Latest / The Driven Athlete / Orthopedics & Holistic Recovery w/ Joe Radich from R3 Health | Ep 56

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Orthopedics & Holistic Recovery w/ Joe Radich from R3 Health | Ep 56 · The Driven Athlete

• 0:00
  Speaker 1: If you're a driven, active person who wants to reach and pursue a higher quality life with some ambition, then guess what this podcast is for you.
• 0:07
  Speaker 1: This is the Driven Athlete Podcast.
• 0:10
  Speaker 1: What's up?
• 0:12
  Speaker 1: Y'all?
• 0:12
  Speaker 1: It's your man, Dr Kyle.
• 0:14
  Speaker 1: Welcome back, Driven Athlete Podcast.
• 0:16
  Speaker 1: We got special guests with us again Joe Radich with R3 Health and MedHouse I know you're a super busy guy, so I appreciate you coming in to share your insights and your knowledge and stuff.
• 0:25
  Speaker 2: I appreciate the invite.
• 0:26
  Speaker 2: You know I'm happy to be here always.
• 0:28
  Speaker 1: And you guys have a really cool setup right at R3 Health.
• 0:36
  Speaker 2: Remind people again what R3 Health is and where you're all located clinic where we help people basically understand how their bodies are aging, why their bodies are aging, and help implement, you know, kind of an individualized program to help people slow aging down and reverse it.
• 0:50
  Speaker 2: And that means a lot of different things to a lot of different people, but we do see people of all ages.
• 0:54
  Speaker 2: We're located in South Florida, we're in West Palm Beach and we're connected with our other amazing facility, medhouse, which is also kind of like our longevity biohacker facility.
• 1:06
  Speaker 2: So we've got R3 Health and MedHouse kind of all under the same roof.
• 1:09
  Speaker 1: I was going to say, it's a cool setup because the R3, medhouse blend, there's a cool community atmosphere.
• 1:16
  Speaker 1: People are usually hanging out getting an IV, having conversations, lounge atmosphere, with the MedHouse thing, and then it's a good streamline for patients that you're seeing with abnormalities and ailments and then transition to the biohacking and reinforcing their wellness and health trajectory.
• 1:36
  Speaker 2: Totally, and that was the premise to begin with is a space where people who have the same beliefs and lifestyles and can go to a place where they don't feel like they're being judged or you know whatever hey, like I eat this way or like.
• 1:50
  Speaker 2: We wanted a space where people can come and talk and like.
• 1:53
  Speaker 2: Again, everyone looks at the practitioners as like you know the people they should be listening to, but people have life experiences and trials and tribulations and you know networks, and so being able to have a place where people in the community can just congregate and share stories and like talk with each other and help each other is was like one of the important principles of what we wanted to build, and we're really fortunate that it's morphed into that.
• 2:18
  Speaker 1: That's cool.
• 2:18
  Speaker 1: Yeah, I totally agree.
• 2:20
  Speaker 1: Thinking like like-minded individuals that you hang out with, it just reinforces versus feeling like you're not in the right place.
• 2:25
  Speaker 1: It's like a common thing that we hear from patients uh, working with us.
• 2:30
  Speaker 1: I'm sure you're the same as in.
• 2:31
  Speaker 1: Like they, just they don't like to be told to just like well, I have an idea.
• 2:35
  Speaker 1: Why don't you just like stop exercising and hurting your joints and I'm like that's one wrong number one.
• 2:40
  Speaker 1: But like like I imagine that active, enthusiastic person that wants to do stuff with their life and like oh, solution, just don't do the thing I love anymore.
• 2:47
  Speaker 1: That's what you're going to suggest.
• 2:48
  Speaker 1: It's like that sucks, you know.
• 2:49
  Speaker 1: Yeah, a hundred percent.
• 2:50
  Speaker 1: I'm sure you guys hear a lot, a lot, too.
• 2:51
  Speaker 1: We do a lot.
• 2:52
  Speaker 1: Yes, that's cool.
• 2:54
  Speaker 1: Um, so last time we talked a lot about, like, um, the aging process, the book that you wrote as well.
• 3:00
  Speaker 1: Um, we wanted to dive a little bit more into musculoskeletal orthopedic joint pain issues.
• 3:06
  Speaker 1: This time, this discussion, and I assume you guys see a lot of orthopedic issues- we do see a lot of orthopedic issues, non-surgical.
• 3:14
  Speaker 2: non-surgical we do a lot of non-invasive orthopedics.
• 3:18
  Speaker 2: That's my background is orthopedic surgery, so we integrated a lot of that into our existing practice, but with that more like alternative, prophylactic, preventative.
• 3:29
  Speaker 2: You know, working with young athletes, you know, just to help them be the best and get the best out of their bodies.
• 3:35
  Speaker 1: That's awesome, contrasting what you guys are doing now non-invasive orthopedic interventions compared to your orthopedic surgery background.
• 3:45
  Speaker 1: Conversely, what are you other than just not doing surgery?
• 3:49
  Speaker 1: What's like the mindset, the approach, what are the contrasting differences?
• 3:53
  Speaker 2: I think for me, the biggest thing that sticks out and I'm sure you've seen this in your experience as well is that you know people get tunnel vision on the injury, right.
• 4:01
  Speaker 2: So someone comes in, oh I've got a bad knee, right.
• 4:05
  Speaker 2: But they don't.
• 4:05
  Speaker 2: Traditional orthopedics really doesn't take into account like the rest of the kinetic chain of energy we call it and I'm sure you're familiar, right so it's.
• 4:14
  Speaker 2: You know, someone comes in with a knee injury, but you know they've got really bad hip instability or their low back is messed up or they got flat or no arches in their feet and their ankles, and so traditional orthopedics is just tunnel vision on the injury.
• 4:28
  Speaker 2: What do we do to fix it?
• 4:29
  Speaker 2: Right, and there's, so there's no evaluation or thought process to the rest of the body that makes that part of the body more susceptible to injury, right?
• 4:38
  Speaker 2: That, I think, is like point number one.
• 4:40
  Speaker 1: Yeah, like, why is the knee getting lit up in the first place?
• 4:41
  Speaker 1: Correct, let's work up and downstream.
• 4:44
  Speaker 2: Yeah, the kinetic chain, like you're saying, totally, and it's basic principles like posture.
• 4:48
  Speaker 2: Probably 80% of the planet has terrible posture.
• 4:52
  Speaker 2: Right, I'm guilty of it myself.
• 4:54
  Speaker 2: Yeah, right, like you, just don't think about it.
• 4:59
  Speaker 2: But, like in traditional orthopedics, like it doesn't ever get brought up.
• 5:01
  Speaker 2: Yeah, nobody watched people walk.
• 5:02
  Speaker 2: You know you don't watch people walk up and down a hallway where you could learn so much about just posture and how they're walking.
• 5:07
  Speaker 2: Yeah, their gait pattern totally.
• 5:10
  Speaker 2: Compensation patterns for sure.
• 5:11
  Speaker 2: So I think that's for me like the biggest difference in our approach versus traditional orthopedics.
• 5:15
  Speaker 2: And I think the second biggest thing that really stands out to me is just there is absolutely zero outlook or guidance on just preventative maintenance, right.
• 5:27
  Speaker 2: So again, you've got someone who's a very active person and traditional orthopedics like you, don't go to traditional orthopedics until there's a problem, right.
• 5:36
  Speaker 2: And so I think for us, when what we do it's all about and you're no different it's about prevention, prophylaxis, how do we make sure that the body mechanically is working well and operating well?
• 5:48
  Speaker 2: And in traditional orthopedics you just don't get that.
• 5:51
  Speaker 2: You only go to the orthopedist if there's something wrong.
• 5:54
  Speaker 1: What brings you in now?
• 5:55
  Speaker 1: Well, my knee's been bothered for six months.
• 5:56
  Speaker 1: Right, right, there's like something going on.
• 5:58
  Speaker 2: Totally.
• 5:59
  Speaker 2: And so you know the biggest difference, the second biggest difference for us, and what we do is just that more preventative outlook, musculoskeletally speaking.
• 6:08
  Speaker 1: Gotcha.
• 6:08
  Speaker 1: So, primary thing, let's consider up and down the kinetic chain, up and downstream, what things are not functioning well enough biomechanically making that particular joint hurt.
• 6:20
  Speaker 1: And then the preventative future prognosis, proactive action.
• 6:25
  Speaker 2: Yeah, and even like, if someone comes in and they have an injury and you've successfully rehabbed them and recover them, how do we make sure it doesn't happen again?
• 6:32
  Speaker 1: Right, totally.
• 6:33
  Speaker 2: Right, like again you go to an orthopedic surgeon like, all right, we're going to go in there arthroscopically correct, whatever it is, that's wrong, right.
• 6:41
  Speaker 2: And then you never see them again.
• 6:42
  Speaker 1: Yeah.
• 6:43
  Speaker 2: So they don't tell you.
• 6:45
  Speaker 2: What they won't tell you is that that arthroscopic procedure is also going to accelerate adhesions and scar tissue and accelerate arthritis down the road.
• 6:54
  Speaker 1: So there has to be some element of, you know, ongoing maintenance or support for the uh post-operative patients that we see, which is pretty rare because, like, the time that we see patients at their post-op is usually six to eight months or three months after surgery and they're like not back to 100% yet, like I want to be able to run or squat or exercise or throw a baseball, like whatever they're doing, and they're like I'm just not there yet and it still hurts, like why you know what I'm saying they didn't fix their compensation patterns or they're limited in some mobility, some areas or strength and stability, um recruitment, stability elsewhere, still making things just not function as appropriately as they could.
• 7:33
  Speaker 1: But the people that we do talk with post-op, um it's very common the lack of, unfortunately, lack of communication of expectations post-surgically, as like even arthroscopically.
• 7:45
  Speaker 1: It's like that thing hurts, you know, I mean, it's swollen, it's jacked up, um, everything around it turns off and shuts down muscular, what neuromuscular function decreases because it's a defense mechanism and everything's swollen.
• 7:58
  Speaker 1: They can't walk, or like they were telling me that I was, they were going to fix my knee and my I was gonna be fixed, and they woke up and like a lot of pain, like why it's like, oh, they didn't, they painted the wrong picture you know totally.
• 8:09
  Speaker 1: First off.
• 8:09
  Speaker 1: I mean, like even back in the day I was in the clinic doing like post post up total knee replacements and hip replacements and even shoulder replacements the patients are coming in like day three, right after a total knee which you could have, matt like they're super swollen there.
• 8:27
  Speaker 1: They can they barely can put any weight on a leg and a Walker you know what I mean and they're like I was told I was going to get a brand new knee, like I have a new BMW in my knee.
• 8:34
  Speaker 1: But why am I like this?
• 8:35
  Speaker 1: I'm like ah, it's a lack of communication.
• 8:38
  Speaker 1: I'm so sorry this happened, but the next 12 weeks is going to be a journey.
• 8:43
  Speaker 1: You know it's going to be tough.
• 8:50
  Speaker 2: That was one of the things that really upset me the most when I was in traditional orthopedics is there was zero emphasis on the rehab piece.
• 8:54
  Speaker 2: Right, and in my opinion the rehab piece is just as important, if not more important, than the surgery.
• 9:01
  Speaker 2: Right, Because you could have brand new hardware in a joint, but if you don't rehab it or you don't strengthen the surrounding musculature, or again in surgery, they're moving muscles, they're moving nerves.
• 9:13
  Speaker 2: So if you don't help all that stuff come back together to the best of its ability, it doesn't matter the components they put in you, you're going to hurt, it's going to be jacked up.
• 9:21
  Speaker 2: So the rehab is, in my opinion, like I said, just as important, if not more important.
• 9:26
  Speaker 2: It never gets brought up.
• 9:29
  Speaker 1: Yeah, I'm biased, of course, and I totally agree.
• 9:38
  Speaker 1: It's a rehab person.
• 9:38
  Speaker 1: You mentioned posture and I definitely totally agree with that From our perspective, because I think we definitely speak the same language.
• 9:43
  Speaker 1: Why do musculoskeletal joint pain things come about in the first place where it's not traumatic?
• 9:49
  Speaker 1: I didn't like fall down a flight of stairs and break my neck, or like I didn't have a car accident and a tear in ACL doing that, or tennis or playing football or something like that.
• 9:56
  Speaker 1: Yeah, why does my knee, why did my knee or my shoulder, my elbow, my back, all of a sudden just kind of like develop pain and nothing traumatic happened right?
• 10:05
  Speaker 1: So like non-traumatic back pain, very, very common, right?
• 10:09
  Speaker 1: It seems like it's a combination of prolonged postures over a long, long time that creates adaptations in your body.
• 10:16
  Speaker 1: The joints adapt to it, the muscles and ligaments and bones and all of the joint, everything adapts to the things that person does continually Right and uh, sitting posture, for sure the most influential posture that we've uh, try to intervene with people sleeping position Cause, like, how many days a week do we sleep Right?
• 10:34
  Speaker 1: Seven days a week for hopefully eight hours, so we're doing that every day for multiple hours a day, like that's going to cause some changes.
• 10:43
  Speaker 1: So if somebody comes in with like chronic back pain, especially teenagers or young adults, I usually ask like how does it feel in the morning?
• 10:49
  Speaker 1: And they usually say it hurts worse.
• 10:51
  Speaker 1: Then I stand up and I move around and as I go about my day it loosens up and feels better, okay, and then you do your sport or activity and exercise or whatever, and it starts to hurt again.
• 11:00
  Speaker 1: Yes, and then you go to bed that night and it kind of calmed down since that physical activity.
• 11:05
  Speaker 1: Yes, wake up the next morning and it hurts again.
• 11:08
  Speaker 1: Right, I'm like, okay, so you felt fine going to bed.
• 11:11
  Speaker 1: Woke up the next day and it hurt.
• 11:12
  Speaker 1: Feel better, warmed up, exercise it hurts worse, settles down, go to bed it hurts again the next morning.
• 11:17
  Speaker 1: Cycle continues.
• 11:18
  Speaker 1: For so I'm like yo, your sleeping position is contributing to things staying irritated.
• 11:24
  Speaker 1: Another really common one is like shoulder that we've heard, where, like, people are like I sleep on my shoulder because it hurts, so I want to keep it stable, so it doesn't like move around at night and I wake up and it hurts and I'm like yo, don't sleep on your shoulder.
• 11:37
  Speaker 1: That's definitely contributing, you know.
• 11:40
  Speaker 1: But anyway, I definitely agree.
• 11:50
  Speaker 2: Like dude, prolonged postures.
• 11:51
  Speaker 2: It creates adaptations over a long period of time.
• 11:52
  Speaker 2: Yeah, I think poor technique also.
• 11:53
  Speaker 2: Yeah, right, even if people live an active lifestyle, like they don't, their technique is off and all it takes is that one degree of wrong torque or wrong twist and you do that repetitively, even people who work out totally.
• 11:59
  Speaker 2: Poor posture and poor technique, I think, are the biggest reasons.
• 12:03
  Speaker 2: Totally, I love that non-traumatic.
• 12:05
  Speaker 1: I love that.
• 12:06
  Speaker 1: What we usually say is like it's the repetitive movements.
• 12:08
  Speaker 1: So the repetitive compensation movements over and over and over again, of like a thousandth knee you know, let's say, knee pain, running a marathon or just running, training runners or squats and lunges and exercise whatever, playing basketball, stuff like that the underlying compensation patterns of the hip, the ankle, the foot, core stability, pelvic mobility, the movement control and coordination, combined with not the right muscle strength and stability, it's going to make other things overcompensate.
• 12:36
  Speaker 1: And the question I usually ask patients is like what's going to get lit up first?
• 12:40
  Speaker 1: The things that are overworking and working overtime?
• 12:43
  Speaker 1: Or the things that don't contribute and are dormant all the time?
• 12:46
  Speaker 1: Or the overworkers, right, the overtime guys?
• 12:48
  Speaker 1: Those are the ones that are going to get lit up and those are tendons, tendonitis, joint pain.
• 12:53
  Speaker 1: Those are the ones that are overworking and taking the brunt of a lot of the forces over and over again.
• 12:58
  Speaker 1: That just causes the compensation issues.
• 13:00
  Speaker 1: So the thing we ask people is like all right, are we here in true disorder pedics?
• 13:12
  Speaker 1: I'm sure there's a lot right Solution rest, take Advil and ice and then after six weeks start trying your thing again, whatever the activity is.
• 13:15
  Speaker 1: So they do that, six weeks later it comes back.
• 13:16
  Speaker 1: It's like it doesn't make a make.
• 13:18
  Speaker 1: I mean, of course, because we didn't fix the reason why happened in the first place, and that's like movement training, you know, like the stability and movement control, coordination, joint mobility, whatever.
• 13:26
  Speaker 1: So that's just cool from your perspective, coming from a traditional orthopedic standpoint.
• 13:31
  Speaker 1: Now that y'all are conveying the same message to your patients, now that's really cool.
• 13:37
  Speaker 1: So what do y'all for musculoskeletal, the lens in which you perceive that, prolonged postures, like you said, technique compensation issues, anything else in particular?
• 13:51
  Speaker 2: I think, and I know you see a lot of like athletes, you know, in all levels, but I think this also, this concept, which is a very real concept, of overtraining, I think it's a big one, especially in, like, younger populations, because nowadays it's so competitive with high schools and college and private sports academies, it's push, push, push, push, hard, hard, hard.
• 14:15
  Speaker 2: We just left my daughter in your office right Rehabbing a hip or a quad.
• 14:20
  Speaker 2: So it's, you know, my daughter dances seven days a week and I try to stick my mouth out there when I can, but she doesn't want to listen to dad.
• 14:29
  Speaker 2: But, like you know, I think it's this concept of overtraining and pressure that people put on themselves to perform and Got to be the best, got to be Specialized, have to be the best, have to be the best, have to work and practice.
• 14:41
  Speaker 2: And that's wonderful and we love the work ethic.
• 14:43
  Speaker 2: But if you're going to do that, I think two things One is this concept of overtraining, and two, that always gets neglected is people don't recover properly, whatever that means.
• 14:53
  Speaker 2: Does that mean rest?
• 14:54
  Speaker 2: Does that mean cold plunge?
• 14:56
  Speaker 2: Does that mean infrared?
• 14:57
  Speaker 2: Does that mean whatever that means to you?
• 15:00
  Speaker 2: to your sport or to your lifestyle.
• 15:01
  Speaker 2: People overtrain and people do not recover good enough Like a recovery.
• 15:06
  Speaker 1: What do you find most speaking with your patients on recovery?
• 15:09
  Speaker 1: What do you find yourself talking points?
• 15:11
  Speaker 2: All the above.
• 15:12
  Speaker 2: It's like, hey, you need to listen to your body.
• 15:15
  Speaker 2: If you're going to push and push and push, you have to carve out time off, yeah, and you're going to have to properly learn how to recover properly.
• 15:22
  Speaker 2: You know like it boils down to basics, but if you're going to continue to push yourself at this pace and frequency and intensity, something's going to give unless you support yourself.
• 15:31
  Speaker 1: Yeah totally Totally.
• 15:32
  Speaker 1: There's a with sleep, sleep being the number one thing we'll first talk about, um, with teenagers usually there's.
• 15:40
  Speaker 1: They're not the best communicators, right?
• 15:43
  Speaker 1: So what I find, um, and they uh leave out helpful information pretty often and we have to, like, dig in and pry.
• 15:51
  Speaker 1: You know what I mean?
• 15:51
  Speaker 1: Um, and often they're like I sleep good, yeah, cool, all right.
• 15:56
  Speaker 1: Um, what time did you go to bed last night?
• 15:58
  Speaker 1: Well, I just went to bed after I played video games.
• 15:59
  Speaker 1: I was like, well, what time was that?
• 16:01
  Speaker 1: Well, I got a snack.
• 16:02
  Speaker 1: I was like, what time was your snack?
• 16:04
  Speaker 1: 1 am, and then you played more video games after that, yeah, and then you got up for school at 7 or 6.30.
• 16:10
  Speaker 1: So, dude, you didn't go to bed until like 2.30, 2 o'clock and you got up at 6.
• 16:17
  Speaker 1: For, like a teenage kid that's playing sports and stuff, I'm like, dude, uh, professional, high career oriented, uh, young adults that are burning the candle off both ends and they're just like grinding and they're like I got to get stuff done, Otherwise I'm just they're not going to get done, right, um, and they don't sleep enough, and that's going to cloud the mental bandwidth.
• 16:36
  Speaker 1: And then also just clarity, um, this is what we found, but did you see a lot of like young athlete, like teenagers and stuff?
• 16:42
  Speaker 2: We do.
• 16:42
  Speaker 2: Yeah, we see a lot of teenagers, just in general not even athletic teenagers, because the biggest issue is they don't prioritize these fundamentals.
• 16:50
  Speaker 2: Sleep, yeah, it's probably the biggest issue that we see in our teenage patient population is when you don't sleep well, like we're talking about, your body doesn't rest, recover, it doesn't heal, it doesn't have the capability to heal as successfully, and what it does, biochemically speaking, is it jacks up your adrenal gland and your body is cranking out cortisol because you're not able to heal and recover.
• 17:12
  Speaker 2: So your body's in this constant repair mode and it causes your adrenal gland to surge and it causes an overproduction of cortisol and then it turns into a vicious cycle because you're not sleeping well, so your cortisol is going up and because your cortisol is going up, it's not allowing you to sleep because you're overstimulated, and that is a very bad hamster wheel for teenagers to be in, and we see it all the time.
• 17:37
  Speaker 1: What is some of the cortisol gets a lot of attention.
• 17:41
  Speaker 1: What is its role and why is it detrimental if it's?
• 17:44
  Speaker 2: elevated.
• 17:45
  Speaker 2: So cortisol over time.
• 17:47
  Speaker 2: What happens?
• 17:48
  Speaker 2: So our adrenal gland releases cortisol in response to a stressor.
• 17:52
  Speaker 2: That stressor could be mental, it could be physical, it could be physiological.
• 17:56
  Speaker 2: So when our body perceives a stressor, wherever that stressor comes from, your body produces cortisol.
• 18:03
  Speaker 2: When your body produces cortisol, your body is programmed to go into this hyper-stimulated fight or flight mode.
• 18:10
  Speaker 2: And when you're in this hyper-stimulated fight or flight mode, especially for long periods of time, it's the biggest catalyst to inflammation, because your body loses efficiency.
• 18:20
  Speaker 2: Think about it, right.
• 18:21
  Speaker 2: If your body's just thinking survive, quote right, that means pump blood, get oxygen to your brain, everything other than those two things suffers and they become very inefficient.
• 18:33
  Speaker 2: And that inefficiency is what creates cellular inflammation.
• 18:36
  Speaker 2: That inflammation leads to injury and all the things.
• 18:40
  Speaker 2: Right, yeah.
• 18:43
  Speaker 1: That makes total sense.
• 18:44
  Speaker 1: What systems get more affected?
• 18:50
  Speaker 2: from this cycle do you find?
• 18:51
  Speaker 2: So I, I definitely will tell you that physically for sure.
• 18:54
  Speaker 2: So musculoskeletal track, right, whether it's your soft tissues, whether it's your uh, joint spaces, right.
• 19:01
  Speaker 2: So tendons, ligaments, cartilage, they're much more vulnerable to to injury because of that inflammation cascade, right.
• 19:08
  Speaker 2: And I would also say in younger people, meaning 50 or younger, I would say cognitively actually.
• 19:15
  Speaker 2: So memory, recall, concentration, focus.
• 19:19
  Speaker 2: You wanna talk about all this ADD, adhd, all this stuff that's out there, guess what?
• 19:26
  Speaker 1: People's adrenals are jacked up.
• 19:27
  Speaker 1: Interesting that makes total sense.
• 19:28
  Speaker 1: You know, um, and I would imagine there's a lot of people that live in that cycle for years and years and years.
• 19:36
  Speaker 1: And like what does that look like after 30 years of an intense family life, the kids and all the intensities that come with that career pressure, responsibilities, anxieties that come with that?
• 19:49
  Speaker 1: Like what does that look like when they reach 65?
• 19:52
  Speaker 2: Yeah, and you, you get to a point.
• 19:54
  Speaker 2: You know not to go completely on this cortisol tangent, but, like, you get to a point where your adrenal gland can't keep up and your adrenal gland burns itself out, and so that's a bigger problem.
• 20:04
  Speaker 2: So it's imagine pushing on the gas pedal 24-7, 365 for five years straight.
• 20:09
  Speaker 2: You're cranking out all this cortisol all the time.
• 20:12
  Speaker 2: Over five years your adrenal gland taps itself out.
• 20:15
  Speaker 2: It's like I can't do this anymore.
• 20:17
  Speaker 2: What happens then?
• 20:17
  Speaker 2: Then it's a big problem.
• 20:19
  Speaker 2: So then you can't get into any type of a fight or flight response, which is also not good.
• 20:23
  Speaker 2: We need that ability to produce cortisol.
• 20:27
  Speaker 2: In times we need it right.
• 20:27
  Speaker 2: You injure yourself, you need that surge of adrenaline, or your body needs cortisol for other things, like blood sugars, and it plays a very big physiological role.
• 20:38
  Speaker 2: So if your adrenal gland is burned out and now you can't make any cortisol for even just your normal physiology, yeah, it just again.
• 20:47
  Speaker 2: It affects the aging process interesting.
• 20:50
  Speaker 1: That's a pot doesn't look good for an inflammatory response.
• 20:53
  Speaker 1: No, after that, for everything else, no, all right.
• 20:56
  Speaker 1: So sleep being a huge priority for recovery, for musculoskeletal joint type pain.
• 21:01
  Speaker 1: One more thing on sleep.
• 21:02
  Speaker 1: I was thinking about that I heard recently read it was like uh, sleep, um, it allows your brain to recover and it flushes out all the waste proteins that then, um, it can be released and flushed out of the system where a lack of sleep doesn't allow those waste proteins to be removed as effectively, and they remain, and those wastes being the things that lead to like, or triggered to be found to, correlated with, like, alzheimer's cognitive decline, neurofibrillary tangles and amyloid plaques.
• 21:31
  Speaker 1: Yep, is that accurate?
• 21:33
  Speaker 2: super accurate.
• 21:33
  Speaker 2: And again it goes back to the principle of your in fight or flight.
• 21:36
  Speaker 2: Your body's inefficient, so you don't, your detox pathways become compromised and when you're not detoxing well, all these cellular and biological wastes accumulate and they've got nowhere to go and again it just causes inflammation and disease process and all these conditions that you're listing.
• 21:54
  Speaker 1: So recovery, sleep, other things for joint related recovery right, and there's something like training a lot.
• 22:01
  Speaker 1: They're very active.
• 22:02
  Speaker 1: Recovery sleep can be one of them.
• 22:04
  Speaker 1: What's another other recovery aspects that you recommend in your practice for joint stuff?
• 22:09
  Speaker 2: So I think I think people and this is like another big concept but just eating properly, yeah, that's where my head went first.
• 22:15
  Speaker 2: Nutrition, micronutrients yeah Right, so key when it comes to just replenishing what the body is is utilizing, yeah, so I think food and nutrition is arguably just as important as sleep.
• 22:28
  Speaker 1: Go over real quick macronutrients and then micronutrients.
• 22:32
  Speaker 2: So macronutrients are the things that we think about when we talk about nutrition, right, proteins, carbohydrates, fats, those types of things.
• 22:40
  Speaker 2: Micronutrients is where we kind of get into the weeds of really trace minerals, amino acids, vitamins, all the individual components that then, when they're put together, make up the macronutrients, the fats, the proteins et cetera.
• 22:55
  Speaker 2: That's the key distinction.
• 22:56
  Speaker 1: Interesting.
• 22:57
  Speaker 1: Are there any specific micronutrients, vitamins and minerals amino acids that you find are consistently off for patients that you see?
• 23:07
  Speaker 2: Definitely.
• 23:08
  Speaker 2: I mean again, anytime there's an inflammatory process or someone lives an active lifestyle, your body is having to rebuild a lot of smooth muscle right Just from natural breakdown, and so things like very important antioxidants, like glutathione, all your essential amino acids and non-essential amino acids, and so the biggest thing that we see in people who are athletic is they undereat and they don't eat.
• 23:35
  Speaker 2: What for what their lifestyle is yeah and that again it just accelerates the injury risk because they don't have the proper macro micronutrients to recover properly supply their activity.
• 23:48
  Speaker 1: That's right.
• 23:48
  Speaker 1: And then the body's naturally going to go towards what's easiest first, which is the glycogen stores from, I've heard, the glycogen stores in your muscle tissue.
• 23:55
  Speaker 1: So your body eats your own muscle, literally, and you're trying to build muscle or maintain muscle, uh, and you're not able to because the body's eating it for energy, yep.
• 24:02
  Speaker 1: Um, that's interesting if, with uh, with the micronutrients for joint related pain, has there been a correlation with a lack thereof and specific arthritic conditions?
• 24:15
  Speaker 2: definitely so.
• 24:16
  Speaker 2: We know for a fact that certain uh omegas, certain fatty acids, we know that certain amino acids like cysteine and glutamine and carnitine there's lots of literature that proves that those macro and micronutrient deficiencies accelerates the development of arthritic changes over time.
• 24:34
  Speaker 1: Interesting, wow.
• 24:35
  Speaker 1: So solution I know omegas right would be fish oil.
• 24:40
  Speaker 1: Is that accurate?
• 24:41
  Speaker 1: Yep, yep, fish oils, and then with the other ones, what other sources?
• 24:45
  Speaker 2: Other sources are things like krill oil, cod liver oils you know, any of your seeded oils which you know we don't love talking about seeded oils but, like olive oils, healthy fats, avocados, beans, nuts, right Huge sources of omegas and fatty acid chains.
• 25:02
  Speaker 2: So those are all super protective when it comes to musculoskeletal recovery.
• 25:06
  Speaker 2: Awesome.
• 25:08
  Speaker 1: With the other micronutrients you were just listing.
• 25:12
  Speaker 1: What other sources of food or nutrients can we get those?
• 25:16
  Speaker 2: It's crazy, right.
• 25:17
  Speaker 2: So everybody's always asked this question and it boils down to just the common sense things, right.
• 25:22
  Speaker 2: So like, yeah, simple, right, but it's true.
• 25:25
  Speaker 2: Dark leafy greens, healthy animal proteins, lots of fruits and vegetables, non-processed, non-preserved, non-stored.
• 25:34
  Speaker 2: You know basic principles.
• 25:36
  Speaker 2: That's how you really make sure that you're optimizing macro micronutrients.
• 25:41
  Speaker 1: That's good to hear.
• 25:42
  Speaker 1: Simplistic, yeah, exactly.
• 25:44
  Speaker 1: Keep it simple.
• 25:45
  Speaker 1: Yeah, there's been a lot of attention with nutrition of plants right, vegetables not being good for humans, and then carnivore diet right, or vegans, on the other hand, it's like that good for you and we want to just crush leafy vegetables.
• 26:01
  Speaker 1: What are your thoughts on?
• 26:03
  Speaker 2: that my number one takeaway message with this part of our conversation is there is no one size fits all, so everyone's body type, everyone's lifestyle, everyone's genetics is more conducive to a certain style of eating.
• 26:15
  Speaker 2: So my number one answer is I don't.
• 26:17
  Speaker 2: You can't expect anyone to follow one specific eating pattern.
• 26:20
  Speaker 1: Yeah.
• 26:20
  Speaker 2: That's my big takeaway message.
• 26:22
  Speaker 2: I tell that to every single person that I talk to With that said yes, there's a lot of these fad.
• 26:28
  Speaker 2: I don't even want to call them fads because some of them are based in science and there's great literature to support them, but there's trends.
• 26:34
  Speaker 2: Yeah, trendy there's trendy Paleo, intermittent, fasting, vegan, pescatarian, mediterranean, I mean, you name it.
• 26:41
  Speaker 2: There's dozens when in doubt.
• 26:44
  Speaker 2: I think, anything in moderation, so I never tell people to cut something out.
• 26:51
  Speaker 2: I'm a realist with people.
• 26:53
  Speaker 2: I think life is too short to be too restrictive.
• 26:56
  Speaker 2: Again, variables there.
• 26:59
  Speaker 2: Hey, you have a sensitivity to something, you can't have it.
• 27:01
  Speaker 2: Yeah, I get that.
• 27:02
  Speaker 2: Fine, totally.
• 27:03
  Speaker 2: But I'm a big proponent of anything in moderation is good.
• 27:06
  Speaker 2: I like mixed plates, you know.
• 27:08
  Speaker 2: I think there should be a protein, a carb, a vegetable on every plate.
• 27:11
  Speaker 2: Yeah, you know.
• 27:13
  Speaker 2: So I again.
• 27:13
  Speaker 2: I think it just kind of boils down to bare bone basics.
• 27:16
  Speaker 2: We all know it's just sometimes we kind of get off track yeah, um the uh with the 80 20 rule.
• 27:24
  Speaker 1: I'm a huge advocate for that.
• 27:25
  Speaker 1: I definitely agree, because there's a time where I was like I'm going to crush this and be super focused and then, uh, deprivation like depriving or being super restrictive yeah, ultimately leads to binging if it's not done in a right way and then it's just like total backslide.
• 27:40
  Speaker 1: You know what I mean and it's funny.
• 27:43
  Speaker 1: It's like this doing things simple and like people are want like what's, what's the trendy, easy or that's a trendy thing, that's get a lot of attention, that I could do.
• 27:51
  Speaker 1: That's cool, you know, sexy or easier.
• 27:55
  Speaker 1: You ever see those like memes online?
• 27:57
  Speaker 1: I think about this.
• 27:57
  Speaker 1: You ever see those memes, the videos online where it's it's like, um, middle-aged, uh, females will do anything to avoid training with weights and they're doing like the moon, shoe jumping or swinging with ropes around the gym or doing like the um, uh, drumstick beating on the physio balls.
• 28:17
  Speaker 1: It's wild.
• 28:19
  Speaker 1: Oh, look at that.
• 28:20
  Speaker 1: I'm like that's totally.
• 28:20
  Speaker 1: They will do anything just to avoid weight, like lifting weight, like resistance training right, because it sounds scary, but it's, it's hard to do, you know.
• 28:28
  Speaker 1: It's like, what are the alternatives here?
• 28:29
  Speaker 1: It's like, well, this one makes total sense and it's been proven.
• 28:32
  Speaker 1: No, no, no, we can't do that.
• 28:34
  Speaker 1: What about these things like we're never gonna make things super complicated and not very effective, just avoiding what we know works.
• 28:40
  Speaker 1: It's so true.
• 28:41
  Speaker 1: I just think that's funny.
• 28:43
  Speaker 1: It is, I get it, I get it, but that's just funny to me.
• 28:47
  Speaker 1: Okay, so we got sleep for joint pain.
• 28:50
  Speaker 1: We got recovery Super important Sleep, nutrition.
• 28:53
  Speaker 1: You mentioned cold plunge, hyperbaric.
• 28:58
  Speaker 1: What other things do you all recommend within the stuff that you guys do?
• 29:03
  Speaker 2: Yeah, so a big part of our practice, because we do see a lot of athletes of all calibers and all ages.
• 29:10
  Speaker 2: I think a big thing for us in our practice is and a lot of people are starting to become more familiar with it but this concept of peptides, yeah Right, so there's this kind of area of our industry in integrative medicine is this peptides?
• 29:22
  Speaker 2: Everyone's talking about peptide, this peptide, that what's wonderful about these peptides is they're all natural.
• 29:28
  Speaker 2: So these are compounds that are based in amino acids, so the very things that we were just talking about, that we get through nutrition, so certain amino acids.
• 29:39
  Speaker 2: When you put certain amino acids together, it makes this compound and there are and these compounds are named peptides, and there are peptides that help on the musculoskeletal side.
• 29:48
  Speaker 2: There are peptides that help on the immune side.
• 29:50
  Speaker 2: There are peptides that help on the hormone side.
• 29:52
  Speaker 2: But what we see a lot in musculoskeletal injuries and issues is that we use a lot of this one peptide called bpc 157 it's a fancy name, it stands for body protective compound 157 and this is a string of amino acids that they put together that has a predisposition to attract to connective tissues okay tendons, ligaments, cartilage, meniscus, labrum, and initiate that healing cascade of events in those connective tissues.
• 30:23
  Speaker 2: So we're able to take this BPC-157 peptide, inject it into an injury area or to a site of inflammation or to an area that's damaged or destroyed and it really helps these connective tissues regenerate, reduce inflammation, become stronger, improve blood flow and it's an incredible therapy.
• 30:43
  Speaker 2: So we do a lot of these peptide types of treatments as well Interesting.
• 30:47
  Speaker 1: Would you inject that in someone's low back knee joint, elbow neck?
• 30:52
  Speaker 1: So we inject these peptides into joint spaces, into tendons, into all the connective tissues, ligaments, cartilage, labrums, anywhere so if somebody is interested, right, and they're like I've been battling this thing, I'm getting some sports PT, cool, I want to dabble in peptides and other biohacking stuff that I can do for my health system and they reach out.
• 31:16
  Speaker 1: Would they expect to get injected day one?
• 31:19
  Speaker 2: No.
• 31:20
  Speaker 2: So, just like when you meet someone for the very first time, you're doing your assessment, your evaluation, right?
• 31:25
  Speaker 2: We to our point earlier, like we were talking about, we have to look at the body as a whole, right, and not just get that tunnel vision on whatever injury that person is coming in for, whatever their complaint is Get a global handle on what's going on and make a decision.
• 31:39
  Speaker 2: Exactly.
• 31:40
  Speaker 2: You have to really get to know that patient and that person and what goes on and what contributed to this and how are we going to prevent it.
• 31:46
  Speaker 2: Then you can really start to kind of formulate or hypothesize a plan, and that plan should have a long-term, a short-term objective and a long-term objective.
• 31:56
  Speaker 2: And at that point is when we start talking about, okay, this modality makes sense, or we should think about this injection, or hey, I need you to go work with Dr Kyle on this range of motion exercise, or this muscle group.
• 32:11
  Speaker 2: Then when you can put all of that together, that's when you're going to have the best outcome, orthopedically speaking.
• 32:18
  Speaker 1: Yeah, yeah, that makes total sense.
• 32:19
  Speaker 1: Yeah, the uh, that's really cool.
• 32:21
  Speaker 1: I know peptides are getting a lot of attention, um, definitely getting very popular, um it's.
• 32:27
  Speaker 1: It's interesting to hear the purposeful applications.
• 32:30
  Speaker 1: You know what I mean.
• 32:32
  Speaker 1: Um.
• 32:32
  Speaker 1: So, bpb, bp, bpc, 157 for collagen, joint ligaments, tend tendons.
• 32:40
  Speaker 1: Yeah, for orthopedics.
• 32:42
  Speaker 1: What other options are there?
• 32:44
  Speaker 2: There's a bunch, right.
• 32:45
  Speaker 2: So there's dozens of peptides, and they're evolving and coming and going, and so the other one that we use a lot of which is a little bit more well-known, or out there is another peptide called TB500 or TB4, but it's a peptide called thymusin beta, and so this is a peptide that stimulates your thymus gland in your body, and your thymus gland is basically what kind of controls our immune system.
• 33:09
  Speaker 2: So by implementing this thymusin peptide or this TB500 peptide, we're activating, we're exciting your thymus gland to produce more, um you know, healing cells, and that could be stem cells, that could be growth factors, that could be just the normal white blood cells that fix things, um, and so this thymus and peptide is a great peptide for also not just musculoskeletal and orthopedic things, but other systemic inflammatory diseases interesting and you could inject, uh, both of those within the same treatment.
• 33:42
  Speaker 1: Yeah, or is it like a spacing period?
• 33:43
  Speaker 2: No, a lot of times we do combine them together.
• 33:45
  Speaker 2: So there's this protocol, that's out there.
• 33:48
  Speaker 2: I won't take credit for it because I didn't come up with it, but they call it the Wolverine protocol.
• 33:53
  Speaker 1: Okay, love that.
• 33:54
  Speaker 2: He's probably my favorite superhero Right, wolverine, no doubt about it, right Like bionic dude.
• 33:58
  Speaker 2: So the Wolverine protocol is basically combining this BPC-157, this thymus and beta and usually some element of a growth hormone stimulating peptide, and it's that magic three, that trifecta, which makes up this kind of Wolverine peptide Interesting.
• 34:15
  Speaker 2: And a lot of times again we'll administer it into a specific part of the body or even intravenously, so we can administer these a whole bunch of different ways.
• 34:24
  Speaker 1: Interesting.
• 34:25
  Speaker 1: That's really cool.
• 34:25
  Speaker 1: Yeah, do you find it more effective to inject into the inflammatory region of the body or IV?
• 34:33
  Speaker 2: So I think, when we're talking specifically musculoskeletal, the localized injection.
• 34:38
  Speaker 1: Got it For sure.
• 34:39
  Speaker 1: For systemic it would be IV.
• 34:40
  Speaker 1: Yeah, interesting, that's really cool yeah, do you do?
• 34:45
  Speaker 1: You do you find yourself um working with a lot of people that, uh, once they get these injections, like they see results within four, three week, two week, five week, like.
• 34:56
  Speaker 1: What's the timeline of?
• 34:58
  Speaker 2: yeah, I think it or treatment protocol.
• 34:59
  Speaker 1: It's like a one time and done, or is it over?
• 35:02
  Speaker 2: For some patients it can be a one and done, cool, you know for sure.
• 35:05
  Speaker 2: I think it just goes back to the point we were talking about earlier, about you know there has to be some element of maintenance if you will Right, because, say, for example, you've got a 25 year old CrossFitter right and you, no matter what happens, you know that they are going to go right back to pounding their body crossfitting right.
• 35:25
  Speaker 2: So would you drive your car without giving it an oil change once every year?
• 35:29
  Speaker 2: What's going to happen to your car?
• 35:31
  Speaker 2: It's going to blow up, right?
• 35:33
  Speaker 2: So there has to be this like component of like maintenance thinking where, if you've got someone you know is a very active person, active lifestyle, a lot of physical demand, and they're going to continue to pound themselves, there has to be some sort of long-term maintenance strategy, whether it's just on the rehab side, whether it's hey, you know, maybe we should do an injection once a year, or once a quarter, or hey, you should be coming in for these uh IV anti-inflammatory therapies once a quarter.
• 35:59
  Speaker 2: Or hey, you should be coming in for these uh iv anti-inflammatory therapies once a quarter.
• 36:02
  Speaker 2: Right, I think.
• 36:04
  Speaker 2: I think a lot of times we want it to be a one and done, yeah, but it's just not realistic for most people's lifestyles or, like you're saying earlier, fix the technique.
• 36:14
  Speaker 1: Compensation issues yeah, that led to the shoulder or the low back issue in the first place with your crossfit or whatever activity you're doing.
• 36:21
  Speaker 1: That, um, combined with that, that's ultimately going to like not keep it for coming.
• 36:25
  Speaker 1: That's going to prevent it from coming back.
• 36:27
  Speaker 1: Yeah, growth hormone sounds scary for a lot of people and explain, um, that we're not.
• 36:34
  Speaker 1: You're not altering somebody's endocrine system.
• 36:37
  Speaker 1: Is that accurate, correct using these peptides, because they're natural Correct.
• 36:41
  Speaker 1: So, like, what does it do and how does it?
• 36:42
  Speaker 1: Why is it safe?
• 36:44
  Speaker 2: Yeah.
• 36:44
  Speaker 2: So just first basic education on growth hormone.
• 36:47
  Speaker 2: Growth hormone is this thing that really gets kind of, you know, misconcept or misconceived.
• 36:53
  Speaker 2: I should say it's a very incredibly important compound in two intervals of our life when we're young, obviously, in our bodies are developing and maturing in puberty, but also then, 50 and older, it becomes just as important again and a lot of people don't know that.
• 37:10
  Speaker 2: But if you think about conceptually why growth hormone is a maintenance hormone, it's what we call an anabolic hormone.
• 37:17
  Speaker 2: It's not an anabolic steroid.
• 37:18
  Speaker 2: I don't want to get people confused.
• 37:20
  Speaker 2: It is an anabolic compound which means it helps things grow.
• 37:30
  Speaker 2: So as we get older and our natural evolution is to degenerate, right, you want something that's going to help things grow.
• 37:34
  Speaker 2: So growth hormone is very important during our early years, developmental years.
• 37:40
  Speaker 2: Growth hormone is very important during our early years, developmental years, puberty years, but then it also comes back second round at 50 plus, when our bodies are really going through that aging and that degenerative process.
• 37:56
  Speaker 2: Growth hormone is what helps your body maintain itself.
• 37:57
  Speaker 2: Your bone density, your connective tissues, lean muscle mass, cartilage all these things that we know wear down with time because of the aging process.
• 38:03
  Speaker 2: Growth hormone helps maintain them or regrow them.
• 38:07
  Speaker 2: So it's this concept that's very important and people get a little hesitant because they're thinking steroids and anabolic hormones and all these illegal substances.
• 38:17
  Speaker 2: But it has nothing to do with that.
• 38:19
  Speaker 1: Yeah, like a Mr Olympia Correct, you know gym Correct and growth hormone and growth hormone stimulating peptides have their place.
• 38:28
  Speaker 2: And they have their place.
• 38:29
  Speaker 2: And even people who are not athletes, right, you think about an older menopausal woman who's got osteoporosis.
• 38:35
  Speaker 2: What's going to cause that bone to regrow?
• 38:37
  Speaker 2: Nothing except trying to get growth hormone production going.
• 38:41
  Speaker 2: Osteoporosis is completely reversible.
• 38:44
  Speaker 2: People don't know that, but it's completely reversible.
• 38:48
  Speaker 1: We see those individuals occasionally where because the thing about like women, it was more women than men, of course profile over the age of 60, right or 58.
• 38:59
  Speaker 1: And they want to exercise and do Pilates and yoga and stuff like that and they're noticing changes in the docs.
• 39:07
  Speaker 1: Like yo, you have osteoporosis or osteopenia right, developing into osteoporosis.
• 39:12
  Speaker 1: What do we do?
• 39:12
  Speaker 1: I'm like yo.
• 39:13
  Speaker 1: We got to look at nutrition.
• 39:14
  Speaker 1: We definitely need to do weight-bearing exercise because the bones adapt to the stress placed on them and it's going to remineralize and create more bone mineral density with more pressure going through your bones.
• 39:27
  Speaker 1: It's on purpose.
• 39:27
  Speaker 1: It's purposeful pressure and purposeful stress that the body then adapts to.
• 39:30
  Speaker 2: But then layering, like you're saying, the growth hormone could be crucial super important and you know, like that's why I said it's for athletes, but also non-athletes, right?
• 39:38
  Speaker 2: Just thinking about maintenance and keeping their bodies strong.
• 39:42
  Speaker 2: And there's a very strong study that came out recently from the American Heart Association and they're actually now showing that there's a direct correlation between lean muscle mass and aging.
• 39:54
  Speaker 2: Oh, totally no brainer, right?
• 39:57
  Speaker 2: Makes a lot of sense.
• 39:58
  Speaker 2: But now, even like, traditional organizations are recognizing how important skeletal and lean muscle mass is to the aging process.
• 40:06
  Speaker 1: That makes total sense Because it represents so much.
• 40:09
  Speaker 1: I've always thought that, like, if you ever meet somebody in my opinion right, and they're in good physical shape, that's not anything that can be faked.
• 40:19
  Speaker 1: In good physical shape, that's not anything that can be faked.
• 40:24
  Speaker 1: Like you can't buy lean muscle tissue, you know.
• 40:26
  Speaker 1: Um, or more, uh, improved bone mineral density with lean muscle tissue, um, it has to be earned, which sucks Like it's hard.
• 40:33
  Speaker 1: You know what I mean.
• 40:34
  Speaker 1: Uh, but anyway, some of that that's an aging, active individual, aging being like what we would, probably over the age of 55, right, they're not 20 years old anymore, they can't just do whatever they want and be fine.
• 40:45
  Speaker 1: You know, it's like I'm entering that, you know, right now, as a post athlete, um, at 35, you know, but, um, that's it's something that in that aging active individual stage and they're muscular, like they're in good physical capacity and shape, and they're must have a solid lean muscle mass profile.
• 41:03
  Speaker 1: That takes a lot of effort, you know, and it's like doing the hard things consistently, because that can't be bought or faked.
• 41:10
  Speaker 1: You know, agreed, and that's a that's super challenging, but I mean it makes total sense.
• 41:15
  Speaker 1: You're saying the correlation that a healthy, a graceful aging process correlated with lean muscle mass, because that means they're exercising.
• 41:23
  Speaker 1: You have to exercise to get that.
• 41:25
  Speaker 1: You can't just do that.
• 41:26
  Speaker 1: You know with that, even just taking steroids, you know what I mean you're not going to get the same thing agreed.
• 41:30
  Speaker 1: Well, that's interesting, that's a great um information.
• 41:34
  Speaker 2: Yeah, big study that's really cool.
• 41:35
  Speaker 1: What else did they find within that study?
• 41:37
  Speaker 2: that was um that the same correlation, not just for longevity but also as a predictor of heart disease.
• 41:43
  Speaker 2: So the more skeletal lean muscle mass you had, the less risk you had for developing heart disease heart attack stroke.
• 41:50
  Speaker 1: Interesting, also makes total sense because that means they're exercising to get that.
• 41:53
  Speaker 1: That's just very I love that because it just reinforces like man exercise is super important and it's just something that I want to normalize for my kids.
• 41:59
  Speaker 1: I love that because it just reinforces like man exercise is super important, you know, and it's just something that I want to normalize for my kids, you know it's.
• 42:06
  Speaker 1: It's really cool, like my wife.
• 42:08
  Speaker 1: Well, my wife right now is 36 weeks pregnant, so like for our third kid.
• 42:13
  Speaker 1: So, heads up, we're about to be off the off the grid for a little bit, but um she uh goes to the gym a couple of times a week, several times a week, three times, and my daughter is always like, and my son they're like oh no, is today exercise day?
• 42:26
  Speaker 1: My wife's like, yeah, I'm going to the gym, but it just normalizes because they're like, oh well, mommy exercises and daddy exercises too.
• 42:34
  Speaker 1: It just creates that normalization for them growing up and they're like we will want to exercise.
• 42:39
  Speaker 1: I'm like, love that normalization for them growing up and they're like we will want to exercise.
• 42:41
  Speaker 1: I'm like love that, let's do it right now.
• 42:42
  Speaker 1: So they'll like do like little air squats and like, yeah, they'll get like yoga positions at home and like push-ups and stuff, but that's important, because that's a really important point, actually, because that's all it needs to be.
• 42:51
  Speaker 2: Yeah, you were talking about earlier, like the funny memes of how, like girls don't want to, younger girls don't want to go to the gym right, we'll do anything to avoid, just lifting weights and it's.
• 42:59
  Speaker 2: But the crazy part is, like you don't have to go to the gym, you could be doing your at home body weight exercises, right?
• 43:06
  Speaker 2: So another kind of be fancy, correct, right, you don't have to be this gym rat, like you don't have to be a CrossFitter, you don't have to be an elite athlete to be active and be mobile.
• 43:15
  Speaker 2: And again, another strong correlation you look at these, what, the blue zones that are out there, right, these areas of the globe that people are living into their hundreds.
• 43:23
  Speaker 2: They call them the blue zones and they did research on these centurions and these blues people who live in these blue zones.
• 43:31
  Speaker 2: And the number one common denominator mobility.
• 43:33
  Speaker 2: Interesting.
• 43:33
  Speaker 2: And you look at these parts of the country and there's no fancy equinox gyms there.
• 43:38
  Speaker 2: These people aren't going to Equinox fitness, they're walking up hills, they're walking, they're donkeys.
• 43:45
  Speaker 2: It's mobility.
• 43:47
  Speaker 2: That's what it boils down to.
• 43:49
  Speaker 1: How can we possibly get in good shape if we don't have a high level gym here?
• 43:52
  Speaker 1: It's crazy.
• 43:54
  Speaker 2: It doesn't have to be fancy, but that's literally what it boils down to.
• 43:58
  Speaker 1: What are we going to do?
• 43:59
  Speaker 1: How are we going to not get exercise?
• 44:01
  Speaker 1: We don't have a warm towel service, equinox, like what's possible.
• 44:05
  Speaker 2: It kills me.
• 44:05
  Speaker 2: And nothing against Equinox.
• 44:06
  Speaker 2: I love Equinox.
• 44:07
  Speaker 2: Totally Incredible facilities, right Incredible company and brand Culture.
• 44:11
  Speaker 2: Yeah, totally Do some air squats or pushups at home.
• 44:13
  Speaker 2: Yeah, do some crunches.
• 44:15
  Speaker 1: There there was a I'm not super well versed on this but I a little bit.
• 44:20
  Speaker 1: I was looking into it Um, the concept of Ikiagi, familiar with that, the Japanese, and from Okinawa, and more of those blue zones of like people just over more than generally live over the age of a hundred.
• 44:35
  Speaker 1: How is that possible?
• 44:36
  Speaker 1: And it's a combination of a lot of things in this diagram that go over and I don't know off the top of my head but I want to do a whole podcast on just Ikeagi but I'd have to dive more research into it.
• 44:47
  Speaker 1: But it's like when your purpose meets, your passion meets what you, the value you bring to society, and where all those kind of meet and the it's like the purpose of life pretty much.
• 44:57
  Speaker 1: Anyway, I thought it was really interesting.
• 44:59
  Speaker 1: We'll dive in at another time, but that I think Okinawa is one of those blue zones of centurion areas.
• 45:08
  Speaker 2: Yeah, and, and, and.
• 45:08
  Speaker 2: From what I know of these blue zones, that is another big concept that they really discovered when they researched these blue zones is sense of purpose, gratitude, happiness, right.
• 45:19
  Speaker 2: These people that live in these blue zones, they don't have the stressors that we all know and have in this wonderful country right.
• 45:25
  Speaker 2: And so there's that portion of it as well, is the cognitive portion, and that's a huge portion of it.
• 45:31
  Speaker 1: I'm really glad I just appreciate what you just said too in this wonderful country.
• 45:35
  Speaker 1: Like man, america is amazing, like it is the land of opportunity.
• 45:38
  Speaker 1: There's a reason why I'm not getting political but why people flood here so we can utilize these resources and knowledge and all this stuff, um, but still retract to simplicity when we need to and look back to what we need to just be simple and like what we need is for us, um but um, interesting.
• 45:57
  Speaker 1: I know last time we talked about like the people that you see from an orthopedic standpoint.
• 46:03
  Speaker 1: They come in, they see you like, all my values seem to be pretty normal, but why do I still feel like crap Right From an orthopedic standpoint?
• 46:11
  Speaker 1: There's a lot of that where everything seems to be normal but my back is just like not getting better Right and my knees still hurt or my neck still causes pain.
• 46:19
  Speaker 1: I have radiating pain down my arm right From a blood panel standpoint.
• 46:24
  Speaker 1: What do you find with that?
• 46:27
  Speaker 1: Or like, what are your suggestions on that?
• 46:28
  Speaker 2: Yeah.
• 46:29
  Speaker 2: So again, as part of what we do and just kind of an overall assessment on people, we're looking at biomarkers via blood work.
• 46:36
  Speaker 2: We're looking at physical markers like body composition and walking patterns et cetera.
• 46:41
  Speaker 2: So when we put all that together, there are definitely some common denominators that we do see, and it goes back to some of the things we spoke about.
• 46:48
  Speaker 2: We typically see macro and mitra nutrient deficiencies.
• 46:51
  Speaker 2: We typically see higher cortisol or higher inflammatory levels.
• 46:56
  Speaker 2: A lot of times we'll see hormonal imbalances, even in younger people.
• 47:00
  Speaker 2: What hormonal balances is in what so meaning?
• 47:07
  Speaker 2: Like you know, we could look at a 18 year old or a 15 year old and their growth hormone levels are two standard deviations below average for their age bracket I see okay right, so something like that low test, low testosterone, for sure testosterone low in men, for sure.
• 47:20
  Speaker 2: Overproduction.
• 47:20
  Speaker 2: Low testosterone in men, for sure.
• 47:21
  Speaker 2: Testosterone low in men for sure.
• 47:22
  Speaker 2: Overproduction of estrogen in men.
• 47:24
  Speaker 1: Interesting All variables and with testosterone, is it the free floating testosterone or which one are you looking at particular?
• 47:33
  Speaker 2: So we, actually we look at all of them.
• 47:35
  Speaker 2: So we look at total testosterone production, we look at free testosterone, we look at something called bioavailable testosterone.
• 47:41
  Speaker 2: We look at all three.
• 47:43
  Speaker 1: Interesting.
• 47:43
  Speaker 1: Okay, I know that that leads to an increased estrogen.
• 47:47
  Speaker 1: Right that imbalance.
• 47:48
  Speaker 1: It definitely leads to a lot of changes and one of those being the vulnerability and susceptibility for joint pain and a chronic inflammatory responses Level.
• 47:56
  Speaker 1: That in with cortisol flood, lack of sleep, sleep, that's just a great recipe for like, nothing's getting better.
• 48:02
  Speaker 1: You know what I mean.
• 48:03
  Speaker 1: Yeah, um, yeah, total sense.
• 48:06
  Speaker 1: Um, for you personally, how do you navigate?
• 48:09
  Speaker 1: You're a busy, individual, professional.
• 48:11
  Speaker 1: How do you navigate your own health and wellness?
• 48:13
  Speaker 2: it's a good question.
• 48:14
  Speaker 2: That could be a podcast all by itself.
• 48:16
  Speaker 2: Uh, 80, 20.
• 48:18
  Speaker 2: Right, I try to not stress myself over not being as good as I need to be or should to be, because we all have lives and we know that things will come up that are outside of our control.
• 48:31
  Speaker 2: So I think for me, the number one thing that I've been working on a lot this year in particular is not stressing about it.
• 48:37
  Speaker 2: Live my 80-20 rule, right.
• 48:40
  Speaker 2: Not stressing about it.
• 48:41
  Speaker 2: Live my 80-20 rule, right.
• 48:42
  Speaker 2: Try to be good 80% of the time and try to allow myself the opportunity to slip up 20% of the time.
• 48:48
  Speaker 2: I am busy.
• 48:49
  Speaker 2: I travel a lot, so nutrition sometimes is my vulnerability where it's a little bit harder for me to make sure my nutrition is dialed in.
• 48:56
  Speaker 2: So like eating out a lot or just grabbing, grabbing stuff on the go, airports, planes, you know I need something quick and easy.
• 49:05
  Speaker 2: Uh, something with you know three minutes that I can scarf down between patients.
• 49:09
  Speaker 2: Um, so I I think nutrition is probably my Achilles heel, being fully transparent.
• 49:15
  Speaker 2: Um, it's also probably why I've leaned myself into more of an intermittent fasting style, just out of habit and logistics.
• 49:23
  Speaker 1: And you seem to respond pretty well to that.
• 49:26
  Speaker 2: I do personally.
• 49:26
  Speaker 2: And again, it's not for everyone, yeah, but for me it works well.
• 49:29
  Speaker 2: What?
• 49:30
  Speaker 1: does that schedule look like?
• 49:31
  Speaker 1: When is your intermittent fast period?
• 49:35
  Speaker 2: So I'm on most days of the year.
• 49:38
  Speaker 2: I'm probably a 20-hour fast guy and my eating window is four hours.
• 49:43
  Speaker 1: Okay.
• 49:46
  Speaker 2: Typically.
• 49:46
  Speaker 1: So variables there, but usually so no breakfast.
• 49:49
  Speaker 2: Lunch no, so my fasted state is generally between the hours of 10 pm and usually 6-ish pm the following day 10 pm to 6 pm the following day.
• 50:01
  Speaker 1: 10 pm to 6 pm.
• 50:02
  Speaker 2: So I will stop eating around 9, 10 pm at night and I will not eat again until generally around 6 o'clock the next day.
• 50:14
  Speaker 2: Oh my gosh, wow.
• 50:15
  Speaker 2: It's a little extreme for intermittent fasting.
• 50:18
  Speaker 2: It actually developed in med school.
• 50:22
  Speaker 1: I can imagine.
• 50:23
  Speaker 2: On rotation in the operating room.
• 50:25
  Speaker 1: Yeah.
• 50:25
  Speaker 2: Just 12, 14, 16 hour days.
• 50:29
  Speaker 1: Yeah.
• 50:29
  Speaker 2: So it just naturally started there and, honestly, like I noticed that I felt better, I felt lighter, my gut was better, like everything about it was like okay, this is kind of cool, I'm just going to run with it.
• 50:40
  Speaker 1: Yeah, ride that train Interesting.
• 50:42
  Speaker 2: And so it's evolved.
• 50:43
  Speaker 1: Maybe it wasn't always 20 hour fasted state, but If you do have a breakfast or a snack or something mid-morning, are there occasions you do do that A hundred percent.
• 50:52
  Speaker 2: There are occasions I do that.
• 50:53
  Speaker 2: How do you feel?
• 50:53
  Speaker 2: So I definitely feel okay, but if I'm going to do that, it's not going to be anything elaborate, it's going to be a shake, it's going to be a smoothie, it's going to be something that's easy to digest.
• 51:05
  Speaker 2: So I'm a very huge vegan protein guy.
• 51:09
  Speaker 2: I don't really like whey or casein or egg protein.
• 51:12
  Speaker 2: So I'll do a vegan protein with some reds and greens powder, some glutamine powder, and that's like my shake.
• 51:24
  Speaker 2: If you will like.
• 51:24
  Speaker 2: If I trained really hard that morning and like I gotta get some calories, yeah that's my go.
• 51:27
  Speaker 1: That's where you're going to.
• 51:27
  Speaker 1: So you and fitness workout.
• 51:30
  Speaker 1: You work out in the morning I do I want an empty like and don't eat after totally fasted wow, totally fasted.
• 51:36
  Speaker 2: Just pound the water first thing before I get to train oh, okay, interesting, yeah, um, and any supplements or pre-workout?
• 51:43
  Speaker 2: and all that time.
• 51:43
  Speaker 2: So I'm a huge supplement guy, okay.
• 51:45
  Speaker 2: So right now, for me personally, again, inflammation management always top priority, yeah.
• 51:51
  Speaker 2: So I've got a good curcumin and turmeric, I've got a good coq10, I've got a good omega, I've got a d3k2, I've got a good antioxidant routine with resveratrol and ashwagandha and I take again, trying to be prophylactic hormone-wise I take a DIM, which is a natural estrogen blocker.
• 52:10
  Speaker 2: That's kind of my foundation, but I'm super diligent on my supplements.
• 52:17
  Speaker 1: What would make you have a shake?
• 52:19
  Speaker 1: It would just be like you had a hard workout and you're feeling lethargic or mentally I just want to.
• 52:24
  Speaker 2: I don't want to waste the workout, right.
• 52:26
  Speaker 2: So, like you, want to replenish the nutrients, exactly right.
• 52:28
  Speaker 2: Or if I just got back from an overnight flight or a late night, or I was at an event or whatever and I just I know I need to like support my body to get me through the day yeah then I'll break the fast and I'll just do a shake in the morning.
• 52:42
  Speaker 1: Interesting.
• 52:43
  Speaker 1: Yeah, that makes understood.
• 52:44
  Speaker 1: Yeah, well, that's cool.
• 52:45
  Speaker 1: So that's an aggressive intermittent fast, not for everybody, but it works for you, works for me.
• 52:50
  Speaker 1: I know me personally like, if I don't eat within six hours, I'm usually like at least four to six hours.
• 52:57
  Speaker 1: I have to eating every four to six.
• 52:58
  Speaker 1: Yeah, I get lightheaded.
• 53:00
  Speaker 1: Um, I get like stomach cramps, you know, I just don't.
• 53:03
  Speaker 1: I'm just not my best, you know, but if I eat too much then I get.
• 53:06
  Speaker 1: I get bogged, have you?
• 53:08
  Speaker 1: always been that way, your whole life yeah, yeah so you have that genetic predisposition where you've probably always had a fast metabolism yeah, right, yeah, if I don't work out, I get thin, um, and I lose strength pretty quickly.
• 53:23
  Speaker 1: It's pretty interesting.
• 53:25
  Speaker 1: I remember in college, like my roommate in particular, he was a stocky, um, muscular, um, dude.
• 53:33
  Speaker 1: South chicago basketball played volleyball with me in college.
• 53:37
  Speaker 1: This guy man I was, he was, and he was jacked.
• 53:41
  Speaker 1: You know, um, we would max out before season strength training and he would squat.
• 53:47
  Speaker 1: He'd put like four or five on the bar and squat at 10 times.
• 53:50
  Speaker 1: He would tell me ahead of time like no way, dude, you know, that's a lot, you know.
• 53:54
  Speaker 1: And he would bang it out and I'm like, how's that possible?
• 53:57
  Speaker 1: I was like, when's that they give you been training up for this?
• 53:59
  Speaker 1: He's like, no, I haven't lifted in like six months.
• 54:00
  Speaker 1: I'm like what?
• 54:01
  Speaker 1: And then six months after season or before, like the fall ball, right, like literally eight months later, do the same thing.
• 54:07
  Speaker 1: And he'll be, he'll put on four or five, squat eight, 10 times.
• 54:09
  Speaker 1: And I'm like, and he hasn't really done anything in the meantime.
• 54:12
  Speaker 1: I'm like, how is that possible?
• 54:14
  Speaker 1: You know what I mean.
• 54:19
  Speaker 1: And if I work out again, I'm like super sore and I'm, yeah, just, I would assume, fast metabolism.
• 54:25
  Speaker 2: No doubt.
• 54:25
  Speaker 2: And that's it.
• 54:26
  Speaker 2: Like your body was genetically predisposed to have a fast metabolism.
• 54:30
  Speaker 2: When you have a fast metabolism, and if you're not eating sufficiently, you're going to have to, you know, use that muscle as fuel, which is why you know when you get that, way you're, you're getting really thin fuel, which is why you know when you get that way you're.
• 54:42
  Speaker 1: You're getting really thin.
• 54:44
  Speaker 1: Yeah, that's what happens.
• 54:45
  Speaker 1: It makes total sense.
• 54:46
  Speaker 1: Um the uh, it has to be the Scandinavian.
• 54:50
  Speaker 1: Um, norwegian and a lot of Sweden.
• 54:50
  Speaker 1: I didn't know until I did, like a of my parents.
• 54:51
  Speaker 1: I got them a 23 and me test for Christmas one year and I was like I don't need to do it, but I want them to do it because I'll get everything if they have it.
• 54:58
  Speaker 1: I'll be curious myself, but also for themselves.
• 55:00
  Speaker 1: Yeah, but yeah, a lot more sweet, I remember.
• 55:02
  Speaker 1: But anyway, it's got to be the Scandinavian.
• 55:04
  Speaker 1: But that's interesting, it's a good point.
• 55:07
  Speaker 1: Like it's not for everybody.
• 55:08
  Speaker 1: Your route, intermittent fasting, dude, I would be dead, like, oh my gosh, I'd be.
• 55:12
  Speaker 1: So I'd be no, bueno, I had to.
• 55:14
  Speaker 1: And on my end for you, like eating every four hours would be like not good, I wouldn't feel good, yeah, yeah.
• 55:22
  Speaker 1: So anyway, considering that for people listening, it's like not everything's just, there's no one size fits all.
• 55:28
  Speaker 1: Whatever you feel like works best for you and if you just like it and are more willing to stay consistent with it, that seems to be the recommendation.
• 55:36
  Speaker 2: Yeah, and I think you're probably the same way.
• 55:38
  Speaker 2: I always tell people listen to your body.
• 55:40
  Speaker 2: You know your body best.
• 55:41
  Speaker 2: Your body's going to tell you what it likes, what it doesn't like, right, and that's with anything Training habits, foods, vitamins and supplements, like how you're responding to stuff it just listen to your body.
• 55:51
  Speaker 1: Yeah Cool, yeah.
• 55:52
  Speaker 1: Well, if people want to, I how's the best way to contact you guys?
• 56:00
  Speaker 2: Best way to reach out.
• 56:01
  Speaker 2: You know, our main office is in South Florida R3 Health and MedHouse but you also don't have to live locally here in South Florida.
• 56:07
  Speaker 2: We actually treat patients all over the country.
• 56:09
  Speaker 2: I think we treat people in like 40 different states and 10 different countries Cool.
• 56:14
  Speaker 2: So through telemedicine nowadays it's unbelievable.
• 56:17
  Speaker 2: So reach out.
• 56:18
  Speaker 2: You know, r3healthco, c-o and then medhouseco, C-O.
• 56:23
  Speaker 2: Okay, but we love to meet people.
• 56:25
  Speaker 1: So just hop on there, hop on the website, reach out contact us form on the website.
• 56:29
  Speaker 1: Cool Yep, awesome.
• 56:31
  Speaker 1: Well, I appreciate you coming in.
• 56:31
  Speaker 1: Thanks for having me as always.
• 56:33
  Speaker 1: Definitely, man.
• 56:33
  Speaker 1: It's always super insightful and if you have any questions for us, you can always reach out to us.
• 56:37
  Speaker 1: We at least can chat about what you have going on, if we can help you, and the best way to reach out to us is probably our clinic phone number, 561-899-8725, or email us at team at athleteRCcom and we'll catch y'all next time.