>> Produced from the Cube studios. This's strong by science, in depth conversations about science based training, sports performance and all things health and wellness. Here's your hose, Max Marzo. Thank you for being on two. Very, >> very excited about what we have going on for those of you not familiar with that Ella Keira, and I'm going to say his name incorrectly. Look here. Is that correct? Had >> the care is right. Very good. Yes. Also, >> I've practiced that about nineteen times. Oh, the other night, and I can't feel like I get it wrong and is one of the more well rounded individuals I've come across. His work is awesome. Initially learned quite a bit about him from Chase Phelps, who we had on earlier, and that came through Moore from blood flow restriction training. I've had the pleasure of reading up on quite a bit, and his background is more than unique. Well, around his understatement and really excited have on, I call him one of the most unique individuals people need to know about, especially in the sports science sylph sports science world. He really encompasses quite a bit of just about every domain you could think about. So add Thank you for being on here if you don't mind giving a little bit of background and a bio about yourself. >> Thanks so much. You know, not to. Not to warn anybody, really. But it kind of started as a front line medic in the Army. Really? You know, the emphasis back then was a get people back toe action as soon as possible. So that was my mindset. I spent about eight years in an emergency department learning and training through them. I undergo interviews and exercise physiology from University of California. Davis. I love exercise science. I love exercise physiology. Yeah, started doing athletic training because my junior year in college, I was a Division one wrestler. Tor my a c l p c l N L C E o my strength coach, chiropractor, athletic trainer all the above. Help me get back rustling within four months with a brace at a pretty high level of visual. On level on guy was like, Well, I don't want to go to med school, but what I want to do is help other people recover from injury and get back to the activities that they love. And so I was kind of investigating. Try to figure out what I wanted to do, Really want to be an athletic trainer? We didn't realize how much or how little money they make, um And so I was kind of investigating some other things. Checked out physical therapy, dentistry. But I really wanted to be in the locker room. I wanted to have my own practice. I wanted to be able to do what I wanted to do and not sit on protocols and things like that because I don't think that exists. And so I chose chiropractic school. I went to chiropractic school, learned my manual therapy, my manual techniques, diagnosis, loved it, was able to get patients off the street, didn't have tto live and die by insurance and referrals, was able only to open my own clinic. And and about four years in I realized that I didn't really know very much. I knew howto adjust people, and you had to do a little bit soft tissue. But not really. We weren't taught that I felt like my exercise background and really dropped off because I wasn't doing a lot of strength conditioning anymore. And so I went back and got a phD in sports medicine and athletic training. I had a really big goal of publishing and trying to contribute to the literature, but also understanding the literature and how it applies to the clinical science and clinical practice and try to bridge the gap really, between science and in the clinic and love treating patients. I do it every single day. A lot of people think I don't cause I write so much education, but, like I'm still in my clinic right now, twelve hours a day in the last three days, because it's what I love to dio on DH. Then just for kicks and giggles, I went out and got an MBA, too, so I worked in a lot of different environments. Va Medical System, twenty four hour Fitness Corporate I've consulted for a lot of companies like rock tape. It was their medical director. Fisma no trigger point performance. Have done some research for Sarah Gun kind of been able to do a lot with the phD, which I love, but really, my home base is in the clinic in the trenches, helping people get better. In fact, >> activity. That's awesome. Yeah, Tio coming from athletic training back on athlete. So I myself play I. Smit played small Division three basketball, and I'm a certified athletic trainer as well, and it's the initial love you kind of fall into being in that realm, and that's who you typically work with and then realizing that maybe the hours and the practice that they do isn't fit for you and finding ways you can really get a little more hands on work. I took the sports scientists route. It sounds like you're out has been just about everything and all the above. So it's great to hear that because having that well rounded profile, we weren't athlete. Now you've been in the medical side of the street condition inside even the business development side. You really see all domains from different angles. Now I know you are the educational director for smart tools with their blood flow restriction training chase. How younger? Very highly, uh, about your protocols. I've listened to some of them. If you don't mind diving into a little bit, what exactly is blood flow restriction training and what are the potential benefits of it? >> Yeah, you know it is about two thousand fourteen. I got approached by smart tools. They had developed the only FDA listed or at that point of FDA approved instrument assisted soft tissue mobilization tools other people like to call it, you know, basically grass in or whatever. Andi was really intrigued with what their philosophy wass, which was Hey, we want to make things in the US We want to create jobs in the U. S. And and we want to create the highest quality product that also is affordable for the small clinic. Whereas before the options Ray, you know, three thousand dollars here, two thousand dollars here on DH. So I wrote education for smart tools because of that, and because I just blot. I just believed so much in keeping things here in the U. S. And providing jobs and things locally. Um, so that's really where this all started. And in about two thousand fifteen, my buddy Skylar Richards up FC Dallas he has of the MLS. Yes, the the the lowest lost game days in the MLS. And yeah, I mean, when you think about that and how hard that is such a long season, it's such a grind is the longest season in professional sports. You think? Well, what is he doing there? I mean, I really respect his work up there. And so, like, you know, we were working on a project together and how I was fortunate enough to meet him. And I just really got to pick his brand on a lot of stuff and things I was doing in the clinic. And what could I do? Be doing better. And then one day it just goes, you know, have you seen this be afar stuff? And I'm like, No, I have no idea. It's your idea about it. And so, as usual at the science geek that I am, I went and I went to med sports discus. And I was like, Holy crap, man, I can't even I can't even understand how many articles are out there regarding this already. And this is back to you in two thousand fifteen, two thousand sixteen. I was so used to, you know, going and looking up kinesiology, tape research and being really bad. And you gotta kind of apply. You gotta apply a lot of these products to research. That's really not that strong. This was not the case. And so I brought it to neck the CEO of startles. And like, Dude, we've really got a look at this because really, there's only one option, and I saw the parallels between what was happening with Instrument assisted where there wasn't very many options, but they were very, very expensive and what we could do now with another thing that I thought was amazing. And it wasn't a passive modality because I was super excited about because, you know, I had to become a corrective exercise specialist because I knew I didn't have enough time with people to cause to strengthen hypertrophy. But be afar allows me to do that. And so that's really where I kind of switched. My mind went well, I really need to start investigating this and so to answer your question. VFR is the brief and in tremendous occlusion of arterial and venous blood flow, using a tourniquet while exercising at low intensities or even at rest. And so what that means is we basically use it a medical grade tourniquet and restrict the amount of oxygen or blood flow into a limb while it's exercising and totally including Venus, return back to the heart. And what this does is the way that explains my patients. Is it essentially tricks your brain into thinking you're doing high intensity exercise. But you're not and you're protecting tissue and you don't cause any muscle damage that you normally would with high intensity exercise or even low intensity exercise the failure. And so it works perfectly for those people that we can't compromise tissue like for me in a rehab center. >> Gotcha. Yeah, no, it's It's a super interesting area, and it's something that I have dove into not nearly as much as you have. But you can see the benefits really steaming back from its origins right when it was Katsu train in Japan, made for older adults who couldn't really exercise that needed a fine way to induce hypertrophy now being used to help expedite the healing process being used in season after ah, difficult gamed and prove healing, or whether it's not for whether or not it's used to actually substitute a workout. When travel becomes too demanding, toe actually load the system now with B f ar, Are you getting in regards to hypertrophy similar adaptations? Hypertrophy wise. If you were to do be a far with a low low, say, twenty percent of your one right max, compared to something moderately heavier, >> yeah, or exceeds in the time frame. You know, true hypertrophy takes according to the literature, depending on what reference you're looking at at the minimum, twelve weeks, but more likely sixteen weeks. And you've got to train at least sixty five percent. Or you've got to take low intensity loads to find his twenty to thirty five percent of one read max all the way to failure, which we know causes damage to the tissue be a farce. Starts to show hypertrophy changes that we two. So you know, my my best. My so I this It's kind of embarrassing, but it is what it is. But like, you know, I started learning mother our stuff. I'm a earlier Dr. Right? So I go right away and I go by the first product, I can. I have zero idea what I'm doing there. Zero like and a former Mr America and Mr Olympia Former Mr America champion and the one of the youngest Mr Olympia Tze Hor Olympia Mr Olympia ever compete. He competed and hey didn't stand But anyway so high level bodybuilder Okay, whatever you us. But he was definitely Mr America. He comes into my clinic when I was in Denver, It was probably a neighbour of you at the time, and he and he's like, Okay, I got this pain in my in my tryst up. It's been there for six months. I haven't been able to lift this heavy. My my arm isn't his biggest driving me crazy, right? The bodybuilder, of course, is driving him crazy, so I measure it. He's a half inch difference on his involves side versus on uninvolved side. I diagnosed him with Try some tendinitis at zero idea what I'm doing and be a far. But I said, Listen, I want you to use these cuffs. I got to go to Europe. I gotta go lecture in Europe for a couple weeks and I want you two, three times a week. I want you to do three exercise. I like to use the TRX suspension trainer. I've done a lot of work with them, and I really respect their product and I love it for re up. So I said, Listen, I want you three exercises on the suspension trainer I want to do is try to do a bicep. I want to do some, you know, compound exercise, and in that case I gave, Melo wrote, Come back in two weeks. He comes back in the clinic. I remember her is involved. Side was a quarter of an inch larger than his uninvolved type, and he's like, Do, That's two weeks. I'm like, Dude, that's two weeks And he's like, This is crazy and I go, Yeah, I agree. And since then, I've been, like, bought it like it's for hypertrophy. It is unbelievable. You get people that come in and I've had, you know, like after my injury in college rustling I my a c l I've torn it three times. Now, you know, my quad atrophy was bad. My calf was not the same size, literally. Symmetry occurs so quickly. When you start applying these principles, um, it just blows me away. >> So when you're using it, are using it more and isolated manner or are doing more compound exercises. For example, if you're doing a C l artifically assuming they're back too full function ish, Are you doing bodyweight squads or that starting off with the extensions? How do you kind of progress that up program? >> Yeah, it really just depends on where they're at. Like, you know, day with a C l's. You can pretty much start if there's no contraindications, you convey. Stay docks. Start day one. I'm right after surgery to try to prevent as much of that quad wasting that we get from re perfusion, injury and reactive oxygen species. All the other things that occur to literally day one. You can start and you'LL start isolated. You might start with an isometric. I really do like to do isometrics early on in my in my rehab. Um, and you can use the cops and you can You can fatigue out all the motor units if they're not quite air yet. Like, let's say, pre surgically, where they can't use the lamb, they're in a they're either bedridden or they're in a brace or they're a cast. You can use it with electric stim and or a Russian stem. And with that contraction, not only did you drive growth hormone, but you can also prevent atrophy by up to ninety, ninety five percent so you can start early early on, and I like to call it like phases of injury, right? Like pre surgical or pre injury, right at injury, you kind of get into the sub acute phase of inflammation. You kind of progressed isolated exercises and he goingto isolated in compound and you going to compound in any kind of move through the gamut. What's so cool about the afar is you're not having to reinvent the wheel like you use the same protocols, even use. I mean, really. I mean, if you're using lightweight with sarabande or resistance to being which I do every day, I'd be a far on it. Now, instead of your brain thinking you're not doing anything, your brain's like whoa, high intensity exercise. Let's let's help this tissue recovered because it's got to get injured. So we're gonna grow. >> That's yeah, that's pretty amazing. I've used it myself. I do have my smart tools. I'm biased. I like what you're doing. I really like the fact that there's no cords. It's quite mobile, allows us to do sled pushes, resisted marches, whole wide span and movements on DH before we're kind of hopped on air here. You're talking about some of the nutritional interventions you add to that, whether it be vitamin C college in glucose to mean. What specifically are you putting together on DH? Why're you doing that? Is that for tissue healing? >> Yeah, that's right. It's way. Have ah, in my clinic were Multidisciplinary Clinic in Dallas, Texas, and called the Body Lounge is a shameless plug, but way really believe that healing has to start from the inside, that it has to start with the micro nutrients and then the macro nutrients. And then pretty much everything can be prevented and healed with nutrition and exercise. That's what we truly believe, and that's what we try to help people with. The only thing that I use manual therapy for and I do a lot of needling and all these other things is to help people get it down there. Pain down enough so that they can do more movement. And so, from a micro nutrient standpoint, we've gotta hit the things that are going to help with college and synthesis and protein sentences, So that would be protein supplementation that would be vitamin C. We do lots of hydration because most of us were walking around dehydrated. If you look at some of the studies looking at, you know, even with a normal diet, magnesium is deficient. Vitamin C is deficient during the winter all of us are vitamin D deficient Bluetooth. I own production starts, you know, basically go to kneel. So all those things we we will supplement either through I am injection intramuscular injection or through ivy >> and you guys take coral. Someone's on that, too for some of the good Earth ion for the violent de aspects are taking precursors in a c. Are you guys taking glue to file? >> We inject glorify on either in your inner, either in your i V or in in the I am. You know, with the literature supporting that you only absorb about five to ten percent of whatever aural supplementation you take. We try to we try to push it. I am arrive. And then in between sessions, yes, they would take Coral to try to maintain their levels. We do pre, you know, lab testing, prior lab testing after to make sure we're getting the absorption rate. But a lot of our people we already know they don't absorb B twelve vitamin, and so we've got to do it. Injectable. >> Yeah, Chef makes sense with the B f r itself. And when I get a couple of questions knocked out for I go too far off topic. I'm curious about some of these cellars swelling protocols and what that specifically is what's happening physiologically and how you implement that. >> Yeah, so South Swell Protocol, where we like to call a five by five protocol way. Use the tourniquet. It's in the upper extremity at fifty percent limb occlusion pressure at eighty percent limb occlusion pressure in the lower extremity. You keep him on for five minutes, and then you rest for three minutes, meaning I deflate the cuffs. But don't take them off, and then I re inflate it same pressure for five minutes and then deflate for three minutes. You're five on three off for five rounds, justified by five protocol. What's happening is that you're basically you're creating this swelling effect because, remember, there's no Venus return, so nothing is. But you're getting a small trickle in of fluid or blood into that limb. And so what happens is the extra Seiler's extra Styler swelling occurs. Our body is just dying for Homo stasis. The pressures increase, and there's also an osmotic uh, change, and the fluid gets pushed extra. Sara Lee into the muscle cell body starts to think that you're going to break those muscle cells. I think of it as like a gay. A za water balloon is a great analogy that I've heard. So the water balloon is starting to swell that muscle cell starts to swell. Your body thinks your brain thinks that those cells need to protect themselves or otherwise. They're going to break and cause a popped oh sis or die. And so the response is this whole cascade of the Mt. Horsey one, which is basically a pathway for protein synthesis. And that's why they think that you can maintain muscle size in in inactive muscle through the South Swell Protocol and then when we do this, also protocol. I also like to add either isometrics if I can or if they're in a cast at electric stim. I like to use the power dot that's my favorite or a Russian stim unit, and then you consent. Make the setting so that you're getting muscular. Contraction with that appears to drive growth forma, and it drives it about one and a half times high intensity exercise and up to three times more so than baseline. When we have a growth hormone spurt like that and we have enough vitamin C. It allows for college and synthesis. I like to call that a pool of healing. So whether you can or cannot exercise that limb that's injured if I can create that pool of healing systemically now I've got an environment that can heal. So I have zero excuse as a provider not to get people doing something to become, you know, healing faster, basically. And are you >> typically putting that at the end? If they were training? Or is that typically beginning? We're in this session I put in assuming that that is done in conjunction with other movements. Exercises? >> Yeah, so, like, let's say I have a cast on your right leg. You've got a fracture. I failed to mention also that it appears that the Afar also helps with bone healing. There's been a couple studies, Um, so if we could get this increased bone healing and I can't use that limb that I'm going to use the other lambs and I'm going to use your cardiovascular function, um, I'm going to use you know, you Let's say with that leg, I'LL do upper body or a commoner with cuffs on in order to train their cardiovascular systems that way. Maintain aerobic capacity while they're feeling for that leg, I will do crossover exercises, so I'll hit that opposite leg because something happens when I use the cuffs on my left leg. I get a neurological response on my right leg, and I and I maintain strength and I reduced the amount of atrophy that occurs. And it's, you know, it's all in neurological. So if I had an hour with somebody and I was trying to do the cell school protocol, I would probably do it first to make sure because it's a forty minute protocol. It is a long protocol. If you add up five, five minutes on three minutes off now, during the three minutes off, I could be soft tissue work. I can do other things toe help that person. Or I could just have an athletic tournament training room on a table, and they can learn to inflate and deflate on their own. It doesn't like it's not has to be supervised the whole time, and that's usually what they do in my office is I'LL put him in the I V Lounge and i'Ll just teach them how to inflate deflate and they just keep time. Uh and there, go ahead. I mean, interrupt my bowl. No, no, no, it's okay. And then I just hit other areas. So if I do have extra time, then I might Do you know another body pushing upper body pole? I might do, you know, whatever I can with whatever time I have. If you don't have that much time, then you do the best you can with the cells for protocol. And who study just came out that if you only do two rounds of that, you don't get the protein synthesis measured through M. Dorsey long. So a lot of times, people ask me what can I just do this twice and according to the literature looks like No, it's like you have to take it two five because you've got to get enough swelling to make it to make the brain think that you're gonna explode >> those muscle cells. >> Well, let me take a step back and trap process majority of that. So essentially, what you do with the seller swelling protocol is that you initiate initiating protein synthesis by basically tripping the body that those cells themselves are going to break down. And then when you add the message of the electrical muscular stimulation, you're getting the growth hormone response, the otherwise wouldn't. Is >> that correct? That's correct. So and go ahead. So imagine after a game, I just you know, I'm Skyler Richards. I just got done with my team. Were on the bus or on the airport, our airplane. My guys have just finished a match. You know, you're Fords have run seven miles at high intensity sprint. You think we have any muscle breakdown? Probably have a little bit of damage. They gotta play again in a few days, and I want to do things to help the recovery. Now I put them on with East M. They're not doing any exercise. There's just chilling there, just hanging out. But we're getting protein synthesis. We're getting growth hormone production. I give him some vitamin C supplementation. I give him some protein supplementation, and now not only do we have protein census, but we also have growth hormone in college, in formation in the presence of vitamin C. So that's where we kind of get into the recovery, which chase is doing a >> lot of work with and how much vitamin C are supplemented with, >> you know, really depends. I try to stick to ride around in a new patient. I won't go start off three thousand and I'LL go to five thousand milligrams. It will cause a little dirty pants if I can quote some of my mentors so I try to start them light and I'll move them up I'LL go with eyes ten thousand if I need it but typically stay in the three to five thousand range >> And are you having collagen with that as well? >> I personally don't but I think it would be a good idea if he did >> with some of that. I guess I really like the idea of using the B f R a zit on the opposite lake that's injured to increase cortical drive. So we're listeners who aren't familiar when you're training one limb yet a neurological phenomenon that occurs to increase performance in the other limb. And so what ends referred to if you had one lamb that was immobilizing couldn't function. If you use BF are on the other limb, you're able to stimulate, so it's higher type to voter units able have a cortical drive that near maximal intent, which is going to help, then increase the performance of the other leg that you also say that is promoting this positive adaptation environment is kind of hormonal. Malu I per se How long does that last for the presence of growth hormone? >> It looks like that the stimulation last somewhere between forty eight and seventy two hours. And so I think that that's why when they've done studies looking at doing the afar for strength of hypertrophy, you know, five days a week, compared to two to three days a week for two to three days a week, or just essentially equal to the five days a week. So I think it is long enough that if you do it like twice a week that you're going to get enough cross over >> cash it and you're using it two for the anthologies of effect. So what do you using Be fr yu have that temporary time period of time window where a need that might be bothering your doesn't irritate as much. And are you using that window than to train other exercise and movements while they have, ah, pain for emotion. >> Yeah, absolutely. So it's and I really can't explain it. It's, um we know from the science that it doesn't matter what type of exercise that we do. There is an animal Jesus effect. And that's why I emphasized so much with provider, especially manual therapists attend to think, Hey, you know, my my hands or my needles or my laser or my ultrasound or East them or whatever it is, is the healing driver. It's not the healing driver exercises a healing driver, and I know that's my opinion and people argue with me. But it's true. My hands are not nearly as important as getting people moving because of the energies that perfect and just overall health effects. With that said, the Afar has some sort of Anil Jesus effect that I can't explain now. Of course, we all know it's in the brain. There's something that goes on where you're able to reduce the pain level for up to forty five minutes and then I can train in that window. There is an overall ability to improve people's movement even longer than that, to what I find is that once I get people moving their tenancy just like inertia. Once you get to move in, it keeps moving. Same thing with people that I work with. They tend to get moving more in my clinic. They get confidence, then they end up moving more and more and more. And they get away from, um, being >> scared. Yeah, I know that. That's a great way to put it, because you do have that hesitation to move. And when you providing a stimulus that might ease some of the pain momentarily. I know there is some research out there. Look at Tanaka Thie, the ten apathy being like knee pain, essentially the layman's term kind way to put it. And they're doing it with, like the Metrodome in the background going Ping Ping ping. They're having that external stimulus that they focus on to help disassociate the brain and the knee and the pain. And this is something I can't top what chase and how he says. Yeah, we've been using, like you alluded to Thebe fr, too. Remove the presence of pain so they can do something. These exercises that they typically associate with pain in a pain for your way. >> Yeah, And then now that they're exercising now you get the additional Anil Jesus effect of the exercise itself. Says I'm like a double like a double lang >> Gotcha. Yeah, with blood flow restriction train because it does promote such an environment that really has an intense Jane court stimulus to the body where you get this type to five or stimulated high levels of lactate high levels of metabolite accumulation. I said she had paper about the possible use of bloodflow restriction trading cognitive performance has curious if you had a chance account dive into some of that. I love to hear some of your thoughts being that you have such asshole listed view of everything. >> Yeah, definitely. I think I didn't get a chance to look at it. I appreciate you sending that to me because I have to lecture and may on reaction times, and I was trying to figure out how I'm gonna like include the afar in this lecture at some point, not be totally, you know, inauthentic. But now I can. So I totally appreciate it. I know that there is, and I know that there's an additional benefit. I've seen it. I've worked with stroke patients, other types of people that I have auto, immune, disease, different types of conditions where I've used the Afar and their functional capacity improves over what their physical capacity is doing on. And so I am not surprised at what I'm seeing with that. And I've got to learn more about what other people are thinking. It was interesting what you sent me regarding the insulin growth factor one. We know that that's driven up much higher with the Afar compared to low intensity exercise and the relationship between that and cognitive function. So I've gotta dive deeper into it. I'm not definitely not a neuroscientists, You know, I'm like a pretty much floor if I p e teacher and, you know, just trying to get people moving. And I've gotta understand them more because there is a large association between that exercise component and future >> health, not just of muscles but also a brain. Yeah, >> one of things that I do work with a neurosurgeon and he's awesome. Dr. Chat Press Mac is extremely intelligent, and he saw the blood flow restriction trade as one those means to improve cognitive performance, and I didn't find the paper after he had talked about it. Well, the things that interested me was the fact that is this huge dresser, especially in a very controlled where typically, if you're going to get that level of demand on the body, you knew something very intense. So do something that is almost no stress, Feli controlled and then allowing yourself to maybe do some sort of dual processing tasks with its reaction time and reading for use in a diner vision board. Whether if you have a laser on your head, you have to walk in a straight line while keeping that laser dot on a specific screen. I'm excited to see how be afar material or just something other domains. Whether it is, you know, motor learning or reeducation ofthe movement or vestibular therapy. I think this has a very unique place to really stress the body physiologically without meeting to do something that requires lots of equipment for having someone run up and down with a heavy sled. I'd be curious to hear some of your thoughts. I know you haven't had a huge opportunity dive into, but if I had a hand, you the the key to say Hey What do you see in the future for be fr in regards to not just the cognitive standpoint but ways you can use B a far outside of a physical training area. What kinds? Specific domains. You see it being utilised in >> we'LL definitely recovery. I love the fact of, you know, driving growth hormone and supplement incorrectly and letting people heal faster naturally. Ah, I think the ischemic preconditioning protocol is very underutilized and very not known very well, and he's skimming. Preconditioning is when we use one hundred percent occlusion either of the upper extremity or the lower extremity. We keep it on for five minutes and we do two rounds with a three minute rest in between. And I have used this to decrease pain and an athlete prior to going out and playing like a like a high level sport or doing plyometrics. We're doing other things where they're going to get muscle damage to that eye intensity exercise so you get the Anil Jesus effect around an injured tissue. But they really unique thing about the ischemic preconditioning is that it has been shown to reduce the amount of muscle damage that occurs due to the exercise. That's why they call it Preconditioning so we can utilize a prior to a game. We can use a prior to a plyometrics session. We can use it prior to a high intensity lifting session and reduce the amount of damage that occurs to the tissue. So we don't have such a long recovery time when we could continue to train at high levels. I think that that is probably the most exciting thing that I've seen. Absent of cognitive possibilities, I think it wise it on is I'd like to use with the lights. What do some lights? Teo, do some reaction time and do some, you know, memory training and things. And I love to torture my people and get them nice and tired. I think what's going to come around is all these mechanisms. They are what they are. But the true mechanism that I'm seeing is that fatigue is the primary factor. If I can fatigue you centrally and Aiken fatigue, you peripherally and the muscle that's for the adaptation occurs So although right now you know we always are on these. We have to use the specific sets and rats and weights and all these other things so true for the research, because we need to make it is homogenous as we can, but in clinic, if you're a patient, comes to me with a rotator cuff tear. I don't know what you're on, right, Max is for your external rotation. I've gotta guess. And so if I don't do exactly the right amount of weight, doesn't mean I'm not getting the benefit. Well, I'm telling you, anecdotally, that's not true. I just know that I have to take you to fatigue. And so if I'm off by a couple of wraps a big deal, I'm just not going to take you to failure. So I don't get the injury to the tissue that you normally would occur with lightweight to failure. I'm gonna get that fatigue factor. I'm going to get you to adapt, and I'm gonna get you bigger and stronger today than you were yesterday. That's the >> goal. Yeah, that's ah, that's a great way to put it because you're looking at again, you know, mechanisms in why things are occurring versus, you know, being stuck to literature. I have to use twenty percent. How do we find a way to fatigue this system and be fr being a component of that now, outside of blood flow research in train with your practice, it sounds It is quite holistic. Are there any specific areas that you see the other? That was other therapists other, You know, holistic environments could learn from outside of blood flow restriction training. What areas could they really? You know what advice such a safer that I would you give someone who's tried together holistic program to dive into outside of Sebi Afar? Is there any specific devices specific modalities supposed to specific means for a nutrition for that? >> I mean, if I was to try to put us you know what we're trying to dio. I would say that it's all about capacity versus demand. I want to try to maximize the capacity of the individual or the organism to exceed the demands that you're trying to apply to it. If we can do that, will keep you injury free will keep forming. If I allow those demands to exceed your capacity, you're going to get injured. So what can I do to maximize your capacity through nutrition, through exercise, through rest, through meditation, through prayer, through whatever that is through sleep? I think that that's really looking at the person as a whole. And if I can keep thinking about what are the demands that I'm applying? Teo, whatever tissue that is, and I can keep those demands just slightly below and try to increase the capacity, I'm going to get people better. And really, that's all I think about. Can that disk take how much pressure cannot take and what direction can I take it? Well, I'm gonna work at that direction and so we can do a little bit more and a little bit more and a little bit more, and I try to really make it simple for myself versus Reliant on a modality or anything else in that matter. Really, it's It's really just thinking about how much How much can they How much can they tolerate? And I'm goingto put restrictions on you so that you don't exceed that capacities That way that tissue can heal. And if it can't and you know, maybe that's referral to you know, some of the surgeons are non surgical positions that I work with is they may be fail my treatment. Most people can improve their capacity. We've seen eighty five year olds, Not just me, I'm saying in the literature. Improve their strength through resistance training. Eighty five. The body will always adapt. Ware not weak beings were not fragile, Weaken De stressed and we need to be stressed and we need to be stressed until the day that you put me in the grave. Otherwise we will get Sir Compagnia and we will degrade and our brain will become mush. And I just want to go that way. And I want help as many people that have the same philosophy, whether I'm doing it, one on one with somebody from teaching others. I want them now The same philosophy, Tio >> well, that makes total sense. I love the idea of we need to continually stress ourselves because do you feel like as we age, we have a Smith or belief that we can't do more, but we can't do more because we stopped doing more? Not because we can't. I work with an individual who are hey, hip replacement. Ninety six years old. He came back and four months later was working out again. And that alone was enough evidence for me to realize that it's not necessarily about, Oh, as I get older, I have to be this and we kind of have that thought process. As we age, we do less so we start to do left but find ways to stress the system in a way that can handle it right to the idea. What is the capacity, like you said? And what is their ability to adapt? Are there any specific ways that you assess an individual's capacity to handle load? Is that a lot of subject of understanding who they are? Further any other metrics you using whether we sleep tracking H R V for anything in that domain? >> I have not really done a lot of a lot of that. It's more about, you know what they tell me they want to do. You know you want to come in and you want a lift. Your grandkid. Well, that's That's our That's our marker. You want to come in and you want to do the cross that open. Okay, well, that's your marker. You want to come in, you want to run a marathon. That's your marker. You know, we could always find markers either of activities of daily living or they could be something out there. That's that's that. That's a goal. You know, Never don't half marathon, and I want to do that. So those were really the markers that I use haven't gotten into a lot of the other things. My environment, you >> know? I mean, I would love to have ah, >> whole performance center and a research lab and all that stuff and then, you know, maybe someday that with what I have and what I work with, it's it's more about just what the person wants to do and what is something fun for them to do to keep them active and healthy and from, and that really becomes the marker. And if it's not enough, you know, somebody had a e r physician committee as well. You know, I walk, you know, twenty or thirty minutes and then I walked, you know, at work all day. And I'm like Did It's not enough. And I sent him some articles that looking at physiological adaptation to walking and he's like, Yeah, you're right, it's not enough that I'm like, you know, we're a minimalist. Were like Okay, well, this is the vitamin C you need in order to be healthy, not the recommendations are so you don't get scurvy. A lot is a big difference between, you know, fending off disease versus optimal health. I'm out for optimal health, So let's stress the system to the point where we're not injuring ourselves. But we are pushing ourselves because I think there's such a huge physiological and but also psychological benefit to that. >> Yeah, this that's a great way to put it riff. Ending off disease, right? We're not. Our health care system is not very proactive. You have to have something go wrong for your insurance to take care of it. It's very backwards. That's unfortunate. Then we would like to be like. It's a place where let's not look at micro nutrients and you what were putting in her body as a means to what he says you avoided and scurry. Well, let's look at it from way to actually function and function relative to our own capacity in our own goals. Um, with that, are you doing blood work? I'm assuming of some sort. Maybe. >> Yeah, we do. Labs. Teo, look, att. A variety of different things. We don't currently do Hormonal therapy. We've got some partners in town that do that. We decided we wanted to stay in our lane and, you know, really kind of stick to what we do. And so we refer out any hormonal deficiencies. Whether you need some testosterone growth hormone is from other things. Estrogen, progesterone, whatever s. So we're not doing that currently, and we don't see ourselves doing that because we have some great partners that you a much better job than we would ever do. So I'm also a big believer in stay in your lane, refer out, make friends do whatever is best for the patient of the client. Um, because there's that pays way more dividends them than trying to dio everything you know all announce. Unless you have it already in the house that has a specialty. Yeah. No, that >> makes sense to find a way to facilitate and where you can excel. Um >> and I >> know you got a lot of the time crunch here. We have the wrap it up here for people listening. Where can we find more out about yourself? Where can we listen to you? What social media's are you on and one of those handles >> So instagram I'm under just my name Ed. Look, terra e d l e c a r a Facebook. Same thing. Just Ed. Look era Twitter and la Cara. Everything's just under Everclear. Really? Every Tuesday I do would be a far I call it BF our Tuesday I do kind of a lunch and learn fifteen twenty minutes on either a research article or protocol. If I got a question that was asked of me, I'll answer it on DH. That's an ongoing webinar. Every Tuesday I teach live be If our course is pretty much all over the world, you can go to my website at like keira dot com or d m e on any of the social media handles, and I'LL be happy to respond. Or you could just call my client body Launch Park City's dot com and give me a call >> and you're doing educational stuff that's on the B Afar Tuesday and your webinars well are those sign up websites for those, And if so, is it under your website and look era dot com? >> Uh, that's a great point. I really should have it home there. It's if you go on my social media you you'LL see it was all announced that I'm doing No, you know, whatever topic is I try to be on organized on it. I will put a link on my website. My website's getting redone right now, and so I put a link on there for be If our Tuesday under I have >> a whole >> be fr. It's called B F, our master class. It's my online BF our course on underneath there I'LL put a link. Tio might be a far Tuesdays >> gadget. Is there anything you wanna selfishly promote? Cause guys, that is an amazing resource. Everything he's talking about it it's pretty much goal anyway, You can hear more about where you work out any projects, anything that you'd be wanting others to get into or listen to that you're working on that you see, working on the future or anything you just want to share. >> I'm always looking at, you know, teaching you no more courses like love teaching. I love, you know, doing live courses. Esso I currently teach to be if our course I teach the instrument assist. Of course. Programming. I teach a, uh, a cupping movement assessment and Fossen course. So any of those things you can see on my website where I'm gonna be next? We're doing some cool research on recovery with a pretty well known pretty, well known uh, brand which I hope we'll be able to announce at some point. It looks like the afar Mike increased oxygenation in muscle tissue even with the cuffs on. So it looks like it looks like from preliminary studies that the body adapts to the hypoxic environment and my increased oxygenation while the cuffs are on. I'll know more about that soon, but that's pretty exciting. I'Ll release that when I when I can you know? Other than that if I can help anybody else or help a friend that's in Dallas that wants to see me while I'm here. I practiced from seven. AM almost till seven. P. M. Every night on. I'm also happy to consult either Via Skype. Er, >> um, by phone. >> Gosh. And you smart tools use a dotcom. Correct for the CFR cuffs. >> Yeah, you can either. Go toe. Yeah, you can go to my side of you connect with me. If you want to get it, I can get you. Uh, we could probably do a promotional discount. And if you want to get some cups but smart tools plus dot com is is the mother ship where we're at a Cleveland our We're promoting both our live courses and are and our material in our cups. >> I can vouch them firsthand. They're awesome. You guys do Amazing work and information you guys put out is really killer. I mean, the amount of stuff I've been able to learn from you guys and what you've been doing has helped me a ton. It's really, really awesome to see you guys promoting the education that way. And thank you for coming on. I really appreciate it. It was a blast talking Teo again. Guys, go follow him on Instagram. He's got some amazing stuff anyway. You can read about him, learn about him and what he's doing. Please do so and thank you. >> Thank you so much. I really appreciate it a lot of spreading the word and talking to like minded individuals and making friends. You know that I have kind of this ongoing theme of, you know, it's all about, You know, there's two things that we can control in our life. It's really what we put in our mouths and how much we move and people like you that air getting the word out. This information is really important that we've got to take control of our health. We're the only ones responsible. So let's do it. And then if there's other people that can help you reach out to them and and get the help you need. >> Well, that's great. All right, guys. Thank you for listening. Really Appreciate it. And thank you once again