Dr. Keith Baar, PhD - Maximize Tissue Health

what I did is took the molecular biology IID learned from my PhD and brought it there and we discovered this protein called pg1 Alpha which is important it's what they call the master regulator of mitochondria so what we showed is that when you do endur this exercise you activate or increase pg7 Alpha you make a smaller more active form of the protein as well and the result is that you get more mitochondria your kids are soft you lack discipline we landed on you didn't earn the knowledge for yourselves so you don't take any responsibility I

like we forgotten who we are explorers [Applause] Pioneers I was actually introduced to you uh via another Dr Beard on the science of ultra uh so that's when I first kind of found out about you and then since then I kind of went on a flurry of just you know reading research that predated obviously that podcast and um mainly it pertain to tendonopathy and uh what you'd put into that field because it plays in you know a rehab based practice like ours um and I mean we'll talk about this obviously it looks like it's kind

of segwayed into you know more metabolics and you know uh molecular kind of uh mechanisms within tissue and training and that's I have a lot of questions which one by the way when I started looking through the abundance of research I was like holy cow 226 articles or at least that's what it says on Research gate well um 50,000 some citations and I was like I got a lot of research I got to do on this guy so impressive yeah well some of it well a lot of it's just luck being in the right place

at the right time and and um especially at the time that I was doing some of these things we were the first ones to do a lot of the molecular components and so when people go back and look and say all right we're doing this based on X oh yeah so we got to site this one and because you know we had the opportunity to to get some of that stuff in first we excited a lot so it's yeah it's really good and but we try really hard to make it so that the work that

we do is repeatable and that we purage people to repeat it and we try and be explicit in how we do things so yeah hopefully hopefully that lends it to being kind of more accessible to to not only not only scientists but practitioners and other people as well that's what I've appreciated is the practicality behind it um you know some research I guess all research has practicality if you can extrapolate and decipher you know what it means to you in your practice uh but I feel like most of the things that I've seen from you

you know that I was aware of or became more aware of as I kept looking at things preparing for this I was like I could see how I could use that and it's not just information that's kind of good to know um which I think is great in this day and age um in my opinion from the practitioner side where we do get a lot of information that's just kind of like what do I do with that you know and that's abolutely I get that there's always more questions from research and sometimes that's the goal

it's not to answer something but it can get a bit frustrating when there's just more information to prise through and you know you got to stay on top of it and you know say what's next I know exactly what you mean we sit there and there's hundreds and hundreds of articles that come out every week and you have to sift through to find the one or two things that are actually useful both from a practice standpoint but also from a science standpoint because a lot of it is not useful and a lot of it is

isn't done as as well as you hope um and so it makes it more difficult to to actually figure out what is real and what's reliable and so that's why a lot of people a lot of scientists actually repeat the the stuff that other people do because they want to make sure that if that's the new starting point let's make sure that starting point is on Solid Ground let's make make sure that it is part of a foundation that we can then build the future work on and we get into a lot of problems when

people don't go back and and redo that foundational work or they redo it they can't get it to work and then they don't publish it they can't get it to work and so nobody else knows oh you know what that really didn't work and so we're all LED down a path that goes in the opposite direction yeah which I can I mean I'm sure you can think of plenty more than I can but yeah there's been various examples of things that we thought were true or mechanisms that were at play and like maybe not you

know and that like you said it kind of rewrites existing things and then it explores a whole new Avenue of research which I mean that's I'm sure why you're you know in it which I do want to back up for a second yeah so so why don't we go ahead and start uh more formally now yeah so uh as I said I really appreciate you coming on the show and uh the first thing I wanted to kind of talk about was actually was this the plan all along as it neologist so I was oh okay

old school so I kind of went to college to become a gym teacher because I thought that is the that is the perfect nothing wrong with that yeah um but the reality is that uh I went to into the US and and they don't train the gym teachers the way they do in Canada so you don't get that holistic training and so it wasn't it wasn't as enjoyable yeah well uh so then what was the shift like what happened what spurred the the want to go to graduate school and then how did you I know

I heard part of this on the just fly podcast which I thought was an interesting story of how you got into working with tissue and tendons in particular but what was that Gap from you know going from a kinesiologist into higher level Graduate Studies yeah so I started like I said as kin as a Kines major in one of the classes that I got to take CU at University of Michigan um a lot of the the sport coaches had to teach as well and so one of the courses I got a chance to take was

strength and conditioning from a from a guy named Mike gson who was for 20 30 years the head strength coach at the University of Michigan and and then I just basically pestered him and pestered him until he let me become a strength and conditioning coach with the football team so I I started from that strength and conditioning coach background and then I was considering kind of next steps I thought about medical school but then I tried um I was a surgical assistant and did a bunch of stuff and I realized that it was a lot

of repetition a lot of the same thing all the time and and I was looking for something where I could be a little bit more creative and so I thought you know coming from a a home where both of my parents were professors and they basically could do whatever they wanted to work on whatever they thought was interesting I I thought that that was really cool so started going graduate work from there went to University of California Berkeley and did a master's degree and there what I the two things that were really important happened one

was I got exposed to Dr firy Who basically was talking all about molecular biology and how you could have these genetic things that control what's going to happen at the tissue level or at the whole body level and I thought that was really cool and that was fairly new at the time CU I'm old and then the other thing that was probably significantly more important is I met my wife so so those two things were the were the things I took from from Cal and then I went and did a PhD at the University of

Illinois Chicago and there what I was doing was I was trying to do what I wanted to do as a strength coach was figure out why some people got big and muscular when they lifted weights and other people did the exact same program and didn't get any more muscular they got stronger but didn't so you you you get into this well why what's causing the muscle to grow now what I did is I I developed this model that was based on how we trained our athletes and so I just electrically stimulated the nerve and what

happened is all the muscles of the he Lim contract because there's more muscle in the back of the leg than the front of the leg that caused shortening contractions in the back lengthening contractions in the front and as everybody knows when you're doing really heavy lengthening contractions that's a greater stimulus for growth and adaptation So within that model I had muscles that were growing say 15 16% over six weeks muscles that were going seven or 8% and then muscles that weren't changing in size all within the same animal and same leg and what that allowed

me to do was identify a molecular signature that was basically the first time that people had talked about this protein Kines called mtor and it's important in the adaptation of skeletal muscle to you know loading to exercise and so what we did is we identified that the greater hypertrophy we saw at six weeks was exactly proportional to the to the activation of mtor that we saw 6 hours after the single bout of extracise so our correlation was 99 something and so it was really really high and so that was really interesting to us because it

suggested that this Central regulator of protein synthesis was activated by resistance exercise and when we activated it we got bigger muscles and so people then went on to start looking at mtor for yeah exercise in people because we did the initial studies in rats they saw the same thing in people they then showed that well mtor is activated by amino acids as well so the reason why you're straight training plus your lucing Rich amino acids are good it's because Lucine activates mtor so when you did the two things together you got a bigger stimulus and

you got more muscle growth so so that was the core of what I did for my PhD and then I went to washu um and I worked with John holl who was the kind of father of endurance exercise and he had discovered that mitochondria increase in muscle when you do endurance exercise and that was long enough ago that that was the first positive effect that people had seen of endurance exercise cuz at that point people didn't know that it was good for them so they he was showing for the first time that the skeletal muscle

showed a doubling of mitochondrial mass and then what I did is took the molecular biology IID learned from my PhD and brought it there and we discovered this protein called pg2 and Alpha which is important it's what they call the master regulator of mitochondria so what we show is that when you do endurance exercise you activate or increase pg2 Alpha you make a smaller more active form of the protein as well and the result is that you get more mitochondria when you continuously do that and so so that allowed me to to get kind of

use the molecular biology to really try and figure out how endurance or strength training affected muscle so historically I was a muscle biologist and that's where I was focused and that was basically where I was doing all of my work and so the transition to tendon came when I started thinking that I could engineer muscles and just pull whatever genes I wanted make this super muscle that we could then maybe put into somebody or do whatever but the guy that I was working with Bob Dennis who's probably one of the smartest people on the face

of the Earth he he was trying he was doing things like he was taking little engineered muscles and he could swim fish around in a little little liquid that he had so he would make he would engineer these little robot fish and put two muscles there and then he would contract them and they would go back and forth so that you could actually have a fish that swam but what he was Finding was the muscles were were pulling off of where he was tying the fish and so there we had to try and understand the

tendon and that's why I started to kind of begin to appreciate tendon as it as a tissue well that's uh I saw a quote from one of your articles and if it's misquoted you let me know but it said tender or tendon is the master mechanical tissue and then in that same article I believe it talked about the at the muscular tendonous Junction experiences five time greater strain than the mid portion or the enthesis and just yesterday I had a patient in that had a a distal biceps tendon repair where they basically you know cut

the the edge of the tendon off and then reimplant the muscle right into the radius and he's about I want to say 7 eight months out and he just just kind of asked me he goes am I just supposed to like you know full range of motion he's doing everything he's back in Jiu-Jitsu he's hanging off a pullup bar but he goes it's just constantly sore and i' had been reading through all your work and I was like you don't really have the Dynamics at play this would be my hypothesis and I want to hear

your input because you've removed that tendon and now you just have muscle which has less Dynamics in it and then an enthesis which is the stiff portion but it's engineered right it's plugged into the bone so my question there which I didn't want to start here but you kind of led me here there's we know there's ligament isation that occurs with like taking a you know hamstring or pelra and putting in an ACL so we go in a year later and that's legitimate of the ligament does that happen with that type of you know plugging

a muscle into a bone do we get tonz is that going to occur is that not you know the mechanism at play yeah so it's a great question and really so functionally what we have and this is part of of just the change in mind that for me that's happened over the last 10 to 15 years is that if I look at a muscle now so I used to be all focused on the muscle and the muscle and the muscle but really what I've got is I've got the bone on one end got the bone

on the other end and that the muscle is actually just an expansion of the tendon where we stick these contractile proteins in so that we can produce a force so as we do that now what we've got is we've got as you said tendon is this incredibly interesting tissue from a mechanics point of view because on one end it's stretchy and then the other end it's stiff so it's a variable mechanical tissue and that's why it's important and so when you do take a a muscle and you you basically take out the tendon and you

and you stretch it first of all you're going to start adding circum in series for most of us that means the muscle is going to get longer we don't know what happens at the innerface very well we know that you're going to form some sort of structure that's going to look like the enthesis or the bone ligament tendon interface well we don't know exactly what that structure really looks like and we certainly don't know whether you're regenerating the variable mechanics that you should have at the muscle end of the tendon and so the best thing

you can do at certain points like that is to try and load it in ways that are going to maximize kind of the properties that you're looking for and there what we want to do is if we take somebody who's never exercised before and we have them exercise the the tenons are going to get stiffer okay just because the structures are now getting lad and they're now going to when they get loaded in a in a single Direction more of the collagen becomes aligned and as that collagen becomes aligned it it has it has more

stiffs okay so but once we've started to train and we're taking athletes who have trained for a long time now how load is going to depend is going to make it so that we either have more stiffness at the muscle end of the Tenon or less stiffness at the muscle end of the time okay so if we train with rapid movements that don't allow um time for the collagen to kind of Shear past each other that is going to be these Dynamic plyometric um really quick movements that's going to cause the the collagen to work

as a sheet and the collagen is going to then get stiff at the muscle end of the tendon that doesn't mean from phone to muscle it's going to get stiffer necessarily it means that at the muscle end of the tendon you're getting a little bit stiffer and if that's the only way that you train with very light very fast movements over time the muscle end of the tendon becomes stiffer and stiffer and what happens is eventually because we're not giving a big load to the muscle the muscle is not getting a signal to be strong

we're giving a tendon we're giving a signal to the muscle end of the tendon to be stiff and now the T the Tenon is stiffer than the muscle is strong and now when we take a step that's when we can we can injure the muscle and we counteract that by doing heavy resistance exercise that does two things it makes the muscle stronger but it also means that we're lifting the weight slower and as we lift the weight slower the muscle into the tendon the collagen will slide that'll break little cross leavs that are in that

area and that will result in less stiffness within between those fasal or those or the different um collagen levels okay so so what that means is the muscle end the tendon gets a little less stiff plus as the muscle fibers themselves get bigger it pushes out the collagen fibral so now when I load them they have to actually come together as they get pulled and that also means that there's less stiffness in the system so all of these things will give us less thith so in an individual where I've got I've basically remove the tendon

what I'm going to try and do is I'm going to try and do slower moves right it don't have to be really really heavy but they have to be slow so people know from their Tenon opathy um studies that okay the the standard of care is slow Ecentric loading perfect that's great the but it's but Michael car has shown beautifully that if you do heavy strength training it has the same effect on tendonopathy that slow Ecentric head the two things have one important aspect in common is that they're both done slowly so the heavy strength

training I'm moving the weight and the weight is going slowly if I do that exact same lengthening program that's going to treat my tendonopathy but instead of moving slowly I just drop really fast now what I'm going to do is I'm going to have a negative aspect of that training so the velocity at which we're loading is super important for treating tendonopathy is for getting that kind of variable mechanics and the muscle end of the tendon all of those things and so that's where we would then begin to use the slowest form of contraction when

that's maybe an isometric and so for somebody who's coming back from removal of a tendon we're going to do very early in the process we're going to do what we call low J isometrics we're just going to have them contract the muscle and the low jerk component is again most of the patients most of the people that you're going to see in your practice their damage didn't come from from holding a stretch too long or from slowly moving into that stretch the damage came from playing tennis and smacking a ball the ball is accelerating one

way you're accelerating the other you get jerk on the tendons of the outer part of the elbow you get tennis elbow or maybe they're going to be golfers and now they're hitting a mat or they're hitting the grass they're accelerating a club One Direction the grass is giving them resistance they get that instantaneous jerk that's going to give them golfer's elbow on the other side of the of the elbow you're going to have lots of jumpers getting jumpers KNE where they're getting Dynamic jumps all the time all of these things have this common property of

jerk jerk is not that person that we hate it's actually a physical property so where I am is my location the rate of change in my location that's my velocity the rate of change in my velocity that's my acceleration and the rate of change of my acceleration that's my jerk so when I'm accelerating one way and there's something else accelerating the opposite direction that means two accelerations are coming together that's when we get jerk the most common is like I'm going to go lift the weight I'm accelerating the weight up if I'm doing a deadlift

I'm accelerating up gravity is accelerating down when I hit the bar when I get that catch phase that's the jerk so when I'm reloading after an injury I minimize that and the way that I do that is I disperse that contraction over a longer period of time so I begin so I slowly apply force over about a 3 to five seconds I going to hold it there and then I slowly let the force off and that's ideal for keeping the jerk down so that the the likelihood of injury is low and by holding that isometric

now I get all this little shearing at the at the end of the muscle in your case and that's going to help that collagen that's within the Matrix of the muscle to begin to have some of the same principles of of a tendon where at the muscle end is going to be more um less stiff and at the bone end is going to be stiffer wouldn't necessarily say that it's going to tendon eyesee but you're going to get something that's as close as you can in that situation well this is why I wanted to bring

you but very this is why I wanted to bring you on though is because I talk about your research all the time in particular one paper that has beautiful illustrations in it that basically give the visualization what you just explained about slower heavier loading is going to have a different outcome than faster lower loading I believe it's 30% below uh one rep max and below that and then faster loading has different outcomes and I I just kind of try to point out when I'm teaching about running rehab or tendon rehab of we can extrapolate on

that old heuristic of hey you start with isometrics you move into Ecentric and you move into concentrics and then ballistics we can be a little more specific based on the injury at hand the tissue profile also of the person that we're dealing with right they using whatever Bon criteria or you know uh the sport that they've played for years and how they've you know evolved or adapted um but in that same article which the other uh the other animation or the other picture that's in there which is just amazing and it's been talked about and

I looked up the outside magazine article that you're quoted in is the use of um vitamin C and gelatin which is you know one of the things that I know you've talked about a lot but this always again I mention your name within the Chiropractic PT realm whenever he's like who and I'm like God how does not everybody know who Keith bar is because these things when you see a and again correct me if I'm wrong a 2X increase in outcomes of tendonopathy just by adding what is it 15 G of 15 G of gelatin

and 200 milligrams of vitamin see 30 to 60 minutes prior to exercise I mean just knowing that if we were working with a professional athlete let alone a you know a stay-at-home mom that plays tennis a couple days a week if we're too Xing the results I feel like that should just be why aren't you doing it especially with such lowcost interventions as you know vitamin C and gelan yeah so so it is one of the things that that the one of the studies that a lot of people look to is the that I did

with Greg Shaw of the Aon Institute of sport where we where we fed people either five or 15 grams of gelatin we've since done it with hydrolyzed collagen which has the same effect and you know really before I even go too far people say oh what about the special one that comes from this company that's more we've never seen a difference between even the cooking gelatin that we get at the at the grocery store versus the hydrolized collagen they which is what I tell people to buy because of your research I say you can go

get the 30 Cent packet of gelatin and I'm pretty sure and that's one of the questions I want to ask you is there a difference between which we can have a sidebar on different types of collagen hydroly bone broth all you know there's lots of options only thing so the only thing I do is I tell people not to go from a bone based source so the bone broth works as far as the collagen goes um a lot of the gelatin works as far as the collagen goes but where a lot of it comes from

is from the bone obviously for the bone broth and so what we what we make sure people understand is that is that most animals they store their heavy metals in their bones so if you're going to take you know cows and now boil down those bones and now we're going to isolate stuff out of there actually there's good data that says in bone broth there's high levels of lead and other things so we try and stay away from the the bone based ones or we try and encourage people to do a skin-based one and so

that's the only real thing that you're looking for is something that comes from a pelt or a skin or you know cuz there's usually fish skin or pig skin or or any of these types um in people who are you know Halal will go for the fish or you know if they have different that's totally fine but there's not really a fundamental difference in how you hydroly for example so if it's hydrolyzed collagen totally fine if it's gelatin it's totally fine as well it's a little easier to incorporate the hydrolyzed collagen because it dissolves in

in relatively cold liquids and so you can put it into and a lot of people will put it into their coffee or they'll put it into into other things that they have kind of at the same time every day and they just get into that routine and the reason that that's important is because what we see with collagen synthesis is that we see this you know this cyclic nature to it so there's a circadian rhythm that comes to it there's beautiful or coming out of out of England and now in Copenhagen that shows that there's

a circadian rhythm to collagen synthesis but also it takes about 24 hours for the collagen synthesis from your exercise yesterday to Peak today so so that's why we want to have that kind of collagen dose about the same time every day if it's an hour before training that's great because then you're going to Target it to the area you trained but it also means that when I do it again tomorrow it's already it's also going to get targeted in the same way so if 24 hours later collagen synthesis is higher than it is today because

I exercised yesterday now I've supplied more amino acids more building blocks for the for the collagen so the cells can make more collagen potential can you touch on the the targeting of it didn't they do did they do radio nucleotide studies with collagen on rats looking at where it where it's going based on stressors and tendons is am I wrong on that or what's the mechanism on targeting so oser has shown that when he gave kind of radiolabeled Proline which should go into collagen because it's every third amino acid or he gave it as as

hydroly collagen that was radiol labeled he saw that more got into the uh the muscular scal tissues when he when they when the mice or the rats consumed it as the whole protein rather than just the amino acid in the skin the amino acid got incorporated into collagen at the same rate but it seemed like the muscular skeletal system so the cartilage the muscle connective tissue and the tendon those things seem to do better when you are giving a more native molecule like a highr collagen or whatnot so that's the only one that I've seen

there the reason that we give it an hour before when we're trying to Target a specific tendon is what we're trying to do is we're trying to use blood flow um normally we use blood flow to deliver the nutrients that we want to the tissues we want so one of the best things that everybody can do is after dinner is take a 10 15 minute walk all that's going to do is it's going to Target more of those food items that you've eaten so the the carbohydrates the proteins and the fats are going to go

to the muscles that you're exercising so your walking muscles in that case so that's an easy way to Target what you've eaten using blood flow to specific tissues the problem with our connective tissues our cartilage our tendons our ligaments there's not a lot of blood flow in these tissues so what they normally do is they normally get their um their nutrients from the solution that they're in so they're in say they're in a sovial joint they'll get the synovium has a has a liquid in it that's going to allow as I load the tissue either

compression for the cartilage or tension for the for the tenant and ligaments now what they're going to do is that's going to squeeze out the liquid that's in the tissue and then as it relaxes now it's going to suck liquid in from the environment if I put the coll the hydrolyzed collagen or or whatever into the system beforehand now there's more of that to deliver to those muscular scal tissues and some of the work that I've just been doing on my sabatical in in myri in in the Netherlands was to use what what's called a

blend so so we know that there are specific amino acids in collagen specifically Glycine and Proline that are very low levels and are relatively low levels in other protein sources like Dairy protein so most people will go out they'll have a whey protein um after they've done their exercise and that's great for their muscles we talked about loosing Rich protein acor you're going to get more muscle protein synes the problem is that what you see and what luk Fen lon's lab is shown is that after you consume just Dairy protein away glycine levels for example

drop and that means that it's has the potential to become limiting and so what we've been doing is blends of proteins they would have say 20 G to 25 gr of wa protein with 5 G of hydrolyzed collagen with the 50 to 200 M milligrams of vitamin C and that seems to give a lot of really good signal to whole tissues at the same time so if you want to do things that are going to benefit the whole muscular scal system having a blend like that where you combine some uh milk-based or way based protein

with a little bit of hydroly collagen and some vitamin C that's a really nice combination and we've we've got data that's that's in review right now that shows that we can increase kind of connective um tissue protein synthesis in the muscle when you take muscle biopsies using that blend um over Placebo control so what that's telling us is it's telling us that yes the hydrolyzed collagen might play some sort of a special role but having the Whey Protein the locing rich protein might also be beneficial and we know that from some of the some of

the studies that we've done in the lab here because if we use an inhibitor of mtor complex one our our little ligaments aren't as strong and so in fact that's one of the ways that people have probably heard igf1 as a way to improve tenin or ligament function the way that igf-1 works is it activates mtor complex one that increases collagen synthesis and decreases collagen breakdown and so or adding the Lucine Rich Protein that's going to activate the same thing that igf-1 does slightly different mechanistically but when you do say the exercise together with that

locing rich protein now you've got the signals that are going to allow that tissue to get bigger and stronger one of the questions I had for you just because I know you've studied and your you know the kind of synopsis of what your Labs looking at you mentioned the Lucine uh you know protein signaling in particular um I have a couple questions on this and I hope I know I'm all over the place but I have so many questions I want to ask you um you said there's kind of an additive effect when you see

these things like an Entourage effect in a food based Source because of all of the other things like are you studying these at all or have any other lab studied side by side like vitamin C like vitamin C is notoriously hard to absorb in a nonf food base so are you looking at that like the synergis effect of like you know as the you know fructose with fiber plus the vitamin C helps and then it's hard if you have a synthetic you know ascorbic acid or something like that base are is there anything out there

so the way that we've done this is is basically by messing up a little bit so what we've done is we've done it so that we had a vitamin C powder that we stored in our laboratory in front of the window in Northern California in the summertime so it's getting totally getting blasted by the Sun all day long that experiment we ran all of the experiments we looked there was no increase in protein syn in collagen synthesis and we did another experiment where we took we were using um Rina or this uh basically a concentrated

fruit juice that has about 50 milligrams of vitamin C and we made gummies so in order to make gummies I dissolve the gelatin in a boiling by boiling the the um the Rina when you boil vitamin C it kills the vitamin C and that one even though it had the same amount of amino acids in it you actually saw no increase in collagen synthesis so again the vitamin C is fundamentally important what we use we use a vitamin C powder so so we don't find that there's a problem with that it could be that as

you if you take the vitamin C together with collagen there's not a problem but maybe it's in a in a whole meal or something else it becomes a little bit more difficult to digest but a lot of times what we'll do um if we're going to if I'm going to make this at home is I'm going to make a smoothie there's going to be blueberri strawberries I'm not putting any vitamin c in there because the fruit is going to have that and so I'm using the fruit not only as a flavoring to give it some

consistency as well because it's frozen but I'm also using it to deliver the vitamin C that I want because I don't need it to be you know Pharmaceutical IAL grade vitamin C that's going to be in my system for a long period of time I just need it to come in at the same time as my my hydroly collagen or my whey protein and and these things coming in together so that the cells not only get the stimulus or the building blocks the reason the vitamin C is essential is because in order for the cell

to spit out the collagen so that it can get into the tendon the ligament the cartilage it actually needs vitamin C to add a little bit of a change in the molecule and when you do that it then can release from the cell so when we do experiments in the lab and we want to measure how much how much collagen the cell is made all we have to do is take Vitamin C out and then the vitamin C stays in the cell or sorry the collagen stays in the cell so then I can just bust

open the cell and measure how much collagen was there and so if I take vitamin C and I added in a dose dependent manner to my cells all that happens is when I collect the cells I bust them all open the ones that have the vitamin C don't have any collagen in them anymore because they've opened up and they've released their collagen into the into the meteor The Matrix whatever and that does that's why vitamin C is essential so if you don't you see a lot of studies where there's no effect of collagen um supplementation

many many many of those are done in a overnight fast and state where they supplement with collagen but they don't provide vitamin C and if you don't provide vitamin C you're not going to make and Export the collagen from the cells that you make it from and so if you're just going to measure it in The Matrix of say a muscle or of a tendon you're not going to find it there if you don't have vitamin C because it's not going to be secreted from the cell and incorporated into the Matrix so vitamin C we've

known as important um the First Nutrition study ever done in the 1700s there was a Scottish doctor he basically took a bunch of sailors with scurvy and he fed them different things one of them was like turpentine I'm surprised anyway surv but two of them got uh a lemon and two limes and those ones got better within a few days and so they didn't know vitamin C was in the lemon and the two limes but then they started giving all the sailors lemons and limes because they knew that that would stop scurvy and basically all

scurvy is was that you'd stop producing collagen so the result is your any old scars would open up your teeth would fall out your hair would fall out all of these tissues where collagen is essential to bind you together would start to deteriorate and you could fix that just by adding vitamin C so for 300 years we've known that the vitamin C component is really important and so seems like more manufacturers of collagen products and supplements need to read some of the the research cuz I mean you just with what you just told me it's

like vitamin C is the key that unlocks the ability to utilize collagen but then if you see a standalone you know and a collagen for your coffee or something and that's not in there I'm not saying that's useless if you eat it with food that has it but it it could be um so that part of the educational process is just making sure that when people if people are having it in their coffee in the morning that they have a piece of fruit that they have a glass of juice they have something that's going to

give them vitamin see um because just by just having the collagen itself isn't enough in of itself right which I think is a great Point within a within a mixed diet you're going to get enough vitamin C through the day but if you're not delivering those things about the same time and most of us have a small breakfast that maybe is a especially in Europe they're going to have a coffee they're going to have like a bready thing and that's going to be their breakfast until lunch they're not going to really have fruits or vegetables

until maybe lunch or dinner if you're delivering your collagen 4 hours or 8 hours or 10 hours before you're going to have any vitamin C yeah your daily vitamin C is going to be sufficient but now you've taken your two signals and you've and you've separated them far enough where maybe they don't have the the synergistic effect that they would have if we took them together well I have a couple of questions about fasted training I know you have some research on there but talking about time dependent delivery of that so for people that are

doing intermittent fasting that maybe have just black coffee in the morning and are waiting till maybe 10:00 a.m. or 11:00 a.m. to eat their first meal but maybe work out in the morning what is the time dependency window on that like how much time do we have yeah so so again when we talk about taking something 30 minutes to an hour before that's to get the optimal effect so it doesn't mean that there's no effect if you take them later um and again one of the reasons you're not necessarily going to have as much blood

flow you're not going to have as many of the things to Target it but you're still going to get an effect by putting these things together and to taking them in um together as as one unit and so what we would tell people to do is don't worry about it if you're training first thing in the morning you're you're you know because this is what I do I get up in the morning if I don't train first thing in the morning time is not really going to make it so that I've got another point in

the day where I can train so I train early in the morning before I eat anything and then I'll come in and I'll have some something kind of later on where I'm going to then bring in some of these things that are going to help my body respond to that training and adapt as optimally as I can and so for me that means having something that has a milk-based protein has some collagen in it has a little bit of of vitamin C with it and then maybe something uh if I'm really pushing it I'll I'll

get some epic caak and Rich cocoa and those are that's really going to form the kind of cor of what I'll do as far as my recovery after that training so if I was taking people who are time dependent feeding and they were going to say not eat until 10 11:00 totally fine I would have something like that that would have they would have something where you've got a little bit of milk-based protein if you can handle it plant-based protein is fine you're just going to probably need to increase the total amount because it tends

to be lower and loosing it's a little bit harder to digest so if I taking 20 grams of a whey protein maybe I'll take 30 plus grams of of say a soy or pea protein then I would take you know you know maybe five grams of gelatin with that or hydroly collagen I would put it all together in if if I'm going to do it in a juice or I'm going to do it in a in a smoothie maybe bunch of strawberries to give me my vitamin C because they're in season right now or whatever

other fruits and season that's going to give you that great if you then you if you're going to do something like epic cakin you can do it with with I just use natural cocoa cuz it's it's it's fairly it's a really good source and so you you just adding that then you have to figure out your vitamin C unless you like fruit flavor chocolate stuff and that's fine but you can do something that has a mixture like that and it's perfect for the rest of the day or you can eat something that's going to be

say yogurt with some fruit you can sprinkle a little hydrolized collagen on it you can do it that way there's lots of different ways you can do it you don't have to worry about precise timing maybe you can get 80% of the effect but it's still a huge amount whereas you know if I'm Elite then that 20% makes a big difference if I'm not Elite if I'm just training for Life getting 80% of the things right oh that's a win that's a huge win and so that means getting my fruits and vegetables and and and

getting some of one of these supplements maybe once a day you know relatively close to my training that's a that's a big win for me yeah and I agree that sometimes we get in the weeds with this stuff with the you know the general public and you know we're going too granular when we yeah should take care of the 80% but if we're if we stay granular for a second when we keep mentioning Lucine and I know you've done some studies on you know Lucine um supplementation and Branch chain amino acids so you kind of

mentioned for different protein sources lucing you know not being as high plant-based protein do you is are is BCA supplementation uh a net positive or negative should people be focusing on Lucine rich foods like eggs or other things in addition or so I would I'm I always focus on the food component the only time that I ever do any kind of supplementation is if if the food is insufficient so what I'll do is I'll look at my meal if I'm going to have something that's maybe it's a carbohydrate based meal and it doesn't have much

maybe maybe it's a hot day I'm going to have a salad and it's going to be something that's going to have lots of edge but it's not going to have much for with protein now what I'll do is maybe I'll I'll add some cheese to it I'll add some eggs to it I'll put something is a protein Source on it and there maybe it's not enough so then maybe instead of having a a water to drink I'll have a milk to drink that's basically how I would do it is I would focus on on actually

getting the the food components and looking at what you're going to eat and if it's not going to have enough protein adding in either from either a lean meat a egg cheese any or or the or just you know instead of drinking water drink milk all of those different ways are ways to increase the protein content of what you're doing and they're far better than sitting down and and taking some sort of siamin we'll get back to uh amino acid supplementation but jumping into fasted trainings we've mentioned you know time to minute feeding inter fasting

which it's you know it was huge there for a while and now we're seeing some articles come out on maybe some cardiac risk and is it actually doing what we think it was doing or is it still beneficial so I know this is a broad sweeping question but from your standpoint because I know you've done some studies on this and I saw correct me if I'm wrong again that um if we do workouts in a fasted State wasn't there increased protein synthesis that occurred with those workouts yeah so so this is work that we've done

some John Holly's done some other people in the field have looked to say if you want especially if you're relatively high level you can get more adaptation by doing some of your training in a low blackag in state not all of your training and you don't want to do it all the time so the best study is probably one from John Holly where what he did is he took triathletes who were training multiple times they had the exact same amount of carbohydrate in their diet one group they had all of their carbohydrate in the first

part of the day they did their last training session their dinner after that would have protein and very low carbohydrate and then they would get up the next morning and train in that low muscle glycogen as well as low liver glycogen State and they saw about 3% greater Improvement in run performance than the ones who um had the same amount of total carbohydrate but had some of that carbohydrate after that second training vot so what it tells us is that some of the reason that our muscles adapt to our exercise is because of the metabolic

stress of the exercise and so if we compound the metabolic stress of the exercise by adding a metabolic stress of doing it in a fastened state or doing it in cage in depleted State we get certain molecular signals that are higher and that will provide an increase in adaptation that that results in Greater performance so where we'd use this is mostly in either Elites but if we're not talking about Elites we're going to use this more in people who don't have a lot of time to train so what we're going to do is is I'm

going to say okay you can only train say three days a week but you want you have this goal of running a marathon so what I'm going to do is I'm going to take one of your training bouts it's going to be over here the other two of them I'm going to do them together I'm going to do one of them in the evening and then you're going to have a low carbohydrate meal so you're going to be in muscle glycogen depleted from the exercise that you did you didn't replenish that and then you're going

to sleep your liver glycogen is going to be depleted to run your body while you sleep you're going to run you're going to exercise again the next morning and you're going to do that session in a glycogen depleted State muscle as well as carbohy as well as liver I'm going to give you a little bit of black coffee in the morning just to get you so that you don't feel like it's as hard as it as it would feel like if you didn't have that and you're just going to train in that fasted that that

muscle and liver glycogen depleted State and now from those same three training bouts I'm going to get more adaptation than if I had done those Monday Wednesday Friday say so that's how we would use it kind of in a in a structured system if I'm doing it with Elites when they're in their base phase now I'm doing two days a week where they're doing evening training next morning low liin training and I'm going to do that twice a week and just have that as part of the component of their training they're going to train the

other six days a week as as relatively normal are there any specifics on the the first meal after one of those backtack facet training sessions is there anything that would be focused on or just typical you know good nutrition good nutrition resupply I would I would again focus on having protein because protein building blocks the one thing that happens when you have those fasted training sessions is that you can become much more you're much more likely to get say upper respiratory tract infections so what we'll do for you know if that's a problem for some

people we could maybe bring in some some fish oils to as a kind of something that we add into their into what they're doing to to improve some of their some of their um immune function but then when they do have that next meal I'm going to make sure again that it's going to have losing Rich protein because that's not only good for building our muscle it's also absolutely essential for the functioning of our immune system and so you know like when people were getting when people were getting their vaccinations this is one of the

things we were trying to make sure that everybody was doing was taking and loosing Rich protein with the vaccine so that as you're having that immune response you're giving your immune system all of this you know loosing Rich Protein that's going to stimulate and help that immune system respond to that insult so whether it's getting a virus or or getting a vaccine we're going to want you to have of the of the food that you eat we want it to be high quality protein is going to be the core of it and we would do

the same in this situation where we put at the core we're going to have a foundation of that high quality protein so that it's going to help our immune system fight off anything that maybe came in when we're doing this more stressful low glycogen training but it's also going to help us build um repair any damage that we've done and then we're going to bring in the carbohydrate as a way to replenish the the metabolic stores that we've depleted by doing the that double training so um I work a lot and obviously I you know

like I said I found out about you from Dr Beard's podcast uh work with a lot of ultramarathoners do a lot of running myself and correct me if I'm wrong so you're I know there's uh you're also becoming more efficient at glycogen kind of pulling glycogen out of the muscle and the liver so delivery mechanisms is it actually having a metabolic response outside of just the I guess the like a protein signaling response because that that was my assumption of what was being talked about is that you're becoming more efficient at uh fatty oxidation versus

like having this fast burning you know glycolytic system Yeah so basically what you're doing is you're you're getting more you're getting more of that thing that we discovered pg21 Alpha because it's activated by that metabolic stress you've put more metabolic stress on your muscle you're going to get a higher pg1 Alpha what that does is that increases the production of fatty acid oxidation enzymes it increases the production of glucose Transporters it increases the production of mitochondria and so now when we to exercise we should have more mitochondria within that muscle it should produce energy more

energy per unit of ox or more energy per oxygen inhale so we've got more mitochondrial Mass within the muscle that we're going to use and so now when we deliver oxygen we can extract more of that oxygen produce more ATP and so yes we become a little bit more efficient at that submaximal level so what you would see is if you train this way or repeatedly for say 6 to 8 weeks what you should see is when you go out and at a submaximal rate and if I look at my heart rate monitor my heart

rate monitor should be a step or two lower because I'm not having to push as hard to go at that constant rate okay so is that a sustained response or what is the so let's say I continue the same training effort but I remove the fasted workouts is that sustained or is that that have a shelf life so it will have a shelf life but it's got a fairly long shelf life it's basically what we see as people go from the base phase to specific preparation that specific preparation we're shortening up we're speeding up we're

getting these things but as we do that we're losing our overall aerobic engine so we're not giving as long and as prolonged a signal to the muscle to get all of those mitochondrial adaptations so over time we're getting a little bit less of that structure and that's causing our metabolic our our our aerobic engine to kind of slow down a little bit but now we're using that different training so we all have experienced that by going from the base phase where we're trying to build that aerobic engine to specific preparation where we're trying to increase

our performance by speeding things up by going short and fast as we do that it's just like when we talked about earlier when all I'm doing is short fast movements now I'm getting stiffer that's making me more efficient that's making me run faster but when I'm doing that I'm also not getting a signal to my muscle to be strong but I'm also not getting them as much of a signal to my muscle to keep the mitochondria that I have so over time I'm losing a little bit of mass and I'm losing a little bit of

mitochondria slowly seras and then what's going to happen is next base phase I'll get that back and so that's what we're doing as we go from base phase to specific prep to base so we're we're we're trading off kind of aerobic engine for Speed uh and performance and so that's basically what we do is we go between those two areas so talking about that mechanism of you know what's uh you're not challenging the muscle the same way when we kind of go into that harder shorter duration you know maybe more specific so I pulled a

quote from one of the articles that was looking at concurrent training there's a big push in this hybd athlete model now which I guess a lot of people would say they are part of like I lift weights and I do a lot of endurance stuff I wouldn't say I'm necessarily specialized in either so I don't know if that makes me a hybrid athlete or if I'm concurrent training or I just have variety but it basically said like um this suggests that the in inhibition of mtor as a result of the activation of amp K by

endurance exercise is likely not the molecular mechanism underlying the impaired hypertrophy and strength with concurrent training so is it more in the realm of what you were talking about or was there another mechanism was found out or they're still looking so there is still we we are still looking um so one of the things that's really interesting as far as the concurrent training effect is that the concurrent training effect has been diminished over the last say 20 years so when it was first identified by Bob Hixon in 1980 if you go back and you look

at the diet the diet was around point8 gr per kilogram body weight of of protein now when we look at the diet it's up around 1.2 too so one of the things that could be explaining the fact that people are able to be more of a concurrent training athlete is that we're increasing the protein content and so there's mechanistically some of what happens as we do lots of endurance exercise well if we do lots of endurance exercise we need to have lots of mitochondria those mitochondria um use more um are able to produce more energy

but it also can lead to uh a little bit of of wa it shouldn't lead to any loss of efficiency but it does mean that you need more caloric input to maintain that bigger muscle more mitochondrial mass and all of that evolutionarily when protein was a limiting thing because we did not grow you know we did not evolve at a time where we go to the store and get a big bag of whey protein and just eat as much we evolve when we're eating tons of roots and maybe we get some meat from time to

time if you're in that situation you don't want to have huge muscles that need lots of energy because that's going to be problematic so there are a number of these what we call molecular breaks that prevent us from growing our muscles really really big especially when we have more metabolic challenges like endurance exercise at the same tire so really we don't see it now until we get to really high training loads so so the elite so we're about to see the Olympics soon we you know you're going to see the rowers check out the rowers

especially the eights the women's eights are you know they can be 80 to 100 kilos these are these are big strong women the men are going to be they're going to be 66 240 260 pound like 100 plus kilos they're training 30 hours a week to row to get the endurance capaity in order to do that the performance as a rower is directly proportional to your your body weight so the more you can maintain your muscle mass the faster you are as a rower so when you're training 30 hours a week and you have to

be big and strong have to have lots of muscle that's where we're going to see that still no matter what we do we're going to see the concurrent training fight we're going to see it in our heptathlon athletes and our decathlon athletes but we're not going to see it in the Monday Wednesday Friday exercisers who go to the gym and they do weights and that's an issue we're seeing more about with people who do seven nine workouts a week or do long distances so there's not going to be a lot of your Ultra endurance athletes

who lift a lot of weights and suddenly gain lots of mess because they're running a distance it's going to make it really really hard for them to build muscle well that is the the big push I don't know if you're familiar with Nick Bearer uh you know that's his thing is basically bodybuilding or functional bodybuilding with old endurance and again I don't know the actual supplement routine if there's any you know uh other AIDS there that's how we're talking about but some of this gets talked about of like fasted workouts and you know supplementation around

there one of the other questions I wanted to ask you on the you know fasted workout state is there's a big push in the I would say just the popularized training realm of like you need some sort of amino acid supplementation essential amino acids if you're going do a fast workout in particular if you're doing multiples a week is there any validity to that or what would the thought process be on why that's important well there is there isn't any need um and the reason for that is uh comes from a recent study out of

Luke F lon's lab by um Yorn what they did is they did what they called the barbecue study where they fed somebody 100 grams of protein and they looked over 12 hours and you could still see protein coming in or amino acids coming off of that protein for 12 hours so what that means is that if I take a big Bolis of protein so I've done my overnight facet I've done my facet training and then I'm going to deliver a huge amount of protein that huge amount of protein I'm going to be digesting and absorbing

for a long time especially if I'm taking it from a food source if I take it from Pure amino acids what's going to happen is it's going to go in and out because those get digested absorbed really quickly and they're removed from the body really really quickly if I take it from a a food based Source now it's going to take a lot longer for those to get in and it's going to stay around for a lot lot longer so if you are going to do say you know the people who do one meal a

day for example what we're going to do is I'm going to do that one meal a day and I'm going to do it right after my biggest training B so if I'm going to do my weightlifting in the afternoon say I going to have my one meal a day right after that so then I'm going to take in a big huge Bowlus of protein I'm going to be digesting absorbing that for 12 plus hours what's going to happen is that's going to come in and that's going to get delivered more to the muscles that I've

just exercised because our blood flow is higher to those muscles for about two hours so that they can regenerate and pull in so the the metabolic or or yeah the metabolic things that they've gotten rid of so that they can replenish glycogen they can replenish some of the other um uh energy sources but also they can pull up amino acids and build that muscle again then I can do my urance exercise the next morning for example and now I'm in a pseudo fasted State and that's going to provide me a good stimulus to get a

big endurance adaptation so if I'm doing say one meal a day I'm doing my endurance in the morning I'm going to do my strength right before my one meal a day that's going to deliver those amino acids to the to the muscles that I work and then I've got you know 12 hours before I go back and I run I'm going to be in a somewhat depleted State when I do that that's going to give me my stimulus to get full aration if you know if you're going to supplement with amino acids it's not technically

fasting obviously but you know it's you can do that but it's yeah and and if I'm going to do that I would just do a whey protein supplementation and that would be enough to to maintain the protein component and it's just like we had talked about before where the the collagen the hydrolyzed collagen is given a lot of times just as an un unflavored no vitamin C that's because it's supposed to be an ingredient in something else so what I do when I use whey protein is I get a unflavored whey protein that is nothing

else so in one scoop of 20 grams it's got four you know it's got 80 calories because there's no sweeteners there's nothing else it's just whey protein and now what I can do is I can put that into something and I can use that if I just want to you know if I'm trying to you know have an aesthetic where I'm trying to change and I've got a really tight calorie budget now what I can do is I can use that whey protein as a way to kind of deliver however many amino acids I need

in a locen rich Protein that's got all of the amino acids that's going to be a high quality protein that I can use but I wouldn't normally do that because I would normally use food to do that and I would but and if you're going to do that the reality is you're not doing fasted training because you've eaten right away protein and so yes you're going to do a low calorie training completely but you can do that as a as a you can do that with tofu you could do that with other protein sources that

don't have a lot of other calories in them and that could be just as as good for because but that's again something that people are doing because of some aesthetic that they want to achieve that's not necessarily something that would be health-based or that would be positive outcomes in the long term I would have to assume based on everything you've said that um and again I'm just using the example of kind of the the workout and then I you know fast at State Overnight workout in the morning that there's going to be a a Time

dependency on that workout in terms of benefit right because if you start pulling further into glycogen stores does it become does it negatively affect you at all or is if let's say we're talking somebody wants to go run 20 miles in a fasted state is there a point where it's like you do need glucose in the system to still run for that period of time or is there benefit to a long prolonged effort over an hour whatever based on Fitness of what's going to put you into that realm of basically going back into that like

short burn cycle yeah so so there's lots of training techniques techniques that have used um either some sort of low glycogen or just longer training um so Arthur lyard used to have people run 100 miles a week only in singles so that you would be running 20 plus miles and the reason that he was doing that is because he knew that you would deplete the glycogen and as you deplete glycogen yeah your performance goes into the toilet that's no there's no question about that but then you have to have other sources of fuels and those

other sources of fuels are going to be fatty acids predominantly maybe some some ketones or other things like that but as you're bring those in those require the mitochondria whereas carbohydrate requires only partially requires the car the mitochondria so it's a greater stimulus to the mitochondria if you're doing these long sessions that have that have that extra depletion to them the problem is when we look at the body as a whole what you're getting is you're getting a great stimulus for the heart and skeletal muscle in that situation of this adaptive situ this adaptive stimulus

but if I'm only working out in singles once a day what I'm doing is I'm getting only 10 minutes to to 20 you know 10 to 15 minutes of a positive signal to all of my connective tissues because my connective tissues adapt differently to training than my mus my skall muscle and my heart my skel muscle and heart if I go out and train for 3 hours they're adapting for 3 hours if I go out and train for 3 hours my tendons liament cartilage and Bone stopped adapting at the first 10 minutes now all you're

doing is you're picking up fatigue or you're picking up tissue level um fatigue that's going to cause breakdown but you're not getting any positive signal and so this is something that I've talked a lot with um Camille Heron about because Camille started her master's degree is in bone mechanobiology and she knew from a long time ago that bone responded to as few as four to 40 stimuli and that's all the bone would need in order to get the maximal stimulus to adapt and what she had always figured is if she did two sessions a day

she would get two signals for her bones her tenant her lits that's the part that she and I talked about is it's very similar for tendon ligam and cartilage so by splitting that into two I still get a muscle stimulus the muscle stimulus is still say if I was going to do 20 miles if I did 20 miles once I get one stimulus for everything if I get 20 M or 10 miles in two different pouts I get two stimuli for my bones tendons ligaments and cartilage and I get the same stimulus from my heart

and my and my skeletal muscle so that would be if I look at this from a holistic P um uh viewpoint that's a much healthier for the system as a whole because we're giving as many signals as we can to our connective tissues and we're still getting the same adaptive signal to our heart and our scell muscle so I would be much more inclined to do something like that if you wanted to do some of the sessions in a low glycogen to give a higher signal to the muscle and the Heart then I all I

would do is take the second session of a day make sure that after the dinner that night just was protein and low carbohydrate so protein and fat we usually do like a fish with some with some vegetables like some some broccoli or some some other vegetables that are relatively low in carbohydrates as well and now what we're going to do is we're going to have fish in that and then the next morning when I get up to get my to do my next session now I'm in a low glycogen low carbohydrate state now I've got

that signal that you're looking for from your fasted training but I haven't had the negative effects on the system as a whole and so I would be much more inclined to do something like that than to do big long fasted workouts yeah you're really tough if you can do that that's great if if it's all about toughness fine but if you want to get the most of your adaptation if you split those into two and you do one of the situ one of them your carbohydrate replete so that you've got lots of carbohydrate you do

some more performance-based moves because now you've got more carbohydrate you should be able to go faster you should be able to maintain that for a little longer but then after maybe three sessions a week if you really wanted to do it that often but two to three sessions a week after that evening boat dinner has is protein and and vegetables and they and relatively low carbohydrate vegetables and now the next morning when I get up and train now I'm getting that same kind of fasted signal but I don't have to do it every day and

I'm getting a much more holistically healthy way of of training so if we were to take that same concept of using time to have the biggest stimulus on uh let's say the Passa tissue systems you know let's keep on tendons so let's say in the clinical realm if I had extrapolate that would it be correct in saying because let's say I'm uh you know PT a Cairo and I want to send somebody home with home exercises for their Achilles tendonopathy whatever you know reactive degenerative whatever stage it's in would it better be better then to

have multiple smaller sessions of those re have exercises throughout the day rather than like hey can we come into the office for 30 minutes do work and like you said due to you know temperature change and hisis we stop stop losing the effect right is that a better programming idea or is that not quite right absolutely and I know the structure is a little bit more difficult because yeah we want to have patience in for 30 minutes we want to do a whole session but the reality is that if I'm doing that if I'm loading

say and if it's just ailles tendon I can load the Achilles tendon after about you know 10 minutes of load that Achilles tendon isn't going to get any more positive signal all I'm doing is building up the negative signal which is you know there's two signals that happen when from any exercise one is the positive signal that the cells sense the exercise they sense the exercise because of mechanical stimulus because of a metabolic signal because of some sort of signal and that signal to those cells in our connective tissues our tenons ligament cartilage and Bone

seems to last about 10 minutes and after 10 minutes we're not getting a further benefit of that exercise where but every time we load that tissue it's getting a little bit more fatigued it's getting a little bit more lifely that we're going to get some small little damage that we then have to repair so if we know that the 10 minutes is all we need to get the signal for the cells to adapt then our training can be 10 minutes if you want to do it in a in a clinical um setting what you can

do is you can do okay what we're going to do is we're going to do 10 minutes on the right leg we're just going to focus on right leg we're going to do we'll do a few more different things we'll do not only the Achilles will do the quad and pellar tendon maybe we'll do some hamstring work we'll do that on the right leg then we'll do it on the left leg now we've done it two separate 10-minute sessions now we've we've now we've got a 20 minute session where we've actually done much more and

we've gotten more stimuli into the into the into the our problem tissues and now we're going to then do that again say the end of the day so if I start with my physical therapy in the morning I'm going to learn those I'm going to do those at the end of the day and if I can do them twice a day maybe once a day at the start when I'm my tissue is really reactive and I'm going to get more inflammation and other things I'm going to do that once a day 10 minutes and then

as I start to build now I can build in a second bout where I can do those two things 8 to 10 hours apart and yeah that's what I'm sending my my my patients home with is is they're going to have a training plan that's going to have these two bouts instead of one bout because that those two bouts are going to give me twice what that one bout gave me even if the one bout is the same time same time under tension I'm still going to get two signals from that those two abouts say

8 to 12 hours apart well we're going to turn you into a sneaky longevity expert because I also saw an article that talked about what was it uh titled train hard not long um and it was talking about B of three minute exercise of higher intensity this is for longevity correct not necessarily performance outcomes but if we start thinking more General Public Training for life and we start taking Concepts right Concepts few methods are many and say hey there's benefits to facet workouts there's benefits to how you program your workouts and not just hey I

got to get my 10 miles but maybe you know time dependency it's easier to do 5 miles in the morning 5 in the evening instead of having to do you know an hour and a half in the morning um in terms of intensity you know we could talk about running or weightlifting whatever it is if we talk about intensity what what was the verdict you know out of that paper maybe there's been multiple papers looking at intensity over duration yeah so so again part of what we're looking at here is is that especially as we

age there's there's a number different things that we have to take into account that happen within our tissues the first thing is we all begin to lose that the this protein disten that we know about because of this disease muscular distrophy and what that protein disten does is it pins our two muscle fi or all of our muscle fibers together so they work as a as a unit and when there's less disten you get more sliding and as you get more sliding you get more little holes in the membranes of the muscle and you get

more damage that leads to soreness so what you'll hear from older athletes all the time is I do the same workout but I get more or and it takes me longer to recover yes because what happens is you're now getting there's now less disten you're getting more sliding you're getting more injury and when we rebuild instead of When We Were Young and those fibers were held together tightly and they would move as a unit and there would be no damage when I'm going to have my protein synthesis response after exercise if I haven't damaged anything

I can build that muscle fiber bigger because that same amount of protein Sy can make the muscle bigger if I've had a slide if I've had Shear that's caused injury now what I have to do is I have to regenerate so instead of getting the same rate of muscle growth when we're older we we get a slower rate of growth because we have to regenerate or re repair the proteins that were were injured okay and repair the muscle fibers that were injured so that's one component of it the other component of it is we tend

to maybe probably not your listeners who who are who probably do a lot of loading a lot of exercise but most of us in the population are becoming more insulin resistant one of the reasons that insulin is important is what it does is it opens blood vessels that supply amino acids to muscle beds to allow us to synthesize protein as we become more insulin resistant we need to use other stimuli other than insulin to deliver the blood to the muscles that we wanted to go to that's where exercise comes into we're using exercise as a

way to deliver those amino acids much more as we're older what we what we see in young PE in young individuals is we do an exercise about today protein synthesis is up stays high and then it actually stays high up to 48 hours later when we look in an older individuals it goes up about the same but it comes down much faster so that would suggest that we maybe need to exercise a little bit more frequently and it's probably because insulin resistance is higher so we we the reason that protein synthesis stays high is because

insulin is helping to deliver amino acids and we're getting that higher protein synthesis in younger muscle so those things all go together and then the last really important bit is when we just take people who are older Who Don't Do Anything what they do is they lose the fast fiber SP we lose type 2 a fibers because we have to in order for us to to recruit those type 2 a fibers we have to go faster okay so there's this thing called the Henman size principle which is my brain's going to send a signal and

the faster the signal goes the more important it is so that what I'm going to do is the faster the signal the bigger and the more motor units I get and the bigger motor units are the ones that are the fast motor this the 2 A's the 2 X's so if I want to get those because I'm getting older and I don't want to lose my type 2A fibers the way that I can do that is I can either lift the heavyweight or I can go faster than I feel comfortable for going so if I

just go out and I walk at an easy pace which is what doctors usually tell people when they say exercise that's not going to be useful for things like brain health for brain health we actually have to go faster than we feel comfortable going and that's what I was referring to for these some of these longevity things is that is going to be important that we for us to deliver mosis the muscles that we have but not only to the muscles themselves but to the muscle fibers so if I use my type 2x fibers I

am going to deliver more of the amino acid that I've eaten to the muscle to the type 2A fibers and so those are going to stay bigger I'm going to be able to maintain my strength and a little bit of my speed for longer so all of those things tell us that as we get older and again the brain health component is really important especially for people who have neurocognitive history in their family part of what happens is if we just PE put people on a generic exercise plan they're going to go out they're going

to exercise at a comfortable rate they're going to walk along they're going to talk to their friends that's great for your heart because at 40% of your max your heart is stretched fully I'm getting no really good signal to my heart to to have good adaptations the problem is that we've never seen positive changes in neurocognitive Behavior or Alzheimer's disease or Parkinson's disease with self selected pacing but when we go over speed chain so we go faster or harder than we feel comfortable going now we see that Parkinson's can be improved by that we can

see that alers disease you get improvements in brain function specifically within the regions that are that affected by some of these diseases so the reason that we talk about going harder or going faster when you're old is because most of the time we tend to say oh you're old you shouldn't do anything we're you're old you shouldn't lift the heavy weight you're we're going to give you these little tiny weights to do don't wrap your old people in bubble wrap all that's going to happen is they're going to die sooner the best example is we

all say oh you're old we're going to move you out of your two-story house into a one-story house scientific evidence shows that when you do that the person who moves from two stories to one story they die sooner than if they had stayed in the two-story house because the the the struggle to go up the stairs multiple times a day that's a higher intensity exercise going up the stairs is what keeps them alive we know that one of the biggest things one of the best predictors of longevity in humans is our muscle mass and strength

so why would we take somebody from who is building their muscle mass and strength by going up and down the stairs yes we're worried about them falling but the biggest thing that we can do to prevent Falls is to help them get strong so if you're stronger you actually have better balance all of these things are going to be all wrapped together and so when we look at it we got to take bubble wrap off old people so that they can go a little bit harder than they feel like it it's going to be good

for their brain their heart it's going to be good for their skeletal muscles everything and then maybe what we're doing is we're exercising a little more frequently because it take we it comes back a little bit we don't have to go hard every single time we just have to do enough to get blood flow to the muscles that we want to keep so that we can get delivery of what we eat to those muscles and doing small bits of exercise is a great way to do that well not to mention I mean there's benefits from

a hormonal standpoint with you know lifting heavy weights and I mean which you know now talk about osteopenia and perosis and yeah I mean we could go on and on and on on the benefits and you know there's benefits and that's the big thing and the sad thing is yeah we need to remove the bubble route from our you know older population but kids I mean the the lack of movement vocabulary and the reductionist nature of you know whether it's you know not specialization but just kids don't have a huge movement profile at an early

age now and then we see that they have kind of an avoidance of these activities for the rest of their life from it so it's like it starts early of getting them used to it but then not stripping it back away from them in a protective nature later in life y um well I'll I'll absolutely be burned at the stake if I don't ask this question by some of my colleagues so the dut whole theory of you know how tenant heals is that still the best model we have is that what's actually happening because I

know there's been some case studies that you've you know either been an author on or co-author of you know that it's not always the case based on whether it's supplementation or I believe some different loading protocols but is that still basically the the model that you know we should all be thinking is is occurring when we see a Toopy at hand so so a ten anop is basically when load isn't going through a certain part of the tissue so I can produce a Tenon opathy in a matter of days by putting you into Boot and

mobilizing for a certain period of time if I look at the ton structure it looks much more like a scar after after that than it does like a a healthy tendon there's a a really nice so we've done a bunch of uh of studies on basically what that suggests is that if if there's no load going through a tendon the tendon starts to look like a scar what do we mean by a scar well there's more cells in the tissue the collagen fibral themselves are smaller and the orientation of the collagen fibral isn't as aligned

and there's a guy named hayashi's a Japanese uh professor and he basically produced took a healthy patella tendon in rabbits stuck a metal wire through the patella through the tibial plateau and just tightened the enough so that there was no tension on the patellar tendon within 7 Days the orientation of the collagen had changed there were five times more cells all of the things that we would consider a scar he had produced in a perfectly healthy tissue that had seen no injury mechanism we've done the same here in Davis using using a rat model we've

seen it across all kinds of different situations when you remove tension you produce a scar so what happens normally in a tissue in a tendon when I get some damage and there's some injury we break some collagen fibal and it does we do break collagen fibral do we see the ends of collagen fibral when we look us electron microscopes no but I can also produce a collagen gel in my lab by taking a solution of collagen changing the salts and it'll produce a collagen gel and if I go look for coll ends of collagen molecules

I won't find them why because collagen is an extraordinarily sticky tissue and so what happens is that the little collagen molecules any ends that are there are just going to stick to whatever's closest and so you'll never find an open end because it's so sticky it's going to stick so so yes you break collagen fibral or you break collagen molecules and now what we've got is an area that is got some un uh that's untethered and around it you've got perfectly normal collagen as I change the directional orientation of the collagen because they break and

now they're they they stick to whatever they're close to as that happens now what I've done is I've changed the orientation of the collagen and so what that means is if I pull on that it takes longer for the orientation to get back to linear and that's when it's stiff cuz that's when I'm loading the backbone of the collagen so if it takes if I've got this region that has to do this before it can get tension on it or in parallel with that I've already got a region that's perfectly straight and can take the

load what happens is the load goes through the healthy part of the tissue and a process we call stress shielding so when I've got a stiff tissue and a compliant tissue in parallel with each other so they go side by side and if I load them equally all of the load is going to go through the stiff tissue because it's stiffer as I go to load it that's going to deform less well it's going to deform and the one that is less stiff isn't going to feel any tension at all okay that's just the way

um any tendon is going to work so if I've got a t tendon especially a big tendon like an Achilles or Bellar tendon and if that that damage happens in the center of the tissue what happens now is the center isn't going to feel any of the tension because the tension is going through the sides but as I pull it longer it's actually going to get skinnier because the tissue is isov volumetric so now the string all the all the string is happening to the healthy part and it's being pulled together so what you get

is you get compression of the middle and you get tension on the sides the result is that you're compressing the cells within the center of a tendon the cells in a tendon are the same from the same um mother cells as the cells from our cartilage so if I compress a tendon for any period of time um Catherine vable had shown this beautifully that if I compress a tendon what happens is the cell start to produce large glycans just like their collagen what do those large fog glycans do they suck water into the tissue so

now I've got a central core tendonopathy I've got strong parts and then I've got this compressed region that compressed region is going to show me water and so when I image using MRI using ultrasound I'm going to see a hole and I'm going to see a dut and traditionally everybody says well treat the donut not the hole well that doesn't that doesn't get that never fixes the tissue so what you have to do is you have to treat the hole the way that you treat the hole is by understanding that the tissue is viso elastic

and what that means is if I pull on it and I hold it the healthy part of the tissue is really stiff at the beginning and then it's going to exponentially decay in its stiffness and as it goes down in stiffness what happens is it becomes less stiff than the scar and now what's going to happen is the scar is going to feel a tensional load which is what it needs in order to fix itself so if I hold uh a relatively lower intensity isometric for 30 seconds for even longer what's going to happen is

the healthy part is shielding stress shielding the injured part that's going to relax now I'm going to get tensional load through the injured part remember I said that it only takes 10 minutes of load to get the signal to those cells so if I do four 30C isometrics where I hold my tissue so if I have a patellar tendonopathy if I do say a Spanish water if I do um an isometric leg extension and I'm just going to pull on it and I'm going to put load across it I'm going to do that for 30

seconds so it's an overcoming isometric I'm going to push out you can do it as hard as you can you can do it at 80% we haven't seen that it makes a really big difference it's really really the time component and so I'm going to hold it for 30 seconds to 40 seconds somewhere in there now what I'm going to do is I'm going to take a two-minute rest I'm going to do that again I'll get four repetitions that'll give me 8 minutes of work that's close to my 10 minutes and if I do that

what happens over time is I'm getting the signal to the central core that there's a directional load that comes across here and now it can actually start to synthesize a directionally oriented collagen in the place where that hole used to be and it's not even though go ahead even though there's fluid within there the tensile load overrides the compressive Force against the fluid scenario what happens remember visal elastic means that what part of what I've got is the stiffness is the is the liquid component so if I hold it for longer what happens is as

that continues to lengthen the the fluid from in there is actually lost from the tissue to some degrees this is how we use loading to decrease inflammation in a connective tissue so it's like ringing a sponge exactly so I don't ever I I don't ever do big antiinflammatories what I'm going to do is I'm going to load and I'm going to hold because as I hold and load what's going to happen is it's actually going to squeeze out all the liquid that's in there then I'm going to re release it and I'm going to do

that again and as I do that what it's doing is it's it's squeezing out the sponge and so over time you're not going to suck in as much fluid because now what I've got is I've changed the the material properties I've given the right signal to that Central core and instead of making proteoglycans that are going to hold water it's now going to make collagen one in a directionally oriented Manner and it's going to regenerate that area of the tending that has been damaged now we've seen that happen in some of our case studies within

seven weeks that it's that you've completely filled a hole in within the patellar tendon and these are significant injuries within Elite athletes so it doesn't take a huge amount of time to do it you just need to you know get in there and get load through that tissue it's going to allow stress relaxation for the for the dut and then it's going to put load on the hole directionally oriented load that is in the direction of that tendon because that's the signal that the cells are now going to use to directionally orient The Matrix they

make and because they're being loaded in tension and not in compression they're going to make tip one collagen and they're going to decrease the production of prot lens so you said in the absence of load you see a proliferation of cells within the tendon um but wasn't it cubo's article that looked at the cross-sectional area of muscle versus tendon and offloading and you see the cross-sectional area of muscle stays the same for six weeks whereas tendon decrease in that same period and that wasn't that the whole drive for the like the noffa athletes and the

the rampant p tendonopathy yeah so so um yeah there's there's problems with that because anytime you offload a muscle um so so again Luke Van lon's lab has shown that you lose about 2 kilos of muscle mass over five days from the quads so and that's with immobilization but when you offload you're going to lose Fair bit of muscle um but what we've shown in our r model is we lose about 10% of the muscle mass over over handful of days but we lose 20% of the collagen Mass yes the tendon is actually and Luke

has shown that if he takes all of the tissues of the KNE out that the turnover rate of the Achilles or sorry of the patellar tendon and of the anter cruet ligament is actually higher than skeletal muscle it's almost twofold higher so it's not surprising that then we're going to see collagen go down faster than we're going to S musm and yes this would would mean that I don't want have a a period of time where I'm not loading my tissues so if I'm a throwing athlete in baseball they always shut you down for a

period of like four months no throwing well that's horrible because those tissues on collateral ligament all of the tissues within the within the shoulder you atrop you for four months and so then I'm gonna you keep the force production the force production stays relatively High even in the face of a loss of some muscle mass so now we can we're using we're using our fascial spring we're us getting all of this velocity from from this fasal component but the tissues are no longer strong they're actually quite brittle because they've lost collagen mass and they've become

a little bit more cross-link and so that makes them more likely to get injured so a lot of the things that we've traditionally done as again healthy oh we're going to keep these people healthy so we're going to you know we're going to keep our old people from lifting weights or from doing stairs we're going to keep our athletes from throwing or jumping in the offs all it does is make them much more likely to get an injury in the future yeah which is a yeah interesting irony but uh it pays the resiliency of humans

and that we're constantly adapting one way or the other right adaptation is neither negative or positive it's just the direction you you know apply force or uh input uh I don't want to take up too much more of your time but I I always ask these two questions to kind of end with um you could take them in whatever Direction you want uh the first one would be what is something that you long held true or believe that you have completely changed your mind on in the last maybe year or two is there anything that

stands out um so I I'm G to open it up Beyond a year or two I used to yeah as a beginner because I started in muscle I thought that in order to get stronger I needed bigger muscles um and that has completely and utterly changed I can get people to be bigger and or to be bigger without getting stronger I can get people smaller that are significantly stronger and I can do every in between so this relationship between muscle mass and strength is not nearly as linear as people or as I used to think

it was so what is the so let's say we have somebody that gains no or like very little muscle mass or size but becomes exponentially stronger what is the mechanism at play then so a lot of it is again there's there's two components that people focus on there's one component that people focus on muscle mass and then the neural component there everybody's like oh well you your brain is doing it I don't think that those are the two components I think that those are two the last one is the force transfer component we've got data

that we've just generated in about 600 rock climbers where we do a low Force um isometric where they put partial body weight on their fingers and they hold the partial body weight it's like between 40 and and 80% of their body weight just so that there's tension across the the the forearm muscles and they do that for 30 days they increase strength the same amount as if they hang as much weight as from their body as they possibly could and and do Max hangs and when you do the two of them together they're addor which

means that really when we're doing the heavy heavy lifting our brains are are activating the muscle more and our muscles growing when we're doing the light one we're working on that force transfer component when we do them together we get a a bigger increase in strength because those three components are actually what we have for strength so when we're getting somebody who is getting stronger but not getting bigger we're affecting how their connective tissue or that force transfer component of of of how they're doing the movement yeah I don't I cannot remember which paper it

came from but there's a beautiful visualization of the windless mechanism of the foot talking about those three subsystems playing together to create really good like you know d uh or high threshold drive with a runner um so yeah I love that okay the flip side is what is something and again this you're a researcher this is literally what you do but what is something that you think is true or this is the way it is but there's no evidence to support that quite yet [Music] um I don't know that's a good question so so um

so one of the things that we have recently shown is that there are specific Pathways that are important in tendon growth so in Tenon hypertrophy so it gets bigger so we've just had a paper that shows that there's a class of drugs that can increase the the the basically the cross-sectional area of a tenant um we have preliminary data and we think that is true that there's a different pathway that actually helps the tenant get longer during development but also might be a play say after an Achilles tendon surgery where we get a longer tendon

and so we think that there's a um a nutrition molecular pathway that works that way that's important in ten in lengthening um that would be really interesting to look at in young athletes and in young people because if you can get the the tendons to grow a little bit longer maybe even just increasing collagen um production as well you might make taller athletes you might make people with longer t who are more efficient and and faster so so there's a little bit about that that that we haven't done enough to know but there's at least

some hints that it might be possible well even that Spurs my interest in you know uh 12-year-old you know basketball player dealing with hosin Slaughters you know that the grow the bone growth is outpacing tendon and we get you know um apal kind of traction so that yeah I think there's multiple applications to something like that one that's one situation where the hydrolyzed collagen is and gelatin has worked almost always for me so my daughter was a big soccer player when she was like 10 to 12 all of her inmates were having either uh Achilles

enmies or osid platter within two weeks of putting them on to hydroly collagen and vitamin C it would almost always go away like I hope I hope you have stock in a company because if you don't and I post that we're it's going to start flying off the shelf um yeah which is a good thing to know it makes sense and we talk about you know there's just a huge epidemic of just calorie deficiency within youth athletes and then you talk about nutrient and deficiency on top of that or in parallel so knowing specifics like

that most are important most young people don't like to chew their food and when you have to chew because it's gristly that's when you get the the normal way to get collagen so if you're avoiding all of those types of things then it's not it wouldn't be surprising that there are limitations based on intake that you can reverse really quite quickly especially in growing individuals so very interesting all right uh well again I I know you're a very busy guy and I can't tell you how much I appreciate I've been you know a fan of

yours forever I've been quoting your research articles in my classes trying to get the word out to more people in my profession so I just want to kind of give you a kudos obviously I know you're going to keep doing this so I'll keep tabs on you um any last parting words or anything else that you're uh want to kind of leave the audience with before we jump off here no that's great thank you for for those kind words and thank you for having me and then you know if there as things come up we

I continue to post things either um I'll still the only time that I actually go on X now is is to actually post when there's some new stuff coming out of the lab but we try and we try and get that out there and we try and do everything that we publish is open access so that everybody can get to it so that it's not behind the pay wall and then if there is anything that's old that's behind a pay wall you can feel free to email me and ask something to te I appreciate that

and uh I'll put links to uh obviously what social media have out there uh some of the links which a lot of these like you said are full text non-pay wallet I'll put links anything that we discuss specifically um again thank you Dr bar and hopefully I'll be able to talk to you sometime in the future and I catch up with you on what you've been working on sounds good thank you for tuning in Please Subscribe via YouTube Apple podcast or Spotify if you like the message please share it we appreciate it thank you [Music]