Dr. Mike T Nelson On Optimizing Hormones, Effective HRV Usage, RPR Techniques & Why Static Stretching Sucks (SSOF Ep. 27)

Mike T Nelson2:20

Yeah, I mean the semi-short version is, like most probably guys, I started lifting. I was a 6'3" eel-shaped rake person during my first year of college after my puberty growth spurt, got crushed by the empty bar trying to bench press in high school. And I don't know if where you're from, you had to do the, we had to do this old physical fitness test, presidential physical fitness test, and it was basically just a way of humiliating kids like me who are very unathletic basically.

And they didn't ever taught us how to train for it. We didn't learn anything from it. It was just, hey, let's just test you and see, oh, you guys are great. Oh, you suck over here. Well, too bad. We don't want to teach you how to do anything. So went to college and started doing Bachelor of Arts and Natural Science, started taking physiology for fun. I took an anatomy physiology class just because I thought it would be cool, and as part of my undergrad they actually used cadavers, which was great, which was also not real popular at that time. So I did that.

And then went on and did a master's in mechanical engineering biomechanics, and did two years as postgraduate before that. I finished that, so I was never going back to school. I started doing a program in a PhD in biomedical engineering, but I didn't finish that. I got stuck at a class on MRIs, and I was the only mechanical engineer in the class. The rest were PhDs in mathematics and physics, and I knew I was screwed when on day one the professor's putting stuff up on the board, and I'm looking at it going, I don't even know what this is.

So I elbow the guy next to me who's a PhD in physics. I'm like, hey bro, do you even know what any of this stuff is? He's like, no, and he's just frantically writing stuff down. And I mean, at the time, probably even six years previous to that, I would just show up at fitness conferences and annoy trainers, and was kind of shocked that they didn't read research and they couldn't figure out why I was there, and I couldn't figure out why they were there.

So eventually switched to do the PhD in exercise physiology. I was looking at heart rate variability and metabolic flexibility, and I started working with clients in person right around 2005, 2006. Did that for a while, worked at a gym for a little while. Decided that I didn't want to be an in-person trainer all the time, and again, there's nothing wrong with that at all.

I just was more interested in the bigger picture, the systems of how do you put everything together. How do you match nutrition to your training? What's the role of aerobic training if someone's just trying to get bigger and stronger? I was much more interested in all these kind of weird overlaps of stuff.

So I transitioned to training people online about eight plus years ago, and then graduated. Been doing that full time. And then right now, I teach for Rocky Mountain University. This quarter I'm teaching a class on advanced athlete monitoring. It's been pretty fun. I got to help design the class too, which is great. I'll be teaching biomechanics for Walsh University coming up online, and then I'm an associate professor at the Carrick Institute. They do clinical neurology. I do more of the exercise kind of nutrition part for them. And then created a couple certifications, the Flex Diet Cert and the Physiologic Flexibility Certification.

James de Lacey5:31

So a lot on your plate then.

Mike T Nelson5:31

Yeah, few other projects. I'm working on the second book of Triphasic Training with Coach Cal Dietz. I've known Cal nice, God, probably 15 years now. His where he was training his athletes, I was in the same building because our lab was literally right on the other side. So I would go over there on my lunch hour and just sit in his office and pester him with random weird questions I was thinking about.

And he was great. He's like, oh yeah, and we tested that five years ago. We took this squat plyometric and that squat plyometric, and a lot of the stuff I've been thinking about, he actually had real data from his athletes on.

So we're working on that. It'll be all new material. It won't be anything that repeats from the first one. So the second version will be all new stuff.

James de Lacey6:29

That's actually a good place to start. So RPR comes out of Cal's cohorts, and yeah, big guy, huge head. Yeah, he'll kill me. So I wanted to start with RPR then. So do you want to maybe explain for listeners what RPR stands for, what it is, and what you're trying to achieve doing it? And I guess it's hard to kind of explain how to do it without actually seeing it, but maybe give that a go too.

Mike T Nelson7:02

Yeah, so RPR stands for Reflexive Performance Reset. And the first time I ever heard about it was, man, eight years ago now, seven years ago. I was still doing my PhD, and Cal would come over to the lab once in a while in between when we had students there. And so he comes over one day, he goes, hey man, I got this guy.

He's flying in from South Africa, and he's going to do a cert here in June. This is like January. I'm like, oh, that's cool, what is it on? He's like, crazy man, crazy. I'm like, okay. I'm like, do I really need to go to this? He's like, oh yeah man, you just, you'll love it. Just you have to go.

I'm like, how much is it? It's like $1,500 for two days. I'm like, okay, okay, whatever. If Cal says to go, I'm going to go, right? If anyone else said it, I'd be like, just jump off a bridge. I'm not going into your weird cert. And so fast forward, we're both presenting at Paleo Effects in April of that year, April, March.

And so we're sitting at the speaker dinner, and I'm sitting next to Cal, and I'm like, hey man, I know I'm going to this certification and you got some guy coming in from South Africa, but I've been so busy I haven't had any time to look at what it is.

And he's like, oh man, stand up, stand up. So we had this speaker dinner, so I stand up next to Cal, who was like 280 at that time, and he sticks his thumb right between the bottom of your ribs and the top part of your hip on your side, like this side, nosy of death. So he's standing there with his arm around me, poking in my side. I'm like, oh God, this hurts. What are you doing? Everybody stops eating, turns around and looks at us. What are these idiots doing?

So I sit down, and I said, oh, I said, oh that hurts. I said, what is this about? He's like, crazy man, crazy. I don't know anything about this other than it hurts and I'm paying you $1,500. I don't know, torture people.

Or something. So in June that was actually Doug Heel who came over and did the first official cert in the US where it was only two days. So Doug Heel does Be Activated training and so RPR got a license to teach Doug's material to strength trainers and personal trainers, and then Doug would do more of the medical model with chiropractors, physical therapists, etc.

And the certification was really good and I was like, "Oh wow, I think there is something to this." And Cal Dietz, Cal is like, "Oh yeah, just come. We're going to do a couple certs here in Minnesota. You should just come to one and then now you can just start teaching it after that." I'm like, "Okay, sure."

So I took all my old clients and everybody I could find the first couple months and just started doing it on everyone. And I had a background doing Hands-On therapy before that, taking a lot of classes through Tom Myers and some other instruction.

But at base level with RPR, so RPR is generally taught as the person is going to work on themselves. So Be Activated training, which is under Doug Heel again, that's more of a medical model where you may be working on someone else. So the big difference with RPR is it's the same idea but the athlete can work on themselves.

So a lot of places, people aren't certified, there's different laws and licenses, etc., and the nice part about RPR is that athlete can work on themselves and you may be guiding them over it. And you're working on different areas to activate specific muscle groups. So for example, you may do work on your sternum. That's to get your diaphragm to move better. You may do work on the back of your head and your skull, where your spine comes into your head. And as weird as it sounds, that's actually an activation point for your glute max.

And so the next question people like, "What? That? Wait a minute. That makes no sense whatsoever. You're telling me to rub the back of my head and that my glute max is going to work better?" I'm like, "Actually, yes."

So when I first started doing it, I was convinced this is just the biggest bunch of [expletive] I've ever seen in my life. And so I spent four months just trying to disprove it. So I'd run around and get people, I'm like, "Hey, what do you think of Hands-On therapy and trying to get your glute stronger?" They're like, "That's [expletive]." I'm like, "Great, come over here."

Because I'm like, if it works in the face of what's called a nocebo event—so someone expects a negative or no result—there's probably something physiologically there, right? Because a placebo effect is a real thing. So after I convinced myself that there was something there, there is some research on it now a little bit, but a lot of it is based on different acupressure points. Some of it is neural embryology, just development.

So for example, the spot on the back of your head is a reflex with infants. So when kids are little and they're learning to crawl, if you notice the first thing they do, they're face down. When their hip goes into extension, at the same time they lift their neck, right? Because you lift your neck as you're crawling, you got to see where you're going. And it turns out there's a reflex that ends up being a two-way street there.

So with kids, as the leg goes into extension, the neck goes into extension. But it turns out you can work on the back of the neck, the top part of the spine and bottom of the skull, and that will also work for the glute max to fire better. And so there's these different targets throughout the body that you can work on that result in better activation of different muscle groups.

And you can do just some old school muscle testing, just a lot of Kendall stuff. And it's not—it looks kind of woo-woo, but you're just literally strength testing a muscle. It's like, "Hey, let's put you in an isolated position in a mid-range." Even if you're old and deconditioned, if I put you in a mid-range for your glute med, I shouldn't be able to just easily move it around wherever, right?

And so you're just looking for these big effects, and that gives you a way to try to determine if the interventions you're doing are working or not.

James de Lacey13:14

Is there an easy way for people to learn this almost on their own, maybe through YouTube? Or is this something where you really need to go to an RPR course to nail it down?

Mike T Nelson13:14

Kind of both. I know I don't know if it's out yet, but I know they were looking at releasing a self-guided course. So for exactly your question, for people who are like, "Hey man, I'm not a trainer, I just want to know how do I do this before I exercise?" I think they're going to release a course on that. Maybe it's even out now by the time this comes out.

You can look up—Cal's put out a few videos, one with Mark Bell and some other people—that kind of goes over the exercises. So you can follow along with that and play with it.

So you can probably poke around and find enough of it online to get an idea. The only caveat with that I would say is you may not understand why you're doing it or what order you're doing it. And then most people probably need a little bit more force than what they're applying initially.

Now again, there's some areas that are very sensitive, the middle of the abdominal area, so you don't want to go crazy if you don't know what you're doing. But most of the places—sternum, over the top of the pectoralis, under the clavicle, back of the head, most of the places but not all—most of them there's not too many other structures that are going to be dangerous if you're poking around in those areas. So most people probably need to go a little bit more intense to see an effect from it.

James de Lacey14:26

Gotcha. And then I guess in terms of RPR itself using it before training, what is it that you're trying to get out of it? For some, obviously you mentioned you're getting better muscle activation potentially if you're doing the back of head for the glutes. But is this something that you're trying to improve before going to your training session? Is, for example, you also mentioned the diaphragm RPR as well?

Mike T Nelson14:53

Yeah, so the hierarchy would be humans are just designed for survival, right? And I initially stole this from Dr. Eric Cobb at Z Health, that if you want better performance, you need to teach your body how to survive better. And that can be very context-specific, but at a global level, the top thing you need to worry about is breathing, right?

You can last all of, what's the world breath hold, 20 minutes or something now, right? So it's in minutes, not hours, not days, not months. You could go without food for many days to months, water—yeah, couple days depending on your environment, right? Breathing, yeah, you're looking at minutes. It's definitely at the top of the scale, next to hip flexion and hip extension. So you can move forward and walk to get to wherever you would need to.

So breathing, hip extension, hip flexion, those would be your top three. And if you get those to function better, as an organism you're just going to be functioning at a higher level. So there is a level within it to start at. And if you think about all main exercises, you're going to need to do some type of stabilization, and that's going to involve—we always talk about the core, but the top part, the top cover of your core is your diaphragm. The bottom of it, imagine it's just like a can or a cylinder. The bottom of it's going to be your pelvic floor.

So if you have a hard time controlling your diaphragm, you could argue you're squeezing the tube of toothpaste and pressure is just going up and out, and that's not going to be very good. And then you get into more individual muscle function there. So it's looking at it from a holistic point of view, and then also the next level down I would say would be order of recruitment.

If you look at hip extension pattern, the hamstring can also be a pretty powerful hip extensor, but we want the glute on that side, glute max, to be first, and the hamstring to be second. And then contralateral, you'd want QL, quadratus lumborum, to be stabilizing.

And what you'll see in some people when you just do a simple hip extension test, their hamstring may go first, or their opposite QL may actually go first. So the order their brain is trying to solve the issue of, "Hey man, I got to get hip flexion and hip extension. I'm going to, if I have to compensate, great. I need to figure out a way in order to accomplish this."

The brain will figure it out, but again, you may not be using the right muscles in the right order, and that's going to cause you performance issues and potentially injuries.

If you've got someone who's a high-level sprinter who's just putting a ton of force through their hamstring and their hamstring is the main muscle that's going first, I'd argue you're at a higher risk of injury than using the glute max first and then the hamstring.

James de Lacey17:33

For sure. Now that makes sense.

And hopefully people listening kind of understand that concept too. But I wanted to kind of change tack a little bit, because I know you're well read, well experienced, and well researched in many areas as well. And one of them is on optimizing hormones.

So obviously optimizing hormones is a pretty broad topic, so I'll try to bring it down a little bit for you. So for example, the craze of using this is, I guess, one thing people are trying to use to elevate growth hormone. But from the research that I've read, elevating growth hormone even two to four times your daily secretion rate doesn't really do much in terms of building muscle over someone who doesn't use it.

So I guess wonder if you want to maybe dive into the idea of kind of the sauna and hormones, and then maybe in terms of optimizing hormone, I guess, daily hormonal balance regarding things like testosterone, cortisol, all that kind of stuff.

Mike T Nelson18:28

Yeah. So to me, hormones are super interesting and can have very powerful effects, but at the simplest level they're just the messengers, right? So you're thinking about, okay, what was the stimulus and then the response? Kind of the connection between those two is potentially a hormone or a direct connection via the nervous system.

So if I'm training and my testosterone is better, or I'm using some exogenous testosterone so I'm using way in the super-physiologic range, yeah, there's a lot of data to say that that is beneficial. Again, depending upon what you're doing, may also be illegal and unethical depending upon the rules of your sport, etc. But at some point, if you elevate it to just way high, yes, that is going to be beneficial.

However, when you scale back down and you look at different hormones, people kind of make the same inference that, oh, if I just have more, it's going to be a benefit. And you see this probably mostly with growth hormone. So if we look at growth hormone in, let's say, super-physiologic range, which people are getting exogenously, so from outside their body—you know, ethics and rules aside—for muscle mass, even in those high levels, it doesn't do much of anything, which is kind of probably surprising to most people.

However, it can have benefits for fat loss. It can have benefits for soft tissue recovery, so may increase collagen synthesis, maybe fascia, but more on the soft tissue side. Again, that's in super-physiologic levels.

So if we back down from there and we look at, okay, so let's say we're not taking in any exogenous hormone, we're doing something like sauna, does that stressor stimulate growth hormone? And actually it does. Again, the protocol for that is pretty brutal—people who have not used sauna a lot—but there's some Finnish research showing you can easily get 10 times the amount of normal growth hormone, maybe 16 times depending upon what study you look at, from doing just an absolutely brutal sauna routine.

Now, would that stay over a period of time with adaptation? Probably not. But even at those ridiculously high levels, it doesn't really do anything.

If we look at exercise-induced changes in hormones, right, so you've probably been around long enough to see that, oh, you know, man, if you program squats first and you do a lot of volume, you're going to see more growth hormone, more testosterone, so you need to do this first in your training. And they'll cite a whole bunch of research from Dr. Bill Kramer. And the research they cite is legitimate. Do you see hormonal increases from doing that type of protocol? Yes, you absolutely do. Growth hormone goes up, testosterone goes up.

But then you have to ask the next question: is that beneficial for better adaptation? So, for example, for muscle mass, do you get more muscle mass doing that type of protocol? And so Dr. Stu Phillips, SLB, Dr. West did this great study many years ago, and they said, okay, do these short acute rises in these hormones do they really matter?

They did an awesome study where they had people come in, human subjects, and they said, okay, so we're going to set up one part of study where you're going to do this pretty heavy squat routine. We're going to take the same parameters where we see increases in growth hormone, testosterone, we're going to measure those hormones. And what they found was, yep, that definitely does happen.

And then they said, okay, cool. So on that day, let's say that's Monday, you're going to do only curls with your right bicep on that day, right? The theory being, if these higher amounts of testosterone, growth hormone matter, that right bicep is going to have a lot more of those hormone concentrations. I think you're going to have a day off, and then you're going to come in two days later.

You're going to do the same squat protocol again. We're going to measure growth hormone, we're going to measure testosterone. You're going to do your left bicep, but the catch is, we're going to flip the exercise order.

When you come into the lab, when you do your left bicep, you're going to do that first. You're going to do squats after, so that left bicep would not see those increases in hormonal levels. So volume is the same, it's the same person, so it gets rid of a lot of other variability issues.

Fast forward to the results. What did they find? No difference between the right bicep and their left bicep. So even though the one bicep saw a lot more hormone output, wasn't really any difference. I think they even replicated the study at least once.

There was another group, Ron Haust's group from Denmark, that did something similar. They did see a result, but then if you talk to Stu Phillips about how they did the MRI and how they looked at it, they don't really think there is a result. So most of the data would say, at least hormone increases from sauna, exercise, etc., do they change? Absolutely. Do those hormonal changes really mean anything in the big picture? I would say probably not.

You even something as simple as just baseline testosterone level—let's not talk about SHBG and free testosterone, everything else—most people would say that, oh bro, if you're at 350 compared to 700, 700 has to be way better. And granted, there's not a lot of data in that area, but for performance and at least muscle mass, most of the data would say probably not a huge difference within that normal range.

Bhasin did one study on this years ago in the '90s, or this would probably never be approved now. They literally chemically castrated males and then they replaced their testosterone at different levels using testosterone enanthate. And yeah, if you're hypogonadal, your testosterone is really low, yes, that's going to definitely impair you. If you're super-physiologic and probably using exogenous hormones, is that going to be a benefit? Yes. If you're in the middle range, probably not that much, really.

So again, I think people make the mistake of assuming that all these relationships are linear, that, oh, if you're low, just go up and it's going to be better. And it depends on where you're at. You know, if you go from 200 to 400, you probably see a difference. You know, 400 to 600, I think it'd be hard-pressed to see any difference with that.

James de Lacey25:21

Yeah, that's interesting. Yeah, that's what I was going to ask you about, being in that normal physiological range if there is any benefit for someone trying to naturally raise their testosterone to the higher end. As you mentioned, there might not be. But for someone who's maybe on the lower end, as you mentioned, like 200, what can they do in their day-to-day lives to potentially help, essentially, increase the testosterone naturally without having to resort to the needle?

Mike T Nelson25:47

Yeah, and that's where, because then people send me hate mail, they're like, oh, she's saying measuring my testosterone is completely worthless. It's like, no, I'm just saying organizing your training to be the sole benefit to increase testosterone is probably just not worth it, right? Again, you want to organize your training for an output independent of testosterone.

Now, that doesn't mean that looking at levels of testosterone is not useful, right? Because if you're very low, first question I'm going to look at is, what is your lifestyle, right? If your nutrition's a trash bin fire and you train seven days a week and you're doing conditioning and skills practice on top of that, you're sleeping four and a half hours and you drink eight cups of coffee a day, I can guarantee you why your testosterone is 200, right?

So most of it is, not all the time, but a lot of time, is lifestyle related. Sleep is huge, huge. Just recovery in terms of setting up an appropriate amount of volume you can recover from. Caloric intake—if you just whack your calories super low, there's some case reports from natural bodybuilders, their testosterone levels right before they show, in almost all cases, is just super low, right?

Because they're stressed out of their mind, they're not sleeping real well, they're on low calories. My buddy Eric Helms calls it competitive starvation, right? You're basically in a starve condition because their goal is to look shredded on stage. There's no performance aspect to that at all.

So it is useful. Those are things that I would look at first. There's some other stuff where if your total fat intake is ridiculously low for long periods of time, that can impair it. Some mixed data on cholesterol, but most people's cholesterol is not low enough they really need to worry much about that. There's some other stuff on nutrient deficiencies—zinc and a few other things. But it doesn't mean that adding more zinc once you're back to sufficient will increase your testosterone. Again, that's where people kind of make a mistake of, oh, I'm taking more zinc now. And I've seen a few cases where people...

Are taking so much zinc that they're actually probably depleting out copper and running into other issues. So is there some benefit? Yeah. Do you really need to take a ton of it? No. And at some point you're going to have the opposite effect, you're going to start to have issues on the other end.

But those are all hard conversations because no one wants to admit that they just need to sleep more, they probably need to fix their nutrition a little bit, and especially your population, maybe they should cut back on training a little bit or do more aerobic training or watch their HRV so they're not super stressed out of their minds all the time.

James de Lacey28:36

Yeah, that's a good segue to HRV. But before we get there, I wanted to ask you as well: within the physiological range of testosterone, are there any other potential benefit from say going from a 400-500 to an 800-900 testosterone level?

Mike T Nelson28:36

Yeah, the answer is we don't know, but you could theorize that your ability to handle training volume might be better at a higher level. So testosterone, even at supplemental usage, is primarily an anti-catabolic. Most people think of testosterone as primarily being extremely anabolic, and it does have some anabolic properties—again, if you're using compounds, depends on what compound, etc.—but a lot of it is preventing protein breakdown. So it's plugging the sink. So yes, hypertrophy will go up, especially if you're using exogenous testosterone.

So in theory, if you're on the higher end of the spectrum, you might get some anti-catabolic benefit. Again, there's no study that's looked at that. But there are other benefits in terms of potentially your ability to handle more volume and recover and get back to normal. There's some other related things related to your drive and just your intensity, because testosterone is a hormone that'll bind in other areas, including the brain, and all those loops are all pretty complicated. It's not only testosterone, some of it is estrogen and other effects.

So in theory, you could say that yeah, there might be some benefits. And if somebody said, "Hey, we could magically increase your testosterone from 400 to 800," I don't think anyone's going to say no. And if I had to pick athlete A and athlete B, everything's identical except athlete A is at 400 and athlete B is at 900, I'm going to pick athlete B.

But it gets into: where are you at, what are you doing? And sometimes I think we just forget to measure output. We're so hung up on a lot of these surrogate markers, which does give us some information. It'd be like if you went to the racetrack and you're just looking at the size of the engine of all the cars, but you never time to see what is the fastest car.

It's like, yeah, I want to know who's fastest first. I want to know what is the output of the car, and then yeah, I probably do want to know stuff about the engine, what kind of injectors it has and how many cylinders and what everything else. But to me, that's secondary to the output and the cost.

But a lot of times we get so hung up because measuring all these intermediate things is more sexy. And then you still have to understand how much do those things change over time. If somebody comes into a lab and they slept four hours the night before, they got an argument with their spouse on the way in, and they did fasting all day yesterday, testosterone's probably going to be much lower than what it'd be normally, just because of the events that happened. So there's the variability of day-to-day things that affect it.

James de Lacey31:29

Nice. I want to jump on the topic of HRV as well. So we've had a couple of coaches come on, talk about HRV, how to implement it, and what they're looking at with the data. So maybe for you to dive into it as well, maybe dive into what you're looking at and then how you're using it to essentially apply to someone's training—whether you're taking the data and removing or adding or whatever it is to training.

Mike T Nelson31:29

So HRV—my little golden rule with it is the only thing that HRV can do is tell you the status of your autonomic nervous system at the time of measurement. So people just remember that and write it down: the only thing HRV can do is tell you the status of your autonomic nervous system at the time of measurement. If you just get that through your thick skull—which granted, took me eight years to get through my head—you'll be pretty good.

And then people are like, "Oh, that sounds like it's worthless." I'm like, no, if I had to pick the status of one thing that I could get within a matter of minutes, I could get daily at literally no cost once I had the technology, it's probably at the top of the list. I mean, I could get some other fancy things, but that would probably be at the top of the list because it is going to be affected by everything: training, nutrition, sleep, etc.

If you use the car analogy again, think of it as—I used to have a little four-cylinder Jetta, and I could just jam the gas pedal down and redline it to get to the local grocery store. But yeah, I'd go faster, but am I really going to expect the car to do 200,000 miles? So to me, HRV is what is the cost that you just paid for your output.

So at first, by all means, measure output. Know what you're capable of. The second question then is, what was the cost of doing that output? And we see this where people will show up sleep-deprived, they'll take a bunch of caffeine, and they could potentially do well on that particular day, but then the next two, three, four days they're just a wreck. And again, if you have a big competition, probably doesn't matter that much.

But for me, with day-to-day training, I'm more interested in if we've got eight weeks to prepare, 12 weeks, six months, two years, whatever the duration is—how can I get the most over that long period of time? So I tend to go more with the lowest stress model. So stress you can more easily recover from. So yes, by all means, stress the athlete, get the adaptation you want, and then let them recover, and then come back as soon as you can and do that all over again. Just do that, rinse and repeat.

And if you have a day that's a really, really high output day, there's a time and a place for that, usually around competition. But by definition, most competitions have a huge amount of time off on the back end, so I'm not as concerned about the cost at that point. But if you start having these high output days every Wednesday and then you're toast until Saturday, to me that's costing you precious training time.

And so can we get the adaptations that are similar over maybe a couple days without paying that big of a cost? And I use HRV as an idea of how much cost did we pay to do that output. And I think people get too hung up on super fancy, throwing every recovery thing under the sink at it, when maybe you should just modify your training first, get to the point where they can recover, escalate your volume in an intelligent way so that it's high-quality output—whatever that is, skills training, etc.—rinse and repeat, do that.

And then if you want to get fancy and add better nutrition, add recovery, add more sleep, great, do it. But those things are harder to monitor and you generally have less control. Even if you take the world's highest-end athlete, they've got a whole team of people, let's say they've got someone in charge of the whole thing, they've got a private chef, they've got everything.

Well, if they're not with you, they still have to eat. You can put someone in charge to watch them eat—you can definitely do that—but they're on their own once they leave your facility. But if you're there doing their training, you have a lot more control.

So again, my bias is: control the things you can control first. And then if the athlete complains, you're like, "Hey coach, I feel like I can do more work," you're like, "Hey, your HRV takes two days for you to recover, so I'm not going to push you until you're ready to recover again." And then they're like, "Oh, well what can I do to change that?" Oh, I'm so glad you asked. Maybe you should not sleep five hours a night and go to bed an hour earlier. "Oh, okay, all right, I think that's doable."

Now you can use it to get buy-in from the athletes and show them that this is your response. This is not me being a dick, this is not me forcing you into my own training philosophy or holding you back or whatever. If you can demonstrate to me that you can do better, awesome, we will give you more stuff to do. But I use it in that aspect too, of putting it back on the athlete. And again, at some point that's going to cap out—there's only so much you can do. But changing the responsibility back to them and showing them what the actual data is.

Then the second part is everyone will respond a little bit different to different things. Some people recover real well from a high-intensity, high heart rate session. Some people don't. Some people can handle just a ton of volume and they

They could train for hours on end at a moderate level, come back, do it again the next day. Other people, that'll roast them for two days, right? And that's how you kind of get into the individuality of each person. But when I have the data on their nervous system status from that, within a few weeks you can figure out where they're at and titrate it real fast. If you don't have that, you can still do it, but it just takes longer.

James de Lacey37:54

The other thing I wanted to cover was static stretching. So obviously as combat athletes, people are wanting to get into various positions, flexibility, mobility seems to be important for most people. Now we know that static stretching, you don't get that structural change in the muscle, so it'll be interesting to hear from your side, I guess where you deem static stretching fit into a training plan if it's even necessary, and if someone actually wants to become more flexible or more mobile, what else they can do.

Mike T Nelson37:54

Yeah, for static stretching, I think it's kind of stupid. But what are you actually stretching when you're stretching? So if we do old school hamstring sit and reach test, you're pulling on the potential muscle, the connective tissue, the fascia. There's Titan, there's all sorts of other structures in there. We did some weird stuff with cadavers once that the skin sticking to the fascia might be an issue, which that's even more way out there.

Most of the research I would say on static stretching is not super favorable for strength and power. I'm not convinced that you see huge chronic range of motion changes. So if we back up even, we go, okay, so old school sit and reach test, we do that, we hold the stretch for say 30 to 60 seconds, we do that again, we do our static stretching protocol, and then oh, we measure, oh look, we got another inch range of motion. So people are like, yay, we stretched the muscle and it's better.

But if you look at some, there's been two or three studies on this now, yes you did get more range of motion, but how did you get that right? People are like, oh well the connective tissue is just much more pliable now. It's no, most of the new research would say that you changed the input to the nervous system. And if you think about the commands and how that test is set up, it's okay, I want you to reach forward as far as you can to you feel a sensation nine out of 10, right, or whatever it is.

Okay, now we're going to do static stretching. Okay, at the end you retest, do the same thing, do you get a nine out of 10 sensation?

What you find is you actually dull the sensation. To me, you made your nervous system dumber with where the end range of motion is. It allowed you more range of motion, but I don't think that's a good thing.

And then if you look at, okay, so we take a muscle, right, or whatever we want to use, and we go to an end range of motion, we hold it there, and we're literally waiting for it to get weaker. I'm like, but if I'm trying to reduce injury and create force, especially in mixed martial arts where you're at all sorts of screwball angles, a lot of the whole sport is designed to take you to an end range of motion, that's part of the deal.

So I don't want to be weaker there. I want to be as strong as possible at an end range of motion, potentially for sport performance and reduction of injuries. Even the general mechanism doesn't make sense. And then I used to do a ton of static stretching and chronically I didn't see anything get better. I was like, but if it helped, why am I still static stretching all the time?

I'd probably throw foam rolling in there too, which will get me more hate mail. But it's like, if it fixed it, why am I doing it all the time? I'm like, that it didn't see greater range of motion into anything else.

So that always begs a question then, okay, well that's great, but what the hell do I do instead? To me, any dynamic mobility or range of motion is probably going to be better. So the simplest thing I've told people is, okay, if you're convinced that you need more hamstring range of motion, well, just go with that argument for now, that's a whole different topic, if you need it or not. Take your static stretching and instead of holding it, go to the end range and come back, go to the end range, come back, go to the end range, come back.

Now if you can do that in some form that you're slightly loaded, even better, right? You scale that all up and what does it kind of look like? Weightlifting with a full range of motion. Do an RDL, do a deadlift, do a squat. And maybe for your sport you don't need to do a powerlifting super wide stance squat that's specific to powerlifting, because your goal is to move the most load, but for your sport that might be a detriment because maybe you need a lot of range of motion with your legs below 90 degrees.

So I do a fair amount of kiteboarding and trying to do better foil boarding, surfing, et cetera. So I probably go very deep on my squats just because I want that range of motion and strength at that end range for what I'm doing. It's specific to what I'm doing. Is that costing me weight on the bar? Yeah. Do I care? No, because it's not specific to my goal.

So that's the first thing I think you would look at. And then other ways you can do it, I sound like a broken record, but I think RPR is very helpful with that. Once you get the right muscles doing the right job, you just get more range of motion.

The first time I saw this in a big way was actually a PRI course, Postural Restoration. I don't remember who was teaching it. I think Ron might have been teaching it, not sure. But I'm sitting in class and I'm like, oh yeah, basic biomechanics, kind of gone all over stuff. And the instructor is like, hey, do you know why you don't get a lot of range of motion in your hamstrings? It's because your pelvis is at a different angle. I'm like, what's he talking about?

And I'm like, oh, so you realize that most of the time when you're taught exercise range of motion and testing, I say, okay, think of hamstring contraction. What does everybody think of? I'm going to bring my heel towards my butt, right? And is that part of the hamstring's function? Absolutely. But where is the other end of the hamstring? So if I said keep your feet planted on the ground and now contract your hamstring, other than look at me real funny, you're going to be like, what are you talking about?

Pull your hamstring from the other end. What does it do? It changes part of the angle of your pelvis, right? Because it's attached to the bottom part of your pelvis. So it's not changing behind your knee and it's contracting, it's changing the angle of your pelvis. And so people walk around with more anterior pelvic tilt, they're literally pre-stretching their hamstrings. If they stay in that position, you measure hamstring passive range of motion, it's usually relatively crappy.

Now again, we could have a separate argument about do world-class sprinters need a test well on that test or not? Probably not. But let's say for the sake of argument we want to get more range of motion. I've got 30 degree changes of range of motion in a single session, not by doing any static stretching, but just getting their pelvis to sit in more of a neutral orientation. They're not walking around with their hamstrings pre-stretched all the time. So when I move the lever arm from the other end, I get more range of motion now too.

And so I think just simple biomechanics stuff we just tend to forget about. And I forgot about it. I remember sitting there going, how the hell did I not learn this in how many freaking years of school I did? Nobody told me. And then as soon as he said it, I'm like, oh, that's so simple, but yet not talked about a lot.

James de Lacey45:25

Yeah, for sure. I think another area as well is the idea of obviously eccentric training as well and increasing the length-tension relationship there. So there's, I guess, multiple ways to increase mobility and flexibility that don't involve sitting there doing hours of stretching or static stretching for potentially not much benefit.

Mike T Nelson45:25

Yeah, and then people always bring up an example of, why have my athletes that stretched for 20 years and they still did well? Yeah, I think that's true. I just don't think static stretching has a huge effect, pro or con. And so you're left in this middle area of where it probably is not extremely detrimental. If you look at the research studies, performance decrements, they go away pretty fast. You got to do a pretty aggressive static stretching program to see a performance decrement in speed and power.

I don't think you're helping the structure long term by doing that. And in some cases, if you do it post-training, you may see some benefit. What are athletes doing? Chilling out, relaxing, doing some breathing, maybe getting into positions they wouldn't normally get in. I think there might be some benefit from that, but I don't think it's really from the static stretching.

I'll have them do a 90-90 position and take some deep breaths. And by all means, get more parasympathetic. But I just don't think static stretching is the fastest way to do that. Do I jump down...

Do I jump down that rabbit hole of foam rolling and the myth of breaking fascia and all that jazz? You're not doing anything to fascia. If anything, you're dehydrating the crap out of it by squeezing all the water out of it potentially. But it hurts like hell.

I'm 100% guilty of this. Early 2000s, I used to buy foam rollers for clients and send them home with them. I'm like, "Hey, come in here. Let's foam roll your IT band." "Oh God, this hurts horrible." "Perfect, keep doing it." I'd buy foam rollers and send them to them.

And over time I was like, "Hey, wait a minute. Why are they not better? Why am I doing the exact same thing and I've seen literally zero change?" Maybe not as sensitive, but movement-wise I couldn't see anything that was better. So you're definitely not changing the fascia. To change fascia is very difficult. I think you can do it over time with loading.

But we did a fresh tissue dissection with Tom Myers once. I've done it three times with him, which is amazing. You get a whole week, each person has their own cadaver with five to six people, and it's all fresh tissue so it's never been embalmed. You do all your own dissections. It's phenomenal.

So I took the IT band a couple times out of the side, dissected it away, and these are unlike generally older people who didn't really train, right? And I'm like, "I want to see how much force it takes to rip this." So I put a four-step clamp on each side. You couldn't do anything to it.

So I'm like, "Okay, so I'm going to start a cut part of the way and then I'm going to see how much force it takes to rip it." Even that, ridiculously hard to do. And if you looked at that, it was very thin, but it's pretty crazy strong.

Now I think the caveat is if you talk to people who do a lot of hands-on work, they're like, "But I've done hands-on work and I've definitely felt tissue changes." Which I've done the same thing and I would agree with 100%. But I don't think you're changing any of the fascia. You think you're putting in the input to the nervous system that allowed that tissue to relax. And so does it feel different? 100%. Can you make big differences doing that? I think you can. Did you alter the fascia in that system? I've never seen any data that you have.

Now the only caveat I would say with that is there's something called GAGs—glycosaminoglycans, I think—but this one guy calls it the fuzzy stuff. So imagine you've got two planes of fascia, like where your vastus comes over your VMO in your leg. If you take those apart, there's a big flat plane of fascia on both sides of there. And why? Because they're designed to have a little bit of movement and sliding and shear between the two.

Now could some of those areas kind of velcro, you get these little outcroppings kind of get a little bit more stuck together? Could you be breaking up some of that type of tissue? I think you possibly could. Definitely felt differences doing that. But again, are you frankly changing the fascia? Probably not.

James de Lacey50:04

I've seen some manual therapy, for example, they like if they take the skin and they pull it. Is there anything, what is that about?

Mike T Nelson50:04

So the first time I saw that I'm like, "What the hell is that? That's the dumbest thing I've ever seen in my life," right? And it was kind of an old—I originally saw it through Rolfing, through Ida Rolf, was doing what they called skin rolling techniques where you'd pick the skin up and you would try to roll it on top.

And when I was doing one of the first dissections with Tom Myers and Todd Garcia was the lead dissector, we kind of got our cadaver. And the great part is they're not embalmed, so you can do range of motion testing and everything. So we do the full range of motion testing, all down on the board. Marked the right knee. I mean, man, maybe 30% to 90, and it felt like a hard end point. It just felt like gravel. There was no going.

And we're thinking, "Ah, maybe she had a knee replacement or knee's just a mess," whatever. We don't have any history on them. So we mark range of motion down on the board.

The first thing you do is you kind of get the skin off of the cadaver so you can get to the deeper layers. I'm working on the right leg, same with the knee that didn't move well. Pull all the skin off of it. And I'm like, "Well, I'll be a good little scientist. I'm going to retest my range of motion," just thinking I'm literally doing this out of procedure.

The knee goes well past 90 degrees and I'm like, "Okay, I screwed this up. I cut something. I botched this thing really bad." I'm looking at it. I'm like, "I didn't cut any of the structures. Didn't do anything."

And so I asked Todd Garcia, I said, "Hey man, here's what I did. It moved real good now." And he goes, "Yeah, that happens." It just wanders away. Like, "What do you mean? That happens? This makes no sense to me."

So I had Tom come over and he's like, "Well, sometimes we think that the skin between the skin and the fascia, that those can get kind of stuck and that that actually becomes a limiter. Because if you think about it, all your structure, your skin is somewhat elastic but not super elastic." So the theory is that the structures are moving inside this bag of skin.

Even then I was just like, "I don't know man, that's pretty out there." I'm like, "We're going to, a couple days later, we're going to get to the knee and we're going to find that there's floaters floating around in it or something else."

So three days later, two days later, we open the knee. The knee's crystal perfect inside. I'm not an orthopedic, but there was no issues with it. It looked like brand new, perfect looking. What the hell?

And so I was asking Tom about it and he's like, "Yeah, we've seen that, not a lot, but we've seen it a few times." And so that's when he was telling me about the skin rolling technique I had seen before.

So their thought process is you're trying to get the skin to move independently of the fascial layer and that that can result in some movement changes too. So where I'll use that in athletes is like if you go down to the front part of their shin, right, so you feel on the inside the front part of your shin where the bone is real flat and there's not much tissue there. So that big area doesn't get a lot of movement and a lot of times it gets just stuck to the bone.

So a lot of times I'll do different technique or sometimes even do like a microcurrent through that area, just to try to get some more movement through it.

James de Lacey53:35

Interesting. I was wondering if they had any validity or probably if it had something to do with fascia or something like that. I might have to start trying that on myself and my wife.

Mike T Nelson53:35

I mean it's hard, right? Because it could be a structural change in athletes. It could be maybe a skin thing. It's definitely the nervous system input. It's all sorts of things go into just allowing your brain range of motion.

And how I differentiate a little bit is if, through the Carrick stuff, even just eye movements, head movements, all that stuff affects it. So to me, if you can make a very rapid change where you did minimal hands-on work or it changed super fast, odds are that was probably more of a nervous system input.

If you're doing more quote-unquote structural work, whatever that is, those probably take a little bit more time. And then I try to do more nervous system input stuff first and then more structural stuff after that.

And if you read anything from the pain people and physical therapists and other people, everybody's still arguing about, "Oh no, it's old school biomechanics and tissue changes. Those don't matter. It's all the nervous system. The nervous system controls everything." And then the old school biomechanics people are like, "No, but if the tissue is too short, that's why you're not getting your range of motion."

And the reality is it's a neuro-biomechanical model. At some point, if your right shoulder is destroyed, then that's your issue. But more often than not, it's usually the nervous system input. And the reality is it's both, right?

Without imaging or even with imaging, it's confusing. So you're left with, "I'll try nervous system stuff first. If I can get a good change of range of motion, probably was a nervous system input." Other than that, then I'm going to look at training, like you said, eccentric, other movements, daily, what position do they sit in, all these other things that we know are forming their structure on a day-by-day basis. And we're still going to work on those too, but it gives you...

James de Lacey55:59

Nice. I know I don't have too much time, so I want to jump straight into something a personal interest of mine now, and that is peptides. I know you've had people on your podcast to talk about peptides and if anyone's competing and they're drug tested, just ignore this section until you finish competing.

Mike T Nelson55:59

Yeah, for everyone else, rules, everyone else.

James de Lacey55:59

Exactly. Have you... I've got interest in it now because I've recently returned back to Austin, Texas, and there's quite a few peptide... there. So it's like, okay, this is interesting, especially with a lot of people coming out—a lot of well-respected people, too—coming out talking about the use of peptides not just for body composition but for healing injuries, things like that. So do you want to maybe dive into just maybe a little surface level thing? A couple of compounds that you quite like or have used or anything.

Mike T Nelson56:52

So peptides are these small molecules that they're in this sort of gray area of, depending on what you read, they're kind of sort of a hormone, kind of not, but they're chemical communicators. And they end up in a gray area because most of them can't really be patented, so pharmaceutical companies are not super interested in them. There's not a ton of research on a lot of them.

So I went down this rabbit hole a while ago and was looking at, like, bpc-157, because everyone and their brother all of a sudden filled my inbox and told me that this is the most amazing thing for healing and all this crazy stuff. And I'm like, "Hey, that's cool. I'll go look at the research," and most of the research is animal models. And then you realize, well, who's going to pay for it? It's not patented, so who's going to run a several thousand, potentially million-dollar trial to figure this out if they're not going to get a return on their investment?

So you're left with this interesting area where some of them definitely do appear to have specific effects, but it's hard to sort out what exactly those effects are and translating some animal models into human models. And what I do in my particular practice is I work with Dr. Ryan Green—he's out of Monarch Health. I literally just send people to him and go, "Hey, what do you think is best?" because he has way more experience with it, is way more up to date on the literature.

And the reality is you want someone who has a mixture of reading the research and a lot of clinical practice, because most of the questions that I wanted answers to, I couldn't find any research to say yay or nay. If I could, it was an animal model, so you're left with finding a good clinician can be helpful.

There has been some data reported on the peptides themselves, and sadly, 70, 80% of whatever you buy on the internet is just crap. And if you get lucky, it's just sterile water. If you don't get lucky, it's something that could cause an infection, abscess, whatever. So that's a bigger issue with it.

The FDA is still in a gray area with do they allow peptides, do they not. So manufacturers are sometimes hesitant because to get a legit facility is not cheap, and they don't want to be all of a sudden, "Hey, we just spent all this money on a legit facility, we're doing it the right way. Oh, and the FDA shut us down next month. Great, we're out however many hundreds of thousands of dollars or whatever." So there's not a huge incentive for companies to start going into the area. But it is exploding.

I have had some clients that we sent over to him that have worked with him. The most common one is usually for injury recovery. So the main ones they used was local bpc-157. Sometimes thymosin beta-4, probably at the same time, can be helpful. Again, talk to your physician, clinician. That seem to be pretty helpful.

And then for the one person who's an employee of ours also, she came in and we did a bunch of RPR movement sessions on her too, because to me, if you have an injury, then yes, if you can find a doc who can use peptides, it's within your legal whatever you're doing for your rules, great. I think it definitely can be helpful. But you have to back up and then go, well, why is that tissue irritated? What are you doing?

And that may be movement patterns, it might be something you see on their movement, and then also might be just underlying—you're back to RPR—how are they recruiting the muscle? In her case, we changed some stuff with her running because I asked her, I said, "Well, do you run with your cell phone?" She's like, "Yeah." "Is it always in your right hand?" She's like, "Yeah." "Interesting. You have outer left hip issues."

And so having her get rid of her cell phone, all of a sudden her pain started going down. And then we came here, did a bunch of RPR stuff towards the end. That made a big difference too. So I look at it as biomechanics and biochemistry. So biomechanics: can you change how you're loading that area and making sure that it's not being constantly irritated? Because if you're constantly irritating it, all the peptides in the world, they're probably not going to help you.

But if you can change that relationship, obviously you're doing the basics—you're getting good sleep, you're getting good nutrition, your stress isn't crazy, all that stuff—yeah, then I think some peptides definitely can be helpful. My bias is I think they're maybe underrated on what you read online. I think they're a little bit overhyped, but long term, I think they definitely can be useful in some cases.

So again, like everything on the internet, it's like, "Oh, it's the greatest thing ever. You just do this and it magically goes away." And yeah, you'll run into those cases for sure. But what I've seen is that it takes a little bit longer approach, usually several months. Work with someone who's qualified to give you good information and make sure you're actually getting legit product, which is a huge issue.

The good part is they're not ridiculously expensive. Some of them are more expensive than other ones. But yeah, it's a super interesting area, and I just wish there was more legitimate research in the field. But again, you're back to who's going to pay for it and who's going to do it. And I don't really have the greatest hopes we're going to see a ton of research in that area come up.

James de Lacey1:02:00

What have you with them?

Mike T Nelson1:02:00

Nothing more. I've only just been listening to podcast stuff. I want to potentially see eventually, once we settle in here a bit more, to see, go see someone here just to at least learn more about it and potentially dabble in it as well, because it sounds like promising stuff.

James de Lacey1:02:32

And I kind of view it a little bit more as a bridge. I'm not convinced that people need to be on peptides forever, but I think if you're getting through a high stress period, you're using them for injury recovery or doing everything else, then yeah, I do think they can have a lot of legit uses. And my caveat is find someone who has good experience with them and then also ask them what else are you doing.

So if you talk to Dr. Green, he's not going to just be like, "Hey, here's your peptides." He's going to be like, "Hey, what's your lifestyle like? What's your nutrition like? What are you doing for training? How's your sleep? How's your recovery?" Because all those things play into it too. It's not like you can just magically take peptides and, oh, everything is amazing now. It doesn't quite work that way.

Mike T Nelson1:03:01

If only.

James de Lacey1:03:23

I know, I know. I want to touch just before we finish on CBD, because obviously CBD and combat sports, almost anonymous in terms of how those two things come together. So I guess my question is, what is, I guess, what is the an actual use case for CBD? Is it that effective for things like sleep? To what kind of dose are you looking at? And three, how are you finding a product that isn't going to be dosed with THC where you're going to test positive?

Mike T Nelson1:03:58

So the last part, there's a ton of published research on CBD being altered or doctored. A lot of times it's for too high a THC. So if you back up and go, CBD—so CBD is cannabidiol—and under the 2018 Farm Bill, you could extract CBD from hemp. So hemp by definition has very, very low amounts of THC, less than 0.3%, but it still has some THC, and by definition you can make CBD from it. In general, it's legal in most states, and so that's where it started becoming real popular.

If you're not a real scrupulous manufacturer, yeah, oh, oops, sorry, the THC was higher than we thought. Or some products were tested for zero THC—oops, we didn't test it right, and sorry. Because you'll find lots of case reports of that too.

The downside is that all the incentives are in the wrong direction for CBD, meaning that the extraction process is not super cheap but not crazy. A lot of the cost comes into documentation, tracking, stuff like COA—certificate of analysis—testing, removing of THC, all the other stuff to make sure that you're doing it in a good and legit way.

To put green stuff in a tube doesn't really cost you that much. So unfortunately, if you're a manufacturer and you don't care that much about the quality, you can probably make a lot of money, sadly. So what I tell people is call the manufacturer. Like, any manufacturer that is doing everything the right way will be more than happy to explain to you why they're doing it, because it costs them a shitload of money to do it. And sadly, most people never ask.

I mean, I do a lot of work with Charlotte's Web and some other companies. So Charlotte's Web, for example, you can look on their box, get an app with your phone, and see the tracking for that lot number and actually pull up the COA for that specific lot number you're holding in your hand. All that costs a lot of money, but they're also a big name and they also have a lot to lose if they screw it up too. So generally, your bigger names are generally going to be better just because they have a lot of reputation to lose.

If it's Carol's CBD she made in her bathtub, who cares? Like, she'll sell enough and retire in Fiji and you'll never find her again, right? So I get a little nervous about smaller companies. Doesn't mean that they're not doing it the right way, just means that they have less incentive to do it that way.

So in terms of does it help with sleep, I'd say maybe. The research on that's pretty split. What I've noticed with people, and I've been using CBD stuff for pretty much since 2018 when it was legal, if they tend to be a higher stress kind of higher wound person, those people I've noticed anecdotally do appear to do better with CBD, usually taking it in the evening.

Again, what type of dosage for sleep tends to be pretty high—100, 200, 300 milligrams. If you look at the research, 300 milligrams is high but not crazy high. There's studies with 600 milligrams. If you look at a lot of the dosing of CBD now, it's like, oh, 20 milligrams, probably not going to do a lot for you. Maybe helps a little bit daytime alertness maybe. I'd say that's real shaky.

So higher doses are probably going to be needed. So read the dosage for the amount of CBD that's actually in there. Unfortunately, with labeling, a lot of times they'll label how much is in the entire container, which you care less about. Like, you want to know how much is in the serving. And again, what is your price point for that.

So with combat athletes, recovery maybe. There's some interesting stuff where I've done some Omega Wave testing on people, and after some hard neuro training, some people using CBD appear to do a little bit better. I don't have enough data on that to say if that's really a true trend or not.

There is some interesting data. It's generally animal data, potentially CBD being useful for people who are in impact sports, especially head impact sports. So athletes I do consult with, if they are in a head impact sport, which obviously mixed martial arts could definitely be in that category, and they can find a legit source, make sure they look at their testing, I think it'd be something to consider. If you're getting legit product, there doesn't appear to be too many downsides to it.

Again, some of the animal data: they did one study in mice where they gave one group of the mice CBD, the other group they did not. The group that had CBD, and they whacked both of them on the head to give them a TBI—so traumatic brain injury, which you can't do in humans, it's a mouse study—the group that had CBD on board, their blood-brain barrier didn't open much at all, actually. The other group, it did.

So if you take a huge whack to the head and you get an acute concussion, TBI, whatever word we're using, the two main things that happen is one, your glucose metabolism just goes completely awry, right? Your brain goes, oh, and it's just starving for energy. And because it doesn't have a lot of energy, it causes this whole downside effect of all sorts of things. At the same time, if you get hit hard enough, your blood-brain barrier can actually start to open.

So all this stuff your body was trying to filter out can now cross into your brain and then make the case of neuroinflammation even worse. So you kind of have two main things. So things that could potentially help with that, on my list of stuff that I would use personally, would be CBD. Fish oil can be helpful there.

Some very interesting data on ketones. So when I travel, when I do kiteboarding back down South Padre, again, right now I'm trying to do at least a 20-foot jump, but if that goes awry, I could get dropped out of the sky like a sack of potatoes. And I actually keep bottles of ketone esters just in case. My thought being, if that happens, I'm going to put myself into ketosis as soon as I can.

We know the ketones can cross the brain normally. We know that they're actually anti-inflammatory, and the brain can use ketones as an alternate fuel even if you get hit in the head. So there's some early human data that's being published in that area. If people are interested, I did a whole course for the Carrick Institute on the use of ketones and traumatic brain injury. They can look up the course.

The only other one that has some data would be creatine monohydrate. What dosage of creatine would you need? That's where it gets tricky. Again, if you go back to the mice studies, they did something similar to the CBD study. They gave some creatine, whacked them on the brain. Gave some other mice no creatine, then whacked them again, gave them a TBI. The creatine group did substantially better.

When they did studies, they could see that their brain was much more saturated with creatine than the non-creatine mouse group. The downside is, if you talk to researchers in that area, like Dr. Eric Rawlson, how much creatine we can get in a human brain is still up for debate, because we can't do dissections. You have to use something like MRS or something to kind of get an idea.

So we don't know how protective in humans it would be. And again, you're not going to have a nice randomized controlled trial of, "Hey, you humans, you get creatine, you don't. We're going to give you a TBI and see what happens," right? That's not going to happen anytime soon. So we know that there's not much downside to creatine.

So if they're a combat sport athlete, I tend to peg in the 10 to 20 gram per day dose, or we'll scale that up before they have like a big fight or something like that, where they know the risk of concussion is going to be a lot higher.

James de Lacey1:12:22

Nice. Well, I think we've done pretty much an hour and a half here, so I think we'll keep going. We can keep going here too, so maybe if you want to share where people can follow you with what you're doing.

Mike T Nelson1:12:22

Yeah, best place is most likely through the newsletter. If you just go to miketNelson.com, there'll be a place there where you can get on the newsletter. So I have stuff going out most every day. Again, most of it's content-based for performance, how to add muscle, not destroy your health in the process.

If they're interested in the Flex Diet Certification for nutrition and recovery, then go to FlexDiet.com. I'll be way they can get on the waitlist there. And then I do have some information that goes out on Instagram. Instagram is just Dr. Mike T. Nelson, just D-R-M-I-K-E-T-N-E-L-S-O-N.

James de Lacey1:13:20

Perfect. I'll link this up in the description anyway for everything. But thanks a lot. Thanks a lot for coming on, Mike. I really appreciate it.

Mike T Nelson1:13:20

Yeah, thank you so much for all the great questions. I really appreciate the time. Thank you so much. Cheers.