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The Wellness Blueprint: With Dr. Caleb Davis
Welcome to The Wellness Blueprint with Dr. Caleb Davis, where we uncover the secrets to living a long, active, and pain-free life. Hosted by Dr. Caleb Davis, an orthopedic surgeon and fitness enthusiast, this podcast is your ultimate guide to musculoskeletal health, injury prevention, and wellness.
Dr. Davis combines his expertise as a shoulder and elbow specialist with a passion for empowering people to take charge of their health. From deep dives into cutting-edge restorative medicine to practical tips on avoiding surgery and optimizing recovery, The Wellness Blueprint offers valuable insights for anyone seeking to preserve their body and thrive at every stage of life.
Join us each week for professional guidance, fascinating medical discussions, and actionable strategies that help you move better, feel stronger, and stay functional for years to come. Whether you're an athlete, a weekend warrior, or someone looking to age gracefully, The Wellness Blueprint provides the tools to design a healthier you.
The Wellness Blueprint: With Dr. Caleb Davis
Episode 8: The Hidden Dangers of Inactivity and How to Overcome Them
Ready to transform your lifestyle with the power of movement? Join me, Dr. Caleb Davis, and my co-host Nicole, as we unravel the complexities of sedentary habits that plague modern society.
Journey with us as we unpack the serious health concerns associated with sedentary lifestyles, from obesity to cardiovascular issues and the silent threat of diabetes. We'll empower you with practical tips to boost your daily step count and discuss the pivotal role of cartilage in joint health, debunking myths around arthritis along the way. Our conversation extends to the benefits of different forms of exercise, including running, weight training, yoga, and Brazilian Jiu-Jitsu, while we compare exercise intensities and share personal stories about the transformative impact of resistance training.
Our discussion doesn't end there. We dive into the significance of strength training across all age groups, highlighting how it can improve your quality of life and mental well-being. We'll share insights on dynamic and static stretching techniques, emphasizing the importance of exercise variety to enhance both physical and mental health. By the end of our chat, you'll be equipped with the knowledge to combat sedentary habits and maintain a balanced lifestyle, promising you a healthier future. Get ready to fundamentally change how you view movement and exercise!
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Hey everybody and welcome back to the Dr Big Guy podcast, a place to discuss injury prevention, optimizing health and living a better life. My name is Dr Caleb Davis, but you can call me Dr Big Guy. As an orthopedic surgeon, I love to fix people after an injury, but my true passion lies in helping you stay healthy, fit and out of the operating room.
Speaker 2:The information shared on this podcast is intended for educational and entertainment purposes only. The content of this podcast should not be considered medical advice, nor is it a substitute for professional consultation with a qualified physician. The views on this podcast do not necessarily represent the views of Dr Davis's medical practice group. If you have health concerns or conditions, it is recommended that you seek the advice of your own physician, who knows your medical history and can offer you personalized recommendations.
Speaker 1:All right, so we're diving right back into the podcast. Nicole, can you tell us what we're going to talk about today?
Speaker 3:Why? Yes, sir, I think we're going to talk about movement.
Speaker 1:So, nicole's right, we are going to talk about movement Now. I think everyone fundamentally knows as a concept that exercise is good for your health. I think there's probably not a single person, at least in the United States, who hasn't heard that concept but maybe doesn't appreciate all that goes into that. So that's going to be the core of what we talk about, but maybe think about a few different variations and key details that maybe people don't think about often. So when we're talking about movement, I'm going to start by talking about the antiment. We're going to talk about sedentary lifestyles and sitting and lying down and not moving enough. So a couple details here, a couple numbers to think about. The average American typically spends about six to eight hours per day sitting. Now, obviously this varies depending on your occupation, depending on your health and depending on your age.
Speaker 3:And that you're not talking about sleep there. You're just talking about what we're doing right now.
Speaker 1:No, that's correct. I'm just talking about being awake and sitting.
Speaker 3:I remember. I remember hearing the, the buzz words uh, sitting is the new smoking.
Speaker 1:Yeah, I remember when that started becoming a thing too, and I think that's a little bit overstated, I think that's a little bit silly, to be honest with you. But it does come with some side effects if you sit too long and are too sedentary in general.
Speaker 3:Yeah, I bet the people who sold the standing desk did really well with that motto though.
Speaker 1:Yeah, you know it's interesting. I was going to talk about standing desks and how I think it's kind of a ripoff, to be honest with you here on the Dr Big Guy podcast. I try not to be too hypercritical of anybody, but I did definitely think that was kind of a gimmick and I'll get into why. So all this sitting time we talked about can be a combination of a lot of things. It can be just sitting around the house watching TV using your computer, or it can be at work. A lot of people have sitting jobs these days in our modern technological society and it's not nearly as manual labor intensive anymore. The most recent data that I could find showed that American adults spent an average of 7.7 hours a day sitting. Now, obviously, this varies from age to age. Older adults tend to sit even more, and that can be up to nine hours a day sometimes.
Speaker 3:You know I'm having a hard time thinking of jobs that are not sitting. Why don't we talk about ones that are more active than they are resting?
Speaker 1:Well, sure, think about construction work. That's the first thing that comes to my mind. I take care of a lot of patients who work in factories, so they're on assembly lines, people who work for Corvette, doing Corvette manufacturing. Ford was a big one that I took care of a lot of patients from Ford manufacturing. So these are people who are not sitting down very often. And is there another job that maybe you can think of that doesn't involve a lot of sitting?
Speaker 3:Yeah, I guess people who work in Amazon warehouses are doing some sort of fulfillment.
Speaker 1:Is there somebody close to you right now who's sitting right now, who doesn't sit that often at work?
Speaker 3:Oh, right yeah, Dr Big guy over there. You know he wears down his sneakers very, very often I do wear down my sneakers a lot medical workers um, yeah, so a lot of medical workers don't don't sit very often.
Speaker 1:It can it. Obviously it varies on what part of medical field you work in. I'm on my feet all day long seeing patients in my office and then when I operate, probably about 80 of the time I'm operating I'm not sitting down. So I I'm definitely on my feet a lot, but that's not necessarily super active motion, because I'm when I operate, I'm sort of standing in one place yeah, like your arms are sort of stuck in this t-rex position, right, like you can't go high or low, that's right yeah we should talk about sterile techniques sometime and kind of go into that to.
Speaker 1:some people understand a little bit better what you're talking about t-rex technique but that's kind of a kind of an apt analogy. You have to sort of stay in your zone without so you don't contaminate your hands when you're working. But when I'm in the clinic I actually get quite a few steps because I'm just walking from room to room to room. Now I do sit down when I talk to my patients just as a matter of course, because it just kind of helps us both connect and be on the same level and feel like that we're both engaged. But I'm definitely getting up and walking a lot.
Speaker 1:That's enough focus on me, though there's definitely a lot of jobs that are more sedentary, but I think more and more people are working from home and more and more people are working in technologically based jobs, so they're sitting quite a bit. Now, if you combine total sedentary time, like lying down, and combine that with sitting, it can reach some in some studies showed up to 12 hours a day. Obviously, again, this varies quite a bit. I was able to collect data from Asian and African countries and they showed a much lower rate of five to seven hours of sitting on average. So it's significantly lower if you think about it percentage wise. So on that line of sitting is the new smoking. Can you tell me more about what your perception is of what sedentary lifestyles kind of what that's associated with?
Speaker 3:Well, it's associated with poor health. I know that my Apple Watch or my Fitbit whatever I'm wearing at the time will yell at me at the 50-minute mark of every hour if I haven't moved for at least a minute or if I haven't moved long enough, and so I'm like oh man, I didn't even realize I was sitting here working on my laptop or cuddling my cat, either both.
Speaker 1:Guys, I got to tell you she actually takes this pretty darn seriously. I'll actually see her get up from the couch and like walk around the house because her Apple Watch told her you got to get up and walk it's. It's pretty funny because I'll right before bed. Sometimes she's like I got to hit my steps, so this is payback for the time she's making fun of my blue light blocking glasses and my nighttime sleep rituals. She's a little out there too.
Speaker 3:Yeah, yeah.
Speaker 1:But I'm more talking about what sort of disease processes are associated with people who have a more sedentary lifestyle.
Speaker 3:Okay, well, I would think I would assume being overweight. So obesity, any sort of cardiac issues? You know everyone's like do cardio, do cardio.
Speaker 1:Think general metabolic disorders, things like heart disease, like you said, type 2 diabetes, things that come with hypertension hyperlipidemia, meaning high cholesterol, cholesterol, things like that.
Speaker 3:I was just reading about fatty liver disease.
Speaker 1:Yes, you were. You were talking about the way that you can actually get non-alcoholic cirrhosis of the liver, and that's often associated with people with these different metabolic disorders, and it can actually cause permanent scarring and damage to the liver, unfortunately. Generally the way to break it down, I'd say that sedentary behavior is associated with increased mortality in cardiovascular disease, decreased muscle mass and even sometimes increased chronic pain and stiffness in your joints because you're not using them and moving them as much.
Speaker 3:Why don't you explain what a joint is to us, dr? Orthopedic Surgeon, what a joint is Okay? Yeah, all right.
Speaker 1:In broad terms, a joint is where two different bones articulate together, meaning join together and have movement. You know we're talking about two ends of a bone in the human skeleton. They join together and are mobile and articulate and have a fixed dynamic range of motion.
Speaker 3:Question yes, is this a joint? That is yes, this is a joint.
Speaker 1:Yes, that is a joint and that's called the MCP joint. It's called the metacarpophalangeal joint, because you have a metacarpal bone here and your proximal phalanx in your finger here.
Speaker 3:So, yes, that's a joint, that's a lot of big words you just threw out there.
Speaker 1:Well, you know, doctors love their Latin, so we got to use it just to make ourselves feel smart.
Speaker 3:Yeah, okay, it's working.
Speaker 1:Yeah, and then the wrist is a joint. There are several joints in the wrist. Yes, I actually didn't know that. There's a lot of different bones in your wrist. They all have different names. They all have different Latin names. We all have to memorize them. It's just to make medical school harder on us. Poor, poor doctors.
Speaker 3:And then elbow.
Speaker 1:You actually have more than one joint in your elbow too, because there's three bones that are articulated together. You have your ulna, your radius and your humerus all joined together, and so there's actually multiple joints.
Speaker 3:That's so funny. Yes, I found that very humorous.
Speaker 1:So yeah, I could name bones and joints all day, but that's essentially what I talk about when I'm talking about a joint.
Speaker 3:Okay, I just wanted to give people an idea, because us lay people don't necessarily think about our knees and our hips as joints.
Speaker 1:Yeah, you know, I've actually had some people say, oh, is this a joint, or is this a joint, and I think I forget sometimes. I take that for granted.
Speaker 3:That's why I'm here.
Speaker 1:I know, and you're the best co-host ever. So what do you think is one of the easiest ways that we might be able to offset sedentary lifestyles and some of the side effects that come from that?
Speaker 3:Well, definitely, getting up and moving at least once per hour is helpful. Starting off your day with a walk, as we talked about, is very helpful.
Speaker 1:Yes, walking is what I was looking for and you nailed it the walking. It seems like a very simple, easy sort of oversimplified intervention, meaning something you're changing in your life to try to improve your health. But actually there's a lot of studies and I'm talking like big, multi centered, worldwide studies looking at hundreds of 1000s of people that examine that just by increasing your step count, you can actually have pretty significant improvements in health outcomes. And the main outcome I'm looking at is even just decreased mortality, meaning the chances of you just dying. Yeah, well, you know when I go shopping at is even just decreased mortality, meaning the chances of you just dying.
Speaker 3:Yeah Well, you know, when I go shopping at a place like Costco, I purposely park super far away. And one, that's because of the massive amount of anxiety I feel attempting to get in and out of a Costco when it's busy. And two, it's because I'm trying to decrease my mortality rate.
Speaker 1:Is that actually something that you think about when you park far away from Costco?
Speaker 3:Yeah, that's what I always say is oh, I don't care where you park, park far away, because we have legs.
Speaker 1:She does say that I can vouch for that.
Speaker 3:I do.
Speaker 1:And I can also say that the my anxiety level correlates with my proximity to Costco. I it's heaven to you, it's hell to me. I just nothing against Costco. They got great stuff, but I just don't like being in it.
Speaker 1:So, just as a kind of a reference range for this talk of walking, you know the, with the rise of smartphones and smartwatches, a lot of people have a pedometer on any device that they have on them at the moment, so it's pretty easy to keep track of the number of steps that you're doing every day, and so there's some studies that have suggested that even up to 4000 steps a day can significantly reduce your risk of cardiovascular death. Now, a lot of the studies you're going to see or at least if you're talking to online gurus and Instagram influencers, a lot of people are saying you should get 10,000 steps a day, and there are studies that kind of show that's where you're starting to get some peak benefits. But really, if you're getting under 2,000 steps a day, I'd highly encourage you to be getting around 4,000 to 5,000 at a minimum, and that's something that's fairly simple to do. Nicole and I like to take a walk every morning, as long as it's not too hot or too cold.
Speaker 3:Yeah, as long as the conditions are just right.
Speaker 1:No but we really do. We enjoy our walks and it serves quite a few purposes. We talked about mental health last week, getting out there and moving and having conversation with loved ones and connecting with people. It also can do that mindfulness that we talked about as well. It gives you time away from your phones. And then now we're talking about physical health benefits from just having some more steps during the day too.
Speaker 3:I have a funny story about steps.
Speaker 1:Okay, please, I'd love to.
Speaker 3:Okay. So, uh, back when I had a full--time job, completely sedentary working at the computer um all day, every day, and I I remember having a fitbit and it wasn't functioning properly. So I reached out to the fitbit support person who happened to be in europe somewhere, I think and uh, this guy said oh, I see, on average you have like 3,000 steps a day. Is that right? I was like yeah, that sounds about right.
Speaker 1:Stop judging me, you European jerk.
Speaker 3:I was like, yeah, that sounds about right. You know, I'm just sitting at home or at the office all day and you know I get up and I do this and do that and I don't walk very often. And he was like, oh, that's, that's pretty bad. You should, you should try to get at least like 6000.
Speaker 1:That's bad.
Speaker 3:That's how I remember it, you know. But no, there was a lot of concern and a little bit of European judgment, I suppose.
Speaker 1:But I mean, I'm here on a podcast telling you all to walk more, so I guess I'm kind of doing the same thing, right?
Speaker 3:Yeah, but that did, that did show me at the ripe age of, you know, 24 or whatever. Uh, hey, maybe I'm not doing the best thing for my health.
Speaker 1:Well, thank you, kind European man, for helping my wife be healthier.
Speaker 3:Yeah, there we go.
Speaker 1:I wanted to talk a little bit more about joints now and, uh, we're kind of at the section that I wanted to speak. I think most people have heard of cartilage. I'm going to go briefly and explain what cartilage is, and you can tell me if you need to interrupt me and have me explain something better, because that's what you do. Oh, so well, Cartilage is the soft spongy material on the ends of our bones in joints that let the joints move smoothly with low friction. Now, that's a very sensitive tissue and it can be damaged really easily and it doesn't have very good blood flow to it. You can think of a lot of cartilaginous structures in joints Think labrum in the hip and the shoulder, Think meniscus in the knee, and then just the ends of the bones have these soft cushions of cartilage tissue too.
Speaker 3:I can tell you that the average layperson does not think about the meniscus.
Speaker 1:Well, I can tell you that the average layperson does not think about the meniscus. Well, okay, you're right. You're right, the average person doesn't think about the meniscus every day. I do think about the meniscus every day, although I prefer the labrum of the shoulder because that's kind of a thing. But I feel like, because of the popularity of collision sports like football, I think a lot of people understand or at least have a brief. They have at least sort of an idea of what ACL and PCL and meniscus are, because of the common incidents of knee injuries in sports you also have a lot of people who don't know the difference between a fracture and a break.
Speaker 1:So I don't know the difference between a fracture and a break. That's a whole different topic. But just really briefly since she talked about it. In orthopedics we talk about a fracture, that that can be a crack in a bone where it hasn't moved, or it can be big break and the bone shifted and moved around. We call all of that a fracture and it was very amusing to me that during my time in training and now in practice, other people seem to have a different idea of that. What I've come to believe is that a fracture in most people's minds means it's a crack that hasn't moved and a break means it's broken.
Speaker 3:You know why you believe that. What's that? Because I told you that that's what people believe.
Speaker 1:Well, you're a lot smarter than I am and I think we've established this pretty much every episode. You really have to keep rubbing it in my face. So but yeah, it's funny because we just call it fracture. We call it fracture, non-displaced, and displaced it took a. It's a common joke in orthopedics is like oh, is it fractured or is it broken? Yeah, cartilage is funny because the way it actually gets nutrients for the most part is by the synovial fluid. The fluid you were alluding to earlier is it's always bathed in synovial fluid. The fluid you were alluding to earlier is it's always bathed in synovial fluid. That's what we call joint fluid and that's actually how it gets its nutrients. The nutrients from the fluid sort of leak into the cartilage and that's how it is revitalized and how it gets energy to be able to reproduce and maintain itself.
Speaker 3:I had no idea that cartilage was this complex.
Speaker 1:Well, every part of your body is complex. I mean, every single cell in your body is constantly using energy as a source to maintain itself, and if you take away that energy, it dies. That's why, if you cut off blood to your arm, your arm becomes ischemic and it dies.
Speaker 3:Don't try that at home, kid.
Speaker 1:No, I don't recommend that. But cartilage to make it even more confusing requires movement and stress to grow and maintain itself. So if you were to tie yourself down to a chair and not move for five years, your cartilage would all die essentially. So you actually have to get up and walk and give it mechanical stress not significant amounts of stress, obviously, but just getting up and walking actually stimulates your maintenance of your cartilage is this why astronauts have to like be strapped in and work on a treadmill and stuff when they're up in space.
Speaker 1:You know that was actually a Fractured Facts when Rachel was on the episode. I don't know if you listened to it.
Speaker 3:No, I think I did. I think that's why it popped in my mind oh, there we go. I definitely listened to it.
Speaker 1:Oh man, you learned something.
Speaker 3:Yeah, awesome.
Speaker 1:Yeah, so actually this is a common theme in a lot of human tissues, that if you don't use it, you lose it, and that would go for bone, for muscle, for cartilage. Even your ligaments and tendons become atrophied or meaning they shrink and waste away if they're not used and stressed. Because your body sort of at least this is the way I like to think of it your body is a signal saying well, we don't need this tissue, so why should we maintain it if it's not being used? To me, the way cartilage grows and maintains itself is really fascinating, and I think this is something people don't know.
Speaker 1:I think a lot of people come and see me for arthritis, meaning loss of cartilage in a joint. Well, if you really want to get strict, arthritis just means inflammation of a joint, but there's different types and generally people are seeing me because the cartilage of their joint is becoming worn out and it causes pain and stiffness. And I think a lot of people say, oh well, I just I walk a lot, or I do a lot of this, or I do a lot of that, and so it was inevitable, it was going to wear out. And that's not necessarily true. There's a, there's a balance, there's. There's too much movement can cause problems and there's too little movement can cause problems. I know people who have never played a sport in their life and had very sedentary lifestyles and have not had a lot of strain on their joints and they can get severe arthritis. So if it was just overuse, like most people think it would be, you know, say, your couch potato type person wouldn't have arthritis. But they sure do.
Speaker 3:I always thought arthritis was somehow your cartilage was getting eaten away.
Speaker 1:Well, that would be more analogous to rheumatoid arthritis. Oh, so there's different types of arthritis. Rheumatoid is where your own immune system attacks the cartilage and starts to degrade it that way. Okay yeah, it used to be thought that osteoarthritis meaning more what people think of as wear and tear was wear and tear. I mean, we literally called it wear and tear arthritis for a long time, but we're starting to think that there may be more of an inflammatory process to that as well. That may be contributing to this, because usually if you have one joint that's worn out, you've got multiple joints that are worn out, and that doesn't necessarily make sense. You know, just if it's just wear and tear.
Speaker 3:Okay, well, good thing we have two whole episodes on inflammation.
Speaker 1:Yeah, the first two episodes of the Dr Big Guy podcast talk about inflammation and how to reduce it.
Speaker 3:So is there like an indication where you can hurt or destroy your cartilage from doing high intensity sports or power lifting or something like that, Jen?
Speaker 1:Yes, yes, there is. Yes, there's certainly indications that you can overwork your cartilage and cause damage. Now, obviously, blunt force trauma, like if you dislocate your shoulder, it can literally shear cartilage off the bone or other dislocations. I see a lot in ankle fractures and things like that. Where you fracture close to the joint, it damages your cartilage to the point that it can't heal itself, and that's pretty common. Cartilage is very sensitive to blunt force trauma and can often not be fully repaired by your body at times.
Speaker 3:So when you do something like a shoulder replacement, are you replacing cartilage?
Speaker 1:Well, yes, you're replacing it, but you're replacing it with man-made materials like metal and plastic. We can't create at least not yet we can't create a tissue that rebuilds itself and remodels itself over time. We're putting in metal and plastic parts when we do a joint replacement. So this way, cartilage maintains itself is a very fine line. The dynamic cycling of a joint actually helps it build itself up. So there's studies showing that just jogging and things like that actually thicken your cartilage over time.
Speaker 1:Now a lot of people may be thinking oh, I've got horrible arthritis If I just go jog, am I going to get better? No, the answer is no. Unfortunately, once there's a lot of damage to the cartilage, as far as I know, there's no real great way to get that back once it's severely affected. But if you're healthy and have reasonable health in your cartilage, this is a good way to maintain it by keeping regular movements. Now if you overdo it, say if you're an ultramarathon runner not saying that you can't be an ultramarathon runner and have healthy joints but if you stress it over and over and over again and you're not hydrating correctly, you're not having correct nutrients, you're not sleeping correctly and giving your body and tissues time to recover, then it's going to be a lot more difficult to maintain that.
Speaker 1:So to sum up the cartilage discussion, I think it's probably easiest to say you need to stay moving and keep your joint healthy, and too much movement can cause problems. Too little movement can cause problems and you always have to be giving that tissue stress an adequate amount of stress to keep it healthy. I did want to briefly talk about one thing, though that's a little bit of a differentiation Static stress, meaning just standing there for hours at a time in the same position, actually does not stimulate cartilage growth. So if you are literally standing at your standing desk for six hours at a time and not moving your knees, for example, you're actually not stimulating cartilage health. So staying in a static position, even if it is weight-bearing, is not necessarily good for you. You need to have dynamic movement.
Speaker 3:So what you're telling me is we need to buy one of those treadmill standing desks.
Speaker 1:You know, I think that's been a trend too. I'm seeing all these videos of people just walking on those little treadmills while they're talking and recording. Yeah, um, I guess that's better than a standing desk. I'm not going to tell everyone to go out there and run and buy your little mini treadmill, though what about?
Speaker 3:what about? Oh, I thought about it tell me no, I mean, I thought about, oh, you thought about getting one. That's surprising. No, of course it doesn't surprise me if you've seen it on internet. You want to buy it true, but if, uh, I've seen people with those little, you know tiny miniature, um like petals, yeah, little petals, and that's all you have, and it's just like sits under your desk. Uh, is that useful at?
Speaker 1:all you're moving right. I think it'd be better just to get up and walk. Personally, you know a lot of people do set a timer so they can get up and stand up from their desk every what 45 minutes to an hour is what a lot of people will do and take a walk um for me. I walk so much in my profession that I don't really have to worry about that. But I think if you are a desk worker or work from home, it would be good to get up and walk every 30 to minutes to an hour.
Speaker 3:Now what about people who struggle with walking?
Speaker 1:Well, if you're thinking, there's certainly plenty of health problems that might prevent you from doing that. Or, to stay more in my line of work, just severe arthritis, where there's no cartilage left in your body and it just or let's say, in the joint in particular. That bothers you and it can be very painful to do any kind of impact activity, even walking, and I do recommend pool therapy or cycling or elliptical machines, things that are lower impact, although you're not going to have as much of a stimulation effect of bone and muscle density or cartilage regeneration, although if we're talking about that severe of cartilage at that point they're probably not going to be going to regrow it back. Anyway. You know, when I talk about growing cartilage I can't stress enough that once you start losing it it's really hard to get it back and some people would probably even say it's impossible. There's, of course, there's more gene therapies and stem cell therapies that people are looking into, but that's sort of all in the works, if you know what I mean. Yeah, I can't really recommend it at this time without strong evidence. But, like we mentioned, with cartilage, bone tissue and muscle tissue also requires stress to grow. If you don't walk on your legs you're even your bones atrophy, which, like we talked about with astronauts, that they see, that they so they see cartilage, bone loss, muscle loss, tendon weakness, and so all of these things go together.
Speaker 1:Since we're talking about activities and sports and different exercises that people like to do, I did want to talk a little bit about some of the injuries that we see with these different types of sports. Now, I'm not saying this to keep people from exercising, because I obviously do encourage people to exercise and be active and even be active in something like an impact sport like running, jogging, sprinting, weightlifting, and we'll get into more of that in this episode. But I did want to talk about some of the injury rates in sports. Interestingly enough, one of the highest injury rates in sports. Take all these numbers with a grain of salt, because you can look at lots of different resources and get different numbers. So like, for example, I looked at just jogging. You know lots and lots of people jog. Super easy to get into. All you need is a decent pair of shoes and a place to run outside, so it's really a very low barrier to entry. I hate it personally and I used to jog a lot, but I can't stand it.
Speaker 3:You used to run like five miles or more frequently.
Speaker 1:Yeah, I think the most I ever ran was around 10 miles and then someone somebody, I won't name names told me I was too skinny so I stopped running so much. Who was that?
Speaker 3:I don't know it sounds like somebody awful who could have done that.
Speaker 1:I mean someone who is big into body shaming. But anyway, back on topic, they showed this one day. Some data that I showed that you could have 2.5 to 12.1 injuries per 1000 hours of running. So we're going to look at this in per per 1000 hours of particular activity. But there's a lot of different. There's a lot of different variation of what injury means.
Speaker 1:So shin splints are a common one, just inflammation of the tissue around your shin bones, just pain in your knees, achilles, tendonitis and, to more extreme situations, stress, fractures of the bones in your feet. Now again, running is not necessarily a bad thing to do and if it's something you enjoy and it brings you pleasure and it also is healthy for you, then by all means I tell people to do it. But I do see people who get really, really into it. They run too much, they don't have enough nutrition and they don't sleep right and that leads to, let's say, suboptimal factors, to that you can actually fracture the bones in your feet. I think a lot of people have heard of the concept that you need to have impact sports to grow bone density. Would you say that's true?
Speaker 3:Definitely, or weightlifting, yeah. Is that what you consider?
Speaker 1:Well, just, I would call it a weight bearing exercise or a contact impact is, I think, what a lot of people think. So I know I obviously see a lot of patients with osteoporosis or low bone density in my line of work because I take care of people who break their bones, so it's it's obviously a very common thing for me, and so I think a lot of people think of walking and running as an impact sport or at least impact exercise. I should say and it's true to an extent, but you actually need more variation in the impact. So just jogging in a straight line, walking in a straight line without much variation, isn't quite as good for you as, say, weightlifting or sprinting or other things that have more variation.
Speaker 1:In a higher impact, plyometric exercise, which involves running and jumping at a higher intensity, will usually have more of a stimulation effect to increase bone density. So sprinting, in contrast to running, has less of these chronic you know, tendonitis and stress fracture type injuries, but you have more because it's a more of explosive exercise. You do see more like hamstring strains, things like that, so you can see that too. Crossfit I was surprised to see that the injury rate showed 2.4 to 3.1 injuries per thousand hours of training, I would have thought it would be higher. To be honest with you.
Speaker 3:Okay, yeah, cause I was going to say how does that compare to running? I can't remember all the numbers.
Speaker 1:Well, running was. One study showed up to 12 injuries per thousand hours. So we're talking four times the rate of CrossFit. I find that hard to believe. Maybe I'm a little biased because I'm a shoulder surgeon, but at the same time there are people who go out and run for hours and hours, where it's a little bit harder to train CrossFit for hours and hours.
Speaker 3:Yeah, unless you're super awesome Icelandic people.
Speaker 1:And which they all are. You know they're all crazy CrossFitters and they're good at it. I'm not hating on CrossFit, by the way. I have a lot of admiration for the really good athletes. My beef with CrossFit is that you're taking complex Olympic weightlifting movements and doing them to failure. And when you do them to failure, oftentimes your form fails, meaning you're not performing the lift correctly anymore, and that's where people get hurt.
Speaker 3:I think for people who don't work out a lot, I'm not sure that they understand doing something to failure.
Speaker 1:Yeah, so understand. Doing something to failure? Yeah, so well, it just means you do it until your muscles literally give out and you're so fatigued you couldn't possibly do another repetition of the exercise you're trying though.
Speaker 3:Yeah, you're trying adrenaline.
Speaker 1:You know going and you don't want to look like a pansy compared to the people you're going against for example, when I lift weights, though, the moment my form is starting to waver, meaning the way I have everything locked in for a lift, I stop the lift, it's like, and sometimes I'll even unrack a bench press and I'll be like, nope, this doesn't feel good, we're putting it back because I don't think I have everything locked in perfectly. And again, not hating on all the crossfitters out there, it's just. I think the sport sometimes encourages oh, keep pushing, keep pushing, keep pushing, even if your form is not not clean.
Speaker 3:I don't know that it's the sport, because I did CrossFit for a while. I don't think it's the sport that pushes it. I think it's really just the type of person that's drawn to CrossFit. That's a good point. Is more of a competitive person.
Speaker 1:Yeah.
Speaker 3:And so they're pushing themselves, because that was me.
Speaker 1:But at the very definition there are workouts that are what they call call AMRAPs right as many reps as possible.
Speaker 3:Yeah.
Speaker 1:So it's sort of built into the workout. It's just up to the person to understand, like well, what's possible and what's healthy may not be the same thing. Yeah, that's a good point. Yeah, so I talked about plyometrics a little bit, so more of that like jumping jacks, explosive body training, but it's it's not just running and sprinting yeah, I really like a body weight training.
Speaker 3:I was hoping you would talk about that yeah because that's something that literally everybody can do without needing access to a gym or even any equipment. It's just the idea that your body is providing you with enough mass for you to move around and feel like it's challenging to do, and it is. I mean, if you've ever tried like females, especially if you attempt to do a push up if you've never trained to do a push up, you're likely not going to be able to do it. I know that's not true for everyone, but yeah, it can be humbling pretty quickly.
Speaker 1:if you've never done it, I think plyometrics are good, although I think they only take you so far.
Speaker 3:You know you're eventually you're going to out outlift the capacity of your body If you train frequently.
Speaker 1:Sure, I was reading an article about this, though to prepare, go ahead, please. Please take over Dr Nicole. She's not a doctor. She's not a doctor.
Speaker 3:But for for something like body weight training. Sure, yes, you, you go as as much as you can with what your body provides, but then, after that, you start to adjust in terms of what they call tempo. So, instead of doing, you know, 30 body weight squats, where you're just squatting, you know getting down to the ground, getting back up again with your with your legs. What you're doing, then is you like go down slowly and then, explode back up quickly.
Speaker 3:So maybe you count to three on the way down and explode back up for a second right so change the tempo.
Speaker 3:I know you know all this, but I'm just explaining it okay, I'm listening attentively yes, okay, um, and then there's the idea of changing what kinds of combinations of movements you do. So, instead of maybe doing a jumping jack and then later on doing pushups, maybe the next workout you do burpees, where it's kind of like a horrible combination of both. And so you you're constantly changing the tempo, the types of exercises, and then you can change frequency as well, so you can increase the number of reps you do per minute. If you want to do things a little bit more challenging, if you're like, oh, I can do a bodyweight squat, no problem, okay, but try to do like 30 of them in a minute. See how you do.
Speaker 1:Yeah, these are all things that you can do to train, uh have variations in the muscle strength, muscle endurance and cardiovascular endurance. I think the limiting factor here would be how much are you able to increase bone density without increasing the load on your body? Because bone responds to to the actual amount of force that's being applied to it. So if you were to load a barbell with 400 pounds, for example, that's a very measurable well, I'm putting 400 pounds on my spine and my femurs and everything, so you're increasing the stress that's put on them, which will, in theory, stimulate increased density.
Speaker 1:Where, if you're dealing with your body weight, you're dealing with your body weight? That's a hard variable to change, although if you involve jumping, that does increase the amount of forces on your bones. So if you're just doing body weight squats, that's a fixed stress. But if you're jumping up and down, the higher you're landing, you are creating impact and force on the bones that's higher than your body weight. But eventually you're going to run out of things that you can do with. That Only in terms of bone density is my argument. Maybe a bone doctor out there wants to argue with me and maybe he's seeing this from a standpoint that I'm not seeing, but that's kind of my view on it.
Speaker 3:I just think it would take years before you actually run out of things to do if you're training that consistently.
Speaker 1:Well, you're probably right If you're doing it just because you want to be healthy and functional. I think it really checks the boxes on a lot of things. It can improve tendon health, muscle health and bone health and joint health doing it. I think the reason I'm going to get on a sticking point here is because I'm treating people who have very poor bone density very poor bone density I'm talking if they fall down one stair step, their spine fractures or they fall from two feet and their hip fractures. And these are life-threatening problems for people where you see an increased mortality rate when you have a hip fracture in someone who's 75 with poor bone density. So my thought is okay, what can I do to get these people increase bone density quickly? And oftentimes the answer is weight training.
Speaker 3:Okay, well, and I'm a big fan of weight training, I think that women in particular need to be doing weight training, uh, to fend off that osteoporosis, uh, in particular, and, fun fact, weight training doesn't make you look like a dude.
Speaker 1:Take it from her. She doesn't look like a dude At least I don't think so I. To talk about one of your favorite uh sports and talk about injuries here, and you'll be pleased to see that yoga has an injury incidence of one injury per 1000 hours, so that's the lowest that we've seen. Have you ever hurt yourself doing yoga?
Speaker 1:I have not, but I know people who have yeah, usually what I see is like a back strain or a wrist strain from doing something with improper form or maybe overstretching beyond your limits, right, but it's usually a pretty what I call a low acuity injury, like it's not going to cause you severe problems.
Speaker 3:You medical people use that word acuity a lot a lot.
Speaker 1:Yeah, it, maybe it's a little bit of a catch all, but acuity would mean the one in one phrase. In one way it would mean the severity, the other would mean the recency. So something that's chronic has been something that's been going on a long time, and then a high acuity might mean it's a serious problem or it's a recent problem that just happened.
Speaker 3:Yeah, so just another, another plug for yoga. I think not only does it help with your overall flexibility and your joints, I think it also helps with your mind. Um, and it helps, helps oxygenate your body. Is that a? Is that a correct word? Oxygenate you're very close oxygenate there you go, you got it okay. Yeah, and hopefully I'm not like pulling that out of out of of air, like no, no.
Speaker 1:I think I think it's a pretty reasonable thing to say I think yoga is good. I don't think it gives you the impact that I want. So I would tell you, if you do only yoga, I would still I would. I'm going to just say it. I think everyone should do weight training in some form or another.
Speaker 3:Every single person on the planet, if they're able to, should do some form of weight training, no matter who you are. Yeah, I can get behind that. Yeah, but you know, I was thinking back to our ancestors, right, like back in the hunter gatherer days. I imagine that our ancestors had to carry a bunch of animals that they killed, and so that was like a weight bearing thing. Or perhaps they had to chop down tree trunks in order to carry them over to build themselves shelter. Um, a lot, of, a lot of parents are having to lift up children and constantly carry them because strollers didn't exist, right?
Speaker 3:so yeah, I'm sure all that played a role yeah, um, and then as we move throughout society, that, like agriculture, that requires a lot of heavy lifting and manual labor throughout the years, right, so it's really just technology has destroyed us.
Speaker 1:Technology and automation and computers have really made us more sedentary and less weight bearing. Just as a quick aside on the exercise, I do have to say that bodybuilding when I use that term broadly, it doesn't mean you have to be a guy in a bikini, in a tiny thong, on stage showing your muscles to do what we call bodybuilding style exercises. It really just refers to a certain rep range and style of workout that you do, involving lifting weights Usually, and anywhere between an eight to 12 repetition of a certain exercise for a muscle group would refer to bodybuilding style workouts. I've never gotten on stage in my life in my underwear, so I was expecting you to say so that I was just waiting but no, I got nothing, I've never, I've never done that, but I used to do bodybuilding style exercises for an audience of one.
Speaker 1:Yeah, I don't plan on getting on stage in my underwear. Just for the record, just so everyone can hear that um, you skipped past your very favorite thing, though well, we're not even there yet oh, okay, you're talking about powerlifting no, oh, you're talking about brazilian jiu-jitsu
Speaker 1:yeah yeah, so I I do. I do participate in brazilian jiu-jitsu. I may have mentioned on the podcast before high injuries, unfortunately I unfortunately I hate to say it, I hate to say it it's a pretty high incidence of injury, up there with running, and I think that's because the idea of the sport is you're literally wrestling with people who are trying to break your arm.
Speaker 3:So yeah, the whole point is to try and submit somebody by pushing their joint into an uncomfortable point where they have to tap right or like if I'm being rolled over. I'm using my head as a base to like keep from being rolled over, so you're compressing your spine and this is like you need to do some yoga after. Yeah, I probably do.
Speaker 1:Yeah, I probably do. I think Brazilian Jiu Jitsu is a great sport. It's a lot of fun, great way to meet people and, if done properly, with the proper nutrition, rest and attention to injuries and taking the appropriate amount of time off when you're injured, it can be a great sport and it can be healthy. If you want to talk about unusual vectors of force being applied on muscles, tendons, ligaments and bones, you're being contorted in all sorts of different ways and those stresses can actually increase your tendon and just general tissue health. Yeah, if done correctly.
Speaker 3:We saw one of our very best friends. Uh uh, she started doing brazilian jiu-jitsu many, many, many hours a week and it was insane to me how, uh, how much her body composition composition changed in just like a year period yeah, all right, I gotta tell this story because I hope she listens to the episode.
Speaker 1:This friend of ours is a big health nut in terms of, oh, I eat organic foods and I eat all this and I try to avoid all these additives and all this other stuff. And she's really crazy about it and is very health conscious, nutrition and diet conscious, wouldn't you say? Is that fair? Ok, we were talking about exercise once and she, she didn't like to exercise at all. Like no, lifting weights, no, nothing, right, right, would you think it's fair to say yeah? So I said to her one day I'm really sorry. I said to her one day okay, you're so health conscious, like why don't, why don't you exercise? And she basically was like, yeah, you're right, I, I need to exercise, uh, and I told her she should try brazilian jiu-jitsu. And now I've created a monster and she trains like three hours a day and she's really talented and really good at it and she loves it. And I don't know how much weight she lost. She wasn't big to begin with but she's like ripped now, like all muscular and like super good shape. And I created a monster.
Speaker 1:You created a monster, A beautifulzilian jiu-jitsu monster and she's probably a lot better at it than I am too, even though I was going to tell her just to to go into it. That seems like a pretty good segue to our very favorite part of the show fractured facts. Nicole, as always, I'm going to try to stump you. Okay With fractured facts. Do you know the longest, strongest, most durable tendon in the body? Hmm, no it's the achilles tendon. Have you heard of the achilles tendon before?
Speaker 3:well, I've heard of the achilles heel well, yeah, from the greek mythology.
Speaker 1:Yeah, the achilles tendon is the part of the heel. It's that thick cord in the back of your of your ankle. That is the tendon that connects your calf muscle to your heel bone, which is called the calcaneus, and this is considered the strongest tendon in the body. It can withstand forces up to 12 times your body weight during contraction. But, interestingly enough, it's also a tendon that often ruptures too. So it's sort of a misnomer that it's the strongest tendon, but it can withstand some of the greatest forces before rupture.
Speaker 1:But for whatever reason certain environmental factors, body factors, sports factors sometimes it's a pretty common thing to rupture. One of reason certain environmental factors, body factors, sports factors sometimes it's a pretty common thing to rupture. One of the reasons people have injuries to the tendon is because it's sometimes underused. And then you go out and you know you play basketball on the weekend with your friends and you really haven't been training that tendon and hasn't been undergoing a lot of forces, or pickleball that's another common one. That's a good one, uh. So think about a tissue that hasn't been trained and hasn't been, over time, been active and thickening and strengthening, and all sudden, boom, you're out there sprinting, doing these explosive exercises. That's probably one of the most common reasons. Well, we'll go ahead and get back to the show with that.
Speaker 1:I know that we've already touched on bone density a little bit, but it's really a big, big issue in orthopedics, so that's why I've sort of focused on it so much for this episode. I wanted to touch one more time on the fact that impact exercise is a big part of that and I really can't recommend enough that everyone do at least some form of resistance weight training. I think people think that walking and jogging is enough, and I'd like to dispel you of that notion, especially if you're you have a family history of bone density problems, or if you are in menopause or post-menopause or have any diagnosis of lower bone density. Highly encourage you to get involved with a personal trainer, get a gym membership, even buy some simple weights that you can use at home.
Speaker 3:There are a lot of apps out there these days that are very affordable, easy to use and they will help with uh training with weights or plyometrics, the body weight training as well yeah, those are all good options too and honestly I think I said this in the first episode if you have an exercise routine you know what it was.
Speaker 1:I said it about diet. If you find a diet that you like and the one that you're willing to do, that's the one you should do. Same goes for exercise. Honestly, I can tell you all day to lift weights, but if it, you hate it and it makes you miserable and you're never going to stick with it. Find a form of exercise that you like. If it's jogging, so be it. It's better than doing nothing.
Speaker 3:I got bored with bodybuilding type exercises like what he used to do, so that's why I started CrossFit and I really enjoyed that, and now I'm in my hot yoga era.
Speaker 1:I really enjoyed that and now I'm in my hot yoga era. What I would tell you is if you're getting out and moving, moving your joints and doing some moderate form of impact, it's going to be beneficial for you. You know, things like cycling, rowing, swimming those are all really good for your cardiovascular health, which can be an essential part of increasing your mortality. And staying alive it's not necessarily going to have as much of an effect on bone density.
Speaker 3:Staying alive it's not necessarily going to have as much of an effect on bone density. Do you find a particular trend in your patients? Are they male, female, are they a particular age?
Speaker 1:In terms of osteoporotic fractures. Is that what you're referring to? Yeah, Definitely. Women over the age of 70 would probably be the most common. Women are at much, much higher risk of osteoporotic fractures because of menopause and losing the protective effects of estrogen when it comes to bone health.
Speaker 3:Is it just menopause, or is it also any woman who's been pregnant?
Speaker 1:You can have decreased bone density in pregnancy, but a lot of times if you are premenopausal, that bone density will return.
Speaker 3:So it's better for women to start weightlifting when they're younger. Yeah, I think everyone should weightlift when they're younger.
Speaker 1:You know, I think everyone should weightlift when they're younger. There is a growing trend in medicine that we think of the bone as a bank and you want to get your balance as high as possible when you're young because no matter what you do, your bone density will drop as you age. No matter how healthy you are, no matter how much you exercise, it will have some decrease after its peak in your late 20s, early 30s, and so there's people pushing for this idea of you got to get your balance as high as possible for retirement. You know what I mean, and as it slowly drips down, you started at a higher level, so you might be better off and avoid that Now. I don't think that's a bad way to approach things. I just I'm wondering if young people are really going to think that far in advance.
Speaker 3:Well, I'm wondering if young people are really going to think that far in advance. Well, I wonder how much of this is a fitness trend, and by that I mean the women in the generation that you're treating now. A lot of those women, I would say, are in our parents' era. They very staunchly believed that it was not appropriate for women to weightlift, that that was only something men did and that it would make a woman look grotesque. I was always surprised when women of that age thought that women weightlifting it was oh, it's just going to make you look like a man, or I can't believe you do that, or oh, you're going to hurt yourself, you know.
Speaker 1:And I think those thoughts still persist and you're probably right that that's something that's probably going to go away with the generation. You know, once that generation has passed away and you see our generation getting older, working out for women is more common and more popular and acceptable. And I think you know, if you look at people who popularize gyms and weightlifting and working out, like Schwarzenegger and things like that, it was definitely a generational thing. So maybe we'll see less bone density problems in the future. It's hard to say.
Speaker 3:We'll probably see less bone density issues and more issues of something else.
Speaker 1:I'm sure there'll be something else. Yeah, you're absolutely right. So we talked about cardiovascular exercise and how it's good for your metabolic health, but some people don't know that muscles can actually help with your metabolic health as well. People with increased muscle mass and I'm not talking about bodybuilders, I'm talking about just lifting weights and staying fit and having decent muscle tone and being strong and functional can actually lower your blood sugar if you're diabetic decrease, I'm sorry increase insulin sensitivity and have all sorts of different effects on blood pressure and other what we think of as metabolic diseases.
Speaker 1:I've already touched on this a little bit too, but it doesn't just apply to muscle and bone and cartilage. It also applies to ligaments and tendons. When you stress the tissues of tendons and ligaments, then they also get stronger at that time as well. So if you think about people who are tearing their ACLs or MCLs or different ligaments in the knees and shoulders and hands and elbows think anywhere. Repetitive stress in the appropriate dosage with the appropriate amount of time of rest can actually prevent injuries. This one might be getting into the weeds a little bit, but it's something that I found really interesting, so I wanted to talk about it, and this is going to be talking about a little bit about range of motion, of exercise. So in my line of powerlifting because I used to compete in powerlifting, you know we but not on a tiny bikini.
Speaker 1:No, I wore a singlet actually, and that, unfortunately, is the truth and hopefully those photos never surface.
Speaker 1:Oh, that sounds like a channel, but the this is going to be a little bit oversimplified but when you bench press, when you squat, when you deadlift, you want to have the least range of motion as possible, in a manner of speaking. The less you have to move the weight, the better, right? Think about that logically. If you have to move a 600 pound weight, you want to move it as little as possible. So a lot of people strategies they use to employ when, when lifting, is to decrease that range of motion as much as you can.
Speaker 1:Now, if you're training your muscle through only a small range of motion, you have to think, if you go outside of that range of motion, that muscle is probably not going to be as strong, and the same goes for the ligaments and tendons involved as well. And I like to use the example of functional muscle versus show muscle. So I'm sure anyone who works out a lot and lifts a lot of weights in a very limited range of motion has experienced this myself included, by the way where, yeah, you can bench press a huge amount of weight, but then you go and have to lift something outside of that plane of motion and all of a sudden it's a whole lot harder. You're not nearly as strong as you thought you were. Have you ever experienced that?
Speaker 3:Yes, I'd say when, at different times, when you even had me do a bench press with a barbell versus a bench press with two dumbbells, I never I didn't understand why it was so much more challenging to do it with the two separate dumbbells. Until you explained that well it's. You know, your, your axis of motion is a lot more with the dumbbells.
Speaker 1:That's right, you're working more. More vectors of pull essentially are of where the bar or where the weight can go if it's not attached to a bar. So there's a big variation there. I think the reason that I've come to think about this a lot more is because of jujitsu. So you know, I'm very strong right here, very, very strong.
Speaker 1:But if someone takes your shoulder out here all of a sudden and they have it locked up here also, you're, you are not nearly as strong.
Speaker 1:Now, some of that's just going to be the way your muscles are lined up and they're just naturally not going to be as strong when they're out of of plane, essentially of how they're designed to pull a bone in space.
Speaker 1:But uh, it does really illustrate the point of the fact that you are weaker in certain positions if you don't train in those positions. I think that's something a lot of people don't think about, and the same can be said for tendons and ligaments in being stressed in certain planes of motion as well. So if you think about you're in the gym, you have the perfect environment, you are lifting with perfect form, all things you should do, by the way, but all of a sudden you play rugby, you play soccer, you do jujitsu. Now your joints are being put into positions that you didn't train in, that are unpredictable. So there's a lot of sports-specific training where they're trying to put you through different variations, so your body is experiencing small levels of stress in different variations that aren't in such a perfectly controlled environment. That is a way to help prevent injuries.
Speaker 3:Yeah, I noticed that in my yoga practice as well.
Speaker 1:A question that I get a lot and actually one of my friends at jujitsu asked me to cover this is stretching. So obviously yoga sort of involves a lot of stretching right? So do you know the difference between dynamic versus static stretching?
Speaker 3:I believe that dynamic stretching is when you're trying to prepare your muscles to do movement, and static is like you're holding it in place to allow the muscle to lengthen and the fibers to lengthen.
Speaker 1:Right.
Speaker 3:But with dynamic you're trying to like warm them up to get them ready to do something else.
Speaker 1:Yeah, that's a pretty good summary. So static just means you're not moving and dynamic you're trying to like warm them up, to get them ready to do something else. Yeah, that's a pretty good summary. So static just means you're not moving and dynamic means you are moving. That's the simplest way to do it, to describe that. But I want to go into a little bit more detail.
Speaker 1:I think most people grew up where you know if you're going to go run track or something at least this was me in middle school, I ran track some and you put your foot up on the fence and you're stretching out your hamstring. You hold it for 30 seconds. You're like, okay, I'm warming up, or you'll. You'll throw your hip across your leg and you're pushing on it. You hold that for 30 seconds. That's what static stretching would usually refer to.
Speaker 1:Dynamic stretching refers to you're actually moving the joint back and forth. You're not holding it for 30 seconds and letting it. You get that good burn stretch and these are two very different things. The thing, one of the things that I do before jujitsu or before squatting is sort of what I would call hip pendulums, where you're letting your hips swing back and forth. You can do it side to side. You can do it front to back.
Speaker 1:You can do shoulder circles. Or you're holding your arms up in the air and your shoulders are going in circles. You can do it front to back. You can do shoulder circles. Or you're holding your arms up in the air and your shoulders are going in circles. You can do the same thing with your hip joints. You can do hip circles, so you're not holding a certain position. There's actually studies that have shown that the static stretches before explosive exercise can actually make you increased for injury. You're pre fatiguing the muscles and making them actually weaker against resistance for a short amount of time. Now I do recommend static stretching after workouts. It can reduce muscle soreness and it can improve muscle healing and it can also increase your overall mobility. So static stretching is not a bad thing, but before resistance training, weight training, sports I actually don't generally recommend it, which I think is news to a lot of people.
Speaker 3:Sports I actually don't generally recommend it, which I think is news to a lot of people. Contrary to that, I feel like since I grew up doing sports, I've known since my teenage years at least that I should not be doing static stretches prior to playing a sport, that I needed to keep that after. But what I don't know is let's say I take a yoga class in the morning, at what point is it safe for me to then go do some weight training later on in the day?
Speaker 1:Yeah, I don't actually have a hard answer for that, like an actual. This is how many hours you must wait, but what I would recommend is you have a full meal. You'll have some food and water. Have at least an hour to recover from that before doing any kind of weight training. I'm sure that there are numbers that look into this, but I don't have those numbers in front of me, so I have to tell you that I don't know the answer to that.
Speaker 3:Okay, but I think having those guidelines is at least helpful.
Speaker 1:Yes.
Speaker 3:I've known I knew not to go straight from yoga to a weightlifting session.
Speaker 1:So we're going to switch up segments of the show. We're introducing a new segment called prescriptions for Life. This is replacing lessons I learned in residency, because I realized that was just too much of a pigeonhole for me to talk about different things that I'd like for people to learn and take home from this. So with that we'll get into our new segment called Prescriptions for Life. So in the segment Prescriptions for life, what I want to talk about is some of the experiences that I've had with weight training and how it's changed my life for the better, and I think the journey that I went through as a young man is probably something a lot of people can relate to.
Speaker 1:I got more into weightlifting in college. My first college roommate, who evidently went on to become a doctor as well although we kind of lost touch after freshman year he went on into medical school at a different part of the state. He took me to the gym and I really fell in love with it. But, as a lot of young men do, I got overzealous and hurt myself a lot. I actually got hurt more often at the age of 18 than I do now at the age of 35, because I'm a lot smarter than I was, but I can tell you it really, really improves your quality of life to do resistance training. And really the short message here is that I'm going to reiterate what I said before. I would really encourage men, women, boys, girls, young, old that everyone should be doing some form of resistance training.
Speaker 1:I understand that there's barriers to it in terms of equipment, gym memberships. There's big intimidation factors like going to the gym and feeling judged and uncomfortable around other people. But, like Nicole said earlier in the episode, there's a lot more resources these days and with the internet you can even have AI program workouts for you and show you different things to do. This is not foolproof. If you have the means, I definitely recommend finding someone who can at least take you through a workout and train you once or twice. If you don't have the means, you know there are there are resources on YouTube where you can find things. Obviously, there's a lot of misinformation on the internet to where you might find bad advice, but I cannot stress enough, as somebody who has changed their life dramatically through resistance training and I've seen other people dramatically change their life through resistance training I can't encourage it enough for everybody. I don't usually take a one-size-fits-all prescription for people, but this is the closest I'm gonna get and say it applies to everybody.
Speaker 3:Can I ask you a question?
Speaker 1:Absolutely.
Speaker 3:I've heard that it's not good for children to be doing something like weightlifting.
Speaker 1:I'm really glad you brought that up. I don't agree with that. Now, I don't think that children should be out there crushing huge weights and pushing really, really hard, because you know they are more prone to injury, I think, if they're with poor technique and poor understanding, but there's plenty of reason for them to do it. There are neurological adaptations that under that that happen in children's muscles when they weight train. They can become stronger, even if they're not necessarily having a lot of hypertrophic effects. But I'm really glad you brought that up because I think that even children should weight train to a to a lesser extent.
Speaker 3:Can you explain what hypertrophic is?
Speaker 1:Yeah, hypertrophic is just the medical word for cellular growth. The volume of the cell increases. So when we think about muscles enlarging, we use the word hypertrophy.
Speaker 3:Okay, so basically your muscle going from not very prominent to very prominent, and that's the kind of training yes, where that's what most people think of in adults, you train your muscles and they get bigger.
Speaker 1:Doesn't happen so much in kids before they hit puberty. Okay, yeah, it also happens in a much less effect in women because they don't have as high testosterone concentrations, have gone through menopause or are going through menopause. To get involved in resistance training in whatever way whether it be with your friends, a group class that does weights, learning on your own and going to the gym I think it could save your life. I think that we pretty much covered all the topics that I wanted to cover on this. It was a little bit kind of all over the place, but a topic that I'm really really passionate about and I think could really help people a lot, so I hope people stayed around for the whole episode and really drank it up.
Speaker 3:Well, thanks for all of your expertise there, Dr Big Guy.
Speaker 1:Nicole, can you kind of close us and tell us some things that you've noticed positively from resistance training?
Speaker 3:For myself.
Speaker 1:Yeah.
Speaker 3:Personally Sure. So one of the big things I noticed when doing resistance training was the increase in my confidence levels. I went from feeling not very capable on a physical level to realizing oh man, like I can lift this 40 pound suitcase, no problem, Like this is not a struggle for me. And strangely enough it started to increase my confidence in other areas as well. So that that was a big thing, was confidence. Another thing was just feeling positively different in my body and about my body.
Speaker 1:Yeah, just to play off of the psychology, since we're talking about mental health last week. I think that's a great point that when you do these feats of strength and understand wow, my body can do incredible things, it really does boost your confidence, and I've seen the same thing. It bleeds into other areas of your life, like your work and your home life. It just makes you a more confident, capable person and I think lots of people who have done this and seen this transformation would would attest to the same thing.
Speaker 3:And also um has helped me do things in life that I enjoy more, like hiking, uh, rock climbing, getting out there, even yoga. I mean, with yoga it's funny if I've taken time off from weight training and I'm trying to hold a particular pose, it's very challenging. If I have done some weight training, like I can handle it a little better. It's still really really difficult, though, because I think you're training your muscle in a different way because you're holding it for such a sustained amount of time versus weight training.
Speaker 1:So with that, we'll just really briefly summarize, because we've gone into this a lot. We talked about sedentary lifestyles and how it can increase your risk for metabolic disease and cardiovascular death. We talked about how even just a moderate increase in steps and walking can significantly decrease your mortality risk and improve your quality of life. We talked about how we maintain our cartilage health in our joints and how the cartilage is really unique in the way it maintains its tissue health, and, in the same way, ligaments, tendons, muscles, bones all in a similar fashion, we talked about the difference between cardiovascular training, like cycling and swimming and jogging, versus resistance training, like bodybuilding, crossfit, powerlifting, just general weightlifting, and all these things have a profound effect on your body.
Speaker 1:Nicole, there's this one more segment of the show that we have not done yet, and that's how we are going to start doing our short, short gratefulness segment. So I'll go ahead and start off. I am very grateful to my parents, who raised me to value exercise and understand the importance of having good condition in your body to be functional and fit. Now my understanding of this evolved as I became an adult and I think I focused more on resistance training, but I have to say that my mother and father really instilled in me the importance of always being physically fit and how it plays a major role in your life. So thanks, mom and dad.
Speaker 3:I am very grateful that I've had people in my life who have encouraged me and inspired me to get fit at various points in my life. When I was a child, I played a lot of sports and then I took a lot of time off from being physically active, and Caleb definitely encouraged me for a long time. But even within that, you know, I joined a CrossFit gym and they were super great. I've joined yoga studios. They've always been very encouraging uh, cross, uh, excuse me, a um, uh, rock climbing place. So anywhere I go, there's always a community of people willing to build you up. Uh, it's not, it's. It does feel intimidating if you're not good at something or if you're newer to it, Uh, but I think there's always going to be at least one positive person, even if it's just the coach, who's going to try and help you get through it.
Speaker 1:Yeah, I'm really glad you said that, cause I've met some really amazing people along the way and people who are enthusiastic about health and fitness and this sort of thing, so that's a great, great way to wrap up. So remember, be humble, be happy and be healthy. We'll see you next week.
