>> Hi, I'm Lewis Howes, New York Times best-selling author and entrepreneur.

And welcome to "The School of Greatness," where we interview the most influential minds and leaders in the world to inspire you to live your best life today.

In this episode, we sit down with Vinh Pham.

He's a licensed physical therapist with over a decade of experience working with industry-leading health and wellness brands and treating top athletes, celebrities, and entrepreneurs.

Today, he shares how to keep your spine healthy and your muscles young, exercises to increase your flexibility, and how to future-proof your body for the long term in a world where we're almost always seated, from driving in our car to working on our desk to meeting a friend for dinner at a restaurant.

I'm so glad that you're here today.

So let's dive in and let the class begin.

♪ I'm curious -- what do you think is the biggest reason why so many people are struggling to stay flexible, mobile, and healthy today?

Is it the extreme workouts?

Is it they're on their phones all day or on the computer?

Is it they just aren't educated on how to be more mobile?

What are you seeing?

>> I definitely think it's a mix of all those three, four things that you said.

But I say the main thing is it's not top-of-mind awareness.

You know, people are definitely more reactive versus proactive when it comes to their musculoskeletal health.

>> Yes.

>> You know, they don't really care about it until they wake up one day and they're like, "Oh, I can't move" or like, "Oh, I don't know what happened.

I slept and I can't turn my neck."

Like, "Oh, I need to go see a physio or see a chiro or get adjusted or get a massage or" you know -- They get very stressed when the symptoms show up.

>> Mm-hmm.

>> But because there's no -- the signs of MSK disease is progressive and more silent, we don't really take care of it.

>> What's MSK?

>> Musculoskeletal.

>> Okay.

>> Issues with your body coming up.

>> Pain, inflammation.

>> Pain, inflammation, knee pain, back pain, neck pain.

Yes.

So, that's, like, essentially, muscle and skeleton together, right?

So it's kind of like body issues.

>> What are the biggest issues people are faced with?

Is it the lower back?

Is it the neck?

Is it the joints, whether knees and elbows and wrists?

What are you seeing is the biggest struggle for most people?

>> 70% of people in their lifetime will have low-back pain.

>> Really?

>> Yes.

So I would say low-back pain is one of the biggest ones.

Crazy stats for you to know.

MSK costs, on average, $600 billion a year for the U.S. >> Wow.

Is that on, like, medicine or rehabs or... >> Healthcare costs and also loss of wages for the U.S. >> Oh, interesting.

Because if you can't work -- Yeah, gotcha.

>> Yeah, $600 billion.

It's 1/6 of all healthcare spending in the U.S. Just to give you comparison -- >> Really?

>> Yes.

Yes.

Just to give you comparison of numbers versus heart disease is like, I think, $309 billion, Cancer is $243 billion, and diabetes is $188 billion.

>> Come on.

>> Yeah.

So, MSK is like $600 billion versus all of that.

>> And MSK includes what specifically?

>> Low-back pain, neck pain, knee pain, ACL tears, joint issues, you know, all that stuff.

>> And are a lot of these things preventable?

>> I would argue yes, to a certain degree, for sure.

Obviously, if you do sports, you're working out like crazy -- >> You get in a car crash or there's an accident, you fall over, you hit your head, or something.

>> Things obviously happen.

But, overall, I would say a lot of it is preventable.

It just takes a lot of work.

>> What happens when someone has lower-back pain, neck pain, joint pain and they don't address it or they address it with just medication and not actually healing from the inside out, not actually doing the proper, I guess, natural remedies of mobility, stretching, adjustments, strength training, core training, flexibility?

What happens if they don't do that?

>> It's kind of like this.

Before every symptom, there's signs.

Signs that show up, right?

Let's say you end up having high cholesterol.

Over time, the doctor goes, "Hey, you have high cholesterol.

You're at risk for heart disease, heart attack.

Do something about it."

>> Right.

>> Right?

>> Yeah.

>> Right?

You have high blood pressure.

That's a sign.

You should be careful.

You might end up getting a stroke.

Do something about it.

The problem with MSK is the signs -- With low-back pain, the signs are silent.

>> Really?

>> Yeah.

>> Why are they silent?

>> Because you don't -- Because the body is so resilient and adaptable that we get away with sitting for "X" amount of hours however we want, doing whatever we want, and then, at one point in time, you get the heart attack or you get the, "Oh, my -- I just woke up, and my knee just gave out," you know?

>> It's kind of an instant.

Like, you wake up and then you're like, "Oh, why can't I move my neck?"

or "Why is my lower back so painful?"

And then it stays with you.

>> Yes.

>> And you might try to take painkillers or something to help let go of the pain, but that's not actually fixing the problem, right?

>> Exactly.

Exactly.

Not fixing the problem.

And because, again, the signs are silent, people aren't motivated or even aware to take care of it or they don't have the impetus to be like, "Oh, I have to do something about it," versus someone, a doctor, being like, "Hey, you have high cholesterol."

Then you start, "Oh, man.

Like, I need to do something about it."

Versus the symptoms of, like, by the time you have pain -- I'm not saying it's too late by the time you have low-back pain or knee pain, but it's way more progressed at that point.

Imagine if you didn't brush your teeth for the last 20 years.

What do you think your teeth would look like if you didn't brush or floss?

>> I mean, they'd be -- Yeah, they'd be cavities and yellow and, yeah, falling out and everything, yeah.

>> You can imagine that world, you know?

Imagine you -- Up to now, you didn't brush or floss your spine or knee or stuff like that on a regular basis.

And that's why -- Imagine if you did.

Imagine how well you'd be moving right now, right?

Would be my argument.

I feel like if you -- it was instilled in the education system, you were educated early about it, your mom taught you how to stretch, or things like that, you would -- the dividends would pay off insane, right?

And that's kind of like what I want to shift the whole mentality of the world towards.

It's like -- It's not about, like, "Oh, let's be scared of back pain and neck pain and all these things."

No, it's like, you should take care of the only possession that you truly own, which is your body, you know?

And not only your teeth, not only your skin, not only your hair, but -- The main reason why people take care of those things is because if you don't brush your teeth, someone's going to tell you.

If your hair look crazy, someone's going to tell you.

You know, if you look like you didn't shower in a few days, someone's going to tell you.

>> Yeah.

And if you don't take care of your body, your body's going to tell you eventually.

>> Yes, eventually, and that's the problem.

It's the "eventually" part, you know?

But there's no warning signs.

There's no "dirt" collecting on your back.

But it is collecting.

And that's what I'm trying to do.

>> It's collecting in your muscles and your spines and your joints, right?

>> Essentially.

Tension, habits.

And did you know?

This is, like, fun stats that I was, like, you know, researching to prepare for this.

1 out of 4 people sit for work.

>> How long?

>> On average, including sitting at home, they sit, on average, 15 hours a day.

>> 15 hours.

>> 15 hours a day.

>> And then you're probably sleeping for 7 or 8.

>> Yes.

And during COVID, people were sitting for two hours more, so 17 hours a day.

>> Oh, my God.

>> And then they're sleeping the rest.

So, you think about -- >> There's no movement.

>> What happens to the body when they're sitting or laying down most of the time?

>> I mean, so many things, like muscle loss, you know, decreased circulation.

You know, you start getting into all these habits, postural habits, that end up staying with you, whether you're here like this, you're here like this, you know, losing neck motion.

You know, sedentary behavior is just the worst.

>> Right.

>> It can lead to so many things, you know?

>> And what happens if someone -- Okay, so, not moving at all, there's a lot of problems.

What happens if someone moves too much?

Is there such a thing as like, "I'm working too hard or "I'm stretching too much, I'm not relaxing enough"?

What happens then?

>> Yes.

I mean, then it's overuse.

So you have an overuse situation, right?

And then what I preach all the time is, it's all about, like, movement efficiency.

It's like, "How do I make your body more efficient at moving, using your whole body versus only using a specific part?"

>> What's the thing that people should be doing on a daily basis?

Is this a thing they do in the morning, in the afternoon, at night?

Is it -- If they only had five minutes a day -- >> I've essentially assembled 12 movements that is essentially going through your whole body.

And if you're doing the whole 12 movements, it would take you, give or take, 15 to 20 minutes.

If you start to learn your body and go, "Hey, listen, I actually don't need this part.

I only need the front of my teeth --" You know what I mean?

Or, like, basically, essentially, like, "I only need my ankle" or "I only need my left shoulder," then you can reduce it down to five minutes a day, for example.

>> Okay.

>> For me, personally, I have a habit of how I sleep is, like, I kind of sleep in a banana, like this.

And that's because of how my nostrils flow and it's my preferred position.

>> To breathe.

>> Yes, to breathe.

>> It brings you back to childhood.

>> Yeah, exactly.

Exactly.

So, imagine if I'm here like this for eight hours, right?

What I need to have my body experience when I wake up is this.

>> The other way.

>> The other way.

So my routine every morning is, I need to open this up, right?

Or I could fix the way I sleep, but I don't want to.

So I would rather just do the homework and have my body open up.

>> Okay.

So, is there one more from the seat we can do?

>> One more from the seat?

Yeah.

So, I would start with actually -- funny you say that -- a full-body movement, but it does everything.

>> What is it?

>> It's called a gears movement.

I learned it by -- I learned it from this man called Gary Ward.

I love him to death.

He's amazing.

You're basically bringing your arms inwards like this.

>> So...okay.

>> Yeah, inwards.

And then when you're doing this, do you notice how your thoracic spine, essentially your mid-back, is flexing?

Do you feel that?

>> Yes.

>> Right?

And let's just experience that.

And then turn your arms out.

And see how now your thoracic spine is extending.

>> Uh-huh.

>> Do you feel how your arms are driving that motion in your spine?

>> Yes.

>> Yes.

So, I want you just to connect that.

Great.

And now this is opening up your mid-spine, right?

And then now what I want you to add is, I want you to notice how your head naturally will drift forward if you turn your arms in.

Yes.

Great.

>> Am I trying to, like, squeeze my back when I pull it here or just let it naturally... >> Yeah, I would say squeeze your back a little bit, stretch a little bit.

>> Kind of stretch it?

Yeah.

And what does this do?

>> This is basically essentially oiling up your whole body.

Opening up -- Yeah.

And then, from here, when you're opening up your arm like this, you want to chin-tuck, right?

And now you're going to get full range of motion in your upper body.

>> So this is going to help from, essentially, your waist up.

>> Yes, from your waist up.

And there's a version like this standing up, but I decided to just kind of get to it from here.

But this is a great exercise for you to do if you're sitting a lot at home.

>> Interesting.

>> You know?

>> So, you do this just like a few times?

>> Yeah, five.

Imagine you do this every half an hour.

You do like five reps. >> Really?

>> It takes you literally five seconds.

>> What should that do?

Will it prevent -- Will it make you more flexible?

Whether you release the pain?

What will that do?

>> It will definitely just -- Like, it's a habit situation.

So imagine you're stuck in this for seven hours a day.

You know, this will break up that pattern.

You know, you're learning more vocabulary, more words to...how you articulate.

>> So, what do you call this exercise or this movement?

>> Gears.

>> Gears.

>> Yeah.

So, it's like gears.

>> Gears.

Okay.

>> Yeah.

Simple as that.

>> How bad are people walking these days?

Like, the gait, their slouched shoulders.

Is it going to affect them long term, how they walk, or is there a specific way that we should be walking?

>> I wouldn't say there's a specific, specific this is the way you need to walk, but there are definitely more efficient ways and less efficient ways, right?

And everybody, to a certain degree, is individualistic.

So you can have a more personalized situation of how they should walk based on a multitude of things -- injuries, limb length, blah, blah, blah.

But, generally, there is a -- you know, maybe like this range of like, this is how you should walk, give or take, if you're healthy.

>> What should it look like or what should we be thinking about?

>> You should be thinking about how well is your foot articulating with the ground?

>> What does that mean?

>> Articulating meaning when your foot hits the ground, it should be this thing called pronation, right?

And then this is supination, right?

So, just to make it simple, pronation is essentially if you were to throw a ball, do you want to throw a ball like this or do you want to throw a ball like this?

>> You want to throw the full range of motion.

>> Full range of motion.

Agree?

This looks way more better than this, right?

This is pronation, right?

You're loading your foot.

And this is supination.

You're throwing your foot.

So your foot hits the ground, you're loading your foot, and then it pushes off the ground and it goes into supination.

A lot of people, if you sit at the airports and you watch -- you start watching how people walk and stuff, people walk with their foot turned out, people walk with their foot turned in, people start whipping their foot.

However it is that they -- >> [ Laughs ] >> Yeah.

>> Why is that?

Injuries or mobility -- >> Yeah, injuries, habits.

They don't use it.

No one taught them how to do it properly.

They mimicked, you know, other people.

Their sports started making their feet a certain way, but no one ever, like, reprogrammed their feet.

And then they -- You know, they go run a marathon, and their knee blows out.

>> So we want our feet to essentially land forward and heel middle to toe, right?

>> Yes, exactly.

>> We don't want to be toe walkers.

You see the toe walkers out there?

>> Yes, toe walkers.

Yeah.

>> You want to be a bouncy toe walker?

Have you seen people that kind of, like, land and they pop real quick?

>> Yeah, yeah, yeah.

It's all about efficiency.

Exactly.

The more you're efficient, the more it's, like, less energy for you.

And you just -- You just whip it, you know?

>> Okay.

>> Yeah.

And you've seen -- I'm sure you've seen people who run really well and people who run less well -- >> I know.

You're like, "What is that?"

>> Yeah, you don't necessarily even understand, but it looks way different.

"You look like you're having a great time."

[ Both laugh ] >> What made you want to say, "Huh, there's something missing in the field, and I want to learn more about how to transform people's health to the next level"?

>> Yes.

I think I always didn't like how -- Working in the industry, I realized that it was very like a mill industry.

And I'll speak specifically for Toronto, and in my experience from talking to other people, it's like that in other words, as well -- other worlds, as well, other countries, other areas.

You come in for physical therapy, and it's like -- It's a factory.

You're in and then you're out.

>> Same thing with chiropractic.

It's like you're in and you're out.

>> "Lewis, you good?"

>> Yeah.

>> "Alright, see you next week."

>> A couple cracks and you're out.

>> "You want an ice pack?

Alright, see you later."

And I was working for a clinic in Toronto and I was seeing -- think about this -- 40 patients a day.

>> Come on.

>> Yeah, 40.

So 4-zero.

40 a day.

And I was rolling -- rotating.

So I'd be like, "Hey, hey, how's your hamstring?

You good?

Okay.

Awesome.

Alright.

You good?"

>> So there were like four people at the same time.

>> Four people at the same time per hour.

It was insanity.

Like, and it wasn't proper care, in my opinion, but it was.

meant to obviously bill insurance and make money and it was meant to make money and not really take care of people.

And I was really annoyed because every job that I would apply to -- in Toronto, anyways -- the clinics were all like that -- set out to make money, not really to help the patient.

Like, how much care can you get in 10 minutes?

>> Not much.

>> Yeah.

Imagine our session that we have, like, when I see you.

10 minutes.

>> It'd be tough.

>> And then, in that process, I was just frustrated at the industry.

I was like, "Hey, I can't do this."

I ended up quitting, working out of my condo/my house and I ended up being -- Within two years, I ended up being full.

So, I was treating people on my living room.

I was treating people in my condo gym.

I was out there hustling.

In this area called Scarborough -- >> Yeah.

>> Yeah, I was, like, the king of rehab in Scarborough.

Everyone would come to my condo, and I would be working out of my condo.

I would have lineups outside of my condo.

>> Wow.

>> Yeah.

And then I did that for two years.

And then condo security was like, "Hey, listen, you can't run a business out of your house."

And I would always kind of, like -- at first, kind of dodge them.

I'd be like, "Oh, no.

This is my friend.

Lewis is here just to hang out," you know?

But then there's like three people coming in a row.

But the main reason is, I just wasn't happy working in a place that didn't care about patients, in my opinion.

Like, it wasn't about the patient.

And everything I do is about educating people, helping people learn about movement health, helping people learn about their body.

I truly care.

This is my mission, reason why I'm here on Earth.

>> Yeah.

>> Fly here, fly there.

I'll do whatever it takes, because I believe that if I can make everyone understand how to take care of their body, the world will be a much, much, much better place.

>> Yeah.

>> Yeah.

>> What's more powerful for protecting our joints and reducing pain and extending life?

Is it strength training?

Is it flexibility and mobility?

Is it stretching?

What is the thing that's going to help us reduce pain and extend our life?

>> Yes, I think in all of that is kind of, like, the cop-out answer.

But to be a little bit more specific, I would say you want to experience your body fully.

What we don't do every day is experience the full range of motion that we're capable of, right?

For example, let's say, right now, you're turning your neck to the left, to the right.

Can you -- Do you really know how much you're missing on each side?

And then can you explore the nooks and crannies of how much -- For example, I have way more range to the right than I do on the left.

>> Right, right.

Why is that most people have range more on one side than the other?

>> It's all movement habits of things you've accumulated over time, mix of injury, mix of your whole history.

>> Right.

>> But you have to unravel that, all this damage that you build and habits that you build over time.

And that is what's going to basically future-proof yourself for the future.

>> Gotcha.

>> And then it's all about exploring the dark zones of your body and learning more about your body, again, coming down to self-awareness for everything.

Forget only the body.

You know, for everything.

>> Why is it harder for us to recover when we're older?

But it seems like when we're younger, we can run around and get hurt and recover so much faster.

>> I mean, this is aging, man, you know?

This is like your recovery, your hormones.

Like, everything just kind of goes downhill when you -- >> What can make us feel like we're younger in order to recover when we're older?

What is that process?

Is it supplements?

Is it diet?

Is it nutrition?

>> I would say, like, you want to mitigate as much of that as possible, aging as possible, by essentially doing everything you just said, which is eating healthy, which is annoying, which is taking care of your body on a regular basis, which is annoying, which is working out regularly, which is annoying.

You know, you actually have to just put more work, essentially, into it, right?

It's almost like in order to stay baseline, you got to spend like 2 to 3 hours a day to, like, work on yourself to be, like -- >> But if you don't do that, you're going to start feeling some pain, and it's going to be harder for the last part of your life.

>> Exactly.

Exactly.

And I'm not saying, necessarily -- Like, three hours is a little intense.

Maybe like an hour or an hour and a half a day is essentially how much you should spend on conserving your body, you know, maintaining your body.

>> What would you recommend to people who maybe have some extra money -- You know, wherever they live in the world, they have some -- They could do some of this on their own, but they're like, "Okay, I want to see a physical therapist or get a massage once in a while."

What do you recommend?

Is that a once-a-month type of thing?

It's great for people to do some type of stretching therapy or... >> We talking perfect world or, like, realistic world?

>> Tell me both.

>> Okay.

Let's start with perfect world.

Let's say I was building a plan for you, Lewis.

Okay, every day, I want you to wake up, brush your spine, floss your muscle for five minutes.

As you learn your body more, I want you to start creating a program for yourself that's literally going to take you five minutes.

And you understand your body.

You go, "Hey, I need to do this.

I need to do this.

I need to do that."

Great.

Step one.

So, you got that down -- check.

Second thing is, I want you to be doing activity, obviously working out, boxing, running, whatever it is that you do 3 to 5 times a week.

And then I want you to get a physical therapist or a chiropractor.

You would go see a professional to essentially fine-tune your movement in those things that you're doing.

You would essentially see them for I'm gonna say once a month.

Once a month is great.

>> Once a month.

Okay.

>> And then, in those sessions once or twice a month, you would get a variety of, like, new exercises to help fine-tune your movement or you would get, like, bodywork, myofascial work, massage, stuff like that to kind of relax your nervous system, realign your body, flush out all the bad energy.

>> Right, right, right.

Okay.

So those would be the three things for sure.

Floss every day, 3 to 5 workouts a week, some type of massage, physical therapy once a month.

>> Yeah, once a month.

>> If you can do that, that's the -- >> That's, like, the gold standard, in my opinion, if you can do that.

But that's a lot, because on top of that, you got to work and then run this -- you know, this enterprise that you have going on and then you got to eat healthy, then you got to sleep well.

>> Here's the interesting thing.

The practitioners of the world who are doing this work, the therapists that are doing this work, sometimes don't take care of themselves.

Is this true for yourself or do you take time to allow your body to recover, too?

>> Yes.

I would say that, in the last two years, I've definitely taken my health way more seriously and walked the walk.

>> Yeah.

>> When I was starting the business, as you know with starting a business, I was just taking care of everybody and not taking care of myself.

The joke I always say is like, "Those five years that I started the business, I was a smoking doctor."

I was like, "Lewis, you should definitely stop smoking" and like, "I'll see you later."

And I'd go in there on my on my break.

I'm like, "Oh, my God.

Life is so hard."

But, yes, definitely in the last two years, I've ramped it up.

It's just like the first five years of my business, I had to focus on it.

>> This is called the "Three Truths Question."

So imagine it's your last day on Earth many years away from now.

>> Mm-hmm.

>> You transformed the world with therapies and all these different things.

You get to accomplish everything you want to accomplish -- personally, professionally.

But for whatever reason, it's your last day, and you've got to take all of your information with you.

>> Okay.

That's a sad world.

>> It's sad, right?

>> Yeah, yeah.

>> But you get to leave behind three lessons to the world, three things that you've learned from your life.

I like to call it the Three Truths.

What would be those three truths for you that you'd share behind?

>> I mean, I have so many, but do you think it should be more from a therapy perspective or more from a life perspective?

>> Either one.

>> Either one.

Okay.

Let me go with life, because therapy perspective, we can go so far and so many advice.

The first thing is, I would say don't overthink it.

I've met so many people that overthink so much of how they move and how they go about life that they end up essentially getting nowhere.

They get in their own way.

They create problems that do not exist.

You have to just sometimes -- Obviously, you don't want to go crazy and do whatever.

Have some thought process to a certain degree to what you do.

But sometimes, you just got to, alright, my gut says, "Let's go for it.

Let's just go for it."

And then you will figure it out.

If you trust in yourself to figure it out, everything will go good, right?

And that's definitely, I would say, number one, truth number one.

And then the second truth I would say is, you know, who you surround yourself with, whether it's a person or a book, all these things that you consume or relationships and things like that, you have to make sure that you choose well.

>> Yes.

>> Being around the wrong people will -- Wrong people, wrong book, wrong thought process, wrong habits will lead you in the depths of hell, right?

As you know, just being -- Yeah, being in bad relationships with people is just -- everything else is like -- >> Yeah, it's not fun.

>> It's not fun.

>> Yeah.

>> Yes.

And then the third one would be...sit up straight, which is essentially not about sitting up straight.

It's about paying attention, which is -- whether it's you're paying attention to your body, paying attention to what you're doing, paying attention to -- Be self-aware, right?

Sit up straight, be self-aware.

What is going on in the world?

What is going on with this conversation?

Is this conversation going good or not going good?

Should I say -- change the way I speak?

Should I -- You know?

And being self-aware will lead to change, and change is good.

>> Final question -- what's your definition of greatness?

>> Greatness, I would say, is just pushing yourself to be better every day, right?

And then -- How do I say this?

Comparing yourself, essentially, to yourself at all times, right?

And then you're just continuously chasing this new version of yourself that you know is just better, right?

And that's how you achieve greatness.

And, you know, that's kind of how I look at it.

>> My man, appreciate you, brother.

>> Thank you so much, man.

>> Thanks, bro.

We hope you enjoyed this episode and found it valuable.

Make sure to stay tuned for more from "The School of Greatness" coming soon on public television.

Again, I'm Lewis Howes.

And if no one has told you lately, I want to remind you that you are loved, you are worthy, and you matter.

And now it's time to go out there and do something great.

If you'd like to continue on the journey of greatness with me, please check out my website, lewishowes.com, where you'll find over 1,000 episodes of "The School of Greatness" show, as well as tools and resources to support you in living your best life.

>> The online course "Find Your Greatness" is available for $19.

Drawn from the lessons Lewis Howes shares in "The School of Greatness," this interactive course will guide you through a step-by-step process to discover your strengths, connect to your passion and purpose, and help create your own blueprint for greatness.

To order, go to lewishowes.com/tv.