The Bledsoe Show

Dynamic Neuromuscular Stabilization and Functional Capacity with Dr. Richard Ulm

Dynamic Neuromuscular Stabilization and Functional Capacity with Dr. Richard Ulm

Currently the owner of and a treating physician at the Columbus Chiropractic & Rehabilitation Center in Columbus, Ohio, Dr. Richard Ulm came to the medical profession after a successful career as an athlete and a strength and conditioning coach. In his practice, he blends his athletic and coaching background with his medical knowledge to offer patient-specific care utilizing the most progressive and advanced therapy tools.

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Table Of Contents

Dr. Richard's Backstory

Mike: I want you to, so DNS is great. And from what I understand as your education goes, can you just run like a 30 second what your formal education is and maybe some of your informal education, like how deep you've gone to figure out how the human body should be moving.

Dr. Richard: I mean, it started probably 1996 honestly. I met a guy named Charles Poliquin. You might've heard of. My coach Jud Logan was a four-time Olympian and trained with Charles before Charles was famous. So I think 1989 he started working with him. And when I came into school at Ashland University, which is just north of here, I had this amazing coach, Jud Logan and I got pretty close access to Charles Poliquin in the late, which was when he was like the guy. When he was like the most famous guy, T Nation, Poliquin principles, German Volume Training, all these things.

So he came in in the fall and he was working on our squat and he was going back and forth between doing some ART active release technique on us. He's working on my clean. So he'd have me do some ART. And like he was working brachioradialis and infraspinatus and then I'd like to do some pull-ups and that going back and forth, I just was like, "Man, that is really cool that he's able to go to both extremes." He's looking at the performance and then he's going breaking it all the way down and figuring out where is the smallest dysfunction that leads to the technique flaw or whatever it was.

And then fast forward many years I did track and tried to make a couple of Olympic teams. It turns out the Honda Accords don't go very fast, so I got to train with some cool people and qualify for two Olympic trials and did that sort of thing. But I was a, what we call an also-ran in a sport that nobody cares about in an event that no one's ever heard of. So it wasn't like I was top 10 in the country in the hundred-meter dash or something like that. But it gave me access to really, really high-end training for a long time. And I did it as hard as I could.

Becoming obsessed with movement and function

Dr. Richard: And then when I was got out of school I was like, "All right, well I love this. I love the human body. I'm kind of obsessed with movement and function and all that kind of stuff." And I decided to stick with it and do the coaching thing and keep trying to make an Olympic team. And I went into coaching and then that's where I started. I was a strength coach and a track coach for a while and I have this, I mean it's just sort of like this obsessive pleasure of learning how things work. So if I see someone's pelvis, it shifts to the right when they're squatting, I have to know why. Like what, why does that guy's knee come in? Or why can this half, why does it, what athletes, their right shoulder tips and the other one, it's the left shoulder that tips, what's going on there.

I was coaching, this is like 2004 five, six, seven. This is before a lot of the stuff that you can get now, we're just sort of inundated with all this stuff. I just decided I said, "Well screw it. I'll just actually go to school and study anatomy and mechanics." And so I went to school to be a chiropractor and while I was there, I did 2000 hours of gross anatomy dissection, which is unbelievable to be able to have that.

A hundred hours is what most medical schools are required. And I did 2000. And that's not even, and I made myself study anatomy or mechanics for at least 30 minutes before I walked into the cadaver lab every time. So once I kind of had the normal anatomy memorized, then I had to go in and say, "Okay, well what is the multifidus lumborum of small muscle in your back that controls your spine? What does that do mechanically?"

So instead of reading an anatomy book, it says, "Oh, it attaches to the transverse process and goes up six to eight segments and does extension, whatever." I would then read a kinesiology text or a biomechanic book and then learn about, well, what does it actually doing in function? So that's, that was a bunch of different books. There wasn't one class I took or whatever. It was just me literally just spending hundreds of hours in the anatomy lab looking at the anatomy and thinking about, what is this doing and oh, how does that apply? And you look at your own injuries and.

Mike: So this is different than most people. Most people go into chiro or PT school and they're like, "I just want to get to the end." And then maybe after they get to the end they go back and learn some really cool shit. But you went in, you were using the program to educate yourself versus needing to get some type of certificate or anything like that.

Dr. Richard: I was a little lucky because I had a career beforehand. I was on the strength training, crack coaching path. And so when I went into school I was 30, if you're 22 I wouldn't have known.

I finished school and did all that extra stuff while, excuse me, well while I was at school I was just taking different classes and I'm always trying to find the source of the problem. One of the questions that I was interested in when I left strength training was the core.

How does the core work? We use this term all the time, but then when we dig into it, I wouldn't really buy the explanation I was getting. So I read books from yoga and breathing and Pilates and strength training and everything to kind of figure this stuff out.

Meeting Dr. Pavel Kolar

Dr. Richard: So I came across Pavel Kolar, the guy that started DNS while I was in school from two people, Robert Lardner, who's one of my buddies and mentors and then also Brett Winchester. Same thing, buddy mentor. And I was like, "Man these two guys are pretty bright. I want to be like them." And so I started digging into this and this is the beginning of mine, I mean a bunch of babies, like I don't get it. And then I, they said, "No, no, just go to course. Study it and actually get in there." And you get in there and it's this amazing explanation of movement and function. But if you just walk in there on the surface, you're just seeing the baby exercises. Well if you dig into it and then you start getting into the neurology of movement.

You're going to sit there and you've got somebody laying on their back in what we would call in strength training, triple flection just sitting there, that's three month position at DNS. And I was like, all right. And then as I kept taking, it's a four day class at this time, I kept just seeing this. I was like, wow, there's way more to this than just a bunch of baby exercises. And so that ended up being this deep dive into how does the core work, and how, for stability, which if you get into, if you really dig into it, it's pretty complex and pretty hard to explain. And Kolar gives one of the best explanations I've ever seen. And so then I got hooked at that point.

And then if you just keep digging into DNS, the subtleties and what you can see when you keep going into it are endless. And so then you keep getting better and better and better at seeing something like, Oh you bring your arms up overhead and you can tell, oh well this shoulder is going to have a tough time stabilizing. Or I watch somebody move and I was like, oh you can't pistol on your left leg as well. And they're like, "How did you know that?" Because you didn't pistol. Well you're watching the muscle synergy in the balance and how they move and you can identify these super, super, I'll say primordial problems that will affect every movement that is more complex or more intense after that. Like if you can't roll from your back to your belly, you're going to have problems doing any rotation movements, period.

And if you know what you're looking for that you learn in a lot of these DNS classes that Kolar is brilliant at, you can see this movement dysfunction in these movements, or these actual activities. Then you can then break them back down and find out, well what is the smallest area where it's still present and then address it there and then you add them back in and then boom. That's kind of what we did with you today. We identified the shoulder.

We just showed your shoulder showed your brain what it felt like or reminded your brain, hey, this is how the shoulder blade should stabilize. And then we did a couple exercises so that you could kind of apply it to weightlifting and then you come over here with Drew who very familiar with all that stuff and he can kind of continue that process and get it to where, all right, well now you can stabilize with the bar over your head in snatch position with pretty good patterns. Right? So the DNS stuff for me in school and then after and then even to today was really that deep dive and explaining movement on its most, on its deepest level I guess.

Functional Capacity

Photographer: Danielle Cerullo | Source: Unsplash

Mike: Let's go ahead and do the functional capacity.

Dr. Richard: Well it ties in well with what you're talking about where, and this is common in the industry. Somebody comes in, we treat you on the table, maybe you're in pain, and so then you get them out of pain on the table. You get them out of pain in that environment, which is nowhere nearly as challenging as holding double body weight overhead or whatever, body weight and a half, whatever it was.

At least triple body weight, for sure. You and four other humans. But what's really important is that whole skill application and then also skill strengthening exercises. So this isn't the functional capacity stuff yet, but in rehab, we need to improve your capability of moving correctly. And by correctly, it's kind of how DNS describes the muscle synergies and the stuff that we can get into later if you want. But we've got to at least get it so you can.

If you have almost no dorsiflexion, you can't squat below parallel. If we don't fix your dorsiflexion, you're going to have to compensate. The early stages of therapy, once you've gotten the patient out of pain, it's going after what I call their functional blocks, so limited hip stability, ankle mobility, thoracic spine, trunk stability, all those things. You have to address those things. Then once you address those now, then you have to move and you have to apply it to whatever their world is. If their world is just working at some job and standing at a desk or sitting at a desk, that's fine. If their world is being more active or they want to be doing snatches and heavy, heavy weight or playing football, well, if you don't apply a reasonable effort to give them exercises to close that gap, then a very small percentage of athletes are going to be able to jump there.

Now, one of the things that I noticed in coming up with the functional capacity thing was having athletes that in the clinic could stabilize really, really well. If I got them to stabilize, well it was great. I could put them in all these different DNS positions and they were kicking butt. I can have them with bands and loading and all that stuff. Then I'd go into the gym, and I'm like, "The fuck are you doing?" I look, and their ribs are up and their back's cranked into extension. They're trying to brace, but the moment you put a barbell on their back, they physically can't do it. Then I really started thinking, "Well, how do we apply this amazing explanation of movements or the neurology of movement, like Colaz describes, how do we get that into the athlete on a platform or on a field or wherever?"

Well, it was because there's some neurology there that prevents you from doing that. If you don't do two things that I'll talk about here in a second, it'll never happen outside of your freaks, your genetic freaks. The two things you need to do is, number one, you need to make sure that you've clearly cleared their functional blocks to the best of your ability. If someone has hip impingement because they have what's called FAI, femoroacetabular impingement, you're not going to improve their internal range of motion for their hip. Some of them are going to be unchangeable. Others, like tight hips, ankle dorsiflexion, and lumbar stability, those are things you can address. You have to address those so that now they at least have the capacity to move well.

The other one is you have to do that threshold training that we talked about. With the functional capacity, it is basically a neurological limit where no matter how hard you try, you are incapable of maintaining that good muscle synergy in the balance where you're using all of the muscles to stabilize the joint well, so you're going to have limited load to the passive structures like the labrum or the biceps tendon or the disc or whatever. In those scenarios, the body can handle a ton of load, high volume, high intensity. But the moment you go over that functional threshold, you lose that muscle synergy, and now you lose that nice, even loading. You're going to overload different tissues, more force is going to go into the passive tissues, and now you start getting bicep tendonitis, labral tears, disc herniations, things like that.

Athletes training outside of their functional capacity

Mike: You're in the world of power lifting, weight lifting, CrossFit. How many athletes are regularly training outside of their functional capacity and putting themselves at risk?

Dr. Richard: 100% of them, unless they know this. It's because of this.

Mike: It's less than 1%.

Dr. Richard: It's definitely less than 1%. The functional capacity, to give the definition for functional capacity, basically, you have… Colaz describes these optimal muscle synergies and movement. Of course, it's based on developmental kinesiology. When you look at somebody move, when they're moving, well, they're going to use all the muscles available to maintain a joint's position even during movement. That's what he would call functional centration. The result of that is that you're going to have even surface loading of the joints, minimum overload of the passive tissues, and the majority of the stability is going to be contributed by the active structures, the muscles, basically. In those scenarios, your performance is better, your movement, your function is better, and you're not loading those tissues enough to where… or sorry, so much that they might get injured. Functional capacity is the range within which you can maintain that optimal muscle synergy. You can maintain functional centration. That, for some people, is at 20% of their max or 50% of their max. Well, if you want to improve your mitochondrial density or you want to improve your muscle hypertrophy, you have to push your body beyond 20%.

Measuring Functional Capacity

Charting Goals
Photographer: Isaac Smith | Source: Unsplash

Mike: But this is not exactly what you're saying, but it's one of those things where I saw that, and I go, "Wow, my bottoms-up press is nowhere near my one-rep max dumbbell press." I go, "Oh wow, it's time to build some stability." How do you measure someone's functional capacity?

Dr. Richard: The measure is the hard part. The measure is the hard part. Right? The measuring at this point is just really, really challenging. We know what the body looks like, what the synergy looks like. You can either look at sort of what's activating when they're actually lifting, or you can look at the positioning of the body. For instance, in the shoulder, like we were talking about with the snatch, if they're able to stabilize correctly, the shoulder blade can stay down, the humerus can stay externally rotated when they're stabilizing. When they lose that position, the shoulder elevates and protracts, and the arm actually sort of… It goes with it.

It's not actually in internal rotation. It's in external rotation, but it looks like it's internally rotated because the shoulder pulls it with. Now it's here and the-

I don't know how we would explain this on a podcast because this confuses people when I'm in a course. I'm going to try to do this, everybody. If you have your arm out to the side and you elevate your shoulder blade like you're pushing into a barbell, and now if you look at the crux of your elbow, the cubital fossa, they call it, and that's tilting forward, people think, "That's an internally-rotated arm."

Now, if you bend your elbow, if that was internally rotated, I should have a crap ton of external rotation. Right? But that's it. But then I have all of this. The shoulder blade itself moves, so the joint doesn't change its orientation… Sorry, the joint doesn't change its actual positioning. The shoulder blade moves, and now the arm looks like it's internally rotated but it's actually externally rotated, which is part of the problem when the shoulder blade gets decentrated when you go above functional capacity, and now that shoulder blade dumps forward.

When you receive the bar, you're receiving the bar at end range. You have nowhere to go but smash that humerus up against the bone. We'd like to do all of our sports in mid-range of possible. It's not always possible, but we'd like to do it there. When you decentrate because you can't hold that position, now you're then loading the posterior labrum or the biceps tendon or the bone because you're not able to receive the bar in mid-range in a centrated position. Right? But you can see those things when you've done it a lot. If we gave a similar example in the torso, if you're stabilizing the torso while the lumbar spine is mostly straight, a little bit of a curve, soft curve, the pelvis is neutral… and what I mean by that is that the top of the iliac crest should be pointing at the arc of the ribs and vice versa. When you have what I call an extension compression stabilizing strategy, which is what you see rampant in power lifting, CrossFit, and Olympic weight lifting, the pelvis dumps forward, so now the iliac crest is pointing forward and there's a hyper extension.

Hyperlordosis, hyperextension, and then the ribs elevate, so they both dump… Now you've got the ribs, the rib cage is up, the angles of the ribs are pointing forward, and then you have the… The pelvis has dumped forward. Now in this position, I know that they're not stabilizing with the abdominal wall, with the diaphragm. There's no pressure on the abdomen pushing the spine back into a neutral position. In that position, they can only stabilize with their posterior chain excessively. Then the amount of force going through the spine just skyrockets because you've got nothing in the front balancing out those mega posterior chain muscles.

When you see that in a weightlifter, this is to answer the question of, "How do you identify it?" if you're going through and you're watching somebody squat, as a coach, you would know what it looks like when you're doing this. You say, "Okay. All right, you're starting to lose it a little bit." You'll see the posterior chain come on. You'll see their thoracolumbar junction arch a little bit. Then, "All right, We'll rack it," and, "All right. Let's rest. Let's try it again. I was seeing this. Here's this. Try to maintain this, and then go ahead and do it again," and maybe they can fix it. Maybe they can't. But when they find that point where they cannot keep those ribs down, pressurize the abdomen, and keep the spine mostly neutral, then you know you're at threshold.

You don't need to know the exact kilogram that, "This is above, this is below." It's probably a five to 10 kilogram range, but you just train right in that sweet spot there where they're starting and their head goes back, right? The elbows a lot of times will sort of push forward. That's when they're starting to lose it. Then you would just stick them right there and build the capacity. That will go up, and then they're able to perform in their sport at a much, much higher level without overloading those passive tissues.

Mike: Their absolute capacity would go up because of this.

Dr. Richard: I said that today it's like cutting something in half. You can never actually get to those things. You can just keep getting in halves and halves and halves. As the functional capacity keeps going up, it will never catch absolute fatigue. The absolute will keep going up and up and up and up and up. But the smaller your functional gap, the higher you can handle training.

When you look at those just amazing… like Rich Froning. The dude's been doing high-end CrossFit for years. If you watch him when he's moving, he's doing toes to bar or he's doing the… What was it? In 2014, he did double-grace? You can see he's still able to pressurize his abdomen and keep his ribs down. He doesn't really have to think about it all that much, maybe. I don't know. I've never asked him about it.

Mike: I think he's done enough repetitions Well at this point, it's probably-

Dr. Richard: Well, but I think that there are some super freaks out there from a neurology standpoint. In DNS, we always talk about Roger Federer, and he moves unbelievably well. Well, until recently, he was dominant and had minimal injuries for most of his career, whereas you compare a lot of the other people that he's competing against who are younger than him that are just plagued with injuries. Well, one of the factors, I'm sure there's many, one of the factors is that he moves so well, and he's able to maintain that muscle synergy, and his functional capacity naturally is super high. Another one is Lu Xiaojun. I think I'm pronouncing that right. But Lu, as everybody calls him, you watch that guy snatching double body weight, and he still maintains really, really good positions. He's incredible.

Now, I don't know if he's aware of this phenomenon, or he's just a gifted athlete. They're out there. Watching Rich Froning do stuff, I don't know if he really knows how he's supposed to stabilize or whatever. A super nice guy, but I've never been able to ask him about this stuff. But I know he's very gifted from the movement standpoint, so now he's able to have such longevity in his career. One of the factors would be that he moves so well. When he's loading structures, when he's moving, he's loading structures that can recover well. Muscles can recover. Muscles can heal. If you tear a muscle or some micro-tears in a muscle, if they're microscopic tears, that just turns into hypertrophy. If they get a little bit bigger, well, that might be a little bit of an injury. You do that to a ligament or a tendon or a labrum or a meniscus or the annular fibers of your disc, those don't heal so well.

If you can maintain that functional centration, you're going to be using what I call an active loading strategy, which means you're using the active structures to load as opposed to a passive loading strategy. When you use a passive loading strategy as you would see in power lifting, that's the butt back, chest up, arches my back as much as possible, smash my facets together to establish the spinal stiffness necessary to rip 800 pounds off the ground or whatever. Right? But if you can generate the same level of stiffness, but by loading the active structures, well, now the body can tolerate that way more. They can heal from it, and they can keep going.

Where To Learn DNS

Mike: Where do coaches learn this stuff? I go, "Okay. All right. Now I'm aware of functional capacity…" Where can we learn it? You're like, "Oh God."

Dr. Richard: No, I'm actually redoing the strength training track for DNS to include a little bit more of this stuff. I also teach courses where I'll cover this in detail. I'm doing one study at the OPEX place on April 18th and 19th.

Dr. Richard: In Scottsdale. That'll be cool because DNS is a huge influence on me, but I also mix a lot of other just strength training things in there that we don't often get to cover in a clinical class. But the influence of DNS cannot be pulled out of anything that I do. It's everywhere. But that class will be interesting because I'll go into some of the capacity stuff, because if I'm going to get… The whole purpose of the class is to get people to know how to train the lumbar spine or the torso or the core, whatever you want to call it really well both from a rehab standpoint all the way up to a performance standpoint.

This class is designed for strength coaches and trainers. It's not a clinical class, so I'm not going to do any like manual techniques or anything like that, but I have to talk about the capacity thing. Otherwise, they're going to leave, and they're going to be like, "Well, what the fuck? I'm doing this on the ground. I'm doing my breathing stuff. Then I get a barbell on my back, and I can't do it." Right? I have to talk about all the limitations that go into that so that when they leave the course, they know how to identify this, they know how to train it so that their athletes can do it at whatever level they need.

It's survival strategies

Dr. Richard: Functional capacity, to remind everybody, was, remember, describes these optimal movement strategies that are based on developmental kinesiology, which is a fancy word for the neurophysiological aspects of a baby going from immature physically and neurologically, emotionally or whatever, all the way up to a mature adult with a full nervous system, full muscular system, ready to go. With functional capacity, there's a range where you can actually move with those ideal strategies that he describes, and if you push it too hard, then you're actually going to collapse into a more primitive stabilizing strategy, so more of a newborn strategy.

Well, you could even think of it more like the limbic brain. You have your prefrontal cortex that can actually inhibit that and suppress that and control, while when you get tired and hungry or your lack of sleep, and then your prefrontal cortex stops doing its job, you go back to a primitive state. now you're going to be more snappy.

But it's the same kind of an idea, where you actually have this more primitive neurology that is a little bit more robust. It can handle the load, like the limbic brain. You're always going to get hungry when you need it. You're always going to want to breed, and you're always going to want to-

Mike: It's survival strategies.

Dr. Richard: the neurology, when the baby's first born, they don't have full access to all those muscles, and the brain actually has to develop to acquire those movements and acquire the activity of those muscles. Well, the later the muscle develops in development, or in [antigenesis 00:52:06], is their term, the more fragile it is neurologically, so the easier it is to challenge it and just get it to shut off. muscles that we see this with all the time are going to be your serratus anterior, your deep neck flexors, your abdominal wall. These are all muscles, your lower trap, these are muscles that easily shut off, and then once those shut-off, you have to go into the more primitive muscles, so your upper traps, your levator scap, your spinal extensors, or psoas.

All of these muscles then crank on and become excessively active to take on the load. That's basically functional capacity. Once you go over that threshold, you resort to a primitive stabilizing strategy because of the neurology, not because of fatigue in the muscle or a lack of acetylcholine, or a limit in mitochondrial density. It's not that. It's literally from the brain down, it just can't maintain those synergies, and so then you collapse into that primitive movement strategy.

You hang out right at that breaking point, right around there where the athlete has to focus, and it's hard to do, but they can do it. two out of their three reps, they can actually maintain a decent pattern.

Pushing Someone Beyond Capacity

Photographer: Victor Freitas | Source: Unsplash

Dr. Richard: The three factors that you can do that will push someone beyond capacity, I talked about load the whole time. The load is the first one. The other one is the duration.

If you do a hundred kettlebell swings, as you notice, there is a consistent pattern that your posture will start to distort. In the beginning, you're going through your swings. Maybe you can keep the ribs down. You can keep the spine neutral, and as you notice, you'll start rocking back on your heels. Your chest will come up. Your pelvis will go forward, and then your actual torso positioning for reps 90 through a hundred are completely different than they were through a hundred through 10, and that's because the neurology is taken away. You've exceeded your functional capacity, so if you want to keep going and get all hundred without stopping, well, then you've got to hang on your posterior chain, which has amazing resilience, a.k.a., just watch a CrossFit competition.

You can hang on your posterior chain and finish the reps, but you're not doing it in a way with these strategies, so you're actually beating up your body a little bit more there, because the movement strategies are less efficient, but they're still more effective in that way. If you watch someone hold a plank, no one in the history of the universe has ever done a plank and felt like their abs kept turning on, and they couldn't turn their abs off. What happens is they hang there in a plank, and slowly their pelvis tilts into an anterior pelvic tilt.

Speed is the other one. this is like the athlete, if you watch your non-contact ACL injury, for instance, I know there's… That's like a can of worms. There's a million factors that go into this, from their Q angle and where are they at in their cycle, and all that kind of stuff. But when you land, the speed at which your knee is going to dive into valgocity, which is kind of when it comes in towards the midline, it's really, really fast because those impact forces are really quick, and it is really challenging for the nervous system to do that. Well, if the nervous system is unable to maintain good function of your abductor and external rotators, so glute max, piriformis, all those guys, then it's not going to be able to control at that adduction of the knee, and then now you've got increased forces going through the knee.

Another one for speed or the Olympic weightlifters, if you notice, either their knees come together when they're hitting their second pull, you'll see the knees come in. You might also see it when they do a box jump. They'll do a box jump, and their knees actually come in really, really quickly. those are times where… This is even at lighter weight, or they might only have 40 kilos on the bar, and maybe they have 110 kilo snatch. Every time they come in, one of their feet sort of turns really quickly. Another one that you might see are the weightlifters, and actually, Drew used to be this guy, one foot turns out more than the other.

4 Pillars Of Health

Photographer: David Mao | Source: Unsplash

Dr. Richard: I mean the recovery thing, we'll just keep going here. So I've got four pillars of health. And we've got diet and exercise, sleep, and then we could really unpack this one, but we'll just say emotional health or all that other stuff. It can be dissected down to the granular level. It could be an entire podcast.

When I was 15, 18, getting into sports, exercise was number one. That was it. And I mean honestly diet wasn't really even a thing. And then you get into college like, okay, I've got to start eating better. And then I realized that, okay, diet is important. And then I start digging into, when I'm getting really serious athlete, okay, now diet becomes more important. It never, ever, ever, ever when I was an athlete, eclipsed training ever. Meaning I never thought that nutrition was more important than training.

I always thought training was more important than nutrition. And then I started thinking, all right, well sleeps, well I got to sleep. But it was never to the level that it is now. Right? So the guy, Matthew Walker, is the guy that wrote Why We Sleep.

I listened to Peter Attia and he does this really good podcast with Matthew Walker and it's three separate podcasts that are each two and a half hours long on sleep. And the end of that basically, I now then took sleep, well, let me hold on, sleep's important, but let me go back to where I was. So I had diet, exercises is the most important, sleep, sorry, diet was second most important. Sleep was like meh. And then stress management, psycho-emotional health wasn't even a thing. Then I sort of retire and I'm like, okay, now diet's more important than exercise and sleep's still kind of like whatever. I opened a business and I'm trying to do all this stuff and I'm just grinding it out. Six, seven hours of sleep or whatever. But then after listening to Matthew Walker's, now I put, I don't know what's more important, sleep or diet. I know diet's insanely important, but changing, making myself have a non negotiable eight hour window of a sleep opportunity as he would call it and setting my alarm eight and a half hours later. So if I need to sleep eight and a half, I do, has been absolutely game changing.

Now if I could go back and say, man, I'm going to make myself get eight and a half to nine hours of sleep. I mean, who knows? I mean I wouldn't have made an Olympic team or anything like that, but I would've got my Honda Accord up to 67 mph. But I mean the sleep one has been huge. So his book, Why We Sleep is great. And then he's got, there's a podcast on 10% happier, which is actually a meditation podcast done by this guy named Dan Harris whose one of the GMA correspondence. He's a really good podcaster.

Mike: I've seen some of his, I saw an interview with him.

Dr. Richard: He's excellent. So he's got a little bit of a self-deprecating attitude, pretty kind of funny guy. Doesn't cut into the speakers too much. Like sometimes you'll have podcasters and they're always just over cutting in there. He's really good about just listening and then he'll answer questions or he'll explain it. But he's got that app and Matthew Walker went on there and if you want a good quick one that's about an hour long and that goes into all the stuff. And to me he hit a home run. I get it. Okay. Sleep's important. And it's been really awesome changing my sleep.

I could put my head down on a table and sleep for 10 minutes and wake up and then go. And that's of course an indication that I'm sleep deprived. But ever since I started doing the sleep thing, probably in October, there's only been maybe two days and they were built around excessive amounts of wine and limited sleep. other than that, I have not even had the need to nap. And so the focus is better. The energy's better, the presence is better. The anxiety or whatever it is. I mean, it's just incredible how much it does all by just sleeping less.

Mike: There's a code out there. The sleep things just become, I can get away with so much when I'm sleeping well as far as nutrition goes, training goes, all that kinds of stuff. If I'm getting great rest, I notice I can get away with a lot more and have more fun. But then you got the psycho emotional thing, you mentioned that. Then you go, oh, how important is that?

Dr. Richard: It's super important.

Mike: My thing is I did a ton of that work over the last five years and there was about a year and a half period where I smashed it really hard. And what I found after doing that level of work is I was wasting a shit load of energy 24/7 awake and asleep. There was tension in the body, tension in the fascia, that just no matter what, I would lay down and sleep and I still had tension. I did a bunch of emotional work and I remember going to bed one night and I was like, I am actually relaxed. I don't think I've ever actually been relaxed in my life. I didn't know what relaxed was.

Dr. Richard: When when you sort of stand there, well think about, you meditate. So think about when you're sitting there and let's say that you're doing a body scan. You're trying to just progressively relax. The first couple of times you do it, you're standing there like, "Oh yeah, I'm totally relaxed." And then when you get to it, you realize you're going like this, you're flexing. And the amount of tension that you have just sitting in your body that takes minutes to just let go is insane. Until you pay attention to it, it just sits there.

Mike: Well, your thing is, the more you have putting out, the more tension you're putting into your body that's being sent out, the less you can feel. I'll just squeeze my rest in however I can hopefully. And I think at the highest level this is just what I was hearing someone say.

Dr. Richard: You have athletes now that will like, I don't know what his exact number was, but I've heard LeBron James talk about how important sleep is and how much he, he gives himself this massive window and all this recovery stuff. So now in the eighties and the nineties, the mentality was just go. Seventies and the 80s, it's even even better. Think about the businessman back then, it's like I only have to sleep four hours, I can get this done and yada yada yada. Now it's like, well wait a minute, we need to actually be doing things for the emotional. So we have to do meditation, we have to do things where, I think you guys call it playing, right? Where you actually have to relax and chill.

So a lot of these people now, these high producing CEOs actually see the value of this. So they're doing silly things like meditate, silly things like sleeping a bunch as opposed to just grinding it out at the office, sending out emails at 12:30 and then getting back there at five in the morning. Like okay, you can do that, but I don't think that you're at your best self doing that. I don't think you'd be doing your job as well.

Closing Thoughts

Dr. Richard: I feel like the nutrition, the emotional health, all that kind of stuff has really started to surface in the last 15 years in a way that it never really has before. So if you think about all the waves of nutrition that have come out, like paleo, keto, all these things are starting to sort of surface and then all this emotional health kind of stuff that's now it's accepted.

That's kind of where I'm sort of a clinician first and a lot of that stuff is when I have free time, I try to blend the stuff that I learned from the rehab world. A lot of what we talked about today with the strength training thing. That's where any courses that I'm teaching, like the one at OPEX, that'll be on that website, articles, videos, all that kind of stuff. Instagram, I've got athlete enhancements on Instagram. I've never ever done Twitter, but yeah, they can look there.

I just kind of put up content and I love teaching courses, so I teach for DNS. I teach the athlete enhancement stuff, which might be courses on the core, Olympic weight lifting or squatting and those kinds of things. And then I also teach a whole medical side of it with manual therapy and all this other kind of stuff there.

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