 You're listening to Barbell Logic brought to you by Barbell Logic Online Coaching where each week we take a systematic walk through strength training and the refining power of voluntary hardship. Welcome back to the Barbell Logic podcast. I'm your guest host Dr. Jonathan Sullivan joined once again by Coach Noah Hayden and we've been invited to do a series of Barbell Logic podcasts on the Barbell Prescription strength training for people in their 40s 50s 60s 70s and beyond and that's what this series of a half dozen or so podcast is all about. Thank you for joining us again. Noah, how you doing? Good. How are you doing? I'm great. Noah is my associate coach here at Grace Hill Strength and Conditioning in Farmington Hills, Michigan. This is our strength and conditioning practice that's devoted to people over 50 and we're going to be talking about some of the concepts outlined in the book I wrote with Andy Baker, The Barbell Prescription and today having touched on our last episode on the concept of the sick aging phenotype, the syndrome of unhealthy aging that we commonly observe in people over 50. We're going to talk about the prescription. We're going to talk about how physical training helps us age healthier and stronger and better able to enjoy our lives and because Noah works with me here at Grace Hill, he's seen how this works as well and so let's go ahead and get into it. Noah, we talked last time about the sick aging phenotype and that is a concept that you've had to come to grapple with here in your coaching practice at Grace Hill, but I think I want our listeners to get more of a feel for who you are and how you came to be here and what you've learned being a coach at Grace Hill and for Barbell Logic. It should be pointed out that Noah is a Barbell Logic online coach as well. Tell us a little bit about that, Noah. I wasn't always a strength coach. I worked in the automotive industry for about 13 years as a union rep and an electrician for parts of those times. I really liked my job. I actually come from a family of skilled tradesmen that did mechanical and electrical work. I really enjoyed prototyping and fabricating, troubleshooting, repairing machines. One of the things that I've learned about you more and more is that you're kind of a jack of all trades. Noah, for example, did all the audio set up for today and Noah is like one of these people who knows something about everything. I try. Yeah. I don't always do the best data, but I try. It turns out you're a little bit of a nerd, dude. Oh, yeah. Yeah. Anyway, I worked in the auto industry. I liked my job, but I got really sick and tired of the bureaucracy of it all, which I think you've had a similar experience. In medicine, absolutely, yeah. Everyone was always just talking about stuff. I was always amazed at the number of meetings. It was endless meetings that we were always in. Everybody was talking and no one was ever doing anything. So I grew tired of not being able to have a more direct relationship with my work. And this has allowed me to do that. You know, I think that fixing machines, fixing relationships, fixing squats, it's all kind of the same thing. Fixing people. Yeah. You've got this ideal concept in your head. You apply it to what you're seeing and identify where the differences are and try to figure out what's causing it. And what's the easiest way to fix that. So it's all kind of the same thing to me. It's been very rewarding. How did you end up here? I hurt my back. Imagine that. I woke up one morning. I don't know when I was 30 and my right foot was numb and I had no idea why I hadn't done anything, you know, just life as usual. And that continued for about two years. I just couldn't quite fix it. And it was just a pinch sciatica that got worse and worse. I ended up in the ER because I was that person from the commercial that had fallen and couldn't get up. Took me about two hours to get up one day. When I, when I bent down one morning to pick up some earbuds that had fallen off the table, something popped or snapped or whatever in my back and down. I went and I just, I couldn't stand back up. And I remember that when I went to my physician for a follow up appointment, I asked her, you know, how long is this going to take to get better? And she was filling out stuff on a clipboard and she didn't even look up from it. And she said, Oh, you're going to be prone to back injuries for the rest of your life. There's kind of blew it off that a 30 year old is just going to have a downward spiral. Yeah, that's how you get, that's how you get medicalized and told that you're broken and the very next thing that she said was, but it's okay. If you need any pain medication, just let me know. So, uh, I didn't get any of that pain medication because I, I ended up being a bit of a masochist. Like I never take medication, even when I probably should. I think you know that because we've, we've talked about that. I've had to, I've had to brab at you a couple of times about it. My idea is that, uh, if you can handle the pain, then you don't need any pain medication. That's maybe a dumb way of thinking of it. It is a dumb way of thinking about it. I mean, you know that that's not true now, right? You know, pain gets to be its own problem after a while. Like it's, it's, it's kind of like you LP the pain. Like the more pain you feel, the better you are at feeling pain. And the more it becomes like part of you and those pathways get ingrained. And so, but that's another topic. Anyway, so your, your back is all foobar. Yeah. And, um, the strange thing about all of this is that I kind of should have known better, I guess. My dad was a competitive power lifter in the seventies when he was, uh, in his late teens and early twenties. Yeah. He knew Lamar Gant, right? He, he drove him to the gym. They, they both trained at Bill Stiff's gym together in, uh, Flint, Michigan. And I believe Lamar Gant didn't have a car at the time. So my dad would pick him up and drive him to the gym. He won the Michigan state championship, the teenage championship in the mid seventies. I think 74 or 75. I think he got third in the country that same year. And then he had kids and life started and all of that. Right. But you, so you had this like idea of lifting and strength training. It was in your DNA. Yeah. We had a squat rack and a bench press in our basement growing up. So I started doing the big three when I was about seven years old. And I actually remember the day that I deadlifted a hundred pounds for the first time. I think I weighed 80 pounds at the time. And I was amazed that like triple digits, you know, I'm getting somewhere. Yeah. It was really fun, but, um, we sort of quickly transitioned to martial arts and running because my dad got into that. And the way lifting just became a thing that I did, you know, occasionally. Like everybody else. Yeah. Yeah. So I rediscovered it as an adult. I wanted to do something about my back. I, you know, I had been working out at the gym where I worked and just kind of broke splitting around. And I was shying away from doing any squats because I didn't want to hurt my back. I figured that would make it a lot worse. And one day I just got a little tired of it. And I, uh, I think I squatted, I don't know, 180 for a triple or something. And I figured I'm going to pay for this tomorrow, but I'm hurting all the time anyway, who cares? I'd rather just squat again. And I remember that the next morning actually felt a lot better. I think because I was prepared for it to feel worse. I was thinking about it and I felt a lot better. So a couple of weeks went by, I back started hurting again. I squatted again, felt better, figured I should probably do something about that. So anyway, I, uh, lifted on my own for several months, did the best that I could coaching myself. And then I came to a training camp at, at the haunted house at the old gym. And that's where I met you. And I hung around afterwards and I asked you if you were interested in having any interns or anyone shadow you and you said, no, I don't think so. Yeah, I remember that. Yeah. I said, all right, that's fine. And I went home and then I think a month or two later, you had a deadlift camp in Lansing at black iron training. Right. With Crisco. Yeah. And asked you again. And then I think, or no, I didn't ask you actually, I think that I just looked at you and then you eventually kind of rolled your eyes and like, send me an email. We'll see if you can't come out one day. So it worked. You know, yeah, I was, I was actually, cause I think subject was already with me at the time, Frank, like my intern at the time. And, and I wasn't sure about the whole intern thing. And, and also at the time I was still, I think I was still in emergency medicine practice and wasn't, wasn't sure how much time I'd have to devote to that. But I remember you came to those camps and you were a very strong lifter and very good form. And even then you're like, you couldn't help yourself. You like did a little bit of coaching on the side with people at the camp. I did. Yeah. I don't remember that. Yeah. Yeah. Yeah. Cause that's just how you are. And so it was like, yeah, okay. And you know, I'd gotten to know you a little bit better by that time. So then you just, you started coming to be an intern coach and it was, it was apparent pretty early on that, that you had internalized the model of the lifts and the model of this whole system of training and that you had thought pretty deeply about, I mean, that became apparent to me pretty early on and that you had a pretty good eye for movement. So I wasn't sorry. I'm getting worse here. So since you've joined us as a coach, what do you think that you've learned coaching here in this clinic with this population that you maybe wouldn't have gotten somewhere else? Well, I've enjoyed working with clients from, I think 14 or 15 up to, geez, I don't know. I've never coached John or 93, 94 year old. Yeah, but you have some clients in their 80s. Yeah, mid, mid 80s, I think is about the oldest that I've coached. I've liked all of them. I can't help but get invested in any client that I have. But I have to say that it's hard to not like an older demographic of clients and the big reason why is that my mindset for lifting is that it really matters. Like I know why I'm here because it's life and death, right? It's a very important thing. And it's, it's critical for long-term health to be able to manage your physical body, the outcome of your physical body, right? Absolutely. Yeah. And you don't have to really explain that to anybody that's in their 70s or 80s because they're all in here because they had trouble getting off the toilet one day. They have trouble taking the trash out to the trash can. It's very obvious to them that they're mortal and that things don't just passively cruise along without effort and attention. I think you really nailed it. It's one of the great things about working with this population for them. It's not cosmetic and it's not just sort of like, you know, yeah, I go and I sling the weights around a couple of times a week because, you know, I should like for them, it's existential, you know, they're in this sort of death match. And so they're all in. I mean, the clients who come to you and I every week, they are the most committed bunch of athletes anybody would could ever work with. It's pretty extraordinary. And they're all like courageous and intelligent because if you're not those things, if you're not committed, courageous, intelligent and willing to do hard work, you know, you're just not a client here. Right, right. Not for long because it, it's required. It's going to, yeah, it's going to weed you out. Yeah. So ostensibly, what we're talking about today is the barbell prescription. Last episode with nurse and bizarre, we talked about the sick aging phenotype, which is, you know, this sort of meta syndrome of unhealthy aging that we see in people over 50 characterized by the metabolic syndrome, which is obesity and hypertension and dyslipidemia and eventually cardiovascular disease and diabetes, along with the frailty syndrome, which basically means that you're, you're easy to break. You're weak, your bones are brittle, you don't move very well, you know, and you're extremely vulnerable to injury and illness. And then the other part of the sick aging phenotype is polypharmacy and medical dependence. Like you identify as a patient, like who you are is you're a diabetic and you're an arthritic and you're hypertensive and you, you know, and I'm a patient and, you know, I'm in all the medical books and all, you know, that kind of thing. And I take all these medicines, you know, this whole corneocopia of medicines that I take, that's the sick aging phenotype. That's what we're trying to fight here. And we've known really for millennia that the best medicine for that is exercise. And as we discussed in the last episode, I got thinking many years now, it seems that, you know, if exercise is a medicine, we need to think about the correct way to prescribe that medicine. What is its formulation? What is its route of administration? What is its dose? What is its frequency of administration? And what are its therapeutic topics? And these are the considerations that we explore in detail in the first part of the barbell prescription. And these are the things that you as a coach here at Graciel working with this population. There's a very special population, which makes you a very special coach, the things that you see going on all the time. You see how this prescription is formulated and its effect. You see it all the time when you're working here. So when we talk about an exercise prescription and when we talk about strength training as an exercise medicine for unhealthy aging, really the cornerstone of a prescription for unhealthy aging. One of the things that we're talking about its route of administration. And in my mind, I don't think that there's any argument that barbells are the best route of administration for a strength training medicine. And so, you know, people have heard my thoughts on that ad nauseam. What are your thoughts on it? I think that, especially how this applies to older lifters, nobody really cares necessarily if they're stronger. Nobody really cares if they look more muscular in this demographic, right? I think it's important to determine what it is you're actually trying to fix. Like what is your goal in all of this? So there's a lot of fitness attributes that a person can have. And I think that the real goal with any training program is to simultaneously improve as many of those fitness attributes as possible. Exactly. That you can without them interfering with each other. So you and I know as strength coaches that training focused on strength improvements is the best way to achieve that for a couple of reasons. First, many of those attributes aren't very trainable, meaning that after an initial increase in, let's say, coordination or balance or power. Yeah, that I mean, that's your balance now, right? You can stand on your feet well. And that's not something that you're going to fine tune over 10 years. And even something like endurance, I used to run fairly long distance, not very fast because I wasn't that great of a cross country runner, but I ran eight to 10 miles five times a week for years, you know, after a month, maybe a month and a half of doing that, the distance, you know, your cardiovascular system is fully tuned in to that. And it's really just a matter of how much food you ate the night before is how far you can go. I mean, that's what I found. You might be able to work yourself to a higher VO2 max and squeeze out some additional, but like at that level, you have more endurance capacity by far than the general population for your demographic. Yeah, and I know that I don't want to get into a big debate about endurance athletes, and I don't want to diminish what they do, but you're not making huge gains to your five mile time 10 years into training for it. It pretty much is what it is. Genetically, same thing with power, right? You can increase your power because of the strength element, the strength component to that formula, force development component of the formula, right, but your explosiveness is pretty much genetically the T component of the formula, the denominator, right? You're not going to change that by orders of magnitude. So you can double your force production in triple your force production, right, but you're not going to cut the T even in half, right? You're not going to cut the time that it takes you to do a particular movement in half. You're as explosive as you are. So and also something like flexibility, which is a fitness attribute or mobility, mobility, whatever you want to call that, the more flexible you get, if you train that to extreme levels, it really detracts from a lot of other things in life, makes you more prone to injury because, you know, joints are supposed to be held together tightly, you know, it's a pretty good way to put it. Yeah. Anyway, and so secondly, I think strength is singularly unique in that list because it is not only the most trainable attribute that you have, but it can be trained for decades, trained and improved for several decades. And even after some kind of peak is reached in midlife, maybe continuing to train primarily for strength slows the deterioration process of aging, which is really what we're talking about here for an older demographic. Exactly what we're talking about here. Yeah, I think you're right. Strength is the cornerstone of our program because it's the cornerstone of fitness itself. It's it's like the central fitness attribute. So if you think about it, we define strength as the ability to develop a force against an external resistance. Well, the ability to develop force is basically the ability to produce movement. I mean, without force production, all the other fitness attributes become kind of irrelevant. Like so if you're really, really flexible, but you don't have the ability to develop force to that flexible range of motion, then you're in a wheelchair, you're in a wheelchair. And the same thing with all of them. So yeah. And then for our population, it's fundamental in other ways too, because what is the organ? What is the tissue that produces force? Well, it's muscle tissue. And it turns out that muscle tissue isn't just important for producing force. It's important as a landscape of insulin receptors and as a major component of our insulin sensitivity as a major sink for glucose and fat triglyceride. So it's this massive metabolic organ. It's the biggest gland in your body. And as you get older and as your muscle gets sicker and weaker, you get sicker and weaker not just because you don't move as well and you're not as strong and you're not yanking on your bones anymore, but also because your insulin sensitivity is messed up and you have an abnormal myokine, an abnormal muscle hormone profile that makes you sick. So it really is fundamental. So that's why strength training is at the core of what it is that we do for this population, but that still doesn't answer the question is like, why barbells? I like the way that you've phrased this that strength training is a prescription, that it's a medicine. It's treatment for a condition because it can change all of those conditions in your body very comprehensively. If you have a syndrome that you're trying to affect, if you can find a treatment for it, that's an anti syndrome that takes a lot of the micromanagement out of it. You don't have to play whack-a-mole. You apply one thing that like we were talking about last time, right, where we were talking about how it addresses all of those symptoms, getting to the root issues as they need to be addressed. Exactly. You know, without you having to worry about that, kind of like eating natural whole foods that are processed, right? If you just put some vegetables and meat in your mouth, you're probably going to be just fine. Exactly. Drink some water, right? Simple as that and your body will figure it out. And if you just move the way that you were designed to move, what we do at Grace De La and at Barbellogic and as coaches in general, what we should be doing, particularly with this population, is, you know, we just look for the movement patterns that are still there. You're taking on new clients at Grace De La, that's our approach, right? We look, we find the movement patterns that are there and then as coaches, you and I are total experts at loading those movements, right? We identify the movement patterns that are still retained and you and I are total experts at loading those movement patterns in a way that can be progressively trained. Right. So I know that we're going to get into a little bit of a rabbit hole here because you and I have talked about this, but in the book, we identify two sets of criteria, right? So the first is the exercise selection criteria for our strength training exercises. We want them to involve the most amount of muscle mass over the longest natural effective range of motion right to move the most weight. And I know that you and I are going to talk about that a little bit. But barbells fit those three criteria beautifully because they allow us to ergonomically and efficiently and safely load those normal human movement patterns. Right. And they're very, very adaptable. I mean, one of the things that you discover as somebody who coaches athletes of aging in a place like Grace De La is that barbells are extremely versatile for loading the retained movement patterns that our clients are able to display to us when they first come to us. And the second set of criteria that we explore in the barbell prescription is the medicine criteria, the medical criteria of any intervention that we're going to use, the criteria that any medicine should fulfill, right? It should be safe, right? So you don't want to hurt people to make them better because that would be stupid, right? And should have a wide therapeutic window, meaning that the range of doses available between the minimum effective dose and the minimum toxic dose should be pretty, pretty wide. Like doctors hate a medicine that has a narrow therapeutic index where the difference between the minimum effective dose and the minimum toxic dose is narrow. So it's because it's dangerous. It's dangerous. A drug like the ophthalen, for example, like you don't, yeah, it's dangerous. You don't want that. So and then we want something that you've already talked about, which is you want it to be as comprehensive as possible. You want the medicine to hit as many therapeutic targets as possible. So if you have a medicine that just gets to one part of the disease process, it just hits one therapeutic target, it's going to be fairly limited in what it can accomplish for you. But a medicine that has protean effects that has, you know, wide ranging effects on the disease process, it both fixes the inflammation and the infection and, you know, so on is going to be the more valuable medicine. Right. We want it to be specific and effective. So, you know, barbell training and getting people in their 60s and 70s strong, that's all well and good. But if it actually didn't address the unhealthy aging itself, if it actually wasn't specific and effective for the unhealthy aging phenotype, then, you know, who cares? It'd be great. I mean, there's lots of great things that people can do. But if it didn't attack the sick aging phenotype, then, you know, what's the point? What's the point? Yeah. And then we want it to be simple and efficient, right? We don't want people to have to learn 53 different exercise movement patterns. We don't want them to have to train, you know, seven days a week. We don't want them to, you know, be using up a big chunk of their time. We want it to be simple and efficient. I think mainly, too, because, you know, people don't have a lot of time. They don't. I mean, you could also say it's because they have limited recovery. But no plan is worth anything if people don't stick to it. So if it's not simple, it's sort of difficult to wrap your head around and people get bewildered. And when they're having a bad day or they're procrastinating about coming to the gym, they don't have an easy way to tell themselves, why am I doing this? And what am I here for? Right. And what's the purpose? It's kind of interesting when people first start with us. Sometimes they like, really? Like, that's it. There's four exercises. That's it. Right. And we're like, yeah, that's it. That's just four exercises. Well, how can that possibly work? Paying a lot of money for four things. Paying a lot of money for four things and very, very quickly, they come to understand the power of that approach. Right. So the argument that we make in the barbell prescription is that we have here with barbell based strength training, a medicine that fits all those criteria. Barbells are safe, right? Millions of people do billions of reps every day and don't get hurt. That's because they're ergonomic. It's because they're natural human movement patterns just ergonomically loaded with a barbell performed indoors, on a stable surface the same way every single time. Which means it's predictable. That's how I think of safety. Exactly. Predictable joint moments. It's a controlled environment. There's no collisions. There's it's it's not it's not crazy dynamic. And right, there's not a lot of unpredictability to it. For the exact same reasons, it has a wide therapeutic window. I mean, so you can start with a broomstick on your squat or your press and work your way up to hundreds of pounds. So the therapeutic window is there and barbells allow for very, very precise dosing, which is extremely important for everybody, but particularly for this demographic for this training population. You know, one thing that we sort of glossed over here is the fitness attributes. Well, that's we've talked about that's the comprehensive thing, right? Right. But what what is your list of fitness attributes? So yeah, so so we always get in trouble here because different people have different lists of different attributes. So I've seen lists that are like, you know, 24 items long. Ours is what I think six. We talk about strength, which is the ability to reduce force against the resistance. And we talk about power, which is the ability to display strength quickly, which is the first derivative, like in a mathematical sense, the first derivative of strength. So it's one thing if you're able to stand up, like off of a chair. But if it takes you all afternoon to get off the toilet because you have no power, then you're in a lot of trouble, right? So you've got to be able to display force, but to display force to display strength quickly, that's power. Endurance or stamina, which is the ability to engage in prolonged physical activity, which is obviously important. A lot of people have libeled the strength training community as like we ignore or we denigrate endurance. Nothing could be further from the truth. Endurance is a fundamental fitness attribute that we train here. Mobility, which is the ability to express a full range of motion and which includes you can unpack mobility into a lot of things like coordination and agility and so on. Sure. Just like you can unpack power and out of that, you can get like explosiveness and you can also get speed, right? So my fitness attributes are relatively unpacked. And then the last one, which I include as a fitness attribute is, well, there's balance, which I include separately from mobility, which is the ability to maintain a stable position in space, which is incredibly important for any athlete and particularly for our population. Because when you're 70, 80, 90 years old and you fall down, go boom, it's not good. And then finally is body composition. You want to have a healthy body composition, a healthy proportion of lean mass to fat and also visceral fat is a primary consideration in our population. So strength, power, endurance, mobility, balance and body composition. Now, you can unpack some of those and get to a longer list, but it doesn't change the prescription because the prescription is still going to get to all of those. And you end up talking about a lot of synonyms. Yeah, you do, right. And there's a lot of overlap becomes a little bit of a semantic exercise. What I think is self evident is that when you train people for strength and conditioning and you do it properly and you do it with barbells, right, you end up hitting all of those fitness attributes in one way or another. So those are the fitness attributes and that all ties into this prescription criterion of it has to be comprehensive. And then, you know, I have a couple more that I would add to that list of fitness attributes. Yeah, everybody does. So go ahead. I think mental fortitude is a really good fitness attribute because if you have someone that's not confident in their abilities, they slip and fall, even if they're in great health, you know, or even if they're strong, like we've seen that, like when people are really tentative under the bar, you know, they give up before they are even trying, you can't express power or strength or any of those things if you're not committed to it. Right. And the only reason why I really, I know that it's not exactly a metric. Yeah. But the reason why I include that probably is because I've worked here long enough that you see it. That's the difference. That's one of the main differences between a client that's going to make long-term significant progress here and the client that's going to leave after a month and say that this isn't for me and it's too difficult, you know. But if they give themselves a chance and they stick with the training for a few weeks, it may be that they'll start to, I mean, we talked about this with Ann last time. You can train that. You can train that mental fortitude and, you know, and that courage is kind of what I would call it. I mean, so can you call it? Absolutely. You know, physical courage, a fitness attribute. Yeah, I think you can. It's not necessarily a physical attribute, but this isn't a physical attribute list. It's a fitness attribute, I meant. No, I know what I'm saying. It's, I think that it is a component of fitness. And you said you had a couple more? The only other one that I've added to this list and kept it on the list was a lack of debilitating pain. Sure. Yeah. I can see that. I think that's a pretty good observation and we see that as well. So what we see is that when we, and particularly pain with movement, right? So what we see is that when we train these movement patterns, we don't just develop strength throughout that range of motion, but we make it a more painless range of motion. That's what we see all the time. So that's a lesson that you and I have to keep learning over and over again. I went through a bad year with my knee and rehabbing the knee. I realized presently that I was avoiding the full range of motion. Yeah. And then what I needed to do is just spend a couple of painful weeks just expressing that range of motion. And lo and behold, it became less painful. And that's a phenomenon that we observe all the time. So yeah, I think strength training is comprehensive and barbell training for strength is doubly comprehensive. We present in the book basically a mountain of data, which is still growing that strength training is good for the sick aging phenotype. And it's good for the metabolic syndrome. It's good for the frailty syndrome. There's less data showing that it's good for polypharmacy, because quite frankly, nobody has studied that because who's going to fund them? Exactly. And then simple and efficient. So what's more simple and efficient than for barbell based exercises two or three times a week? There's, you know, that's the, it's the ultimate in simplicity and efficiency. So the barbell meets those criteria. And as listeners of the barbell logic podcast will be aware, strong arguments have been made over and over again, that the barbell movements fit the exercise selection criteria of most muscle mass over the longest natural effective range of motion to move the most weight. But I know, Noah, that you have given a lot of thought to these exercise selection criteria and that you're not necessarily satisfied with them. So you're going to, you're going to kind of go off the reservation here a little bit. And I'm going to let you go ahead and tell us about it. Your thoughts on this topic. So out of the, the barbell logic coaching academy, they have changed one of these criteria from use the most muscle mass to train the most muscle mass. And I think that's a very subtle distinction, but a very important one. Well, let me be the devil's advocate here and say, yeah, what's the difference? So is it a distinction without a difference here that you're making? We know that involving a lot of muscle mass is a good thing in a movement because it produces more systemic stresses on the body, which is useful in driving a lot of adaptations. And as you touched on this earlier hormonal adaptations in the body, you actually changed the chemical makeup of the body, which is really what we're looking to do. If just using that muscle mass was good enough, you could do booty boot camp. You're using every muscle in your body doing aerobics too, right? So the muscles involved have to be loaded with enough intensity to actually train that mass, which is why we're using barbells and why we're using difficult movements that are challenging to complete. If you're not doing that, it's kind of missing the point. So this would be the argument against, say, push presses in place of strict presses, where you're using a certain amount of muscle mass, but you're not really stressing it and forcing it to adapt. Are the quads really being trained with the low amount that you can push press, right? It's always going to be much less than what you can squat or what you can deadlift. And by involving the quads and the hip extensors that much, you're not training the shoulders and the upper pecs and the triceps in the lower part of the range of motion of a press. So kind of misses the point. And, you know, I would argue that it's effectively junk volume that possibly interferes with recovering from more high quality movements that actually train that other muscle mass, like the squat and the deadlift, right? So I think that train the most muscle mass is a good distinction over the longest effective range of motion. We already talked about that. And then to move the most weight. What are your thoughts on that? I think that's a pretty good criterion, actually. But I know that you see some wrinkles there. Well, I think there's a considerable amount of overlap with this one. More weight being lifted without regard for the first two criteria really defeats the purpose of that point because you can lift more weight with a rack pull than a deadlift, for instance. Sure. But we have all three criteria, right? So the rack pull doesn't satisfy necessarily the first two criteria. Exactly. Because the shorter range of motion and you could have a longer effective range of motion, right? So I just I feel that it's a little redundant. And another good example is squatting astagrass, that the additional range of motion forces you to lift less weight because you're sort of disengaging the hamstrings the rest of the way down, which limits the amount of weight that you can lift, which makes it an ineffective additional range of motion. Sure. And I think those are excellent points. But again, to play the devil's advocate, I guess what I would say is you have to have the three criteria operating together, like the other two criteria, keep that third criterion honest. You see what I'm sure? See what I'm saying? Yeah. But you have been thinking about whether or not it was time to reexamine these criteria and whether or not there needed to be maybe additional criteria as well. So do you think that there needs to be any more? I'm not sure that that we need any additional criteria. I'm willing to be open to those and to be convinced to tell you the truth. I don't actually spend a lot of time thinking about these exercise selection criteria. I sort of look at them as sort of quite honestly, and I'm going to get in trouble here, I sort of see them as sort of a retroactive sort of rationale for exercises that we're going to do anyway. Sure. Again, what I think that you and I do here at Graciel is to repeat, somebody comes in here and we look at that person and we say what movement patterns do you have? Right? Yeah. What are what are the movement patterns that you still have? I mean, you and I meet people all the time who just cannot do an overhead press or can barely stand up out of a chair and barely stand up out of a chair. So we look at them and we say, OK, those are the movement patterns that you have, we're going to make those movement patterns stronger through the range of motion that you're able to express physically and without pain. Right. And you and I are total experts at loading the movement patterns that the athlete has. Right. And what we may find when we do that and we train those movement patterns with a barbell because barbells are the best way to train those movement patterns usually is that we may end up opening up and retrieving other movement patterns that were lost or we may not. Right. But when we do that, when we take the movement patterns that the athlete has and load them and progressively load them using progressive overload and make those movement patterns stronger and less painful and more powerful, we train that muscle mass, we train it. Right. And we maintain and eventually probably expand that range of motion and we certainly increase the amount of force that that athlete can produce within that range of motion. So when somebody comes into me and let's say that their mobility is limited and, you know, they're very old and they're very frail, do I think about these exercise selection criteria? I don't actually think about them. Instead, what I think about is like, what can this person physically do? What movement patterns can they still display? And how do I load them? Once I've identified what those movement patterns are, how do I safely and progressively load them? That's kind of my entire approach. I think that you do that because you've been coaching long enough that you already know it's implied. You already know what it is that you're looking to do. I think that these sorts of criteria are better for newer coaches that don't know exactly how to approach these things. And then it becomes a bit more natural, you know, the longer that you do it. So I've written a few more down, but that's really the reason why I've tried to do that and create a bit more of a detailed list of what the real criteria are. Some of them are sort of implied and never really expressly said. Please feel free to explore them with us. So train the most muscle mass. I think that should be first in normal predictable movement patterns, which is your argument against bozu balls. Or, you know, when we talk about cardio components to training, once people get past the beginner stage, it would be the argument against something like a yoke for hit training, right? Right, because you're exhausted, you're going to roll an ankle and you're loaded with an implement, not really the best idea. Or why we're not particularly keen on including the power clean or the power snatch in a master's population. And why one of our criteria for training those exercises is aptitude. So if we give somebody a try with the power snatch and they're able to do a pretty good power snatch after a short period of training and to reproduce the movement reliably, then maybe if they're able to tolerate it and they enjoy it. But if every time they do the exercise, it looks different, right? And waves around in a different way. Now you've brought in that unpredictability. So how can you safely progress and load the exercise? And one of our principal key determinative things here is like you just, you can't hurt these people. Right. You just cannot hurt these people, you know, and you can't even risk hurting them in a way that you might push a younger athlete like a kid who's just going to bounce back. These people don't bounce back, right? Right. So I like predictable. I like that. The next one that I've wrote down is requiring normal coordination when possible, which is essentially loading the skeleton, making people stand on their feet, which helps with balance and coordination and all of that. But the big thing there for an older population is to help them increase bone density in their entire skeleton, which is a big reason why a lot of our female lifters even come here. So I think I understand what you're saying here. So that's not just something that we would unpack from the normal human range of motion criterion. You're actually, that's a standalone criterion. And I think the way I might say that is you need structural exercises. In other words, exercises that load the axial skeleton spine and the hips, right? So that you get that bone density component, which is so important for our lifters here. And yeah, I might bite down on that. I think that as a standalone exercise selection criteria, I think you can make a pretty good case for that. And we do that all the time. You know, when we get an older person in here that can't press overhead, which is very common, what do we have them do? Standing curls, standing curls, standing barbell curls. And I just told a client the other day, who is progressing her curls to the point that it's pretty difficult to keep going. I told her, I said, you know, I honestly don't really care how much you're curling. What I care is that you're standing up, you're standing up, you have trouble standing up. Yeah, you're standing up below. And that's what you're here for. Right, exactly. And so, and she was complaining about the weight. And I said, let's drop it down a little bit. Who cares, right? You're not in here to get curl PRs right here to stand on your feet and keep your body upright and rigid while doing that exercise. That's the difficult part for her. Right. Over the longest effective range of motion again, that is structurally sustainable. And this goes back to what you said about the Olympic lifts. It's the reason why we don't have someone with arthritic knees do power snatches. Probably not a great idea. But another great idea, if someone has had some shoulder surgeries or something in the bench press irritates their shoulder, not a great idea, then you've got to figure out either some way of modifying the bench press or a different movement. Yeah. And to our listeners, you know, please stay with us during this series, because this whole issue of exercise selection is it's important for any coach, but for coaches like me and Noah, working with this population, you have to modify. Exercise selection and modification is a huge part of what we do. And we're going to be talking about that with our 94 year old client, John Clausen in the next episode. So please join us for that. So anything else on these criteria, any other modifications? Sounds like you've thought about it, you know, pretty deeply. We've talked about it. I was going to write an article about this and I never quite finished going through all of it. It's just been on a back burner and I haven't touched it in six months, I think. But yeah, I've tried to give this some thought. So the last one that I have is pretty self-explanatory with exercises that can be easily titrated or have a wide therapeutic window, which is a repeat of one of your criteria. One of our one of our exercise medicine criteria. Right. Right. It's one of our exercise medicine criteria. So I like to organize the criteria that way. And so if we went back through those exercise criteria, we would probably end up with the low bar back squat as the movement that best satisfies all of those criteria. The deadlift, I think, would come in a close second as a slightly shorter range of motion. A very close second. I mean, the death. So we encounter people who can't press, we encounter people who can't squat, we encounter people who can't, you know, bench, certainly not a, you know, an unmodified bench. How often do we actually encounter people who can't do a deadlift? It's actually pretty rare. At least from blocks. Right. Raised up a little bit. Yeah, pretty much everyone can do that. Yeah. And I also think that with some people that have a lot of difficulty with the squat, maybe they're very cathartic or something of that sort, or they have to use a box where you can't load the squat with a ton of weight because they need so many modifications. The deadlift is their main driver of full body stress. Right. It's a very high quality stress. So we have a subpopulation here of athletes who are deadlift bench specialists. Yep. So the squat it is then. The squat it is. We can just squat every day and that's it. Right. Well, not exactly. Right. So I think that we need a second set of criteria. I'm sort of working backwards from from your criteria sets. I think we need a second set of criteria to know when a group of exercises are sufficient for our needs. So my second set of criteria I term it the programming criteria and it's similar to the exercise prescription criteria. So train all the major muscle groups is the first one, which makes it comprehensive. Exactly. Right. So when you go through the exercise criteria, you come up with the low bar back squat, doesn't train the triceps or the biceps or the shoulders very much or the packs very much. Right. And so you have to go back through the exercise criteria again and find something that maybe doesn't hit all of the muscle in the entire body as much as possible, like a push press, but it really targets the muscle groups that are left out of some other exercise. And that gets you to the press and the bench. Exactly. Right. Improving as many attributes as possible that do not interfere with priority adaptations. Well, that sounds a bit of a mouthful perhaps you can unpack it for us. The point with this one was once people are done with novice training, they need to have some cardio component in their lives, maybe not necessarily in their training at the gym. So so I'm going to stop you right there, though. So do you mean cardio as in aerobic? So cardio is a term that kind of rubs me a little bit the wrong way. So what you're talking about, though, is endurance and metabolic conditioning. And we've worked together long enough. You know how I feel about this. Yeah. Too much endurance work I feel is kind of the nemesis of an older population because it encourages the body to adapt to the things that you're doing in exactly the way that we don't want their body to adapt. Exactly. We don't want them to, you know, if you're using slow twitch muscle fibers in an aerobic capacity for long periods of time, your body is going to preferentially rely on slow twitch muscle fibers more and get rid of fast twitch muscle fibers that aren't being used as much, which is precisely the aging process. Couldn't have said it could not have said it better myself. It's exactly the thing that we don't want to have. Absolutely. Absolutely. 100 percent. That's exactly why we emphasize strength training for this population. In particular, I think it's the proper emphasis for any athlete, except like a cross country skier or a marathon runner. It's exactly the emphasis is strength training for precisely the reasons that you just very eloquently stated. We want to hang on to the fast twitch muscle fibers, the strongest, most powerful fibers in the body are the ones that are preferentially lost in the aging process. And we have got to hang on to those for dear life and training in the aerobic energy system for endurance is exactly the wrong thing to do if you want to hang on to those fibers as you age. And that's what you need to do. I would go so far as to term to say that it's almost like a wasting disease. Oh, yeah. Right. I mean, and it's pretty obvious if you look at any Olympic marathon runners, they all look the same. I don't mean to disparage them, but kind of looks like a concentration camp. No, no, they are very accomplished athletes. Absolutely. What they do. But the muscle phenotype that is displayed by those sorts of athletes is pretty much the muscle phenotype that we see in wasting diseases, including the wasting disease that we call unhealthy aging. Right. So no, I couldn't agree with you more. I feel that the medical community that gives advice to an older population that they rely on for advice on the best ways to treat themselves to live the healthiest, longest, happiest life, most of those people are told just to run on a treadmill, get some cardio in. Very cardio is a very cardio centric exercise prescription mentality in the medical community as if the patient in front of you were this disembodied cardiovascular system. Now, we know that this kind of training is in fact very good for the heart. It's very good for the blood pressure. And and actually like all vigorous exercise, it's very good for insulin sensitivity. What it's not good for is bones, joints, range of motion, mobility, balance and body composition, meaning it becomes a muscle wasting exercise prescription. It's exactly what we don't want. And since it turns out that we can get those cardiovascular benefits and the endurance fitness attribute trained up without long slow distance exercise in the aerobic energy system, it's actually unnecessary. Right. That's what I love about hit. It's so important for us to train the heart and lungs as well. So you definitely need something besides just barbell lifts after an initial period after the novice phase. Yeah. You have this wonderful option in hit training with a sled. I like using a sled or a prowler, whatever you call it. The prowlers are central prescription here at Grace deal for conditioning. We offer people a range of choices, but it's perfect. It's 90 percent of them end up using the prowler. Absolutely. Any exercise or movement done to failure must be as low skill, low risk as possible. I like that. What we're really talking about here is safety is hit, right? That you don't want to use farmer's handles to exhaustion. If you can use a sled to exhaustion because you're not loaded in any way. If you falter and have a misstep with the sled, you just stop pushing it. Better yet, you're holding on to a walker while you have a misstep. It's perfect. Right. I mean, that that's basically what the prowler is. It's a loaded walker. Right. It's like and so you can't even fall down. Exactly. Unless you like work at it. So I like that. And, you know, you and I both know that in our system of exercise for all of our clients, we're not big fans of exercises to failure. Right. Absolutely. Like coaching a squat to failure or coaching deadlifts to failure, in my opinion, that's just stupid. Very reckless. And in our population, it's not just stupid. It's it's downright dangerous and it's coaching malpractice to be coaching some 80 year old lady with osteoporosis to failure in a movement pattern. You know, you're just you're just begging for disaster. That is that's crazy stupid. Yeah. So so I like that. The last one is also implied in the minimum effective dose required to continue making progress. All right. So you'll have to unpack that. Well, there's been a whole master series of programming on the Barbiologic podcast that was excellent done by Matt Reynolds. Pretty much includes everything that I can think of for programming. And that's been talked about a lot on this podcast already, the minimum effective dose. But I think that approaching it that way, that's a pretty complete picture of a standard exercise prescription for people. So give us an example of how that is because that's a little bit vague and abstract and theoretical. So give us something to exemplify or illustrate this this concept. Well, a great one would be that when you first start, let's say someone comes into the gym and they can barely stand up out of a chair. I've had a client that did five sets of five chair standups and then they went home. Because they were exhausted. You delivered an adequate training stress to force adaptation without overwhelming the clients. Right. Recovery capacities. And they adapt really fast to that small amount of stress. So very quickly, you have to give them a lot more stress than that for them to continue to make progress. You wouldn't go a month in. You wouldn't say, OK, let's do six sets of five chair standups. It wouldn't work. Right. Another good example of that is when you first start training in the main four lifts, you don't need a hit component to your training. I agree because it's tough enough. It's hit. I can't remember the number of times that I've seen someone a month into deadlifting and they stand up after the last rep and say, oh, I'm a little dizzy. Why is that? And I say, well, probably because your heart's not strong enough to keep pumping blood when you hold your valve salva hasn't had to do that before. Well, what do we do about it? Well, you're going to keep deadlifting and your heart will adapt to it. Right. So we observe this all the time that, you know, clients come into us, they're not only catastrophically weak, but they're massively deconditioned. Right. Their exercise capacity mean their capacity to do anything like a load of laundry is severely diminished. Right. And what we observe is massive improvements in their conditioning just from doing the four exercises without even adding a conditioning component. When they first start as a raw novice, the exercises are the conditioning component like three sets of five is that it's like a hit workout to them. Exactly. Exactly. So those are very well thought out. I do hope that you'll continue to explore those and just put them out there where people can like, you know, argue about them and and help you, you know, help us all refine our thinking about this. Yeah. At the end of the day, you know, it's kind of like you were alluding to earlier. These criteria, you know, it's kind of like the philosopher Wittgenstein said, it's like a ladder that you climb and then you kick the ladder away, you know, or like a martial artist learns all these forms, but like, you don't actually use the actual prescribed movements when you're actually in combat or something. So I think for you and I, and for a lot of the coaches, like when a client comes in, you know, I guarantee you Matt Reynolds doesn't look at that client and say, well, now I must select the exercises that exactly express the longest effective natural range of motion and move the most muscle mass, you know, to produce the most strength. So, you know, I'm going to have her do that pull downs, right? He doesn't like, he doesn't think that way. It's all implicit because we've internalized it over time. So, you know, this is very didactic, but I think it's also important for our listeners to know that this is sort of the matrix, the the conceptual underpinning of what it is that we do. And then it's important for us to revisit that from time to time. And remember why it is that we do things the way we do and why we think the way we do and approach our clients the way we do and reexamine those criteria, reexamine those theoretical underpinnings to see if there's a way that we can get better because we can't hold ourselves out as a profession and we can't hold ourselves out as delivering exercise medicine particularly to this client population without our own sort of progressive overload and our own sort of progressive improvement, examining our assumptions from time to time and getting better, getting better at what it is that we do because what we do is pretty important. Absolutely. So I think that's our time and really good discussion. Noah, you've clearly thought deeply about this stuff and I really want to thank you for bringing that to us today. So we're going to be joined next time by John Klosson, our 94 year old master's athlete here at Grey Steel. And we're going to talk about exercise selection again with Coach Noah Hayden. Thank you for listening to the Barbell Logic podcast and this Barbell Prescription series. And we'll catch you next time. Thanks a lot. Bye.