Strength Training For Chronic Pain Relief With Dr. Alex Hu || WBWL EP 60

This is a great episode I made last year that a lot of people got a lot of value from. I wanted to just put this one back on just in case you have missed this.

Strength training is by far the best long-term intervention for pain relief and quality of life backed by high level research.

In this episode, Dr. Alex Hu, a physician from UCLA, speaks about how he empowers his clients through strength training to relieve their pain and improve their quality of life.

I truly enjoyed this episode as Dr. Hu and I are both huge supporters of strength training and we both are healthcare “dads” striving to stay strong and active with our kids.

If you’ve been told to play it safe, stretch, RICE, use a heat pack, take some meds and wait it out…

Or you’ve gone down a path where the treatment you’re getting is quite passive and doesn’t require you to work hard to relieve your pain..

I guarantee you’ll get a wealth of information from this episode.

Transcript

0:02

Welcome to the Won Body Won Life Podcast. Hi, I'm your host, Dr. Jason Won lifestyle, physical therapists. I talk about everything health and wellness related. So you too can have a more resilient body and a more fulfilling life. If you haven't yet, we have well over a thousand listeners to date. It would help me greatly. If you can leave a five star rating on Spotify or iTunes, that way I can continue to grow the channel and push more free content to all of you. Today I have a very special guest. His name is Dr. Alex, who he's a physician from Southern California. And welcome in, man. How are you doing? I'm doing well. Thank you for welcoming me onto the podcast. Excited to be here. Happy new year as well. And why don't you just start off with just giving kind of a brief introduction on who you are and a few different things about your background. I know you have a pretty illustrious background. That's why I got you on this podcast and I'd love to, for you to share, just to show that we do have some, we have some authority and that we've worked with many different people in the past, but yeah, I'd love for you to share. Yes, not a problem. So my name is Alexander who I go by Alex. My typical day to day. I'm an urgent care physician. I work for UCLA. Also the side. I also am a sports medicine doctor. So I deal and help with non surgical orthopedic problems. And outside of my day job, I volunteer with the U. S. Olympic weightlifting team and I provide medical coverage for when they compete. Both internationally and nationally. And on the side, which, was just my, I shouldn't even say side. That should be actually my primary job. I'm a father. I'm a husband. And I used to compete in powerlifting and still dabble in strongman lifting, but now I just go to the gym for the sake of. Living a healthy lifestyle. Perfect. And I think we definitely have that in common. We both love to train. We both are fathers. We both know how to prioritize our health. And that's what we do for our clients. And we inspire them to be healthier as well. And so we want to talk a lot about like the main themes of today, which are like strength training and the role in strength. And I'm just curious everybody has a different definition. So how would you define strength and why should it matter to people? So for strength for me means being able to overcome daily challenges, whether that be physical or mental and having the reserve to meet each of those challenges without failing. And so in general, that's what strength training means to me. I know it seems very philosophical to go from something about when we're talking about lifting and whatnot. But I do believe that some of those lessons and mental and physical struggles that you deal with in the gym and outside train your body and mind to be more resilient, which is, part of the aspect that you focus on this podcast, which I think is a excellent Thing for people to really hone in on because it gives them so much more life to live on a day to day basis for sure That's a great definition. I love that you said Reserve I define that we define that same way like capacity Which is if you just think about your phone has a specific capacity, which is a battery Otherwise it dies out is that each one of our muscles ligaments and tissues in our body have a specific capacity for Load. If you overload those tissues, it can, oftentimes it can cause an injury. It can cause something detrimental, but if you do strength train you generally develop a greater capacity for things. Hence why you said that you can live a more fulfilling life. If you are stronger, you have more confidence to move things. You can pick up your child. You can do day to day activities without feeling like you just got hit by a bus, if you will. So I love that. We both believe in that. And. I guess when people are let's say they're coming to you and they're overcoming any injuries or they have persistent ailments or pain there are a number of people who would take different courses of action. As some people will reach for the pain meds and they'll rest it up. Commonly. That's what's. Always been pushed, right? It's like pain medication. Don't, avoid anything that hurts, rest it up, wait for the pain to go away. Some will take hot packs, cold packs. I think there is some research that's that's for another debate and controversy and some will just stretch it out. And I think that's a decent viable solution. I think it feels good in the moment. But how does strength help you and your clients with injury or pain? I'm glad you brought that up because a lot of my job is. Education and going trying to actually uneducate that portion of how to deal with pain. Taking a little sidestep here that I would say that there is no easy answer or there's no easy way to treat it because most of those modalities you mentioned are passive. You don't have to do anything. It's easy to just sit there and rest and expect the pain to go away. But for, barring from some smaller injuries, if they're long term, you've had this for a long time. Resting more is not going to help. You need to dig yourself out of that hole and that is where I believe having guidance in terms of building strength for whatever structure or thing that is injured is necessary to get out of it. One good example that we always I'm sure you've all you've seen before in your physical therapy realm is frozen shoulder for folks that don't know the medical term is adhesive capsulitis typically happens after, and in general somebody that just happened to injure their shoulder doing something random, usually associated with a rotator cuff injury, and they just rested. Cause it hurts. Can't bring it above their eye level and just say I'm going to avoid it and just see if it heals up contrary to what their belief is over time and weeks go on, gets tighter and tighter starts hurting more and more despite however much rest you do. And the only way out of that is that. You have to hit physical therapy, range of motion, strength training hard, also ends up sometimes, unfortunately, some patients end up going to do surgery just to get that range of motion done or returned. That's a key example. I usually use another one's chronic low back pain. People think resting and more. Is the answer when in fact has to do with lack of truncal stability and strength as we're talking about. And so the more you rest that actually the more atrophy and weakness you get. And so the pain perpetuates. And it's why professionals such as yourself are so valued. At least in my opinion, when it comes to comprehensive care and when I see them, because I don't see them all the time and I'm going to you guys because you guys are putting in the hard work. For sure. There's a lot of detriments mentally and physically to resting and don't get me wrong. I think that, me and Alex are not saying absolutely don't rest. It's we do need our rest. Rest is for recovery. And That's something that when you are strength training, you do need to rest. You can't just hit it hard every single day and expect your body to recover because tissues do break down when you're strength training and you need to recover in the form of sleep, nutrition massage cases. So you do need to recover. I think there, there's a valuable. Thing that we can take from this, which is also like absolute versus relative rest. And maybe you've heard of that, which is absolute rest is after you've hurt your back, right? Commonly people get scared. They get very anxious, and they'll just rest it up. And commonly, like you said, it's going to lead to more atrophy over time, chronically acutely. If you just rest in bed immediately after an injury, you gently feel really bad getting up off that bed. So relative rest is basically just saying, Don't just lie down, but you can at least decrease the load. You can, instead of weight training, you can just walk. And is that something that you promote to your clients in terms of saying, stay active, you don't have to do the same exact activity to a hundred percent capacity, but you can do something that's sub maximal threshold. You can do something that's relatively easier that will still keep your lower back moving. Yes, you're hitting the nail on the head. I essentially, in fact, I'll go as far as to say as even doing the same thing that you were doing maybe before, for example, you were shoveling a lot or something. You can still do things that require that motion, but if it's not beyond a certain pain. Scale, and I think the general number we usually give just for somebody to keep in mind something like 3 out of 10 pain. If you can keep it to around that level, that's okay. You shouldn't avoid pain 100%. You need to teach your body that this is acceptable and to keep going because in the end, your body will depending on how you treat it, right? If you treat it as a resilient machine, you're It will adapt. You treat a very frail and just something that is like porcelain build. You will become more frail and porcelain and so I think we always give our bodies a little bit of lack of credit where it's due that it is an adaptable machine that we're, if you're where we are, because we are have that capability of doing so and allowing people to feel that is a possibility rather than just saying no. You can't do any of that. You're going to injure yourself more. That's actually one of my biggest pet peeves is people saying you just can't lift anymore. You can't do this anymore, ever. That's avoidable. Yeah, that should never be the case. That's extreme stance, but to say that should be a very rare exception, never the rule. And Just let you guys know. I know a lot of people come into this podcast wanting to learn about relieving pain. I know that me and Alex are talking about strength training. Just remember that pain is very multifactorial pain is essentially it is a perceived threat. I think a lot of people back when we had this. This very like clear cut and dry black and white pain is indicated by like tissue damage. And we start to realize in research that people with chronic low back pain is that many people's tissues they heal near, near fully granted they might be older, but pain is a product of the multifactorial experiences in our life. It could be that. A doctor has told you to avoid versus Alex, trying to change that narrative and pain is also a product of whether you get bad sleep or you have a poor relationship and, or whether you injure yourself repeatedly, and then you start to get into this fear, kind of fragile mindset, if you will. And so just let you guys know, pain is not always just indicated by. You have a bad back. You have weak tissues, right? Pain is like you can learn and also unlearn pain away. And I think that strength training is a huge pivotal piece to that. The fact is, if you've hurt your back a number of times, either lifting weights, lifting a baby, lifting a bag of garbage off the floor. Mentally, that's going to weigh against you, right? And you're going to second guess the next time that you lift. But if you have somebody like Alex or myself to teach you proper technique and you slowly get back into the act of hinging through your hips and lifting that's going to give you the confidence again. And the pain will surely. Dissipate, but what are your thoughts on that? And how pain is somewhat multifactorial as well. Without saying it I think sometimes physicians coming from our side, we don't usually, really impart that, but that is very much the truth. We know that for in fact, pain is multifactorial. In fact, to give a perfect example of how sometimes chronic pain is managed. Some patients, such as the ones that may be even listening to this podcast, notice that their doctor might prescribe. Something called Cymbalta, it's actually used for anxiety and depression, but. Why is it given for my low back pain? And. Believe it or not, the, the pain that you're experiencing, for sure, it's real. I'm not saying it's imagined or it's not something that you're experiencing on a day to day basis, but much as you're describing it's multifactorial, there are multiple aspects you can do to, that can both alleviate the pain and also make it worse. I think you mentioned the bad sleep for sure. Just feeling tired and more fatigued that day, your experience of that pain. That's usually if we were to use again, use our severity scale might generally be like a two or three, all of a sudden there's a six today. Everything just aches, hurts doesn't feel good when nothing else has changed. You have not injured yourself. You have not somehow done some. Microscopic damage to the tissue that's causing you discomfort in the initial beginning. So I think taking a step back rather than just focusing on the minutia of oh, this may be damage or that thing might be a little hurting here. We need to go fix that. It has to be taken in a bigger context of a wellness of having, is your sleep going? Is your relationships at home going? Do you feel. Fulfilled in life. Are you having a purpose, things like that, which believe it or not, in fact, pain having something to strive to, I think can help you realize that the pain itself is something that doesn't necessarily need to be focused on. And when you have nothing else to lean on, the pain can be more severe. I'm rambling a bit, but long story short, yes, I totally agree that there's a lot of things when it comes to pain that it's not so cut and dry. And speaking of cut and dry, that is why from my practice, I will Unless absolutely needed to. I will 100 percent try to avoid any procedural or even surgical intervention unless it's really truly needed. If you have a huge massive thing, a bony growth that's pushing on our nerve for sure, you can't physical therapy or out med Medicaid that you need to cut off that extra piece of bone. But barring those rare circumstances, there's a lot of things you could do to make it. Pain better. I think there's actually a statistic out there that shows that 90 percent of people with acute or chronic low back pain, no matter how severe it is that within 6 to 9 months, that pain will dissipate, right? No, even if you were bedridden or you decided to weight train, it's there's a lot of that. And that's the thing is that I think a lot of people are pushed for surgery because they have their 60 years of age. I think everyone over the age of 60 has some confirmed lumbar arthritis. And just because you started to develop back pain because of COVID or some sort of stress, you get an MRI and all of a sudden it shows, Oh, you have you have some disc desiccation here. You have some disc degeneration and people start associating. That structure is causing my pain when in fact they could have had disc desiccation for. Five to ten years. Oh, yeah. That's just the unfortunate part is having doctors like yourself that can unlearn some of the what do you call it? The over, over emphasis on structure versus just saying Hey, give them assurance that things are going to be okay, give them the evidence that most low back pain will go away for time and start to tell them like, Hey, as if you can start to sleep a little bit better, stress less it becomes more simplistic, but again, that, yeah. The simplistic route oftentimes is like the longer route and I think some people are still looking for that quick, get me under the knife, let's get it, let's get it done and oftentimes a quick fix ends up being like a much longer cost to them, not just financially, but also time wise. Yes, I certainly agree. And it's funny you mentioned that because when you really take a step back and think about we see something wrong with the MRI or your image of your low back, let's do the surgery. People often forget that there is a long course of physical therapy afterwards. Yep. And by the end, you're hitting that 69 month mark. You know what? Nothing probably would have been any different. In fact, sometimes it might be even prolonged because you've altered what was inherently there and again, I'm not there to bash our, surgical colleagues or anything. They're definitely very valuable. It's just that I think we don't sometimes give people enough of a chance and also impart that idea that you need to give it a chance. To really go back to where it was before in which, the statistical term is regression to the mean, going back to what the typical average is. And without trying to get ourselves out of a job. Yeah, you're right. You do not, you do whatever you do on a daily basis, probably by the six to nine month mark, your pain will be better. You didn't need to see me. You didn't. You do need to see the Jason for some of the things, but you don't need to see me. And your pain would have still gone better unless there's something inherently worrying aside from the pain itself. But I'm glad you bring that up because it's I don't like people to be in that fearful state that, Oh my gosh, this is going to be forever. Yeah. And just to hit on that next point, and I'd love to hear a little bit more about like just the different. Roles and things that you play in life outside of the, you being a physician, but I often tell people fear of pain is worse than the pain itself is that fear and anxiety perpetuates more pain and increases the intensity of the pain subjectively. If you're living in a fear bubble, and you're living in a more fragile mindset, and you're trying to just play it safe that's going to lead to atrophy that's going to lead to limited movement. It's going to lead to stiffer joints, probably increased the chances of. greater arthritic changes because your body's not moving through full range of motion. So that's why one range of motion is important. Mobility is important to to get better blood flow to, to enhance your flexibility and mobility, but you have to be strong within those ranges. That's why. Yeah. I think it's great that when it comes to people that just simply just stretch it out, but being able to load into that position, I think is going to give you the confidence to be within that range. I'm curious just based on your, your eclectic background, have you had any experiences of somebody that was. Either taking a more passive route or let's say there's a stretching or resting it up and then you actually promoted some form of strength training really pushed that to them and they had a lot of success. Can you think of anybody that and I'm sure you have a lot, but yeah there's, I would say, yes, there are many cases. One common example I have is yeah. Is a off the top of my head, I can remember like a college level athlete that was getting basically what amounted to soft tissue massage, sometimes chiropractic treatments for their bum shoulder. And they thought that maybe loosening it up more would help, but understanding that this was a collegiate level athlete. But I believe off the top of my head was. Pitcher back when I was doing part of my fellowship and, all these passive things, right? But now taking a step back, this is a pitcher in their dominant arm as throwing, fastballs up to 90, a hundred miles per hour, whipping their arm, probably not having a mobility issue, but yet they were still stretching. They were getting massages to loosen up, whatever believed restrictions were there still had pain six months, six months later. And It's a quite a bit of convincing and actually basically having the same discussion that we're having now about how these processes occur, why it's not necessarily the best route. And, by, I think the 3 month mark pain was probably at half. And, they still went on to have a very successful pitching career within the college itself, but that's the one I remember off specifically off the top of my head. It was just, when you have these assumptions that something is locked up, something needs to be stretched out when you don't need to participate in that's usually the times I'll see a patient really stuck and just not getting past a certain point. And so that, that's one example off the top of my head. There, I'm sure many more, but I can't keep it off the top of my head. It's me convincing them to go see people like you, that you should go do this. You can't just sit at home and expect to make better. Yeah. The common narrative is like when something's in pain, when something's tight, you got to stretch it out. And I actually on my previous podcast, two episodes ago, I talk about how passive stretching is actually not really important for anything. It's actually better to strengthen within a longer range of motion and you'll gain the same exact benefits of tissue elongation and better mobility just by doing strength training within the larger range. So yes, that's a great example. I'm glad that you brought that up. How a baseball pitcher. Softening up their tissues and probably cranking on their arm more or let's say they go to Cairo and they're like cavitating the arm in some way that's likely to create more mobility or more hypermobility. They already have probably 150 degrees of external range of motion and just cranking on the arm even further, it's likely to create more inherent instability. So working on trunk stability ensuring that those pitchers have good lower body trunk strength. So that they can actually push off their legs and go into triple extension and actually making sure that they, you give their rotator cuff enough endurance so that they can tolerate a specific amount of pitch pitches on their shoulders and go haywire. I think that's that's the thing that I usually push for my baseball. And I usually rarely would say, Oh, you need to like crank, you need to stretch it out more. Sometimes there is like stiffness in the thoracic spine and you have to stretch that out. That could be like a compensation. But for the most part. Strength training is ready to go. Hashtag nothing wrong with getting strong. That's the one that I always tend to use too. And yeah, I guess just switch modes. I love to, for our audience to get to know you better. You're like myself, your father, your physician, your manager from hats. What significance does strength training play in your own life and how does that allow you to be the best at both at all those roles? That's a very good question. In general, which I alluded to in the very beginning having purpose and finding some place where you are able to express that in a healthy way. I think we'll make you just taking a step back from strength training alone. That makes you a better person. You're able to bring 100 percent of yourself. When you are finding purpose and driving towards something. So for me, that means being the best father and husband that I can be. And then on a secondarily also being the best position I can be in my specific niche. So by strength training for my role as a father, not just having a quote dad bod. I'd much rather be a father figure, take that how you will, but, I want my son to see me as somebody strong, whether that's truly true or not. But regardless, I want him to see that being an active lifestyle should be a normal thing, and that should be part of everybody's life because that's such so many more implications about how you experience life on a day to day basis. I can go wrong with my kid. I can play, I play with them on, the playground running up and down everything without losing my brother saying, Oh, you go ahead. I can't do that. Or going on hikes, it just makes life a lot richer because I have the capacity to do that. But taking even away from the vanity aspect, it's just I have the ability to do those things. And I'm sure some of the folks thinking back to what does it mean to be like an engaged father? It's being there. Can you practice with them? You run around, play a soccer ball. It's also another way to prevent injury for me from happening. And then that's time away from other things I could have been doing that's more fulfilling. Without rambling on too much further, that's what strengthening, at least for being a father means. And in the same case also ties in with being, a good husband. It's just that I'm fit. I'm not sloppy. Part of having a good relationship is having. Respect for each other's partners but not only just, mentally and what are their personalities, but also physically, part of that attraction is still to keep a relationship healthy. I think that ties in parts of it, which is why I'm still motivated to do and lastly, it gives me the, like I mentioned before, the reserve to have extra energy devoted to things that matter. By building on my capacity in the gym, just, and I'm not doing crazy workouts. I'm probably spending 45 minutes, an hour, maybe three, sometimes the five days a week. If I'm very lucky, but generally ballparks around four by building on the capacity, I had more energy, more of myself to give. At 100%, rather than being tired all the time and trying to be dismissive because I can't meet, whatever demand is needed of me at that point in time. In any case, a little philosophical without actually tying into like specific strength goals or specific physique goals. That's what at the core it means down to me. And the last day for as a physician I have my own personal little nuance about that is I believe all sports medicine and people that deal with musculoskeletal injuries should at least be physically active and know what it is to go through resistance training. I'm not bashing though. Yeah, exactly. Exactly. Preach what they teach and you can't say you see somebody that would like me pain that goes to the gym and squats. If you don't squat yourself, you have no idea how that feels. You have no idea how the recovery aspect feels, how that may tie in with other things that could be alternatives. Instead, if you just say don't squat, then you have done that person a disservice coming from a place of authority without lack of experience you're basically, not providing good care is my personal opinion. In any case, I'm not saying you have to be like a, competitive lifter or anything. You should just know what it feels like and know what it means to go do that grind because that person is doing it too. You can't have never ridden a bike and then tell somebody health, how to ride a bike. It doesn't work that way. And I believe that aspect allows me again to be a more precise physician and also more accurate one without unnecessarily restricting somebody's life, out of an experience. Yeah. You hit on so many great points. I think that when you're looking for a physician or a physical therapist, make sure that they look the part, preach what they teach. I think that's really important because again you are, you're literally in their shoes. If you squat, if they're trying to squat and you squatted before, there's going to be greater rapport. You can tell them exactly how you felt. You can tell them this is my experience, right? And it just develops that better. Connection and better adherence to the program or whatever tips they give you. If you are smashing down hoagies and the fat's coming over your belt, I don't think that you're going to demand a lot of respect. And they'd be like, Hey you, do you squat? Do you run? Are you going to tell me what running shoes I need? If you yourself don't run, I think there's a lot of, it's not to say that you were disrespect. It's just that you wouldn't think to that, say that, okay, this person knows exactly how I feel. Exactly. You cannot put that person in your shoes. Exactly. I think we call that the therapeutic relationship. It's just that relationship has to be present in order for you to heal because they're not only needs to be at the right advice, but also buy in, from the patient that has, they have to believe in what you're saying and also agree with it too, in order to get better. And yeah, exactly what you're saying. Yeah. And going back to the points I think really the things that you said about you being a father, I think definitely resonate with me. Yeah, when my kid was born, that was like one of the happiest moments of my life. And from then on, they're saying, Oh yeah this is the end of your fitness career. This is going to be dad bod, right? Believe it or not, like the day that my baby was born, like I pushed myself harder to work out than ever. All right. It's like you have that extra intrinsic motivation for any of you guys that are considering a strength program, or let's say you have pain or injuries that are stopping you. I encourage you to think about Alex's words about focusing on the present and developing better memories. Like you will have greater reserve to create more memories. If your body is able to do if you have more energy, you will create better memories. Like you will actually be hiking with your family. Instead of trailing along the way, or if your kids want to play on the floor, you're not that parent that's just lying on the sofa because you're too tired to do anything. So I think it just creates a better memory. And I think also, if you're not somebody that generally focused on the present, we'll think about the future of if your If you're not strength training now are you going to you're not going to have as much reserve now and your reserve is going to dwindle out much faster. And so you're going to potentially be that father or that mother that needs to be helped by their kids off the couch. And that's actually what I had to do for my own dad when he passed. So I just encourage people that. What Alex said is that you create better memories, but also think about the present about who you are currently and strength train now so that you can build a reserve and think about the future so that you can enjoy your twilight years, if you will, and still be able to build memories. There's a lot of research that says strength training is actually more effective for brain health and cardiovascular training. That's actually something that it's amazing. It actually secretes a myokinase and it actually will actually stray away the chances of Huntington's Parkinson's as well as Alzheimer's because it actually keeps the brain healthier with secretion of certain enzymes. And I think that's incredible. Like the fact that there's how many other things can you do that actually stave off the. It staves off disease. Since you're bringing up the studies, there's one that I always hold dear to my heart that I want to say it was in the in the journal JAMA, which is a highly regarded medical journal and folks, if you're out there and you find out it's another, some high impact article, forgive me, but that strength training was and whole body strength was associated with all cause mortality, meaning anything that could kill you. Is reduced the risk of anything killing you is reduced if you do resistance training. So I just love the idea that, you don't need this special pill, this special drug that only, the rich and famous can have access to. All of us have access to this tool and it just requires you to be there and show up and you can make all these changes to your life. live longer and live better. Essentially. That leads me to my, my next question. Just cause we know the plethora of strength training benefits already. So if you're listening, definitely try some form of strength training, even if it's without dumbbells, try even just air squats or something, but a question that I sometimes get Alex is strength training for everyone. Obviously for someone with zero comorbidities or a teenager, obviously there it's a no brainer. They can probably strength train and make a plethora of gains there. But what about people with like multiple comorbidities, like heart disease, diabetes, let's say they have arthritis. Is this something that you still promote to them? Yes. As I alluded to before, just with the previous study alone, I told them that Doing something is going to reduce your risk of dying prematurely. Flat out. It's proven. If you, of course, I'm not telling the guy with like bad heart failure, like a really active chest pain every time he gets up to move to go just start training for a marathon. But we do know that, for example, patients with angina, a little bit of blockage in the heart is basically What we're talking about that we do that, have them perform treadmill exercises just to start get moving, get the heart pumping, gets it more fit. You will have less episodes of that pain and you'll be able to do more without feeling pain and discomfort. And also because strength train does confer aerobic benefits as well. And it doesn't require you to get necessarily all this extra equipment you don't need by 1, 000 treadmill or a fancy Peloton bike. Like you're saying, Jason, you could just do something as simple as air squats at home planks at home. Things are going to strain your body a little bit beyond what it's comfortable doing, and it will adapt in a positive way. But, we're then a certain limit, but to encourage people to start doing something now, rather than waiting. Is always encouraged. You will I cannot think of a scenario unless maybe actually I can, but I'm saying that chance of that would be so rare. Like you had something called osteogenesis imperfecta where your bones broke really easily, but even then you could do some form of strength training to strengthen the muscles or protect your bones, but in general, there is. I can't, I honestly can't imagine a time where you cannot strength train unless you literally physically can't do it. So it's for everybody. And it's it's an open secret, it's one of the things that tie in with living longer and people are always trying to find what the next secret is to living a longer, healthier life and longevity. This is going to be the biggest thing for your buck that you could do And I think as well I always tell people if you work hard now, you can have an easier life later. If you take it easy now, you will still have to work hard at some point. And when you have the motivation to work hard, when you have heart disease and when you have multiple comorbidities, if you don't develop the habits and the persistence and the mindset to work hard now. You might not work hard later. So you really have a choice. You work hard now, develop as much strength and reserve as you can now in your younger years so that you can enjoy life to the fullest later. And then I think just to hit on one more note about. Progressive overload strength training as much as people think that strength training is just a classic. Let's say 3 sets of 10, 3 sets of 10, everything and you can settle with the same weight. Is that something that you promote in your own life, like progressive overload to be able to increase the parameters of weight or increase the time under tension or increase the load or the speed in some ways and is. Is that something that you practice yourself and is that something that everybody should be thinking about when it comes to strength training? Yeah as I mentioned before, if the body is resilient, it will adapt given, the right amount of. Stimulus. I think there is some research in it in the physiology journals. We call that minimal volume response or minimal response to volume. In either case, your body will need a certain dose, just like medication, right? For medicines, the appropriate dose will get the right response. And so for the body to adapt in terms of strength, tissue resiliency tendon strength. You do have to eventually start pushing the envelope a little bit. Once you Don't and either in either overall loadage or maybe the weight that you are attempting at that point in time, then that is when your body will stagnate. Of course, as you get more and more advanced throughout the years, the gains and the, the amount of adaptations that will take place is going to be a lot smaller. But yes to answer your question, that is something I strive for every time. In my mind, when I go through a workout, I do pretty much the mostly the same exercises that are of course, large compound resistance exercises, but some parameter I am changing. I either I am. Increasing the weight. I'm doing a different version of that same exercise and pushing that envelope until I fully adapt and I can't push it anymore. Or I do more volume within a reasonable amount to get a response. And without diving too much into the specifics that is how life should be lived. It should be also, you're pushing the envelope in some way, giving yourself meaning that I'm not just going to gym just to do a workout where I shut my mind off. Although it's not that I definitely go turn my mind off. I get into this flow state where I am trying to tweak things here and there and make getting the most I can out of the 45 minutes to one hour that I have for this day. And I think there are some lessons there for how it can be applicable to daily life outside of the gym. So without diving too much into it, but yes, I. I think trying to push the envelope should be something that everybody strives for because it gives you also a reason to go back. You're thinking that, okay, I didn't do it this time. I'm going to go back there next time. Yeah. And adaptation, resilience, the ability to push yourself in the gym, I think does translate very well to being motivated to do other day to day tasks. I think that if you. Are able to measure and actually see measurable changes in your strength. I think that leads to so many other factors like mental resilience hardiness to complete projects faster to be a better father and mother. And I was actually talking about this with another colleague about how. Whether progressive overload and being able to see measurable progress in, in the gym or in your workouts translates to a goal completion in other aspects, like whether being more financially sound I'm curious to see if there will be research on that at some point. But like I said, it's your body is adaptable and it's very resilient for anybody that is watching right now and thinks that they're fragile to thinks they that they're that their life is limited. I encourage you to that strength training is legit for everyone. It's whether you start off with even just air squats or whether you're. Someone at Alex's level and you're actually starting to do dumbbell and resistance training. Everybody will have a specific baseline. Everybody has a specific reserve. You understand those boundaries. You can start to play with those boundaries and push yourself so that reserve gets larger and that you become I guess just more whole and complete individual. I guess I agree. Yeah, for is there anything else? Any last messages to my audience? I think I've explained to you my audience and the general people that speak, but is there any like last words of advice or messages for those that are that are listening right now? So I know we've been talking a lot about the gym, but the gym is a accessory to life. It should not be your life. And I just really encourage somebody that think that's listening to this and still really doubting that you just can't go to the, you can't do something. I encourage you to push that boundary. I want them to take out that negative talk and just try it and see how far that gets you. Cause even digging that first initial step, rather than just sitting there and doubting is going to take you leaps and bounds much further than just. Saying I can't I want to tell you in your office that you can you I truly believe you can both, in the mental sense and also from the medical, physical sense. You can and if you are able to do it, I encourage you to try. Absolutely. And that's a great message to end with. Obviously, if you are having any doubts or uncertainties about starting a strength program, that is where you can talk to Alex or myself. And and I'll also leave Alex's Information, but thanks for your time, man. I really appreciate it. I know that we have very similar, just backgrounds and the ideations and the way that we perceive life and our purpose it's golden. And we're both doing great work. Is there, for some people that want to learn more about you or find you in some ways, where can people find you and find out more about you? The easiest way is I do work for UCLA. So if you are seeking for somebody to just. Pretty much tell you the same thing I just told you on this podcast. I'd be happy to see you. You can Google my name, which is Alexander Hu. And then I work for UCLA. And if you put those two words together, you will find me at Woodland Hills, California. And yeah, I'd be happy to help anybody out if they seek it. Awesome. I appreciate your time, man. And that's what I got for you guys today. If you enjoyed this episode, definitely hit that subscriber follow button. I do release episodes every morning on Wednesdays, and I'd love if you can leave a rating in your podcast app, Spotify or iTunes. That way this will be pushed out to more people. People will hear Alex's message. And we'll be able to grow this channel as well and push this message about strength training out there. And if you have any feedback, good or bad, I don't really care. And I also, I'm very receptive to feedback. You can either email me jason@flexwithdoctorjay or send a quick text 4 1 5 9 6 5 6 5 8 0. And I'll leave you always with these last words of advice. We only have one body, one life, make every action you take be the one that makes you a better version of you. Take care.