2. David Otey, CSCS: Changing Lifestyle Habits In and Out of the Gym

Hello everyone, I'm Dr. Darsha Shah, and I'm Dr. Altamash Raja, and welcome to Medicine Redefined, a podcast where we will explore the often overlooked but necessary components of health, what we consider to be the fundamentals. We will investigate topics and practices that can give you and your patients the best chance to optimize a healthy lifestyle. It's time to move the needle forward and put the health back in healthcare. This episode is being brought to you by the Doctors Unbound Podcast. Check out the show for fascinating interviews that share health decisions or make an impact outside of the hospital or clinic. Whether it's founding a health tech company, running for public office or starting a nonprofit, tune in to the Doctors Unbound Podcast for weekly stories that will uplift and inspire you. If you're interested in financial literacy and independence, Dr. Dave regularly covers those topics as he and his family are on the very own journey of achieving FL with short term rentals. Subscribe to Doctors Unbound for free wherever you listen to podcasts. Okay, everybody, it is not time for an okay episode. No, it is time for an OTAE episode. Our guest today is none other than David OTAE. David is a strength and conditioning coach. He serves on the advisory board of men's health and is the chief content officer of the Pain Free Performance Specialist certification. He has also wrote numerous articles for men's health, muscle and fitness and T-Nation. Guys, those are some big name magazines. So with New Year's just around the corner, this is going to be the perfect episode for you guys to shape those resolutions. Dave is going to take us through his job, not only as a trainer, but also as a coach. He tells us the strategies that he implements to change his clients' habits and how we as individuals can also do the same to create our success, our own success, in and out of the gym. I personally got lost in how well he explained concepts using amazing analogies and honestly that are still stuck in my head. Guys, you're going to love them as well. Let's not hold this amazing episode from you guys any longer. Let's go. All right, guys, another beautiful night with us today is David Ote and he's definitely somebody that I've known for quite some time and our past diverge, but today he's back with us and we're going to talk about some really important things that we're all really passionate about and we kind of share this passion. So David, you've been busy despite the world ending, like you said before, you've been busy, you're doing your grinding. And burning and you're still educating, which is what we love. So, you know, not everybody who's tied into the fitness industry, a lot of the people who are listening to us, they're not going to know about your work. So why don't you tell us a little bit about yourself, your journey of how you got to where you are now? Awesome. So, for those of you that don't know me, which is probably every single person listening to this, my name is David Ote, I'm the chief content officer for the pain-free performance special certification. I've been in the exercise science training field for 14 years now. I got my degree in exercise science from Rutgers with ALP and been a CSCS, which is a certified training specialist with the NSCA. I'm also a member of the Men's Health Magazine's advisory board, so I'll oversee the content for them. I write for Muscle and Fitness Men's Health on it and a bunch of different magazines. But it all rooted for when I was younger. So when I was younger, my father raised me looking up at bodybuilders like Arnold Schwarzenegger and Franco Colombo and all those guys. And when I was 30 years old, yeah, they're rare breeds. You know him from Jingle all the way. When I was 13, I saved my eighth-grade graduation money and I bought a 300-pound Olympic weight set, bench press and a preacher curl, and I used to just go on the front porch and listen until I collapsed by M&M and went great, so. And I was lucky enough that I got someone that took me under their wing when I was 16, one of my high school junior teachers with a sports performance coach at a local facility. And he knew that I loved to work out. He was inviting me in at 6am workouts with the seniors when I was a freshman. And he said, why don't you come by and check out what I do as a sports performance coach. It was the first job I ever went to where I wasn't staring at the clock. And I knew at that moment it was something that really resonated with me. And I wanted to find a way to monetize it. I think, you know, kind of like what you hear Gary Vee talk about, which that'll be the only reference I give a Gary Vee, is, you know, find whatever you love to do and find a way to monetize it. And when you look up like glass door, you'll see personal trainers on average make like $37,000 a year or something ridiculous. And I can tell you from experience, that's not the case if you want to really push it that way. So, you know, I did my work with exercise science with the Research Lab with Dr. Sean Arnt, worked with the football team, worked as a student athletic trainer, and have tried the volunteer all the way through it. So now I teach on the road and teach the certification, I write, and then I speak to universities and college students trying to figure out what the health are going to do with their exercise science degree, whether they want to pursue personal training going to physical therapy or pivot towards something like sports medicine and physical medicine like you guys are doing. And that's really my background in as small of a rant as possible. Wow. Yeah, I mean, I guess the question would be like, what is it that you're not doing? That would have been a lot easier, huh? I'm not doing what you guys are doing, I'll tell you that. I do, that's so freaking awesome. And I've been so excited for this conversation that, you know, that we had set up because, obviously, I've been following you for a long time and kind of been excited to say, oh, hey, I knew that guy, obviously you were doing, you were, you had to, you, you grind in and back even when we were, we were, we were juniors and seniors in college when we were together. But, you know, over the last couple of years, you're saying, in the fitness industry, you were writing for mental health and, you know, you're the chief cotton's officer for PPSC now. And my time in the fitness industry, you know, some of people that I looked up to very much being rehab medicine type stuff, I, you know, kind of, you know, more affinity towards people like Eric Cressy and, and listen a little bit more, Jay Frujian, and those kinds of folks as well, even Mike Reinold. So what I've learned, just like in medicine, there's specializations, right? And then there's some specializations, right? So a little niche that you might have, do you think that you might have one of those as well, like whether it's more muscle building or rehab related or do you think it's still you're trying to be a savage generalist? Um, I think that's a good question. I think that you have to be, I think you have to be a dedicated generalist in that way, like you want to have a niche, right? But in my opinion, like the certification we teach the pain free performance, best certification, which in one way or just so people know, we're not diagnosing pain. We completely understand the scope of what we do as a trainer as a, as a health coach for somebody. That is not in any way what we're doing. But you know, in that way, it's like, okay, you can look at, is that as a niche or any trainer should want to not hurt their people or or avoid pain in any possible way. So it's almost like it's a no brainer in that where I think that most people need to brush up and get a little better at, which I think we were, you know, very fortunate and spoiled having Dr. A and, um, you know, everyone on staff, Dr Alderman, when we were going through school, like, is becoming more nuanced with understanding how the system works, right? I think understanding how it goes through it, because even with our university, which is different from other ones too, is you know the anatomy lab when we're doing it with a human and you're doing an actual cadaver is vastly different from doing an anatomy lab with, you know, a fetal pig or something like that. It's not the same experience. And that was the part of the exercise science program, which really opened the doors for me and opened my eyes to go, holy shit, this is, this is incredible. Like this system is so complex. And that was the beginning where, you know, when I thought I knew things and even when I got my degree and, you know, you come out and you're like, Oh, I know what I need to know now. Every year, I realized that I don't know anything. Like the more I learned, the more I realized I know very, very little, just even the fact that like us, we don't really know, we know a small percentage of how the brain works compared to how complex the brain is. So then by definition, we don't know very much about how the body works if we don't know how the brain works. So it's like, you want to be a generalist in that kind of way. I think that's, that's critically important. But you want to specialize in the areas that you know are going to be the general concerns. You want to have command over where there is high demand. And being those people that, you know, are using poor form or getting poor, poor information. Say they're talking about, you know, low back pain is something that 50% of people will run into at some point in their lives. Shoulder injuries is quickly creeping up on that. It's way more than 50. It's, it's, it's, yeah, it's, like every single patient. Yeah. Low back pain has been seen in a lot of surveys is up to 80, up to 80 is some of the, when they say low back pain, unfortunately, what they do is they make it very generalized. So it's like, okay, my back's bothering me. Okay. Well, then that's low back pain versus, you know, spinal thesis or spinalitis or a fractured vertebrae or a slip disc or a bulging disc or whatever. But yeah, you're right. Like every human on the planet has low back pain at some point in their life, which is insane. So instead of saying like, okay, well, then this is a flaw in the human system. It's probably a flaw in our societal movements and what we do. How do we adjust that? And I think that's where we, you know, we all collected to come together to approach the conversation. Yeah. Man, so there's, there's a lot you said there that I can, I can really break down and kind of take in any different direction. But I want to, I want to stick with the back pain. So for me, what, what really made me go into physical medicine rehab was, I herniated my L5S1, age 18, picked up a tennis stringer, you know, without any proper form, felt like a pop kind of got three epidural injections, didn't do jack for me. You know, what ended up really helping it was actually deadlifting again and just like getting back in the gym, even though I was told by a physical therapist, never deadlift again in your life. Yeah, bad for your back. Don't ever. Yeah. That's like, that's like the only advice of every guy. And so like I started getting to yoga and these things. And again, that's kind of what made me go into the field. And I think all has a similar story as well. So like, what, so you're dealing with a lot of pain, obviously, as a specialist. And again, you're not diagnosing, but you're there kind of treating and gauging the pain and helping people kind of navigate through that. What do you think the role of the physician is in this case when we are seeing so much back pain, so much shoulder pain coming in? And again, I think me and Ultramache have an advantage being in the PM and our field, but it's not like we're the only doctors that are going to see pain or back pain as a, you know, chronic issue everywhere. And you, as you mentioned, your wife's an ER nurse. Like, what are kind of things that you think that need to either be changed or things that you're seeing that you're like, you know, this is kind of the way I wish patients were dealt with pain in that, in, in, with a primary care physician or something. So I, great question. I think there's two, there's two ways in that again, all these are just my opinion based on what I've done, but there's two things that I think are critically important. And I think doctors, as a field, need to go to surgery as the last possible option. Surgery should never be option A unless it has to be, but that's like the most critical thing because, you know, I got into specifically doing the PPSC because, so for background for you, I fractured my L4 and L5 spine when I was 17. So I wore a back brace for six months, bone stimulators, all that kind of stuff. And so I, I feel that pain every single day. So for me, my goal switched quickly changed from, okay, I want to be able to deadlift and bench press 500 pounds to, I want to be able to pick up my grandchildren when I'm 80. I want to be an active participant in my life. So I, I think a, not suggesting surgery is the first thing because surgery, especially with the back, does not have a great success rate if you're going to start fusing things which, by nature, were made through evolution to not be stuck together. Two, I think that, you know, the medical field, A, the fitness field needs to do better job as being educators rather than entertainers. And the medical field needs to put in a better effort in trying to understand these specific things on how they work into it because then every time I get someone that has low back pain or they have knee pain. And I get a doctor's note from someone saying, this person's not allowed to squat, walk, they can't breathe anymore, they have to lay in bed if they hurt them, it's just like the most absurd thing because that shows this person has zero context on what movement is. And I would venture. They probably haven't been in a gym themselves or maybe on the other side, maybe they've worked with a coach who wasn't qualified enough, who didn't know what they were doing, and they didn't see the value in it, which is then a training side thing. So I think it's a very layered question, but at its root, A, I think we can't opt for surgery as your first option, we have to try, we have to exhaust every possible thing to maintain quality of life before we shoot for surgery. And then B, we need to do a better job as a field helping to educate these medical professionals so that they have better ideas of why things are done, how they're done, and at least giving context so they can make their own decision path that point, not even going to agree on everything. And the same way that we're seeing this COVID pandemic, we got 99% of doctors that are saying, hey, we can do a vaccine or booster shot or a flu shot type setup where we have over and over type things. And then we have 1% voodoo doctors that are saying, well, no, we're just going to think really hard and we'll wish COVID away or we'll just pray God and we'll blow it away. That's not how medicine and science works, unfortunately. So I think in that way, we need to help as many people as we can. Yeah, no, absolutely. I cannot agree more. When I shadowed sports and spine, that was one of our biggest goals is to not turn people to surgery first and foremost, because we know once you undergo surgery, like you said, it's a very tough time to kind of get back onto your feet and get back to being functional. Total. And the second part to that too, where I feel like once we get our degree as an MD or DO, for some reason, I think no matter the specialty, we feel like we have some sort of like all-encompassing knowledge in terms of what happens in the gym and what happens in movement. And when we write no squats, none of this, like, we're not, we're not coming from an understanding as a specialist in that field like you are. So speaking on that, is there something? So you've been in this journey for a while and like you said, you kind of come from a general's perspective, but then you also are a specialist in this pain-free stuff. Is there something that you believe in that most people in the fitness industry would actually disagree with you with? That's a good question. I think one of the base things that we'll talk about, let me just give you one example. There's not many, there's not many, but there's one example of that. That is that deadlifting from the floor is not appropriate for 93% of people, 95% of people. And the reason behind that is, like, specifically with the certification that we teach, we want to challenge the arbitrarily-based numbers. And a barbell deadlift from the ground is one of those, just for an example. So I'll explain it a little bit more. The reason why it's an arbitrary number is, you have to understand why the barbell is a certain height from the ground. And the barbell is 8.75 inches off the ground. And the reason it's 8.75 inches off the ground is, yes, because it's half the size of an Olympic plate. But it's 8.75 inches because of, you know, the years and years of weightlifting. And if you look at the human skulls with, it is never going to be above. I think it's like 8.5, 8.25, something like that. That can't be quoted on. It's somewhere in that range, but it's definitely below 8.75. Your head is not going to be 8.75 wide unless your berry bonds mid-steer word run. But the 8.75 number is so there is specific clearance on the head. So God forbid the barbell comes down. It's not going to hit your skull. Wow. I don't know that. So the reason that that's there is, based on skull width, has nothing to do with the anthropometric to your body, has nothing to do with the osteokinematics of your body, the arthrokinematics of your body, how your bones and joints move around, has nothing to do with that from a biomechanical standpoint. So the assumption that everybody should be able to deadlift from the ground is just, it's almost like a, you know, we just thought it should be because it's on the ground and we think you should be able to do that. So we know that the femur gets 120 to 125 degrees of flexion at the hip. We know that the knee gets a certain amount of flexion or the tibia and the femur get a certain amount of flexion with themselves. And that won't necessarily get you down to that spot. We know that, you know, people are individualized. People have different limb length, whether it's arm to leg, leg to arm, torso length, whatever. All that nuance specifically and inherently makes everyone a unique person. So getting to that length of 8.75 is a very arbitrary number. It's in the same way that, you know, if you find out why basketball hoop is 10 feet tall, it's because when nascent was inventing basketball, he put the peach basket on the edge of the garage roof. If the garage was 15 feet, basketball would have a 15 foot hoop. But it wasn't. It was 10 feet. So like, we can't get caught on saying like, well, based on the barbell set up, it's for anatomy. It's not for anatomy. It's for the anatomy to see that you don't crush your skull. That's not for the anatomy that you're able to deadlift from the ground. So I think in those ways, you know, we need to be better suited than that. And I think that's where we're seeing more people are agreeing on that topic. Now that we're opening up the can on that and people like, maybe I don't have to deadlift from the ground. That kind of does bother my back a little bit or it does feel kind of uncomfortable. I think that's one of the most important things to fitness that doesn't happen right now is questioning why you're doing something versus what you are doing. Like does it make sense for you or are you just doing this because someone wrote it into a program or you read it in a men's health magazine and some idiot David Ote wrote about it and said it was the exercise you have to do. I'd rather someone question that and try and figure out what's going on. Yeah. So how do you recommend people getting to understand their like theme or length and obviously not going ahead and getting a measure and tape and doing it, but understanding what works best for them if they need to use a trap bar or if they are okay with lifting from the ground. I think most people should use a trap bar just based off of, you know, where they're at mainly. Okay. Specifically because if you use the high handle of the trap part, you're giving yourself that three to four extra inches based off the bar that you're using to because of the neutral grip by your hands, it's much more translatable to what you're going to be using for, you know, everyday function. And then specifically when we're talking about ex, like the reason we do exercise is to translate to what we do on our everyday life, ideally. So when we look at the specific research with the trap bar versus the barbell deadlift, the barbell deadlift is going to increase recruitment from biceps femoris, from a little more in the glutes and a little more in the back stents. There's everything you would assume with a front loaded weight. The research also showed that people had more force velocity, more power. They had a higher velocity curve with the hex bar because it gives you that extra range of motion. There's less flexion at the hip. It's just, it's an easier position to be in. So at the base root of the question is, you know, I asked us to all the time to coaches that go through the cert, why are you, why are you working out? Like what, what made you work out in the beginning? I guarantee it wasn't that you wanted to do a 400 pound barbell deadlift. It was most likely you wanted to get stronger or a fit or you want to train first sports or you wanted to lose weight or you wanted to feel more confident. One of that is based off of a specific modality, none of it is based off of a specific exercise. And I think that's where we need to start questioning things on what we're actually choosing and why we're choosing it. So true. Dude, I'm still fascinated by the knowledge that you dropped about, you know, the eight interesting right there. I had to do a quick Google search and, according to Google, yeah, the average head is six to seven inches. So that's the best thing I've learned today. That's an help. But dude, yeah. So going back to that, I mean, obviously it sounds like a lot. You're talking about individualization, right? You cater the program to the individual, right? And so I think much of medicine and a good practitioner, regardless which field they're in, whether it's in strength conditioning, when you're a personal trainer, whether you're a physician, whether you're a physical therapist, you are going to try to make good assessments and you're going to make a very specific program, you know, plan, whatever it is for that individual. So I remember reading on one of your social media posts, you talked about how, you know, fitness programs should be client-based and science-based. I love that, right? And I remember, you know, back when I was kind of in their end, obviously all of us when we started reading on T-Nation, and I don't remember if it was Coach Tibido or Charles Pollack-Wen who I was reading, but they were talking about the reason, you know, that a lot of the fitness professionals or strength conditioning coaches don't have data and research to support. A lot of this thing is because they've been in the trenches doing all this, and the research, the evidence takes years to catch up to that kind of stuff. It's tried in true methods, right? Like, Schwarzenegger, you alluded to him years about talking about different ways to kind of maximal hypertrophy of the biceps and whatnot, and finally, the exercise science literature is kind of catching up maybe like five, ten years ago, right? Probably published by Dr. Arn because he's all over the place. So how do you balance that, man? How do you balance that? How do you make it like very much science-based, like what's that like for you? I think that's part of the feedback you get from people, but I think you have to make a science-based in the way that you're following things as best as they are. And I think, I don't mind taking risks in programs, but if you're taking a risk in a program, A, it has to be a very, very conservative one. You have to head your bet. You're not, I'm not doing something crazy, you know, like, we're not going to work on balance, and I'm going to go, well, I saw some coach on Instagram have someone balance on one leg on a Bosu ball, juggling, flaming bowling pins, like that's not risk or reward scenario. That's a terrible idea. I guess I do as in count as a good citation. You can reference that. Yeah. All right. But for that, you may take a couple of small little risks when it comes to that, but the second thing too is the client also has to be aware of what they're doing and they have to be on board with that. I think that's, you can as a coach independently start making decisions and doing things. I think the most critical part is that you have buy-in from the person that's with you, and if they're willing to try that out, then that's great. But you know, that's how the research is. The research is always going to take five to 10 years to 20 years past what's going on, just because you can only do research studies with one variable at a time, like you're not doing multi-variable situations and even some of the groups that you're doing. Maybe it's like a study on hamstring activation, doing the leg curl versus a Nordic curl. And you end up getting like 12 guys that are between the ages of 21 and 26, and you can't base a study off of 12 guys, not reliably, and then you have to wait for it to be then replicated in a study. And then once it's replicated, it can be replicated more, and then once it's replicated more, can you do it into a systematic review? Do you have enough people that put it into a meta-analysis? And then at that point, then maybe we as a scientific community can start to understand it. So I think that's always going to be a battle. We're always going to have to be challenged with that and understanding like, is this something that I can really, really rely on or is this something that I'll have to wait for more information, like one of the perfect examples of that. Like blood flow restriction training is one of those ways where it's like, listen, don't just start throwing straps around your arms thinking that it's going to, like, yeah, you're going to, it's going to feel good, but like, you don't know the long-term effects that right now. And it could be really good. It could be something that you want to be cautious of, and it's not for everyone. So like in that scenario, like I just die off, like what exercise programs are working fine before that. Yeah. Am I going to bring a client's health for that one to two percent gain? Probably not. Doesn't make sense to me. I will say though, specifically to be a far, though, particularly for rehab. It's rehab. It's great. Yeah. It's great. Yeah. What do you want to do? Like muscular hypertrophy. I hypertrophy, right? There's a lot of, there's still a lot that's out there that's not there. I know. As far as I'm gazing, I'm looking for a charger because I have three charges in front of me on this desk. None of them are plugged in. So I want my computer guys, I'm looking for charges while I'm at it, but I don't think you are. Yeah. Well, did you take this away from me, Dave? I'm with you guys. Well, okay. So while Dave's looking for his charger, he's still listening to us. So he's still here. I'm on it. I'm in it. Yeah. Yeah. But, Josh, what do you take away from that, dude, like I, I mean, this has been my biggest struggle. I'll share this with you because I don't think it's, you know, I recently learned from, I think our chair that kind of told us that, you know, obviously pretty heavy into research and where we are. And in my neck of the woods, he said that the average time for like a research to come out and that, like that specific modality to be implemented into practice, 17 years. That's insane. Yeah. Isn't it? Yeah. It's true. Because my dad, he's at J&J and even like big farm and all these things. It takes like 20 years at least, yeah, for anything, any type of like research, it's absolutely insane. And I'll give you the flip side of that too, right? So the doubling time of information and medicine, I think in the 70s used to be like five years. So every five years, the amount of information would double it today. I think it's like 28 days is the amount of information that just doubles. Obviously, like 99% of it is just quackery and just like random stuff that people put out there. I think we're all just going to get a name on a paper or something. But in order to sift through all that, to see like what is legitimate and what is not is ridiculous. So like, you know, we're kind of living on both ends of the spectrum where we're getting too much information, but then we're not getting the information that we need. And it's tough to get that sweet spot, especially with the research and like Dave said, getting enough subjects in there and then repeating that and then the meta-analysis, you know? So, yeah. I mean, it's part of what you said too, where it's like, it's sucks because there only takes one person to screw it up for everyone. Yeah. It takes the one person that wants to fudge some numbers to try and get their name out there to then discredit an entire situation because they wanted to be the first one to get it there. It's like a TMZ article where it's like, I want to be the first person to report it. So everyone remembers who's me. Yeah. And then you ruin it for everyone. Yeah. One bad out. Nature is slow, glacial speed. So it's just going to take some time with that kind of stuff. But I also think that the problem is, is the way our society gains information now and the way that science works are completely different trajectories. Yeah. Like, we're looking at, for example, like I heard this, I thought it was a great ad in from, you know, Chipel was talking with Joe Robyn. They were talking about how the world is now watching a vaccine come out. But it's still not even realistic because we're at such high per speed of trying to get this vaccine out. It's not even close to how vaccines normally would go through trials and certain levels of kickback. And like, right now we're, we're literally like rummaging through the extra random drawer in our kitchen, trying to find anything that's remotely close to scissors. Like what's the one thing that could really be close to that? And that's how we're figuring out this vaccine. So for people that are like, why is it taking so long? That's how science works. Because if you want things to be done, they have to be done right, not right now. Yeah. And that's when we get ourselves in these situations where, like you said, and kind of like I mentioned earlier, it's one thing if we have information that's coming out and it's going to give us really, really concrete stuff. It's another thing if we're rushing to something to go, well, I'm going to add in this new modality because I heard about it and it could be revolutionary. Okay, but is it only one percent difference? Because if we're looking at the one percent difference in that versus old school stuff, right? Like it was talking about earlier, there's plenty of people that have track records of getting really fit and staying in shape and all that kind of stuff. Staying healthy, not creating chronic issues from a joint perspective or an osteopathic perspective. And they didn't have that method available to them. So is it that crucial if it's revolutionary, sure? But we haven't had anything come out revolutionary in our time. Like not from a science, exercise science, fitness perspective, not even close. Yeah. And the other thing I'll say is another difficulty that I have when I'm talking to my parents or I told Darcy recently is when I'm talking about nutrition, yeah, one you want science to be slow, just like you said, the second thing you never want it to be absolute, right? It's not like math, right? Today we learn something and we think this is good for you and then we'll do it tomorrow when we know better. We're like, oh crap, that wasn't so good. This is better. Let's do this. And so many people, when it comes to nutrition, you know, again, that we talk about the pendulum just swings left to right, like intermittent fasting is the best thing. Oh, intermittent fasting. You know what I mean? Like these things are not absolute. And so yeah, I mean, that's such a good point. But the problem also is that people don't take the time to understand the science of it first and they don't truly understand what something is, right? So intermittent fasting is a perfect example because most people don't get intermittent fasting on what it actually has done as a setup, right? Like I have had people come in and ask me, they go, hey, I heard intermittent fasting is a great way to lose weight. What do you think about it? They go, where'd you hear that from? Like I like to get people to, where'd you hear from? How's it going? Well, my boss is doing it and my boss lost 20 pounds. Cool. What's his intermittent fasting link? Well, he's not eating until noon and then he's eating until 8 p.m. And he's having lunch and dinner. Great. And then my response is, so he skipped breakfast and they go, well, no, he's intermittent fasting. No. What you told me was he skipped breakfast. You said he's only eating lunch and dinner from 12 to 8. He's not eating the morning. So he skipped breakfast. Well, I thought it was intermittent fasting. If you skipped one meal a day, do you think you'd lose weight? Well, yeah. Okay, well, that's probably why I lost weight. Sometimes it's very baseline for that kind of stuff, but it's not like a scientific way. That's also like with keto, people put keto in the category of just being like, oh, it's all high fat. But for the most part, what they're doing is they're doing low carb high fat, which is essentially the actin's diet. And they don't know that the keto diet was specifically made. I believe in the 1930s and it was for children with epilepsy. So it's like, there's a specific reason why the keto diet was brought out. And this isn't anything new. It's like fashion. It was just reintroduced into the lives into the mainstream and people love it. People still eat up marketing all day. So I think on that, what we need to do a good job of as fitness people, mainly because I think that's one of the bigger issues we have and is this part of the conversation is instead of making people feel stupid for that kind of stuff, we want to educate them and empower them in certain situations for doing the research and trying to find something that was a better way or just even taking the time to look something up. We have to pat people on the back for that kind of stuff because it shows they're putting something into it versus them coming in and going, what do you think of intermittent fasting in them? You're an idiot. That's stupid. Why would you do that? My job is to help someone out. It's not to make them feel bad about something which they should have no reason for feeling bad about. They're the one that doesn't know. I'm the one that knows. You don't shame people for not knowing information. Absolutely. I also try to tell people like self-experiment as much as possible too, right? I think with intermittent fasting, there's so many different variations, right? If we're going to use that as an example, even for me, when I first learned about it, I started it, did it for about two years and I just noticed like, hey, I wasn't making any progress and it wasn't even for weight loss, it was just for like energy and stuff. I got bloated every single day and now, you know, I moved it more towards, I just do 148 hour fast a month and now I'm going to self-experiment starting January. Again, just doing one 24 hour a week and just kind of seeing like what works best for my body. So, you know, I'm always trying to tell people, you know, try to self-experiment as much as possible too to kind of see what works for you because it's not a one-size-fits-all. It's not only just a 16-8, you know, that everyone's doing. No, everyone, we look at each other and we know that everyone is inherently very different. Why we think that someone's diet should be the same, why we think that someone should squat the same, why we think someone should lift in the same manner is, it's crazy to me. It's crazy that we look at it and we go, well, we're all very, very different for a lot of reasons. But in this scenario, we're exactly the same. No, the only exact same thing that I would say 99.99% of us are on the page for is our brain has a function that says, do not die. That's it. Inside of that, there are specific diseases and specific illnesses that may shut that switch off to where you don't have that fear of that and you don't think about that and, you know, there's self-harmoned, flicking diseases, etc., that is completely outside of my realm. But when we talk about that kind of stuff, like that's the only thing that we all have in common as humans for the most part, is that survival messaging in our brain. Inside of that, we're all very different in that. That's the part that kills me, too, is you'll see people and they're like, imagine we were on diets and all it's got a six pack and rock and major flap. And I'm like, well, how come all can eat pizza and I can't because you're not him. Very basic. You're not that person. You're about the same. It doesn't react the same. It reacts to different macronutrients in different ways. And then that's even just looking at macronutrients. We're not looking levels and levels and levels and levels below that when it comes to vitamins, minerals, phytonutrients, you know, like phytotoxins. We're not looking at any of that stuff. We're just looking at the macro of it. A slice of pizza. Like I said before, our body's way more nuanced than that and I think it's almost a slap in the face to think that it's very basic to be like, well, it's just one thing, no, it's not. And our bodies are highly complex and to assume that we're all the same is crazy. Yeah. Dave, one of the things that you mentioned just earlier, you know, kind of resonated with me. And again, I remember I have so many follow questions for you because I've, like I said, I've almost been stalking you on Instagram and not a bad way. But you, you know, the reason I resonate with me and it kind of struck a tone is because I think it was opposed to the U.S. said that when you, when you talk to somebody, you know, and they come to you and like, Hey, like I don't have time to work out, I don't have time to eat, right? I don't have time to prepare my meals. And then you give them the spiel, Oh, okay, there's 168 hours in a week and, you know, you do this and you kind of break them down and you kind of time management and shame them. Something along that lines. That's not a good coaching strategy. Now one of the things that I think that physicians and I'm guilty of this myself because I used to kind of do that. Like, Oh, you have a hundred six, you know, this is not a priority for you. You're two. I say 160 hours. Yeah. That's not. That doesn't work. Right? That doesn't work. And I think, like, again, we're trained to be excellent diagnosticians and like, okay, here's the, here's the, the, this is what you've diagnosed from this is the bacteria treated with this medication. This is this treated with this, but it doesn't matter. You can know, we can have all this knowledge. We will go through tons of education. If the patient in front of you, the client or your athlete doesn't buy in, it doesn't matter. It doesn't matter. So obviously, you've, you've had tremendous growth in your coaching career. So like, how would you counsel like, you know, young coaches when they come to you, exercise phase students, you talked about your teaching that, hey, prioritize this because this is the most important, that connection, getting the client to buy in. I think it's, it's just prioritize the person. That's it. Like, you need to create a strong relationship with that person. Like, they need to, they need to trust you with information because in certain fields, you'll trust you based off of just strictly degree or license or like they may, you know, and that's the crazy part. Like, you'll see people going to a hospital and they're like, this is the top head of surgery and they're like, well, where do they go to school? And it's like, that's not, I want someone who genuinely gives a shit about me, giving me feedback. That's what matters. So when we talk about that, like, it's very, you can't be surface level as someone and just regurgitate information and I think that's, that's one of the things medical professionals are trained to do and they're also, you know, some people are better than others. Where I get it and the medical profession, like, you can't have a certain level of empathy, you have to be pretty, you know, unbiased in your opinion and stick to the text and stick to what you know and, and going by what the best, most prudent decision is in that moment in time. But when it comes to having hard counseling with somebody, there has to be the availability to have a conversation and know how to connect with that person or know how to just choose things in bite-sized manners and not doing this whole, you know, clean swoop of, let's do this right here. So here's an easy example because my doctors, I've had two primary physicians and they both suggested this to me in the same way. When they said, oh, you need to drink more water, it was always like, well, you got to just drink 10 glasses a day or just drink, all you got to do is just drink 10 glasses a day. I get that. It seems very basic, but to most people, they don't know how to add that into a routine. So they're going to end up drinking 10 the first day, the second day, they're going to drink like four at the end of the day, they're going to chug like three and they'll get out of seven. And then after that, they're just not going to have to know how to mesh it in. So for example, like, if I have a client that comes in and I need to get them to, let's say, let's say 12 for a number, say they say they drink three glasses a day. Amazing. All I want you to do moving forward for the next three weeks is I want you to drink a glass first thing in the morning and then a glass immediately before you go to bed in addition to your three that you normally do. Outside of that, just let me know how that goes. Three weeks later, once they can accomplish that, then I'll say, okay, now what I want you to do is drink an extra glass of water with breakfast, lunch, and dinner in conclusion with the first in the morning and last night and your three during the day. Let me know how that goes. Now up to eight. Now I want you to drink one bottle while we're working out the entire time. Now we're at nine. Let me get you to add one before we work out and after we work out, there's 10 and 11. And then we can add 12 in there very easily anywhere else. But at that point, we've then created a routine for them where they know that first thing in the morning, they're not reaching for a cup of black coffee necessarily, but they're drinking for reaching for glass of water first. Like it's, my wife makes fun of me when I wake up in the morning because when I wake up in the morning, I have a tall, shaker bottle full of water. Then I usually have a protein shake next to it, and then I have a cup of coffee with that. And I'm putting down like five glasses of water first thing in the morning. So it's like eventually through that routine building, we can find better ways to coach our people. But I also understand on that end too that, you know, with a doctor, they may see that one time for that physical that you happen to sign up for for the first time in seven years. They're not going to be able to coach you every single week, like like a fitness professional kind or like a personal trainer, like that, which is why like I made a post last week that as personal trainers, you need to recognize the fact that you are the most frequent healthcare advocate that someone sees on a regular basis. And if you don't take that shit seriously, you should not be in this field. Our job primarily is to do that. So even on certain things where, you know, maybe I, you know, not me specifically, I completely agree with what we need to do for, you know, everything going on with the pandemic stuff, a lot of it. But say there's people that I understand in certain areas where like I don't want to wear a mask, I don't want to do this. I get it. That's fine. Everyone's entitled to their own opinions on certain things. I get it. But if you have someone that you know is at risk, you have people that are going for, you know, Thanksgiving and holidays and whatever, or you have just people coming in and they could potentially get sick, your job is to make sure they stay healthy. You ask them to come in and potentially put that at risk. You are going against what you're advising people to do or saying what you stand for. So that's when that moral and the ethical aspect comes in like, are you doing what you're doing because you love what you do and you work with? Are you doing what you do just because it's a job or just because you get to wear sweat pants to work every day or, you know, you get to create an Instagram and people want to, you know, like your shit. But I think that's the part that has to become first and foremost is you have to care about the people that are in front of you. If you don't care about the people that are in front of you, you should not just, this is not the job for you. Yeah. I completely agree and I think the biggest takeaway for me on that and for our audience who are practicing medicine is that a doctor, you know, like if you take the Latin word of doctor, right, it means to teach. So we're not only a doctor, but we're also coaches, right? And I think it's so important for us to approach our patients in that coaching manner where we're not just telling them, hey, do this, but where you can break it down in simpler terms like you, like you gave that example of water. Yeah. If you give people context, they're more likely to understand and believe you. The problem is is even coaches, physical therapists, like we don't give context on situations. And if you can't give context, you shouldn't give an opinion. But once you give context to help, so for example, like if you have a kid and you tell the kid, hey, I want you to bet at 8 p.m. Third of a say, no, no, I want you to bet at 8 p.m. Because I said so. It's a crappy response. Now, we tell the kid, hey, I want you to bet at 8 p.m. We're going to Hershey Park in the morning and we're going to go hit the rides. They will tuck themself in because you need context. You gave them a reason why you didn't just make up some nonsense and say it's because I said so. That's when people go into immediate rebellion mode and they're like, nah, that's when the teenage version of everyone comes out and they're like screw that. I'm staying out. No, you got to give context to people. You got to treat them like adults and treat them like they understand what's good for that. That's why I don't like the elitist side of training. That's why I don't like the elitist side of anything in health care where people think that they are above someone else or like at its root, we are all people. And that's the job you chose to do. You shouldn't be choosing to do it because the money, you should be choosing to do it because you want to help people. And that's what you want to do. You're not better than anyone. So you've got to remember that in that way, like listen, when we strip everything down, we're all just people. So you have to meet them there and you've got to show that same empathy when it comes down to recommendation, coaching, teaching, enlightenment, you know, inciting motivation, whatever it decides it's going to be. Yeah, dude, one of the things that you mentioned earlier when you give the example of water vicking, I mean, it's very much like habit coaching, right? I mean, there's, I think, I forget where, I want to say it was John Brody that I heard when choosing nutrition is very big and in, yeah, habit coaching and behavior coaching. Yeah. I love how a lot of his work and his recent book, which is on, it's in, it's on my shelf changemaker that I can't wait to start because that's, that's what I am more interested now, right? And learning about how to actually get that rather than just absorbing all this information and learning the best schemes of percentages of how to program something or how to treat something. But, you know, the one thing I wanted to mention is like, I think he quoted, forget where the study was, but I remember him saying that if you give an individual one habit to do at for a certain time, chances of success are 85%. If the moment you give them two things, it drops at 33%. If you give them three things to do, it's 17%. That's not, and then how many times, Dave, have you had people come in like maybe, maybe January 1st, news or resolution, I'm going to start intermittent fasting and I'm going to hit the gym six days a week and I'm going to sleep eight hours, it's just, it's mind blowing, right? And the most successful people who I've seen have actually had success with their clients or patients are the ones who are doing exactly what you just said, you know, it's taking it, it's taking it bite size. And, you know, like that's a great point and it's a, changemaker's a great read, John Marardi is a very good writer, it's an awesome book, you'll, you'll really enjoy it. But that, that's an important part of it is like giving people tasks, the first and foremost, you've got to give people tasks that are realistic for them. Two, you have to find out if it's realistic for what they actually want, I think because that's the biggest part, like I feel like if you ask everyone, everyone has five pounds to lose. What's different about you, five pounds later, like how is your life going to change five pounds later? Well, no, because five pounds later you're going to go, well, I could probably use five more. Like no one's ever satisfied when it comes down to that. So let's throw that out the window. Then let's look at it from the perspective of it's like, okay, well, you know, why are we doing something or how are we implementing that specific thing? So to, to what you mentioned, like I had a client come in and he wanted to start working on his diet a little bit, he wanted to focus on a little bit more. So I asked him, I go, you know, what are you eating now? Let's, let's just hear what it is, like unfiltered, just, I want to hear it all. He told me everything he was eating and then after that he's like, so what do you think I should start eating now for lunch? Like, what do you think of the cod, like should I start eating kale or spinach, something like that? And I go, how appetizing does that sound? He goes, I'm not going to like it that much. I go, well, then you're not going to eat that. Why would we even make that a goal? We know that's not something you're going to want to have. I've had reheated cod in the microwave. It is gross. That is not something you're going to want to do. So what is a small step from what you're doing right now? It's a small increment that we could change from where you're at. So he was eating like an everything bagel with tail or hand, egg and cheese for breakfast every morning from the local bodega or whatever like that. Okay. So then let's, let's bring it to just an egg and cheese and let's do it on like a croissant. Small step. Let's just, let's slowly ween you off it. We're not going to go cold turkey on cigarettes. Let's slowly ween you off it if we can. What the problem is is that people hear these unique scenarios and they think, well, that could be me too. Right? Like I talked about the person that eats pizza and has a six pack. There are plenty of people out there that eat pizza all the time and can still have a six pack. There's also a large percentage of people that eat pizza and they will definitely not have a six pack. So don't go off of the exception to the rule. You have to go on what is the most, you know, what's the most frequent thing? What's the, what's the mode in the data? What's the most statistical thing that we see the most going on? That's the thing that I want to go off of. Not necessarily what is the exception to the rule because that's the problem is people look at the exception to the rule and they'll look at it and they're like, well, I think they start running and you're like, why start running? They're like, well, I heard this podcast and David Goggins was talking about it. Like David Goggins is a freak that I passed every special armed forces test possible and runs marathons for snacks. You know that's not you. You watched all episodes of Joe Exotic when it hit Netflix in a row. David Goggins didn't do that. But people think that they go, all I have to do is this and it's like you're trying to overhaul your life and you know that's not you and you know that's not who you are. But I think that comes down to the bigger question of like, do people understand what it is they want to do? I think the biggest question that we may never have an answer for is because it's undefinable. But what is fit? What's considered fit? Because to the marathon runner, it's going to be a marathon runner or a David Goggins to a bodybuilder. It's going to be Arnold Schwarzenegger to a CrossFit person. It's Matt Frazier to a swimmer. It's Katie Ladecki or it's Katie Hoff or someone like that. It's going to be someone in those different disciplines. So there is no overall definition of what fit is because someone may say that, oh, this person's strong. Okay. Well, Simone Biles is strong as hell. But she's not deadlifting, you know, weight off the ground like how for Bjornsson and how for Bjornsson isn't doing flips and carrying themselves the way that Simone Biles is. So what is strong depends on the person who's interpreting it. So I think that's where we run into a big issue. But it's like there are some fundamental things that we can all get on the same page with. And those fundamental things come down to the fact of like, you know, what's realistic for you? What are these bite-sized pieces of change? Like you said, like one change is going to be very attainable, but it's also a matter of how stark is that change, right? If you go from no cardio to now I need you running seven days a week for four miles, that's unrealistic task for 99.9% of people. There's going to be the small percentage that will overcome that. But for most people, that's a very unattainable task. So then how do we determine what bite size is? And I think that's where all of us can be better as a profession, mainly personal trainers and healthcare practitioners. Definitely physical therapists. I think physical therapy also is, you know, there's a lot of people we're seeing integrate more with training and more trainers integrate better with physical therapy. And I think of the root of the problem with what we all talk about is there has to be better communication. There has to be much better communication. I don't discount at all what doctors put in when it comes to residencies, time, effort, studying, like that is not a schedule that I envy. But if you have a patient or someone working with you that, you know, that has, say for instance, you get someone that has to get a hip replacement. And you know they overheard that they said they work with a personal trainer. You can make the call to the trainer to connect and make sure that your patient is taking care of. And on the vice versa, the trainer should be asking them, who's your doctor? Do you mind if I reach out? Because I do that all the time. And I get some doctors that just don't even want to talk. I get other doctors that are wildly surprised that I follow up and asked and wanted to check in to see what their recommendations were or to figure out why. Like, what do you, because I may not have all the information, I'm relying on the middle person who's translating for the doctor. So let me go straight to the source. What's the situation with Marianne and what should I know about her past history? What are some things that I should be aware of moving forward that maybe you saw within the hip replacement surgery? Maybe you went from an interior lateral approach versus a posterior lateral approach, which means there's different contraindications, like, what are the specifics of what happened? So I know that we're on the same page because at that moment of time, we're on the same team. We're not on competing teams. You don't want her coming back to you. And if your doctor wants her coming back to you, you shouldn't be in the profession. And if you're a trainer that's not concerned with Marianne going back to the doctor, you shouldn't be in the profession. So we have to communicate better on that. There can't be this entitlement where a trainer thinks, well, the doctor should call me. And where the doctor thinks, well, the trainer should call me. Yeah. That's so awesome. That's so awesome. What you're talking about is we talk about handoffs or signouts to each other in medicine. Physicians do this to each other all the time, right? But you're taking to the next level, which is incredibly awesome. The one thing I do want to mention, what you had talked about when clients or athletes or those people come and they say, hey, I want to be the exception to the rule. I want to look at the pizza, the guy who's getting a six pack or eight pack with pizza. I think that that's also paramount for trainers and clinicians and practitioners to understand on the coaching side of it as well. Hey, coach what the statistics are, don't like the classic example I'll use in medicine, musculoskeletal medicine and sports medicine today is orthobiologics, right? ERP, adipose tissue, all these things, you know, the great ones or the good ones who actually understand the evidence, understand that the literature is not necessarily there to support it. However, there's always a time. There might be a patient who is a good candidate for this and this patient is the exception to the rule. And I think that's just as important for them to be successful. But I want to go to what you just kind of talked about earlier. You said that, you know, when you had posted that, you know, fitness professionals are the most freaking healthcare advocate. That's what I miss the most, man. When I was working with athletes, I felt like I was truly in the front lines, you know, so many athletes, individuals, they don't go to the physician until it's not necessarily too late, but things are always simmering for a while, right? Oh, yeah, you know, to them like, oh, hey, man, Dave, my coach, like, you know, my back of my shoulder hurts a little bit and you might instruct them, hey, let's try a little bit manual therapy. Let's try a little mobilization. Let's do a little Y2W's or some cuff work directly or something like that. And I know that you're pretty knowledgeable when it comes to foam rolling type stuff. Now, I don't know if you know this, but Tarshan and I are both osteopaths, right? And one of the things that drew me to osteopathic medicine was the whole idea of seeing all of this great stuff happening. My fascia released from foam rolling and all this stuff and we did a lot about Cresce and, you know, Martin Rooney, I was following them talking about how structure and functions interrelated. And that's the reason I went to the osteopathic route. So talk a little bit about foam rolling, a self-myo fascia, a natural foam rolling, but self-myo fascia released, right? How can our physicians, when we see people with pain or musculoskeletal dysfunction, how can we possibly counsel patients to use self-myo fascia release as a modality for, you know, therapeutic? I think it's a great point. I think it's a budding field right now where there's unfortunately a lot of misinformation that's out there between the people that are trying to learn it because they think of all these things. So, number one is understanding that SMR is primarily a neurological response-based thing that we're looking to do. So while we're focused on fascia, which is a, you know, it's a connective tissue, but it's a highly collagenous tissue itself. It's a hydration system that moves within the body. Like we were essentially shifting water through our systems because that's one of the biggest things that patients or clients or whoever don't understand is the human body's roughly 60% water. Like we operate heavily on that. So it's important to filter it in and out. But as we're moving through this, like understanding what SMR does is important. What it does for the most part when it comes to training is it's a neurological response of what we're looking to do. And what we're trying to do then is we're essentially deactivating the security alarm at the bank for a heist. What we're doing is we have a certain window of time now based off of SMR that we can then have better capabilities, better range of motion, better mobility, better stability, et cetera. Then what do you do in between there? The problem is so many people they do SMR and they do nothing on top of that. They don't stretch past that point. They don't do corrective movement past that point. They don't do activation exercises past that point, which really drive home the pattern. So when you see like with specific trigger point type setups is you'll see a lot of people will then follow that with body weight squats or lunges or something so that you can then groove in that pattern, you know, if things fire together they wire together. So if I can get things to start connecting those synapses between the new feeling and the new sensation in a certain part of my body and allowing the brains to understand, hey we're in a safe range of motion, we're okay, then that's important. What foam rolling does not do is it's not going to immediately change your posture. It's not going to open you wide, wide up. The problem with that is people don't understand that it takes about 18 months to 24 months of consistent work on foam rolling in order to start seeing long term changes. Like it's going to take a lot of consistent foam rolling and that's not going to work for everyone. So what we want to really do from that is we want people to be foam rolling and getting themselves into a scenario where they understand the purpose of why they're doing it. It's no different from the first three months of you exercising. You gain incredible amounts of strength. It's not because of, you know, you had better technique. It's the neurological response. It's your brain saying, you know what, we can do that. We're not going to get hurt. That's that do not die response. I don't want to get hurt because if I get hurt, I can't do things. I can't do things. I'm vulnerable. Your body doesn't want to be vulnerable in that way. So, you know, understanding what foam rolling is is a critical thing and how it functions with the structure of that. The common thing that people get wrong, they think that more pain is better or they go into an area where there's too much pain. So we always suggest the pain threshold of four out of ten. When you get too high on that pain threshold, you move yourself into a more sympathetic response versus a parasympathetic response. And you know, as you guys who well know the CNS system, the peripheral system, the autonomic system within branches off and then you have your sympathetic, parasympathetic, that's when we run into it where it's like, okay, I can't have someone going into that fighter flight when I'm trying to teach the body to relax in that state. So people go through it and they're grimacing and they're like, oh my God, that feels so good after it feels great. Yeah, because you put it through excruciating pain, your body flushed yourself with these hormones going, we've got to feel better now. Like, please make that feel better. So what you're essentially doing is, you know, someone's robbing the front door and there's a fire in the corner and instead of paying attention to the robber, go like, oh, look it's a fire. And that's all you're doing with that excruciating pain response. As you're just telling your brain, you're distracting at something else. So you're not making physiological changes, you're just making immediate responses. It's no different than, you know, feeding into an addiction that you'd normally have and having that cookie or having like, all you're doing is hitting that pleasure center for yourself, hitting that pleasure button and allowing yourself to move from there. But I think foam rolling is one of the more critical things that we need to start implementing and, you know, you just need a foam roller at a basis. If you want to get a cool fancy one, that's all the power to you. But you need a basic foam roller for now. You can get an Amazon basis for $9. But you have to take the time to how to properly do that. Because when it comes to soft tissue work, you can't screw around. And I think that's the problem where, you know, we see these trigger point guns and we see people, they have foam rollers and they think they now have an authority on what to do. LMTs are still very much available. PT's are very much available, you know, physical medicine docs are very much available. People that know what's going on in the body versus someone who gets a trigger point gun and they go, oh, I'm going to start jamming this jackhammer in my leg. It feels pretty good. You don't know what's going on there. You can maybe create a more damage than help. So soft tissue work is highly important and I, you know, I don't like the word prehab personally because it makes it seem like we're doing something before to make sure we don't get hurt, which is what you should be doing anyway. So there shouldn't even be a label for prehab. That should just be what the standard is. The standard should be, hey, let me do things so that I feel better and don't feel bad in shitty. Cool. That should be baseline. It shouldn't be the exception where you're like, oh, I'm in a niche market. I do things so that I make sure I feel good and then I'm not going to get hurt. Cool. That should be everyone. So that's why I don't really like the term prehab specifically for that. There's so much, so much real talk in that, so many knowledge, bombs. I love it. I love your examples as well, you know, so much of it is true. Like, even for me, as a doctor, you know, just so you know, I'm actually writing down your analogies and I'm going to steal them just so you know, you're so good, but like as a doctor, I know about the sympathetic nervous system. I know about the parasympathetics, I preach it, but it's so funny because I don't synthesize it like the way you just did. And it's such a great reminder, you know, for me to kind of just self-reflect and just get down to basics and just understand like, hey, what is truly going on here when I'm foam rolling? Am I supposed to feel this much pain? Am I not, right? And I think I think you laid out beautifully. So it's obvious your brain has gotten so much larger since you, you know, right, have started. I hope not physically because then the barbell won't get over. That's right. That's right. We're going to have to make bigger barbells for you. But if you could, if you could go back to when you first started lifting weights and first started getting into fitness, what advice would you give yourself? Leave your ego at the door. Stop trying to be a show off. Stop trying to, you know, what you realize is that things are cool for a moment in time. That's about it. Like once you do something, it loses its flare after that point, right? You guys are preparing to be doctors and then which is a, a colossally bad ass thing. But then once you have the doctor in front of your name, you're going to be like, now what? Right? And there's always a progression scheme to that. So that's the biggest thing for me is like, don't, like, I remember when I first, I was, it's funny. I did a podcast earlier today with Sean Heisen, who's the chief editor for on it. He's Aubrey Marcus and Joe Robins company. They do supplements. They do steel maces, kettlebells, all that kind of stuff. And the question I asked him was, you know, when did, when did the excitement and the, you know, and the allure of what you're doing wear off? Like when did you write that first, that second, third, fourth magazine article where you were in men's health or muscle and fitness or he was in men's fitness at the time? And it just, it wasn't as, it didn't have as much flair to it as you thought it did the first time. I think that's the stuff because it's like, you do a lift or you do something crazy and it's cool. It's really cool that first time. But after that, it's just a normal thing. Like, I always make the analogy, you know, you think about the kid in high school that had the really, really sick car, right? We all know there was that one kid in school that had like the new Mustang or we had the BMW or just something nice. And the first time you see that car and you see that kid, you're like, holy shit, that's a nice car. He's like, thanks, man. Things great, right? It's loud. It's got horsepower, all that. You're like, yeah, that's awesome, man. Second time you see it, you go, dude, I love your car. He's like, thanks, man. I love it. Third time, it's just his car. And he's still stuck paying lease payments for the next three to four years, right? So it's like, in that way, when you look at it, okay, is it worth someone saying that for you on a chronic pain standpoint, to be paying the lease payments on your chronic pain for the next 30, 40, 50 years of your life, just to say, hey, I did a 400 pound bench press because I've done a 400 plus pound bench press. I felt like my ligaments were going to rip off. I felt like my tenons were going to just snap. I felt like the muscle was going to come off like it did not feel comfortable. And I never did a max out past that point. I've never done a one rep max since then. It didn't feel good. It felt like necessity. I remember Matt Winning said that when he did his thousand pound squat, he said he could feel his femur's bowing. And he was like, I'm either going to die or I'm going to be a thousand pound squatter. That's a crazy mentality. And that should not be the thing that is immediately on your mind. So if I were to go back and talk to myself, A, it would be, remember why you do certain things. B, keep your ego in check. You do this for you. You don't do this for other people. Other people don't care. Like newsflash for anyone listening. Nobody cares about your life as much as you do. Not one person. They may like your photos, they may follow you, they may shoot you DM every once in a while. Everyone's there celebrating when you're doing well. Many of you people are there when you're not doing well. So why are you doing something? Because when the crowds aren't there, you're the one stuck with it. When the kid's not saying you got a cool car, you're the one paying at least payment. So is it worth it in that moment in time? I think we need to ask ourselves that more often than not. And then even on the other side, if you're not doing stuff, is it worth it? Is it worth skipping this workout this one day because you're kind of sleepy? Is it worth skipping it? It's only going to take 30 minutes. You don't need two hours. 30 minutes to get the work done. It's no different than brushing your teeth. You know, like if everyone woke up with minty fresh breath and no cavities and clean teeth, no one would brush your teeth. I'm going to, it brush your teeth takes a minute and a half. I'm going to put my money on it, no one would brush their teeth if I didn't have to. If it wasn't to clean their teeth and they had great breath all the time and it wasn't the concern, they wouldn't do it. Exercising is no different. You do it for your health. You don't do it for the aesthetic. You do it for your health. So when you get to that age where you're like, oh, I need to get my, you know, a certain valve replaced in my heart. Well, why? Because, well, because I went to Buffalo Wild Wings and I refused to work out when I was younger. That should never be the response. Like what are the tiny maintenance things you're doing? So that's what I would do. I might go and I'd say, you know, remember, man, you don't want to keep paying that lease past it's due. Dude, once in a while, Buffalo Wild Wings is okay, you know what I'm saying? It's the same. Modern. But too much, if anything is bad, I agree. But do water is great for you. Too much water you're going to drown. This is a good point. This is a good point. I'm glad though you brought up the concept of, you know, somebody being chronic pain and kind of pain that lease pain for a long, long time because I know you recently talked about people dealing with chronic pain. I'm not going into like pain medicine, but I see these people every single day, Darcy see the people every single day. You see, I mean, it's just plaguing our society, chronic musculoskeletal issues, right? We talked about back pain shoulder pain being the top two reasons why you see doctors. But you also said that, hey, whether it's using interventions to whether it's using exercise to become resilient, you know, for some chronic pain is unfixable, right? When we're talking, maybe it's cancer related, something like truly that's something like that. But when we're talking about people, it's something they just accept, oh, man, my shoulder hurts and I've got a torn red hair cuff and it's just going to hurt forever. And I'm going to keep benching like a jack wagon and doing the things and not, you know, working on their cuff work and those kinds of things. How do you get these people to say, okay, let's just take a step back. This is not a situation. This is not the state that you have to live in for the next 30, 40 years. You don't have to be miserable. I'm sure you see these people every single day. All the time, I think it's small bits of buy-in. The problem is people think about now, they never think about the future, right? Like they've done, I forget who did the presentation on this, but there's research that shows that people always have a much better vision of themselves six months, 12 months, two years down the road than they do today. Everyone's like, oh, I'm going to start saving money now. Now, I'm going to start investing at the right way. Now, generally, the person you are today is the person you'll be in a year is the person you'll be in two years. You are that person. If you are messy now, you're probably messy in a year, probably messy in two years. From that, I think it's important to try and connect with the person on what it is. If someone wants to then be in pain, I can try and talk them out of it, but people in the end ultimately make their own decisions. Like, I think we touched on it earlier where it was the 168 hours thing. I'm never going to tell someone how to spend their time. Your time is your time, it's your life time is invaluable. All I can do is try and put in perspective how little of it it actually takes for you to see a result, because for most people, the expectation of that, hey, I got to work out five days a week for an hour and a half, and that's not weak. You can do three days a week, 40 minutes, full body, that's really what you need. You can do the Rocky Balboa workout, just run a mile, do some push ups, do some sita, or do some planks, and do some pull ups. You're good to go, but people have a skewed expectation of what they actually have to do. That's first and foremost. When it comes down to setting the expectations for someone and getting that going, I think back to the hour thing, I'm never going to tell someone how to spend their time, never going to tell someone how to spend their money. When you position it and you say, okay, well, based on this chronic pain, what you can do is like, here are some ways you can help fix this, here are some ways you can help alleviate this. Let's put it that way. Not necessarily fix it, but here are some ways you can alleviate that through this, through this. If people then want to go through with interventions, great, if they don't, I don't want, I'm still not doing that. There's not much I can do about that. I can try and hide the vegetables in certain ways in their program. I can program a little more intelligently and choose things that will aid them in certain ways. But most people are just fearful of more pain or they're just, there's a fear response and people don't like acknowledging a fear response. I think that's similar to when we were talking about foam rolling, some of the stress that's involved, the sympathetic response I was talking about, some people just get a sympathetic response just by going down to the floor because they're nervous that they're not going to get back up. So are we considering that with foam rolling? Is that maybe putting them in a sympathetic response, maybe it's not the pain response, maybe it's their fear that they won't be able to get back up or their fear that they look silly laying on the ground or their fear that they're doing it wrong and their fear they look stupid and that, you know, people are going to laugh at them rolling on the floor like, those are real scenarios, those are things we need to acknowledge. So when it comes down to the chronic pain situation, what are some real life interventions that we can do that I know are doable? If someone's paying me to spend time with them, we'll do them during our time because that's one thing I can't stand is when trainers will choose things that they know the client will probably not do as homework and say, hey, let's still do this homework. No, let's do that now. Like, I just have a client that would come in and he only wanted to do legs, he wanted to do leg bodybuilder type leg workouts, get really strong, do heavy squats, dead lifts, all that kind of stuff. We finished the workout and he'd go, hey, we didn't do calves today. And I was like, hmm, okay, next time we'll get calves next time. He goes, okay, cool, I'm going to go in the gym, I'm going to do calves. Second time, hey, we didn't do calves again. Oh, you're right, we didn't do calves, okay, sorry, we'll do that next time. Okay, that's fine, I'm going to go in the gym, I'm going to go do calves. Third time, he goes, hey, we're still not doing calves. I go, well, are you going to do calves right after the workout? He goes, well, yeah, then why are we spending time doing calves? Because if I ask you to do hex bar deadlifts after the workout, you're not going to do that, but you'll do calves after the workout. So I know that's one of those things. It's almost like the research on running and lifting. What should I do first? I don't know first, or should I lift first? Well, you know, the research can go a little bit either way, but they've said that it's more beneficial that you run after your training session. You're supposed to run after your training session because of, you know, the way the body gets itself ready, any more efficient, et cetera, blah, blah, blah. And to be specific, we're talking about like steady state cardio, not like sprinting. Yes, yep, steady state cardio, yep, yep, which is great, ideal, beautiful, scientifically sound. Great. From a science perspective, makes total sense. My client hates running. Okay. So should I go on the science route and say, well, you should run after your workout when they're already tired and they're probably not going to do it? Or do I make them do it first when I know they're still going to want to lift and get a pump in after that? At that point, science doesn't matter that much. And then it comes down to the psychology of the person. How does that, what makes them tick? How do they operate? And I think that's where we as an entire community can do better and need to do better. Finding out what makes people tick. When we, when you, when you get that, you will get people that will respond, you will get people that will listen, you will get people that will be, you know, more empathetic. They'll be less bitey like they won't snap back as much. But my, my wife has gotten that a lot in the hospital where, you know, people aren't sure about the COVID response and what's happening. They feel out of breath and they're moving. They're like, I need to stand up. I need to move around. And it's gone to the point where it's like you have to let the person know, listen, this is the second highway. I need you to not move. I need you to lay down and not move because people that have, you know, aren't seeing good results and you freaking out is making it worse. I need you to trust me. I've seen this. I need you to lay down. And in that moment, those people, they immediately, they're like, done. Cool. I'm in. But it takes, sometimes it takes that question. Like you have to, you have to talk to people and see them as people first in order to have that conversation. So when we're talking about that, like, you know, going through chronic pain or foam rolling or any kind of stuff, like in order to integrate something, we have to have a conversation about it. In order to have a conversation, the person has to be willing to listen, not going to listen. It's not a conversation. It's me talking at someone and that's where we get ourselves into a really, really poor spot. Yeah, man, in terms of you just said that, you know, your wife kind of talks about people snapping back and, and I mean, even on the practitioner side, you know, a common thing that's being talked more and more about and it's obviously extremely prevalent is burnout and the term, I think the appropriate term is compassion fatigue, right? Again, going back to, I think that you deal with these folks because you were truly on the front line of all these things and people are coming to us when, again, when things are gone haywire and it's like a Wall Street bailout model, right? Do you think that compassion fatigue exists with trainers and coaches and that and that's why they're like, do this homework even though the patient, like, the client's like, I'm not really going to do this homework and they're like, just, just do it, just do it. Be sure. I think compassion fatigue happens, but I think part of that too. So compassion fatigue, I think happens in the medical field because of repetition and volume. You guys see a lot of visits quickly with, I would say a lot of things are in similar buckets or similar silos, you know, and like, when it comes to, like an orthopedic doctor looking at a lot of knees, a lot of hips, okay, a lot of shoulders, those are those specialties we're talking about and the foot because the foot is just a disaster. But compassion fatigue, I think, with trainers specifically comes with time with the person. What unfortunately happens is too many people, they become friends with their clients instead of being friendly with their clients. There's a big difference. So when it comes down to that, like, there's a coaching fatigue in the same way where it's like, if I hear the same person saying the same message over and over and over and over and over again, eventually, my brain is going to mute it out. It's going to just, it's going to delete it and say, yeah, I'm not really going to listen to it. But it takes a new person that can say the exact same thing and it may resonate and maybe the way they say it and maybe the way they articulate it, the tone, their level, their personality comes through on it, one of those things. But that may be the reason why it resonates with me at that moment in time. So I think the thing that trainers don't like to hear and they don't want to hear is that your clients shouldn't be with you for years and years and years and years and years. After a certain point of time, they need to cycle to somebody else to hear a different message. And I say this all the time when it comes to clients that are training, after six months, you should be training with me either A, because you love the appointment and need the accountability. It should be B, because I'm the best workout partner you could have, because I'm going to make sure I'm pushing you through certain things, pay attention to your rep scheme, your rest periods, etc. Or three, because I am just so damn charming that you want to spend three days a week with me. The reason it should not be is it shouldn't be, well, I don't know how to work out on my own, because my job is to teach you how to do that. My job is to teach you the art of cooking and knowing that whatever ingredients and recipes you have in front of you, you know how to cook. That's my job is to teach you that. So what happens is people then, they'll come to me and they'll go, hey, I worked with a trainer for years. I'm like, okay, well, what exercises did you do? They're like, well, I did some of these, and I did these. And the fact they don't even know the name of those things, or why they do it, or what a superset is, or what a compound set is, or why they're training a certain amount of time a week, or why you don't train the same muscle group back to back, or why you're supposed to rest a certain amount of time, or why nutrition is so critical to the process. Like, that's a huge red flag that person did a major disservice to you. Like the first thing I teach people is exercises bad for you. My definition exercises bad for you. You're tearing micro tissues in the muscle. You're creating damage within the cardiovascular system. You're creating these damages that your body, you know, will adapt to based off good nutrition and good recovery, and you're sleeping. You're not doing those two things. You are just tearing your body to pieces. So they have to learn that lesson first and foremost, exercises bad for you. So you know, you have to treat it with respect and do these other things on the back end to make sure that you're actually building a stronger version of yourself. But I think that, you know, people need to have different voices in their head or different people talking to them and coaching them because, you know, the three of us may be looking at the same exact statue. We may be outside of the Lincoln Memorial, but based on where we're standing, I may see the crack in the statue on my end where you guys don't just because of your vantage point. It's always critical to get other people's vantage points because they may see that one thing that makes a huge difference for the person that I didn't see. They may see that one emotional connection that makes a big difference. They may see that, you know, one technique that really resonates with them. They may see that one thing that is a small change that makes the big difference. What's the lowest hanging fruit? I may not see that because that's not where I'm standing at. So I think it's important for trainers to then refer their clients to other people eventually. And that cycle should happen over and over. But if you have a client for 10, 15, 20 years, I think it's a disservice on both parties. Yeah. And that goes, you know, just as well in the medical room, too. Like if you're having the patients, you know, on three-month appointments, just coming over and over and over, over, like for knee pain and you're just not doing something and you aren't able to get them graduated to leave, whether it's in physical therapy, whether it's, again, in the actual doctor's office, it's the same exact thing, right? You should be able to educate them to get them out or at that point, maybe that is when surgery is the appropriate because you're not getting better, right? It's a later resort. Yeah. You just can't go on a complacency. Exactly. That comes down. We probably should have let with this, but I was just so excited to start this conversation because that's so many questions for you, man. But, you know, again, you mentioned that you are a leading instructor for PPSC. But I think that it's probably worth trying to explain to people what, you know, PPSC is. And, you know, tell us a little bit how you got involved and, you know, how you met John and, you know, how did that all that happen? And then I also want to know, obviously, it's a lot for like trainers and coaches and stuff, but who else? I mean, could this be applicable to, you know, a more in the health care side, like physical therapists and those kinds of things, maybe physicians, even interested? Talk about that. Absolutely. So the PPSC is the pain-free performance specialist certification. And our job is to evaluate, we're to screen and assess people based off of foundational movement patterns, being squat, hinge, lunge, push, pull, carry, or just locomotion for the carry aspect. And we're going to have screens and assessments for both. And the important thing for that is knowing that, you know, we need things to be good enough not perfect. Chasing perfection is not something we're going to get when it comes to human movement, but chasing good enough is. So our job is to troubleshoot someone's, you know, potential things that are leading to chronic pain or leading to nagging injuries that may be there. Because a lot of them are just low-hanging fruit. Like what's the one part of your, you know, movement capacity or movement literacy that is lacking that may be holding you back? Maybe it is a specific joint. Maybe it is an inability to translate verbal cues into movement. Maybe it's one of those things, but our job is to troubleshoot through that. So as a PPSC coach, the first thing we don't do is we don't diagnose pain. But what we do is we try and get hurdles off of the tracks so you can run a clean 100 meter. That's it. How do I get as many of these things out of your way that you are self-inflicting on yourself? Like what are things that you just either maybe weren't coached on the certain pattern, or maybe you have a course stability deficit, or maybe, you know, you don't have the necessary ankle mobility for certain things. So you maybe, you know, watching all these YouTube videos on why I can't squat. I don't know why my form is not there. Maybe your ankles won't let you do that. Maybe you'll never be able to do it the squat that way because of your ankle mobility. So I can't just throw plates underneath my heels and make it work? You can for certain things. You can for certain things. But then it goes to the, then it goes to the base of that like, well, why do I need to squat to the ground? Do I? When's the last time you squatted all the way but to the ground with 300 pounds on your back in your everyday life? You didn't? Didn't think so. So then like does that, does that stuff matter? Sorry, I think a lot of what the certification is is broaching those questions and hopefully inciting some thought because that's what should be in, in personal training is thoughtfulness. Do not take the personal ad of personal training. Now the key thing is the last couple of workshops we've had and this has been, we're done and over that is we have a heavy amount of physical therapists that come out to these workshops, heavy amount of LMT's that come out to these workshops. We've at orthopedics come out on our staff. We have Dr. Dave Marco who's an orthopedic surgeon with University of Wisconsin at Madison. One of our lead instructors is Dr. Justin Farnsworth who is ranked the number one physical therapist in Rochester in New York and then John Russell is a DPT by trade. So he got his DPT and never practiced physical therapy. He immediately pivoted to strength coaching because of the parameters that were then PT but you're seeing a lot more PT's are getting dual hurts where they can bridge that gap between it. So the main reason I didn't go in physical therapy just to be transparent is because it didn't feel right working with clients who weren't specifically wanting to work with me but had to work with me based on circumstances and be the more important thing is I don't like working with people when I know there's an expectation that things can't really change. What I mean by that is the person that has knee surgery and you know horizon blue cross blue shield will pay for six visits and then I have to try and get them from non-moving knee to six visits later back in regular health. That is an immediate fail and I know that person's not going to renew. I know they're not going to want to buy and pay out a pocket pass that point. I know they're just going to use their six sessions and then the problem with physical therapy that happens which by the way I love physical therapy there's a lot of really good physical therapists but like any field there's good and there's bad. There's really bad trainers there's really bad physical therapists etc. So the problem is those people that then have six sessions left with that person they let them go through the motions and they go okay go do some leg curls on the machine and then do some leg extensions on the machine and then I want you to walk on the treadmill then we're going to attach the the east and around your knee and you'll be good to go. And then the next time they come in they just give a machine with those exercises to go here's your exercises go do them. You shouldn't be getting paid anything at that point. You are not helping that person one bit but I also get it that when it comes to physical therapy they're getting paid by visits and more visits more money or money than you get a higher bonus percentage so like the system itself didn't it just didn't work for me it didn't make sense for what I wanted to do and specifically the director that I wanted for myself. Yeah and dude I kind of want to share a story with you that actually happened to me relatively recently and again like you mentioned there's good bad in every single profession and physicians are at the top of the line for that right and I'm part of our hope with this whole thing is to educate and this has been like one of the best lectures I've heard since Dr. A talking back in 2011 honestly man it's been it's been awesome but the story that I want to share is I remember recently being somewhere and I was shadowing a physical therapist actually because I mean I was scoping this area out for future potential job and it was an individualized program and this person was working with the physical therapist but he was kind of like he was kind of walking around setting up the next session but he was kind of keeping an eye on the patient but from distant and so he put the patient on and I was watching well the first patient was doing bird dogs and you know he put the formula on the back kind of like all throughout the spine to make sure that hey this is going to check your form. I'm sorry actually he put it horizontally right and the formula kept falling and he would just keep putting it back on keep putting it back on I was like well let's think about this if that and I'm watching the patient the whole time and I'm like the the form was so nutritious Dave I couldn't even tell you right the patient had full cervical extensions lumbar hyperexgences the max it was just the worst bird dog not the worst but a bad bird dog and the formula kept falling which was supposed to be a cue that your form's not good but the physical therapist kept throwing it back on so that's that's a red flag the bigger problem was the next patient who came in he put her on the chest press machine right and as the patient was going back into glenohumeral extension right I was seeing she did not have the reckless flexibility to be able to get there but I was seeing that scapula tilt anteriorly and that you know flare up and the foreshoulder yeah absolutely the foreshoulder right Eric Christy talks about this lot on his rose and so I was watching if I watched it happen for three sets I was like every time I was just cringing but the PT is not noticing that and then he comes in and the patient goes oh my shoulder hurts and I was just dude and the PT goes oh it hurts okay all right let's not do a forte let's go to something else and I was like I saw it happen but you know I just I couldn't you know do you remember what she was in for if you don't mind me ask she was in she was in for something like I think they had an infection in the foot so he was just kind of doing a global thing it wasn't for a shoulder thing right she had an infection in the foot I was gonna joke and say let me guess she like rolled her ankle or something had a foot yeah let's put it on chest press she should not be doing four sets anyway this uh look we're gonna do five three one with you exactly now we're doing our skin one learn here let's throw this on dude so I mean at the time obviously you know I'm the physician but at least I knew my place I didn't want to say anything but I just my mind was and this is kind of why I love that you said that hey I'm so happy to hear that there's an orthopedic surgeon physical therapist coming and this kind of stuff and it's definitely on my thing to come check out um and that's one of the reason I've kept my CSS and I keep learning education continuing education and this going to perform better all that kind of stuff because it's so important to bridge that gap the integration that you've talked about the sign out that's my favorite thing that you you already said that hey that you know calling and and I'm hoping that when I'm in practice I will continue to sign out to the physical therapist to the personal trainer and have that collaborative stuff um so dude I I want to thank you again man this has been so friggin awesome I know you're a busy guy uh but it's been so awesome just just taking your brain a little bit I hope we can continue to do this in the future yeah man I mean listen I always got time I I appreciate you I know how hard you work through our undergrad and all that kind of stuff and I love seeing the direction you're going and I think it's it's it's so it's so awesome knowing that you really really give a shit about who you're gonna be working with um I think that's such that's such a critical piece to it because I think that's the part that you know we can always do better at everyone is am I constantly getting better at what I'm doing because if you're not getting better every day you're getting worse if you're staying in the same spot that means if it's name information over and over and if you're not developing yourself you're not getting a better perspective on what you can do um regardless of field and I think on that end I would encourage anyone that is listening to this podcast find you know one of the trainers that you know that are within your network find physical therapists you know that are within your network find an LMT that you know that are within your network and find reliable people that you know understand the process and learn from each other as well as just the referral aspect you can get a lot of extra referrals from people that'll go to someone that they know understands the importance of fitness health and wellness and you will have trainers and physical therapists and LMTs that also understand the level of what you guys do on a day-to-day basis so creating that network is so critical and you know we have to be willing listen if if I can't go out and say hi to someone and ask them a question I'm at a big loss of what I'm gonna want to do specifically in a very client facing field so um I think reach out to people and and you know I appreciate you guys for reaching out and asking to come on and and just you know I love talking shop and I love talking about this kind of stuff this is this is what you know this is what's all about is helping get people information I'm never gonna say I have the ultimate uh information or I'm the I'm the best person out there or any that kind of stuff but all I can do is give my opinion on what I've seen over 14 years and what I see the industry doing right now and you know I hope some of it resonates for some people out there absolutely David I mean even for me man I can't thank you enough for coming on here I think you really open my eyes in terms of one me just being a better coach and what it really takes to be a better coach and the things you need to ask and think about and then two me being a better athlete in the gym not for anyone else but for me right because that's that's who it's for in the end um absolutely so a lot of real talk you man I just want to ask you one last fun question um if there's one lift that you could do for the rest of your life what would that lift or stretch or whatever it is what would it be man you're gonna ask me a question of want versus need yeah I'm actually you know what I'm interested like I want to know from yourself assessment what do you feel like is the one that's that you need to do right and then versus want you know what do you enjoy the most um my so my answer for need to do is just gonna be a it's a total cop out it's gonna be anything locomotion moving around movement people need to move around I think loaded carries I think that type of aspect because you've used to correct the exercise and go oh what's core base that's easily the best thing locomotive stuff and carrying movements are by far the most undervalued of pieces when it's the thing that we do the most in our everyday life right like I I went to the gym today at Metro Flex in Arlington I hit chest I hit triceps I hit shoulders I hit all that kind of stuff but I carried my my nomotech bag through the airport this morning to my car carried my stuff into the hotel carried stuff downstairs carried books upstairs I'm gonna go to staples pick up more pamphlets carry them out like locomotion and carrying movements or something we do all the time and we don't train for that when that's the thing that can make our lives a lot easier that's the thing that we can really translate so I think that's the one thing I would encourage that people need to do more is purposeful loaded carries or just you know locomotive movements in general just get off your ass and move and know your shift at the hospital or the doctor's office doesn't count I don't care that you get five miles on your feet when you walk around you ps drivers are fat too and they deliver boxes all day your body hits homeostasis you still need to do above whatever that number is so whatever your threshold is go above it but if it was for pleasure what's the one thing I would do for us my life I've always just been a bench press guy it was the first thing I ended up doing uh you know I see this at the workshops too is you know bench press was always the first thing I was doing because I watched pumping iron with Arnold and he had a massive chest and massive arms and what he did was bench and barbell press and shoulder press and incline press and he did preacher curls like I said when I was 13 I bought a 300 pound Olympic weight set barbell with a preacher curl why do you think I bought that so when I talk about like foam rolling in our workshops I ask people to make foam rolling sexy and what I mean by that is if I watched pumping iron when I was 13 and I saw Arnold foam rolling before every lift he did every session he did you know I would have bought a foam rolling I was 13 so I think in those scenarios like that that's what I would um if I had to stick with it it would be bench press I mean that just it's my strongest lift and people like to do what they do so yeah uh I'm pretty good at it I'll stick with it love it my shoulders won't like it but that's the way all right so David where can our audience find you uh they can follow me at David Ote fit um I have a lot of if you want they can they can uh if they google my stuff they can take any content that I have it's already out there um so I have a website uh Ote fitness which should have a lot of it catalogs for now but um I have articles with women's health men's health muscle and fitness um teenation weight watchers teenation like all over the map helping you know 45 year old moms and 19 year old meatheads all over the place so absolutely I just thought I saw YouTube of you doing a 15 minute lower home body workout so you know for those in COVID they didn't go to the yeah for men's health one quarantine here which still it's it's going to be a good one to start using the next week or two yeah you know what about uh what about Instagram David because I know you do sometimes we'll do live workouts on IG what's your hand so at at David Ote fit is my Instagram handle and then every uh Tuesday right now it's Tuesday but every week uh men's health we do uh live Instagram workouts at 12 p.m eastern standard time right now I'm doing every Tuesday um so you know tune in go for a workout I'm not gonna do the glitzy burpee ridden nonsense that everyone else is doing uh I'm gonna do the strength training lifts and I'm gonna try and answer questions and teach people as we go along with it if I can help you know 50 60 people learn that kind of stuff then that's that's what I'm here for sweet deal man and we're gonna sure we're gonna link all that stuff uh in our show notes uh so people can find you pretty easily David again thank you for your time buddy they appreciate you thank you appreciate you that's a wrap on the show but want to again share how you can find the doctors unbound podcast on your podcast app if you have a minute and you're not driving look the podcast app on your phone that you're listening to this show in search for doctors unbound click subscribe and that's it thanks for supporting fellow physicians as they pursue incredible lives out of medicine see you there all righty everyone we really hope you enjoyed this episode of medicine redefine just as a reminder everything in this episode is for general information only it does not cost you the practice of medicine and we are not providing any medical advice no patient physician relationship is formed and anything discussed on this podcast does not represent the views of our employers if you got value out of this podcast please please feel free to subscribe share rate and review this podcast and be sure to send it to your loved ones so that they can also be on track as 2021 approaches let's put the health back in health care