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I came across your work for the first
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time. Shockingly, it's astonishing to me
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I didn't come across you earlier because
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I put a tweet online, not sure what the
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noun is for something like that on X at
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this point, asking about remedies
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related to tennis elbow specifically,
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and it was within the context of rock
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climbing. And someone put up a video
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from YouTube by Emil Abrahamson. I'm
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probably pronouncing that incorrectly.
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Who is a highlevel climber, great
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YouTube creator and teacher who put up a
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video called something like doing
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hangboard training twice a day for 30
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days. And that is where he referenced a
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study of
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yours or may have been a review. I'm not
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sure exactly, but minimizing injury and
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maximizing return to play lessons from
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engineered ligaments. And I just want to
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give people the punchline to this
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because and then I'll shut up and let
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the expert talk. He is a highlevel
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climber. He climbs V15s, bouldering. He
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is incredibly good. And after 30 days of
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doing 10 minutes a day roughly of
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hangboard, not even full hangs, let's
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just say 70% body weight, so his feet
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are on the floor, kind of like a nice
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stretch for 10 seconds on, 50 seconds
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off. So 100 seconds of tension per
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session. He I think added 60% weight to
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his maximum hangs. So this is weight
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attached around the waist. He went from
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something like a 0.5 second one-handed
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hang on a tiny little ledge. I'm not
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using technical climbing language here
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to 13 seconds and so on and so forth.
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And it just blew his mind completely. So
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let's just start with asking what is
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happening here? What are the adaptations
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that are allowing something like that to
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happen? And then we'll kick off from
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there. It's a great place to start
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because we think it actually shows
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something fundamental about strength
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because what we do is I'm in our
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strength physiology facility here and
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and we normally think of strength is
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yeah, we're going to lift weights. we're
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going to do something really, really
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heavy. And because that's going to make
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us stronger, we know that when we lift
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heavy weights, we get stronger. And the
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reality is that there are certain,
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especially certain athletes like
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climbers where they're doing all kinds
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of heavy lifts. They're doing all kinds
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of heavy work. They're doing all kinds
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of really dynamic moves. And what
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happens, what breaks down is they break
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down in their finger tendons and they
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break down in the little pulleys within
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the tendons.
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And we had come to this because for
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years I had been working on how to make
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muscles bigger and stronger. And I
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always said, okay, bigger and stronger
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because the definition in my old
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textbooks would say that the strength of
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a muscle is related to the
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cross-sectional area. It's proportional
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to the cross-sectionality of the muscle.
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And so I was like, okay, to get
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stronger, you need to be bigger. So I
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actually was really fortunate to be to
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be part of the team where we discovered
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the the small molecule in our cells that
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actually allows our cells to get bigger
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when we do resistance exercise. What is
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the name of that just in brief? So it's
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mTor. So it's mTor complex one. It's the
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mechanistic target of rapamy. So I had
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been doing this. I had a laboratory. My
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first laboratory was in Scotland and I
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was invited down by the English
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Institute of Sport to come to to their
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cycling center and they were like,
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"Okay, this is great. We need to we have
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these incredible athletes who are
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winning all kinds of gold medals and we
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want them to get stronger." And so I go
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in there with my spiel about bigger
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muscles and all of this. And they're
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like, "Yeah, but we got to carry that
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muscle mass." And I've got five years of
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data that shows me I'm getting these
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athletes stronger without making them
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any bigger and in many cases making them
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smaller. And I'm like, "Oh, well, so
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much for all the science that I've been
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doing for a long time." But then I had
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to figure out, okay, so how is this
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working or how are they getting people
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who are stronger without them getting
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bigger? And so what it came down to is
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it if we have the little motors in our
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muscles that are going to produce the
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force, what we then have to do is we
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have to transmit that force. And that
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force has to be transmitted from our
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muscle where we're producing it to our
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bone where the movement is going to
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occur.
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And that's going to go through tendons,
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it's going to go through connective
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tissue, it's going to go through all of
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these proteins that are that we call
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colloally force transfer proteins. And
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so that was the first thing that we were
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thinking of. And then what we what we
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were doing is we would make these little
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engineered ligaments. And so the goal at
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the beginning is, hey, I'm going to make
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ligaments. You're going to rupture your
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ACL. You're going to send me like a a
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sample that we'll take in the doctor's
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office. I'm going to isolate the cells.
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I'm going to make you an ACL in the dish
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in my laboratory. I'm going to send it
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back to you so that you don't have to
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take your hamstring or the middle third
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of your patella and we can replace that
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ruptured ACL. That's the idea. But we
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have to get them stronger. So we started
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looking at, okay, we know exercise makes
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these tendons stronger, but what about
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the exercise? And what we found is it
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didn't matter whether we stretched them
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20% or 5% or 2%. The signals to get
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bigger and stronger were the same. But
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then we started doing for different time
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lanes and it started the signal would go
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up and then it would go away really
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quick. And so the way that I explain it
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now is it your tendon, ligament, your
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bone, all of your connective tissue
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cells are a lot like my 17-year-old
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daughter. She's going to listen to me
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for maybe 5 minutes, maybe 10 minutes,
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and then she's going to just tune me
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out. So I need to get all the
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information in in that 5 to 10 minutes.
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So if you're going to go and you're
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going to climb, for example, like Emil
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would do all the time, he's going to
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spend 3, four, 5 hours at the wall doing
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different things, the tendons stop
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getting the signal to adapt at 10
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minutes. Everything on top of that was
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just wear and tear that could, you know,
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slightly cause problems. And so what
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that meant to us is that there's this
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minimal effective dose. So if I give you
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10 minutes of loading that is optimized
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for those connective tissues whether
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it's tendon, ligament, cartilage or
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bone, I can get you to get all of the
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signal from that whole exercise bout in
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10 minutes. And so that was the first
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part. The second part was how long does
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it take before I can get more signal to
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go through that system? Think of it like
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your toilet. I flush my toilet, it's
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going to flush. But if you know when my
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daughter was younger, she Oh, that was
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fun. Let me do that again. It wouldn't
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flush for a while. She needed to let the
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bowl refill, let the tank refill so I
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could flush it. So that's called the
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refractory period. How long do I have to
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wait before that next session and what
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we found is about 8 hours, 6 to 8 hours
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later. And amazingly, that was almost
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exactly the same thing that other
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researchers had found for bone. That as
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little as as few as 40 stimuli with
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eight hours of rest was maximal for
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bone. We found that 10 minutes of
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activity, whether you did walking or
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running or just holds, 10 minutes worth,
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so 10 seconds on, 50 seconds off, 100
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seconds total, over that 10 minutes,
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that's all the signal your your cells
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need. You wait 8 hours, you could do it
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again. And so Emil's brother had lots of
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injuries. So he did it twice a day. His
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hands are healthy now. He can climb.
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Emil because he's a huge strong
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boulderer who does these dynamic loads.
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He had a really big effect of doing
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those isometric holds because he was
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getting all of the stimulus to make the
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muscle stronger, the brain power to
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stimulate the right muscles to help him
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to be able to contract that. What he was
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missing was he was getting too much wear
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and tear on the tendons on the force
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transfer stuff. So, when we just got him
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to do those 10-minute session, his force
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transfer capacity went way up and now
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his grip strength went way up. And one
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of the best videos that he has is he
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becomes a competitor in the world's
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strongest grip competition. Oh, it's an
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amazing video. It's so good. And so,
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these guys are twice his size and he's
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grabbing all these things about the same
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as the the people who are twice his
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size. It's awesome because Emile's
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smaller than me. He's a great guy. And
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but it's like, okay, so you're getting
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to the point where you have some of the
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strongest grip in the world and all
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you're doing is these little things.
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You're doing your dynamic climbing and
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you're combining that with these
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isometric holds. And so what we're
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improving is that ability to transmit
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the force between the muscle that's
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making it and the bone that's trying to
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help us do the movement.
