124. Best of Strength Training: Why Strength Determines How You Age

Over the past year on Extend, I've had powerful conversations with experts who all kept pointing back to the same foundation: strength training. So in this episode, I'm bringing together a Best Of compilation featuring key moments from Andy Galpin, Vonda Wright, JJ Virgin, Louisa Nicola, and Kelly and Juliet Starrett to highlight why strength matters far beyond the gym. This episode explores strength training from every angle that truly impacts longevity. I break down why muscle is a metabolic engine, how bone health shapes aging decades before problems appear, and how strength and movement directly support brain health and cognitive performance. You'll also hear why mobility is a daily practice, not a workout add-on, and how small habits outside the gym often determine how strong, capable, and pain-free you stay over time. Across these clips, the message is clear: strength training isn't about aesthetics or chasing extremes. It's about building a body and brain that can adapt, recover, and thrive for decades. Whether your goal is longevity, injury prevention, better energy, or aging with confidence, this episode brings together the most important insights to help you train smarter and move better for life. What We Discuss: (00:00) JJ Virgin, nutrition and fitness expert, explains why muscle is the foundation of metabolism, strength, and long-term vitality, and how protein intake and smart training support powerful aging. (00:00) Andy Galpin, human performance scientist, breaks down how personalized training and understanding individual physiology can help you build strength more effectively and recover like a pro athlete. (00:00) Dr. Vonda Wright, orthopedic surgeon and longevity expert, explores how strength training protects bone density, supports hormones, and reduces fracture risk as we age. (00:00) Louisa Nicola, neurophysiologist and performance coach, connects strength and movement to brain health, explaining how exercise supports cognition, reduces inflammation, and protects against neurodegeneration. (00:00) Kelly and Juliet Starrett, movement and mobility experts, share why daily mobility habits matter as much as workouts, and how strength, posture, and movement patterns shape longevity. Thank You for Our Sponsors: Pendulum: You can go to pendulumlife.com and use my code EXTEND for 20% off your first membership order. Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram:@darshanshahmd https://www.instagram.com/darshanshahmd/ Learn more about Dr. Vonda Wright Website: https://www.drvondawright.com Instagram: https://www.instagram.com/drvondawright Facebook: https://www.facebook.com/DrVondaWright Learn more about Andy Galpin: Website: https://www.andygalpin.com/ Instagram: https://www.instagram.com/drandygalpin/ Learn more about JJ. Virgin: Website: https://jjvirgin.com/Instagram: @jj.virgin https://www.instagram.com/jj.virgin/ Learn more about Louisa Nicola: Website: https://www.neuroathletics.com.au/ Instagram: https://www.instagram.com/louisanicola_ Learn more about Kelly and Juliet Starrett: Website: https://thereadystate.com/ Instagram: https://www.instagram.com/julietstarrett/?hl=en Instagram: https://www.instagram.com/thereadystate/?hl=en

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:03Dr. Darshan Shah?

  Welcome to Extend with me, Dr. Darshan Shah, a podcast dedicated to cutting-edge science, research, tools, and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21, and trained and board-certified at the Mayo Clinic, I've accumulated three decades of practice as a board-certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results when it comes to your health span. We're living in a new era where we are creating a new healthcare system, no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world-renowned experts, offering you a step-by-step guide to proactively avoid disease, and most importantly, extend your health span.

• 0:49Dr. Darshan Shah?

  Over the past year on Extend, I've had conversations with some of the smartest minds in strength training, human performance, and how these fields tie into longevity. One theme kept coming up over and over again: "Strength changes everything." So today, I'm putting together a best-of episode, focused entirely on strength training. This is a curated collection of one of the most important moments from five different conversations I had last year, pulled together to give you a clearer, more science-backed understanding of why strength training is foundational to how we age. In this episode, you're going to hear how muscle supports metabolism and hormone health. As you know, I always say, "Your metabolism lives in your muscle." You're also going to hear about why bone density,

• 1:33Dr. Darshan Shah?

  mobility, determine independence later on in life. You'll hear about how strength and movement protect the brain, and why daily habits outside of the gym matter just as much as your workouts. These clips highlight the ideas, I believe, are essential if you want to build a body and brain that stay capable, resilient, and strong over time. If you missed some of these conversations in 2025, or you want more of these impactful insights, go back to the episodes where you hear these guests speak in long form. There's an incredible amount of information there. Let's get started. First, we'll start off with JJ Virgin, and we're going to look at why muscle loss is one of the earliest and most overlooked drivers of metabolic decline, and why JJ Virgin believes that strength is foundational to long-term health.

• 2:20Dr. Darshan Shah?

  When you get strong, you will also lose weight. You will also have a better body composition and you'll have all the benefits you're looking for with being skinny without having the metabolic disease aspect of being skinny fat.

• 2:31Speaker 01

  Right. And without having to try to maintain your weight. I'm sure you've heard of TOFI or sarcopenic obesity, thin outside, fat inside, where they found that the people who were struggling with that were the people that were trying to maintain weight through diet alone. And when you put on muscle, your metabolism's so great, you don't have to worry about it. It's a non-issue. You can actually eat. And if you're eating correctly, you're not going to be hungry anyway.

• 2:57Dr. Darshan Shah?

  Yeah, absolutely. I always say that your metabolism lives in your muscle. Like, we think it's somewhere else.

• 3:02Speaker 01

  That's a great statement. I'm going to quote you.

• 3:04Dr. Darshan Shah?

  You can use that one, for sure. But yeah, the more muscle you have, the better your metabolism works, the less chance of metabolic disease. It's all about the muscle mass.

• 3:14Speaker 01

  Which means we should be packing on. It's like, I think of it so much as a retirement account. We should be packing on as much muscle as we possibly can. And I just want to emphasize to women, you'd be lucky. You'd be dancing up and down if you could put two pounds of muscle on a month.

• 3:31Dr. Darshan Shah?

  Yeah, absolutely.

• 3:32Speaker 01

  Like, this is no easy feat to put on a bunch of muscle.

• 3:35Dr. Darshan Shah?

  It's not. And I want to go over some specific protocols that you give for men and women about putting on muscle, because I think that's really what we need to hone in on, because there's so much misinformation out there and people are just confused. And people don't know, like, how much, what's the right dose? How does protein play into this? And so, we should go dive into each one of those topics. But before we do that, you talk a lot about aging powerfully. And I want to tie in the longevity conversation as well. So, tell us what you...

• 4:04Speaker 01

  Why do I say that? Yeah, it's like, forget aging gracefully. And I still hear this all the time, well, age gracefully. I'm like, no, we do not want to age gracefully. So, we have two distinct types of muscle fibers. We have slow twitch and fast twitch. And then, we have these hybrid fibers that can convert to either one. Women tend to have more slow twitch than fast twitch. We're all different snowflakes, but we tend to have more. And it's the fast twitch that's really capable of more hypertrophy. As we age, we start to lose more fast twitch than slow twitch. Now, here's why this is important. Women, when you look at a lot of the activities women tend to do, they tend to do more things

• 4:46Speaker 01

  that are not going to really work their fast twitch muscle fibers. Most women are not doing sprint training, power training, you know, that type of thing. CrossFit would be a great example of things that are going to work fast twitch. But things like yoga and walking, these are slow twitch muscle fiber activities predominantly. Right. And that means that if I'm focused on those, then those hybrid fibers are going to move into slow. And now I'm atrophying and losing my fast twitch. So I'm just making myself slower. And that is the opposite of aging powerfully. And so that is why, when you look at what do we need to do as we age, we need to prioritize

• 5:29Speaker 01

  fast twitch muscle fibers, because if we don't use them, we do lose them. Right? Absolutely. And, you know, I think the important thing here is, is the less you do, the less you can do. And the more you do, the more you can do. So I've got a very different idea about training than I see most people doing out there. And this really started back when I was working in physical therapy. And most of my grad work was in spinal lifting biomechanics. And what I saw in physical therapy and what we were taught in school, we were taught two really dumb things in grad school. Number one, don't lift weights until you lose the weight. That is so wrong. Yeah. That is so wrong. I remember hearing that back then. It's still out there. It is. It is still out there. It's sad that people still think that that's reality.

• 6:12Speaker 01

  The other bizarre one was, and this was especially so obvious to me, being, focusing on lifting biomechanics, they were like, if you have a bad back, avoid extension exercises. Don't work your back, just do flexion and work your abs. I go, that would make you worse. Right. That would make you weaker. Absolutely. We have this thing in, in muscle physiology called Reciprocal inhibition, if you're working, flexing forward to work your abs, your back muscles have to not do anything, otherwise you would be static. You couldn't move. So if you focus on one area at the expense of the other, that other area gets weaker.

• 6:46Dr. Darshan Shah?

  Absolutely.

• 6:47Speaker 01

  Right? So when you look at why people tend to not exercise, the number one reason is time, of course. Right? And that's an excuse. If you can't, if you don't have time, find time. Just make time. There's nothing more important than this. But the other reason is some type of an injury. Now, when I was 17, I blew out my knee. And then when I was 21, I broke my foot, just dumb sports injuries. And those became my whys. For so many people to go, I have a knee injury, so I can't work out. I was like, I have a knee injury. I have to work out. And I literally had a bone on bone, very bad knee that they're like, you must have a total knee replacement. I put it off for 30 years because of how strong I had everything around it.

• 7:32Speaker 01

  And so that's what I want to emphasize. If you're listening, you go, oh, I can't do these things because of arthritis, because of an injury. No, that's why you want to do these things.

• 7:42Dr. Darshan Shah?

  Right.

• 7:42Speaker 01

  Right?

• 7:42Dr. Darshan Shah?

  Absolutely.

• 7:47Dr. Darshan Shah?

  Now, we're going to hear from Andy Galpin. We're going to shift to why strength matters and especially in how you train. And we're going to talk about how you can train in a way that actually fits your physiology. Incredible insights from Andy Galpin.

• 8:02Dr. Darshan Shah?

  It's kind of counterproductive to compare muscle versus the O2 max. Oh, yeah. You really need both, right?

• 8:07Speaker 02

  There's no, it's kind of like saying, what's more important? My, my front wheel of my car or my back wheel?

• 8:12Dr. Darshan Shah?

  Exactly.

• 8:12Speaker 02

  No, no, no, no. This is not an either or thing.

• 8:15Dr. Darshan Shah?

  Right.

• 8:15Speaker 02

  Like this is a, you're not going to drive well without both of these things.

• 8:18Dr. Darshan Shah?

  Exactly.

• 8:19Speaker 02

  And I know, we've done longevity research. We've done studies on lifelong exercisers in many of these things. So. We've done things on, we did actually a twin study on monozygous.

• 8:30Dr. Darshan Shah?

  Oh, wow.

• 8:31Speaker 02

  Yeah, so this is great for translation. That means you have the exact same DNA, right? So egg is fertilized and split into two, you get to clone, okay? And so we don't longer have the, well, what if their genetics was different? Question. We know that they are identical. However, they had thirty, thirty to thirty-five years of discordant physical activity patterns. So this is the ideal scientific study, right?

• 8:52Dr. Darshan Shah?

  Awesome.

• 8:52Speaker 02

  Complete genetic control of that. Well, the exercisers in this particular case were mostly steady state endurance type of exercises with no lifting compared to sedentary twin. And most of the things that you would predict were improved in the exercising twin. Cardiovascular health, blood lipid markers, VO2 max, body composition, all of it better. However, muscle strength, muscle functionality, performance, muscle quality as identified via imaging. All not any better or worse than the non-exercisers.

• 9:24Dr. Darshan Shah?

  Wow, that's incredible.

• 9:26Speaker 02

  And so, I mean, there's a number of conclusions to that paper, but one of them was simply that endurance exercise is phenomenally good for your health. It's tremendous. But if you don't also do strength training, you're leaving many physiological adaptations on the table. There have been many studies, again, on lifelong strength trainers, and you see the same thing. Great in a number of areas and limited in other areas. There's been lifelong endurance exercisers. We've done other work. I went to Stockholm, Sweden years ago, did research on cross-country skiers. Who have been training and competing in skiing since the nineteen forties and fifties and compared them to eighty. These are all eighty to ninety year olds, by the way. Compared them to age matched individuals who didn't compete in sports.

• 10:09Speaker 02

  Lots of improvements in VO2 max and other markers, equal if not worse muscle function.

• 10:14Dr. Darshan Shah?

  Wow.

• 10:15Speaker 02

  So the story is very, very, very clear here. You're gonna want both of these two things on board. And so if we look at what's going to determine the most about how people look, feel and perform throughout their life. Give you the longest life, the most high quality life, health span, you know, all this stuff. Number one is staying out of disease, right? So don't get cancer. Great, okay. I'm gonna leave all that off the table. That's doc. You're part of the equation. I'm not an M D. Okay, so from this side of the equation, what we're left with now is things like, okay, do we have an appropriate metabolic function? Right? Is our metabolism running without major cause, major problems? What's that mean? Either completely compromised thyroid function, very low metabolic rate,

• 11:00Speaker 02

  extremely high fat utilization, or extremely high, some dysfunctional thing, right? Can it just be like, don't be terrible? Give me the bell curve here, right? That's all we have to be in this one. Can we have a functioning immune system? Right? And then we can, we get ourselves through the world. Right? And that, really, all three of those are going to be regulated by skeletal muscle. No. Skeletal muscle is what's going to determine your ability to move throughout the world and to not get hurt. If your VO2 max, half that is skeletal muscle. Right? There's a central, there's a peripheral component to that. Your VO2 max in general, we already talked about. If you don't have enough muscle, we're going to struggle to support the immune system. We're going to struggle to support recovery. Metabolism is going to be compromised. And so I mean, I could go on and on about these things, but globally,

• 11:43Speaker 02

  you don't have to have any specific phenotype from a muscle perspective. You don't have to look a certain way. You don't have to have enormous muscle or be a professional powerlifter or weightlifter, but you just can't be in the bottom 25th percentile in terms of muscle size.

• 12:01Dr. Darshan Shah?

  In this next segment, we're going to talk about one of the most important overlooked aspects of why strength training matters. We're going to explore how strength protects bones, joints, and long-term independence with Dr. Von DeRae.

• 12:16Speaker 03

  FAC carry a load, meaning weightlifting. Now, when you weightlift, you got to know why you're doing it. In Unbreakable, I'm talking about building strength and power. We need to be strong as we age and we need to have power. It's not to say that lifting for endurance is wrong. Lifting for endurance is picking up the mamby-pamby pink weight and doing it 30 times so that you fail after 30 times. There's nothing wrong with that if your goal is endurance. It's not my goal. There's nothing wrong with lifting for hypertrophy, which is the big muscle, tearing up muscle, healing the muscle, building bigger muscle. Nothing wrong with that.

• 13:00Speaker 03

  But that range is 10 to 15 reps.

• 13:06Speaker 03

  Our goal is strength and power. So we're going to work up from wherever we're starting to lifting really heavy weights, low reps to failure. It's always to failure. You have to condition your ligaments and tendons. You have to get your form really well. This is where I think of all the lifting techniques, you probably need to hire a strength and conditioning coach to teach you first. And I did, and it was critical, right? So that is, in the literature, a range of three to six. I'm going to tell you as a, I don't have to tell you as a clinician, but in general, people need specific instructions.

• 13:40Dr. Darshan Shah?

  They do.

• 13:41Speaker 03

  So I prescribe four reps, four sets of really heavy lifting in the compound lifts. Push, pull with the upper body, push, pull with the lower body. And then you supplement with the single muscle lifts

• 13:54Dr. Darshan Shah?

  Yes.

• 13:55Speaker 03

  at slightly higher reps, right? It sounds like a lot. I can accomplish this in 30 minutes in the gym.

• 14:01Dr. Darshan Shah?

  Yep.

• 14:02Speaker 03

  That's how to lift for strength. And then finally, F A C E, equilibrium, which is balance. I'm teaching people to stand on one leg when you're brushing your teeth. Do the balance reach and foot speed. I also happen to have a Olympic agility coach, foot speed and agility coach in my building. And she has taught me and all the people I take care of agility drills, like you see athletes doing, to rebuild the coordination for our type 2 muscle fibers.

• 14:36Dr. Darshan Shah?

  Right.

• 14:36Speaker 03

  And you know, the interesting thing is when you first start doing these alternating drills, heel toe, heel toe, your brain stops you. It's a little hard to coordinate because you're rebuilding those coordinating pathways. So imagine in a real life situation when you're about to fall and you haven't had a coordinated pathway, you're not going to catch yourself.

• 14:56Dr. Darshan Shah?

  Right.

• 14:57Speaker 03

  Versus if you have, you're like, got it.

• 14:59Dr. Darshan Shah?

  Yes.

• 15:00Speaker 03

  So F A C E are the four components of building physical resilience in midlife.

• 15:10Dr. Darshan Shah?

  A quick note before we dive in. If you've ever been consistent with your habits, but still dealing with low energy cravings for food or slow progress in your weight loss journey, there's likely a microbiome component to what's happening. And supporting that foundation can change how your whole system functions. So I want to take a brief pause because I want to talk about something I see all the time. A lot of people have the discipline. They're exercising, they're mindful of their sugar, they're trying to eat real food, but they still get the low energy cravings and slow progress with their journey in weight loss. And when that happens, it's easy to think, I just need to keep trying harder and harder. But this might not be an issue with motivation at all. You really need to look at your microbiome. There's certain key strains in the gut.

• 15:53Dr. Darshan Shah?

  And when these are depleted, especially one called acromansia, the body has a harder time maintaining the lining of your gut, supporting healthy GLP-1 signaling, which reduces your cravings, and also producing reliable, stable energy. So you can be doing all the right things, but your body doesn't have the internal support to benefit from it. This is where Pendulum comes in. Pendulum was the first to bring live acromansia to the market. This is a strain supported by thousands of scientific studies that I've talked a lot about in my podcast. And the Metabolic Daily Formula combines acromansia with other strains to support energy production, metabolism, appetite, digestive comfort, and just resistance to stress. So in other words, it's going to be a foundational support

• 16:38Dr. Darshan Shah?

  for your body to respond to all the work you're already doing. So if you're feeling like you've been pushing hard, but you're not seeing the return, I would actually start with your microbiome and Pendulum acromansia. If you go to pendulumlife.com and use the code EXTEND, you can get a 20% off your first membership order. That's pendulumlife.com code EXTEND.

• 17:02Dr. Darshan Shah?

  In this next segment, we're going to break down the direct connection between strength training and brain health, explained by Luisa Nicola, neurologist.

• 17:14Speaker 04

  Now, let's move on to the importance of resistance training. This is where I think many people go wrong because A, it's difficult, B, it's intimidating. So adherence is hard for a lot of women. C, who's got time for it? I can only imagine. You said you've got kids. I mean, you're going away this week. It's a lot of time, right? Who has time to hit the weights? So best case scenario is setting up a gym in your home. But what does resistance training do? Well, it improves strength. We know that strength, grip strength, is one of the risk factors for all-cause mortality. It increases muscle mass. Muscle mass is, or muscle is an endocrine organ. So we need this for longevity.

• 17:57Speaker 04

  But in terms of brain health, what happens is when you stimulate your muscle, you contract it, it releases something called myokines. Myokines are these muscle-based proteins. Once they go into the bloodstream, they go into the target organ, they cross the blood-brain barrier, if you will, they go to the prostate, they go to the liver, the kidneys, and they have positive effects on the brain. They can help your brain function better. They can help grow the brain. They can help with blood flow. They can help with the amelioration of amyloid beta, which is a hallmark of Alzheimer's disease. So you could paraphrase it and say that your muscles are the pharmacy and the myokines are the medications.

• 18:41Speaker 04

  So if you want the antidote or the elixir to brain health, it is exercise, in my opinion.

• 18:50Dr. Darshan Shah?

  Very powerful. So the muscles are actually an endocrine organ because they are sending signals to the brain with the myokines that are secreted. And what specific effects do the myokines have on your neurons?

• 19:05Speaker 04

  So they are, so let's take lactate, for example. Lactate is a molecule, it's a hormone, and that can help with

• 19:15Speaker 04

  Glycogen replenishment, that helps with the way that we utilize our brain energy. So our brain is fueled by glycogen, but it's also fueled by ketones. Can be also fueled by lactate, so you get more brain energy. So your brain is able to produce energy at higher speeds. We have something called iressin, it's another signaling molecule that acts as a messenger molecule. So it actually helps with the expression of B D N F, which helps grow new neurons. It helps preserve new neurons and it helps with something called synaptic plasticity. So we have something called synaptogenesis, so you can grow new synapses.

• 20:00Speaker 04

  Coincidentally, if you look at the, if you look at depressive like symptoms in patients, or if you look at patients who have got major depression or even mild depression, they lose the ability for the neurons to communicate with each other. So you can get this natural antidepressant effect from exercise as well. The most exciting part right now, though, of this line of work, so I'm now just doing, and I'm on to my second systematic review, which is crazy if anyone's written one. It's a, it's a big process.

• 20:30Dr. Darshan Shah?

  It's a bear.

• 20:31Speaker 04

  But I'm actually looking at the relationship between exercise on cancer. And it turns out that just thirty minutes of exercise per day can down-regulate thirteen types of cancers and help prevent thirteen types of cancers. And one way it does this is through natural killer cells. So what happens is when we are exercising at our maximum, I'm talking like going eighty-five to ninety percent, but you can also get it from aerobic training. Eighty-five to ninety percent of your maximum heart rate. You are, first of all, you're shunting blood through your system at maximal force. Now, if you have a tumor at one specific site in your body, we'll call this stage one.

• 21:15Speaker 04

  That tumor is really intelligent. It needs blood supply and it's a hungry little beast. And what happens is it gets blood supply, so it basically recruits these tumor cells. By the way, I'm not an oncologist, but I've, this is what I've, I've been reading and researching. It recruits these, um, these other, these other tumor cells. And it basically says, guys, we need to take over the system, the system being the body. So it pushes out what we call circulating tumor cells. These circulating tumor cells go and they try and migrate to another area of the body. That's what we call metastases. When one tumor site from one organ in the body goes to another area and metastasizes, it goes around the body.

• 21:59Speaker 04

  It turns out that maximal exercise can help ameliorate these circulating tumor cells. And it does this via natural killer cells. And Ben De Peterson, she's, um, a wonderful, she's a wonderful physician and a chronologist, um, in Copenhagen. And she was the one that found this, that during exercise, natural killer cells get shunted to the tumor. And they kill them because that's what natural killer cells do. Right. Okay, they, they go in and they kill the tumor. And she showed this in prostate cancer. So we're now seeing that exercise can help down regulate and inhibit the growth of tumors. But also, once being diagnosed with cancer, you undergo treatment via chemotherapy.

• 22:44Speaker 04

  It can actually help the prognostic status of that.

• 22:51Dr. Darshan Shah?

  And finally, let's look beyond the gym and focus on how movement quality and daily habits determine long-term resilience and why your mobility matters so much with two of my favorite people, Kelly and Juliet Starrett.

• 23:08Speaker 05

  There was a great, some research that was talked about in David Epstein's wonderful book, The Sports Gene. Where they took these mice and they, researchers started to notice that some mice were running about a mile a day. And then every once in a while, mice would pop up and run three miles a day. And they were like, oh, that's weird. What's about this mouse? So they started breeding those three mile mice. And pretty soon they had these super mice that were running like six to seven miles a day. They just loved to run, loved to run. And the other mice, one mile a day. But when they give those mice Ritalin. They ran one mile a day.

• 23:34Dr. Darshan Shah?

  Oh, interesting.

• 23:36Speaker 05

  The hypothesis there is that we actually have, and we know this, there's a large genetic drive to move. And that's different for all of us. Like, we, and we're not weirdos, but we've tested our kids' genes. And we have one, we have one daughter who has low sort of genetic drive to move. And if given her preference, she would love to bake, she started a subscription cookie business, she's an entrepreneur. But she'd be like, I'm just gonna watch TV and bake. And we were like, knowing this about her, we're like, okay, what sport are you gonna be in? Let's, you know, we had to really sort of motivate her. I, my genetic drive to move is like 99th percentile. I'm like, oh, what are we doing? Where are we going? So what we're often seeing is that for some of us, it's easy to move. And for some of us, it's difficult to move. So what we need to do is be thinking, how do I shape my environment?

• 24:20Speaker 05

  So that the environmental constraint sets me up to do what my need to do. Look, I know you don't wanna brush your teeth and eat vegetables and fiber, but that's what human beings do. So let's go ahead and, and get, pull on your big boy pants and eat the berries.

• 24:32Dr. Darshan Shah?

  And figure out how to make that happen, for sure. All right, so we've, we're not gonna be sedentary, we know that. We're gonna incorporate movement into our day to day life. However, that's not the whole story. Because I can tell you, I have a lot of patients that come in and they're not sedentary. They're getting their 8 to 10,000 steps a day. They do the test on your app, and we find movement issues. And you know, I kinda go, I look at the human, I see their neck, I see their shoulders, I look at their back, hips, knees, ankles. And so that's kinda how I look at a person's movement deficits. And it could be, you know, maybe just their neck, maybe it's their neck and their hips, maybe it's their knees. And you see these weird patterns of movement deficits.

• 25:15Dr. Darshan Shah?

  And so I'd love to hear what you've found. I mean, you have a ton of data, cuz you guys have the app. I would love to hear where you see the most movement deficits, why those are, and what people can do about them.

• 25:26Speaker 06

  Were you just ready to cue Kelly up to talk about his favorite subject, Darshan?

• 25:30Dr. Darshan Shah?

  I had no idea this is-

• 25:30Speaker 06

  Hip extension.

• 25:31Speaker 05

  Well, in this situation, remember that-

• 25:34Dr. Darshan Shah?

  Is hip number one?

• 25:35Speaker 05

  That's right.

• 25:36Speaker 06

  I think hip extension is number one.

• 25:37Speaker 05

  It's, um, you know, ultimately, if you're a movement nerd, you're probably gonna start with the spine and the pelvis. And then eventually become obsessed with the feet. And then you're like, okay, well, the whole thing matters. You know, we call it complex regional independency, right? And which means is, for example, if you have neck pain, but you don't have complete shoulder function, can't put your arms over your head. Right. It's difficult to put your bra on, you have no internal rotation. Then we're never ever going to actually solve the neck problem until we restore the function of the system. Hmm. So we should see the neck, the upper back, and the shoulders as a system. The same way now, we're beginning to see the lumbar, the pelvis, and the femur as a system.

• 26:20Speaker 05

  So if you go to see your physician, and she isn't asking you about your hip range of motion, you should leave. Because that's like, hey, you know, I'm gonna look at how your car is functioning, but I'm only gonna look at the steering wheel. You know, we need to understand how these things, these things comport. And what we've, what we've found to be useful was that if we could come up with some really easy assessments for people. Right. Quick, quick tests. And, and what we're, we feel like is, when we're talking about high performance or limits of human performance, it's one or zero. Either can be full range of motion, or you're not. But for everyone else, we say red, yellow, green. Okay. Right? Like, because, you know, my life doesn't depend on my body, you know, to make the catch.

• 26:59Speaker 05

  So what we find is, when we work first on the big primary engines of the hips and shoulders, the, the spine is the first engine of the body. And that's why we talk about breathing, and, and, you know, how are you using your spine? And how are we loading and, and playing? But then the next sort of, you know, valence out is looking at the hips and the shoulders. And, and it's an easy way for people to understand sort of where they need to begin to start to restore those ranges of motion. The disconnect is that we fail to look at people's, how people's movement practice. Pilates does an amazing job of touching the shapes, exposing isometrics. So if you're doing Pilates on the regular, you're more likely to have complete positions.

• 27:42Speaker 05

  Yoga, again, same thing, a movement practice. Now, let me be clear. Pilates and yoga do not work on VO2 max. They're not gonna build strength. Right. Right? They're gonna get some strength, some, some, some tissue loading, but not the kind we need from kettlebells and deadbell, and, and deadlifting. But also, you can't go to the Olympics doing those two things alone. Sure. But they're movement practices. Modern GPP practices, like CrossFit, or some of these other practices, where we're asking people to express the normative ranges of motion in the language of modern strength and conditioning. Pull-ups, being able to squat all the way down, snatch. Some of the root, what we see is turns out that the formal language of strength conditioning is actually the root language of the body.

• 28:26Speaker 05

  And now we can say, well, how much of that do I need? Or how much do I want to lean into this piece? But it's a really easy way of making the invisible visible. And that's what we're trying to do is say, instead of doing something and then testing, I should be testing myself every day through my movement practice.

• 28:44Dr. Darshan Shah?

  Right.

• 28:45Speaker 05

  So sort of because your range of motion is going to be a dynamic change. It's going to be a sort of a dynamic system. So if you run a marathon, jump on an airplane, you know, pull a red eye, I'm going to measure your hamstrings and guess what? It's not going to be great. Your hip flexion is not going to be great.

• 28:59Dr. Darshan Shah?

  Right.

• 29:00Speaker 05

  But, you know, so what we want people to do is start to think every day, how am I feeling today? In which positions do I need to add in? So when we're asked to come into complex, you know, sports environments.

• 29:13Dr. Darshan Shah?

  Sure.

• 29:13Speaker 05

  We look at how people are moving, what movements are there? Where do we need, hey, we need to spend a little bit more time loading hip extension? Or hey, I see that you are not doing anything truly overhead, or we need to do something where this leg is a little bit more midline. So suddenly the universal root language of human is the push-up, it's the deadlift, it's the pull-up. And now we all can agree, it's not how much hip flexion do you have? It's do I have enough range of motion to put my arms on my head to press?

• 29:39Dr. Darshan Shah?

  Got it.

• 29:43Dr. Darshan Shah?

  I really hope you enjoyed that best of episode all around strength training. In 2025, we have episodes on multiple aspects of your human physiology. And I believe strength training really came to one of the top three topics that we talked about over and over again. Like I said, if you really enjoyed these speakers, please go back and listen to their full form episodes. Thank you so much for listening and here's to a great, strength-filled 2026.

• 30:11Dr. Darshan Shah?

  Thank you so much for listening to the podcast today. Please remember to subscribe if you liked this episode and give us a good review and share a link with your friends. It really helps to support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying health conditions or on any medications. Your doctor knows your personal health situation the best and it's always important to seek their guidance.