Keva Silversmith | Heal faster

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[Keva Silversmith | Heal faster @kevasilversmith]

The Perfect Shoulder Superset

Here's your periodic reminder that lateral raises are best performed in the scapular plane (about 20 degrees in front of your torso) rather than directly out to your sides. This motion puts the shoulder in a more natural position and is often more comfortable.

In addition, a slight forward torso lean improves the resistance profile of the movement,  keeping tension on the lateral delts in the bottom portion.

This exercise pairs perfectly with overhead presses as a superset. By pre-fatiguing the delts with lateral raises, your shoulders become the limiting factor during the press, allowing you to challenge them harder while your triceps remain relatively fresh.

[Keva Silversmith | Heal faster @kevasilversmith]

@ze_rusty Low cholesterol due to plant based diets.

[Keva Silversmith | Heal faster @kevasilversmith]

@SeedOilDsrspctr Massive excess iron in pet food, @Mangan150 talks about this.

[Keva Silversmith | Heal faster @kevasilversmith]

The BEST Overhead Tricep Extension for Bigger Arms

Most people do overhead triceps extensions standing upright, but I prefer this variation facing away from the cable stack.

By leaning forward and keeping my elbows near my head, I get a deep stretch on the long head of the triceps — the part that crosses the shoulder joint and contributes to a lot of overall arm size.

Another thing I like is that facing away from the stack lets the cable pull slightly behind my elbows at the bottom. That helps maintain tension where many dumbbell and free-weight overhead extensions start to lose it.

If you're looking for a triceps exercise that combines a deep stretch with constant cable tension, give this variation a try.

[Keva Silversmith | Heal faster @kevasilversmith]

Body Proportions and the Decline Bench Press

Experts say the decline barbell bench press is easier on your shoulders, but I get extreme shoulder soreness the next day.

Body proportions matter.

Your arm length relative to your torso, your ribcage depth, and shoulder structure all change how a press feels.

On a flat or incline bench, most people naturally stop where their shoulders want to stop. But on a decline, the angle can pull some lifters deeper into the stretch.

The decline as a shoulder-friendly movement is true for some people … and completely wrong for others.

[Keva Silversmith | Heal faster @kevasilversmith]

The Insomnia Trap: Trying Harder Makes It Worse

**A conversation between an insomniac and a therapist.**

Therapist: Tell me about your sleep.

Patient: I can’t fall asleep.

Therapist: How long has this been going on?

Patient: Since my junior year of college. I’m 52 now.

Therapist: So over 30 years?

Patient: Yes.

Therapist: Do you practice good sleep hygiene?

Patient: Better than most sleep experts.

Therapist: What does that mean?

Patient: I watch the sunrise every morning to anchor my circadian rhythm, and to start the biological process that governs nighttime melatonin release. I stop drinking coffee before 9 a.m. I wear blue-light blocking glasses after sunset. A bed is for sex and sleep only — no screens, no books, no TV. I follow a consistent sleep and wake time seven days a week to avoid social jet lag.

Therapist: That’s an enormous amount of cognitive bandwidth devoted to preventing sleep disruption.

Patient: Wait ‘till I get going! I’ve set my phone to switch to night mode as the sun sets and my computer screens do the same. My bedroom is cold and dark, as it would have been for our ancestors. I avoid eating or drinking at least a few hours before bedtime.

Therapist: Do you exercise?

Patient: Intense exercise six days a week. I also do cold plunges four or five times a week.

Therapist: Cold plunges late in the day?

Patient: Don’t be ridiculous. I finish by noon because I know the body’s efforts to rewarm after a plunge can interfere with the normal evening drop in core body temperature that helps trigger sleep.

Therapist: So you’re tired at night?

Patient: Exhausted.

Therapist: But you can’t sleep?

Patient: I climb into bed tired, drowsy, ready to sleep. Then nothing happens.
_____________________________________________________

Therapist: Have you tried medication?

Patient: I’ve taken a low dose of lorazepam for about twenty years.

Therapist: Does it work?

Patient: Every time, but I understand the impact of a sedative on sleep architecture compared to a true sleep aid.

Therapist: Have you developed a tolerance to it?

Patient: Oddly enough, I’ve become more sensitive to it over the years.

Therapist: Have you tried replacing it because of the studies that show a correlation between long term use of benzodiazepines and dementia in the elderly?

Patient: Yes. Trazodone worked for me for a few months and then fizzled. Doxepin did nothing. Mirtazapine just made me hungry. I know that the remarkable drug GHB works great for sleep onset insomnia and keeps your natural sleep architecture intact. Unfortunately, the FDA killed GHB in the early 1990s because it threatened drug company profits.
_____________________________________________________

Therapist: Let’s talk about your family.

Patient: My mother has the same problem.

Therapist: Anyone else?

Patient: My sister.

Therapist: Anyone else?

Patient: My uncle — my mother’s brother.

Therapist: Interesting.

Patient: Why?

Therapist: Because we’re no longer talking about someone who simply has bad habits. Genetically, some people are born with extraordinarily resilient sleep systems. Others are born with fragile sleep systems.

Patient: It’s funny you say that. My father can sleep soundly on his side of the bed while my mother packs a suitcase after midnight on hers. I was married to a woman who watched screens in bed, didn’t care about her sleep schedule, engaged in late night socializing, was oblivious to blue light exposure at night, ate late meals … yet slept instantly under any conditions — on planes, in cars, and around every kind of noise. Pretty impressive actually.

Therapist: They slumber because their nervous system fundamentally trusts the transition into sleep. You believe sleep is a high stakes event that every day must be carefully engineered and defended.
_____________________________________________________

Therapist: What happens if you only sleep four hours on a particular night?

Patient: I’ll feel terrible.

Therapist: Anything else?

Patient: I’ll be less productive. Less healthy. I might have to miss my workout. I’m damaging my brain.

Therapist: So we’re not just talking about sleep anymore. We’re talking about catastrophe.

Patient: But sleep is health. Metabolic health. Insulin sensitivity. Cognition. Emotional regulation. Cardiovascular risk. Immune function. Longevity. Recovery. Memory consolidation. Everything else in the health ecosystem is just improvement on the margins if your sleep foundation is intact.

Therapist: That’s true. But there’s a difference between respecting sleep and having sleep become the organizing principle of your existence. After enough years, the cost of that lifestyle, including social withdrawal, can exceed the direct physiological cost of imperfect sleep itself. There’s actually a name for this phenomenon: orthosomnia. Honestly, has the sacrifice been worth it?

Patient: I can’t say.

Therapist: Sleep is unique because it is one of the few biological processes that worsens under effort. You cannot make yourself sleep in the way you can make yourself diet or exercise. Sleep requires a kind of neurological surrender.

Patient: So what’s the lesson?

Therapist: The pursuit of perfect sleep often creates the very hypervigilance that prevents sleep. Some people improve by gaining confidence they can survive imperfect nights, recognizing their body is not terrifyingly fragile, and accepting that sleep does not require constant supervision.

Patient: Ok, but where do I start?

Therapist: I think you should consider that your goal is to build a meaningful life. Sleep is important, but it isn’t the purpose of your life. Somewhere along the way you’ve reversed that relationship, with the current purpose of your life designed to facilitate sleep.

Patient: So I should stop caring about sleep?

Therapist: You should stop measuring your life by last night’s sleep.

[Keva Silversmith | Heal faster @kevasilversmith]

What Exercise Has The Worst Ratio of Pain to Gain?

If I could give up just one exercise I think it would be this one. Barbell curls hurt like hell in exchange for working a low priority muscle.

When I go heavy, I also sometimes strain muscles unrelated to my biceps, like my traps or shoulders.

I have no issues with a painful leg day because the health benefits are metabolic and functional. With biceps, I’m just doing it for show.

[Keva Silversmith | Heal faster @kevasilversmith]

My Experiment With DMSO for Plantar Fasciitis

Plantar fasciitis can come for anyone, regardless of status. Tiger Woods withdrew mid-tournament from the 2023 Masters due to unbearable heel pain. NBA Center Joakim Noah, once awarded Defensive Player of the Year, had his electrifying career cut short because, he said, “It feels like you have needles underneath your foot while you’re playing.”

Schlubs like me hobble through the same issues, in obscurity, often for years. A long-term study published in the Orthopaedic Journal of Sports Medicine found that among people who suffer from plantar fasciitis, 45.6% had symptoms after a decade, and 44% still had plantar heel pain after 15 years. I am in year four.

Studies of plantar fasciitis tissue have shown that the condition is actually chronic wear-and-tear degeneration (“fasciosis”) instead of an inflammatory condition (“fasciitis”). Fascia overuse is just like tendon overuse, where repetitive mechanical overload causes your body to give up on healing. Tendinosis leaves you with chronic golfer’s elbow, or rotator cuff discomfort, while fasciosis drives plantar heel pain. Once degeneration develops, the already limited blood flow to joints and fascia can indefinitely stall repair and remodeling.

Doctors have no idea how to cure plantar fasciitis. Surgery shows a mild benefit only if you do it within the first year — when you should be prioritizing rehab. Unfortunately, there’s no way to predict what non-surgical interventions, if any, might relieve your heel pain. Here are some approaches you can try:

-ToePro foot strengthening
-TENS muscle stimulators
-Toe spacers
-Calf strengthening exercises
-Rolling your calves with a muscle stick to break up adhesions
-Gua Sha soft tissue therapy
-Calf stretching
-Toe stretching
-STJ/talocrural joint manipulation
-Sleeping with a Strassburg sock
-Hand and machine massage
-Myofascial release
-Foot taping
-Short foot exercise
-Switching to wide toe box footwear

You see the problem. Plantar fasciitis rehab is a fulltime job that often accomplishes nothing.

What Is DMSO?

DMSO — dimethyl sulfoxide — is an is an organic chemical compound that is known for its ability to easily penetrate the skin and biological tissues. In the early 1960s, the medical community discovered that DMSO quickly healed acute musculoskeletal conditions with minimal adverse effects, likely by increasing blood circulation.

As public and professional interest in DMSO surged, the FDA found the situation intolerable. The agency stepped in to block this cheap and widely available cure, issuing a global research ban on November 10, 1965. Doctors stopped using it out of fear of prosecution.

In the 21st century, we have little knowledge about how DMSO can treat orthopedic injuries. Recently, curiosity about DMSO has returned thanks to a doctor writing anonymously to over 250,000 subscribers at The Forgotten Side of Medicine.

While DMSO can be administered via IV for complex health issues (neurological disorders, cancer), for acute sports injuries you pour some into your hand and apply it topically at the site of injury.

My DMSO Protocol

There is no evidence either way about the impact of DMSO on chronic musculoskeletal injuries. Early researchers never addressed this use case, and doctors never got the chance to try it out. You could say I’m a trailblazer for addressing my own chronic plantar fasciitis with DMSO.

I started by slathering DMSO along the bottom of my foot twice per day, for about a month. (DMSO may also help your hair grow, so I rub the DMSO residue on my hand onto my scalp). Then I took a one week break to let everything settle and to assess. My foot pain was better but not gone, so I’m now doing a second round of twice-daily treatment.

Although I may have successfully rebooted collagen turnover in my fascia, the healing process can still take up to six months, even under the best of conditions. Certainly a steady reduction in pain is a good sign that the tissue is remodeling.

In any event, I have a biologically plausible explanation for how DMSO might help. Whatever you do, just don’t tell the FDA.

[Keva Silversmith | Heal faster @kevasilversmith]

DMSO for Plantar Fasciitis

DMSO is an organic chemical compound that is known for its ability to easily penetrate the skin and biological tissues. It can quickly heal sports injuries with minimal adverse effects, likely by increasing blood circulation.

I’m using DMSO to address my own chronic plantar fasciitis. I slather DMSO along the bottom of my foot twice per day to reboot collagen turnover in my fascia. My steady reduction in pain is a good sign that the tissue is remodeling.

[Keva Silversmith | Heal faster @kevasilversmith]

@AmmousMD @Ariel11088885 @DrJackKruse https://t.co/uHBb7lKYNw

[Keva Silversmith | Heal faster @kevasilversmith]

Why I Keep Seated Good Mornings

The interesting part about this set of seated good mornings is not how my range of motion improves after each rep — that’s just my nervous system relaxing rather than some meaningful mobility restoration.

What is important is that after adding this exercise to myroutine, over the course of several years:

-->I’ve been able to add more weight to this exercise
-->I can train hinge mechanics in a controlled environment
-->I am directly working my spinal erectors with minimal risk of irritation

The rep-to-rep ‘unlocking’ is just my nervous system warming into the position. I keep the exercise because it actually delivers training value.

[Keva Silversmith | Heal faster @kevasilversmith]

10 Positives of the Coming Food Shortage – Oil Edition

In March 2022, after President Biden warned that the war in Ukraine would cause ​food insecurity​ across the planet, I wrote a blog post about the upside of the coming food shortage.

Well, here we go again.

Logistics experts are sounding the alarm about energy shortages, particularly in diesel fuel. They point out that even if the Middle East conflict ends today, a significant lag exists before the world can return to normal energy stockpiles. Oil infrastructure needs to be turned back on, oil tankers need to be filled, and these ships need to sail across the globe to refinery destinations.

In the United States, 70 percent of all agricultural and food products are transported by truck, and every truck runs on diesel. When trucks stop moving, so does everything the trucks were meant to carry.

So let’s stay positive and look on the bright side of what comes next.

10) People will get plenty of sunlight and fresh air while standing in ration lines for food.

9) The lack of food available to buy will offset rising grocery prices.

8) Less obesity and better metabolic health means the coming shortage of pharmaceuticals will impact fewer people.*

7) Cookies really will be a sometimes food.

6) You can permanently cross weekly meal planning off your to-do list.

5) People who do intermittent fasting will no longer have to defend their lifestyle choices — or even be noticed.

4) Portion control will no longer require willpower, apps, or lifestyle influencers.

3) “Out of stock” labels will reduce decision fatigue across all grocery categories.

2) With no trucks to transport food, the “buy local” crowd finally wins.

1) The political divide in this country will disappear when everyone is fighting over the last rotisserie chicken at Costco.

__________________________________________

*In the pharmaceutical industry, oil-related disruptions lead to: missing petrochemical feedstocks; less plastic for IV bags, syringes, and packaging; and insufficient quantities of the solvents used in manufacturing processes.

[Keva Silversmith | Heal faster @kevasilversmith]

Stop Doing Weighted Pull-Ups (Unless You Know This)

If you care about your elbow health, you should never do weighted pullups — with two exceptions.

1) Use pullup handles that allow for a neutral grip. Never use a straight bar.

2) Use a very light weight. I used to crank these with a 25 lbs plate or more, but then I had to spend years healing my golfer’s elbow. 10 lbs max is fine.

As always, for elbow health, never start a pullup rep from a dead hang.

[Keva Silversmith | Heal faster @kevasilversmith]

Why Old School T-Bar Rows Hit Different

The old school T-bar row has you jam a barbell into a gym corner, throw on some small weight plates for the longest range of motion, and plant your feet flat on the floor. It has a barbell row feel but with a more comfortable grip. There’s a certain freedom in no platform and I was fine with no belt on.

The only problem with this T-bar version, which I realized several reps in, is that the modern T-bar row machine is designed specifically so that on every rep you’re not hitting yourself in the nuts.

[Keva Silversmith | Heal faster @kevasilversmith]

Why Sweating Isn’t Detox

One fascinating aspect of gym behavior is the effort people make to avoid doing the work. Take the elliptical machine … please. It’s not only that people congratulate themselves on a workout less demanding than a gentle walk, but also how some people add gimmicks to make the session even more meaningless.

In particular, I’m thinking of this guy who puts in hours every week on the elliptical machine while always wearing heavy sweatpants, and a sweatshirt with the hood up. His goal is obviously to sweat more — to “detox.” The problem is that the human body doesn’t work this way.

For starters, sweat is 99 percent water and .9 percent sodium, with a trace amount of potassium. The body’s real detox system is the liver, kidneys, lungs, and digestive system. All the sweat in the world from exercise, baggy clothes, and saunas won’t remove toxins on a scale anywhere near what the body does naturally.

A real detox program means supporting your body’s innate cleaning system through good lifestyle choices: stable circadian signaling (including food timing) and quality sleep, and intentional movement that helps circulate lymph fluid through the lymphatic system (jumping, walking, trampolining/rebounding).

For folks that want to accelerate detox further, here are some ideas with actual value.

Renovate your melanin sheets (i.e., go outside)

Melanin is the body’s master chelator, with a chemical structure that acts like a magnet for heavy metals. Melanin binds to lead, aluminum, and mercury, and eliminates heavy metals through the constant shedding of skin cells. The properties of melanin also enable it to adhere to microplastics and plastic-related chemicals like phthalates, and to excrete them like heavy metals.

Drink high silica water

Silica (silicone + oxygen) is one of the most common minerals on Earth. The high silica content in consumer water brands like Fiji or Gerolsteiner binds to heavy metals in the body and facilities excretion. My eight-year-old son laughs hysterically whenever I drink a bottle of Fiji water, and I tell him how I’m going to spend the rest of the day pissing aluminum.

Donate blood

Regular blood donations reduce levels of PFAS, the human-made, synthetic “forever chemicals” found in products like Teflon and plastics, which bind strongly to blood proteins. Blood donation also removes microplastics from your body. For both substances, donation physically removes the contaminated blood which the body replaces with fresh blood.

In any event, your best bet for detoxing (as with every health threat) is to focus on prevention rather than counting on a cure. You should filter your drinking water through reverse osmosis to remove carcinogens (like glyphosate), PFAS, and fluoride. You can install a water filter in your shower to avoid absorbing these same chemicals through your skin. Stay away from foods drenched in pesticides. Don’t smoke or vape to avoid inhaling thousands of chemical compounds. Reject vaccines, especially because the heavy metal adjuvants get injected directly into your bloodstream rather than being processed first by your liver.

And whatever you do, stop patting yourself on the back for sweating out a bunch of water, sodium, and potassium.

[Keva Silversmith | Heal faster @kevasilversmith]

Barbell Plate Safety Myth

I read once that the standard size of a barbell plate is related to safety. If you collapse on a lift, the bar is supposed to roll over you rather than crush you.

I ran an experiment and it’s actually not true.

The 17.7 inch plate diameter comes from standardization in Olympic weightlifting, not from a safety concept.

My experience with the bar hitting my ribs and nose is exactly what you should expect. So keep lifting smart.

[Keva Silversmith | Heal faster @kevasilversmith]

@BrentAWilliams2 The sun.

[Keva Silversmith | Heal faster @kevasilversmith]

@Cernovich Here is the official debunking of Attia's article: https://t.co/fUZeKPnEdN

[Nick Norwitz MD PhD @nicknorwitz]

Peter Misses the Plot: a Swift Debunking 👇

It’s come to my attention that @PeterAttiaMD has come out with an attempted debunk to The Cholesterol Code documentary and, more broadly, the research on lean mass hyper-responders.

I won’t mince words: It’s embarrassing. It’s simultaneously arrogant, deeply misinformed, and, as I read it, a transparent avoidance of the facts at hand. It’s posturing, not insight. And I’m prepared to back that up.

First, Peter attempts to discredit the documentary, the research on lean mass hyper-responders, and the Lipid Energy Model, on superficial grounds: credentials and authority.

He almost exclusively referring to the work as a product of the Citizen Science Foundation (CSF), i.e., @realDaveFeldman: the 'uncredentialed' outsider.

He conspicuously avoids discussing the broader teams involved, many of whom carry credentials that would easily meet the standards typically valued in more traditional, credential-focused settings (and exceed his own). Even setting aside myself, an MD-PhD, there is: Dr. Adrian Soto-Mota, MD-PhD, ith the Lundquist team, there are others who have co-authored work in this space, including Anatol Kontush, Ronald Krauss, William Cromwell, and, notably, Peter’s own former head of research, Bob Kaplan. Go figure.

Might have been a fact fact for Peter to include: "My former head of research was a coauthor on the Lipid Energy Model paper I'm inadequately trying to debunk."

And that’s the short list.

I’ll also point out that when I was writing an editorial on lean mass hyper-responders, I reached out to Peter, and he declined to contribute, citing that it was not his area of expertise.

He instead referred me to Ronald Krauss at “the expert,” who has now collaborated with us on a couple of projects.

So even at a superficial level, what we’re seeing here is avoidance, posturing, and frank hypocrisy.

Peter further attempts to cast doubt on lean mass hyper-responders by questioning the existence of the phenotype, which is, frankly, comical. It exists. It is defined by three clear cut points, and people meeting those criteria unquestionably exist. It is also a dynamic and reproducible phenomenon, as demonstrated by multiple experiments, case series, and even meta-analyses of randomized controlled trials that we have published. Peter forgot to talk about those data. No surprise there.

Peter also demonstrates a misunderstanding of the Lipid Energy Model, for example by incorrectly suggesting a contradiction between the model and the low triglycerides observed in lean mass hyper-responders. And, more broadly, he reveals a lack of familiarity with the practical realities and constraints of clinical study design. If we are going to lean on authority, then it is fair to ask about experience. To my knowledge, Peter has not conducted clinical trials, and frankly, that gap shows here.

At a deeper level, I don’t think Peter understands this physiology or this domain. And behavior like this, particularly when presented under the banner of scientific critique, is exactly the kind of thing that fuels “broader distrust in institutions and experts.”

This is a textbook case of the pot calling the kettle black.

I could go on, but I think the core point is clear. If further discourse is needed, Peter and his colleagues, including Tom Dayspring, have had ample opportunity to engage, collaborate, and discuss these ideas directly.

If they choose not to, that speaks for itself.

In the meantime, we’re not going anywhere. And no amount of pedantic posturing is going to change the trajectory of the data.

Oh, and two more things…

i. For those tempted to fall back on the overly simplistic take that “they’re saying high LDL is good” and “fear mongering about pharma,” or similar caricatures, you’ve entirely missed the plot.

And, I have something coming this week.

Again, if you interpret it as a pivot, you’ve missed the point entirely, as Peter has.

ii. Finally, Peter’s central criticism seems to be that the documentary and our research suggest that even very high LDL cholesterol may not always indicate cardiovascular risk.

Well, yes.

The alternative is to argue that in all circumstances, at all times, very high LDL necessarily drives cardiovascular disease.

This isn’t about discrediting, with a blanket statement, any role of ApoB or LDL in cardiovascular disease. This is about asking important questions at the frontier of science, because the status quo has been wholly inadequate in addressing the problem at hand.

That's obvious.

At least to some extent, we have been barking up the wrong tree.

Anyone with a modicum of perspective can see that.

And anyone with genuine curiosity would be willing to engage with the nuance, rather than lecture, avoid, and misrepresent, as Peter is doing here.

Lastly: See the Cholesterol Code Documentary. It's on Amazon. And judge for yourself.

[Keva Silversmith | Heal faster @kevasilversmith]

@Pat_Stedman https://t.co/mTyurjfqWX

[Keva Silversmith | Heal faster @kevasilversmith]

Fix Your Form: Leg Raises

Leg lifts are a surprisingly controversial movement for abs. Many influencers say that any exercise that lifts your legs towards your torso doesn’t do much, but that’s only half the story.

The point of any variation of leg lifts is that you must think about curling your pelvis towards your ribs. If your hips don’t roll up at the top, your abs aren’t doing the main work.

For this exercise in particular you can determine proper form based on feel.

If you feel it mostly in your hips and thighs, you're likely not curling the pelvis enough. If you feel a deep burn in lower abs, you’re doing it right.

In short, after your legs come up, you still need your hips to continue curling upwards while keeping your legs straight.