Podcast #168 from http://www.bengreenfieldfitness.com/2011/10/stop-chronic-pain/Introduction: In this episode, how to stop chronic pain forever, are marathons bad for your heart, supporting your lower back while swimming, splenda addiction, aspartic acid for boosting testosterone, vibram five fingers, PMS, fasted running and choosing bike wheels.Ben: Hey, folks, welcome back to the Ben Greenfield Fitness podcast and this week over at BenGreenfieldFitness.com, a couple of new articles came out. One was about topical magnesium and why I splatter that on my body everyday. Certainly it’s an interesting read and I guarantee you’re going to learn a lot of cool things about magnesium if you go over to BenGreenfieldFitness.com and read that. And then the other post was a video and an article about ways to stop mindless eating and I think you’ll probably pick up a few good tips from that as well, so head over to BenGreenfieldFitness.com if you haven’t seen those articles yet. Now, today’s featured topic is an interview with Dr. David Minkoff and it’s about pain, and really, some of the techniques that he uses down at Lifeworks Wellness Center in Florida, to work with people who have pain that just won’t seem to go away, whether it’s low back pain, muscle pain and chronic full-body pain, but if you are an athlete or someone who has experienced pain that you just can’t simply seem to stop, then you’ll pick up some things from this interview that should help you. I thought it was really interesting and he goes into some very cutting-edge techniques with which I wasn’t really familiar. So be sure to stay tuned to listen to that but first we’re going to have a few special announcements and then our listener Q and A.Special Announcements:Ben: So first of all, the Ben Greenfield Fitness show is now on Stitcher and Stitcher is a really cool free app that lets you listen to your shows on iPhone, android, Blackberry phone, whatever but it is an alternative to just like going in and downloading the show off iTunes. So Stitcher is totally free and because the Ben Greenfield Fitness show is on Stitcher now, you can go to Stitcher.com/Fitness and that’s the channel and if you register when you download the free app and you register, you get entered to win $100 if you just use code ‘Fitness’, so pretty easy to remember. Grab it at Stitcher.com/Fitness and then use promo code ‘Fitness’ to be entered for $100. So pretty cool, I’m a fan of Stitcher Smart Radio. So a few other things, next week I will be doing that live Q and A and during the live Q and A, it is a little bit different than Q and A’s that I’ve done in the past because this one is me answering all of
your questions about my books, my consulting services. I get so many questions from you, guys, about how I can help you achieve your goals that I decided to just answer them all. So I will put a link in the show notes where even if you can’t make it to next Wednesday, that’s Wednesday November 2nd, even if you can’t make it to next Wednesday’s live Q and A, you can log-in and ask your question beforehand and then during that actual Q and A, you can interact via audio, via Skype or just via typing through your computer, so I’ll put a link to that in the show notes as well. And a really cool special announcement for you triathletes out there, I finally have a 2012 triathlon camp scheduled that I‘m going to be attending, it’s going to be epic. Ironman world champion Scott Molina is going to be there, Ironman talk host John Newsom is going to be there and this is down in Kona, on the famous Ironman Hawaii course. It’s an all-inclusive camp and it will culminate with the Ironman 70.3 Hawaii race and that’s the race that I do every year down there, it’s actually a qualifier for Ironman Hawaii. That was actually the way the past couple of years that I personally qualified for Ironman Hawaii was racing that race. So it will be a week of swimming, biking and running they’ll kind of taper off as the race approaches. I’m going to be there, it’s going to be fantastic. Awesome lodging, awesome food, awesome company, pretty epic experience and I will put a link to all the full info on that in the show notes. Space is limited so you got to get in soon. I guarantee this thing is going to fill-up fast. So go to BenGreenfieldFitness.com and just head over to the show notes for this episode, Episode #168, and you’ll see that at the top of the special announcements where you can click and get in to that camp. So that about wraps up our special announcements. One quick word and then we’re going to launch into our listener Q and A.Listener Q and A:Listener: Hey, Ben, I’m calling about a paragraph that I saw in the September-October issue of Men’s Health and I know you talked about this before how being an ultra endurance athlete may not be healthy for you, so I’m going to read here what they say, says “You are on marathons year after year, must be super fit right? Maybe! In the Minneapolis Heart Institute study, men who have completes marathons for 25 consecutive years show surprising levels of arterial plaque, 62% more than sedentary men. Then the study was by Dr. Jonathan Schwartz and he says that the physical stress of training races elevated heart rate and blood pressure, so I just like you to discuss this for us. I know ultra endurance may not be healthy but they showed just completing marathons may be unhealthy. So, please let us know Ben and thank you so much and thanks for putting up this podcast.
Ben: Alright. So, the study that‘s being referred to is one from the Medicine and Science in Sports and Exercise Journal. It was done over in the University in Germany and what they did was study heart disease in marathon runners. They used a hundred runners, about 50 to 75 years old and all those runners had to have completed at least five marathons in the previous three years, so in the three years prior to them being actually studied. So, they ran them through in these battery of tests to assess how healthy their arteries were both of their heart and throughout the rest of their body. And then what they did was they used an ultrasound, they used something called electron beam computed tomography and a bunch of other methods to see how much plaque was in the arteries of these marathoners. They found plaque in the arteries of 90 of these runners so, basically all but ten of the runners. So, then, what they did, because this goes a step further, most of the magazines kind of reported that and stopped there, but what these research then did was they ran a bunch of statistical analysis to try and figure out what differentiated these runners that were plaque-free from the runners who had arterial plaque. And what they found out was that the subjects at the highest risk of having arterial plaque were increased risk of heart disease would actually already be identified as high risk by conventional heart disease analysis. For example, there’s one heart disease analysis that’s used quite commonly called the Framingham Risks Score that looks at your risk for heart disease based on a variety of different health factors, and all of these subjects whether or not they had been running would have been considered at higher risk for arterial plaque. So, there was kind of a big weakness to the study in that respect and basically what that comes down to is that being a runner didn’t really exclude these people or from having heart disease but it also did not cause them to have heart disease. It just so happen that a very large portion of these frequent runners were engaging in other lifestyle habits that were leaving them at high risk for heart disease. So, that’s kind of a weakness in having a relatively small study of just a hundred runners. I mean, for big health studies that are coming to major conclusions like this, you want a number of subjects that’s very significant. You want to get a thousand plus ideally and a lot of these studies that come to conclusions like this, you’re seeing 20,000-30,000 people; this is just a hundred people so while risk of arterial plaque formation is certainly something that you should be aware of and you should design your lifestyle around to reduce risk of, running a lot or doing marathons isn’t necessarily going to leave you at a higher risk for a heart attack. Now that being said, I will put a link to an article that I wrote in the show notes and the article is the “Top Ten Reasons That Exercise Is Bad For You” and in reason number two I talked about how exercise can hurt the heart.
In other words, wear and tear in years of heavy duty workouts or lifelong endurance exercise can weaken your heart muscles. It predisposes you to a condition that you see popping up in a lot of athletes especially pro-athletes called Ventricular Arrhythmia in which the heart beats erratically and it’s due to damage to the right chamber of the heart. This is usually due to excessive exercise with inadequate recovery or some type of mineral deficiency like magnesium deficiency or lack of proper electrolyte intake apart from exercise, constantly sweating and letting yourself become very sodium depleted. These type of things can cause some damage to the heart so my recommendation, and I give several such recommendations in the article: “Top Ten Reasons That Exercise Is Bad For You”, is that if you want to be that person for when exercise actually extends your life then don’t beat yourself up. It’s why pretty much every Ironman Program I write is based off of a maximum of about 15 hours a week of exercise and usually closer to anywhere between eight and 12 and the reason for that is because I am not a fan of extreme endurance exercise unless you’re doing it because A) you’re aware of the health risks of it and you don’t care and you’re willing to take those risks, whatever. You’re okay with dying five years early, if you’re living your life at that much faster of a pace, there’s nothing wrong with that, I don’t think. That’s the choice made by you. Or if you’re doing it to put money on the table if that’s your way of feeding your family. You’re a professional athlete, you exercise a lot, yes, you’re probably gonna do damage to your heart but so would other jobs like working in the coal mines. So I would eventually like to see if it’s possible to get really good at something like Ironman, I mean do Ironman in less than nine hours and be able to do it without doing as much damage to the body, without engaging in 20 to 30 hour training weeks but I think it’d be pretty difficult to do. I’m of the persuasion that Ironman isn’t the healthiest activity on the planet anyways. Marathon is slightly less intensive but still could be tough if you’re not recovering properly. So, hopefully that helps you out with your answer to that question. Remember, if you have a call-in question you can call to 877-209- 9439, that’s toll free to 877-209-9439 or if you’re a Skype user you can Skype to username: pacificfit and leave a message there.Listener: I’ve gotten in to the triathlon scene the last few years and then quite a few on the Sprints and Olympics and did my first 70.3 in September, 45 years old. I had a spinal fusion done in the L3 and L5 areas about 20 years ago. I had a bad accident that left me unable to walk and since regained my ability to walk and two shoulder reconstructions but my question is from a swimming standpoint, somehow I’ve got a lot of drag in the water probably because my spine is fused so I swim at an angle and I’m unable to get myself to plane in the water so I’ve tried increasing the speed on
my arms, I’ve talked to some coaches about different kick techniques, I’ve tried lowering my head to the water to have more water go over my shoulders. Basically, I still swim at an angle and have a lot of drag so when I come out of the water I’m usually pretty far back in the pack and then I have to really go all out on the run and bike which you should go all out anyways but I’m just looking at ways, techniques on maybe how to work with people with spinal injuries and how to plan a little better that ways so that may be I can, instead of finishing 50th in a race I could maybe break in to the top 30 or so.Ben: Well, John brings up a really valid point because spinal fusion is a surgical technique that’s used to join two or more vertebra and when that happens you can experience a significant loss of range in motion in the spine and specifically for an exercise like swimming that requires some hip rotation, sometimes pressing down with the hips, kicking from the hips, there can be a little bit of a frustration that occurs when you’re trying to swim and maintain that spine in the proper position. Now while there’s very little research out there on spinal fusion in swimmers, I thought about this a little bit and I came up with a couple of ideas for this gentleman who has a spinal fusion and wants to improve his swimming technique. And basically both would involve bracing the core musculature as you swim and this would be something that anyone with a weak core or back problems could probably benefit from when it comes to swimming and swimming technique. So the first would be kind of a do-it-yourself type of fix and that would be using like one of these muscle belts that are specifically design for weightlifting but grabbing like one of the Neoprene ones and actually wearing that as a lower back brace as you’re swimming to keep your back braced as you’re swimming. You would just wrap it around your waist and basically use that during your swim sets. Now, believe it or not there is a wet suit company that’s kind of a one step ahead of me here that built this type of brace into the actual wet suit and I’ve worn this wet suit before and the amount of lower back bracing that happens when you work is pretty significant. What they call it is a Core Power System that stabilizes your core, provides lower back support and gives you more powerful hip rotation so you can maintain a more stream line position in the water. I will put a link to this wet suit in the show notes but it’s called the Aqua Sphere Phantom Wet Suit, the Aqua Sphere Phantom Wet Suit. It’s a black and green wet suit and it is, in terms of wet suits that I’ve worn that give the greatest amount of support to the core, the best when it comes to that particular feature. Now a lot of people in my opinion don’t need that type of core support. However, if you have spinal fusion, if you have lower back issues, it’s certainly something that may benefit you to try. So, hope that helps you out, John, so check
that out. It’s the Aqua Sphere Phantom Wet Suit. I’ll put a link to it in the show notes.Yanet: How do I detox from Splenda? I only drink one coffee in the morning but I need eight Splendas or it is not sweet enough. I have tried Stevia, Agave, but they do not taste sweet to me no matter how much I put. Have I developed a sugar tolerance? I still want to drink my Espresso every morning, what do you recommend?Ben: Well, Splenda is definitely something that not only causes stimulation of neurotransmitters but actually can be neurotoxic and that’s a real issue with Splenda that, in addition to the fact that of all the artificial sweeteners that are out there, Splenda is the most damaging to your gut. It can reduce the amount of good bacteria in your intestines by about 50%. It can also increase the PH in your intestines and it can contribute to increases in body weight as well as affecting certain type of protein in your body that makes you less sensitive to things like supplements and medications so, Splenda in my opinion is bad news. It always shocks me how many people like body builders take Sucralose and Splenda when you take a look at it and it’s so bad for you. There are other artificial sweeteners out there, of course, but these are some of the issues with Splenda and it’s in a lot of stuff. If you turn around and look at the nutrition label of a lot of even health compounds, Splenda is in there. Splenda can also cause some shrinkage of your Thymus glands as well as enlarge your liver and your kidneys so it’s got some serious issues with it. It’s basically a sugar molecule that’s been chlorinated essentially so one of the issues of course is the ability to cause an addiction. Now anytime you’re talking about an addiction that’s caused by neurotransmitters, one of the things you want to think about are some of the same type of fixes you would use if you were addicted to sugar. And I put on an article over at BenGreenfieldFitness.com called “12 Dietary Supplements that can Control your Most Intense Carbohydrate Cravings” and in that article, I specifically bring up some things that would be considered like neurotransmitter or brain support supplements that can really help out if you do a lot of emotional eating or if you have a real heavy addiction something like an artificial sweetener so, one is L’ glutamine. You can get L glutamine in capsular form or powder form, it’s actually considered very good for recovery as well. If you didn’t want to take L glutamine you could also just take a whole amino acids supplement. I’ve talked about Master Amino Pattern on the show before. I’ll put a link to it when I talk about Dr. Minkoff, who I’m interviewing today because he’s the inventor of that stuff. That’s a full amino acid profile that could work in a similar way as L glutamine. There’s another one that can work really well on a situation like this called Gamma-AminoButyric Acid.
It’s abbreviated G-A-B-A and in that particular article the dietary supplements that can control your carbohydrate cravings article, I put a link to one of the things that I used as kind like of a pre-bed time GABA source that you could also take about 30 to 60 minutes before you eat and that may help a little bit as well. You can also just get GABA in its isolated form, from a supplements company. Diphenylalanine is another one that can help. Those would be the top three: L glutamine or an amino acid source supplement called Gamma-AminoButyric Acid or Diphenylalanine. Those would kind of be my top three that if I were addicted to artificial sweeteners, I would try and you would want to try them about 30 to 60 minutes kind of before you’d usually sit down to your cup of coffee and in the mean time I would, of the things that you could use in your coffee, I’d go with Stevia. Stevia would probably be the best that give you a little bit of sweetener. I know that it probably doesn’t taste quite as sweet to you as Splenda or sucralose, you could always try more Stevia though. It definitely doesn’t have the type of health risks associated with it that Splenda does so, good question.Kevin: What is your opinion of Aspartic acid as a natural testosterone booster? I’ve read a few reviews and studies and have yet to see any negatives.Ben: Well, aspartic acid is interesting. It actually does have some good studies behind it that shows that it’s able to increase testosterone levels specifically in men and there’s a couple of different ways that it does that both on a neurological level and it then also works down in your testes as well to help with testosterone production. So, basically in the brain it’s an agonist which means it’s a stimulant for a type of excitatory receptor in your brain called the glutamate receptor and that can actually modulate the release of testosterone down under. So that is one of the ways that it can work on a neurological level and the way that it can work hormonally is it can increase your testosterone syntheses by up regulating literally a part of your RNA that produces a protein that regulates your androgen synthesis or your sex hormone synthesis in the latex cells of your testes and so you up regulate that. You can raise the maximum amount of testosterone that can be produced by the testes. So, supplementing with the Aspartic acid can actually help and this question inspired me to do some research on this and I really liked most of the studies that I saw on aspartic acid. However, one thing that you should be aware of is that it works best when you use it with what is called an aromatase inhibitor and what at aromatase inhibitor is it’s something that basically slows down or stops the conversion of testosterone into estrogens. Basically, aromatase is an enzyme that helps to synthesize estrogen. So in terms of aromatase inhibitors there are certainly natural ones out there as
well as pharmaceutical drugs that are considered the aromatase inhibitors. I’m a bigger fan of natural aromatase inhibitors and what you’re going to be looking for are compounds that contain a natural plant based what are called flavonoids. So you want to eat a large amount of vegetables but one of the most powerful flavonoids that you could get that you’d want to look for is one called chrysin, that’s C-H-R-Y-S-I-N and if you were to combine aspartic acid with an aromatase inhibitor like that and track your testosterone levels at the same time just to see if you’re getting results. Research shows that there could be some good benefit from that and not a lot of risk versus like taking testosterone or injecting testosterone or using a patch or something like that which can actually shut down your body’s ability to produce it indigenously so I’m always a bigger fan of stimulating the body to produce it on its own versus giving the body some external source or something.Darren: I recently got a pair of vibram five fingers and I’m building up mileage. I know a few people who train in vibrams but then they race using standard running shoes. Would I be risking injury by racing in my standard shoes but training in minimal shoes like vibrams?Ben: Well, this is an interesting question. I ran a marathon and I did a lot of the training on trails and soft surfaces and the actual marathon itself was on a pavement, it was on a road the entire marathon. By about mile 16, although I’ve done a run up to 17 miles in my training, by mile 16 my joints were just pounded to hell and I felt horrible and my body simply wasn’t ready for that amount of pounding on those hard surfaces because I hadn’t prepared accordingly. However, what you’re talking about is a little bit safer approach. It’s racing in shoes that are a little bit more built up and can reduce impact forces a bit more and simply training in your minimalist shoes and while at first glance this would appear kind of safe, the issue is that your biomechanics significantly change when you shift from a minimalist shoe to a supportive shoe. The whole idea behind a minimalist shoes is they caused you to lean forward, use a little bit more of the mid to front fore foot when your foot strikes and to run with lightly softer feet in a higher cadence. Once you switch to standard shoes you’re biomechanics change so the muscles that you’re working in your feet, your ankles, your knees, your hips, your core possibly all the way up into your shoulders because it’s all connected via this kinetic chain, changes. So, when you’re using all these different muscles during 26.2 miles of a marathon, you really do risk injury in a great amount of discomfort even if it seems you’re racing in a little bit more cushiony format than you are when you’re training. If I were you, and you really want to train as much as possible in your minimalist shoes, is I
would, let’s say run in four times a week, I would do 3 sessions a week in your five fingers as it sounds like you’ve been doing. But then, for example, for like your longer aerobic run or like a mid distance tempo run, I’d wear the actual shoes that you plan on racing in so that your body really does get used to the different use of different muscles when you’re wearing those shoes so, that would be my approach. I would definitely include at least 1 session a week in the standard shoes but if you’re doing that you should be okay training the rest of your sessions in your minimalist shoes and then wearing your standard shoes for the actual race. You could also, if you wanted to try to wear your vibram five fingers in the race. In my opinion, that’s a bit risky even though the human foot is really cool and we’d like to think that’s designed to handle just about anything, I’m not quite sure it has, so to speak, evolved to handle asphalt surfaces for 26.2 miles.Tony: I have a question about my wife in her PMDD. It seems like the week before her period all hell breaks loose in our house so she went to see her doctor and they diagnosed her with PMDD based on her symptoms and prescribed her an anti-depressant. My wife is wondering what she can do different nutritionally so her adrenals start functioning correctly so I’m speaking for myself and my kids, Ben. Can you help my wife gain her sanity back?Ben: Well, PMDD is kind of like a PMS on steroids, pun intended. What happens with PMDD, which is technically called Premenstrual Dysphoric Disorder, is that the hormones become much more destabilized than they do during like PMS specifically the leading theory in terms of how PMDD is actually caused is that there is a lack of serotonin or a lack of sensitivity to serotonin which is a neurotransmitter and what happens is that since neurotransmitters like serotonin kind of mediate the fluctuations of these different hormones, these sex hormones in your body like progesterone and estrogen, testosterone, these things get way out of whack in specific phases of the menstrual cycle and you get very moody specifically because some of these hormones really assist with regulating areas of the cortex of your brain that’s responsible for regulating mood. So, you get a lot of issues going on and one of the reasons that they prescribe anti-depressant drugs for something like this is because most of the time anti-depressant drugs are selective serotonin reuptake inhibiters or SSRIs and those have shown to have an effect on your ability to be more sensitive to serotonin or produce more serotonin and they help to treat the mood. There are a lot of kind of side effect issues with SSRIs though since they are basically what would be considered a psychotropic drug. They have a lot of cardiovascular side effects, some sexual side effects, increased suicide risk, it can increase aggression, they can affect with your
carbohydrate metabolism and a lot of kind of issues with them. So,if I were in your wife’s shoes and I don’t want this to bemisconstrued as medical advice, I would certainly look into somenatural methods of boosting serotonin levels and also naturalmethods of kind of decreasing some of these symptoms of moodand depression disorders. So the first thing that I would consider isspecific type of amino acid that gets converted to serotonin in thebrain, it’s called tryptophan and it is basically a component ofprotein, so if you’re on a low protein diet you probably aren’tgetting enough tryptophan and specific foods that include a lot oftryptophan are things like turkey and fish and chicken, so a lot ofthese poultry-based meat products. Cottage cheese and cheese arealso good sources of tryptophan. A high quality egg like a farmraised Omega-3 eggs are really good and nuts and beans alsocontain good levels of tryptophan. So I would make sure that she’seating enough protein in her diet and getting enough tryptophanspecifically, and you can also supplement with a natural tryptophansupplement. Fats are really important since pretty much everyhormonal process requires essential fatty acids. So again I wouldrecommend those Omega 3 enhanced eggs in the diet, as well as afish a few times a week like salmon or sardines or mackerel or tuna.Make sure you’re also getting in your natural fat sources, avocadoesand nuts and flax seeds and eating some walnuts, guacamole, olivesand olive oil, pumpkin seeds, things of that nature. Along the samelines I would also be including fish oil in the diet, not necessarilybecause fish oil helps with the production of serotonin, but becausethe essential fatty acids that you get from fish oil are really going tohelp with your brain health and your mood regulation, so get on tofish oil. I assume your wife is exercising. Exercise is kind of a catch22 because there can be some adrenal fatigue involved as she’sexercising hard. I would say it’s somewhere in the range of 15 to 30minutes a day is fine, that’s enough to help with symptoms ofdepression. Technically, what they find in research is you only needabout 15 to 20 minutes of exercise a day to help you feel good andhelp produce some of those endorphins, some of those happyhormones like serotonin, like dopamine. So, about 15 to 20minutes a day, maximum 30 of a moderate exercise would help out.Definitely avoid anything that’s going to over stimulate Cortisol,drain the adrenal glands, affect hormone production, big three arecaffeine, sugar and alcohol, so really make sure that she’s limitingthose. If it was my wife I would be doing everything possible towean off caffeine, sugar and alcohol. Lots of sleep, really good formoderating serotonin levels, even if you got to start off by giving herof a little melatonin to help her sleep at night, getting seven to eighthours of sleep at night would be huge with this, as well. There’s oneof the things that I would look in to that can kind of slow down theprocess of serotonin breakdown. Chinese herbal extracts, what are
called adaptogenic herbs can be really good at this, rhodiola for example. Rhodiola extract is one example of an adaptogenic herb that can really help to slow down the process of serotonin breakdown. I’ve talked about Tian Chi before on the show, I’ve interviewed the guy that formulated that, that’s about 40 pounds worth of Chinese herbs that have been extracted and they’re fresh and they have been spread with Ethylene oxide or sat over in big bins in China for six years. They’re actually fresh herbs that you feel acting on your body and those are also something that I would recommend her trying out just go to BenGreenfieldFitness.com and do a search over there for Tian Chi, T-I-A-N C-H-I. Those would be the things that I would try so hopefully that helps out and keep us posted if, for any of you who asks a question and see good results, makes my day when you email me and tell me about positive results that you’ve had.Jesse: How many fasted runs should you do in a week? I do most of my running before my wife and kids get up or I get to work which means I haven’t eaten for at least 12 hours. I’m running four days a week and should I eat before some of these or is it okay to do all of your exercise fasted?Ben: Well, my response to this is that while there is some benefit to fasted exercise, specifically for enhancing your ability to use fat as a fuel and train you to use fat as a fuel, as well enhancing the up regulation of some of the components of your body that are responsible for things like anti-aging. There certainly can be a law of diminishing return because every time you work out on a carbohydrate depleted state, it can slightly weaken your immune system or make you more susceptible to infection. So I would be very careful especially if it is kind of leading up to a race to do a ton of fasted sessions that are intense. Easy fasted sessions are fine like an easy walk out the door, an easy jog, elliptical trainer or something like that, but like a hard weight training session or a hard tempo run, I’d avoid doing those in a fasted state when you’re in any type of situation where staying healthy and not being sick is a prime importance to you. The other thing that I would consider is that you don’t want to do, I would say more and I’m not basing this on research, I’ve just been basing this on how I feel with fasted exercise sessions, I wouldn’t do more than two hard work outs each week in a fasted state. And by fasted I do mean going 12-15 hours without fuel and then trying to throw down a hard work out. I really would not do that more than twice a week. For easy work outs you can do it every day of the week and you’d be fine just because you’re primarily burning fat as a fuel and you’ve got tens of thousands of calories of storage fat but if you’re dipping up to the point where your muscles burn or you’re breathing heavy, that’s the
sign that you are metabolizing carbohydrate and producing lactic acid and that is a sign that you could be stressing your body. You’re overstressing our body if you’re doing that day after day in a carbohydrate-depleted state, so just be careful. Remember that no matter what whether or not you’re a low carb for most folks I do recommend you get at least 400 calories of carbohydrate on a daily basis especially if you’re exercising.Bill: I know you used carbon clincher wheels by Gray but if you were to do it all over again with all the new wheels out there, would you consider a tubular tire to save a few grams? Also, are the claims of Super Aero wheels from Zipp Firecrest and profile making up real world difference for the 20 mile per hour riders?Ben: Well, this is a good question. So first let’s deal with the carbon clincher versus tubular question. Here’s the reason that I don’t use tubular, which are these sew up tires that tend to be a little bit lighter and traditionally up until the past few years when the clincher tires have gotten much better and faster, were faster than carbon clincher tires. But now, yes you save a little bit of weight but no research studies have shown that to necessarily be faster and also, the carbon clincher tires in my opinion, are a little bit less of a pain to deal with. They’re cheaper, you don’t have to glue them, in many cases the tubular although if you’re very good at changing them can be quicker to change, a lot of times I’ve seen athletes take a lot longer to change a tubular. When you do change a tubular, you’re not going to be able to have quite as well glue during the race so if you flat during a race, you risk the tire actually rolling out from underneath you when you corner and so if you flatted and you’re on a real undulating course with a lot of corners, you’re going to basically have to go slower; then there’s just a lot more pain and expensive valves in using a tubular versus a clincher. That’s why I personally used a carbon clincher wheel and the carbon clinchers have gotten to the point where they’re just as good and just as fast as the tubular. Now, we do have these newer wheels that are basically shaped a little bit differently like the Zip Fire Crests and basically what those are, is there what’s called the toroidal shape. It’s a little bit more aerodynamic and specifically produces less drag when you’re riding with an angular wind with a greater amount of what’s called yaw, which means that wind is hitting you from the sides and from an angle coming at you from the front. So, you don’t get blown around the road quite as much, you talk about a race like Iron Man Hawaii with all these side gusts. A wheel like that certainly is going to be more comfortable whether you’re going 20 miles an hour or 25 miles an hour or 15 miles an hour because it will help you stay a little bit more stable with that side wind. If you’re not having a deal with the wind it really doesn’t matter too
much but you’re not getting a lot more in terms of aerodynamic advantage but you’re certainly getting a little bit more in terms of handling advantage with the wheel like that. Now, your other question was whether or not it’s even worth it, if you’re slightly slower to get a faster wheel. Interestingly, in terms of the percentage of time saved, a slower rider is gonna save a greater percentage of time with aero wheels than a faster rider and that just basically has to do with the aerodynamics of the wheel at certain speeds. But if you’re a slow rider, you’re still going to get an advantage from an aero wheel in terms of time advantage you’re looking at right around the minute for a 40K Olympic distance triathlon around three minutes for a half Ironman Triathlon and about six to eight minutes for an Ironman Triathlon so that really starts to add up when it comes to the advantage of using a nice wheel. There are certainly some other things that can help you get more aero dynamic as well. Good time trial helmet is good; not using baggy clothing is certainly good. A bike fit is one of the best things that you can do and then using a natural bike that’s designed with the time trial frame or a frame that’s designed to be aerodynamic versus a standard road bike. It can also help out quite a bit so hopefully that helps you out with your wheel choice. The reason I liked those carbon clinchers from Gray is that they are one of the least expensive carbon clinchers out there. They’re a good wheel. I’ve had a lot of success with them. Just remember that if you’re getting nice aerodynamic wheel use it a little bit more often than just in your race. Throw it in your training right on those wheels every now and again, it kind of helps you learn how to handle the wheel in different conditions and helps you make these little micro corrections that help your body to handle or balance your bike with that different wheel on it and that can help you to be faster on race day. So, remember that anytime you get an aerodynamic wheel it’s a little bit trickier to balance in the handle so take that into account and practice with a little bit and hopefully that helps. Alright folks, that wraps up the questions for today so we’re going to move on to the interview about chronic pain with Dr. David Minkoff.Ben: Hey, folks it’s Ben Greenfield here and if you’ve been a fan of the Ben Greenfield Fitness Podcast for any period of time you are familiar with Ironman triathlete and physician, Dr. David Minkoff, who lives down in Florida and runs the Life Works Wellness Centre down there. He’s also the mastermind behind Master Amino Pattern, the amino acid that I used and recommend to a lot of other folks and he has some pretty cool new procedures that he’s been using to get really good recovery and performance results in athletes and people who are exercising a lot. And so, today we’re
going to go into those things and this is stuff that we haven’t talked about before on the show, but Dr. Minkoff is always on the cutting edge when it comes to this stuff so if you get something out of this interview you should go to BenGreenfieldFitness.com and do a search over there for Minkoff, that’s M-I-N-K-O-F-F and you’re going to find some of the previous podcasts we’ve done with Dr. Minkoff, as well as some articles that feature him and he’s got lots of very cool stuff. So, Dr. Minkoff, thank you for coming on the call today.Dr. Minkoff: Absolutely, Ben, it’s a fun to talk.Ben: So, you told me or telling me about two things in particular. In the first it was something that you called EECP which stands for Enhanced External Counter Pulsation, what in the heck is that and why would you use it in somebody who was injured or needed help?Dr. Minkoff: Well, originally this technology was developed probably 20 or 25 years ago and the purpose of it was to help people who has blocked arteries in their heart as an alternative to bypass surgery or putting stints in the heart or dilating up the heart blood vessels and the way that technology works is that a person lays on the table and they have blood pressure cuffs put on their lower legs, upper legs and lower abdomen and these blood pressure cuffs can be inflated in milliseconds and their blood pressure cuffs are connected to an EKG so that they can be filled up when the heart is in the resting phase so in the diastolic which is when the heart is in its relaxed phase, it’s when it heals. These blood pressure cuffs fill up all at the same time and they pump blood throughout the whole vascular system. Now, what happens is when this occurs, is that it makes blood flow in the internal organs of the chest and the legs and the genitals and the brain and the heart increase by about 25% and that increase puts a lot more blood in areas where normally wouldn’t be and it pumps a lot more oxygen in, in a lot more ways out and what they discovered in doing this is that in people who had blocked arteries first in their heart which where the original research was done, is that it would stimulate the body to grow new collateral blood vessels that is there’s the block, the blood can’t get through the heart muscle and the heart muscle would grow new little arteries around the block so that that muscle could get profuse and it could get blood. Now, this occurs because the stimulus activates the hormone in the body which is called Vascular Endothelial Growth Factor and what that mean is it’s a hormone that the body produces in response to this stimulation that makes new blood vessels grow and so someone gets in the machine, the treatments are for an hour. We do it an hour a day for a 35 total treatments and what you see is that you get new blood vessels growing around
where the old ones were and you get much better function of theheart and vascular system and when they compare this to doingstents in people or in doing bypass surgery in people with anginawhere they are getting chest pain with activity, they actually workbetter than both of those other technology after a five year period ofobserving people, there was no downside because nobody dies onthis technology, it’s very safe and it’s non-invasive so, you don’thave to open up your chest to put catheters in your heart and putlittle stents in the blood vessels because you don’t need to. This isan external treatment, it’s very safe in all age groups and it’s verywell tolerated. Now after a lot of experience with this, what theyfound is that it worked not only in the heart but it also worked forpeople who had erectile dysfunction, when they couldn’t get bloodflow into their penis, or in people who had peripheral heart diseasewhere they would walk and get chest pain or where their toes wouldget blue, where they would gangrene because they couldn’t getblood down there because their blood vessels were blocked and they,it would improve those people, too. And then somebody got thebright idea well what if it, would it work for things like fibromyalgiawhere people have areas in their muscles, especially, and usuallythese people complain mostly about their upper back, theirtrapezius, their rhomboids, where they have chronic pain, they’vechronic inflammation, they’ve reduced blood flow, they have lacticacid build up but it would also help these people because it makesthe profusion of blood in those areas greatly increase. And thensomebody got the idea well what would happen if you did this withathletes, could you recover faster? And so now, there areprofessional sports teams that put their athletes on this machineafter competition. So, they would finish a basketball game, all theguys would go down to the place, they get on this machine, they’dbe on it for an hour. It basically would hyper profuse their muscles,wash out the lactic acid, give their blood, their muscles a hugeincrease in blood and they would recover much faster. So, we’vehave some very exciting experiences with this. One of the guys thatis just finishing up now was a 66 year old gentleman, 67 year oldgentleman, who had been through regular cardiologist andsurgeons because he had blocked arteries in his heart and he hadgotten three stents in his heart, he also had blocked arteries in hisleg and in one of his legs he had a stent put in his upper, in hisartery up in his leg but he was still having a lot of trouble and theythought they were going to possibly have to amputate his footbecause even with the stent, his foot didn’t get very good bloodsupply and he had a numb leg because also he didn’t had a verygood blood supply and he was pretty much reduced to sittingaround the house, he’s got a big boat and he couldn’t go out in hisboat and he couldn’t be very active because he just didn’t feel welland he didn’t had very much energy and so he had been coming to
our clinic to get chelation therapy where we run some amino acids in his veins to try to clear out his arteries and veins and that had been helping him some but when we got the new EECP machine, we put him on there. And after his fourth treatment, now, when you can see the wave of heart pulsation when you do the treatment and when we first put him on you could see that his blood vessels were very stiff and they were very unresponsive but by the time he had 4 treatments, the wave pattern in his blood vessels have changed a lot and the blood vessel compliance elasticity within his arteries had changed a lot and they were much more responsive. I’d never seen this before but it was interesting that within only four treatments you could see a change. Now, that guy went home and when his wife came home she couldn’t find him and she started looking for him, got worried and she found him out in the backyard in the garden, working in the garden and she says what are you doing and he says I’m feeling better, I’ve had some energy and I felt like I could go pick some weeds and putter around here. So that was interesting. We just finished the 29th treatment and he told me this morning that yesterday he had dropped his car off to get service and his wife was supposed to pick him up but she couldn’t make it and he decided he was going to walk and he walked two and a quarter miles from the gas station, the service station where he’s getting his car fixed on with no leg pain and no cramping and the numbness in his leg is pretty much gone. So, this is a very exciting result in a very short period of time where you can so much improve someone’s circulation that they really feel better. So, there are a lot of applications to other things like I said in diabetic, in athletes, in people who have cerebral vascular, when they are getting TIAs, when they are not getting blood up to their brain or erectile dysfunction, where you can apply this and it really helps somebody so, that’s the kind of the overview on that particular application.Ben: So.Dr. Minkoff: And if you have some questions that I can..Ben: Yes, I do have one question. Is this Enhanced External Counterpulsation different in say like recovery boots or this NormaTec boots or the type of things that you see like a Triathlon Expose where people are getting these boots pumped up, full of pressure and then release pressure and then pump, is this kind of different?Dr. Minkoff: Well, the idea is similar although this thing goes with each heartbeat so, if you see somebody out on with these, they rock actually some of this guys I saw sleeping while they’re doing it but it actually blows up, if their heartbeat is 70 times a minute, this is
blowing up 70 times a minutes so it’s boom, boom, boom, boom, boom, so every time the heart beats and then as soon as it relaxes, these things fill up, force blood back to you then the heart beats again these things blow up so it’s very much faster and you can, you put a monitor on their finger so that you could watch the pulse waves and you can time these things so that you get an optimum wave where you really are getting profusion back into these little capillaries and these other blood vessels or you can just dial it in a lot better plus it’s a lot many more times.Ben: So, is this something that you would need to go to a health clinic to have done or is this something that you could like buy to use in your own home?Dr. Minkoff: Well, no you have to go to a clinic and get it done. There’s about, I think there’s about 700 tables in the United States.Ben: Okay.Dr. Minkoff: So, most of the time there are in cardiology offices. Unfortunately, the way the cardiologist look at this, is that only if you don’t need, if you’re too sick to get a stent put in your heart, or you’re too sick to get a bypass will they allow you to use this treatment which is unfortunate because cost-wise it’s very much less expensive than getting stents put in with a hard cast or an angioplasty or certainly from heart surgery, it isn’t even close and probably they don’t use it. But most of the people that are doing them like there are several tables in our, in the city that I’m in and I had a friend call up there because she wanted to get it done and they said really you can’t get it done unless your cardiologist said that you’re not a surgical candidate because you’re too sick and then we’ll do it. So, they don’t use them very often but in clinics like ours where we’re trying to be non-invasive, we’re trying to do, do no harm, to get people healthy without giving them pharmaceuticals and things unless they absolutely need it. You’re more likely to find it in a place like that and if you do a search for EECP, say Google search you can find clinics and you can find more explanations of the technology and videos of people getting it unless somebody wants more information.Ben: Perfect.Dr. Minkoff: It is a commitment because they got to come in everyday for 35 days so it’s seven weeks, five days a week, 1 hour but it’s, it doesn’t hurt, nobody pokes you, some people listen to music or some people go to sleep and I got two 90 year old now on the table, who, one of the guys has a blocked vessel on his leg that they want to do surgery on
and he was, it would mean general aesthetic and he just didn’t want to do that and actually, his wife, who has got memory problems, because she’s got decreased blood vessel, blood supply to her brain and they just started but again they, he could tell the difference but by the fourth treatment that he said boy, I’m feeling better, I’ve got some energy. I can really tell something good’s happening so it’s… any age group really is a candidate. If you’re pregnant you can’t do it, but pretty much, or if you have a blood clot in your leg you can’t do it but pretty much anybody else there’s no contraindication to it.Ben: Yes, and if you have lots of pain and discomfort it seems like an hour a day for a month is not a huge sacrifice, right?Dr. Minkoff: Well no, because if it’s, if you have a blocked artery in some place, chances are it’s going to greatly improve it and you’ll going to feel a lot better so, no it’s not. It’s more of a little commitment, it’s not really a sacrifice.Ben: So you talked about this other new thing that you’re doing called Prolozone? What exactly is Prolozone?Dr. Minkoff: Well, I’ve been doing Prolo Therapy for a long time and Prolo Therapy, prolo is short for the word proliferator, proliferative which means to get something to grow and in the, probably 20 years ago there was a physician in Ohio who discovered that a lot of times when people are having pain around joints, knee pain, back pain, neck pain, shoulder pain, ankle pain, that the reason for the pain was not a torn cartilage or not a disintegrated cartilage but the reason was that they had either through wear and tear or trauma or inadequate nutrition that the ligaments that held the joints together were stretched out and that the joints was then had too much mobility, it went too far in any given direction and it was unstable and that the body’s answer to that, to try to fix it, was to increase the resting muscle tension around the joint to try to hold it still. So, someone who’s got chronic low back pain, if you push on the muscles around their low back, you will find that they’re off and tender and they’re tight and they hurt and the reason is that the resting muscle tone in those muscles is too high, trying to keep that low back stable, so that those vertebrae don’t move around too much. And so he discovered that if you took some sugar water and you injected it in to where those ligaments attached to the bone, the sugar water would stimulate a healing response in the ligaments and tendons and they would shorten and thicken and you could make an unstable joint stable which would then result in reduction of chronic high level muscle tension and the pain will go away. And the guy would have stable joint. And probably 80 to 90% of the time it works and the only downside to it is sometimes it would
mean a bunch of shots around the joint and they hurt. So peoplewho have had results with it love it and are willing to put up with itbut some people are a bit squeamish or they can’t take it and they’drather try something else or use Advil or have an orthopedist go inthere and scope or do something else. Now, about last 8 to 10 years,another guy who’s a prolo therapist discovered that rather thandoing all those shots in all those ligaments, if you stuck the needlein the joints and you put a local anesthetic in there with some goodnutritional things like B Vitamins and Folic acid and B12 and somehomeopathic remedies like Traumeel or Zeal or you could alsostimulate healing response and then as soon as you injected thatstuff, you injected ozone into the joints, ozone is oxygen but insteadof having two oxygen molecules together which is what we breathe,a third one is added and there is an ozone manufacturing machineand probably a lot of people that are listening use ozonators as airfreshener and that they would then, but if you add ozone to the mixthat you get a healing response that works actually better than thesugar ad you don’t have to inject all the individual ligaments. Theozone spreads out into the joints, it spreads out in to thesurrounding tissue, it’s painless and it causes a huge increase inlocal tissue oxygenation and local tissue ATP and you get aremarkable healing response and it’s remarkable how fast it worksand how good it works, it’s better than Prolo Therapy. Now I did aguy yesterday, I did about four to five Prolo Therapy treatments onhis shoulder before I learned this. It helped his shoulder but he stillcouldn’t do pull-ups and he had to be very careful when he did this.He’s a very muscular guy, he’s very fit but he still had to reallywatch it and so he heard about this new thing and he came over andI did the Prolozone Therapy on him and in 48 hours he was doingpull-ups and he was doing dips and he came in to tell me that hecouldn’t believe how fast it worked and how good his shoulders feltand that’s been true of all the people that I’ve done – ankles, knees,shoulders, lower back. One of my nurse practitioners had chroniclow back pain; it has just been unresponsive to anything. We’vedone chiropractic and massage and pulse magnetic field and triggerpoint and Prolo Therapy and lasers and all the nutritional handlingsand her chronic low back pain has just not gotten better and I did acouple of Prolozone treatments one her back and in 48 hours shesaid, “I feel like I just got a miracle treatment, I feel so muchbetter.” So it’s one of the best things that I’ve ever seen and Ithought Prolo Therapy is really good except I would always cringe alittle bit because you do cause people pain and I’ve had it myselfand it hurts but this Prolozone is nothing. It’s one-needle stickusually and you don’t even feel that and then you get release and itisn’t perfect but it’s really good and so anybody out there if you havechronic pain on virtually any place I would see if there’s somebodywho’s doing Prolozone in your area and get a treatment or come
down to Florida or the guy who’s in Carson City, Nevada. His name is Shallen Berger, go see him. There’s guys in Northern California, there’s guys in Los Angeles who do this and it’s just a great treatment and you can really help somebody get out of chronic pain. The average is maybe three, maybe at most five treatments separated by two to three weeks but the response that I’ve gotten have been actually quicker than that and it’s fun to do it.Ben: Wow, cool. So, in addition to this Prolozone and the Pulsation Therapy, are there any other things that you want to bring out for folks who may have chronic pain or maybe need to detox or any other types of things that you’ve been doing that you would consider to be kind of new or cutting edge things?Dr. Minkoff: Well, I think the other thing, and I use a lot for myself which is, it’s PEM method, Pulse Electro Magnetic Field and the unit we used is called the PER 2000. Iif you search for that in Google you can see the machine. It’s used by the 49ers, it’s used by Shaquille O’neal, there’s quite a few sports teams that used it and this things is a fantastic device and the basic theory of this is about half of the energy that your body creates so you eat food and you breathe oxygen and your body makes energy out of that and about half of all the energy that your body makes is for one purpose and that purpose is so that the membrane that surrounds each cell in the body, trillions of cells, 13, 15 trillion cells, every one of those cells has an outer membrane and that membrane has to maintain an electronic charge. There’s a standing voltage in that membrane and that is how the cell can control what comes in and out and the cells help us determine by that membrane being able to maintain its electrical charge. Now half of the energy created in the body is solely to maintain that electrical charge. Now, if someone isn’t getting enough amino acids or enough B Vitamins or enough anti- oxidants or their membranes are… they’ve been eating a lot of bad fats, too many doughnuts and not enough Omega 3 oil and too many trans fats or too many Omega 6 fats and those membranes are structurally wrong. The body has substituted the wrong things in there in order to try to put something there instead of what it needs or there’s environmental toxins, there’s plastics in those membranes or there’s heavy metal to the extent that the cell then is poisoned and it can’t make energy or it substitutes things in those membranes that they don’t function right then the membrane can’t hold its resting charge. So for example, an average cell membrane has a resting charge of 70 or 75 millivolts. A cancer cell has a resting charge of maybe 16 or 20 millivolts that’s why it’s sick. Someone in chronic pain, the resting potential might be 25 or 30 millivolts and that’s why that thing isn’t working right because it can’t pump up its membrane to what it should be so that it can then
detox and it can pull in the nutrients that it need. If you put this pulse magnetic field device in an area of the body and what it is actually a pulse magnetic field, it’s a very brief, it’s probably a few hundredths of a second. It’s a magnetic wave that goes boom boom boom, you can feel it in an area say, so my thighs are sore. I know those things are in pain, they’ve been overworked and I put this thing over that area for three minutes. It will recharge the cell membrane. It’s almost like an external battery recharging your cell membrane and it lasts somewhere from four hours to a couple of days depending on the person and how bad the shape the membrane is but when that membrane potential recharges it then allows the cell to get active and detoxify itself or pull in nutrients that it needs so that it can then function better. Now, the guy that I go to massage to before I started using this thing, he said look I’ve done 38 Ironman and I’ve been doing high intensity exercise for a lot of years and he feels the back of my hamstrings and he says they’re like cobble stones. He said, “you just got too many miles on these things, I don’t know what I can do for you.” He’s a good guy and he’s a good masseuse. I started using the Pulse Magnetic Field about a half hour a day. I do my calves, my thighs, my hamstrings, my low back and my neck and after a couple of weeks he says to me one day, “what are you doing? Your legs feel like butter.” I said, “I’m doing this new thing and they feel better, they recover faster.” So it’s make a structural difference, it really makes a difference and so we sell these things, so we sell them in ten treatment blocks. Half hour treatment, 35 bucks, it’s cheap and the guy comes in and the technician does the areas of the body that are problem area. People with fibromyalgia or athletes that are over trained, it can really help if you do it. We have athletes that come in three times a week, they get the treatment and then they recover faster and this is also good for chronic pain. Chronic shoulder pain, some of these guys don’t want the injection therapy, they want this, so it’s great and you feel energized when you’re done. You can feel like your body is electrified to a certain extent because it’s pumped up with energy, so that’s another one. It’s relatively new and it’s available and so for athletes, tendonitis, chronic muscle sores, I think using that along with good nutrition, take your MAP, take your anti-oxidants, it’s really good.Ben: Yes, you know what, I think it’s amazing how many people actually are in this state of pain. You talked to a lot of people you perceived to be very fit looking athletes or people who seem to really have things figured out from the physical or physical appearance perspective and a lot of times there is a lot of pain going on, so I think a lot of these methods that you’re talking about are far superior to popping four Ibuprofens, three times a day.
Dr. Minkoff: Well, yes, because that stuff hurts you. It hurts you in the short run because see, in the whole idea of Prolo Therapy is a guy gets injured, and there’s supposed to be a natural inflammatory response that occurs to an injury where the body goes through healing response, it puts blood in there. It pumps in white blood cells, it pumps in fibroblasts, these are the cells that make connective tissue and they complete the cycle and you get a healing. If you put Advil in there, you block the healing response; it blocks the inflammatory response and the thing gets incomplete healing that’s why the thing doesn’t heal in the first place. Common theory in Prolo Therapy is that you create inflammation and then you let the cycle complete so the body can heal and I think you’re right. We know that the guys who take Advil after an injury that the healing area doesn’t heal right. The scar isn’t a good scar, it damages bone. A lot of guys with high blood pressure have taken too much Advil and they’ve damaged their kidneys and they’ve damaged their livers because they’ve been taking in anti-inflammatory too much, too long and it’s harmful and you’re better off with natural anti-inflammatory, proteolytic enzymes, Wobenzym, Vascuzyme, there’s a lot of bunch of different ones that can help with inflammation without turning off the response. DMSO, so that you get, you can allow the healing cycle to complete itself without putting yourself one step forward because it doesn’t hurt and then two steps back later. You set yourself up for re-injury which is what you really don’t want.Ben: Yes, and you’ve done 40 Ironman triathlons, right?Dr. Minkoff: I’ve done 38.Ben: 38, okay. Do you think you’ll get to 40?Dr. Minkoff: Oh, yes.Ben: Nice.Dr. Minkoff: I mean, I’m doing Ironman Wisconsin for next year. I may take up one more I’m not sure yet. So, yes I’m going to get to 40. I love it.Ben: Awesome. Well, folks, Dr. Minkoff really knows what he’s talking about. For any of you listeners who are down in Florida, he’s right there in Clearwater and I’ve been to his clinic and he really has a very cool thing going on, very cutting edge so I highly recommend that you go to BenGreenfieldFitness.com, listen to some of the other interviews that I’ve done with Dr. Minkoff. Like I said I take the amino acid supplement that he invented and created and get a great deal of success from that as do many of the athletes that I coach so I would check that out or just shoot me an email or leave me a
question on the show notes for this podcast if you have questions about that. So, very cool information about pain management, pain control and it really is very relevant stuff for people who are dealing with injuries or chronic pain from injuries and their active lifestyle. So thank you so much, Dr. Minkoff.Dr. Minkoff: You bet, Ben. Thanks for having me. And any time, it’s fun to talk.Ben: Well, folks that is going to wrap it up. If you’re listening in this podcast the day or the day after it comes out, please vote for the podcast at podcastawards.com, that’s podcastawards.com. Also, you can donate a dollar and you can do so by going to BenGreenfieldFitness.com and right there in the show notes for each of the podcast in the special announcements, there’s a big button that you can push that lets you donate $1 via PayPal to support this show and it really does help out. Now, remember everything that I talked about is in the show notes over at BenGreenfieldFitness.com for this episode, Episode #168. Don’t forget about that 2012 Ironman Hawaii Triathlon Camp. Also, don’t forget about next week’s live Q and A with me and there will be a link to both of those in the show notes. So, until next time this is Ben from BenGreenfieldFitness.com signing out. For personal nutrition, fitness or triathlon consulting, supplements, books or DVD’s from Ben Greenfield, please visit Pacific Elite Fitness at http://www.pacificfit.net