Brent Brookbush Evidence-Based Research

Brent Brookbush
Full Transcript

Back to Episode

The Ready State – Brent Brookbush

Kelly: [0:00:04] Hey everyone, I’m Dr. Kelly Starrett.

Juliet: [0:00:06] And I’m Juliet Starrett.

Kelly: [0:00:08] And you’re listening to The Ready State Podcast.

[music]

Juliet: [0:00:16] This episode of The Ready State Podcast is brought to you by Momentous Essential Plant-Based Protein.

Kelly: [0:00:22] The reason we’re talking about the plat-based protein, it’s not so we can get in some argument on the internet about which protein allows me to express myself through my movement. It’s about the fact that we have a whole lot of people, in spite of the fact that the regular whey protein has incredible enzymes that make it more digestible, cannot handle lactose.

Juliet: [0:00:42] Yeah, it makes them feel sick and they don’t digest it well.

Kelly: [0:00:44] And we also have a lot of friends who are vegans and vegetarians. And what we try to do in our family is be judgment free. Instead, we’re saying, hey, look you’re going to eat the way you want, eat according to your values, but at least get enough protein.

Juliet: [0:00:57] And this protein is a mix of pea and rice protein. It has a complete amino acid profile. And again, what’s always the most important to me-

Kelly: [0:01:06] Oh, don’t do it. You’re going to say it.

Juliet: [0:01:07] It actually tastes good.

Kelly: [0:01:08] I know, I know. We have a ton of professional athlete friends who had a hard time. They’d get runny belly, they would really, really trying to add protein in as a supplement. When they switched to a plant-based protein, when they switched to Momentous Essential Plant Protein, no problems and they were able to eat their macros. Because our model is eat whole foods first and foremost. But I oftentimes struggle to get enough protein during the day. I’m just going and just don’t eat it. So I love myself a protein shake. It’s how I hit my protein macros every day.

Juliet: [0:01:36] If you want to try some plant-based protein, go to thereadystate.com/momentous and use code TRS for 20 percent off your first purchase.

Juliet: [0:01:46] This episode of The Ready State Podcast is brought to you by ChiliSleep.

Kelly: [0:01:50] Look, the thing that I have battled my whole life the most-

Juliet: [0:01:55] Is being a hot sleeper.

Kelly: [0:01:56] The hottest. Like drenched. Pillow soaked, little chalk murder outline of my body. And no one wants to touch me because I am 1,000 degrees.

Juliet: [0:02:05] You are 1,000 degrees. There’s not a lot of spooning going on in the Starrett household.

Kelly: [0:02:08] I ran into the ChiliSleep kids at a big conference and immediately was like, okay, this is the day my life changed because ChiliSleep basically circulates cold water underneath your sheet at a temperature that’s right for you. I started sleeping better, I started sleeping more densely. There are many options based on your cooling power needs and budget.

Juliet: [0:02:28] And your budget. And I can really attest to the fact that of all the products that have landed in our laps over the years, this is one of Kelly’s favorites and maybe one of five or so that he recommends the most to his friends and people he works with professionally.

Kelly: [0:02:42] If you’re also struggling to improve your sleep quality, oftentimes you’ve got the eye mask on, you’ve got the earplugs in, it’s dark, you’re off the blue light.

Juliet: [0:02:50] This is the missing piece.

Kelly: [0:02:51] It is the missing piece. What’s amazing is how cold I can get these days, especially when it’s hot out. We don’t have AC in our house; true fact. And it doesn’t matter.

Juliet: [0:03:01] Head on over to chilisleep.com/TRS to learn more and save off the purchase of any new Cube, Ooler, or Dock Pro sleep system. There is an offer available exclusively for The Ready State Podcast listeners and only for a limited time. That’s chilisleep.com/TRS to take advantage of our exclusive discount and wake up refreshed every day.

Juliet: [0:03:27] Dr. Brent Brookbush is the founder and CEO of the Brookbush Institute. He has led the development of an education platform that puts 160 plus evidenced based accredited courses and three certifications in the palm of your hand for a fraction of the cost of comparable courses and certifications in the industry. The Brookbush Institute continues to innovate with the intent of building the education platform all of us wish existed. Outside of his duties as CEO, Dr. Brookbush continues to consult and practice as a physical therapist and personal trainer in New York City.

Kelly: [0:03:59] Brent has been in the health and wellness industry since ’98. He’s an impassioned educator and has been working with industry giants with Shape Magazine, Town Sports International, Equinox and even NASM, National Academy of Sports Medicine. JStar, this conversation is pretty amazing because I feel like we are being hit over the head in the world about research and Brent is an expert in understanding and disseminating research.

Juliet: [0:04:26] Yeah, I thought this was such an important conversation because I think we’re all in a place where we don’t really understand research, or most of us don’t, anyway. We don’t understand how to read it or interpret it and we bandy about terms like evidence based when we don’t even know what that means.

Kelly: [0:04:40] I’ve been following Brent for a long time and use him as a way myself of how he aggregates and really disseminates a lot of the research in my field, my vertical. But he also spends a lot of time educating practitioners and, believe it or not, professional people, in their consumption of the research because even just coming through COVID where we saw research weaponized, it’s really difficult to understand who’s an expert and who’s not and what do I come to trust as a person just trying to make their way in times of change.

Juliet: [0:05:11] In the crazy internet world, you mean? You know, the other thing that I love about our conversation and that I admire so much about Brent is that he’s on this mission to try to transform education and based on his own experiences in education, many of which he found to be lacking, he really has sort of set forth to figure out how he can offer courses that are consumable, that are accessible and available for people. And that’s really the core of his mission and it was cool to hear him talk about how passionate he is about that.

Kelly: [0:05:38] Yeah. The other piece of it is that it’s easy to forget that he is not just a clinician talking meta. He’s been coaching people, he’s an active physio, and because he’s a user, he’s an actual person who works with other people helping to solve problems, that’s his primary filter. This isn’t just academic, for lack of a better phrase. This is a person saying, “Hey, I’m trying to help people feel better, work better, live better lives, and I think we can do a better job of educating the professionals who are also doing that.”

Juliet: [0:06:07] Yeah, we had a super cool conversation with Brent and I think you guys are all going to really enjoy it.

Kelly: [0:06:12] Hold onto your butts. 

Juliet: [0:06:13] Hey Ready State listeners, if you like what you’re hearing, please subscribe and leave a review on iTunes to help others find our show. Brent, welcome to The Ready State Podcast. We’re really excited to chat you up today.

Brent Brookbush: [0:06:25] Awesome. I’m really excited to be chatted up.

Juliet: [0:06:27] I think chatted up. First of all, I’ll just start by answering your pre question: We can get you a Ready State hat immediately.

Brent Brookbush: [0:06:34] That’s fantastic. I’m also going to need to know about Kelly’s tattoo artist, except I want cheetah prints on my right arm. See, like-

Kelly: [0:06:43] A, we can do all that. Second is that I try to wear a foam trucker hat anytime I’m trying to speak to something on topic from a point of perspective because I’m trying to really elevate the trucker hat.

Juliet: [0:06:56] It’s like an intellectual trucker hat?

Kelly: [0:06:58] Yeah. Well, I just want to show everyone that my trucker foam hat has a sensitive intellectual side.

Juliet: [0:07:06] All right, well, with that, Brent, I would love it if you could just give our listeners a quick background about who you are.

Kelly: [0:07:13] And where you are.

Juliet: [0:07:14] And where you are and what your company does.

Brent Brookbush: [0:07:17] Okay. Who I am, where I am, what my company does. Who I am. All right. So I’m Brent Brookbush. I’m a trainer, doctor of physical therapy, and education is kind of like my thing. Where I’m at. I’m in New York City personally. Our company is more of a virtual education company. So I guess we exist online. And what we do, obviously, is optimize education for our colleagues, which we consider all movement professionals. So we’re very inclusive. Trainers, physical therapists, chiropractors, athletic trainers, occupational therapists. Who am I forgetting? Osteopaths, massage therapists. Did I say massage therapists already? I might have. Anybody who’s in those movement professions are part of what we consider that profession that we should all be working to combine. And of course, what we do from a practical standpoint is we’re a continuing education company so we provide those CECs the certified licensed professionals need to maintain their certified and license, as well as we offer certifications ourselves. So we offer certified personal training certification as well as advanced credentials, being a human movement specialist, which is corrective exercise based, and then the integrated manual therapist, which is an integrated manual therapy certification.

Kelly: [0:08:34] You said something I just want to come back to because I really want to dive into how subversive and radical your education platform is. It’s not the Brent Brookbush Institute, just the Brookbush Institute

Brent Brookbush: [0:08:48] True.

Kelly: [0:08:] R48eally has gone out of its way to disrupt how people can consume continuing education based understanding, credits, in an affordable way. But before we even get there, that I feel like is one of the most radical things you do, is you just expanded movement professional to include the people actually teach most of the movement: trainers and coaches working in YMCAs. When I went to physio school, we were talking about allied healthcare and it did not include chiros, it did not include trainers. How did you make that switch? I mean I think I understand how as a coach how I make that switch, but that’s a big deal that you just sort of cast this bigger net and said, oh, no, no, no, no, we’re all on the same spoke on a wheel.

Juliet: [0:09:28] Which I think just before you answer that, I’ve never heard it described that way, and I’m definitely using that in the future because I always use practitioner or some kind of word that doesn’t, I don’t think properly describe. But movement professional is great. I think it is just an awesome way to describe this group of people.

Brent Brookbush: [0:09:45] Yeah, I think I kind of morphed into the movement professional label. And I think it comes down to talking to my colleagues and realizing that obviously, Kelly, you and I are physical therapists, but then we go and talk to a chiro who’s working with, for example, let’s say talking to a chiro who works with athletes, and their scope of practice is the same. If you’re doing orthopedic, outpatient physical therapy and you talk to a chiropractor who’s a mixer, right, is the term they use, who’s using some exercise and using some other techniques, we’re basically ending up in the same place, right, because we all want to be effective at the end of the day. So we all kind of gravitate towards the most effective techniques and an integrated approach. Well, then you start pulling in some other things. Well, like ATCs do the same stuff we do, right? They’re not really different. And then you even start thinking about, okay, well, if we take this outpatient, occupational therapy thing even a little further, knowing that it is part of this whole fitness performance rehab sphere, occupational therapists become a part of that. They’re definitely working with exercise and movement and they should probably be able to do some manual techniques. In fact, it’s within their scope. They just don’t get taught as much of it as they probably could use. And then of course, massage therapists. Why are massage therapists using assessments and using massage more as a means of helping people move better, right, so that their long-term outcomes are better? You start realizing as long as it’s within your scope, at the end of the day, the only thing that matters is the patient, the client.

Juliet: [0:11:18] Right. And the outcome.

Brent Brookbush: [0:11:19] Right. So I’ll talk a lot to people, like, the outcomes don’t care about what your title is, right? The best way to treat isn’t based on the fact that you’re a doctor of physical therapy. The best way to treat is based on what’s going to get your client or patient the best possible outcome, which now you think about what I was just talking about with all these spheres and scope of practice and it’s like, okay, just for a second, let me do this thought experiment: If you laid out all of the techniques we all know on a table, what would you choose and what would it be based on? I can tell you right now it wouldn’t be based on, well, I’m a physical therapist, so I’m going to pick up the Graston tools, right, or the ISDM tools. We use smart tools over here, but whatever. You get what I’m saying. But we wouldn’t just pick things up because we’re a profession. We would pick things up, if we’re really being smart about it, we would work our way from outcomes and go backwards. So if I want to get the best possible outcome, right, so I want the best long-term, most reliable, most effective technique that will get them there the fastest, and it’s probably going to be a mix of techniques, what would those be?

Kelly: [0:12:33] I try to describe all the time to people, I’m like, well, I was classically trained as a physical therapist but now I do something that feels akin to something else. I can say where I came from but in strength and conditioning-

Juliet: [0:12:47] Yeah, like that’s your formal training. Yeah.

Kelly: [0:12:47] That’s my formal training. But you’re a CEO but you also happen to be, you’ve trained as an attorney, right?

Juliet: [0:12:54] Right. 

Kelly: [0:12:55] Right?  One of the things that happens in strength and conditioning and performance is I’m like, oh, these endurance athletes know a lot about fueling long distance and training cardiac capacity and zone two and thyroid adaptation. And I’m like, oh, these body builders, they know how to put mass on people fast and they know how to manipulate body composition. And all of a sudden, you realize that so many of these seemingly disparate fields of course are connected, but where I think we get into trouble, and help me how we should think about it, is it seems like there is an awful lot of overlap, and that sets up the possibility where people are elbowing for space. This is my dance space, you’re in my field. I see a lot of…. The internet has blown this regionalism apart, right? Because I think one of the things that I find so amazing about your content is that you are teaching people things that were traditionally really behind a very expensive paywall. And you’re doing so at a really safe, forward thinking, progressive way that’s appropriate as an expert in education. But you’ve blown apart these divides. Do you feel like you were one of the first people into that space? How have you managed to not lose your sanity when you’re bringing all these people together and they’re seemingly competing with each other?

Brent Brookbush: [0:14:15] I don’t think I’m the first. In fact, if anything I would say I’m part of that second generation, right, where I think you had like the Gary Grays and then like the Mike Clarks of NASM and you had some of these other guys who were already starting to bring the physical therapy and sport medicine worlds together. To your point, you had this huge overlap between endurance athletes and hypertrophy athletes. We know that it all comes down to fueling and exercise and frequency and what are your acute variables and how do you periodize. And that’s all within that stuff. But then you also look at any of these athletes and it’s like you’re only going to make progress if you stay orthopedically healthy. So that’s where the corrective exercise and rehab comes in because if you think you’re going to be a high-level athlete and never get injured, good luck. 

Physical therapy or corrective exercise and self-management of exercise like The Ready State, that actually might be the most important piece for high-level athletes because keeping up their training is really hard once you start getting into those higher volumes and you start really pushing the intensity you get. So I don’t think I’m actually new to any of that. Like I said, if anything, I would say I’m part of that second generation I would say. Me and you are part of that second generation. There’s another generation coming after us. I would say that first generation, you can look back and definitely see where some of this was coming in with NASM and even the NSCA for a second had a partnership with FMS, with Gray Cook. He actually comes after Gary Gray too. But within that 10-year period which was the ’90s, early 2000s, there was definitely people already starting to bring this stuff together.

Juliet: [0:16:00] So one of the things I think is so compelling about what you’re doing is in addition to all of the awesome actual content you put out there or your company puts out, but I feel like you’re really a disruptor of education and you really try to think about how to do education differently, which I think is also so relevant in these COVID times. Regardless of whether you have kids or you’re an adult or whatever, I think it’s been sort of a time where we’ve all rethought how people can learn and what’s possible. So can you just talk a little bit about how you came to even care about doing education differently and what it is you actually do differently?

Brent Brookbush: [0:16:38] Yeah. I’ve said this on a couple podcasts. People think I’m in education because I love education. I’m actually in education because I hate education. And I think anybody would get there like I did after putting themselves through three degrees. And I hate to get into this woe is me story, but it was like I was on my own, I’ve always been on my own, I’ve put myself through school. And you guys know, trying to hold down a career and put yourself through school is a nightmare. And especially doing three degrees: a bachelor’s, a master’s, and a doctorate. I was basically running myself ragged for like a decade or more. And it’s just not fair. The caste system of education has become so much more complicated than the finance. Everybody talks about tuition costs but they forget about the fact that when you get to DPT school, they basically look you in the face and go, “You think you’re going to hold down a job? We’re going to make sure we get in the way of you holding a job every chance we possibly can.” Right? They will scold you for leaving class to go to work to put food on your table. It’s crazy, right?

Juliet: [0:17:43] That definitely happened to Kelly.

Brent Brookbush: [0:17:45] It happened to me. I can’t tell you how many arguments I got into where I mean often it wasn’t even me being irresponsible, booking a work shift or booking a client during a class, it was them changing the class into my work shift and then they expect me to give my work no notice. Stuff like that. So anyway, that paints a picture, right? That paints an atmosphere. I think everybody can relate to what I’m talking about. And then you start just breaking all this stuff down and you go this just isn’t necessary. Why are we showing up to class for didactic information? Didactic information can be taught online. In fact, you look at-

Kelly: [0:18:20] Khan Academy. 

Brent Brookbush: [0:18:20] Khan Academy was one of my first major influences for them where they flipped the classroom. They put the lectures on video and there’s such huge advantages to video for students because rather than bother me while I’m teaching, ask a question, ask a question, ask a question, ask me to repeat myself, ask me to repeat myself, ask me to repeat myself, hold on, can you just stop for a second so I can write a note, all that stuff, they can pause, they can replay, they can watch things two or three times. That’s how the Khan Academy got its start is he made some videos for his nephews and his nephews actually flat out told him they liked the videos better than him. They’d rather watch him on video rather than have him actually tutoring them and it’s for all the reasons I just said. So you take that little piece and you go, well, how far can we push this? We can have a video, we can have texts. All of our courses have voiceover. I’m in love with Audible. Audible has changed my life. Audible from Amazon. I do all of my business reading through Audible. That’s another route of learning. 

And then you start breaking that down and go, okay, well, not only are we going to have this multi-media thing, since we’re online we’re going to put it on a couple different formats. We can be mobile on a phone, we can be on a computer, all right, so we can design for those two platforms. And then if we’re going to get really crazy, we can start thinking about things like, well, shouldn’t this be bite size? Wouldn’t it be a lot easier to get through education if you could do it 30 minutes, 60 minutes, two hours, three hours at a time rather than having to sit there for eight or nine hours? I don’t know, Kelly, me and you love to teach workshops. But you can look at students at the end of a two-day eight-hour, nine-hour workshop, they’re just fried, right? Now obviously workshops have their own advantages, so I’m not taking anything away from what me or you do for live workshops because that’s practical education, those are a lot of fun. I think those events are very, very important. But when you talk about education as a whole, how much can we get modular, get online so that they’re convenient and portable, put them in multi-media formats so whatever your learning style and sometimes just the information you’re looking at, right? Sometimes information is easier to look at by text, like research stuff. Some things are just you’d rather watch on video like demonstrations of exercises. Some things you’d rather listen to a couple times while you’re doing your chores like practice applications or reviews of research you wanted, listen to a couple times before you take your exam. You take advantage of all of that. Okay. 

Well, here’s the next advantage. If I can get it all online, I can get to the multimedia, I can get it automated. It is now infinitely scaled, which now all of a sudden, we go, okay, obviously operating budgets for education, right, and this is not an exaggeration, operating budgets for an education company are in the millions per year. There’s almost no way to get around it. You start adding accreditation, web development costs, content development costs, it’s in the millions. But if I got to a certain membership base, how much could I reduce the upfront cost of education? And then all of a sudden, we were talking about the Khan Academy before, you look at something like Netflix and you go, oh, wait a second, if Netflix can do it and you start looking at Netflix as a multi-million, billion dollar content development and organization platform, why can’t we just take that and do it for education? And the truth is, well, at least according to me-

Juliet: [0:22:04] You can.

Kelly: [0:22:04] One of the things I love about this is I’ve become re-obsessed with this idea of hyperlocality, that you have hyperlocal systems. Like Juliet knows her family better than anyone else. She knows the realities of her family. And one of the things that you do with a person working with clients locally in their gym is they know the backgrounds, they know the culture, they know the movement history, they know the experiences, they could minister to that person in a real way that you could never do with a national program. Or if I’m like everyone must do The Ready State and here is the program on A day, you have to do these things for an hour, just doesn’t work. People throw it out. Why? Because we are in the business where rubber hits the road.  So I come in and teach principles and I say here’s how this integrate and here’s how my system and my thinking can do with what you’re doing. And I feel like the Institute, the BBI, does that really well because-

Juliet: [0:23:02] Is that actually a name? Did you just name it that?

Kelly: [0:23:] Brookbush Institute, BBI.

Juliet: [0:23:05] I know. I know.

Brent Brookbush: [0:23:05] It’s just one B. It’s just one B.

Juliet: [0:23:08] I saw Brent laugh.

Brent Brookbush: [0:23:09] One B. BI.

Juliet: [0:23:11] I just saw Brent laugh. When you said BBI, I saw him laugh and I was like, this must be a first.

Kelly: [0:23:15] I think I said BBI on our text. But the idea is what you have done is create an opportunity to have the full guns and access, equity, of higher education, really excellent content, and, A, an affordable model, and B, in a way where someone could actually consume it in a way that makes sense to their life, that I could, from 10 to 11, I could work or I have a break.

Juliet: [0:23:40] I think the word for that is accessibility.

Kelly: [0:23:42] It is but also it respects this hyperlocality that this trainer working in the middle of nowhere with no resources or few resources can make a positive impact on their community if we can give them the right information in a way that they can consume. That’s a big deal.

Brent Brookbush: [0:23:58] Yeah. I mean we kind of have these different parts of our business, right? And obviously, we talked about the accessibility piece, which we can do through technology, and of course, the affordability by using something like the Netflix style membership model, or the SAS model if you want to take it from more a technology place with salesforce. And then you have that delivery piece, which you’re talking about. It’s like how do we make it flexible and convenient and optimize delivery, which is actually how I got the whole Brent Brookbush Institute started was me going there’s a lot of smart people in our industry who do not know how to teach. There is a science behind teaching. It is amazing that you have to have a master’s degree in education to teach high school but to teach a doctorate, you don’t need to know anything about education.

Juliet: [0:24:45] That is really a headscratcher, right? Just think about the amount of training you have to have in education to be an elementary school teacher and then we spend ourselves and pay for our kids to go to all these schools and colleges and graduate programs where those people have zero training in actual education. That’s kind of a mind boggler.

Brent Brookbush: [0:25:07] The sad thing about that is too, is you can get probably 70 percent to ideal education, ideal delivery, with a fairly small amount of education and education. You could probably take a weekend workshop, get the majority of the way there, and then it takes practice. It takes a lot of explaining it to students, seeing what explanations work better than others, seeing how your test results run. You just AB test, AB test, AB test, AB test, you know? I’m sure-

Kelly: [0:25:39] It is AB testing.

Brent Brookbush: [0:25:40] Me and Kelly can talk for hours about different examples, analogies, activities we’ve done inside of our workshops that start scoping and refining the way we deliver these things. That is all lesson plan development. And then you’re starting to talk about content. And I got lucky in the sense that I was taught evidence-based systematic integrated outcome driven right off the bat. So I never had this idea in my head that it was Brent’s way or the highway. It never crossed my mind that I would be able to go, “Hey, fitness industry, this is the Brent method and you should be able to buy my stuff because I’m really cool and I shave my head.” I mean you guys laugh but some of the stuff I look at online, I feel like it’s just that random. So when you take those concepts, if we add patient centered in there somewhere too, evidence based is you have to be driven by your outcomes and then refined by research. What is the research telling us to do? You have to be systematic about your approach. You can’t just randomly take research. How do you create a process that allows you to review research in such a way that it’s going to improve accuracy and reduce bias and errors? This whole idea behind accuracy of information and you kind of end up where we’re talking about, where it’s not… The quality of information is the way it is, not because we’re just trying to be better than the next guy. It’s like no, no, this is evidence-based practice, this is what everybody’s been talking about. It just unfortunately is me and Kelly talking about on several on several occasions on our little personal notes back and forth to each other, seems like there’s very few people really willing to put in the effort to be evidence based.

Juliet: [0:27:37] I have like 10 questions on this evidence-based practice thing. But before we get too far afield from that, Kelly and I both also listen to a bunch of audio books on Audible. Huge fans. And it’s really for me changed the amount of books I can consume because I can listen to a book while I do the dishes or fold the laundry or go for a walk or whatever. So that’s been miraculous. But we recently were making a note in our newsletter about how we listened to some book and then we decided to do a poll on The Ready State Instagram stories about whether listening to a book on Audible is reading or not. And before you answer this question, given that I consider you to be an expert in education, whether you would call yourself that or not, I actually was really surprised because to me it is reading and does count as reading and my assumption is that it is absorbed into your brain in maybe a different pathway but still is sort of the same as reading.

Kelly: [0:28:35] Maybe better pathways.

Juliet: [0:28:36] And the last time I checked the poll though, it was like 52 percent it is reading, 48 percent it isn’t reading, which really surprised me that that many people thought it isn’t reading. So before I ask you about anything actually related to your expertise, what do you think about that and can you put this debate to bed once and for all?

Brent Brookbush: [0:28:56] We could just say I listened to a book, which then makes everybody scratch their heads too. I call it reading a book. To your point, I get through something like 70 to 100 books a year on Audible. I do all the same stuff you do—I’m actually watching my neighbor’s dog this week—while I’m walking the dog, chores, while I’m doing my warmup and corrective exercise or my cooldowns, I just take in all of these books. And everybody has the same critique and they are totally missing the point, so I hope everybody’s listening in right now. I don’t absorb as much when I listen to a book. Okay, but you don’t read books. So absorbing less of something is still-

Juliet [0:29:43] Better than absorbing nothing

Brent Brookbush: [0:29:45] Of nothing, right? So I admit that if I sat down and read a book and took notes I would probably retain more. But if I retain let’s just say 10 percent of what I listen to, 10 percent, that means at the end of the year reading 70 books, I’ve absorbed the equivalent of seven full books. How many people actually read seven full books a year with 100 percent retention, right?

Juliet: [0:30:15] Probably zero.

Brent Brookbush: [0:30:16] Not to mention if I… So to your point, there is recommended, not recommended, there is mandatory reading for my employees. And what I will do is before we have a meeting going over those books and how they apply to our overarching strategy, I’ll listen to them again, which then puts my comprehension even higher, right? And if I really want to comprehend a topic, I’ll listen to multiple audiobooks on the topic. What you start to do is once you start understanding the language around a topic, your retention increases.

Juliet: [0:30:51] Improves. Yeah.

Kelly: [0:30:52] Okay. Brent, CEO, tell us what some of those books are. What do you make your-

Juliet: [0:30:58] Yeah, what are your top five, top eight? What are the not to miss?

Brent Brookbush: [0:31:01] Okay. So we can actually take one of the books and go back to another conversation that I think we want to have, which is life is probabilistic. Nothing is perfect. We’re looking at best probable outcomes. If you’re running a business, you need to read a book called The Lean Startup by Eric Ries.

Juliet: [0:31:22] Great book. I read that. It’s a great book.

Brent Brookbush: [0:31:23] Yeah. Starting with an MVP, minimally viable product. Learning how to AV test, learning how to optimize, disregard, right? And continuing, learning how to iterate at a faster and faster pace. That book changed the course of the Brent Brookbush Institute for sure. So that is one of them. I then go down this rabbit hole on project management. There’s an author named Eliyahu Goldratt who’s a genius. He has several books. The Goal, Beyond the Goal, Critical Chain. These all have to do with the idea of constraint theory and through put. I would definitely read The Goal. It’s actually really funny. It’s a story about how these things apply to this little factory with this really outdated romantic relationship which will totally make you laugh. There’s a tech version of The Goal called The Phoenix Project, which I make all my web dev guys read.

 So we had The Lean Startup. We had The Goal. What are some other books I have my guys read? Deep Work I think is a really important one to learn how to improve the efficiency of your day. I actually teach a business lecture; I’ve done it a couple of times at conferences. Essentially the most important thing you can learn is what to do with your time on a day-to-day basis. So how efficient can you make your day? But I have certain things I do at certain times of the day because I know I’m more effective at those things at those times. So I can’t do technical writing at night. My brain just won’t do that. But I don’t have a problem being creative at meetings. And I don’t necessarily have a problem doing grunt work at night. So my day usually goes technical writing, meetings in the middle, grunt work at the end so that I maximize my efficiency. And that’s all from that Deep Work book. Beyond that we’d have to actually pick a topic because I know so many books in so many different directions, it’s kind of hard. I’m reading The Model Thinker right now which is all about the multi-model theory and how if you use multiple models to look at a problem, you’re more likely to be accurate than if you only look at one model. I’ll read stuff on logic. With Salman Rushdie being in the news, I’ve been reading through his books. But that’s like kind of-

Kelly: [0:33:36] The Moor’s Last Sigh. One of my all-time favorite Salman Rushdie books.

Juliet: [0:33:40] Well, we’ll obviously link to all these books in the show notes for anyone who wants to read them.

Juliet: [0:33:49] Hey, guys, we just wanted to take a little break in this podcast episode to actually tell you about one of our products, and that’s our Ready State Virtual Mobility Coach.

Kelly: [0:33:58] Yeah, the app literally is the first place you should go if you’re trying to feel better, if you’re trying to solve a movement related problem, if you’re trying to not be as sore from your workout.

Juliet: [0:34:10] There is so much going on in this app. We have a mobility test that is comprehensive and designed by Kelly Starrett himself.

Kelly: [0:34:17] It’s pretty good.

Juliet: [0:34:18] So you can figure out what your biggest limitations are and start to work on that. There are sport specific mobilizations if you want to try to lift more or run faster. There is a pain area. And we even have a ton of bonus content. You can do challenges around squat and ankle and a bunch of other specific body parts so you can just generally get more supple and awesome.

Kelly: [0:34:38] You’re killing it. You should talk about this app more often. Look, we started the original mobility project back in 2010 trying to help people solve problems for themselves. We think that every human being should be able to perform basic maintenance on themselves and we want you to be able to engage in some self-care in a really reasonable, responsible way. One of our favorite parts of it, daily mobility. You have a 10-, 20-, or 30-minute follow along with me if you just have a ball on a roller, think you want to feel better, move better, play along. I mean we really feel like that’s the base camp practice and you can add in what you need.

Juliet: [0:35:11] We’re really proud of this and what we’ve created here and we think you should give it a try. Head on over to thereadystate.com/trial and use code Pod 20 for 20 percent off your first month. And just FYI, including our two-week free trial, that’s literally six weeks for $11.99. You can’t beat that. There’s so much amazing content to help you feel better and move better for $11.99.

Kelly: [0:35:35] In the words of our podcast producer: bananas.

Juliet: [0:35:45] I do want to go back to this pre-Audible discussion that we were having. And thank you, by the way, for your feedback on Audible. It was probably just to sort of make myself feel better about all the Audible books I listen to. But you have said the phrase evidence-based practice a few times on this podcast. Can you define what that is for people who don’t know?

Kelly: [0:36:03] Because that really is a greater conversation of something you really try to do and you can see it in your social media about talking about research and talking about what is and isn’t evidence based practice so people can begin to sort out who’s an expert and who’s not an expert. What do I listen to? I think that’s really the heart of what’s so confusing about this health and wellness space right now. It’s really difficult to tell where I should give my attention. 

Brent Brookbush: [0:36:29] Yeah. It’s a complicated topic but let me break it down simple and then I’ll just keep getting more and more complicated. You guys can stop me whenever you want. So I think when you look at how we develop our courses, all of them built on systematic review with the intention of being practical and improving outcomes, it really comes down to one thing: accuracy. I think my students deserve the most accurate information available. And that comes from, again, hating education and the amount of times I’ve had to reteach myself stuff because a teacher was completely inaccurate at some point in my education process. And Kelly, I know you felt that in physical therapy school because you almost always in every physical therapy school in the country get that one 75-year-old whack job who’s still teaching stuff that doesn’t make any sense, never made any sense, like I’m feeling axonal flow through your nerves in your arm, right? Really weird stuff. And I don’t think that’s fair.

Kelly: [0:37:33] Don’t test my axonal flow, bro.

Brent Brookbush: [0:37:35] Yo. So if we just go back to the education piece just one little second and go I think my colleagues deserve the most accurate information I can possibly create. Okay. How do I get there? Well, there’s this evidence-based practice thing. Sackett et al. is probably the reference that is most widely used. He talks about a three-legged stool. I’m going to simplify that three-legged school because he’s actually not particularly clear in the article. But if we simplify the three-legged stool to outcomes, hopefully from objective, reliable assessments, research—he talked about third party, objective data—but let’s talk about peer reviewed research there. And then of course we talk about personal experience or professional experience being that third piece. And I do think that that piece is important. It’s kind of funny how some people take it way too far and then some people squash it all together. There’s not a lot of balance around that one. But that’s the three-legged stool, right?

Kelly: [0:38:42] And let me give people a concrete example. I just saw a big system review that looked at the efficacy of having your meniscus scoped. And it turned out maybe taking your meniscus out wasn’t as great as we thought, right? And I think that’s a great example of we’re thinking this is the gold standard, I have a torn meniscus, let me go in there and clean up this meniscus, clip it out, and it turned out the outcomes weren’t better, in fact, they may have been worse on that thing. And we only know that because someone was like, hey, let’s actually see what’s happening when we do these things and now, we can make a little bit better decision about should I have this; I have a torn meniscus, should I get it cut out or not. I think that for me is a great example of what you’re talking about, how it will drive real change, real efficiency, and real better outcomes.

Brent Brookbush: [0:39:28] Yeah. And I mean we can even take it all the way back around, which is like, so maybe meniscus removal is over recommended because the outcomes don’t match. But then if we took a little step further and we looked at all of our objective outcomes from patient records on top of personal experience from the docs, we might find that somewhere along our bell curve, there are people who actually do do better with getting their meniscus removed. And that’s that three-legged stool. It’s just what I just said. It’s not all or none ever. So going back to this evidence-based practice thing, when it comes to the Brent Brookbush Institute, we try to stay practical and outcome driven. So all of the education we teach, we’re trying to think how are you going to make a professional better. I think there’s a lot of certification programs out there, lot of continuing education programs out there who are making people smart for the sake of being smart. It doesn’t necessarily make them better practitioners.

Kelly: [0:40:28] We actually call it the Kluge effect. You’re agglomerating more information onto a nonelegant system and it gets wieldy and doesn’t actually inform what you do or how you get outcomes or the efficacy of your practice or your coaching.

Brent Brookbush: [0:40:445] We were talking about training earlier and strength and conditioning, one of the most well-respected certifications, and I won’t name them, who I was certified through, spends an obnoxious amount of time naming physiology, hormones, hormone production, what it does to hormones. And then you look at the outcomes and literally all of the research that I have seen shows that that stuff has a very little if any impact on how we actually program or do anything. So there’s a perfect example of it’s not that it’s bad information; I’m not saying it’s bad-

Kelly: [0:41:19] Misplaced precision.

Brent Brookbush: [0:41:19] Yeah, it’s not practical. So is it important? Yeah, probably for researchers probably wanting to experiment with some different thing going down that rabbit hole. So we try to stay practical, we try to stay outcome driven. One of the things that we do need to do a better job teaching in both the rehab side of things as well as the fitness and performance side of things is assessments. So this is the outcome piece. Assessments should be reliable and objective.

Kelly: [0:41:45] Observable, measurable, and repeatable.

Brent Brookbush: [0:41:48] Right. Exactly. Exactly. We’re saying the same thing there, right? So I think what too many physical therapists and trainers—we’re just going to pick two distinct pieces of this puzzle—do is they do some therapy, maybe they started with some assessments, and then they go, “How do you feel?” And the person goes, “Better.” And then they go, “See. I’m effective.” And you’re like, nope, nope, nope, that was not part of your reliable, objective assessment. Short-term subjective measures like how do I feel are not reliable, right? You didn’t reassess using your objective measures so you actually have no idea whether you were effective because your intent was to change your objective measure, not just pain or not just how somebody feels or not just… If you went in for weight loss and nobody loses weight but they feel better, you still failed. Sorry. I hate to be such a jerk. But at the end of the day, we need outcomes. So we take that outcome piece, we’re always talking about that. And then of course what you’re talking about with the Brent Brookbush Institute, which we try to do, and it’s a huge, monstrous undertaking, is we take this research piece, and that’s where things get a little squirrely because this is third party objective data. Research is not always easy or simple. 

Kelly: [0:43:05] Especially not when it’s on human beings.

Brent Brookbush: [0:43:07] Right. People talk about the term cherry picking. They like to throw out the term cherry picking like they’re annihilating somebody. Well, cherry picking is just using less research than is available. So how do you be truly evidence based? You have to do comprehensive systematic reviews. Well, as soon as you go to comprehensive reviews, as you’ve seen in our courses, the number of citations you’re talking about gets very large very fast. And sometimes what you find out is only a small change in what people were already doing. It’s an important piece because it refines, because it tells us even sometimes it just supports what we’re already doing. But that is the research piece. 

Of course, and then that last piece being professional experience, well, if you’re talking about the Brookbush Institute, they’re involved in content with us, they have a master’s degree or better, most are licensed professionals with doctorates. And of course, we’re all just pounding these techniques and testing things, trying to see what works and what doesn’t. We’re doing them in our home workouts and we’re trying to see… I heard you mention a term once like okay, so we take this exercise, and I think this exercise is really cool, and so then I try to teach it to another one of my professional buddies, and they’re like, “Oh, that’s really cool,” and then we go to a class and we try to teach it to the students, and they go, “What the __ are you talking about?” And we realize real quick that the technique, which this is your term, was not scalable. It’s so complicating, this thing that we’ve created. Although it’s effective, we would never be able to get it in a home exercise program. And I think that’s where that professional experience comes in, is you have to test and work with a lot of different things to find those techniques that are going to make it all the way from idea to effective to supervised exercise to generally recommendable to the general population. 

Juliet: [0:45:03] So give me a second to tee this one up because I do want to go back and talk about the research leg of the stool. And I’ll start by saying I’m not sure how we talk about this without talking about the massive amount of information and misinformation in the internetsphere. And what I see as a user are sort of two types of people on the internet, especially in this larger movement professional health and wellness based, which are people who just say things with absolutely no research whatsoever; they just say whatever.

Kelly: [0:45:35] Or no formal training.

Juliet: [0:45:35] No formal training, no expertise, no whatever. They’re just coming out of nowhere and they’re like, I say this is true and it is and it worked for me. They do a lot of end of one thing. And then there’s another group of people who are kind of trying to support their thinking and ideas with research but they’re getting it wrong because they don’t understand how to read or interpret research or how to put the appropriate weight on types of research. So can you just give a Reader’s Digest version of the hierarchy of research? Because you’ll see people talk about, well, in a recent meta analysis, in a recent peer reviewed study, there was this longitudinal study. Honestly, I think like 98 percent of people don’t understand the difference between those things, nor do they know how much weight to put on one versus the other, like which actually has more meaning and which has less meaning. So do you think you could… I realize that’s a gigantic question, but do you think you could-

Brent Brookbush: [0:46:29] Let me teach introduction to research methods in 10 minutes. Here we go.

Juliet: [0:46:32] Yeah. Here we go. Go.

Kelly: [0:46:34] I only had three semesters of research.

Juliet: [0:46:36] Just go. Just a little 100,000 foot-

Brent Brookbush: [0:46:41] Don’t forget two semesters of statistics. Yeah, let me get into some of that because this is important. I think we can come at this thing a little bit with a couple of myths that need to be broken down. Number one: Supporting your ideas with research is confirmation bias supported by research. Developing your conclusions after reading the research is how evidence-based practice actually happens. When you go and read data, we’re talking about the scientific method; that’s all we’re talking about at the end of the day. It’s the scientific method. We’re talking about the scientific method. You’re supposed to go and collect the data and then try to make sense of it, okay? That’s what evidence-based practice is. 

Now if more people did that and then they took the second point into perspective, research does not conflict with other research. I said it. Right? Research does not, generally speaking, conflict with other research. Data is data. It is a researcher’s responsibility to look at all of the research to develop a nuanced, detailed conclusion that make sense of all of the data findings. For example, we have that example of meniscus removal. Well, somebody’s going to go out there and find a couple studies that show that meniscus removal works. Right. Well, that conflicts with this meta analysis. No, it doesn’t. We know that generally speaking, meniscus removal was over recommended. But for this subcategory of the population, meniscus removal may be the best intervention for the best possible outcome. That is a nuanced conclusion. That is what science is all about. 

Now as far as the levels of evidence, this whole topic needs to be blown up. We need to start over. Meta analysis and systematic review are not the highest levels of evidence, period. They are a different type of evidence like a textbook. They’re a review. It’s like watching a Siskel and Ebert review of a movie. It’s not the actual movie. Meta analysis does not make the data more reliable, it makes it less reliable. It adds potential bias and error. Does that mean systematic review and meta analysis are not helpful? No. They’re good as a general overview of what’s coming in. And then you have RCTs, experimental studies, observational studies. And then below that is where you’d actually be able to draw a line, which is case study, expert opinion. So obviously we have these meta analysis and systematic reviews, we’re going to put them over here with textbooks. Not bad, just different. 

Then you have experimental data and observational data. That’s actual research. All right, we’re going to hold that up as the pinnacle of quality information. Generally, very, very narrow. That’s one thing that people have to understand. There’s this artist named Seurat. He did pointillism towards the end of his career. And you guys have probably seen these paintings. But at the end of his career, he was painting with little dots. Little dots of paint. And then when you would step back, you would see the whole picture. One research study is like one dot. It doesn’t usually tell you much. You have to get all of the body of research to see the whole picture. But each one of those dots is nice and pure. That’s our experimental and observational research. And then you have case studies and professional opinion. Case studies are great when we have no other evidence. At least we have somebody that’s done something about this before. We have some idea that something happened once. 

And then obviously professional experience or expertise, that obviously is helpful when you have no knowledge, education, ability to interpret some of the stuff that I was just talking about. Of course, this conversation we could have for another couple of days. I mean if we’re going to talk about research, we get into statistics and what is a null hypothesis and how do you set up a good experiment and isolating variables, why do we use statistics and what’s a correlation.

Kelly: [0:51:19] You do a lot of education around research and the language of research. And I don’t know if anyone sees it, but definitely go to the Instagram and check out the socials and you can pick up a lot about how to be a better consumer of research, which is really what I think most of us need to do. We need to be better consumers of information and not conflating some research with logic. I feel like we’ve also sailed… We don’t have to think critically, we don’t have to use logic anymore, there’s not a research study saying that this toothpaste, the same ingredients as this toothpaste, it’s not effective.

Brent Brookbush: [0:51:58] There’s two myths I want to nail right off the bat. Number one: If I post a conclusion and that conclusion is backed by 10 research studies, and you, Kelly, come in and you go, “Well, here’s why I don’t like that research study, and here’s why I don’t like this research study, and I think these three research studies are less relevant than I would like,” and you decide that you are going to take the opposing position but you have no evidence, you are wrong. You poking holes in my evidence does not make you more right. That’s the unsupported default.

Kelly: [0:52:35] No, you have all the cake, I have no cake. I can make fun of your cake, but I still have no cake. 

Brent Brookbush: [0:52:39] Right. This is the unsupported default position fallacy and you see it all the time. People think that if they prove me wrong, they’re more right. No. Every assertion, every conclusion, every position, needs its own individual support. This is something that everybody needs to learn, they need to get it down because you see it on the internet. I hate to sound so egocentric but I don’t know how else to say it: I feel like in our field I’m the only person… Well, the only company; shouldn’t say the only person. The only company that continuously backs everything with research. I’m the only one that posts citations, this is why I think what I think. And every time they attack the citations. And people are like, “You’re full of shit,” or you’re this. And I’m like, prove it; where’s your evidence?

Kelly: [0:53:29] We’ve always tried to say The Ready State is a model. Actually, how we look at movement is just a model. And what I can say is here’s what the model predicts. And all of our model is based on normative joint and limb range of motion. This is what your shoulder should be able to do. Here’s what predicts if these things are restricted or if you don’t have the skill. But it’s all based on do you have normative dorsiflexion or not. And I happen to know what normal dorsiflexion is so it’s useful for me to be able to say we’re going in that direction. But what’s nice about it is I’m like, well, here’s what the model predicts, and I actually can remove myself from that the same way you can. You’re like, well, here’s what our available… I mean it’s not your research. You’re saying here’s what I have understood to be the mechanisms for this or why this is true. And it’s very different and fortunately, it doesn’t take my feelings into consideration.

Brent Brookbush: [0:54:21] Right. It never does.

Kelly: [0:54:22] It hurts my feelings.

Juliet: [0:54:23] Can I ask maybe a question out of that? And that is, it’s sort of the end of one thing I mentioned, but one of the things I see, and I don’t know how you strike this balance between acknowledging people’s lived experience and also saying, dude, you’re end of one. I don’t know what other example to give other than so many people were like, “I got a headache from getting the COVID vaccine and then I went online and I read that four other people got a headache from the COVID vaccine, which means the COVID vaccine causes headaches and therefore must be bad,” or whatever. You could go online and find a thousand other examples of that, where someone in their own lived experience had probably more likely a correlation versus causation experience to something, whether it’s a diet or a vaccine or whatever, you name it. They have this lived experience, chances are they’re correlating it to something else, but then putting it out there into the sphere. How do we manage saying, okay, look, your experience is valid-

Kelly: [0:55:18] Shout louder.

Brent Brookbush: [0:55:18] It’s not though.

Juliet: [0:55:19] But maybe it’s not. Can we say that?

Brent Brookbush: [0:55:22] Yeah. 

Juliet: [0:55:23] Can we just say it doesn’t matter that you got a headache when you got the COVID vaccine-

Brent Brookbush: [0:5527] That absolutely doesn’t matter.

Juliet: [0:55:27] That’s probably correlation and not causation.

Brent Brookbush: [0:55:28] Well, and let’s pull apart the correlation causation thing because that’s another myth I can blow up. People who say that’s a correlation not a causation, it’s a stupid statement. I hate to be so blunt. But I’m going to get back to that in a second. Let’s talk about the end of one thing. This is what’s called a fundamental attribution error. We have to realize… I was reading a book once and they said if you were going to put anything on a billboard to teach the world, what would it be? Life is probabilistic, not binary. It’s not yes or no. It’s not all of this or none of this. It is always probabilities. And if you can wrap your head around that, life is so much easier. Because all you try to do is stack the probabilities in your favor. You know things are going to go wrong, but if you stack enough of them in your favor, eventually things are going to lean in the right direction. This is how my business operates. How many tests can I possibly run today? So I’m going to run all these tests. Now how we weight those tests might be about how much they cost, what the chance of actually affecting our outcomes actually are. But are they all going to work? No. No. If every one of my tests and ideas worked, we would be having this call from my personal jet. It would be a totally different conversation. You were talking about the COVID vaccine. Let’s jump into this for a second because to me watching the COVID thing play out was just watching the nightmare that is the lack of education around statistics and science around school programs. Did people die from side effects of the vaccine?

Kelly: [0:57:22] Yes.

Brent Brookbush: [0:57:23] Absolutely. One hundred percent. What were the chances of dying from the side effects of the vaccine versus the side effects of the disease? I mean those two things are not even close to one another. We’re talking 10,000 to one. The number of people who died in the United States following the vaccine is so much smaller than the million people we lost from the virus. People are like, “Well, I still don’t have to take it.” You’re absolutely right. You do not have to take it. But if one in 400, which is the number of people who died from COVID in the United States—one in 400—if one in 400 people died crossing the street in front of your house, you would not cross the street. Now if I told you, you could cross the street next to it and your chances immediately went to one in 10,000, which that is a ridiculous statistic, the number of people who died after getting the vaccine is actually much, much lower than that. But let’s say it’s one in 10,000. If you had a choice in going one in 400 you might die or one in 10,000 you might die, you’re going to cross the street that is one in 10,000 every time. 

That is setting yourself up for a life based on probabilities. Might you die crossing the one in 10,000 street? Absolutely. Nobody’s denying that. Nobody’s saying that this is any less sad. But it’s a little unfair to think that nothing is ever going to go bad for anything that we do. It just doesn’t exist that way. Now when we talk about models, we talk about what we do. We have to think in the same way. So people will be like you know the research, Tim Hewett one of my favorite researchers, he does all this research on the correlation between knee valgus during squat with the left test, which is kind of like an overhead squat assessment when you do a death jump. Squat or left test, knees bow in and future risk of ACL injuries. Could you have knee valgus and never have an ACL injury?  Yes.

Juliet: [0:59:30] Yes.

Brent Brookbush: [0:59:31] But does it increase your chance of knee pain and ACL injury? Yes. So which direction are you going to go? That’s all we’re talking about. Do I get things wrong? Yeah. Yeah, I’ve had patients where it didn’t work. Kelly can appreciate this. I talked to this in my classes. Any physical therapist who says they haven’t flared up a patient—lying. That’s just-

Kelly: [0:59:58] Oh, you were way more sensitized than I thought. Sorry about that.

Brent Brookbush: [1:00:01] Yeah. Whoops. I mean have I ever-

Kelly: [1:00:03] Next time I’m much better at identifying that I will want to leave you having leave here… think I’m going to manage that a little more effectively. Yes, that’s true.

Brent Brookbush: [1:00:11] Yeah. People ask me have I ever had somebody get off the table and their overhead squat assessment was worse. Yes. It happens.

Kelly: [1:00:19] Yeah, my favorite, just so everyone, this is an aside, I love old and cold. Oh, this happened to you long time ago, it’s not irritable and sensitive and flaming red hot? I’m like let’s go, let’s party. Old and cold, that’s my jam.

Brent Brookbush: [1:00:32] Yeah man. For sure.

Kelly: [1:00:33] That’s because I don’t have that problem as often.

Brent Brookbush: [1:00:35] Yeah, there’s something to that. Gray Cook said it first where he was talking about maybe what we should be going after is the dysfunctional nonpainful segment. So if you have cervical pain, maybe you should be working on upper thoracic mobility first rather than just jabbing at the neck. Anyway, this goes back to what you were talking about. I hope I’ve given some examples of like, okay, the fundamental attribution error is a real problem, right?

Kelly: [1:01:01] Yeah.

Juliet: [1:01:01] Yeah.

Brent Brookbush: [1:01:01] It allows us to be pulled towards the lower probability thing and think that it’s bigger than it is. And everybody can find a situation. That end of one thing, either you could be an outlier, you could be the less likely scenario. The other thing that happens with the end of one thing that does not get enough credit, especially in fitness, is you don’t actually know what worked. Well, the Paleo diet worked for me. Well, it just so happens that when you went on the Paleo diet it was also the first time you ever tracked your nutrition, first time you ever ate less calories, the first time you ever worked out on a regular basis, the first time you ever started tracking your sleep because you happened to get a Fitbit or iWatch or whatever at the same time.

Kelly: [1:01:44] Or self-identified with the Paleo community and suddenly you had support. 

Brent Brookbush: [1:01:47] Right. Exactly. Right. So that’s what research is really good at, is trying to determine what the variable was that was successful. So if we put 25 people on the Paleo diet all from different walks of life and everybody loses weight, then we think, okay, then we think maybe the Paleo diet might have something to do with it. We could take this one step further if we’re going to go through these levels of evidence. That would just be an observational study. We could set up a randomized control trial, do somebody not on the diet do the Paleo diet and then compare it to something, like maybe just a low-calorie diet. The same calories as on the Paleo diet but just a normal mixed diet. We’ll call it a normal American diet. That would be an interesting study. 

So you’ve got the fundamental attribution error, you’ve got why end of one doesn’t work, you’ve got life is probabilistic. And then we hit on this other thing which is, well, it might be correlation and not causation. Oh my God. Do you know what it takes to prove causation?

Juliet: [1:02:52] It’s really hard. 

Brent Brookbush: [1:01:54] Okay, you know what? That’s the right answer. Here’s why. People are like, well, is it a correlation? Yes, it’s a correlation. But you’ve set up an argument that can’t be won. How do I prove to you that it’s causation? Well, you have something called the Bradford Hill criteria for causation. And you know what causation actually comes from? Lots of different correlations.

Juliet: [1:03:17] Correlations.

Brent Brookbush: [1:03:18] That’s it. So if we have a bunch of different correlations that under multiple different circumstances with different audiences with different experiments, different research studies all point to the same cause, we start to believe that there’s causation there. Like this argument of correlation versus causation, it’s stupid. It’s like what end of the spectrum are you on?

Kelly: [1:03:43] We’re actually looking for correlation. We love correlation.

Brent Brookbush: [1:03:47] I mean we could make an argument, I know some statisticians will argue with me on this point, but in a way, all research does is determine correlations. So all a research study really tells us, and this is why people get so fed up with science not using definite language, they don’t use definite language because we use research. Research uses statistics, statistics gives us probabilities, which are just in a way strengths of relationships. There is a 92 percent chance of X. That’s a relationship; that’s a correlation. I would lean in favor of the 92 percent over the 8. But I guess you could take the 8 percent.

Kelly: [1:04:26] I want the 99 percent proof that my juice cleanse is going to give me abs. That’s all I’m looking for.

Juliet: [1:04:33] Okay, so I’ve got a question for you that may be unanswerable given your actual education. 

Brent Brookbush: [1:04:38] Drinking mimosas all day is not a juice cleanse.

Juliet: [1:04:40] Yeah. Does not count as a juice cleanse. Okay, so one thing I want to say when I listen to all this, and my background is so different from yours-

Kelly: [1:04:51] By the way, I just have to say, I really love that because sometimes I’m like, hey, define your terms. You said stretching doesn’t work. What do you mean by the word stretching?

Brent Brookbush: [1:04:57] Oh, we can get into-

Kelly: [1:05:00] We’re going to do part two. But I’m like you don’t identify your terms

Juliet: [1:05:03] One of the things when I hear you talking about this is actually, I’m really grateful for my law school education because what’s hammered into you in law school is that you don’t know anything and that the answer to 99.9 percent of questions is that it depends. And so you’re actually literally trained to think that it’s okay to have duality and that nothing is binary and you’re speaking in terms of probabilities but it’s like in the law, ah, it kind of depends. There is this law but you could have murdered this person this way and then someone else murdered this person this way and so it depends on how you apply the law to those two different set of facts. But anyway, it’s very similar to sort of a different way of coming at it.

Brent Brookbush: [1:05:41] Sounds like a lot of people buried in your backyard. 

Kelly: [1:05:45] I was going to say the same thing. I was like why did she look at Lisa when she said murder?

Brent Brookbush: [1:05:48] Dah dah dah.

Juliet: [1:05:53] But what I wanted to actually ask you, and again, this may be hard for you to answer because of your educational background, but what do normal people do? I think there’s a lot of people who are actually taking in information on the internet and they really actually care and they want to try to learn and choose people to follow who are giving them good information and be able to distinguish between what is entertainment and actual information. And how do regular people who are educated at different levels but still kind of care about trying to understand correct, accurate information, how do those people sift through the quagmire of misinformation to identify good information? I mean I do think, by the way, understanding the hierarchy of research studies is helpful because one just side subtext is I feel like whenever anyone writes, “In a recent meta analysis,” just because the word meta sounds so awesome, that people actually think a meta analysis maybe has more weight than some other kind of study because meta sounds, I don’t know, sounds huge. So how do people navigate this?

Kelly: [1:07:01] That’s why I use mega analysis.

Juliet: [1:07:02] Yeah. It’s like a meta analysis but mega.

Brent Brookbush: [1:07:05] Yes. That’s a great question. I think number one, you have to try to stay away from the logical fallacies. I see way too much of this on the internet, politics. There’s no doubt the political environment is affecting our scientific community. People have politicized everything to the point that it’s like they use this, well, that’s your belief, and you have to—what’s the word I’m looking for—you have to respect my truth, right? They have this idea that we all are supposed to respect each other’s opinions. No. No, actually I don’t have to. This is science. I don’t care about your opinion. You’re a 25-year-old new grad. I’ve been educating for almost as long as you’ve been alive. I’m sorry. I actually do not have to consider your random ass opinion that you just came up with without support. So I think this idea that every idea should be respected is actually not true. 

I think not giving up, not falling for these fallacies, continuing to try to learn is actually the most important thing you can do. I would rather you understood 30 percent of an abstract of a study than listen to some of the ridiculous gurus that are out there. Now long term, here’s the solution: Me, Kelly Starrett, have immense amount of work to do to make sure that we are at the top of the hill. And that sounds egocentric, but I actually mean it absolutely the opposite. This is a humility thing. We have failed our industry. We have failed to become, although both of us are working very hard to create these evidence-based systems… You mentioned one of my favorite words which I mentioned at the beginning, which was modeling, sorting, algorithms, all of this information theory. We’re trying to push all of this forward and me and you have failed to become the most accurate and most popular so that we have the most students.

Juliet: [1:09:16] Do you think you could talk about this evidence while not wearing your shirt and that would solve the problem of accuracy plus popularity?

Brent Brookbush: [1:09:23] Me personally? I mean-

Kelly: [1:09:28] I chose the wrong parents.

Brent Brookbush: [1:09:28] Yeah. I was about to say I think one of my parents might have been a vampire. I am so pale it’s a little ridiculous. It’s sad. It’s sad. I can’t go to the beach. It’s an affliction. But what I was saying, I don’t want people to think I’m going off on this ego thing. It’s just not me and Kelly. I’m just using us as two examples. Those of us who are trying to do a systematic approach to refining evidence-based practice are not winning the war of marketing. We’re not winning the war of getting the word out. We’re not winning the war of making it accessible. Now you guys, I mean Kelly, I think that’s your claim to fame, for a while there and maybe still, you were the most popular physical therapist I think I’ve ever seen. I was like, holy shit, there’s a physical therapist on TV. I didn’t think that was going to happen.

Kelly: [1:10:28] Be a physical therapist, they said; see the world, they said.

Brent Brookbush: [1:10:31] But why aren’t you still up there? Why aren’t you the next Dr. Oz? And this is not an attack, Kelly. You know I have nothing but the utmost respect for everything that you do.

Kelly: [1:10:40] Oh, no, no. I hear you. I hear you. 

Brent Brookbush: [1:10:40] We can’t stay there. We can’t get there and stay there and influence… I mean we know like Dr. Oz for example went totally off the rails and just started supporting anything that would get him money, obviously not evidence based, despite the fact that he was the real deal at one point, which totally pissed me off. But yeah, that’s where I think-

Juliet: [1:11:02] I just have to tell you though, it was a true story, we had like a pseudo competitor person that was just growing like crazy on Instagram. And I said to our social media team, I was like, “Hey, so our content is as good if not better than their content.”

Kelly: [1:11:17] Better.

Juliet: [1:11:17] Better. And yet their Instagram following is growing by 10,000 a month and ours is growing by 1,000. What’s the difference? And literally with a completely straight face, our social media guy is like, “Well, the guy in their video is never wearing a shirt.” So that’s where we are. And I was like, wow, okay. Again, it’s like how do we-

Brent Brookbush: [1:11:39] I wasn’t going to do this, but-

Juliet: [1:11:42] Yeah, I just think that’s an example because it’s such a point well taken how do you have the best information, the most accurate, evidence-based practice, and then how can you also make that the most popular? That’s the ticket.

Kelly: [1:11:54] I’m going to cherry pick some of your social posts. 

Brent Brookbush: [1:11:59] Yeah. Do it.

Kelly: [1:12:00] That I think are the most controversial. And what I would love to do is have another episode where we could talk about these, I call them zombie thirst traps. It’s a thirst trap where you’re looking for attention on the internet so you post a zombie argument. I’m like this argument should be dead already but it’s not and you needed attention, so ergo, the zombie thirst trap. And you do such a good job of taking on foam rolling doesn’t work, stretching doesn’t, some of these. I would love to go through with you sometime and talk about some of these I’m going to call them third rails. I don’t even touch them anymore.

Juliet: [1:12:40] Didn’t there used to be a show called MythBusters? It’s like MythBuster with Brent and Kelly.

Brent Brookbush: [1:12:47] Yeah. I published Fitness or Fiction in 2011. That was all myth busting. That was my first book. I do feel like no doubt we could do coffee talk with the three of us forever. We could do this weekly. We’d never run out of topics to talk about.

Juliet: [1:13:04] It’s never ending.

Kelly: [1:13:08] Welcome to zombie thirst trap. Today we’ll be taking on-

Brent Brookbush: [1:13:09] Today we’ll be taking off our shirts and taking on-

Kelly: [1:13:15] I want to wrap this because we have a lot in common. You and I are friends. Juliet and I are obsessed with the things you’re really good at. Where can people begin to learn more about the Brookbush Institute? Where can people become curious about following the way you’re thinking and teaching and promoting science? Where does someone start to know a little bit more about your brain?

Brent Brookbush: [1:13:40] BrookbushInstitute.com is the website. We try to make things as open as possible. Brookbushinstitute.com/courses is all of our courses. You can see all of them. There’s free to view courses. I think we’re on all social media platforms, Instagram, Facebook, LinkedIn, YouTube, we’re even on Twitter, although I really don’t like Twitter much for the fact that it’s the haterverse. So I think if you’re on social media, you can definitely take us in that way. A little sales pitch here: We are taking a Netflix model. When we say a Netflix model, we literally mean a Netflix model. We are $19.99 a month, cancel anytime. And every course you take with us is approved for CECs and counts towards certification. So I think there’s a lot more people who should just try it. We even have a 30-day money back guarantee if you don’t like it. But I’m not saying that just to sell you a membership. It’s like the upfront cost is low because we believe the upfront cost should be low so that you can try what you’re going to get involved in. Because the bigger commitment is not finance; it’s time. We know that. So yeah. Brookbushinstitute.com and everywhere on social. And now on The Ready State Podcast

Kelly: [1:15:00] That’s right. We’ll get you over to TikTok eventually, my bro. 

Brent Brookbush: [1:15:02] That’s right. I’m an excellent twerker.

Kelly: [1:15:05] I just want to see you pointing and lip syncing to research. That would be my jam. That’s exactly right. 

Juliet: [1:15:13] He’s all about accessibility.

Kelly: [1:15:15] I’m telling you, he’s my pocket PT. He’s in my personal cabal of touchstones of trying to understand the world. That’s really all I’m trying to do is understand the world and bring some people along with me.

Brent Brookbush: [1:15:28] And you know, The Ready State was my next business idea. I say that out of love and affection. I think it’s so important that more people have access to trying to help themselves. I was talking about the caste system of education. There’s other caste system that’s like all of the self-managements of injury prevention and injury recovery that you guys do. I was like that was my next business. You took it, Kelly, so I’m not going there.

Kelly: [1:15:58] I had two choices. I was like I can do research and education or I can do this self-care. And I was like, ooh, self-care. 

Brent Brookbush: [1:16:05] Thanks for leaving me with the tough one, bud.

Kelly: [1:16:07] You’re welcome, buddy. Hey, thank you so much, my friend.

Juliet: [1:16:10] Yeah. Thank you so much.

Brent Brookbush: [1:16:11] You guys are very, very welcome.

[music]

Kelly: [1:16:18] Thank you for listening to The Ready State Podcast. If you like what you’re hearing, check out all our episodes here or at thereadystate.com. And be sure to subscribe or leave a review on iTunes to help others find our show. 

Juliet: [1:16:30] Check us out and follow us on Facebook, Instagram, and Twitter @thereadystate.

Kelly: [1:16:35] Until next time, cheers everyone.

[music] 

Back to Episode