#16 - The Neural Hierarchy Pt 2: The Vestibular System

[MUSIC PLAYING] Welcome back to the Cruisalete podcast. I got Tony here. Tony, how are you? I'm good. Good morning to you. Happy Friday. Happy Friday. Yes, happy Friday. I'll be honest. I am tired at the moment. But it's because of the time change. It's-- I hate it so much. Me too. I'm pretty sensitive to it. Do you have any strategies that you employ to try to deal with it? Is it just like great your teeth and get up when the alarm goes? Yeah, that's literally what I've been doing. Luckily, this time around, so my daughter is three now. And she has not been affected like my wife and I. So that allows us to get back on track much faster. But when she was a little bit younger, it was harder. Because we were working hard to solidify a good sleep schedule. Yeah. But now that she has that, she sort of adjusted right away. And the only thing that's been difficult for us now is we're just waking up much earlier, because that's what she's doing. But we're just-- yeah. We're just kind of grinding through that. And really what it comes down to is, last night, I had Jiu Jitsu. And so my classes are late at night. And it's normally difficult for me to recover from those anyway, because they're so late at night. It's not my ideal time to train. It just doesn't work great for me, but I just suck it up and do it. But combine that with the time change and it's hard. But luckily last night, I actually had a good-- I had a good Jiu Jitsu session, which was kind of long overdue. I've been in like a funk for, I don't know, months, months. And since the cold weather set in, probably. Yeah, it's just-- Jiu Jitsu's funny man. It's just up and down, up and down. It's such a slow process trying to learn. And you just go through these waves of feeling like you aren't learning anything. And it's just so difficult to retain technique. And then all of a sudden, you have a couple of weeks where you're on fire. And then you're like, oh, I am learning. This is great. And then the whole kind of process repeats itself. And yeah, it's interesting like that. It's really-- it's like learning a whole new language. It's really complex and very difficult to learn. But in a really, really cool way. It's just a great challenge. So let me ask you this. When you say you had like a good day in Jiu Jitsu, what does that mean? Like, how does that present? So for me, the first thing is my energy was good. So I walked in the class. I kind of can predict how it's going to go at this point, just based on how I feel walking in, or how I feel right after we basically warm up. And so I kind of felt pretty good going in. And basically what it means is for me, we went over some techniques that I felt like went really well with my game. They were things that I could attach to very quickly, because they're similar to other techniques that I do well with. And so when you come across a technique that sort of reminds you of other things, it really just gives you a whole new perspective on how it could fit into your style. And what happened to me last night is we learned something new that wasn't that different from something I'm very solid with. And then I was able to immediately apply it in live routes, which is really hard to do. That's where the challenge is. Like you can learn something drilling, and you can do rep after rep of that. But then as soon as you switch to live routes, it's totally different because you've got somebody coming at you at 100%, and they don't want to let you do anything to them. So because I was able to apply it live, I was like, nice. And when that happens to me, if I can do something live once, it's to me, it is equal to 1,000 reps of drilling. That's just how it is for me. I don't know if that's how it is for other people, but it's such a-- I connect so much to it. Once I accomplish it live, that the next time I go live, it's in my arsenal. And I can call on it when I need it. It's really cool to think about, actually. Obviously, I love talking about the brain and stuff. Jiu Jitsu is so brain-based to me in the sense that it's all pattern recognition. It's just recognizing patterns. And you recognize the same patterns over and over and over again, but in different positions. It's super cool to think about it like that. So the better you get at recognizing a specific position that you're in or your opponent is in, the more you-- all of a sudden have these options that you can utilize when you recognize that pattern. And that's really to me what the whole process is. It's just getting better and better at recognizing those patterns in all the various positions that you can find yourself in. So it's really great. I'm excited for you to get back and get started with it. I think you're going to like it, man. The way that now that I've known you long enough, the way your mind works as far as I can tell, you're going to dig it. Yeah. I think even hearing you describe that that sounds intimidating, but also a lot like musicianship, where it's like muscle memory. You've got to drill a lot of different things for timing and melody and technique. And it's not until you're able to just pull it out of your bag of tricks, excuse me. In a jam setting or in the context of a live performance that you really feel like you own it. Right. So in that sense, it does feel like a language as well. Yeah, that makes a lot of sense. So we'll see. We'll see. I do think that the learning curve is definitely daunting. Like, what belt are you right now? I'm a purple belt right now. And so it goes white belt. You start as a white belt. Then you become a blue belt. Then comes purple belt. Then brown belt, then black belt. So it's a process. I mean, I think from what I've experienced in watching other people kind of go through the rankings, from white belt to black belt, could be a 10 year process for somebody who's actually very consistent with their training. I definitely have met people that did it in less than 10 years. It just comes down to how much mat time you're getting. I mean, it's hard to get enough training to make that journey quickly. And it could take a long time. It could take much longer than 10 years to. There's just, there's so much to learn. There's so much to learn. There's the basic positions. And then there's iterations of it. And then there's all of the movements out of it. And I'm just imagining these like webs just splintering in all these different directions. It's exactly a decision tree, right? It's a decision tree in every single technique, you know, has a number of different counters, you know, and it's just, it is. It's just all like building your options so that you can recognize patterns and make those decisions very quickly. So good stuff. Well, I'm glad you had a good session despite the time change, which yeah, really, really kind of makes me mad. So I'll share this one story about the time change. And then we can get started. But I was working a gig late at night and like bands stop playing at like 130 in the morning. And it was actually a pretty quick wrap up. So I was almost out of the door by two. You know, it's about a half an hour drive home. And I get home and I left like before two in the morning and I get home and it's 3 30 a.m. And I was like, wait a second. Like I felt like to be awake and like doing stuff at that time where it switches over. Like I was mad. Yeah. It was like holy shit. Like it's 3 30. I need to be in bed right now. Yeah. So I felt like I got robbed a little bit. Yeah. But the saving grace is, you know, it's so light out later now. Right. Which really does feel good. It does. And honestly, that's probably why I did better at jujitsu last night. Like interesting. Leaving my house and it's not pitch black. Uh huh. I mean, that's significant. Yeah. So that helps. Cool. So last week we talked about, we were talking about the Neural Hierarchy. Yep. And we started talking about the visual system. And so today, I think we're going to keep going down the Neural Hierarchy. So what are we talking about today? So today is all about the vestibular system. So we had we had mapped out this Neural Hierarchy. The visual system sits at the top of it, then comes the vestibular system. And then finally, the proprioceptive system. And, you know, we're calling it a hierarchy. And the reason why it's arranged like this is because when we look at the different systems, what it appears to show us is that the visual system represents our sensory system that takes in the most information. So we talked about it being 70% or more of sensory information is coming through your eyes. OK. And I think that those numbers are even starting to change as we learn more about these systems. One thing I want to be clear about is that just because the visual system is sitting at the top, it is still hard to say that that is the most important one. When we kind of-- reverse engineer things so that we can learn them easier. It's good to put things in a specific order, right, because it's helpful for learning. But really what it comes down to is like each person generally has one of these systems that's going to be most important for them. It may be the visual system because that one is such a heavy hitter. It could also be the vestibular system. In fact, I think now that we're starting to understand the vestibular system better, my guess or prediction would be that in the next however many years as more emerging, you know, research comes out, we're probably going to find that the vestibular system is just as important as the visual system. That's just my prediction. I don't know, you know, if that will happen for sure, but it is, it is so important. So we're talking about that today. And it is a heavy hitter, just like, just like the visual system. This one's a little bit harder for people to conceptualize it first because when we talk about the visual system, it's easy to say, Hey, we're talking about your eyes. And we can all see people's eyes. So we're like, OK, we're, I get it. Like this is about the visual system. I can see the organ that we're talking about with the vestibular system. It's different because what we're actually talking about is an organ, but it's hidden, right? It's inside. It's inside the skull. It's encased in bone and it's deep in the skull. And it's a very small organ that looks really bizarre. Actually, I wish I could show an image for the podcast, but if you do want to see what it looks like, you can easily just Google it up, vestibular system and check out some images. What you'll get is an image that honestly looks like a snail. It looks like this coily little, you know, organism. And it's very small. So we're talking about something that is likely the size of your fingernail. Very deep in your skull and encased in bone and you have a right vestibular organ and you have a left vestibular organ. And so when we're talking about this, I often refer to it as the inner ear. That's what we're talking about. OK, this is the inner ear. And our vestibular system is essentially our on board balance system. OK, so it is highly involved in helping us maintain our balance and our stability. The vestibular system is constantly asking us two questions. The first question is, or telling us the answer to these questions, I should say, the first one is, where am I going? OK. And which way is up? So your vestibular system is helping your brain understand how you move through the world better in relation to your external environment and gravity. OK, it also helps you stabilize your head and your neck and your eyes. And it helps us see clearly as we're moving as well as adjusting our posture. As we are at rest and moving and also adjusting our respiration and even blood pressure. So there's a lot at play here with what it feeds into. OK, really, really interesting system. So I actually put together kind of a short bulleted list of more relatable history findings that are related to the vestibular system. Because here's where it gets a little bit tricky. When you hear or read about the vestibular system, it often sounds very clinical, right? Because most people have heard of, like, vertigo, where you get a problem with your inner ear, a loose crystal in the inner ear can kind of cause havoc on your vestibular sense. And what that eventually results in is a person is really suffering from dizziness. And a lot of people actually experience vertigo. Last time I looked, I think it was like the statistic was like 40% of people in their lifetime will experience some kind of vertigo. And I actually think a lot of people end up going to the ER for symptoms of vertigo to was a really big number. I forget what that is. So often the conversation doesn't go beyond vertigo. And so it makes vestibular issues sound super clinical. However, there's a lot to know about the vestibular system and how even a healthy population can have low grade vestibular deficits. It's like when we were talking about the visual system, I remember you asking me, I was really happy you asked me this. You said something like, how many people right actually have some kind of visual deficit that is significant enough for us to care about. And I told you that when I had first learned about this stuff, I was kind of thinking, well, not that many people are going to have these issues. Everyone seems, you know, at least the folks I'm working with, everyone seems relatively healthy. Some people wear glasses. OK, contact lenses share, but, you know, do they really have problems with their eyes. And then as I continue to assess people, I started finding low grade visual deficits in so many different kinds of people and with different ages as well. The vestibular stuff is the same. So at first, I was like, OK, cool. This is good information to know, but how many of my clients are actually going to need this. And as I tested their vestibular system, because there's very specific ways to do that, I was shocked at how many people had low grade vestibular issues and actually just experientially. I would say that I find more vestibular deficits than I do actual visual ones, which is really interesting. Yeah. So here's a little bulleted list of history findings that I think are a bit more relatable than what you might find if you did your own research and just saw how, you know, everyone's usually talking about only vertigo vertigo is absolutely a finding when it comes to the vestibular system, but here are some other ones. So bilateral postural issues, bilateral means both sides of the body. This is a really, really hypercritical one because what we'll talk about at some point is how our vestibular system is so intimately connected to our posture and our spine. And so some people have heard words like kifosis, which is like describing a rounded posture of the upper back. Okay. Lordosis is describing a very extended posture of the lower back. Usually when these terms are being used, it's because we're seeing what we are saying is not ideal. We're saying your posture is too rounded, you're too hunched over or you are too arched in your lower back. Right. Also, people are familiar with the the word scoliosis referring to like a spinal deformity where there's curvature in the spine that is not ideal. These are all things that are on the history list because the vestibular system is speaking to the muscles of our spine. If you have vestibular deficits, you can actually have muscle imbalances around the spine. And that can lead you to postural issues, whether it's kifosis, Lordosis, or even scoliosis. And there is a lot of new emerging research coming out that is more and more pointing to the fact that Scoliosis can be a result of a vestibular dysfunction, which is really interesting. So those are big ones. Quick question about that if you don't mind. Yeah, once upon a time as a youth doctor told me I had minor scoliosis. I don't really remember When or how the dots were connected, but I used to carry a heavy backpack on one side of my Sure. On one shoulder, like really heavy for for my age all the time for years. Yep. Because that was a cool thing to do. And I always suspected that was what caused it. Yeah, it could be. It could be. I think that could be. I mean, that's more of like potentially that was developing more of through proprioceptive consequences, right? And maybe not inner ear ones. Yeah. So that was my question was sort of like a does it always originate from the vestibular system of vestibular deficit or can it originate from Yeah, that's a great question. I think it can originate from other places too. I am really hesitant to approach anything anymore in absolutes. Just because I know how much these systems actually work together in harmony. When we're learning about this stuff and we're discussing it, we're really kind of isolating Topics within it. But I do think that it could be other things contributing and that it may not only be vestibular. In that case, as a young person and you're growing so much, right? I think that they're actually definitely could be a consequence to, you know, wearing your backpack a certain way and gosh, those book bags were heavy man. Remember those That textbooks like a bunch of them. You'd have to take like eight around. No wonder we were in better shape than the kids today. We had to carry all the heavy books. We were doing farmers' carries basically through school, instead of just with our phone and our pocket. Yeah, very different. Very different. So back to this bulleted list. So big ones, back pain, neck pain. Those are huge ones that I often hear about from clients when we're doing history. And again, that can often be due to vestibular deficits because those muscles of the spine are getting a lot of their commands from the vestibular system. If there's a vestibular dysfunction, that could certainly be involved with back pain or neck pain. Head tilts and rotations. So for our listeners, how many of you have ever seen photos of yourself with your family and your friends? And you're like, "Damn it, I'm doing that thing again." And you're like, "You got your arms crossed "and like one shoulder's higher than the other "and then your head's tilted." And you're like, "Why the heck do I do that?" And you're always in this exact same posture for pictures and your head is always tilted. Sometimes when we have those chronic head tilts or rotations, those are differences in posture. And that can be related to issues of the inner ear or even the visual system. 'Cause remember, these higher-order systems are kind of running the show in terms of sensory information. So our brain is always going to prioritize them over the proprioceptive system when it comes to posture. So oftentimes the posture that we are carrying is due to what our eyes and our inner ear are actually telling our brain. So if you have a vestibular deficit, you may see the world slightly different. Your brain might think that, you know, up or, you know, I have actually a cool story to share in a minute. What your brain is perceiving as up and down and left and right and just how you're orienting yourself might be different due to how your vestibular system is taking in input. And that may cause your posture to be a certain way. And sometimes like when I do history, you know, intake with clients even over Zoom calls and stuff, I'm actually watching to see like how are they presenting their posture as they're sitting there talking to me. And somebody that's talking to me with a right head tilt the whole time, I'm kind of taking note being like, well, maybe they have something going on with their eyes or their inner ear because they don't really seem to be coming out of this right head tilt or this right rotation of their head. So that's a big one too. Real quick before I go into the other ones, I used to run an assessment with people back when I was, my wife and I had our one-on-one in-person studio. This was a wild assessment. I think you'll find it interesting, Tony. So we called it the bucket assessment and basically what we had was an app on our phone. And the phone we would actually tape inside a big bucket like just a really large bucket that we got at the hardware store. And you would tape the phone inside the bucket and the app on the phone was able to understand its orientation based on how the phone was angled. Like it knew exactly what vertical was. It knew exactly what three degrees tilted to the right was and it would give you a readout on that. And so what we would do is we would stand the person up and we'd put them their head inside the bucket. So we would hold the bucket over their head, not vertically, but horizontally so that they were looking straight ahead inside the bucket and they could see the screen on the phone. And the way that we would do this is we, so me, the coach, I was in control of the bucket and I would start the bucket rotated so that they were looking at a line on the screen of the phone and I would instruct them to tell me when they thought the line was vertical. So I would say, okay, ready, set, go. And I'd rotate the bucket, okay. And they would say now when they thought the line was perfectly vertical or when they thought the line was perfectly horizontal. And so what we were doing was getting an idea for how good was their understanding of which way was up, which way was down or where's the horizon line, if you will. How good was their understanding of the environment when we remove visual information? Because remember, they couldn't see anything except the inside of the bucket. Yeah. And then they'd say, okay, stop or actually the way we did it is they would put their hands on the bucket and stop it right where, they thought it was. And we would do this several times trying to figure, giving them multiple chances and then we'd take the bucket away and we could go into the app and the app would spit out some numbers for us. You would not believe how many people would be 10, 15 or 20 degrees off with understanding which way was up. And this was consistent, they'd consistently be 10 degrees. So the right way. Yeah, generally what you would find is, okay, let's say the first time they blew it and it was like 20 degrees off, they would learn something from that, wouldn't they. They would, they actually learned something from doing the assessment, which is how our brain works, right. It's like, okay, I got some feedback. We do it again and maybe there are 15 degrees off. We do it again and maybe they were four degrees off, right. The point being, you take this stuff for granted, but when we remove a high order sense like the visual sense and now you have to rely on your inner ear and you don't have that much proprioceptive input going into it other than the fact that you're standing in one place, right. You're standing up, you are getting proprioceptive feedback. It's amazing to see how many people flunked that assessment. And then I would see people that would absolutely nail it. I mean nail it every single time. So that's the next question. Yeah, interesting. Yeah. So oftentimes I'd put like some, you know, pretty high level athletes and stuff on that bucket test and they would do really well, not always, not always I have worked with high level athletes that had really lousy vestibular systems. You know, it does happen, but it was just so interesting to see the difference. So that was one thing that came to mind back when I was starting to test people's inner ear more. That was one that was like really wild for me to consider. So we talked about head tilts and rotations, bilateral posterior chain muscle issues. This is a really interesting one. So bilateral means both sides of the body. And we're talking about muscle problems. So this made me think of a story. I was working with a guy. This is like eight years ago. And he, he came in and said, I have chronic calf cramping when I go running. And it's so bad that when I start my run, I'm okay for like a few minutes because I, you know, he stretches his calfs before he runs. And eventually the calf's just kind of tension builds up and the cramping in his calfs. This is both calfs. Remember, that's the key. Both calfs cramp so bad that he has to stop his run stretch. He runs some more has to stop stretch. You know, he had done all sorts of different things to try to solve this. Mainly rolling his calfs, stretching his calfs, seeing manual massage therapists, changing his footwear, trying to work with, you know, someone to help them learn how to change his running gate. Nothing seemed too help. So he's explaining this to me and thinking, well, you know, if you've been working on this as long as you have and you've tried these other things and they're not giving you results, like there's got to be some higher order thing happening here that might be causing this. So took him through a battery of assessments. He didn't have the best two things stood out. He didn't have the best vestibular system. He also had a lot of work that he had to do, appropriately, you know, in terms of moving his joints. And so we started doing both of those things and very quickly, actually, he got some very drastic results within, I think it was like three or four sessions. He was coming back in saying, dude, I don't know what we're doing. It seemed so weird, but those eyedrails that we're doing seem to be helping my calf cramps aren't happening anymore. And so this is a really neat one to think about because so many people, too, have like the complain of tight, tight calves and Achilles problems. And sometimes it's both sides of the body. So here's how this works. Your vestibular system has descending pathways. So just think about that as circuitry, right? The way that our vestibular system are inner ear, that organ, we talked about at the beginning, it looks like a snail, right? We've got a right one, we've got a left one. And there's descending pathways or circuitry that allows our vestibular system to speak to the muscles on the back of our body. We call that the posterior chain. So think about the muscles you activate when you do a deadlift, right? Your hamstrings, your glutes, your spinal erectors, even your calves, right? The muscles on the bottom of your feet were talking about the whole posterior chain. Those-- muscles are highly influenced by the vestibular system because your vestibular system, one of its main jobs, is to help you stay upright against gravity and to help you maintain a good posture both statically and dynamically. So a lot of the commands that your muscles get to help you stay upright and stable come from the inner ear. Now let's say you have an inner ear deficit. The way the vestibular system works is it has a frequency of firing, meaning that even at rest your vestibular system is working. It's firing. I think when I originally learned it it might be something like a million times per second. It's pretty wild. Yeah. Yeah. It's a frequency of firing that's extremely high and because it has to be balanced, remember we have a right one and a left one, the frequency of firing has to be balanced on both your right and left sides. And if you for some reason have a deficit with the vestibular system, maybe one side is firing at the you know a million times per second and the other side is firing less than that, there's going to be a consequence to that in terms of your muscles. Because now your brain is understanding the world differently. Remember if your vestibular system is constantly trying to figure out which way is up and which way you're going, a change in the frequency of firing between your right and left sides is going to confuse your brain. But remember your brain is very dedicated to trusting your vestibular system in your visual system because they're higher order senses and it is willing to make proprioceptive changes based on what those two higher order systems are telling it. So this is the case that I often hear about where the stretching, the yoga, the foam rolling, the manual massage work, all that stuff might have given temporary relief but it didn't give them the long-term relief because it wasn't proprioceptive problem. What was happening is his body or his brain was feeling like he was falling forward all the time because of a difference in the way the vestibular system was balanced. And if your brain thinks that you're falling forward all the time, okay, it's going to hyper-correct you proprioceptively. Yeah exactly like clean. Yeah, I'm right. Yeah, literally watching you do the exact body motion. So those muscles that are supposed to keep you upright are going to be told to do that chronically all day long no matter what you're doing because your brain is sensing that you're falling forward a little bit. And so the musculature of the lower limb is actually very involved in the conversation between the proprioceptive system and the vestibular system because when we lose our balance even just a little bit what do we do? We correct one of our first one of the first corrections that we make to recover our balance is coming from the ankle right? It's coming from the foot in terms of how we engage muscles. This is very reflexive so it's not something you necessarily think about it just happens because the vestibular system is a reflexive system. You don't necessarily tell yourself how to keep your balance. It just happens, right? I'm thinking of like a balanced beam situation where your arms are just kind of moving and your your feet are stabilizing and it's not like you're telling your hey lift your right arm up so that you balance it just you do it. Exactly you just do it. It's reflexive. You don't need to think about it. It's not a conscious decision. So the lower limb muscles are super involved as well as the whole posterior chain. And this gentleman that I was working with his his brain was kind of just interpreting what was happening as falling forwards. And so he was always hyper correcting by essentially plantar flexing so like pointing his feet and trying to stay upright using his extensor muscles to the point where the muscle tone was now doing the right thing according to what his brain was telling it to do. But what we know about postural issues is the adjustments that your your body figures out how to make are good ones for the short term. And then in the long term there can be a consequence to that. And so a lot of the issue that this guy was feeling with his bilateral calf cramping was due to the fact that his vestibular function was not great. So he started doing vestibular drills. I had him do and take home exercises, staring at visual targets, moving his head, side to side, doing all the weird stuff that we do. And within a very short time he started getting some really really great results because the muscle tone was recalibrating. The way he was holding his body and his posture was changing and it was taking stress off of his calf muscles. So that was a really really neat one for me kind of early on where you know it's like you want it to be proprioceptive. Like you want it to be as easy as stretcher calves do some foam rolling. But when that stuff fails we got to go looking at at some of this higher order stuff. I'm sure you're already heading this direction but the big question is what are some vestibular drills? And then the next question would be is it like the visual system where you can have a training effect where you can actually get better over time or is it like a temporary stimulus? Yeah. Yeah. So it's it doesn't I remember you asking something similar on the visual system and the answer is is similar. It's both. So when you have a vestibular deficit it's in your best interest to fix it because a vestibular problem will make you move through the world differently and it can be the root cause of a lot of the different issues that we hear about. Pain in the neck, pain in the back, right? These bilateral tight calves, Achilles problems, right? Whatever the case might be. Or sometimes just lousy balance. Right? And you don't want to have bad balance. Okay? Because balance is really a prerequisite to everything. Balance instability is the prerequisite to walking and walking is what makes us human, right? Being able to get from point A to point B. And this quality of balance kind of in my mind gets pushed under the rug a little bit because we get so hyper focused on say strength and now mobility, right? But balance is so important. So when people have a real balance problem they usually know about it, right? Because it's interfering with their life. It really reaches into every facet of their life. One of the things that I kind of always try to observe with people is like how they're walking. Do they hold on to things? Do they make kind of odd little recovery steps? And you know our listeners might hear that and be like, well, you know, I'm a high level athlete. And no, I don't I don't use the handrail when I go downstairs. So I don't have a balance problem. But you can actually have low grade vestibular issues that do lead you to some potential balance issues that you might not be aware of. Right? So it can it kind of depends like it. There's a scale for this. And back to your original question with how do you train it or actually make back up even a little bit more when we train the vestibular system, we can do it for the reason of trying to solve problems and balance out the deficit. Right? And that's going to take more long term training. That's going to take actual training like we, you know, we would do in the gym. Right? If you want to get stronger with your squat, what do you have to do? You have to squat. And if you want to get a stronger vestibular system, one that works better for you, yeah, you have to practice vestibular exercises and balance drills. Sometimes you have to do it very specifically. If you have very specific imbalances in that system, but other times with a healthy population of people, sometimes you can do just fine just activating it. Right? Through these various vestibular types of activities that we have. So what are they? How do you train it? So it's kind of two categories that I think about with this. We've got more isolated drills that actually require you to like look at a visual target. So if you look at a visual target that's out in front of you and you keep your eyes on that target and you move your head left and right. Okay? Horizontally keeping your eyes on that target, your vestibular system, specifically a reflex called the vestibular ocular reflex, allows you to keep your eyes on the target as your head is moving. This is something we take for granted because when we do things, we don't realize that our eyes actually need to be stable as we do things. Otherwise, we wouldn't be able to see clearly and it'd be like watching a video that didn't have camera stabilization. Like you've ever watched something like maybe a mountain biker with a head cam on or something and it's like boom, boom, boom, boom, right? And the visual pictures all over the place. Imagine going through life. And that was your visual picture. And according to your brain, that's going to drive up threat levels unbelievably because you don't have a stable visual picture. And your vestibular system is what allows you to have a stable visual picture through a variety of different reflexes. Those reflexes are trainable. We have exercises for all of them. We use those VORs all the time. We use other ones called VOR cancellations, where now the idea is to kind of keep your eyes centered, merged with your head and neck, and kind of move with a visual target as you track it. There's lots of different more isolated drills to approach it. We have a wonderful exercise called the Infinity Walk. The Infinity Walk is more of an integrated drill that uses all systems, visual vestibular and proprioceptive. And you essentially, it's very athletic. You look at a target on the wall or wherever you want to put it, and you set up two cones. And you can walk or run or skip whatever you want to do for the locomotion part. You go around the cones in a figure eight as you keep your eyes on the target. And we have different ways that we approach the footwork for that. Some of them require us to pivot around the cones. Sometimes there's no pivoting. We can set up the cones in different ways and challenge angles and stuff. But the idea being your goal is not to let your eyes come off the target. And so that's a really unique one that trains the vestibular system as well. So there's great drills that we do. Here's a big takeaway. You don't just have to isolate the vestibular system with those types of drills. What people don't necessarily recognize is that all the playful forms of training or play that we can encounter such as running and skipping and jumping and landing and turning and rolling. All of these things activate the inner ear a lot. Basic forward shoulder rolls, backward rolls, jumping and turning and landing. I mean, all this stuff is actually vestibular training because your vestibular system is sensing the movement. It's sensing the accelerations in your head and neck movement. It's also sensing the linear accelerations that your body is going through, whether you're moving forwards, backwards or side to side. So all of those things are ways that you can train your vestibular system. And this is why it is hypercritical when you are trying to be a healthy and fit person that you don't just lift weights, right? Or you don't just get on a treadmill, right? You don't get boxed in by being essentially in one place stationary all the time because even with weight training, like I love weight training and it is so important for people, but you need to move dynamically. You need to move like an athlete as well, regardless of what you feel your skill level is or what your age is. The use it or lose it principle applies to this system. In our program, in the strength, Ojo, right, where we do a lot of our conventional and non-conventional strength training, we mix in a lot of vestibular training. One of the things that I teach everybody to do is a basic forward roll, basic backward roll or even like log rolling, right? All these different forms of kind of playful types of movement. And what we find is that like older adults come into this and they're very intimidated by it. And luckily we have like really awesome modifications that we can start to teach people to bring them through a progression so that they can get the vestibular stimulus in a way that's not too aggressive at first. And we bring them through these progressions and it's really cool because so many older adults are like, oh my gosh, I don't remember the last time I ever did anything like this. Like I probably did my last forward roll when I was like 13. And when you consider that, imagine the amount of time that goes by where an adult doesn't jump in turn or doesn't do a forward roll or backward roll. Sometimes people have never learned how to do those things. Cart wheels, right? Stuff like that. Any kind of exercise that requires you to invert, right? Where you're essentially upside down. Like this stuff is not involved in people's lives, most people's lives. And so it's up to us to make sure that we're providing enough of the vestibular stimulus so that we can activate your vestibular sense because there's so many reasons that we can, you know, as we build a case for this, there's so many reasons why that can be helpful for a person in terms of both their fitness, but also their health. Yeah, that's so cool. I love how you brought up the box like being boxed in by holding the same positions. It may be think of different exercises that do move you through different planes and have you, and I was thinking Turkish get ups like with those actually train your vestibular system because you're going from recline to sitting up to standing to, you know, yeah. Yeah, that's a great way to think about it. So something like the Turkish get up is certainly more dynamic in that regard than compared to like a bench press, right? Because your head is moving through space, your spine is needing to change its posture right with a Turkish get up. So that's a good example. The one thing that I'll say is with vestibular training to progress it, right? To actually kind of get to a point where we're really getting a lot of vestibular stimulus, you have to move quickly. So a Turkish get up, you don't really move that quick, right? It's still, you are still calling on your vestibular system to help you stabilize as you move through different planes. That's different than doing a forward shoulder roll. If you're and if you're not familiar with like a shoulder roll, I'm talking about essentially a summer salt except that it's at an angle. It's just I prefer to do like shoulder rolls because it's a, it's a very skillful thing that we learn to do in martial arts to protect our head and our neck. It's different from a traditional summer salt. Traditional summer salt are cool too. There's nothing wrong with them. I just I like teaching people how to control their body on the ground so that they're safer when they when they move. That's why I prefer those shoulder rolls. But a shoulder roll forwards, backwards. We have a whole variety of them. You're moving through space much faster. And so that's going to that's going to elicit more inner ear activation. The way that our vestibular anatomy works is that we have what's called semi-circular canals. So going back to that image that I kind of described at the beginning where the vestibular organ looks like a snail. If you look at that image, it looks like a snail. But then there's also kind of these like little kind of branches off of that almost like tubes, right? And they're circular in nature. And when we move our head through space, our head and neck, those semi-circular canals are sensing the acceleration of the head and neck movement. So that's how that part of the anatomy works. And then there's other aspects of the organ called the sacchial in the utricle that are sensing more linear accelerations and movement. So when I do a forward summer salt, my semi-circular canals are really helping me with that because my brain is now picking up and sensing the acceleration of my head and my neck as I make that roll. Now think about doing a squat, just a standard bodyweight squat. It's very up and down. It's very linear. And the sacchial, another part of the anatomy, is sensing that up and down movement. So think about like being in an elevator. You know you're going up and you know you're going down when you're in an elevator because the sacchial is helping you understand that. And if I do say a lateral lunge where I step to the side now and do a lunging motion, that's the other part of the anatomy called the utricle that is helping us understand the linear movement in the lateral plane. And so we've got different parts of the anatomy that help us understand which way we're traveling, which way we're going. Is it up, is it down, is it left? Is it right? And that's something interesting to think about because like for example, if somebody says I, how many times do I hear this every day, I have ankle mobility problems when I squat. I try to squat, I run into ankle mobility. I do all the ankle drills. I do the stretching, I do the rolling, I do the band distractions, I do the joint mobility, all this good stuff, but their ankles are still tight. One of the things that can be amazing for individuals who have ankle mobility problems that don't seem to change with all the other stuff is doing vestibular drills. Right. And oftentimes it's the sacchial part of the anatomy that needs stimulation because the up and down, right, of the squat. So this sounds crazy, but I have seen this work. really well for certain people. You stare at a target on the wall, a little letter or something. You make sure you can see it clearly. And you bounce up and down in place as you keep your eyes on the target. And that's just a really simple way to get a sacri-will activation. And then after that, your reassessment is how well do you squat? And that's just one example of a certain vestibular drill that may help a person squat better. Imagine this, how threatening is a squat if your brain can't figure out what the heck is happening. Falling is one of the biggest threats that we could come up against as humans. And your vestibular system is the system that is helping you maintain your balance and keep you upright. If you have some kind of deficit and your brain's not sure about the information it's collecting through that system, then doing something simple like a squat might elicit so much threat that you can't break through the muscular tension during the squat because your brain is so threatened, it's essentially turning up the gauge for muscle tone because it's doing everything in its power to keep you safe and to try to prevent you from falling. So all of a sudden, you're an individual with chronic mobility problems and you're running into all this tension that won't release and go away. And if the proprioceptive training is not doing it for you, then perhaps it could be the vestibular system because you're running into tension that's building through or because of poor input coming in through the inner ear. So there's a lot of ways to look at it. And like I said from the beginning, this goes beyond vertigo. Like we're talking about basic stuff that we take for granted squats and lunges and jumping and landing. And sometimes the restrictions and limitations that we have can lead us back to inner ear issues. - Man, that is so cool. And somehow so much more intuitive, I think than even the visual system. - Oh, interesting. - Yeah, for whatever reason, this is really clicking for me. I do wonder, do you think or do you know if there's a correlation between fear of heights and vestibular deficits? - There absolutely could be. This is something I've been asked before and I don't, I can't say I for sure know the answer, but I think that when I think through it, I think it absolutely could be involved. I think that there's gonna be other brain areas involved too, like the cerebellum, which is something we can unpack another time. It has a lot to do with proprioception actually. Maybe when we hit that topic, we'll talk about the cerebellum. But I do think that there could be some relation there, for sure. - Yeah, yeah. You know, I gotta tell this story. It's just, it's so cool. And it'll be something that I think will be a nice way to kind of start to wrap up. So this is, you know, years ago, I think maybe seven years ago, six years ago at this point. Again, when my wife and I were doing a lot of one-on-ones in our studio, we worked with this wonderful guy. His name was Corey. And he had a lot of complicated health issues. He, without going too deep into it, the big thing was he had a double lung transplant. - Oh, wow. - Yeah. And so we started working with him. He was in his 20s. And he had had just such, you know, came from a wonderful family. It's not that he had a lousy upbringing or anything. He had a wonderful upbringing, but physically, physically, he did not get the same exposure to moving that somebody might get growing up. And there was a lot of complications because he had a feeding tube. And so he, you know, he wasn't even getting the physical part of, you know, consuming food and stuff. And so like from a physical perspective, he was just lacking so much exposure to those things. And of course, there's consequences to that. And he had a double lung transplant. And this initial transplant was successful, which was great. And they really improved the quality of his life. And, you know, he had had such a lack of exposure that when it came to working with him, he wasn't even sure what his goals should be. And so we helped him with that. And so we were like, well, let's work on your breathing, right? Was an obvious one. And one of the things that we could see is that his balance really suffered. He had a very wide stance with his gate and his feet were turned out as a balanced strategy. Because remember the communication between the inner ear and the limbs, right, the lower limbs. His body was making proprioceptive adjustments based on what his eyes and his inner ear were actually telling the brain. And so he had a really hard time with walking. And he had never run in his life. And so I was like, why don't we try to run? Like, wouldn't it be cool if like you learned how to do this? And he was like, okay, like that sounds incredible. And then we also taught him how to catch and throw. He had never learned how to catch and throw a ball. So we started doing all this great neuro work with him, which was really cool. And I mentioned an exercise when we're talking about training called the infinity walk. And the infinity walk is the one with the walking the figure eight while keeping your eyes on a target. And we had him doing, I mean, hundreds and hundreds of repetitions of these infinity walks in different ways. Sometimes with different movements involved, but the goal was always keep your eyes on the target and get around these cones very accurately. And we also did a lot of the VOR exercises. We even brought in some breathing work, which was really cool. The outcome of this was profound. Okay, so the main thing that I wanted to mention is over the course of working with him for maybe two or three years, he actually gained two inches in his height, two inches in his height. So his posture improved so dramatically. We did no foam rolling, we did no stretching. We weren't even doing a whole lot of strength training at the time. We were doing some, but it wasn't what, you know, you and I would kind of look at as a strength workout. We were doing a little bit of it, but most of it was centered around his breathing and his vestibular function. And he got two inches taller, which was so cool to think about and I did not expect that. I didn't expect that. And so when we learned about that, we thought it was, we were all kind of celebrating together. That was really neat. And he had some really amazing improvements in his breathing too. So he would go every couple months to the doctor and stuff and he would do a breathing test where they would basically measure his force output with his, his exhalation. And they would also do it with his inhalation and that stuff actually increased fairly dramatically too, which was really neat. And a lot of that actually came from a healthier vestibular system. I believe probably because of the neuroanatomy with how your vestibular system has those descending pathways that insert into the brainstem. Your brainstem is a brain structure that is highly involved in adjusting autonomic function and respiration. And so yes, we were doing breathing work. So we're going after that, doing that independently. But I also think that the upgrades that he got in his vestibular system also contributed to healthier respiration, which in his case was really important. So that was just a cool one that came to mind to kind of help listeners understand how training your vestibular system can have such a profound influence on posture. And posture is just a topic that comes up all the time. People want to know, how do I improve my posture? Should I do more, you know, tease and wise, right? With my weights and, you know, yeah, that stuff's healthy. But sometimes the thing that really moves the needle in the right direction is working with your eyes in your inner ear just because they have such a big influence over posture. - Yeah, that's so powerful. And I mean, amazing that it sounds like you profoundly changed this young man's life. And his situation was pretty extreme. But I do see the takeaway for like the everyday person, everyday athlete. Yes, that's amazing. So one kind of a sciencey nerdy question, you were talking about these pathways, right? So the vestibular system talks to the muscles around the spine, for example. And, you know, the proprioceptive system obviously does a similar thing. Do those pathways, are they shared or are there specific pathways for the vestibular system and for the proprioceptive system as they go through your body? - No, that's a cool question. So those pathways are individual pathways for the system as far as we can see that. So the vestibular system has its descending pathways. Your proprioceptive system or your cerebellum also has its pathways, right? The way that we understand the neuroanatomy is that these pathways to some degree, intersect. And they intersect often a lot of them are intersecting in the brainstem. So you have nuclei in the brainstem. When you see an image of the brainstem, man, it's crazy. Like, I couldn't possibly understand all the different nuclei in the brainstem. There are so many little dots on a diagram when you see the brainstem and they're called, you know, the names are wacky. And each of these nuclei have different things that they're related to. Like I mentioned breathing being important in the brainstem, you have nuclei dedicated to the process of respiration. Inhalation, exhalation, right? You have pathways that are more proprioceptive that are for creating accuracy of movement. So like, think about targeting. Like, when you reach out and hit your keyboard, the fact that you can touch a very specific key on the keyboard is utilizing a pathway that is for accuracy and targeting. We have other pathways that are for rhythm. So the nice movement that you can make with your arm, as you reach out and hit that keyboard, that's a rhythmic movement. It's not jerky, right? It's not, it's not an odd movement path to get there. It's direct. It has rhythm and it has accuracy because we have pathways dedicated to helping us with these little nuances of movement. So to some degree, you know, when I think about your question, I visualize the intersection of these things. And then I think about something we always say, things that wire together, fire together. And that's a very common thing that you hear in the world of applied neurology or a rising tide raises all ships is another one, right? It's kind of like when you have activation in one of these areas, it's actually going to activate areas that live next to it as well. And this is what makes applied neurology so cool. And like for the movement professionals that want to get into this type of work, this is what allows us to understand training and rehab more holistically is that if we understand the pathways and where they go and what they intersect with. And we know that things that wire together, fire together, now I can start doing stuff like, oh, you want to improve your balance? Let me do a breathing drill with you first that focuses on inhalation, right? Because I know that breathing can influence vestibular function with neuroanatomy, it's a two way street. Oh, you want to improve your breathing? Well, let's do this vestibular drill because of where that descending pathway goes and where it lives and what it lives next to. Now I can start doing something that seems so unrelated, right? But it's not because of where the pathway goes and what it lives next to by activating it, we can get other things to activate too. This is why when you see stuff that looks weird that I do or for that matter, anyone else does that practices some kind of unique technique. This is why people look at it and they go, oh, that's bullshit. Right? That's woo, woo, that's that's just no way. There's no way that can be I was like, ah, guys, like not just the stuff I'm doing. Like I got, I got news for you. Like when something looks weird and it helps somebody, there's usually a neurologic rationale for why it worked. And that's why I love neurology. That's why it was the thing that kept me in the industry because at first when you're a movement professional and your only tools are, hey, pick this weight up and make your hamstring stronger or your biceps stronger. But then you have like 99.9% of your clientele coming to you saying like they have pain or they have a limitation. Now you're left to be like, well, there's got to be more to this. It's got to be more tools than the tools. Yeah. Yeah. So this whole, you know, you know, neurology, right? It really is the most holistic of the sciences. And that's that's why I love it. That's that's why I enjoy, you know, playing around with all these different types of training stimuli. And like I said, when when we do something that's weird and it looks like it couldn't possibly be related, oftentimes there's a great rationale for why it is. It makes me think that everybody should be training these separate systems regardless of deficiencies or issues like I do wonder what the outcomes would be if like the entire population was doing something for their vestibular system, something for their visual system in addition to like mobility and strength and movement, you know. Yeah. And that's why we put all, I mean, very proud to say we put all this in our program. Like, like when we look at this neuro hierarchy, like this is sort of one of the templates that we use for trying to give a person stimulus for all these systems, right? And we have in our in our strength, Ojo, a section of our workout is called the skills portion and inside the skills portion, it's like a 10 to 15 minute kind of athletic training part of the program and we put vestibular drills in there where you're actually working these and training these reflexes. And then we put a lot of like rolls in there and lots of athletic movement where you're jumping and landing and skipping and the whole premise behind that is when you really peel this back, yeah, we're trying to move athletically, but we're trying to give you a lot of vestibular stimulus as well because we know so many people go without that and the long-term consequence to that is pretty great. You know, as we see with the aging population, the older you get, you know, we start to see changes in posture and part of the reason why we see such a drastic change in posture with elderly folks is because they're no longer receiving the same amount of vestibular input that they once were. And so by stimulating the inner ear, we are helping, you know, that sense be smarter and work better. And as we talked about with the correlation between the inner ear and the muscles, right, we're helping you maintain better posture as you age, but like you said, this is for everybody. This is for everybody and that's why I'm passionate about educating on it and making sure that we're not just talking about it. It's fun to nerd out on it, but we're actually doing it. So that's what's fun. Yeah, well, thank you for sharing those those examples. I mean, that really brought it to life in my mind. Awesome. All right, there it is, Tony. And I hope everybody enjoyed that one on the vestibular system. If you want to learn more, please follow the podcast, check out the website and the dojo and come along for the ride. I promise you'll learn valuable lessons and build a tool set that will help you keep training pain free for years to come. Thanks so much for listening. [BLANK_AUDIO]