37. Kelly Starrett, DPT: Performance Therapy, Self-Care, Expanding Movement Language & Improving the Healthcare Paradigm

Hello everyone, I'm Dr. Darsha, 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. Before I introduce this week's guests, a quick story time brought to you by LocumStory.com. Today we'll be reading one job, two job. One job, two jobs, red blob, no job, elective doc, emergency doc, summon overstock, summon out of stock. This doc is too abused, this doc is utter used. This doc can't get sick, say, let's try brand new trick. For all the docs about to cry, here's an idea you can try. Look into Locum tendons assignment, a really great option you might find it. Don't forget Locum's pays much better, and you can find assignments in any type of weather. With all this new info, track up in your thinker, go to financialresency.com, slash LocumStory, and use your mouse to thinker. It's here you'll find the unbiased answers you're after, so you can decide if Locum tendons is your next chapter. Now onto this week's guest who has none other than Dr. Kelly Storet. Kelly is a coach, physical therapist, author and a speaker, along with his wife Juliet Kelly is co-founder of the ready state, which was previously known as mobility wad. He received his doctorate of physical therapy degree from Samuel Merritt College in Oakland, California. Kelly has worked with the lead athletes in every major sport, as well as several Olympic gold medalists, tour different cyclists, world and national record holding Olympic lifting and power athletes, as well as CrossFit game medalist, ballet dancers and military personnel. Kelly is the author of the New York Times and Wall Street Journal bestsellers and becoming us up a leopard and ready to run. He is also co-author of the Wall Street Journal bestseller desk bound. If that isn't enough, Kelly and Juliet also started San Francisco CrossFit and stand-up kids. The latter is a nonprofit dedicated to combating kids' sedentary lifestyle by bringing standing and moving desks to low-income public schools. Today's stand-up kids has converted 95,000 kids from sitting to standing. Over the past decade, Kelly has revolutionized the field of performance therapy and self-care, which is why Darshan and I were incredibly honored to have him join us and discuss some of the real issues we face in the current healthcare paradigm. We start with more of his background and athletics and journey through physio school and how he came to think about everything they now teach at the ready state. We dissect some of the limitations of the current healthcare model and the role of healthcare practitioners in helping influence change or at least establishing better practices. We also discuss the role of the individuals, patients, athletes or users in augmenting behaviors with respect to sleep, expanding movement language, nutrition, etc. Kelly explains what he means by getting to base camp before we can think about climbing Everest. We are so grateful for the opportunity to pick Kelly's brain even though there were probably a hundred other questions I wanted to ask because Kelly has been a first-line responder for the current form of healthcare or sick care, at least in the physical medicine realm. So without further delay, I hope you guys enjoy our amazing conversation with Dr. Kelly Starrett. All right, what's up everyone? Welcome to another episode of Medicine Redefined. Ultima and I are here sitting with none other than Kelly Starrett, so this is going to be a surreal experience for us. Kelly, how you doing, man? Very well. It's surreal because it's not in real life because it's a little bit of both, man. I don't know. I've been listening to your podcast for a while. Ultima has introduced me. I use the Ready State all the time every morning, so it's kind of cool to be here and talk to you about stuff. Oh, man. Let me say that you'll never get that time back. Ideally, if there's other people in your house, I can hop their dreams. That's really what I want my goal. Love it. Love it. Well, Kelly, for those that might not know about who you are, why don't you take us through a little bit about how you got started into the physical therapy world and how you kind of transitioned into starting the Ready State? Well, I tell you what, the bottom line is, at first, I was a user. I used to canoe on the US canoe impact team, which is where they hang the gates over the river. You see it every four years. It's like standing in a shower, ripping up $20 bills. The old model of exercise and training was trained as hard as you can because much volume is you can. If you don't break bully, and if you do break, we'll back off figure out what's going on. I broke. I had a terrible brachial plexus, I don't know if it's a traction injury or a hot nerve root, but it ended my paling career. When I really started to deep dive into it, that was my first real experience with what I'm going to call emergency athlete medicine, which is, hey, can you take away this pain and this problem so I can go back and do exactly what I was doing before, but more of it, right? I was like, no, no, put a course on the shot in there, give me the Medjoldos pack. Let's do the MRI, let's do acupuncture, let's, let's, oh, traction machine, that sounds great. Let's do that too. So anything that I could do, except understand what precipitated that, except understand what my ownership was and how to get myself out of that. And it was complicated. I was a terrible asthmatic at the time. In fact, I mean, I had to register my inhaler with a IOC and, you know, that only matters if you're a physical medicine person. Passive accessory breathing is really hard on the neck and imagine having your left arm over your head in a canoe position, 300 days a year, sometimes twice a day a year, there are some patterns that sort of rear their heads. And our definition of warm-up was no hard strokes for five minutes. That was what we used to do. And, you know, we would brag because we would ride our bikes to the pool, we would swim, we'd ride our bikes back, we'd go to the weight room, we'd paddle, that was our second paddle session today, and no one outworked us. That was our sort of badge of honor. And of course, I've come to realize we'd call that plausible deniability athleticism where you can point at your workout volume and say, well, no one outworked me, so it's not my fault I broke. It must be someone else's fault. That ended in my career. I went on and realized that I probably needed to go to physio school, I needed to understand why what I was offered as a patient, especially as an athlete patient, was so far removed from my experience of being an athlete. It wasn't in the language of athletics, it wasn't in the language of training, it was like a correlate parallel rehab universe language that frankly didn't work. And certainly didn't give me a rationale. And I understand that it's complicated when we talk about does this cause injury, yes or no? That's a complicated question. But there's a lot of things we can do to mitigate, attenuate, eliminate risk variables. I'm still, you can't go to zero, but catastrophe happens, so if you're talking about getting hit by a bus, that's not the same thing as you don't sleep, your movement is less efficient, your passive excessive breathing, your super stress case, there's a lot of things wrapped up in there. So fast forward a little bit, I went to physio school and my first semester of physio school, I discovered this nascent and emergent phenomenon called CrossFit and you have to understand this is way back in 2004, that's very different than the class that we see today. And one of the things that happened was I suddenly realized I wasn't very skilled and I wasn't very strong and I wasn't very fit. I don't mean that like I couldn't just do a bunch of work, lift the sandbag over your head a thousand times, you know, do a billion burpees, but I meant was man, I hadn't really sung a kettlebell before, I couldn't Olympic lift dumbbells, I was already working with an Olympic lifting coach because I knew that that was something I needed to do. But I didn't understand the tenets of gymnastics, I wasn't competent understanding swimming or structures of monstructural aerobic work. And more importantly is I discovered these two twin aspects, I mean young doc student physio and simultaneously I'm learning that I don't know much about strength and conditioning, formal strength and conditioning, real, movement language. I suddenly realized that there's still a gigantic gap in between those two processes. So my second year in grad school, everyone does this, I first year I had a baby, second year I had a baby and I didn't have another baby, I had the same baby and I opened a gym. And I got pulled into the dean's office and said they were like are you mad, you're crazy, this is you're going to die and it was like well I think this is the future. And what was interesting about opening a gym in physio schools, suddenly I had access to pattern recognition at an order of magnitude higher information where I could suddenly understand cause and effect and what I realized is that I had a really brilliant diagnostic tool to see what was going on underneath and I began to see a relationship between people who were injured or in pain, oftentimes had poor movement control skills, didn't have access to their full range of motion or didn't even have full range of motion. So someone is putting their arm over their head and their shoulder hurts and they don't know how to put create a stable shoulder when the arm is over their head and they're missing 30 degrees of range of motion, those some things sometimes are correlated and when I ended up realizing was that missing variable in there was genetic tolerance, right, environmental durability that a lot of people can tolerate a lot of stuff in less effective positions. And so what I realized is that when I was young physio, when I restored people's positions I was restoring their function. But simultaneously I was working on this performance side that if I could improve people's performance or positions I was able to restore there and improve their performance. And then I had this laboratory that I got to test it in all the time with my own athletes, with groups that looked start to rhyme with the NBA and FL, NHL, I started to develop a model of understanding, you know, sort of health and wellness from an organization level when you work with, you know, and you're talking to every doctor who is responsible for a health care in the army, you get to play it a slightly different scale and really get to see people's very laundry. So lo and behold, one of the things I realized is that we didn't have a really good idea, everyone understands sort of normative ranges, but what does that normative range mean and how much should I be able to control that? And what we don't have is sort of movement vital signs. What we do is say work really hard and continue to work really hard in this peloton or this complex solution, as long as you're sweating and burning and toning, then it's enough. And then lo and behold, if I asked my physician friends, how we doing on the old ACL injury front? We've solved that problem, right? There are no more back surgeries. We've been bracing the core for a decade. We've been strengthening the glute meat for a decade. So do we fix that? And it turns out that maybe there's a combination of things happening. One is that we haven't done a good job of empowering people to understand their role in this. And secondarily, we're continuing to see an advancement in the degradation and unwilding of human beings as it relates to sleep and quality nutrition and non-exercise activity and physical practice and basic movement, competency language, and that's no one's fault. Everyone comes from a thing. And so what we've tried to do with the ready state, because we were born in performance, is take those biopsychosocial components, which we all knew mattered so much to make a championship team and transfer those best practices and give it back to everyone else. To take what we understood around restoring basic range of motion and actually showing people how to regress and progress that up the chain and down the chain in the language of strength and conditioning, which is the formal movement language of the gym, push up, squat, lunge, pull up, those foundational movement practices everyone understands. Then suddenly we had a language about improving the ball with musculoskeletal care, because one of the things that's happening, as you both know, is that there's a lot of silliness that people are bringing to their physicians, which isn't a physician-related problem. The physician may have six to eight minutes of time to talk to you. He or she or they do not have a chance to watch you run or look at what you under fatigue or get into your nutrition or your injury history. They're really trying to triage that, and so what I think is happening is we're misusing our physicians, and we were like, well, my physician sucked, and I'm like, hang on, hang on. What part of this do you own, what we see is we have not empowered anyone, so it's basically people bringing their goal fish to their car mechanic, and I'm like, okay, that's sort of a type one error in that. The more we can shift this around and start earlier and put quality and movement skill back into the language of exercise, the more that we end up seeing durable positions, better joint function, et cetera, et cetera. That's what we're doing through ready to say. I love that, Kelly. I know a lot of what I'm hearing from you is that during your time as an athlete transitioned to a physio, what you came to learn was that, hey, I have to prioritize self-care, first inform us for myself, but then also empower my athletes, my clients, my patients to prioritize self-care. That's what you've been exceptional at, with all the stuff that you've done, your books, the virtual mobility coach that you have. I think it all, of course, begins with having these deeper conversations with the patients. Very challenging to do it in eight minutes. You're right. No, no. We can do it in 30 seconds on TikTok. I don't even know. Oh, yeah. You guys are what we call time-rich. It must be honest. The brain is the most complicated, sophisticated structure in the own universe. The spine and the forces on the spine are so complicated, we can't be modeled into a computer. 30 seconds TikTok go. Yeah. And that's the difficult part of the situation is, like, I'm still in this computer, Tia, talking about how the world has lost its appetite for nuance and everything has to be 140 characters. I don't know what Twitter is anymore, 30 seconds of TikTok, whatever it is. But coming back to, I think about this thing, one of the things I've noted by my current profession now, Kelly, is that people get super excited when I tell them that I'm the team physician for a university, maybe even a professional team. But I find that that's not often where I'm making the most impact. Let me tell you what I mean. I remember, my coach, when I worked at Precy Speed School, I think it was Martin Rooney who said to me at a time that it's not necessarily that hard to train an elite athlete, Olympic athlete. Because those guys are self-motivated, you know, and a lot of time you just kind of have to get out of their way. You just have to empower them to find the technical faults at a high level. Sometimes they've already hit the genetic lottery. And in fact, sometimes, you know, these individuals are going to succeed despite the coaching. Of course, not coach Rooney. He's exceptional. But you know what I mean. But he said that training, maybe a nine-year-old athlete at Precy, who doesn't necessarily want to be there, keeping them engaged to be in practice, and then, you know, empowering him so he leaves and wants to come back. That's the challenge. Now, today, I didn't know what you described there, but it wasn't strengthening and it wasn't training. Right. Behavior, modification, coaching, teaching is what you described, which really we need to talk about more because you really just hit something that Rooney, who I know and Precy, who I know, are experts at communicating, and experts at motivation, and expert behavior change, and experts at behavior modification, and ultimately, that is the thing. And, you know, I'm terrible at training my daughters, I'm terrible at it. I make them cry. I'm just like, I don't like to gamify things. I offload that as much as I can, and exactly your point, the only thing that matters, and this is what's crucial, is that in my thinking, one of the ways that I evaluate programming and thinking asks, does this scale, or is it a dead end? So we always teach to the highest expression of the movement. So if I'm working with a nine-year-old, I'm setting them up for the same sets of foundational movement practice and skills that I can advance all the way up to the Olympics. And in fact, you can see the thinking all the way through the skill, and there's no place where we're like, okay, now this is 11-year-old squatting, and now this is 13-year-old squatting. The loads, the complexity, the ways we challenge position with part of respiratory demand and metabolic demand, right, the load and speed and competition. Those things change, but the only thing that remains constant is I have to make sure that this person and I are in some kind of therapeutic, mutual, respective relationship, right? And secondarily, so that's trust and humans. And secondarily, that I want to see that your thinking has through narrative, that it scales up and scales backwards, and that's really, really crucial. And what people don't understand is that the best coaches in the world can do that, and also the best physicians in the world can do that. And don't get me wrong, there is absolutely the place for the specialist. I am such a fan of specialization, but all the specialists I really respect across any field are also savage, generalists, and they can step into any group and be a physician, be a coach, be a trainer, be a physio, to anyone, because first principles are first principles, and you can see how their thinking scales up and scales back. I mean, didn't wrap you there, but it was super important what you said. I agree, no, and I think that's bad on, I appreciate that. Well, what about the opposite of the spectrum, right? So we're dealing with this 7, 8, 9-year-old athlete trying to impart these best practices that you talk about quite often. They're at a stage in their life where the brain is malleable, and they're extremely resilient. We know this as well, as long as you're not doing too crazy. On the opposite of the spectrum, what I see a lot of, unfortunately, now is, I'll see a lot of folks in their 50s and 60s who have significant neostrathritis, something probably you had at some point, not too long ago, and we have BMI as a 45 and 55 who come to me because they want to get out of knee pain, they want to restore their function, they want to improve quality of life, play tennis, whatever have you, and I spend a great deal of time trying to explain to them, hey, this is a load bearing problem, right? You've got the issue, some of the issues that you talk about, but primarily this is a load bearing problem, and if you want this pain to go away and you want that function to be back where it's going to improve your quality of life, then they've got a journey to embark on where they have to address their nutrition, they have to work on the sleep stuff, to reduce that load, they have to work on that weight, but I can tell you probably a handful of times when I've been successful in having that conversation where they're like, okay, well, what about this injection, what about this and what not? I apologize because it's a little long-winded, but I want to ask you is, how do we address that issue? Because this global health issue that we're both, you and I are both, and Darsha as well, where we have 43% obesity epidemic, up to almost 50% about 2030, how are we going to address that? Well, when you say obese, you're not even talking about a weight, you're talking about a beast. We've actually have a new clinical designation for children called super morbidly obese. We're into that realm now. So one of the things that you're, I think, struggling with is there is no movement mechanics without tissue quality, right? So what you're seeing is that, hey, don't have a lot of lean muscle mass, I'm not spreading this out, don't have movement quality. And then we layer in these key components, the foundations of being, let's call it, a human. Because, you know, Matt Walker in his book, I saw a quote from him recently, and why we sleep. And he was saying, you know, sleep is really sort of a wasted time. Like there's nothing really useful happening with sleep, we're vulnerable, we can't forage, we can't reproduce, we can't create. So in two and a half million years of evolution, do you think it would have been an evolution advantage to whack, to knock 10% of your sleep off, just get 10% gain in that seven hours of sleep? And it turns out, we haven't done that. There are these minimums because it takes that long for your body to do what it needs to do during sleep. So what we're beginning to have a conversation about is, you're coming to me with a problem, the knee is a lagging indicator to a really larger conversation. And in there were three different sort of requests. The request to change body composition, I don't like the way I look and feel, okay? Quest about getting out of pain, which has nothing to do necessarily with those other things. I know people who are highly inflamed and overweight and party and they have no pain, you know, one time I famously told a story where I got into an elevator in Vegas, one of my best friends. And there was this woman who was like 400 pounds and 5 feet tall and she had a four foot bud wiser and was smoking a cigarette and had a bag of donuts. This is not hyperbole and she started flirting us up and she was 60 years old and she was trying to get us both back to her bedroom. And I was like, damn, look at how amazing people are. Like this woman is killing it, right? So we have this amazing tolerance. And the real question is, is the physician the right place for this conversation? And what I would argue is that if you feel frustrated in your position, it's because you don't have the tools, the time, the wherewithal, the follow-up to do this. What needs to happen at a medical office, and I was just having this conversation with one of our staff members, Dr. Travis Jewett, some of the best results we've seen at hospitals is that the surgeon then makes a call to a lifestyle counselor who is a full-time strengthening coaching coach. That full-time strengthening coaching coach gets paid a salary year, goes on a walk, begins to track and follow-up. If you're a working physician, your ability to make these behavioral changes and have these interventions that are significant and important and be able to track of them is zero. In fact, I'm not even sure how you bill for it. I'm not sure how you follow-up. I'm not sure. There's a whole lot of, we're just the system isn't set up for this right now. What I would say is, as a physician, it's great if you can point people in the direction and begin this conversation about, hey, there's a lot of things we can do to make your brain less sensitive, to improve so your body isn't sending off those air signals interpreted by your brain differently, by getting you leaner. I mean, honestly, name one high performance environment where I'm not talking about nutritional quality. I don't. In fact, the older you get, the gnarlier that conversation gets because you can't smash beer and drink pizza like you're 20. You're like a young resident who doesn't need to sleep ever, apparently. What we're seeing is the foundations of human performance around tracking sleep, around walking more. What we're finding is that we're able to go into some of these high performance environments and take out best practices. One of the military crew and military groups I work with, when they have sleep dysfunction, the first thing they do is have their athletes, their warfighters walk more, which is totally counterintuitive. But I'm an elite war fighter, right? I need you to get 15,000 steps a day so you get enough non-exercise activity so you can actually accumulate sleep load and then want to fall asleep, right? Not exercise, non-exercise activity. I need you to accumulate enough fatigue during the day that you actually can have the sleep pressure and trigger that sleep cycle. If you, people will understand, if you asked this question, tell me about how much coffee you drink, and then tell me how much alcohol you drink in the night. We asked that question a lot, and my wife is actually a breast cancer survivor in 2019, diagnosed with breast cancer, a mastectomy reconstruction, and it goes in for the oncologist afterwards on fall-up care, and the nurse is like, so how much wine do you drink? My wife says, I actually, we don't drink, and she's like, okay, so like one glass a night, it's like, we actually don't drink, and she's like, wait, what? You don't do what? How are you coping? You know, like the woman's head exploded, but the reason I mentioned that is not because caffeine and alcohol are bad, I think they're both proof of intelligent design in the universe and God's love and all of the reasons that they're amazing, but if you get on a stimulant cycle, and you hit that stimulant late in the day, it's going to affect your sleep latency and sleep quality, and in order to hit the brakes and actually feel sleep and take the gas off, you're going to have some alcohol, which further disrupt your sleep. So now we have highly disrupted sleep, and the next morning we wake up, fatigued, don't feel like working out, feel like getting more catmore, and you have a caffeine bump at four o'clock, and then in order to go to sleep, you're hitting the gas pedal, hitting the brake, hitting the gas pedal, hitting the brake. People that realize that all of these behaviors are tightly coupled, that they are tightly constrained within the system, so that, you know, one thing begets another thing, begets another thing, and I think when we end up pulling out best practice, what we need to ask the question then is if this is what we know about changing body composition, or putting muscle mass on, or people walking more, we have to have this conversation in a different place. I like to tell people, I use my physicians for emergencies. That means I have pathology going on, right? Night sweats, business fever, vomiting, nausea, okay, I'll wait for a little week, I'll chain, right, change the bell or bell function, or I've just been hit by a car, there's a bone sticking out or a broken bone. Those are the best uses of your physician, they are, you guys are experts, the men and women in my life who are physicians are ninjas, but if you take in a complex behavior problem to your physician, they aren't set up, reimbursed, have the time, the follow-up and the ability to do that. They can initiate a conversation, but we have to ask where are people going to give this information to the places, because you're right, and it's interesting for us is that we are sifting it, even a shifting dynamic of pain and who owns pain, pain is a request for change. I've seen knees that look like garbage cans, or I've been in surgery and I'm like holy crap, even their boulders floating around, and no nomeniscus, and conflict defects, and that person has no pain, they're complaining if they can't flex their knee. So what we know is that there's an incongruence between results sometimes, pictures and function and experience of function, and sometimes if you have a blown out, super hot disk or there's a bone sticking out of your leg, that's the problem simultaneously, right? So what we need to say to people is, hey man, arthritis is a complex phenomenon, and here are the things that are in your power to be able to change. And then you have to appreciate that person's going home and being crushed by social media, all of this caloricly dense food, their sleep is disrupted, their stress case, we haven't taught that person how to do any of this care. We started thinking differently about the problem after a talk I did at Google when we went to our kids school and said, hey, our kids are sedentary all day, we think that that's maybe not the best for a developing body. What do you think? And they were like, good point. So we switched our kids to these dynamic work stations, aka standing station with a stool in a bar that they could fidget and they could sit on the ground, and we converted the whole school to that environment, which wasn't about standing versus sitting, it was about moving versus not moving, giving the kid more movement choice. We ended up converting the whole school, we started on, et cetera, et cetera. We are now doing some research with Cal Berkeley, and one of the things we've seen in some of the research that we've done with fourth-fifth graders is they don't know what good food looks like, they don't know how much soup they should be getting, they don't know how many steps they should walk, they don't have fundamental building blocks of health practices that we should be teaching every second grade, third grade or fourth grade or so by the time they come through, it ends up being a much different conversation, because when people are coming to you with that situation, they're like, I don't know why my knees like this, but it bugs me, and I can't do the things I want to do, right? What you should say is, here is the things that you should do that can improve your health if you take it, and they're like, yeah, I do that, I already know it, I'm doing that. When is that conversation ever happened, never ever in the history of the world never happened? So we need that conversation to happen a thousand times before that person runs up in their physician's office with a complex need, with actual skilled care, because a lot of what we're having to do, and I think the beef on health care is that we're actually, it's non-skilled care, it's course important, of course it matters, but it's not the best use of our physician's time or our physical therapist time. So where are the people getting this information? Where are they spending three to five hours a week with their coaches and trainers? Means we need to shorten the gap between what we say is the squat rack in the doctor's office. How do we make it so there's a sliding door of information? How do we get people to that information earlier? We're going to have to start a lot earlier. Here's a case study, I work in the NFL, some of the coaches in the NFL were like, you know what the problem is with the NFL, they tell me, they're like, well, all these kids come out of college, still banged up, and I was like, oh, college coaches. So I work in a lot of universities, imagine University of Michigan, head coach telling you their strength coach telling me 22 out of our 24 all-American recruits had knee pain doing an air squat. I'm like, oh, that's not great when you're 18 and you already have knee pain doing an air squat and you're starting your career, it's like, you know what the problem is. And I was like, oh, tell me, he's like, his kids are in high school and they're like, oh, there's high school kids, damn them. So I go to the high schools and then they're like, you know what the problem is? And I was like, wait a minute, who owns this? Why are we just saying it's someone else's problem instead of consistently improving the ball? So that is the heart of what we're doing and it's, frankly, what I'm obsessed with doing in my work. Julie and I are working on a new book right now called Built to Move. It is intended to be the Bible where you walk into your physician and your physician says, hey, we're going to take care of all these complex things but do this first. Here is the lifestyle plan around sleep and walking and eating more micronutrients and drinks and water and controlling your sleep so that we can have a much better outcome. And ultimately, the reason we'll get the rentier capitalists involved in this, the insurance agencies is that we'll save everyone massive amounts of money because our outcomes will be better. And I do say all the time, you can still do the right thing for the wrong reason and it's still the right thing. So I'm down. Let's do the right thing for the wrong reason. I love that man, there's just a lot in there. And again, I couldn't agree more. I think that we can, we all know that this change is going to happen at a systemic level. And that's why it's not right or it's not right. I think again, going back to your press, he said, you know, there's a hardware and the extremely hard way, right? And we're all trying to take the hard way. And a couple of the initiatives that you've already talked about that you guys have been doing for a long time. But also at the individual level, I have two thoughts on this, right? I go back and forth. Again, your friend, somebody that Darshan, I admire a lot, E.C. Sinkowski recently, she had posted on, I don't know if you've got to see this on Instagram about how people don't, like you can't get people to change, right? People change when they're tired of being sick, if something along the lines and then they don't want to be tired or sick anymore. And that's when they know, hey, I need to make some change there. I would jump in and say that's not always true. It's more likely to happen because you've been, I've been in plenty of procedures where someone's getting, you know, in the STET lab, you know, have some kind of cabbage and I'm like, dude, you have all the resources available to you in five daughters and you still couldn't change. Like you still couldn't stop smoking. That's how hard it is to change behavior. So just, that's a no likely event. I agree. I'm going to be honest. I wouldn't be there, right? No, I know. I certainly appreciate that. But this topic of behavior change is so critical, guys, I think this is what it really all comes down to. You guys have been so exceptional at that. I think about John Burdy's book, right, Changemaker, Exceptional Read. There's a quote in there and I hope I'm getting it wrong. He talks about how the difference between just, you know, folks who are really passionate and change makers is that, you know, they're the old saying that you can lead a horse to water but you can't make them drink. And then he says that Changemakers make the horse thirsty. And that one really stuck with me. And I think this is something you, my friend, have been the ultimate changemaker for such a long time. A question for you is how do you make these quote unquote horse, how do you make them thirsty and inspire them to to make that change? You know, if you find out, let me know, that's the first. You know, so I have a couple ideas here. One is that I studied geography at university, I was into the cultural geography department. How do humans interact with their environment? Isn't that interesting? And I'm like, oh, look, I'm still back in the geography department all these years. How do humans interact with their environment? That's the heart of what we're talking about here. The thing that I ended up looking at and sort of specializing in at the end of my physio education was what are the barriers to adherence? How do we keep, to do actually what they say they're going to do and we all both agree that they're going to do? And of course, it turns out the more steps in that, the less likely someone is to adhere to that. When my wife and I ran an embodied leadership school for kids with HIV and AIDS for 10 years when pediatric infectious disease around HIV was still really gnarly in the United States. And some of the, you remember some of the early HIV drug regimens were so complicated that they used to give volunteers, M&Ms, and volunteers couldn't even adhere with M&Ms. They couldn't get the timing, the mortgages, the food, the requirements. We used to have to wake up our kids at three in the morning, put them on a drug that made them stoned so that they wouldn't be nauseous from taking the northera. That was like how we solve this problem. So this is a long way around the barn of saying, whenever we can, we're big fans of one asking what's important to that person and really administering to that and monitoring to that and administering to that. Two, is that anytime I can constrain the environment where you don't have to make another choice, that's really important. In strength conditioning, you're doing burpees and jumping with your feet, landing out like a duck and collapsing your arch and valgus knee and over standing. You get to win, jump together feet, landing together burpees where you have to hike and land with your feet together. And guess what? Problem solved. And when you want to be an adult and land like an adult, then I'll move your feet apart. So if I don't want to have cookies in the house, guess what I don't have in the house? Cookies. Otherwise, I will wake up at 2 in the morning and those cookies are not safe and my family is not safe until the cookies are gone. It's what literally happens in the back of my brain. So we have daughters and if you think you're like, I'm an expert in behavior change, go ahead and go into your kids and look at how much screen time they have and tell me how you're doing and look at how is their phone in their bedroom. And I'll tell you that you are a liar. I think I mean, so you can't get the phone out of your kid's hands in the bedroom and we have really strict rules because you know, like, look, the phone is the phone. I would have abused it. I would have been snapping my girlfriend at 2 in the morning, but if I'm like, hey, Georgia, there's little cocaine next to the bed, just leave it there, it's a little heroin, don't leave it there. A little serotonin bumps right there, but just don't touch it. Right? Like whatever dad, I'm going to hit that thing. And so, you know, the key here is to understand that we have to set up the environments that you don't have to make a choice. If we made things like every kid needs to walk a mile away at school as part of a class, that would happen. If we said no one is allowed to drive this school within a mile of the school, you have to walk in the last mile, that would happen. If we said you can't have sodas on campus, that would happen. If, well, the classic research around smokers in the workplace, you would call this at a further, the healthiest people in the workplace were the smokers, because they had to get up and walk around more. And the further you put the smoking section from the workplace, the healthier those people became, right? Because they had to walk more. And what I'll say, real quick, sorry, the irony of the situation is, at least what I was growing up, the school bus wouldn't pick you unless you were, you know, only if you were within a two mile radius. So if you were within two miles, you would get picked up, otherwise you would not get picked up. That's exactly right. You've nailed it. Well, we, I want to think differently about these problems. So with our movement environment, boy, you can control the crap out of kids, or you can constrain the environment so that there's more play, and then you don't have to do it, right? You can give the, the, the choice. I want you to stand in fidget, or I want you to sit on the ground. And then all that in between is a choice, and it feels good. And, but if I have to say, sit up, Johnny, like last never going to happen, if I have to tell you not to eat these delicious, calorically dense things in the break room that people brought to you because they love their doctors, you know, you just need to take those things and throw them away or donate them right away. You can't have them in there. So if you want people to eat fruits and vegetables, they're not going to eat fruits and vegetables unless they're fruits and vegetables, right? So I have to, I want us to give ourselves permission here to say that we are hardwired for sugar. We love it. We're hardwired for serotonin. We love it. We're hardwired for porn. We love it. Right? We're hardwired for entertainment, and, and what you'll see is that this opiate addiction problem that we have works because our opiate risk roared system is so strong. It is. That stuff taps into the primalness of our humans. And so suddenly when you start looking at people's drinking as a self soothing model, right? We see, you know, in Marin County, we used to be the healthiest county in Marin, northern California. And suddenly we weren't because the adult binge drinking. And even in our sort of collection of families around us, there's a lot of midday wine consuming one because they have access to good wine, because they found it as to be a really powerful coping mechanism to manage the stress of being a really harried working parent, working at the limits of their abilities. And they don't see that that sleep gets disrupted, et cetera, et cetera, endocrine function. I mean, it's just you cannot poison yourself with a bottle of wine night after night or night. Come on. I guess that, man, if you pour me a glass of that screaming eagle, I'm not going to say no. So I'm into the one. But what I want people to recognize is these behaviors are often self soothing behaviors. And the same way we would handle anyone with an addiction, they're not a bad person. We have to understand the brain chemistry of why this is going on. We'll do the same thing with food, we'll do the same thing with tech. And once we start to see that, you know, self soothing is a piece of this that people are trying to make themselves feel better and tell you give someone a better solution that allows them to constrain the behavior and have another option. We will continue to do the same things we've done. And just go to Starbucks in the morning, look at a lot of really smart adults drinking a 20 ounce frappuccino. It's a milkshake. Like, I mean, what would your grandma say about you? I mean, if you just ran everything through this filter, what would my grandma say about drinking a milkshake for breakfast? So you know, she'd be like, well, it's your birthday. So I'm not yourself out. It's your birthday, 365 days a year. So people don't know where the guard rails are until they're given a chance. Everyone comes out of a movement environment. Everyone comes out of an eating environment, eating tradition. And until we sort of start to think differently about the problem, we should expect to get what we're getting, which is a continuation of obesity. When we were all in high school, chance of us being diabetic was one in four. I'm 48 now, so maybe you guys were all in not born yet. But now we were one in 4,000 chance of us being diabetic when I was in high school. Now it's one in four. And if you're a Latino male, it's two out of three. And if you're a black woman, it's two out of three. It doesn't matter how much money your parents make. It doesn't matter the color of your skin, one in four. So I think until we can start to think differently about this environmental pressure on us as humans, and begin to say, well, what is minimum? Seven hours of sleep is our minimum threshold for survival. You went in an extra hour in there. I can't really even talk to you about your chronic pain yet, because there are so many stressors on the system that until we begin to tug at certain aspects of the knot, we're not going to really have a better picture. So it's complicated in nuance, and it means we may be slow to help a generation of people. If you are looking for good investments, CPAP machines, dialysis clinics, continuous glucose monitoring, why? Because it's that difficult to change behaviors. We know it is. So let's start thinking differently about the problem, so we can not pull our hair out, because position burnout is real. We need to start thinking about these problems out of community and family household level. I love the concept of what we're talking about. I'm currently reading Jordan Peterson's book, 12 Rules Delived by her, 12 Rules of Life, and rule number two. He says, treat yourself like someone you are responsible for helping. So if we have pets, dogs, cats, we're going to make sure they don't do the cocaine. Think for they don't drink soda, we'll give them water, we're not going to give them alcohol, right? But when it comes to ourselves, like you said, we have this problem. And it's interesting to me, because I always think in a dichotomous way, right, is it self-care, is it our responsibility as individuals, or do we need an accountable partner? Or two, is it the rules that we have to abide by, or do we just rewrite our own rules? And like you said, we look at diabetes, we look at chronic conditions, all of these things, like 90% of the issues in health care, chronic, right? They're all preventable, and probably could have been fixed if we fixed the system. But I just kind of want your insight in terms of, where do you think the future is going with this? In terms of, like I, you did say, let's make investments, right? And kind of like CPAP machine dials this, because we know it's probably not going to get any better. But there's so many companies out there that just have such a stronghold on the rules, right? And I think, are we getting weaker as a species? How exactly do we think about that? Let's talk about something happy instead, shall we? You know, I think what's really interesting is, if we look at the current, sort of, just take a, every man, you know, interview on the street, is diet and exercise important? Yes, yes, which diet, which exercise, you know, that's kind of classic tropism. Right now, we're currently seeing there's a conflation of durability, which is what we're going to call the basic practices that make you a successful human. Like, you want to talk about what rope you should carry up, base, Everest? That's totally cool. We can have that conversation, but let's get to base camp first. And no one's at base camp yet. So we call these behaviors, base camp behaviors, right? One of the things that we're seeing is, in this sort of complexity is a lot of entertainment, where people think, well, I sweat on my peloton, I'm good, right? I'm totally good. And I'm like, well, I mean, you mean your fall risk is through the roof because your ankles are stiff. And, you know, you don't have any hip extension and, you know, sure. And if you think that, you know, so we're, if you look at big tech right now, Apple Fitness, Amazon, if you look at sort of what they're selling as fitness, it's fitness is entertainment. And it's kind of athleisure. And it doesn't mean we should look at those things as like a sport. That's super cool. Dance class is like a sport. You know, you play basketball, you go to a jazz exercise class, whatever that class is, you go to peloton. It's view that thing as a sport, but that has nothing to do with the behaviors that make up durability. But then we have big tech coming in, companies like Tonal and Tempo and Peloton and Mirror and what's happening is we're adding, and they're not all equivalent, but we're still adding a complex solution on top of a complex behavior, which is the recipe for adding complexities and that weird where we don't really understand what's happening. We should, there's a great book everyone, if you're listening to this, you should read called Normal Accidents by Charles Perro. It's about normal accident theory, which is basically saying that systems of complexity are sufficiently, some of the processes are sufficiently tightly coupled and hidden from us, that it's difficult to understand inputs and outputs. But if you give the complex system enough time to express itself, what looks like an error or an outlier is actually a normal expression of the system. So Fukushima is a good example. We didn't think that a tidal wave would come in and then turn off the pumps, right? But if you just gave that system enough time, a tidal wave was going to come and turn off the pumps and then cause this meltdown. So what we're seeing right now is that we keep adding these layers of complexity in and diet is another example of extreme complexity where we're coming to understand that basically intermittent fasting may not be great for everyone. It's a form of calorie control and that keto is a form of calorie control that it's maybe not the sugar. It's the total calories and the caloric density of foods, not necessarily the sugar that's in the food. So, ultimately, when we keep coming up with complex solutions in especially in the guise of entertainment, right, then, and we're trying to continuously sell something to someone as a solution, that's sort of industrial fitness, right? It's not a tour fitness and I'll call it a tour fitness is trying to transform society trends. And if you even go back to E.O. Wilson in his book, Consilience, he says is the highest calling of science is to inform the humanities. So let's just take that as face value. How are we doing? Are we informing the humanities? Are we adding complexity because in the vertical of people who are into their fitness and tracking and starting to watch the body composition, we are getting really good at talking to this verticality of people who show up and know our super patients, highly adherent into functional medicine, efforts and vegetables, right, like they're on it. And then what we have is a whole, you know, swath of the cohort, which no one is talking to and they don't even know where to go. You know, there was a girl who was a local checkout worked at our local market and one night, you know, I'm just taking this as a snapshot, I don't know any background, I don't know if she was on a way to a party, but it was the end of the night and she had four boxes of jingas, pizza rolls and a six pack of full sugar cream soda and that. And I was like, oh, you know, you're heading home, she's like, yep, just getting some dinner and I was like, oh, okay, like, okay, that's, that's really tough. You're going to drink a six pack of cream soda and eat four packets of jingas rolls. Where did that come from? She is an adult now, but that is a failure of the whole system to protect children and teach children what it means to be a human being. And I don't mean like, you know, the cycle of emotional components of that, that's super cool. I'm also talking about that there are these practices of durability that we're going to have to think about differently at scale or invested in diocese clinics and get rich, you know. Look, how's it going? How long do we need to run this experiment before we're like, holy crap, it's not working? And then, you know, the, um, President Kennedy started the presidential physical fitness challenge, right? People don't realize that that if you were, you were in the presidential fitness challenge or you had, you know, good feelings about that is because John F. Kennedy didn't think there was a generation of kids who were fit enough to be deployed to work in the Cold War. So you were part of the Cold War propaganda to sit and reach the shuttle run to look at fitness because he saw a youth that couldn't be deployed in a military action. So at some point, we can gamify it. And that's what that was, that was an early expression of a gamification to have a system of looking at minimums and healthcare and kids. I love this concept that you mentioned, yeah, at leisure, I think that's what you said, right? I mean, usually it's like clothing. Like, Louis Lehmann's athletes, but I'm like, uh, uh, that's called fitness as entertainment. I love that, man. You know, one of the concepts that you talk about is caching in your credits, right? You're accumulating all these credits, spending time in the gym, spending time in the treadmill, elliptical on the track and stuff. And I've been guilty this myself, my friend. I, you know, I spent years and years just training, training, just staying and not really engaging in a lot of sports. Okay, partly it's because I move every year for different training. And so it's hard to kind of have continuity. But despite that, you know, sometimes you're just accumulating all these credits, but you've talked at length and, you know, you're a better half on your podcast talks about that as well. Why it's so important to cash these credits in and have varied by not random movement. Maybe for those who don't know what you mean by cash in the credits, you kind of touch on it, but, but dive a little bit into why you're so passionate about that. Why is that so important? Hmm. What we, what we really come to realize is that the gym was a wonderful place to build culture, to have a community, to exercise across energy system domain, right, to develop skills. It was super fun. And it was easy to track. Ooh, I got stronger than the Kilo, I went faster. And ultimately what we saw was a lot of what we call recursive fitness training. I do more pull ups, so I can do more pull ups, so I can do more pull ups. And I don't know the last time pull ups from the Olympics, but they're not in the Olympics FYI, right? And I think what we forgot was this notion of play, this notion of experience of learning, of being outdoors, of interacting that way. And what ended up happening was that we sort of fetishized the gym. And for sometimes, what, tell what, if you are a busy person and you happen to be a physician or a residency or you have a new parent, all you may able to do is some kettlebell swings in your kitchen. And you need to be like, that's good. And let me tell you about my grad student, like working hot, like this is when I was my worst trashed self. I called it the 10, 10, 10 at 10. And I would do 10 movements, like 10 burpees, 10 pull ups, 10 swings, at 10 p.m. for 10 minutes. And I'd be like nailed it, elite fitness right there. But all I did was check the box, I just did something today, right? That was what I had today. And when we expand, you know, the goal of training for something, because honestly, like how strong do you need to be to play soccer? Turns out not super strong. You need to be skilled to play soccer, right? But the gym is a great place to work on minimums, a great place to understand processes, because it's basically a formal movement diagnostic training all the time, except we usually look at it as, well, you're not very strong, you're not very fit. Those are diagnostic tools, but we can say you're not very strong in every fit. And you have this need, you can't put your arm over your head. So let's do some monkey bar swings. So we can add it a little bit there, but the goal for us was, Julie and I were realizing that people weren't going outside and playing, they weren't experiencing. And so we say cash or credits. It's okay to go on vacation and go hiking and lose some of your pull-ups. It's okay to take a trip and have your not-delift for a couple of weeks, because you're riding your bike. That's totally okay. And so, you know, one of my Russian coaches used to say, she's like Kelly, you know, the human animal is the only animal that weighs the same year round. And I was like, that's weird, you're right, that's super weird. The winter were a little fatter, and then I'm a little bit skinnier in the spring, and you know, I'll get a little fat again. But you know, you're like, you know, I have been weighing the same since I was in high school. I have these jeans to prove it. And so what I want us to do is sort of have that same mentality around being able to go out and play and have seasons of exercise, get into biking for a while. It's so awesome. What's the minimum amount of squatting I need to do to maintain my biking, and then kind of burn down on biking, and you pick up standard paddling, and ultimately, what we're trying to do is expand your movement language and vocabulary. And for someone who's listening, they're like, bro, I don't have time to do any of that. When I'm asking you to sit on the ground tonight while you watch TV, that's expanding your movement language, right? I'm telling you, go take your shoes off and walk a block barefoot. That's expanding your movement language. You know, go pick up a new sport or skill. Oh, why didn't you go to work that in? Well, there's so much you can do to add in movement richness. But if we look at your, if I have to grade you, you're like, Kelly, give me a grade. I'm like, well, let's look at the shapes that you adopted this week. And what I can tell you is that you probably want near the end ranges of your normative expression of your joints and many of your shapes all week. You didn't put your arms above your head once week. You didn't, you know, what we think is why I didn't breathe hard. But I'm like, dude, you didn't even close your hip to full range flexion this week unless you happen to sit in a full squat or right, you didn't end up touching end range dorsal flexion this week. What you'll end up seeing is that people are going weeks and weeks and weeks without experiencing normative ranges, normative expressions of their tissues, turns out play is hugely important to the environments. Go through the frisbee in front of your house for 10 minutes. And what you'll see is that all the twisting and throwing and changing and cutting directions is a hundred times better than anything you can replicate with a medicine volunteer. Absolutely. I think that fact about playing is so key, right? Just to get every individual more into fitness, more into movement and we start to interact with our environment better. And that's something I've been learning by doing the ready state, honestly, and you talk about this and you start to realize how much bullshit there is in our lives that we pay attention to, that we don't need to, right? And once you start getting into those things that you start to really care about and you start to see the difference in your own life. You start to narrow in on the things that do matter. And it's going to take a minute to turn that ship. But I want everyone to hear this, you know, because if I have to come in and do a lifestyle audit of my physician friends, it's not, it's not, it's not, it's not, it's looked very good. And like, did you eat your headphones? Did you eat your headphones? Did you, did you? You know what I mean? And it's because you are the paradigm of overworked, over scheduled, hyper stressed, hyper, you have a lot at stake. You have a lot of people's health on the line and how do you cope when you get home? Who? It's just three fingers of vermin. Bam, feel better. I smash myself on my Peloton. You know, and what you're saying is, if you're listening to this, give yourself permission to understand the clock resets tomorrow that you can wake up. What we try to do is teach in this 24 hour duty cycle. Wake up in the morning. I'm like, get up 10 minutes early, give me 10 minutes of breathing. Do the hip spin up, right? Eat a fruit and vegetable and a protein. Then you don't have any, your day is gone. You got your kids off to work, you're at work, good luck even eating a food. Maybe you can drink some water and walk around today. I watch. Maybe slam something down, like a protein shake. But the second you're home, you have some agency again. So you better cook or eat a whole food or have a prepared whole food available to you. And then in the evening, let's say that all you can do is get on the ground and roll around for 10 minutes on a lacrosse ball or a roller. We'll call that a pretty good physical practice. If you hit your 10,000 steps, you got a breathing end. You did some soft tissue work, you moved around during the day. That's the difference between durable practice, base camp behaviors, and I didn't exercise today. How many of us have gammas who've never exercised in their lives and are 100 years old? What is it about those people that makes them so durable and it's not how much do they power clean in their e-mom, right? That didn't happen there. So let's get these first things first and realize that Ben, a blew it today, tomorrow, I can play again. The game resets every single time and it starts with your sleep. So tonight, my homework for everyone listening ever is just to get in bed a half hour early. Just then, that's all I need you to do because if you're in bed, guess what happens next? You actually go to sleep or you have sex, which are both really good for your brain. But if you're not in bed, you're not going to go to sleep and you're not going to have sex. So what are we even talking about at this point? And if you're in bed a half hour early and get 30 minutes more sleep, just commit to 30 more sleep, that's a whole extra night of sleep in two weeks. And what if I said to you, I can, you'll pay me $100 and I'll give you an extra night of sleep every two weeks, you'll be like, I'm in and then I'm like, get in bed half hour early. So what you, you start to do is realize that every single day, you're going to play to your limits and then don't worry about it because you're a durable, bad-ass human being who has a minute and there'll be times in your life and you're totally sleep deprived and crazy. And when we cut you in half and count the rings, it's going to be grim. We're going to be like, this person was living through a forest fire drought time. But then the second it opens back up, put the sub-tricket as much wine, sub-tricket as much coffee, start walking a little more, you know, and then start to play a little bit better. And when you rinse wash repeat for decades, you'll see the difference. And those of you who are listening who are in their 40s and 50s, look around and tell me how it's going for us because the aging acceleration is happening quickly. When you start to turn 50, I'm here to tell you. Absolutely, absolutely. I love it, man. And I think our audience will as well and they're going to listen to this and say, that Kelly seems like a smart guy. I kind of want to find out. He seems so reasonable. Yeah. And yet I am not reasonable. I am so unreasonable. But as I've gotten older, I'm like, yeah, you know, did you go for a walk? Did you sleep? Yeah. No. We're in drinking a water. Maybe you could do better. I wonder why your Achilles is so pissed off. It's so weird. That's right. Where can our audience find you, man? We are at the Reddy State and we have podcasts and coaching courses and we even have a two week membership where we'll teach you how to take care of your body for two weeks and cancel. Get out. It's a scam. We're going to take your money and we're going to stick around and become obsessed with this. But for two weeks, play in the domain, jump in the challenges, see how your body works. And if you know everything, cancel, but what we have to do, a better job is giving people better tools. And I really, if I'm a humanist, I'm a humanist in so much that I really do believe that people will act in their best interest eventually. Once they're given the right information. It's good stuff, man. I've been doing it now. I can tell the audience for probably about a month now, seriously, and I've noticed the difference and I've started to realize how much mobility, stretching, flexibility, all this stuff matters. And I've been an athlete my whole life and there's things you know of, but again, I'm about to turn 30, getting there and old, but these are things that matter. So I can definitely test that. Well, I appreciate that. And you know, really, when we say some soft tissue mobilization, I'm like, that's 10 minutes. And what I really like you to do is get on the ground, even just that's a miracle. And then grab a ball, grab a bottle, grab a foam roller that you have in the corner, and then ask yourself, what doesn't feel good today? My hips were tight, my hamstrings are sore. Man, I bet I can lay on the stomach and do some breathing. And what you'll see is that we start to conjoin these behaviors so they end up being a coach at whole that I'm thinking to myself, man, I didn't eat many vegetables today, I'm going to eat some more vegetables for dinner. My hips are really stiff. I wonder if I can do a hip open or during, during TV. And what we see is that we can begin to stack these behaviors so it doesn't feel like one more thing you have to do because that's another sign of the system overwhelming us. If I give a busy mother another biohack, like you have to do your motor like, you all die. Don't kill me. And I say to my wife, look, you can do this way and doing something else. Doing that Zoom call, put a lacrosse ball in your hamstrings, let me know how that goes for you. You know what I mean? So there's plenty of ways when we can be integrating these things into our lives so that we have more free time to dilly down. That's really what it comes down to. I want to give you your life back. A little self love. I've never heard anybody. Fat. I'd really appreciate that. Kelly, to close it out and ask you two quick questions. One of them is pretty loaded, but we spent the first maybe three quarters of the episode of talking about it. So maybe you can summarize it. Just tell, you mentioned you're writing a book, right? You and Juliet. And, you know, what else is out there? What's next for you other than this book coming out? What are you excited about? And then last question that we'd like to ask everybody because it's kind of the mission of the show is, how do we add the health back in health care? You know, the thing we're excited about is we continue to see that we have as strengthing conditioning, coaching, and trainers, come more sophisticated, health care providers have a whole army of untapped potential to go help improve this system. We can look at the yoga teachers and the spin instructors, and this is where people are getting their information, so we can do a better job of empowering them to be our first line responders, to be able to manage really level, level, unskilled care, teaching people how to dress painful problems, being able to say, hey, look, I think you need to go talk to your doctor about this, you know, putting movement back in, you know, that it's complicated, we've been so worried about, you know, being sued because we'll, you know, help someone, but we really have to ask, where are people spending the most time, and our work, we just finished a course called Train Engine Athlete, where we see a lot of people come out of surgeries and these experiences, and they're just sort of cast a drift, they've run out of physical therapy visits, the physical therapy office had, you know, carpeted floor and a hung ceiling, it wasn't even a place where they were exercising, and then they just wait long enough to maybe have that thing of fires go out, and five months later, I guess you can load it. So, you know, we're trying to step into the gaps where we feel there are blind spots, and training the injured athlete is helping coaches and trainers who are skilled understand why your physician has limitations on range of motion during these healing times, and how you can be well body training, and how you can be an ally. This book, which will be out in, I think January, February 23, is our big crack, big swing with Knot Flux, we're really excited, we have a big publisher to really try to take a swing at public health. We have a moment, I think, where we can capture people's attention, when we just stress tested everyone's livelihoods and lives in the COVID, and we're not out of it yet, and I'm like, how did we do? Were you able to self-soothe and eat and exercise? Oh, we fell on our faces, so there's an opportunity for us to sort of level up, and how we put the health back in health care, we keep reminding people that they are not fragile, that there's never of time where your body stops healing, and we need to think differently about where people are getting their health information, to a place where it's not health information, we're not playing defense, we point positive, we want you to do these things because you can actually feel better than you currently feel, and if you do these things, you actually can run further, and run further and feel better when you're 110, and you just don't want to corvette, and you're climbing up the window of your Jones lever. So that's really the goal here, is to play this game, so that you have more function in the long haul, because there's some of us who have been in the hospital, seen someone break a hip when they're 70, and that's the end of their life. And I, we're playing a little bit of a desperate game, because we're like, we know what the end of the story is, the end of the movie, and everyone else is like, this is so great, I can do whatever I want. And so we have to just start thinking differently about this behavior modification, that's how we make health care what it really is, human care. I love that, human care, we're on the same page there, man. Thank you so much for your time, I really appreciate everything that you do, the last 20 years of awesomeness, and I'm sure you were doing awesome things before that, and then all the things that you're going to continue to do, we're excited, we're going to be fans to continue to follow you, and thank you so much, man, we appreciate you. Well, my, total my pleasure, and just everyone's listening, my father's physician, grandfather's physician, there was no way they could have paid me enough money to be a physician at the time when I had that opportunity, I was like, that's a terrible life. But we're starting to see that the forces are marshaling, that, you know, we put this person in the center, and we also take different turns of being the primary point of contact, but we're starting to see it. I think that we did our physicians wrong, we did our physical therapists wrong, and we're starting to be able to swing that around. But one degree of change on the horizon is a lot of change over a lot of times, so just hang in there, one of my friends says small hinges swing big doors. That's right. Thank you. Thanks, Kelly. Cheers. I hope you all enjoyed that awesome conversation with Kelly. As he said at the ready state, they have been pointing positive for an incredibly long time, which is why I'm a huge fan of their work and why you should follow them at the right state. On that theme, I want to point you guys positive as well. So even though there was a lot in there for us to unpack, pick one thing, one action that you can implement in your daily practice, may it be a short walk, going to bed 10 minutes earlier, or spending some quality time with your loved ones without any distractions. Remember just because some of the problems are complex does not mean the solutions have to be as well. Now for my doctors, remember the story has changed. Visit financialresency.com slash locom story to see if a locom tenants assignment is right for you. It's here. You'll find the unbiased answers you're after so you can decide if locom tenants is your next chapter. Also, please remember they always super important disclaimer that everything in this podcast is for educational purposes only. It does not cost you to practice a medicine nor should it be construed as medical advice. No physician patient relationship is formed and anything discussed in this podcast does not represent the views of our employers. We recommend that you see the guidance of your personal position regarding any specific health related issues. However, if you enjoyed the show, please be sure to subscribe, review, and share with anyone who you think will gain your value from this. Until next time, thank you for listening.