Given that Ruthless Performance is based out of a land-locked state, the paddleboarding or surfing communities are not populations which we traditionally cater to, but given my own predisposition to the sport (surf when I’m on the west coast, paddleboard on the east…), I’ve spent some time thinking about the demands of paddleboarding, as well as what it takes for me to make sure that I’m most prepped for when the opportunity to take a road trip with the board arises.
Paddleboarding itself is a workout and can be easily classed as its own sport, so with this in mind, most of the strength & conditioning exercises and techniques I’ll employ to maximize performance on the board are done to stimulate some of the neglected or underused movement patterns, muscles, and skills while alleviating some of the overuse that can develop over long days on the board.
Consider the following points to help develop your skills on the board no matter how far away you are from your favorite spot…
1. Glute Development Still Reigns Supreme
The glutes are the powerhouse of the body and are pretty heavily correlated to peak athletic function (regardless of domain). Even in the case of paddleboarding, where you are more stationary and have less force input/output demands than some other sports, you still need the glutes for a handful of reasons.
Glutes work in synchrony with the lats (most notably through the lumbodorsal fascia) to assist in each stroke of the paddle. Weak glutes in paddleboarding can also cause severe long-term back pain. Because the standing position on a paddleboard relies on a hinged hip, the inability to maintain tension over time throughout the glutes causes unnecessary tightness in the low back.
Consider including box squats, 180 hip extensions, side-lying clams, lateral band walks, deadlifts, and glute bridges/ thrusts to maximize development of all three glute muscles (max, min, med).
2. Don’t Fall Into Sport-Specific Traps
It’s easy to see how an athlete would want to utilize his/her time in the gym replicating paddle after paddle, pop-up after pop-up, but this is not an efficient use of time. Keep the paddleboarding-specificity in the water. When strength training for the sport, you should want to engage in what we call ‘anti-specific training’, which mostly just means engaging in exercises, drills, and positions that bring about a more neutral posture while maximizing power and force development that you couldn’t otherwise get while on the board.
Many paddleboarders will align themselves with the ski erg for their energy system training because it most closely replicates their sport. I’m highly averse to the ski erg to begin with, then putting a population whose entire sport exists in a state of flexion onto this machine is a recipe for overuse injuries in the shoulder (and elbow for that matter), slipped discs in the lumbar spine, and hindered transverse plane arthrokinematics.
3. The Value of Unilateral Work Can Not Be Overstated
There aren’t very many sports or events that exist on such an unstable surface, so maximizing strength and stability at contact points is paramount. Then, take a guy who boarders on flatfooted like me and put him on a paddleboard for a few hours and his/her ankles will be smoked. Strengthening the feet with various unilateral drills will help extend a paddleboarders’ time on the board each day.
Most exercises that can be done on two feet can be done on one. In fact, performing some of the aforementioned glute exercises on a single-leg is a great way to maximize time in the gym. Some of my favorite unilateral exercises are Unilateral Cable Deadlifts (can be done with barbell, dumbbells, kettlebells…), contralateral push press, contralateral low cable row, pistol squat, Chaos Rear-Foot Elevated Split Squat.
This shouldn’t be misconstrued as instability work on a BOSU ball. The goal of the exercise isn’t to make balancing harder, but rather to make balancing easier over time. This can not be achieved on something like a BOSU ball / instability trainer.
Overall this has barely scratched the surface of strength training for paddleboarders. These are just some quick thoughts I’ve had on this topic, mostly as it has related to my own development as a paddleboarder, but from the perspective of a scientific and methodological practice and training environment.
Are you a paddleboarder interested in starting a workout program to maximize your skills on a board? Reach out to me at John@RuthlessPerformance.com to get started today.
**Editor’s Note: Today’s Ruthless Performer Q&A Series is one of the most expansive in the Q&A series to-date. Like many health professionals, Kyle’s own history in sports and wellness lends credibility to many of his thoughts on health and maximizing the health of athletes and the general population. If you like what Kyle has to say, check out his Youtube page (links provided throughout the text). Enjoy!**
1. Hey Kyle, glad to have you on the site… We worked together in college, but you’ve since came back onto my radar with a video you recently put out that was pretty critical of the modern health care system. What was the chain of events that made you view our healthcare system so unfavorably? What was the straw that broke the camel’s back and lead to you to make that youtube video?
The chain began with myself at a young age while in middle school my body began showing warning signs of early degradation of my joints that carried on into high school as well. Don’t get me wrong I played hard. I never really had a good internal gauge of when to slow down and just play for fun. I was the guy going 1,000 miles per hour at all times. It didn’t matter if it was dodgeball or riding a goat it was all at my best effort. But the immobilization and rest prescription never made sense to me. Before the age of 14 I had 2 ankle casts, 2 full leg casts and a corset back brace applied for a stress fracture in L4 and L5. After all these immobilization techniques and very little rehab you can imagine the insuffiencines that were creeping up in my musculoskeletal and nervous system alike. I felt confused and not well understood during these conservative treatment techniques and believed more could be done. Why not add in an abundance of z packs for sinus infections with the side effect of increased chances of achilles tendon ruptures to the mix. So I continued on my merry way through high school with an unbalanced motor and a broken down immune system. My skin began showing signs of immune system malfunction with acne and a condition called vitiligo that failed conservative medical doctor directed treatments for 8 years. Between dermatologist and orthopedic appointments I had about all but given up on this whole idea of health.
Around this point I had started spending time with a local chiropractor Dr. Lee Lausch that had treated me with a non – traditional modality called the ARP electrical stimulation unit. This really blew me away as it got me back significantly faster than any other treatment I had tried in the past (rest and ice). So I began asking more questions and that’s when the flood gates opened. He began providing me with information on nutrition and really from there I began viewing the world through this lens of the body can heal itself. Just at the point where Dr. Lausch and I really began connecting my father had gotten into a traumatic accident. During football camp my senior season a truck had fallen on him and he broke 36 bones in his body. He survived, in which I am so thankful for all the modern medical system has to offer in regards to trauma care. Once they patched him back up is when the wheels started to fall off. He had his entire right femur replaced with a metal rod. His left ankle was in pieces and needed to be put back together. So they essentially did a full ankle replacement. This didn’t last long. He was out hiking one day looking for turkeys as he is an avid archery hunter. The ankle replacement had failed quickly and we later found out the bone was necrotic. The surgeon mistakenly anchored the metal into bone that had little integrity. There was no other option at this point but to amputate his leg from the mid calf down.
Yet no fault taken for this complete lack of patient care or pure ignorance to the integrity of the bone. Now this poor guy is 10 plus surgeries in and can’t seem to find his way out. His phantom pain is real now from the amputation, he can’t sleep and he feels constant jolts of electricity going down to his foot. This seems to be common after an amputation and this field needs more research focused here as it massively affects our veterans.
At this point hes taking a cocktail of medications mainly to control his pain, with the rest of the meds to manage the side effects. We’re 2 to 3 years in and his liver is struggling to keep up. The only thing this medication did was temporarily decrease pain and rip apart his body from the inside out. He was getting more unhealthy, losing more of himself and ultimately slowly dying. I came home from college one day and things began to click. One of the last doctor appointments I went to with him they recommended a battery powered device to place into his sacral plexus. This was intended to shut off the pain signals to his lower extremity. We both just stared in disbelief. Lets just say we walked out confused without answers. My dad was at his last resort and that was getting off the meds, begin exercising, fixing his nutrition and using alternative modalities and physicians to get back on track. The results were astounding. Within 6 months he had completely got off his medication, lost give or take 50 pounds and actually started to live his life again. Solely from the pure will of his heart. Not guided by a physician.
Here’s the loophole that he discovered that most people will never tell you. And quite frankly what they don’t want you to know. His medical doctor didn’t want him off medication. The only thing his nurses ever called him for were to check and ensure he was taking his meds. If he didnt fill his script in time you better believe they were calling in minutes to question why that didn’t happen. Workers compensation won’t pay for much of any alternative therapy beyond what big pharma doesn’t control. But here’s what they will cover. And this is exactly what my dad did to get his life back. A massage from a licensed massage therapist, a gym membership, physical therapy and chiropractic care. You mix in some quality supplementation and a whole foods diet and voila you have your recipe for success.
The problem was who was going to tell us this? First, the person has to be open to it and that is definitely step number one. But our medical doctor wasn’t getting a cut to tell him he gained weight and needs to lose weight. Their concern wasn’t directed on fixing. It was solely directed at managing. We had to piece this together through trial and error. You get what you get because you do what you do. If you allow the system to guide you, you can only get out of that system what they offer. You don’t know what you don’t know.
Well now I know and I’m here to express my story. This was 10 years ago the alternative health movement wasn’t as mainstream as its slowly becoming.
2. What roles have you played in the healthcare system? What do you do currently?
I have played many roles in the healthcare system. It began with personal training at the chiropractors office I mentioned previously. Here I was training highschool and Division I athletes all the way up to 70 year old mail carriers using the super slow method on MedX machines. We focused on metabolic specific training from the book Body by Science written by Doug McGuff, M.D. If you haven’t read this I highly recommend it.
From here I went to Florida International University to do my graduate work in Athletic Training. As a student I spent time in Division IA football and soccer, NFL with the Cleveland Browns, Orthopedic Urgent Care with a Upper Extremity surgeon and a Private High School. During my time here I also continued studying nutrition with a focus on holistic healing, which was the missing link that I continually found within my more than 2,000 hours of clinical experience in school. It’s the large pink elephant in the room and nobody wants to address it. Because the reality is, the majority of folks in these settings have little to no knowledge on the topic which is a system flaw not a personal issue. So really the only way you get proper nutritional training is if you take the time to do it yourself. Period. If you’re not learning you’re dying. Athletic trainers must have an overseeing physician in most states to practice. Medical Doctors volunteer for teams to get their ‘in’ for more prospects for their clinic to produce of course more money. What the orthopedic doctor says goes.
I saw the small influence the athletic trainer really had when push came to shove. Especially when speaking on the NFL and athletic trainers role in that setting. They’re puppets to the medical doctors and physical therapists. Why hire highly trained medical professionals (ATC’s) then disregard their skill set? Once this really clicked for me I decided the NFL was certainly not for me. I passed my board exam early in February before I graduated and accepted a job in march to work as an athletic trainer at a NAIA school in Maine. Everyone thought I was out of my mind for accepting this job due to the location being in northern Maine.
What most didnt know is that I as the primary caregiver for 110 college athletes with no outside influence. I was able to run the strength and conditioning programs, implement injury prevention programs for warm ups, take the athletes grocery shopping and facilitate healing through nutritional understanding and direct application. I wanted to see what I could do with a group of individuals with this approach of an all encompassing program. I was in absolute heaven. 4 of the 5 teams I worked with made it to the national tournament. Men’s basketball made it to the final four and both mens and womens soccer teams won the national championship.
Unfortunately the majority of the staff left after this year so I parted ways as well, and moved to Texas. In Texas I worked for a small group of wellness centers that was developed and run by chiropractors. Here I was the movement director and the marketing director. My roles as the movement director included community health education, orthopedic evaluations, soft tissue application and corrective exercise. Here is where my understanding of community health and what the general populations thoughts were on health really expanded. Myself and the chiropractor would go into businesses to provide the employees a green smoothie and salad for lunch. In turn we would present on health and wellness and provide a quick posture screening. My biggest take away here was that people still weren’t connecting the dots between what is at the end of their fork and their health. As well as the degenerative effects of sitting under artificial light for 8-10 hours , staring into a computer while in high stress environments.
I mean how far can we possibly get from a human’s thriving environment? The typical american spends more than half their life in captivity which is essentially the example I just gave. From a 50,000 foot view of how the typical american lives it looks as if were living in a cage. At the end of the day we’re animals. No if, ands or buts about it.
Currently I am one of the athletic trainers at an all boys private high school in Miami Florida where I care for 1,000 athletes that participate in 22 different sports with a total of 50 sports teams. Its my absolute dream job. I perform exactly as NATA states: We collaborate with physicians to provide preventative services, emergency care, clinical diagnosis, therapeutic intervention and rehabilitation of injuries and medical conditions. I am the first person to see an injury and the last person to clear them to return to play. This is key for me as I advise the direction of the athletes referral and treat mainly all in house. This is what I learned early on about athletic training, that I feel most people are unaware of. We’re holistic healers and use nutrition, modalities and exercise to treat orthopedic injuries. It’s a beautiful process. You can essentially build and run a clinic exactly how you want within the confines of your licensure in that state.
3. I know you have experience with athletic training, what are your thoughts on this profession? Where should field of athletic training be applauded for doing a good job and where are mistakes being made?
I’m a big believer that your perception is your reality. Coming into the profession I was very hesitant on staying traditional–referring to working in an academic setting or for a professional sports team. For the sole reason that’s what I was exposed to at the time and it seemed as if athletic trainers are all burned out, overworked and underpaid. As a whole is this true? I believe so yes.
The reality is in medicine if you don’t work with insurance, prescribe medication or do surgery it’s difficult to make great money. Is it possible? Absolutely, but not common. What I discovered is athletic trainers are now everywhere in healthcare and it’s expanding which is awesome. It’s so important that you find your niche. Every job is very different from the next and that is so important to consider. Like my job in Maine. All the moving pieces were there they just needed someone to glue them together. I was told not to go time and time again.
As an AT you MUST be creative, open minded and adaptive at all times. If you’re open to that it will be a blast. Its fast pace, ever changing and always exciting. It’s certainly not for everyone. But I believe I found my jam.
Athletic training has been making bounds and leaps in the last 10 years. Especially here in Miami-Dade county. All public secondary schools are required to have an athletic trainer on site. I think this has been our biggest impact. Research and the implementation of evidence-based medicine is so important. Don’t get me wrong. But big picture and where I think the focus should be is on the youth. They are vulnerable and exposed to a lot of injuries, specifically concussions. This age group is in such a critical time in human development.
To have someone there on site to assist them with acute management and recovery of injuries. I believe we will continually keep sports safe and will remain developing the youth in a really positive way that just makes society an overall better place.
The mistakes are in athletic trainers allowing past culture nuances of athletic training to continue in the growth that is now taking place. All athletic trainers are now required to have a master of science degree in athletic training to practice. When previously it was a Bachelor’s degree. Degrees aren’t everything, but the cost vs benefit has to be there. The reality is as a seasonal athletic trainer that is board certified and licensed in the NFL typically makes between $8.50 and $15.00 an hour. This is for a 7 billion dollar company. Yikes. This is supposed to be the peak of the profession, huh? Not to mention athletic trainers are still taking jobs for $30,000 a year after giving over 1,000 hours of work for free and a $100,000 master’s degree. It makes absolutely no sense. Know your worth, create your value and stand by it.
4. It’s good to see someone involved in the well-being of young athletes being active and leading by example. What are you doing to maximize your health and wellness as an individual?
This is ultimately how I found athletic training. I wanted to know how to heal from injuries and to perform at a high level at all times not just in sports. I had to learn the foundation of this process by really understanding anatomy. I learned anatomy in undergrad but it was nothing remotely close to what I learned in the athletic training degree. From there I could expand.
My daily routine focuses are: mindset, nutrition, exercise, sunlight, giving back, sleep. In that order.
I’ve really focused on developing in my career to allow these to flourish as much as possible.
This is a big reason why I love my job so much. I go outside everyday, my job requires walking, running and lifting with sitting being a choice. The key focus and most rewarding part is to give back to others and help when they are in need. What a true blessing this really is.
To develop my mindset for the day, I begin my day with gratitude and journaling. This has been the biggest game changer in my life. Setting your intention for the day, being thankful for what you have and sending out some motivational videos/quotes to loved ones that I think will help them that day. Knowing where to focus your consciousness daily can and will help you reach your goals. Instead of letting your day direct you, you direct your day.
Take my probiotic: ultimate flora fx on a empty stomach to create the optimal environment for digestion and immune function throughout my day
Chug a glass of clean water: zero water filter is what I use
Go through emails, write and listen to a collaboration of podcasts or videos for whatever I’m tackling that day.
After my probiotic breaks down for about a half hour I introduce food which typically looks like 3-6 pasture raised eggs cooked over easy in grass fed butter along side smoked salmon, grass fed cheese and organic berries – this varies.
This is on days I exercise. If I know I’m not going to lift I will fast until lunch and just supplement throughout the morning.
My daily supplements in the morning currently are:
Tangy Tangerine 2.0 and Osteo FX: multivitamin and mineral powders
- 60 minerals
- 12 amino acids
- 16 vitamins
- All plant derived from organic/non-gmo ingredients
Read more about this here.
I’m currently detoxifyng my liver so I’m also mixing in that same drink a powder called Pollen burst: superoxide dismutase (SOD)/Gliadin complex
- Created from Flower pollen
- To Increase antioxidant pathways
Read more about this here.
Also, Ultimate EFA plus.
- Fatty acids from Borage, Flax and Fish (anchovy, Sardines and Pollock)
- IFOS (international fish oil standard) certified
- This is so essential as it tests the product for oxidation, heavy metals and potency along with many other specifications
Read more about this here.
I26 hyperimmune Egg: Immunoregulatory supplement that is well documented and quite an advancement in the ability to assist in arthritis healing and digestion.
Read more about this here.
Ultimate Selenium: This prevents many types of cancer specifically two types breast and prostate
- Essential trace mineral
Read more about this here.
Zinc Fx: 48% of americans are deficient in zinc. This trace mineral isn’t talked about enough.
- It builds & supports immune system
Read more about this here.
Lift right before lunch:
What I have found for myself that works really well is quite simple. I lift weights/exercise for 30 minutes a day everyday. I believe the core foundation to a successful healthy lifestyle is rooted in quality and consistency not much of anything else. I don’t think there is a specific exercise that is going to correct anything in the body but more the collaboration of movement and consistency at which you perform that exercise. Currently because of the lifestyle I choose to live, training to become proficient in advanced lifts isnt what my focus is on. So I choose the most effective and efficient way for my body to prevent illness and thrive. Which for me and my physiology is 30 min a day of no short rest heavy lifting. I usually keep it to 3 to 4 different lifts that change frequently to attend to the SAID principle, the process of reversibility and engaging in different exercises to challenge my nervous system to generate growth in neural pathways.
What I don’t currently do enough of that I need to refocus on is just going outside and playing. The psychological aspect of creativity in exercise is so important and finding ways to move the body and challenge the nervous system with complex dynamic movements is key. Playing frisbee, golf, volleyball or climbing a tree and using the gifts we were given as humans is the best way to fulfill the human bodies requirements of advanced technological movement patterns that dampen quite fast if not used.
To categorize my diet to American fad diets you could say it’s a paleo diet mixed with keto fasting focusing on quality not quantity. I eat less and focus on high quality diversification of nutrient dense foods and supplementation. Most of my calories come from lunch. Lunch consists of a small amount of carbs such as white rice, yuca, sweet potatoes, plantains. With protein I try for two different types each meal between fish, eggs, pork, beef, and chicken. A large salad with fresh raw veggies and my dressing is ACV or balsamic vinegar. I like to include a majority of raw fruits and veggies as I’ve found this is what works best for me.
At lunch I do nutrition counseling with some athletes on what to eat for that day which keeps me accountable and learning everyday from them.
Dinner: Raw fruit and vegetable based. This has really worked for me and has been a great alteration in my diet that was a big change from how I grew up. Dinner was always the biggest meal to now dinner being my smallest meal calorie wise, because of the way my day is set up. Sleep is the last focus for the day. My greatest challenge here has been slowing down my mind enough to rest. My strategy consists of putting my phone down and turning on airplane mode, getting rid of all the white light and just leaving my salt lamp on while I reflect on my day. Once I generate my thoughts I journal and get all those thoughts on paper. This has really allowed me to fall asleep and once I’m out I’m out for the night. With a typical night being 8 hours. I don’t believe everyone needs 8 hours but it’s what works for me. Some people may need more or less.
5. Some (of many) similarities I see between us are your voracious reading habits and how up-to-date you are in the world of health. What trends do you see emerging? Are these good trends? Where should the academic sphere of health be directing its resources?
It’s been an incredible journey thus far. I think it’s our obligation to read and keep up with the steady flow of information. I don’t want to outsource my problems to someone else. I’d rather take the time to learn myself.
The trends I see coming are environmental awareness which the nutrition and holistic healing community are dovetailing off of. People are gaining interest in less medications and are looking for alternative routes to the failed health care system here in America. This has also brought about a spiritual shift as well. We’re connecting the mind, body and spirit instead of tearing them apart into separate entities. I think this is where the big yoga explosion and the legalization of cannabis are coming from and millennials aren’t interested in the old failed systems. We’re interested in progression and change for the most part. The age of information has opened the door to self healing and questioning of what’s really happening in health care. I think these are great trends and I am so excited to be a part of it.
Academia should be directing their focus on staying up to date with the latest evidence. But presenting it in a way the common man can benefit. Not manipulating information to benefit big corporations. The gap is in the presentation not the information. I don’t think we need more evidence at this point to prove that daily exercise, proper sleep, exposing yourself to sunlight and the outdoors, eating organic whole foods, drinking clean water and surrounding yourself in a loving community prevents illness and is required for the human body to thrive. These things are non negotiable. Yet its still so far from common knowledge.
My point here is: It’s simple. Let’s start with the basics and build from there to heal this planet and the human race. No magical discovery of a gene, medication, working at stressful job inside a cubicle, and separating ourselves from society is going to fix the problem. Vote with your dollar if you want change not on a ballot. Support your local farmers and small businesses.
6. If you had $1,000,000 to maximally improve the health of as many people as possible, what would you do?
My dream is to be able to create a project for an annual immersion retreat similar to what Tony Robbins does, but make it very affordable to the common person that will focus on daily routine alteration. Teaching cooking, exercise and play, education series each day, nature immersion and connecting to the earth and your food, mindset development through self love and expression. There are many retreats like this going on now. I just feel as if they are all separate and not brought together as one complete piece. I know I can’t reach everyone, because people are ready when they’re ready. One of my favorite quotes is “when the student is ready the teacher will appear”- unknown.
7. Do you have any closing thoughts? Where can people find more about you and what are your plans for the world of health and athleticism over the next year?
Ask questions and educate yourself everyday, create a filter of truth for yourself to view the world, never settle, love yourself, you’re beautiful in your own ways, be kind to others, get outside and play you’re never too old, eat real food and have fun. Being healthy is exciting not bland and boring.
I’m currently proposing to the school I work at to develop two strength training courses that will teach movement and nutrition to freshman and juniors for next school year. I also began my personal brand called the Alternative Fish which is a youtube channel, facebook and instagram page that will be for information on exactly the topics I covered here. I just started it so bare with me. Lots of posts to come!
Thanks for having me. Really looking forward to this collaboration.
As we settle in the holiday season, it seems like sweets tend to surround us with chocolate temptation and sugary savory cookies. Many folks tend to give in and engulf pounds of desserts over the course of the holiday season. The problem isn’t the sweets themselves, but self-control. Now, I’m not saying to stay away from all desserts or make claims that sugar is evil. If you want some sweets, go ahead! It comes down to self-control and serving sizes. To tell you all to not consume any sweets during Christmas is absurd and can surely ruin the night. It’s also completely understandable to want to stray from desserts because “you don’t want lose your gainz! Or all of your hard work will be a waste”. I can assure you, there is a way to enjoy the holiday season, maintain your gains, and still achieve your goals.
Reach for the Christmas cookies and have a handful. Do not feel guilty about this. Just don’t overdo it like a plate or two stacked with brownies, cookies, candy canes, etc. Now if you exercised that day, you have a little more leniency but still not much, keep it minimal. Here are some tips that may work for you:
- Hungry? Go for a protein snack (Greek yogurt, beef jerky, hard-boiled eggs, protein smoothies, protein bars/cookies). Not the tastiest but better for body composition. How is it better? Protein is more satiating (feel full longer) and has a higher TEF (thermic effect of food), essentially burning more calories during metabolism.
- Drink water! Sometimes hunger may be mistaken for thirst, so if you’re feeling hungry and want a snack, drink some water first then decide if you want to go for that snack. It may also help if you drink water before dinner. This may give you a “full” feeling thus, potentially leading to less food intake.
- Same like the first tip, add more protein than anything on your dinner plate, i.e. chicken breast, turkey, beans, steak, roast beef, etc. Eat your protein first, then go for the mashed potatoes, etc.
- Add fiber to your dish. Fiber also adds satiety. Examples include, broccoli, spinach, cauliflower, celery.
- Use smaller plates. People tend to eat less with smaller plates. Try it out and see if it works. It may not but this is about experimenting.
- Make substitutions. Choose a fruit cup with cottage cheese over a gingerbread cookies and hot chocolate. Choose wine over beer. Simple substitutions like this can help.
- Most importantly, if you lose all self-control and go on a 3-week sweets binge, don’t worry, you will be okay. Enjoy the holiday season!
If looking to make healthier desserts, click here (no affiliation, just cool ideas).
If you’re interested to find out an individualized nutrition plan just for you, contact email@example.com for our nutrition services.
Most of the programs that we design and implement at Ruthless Performance have some meticulously detailed cool-down for an athlete to do following their last exercises of the day. And in most cases these are some combination of mobility drills, breathing techniques, or myofascial release strategies.
Past all of the very significant reasons that a proper cool down in crucial for athlete development, there’s a handful of additional benefits an athlete will receive by doing their prescribed combination of mobility drills at this particular time. When an athlete does these drills early on in the workout, likely in their warm-up or as an accessory drill between main sets, more mobility (active use of ROM) is required of the articulations themselves–like in the spine or at the hip.
But after a workout, while there is more blood circulating in the muscles, the mobility drills will more specifically target these areas–even if it is the same exercise that is done pre-workout.
There also seems to be more lasting changes in range-of-motion when these exercises are completed post-workout. Whereas in the warm-up, these drills serve to enhance proper movement and function during the workout, but the lasting effects seem to be negated by the workouts themselves.
This is why we recommend including high-priority mobility drills in the pre and post-workout time period.
We’ve added a new post in our Internal Program Review series. This time, we’ve published the post with our partners at Swimming Science. This program review focuses on a single training day within one of our high school swimmer’s program.
You can also find other Internal Program Reviews here, on RuthlessPerformance.com.
An unfortunate setback in the science of human performance is the large emphasis currently placed on muscle physiology as a means of maximizing performance. While obviously the muscles play a critical role in athleticism, the muscular system is completely at the whim of the nervous system; the junction of these two is known categorically as the Neuromuscular System.
In an ongoing effort to inform our athletes, parents, coaches, and general audience, we will be regularly detailing some specific segment of the Nervous System or the aforementioned Neuromuscular System. These are the areas of human performance which should be of primary interested to clinicians and academics rather than the simplistic if-A-than-B relationship of the muscular system as it works when viewed in isolation.
The Hypothalamic-Pituitary-Adrenal Axis (HPA Axis)
A critical element to training progress is the management, application, and adaptation to stress. Many will correctly point out that the improvements associated with practice and/or exercise come not in the training bouts themselves, but in the subsequent rest and tissue regeneration/ restoration. As a coach tries to monitor training loads and competition frequency to optimize the stress response, the HPA Axis performs this function internally.
The HPA Axis refers to the interaction of 3 fundamental structures. The Hypothalamus–a part of the limbic system which up/down regulates various hormone levels to maintain homeostasis (the drive to maintain stable internal states) in the body. Also it is comprised of the Pituitary Gland, which may be the most widely-known of the 3 parts; the pituitary is responsible for a wide array of physiochemical reactions like water retention, sexual development, and importantly for the HPA Axis, stress responses. Lastly, the Adrenal Glands function as the response to deviations in stress levels. Among others, the adrenals generate both of the stress hormones adrenaline and cortisol.
To bring these three structures together, think of it like this: the Hypothalamus wants to maintain a cohesive and stable environment among all internal systems. The pituitary manages stress and interacts with the hypothalamus to mitigate deviations to equilibrium. The adrenals generate the chemical messages (hormones) necessary for the stress response to occur and bring about homeostasis.
The HPA Axis and Performance
As alluded to, performance enhancement comes in the form of an adaptation to a stressor. In the case of an athlete, that stressor would be a rigorous training bout. With this in mind and a better understanding of the HPA Axis, it should now be a bit more obvious how managing and overcoming training stressors relates to a neuroendocrine system that deals directly with stress.
Through various methods, we can optimize the function of the HPA Axis to better deal with training stressors.
The role that the pituitary gland plays changes drastically in scale throughout adolescence, during puberty, and into the late teenage years. To maximize an athletes long-term potential, a great deal of care should be placed around ensuring an optimal stress load throughout this time.
On one hand, a young athlete may be under-stressed, as in the case of a single-sport and otherwise sedentary individual. This particular athlete’s long-term ability to generate stress hormones would blunted. In contrast to this, an athlete of the same age who competes year-round in the same sport, in addition to various other roles and obligations may be overstressed. A sign that over-stress is occuring is athlete burnout. The long-term biochemical response to prolonged periods of stress in adolescence can be a lifelong hypersensitivity to stress. This minimizes the total training load an athlete can undergo, lessening potential athletic adaptations, and increasing the overall likelihood of mood-related illnesses (like depression or anxiety).
The solution to this is an intermediate stress load to maximize stress tolerance and sensitivity. This can be done by ensuring a young athlete is engaged in multiple types of sports, only specializing in a singular sport with age.
As athletes develop they are still susceptible to changes in the HPA Axis. Recreational drugs and alcohol can impede the ability of the adrenals to produce adrenaline under normal stress environments like sport-specific training. This, in theory, seems to indicate a higher training load would be needed to achieve similar results.
Regardless of an athletes age, this stress response is a reason why lifestyle stress should be minimized during periods of high-stress in training. This is why it is common for elite athletes to minimize contact with boyfriends/girlfriends during the training leading up to a big event. Similarly, chronic sleep deprivation limits the downregulation of the stress hormone cortisol, leading to chronically elevated cortisol (stress) levels.
By simultaneously minimizing various stressors system-wide and effectively delivering a training response to overcome, an athlete’s short and long-term performance can be drastically enhanced. The scope of the HPA Axis goes far beyond athlete development. The HPA Axis also plays crucial roles in immune system function, emotional stability, and even in the activation of various genes.
Throughout the entirety of my college tenure and time as a collegiate strength & conditioning coach, I was extremely averse to CrossFit. Though my stance hasn’t changed much regarding CrossFit as a means of enhancing athletic prowess, it has changed considerably towards using CrossFit as a means of enhancing fitness in the general population as well as CrossFit as a sport unto itself. My thoughts on CrossFit as a whole are best saved for another day, but my opinions on it have been trending more positively as of late.
During this time in my life, I would have never anticipated that moving forward I’d have a wonderful working relationship with a handful of CrossFit affiliates, as well as having a roster on-hand of over 300 CrossFit athletes that I actively assess, program, and am generally accountable for with regards to health and longevity in the sport.
With all this said, I wanted to do a break down of one of the Ruthless Performance Ex Phys Interventions, one of our flagship corrective exercise protocols. This internal program review will vary slightly from some in the past, as some information has been redacted/blurred. I don’t have any problems answering any questions, or providing explanations for these programs, but because of the highly individualized and semi-clinical nature of these programs, sharing the entirety of these programs can be counterproductive as many exercises that work for the client may not work for others.
I’ve only left the information visible on this program that I want to share (and am capable of covering) within the scope of this article. The Ruthless Performance Ex Phys Interventions are largely just corrective in nature and do not comprise the entirety of an athlete’s program. These are usually done in conjunction with our Remote Programming, Athlete Development Training, or in conjunction with other sports (like CrossFit, powerlifting, or weightlifting).
Ex Phys Interventions typically have a handful of components meant to mend well with existing programing. Programs are almost always comprised of warm-up, cool-down, activation work, and then from here may include some combination of at-home work, daily mobility circuits, weekly totals, etc..
So let’s dig in…
1. To Fix Something Rapidly, Do it Frequently
The daily exercises typically involved in our Ex Phys Interventions seek to address some underlying physical deviation causing undue strain on the musculoskeletal system. By assigning these exercises to do frequently, but with low-intensity, these can be completed shortly before bed, upon waking, during lunch breaks, and so on…
In this case, we’re dealing with an athlete that has prominent Anterior Pelvic Tilt (APT), slight Upper Cross Syndrome, and flexion-intolerant back pain (read more on flexion vs. extension intolerant back pain here). The at-home exercises were largely meant to remedy these issues, while requiring relatively little input from the CNS, allowing the athlete to perform these with a greater level of frequency.
This exercise circuit is listed to be performed 3x / week. More is better in the case of these exercises, but 3x / week is a frequency that an athlete can adhere to with relative ease.
2. Breathing Drills are Making a Come-Back
Breathing Drills are one of those topics that deserve their own article (if not their own book). There are many great resources to learn about the significance of proper breathing in greater specificity, but suffice it to say that in a cool-down, we are looking for activation of the diaphragm to help pull the athlete into a more parasympathetic-dominant state (the CNS should be the focal point of Exercise Science curricula rather than the muscular system, again another post, another day…).
The Deep Squat Belly Breathing w/ Lat Stretch drill is useful specifically with this athlete as we’re attempting to alter the CNS, while simultaneously helping the client feel better overhead, minimize input from various accessory breathing structures, and get some extra post-workout work on that deep squat position; mobility drills done post-workout seem to have longer-lasting effects on range of motion and function.
Additionally, I’ve left in the header of her assigned myofascial release work for a quick note… The effects of myofascial release seem to be slightly overblown BUT myofascial release is still important enough to make our corrective programs. By drastically cutting down the time on the rollers & lacrosse balls, but maintaining frequency, we can experience the benefits of myofascial work without it taking up more time than is needed. 15 seconds on the roller and LAX ball per muscle group as a standard and doubling this only for trouble areas.
3. Corrective Exercises Aren’t Always Crazy Stretches
I’ll be the first to admit that many of the exercises within our corrective protocols are complex and can be viewed as a novelty. This theme can encapsulate athletes’ perceptions generally towards correctives, but this isn’t always the case.
Both biceps femoris (legs) and biceps brachii (arms) tend to be an issue for CrossFit athletes… Since many CrossFit facilities tend to avoid use of machines, the hamstrings (biceps femoris) tend to be neglected, specifically the short head of the muscle, whose primary responsibility is lower leg flexion. In the case of the arms (biceps brachii), which are stimulated by exercises like traditional dumbbell or barbell curls, there again tends to be an imbalance between the long head and short head, leading to problems at the shoulder, elbow, and even wrist.
By adding in a weekly total for barbell curls, we can ensure the athlete is getting sufficient short-head activation without much complexity. Barbell curls, no weights, hit this total every week; that’s it.
4. Multi-Function Joints Need Multi-Function Stimulation
The joint-by-joint theory popularized by Physical Therapist Gray Cook can appear invalid at the shoulder, as it is comprised of two primary joints. But as the data points to, the theory fits as one joint provides stability (acromioclavicular joint) and the other yields greater range of motion (glenohumeral).
With this in mind, we’ve focused the athletes Day 1, 3, and 5 activation drills around ensuring these various functional components of the shoulder and thoracic spine are being stimulated.
The Half-Kneeling 90/90 External Rotation stimulates the Supraspinatus in isolation. I reference the significance of the Supraspinatus regularly, but its significance is largely rooted in its function as one of the few muscles that externally rotates the humerus. Bench T-Spines are ideal for wedging the shoulder blades into the thoracic spine, thus forcing some sagittal plane mobility (thoracic extension). And of course, this variation of carries works the rotator cuffs of the shoulder independently of one another, while ensuring large amounts of irradiation (tension directed upwards in the kinetic chain) because of the bottoms-up grip. This further supports the desired outcome of very active, healthy rotator cuffs.
For more details on any of our corrective exercise programs, send us an email at info@RuthlessPerformance.com. Program facilitation available in-person and online.
Today’s Q&A guest is our own sports nutritionist Jesse Rodriguez. Jesse has his own prolific history as a national-level swimmer for El Salvador and here in the United States competing in college and post-graduate for the University of Southern California. This all makes Jesse a world-class resource as not many people have competed at this level at any sport. With this background, plus his vast time spent in academia studying nutrition, interning with top sports teams, and the clinical work necessary for his Registered Dietitian status, we’re glad to have him on-board.
1. There are lots of people working with nutrition in some capacity, what sets you apart?
Firstly, I’m a licensed registered dietitian which means I went though extensive schooling and professional training. Secondly, I was an athlete for the majority of my life and I began studying/applying nutrition since I was 16. Lastly, I continue to read and study a lot! Mostly on clinical, biochemistry and sports nutrition research articles. Overall, I’ve been in this game for a long time and still aiming to be well-rounded in all elements of nutrition. (Editor’s Note: You read more about the difference between a Nutritionist and a Registered Dietitian here)
2. Given your personal and prolific history as a swimmer, you’re uniquely qualified to critique high-level sports nutrition, particularly in swimming. What are athletes doing right with their diet? What are they doing wrong?
Nutrition in sports has gained more popularity over the years and many athletes found the benefits of fueling appropriately. I’ve noticed that more athletes know about nutrient timing, and the importance of including carbs as fuel and protein for recovery. I think that many athletes know how to fuel around training times but during other times (i.e. dinner at home or restaurant), they tend to lack in nutritional knowledge. A lot of athletes still eat junk food throughout the day, maybe because they feel they can get away with it or something, but that’s our job as sports dietitians to correct. Additionally, building the appropriate plate according to their goals (i.e. body composition, better recovery) seems to be a problem along with maintaining hydration. Here’s an article I’ve written on RuthlessPerformance.com on this is.
3. Supplement must-do’s… What supplements (if any) are generally worth taking? What supplements are a scam?
Supplements for athletes typically aren’t necessary since athletes are eating more than the general population but it all depends on the athlete. Supplements would be necessary if an athlete is deficient in a nutrient like Iron or Vitamin D. Athletes following special diets like the vegan diet may need to supplement as well. As far as supplements for performance, the most studied and useful would be: Caffeine, Creatine, Beta-Alanine, Nitrates, and Sodium Bicarbonate (baking soda). It’s hard to say which supplements are a scam because they’re so many in the market and it can vary due to individual responses to them. With that being said, it’s important to make sure if you’re going to take supplements, that they’re 3rd party certified by organizations like the NSF.
4. You’ve gone pretty far in your journey through academia… With the emphasis of studies, objectivity, and research in academia there is still surprisingly lots of room for subjectivity and interpretations of results and outcomes. What are your thoughts on this? What can be done to fix or improve nutrition science?
Correct, I think there is always room for development in the field so it’s my job to follow along and stay up to date with the latest research. This for me is actually fun because I enjoy reading research papers and learning to new things. The science of nutrition can be very complex and as of now, I don’t have any solutions. I think that the correct messages (evidence-based results) need to be sent out to the general public so myths can be debunked. It’s more about nutrition education than anything at the moment.
5. From a more general standpoint, the headlines regarding nutrition are changing on a damn near daily basis. What elements of sports nutrition do you think are firmly established? What rules of nutrition have outlasted the scandalous and salacious headlines?
Hydration, nutrient timing, and recovery nutrition seems to be the foundation. There will always be a new thing that comes out, but those three are firmly established. Individualized nutrition is fundamental in sports nutrition and I think that will outlast any headline or diet (i.e keto diet, intermittent fasting, etc). I also think that sticking to the basics, such as nutrition from food rather than living off smoothies and supplements for example, will always have the edge. Of course, going back to supplements, this will depend on the individual’s status.
6. Where does sports nutrition go from here? What do you think we’ll be seeing in the coming years regarding nutrition? Gut health seems to be a hot topic as of late, what are your opinions on this? What should nutrition scientists place more emphasis on?
The basics of sports nutrition will remain the same and to be honest, I don’t see anything revolutionary coming soon. However, they’re new things coming along such as nutrigenomics and the importance of gut health, antioxidants, and periodizing nutrition which looks promising. Gut health has been popular lately and for good reason. Because of the gut and brain connection, I feel it’s important to treat your gut right just like most want to treat their blood sugar levels right. I think emphasis should be placed on education and sending the correct messages to athletes and the public. Researchers are doing a great job in nutritional science but there hasn’t been anything lately that can change the whole world of nutrition and its effect on humanity. If we can do this, that will be the next revolutionary thing.
**Editor’s Note: Jesse will also be featured on ‘Healthy Habits with Dr. T’ on Wednesday, Oct. 17th at 7:00 PM EST, we’ll post all of the details for event pre-registration and where to view it on our Twitter and Instagram.**
Want to learn more about Jesse or our various nutritional programs and consultations? Fill out the form below to get started!
With the vast expanse that is the winter swim season raipidly approaching, I wanted to take the time to yet again detail one of our swimming programs. In this particular case, we’re going to explain the Ruthless Performance methods that made this program so effective.
To provide context for this case study, we will be talking about a male swimmer, approaching the end of his high school career, who specailizes in short to mid-distance freestyle and butterfly…
We’ll be looking at ‘Day 2’ of his 3-day program, and what we’re doing to get him in-shape for the upcoming swim season.
1. Emphasising Both Activation & Mobility as Needed
Like most other programs we run our athletes through, this workout begins with a comprehenisve warm-up. Athletes are compartmentalized into a warm-up by age, ability, past injuries and training history. From there, we specialize and individualize the workout starting at our ‘A’ Exercises which are very rarely similar from one athlete to the next.
Landmine-based exercises have recently become a frequent addition to our programs because of the unusual loading parameters we see with this exercise variation. As opposed to a traditional barbell exercise, landmine exercises get lighter as the angle of the bar approaches 90 degrees; this has a wide array of benefits, but here we are using this to maximally loading the shoulder at the bottom of the press, while ensuring a greater ROM (range of motion) as we near the top of the exercise. Beyond just encouraging more ROM, this also assists in activation of the Serratus Anterior — a troublesome area for many athletes, which in the case of swimmers can be career ending.
In addition to creating muscle activation in the shoulder, we’re trying to use this ‘A’ circuit to enhance hip mobility. In our A1, the Half-Kneeling Overhead Landmine Press assists in creating hip mobility via Rectus Femoris Stretch caused by the Half-Kneeling position. Though this is a secondary component to the A1, hip mobility is the primary element of the A2 –the weighted cossack squat…
Because this swimmer is primarily a freestyler and butterflier, the hip is exposed to a relatively small ROM. By expanding this capacity in a structured and controlled training environment, we can help minimize injury (while maximizing power output) via enhanced ability of the hips to absorb and generate force outside of the saggital plane.
2. Creating a Neutral Spine Where and When Possible
In a previous article, I explained the differences between flexion and extension intolerant back pain, this particular athlete sits closer to the extension-intolerent end of the spectrum. To mitigate this, we’ve added Band Pull Aparts and 180 Degree Back Extensions as part of his ‘B’ exercise circuit.
Band Pull Aparts are one of the most common exercises within any of the Ruthless Performance programs, regardless of sport; but in the case of swimming, these provide countless benefits. Beyond the primary benefits to swimmers, like scapular control and improved stroke efficiency, we’ve added this as a means of minimizing kyphosis. Like many high school athletes who sit behind a desk for 6+ hours / day, this athlete demonstrates an internally rotated and kyphotic posture. The solution to these problems almost universally starts with a very high volume of band pull aparts.
Though the ‘B2’ is listed as 180 Back Extension, it is talked about and referred to internally as a 180 Hip Extension. Though this may seem semantic it is not. I won’t go into detail here again, though you can find more in our first installment of our Internal Program Review, where we go over this difference in detail.
The video below from our instagram also explains this to some extent with yet another one of our swimmers performing this exercise.
3. Enhance Cardiovascular Capacity, But do so Efficiently
The primary purpose of the off-season program should be to build up strength and other various capacities that are often neglected during the regular swim season. Going into the season, however, should at least provide some basic framework for sport-specific work capacity.
Another one of my frequent rants is that about the purpose and function of the rotator cuff… 4 anatomically independent muscles grouped together because of their function (physiology) with regards to the shoulder, which is simply to maintain the position of the humerus. With this in mind, any time we spend engaging and maintaining a stable shoulder, we are inherently training the rotator cuff. Here, we’re doing so concurrently with a few other goals in mind, enhancing cardiovascular capacity (as mentioned), but also encouraging overhead ROM with the slam ball, generating force outside of the saggital plane, and developing abdonimal activation/ trunk stability during both the C1 and C2 exercises.
Though these aren’t traditionally exercises performed for energy system training, we can manipulate the variables to ellicit this desired response. Rather than simply adding in more sets or extending the length of time to complete the exercises, we’ve focused in on the density component, which is simply the ability to do more work in the same period of time. A 5-minute time cap ensures that from weeks 1-4, the athlete is developing his work capacity, in a manner condusive to short to mid distance swimming events. As opposed to conventional wisdom, maintaining a high level of force output and muscular endurance over this relatively short period of time is all that we need for this particular workout going into more sport-specific pre-season swim training.
This post marks the first in our new Ruthless Perfomer Q&A series. Throughout this series we’ll be talking with various health and fitness influencers regarding their specific niche and how it effects the world of health and wellnessa at-large.
Today we’re joined by Dr. Touchinsky who established Blue Mountain Family Chiropractic in 2005. His early focus was helping people suffering with pain and injuries utilizing hands on chiropractic care. Within the first few years of practice, he realized that many of the cases seen required more than just physical treatment. People were dealing with issues caused by poor diet, lack of exercise, inadequate sleep, and other lifestyle related factors. However, due to a variety of reasons, none of their health care providers were addressing these issues. This lead Dr. Touchinsky to study and become certified in Functional Medicine.
What is Functional Medicine and why is this something you’re so engaged in?
Conventional medicine usually seeks to identify a problem, an injury, or an illness. Diagnosis and treatment of that diagnosis is their forte. They are the doctors of “what”. They want to know what is wrong with you, and then they apply the treatment designed for that problem.
The best way to describe functional medicine practitioners is we are the doctors of “why”. Why are you sick? Why do you have an autoimmune disease? Why do you have chronic fatigue? This “why” can vary… it may be poor gut health due to frequent use of antibiotics in the past, or nutrient deficiencies due to an inadequate diet, or excessive stress from work, overtraining in the gym, or lack of proper sleep and recovery. The “why” can vary from person to person so we look at each individual’s “why” so we can develop a plan for that person and not their disease.
Teach us something… What is something within health that you think many physically active, healthy individuals may be ignorant to (i.e. I am always sure to teach clients about the relationship between the lymphatic and muscular system)?
Gut health is supreme. “You are what you eat” is a common saying. However, it’s not that simple. It’s what we eat, digest, assimilate, and excrete. Our digestive system helps manage what our body takes in to help build muscle, health and repair all sorts of tissues including our vital organs, make neurochemical and hormones, etc. It also helps us get rid of the toxic by products of doing all of that. It’s both the fuel injector system and the exhaust system. If the gut is chronically inflamed it’s going to affect nutrient absorption. If there’s constipation, it’s like plugging up the exhaust pipe in your car or the chimney in your house. This affects health more than most people realize.
If you doubt that or this is a new concept to you, google “gut” and <insert health problem or disease name here> and take a look at what shows up.
What do you think is the easiest thing individuals already engaged in a fitness program can change about their daily routine to further improve their health?
Most people can benefit from eating less meals per day and eating within a 12 hour time period per day, with earlier being better. An example might be at 7am, 11am-1pm, and 5pm-7pm. Eating food disrupts normal equilibrium and places the body under stress. It’s a necessary function, but triggering that stress every few hours is not good. It’s beneficial to give the body plenty of time between our meals and then one long period per day of 12 hrs or more. There even some interesting research showing that more than 12 hours can be even more of an advantage. This is called intermittent fasting or time restricted feeding. This can be taken even a step further by doing full water fasting or a Fasting Mimicking Diet on occasion. For more information on that, search for fasting and Dr. Valter Longo.
As someone within the field, what do you think about the current state of chiropractic care? What are some common myths or concerns that you come across regularly? Are these concerns warranted?
Chiropractors practice methods that are the most effective means of addressing muscle, joint, and many nerve issues in my opinion. We have extensive training and spend our career seeing people with injuries and pain. Not only are we trained in treating these issues, but diagnosing them as well. This makes us a great first option when someone has something wrong. If it turns out it’s a more serious issue that requires a surgeon, or if there’s doubt and more testing needs to be done, we can refer or order testing such as blood tests, MRIs, and CT scans. Most of the time we can start treating immediately and begin providing patients relief on day one.
Some common myths that I see are we only treat the spine. That might be how we got our start over 100 years ago, but we now are trained on evaluating and treating a wide variety of issues. We’re not just “bone setters” either. I work just as much on the muscles as I do the bones and joints. Another common myth is that once you start going, you have to keep on going. There may be some cases of permanent injuries or those that have very demanding jobs where it makes sense to see someone once every few months to keep them in good shape, but in most cases my goal is to get the person out of pain, show them what they can do for themselves to prevent the problem from recurring, and then discharge them from care.
Most forward-thinking individuals working in healthcare admit it’s a rather flawed system. What do you think is the most troubling aspect of modern healthcare in America? What do you think is the easiest problem within healthcare to fix?
It’s a very flawed system. Health insurance dictates care and most providers end up treating to the insurance. Insurance payment to providers is based on what is done to a patient. It’s procedural based. That means that the more “stuff” that we do to patients, the more we bill, and the more we get paid. If you do less “stuff”, you get less payment. This only promotes overutilization of certain services. Additionally, an officer visit where your doctor diagnoses a common cold gets paid the same as a visit where they diagnose and (attempts to) manage diabetes. The latter is way more complicated and requires much more attention and expertise to handle. I could really go on and on, but I’ll leave it at that.
The easiest problem to fix is to take away the middleman. Take away insurance. That sounds horrible because it’s the only way most people can afford to see a doctor, but by taking away the middle man we would lower the costs for everyone. If people had to pay for everything out of pocket (at least up front), then they would help, along with the doctor, if a procedure or test is really necessary. If you doubt this, ask any provider, “do you tend to order more testing on people with or without insurance?” For those that truly can’t afford care, we can take the money we use to subsidize health insurance and set up free and reduced clinics. At least this would put money directly into communities and building facilities and paying providers, vs. sitting in the coffers of insurance companies to selectively dole out as they wish.
**Editor’s Note: John Matulevich of Ruthless Performance will be appearing on Dr. Touchinsky’s Podcast “Healthy Habits with Dr. T” this wednesday night. You can preregister to listen to the podcast at the address here or watch it live on facebook at: https://www.facebook.com/doctortouchinsky/ **