Fast Talk and the Four Fitness Foundations with Dr. Stacey Brickson

In this episode:

We’re diving into the world of off-the-bike training, and let me tell you, it’s a game-changer! This episode kicks off with a bang as we chat about the four fitness foundations that every endurance athlete needs: mobility, flexibility, stability, and strength. You heard that right—no one-trick ponies allowed here! We’ve got Dr. Stacy Brickson joining us to break down how these elements work together like a well-oiled machine to keep us from turning into creaky old bicycles. Seriously, if you think you can just pedal your way into your golden years without some solid off-the-bike action, think again! So grab your yoga mats and resistance bands, because we’re getting real about how to keep our bodies functioning at their peak and fend off those pesky age-related declines. Buckle up, folks, it’s time to get functional!

Episode Transcript

(00:00):
Foreign.
Hello and welcome to the April18, 2025 edition of the Tridock Podcast.
I'm your host, Jeff Sankoff,the tridoc, an emergency physician,
triathlete, triathlon coach,and multiple Ironman finisher coming
to you as always.
Well, actually, this time I'mnot coming to you from beautiful

(00:23):
sunny Denver, Colorado.
This time I am somewhere inthe air making my way back to Denver,
Colorado.
I have been for the last twoweeks in beautiful Indonesia on a
scuba diving vacation with mywife Sandra.
And so I am not going to bepublishing one of my usual tridog

(00:44):
podcast episodes.
Instead, I have a specialtreat for you all.
As you may or may not know, Ihave been doing a fair bit of collaborating
with my friends over at FastTalk Labs in Boulder, Colorado.
They are a group of cyclingcoaches who do a podcast called Fast
Talk and have a website thatis dedicated to coaches and cyclists

(01:05):
and even triathletes, teachingthem how to leverage nutrition and
strength training and ofcourse, bike riding in order to become
the best cyclist that they can.
Well, a couple of months ago,Fasthawk had an episode with a USA
Cycling coach and a doctor ofphysical therapy, Dr.
Stacy Brixon, and she cameonto the show to talk about the four

(01:26):
fitness foundations ofmobility, flexibility, stability
and strength.
And so I wanted to share itwith you now that I am going to be
away on vacation, give yousomething really interesting and
entertaining to listen to.
I think you will all find itto be incredibly educational and
if you enjoy it, and I knowyou will, I hope that you will go
on and have a listen to theother episodes that Fast Talk has

(01:47):
published.
I am actually featured on afew of them and I think that you
will find it to be a veryenjoyable addition to your podcast
library.
That's what I have for you.
I will be back with CoachJuliet for another episode of the
TriDoc podcast in a couple of weeks.
But for now I hope that youenjoy Trevor Connor and this episode
of the FastTalk podcast thatwas originally published in early

(02:09):
January of this year.
Hello and welcome to FastTalk, your source for the science
of endurance performance.
I'm your host, Trevor Connor,here with Coach Grant Holicke.
This It's New Year's and ifthere's one thing that marks this
day besides perhaps regretsabout how much you drank on New Year's
Eve, it's the number of peopleeverywhere who make the resolution

(02:30):
to get back into the gym asendurance athletes.
We may not love the gym.
Voiding is why some of uschose to run our bike in the first
place.
But the truth is that we needit just as much, if not more, than
everyone else.
We've talked about the valueof strength and flexibility work
in the show, but that'sactually part of the picture.
To keep our bodies functionaland performing at their best, we
need to think about four key.

(02:50):
Mobility, flexibility,stability and strength.
All four work together, and ifwe are lacking in one, we can see
our performance drop.
And worse, it can lead toinjuries, particularly for those
of us reaching a certain age.
Here to talk with us abouteach of these four foundations and
why they are so important tous is exercise physiology professor,
bike fitter, physicaltherapist, and founder of draft responsibility

(03:11):
coaching, Dr.
Stacy Brixham.
She has spent decades workingwith endurance athletes, keeping
them functional and injury free.
We'll talk with her aboutcrossover syndrome and why it's such
a concern to cyclists.
When the issue is big enoughto see an expert, then we'll dive
into each of the fourfoundations, starting with mobility
and how it is the base of thispyramid and what we're ultimately
trying to accomplish.
Then we'll talk aboutflexibility, how it contributes to

(03:33):
sarcomeregenesis, and whythere's no hard rules about static
and active stretching and yoga.
Next, we'll dive intostability and why having a good core
is so critical to avoid injury.
Finally, we'll addressstrength work and why we need both
high weight, low rep work andlow weight, high rep work.
Dr.
Brixton has been very kind tous and put together three great workout
routines that you can find inthe show notes for this episode on

(03:55):
our website.
They are routines you can doat home with minimal equipment that
are going to work all four ofthose foundations.
So take off the bike kit,throw in your gym clothes, and let's
make you fast.
Well, Dr.
Brixham, pleasure to have youon the show.
Thanks for joining us.
Thank you for having me.
I'm excited to be here.
So this is actually an episodeI'm really excited to do because

(04:16):
we have talked on the showmultiple times about work outside
of the primary endurance sport.
So I think we're going toprobably focus on cyclists today,
but we'll also talk to runnersand swimmers.
But we've said again and againand again it is really important
to get off the bike, to takethe running shoes off, get into the
gym and do this sort of work.
But, you know, we've probablytalked about a little bit about flexibility

(04:39):
here, a little bit aboutstrength there, but what we're really
going to do today, and I'mgoing to give you full Credit on
this.
You sent this fantasticoutline of kind of these four aspects
of this off the bike gym type work.
And I think this is the firstepisode where we've really gonna
pull it all together and givesuggestions to athletes of here's

(05:01):
the sort of things you shouldbe doing in the evenings, in the
mornings, when you're not onthe bike, when you're not out running,
that's going to keep youhealthy, keep you stronger.
So I'm really excited about that.
You sent a great outline.
But I think where I'd like tostart, because this really is your
expertise, is to throw thequestion to you.
Why is it so important forendurance athletes to do this stuff?

(05:23):
That's a great question.
As a cyclists myself andspeaking to your audience, a lot
of whom I know are cyclists,we do what we love.
So cycling makes us aproficient cyclist.
But if we only stay on thebike, especially in the off season,
it doesn't make us a veryplastic, resilient or durable athlete.
And I think that those threethings, plasticity, resiliency and

(05:46):
durability, is really whatgives us the health span.
So the ability to bephysically active throughout our
entire lives, not just on thebike, but off the bike.
And so I think it's importantto convey that to your athlete, to
incentivize them, to give thema reason to get off of their beloved
machine in the off season orat least add a few other components

(06:11):
to their beloved machine inthe off season.
I think that's a great point.
I think the thing that I loveabout this is we've talked about
it a little bit with nutrition.
Right.
Trevor?
This idea of what we do on thebike isn't necessarily the best thing
for us in the big picture ofour health and our lifespan.
And you know, what we do onthe bike, yeah, it's good for us,

(06:31):
it makes us healthy, but itprobably doesn't make us the most
well rounded human.
We weren't evolved to get on a bike.
So I really love where you're taking.
Us and I actually want toshare a story of how important this
can be.
Even if you're just, you'refocused on how well can I perform
on the bike.
I mentioned this in a previousepisode that I was getting ready
for my big race, the Tour ofTobago, and I went in for a bike

(06:55):
fit.
And the fitter, Ryan Ignatz,who was on the show not all that
long ago, he took a look at meon the bike and just went, your glutes
aren't firing at all.
And said, You've got to belosing a ton of power.
And yeah, I'd noticed that itwas pretty extreme in the last year,
year and a half, you know, myFTP, my threshold power has probably
dropped 40, 50 watts.

(07:16):
And I was blaming on otherthings, but he was like, if your
glutes aren't firing, you'renot pulling into your best muscle
to work the bike.
So that's probably whereyou're losing a lot of your power.
So that had an impact.
He fit me on the bike.
But then in the off season, Ialways go out running and this year
running, I'm getting all thiscalf pain, I'm having all these issues
with my running, I'm really slow.

(07:36):
So again, I went to see anexpert on this and described it and
she went, well, that's whathappens if your glutes aren't working.
Because, you know, if yourglutes aren't doing the primary movement,
you tend to rely on yourcalves and then you're going to get
really sore.
So you're just seeing this.
I have lost this particularfunction that if I had been more
prudent about that off thebike work, about getting in the gym,
doing this sort of stuff,might have been able to tell a very

(08:00):
different story.
And Stacy, I'm sure you seethis sort of thing all the time.
Yeah, Trevor, that is a reallycommon occurrence among cyclists.
So as you know, when you're ina posture like cycling chronically,
so hours and hours and hoursupon the bike, we adapt to that position.
So in a typical cyclingposition, and I know typical is different

(08:21):
for a triathlete than it is acyclocross, but in general, our cycling
posture creates a shorteningof tissues in one plane and a lengthening
of tissues in the other.
So, for example, there's thisphenomena called the crossover syndrome.
So back to your glutes.
You can imagine if you're on abike and your hip flexors, or I should

(08:41):
say your hip joint is in thisacute position, it's natural for
your hip flexors to shorten,to adapt to that position.
So when you're pedaling andthere's an acute angle at your hip,
the hip flexors see that andthey think, well, we should adapt.
We should be more proficientin this shortened range.
And so they actually losesomething called sarcomeres, or the

(09:03):
functional unit of muscle.
And so they become really goodin the shortened position.
Well, that seems like a great idea.
But what that does then is theopposite muscle of that, the glute
go, hey, we're Lengthened, wedon't like it here.
The cross bridges, the actinand myosin, the little, not so little,
but the important protein thatallow contraction.

(09:26):
Now they're lengthened,they're like, well, what the heck?
So they stop firing.
And then from there, whathappens is that the pelvis becomes
more anteriorly tilted becausethese hip flexors are shortened,
the glutes can't oppose.
And now that sets you up forknee pain, foot and ankle issues,
because if you lose thatstability from which to move, the

(09:51):
sequela is that those forcesbecome abnormal below the chain and
above the chain.
Above the chain.
But because we're bipeds, thatdoesn't become quite an issue unless
you're a swimmer.
So that is very common to seethe weak glute and then knee pain,
ankle pain, tight Achilles forrunners, beyond that.
So, yeah, chronic position isgoing to lead to crossover syndrome,

(10:12):
which, again, is just adaptiveshortening on one side and stretch
weakness on the other side.
Yep.
Which.
So the expert who I'm going tosee who's helping with this, she
tried stretching my hipflexors and just started laughing.
I was so tight.
So that makes sense.
So, yes, you know, cycling inparticular is a very imbalanced sport.

(10:35):
So what are the sort of commonissues that you see with people who
just ride the bike and don'tkeep their bodies in balance?
And I just described one thatunfortunately, I used to be really
good about keeping this in balance.
I haven't been doing as muchoff the bike work as I should be,
so I'm a prime example of whatcan happen.
But what are other things thatcyclists see?
Right.
So we just talked about thefirst one, this, you know, crossover

(10:58):
syndrome of the lowerextremity that also happens in the
upper extremity.
Cyclists don't complain aboutit as much on the bike, but off the
bike, they notice it.
So we tend to have reallytight pecs, upper trap levator, scapulae,
so they lead to this sort ofkyphotic posture.
So real rounded shoulders anda forward head is what his grant

(11:19):
straightens up is what thatlooks like.
And that's problematic off thebike as well as on the bike.
But, you know, people may haveneck pain, they may have some shoulder
instability because theirscapula or their shoulder blades
are now protracted or rounded,and so they're unable to perform
their upper extremity motionsfrom that unstable base.

(11:40):
I think the other thing thatwe don't pay as much attention to
as we should are the feet.
So, you know, feet aren'tmeant to bike.
They just weren't designed tobe locked into a shoe that is locked
into a pedal.
So normally when we're walkingor running, we have this natural
movement of the foot, which iscalled supination to pronation.

(12:03):
Back to supination, right?
This rigid lever to this veryaccommodating position.
Back to a rigid lever.
On the bicycle, we stay prettymuch in a pronated position.
And when we do that, we reallylose the strength of our foot.
Intrinsic muscles, we flattenour arch, we compress the neurovascular
structures through the foot.
That's what hot feet are, hotspots.

(12:25):
And so I think that over time,the feet become fairly problematic
and that we should off thebike, pay more attention to those
structures and give them theattention they deserve.
Well, I think one of thethings that's really interesting
that you brought up shoulderand upper body position is the rest
of our lives don't tend tohelp that very much either.
We're at a desk or on a computer.

(12:46):
We're driving in a car.
All these things that we'redoing take us away from that good
posture that our bodies arecreated to have, walking or running.
And so everything starts tocave forward and you bring up shoulder
instability.
I mean, you see how manypeople have we talked to as they
get older?

(13:06):
Like, I don't know, I wasreaching behind me in my car and
I hurt my shoulder.
You know, these little thingsbecause that we're just not taking
care of ourselves.
And everything we do piles onand exacerbates the pain or exacerbates
the weakness or the instability.
I was just going to say that'sa really good point.
You know, with computers andthe like, our posture has gotten
worse.
And I would point out that thebike is one of the only sports that

(13:29):
I can think of that reallyexacerbates that poor posture.
So if you're playing soccer orbasketball or running or swimming
or rowing or cross countryskiing, there is a need to really
open up the chest and stay functional.
Cycling is the one sport I canthink of that absolutely condemns
that good posture because of aerodynamics.

(13:51):
It's horrible for function offthe bike.
Well, I still remember talkingto Dr.
Andy Pruitt and he just said,if I'm walking down the street, I
can point out the cyclistslike, the kyphosis that you see is
incredible.
They're all just kind ofhunched over.
You can tell.
Yeah.
Well, there's other reasonsyou can tell.
Tan lines, skinny arms.

(14:15):
I think you're right.
I think the Kyphosis sticksout, too.
Yeah.
The tan lines.
I was just down in Tobago inthe sun, and I'm watching all these
guys sitting there on thebench making sure the pant legs line
up perfectly.
They want that tan line.
Oh, yeah.
And they gotta cultivate it.
Right.
It's a badge of honor.
It is a badge of honor, exactly.

(14:36):
I would like to point out oneother thing that you particularly
see in cyclists that's less soin runners, which is there is no
eccentric activity in cycling.
And I'm a big believer thatyou need that eccentric work work
to, for lack of a better term,build some resilience, build some
durability in the muscle.
And I think cyclists lose thatif they aren't doing eccentric work

(14:58):
off the bike.
Stacey, would you agree?
Yeah, I would agree.
I mean, we're all aware ofthis, but some of the downsides of
cycling are that it's notweight bearing.
So bone health is one thing,but as you said, Trevor, there's
virtually no eccentric loadingof the upper extremities, some just
holding our posture, butvirtually none of the lower extremities.
And eccentric strengtheninggenerates much greater force than

(15:22):
concentric.
So in a way, I don't know,it's fair to say that we're losing
strength, but we certainlyaren't gaining strength or the tensile
strength of the tendonstructures that we get with impact
and eccentric loading.
We also lose our balance.
I mean, you have to balance ontwo wheels.
But there is a.

(15:43):
I think it's called thegyroscopic effect, which is making
me sound smarter than I am,because I really don't know what
that is.
But there's something aboutthe spinning that keeps us on the
bus bike that we don't haveoff the bike.
And so it's really easy for usto lose our balance.
So I think those are the threecritical flaws in cycling from a
healthy person standpoint,from a health span standpoint.

(16:06):
So I think we've covered someof the things that you see in endurance
athletes if all they're doingis their sport.
And I'm really excited to getinto what you can do to help these
things to keep yourselfbalance, to keep yourself healthy,
and actually to keep yourselfstronger in your sport.
But I do think we just need totake a couple minutes before we get
there and say there are issuesthat you have where you need to go

(16:29):
and see an expert.
And, Stacy, I just want to askyou, what are the signs where somebody
you know in an enduranceathlete where you say, this isn't
Just take the routine.
We're actually going to giveyou some routines that we're going
to put on the website to givea try.
But what are the signs of?
Those aren't enough.
You need to go see a pt.
You need to go see an expertand get some help here.

(16:51):
Yeah, I might answer that alittle bit differently.
Not so far as the signs, but Ithink that it's really important
to know the cause, theunderlying root cause of what, what
is responsible for yoursymptoms or the complaints that the
cyclist has.
Because if you don't know theunderlying etiology, you're just
taking a whack a mole approach.

(17:12):
Right.
You may be having someoneaddress the IT ban with soft tissue
mobilization.
You might see a massagetherapist or a provider of your choice,
or you may be seeing aphysical therapist for knee pain,
but you're missing imagingthat tells you that you have a meniscus
tear.
Right.
So I think that the answer toyour question, I'm going to just
pose it a little differently,is to have a really good understanding

(17:36):
of what is causing the symptom.
And so to help you figure outthat biomechanical puzzle, where
to start, Obviously at the topof the food chain is a sports medicine
physician, not necessarily anorthopedic surge surgeon, but a physician
who has training a one yearfellowship in sports medicine because
they can order diagnostictests, an X ray or an mri, or they

(17:56):
can order a blood panel sothat you're not taking a whack a
mole approach.
You know, right from the startwhat you're dealing with from there.
I, I think a physicaltherapist is a reasonable next stop.
And you know, all PTs aretrained to be generalists and beyond
that you specialize.
And so I would seek someonewho is, got some experience in sports

(18:17):
medicine.
But I will tell you, as a pt,bike training is a whole nother thing.
We never once talked about thebike in physical therapy school,
not once.
And I'm sure that they do now.
The profession has evolved,but it's important to find a PT that
knows how the body's machineinterfaces with the bike machine,

(18:38):
because again, cycling is aunique sport where those two machines
come together and are reallylocked together.
And so physical therapiststhat really understand that interaction
is important.
So those are the two places Imight start.
It's really interesting whatyou're saying, because I think this
is a big thing I've seen incoaching for a long time with physical

(18:58):
ailments is we tend to betreating the symptoms of the real
problem.
Right.
And if we can get to the rootof the real problem, then we're not
just treating the symptoms.
Now we're treating the real problem.
Like, I have a reallydestroyed shoulder from swimming
and baseball and water polo inyears of that.
So I ride protecting thatshoulder, which kicks my body to

(19:19):
one side, which puts pressureon my left hip, which fails my right
hip.
So, like, how do I go downthat chain and deal with and treat
the cause of all of thatinstead of just, as you're saying,
playing whack a mole with abunch of symptoms?
So I'll give an example.
Let's say I'm seeing somebodywith knee pain.
It might be that that kneepain is caused by some osteoarthritis,

(19:42):
that there's actual changes inthat patellofemoral joint.
Well, my solution or thesolution for the athlete might be
shorter cranks.
And certainly we'll do someother interventions.
But that is going to make thebiggest difference because I'm not
going to be able to change thejoint surface quality with anything
that I can do.
But let's say that that sameperson with knee pain, the origin
is a weak glute.

(20:02):
Back to Trevor's story at the beginning.
Well, that's different.
I don't need short cranks.
Now I'm really doingfunctional strength training because
that glute isn't really weak,it's weak while cycling.
Right.
There's two different thingsthere, a true weakness or a functional
weakness.
So I'm going to do what I callfunctional training to remind that

(20:23):
glute how to fire to opposethose tight hip flexors.
Or we may find out that theglutes firing.
There's no osteoarthriticchanges at the knee joint itself,
but this particular cyclisthas a really tight iliotibial band.
Well, in isolation, nothingelse going on.
So now I might focus my inner mention.

(20:44):
It's some really good softtissue mobilization for the IT band.
Or maybe I look at theircleats and I figured out they haven't
changed them in a couple ofyears and I put new cleats on and
their knee pain goes away.
So I think that my point isyou really have to find somebody
whether that's a sportsmedicine physician, whether it's
a pt, whether it's your coach.

(21:04):
Coaches are better sometimesthan anybody at analyzing movement
and figuring out the sourcerather than whack a molecule.
The last thing I want to addto all this for any of our listeners
who are saying, well, you'rekind of talking to professional athletes
here.
This doesn't really apply to me.
I'm actually going to flipthat around and say this is almost

(21:25):
more important to the peoplewho are just looking to be lifelong
athletes.
You know, I'm 53.
I'm now getting veryinterested in healthy aging.
And I see so many of myfriends that are having issues and
just going, well, that'snatural aging.
This stuff should be happeningin your 50s.
We should all expect this.
And I just want to emphasize,no, that's not the case at all.

(21:46):
And these are the sort ofthings that if you can stay ahead
of them, you can prevent a lotof what we think of as natural aging.
And an example.
Sorry to throw my father underthe bus here, but to give you an
example, my dad was a greatathlete, but he was very much the
old mindset of, you just doyour sport.
You don't do any of this.
Get in the weight room, dofunctional work.

(22:06):
I actually tried to give him afunctional routine, and he did it
for a week and then said no.
And I went, why aren't youdoing this, dad?
And he goes, well, it doesn't hurt.
It's not hard because I wasgiving him all just body weight stuff.
He goes, I don't see thebenefit of this.
So he just refused.
But, you know, as much as I'mkind of making fun of myself for
my glutes aren't firing andI'm having that issue, that's a relatively

(22:26):
minor issue compared to thefact that I look at my dad when he
was 53, he had already had aknee replacement and a shoulder replacement.
And that's something.
I'm not even talking to peopleabout that stuff because I have spent
my life doing a lot offunctional work.
My joints are still in apretty good place.
So that's why this is important.
This is going to help you agea lot better.

(22:50):
I would echo that comment, Trevor.
I mean, I see in my physicaltherapy career less than 2% of the
patients that I see areprofessional athletes, probably less
than 1%.
So this is for all of thepopulation, not just the elites.
And by the way, I wouldidentify an elite athlete as anybody
who wants to move.

(23:10):
Not just Olympians or WorldChampionships, anybody who moves
as an athlete.
And so my job is to protectthe health span of people just getting
to the grocery store andreaching into a cupboard and picking
up their grandbabies, not justwinning a cyclocross event or a big
cycling event.
So, absolutely.

(23:31):
You know, when you first startout in your career.
I graduated from PT schoolwhen it was Still a bachelor.
So I was all of 22 years oldand I remember seeing some really
high level athletes, BirkeBiner, cross country, ski racers,
triathletes.
And they were old to me.
My gosh, they were 40, theywere 50.
I mean, you know, as a sassy22 year old, that seemed forever.

(23:53):
And I wish I could go back andapologize to those patients because
I just assumed that they wereold and that's why they were dysfunctional.
And the other thing that Iwish I would have done is paid more
attention to what kept thosepeople going, because that's where
the art of functional training lies.

(24:14):
It's not just doing yoursport, it's preparing your tissue
in all three planes to staypliable, durable and resilient.
The one thing that I think isreally, I wrote it down because,
you know, I was listening toTrevor earlier and he was talking
about what's not working andI'm talking about what's not working
and I almost.

(24:35):
And what my note was, is thisage or is this just we're not doing
what we need to do off thebike to stay in a place where we
can be in a healthy healthspan when we're getting older.
And to me, as I get busy, youknow, we're off mic earlier and I'm
talking about my day and as weget busy, where do I put this in?

(24:58):
Right?
And I think that's what getsso hard as the athlete gets older.
Our responsibilities go up.
What we need to do gets up,goes up and where we're going to
fit this, it just doesn't work anymore.
And then if we get to thatpoint where maybe we do have the
time to do it now we're olderand we haven't done it for 20 years
and now trying to get backinto it, it's just not something

(25:18):
that feels very good.
So I mean, to me, so much ofthis question is, are we really,
you know, and this is to yourpoint, Stacy, the, the functionality
of what we're doing is thisage that's causing these deficiencies
or is this, we're not doingthe work off the bike that's causing
these deficiencies.
I would obviously lean to ladder.

(25:39):
It's both.
I used to, I used to tell mystudents, don't tell me it's both.
I don't want to hear that it's both.
It's not Grant.
It depends.
Right?
It depends.
It depends.
I used to tell my students, ifthere's a question on an exam about
age and it's multiple choice,look for the answer that says worse,

(26:00):
because that's going to be it.
So.
So nothing mechanicallyimproves with age.
And I think that shouldn't beoverwhelming and negative.
It should give your athletesincentive to get better.
Even though getting betterafter 40 looks like staying the same,
and I think that's a key thingto educate your athlete on, is you

(26:24):
are getting better by doingthese things off the bike, you're
warding off to some extent theravages of age.
And in doing so, you'restaying the same.
If you didn't do these things,you would be getting worse.
So.
Right.
My favorite point is when amaster's athlete once told me they

(26:44):
were in their late 40s, early50s, and they said, My FTP hasn't
gone up in five years.
And I said, has it gone down?
They said, no.
I was like, you're doing incredible.
I don't know how to tell youthis, but you're doing great.
Well, look, I'll give you anexample and what I would say, my
answer to your question,Grant, is it's not inevitable, but

(27:05):
as we age, the body becomesless forgiving.
And you know, the example I'mgoing to give you, people who have
been listening to our showsince the start know that back 2018,
2019, I had a real back problem.
My back was going out everycouple months and, you know, we talked
about it a bit on the show andyou think, you know, that's five,
six years ago now, my backshould be worse.

(27:27):
I put the work into seeing abunch of people to find out what's
the routine, what can I do tohelp my back.
And I have found a really good routine.
And I have just simply said,yeah, I'm a busy person with a busy
job, but I'm just going to getup 20 minutes earlier every morning
and I go down to the weightroom in my basement.
I have a 12 minute routinethat is designed to protect my back

(27:51):
and I do it probably fivetimes a week and my back hasn't gone
out in over two years.
But if I stop that routine, ifI go a couple weeks without routine,
my back starts grumbling.
I know it's just something Ihave to keep up.
You brought up two key points,really essential.
One is routine.
So if you're doing somethingand it's not part of your routine,

(28:12):
you're likely not to do it.
And athletes know this, right?
They make training part oftheir routine.
So it's just a matter ofputting these things off the bike
into their routine.
And the second thing is tokeep Them brief.
When I first started as aphysical therapist, I thought it
was my job to give the patientevery single exercise that could

(28:34):
potentially benefit them.
And the compliance washorrible because if you give someone
10 things to do and they dotwo, they feel like they failed and
so then they do none.
But if you give them two andthey succeed, they're gonna come
back and say, can I do more?
Is there a third or a fourth?

(28:54):
And you might end up gettingthat patient.
Just like you said, Trevor,it's a 12 minute routine.
I bet there's not more thanfour or five key exercises in that
routine.
And so less is more.
And putting it into a routineis crucial.
I would say it's a sevenexercise routine, but there are three
that are crucial.
So if I have very little time,I go down, do those three exercises,

(29:17):
it's five, five minutes.
And that was a trick, figuringout the exercises that have the biggest
impact, because as you said, Ididn't want a 25 exercise routine.
I know my compliance would getreally bad.
So, Stacy, you sent to us alist that was absolutely fantastic
of kind of the four categoriesof functional work, or off the bike

(29:37):
work, whatever you want tocall it.
So I think we're going to diveinto each of these, but let's first
just give us, please, a quickoverview of the four.
It's mobility, flexibility,stability, and strength.
What do you mean by each of those?
Yeah, well, first off, I don'tget to take credit for that brilliant
outline.
That's movement hierarchy thatsomeone else thought of and described.

(29:59):
I'm just repeating it.
So those are sort of thepillars of movement in a hierarchical
sense.
So we think about this as a hierarchy.
Mobility is the base of thepyramid, and mobility is, is freely
and fluidly moving through afunctional range of motion.
And we'll come back tomobility because it's also the apex

(30:21):
of the hierarchy.
Flexibility is really onecomponent of mobility.
And flexibility is justdefined as the ability of the muscle,
the tendon and the ligament,so both connective tissue and contractile
tissue to lengthen passivelyor to stretch throughout that range
of motion.

(30:41):
And then we move on to stability.
And that's really an anchor.
It's the steady foundation ofour pelvis, our lumbar region and
our hip.
So the lumbo pelvic hip regionand that stable foundation or that
steady foundation, that anchorthen allows movement.
So again, we're back to mobility.

(31:02):
And in order to have mobilityon stability, you need strength.
So strength is just the forcethat can be produced and transferred
and Then again, because it's apyramid, we come back to the apex,
and that's mobility.
So now we have this stable structure.
We've got strength, and we canmove fluidly through a functional

(31:23):
range of motion.
I love that description.
I particularly love thatdescription because it shows that
you need all four of these.
They really need to work in conjunction.
And if you only ever work onone without the others, you can get
yourself in trouble.
I always love.
I forget the guests on theshow, we were talking about flexibility,
and they said, well, if allyou ever do is flexibility without

(31:43):
the strength and stabilitywork, you just get a floppy muscle
and you're going to get injured.
I love that term.
Floppy muscle.
Floppy, yeah.
Just thinking floppy.
I was thinking of a toddler.
And that's really a perfectexample of mobility.
At the base of this movementpyramid, they have incredible range
of motion, so they've gotmobility with that regardless, and
they've got flexibility, butthey don't have the stability or

(32:07):
the strength.
So once they acquirestability, they can crawl.
Once they acquire strength,then they can walk.
And once they acquire skill tobring all of those together, then
they can run.
So, Stacy, that was a greatexplanation of the four.
Let's dive into them now, andlet's start with.
Tell us more about mobility.
Mobility, by definition, Ithink of it as the three Fs.

(32:30):
It's freely moving, fluidlymoving through a functional range
of motion.
So free, fluid, functionalmovement through range of motion.
And by range of motion, wejust mean degrees, right?
So your.
Your knee has maybe 140degrees, and your elbow has maybe
130.
So that's what we mean byrange of motion.
It's described by the jointgeometry, and that's the base of

(32:53):
the foundation, but it's alsothe apex.
So we'll come back to mobility.
So that's sort of the piecesof the pyramid.
And as you think about that,Pyram said it's helpful to think
about it as a chain.
So each joint being a link inthat kinetic or chain of movement.
And so if you lack mobility atone of those segments, it's gonna

(33:15):
most definitely cause problemsat an adjacent segment.
It might be above, it might be below.
So, Trevor, you'd notice thatyour glute was weak and you'd ended
up with Achilles issues.
That's an example of failureof one segment in that kinetic chain.
And because of that, the loadwas distributed somewhere else, and

(33:37):
that joint, the ankle joint inthis case, had to take up that extra
work, and it couldn't handle it.
It was overloaded.
So mobility is really the baseof the hierarchy.
Every single segment has to beable to move or there will most likely
be problems at other segments.
So that's the first one.

(33:58):
So let's shift to flexibilitybecause anybody who's interested.
Episode 97, Going Back a bit,we had Menachem Brody on the show
and he was pretty negativetowards flexibility, saying endurance
athletes, this might besomething you want to rethink.
And I've seen research thatsays this actually hurts performance.

(34:19):
I've seen research that saysit helps.
I actually was looking at astudy last night that talked about.
And I know, Stacy, you'regoing to love this, talked about
viscoelastic changes becausethis is your area of expertise that
could potentially help performance.
So where do you stand on this?
Is this a good thing?
Is it a bad thing?

(34:39):
What are the dangers, what arethe advantages and how should we
approach it?
It's a really hot topic.
It has been through my entirecareer and I loathe that.
Your listeners love the answer.
It depends.
And so I'll just start withthat one to satiate them all.
Yeah, exactly.

(35:00):
So when we think aboutflexibility, it is one component
of mobility.
So going back to ourdiscussion about the mobility exercise
where we swing our leg forwardand touch it with the opposite hand,
think about the extensibilityof the hamstring throughout that
exercise.
If we don't have thatextensibility of that tissue, we

(35:22):
aren't going to be able tohave mobility through the hip and
knee to achieve that.
Right.
If we don't have adequateextensibility of the hamstring, we're
going to have a reallydifficult time posturing on the bike.
If we don't have that lengthand we want to get aero, what we're
going to do is flex from our spine.
If we can't anteriorly rotatefrom our hip because our hamstrings

(35:45):
don't have that extensibility.
So I do think it is important.
Do you need to be Gumby?
No, that's more of yourgenetic predisposition.
That's going to come from yourDNA's prescription for the type of
collagen that you have.
You know, and we're not goingto change that with stretching.
We're not going to change theinherent nature of your tissue.

(36:05):
There's a reason that we self select.
A gymnast probably isn't goingto become a cyclist.
A cyclist probably isn't goingto become a gymnast.
So there's some inherentflexibility characteristics that
we can't alter.
But I do think that there's arole for flexibility, at least short
term response to stretching,like you said, that deals with the

(36:27):
viscoelastic properties of muscle.
So all I mean by that is thatmuscle is like silly putty, right?
It has an elastic component,you pull it and it comes back.
But silly putty also has aviscous component.
So by stretching, if you arepulling on that silly putty and you
are holding it at a certainlength, there's going to be a relaxation

(36:52):
of the amount of stress of theforce that that tissue sees.
That's a good thing.
That happens in a region ofthe stress strain curve where we
function, okay.
Called the toe region.
And we don't need to get into that.
Likewise, that tissue is goingto also creep.
So if we put a stress on thattissue, it's going to slowly lengthen

(37:12):
over time or that silly puttyis going to get longer.
Okay?
So those are two properties,stress relaxation and creep, that
are important to our tissue.
I don't know necessarily thatthey prevent injury.
There's not data to suggestthat stretching prevents injury,
or at least there'sconflicting data.
But I do think it helps usmove more fluidly through the range

(37:34):
of motion that we are askingour bodies to move through.
It makes that more comfortable.
There is an analgesic effectof stretching called stretch tolerance
so that our bodies are morehappy to move through that.
And this is a silly analogy,but it makes sense to most people.
Your bladder has a stretchreceptor, right?
And for people that use thebathroom all the time, they feel

(37:55):
like they have to pee all the time.
And if you can get yourbladder a little bit more full, you
become a little bit moretolerant to that.
A little bit more stretchtolerant doesn't mean that you overfill
your bladder, that you don'tknow to pee.
It just means you're a littlebit more comfortable with a semi
full bladder.
And I like to think about thatas a stretching analogy is that the

(38:19):
tissue isn't going to overstretch and get injured.
It's just that within thecapacity that it needs to, it's a
little bit more comfortable.
High performance isn't justabout race smarts.
It's about managing energy.
Talk with me, Jared Berg andwe can create a personalized sports
nutrition plan to help youtrain and race.
I'm a registered dietitian andan exercise physiologist.

(38:41):
Let's meet, meet up to solveproblems like GI issues, bonking
or to fine tune your sports nutrition.
Learn more about sportsnutrition and see how we can [e-mail]
just look for athlete services.
So a couple things you'vetouched on that I find really interesting
is one, the fact that themuscle tissue itself, so if you disconnect

(39:02):
it from the tendons on eitherend, you take off the fascia.
It is silly pumpkin.
It is highly pliable.
So it's not really the musclethat you're stretching.
But another thing that youmentioned briefly earlier in the
show that I want to ask alittle more about, and let's see
if I can pronounce this term.
It does seem in the research,one of the things that you get from

(39:23):
stretching is what's called sarcomerogenesis.
I just butchered that because,yeah, that's a tough term.
But the idea is when youstretch, I don't want to go too much
into the physiology, but youhave sarcomeres in your muscles.
That's where the contraction happens.
So the more sarcomeres youhave, effectively the stronger the
muscle's going to be.

(39:44):
And stretching can cause yourmuscles to develop more sarcomeres.
So can you talk a little bitmore about both the importance of
the connective tissue and thatpotential adaptation to stretching?
Yeah, and you didn't butcherit at all.
Sarcomerogenesis, you nailed it.
So as far as.
Yeah, as far as stretching,you certainly do.

(40:05):
Well, I'll back up.
When I first startedprescribing stretching, I thought,
and I told patients that wewere stretching muscle.
And later in my development, Irealized that that was sort of a
misnomer.
The muscle is certainly stretching.
So I do a lot of single fiberwork under a microscope.

(40:25):
So you strip all of theconnective tissue off and you do
experiments on just the muscle tissue.
And certainly you can get itto stretch.
But.
But when you stretch a muscle,the units of the sarcomere that are
contracting, they lose theirability to optimally contract.
So you're really not wantingto stretch the muscle per se, you're
wanting to stretch theconnective tissue.

(40:46):
And there's connective tissuearound each muscle, fiber around
each muscle bundle, and aroundeach muscle.
So three layers of connective tissue.
And then you have the tendon,which is also a form of connective
tissue.
And so we're stretching.
We're really stretching theconnective tissue, not.
Not necessarily the muscle per se.
So that is a good point.

(41:06):
And like we talked aboutbefore, that tendon structure and
that connective tissuestructure is viscoelastic.
So time under tension, slowstretching, long holds, is optimal
to address those viscoelastic properties.
So the sarcomeurogenesis, ifwe can go back to your glute example,
when you're sitting on a bikeor any chronic posture for a long

(41:27):
period of time, Tissue on oneside shortens, hip flexor.
Tissue on the opposite sidebecomes stretch weak.
So just like we talked about,the hip flexor needs to be optimal
in that shortened position.
So we lose sarcomeres, thefunctional unit of muscle.
And so the actin and myosinare optimized that they can find

(41:48):
each other for contraction.
Well, the glute on the otherside is stretched, and so the actin
and myosin can't find each other.
And so what the glute says is,ah, let's have some sarcomerogenesis.
Instead of taking away thosesarcomeres on the front side of the
hip flexor, we're going to addthem on the posterior side.
And now, because we have moresarcomeres through stretching, that

(42:11):
muscle effectively got longerand those contractile proteins can
find each other again.
So when we stretch or when wework eccentrically, which is a different
kind of stretch, that's a cellsignal to add sarcomeres.
In series, oursarcomerogenesis building of the
genesis, the creation of new sarcomeres.

(42:33):
So let's switch to a bit ofthe practical side of this.
When somebody wants to workflexibility, what is your recommended
approach to this?
Like, how do you feel aboutstatic versus dynamic stretching?
How do you feel about thingslike yoga, Pilates?
What do you feel are the bestapproaches to build flexibility in
a healthy way?

(42:54):
Oh, I have so many feelings on that.
Good to start.
Kind of to go back to yourprevious convincing concern about
stretching being detrimental,Static stretching is really where
most of that research comes from.
And there is evidence thatstretching in almost all forms of
muscular performance, forcegeneration, power output, vertical

(43:14):
jump, sprinting, iscompromised with static stretching.
And the idea there issomething called hysteresis, another
big word.
And that just means loss ofenergy through heat.
So if you take a spring andyou stretch it, hysteresis would
say that the energy to comeback in that spring is somewhat lost.

(43:35):
So there is valid research on that.
And so I'm not advocating thatpeople do static stretching.
And static just means, youknow, passive.
The muscle's not contracting,you're just trying to lengthen through
it.
Yeah, that's probably not thebest thing to do before you go do
a track sprint or a high jump.

(43:55):
But that's not to say thatstretching is bad.
It's just that that mode ofstretching prior to high power output
isn't the best idea as Far asleading to injury, it's not stretching
itself, it's hypermobility.
So if you have a joint, let'ssay you're a gymnast or a swimmer,
and you've got a lot ofmobility in that joint and a lot

(44:18):
of flexibility, becausesomeone like a swimmer or a baseball
pitcher or a gymnast has takenthat joint through almost extreme
range of motions repetitively.
The passive structures, theydon't need to be stretched any further.
So if you attempt to do that,yes, you may injure that joint.
So hypermobility orstretching, whereby the joint is

(44:39):
beyond its normal range ofmotion, can be detrimental.
But the converse of that is,if you have somebody who has limited
flexibility, they can't putthat joint through its normal excursion
because the connective tissueis not very extensible.
That's going to create several problems.
One, your nature's WD40, whichwe call the synovial fluid in the

(45:04):
joint.
If you can't move freelybecause of your lack of flexibility,
you don't get that shot of WD40.
That's not a good thing.
So you're hindering that jointhealth because you haven't created
milieu that allows it to movethrough its full excursion.
And as we talked about before,now you've got limited mobility at

(45:26):
one joint.
What do you think happens atthe joint above or below?
So if you have a hamstringmuscle that is not adequately extensible,
it does not allow mobility,passive mobility, in other words,
flexibility.
And you're sitting on the bikeand you're trying to get aero, you're
going to get that from yourlumbar spine because you can get

(45:46):
it from the hip because thathamstring is pulling so tightly.
And so now you create asituation where lack of mobility
at the ham, at the jointcontrolled by the hamstring creates
stress or strain on the low back.
So I think that it's reallydifficult to just be in one camp
and say flexibility is bad.

(46:08):
Well, yeah, it's bad.
If you do a long staticstretch before a power lift.
I don't think you can just sayit's good either.
You can't give flexibilityexercises to a shoulder of a swimmer
that's hypermobile.
So I think you really need todefine why it is and what it is that
you're trying to make flexible.

(46:29):
And in my world, I'm givingflexibility exercises where I think
it improves mobility.
Hey, Trevor, it depends.
You were just waiting.
It always depends.
Oh, it just depends.
I've been waiting the wholetime she was saying, saying that
to Just chime in and go, hey,Trevor, it depends.
Grant's favorite term.

(46:50):
There we go.
Yes.
So, last question.
On the flexibility side, howdo you feel about things like yoga
and Pilates?
I have changed my view on yogaand I can't really speak to Pilates
because I've never done it.
I initially really didn'tunderstand yoga, and most things
we don't understand, we'refearful of, so we don't like them.

(47:12):
And that's where I started.
I think that when you goingback to our discussion about what
it is that you're actuallystretching, when you realize that
it's the connective tissuemore so than the contractile tissue,
you realize the connectivetissue isn't in one plane.
Right.
So if you're stretching yourhamstring, I was taught as a PT to

(47:33):
flex at the hip and extend atthe knee.
So you're pulling that tissueover both joint ranges in the sagittal
plan.
But that's so silly becausethat fascia works in a transverse
plane, in the frontal planeand in the sagittal plane.
So things like yoga addressstretching of the tissue in a multiplanar

(47:54):
capacity, which is exactlywhat we need to do.
You can modify your hamstringstretch to be triplanar, but we don't
usually do it that way.
So I like yoga for thatreason, and it depends if I have
an isolated muscle that hasbeen injured and I know that it has
a chunk of non contractilescar tissue in the middle of the

(48:16):
muscle, absolutely.
I'm going to stretch thatmuscle in a uniplanar way to get
at the orientation that's most restricted.
But in general, a triplanarglobal stretch is better.
So that's my feeling on yoga.
It's terrific for sort of aneverything approach.
But don't forget to isolate ifyou have a specific need at a specific

(48:40):
joint for a specific tissue.
So we're going to move over todisability, but before we move there,
I just want to let everybodyknow Dr.
Brixim was really kind to us.
She's actually put togetherthree routines which we'll put on
the website.
She's actually going to writean article for us explaining mobility,
flexibility, stability andstrength with links to those routines.

(49:01):
So please go to the website,look for these.
They're great workouts.
And she put together one thatkind of combines the mobility and
flexibility work.
So that'll be on the website.
And with that, tell us alittle more about stability.
I will.
But can I say one more thingabout flexibility?
Because I feel like I droppedthe ball.
So we talked about static stretching.
And static again, meaningpassive, or the muscle itself isn't

(49:25):
involved in contracting,you're just lengthening it while
the contractile properties are quiet.
But there's also this wholeconcept of active stretching.
And I don't mean active likewe talked about dynamic.
I mean active stretching,where you're using stretching, the
muscle itself, properties ofthe muscle, namely the Golgi tendon

(49:45):
organ or the gto and themuscle spindle in a way to sort of
trick the muscle into givingyou more length.
That active stretching isrooted in something, a big fancy
word called proprioceptiveneuromuscular facilitation.
So the proprioceptors arethese GTOs and these muscle spindles.

(50:06):
The neuromuscular just simplystates we're using the nervous system
to trick the musclefacilitating the muscle stretch using
these GTOs and muscle spindle.
And it came out of work donein the late 40s and early 50s by
a neurophysiologist and aphysical therapist who were treating
polio and other conditions.
And we have sort of taken thatand applied it to athletes with musculoskeletal

(50:32):
abnormalities or impairments.
And I'm a huge fan of PNFstretching, especially after exercise.
And it's something that theathlete can do themselves.
And in that handout that youalluded to, I've touched on that
a bit.
So I am a huge fan of activestretching or PNF stretching way
more than I am static stretching.

(50:53):
So give us an example of howyou do a PNF stretch.
Yeah.
So if you're stretching yourhamstring, let's say you're on your
back, so you're on the floor,lying straight out.
And the target hip, say it'syour right hip, you're going to flex
your hip to 90, and you'regoing to flex your knee to 90.
Okay.
And then you are going toclasp your hands, interlace your

(51:15):
fingers behind that rightthigh, and you're going to use your
hands as a blockade.
So I am going to activelycontract my hamstrings to extend
my hip, but I'm not going toactually allow any motion at the
hip to occur because myinterlaced fingers behind the thigh
are blocking that motion.
That's called an isometric contraction.

(51:36):
So I'm contracting thehamstring to extend my hip, but I'm
not moving.
I'm not going anywhere.
And I forcefully do that, like80%, maybe of my max contraction.
So I hold that 2, 3, and thenI relax.
My hamstring.
And when I relax my hamstring,I'm going to use my quadricep actively

(51:57):
to extend my knee.
So my foot's coming up towardsthe ceiling.
And when I get it as far as Ican, I'm going to hold that statically
for 20 seconds.
Seconds.
Then I'm going to repeat thattwo or three times.
And when you do that, it'sshocking the length that you can
achieve that you couldn't onthe first repetition.

(52:17):
You can also get fancier.
And instead of using yourfingers interlaced behind your thigh,
you can use like a yoga strap.
And now put it around your ankle.
Okay, so now you can fire yourhamstring and you're resisting with
the strap.
And so now you can extendyour, your hip and you can flex your
knee, right?
Because you've got this strapthat's resisting that.

(52:39):
And now when you relax it, soyou hold it, two, three.
You're tricking the proprioceptors.
And when you relax now, youcan fire your quad and you can use
your hands to pull on thatstrap to take up the tissue length
that you've achieved.
And you can usually get anadditional five, sometimes more degrees

(53:02):
out of that muscle than youcould with just static stretching.
So that's an example of anactive stretch.
You're using the muscleactively to gain more extensibility
or flexibility out of it.
All right, let's shift over to stability.
So now tell us why this is important.
This is the low hanging fruitfor the cyclist.
I feel like this is where,Trevor, you were probably alluding

(53:26):
to some of this in your sevenexercises exercise, 12 minute basement
workout.
So when we say stability, Ithink of, this is the anchor point.
So I've got a foundation fromwhich to move.
And if that foundation is notstable, well, look at the Leaning
Tower of Pisa.
Right?
So you can't move effectivelyif you don't, if your body doesn't

(53:47):
know or can rely on a stablefoundation from which to move.
So if we are going to transferforce through the pedal or through
the water in a swimmer orthrough our feet like a runner, we
need to do that from a placeof stability.
And it's really been in the literature.
Unlike stretching, theliterature is fairly concrete and

(54:12):
unequivocal about injuryprevention with stability.
So one of my mentors, Dr.
Tom Best, he was a sportsmedicine physician at the University
of Wisconsin who I did my PhDwith, he did this study in the early
teens and it looked athamstring injuries.
And basically what it showedis that if you have a athlete with

(54:35):
a hamstring injury, thatathlete is going to have less chance
of recurrence if they work oncore stability and agility drills
than they are if they simplystretch their hamstring and strengthen
their hamstring.
So that's not injuryprevention primarily, but it's secondary.
It's recurrent injury prevention.

(54:56):
So the other studies, theywere sort of hallmark studies in
the late 90s by Hodges.
He looked at patients with lowback pain and he looked at recruitment
and he said, geez, in allthese patients that have low back
pain, they end up moving theirarms and their legs, so both upper
extremity and lower extremity movements.
And they initiate thatmovement before they fire their core.

(55:19):
And I'll talk about what thatmeans in just a minute.
And when he looked at peoplethat fired their arms and their legs,
movement patterns that didn'thave low back pain, lo and behold,
they fired their core prior to movement.
So they initiated basicallycontractions of what we call the
transversus abdominis and themultifidi, the front door and the

(55:42):
back door of the core cylinder.
And I think that's really gooddata to suggest, you know, that the
core is, at least in thispopulation, it was a little back
pain, but I think other peoplehave shown that to be true across
the board for other types ofinjuries and pathologies.
So that's my feeling on core.
When you're talking aboutstability, would you say core is

(56:03):
the most important part?
And it's a bit of a leading question.
You might disagree with me,but I think if somebody has a weak
core and it's not firingcorrectly, it's impossible to be
stable.
So I always feel it's at thecore that stability starts hurts.
I agree, and I'm sure everyone is.
Well, I'm not sure because Ididn't understand core when I first
started as a pt and I again,I'm sure my patients out there are

(56:26):
thinking, ban, can I get a refund?
Like, what was she doing inthe early 90s?
But I thought core meant likea, like a six pack abs.
I thought that's what core was.
And so you know, crunches.
And I'm not saying crunchesare bad, I'm just saying that's what
I thought core was about.
And it wasn't until later.
And now I think it's really commonplace.

(56:47):
But in the PT world, this camelater for me is the core is really
a cylinder.
And if you think of acylinder, the front door is this
tra.
The transversus Abdominis,it's your belt muscle.
It's the front door of the cylinder.
The back door are your multifidi.
And these are the smallmuscles that run between the spinal

(57:07):
segments that cause rotationor stability of the spine.
That's the back door.
The floor of your cylinder isyour pelvic floor and the ceiling
is your diaphragm.
And we sort of ignore thediaphragm because the diaphragm,
it has to contract and relaxbecause that's how we breathe.
So, you know, you kind of haveto let the ceiling do what the ceiling

(57:30):
is going to do.
But if you can really keepthat cylinder contracted, you're
increasing the pressure inthat cylinder.
And that pressure acts as astabilizer for the spine.
And so those four muscles,muscles are what I talk about is
our core stabilizers.
And then beyond that, we'vegot what I refer to and what others

(57:50):
refer to.
There's some discrepancy.
It's not that this is right or wrong.
I call global stabilizers.
And that I think of is our sixpack muscles, our internal obliques,
our external obliques on thebackside, our spinalis.
So the core provides thisstable foundation of the lumbar,
low pelvic complex, right?

(58:12):
And then the globalstabilizers provide postural alignment
of the vertebral column.
All right, so that's next,you've got, you have our base, and
now we have our alignment ofthe vertebral column on our stable
base.
And the next, we go to ourglobal mobilizers.
So core stabilizers, global stabilizers.

(58:34):
And now I think about ourglobal mobilizers.
And that's where the hipbecomes part of this lumbo pelvic
complex.
So our rectus femoris, the onequad muscle that crosses the hip,
our iliopsoas, our hipflexors, our glute meat, our glute
max.
These are the more superficialmuscles from the core that connect

(58:55):
the trunk to the extremities.
So those three groups ofmuscles are where the low hanging
frame, fruit for everybody is.
And if you can get those tocoordinate, then you can start thinking
about strength and powerthrough the pedal or strength or
power through a swim stroke orstrength and power through throwing

(59:19):
a baseball or swinging atennis racket or kicking a soccer
ball.
But unless you've built fromthe core stabilizers to the global
stabilizers to the globalmobilizers, I think you're really
losing power and losing yourstatus as far as preventing injury.
I think that's where the moneyis, at least in my World, in my thought.

(59:41):
But I will say, I mean, theremight be some people listening to
this going, well, I'm a cyclist.
You're locked in on the bike.
There isn't that much movement.
So how important is this?
But I can tell you I've seencyclists with really bad stability,
really weak cores, and you seeit, their knees are moving in every
direction.
They're kind of floppingaround on the saddle battle.
There's just no stabilitythere where if you look at somebody

(01:00:03):
with really good stability,their feet are pedaling in circles,
but the rest of their body isjust solid.
There's no movement whatsoever.
And when I see that person haspoor stability, you go, yeah, you're
the one who's going to startgetting knee pain pretty soon.
Yeah, it all goes down the line.
Right.
You know, at some point.
And it's the same thing withfoot stability and mobility as Stacy

(01:00:25):
was talking about earlier.
It'll climb, climb up the line.
Because I'm usually a middleto back of the packer, I have the
opportunity to watch lots ofcyclists go by and of course, I don't
get to see them afterwards,but I can probably predict which
ones are going to end up injured.
And every once in a while,there was a woman that just blew
by me at Big Sugar that was onthe podium.

(01:00:48):
So clearly she's very good ather sport.
But.
But I don't know for how long,you know, watching her go by.
All I could think of was youwere on the age group podium.
You could have probably beenon the pro podium if you could figure
out how to put the forceyou're generating through the pedal
in one direction rather thanhaving it go in every direction because

(01:01:12):
your pelvis is completely unstable.
And yet when I do a bike fit,a lot of times it's a puzzle to figure
out, is there something aboutthe bike that's making you unstable
and we can change that, or isit you're unstable and it doesn't
matter what I change on thebike because it really is going to
take you getting off the bikeand working on core stability in

(01:01:35):
order for you to perform.
And that's really a funbiomechanical puzzle looking at two
machines and which one is the problem?
Sometimes it's both.
And so for anybody who'slistening, who's going, well, how
do I work stability again?
Dr.
Brixham has put together agreat workout for us.
I recommend taking a look at it.
We'll have it on the.
I think you made an importantpoint just going to do it a Bunch
of crunches and getting a sixpack ab doesn't necessarily make

(01:01:58):
you stable.
So we've got the final aspect here.
Dr.
Brixham, let's talk about strength.
Yeah, I'm happy to.
It's probably where I spendthe least amount of my time.
I often send athletes tostrength and conditioning coaches
for more personalized training.
So the few things I'll sayabout strength training for the cyclists,

(01:02:19):
we touched upon them brieflyat the beginning for bone health,
it's critical because cycling,cycling isn't an impact sport for
tendon strength.
It's critical to really bringabout changes in tensile strength
for the tendons.
For muscle strength, we'rereally strong in the quads, but we're
only as strong as the biggestgear and the biggest hill we can

(01:02:40):
climb.
So there's lots of strength tobe gained off the bike as well.
And as we talked about thiscrossover syndrome, gaining strength
in those stretch weakened muscles.
So from a postural standpoint,we've become kyphotic and those shoulder
retractors have become strongin a lengthened position.
But when we get off the bikeand we try to stand up, they're really

(01:03:03):
weak where they're supposed tobe strong.
So I think a strength in thatsense and I really leave the reps
and sets to more of thestrength and conditioning professionals.
But certainly there's adifference between what we do in
the off season versus what wedo in season.
And just a quick shout out toStacey Sims.

(01:03:23):
I think she has done a lot ofreally groundbreaking work in strength
training for women.
So we have to be cognizant ofsex differences and also age differences.
And so I think strengtheningdoesn't necessarily become more important
as we age.
It should have been importantwhen we were young so that we're

(01:03:43):
not making up for lost time.
But because most of us don'tthink about strength when we're young,
because we feel strong stress.
Strength therefore becomesrelatively more important as we age
because whether we like it ornot, sarcopenia will happen, the
natural loss of muscle.
So the more we can put in thebank early on, the more savings we

(01:04:03):
have to draw from as we age.
I think a really good pointthere that is really interesting
is the individuality of astrength program.
How important it is to havethat conversation between the athletes
athlete and the strengthconditioning professional to really
make sure that it's tailoredto that athlete.
And we can do some generalstuff that's going to help all cyclists.

(01:04:25):
We can do some general stuffthat's going to help most runners
but if we're dealing with someof these discrepancies, a true tailored
individualized program isgoing to be very, very helpful.
I remember reading afascinating study that talked about
orphan fibers, which, where sowhen you think about your muscles,
you actually have to thinkabout neuromuscular units.

(01:04:48):
So there's a nerve thatconnects to multiple fibers, and
when it activates, itactivates all the fibers.
You can't just contract asingle fiber.
You contract them as a group.
And if we don't do strengthwork as we age, you get what are
called orphan fibers.
They just disconnect.
And what will happen isthey'll eventually connect to another
neuromuscular unit.

(01:05:09):
But if that happens a lot,over time, you end up having fewer
neuromuscular units, whichmeans you lose some fine control
of the muscle because there'sjust fewer units to control how much
of a contraction you do in the muscle.
And that's something that weassociate with aging.
But they've shown, keep up thestrength work, do these sorts of

(01:05:31):
exercise on your muscles, andyou can prevent a lot of these orbits
orphans.
So you can prevent a lot ofwhat we think of as aging.
That's exactly right, Trevor,and a great point.
So I like to think ofstrengthening as hardware versus
software.
So if you're doingstrengthening exercises that are
more low weight, high rep,you're really working the hardware.

(01:05:51):
You're trying to hypertrophy,you're trying to build more of those
muscle fibers or the size ofthe muscle fibers.
But when you're lifting highweight, weight, low reps, you're
really working on thesoftware, meaning the central nervous
system, which is exactly whatyou're talking about, are those motor
units.
And so working the software isreally where I like to see athletes

(01:06:14):
spend their time in the off season.
And working the hardware ismore where I like to see that athlete
working in the in season andwhere I'm very comfortable.
So I, I kind of leave that tothe strength and conditioning specialist.
What I, I hope that a lot ofcyclists do listen to this podcast
is think about functional strength.
So this is using your body inthree planes.

(01:06:36):
The transverse plane, whichwas rotating.
The frontal plane, which islike a jumping jack, and our favorite
sagittal plane, which iscycling and running.
So it's strengtheningthroughout all three of those range
of motions, which is how we function.
If you think about reachingfor something on a high shelf, you're
flexing your abd ducting andyou're rotating.

(01:06:58):
And so using low weight orbody weight, really, and you can
do this at home with nothingmore than a band and a physio ball.
And I provided just some basicexercises that are my go tos.
Functional strength should beyear round, not just the off season.
But if you're somebody thatreally doesn't like to get off the
bike in the in season, a realfocal point for the off season season.

(01:07:20):
So yeah, we've actually donepast episodes on strength.
I love some of the ways youdescribe this.
Working the different planesis really important, not just the
planes that we use in cyclingand running, why it is beneficial.
So Dr.
Brixton, let's just shift overto what are some of your practical
suggestions for working thestrength side.

(01:07:42):
And again, really appreciated this.
You put together a greatstrength roll routine that will be
on the website.
So anybody who wants specificexercises, go check that out.
But what are your overallpractical recommendations here?
Sure.
I think most of your listenersare probably familiar with the foundational
movement.
So squat, lunge, hinge, push,pull, plank, rotate.

(01:08:06):
And when we think aboutcycling, we're always pushing.
So from a practical take homepulling, if you're in the weight
room, spending more time onthe pull.
So for upper extremity thatwould be things like bento over rows
or seated rows, and the lowerextremity things like deadlifts,
double leg or single legdeadlifts or pulls, we've hit this.

(01:08:27):
But the planks working on corestability, which we often neglect
during the season.
And then I think the idea ofmore functional training and all
that that means is if you takeone of your foundational exercises
like a lunge, rather than justlunging forward forward in our sagittal

(01:08:48):
plane, try lunging backward.
It's still sagittal plane, butit's a different movement puzzle.
And it speaks to that wholeplasticity, your ability of your
brain and your body to figureout new puzzles so that when you
face them out in the realworld, meaning off the bike world,
that you have that plasticityto face that challenge and adapt

(01:09:11):
structurally and functionallyor do a lateral lunge, or do a posteromedial
or a posterolateral or aanteromedial or an anterolateral
lunge, in other words, thewhole star drill.
And I think that that's anincredible exercise just to take
a foundational movement andchange the planes and you'll see

(01:09:32):
how your tissue doesn't like it.
And if your tissue doesn'tlike it, it's because it hasn't seen
it.
And if it hasn't seen it, it'sprobably either become stretch, weak
or or functionally shortened.
So it's a good idea to remindyour tissue that it can work outside
of how it does on a bicycle.
Great suggestion.
And I bet I have an exercisethat I love to do.

(01:09:54):
It's something I actually doat the office when I just need a
quick break that I got fromdancers, which is doing lunges.
But first you lunge forward to12:00, then you lunge to the side
to 3:00, then you lungebackwards to 6:00, and you have dancers
that'll actually just kind ofgo all the way around the clock to

(01:10:14):
make sure that not only justable to do the lunge, but in multiple
directions.
Right.
That's exactly what I wasprobably not very good at articulating
is that star drill.
I think my other favorite isin physical therapy, we call it a
chop and a lift.
It goes back to thatproprioceptive neuromuscular facilitation,
or pnf.
So if you're in a squatposition and you take a kettlebell

(01:10:38):
or a medicine ball and youstart with that ball between your
feet, and as you lift, youcome up your right shoulder like
you're throwing something upand back over your left shoulder,
return to that startingposition, and then come up and over
with that ball over your left shoulder.
So you're incorporating trunkrotation, neck rotation, shoulder

(01:11:01):
mobility, and you're gettingyour squat in there.
That's a really nice upperbody, lower body combination exercise
that I do.
And you can do it with bands,you can do it with a ball.
But it's one of my go tos toadd some rotation.
You know, the last thing I'llsay on this, it was really in the
70s and 80s that you saw gymsstart to pop up and strength training

(01:11:23):
became really popular.
And back then, the belief wasreally about joint isolation.
So you just did one movement.
Think about bicep curls orgetting locked in and just working
the hamstring or just workingthe quads.
And I know one of thecriticisms that you saw was you'd
get these people who looked great.
You know, they had greatmuscle form on their body.

(01:11:46):
Sorry, wrong word, but youknow what I mean?
But there's just no mobility.
They looked good, but theyjust couldn't move around very well.
And I think one of the biggestchanges you're seeing now in strength
work is working multiplechains, working in multiple planes,
multiple directions.
So not only do you build somestrength, but you can move that strength
in multiple directions andhave a lot more function with it.

(01:12:09):
That's exactly right.
I'm not opposed to isolating muscles.
In fact, in rehab for physicaltherapy, we do that often.
You know, if you have your ACLreconstructed, we're going to isolate
your quad and we're going toisolate your hamstring and rehab
those because they become weak.
They're also really helpfulfor people who are intimidated in
the weight room because thosesingle station machines guide you,

(01:12:30):
and so they kind of restrictyou from doing a movement that may
be outside of your realmbecause you're locked into that machine.
So they have a place theyminimize the need for balance, which
is both bad and good.
If you have a client with poorbalance, it's difficult for them
to do strength if they have tomaintain their balance.
So those machines are helpful.

(01:12:50):
But if you're looking to buildbalance, those machines don't ask
that of your body.
So isolating has a place, justlike everything.
It depends.
But I think what you saidabout being strong without being
functionally strong is the keyfor me.
So if you only do legextensions or only do hamstring curls,
that quadricep and thathamstring only function in the way

(01:13:14):
that you trained it.
Well, we don't do much withour feet off the ground.
So if you're training thosetwo muscles on a leg extension or
hamstring curl machine andthen you go to run.
Well, the motor unitrecruitment, the software hasn't
been built because you didn'tteach your body to use that muscle
in a functional capacity.
You taught it to work in anisolated capacity.

(01:13:36):
And that's rarely how we function.
So it's not that they don'thave a place, it's that you can't
have it be the only way thatyou strength train and expect to
increase your performance oryour health span.
Great answer.
So, and again, love theroutine that you built for us.
That's going to be on the website.
I recommend to everybody tocheck this out.

(01:13:58):
All right, well, everybodyhate to say it because I've been
loving this conversation.
We've gone over time, but Idon't mind because I think this is
such an important conversation.
Conversation.
That said, it's probably timeto shift to our take home.
So before I ask each of youyour key point, we do have a question
for our forum.
So anybody who's been reallyinterested in this episode, please

(01:14:19):
go to the forum.
Answer this question.
Let's get a good conversation going.
And that question is, do youdo anything structured outside of
your primary endurance sportand have you found it helps or hurts?
Hurts.
So basically asking all of youto come in, say what you've been
doing and whether it's beenbeneficial or you're recommending
something, don't try this.

(01:14:39):
I tried it.
It didn't work.
Would love to hear what youhave to say.
And with that, Dr.
Brixham, you listen to the show.
So you know how we oftenfinish up.
Each of us has one minute togive their most salient point from
the whole episode.
So let's start with you.
What is your one minute take home?
Try to keep it under one minute.

(01:15:00):
I think the first thing is formovement literacy, you really have
a toolbox, and you want asmany tools in that toolbox as you
possibly can get.
And so mobility, flexibility,stability, strength, and skills are
all tools.
Try not to keep using yourfavorite tool and so acquire the

(01:15:20):
tools that you don't have.
My second is that that if youhave a movement dysfunction, try
to avoid the whack a mole approach.
Really find a gooddiagnostician, somebody who can get
at the etiology at the rootcause of your dysfunction and treat
that rather than trying to,you know, potpourri it and do a little

(01:15:41):
bit of everything.
And the last thing is thatexercise truly is medicine.
So dose it correctly.
Too much of an ingredient isnot necessarily a good thing, and
too little is not necessarilya good thing.
And a key point is that thatexercise for medicine changes as
we age.
So as you get older, don'texpect that the medicine stays the

(01:16:04):
same.
You might need more strength,you might need more flexibility,
and you might be able to getaway with a little less of the aerobic
endurance that you've builtover the decades.
That will remain important.
But you can maybe spend 10minutes less there and 10 minutes
more with your other tools.
And lastly, well, I did say lastly.

(01:16:26):
This is part of that samething as we age, realizing that getting
better looks like staying the same.
And so try not to befrustrated by that, because you are
improving.
You're offsetting the ravagesof age.
And so you look like you'restaying the same, but you really
are getting better.
All right, Grant, what about yours?

(01:16:47):
I think my take home on allthis is just kind of what I mentioned
earlier, that it doesn't haveto be this, this I'm getting older,
so everything's going to startto fall apart.
We are going to have thatinevitable loss of some strength
and maybe even some stabilityas we get older.
But what we're doing and whatwe can put into the equation on our

(01:17:07):
own time off the bike andreally purposeful efforts can really
delay that.
It's dramatic how much morepower can be established when we
get the right muscles firingand the right, right way.
And it's very vital that wetake the time and we prioritize some
of this off the bike work.
I know for so many athleteswe're always going to prioritize

(01:17:30):
the bike first, but there areso many things here that can meet
these big gains if we'reprioritizing off the bike work.
All right.
Well, I guess my take home,what I found interesting is when
we proposed this episode, theworking title was off the Bike Work
in the Off.
And what I noticed is wedidn't talk about the off season

(01:17:50):
at all.
We're just talking aboutimportant work both for performance
and for healthy aging.
And so I'm glad we didn'treally bring in that off season component
because this is somethingthat's really critical to be doing
all through the year, I'mgoing to say, for all ages.
But as you get older, you aregoing to notice if you don't do this

(01:18:12):
sort of work.
And a lot of things that youmight think of as, well, I'm in my
50s.
That's normal aging.
It actually isn't.
These are things that you can prevent.
But you know, the last thingI'm going to say here is, Dr.
Brixham, I love that youpulled it all together.
There's these four components,mobility, flexibility, stability
and strength.
And they all work in unison.

(01:18:34):
You can't really be healthyand just work on one of those.
You have to work on all four together.
Well, Dr.
Brixham, real pleasure to haveyou on the show.
Thanks for joining us.
Thank you for having me.
I appreciate it.
That was another episode ofFast Talk.
The thoughts and opinionsexpress in Fast Talk are those of
the individual.
Subscribe to Fast Talk.
Wherever you prefer to findyour favorite podcast, be sure to

(01:18:56):
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As always, we love your feedback.
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Join the conversation atforums.fasttalklabs.com or learn
from [e-mail] for Dr.
Stacy Brixham and GrantHolicke, I'm Trevor Connor.
Thanks for listening.