AGING with STRENGTH

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Dr. Matt Kaeberlein is a biologist and one of the leading authorities in the space known as longevity medicine. He’s also one of the few leading scientists willing to call out his peers who are, in the vernacular, full of crap. He’s also CEO of health tech company OptiSpan.

In this conversation, we discuss Kaeberlein’s dislike of the phrase “longevity medicine,” his willingness to call out longevity chiselers like Harvard’s David Sinclair and why almost all other senior scientists stay silent when their peers lie about or overstate their research. We then go into Kaeberlein’s personal fitness and nutrition routines before ending with his review (for paying subscribers) of 11 popular longevity supplements and a few others that the science shows are most effective.

Timestamps

01:32 — Is there any drug, supplement or treatment that can reverse aging in humans?

02:30 — The problem of scientists who mislead the public about longevity research.

04:05 — Exhibit A: David Sinclair, Harvard’s tenured longevity charlatan. “He lied.”

05:38 — Academic scientists who sell supplements through deceptive advertising. “We do not needed our credibility degraded any more than it already is.”

06:22 — Why most other senior scientists don’t call out chiselers like Sinclair. “The perception of shoddy science and charlatanism in this field has had a negative impact on resource allocation,” hindering research. Some leading scientists take the view that any attention brought to the field, even if it’s false information, is beneficial.

07:55 — Modifying aging as a biological process. “In theory, we should be able to reverse that biological process.”

09:01 — The importance of resistance training and body composition tests (e.g., DEXA scans) to understand fat and muscle mass.

11:00 — Two camps of scientists: those who try to disprove their models with rigor vs. those that try to prove their models to support their pre-existing notions.

13:15 — “Misinterpretations” by Sinclair and others about NAD+ research. “If you got a loud megaphone and you’re at a top institution….your opinion becomes dogma until it can get disproven,” which can take a decade or longer.

15:28 — Why he’s on the fence about NAD+: “There’s a lot of things that have been published around NAD precursors and aging that has not been reproducible.”

16:15 — Kaeberlein’s four pillars: Eat, move, sleep, connect. The importance of reading food labels, tracking your food intake, and understanding your body composition.

“As a screening tool, [DEXA] is really valuable helping people understand…whether you need to focus on increasing muscle mass in particular.”

18:30 — The importance of social relationships in longevity and healthspan. “Don’t avoid human interaction. Seek out opportunities to do things with other people.”

21:15 — The connection between healthspan and mattering to others or showing others that they matter to you. Intentionally giving positive feedback (even if you don’t need it yourself.)

22:45 — Kaeberlein’s thoughts on 11 popular longevity supplements, and the specific supplements he uses or recommends.

I recently had a life-changing conversation about managing stress.

One of the more disturbing features of stress is that we often don’t notice it. But others do.

The sources of this stress today feel existential, thanks to the growing instability of our financial, social and political futures.

Maybe you’re struggling with a painful, chronic injury or disease. Maybe you’re managing a parent in the grip of dementia. Or trying not to panic about money and being able to afford life as you know it. Maybe our government’s willingness to act less as a public steward and more like a vaccine-skeptical kleptocracy is forcing you to think about your future in ways you never imagined.

Let me tell you about that life-changing conversation — with my 10-year-old daughter.

As my daughter and I talked, it suddenly dawned on me: the SOURCES of my stress — finances, career, relationships, the state of the United States, and so on — hadn’t changed so much as my ability to regularly purge them. Through exercise.

The other lesson I learned from that conversation was what I needed to do every morning, before anything else....

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Dr. Renee Young, a Yale-trained naturopath is a medical-investigative force of nature who, at 50, is practicing the detailed and complex longevity gospel she preaches to her patients.

In this 35-minute fast-moving interview, Dr. Young describes offers a portrait of what your life would be like if she had a say in keeping you healthy, fit and well for as many years as possible — even if you think you’re perfectly healthy already.

01:25 — What’s a naturopath? How is naturopathy different than what your PCP does?

03:10 — What a naturopath offers that your insurance-provided doctor can’t.

04:30 — “One of the questions always in my mind is, ‘What will this person meet their demise from?’”

05:24 — Component’s of Dr. Young’s “executive wellness” check.

06:10 — The NutrEval comprehensive metabolic/nutritional test, and why Dr. Young recommends it.

06:56 — Polygenic risk scores and genetic testing.

07:55 — Paul’s recent NutrEval results: negative and positive surprises and what they show about how much insurance-provided annual blood/urine tests don’t tell you about your health.

11:10 — Medicine’s marketing problem.

12:26 — “How much healthcare do you want to consume?”

18:00 — The curious doctor.

19:05 — How to keep up with the explosion of longevity information and misinformation nowadays.

20:10 — “Ask yourself hard questions.”

21:15 — The Big Three aging processes to know and understand.

23:32 — Investigating your own healthcare.

25:55 — Next-level diagnostic tests.

27:00 — The five pillars of aging.

28:07 — Wellness as a series of rituals: yearly, monthly, weekly and daily.

30:38 — Intermittent fasting! (One of Dr. Young’s favorite topics.)

33:42 — The major benefits of assessing and knowing your biological age.

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Not many professional bodybuilders start in their late forties. Fewer do it after overcoming a drinking problem. Almost none started out as a newspaper journalist — trust me on that one.

Anne Marie Chaker is that rara avis who overcame a large amount of personal adversity to inadvertently reinvent herself, a story is captured in her just-published book, “Lift.”

In this 18-minute conversation, Chaker reveals the road she traveled to become not only physically strong but also a more powerful person, and the many different ways in which her muscle-building lifestyle helped turned her life around.

Time-stamped highlights:

0:51 — “I remember being in the car, craving a drink,” and how a chance meeting with another hockey mom motivated Chaker to stop ignoring nutrition and start working out in a gym.

02:15 — How Chaker’s 2020 first-person essay in The Wall Street Journal, titled, “I never thought I’d write this: I’m a female bodybuilder,” launched the idea for “Lift.”

03:15 — “I just didn’t feel like I needed the booze anymore.” And, “I performed at my best when I was well fed, when I was strong.”

05:02 — Going from “meh” to “Girl, you look good!”

05:29 — “Aging Beastfully”: What it means and how you know if you are.

08:15 — Flexing, or not, in the gym mirror: “I would love to have the balls to strut across the room — a woman — in a double-bicep pose.”

11:50 — Chaker’s journey from muscle building to professional bodybuilding.

13:28 — Chaker’s food and eating regime: A fridge full of salad and all the protein under the sun.

15:33 — How people new to weightlifting and working out can build muscle, at home or the gym.

16:43 — Chaker’s home gym set up: Some weights, a bench and some bands. “If you have a body, you have a gym.”

17:15 — Chaker’s frustration with fitness gadgetry. “They make it way more complicated than it has to be.”

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There’s not many 43-minute podcasts you really need to hear. This is one of them. Annie Fenn offers a masterclass in creating a nutritional foundation for maximal brain health and muscle building in midlife and beyond. I learned a lot during our conversation, and I’m pretty sure you will, too.

No more lunch meat or salted nuts, for instance.

Annie Fenn, MD is the author of, ”The Brain Health Kitchen: Preventing Alzheimer’s Through Food,” a science-based cookbook for the brain. You may be familiar with her incredibly substantive, fact-packed Substack, Brain Health Kitchen. Annie, who’s a board-certified OB-GYN, is also a trained chef, making her advice about nutrition and brain health essential for building a strategy to maintain superior cognitive function throughout life.

How to build brain healthy eating habits:

01:25 — ”What you eat at midlife seems to be particularly predictive of whether you become vulnerable to one of these neurodegenerative diseases.”

02:08 — “Most of the dementia that people get has a very strong dietary link. That’s why what you do at midlife is so incredibly important.”

04:45 — How “food environments” create better nutrition habits.

05:15 — “Unless you address your food environment, I don’t think it’s really possible to make meaningful change.”

06:23 — ”What’s your brain health mindset?” (Figure out what really motivates you to alter entrenched eating habits.)

07:45 — Building “your own brain-food pyramid.”

09:11 — The building blocks of the Mediterranean Diet: “peasant food.”

11:48 — Making beans and legumes a bigger part of your brain-healthy eating habits.

17:01 — How to go from a bad food environment to a healthy food environment.

19:31 — Vegetarian and vegan diets.

21:27 — Eggs, cardiovascular risk and nutritional cholesterol vs. blood cholesterol.

24:57 — Defining what is and isn’t “processed meat;” how bad is lunch meat, really?

26:35 — Processed meat and “AGEs”: a recipe for inflammation and brain aging.

27:39 — How to cook meat to avoid AGEs and the problems it’s associated with.

31:35 — Protein for people over 40; the relationship between protein and dementia.

33:40 — “Strength training is mandatory for women,” especially after their late 30s.

36:00 — Is there a gender divide in nutrition for people over 50?

37:20 — Getting strong and eating enough protein in perimenopause to ward off pre-diabetes, muscle loss and other potential issues.

38:20 — Sugary drinks: a metabolic and brain health disaster.

40:45 — Annie’s Top 3 takeaways for eating healthy after 50.

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.agingwithstrength.com/subscribe

Update, June 29, 2025: Turns out that simply talking about the goal of drinking less helps effectuate actually drinking less. Since I first recorded this conversation with Wendy Bounds, and certainly in the several weeks since publishing it, I drink noticeably less, which is to say less often, than at anytime since the pandemic.

Original post: Earlier this year, I began talking with Gwendolyn Bounds, who is just a terrific explorer, journalist, author and human, after being introduced (remotely, as we live on separate coasts) by a mutual friend. Over the course of a couple phone conversations to explore our respective interests in all the ways to be better in this world, we quickly learned that we were both on individual quests to drink less.

As we talked about our very different alcohol origin stories and strategies for winding down our respective drinking habits over time, we stumbled upon two ideas:

* An unvarnished, candid and unselfconscious conversation about drinking less is something we should record, not because we know more or better but because our struggles and strategies may be helpful to others also trying to drink less.

* Though Wendy and I have yet to meet in person, having a “non-drinking buddy,” as she aptly calls me in this recorded conversation, is a good thing.

There’s a third idea, and it’s mine only.

But first, in case you missed it:

It’s that Wendy has been rather more successful and with setting her “drinking less” goals and achieving them than I have. We’ve each developed some tactics and mindsets that mitigate the urge to drink once the clock strikes a certain hour (and even that hour is different for her and me).

* the Cheetos Protocol: If don’t want to consume it, don’t keep it in the house

* put out visual cues that remind you why you don’t want to drink

* sip your drink more slowly and parsimoniously

And many others.

For me, drinking has never been a problem, but it had become a very cozy, enjoyable and, honestly, lazy habit. One that exists at cross purposes to what I want to achieve in aging with strength for the remainder of this one life.

Wendy, now a New Yorker, is originally from the South. I grew up in the steamy and frozen Midwest (those are my only two memories) but have now lived in California for almost as long. You will not be surprised to learn how differently our drinking was and remains today. But on the idea that we can never have too many non-drinking buddies, I hope you’ll listen to our 33-minute conversation and tell us what you think — about anything — in the comments.

AGING with STRENGTH only recently learned how to properly pronounce Sláinte. But the favorite foreign word for cheers remains the Hungarian: Egészségedre.

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.agingwithstrength.com/subscribe

We all need to build more self-forgiveness into our lives.

This topic is a pathway to greater strength, not weakness, and I’ll explain why. Not everyone needs a psychoanalytic intervention here, but almost every person I know, and who you know, I’m guessing, could benefit from taking a minute to consider how minor acts of self-forgiveness — some people prefer the term self-compassion — can make them stronger in life’s all-important second half.

It’s so easy to just continue to be too hard on yourself.

Two kinds of self-forgiveness

* Tier 1 self-forgiveness addresses either profound, deep-rooted feelings like inadequacy, unlovability or trauma that go back to childhood, or more contemporary shame and guilt for something we’ve done to someone else.

* Tier 2 self-forgiveness is caused by routine daily mistakes

Self-forgiveness arises from the cognitive dissonance we experience when our actions don’t reflect our beliefs.

Actions that build self-compassion

* Admit your major failures. If you’ve wronged someone else, acknowledge that to them, apologize and explain why it won’t happen again. You won’t forgive yourself until you ask the other person to.

* Be kind to yourself. Treat yourself with the respect you would give a loved one.

* Recognize what you’ve done well. Take the time and words, if only spoken to yourself, to celebrate your achievements.

* Practice regular self-care through what makes you feel well: exercise, time in nature, getting a massage or watching the big playoff game; whatever brings you joy.

Aging with emotional strength is harder than it seems. But it’s worth the effort. I’ll leave you with these six very good questions we should all be asking ourselves, courtesy of Helen Marie on Substack:

What kind of life am I quietly dreaming of?

What are the small joys that are holding me together?

How can I return to what matters most?

Who are my people & how do I nourish them?

What stories am I ready to stop living out?

How can I let myself be more fully alive?

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.agingwithstrength.com/subscribe

My interview with Sydney-based Erica Koo, a Level 3 fascia stretch therapist and former competitive powerlifter, explores how Fascial Stretch Therapy (FST) can make life better for people with significant mileage on their bodies, hearts and minds.

Erica and I discuss FST’s significance in pain relief, mobility and overall health, the role of fascia in the body, its connection to movement, and how FST can benefit people over 40.

Erica also shares her personal journey (see timeline below, if you’d rather jump to that fascinating part of our conversation) from a complete non-athlete to becoming a competitive powerlifter, lyra (aerial hoop) performer and FST therapist… who’s now on the road to also completing her psychology training. (Her latest athletic obsession is sprinting….clearly, Erica doesn’t do anything halfway.)

Takeaways:

* Fascial Stretch Therapy (FST) is crucial for pain relief and mobility

* Fascia is a web-like connective tissue that affects movement

* Aging increases the need for fascia care due to accumulated stress

* FST works by addressing the fascial connections throughout the body

* Therapists assess the body as a roadmap of experiences and pain

* Immediate relief can often be felt after the first session of FST

* Resistance training is essential for maintaining health as we age

* FST is a collaborative process that prioritizes client safety

* Psychological benefits accompany physical relief in therapy

* Holistic health involves 5 pillars: exercise, nutrition, hydration, sleep, community

Erica Koo/fascia stretch therapy video timeline:

01:01 Introduction to FST: What is it & why you should care about your body’s fascia

02:20 How Erica evaluates pain via fascial connections throughout the body

04:50 Why fascia is so important for people over 40 to understand

10:38 “The body is a roadmap” to everything it’s gone through in life

11:24 Expectations of FST as a reliever of chronic pain

14:15 Characteristics of people whose fascia is in the best shape

15:40 Erica’s story: competitive powerlifter, aerial hoop performer, psych student

22:00 The wide range of physical & neuro issues that Erica treats with FST

28:10 The 5 pillars of healthy living: exercise, nutrition, hydration, sleep, community

“With fascia stretch therapy, the more you move the joint, the more it does let go. And in doing so, you're able to create freedom in the joint and the muscle” — Erica Koo (aka “Stretch”)

(SKIMMABLE) INTERVIEW TRANSCRIPT:

Paul

Erica Koo, thanks for being on AGING with STRENGTH.

Erica

Thank you so much for having me, I'm super excited.

Paul

Yeah, this is going to be an interesting conversation because I don't know jack about fascia stretch therapy — FST as it's called.

So could you tell us what FST, fascial stretch therapy, is and why we should care about it?

Erica (01:08)

It's a form of assistive stretching that allows us to work deep in the joints and stretch the move the body in ways that the client themselves may not be able to. In doing so, what we're aiming to do is relieve pain, restore joint integrity and also improve overall long-term mobility as well.

How I would explain it to clients when they walk in is that fascia is a web like connective tissue that is all across the body. There is nowhere in our body that fascia does not exist. But the function is it helps hold our body together, but also helps coordinate smooth movements when we're walking, running, especially when we're training things like that.

It's very flexible. It's meant to stretch and adapt when you move, but it can become quite stiff or tight if you have things like poor posture, if there's lack of movement or injury. And with massage, when people come in and they go, my shoulder's really painful. A massage therapist would just look at the shoulder and go, okay, well, we'll release the bicep, release the shoulder, neck, off you go. A physio would look at it and look at it in terms of a diagnosis. So they'll probably go through multiple assessments to be able to see what's the range of movement like, where's the pain, what sort of movements are triggering that, has there been an acute event to have caused that pain.

With fascia stretch therapy, when someone presents with pain, I look at how that structure is fascially connected to different areas of the body. So for example, there's multiple different fascial nets across the body and you wanna think of fascia as a web like I mentioned before.

And this fascia connects anatomically separate structures together across the body. So there's one called the superficial back net, for example, and it's just a big slab of fascia that runs from the top of the cranium all the way down to the neck, back, lower back, hamstring, calves, and down to the plantar fascia as well. They've done cadavers on this too. So if you are interested, you can sort of Google superficial back net and it should come up with like this big structure. So I look at, okay, well, I can, yes, stretch the shoulder if your shoulder is painful.

But what other things, for example, cause internal rotation of the shoulder? What other things can lead to that sort of shoulder pain? So I look at an assessment that way. And then for my practice, I genuinely try to move away from pain, initially. So if someone's come in with a chronic issue that they've had for, let's say 10 years, which is not unusual for clients coming in to see me, I don't want to necessarily make them force through pain that they have been forcing through for 10 years.

And I feel like that's where the magic of fascia structure comes comes in is that we can start down regulating the nervous system by working on and stretching structures that that shoulder is connected to and then work our way closer to the area of pain. Once the person is feeling a lot less of that.

You mentioned foam rolling actually and how foam rolling relieves your back pain. When we look at how foam rolling works is essentially it, it inhibits the part in your brain that interprets the pain signals as threatening. That's why you get a relief in mobility, relief in overall pain, and then it helps you move better and actually get a lot more out of your training. So we're working very similarly with that process. If I'm looking at, what can I work on first? So is it bicep? Is it just the shoulder joint moving it around? it, is it okay? Is the body letting me move the shoulder around without pain? Okay, well then that maybe I can progress a little bit deeper into the structures.

Paul

Is this important for just young athletic people or, know, obviously my audience and this audience here at aging with strength is 45 and up, generally speaking. Why should they be interested in what you're saying to them right now?

Erica (05:00)

Because fascia exists regardless of age and it is crucial for smooth movement and health overall. And one of the common things I hear from people who are 40 and over is, oh, you I feel so stiff and I think that's just a part of aging. I always ask the question, okay, well, let's think about it this way. How much stress have you been under across the 40, 50 years that you have been alive?

When did you start, when did your career start taking off? Did you start a family? Did you have any big stresses in your life? know, mortgage, moving house, moving, changing careers, things like that. And when did you stop moving the way that you did in your twenties and thirties, if you were training in the first place? So as we go through the different stages of our life, you also encounter different stresses. There's almost an accumulation of stresses and experiences, if you will.

There becomes less time behaviorally to engage in the self-care methods that you may have done or that you could have gotten away not doing in your 20s and 30s. So I think as people age into their 40s and 50s, there's an increased need to take care of their fascia because they might just just might not be getting the same opportunities with increased stress compared to when they were younger.

Paul

So what is…sorry, you may have answered this, but what is fascia? What's it made of? What does it feel like?

Erica (06:33)

Very….So how I would feel it when I'm looking at the person on the table, we have a movement called traction, which is essentially where I kind of pull the joint away from the body to see how it responds. And depending on that pull, I can feel where the tightness is coming from, whether I'm pulling on the leg and I'm tractioning the leg, do they have more tightness in the calf or is it coming from the hip? And then based on that, I work on what needs to be done first.

And then even with fascia, you have the superficial layers on top and then the deep layers at the bottom. So fascia is like a connective tissue. when you, for example, look at images of what fascia is like under the microscope, it essentially looks like interweaving spider webs. So it's that thick layer that connects all together. And that's how it is able to stretch and able to produce force and absorb force as well.

Paul

Is it really a function of the more you massage, I'm using massage to mean any kind of manipulation or the more that you knead it like dough, the more supple it gets, is it that simple?

Erica (07:43)

Massage works a lot in isolation. So it will directly target, let's say the deltoid or the pec muscle and work until it releases or the muscle let's go. FST or fascia stretch therapy looks at, how do we use movement to create throughout the entire limb? So any, everything encompassing the wrist, bicep, shoulder. So instead of working in isolation, we're looking at, how do we move it around the body in the way that it should be moved?

And with fascia stretch therapy, the more you move the joint, the more it does let go. And in doing so, you're able to create freedom in the joint and the muscle.

Paul

Okay, so why do people need fascial stretch therapists? Like what do you do that I can't do at home with my trusty foam roller or my friend who twists my arm backwards or whatever? What's the secret sauce?

Erica (08:36)

I think if…so, most people who come to facial stretch therapists is for a specific goal. Mostly pain relief. Some people come in for lasting improvements in mobility, especially if they're athletes, but pain relief is definitely the biggest motivator. And we need a trained person to do it because firstly, you may not necessarily know what you need. Just because you know that you have the pain doesn't necessarily mean that that area that is painful is necessarily the one that needs to be treated. If we compare massage and FST, I talked about how massage works a lot in isolation of the muscle, but if you have lower back pain or if someone comes in with shoulder pain, just releasing through that shoulder joint might not be necessarily enough. Because the way that these structures are connected, if you look at fascia as like a piece of clothing, so let's say like we've got a fabric here, piece of clothing that covers everything.

We have tightness or injury that pulls the entire structure that way. So see how it then impacts other parts of the body. So what fascial stretch therapy does is it allows us to restore that across so that it's overall more flexible and reactive to the stimulus that it needs to be. So first thing is that people might not necessarily know what to do or how to work in the area that is painful. The other thing is certain techniques require certain angles and pressure that you cannot necessarily do by yourself.

Paul

I see.

Erica (10:01)

And then third is a therapist will be able to get your joints or your limb into positions that you may not be able to achieve by yourself.

Paul

When someone comes in saying, you know, my lower back is painful or another part, I imagine you don't go just to the lower back, but you're kind of trying to figure out where this is coming from and how do you do that?

Erica (10:24)

I try to get a very comprehensive history. I also have a psychology background actually. So I'm training to become a sports psychologist. And in my nine years of being a PT and fascia stretch therapy, what I've deeply understood is that you can't separate the mind from the body. And when a client comes in, the body is like a roadmap. It's a roadmap of things that they cannot necessarily verbalize. And the pain that they're coming with and the conditions that they're coming with may actually be a reflection of the things that they have been through. So a very...

Paul

Sorry, can you say that again? Just say the road map part. I just want to catch that again.

Erica (10:56)

Yeah, sure. So people's bodies are like a roadmap, a roadmap of experiences and things that they have been through that they may not necessarily be able to articulate. So the pain and the conditions that they come in with can sometimes be a reflection of some of the things that they have been through. So

what I have seen clinically is that people coming in with lower back pain or knee pain, normally there is other things happening further up the body or further down the body, two or three joints, sorry, one or two joints up or down each way.

Paul

How quickly do your patients find relief?

Erica

So most of them, I would say need at least four to six sessions to be able to see lasting change. But it's a little bit like training. You're not going to do one training session and then expect that to suddenly make miraculous results. Most clients, however, do experience immediate relief on their first or second session. I find the second session to be quite magical. First session is always about building trust. you know, letting the client's body know that it's a safe space, what the treatment entails, and having them, their body understand me as well as in how I work as a therapist….

Paul

You're not going to hurt them too much.

Erica

No…well, that's it. And if you're coming in with a chronic issue and you've been in pain for 10 years, that area is going to be very protective. It's not necessarily going to let you do the things that you would want to do. And in those cases, the priority is to try and reduce the brain from thinking, there's a lot of threat there. I need to be producing these pain signals because I'm still injured or it's perceiving that that area needs to be protected in some way. One of the things I always tell my clients is that pain itself is not necessarily an indicator of how severe an injury is.

The people I find the hardest to stretch are people who've never trained before and they have very little muscle tissue because you can really feel it. It just feels like joint on joint. And I think with older people, particularly people who have not trained or do not do any movement, most difficult to get changed within, let's say the average of four to six sessions….

Paul

So it sounds like you're dealing with the body's own willingness and familiarity with manipulation of any kind, like physical manipulation. People who, like I could be a broken 58-year-old athlete — which I am (broken, that is) — but because I'm used to stretching and used to sort of trying new things, I might be a little bit more amenable than someone who's never come into be manipulated physically in any way. Is that right?

Erica (13:37)

Yes. Or even just because you train and you've been an athlete before and because you have like layers of muscle tissue, that's going to be easier to treat and it's going to be overall more responsive. You're also going to be overall more resilient to whatever manipulations we do and also gain a lot more out of them. Yeah.

Paul

Interesting.

So, you know, I'm wondering what you, Erica, see or what you notice in terms of like, my question is geared toward what can people do to remain vigorously, physically healthy for as long as possible. Do you find that the people that you interpret as being that have

Certain kind of background or have developed certain habits. I'm just wondering if you've gleaned anything from your your practice

Erica

Very interesting question. Look, I used to think that, well, as long as you do find something that you enjoy, then you can stick with it, then that's probably the best option. I think after now having worked on people for several years, my opinion on that has changed. I think everyone needs minimum two to three days a week, some form of resistance training.

And then added to that, you want to add in some sort of cardiovascular or aerobic work, maybe twice a week. And then walking would be a non-negotiable. So I do think maybe that's on the extreme end. I don't know. But I think if we're looking at overall health, I think that's really crucial because in terms of resistance training, we need it for things like brain density, overall muscle health, joint health, and also just longevity too. So the older you get, the more brittle your bones get as well. So it's like you're more susceptible to things like falls and injury. Being able to recover from that, being able to have some sort of muscle and some sort of resilience is really important. If you have a basis of that sort of training, you're also going to be more adherent to rehab, more open to overcoming some level of discomfort to be able to adhere to the rehab in order to get better.

Paul

Let's talk about you a little bit because you're a pretty interesting person in terms of your training, your background. You're a power lifter, if I understand, definitely an athlete. Can you tell us a little bit about where you come from, athletically, and your training background and how you became a FST therapist?

Erica (16:05)

Yeah, I actually came from a very non-athletic background. So I hated sports and hated any sort of physical activity when I was a child. I only really got into resistance training maybe in my early twenties. That was mainly motivated by weight loss. So I was never really a big person. However, I came from a Korean culture where being skinny is considered beautiful, like being the thinnest version of yourself, it's basically beautiful. So it was initially motivated by that.

So I started weightlifting and resistance training. And then there came a point where I realized if I didn't fuel myself to be able to lift these weights, nothing was going to change and I wasn't actually going to get better. That was also when Instagram was sort of taking off and social media and the rise of I guess more women getting into the gym and starting to lift weights. And at the time I was also really interested in things like starting strength, Mark Rippetoe and Elliot Hulse and those are the sorts of videos I was consuming because I fell in love with strength training.

And then that eventually led into my powerlifting career, which was great in terms of my strength, but also not so great in terms of my health because I was also very into that anything above five reps is cardio. I was like [inaudible] basically. So I was like, “Well, I'm powerlifter, so I don't need to do any cardio.…”

Paul

(laughs)

Erica (17:12)

That wasn't very good for my health, either. Blood pressure and things like that really quickly impacted my sleep. I was overreaching very, very often.

Yeah, I could squat really well, but I could not, you know, go hiking without feeling quite tired or feeling as if it was quite difficult. So it kind of moved from that. So I've gone through a bit of a journey in terms of being very extreme. So extreme weight loss, extreme restricting of food to only focusing on strength and powerlifting and, you know, building muscle. And then it's taken a few years to find my middle ground. So from competitive powerlifting, I moved on to weightlifting and sprinting now is my great, great joy at the moment. Really enjoying learning how to do that. I also delved in circus for a while, which is the stuff that you see in Cirque du Soleil. So like the aerial hoop did a few performances after I learned that as well.

There was an element of perfection that I was always chasing. And I was like, well, I don't want to put myself in situations where I'm going to be made to feel like I'm not good enough. So when I started doing the fitness related things, I tried to flip that narrative and go: What can I do that will put me as a complete beginner and allow myself to experience getting really good at something that I wasn't good at before?

So that's why I started weightlifting. That's why I also started the Lyra. And that's also why I took up sprinting recently as well.

Paul

Sorry. Lyra…what is that?

Erica

Lyra is the aerial troop that you see in Cirque du Soleil.

Paul

Can you tell us a little bit about your formal training, your academic or therapy training?

Erica

Yeah. I did my cert three and four, which are the, like, which are the fitness courses that you do in order to become a personal trainer. Um, so I've been a strength coach for about nine years now. Uh, I did my facial stretch therapy course level one in 2019. And then I've been back to Canada and Arizona twice after that, to be able to certify level two and level three,

Paul

You seem to be at the front end of the vanguard of a therapeutic evolution. Do you feel that way?

Erica (19:12)

I do think there is something really special about fascia stretch therapy itself. Like the prioritization of client safety, there's lots of therapist values that they preach prior to just teaching us the techniques. and they emphasize that importance of, being able to build the trust, being able to assess comprehensively, being able to assess for clients needs and really asking them what they want. And then making it a very collaborative process throughout the treatment session.

And that's also something that's very much in line with what I've learned in my psychology as well, which is the value of collaboration with the client, building psychological safety, all of those things. So I think that's why I chose fashion stretch therapy over other fashion manipulation techniques.

Paul

if you have to travel internationally just to get certified I'm wondering: How easy it is for anyone to find people like you, around where they live?

Erica

Yeah, there'll be a lot more in America than there are here. For sure. Yeah, fascia stretch therapy, Stretch to Win, they have a directory of therapists and you will be more likely to find someone over in California, over in the US than you would be in Australia.

Paul

So if I understand right, fascia stretch therapy is a specific kind of therapy and it's different than other kinds of fascia manipulation. Is that right?

Erica (20:43)

Yeah, look, there's always going to be parallels because we're working with the fascia and we're working with, let's say, like the nervous system and the brain because when we're treating them, we do work with those things as well. But I think quite a lot of different techniques and the way we approach in our treatments would be quite different.

Paul

Do people come to you because they they've encountered a problem or because they're not yet encountered one and they they want to sort of just feel better than they already feel?

Erica

Both. There's two, I guess, two main groups I work with, which is like people with chronic conditions. So I've had clients who've had a stroke, suffered a stroke. That's why they come for the treatment because it helps their mobility and also provides them a bit of relief. Chronic conditions like chronic fatigue syndrome, multiple sclerosis.

And also just chronic pain that they cannot explain.

And then the other group that I normally work with are like athletes. So people who come in, they'll initially come in with an injury or some sort of pain complaint and then they continue to use that as a form of like a preventative, I guess, yeah, and keep them in the best shape possible.

Paul

What about, you know, people who've had, whether they're athletes or not, you know, like some kind of joint surgery, I'm thinking shoulder, you mentioned knee….

Erica (22:05)

I've worked with clients who've come in with double mastectomies and also double incisions. Scar tissue takes about six months to a year to completely settle. So in that time, it continues to change.

So the priority is the aftercare is, okay, well, can we keep promoting blood flow and keep that tissue moving while it's healing? The clients who've come in after the mastectomies, it's been a couple of years, close to like a decade. And even they experience a lot of relief when we do some scar tissue specific work. So actual massage of the scar tissue. But then also remember I spoke about anatomically separate structures being fascially connected.

If we're able to stretch their shoulder joint, if we're able to stretch their bicep, all of that again, promotes more mobility and relief through the areas that they have the scar tissue in as well. In terms of things like hip replacement and shoulder joint replacements, ACLs, all of that, it does have an impact on their mobility in terms of, it also depends on the aftercare. Like I think with people who are a bit older, they came from a stage where, all right, you've just survived a double knee replacement. No worries, off you go. You can function. It doesn't matter if you can't ride the bike or

You can't do your marathons that you used to love doing that was a huge part of your identity. You can just go off and do that now. For people like that, I do find there's a lot more residual pain because they've kind of learned to work around their surgery. Some of them end up just stopping their physical activity completely because they just never had any sort of guidance in terms of how to ease back into it. So for them, it's two things. So firstly is treatment to relieve whatever pain, restore mobility, do what we can.

And then second is helping them train their way back into whatever it was that they were doing. you have the treatment, but I believe no physical therapy is complete without some sort of training. And you could call it rehabilitation, “prehabilitation,” whatever you'd like to call it, but some form of strength work. So let's see if someone's come in because they've had a double knee replacement, you'd be looking at things like, is there, can we strengthen their hamstrings, hamstrings, glutes, calves, footwork, things like that after treatment.

Paul

Yeah, you know, as you're talking, I'm thinking, wow, like I've had shoulder surgery for a tendon. I've had three arthroscopies on my knee, not to make it about me, but in all of them, I don't believe I ever left with any plan from the healthcare system to be like, here's what you need to do after surgery in order to make sure that you don't get a ton of scar tissue or frozen shoulder or whatever it may be. They just sort of [say], like you said, “You've had surgery. Thank you very much. Please pay your bill on the way out, and we'll see you in the next life.”

And I don't know what... Is it like that in Australia also?

Erica (24:45)

I think it's changing because I know a lot of good physios and a lot of good, I guess, like surgeons who are more aware of this stuff now. So what they'll do is after the person's surgery, they'll go, we recommend that you go and get some scar massage done. We recommend that you go and train. Issue is you can't just leave the person with a recommendation. You need an actual referral network. And I think that's where it falls through.

Awareness is never enough, you have to do something with the awareness.

But I think where it falls short is, okay, you're living now. You had a life prior to your injury. It doesn't really matter if you can't get back to that because you're walking.

Oh, you used to do marathons? Well, yeah, you probably can't do that now. Oh, you used to do powerlifting? Probably can't do that now. There's no exploration into, yeah, look, you may have a hard time getting back into it, but these are the methods that you can use to try and get yourself stronger and not exploring that possibility and not providing that aftercare to bridge the gap between, I guess, function and livelihood or people's lives don't just stop as function.

Paul

What do your clients get out of the treatments they receive from you that are not about physical relief? Do you find that there is associated psychological or wellness or dopamine, just sort of a well-being effect also?

Erica (26:12)

Yeah, definitely. So I guess I've seen a few things. So firstly is I have a few clients who are neurodivergent. So they have quite strong ADHD and normally they find that they can't wind down always super hyperactive, can't sit still. FST is probably the one time where they start falling asleep on the table and then they walk out feeling like all their physical tension is gone.

Because there is physical tension associated with things like restlessness and anxiety and ADHD as well. So for my severely ADHD clients, they do find that. For people who don't necessarily, aren't necessarily neurodivergent, all of them do experience a sense of calmness. And you want to think of it as a feedback to and from the brain. So you have your body signaling, hey, this is tight, this is painful, we can't move this back to the brain.

Brain interprets it as threatening signals and go, okay, well, let's not move that joint. Let's keep producing pain signals so that you don't move it. When we're able to calm that down, people feel a lot better and they feel calmer. They feel less wired in their head. The other thing is also if you've been in pain for that long and your brain has been monitoring that for a very long time, you're always also going to be on edge. So FST also helps calm that down as well.

Paul

Great, I love that, thank you. I'm going to ask you about, do some show and tell. What's your opinion of these things? [holds up a Hyperice vibrating therapy “gun”]

Erica (27:48)

(Laughs) Yeah sure. Look, if it makes you feel better, it makes you feel good and helps you train better, then I'm all for it.

I do think there are some limitations though, in terms of it's not really going to elicit long-term change that you're looking for. And if you're having to use it multiple times a day, throughout the entire week, then I think you might need to search for it: Well, why is it that I need to use it so much?

I think I would definitely agree in terms of the treatment is only one part of a person's health. You want to look at several pillars. So you've got things like exercise/movement, you've got nutrition, you've got hydration and you've got sleep and social connections. Let's say five, five pillars of health. If one falls, you're probably going to be okay. Normally what happens is with most people, if their exercise or their physical activity falls due to an injury, their nutrition and their hydration both fail and then their sleep starts to go. That's when problems start to happen.

So you can't mask away big issues with treatments. and I always tell people as well, there's, there's a reason why you're in this much pain. Some things are acute and we can probably treat them away. But if you're consistently getting back into, let's say you're sitting for 10 hours a day, really stressful job, under like a really horrendous boss, it's probably going to come back.

Paul

Erica, thank you very much for spending your time talking with me about fascia stretch therapy.

I think you've alighted on a lot of interesting points for people who are athletes, for people who are not athletes and certainly people who are in midlife or older who may or may not understand how important fascia is in one's body and attending to it because it sounds like there's a lot of psychological and emotional benefits of this kind of physical stretch therapy, not just the immediate physical results.

Erica

Thank you so much for having me. This was great.

END

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.agingwithstrength.com/subscribe

Andy Walshe is a globally recognized leader in the field of elite human performance for individuals, teams and large organizations in sport, culture, the military and business. Andy is a founding member of Liminal Collective, whose members include some of the most accomplished human performers (artistic as well as athletic) on the planet. Their quest is to answer a fundamental question: How do the best of the best operate, and what can we learn from them?

Show Notes:

1:50 — The 5-minute breath-holding exercise, the “threat of running out of air” and why it’s an effective training tool.

3:56 — The definition of “human performance.”

4:33 — Applying human performance principles to people 50 and older.

5:20 — Andy’s patented human performance framework (with visuals).

6:15 — “You are an N of 1, a unique individual….”

7:30 — How to create a human performance framework for yourself (what you want to achieve + your restrictions + what works for you).

9:10 — The “I saw an elite athlete do it!” trap and how to avoid it.

10:15 — Defining characteristics of the highest performers: The ability to adjust in the moment; bringing oneself back to baseline; “inter-receptiveness” (being able to register how you’re feeling and respond to that), and more.

12:30 — Why the breath-hold exercise is so effective: Recognizing your triggers and practicing handling them in the moment.

14:00 — Training Tier 1 military special operations teams to do comedy improv (the value in training elite performers in “non-traditional environments.”)

17:45 — The importance of not dwelling on failures and moving forward quickly. “The Roger Federer Effect” and the “threat vs. challenge mindset”: I made a mistake. What did I learn?

21:05 — The value of seeking out coaching in some form or another.

22:35 — Using AI as a coach, and the technology advances just around the corner. Uploading “your own version of yourself.”

24:18 — Red-light therapy: useful or waste of money?

25:13 — Andy’s “70-20-10 Rule” for human performance training.

29:17 — The trap of relying on shortcuts, tech toys and supplements.

30:43 — Andy’s take on alcohol and drinking.

31:40 — Finding the Keith Richards prototypes. Andy: “That’s research I could get behind.”

32:40 — Wrap-up thought on aging well.

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.agingwithstrength.com/subscribe

Here's some strategies for dealing with midlife athletic injuries and the frustrating, sometimes demoralizing limitations they impose on us. One of the most challenging aspects of hitting my fifties (and maybe you can relate to this) is reconciling the inevitable decline in physical strength and performance with my expectations — unreasonable as they are — that I should be able to just keep doing pretty much what I did last week, last year or 15 years ago.

Not to mention the particular personal psychology that whispers, convincingly, that physical strength and ability are standards that must be upheld. As if they were virtues that, like all actual virtues, don’t ever change.

And the pernicious feeling that if I can’t maintain my athletic standards, well, then, who am I, really?

Of course, these thoughts and feelings are rarely overt; they’re more like emotional microplastics polluting my subconscious. But like all toxins, they tend to accumulate over time, to the point where they can influence my self-perception and, thus, my behavior. And here’s the problem with that: If you’re in a state of continual dissonance between what you want your body to be able to do and what it can actually pull off, you’re all but asking for an injury.

Or, more to the point of this post, a nonstop series of injuries.

Because athletes in their 50s are like the Tom Hanks character in, “Cast Away.” Remember that movie, from 2000? A guy stranded on an island invisible to the outside world. He survives on pure improvisation, lives in a cave gnawing on fish bones, staring at the wall wondering WTF. And then he becomes emotionally dependent on a volleyball and cries when it goes away.

Sound familiar, athletes? If “Cast Away” isn’t an analog to life after 50 I’m not sure what is.

At least we have access to ibuprofen and CBD gummies.

The consequences of “ignore & override” for older athletes

At this point in my audiocasts, I usually offer a disclaimer that I’m speaking not as an expert but as a journalist and curious explorer. But on this topic…I’m an expert. My guess is that many of you are, too.

Or, if you’re not yet, because you haven’t yet hit the 50-something athletic injury wall that no one ever bothered to tell you is approaching, I’m here, now, warning you about the negative surprises that many midlife athletes confront.

Or, as the case may be, simply ignore.

I wrote a post in October that examined the consequences of continuing to fight through athletic pain. And in the months since then, I’ve become a living lesson of what happens when ignore & override becomes your rule instead of the exception.

A brief summary of my 50-something injuries

So let me quickly run through what I’m dealing with, so I can get to the strategies for managing the nonstop injuries after age 50 with credibility.

* My right shoulder now has 2 partial tears that make upper-body training tough. They wake me up, every night. I probably need surgery, because it feels a lot like my left shoulder 8 years ago, when a surgeon stapled together a full tendon tear.

* But now, in both shoulders, I also have severe tendinitis of the long head biceps tendon, which connects the biceps to the shoulder. This is a direct result of my ignore & override habit, after too many rounds of hitting 200 tennis serves at a time.

I was in too much of a hurry to be really good at tennis, and got a repetitive stress injury as a result.

Consequences!

So, now I focus more on lower body and core strength training, for stronger legs, quads, glutes, hip flexors, lower back and pelvic strength. As you get older, you want to be stronger from the ground up. And these are big muscle groups that burn a lot of calories.

* Oh, yeah: As if on cue, last week my right knee took on fluid, for reasons I have yet to pin down. Going too heavy on the box jumping? Or the stair workout? Tennis drills against the pitiless ball machine? Whatever.

Using athletic stress therapy to speed recovery

Though I make light of the stress I put on my body — and maybe that’s just another variation of ignore & override — when it comes specifically to tending to athletic injuries, I’ve found that continuing to use it — playing, running or working out on whatever part is hurting — can in some cases speed up the repair process far more effectively than the RICE therapy, which is based on Rest, Ice, Compression and Elevation.

Carefully stressing certain non-acute injuries, through newer therapies with acronyms like PEACE, LOVE, and MEAT works only if you know what you’re doing and have a strong and sensitive connection to your body’s nuanced pain signals.

I could do an entire post on physical stress therapy, so I won’t go deeply into it here, but it’s not for everyone.

But what if, instead of more effective therapies, we avoided taking on athletic injuries in the first place. Maybe there’s a better way to build strength and endurance and flexibility after 50 than simply by pressing on with the same workouts, the same routines, the same sports, even, that we practiced 5, 10, or 20 years ago.

Getting smarter about staying physically strong

In that previous post about the consequences of continuing to ignore & override progressively louder pain signals, I gave two examples of friends, each with great tolerances for pain, who decided to stop doing certain sports they loved, to save their bodies.

Because, yes, discontinuing what is painful may be the smart move.

There are always other creative ways to build physical strength, including neuromuscular strength training.

The concept of slowly, slowly ratcheting down your workouts over time

But, instead of just pressing on doing the same routines and talking to a volleyball to keep from losing our minds, I’d like to introduce the idea of a controlled, almost imperceptible ratcheting down of your workouts, over years, as a way to stay healthy, remain physically strong and flexible and get off the perpetual injury train. Through more mindful, disciplined movements that recognize, instead of ignore, our changing physical abilities.

It would look something like this:

1 | A 1% per year reduction in weight/duration/distance/intensity of the training regimens or sports most likely to cause the injuries that set you back, physically and mentally.

* maybe it’s 1%, maybe 5%, maybe .05%, but it becomes something you manage, which requires forethought, attention and discipline — things that athletes tend to be good at.

* in the gym, that can look like preemptively reducing the amount of weight you're using in favor of doing more repetitions. You don’t need to go heavy to build strength or muscle.

* after my 2017 left shoulder tendon repair, I ratcheted down to 50 pound dumbbells for chest presses, from 60 pounds, and that was absolutely the right move. 60 pounds is ego; 50 pounds is disciplined, mindful.

* instead of keeping your max workout volume at 11, turn it down to 9. At first, it can feel disappointing, like you’re leaving endorphins on the table. But it’s still 9! And it creates a disciplined buffer against frequent commutes on the athletic injury train.

* I no longer hit 200 idiotic tennis serves at a time, and instead limit myself to 40 or 50. That’s lowered my daily pain score, which I’ll explain in a moment.

2 | Commit to acquiring no new injuries

* what would that require you to change in practice, at the gym, on a bike, on a running trail, in the pool, or just negotiating a darkened staircase while texting and eating a sandwich?

3 | Quantify the pain load you’re carrying, to lower it

* example: on a scale of 1 to 10 daily, my right shoulder is a 5; my knee is a 1; my left shoulder a 2, for a total pain score of 8. I want my daily number to be 4 or lower. What’s my plan to achieve that?

4 | Acknowledge the mental and emotional stress that athletic injuries create

* that daily pain score directly correlates to the energy that you require to ignore & override or, worse, unleash your transmogrified pain on someone else.

5: | Invest in high-quality, professional guidance for your specific athletic goals

* instead of training only using free YouTube videos, which I use as well, create a modest budget to spend on your personal physical performance and maintenance.

* a good physiotherapist or coach is as valuable to your enduring physical resilience as a good psychotherapist is to your emotional well being. This is a worthy investment that takes time and effort and pays major dividends.

Since I mentioned psychotherapy, which I’ve been reaping the benefits of for 20 years now, let me mention one final, really important element of what drives many of us, especially men, toward unsustainable levels of athletic stress, pain and the dead-end of ignore & override. And this is where I also speak from personal experience.

Confronting the lingering need to be dangerous

What I’m talking about here is the need to remain “dangerous.” Which continuing to keep up an increasingly painful athletic standard, almost regardless of the consequences, bestows.

This is a real need, felt by many men, especially. Here, dangerous does not mean antisocial, threatening or violent, but something much more subtle, socially acceptable and rooted in athleticism: a form of physical achievement and self-possession that tends to make people take notice in some way, small or large.

As many psychotherapists, including mine, will tell you, the reason so many men of a certain age resist dialing down our athletic habits is because to dial down would be a tacit acknowledgement of mortality. But if you can still blow away that 38 year old dude on the trail, or compete with him, entirely in your mind at the gym, you’re not average! And you’re not going to die!

As my therapist said to me recently: “There’s a limit to how strong one can be at different points in one’s life, regardless of one’s will. You need other capacities, other than just determination.”

Other capacities: like maybe self-acceptance, self-forgiveness and an appreciation of the non-athletic qualities that make you strong, attractive and worthy. Capacities like tolerance for the physical declines that are, in fact, inevitable.

We can’t will our way back to 35.

But I think we’ve all seen what happens to some people — men, mostly — who haven’t cultivated capacities other than the very traditional pathways to perceived masculinity.

I mean, I get it. There’s a reason I talk about the male need to feel dangerous with my therapist. There’s a line from the 2012 movie “Act of Valor,” about a Navy SEAL team, voiced over by an active-duty SEAL, that captures this dilemma, which is:

“Before my father died, he said the worst thing about growing old was that other men stopped seeing you as dangerous. I've always remembered that, how being dangerous was sacred, a badge of honor.”

For many older athletes, modulating if not letting go of the need to be seen as physically elite or, for men, as dangerous, as a socially acceptable form of masculine identity, remains unexamined aspects of our personalities.

But sooner or later, the time comes to work out that problem.

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.agingwithstrength.com/subscribe