This episode is sponsored by StationWise, the
first staffing software to be truly firefighter
proof. Now you may be wondering why I have software
as a sponsor when I focus usually on physical
and mental health of the first responders, and
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.com. Welcome to the Behind the Shield podcast.
As always, my name is James Geering, and this
week it is my absolute honor to welcome on the
show, Doctor of Physical Therapy and Air Force
Reservist, Dr. Nick Detrick. Now, in this conversation,
we discuss a host of topics, from Nick's journey
into the world of medicine, the nuances between
regular airmen and the Special Warfare Human
Performance Squadron, his introduction to the
fire service, injury screening, fitness standards,
rehabilitation, the power of sleep, and so much
more. Now, before we get to this incredible conversation,
as I say every week, please just take a moment.
Go to whichever app you listen to this on, subscribe
to the show, leave feedback, and leave a rating.
Every single five -star rating truly does elevate
this podcast, therefore making it easier for
others to find. And this is a free library of
almost 1 ,200 episodes now. So all I ask in return
is that you help share these incredible men and
women's stories so I can get them to every single
person on planet Earth who needs to hear them.
So with that being said, I introduce to you Dr.
Nick. Detrick, enjoy. Well, Nick, I want to start
by saying thank you so much for taking the time
and coming on the Behind the Shield podcast today.
Thank you for having me. I've been a listener
for a while, so it's an honor to be here. Well,
thank you so much for coming on. Very first question,
where on planet Earth are we finding you today?
I'm at my house in Folsom, California, which
is a suburb a little bit outside of Sacramento.
Brilliant. Well, I would love to start the very
beginning of your timeline because you've got
a very interesting journey through medicine and
then the military and the first responder professions.
Tell me where you were born and tell me a little
bit about your family dynamic, what your parents
did, how many siblings. I was born in Mountain
View, California, which is in kind of south of
San Francisco. And then very early, like before
I was a year old, my family moved out to the
Sacramento area. They actually competed in water
skiing. So there's a country town and there's
a lake out there. And so we relocated. I'm the
youngest of three boys. And then my mom was a
real estate agent most of my life. And then my
dad worked for Pacific Gas and Electric, just
kind of did a lot of odd jobs at PG &E. Do they
still ski? They do. Not as much. They actually
just moved away from the lake last year. So it
was like from 91 to 2024 that they were living
there and still competing. And then my middle
brother still competes at a very high level.
It's like travels all over the world for it.
I think if I'm not mistaken, Florida was a big
hub for skiing too. We used to have, what's it
called? It's Legoland now. It was something gardens.
But anyway, that was where all the skiing competitions
used to be down here. Yep. Yeah. Yeah. We used
to travel out there. I feel like all of our vacations
growing up would be either out to Florida or
central California, like Barstow Bakersfield.
There's a couple of lakes out there. So yeah,
a lot of water ski tournaments. Absolutely. It's
Cypress Gardens, as it was called. And there's
still a nod to that now. If you go to the Lego
Land in Florida, there's a Lego water ski stunt
show. So they kept that attachment. All right.
Well, then what about sports and exercise? What
were you playing and doing as a young boy? Yeah,
so I dabbled in water skiing. I wouldn't say
I got into it as much as my family did, but my
big things were soccer, baseball, basketball,
like anything I could do. getting active so we
played competitive soccer and baseball until
about middle school and then again lived in a
small town football was a big thing like Friday
Night Lights so I transitioned to football in
seventh grade and then continued with that all
the way through high school. Did you yourself
have any injuries as a youth athlete? Nothing
significant as a as a youth I had a couple like
little hip flexor things back injuries that sort
of stuff but nothing significant, fortunately.
My biggest injury was actually in college. So
I was trying to hang up my athletic jersey and
retire and still wanted to do stuff as I got
into college. So I joined the water skiing wakeboard
team. And again, growing up around the sport,
being a young, was I 18 at the time, just tried
to do something too big too soon. So one of the
events is you go off a five foot ramp for distance.
yeah just wasn't a smart young man and ended
up in a wheelchair for a couple of months uh
so that was kind of that was the biggest injury
that i had to deal with as a young athlete what
was the actual injury uh so i look back on it
the recovery should not have been that bad they
thought i tore my acl and then i also tore i
fractured like the upper part of my tibia and
tore two ligaments in my ankle so essentially
these are like long skis i think they're probably
like six seven feet and i just stuck the tip
into the water and twisted but because they thought
i tore my acl and have you having lived in california
kaiser has like it's a separate entity from norcal
to socal so i was a norcal patient but socal
resident where i was going to school so i just
had to figure out how to rehab on my own And
that's what really delayed the healing, unfortunately.
But it was a good experience. So while we're
on the subject of youth athletes, this is something
that I like to talk to as many people as I can
because I think it's an important message for
the parents out there primarily. When I first
moved to America, and I've told this story many
times on here now. i after a couple years i kept
me in what i would term as uncle ricos and i
mean that affectionately but these now deconditioned
men either side of 30 ish that told me these
i could have would have should have stories of
football baseball basketball etc and they were
talking about mcls and slap tears and all these
different injuries at you know 15 16 17 18 years
old and My question after a while was, what are
we doing to these kids? And then I become a parent
and I'm more exposed to travel ball and some
of these other things. My son didn't do that,
but this kind of concept. And I realized that
it seemed like in a lot of places, sometimes
the wellness and longevity of the youth athlete
became less important than the performance. So
that school, that college could win at that moment.
What is your perspective of that in the American
youth sports environment? Yeah, I think we not
only the whole Uncle Rico thing, which is awesome,
like we hear that in the fire department all
the time, too, but is I'm going to live vicariously
through my kid. And so my kid is going to be
the best. My kid's going to get scholarships.
I saw it a lot more in Southern California with
kids getting specialized in the sport super early,
baseball being one of the worst. Right. And yes,
you have pitch counts, but if you're on three
different teams. They're all doing the same pitch
count. Are you triple it? We would see some parents
who are voluntarily doing Tommy John surgery
on their young athletes thinking, well, they're
going to need it eventually and they heal better
when they're younger, so let's just do this beforehand,
which is wild to think about. Why are you doing
a voluntary surgery like that versus... I think
one thing I look back retrospectively, my parents
had us in a lot of sports. But we had soccer
season. We had baseball season. We would do a
variety of things. You'd have to pick up and
learn and roll with the seasons, which I think
is when we look at the best athletes, the people
who are in the NFL, in the NBA, like you look,
they all played multiple sports. Very few of
them started specializing at age 9, 10. Yeah,
some people are just really good athletes and
they're going to make it there. Well, I think
this is an important thing for people to hear
because this is exactly what I get told over
and over and over again. I'm not the expert.
You know, I'm just a weekend warrior athlete
that, you know, still trying not to die in my
50s. But yeah, I mean, you have these camps and
these travel balls and even the travel ball thing.
I mean, the concept that your child's team is
so good that they need to travel 500 miles to
play someone that's going to match them. I mean,
your child isn't. They're not that good. If they
are, they would be in, like you said, the grooming
kind of path to be a professional athlete. But
the multi -sport athlete, which is how we've
played sports since the beginning of time until
very recently. does seem to forge you know physical
resilience but also mental resilience and avoid
burnout from this yeah i think one thing too
that it's not just from the parent standpoint
but one of my experiences with coaches is yes
they may encourage you to be in multiple sports
but then if you're not playing year round you're
not with them year round then you lose your spot
and so then you get pressured into well if i
take six months off because this is good for
my body good for my overall development But I
can't play next year. Now you start siloing teams.
And so, yeah, it's a whole system issue, unfortunately.
Well, the other side of the coin, I think, is
really worth talking about is when I was in the
UK, which, again, was a little while ago now.
But when we played sports in school, we just
played sports. We didn't have weight rooms or
any of that kind of stuff, which there's absolutely
a place for that. Then when you leave school,
because of that, you just keep playing sports.
Whether you throw a bunch of sweatshirts on the
floor and make goals and kick a football around,
or there's cricket tournaments and all these
different things, pub leagues. But I noticed
that British people would stay active overall.
But what I saw in the States is you have such
a high level of performance with these youth
athletes. And then there's the injuries or the
lack of identity, all these other compounding
elements where there's a steep drop off. And
now you have people in their 20s and 30s that
aren't doing any sport or exercise anymore. Absolutely.
Yeah, I am trying to reflect on my own time.
And I played flag football in college, right?
Little, what are they, intramurals, that sort
of stuff. But even as passionate as I am about
health and fitness, and I remember. my first
summer home from college, my buddy and I did,
was it one of those insanity workouts? I remember.
Kind of in the P90X realm. And we're sitting
there and we're both track and football athletes.
How have we only been out for a year and we are
gassed by this online video exercise, like no
equipment. And yeah, that decline or the regression
can definitely be quick, unfortunately. Absolutely.
Well, what about career aspirations? What were
you dreaming of becoming when you were in the
school age? Yeah, so I'd like to think that I
never would fall into the Uncle Rico category
because I knew like I was an average athlete,
but I always loved being in this realm. And so
I really wanted to be a sports agent, to be honest.
And people would always ask me like, oh, you
must have watched Jerry Maguire, which have you
seen that movie? it's funny i was actually talking
to someone yesterday who's working with the guy
that was actually based on so yeah i have yeah
i i always wanted to be an agent and then i saw
that movie and i was like why would anybody want
to do this like that does not look like a fun
job i i still wanted to pursue it but yeah that
movie did not sell me on wanting to be a sports
agent at all but i thought it would be fun to
be involved in that world And so I actually,
before all of this kind of like health and wellness,
physical therapy, I, at a high school, I kind
of always had a call to serve, felt like I wanted
to serve. And so I was lucky and got the ROTC
scholarship for the Marines to USC. And at the
time, the recruiter was like, oh, you want to
be a sports agent? Like, well, you'll go to school,
you'll go to law school, then you'll be a JAG
officer, and then you'll get out in seven years
and be a sports agent. So I'm thinking. hey i'm
set right my my grandpa my uncle and my cousin
were all marines so i was thinking okay like
i'm following in their footsteps um and then
i started doing a little bit of research and
learned that recruiters may stretch the truth
at times right apparently we sound a little more
uh sunshine and rainbows than reality and so
i kind of learned i was like oh the odds of me
going to law school are pretty low So then you
become an infantry officer, which there's nothing
wrong with that. But that's when my uncle and
my grandpa started kind of planting seeds of
caution. Like, hey, you might want to reconsider
this. And I'm thinking, I'm doing this in your
guys' honor, right? Like the Marines are the
family tradition. And I must have had them fooled
as a kid because they were like, you're way too
smart for this. Like, we're grunts. You don't
need to do this path. So I ended up, USC was
my dream school. And I took a picture with the
Marine and the big check and ended up turning
it down and then went to San Diego State instead.
So that's where I started my college education.
Did your uncle or grandpa see combat in their
service? My grandpa, not much, but my uncle was
a Vietnam era. And to be honest, I haven't gotten
all of the stories, even having served now. Like
when him and I talk, you can tell there's some
guarding. There's some stuff that he hasn't processed.
And that's more that generational difference,
right? I think a lot of the Vietnam era just
kind of keeps it in. But yeah, he definitely
saw some stuff. The Vietnam vets that I've had
on the show. It's so different. I guess there's
three different tiers. You've got the World War
II generation, which I would argue seems to be
Iraq, Afghanistan, similar where the country
was behind them. They were welcomed home with
open arms. Overall, you have the Korean generation,
which that really breaks my heart because people
basically pretend that never even happened. And
if you look at what the allies did as far as
South Korea, the North Koreans were almost to
the southernmost tip. And they pushed them all
the way back to the line. But with the Vietnam
generation, James Capers and some of these other
ones, Rich Rice, the way that they were received,
you talk about organizational betrayal and moral
injury. We did such a disservice to those men
and women of that generation. I feel that we
still need to lean in and kind of encapsulate
them because now that we are. in an environment
where it's okay to talk about this, we need to
go back in time and figure out who's fallen through
the gaps. Absolutely. Yeah, there's, I think
there are a lot of veterans and you start thinking,
I'm thinking about my uncle's age, like they
are, I mean, my dad just turned 70. He was too
young for the draft. So these individuals are
definitely later in life and yeah, need to take
care of them as much as possible while we can.
Absolutely. My father -in -law, he was Navy in
Vietnam and he went to Coast Guard. But yeah,
I mean, you can just tell a lot of these men,
like you said, they're keeping it in, but it's
still in there doing damage technically. All
right. Well, then walk me through your journey
into physical therapy. Yeah. So again, I started
at San Diego State. uh and quickly i was on like
after two months i was already on the six to
seven year plan because when i was in college
i was at uh it was 2009 so the recession was
really hitting classes were furloughed a lot
in california so i kind of had to make that decision
of Do I want to stay here for six or seven years
or go private and try to get out earlier? Yes,
it's going to be more expensive, but kind of
move on with my life. And so luckily, I had my
parents support and I ended up getting accepted
to USC. So I ended up getting to go there. And
at that point, I'm thinking I'm back in this
awesome network, the USC world, high quality
athletes, that type of stuff. Right. So the sports
agent dream is back alive. And I was a business
law minor. and took my first business law class
and thought, absolutely not. I have zero interest
in this. I saw some of the people that were in
the class and like their cutthroat personalities.
I'm like, I will get walked all over. This is
not going to fit for Nick, right? And so I was
having this existential crisis. I remember I
worked at the school gym to kind of help pay
for school. my friend and i were talking we were
both turning 20 which i look back on so young
but we were thinking oh my gosh like we're getting
too old what are we going to do with our lives
she was like hey man like you love working out
you love being active you've had your own injury
history i kind of shared like as as i rehabbed
myself like i had to teach myself how to walk
again i remember sitting in the pool and doing
exercise and like i know that feeling um and
she was like why would you ever consider physical
therapy as a career. And oh my gosh, like that,
that could be pretty cool. Like if I can be part
of somebody else's journey back to doing the
things they love to do, getting their quality
of life back, not having to go through it alone,
like I did, like that would be amazing. So then
I, the next year I started working as a student
athletic trainer at SC and just kind of following
that, that pre PT pathway. What was the first
type of, uh, you know, athlete or background
that you started working with initially? So I
worked with, I was really lucky. I worked with
USC's football team my first year and then the
tennis, the men's tennis team the second year.
So those were the two primary sports I worked
with. And what were some of the common denominators
as far as the injury and maybe even the reasons
behind them? Uh, tennis obviously was a lot more
like shoulder, elbow, a little bit more knee
from impact stuff. Um, one of the things I've
learned with tennis is I would get, let's say
somebody came in with tennis elbow. I would be
so focused on that joint and not thinking about
the rest of the kinematics and like what's going
on at their shoulder strength, what's going on
with their thoracic mobility, or are they stabilizing
well from their core, their hips. I had a really
good mentor there that helped me look beyond
just the isolated area where the symptoms are.
Football, you saw a huge mix of things. I worked
with the D -line, so a lot of wrist, finger injuries,
dislocations, those types of things. I watched
one of the coolest experiences, not for this
individual, but I saw him tear his ACL, got to
be part of his... prehab sat in on the surgery
and then got to be part of his rehab so like
as a pre -physical therapy like young student
young young learner excuse me that was awesome
to be able to like see the whole scope for him
what about the tbi side concussion protocol etc
back then when you were working early in your
career yeah i saw A little bit of it. We would
do like the baseline concussion or the baseline
cognitive tests at the beginning of the year.
And I think one thing that's always alarming
with athletes, you would see some people purposely
do really bad on them so that their baseline
is bad so that when they do get concussed, it's
not as bad. i remember one one day so we'd be
sitting on the sidelines during the games and
one of our guys had like an unbelievably big
hit on kickoff uh everybody's celebrating he
comes off the field stands next to his buddy
which is like right in front of me he's like
oh my gosh i'm so concussed and then he looks
at me and he's like oh nick like please don't
say anything right like everybody wants to and
of course i i have to say something um Yeah,
I think at least from what I see as a fan, the
whole like medical blue tent, I think they are
doing a better job at least catching it initially,
like screening everybody that potentially has
it. Now, what actually goes on in the tent or
afterwards in the concussion protocols, I don't
know, but I'm glad to see at least some movements
in the right direction. Absolutely. Well, going
back to the tennis players, I did, I hurt my
back about. I think it was about 12 years ago
now. And went to the doctor, the workman's comp
doctor, and they were like, okay, here's a bunch
of pills. And the next step I'm sure would have
been surgery. And I'm like, look, I come from
somewhat of an excise background. I'm not taking
your pills. I'm certainly not talking about surgery.
If there was an imbalance that caused this injury,
I believe that there's a way that you can rehab
where I don't need surgery and I just strengthen
everything. Went to the Cairo I paid out of pocket.
I was trying to do, you know, my own kind of
slow rehab in the gym. The PT I was going to
in Ocala here is basically retirees. So great
people, but they really didn't have an understanding
of what a firefighter needs to be able to do
on day one when we go back. So by accident through
the Cairo, I found this thing called foundation
training. started doing it was a free video on
youtube i was so impressed at the healing that
i had i ended up going over and getting certified
with them and then bring it back to my fire department
the reason i talk about this is one of the things
that eric goodman who's the founder dr eric goodman
um was talking about you know all these surgeries
that people would have for carpal tunnel and
um uh plantar fasciitis where the origin of the
pain was actually coming from as you said the
hip the shoulder or maybe even the spine itself
so let's just elaborate on that concept a little
bit if someone is feeling pain in a certain area
talk to me about the dangers of focusing just
on that area yeah so We as humans, we're complex,
right? And so there could be areas of pain referral,
meaning like, so there's instances where kids
may have like a fractured hip, but they're complaining
of a lot of knee pain. So even though the actual
injury is up at the hip, it can refer down. There's
nerve related pain, right? So if you have back
pain that it's going down your leg into your
foot. There's a lot of things up or down the
chain. So we'll take something somewhat simple.
A lot of people refer to it as like runner's
knee or jumper's knee, which I personally, I
hate those type of diagnoses because it's like,
okay, yeah, you have knee pain when you jump
or you have knee pain when you run. That's not
very specific what's going on. I always will
look at the hip and the foot and ankle with those
to see, is there something contributing? Are
there, whether it's mobility issues, strength
issues. We got to look up and down the chain
to figure out, is there something else contributing
to the actual movement pattern that we're seeing?
Brilliant. Does that answer that question? No,
it does. I think just simply that concept, getting
people to realize, because again, at the extreme
end, if you are having surgery on your foot or
your hand, where ultimately the root cause is
an impinged nerve, for example, at the hip or
the sacrum or wherever it is. Yeah, that you're
never going to fix the issue. And these people
are going to get worse and worse and worse with
these surgeries. So if your physical therapist,
physician, whoever it is, isn't talking about
looking at, as you said, the chain, either side,
north and south, east and west of wherever it's
hurting, then I think it's something that a lot
of people just don't think about. But it's so
important for people to know as their own patient
advocate before people start whipping out scalpels.
Absolutely. uh yeah two points on that so one
this is this complexity is why i struggle a lot
of times people ask me like hey put like a low
back pain program together and i always say like
well it depends what's causing it right like
is there hip mobility is there thoracic mobility
whatever it is so it it becomes more complex
to you really want an individualized plan and
then as you mentioned like before you go through
under the scalpel like I know a lot of people,
they hate, oh, I have to go to PT for six to
eight weeks before I can go see the surgeon or
before I can get surgery. And I'm just checking
boxes. It may feel like that, but I believe strongly,
like worst case scenario, if you go through a
good PT plan before surgery, you're going to
be stronger. You're going to have more range
of motion. You're going to have your pain decreased.
So if you end up having the surgery, you're going
to have better outcomes. best case scenario you
realize oh wow i'm already good and i don't need
a surgery anymore like i just go back to living
my life um yeah so that's that's kind of how
i try to improve buy -in like i get this feels
like checking the boxes but if you're not doing
it right you're not going to get a good outcome
well with my back my whole thought process was
i got hurt because there was some imbalance So
not that surgery was even on my mind, but let's
say hypothetically I did, that imbalance is still
there. So I haven't really fixed anything. I've
just cauterized a nerve or whipped off a disc
or whatever it is. So with this foundation training
and all the other things I was doing simultaneously,
but the foundation training was phenomenal. What
it was, was the kind of excess, the anterior
tilt of my hips and the tightness of my hamstrings.
And so when I'm... um, putting the balance back
around my joints and then under load, you know,
building up to the point where I can be a firefighter
again, I was stronger than I ever was before.
Not that I was chasing some massive PR, but consistently
in awkward positions, I was much stronger because
I'd taken the work to address the issue. If I
just had pills and surgery, I might've made the
pain go away for a bit, but I would imagine it
was only a matter of time before I was going
to hurt myself again. Exactly. All right. It's
there a lot of bandaid fixes. And I think we
were in a society where we want everything quickly.
Right. And it's gonna not be as quick going just
through physical therapy, but you're going to
get the long term outcomes versus the short term.
So it's all about how we put that lens on like,
what are what are we really looking to do? Absolutely.
All right. Well, then you talked about coaching
or sorry, being physical therapist for collegiate
athletes. How did your journey take you into
the military finally? Yeah. So after undergrad,
I went to state at USC, did my doctorate of physical
therapy. And at this point, I felt like, hey,
this is my avenue back into the military world
of I can follow this passion of physical therapy.
and go active duty. And so I was lucky. I got
to do a couple of clinicals during PT school.
And my last one was a four -monther at Travis
Air Force Base, so up in Northern California,
and got to see what it would be like to be an
active duty PT. So now Lieutenant Colonel Briggs
is my supervisor and just got to see like, okay,
what is this patient population like? It is a
lot different being a PT in the military as far
as our scope of practice. And I was hooked. And
so I applied and luckily was picked up about
a year later and commissioned into the Air Force
in, what was that, August of 2018. And then was
stationed not too far from you guys out at Eglin
Air Force Base in Florida. So do you know where
that's at? I'm familiar with it. I'm not 100
% where it is, but I've heard it a few times
before. Destin area. Lower Alabama. So talk to
me about the spectrum of airmen that you work
with. Yeah. So every base is going to be a little
bit different based on what their mission is
and like kind of what type of personnel are there.
But for the most part, an active duty, at least
where I was at, I was working at a big hospital.
So as a traditional outpatient clinic, I was
seeing a lot of musculoskeletal injuries from
training. a lot of people like getting ready
for their annual fitness test so for air force
at that time it was a mile and a half push -up
sit -ups so whether they had pain with that stuff
or needed help getting ready it was it was pretty
traditional outpatient clinic it wasn't anything
too too crazy i think when i went through school
i did a rotation where i got some traumatic brain
injury and amputee experience and that wasn't
that at all i think by the time i was in the
military a lot of our blast injuries had had
gone away thankfully uh we weren't seeing that
as much and those are the highly specialized
they're going to the walter reeds or the uh center
for the intrepid in san antonio that type of
stuff if they're at that high level Talk to me
about the fitness test. When I was young, which
was a long time ago, we were doing sit -ups with
our hands, our fingers encircled and yanking
on our neck. And then as time goes on, they tell
us it's a horrible way of doing a sit -up. But
then you look at a lot of the selection processes
for the military, fire and police, and they're
still doing the 1980s movements for professions
where really being able to ascend, move under
load, that kind of thing is far more important
than... 50 pushups. So what is your perception
of some of these baseline fitness tests in the
military specifically? Yeah, I think it misses
the mark. I think we're doing a lot better. I
know like the army has their combat fitness test
and Marines have that as well. So I think getting
more job specific, I think One thing that a lot
of people don't realize about the military is
that it really is like a microcosm of general
population. You have these what we think of as
military personnel, infantry operators, that
type of stuff. But you also have a lot of desk
workers. You have a lot of people in the admin,
people that don't have a physically demanding
job. So I think we're where the military is moving
right now is getting more job specific on those
fitness tests, which I think is is a positive
thing. But I'm also seeing even like I look at
the Air Force mile and a half times and the standards
continue to get lower and lower because all of
us, military, police, fire, we're having recruitment
and retention issues. And yeah, so I don't know.
The tests aren't necessarily great, but also
the standard is subpar for what we need these
operators to do. The term false economy seems
to become more and more apparent in so many areas,
and we'll get to the firefighter workweek in
a little bit. But when it comes to the lowering
of standards, so you are allowing someone with
worse strength and conditioning to walk through
the door, what is the potential cost and ripple
effect that... Maybe, you know, kind of be an
amplifier of cost versus if you kept that bar
higher, invested more and and only brought people
in that were at that initial benchmark that you'd
set. Yeah, so I at our fire department where
I'm at now, I have kind of some injury risk reduction
guidelines, and one of them is building and maintaining
physical resilience. Right. So having a good
between. I call it physiologic metrics. So how
well are your heart and lungs working, your VO2
max, how much body fat are you carrying, some
mobility and strength and power stuff. If we
don't have a good foundation of this, you are
going to sacrifice in some capacity out in the
field. I like to say we as humans are smart,
right? We are going to compensate. So if I don't
have enough hip flexion, say I can't get into
a deep squat, but I have to pick up that two,
300 pound patient. what am i going to do i'm
going to bend over i'm going to put my back at
a higher risk and if i don't have the back strength
to support that that's a higher risk right so
that's that's from an individual standpoint that
cost i'm also a big believer in and there's a
lot of studies out that show when you are operating
at a very high level like near your threshold
now your cognitive skills are also going to diminish
right so if i'm tapped out i'm i my vo2 max is
bad by the time i get up to the fire i'm already
gas now am i am i missing a victim am i not searching
appropriately and right i am not a firefighter
so i will butcher some of those terms i can act
like i i know this stuff um but so like what
are we missing I've even thought about that within
police environments of what are we missing or
does somebody become more fearful as trying to
defend themselves as a police officer because
they don't have the physical capabilities to
defend themselves, to catch up, anything like
that. That's a whole different ball of wax. But
yeah, we have a big cost if we do not maintain
our physical resilience. We've kind of opened
the door for this, so I'm going to jump in now,
even though it's pertaining to the fire service,
which we'll get to in a little bit, but sleep.
I've had quite a few sleep researchers from multiple
branches of the military, and most recently it
was Alison Brager and Rachel Markwald, and they
were talking about the reduced cognitive performance
when it came to sleep deprivation and the increased
perceived threat, which obviously could be dangerous
in law enforcement. Talk to me, let's just stay
on the physical first. How important is it for
gaining the benefits of strength and conditioning
and or the rigors of the job? How important is
sleep from the physical side? Absolutely. I don't
know if there's a way that I can quantify it.
Nothing I've seen in the research quantified.
I think one of the big things, I'm a big believer
in. A lot of our issues are multifactorial, right?
So is it just sleep? Is it the call volume? All
that sort of stuff. But yeah, if you are not
recovered, we all feel it. When you wake up in
the morning, if you feel like shit, you're probably
going to train like shit, right? Your mobility
is not going to be there. You're just not going
to be able to have the same strength and power.
And let's say you're following a good periodized
strength and conditioning program. Today, I'm
supposed to deadlift, whatever, 400 pounds because
that's what it says on my plan. If I'm not feeling
it, well, now, yeah, I probably am not going
to be able to do it. But also, I'm going to increase
the risk of injury because I'm not at that ready
state. And I think there's a lot of cool tech
out there now. Like I have a Garmin watch. It
gives you your training readiness. I think a
lot of people kind of blow that stuff off. We
should be listening to our bodies and listening
to the tech if we have it to say it's okay to
take an easy day, an active recovery day, and
then I'll get back into the hard strength and
conditioning later. When you look at it chronically,
if a first responder is not sleeping on average
every third day, What does that do to the likelihood
of injury if they're taking their job seriously,
they're doing the strength and conditioning,
they're stressing their muscles, ligaments, and
tendons, but are not having the ability to heal
and strengthen them through sleep every third
day? Yeah, there's a couple of different risk
factors. So let's say we're speaking with the
fire department. We have somebody on their day
three mandatory, and they're getting in and out
of the rig all day. think about most of us when
we're we're sleepy we fall asleep on the couch
we get up or kind of stagger a little bit right
now you're getting on and off of this huge rig
multiple times on the uneven footing you're not
paying attention as much because you're just
trying to go through the motions yeah your risk
of injury is going to be higher when when i first
started at this new position in sacramento we
i sat down with our risk team and our work comp
team and they were showing hey um I think it
was overtime only, it's only 20 % of our injuries
are occurring on overtime. So it's really not
that big of a deal. And I kind of looked and
I was like, wait, 20 % of our injuries are overtime,
but like how many hours worked are overtime?
And they were kind of confused. Like, wait, what
do you mean by that? Well, not every, like we
probably only have 5 % of the hour, total hours
worked are overtime. And if we have 20 % of our
injuries are overtime, that means you're at a
four times increased risk of injuries. And that
was kind of like a light bulb moment to them.
Oh, I haven't thought about it. And that, right.
It's, they just think it's a five times more
risk during the regular shift because it's only
20 % on overtime. So I think that's, that's where
it's fun to like have a different lens than,
than some of our administrators. And yeah, sleep
is a big. a big thing i talk about it with a
lot of our firefighters i have all of the these
ideas health and wellness wise and things that
i can do and especially with my background as
a pt but if we don't get sleep under control
we're just going to be beating our heads against
the wall for the most part well the conversation
i i mean i've been having for nine years now
um is we we keep talking about the shift Like
a Rubik's cube. And we'll spin the cube and we're
like, what if we change the days to this, this
and this? But it's the same exact 56 hour work
week. And there's no conversation of why does
everyone else work 40 hours and we work 56 because
we're not sleeping all night. Let's debunk that
myth. You know, we're either actually running
calls or not in a deep sleep because we're waiting
to get woken up. And then you've got this recruitment
crisis, which really, if we're looking at it.
is a result of young people looking at how we're
doing and going my god those firefighters are
falling apart i think i'm gonna go be a welder
instead um so now you've got this forced overtime
so a lot of the country it'd be interesting to
get your take on who you've worked with at the
moment are relying on overtime constantly and
that cost is the potential cost to proactively
invest in A fourth shift, I think of 2472 to
me, is really the force multiplier for a lot
of things. So people say to me, if we're talking
about statistics, well, we don't have the money.
Well, how much are you spending on overtime?
How much are you losing every time someone walks
out the door after two, three years you've trained
them and put them through medic school? What
is your workman's comp premium? What are the
lawsuits that people are making mistakes because
they're so tired? I mean, there's a huge amount
of money downstream. So just kind of pertaining
to what you talked about statistics, I find a
lot of times, you know, people are looking at
them with the wrong lens. You know, we don't
have the money. We don't have the money because
of the way you are working people now. But if
you took that money you put at the front, you
would actually save money that then you could
pour into a physical therapist and a mental health
counselor and a fitness, you know, punitive fitness
test and some of these other things that then
would just amplify the physical and mental health
of your people. Yeah, it's definitely a complex
situation. Having listened to your podcast for
a little while now, I've definitely broached
the topic with some of our chiefs of like, what
are the options for shift changes and that sort
of stuff? And that's a big uphill battle. I will
say one thing I'm curious, and I don't know how
it works, and this is an issue, I don't think
just in our department, but in a lot of departments
in California specifically, is with the cost
of living here everybody is reliant on that over
time so while we hate it they also like their
lifestyles now are used to overtime and so i've
heard a lot where our union may not support like
a 24 72 just from the financial consideration
of the individual firefighter which i find is
interesting because we we complain about not
getting sleep but then we if we try to push things
that are going to help you there's there's that
uphill battle um But I do think it is worth exploring
all of the different options. And that's a goal
of mine is to try to lead the way and have these
conversations with our chiefs and our leadership
and figure out where we are going, which luckily
we're in a really good spot within our department.
Our leadership fully supports a lot of the initiatives
we're pushing forward health and wellness wise.
So I think we're in a good spot right now. The
response to that exact question, because I've
been given that a lot, is twofold. Firstly, if
you work a 24 -72, your hourly rate goes up.
So when you do work overtime, you'll actually
get more. The goal is to make overtime a lot
less. But then when it is your turn, guess what?
You're more valuable to us. We're going to give
you more money for being away from your family
for 24 hours or 12 hours. But the other thing
that people miss in this whole conversation is
so many firefighters enjoy doing other things
as well. So now you have this extra time between
shifts. And if you love carpentry or personal
training or you're a PTA or whatever the things
are, you can do that on the side. Different tribe,
different identity, different income source.
So God forbid you lose your job as a firefighter,
you've got something to fall back on. But there's
a fallacy that we make so much money in the fire
service and I could never make it anywhere else.
when that's rubbish. But the good thing about
earning your money that way is you go home at
night and you have dinner with your family and
you sleep next to your spouse. So different than
another 12 or 24 hours in the fire service where
you've seen the people that you love even less
and the chances of you having some physical or
mental health issues down the road and shortening
your lifespan have gone up even more. So I think
we've got to reframe what is the most valuable
currency. And time at home is the most valuable.
Do you need some extra money? Okay. Then be an
entrepreneur or an intrapreneur. Find something
that you also love doing and do that on the side,
just like we did in the fire service since the
beginning of time. Most of our predecessors had
side hustles. They didn't work overtime into
the ground. Yeah, I think. Especially, and I
say this, I feel like I'm in between generations.
So I'm not quite as young as our young academy
recruits, but definitely not near retirement
age yet. And we're already seeing a shift in
these new recruits and they're wanting to have
a balance in life. And yeah, they'll work the
mandatory, but they're not signing up for extra
overtime for the most part. So yeah, they're
finding that balance and prioritizing life. That
is one of my big goals. While I'm here to serve
the city, serve our department, what I really
want, Nick's secret mission is improving quality
of life for all of these people in the service
and outside. Absolutely. We've got to keep pushing
for that. 100%. All right. Well, back to the
military. You talked about the people just trying
to pass their annual test, for example. Talk
to me about working with the Special Warfare
Human Performance Squadron. Yeah, so that's been
so backtracking. I left the military in 2021.
This is again, we're talking about just coming
off of prioritizing life and that sort of stuff.
My girlfriend at the time, now wife, was out
in California the whole time that I was in Florida.
And so I chose I wanted to be closer to family,
have a little bit more say in what I was doing.
And so I transitioned to the reserves. And that's
the position I've been in at the reservists is
our special warfare human performance squadron.
So if we think about for Air Force special warfare,
like our attack P's, our PJ's, that sort of stuff,
they go through anywhere from like a year and
a half to two and a half year training. And so
our squadron basically just supports their health
and wellness throughout. their training program.
So whether they go out to satellite trainings,
like there's dive school in Florida or jump school.
Um, and then they kind of come back to San Antonio
where the headquarters is and we just manage
their, their health and performance. I've always
said that if there was any military special operations
group that matched the American firefighter paramedic,
the most it's the power rescues, the PJs. But
when you talk to the PJs, of which I've had many
on the show, and you look at the level of training
and the level of human performance and sports
psychology and some of the other areas that they're
given, and then you compare it to most police
and fire, there is quite a chasm. But arguably,
we're doing somewhat a similar job. Obviously,
people aren't trying to kill us in the fire service,
not usually. But we are responding to everyone's
worst day as they are. Talk to me about that.
Obviously, you're looking now with this fire
service lens, but working with that elite performance
in the Air Force side, what are the differences
between the physical, mental health and performance
side that our PJs and TACPs are getting versus
most police and fire that you've worked with?
Yeah, when I think of, and caveat, I'm out there
like two weeks a year. So sometimes I forget
the exact logistics of it all. We have strength
and conditioning coaches. We have clinical psychologists,
physical therapists, occupational therapists,
med docs, all in like the same clinic, right?
So it's this very multidisciplinary team, almost
like you would see at like collegiate or professional
athlete level. And then we have a whole nother
part of our squadron that is a research flight.
So they're doing data analytics, looking into
the research. What can we bring? And there's
probably four or five people just in that research
flight. And I think about all of that. This is
one thing I'm blessed to be part of the unit
is I then go back to the fire department and
I am all of those people in one, right? And trying
to do that. So we have an unbelievable amount
of resources and whether it's grants or federal
funding, all that sort of stuff, they get the
cream of the crop for our special warfare. That's
for sure. I think where it's exciting because
we've got a doom and gloom conversation in the
fire service and it's because that's how it is.
At the moment, we are not doing well as a profession.
If you look at the retention, you look at the
recruitment, you look at all the cancers and
heart disease and strokes and the suicides and
the addictions, it is a real statistic and it's
something that we need to take care of and we
can't just beat our chest and say we signed up
for it and just keep doing the same thing. But
where I think there's an opportunity for some
really exciting conversations is when it comes
to strength and conditioning, when it comes to
mental health conversations, it really does stop
at let's try and stop them dying as much. Now,
all the way on the other side of the Grand Canyon
is elite performance. So, you know, how can we
get a firefighter carrying 100 pounds of gear
for a high rise strip to be able to ascend 20
floors? And then as you talked about. have their
heart rate under control, be cognitively clear,
and then breach the door, make entry, search
for a child, and then bring them all the way
down. Elite performance. You ask anyone in a
top -level military position, if you said this
is the situation, I'm sure they would agree.
So where I feel that there's an exciting conversation
is... shifting towards performance you know that
will also uh help the the physical helps uh excuse
me the the mental health side it will help the
injury prevention side it will help all of these
things but we've been so we've been on the back
foot for so long that i feel like the conversation
needs to shift to how can we really get firefighters
to perform now the work week the sleep absolutely
huge you know part of that conversation but then
when we do But what are we talking about with
fitness standards, you know, expectations, strength
conditioning, you know, injury prevention, you
know, breath work, all these elements so that
that first responder has the highest chance of
actually facilitating that rescue when they enter.
Yeah, it's you are describing all of the missions
that I'm trying to work on right now. And I would
say. We, we, in our department right now, we're
making some good steps where as far as fitness
standards go, when, when I showed up, so I've
been here for about two years, we had like a
mile and a half run and it was in 12 minutes
or less. And if you did it great, if not, I guess
you still get off of probation. Yeah. So I've
really changed that. I've tried to bring a little
bit of the military experience. Have you ever
seen, at least I'll speak to the Air Force PT
chart. Have you seen those where I have not the
air force one. So there's, let's say for your
mile and a half, if you, I think at like under
30 years old, you have to run like a nine 15
to max out, like to get your 50 points. And then
as your time gets slower, you get less points.
And then same thing for pushups. There's like
a max and then you get less points. So I brought,
I created a chart like that for our academy and
for our probation officers. So we have. a mile
and a half run and then we have uh force plates
so we're fortunate to get some evolved force
plates so we have max deadlift so we're testing
their strength and then a low back endurance
test which under a certain threshold you have
an increased risk of low back pain and so we
have they have all three of these they have to
get a minimum score on and in the academy they'll
get diligence if they don't hit those and then
the expectation right now especially on my 25
one you guys are coming up on this in a couple
of months you guys uh like they will have their
probation extended if they're not hitting their
fitness standards because that is a job requirement
now once they are offered probation that's where
so the next 29 years of the 30 -year career that's
the big uphill climb we don't really have much
uh That's where it switches from the stick and
it's much more of the carrot motivation standard
and trying to just uphold their physical capabilities
throughout their career. What are you seeing
as far as the fitness of the new recruits? When
I think back to working in California, I was
struck. by the fact that they just simply were
a fitter population. I'm talking about really
near the coast as well, Southern California,
but it doesn't matter if it was Fullerton or
Orange or wherever, you know, the men and women
that were in uniform, like it was very unusual
if you saw someone that was even, you know, a
little heavy down there. Conversely, you know,
you go to other parts of the country and that's
not so much the case. Someone said to me recently
that the exciting thing about this younger generation
is the fit ones are very fit now because they
have access to all things, strength and conditioning
and rehab and prehab, etc. What are you seeing
as far as the level of strength and conditioning
and understanding of that with a lot of these
young people you're working with now? Yeah, I
feel like the ends of the spectrum are going
in opposite directions where you don't have that
many people in the middle. anymore you have the
individuals like you just spoke of of the really
fit they have good resources they have an athletic
background and then you have the people who haven't
moved at all and you know we just did our our
pre -academy for this next selection and i think
14 or 15 out of the 37 didn't pass the mile and
a half and so we're it's like okay we we have
some some work to do um so yeah i i think you're
starting to see this divide where the middle
is not as strong anymore and you're getting very
fit people or very unfit people who, for whatever
reason, want to go into this service, whether
it's they have family in it, it's good benefits,
whatever is calling them to it, but they aren't
used to or prepared for the physical elements
of this job right now. See, when I tested for
Anaheim, so 21... Years ago, 22 years ago. No,
20 years ago. Sorry, I'm getting my math all
backwards. 20 years ago, I was testing in the
written test. So there's obviously more people
that applied. A thousand people in the Anaheim
Convention Center sitting down doing the written.
And so if you look at the fact there was only
30 positions available, everything had to be
as... good as you possibly could so the biddle
was the one that we took then like you need to
be smashing your written your biddle your your
two interviews obviously your background check
needs to be solid um and so you know therefore
you had back then i would argue an environment
where if you were trying to get hired in most
places around the country you had to be doing
the work you know not the bare minimum but the
bare maximum to even even have a chance of getting
hired With this, as I said, this devolution now
that we're seeing, and I really feel like the
2472, some of these other initiatives are going
to be the thing that's going to turn the ship
around. It feels like it's the opposite now where
people, instead of taking, that was literally
the top 3 % of the list that they took. Now people
are taking, I mean, literally I'm hearing everyone,
everyone that applies, they get a job. So now
that bottom group is making it into the academy.
I'm sure there were probably some of those bottom
groups when we were testing, you know, even 10
years ago, but they never made it to the drill
ground because they weren't putting the work
in. Now, sadly, with these hiring bonuses and
these high school incentive programs, you're
bringing those people in and it's a disservice
to them and their own physical health. It's a
disservice to the people that they're going to
be partnered with. And it's a disservice to the
people that are going to be serving. Because
there is a much higher chance that they are going
to get hurt, their partner is going to get hurt,
or they're never going to make it to the person
they're supposed to be responding to. And I think
as a profession, we really need to take a step
backwards and look at this lowering of standards
and rectify it. Yeah. And to be honest, I...
maybe wrong with this. Again, I'm pretty new
at this position. So but I don't know if we we
have the CPAT is their their minimum to apply.
But I don't think we have any other physical
standard as far as like applying or getting accepted
to a position. So I don't even know if that's
part of our our thought process or our entrance
right now. And I've done some research on the
CPAT. I look at it. Sorry if I offend anyone,
but it doesn't seem like that hard of a test.
Right. And I've recently I have a couple of I
coach on the side as well. And people reach out
like, hey, like I hear you're good with fire
fitness. Can you help me? I failed my CPAT. I
need a lot of help. And I'm thinking like, wow,
like this is I'm happy to help. I'm glad you're
like reaching out for resources. But if this
is if you're not hitting this standard, we have
a lot of work to do. before you go to, and like
our academy, especially is very physically demanding.
So if you're going to come to that type of academy,
like we have a lot of work to do to get you ready
for success in a safe manner. One of the things
that I saw that the CPAT is a 1020 pass or 1019,
I guess is technically the pass. You'd have these
programs or people that I worked alongside that
were a lot of times they were the single -serve
paramedics and they were trying to get into the
fire. They would take multiple times and then
they'd come into the station one day and high
-five everyone because they got a 1019. And again,
going back to when the standard was high, the
CPAT is a great, great test. But the lower your
score, the higher chance you had of being high
on the list. So it wasn't about getting a 1020
or a 1019. And just to illustrate the point.
I am not an elite athlete. I am not, you know,
a world champion in anything. But a few years
ago, I did the CPAT to get ready to join the
fire service again if I couldn't get sponsorship
for the podcast. And I got a 720 at 45 years
old or whatever it was. So if my old ass can
do 720 on the CPAT and I'm not a big strong dude
at all, then, you know, I think you could argue
that three more minutes, you know, that you could
bring that down a little bit. It's a great test.
I really think the CPAT or the FPAT, which is
another one with the firestead, they are great
tests. But again, are you taking the bare minimum
or using that to get people to challenge themselves,
be competitive? You know, if they got a 950,
then great, then go away, you know, do some more
strength conditioning to see if we can get you
to a 930. But it's not. It's that bare minimum
mentality. Again, I think that's a very dangerous
mindset. Yeah. and again i i may be wrong i don't
see all the things within like the hr and hiring
process but i i believe we just see it's a pass
fail right so there we have no clue like what
their their time was yeah yeah a lot of work
to be done indeed well just i guess going at
a slightly different direction for a moment you
came from high level collegiate athletes You
have worked obviously in the reserve side with
high level tactical athletes on the Air Force
side. What were your initial impressions of fitness
standards or lack thereof in the first responder
professions when lives depend on us literally
on a daily basis? Yeah, I think it's been a good
experience over the past year, year and a half
trying to figure out like, okay, where are we
at as a department? And overall, I think our
department does pretty good. But there's again,
you I think you have that. It's not so much of
a bell curve anymore. You have the people who
are in really good shape and put effort in. And
and I would say that's at least two thirds of
our department. I'd say we're a pretty prideful
department on holding each other accountable.
But then there's another at least third to half,
maybe that. Do you want to end up on the drill
ground with them? Do you hope that? they're sitting
next to you in the back seat when, when the big
fire goes or that I kind of always challenge
what I'm challenging our new recruits and our
probationary firefighters with are be the firefighter
you want showing up when your family needs help.
Right. And, and can you look at yourself in the
mirror and say that individual would save my
family, save all the kids, save, save your dog,
everything like. And if you can't honestly answer
that, yes, I feel confident. There's nothing
wrong with that, but it's good to do a self -reflection
and then lean on the resources, lean on people
like me or go private and use that to, there's
so many resources out there. Like make yourself
better, a little bit better every day. What about,
let's stay with the PJs because it's the closest
apples to apples. What standards are they held
to, to maintain fitness? Oh man, to be honest.
I can't speak to that right now. I don't know.
It is so far beyond what we hold our people to,
though. Like I know when I go there, generally
when I'm there, what I go to help with is it's
called A &S, their assessment and selection.
So it's like their hardest two weeks. And we're
just doing sick call and treating injury like,
hey, I rolled my ankle out on like the midnight
rock. So I don't know too much about their fitness
standards, but all of these individuals, like
you just see them walking around, working out
and like, man, I wish I got paid to work out
six, seven hours a day. They are in absolutely
phenomenal shape. I think they would breeze through
Fire Academy, at least from a fitness standpoint.
Well, this is what I hear from, you know, all
sections of special operations. But another group,
which I think is really important to highlight
is the Ocean Lifeguards. So usually a lot of
times they're attached even to fire departments
in Southern California, but I was a lifeguard
in open water, not, not ever the ocean though,
but you are held to a standard. If you don't
recertify for, for example, your swim test, which
involves a lot of, you know, cardio and strength
and conditioning, then you're not a lifeguard
anymore. It's just that simple. And so I think
that we as a profession have done such a disservice
by never putting a standard in when one could
argue that you are held to a standard in the
academy. So no one can say it's not fair. You
pull dummies, you climb stairs encumbered, you
chop wood, all the things. So it's a beautiful
way of just keeping that standard held with the
CPAT, with the FPAT, something that's completely
job specific. So you're not being unfair to the...
120 pound firefighter or you know the six foot
five firefighter that might have you know more
challenges you're just saying you either can
or you can't do the fire ground tasks when put
in a sequence so i don't understand why there's
such resistance when pretty much every other
high level life -saving profession requires that
people to be held at a standard and if they're
not then you're not a seal anymore you're not
a green beret whatever the thing is if you can't
maintain it And then you create a culture of
that where you almost don't need a standard because
it's just an accepted conversation, which to
your point, a lot of fire departments, they have
that group that doesn't matter what you tell
me I have to do. I'm going to train because I
understand the nature of my job. But I think
it becomes a deterrent then, like you said, for
that middle group that can be swayed either way
not to allow themselves to slide. Yeah, exactly.
It is an interesting... I feel like I have a
lot of conversations at our department right
now of what would this look like to actually
implement a standard? And is it punitive? Do
you have to do incentives? I think one thing
that has been eye -opening as far as just learning
the processes different from the military versus
now in the fire service is the introduction of
unions. And now you have these protected class
employees. And what were the contracts like when
they signed up? It's definitely an interesting
thing of how do you work all of this in and make
everybody happy, which I don't know if everybody
will ever be happy. Well, I mean, from the union
point of view, it's a super simple answer. Do
you want your men and women to be healthy and
have long, fruitful retirements? Well, then why
would you oppose a fitness standard? It's that
simple. Opposing a fitness standard is basically
increasing their chances of dying from physical
or mental health disease. Yeah. So if you're
supposed to be there for the benefit of the workforce,
you should be the one spearheading the fitness
standard. A fair one, like I said, a CPAT or
something, not, you know, must deadlift 500 pounds
and then run a sub four mile. But, you know,
that is you literally at the front door expected
that if we're going to be talking about cancer
and heart disease and all these things, but you're
not being part of the conversation for a healthy
work week and a fitness standard, then you're
not taking any of those issues seriously. Absolutely.
I know a lot of people argue like, hey, the system
is broken. We need to figure out the shifts or
we need to figure out the call volume and all
of these things. And while they are absolutely
right, there are a lot of system issues we need
to change. That doesn't mean you need to wait
to make your own personal individual changes
and like figure out, am I eating well? Am I sleeping
as much as possible, at least on my off days?
Am I exercising in an appropriate way? Right.
We still have some individual responsibility
to this. I'm curious because one one always pushback
I hear with the fitness standard is would we
make it age or gender determinate or like like
we scale it for those? I'm curious what your
thoughts are on that. Well, as a 51 year old
bloke that still does all the training and would
actually be able to do the fire ground stuff.
And having people older than me in my gym that
could also do it. I mean, I think there's a very
easy answer, which is we're all in gear. And,
you know, it's your family that are up on that
eighth floor apartment. Do you care who's inside
that gear? Gay, straight, 50, 18, you know, or
do you just want them to be able to do the job?
So if you are going to be on an engine, a truck,
whatever it is, and bearing in mind, as you alluded
to. If you did the CPAT as a standard, it is
not a hard test. It is not. It's just maintaining
the ability to do it. And it then is a beautiful
way of seeing, all right, am I getting some immobility?
Are things starting to hurt? Am I having problems?
It's a great assessment tool for you to work
on yourself without getting too far beyond and
getting hurt. But it just comes down to the point
of can you or can you not? And age is no different
than skin color and gender and sexual orientation.
You either can or you can't. And I certainly
wouldn't accept that my child died when someone
said, yeah, but I'm 49. I just couldn't make
it up there. So that's, again, it's a big boy
conversation. If you want to be a firefighter
and you want to work for 20 or 25 years, then
you have to maintain that standard. But I'm also
very fair. How can we expect our men and women
to maintain a high level of performance when
they're working 56, 80, 120 hours a week? So
those have to go hand in hand. If we're going
to expect our men and women to maintain the standard,
we have to give them the work that allows them
to actually perform at that level and maintain
their body composition. Absolutely. Yeah, my
short answer to that question is always the family
that you're going to help doesn't care how old
you are, how you identify, anything like that.
I think that's where I try to strive on. we shouldn't
be hitting the minimum standards when we are
in our 20s and our 30s. Because yes, your performance
may dip as you age, as you have injuries. But
if you're starting at the minimum, oh man, it's
going to be a steep decline in the next 20 years.
Versus if you start really, really good, yes,
you may have a slow decline, but you're still
hitting that minimum standard by the end. It's
literally the same as the guy that says, I don't
need a train. I just see red. The adrenaline
will help me out. You're like, no, you fall to
your level of training. You don't rise to your
level of expectations. So if at the front door,
you're already on the back foot, where do you
think you're going to be 15 years later? Yeah,
absolutely. Yeah. And seeing red, it may work
once, but then if you get a second call or it's
a bad call, like that's not going to last too
long. No, exactly. Well, you alluded to injury.
So let's get because I want to talk about rehab
and, you know, getting back to work. It's a really
important conversation. Now you've got these
people, you know, you've had the standard, you've
had a good strength and conditioning cycle in
the academy. Now they're on the floor. What are
some of the most common injuries that you're
seeing? And are there any things that you're
pulling your hair out going, we can avoid this
if we just started doing this? Yeah, I'd say
most the most common injuries across the tactical
population is going to be shoulders, back and
knees. And so so that's kind of the most common.
And again, that's very general of like what's
actually causing this. I have started doing like
some injury prevention stuff. So I go out to
the stations and it's weird in my role right
now. So I'm hired as their health and wellness
coach. So I'm not actually allowed to do physical
therapy with my current classification. So, so
that's a little bit challenging, but I'll go
and like, Hey, do you like, what workshop do
you guys want to do today? And let's say it's
the shoulder workshop. I'll have them do a lot
of like pre -test post -test. So range of motions,
things that might hurt their shoulders. And then
we go through a bunch of exercises and we retest.
And it's one of those, like, if you happen to
feel better after, whoops, it wasn't physical
therapy. We were just exercising them. Now you
feel better after. How cool. And a lot of them,
most of the time, they're like, man, why don't
I do this more? I don't know why. That took 10
minutes. Why don't you guys do it more? And so
I think one thing that I'm kind of like pulling
my hair out a little bit is a lot of times in
this population, we want to train very, very
hard. Like we want to redline a lot. And so.
pulling back the reins and being able to say
like so for instance where our department is
a 4896 hey i'm on day two i'm on day three i
don't need to do a crazy workout today i still
want to go be active but maybe i'll do some of
that like hip injury prevention stuff maybe i'll
go do this where i'm getting a benefit i'm still
exercising but it is not a crazy energy expenditure
so that if i do get a bad call or like it's just
going to help me sleep better So that's one of
my big missions right now is how do we introduce
more of like mobility or stability training to
help with injury prevention and overall wellness?
I had Jeff Nichols on the show. I think it was
the first time he came on. Former SEAL Team 6
turned strength and conditioning coach. I used
to have the mentality and I came from a background
of being a coach and an athlete and an ex -phys
major and all these things. But I would come
off shift and go, all right, I'm going to go
crush myself at the gym and sweat out the stress,
air quotes. And something he said, but he was
like, you're just adding stress to stress. And
it just hit me like a, you know, lightning bolt.
I'm like, God, I'm such an idiot. Of course.
So kind of like you're saying, if you've done,
you know, just say it's just a 24, not something
insane, like a 48. That's my opinion. Um, you
know, you come off shift and you barely slept
and then they're like, okay, it's Murph today.
Maybe just maybe, or Fran, that's not the one
for you. Maybe just when everyone else is working
out and just go take a one mile slow run or go
for a walk with your dog or row or swim or something
else. And the moment I realized that, yeah, when,
when you, are stressed, adding a high intensity
workout is not the time to do it. And like you
said, you can take a different kind of workout,
a low intensity one, and that will help bring
the stress down. And then maybe after your first
full night's sleep, that might be then, okay,
today I can do that red line workout. Yeah, exactly.
I recently gave an injury management lecture
to our department and I had one of my guys just
got off of probation. I was talking about overtraining.
And some of the signs, one of them would be like
a decreased HRV, your heart rate variability.
And that's essentially a, simply put, like how
well is there a balance between your parasympathetic
and sympathetic nervous systems? And if it's
really low, like most of us are just in this
like fight, fight, fight all the time. We're
always fighting or fighting. We don't get that
slow down, calm. And he came up to me after and
he's like, hey, I have one of those Garmin watches
and it is, I'm in the red all the time. It says
like low or poor training readiness all the time.
Like, why is that? Because you don't give yourself
enough time to sleep. He's a young kid. Love
him. I think he's like 23, 24, has two kids.
So he's balancing it all at home and at work.
And so I pulled him aside with his captain and
I was like, hey, the next two days, all he gets
to do is this. I have like a 20 minute hip and
low back mobility video that I've shared with
him. That's all he gets to do for exercise. And
like, make sure he goes to, he's not the typical
24 year old who's staying up till midnight at
the station, like let him get some sleep. And
I saw him a week and a half or two weeks later.
He's like, I feel amazing. Like what is, why
is it? Yeah. Like you don't have to train crazy
hard all the time, right? We, we need to find
that balance of training with intent, but not
crushing yourself all the time. Absolutely. And
with the 48, there's a Swedish study that Daniel
Higuera shared with me. And they actually studied
the 24 -72 in some busy departments. And this
is a fit population. The Swedish firefighters
are very fit. And they showed that it did take
a full 72 hours to get close to baseline after
24. And if you listen to all the people in the
sleep medicine world, a 48 hour. straight without
sleep or disruptive sleep is just crazy. And
I think another thing that people don't think
about, and you kind of alluded to, is the more
tired we are, the more chances there are also
for slips and falls and just, you know, other
ways to injure ourselves. So I'm a big, big opponent
of the 48 hours because, you know, it's not my
opinion at all. It's literally just science.
Like if you ask anyone about sleep, the big kind
of aha moment for me was when you think, okay,
well, when do people use sleep deprivation deliberately?
And it's for special forces selection, interrogation,
and torture. So if that doesn't underline that
we shouldn't be sleepless for multiple days in
a row in a life -saving profession, then I don't
know what does. Yeah, I have every year, we have
what we call coach's drill. So almost all of
our membership comes through and we do like their
hearing test. SCBA mask fits, but then I have
like a fitness portion and assessments and something
that I would want to do. It feels complicated
to try to figure it out, but is looking at the
averages of individuals on day one. Like if they
came in on their day one versus this crew came
in on day two versus these people are on day
three. And let's look at like the performance
standards and even simple things following very
simple directions. I joked around that. So we
have almost 600 people coming through this. You
know, those dog buttons that you can hit, like
walk, like I want to go for a walk or I want
food. You know what I'm talking about? By the
end of this month, I wanted those in my office
so I could just hit the stuff that I kept repeating
for them because they can't follow simple cues.
And you guys are who we're calling for when we
need help. This is very alarming. And obviously,
yeah, they snap to it when the time comes, but
it's still how many times can you do that over
a chronic period of time? Yeah. I mean, I'm all
for the 24 -hour shifts. People get nervous.
They talk about shifts and, oh, we'll just do
12s. And it's like, no, there's glaring evidence
that's not a healthy shift, bouncing from day
to night in the circadian rhythm. And look at
the people that do, the ER doctors and nurses
and the police officers, many of whom are not
a pillar of health. But if you take that same
model and you put it, all right, well, then would
you want the pilot that you're flying with to
have not slept for two days? What about the truck
driver? You know what I mean? You put it in other
professions, you go, hell no. So then, you know,
you're a neurosurgeon. Then why, like you said,
you wake up from a dead sleep, 3 a .m., slide
down the pole, drive the back of a tiller, go
to a structure fire, throw a ladder, climb, make
entry in a second floor bedroom window, find
a child. take them out of the window, doff your
gear, now start working a pediatric cardiac arrest
algorithm, and you're okay to have not slept
for 48 hours straight and worked 56 or 80 hours,
but the person that made you a coffee yesterday
taps out at 40. You know what I mean? It makes
no sense whatsoever. It really doesn't. I agree.
I agree. These are the big system changes. The
old big ships turn slowly, right? So we just
got to keep... trying to nudge it in the right
direction and hopefully we'll get there soon.
Yeah. Well, I always said they, they sure as
shit stopped a big ship in its tracks during
COVID. So I think in that analogy, enough people
want to make it happen. It will just happen.
Simple as that. So, all right, well then moving
on a world that I'm very familiar with. I've
had meniscus surgeries on both knees. I had that
back injury and all three times rehab myself
all the way back to fully fit for duty. If we
get that. you know, skyscraper fire on the first
day, I was ready, absolutely ready for it. But
where the bar was, if I wasn't someone that came
from an ex -phys and strength and conditioning
background, would have been a lot lower. And
I would argue that I wouldn't have been ready.
And maybe even the possibility of re -injury
would have been there. So talk to me now with
your physical therapist hat on. about the tactical
athlete the firefighter who has been hurt whether
they're rehabbing whether they had surgery and
then rehabbing after that and how we get them
to fully operational before they get back on
the rig yeah that's where we really like first
off need to find what we refer to as a culturally
competent or just physical therapists or clinicians
that are aware of the job requirements what you
guys have to do and are testing things in a very
objective way. And so we need to be doing like,
one thing I like about our current fitness tests
is I'm getting not only seeing where people are
at and how can I help, but if these individuals
get hurt, now I have their healthy baselines.
And so I'm using that sort of data as part of
our reintroduction to work. It's not necessarily
the barrier, like if they pass the minimum, they
still get in, but I can start working on their
strength and conditioning at that point. But
we really have to have a good conversation with
our clinicians of here's what I'm doing. How
does the treatment that you're giving me, like
what is the intent and how does it get me to
where I need to be? So having really good, transparent
discussions with our providers is important.
One of the, I think it was a PT as well, a long
time ago said to me that when you feel like an
injury. is healed when you feel pain -free is
actually only at about 80%. And that's where
the danger of re -injury is. I don't know if
you want to elaborate on that. Yeah, absolutely.
We are not treating just for symptoms, which
is what we're feeling. We're treating for function
as well. And that's where a lot of, whether you
have things like the force blades, things like
dynamometers. So like a dynamometer, a lot of
us are familiar with it with grip strength. but
you can have them where they have compressive
forces or tensile forces, and you can test pretty
much every muscle in the body. So comparing side
to side, making sure you are fully good. I think
having that helps not just identify where are
continued areas for improvement, but also helps
you see, okay, like James, you're my patient.
Yes, you feel great. You feel like you're ready
to go back, but your injured side is only 75
% strong compared to your uninjured side. Which
even that sometimes you could argue, is your
uninjured side weaker than it should be? That's
a whole different rabbit hole. But we need to
figure out like, it's not just the symptoms we're
treating, it is the function. And that is really
what prepares you to get back to the job. Another
thing that I saw, because obviously, like I said,
three times, firstly, there was a kind of push
to go to light duty. And what I did when I got
her up was like, well, I'm a full time rehab
now. And I've got, like I mentioned, Cairo and
the gym and PT and all the other things I was
doing, yoga, anything I could do. And it was
almost a full -time job just trying to rehab
this injury so I could get back successfully,
which I did every time. So obviously that worked.
But the pull to either go to light duty, where
I would argue you can't then do a lot of this
unless you've got, I mean, you might be going
to a PT session, but now you're then... kneeling
on the floor filing for six hours after that.
Or there's this kind of mythology that there's
a badge of honor about getting back quicker than
the doctor told you as well. Like the department's
just going to put you on a pedestal and they're
all going to applaud for you. No one seems to
give a shit. So that resistance to not feeling
driven to go back. And I'm not talking about
sandbagging, but not rushing the process to get
back. under the kind of false pretenses that
that's a good employee thing. Yeah, I feel like
I see both ends of the spectrum with that. I
think, you know, something I've heard on your
podcast, again, the cost of living here in California,
people often don't live in the city that they
work in. So when you put them on a light duty,
especially if it's a 5 .8s or 4 .10s, They joke
nothing heals you faster than light duty, right?
Like they don't want to commute all the time.
So we get people that rush back too soon. And
then you also get the people who do milk the
system. They're off for a year or two for something
minor and you don't know what's going on. I think
that's where one of my goals is building this
internal wellness division that we're trying
to strive for right now in Sacramento is. if
i'm actually able to be the physical therapist
and we now you like james you're hurt you're
coming into training and yes you're on light
duty but you're here at the gym with the pt we're
working on strength and conditioning like we
can help with that bridge the gap and maybe you're
helping drive rigs around and stuff because obviously
you can't be working out all day but finding
that balance of still serving a role in the department
but having the time needed to actually get healthy
Like you said, that should be your full -time
job is to get healthy enough to get back to your
full -time job. Going back to the fitness standards
and the type of candidate at the front door,
talk to me about the improvement in overcoming
an injury, rehabbing from injury, if you were
already in good shape prior. Yeah, it's huge.
If you just have a baseline level of mobility
and strength, your ability to recover is going
to be greater versus if you, let's say for shoulder
pain specifically, a big thing that I think gets
overlooked is thoracic mobility. So for those
listening, thoracic would be like your mid -back,
the levels of your spine that the ribs attach
to. So poor thoracic mobility has a big, big
correlation to shoulder pain and neck pain. If
you aren't on top of that, your shoulder range
motion's bad, and then all of a sudden you hurt
your shoulder or thrown a ladder, Yeah, your
recovery is going to be worse versus if you've
done all that pre -work and then the latter injury
still happens. One, it's probably less likely
going to happen, but your recovery is going to
be significantly better. Absolutely. And then
let's talk about the aging firefighter. Again,
you know, none of us are pretending that the
50 year old is, you know, if they're both of
the same kind of level, the 50 year old. They
would have been the same level at 18 is what
I'm saying. The 50 -year -old now obviously is
not going to be able to be as strong and as fit
as the 18 -year -old if they've been through
20, 25 years in the meat grinder. But that 50
-year -old has been diligent and taking care
of themselves, is still going to the gym, still
doing mobility. What are some of the factors
for the aging tactical athlete, not lowering
standards and that kind of thing, but just to
help them maintain? maintain their performance
so that they can have a healthy retirement and
not be riddled with ailments once they leave
yeah i think the the over training thing realizing
like as you get into your 30s 40s and beyond
that you don't need to be in that red line all
the time and accepting that exercise whether
it is it looks like physical therapy and it's
just some mobility or some light strengthening
like that is still beneficial for your health
and wellness that is something that honestly
i don't think a lot of our firefighters it's
hard to tell them that because they get excited
they're like oh you mean i don't have to work
out hard anymore great because it hurts but also
you still need to put in that work that just
30 minutes on the elliptical twice a week three
times a week like that's also not going to cut
it right so you You need to find that balance
of not super low level, but it doesn't have to
be super high level. I'm a big believer, and
this is kind of how our Academy Fitness runs
in what would be more like functional fitness.
So a lot of push, pull, carry, squat, hinge,
and lunge. And how do you work those into your
everyday workouts? So especially for our tactical
population, we don't have the benefit of kickoffs
at Sunday at noon. Every day we might be going.
So coming up with a good strength and conditioning
program is a little more challenging. And so
that's where I'll mix in. I won't do like chest
day or back and bys day. And then those areas
are super sore. I kind of sprinkle in everything
throughout the week. So you get the same amount
of volume and you get the exercise benefits,
but you don't have that like my body just got
beat up feeling. And so that's what I work on,
even with our young people that try to develop
habits, but definitely our older firefighters.
At 51, one of the kind of realizations I've had
is, you know, I'm not going to be, unless for
some reason I decide I want to get into powerlifting
100%, at 51 as an all -round athlete, I'm not
going to be getting even stronger than I was
when I was 30, for example. But I'm fit, I'm
strong. where my limitations are on my mobility.
So I feel like that if I focus more on that now,
I create more strength, more endurance by moving
more efficiently versus trying to chase endurance
and chase strength training in my middle age.
Yeah, yeah, it's a delicate balance, right? I
think one thing I was just thinking about, as
you were saying, chasing the mobility too. that
I try to work on with everybody, but definitely
our older guys is having a good warmup. I don't
think can be overstressed. And a lot of people
are like, ah, if I warm up and then the tones
go off, like then I didn't get to do my workout.
Yeah, you're absolutely right about that. But
if you have an intentional warmup where you're
going through both mobility and some sort of
like muscle activation, strengthening, worst
case scenario, you got some injury prevention
in. Best case scenario, you got to still work
out and you got way more out of that workout
than you would if you just jump in cold turkey.
Absolutely. You mentioned as well about some
of the movement patterns. I am a weekend warrior
coach, never been like a full -time coach, but
I teach once a week, a free class here in town.
And throughout my career as well, I really love
the strongman implements. So, you know, the sleds
and the sandbags and the kettlebells and some
of these other things. Firstly, and most importantly,
because they really mirror what we do. We do
push, we do pull, we do drag, we do climb. But
the other thing was, especially when you have
some of the firefighters that have found themselves
deconditioned, if you ask them to do an Olympic
snatch, you know, and then an overhead squat,
you know, between the mobility and just simply
the skill of the movement, there's a huge fear
of I'm going to look stupid. And I fully understand
that. But if you tell someone, pick that sandbag
up and just walk over there and put it down by
the cone. And there's this kind of you remove
that fear of, oh, what if everyone thinks, you
know, what if I can't do it? So I love the simplicity
of those movements because it takes away that
fear of, you know, what's everyone going to think
or the frustration of trying to do a movement.
A squat is a very, very technical movement. So
talk to me about some of your favorite kind of
implements and tools that you use on the strength
and conditioning side to mirror what we do. Yeah,
I. I just kind of caveat to what you're not caveat
following up from what you were saying is having
people be successful. Like you still want them
to be challenging, but are challenged, but you
don't want them to feel like walking out of the
gym of like, wow, that sucked because now you
just lost them. Right. So, so finding that balance.
And that's where I agree, not having something
super technical, like overhead squat snatch.
i was into crossfit for a while myself and it
is like there's a lot of skill movements with
that that aren't necessary for our job but i
add in a lot of because we're trying to also
make these workouts time efficient right because
we're all busy in our lives typically our workouts
are 30 to 40 minutes max and then with a warm
-up before that but it is a lot of twisting a
lot of multi -planar stuff so i'll add in like
uh one thing i'll call is like a stagger stance
romanian deadlift so imagine you're picking up
a patient who's stuck between the toilet and
the shower and right we're not going to have
perfect deadlift technique so how do i get used
to deadlifting with a little bit of a twist and
we'll do that mostly with kettlebells or um using
landmines for that's one of my go -to's for training
somebody who's struggling with ladders is how
do we work on that transition of a ladder pickup
to shoulder press and really use their body right
you're getting those twisting multi -directional
patterns in rather than just our traditional
bodybuilding stuff is going to be much better
for aesthetics sure but you're just training
one joint in isolation which is not how we live
Let's go to nutrition, hydration. What are some
of the principles? Because I mean, everyone will
tell you that their way of eating is the best
way if they're selling a program for it. But
overall for this population, what are some of
the principles that you usually tell your firefighters
when it comes to the hydration side and then
the nutrition side? I'll start with hydration.
So general, general principle is we should be
aiming for half of our body weight in ounces
per day. So if I weigh 200 pounds, I should be
starting with at least 100 ounces and then increase
that if you're spending a lot of time out on
the drill ground. That's where if you want to
get really specific with it, you can weigh yourself.
Like if you're in the academy, weigh yourself
in the morning, weigh yourself when you come
back from home. That'll give you a good idea
of how much fluid you lost and how much fluid
you need to put back in your system to get ready
for the next day. Another thing I'll let people
know is like if you're a salty sweater, you see
it on your hat, your shirt, like kind of those
white stains, we need to definitely add some
electrolytes for you. I think a lot of us got
so scared of especially like high sodium in our
foods. And granted, the general American diet
is still very high in sodium. But if we're burning
a lot of electrolytes, especially you live in
a place like Florida, it's hot in California,
you're sweating out a lot of your salt. Like
you need to add those electrolytes back in. for
sure. There is always a caveat. I feel like last
year we had one recruit who was saying he was
thirsty all the time. He was drinking so much
water, blah, blah. And then the follow -up question
was like, how many, I think he was using elements.
And I think he was using five or six elements
a day. He's like, okay, yeah, you're basically
just consuming salt water. Of course you're thirsty.
So you have to find that balance of water with
electrolytes. But yeah, that is a big one. And
sticking with the hydration, not only is that
good for just general health and wellness, but
if we think about it from an injury standpoint
as well, I like to use the example of our tissues
being like beef. And when we are hydrated, it
is a nice, soft, supple steak where it's malleable.
It can move and not break versus dehydrated beef
jerky, right? And I can shred it easily. lowering
your risk of tendon and musculoskeletal injuries
as well as big with hydration. What about energy
drinks? I'm hearing a lot of stories of rhabdo
and some of these other areas. You know, you've
got these young people just slamming monsters
and God knows what. Talk to me about that whole
thing. I try to encourage people to avoid them
at all costs. I think there's so much stuff in
them. The rhabdo is a big concern, but just everything
that's in it, as much as possible, avoid the
energy drinks. I see people pack them in their
coolers when they're jumping on the medic. Obviously,
you need to do what you need to do to stay awake,
but I think there are a lot better alternatives.
I'd rather have somebody have some caffeine tea
or something like that than just slamming monsters.
Yeah, that's some people's breakfast of champions,
unfortunately. Yeah, there's an amazing cognitive
supplement called sleep that people can get for
free. Yeah, absolutely. If only. All right, what
about the nutritional side then? So nutrition,
I will caveat like my, my specialty is in the
musculoskeletal stuff. So I'm, I'm not a nutritionist
by any means. I've been doing a lot more studying
on that, but I take a very simple approach with
nutrition of calories in calories out. We were
lucky that we got like a, one of the higher level
in bodies in recently. So that's your body composition.
And so I'll have our new recruits jump on that.
And that gives an estimate of not just their
body fat, but their basal metabolic rate. And
so for those listening that don't know what that
is, I call it like your survival calories. So
if all I did is lay on the couch and walk to
the bathroom as needed, that's how many calories
I would burn per day. And then you add your calories
to that with exercise, with activity, the physical
demands of the job, all of that. And so we kind
of talk about set this framework of, for example,
my active calories plus my basal metabolic rate
is 2500 i need to eat that many calories to maintain
my weight if i'm the skinny 125 year old or 125
pound kid here's how much you should eat to gain
weight if you need to lose weight here's how
much and i generally shoot for people to have
a 500 to a thousand calorie max deficit so 500
calories per day deficit would be a pound a week
of weight loss a thousand would be two pounds.
I think all of these like crazy fad diets, things
where you're losing 10 pounds in a week, like
awesome. But did you learn any lifestyle habits?
Did you learn how to like actually maintain this?
No. So I take a very simple approach with let's
build habits that you can sustain, not gain 10
pounds, then lose 10, gain 15, lose 10, all that,
right? Like what can we do to sustain these lifestyle
habits? I think that's the danger of a Zempik,
aside from some of the side effects. I think
especially in the morbidly obese, I think it's
far safer than gastric bypass. I've got two,
my wife's best friend and one of my fire academy
friends both died from complications from that.
So I think it's horrendous. You look at the concept,
it doesn't even make any sense health -wise.
But if you're using that as a way to lose weight,
and one of our gym members I just bumped into
in the car park a couple of days ago, and she
looks great. But now is obviously when you have
to start adjusting how you move, how you eat.
Now that you've got yourself to a body weight
where it's comfortable to move again. Brilliant.
But the same thing. OK, you've used this to get
to a point. Now, what's the exit strategy? How
are you going to wean yourself off this so that
now you don't need this drug anymore? Yeah, I've
actually talked about this at length with my
my oldest brother has struggled with weight.
And he was asking me about it. And he kind of
came to the conclusion of, you know, I'd rather
do the hard work. I want to do this. And yes,
it's going to take me longer. And maybe I compare
myself to other people and they're progressing
better. But something that I'm really proud of
him for is the sense of pride. He's like, I will
be so much more proud of myself and the accomplishment
that I made. And he's got two daughters and like
showing your family. the quote -unquote right
way to do things versus shortcuts um i was super
proud of him for like coming to that decision
and and excited for the journey that he's on
yeah no and this is the healthiest way isn't
it because we know if it comes off slowly it
will stay off but if you see these you know biggest
loser documentaries i mean they have these crazy
losses and then they're all the same size again
yeah We did watch that recently. That was crazy.
I grew up loving that show. So it was funny,
not funny, but very eye -opening to see the behind
the scenes of some of that stuff. Yeah. And it
wasn't anywhere near as compassionate as we thought
it was behind the scenes. Not at all. Not at
all. All right. Well, I want to transition to
some closing questions so I can be mindful of
your time. The first one I love to ask, is there
a book or are there books that you'd love to
recommend? It can be related to our discussion
today or completely unrelated. Yeah, two books
that come to mind. One kind of related to the
stuff we're talking about would be Switch by
Chip and Dan Heath. So that's it's like switch
how to how to make change when change is hard.
And so it really looks at like system changes
or small little things that we can do to make
changes in our life that a lot of these times,
like the change doesn't have to be as hard as
we think it is. And so there's a lot of cool
stories in that book, highlighting that. And
then the other one, my favorite, absolute favorite
one is Unbroken. It's the Louis Zamperini story.
And obviously I'm biased as an SC guy, but his
whole story, are you familiar with Louis' story?
I am. It's funny how many times that book's recommended
as well. Oh, yeah, I love it. And I know, was
it Angelina Jolie came out with like his, the
movie about it. I just you can't do that book
justice, the getting the psychological behind
the scenes of like how he's feeling and all that
in the book. When when I think about like the
things that we struggle with in life and in our
day to day, we are so comfortable in reality.
Most of us are very comfortable day to day lives
getting into his mindset and the thought process
there and like how he continued to persevere.
From just a mental health standpoint and mental
resilience, that's my absolute favorite. So I
think his iPhone breaks, doesn't he? That's what
the real struggle was? Yeah, yeah. Yeah, man,
it is crazy. His whole story, I had the opportunity
before he passed away, he came and spoke. We
kind of heard some stories from him at SC. And
at this point, he was probably early 90s. I think
it's been almost 10 years since he passed away.
But he had this old like tattered USC hat on
and the Trojan band came out, gave him this brand
new hat. And all of a sudden you see him lean
over to his son and he asks for his old hat back.
He just wanted his simple stuff. Like, man, the
Louis Zamperini story is absolutely amazing.
If anybody hasn't read that, I highly, highly
recommend that. Absolutely. Well, what about
film, television, documentaries that you love?
I'm not too big on that stuff, to be honest.
My wife is also a physical therapist, works more
in the hospital setting. And when we're watching
TV, it's escapism, as bad as that sounds. We're
watching trash reality TV, just anything to kind
of get our minds off of work or off the stresses
of it. Yeah, not too much TV. Brilliant. Well,
the next question, is there a person that you
recommend to come on this podcast as a guest
to speak to the first responders, military and
associated professions of the world? Yeah, two
people came to mind. One would have been the
third book I'd recommend, which is Outlive by
Dr. Peter Attia. He is big in like the longevity
world and what he refers to as medicine 3 .0.
I think it would be amazing to hear. his thoughts
and like viewpoints on this the tactical community
your fire specifically just within the sleep
and and all of the other cancer and cardiac disease
risks that would be really cool um and then uh
another pt that i would recommend one of my mentors
is danielle anderson she's a lieutenant colonel
in the air force and been working with nasa for
i think four or five years now so she's been
like the one of the head pts at nasa and just
an absolute badass so smart could speak way higher
of like what we could do as pts in a unique setting
and trying to help out uh people so yeah danielle
would be awesome fantastic thank you so much
all right well then the last question for you
make sure everyone knows where to find you what
do you do to decompress yeah so i'm a movement
junkie as i think a lot of us are so uh running
exercise, anything like that. Very lucky where
we're living, we can paddleboard almost every
week or go hiking. And then during this time
of year when it's getting darker out and colder,
honestly, puzzles. I'm sitting next to a puzzle
on my table here right now. That is a nice way
for me to try to not be in front of the TV and
just kind of tinker with something. My wife and
I will turn on some music and just knock that
out. Brilliant. My son just bought one for that
same reason. And he's 18, so that's good. Get
him away from the screen. Yeah, it's nice, right?
It helps pass the time. We'll set a timer and
be like, oh my gosh, an hour passed. Cool. Sometimes
it's frustrating, but it's a good cognitive task.
And yeah, problem solving, it's fun. Absolutely.
Well, for people listening, where are the best
places to find you, learn more about you online
or social media? Yeah, probably the easiest two
would be Instagram at tactical underscore athlete
underscore performance or at my website, tacticalathleteperformance
.com. So that's where I do a lot of the consulting.
I do physical therapy still on the side, like
outside of the stuff with the city of Sacramento,
but those would be the two easiest ways. Beautiful.
So just expand on that a little bit, because
we didn't really hit that. So you're working
with Sacramento. So what are the services that
you offer for other people are looking for, you
know, using you and your skills in your company?
Yeah, so coaching. So like I mentioned before,
like coaching for pre academy, or just people
trying to get in shape for fire academy, or even
if they're online already. And then physical
therapy. So either in person or virtual. I do
a lot more consulting now of like second opinion
type stuff. Like, hey, here's what I'm going
through with my provider. Do you feel like I'm
getting good care? How should I advocate? Does
this seem like I'm on the right path? That sort
of stuff. I'm a very big believer in teaching
somebody how to fish, which is great for individuals,
but bad for business. So most of the time I average
one or two visits per case. just because we're
chatting and giving you all the tools that you
need to do to rehab. So those are the two biggest
things. And then a little bit of consulting with
departments. People want me to come out and do
lectures or any sort of injury prevention type
work. But all of that caveat is outside of my
job within the city. So my availability is good
on the weekends and late night weekdays. But
yeah, I'm very committed to Sacramento right
now. Trying to hopefully make some changes here.
Brilliant. It's funny that circles around to
the sports agent conversation at the very beginning
and the kind of people that were in that business
law class. I've heard people in your field say,
I could just keep people coming back, but I want
them to get better, which is a terrible business
model, but it's a beautiful human model. And
I would argue it's a good business model because
if you're the kind of person where they go and
visit you and... they get better, then they're
going to tell other people who will then come
and visit you and they tell more and they tell
more. But it's funny, on the dark side of medicine,
there's a lot of professions, you know, Cairo
and some of these other areas where there's less
ethical practitioners that are deliberately keeping
you coming back rather than giving you the tools
to heal yourself. Absolutely. I use the mechanic
analogy a lot, right? Like you wouldn't keep
taking your car back to the mechanic with the
same check engine light keeps coming on. Like
eventually you'd be like, this guy doesn't know
what he's talking about. So yeah, I love the
concept of most of us have like my dentist, right?
Like I go to, I know who I go to every six months
for routine checkups or if I need anything. Having
that same philosophy of like, that's my PT. I
know I can trust Nick to whenever I need something.
I know he's going to give me the best care that
he can. That is my goal rather than this like
recurring business model. And yeah, I'm not good
at business at all. Me neither. All right. Well,
Nick, I want to thank you so much. It's been
such an. an important conversation with the kind
of lens that you have between the collegiate
sports, then the military space, especially in
some of the high performers that you work with,
and then comparing that to the fire service.
And hopefully people have got a lot out of this
conversation. So I want to thank you so much
for being so generous with your time and coming
on the behind the shield podcast today. Yeah.
Thank you, James. I appreciate your time and
everything that you've been doing. It's a, it's
awesome to keep getting education.