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5-Shot Friday: 5-ish Principles To Hit The Ground Running

Welcome to the Friday the 13th, 2017 edition of 5-Shot Friday. Rather than a collection of linked posts of interest, I wanted to share a literal handful of principles that when applied regularly, has worked well for me, both personally and professionally in advising my patients and colleagues.

Principle 5, however, is for next time due to space constraints.

Long post follows.


Principle 1: Use It Or Lose It


I’ve been nursing a hurt shoulder for the better part of 2 months, and it’s slowly gotten worse. It gave a little sproing while doing basic kettlebell swings 2 months ago, I’ve done every mobility and HEP exercise I can think of as a sports medicine fellow, had x-rays and another sports med fellow look at it, and we’re still scratching our heads. (The best guess is a strain of my subscapularis, one of the more obscure rotator cuff muscles, and my coracobrachialis, an even more obscure inner arm muscle, and where they insert into my upper arm bone, and I have no clue how I could have selectively injured those little buggers.)

Translation: Shizz stops working as you get older. Use it or lose it. You must exert precious time and resources just to maintain your place in line.

It takes much, much longer to rehabilitate something that’s broken, than to maintain its original functional state. The problem is that there’s no positive reinforcement to maintaining something “as is”; if it keeps functioning like it did yesterday, there’s no pat-on-the-back attaboy. It’s a hard sell, telling folks that if they put out extra effort, nothing is supposed to happen.

But after a thing or two breaks, you realize the enormous cost of going non-functional for a few months (you really, really need functioning calf muscles to take a shower, to get out of bed, get off the toilet, pretty much…everything. Ditto with functioning back muscles, and the shoulder seems pretty important, too). Some activities simply stop, and there’s a huge cost to going offline and having someone or something else take up the slack. Add to that the time and energy to fix the problem, and you very quickly appreciate the value of preventing breakdowns in the first place.

Put another way: if you JUST KNEW that you’d be paralyzed from the eyeballs down and all you could do was widen your eyes and make muffled whimpers UNLESS you performed a strange 60 minute daily devotional (stretches, runs, heavy artifact lifting, and unprocessed food consumption), you would do it, right? 60 minutes out of your day sounds like a lot…until weighed against THE END OF YOUR LIFE AS YOU KNOW IT. Then it becomes a frickin’ bargain.


Principle 2: Define Your Critical Daily Subset


Coach Dan John, strength coach extraordinaire, quoted someone who made so much sense that he adopted the saying for his own students and clients, and I pass it along to you, it resonates so strongly.

If it’s important, DO IT EVERY DAY.

Does your back, calf, shoulder, or whatever give you fits unless you’re careful with it? Find a regimen that makes it bulletproof and do it EVERY DAY.

Have high blood pressure and the thought of a stroke and your family wiping your butt makes you break out in a cold sweat? Take your BP medication, lose 20 lbs, nix the sodium and processed carbs, and do cardio EVERY SINGLE DAY.

Worried about your steady weight gain, no matter how much you swear you eat like a church mouse and are as active as you were 10 years ago? Forget about how your body “should” be responding, figure out a food intake, exercise pattern, and hormonal optimization combination that drops your weight, and stick to it EVERY SINGLE DINGDONG DAY.

It is absolutely possible to make tremendous improvements by analyzing your workflows and changing up a few critical areas. Tim Ferriss’ approach to work and life is based on this, and I’ve used this approach to take healthcare organizations from dead-average to 90+%-ile performance within 4 months. Working smarter rather than harder is always a Good Thing, and you can leapfrog your performance into the stratosphere using small amounts of well-placed effort.

But.

You can achieve astonishing things with simple routines, done daily, over months, years, or lifetimes – think dance or musical virtuosity, or martial arts expertise. Daily habituation builds a different kind of stratospheric performance. Working smarter/not harder clears out the dross and lets the machinery hum; in essence, it lets you get out of your own way so things can work the way they’re supposed to.

Daily habituation builds durability and key infrastructure. We live in an unprecedented era of data overload – we are bombarded by all manner of call outs to buy this, like that, consider this new thing, and vote the way the cool kids do. Living your life by “just getting by” means being overrun by the piranha cloud.

Daily habituation builds a more solid YOU. It is your chance to build strong, resilient ways of functioning based on what you’ve decided is key.

My daily habits list from today looks like this:

  • TM
  • Walk/DB/shoulder
  • Green/Paleo
  • Recovery

It’s much the same list every morning: meditate, walk & move, eat properly, and for today, a reminder to take something to reduce the inflammation in my shoulder (I almost forgot that, just took the Recovery tablets now!).

There’s any number of things due today that make up another to-do list – including writing this blog post – that changes from day to day with the needs of the moment.
But the bedrock, the infrastructure upon which everything else depends, I build by meditating, exercising, and eating in a specific pattern, every day.

For example: the more I avoid processed carbs and refined sugars, the more it becomes an automatic habit, and the easier it becomes to say no to tempting foods when I’m tired or pulling an all-nighter. The more I stick to said habit, the closer my weight drops to my college weight. The more my weight drops, the lower may blood pressure goes without needing more medications and longer exercise sessions, and the less sluggish I feel at day’s end. The less sluggish I feel, the more energy I have to think outside the box for my work and my family, aside from just myself.

The more I meditate, the more regularly I enjoy the very concrete benefits of meditation: increased focus, more spontaneous insights, less irritability and pettiness. The more focused I am, the more I can get done in less time; the more insightful, the better problem solver and “that’s a great idea!” resource I become; the less crabby, the more relaxed and more “playing at their best” those around me become.

Having a small subset of routines that you do religiously every day may not seem like much, like carving out a little breathing room to relax. But the benefits multiply rapidly, forming the foundation for all kinds of benefits in wider spheres.


Principle 3: Take Charge: Review, Redirect, Repeat


One of the benefits of journaling is seeing what you were preoccupied with, way back when. And while I’m happy to see that I hit certain personal and family goals, there were many more times when I was struggling with the same issues I am now (keeping weight in check, lowering BP, injury-proofing myself, etc).

Without a REVIEW process, you are doomed – doomed, I say – to replay snippets of your life video. You get busy, tired, or sidetracked into putting out The Major Brushfire Of The Month, and your nifty new plans to GO NORTH take a sharp turn to the left. You fall back into whatever your default pattern of living is, which is usually something besides GOING NORTH, and eventually find yourself making plans to once again – how about that? — GO NORTH.

Organizations of all shapes and sizes have faced this exact problem, and the best and most nimble of them fix it with a simple formula: course correct as you go, frequently and often. HEAD OUT for a bit, then LOOK AROUND. Getting closer to the goal? Keep going. Goal fading into the distance? Turn towards it; basically CORRECT COURSE IF NEEDED. Then REPEAT: go a while, look around, see how it looks, act accordingly. And REPEAT again, and again, and again: Review, Redirect, Repeat.

If you don’t ever make it to Review…you can see the problem.

If you find yourself in the same situation and you’re in need of progress, something is broken in the Review, Redirect, Repeat loop. It only stops when you’ve arrived.


Principle 4: Get Help


According to Ecclesiastes, there’s a time for everything under the sun. That absolutely includes a time to get input from trusted colleagues, mentors, or friends.

When I was in high school, I was the smartest kid in my grade, and for a while, in my entire school (it was a pretty small school). I got nominated to attend a special summer school at Cal Tech – THE Cal Tech – and I eagerly went, wanting to learn about math and science from the experts at the campus of the holiest of science holies.

Suddenly I was no longer the smartest brain in the room. Not even close; I didn’t understand the questions being asked, much less how to get the answers. I had no experience with a situation where I couldn’t solve the problem with my own intellect; I sputtered, collapsed, and dropped out. It didn’t even occur to me to ask for help, for tutoring, for example.

So easy to overcome, in retrospect.

To get to a better place, there’s plenty of work you can do on your own – cleaning up your own messes, for example, or putting in the hours you’ve already decided need to get done. And some things are best incubated within one’s self, when the ideas may be fragile, subject to ridicule from the peanut gallery and all kinds of uninvited opinions.

But eventually, you will need some kind of input from beyond your own borders. Simply put, bold goals beyond your immediate circle require others who can magnify your strengths and mitigate your weaknesses. And sometimes, help from others is necessary just to get out of bed and face the day.


So As You Start The New Year…


…consider these 4 key principles.

If you really like doing something and would sorely miss it if you suddenly couldn’t, keep practicing and maintaining it.

Define a handful of things critical to YOU, that you will do daily, because they are really that important for you to become expert at.

Review, Redirect, and Repeat, to continually improve.

And don’t be shy about getting help; none of us get very far without it.

Next time: Principle 5: Build And Feed Your Avengers Team.


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Peter L Kim, MD

Dr. Kim,  is the Medical Director of Family Care Centers, Former Chair of the Department of Family Medicine at Hoag Hospital, and a recipient of the Physicians of Excellence award from the Orange County Medical Association. He is Board Certified in Family Medicine, and has been practicing in our community for over 20 years. He is an excellent, caring, and well­qualified physician who is dedicated to providing you with superior health care. A native of Los Angeles, he graduated from UCLA and received his medical training at the LAC­USC Medical Center. After completing his residency in Family Medicine, he accepted a sports medicine fellowship at San Jose Medical Center, an affiliate of Stanford University. He enjoys working with patients and families who are training or want to get back into an active lifestyle.

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