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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and then got into the London Marathon and went and ran that seven weeks later and started to get, for the first time ever, a little bit of knee pain. Yes, the other knee. The other knee. So can you explain why you didn't think that was a coincidence?
And so if the knee is caused by the hamstring, what do you think is the cause of the hamstring injury? And why are women, middle-aged women, so susceptible to this injury?
And the other thing I would add to this, which I suspect any woman listening to us who's had kids will appreciate, is even though Jill is tiny, she said her body never went back to pre-pregnancy. So if she talks about how she used to run before 2008, so our first child was born in 2008. And she ran a bunch of marathons before then. And then she's run a bunch of marathons since.
And she weighs the same. She's been very fortunate in that regard that her body weight hasn't changed in that period of time. But she says she cannot biomechanically do what she used to be able to do. Now, when I hear that, I assume her pelvis was mechanically changed having kids. And she feels it, but she can't articulate it, nor can I necessarily. But she just says there's something different.
She felt like she used to float. And now she feels like she runs. Yeah, right. She's colliding.
I hope somebody is listening to us, by the way, and is thinking of another type of a 10 squared, which is what are we doing for women immediately post baby? Vaginal and C-section is two totally different operations or two different things. There should be really robust rehab paths to get them back in amazing shape immediately, as opposed to we'll come back to this in 10 years.
I think there's something about the pelvic floor that is absolutely decimated in pregnancy or delivery, more to the point. I deep down believe, no pun intended, that that's a part of what has gone wrong in her hamstring. I see this in many of her friends. This is a very common complaint. It doesn't present as even a hamstring injury. It presents as
Either a knee injury, like an ischial tuberosity pain, which is like the sit bone. And they say, oh, it's just not comfortable sitting. Yeah, I don't want to sit.
Let's talk for a minute about the core. I hate the term because it's so misused, but the way we talk about it is probably most closely aligned with how DNS thinks about it, dynamic neuromuscular stabilization. So maybe just say a moment about it through the lens that we think about the core as a cylinder as opposed to quote unquote abs. Yeah, exactly.
Yeah, there's so much I want to say on this. I don't want to lose the thread, but I'll sort of say two things that seem unrelated, but they're quite related. The first is, I wish there was another word for stability that didn't imply static. We think of that as things that are not moving. So rigid, stable, et cetera. But the truest way to appreciate stability is kinetic stability.
That's why in the book, which I know you haven't read, but if you do read it one day, no. I've been too busy. Yeah, I know. The section of the book where I write about stability, the analogy I use much against the desire of my publisher who hated it was that of a race car. Because again, you're thinking like, how does a race car explain stability?
But if anybody's driven a race car, or if you haven't, if you can take my word for it, one of the fundamental differences between a race car and a street car is that in a race car, you're transferring much more of that horsepower to the tires than you are in a street car. In a street car, a lot of energy seeps out because the chassis is not very stable. And you might say, well, why?
Well, in the case of a car, it's because it's more comfortable. Race cars are not being optimized for comfort, they're being optimized for performance. If you're optimizing for performance, you actually want more stability in the chassis and the suspension so that you're transmitting more force to the tires and the tires to the surface.
And similarly, when you think about an individual who has stability, they are able to transmit force much more directly to the outside world and they are able to receive force more safely from the outside world. And that's why no matter how long you ever gave me, I could never throw a hundred mile an hour fastball. And it's not that I don't have the strength.
I'm sure that if you put a 20 year old version of me next to a pitcher, I could have outdone him in every measure of strength. but I didn't have the stability to be in motion and stabilize the capsule of my shoulder and transmit force like a whip through my arm. You wouldn't look at a picture and think that's stability, but it's remarkable stability.
So when a client comes in at 10 squared and you do an assessment, how do you gauge how far they are away from being able to do... the dynamic movements? How are you gauging? What are you testing? What are you looking for to say, yeah, this person could start doing plyos.
Like for example, one thing I love doing, I don't have this on my centenary and decathlon list because we're being so strict about that only having 10 things, but I have kind of a side list of things that I want to be able to do. Like I want to know how late in life I can maintain certain metrics. And one of them is how late in life can I still do a broad jump of my height?
So why is that something I enjoy doing? Because it combines two things. It combines the concentric strength and power to be able to leap, but even more importantly, and at least as difficult, is it requires the eccentric strength to land and decelerate really quickly. How do you know when you look at someone if they're ready to do that, for example?
So just to be clear, people understand a wall squat is just level one.
Number one is failure constituted by pain or not doing it for a certain length of time.
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