280. Will Harlow: STOP Losing Muscle After 50 (Do This Instead)

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

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

• 0:00Speaker 00

  We almost look at people who've got these age-related problems and say, well, what do you expect? You know, you're 60, you're 70, everyone's suffering with this. And the worst part is when people are told that so many times, they believe it.

• 0:12Gary Brecka?

  It normalizes this culture of group suffrage. And when it seems normal in your peer group, you just accept it as a consequence of aging.

• 0:20Speaker 00

  We think that people only lose independence in their 80s and 90s, and we just don't think about it. It's one of those things we take for granted that we start to lose a lot earlier than we realize.

• 0:30Gary Brecka?

  Independence truly is freedom. As we get older, one of the measures of independence is do you need help with the activities of daily living?

• 0:37Speaker 00

  The four pillars of independence, as I call them, are mobility, strength, so how strong you are, but also how much muscle mass you have on your body, balance, and then the fourth pillar is skeletal health.

• 0:47Gary Brecka?

  The age-related muscle wasting is more rapid, I think, than people realize.

• 0:51Speaker 00

  Muscle mass throughout the entire body is an independent predictor of longevity.

• 0:55Gary Brecka?

  How important is it for people that are trying to build strength, but in older ages, to return that strength? Do you have them draw their attention to those muscles? Do you find that that helps?

• 1:04Speaker 00

  So what I tend to do with people now, and this is something people can do at home,

• 1:08Speaker 00

  is...

• 1:21Gary Brecka?

  Hey, guys. Welcome back to the Ultimate Human Podcast. I'm your host, human biologist Gary Brecka, where we go down the road of everything: anti-aging, biohacking, longevity, and everything in between. And today's guest, all the way from the United Kingdom, physiotherapist that I'm actually greatly interested in running this podcast with, decided at one point in his life that the patients that he was caring for that were leaving his clinic without pain were going home and the pain was starting to return. And he wanted to find a solution to how people could care for themselves outside of the clinic and make a material difference on the trajectory of their life. And this has to do with musculoskeletal pain and movement and your posture and so many things that are overlooked by modern medicine. And we're

• 2:05Gary Brecka?

  starting to treat those symptoms that actually have a chronic underlying condition that can Be fixed so you can put them permanently in your rearview mirror. So, welcome to the podcast, Will Harlow.

• 2:15Speaker 00

  Thank you, Gary. That's very kind.

• 2:17Gary Brecka?

  Yeah, I'm super, uh, super excited about today. And, um, as always, we usually start running a podcast before the podcast starts. But, you know, so we, we had a great conversation before the podcast started. But I wonder if you might just give a little context to my, um, listeners. Because you're working at NHS as a physiotherapist. And having a great deal of success with the patients that you were hands on with. That could come into the clinic and, and actually receive treatment and guidance. But at some point, you noticed that when they would leave, those gains would go away. And, and it was, and it was, the chronic condition was coming back.

• 2:54Speaker 00

  Yes.

• 2:54Gary Brecka?

  And I believe that the people that are the most driven, purpose, purposeful, like passionate and impactful, are the people that are solving problems. And so that seems to be the problem that you solved.

• 3:08Speaker 00

  Hundred percent.

• 3:09Gary Brecka?

  So give us a little context around that.

• 3:11Speaker 00

  Yeah, so, um, I was in the NHS at one point, but I actually started in professional sport. And it was a, it was a funny trajectory for me, really, because I spent my whole childhood, growing up, thinking, I want to work in professional sport. I don't care what I do. I just want to be in and around the clubs and the players. And I was also really interested in the human body as well, like yourself. So, um, when I heard about this thing called physiotherapy, I thought, great, this is going to tick both boxes. You know, I'm going to be able to help people with their bodies whilst also working in professional sport. So I was locked on this idea of working in professional football, soccer, as you guys say.

• 3:49Gary Brecka?

  Yeah.

• 3:49Speaker 00

  And I went right through university with this goal, came out the other side. And, um, I got an in with a local football club, which just so happened to be the club that I supported my whole childhood.

• 4:00Gary Brecka?

  Oh, man.

• 4:01Speaker 00

  Yeah, so dream come true. Um, got an interview, got the job, got in there. And within about three to six months, I was looking around thinking, this is not what I want to do at all. I'm in the wrong place. It just was a bad character fit for me. A bad fit for, you know, the environment. I didn't really like the culture. And it was almost like the world was coming crashing down for me. So I thought, I've trained my whole life for this. I've got no plan B. What on earth am I going to do now? But I took the chance and left. And while I was trying to figure things out, that's when I went into the NHS.

• 4:36Gary Brecka?

  Ah, okay.

• 4:37Speaker 00

  And when I was in the NHS, we were in this big kind of corporate mill-like clinic. I was seeing 15 patients a day. They were all referred from their primary care physician. And about 90% of them were people over 50.

• 4:49Gary Brecka?

  Hmm.

• 4:50Speaker 00

  I never really worked with this pocket of people before. So I've seen people with knee.

• 4:54Gary Brecka?

  Careful, I'm over 50, dude, so don't, don't, don't come at us too hard.

• 4:58Speaker 00

  I would never dream of it.

• 4:59Gary Brecka?

  All right.

• 5:00Speaker 00

  People with knee pain, people with back pain, sciatica, all of these things. And from my training, I knew I could help these people. And I started to see these wonderful transformations.

• 5:10Gary Brecka?

  Hmm.

• 5:10Speaker 00

  I was just giving people basic advice, telling them what they needed to do, coaching them through it.

• 5:15Gary Brecka?

  Mm hmm.

• 5:15Speaker 00

  And then watching the outcomes. And I look back about three months into the process and thought, this is the most fun I've ever had.

• 5:22Gary Brecka?

  Yeah.

• 5:22Speaker 00

  So it was at that moment I knew this is what I was destined to do. And I don't know about in the US, but in the UK, that there's a huge problem in terms of the attitude we have towards aging.

• 5:33Gary Brecka?

  Oh, no question.

• 5:33Speaker 00

  We, we almost look at people who've got these age-related problems in inverted commas and say, well, what do you expect? You know, you're 60, you're 70, everyone's suffering with this.

• 5:44Gary Brecka?

  Yeah.

• 5:45Speaker 00

  And I knew from my training.

• 5:46Gary Brecka?

  It normalizes it, yeah.

• 5:47Speaker 00

  I know. And the worst part is when people are told that so many times, they believe it. And they go, well, the doctor said, this is it. So I guess this is just life now.

• 5:56Gary Brecka?

  Yeah.

• 5:57Speaker 00

  But seeing people improve, I knew that there was something here and I knew the demand for it was massive. The NHS wasn't the right environment for me to take it further. We were very much constrained by how often we could see people and what we could do. And I remember being given a, a 2.5 session average cap. That's how many times you're allowed to see people before you have to get rid of them and bring someone else.

• 6:20Gary Brecka?

  2.5?

• 6:21Speaker 00

  Yeah, we were marked only on our session average.

• 6:26Gary Brecka?

  Oh, my gosh.

• 6:27Speaker 00

  Yeah.

• 6:28Gary Brecka?

  Wow.

• 6:28Speaker 00

  Because you've got to make room for someone else.

• 6:30Gary Brecka?

  Yeah, yeah, because it's just a mill.

• 6:32Speaker 00

  Exactly.

• 6:32Gary Brecka?

  Yeah.

• 6:32Speaker 00

  So I knew that wasn't the right setting. So I didn't know anywhere else that was offering this kind of help for older people. So I decided to start it myself.

• 6:40Gary Brecka?

  Hmm.

• 6:41Speaker 00

  So I left and I set up my own clinic and it just, it really took off because I think the message just resonated straight away.

• 6:48Gary Brecka?

  Hmm.

• 6:49Speaker 00

  That, you know, you're not just destined to suffer like this forever. There's a lot we can do. You just haven't had the right guidance yet.

• 6:55Gary Brecka?

  Yeah.

• 6:56Speaker 00

  So that's how it started.

• 6:57Gary Brecka?

  You know, I think too, you know, with aging, just in general, what happens is as we move through life, right, like my, my kids are in their twenties, um, early twenties to late twenties, all their friends are getting married, right? So like every weekend, there's another marriage. And then, you know, as they're emerging from that, it's like now everybody's having babies.

• 7:16Speaker 00

  Hmm.

• 7:17Gary Brecka?

  Um, and in my age demographic, and then I look at my parents, it's like, everybody has similar ailments and, and issues going on. So it's very normal. It's like, well, you're on blood pressure medication, so am I. What do you take? Oh, I take Endrol, I take Ovatebugger. Um, hey, we all take it, you know, and, and, uh, you know, my knees hurt all the time. So does my back. I wake up, I can barely move. Yeah, neither can I. It's like, it normalizes this, it's, it's sort of this culture of group suffrage, right? And, and when it seems normal in your peer group, you just accept it as a consequence of aging.

• 7:53Speaker 00

  Yeah.

• 7:54Gary Brecka?

  And I would argue the same thing that you're arguing. They're not consequences of aging at all. It's just not having the tools to put these things in your rearview mirror.

• 8:04Speaker 00

  Absolutely.

• 8:05Gary Brecka?

  And, um, and so you, you, you started your own clinic, but at some point you started to notice that people were also, um, you're making these major strides in the clinic, but afterwards they're, they're sort of post care, you know, where, where they were left to their own devices, they, they started to slip backwards.

• 8:23Speaker 00

  Yeah.

• 8:24Gary Brecka?

  Right? Which led to you doing this online.

• 8:27Speaker 00

  Yes.

• 8:28Gary Brecka?

  Right?

• 8:28Speaker 00

  Definitely.

• 8:29Gary Brecka?

  And, um, so talk a little bit about that transition.

• 8:31Speaker 00

  Yeah, for sure. So I think looking back, um, and bearing in mind, I was very early in my career here. So when I just started, I was very much still focused on pain. Like what's the problem this person's got that's causing pain? Great. Once you figure it out, let's fix it. Once the pain's gone, we'll send them on their way. But as you say, they were coming back and I was like, well, why is this person's knee pain come back? You know, I've fixed the problem. But I hadn't fixed it because there were deeper rooted things that we hadn't yet addressed. Now, through seeing this many times, I decided that one of the better ways I could help people to avoid this cycle of almost boom, bust, get better, then get worse again,

• 9:13Speaker 00

  was to give them things to do in between their sessions and after they leave me. And one of the best ways to deliver that was via video.

• 9:20Gary Brecka?

  Right.

• 9:20Speaker 00

  So I started putting these videos out initially just to help my patients.

• 9:24Gary Brecka?

  And I've seen a lot of your videos, you like your rotary videos, your glute strength videos, your, your, your, your shoulder mobility videos.

• 9:31Speaker 00

  Yeah.

• 9:32Gary Brecka?

  And, and they're very easy to follow. I mean, they're, they're simple routines and you're very specific about different ailments. And, and having gone to chiropractic college and having a pretty fundamental understanding of, of anatomy, you know, they make extraordinarily good sense, you know, because the biomechanics get off, the pain shows up.

• 9:53Speaker 00

  Yeah.

• 9:54Gary Brecka?

  And we think the pain is, you know, the shoulder pain is because something happened to my shoulder, but it's, you know, the biomechanics sort of led to that repetitive use issue.

• 10:02Speaker 00

  Yeah, definitely. And I, I always try and strip things back to the most fundamental basics of movement. Cause I never think of myself as a smart guy. I'm like, I have to see something work for me to understand it.

• 10:14Gary Brecka?

  Yeah.

• 10:14Speaker 00

  And I figure that a lot of people like that approach as well. They just want something very simple, like a really simple explanation and then one thing they can do to fix that problem. And I think that was probably the approach that really, you know, propelled the channel to getting so many millions of views. But really the mission hasn't changed from there. But still like give people something very easy that they can do and don't over complicate it, strip it back to basics, figure out what has gone wrong and then a simple strategy to try and improve it.

• 10:46Gary Brecka?

  I, I love that. You, you talk about the fear of movement sometimes being as bad as the injury itself.

• 10:52Speaker 00

  Yes.

• 10:53Gary Brecka?

  What, what do you mean by that? The fear of movement?

• 10:55Speaker 00

  Yeah. So. Let's go back to pain science for a minute. Okay, because this is really, really important. We used to think that when someone was in pain, that was because there was a tissue that was damaged. And the only reason someone can have pain is because there's some element of damage there.

• 11:12Gary Brecka?

  Right.

• 11:12Speaker 00

  We now know that's not true. We now know that there are many things that can cause pain. And there are studies showing that people who have been through an MRI scanner without pain are just as likely to have some of these injuries in inverted commas, as people who do have pain. So there must be some missing pieces to the puzzle that we hadn't figured out. Now, one of these is a fear of movement. And fear of movement is something that triggers muscle spasms. It tightens everything up. It restricts the movements of your joints. And it's primarily driven by what's going on in the neural circuitry.

• 11:50Gary Brecka?

  So like neural inhibition.

• 11:51Speaker 00

  Exactly. And that drives pain up even more. So I had many people come into the practice who didn't have any obvious injury, but they still had a lot of pain. And a lot of that was because they were so afraid to move from something having gone wrong a while ago, that that was now the primary driver of pain.

• 12:09Gary Brecka?

  Ah.

• 12:10Speaker 00

  So figuring out what's causing that fear of movement and then slowly unpicking it can have dramatic effects for people that have suffered with this kind of mechanical pain for a very long time.

• 12:20Gary Brecka?

  Listen, there's what I share on this podcast, and then there's what I share with my inner circle. If you've been following me for a while, you know how I hold nothing back here. But my VIP community, that's where the real magic happens. Picture this, you're struggling with energy crashes, brain fog, or just feeling like you're not operating at your peak, and you don't know where to get real answers. But here's what really sets this apart. You're not just getting my insights. When I have incredible guests on the podcast, VIP members get to submit questions for a private podcast segment. So that world renowned expert we just interviewed, you get exclusive access to their knowledge tailored to your specific situation. This section is under the private podcast section in the Ultimate Human Community. And speaking of exclusive, you're getting my personal protocols,

• 13:05Gary Brecka?

  the exact tools I use for what Fasting, gut optimization and morning routines that have taken me decades to perfect. This isn't theory. This is what works in the real world. The community launches challenges throughout the year where you get direct access to me and my network of experts. It's like having a personal health advisory board for less than a hundred dollars a month. Your health is your wealth and this investment pays dividends for life. Join the VIP community at theultimatehuman.com/vip and step into your ultimate potential. Now let's get back to the ultimate human podcast. You know, it's interesting is I interviewed a sports psychiatrist a long time ago and he said, one of the challenges in, and especially in professional athletics, very high level athletic performance.

• 13:48Gary Brecka?

  When someone, when an athlete gets injured is very often they start to see themselves as an injured person.

• 13:54Speaker 00

  Yes.

• 13:54Gary Brecka?

  And, and the brain subconsciously will guard through this process called neural inhibition.

• 14:03Gary Brecka?

  Different limbs from engaging in certain movement planes. Because doesn't realize that the injury is over and it's safe to move again. And so very often he was like, you know, would, it would throw their biomechanics off even though there was anatomically nothing wrong with them. They had, they had healed from surgery, trauma, you know, whatever it was. And you talk about these four pillars of independence. And I wonder if you'd lay those out because you know, that's seems to me a good foundation from, for us to start with. You know, independence truly is freedom, you know, as, as we get older, one of the

• 14:47Gary Brecka?

  measures of independence is do you need help with the activities of daily living?

• 14:51Speaker 00

  Yeah.

• 14:52Gary Brecka?

  And starting early is the cure for that.

• 14:55Speaker 00

  A hundred percent. And I define independence as being able to do what you want, when you want, for as long as you want, without needing help from someone else unless you want it. And independence is one of those funny things where we think that people only lose independence in their eighties and nineties. And we just don't think about it. It's one of those things we take for granted that we start to lose a lot earlier than we realize. So when I was thinking about what actually influences independence, I looked back at the patients I've treated. And tried to think, well, what were the reasons that those people had lost independence to begin with? And it came down to these four things. And the four pillars of independence, as I call them, are mobility.

• 15:39Speaker 00

  So how well you can move your joints. Strength, so how strong you are, but also how much muscle mass you have on your body. I'm sure we can talk about muscle later, but it's one of the most important things for your health.

• 15:51Gary Brecka?

  I would agree with that, yeah.

• 15:52Speaker 00

  Balance, so how well you can stay on your feet is the third pillar. And then the fourth pillar is skeletal health. So I define that as the health of your joints, so what's going on inside the joints and the health of your bones as well. So avoiding things like osteoporosis and osteopenia. Because those lead to a big loss in independence for many of the people that I've treated, even if the other pillars are intact. So I see these four pillars almost like the four legs of a table.

• 16:19Gary Brecka?

  Yeah.

• 16:20Speaker 00

  So you need all four to have a sturdy table. If you knock one away, the table's wobbly at best. If you lose two, the table's on the floor.

• 16:28Gary Brecka?

  Right.

• 16:28Speaker 00

  So that's how I see it.

• 16:29Gary Brecka?

  Yeah, and and some of your solutions I I find really fascinatingly simple if they're done, you know, consistently. Right, like brushing your teeth on one foot, you know. And so standing barefoot and brushing your teeth on one foot, just to get that one minute of extra foot stability. And like, you know, calling your attention to your balance while you're doing something else. You know, things that I feel like everybody could incorporate into their lifestyle relatively easily.

• 17:01Speaker 00

  Yeah.

• 17:01Gary Brecka?

  And so how much of it is under our control?

• 17:05Speaker 00

  So much of it. And the thing you're referring to, Gary, there is something I call exercise snacks.

• 17:11Gary Brecka?

  Yeah.

• 17:11Speaker 00

  Now, exercise snacks, I think it's just worth bringing this to everyone.

• 17:15Gary Brecka?

  Yeah.

• 17:16Speaker 00

  It's short bursts of movement or exercise, typically thirty to sixty seconds, that you do in otherwise dead time throughout the day. So the classic time to do it, as you say, is standing on one leg whilst brushing your teeth to work on your balance. You don't need to work on your balance in an exercise snack. You could work on your strength, you could work on your mobility, you can even work on your bone health. So what I tell people to do is to pick the one thing they want to improve. And then build almost an exercise snack regime around that one attribute.

• 17:47Gary Brecka?

  That's cool.

• 17:47Speaker 00

  And you can rotate the exercises you choose, but if you have a clear goal, like let's say you wanted to build up some strength in your upper body. You might do a 30 second exercise snack of wall press ups. And then you might have a resistance band loops around a door. So next time you're you walk past it, you do 30 seconds of rows. And before long, you are going to start building up that attribute. And the research really supports this as well. This is not just like some, you know, little thing that you can do that might or might not work. This is really evidence based.

• 18:17Gary Brecka?

  You know, it's fascinating to me too, because I think we've been trained to think that exercise happens in one duration burst. You know, 45 minutes or an hour every day at same time and then it's done.

• 18:30Speaker 00

  Yeah.

• 18:32Gary Brecka?

  Where, you know, you're saying, hey, even if you have a really busy lifestyle and you have a lot going on, you have these moments throughout the day where you could just draw attention to whatever it is that you want to focus on.

• 18:42Speaker 00

  Yeah.

• 18:43Gary Brecka?

  I've got to ask you about sciatica.

• 18:46Speaker 00

  Sure.

• 18:46Gary Brecka?

  Because, you know, growing up and having graduated from chiropractic college, you know, there's so many people suffer from this and it can be, excuse me, debilitating and get progressively worse.

• 18:58Speaker 00

  Yeah.

• 18:58Gary Brecka?

  And it's one of those things that draws people's attention away from everything else. It's sort of subconsciously on your mind if you have it. By the grace of God, I've never, never suffered from it, but I know people that have had really chronic sciatica and it's debilitating.

• 19:11Speaker 00

  Yeah.

• 19:12Gary Brecka?

  And eventually it can even lead to like atrophy and, you know, other things.

• 19:15Speaker 00

  Yeah.

• 19:17Gary Brecka?

  But what would be some of your go tos people could do at home, let's say, for sciatica?

• 19:24Speaker 00

  Sciatica is such an interesting one. It's actually one of my special interest areas.

• 19:28Gary Brecka?

  Really? Oh, awesome dude. I'm glad I asked then.

• 19:30Speaker 00

  And in a, in a real cruel twist of irony, a couple of years ago, I had it myself. I picked up a nasty bout of it from a deadlift where I just wasn't concentrating. I, I rounded my spine too much picking up this heavy weight. I just got back from a long holiday without any weight training and was anxious to get back into it.

• 19:49Gary Brecka?

  Yeah.

• 19:49Speaker 00

  So it was a typical case, you know, rushing in, no warm up, bad technique, bang, I felt this pain down the back of my leg. And like any good physio, I thought I've pulled my hamstring.

• 19:59Gary Brecka?

  Yeah.

• 19:59Speaker 00

  But of course I hadn't.

• 20:01Gary Brecka?

  Yeah.

• 20:01Speaker 00

  It was a probably a disc injury.

• 20:03Gary Brecka?

  Yeah.

• 20:04Speaker 00

  And that really brought it home for me because I've been helping people with this problem for so long without ever having suffered myself. And then having that pain for three, four months, having the numb foot worrying if it was ever going to get better, that really brought it home as to how debilitating this can be. So it kind of renewed my interest in helping people with it. So there are lots of different ways to treat sciatica because there are lots of different things that can cause it. The most common cause is an issue with one of the discs in the spine, so a disc bulge or a herniation. But really, anything that presses on one of the nerve roots or irritates one of the nerve roots in the lower part of the spine can cause sciatica.

• 20:48Speaker 00

  Okay, so it could be a disc, it could be a joint, it could be a muscle that traps it, it could just be general inflammation. And sometimes there's sciatica and we have no idea what's caused it. There's no diagnosis there, the person just has the pain. So once upon a time, I used to try and treat sciatica based on what the tissue was that was causing it. But then I realised that was an oversimplification.

• 21:11Gary Brecka?

  Yeah.

• 21:11Speaker 00

  So the person needs treating as a whole, not as an injury, if that makes sense. So what I tend to do with people now who have it, and this is something people can do at home, is most sciatica is linked to movements of the spine. Okay, about 90%. If you move your spine in a certain direction, it's either going to make it better, or it's going to make it worse, or it's going to do nothing. So the first thing I would recommend people do is find out what those movements are for them. So it might be that if you bend forwards, that sciatica gets worse. So now you know, okay, so when I flex, that aggravates it. So what you need to do then is for a moment, until it starts to improve, try and avoid doing lots of those flexed positions.

• 21:53Speaker 00

  Because with any nerve pain, this is not a no pain, no gain thing. It's the total opposite. You have to avoid the thing that's causing the pain, otherwise it increases the inflammation and the problem goes on for longer.

• 22:06Gary Brecka?

  Right.

• 22:07Speaker 00

  So once you've found the thing to avoid, you make sure you take note of that. Now you're going to test the other movements and chances are you'll find one. That makes it feel maybe slightly better. And that is your almost golden movement. You're gonna keep coming back to that, almost as an exercise snack again, going back to that concept. Keep repeating it. And what people often find is the pain starts to reduce when they do that. So this really helps in the early phases. Once that pain is under control, we then wanna start rebuilding strength around the area. Because it doesn't take long after having an injury like sciatica, that pain in your leg, for strength to start to reduce.

• 22:45Gary Brecka?

  So true.

• 22:46Speaker 00

  And with it, mobility and with it, confidence.

• 22:49Gary Brecka?

  Yeah.

• 22:50Speaker 00

  So strengthening the glutes up, strengthening the core, strengthening the spine itself. Absolutely vital for anyone who's been through this. But you have to start by knocking that pain down a few notches first, because otherwise, everything aggravates it. Another good evidence-based thing is walking. Walking can really help to reduce and control the pain of sciatica for as much of that as you can. And just avoiding things that cause pain. And sometimes those things are unusual. I know for me that when I had that pain, if I slightly leant one way, it really hurt. But if I leant right the way down, no problems. So I avoided any exercises where I was slightly leaning forward. So anything with weight on my back that caused me to come forward slightly, avoid.

• 23:36Speaker 00

  But then other exercises, even things like the leg press, which people typically think you should avoid with sciatica, that was fine for me. So it's very individual.

• 23:43Gary Brecka?

  Okay.

• 23:44Speaker 00

  So avoid what hurts, do more of what doesn't, keep moving and rebuild that strength.

• 23:49Gary Brecka?

  Do you find that most sciatica, even chronic sciatica, goes away over time if you do that?

• 23:57Speaker 00

  Yeah, most of the time. If you're following a good plan and it's designed to help you reduce pain, restore mobility and rebuild strength, 90% of cases get better.

• 24:10Gary Brecka?

  Wow.

• 24:11Speaker 00

  And I think people's perception of it is skewed because we all hear about the awful cases that are there all the time and didn't get better. That's probably only about 10% of cases. And then there are people who have recurrent sciatica, which is quite common. But again, I would argue that most people where it's recurrent, they haven't fully regained mobility or rebuilt strength. They often wait until the pain goes away, then they just jump straight back into doing what they were doing before. And there's still that underlying problem that might not be causing pain now, but it's leaving them vulnerable to a re-injury later.

• 24:47Gary Brecka?

  So for, I'm sure that when you were at NHS and in a lot in your clinic, you were seeing a lot of post-surgical or post-traumatic recovery, like where people had some kind of specific incident and then it led to the need for rehabilitation. But what percentage of people or how often did you see like repetitive use injuries or people that had prolonged poor posture over time? And now it's just starting to manifest and you have to correct that because I think, you know, that too little attention is paid to biomechanics.

• 25:22Speaker 00

  A hundred percent agree.

• 25:24Gary Brecka?

  You know, I've talked about this before, you know, every, every professional golf coach would rather start somebody swinging a golf club from day one, rather than unlearn somebody who's been swinging a golf club wrong for 20 years.

• 25:38Speaker 00

  Takes twice as long.

• 25:39Gary Brecka?

  Right, takes twice as long because those neural patterns are ingrained. And I think, you know, the, the way that those neural patterns get ingrained, you know, when your posture is off or your gait is off and now it's starting to manifest pain and people think, oh man, my hip is starting to go. And it's like, well, you're just starting to feel it. It's really been going for a long time.

• 26:00Speaker 00

  Yeah.

• 26:01Gary Brecka?

  So how do you restore like, like what is good biomechanics and how do we restore that overall?

• 26:08Speaker 00

  It's a really good question. And as I've moved through my career, I've come to the conclusion that probably 80% of the cases that I treat in the clinic are what I would call mechanical problems. It's a mechanical pain. We used to think, as I said, everything that caused pain is an injury.

• 26:27Gary Brecka?

  Right.

• 26:27Speaker 00

  Now we know that you can have pain in the absence of injury and you can have an injury in the absence of pain. So the actual injury itself is a poor predictor of how much a person is gonna suffer.

• 26:38Gary Brecka?

  Yeah.

• 26:39Speaker 00

  We even see this with people with almost no cartilage left in their joints.

• 26:43Gary Brecka?

  Yeah.

• 26:43Speaker 00

  You put them through an X-ray machine for another reason, you say, how's your knee? Does it hurt? And they're like, no, it's fine. You're like, well, you've got no cartilage, you're bone on bone.

• 26:51Gary Brecka?

  Yeah.

• 26:51Speaker 00

  But they don't have pain.

• 26:53Gary Brecka?

  Yeah.

• 26:53Speaker 00

  And the reason they don't have pain, I would argue, is that their mechanics were still pretty good around that knee. So there wasn't stress going through the joint as much as someone else who did have the pain.

• 27:04Gary Brecka?

  Right.

• 27:05Speaker 00

  So in answer to your question, biomechanics are so important. And when I look at someone's joint and I'm looking at the biomechanics and how to fix it, it often starts with the muscles. So I'll look at what those muscles are doing to protect that joint. Because your muscles are like your joint's bodyguards.

• 27:23Gary Brecka?

  Yeah.

• 27:24Speaker 00

  That's their job. Their, their job is to reduce stress and strain on the joint tissue itself. Okay, because we've got cartilage in our joints and it does a pretty damn good job, but it's not designed to take the entire weight of the body every time you move. You need the muscles to take some of that weight as well.

• 27:39Gary Brecka?

  Right.

• 27:39Speaker 00

  And if they're not doing their job, that's often the first place I would start. And then we also want to look beyond that joint itself. So this is absolutely classic and we were speaking about this before we came in.

• 27:50Gary Brecka?

  Yeah.

• 27:51Speaker 00

  You mentioned having a foot problem. And then before long, your back starts to hurt.

• 27:56Gary Brecka?

  Yep.

• 27:57Speaker 00

  Well, there probably wasn't an injury in your spine causing the pain, but the mechanics lower down were having an influence on the mechanics higher up.

• 28:06Gary Brecka?

  Yeah.

• 28:06Speaker 00

  Is that making sense?

• 28:07Gary Brecka?

  Making so much sense. I mean, because I, I have flat feet. And on the, my left foot, I have a really collapsed arch. I mean, it's flat on the ground. And I noticed, you know, as that arch collapsed, I would get a little medial knee pain. And then I would get some lateral hip pain and low back pain.

• 28:24Speaker 00

  So common.

• 28:24Gary Brecka?

  And eventually it worked its way up to my shoulder. And finally, I've gone through corrective, I had a really good physio that you just met, by the way. He happened to be here working with my wife, Dr. Evan. And doing all the like boring stuff that I. Didn't want to do like band rotations and holding a, you know, a five pound and then a 10 pound weight and externally rotating and, you know, just re-strengthening the rotator cuff. And really what he attempted to convince me of in the beginning and what I'm now convinced of is just, I was anatomically just not in the right position, you know, in my case, my shoulder had just come forward and, and posture was terrible. And so that anterior

• 29:09Gary Brecka?

  bicep just never healed. And as soon as I strengthen the rotator cuff, there are just time and consistency with these exercises, I'm back to no pain. Pull-ups, overhead exercises, you know, everything.

• 29:22Speaker 00

  You've just demonstrated the magic of fixing those mechanics.

• 29:25Gary Brecka?

  Yeah.

• 29:25Speaker 00

  So you've taken the stress off that bicep tendon by strengthening presumably the muscles at the back of the shoulder girdle. And that's allowed it to move in the way it was designed. And then, hey presto, the body starts to heal.

• 29:38Gary Brecka?

  Yeah.

• 29:39Speaker 00

  So this is how we kick off healing, by fixing those mechanics.

• 29:42Gary Brecka?

  Putting the right biomechanics back in place so the body can do what it was meant to do.

• 29:46Speaker 00

  The body wants to heal.

• 29:48Gary Brecka?

  Yeah.

• 29:48Speaker 00

  It wants to work with you. It's not trying to work against you.

• 29:51Gary Brecka?

  Yeah.

• 29:51Speaker 00

  But it needs the right conditions to do so.

• 29:53Gary Brecka?

  And the right inputs.

• 29:54Speaker 02

  One of my favorite bio hacks outside of breath work by far is mineral salts, Baja Gold Sea Salt. It's got all of the trace minerals that the body needs. You know, most of us are not just protein deficient, meaning amino acid deficient or fatty acid deficient. We are mineral deficient. So a quarter teaspoon of this in water, first thing in the morning, will make sure that you get all of the essential minerals that you need. It tastes amazing. In fact, I made a steak today. I actually made a grass-fed steak with grass-fed butter and I put just mushrooms and a little bit of rosemary and I sprinkled Baja Gold Sea Salt all over the top. Try it. It'll be your new favorite for cooking too. It's the cheapest and one of my favorite bio hacks. I don't know, a $15 or $20 bag of this will probably last you five years. It's literally the world's best biohacking secret.

• 30:36Gary Brecka?

  Now let's get back to the Ultimate Human Podcast. So you also have, which I'm really curious about, a great predictor of longevity. The, the, this simple sit-stand test.

• 30:50Speaker 00

  Yes.

• 30:50Gary Brecka?

  I want to, I want to do it. I'm hoping that I don't embarrass myself, but.

• 30:57Gary Brecka?

  And it's basically in a 30-second timeframe.

• 31:00Speaker 00

  Yeah.

• 31:01Gary Brecka?

  What the number of times you can sit and stand and sit and stand to a full standing position.

• 31:05Speaker 00

  Yes.

• 31:06Gary Brecka?

  And you cross your arms, right?

• 31:07Speaker 00

  That's right. No arms allowed. Yeah.

• 31:08Gary Brecka?

  Arms allowed. So you sort of rock forward, stand up, sit down, rock forward, stand up. And there's evidence that the number of times that you can do that in 30 seconds is a predictor for, you know, mortality and longevity. I would actually heavily agree with you on that.

• 31:29Gary Brecka?

  Can we do that during the pod? Can we fire it up? Can I, can we do it?

• 31:32Speaker 00

  Okay.

• 31:34Gary Brecka?

  Hopefully this goes well or we'll just have to cut this right out of the podcast. All right. And I have a weighted vest on, so I am going to take the weighted vest off. I'm wearing a seven-pound ion weighted vest. Let me give myself every possible advantage here. Is this chair good for it?

• 31:51Speaker 00

  To be honest, you would want a nice firm chair normally, but we can make do. We can make do.

• 31:55Gary Brecka?

  Let's, let's bring the firm chair up here.

• 31:57Speaker 00

  Yeah.

• 31:59Gary Brecka?

  Pull this bad actor back, right there.

• 32:01Speaker 00

  That one would be perfect.

• 32:02Gary Brecka?

  Okay.

• 32:06Gary Brecka?

  Cause then I could always blame it on the chair if I.

• 32:10Speaker 00

  Need a scapegoat in case this goes wrong.

• 32:12Gary Brecka?

  Yeah, yeah, dude, I would have actually left the chair.

• 32:15Speaker 00

  That would be good, actually.

• 32:16Gary Brecka?

  Okay, so I'm just gonna.

• 32:19Speaker 00

  We've practiced this.

• 32:20Gary Brecka?

  Okay.

• 32:20Speaker 00

  So you want to be sat on the edge of the chair.

• 32:22Gary Brecka?

  Okay.

• 32:22Speaker 00

  So you're going to come up, all the way up. That's it. And then all the way down to a full sit and then straight back up again. But there's no pauses. So we're going to do it as many times as you can.

• 32:32Gary Brecka?

  Okay.

• 32:32Speaker 00

  In 30 seconds.

• 32:33Gary Brecka?

  Many times I can in 30 seconds.

• 32:35Speaker 00

  Yeah. So we're going for rapid movement.

• 32:37Gary Brecka?

  Okay.

• 32:37Speaker 00

  Okay.

• 32:38Gary Brecka?

  And.

• 32:38Speaker 00

  Shall I start? Shall I time it?

• 32:40Gary Brecka?

  You got a timer?

• 32:41Speaker 00

  Yeah, I got a timer.

• 32:41Gary Brecka?

  Okay, so I'd start sitting.

• 32:43Speaker 00

  Yeah. So we start sitting and the first number one is when your bum touches the seat again. And then you just keep going.

• 32:49Gary Brecka?

  Okay.

• 32:49Speaker 00

  I'll tell you when to stop.

• 32:50Gary Brecka?

  I don't get one for standing up?

• 32:51Speaker 00

  No.

• 32:51Gary Brecka?

  Oh dude, that's.

• 32:52Speaker 00

  It's got an up and down as one.

• 32:54Gary Brecka?

  Okay.

• 32:55Speaker 00

  Yeah. Okay.

• 32:56Gary Brecka?

  All right.

• 32:56Speaker 00

  I'll give you a countdown. So you're going to go on, go. All right. Three, two, one, go.

• 33:14Speaker 00

  Keep going Gary.

• 33:26Speaker 00

  This is phenomenal.

• 33:30Speaker 00

  And stop. I'll give you that last one as well.

• 33:32Gary Brecka?

  Twenty-nine?

• 33:32Speaker 00

  Yeah, amazing.

• 33:34Gary Brecka?

  Is that good?

• 33:34Speaker 00

  That's a very strong score.

• 33:36Gary Brecka?

  Yes!

• 33:37Speaker 00

  Yeah.

• 33:37Gary Brecka?

  The ultimate human!

• 33:39Speaker 00

  How old are you Gary?

• 33:40Gary Brecka?

  Uh, fifty-five.

• 33:41Speaker 00

  Okay, you're in elite territory of that.

• 33:43Gary Brecka?

  Yes, dude, elite territory!

• 33:45Speaker 00

  You smashed it.

• 33:46Gary Brecka?

  Clip that, put it everywhere.

• 33:48Speaker 00

  So, for your age, anything above twenty is really strong.

• 33:53Gary Brecka?

  Really?

• 33:53Speaker 00

  And that might surprise you, right? Because you did that quite easily.

• 33:55Gary Brecka?

  Anything about, yeah, alright, hold on, let me get the other chair back. Catch my breath.

• 34:03Gary Brecka?

  Alright, good, good.

• 34:04Speaker 00

  Yeah, yeah.

• 34:04Gary Brecka?

  Glad that went well.

• 34:04Speaker 00

  You smashed it.

• 34:07Speaker 00

  Yeah.

• 34:09Gary Brecka?

  Elite territory, you got that, right?

• 34:11Speaker 00

  I mean, that's... You had it here.

• 34:12Gary Brecka?

  Audio is clear.

• 34:14Speaker 00

  Smashed it.

• 34:15Gary Brecka?

  Oh, that's awesome.

• 34:16Speaker 00

  Yeah, so, anything above twenty, for people between fifty and sixty is very strong.

• 34:21Gary Brecka?

  Wow.

• 34:22Speaker 00

  Um, but this is on like, population average, right?

• 34:25Gary Brecka?

  Mm-hmm.

• 34:25Speaker 00

  So, obviously, this is tens of thousands of people. So that gives you an idea of how low, probably, the real average is.

• 34:33Gary Brecka?

  Right.

• 34:33Speaker 00

  So, anything below fifteen, at your age, would be a little bit concerned.

• 34:38Gary Brecka?

  Mm-hmm.

• 34:39Speaker 00

  Anything below twelve is deeply concerning.

• 34:42Gary Brecka?

  Okay.

• 34:42Speaker 00

  Now, the numbers that you should hit are different for each age group. So each age group's got its own, and each gender as well.

• 34:48Gary Brecka?

  Right.

• 34:48Speaker 00

  Okay? But I would say, I would argue that any age below twelve is problematic. And there's some pretty robust data to show that anyone who can't hit more than twelve of those in thirty seconds have about a two X risk of falls.

• 35:04Gary Brecka?

  Wow.

• 35:04Speaker 00

  In the next year.

• 35:06Gary Brecka?

  Which is the greatest risk for...

• 35:07Speaker 00

  Which is the greatest risk, so...

• 35:08Gary Brecka?

  In older ages, yeah.

• 35:09Speaker 00

  Absolutely. So, with falls, they cost your healthcare system fifty billion dollars a year.

• 35:15Gary Brecka?

  Really?

• 35:15Speaker 00

  It's massive.

• 35:16Gary Brecka?

  Falls?

• 35:17Speaker 00

  Yeah, just falls.

• 35:17Gary Brecka?

  In the elderly.

• 35:18Speaker 00

  So the fallout of falls in the elderly. And, um, many people who fall, who are over sixty-five, will fracture their hip. And the scary stat there is that one in three of those people will die within the next 12 months.

• 35:30Gary Brecka?

  Wow.

• 35:31Speaker 00

  So it's terrifying.

• 35:31Gary Brecka?

  We actually used to call that in the mortality space, the triad of death.

• 35:35Speaker 00

  Yeah.

• 35:35Gary Brecka?

  We had a nickname for it.

• 35:37Speaker 00

  Oh, wow.

• 35:38Gary Brecka?

  These hip fractures.

• 35:39Speaker 00

  Yeah.

• 35:39Gary Brecka?

  What was super interesting was when we really looked deep into the data, very often, the hip breaks and then they fall.

• 35:50Speaker 00

  Oh, interesting.

• 35:51Gary Brecka?

  The fall wasn't always causing the fracture. Like, they'd be so osteoporotic or osteopenic that the femoral neck would break and that would cause the fall. So instead of the fall causing the fracture, the fracture caused the fall.

• 36:03Speaker 00

  I've never come across that.

• 36:04Gary Brecka?

  Yeah.

• 36:05Speaker 00

  I mean, that's probably happened loads of times without me realizing.

• 36:08Gary Brecka?

  Yeah, grandma's standing there at the sink, you know, washing dishes and crack the hip breaks and she just falls. And sometimes a family member will say, why did she fall? You know, I was watching her. She was just standing at the sink washing dishes and she just bang at the floor. And then they would realize, yeah, the femoral neck broke because this skeletal system had gotten so weak. It couldn't even support itself. That's a great, so, so let's talk about, first of all, everybody needs to do this.

• 36:36Speaker 00

  Try it, it's such a good test.

• 36:37Gary Brecka?

  See if you can be 20, would I get 29? You gotta be 29. But if, if someone is in that 12 or under category or 12 to 15 category, what's that a wake up call to say, you gotta start doing X?

• 36:52Speaker 00

  So it is primarily a measure of your leg strength and specifically quads and glutes. And I call these your independence muscles. Because if you've got strong quads and strong glutes, you're just much better overall in terms of your mobility. You've got less chance of an injury when you step down from a height, which is one of the key risk points as we age.

• 37:14Gary Brecka?

  Ah, not being able to hold your own weight and just.

• 37:16Speaker 00

  Stepping down from a curb, stepping off a bus, stepping downstairs is a double risk there because, A, your muscles lengthening as you control, so you're more likely to lose that control. But also you're on an elevated height. So if you do lose control and you fall, the stakes are higher.

• 37:31Gary Brecka?

  Right.

• 37:32Speaker 00

  So having strong quads and glutes prevents. Some of that risk.

• 37:35Gary Brecka?

  Okay.

• 37:36Speaker 00

  Now, it also means if you've got less than 12, chances are you've also got poor muscle mass in your legs. And we know that muscle mass throughout the entire body is an independent predictor of longevity. And the more muscle mass we have, the healthier we are, the longer we live. It's just as simple as that. And for every 10% decrease in a mark of muscle mass index, so how much muscle you have on your body, there's an 11% increase in your all-cause mortality risk.

• 38:07Gary Brecka?

  Wow.

• 38:08Speaker 00

  So for every 10% you lose, it's an 11% increased risk.

• 38:12Gary Brecka?

  Wow.

• 38:12Speaker 00

  So not good.

• 38:13Gary Brecka?

  And, and, but the thing that's fascinating is this is within our control.

• 38:17Speaker 00

  A hundred percent.

• 38:17Gary Brecka?

  So like, i- if, if you are one of those people that hit 12 or less, or 15 or less, that's your wake-up call to change it, not, you know, you're not stuck.

• 38:27Speaker 00

  No, absolutely not. And there's so much you can do.

• 38:29Gary Brecka?

  Yeah.

• 38:31Speaker 00

  So that many simple exercises will help you build up the strength in those key muscles. But what I want to just address really quickly is, there's probably some people who tried that test and they're feeling pretty hopeless.

• 38:43Speaker 00

  The research shows that you can make incredible improvements at any age. And on the flight on the way over here, I read a new paper that came out just the other day, which said that a group of nursing home residents, so these were people in their 90s and older.

• 39:00Gary Brecka?

  Wow.

• 39:01Speaker 00

  Were put through an eight-week quad strengthening program. And in that eight weeks, they improved their strength by 175%.

• 39:11Gary Brecka?

  Oh my gosh.

• 39:12Speaker 00

  175%.

• 39:13Gary Brecka?

  175% in a 90-plus-year-old age immigrant.

• 39:17Speaker 00

  Weeks.

• 39:18Gary Brecka?

  Wow.

• 39:18Speaker 00

  Which is not long at all. Now, for those people, I have no doubt that was life-changing, because they can start walking around again, they can probably get in and out of chairs again independently. Can make a huge difference to them. So what this proves is it's not too late at any age.

• 39:34Gary Brecka?

  I love that.

• 39:35Speaker 00

  Make improvements. And another bit of great news is that when you first start working on your strength, we typically see improvements within as little as two weeks.

• 39:45Gary Brecka?

  Wow.

• 39:46Speaker 00

  It's not because you can build muscle mass in that time because you can't. But you build up those neural connections again, and that happens fast. So your body learns these movement patterns quickly. So within two weeks, there's a meaningful change in what you can functionally do. But you just have to get started and you just have to stick to it.

• 40:04Gary Brecka?

  Cause I noticed, you know, in older ages, the first sign is people will start pressing on their knees or they'll start grabbing the chair to get up or they'll pull themselves up somehow.

• 40:14Speaker 00

  Hundred percent.

• 40:14Gary Brecka?

  Hence the crossed arms, right? So you're fully independent and with no assistance. Both of my parents are at that stage now and I have them working with a physio actually to try to improve, improve that strength. Because, you know, the, once you're in bed and the bed's up high and there's not much that you need to do and, you know, to stand up and you kind of shuffle around all day and then go back into bed, you're not really, that strength is leaving fast. Sarkopenia in older ages is more rapid than, age-related muscle wasting is more rapid, I think, than people realize.

• 40:47Speaker 00

  Definitely. And we used to define sarcopenia just as a loss of muscle mass. But now we define it as well as a loss of strength and function. So it's multiple things happening at the same time.

• 40:58Gary Brecka?

  Yeah.

• 40:59Speaker 00

  And even though muscle mass and strength are very closely linked, they're not the same thing. So you lose muscle mass over the age of 30 at about a rate of three to eight percent per decade, if you do nothing about it.

• 41:13Gary Brecka?

  Right. So if you're just not strength training, you're going through your normal daily life, even if you're walking to work, right? You're still declining in muscle mass. What was really astounding to me was looking at some of these sagittal plane views through the quads.

• 41:28Speaker 00

  Yeah.

• 41:29Gary Brecka?

  You know, where the, it looks like they just chop straight through a quad. You can see the femur in the center and then the muscle, you know, going out almost looks like it's touching the skin. And then five years later, you see more fat on the border and 10 years later, more fat. 20 years later, 30 years later, and the muscle almost seems to be like melting into the bone. And sometimes it looked like their circumference shrank a little bit, but not that much. It was just replaced with fatty tissue.

• 41:56Speaker 00

  Yeah. And you can see the fatty infiltrates inside the quads themselves as well. Inside the muscle. But have you seen the same cross sectional studies with masters athletes? Who are still going into their 60s, 70s, 80s. These guys have got muscle that looks very similar to many people in their 30s and 40s.

• 42:15Gary Brecka?

  Right.

• 42:16Speaker 00

  It's because they're using them all the time.

• 42:18Gary Brecka?

  Right.

• 42:18Speaker 00

  So they avoided these changes that we used to think were inevitable because they're using it, not losing it.

• 42:24Gary Brecka?

  Yeah. So let's say that someone's at home and tries this sit, stand exercise, doesn't have the wherewithal to go to a physio. Where would you start? Would you start by just repeating that exercise or where would you start?

• 42:34Speaker 00

  The simplest place would be to repeat it. But if they're, you know, if they're in pain or they got a really low score or they just couldn't do it. They had to use their hands. We might need to even wind it back a step further. So from that position, which by the way, is where I find many of my patients when they first meet me. They often can't get out of a chair without help. We might start with some seated exercises. So just getting the quads going. Add some weight to the ankle. So you're getting the quads going like that. You might get them in bed and doing a straight leg raise against a resistance band. So non-weight bearing exercises, but still building up the quads.

• 43:08Gary Brecka?

  Okay.

• 43:08Speaker 00

  Once you can get to that position where you can get in and out of a chair, that's a great thing to practice. But then we want to progress that pretty quickly as well. So then we start to add a weight in. So a goblet squat from a sit to stand position. Exactly.

• 43:22Gary Brecka?

  Hate those. I do them, but I hate them.

• 43:24Speaker 00

  They're savage, but they work really well.

• 43:25Gary Brecka?

  Has me do them. Yeah.

• 43:27Speaker 00

  Yeah, they're great. And then you get rid of the chair and you have them doing squats without the chair if they can handle that as well.

• 43:31Gary Brecka?

  Right.

• 43:32Speaker 00

  And there's just so many ways to progress and make things tougher over time. I like to keep things simple. I have a rule of just one progression at a time. So you either increase the reps, you increase the weight, or you change the technique, but not at the same time.

• 43:46Gary Brecka?

  Right.

• 43:46Speaker 00

  And then over time, that's how we get that progressive overload that actually rebuilds the muscle.

• 43:51Gary Brecka?

  And it really helps them focus on those nerve pathways, you know, I I've had like Chris Bumstead, you know, uh, was he six or maybe even eight time Mr. Olympian?

• 44:00Speaker 00

  Incredible.

• 44:01Gary Brecka?

  Eight eight time Mr. Olympian, I think.

• 44:03Speaker 00

  Amazing.

• 44:04Gary Brecka?

  And and he talks a lot about the the muscle mind connection. And the difference between sort of mindlessly working out and pushing weight and and thinking about the muscle contraction, being very present for that muscle contraction, you know, just having your brain and your muscle seemingly connected during that that exercise. How important is it for people that are trying to build strength outside of somebody who's trying to get super athleticism or, you know, become a bodybuilder, but in older ages to return that strength? Do you do you do you have them draw their attention to those muscles? Do you find that that helps?

• 44:42Speaker 00

  A hundred percent. And what I would say is it's fascinating how many of the techniques we use now with the older population originated in the bodybuilding world.

• 44:52Gary Brecka?

  Oh, really?

• 44:53Speaker 00

  Yeah, it's it's amazing. And this is one of them. So the mind muscle connection we used to think of as just for guys that are trying to get huge. But it works just as well for older people that are trying to build some strength back up in their quads, right?

• 45:06Gary Brecka?

  Yeah.

• 45:06Speaker 00

  And there's there's evidence to show that it isn't just what your muscle itself can do that produces the contraction, it's how well neurally you can connect to it.

• 45:17Gary Brecka?

  Yeah.

• 45:18Speaker 00

  That's very well established. And just concentrating on it is a way to improve it 20, 30% just like that.

• 45:24Gary Brecka?

  Yeah.

• 45:25Speaker 00

  Just having that presence of presence of mind to do it, definitely. So I try and avoid telling people to do exercises absent mindedly while watching TV.

• 45:33Gary Brecka?

  Right.

• 45:34Speaker 00

  I think they deserve the full attention, especially if we're just doing, you know, a minute to two minutes worth of work at a time.

• 45:39Gary Brecka?

  Right.

• 45:40Speaker 00

  Everyone can put down what they're doing and just focus on that thing because you get so much out of it.

• 45:44Gary Brecka?

  Yeah, I you know, I noticed that uh, the The chiropractor physio that's working with my father will have him do it in front of a mirror sometimes.

• 45:51Speaker 00

  Oh, it works so well.

• 45:52Gary Brecka?

  Right? So he can see like what side he's leaning to and, and you know, visually corrected. And I think probably at the same time, that visualization going back into the muscle in real time and that real time feedback. And Chris talks about that too, you know, working out in the mirror. And people think, oh, you're just trying to be your vein. You just want to watch your muscles flex. But you know, just to make sure that they're symmetric and they're, and, and also it just has your mind lock into, okay, we're working on our shoulders now. And really drawing your attention to that.

• 46:24Speaker 00

  Yeah.

• 46:24Gary Brecka?

  So, hey guys, let me tell you about one of my favorite new hydration drinks. Now, this is for distance athletes, HIIT cardio exercisers, people that sweat a lot or exercise intensely. And A Game is a hydration drink. It has eight essential vitamins. It has all of the electrolytes, the entire suite of B vitamins. Before you freak out and read that it has 21 grams of sugar, which it does, the sugar is coming from natural cane sugar and honey. My preferred mechanisms for getting glucose into the blood during intense exercise. It also has natural flavors, but these natural flavors don't come from bacterial fermentation. They actually come from real citrus fruits and the color is from vegetable juice, not artificial dyes. So next time you're looking for a great hydration drink and you're exercising intensely, A Game is your choice.

• 47:08Gary Brecka?

  Now let's get back to the Ultimate Human Podcast.

• 47:12Gary Brecka?

  So the, the main reason why people were coming to you was for pain, either post-surgical recovery or for pain that had become chronic. On your site, do you have the exercises that we just talked about? Can somebody go to your, join your, uh, uh, join your membership program and actually get some of these exercises for them to do at home?

• 47:34Speaker 00

  Yeah. The membership program is about putting it into structure for people, but you don't need to join the membership to get them. I've got it all on my YouTube channel, all broken down for people.

• 47:43Gary Brecka?

  Yeah, I've watched, like I said, I watched, I've watched a bunch of them and they make perfectly good sense. So what was the impetus for now wanting to put this into a book?

• 47:53Speaker 00

  It's a great question and.

• 47:56Speaker 00

  When I was thinking about how I could best help people, because this is where the motivation comes from. I want to reach 100 million people over 50 and actually impact their lives meaningfully in some way. And the first book I released.

• 48:10Gary Brecka?

  Well, you've impacted mine, so that's 99 million, 99,000 you have to go.

• 48:14Speaker 00

  I'll share that garage, thank you. I'll put your name down.

• 48:16Gary Brecka?

  I'll give you one, yeah.

• 48:18Speaker 00

  So the first book, I got so many messages from people saying what an impact it had. So I knew that a book was a great vehicle for that. And I recognized that there were two types of people who were coming into my clinic who both needed help. And perhaps the way we were helping them was incomplete. So the first type of person was the person who was in a pretty bad way. They were in pain. They'd been told by a doctor or by friends that, you know, nothing can be done for you. This is just your age. What do you expect?

• 48:52Gary Brecka?

  At some point, we'll do surgery.

• 48:53Speaker 00

  A hundred percent. They'd gone downhill, you know, they'd lost their strength. They'd lost their mobility and they were just feeling hopeless. And they didn't know where to start. It just felt like there was nothing they could do. I wanted to put in one place all of the strategies and the tactics that I've used with my clients that they could follow so that they wouldn't feel so overwhelmed and wouldn't feel like they were hopeless. And they could actually see light at the end of the tunnel. So that was the first group of people. And then the second group of people are quite different. They're people who are very health conscious. They're already doing a lot for their health, but they're listening to all the podcasts. They're watching all the YouTube videos, even all of mine. And it's like, where do I start now?

• 49:38Speaker 00

  Like, I want to do the right thing for my health, but I'm walking 10,000 steps. Now someone's telling me I shouldn't do that. And I'm doing this diet. And now someone else has said, that's actually the worst thing you can do for your health. I'm lost. So I wanted to give them the minimum effective dose, science-backed answer to this is what you actually need to do if you want to see progress. So I put, I kind of had both of those people held in my mind when I wrote this book. So that's who it's for.

• 50:05Gary Brecka?

  And so you can meet somebody wherever they are on their journey, right?

• 50:08Speaker 00

  That's the idea.

• 50:08Gary Brecka?

  Some of the sub 12 on the stand to somebody that actually wants to go to the next level. And you know what I'm, I'm really encouraged by is it seems like the last five years, we've really drawn attention to how much control we have over our destiny.

• 50:25Speaker 00

  Yeah.

• 50:25Gary Brecka?

  You know, I think until the pandemic, almost, most people felt like their healthcare choices were in somebody else's hands and healthcare wasn't something that you reached out for until you, you needed it. There was either a pain or an incident drove you to the yard, drove you to the urgent care, made you make a doctor's appointment. But we're realizing now that it's going to be so much easier, easier to keep people out of the system.

• 50:52Speaker 00

  Yeah.

• 50:52Gary Brecka?

  Right? Then it will be to fix the system. Right? I mean, I'm a big part of that with Maha Action and some of the other organizations I give time to. So Independence for Life, I love it. I'm going to put them, it's out now, right?

• 51:06Speaker 00

  It will be out when this airs, yeah.

• 51:07Gary Brecka?

  So I'll have a link, link in the show notes for the book. This has been amazing. My VIPs have a lot of questions for you.

• 51:15Gary Brecka?

  So my VIPs, the ones I tell before the podcast starts, you know, who's coming on the podcast?

• 51:19Speaker 00

  Yeah.

• 51:20Gary Brecka?

  If you're interested in becoming a VIP, just go over to theultimatehuman.com/vip and you can sign up and I'll see you in these podcasts and I'll see you on some of the live sessions. But I wind down all of my podcasts by asking my guests the same question. And there's no right or wrong answer to this question, but what does it mean to you to be an ultimate human?

• 51:39Gary Brecka?

  Because I feel like you're an ultimate human.

• 51:43Speaker 00

  I would say no, there's a lot I'm still working towards, I would say, but I'm on the right path, I think. In answer to your question, the word I would keep coming back to is momentum. And momentum is obviously a movement word, and I think movement is obviously so important. It's what I've built my career around. But I think momentum also describes progress. And I know personally for me that when I felt at my best, it's been when I can actively feel like I'm making progress towards something. If I'm flatlined or if I'm declining. I'm a terrible version of myself. So I feel like everyone just needs to feel or to get into a position where they feel like they are making progress and they do have some momentum.

• 52:28Speaker 00

  Because momentum is a privilege and it keeps you driving forward. So I would say that's my definition.

• 52:34Gary Brecka?

  That's great, man. What a great answer. Well, guys, I know you're gonna enjoy the book. I'm definitely gonna read it. I'll put a link to it in the show notes. And until next time, that's just science.