Episode #137: “Dr. Two Fingers” Reveals His Teeth-Gritting, Body-Healing Secrets.

In this podcast, an interview with Dr. Two Fingers. How soon to exercise after vasectomy? Fish smelling body odor Maintaining run fitness with limited time is high blood creatine, bad adrenal fatigue and sodium intake, Pain in a screwed ankle, runner's knee, effects of fat deprivation and does drinking milk lower testosterone?

Welcome to the BenGreenfieldFitness.com podcast. We provide you with free exercise, nutrition, weight loss, triathlon and wellness advice from the top fitness experts in the nation. So whether you're an Ironman triathlete or you're just trying to shed a few pounds, get ready for non run of the mill cutting edge content from BenGreenfieldFitness.com.

Hey folks, this is Ben Greenfield sitting here in Spokane, Washington getting ready next week to head down to the Caribbean actually to do a triathlon down there called the Tristar Tristar Nevis. It's a 1k swim, a 100k bike and a 10k run. So lots of time in the bike saddle. Should be fun. In today's interview I've got Dr. Craig Buehler, also known as Dr. Two Fingers, who's going to be talking about advanced muscle integration technique. Really cool stuff from an injury prevention standpoint. As a matter of fact, I gotta tell you, it rings close to home to me because just last weekend I went over to coeur d', Alene, Idaho, which is only about 40 minutes from my house, and I visited a guy there who is kind of infamous among local Ironman triathletes and folks who exercise a lot for being able to kind of fix just about anything that's going wrong with your muscles. He calls himself a bird body mechanic. His name is Brian Sanders. As a matter of fact, if you happen to be a listener and you live near Coeur d', Alene, if you haven't seen him yet, you need to email me ben greenfieldfitness.com and I'll be able to hook you up with the body mechanic. He will fix you for sure. If you haven't been to BenGreenfieldFitness.com lately, then you would be very interested if you are a coffee drinker, in checking out the two week java judgment that I'm doing. I'm trying to have two different kinds of coffee. One is a drip coffee substitute, lower acidity. It's basically a coffee extract mixed with a black tea extract called super coffee. And I'm trying that for a week and then I'm also trying something called Teecino, which is a mix of a bunch of different herbs and spices kind of almost like tea, but it tastes like coffee designed to be brewed like coffee. And I'm going to be reporting on my experiences with those two healthy coffee alternatives. So be sure to check that out over@BenGreenfieldFitness.com and and then finally, of course, if you want to donate to the show, then I will send you a bag full of goodies and a nice jet black. My personal trainer told me to eat more fat. BenGreenfieldFitness.com T shirt and special thanks to Robin this week for sending in a T shirt donation. And your shirt is on the way, Robin. Finally, be sure to if you haven't yet, follow us over on Facebook. Or I guess it's technically a like like BenGreenfield Fitness over at Facebook. Go to facebook.com bgfitness I'm doing stuff over there that I'm not doing on the blog or on the Twitter feed, and the next thing that's gonna be happening over there is a live video debate. Stay tuned for more on that and you can do so by going to facebook.com bgfitness I guess I just kinda rocked out all the special announcements without even getting to the special announcements. So we're going to go ahead and jump right into this week's Listener Q and A. I listened to your requests and decided to continue to take more questions rather than fewer questions on the Q and A. So here we go. Get the inside edge from Ben Greenfield Fitness delivered straight to your phone. Just text the word Fitness to 411247 and you'll instantly get exclusive VIP discounts and insider tips that no one else will ever see except you. Do it now. Text the word Fitness to 411247 and you'll be in Ben's VIP Text Club for free.

Listener Q and A.

Remember, if you have a question, you can ask it by calling toll free to 877-2209-9439. You can Skype username PacificFit. You can ask your question via Twitter by going to twitter.com BenGreenfield or you can use the handy Dandy Ask Ben form over@BenGreenfieldFitness.com for any of the podcast show notes, and this particular show is show number 137. Richard writes in with the first question. He says, I'm thinking of having a vasectomy and wondering if you had any information concerning recovery. I've entered a number of triathlons this summer and I'm concerned about how long the operation may put me off the Bike. Well, I kind of share your frustration, Richard, because if you were to go, say, look on the Internet for vasectomy recovery, what you're going to find is that the times vary hugely. You're going to find some people tell you you can return to exercise after four days. Some people will tell you you can return to exercise after a few weeks. And the reason for that is because there are so many different of vasectomy surgeries. Conventional vasectomy involves an incision and is somewhat invasive, but there are less invasive forms of a vasectomy. You can get a no scalpel vasectomy. You can get what's called a vasclip implantation. There are variations of the conventional surgical vasectomy, so all sorts of different ways to do it. Ultimately, what it comes down to is you will want to listen to your physician depending on the type of vasectomy that they do. And the no scalpel vasectomy is going to be the one that will likely have the shortest recovery time. What you are looking at is for conventional vasectomy, typically somewhere in the range of two to four weeks. In a less invasive vasectomy, you may be able to run after as few as three days. I would highly recommend that whenever you return to activity, you wear a cup or a jock strap. You wear some tight, supportive boxer briefs, maybe some lycra shorts. Definitely take advantage of the pain medication that you'll be getting after the vasectomy, something like a Vicodin, because that will certainly help that recovery. Come along just a little more nicely. And then you will want to have some bags of frozen peas or frozen corn or some type of ice in your freezer to put into that area to really help with some of the pain and the discomfort that will stay with you for a few days up to a couple of weeks after the surgery takes place. But ultimately it's going to depend on the type of surgery that you do. And again, the no needle, no scalpel vasectomies, you can usually get back to things within a few days. But in terms of actual pressure on your scrotum, because basically that's almost like a balloon and it can fill with blood if there is any type of trauma down there. I would be very, very careful to be 100% sure that you are healed and ready for exercise and been cleared by your doctor for exercise or before you get back specifically onto a bike saddle, because that's going to put direct pressure on the scrotal areas. And then, of course, swimming is something else in terms of the Water that you'll want to talk to your physician about as far as letting water in there after the surgery. And sometimes that can be up to a week or more before that can take place. So I hope that helps out with your question. Ultimately, it's going to depend on the type of vasectomy that you're getting done. Jennifer says when my husband sweats a lot after or during a workout, he starts to smell fishy. It doesn't happen all the time, but it happens often. He says it happens when he takes certain supplements such as omega 3 or fish oil. But I notice that it happens all the time. I was wondering if you could know why and if you could offer any solutions. Well, this is interesting because there is actually a condition that causes fish odor syndrome or causes you to have like this strong body odor that smells like fish. And it's called trimethylaminuria. And the reason that it happens is because you actually have this metabolic disorder that causes you not to be able to produce an enzyme called a flavin containing monooxygenase that actually breaks down another amino in your body called trimethylamine. And this trimethylamine is building up in your sweat, in your urine and your breath. And so you tend to get this fishy odor because that's what the trimethyl compound actually smells like. What can you do about it? Well, as a matter of fact, your husband is right that the consumption of things like protein powders, fish oils, and pretty much anything that contains nitrogen or sulfur like compounds is going to compound this problem. And anything like eggs or legumes may also do it. So in terms of supplements that could help with something like this, there has been a study done on this and supplementing with activated charcoal, which is actually a supplement you can find at most health food stores, or copper chlorophyllin, which you can also find at most health food stores, could help with the actual odor. But if your husband has this condition, then it may just be something that he's going to have to deal with and he may have to go for like a lower protein intake or look into a real, real smart vegan or vegetarian diet. So there may be some real dietary and lifestyle changes that need to be made. He could actually get tested for this via standard screening blood test that looks into that enzyme and whether or not there's a deficiency of the enzyme responsible for breaking down the trimethylamines. So that is a very interesting question. Thanks for bringing it up. And for anybody out there who has a fishy smelling body odor, incidentally, I actually do not encourage the use of deodorant due to the aluminum compounds that are in the deodorant. Your skin can basically suck those up just like your mouth can. And I would actually recommend you use something called Action Wipes. There's a spray out there called Action Wipes that I've talked about on the show before. If you go to BenGreenfieldFitness.com and do a search for Action Wipes, that's a really good spray made for from some really natural essential oils. Another thing that you can use is just baking soda. You can apply the powder to your armpits and that kills bacteria. It helps to absorb perspiration. And the other thing that you could use instead or mix with baking soda is cornstarch. So those are a couple of things that you could use as an alternative to the deodorants or the antiperspirants. Yes, they may attract women like flies, according to the Axe Body Spray commercial. But they also may not be all that healthy for your lungs, your skin or your body. So let's go ahead and move on to the next question. And this is from listener Michael Quick question for you on ultra running. I'm currently in Afghanistan trying to keep up my running in preparation for the Leadville 100 miler with very limited time to run. What do you suggest for a running regime that will maintain fitness for these ultras? When I get back three weeks before Leadville, I have access to treadmills, ellipticals and any kind of weightlifting equipment or machines. And he also has a follow up question. He says there's a ton of dust over here. What is a good way to protect against inhaling all the dust, especially when I'm forced to run while being passed by convoys every morning? First of all, from the dust perspective, obviously the cowboys did it and you can do it too. Bandana. That was the original Dusk mask. Anything from a bandana to a scarf tends to work really well at filtering out some of the dust. If you want to go with something a little bit more streamlined, there's actually a mask out there called the U2 sports mask. You could check it out. U2sportsmask.com they don't pay me to mention them or anything like that, but they make a mask that is designed to be worn during extreme sports and block dust out and that'd be a really good one to look into. It's kind of smaller and more low profile than a scarf or a bandana. The U2 size sports mask but onto your training question. In terms of maintaining fitness with limited time for running ultra endurance efforts, really it comes down to getting your body to recruit as many motor units as possible with as little training as possible. And I'll be talking about this more with Tim Noakes, Dr. Tim Noakes from South Africa, who's an exercise physiologist down there and does a lot of research on something called the central governor mechanism. Because what he proposes is that typically fatigue is due to the brain's inhibition of muscles due to pain and sensory perception of pain. And that one of the ways to override that is to actually get your brain to be able to recruit more motor neurons and more muscle units before it actually begins to shut down the body. And so one of the ways that you can do that, of course, is to do high intensity intervals or exercises that incorporate a large number of motor units or activate a lot of muscles. So if you're going out for say like a 10 mile tempo run, because you sent me your routine and I see that you're doing 10 mile run each morning with upper body and lower body weight training six days a week, I would keep up with the upper body and lower body weight training, but I would make sure that you're doing very short explosive sets. So nothing endurance based in the weight room. So all of your sets should be in the range of 5 to 10 reps. About 3 to 4 sets really overload your body. For example, my weightlifting squat routine for running right now is six to seven sets of three to four reps of squats. Very heavy, just so I can activate as many muscles as possible. In the process of writing a book about this style of weightlifting, it's a little bit kind of a new theory for endurance athletes. But then the other issue is that during your runs, rather than doing a 10 mile run every morning, I would highly recommend that you get rid of a couple of those 10 mile runs and replace them with a track work or speed work, preferably one session that kind of targets about that 30 to 90 second range and then another session that targets the 90 plus second range. So kind of going after the short, powerful, explosive session and then also the longer, still fairly intense interval based session and then also include a lot of hill work. So if you can do a short steep hill day or a long semi steep hill day, that will help tremendously. So doing a 10 mile run every day is going to keep endurance up, but it's really not going to get you the most bang for your buck in terms of motor neuron Activation and getting some of the beneficial effects of intense interval training, which is also going to do some of the same things as aerobic training, can still increase your heart stroke capacity. You can still improve what's called your mitochondrial density, your ability to use oxygen. It can still improve your ability to oxidize fat. So I would highly recommend that you kind of ditch the 10 mile run each morning and replace it or most of those sessions with interval sessions. And he'll work. Jerry writes in hi, Ben. I just recently turned 45. I've been a triathlete for about two years. About three years ago, I led a sedentary lifestyle and was overweight. I've had excellent lab results on my blood work the last three years that I've been fit. But notice in the last two physical exams that my BUN to creatine ratio is slightly higher than normal. I know you're not a doctor, but what do you know about this ratio and its significance to athletes? Okay, so let's kind of explain what this is. The BUN to creatinine ratio is basically a measure of your blood urea nitrogen, which is something that's filtered by the kidneys, nitrogen being a breakdown of certain metabolic processes like digesting food and metabolizing fuel for energy. And then creatinine is a waste molecule that's generated from muscle metabolism. So what happens is creatinine is produced from creatine, which is one of the major sources of energy production in your muscles. And about 2% of your body's creatine is converted to this creatinine every day. And more than that in athletes. Athletes and people who are exercising a lot. So this creatinine that's a byproduct of creatine breakdown gets transported through your bloodstream and into your kidneys. And the kidneys filter out the creatinine and dispose of it in your urine. So if you just wanted to find out how much creatinine was in your bloodstream, you could just do a blood creatinine test. But this other test, this BUN2 creatinine ratio, is a little bit different because here's the deal, your kidneys are always going to filter just a little bit of creatinine. So there's basically what's called minimal creatinine absorption. So if you think about a ratio as being like the top number and the bottom number, in this case, creatinine is the bottom number and your blood urea nitrogen is the top number and the bottom number. The creatinine is going to stay relatively constant. However, if your level, your ratio goes up, it's going to indicate that blood urea nitrogen is rising. And there's a few different things that could cause blood urea nitrogen to go up. Heart failure would be one of them. Not something you see quite common in athletes. Dehydration would be another thing that can cause that, and that's something that would be more common. A diet high in protein could also cause your blood urea nitrogen to go up as well. And that's something that a lot of times when people switch to, to say, like a healthier diet, sometimes their protein tends to go up. So that's another thing I'd look for is, has that happened in your diet? If you actually had a blockage in your urinary tract, like from a kidney stone or even something like a tumor, that could actually restrict the loss of urea, and that could cause a high ratio. It could also be caused by diabetes or some type of issue with your kidneys, some type of renal failure. There's also a disease called Addison's disease, which is. Which could cause a high blood urea nitrogen value. And interestingly, that's something that we'll talk about a little bit later. When it comes to adrenal fatigue, however, you'd have a lot of the other symptoms of adrenal fatigue, like weight loss, usually a lot of bowel problems, weakness, of course, fatigue. And that's something that you probably know if you were experiencing. And there's some medications that could cause a high blood urea nitrogen. I don't know what medication is you're on, but ultimately, in very active, healthy individuals, usually it's an issue of dehydration or very high protein intake. So I would look at those as being the culprits and then go from there. So, great question. And speaking of adrenal fatigue, here is the question on adrenal fatigue from Cindy, who was actually. She talks about how she was just diagnosed with adrenal fatigue. She says, I want to heal my body, but I also want to continue on with my training. Any advice? I've heard people with adrenal fatigue have to be careful about bananas, sports drinks, or supplements that have too much potassium in them because it throws the sodium balance off. Is that true? Well, from a nutritional standpoint, there's basically two things that can stress out your adrenal glands, which are the glands that sit right on top of your kidneys. The first is your adrenal glands make a hormone called aldosterone and that controls your blood sodium and your blood potassium levels. So if your potassium levels get jacked up and they become really high from a high potassium intake, you know, something like eating a bunch of bananas or taking a supplement that's really high in potassium, your kidneys are going to secrete a bunch of aldosterone. And that's going to cause your kidneys to excrete more potassium and retain more sodium. So if you have a real, real low sodium intake or rural high potassium intake, it's going to put stress on your adrenal gland because they're going to have to up increase their production of this aldosterone. So lots of fruits, whole fruits, vegetables and juices are going to have a lot of potassium. So a diet real high in whole fruits and vegetables may not be the best thing for somebody with adrenal fatigue. So the other thing that could cause a little bit of a stress when it comes to adrenal fatigue is that the other thing produced by the adrenal glands is cortisol. And cortisol stimulates the breakdown of proteins and fats, and it also allows the conversion of the amino acids in your body into glucose, which is also known as gluconeogenesis. So basically, cortisol is used for this breakdown of some of this energy into something you can utilize and make into sugar. But if your diet is really low in protein, or if you're not digesting protein adequately due to some kind of digestive insufficiency, your adrenal glands have to make a bunch of extra cortisol because they're going to have to break down your muscle tissue to turn that into amino acids because there's not enough dietary protein coming in. So real, real low or inadequate protein intake could also cause adrenal fatigue. So we combine this high fruit and vegetable intake with a low protein intake. Can anybody say vegetarian or vegan diet, and you're kind of setting yourself up nutritionally for adrenal fatigue, or if you have adrenal fatigue, you're setting yourself up to continue to stress your adrenal glands and keep yourself from healing properly. Now, there are other things that can fatigue the adrenal glands since they produce your adrenaline based hormones, energy drinks, lots of caffeine consumption. Interestingly, tons of aerobic exercise can also cause a lot of stress to the adrenals, and so can a constant state of dehydration. And that Addison's disease that I mentioned earlier is basically just a disease that's really a combination of high potassium, low sodium and adrenal insufficiency, and those are some of the classic symptoms of Addison's disease. So what this comes down to is, yes, you're correct, a high potassium diet could be an issue. So could a low protein diet from a healing standpoint for adrenal fatigue. This is something I've talked about many times before in the podcast. If you go to BenGreenfieldFitness.com and do a search for adrenal fatigue, just last week I talked about a bunch of things you can do to really control that cortisol production and to bring yourself back in alignment. Everything from sleep to really backing off the aerobic training to some nutritional adjustments that can be made and some supplements you can take. So go to BenGreenfieldFitness.com and listen to the podcast that I did on adrenal fatigue, and you'll be able to find out a bunch of different things that you can do. So I hope that helps. And next, we have a question from Gallop, who says, I broke my talus about 15 years ago. Water skiing. Talus is a bone in the, in the foot, ankle area. For those of you who wonder what that is. He says, I got it screwed and it's near 100%. Since I do get pretty sore in this area every time I go for a long run, the soreness is on any of those ligaments around the outside of the joint. I take ibuprofen and topical ketoprofen and sometimes ice. What would you recommend for an injury like this? So basically you've got this, this screw in your ankle or possibly several screws in your ankle. And typically when you're getting a lot of referred pain like that, there's either two situations. Either there are muscles or tendons around that area that are being overloaded, and those are actually stressed and inflamed. And that's something you'll learn about a little bit more in actually today's featured topic interview with Craig Buehler. Or there's actual friction between the screws or the hardware that's in your ankle and the soft tissue. So the plate or the screws are irritating a tendon or something in your ankle. And obviously that would require you to go visit with a surgeon and have those screws removed. And that's what a lot of folks do. And it actually helps quite a bit when they do that. So there's kind of two routes there. One would be like a manual therapy using some of the suggestions that are going to come up in today's feature topic. The other one would be to get the screws taken out. But I'd also really caution you against your frequent use of the nonsteroidal anti inflammatory drugs, whether those are the topical ketoprofen which is going to release it through the skin or like the oral Advil or Motrin or ibuprofen, because those are going to block prostaglandins and prostaglandins will block pain, but they also protect the stomach lining. And so you get a real risk of GI bleeding, you get a real risk of leaky gut syndrome. And you can actually get a lot of the things that simulate toxic shock syndrome when you're exercising, especially in heat and taking in ibuprofen. There's been several medical studies done on this and the effect of ibuprofen on muscle damage during exercise, muscle soreness and some of the markers of inflammation and muscle damage. And they're always through the roof when folks are taking ibuprofen. So I really recommend that's kind of like the emergency thing that you take when you simply have to get through a workout session or race and you have no other alternatives. I'd highly recommend you go with a safer alternative, something like phenocaine. I've talked about phenocaine on the show before. You could do a search@BenGreenfieldFitness.com for phenocaine. Also look into like a topical analgesic. There's a lot of topical analgesics. There's one called Rocksauce. If you go to rock tape, they make something called Rocksauce that's a really good strong analgesic. Those are some things that you could use in addition to some of the manual manipulation techniques that you'll hear about in today's interview. So great question. Next question is from Alberto. He says, I have a concern about my knee. In November I did my first half Ironman and six miles into the run my knee started to hurt a lot of I couldn't bend my knee for three days. After several exams, the doctor said I have get ready for this multioculated synovial cyst which is located medial to the medial head of the gastrocnemius muscle bundle with minimal joint fluid and a chondral softening within the lateral patella facet without a focal high grade chondral defect. Have you heard of this certain type of condition on triathletes? Actually that big mouthful of words that I just spit out, which I'm assuming you just copied from your medical records? Yes, it's basically a multi oculated synovial cyst. Is a cyst. And this chondral softening within the lateral patella facet, that's basically chondromalacia, which is also known as runner's knee. So let's talk about the cyst. Basically, the way that a cyst forms is any type of joint swelling or excess fluid in your knee from inflammation, which could be due to overuse, which could be due to tendon irritation, which could be due to some type of muscle injury sustained during the race. Basically, all of that can bulge to the back of your knee and form a cyst where all that synovial fluid collects and basically stays. So you get this fluid filled sac that's called a cyst. But I'm surprised that your physicians did not offer you this option. But many times you can simply get that excess knee fluid removed literally with a needle, and then that in combination with a cortisone injection to shut down the inflammation, often has you up and running again from a cyst within a matter of days. So drainage followed by cortisone injection is something I would be asking your physicians about. When it comes to the cyst, when it comes to the chondral softening of that facet on your patella, that's basically chondromalacia. And what chondromalasia is, think of it as like a blistering on the surface of the cartilage on your knee. And usually you can get it from arthritic degeneration, but you can also get it from some type of improper movement of your kneecap. Because what happens is, normally the underside of your kneecap is covered with this layer of smooth cartilage, and it glides across your knee when you bend your joint. But what happens is, in some people, that kneecap or your patella can start to rub against one side or the other of your knee joint, and as that surface that it's rubbing against becomes irritated, you get knee pain. You can also get swelling and inflammation. It's likely that this is what caused that cyst to form in the first place. Typically, it's caused by your kneecap not properly tracking, and typically that's caused by weak quadriceps muscles or the inability to actually control movement of the kneecap. I don't know if you're doing strengthening right now and knee strengthening, but over at one of the other podcasts I do at the Rockstar Triathlete Academy, Carey Sullivan, my partner over there, and I talked about this quite a bit in Terms of some of our favorite exercises for strengthening the muscles around the kneecaps. And although we talked about a large number of different exercises, I mentioned one of my favorite, especially for runners, is to simply take an elastic band or a cable, have it attached to your ankle and do standing straight leg kicks almost like you're kicking a soccer ball. But you keep your knee almost completely locked. You turn your toe slightly out so your toe is slightly externally rotated and you just kick about 15 to 20 times for one leg and then move on to the other leg and go back and forth four to five times, really focusing on that kind of teardrop shaped muscle on the inside of your leg. It's called the vastus medialis. That's the one that tends to be the most weak, especially in runners. And so you get tight IT bands and a weak vastus medialis. And what happens is the kneecap gets pulled towards the outside of the leg and rubs against the area that you're getting that irritation in. So combination of draining the cyst, getting a cortisone injection to shut down the inflammation, and then completely shutting off any type of running or cycling until you can strengthen your quads sufficiently to where your kneecap is tracking properly, focus on some hamstring flexibility as well. That will help out quite a bit and that should help you out. That's what I would do. Like you say, I'm not a doctor. That's not supposed to be medical advice. It's just what I would do if I were you. Okay. Greg says. Do you know of the possible adverse effects of long term fat deprivation? I did this for a two year period and my energy regulation is completely screwed. I'm frequently weak, irritable, headache and poor concentration. My blood glucose levels are consistently within a normal range. So endocrinologists have told me there's nothing they can do. The only thing that seems to decrease the symptoms are hot weather, intense high heart rate exercise, and eating complete meals like protein and fat. Saturated carbs. Carbs. First of all, I don't know why your endocrinologists have told you that there's nothing that you can do if your blood glucose levels are consistently within the normal range. The reason for that is that there are multiple risks to a long term fat deprivation. And I'll go over them. But basically fats are crucial for the formation of the hormones in your body, not to mention your brain tissue. And so when you're not making your testosterone and a lot of the hormones that are responsible for anabolic recovery, you get breakdown of Muscle mass, you get low hormones, low energy. And one of the best ways to fix that is to get on some type of natural hormone replacement therapy combined with a high fat diet and you're off to the races. So when you have fat deprivation, what happens is, first of all, there are fat soluble vitamins like fat soluble vitamin A, D, E and K. Because all of those nutrients are fat soluble, your body has to have dietary fat to utilize them. So all those vitamins get stored in the liver, they get stored in the fat tissue, they're important for your growth, your immune system, your cell repair, your blood clotting. If you're not eating enough fat to actually get those vitamins absorbed, they're going to get excreted by your body, they're not going to get stored. And so you get a risk of vitamin deficiency for vitamins A, D, E and K. So in combination with upping your fat intake, I would look into upping the intake of your fat soluble vitamins like A and D and E and K, especially D, I would look into high dose vitamin D, like 10,000 international units, plus the fat intake. Because like I mentioned, in terms of mental health and brains, essential fatty acids are very crucial for brain chemical regulations, especially omega 3s and omega 6s, which play a huge role in your mood and your behavior. If you're deficient in those fatty acids, which you're going to get from things like fish seeds and nuts, then you can actually have a lot of depression symptoms. And those fatty acids also help insulate nerve cells in your brain and help the nerve cells to communicate with each other. So because those may be damaged or deficient, you could be at risk for bipolar disorder, schizophrenia, attention deficit hyperactivity disorder, eating disorders, tons of other mental disorders as well, colon cancer, breast cancer, prostate cancer, all of those are correlated with low intake of essential fatty acids. So that's another reason to bump up your fatty acid intake. Research has shown that high omega 3 fatty acid intake intake can slow prostate tumor and cancer cell growth. So again, we're talking about cancer risk as far as cholesterol and heart disease. If your fat intake is low, your high density lipoprotein cholesterol levels are going to be low. And that is the protein that's responsible for transporting cholesterol into your liver to be excreted. And specifically, it's very important for getting rid of a lot of those small pieces of cholesterol that can get oxidized through a high carbohydrate intake diet and lead to heart disease. So HDL is low with low fat intake. So you're in, you're increasing your risk of heart disease. A lot of times if you're not eating enough fat, then you're getting a ton of excess carbs and protein as well. And so that carbohydrate rich diet is of course going to increase your chance of diabetes. And of course fat is very satiating as well. So if you're depriving yourself of fat, you're also probably going to have a higher appetite than you normally would. So lots of things going on there when you cut yourself off from fat. In terms of what I would do, I would get on a high fat diet, I would get on a fat soluble vitamin diet and I would also go listen to any of the interviews that we've done on natural hormone replacement. Specifically in your case as a male, I would definitely be looking into going to an endocrinologist and it looks like they're testing your blood sugar. But I would have them test your testosterone if it's low. See if they can put you on something like an Androderm patch or a testosterone injection to get that back up and get the full range of hormone testing and try and get that within range right away. And we could talk for hours about that. But that's where I would start if I were you. The fact that when you eat complete meals with a bunch of protein and saturated fat, that helps to decrease the symptoms. The fact that intense exercise helps to decrease the symptoms. Well, both of those activities can increase the level of your anabolic hormones and the hormones responsible for giving you the energy that you're lacking. So that makes sense. Last question here from Paul who says, I've recently started training quite heavily, doing a mix of a weight training. And I recently heard that training too much can lead to a drop in testosterone. And I heard one way to bump the testosterone up is to take zinc and vitamin B6. However, I drink a lot of milk and I heard that calcium in milk decreases the effect of the zinc. I really like milk, but was thinking of giving it up. I know milk is good for you. Also, for your information, I am slightly asthmatic, so I am wary about milk causing a buildup of mucus on my chest. Okay, just regarding that last sentence, if you're asthmatic and you worry about milk causing a buildup of mucus on your chest, that is a worry. Milk can increase mucan production. I would just consider that maybe genetically you might not be the best person to be drinking a bunch of milk and you may Want to look at some alternatives like almond milk or rice milk, because frankly, growing individuals, people who are trying to put on a bunch of weight, those are the type of people who really need all that insulin, like growth factor and hormones that are in milk. The average person who's trying to lose weight really isn't doing themselves any favor by drinking milk. But when it comes to your question about calcium, calcium can inhibit the absorption of zinc. Now, when it comes to how much calcium could actually inhibit the absorption of zinc, in studies that they've done in humans, specifically in postmenopausal women, which I know is not you, Paul, I'm assuming because of your name, but we can at least use that. As a baseline, when calcium. The total calcium intake was up around 1400mg per day. That was enough to reduce zinc absorption and affect zinc balance in women. So that's up around 1400. If you look at the average glass of milk. The average glass of milk has about 80 or so, I'm sorry, not 80, 300 milligrams of calcium in it. So you'd have to be drinking several glasses of milk, plus doing a lot of other, like yogurt and dairy products, lots of dark leafy greens, seeds and nuts, things of that nature. You could easily get up to about 1300 milligrams of calcium or more, and that would absolutely affect that zinc absorption. And the reason that zinc can actually increase testosterone levels is that zinc is an aromatase enzyme inhibitor. We've talked about this a little bit on the show before, but basically testosterone can be converted into estrogen or can be broken into estrogen like compounds, and zinc can keep that from occurring. And so especially as you age, as your testosterone production decreases a little bit anyways, or as you increase in the propensity of your body to convert testosterone into estrogen, the intake of zinc becomes more important. I've talked about the Prostolon supplement on this show before. Prostolon is, for example, one thing that I take every morning. It's got zinc in it, it's got pollen extract in it, and those are a couple things that really help in terms of aromatase inhibition. However, if you really want to keep drinking milk, there are other things that you could do in addition to zinc to increase your testosterone levels. And I did a huge video seminar on this. Just go to BenGreenfieldFitness.com and do a search for testosterone. There's been multiple podcasts, the most recent being the video seminar that I did, that tell you exactly how to increase your testosterone. And if you wanted to kind of have your cake and eat it too, keep on drinking milk, taking in 1300 plus milligrams of calcium per day, and then not really have to worry about decreasing your zinc absorption. There are some other things you could do in addition to zinc for aromatase inhibitors. So I hope that helps your question. And that wraps up the questions for today. So we're going to go ahead and move on to this week's interview with Craig Buhler after a quick special announcement.

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Hey folks, this is Ben Greenfield and with me today is Dr. Craig Buehler. Dr. Buehler, you may know most recently from being featured in Tim Ferriss Four Hour Body. There was an interesting anecdote in that book in which Tim Ferriss nicknamed Dr. Bueller, Dr. Two Fingers because of an unusual approach that he has to isolating and reactivating individual muscles that have been injured or deactivated. And it's a very interesting procedure. I will let Dr. Buhler introduce the Advanced Muscle Integration Technique, which is what he calls the procedure that he does tell you a little bit about how it works and also how you might be able to implement it if you want to work on an injury or improve performance. Dr. Bueller himself received his Doctor of Chiropractic back in 1978 from Western States Chiropractic College in Portland, Oregon. And he's worked with many, many individuals since then, including several professional athletes, one actually right here in my hometown of Spokane, Washington, John Stockton. And other people that he's worked with include Bill Romanowski, who's a four time super bowl star linebacker. He's worked with Karl Malone, the Alpine ski star, Peekaboo street, and a handful of other professional athletes. So we're very honored to have him on the call with us today. Dr. Buehler, thank you for coming on.

Well, it's my privilege. Thanks for the opportunity.

So the best place to start I think would be for you to kind of lay down an explanation of what exactly advanced muscle integration technique is?

Well, it's a very elegant approach to the assessment, diagnosis and treatment of conditions that people deal with. Really, the advantage to this is that we can assess every single muscle in the body for function. Each muscle in the body has a specific motion that it's responsible for. And what we discovered years ago is that if a muscle is overloaded beyond its ability to handle a stress, either because of lack of conditioning or because the trauma is too severe, if the integrity of that muscle is exceeded, the little nerve centers contained within the muscle shut the muscle down proprioceptively.

When you say proprioceptively, what do you mean when you use that word?

Well, all the tissues of the body are endowed with all these little receptor sites that monitor tension pressure. There's some receptors that are only active during inflammatory processes, but they're centers that give feedback to the brain about the status of different tissues. And there are little fibers called Sharpey's fibers that attach the muscle into the bone. And those little fibers are loaded with receptor sites that monitor tension. And if the integrity of that muscle is exceeded, those little fibers trip just like a circuit breaker. Now, there are other fibers in the tendon that can be inhibited as well. Especially the muscle's overstretched, but they're built into the system to protect it. But once that muscle is overloaded and the muscle is shut down, it will fire under passive range of motion. But if you load it, it gives way. If you continue to load it, the body creates pain to protect you. Now, at more point, the central nervous system computes an adaptive strategy by using the muscle next to it. And so the joint angles will change slightly to accommodate the muscles that are working and avoid the muscle that's inhibited. And if you're successful in that adaptation, there's no longer any pain. And you think, okay, I'm better. But if, you know, mechanically, there's a shift in your form. And so that adaptive tissue becomes the next side of injury. So we go from one injury to the next, the next. Before long, we end up with an area where there's so many muscles that are inhibited, there's nothing left to adapt with. And that's when we end up with chronic pain. So what we find is that when muscles don't fire appropriately, Then they don't absorb the shock efficiently. And so there's more stress placed on the connective tissue capsule and the joint. And so the joint becomes inflamed. And the longer you're inflamed, the more you break down the joint and end up with arthritic changes. So it's a cascade effect that occurs over time. And when we treat pain with anti inflammatants or pain pills, we're basically masking the body's alarm system, the protective mechanism, and we actually accelerate the breakdown process.

Now go ahead.

As a result, we don't treat symptoms in this model. We look at function or distortions from normal function. So let's say a person comes in with shoulder pain. I'll ask them what motion causes your pain. Well, they'll go through the motion. When I reach a certain way, I get pain. Well, if you understand anatomy and know what muscle is responsible for that motion, you know exactly which muscle's inhibit it. So if you isolate that muscle in a muscle chest and challenge it, it'll be weak and painful. And so that pretty much defines the source of the pain. And then we've got a whole series of integrated therapies that allow us to reactivate that muscle. So in 10 minutes we can take a muscle that's weak, painful and bring it to a level where it's strong and no pain. And athletes will get off the table and move around, say the pain's gone. So it's a difference between treating symptomatically and treating functionally. And as a result we see miraculous changes in athletes. We can treat acute injuries with ease in a matter of 10, 15 minutes and have athletes back competing chronics are more difficult.

That sounds simply amazing. And it does make sense that the body will take action to protect itself or to isolate. And I guess the way that it seems to make sense to me almost form a wall around an injured or strained or stressed area. But before we kind of go into what you do with a chronic injury, with an acute injury, let's say someone sprained or strained their ankle. They're listening to you talk about what happens on this central nervous system level when they do that. Is there a way to ensure that that central nervous system response doesn't happen in the way that you've described it? Or is this simply something that we're stuck with when we get injured?

Well, I'll give you an example. On my website there's a video of John Stockton spraining an ankle. It's a severe sprain. They had to help him off the court, which was unusual. We went back in the locker room, we evaluated him, I treated a couple of muscles, adjusted his ankle, and he went back out and played the fourth quarter pain free. Now Next day he was purple from capillary hemorrhage that occurred due to the trauma. But standard medical care would say off it for a week, then start gradually working the passive range of motion physiotherapy modalities. And each week you increase the activity to where? Four to six weeks out, you're back to normal function. Well, in this model, we look at what happens during the trauma inversion sprain, which means your ankle rolls out, usually when you're in full plantar flexion, which is on your toe, usually come down somebody's shoe and you roll the ankle, it distorts the joint within the ankle itself, so it displaces slightly. The receptors on those joints create a protective splint of the muscles around that area in addition. But you also overload the lateral support muscles and they shut down so they don't support you. At that point, walking becomes an irritant. What we do is evaluate the muscles, find out which ones are shut down, adjust the articulations of the joint back into position so they move the way they're supposed to. And then we have a player get up or an athlete get up and walk. And the first few steps, it's painful. Each step thereafter gets less and less painful to where we're having them run up and down the locker room pain free. So we tape them and they're back out on the field or back out on the court. At that point, running and walking actually becomes therapeutic because you're facilitating lymphatic drainage, better circulation, and so the body can start the healing process a lot sooner. So once you reset those joints back into position, then the little pain receptors that are firing become, because the trauma become deactivated. And so you have pain free joint motion and stability. And it's pretty miraculous. People are shocked.

It sounds a bit different than the traditional rest, ice, compression, elevation. When it comes to an injury, it is.

And that's why there's so much controversy about this technique. It's because it's, it defies standard medical care. But I've used it at the professional level for 30 years and it rarely fails. If after I adjust the ankle and I reactivate the muscles, it's still unstable, then we've got a tear somewhere, which is usually a surgical situation. We rule out a fracture initially to make sure that there's no problem that way. But once we rule out fracture, then we go ahead and treat. But I would say in 80% of the cases, 85% of cases, athletes are back out competing within 10, 15 minutes of being treated, which shocks them, you see a bad angle, you see that ankle sprain on my website, you think that's severe. But when you see them come back out 10 minutes, 15 minutes later and play a full quarter, say, he must not have been hurt that bad. I mean, it really does defy. But it's a different paradigm. And you know, there's always throughout history a different paradigm that shifted the technology and proof in the pudding. Yeah, you can talk a little line, but if you can't produce consistent results, it's just so much jargon.

Yeah. Now let's shift focus to the person who. Why not just keep going on with this ankle sprain analogy? Say someone is competing in a sport now, like they're doing marathoning or triathlon or distance running. And back when they were in high school and in college, they played sports like basketball or football or baseball or something like that and sustained ankle injuries in sports like that. And now they're having pain in their knees or pain in their hips. And it sounds like from your explanation that this type of pain could be related to muscles being shut down or protected because of previous injuries. Now that person comes into you and what can they expect? What happens?

Well, in acute injuries, you treat the local area. But if an acute injury is not solved within six weeks, the central nervous system is forced to adapt into other tissues. And so in chronic problems, you never treat the local symptom area, you actually treat away from the injury site. So let's say, for example, you sprained an ankle in college and it's treated medically, those imbalances are still in place. If you stand on two scales, one on one scale, one on the other, you'll find you're putting more weight in the non trauma side. Even though the ankle that was sprained a year ago doesn't hurt because your body's accommodated, so you're putting more stress on the opposite leg. Now if you're still active, you create what's called a repetitive stress injury where you're putting more stress on that opposite knee joint or hip joint, and you start getting pain in those joints, well then you might injure your knee or injure your hip. Now you've got an acute injury on top of a chronic problem. And so a lot of times when people come in with knee pain, let's say they have left knee pain and their history shows that they sprained a right ankle a year or two ago, you treat the right ankle and the left knee pain goes away. And yet everybody's been treating the left knee. So it's a matter of, are we treating the cause of the problem? Are we treating the adaptation to the problem? That's when it gets really kind of complicated. And the assessment process is really critical to define the source of problem rather than merely treating the symptom.

And what does that assessment process involve?

Just testing all the muscles in the body. So you start from the ankle all the way up to your neck. There are 740 muscles in the body. And so, you know, we don't test commonly every muscle because you got the small lumbrical muscles, interosseous muscles in the fingers and the toes. We don't test those unless there's a problem in those areas. But we get it. We get a great assessment on people. We've taken patients. For example, we took a football coach, and I said, I don't want to know anything about your history. I'm going to do my exam on you, and then I'll tell you where your problems are and where your injuries have been. So I went through an assessment. Then I sat him down and explained to him what I'd found. I nailed every single injury he'd had all through high school and college football.

Wow.

Now, the way I look at that is, okay, if those injuries healed back in high school or college, how come I'm finding them 30 years later? And the answer is, because they're still there. The body's just adapted. And what we find as people get older in their 60s and 70s, those old injuries that occurred when they were younger start to show up again. Well, again, if they heal back then, how come they're showing up again now? And it really validates this whole concept that we adapt around those errors and never really truly balance them.

Interesting. Now, from an inhibition perspective and a muscle tightness or a cramping or a spasming perspective, I noticed that on your website, you explained how when the body or when a muscle is active, actually shut down or inhibited in the way that you've explained due to an injury, that it actually loses its ability to inhibit an opposing muscle, like the hamstrings and the quads, for example, can you explain how that actually works to people who are having to deal with tight muscles? Maybe those tight muscles aren't the muscles that were injured.

Tight muscles are a symptom. And so in this model, we never treat tight muscles. So I'll give you an example. And I can talk about this because it was reported in the media. We had a basketball player, Carlos Boozer, for the Jazz and he had been out for the first part of the season with a chronic hamstring tear. And they went through all their therapies, got him back to where he was working out again. As soon as he stressed this, it pulled again. So they went through the same process again, and he pulled it again. Well, after the third time, he came into my office. This was after I had resigned from the Jazz and everybody had been treating the hamstring. When I did my evaluation, I found that the quadriceps were shut down. So when we walk, when we get to a certain point in our gait, the hamstrings engage and they send inhibitory impulses to the quadriceps to cause the quadriceps to relax. And then at the mid stance, gates, all that changes. And so the quadriceps contract and inhibit the hamstrings. That's how we move. No muscle is ever totally shut off, but they relax and contract as we go to a movement pattern. So if the quadriceps muscle groups are inhibited proprioceptively because of injuries that we've sustained, they lose their ability to reciprocally inhibit their antagonist muscles, which are the hamstrings. So by reactivating the quadriceps, it allows that inhibition to take place, and so the hamstrings release without even touching the hamstring. So you're going to have an athlete come in with tight, pulled, injured hamstrings. You ask them to bend down as far as they can, and they might get down to the mid part of their shin before the hamstrings start to hurt. You clear the quadriceps. With no more tension or pain. Now, that's just one example of this inhibitory process that we see and why we don't treat tight muscles. Because most people, if they think about their experience of pulled hamstrings, they never get better. And they never get better because they're being treated the wrong way. Yeah, get temporary relief. You know, you can stretch it, you can do therapy on it. You get off the table and, oh, that feels better. But the next day after competing, they're tight again, and eventually you tear them.

I have a question for you. In terms of what people can expect when they actually come in to try out this Amit technique. Does it hurt or is it uncomfortable? I've myself been to see various chiropractic physicians and kind of use myself as a guinea pig for a few different types of treatment. And what I have experienced is that sometimes there's a little bit of teeth gritting involved. Have you seen that? To be. Or is that something that people can expect when they come in?

Yeah, yeah, they can, but it's not that extreme. When you have a muscle that shut down, the muscle attachments become painful and inflamed. So if you start stimulating those attachments, which we do, they're uncomfortable. But the longer you stimulate, the better it feels. I mean, I treat elderly women here, I treat kids. They don't like it, but it's not so extreme that they're like saying, I don't want to do this. But anytime you have an acute problem, a chronic problem, and you start treating those areas of inflammation and pain, it's going to be uncomfortable. But the outcome is so phenomenal that people say, hey, I'm going to do whatever I need to, because this stuff works.

Right? Right. Okay. So let's say that people listening in want to get this done. They want to find a practitioner in their area or they want to find some type of resource that they can use to try this technique or to have someone perform this technique on them. Are there people they should see or they shouldn't see? Are there resources that are available for practitioners? Are you kind of like the only person in the world that does this?

Well, I'm teaching certification programs now. There are 10 physicians that have been certified to use this technique. But there are a lot of different great body treatments out there. You know, Tim Ferriss talks about active release technique. There are active release art practitioners all over the country. He's been teaching this for years. Yeah, that can be a painful treatment to have done, but it's a great technique. It improves range of motion, it breaks up adhesions. It's a tool. And so when you apply that, when you apply any kind of bodywork, you're going to get value. I like the advanced muscle integration technique because it integrates about 17 different disciplines. And it goes a lot deeper than these other techniques go. But not everybody needs the deeper work. But if you're dealing with a chronic problem, a lot of times you need to go deeper to find out why and where it's coming from. Because muscles can become aberrant for a lot of reasons. Nutritional deficiencies, organ gland imbalances, emotional stresses, dehydration, neurological issues in the spine, local injuries. I mean, there's a lot of things that go into the mix. So, you know, there's a. Like I said, there's a lot of techniques out there that are. That are valuable. People just need to access what feels comfortable for them. But I don't. I know. I wouldn't have been able to produce results that I produced through the years with the ski team and the football players, the NFL and the Jazz if I hadn't had the tools available to me that I use in the AMET model. But if people want to look for a practitioner, they can go to my website. And there are, there are a number of practitioners listed. But again, it may not be easy. They may have to fly to another state. I've had people flying in here from all over the world to access this work because there aren't that many practitioners yet.

Right, right. Well, I will put a link to your website in the show notes. And for those of you listening, listening in, Dr. Bueller is located in Kaysville, Utah, correct?

Yes, sir.

Okay, so he's located in Utah. If you go to his website, you're going to find practitioners in Nevada, Utah, Idaho, Oregon, Illinois and Colorado. I will put a link to that in the show notes. And I'm sure that if you're somebody who wants to fly in and see Dr. Bueller, you. You can contact him via his email that's there on his website. And I'm certain that he can speak with you about that or I'm sure he can call his office as well. I think it's quite interesting and it makes a lot of sense. And I want to thank you for coming on the call today and telling us a little bit more about it. Dr. Bueller.

Well, it's my pleasure.

All right, folks, that's Advanced muscle integration techniques. A mouthful, am I T? You can call it. And this is Ben Greenfield and Dr. Craig Buehler signing out from BenGreenfieldFitness.com well, folks, that's going to wrap up today's podcast. Please be sure to go over to itunes and leave a ranking or a review. An interesting review recently accused me of being puny and weak looking. I got a kick out of that one. But if you want to go over to itunes and leave a review or a ranking, it's pretty easy. Just go to itunes and do a search for Ben Greenfield. Everything that I talked about today is of course available in the show notes for this podcast. Podcast number 137. Coming down the pipeline, a ton of great interviews. I mentioned one coming up next with Tim Noakes. Great interview with KC Creischy. And also I did recently release a rather controversial interview on fluoride. It was the post before this one. So if you didn't get a chance to hear the interview with Paul Kinette and you're interested in fluoride, be sure to check that out. And there will also be another Inner Circle podcast coming out in a couple weeks on Healthy Brains and healthy Kids. So trying to bring you guys as much content as possible. Thanks for listening in. Let me know if I can do anything for you. You by contacting ben@bengreenfieldfitness.com using the free iPhone or free Android app which you can also get in the show notes to this episode to ask me a question or even calling toll free to 877-209-9439. Okay, until next time, this is Ben Greenfield signing out for the next podcast I'll be coming to you, most likely straight from the Caribbean. See you then.

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