You’re Moving Wrong — And It’s Shortening Your Healthspan (Most People Are)

You’re Moving Wrong — and it’s shortening your healthspan (most people are)

In this episode of the LiveMore Podcast, I sit down with Dr Lisa Corsa, Doctor of Physiotherapy and founder of Premier Therapy Solutions in Boca Raton, Florida.

Dr Corsa flew from Miami to London to record this conversation — and what she shares will completely change how you think about movement, injury, and longevity.

Because you can optimise your biomarkers, train consistently, and follow every protocol…
But if your body isn’t structurally sound, it will catch up with you.

In this episode, we explore:

 • Why running isn’t bad for your knees when done properly
 • Why most gait analyses are incomplete
 • The real drivers of chronic pain and failed surgeries
 • How poor biomechanics leads to long-term joint damage
 • Why movement quality is one of the strongest predictors of longevity 

Key takeaway:

Longevity isn’t just about living longer — it’s about maintaining the ability to move, perform, and function for decades.

And most people are neglecting the very thing that determines that.

About Dr Lisa Corsa

Dr Lisa Corsa is a Doctor of Physiotherapy, manual osteopath, and founder of Premier Therapy Solutions, a private concierge clinic in Boca Raton, Florida.

Her work focuses on identifying the root cause of pain through biomechanics and structural alignment, helping patients avoid unnecessary surgeries and restore full function.

🌐 https://www.premiertherapysolutions.com

Connect with me

LiveMore Podcast
Instagram: @biohackrob
All links: https://linktr.ee/BioHackRob

Transcript

SPEAKER_02 0:00

Sitting is worse than smoke. If you have a sitting job by a standing desk, set your iPhone alarm every 30 minutes to get up and walk. To lubricate your joints. The large artery behind the knee called the popliteal artery, vein and nerve, it actually does get compressed.

SPEAKER_00 0:16

Is running actually bad for your knees?

SPEAKER_02 0:19

Running is not bad for your knees. You see people running well into their 90s. As long as you keep the body symmetrically, correct? As long as the body stays strong. You can run forever. I will tell you, must live my five pillars of longevity. Pillar number one is sleep.

SPEAKER_01 0:42

Dr. Lisa Corsa, uh, welcome to the Love More podcast, where we dive deep into longevity health optimization. And keen to get your perspective on what you focus on in terms of your um longevity practice over in Oka Raton, Miami, Florida. Uh we met in Davos back in January. And I think this is an interesting episode because a lot of people are data-rich focusing on, for example, tracking their sleep, their biomarkers. But I think it's interesting because one thing that I don't think is nearly spoken enough about is how well you're actually moving. Things like structural durability. And I think it'll be good to unpack that with you a little bit more in terms of like biomechanics as well, which is something that you're focused on as a doctor of physiotherapy. So without further ado, I'd love for you to introduce yourself to my audience and explain what got you here. You know, what is your background, and yeah, I'll let you take it from here.

SPEAKER_02 2:04

Well, thank you so much for having me, Rob, on your amazing Live More podcast here in cold London. It's a far journey from hot, sunny Florida. Um, but thank you. Yes, I I own Premier Therapy Solutions located in Boca Rotone, Florida, and I love your sentence of structural durability. As a physiodoctor and a manual osteopath, I've spent 30 years of my life breaking down the human body into simple physics. Physics, chemistry, and biology. And from there, I've been able to unpack and uncover root cause of pain. And then once you've uncover the root cause, then I create the algorithm and the solution to fixing it. It's been wonderful. It's been a great journey. You know, my clinic in Boca Ratona is called Premier Therapy Solutions. It's a private medical concierge facility, and we have all types of physicians: allopathic, clinicians, physio, osteo, neurology, cardiology, that we bring in to really solve complex cases.

SPEAKER_01 3:13

Fantastic. And I hear you also have experience working with elite athletes. It would be interesting to see what sports are you seeing the most injuries come up in in terms of like, is that more towards like sports where there's change in directions, like football, soccer. A lot of people are running, um, so there might be overuse injuries there. So I think there's a lot of nuances in terms of what kind of sport you're actually playing or doing. It'd be interesting to see what your take is on that in terms of what you're actually seeing every day in your practice.

SPEAKER_02 3:53

So, as far as the elite athlete, let's let's talk about three types of athletes. The weekend warrior, right, that just goes out and says, Let me play 10 rounds of golf or I'm gonna do pickleball or tennis. Then you've got the collegiate athlete or high school athlete, and then you do have the elite professional. And really, you know, for all of them, it boils down to something very simple, whether you're the weekend warrior or the elite athlete. And the word really is recovery. The recovery protocols you do, which is part of my course and method, helps to prevent injury, you know, helps to prevent seriously massive fractures or, like you said, the cutting, sprinting type of, we're going to see injuries in football all the time. ACL injuries. Soccer players have those injuries. But I sit there and say, but what about that soccer player who never got that ACL injury? Why? Because their recovery off the field and off the court was at the top level of the game. And that's truly how we avoid these injuries. Sure, rugby, they they have terrible injuries, downhill skiing. You heard what just happened with Lindsay Vaughn. I mean, these injuries are devastating. They're not career-ending, though. They're not. The body can heal. So you name the sport. I'll tell you the injury, top three. That's I always loved to play that game. You know, my son said, Mom, well, how come you won't let me play football? Because of these top five injuries that occur. So, you know, even though it's six foot five and 200 pounds, no, you're not gonna do it. I don't want you to get a head injury, an ACL rupture, or rupture your rotator gum.

SPEAKER_01 5:33

Absolutely. I'm someone who's big on running, so run often, average probably about four times a week. So I think a big myth that would be interesting to explore with you is is running actually bad for your knees?

SPEAKER_02 5:51

I will tell you that running is not bad for your knees. You see people running well into their 90s. As long as you keep the body symmetrically, correct? Meaning muscle symmetry, as long as the body stays strong, and as long as the body stays mobile in the joints, you're not gonna injure yourself. You can run forever. So the key factor is make sure when you're a runner that you do supplement in the gym. You must supplement because let's face it, running does not work, all 636 muscles in the body. So you need to supplement with those muscles that become dormant in runners, i.e., the glutes. The glutes actually, gluteus maximus, medius, and minimus, are not strong in runners at all. They're not. Now, sprinters is a different story. But running long distance, weak glutes. They even get a muscle that becomes very weak called the peronials. The peronials are a group of muscles based on the outside of the lower leg, on the lateral side of the leg, that are so important for stability of the ankle, the knee, and the hip. So when that whole group of muscles are weak, you can then break down the knee joint and the hip joint. So you must, you know, find someone like me who does the full analysis and says, you're wonderful for these muscles in running, but these are the 35 you're not working, and you better work those in the gym. That's how you stay not injured and running and run until you're hungry.

SPEAKER_01 7:39

That's fascinating. A lot of us, when we go to like running stores, we get what's called a gate analysis done. So it checks, for example, whether you're over-pronating or under-pronating. But is there more to it? Would you say that a gate analysis isn't really uncovering your full biomechanical range and movement? And it's not probably sufficient in terms of determining what running shoe is appropriate to you. I think there's a lot more to it than just appropriate running shoe.

SPEAKER_02 8:17

Correct. I would say the gate analysis you get in the running store is very rudimentary. It really is only looking at a few pieces in a moment of time. You know, you need the full-body biomechanical analysis. Again, that's what I do at Premiere Therapy Solutions. So we are assessing your 360 joints, 206 bones, and 636 muscles. The gait we're doing posture, coordination, balance, gait, all of those jumping mechanics. That's really what's going to keep your body symmetrical. And you can buy any shoe in the world. I've test a lot of different shoes on different companies. And I will tell you, there are some specific shoes that I'm going to say are absolutely not good. And then there's shoes that are phenomenal, and I'm going to give you those top five reasons why. You know, we all have so many different types we like, but analyzing shoes from a physics perspective, I'm going to tell you that this shoe's not good because it's shifting your ground reaction force anterior to the hip, which is going to load the lumber spine. So you've got to be careful of these fad things with the carbon fiber. Sure, are they good part-time, but not full-time? It's just like barefoot running was a fad, right? There's nothing wrong with barefoot running, but not forever. You need to take everything in moderation. Is barefoot running great on a beach for a little while to strengthen the foot intrinsic muscles? Absolutely. But I wouldn't tell you to do it every single day. So I think getting a full analysis of your runner once a year is really required to stay running injury free.

SPEAKER_01 10:00

Absolutely. Does it matter, for example, if you're heel striking or actually what point is actually in contact with the ground every time you're impacting it? Is that is there a nuance around that as well?

SPEAKER_02 10:14

There's a main nuance with the heel strike. So there are six phases of normal gait, okay? And initial contact is when the foot is in 20 degrees of something called dorsiflexion. So with dorsiflex, we strike the heel on the ground. The problem is, is most people don't even have a normal range of motion of the ankle joint. So every time you're striking the ground, you're striking it at a 50% less range of motion, which then creates this abnormal deleterious force up the kinetic chain through the tibia, the femur, the hip, and the spine. And that creates this abnormal ground reaction force. So when we run, let's not forget that we have gravitational force at 9.8 meters per second squared coming down on us, and our muscles need to co-contract to keep the joints stable. So if the muscles don't co-contract when we're running, you're gonna get shifting of those joints. And that's where you get wear and tear of the meniscus breaking down, like you said in the knees, or you can get wear and tear in the labrum in the hip. Or runners, believe it or not, actually get vertebral compression in the lumbar spine. So they say I have the worst running back, but then I'm saying, but how do you have a runner who's 75 years old and has no arthritis in her spine? Why? Because she kept her core strong. So supplementing in the gym with some planks is a phenomenal exercise to keep the core front plank, side plank. Those are just wonderful things to keep in that core strong. Doing some specific exercises to strengthen the rectus abdominis and the multifidus and the erector spinae, which are the key muscles for when you're running, is vital. And you should really speak to your physiotherapist and say, give me this prescription so that I can stay running safely.

SPEAKER_01 12:01

Absolutely. Posture has a lot to do with as well, how you're sitting every day. Uh, one of the things that keeps coming up is sitting is become the new smoking. So sedentary behavior and the impact it has on the body. And I was actually looking into this because I flew recently to the US. So uh London to LA, it's around an 11-hour flight. And it's interesting to look at one particular study that shows there's like a 50% reduction in blood flow in the artery behind your knee. So just showing you there what's happening on a long haul flight, and if you're constantly sitting down during your workday and not getting it up enough, that can cause a lot of issues as well in terms of your posture, right?

SPEAKER_02 12:47

Absolutely. You said it right, Rob. Sitting is worse than smoking. Sitting is deleterious to the human body. It is. If you have a sitting job by a standing desk, set your iPhone alarm every 30 minutes to get up and walk, to lubricate your joints. And that is correct. The large artery behind the knee called the popliteal artery, vein and nerve, it's all there. It actually does get compressed. So when someone says, why are my legs swollen? because you're not moving on an eight to ten hour flight. And when you get fluid inside a joint, it infiltrates a muscle and renders the muscle inactive. And the nerve becomes latent or lazy. So now the nerve doesn't, you know, contract correctly, and then the muscle doesn't work right. So that's why recovery, we're back to recovery. Getting those compression boots that you can wear after a long-haul flight, doing my course of conditioning kit on a long-haul flight, doing 20 minutes of exercise, moving the limbs, getting up every 30 minutes, and doing small little exercises is very simple, and that's what I came up with.

SPEAKER_01 14:02

I just thought of a very simple biohacking protocol that's often used, and that's, I think, red light therapy. Do you believe in that? Do you think that actually is helpful?

SPEAKER_02 14:12

I believe in red light therapy. I offer red light therapy at my clinic, Premier Therapy Solutions and Boca Ratone. Red light therapy activates a cascade of cellular events to promote healing, to reduce inflammation, really to help with cell regeneration. Absolutely believe in it.

SPEAKER_01 14:30

Fantastic. I actually use one of those um air compression boots as well. Um, so yeah, I find that helps.

SPEAKER_02 14:40

There are so many types of air compression boots out there. The latest one that I use in my clinic is a very specific one that actually changes the millimeters of mercury of compression per compartment of the leg. So I can adjust the foot to be a stronger pressure than the calf, then the thigh, than the hip. It's fantastic. And then it's gradient. So it pumps and creates that actual vascular pump that you lose staying sedentary. So it's a phenomenal product. I use it. It comes with a backpack. You can take it anywhere, anyplace. And again, really good for recovery and rehabilitating because if your legs are swollen, they are not going to perform well.

SPEAKER_01 15:25

Absolutely. Are there studies that show that these air compression boots that the effectiveness of it 100%?

SPEAKER_02 15:32

You know, Mueller is a phenomenal company that I, you know, have partnered with over the years. They have spent millions of dollars globally worldwide in RD research and development for these types of boots. Um, one of their products is called the Revive, and it's fantastic. I have it on my website. It there are multiple studies at how this improves vascular pump, reduces inflammation, you know, really helps with the blood flow circulation and decreases pain.

SPEAKER_01 15:59

And what about heat therapy and cold therapy? So a lot of people are, for example, using ice baths. What are your thoughts around that? Using the sauna. I use the sauna for recovery, particularly after strength training, but definitely don't use um cold therapy after strength training because I've heard that um it's not great for strength training. Um well, doing it straight after strength training.

SPEAKER_02 16:23

Yeah, right. So I use cryotherapy in my clinic. Um, I also use infrared sauna. I have a phenomenal sauna. Cryotherapy is definitely indicated when you injure something. So if you've got an acute injury, putting ice on an injury really does help and stop that inflammatory process. Um, there's also ice baths, cryobaths, two, three minutes has been shown to, you know, really boost the metabolism recovery. You know, the footballers after playing, you know, eight hours, they'll jump in that cold bath. There is some literature to discuss that that, you know, cooling of the body helps to decrease swelling, inflammation, and pain. Um, there's for sure some studies there. There are controversial studies that if you do it actually pre-strength training or post, it can delay healing times. So again, you've got to use it in the context of what the injury is. I recommend doing it for injuries. Okay. Infrared sauna, a lot of research and development for sleep, inflammation, weight loss, stress, anxiety, all of those things. I really do believe in infrared sauna daily. They even use it on cancer protocols. You know, some of the largest cancer institutions in the world were doing infrared saunas. So I think a sauna is very good.

SPEAKER_01 17:37

Absolutely. I try and use the sauna as well. But I've looked at the finished studies, and I think they show that the dry sauna, you don't have to spend as much time for the equivalent benefit when compared to like a red light sauna. Apparently, you have to spend, I think, approximately 40 minutes in a red light sauna compared to 20 minutes in a finished dry sauna.

SPEAKER_02 17:58

Correct. That is correct. The dry saunas back in the old days, remember those were the original saunas? And you know, people would, you know, go completely naked in that sauna and really get that benefit. The dry heat penetrates our what's our largest organ in the body? The skin. So the dry heat penetrates that skin and it activates this, you know, cellular events again quicker because it it gets into the body faster. Somehow, with the infrared sauna with the light combined, it's not getting there as quick and creating that cellular cascade of events. But regardless, they're both really good. I would recommend both of them. You know, what you if you have, depending on what region of the country or the world you're in.

SPEAKER_01 18:44

Fantastic. Just a shift in direction here. Lower back pain. So there's evidence to show that lower back pain is the leading cause of disability. I think in a study done in, I think it was 2020, in the Lancet, if I'm not mistaken, 619 million people diagnosed with some kind of lower back pain issue. And this is predicted to increase by 2050. Um, so just wondering what your thoughts are around that and how that can be minimized or prevented for as long as possible.

SPEAKER_02 19:24

I'm so glad you're bringing this topic up. Chronic low back pain is the number one cause of disability in the world. It is 90% of the cases I see. That's why I developed the algorithms to fix chronic low back pain. Everyone is fixed. First, you've got to get to the root cause of the pain. And that takes time. You have to dissect medical records, dissect MRIs, blood work, all the failed epidurals, failed back surgeries. Did you know that's greater than 70% of back surgeries are failed? Failed back surgery syndrome is something I treat. And we sit here and say, why? Because they're not, surgeons aren't attacking the root cause. There is only one or two reasons why you actually need surgery. So when you come to my clinic, I'm gonna do my full exam, it takes a couple of hours, and there is that small minute chance that I'm gonna say, don't waste your time and money with me. You need back surgery now. But I'll tell you, Rob, I rarely say that. I'm going to say you must spend the time for this next year to fix your back. The back is fixable, but it's leading to opiate addiction. Do you know it's our the world is addicted to opiates, and then you don't sleep. And now you're not sleeping, you're on drugs, and your back pain gets worse and worse, and you go through this pain-spasm cycle. And then they keep giving you cortisone shots and cortisone shots, and that doesn't work. So we must get to the root cause. And a lot of times, the root cause is a biomechanical mishap, malalignment, an abnormal length tension on the muscle and the tendon, an abnormal ligament that's stretched beyond its anatomical limit. That's what I find. That is why I do what I do, and that's why I fix chronic low back pain.

SPEAKER_01 21:21

What I find fascinating is that you can be metabolically healthy, have perfect biomarkers and biometrics, but yet have very poor biomechanical movement and mobility, which I don't think again is nearly discussed enough. And I think when it comes to longevity, longevity is not just about living longer, it's about performing better in everyday life. And I think structural integrity joint movement is fundamental to that. So, in terms of protocols that the everyday person can implement, let's say you've got someone that's desk job. Bound, you know, they're going to the gym three times a week and they still feel stiff. What would you advise or suggest to that particular individual?

SPEAKER_02 22:10

If you're going to the gym three to four days a week, I will tell you, you must live my five pillars of longevity to stop that stiffness. You know, there's no reason for you to have joint stiffness, but you've got to, you've got to attack the five pillars. Number one, pillar number one is sleep. So if you don't get eight to ten hours of sleep, you don't activate those recovery mechanisms at night to clean out the joints, to clean out the microglial system in the brain, which contributes to the amyloid tau plaques and Alzheimer's and dementia. You must get that eight to ten hours of sleep, avoiding alcohol, blue light, you know, the televisions at night. Sleep is number one. Number two is exercise. You must exercise, in my opinion, seven days a week. There's nothing wrong with going to the gym seven days a week. I do. I work different body parts, I stretch different things, I activate different types of contractions. There are three different types of contractions. You know, I'll do eccentric contractions, concentric contractions, isometric contractions. That's what's creating injuries. People just work out in a specific motion. That's creating the injury, even in the 20-year-old. So exercise is number two. Number three is nutrition. Food is medicine. You are what you eat. You must, must focus on eating a minimum of one gram per kilogram of body weight in protein to build muscle, maintain lean body health, and keep well. Protein, eat. Avoid those anti-inflammatory foods. But number four is really important because you just mentioned it. It's actually called stretching. If you don't stretch, you're not gonna reset the length tension of the muscle, 636 of them, you're not gonna reset the length tension. Now you go ahead and do the bicep curl again, and you didn't lengthen it back to its normal length, and it gets injured. Nobody stretches, and we're sitting and getting tight and short. Stretching is vital, and part of my coursa method is stretching. And the last part of my five-pillar of longevity is definitely something called meditation, mindfulness, social engagement, doing something that you love. Get out and take a walk with some vitamin D, maybe do a five minutes of meditation, close your eyes and breathe, put on some classical music. Medicitation can look in any form, any shape or form. So if you practice those five pillars, that 30-something, 40-something, or even 50-something, I promise you, that stiffness will go away.

SPEAKER_01 24:53

Absolutely. Just wondering in terms of you've seen you said you said that you've seen a lot of patients that have had a case of too many failed surgeries. Just wondering at what point would a patient would you see a patient and say, okay, you know, we've we've done everything we've can we we can in terms of you know biomechanics and whatnot. At what point might you refer them to, let's say, take a look at surgery as a next option?

SPEAKER_02 25:26

I would say for fail, well, first of all, let's talk about failed back surgery syndrome. Why does the back surgery fail? It's not the surgeon's fault. It's your fault for not completing the rehab and putting the body back in its normal biomechanical alignment. So, truly, the only time I say to someone you need surgery, is if you have a drop foot, the nerve is compressed so much that your foot is now paralyzed and you can't move your foot. Well, that's a surgical intervention you need. There's also something called cervical myelopathy. That is an intervention that you need surgically. It's when the spinal cord is so compressed that the electrical signal's not getting down to the limbs and you're dropping things. You can't button, you can't zip, you can't type. That's serious. Or you're tripping and falling because your foot is paralyzed. But truly, those are the only reasons for back surgery. Just as general low back pain or herniated disc, a disc is fixable. Your herniated disc can resorb back into the body. It's called disc resorption. It occurs in every disc. It takes 18 to 24 months. With excellent physiotherapy, you don't need back surgery.

SPEAKER_01 26:48

Absolutely. I think a common procedure is getting a knee replacement, I think, at some point in time. I don't know at what age that commonly happens, but how can one avoid those kind of things?

SPEAKER_02 27:03

So let's talk about joint replacements. I treat so many joint replacements. I have a prehab program where for six weeks I prehabilitate you before you go under the knife so that when you're post op, you don't need pain medicines, you're up and walking same day, next day, and your rehab is expeditious, you're done and done back on the golf course. However, I'm trying to avoid you to get a knee replacement or hip replacement. And that comes with the big global term osteoarthritis. Let's face it, what do you need a hip replacement for or knee? Because you had the wear and tear and breakdown of the joint. You didn't live the five pillars of longevity, you didn't practice the Corsim method, and you broke down the joints. The recovery needed to happen. So these total joint replacements usually only happen from wear and tear. And why do we get wear and tear? Because you didn't do the saunas, you didn't ice the joint, you didn't stretch after you worked out. You just kept doing squats, squats, lunges, lunges, but you never stretched the muscles after. So these joints, you know, honestly can repair. And then you didn't sleep. You lived a life of a CEO that sleeps four hours or five hours and you're sitting on an airplane. You should be exercising and lubricating the joints. Don't forget, movement is medicine, mobility is longevity. So you really need to lubricate those joints to avoid a knee replacement. I've gotten many people where I've prehab them up to their surgical date, they've actually walked out of the operating room and didn't need the joint replacement. Joint replacement surgeons hate me. They say you're making me lose money because we're saving people from joint replacements. No, I'm fixing your physics and biomechanics and making you walk normal and fixing your posture. Because everyday life we're bent forward, texting neck. It's a nightmare. Do you know that I've got 20-year-olds who have a neck of a 90-year-old arthritic?

SPEAKER_01 29:05

It's horrible. That's insane.

SPEAKER_02 29:06

Horrible. Horrible. Because of our iPhones. We're all looking down, we're stretching that nuclear ligament in the back, and the bones are becoming so arthritic in the spine that we're now doing disc replacement surgeries on 20 and 30 year olds. It's terrible. From phones.

SPEAKER_01 29:25

Shocking. In terms of your cartilage as well, how can we maintain the health of our cartilage for it not to degradate? Because I think that's a that that's a massive factor as well. Um what are what's the secret to people maintaining that? Like, for example, I supplement it with um so collagen, hydrolyzed collagen, which I use, does that help? Is there evidence to support that that does actually help maintain your cartilage, or is that just nonsense?

SPEAKER_02 30:01

You know, the supplement industry is tricky. It's tricky. It's a billion-dollar industry. You know, a lot of this supplement industry is not studied. You know, we have our FDA, not FDA approved, right? So we don't have a lot of studies about collagen supplementation. You know, does it hurt? No. Does it truly get into the cartilage of the joint and rebuild? We don't have those studies out there. You know, is there some data to support that drinking, you know, and having these supplements helps with cellular optimization? Yes. You know, I take supplements myself, you know, some vitamin D3 with K2. You know, I do believe that there is a time and a place for supplements. So there's nothing wrong with taking them. You obviously need to, you know, check with your primary care practitioner to make sure some of these supplements don't counteract with your medications if you're taking medicines. But let's talk about cartilage. What does cartilage need? It actually needs healthy joint compression. It needs joint compression. You need to get up and walk. Believe it or not, lying down and sitting is deleterious for cartilage. It causes breakdowns. You know, it really needs that ebb and flow of joint bones touching and moving the cartilage. It likes tensile loads, safe tensile loads. That's why exercising with weights, bands, resistance bands is healthy and excellent for cartilage. So again, I have meniscal tear patients with their medial meniscus or torn knees cartilage. We fix them. They don't need surgery.

SPEAKER_00 31:44

Right.

SPEAKER_02 31:44

It's it's it's really good. So, you know, I would say really be careful. You you've really hit the nail on the head, Rob, about biomechanics and going back to your initial sentence of you know, structural deterioration, we're really not giving that more credit. And it needs to be in the longevity world. You know, we're talking all these biohacking devices, but let's look at the physics of the human body.

SPEAKER_01 32:08

Absolutely, I couldn't agree with you more. I think that's often not spoken about enough. What about in terms of MRI scan? So one of the things I researched and looked into was that often you might have someone that let's say you might have two patients that both have the same issue, but one doesn't experience pain whilst the other does. And it'll be interesting to unpack why that is the case in terms of biomechanics, that both these patients have the same problem on imaging, but one doesn't have the pain and one does.

SPEAKER_02 32:51

As part of my full-body musculoskeletal and neuromuscular evaluation, I look at the MRIs with my chief musculoskeletal radiologist. And you are right, we can have the same scan back to back with two human beings with a blown-out herniated disc, and one can barely walk and the other one still walking with no pain. It boils down to looking at the structures that are around the disc, such as ligaments, tendons, connective tissue, muscle, and those muscle forces that are pulling on those ligaments, tendons, connective tissue, and disc. So when you look at those structures, I analyzed it to say what is your root cause of your pain? And 90% of the time, it's not that herniated disc on that MRI. It's not. It's actually something that compensated as a result. So it's the compensatory mechanism that causes the root pain that people just shove under the rug. Now you go and have spine surgery and they're still in the same pain because the surgeon didn't do that. That's not their job. The surgeon is, you know, honestly, truly just that, you know, hammer and nail fixing that problem. They're not looking at the root cause, that it could be the muscle, it could be the tendon. Usually is the muscle, the ligament being pulled wrong. And that's what I do. Realign the body, shift the muscle. I actually turn down a muscle and turn on a muscle like a light switch. There's muscles that are too strong, there's muscles that are too weak, but listen to this: there are muscles that are too long and too short. Do you know that's four different things? Strong, weak, short, and long. I look at all that, and that's the key to longevity, knowing that.

SPEAKER_01 34:47

Right. In terms of defining osteoarthritis, that is, from what I understand, as a result of poor biomechanics, right? And is that resulting in inflammation in the joint? Is that what osteoarthritis is? Just trying to understand that.

SPEAKER_02 35:04

Correct.

SPEAKER_01 35:05

And from layman's perspective.

SPEAKER_02 35:06

Osteoarthritis, which affects millions of people worldwide, is inflammation surrounding the joint. You know, the knee joint being number one. And did you know that the thumb joint is starting to creep up as the number two osteoarthritic joint? It's called the CMC joint because everyone's texting. So we have texting thumb problems. It's a serious problem. So I, you know, came up with a texting thumb protocol to fix that joint. They're even doing thumb replacements now. It's that bad.

SPEAKER_01 35:39

That's insane.

SPEAKER_02 35:40

You said overuse syndrome, you know, overuse syndrome. This is why runners have to stop running, overuse syndrome. Tennis players have to stop playing tennis, overuse syndrome in the elbow. But that's all fixable. So osteoarthritis affects all the joints, with the main ones being the knee requiring a total hip knee replacement, the hip requiring a total hip replacement, and the thumb requiring a total thumb replacement. That's all fixable. We just fix the physics, the biomechanics, we turn muscles off, turn muscles back on, get rid of the inflammation, and your joint is as good as new.

SPEAKER_01 36:16

Right. Going back to pain, what's often used to manage these symptoms is, I believe, cortisone shots. What are your thoughts around that in terms of as a form of treatment? Um it might be helpful perhaps for short-term pain relief, but are you just masking the symptoms?

SPEAKER_02 36:41

I would tell you that cortisone has positive and negative effects. There's really a time and a place for cortisone, if clinically indicated. I don't like cortisone. It causes a cascade of events that really can weaken ligaments, weaken tendons, weaken muscles. But if needed short-term benefit, then yes, we do recommend it for specific, you know, diagnoses. But I don't like when people come to me and say, well, I had three cortisone injections and it didn't work. Of course it didn't work because they weren't getting the root cause. But I'm gonna go back to your supplements. There are some wonderful supplements out there that do counteract inflammation, some natural foods that decrease inflammation, you know, cherry juice and these anti-inflammatory, you know, pineapples and you know, the berberine, these things that can help. They are indicated. There are there's a whole literature review of food science. And food science, we're not gonna discredit. You know, back in the old days, that's all we had were food. We didn't have medications. We used food to help combat inflammation. So I am not a fan of cortisone. I think it should be a last resort and only if clinically indicated, and then it don't forget that it'll start deteriorating joint after joint. So if you didn't get benefit for cortisone, don't go back for more. It's not gonna work.

SPEAKER_01 38:06

Absolutely. And another study that I was looking at at gate speed, I think, in um over 65-year-olds, I think that's a major factor for increased mortality of your gate speed. So I think it's how much distance you can cover whilst you're walking. I believe. So if your gate speed is slower, that tells you a lot about your longevity and your health span.

SPEAKER_02 38:35

You are correct. As a gate analysis expert, gate speed is a big predictor of longevity. We want to keep you walking. We even do something called the six-minute walk test in our clinic. And we have found subjects in their 70, 80, and 90. If you're still walking, boy, are you gonna live to that hundred. So it's a really important predictor of longevity along with thigh muscle strength. You know, the girth and the size of your thigh muscle is a big predictor of longevity along with grip strength. You know, these frail women that are getting osteoporotic and have no muscle in their lower legs, they're at risk for falls. And did sarcopenia, we can talk about. Did you know that one third of the world is at risk for falls? And that of those one-third people over the age of 65 that fall, 50% of the people that fall die as a result of the fall complication. So everyone in my clinic has to perform balance training. It's required. I don't even care if you're 10 years old. We're gonna do balance exercises to keep those neurological reflexes adapting to movement, quick speeds, a trip, a fall. So, really important predictor gait speed, thigh girth, and that will prevent, well, what prevents sarcopenia? You just did it. You're going in the gym three, four days a week. Get to the gym. Muscles are longevity for sure.

SPEAKER_01 40:09

Absolutely. Obviously, a combination of strength training and cardio is important. What are your thoughts around how that should be combined?

SPEAKER_02 40:20

You know, I really kind of get upset at the person that says, Well, I golf five days a week. That's a workout? No, wrong. That is not a workout. Five days a week of doing the same thing over and over is just gonna create overuse syndrome, repetitive stress syndrome, RSS. You do need to vary it. You do need to do high-intensity interval training. Even when you're 90 and 80, something that high intensity interval training can look as sit and stand 10 times, get up from a chair 10 times. That's high intensity interval for a 90-year-old because you're gonna breathe deep and heavy. So you should supplement high-intensity interval training, cardiovascular training, strength training, stretching. Those are key factors of a workout. Don't just go and walk on a beach seven days a week. Don't do yoga seven days a week. It's not correct or safe. You have to vary your workout over and over to avoid overuse syndromes. So, very important. In my opinion, you know, our surgeon general now says seven days a week. Don't just take a day off. When you go to the mall, park at the farthest spot and walk. Don't take the escalator, take the stairs. That could even be a form of cardiovascular for some people. Did you know that stair training helps that metabolic equivalent? It's it can be difficult. It's excellent for you. So you do need, I would say, three to four days a week of cardiovascular, seven days a week of strength training. Muscles are medicine and longevity. Did you know that building muscle releases these chemicals, these myokines?

SPEAKER_01 42:06

Irison. That's it?

SPEAKER_02 42:08

Irison, it's amazing. It's so important for longevity.

SPEAKER_01 42:12

Absolutely couldn't agree more. What are three actionable tips that you would give to any viewer that's watching this at the moment that they could implement in their life to prolong not just their longevity, but optimize their performance in everyday life from a biomechanical standpoint and in terms of structural durability?

SPEAKER_02 42:36

The top three tips I could give your listeners to make actionable change today is number one. Get up and move every 30 minutes. Set your alarm every 30 minutes that you get up and walk for five minutes, or do some mini squats or toe raises or calf raises. Every 30 minutes you need to move. Definitely. The second actionable change is make sure you're eating enough protein. We are for sure not eating enough, which then won't give the building block to create more muscle. So you should aim to one gram per kilogram. I'm eating 130 grams of protein a day in order to maintain my muscle mass and keep my high basal metabolic rate. So be conscious about the food choices you make. Make sure there's protein on every single plate that you have. Don't just skip breakfast. It's vitally important. And the third thing is go to bed at the same time every day. It's so important to get eight to ten hours of sleep in order for your body to heal. Those are actionable changes your listeners can do right here, right now.

SPEAKER_01 43:53

Absolutely. You someone, I'm just curious, that implements fasting protocols or intermittents. Fasting and what are your thoughts around that?

SPEAKER_02 44:02

I am a fan for intermittent fasting in the initial 90-day algorithm. When you come to my clinic with multiple comorbidities and your cholesterol is really bad, and your blood work in labs are so incorrect, and I've got to fix the needle, I'm gonna do intermittent fasting. Obviously, if it's clinically indicated and you're not a diabetic. But intermittent fasting is a really great tool that can set the metabolic rate, can help you lose weight quickly, safely. So I do believe in it if clinically indicated for someone that I'm trying to reset a whole list of comorbidities. And I've got patients, Rob, that have 25 to 35 diagnoses on one list. It's crazy. And every single one of those diagnoses can be fixed with the letter E. Exercise.

SPEAKER_01 44:59

Right.

SPEAKER_02 45:00

Period. End of story.

SPEAKER_01 45:01

Fascinating. One of the things I find interesting, just to tie this episode up, is the point around protein. Because on one hand, yes, I agree, having sufficient protein is important for obviously stimulating muscle growth and repair. But on the other hand, one of the root causes of aging, I believe, is overstimulation of mTOR. And I think this is where fasting plays a role. So on one hand, you're gonna have to stimulate M-Tol because that's what protein does, right? But on the one hand, on the other hand, having periods of fasting is good in terms of not overstimulating it as well. So I think there's a lot of nuance there. I'm not sure what the science says precisely around that, but I think it's a balance between performance and longevity, I believe.

SPEAKER_02 45:54

Absolutely. I think you said it great, performance and longevity. You know, are you that elite athlete? Are you trying to perform at a different level? You know, I think we're also talking a little bit about autophagy, right? You know, this autophagy where the senescent cells that were trying to, you know, kill off.

SPEAKER_01 46:10

Senescent cells is also one of the root causes of aging.

SPEAKER_02 46:12

Right? So I do believe I there is that period of autophagy that helps. You know, juice cleansing. I juice cleanse. I mean, I drink a green juice every single day, um, I believe is really important. So I think that we you need to individualize care. You need to, you know, meet with your clinician, your physician to get a balanced program that's right for you. Because if you are sarcopenia and you have osteoporosis, you need to eat more protein. You need to do bone density weight-bearing exercises to reverse osteoporosis, which you can do. You can reverse it through weight-bearing exercises. So I think as we age, I really do believe that intermittent fasting may not be the best thing for you. I'm believing that you must eat five meals a day, more snacks, more healthy snacks. You know, go for that, you know, lunch 10 a.m., you know, hummus and vegetables. You need to be eating greens and vegetables at every single meal, also. You know, let's not forget that fiber in one's diet is vital because as we get older, we're getting constipation, which is a big problem. And I really want to just bring this topic up, but you know, the whole world is starting to become addicted to GLP1s. And we're on these GLP1s where I have combated through the Corsair method the GLP1 workout, because these people are injecting once a week GLP to lose massive amounts of weight. Now they're losing massive amounts of muscle, yeah, and their skin is sagging. This is very, very bad for longevity. We must maintain our muscle mass, and I created a protocol to keep that muscle mass on those GLP1s. So we've got to be careful with these, you know, medicines that we're prescribing over to all of these people.

SPEAKER_01 48:10

That's interesting. Uh, what in what scenario would you suggest a GLP1 versus not in terms of is it a certain body fat percentage?

SPEAKER_02 48:21

A GLP1 is clinically indicated right now for the type 2 diabetic. That's what it was originally used for. Someone who's morbidly obese, can't lose the weight. That is what it was intended for, and it's working. But you know, now we're giving it to everyone. People that have a normal BMI. Oh, I want to lose 10 pounds. That's not indicated. If you want to lose 10 pounds, get up and move. It's simple math, Rob. Calories in versus calories out. There's no fat here. This diet, that diet, this diet. You are what you eat. Eat healthy. Calories in versus calories out. So the GLP ones I think are indicated for someone who's morbid obesity, that really is struggling to lose weight, and someone that's immobile from obesity as well. I think is important and very helpful for that person. But after that, please stop being lazy. Get to the gym and work out.

SPEAKER_01 49:18

Absolutely. In terms of the point around calories in versus calories out, I also think it's important about the macronutrients that you're getting in terms of because not all calories are equal per se.

SPEAKER_02 49:30

Correct. You need to look, that's an excellent point. You should speak to a functional nutritionist. That's part of our program. When you come to Boca Ratone, we give you the full program with a nutritionist who's gonna help you count the macros, making sure you're eating the good fats, the good fibers, and what time are you eating these foods? You know, right after the workout, I'm consuming those good carbohydrates and I'm consuming excellent protein, healthy right away to fuel my muscles. You know, I'm not gonna sit there and have a, you know, a sugar-laden meal right after the workout. So I think counting your macros is really important. I really believe it.

SPEAKER_01 50:14

Fantastic. I think this has been very, very helpful. Is there anything that you think you wanted to cover that we haven't covered?

SPEAKER_02 50:22

I'm here to tell you that honestly, don't be afraid to move. Don't make an excuse. There's no excuse out there. With my course of conditioning kit, I made the no excuse therapy. You can exercise anywhere, anytime, anyplace. I don't want to hear I'm on the airplane. I don't want to hear I have no time. You guys can do this. Just get out there and move. That's what I'm here to tell you.

SPEAKER_01 50:49

Absolutely. You have this device here. I just wanted to point to that. Can you explain to the audience what this is?

SPEAKER_02 50:54

Yes. So in my course of conditioning kit, I came up with three or four things. I'm showing you two of them. The rest of them are on my website. But you can do a full-body workout with a hundred reps of everything, getting the core, the arms, when you're sitting in the car, when you're at a light, when you're standing in the grocery store, when you're on your long-haul flight like you just took to Los Angeles, there's no reason why you can't do these exercises. And I came up with them, they're on my app, ptviphealth.com. And you can get the app, download the exercises, and do a full body workout in 15 minutes. No excuse. Just get out there and do it.

SPEAKER_01 51:35

Perfect. Final question. If you could ask any question to the next guest, what would you ask them?

SPEAKER_02 51:46

What did you have for breakfast today?

SPEAKER_01 51:49

Love that. Thank you very much. I hope you've all found this useful. Please subscribe to the channel if so. And thank you very much for listening.

SPEAKER_02 51:58

Thank you, Rob. It was awesome. So happy to you to spread the word. Biohack Rob, you're great.

SPEAKER_01 52:04

Thank you.