Sports Science Dudes

Episode 81 - Marieta Buse ND CISSN - Integrating Naturopathic Medicine and Sports Science

• Jose Antonio PhD

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Ever wondered how a holistic approach can redefine sports medicine and athlete care? This episode features the insightful Dr. Marieta Buse, a naturopathic doctor and Certified Sports Nutritionist (CISSN), who shares her journey and extensive knowledge on treating and preventing injuries through naturopathy. Dr. Buse offers a compelling contrast between the training required to become a naturopathic doctor in North America and programs elsewhere. She also walks us through her multifaceted approach, encompassing hands-on therapies, lab testing, diet, and supplements to enhance not just musculoskeletal health, but also cardiovascular and digestive well-being.

Dr. Marieta Buse ND, CISSN

Dr. Marieta’s passion is sports medicine, with her background in naturopathic medicine. To treat and prevent injuries, she uses hands-on, physical therapies to restore and maintain functional alignment of the body. The benefit of a naturopathic approach to care is that she uses lab testing, diet and supplements to enhance the function of all systems of the body beyond the musculoskeletal system, including the cardiovascular and digestive systems.

Dr. Marieta works with all-level athletes & outdoor enthusiasts to optimize performance, health and general well-being. When not in the clinic, Dr. Marieta can be found in the great outdoors enjoying her favorite sport, rock climbing.

About the Show

We cover all things related to sports science, nutrition, and performance. The Sports Science Dudes represent the opinions of the hosts and guests and are not the official opinions of the International Society of Sports Nutrition (ISSN), the Society for Sports Neuroscience, or Nova Southeastern University. The advice provided on this show should not be construed as medical advice and is purely an educational forum.

Hosted by Jose Antonio, PhD

Dr. Antonio is the co-founder and CEO of the International Society of Sports Nutrition and the co-founder of the Society for Sports Neuroscience, www.issn.net. Dr. Antonio has over 120 peer-reviewed publications and 16 books. He is a Professor at Nova Southeastern University, Davie, Florida in the Department of Health and Human Performance.

Twitter: @JoseAntonioPhD

Instagram: the_issn and supphd

Co-host Anthony Ricci EdD

Dr Ricci is an expert on Fight Sports and is currently an Assistant Professor at Nova Southeastern University in Davie Florida in the Department of Health and Human Performance.

Instagram: sportpsy_sci_doc and fightshape_ricci

 

Dr Jose Antonio:

Welcome to the Sports Science Dudes. I'm your host, dr Jose Antonio, and filling in for co-hosting duties today is dietician and PhD student Cassie Evans. You can find our podcast on Spotify, youtube and Apple Podcasts. If you get us on YouTube, make sure you hit the like button. Hit it as many times as possible.

Dr Jose Antonio:

And today our special guest is Dr Marietta Buse. She's an ND and CISSN. She has a background, obviously, in naturopathic medicine, and a little bit about her. I don't know why people are texting me Cancel. Okay, actually, I need to turn off my phone. To treat and prevent injury, she uses hands-on physical therapies to restore and maintain functional alignment of the body. The benefit of a naturopathic approach to care is that she uses lab testing diet and supplements to enhance function of all systems of the body Beyond the musculoskeletal system, including the cardiovascular and digestive systems. Dr Marietta works with all-level athletes and outdoor enthusiasts to optimize performance, health and general well-being. Works with all-level athletes and outdoor enthusiasts optimized performance, health and general well-being. When not in a clinic and this is kind of cool you'll find her the Great Outdoors. We all love the Great Outdoors. She enjoys her favorite sport, rock climbing, which is super cool.

Dr Jose Antonio:

And before we start the show. I do want to mention that you did a really good job with your ISSN miniseries. You have the part one on protein absorption, part two on HMB, part three, creatine, part four pyramid of anabolism, part five low energy availability, and then part six. The position stands and this is on Instagram, so make sure you go on our page. It is inspire the climb. Is that correct? Inspire the climb? Yeah, thanks for coming on the show.

Dr Jose Antonio:

Marietta appreciate it thank you so much for having me well, I think well, one of the first questions I have, because I'm not familiar with the nd process and I think the audience also would want to know what is the and I I tried looking this up the difference between nd, md, do and basically the whole slew of clinical. There's so many clinical doctorates now that I, you know, I can't keep them straight. So explain the process and why you chose this route versus, let's say, other routes.

Dr Marieta Buse:

Yeah, so in terms of the designation, like, like naturopathic doctors, to protect a title like DC and MD, rmt, and so essentially to be a naturopathic doctor, you have to do a postgraduate degree, so you do an undergraduate in my case it was in biological sciences and you have to get certain prerequisites similar to the process of applying to medical school, like.

Dr Marieta Buse:

So you have to have like organic chemistry and like physiology, things like that our favorite courses, yeah love that and then, uh, yeah, you do the interview etc, apply in and then it's a four-year degree for naturopathic medicine. It is different than, let's say, if you were to be a naturopath like in europe. I think it's like two years online, like that kind of stuff, whereas like in North America, it's well established that it is as much as we can do a medical degree for it. So we in those four years are learning in-depth anatomy, physiology, and then we are also layering on these kind of like alternative medicine practices. So we do four years of nutrition, botanical medicine, physical medicine.

Dr Marieta Buse:

So it is a lot that's packed into four years, a very, very, very intensive program. But when we graduate out of that it's basically up to the practitioner to figure out like, do you want to niche? And like work in a city, let's say, where you'll see people. That, for example, with me, like I work in Vancouver, so I'm focused more on sports medicine, but you'll see naturopathic doctors in more rural parts of whether it's in the US or in Canada. They're working very much like general medicine, just basically trying to support the medical system. If there aren't enough primary care physicians, they'll kind of help fill in the blanks there if they need more support in that kind of community. So yeah.

Dr Jose Antonio:

Now, when you use the term alternative medicine I know here I really can't speak for everyone, but the physician community and I guess primarily MDs and DOs and actually even scientists will when they hear alternative medicine they automatically assume that well, if it's alternative medicine then it's not medicine, it's something else. And I think maybe I guess defining the term so that when someone says alternative medicine it means because I think you threw nutrition in there, which I've. To me nutrition is important. I mean, you know Cassie would agree we don't consider it alternative medicine. It's just you know you should eat well and it's good for you. I guess technically it could be alternative medicine. So how is that defined?

Dr Marieta Buse:

Yeah, I think even in BC we've gone over some pretty big changes like legislation, like I think now we are now grouped in under. I think we're calling us like complimentary medicine, and so it's like naturopathic doctors, chiropractors, rmts, and we're all kind of like grouped together. So yeah, in terms of alternative medicine, it's just something that I kind of threw out there, because when we think of like chiropractic adjustments, which is like one of the physical modalities that we learn, or botanical medicine, it's not part of what you would think of like a conventional medical degree. And that's where I was trying to make a little bit of that comparison is that with our degrees within the four years, we've used that template of what they would learn in like, let's say, conventional traditional medical school. But we're trying to also superimpose in a bit of a more broader perspective of the body. When we're graduating out of the program and we're looking at the body, it's not, as um I would say, linear, like within the conventional system. It's very like X equals Y equals Z. When we're thinking of the process of a diagnosis. When we're looking at the body, it is very much. A lot of it is influenced actually from like traditional Chinese medicine, like we learn acupuncture, or like Ayurvedic medicine, where it looks at the body more like many systems that are interacting more at once, which, from my perspective, that was a big pull, because when I was in my undergraduate degree I was actually on course to do like the pre-medical sciences at Western University and I was very gung-ho about going down the medical school route.

Dr Marieta Buse:

In the meantime I got sick and I found that I was kind of falling through the cracks of the medical system, like you kind of are in this place, like especially in my case where there weren't enough tests or things that were showing up that would allow for me to go down like a more referral type of system, go down like a more referral type of system, and so, because a lot of the tests are coming back normal but I wasn't feeling well, it allowed for me to kind of have a different perspective and, especially with having now graduated out of the program, I do see a lot of benefit of seeing the interplay of different systems, rather than if a patient were to be in the conventional system, they will often be referred to just a gastroenterologist or just a cardiologist, whereas oftentimes especially when we're working with athletes, like you'll see a lot of these systems interplaying with each other and I think that is a very, very important piece.

Dr Marieta Buse:

So for me, like I try and work with medical doctors, with chiropractors, with RMT, so that it is a bit more of like this, like systems support, and looking at it from very many different perspectives, because you never really know with a patient or an athlete what is really going to help or resonate with them.

Cassie Evans:

Well, I think too, like you said, with conventional medicine, a lot of time it's like, well, if you're experiencing a, let's just give you this to experience a, and now maybe you like get another symptom B, and now we're going to give you something just for B, but we're not really identifying, like what is the root cause of everything. We're just trying to fix what you're experiencing and and, like you said, I think it's more common in women to have that same sentiment is I, something doesn't feel right, and then, but your labs are coming back normal, and then a lot of time, the doctor's telling you that you're just like being dramatic or you're depressed or you're something else, when, like you, you know that something's not not white.

Dr Marieta Buse:

Yeah exactly.

Dr Jose Antonio:

Well, what is the um? Well, let me tell you, sir, when I was this is uh. When I was, when I was in grad school, I suffered. I was pulled by low back from lifting and I probably pulled it twice a year. And I almost did it the same way doing bicep curls, standing curls, always too much weight, because that's what guys do.

Dr Jose Antonio:

So what would I do? Well, first thing, I'd go to a physician. Physician gives you drugs Okay, maybe the pain goes away, but it's always there. Then the physician says, well, go to a physician. Physician gives you drugs Okay, maybe the pain goes away, but it's always there. Then the physician says, well, go to a physical therapist. So I go to a PT. And they would say, well, you got to show up three times a week for the next 12 weeks. I'm like, screw that, I ain't doing that. So by then it probably resolved itself.

Dr Jose Antonio:

But then I had a friend who was a personal trainer, who actually had no formal education but was very smart. He's like you know what? Just go to my chiropractor, I bet you he'll fix you. So I remember my dad telling me who was a physician. He got his MD at Far Eastern University in the Philippines. He said, oh, chiropractors are all quacks, bunch of quacks. And that stuck in my head for like years and so I'm thinking, hmm, I wonder if they are quack. So I went to this chiropractor, still had low back pain. I'd never been adjusted in my life and he adjusted my, my neck and my back and I stood up and I was like, wow, I don't feel pain. This is really weird.

Dr Jose Antonio:

And so after that I had a much more open mind towards I guess you could call it alternative medicine and, oddly enough, my view of traditional allopathic or Western medicine has kind of taken a nosedive, particularly with COVID and how things that make you healthy were just completely ignored For like literally two years. No one talked about exercise, no one talked about being outside getting sun, no one talked about eating well, no one talked about maybe you should lose weight. It was vaccine, vaccine, vaccine. Take this drug, take this drug. And it's like I don't think this is working for most certainly most Americans as you know you're in Canada, but Americans are grotesquely out of shape. I mean the majority of them. So that was a long preamble to ask you how do most traditional people in medicine, dos and MDs, view what you do?

Dr Marieta Buse:

It's definitely going to depend on the state or province that you're in, because, for example, Ontario and BC, we have a naturopathic school and so there's a higher like caliber of practitioners and more of us here where we're kind of setting that precedent, especially on the west coast, and that does even include like down into some of the western states, um like Washington that also has a really good school, that um are very, very progressive with their um medical models, and so that's not to say every doctor in BC is like, yes, we love naturopaths.

Dr Marieta Buse:

No, there's definitely going to be some that are like poo-pooing it or like no way, never going to work with them but, he's really refreshing because, like I, had the perspective that would go into practice and that, like every medical doctor would like hate me or something like that, and that's actually not been the case. I find that more times or not, if I'm working with a patient, that their family doctor is really willing to work with me as a naturopathic doctor. So for the most part in these kind of more like Western provinces or like Ontario where they have a good, strong school, that the relationship will be better. But it's again, it's more of like having that like open-minded kindness to reach out. Oftentimes, if you put a face to the name or the designation or the profession, chances are, if they're speaking with you and they're seeing that this is a normal, intelligent person that's not quacky or anything like that, that they will engage with you and it's always, at the end of the day, for the benefit of the patient. That's what we're both there for. So from that perspective again, it's, it's, it's quite good, um, I think.

Dr Marieta Buse:

I think it would be very rare to come across like a chiro that's wouldn't be working or jiving with a naturopathic doctor. Like I think for the most part we're like in the same kind of like dogma or worldview of how we think, see things. So there's a lot of similarities there. Um, beyond the west coast there is a little bit more of that example of like complementary care between many practitioners working together. I can't speak as much to a lot of the US states, but I know that there are at least seven schools in the? U, the US, and so are six to seven of them, and in those states you'll see that the laws of what a naturopath can do, like, what is their scope of practice and how much that may or may not be similar or mimic what a medical doctor can do, and that is like a definitely thing that you'll see.

Cassie Evans:

I think they're trying to push to more collaboration because that's a big thing too, like. So if you have somebody else that's not willing to collaborate with you, then it kind of makes it really difficult. So as a dietician we're not always thought of very highly. I think sometimes in like the collaborative team, depending on what I guess population that you're working with. But I have noticed that, like at least in my experience with the eating disorders, the treatment team is very obviously willing to collaborate with you, with the doctor. But I think sometimes on the clinical side of things people do forget the food or the nutrition part, and so they're kind of more quick to dismiss the value of having a dietitian on the team.

Dr Jose Antonio:

Tell us a little bit about the um. You've done some work with gymnastics and also, obviously, climbing in terms of reds. Um, tell us a little bit about that. And then later on, I do want to ask you how you train for climbing, cause it's one of those, one of those very esoteric sports. And here's the thing my exposure to climbing is watching the movie free solo and I'm like, wow, that's that guy's kind of crazy.

Dr Marieta Buse:

Uh, I don't know the ones who want to do this yeah, so in terms of red s, or like relative energy deficit syndrome, um, it has a very high prevalence within weight dependent sports, like um climbing gymnastics, and so that is something where I think, as a National Weather Doctor, I'm very well positioned, because the Can I stop you there a second?

Dr Jose Antonio:

You said within climbing, would this be? Male and female climbers would have reds.

Cassie Evans:

Okay, my understanding. They kind of brought in using reds instead of the female athlete. Try to include men as well, because they can absolutely suffer from energy deficiency, although may look a little bit different.

Dr Marieta Buse:

Yeah, a hundred percent. And so, um, I guess, when we're thinking of like red S in these sports and where the athlete may be more likely to, let's say, be under eating combination with overtraining as a naturopathic doctor, because I've had the education to look and be able to do testing, treatments for every system of the body, and you never really know with red s what system is going to show up so I think that's where they really did do such an amazing job with the ioc and their um concessions, concessions. That's the statement on the uh red s, that it can be in the urinary system, it can be in the mental system, it can be cardiovascular or digestive or mental, and so when I'm working with a patient, I think it's so incredibly important to take a look and not just, I guess, diagnose like okay, they're having, let's say, diarrhea, and it'd be so easy to like go down that route and be like, do we need to do food sensitivity testing? Do we need to put you on this supplement or this medication? When, if you take a step back, you look at the athlete as a whole and you're actually seeing like, how much are they eating? What is the calorie, what are the protein, what are the demands on the body and like in terms of physical and mental, especially if it's a child in school?

Dr Marieta Buse:

And so taking that step back and looking at the whole athlete is incredibly important, and I think naturopaths are very well positioned to be able to do that, because we get education in all of them and be able to support the athlete, as we're, yes, increasing calories, doing the best to decrease the load on the body, whether it is a combination of mental and physical. Physical in terms of training, mental if there is any sort of exam, stress and other type of stresses going on in their life. So we're doing that for sure, cause that is, like we said, the root cause. We never want to miss the root cause, but, at the same time, we also want to make sure that, like, they don't have diarrhea every single day when they're doing this.

Cassie Evans:

So, yes, we can do some more targeted supplements and things like that to help ease that load on the body as they're healing and, hopefully, like, returning to full performance hey, you mentioned something about the weight dependent sports, so in in climbing, because I'm not as familiar with it is, are there actual specific weight categories or is it more of the performance advantage of being smaller and leaner?

Dr Marieta Buse:

There is a very long history of misconception that the leaner you are, the better you'll perform. The lighter you are, the less load on your fingers as you're climbing up, and there's been a very big push and pressure on the IFSC. So the international sport climbing federation, that essentially they were. We were seeing as the public, the medical doctors that were working with them, the athletes, were saying that this is not okay. Like when we're looking at the people that are competing. Too many of them are way too mean. They look quote-unquote like skeletons.

Dr Marieta Buse:

I was like a big word that was really thrown out is not rearing the next generation of skeletons.

Dr Marieta Buse:

It was a big thing in our community and because of that push onto our governing bodies, they did finally kind of come back and put a little bit more emphasis on proper screening.

Dr Marieta Buse:

Not that Bmi is the best marker.

Dr Marieta Buse:

We know that there's a lot of holes there but at least it's a step in the right direction to make sure that we're screening athletes. If you're not meeting this bmi, you need to have a medical doctor take a look at you, do a proper red s screen, make sure that there isn't any health outcomes, because, yeah, there may be an athlete that is quote unquote normal health but has a lower bmi. So, again, with climbing, I strongly work with climbers and especially with young athletes, to really reframe that and make sure that, like, we want to be fueling the body for performance, we want muscle, we want to have strength, we need to have muscle bulk around our joints to actually like, help keep stability there and help be able to actually like, pull and use and generate power. So, again, like even within gymnastics, we're seeing a bit more of a shift on that perspective of like leaners not always better, and the more you're feeling yourself, not only can you perform better, but you're also going to have better like long-term health outcomes, like less risk of nutrient deficiencies, etc.

Dr Jose Antonio:

So, yeah, the difference, I think well, between climbing and gymnastics. Actually climbing in any sport is, I guess, depending on how you do it, there's much greater risk of injury and death. Now I don't know what kind of climbing you do, but I would imagine death would be. I mean, if you're free climbing, then there might be death. Now that's sort of a preamble to the question of you know, using BMI. When I look at climbers just I go on YouTube I'm like, okay, let's see what this guy's climbing, whatever. At least the guys all look quite they have long limbs. At least they seem to have long limbs, maybe because they're just skinny, they're all thin. You can't be, you can't carry any excess fat as a climber. So there does seem to be a body type to climbing. That that I guess the question is. I don't know and this is me asking because I don't know, and this is me asking because I don't know anything about climbing I don't know if there should be a minimum, like you have to be a certain BMI above whatever that threshold is.

Cassie Evans:

Well, I think it's more of screening, because I think BMI is really I personally, in my experience for the low end of things. I think it's actually great for picking up on somebody that's potentially underweight. So if you have somebody that's potentially underweight in any sport, not just climbing, you would want them. So I don't necessarily think it's like a requirement per se. It's more of like a red flag. Hey, like they're underweight, you need to assess like, are they just somebody that's always fallen on, like the I don't know 10% of the growth chart their entire life and that's just how they are? Or is this somebody that is clearly not getting enough nutrition and energy and needs to address some other things that I don't think it's or maybe I'm incorrect. I don't think they're banning them, no it's a hundred percent, it's the.

Dr Marieta Buse:

It's not necessarily that it's a hard fast rule. It's that we're trying to screen our athletes rule. It's that we're trying to screen our athletes. If you're falling below 18 as a BMI, then that is a requirement for a medical doctor to then come in and do a screen and see is there a health issue going on here? And if there isn't, great they can compete. That's not the issue now.

Dr Marieta Buse:

In terms of body type, it really depends on the climb itself and that is so. Okay, maybe let's kind of piece things out a little bit. But in terms of, like, outdoor climbing and indoor climbing, very, very different things like almost compare like running on a trail outside versus like running on a treadmill, like very different sports. In terms of, like what's going on now you can use indoor climbing as a tool to train for outdoor 100%. When we're taking a look at competition climbing, which we've seen in the Olympics now, like two times in Tokyo and now in Paris, and so that type of climbing is very different. We'll see three different disciplines. We're seeing the bouldering, so you're not using any rope or gear, you just climbing us to a certain height and falling onto safe crash pads, like the heights are not insanely high where there's a high risk of injury. These are.

Cassie Evans:

I've seen this like hiking before, like I've been on a hike and I've seen people with what almost looks like a gymnastic mat under, like a rock, yes, and then they're and then so they fall and they know how to like safely fall, and usually if you're outside climbing you'll have a spot or etc.

Dr Marieta Buse:

But in terms of competition bouldering it's a specific type, um. So there's like bouldering. Then there's like sport climbing, where you're actually like using gear, you're using a rope, you're clipping in because the heights are actually quite high. You can't fall safely from those heights, um. And then you have like speed climbing, which is like, again, you're still geared in. It's just like an auto belay, you're going as high, like fast as you can and clicking the buzzer, kind of thing.

Dr Marieta Buse:

So those three disciplines, um, speed climbing, yeah, like there's a specific type of body type that does tend to do really well with that, um for sure, but with the rope climbing and with the bouldering, it does really depend on the movements that you're doing. So you can have a smaller climber that can kind of compress into a smaller position and actually be able to generate force easier than someone that's very tall and they can't quite fit their box into that movement. Vice versa, um, for that, like there was actually at this past olympic a shorter climber that wasn't able to run up and then jump and kind of do a compression movement which was a lot easier for the taller climbers to do, and so there was that discussion with the route setters. Did they make that appropriate? Are they unintentionally screening out um, a good candidate, like a good uh climber, just purely because they're not able to do that move, because they're shorter, they can't quite get that height there.

Dr Marieta Buse:

So there is a potty type to an extent, but in terms of like height and like everyone is going to have strengths, like even when I take a look at my climbing, like I use a ton of like my legs because they're quite strong to be able to use, like my heels and my toes to keep me close to the wall.

Dr Marieta Buse:

So there is, but you can always find an advantage for your type and everyone's going to have a different style or different preference and like lean towards certain types of climbing for sure. So it's not a hard fast rule and we're really trying to kind of dispel that like you have to be this super lean, like no body fat and like under eat, especially the under eating like that has been such a huge issue in the culture that is trying to be reframed and shifted away from, and I basically educate this new generation that, like you need to eat. You need to eat for performance and to get nutrients and to climb well and for your life, like your whole life, like we don't want you burning out, which we do see a lot, unfortunately, if they're not eating and they have, for example, red ass and injuries and they end up burning out from the sport.

Dr Jose Antonio:

A quick digression. I meant to ask this earlier. In the United States, only physicians and dietitians can do MNT right. Cassie, medical nutrition therapy.

Cassie Evans:

To my knowledge, yes.

Dr Jose Antonio:

Can naturopaths do it?

Cassie Evans:

Like a wellness coach per se. Actually, it depends on the state. So in states from a dietetic standpoint, so in states like New Jersey and New York and, I believe, california. There's a couple other states, but those are the three that I know for sure, where licensure is not a requirement to be a dietitian, you can be a nutritionist here in Florida- Well, I'm talking about specifically MNT, medical nutrition therapy Right, but which?

Cassie Evans:

is essentially just curtailing someone's diet. For instance, if you have, like a glycogen storage disease, right, it's eating a certain way to support that your blood sugar during glycogen storage, right. So like you, if you're knowledgeable in it, essentially you could do it in New York even though you're not a dietitian but you have a nutrition background or a nutrition degree. But in the state of Florida you're you're not supposed to so for like a lot of the things sometimes you'll see, like, eat this for your gut health. I mean technically is MNT, because now you're addressing a medical issue through diet. So I think it just depends on the. So I would assume it's going to be the same for a naturopathic doctor. It just depends on the state and their regulatory thing, which I think you kind of said that Canada has something similar, that in like some areas To some extent, like I would say, at least within like Ontario and British Columbia, columbia.

Dr Marieta Buse:

We again, because we're like naturopathic doctors, under that umbrella we are allowed to do clinical nutrition. Now they're like you said, there's like nuances to that. So most of us coming out of our like four-year degree are quite proficient and let's say, yeah, working with patients that have digestive issues and doing gut protocols, etc. Like we are very well positioned to be able to do that. Now there are practitioners that come out of school that choose to focus in a specific discipline. So, for example, with me with sports medicine, I knew that what I learned in those four degrees, it gave me a good foundation. But not with working with athletes. Like I had to go get that education. That's why I got my CIS at CENT.

Dr Marieta Buse:

Um same thing with, for example, um there's naturopaths at work with cancer patients. Um, we have to have a FABNO designation. So essentially we have to get um like a residency where we're like properly trained in working with cancer patients. So again, nutrition for cancer patients would be very different and really specific. Um same thing if someone is going to like, for example, work with, like kidney patients. There's so many nuances there like you have to really be on point to know what you're doing. So the expectation would be that you've, like, had the training to be able to work with that type of patient proficiently, and so in provinces like BC and Ontario there are systems in place for that.

Cassie Evans:

I can't speak as well to the States and where the line is drawn as to what's like allowed and not allowed, but yeah, they have like well, within dietetics, within the Academy of Nutrition and Dietetics, they do have like additional, like certifications or designations, like what you were talking about. So you can have like the diabetes certification, there's one for eating disorders, there's one, I believe, for cancer as well. I would not be surprised I'm not as familiar with the academy, although I should be but I would not be surprised if they have one for athletic athletics as well. But it is kind of like what you're saying. It's in addition to what your schooling was, cause I felt very much.

Cassie Evans:

I've felt like you many times after completing a degree where I'm like okay, but I need. I'm like this is this is great, but like now for like the population I want to work with, but so it's, yeah, you have to do so many hours, you have to in some cases take a certification exam and whatnot. So from somebody that works with athletes but then also the naturopathic background, I know that outside of reds, just demanding training schedules and sometimes the stress of life and being an athlete can put athletes at risk for maybe an upper respiratory infection or just maybe a common cold if they're run down. So what is your go-to Cause? Like I grew up with my dad, like saying, just vitamin C. Vitamin C, like what is your go-to for, like the common cold, if you know, cause not everyone's going to take medicine, and I'm just very curious, like what your take on that is.

Dr Marieta Buse:

Yeah, like that's, for example, something that I would see, even like, let's say, a red ass patient like a client, like a athlete, young athlete coming and they maybe historically, as a child always had chronic recurrent ear infections and then, as they got older, like recurrent tonsillitis, and then they're an athlete and now suddenly, like every competition, they get sick and then they have to take time off of school etc. So, um, let's say, in a situation like that, to make it a bit more of like a case study, if they're coming in and they actively have an infection, we obviously have to discern if it is strep throat, they probably need to be on a medication, like an antibiotic, and that does fall within our scope as naturopaths in BC. We can prescribe medications here, like a limited one, but we can prescribe. So that might be first line, get rid of the infection, okay. But then, like, as we know, like everything that you take, there's pros and cons, there's going to be consequences, and so, if they are on, let's say, an antibiotic, we're also going to be making sure to try and replenish that gut microbiome, get them on a good quality probiotic and then, once we've kind of like helped, transition them out of that like acute state um. So let's say, to go back to like maybe they didn't have like a infection like, uh, like a bacterial infection, maybe it was more like cold or flu, kind of more viral in nature.

Dr Marieta Buse:

Then, um, personally with me, like I'll work with um like a botanical compounding um pharmacy where we can actually create different tinctures. And for me, like I do tend to really like combining and it depends on the athlete in front of me and what works with them. But obviously, like echinacea is going to be a really great one. Um garlic onion, like those are ones that tend to be really antimicrobial in nature, so you can include those into a formula. But I will also again try and take a step back and take a look at the whole picture. Like maybe I need to throw in some herbs in there that have more secondary actions towards like maybe, especially if it is happening at competition time where it's like stress is super high, that we need to have more like adrenal or adaptogen type herbs in there. So those would fall under, like reishi, which works under the immune system, or cotinopsis, which works under the immune system, or things that are more targeted to the adrenal system, like pan-extensing and stuff. So there's a bit of room there to do, yes, very, very targeted for what's in front of you, but then work on what else is going on with the client and then especially with something like they have a long history of like constant, really, just essentially a very susceptible immune system. So when they're in a situation of red s and which of the systems most likely going to go it's the immune system, because they have a more susceptible immune system, then I would.

Dr Marieta Buse:

I would prescribe something like one of, for example, a product saint francis has deep immune and I really like that product because it's very comprehensive and like basically tonifying or buffering up that more weakened system. So it has um astragalus, which is a really good herb for the immune system, has codonopsis reishi, a couple other herbs, again like panax. Schisandra is another one that's in it there too. So as a formula I really like that one. And again, you can play on capsules or tincture. I tend to prefer tincture, especially if I'm working with an athlete, where they're a child and smaller and you want to kind of like dose it appropriately for them.

Dr Marieta Buse:

And a lot of times with these kind of antimicrobial formulations you can play around with the dose, like maybe the first bottle, like when they're like acute, whether it is cold, like a viral infection or strep throat if we have them on this deep immune at a higher dose, like, let's say, I don't know half a teaspoon three times a day, to kind of kick it for the first bottle, that will maybe last three weeks and then after that we would have them on a lower dose, like maybe just half a teaspoon once a day, for a little bit of a longer period, like three to six months, because again, the immune system needs time to actually respond to the therapy.

Dr Marieta Buse:

And from there on out, like hopefully, yes, we've like helped buffer their system. But if we see that like their susceptible system is immune system every time they get stressed, then yeah, maybe we will have a bit more of a prophylactic approach where we have them go on a product like, let's say, Deep Immune, and taking it like again at a low dose for like two to three weeks leading up to a competition or something. So hopefully that answers your question.

Cassie Evans:

Very individualized, which is nice and, I guess, kind of different maybe from like the more cookie cutter approach of of traditional medicine here in the U? S, which is just kind of, I feel like sometimes like what's good for one person is good for everybody, which is we've seen is not the case. Um, okay, so he had a question about climbing, but I did too, because you had mentioned something about like training, where you like literally would just hang and like, yeah, which spider man, nearly like deadlift, because my grip strength is so poor. So like I really want to hear about this like hanging with your fingers just with weight, cause that sounds insane, it sounds like American ninja warrior stuff, like honestly a lot of really proficient.

Dr Marieta Buse:

Uh like ninja warriors are climbers or gymnasts because of that like ability to have like the coordination and it just like the finger strength. But yeah, like I I'm. It's always funny because if someone hasn't really like dived into the climbing world, like the really like sexy thing is going to be those really climbing specific things like, for example, hangboarding, campus boarding. So hangboarding is where there's like tiny rungs, you're just like hanging on the tips of your fingers. You would start first like at your body weight or maybe like one foot on um, and then eventually like no feet on and you're just hanging by your fingers.

Cassie Evans:

And then, for me, how much tip of the finger. Like are we so?

Dr Marieta Buse:

for example, for me, like I would have started out on like a 20 millimeter edge, so it's like less than your finger pad really, oh my god, um. But then, like now I, over time, I'm like worked down to like a 12 millimeter and like 10 millimeter edge, I've started nothing I'm trying to put my fingers on the desk right now and I'm like wait I have one too.

Cassie Evans:

I actually have one handy, for some reason wait, so what? Did you say?

Dr Jose Antonio:

how many millimeters?

Dr Marieta Buse:

uh, right now, like I'm working like 12 millimeters, uh, but I also add weight on top of my body weight because, again, we really want that really high strength weight ratio. So for me, like I'm hanging on a 12 millimeter with like 45 extra pounds yeah, that's less, that's nothing yeah, it's small that's a strong flexor.

Dr Jose Antonio:

Digiti minimi.

Dr Marieta Buse:

It's a strong flexor digitorum, profundus and superficial. It's really key for strong fingers, but so, again, like those are really like really specific. It's one aspect of climbing and I find that when someone gets first into climbing, like in the first year or two, they're so excited, they want really strong fingers but they actually haven't allowed for their tissues inside, like if you almost think of like calluses, like you want to be able to have like good calluses when you're like lifting, and we also want the tissue like below the calluses to also respond to whatever load you're putting onto it. And it usually takes a year or two for your tendons, like in your elbows and your shoulders and in like your ligaments and your fingers, to actually adapt to the sport. And so, yeah, I usually don't really recommend people start with like weighted hangboard type of training until they've at least had a good year or two.

Dr Marieta Buse:

Like you have to build good technique on the wall, like make sure that you're using your feet, because, like you're not going to go very far with climbing If you're just like literally bunking and not using your feet, because, like you're not gonna go very far with climbing if you're just like literally bunkying and not using your feet, for example, like you're gonna get injured. We have to as athletes, like if you're gonna be proficient and like in the sport for long, you want to be able to distribute your whole body weight from like your toes all the way up to your finger. So it requires like a very strong core type of tension and it's's more training than than just like that's what I do, maybe twice a week and then I'm training at least five days a week between climbing and bodybuilding and stuff like that. So it's it's a very small portion.

Dr Jose Antonio:

How much, how much of your training is cause? It's just, there are a lot of sports like, for instance, how do you train for running? You run. How do you train for swimming? You swim. This is one of those sports where I don't know if you just climb all the time or you separate climbing versus strength and conditioning for climbing and I'm sure there's not a magical ratio. But so, for instance, what do you do in terms of non climbing training versus climbing training?

Dr Marieta Buse:

So, again, like I've been climbing for 10 years, so what? My approach is going to be very different than someone that like, yeah, if you first start running or things like that, you want to be able to do the sport, primarily to just like understand the biomechanics and what's going on. So, for climbing, like, yeah, like when I used to teach women in bouldering, um, an intro class is at one of the climbing gyms and essentially, like you want them actually just like going and climbing and trying different angles and different types of holds and don't limit yourself to just like one angle or one type of hold. Which a lot of climbers do like to do is like I'm this type of climber, I'm a slab climber, I'm a crimp climber, whatever it is, and it's like you want to really try and get a lot of diversity and basically like teach your body the coordination that it needs. So, beginner climbers, that's actually the most important piece as you start to develop like your skill set and your technical abilities. That's where, yes, you can start to incorporate things like, let's say, twice a week, hangboarding and there's also like a campus board, which essentially that is where there's rungs and you don't have any feet and you're just like kind of launching yourself from rung to rung to rung, so it's a lot of power in your shoulders. So again, that's something like a year or two in you could start to incorporate again. You want to do it like a couple of times a week, nothing where you're doing it every single time. You need your, your tissues need time to kind of recover from it.

Dr Marieta Buse:

So for me, like I do, days where I'm campus board moonboarding, and then there's also another board called a moon board, which is a very steep angle, it's like 40 degree angle and really tiny holes, so it's just like you're really bearing down super hard but it teaches you that kind of tension that you need for really applicable for outdoor climbing. And then it's also like big kind of tension that you need for really applicable for outdoor climbing and then it's also like big kind of jumpy movements at a steep angle. So I usually don't spend long on that type of board. If you're spending like three, four hours on that you're going to get injured, like for sure, unless again, you're, um, a very, very proficient, developed climber, um. So for that type type of climbing I'm only doing it twice a week and then I'll just have general days at the climbing gym, like maybe one to two times a week, inside for two to three hours. I'll have one day a week, hopefully, where weather permits I can go outside.

Dr Marieta Buse:

For me it's usually like four to six hour days of bouldering outside, um, and then I am very like proficient or adamant about doing like the training that allows for you to like have longevity in the sport. So like the conditioning exercises that your physio tells you to do, like I am very diligent, like I don't let myself quote unquote play or go climb unless I've actually done my rehab exercises. So like I do rotator cuff strengthening exercises four days a week, like today I woke up at five when I was doing my rotator cuff exercises. I do like my wrist extensions and supination of the wrist because those are really important for, like, balancing your forearm and for me, like I do a ton of stuff for like activating my glutes and strengthening my hip flexors. So those are things that are just like conditioning.

Dr Marieta Buse:

And then for me, a big game changer was actually adding bodybuilding in, because it is such an amazing sport, um, that I had no idea until I started doing how applicable it was for for climbing, just like those like bowling ball type of shoulders that you're building, like the front and middle and back delts and oh I love it. And like even just like how much you train and how well you have to train the hamstrings and the glutes, like I had no idea how much that was actually going to translate to climbing and like literally push me up to like a different level of climbing so do you compete in climbing, or is this, is this more of a I guess?

Dr Marieta Buse:

uh, I guess people do it because they love to do it, but it's not necessarily a competitive no, like the competitors, like they're trained, like I am working with young competitors, like they're like quite young. I think back in university when I first started climbing and maybe did like one university bowling series kind of thing for fun. But most people are training from quite a young age to do it and the type of climbing that you do for competition is very we call competition climbing. It's very like parkour in nature, so it looks really spectacular when you're like in the audience. That's what they're designing the boulders and stuff. So for me I don't love that type of climbing. I try and do things that are more translatable to outdoor climbing, specifically bouldering, because that's what I like to do.

Cassie Evans:

Yeah, outdoor climbing, while I think is like really cool, would be kind of difficult to have as like a spectator sport, because a lot of times like for instance, when I came across those people that were bouldering, I this was like a couple miles into a trail, it wasn't on the fringe of a park. So I think it would be difficult and, like you said, it might not be as flashy or, you know, jumpy. So to the average spectator it might not seem as cool, but I feel like that's still that makes the sport even more special, because then you get people that are really doing it because they love it, and the people that understand it will appreciate the different types that they have.

Dr Jose Antonio:

Yeah, have you noticed? I actually have never climbed, except maybe twice, and I was in grad school at the time and there was a climbing gym and at the time this is in dallas, texas it seemed to be growing quite a bit, these indoor climbing gyms, or at least part of gyms, but now I guess I don't see it.

Cassie Evans:

I don't know if I just don't hang out with those people. We're in Florida. There's nothing like. We're flat. There's literally nothing to climb in Florida.

Dr Jose Antonio:

Well, it's true, you can climb buildings. I mean, people climb buildings, right, I mean. So I don't know, has the sport grown since? I mean, this was like 20, 30 years ago when I was in grad school. Cause, yeah, I guess Florida is not the best example. Maybe we can go to Colorado or Utah or Montana, you know, climbing's probably more more prevalent. But yeah, where's what's the status of the sport in terms of participation? You know, popularity.

Dr Marieta Buse:

Like before the Olympics, it was definitely a very popular sport and with each year it was like building more and more and more and more accessible because there are more and more climbing gyms. Like even when I came down for the conference I was like, okay, where is like the closest climbing gym? And like after the conference I went to Uber to the gym and like came back and stuff.

Dr Jose Antonio:

So oh, you found a climbing gym yeah, it was like 15 minutes away and it was actually a decent one.

Dr Marieta Buse:

Like I was like okay, this is like fun, I can do my two-hour sesh here and not miss out on the training thing.

Dr Marieta Buse:

So yeah, very cool, um, yeah, but essentially like the sport for like basically since the 2000s, was like exponentially growing and then, after the Tokyo Tokyo Olympics and just it being an Olympic sport, it like boomed and so now it's like very, very popular, I would say, and especially like yeah, like in Western Canada where we have Squamish BC, it's like one of the climbing meccas of North America. And then there's tons of them in the states like I'm super excited to go down to Red Rocks near Las Vegas to go climbing. It's going to be such an epic trip there. Um, and then, yeah, like, obviously different parts of like, even in China and parts of uh, like South Africa.

Dr Marieta Buse:

Europe has like so much good quality climbing so a lot of the gyms originally started around these climbing areas but now, like you and at least in Canada I know you can go to like almost any corner of Canada. They'll probably be some sort of climbing gym. May not be the best gym, may not have the best route setters, but they'll have something there for the most part you know, in Pompano they have kind of like an American ninja style type gym.

Cassie Evans:

So I would assume that they're they're definitely going to have maybe not like a full climbing wall, but a lot of the things that you were talking about, kind of like the rings or different, like things that you can hang on or practice like that, maybe similar movements, so maybe not exactly a full climbing gym, but I know they have climbing these climbing walls on cruise ships. We have one at Nova.

Dr Jose Antonio:

And oh, that's true, they do. There's one at the university, but you know it's funny. On the cruise ships it's kind of crazy, but people get drunk and then they start try to climb. It's. I mean it's kind of funny, but I'm like you guys, you're inebriated, you shouldn't be climbing, but anyway we're running out of time. You shouldn't be climbing, but anyway we're running out of time, you know. I want to ask you one more question in terms of your CISSN, so you know a little bit about sports nutrition. What supplements do you think are critical for someone who wants to be a better climber?

Dr Marieta Buse:

What do you think? Try and climb like a professional athlete, but they do not eat like a professional athlete, they do not train like a professional athlete. So a lot of it for me, actually, is more so. Coming back to the nutrition basics, like are you eating enough calories? Are you eating enough protein? Especially, that's a huge one that's missed. So if I'm going from that perspective and they need help to buffer their systems, like for climbing, I would say yeah, like an essential amino acid mix where they're getting like the raw amino acids to help, even if you are not ready for the day.

Dr Marieta Buse:

Collagen is going to be one to consider, especially because it is a sport that you have to be very strong at end range, so it's a huge load onto your ligaments and tendons. So collagen is one that I would consider. Vitamin c on that aspect, um now, in terms of anything else more specific than that, like if I was working with um like a professional athlete, like we would have to really take a look at like their diet, maybe do some sort of testing and see, like what's missing. But for the like average climber, I would say essentially, amino acid mix, collagen, vitamin C are usually my go-tos for that.

Dr Jose Antonio:

Awesome Cassie. Any final questions for Dr Buse?

Cassie Evans:

No, I'm just. I think the climbing. Now I understand the climbing a little bit more. I didn't realize there were so many different like types or aspects of it and everything.

Dr Jose Antonio:

You're going to buy one of those boards, huh and like climb, and actually you know what, get your son and just have him grab it.

Cassie Evans:

Actually I will say my son likes to climb already so he just turned one, but before he was walking I had like the triangle with the rungs on it and he likes his favorite activity literally is to climb up that, or he'll climb up the slide backwards and then pull all the books of the bookshelf down and he gets stuck. But as of like a couple of days ago, he has learned that he can either straddle this triangle or he can hold down and like slide tummy feet first but on his tummy down the slide. So but he was climbing like on stuff literally before he was walking.

Dr Jose Antonio:

So yeah, you got to watch out those kids. They might hurt themselves. So, uh, um, marietta, where can people, if they want to learn more about you, where can they find you on social media? Are you on twitter or x? I know you're on instagram, uh instagram inspire the climb.

Dr Marieta Buse:

Um yeah, that's the main thing to find in me.