Dr. Peter Attia
speaker
5,258 appearances
36 recordings
6 series
first heard Jan 2024
last heard Jun 2025
Dr. Peter Attia’s voice in public audio — every appearance, attributed to the second.
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Discuss a framework for assessing and treating individuals, heightening the importance of understanding from between movement patterns, functional asymmetries, and personalized rehab approaches. Talk about some specific case studies, including Kyler's work with professional athletes and others to demonstrate the benefits of individualized strategies.
the role of fear in movement and rehabilitation and how overcoming mental barriers is just as crucial as physical recovery, actionable strategies for you to assess your own movement patterns and implement proactive training techniques to build strength and longevity.
Now, in addition to this conversation, Kyler also filmed a short series of videos in the gym demonstrating exercises for common issues like lower back, neck, shoulder, and knee pain. These are designed to help you put some of these concepts from today's episode into action. The videos are only available to subscribers and can be found on the show notes page for this episode.
So without further delay, please enjoy my conversation with Kyler Brown. Kyler, wonderful to have you. Yeah, thanks for having me.
I want to kind of give folks a little bit of a sense of what you and I came up with a few years ago in the throes of my recovery from shoulder surgery and why that gave us this idea to take two things that seemed quite unrelated at the time, my recovery from an injury, coupled with this idea that I'd been
marinating around this idea of a centenary decathlon in a marginal decade and why we decided to kind of put the best ideas or the themes of these together. So how does that sound? Sounds great. All right. So let's see, you and I met four years ago as soon as I moved to Austin. I don't even remember what we worked on because I think it was just like preventative stuff.
That's right. You're right. We were probably a couple months in maybe, and it was clear that I was nursing this bad shoulder. Um, And I knew what was going on because I had torn the labrum before. The diagnosis, I remember, was actually made in 2009. I had my first arthrogram in 2009.
For folks listening who don't know what that is, an arthrogram is an MRI where prior to you going in the scanner, the radiologist takes a needle about yay long, like four inches long. shoots the needle into the capsule and injects contrast so that it really allows the MRI to show the labrum and how much it's detached from the glenoid fossa.
And so it was patently clear at that time I had a torn labrum. It was significantly torn, but not as torn as it would be 13 years later. But I had largely avoided surgery by doing as much as I could to strengthen the rotator cuff. And frankly, I was afraid to have surgery. That was the bottom line is I didn't want
to trade one problem for another, meaning I didn't want to trade pain and instability for immobility. And I saw that as the trade-off. Folks listening probably recall that I had a podcast. I did a sit-down discussion with Alton, who is the amazing surgeon, Alton Baron, who ultimately did the repair. But what I was most impressed by in that experience, which turned out to be wildly positive, was
that immediately you and Alton started working as a team. And maybe you could talk a little bit about what you guys decided to do in the six, I think it was eight weeks we knew prior to surgery. We scheduled it such that you could do something before then. What was that discussion like?
I need to be strong. Basically, I needed to be able to hunt in September. So we backed out of that, said the surgery needs to be no later than March. It was January. And then the question was, should you do the surgery right away or do you use two months to prehab?
And so tell me how you thought about that.
So the things that I remember, which are probably fewer details than what you remember, is one, how much rotator cuff work we did ahead of time, particularly around supraspinatus. So we really got that muscle as strong as possible in eight weeks. Anybody who's gone through that type of rehab, which I'm sure many people listening have, it's uncomfortable.
I mean, you're burning a little tiny muscle that is not used to working that hard. The second thing that I remember, and hands down the most important thing, was what you and Alton decided to do post-operatively completely shattered everyone's understanding of what we do with these patients. So the traditional view is, especially, this wasn't a slap tear. The entire labrum was hanging by a thread.
And normally, as you said, a surgeon's primary objective is, hey, I'm going to make sure that this is never unstable again. I'm going to cinch this down really tight and you're going to be in a sling for four to six weeks. And that's going to give it plenty of time to heal. All of that sounds great, but you'll never regain your mobility.
You'll never regain the range of motion you want, the healthy range of motion you had. And frankly, you'll probably atrophy away. And so Alton said, no, we're going to have you out of a sling in 24 hours. And I was like, how is that going to be possible? And yet we did. There's no way he could have done that if you guys weren't partnering on this. How is that even possible?
And why does that fly in the face of everything we would think of?
Truth be told, I learned a lot of that the hard way from my first orthopedic surgery back in 2000 when, A, I'm not even convinced I received post-operative instructions. And if I did, I didn't read them. And I was breaking every rule there was. The stakes were higher here in a way, and I think I was very mindful.
For example, people, myself included, when you have surgery, you tend to go on YouTube to learn all about it.
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