As Fit As In My 30s?

Ever wonder if 60 is the new 30... on a bike? This episode of Cycling Over Sixty is packed with mountains (both literal and metaphorical). Tom Butler tackles a challenging 25-mile test ride through the Washington mountains, a key section of this session challenge to ride across the state. But will the test ride answer concerns or raise red flags with his ever-supportive (but perhaps slightly apprehensive) wife, Kelly?

Plus, is age really just a number? Tom sits down with Dr. Erin Medina, a lifestyle medicine expert, to discuss a couple of thought-provoking articles by Phil Daoust in The Guardian online. Can Tom turn back time on his fitness level, or are there new ways to define peak performance over 60?

Link for Phil Daoust's writings: theguardian.com/profile/phildaoust

Thanks for Joining Me! Follow and comment on Cycling Over Sixty on Instagram: https://www.instagram.com/cyclingoversixty/

Consider becoming a member of the Cycling Over Sixty Strava Club! www.strava.com/clubs/CyclingOverSixty

Please send comments, questions and especially content suggestions to me at tom.butler@teleiomedia.com

Show music is "Come On Out" by Dan Lebowitz. Find him here : lebomusic.com

Transcript

Tom Butler: 0:04

this is the cycling over 60 podcast, season 2, episode 47, as fit as in my 30s, and I'm your host. Tom butler, thanks for joining me here on the podcast, where I interview people who I think have valuable information to share about how to get fit and stay fit later in life and to talk a bunch about bicycling. First, here's a brief update on how my fitness journey is going. I just want to say again how much I enjoy hearing from people in the Cycling Over 60 Strava Club and I particularly enjoy the pictures. I know I've said this before, but it really is true. This week I enjoyed the sight and sound of a young osprey that Larry L posted on Strava and I certainly enjoyed the message that Erin Ely posted about her journey. It was spectacular. The whole post is great and it starts out with her sharing that she started weight training at 61 years old. I would encourage everyone to go to the club posts and read her story. Thanks, erin, for sharing. It was super motivating.

Tom Butler: 1:10

As I mentioned, last week, on Friday I rode a section of US Bike Route 10 that I plan to use to ride across Washington in September. I started at New Halem and rode 25 miles to the East Creek Trailhead. I think that ride gave me a good idea what it would be like to ride over the passes. A big reason to scout the road was so that my wife Kelly could see what the conditions are like. She hasn't thought this challenge for season two was a good idea. I was hoping that by seeing the route either I would determine it was too much of a challenge or she would become more comfortable with it. She drove from Marble Mount, where we had stayed the night, to drop me off at New Halem. Then she picked me up at the East Creek Trailhead. After that we drove to Washington Pass to check out the rest of the climb, and then I recorded her response to seeing the conditions. Here's what she had to say you just got done driving State Route 20 from marble mount to washington pass, so what's your impression?

Kelly Butler: 2:07

it's pretty okay lots of places to hike and lots of views to see, lots of waterfalls it'd be definitely a place that we would want to come do some camping.

Tom Butler: 2:18

Huh yeah, how about for someone riding a bicycle?

Kelly Butler: 2:22

I don't know.

Tom Butler: 2:26

You have been not excited about me doing that ride. Yeah, what did today do?

Kelly Butler: 2:39

Did today confirm your nervousness or did today alleviate your nervousness? Today resigned me to it.

Tom Butler: 2:42

Resigned you to it. Yeah, Like you're not happy about it, but you're kind of like it's going to happen. Is that what you're saying?

Kelly Butler: 2:52

Yeah, it's going to happen and I think it will be okay.

Tom Butler: 2:55

I mean.

Kelly Butler: 2:56

I can't say that I really think it's still a great idea, but I think it's going to happen and it'll be probably okay.

Ernie Medina DrPh: 3:02

Okay.

Tom Butler: 3:03

Well, that's good news, because it could have been different and you know there were some places that we were driving that the side of the road looked terrible.

Kelly Butler: 3:12

Yeah, they were, and I wanted to ask you about those.

Tom Butler: 3:16

Before I talk about my thoughts on the route, let me ask what did you think of her response? Not a lot of enthusiasm, I would say. I think it is hilarious that when I asked her what she thought, her first comment was about how beautiful it was. Like she was avoiding the thought of me riding that route. So I went with it and talked about camping, seeing if she would bring the conversations around to her thoughts on me riding State Route 20. But that didn't happen. And then when I asked her specifically about riding it, she said how about for someone riding a bicycle?

Kelly Butler: 3:47

I don't happen. And then, when I asked her specifically about riding it, she said how about for someone riding a bicycle?

Tom Butler: 3:49

I don't know, isn't that as lukewarm as you can get? And talking more about it didn't seem to help. You have been not excited about me doing that ride. Yeah, what did today do? Did today confirm your nervousness or did today alleviate your nervousness?

Kelly Butler: 4:10

Today resigned me to it.

Tom Butler: 4:12

Resigned you to it.

Kelly Butler: 4:14

Yeah.

Tom Butler: 4:14

Like you're not happy about it, but you're kind of like it's going to happen. Is that what you're saying?

Kelly Butler: 4:22

Yeah, it's going to happen and I think it will be okay. I mean I can't say that I really think it's still a great idea, but I think it's going to happen and it'll be probably okay.

Tom Butler: 4:34

I guess I'm resigned to it and I think it is going to be okay is the most I'm going to get at this point.

Tom Butler: 4:43

Now I'm going to be honest and say I wish Kelly was excited about it, but I do believe, as funny as it sounds, that her response there is better than what she's been thinking, and I think if she was really afraid of me riding the route, I think she would have said that I do see that we are moving in the right direction here. After all, before we did this test ride she was really against me doing it. I'm hoping that breaking down the route a little bit more, she'll warm up more and more to the idea of me doing this challenge. Here are my thoughts about the route. First, I never felt unsafe on the ride. There was one time when a large motorhome passed me and I felt the gush of wind from it. It was too close to me. I can be sure that I will get passed by several motorhomes on this trip, so I'm going to get a mirror on my bike before I do it. That way I can make sure that I can move over as far as possible when a big motorhome is coming.

Tom Butler: 5:39

An important thing is I felt comfortable with the climbing. For the 25 miles I climbed 3,081 feet. I wasn't sure what I would feel like after doing that climb, but I felt fine Because of the downhill sections. I was able to average 9.4 miles per hour. I believe that is enough to get me over the passes and then down the other side to where I want to stay and do it in a reasonable amount of time. To where I want to stay and do it in a reasonable amount of time. Again, on this test ride I stopped after 25 miles and I will have to do another 17.8 miles to make it over Washington Pass. That 17.8 miles includes about the same amount of climbing, so it's a little bit steeper, but I still think it's not going to be a big problem. And then from there there is a 30-mile downhill to where I will stay in Winthrop. Now, based on this test ride, I think I'm good for at least the first two days of the trip, but I still have challenging days beyond this, so I'm still not 100% confident I can do the whole ride. I do know one thing I will need to figure out how to carry enough water if it is a hot day when I'm climbing up to Washington Pass. There aren't many places to stop for water in the park. Of course Kelly is going to be around in the support vehicle, but there is no cell coverage in the park, so everything has to be coordinated in advance.

Tom Butler: 7:10

I got interested in the writings of Phil Doust, a joint deputy editor at the Guardian. In March In the Guardian Online he posted an article with this title Will Years of Drinking and Inactivity Be a problem? Since March, dost has posted several articles about longevity. I thought a friend of mine, dr Ernie Medina, would be a great person for me to discuss what Dost was writing about. He has been focused on the link between lifestyle and longevity for his whole career. I'm so happy that Ernie joined me to answer some questions on the topic. Here is my chat with him. I am so pleased to welcome Dr Ernie Medina to the podcast this week. Dr Medina, thanks for joining me.

Ernie Medina DrPh: 7:52

Thanks, thanks for having me, tom.

Tom Butler: 7:54

Now I have wanted to have you on since, like the beginning of the podcast. We have known each other for a very long time and I thought that your perspective would be really good, and a big reason for that is that I know that you've been focused on helping people stay healthy for a long time. Lifestyle medicine is a term that has been around a while, but when you started working in the field it was really before that concept was really widely known, I believe. Yeah, so can you talk about what got you interested in the link between lifestyle and health?

Ernie Medina DrPh: 8:34

Well, you know, I grew up in a healthcare family, a medical family. I think you remember my parents from back from our Michigan days. They were both physicians. So I was exposed to, you know, healthcare stuff for a long time. But then it wasn't until a mutual friend, dr Wes Youngberg, who really got me thinking more about the wellness side of things. That was my senior year, my junior year in college. Basically that's sort of what steered me away from more sick care to health care and wellness care, if you will, and prevention. So that was sort of the start of it.

Ernie Medina DrPh: 9:11

I got back I was serving a year in Japan, in Singapore, as a student missionary and teaching English, came back thought I was going to go the usual route, follow my friend's footsteps. But then when I talked to Wes, he was the one that really turned me on to lifestyle medicine. We didn't call it lifestyle medicine back then, it was more about it was just more about preventive medicine or prevention, and he was here at Loma Linda at the time. So he told me all about this and, hey, this is the field you'd really love to get to. It's all about exercise and nutrition and all that. And that really piqued my interest because I was really more interested in prevention versus just fixing sick people and treating them after the fact. So that's sort of where it all started.

Tom Butler: 9:53

And I'm guessing this is like 86, 87.

Ernie Medina DrPh: 9:57

Yeah, I got back. I was gone 85, 86. I came back in 87, january of 87. So that's when I changed my major. I was a med tech major, switched it to health science. Fortunately the prerequisites for grad school were similar, so I didn't have to do a whole lot. But I did change my major and then finished in 89 and came out to Loma Linda University in 89. Then I've been out here ever since and teaching. Yeah Well, when I graduated, I in 93 from with my master's in public health and health education and my doctorate in public health, in preventive care, and I grad.

Ernie Medina DrPh: 10:31

So when I graduated 93, I immediately my last place where I was doing my internship was at a place called beaver medical group in redlands, california, and so I did about six months there, my last six months of my, my graduate school program. I was working on my research, my dissertation at the same time and then I was basically working full days working in health education there at the time as an intern, a student intern. Well, where are you going? Who's going to keep doing all this stuff that I started over those last six months? I started a stress management program. I revamped their quit smoking program. I was working in weight loss and all that. So I said, well, I'm looking for a job. And so we went right down to HR and she created my job on the spot and I was like number three employee in the department at the time. We had a part-time dietitian, full-time secretary and a director. So I was like a third person. And then I worked there for about 21 years. So it grew from a very small few clinics to a very large medical system and so by the time Loma Linda brought me back that was like 21 years later we had grown into a huge facility, you know, over 100 something physicians and our department was big and so.

Ernie Medina DrPh: 11:53

But I came back to Loma Linda because I figured, hey, you know, I could help train the next generation of preventive care specialists and and and all, and still do some of what I was doing there, because that was one of my conditions for coming back. I said, hey, I don't want to leave the clinical setting. And they said, yeah, yeah, no, we don't want you to leave that, we want you to be sort of a bridge between academia and the clinical side, because there was all these silos. And so because I sort of spoke, I was sort of a bridge. I was on the clinical side but now I was in academic side. I was on the clinical side but now as an academic side I was sort of like that bridge and so, and then I've been here now 10 years. So it's been 10 years since I've been here.

Tom Butler: 12:29

So I've been in wellness and lifestyle medicine, preventive care, for a little over 30 years now have this real clinical application early on, where there wasn't a lot of places around that took prevention that seriously. As a member of the entire care team, is that a fair statement to make?

Ernie Medina DrPh: 12:58

Yeah, that's true. That's true. I mean back then when I was first starting out, there was hardly anybody focusing in this area. I mean I knew some of my mentors, like Wes and others, were the founders of the American College of Lifestyle Medicine, for example, aclm. Back then we only had like a couple hundred members at the most. Most of them a lot of the members, the founding members, were from Loma Linda, because we were really the only ones at the time doing lifestyle medicine and I was on the board of directors. I mean because they probably needed they're probably desperate for board members at the time. So I was really early on. I was in that.

Ernie Medina DrPh: 13:31

Now when you look at ACLM, it's the leading lifestyle medicine association out there. You know it has. I forgot how many members they have, but when we were having our annual meetings back then we maybe lucky to get a couple hundred people. I mean that was like wow, we're doing really well. Now they get over 4,000, 5,000. I mean it's huge and there's universities from all over the place and a lot of people are involved in it. So yeah, it was not a known thing back then within the healthcare system. So we were really Loma Linda was really on the cutting edge of lifestyle medicine, preventive care, that kind of thing.

Tom Butler: 14:12

And Loma Linda is known. We've talked about it a few times on the podcast as a new zone yes, so it is in the heart of some place that's been recognized as a community that embraces longevity.

Ernie Medina DrPh: 14:25

Yes.

Tom Butler: 14:25

I think that also gives your perspective something unique, because of being in the heart of that and the research that goes on there.

Ernie Medina DrPh: 14:34

You're right. Yeah, no, that's exactly right. I mean it's sort of in our DNA. I mean it's, you know, even from the spiritual side. Loma Linda is a Seventh-day Adventist church and even our denomination is really rooted in health, and you know we're known for our healthful living and that kind of thing. So it's part of our makeup, you know, not just academically but also from a spiritual denominational standpoint.

Tom Butler: 15:00

Now you have a relationship with cycling. Can you talk a bit about cycling in your life?

Ernie Medina DrPh: 15:06

When you say cycling, probably we should clarify there's a lot of cycling, right, there's a lot of different. So I am not a road cyclist, I'm more of a mountain biker. I like mountain biking, I was a mountain bike coach so, which I didn't actually do a lot in my undergrad back in Michigan, because there's no mountains there, right, it's just it's flat. But when I came out to California, that's when I really got into it and then so my wife and I, really early on, we were into mountain biking and would go up to the mountains every weekend and find a new trail, a new ride up there. And then when we had our daughter, she was, you know, we were pulling her on the bike trailer and then the tag along bikealong bike. Then she had her own bike and, you know, fast forward she got onto the mountain bike team and in her senior year I was a mountain bike coach for the team, a parent coach, I should say I wasn't the main coach, we had main coaches, but parent coach.

Ernie Medina DrPh: 15:58

And then her senior year of high school, they won the SoCal Division II mountain bike title for NICA, which is the National Intercollegiate Association. It's basically the organization for high school mountain biking in the US. So that was really exciting, and I still do mountain biking now. When we were homeschooling summer our daughter, I started a mountain bike club for the homeschoolers. Since I was one of the few dads that had a flexible schedule you know, being being a teacher, I could, you know, arrange my time so I was the one that would lead out and help the kids, the homeschool kids, mountain biking here in our hills right here in Loma Linda as I watch cycling, cycling competitions, whether it's the Tour de France or a smaller mountain bike competition, like you would have been observing as a parent, it seems like there's an element of crashing.

Tom Butler: 16:54

I mean, was that ever like a consideration as a parent, watching your daughter fly down some hills or whatever? Oh, definitely.

Ernie Medina DrPh: 17:02

I mean I remember when she first started on the team officially, she, you know she, she was on the swim team since she was six, so she did swimming and then she also did ballet and dance. So she was very cardiovascular Her, her VO2 max was through the roof. I mean she could swim for for hours nonstop. She was a machine and and the butterfly was her, her signature stroke, which is one of the hardest strokes out there, and I think her ballet dancing helped with that because she was very flexible, you know, through her whole body. So cardiovascular she was a machine.

Ernie Medina DrPh: 17:34

But going downhill she was as scared about crashing as anybody else. I mean she would go. So she would pass a lot of kids you know girls that she raced against on the uphills, but then on the downhills they'd all pass her. So that second, between the first and second year that she was racing, her junior and senior year, she was JV on first year, varsity on the second year the coaches really had to work with her about increasing her speed on the downhill, her confidence and really what it boils down to. It really boils down to technique. And you know they're not doing Red Bull. You know you've seen the Red Bull riders. I mean they're not doing that. In fact, in NICA your team will get penalized if you're caught, you know, doing unnecessary jumping. I mean they try to keep it really safe for the kids. So if you learn the technique, you know you can keep crashing to a minimum. And so she learned the technique she did. You know she did crash a little bit here and there, but nothing like crazy crashing. And yeah, she increased her speed quite a bit. She became a much better mountain biker than me. She could leave me behind in the dust on the uphill and the downhill so I wasn't worried about her.

Ernie Medina DrPh: 18:41

I was worried more about when I, actually when I bring the parent, when I bring the kids homeschool, kids mountain biking and parents will ride with us. I'm more afraid of the parents than I am of the kids. Because I say this in my 25 years of bringing now three generations of kids, the last group of kids, you know, not the current ones, but the last group of kids that I was bringing out riding. They're all graduating college now. So you know they came in waves. And all those years I've been doing that I haven't, you know, I didn't lose a single kid to a serious injury. Yeah, knees scraped and all this and, but never had a broken bone, anything like that. But parents, that's a different story. I've had parents, broken collarbone, you know. Yeah, I've had some serious fractured vertebrae in the neck. I mean, one parent hit a jump that she didn't know was there and landed on her head so we had to walk a bike out, you know, and all this I mean so the parents were the ones I was more worried about than the kids.

Tom Butler: 19:42

So yeah, it just seems to make so much sense really when you think about it Again, I wanted to have you on, I wanted to talk to someone who had a lifestyle perspective, but I don't want to move on to that without talking about another sport.

Kelly Butler: 19:57

Okay.

Tom Butler: 19:57

Now you are familiar with pickleball and you are not a casual pickleball player, right?

Ernie Medina DrPh: 20:05

Yeah, yeah, yeah. I am not a casual, that's true, I'm not a casual pickleball player.

Tom Butler: 20:11

So talk about pickleball a bit. What? What are you involved in these days with pickleball?

Ernie Medina DrPh: 20:17

Oh geez. The better question probably is what am I not involved with in pickleball? Unfortunately, pickleball has sort of overtaken my life and I don't ride as much mountain biking as I do now, so I'm sort of in between homeschool groups right now. But I started pickleball in 2016. My mom I was back in Michigan visiting. I was actually picking up my daughter from our alma mater and Andrews University. I was picking her up after her freshman year in 2016. And my mom invited me out to go play pickleball at the church the Philan church. There they have a gym. She said, hey, come and play pickleball with us and I'm like, play what?

Ernie Medina DrPh: 20:51

But I grew up playing tennis. You know I'm not that tall and five foot six, so I wasn't good at basketball or volleyball or you know where height was a premium, you know, and so I. But I excelled. I excelled at racket sports, tennis. You know, when I was in academy I was playing. In high school I was playing college students in tennis, racquetball. I picked up in college and I did very well at that. Ping pong I was playing since I was a kid. You know, I'm Filipino, so all Filipinos have a ping pong table right, so I can make that stereotype right. So you know anything with a paddle or racket. I did very well, and so when my mom said, oh yeah, this is, you know, it has a paddle, I said OK, I'm in, and from that moment on I really got into it.

Ernie Medina DrPh: 21:33

So when I came back to California, however, there was no pickleball right here around the Loma Linda area, probably like within a 40, 50 mile radius of us. There was no pickleball. Within a 40, 50 mile radius of us, there was no pickleball. So, long story short, I ended up getting a net, started it in a local public tennis court here, invited some friends there was like actually nine of us and that was the start of pickleball here in the Loma Linda area. And then it kept growing, growing, growing. I kept hopping around looking for other places to play. In the meantime I became the ambassador here because there was no.

Ernie Medina DrPh: 22:03

So USA Pickleball is the national governing body of a pickleball. Like USA Swimming, usa Gymnastics, usa Pickleball is the national governing body of pickleball. And so they make the rules, they approve the paddles, what's legal, what's not legal. Their mission is to grow pickleball in the US and then eventually, when it gets to the Olympics, then we will be involved with selecting the Olympic team, but right now it's not even close to being in the Olympics yet. So I became an ambassador for USA Pickleball. It's a volunteer position, but I became the ambassador so I was sort of the spokesperson in this entire region as we kept growing.

Ernie Medina DrPh: 22:40

That's when people said, hey, we should start this in Riverside, we should start this in Redlands, we should start this in Yucaipa. So, being the only ambassador at the time, I would go and meet with Parks and Rec, city council meetings, you know whoever. We'd drive around looking at tennis courts, trying to find an empty tennis court that we could potentially start a pickleball group there. So that's how these places started. And then once we got, we found the place, we got the okay with the city. Then I would tell those people, those residents from that particular city, because they were all playing in Loma Linda at the time I said, okay, now we have a place, set your schedule, and then now you'll have to select an ambassador, because I can't run Loma Linda and I was doing Grand Terrace as well, because that's where my church is and we had pickleball courts at the back of our church. So I said I can't run two city, I can't run more than two cities. So that's how the ambassadors started growing in this area. And now you fast forward to today. In every city around Loma Linda there are pickleball ambassadors, pickleball clubs I mean huge clubs, cities building new courts. Yucaipa is just finishing up 12 new courts. We got a half a million dollars over COVID from the city council to expand their pickleball program. Riverside is in several parks and they're building another pickleball facility there. So I mean it's crazy to see how it's exploded in this whole region just from the nine people that started.

Ernie Medina DrPh: 24:02

And I look at it not just as a fun sport to play but I look at it as a public health intervention Because if you think about it now, there was nine of us playing pickleball. Now you look at, I mean, every day of the week there's pickleball happening somewhere. And now there's generations of people like if I show up at Redlands I could play there, they would know me from Adam. I mean, even in my own courts at Loma Linda I just met somebody, um, on Sunday. They didn't know who I. Well, a lot of people know who I am, but they don't know who I am. So when I introduce myself, let's say, oh, you're Ernie, like. It's like oh, is that a good thing or bad thing? I'll still run into people that don't even know who I am and they they'll ask me oh, how long have you been playing pickleball?

Ernie Medina DrPh: 24:45

And then once I share them a little snippet of what the story is, because we were the ones that got the pickleball started at Loma Linda. They're like, oh, my word, you're the, you know the founder. But if you look at the Blue Zone show, you know the one, the Netflix show on the Blue Zone. On Netflix, dan Buechner calls my mom the god, and people who know her and know us they'll say wait, how is she the godmother of pickleball? But she lives in Michigan. You know Loma Linda. She doesn't live here, but if they know the story, it was because of her. She got me in the pickleball and then I got it here. So the people who know the true, you know the real history. They credit her for introducing it to me and then me bringing it back and then starting it here. Introducing it to me and then me bringing it back and then starting it here.

Ernie Medina DrPh: 25:34

So I've been as an ambassador since 2016. And then, in 2020, I was elected on the board of directors for USA Pickleball. It's a nonprofit so they have a board of directors. So I've been serving on the board of directors now since 2020. So that has been a really unique opportunity to see the growth of pickleball both in the US and internationally from the 30,000 foot level, because you know, we're the board of directors over USA Pickleball. And so a lot of drama in the pro side. I'm glad I'm not really involved in a lot of that. But on the recreational side, the grassroots side, it's exploding. Since COVID it's been just going vertical. I'm teaching. I'm a certified pickleball coach as well. I got certified a few years ago. I'm teaching here at Loma Linda part-time. That's my other hat I wear as a pickleball coach. I'm teaching pretty much every day of the week, either private lessons or classes, because so many people want to take lessons and learn about pickleball. You can say I'm a little bit involved. I play tournaments as well I do train and I drill.

Ernie Medina DrPh: 26:35

Besides teaching people, I drill and practice myself as well. I play now mostly nationals is the big tournament I play and then I play a lot of local small tournaments just to keep, you know, get that tournament feel. But nationals is my one big tournament I like to to go to and play.

Tom Butler: 26:53

Next year might be a big year for you. I think Is that right?

Ernie Medina DrPh: 26:56

Next year? Oh yes, Because in the pickleball world everybody's excited to get older. So once you hit 50 and older at the big tournaments they go by five-year increments older at the big tournaments they go by five year increments 50 to 54, 55 to 59, 60 to 64. So then you end up playing people in your age category and your skill level. So next year I turn 60, so I get to age up into the next category and I'm the youngest at that category. So it's like great, I get to play all these older guys and I'm all excited about that because you know, I like that you called it like a community health education intervention.

Tom Butler: 27:41

I don't know, intervention might not be the right word, I don't know strategy.

Ernie Medina DrPh: 27:46

Well, I call it. I called it a public health intervention because I think of it as an intervention that gets people moving. Because you know what the federal recommendation is for physical activity, right, it's 150 minutes of moderate intensity activity per week. That's the dose of exercise that's recommended to all Americans, right? And last I saw there's still like 25, 30% of Americans that are getting close to zero. So we've got a quarter of Americans and not even getting close to that. Then you have probably 50 or 70% more that are barely getting some but not that. Then you might get only like maybe 25% Americans who are getting that minimum or more. So you know we've got a long ways to go to get people more physical active. So that's what I look at pickleball Cause, if you looked at this area and you look on those courts, I can guarantee you most of the people I go to any court here in the Inland Empire, which is our area here where Loma Linda is, and you ask them what they were doing before pickleball, most of them would say they weren't doing anything, they were sedentary, they were not active.

Ernie Medina DrPh: 28:50

Maybe they were active before, when they were younger, whereas you know, if you're talking to older people, they weren't active at all. So now you see them being active and you know it's. You know I use the acronym simple to explain pickleball or to remember the attributes of pickleball, because, you know, when I was working at Beaver I was trying to promote physical activity to people, to the patients. But mountain biking was like you said, it was sort of scary and dangerous and it's very intense. I mean, you just don't get on a mountain bike and start riding. It's very intense, it's very hard to do.

Ernie Medina DrPh: 29:23

I played ultimate Frisbee when I was younger and that's also a very intense sport. So, again, I wasn't going to get my patients who were overweight, out of shape, you know, diabetic, whatever to all of a sudden start playing ultimate Frisbee. And so I was always looking for that holy grail of exercise, physical activity that could override the excuses that people would tell me. So over the last 30 years I would talk to a lot of patients and they would tell me why they don't exercise. They know they should exercise, but they would tell me why they don't. Oh, it's boring, it's too difficult, I don't have time, it's too expensive, it's too difficult, you know, to do. I mean not just intensity wise, but it's too difficult to to perform, you know. So they would give me all these things.

Ernie Medina DrPh: 30:06

When I started playing pickleball I found that pickleball basically checkmarked all those excuses off, so they had no excuse Like. So that's why I use the word simple, because simple, you know, it's social. So, you know, because I don't like some things that are boring. Like, to me, walking is boring because it's just it's I can't be. So I mean I could walk with other people, but I don't know, it's just not social enough for me, even though I know it's easy. But pickleball is social.

Ernie Medina DrPh: 30:34

The I in simple stands for inexpensive. All right, so it's inexpensive. And also it's inclusive. So I've taught kids to. I've taught six years old to 60 years old and plus, or 80 years old, my mom's 86. She still plays four times a week, right, so it's inclusive.

Ernie Medina DrPh: 30:51

I played with people in wheelchair, okay, wheelchair pickleball players. So I played with deaf players. I mean we have a whole school of the deaf here in Riverside. There's a bunch of them that are really good pickleball players. So it's inclusive. It's inexpensive. A paddle we started with wood paddles. Those cost 10 bucks, right, the net is inexpensive.

Ernie Medina DrPh: 31:11

M stands for multi-generational. So my mom, kids, grandkids, you know that we all play. We all play and we can all play well. And my mom and I can actually beat a lot of the younger players because of the way the sport is designed, so multi-generational L oh, I forgot P you can play anywhere. So that's why it exploded during the pandemic because you could set up a net. I've played in hotel lobbies, cul-de-sacs streets, parking lots, hotel conference rooms, wherever I can set up that net. You can play pickleball right.

Ernie Medina DrPh: 31:43

The L stands for the learning curve is very easy. I can teach most people within an hour. They're playing their first game. All right, very easy learning curve. Tennis. You got to take a lot of lessons in order just to even serve the ball Right. So learning curve is easy.

Ernie Medina DrPh: 31:58

And then the last part, e, is that it's enjoyable. You know, if it's not enjoyable, I don't care how good the exercise is. If I had a patient who did not enjoy the activity, they would not do it Right. So pickleball pretty much checkmarked off all those excuses I heard over the years. And so to me pickleball is like the holy grail of promoting physical activity, because you can do it anywhere, it's cheap. Well, you know all those reasons. So it's just a matter of getting people to try it, and not everybody. My wife doesn't play pickleball. She has zero hand-eye coordination, so and she has a partially torn ACL so she can't move laterally, so that's fine. She runs every day. I'm not worried about her, but it's the other people out there that I'm worried about the other 80% of the people.

Tom Butler: 32:41

I ran across a couple articles in the Guardian online and.

Tom Butler: 32:46

I wanted to talk to someone about it. Like I said earlier, I wanted to have you on and have a conversation with you for a while. I think your background gives a really good perspective on part of this. The articles were not written by a health expert, but by Bill Dowse, the joint deputy editor of the Guardian. I think that makes them interesting because it is a perspective of a pretty normal person. First off, in March, dowse wrote about his desire to live longer with better health. What I'm wondering is, from your experience, how typical is it that people get to their 50s and 60s and then all of a sudden realize you know what, I need to do something different?

Ernie Medina DrPh: 33:34

Yes, no, that's that. That's very. That was probably a lot of the patients I saw working when I was working at Beaver Medical. These are people that are in their 50s, 60s, you know they, they've their kids, are now teenagers or, you know, high schoolers, you know, maybe even college, depending on they, started having kids and so they're, they're starting to get like oh, you know what I'm going to start doing. I want to do stuff with my kids, be active with them, or I'm they're getting back. You know they're starting some new things or doing that and they're finding that, man, my back hurts, this hurts, I'm overweight, my knees hurt my joint, I'm overweight, my knees hurt my joint. You know they're out of breath, they can barely walk up flat stairs.

Ernie Medina DrPh: 34:14

Then they realize, oh man, all these years from my, from my thirties to my fifties so that 20 year gap people usually have let their health slide. You know, up to their twenties they're in college, they're, they're young. You know they don't think about that. You know the body. They can, it can take a lot of abuse. Then they get into their mid-20s and early 30s, like my daughter's 27 right now. So she's just starting her career. So you know they're busy and they still want to have a good time. But if health is not a priority for them and it hasn't been established early on, that's usually said well, I don't have time, I'm busy with work, I'm establishing my career.

Ernie Medina DrPh: 34:48

So then for the next 20 years from their 20s let's say 25 to 45, they sort of let that part of their life slide. Okay, and they're not exercising, they're not eating right, maybe their sleep habits aren't that great, whatever. Then they start getting their 50s and all of a sudden their blood pressure's up. They're borderline type 2 diabetic. You know, we call that syndrome x or metabolic syndrome.

Ernie Medina DrPh: 35:11

You know, now they're getting all these warning signs, right. You know, at 50 you have to get all these tests that you have never gotten. You know, I got my colonoscopy right. So you start getting all these checkups and you realize, oh no, I've just wasted the last 20 years and not doing anything, and now I'm at this crossroads. And so I think that's why we see a lot of people in their 50s and even 60s are saying look, you know, they see the 60s and new 50s now because everybody's living longer and all this. So I think that's why we're seeing those people are like oh, I, you know, I don't want to live the next 30 years on using a walker or a wheelchair because I I was a diabetic and then I'd get amputated, you know that kind of thing. Or I went blind because I didn't take care of things when I could have so. So I saw a lot of patients in that age range because it was sort of a wake up call for them.

Tom Butler: 35:59

Now, people like you have been talking about this for a long time. You know the mid eighties, late eighties, which you know. How do we get people to recognize that they need to take action before they're already in a disease state?

Tom Butler: 36:15

But, it seems like the medical system is still training people, the culture is still training people that unless you're seeing some problem, unless you're seeing some disease, unless you have some diagnosis, it's not time to act yet. And so do you think that we're learning things? Do you think we're getting better as a culture at saying I don't want to wait until I have a problem before I do something? Or do you think it's just a problem? That's just going to always be there?

Ernie Medina DrPh: 36:47

I sort of see it as two-edged sword. I think people are more aware in general because there's so much information out there now, right on the internet, on Netflix. I mean you look at all those health documentaries from Forks Over Knives and you know all these kind of shows. I mean they see the shows, they realize that, hey, I can do something about it. And when we look at our healthcare, you know our healthcare cost for our country is over $3 trillion, and the majority of that is connected to NCDs non-communicable diseases. If you look at those NCDs, the majority of those are lifestyle related. Right, that number one still is heart disease, with cancer at close second, hypertension is in there, type 2 diabetes is in there. So when you look at the top four or five, they're all lifestyle related. And when you look at the root causes of those diseases, they're usually connected to smoking, physical inactivity and poor nutrition, and then also excess of alcohol. So those are the four main root causes of the majority of those things. So I think people have become more aware.

Ernie Medina DrPh: 37:51

What has been the challenge, though, however, is with that increase of awareness, medicine has also progressed. So I think sometimes people are like, yeah, well, I know, I need to change this and that, and I've got, you know, fogging of the arteries. But I just saw this other show about the latest thing. Where they can, you know the medical technology can take care of it. So I don't have to change my behavior. So most people don't want to change their behavior. They're still looking for the magic bullet from healthcare. So I think that's why we're still having this tug of war, because medicine, our current healthcare system, would rather pay $10,000 or $30,000 for this magical stent to keep the vessels open for a few more years till it restenosis and clogs up again, versus $1,000 for a personal trainer to work with that person every week and then keep them healthy and active and eating the right foods and that kind of thing.

Ernie Medina DrPh: 38:43

So, yeah, it's tough. When you're working in my field, just telling people what to do isn't enough, and that's why we teach about health coaching, motivational interviewing because when you're trying to get people to change behaviors, just giving them information and just telling them what to do hasn't been working, and that's a challenge that we face and that's what we teach our students now. How do you become a health coach? Use motivational interviewing to really be client-centered so that they're making the choices, and so our goal, our whole goal is is to make the person become intrinsically motivated to make the changes, and not me telling them, because I have my doctorate and I've studied this and I know what's best for them. We know that doesn't work, and it may work for a little bit, for a few people, or temporarily, but it doesn't work long-term.

Tom Butler: 39:34

One thing that Douse talked about was that he thinks he's in better shape at 60 than he was at quote 50, 40, or even 30. So what do you think about that? If someone has neglected their fitness for you know, 20 years, how likely it is that they can be stronger?

Ernie Medina DrPh: 39:54

at 60 than they were, you know, say at 40 you know that's yeah, I mean it's a matter of perspective, you know, without knowing what he was like back then, I think it's it's possible because I mean I've had some friends in my 20s and 30s who were really out of shape and then they lost a lot of weight, they got healthier. So I can definitely see somebody in their 50s and 60s being better than they were in their 30s. But if I look at myself, I was, you know, I can say, in awesome shape. But I was in pretty good shape. I mean I was active, ate pretty well, I practiced the lifestyle.

Ernie Medina DrPh: 40:28

I wasn't vegetarian back then. We still ate red meat at the time, at least before my dad had a stroke. So I mean I wasn't super, super healthy, but we were pretty healthy compared to the norm. So even if I did everything perfectly today, I know I will never feel like I did when I was 30 years old or 25 years old on the tennis court playing for five sets. I know I mean my, my body will tell me. So I know for me, I know I wouldn't get that, but I think for somebody who was really out of shape back then, getting in shape now I could, you know, I could see how they would feel that that way. So you know, genetics is genetics and so some people have that potential to really make a big change. In others they're not going to see that great change, so it just there's a lot of factors in it, but it's possible there's also an element of definitely from a mental perspective.

Tom Butler: 41:21

I could definitely see if you lived a very, very counterproductive lifestyle right, if you were sun fairy, if you were eating poorly, if you were douse talks about using alcohol. I think if you have kind of that mix of things and then you know at 60 years old you start eating healthy, you start exercising, from a mental perspective I definitely think that you could feel better.

Ernie Medina DrPh: 41:49

Oh, yeah, yeah, if he was drinking alcohol, you know, eating the wrong foods, physically inactive, you know, he probably didn't feel that great in his 30s and 40s. And now when he's clean, right, clean circulation, clean living, I mean yeah, you're going to feel a huge, huge difference in your 60. I mean just your, from your brain through your whole body. Yeah, it's going to be a huge difference. So, yeah, I totally agree.

Tom Butler: 42:15

And he also talks about sleep and that sleep is one of those things he focuses on, that he sees as important for longevity. How do you feel about that?

Ernie Medina DrPh: 42:25

Oh, definitely, you know, with our testing methods that we have now, I remember seeing this one study where they found that during sleep there are these pathways in the brain these channels, if you will that actually open up while we're sleeping, and that is the time, then, when a special fluid in these channels will flush out all the metabolic waste products from the cells and flush it out. And that only happens at night, while we sleep. So when you think about a cell, a cell is metabolically active you think of it. It's like an engine, right. It takes in fuel and then it produces waste product.

Ernie Medina DrPh: 43:04

And so our brain cells are one of the most metabolically active cells in our whole body, right? I mean, the brain is an amazing organ, so it's very metabolically active, so it's producing waste all the time. That's natural, okay. But if you don't empty the trash on a regular daily basis with your sleep, that means that trash is staying in your brain. That's toxic to your brain cells. If you're not getting enough sleep, you're not flushing out all that, all those toxins in your brain. So, so, yeah, so sleep is is critically important for flushing out and cleaning out the brain.

Tom Butler: 43:39

In March is when the first article that Doss wrote it was on the Guardian online. I'll put a link in the show notes if anybody wants to see what he's writing, because he's continuing to write about his journey to get healthier, which is interesting. And in April he wrote a piece with the title the Muscle Miracle and I build enough in my 60s to make it to 100, even though I've never weight trained. End quote. I think that's a really interesting title and I'm wondering if you could just first talk about, like, how that title hits you without talking about anything in the title. How does the muscle miracle and the concept of building enough in my 60s to make it to 100? What do you think about when you hear that title?

Ernie Medina DrPh: 44:25

Oh yeah, you know, I've actually been preaching that for a long, long time now, just because not that I'm a bodybuilder or anything like that I did work out, you know. I think I started working out more regularly when I was in college because I had access to a gym and all. Yeah, I totally, 100% agree with that, because as I've been getting older, I've been feeling the effects, or the benefits, I should say, of muscle training, strength training we call it, anaerobic training is the other term that we'll typically use but I've been feeling the effects of that because Loma Linda is known for being vegetarian, right, that's the big thing. In almost every exercise lecture that I give, guest lecture that I give and I've been doing this now for like 30 some years or exercise talk that I give, I always start off with this question People knowing that I come from Loma Linda and they know all about plant-based vegetarianism, blah, blah, blah. So I'll say this.

Ernie Medina DrPh: 45:16

I'll say which is more important your diet or exercise? Now, I don't specify what kind of exercise, I just say exercise in general, right, exercise, or your diet, nutrition, right, and I'm not talking about well, if you don't eat, you're going to die. Yeah, duh, that's sort of duh. Obviously you got to eat. So I say which one's more important? And so you know, oftentimes people will choose diet because you know, that's what we've always been hearing about, that's what we usually hear about. So then I show two pictures after they I've surveyed the audience and I see how many people chose diet over exercise.

Ernie Medina DrPh: 45:51

I'll show two pictures astronauts and somebody in a coma and I'll say this what kind of nutrition do you think NASA is giving the astronauts? They're giving them the best food. Money can buy best nutrition, right, supplementation, phytochemicals, I mean, you know, whatever they can get, nasa can get them. They're giving them the best nutrition NASA can afford them. And yet, if they were to stay at the International Space Station or go on a mission to Mars, that would take years. Okay, even with the best nutrition, what's going to happen to their body? And everybody, most everybody, knows the answer, right. What's going to happen to their body? They're going to atrophy atrophy, right.

Ernie Medina DrPh: 46:36

Their muscles and their bones are going to literally fall apart, even with the best nutrition. Then I bring it closer to home. I say go to the hospital, look up a coma patient. You know, medicine is pumping into them through tubes. Whatever, even if they're in a coma, they're pumping in the best nutrition medicine can give them. And yet what happens to their bodies over time? It's still atrophies, right, falls apart, the muscles break down, the bones break down. You know, even if they're doing physical therapy in their beds, they're laying in bed 24-7. So it's sort of a trick question.

Ernie Medina DrPh: 47:11

But I say even if you have the best nutrition and you don't exercise, you're going to fall apart. That's the bottom line. So we were basically created to move, be physically active. The best is to have good nutrition and exercise. That's, I mean, obviously the best. And yes, you can have pretty good bodies and have good nutrition and exercise. That's I mean, obviously the best. And yes, you can have pretty good bodies and have bad nutrition for a while, but then that eventually catches up, especially more on the inside.

Ernie Medina DrPh: 47:36

If you think that just being a vegetarian or plant-based diet person is all you need to do, you're in for a rude awakening when you do get to your 60s. You know, 50s, 60s, 70s, 80s, if you're just doing good nutrition only, you're going to have problems with breaking bones, falling, imbalance, weakness. You know you can't get the bags out of the car, lift the grocery, I mean. You know your daily acts of living are going to be severely impacted, you know, because even though you're a vegan, perfect plant-based diet, if you're not physically active.

Ernie Medina DrPh: 48:10

So yeah, so to me, the fountain of youth really is not a liquid that we can drink, but it's really physical activity. And specifically as you get older, I even divide it then between aerobic and anaerobic. You could have a great heart and you could be walking every day, but if you're not doing strength training, you're still going to fall apart eventually. As my mom has been getting older, I've been pushing her to go to the gym because she plays pickleball four or five days a week. She's out there running, got a great ticker, you know. Cardiovascular system, respiratory system is great, but her muscles can still be wasting away. So she's in the gym two to three days a week pushing the weights and staying strong. So that, to me, is really the fountain of youth, because if you can't get up and if you can't get yourself out of the chair on your own power, you're going to be pretty stuck in sedentary.

Tom Butler: 48:59

You know it's interesting, I, after years of not cycling, a couple of summers ago I decided to buy a new bike and get back into it.

Tom Butler: 49:07

I've been on the bike now doing longer rides and training, and training for things like the Seattle-Portland ride. What I'm starting to learn now, after two years in, is that that has been incredibly beneficial. No doubt about it. My metabolic disorders are improving, improving, improving, which is awesome. Recently, I started learning more about the activity that I'm doing. When I go out and I do very low intensity for 50 miles even, I'm not stressing my body in certain ways, and so those slow twitch fibers versus fast twitch fiber. So there is an element of resistance training that is different than getting out there and just spinning lightly for several miles. Can you talk a bit about that?

Ernie Medina DrPh: 50:04

Yeah, I mean, you know, coming from, you know you're road riding, I'm mountain biking Typically. You know coming from, you know you're road riding, I'm mountain biking Typically. You know the leg muscles are going to get a lot of strength training because you're you know you're climbing and you're going up hills as well and all that kind of thing. But yeah, in the end, but we have gears, and so in the end though, because you're doing something that's sort of a more rhythmic, you can only push so hard to get that kind of strength training from a cardiovascular activity like cycling or running or something. Yeah, you're going to tone up somewhat in those muscles, but it's not quite the same, like you said, of stressing it even more so to the point where you can actually stimulate growth. And so that's why cyclists, especially if you're a racer, for example, and then you have an off-season you'll notice a lot of articles in bicycle magazines in the off-season will focus on strength training to sort of build up that strength capacity, especially in your core, because if you're bent over that bike, that's a lot of stress on your low back, your shoulders, your neck muscles. Your know you're holding that position for a long time and that's, you know, almost like an isometric kind of thing, where you're not moving a lot but you're holding that position. If you don't strengthen it beyond what you would get on the bike, then over time it'll just get harder and harder and harder. So the body responds to you have to push it harder in order to then do your daily stuff that you want to do, and you can only push it harder if you are doing it in a safe manner, which would be like strength training off the bike. So that's why, if you're doing some kind of cardiovascular whether it's running, cycling, swimming or something like swimming, for example, when summer was getting up higher levels they had a component of dry land exercising. They did weights, they did rubber bands, they did core strengthening, because they knew that doing that kind of thing number one would protect them from injuries overuse injuries in the pool and number two, it would make them stronger in the pool. They just didn't swim more and more and more and more and more and just doing more of the same, because that would just lead to overuse, injury and the cardiovascularness of swimming would only offer so much resistance, right, I mean, it would only go up to a certain point, but with dry land exercising. You could use stronger and stronger bands or heavier weights or medicine balls and you could push your body in short sets and reps and then push it harder, break down the muscle, build up more muscle so that we then in a pool or on the bike or on the, on the track or on the street now you can do that activity safe, more safely, stronger, faster I mean. That's why I strength, I was strength training.

Ernie Medina DrPh: 52:42

I was at the gym this morning so I was working out with, with, with the weights, with the machines. Not so much because I want to try to get to a physique like you know. I want to be, you know, a bodybuilder looking physique. No, I'm doing it because I want to reduce injury on the pickleball courts and I also want to increase performance on the pickleball courts. And just playing hours of pickleball will not do the same thing for my muscles and bones and tendons and ligaments like it would when it's getting more stressed in a controlled and safe way in the gym. So that's why I do my gym workout for the pickleball court.

Tom Butler: 53:17

It can be intimidating sometimes. I shouldn't say sometimes, I should say it can be intimidating going into a gym and there's, you know, whatever be intimidating going into a gym and there's, you know whatever, 40 different machines and figuring out what to do. Do you have some advice for someone that's not done, uh, any weight training and later on in life they decide to walk into? A gym and take it on what. What would you say?

Ernie Medina DrPh: 53:43

you know, my number one advice that I always tell the patients is this is that that you know?

Ernie Medina DrPh: 53:47

Because I can talk about it in class, I could talk about it in our private appointments. You know exercises, what to do, but I know that just telling them in the office setting probably wasn't going to be that beneficial, because they either would forget, they wouldn't understand, they wouldn't know how to do it. I mean, we didn't have a gym at our clinic, right? So I couldn't even show them. So my number one advice I would always tell everybody and I still do to this day is get a trainer. Get a trainer, pay for, you know, a few sessions. Have them, show you the machines, the exercises to do, how to do it properly, how to set up the machine properly. You know all those kinds of things, because then once they learn how to do that, then then they could do it on their own. They don't need a trainer. You know they're not an athlete, so they don't need a trainer all the time pushing them. But at least get a trainer to show them how to do that. I mean, I remember when my dad had he had a stroke, but he passed away about five years ago, so about 30 years ago he had a stroke and I remember one time he came here to Loma Linda from Michigan. He was using a quad cane, okay to walk, because his right leg, you know, was affected by the stroke so he couldn't walk very well. So he came out here for a month. So I was his personal trainer for one month. I met him at the gym at our university here at Drayson Center, monday, wednesday, fridays I was still working at Beaver at the time so I would come on my lunch hour meet him at the gym. You know we were doing all different exercises. His right arm and his right leg were the ones in fact affected, right, so we would do all these different exercises and I remember real clearly he, you know his right leg, was so weak that on the leg press you know he's sitting in a chair and then the leg press plate was in front of him, like in front, and then he'd push his legs away from his body. His right leg was so weak and I was doing single leg so I wasn't having him both legs up there, I had his right leg on there. His right leg was so weak he couldn't even hold his own foot up there it would just flop off. So I literally had to hold his foot on the plate and then I had to put with zero weight, literally had to hold his foot on the plate and then I had to put with zero weight, push the plate for him. You know, help him as he pushed his leg on that. Zero pounds of weight one month, three times a week. By the time we were done, and I would push him. You know, we did two sets, three sets of 10 to 15 reps and when he could do a certain weight easily, I bumped it up, bumped it up the weights. By the time he was done that the month they visiting here he was leg pressing with his bad leg 45 pounds, wow, 45 pounds.

Ernie Medina DrPh: 56:16

Now, what do you think? How do you think that impacted his walking? He was able to walk without his cane. I mean, that's how strong his leg got from. You know, post-stroke okay, he goes back to Michigan, doesn't have the gym there because they hadn't built their university gym at the time, had no personal trainer, nobody to push him hard, keep increasing the weight, stressing out his leg. Within a month he was back to using his quad game. That's how fast he lost the muscle in his leg just because he didn't have, and I was pushing him. I mean, if I saw that he was doing it pretty easily, the next, I made a note of it the next time he went into workout I'd bump it up.

Ernie Medina DrPh: 56:57

In fact, one time for this was for one of the arm exercises I didn't tell him, I changed the weight and so he was pushing and struggling. And you know, and come on, dad, you know, you're just being a wimp here, you know, and I would smack him with a towel and he'd get upset at me. I said, come on, you can do one more rep, one more rep. I kept pushing and pushing that hard. I was pushing him that hard, right, finally he would do the sets and the reps. And then I say, oops, I had it on the wrong setting. And then he'd get all upset at me. But I said, look, dad, though, you did 10 reps, two sets of 10 reps at that new setting. Right, it's all in the head. So that's how I kept pushing and pushing him, and so that that's what the muscles need, is that kind of being pushed to, so you don't think you can do it anymore.

Ernie Medina DrPh: 57:38

And again, we weren't trying to make him a bodybuilder. It was all for quality of life, but that that was always so dramatic to see just in one month how much muscle and at the time he was, I think, like 70 or 69. How much muscle he gained back in his stroke leg, his right leg, in just one month of three days a week and enough to that he could walk without the cane and then how fast he lost it when he went back home. That's an extreme example with somebody with a stroke, but that happens to every other person. That's sort of quotes, normal. And they say we lose one to three percent of our lean mass every. I've heard different things every 10 years, every five years, whatever.

Ernie Medina DrPh: 58:23

But just know this depending on your genetics, of course, and your lifestyle, you are. If you are not doing strength training, you know actual strength training with weights and pushing your body to that point where you know you can't do another rep or whatever, or even even if you can, I mean but you know pushing it to the point where you're having to strain. If you are not doing strength training of any kind, whether it's calisthenics or you know yoga, power yoga or you know whatever, lifting weights or doing a machine If you're not doing that, you are losing muscle and bone. There's no question. You are losing it. Even if you're cycling, even if I'm playing pickleball, even if I'm walking or running, I'm not doing strength training we are losing muscle.

Tom Butler: 59:02

The American College of Sports Medicine. That's an organization that I believe you're certified with of. Sports Medicine that's an organization that I believe you're certified with. Yes, you know if I wanted to go out and find somebody that really understood the issues of somebody that was older.

Tom Butler: 59:14

Would it be? Do you think anybody with American College of Sports Medicine certification would be good? Do you think it would be valuable to look for someone that has I don't know what you would call it a geriatric fitness perspective, or whatever? What do you think about finding a trainer and looking for someone that's really going to understand the issues of someone that's older?

Ernie Medina DrPh: 59:32

That's a very good question. I know there are certifications I'd have to check with ACSM but I know there are certification for trainers that are specific to geriatric and the senior population. So that would be one thing to see if they're certified in that kind of thing. The second thing would be is there's a lot of certified trainers that have, you know, good academic backgrounds. They might be an athletic trainer, they could be a physical therapist, even right. So if they have that kind of training, then I, you know, then I would trust them to know what to do for a senior population. But there are certifications that are geared specifically for strength training with with seniors. So if you know they have that and if they said they've, they've, they have a pretty good track record, a history of working with seniors, because seniors, yeah, you need to know certain things about working with seniors than you do with working with somebody who's in their 30s or 20s.

Tom Butler: 1:00:22

So I would look for those, those kind of things this has been a great conversation and I knew it would be. I'm so glad that you agreed to come on Talk a bit about what you have on the horizon as far as your own fitness goals.

Ernie Medina DrPh: 1:00:36

My own fitness goals. Well, that's a good question. Well, I have one goal for pickleball. One of my goals for pickleball I don't know if this is fitness per se, but one of my fitness goals is to play a tournament in every state. I mean they have that for running, right, you could do a marathon in every state. So I said, hey, why not for pickleball? And I'm not just talking about just playing pickleball in every state. I mean, I know other people who are working on that and doing that. I said that's too easy. I want to play a tournament, so I have to pay, register, go there, play with a partner and all that. So that's one of my goals.

Tom Butler: 1:01:11

Have you started that?

Ernie Medina DrPh: 1:01:13

If you were going to add it up right now.

Tom Butler: 1:01:14

How many states would you say?

Ernie Medina DrPh: 1:01:17

I have a note on my phone, but I think I have about 12 states I've done. Somebody gave me a water bottle, a big water bottle, and I've been putting stickers and they gave me a set of 50 state stickers. So that big water bottle is already covered with all the stickers that I've done so far. But I've done about a dozen states so far. So every year now I'm like okay, where can I go this year that I haven't gone to yet to play a tournament?

Tom Butler: 1:01:48

Yeah, I think that's a fantastic goal and again. I think it goes back to the thing of making it fun.

Kelly Butler: 1:01:53

Yeah.

Tom Butler: 1:01:54

Sounds like a really fun goal.

Ernie Medina DrPh: 1:01:56

The thing is about pickleball. I've met so many people that I would otherwise have never met. I have met people in so many different countries. It's like I could go anywhere in the world and if I mention I'm a pickleball player and they're a pickleball player, boom, we're instantly like you have this special camaraderie, they'll invite you over. I've stayed at people's homes that I never knew before and just because we're pickleball players I'm staying in their homes. None of my other sports ultimate mountain biking, whatever. I've met other mountain bikers before. We don't have that same chemistry and all.

Ernie Medina DrPh: 1:02:29

But with pickleball it's sort of like instant family boom anywhere. So so that's to me is probably you know, from a social, mental health aspect, having friends all over the world that if I'm you know I'm going to philippines and japan in august to do some work and vacationing. My mom's going with me and you should see I was just texting with some people this morning about their planning, you know, taking us on this trip and visiting this and playing pickleball here in Japan and in the Philippines. My mom just texted me oh, there's a choir that's singing in Andrews from the Philippines and when we go to the Philippines in August they're going to play pickleball with us, because someone will play pickleball, so they're already waiting for us to come back. I mean, you know, it's like instant friends anywhere we go, so it's fun.

Tom Butler: 1:03:15

I think that's one of the big things that has happened with me is that I'm surrounding myself with active people and, I would say, a culture that is counter to the norm. You know, and I would say a culture that is counter to the norm. I think the normal North American culture is a sedentary culture, getting involved in cycling and in the Cascade Bicycle Club and doing rides and ended up sucking my son-in-law into it. And my daughter not too long ago bought a new bike and my wife. We had a semi-recumbent bike built for her.

Tom Butler: 1:03:54

Yeah, creates this norm. It's kind of you're in another culture and the norm for that culture is to be active and I think that's healthy. And I think that's what you're describing too with pickleball.

Ernie Medina DrPh: 1:04:04

And you know, and the thing too is, when you're surrounded with those kinds of people that are, you know, you have a common bond of that activity, whether it's cycling or pickleball, whatever you then that sort of leads out to other things. Because you know cause we always go out to eat afterwards I'm sure you do too, right, we go out to eat together, all this kind of things. And then you start talking and you learn and people oh yeah, you know, I got to watch my cholesterols and you know and then they want to all get better and do better on the court and all this, and so it just sort of is a natural cascade of you know. Hey, what else can I do to make my cycling better? Or ride longer, or ride farther or faster, play pickleball faster, do better, reduce my injuries? I mean, then you could, then I can share from my background. Hey, you know, nutrition is part of that, Sleep is part of that, Strength training is part of that. You know, all these things are all part of that, and so it's just.

Ernie Medina DrPh: 1:04:54

But because we know each other from a common interest, now we've developed a relationship, and when you develop that relationship, you develop trust, and then, when you develop trust, then they're more open to listening, versus if I was a stranger, walked right up to you and said hey, you know, did you know that strength training is important for you? And you might say I'm not a bible, what's that? You know? What's that got to do with me? You know, you might just blow me off right.

Ernie Medina DrPh: 1:05:16

I think the physical activity gives us that common bond and it doesn't matter who you are, what your background is. You know how much money you make, how many letters you have name. You know, we're all on the bike, we're all in the court, we're all the same. You know, and that's what I really like about it. And then later on we learned oh wow, you know, he's a judge. Or oh wow, she's a lawyer. You know, or she's a this or that. I mean, you know, we don't learn about that until way later, but we're already friends. So I think of all the things, all the benefits of being physically active, that's for me anyway, that's the biggest thing.

Tom Butler: 1:05:49

I love it.

Ernie Medina DrPh: 1:05:50

Said and done.

Tom Butler: 1:05:51

Well, Ernie, thank you so much for joining me again. That's such a fun conversation, fun to get an update from you. It's been years.

Ernie Medina DrPh: 1:06:01

I know.

Tom Butler: 1:06:05

And just thank you for the work that you do. All the stuff that you talk about the early years in a clinical situation, learning, you know, I know that the conversations you were having with people like Wes Youngberg and others and you guys were really formulating some of the strategies that needed to be implemented in a clinical setting. Strategies that needed to be implemented in a clinical setting and some of the strategies about how to work as a team with medical professionals in a situation.

Tom Butler: 1:06:33

So going all the way back to that, that's awesome work. The, the work that you've done to help people get active through pickleball, the coaching that you do. I just appreciate you for all the work that you've done. So again, thanks for thanks for joining me, thanks, tom, and thanks for the opportunity to share've done so again, thanks for joining me.

Ernie Medina DrPh: 1:06:49

Thanks, tom, and thanks for the opportunity to share.

Tom Butler: 1:06:50

Yeah, loved it, so I will talk to you later.

Ernie Medina DrPh: 1:06:54

All right.

Tom Butler: 1:06:54

Take care. So what about the question at the heart of this episode Am I as fit now as I was in my 30s? I would say yes. Here is my justification for that answer. In my early 30s I was pretty fit, but starting around 35, life got busy and I started getting less and less activity. I'm positive that I then put on more fat every year for like 24 years. That combination of inactivity and fat gain, especially visceral fat, created a health disaster. I am now turning that around and losing fat every month and I am very active.

Tom Butler: 1:07:42

At 35, I am sure that I couldn't hop on a bike and ride 100 miles a day for two days, like what I'll do in Seattle to Portland. So my activity now means that I am more fit by that measure. One thing for sure I am more fit from a mental health perspective. Riding frequently means that I'm burning off stress hormones and avoiding the damage that they cause physically as well as emotionally. In addition, the time on the bike is a form of meditation to me, avoiding the damage that they cause physically as well as emotionally. In addition, the time on the bike is a form of meditation to me. I am 100% sure that I would rather have my fitness level today than what I had at 35. Of course, I wish at 35 I would have made the changes I am making now. No doubt about it. But given that I can't go back in time, I am happy with the steps that I am taking and believe I will continue to reap the benefits for a long time.

Tom Butler: 1:08:33

What about you? Do you feel you've turned back the clock on your fitness level? I would love to hear your perspective. You can find my email and the show Instagram link in the show notes and consider joining the Cycling Over 60 Club. There are 52 of us in the club right now and it is a great group of people. I hope all of you are finding ways to get and stay fit and finding a lot of ways to boost your mental well-being while riding. Stick with it and remember age is just a gear. Change you.