, who both needed help and perhaps the way we were helping them was incomplete. So the first type of person was the person who was in a pretty bad way.
Starting point is 00:48:45 They were in pain. They've been told by a doctor or by friends that, you know, nothing can be done for you. This is just your age. What do you expect? Some point we'll do surgery. 100%. They'd gone downhill. You know, they'd lost their strength.
Starting point is 00:48:57 They'd lost their mobility. And they were just feeling hopeless. And they didn't know where to stay. it just felt like there was nothing they could do. I wanted to put in one place all of the strategies and the tactics that I've used with my clients that they could follow so that they wouldn't feel so overwhelmed
Starting point is 00:49:18 and wouldn't feel like they were hopeless and they could actually see light at the end of the tunnel. So that was the first group of people. And then the second group of people are quite different. They're people who are very health conscious. They're already doing a lot for their health, but they're listening to all the people, they're watching all the YouTube videos, even all of mine.
Starting point is 00:49:36 And it's like, where do I start now? Like I want to do the right thing for my health, but I'm walking 10,000 steps. Now someone's telling me I shouldn't do that. And I'm doing this diet, and now someone else has said, that's actually the worst thing you can do for your health. I'm lost.
Starting point is 00:49:48 So I wanted to give them the minimum effective dose, science-backed answer to this is what you actually need to do if you want to see progress. So I put, I kind of had both of those people held in my mind my mind when I wrote this book. So that's who it's for. And so you can meet somebody wherever they are on their journey, right? That's the idea. The sub 12 on the stand to somebody that actually wants to go to the next level. And you know, what I'm really encouraged by is it seems like the last five years, we've really drawn attention to how much control we have over our destiny.
Starting point is 00:50:25 Yeah. You know, I think until the pandemic almost, most people felt like the healthcare choices were in somebody else's hands. And healthcare wasn't something that you reached out for until you needed it. There was either a pain or an incident, drove you to the yard, drove you to the urgent care, made you make a doctor's appointment. But we're realizing now that it's going to be so much easier to keep people out of the system. Yeah. Right? then it will be to fix the system.
Starting point is 00:50:56 I mean, I'm a big part of that with Maha Action and some of the other organizations I give time to. So independence for life, I love it. I'm going to put them. It's out now, right? It will be out when this says, yeah. So I'll have a link in the show notes for the book. This has been amazing.
Starting point is 00:51:11 My VIPs have a lot of questions for you. So my VIP is the ones I tell before the podcast starts, you know, who's coming on the podcast. If you're interested in becoming a VIP, just go over to the ultimate human. dot com forward slash VIP and you can sign up and I'll see you in these podcasts and I'll see you on some of the live sessions but I wind down all of my podcasts by asking my guests the same question and there's no right or wrong answer to this question but what does it mean to you to be an
Starting point is 00:51:37 ultimate human does I feel like you're an ultimate human I would say no there's a lot I'm still working towards I would say but I'm on the right path I think um in answer to your question the word I would keep coming back to is momentum. And momentum is obviously a movement word. And I think movement is obviously so important is what I've built my career around. But I think momentum also describes progress. And I know personally for me that when I felt at my best,
Starting point is 00:52:11 it's been when I can actively feel like I'm making progress towards something. If I'm flatlined or if I'm declining, I'm a terrible version of myself. So I feel like everyone just needs to feel, or to get into a position where they feel like they are making progress and they do have some momentum. Because momentum is a privilege and it keeps you driving forward. So I would say that's my definition.
Starting point is 00:52:34 That's great, man. What a great answer. Well, guys, I know you're going to enjoy the book. I'm definitely going to read it. I'll put a link to it in the show notes. And until next time, that's just science.

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