In this episode of the Flex Diet Podcast, I sit down with Dr. Jeremy Bettle, a performance director and applied sports scientist, to dig into what actually moves the needle for performance, recovery, and long-term resilience. We cover everything from high ankle sprains and injury prevention to smarter load management, and why understanding stress, recovery, and tissue capacity matters far more than chasing random training trends. Dr. Bettle shares insights from years of work across the NHL, NBA, and international sport, along with how elite performance systems can — and should — be translated to non-elite humans who want to train hard, recover better, and keep doing this for decades. Sponsors: Rogue: https://miket.me/rogue Beyond Power Voltra 1: https://www.beyond-power.com/michael13 Fitness Insider Newsletter: https://miketnelson.com/
In this episode of the Flex Diet Podcast, I sit down with Dr. Jeremy Bettle, a performance director and applied sports scientist, to dig into what actually moves the needle for performance, recovery, and long-term resilience.
We cover everything from high ankle sprains and injury prevention to smarter load management, and why understanding stress, recovery, and tissue capacity matters far more than chasing random training trends.
Dr. Bettle shares insights from years of work across the NHL, NBA, and international sport, along with how elite performance systems can — and should — be translated to non-elite humans who want to train hard, recover better, and keep doing this for decades.
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Speaker: [00:00:00] Welcome back to the Flex Diet Podcast. I'm your host, Dr. Mike T. Nelson. On this podcast, we talk about all things to increase muscle performance, improve body composition, and do all of it within a flexible framework without destroying your health. Today on the podcast we've got Dr. Jeremy Betel. He is a performance director and applied sports scientist who's worked across the NHL.
The NBA Major leagues and high Performance International Sport. His background spans injury prevention, return to play systems, load management, long-term athlete development, with a strong emphasis on integrating strength training, rehabilitation and recovery into cohesive performance models. So after many years of working on the professional level, he's now focusing on translating elite performance systems into real world.
Strategies for longevity, [00:01:00] resilience, and human performance. You can currently find him at Vitality Collective Performance. We'll put a link down below here and also check out the Vitality Collective podcast. You may even find some weird nerd like me on his podcast, which is great. So, uh, huge thanks to him for being on the podcast.
Uh, we had a really good discussion about wide range of things. Everything from injury prevention to return to play high ankle sprain, load management, training and recovery. Uh, what are some of the benefits for ecentric and isometric training, soft tissue injuries and how you can possibly prevent them recovery strategies, collaboration, and a whole lot more.
So I think you'll really enjoy this conversation. Again, even if you're not working in a team setting in any [00:02:00] form. Again, a lot of these concepts can be applied to yourself. So I take the concept of load management. That's generally done at a team level, but I use it all the time as we talked about in this podcast for my individual clients.
And you can listen to the podcast and get all the more details about, uh, what that is. So I think he'll really enjoy this conversation. Uh, he is a wealth of knowledge and was just super fun to chat with him about. All these things. Sponsors of the podcast today, if you want more information from me, be sure to check out my free newsletter.
Go to mike t nelson.com or go to the link down below. You can hop onto the newsletter completely free. We even send you a cool gift and you'll be able to get. Updated on all things performance, muscle body composition, and try to make the newsletters as entertaining as possible. So vast majority of the content for [00:03:00] me is on the private newsletter, which you can sign up for free at the link below.
Also, check out our friends over at Beyond Power with the VUL Ultra one. If you haven't seen it before, think of it as a super fancy cable system. But what's super cool about it is it allows you to do eccentric concentric. Uh, you can separate those two. So if you want a way to do heavier eccentric overload training, uh, this allows you to do that.
Also gives you feedback on each rep. This could be used for velocity based training if you want to go down that route. And then you can even do isometric testing. So for example. I put on the, the Iron Neck here the other day in the Extreme Human Performance Center, which is the Garage Gym, and I did some isometric neck testing left, right, front and back.
And what's cool about the V Ultra one is it allows you to do [00:04:00] isometric testing and it'll tell you exactly what it is. You can look for injury prevention or you can use it for training modality. So I really like it. It's been super super helpful. I am an affiliate for it, so if you do purchase it through the affiliate link, I do make a few shackles.
Um, but Elliot and the guys there have been super, super nice and it's had it now I think probably coming up on, is it over five months? And yeah, it's, it's, it's been working great. So highly recommend you check that out. Um, also check out our friends over at Rogue. Uh, this is an affiliate link also. Not only do they have great strength training equipment, plates, bumpers, all the basic essentials, you can pick up my favorite machine for increasing your capacity, which is the concept two rower.
Uh, rogue also has their own rower there too. It's pretty good. I, I like it, but overall I still like the concept too, a little bit better. Uh, but they did some cool stuff with it. But either way, [00:05:00] uh, you can check that out there or you can check out the Echo bike, which is great. I've got wonderful stuff there.
It is an affiliate link. So again, you are helping support the show by going through the link there. Same price to you. So those are the sponsors. Thank you so much for listening. Really appreciate it. And without further ado, here's this week's episode with Dr. Jeremy. Be.
Dr Mike T Nelson: Welcome to the program doc. How are you doing?
Dr Jeremy Bettle: Absolutely. Great, mate. Thanks so much for having me on. I'm super excited to be here.
Dr Mike T Nelson: Yeah, thank you so much. I was on your podcast, which was great, and I was like, oh, gotta get you on my podcast, because that was so much fun. Yeah,
Dr Jeremy Bettle: it mate, it was so much fun and super popular episode for us too.
Dr Mike T Nelson: Oh, thank you. Thank you. Very nice.
Dr Jeremy Bettle: Yeah. Yeah, it was great.
Dr Mike T Nelson: Today I wanna talk a little bit about, I would say I classified as injury adjacent injury related It. Yeah. And maybe because I'm a big Vikings fan that [00:06:00] I can't go anywhere on Instagram now I swear. You click on one video, you'll get everything else.
If you work in the fitness industry, you get all sorts of crazy stuff. Yeah. Just because you're in the fitness industry. But it seems so our quarterback that we have, JJ McCarthy, who hasn't played it as if this is recording, other than, basically a very short season so far had a high ankle sprain and the backup quarterback, the last game didn't go so well.
So now it seems like everyone is a high ankle sprain expert and they're like, he should be in there playing. It's been over two weeks. What are they doing? They're a bunch of idiots. They're trying to protect him. And which it's almost hilarious because you know that if they put him in and it was too early and he got injured or reinjured it, which again could exacerbate it, make the whole thing even longer, everyone would be like.
You're so stupid. Why'd you put him in knowing he wasn't? A hundred percent. It's like you can't you'll never win. And it's just, yeah. Glorious to me. Like these, [00:07:00] a lot of these people are saying this stuff have, as far as I can tell, no medical background, no physical therapy, no exercise, fizz, no. It just all of a sudden anointed themselves, the high ankle sprain, king or queen, and it should just follow what they say.
Dr Jeremy Bettle: Yeah. I have been that idiot being yelled out. Oh, so side, right. It's so funny. It is. It's the target always goes on to that staff who are caring for the player and it's funny, like even that statement like these guys are such idiots. They're trying to protect the player.
That's a stupid thing to do.
Dr Mike T Nelson: That's a bad thing. Right. I'm like, wait a minute. Isn't that like part of their job?
Dr Jeremy Bettle: Yeah. Isn't that what we're supposed to do is have our players be healthy and protected? Yeah. Yeah. So yeah, it's such an interesting one. And we went through a bunch with the Maple Leafs of high ankle sprained stuff.
It is such a different injury to the lateral ankle sprain, and I think people confused the two. They don't really, yes. It's not that it's just further up the ankle and it's still just a lateral [00:08:00] sprain. When you get into tearing that syn osmosis in between that tip fib and you start getting that separation the healing that requires so that you can put weight through it, right.
So that you can run and effectively, and it doesn't just re-tear every time you put your foot down. It's such a hard a hard injury to rehab and takes so much longer. And so you've really gotta be so patient and looking in from the outside. It's easy when you're on the outside and you've got nothing at stake, right?
Oh yeah. Oh, you should do this and you should do that and you should tell the coach this and you should tell the GM that. Go sit in the chair and then have those conversations and make those decisions and live with the consequences.
Dr Mike T Nelson: Yeah. 'cause it's your ass on the line too. Yeah. You got a lot of stuff in the game then.
Yeah.
Dr Jeremy Bettle: And your relationship with that player. Yeah. Right. You throw 'em out too early and they get a re-injury now they're looking at you. It's your trust with that player. Right. You hold 'em back too long. [00:09:00] 'cause they all want to play. These guys don't want to be sitting out.
Dr Mike T Nelson: Yeah. And it was a criticism in the rehab.
Someone in the press conference asked him, they said, well, are you ready to go? And he is yeah, hi. I'm doing practice. I'm going through everything. And he's well, when do you want to go out and play? He is I'll go now. Which of course the player's gonna say that when they're, he's gonna say that, yeah.
Close to getting ready. What do you expect them to say? And so then they're like, yeah. And then he's telling the, he said he's ready. Same thing.
Dr Jeremy Bettle: Yeah. Yeah. Well, that, that's like when the coach comes out and puts pressure on them or asks them, how you feeling? Can you play? Yeah, I can play.
And then they turn in, well, Jeremy's saying you can't, like what's going on? Yeah. So it that it's always that difficult period. Of course, the player wants to play, of course the staff want him to play for sure. But they have to get him in practice. They have to get him the reps so that he is now prepared for the, ultimately for the demands of the sport again, in order that he doesn't break down as soon as he's put into a slightly compromised position, because that [00:10:00] sport, the easiest way to prevent sporting injuries is stop playing sport.
Dr Mike T Nelson: Yeah. Yeah.
Dr Jeremy Bettle: Don't play. That's not the point. Right. So we have to expose them to a wide variety of extreme demands. Before we put them back on the field so that they, we know that they're prepared. Right. And we can make really informed, data-driven or data informed decisions with the player, with the coach and make sure it's right for the team.
'cause the worst thing you can do is instead of losing him for five weeks, now we let him come back two weeks too early and we lose him for the season.
Dr Mike T Nelson: Yeah.
Dr Jeremy Bettle: Right. That isn't a better outcome. Right. So we have to be really judicious. If he needs another week, that's better than losing him for another couple months.
Dr Mike T Nelson: Yeah. And it's also, it's week seven. It's not if you don't win this game, like your season is finished. It's okay, I, I get it. If you're close on the edge, it's a high stakes game. You don't [00:11:00] win, you don't have any more season. Oh. Okay. And then on the back end of that, you potentially have a lot more rest if you don't make it.
Earlier in the season too, and I would imagine this is just me theorizing, is that as a newer player, he didn't play much last year because of meniscus injury. That I would imagine that has to be taken into account also, because you just don't have the experience, you don't have the reps.
The last thing you want is not feeling a hundred percent stable, especially on a plant angle and things like that. You've got enough things to learn and things coming at you at a hundred miles an hour like that. You don't want that to add to the list of things you're wondering about when you're trying to play too.
Dr Jeremy Bettle: Yeah. And that's the thing, hesitation is an injury factor in and of itself. Yep. Right. So when we would return people to play, the last criteria that they would have to pass was actually the psychological readiness to return and that was, is the athlete psychologically. So that they can [00:12:00] say they're ready, but if they tell you, I, I don't have faith in my skill, I don't have faith in the ankle, I don't have faith in this, they're gonna be hesitant.
And so they're gonna plant with a stiffer leg, they're gonna shorten the stride a little bit, which is an a risk factor for another knee or ankle injury. Not to mention the fact that if you're half a step off the pace in the NFL, you're going to have your head taken off.
Dr Mike T Nelson: Yeah.
Dr Jeremy Bettle: Right. So now you're exposed to a whole array of other injuries because people are out there trying to kill you.
Right. So you have to have an athlete who is at their level of competence to compete at that level. And I think you're right in what you're saying on where in the season, there's a big risk reward element to that decision on when is he ready? If it's the Super Bowl, we're probably a little more tolerant to risk.
Sure could he get re hurt? Sure. If we're in the [00:13:00] Super Bowl, we might be a little more comfortable and he might be a little more comfortable that, look, this could go wrong. Okay, it's the Super Bowl week seven, going into wherever, Jacksonville, I don't know, you're probably not as tolerant to that risk, but hey, this could be a really bad outcome.
Okay, well then let's wait till next week. So, that's a big part of the decision making.
Dr Mike T Nelson: Yeah. And for this particular game, it's a Thursday night game, as is of as of this recording. So you have a really short week on top of it. Like you don't have normal practices, you can't get as many reps in. So even if you hypothetically were at a hundred percent.
Now you've got, are you gonna toss someone in who has less experience on a short week of practice on top of it versus, if it was a Sunday game might be a different decision. Okay, you can get a normal practice weekend, you can get all your other reps, that type of thing. Yeah. So I would imagine that's a factor too.
Dr Jeremy Bettle: For sure. Yeah, no question. [00:14:00] No question. They, we would always have them, basically a guy who was returning to play their last week of their program. They would replicate the team's schedule on their own. So cool. They would join in practice, they would practice full go. But if we had full games, they would have to do replica games on their own to match the team schedule if they're on a back to back.
That guy played, basically we, we figured, okay, how many shifts does he do during a game? What are his movement patterns? What's the duration of the shift? And he would do that in the morning of the game. That way when he came back. Into the lineup. It wasn't much of a jump for him. Right, right. We kept him, if we look at the acute chronic workload ratio, we kept it at that 1.3 that, that Tim Gats highlighted, we really liked it with, if it was just that next intuitive step.
And so I think you're right. If that's a Thursday turnaround, he really hasn't had the [00:15:00] chance to go through that full spectrum of demands. So we'd definitely want him to have that full run going into a game.
Dr Mike T Nelson: Yeah. Do you wanna talk a little bit about that in terms of load management and load spikes and, Tim Gson a lot of great work on that and I think it's a lot more, I don't wanna say popular now than what it was when it came out and now some of the things I see on the periphery are almost like, yeah, I don't wanna say too far in that direction.
I, it feels like in, in fitness and everything, there's like the pendulum swing of ooh. Yeah. Look at this new thing. I don't know. I don't know about this new thing. I don't know about it. Eh, it sounds crazy. And then, oh yeah, this definitely is a thing. And now, oh man, this is the thing. If you're not thing, it's the only thing.
You're not following this gospel. You
Dr Jeremy Bettle: idiots. What are you doing? Yeah. Yeah. Well, and that, that's how it went. And it, it's amazing 'cause Tim put out a couple of paper, a couple of papers. He's the most prolific research guy. So many freaking papers is crazy. It's nuts. He was actually top 10 [00:16:00] researcher, like in, in the history of like exercise science.
Oh wow. That's in terms of his productivity. Yeah. It's absolutely wild. People are making careers off just basically throwing mud at him on Twitter right now. Right. And it's crazy. There's this one guy, he's an Australian researcher. He's just absolutely slinging mud at Tim and it's. That's where this load management thing is has got so crazy and it's become something that, that Tim, who really popularized this stuff it's completely missing the point where it's the only thing.
Yeah. And people have read into it that this is a prediction model. If you go to 1.3, spike on your acute to chronic workload ratio. So I'll back up. Your chronic workload is essentially a rolling average of how much work have you done over four weeks. Right? So that's your conditioning, your acute workload.
It's how much have you done over the last week? So that's your stress and fatigue. And if [00:17:00] we take our stress way above our conditioning, our capacity, you're exposed to more risk of injury. Right? Tim identified a threshold of about 1.3. There's another threshold the other. At about 0.8 where you can be under prepared and you actually start de training.
So we like to oscillate between those two in load management. The point being that this is not the factor, it is not a prediction. It is a, an indicator of risk, right? So if we go to 1.3 and we stay there, we have exceeded your capacity for a long period of time, you are now exposed, right? And what that would come out as is fatigue.
And what fatigue does is it exposes your weakest link. So if you are super weak, you are gonna start getting sore really quick. 'cause [00:18:00] we have exposed that weakness. We found that strength was actually one of the biggest protective mechanisms for injury prevention.
Makes sense.
We would look to build this chronic workload as high as we could get it safely.
Right. So we actually, we thought you are actually twice as likely to get hurt if you're under prepared and you have low capacity versus if you're really highly prepared. And because it's hard to spike your load above a really high base of Yeah, where are you gonna go? Exactly right. So, yeah, no, I've got this I'm used to this, but you've gotta get there safely.
Yeah.
And that's where the 1.3 was a guide to us is let's not just go from zero to a hundred. You can't just throw them back into the game. So we would use that, that four weeks lead into a return to play to, to progressively step them up to that level where that replica week basically gave them a 1.3 into now full play.
So that was [00:19:00] our load management strategy and how we monitored it was we assessed all of the major risk factors for. Groin injuries, for example, in hockey, right? Five major risk factors. And we assess that every two weeks. We knew that if you were susceptible in any one of those areas and you put on top of that a spike in load, we had to do something to intervene.
We tried not to pull you from hockey, that was a last resort, but maybe you need some work with the strength coach. Maybe you need to be with the pt. Maybe you need to be with the massage therapist just to give the tissue the capacity to handle that extra load. So game by game, we would monitor training load, and I would just give a list of guys who were really spiking.
I would give that to our physical therapist and we would coordinate an intervention around that. So it wasn't so much load management in, okay, shut 'em [00:20:00] down, right? Or we weren't picking the 20 games that the guy's gonna miss. It was, how do we keep them in all 82 games? Right. And we actually set a franchise record for the most players to play 82 games in franchise history because we just kept monitoring, kept intervening and creating a really healthy squad.
Dr Mike T Nelson: Oh, that's awesome. I think of the modeling of it to, to my brain matches some of the stuff I've done in HRV and a lot of the work that's been published in HRV. It's like you have your acute number, you have your chronic number or kind of your running baseline. Take four weeks, seven week, whatever.
There's different ways you're looking at your coefficient of variation, right? So how much do you vary day by day? How much do you vary over time? And if you start seeing these huge changes like. Some shit's going on, right? If you, all of a sudden, right, HRV goes down significantly, you may not be at risk for that [00:21:00] day.
We could argue about acute things and activation and things like that. It's probably not the best. But if you are living now for three days at a very high level of stress, something's going on and your risk is now gonna become higher and higher, and you even see that in HRV on the opposite side, you can actually go too high parasympathetic.
Mm-hmm. And athlete's performance is just dog crap. Like especially in speed and power sports, right? So again, you want the kind of happy medium. If their HRV is real low, they may need more capacity. So we're gonna slowly build them up, especially with aerobic work, things like that nature, to get 'em to a level.
If it erodes a little bit over the season, it's probably gonna be okay. But if they start at a high level and erodes a little bit. We're okay as long as you're, coefficient of variation is not crazy. But if you start in the basement and you start eroding, like you're gonna be in a world of hurt by like week six.
Dr Jeremy Bettle: Exactly. Right. That's exactly how we looked at it. And that HRV is a, it's the canary in the coal mine, [00:22:00] isn't it? Right. Right. Just these were, for us, it was something to say, Hey, go investigate what levers we need to pull to get this guy back where he needs to be.
Dr Mike T Nelson: Yep.
Dr Jeremy Bettle: And that's what load was for us.
It wasn't that we were super worried that he was training or playing really hard, it's just that was exposing him to something that we might need to go look at. Right. To make sure this wasn't a problem. And I think anytime we start leaning on one metric too much, we start not using it for what it's for.
And it's easy to go yell at Tim because why? We went to 1.3 and no one got hurt, or this guy was at 1.1 and someone got hurt. Oh my god. Tim's an idiot. Oh geez. Right? The model
Dr Mike T Nelson: didn't cover every possible thing in a high speed back
Dr Jeremy Bettle: sport. It's crazy. So the thing we knew, like every year, if you were in the bottom 30th percentile for groin strength, and this was relative groin strength [00:23:00] you had a flare up in training camp every year.
Everyone in the bottom 30%. If you were weak, you had low local tissue capacity. You were, you are exposed. And so that e exactly to your point, if you start low and you start seeing a drop off or you start seeing a spike in training load, you're in real trouble. Right? It takes a longer time to get you to where you need to be.
Dr Mike T Nelson: Yeah. And the takeaway for the meatheads listening to this are like, oh, bro, but I only go to the gym every once in a while. Like the big thing that I took away from this literature was most people, if you're consistently going to the gym and you're on a halfway intelligent program, you probably don't need to worry about it.
But the caveat I would add is that if you go on vacation or if you get sick, or God forbid you're on bed rest or have surgery, or you see something dramatic, like you literally go from whatever your load was to potentially fricking zero, and [00:24:00] then you go from zero to potentially, if you're gonna go back into it and you're like, oh, I'm just gonna pick up at just where I was before, even though I had two weeks off of doing not much of anything.
To me that's. Where I changed a lot of my programming and so now I have what I call like a reentry week. Yeah. Even if you just had a light week and you were off like, we're probably gonna drop you to two sets, don't go push it too hard. And especially if the athlete is older. My concern, I dunno what your thought on this would be, is I'm more concerned about the soft tissue than I am the muscle itself, because I don't have any data to base this on per se, but my hypothesis is as you get older you have those load spikes.
Yes, it's a load spike, but I think it's a de training faster than what we realize of the soft tissue component and therefore when you go back into it, it's just not as adept as it was before if you go full potato back into what you were doing.
Dr Jeremy Bettle: [00:25:00] Yeah. And I think look, that's why men in their forties tear their Achilles so frequently
Dr Mike T Nelson: because Yeah,
Dr Jeremy Bettle: there's a lot of Achilles tears.
A lot of Achilles tears. Right. And it, we can spread that throughout the body, but we use this as the example. 'cause when we are young, we're playing basketball regularly. We're lifting weights, we are, we're doing jumping type activities. Then we get jobs and we go and sit at a desk for 10 years and we think that every three weeks we can go out and play basketball at the same level with none of the preparation.
And so, I think you're exactly right. And this is where I really caution people who are gonna start running programs, going and playing pickleball. Pickle balls are worse, man. That's, I think it's a high intensity, a stop start.
Dr Mike T Nelson: Yep.
Dr Jeremy Bettle: Right. So it, it's a really highly challenging thing. It doesn't look like it on the surface, but we can't go from sitting at the desk to a full speed stop start type sport without thinking we're gonna get some at least [00:26:00] irritation.
Maybe. Worst case scenario, we get an Achilles tear. So that's absolutely where I think this does come in is that we do go on vacation, we do get injuries. We do, surgeries are where these big drop offs in capacities come. We've gotta try and avoid these at all costs because we must regain that capacity after surgery.
We absolutely have to. Otherwise, we're so susceptible to these injuries and you and I joked on my podcast about the ego injury. Yeah. How many of those have I had? Right? Oh, yeah. Where I'm in the gym thinking no. I can hit this next list. I can
Dr Mike T Nelson: do one more. Hold my beard. Yeah,
Dr Jeremy Bettle: exactly.
This is exactly what I would tell my clients to do. Yeah. Yeah. So, yeah, I couldn't agree more. I think you've gotta be so conscious about exposing your body to these loads and to the types of activity. The forces the velocities and the directions you're gonna be moving in are critically important [00:27:00] because you can exceed your capacity in any of those three quite easily, especially after one of those interruptions.
Dr Mike T Nelson: Yeah. I told my little belt squad story before, but. I think bell squats are a great exercise. You can do full range of motion, no spinal loading. So even if you're kilted over a little bit, it's not loaded. So no big deal. So to me, that's like a great exercise for kite boarding, snowboarding. If you're gonna do a big drop and your knees are gonna end up in your chest, like you probably should train that type of motion.
But man, though, you get the weirdest looks in the gym, and I've had three people come up to me like over the course of the last six months of what are you doing? And because it, you think about it and you're like, oh, I guess it does look weird for someone to do a full loaded squat in the gym where their butt is on their ankles.
And the first question is but you can't lift as much. I'm like, no, I can't lift anywhere close to, if I just stopped a parallel. But I explained to 'em, what my goal is and what the thing is, and [00:28:00] yeah, they're like but I, yeah, I just think like you, you have to run the priority list of.
What is your top priority? What are you training for? What are you trying to do? Yeah. What risk is involved with that? Because if I'm trying to do a 20, 30 foot jump in the air, like kiteboarding, there's some shit that could go wrong, right? And I'm under no illusion that's like a safe thing to do. I think you can do in a safer manner for sure, and you can prepare your tissue for it.
But it's fun and I've accepted the risk for it. At the same time, I'm doing everything I can to mitigate the risk, which I think is a lot like, hockey, NFL, whatever, like these people have all signed up to play a very violent high velocity sport. By the nature of the sport, there are gonna be some probably pretty bad injuries.
However, you're also gonna do everything you humanly can to try to reduce that risk to as low as you possibly can at the same time.
Dr Jeremy Bettle: Exactly right. And you said it, [00:29:00] there is understanding the risk, understanding the demands of what you're going to ask your body to do. Right. That's the parallel between sport and coming out of sport.
Like you, you're non-athlete, it is no different to your athlete. Right. The end product of me jumping and LeBron jumping looks a little bit different, right? Just a smith. Yeah. But we've still gonna, we've still got to take those impacts. Same physics on landing, right? Same physics are involved. Same physiological systems, same mechanics.
And so if you want to kite surf, no problem. Right? If you want to pickleball, if you wanna play tennis, you name the sport you want to play, absolutely go and do it. It'll be great for brain health, cardiovascular health, muscular health your social community. But what you have to do is understand the demands of that activity, whatever it is.
It could be Helly scheme, understand the demands and work backwards from those where [00:30:00] you train your capacity to be able to do that. And that's how you'll have a long run playing your sport versus going out, doing it twice, tearing your Achilles and never going back out. Yeah. I think that's where we expose ourselves outside of sport.
'cause we're not thinking with that goal in mind.
Dr Mike T Nelson: Yeah. And in some environments it becomes almost paradoxical where I won't say his name, I dunno if I have permission to use it, but he was a intern in the NFL at a very popular team. He was in charge of one of their top players and he came in and they told him like, all right, you're in charge of that guy if he gets injured.
Just don't even say goodbye. Just pack your bags, just get in your car and go home. Right? Right. He was like the first test he did was this guy was a linebacker had a treadmill test and he made the mistake of running the two top athletes on the team next to each other on the [00:31:00] treadmill. And so he is looking over at the guy next to him and they had this contest all of a sudden in training to see who could, get the faster top speed.
And he is going, oh my God, I'm so screwed. Like I'm gonna get fired. And it's this weird culture of you definitely can injure anyone. You're playing in a controlled environment, like you have to be safe. But at the same time, like you said, with adaptations, you're literally training these two, 300 pound human beings to run full speed into another human being.
Another human. That's that big. If you don't train and you're not strong and you don't have the tissue and everything else, like being weak, you're gonna get injured also. So it's this balancing act all the time because you can't just not train because that's gonna be worse, but you can't go above and beyond the demands either because then you're at a risk of an injury in a sport that's already, prone to injuries just by the nature of it.
Dr Jeremy Bettle: Well, and that's where I think we've got to look at what load management [00:32:00] became. And similarly, as you're saying with HRV, we started measuring load, we identified that there were injuries at high load. And so we just thought, okay, well let's do everything we can to remove it.
both: Right,
Dr Jeremy Bettle: right. And as we did, what happened was, oops, injuries in the NBA doubled, right?
Yep. We got rid of practice, we got rid of shoot around, we got rid of just about every way we could load a player. Then we started telling them, okay, well now you're not gonna play these 20 games. Right? Right. Because we need to manage your load. So guys, we're just de training and becoming way more susceptible to injury.
So just like you said, we can't be too parasympathetic or too sympathetic, but we need to be able to have the range to operate at both ends. Like we wanted people to oscillate between that 1.3 and 0.8 because we need to be down here to recover, [00:33:00] but we also need to be up here to condition to actually improve our capacity.
So, so how do we balance effort and recovery? That's the key. It's not just being at 1.0 the whole time. 'cause then you're just going, no, you are what you are. Yep. Right, and that's the thing. You can't perform if you're two paray plates. So we need you to be. A little bit sympathetic in order to perform.
We just need you to be able to shut it off once you're done and come into a recovery state. So that oscillation is very important. And we mustn't protect ourselves from load. We must stress the body. We must keep working. We just need to do it in a safe way.
Dr Mike T Nelson: Yeah. I have a little concept I just call human dynamic range.
Basically, what's your low, what's your high, and how fast can you oscillate between them? Right? And this applies to heart rate, HRV, respiratory rate, minute ventilation, load management, like the same principle shows up across [00:34:00] multiple spectrums. Right? And if you lose that variability, like in pretty much all cases, that's not a good thing.
And again, I'm biased because my whole thesis was fine scale variability analysis across physiologic systems. So I seven years of doing that stuff wires your brain to look for it everywhere. But you see it show up time and time again. And it's a harder concept to explain because everybody likes linearity.
Everybody likes one number. Yeah. Wants things to be the same. What is the goal? What are we shooting for? It's no, you want a range. You want to be within a set range, and then can you oscillate between that range? Mm-hmm. And maybe safely over time. We could expand that range a little bit,
Dr Jeremy Bettle: yeah, that's exactly it. And I think, I love that you're looking for it everywhere. 'cause for me it is everywhere.
Dr Mike T Nelson: And you see it too, right? You see it across most systems.
Dr Jeremy Bettle: Yeah. And when you've pushed people at the highest level you really see their capacity. It's amazing [00:35:00] how robust the human body can be.
Oh, yeah. And having now I'm at both ends of the spectrum now. I've been in the NBA, the NHL Major League soccer and seen what those. People that are so far from the norm can do. And now many of my clients are in their eighties, but they can still do and still adapt to the stimulus.
Yeah. Again, it doesn't look like these guys, but everyone's improving in their eighties. Right? Everybody adapts. And so we can keep that range. And I think that's what the people in their eighties, how this becomes longevity for them is because we give them more robustness for a range of risk exposures.
Right. It's not that they're not going to trip, but can they catch themself? Mm-hmm. Right. Can they not fall if they trip? If they do fall, can they not break their hip? If they hurt their wrists, can they still get up without their hands? Right. So I think that [00:36:00] range is super, super important for everybody, especially in everyday life.
Dr Mike T Nelson: Yeah. And I also like the idea of, in engineering you call it a safety factor, which basically just means, Hey, we did all these calculations. We think the stress on this structure is X and safety factor too, which is multiply everything by two, so we're safe. Like it's this like physiologic headroom, like how much extra capacity do you have?
Because if you have those insults or you trip and fall if you watch videos of a lot of older people trip and fall, from what I've seen is most of the time the reflux is there and they get the position semi okay, but then they just fall. They just fold like a house of cards because they can't handle that impulse at that speed with that force, et cetera.
Dr Jeremy Bettle: Right, right. And that's exactly it. So think about what goes in, and this is why I think what. We focus a [00:37:00] lot on power training in our 18 bolts. Yes. Right. Because think about what you'd need, like you trip, first of all, you need the reactions. Yep. Now you need the fast twitch to be able to get your leg out in front of you.
Once you get that plant, as you said, now your quads got to fire with a rate of force development that actually can put the brakes on for you. It's gotta have the overall strength now to hold that position so you don't just crumple. Right. So there, there's so much that actually goes into not falling it.
It's a critical thing that we need, we should be training. All of us should be training for this. Well, I love sport, love tennis, love pickleball because it teaches you to stop and start. Oh yeah. Right. And there's not a much, not much better than going quickly into a lunge to play a drop shot to, to replicate that trip and fall.
So Yeah. I couldn't agree more that we just need to give people. The range and the capacity in all of these [00:38:00] different traits to be able to, like ultimately the longevity sport is don't fall down and hurt yourself,
Dr Mike T Nelson: right? Oh, definitely. Yeah. Yeah. Are, what are your thoughts about the centric portion of that?
My bias is probably, I'm highly biased because I helped write the second phasic two book from Cal Dietz that I think with newer technology now, like with the, like the K box or shout out to Elliot at Beyond Power of Vulture One, I think there's ways we can safely train eccentric now that might have been a little bit harder to do in the past, and I think that's a underrated thing, especially in older individuals.
Dr Jeremy Bettle: Yeah. We emphasize that so much they, that breaking effect, right? Your ability to slow down. I don't know that like with most people, even like getting them on a [00:39:00] K box would be the limiting factor or really super loading that eccentric is even necessary for a lot of people right away.
Dr Mike T Nelson: Sure.
Oh, I agree. Yeah. It's a progression for my
Dr Jeremy Bettle: people. It's, yeah, it's can you sit all the way down into the chair without dropping that last three inches?
Dr Mike T Nelson: Yeah. Because if you watch someone, it's good. Kaboom, boom.
Dr Jeremy Bettle: Yeah, exactly. So even just a really concent, right. Without even getting to where we've got to really put this specific emphasis on it, for me it was, it's been about can they control with good mechanics through the range of motion that they're gonna need to go through through the full.
Three phases, right? Can they eccentrically drop down, can they isometrically pause and then change direction And then we play with those velocities, right? Can they drop into a little faster and be able to turn it around quicker right. When as we start jumping [00:40:00] I just introduced drop jumps for an 83-year-old woman recently.
Oh, cool. And she's jumping off, I dunno, it must be, I'd say it's probably 18 or so inch box. Oh, nice. Jumping off the box, landing on the ground, jumping back up. Right. Doing a vertical jump off the landing so we can get you there. And that eccentric component, I think is vastly underrated in what's going to be important for you as
Dr Mike T Nelson: yeah.
And my brain goes to. I wonder if you did like aphasic type approach where you did more eccentric emphasis for two weeks, isometric for two weeks, and then put 'em back together the following two weeks. Yeah. Would you see faster progress? Because, I dunno, what you've seen also is that if I have somebody new who's younger and I have the choice of using some eccentric overload on 'em, not [00:41:00] all the time, but I would say a vast majority of the time, their form looks much better.
Almost instantly. There's something about that eccentric component that it's easier to get in positions. For some reason I'm, I've never been quite able to figure out or even really articulate.
Dr Jeremy Bettle: Yeah we absolutely use that, certainly at the college level a ton. Sure. But then, I'm seeing it a lot now where, for example, if somebody couldn't do pushups.
It wasn't very good at pushups with good form. If somebody couldn't do pullups yet we would have them if pushups, most of them could do, we would have them do a set of pushups to failure and then add 10 eccentric pushups onto the end.
both: Oh, nice. Because they could
Dr Jeremy Bettle: still manage that eccentric control after failure.
Yep. And so that's how we would use to boost the strength there. And similarly, if they couldn't do pull-ups, we would actually have them do eccentric pull-ups.
both: Mm-hmm.
Dr Jeremy Bettle: So we would [00:42:00] actually start them jumping up into the start position and control the descent on the pull-up to increase that capacity because we know you can produce more force and that adaptation does transfer into the concentric as you adapt.
But it's really the only way that you can load that movement effectively. Once you're past, being able to do a lap pull down or, mm-hmm. In our gym, we didn't have a lap pull down, so that's how we could get them exposed to that load and start improving that.
Dr Mike T Nelson: Cool. I like that. Yeah, I've used that a lot too.
And my other little thing in my head is just watching how fast the eccentric is and if it's mm-hmm. Too fast, it's oh, let's find something else for a little period of time. But for most people it works really well.
Dr Jeremy Bettle: Yeah. I think so. And that is a great place for people to observe their [00:43:00] movement, if you're dropping into your squat too quick and trying to bounce back at the other side.
Can you control that all the way through the movement? And, often you, again, you'll need to strip off a bit of weight and it can be a bit of a blow to the ego, but, great place to start is making sure that eccentric form is really good. 'cause again, that's where we found a lot of the injuries happening because it's such a high force movement to contract while lengthening and change direction.
So if a guy couldn't control their mechanics going into an eccentric, it was, there was a big flag for injury risk for us.
Dr Mike T Nelson: Have you found if say we're doing a squat and we're saying, okay, do it over six seconds and the athlete, it's done a few reps, they they have the timing down, then you add a little more load and load.
I've noticed that the portion where they move the fastest almost always matches to where their weakest position is also. Right. So again, like if you see a [00:44:00] squat and you're like good. The last maybe three inches, you're like, whoop. That tells me without having to. Load them to failure, that I can almost guarantee that's the weakest portion of the lift.
Have you observed something similar?
Dr Jeremy Bettle: Absolutely. I see it with athletes. I see it now with the population I'm working with. Think about the step up, right?
They'll try and jump through the first little
bit.
both: Yep.
Dr Jeremy Bettle: Right. And then they'll be good and they'll come down and about that same point, they'll drop down.
Right. So that you, this first portion for me absolutely. Is an indicator of where they're going to be challenged. I think it's it's a really interesting place to be, to set the range that you want them working in and start to gradually challenge it and expand that range so that we can build that capacity.
Dr Mike T Nelson: Yeah. I found that with even. On a lateral side. I realized this after I blew up my ankle in [00:45:00] 2005 that I thought I was all good. After about a year, everything was good, but I realized that even just on the width of a freaking curb, if I'm holding onto something and I put my toes up and I allowed myself just that difference of, three, four inches or whatever, like I would go down that last inch.
I was missing all of the time first from, the contralateral position. Yeah. And so I started testing a bunch of people, and I'm like, holy crap. In certain positions, it's crazy when you take away the compensation, so you can't bounce off. You have to keep your heel up and then to reverse out of it.
So I would have them drop, just touch your heel and come back up. It's amazing, like with just that small portion, how weak a lot of people, myself included, were, and that didn't even make sense to me until you realize, oh, they're almost always doing those movements with using the calf and using the toes.
Which is fine that's not bad, but it's interesting how when you start removing stuff to see what's underlying [00:46:00] it, you're like, oh, interesting.
Dr Jeremy Bettle: Yeah that exactly. Every time, especially with the athletes, we would really make sure that I want your heel to touch, not your Yep. Because it would always assist them on the way down and help them jump a little bit on the way back up every time.
Dr Mike T Nelson: Cool. What are your thoughts about, just in general, soft tissue injuries? Right, because I would say you do have athletes that do have muscular injuries. That does happen, but most of the stuff I've seen, even for most gym goers, it seems like it's the soft tissue that vast majority of the time, if they have an injury is what's breaking down.
Any thoughts on that? Would you agree with that? And then anything you can do to try to, reduce the risk in that area?
Dr Jeremy Bettle: Yeah we absolutely saw. We did see some true, like muscular injuries.
Dr Mike T Nelson: Yeah. You
Dr Jeremy Bettle: will. No, no question about that. But I think that tendon I think it's really [00:47:00] important to pay attention to not just your forced production.
We, we, one of the really interesting things we had to deal with in, in hockey was the Achilles tear, not playing hockey. It was when guys got home and started their their home workouts, actually dryland workouts because they'd been locked in a boot Oh. Eight months. And then with basically no vertical loading component whatsoever.
Sure. And then they go home and the guy's been waiting in Sweden for them for the last eight months. And he's raring to go for the off season and day one of plyo. Right. And he and guys ruptured their achilles. And we had that happen two or three times at different levels. And it became really important to us throughout the year to maintain the guys doing plyometric work.
And I, I think that's where the soft tissue really [00:48:00] comes involved is in those very fast movements. And because we, that's where we store our elastic energy versus the muscle. I think that's where we can see the higher instance during sports of these soft tissue injuries. So one of the mistakes we make is that we get super, super strong and we lift a lot of weight, but we don't do the plyometric work that is indicative of athletic performance.
We assume that the sport is enough, but I've always thought that we have to provide that stimulus to, to train and increase our capacity. In order to protect from the demands of the game. Mm-hmm. Something I did in the NBA, was when I was with the Nets was we would start every practice with basically three rounds of 50 jump ropes band around the ankles, 12 each way working the, for the glute mead.
And we'd just go [00:49:00] back and forth and we'd do three rounds of that just to make sure just that jump rope was gonna be enough for me for that Achilles. Right. We just had to keep giving it the stimulus and we didn't have any achille, achilles problems throughout that time. So that's the missing piece for me.
I think we shy away or we put our PLIs in blocks or Okay, now we're doing the power phase. Right. And we spend six weeks doing it, and then we don't do it again for another six months and think that is gonna continue to protect us. But it really, it just, it gets washed out. After the first three or so weeks if we, we stopped doing it.
So we started putting year round, we're doing p PIOs doesn't necessarily have to be the highest level year round. We're going in multiple directions, right? So we're gonna be doing lateral PIOs, vertical long jumps, things like horizontal play and really conditioning for, again those three, the force, the velocity and the [00:50:00] direction in order to protect against those specific types of injury.
Dr Mike T Nelson: Very cool. I know again, coach Cal Diets has talked a lot about the ankle rocker series. He has, but his both professional and a lot of his college hockey players of, and the first time he explained it to me, I was what are you talking about? They're playing a boot all the time, but then you realize that, oh, idiot, like the body is still sensing all of those structures and it might even be more imperative, like you were saying, because.
They're playing in a boot all the time. They're probably maybe not seeing some of those stresses that like an NBA player would see, because it's a different scenario. So it may be more important to provide an external stimulus to keep all those structures and everything else intact and up to par because the sport is a little bit different.
Dr Jeremy Bettle: Yeah, exactly right. And if you think something I didn't know about hockey before I went and worked in the NHL, was the edges on the [00:51:00] skates, right? And so you're on a blade, but that blade is actually grooved.
And so
You've got those two edges. So actually your dexterity in your foot as well is really important so that you can be more agile on the skate.
Our best guys were the ones who could find their edges quicker, stop, start, change direction, much more SubT. And through the foot and ankle versus, with the whole body movements.
both: Mm-hmm.
Dr Jeremy Bettle: So that it was really important parts as cal alludes to with that, to train the feet of the hockey player inside the boot is a very important thing.
Dr Mike T Nelson: Yeah. Yeah. Very cool. What are your thoughts about some of the work from Keith Barr stuff about, 20, 32nd isometrics and the thought being that you're so isometric. I was always thinking this never made sense to me. I'm like, wait a minute. Isometric contraction. There's no [00:52:00] muscle working there.
Well, hold on, I did a wall sit for 30 seconds. This sucked horribly. I didn't go anywhere. What the hell's going on? And then you realize the muscle is still obviously contracting to hold you there. And so his theory is that you're, if you're always doing impulse loading, like if this, the four fingers are like the size of the load.
It's only the path of least resistance that's getting used all the time by that soft tissue. And now if I apply a 32nd isometric, the muscle's contracting all the time and I reduce that stress shielding. So now I'm starting to get some force i'll beit at a low level through the rest of the soft tissue.
And because there's force going through it, the body comes in and goes, Hey, we gotta, strengthen some of these Yeah. For these areas. Up.
Dr Jeremy Bettle: Yeah. A hundred percent we would, one of the rules that we had for guys that we did an isometric groin exercise every single day.
both: Mm-hmm.
Dr Jeremy Bettle: Right? So there was a lot of [00:53:00] emphasis in the literature put onto eccentric loading.
We didn't find it particularly important, which we did what we knew in an eight two game schedule, we couldn't have the guys be soar. So it gave us a couple of benefits. The isometric groin allowed us to keep it active and keep it strong. Keep the contraction there, as you said, once, once you're fired and that motor unit starts to fatigue, another one has to kick in to help it.
Sure. So we got that sort of cycling and that more comprehensive look. But then we also got that tendon involved. Right. Because it starts to take some of that, that strain, and then if, adding into his work, if you add in some of the collagen Sure. Before you, you're working out.
I don't know how much it helped us, but we sure as hell did it.
Dr Mike T Nelson: Right. Yeah. Yeah. Because why not multiple teams? I'm like, yeah, I can show you his work. It's based on his research. [00:54:00] I don't know a downside. So I would do it if I were you.
Dr Jeremy Bettle: Right. Why wouldn't you? Yeah, exactly. Yeah. So that's exactly what we did.
Super, super important on the isometrics because as we said it doesn't make you sore. It does give you more muscle recruitment. It does recruit into the tendons. So why wouldn't we put that in, in, in high velocity sports like hockey, basketball and others.
Dr Mike T Nelson: Yeah. I've even programmed it more for just different, even recreational athletes and stuff now too.
Like I probably a year and a half ago started doing it more for grip stuff and stuff too. And the thing I noticed was almost immediately like any niggly issues I had in my forearms or my elbows or stuff like that, it literally just went away, which is interesting, crazy. And so then I got probably a little bit aggressive and I thought, okay, how far can I push this, and do like the 10 minutes per day.
And it was the weirdest thing, like you would get some [00:55:00] slight muscle soreness. And again, I would not recommend people go to the max like the first day, but I'm like, I'll try it. What the hell? But it was the weirdest soreness. It almost. Felt like my soft tissue was sore. I don't know if you've ever had that sensation before.
Like for grip stuff. The first time I ever did a Saxon bar, which for listeners is like a two by six, you can load with weight and so you're doing it with an open hand pinch, grip, and flexion at the same time. So like I lit up like everything from the end of my fingers all the way up, my whole like forearms to have that sort of soft tissue.
Yeah. Soreness. It's, yeah, it's a different sensation than muscle, but I'm like, I don't know, I just, it just feels like it's doing something.
Dr Jeremy Bettle: Yeah, it's like a deep ache, isn't it?
Dr Mike T Nelson: Yeah. It's a, it's an odd sensation that if people haven't had it, it's hard to explain 'cause it's not soreness, it's not like a niggly thing.
It just literally feels like your soft tissue [00:56:00] is just like somebody strung it tight. Almost.
Dr Jeremy Bettle: Yeah. Yeah. That, that absolutely yes. Resonates with me.
Dr Mike T Nelson: So do you think there is some benefit then you would agree with doing some isometrics, having, 12, 15 grams collagen, 40 to 60 minutes before?
So some of his early work with Shaw showed, use of vitamin C, debatable, if that makes a difference, but
Dr Jeremy Bettle: Yeah. Yeah. But throw it in anyway.
Dr Mike T Nelson: Yeah. It's not
Dr Jeremy Bettle: gonna harm anything. We always thought that with the athletes, right? And I am taking all of that learning now that we got with the athletes and applying that to the general population.
Awesome. So we just moved everything from, that we were doing here over to this new group. And because the principles are the same, of course it is, it's the same body. Yeah. Right. And so we just thought if you look at a problem. Everybody takes their perspective on it. From the nutritionist to the physical therapist, the athletic therapist the strength coach, the data science.
Right. The [00:57:00] technologist. If we all have a theory and a perspective on it, don't sit and argue which one of you is right. Do it all. Yeah. Right. It you get a more complete look at the, or you get a more complete solution. I'll say, because you might disagree with that guy. Well, you don't have the same training as him.
Right. Right. And why don't, why not do it? Find a way to make it a system and put it in. So absolutely. We would use the collagen, we would use the vitamin seeds. It would, we had protocols for every type of injury with different nutritional supplementation, different dietary recommendations. To complement the work we were doing, the stimulus that we were giving the body, so it had the building blocks it's leveraging everything that we think could have a benefit for the human body.
And doing it, not having your [00:58:00] physio and your strength coach arguing with one another over who's right or wrong. Just right. Just do both. Like why wouldn't you?
Dr Mike T Nelson: Yeah I agree with that. And then the land of recovery, is there any other things you use that I don't wanna say are on the bleeding edge, but again, may have limited data but you found useful?
So for example, like we were talking earlier about the shift wave chair that I'm testing now, which I think is pretty cool for downregulation. I have used some PEMF systems that I don't pretend to understand anything. The people who run the PEMF tell me, but. Some of the systems I have found seem to be beneficial.
Has there been other kind of weird, esoteric stuff where you're like, I don't know, man, but this thing seems to work?
Dr Jeremy Bettle: Yeah, so our approach to, well my approach to recovery evolved a lot throughout [00:59:00] my career. And I saw it replicated in young practitioners who were following behind me and I got to mentor.
I tried to control too much of it. I think we shouldn't feel like things that we do to the body are more important than the things that the body does to itself.
both: Mm-hmm.
Dr Jeremy Bettle: Right. If you are not eating right, if you are not sleeping if you are not getting good therapy, if you're not spending time with friends and family.
All of the esoteric stuff melts away. Yeah. Right. Don't, as a young practitioner, don't get guys to come in to the facility on four hours of sleep to sit in the n NormaTec boots so you can see them. Yeah. I never understood that. Right. Let them stay at home and get some sleep. I promise you just, even if you can't see them, it's better.
Yep. So [01:00:00] once we've got these big rocks that we know are very impactful in recovery. We found that everything after that was, do you think it's helping you recover? Yeah. Yeah. And you and I were just talking before we started, anything that gives me the perception of relaxation is going to put me a little more parasympathetic
Dr Mike T Nelson: For sure.
Dr Jeremy Bettle: Physiologically, are the norm tech boots going to heal the micro tears in my muscles and make me less sore? No, absolutely not. Does it put me in a more parasympathetic state? Because it feels amazing. I love it.
Dr Mike T Nelson: Yeah. And some people hate it. Like I was shocked. Like some people are like, this is the most horrible thing ever.
I'm like,
okay, let's not do it. And so for you, it won't help
Dr Jeremy Bettle: you recover, right? Because you'll be more stressed. Yep. So we've got to find, what are the things that you just enjoy doing? Like the red light bed, they have one at the gym that I train at. [01:01:00] Do I know if it's giving me a real physiological impact?
No. Am I laying there basically meditating without my phone for 20 minutes? Yes. Yeah, so and so it's beneficial to me. So I think that's where I go with recovery is. Some of the stuff I don't know. It probably doesn't directly physiologically impact the stuff that, that we or the company certainly will say it does, but I can tell you if you believe in it, if you enjoy it, if it makes you feel good and relaxed, you are recovering.
Dr Mike T Nelson: Yeah. Yeah. And I think that's like a huge component. A friend of mine, Frankie was saying it's state before skills, like the state of which you do something in matters a lot. And I've seen way too many esoteric recovery stuff forced on clients and athletes who [01:02:00] venomously opposed and hate it.
There wasn't any good research. It wasn't like, Hey, we're instituting a curfew, you should go to bed. It was like, let's try this crazy wackadoo thing and I don't like it, and Oh no, you have to do it. And then it's really? Is this a battle you wanna die on? I don't know, man. Yeah.
Dr Jeremy Bettle: Yeah. I had a buddy in the English Premier League, and they had a young kid who had just signed from Africa at, right out of, I don't know if it was the right to Dream Academy, but he'd come right out of an academy in Africa and this kid had just grown up playing there.
And you play and that you eat and you recover and off you go. And they bring him over and it's he's in the north of England and we are gonna fine you every time you don't do an ice bath.
Dr Mike T Nelson: Oh. Oh
Dr Jeremy Bettle: geez. Do you really think that kid who has never done an ice bath in his life, do you think that's going to be a recovery strategy for him?
Or do you [01:03:00] think that's gonna cause him so much stress? Oh yeah, it's actually gonna be, so he just signed his first contract. He just wrote a check for the fines for the year and just, yeah, I'm not doing this, but that's it. You just, you put so much weight on things that you think you can control and you can go tell the coach I got it.
I'm on top of him. They're recovering 'cause I can see them. I think it's an illusion.
Dr Mike T Nelson: Yeah. And a lot of times it's kinda sad that a lot of it's not measured. It's I don't care what your measure is. If you're want to take Omega wave, you want to take vertical jump, you wanna take HRV, you. Resting heart rate, respiratory pick one.
Like just pick one and then tell me you did said thing. Did it move the needle or not? And if you have some interesting data, cool. If it were me, oops. I may cut you a little bit more slack because you could demonstrate what's actually going on. But I guarantee that some of the [01:04:00] more esoteric stuff, like not all the data is gonna match and you are gonna have people where it went the opposite way mm-hmm.
Of what you find. And then you're back into, okay, well what do we do with the know the three people that got worse to be custom it further? Do we tell 'em they have to do it? What's our culture? Do we want everyone to do it? Do we allow them in individuals to do some stuff, not other stuff. And it just gets real messy, real fast.
Dr Jeremy Bettle: Yeah. We we had a point system in the end. If we were going to have the guys in the facility and they were going to recover, if there was something that we knew physiologically was going to have an impact, we would give it five points and down from there. Right. And so basically we would say, okay, everybody's gotta get 20 points.
Yeah. Right? So you could, if you do the thing that we think is most important, you get five points, you'd have to do less of it. [01:05:00] But if you just want to do this stuff that's you sitting in a chair on the normal tech with your phone, you're gonna have to be here for eight days. Yeah. So I think giving the athlete or for yourself, right, if you're a non-athlete, giving yourself agency and flexibility.
I think's really important. And then on, on the measure I think you actually put a post out. It might have even been today that you are still the best recovery monitor that's going.
Dr Mike T Nelson: Oh yeah.
Dr Jeremy Bettle: I always thought we can measure all this stuff with athletes, but maybe just ask them,
both: yeah, soccer, how are you feeling?
Dr Jeremy Bettle: Right. And they'll probably tell you, Hey, I feel like crap. Oh, I feel pretty good. And that is going to be as accurate or more than any of these bands that you can buy. And some of them frankly, are random number generators, right? And then we start making decisions based on what this data is that's coming out and we start outsourcing to [01:06:00] them.
You wake up, you slept great, you look at your watch, oh shoot, this says I didn't sleep well. This says my readiness. Shit, I can't train.
both: Yeah.
Dr Jeremy Bettle: And I think allowing things to guide and not make decisions is what's really important with that.
Dr Mike T Nelson: Yeah, and that was wild. I think I might've been telling you like the presentation I did for the F1 racing teams for their staff and stuff was, I've had all this data on respiratory rate and HRV and we had a great discussion.
The coaches had amazing questions and a buddy of mine also works for them. And he was saying he is yeah, he was saying that, just asking them qualitative how they feel what are your thoughts on that? I'm like, yeah, it's still probably one of the better metrics we have. Especially the caveat I would add is on athletes who are in very clear timed sports.
Obviously F1 is one of them. Track and field swimming, et cetera. Soccer, football, fuzzy sports. It gets a little bit harder to try to determine performance because it's [01:07:00] not as set and easy to see. So there's some caveats, but mm-hmm. Most. High level athletes, as long as you get a true interpretation of what they think, and they're not telling you what they think you want to hear.
Right. I think it's, the qualitative approach is still like really good to know.
Dr Jeremy Bettle: Yeah. And I, I think that there will always be those athletes that are telling the truth. Oh, for sure. Yeah. And so they give you a really good pulse on the rest of the group. Yep. I think those will be the guys that you can go into and be like, okay, for real.
Yeah. How are we doing? Right. How are we doing? And they'll tell you, especially if you've got a young team and nobody wants to be the guy that says, oh, I'm pretty tired.
Dr Mike T Nelson: Right, right. And you ask him in private, you don't take a poll in front of the group. Yeah. Everywhere here feels
like shit.
Oh Bob, you suck. Yeah.
Dr Jeremy Bettle: You're off the team. Bob.
Dr Mike T Nelson: There you go. Bob, you're out.
Yeah.
Cool. Anything else we missed in this [01:08:00] area you wanted to discuss?
Dr Jeremy Bettle: I think a really important thing like is the team we've talked about this a little bit, but understanding that everything happens on a spectrum, right? Low intensity to the highest intensity, and all of our skill sets are complimentary.
We talked about it a little bit with, the strength coach arguing with the physio or the athletic trainer a ton. You're both right. You both just do different things and I think there's if you're a practitioner or let's say if you're a person who's injured or an athlete who's injured, each one of your practitioners does something different.
They've gotta have enough self-awareness to know what their scope of practice is and what their expertise is. You've gotta have the humility to know when the next guy. Is better than you at the next job, right? So your athletic trainer can take them through the correctives into the weight room, but he is not a strength coach.
[01:09:00] Right? Your strength coach can take them back through correctives, but is not a physio or an athletic trainer. And so I think understanding when it's your job on that spectrum and as the person, maybe it's me and I'm out in the real world and I've got to go and rehab an injury knowing that I need a team of people, that you need your physical therapist, but they can only take you so far.
Once you're done with physical therapy, you have to finish the job and work with a personal trainer, work with a strength coach to take you up to the demands of the thing you're trying to return to. That's your, you've gotta bridge that gap too, right? We so often we get cuts off from PT by insurance.
Then we try and go right back to playing that sport. Yeah, right. We gotta do the work to finish the job and get back to those demands and really use the complimentary skill sets of everybody on our team in order to have a really complete and [01:10:00] comprehensive injury prevention program as we're rehabbing from an injury.
But same goes even if we're healthy we should still be using that full spectrum.
Dr Mike T Nelson: Yeah. My only 2 cents I would add is shocker. Talk to the other professionals you're working with. I know it sounds so stupid too, but I've seen too many organizations where it's a lot of more old school sports, I would say, where it's so siloed and you don't know what the limits of the silo are.
So I was in Europe Yeah. On a while ago, helping with very high level tennis guy. Obviously, I'm not gonna say their name. Everyone there, the staff was super cool. Everyone was wonderful. And I was there. He unfortunately got injured beforehand, so I'm trying to help them, piece this guy back together.
Long story short, could not get his glue to work. Well, his QL was over firing. Finally figured it out by having him lie his side doing some conversion shit with his eyes. And I'm talking to the [01:11:00] physio as I'm doing this and I'm like, Hey, cool, look, we got his glute to work. He looks over, he is yep. I'm like, you saw that, right?
He's yeah. He's that's better, right? He's yep. I'm like, do you wanna know how I did that? He is like, Nope. I'm like, no. He's ah, you're doing some shit with his eyes. And I'm like I couldn't figure it out. So later at lunch I asked the guy and I said, no offense man, but is this something you're not interested in?
And his answer, which is valid, was, we did ever learn that's not the thing. We do the standard hands-on manual therapy like somebody else does that stuff. And I'm thinking, oh, I always thought this was like a physio thing, but you don't know what the other people think is their boundary Yeah.
And what their lane is until you actually, talk to 'em about stuff. Which is, yeah. It's a weird thing. But everyone has their own boundary and then into places where it's the opposite, where everybody's trying to do everybody else's job and that's just as big a disaster too. So,
Dr Jeremy Bettle: [01:12:00] absolute disaster.
It's really funny. I was laughing when you mentioned it because the, probably the most controversial and thing I had to fight for the most when I got the, these performance director roles was I had a mandatory all staff meeting every morning to talk about the entire roster.
Dr Mike T Nelson: Oh, nice. So everybody knew
Dr Jeremy Bettle: everything.
Yep. And so we democratized all the information. Well, often in a sports team, information's currency. Yep. Right. If I keep all the information, everyone has to come to me. Yeah. Right. The coach has gotta talk to me. The GM's gotta talk to me. I'm important. And now we gave it to everyone. Yeah. And it was the hardest thing was just to get everybody to speak up in front of everyone else.
Okay, here's the athlete. At what are you doing with him? Pt, what are you doing with him? Strength coach, what are you doing? Here's the load management data for it. So now we all know and so I, I just, I can't emphasize that enough. Speak to [01:13:00] people, get together as a group. You will be better.
And the athletes at the center, right? Yeah. We all work for them. Right. So it helps when you understand what everybody's doing around that guy.
Dr Mike T Nelson: Yeah. And it's shocking and even I see this more in a handful of individual sports where. They have all great staff, like they've got the strength coach, they've got the skills coach, they've got an agent, and then they've got the physio, whatever, and then something falls apart or there's an injury or you can't resolve something, and then they start having set experts come in.
Who might be the best? Might not be the best, but there's no one who's at the head saying exactly what you're saying. Okay, what are you doing? What are you doing? What are you doing? Okay, we all on the same page here. It's like everyone does their own little thing and yeah, it seems just, and it's gotten a lot better, but it just seems so odd to me that there's no systems based approach there.
There should be one person. Yeah. Now whether that's the athlete or not, sometimes the [01:14:00] athlete wants that to be them, him or her. Sometimes they don't. There has to be some structure, like you said, of having a meeting. Here's what we're doing. Whoever the coordinator is, they might not be the expert in every area, but they're in charge of, let's make sure we're all working together.
And again, it's usually not a malicious thing. Nobody's trying to do anything wrong or malicious. It's just a lack of just simple communication. A lot of times
Dr Jeremy Bettle: It is. And that's what that role is for. My, that's what my career came to was being a performance director and being that the first guy to hold that role in, in a bunch of different clubs.
And it, it's somebody to make a decision. Yes. Right. If the AT and the PT can't decide if they're gonna argue if the strength coach is gonna argue with the, at, it's somebody impartial to listen to both and make a decision. Yep. Because we, when we start clashing heads and everyone digs the heels in 'cause they're the smartest guy in the room.
That's when we start [01:15:00] getting in trouble. We need somebody to say, okay, I've heard you all, this is the direction we're going and I'm responsible.
Dr Mike T Nelson: Yep. Yeah. And you take the responsibility too.
Dr Jeremy Bettle: Yeah. Right, right. And you are you guys that do your jobs. This is your job, this is your job. I take responsibility for the decisions that are made by the group going forward and it frees everybody up and allows people to thrive in their roles.
'cause they're not competing over who's in charge. 'cause there is a person in charge. And that's why it worked so well. When we're at the leaf and we're able to coordinate a system, we're able to have everybody do their job and ultimately go three and a half years without having an injury.
Because we all met, we all communicated and everybody did their role within the program. And it was a systems based approach as you say. We could do a whole nother podcast on this.
Dr Mike T Nelson: Yeah. Last part I'll have you tell the story of how athletes came in and I think the analogy you [01:16:00] used was they like get in a little raft and they flow down the river.
Right. They go to each station. The next station. The next station. Which, yeah. To me that's so brilliant because I think people underestimate, even for themselves, like just offloading stuff to a coach, offloading stuff to someone who's an expert who's looking out for you. So your job is execution. If you have the money, maybe hire someone to help with food prep.
But even at the highest level, having, if it were me as an athlete, knowing that, okay, I just show up and everything's taken care of. Is this thing the next thing, the cognitive burden I guess, for lack of a better word, just gets reduced so much.
Dr Jeremy Bettle: Yeah. Just taking that decision fatigue off.
Yeah. The guys and just so it's exactly as you said, like the way I viewed it was when the guy parks his car in the parking lot. He steps out his car into a river and he just gets swept along by the current, right. So when they would walk in, we designed the environment so that much of the system happened to the athlete.
Yes. Right. [01:17:00] It's all the behavioral economics theories, Daniel Kahneman and those guys mm-hmm. Where the nudge principles. So we knew as he walked through the door, we built a kitchen, hired chefs hired the registered dietician. So we knew what breakfast he needed. So when he walked through the door, the chef handed it to him.
Right. We had some buffet style stuff and we put the stuff they wanted to eat, we wanted them to eat at the start, so we knew they would load their plate rather than being an athlete driven training room, they had appointments. So everybody had to be on the table for their appointment at least once a week.
So we knew they were getting a checkup on the table once a week. Preventative maintenance. We had a team left. Everybody knew when everybody had to be in the weight room. They were individualized programs, but everybody's in there at the same time. Everybody's hitting these big things that we knew were gonna be impactful.
Right. It doesn't have to be as complicated [01:18:00] as you think.
both: Yeah.
Dr Jeremy Bettle: They would go through, they had a a meeting with the head coach. His meetings were exactly four minutes and 20 seconds every day. So four minutes, 20 seconds. You're on the ice with the skills coaches, you're on the ice for practice. You come off, you do your recovery and you go through any individual what you need to do.
You'll eat, you get out. Now, in that system, it was so hard for them to not be bought in, but how do you work hard enough to not be in that system? No, I'm gonna eat what I want to eat. Okay. Where are you gonna get it from? Yeah. Yeah. I'm I don't like the trainers. I'm not going on the table.
Well, you have to. Yeah. Yeah. Like I'm not a guy who lifts. Well, all of your teammates are lifting. Yep. Right? And you're not gonna be in the weight room and not lift, so it was structured. I think almost over structured it at some times. I go back and forth. Did we take away too much of their decision making?
But [01:19:00] we had a pretty young team and we were teaching them professionalism and the guys hated the regimented nature of it when we first put it in. But I bet they loved it at the end. Loved it. Yep. Loved it. Because by forcing them to be in the system, they saw the benefits of it. And so they loved it.
Right. If they never participated in it, they'd never see the benefits, and so who cares? But because we forced their hand at the start. Go in and getting treated every week versus waiting until your groins blown up.
both: Yeah.
Dr Jeremy Bettle: It's very different feeling. Right. You feel good all the time. And we just thought let's monitor this stuff and let's design that program now.
And as we learn more about them and as we test and monitor more we run through their groin monitoring every two weeks and we measure everything they do now. It becomes their program that, that is guiding them through. And we optimize each guy [01:20:00] every day. And so they just feel amazing all the time. And it's all from systematizing and just have as much of your environment designed so your stuff you need to do happens to you that you don't have to think about it as possible.
'cause it makes it so, so much easier.
Dr Mike T Nelson: Yeah. And even if someone is just a general fitness person, like I. Can't tell people like how much, just have a rower, have a bike in your garage, have a couple kettlebells, like you don't need a fancy gym. Like I'm a weirdo. Like I love spending money in my garage gym.
It's amazing. Yeah. But you don't need to go to that extreme, just have something like, for God's sakes, pre-cook some protein for the week. Because like you said, like you're just hedging the deck, rigging the system in your favor. Yeah. It's just gonna be a lot easier. You're gonna reduce that sort of effort and it's just gonna make it a lot easier.
Dr Jeremy Bettle: Yeah.
At the very least. Yeah. Have it in the fridge, marinating. Yeah. [01:21:00] Because if guarantee Wednesday night, you're gonna be too tired to cook. Yes. Yeah. All the best intentions when like at some point it's going off the rails. Right. So just, yeah just have the system ready and make it as easy as possible to execute.
Because you said it on our show the best program is the one that you do. It's like execution. Oh, for sure. If we put together the perfect program, but by Wednesday we're tired and we don't do it anymore. It's no good. So I think that's the one. Find what works for you that you can do every day and absolutely stick with it.
Dr Mike T Nelson: Yeah. It's a violent consistency. And then, have a little bit of flexibility in your program. It's as long as it gets done, most of my clients know as long as it gets done at the end of the week, that's by far the biggest thing. If you wanna flip days around, you need to finish part of it.
You need to take this day and split it into two days. Great. That's awesome. Is that optimal? No. [01:22:00] But is it gonna be close enough? Yes. Is it gonna be infinitely better than you skipping half of the week? Oh, by far.
Dr Jeremy Bettle: Right. And understand if you are under periods of stress I've got clients, in, in massive periods of stress.
And so it's okay to go into a maintenance program. Oh, for sure. And just do a little bit for a period of time to keep yourself going. Just to do something. 'cause it, it would be really easy to either burn yourself out or just go way off the rails. Just stop altogether. Yeah.
Dr Mike T Nelson: And it doesn't take that much to to keep where you're at.
If you've been exercising for a while, it doesn't take too much. Like you may not be at your peak, you may not feel amazing, but just doing one or two sessions a week is light. Years above f all nothing. Yeah. Yeah.
Dr Jeremy Bettle: Most certainly is.
Dr Mike T Nelson: Awesome. Well, where can people find more about you?
Dr Jeremy Bettle: Yeah. So, basically everywhere we are at Vitality [01:23:00] Collective performance, so that's Instagram, that's LinkedIn.
And on YouTube we're developing the YouTube, all of our podcasts go on there. And then our podcast is the Vitality Collective Podcast. Love people to follow along with that. We have some great guests, including Dr. Mike.
Dr Mike T Nelson: Yeah, it was on there. It was fun. Yeah.
Dr Jeremy Bettle: Yeah. So, so yeah, that, those are the main places we'd love people to follow along with what we're doing.
We're trying to bring all of this content and network out of sport and give as much of the knowledge away as we can. So it'd be great to see people following along.
Dr Mike T Nelson: Awesome. And who is your general kind of target audience? Is it pretty, pretty wide?
Dr Jeremy Bettle: Yeah, very wide. We are it's anyone with a human body.
There we go. So we're casting a bit of a net. So on. We are looking at basically it's people mid forties and up. Okay. It, we're looking at it, this is a vitality program. It's all aspects of health, and so we're really creating strategies for people around that longevity but really around how do [01:24:00] you thrive, right?
How do you live the absolute best life possible and keep doing the things that you love doing for as long as you can do them? So, it the target audience is in, in that sort of 45 and up range because that's when you wake up and you back hurts because you slept, right? Yeah. The first time that happens, you start thinking about your longevity, right?
So yeah.
Dr Mike T Nelson: Yeah, definitely. That's
Dr Jeremy Bettle: be a really good demographic for us.
Dr Mike T Nelson: Awesome. Well, yeah, I would highly encourage everyone to check out all the great stuff you've got going on, and thank you so much for being on the podcast. Really appreciate it.
Dr Jeremy Bettle: Yeah. Dr. Mike, thanks so much. I really appreciate the opportunity.
Thank you.
Speaker 2: Thank you so much for listening to the podcast. As always, really appreciate it. Uh, huge. Thanks Dr. Jeremy Betel for all the great discussion we had here today. I hope you can apply some of this to your training or maybe you're in a team, uh, setting there. [01:25:00] Also, make sure to check out all of his great stuff over at his website, all the wonderful services and everything that he provides, which are all top notch.
And then also check out his podcast. Didn't even look for the episode that I did. There he is. Got a lot of other really cool guests on there also. And you can even follow him on the old social media. Tell him I said hello. Our sponsors, uh, my own business. So check out if you wanna be on the newsletter.
We've got tons of great information that goes out on a pretty much daily basis, try to make them entertaining and useful, and it's completely free. And if you don't even like it, you could sign up and then you could unsubscribe if you want. But, uh, check it out below. We'll send you a cool free gift. Like 90% of the content I put out now, uh, goes directly to the newsletter.
So hop onto that. Check out our friends over at Beyond Power with the VUL Ultra one. You're looking for a way to do eccentric training, concentric training. You can even measure [01:26:00] ISO metrics. You can do ISO kinetics. You can do all of it with one device. You can bolt onto a power rack or they have other methods of attaching it to different, uh, areas or devices and it's been super helpful.
I've used it literally almost every time I've been training in the gym here. And as I mentioned at the top of the show, I was doing some isometric neck training the other day and it's always something cool I find to do with it. Last sponsor, check out our friends over at Rogue. If you're looking for strength equipment, bumper plates.
Dumbbells or my favorite piece of capacity training equipment, the concept two rower. You can check them out there now. Those are affiliate links, so it does help support the show. Thank you so much for listening. If you could do us a favor and hit the like, subscribe, download, leave us a review, comment, all that great stuff helps us with the old algorithms to keep getting wonderful, great guests, uh, completely free for you.[01:27:00]
So thank you so much, greatly appreciate it. I'll talk to all of you next week.
Speaker 3: There's something wrong with his hearing aid. Yeah. What's wrong? I can't hear with it.
Speaker 4: Oh, no wonder. It's too far away.
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