Once or twice a week a client will text me some link to some bullshit site about some supplement or high level tweak that they want to add. It also comes from here-say recommendations. My buddy has been drinking yack urine and is f$cking jacked, can I do that?
These types of texts make me noticeably angry, not because I am mad at the people (ok a little) but because the black hole of the internet and personal recommendations from unqualified friends are the lowest forms of information.
A lot of people say I shouldn’t give clients my phone number, but I like to be accessible and at night I have the ability to flick the iPhone off. Let’s face it if someone is blowing me up with power clean questions at Midnight, we have much bigger problems and there is no way I am answering. The other virtue I have to instill in my clients is where they get their information, how to sift through the nonsense, and better yet how to just flat out avoid it. In our culture, information is stressful and unrelenting. I have to give them the security so their beliefs are unwavering. They have to know they are doing the right thing and therefore they aren’t flipping around in the wind, swayed by every Tom, Dick, and Marge that comes by the house and talks about their new Splenda and Collard Green diet or the most bestest fluorescent bottle of RED 40 on the shelves of GNC.
These texts usually come from new clients who haven’t mastered the fundamentals. This is because when you master the fundamentals everything else is just a drop in the bucket and your bucket is already full of swoll, slender, feel-goodness.
So what are the Fundamentals?
I love Dr. Kirk Parsley’s car analogy.
Your car/truck has four wheels:
If one of those wheels is off you can’t put on a bigger wheel of nutrition or add in some extra massage sessions with Betty Lou – it ain’t going to matter. You have to have those four wheels on the car before you can go play around with lifting up your truck, putting on a fancy new exhaust of creatine and BCAAs, because if you don’t, you will just have a really expensive useless frame of bells and whistles that can’t pull out of the driveway.
Let’s take this thread from a guy who drinks like it’s going out of style, is prediabetic, doesn’t sleep, and handles work stress like a sugar deranged toddler.
Here is the text (read italicized texts with an Aziz Ansari accent)
Weightlifting raises testosterone – can I train 5 to 6 days a week?
The increase in testosterone is generally transient and overtraining it probably more a risk than undertraining for the majority of our population. When testosterone is low it is in an indicator that you are over driven – so likely you have to park the vehicle and put the wheels back on. If this guy lifted weights 5 to 6 days a week I can guarantee it wouldn’t help and he would get injured in under three weeks due to the aforementioned shit show.
“Low testosterone in the absence of primary hypogonadism is a barometer of ill health, rather than a primary marker. “
– Corey Schuler, MS, DC, LN, CNS, CNP, FAAIM
Next text, 2 seconds later.
What about BCAAs and intermittent fasting? Those raise testosterone.
Here was my response.
Get off the internet.
Next texts a few minutes later feeling remorseful.
BCAAs are fine. BCAA away.
Intermittent fasting, maybe but it will depending on blood glucose homeostasis and adrenal function.
Next text knowing that this conversation is far from over.
All of these things you are texting about are tiny drops in the bucket of your problem. Your body needs rest, quality nutrition, quality movement, and stress management consistently over time. Sorry it’s not sexy, but you don’t pay me to lie to you.
I can say all this because I am not afraid of losing business. If he doesn’t like what I have to say, by all means find some 22 year old that will combine all the things you want – intermittent fasting, BCAAs, and weightlifting 5 to 6 days a week on a Vietnam shoulder, a shattered ankle, and low testosterone levels. Good luck. He will be back or he won’t, but I can guarantee is problems will be worse and the results he wants won’t be had because he took a giant poop on the fundamentals. Guys unfollow people who suck. If you are going to read things on the internet have a plan and only intake information from people who have credentials and the respect of the industry, and for god’s sake when in doubt – master the fundamentals – there is nothing more powerful.
A few weeks ago I was at an APEX – Functional Medicine Seminar in Dallas and my Truck got ripped up with screwdrivers and bashed in with a tire iron. This is what I wrote right after it happened as I walked back into the seminar with no belongings and little concentration.
“My truck got robbed. Locks ripped off, shattered glass everywhere, and an 18,000 dollar device gone out of the back seat. All my clothes, my cooler full of broccoli, and my lifting shoes. Poof. Insurance will likely cover $200 bucks.
I walked through the door back into the functional med seminar and I couldn’t pay attention. All I could think in my head was F$CK. They took my compression tights. Those were f$cking expensive! Then the lecturer Dr. Brock started telling a story about diagnosing a man who had muscle belly growths all over his body. He said this gentleman didn’t know yet, but he had ALS and less than two years to live.
It could be worse, I just have to buy some new underwear.
Time to learn.”
This is the first time I have been robbed since High School. It leaves an eerie feeling in the pit of your stomach, but this feeling didn’t even come close to when our house got robbed multiple times during the recession, they even ripped off the copper gutters up to the second story while we were asleep. I am not an innocent angel by any means and likely have built up plenty of bad ju ju from my adolescence, so shit happens…
We can only hope there are few hoodlums in Dallas who are testing their readiness before they go out busting car windows and wreaking havoc. I also hope their HPA axis is in the shitter. Petty, I know.
Over the last few weeks, I have been collecting receipts, getting estimates, blah blah. Just a bunch of busy work. Coach Davis has been relentless in his acceptance and help with the situation and OmegaWave has been nothing short of amazing. We are almost back up and running at likely more than full speed.
The biggest hit is not the money or the time it has cost to get back online, but the data. We had full cross-sectional data in over 500 athletes and who knows how many follow-ups, we hadn’t backed it up because we thought it was in the cloud. It wasn’t, an oversight on our part, which won’t happen again. We can’t get that data back, all we can do is build it again. So we will be evaling everyone who comes to the Seminar for free (likely multiple times) and we will be cutting our full eval price in half to $100 bucks for the next month (through Aug 9th).
Thank You OmegaWave for all your help, Thank You Davis for not stabbing me in the jugular for losing the OmegaWave, and Thank You to my boy Zach Williams who took me to the mall in a monsoon so I could purchase some fresh undergarments.
By: Ben House
I started reading Getting Naked: A Business Fable About Shedding The Three Fears That Sabotage Client Loyalty by Patrick Lencioni yesterday in the mid-afternoon and finished it right after dinner. That is how I spend my Friday nights. I know tantalizing. The book is about how to do small business really well. I first read the book a few years ago at the suggestion of one of my mentors and forgot how simple and powerful it was. The book will immediately make you think of small businesses or people in your life that just seem to be naturally successful without a giant marketing budget or fancy business training.
Below are some quotes, some discussion points, and the Three Fears.
“And then it dawned on me. I was a salesman. Dick was just a consultant. He didn’t do any selling at all. Instead, he just went in there and started helping them.”
“Almost all of the time and energy at Lighthouse Partners was being directed toward consulting to paying clients. Those clients in turn became the sales engine for the firm, and even when they did an occasional cold call, it was the references from clients that shortened the sales cycle considerably.”
This is a good reminder for me to stop thinking about price points and marketing strategies and just pony up and do everything I can for my people as well as the community. The rest has always taken care of itself.
“We’ve learned over the years that having a bad client is worse than having none.”
This is a big one in the fitness industry. Oh you have money – come on in! But for us if a client doesn’t do what we say and just finds us annoying or intrusive on their plans to keep doing what they want to do like not sleeping and slurping frosties – it ain’t going to end well for anyone. We are not in the volume business and never will be – we look for people who are open, ready to make changes, collect data, and act on the findings. That population is growing but it definitely isn’t for everyone and that’s ok. The right client at the right time.
Now let’s get into the Three Fears which take up a good part of the book and will really make you think about your own thought process and actions when you are with clients.
#1 Fear of losing the business
Consult, don’t sell. Give away the business – easier said than done, but it will change the game.
Tell the kind truth – not what they want to hear. Your movement patterns aren’t strong enough for us to load you up yet. We have to go back to the basics for a chunk of time and then slowly integrate the fancy stuff back in as your movement patterns change. No one likes to hear that. But if you word it correctly, live up to expectations, and stick to your guns results will be had.
Enter the Danger – don’t be afraid to talk about the thing no one else wants to talk about. Bowel function, libido, mental and emotional stress all really important aspects of optimization and data collection. Keep it professional and don’t side skirt them.
#2 Fear of being embarrassed
Ask dumb questions – How much sleep did you get? How do you feel? What do those letters on your shirt stand for?
Make dumb suggestions – Why don’t you go to bed earlier in the evening and shut off your phone 2 hours before bed? Because I am a single Father and night time is the only time I have alone. Well shit, let’s trouble shoot this because it is keeping you from your goals and you are spending an ass ton of money on recovery strategies like Cryo and massages that sleep might take care of.
#3 Fear of feeling inferior
Take on a role of true subservience to a client – Put weights away, get them a towel when they are sweating profusely. Replace toilet paper. It will be ok, your ego will recover.
Make everything about the client – limit your story telling and make the entire session about what they need. Listen. Correct. Be Present.
Do the dirty work –I don’t think we need to be baby sitting our client’s kids for free or mowing their lawns on weekends, that would probably just weird people out. But, doing the dirty work is just a natural part of our job. No one wins balloons in the weight room. They win them in life, competitions, and on the field. We can’t really do the dirty work for our clients, they have to put in the time. Yet, we can be clear, honest, and hold them accountable.
“A leader is best when people barely know she exists, when her work is done, her aim fulfilled, they will say: we did it ourselves.” – Lao Tzu
This is the nature of our profession. We live and thrive in the shadows. This is not about us.
By: Ben House
It’s 4:10am in the morning. I couldn’t sleep I was so excited about life. It’s ok, I went to bed at 8pm. We have swept real health under a rug and replaced it with the cursory definition – lack of ill-health or disease. All of us deserve the right to quality health care, we deserve the right to answers. We deserve the right to leading indicators. Unfortunately, in our current climate the only one who can do anything about this is YOU.
People feel their doctor can’t help them unless their appendix is going to blow up or they lacerated their femoral artery with a chainsaw. This is because they go to the doctor’s office and the conventional doc says, “Your labs look great! Cholesterol is a little high, so watch your fat intake.” Your insurance paid 900 dollars, for that? All this even though you are 60% of the way to diabetes, have brain fog, and feel like the carpet got pulled out from under you at 3pm. The writing is on the wall…they just can’t see it.
There is no better marriage than Athletic Performance and Functional Medicine. For some this may seem like an oxymoronic statement, but the people that I have found who are willing to take a good hard look at their physiology and what’s going on with the system are after optimization. They aren’t happy with just getting by or using the bullshit phrase, “I’m getting older.”
For many athletes and clients, we are the gateway into the functional or integrative medicine realm. The OmegaWave is one of the best check engine lights on the market and it usually gives a loudspeaker to the voice in the back of your head that is whispering maybe things aren’t OK. Enough talk let’s take a look at a few imaginary case studies.
1. A twenty something female athlete who wants to optimize aerobic and anaerobic capacity, as well as strength and power. She trains 5 to 6 times a week combined with a busy job and sometimes goes out on weekends. She feels ok, but has recently felt very fatigued and has been needing more and more caffeine to get going especially later in the day. She also can’t seem to get her work done as fast as before. Her coach tells her to get more sleep.
She comes into your office and you find out she is borderline anemic, so none of the tissues in her body are getting adequate oxygen so thus the oxygen depleted body is only dealing out oxygen to the most necessary function. She is also deficient in vitamin D despite taking 2,000 IUs of a vitamin D supplement from Whole Foods. Finally, due to years of birth control use her binding globulins are elevated so even though her thyroid hormone production is adequate to turn on every cell in the body, the signal isn’t as strong as it should be. Think this couldn’t possibly be you?
9-12% of Caucasian women and 20% of minority women have full blown anemia.
50% of American Adults and 70% of American Children are Vitamin D Deficient.
62% of women of reproductive age are currently on oral contraceptives.
2. A male client with 2 young children. He wants to stay lean and look good for his wife as well as be the vibrant man he has always dreamt of for his two boys. He runs a construction company and lifts with some friends 4 to 5 times a week. He was a college athlete and has stayed in pretty good shape since then. He thinks his diet is way better than everyone else’s’. He sleeps about 6 hours a night, but just can’t shake the fact that he doesn’t have as much energy as he used to, he forgets where his keys are regularly, and is starting to lose the hair on his legs. His doctor said he looks fantastic and that his total cholesterol is superb at 147 mg/dl, far below what he sees in most patients.
This patient comes into your office and you run some labs, you find out that his cortisol is dysregulated and very high and this is eating up his hippocampus (the portion of the brain responsible for short term memory), as well as his supply of pregnenolone, the precursor to most steroid hormones in the body. You also find out that his testosterone is borderline low at 364 ng/dL, although his LH comes back in the middle of the normal range meaning that his body has become acclimated to this new sup-optimal state (with testosterone this low the brain should literally be screaming to the testicles to produce more testosterone – how it screams is LH). You know that this patient needs stress management, less exercise, and far more sleep, which is the most anabolic activity we can take part in, once those aspects are addressed if levels don’t normalize one may possibly need to jump start the pituitary gland which secretes LH as well as look deeper into why the cortisol may be dysregulated.
92% of all Americans have some type of cortisol dysregulation per Dr. Gottfried.
The number of men on testosterone therapy has quadrupled since the year 2000.
65% of Americans get 7 or less hours of sleep per night.
3. A post-menopausal female weight loss client has been training very hard for 9 months but can’t get results no matter what she tries or how little she makes herself eat. She is a stay at home mom with a million places to go all at once. She has 1 child in middle school and another just starting high school. She has intense sugar craving and has trouble sleeping through the night, she has also noticed that her eyebrows are thinning. She consistently has a lot of GI discomfort and finds whenever she does eat a higher carb meal she gets bloated but she doesn’t like to talk about it.
She comes into your office and tests positive for a SIBO (small intestinal bacterial overgrowth) breathe test as well as H pylori. Her cortisol rhythm is highly dysregulated, and her hemoglobin A1C is elevated above the functional range. You also find a positive test for TPO antibodies against her own thyroid.
135 million Americans have some kind of GI infection and some estimate it to be much higher at 80-90% of the population.
50% over the age of 60 have H Pylori, which is a bacterial infection of the stomach that causes a reduction in acidity which can lead to the subsequent migration of bacteria from the large intestine into the small intestine.
Over 10 million women have Hashimoto’s Thyroiditis.
50% of Hispanics and 33% of Caucasians will become diabetic in their lifetimes and more than 25% of Americans are currently pre-diabetic.
If you are thinking, why is he talking about me? I made every one of those examples up off the top of my head. They are common themes we see, but fictitious nonetheless. Now if you are a trainer, the crazy part is that you could be doing the most sound and evidence based work under the sun, but without getting physiology dialed in you are eventually going to be bashing your head against the wall and blaming your client for not following your rules, even though they are or just physiologically can’t do it.
I have constantly searched for these types of answers and a way to explain them in a way that doesn’t lay blame but instead motivates and inspires. As strength coaches, personal trainers, people who lift and eat vegetables, whatever you want to call us, we are the professionals that touch the most people. We are the gatekeepers. Get people to the right place, get people quality labs and quality interpretation and your job will become so much easier. You are not alone. You can’t be.
If you are looking for a Functional Medicine Doc in Austin, just ask me for a recommendation. I am happy to help and/or send an introduction. If you are in another city head to the Institute for Functional Medicine’s website and search for practitioners, or just click here. If you want to learn more about how we blend Functional Medicine into our on-boarding and evaluation process please click here for more information on the Optimizing Athleticism: The Health and Performance Solution seminar August 8th and 9th in Austin, TX.
P.S. and doing the right thing can be extremely rewarding
By: Ben House PhD Candidate, FDN, fNMT
Coach House asked me to weigh in on the article PRI- A Continued Conversation. To be honest when it comes to giving opinions on acronyms via social media I usually stay away. 9 times out of 10 it ends in petty infighting worthy of the Black & Blue Vs. Gold & White Dress debate.
“Duh guys — it’s Gold & White.”
On a more serious note I draw parallels to the perennial philosophy when I hear such debates within our industry. I truly believe we all begin from the same universal truth and as time passes our own societal need for uniqueness (research based) balanced with our need for acceptance diverts us into groups, sects, clans, etc. The point being we all start from the same universal truth, we just call it something different.
As a coach who is trying to understand ALL. THINGS. you learn fast not to get overwhelmed and concerned about the fighting between different schools of thought but instead search for universal truths.
As we dissolve the arguments or philosophies down we see the universal truths being breathing, and pattern recognition. All important and all are a part of the process.
For obvious structural reasons there is a need to address breathing with our athletes. As Coach House alluded to previously, we need to get off the training table and have this integrated within our sessions. We are strength and conditioning coaches aren’t we? If an athlete is spending more time on a table than on the weight room floor chances are you are doing something wrong.
For simple integration within the session, breathing exercises in the warm ups or core exercises are great focused reminders. This allows you time (not under load) to really help the athlete feel the dynamics of the rib cage in inhalation and exhalation. This also sets up coaching cues used in the actual lifting session — Win Win.
On the programming side it’s important to limit anaerobic work if an athlete is really in need of changing their breathing dynamics. If not you will be chasing your tail (especially in the CrossFit population) though loaded carries and holds sometimes have their place when bridging the gap between table and specificity.
It’s not the patterns themselves but how we recognize patterns in athletes which seems to be the most debated within our industry.
What system do you use? Are you on the table using an orthopedic assessment, stationary or dynamic movement screen?
Just pick one or two, or none. I mean who is this eval for?
It’s for US.
We cling to certain systems to tease out the lowest hanging fruit but these systems…
“makes us see the world as more tidy, simple, predictable, and coherent than it really is. The illusion that one has understood the past feeds the further illusion that one can predict and control the future. These illusions are comforting. They reduce the anxiety that we would experience if we allowed ourselves to fully acknowledge the uncertainties of existence.”
How does the athlete feel when they leave the evaluation? Do they feel good about themselves? Do they now feel dependent on you — got you a new client now? Or have we now left them with a “thing” (dysfunction/asymmetry/insecurity?).
I understand the need for some to have a standardized language when discussing athletes between coaches, athletic trainers, physical therapists, etc. but haven’t we done a shit job using the english language as it comes to communication in general let alone trying to simplify or make it more complex?
That’s why I always enjoy our network in Austin. Ideas and thoughts clearly exchanged but the most important part of this is the willingness to do so.
This always brings me back to the eval process. How can we lose the name (eval/assessment), make it more free flowing, less writing shit down (numbers, letters), make the athlete unaware of what we are doing? Move to the psycho-social model.. yet still tease out the information we need and become more athlete centered?
By: Aaron Davis
For instance, I sent the message below to a client who is highly athletic and been with us for about a month, in which we have made huge strides.
“My value add will likely diminish for you when I teach you all the lifts and get you moving really well consistently. There are always little tweaks that we can find, but you are self-motivated and smart sooo programming may be all that is needed after we accomplish what we set out to from the beginning.”
This may strike some as odd, why would I tell a client they may not need me for more in-person training?
- We are expensive and that is unlikely to change any time soon.
- It is the right thing to do.
This client sought me ought for a specific reason which we will have fully addressed in two months time. My job is not to sign this person up for lifetime training, it is to get them doing what they love to do better, more confidently, and most definitely without pain. Now if that thing they love to do is training with me – great. If it isn’t, carry on and come back when you need further insight.
This ideology of doing the right thing seems to be lost in this snowballing business of health and fitness. I get it, people have bills to pay and lights to keep on, but I have found if you do the right thing it tends to come back around, especially in a field that tries to up-sell every chance it gets.
Shit, we tell potential clients they can only buy a month of training because we don’t know if it is going to be a good fit. They have to prove that they can live up to what we ask them to do. Yet, for some of our clients I have zero hesitation signing them up for three months because they desperately need that face to face interaction/direction. We work well together and they value what we do. I always try to contemplate – is this the best choice for this particular client and am I the best professional to help them? If the answer is no, then I take a good hard look at what is the best course of action and who or what might be a better fit.
Davis and I do a lot of things that don’t make sense financially and go against the fitness grain. We can do this because we aren’t married to a giant facility. We eval athletes for free for other trainers. We have been known to monitor athletes for pennies. We nearly always agree to get on phone calls with other coaches or young people who may want to ask us about what we do or how we do it. We got into this industry to help people and collaborate and god damnit that is what we are going to do
….and here comes the sales pitch…kind of
We created this upcoming seminar – Optimizing Athleticism: The Health Performance Solution (August 8th and 9th) and it is going to be a horrendously good time. I can see it already. It will be a ton of effort, but it will blow people’s minds.
We will make zero dollars on this seminar. It will all go to putting it on. From a monetary standpoint we would be better off selling protein shakes on the street corner.
Maybe that is really stupid, but I desperately wanted to get Dr. Rakowski in front of our network of coaches and functional medicine practitioners here in Austin because I know his message and its delivery are so strong. Every functional medicine seminar I go to, I chat with people about what I do and inevitably someone always asks, “Oh have you heard of Dr. Rakowski?!!” He is that well known in the field and the practical tips and tricks regarding heavy health and performance concepts that you are going to take away from this two day seminar will be unlike anything out there.
So when you register, know that you are paying $295 to learn how to do the right thing by your clients, friends, and family. Know that we are putting this on so that we as a unit can help transition this industry from diet and exercise peddlers to citizen scientists, healers, and listeners who act with both integrity and knowledge, a ruthless combination.
By: Ben House PhD Candidate, FDN, fNMT