The Secret to Longevity: Keep Moving – Chasing Life with Dr. Sanjay Gupta

‘Welcome to Chasing Life! I know for me, between having three teenagers, having dogs, the carpools… finding time to exercise is not always easy, but at the same time, it is essential. It’s got to be as important to you as the most important habits in your life. You’ve got to make exercise and movement one of those priorities. And that is why I am recording this podcast right now from the ground. Okay, I’m going to explain. I know you can’t see me, so you’re going to have to take my word for it, and my wife, who is actually helping me right now, I’m sitting down on the ground, crisscross applesauce, a man in his mid-fifties, why? Because it turns out that doing this every day, just sitting on the ground is really good for my body, it’s really good for my joints, and good for muscles, but also importantly, my ability or inability to get up from this position without really using my hands or any help from Rebecca. That is a real test of my overall health and fitness.

Because it’s not about strength. It’s about your ability to move your body to solve problems that we know are going to become important to you.

‘That’s Dr. Kelly Starrett. He’s a physical therapist, a former professional athlete, co-author of a really good book called Built to Move, The Ten Essential Habits to Help You Move Freely and Live Fully, and he wrote that book with his wife Juliette. Kelly is also an expert and a leading voice in the growing fitness trend called mobility.

‘Ultimately, we want to give you more movement choices. So what we see is that people who sit on the ground, their 5K times get faster. Their backs stop hurting. They want to walk more. They want interact with their neighbors more because their bodies feel better. And it’s simply because we’re having the body engage in body-like things.

‘So I wanted to have Kelly on the podcast today to talk about this idea of mobility. What exactly is it? Why is it so important as we age? What are some potential red flags? And to give all of us busy people some of the simple tools to improve our range of motion, our posture, decrease our pain, and yes, become more mobile. I’m Dr. Sanjay Gupta, CNN’s chief medical correspondent, and this is Chasing Life. Criss-cross applesauce to standing up. I’m not gonna lie, I did use for a split second my left palm to sort of just boost me up.

You know, I think when I was reading about you, one of the things that sort of struck me was this idea of just fitness and how people define it. Like I think of myself as a fit person, but to be honest, after again, reading some of your work, I started to wonder about that a little bit because I focus a lot on strength, I focus on cardio. But one of things that you talk a lot about though is mobility. And it almost seemed like a third pillar. So cardio, strength, mobility, and it made total sense as I was, you know, again, reading your work. So I wonder maybe if we could start with some basic definitions. What is mobility? What does that mean?

‘We, when we started to think critically about how teaching this and the language around it, what we had was non-specific words like stretching and flexibility.

Flexibility, right.

Right and what you’d say to someone is do you stretch and like your coaches were like, did you stretch? Oh, yeah. Yeah sure coach I stretched and like

You talked to my coach apparently. Yeah, yeah, sure.

‘Yeah, yeah, sure. So what we found was we didn’t have clear definitions of what those things meant. So we tried to use this word mobility and what we intended were, and I would say, I’ll give you two definitions. One is that every physician on the planet, every physical therapist, every chiropractic physician, all agrees about what the body should be able to do. We’ve said, here’s what blood pressure is, and everyone knows that, and here’s what temperature is and everyone knows that. We started to become very sophisticated about understanding some aspects of our physiology, but not range of motion. So what ended up happening is we create this definition of do you have access to your native range of motion? Can you control it? And when we improve those things, did what matters to you improve? Now let me give you the definition that I have in my 50s, right? This is a little bit different now. Number one, are you pain-free? And I think this is really important because I think the problem is that it’s very normal for human beings to experience pain and discomfort. That is, I mean, talk to your children, everyone like knee hurts, back hurts, right? This is a feature and what we’re trying to do is help people reimagine what does pain mean by starting by saying pain is a request for change. And number two, I want you to be able to do with your body what you want as it relates to your job, as it related to your recreation, as it relate to being a family member. And that’s a much better definition of mobility.

So just a couple of quick questions about that. The normative range of motion. So again, I think cardio and strength and I can measure how fast I’m running. I can see how much weight I lift. But when it comes to mobility, I’m in my 50s as well. So would your normative range of motion and mine be the same? Is it changed throughout our lives? Different from men and women?

‘Great question. So no, the one thing that doesn’t have to change over the whole lifespan is your range of motion. We absolutely are likely to see if you know, nobody ever said, hey, you should put your arms over your head or be able to take a big breath, you might get stiff in your shoulders and upper back. What we don’t have change is our access to our range of emotion. So for example, one of the ways that one of ways we want to think about this is I have a finite amount of time to work on my body. It would be great if I could go to a fantasy health ranch and I could have someone massage me every day and someone makes my meals and someone does a perfect program. But let me introduce you to having teenagers and working a crazy job. And like this is all of us. And so one of the things we really try to spend a lot of time is saying, how do we simplify the process so it doesn’t feel so overwhelming? I’m not giving a busy working mother another listicle. Here’s how you’re gonna optimize your morning routine. She’s just stoked to have a coffee and get her kids out the door with lunch, right? So what we wanna be thinking about is where are the places in my day-to-day life where I have some agency and some control? And one of the things I’d like everyone to leave here with is if you begin to sit on the floor in the evening for 20 or 30 minutes. We know you’re watching TV, the research bears that out. So all I want you to do is… get off your couch and sit on the floor. And you can sit cross-legged, you can be 90-90, you can side-saddle, you put your legs out in front of you, you can kneel, I don’t, it doesn’t matter. In fact, when you need to fidget, go fidget change your positions. But what we found is that if we can spend 20 or 30 minutes in the evening, touching some of these novel shapes of the tissues. You know, we’re in, if we took a step back and I said, okay, I’m gonna look at all of your movements during the day. What are all the things that Sanjay does during the day? I could create almost like a library of words, of vocabulary words. I can see the shapes you are in. Most of us occupy just a few shapes. We just use a few words. We get up out of the bed, we stand up, we walk around, we sit back at the desk. Maybe I do a little peloton, which again is more sitting and it just, you know, more aggressive sitting. And all of a sudden what we see is we didn’t really take our bodies into the shapes and positions that we’re capable of. And one of the ways that we can begin to shift and expand your movement language is to just start to have some exposure to some of these shapes where having the body engage in body-like things. And I think that’s how we can began to say, how do we simplify this seemingly complexity in that world? Well, let’s begin by sitting on the ground.

I love that. I mean, it’s simple, obviously, but and I think I understand what you’re saying. You’re utilizing different you say language, but using different muscles different Joints and things like that to sit on the ground and then you have to get up and that’s by the way a quick side story. Jimmy Carter, I interviewed him several years ago as 2015 I think yeah, what a guy And I’ll never forget at the end of the interview he was sitting in a nice chair and at the end of the interview, he got up out of that chair without putting his hands on the side rests. And I was just kind of blown away by that. Of course, you know, a lot of people when they get up out of a chair like I am right now, they’re kind of giving themselves a little boost with their arms. He didn’t do that. And I remember thinking, I hope I’m like that when I’m in my 80s. But you’ve brought up this notion a couple of times now, Kelly, this correlation between mobility and longevity. Yeah. Well, my guess is, you can correct me if I’m wrong, is that as a society, especially in the developed world, we’ve probably become less mobile because we’re addicted to these devices, we’re sitting in these chairs, on computers. So it’s gotten worse, not better, and yet at the same time, we know that mobility is associated with longevity.

We can absolutely just start there is that we can say, well, what’s the number one reason people end up in the ER? Turns out it’s falls. What’s the Number one predictor of death above people at 65? A fall. And one of the reasons we’re seeing is if I don’t have access to balance or range of motion, I can’t solve as many movement problems and losing your balance is a movement problem. Getting up and down and being independent is a movement problem. Being able to rise from a chair while you’re holding your baby or your cat or holding a cup of coffee and a book is just a movement problems. So how can we keep as many movement solutions available to the brain as we can and the stiffer we become, the less access easily that we have of our joints, but getting up and off the ground, not only Does it help me create and maintain my movement solutions. It correlates really well with living well because of all the ancillary benefits that come with it. I’m more likely to garden and be outside and be able to stay connected to my community. I’m likely to want to be in an exercise class. I’m more likely to be less timorous about riding my bike around Central Park. And the real question is, who and where are we thinking about this? And the answer is, we’re not. We like the word. We think longevity is definitely a buzzword right now. We all want to be, we’re obsessed with being old. But ultimately, Julia and I feel like, my wife, and who’s my business partner, we feel like durability is the best word. And the reason is, we think the hits are going to come. If you’re over 50, you’re going to, something bad, Your body’s going to throw an error. You’re likely to have something bad happen to you. You are not as robust. So, what we’re really saying is If I wanna have a joint and tendons that act like joints and tendions my whole life, I better use that joint and I better load those tendons. Otherwise, they’re not gonna be available to me as readily. And the good news everyone, muscles and tissues are like obedient dogs. They always adapt. At no age do you stop healing. At no wage do you lose the ability to reclaim range of emotions. It’s gonna be a little slower than when you were 15. That’s true. but the bottom line is your body is always going to adapt. So let’s begin with something really simple.

‘Look, I think as much as we talk about fitness on this podcast, I don’t think we’ve talked about this topic enough, and I think Kelly is really spot on here. The human body has this remarkable ability to adapt and grow and heal, in both directions, by the way. It can get bad really fast, and it can improve really fast. So it’s never too late to reclaim our ability to move pain-free and to live well. So when we come back, Kelly’s going to give us some pretty simple tools to help us get started.

You and your wife, as you mentioned, Juliette, by the way, that’s fantastic, that your wife is your business partner and you guys have the same interests and you wrote a book together. And one of the things that you talked about in the book was this concept of mobility vital signs. Yeah. And you’re likening this to, you’re measuring your blood pressure, your respiratory rate, actual vital signs, how did that come about? How did you start to think about this in terms of vital signs?

Number 1 We don’t always give people clear objective measures around their body. Sometimes…

We do and and that exists though to be clear like if I if I came to see you Kelly, The idea that you could objectively tell me what my what my What these measures should be for my mobility that exists that exists

‘Absolutely. And you don’t need a professional person to help you understand how your body moves. So for example, everyone can understand that 120 over 80 is not heroic blood pressure. It’s a sign where we start to say, hey, maybe we need to make a little small change in our environments, our behaviors. And what we found was that we hadn’t done that for how the body moves in space. And we certainly hadn’t in the language of mere mortals. So how can I understand my range of motion. How can my children begin to understand their minimum range of motion? And then what are the simple tools to help me just keep an eye on it? We were democratizing self-care. The same way we all think we all should probably eat fruits and vegetables and some quality protein, we should get some sunshine and we should play. We just wanna objectively measure those things a little bit so that we can begin to say, oh, wow, I haven’t done this for a while. Or, hey, my knee hurts. I look at how stiff my quads are and it turns out I found a problem and that’s something I can change.

Everyone should read the book. It’s one of those things that probably should just be there right as a manual for your life next to, you know, the joy of cooking, a finance book, whatever it might be. But you mentioned the first vital sign, which is being able to get up and down from the ground, which I think is great. Second one, I’ll just mention a few of these. Maybe we can talk about a couple of them. Breathing, just how long can you hold your breath? Um, which again, there’s objective measures of this. You can count how long you can hold your breath, but there’s normative standards as well.

‘The first movement of the spine is the breath. That’s the first thing that the body does is it takes this breath. Rib cage needs to expand, the belly distends, right? And what we see oftentimes is we fail to appreciate how the environment is impacting my ability to ventilate effortlessly. So probably people have heard that when you’re not working really hard, you should probably be able to breathe through your nose most of the time. And one of the reasons we do that is that we get better function. Suddenly if I take a nose breath, my diaphragm is recruited. If I breathe through my mouth, I don’t really use my diaphragms. I end up using my neck musculature. But if I’m using my knack all the time to ventilate because I can’t access my diaphragm or I’m sitting in a chair, well suddenly you have really ineffective breathing So you’re going to walk up those stairs and feel out of breath, even though You’re not. And then the impacts it potentially has on our anxiety, our abilities to regulate, is really profound. And what’s cool is that I’m pretty sure modern people are not the first people to ever think about breathing. I’m sure it’s a cornerstone of the yoga traditions. People have been doing this for a long time, but by tapping into the objective work of our brothers and sisters out there, we were realizing that, hey, we should probably put this as a vital sign because it has so many possibilities to up-regulate function. Right, right. No.

There’s 10 of these vital signs, and I’m just gonna tick through a few of them. The next one is one that I gotta tell you, Kelly, I have trouble with hip mobilization. And it’s interesting, I remember, I like to do triathlons, and I remember getting done with a triathlon and just being kind of pretty racked at the end of this thing. Way more racked than I should have been. I was just like, God, I mean, this is not fun, and I feel. And I went to go see a physical therapist who was near the finish line, and right away it was all about my hips and the hip mobilization. So you’ve listed that sort of as a third vital sign. Why is it so important and what could someone like me do about it?

Well, you know, we fortunately have already talked a little bit about one of my favorite interventions which is sitting on the ground. Which is your first vital sign as well, right? So these are, these, they’re related. Yeah, absolutely. So looking at how your knee comes to your chest is one of those key pieces. And one of the reasons we started with the sit and rise test is that in order to stand up from a seated position, cross leg position, you have to lean forward to shift your center of mass over your feet. So you’re sitting cross legged, but if your hips are stiff and you can’t bring your knee to your chest or your chest to your knee, that becomes impossible. It becomes an impossible test. So all we’re doing is putting the body into position that requires more normative, not even full range, just some baseline range of motion to express that hip range of motion. And the reason we love that test is that it’s one of the first times where people confront the fact that their hips are stiff, because you were able to do a triathlon and still kick butt, but you didn’t even need to have full range of motion. But what you experienced is that you paid a very high session cost. You had to pay a price for this inefficiency. So imagine you’re driving your car with your handbrake on. Look, cars, human beings aren’t cars, I get it. But if I just click that handbrake on one notch, there’s sort of a drag on the system. You’re not gonna get good fuel economy, your brakes get a little hot sometimes. It’s not a high performance machine. So all we’re trying to do is say, let’s take the brakes off by restoring. And this knee to chest is a really simple way to do that.

‘I’m going to do it right after this podcast. I’m going to self-assess, Kelly, and I’ll call you and let you know how it goes. Another chapter in the book is called Future Proof Your Neck and Your Shoulders. And again, we talked about the fact that so many of us are on devices and staring at computer screens way too much. What’s an easy way for listeners to sort of assess if they’re starting to get into the danger zone with regard to that?

Well, let’s start by saying not necessarily a danger zone. You could have terrible shoulder range of motion, not be able to take a full breath, and you may never have neck pain. But likely is your tolerances for silliness start to go a little bit down, right? And then you’ve been in front of your computer all day long, and all of a sudden you’re like, hey, your neck is a little but sore. And again, I think most of us are like, my neck’s a little sore, let me reach for that glass of wine or ibuprofen because I don’t have time for that right now. So what we can do instead is start to say, hey, what is it I’m supposed to do? And notice that we already talked about one of the most important interventions for neck pain, which is breathing. So if we restore your ability to ventilate, to take a massive breath, what you’re gonna see is that your rib cage, your thoracic spine, ends up being a really important chassis off of which your neck and head function. So we start to see the neck, the shoulder, and the upper back as a really simple system. And if we want to improve one aspect of the system, we look at other aspects of that system. So for example, if you’re sitting here with me and you’re listening to this and I’m slouching, if I turn my head to the right, I may not be able to rotate as far. Now watch this. Get into a position where you can take a big breath. So you and I are both going to adopt slightly dwarf organizations. I didn’t tell you what to do with your head or your shoulders. As I said, get into a positioning and take a bigger breath. And if you rotate now from that position, you’ll see that you can rotate a lot further. And that hints at the fact that when we’re in better sort of organized sort of geometries, better structures, that hint at more function, we get more function back. And when we restore people’s function, we oftentimes knock paint out because we’re not overusing tissues, we’re misusing tissues.

And I don’t mean to oversimplify, but just posture, just your overall posture, when you’re sitting, when you are standing. I slouch, time to time, my mom.

So say we all.

So say we all, how big a deal is that? How much do you think about that?

I think we should, if I took a picture of you, just not aware, would you like what you saw, right? In terms of how you’re organized. And what I’ll tell you is that there are a lot of hints out there about what good organization looks like. Look at the Vitruvian man, right, shoulders, I mean, that’s Shavasana, right. So it’s almost like our, you know, our genius was like, hmm, these yogis know something about Shavasna. That’s the same organizations as the Vitruvian man. So, really… posture is the Latin derivative is just position. So what you’re saying is, I have good position or a bad position. And what we wanna be clear is that there are postures, there are positions and shapes that are more highly correlated with dysfunction. So forward head on neck, rounded shoulders, those positions may or may not ever cause pain, but they’re certainly really bad positions to swim in. And more importantly, they are well correlated with disease with dysfunction. But what we don’t wanna say is, I have pain because of my posture. What we say is hey, the reason we choose this organization of the body is that it maintains more lights on in the room.

You know, I mean, have you ever wondered why, if we have this sort of native way that we should carry ourselves, this native way, that we should be mobile, that we should sit, if we are sitting or standing, why do we lapse into these sort of bad habits, would you say? What, why does, I mean, because it is quite normal to, if I look around the office, to see a lot of people slouching, or even if they’re walking and standing, they’re sort of head forward, You know, is it just because of the technologies that? Is that what’s doing it to us? Why do we evolve this way?

‘I tell you what, we, uh, we wrote another book called ready to run. Ready to run, play off on our friend, Chris McDougall’s book. And one of the things that we wanted to say is like running is a natural normative skill. But what we noticed with our kids was that we had all these beautiful runners, everyone runs the same in kindergarten. They all like they’re little Usain bolts. They run on their foot, they lean forward. They have powerful hip extension. and they land on the ball of the foot, and then halfway through the first grade, some of those kids start to do heel striking. They fundamentally alter their primary locomotive pattern. So instead of sprinting now they’re putting their foot out in front of them and heel striking, and they’re in these crazy shoes. And it’s crazy. That’s like halfway through the first great we switched from riding right-handed to left-handed. That’s what the equivalent is. Like, hey, we have this skill we’ve been developing for six years, and now let’s throw that skill away and change it. We have to ask, what has changed for this child? And the only answer is they’re now engaged in more chronic sitting at desk behaviors. So their bodies have started to adapt. So when we see people our age, the peak of their powers and they’re working hard, what we see is their body tells a story of their movement history, of their environments. And there’s a reason that when you run into a gymnast, you’re like, oh yeah, you are a gymnasts, I can tell, right? You were a dancer. What is it about that? Well, part of that experience of being able to do those things is that we had to practice a certain carriage and organization that turns out to transfer really well to these pieces. And so what we need to do as modern humans now is say, hey, maybe I have to think differently a little bit, or I have sort of manage this adaptation response to the environment. And that might just be by sitting on the ground or. hanging from a pull-up bar, which is one of my absolute favorite interventions. You wanna change your posture, start to put a pull up bar on your house, start to hang on something, go to the park, spend three minutes hanging, you can have your feet on the ground and you will be a different human being into you.

Even with your feet on the ground, just hanging from the… What is it? Just, it’s, I guess, addressing many of the things that you’re talking about with these vital signs. Yes, yes.

and doing so in a play, movement position. Right, you can do downward dog too. Three minutes of downward dog a day will get you. But what you’ll see is that I don’t even have to be skilled. I can just put my arms up and just let gravity take over and you’ll start to see changes in your shoulder, changes in you upper back, your ability to rotate, your ability take a big breath. All of those things will change. And maybe some of you need four minutes a day and some of only need one minute a day. This is, this is,

This far more fascinating than I even expected it to be. And I expected it be fascinating. I love this. Will you come back, because what I’m going to do is I’m gonna spend some real time putting into practice some of the things that you’ve talked about today. And I’d love to give you a report and just get some feedback.

I love it. And I, again, I want to get beyond pain, no pain. I want to be, I wanna know how you swam faster, how you dusted that kid, that young 17 year old kid at the gym, I wanted to know how you crushed him. And ultimately, you know, we feel like if we can improve the health of the household, we don’t need to worry necessarily about some of the things that the universe is telling us to worry about. We are robust, incredible humans and the magic is being able to spend time with our friends and family, with our neighbors, and walking, playing, these are the ways of how we transform our communities and society.

I mean, that’s the ultimate measure, I think, like you said, but the human body is so remarkable. And I sometimes think, you know, people buy these really fancy SUVs that are all tricked out and all they do is drive their kids to school a couple miles and back. They never really put it to the test. And some of the things that you’re talking about allows our human bodies to be put to the test and to show off a little bit in terms of what we can do, which is fantastic.

Yeah, you know, I’ll just leave everyone with an anecdotal story. We started walking school bus for our to bring our kids to elementary school. Not everyone felt like they could walk their kids were like, we’ll be here. It takes about 25 minutes, we will be here every morning. We have a little more flexibility in our schedule. But drop your kids off. And so we started dropping, we started walking our kids and we got out of the drop off lane, which was toxic and chaos. And we’d walk this mile and a quarter to school, interact rain or shine. And then parents were kind of started jumping in with us. And We had a couple parents who lost 30 pounds. Wow. Walking their kid to school. And they were like, this has changed my life. I’m like, hold up, we just walked your child to school, we walked two miles a day and you lost 30 pounds? Like, that’s not fair. And so I think when we start to put movement and we start think differently about the choices we make, suddenly those small aspects end up aggregating to really massive change. We just need to run this experiment for our lifetime.

What a pleasure, Kelly. Thank you so much for your time, and I hope to talk to you again soon.

Likewise, everyone knows we are such major fans and it’s such a pleasure meeting you. Thank you so much.

Give my best to Juliet as well.

Done.

Okay. Chasing Life is a production of CNN Audio. Our podcast is produced by Eryn Mathewson, Jennifer Lai, Grace Walker, Lori Galarreta, Jesse Remedios, Sofia Sanchez, and Kyra Dahring. Andrea Kane is our medical writer, our senior producer is Dan Bloom, Amanda Sealey is our showrunner, Dan Dzula is our Technical Director, and the Executive Producer of CNN Audio is Steve Lickteig. With support from Jamus Andrest, Jon Dianora, Haley Thomas, Alex Manassari, Robert Mathers, Leni Steinhardt, Nichole Pesaru, and Lisa Namerow. Special thanks to Ben Tinker and Nadia Kounang of CNN Health and Wendy Brundige.