Dr. Ed Le Cara – Why BFR Training Is the Most Underrated Performance Tool in Sports Medicine

All right. Welcome back to the Casey Adams Show. Today I AM joined by Dr. Ed La Cara. He is board certified in sports medicine and rehabilitation and the director of education for smart tools, the leaders in BFR training. Dr. Ed, thank you so much for coming on the show today.

Well, thank you for having me. Of course.

So, one thing to I wanted to kick off this conversation and say that we, we both share something in common in the sense of we've both dealt with injuries from sports that have really led to transformative times in our lives. Mine being, and I'll mention it quickly, is back in high school, I was in a neck brace for six months, nearly paralyzed. And it was this inner spineous ligament damage. And that was a pivoting point in my life that I won't dive too much in, but we'll get to later. But I want to start on your end like this. An injury in your life that really led you to diving more in depth into everything that you're doing now. Bring us back to, you know, what inspired you to get into the field that you have spent so much time in over these years. And also the reference of the injury from your perspective of, you know, how that was a transformative time in your life.

Yeah, sure. I was, I was a Division 1 wrestler in college at wrestled. I've probably started wrestling when I was in about the sixth or fifth grade. Really didn't know much else. But in college was in my junior year. I was at a tournament up, we were wrestling up in Corvallis, Oregon at Oregon State in semifinals of a of a tournament. Was hoping to make my first finals as a collegiate wrestler. And just kind of a freak accident happened. My knee got blocked and my opponent tried to take me over his his knee. And I tore three out of the four ligaments in my knee. And so I just heard this pop, pop, pop. Like people all across the arena said they could hear it. My knee got super mushy. I knew right away that there was a problem. My coach ran over who was like my best friend at the time, not just my coach. And I just said, tim, I think I'm done. And he's like, what? I'm like, I think I just tore my ACL and probably something else in there. And he's like, no way. And I'm like, yeah. So it ends up I tore my acl, part of my PCL and my lcl. Luckily, no miniscule damage, but it totally rocked my world. Casey. It was like, you know, here's a sport. I was a captain of the team just had gotten ranked nationally. Like, and you know, you go seven or eight or nine hours a day of training and being with your guys. And that was my fraternity and my people. And all of a sudden it was just like, you're done. Like all of a sudden, seven or eight hours open up for you, right? You're like, now what do I do? And I have this like vivid memory of like the next duel meet that we had. I'm used to being the one that goes out, shakes the other opponent's hand. And I remember sitting up and my replacement had replaced my position as the captain. And I was just like, oh my God. Like, I went through a pretty deep depression. Now looking back at what, what that was, because it was just so drastically different. I mean, broke up with my long term girlfriend. Just crazy chaos. So I was like, okay, what am I going to do? How do I get back wrestling? Because I still had a senior year of eligibility. Of course the answer would be have surgery right away. That's what everybody was telling me. But my orthopedic, there I was at the University of California, Davis, he would not release me for a full 12 months no matter what. And this, it happened on December 30, 1994. Not that that hasn't left an impression on me. And he's like, I can't clear you for at least a year. And so that would have basically taken away my whole senior year. So I was like, God, what am I going to do? I consulted with a lot of different people. My athletic trainer, my strength coach, my neighbor who growing up was my chiropractor. I mean, I just, I, like, I talked to whoever I could. And it was actually Dr. Ogden, my chiropractor, who's a mentor of mine. He, he basically said, well, have you thought about just strengthening it and then maybe have to wear a brace, but at least, you know, giving yourself a chance. He's like, what do you have to lose? Like, worst case scenarios, you just have the surgery because either way you're going to lose your senior season. And I'm like, okay. Nobody has really presented that option to me. I grew up in an environment of very allopathic medicine. My mom has a master's in nursing. She's been a nurse for 60 years. Wow. Her whole mindset was, you know, you get, you have surgery, you have medication, that's, that's what you do. And so I chose to rehab it. And so with my athletic trainer, Lisa, who's amazing, she just retired last year and I just like, love her to death. My strength coach, Dr. Ogden, help with the orthopedics. I was wrestling in four and a half months. I had a brace. I wasn't at 100% because the instability in the knee, but it just showed me, like, not everything has to be drugs and surgery. And it was the first time that it ever really had come to me. I was an exercise physiology major. I was a combat medic in the Army. So I was used to. I was used to the medical model. I was used to, like, you know, you have a problem, you get it fixed or covered up with drugs and surgery. Yeah, it totally changed. Like, I'm like, this is. My people helped me get back on the mat as soon as possible. How do I do that for others? And so I just started. Started investigating different careers, like, did I want to be an athletic trainer? Did I want to be a strength coach? Did I want to be a chiropractor? Did I want to still go to medicine? Because that's what originally I wanted to. And I. I decided that I wanted to. I. I wanted to treat alternatively, and I wanted strength and conditioning and nutrition to be of the paramount emphasis in how I treat and handle patients. So that's happened a long time ago in 1995, but that's. To the. To this day, what I still do.

That is I appreciate you for not only sharing that story, but the context there.

It's.

It's rare to have someone that's. It's so relatable. And you say the, you know, the deep, dark depression, like, for myself, coming out of that neck injury for six months, like, I feel that and, you know, that's a day and, you know, time in my life that completely transformed the trajectory of my life. And I want to talk about, like, from that point of obviously having the personal experience of rehabilitation and, you know, kind of doing things a little differently. How. What led to. You've had this incredible career. I know you mentioned that you served in the U.S. army for combat medic. What led to that opportunity? And you wanted to go pursue that back in the early days of your career?

Well, we had just finished my senior year. We were in the Gulf War. The first goal for. And I don't know, I'm a little crazy. Like, I see stuff and I'm like, can I do that? Like, I. I wonder if I could do that. And so part of it was I wanted to serve my country. I'm very grateful for the opportunities that I've had, the opportunities that my family have had, you know, My dad was one of eight children. A grandmother came. Grandmother and grandfather came over from Sicily, didn't speak any English. He was the first one to go to college, get a master's from Columbia. Very successful. Passed that opportunity down to me and my brother, who both went on. So he was the first in the family. I was the third. My brother was the second. And, like, I don't take it lightly. Like, people take it for granted, like, oh, you know, going to college is, you know, no big deal. But, you know, I. I'm very grateful for where I was born, and I'm very grateful for the opportunities that I've had. And so I wanted to serve my country, and I kind of had this thing. Can I get through basic training? Can I be away from my friends and family for 12 weeks? Can I go through the medic training? Can I do these things that make me very uncomfortable? And what I found out through all that experience is that people don't like to be uncomfortable. And I should have known that being a wrestler, because wrestlers were a little crazy, too, that, you know, it's. It's just kind of one of those things. Just like being an entrepreneur, you know, it's like you're out on this limb. You're one of, you know, one of 1%, really, that actually takes the risk. Yeah. And so, yeah, so I wanted to get the training I wanted. You know, I wanted the challenge. I wanted serve. There was just a lot of different reasons. My poor mom, she went crazy when I came home because I didn't tell her I was doing so. My dad, but I didn't tell my mom until I got home, and she's like, what? You're doing what? Wow. But. But, yeah, it was really great experience. Highly recommend, especially now, like, just. Just figuring out how to be uncomfortable. And, you know, I was with people that had no chance of going to college, grew up, you know, super poor, where a lot of people in basic training were either told they had to go to jail or they were going to serve. And so it was a lot different than growing up where I grew up in Danville, California, you know, Northern California. It was. It was just very humbling. And I think it was a really good experience for me that I needed. Probably wouldn't be bad for me to kind of redo it every 10 years or so just to kind of get a reset. But, yeah, it was. It was a really good experience for me.

That's. That's incredible. And once again, thank you for your service. That's just hearing the. The Purpose there. And the reason why is it's incredible to hear and I think not only myself, but everyone can learn something from that. I want to talk about something that I find very interesting, that I look forward to learning more from you, which is all things about the benefits of blood flow restriction training. I know that you are the director of education for Smart Tools, the leaders in BFR training, and would love to first have you, you know, describe what is Smart Tools for me for people that may not know and really dive into the benefits of blood flow restriction training and really what it is for people that may. Excuse me. Or may not be familiar.

Yeah, sure. So I got introduced to Smart Tools about. It's pretty close to 10 years ago, probably 2015. I was at an athletic training, national Athletic training conference. I got approached by the CEO, his name is Nick Colosi from Cleveland, Ohio. And he, he said, I'm starting this new company and I need somebody to write education. And I had been writing education for some companies like Rock Tape and Trigger Point Performance and had spent some time with 24 Hour Fitness on their executive team and their medical advisory board, some other companies as well. And at the time I was with Rock Tape. And I said, no, I'm pretty busy with my practice and, and working with Rock Tape, but I'd like to hear more about it. What are you kind of doing? And what Nick really kind of tugged at my heartstrings was that he's like, I'm kind of sick and tired of getting taken advantage of as a clinician where these companies come out with these really expensive products and then they want us, as a small practice to purchase these products. At the time, it was instrument assisted soft tissue manipulation, or some people would know it as scraping using stainless steel tools to kind of manipulate the nervous system to help with range of motion and some other things. So it kind of piqued my interest. I was kind of like, huh, that's kind of interesting. And I kind of like that he really wants to create a really high quality product, but make it very affordable. And so kind of some time had passed. We sort of kept in touch and things went a little wonky for me with my education development stuff. And we kind of reconnected. And he's like, you know, if you're still interested, the position's available. And I said, you know what? I'd like to do that. I'd like to kind of contribute to a company that has the end users really best interest at heart, not just making a dollar. All the products are made in America. And of course, with my background, I was like, yes, this is what we need. All family run. His uncle is the bookkeeper and. And chief financial guy. His dad runs operations on building tools and development. He does most of the development and marketing. His mom works with distribution and sales. Like, this is a small little company. I'm like the only outsider, minus some people that are contracted to write apps and stuff that, you know, we can't do. And so, yeah, so that's how I got kind of started with them back in about 2016ish was writing education for instrument assisted soft tissue. I wanted to make really evidence based because, you know, at the time everybody was thinking like, oh, you take this tool and you scrape the crap out of you and it gets you all bruised and you're changing the fascia and it's just all. And it's just all B.S. like, you know, you don't just. You just don't like pull fascia and all of a sudden it's loose. Like that doesn't. It doesn't really work that way. And so really trying to educate people on. It's the neurological benefits that we're seeing with this and, you know, really trying to just educate not just clinicians, but the public on the benefits and really providing an excellent tool. And so we were kind of like chugging along. Things were, you know, great. I had a team of teachers, I think we had about 20 teachers internationally. We're teaching a bunch of classes and I stumbled across something called blood flow restriction training. And the way I stumbled across it, my buddy was the director of sports medicine for FC Dallas, which is the MLS soccer team here in Dallas. And I love the guy, but, you know, he was telling me that he had won the award for the least amount of injury time for his team. Three years in a row in the mls. I'm like, what? Like, how do you. How like I know you, dude? It's like when you know your friend from high school and you're like, how are you like this famous attorney now? Like, it doesn't. That doesn't set up the same thing. I'm like, what are you doing? And he's like, well, we do some cool stuff, some monitoring and things, but the big thing is we do our rehab with blood flow restriction training. I had no idea what it was. This is 2016ish.

Okay.

So he sends me a couple of links of some articles. I go into PubMed, which is a pretty large journal database, and there was like 800 and some odd studies validating its BFR's efficacy. And I'm like, whoa. All the other education I had pretty much written for all these other companies was always done the wrong way, which was we had a product and I need to try to validate its use backwards. Right. Go find some research that supports what we're doing. This is the complete opposite. This already had research to validate what was happening. So I'm like, okay, this seems like the real deal. And here's where, as a rehab professional, why it's the real deal is because they were taking very, very, very lightly loads. Like think about going to physical therapy. What do we normally get? We get like a tubing or a theraband.

Yep.

3 pound dumbbells and we start to exercise those things. Well, I've known my whole career as a. I was a, you know, still doing my undergrad. I got certified as a strength and conditioning specialist and I still have that certification. The. I knew that we were never really building strength with light loads. We were never really building muscle mass with light loads. We might be like kind of maybe turning on some motor units. We might be kind of facilitating some movement. But honestly, I'd kind of given up of trying to increase strength and hypertrophy or muscle mass in the clinic just because, you know, it just. It's too difficult to do in a rehab setting.

Yeah.

The thing with bfr though, is that if you put these cuffs on and what the cuff looks like is this.

This is our right there.

Well, I thought it would be. I thought it would be a lot interesting, like demo it versus just talk about it. But, you know, this is a medical grade tourniquet. Basically it has a housing that has a pump and a doppler built into it, which essentially think of it as almost like a fancy blood pressure cuff.

Yeah.

I put this on my limb and I inflate it to a certain percentage or a certain millimeter of mercury. I'm reducing the amount of blood flow now into my limb.

Yep.

And I'm totally preventing any venous return. So there's no blood exiting. Okay. So think about when you go like, you know, when we were in high school and college, I'd go out, actually shoot. I still do it before I go out to the beach. I'm going to do a bunch of push ups. I'm going to kind of try to get that pump right.

Oh yeah.

Appear a little bit bigger. Well, it does that. This does that on basically on steroids. It like facilitates what's called a cellular swelling phenomenon. What's really Important about that is that in a rehab setting or let's say in a geriatric population that can't lift heavy weights, or people that don't want to lift heavy weights because they feel like they're going to hurt themselves or they have some sort of joint issue like osteoarthritis, we can use those light loads that we normally get in rehab, apply the cuff and now they're essentially the same. I'm not going to say they're the exact same, but they're essentially the same. Like 98%, you get 98% of the benefits or so 95 to 98% of the benefits of using light load BFR compared to heavy load training. And remember, heavy load training is anywhere between 65 and 90% of your one rep max. That's the stuff that you lift when you can only lift it about five to eight times. Right. Maybe nine times before failure. So kind of in a nutshell, all that is I was able to do the things with BFR that I couldn't do normally because I'm stuck using very light loads because people are injured and they can't tolerate the heavy loads. So I've got the literature to support it. I'm like, where do I find a set of cuffs? So what do I do to go searching on Google where you know, what's the best cuff on the market? The best cuff at the market on the, at the time was $6,000 for a single cuff.

Wow.

I'm like, dude. And to buy the cuff you had to spend 600 or 599, I think at the time to take a course in order to be able to even purchase the cuff. So you're eight, oh man, $7,000 in by the time you travel, take this course, spend the whole day like, yeah, one single cuff. And I'm like, wow, what?

And this is for like at home use, for like at a consumer or for like medical brain.

They wouldn't even sell it? No, they wouldn't even sell it to anybody that wasn't a licensed medical professional. So even as a strength and conditioning coach, if I didn't have my other credentials, I wouldn't be able to buy it.

Wow. And this was like the reality for the whole space. Like, no, this was not a readily available practice per se.

It wasn't available.

Yeah.

And so I immediately went to Nick and I'm like, okay, let's repeat what we did with instrument assisted soft tissue. Make a kick ass product with amazing education at a reasonable price. And let's lay it out to the masses. So we were on a trip to Australia. I was teaching a bunch of instrument assisted out there and I think we had also gone to, I don't know, we were somewhere, we're across the world somewhere and we were like messing around with this kind of like this cheap version of a cuff. You could find it was not very good, but we were just playing around with it like, what would we improve? Like, how could we make this better? And so that's kind of how it started. Like basically repeating what we did with instrument assisted, applying it to bfr. And now this is our fourth generation of cuff we made. Our first one didn't go so well. We made some mistakes, quickly fixed it, got into Gen 2, then Gen 3, and then released Gen 4 last year.

That is so cool to hear.

Yeah, it's been a journey, but it's. But I stand by our product. I mean it's. I mean no other company in BFR space has four generations in the last 10 years.

Yeah, I mean that is. I love the saying hardware is hard and the ability to learn and adapt and to create those iterations, especially with something that was once so like not readily available. It's really incredible to see. And I'm curious when it comes to, you know, the use case today, just so I'm sure people are, are wondering, right, like this, is this something that people tend to do at their homes? Is it preferred to do it with, you know, clinician and like in an office with someone or what's your, you know, the, the recommended advice slash like the norm of doing so. And how has that changed over time?

Yeah, it's a great question. So originally we were focused on the clinicians, you know, nine or eight years ago the whole focus was let's get it into the hands of physical therapists, athletic trainers, rehab professionals so that they can use it for rehab. Because that's really what it was brought. That's how it was discovered in America through the Veterans administration, through the DoD. Interesting. I think you'll dig this is the reason that it was even discovered by the DOD was that they were looking for a way to improve growth hormone endogenous, your own growth hormone production. And they stumbled across the research around blood flow restriction. And so they were using it for soldiers and individuals coming back from Afghanistan at that time in 2012ish that had soft tissue injuries and like, you know, had to have prosthetics and other things and they were needing. With skin grafts, you need a lots of, you know, you need a lot of luck in order to get those to stick and not reject them. And so growth hormone helps that healing process. And so they were looking for ways to produce it naturally without injecting it. And blood flow restriction training does that, which also helps the rehab process. So anyway, that was kind of a side note, but that's how it was discovered and brought over to the US because it's been around since about the late 70s, but mostly in Japan. And a lot of their research had not been translated to English. And it wasn't until about early 2000s, you know, 2008, 2009, where it really started to get translated and then being able to at least be pseudo adopted and understood here now we have thousands of studies validating its use and safety. But to kind of get back to your question, I see it always now. Like in the beginning it was with the clinics and what would happen is we taught the physical therapist, the physical therapist then used it on their patients in the clinic. And then a lot of times patients for their home exercise would purchase their own set from the physical therapist and then go or borrow it. Like in my case, I usually just let my patients borrow them for four to six weeks, whatever they need it for, until they can get back to their normal heavy lifting. Now we're seeing a kind of this. People are trying to do it on their own a lot, whether it's because medical insurance in America sucks and they want to do. They want to try to figure out on them on their own. So it's a lot of direct to consumer now where people are just utilizing it and then they'll consult with me or one of my other instructors on, all right, now what do I do? Like, I've got these cops and I understand that it's helpful for my rehab process, but how do I put into place, how do I do programming? How do I. Yeah, you know, what does that look like? How long do I do it for? How often? At what pressure? You know, there are some learning things that, you know, it's not just. And it's just like going to the gym, like, totally. You know, people think it's, you know, I mean, shoot, I, I don't even think we're taught to walk. I mean, so many people have problems walking. You know, you think like, oh, you should just be able to get up and walk, but, or, or run and, you know, I mean, how many different ways are there to run? Like, there's plenty of running coaches out there helping people to run. Same thing here. It's like if you want to get it done, you get a consultant and you integrate it. But you can learn it on your own. It's just. And we have tools to do that for sure. But most of the time it's still primarily clinician run or orthopedic prescribed. We get a lot of those too. Like somebody had a surgery and the surgeon will say like, hey, get a cut pair of cuffs. And here's your, here's your protocol for this, you know, post surgical rotator cuff and start using these cuffs after week two of surgery and go from there. But it's kind of a mix now. But we're seeing a large insurgence of just going straight to consumer. Because I think there's this big, big awakening recently within the last couple years, you know, guys like Peter Attia and Dr. Gabriel Lyon and Huberman and Rogan and all these guys are really releasing a lot of great information and people are starting to consume all this information. And there's this big emphasis right now on muscle mass and muscle mass for longevity and muscle and strength and grip strength and sit, to sit, to stand. And the days of me being able to get through my life healthy and have good longevity without lifting weights is over. Like if, if you're not lifting weights, I'm sorry, this will make people mad. You're not doing it with 10,000 steps, you're not doing it with yoga and Pilates. You gotta lift heavy weights at least one day a week. That's at least what I convey to my patients. If you can't lift heavy weights, the next best thing to do is use BFR with light loads. So it gives those people an option that can't lift heavy weights.

So that is the, and that's, that's what I was actually curious about. Meaning there's the recovery, the recovery aspect or even someone like my dad, for example, he's had two back surgeries, but growing up he was like all the heavyweight sports and then after the back surgeries, like he just can't do like risk doing all the heavy lifting. So something like this is like, it doesn't always have to be primarily for recovery, even though that may be the priority use case. But for those that again can't lift heavy weights or don't want to risk it due to past injuries, this is, gives you, as you said, that 95 to 98 percentage of effect as if you're lifting those heavy weights through using these cuffs and the light loads.

And that's just for strength. Yeah, that's where it's getting close to. But for hypertrophy, for muscle mass, BFR in the short term is actually better than high intensity. You'll start to see increase in muscle mass at week three versus normally it's going to take somewhere between eight and 12 weeks to start to see muscle hypertrophy with normal heavy weightlifting. So what my recommendation is that if you're using it to put muscle mass on, you know, you just, you vary it. You know, you do a six to eight week mesocycle, which is a fancy strength and conditioning term for like a block of time, and then you switch to a strength cycle, then you switch to an endurance cycle, then you switch back to a hypertrophy cycle and you constantly varying it. Like in my clinic, we just bought this last year a DEXA scanner so that I can, I can visit, I can actually, you know, measure your body mass, I can measure your bone density and now I can prescribe exercise. Based on what, what do we need? Do we need to get rid of your visceral to post tissue because you're metabolically inactive? Do we need to increase your muscle mass? Do we need to increase your bone density or do we just need to keep you healthy because everything looks pretty good? And then, you know, trying to treat them like an athlete, I will calendar out their whole year. I'll be like, okay, you ski in the winter, so guess what? Starting October is preseason for ski season and then ski season is your in in season. And then whatever you do in the summer, hiking or whatever else becomes your next season. And I think it just creates a little bit more, just makes it a little more interesting for your training. And so we are starting to see this kind of like, I don't know if it's, I think it's a revolution. I think it's this thing where like, yes, you need to eat a lot of protein, yes, you need to lift heavy weights. Yes, you need to do high intensity interval training at least one time per week, you know, for long term health and longevity and to try to reduce dementia and sarcopenia or the, or the muscle wasting as we age to stimulate testosterone, we're losing testosterone at rates in this country that are out of control. We're seeing, I'm seeing kids in their teens and early 20s, 20s with testosterone of like 50 and 60 year olds. And it's not because they have gonadal problems. It's not because they don't, they have a problem with their brain stimulating. It's because they're, we're, we're bombarded by Pesticides and plastics and we sit around too much and we don't do hard and oops, sorry about that. And, and you know, it's just, it's a problem. And you know, I think we're starting to see a transition.

Excuse me. Absolutely. And I know that, you know, you mentioned Atiya and Huberman and a couple great people that putting are putting out this information. And I think as someone that for context, like I'm 24, I got injured when I was like 16, and of course you hear things from the doctor you're working with, but this era of like in depth education outside of books, of course, but you know, like building relationships and trust with these doctors online and how that has just completely opened up this, in my opinion, like focus on some of these key things you're talking about.

Right.

Of like people might know. Yeah. Like get your protein. But then these, the widespread adoption of information and quote, unquote protocols that people are getting behind in the masses. I think it's incredible to see and I'm curious to know what you think about this world of podcast information at scale with informed doctors that are talking about this type of information, including yourself. What do you have to think about? Like, how do you think about this era of, you know, information? Because that also comes with the, you know, misinformation. And I think that's something that I always, you know, you read about, you hear different points of views and curious to get your thoughts on that. You know, in this era of social and podcasting as from the lens of a doctor when it comes to the positive benefits. But also maybe the things that people, you know, you know, don't like to hear.

Of course, yeah, sure. I mean, I think it's amazing to be able to pick and choose a subject matter and get a content expert on it. Like, you know, you can go to Dr. Huberman's podcast and if you want to learn about sleep, you can get one of the best sleep guys in the world. Right. It's pretty amazing. For free. I mean, I will say from the, from the clinician side, because I see patients, 46 hour clinical hours a week. I see a lot of patients. Yeah, I don't have time to do a lot of social media because people always tell me all the time, like, why aren't you posting all the time? Why aren't. I'm like, dude, I see patients all day. The guys that are in the trenches that are actually trying to implement change. I'm not saying that the podcasters are not trying to implement change. But the boots on the ground is a lot different. Having a philosophy or like this, you know, hey, you know, your vitamin D level needs to be 80 nanograms or deciliter. And you're like, okay, yeah, I've got patients that are like, in their sevens and eights and tens, and I need to get them up there. And now I'm trying to actually get those levels up and be able to, you know, show the proof in the pudding of what I believe and is making these changes. So I think you've got to be, as a. As a consumer of this stuff. Like, you've got to have an open mind, and you got to say, okay, who do I trust? Like, do they have the credentials? Yes. Are they seeing patients on a regular basis and those patients are getting the outcomes? Because I think so many people are online and they're like, they have a degree maybe, but they're not. They've never been in the trenches. Like, I know lots of people that fit this, that have, like, you know, theoretical. Yes, this is what you need to do. But they're not implementing those changes on a daily basis with patients. I think there's something to be said for that. And I know that I'm seeing this from one lens, and so it's probably a little biased, but, you know, there's. I think you have to be very selective with who you trust and who's trying to sell you, you know, the next best nutritional supplement and who has your. Who has your, you know, kind of who has your back. Like, is this. Is there a monetary impetus on this? Or is there. Is there. Are they truly trying to help. Help me. So.

But it's a.

It's a. It's an age of unlimited information, if you want it.

Totally. And I love that. The perspective as well, of the. You know, it goes with every industry. Right. It's like the people spending, talking about X advice, business advice, life advice, versus the ones that are doing it to the highest levels. Maybe, you know, it's. It's a different. It's a great perspective to carry, and I think it's always good to be like, reference that point of view. Um, I want to talk about your. The clinics. I know you had a clinics in Dallas as well as Denver, and I believe it's the Kinetic chain. Is that correct?

That was my old clinic. Yep. We had started Dallas and then opened three up in Denver, and then I moved back to Dallas in 2018 to open up what we call Body Lounge Park Cities.

Yes, got it. So Body Lounge Park Cities and talk to me about this. You know, for people that like there's lots of listeners from all these different cities or I'm sure people have friends that hey, like maybe go check this out if they're interested. Like what can customers experience and clients experience at one of your facilities, especially this, during this, you know, present time?

Well, we try to be like a very local based clinic, meaning you're always going to see either myself or my wife because we're both co owners, love that. And so most of our, most of our patients are our friends. Like we live about three blocks from our practice. And I think that there's in a, in an era where private equity is coming up and scooping up all these clinics, whether it's a dental office, physical therapy office, primary care, whatever it is, I think there's something to be said at least we think there is when there's a little bit more accountability there. So if I screw up, I'm going to probably be seeing you on the sideline or a local restaurant and I'm going to have to probably face the music. Whereas if you go to a different clinic and the owner is in Atlanta, you're just seeing a clinician. There's just a different feel. I think number two is we're small. Like, you know, I have one clinic and we've done that on purpose. We've been asked to brand out and do other stuff. And what I have found, it's very difficult to find quality clinicians that will stick. And so I just have not wanted to dilute us. And my wife feels the same way that it's, you know, you, you want to bring as the highest quality product that you can. And when we're talking about people's health and longevity, it's just, it's just really important to have that, that relationship. And so that's what we try to bring. And we, you know, we have all the cutting edge stuff like hyperbaric chambers and cold plunges and full body red light therapy, Normatec recovery. I do a lot of training with blood flow restriction for rehab. I use the ARX adaptive resistance exercise, computerized resistance training for muscle hypertroph strength training, bone density, lots of bone density. We have a DEXA scanner. I have two nurse practitioners that work for me. We do functional medicine. Well, I wouldn't call it functional medicine. I'd call it whole body wellness and kind of, yeah, because I, I'm not crazy about the functional medicine where it's kind of like what Med Spa was 10 years ago. It was really Sexy for a while and then I feel like it's kind of gotten diluted. So basically people can come in and we can start as, as low on the pyramid as genetic testing and then go to hormone testing and blood work and then kind of work up the channel depending on where your needs are. Like, it's our big belief that people, we meet people where they're at, you know, whether that's they're coming to us because they have a mold toxicity and they need help with that or they need, you know, they have a concussion and they need help with that or I'm seeing somebody for a simple, you know, I woke up and my neck's got a little kink in it. Can you help me feel better by tomorrow? Like, we see it like from all, you know, from the bottom up. We do a lot of hormone optimization, lots of peptides. We're trying to avoid medications as much as we can, but we use them when we need to. Trying to get people off of medication, we're trying to get people off of statins. Nobody has a statin deficiency. We're trying to encourage people to eat well. We have a dietitian that's board certified in functional dietetics. She is awesome at the gut and resetting biome that way. So really, wherever people are at, we try to meet them. And we have patients that come in the clinic every single day. They're getting a peptide, they're doing red light, they're doing a cold plunge, they're doing an infrared sauna session, they're doing a strength training, they're doing high intensity interval training on a Vasper. Then we have some people that I see once or twice and we love everybody, always welcome. I'll help you any way that I can. Um, so that's what you kind of get at body lounge and incredible. And yeah, we're, yeah, I, I, I.

Think there's first off, I, that's so incredible to hear. And I know for, for people that are listening that are in Dallas or have friends in Dallas, of course I'll be able to link everything down below for the people to check out. But one thing that I, I recently got a, a red light infrared sauna. I switched it out for. I had a cold plunge for a while and obviously having both would be great. Just don't have the space. But I'm curious to know and of course like, it comes down to what you just said of like meeting people where we are. There's no one size fits all. This is exactly what someone needs. But I'm curious from your personal perspective, like what are some modalities and things that you maybe have incorporated the last handful of years that have become like non negotiables for you or maybe there's a new piece of literature that comes out that makes you try something new, like with all of the access and of course, information you have. I'm curious what's like interesting to you now or has become more interesting over time, given the perspective and how insightful you are with all these different tools out there.

Yeah, that's a great question. You know, I still, I still preach the foundation, which is sleep diet, sunlight grounding, high intensity interval training at least once per week, lifting heavy stuff at least once or twice per week. Zone 2 more than 60 minutes at least once a week. Zone 2 aerobic capacity at least one time a week, over 30 minutes and then one short aerobic capacity. I think that's kind of your minimums, those are your basics. And then off of that, I think peptides right now are, are super hot and you know, fascinating. I think that I'm very interested to continue helping people lift heavy stuff. Like I'm using the arx, which is computerized resistance that basically makes heavy lifting very safe. You can't, I mean, you could hurt yourself, but it'd be, it's very hard.

Arx. What is arx? I'm not familiar.

It's an adaptive resistance exercise is what it's called. It's a company out of Austin, Texas. It's this big piece of machinery. Basically it's computerized resistance. And what you can do with it is you can, in order to make lifting weights very efficient, time wise, you've got to basically maximize your time under tension. When we think about, and BFR does this too. But when we're trying to get physiological adaptation quickly, because that's the first excuse people tell me is I don't have enough time to go to the gym three or four days a week, which I get. I don't either. I've got to be very efficient with my time. You want to try to stimulate the system, the system being us maximally. And so the way to do that with weightlifting is if you're using computerized resistance, you're able to maximize the resistance you're lifting in all different positions. Like normally. Normally if I'm bench pressing by myself, I'm the weakest in this position right here. Right. But from my chest to about 6 or 7 or 8 inches off, if I can't lift that weight, it's going to fall back on me. Right. Once I get it past this, then it's pretty easy. And then on the way back down, it's really easy. Like I can load that for a long time. Imagine if a machine can maximize the resistance that you're lifting, not just off the chest, but through the whole range of motion both ways. Now we start to move the needle on how we can get tissue tired, maximize that fatigue so that your body will adapt for the next training session and then be able to basically measure those, that resistance, that force production each session so you know that you're getting better each week. That's what you do with computerized resistance. That's what you do with arx. So I, I really, it's, it's amazing to take somebody that's never lifted heavy weights before. With guys it's usually pretty like, oh, I was a high school football player, I was a high school rugby, you know, whatever, and I used to lift heavy weights. I'm used to it. Sports been 20 years, but I'm used to it. They know how to kind of push heavy weights. When you take somebody that's never lifted heavy weights and you start introducing this to them, it's just amazing how like competitive they get and how they just start to like really dig in, like, and their strength just makes changes so drastically. It's so cool. With very limited time, like 15 minutes once a week is all I really need to make those changes. You know, it's so vital for people for their bone density as we get older. You're not, you're going to live to 100. You better build that bone density up, you know, up until the age of 30, because otherwise, you know, it's just diminishing returns unless you keep lifting weights after that. So, so I think to answer your question, I, I'm really like deep into the peptides right now. We've been using peptides now for four or five years. It's just getting kind of mainstream.

Yeah.

And people are starting to actually come in and ask for specific ones. It kind of blows me away now. This was never the case. I'd be like, oh, you want to put a muscle mass? Try, we're going to try MOT C. We're going to do this or that.

Just to interject real quick, I was going to ask about peptides and so I'm glad you brought it back up. If people are unfamiliar with it, like what are, like what are the key things they should know about the potential benefits of peptides? Or maybe they've heard about it. But, you know, next time they go in to see a physician, like, why should someone bring this up and why is it more important today or more common today, in your opinion? I think this is a good topic to end on.

Sure. Well, again, I, I think a lot of our podcasters and, and, and thought leaders are talking about it. You know, you go on a Rogan Pod podcast, you're gonna, you're gonna hear about peptides. You're gonna a greenfield, you're gonna any of these. You're gonna hear about peptides. Peptides are naturally, typically naturally forming in the body. Like insulin is a peptide that controls blood sugar. But then, you know, it's been very pop GLP1s these weight loss peptides. And that's really where people started to hear like, oh, yeah, you know, this weight loss drug is a peptide. What other peptides are there? Basically, peptides are small chains of amino acids. Proteins are long chains of amino acids. They're basically short proteins that are like keys. They're keys to your body. So certain proteins are keys to unlock increase in insulin. That's basically what a GLP is.

Got it.

There are peptides that increase growth hormone production that would be like your ipamorelin or your CJC 1295. There are peptides that help you repair your body. One in particular called BPC157, body protective compound 157. They call that the Wolverine peptide because, you know, you take it and your body basically repairs like Wolverine. And when, when you know, he gets shot and all of a sudden he's like, down, and then it just kind of repairs and he's up and he's kicking your butt already.

Wow.

So we have all different types of peptides that we use and it just depends on. Yeah, again, where people are at, what do they need, what are they interested in? And you know, to safely and effectively implement it should be done with somebody that's knowledgeable. You've got to get them at a good, in a good place, like a compounding pharmacy that, you know, is testing third party. A lot of the stuff that you can get online is all coming from the same place in China and have been shown to not have what's in there. So, you know, you just got to be careful with what you're taking. And there's not a lot of literature on, you know, how much do you take. And so you need to have somebody that's kind of got that dialed in. And so we've got that dialed in. We've. We've Spent a lot of time learning and educating, spending money on the education process to do it appropriately and safely.

I love that. Well, that's very fascinating to hear. And before we wrap up, I just wanted to say thank you so much, Dr. Caro, for coming on the show today. I think this is a conversation that I could, I could keep talking to you for an hour plus. So we'll definitely have to do this again sometime in the future. And for people that made it this far during the episode, where's the best place for them to stay in touch with you? And of course learn more about Body Lounge Park. If they ever happen to be in Dallas or they have friends out there, where can they learn more about everything that you have going on? And of course, you know, all the great things you talked about regarding smart tools, of course that's more user friendly that anyone can go check out. So we'd love to. Where's the best place for everyone to stay in touch?

Yeah, sure. So I have been trying to do a little better at my social media. So Instagram, I'm just Ed La cara and also LinkedIn, same thing. Ed La Cara, Twitter or X, whatever it's called now, same thing. And then Body Lounge, Body Lounge Park Cities is our website. That's where you can kind of get a list of all the different things that we do in the clinic. I have a school community, it's called a Smart Tools Society. Basically it's a free community to come in and learn about blood flow restriction training. Has a free course in there. I think it's a little over an hour and a half of me just kind of teaching you how the basics. So it's kind of what I recommend if people are going to start diving into it at least a little bit. So lots of you can go. My YouTube channel again at La Cara and it's got videos on BFR and you know, different things. So yeah, there's a lot of, there's a lot of information out there. But if somebody's really interested in bfr, that school community is something that we started last year to try to just educate and you know, there's no cost. You can go in, jump in, ask questions and not just me answering, but the community answers as well.

That's awesome. Well, I will absolutely be sure to link all of that down below for everyone to go check out. And once again, thank you so much for, for taking the time to come on the show today. Really appreciate it.

Yeah, it's my pleasure. Thanks for having me.

Of course.