LS 43 - Ben Shatto, Longevity through Physical Therapy

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Welcome to the Longevity Show, Informing listeners on the important aspects of health, wealth, and happiness to ensure you live life to its fullest. With fascinating interviews with top authors and gurus in the field, along with the latest news in the science and technology of longevity, we're going to reveal expert advice and amazing secrets of living a longer, happier life. And now, here's your host, Jason Hartman.

It's my pleasure to welcome Ben Chouteau. He is a physical therapist and he's the founder of thephysicaltherapyadvisor.com and he has recently enlightened me as to my renewed importance and interest in physical therapy for longevity and for hacking our biology. And I think it can really do a lot more for us, a lot more than I knew. So it's a pleasure to have Ben here. He will fill us in on some of the great benefits. Ben, welcome. How are you?

I'm great, thanks, Jason.

It's good to have you. So where are you located? Give our listeners a sense of geography.

Yeah, I'm actually in Boise, Idaho.

Fantastic. And I was just there, but we just missed each other when I was there for a conference recently. So physical therapy now, you know, to my thinking, and I would assume a lot of people think like me in this vein, is that, you know, if my shoulder hurts, if my back hurts, sprained my wrist, a physical therapist can help me. And that is, of course, true. But there's more than that, right?

Absolutely. And you're right, all those things are true. We treat folks with those types of conditions all the time, and we do a really good job of it. But we also do a lot of other things that a lot of people might not be aware of or think of. As far as the importance to involve a physical therapist earlier on. Right now, we're at the end of October, and October is actually National Physical Therapy Month. And the big theme this year was or this month was to age well. And physical therapists always kind of, we think of ourselves as movement specialists. And a major part of our treatment philosophy is basically exercise prescription or an exercises medicine concept. So when we think of that, we really should be providers of choice when we look at treating clients with chronic illnesses such as diabetes, osteoporosis, falling. We even can help out with heart disease. And more and more research is showing the importance of exercise with Alzheimer's disease and dementia.

And so, you know, these days, there's a lot of talk and especially on your show about lifespan. But more important than that, in my mind, is healthspan. And that's where physical therapists can really help a person optimize their health and their mobility to improve their quality of their life, however long that might be.

You know, Ben, it's interesting you mentioned falling, and I recently read an article that talked about how when an older person has a fall, which they sort of undoubtedly will probably, that really is a sign that lifespan is shortening quite a bit after that fall. A lot of those falls become very serious issues, don't they?

Yeah, you know, that's a really good point. And it, you know, basically the number one predictor of a future fall is a past fall. And so once you start having those types of issues, that's a really a warning signal that things are on the edge of not going well or maybe, you know, something's already happened, like a broken hip or a pelvis. And that can really set someone back significantly in their lifespan and their health span. The key is to try to intervene early in that process to prevent those falls from happening. And that's really a doable thing. And physical therapists are great at that. The hard thing is identifying what is the common cause for some of these falls. Is it the balance? Is it strength? Is it medications? So there's a lot of factors that need to be addressed to prevent falls, and physical therapy should be a number one approach to do that. And the earlier person starts working on those different aspects of fitness and health, the less likely they are to suffer injury from a fall or a fall in general.

So is physical therapy really something that should be used proactively? You know, certainly I always think of it as a reactive thing where, you know, if you, if you get carpal tunnel syndrome or you have one of these problems we mentioned earlier, you go to, you go to physical therapists for rehabilitation. But you're suggesting it as a proactive approach, right?

Yeah, absolutely. I mean, physical therapists have been known for a long time to be helpful in the rehab arena, whether you've had surgery or an injury, back pain, whatever. But more and more the focus is on that prevention aspect. And that's really.

An entrepreneurial mindset among physical therapists realizing our healthcare system really has a lot of problems. And if we don't really push for the prevention side of things, there won't be enough money in the system for us to basically have the treatments we would all hope to have as that end of life care happens. And so prevention is really a key factor. In so many of the most chronic conditions we suffer from these days are all preventable. Again, you're back to diabetes, osteoporosis, obesity, all these things are mostly lifestyle diseases. And physical therapy can intervene early on to get someone back on track before they have some of the negative health ramifications from those types of conditions.

Talk to us a little bit about the other issues. We talked about falling. You know, obviously people know about rehab type things. What about diabetes? Any other things?

Yeah, let's talk about osteoporosis real quick. That is something that really affects folks as they get older as well. And we all know that exercise, and particularly weight bearing exercise is a key factor in to preventing osteoporosis. The problem is.

Once you get to a certain age, you're likely to have had other problems, whether it's back pain, knee replacement, a bad hip, whatever it might be, but you still need to perform those weight bearing exercises. And how can you do that without hurting yourself further? Then that's where a physical therapist can really guide that treatment. Personal trainers and things like that, they do a good job of assisting some of the younger folks, but they're not really trained to help a person navigate a lifetime of other injury that may have happened. And that's where understanding the body and the medical side of things, we can guide a person through the proper amount of exercise to stimulate the bone or whatever system we're working on to get the benefits that's needed. Because if you don't push the body hard enough, you don't get the response you want. And if you push the body too hard, you're going to end up injuring something else. So it can be a fine line, and usually the later in life you are, the finer that line becomes.

Okay, so why does the line become finer? And how do you know when you're pushing yourself too hard or not hard enough to have? I mean, you got to push to make progress, I assume. But if you do it too hard, you overdo it and that's regressive, right?

Yeah, that's a good question. And it's a hard question. I always talk to people in terms of margin of error. So when you're in your 20s, you can get away with a lot of things that you can't when you're in your 60s and 70s, and that's that margin of error. Your body has a large reserve capacity to maybe do stupid things or not do things. Exactly right. But it can recover pretty quickly. And as you age and that normal process of aging, there are Some things that occur, your hormone system changes, there are some bone density changes that would be considered normal as well as muscle mass changes. And so that margin for error really decreases. So as you're trying to maintain where you're at, you really have to do it in a proper, correct way so you don't overload the system. And how do you know that? Well, usually there' syou'll have signs that are telling you that, you know, maybe you're, you're pushing yourself too hard. And there's more and more research on this. If it's, if we're talking cardiac, there's heart rate variability is a, is a good way to monitor if you're pushing too hard. Just general muscle soreness and stiffness can be an indication if you start to get swelling in joints. And you know, we're talking about folks that might be middle years to older. Those are all signs you might be pushing your body too hard or you're just exercising inappropriately. And that's where you need an individual approach from someone that's trained to assist in that, that type of exercise. And a physical therapist can just go through and basically look at your entire health history and determine what's going to be a safe form of exercise for you so you can get the benefits you need without any of the negative consequences that could happen.

And you know, any, any additional thoughts, Ben, on why this happens? And you know, of course, this is a question of the ages that, you know, why can't we solve the aging problem? Well, you know, I do think we are getting a lot closer. You know, why is it that, and I'll just use, not that I'm recommending it, but alcohol as an example. Right. You know, when I was in my early 20s, I mean, I could, I could drink and wake up and feel great. I can't do it anymore. My body just doesn't want this stuff anymore. I'm just not interested in drinking.

It's a great question and it is the question that everyone's trying to answer. We know there are certain processes that start to change as we age and there's certain normal consequences that happen from aging. There is a steady decline in bone density as we age. There's a decline in muscle strength and mass as we age. It would never be considered normal to get to the point of debility where you can't function. That would not be considered normal. But there are these age related declines and I think a lot of it has to do with hormone regulation and how the body responds to just its environment. So it's constantly taking an onslaught from environmental factors. Food, air, water. And then you combine that with the normal aging process, with the shortening of the telomeres and the changes in hormones, and your body is just slowly declining. And through exercise and proper eating, we can either improve in the short run or stave off some of these effects over time. And that's what we're looking for. We're looking to improve that health span. And then we're hoping the modern science will also improve lifespan. And if that's. If that ever becomes the case.

The combination of those two is really going to make a big difference and change society in general. The problem will be if you improve lifespan and you don't improve health span. Now, we've taken our medical problems and times them by 10, and we're.

That's just. That's just creating torture is what that is. Yeah, exactly.

We're all in trouble with that now.

Okay, so I want to ask you about diabetes in a moment, but since you mentioned it, I thought we'd talk for just a quick moment. And I know this may not be your. Your primary area of expertise, but you did bring it up, is telomeres. I've had many experts on the show talking about telomere length. There's a supplement for that. There may be a few of them. I know one, it's called TA65. But the danger is with trying to lengthen your telomeres with. Which is a sign of your genetic age, I guess is the right way to put it, is that it may fan the flames of certain types of cancer. And so that's risky, obviously. And then hormones. Boy, messing around with hormones.

That's a Pandora's box, too. Probably just wanted to ask if you had any thoughts on either of those.

Yeah, well, those are great questions, and.

It'S kind of an unsexy answer. But when we look at exercise as medicine, you kind of get those benefits. We know the research is very solid that with proper exercise, you're going to stimulate hormone function, you're going to improve testosterone levels, you can improve growth hormone levels. And so we don't have to mess around with, you know, synthetic forms or trying to get the right amount. We can use our body's natural process to improve those things, the telomeres. It's in and involving science. I've kept up with a little bit partly through your show. It's very fascinating.

I don't know exactly where that's going to lead, but there are always ramifications when we Start messing around with medications. And I think, though it's not the most exciting answer, I think right now the best you can do is lead a healthy lifestyle, try to avoid those environmental toxins and, and really be a regular exercise. And not just a single dose a day, but just improving activity level throughout the day. The new research on that is even for exercisers that are high intensity, like triathlons or marathoners, if they sit more than two hours a day, they're at the same risk as a sedentary person. So it's this chronic sitting and lack of movement that's really a bigger problem and it's really an easy problem to address if we would just move more.

Yeah, I totally agree with you. Just use your body's internal pharmacy. I mean, you know, I'd say one of, one of my downfalls is sugar. I'm lightening my load on sugar, but I tell you, I miss it. But you know, one thing that helps regulate sugar is extra. So you know, if you're gonna sin, then make up for it. You know, you gotta pay your penance. Right?

Well, that's an excellent segue into the diabetes discussion because you're right. Exercise can help regulate blood sugar levels and it also helps regulate insulin sensitivity. And so the really neat thing about that is that the research shows that one bout of exercise can have up to 24 hour effect on.

That regulation. So that's another reason that daily exercise is so important, particularly for that blood sugar regulation and insulin sensitivity regulation. And so exercise is really, it comes back to the same thing that our bodies were meant to move and they were meant to move frequently. Another kind of hack, if you will, to help regulate blood sugar is walking after meals. We've known for a long time that the Europeans and the Mediterranean diet really is helpful in preventing diabetes and cardiovascular disease. And part of that is not just the diet, but it's their culture to walk after meals. And that really has a stabilizing effect on blood sugar.

Yeah, it sure does. It sure does. And I tell you, get yourself a little quantified self device like a Fitbit. Just get your 10,000 steps a day and it really is amazing. Okay, so anything else on diabetes and physical therapy?

No, I think that was great advice. Get your steps in and just remember that movement is key. I know we also talked offline briefly and you were wondering kind of what the minimum effective dose for regulating blood sugar is. And right now if you're performing high intensity training, it looks like you need about 60 minutes of exercise a week. If you're not performing the high intensity training, then you're looking at 20 to 30 minutes of moderate intensity exercise to really have the benefits you're looking for. But the take home message is we just all need to move a little bit more. And if you've got pre existing conditions and you're not at 20 something, then probably a physical therapist would be beneficial for you.

So, Ben, I'm not surprised that a disease like osteoporosis would be related to physical therapy, and physical therapy might definitely help with that. But things like diabetes and even heart disease, Alzheimer's, dementia, how's that related?

Oh, that's an excellent question. I get that question a lot. Diabetes specifically is such a big problem for our healthcare system these days. And really physical therapists are the perfect people to help address that because we prescribe exercise and we know exercise decreases blood sugar and it improves insulin sensitivity. In fact, research is pretty exciting on this because it shows that even one bout of exercise can have a protective effect for up to 24 hours offline. You and I had spoken, you know, what is that minimum dose required? And you know that research is still ongoing, but at this point it looks like if you're performing 60 minutes a week with a high intensity program, you should see some good benefits. If you're not going the high intensity route, then you probably need about 20 to 30 minutes of moderate exercise daily to help manage.

In the case of diabetes, you know, you mentioned Alzheimer's and dementia. Both of those seem to respond well to exercise. It's probably related back to blood flow reasons. And also exercise is so important in hormone regulation, which also has an effect on those diseases. So, you know, osteoporosis is another common one that you mentioned that you're not surprised that we work with. And that's true. I mean, we help people with weight bearing exercise, we know that's important to bone stimulation. But more than that, exercise is so important to hormone regulation. So when you're talking about adequate testosterone production or human growth hormone stimulation, exercise and weight bearing, exercise is really a critical component of it. Just to expand on that further, a question I always get is, well, why do I need a physical therapist and not a personal trainer? And it's a really good question. I think the answer to that question is, where are you at physically? If you're 20 and you have no other problems, then a personal trainer probably is a great fit for you. But if you're 50 or you're 60 and you've had a back surgery or a bad shoulder Or a knee replacement. I don't know if a personal trainer initially is the right person for you. You need someone that can understand your medical history and then help you design an exercise program that will benefit your needs and still be enough of a stimulus to make a difference. And so that's where physical therapists can really distinguish themselves. But because we work with those folks that aren't necessarily healthy, they've got other problems, and we can help guide them in the amount of dosage that it will take to make a difference for their lives.

Very interesting, very good points. What else do you want people to know about the importance of physical therapy, just in general? Maybe a question I haven't asked you.

Well, I think the important thing is just back to the aging concept. We want people to not only live longer, we want them to live longer. Well, and it really doesn't matter your age. That's not the limiting factor. We know through a lot of research that muscle will respond similarly whether you're young or old. And so you need to be out there performing some kind of exercise at an intensity that's going to do your body good.

Isn't it just amazing? No matter who you talk to, it's always, you gotta move your body. Exercise, exercise, exercise. It's just so important.

It's really how humans were designed. I mean, we're meant to be mobile. We're not meant to be sedentary. And, you know, it's kind of amazing.

That this is the biggest problem this day and age. We got fitness places everywhere you look. It's just sort of ironic in a way, you know?

Well, I think maybe we're a victim of our own success in that respect. But I just want people to know you can't rely on big pharma to get you the magic pill. Really. The magic pill is in through movement and exercise, and it's a holistic approach to how you move and how you live your life. You need good strength, balance, flexibility, endurance. There's the mental aspect of it, nutrition. So there's a lot to it. And you really need to think of the long term. I mean, you've talked in your show many times that the lifespan is going to improve. And so you need to manage your conditions now so your health span can keep up to what the lifespan is likely going to be. And that also includes your finances. And I know you have other shows that delve into that topic. But if you're planning on, you know, retirement at 60 and then you're only going to live till 70, that's probably not going to happen. You might be well into your 90s.

Or hundreds or a lot older than that. Yeah. The problem is too much life at the end. End of the money, maybe, but again, it's also in your area. It's too many years left at the end of the health. There's the concept of lifespan, we all understand that, but there's the concept of health span.

Are the last 10, 15 years of your life just going to be miserable? Right. And nobody wants that.

Yeah, that's exactly the point. And that's where if you really want to have a good health span, you've got to be active and take a proactive approach to your health. And you know, you can start anywhere. You can be 20 and start. You can be 80 and start. In fact, just a quick story. My oldest client was 102, and when her family contacted me, the goal was to get her out of bed for her last year. She had been bed bound for almost six months. And we took her from bed bound to walking over 100ft for the last six months of her life. And she was one of the most grateful people I've ever met. Just because she didn't have to spend her last days stuck in a hospital bed. And everyone else had given up on her thinking she was too old. And we had phenomenal success. She wasn't too old. She just needed someone that could understand where she was at physically and help her progress to what her goal was. And her goal, frankly, was just to get up and go to the bathroom on her own. And so it's never too late.

Ben, is there any advice you have? See, I don't know. I'm sure probably other listeners feel this way too. I certainly do. As you're talking, I think everything you say is a great idea. I think the annual physical therapy checkup would be a good one because gosh knows, you go to the doctor and they're going to say, well, I can prescribe you some painkillers. And that's just a mess. You don't want to go down that pharmacy path unless you absolutely have to. Is there any way to compress time with this stuff? The thing about physical therapy is it does take time. You know, I've had it a couple of times in my life. And they'll tell you, you know, you got to come in three times a week and you do these little really minute sort of movements and you feel like this is not exercise, but it really does work. It's amazing. Is there any way to, you know, any sort of DIY doing it yourself solution or you know, physical therapists that come to you. I know that's out there, but, you know, I just thought maybe you want to address that for listeners.

Yeah, no, that's a great question. You know, if you had to boil it down like, what's the bare minimum you need to do to stay healthy? I think the first thing is you got to keep moving. That's the number one thing. And then when you look at what areas do you need to focus on for today's society? And you need to focus on that posterior half of your body, whether it's your upper back and shoulders for your posture or your low back and your glutes for lifting, bending, twisting. Because as you sit, those posture muscles on the back half of us, they just get weakened and they get reflexively turned off. And so the only way to improve that is through movement and exercise. So if you're going to boil it down, we need to do something every day and you need to focus on the back half of your body a lot more than the front half of your body. And yeah, the options for physical therapy are really endless. There's therapists in health clubs, there's therapists that can come to your home, they might be at your workplace. A lot of folks just might need to ask their boss, is there an in house physical therapist for ergonomics or something of that nature. So there's a lot of access to the physical therapy. And these days, I believe in all 50 states now, you don't need a doctor's prescription to see a physical therapist. You can call up your local physical therapist and get right in. Now your insurance might require, you know, some hoop jumping, but most therapy clinics will help you with that part of it too.

Good stuff. Where can people find you?

I can be found online@the PhysicalTherapyAdvisor.com and also on Facebook at the same hePhysical TherapyAdvisor.

The Physical TherapyAdvisor. And Ben, one last question for you. When you talk about living long and living well, you talk about some of the, I'll call them softer things like, you know, being loving and generous, being active and engaged in your community. Do you want to just touch on that real quickly before we wrap up?

Yeah, that's, it's a good, it's a good question. And you kind of wonder why would a physical therapist even think about those things? But really, you know, as humans, there's more to us than just, you know, our mental capacity or physical capacity. The research is very clear when it comes to aging well. It's it's physical, it's mental, it's proper nutrition, it's social being loving and generous and active in your community. Those that are have strong affiliations to civic groups or religious groups. All of those folks always tend to live longer, healthier lives. And there's really not any argument in the research about that. So if you're looking to live a long, healthy life, you need to look at all those aspects, not just exercise and not just this or that. It's really a combination of the above to bring our whole being into wellness. And that's how we're going to live a long, healthy life.

Excellent. Very good advice. That's Ben chateau. It's the physicaltherapyadvisor.com and Ben, thank you so much for sharing these great ideas with us today.

Thank you, Jason. I'm happy to Happy to help.

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