wise athletes podcast

Sponsor: RePowerU — a free fitness practices assessment (a 10-minute questionnaire) Who is Dr. Adam Bataineh? Adam Bataineh, MD: Internal medicine doctor focused on aging and longevity. Co-founder and chief medical officer of Span Health, a longevity-focused health coaching app. The focus of the Wise Athletes podcast is older athletes, and how they can improve athletic performance today and retain their athletic capability for a long time.  As a group, older athletes are big users of performance tracking tools for heart rate, power output, speed, and distance; and more and more we are adding biometric tracking wearables for general health and fitness tracking, such as sleep duration and HRV. Dr Bataineh is an expert in the wearables market. Dr. Adam Bataineh on Twitter: https://twitter.com/DrAdamBat Our discussion topics: Why do we need continuous tracking of anything?  Why isn’t my annual physical and blood test with my family doctor good enough?An overview of the market:  types of devices, data services that sit on top of devices to give us advice?Where are the devices and AI accurate enough to turn over our decision-making to the machines?What is the 80/20 rules in this space?  How do I get the biggest bang for my money and time? What is Span Health? Span Health is one of the startups that translates the science of personalized nutrition & lifestyle using your data to find what works. “We started with a mobile app with tools and content to run experiments, validate which ones truly work for you, and stack healthy habits into a sustainable routine, “says Patrick Samy, co-founder and CEO of Span Health. Span Health website: https://www.span.health

My Talk with Dr. Luks Dr. Luks is a top Orthopedic Surgeon and Sports Medicine Physician who is also a masters endurance athlete. Dr Luks knows all too well how hard it can be and how important it is to remain athletic for the pleasures it brings to life as well as for the many health and longevity benefits that cannot be obtained in any other way. In our discussion we cover a set of topics that are of interest to all older endurance athletes, including: How do I interpret that joint pain that appeared out of nowhere, and what should I do? When should I get an MRI? How to avoid training mistakes behind “overuse” injuries that can take away our athletic fun. Arthritis:  ….. am I causing arthritis by exercising a lot?  Should I rest my joints to let them heal? Surgery vs. no surgery:  What’s this top orthopedic’s surgeon’s surprising perspective on the role for surgery?  If you are dealing with chronic pain, thinking about surgery, worried about arthritis or just want to understand your body a little better…listen in to this conversation.  You will learn a ton. Who is Howard J Luks, MD? Dr. Luks has been named as one of the top Sports Medicine Physicians in the United States, by US News and World Report.  He has also been named as one of the Top 10 “Social Health Makers” for Osteoarthritis.  Dr. Luks has been named one of the top Sports Medicine Physicians in New York for nearly 10 years in a row and Dr. Luks was named one of Twitter’s Top Ten Doctors and served as an Advisory Board Member of the Mayo Clinic Center for Social Media for 3 years. After graduating with honors from New York Medical College, Dr. Luks completed his Orthopedic Surgery residency in NY in 1996 and a fellowship in Sports Medicine at the Hospital For Joint Diseases in NYC in 1997.   As the Chief of Sports Medicine and Arthroscopy at New York Medical College for over 20 years, Dr Luks was entrusted to teach the next generation of Orthopedic Surgeons about the needs of athletes of all ages.  As a Board Certified Orthopedic Surgeon specializing in Sports Medicine, Dr. Luks focus is on injuries that involve the shoulder, knee, ankle, and elbow.   More than twenty years of experience in an academic community has enabled Dr. Luks to offer a comprehensive sports medicine treatment experience; including a solid education about what’s bothering you, and a formal plan to move forward and back to your anticipated level of play.  Most injuries are managed non-operatively with a focus on how to adjust training, lifestyle, diet, and exercise to improve condition.    Blog post on when to get an MRI: https://www.howardluksmd.com/sometimes-our-joints-just-hurt-and-its-ok-not-to-know-why/ Website: https://www.howardluksmd.com/ Twitter: https://twitter.com/hjluks

Sponsor: RePowerU — a free fitness practices assessment (a 10-minute questionnaire) Who is Dr. John Day? Dr. John Day is a cardiologist specializing in the treatment of atrial fibrillation and other abnormal heart rhythm conditions at St. Mark’s Hospital in Salt Lake City, Utah. He received his medical degree from John Hopkins and completed his residency and fellowships in cardiovascular medicine and cardiac electrophysiology at Stanford University.  Dr. John Day is board certified in cardiology and cardiac electrophysiology. Since 2004, Dr. John Day has appeared as a health expert on all of the major television networks. For several years he had a weekly television segment on the CBS affiliate in Utah.  Over 65,000 people now follow him through his newsletter, blog, or social media channels.In 2017 Dr. John Day published his first book, The Longevity Plan.  This book went on to become an Amazon number one best seller and was named best books of 2017 by the Huffington Post.In 2021 Dr. John Day published his second book, The Atrial Fibrillation Cure which was also an Amazon best-seller and was the top selling book in the entire cardiovascular space for over two months.In addition to his books, Dr. John Day is the prolific author of more than 100 studies that have been published in many of the most prestigious scientific and medical journals.  He also is the founding editor-in-chief of the Innovations in Cardiac Rhythm Management medical journal.Dr. Day is also a researcher and pioneer in the field of electrophysiology, with a patent on technology that allows physicians to map the source of atrial fibrillation three-dimensionally. https://drjohnday.com/ Podcast Summary Notes “Long time, competitive endurance athletes have a higher risks of AFib, which is a marker of premature aging. The faster you solve AFib, the better your long-term outcome. Ablation technologies have come a long way….success rates of 80-90% can be expected.” What is atrial fibrillation? (https://www.cdc.gov/heartdisease/atrial_fibrillation.htm) Atrial fibrillation (AFib or AF) is the most common type of treated heart arrhythmia. An arrhythmia is when the heart beats too slowly, too fast, or in an irregular way.When a person has AFib, the normal beating in the upper chambers of the heart (the two atria) is irregular, and blood doesn’t flow as well as it should from the atria to the lower chambers of the heart (the two ventricles). AFib may happen in brief episodes, or it may be a permanent condition. Cardiologist vs. Cardiac electrophysiologist (EP)? To become an EP takes an extra 2 years of trining.  EP’s deal with every electrical related to the heart.  Treatments:  ablation, pacemakers, etc. What is the connection between AFib and long-time endurance athletes? It is true.  There is a U shaped curve with both ends having a higher than average risks:  a couch potato on one end and the highly competitive athlete (very long endurance events and/ or maximum heart rate races) on the other.  The more races you do, the more risk you may have…up to 4-5 times higher.Lowest risk?  Regular, modest exercise. Why AFib for older athletes?   High sustained heart output….stress on the heart for too long might be a cause.  Perhaps related to the very low heart rates of the athlete when at rest.The heart is a pump with valves.  Scarring on the heart can take place with athletes…just over using the heart somehow.  Little areas of micro scarring …could it be related to blood flow issues, maybe.  Maybe the level of cardiac output is just too high, and some people are subsetible to this damage.Still, the risks to inactive people is higher than for athletes, even though the long-time, competitive athlete has a higher risk than the average person who exercises regularly but modestly.How common is AFib?  40-50% higher risk up to multiples higher.  About 1 in 4 people in US will have some AFib in their lives. What increases risk?  Chronic risk of repeated AFib episodes Extremely long endurance racesExtremely high HR racingFamily history of AFib (20-30% of cases)Caucasian have a higher riskOverweight is more likely….causes higher stress on heartDiet plays a role.  Fast food, over eating, greasy food can increase risks AND be triggers of episodesAging…the older you get the higher the risk Short term triggers of AFib episodes Alcohol can trigger Afib even in young people with zero other risksHigh stressCaffeine?  No, not a trigger, but cut back if you feel sensitive.Energy drinks, yes!  Exercising in dehydrated or electrolyte (magnesium and potassium) depleted state AFib begets AFib — don’t let episodes continue.  Heart scars more quickly when you are having episodes…and more scaring means more episodes.  And get the AFib to go into remission.Put it in remissionLose weight.  Back off of the extreme athletics.  Get an ablation to avoid medications which compromise athletic performance.  In general, slow the aging process:  optimize nutrition, keep weight in check, optimizing sleep, managing stress, regular exercise while hydrated but not too much or too hard. AFib is a marker of premature aging.  A marker of a person who hasn’t taken care of themselves enough given their genetic status.Cardiac output drops 20-30% when you are in AFib.  And the poor beating leads to blood clots that can kill you.  Heart failure is another potential consequence. Ablation   Out-patient surgery.  Run catheter up a leg vein.  Surgery over in 2 hours, patient observed for 3 hours, and then back home.  About 5 days until returning to full activity.  It’s not major surgery; well tolerated.  The technology is improving all the time; fewer and fewer people don’t respond well.  Sometimes a 2nd session is necessary, but rarely. Younger (30-40 yo) get 90-95% success rateOlder people — 80-90% successBetter for men, but even women get fantastic results. If they don’t go crazy with risk factors, they don’t get it again. Just to be safe, people should be prepared to shutdown AFib episodes if they do happen. Everyone is different, and they should work with Dr’s to figure out what is beset for them.Wearables:  Apple Watch and many others have AFib detection software that is very good.  Do that.  Don’t worry about the super high tech AFIb trackers…an EP wants to see the tape, not a blip on a device.Stay hydratedTake a nap…or go to bedExercise to stop a low HR AFib episode (check with DR)Do some meditationBear down, cough — vegal tone“Pill in the pocket” — work with your dr.  Take it only when the rare episode pops up to stop it to avoid a trip to the ERIf all else fails, go to the ER to get the heart shocked back into rhythm. Right side vs. left side sleeping Most AFib patients sleep on right side to minimize the sensation of heart palpitationsMaybe left side sleeping contributes to AFib but maybe not.  Certainly makes the sensation more noticeable. AFib and Sleep Apnea Sleeping on back is bad for Apnea and AFibApnea makes is 4x higher risk of AFibOxygen levels can fall into 70% rangeMany times solving sleep apnea causes AFib to go into remission.T-shirts with a pouch for a tennis ball to teach you to not sleep on back. Final Advice from Dr. Day: For the competitive athlete who cannot give up the extreme exercise and they have done everything else right.  Don’t be afraid of ablation.  The sooner they get treated, the better their long-term success rate Two books written by Dr Day: Longevity PlanThe AFib Cure Newsletter, podcast, blog on Website:  drjohndaymd.com Previous Episodes on AFib: Episode #10 – Endurance Athlete’s A-Fib, Part 1 Episode #11 – Endurance Athlete’s A-Fib, Part 2

Sponsor: RePowerU — a free fitness practices assessment (a 10-minute questionnaire) This is a shortened version of Episode 50 (1.5 hours long)….I cut out the good and left the great. If you haven’t listened to the full episode, start with this one and then graduate to the full story from George Dallam, PhD. Nasal breathing is not a trick or hack to get an unnatural advantage.  Nasal breathing is the designed in way to breathe properly.  Not nasal breathing causes health and performance problems. But it’s never too late to do it right. Learn the why’s and how’s of nasal breathing from George Dallam, PhD. Dr. Dallam says, “One simple rule:  breath through nose all the time, or as much as possible.” Benefits of nasal breathing:  Better filtering of particles and viruses (less nasal infection, bronchitis). Filtering becomes even more important when exercising because we take in so much more air.Less water lost though breathingLess energy spent on breathing (more energy for locomotion); higher O2 extracted per breath (higher efficiency)Recovery from “EIB” exercise induced bronchoconstriction (exercise induced asthma)Provides a powerful training stimulus to improve fitness…make you faster even if you go back to mouth breathing in high intensity efforts, such as racesImproved stress managementBetter sleep, and overall improved recovery from exercise (lower stress, avoidance of snoring)Better posture and movement ability with improved diaphragm activityFunctional movement benefits —diaphragm is a major core muscle that is under strength when we mouth breathe. Avoids possible damage to the heart from over breathing (a hypothesis from Dr Dallam)  Notes from discussion with George Dallam, PhD Myths about breathing: I feel the need to breath faster when I need more oxygen — mostly false.  It is the presence of higher than usual CO2 in the blood that causes the “air hunger”CO2 is bad, and needs to be removed as fast as possible — false; CO2 is necessary for normal bodily functions.  Too much AND too little CO2 are bad for the body.Breathing faster brings in more oxygen (superoxygenation) — no; red blood cells are generally 95-98% oxygenated after passing by lungs.  You don’t get more oxygen into red blood cells, you just lose more CO2 from blood plasma, which creates problems for the bodyBreathing doesn’t take much energy or oxygen to do — false.  During exercise, breathing can use as much as 15% of the total energy burn of the body…15% of the oxygen being used.  If we can save 25% of that by breathing more efficiently (less breathing for same oxygen), we’ll have more oxygen left over for other muscles to use.An athlete cannot get enough oxygen for exercise though just nasal breathing — false.  It is easy to see why people would come to this conclusion after one attempt, but with adaptation, many elite athletes compete using just nasal breathing. What does the nose do for us? Conditioning of the air:  humidifying the air and warming up the air.  Reduce lung dehydration and related wheezing and breathing problemsFiltering:  particulates (dust, smoke), viruses are captured instead of putting in lungs.  Avoid damaging lungs long-term (emphysema, cancer) and reduce infections impacting lungs.Increasing air resistance…forces a recruitment of the diaphragm which is the best muscle for efficient breathing.  Breath through the nose, then you will breath diaphragmatically without thinking.  You can stop trying to train yourself to “Belly Breath”.Calming.  Reducing stress.  Deep slower breathing vs. quicker shallow breathing activates the parasympathetic nervous system…lowers the stress level of the body.  This is definitely true at rest.  For athletics, peak performance comes of being able to relax into the effort..not by trying as hard as possible, so stress level might also play a role in athletic performance.More efficient breathing:  breathe less to get the same amount of oxygen.  25% less breathing when nasal breathing.  So the 15% of total energy expenditure being spent on breathing is lowered to 11.5%….a 3.5% point reduction in energy used for breathing that can now be used elsewhere.  This is the same level of economy improvement that elite endurance athletes seek to obtain from using weight training…and this is just from breathing through your nose.Avoids the over breathing associated with mouth breathing. Over-breathing MAY be a cause of damage to the heart seen in endurance athletes as a higher incidence of AFib….lowering of CO2 in blood (from over breathing) results in blood flow restriction, which may be a cause to a lack of blood flow (a lack of oxygen) to the heart.   Related to Exercise Induced Asthma / Bronchial restriction (EIB) The lungs are filled with alveoli … the little sacs that allow the body to exchange gases.  Single cell thick, covered in a surfactant that allows the sacs to stay open even at low pressure.The lung environment is very liquid and very delicate.Imagine blowdrying wet tissue paper with a hairdryer…not good.When the air comes into lungs via the mouth, the air is not treated. Everyone has experienced coughing…the only way we have to get stuff out of our lungs that shouldn’t be there. It also is what happens when we have damaged our lungs, whether from breathing air that is too cold or too hot or too dry or too wet or filled with damaging particulates or just through over extertion.Our body creates “broncho constriction” to protect the lungs. If you ever had a wheeze at the end of your exhales, you’ve had this thing.This correlates very highly with mouth breathing athletes. Bronchio restriction is vey common among elite athletes…cycling, swimming, running. 20-50% of population vs. 5% among sedentary population. The more you breath, the more important it is to treat the air you breath and protect the lungs.The availability of broncho inhalers may just be serving to allow us to overcome our natural defense again damaging our lungs from mouth breathing. HOW TO NASAL BREATHE? The transition to nasal breathing is easier for some people.  Some people feel a terrible air hunger while others get used to it very quickly.  The path forward for everyone is to find your way to just the threshold point that your body can do it…with just a suggestion of air hunger…and then move higher over time.    It takes 6 weeks to 6 months.  Three key variables that impact time to adapt: Existing sensitivity to CO2.  If low sensitivity, then short time to adapt.How well developed is the diaphragm muscle.  The more you need to build, the longer it will take.How dedicated is the effort to adapt.  The more you nasal breath, the faster you will adapt. What do you need to do to be able to nasal breathe all the time? Break / Start the Habit Break the habit of mouth breathing.  Do it whenever you realize you are not nasal breathing.  Set reminders.  (See Episode 45 on building habits: https://www.wiseathletes.com/podcast/45-build-strong-habits-with-samuel-salzer/https://www.wiseathletes.com/podcast/45-build-strong-habits-with-samuel-salzer/):  During exercise, put a little water in your mouth so you don’t have to think about nasal breathing.According to Dr. Dallam, “I also found that focusing on nasal breathing during exercise facilitated focusing on it throughout the rest of my life as well.   While subjective at best, I consider that I am more relaxed, more thoughtful, sleeping better and happier as a direct result.” Once you can do your endurance & recovery workouts while nasal breathing, the adaptation will go very fast because that is most of your training.  And, if you are nasal breathing outside of exercise as well, you are essentially always nasal breathing at this point.You’ll adapt even faster if you will take down the level of effort to match your ability to perform while nasal breathing, and only increase as your nasal breathing improves.Separately work toward nasal breathing during sleep.  This is harder as you will be unconscious, but this will have a gigantic impact on your health and ability to recover from exercise.  Look into mouth taping and breathing exercises to open nasal passages before sleeping. Reduce CO2 sensitivity: By nasal breathing more, you will have less CO2 in your blood.  Your body will get used to that …meaning it will start to feel normal quickly (in days).  Keep pushing on the edge of discomfort to keep lowering your sensitivity.  Pushing too hard will backfire, so take your time.  This is not the place to develop a psychological problem.  And, this adaptation will happen faster than the muscle development so there is no payoff from pushing harder than just enough. “Breathe light” exercises:  just breathe more slowly while resting…until you feel an urge to breath more….just experience the feeling (from Patrick McKeown)Do breath holds while moving (walk, light jog).  Hold until the air hunger is strong.  Recover your breath fully, then repeat (from Patrick McKeown)https://pneuma.plus/ — a free site with breathing exercises Muscle development: Training the breathing muscles to get stronger.  This happens simply by using nasal breathing.  Just give the muscles some time to adapt.  It’s like getting used to using a bigger gear on the bike….You can do it for a short time right away, and over time you will get more muscular endurance as you get stronger.The Diaphragm muscle has to adapt.  At first, you won’t be strong enough to keep nasal breathing (i.e., pulling air through the nose and down into the bottom of the lungs) for a long time.  But the diaphragm muscle will get stronger and eventually you will be able to breath diaphragmatically for as long as you need and train for.  This might be the slowest part of the adaptation..The nose muscles have to adapt as well. Nasal passage recovery: If you haven’t been using your nasal passages in this way, you will have to get them adapted to this level of use.The most important thing is to just breathe through your nose as much as possible.It will probably help to start using a Neti pot or Neti bottle (there are many varieties).  Use distilled or boiled water, not tap water.  Remember to not blow your nose too hard after rising nasal passages with water…you may inadvertently push water into your ear tubes which may cause irritation.  I do it first thing to let the water fully drain out before I sleep. The first few times will be unpleasantly reminiscent of getting water up your nose at the beach.  But do you remember how amazingly good your nasal passages felt after a day in the surf?  This is the same thing.  After doing it for a week, you will never want to stop.  And it will make nasal breathing so much easierUse BreathRight strips or the like to hold open the airways in your nose.  George says his nose muscles got stronger after a while, so this may be a temporary thing.  But it does make an enormous difference in the beginning.  There are other nasal dilator devices to try if you like the idea of stuff up your nose.  I don’t.Try the Buteyko (bu-tek-o) method for clearing mild nasal congestion Metrics: It can help to track improvement if you use metrics but you don’t have to do so because the goal is NOT to breathe less, it is to use nasal breathing.  The rest comes naturally.HRV — your HRV level should start to increase, especially if you can nasal breath while sleepingHR — you may find your HR starts getting lower for the same power / speed.  This doesn’t occur for everyone.Breaths per minute — monitor your natural breathing.  Oura ring & Whoop strap do this for sleep, which is a good way to see if it is falling.  You want to get to 14 or less breaths per minute.  10-14 breaths per minute is normal, according to Patrick McKewon.Length of time until air hunger —  5 normal breaths. Exhale. How long until impulse to breath?  25 seconds minimum. 40 seconds target. Maximum breathlessness test:  normal breath in and out of nose.  Exhale, then hold and see how many steps you can take.  60 steps is minimum for “good” CO2 sensitivity.   How to get started with nasal breathing during exercise, According to George: Get on an indoor device you like to use:  stationary bike, treadmill, etc.  Get going at a pace that is lower than normalBreathe nasally.Every 3 minutes increasing the pace just a little, and rate how much the air hunger you feel.When you find the level at which you feel you cannot keep going, back off just a little so you can keep going.  It will feel hard but not feel like you are suffocating. The effort should be in the challenge of pulling the air in and out, not in staying conscious or in dealing with the fear of suffocating.  Another thing to watch is a rising HR…if your HR is higher than it should be for that level of power / pace, then you are struggling too much…just back down a little until the HR stabilizes The next workout, try to go a little harder while nasal breathing to see if you can do it.  You will probably find you can go harder every time for a while.  The early, beginner gains will be the easiest, as in most things.Continue the upward progression over timeFeel free to mouth breathe once in a while if you want to go harder.  It won’t be a set back, but it won’t help you progress toward 100% nasal breathing.  Just don’t lose track of the behavior change you are trying to instill as a habit. George M. Dallam, Ph.D. – Biographical Information Dr. Dallam is a professor in the School of Health Science and Human Movement at Colorado State University – Pueblo. Dr. Dallam has taught a wide variety of classes in exercise physiology, research and statistics, behavior facilitation, sport psychology, kinesiology, biomechanics, management, exercise assessment and prescription, swimming, running and triathlon. He is currently chair of the CSU-Pueblo Faculty Compensation Committee and is the outgoing chair and an ongoing member of the CSUP Institutional Review Board. Dr Dallam is also the former inaugural National Teams Coach for USA Triathlon and worked for many years with elite U.S. triathletes as a coach, advisor and consultant. Athletes coached directly by Dr. Dallam have included National Elite and Age Group Champions, Olympians, Pan American Games Medalists, World Age Group Champions and the top ranked male triathlete in the world in 2005-2006, Hunter Kemper.Dr. Dallam has been involved in numerous research studies and the publication of their results at both CSUP and the USOC examining various aspects of triathlon performance and training, diabetes risk factor modification, and the effects of functional movement improvement on running . His primary research interest recently focused on the capability of human beings to adapt to nasal only breathing during exercise as a way to improve both health and performance. Dr. Dallam was both the founder and a long term member of the USA Triathlon National Coaching Commission. He has authored numerous articles and book chapters applying training principles to triathlon and is the co-author, with Dr. Steven Jonas, of Championship Triathlon Training, published in 2008 by Human Kinetics and Teaching and Coaching Triathlon Successfully, published in 2014 by Coaches Choice. He is currently writing The Nasal Breathing Paradox during Exercise for future publication. He is regularly sought as a speaker and expert on exercise related topics having provided insights to a broad range of publications. Dr. Dallam has received both the United States Olympic Committee’s Doc Counsilman Science in Coaching award (2004) and the National Elite Coach of the Year award (2005) for triathlon. He has also received all three of CSU-Pueblo’s university-wide awards for teaching (2001), scholarship (2003 and 2021) and service (2005). He has further twice received the outstanding faculty member award (2005 and 2013) in the College of Engineering, Education and Professional Studies at CSU-Pueblo and the inaugural Scholarship Award (2021) in the newly formed School of Health Science and Human Movement. Finally, Dr. Dallam has been continuously training and competing in triathlon since 1981 and has recently also begun playing water polo again as a masters athlete.

Sponsor: RePowerU — a free fitness practices assessment (a 10-minute questionnaire) Nasal breathing is not a trick or hack to get an unnatural advantage.  Nasal breathing is the designed in way to breathe properly.  Not nasal breathing causes health and performance problems. But it’s never too late to do it right. Learn the why’s and how’s of nasal breathing from George Dallam, PhD. Dr. Dallam says, “One simple rule:  breath through nose all the time, or as much as possible.” Benefits of nasal breathing:  Better filtering of particles and viruses (less nasal infection, bronchitis). Filtering becomes even more important when exercising because we take in so much more air.Less water lost though breathingLess energy spent on breathing (more energy for locomotion); higher O2 extracted per breath (higher efficiency)Recovery from “EIB” exercise induced bronchoconstriction (exercise induced asthma)Provides a powerful training stimulus to improve fitness…make you faster even if you go back to mouth breathing in high intensity efforts, such as racesImproved stress managementBetter sleep, and overall improved recovery from exercise (lower stress, avoidance of snoring)Better posture and movement ability with improved diaphragm activityFunctional movement benefits —diaphragm is a major core muscle that is under strength when we mouth breathe. Avoids possible damage to the heart from over breathing (a hypothesis from Dr Dallam)  Time marks to find particular parts of discussion: Dr. Dallam background and the beginning of interest in nasal breathing: 4:58Myths about breathing:18:51What does the nose do? 31:00More problems from mouth breathing: 39:30Stress and related lower performance from over breathing: 46:30Intro to transition to nasal breathing:  50:50Advantages of nasal breathing: 53:58Potential heart damage (related to AFib) from mouth breathing during hard exercise: 1:05:23How long does it take to adapt to nasal breathing during exercise: 1:07:15Summary of adaptations in transition to nasal breathing: 1:12:13Recommendation for getting started: 1:20:14How to find Dr. Dallam:  1:26:10 Notes from discussion with George Dallam, PhD Myths about breathing: I feel the need to breath faster when I need more oxygen — mostly false.  It is the presence of higher than usual CO2 in the blood that causes the “air hunger”CO2 is bad, and needs to be removed as fast as possible — false; CO2 is necessary for normal bodily functions.  Too much AND too little CO2 are bad for the body.Breathing faster brings in more oxygen (superoxygenation) — no; red blood cells are generally 95-98% oxygenated after passing by lungs.  You don’t get more oxygen into red blood cells, you just lose more CO2 from blood plasma, which creates problems for the bodyBreathing doesn’t take much energy or oxygen to do — false.  During exercise, breathing can use as much as 15% of the total energy burn of the body…15% of the oxygen being used.  If we can save 25% of that by breathing more efficiently (less breathing for same oxygen), we’ll have more oxygen left over for other muscles to use.An athlete cannot get enough oxygen for exercise though just nasal breathing — false.  It is easy to see why people would come to this conclusion after one attempt, but with adaptation, many elite athletes compete using just nasal breathing. What does the nose do for us? Conditioning of the air:  humidifying the air and warming up the air.  Reduce lung dehydration and related wheezing and breathing problemsFiltering:  particulates (dust, smoke), viruses are captured instead of putting in lungs.  Avoid damaging lungs long-term (emphysema, cancer) and reduce infections impacting lungs.Increasing air resistance…forces a recruitment of the diaphragm which is the best muscle for efficient breathing.  Breath through the nose, then you will breath diaphragmatically without thinking.  You can stop trying to train yourself to “Belly Breath”.Calming.  Reducing stress.  Deep slower breathing vs. quicker shallow breathing activates the parasympathetic nervous system…lowers the stress level of the body.  This is definitely true at rest.  For athletics, peak performance comes of being able to relax into the effort..not by trying as hard as possible, so stress level might also play a role in athletic performance.More efficient breathing:  breathe less to get the same amount of oxygen.  25% less breathing when nasal breathing.  So the 15% of total energy expenditure being spent on breathing is lowered to 11.5%….a 3.5% point reduction in energy used for breathing that can now be used elsewhere.  This is the same level of economy improvement that elite endurance athletes seek to obtain from using weight training…and this is just from breathing through your nose.Avoids the over breathing associated with mouth breathing. Over-breathing MAY be a cause of damage to the heart seen in endurance athletes as a higher incidence of AFib….lowering of CO2 in blood (from over breathing) results in blood flow restriction, which may be a cause to a lack of blood flow (a lack of oxygen) to the heart.   Related to Exercise Induced Asthma / Bronchial restriction (EIB) The lungs are filled with alveoli … the little sacs that allow the body to exchange gases.  Single cell thick, covered in a surfactant that allows the sacs to stay open even at low pressure.The lung environment is very liquid and very delicate.Imagine blowdrying wet tissue paper with a hairdryer…not good.When the air comes into lungs via the mouth, the air is not treated. Everyone has experienced coughing…the only way we have to get stuff out of our lungs that shouldn’t be there. It also is what happens when we have damaged our lungs, whether from breathing air that is too cold or too hot or too dry or too wet or filled with damaging particulates or just through over extertion.Our body creates “broncho constriction” to protect the lungs. If you ever had a wheeze at the end of your exhales, you’ve had this thing.This correlates very highly with mouth breathing athletes. Bronchio restriction is vey common among elite athletes…cycling, swimming, running. 20-50% of population vs. 5% among sedentary population. The more you breath, the more important it is to treat the air you breath and protect the lungs.The availability of broncho inhalers may just be serving to allow us to overcome our natural defense again damaging our lungs from mouth breathing. HOW TO NASAL BREATHE? The transition to nasal breathing is easier for some people.  Some people feel a terrible air hunger while others get used to it very quickly.  The path forward for everyone is to find your way to just the threshold point that your body can do it…with just a suggestion of air hunger…and then move higher over time.    It takes 6 weeks to 6 months.  Three key variables that impact time to adapt: Existing sensitivity to CO2.  If low sensitivity, then short time to adapt.How well developed is the diaphragm muscle.  The more you need to build, the longer it will take.How dedicated is the effort to adapt.  The more you nasal breath, the faster you will adapt. What do you need to do to be able to nasal breathe all the time? Break / Start the Habit Break the habit of mouth breathing.  Do it whenever you realize you are not nasal breathing.  Set reminders.  (See Episode 45 on building habits: https://www.wiseathletes.com/podcast/45-build-strong-habits-with-samuel-salzer/https://www.wiseathletes.com/podcast/45-build-strong-habits-with-samuel-salzer/):  During exercise, put a little water in your mouth so you don’t have to think about nasal breathing.According to Dr. Dallam, “I also found that focusing on nasal breathing during exercise facilitated focusing on it throughout the rest of my life as well.   While subjective at best, I consider that I am more relaxed, more thoughtful, sleeping better and happier as a direct result.” Once you can do your endurance & recovery workouts while nasal breathing, the adaptation will go very fast because that is most of your training.  And, if you are nasal breathing outside of exercise as well, you are essentially always nasal breathing at this point.You’ll adapt even faster if you will take down the level of effort to match your ability to perform while nasal breathing, and only increase as your nasal breathing improves.Separately work toward nasal breathing during sleep.  This is harder as you will be unconscious, but this will have a gigantic impact on your health and ability to recover from exercise.  Look into mouth taping and breathing exercises to open nasal passages before sleeping. Reduce CO2 sensitivity: By nasal breathing more, you will have less CO2 in your blood.  Your body will get used to that …meaning it will start to feel normal quickly (in days).  Keep pushing on the edge of discomfort to keep lowering your sensitivity.  Pushing too hard will backfire, so take your time.  This is not the place to develop a psychological problem.  And, this adaptation will happen faster than the muscle development so there is no payoff from pushing harder than just enough. “Breathe light” exercises:  just breathe more slowly while resting…until you feel an urge to breath more….just experience the feeling (from Patrick McKeown)Do breath holds while moving (walk, light jog).  Hold until the air hunger is strong.  Recover your breath fully, then repeat (from Patrick McKeown)https://pneuma.plus/ — a free site with breathing exercises Muscle development: Training the breathing muscles to get stronger.  This happens simply by using nasal breathing.  Just give the muscles some time to adapt.  It’s like getting used to using a bigger gear on the bike….You can do it for a short time right away, and over time you will get more muscular endurance as you get stronger.The Diaphragm muscle has to adapt.  At first, you won’t be strong enough to keep nasal breathing (i.e., pulling air through the nose and down into the bottom of the lungs) for a long time.  But the diaphragm muscle will get stronger and eventually you will be able to breath diaphragmatically for as long as you need and train for.  This might be the slowest part of the adaptation..The nose muscles have to adapt as well. Nasal passage recovery: If you haven’t been using your nasal passages in this way, you will have to get them adapted to this level of use.The most important thing is to just breathe through your nose as much as possible.It will probably help to start using a Neti pot or Neti bottle (there are many varieties).  Use distilled or boiled water, not tap water.  Remember to not blow your nose too hard after rising nasal passages with water…you may inadvertently push water into your ear tubes which may cause irritation.  I do it first thing to let the water fully drain out before I sleep. The first few times will be unpleasantly reminiscent of getting water up your nose at the beach.  But do you remember how amazingly good your nasal passages felt after a day in the surf?  This is the same thing.  After doing it for a week, you will never want to stop.  And it will make nasal breathing so much easierUse BreathRight strips or the like to hold open the airways in your nose.  George says his nose muscles got stronger after a while, so this may be a temporary thing.  But it does make an enormous difference in the beginning.  There are other nasal dilator devices to try if you like the idea of stuff up your nose.  I don’t.Try the Buteyko (bu-tek-o) method for clearing mild nasal congestion Metrics: It can help to track improvement if you use metrics but you don’t have to do so because the goal is NOT to breathe less, it is to use nasal breathing.  The rest comes naturally.HRV — your HRV level should start to increase, especially if you can nasal breath while sleepingHR — you may find your HR starts getting lower for the same power / speed.  This doesn’t occur for everyone.Breaths per minute — monitor your natural breathing.  Oura ring & Whoop strap do this for sleep, which is a good way to see if it is falling.  You want to get to 14 or less breaths per minute.  10-14 breaths per minute is normal, according to Patrick McKewon.Length of time until air hunger —  5 normal breaths. Exhale. How long until impulse to breath?  25 seconds minimum. 40 seconds target. Maximum breathlessness test:  normal breath in and out of nose.  Exhale, then hold and see how many steps you can take.  60 steps is minimum for “good” CO2 sensitivity.   How to get started, According to George: Get on an indoor device you like to use:  stationary bike, treadmill, etc.  Get going at a pace that is lower than normalBreathe nasally.Every 3 minutes increasing the pace just a little, and rate how much the air hunger you feel.When you find the level at which you feel you cannot keep going, back off just a little so you can keep going.  It will feel hard but not feel like you are suffocating. The effort should be in the challenge of pulling the air in and out, not in staying conscious or in dealing with the fear of suffocating.  Another thing to watch is a rising HR…if your HR is higher than it should be for that level of power / pace, then you are struggling too much…just back down a little until the HR stabilizes The next workout, try to go a little harder while nasal breathing to see if you can do it.  You will probably find you can go harder every time for a while.  The early, beginner gains will be the easiest, as in most things.Continue the upward progression over timeFeel free to mouth breathe once in a while if you want to go harder.  It won’t be a set back, but it won’t help you progress toward 100% nasal breathing.  Just don’t lose track of the behavior change you are trying to instill as a habit. Links to Amazon books (kindle preview) on this topic (no affiliate fees involved): https://read.amazon.com/kp/embed?asin=B00RLU286G&preview=newtab&linkCode=kpe&ref_=cm_sw_r_kb_dp_5CB4TTKDEBGPFRDT5NQ1https://read.amazon.com/kp/embed?asin=B08ZT37NQ8&preview=newtab&linkCode=kpe&ref_=cm_sw_r_kb_dp_JC58H1D288HHZE35AM5Xhttps://read.amazon.com/kp/embed?asin=B0818ZZNLR&preview=newtab&linkCode=kpe&ref_=cm_sw_r_kb_dp_EVB5D44YS4BW6BX3WYXFhttps://read.amazon.com/kp/embed?asin=B07B8S1P26&preview=newtab&linkCode=kpe&ref_=cm_sw_r_kb_dp_JC5JZZ9JEAZZH8F2GPGM George M. Dallam, Ph.D. – Biographical Information Dr. Dallam is a professor in the School of Health Science and Human Movement at Colorado State University – Pueblo. Dr. Dallam has taught a wide variety of classes in exercise physiology, research and statistics, behavior facilitation, sport psychology, kinesiology, biomechanics, management, exercise assessment and prescription, swimming, running and triathlon. He is currently chair of the CSU-Pueblo Faculty Compensation Committee and is the outgoing chair and an ongoing member of the CSUP Institutional Review Board. Dr Dallam is also the former inaugural National Teams Coach for USA Triathlon and worked for many years with elite U.S. triathletes as a coach, advisor and consultant. Athletes coached directly by Dr. Dallam have included National Elite and Age Group Champions, Olympians, Pan American Games Medalists, World Age Group Champions and the top ranked male triathlete in the world in 2005-2006, Hunter Kemper.Dr. Dallam has been involved in numerous research studies and the publication of their results at both CSUP and the USOC examining various aspects of triathlon performance and training, diabetes risk factor modification, and the effects of functional movement improvement on running . His primary research interest recently focused on the capability of human beings to adapt to nasal only breathing during exercise as a way to improve both health and performance. Dr. Dallam was both the founder and a long term member of the USA Triathlon National Coaching Commission. He has authored numerous articles and book chapters applying training principles to triathlon and is the co-author, with Dr. Steven Jonas, of Championship Triathlon Training, published in 2008 by Human Kinetics and Teaching and Coaching Triathlon Successfully, published in 2014 by Coaches Choice. He is currently writing The Nasal Breathing Paradox during Exercise for future publication. He is regularly sought as a speaker and expert on exercise related topics having provided insights to a broad range of publications. Dr. Dallam has received both the United States Olympic Committee’s Doc Counsilman Science in Coaching award (2004) and the National Elite Coach of the Year award (2005) for triathlon. He has also received all three of CSU-Pueblo’s university-wide awards for teaching (2001), scholarship (2003 and 2021) and service (2005). He has further twice received the outstanding faculty member award (2005 and 2013) in the College of Engineering, Education and Professional Studies at CSU-Pueblo and the inaugural Scholarship Award (2021) in the newly formed School of Health Science and Human Movement. Finally, Dr. Dallam has been continuously training and competing in triathlon since 1981 and has recently also begun playing water polo again as a masters athlete. Nasal-Breathing-StudyDownload

Sponsor: RePowerU — a free fitness practices assessment (a 10-minute questionnaire) Matthew Smith, DC, CES Dr. Matt Smith is a sports chiropractor, strength coach, and the founder of EverAthlete, an online strength training, injury prevention, and recovery resource for outdoor enthusiasts. Matt has been a trusted coach and consultant to some of the best athletes and highest performers in the world, helping them navigate injuries and perform at their best.  EverAthlete website: https://www.everathlete.fit/ Instagram: https://www.instagram.com/everathlete/?hl=en Part 1 — Breathwork for Recovery (episode 48) — https://www.wiseathletes.com/podcast/48-breathwork-for-faster-recovery-matthew-smith-everathlete/ Part 2 — Injury Prevention for Older Athletes Older Athlete are particularly vulnerable to injuries: Many years to accumulate movement problems and muscle imbalancesPast injuries from accidentsToo much time sittingToo little cross-trainingSlower healing  Summary (1) Do assessments to identify body areas that need work Example: Lunge Movement Assessment:   Lowering the body down so the back knee comes close to touching the floor.  Then stepping back to the original position.  A few things we look for in a test like that are:  (1) torso control:  Does the torso stay upright or does it drop down towards the floor, towards the knee as you go through the movement.(2) lower body:  are the hips (and torso above) shifting from side to side, and do the hips stay level?(3) front foot points straight ahead(4) front knee to point straight ahead in line with 2nd and 3rd toe (vs. pointing inward our outward relative to the foot)(5) overall movement should look smooth and stable When we see a problem, we do further breakout tests to fine tune the finding.  Do they struggle with hip or ankle mobility or lumbar stability?  Deficiencies in those areas can lead to a “messy” lunge. (2) How to avoid injuries: Focused efforts on individual muscles that need to be addressed (based on assessments) in order to allow proper movement patterns: tissue work (foam roller) stretching (lengthening tight muscles) activation (such as using bands to turn on muscles creating muscle imbalances)Practice standard movements until competent (check out Matt’s Instagram or Website for details)Mix up training: use of strength training as cross-training:  healthy exercise to build balanced strength into the body for greater resilience as well as to learn proper movements that don’t lead to stressful movements (and pain or poor performance). Force the body to adapt to a variety of movements…to bring the body back to balance.  If we focus too much on one sport we become unnaturally adapted to that limited movement set.  Reduce the cycle of repetition.Periodize your training.  Undulating the load over time…each week up through each annual cycle.  Have a buildup, a peak, and then a recovery phase.  Build time into the plan for cross training (for balance) as well as recovery (for repair of biological systems).  Without this expedites the breakdown of the athlete.Add daily tissue recovery practices.  Restore tissue mobility, joint mobility, core stability control.  Lead to less compensation issues. How to: Start the day, prepare for exercise, get into recovery asap For a morning routine, just to start the day feeling a little better:  Use slow, light, full body movements to check in with your body to see how you feel and if you have soreness or tightness.  Then address any issues:  foam rolling, light stretching, some activation.Preparing for a workout, it’s more of an excitatory routine.  You are building in more neuromotor demands as you go.  Start with tissue work (like foam rolling), then core activation (bird dog), then dynamic stretching:  light lunges, light squats, jogging back and forth, side shuffling.  Things to open up the body in motion.Post workout:  is more about recovery.  Stimulate the parasympathic system to re-build toward the next workout.  Do breathwork to calm down.   Light tissue work, static stretching holds for longer periods of time, long and deep breathing patterns.  Just get things to calm down as fast as we can. ——— Discussion Notes (not a transcript but my notes from the discussion) Q:  what is your approach to helping athlete avoid injuries? A few different things to do: (1) tissue work and stretching and activation technique using bands ….like what you’d see in a rehab setting (2) strength and cross training.  Healthy exercise can help with past injuries as well as make the body more resilient. If done the right way. Q:  what is the “right way”? We leverage compound movements and cross training.  We like to provide the body with practice in a range of compound movement needs (demands of the exercise).  Squat pattern, Hinge pattern like a deadlift, or a pull-up.   Q:  What I hear from other experts is:  before you should try to get strong, you have to learn to move properly.  That moving improperly, from past compensations or whatever the source of the improper learned movement patter, is the source of a lot of chronic problems. And, we don’t want to get stronger in that patter, we want to learn a proper movement pattern first.  Is this what you are saying? Yes.  Part of the reason cross training like strength training for endurance athletes works is that it pulls athletes out of their repetitive stress patterns.  We can leverage movement patterns to give athletes a foundational way to bring their body back to balance and out of normalized stress patterns, and once they achieve competency with no or low weight, they can start training to get stronger in the proper movement patterns. If you are a cyclist who has spent a lot of time in a seated, flexion position:  rounded mid-back position without cross training….you may have lost the ability to stand fully upright:  full range of movement through the hips, turning glutes on.  This is a problem. The brain has different programs to activate muscles for particular movements.  When we sit too long in one position, it tends to dampen the response to the brain’s movement programs.  By leveraging movements in the gym that require full hip extension, you can begin the retrain the body to move properly with a full range of motion.  This will provide a huge benefit over time in performance, avoidance of pain, longevity in the sport. Q:  I’m looking for general good advice for the older athlete.  What can we do to be healthier longer?  Do we need to think about posture?  Is poor posture a sign of a problem in movement patterns?   And, what general thoughts about movements that a person could try to see if they have a problem, such as a body weight squat:  can’t go down far enough, etc.? Posture is generally regarded as a static thing vs. dynamic.  We focus on the dynamic…how people move.  Anytime we start to work with a new athlete, we do movement assessment.  See how well they are able to move their body, core stability, overall strength, neuromotor control.  I’m looking for spinal control, lower body control, and fluidity throughout the movement.  Then I create a mobility program to address what I see that would help them as an athlete. Q:  Can you provide any details to help a person to be able to tell if they need help? Yes.  Let’s do a lunge.  Lowering the body down so the back knee comes close to touching the floor.  Then stepping back to the original position.  A few things we look for in a test like that are:  torso control:  Does the torso stay upright or does it drop down towards the floor, towards the knee as you go through the movement.lower body:  are the hips (and torso above) shifting from side to side, and do the hips stay level?front foot points straight aheadfront knee to point straight ahead in line with 2nd and 3rd toe (if knee moves inward, it signifies a stability issue or movement pattern problem)overall movement should look smooth and stable When we see a problem, we do further breakout tests to fine tune the finding.  Do they struggle with hip or ankle mobility or lumbar stability?  Deficiencies in those areas can lead to a “messy” lunge. Q:  These sorts of problems lead to “Overuse” issues?  What is the take-home for the listeners? If you are running into pain issues (knee, lower back) or your performance is not what you want, one of the causes could be an underlying movement deficiency.  There are a lot of professionals who can evaluate movement and identify how each person can improve how they move, and how they are positioned on bike. Q:  if they already have chronic pain or recurring injuries, then this sort of poor movement pattern could underlie that? Yes. Q:  even if they don’t have pain, if the movements are not optimal, it might be a matter of time before there is an injury or lack of performance.  So testing yourself or by a professional is a good idea. Yes.  Pain tells us there is a problem but the pain doesn’t help us to understand what the problem is.  for example, a swimmer with elbow pain can be caused by poor mobility or stability of the shoulder.  The shoulder is causing a poor movement in the elbow so you have to work back to the root cause to really solve these problems. Chronic injuries do not come out of nowhere.  The body is resilient, and it takes a lot of poor movement to cause pain to show up somewhere.  Don’t wait for the pain to arrive. Q:  But often people don’t seek help until they have pain, right? True, but that is why we try to offer improvement in movement patterns to head off pain.  Taking the lessons learned from working with athletes in rehab and created programs to allow athletes to find deficiencies that might later result in pain.  Q:  Is Overuse injury a real issue?  I’ve heard it both ways.  Is overuse only related to improper movement being used over and over? No.  There are several ways to get overuse injury.  Improper movement is only one.  If you increase your activity level too fast, even using proper movement, you can also damage yourself.  Also, you need to allow for enough recovery and healing after workouts or you can get “overuse” injuries.   Best Advice: Mix up training.  Use cross training to force the body to adapt to a variety of movements…to bring the body back to balance.  If we focus too much on one sport we become unnaturally adapted to that limited movement set.  Reduce the cycle of repetition.Periodize your training.  Undulating the load over time…each week up through each annual cycle.  Have a buildup, a peak, and then a recovery phase.  Build time into the plan for cross training (for balance) as well as recovery (for repair of biological systems).  Without this expedites the breakdown of the athlete.Add daily tissue recovery practices.  Cross training and recovery.  Restore tissue mobility, joint mobility, core stability control.  Lead to less compensation issues. Q:  Here’s my summary of what you said.   Make sure you are moving properly so that when you are putting stress on the body, the stress is not creating damageDo some cross training so you are not always engaging the same stress over and overLeave enough time for recovery…each day as well as over time.  And if you are trying to get better, make sure your peaks in performance are separated by valleys to allow for healing and repair and adaptation.  Don’t always go for PRs Q:  What about flexibility?  What should I do in the morning to loosen up after being immobile for a long night of sleep. For a morning routine, just to start the day feeling a little better:  start with some foam rolling to activate tissue and get fluids into the tissues.  Then some stretching and activation work to reinforce the elasticity and elongation from the tissue work.  To improve how you feel during the day as well as to create better performing muscles if done regularly over time. Use slow, light, full body movements to check in with your body to see how you feel and if you have soreness or tightness.  Then address any issues:  foam rolling, light stretching, some activation. Q:  What about warming up and/or cooling down after exercise? Preparing for a workout, it’s more of an excitatory routine.  You are building in more neuromotor demands as you go.  Start with tissue work (like foam rolling), then core activation (bird dog), then dynamic stretching:  light lunges, light squats, jogging back and forth, side shuffling.  Things to open up the body in motion. Post workout:  is more about recovery.  Stimulate the parasympathic system to re-build toward the next workout.  Do breathwork to calm down.   Light tissue work, static stretching holds for longer periods of time, long and deep breathing patterns.  Just get things to calm down as fast as we can. Q:  Why stretching after workout? Relates to getting the body back into a normalized state after hard work.  So after a hard workout.  Muscles might feel tight, and need stretching or activation (turn on muscles) to address muscle tightness elsewhere.  Want to normal length / tension….to muscles that are over stimulated.  Also relates to fascia, ligaments, tendons. Q:  How does pain come into this?    Low, dull pain vs. sharp pain? Do you start with pain?  Hopefully you are being guided by a professional.  If you have pain that is lasting for more than a week or two, you should be seeing someone for help who is a sport minded healthcare professional. Escalation of pain should be temporary at most.  Foam rolling can cause temporary pain that disappears once the activity stops. If you are are pain free, and you do a mobility or stretching routine, you should stay pain free.  You might feel soreness if you are not used to it, and that pain should not last more than 48 hours.  You should not feel sharp pain at any time. Q:  how can people find you and EverAthlete? Instagram:  @everathlete Website:  everathlete.fit

Sponsor: RePowerU — a free fitness practices assessment (a 10-minute questionnaire) Matthew Smith, DC, CES Dr. Matt Smith is a sports chiropractor, strength coach, and the founder of EverAthlete, an online strength training, injury prevention, and recovery resource for outdoor enthusiasts. Matt has been a trusted coach and consultant to some of the best athletes and highest performers in the world, helping them navigate injuries and perform at their best.  EverAthlete website: https://www.everathlete.fit/ Instagram: https://www.instagram.com/everathlete/?hl=en Summary During exercise, approximately 15% of the calories we burn is used for breathing.  That is oxygen that is unavailable for our muscles that propel us.  What if there was a way to be more efficient in breathing? What if that same skill in breathing would allow us to be more calm and recover faster?  To sleep better?  Wouldn’t that be a skill worth learning? Overbreathing Caused by stress:  shallow chest breathing Causes stress:  mouth breathing increases stressPoor breathing habits How? Belly breatheBreath slowerNasal breathingGet comfortable How to start Everyday lifeLow intensity exercisePush the envelope Videos: Diaphragmatic Breath Video: Diaphragmatic BreathingClear the nose to be able to breathe nasally: https://youtu.be/1IWWcyk3_jkSwitching to nasal breathing during exercise (10-12 weeks): https://youtu.be/0gtlAAQzENw ——Notes on discussion with Matt (not a transcript)– We are interested in understanding your perspective on how fitness impacts health and longevity, and on how health impacts fitness. Matt is a sports chiropractor and strength coach.  Worked in athletic performance for 15 years.  Founded Everathlete….now an online platform focused on helping athletes improve outdoor pursuits:  hiking, swimming, biking, running.  Training programs and recovery programs.  Started with a focus on injury treatment and prevention for athletes…migrated into a performance training company designed to meet people where ever they are, and helping them get to where they want to go.  We use a wide variety of resources including strength training, soft tissue therapy, injury prevention techniques, breathwork (as a tool for recovery). We will be recording two podcasts with Matt.  (1) breathwork and (2) performance training for adventure athletes including injury prevention. Worked with a wide variety of athletes:  olympians and world champions, as well as many masters athletes. Breathwork: Several books have come out in the last few years.  Oxygen Advantage, Breath are the most notable. Q:  What is breathwork? Breathwork is the practice of breathing to improve one’s health.  Used it heavily personally and with athletes.  Deliberate practice of breath to improve your state of being.  Incorporating a breath practice to improve your overall health and performance.   Based on a couple principles:  (1) we need oxygen to survive and compete, and we need to be efficient in the capture, transport and utilization of oxygen to produce energy, and(2) we need to be good at recovering from training to get the adaptations we did the work to get.  Stress is something we have to deal with and work around and thrive in, and we live with stress in our everyday lives.  And training adds to the stress our bodies must contend with.  Recovery is the transition to a restful state that gives us access to the benefits from our training.   So the skill of recovery is critical for the high-performing athlete, and breathwork is a tool for recovery. Breathwork allows us to access the parasympathetic state of recovery….to shut down the sympathetic state and transitioning to a rest and recovery state to begin the recovery and adaptation from the training. Benefits from an immediate, real-time perspective and longer-term perspective:(1) real-time benefits of being more efficient in the usage of oxygen in our muscles(2) improved ability to recover and destress our bodies in general to facilitate better recovery and adaptation, which should lead to higher performance over time. Break this into chunks: (1) why it works(2) benefits to athletic performance and general health(3) what are the practices to adopt to get the benefits Q:  Why does breathwork work? Lot’s of different things can be done.  In terms of how do we improve the oxygenation of our tissues, and how to we improve our ability to get oxygen out of lungs and into our tissues.  It can be counter-intuitive since oxygen in lungs does not mean the same thing as oxygen in tissues.  This is the hardest thing for people to get. Q:  So just breathing faster does not result in more oxygen getting into the body? Faster breathing does not result in “super oxygenation” of the blood.  It just removes extra CO2, which makes it harder to capture oxygen from breathing. Q: Isn’t “air hunger” related to CO2? Yes, being comfortable with higher CO2 in the body is a skill that we can learn, which then provides benefits to the body.  Generally, people have a low tolerance to CO2 which results in chronic over breathing. I think the root cause behind why we over breath is our general state of being over stressed.  Driving to work, dealing with kids, spouse.  Many stressors everyday.  And without awareness of practices to use breathwork to move out of the stressed state into a restful state, we just stay over stressed all the time. Q: I’d heard that just habitual breathing in poor ways, such as chest breathing or shallow breathing because of bad posture, then leads to stress.  A stressful way of breathing leads the body to become stressed, and then all the over stresses compound on top to create even more stressful breathing to make the situation worst.  True? Yes, poor breathing mechanics can create a vicious cycle that feeds back onto itself.   Poor posture and poor breathing mechanics leads to more chest breathing and less diaphragmatic breathing.  Using neck and ribcage muscles to expand the ribcage to breath instead of the diaphragm is naturally stressful on the body.  Leads to shallow breathing that leads to more rapid breathing which switches on a stress response in the body. The practice the skill of getting a good, deep breath is a skill we can lose. The Foundation:  With my clients, I start with  (1) breath mechanics(2) cadenceAnd then(3) we focus on getting used to a higher level of CO2   Q: Here’s a bundle of things to discuss: (1) These practices of breathing seem to come from yoga and meditation.  The question of why it works is hard to understand.  But it is true that our brains control our bodies but it is also true that our bodies have an impact on our brains.  Everyone already knows this…anyone who has ever forced themselves to smile finds that they feel happier afterwards.   (2) So the “why it works” would be interesting but the fact that it is known to work means we can just get started with these practices to have these desired effects on our minds and bodies.   (3) Unfortunately, we have already learned bad habits that take advantage of this brain-body connection, and we are over breathing, over stressed, and not recovering as well as we could be as a result.  We need to unlearn these bad habits, and return to not just breathing properly when we are thinking about it but all the time, without thinking….including when we sleep. (4) And let’s also touch on nasal breathing. Q: Just dive in, Dr. Matt. Our autonomic ability to breath properly is not great, just looking at our society.  Impacting longevity and quality of life.  Over breathing seems to be related to many diseases. The practice of slowing down breathing….lessen the amount of breathing throughout the day.  You can do it through deliberate breath practices.  You can also use Wim Hof breathing to stimulate alertness.  But slowing down our breathing can have big health effects. Nasal breathing is a primary was of slowing the breath.  Nasal breathing has other benefits such as adding nitros oxide into the air we breath, which leads to blood oxygen delivery.  Use BreathRight strips during sleep….and tape mouth during sleep to encourage nasal breathing during sleep.  It helps to begin the transition to nasal breathing to get improved health from improved sleep.  And getting better sleep is good for recovery for training. Sleep apnea can be caused by mouth breathing during sleep. Dr. Matt’s sleep has been dramatically improved. People dealing with asthma, COPD can use breathwork to improve breathing.  There are multiple ways to overcome congestion or swollen sinuses.  Lot’s of YouTube videos on this subject.  Use nasal breathing, and breathing slowly, will let the body stop reacting to a co2 level that is lower than necessary. Q:  If you breath in a less stressful way all day, then do you recover better all day? Yes.  Your breath patter will adapt to what you are doing.  But you also can create a less stressful environment by controlling your breath.   Lower heart rate, reduced blood pressure.Sleep hygiene can include preparing for lower stress and a relaxation breathing.  Be calm.  Manipulate the nervous system through breathing practices.   Q:  What is the difference between using breath to calm vs. activating for alertness? Cadence patterns are different.  Calming is more common a need for athletes rather than activating alertness or stress level.  Athletes tend to already be over activated.1-to-2 ratio of inhale timing to exhale timing.  5-10 minutes.Hyperventalating such as Wim Hof mouth breathing rapid breathing with breath holds is a way to activate.  Reverse the cadence patter to get alert vs. calming.  Alertness and focus improves dramatically. Q:  How to use nasal breathing to improve athletics? Use nasal breathing as a training aid.  Like wearing a weight vest to get stronger, then take the weight vest off to perform better.I think there is a place for mouth breathing in athletics.  Your ability to nasal breath is an indicator of fitness, and doing nasal breathing can help you get stronger.At the beginning, use nasal breathing during low stress training days, just to get a little more out of the easy session.  Don’t use it during intervals if it would reduce the effect of the intervals.Plus, nasal breathing can help you maintain intensity discipline when you WANT to do a zone 1 or 2 ride.  Nasal breathing can help you manage your pace and getting adaptation to breathing allows you to get more out of the easy sessions.  Q:  Anything else? Be careful with changing your breathing.  Experiment but don’t take chances.  Don’t hold your breath while outside riding or running.  Try it while riding on Zwift and just be careful.

Sponsor: RePowerU — a free fitness practices assessment (a 10-minute questionnaire) Christine Bell Christine Bell has more than 20 years of experience and expertise in treating orthopedic and sports injuries. Having worked in Australia, the UK and the USA she has learned many treatment methods and techniques and treated a vast array of sports and orthopedic conditions. She is an expert in many techniques for healing injured athletes, including Dry Needling, which is a super fast method of healing the soft tissues of an athletes body.Contact Christine here: https://aussie-pt.com/contact/ Mobility & Strength Class Video: https://us02web.zoom.us/rec/share/ZiE8tLNNrVTgvEJKjuN4aX28t5QQnnpejNOtholCGJ3f9t8f2k81M2yLCdCZy3wD.WJ4JM9iStHsHnhDQ Passcode: 71L&VPo+  Note: you need a long foam roller, a mat, hand weights and a small looped band for this workout.  Notes from Discussion with Christie Bell, P.T. Christine is in the business of fixing injured athletes Q: Why are you so good? The first thing I look at is the cause of the injury.  I don’t just look at the spot that is painful.  I look for the source of the problem.  Further up or down the chain, that is directly influencing the injury.  Look at the overall body. The key is to have enough time.  I book 1 hour sessions to have enough time to get to the bottom of what is happening.  What is it they are doing that is causing that pain. Lately there are a lot of problems related to working at home…which is not setup for sitting in a good posture for a long time. Q:  What is your backstory? Grew up in Australia.  Primary sport was basketball.  Always spraining ankles.  The physios helped me a lot, and I eventually wanted to do that.  I got my PT education in Australia and later Boston, MA USA. Q:  What is Dry Needling, and how does it help? Dry Needling is a fairly new modality.  It is based on trigger points.  A PT is trained to deal with trigger points, but it is hard to get at the trigger that can be deep in the muscle.  So, a needle can get down into the muscle without having to push through the overlaying tissue.  Plus Needling takes a second vs. 30-60 minutes, maybe multiple times rubbing on the trigger point.  It is fast. Trigger Point — like a lentil (bean) under the muscle or a tight, ropey band in the muscle that is switched on all the time.  Can be from over use  Referral pain — a spinal / nerve being pinched by a tight muscle in the back that is causing a nerve pinch.  Sciatic nerve pain is a sharp pain.  A referred trigger point is usually a dull muscle pain. Q:  What is “Dry” needle?   Same as acupuncture needle.  The needle is very thin since there is not hollow channel inside for delivering liquid like you would use for an injection.  Because it is so thin, you usually cannot feel it. Q:  Acupuncture vs. Dry Needling? Acupuncture is based on meridians where as dry needling is doing directly to the muscle to relieve trigger points.  Acupuncture is for systemic issues more than muscle issues. Q:  What is Dry Needling use for? Muscle issues and tendon issues.   Neck, back, thumb, tennis / golfer elbow.  Spasm around that area.  Release the spasm and encourage blood flow.  The knots in the muscle contain byproducts of muscle contraction that had been held due to poor blood flow.  It gets released and lets the muscle relax which lets the blood flow properly. Plus the tight muscle can pull the joint improperly which creates poor movement and eventually injury. It reduces pain and helps the body to heal.  If you can get the pain to be relieved, the brain can believe in another state of being.  Plus the use of needles is a strong psychological signal that something massive has been done…it provides relief to the mind…provides a whole body relaxation.  A big release of tension. For speed to recovery, dry needling is the fastest possible path. Q: Have you noticed anything about older, endurance athletes…anything common? As we get older, we get tighter.  collagen shrinks.  Wear and tear.  All the miles in the past, maybe done without stretching and proper healing work….there is a consequence.  Tissue isn’t as elastic anymore.  Plus older athletes need more time to recover. When older, just taking time off of training won’t solve the injuries.  You have to get some treatments to resolve the problems directly since we cannot just wait for the body to heal itself. Q:  Mistakes made by older athletes related to failing to recover or dealing with injuries properly? Underestimated the value of mobility.  Need good form to avoid problems. Mobility:  flexibility.  Ability to move well through a full range of motion.  Fire the correct muscles.  Strength training is great, but you must have the mobility in the joint before you can make it stronger without creating compensations and a setup for injuries. The body is naturally great at compensating for pain or injuries.  If it goes on for too long, the compensations stack on top of each other…then nothing is moving properly and posture is poor. Do stretching and range of motion work everyday before exercising.  Don’t ever skip the 5-10 minutes of movement.  After the workout, do more detailed stretching that elongates the muscles which are warm after a workout. Mobility & Strength Class Video by Aussie PT https://us02web.zoom.us/rec/share/ZiE8tLNNrVTgvEJKjuN4aX28t5QQnnpejNOtholCGJ3f9t8f2k81M2yLCdCZy3wD.WJ4JM9iStHsHnhDQ Passcode: 71L&VPo+  Note: you need a long foam roller, a mat, hand weights and a small looped band for this workout.  Q: Painkillers? Pain killers are a bad idea related to not dealing with the pain.  Making the problem worse and/or developing compensations that will be hard to lose in the future.  But, after surgery, pain killers allows for movement which will help with healing.   So, painkillers do have positive uses. It’s better to stop for a short time to get rid of the source of the pain. Q:  How do you tell the difference between a pain that will go away on its own vs. a pain that needs professional treatment? Ignoring pain is a commom mistake. If the pain is less than a 5 out of ten…if the pain is not too bad and gets lower as you warm up, then that’s promising.  If it doesn’t feel worse after exercise, then it might be something that will resolve on its own.  If might be worth getting it checked out anyway. If it is a sharp pain….if the pain is changing the way you move…it gets worse during or after the activity.  Just stop.  Get help. Q:  Any advice on diet? Make sure to hydrate and use electrolytes.  Get enough magnesium if you are cramping, or have tight muscles.  Magnesium can change the structure of the muscles. If you have a tight muscles all over your body…..  Look to cut out processed sugar, gluten, dairy to see if that helps.  See a nutritionist for support. Q: Anything else to stay out of your office? Don’t cut out mobility or stretching before workout.  If you are short of time, shorten the workout not the stretching / mobility Put quality food in your body. Contact Christine with any questions:  christine@aussie-pt.com Looks for videos on Facebook page:  https://www.facebook.com/Aussie-PT-339401212744116/ Aussie PT Sports Physical Therapy & Endurance Training Aussie PT specializes in providing physical therapy and strength training for endurance athletes. Using skilled specific hands on techniques, including mobilization and manipulation, we can diagnose and treat soft tissue and joints thus improving your range of motion, reducing inflammation and encouraging tissue repair. This will in turn decrease your pain and improve function. These specialty techniques are used commonly to treat sports related injuries like lower back pain, neck pain, shoulder impingement, plantar fasciitis, anterior knee pain and hip pain. Based in Boulder, Colorado, Christine Bell is a Sports Physical Therapist and a Multisport Coach with a focus on strength training to help prevent injuries. Christine works with triathletes, cyclists, runners and swimmers that want to take their performance to the next level. Bachelor of Human Movement Studies, University of Queensland (1984)Bachelor of Applied Science in Physiotherapy, University of South Australia (1991)Master of Science in Physical Therapy; MGH Institute of Health Professions (2002) Website: https://aussie-pt.com/ Facebook (with videos): https://www.facebook.com/Aussie-PT-339401212744116/

Sponsor: RePowerU — a free fitness practices assessment (a 10-minute questionnaire) http://rockymountainhpc.com/dr.-black.html Dr. Stephen Black is the CEO and Owner of Rocky Mountain Human Performance Center.  He is an acknowledged leader in the field of sports medicine, rehabilitation, fitness, and sports performance. Dr. Black has worked extensively with professional and amateur athletes in many sports, leveraging his holistic and integrative approach to improve performance. Dr. Black is himself a long-time, high-level athlete, who knows personally as well as professionally the challenges and opportunities available to us all for slowing the effects of aging with individualized programming for higher fitness and superior performance.   Dr. Black’s philosophy is to proactively addressing imbalances, deficiencies, and poor movement patterns to help older athletes become healthier and stronger while having fun.  Show Notes:  not a transcript but a summary of the key points discussed with links to other material mentioned. Key Points Summary: Age: Chronological vs. physiological age:  create a gap in your favorStart Early:  the earlier you start in athletic, the better your health as you get older (don’t wait!)Be Proactive:  avoiding health problems has a much bigger payoff than solving health problems after they arrive.Consistency & Moderation:  for the older athlete, consistency is key to derive the benefits of healthy behaviors, and moderation is important as we shift to prioritizing health over performance.Patience:  progress toward health and fitness is a journey, not a destination.47 foods:  stay within your food selections to find consistencyProtein: 1.5-2.2 grams of protein per kilo of body weight for an active person working out 1-3+ hours per day.  And, err on the side of too much to compensate for worsening digestion and signaling in our bodies as we get older.  Eat protein with carbs (1-to-3 ratio of protein to carbs)Weight-bearing Resistance Exercise:  older athletes must get some weight-bearing resistance exercise to retain muscle mass and maintain bone health.Recovery:  Use a 1-to-3 ratio.  For every 1 dose of high intensity, 3 does of recovery.  Dose = time exercising.  “I’m as good once as I ever was”.  But get the recovery to avoid injury and/or catastrophe. Q: Connection between Health and fitness today as well as between health and fitness into the distant future. Consider two sides of that questions:  chronologic age vs. physiological age. One thing is the younger a person started participating in athletic activity, the greater their health as chronological age progresses.  Exceptions can occur due to lifestyle changes and accidents.  But putting deposits into the fitness bank helps delay aging. Q:  One of the key questions is, for each person, what are the interventions that will make the most impact for the least investment, least effort?  I assume it will be a unique conclusion for each person, as everyone is different genetically, and has had a unique life to date, but also each person has attempted in his or her own way to compensate for the impact of aging on health and fitness.  So, how do you find those best few things for each person you work with? I’ll start by saying it is always better to be proactive than reactive.  If you can get ahead of issues, you’ll get further than you will by trying to solve issues after they arrive. If proactive is the goal:  take a close look at your current level of health.  Get blood test, physiological testing (HR, VO2Max, etc.)….get objective measures.  Then set some reasonable goals, and develop a plan to move toward those goals. Consistency and moderation are two important strategies for the older athlete.  Apply to everything: nutrition, supplements, exercise prescription with a balance of cardio and strength as well as flexibility and mobility.  And then a reasonable timeframe. Q:Want to come back to consistency…..touch on habits, breaking and setting habits Q:First let’s talk some specifics.  In your long experience, are there some actions that come up again and again with your clients as important things to do….that fall into that bigger impact category for many or most older athlete? Absolutely. Let’s hit a couple of categories.   Blood work;  I mentioned getting blood work done to find out what is going on metabolically in your body.  3 things to quantify and control to impact health:  sugar, salt, fat. Blood sugar – A1C testSalt – hypertensionFat – cholesterol levels. Maximum heart rate:  not calculated, because that is based on age.  But a physiological test.  A normal stress test from your doctor will not determine your maximum heart rate.  Your physician will take you to your predicted max, which could be far below your actual max HR if your physiological age is less than your chronological age.  Plus, they often say you don’t want to exceed 60% of your calculated maximum, which will not be able to assess your fitness unless you are very, very unfit. With this information, an exercise program can be constructed to meet your goals over time. I talk about Nutrition, not diet, whichI think of as short term success and long term failure.  Fuel the body like you are fueling with the optimal fuel for optimal performance, regardless of how you define performance.  Nutrition is a key factor in healthy longevity.  Amounts of fats, carbs, protein, electrolytes, minerals. Q:  Does activity type come into play when scheduling nutrition? Yes, set the baseline via the blood work numbers plus what they do as an athlete and where they are in their annual plan (building, competition, recovery). Calories, types of foods. 1 week food diary, and then a monthly food diary. People migrate to about 47 different foods, and they will not comply with anything outside their list.  So you have to work within they will eat.  Give them the right amount of calories, but also work in the proper balance of carbohydrates for the level of effort in the workplan.  Q: What about protein volume? Protein is extremely important in all phases.  Whether in competition or recovery, we are breaking down protein and we need to consume enough.  A complete protein is important.  A plant based diet is okay but you have to be careful to combine foods to get a complete protein. An active person working out 1-3+ hours per day:  needs 1.5-2.2 grams per kilo of body weight. Q:  does the amount needed increase as we get older? Yes.  There are two parts to this answer.  One, we don’t digest and assimilate protein as well as we get older, so we need to eat more.  Two, related to “leaky gut syndrome”,  because of poor diets and medications which increases inflammation in the body and further decreases ability o digest the proteins we eat.  So, yes, eat even more protein as you get older to be sure you get enough. Another point on protein.  There is an optimal ratio of protein to carbohydrates.  A 1- to-3 ratio, meaning 1 gram of protein with 3 grams of carbs provides optimal uptake.   Ed Burke:  https://books.google.com/books/about/Optimal_Muscle_Performance_and_Recovery.html?hl=fr&id=O_7XIjDhAMYC And, always start with real food first…..use supplements or manufactured products only to fill gaps. Q: I tried a plant-based diet at one point in an experiment to see if I got any recovery benefit that I had heard others had gotten.  I did seem to get a recovery boost but I couldn’t get enough protein without supplementing with protein power.  I felt like I was constantly drinking plant protein shakes so I went back to eating fish.  I did think I got a recovery benefit, and I never felt like I lost it, for whatever reason. Plant based proteins are not complete and so breakdown faster for easier digestion, less taxing on the system leading to better quality of sleep which leads to better recovery. Q:  Anything else on the typical findings of what older athletes tend to need to focus on to get the biggest bang for their efforts? One additional thing that the older athlete needs to include in a good training plan is resistance exercise to maintain muscle strength and preserve bone health.  There needs to be weigh bearing resistance exercise to be most effective.  Balance and coordination are supported as well. Body weight and band work is good for maintain what you have, but weights are necessary to get stronger.  Often cyclists and runners will say they don’t need to lift lower body because their legs are already getting a workout.  This is false.  They would be stronger if they lifted weights with their legs as well as upper body.  If they did HIIT using weights to get the best results for the time invested. Q: What about getting too tired from lifting…and then you can’t do your cycling or running workout? Everybody needs a annual, periodized plan.  Sometimes you need more gym work and less bike/running work.  If people are doing the same thing all year long, they are working against themselves….the body will adapt. And go to where the cyclists hang out, and see which one’s stand with a hunched over posture and have “olive oil” arms.  They are the ones who are not working on getting rid of muscle imbalances caused by their sport (and by sitting too much).  This is related to the idea of not just focusing on getting faster and stronger in your sport but also working on your health for the future.  These are obviously related but still separate ideas. John Jerome. Author and Sports psychologist.  High ranking tennis player.  Wrote Sweet Spot in Time.   https://www.google.com/books/edition/The_Sweet_Spot_in_Time/HKm6tAEACAAJ?hl=en You are too old to die young.  Dan Zeeman.  Athletes need to make the transition from competition to lifestyle.  Switching the mindset away from performance and toward more lifestyle for health and longevity.  Nutritional, cardio, strength, mobility, agility.   https://medium.com/46-to-64/introduction-to-youre-too-old-to-die-young-by-dan-zeman-64d397940321 Q:  To be clear, cycling help me to compensate for having an otherwise sedentary lifestyle, but doesn’t compensate for me sitting so much of the day, which is roughly the same body position as sitting on a bike.  So, I need to compensate for that too, right? Yes.  It’s important to be mindful of your current situation, and be aware that you need to change it frequently.  The body adapts to chaos better than I adapts to sedentary being.    After sitting to do this podcast, we need to be prepared to move afterwards. We are only just scratching the surface of the power of the mind. Q: How do you effect behavior change so you get the consistency in behavior that you need to get the benefits from a good nutrition plan, a good training plan? For me personally, I am lucky in that I have daily contact with my clients.  That drives me to be a role model of effective behavior plus I get constantly reminded of what can go wrong if I was to lose focus and fall away from healthy behavior. In addition, our wearables and reminders on our phones allows us to have the proper cues to drive good behavior. Another factor is the social factor.  If you can become engaged in your healthy behaviors, it helps a ton in making sure it happens. Simon Sinek.  Leadership podcast.  The characteristic of a Leader is to carry others along.  That’s also the meaning of the word Coach.  Also the philosophy of the team, like the Navy Seals:  one is none, two is one. https://simonsinek.com/podcast Building Strong Habits episode: https://www.wiseathletes.com/podcast/45-build-strong-habits-with-samuel-salzer/ Q: To summarize, we’ve chatted about (1) your process for identifying a personalized plan as well as (2) common fitness / health activities that apply to most people.  How can we summarize these for the audience. Process:  Find out where you are today.  Establish a base.   Identify goals and the tools for figuring out what is needed to achieve goals.  Figure out where you have foundational gaps, and also identify which specific protocols will be best for the individual to achieve the goal.Get standard blood profile for assessing metabolic health.Measure physiology:  HR (max, resting), VO2Max (oxygen consumption)Evaluate past history:  injuries, illnesses, surgeries….input to considering in building an effective AND safe program.Motivators:  How does the person best respond to adding prescribed behaviors.  Find a buddy, use an app.  Ongoing assessment for managing the process and outcomes of improvement.Fitness activities:  A balanced set of activities for well-rounded health and fitness.  Strength / Mobility / Flexibility.  Every older athlete is going to need some weight bearing resistance to build and keep muscles and bone health.Cardiovascular.  The heart doesn’t know what sport you are doing, it only responds to a demand.   So pick any activity that gets the HR up to the levels identified as appropriate for the person to be safe and to achieve fitness goals and to burn calories to stave off cardiovascular disease.  Over a week, the plan typically is:  1 day of intervals, 1 day of mid-distance sustained HR (60-80%),  and the rest is recovery (55-60%).Recovery.  The older we get the more we have to work on helping recovery to work well enough. Use a 1-to-3 ratio.  For every 1 dose of high intensity, 3 does of recovery.  Dose = time exercising.“I’m as good once as I ever was”.  But get the recovery to avoid injury and/or catastrophe.Balance:  the key is to balance spirit, mind and body to uncover a healthier, happier longevity.  A good, balanced portion of:  physical activity, mental stimulation, rest and recovery, and enjoyment.

Sponsor: RePowerU — a free fitness practices assessment (a 10-minute questionnaire) Build strong habits to find the consistency you need to create the life you want to live Our Guest Today — Samuel Salzer https://www.samuelsalzer.com/ Samuel Salzer is a habit expert and experienced Behavioral Designer, specializing in creating scalable behavior change solutions. Co-author of the book Nudging in Practice – How to Make It Easy to Do The Right Thing and one of the world’s first Chief Behavioral Officer’s in tech. He’s co-founded the Habit Coach Professionals, providing the first certification dedicated to helping coaches level up their coaching business using tools and insights from behavioral science. Changing behavior is hard. Generating engagement, increasing adherence, improving retention, maintaining growth — online or offline, it doesn’t matter. It’s hard. The good news? Behavioral Design makes it easier. Sam is a expert in applying insights from Behavioral Science and Behavioral Economics to fuel habit formation and digital behavior change. Sam wants to make the world a better place, one good habit at a time. To that end, Sam provides help to coaches and value-driven organizations make their products and services better using the latest Behavioral Design tools and insights. Show notes:  not a transcript but a rough but thorough description of what was discussed and the points made People struggle to make changes in their lives.  Sometimes for a long time.  People want to improve themselves in some way.  They have a good intension but when they seek help, the world gives them a terrible solution that either doesn’t work at all or only provides short term benefit, and sometimes provides harm. Samuel’s fuel is to take the science behind behavior change to turn it into actionable advice and tools for regular people to use in making their lives better. Samuel has worked on solutions that have helped millions of smokers seeking to break the habit, and for weight management interventions, and he has provided 1-on-1 coaching as well. I now know that behavior change and habit formation is a skill that any of us can learn.  So we are not helpless if we care to get control over ourselves to install good habits that will allow us to do the things we want to do consistently. I originally started the Wise Athletes podcast with Dr Glen Winkel in order to talk to experts to discover what would make a difference for the older athlete looking to both improve performance AND to extend the time in life I could be a strong athlete.  My initial idea was that if I only knew what to do, that would be enough, but I was so wrong. There are 3 obstacles: (1)  what IS true, what should older athletes like me know in order to make good decisions about improving performance, staying healthy, and extending the window for being a strong athlete.  But quickly I came to understand that: (2)   there are too many things that are true and relevant to my goals.  I had to find a way to prioritize, to apply an 80/20 rule, a way to be sure to do the behaviors that will have the biggest impacts for the smallest efforts… https://www.wiseathletes.com/applying-an-80-20-rule-the-fitness-practices-assessment/ Because, surely…. if I knew what would have the biggest payoff I would do it, right?  but no. ….the third and the hardest obstacle to overcome is: (3)  It is so hard to stick to a fitness plan that it approaches impossibility for nearly everyone to be completely consistent.  Of course this is true.  Who hasn’t walked past a plate of brownies and been unable to resist.  This is why the words Willpower or Freewill even exist.  But, Samuel, what is really happening here.  What is underlying this human nature thing that everyone knows.  What is this difference between what I think I want to do to have the life I want to live VERSUS what I apparently really want to do on a moment to moment basis?   Why do I have these two selves that contend for control of my behavior?   Samuel, can you explain this to me? Samuel’s answer: Our brains evolved to survive in conditions very unlike what we have today.  Our brains have not had time in the last 10,000 years to adapt to a consistent availability of food….to adapt to a life where we never experience famine any longer.  Plus, our bodies are always seeking efficiency, for example  if we start consuming a chemical that our body makes, we’ll stop making it.  Our bodies always prefer to conserve calories even though exercise is good for the body. Dr Barrett, says the primary job of the brain is to budget our resources and cognitive capacity.  Not to think. So, when I walk past a table with a plate of brownies and a plate of carrots, my brain wants the brownies because of the calorie density.  Of course, brownies are not in my calorie budget, and I am not worried about starving to death, so I have to do battle with my automatic self to NOT eat the brownie.  And, this battle goes on all the time. So, what can we do?  How can we human beings get better control over ourselves or bring our conscious and unconscious selves into better alignment? First of all, the fight is not a fair fight.  It’s more like an elephant (automatic self) being ridden (directed and somewhat controlled) by a small man.  If the man is foolish and unaware of the nature of the elephant, the elephant will do whatever it wants.  But if the man is smart and knows the elephant well, and can control the environment around the elephant, the man can exert a strong control over the elephants behavior. It’s not a fair fight, but there is a way to win, to be in control.  It’s a skill that we have to learn. I’ve been taking your course about habit change…I’m only half-way through but I’ve been trying to come up with a way of thinking about it.  In my mind I imagine a scale…like the scales of justice.  One one side is my deliberate mind and on the other is my automatic or reflexive mind, and on a moment to moment basis, whichever side is stronger (heavier) wins and controls the decision on what behavior I will exhibit.  So there are two categories of actions I could take to shift the balance toward my deliberate mind:  I could weaken my unconscious side and I could strengthen my conscious side.  And a third category would be the idea of making my reflexive decisions into my habits, so that I don’t have a fight to win in order to behave in the way that is good for my health and performance. So 3 categories of things we can do to improve our results: weaken the reflexive side:  for example, don’t have a plate of brownies sitting on the table,  put your gym bag in your car so you can stop at the gym on the way home from workstrengthen the deliberate side:  for example, publicly announce your intention to do somethingBut the ULTIMATE solution is:  make the reflexive behavior the same as the deliberate behavior:  turn a desired behavior into a good habit Samuel, how do you think about this? That construct can work.  There definitely are things we can do to get better control.  I think the simple solutions offered so often are not effective.  This is hard, and there is nuance to apply to making these changes to get control.  But we definitely CAN get control. The external environment and social environment matters a lot. And changing the way we think is another factor. But making the things we want to do become automatic is going to be hard.  Yes, it is possible, but it isn’t as easy as people have been told.  It’s a journey. What is a habit? Let’s go back to the beginning and start by you telling us what is a habit…what are the characteristics of behaviors that are habits, and then we can go through tactics of getting more control over our behavior. Habits are based on a context, which is more than just a place.  For example, we have different habits when we go into the kitchen in the morning than we do when we go into the kitchen around lunch or in the evening.  The entire context in important. We can think about the context and what activates or triggers a habit in two ways:   Externally:  everything we see, hear, smell, time, etc. can activate a behavior.  Unfortunately, studies show that people do not think their environment has much of an effect on them.  But they are mistaken. Overconfidence in our “willpower” over our environment (candy sitting on the desk) is a common problem. Internal:  perceptions, feelings, thoughts, cravings, hunger, pain (perhaps the most powerful which is why it is so hard to change habits…even after we get rid of the snacks, we still can crave them). People often don’t recognize this issue either because it can happen so quickly that we move from urge to action that our conscious minds do not get involved except to rationalize the behavior after the fact.  In working with smokers trying to quit, they don’t often feel the craving for a cigarette.  They just notice that they have a cigarette in their hand.  It’s only when they reach for a cigarette but don’t have one that they feel the craving.  We are all that way in some way. One requirement for breaking bad habits is that we must become aware of the cravings before we act on them.  We have to notice that we are about to do the thing that we want to stop before we can have any hope of stopping it.  But that is not all we must do. Another thing we can do to help us is boost our confidence.  Often people think that not complying with a craving is impossible.  But with some training, then can learn to have a great deal of power over cravings.  The main concept is “urge surfing”. Urge Surfing:  Notice the craving.  Accept that the craving is there.  Don’t give into the craving but don’t fight it either.  Just be mindful, just experience the feeling of the craving for as long as it happens, which isn’t usually very long.  It is like a wave that has a peak, and then subsides.  This is one of the most impactful tricks for a person to use to learn that they have control over their habits, their cravings.  They actually can be in control. I tried “Urge Surfing” myself as a part of the program.  It was a profound, first of its kind experience.   I was trying to extend my weekly fast a bit longer but was having trouble dealing with the agitation in my body, so I would eat before I wanted to.  But when I did the urge surfing I found that I could just feel the bad feeling without a need to act on it.  I wasn’t fighting the urge with willpower, I was being in the present moment feeling how my body felt.  It was like noticing that the sun was hot on my body.  I felt uncomfortable but I knew I would not die or be damaged by the experience, so I just experienced it.  I in this case, the urge to eat went away after a short time so I could extend my fasting to 24 hours without suffering and without distracting myself.  It was amazing. The biggest problem most people have with habits is co-existing with their negative states, whether it is hunger or boredom or whatever.  They just can’t stop themselves from resolving that bad feeling as soon as possible.  They want to avoid that feeling, and can’t think to just let the feeling happen and go away. A common example is social media…people want to cut back on social media.  And there are many things a person can do to make it impossible to get onto social media too much.  But that misses the point.  The reason they want to be on social media is to escape some negative feeling:  boredom, stress, loneliness, etc.  If we don’t recognize and address these internal states, then those issues will come out in some other way.  Binge eat, or watch too much TV or some other thing that we don’t want. One key thing to remember is that habits are just a way our brain and body creates efficient behavior repetition loops.  The ability to manage these habits is a skill which can be learned.  Just as juggling is a fantastical skill that looks impossible but is highly learnable.  Habit change is a skill we can learn.  It is much more complicated than juggling, and so we may never be perfect habit managers, but we can get better and better by first understanding what a habit is and how it is formed, and then practicing the techniques for getting control over these processes. So hang in there. Habits have three parts:  a trigger, the habitual behavior, and a consequence of the behavior. So we started with triggers of habits.   Habit Triggers We want to think about adding triggers to the environment for good reminders to do the things we want to do, and we want to think about removing triggers from the environment to avoid being reminded to do things we don’t want to do.  Removing the candy from the table, and putting apples on the table. Also, we should cultivate a curiosity for the feelings we have in our bodies, our internal states, and to learn to just experience those feelings without acting on them. Ability to Do the Behavior For the actual behavior, think about our ability to do the behavior.  It is like swimming upstream, against the current, harder than it could be…..or downstream, with the current…easier than it could be.  For example, going to a gym that is close by is an easier behavior than to have to travel a long way to go to the gym.  On the other side, having a fast food place near where you live makes it more likely you will go there. To make good behaviors easier to do, reduce the friction.   And, increase the friction for behaviors we want to stop or reduce. Another dimension of improving our ability to do a behavior is to make the behavior itself easier.  Rather than setting a super hard goal to accomplish in a short amount of time, just get the habit started with something easy enough to do that it gets done every day.  Then make it harder.   My mom wanted to make meditation a regular part of her life but she wasn’t having success, only doing it 1-2 times a month.  She felt meditation meant a 45 minute session every morning.  To improve this, we looked into what is the minimum viable dose of meditation….where she’d still get something out of it but it would be as easy as possible so she could get better consistency. She picked 5 minutes to start.  That change allowed her to get a 100-day meditation habit going We should always start with a goal of building a habit, and then tweak the habit to help us achieve our real goal. Consequences of Behaviors:  REWARDS! Rewards are crucial for sustaining behavior change.  If we set goals that are too hard, such that we cannot consistently succeed, then the habit will not form. The goals should be hard enough to make progress (so we are motivated to do it) but easy enough to be certain to do the behavior, so that we get the rewarding feeling of accomplishment and repeat the behavior again and again.  This is how habit form.  Once we have established a habit, we can improve the behavior further. It is very hard, and almost no one is good at dealing with failure.  It is the most common reason for giving up.  Failure is a motivation killer. People who are good at building sustainable habits start small.  They often choose to exceed the behavior when they can but the bar is set low enough that they consistently hit the minimum threshold.  Momentum is very motivating.   So far, we’ve talked about the importance of triggers.  The ones inside of us and in our external environment. And, we’ve talked about the ability to do the behavior by modifying the environment to make the friction easier (swimming downstream) or harder (swimming upstream) depending on whether we want to do the behavior or DO NOT want to do the behavior. And, we’ve talked about how important the reward is in establishing a habit.  We repeat behaviors that are rewarding to us.  Ideally, the behavior itself is a pleasurable, enjoyable thing.  But not everything is like that.  But just feeling a sense of accomplishment can be enough if we consciously connect that feeling to the behavior.  If we feel good about having done something that we wanted to do for our health, for our quality of life, for our sense of who we are or want to be…that can be a rewarding feeling as well.  Be mindful of what you are trying to build. Trigger —> Ability —> Rewarding Experience In the brain, every time we complete the same action in the same context (time & place), and we have a rewarding experience, that there is a strengthening of the neural circuits.  What they say in neuroscience is “fire together, wire together”.  So the key is to repeat the behavior…without this there is no habit building.   Support the Repetition The fourth thing then is to support the requirement that the behavior is repeated again and again.  What can we do to support the repetition of the behavior once we have established the pattern of habit formation? (1) If-Then Plan:  Start by thinking about why I might fail to do the things I set out to do. So if my targeted behavior is to eat a healthy lunch, then why might I fail to do that? Maybe if I have a bad breakfast, then I’ll have more cravings during lunch time, or… If I eat lunch with colleagues at work, I tend to eat what they are eating. Once I had identified this likely reasons for possible failure, then I create a backup plan to respond to this conditions.  Perhaps I will do something before those things happen to take me off course, or I might add something to my behavior if I fail to do my targeted behavior. Or, we might make a pact with a co-worker regarding lunch.  If we go to lunch together, the co-worker agrees to order for me or remind me of my targeted behavior. This allows you to not feel so badly about a miss because you managed to do the behavior in some other way, and then the fact that you didn’t do it as planned just becomes another data point in the process of learning how to create this habitual behavior. A recent weight loss study showed how anticipating failure make people much more resilient to failure.  The positive mental attitude people who only said positive things about how certain they were to succeed in the weight loss program did far worse than the people how thought about how they might fail and plan ahead for how they would react to the situations that would cause them to fail. (2) Another tool to use is commitment devices.  We do something now that makes it harder to NOT do the desired behavior at some point in the future. Here’s one:  brush your teeth after dinner.  That will make any food you eat afterward taste funny, plus you’d have to brush your teeth again if you ate something.  A more extreme version of a commitment device is getting a dog.  When you commit to a living animal that loves you, you are more likely to take walks during the day for the health of your pet and you home.  Or getting an accountability coach is another device.  Sam will provide a link to his list of 50 ideas for commitment devices. Sam uses a meal preparation service to provide a few dinners each week to keep him from getting junk food when work causes him to miss the family meal.  Same thing. Here are some links to commitment device ideas: Summary: We are chimpanzees stuck in a modern world.  People are naturally inclined to build habitual or without thinking behavior, which takes less energy than thinking, and which allows us to do more things at a time.  We can multi-task very well on habitual behaviors but not on conscious thoughts or behaviors that require thinking to perform well.  Think about sports performance…how important it is to have the skills just happen without thought. These reflexive or subconscious or unconscious behaviors can present as a physical act we do without thinking or as a thought (craving) or emotion (anxious) that drives us to do something.    These habits are made up of 3 parts:  Trigger —> Ability —> Rewarding Experience Triggers Habits are contextual, meaning that the internal and external things that TRIGGER the habit are connected to the environment where and when the trigger occurs.  When you see or smell food, you might feel hungry.  Or when you are bored with work, you might crave checking social media. Habits can be impeded (for habits we want to stop) or encouraged (for habits we want to build) by understand the triggers, and weakening or removing them, or by strengthening or adding them. An important thing to do to combat the power that unconscious thoughts and emotions have over us is to learn to explore and get comfortable with our internal states.  When we are hungry, just feel the sensation of hunger rather than try to decide whether to eat.  Just feel it like you might feel a cold or hot temperature on your skin.  It is just a sensation.  Then you can bring your conscious mind to bear to decide whether to act on the craving.  Learn to surf these waves of craving or emotion or thoughts that come up without effort. Ability  We can also modify our ability to do the behavior to either reduce the likelihood or increase it.  Moving things further away or closer, or making the behavior harder or easier to do in any way will have an impact on the behavior.  Change the environment so that we can only do what we want to do.   Also, when trying to build a good habit, focus on repetition of behavior to start.  Pick a goal that is achievable every time but still moves the needle.  Once the habit is established, make the behavior more difficult to get more benefit from having the habitual behavior. Rewards Habits form around repeated behaviors, and we repeat what is rewarding.  Rewards are typically connected to physical action.  We are motivated to DO something if we will get a reward for it.  The best, most sustainable rewards are the intrinsic rewards where we feel good for doing the behavior.  The best is when the behavior actually is pleasurable, but when that is not possible, we can feel good about doing the behavior that we wanted to do for our health or our fitness.  Our identity, how we see ourselves, is a key here.  If we behave in a way that makes us feel good about ourselves, we will feel pleasure.  And over time, the behavior will begin to feel pleasurable.  The reward will begin to migrate over to the activity that resulted in us feeling good about ourselves. Support Repetition Repeated behaviors form habits.  We repeat what gives us pleasure (which can be removal of pain as well).  So to create a new behavior, we must repeat it while getting a reward.  To support this necessity, we build in safety nets to keep us on track if the behavior implementation plan is not working well enough…if we might not be consistent enough because of stuff that happens in our lives at home or at work.  We build in if-then plans and commitment devices. Habit Coach Pro:  Link to course: https://www.habitcoachpro.com/ Last message: Everything you learn about, behavior change included, requires that you find a way to integrate it into your life.  It will be hard.  Don’t be too hard on yourself.   The best thing to do is see this as an experiment.  Something your are going to try just so you can learn more about yourself.  And, during that journey, be kind to yourself.  Be okay with things not going exactly to plan.  It will be interesting and fascinating, but hard.  You will start to see yourself more clearly, have more self-awareness.  This effort will require introspection.  And it will allow you to better relate to other people, and the challenges they face. Commitment Devices Article: https://medium.com/behavior-design-hub/your-commitment-devices-database-35a54df3a64fDatabase: https://www.habitweekly.com/commitment-device-database Sam’s experience includes Chief Behavioral Officer (CBO) for Nordic Wellth, leading the way in personalized digital health.Behavior change and persuasive technology expert in EU Horizon 2020 project Live-Incite. Developed the digital app and platform MyLi powered by machine learning to support patients required to stop smoking and consume alcohol.Helped the digital health app Lifesum to apply behavioral design insights to support its 35 million app users build better eating and health-related habits.Had the plesure of supporting the team at Deedster, a digital app that aims to make it both fun and easy to live more sustainably. Helped to increase long-term retention by making the app more habit-forming.Worked as Behavioral Strategist and helped grow Beteendelabbet (Behavior Lab), Sweden’s leading behavioral consultancy, committed to creating a positive impact in society and nudging the world in the right direction. Contact info: https://www.samuelsalzer.com/ https://www.habitcoachpro.com/