November 16, 2015
[00:00] Introduction/Space Boots
[05:23] How Does NormaTec Boots Work
[07:09] Where NormaTec Idea Came From
[09:51] How The Body Actually Move Fluids
[12:07] The Pre-Inflate Cycle/Sizes of Boots
[14:46] The Main Differences Between Pulsed Compression in the Compression Boots and Regular Compression
[19:48] What Happens Biomechanically When You Wear the Boots, Particularly For Flexibility, Arterial Function, Pumping of Blood and Lymph
[26:58] How the Normatec System Can Compress Your Hips and Your Arms
[33:15] The Difference Between Pulse and the Pulse Pro
[37:25] Combining Ice With the NormaTec
[43:25] End of Podcast
Ben: Hello, it's Ben Greenfield here. You know it's pretty rare that I release a podcast interview on a Monday, but I'm doing just that. Yes, I'm breaking all the rules. Getting all crazy. Usually I release a podcast on a Wednesday, our special Q&A episode and also on a Saturday and that's usually a special interview, but I decided that I wanted to give you a podcast interview today because a) I just got done racing for 24 hours at the World's Toughest Mudder in Las Vegas and frankly I didn't have a whole lot of time to pen an article for you as I was out there punishing myself in a feat of extreme masochism. And then number two, this is actually really interesting because, the boots that I talk about in this particular episode or something that I wear now almost every day to make my legs feel light as a feather after the day's activities of standing workstations and running. And these things really do work. I sit there, I sip my glass of wine, I typically work a little bit on my fiction book and let the boots do the massage work for me. So if you like what you hear in this interview, you can save a hundred bucks. Yep, that’s a hundred bones on a pair of boots for yourself and all you have to do is go to bengreenfieldfitness.com/spaceboots. That's bengreenfieldfitness.com/spaceboots where you can read the research that Gilad and I talk about in this interview and you can also grab some boots for yourself just in time for Christmas. So check them out, bengreenfieldfitness.com/spaceboots and enjoy today’s show.
In this episode of the Ben Greenfield Fitness Show:
“Circulation is all throughout the body, right? So it’s all this systemic type situation, but when you have certain diseases and complications from those diseases, anything you can do to enhance circulation is very advantageous. So someone with diabetes with wounds on their legs that don’t heal, for example, you could focus in on just trying to heal the wound where the wound is, but the whole reason they have a wound to begin with is poor circulation. So if you kickstart the circulation, everything starts to get better.” “Question is, what's that next frontier for athlete performance? We're really seeing that the whole area of recovery rejuvenation is really what's next and we’re really happy to continue to lead a charge on that part.”
Ben: Hey folks, it’s Ben Greenfield here and I think it was about six years ago, possibly even seven years ago now, in a tiny little hotel room lobby in Kona, Hawaii that I met this guy named Gilad Jacobs. Gilad, am I pronouncing your first name correctly?
Gilad: Ah, real close. Gilad?
Gilad: With a ‘G’ as well.
Ben: Gilad is pretty close. What nationality is Gilad?
Gilad: It's an Israeli name.
Ben: Okay. Gotcha. That’s what I thought, but Gilad, I remember, I don't know if you remember this but when I met you, you were holding like a big black box about the size of a shoebox and I had these two big space agey looking boots kind of sticking out of it via these two air tubes and I was filming a video back then for Everyman Try, a triathlon website that I believe is now and somewhat defunct. But anyways, I managed to fumble my way into these boots and I sat in a chair there in the hotel lobby in Kona while the black box pumped air in and out of the boots, and you know back then it seemed like kind of a hack together device impossible little hokey, and I wasn't sure whether or not it would actually work to make my legs more fresh. But since then you've kinda come a long way with this little device that you showed up in Hawaii with six, seven years ago and now it's called NormaTec and it is something that a lot of people are using like pro triathletes, Craig Alexander, Chrissy Wellington, Jordan Rapp, Miranda Carfrae. You've got a bunch of NBA and professional football players, pro cyclist, pro runners like Meb Keflezighi and Ryan Hall, and a bunch of these folks using it. Ton of like CrossFit boxes, pro crossfit athletes, so it's kinda seemed to take the world by storm and I figured it was time to get you on a call and find out exactly how these boots worked, and what they do, and what people can expect when they put them on. So what do you think? You want to jump in and talk shop about NormaTec?
Gilad: Yeah, absolutely, Ben. I appreciate the time today. Indeed I think it was probably going back six or seven years ago exactly where we met up. I think it was in the King Cam.
Gilad: And often Kona and it was probably the first year that we were there and back then we as a company, NormaTec, was just me, I’m starting off our sports division. Really trying to figure out what kind of role we were gonna have in athlete performance in the years ahead and we had a few athletes who were using it. And that unit that you remember, the kind of larger than life shoebox with the boots and everything else was our first generation equipment that has taken a completely different turn of the last few years with all the R&D that we’ve put into it, but that was kinda how we got started and the goal was to introduce compression as a way to help athletes recover.
What we quickly started to see was the feedback we we're getting from the pro athletes at that top level, was really quite astounding. Typically, you’ll have one or two athletes that are willing to do just about anything, but when every single athlete basically that were trying the NormaTec on we're giving us feedback and saying, “Yeah I'm actually using it every day not just because you want me to use it but because I am using it, and I love it, and I need one and I need one for my wife, or for my husband, or for my training partners and you guys need to progress this technology.” Six, seven years ago, we really were in the early infancy, so to speak, of this technology.
Ben: So whose idea was this? Whose idea was it to like put on boots that pump air in and out to compress your legs?
Gilad: So the technology for external compression has been around for a long time. I mean compression in general as an industry has been around for a long long time. We, going back 3000 years ago, we used to mummify bodies in Egypt and that concept of compression has evolved in one form or another over the last few millennia. In the 1960s and 70s, these compression pumps started to come on the market to help patients after surgery and problems that would come up as a result of surgery or injury, as part of the rehab process. And my late mom, Laura Jacobs, was an MD, PhD and founder of our company to help patients again, with the problems and when I came out of college, I was working for the company. I said, “There's gotta be some application in sports.” She said, “Alright kiddo, this is not my jam.” There’s a unit or two and five grand sink or swim kind of thing.
Ben: And so at that point, your mom was using this for what?
Gilad: So you have a lot of stuff that goes on. I mean in the end you have, circulation is all throughout the body, right? So it’s all this systemic type situation, but when you have certain diseases and complications from those diseases, anything you can do to enhance circulation is very advantageous. So someone with diabetes with wounds on their legs that don’t heal, for example, you could focus in on just trying to heal the wound where the wound is but the whole reason they have a wound to begin with, one of the major reasons is poor circulation. So if you can kickstart the circulation, everything starts to get better. And we started to get a lot of feedback from patients of all walks of life who were using it whether it was women after breast cancer, or patients after surgery that would have swelling, that this was a very effective means of what was going on. And I guess to get to your point in terms of kind of how we got started it was my mom’s brainchild, her brilliance to fuse her MD and her PhD disciplines together to say the way that we're compressing, massaging around the limb, leg, and arm, is not as effective as it can be.
So what she did is she said, “When you're out there and you're running to the bus stop as a regular old patient or you're an athlete and you’re trying to move as fast as you can on the course, or on a bike, or wherever you are, how does the body move fluids naturally? And if we can take those physiological mechanisms, the things that the body uses when you're healthy to move fluids, maybe we can put that into some kind of apparatus or shoebox if you will that can go ahead and help you while you're at rest.”
Ben: So how does the body actually move fluids? Like if I've got a bunch of fluid in my feet, for example, and I'm not wearing a boot or I’m not wearing a compression sock or something like that, how would my body normally get blood from my feet back up to my heart effectively?
Gilad: So it’s interesting as if you're just sitting there, it’s actually not as easy as you want it to be and that's why a lot of patients and individuals who are sedentary for a long time or non-ambulatory, they're in a wheelchair for example, we all know our loving grandparents who sometimes at that age has to sit in a wheelchair and they have these swollen, puddles ankles because you don't have the good blood flow going back, the venous return back to the heart. So when you're out and you're walking and you’re healthy, your body is doing a whole bunch of different things to move the blood flow and the three areas that we really zeroed in on first is the calf muscle action. Your calf muscle’s made up of two muscles, the gastrocnemius and soleus and they call the muscle complex. And as you walk and push off your toes, your calf muscle is contracting, pulsing if you will. Every time it pulses it drives the fluid up north and that's very important. So we in the NormaTec have a patented massaging action that incorporates a pulsing action. Two, three seconds pulse on, two, three seconds pulls off. So that's the first, pulsing in the calf muscle.
Second part is gravity wants to bring that fluid just that you just pulsed up right back down. So in our veins and lymphatics in a normal body, we have one-way valves in these channels and it kinda creates a directionality effect. Kinda one direction up to the right part of the body as opposed to going back down towards the toes. So in the NormaTec, as your pulsing overlooks say the knee, you're actually holding at a slightly higher pressure over the calf and the foot and that's creating a one way valve effect. And then finally we have this concept in the body of a distiller far away from the heart released so as we’re pulsing in the quads or holding in the knee and the calf, that’s creating the one way valve effect and then we release way down low in the foot and that allows a rush of blood flow to enter back in. So we're getting the bad stuff out while getting the good stuff in all the same time it also feels tremendous.
Ben: Interesting. Okay. So as far as my own use of these boots, I tend to put them on when I finish up my workouts for the day. I wear them almost every day now and I'll sit there and I’ll drink my glass of wine typically keep them on for about 20 to 30 minutes while I'm writing or reading and one of the things I notice right when I put them on is they go through this cycle that I think you called the pre-inflate cycle. What exactly is going on when they first start to kinda hum and wrap around my legs during that initial cycle?
Gilad: Yeah, exactly. So one of the interesting engineering challenges that we had was how to get a really good fit for every single athlete. You have general sizes, right? You don't have the guys who are in the NBA. That's a very specific size but even within triathlon, what do you do to make sure that every athlete gets the right fit? So when you first put the boots on, whether they were used 10 minutes ago or you haven’t used them for a couple of days, pain is always going to go through a pre-inflate cycle, as you mentioned, where it's gonna custom contour inside the boot with air to your individual dimensions and that way you get a custom fit every single time.
Ben: Okay, so it's basically filling it with air in detecting the size of my actual leg?
Ben: Okay and do the actual boots themselves come in a different range of sizes because for example like my boots go up to my hips which I think is about how far they're supposed to go but when someone orders a NormaTec boot or a NormaTec system, do they need to specify a certain size or send you their leg length?
Gilad: Yes. With the technology of the pre-inflate, we’re actually able to get a lot of sizes in one but we do have multiple sizes. Obviously if you're a four foot 10 gymnast or on the shorter end of the spectrum, you're gonna need a shorter boot than somebody who is in the five or 5’5 to 6’2 range and then obviously we have for those taller athletes that are out there 6’3, 6’4 and up, we have a tall size as well and then also depending on how wide your leg is as the circumference, we can make accommodations for any size athlete any size limb. But typically, we have really good abilities to fit most athletes into our standard size and they go from there and that was done by design.
Ben: Okay. Gotcha. So in terms of compression, there are compression socks, there are compression tights, there are even other boots that I've seen that are compression boots that have the air tubes coming out of them that bring air into the boot to compress. What is the difference between that type of compression and something like the NormaTec system?
Gilad: So as you pointed out in the beginning part of this podcast here when we started we did have this big bulky shoebox and the technology was in is its infancy. So what happened was we started getting feedback that this was going to be a tremendous option and tool for athletes who were going through a problem. They just had an ankle sprain, they were going through an ACL repair, there was an issue that needed to be helped with compression to move fluids. And what started to happen kind of naturally was this feedback from the coaches, from the athletes, from the athletic trainers that they were using the NormaTec technology not just on problems but also on athletes who just wanted to perform better. And that's kind of how we all got started here and our specific technology of what's actually happening in the boot when you have it connected on your legs, arms, or on outside hip pieces, that patented action to move the bad stuff out and get the good stuff in is so powerful that massaging action that not only one, we patented it and two, it’s so effective in so many different areas. So you can use it after an injury.
You can use it after a hard work out and in the case of many of the pro athletes you can use it actually before a practice session or before actual go time. So you can actually get the boots on and it makes your legs feel great. And that's all again based on the patented action. So whether it's any other type of compression that’s there be it a compression sock that typically maxes out at about the 30 millimeters of mercury pressure level, we start at 30 millimeters of mercury, go up to 110 millimeters of mercury. But it’s not just how much pressure it’s the patented massaging action and that's unique to the NormaTec system.
Ben: What do you mean a patented massaging action?
Gilad: So what we talked about earlier, the pulsating, the hold, the release that action of what's happening in those zones with the air. How is it massaging? Right, there's a method to the madness. Not all massage is created equal, not all compression is created equal. So in order to move blood flow effectively in the body, we had to look at not only how big the system is and the materials and what it’s called and those are the nice things about designing any product. You just have to be smart about it, but the real method to the madness is how it's actually moving fluids in the body and that massaging technique that the NormaTec has is so powerful and effective that it’s actually what we patented.
So it’s kinda like, Ben, you go to your doctor and he says, “You know what, you're sick. You need some antibiotics. Go home and swallow a pill that’s round.” You look at him like he's crazy but that’s, many times, what we do in the world of compression up until the NormaTec came around. Well I think I have this machine under my bench for the last 20 years. It says compression pump on the side. It should be good or I have these compression socks or maybe just the calf sleeve let’s put it on. It should be good. Well how was it moving fluids? Well no one really thought about that and that's really where we came and changed the game.
Ben: So it’s the difference between just like squeezing a body part or squeezing a muscle for an extended period of time verses squeezing different sections of that muscle from the end of it up to the beginning of it in like a pulsing pattern.
Gilad: Exactly. So it's not just the squeezing in terms of the sequential action where you’re starting below and you're kind of going up but it's really all about that dynamic action. We’re very dynamic beings, right? When we’re healthy ,we're very dynamic as an athlete. When we're out there training or we’re competing, how can we also be very dynamic about or recovery? And that's really, I think, one of the coolest things that we've seen over the last six years is not only a development of the product which will get into and tell you, that’s some exciting stuff that we have coming out for 2016 but in addition to that, every sport, endurance sports especially, looks at four pillars if you will, to improve athlete performance legally. So up until now the history books have shown that all the technology, the research and development has really been in four areas to improve athlete performance. One is coaching. That’s a lot of what you do and what you preach on a regular basis. One is training which is very important. One is nutrition and the other is gear. So triathlon for example is a great example of that gear had this so much time and effort focused on how do I improve my results based on my gear.
And while that's great, we're now realizing that bikes aren't getting that much more aerodynamic because we've done all the research around it. Same thing with nutrition, we don't just carbo load before a big event anymore and then not take on any nutrition action during the event. We’re smarter about our nutritional needs and then how it actually interacts with our body and what demands we need to have there. Same thing training, right? We don't just run laps anymore until people drop. We’re smarter about tapering and we understand build sessions and strength and cardio and everything else that goes into it. Question is what's that next frontier for athlete performance and we're really seeing that that whole area of recovery rejuvenation is really what's next and we’re really happy to continue to lead the charge on that front.
Ben: Yeah. I want to ask you about some of the studies that have been done on this. One was on flexibility. This one was in the Journal of Strength Conditioning Research called peristaltic pulse compression of the lower extremity enhances flexibility. What's the proposed mechanism of action there to where basically squeezing a muscle would increase the flexibility of it?
Gilad: Yeah, you know it's actually a great question. That study was done at the US Olympic committee on US Olympians where flexibility obviously is very important but especially at that level. It was a pilot program so it's actually something that we're going to continue to study and there's a number of physiological mechanisms that are actually are at work. But it looks like doing things to the muscle as you begin actually puts the muscle in a state where it can actually be more flexible. And if that doesn’t really make sense, the researchers are still trying to parcel it all out and figure out how it's actually working but we know that when you stretch, we’re doing things to the muscle to elongate and to kind of massage and to kind of soften if you will. So we think that has a lot to do with the mechanisms in and around the enhancement of flexibility.
Ben: Interesting. Now there was another one about pressure to pain threshold. Looks like this one was pretty recent in the Journal of Strength Conditioning Research. What is pressure to pain threshold and what would that have to do with recovery?
Gilad: Sure. So pressure to pain threshold is really just an easy way of saying sometimes you feel pressure, sometimes you feel pain. This was also done, interestingly enough, at the US Olympic committee and published I think in the summer this year. What's really interesting is if you look at the world of athletic performance, when you try to objectively measure recovery, it's really not an easy thing, right? Wind tunnel testing is easy. Put the bike in there, you put it an athlete or a dummy on there and you see kind of what the properties are but when it comes to recovery there's a lot of subjective and it’s applied, maybe you're recovering in a place that’s air condition, well what effect does that have on the results? Maybe there’s nutritional aspect, maybe you like your massage therapist more than the other massage therapist. So there’s a lot of variables.
So to try to limit the variables and measure recoveries effective as possible, they have this device that's been around for about 30 years now called a muscle ergometer. And a muscle ergometer looks like an old school Ipod with a hard rubber tip. Totally noninvasive, just something that you would use and you push it down into the muscle belly so let’s say the quadriceps or the hamstrings which is two areas that were done I think the calf was done as well and you push down and the athletes like, “Okay, yeah, I’m feeling pressure, feeling pressure, feeling pressure.” And as soon as they feel pain they say ‘mark’ and you take a reading on this muscle ergometer and the ideas is the more recovered you are, the more downforce you can apply before the athlete indicates pain, right. We feel this, same thing, if you haven’t worked out in a couple of days, you're feeling really good, you can go and get a massage from your masseuse and they can really usually work a little harder and longer on you. If you're more sensitive because you're not recovered, you know that feeling of, “Okay. Wow. I'm actually, it hurts a little bit when you press. Don’t press too hard.” So that's an indicator of recovery and that's why it was used to measure recovery and the effects of the NormaTec.
Ben: Okay. Got it. So biomechanically we've got increased flexibility, we’ve got more pumping of blood and lymph flow and everything back out of the muscle tissue and then we've got almost like this increased pain threshold that allows us to push harder if we say like used to boots before an exercise session or before a race or before game day. Now what about biochemically? I noticed that there was another study that looked in the nitric oxide synthase and something called PGC-1 alpha. Can you get into what those are and how the boots effected those?
Gilad: Yes. So what's really interesting about that is we tend to really just look to the outside, a lot of times the body. How are we doing? How’s the muscles doing? How do they look? We’re very visual beings. But what's fascinating is now that the science is allowing us to get a really good in depth look at what's happening actually underneath everything within the bloodstream and the chemicals that are going on in the body and we are a big chemistry experiment as humans. And it’s amazing. All the various processes are happening in the body at any given moment. So one of the naturally occurring chemicals in the body is NO or nitric oxide, right. Not to be confused with nitrous oxide which is laughing gas that you get at the dentist’s office before a root canal, but nitric oxide actually is released in the endothelial cells which are the cells that line the walls of the arteries and when this chemical is released it actually acts as a vasodilator. It dilates or opens up the arteries and an easy way to think about this is if you have a garden hose and you’re trying to push water through it, you can push as hard as you want, but there's a limited amount of flow because the garden hose is a certain size. You now increased that garden hose, just by a little bit you’re gonna be able to get more blood flow going.
So it's really the body's way, one of the bodies ways, to move blood flow more effectively is to release this chemical and to some degree it’s kinda like this holy grail of how do we actually get this chemical to be released more often. You can't just say, “Okay, I wanna release nitric oxide. Body, go.” And it turns out that the NormaTec actually is being successful at inducing this response of this nitric oxide release. So we’re having a really interesting time to see kind of what are the bounds that we can actually push now that we can actually move blood flow more effectively through the release of this chemical.
Ben: Okay. So basically this Enos protein is going to cause vasodilation. What about the PGC-1 alpha, is that doing the same thing or is that working on a different system?
Gilad: So that's working on a different system and that's actually something that we're continuing to study. It's just very fascinating what's happening but I think, Ben, what you're getting into is exactly the point of this. Not just within the NormaTec are you feeling better which is great and very important. Not just is it doing things the actual muscle as we saw in some of these pressure to pain threshold and the stretching improvements, but we're also doing things on a biochemical level. And when you put this together you really start to see the layout and the overall kind of view that this technology now, if you're able to get it on your legs on a regular basis, is going to help many different facets of your athletic performance and not just one. So it's a constant adventure looking at what we're gonna be looking at next. The good news is when we started before we had any of this data back in the Kona Hotel, we knew that something was up because athletes were like you know, and a lot of times this is how these things start. Athletes do something, doesn’t make sense. We don't understand why and then the science starts to catch up to it and that's exactly what's happened here in the case of NormaTec.
Ben: Now you said you have hip attachments and arm attachments. How would hip attachment actually work? And what would one use that for?
Gilad: So what's really interesting is if you think about it, we have different things that happen to our bodies during workouts. So when you workout really hard, you go for a hard run, hard bike, hard swim whatever your discipline is, you're gonna feel stuff in your hamstrings, in your quads, especially calves are usually on fire the next day and it's important to kind of really massage those areas and it's obviously something that's done all the time with massage therapist. But when you're getting off the bike and you're getting on to the run, you’ve been in a certain position for a long time. So your hip flexors, your glute kneads, the top of your butt, all those areas need to kind of be stretched out and elongated and a lot of people spend a lot of time as I'm sure you do as well foam rolling, getting work done in those areas. So I was watching a Boston Bruins hockey game, we’re based in Boston, love the Bruins, and I was like, “Wow. You know these athletes a couple years ago they're wearing these hockey pants to protect that area between their knees and their groin, and basically to their belly button and lower back and hips and everything else. If they wanna protect that area maybe they wanna recover that too.”
So we started looking at what aspects of the body that type of attachment kind of hit the hockey pants. And we actually modeled it after and it feels tremendous and not only are you getting the upper quads and your groin, you're getting the lower back, you’re obliques, you're getting that whole area that sometimes is unfortunately kind of left out. And you can do it in a way that's very effective and that's probably the other thing that we find as well through the feedback from our athletes and our coaches is that this is something that you could do in the privacy of your own home or with your friends and family while you're engaging in something else. If you’re watching your favorite TV show. You can incorporate it very easily is the take-home message. So even if you could afford massage every single day which just about nobody can, right? Not even the Tour De France are getting necessarily massages every single day. You're able to do this every day and not have to disrupt your routine. So I know you're a big time guy on the computer, you’re on phones, you could be doing this while you’re doing up all of your work, your kids can be climbing on you and it can be something that's very effective and in the end not only does it have to work but we have to be smart enough to know that all the pressures that we have on us today, it needs to be able to be easily incorporated into your routine.
Ben: Yeah, and with the hips and the low back attachment, does that actually go far enough up to where it would affect your lumbar spine like let’s say after a long bike ride or something like that. Soreness after an activity like that or after sitting all day, does it have like a decompression effect?
Gilad: Yes. So what's interesting is if you think about what's going on when the boots are on your legs or on your arm sleeves, you’re 360 massaging action. So take your calf, right? So it’s massaging your calf, it’s also massaging your shin. When you start talking about the lower back, you have to think about what's going on on the other side so from your lower back the higher you go up, well you have your diaphragm starts to kinda hang out in that area and when you start compressing over the diaphragm, you start to have some challenges with breathing obviously, right? Because it’s gonna effect what's going on with your breath. So you can go about as high up as the bottom of your diaphragm, that’s in the front, because once you start compressing over that it’s somewhat uncomfortable.
Ben: Okay. Got it. Now what about the arm attachments? What are people using those for? Why did you designed those?
Gilad: Man, the arms are awesome. So just like with your legs even though those are the largest muscle groups in your body and every athlete more or less will do something with their legs. We have a lot of athletes who are focused for various reasons whether it's part of your sport, like swimming, on the upper body. We also have certain efforts that athletes do that are very specific to the upper body. So a great example is a professional quarterback or a baseball pitcher who really needs to make sure that their limbs are in the tip top shape. So when you have a swimmer that's going out there and they’re doing their pool sets the pool, being able to have the arms is gonna help the arms recover just like the boots are gonna be able to help the legs recovers as well. It really just feels great.
Ben: I was actually thinking about myself and how much I do a lot of upper body work, pull ups, et cetera, for obstacle course racing but then I also do a lot of typing and spend a lot of time basically using my forearms during the day. Do these go as far down as the forearms or are they just the upper arms?
Gilad: So we're really big on a full limb length attachment whether its arms or legs. We never really quite got those half boots or half arms that are out there compression socks that don't really go up all the way. So this is gonna go from your fingertips all the way up to your shoulder. It’s funny that you mentioned that you do obstacle course training, you would use it on that, but then also typing, one of the areas that we actually find somewhat funny when we first started but obviously it's a very serious component of what we do now is massage therapist actually get these NormaTec systems for their practice to be able to put the patients or their customers in before and or after massages, but then they’ll use it on themselves especially their hands that obviously gotta work on their profession at the end of the day to help themselves recover. So I wouldn't be surprised if you keep using the arms and your typing gets even faster.
Ben: Interesting. Okay. So are you guys going to eventually just get like a full body sleeve that you can basically climb into and lie inside like a caterpillar?
Gilad: That’d be pretty dope, huh?
Ben: Yeah, my kids have actually climbed inside my boots that I have. They can get their entire bodies inside. I think I sent you a photo of that.
Gilad: Yeah, it's pretty funny. You should see some of the larger size because obviously you’re a fit guy in and fit into our slimmer boots no problem but some of the larger athletes that you have, professional football and some of the throwers that you have with track and field, they need an even wider and roomier fit boot. So being able to do that is pretty interesting. Kids can easily make that a sleeping bag depending on how big they are.
Ben: Now you’ve got two different models. You have one called the Pulse and one called the Pulse Pro. What's the difference between those two?
Gilad: So we see online now on normatecrecovery.com is [33:23] ______, we launched a product at Kona this year. And it was just awesome ‘cause we’ve been going there, as you mentioned in the being part of this podcast, for like six, seven years and when we started it was this kind of travel beauty case size thing, if you will, like a very large shoebox and believe it or not the new unit, technology’s awesome, we spent a lot of time in NormaTec focusing not only on our technology of how to move blood flow in the body, but the technology that surrounds our equipment. So we’re constantly pushing the envelope. And what we just came out with this is new Pulse series product. So the pulse series, we have a more amateur level age group model, if you will, focus on recovery and we have a professional model called the NormaTec Pulse Pro. These systems that control units if you will are literally a quarter of the size of the original system that you saw on Kona seven years ago. And that was our first generation. Our second generation have been rocking for the last three to four years. The new system is half that size.
So being able to focus on the aesthetics, get the size and weight down, putting in batteries into it for continuous use rechargable lithium ion batteries which is a whole lot of fun and making it more accessible for people at a better price point is really what we're all about. So the two systems: the Pulse system is a non-touch interface you have this really great screen with buttons on the right and left that you can increase time, increase pressure, you can see what's going on at any given moment in the blue icons that are on the screens so you can see what zone is holding and releasing and pulsing and have the ability to get really awesome recovery with that. The Pro-model is really available to pro teams and professional athletes that has a four-and-a-half-inch beautiful full color touch screen interface where you can select all kinds of customize options depending on what your situation is and what your needs are.
Ben: Okay. Got it. So as far as the actual units themselves, are they something that you would consider to be somewhat portable? I mean, I know my unit right now it looks like it might be even a little bit larger than these newer units that you have set up and I've traveled with it in and had it in the car and things like that but are these even smaller? This Pulse and Pulse Pro? Like about what size would they be?
Gilad: Yeah, so the unit that you have right now which is our second generation and we sold a lot of them an athlete feedback has just been tremendous, about the size, we would say right about a car battery size?
Gilad: Yeah about a car battery size. So this new system is literally half the size. So imagine that it’s more tapered and contoured and it obviously looks a lot nicer too. We spent a lot of time and effort researching kind of a look and the feel of the product because we want it to not only be very effective but really be in line with what a professional and a true athlete comes to expect from their gear these days. Hit 2016 with a bang. So the system is half the size of the unit that you have. You can easily hold it in your hand to give you an idea of how big it is. The unit only weighs about three and a half pounds so it's very manageable whether you're a younger athlete, older athlete, somewhere in the middle, male, female. We really built it so that everybody could really utilize it effectively no matter what your age or background.
Ben: Okay. Last question. On your website and by the way for those of you listening in, I’ll put a link to all this stuff if you go to bengreenfieldfitness.com/spaceboots, bengreenfieldfitness.com/spaceboots. You’ll get a link to all the research and everything else that Gilad and I are talking about today. But on your website you have a list of a whole bunch of different locations that people can go to either rent time to sit in a NormaTec recovery system, check them out or buy them, and I noticed that an additional like CrossFit facilities and bike shops all over the US, you've also got the boots in a few of these cryo chambers like these cryo spas. Is there a way to actually combine these with ice? I’ve thought about before like putting ice packs in targeted locations that are injured or are especially sore after a workout and then pulling on the NormaTecs over the ice. Is that ill-advised or can you do something like that like combine ice with the NormaTecs?
Gilad: Sure. So you can do anything you want as long as it’s feeling good. I mean, we're big proponents of that. What happens with the icing world and it's very interesting most of icing started out because of this term ‘RICE’. You’ve heard of that rice? Rest, ice, compression, elevation. So where did that come from? That actually came from an orthopedic surgeon who wrote his bestselling New York Time's novel or book I should say, on sports injury prevention in the 1970s. And on like page 78 or something like that he coins the term ‘rice’ for the first time. First time it ever showed up in literature. Unfortunately, about a year ago, he's still around, his name is Doctor Gabe Mirkin and he actually published a position paper saying that he was wrong. Rice and ice specifically was the best that what was out there back in the seventies.
We know now actually that icing unfortunately is actually doing sometimes more damage than good and not as effective as we kind of want it. So icing from that perspective, it feels great if you're injured or if you worked out really hard and you want to throw yourself into icing, but if you think about what's actually happening, in a deep cryo, which is different than some of these cryo chambers and we talk about that as well, that you just mentioned that are on the website, it's limiting the blood flow coming from the heart which is why everything kinda tightens up when you jump in an ice bath, right. Everything kind of like shrinks up and tightens up around you and with your skin because it's limiting the amount of blood flow. So what we do sometimes, we do these contrast baths where you jump into cold and a couple of minutes later you’re jumping into hot and the idea is the cold tightens up on the vessel and the hot opens it up and then back and forth. You actually do that motion with your hands, the opening and closing, that's actually gonna go ahead and mimic kind of what the NormaTec does, clamping down and then releasing around you. So by actually not incorporating ice and focusing on how to massage with the air, we get unbelievable results. Now some of these cryo spas that are setting up, again, it's very much in line with the industry trend that we're seeing which is a move towards regeneration and recovery which is very important.
Ben: Yeah, I wrote about that in my book a little bit actually about how icing should ideally be always combined with compression to prevent some of that back flow.
Gilad: Right, and there's really just not a lot of research that's out there at all that talks about how icing with compression is more beneficial than just compression. And obviously now with NormaTec style compression that we patented, we're getting even better results. So it's kind of a new school thought on an old school technique and more research obviously needs to be done, but if you look at what the pro and college teams are doing, we go into these training rooms and facilities every day of the week with our staff to make sure that the NormaTecs are getting the use that they need to be getting and answer on all questions that they have and you really see them kind of moving away from traditional kind of old school icing.
Ben: Yeah. Interesting. Well, I'll continue to drop ice into the NormaTecs when use them then, occasionally. It seems to be working quite well. Like I mentioned, folks, if you want to check out these boots for yourself you can go to bengreenfieldfitness.com/spaceboots because there I now only have a link with a nice discount for you on a set of boots for yourself but also linked to some of this research that's been done in the Journals of Strength Conditioning Research, and also the Journal of Experimental Physiology and The European Journal of Applied Physiology on these boots. I generally don't tend to spend much time messing around with stuff that hasn't been proven by science to actually work and so I appreciate that these things not only make my legs feel light as a feather but it's also not just a placebo. So check out the show notes over at bengreenfieldfitness.com/spaceboots, and Gilad, I’m hoping to perhaps see you in Kona in 2016. You plan on going back?
Gilad: Absolutely. Every year we seem to have a bigger and bigger presence and we’re actually Ironman partners for their US series for 2015 and 2016 which is just a really great opportunity for us and continues the trend of excellence in athlete performance in Ironman and in the 70.3 series. So it's been a lot fun and we’re looking forward to what's next.
Ben: Sweet. Alright. Well folks, like I said, you can get yourself a fat discount on these things if you go to bengreenfieldfitness.com/spacebootshttps://bengreenfieldfitness.com/spaceboots and until next time, I’m Ben greenfield along with Gilad Jacobs from NormaTec boots signing out from the bengreenfieldfitness.com podcast. Have a great week.
Nearly six years ago, in a tiny hotel room lobby in Kona, Hawaii, I met a guy named Gilad Jacobs.
Gilad was holding a black box about the size of a shoebox, and had two big, space-agey looking boots with him, which attached to the box via two air tubes. I fumbled my way into the slightly awkward, hip-high boots, then sat in a chair as the black box pumped air in and out of the boots.
I'll admit: six years ago it was a little hokey, and I wasn't quite sure whether the things actually worked to make my legs “more fresh”.
But since then, Gilad and that tiny black box have come a long way. His company NormaTec is now one of the world's leader in rapid recovery, and give a competitive edge to a host of the world’s elite athletes, coaches, and trainers, including…
Pro triathletes like:
Pro cyclists like:
Pro runners like:
Crossfit athletes like:
NBA basketball players like:
NFL football players like:
Those old-school boots I tried on many years ago have now evolved into something called the NormaTec PULSE Recovery Systems, a dynamic compression device designed for recovery and rehab, and something I personally use nearly every day now.
The NormaTec systems include a control unit and attachments which go on the legs, arms, or hips. They use compressed air to massage your limbs, mobilize fluid, and speed recovery with a pulsed massage pattern.
When you use a Normatec system, you will first experience a pre-inflate cycle, during which the connected attachments are molded to your exact body shape. The session will then begin by compressing your feet, hands, or upper quad (depending on which attachment you are using). Similar to the kneading and stroking done during a massage, each segment of the attachment will first compress in a pulsing manner and then release. This will repeat for each segment of the attachment as the compression pattern works its way up your limb.
Today, I interview Gilad, who serves as Vice President of Sports Medicine at NormaTec Industries, LP. He leads NormaTec's Sports Medicine division, which he established in 2007, and is responsible for sales to pro teams, top college and Olympic programs, and elite and amateur athletes.
During our discussion, you'll discover:
-How these space-age boots took the leap from being a pure medical device to being an underground method for athletes to recover faster…
-The main differences between pulsed compression in the compression boots and regular compression from something like compression socks and compression tights…
-What happens biomechanically when you wear the boots, particularly for flexibility, arterial function, pumping of blood and lymph…
-Two chemicals that get released in response to pulsed compression that massively dilate the arteries…
-How the Normatec system can compress your hips and your arms…
-And much more!
Resources from this episode:
-Study: DYNAMIC COMPRESSION ENHANCES PRESSURE-TO-PAIN THRESHOLD IN ELITE ATHLETE RECOVERY: EXPLORATORY STUDY – Journal of Strength & Conditioning Research 2015 May; 29(5):1263-72
“The purpose of this study was to assess peristaltic pulse dynamic compression (PPDC) in reducing short-term pressure-to-pain threshold (PPT) among Olympic Training Center athletes after morning training. […] We conclude that PPDC is a promising means of accelerating and enhancing recovery after the normal aggressive training that occurs in Olympic and aspiring Olympic athletes.” —view article on pubmed.
-Study: PERISTALTIC PULSE COMPRESSION UPREGULATES PGC-1Α AND ENOS IN HUMAN MUSCLE TISSUE – Experimental Physiology 2015 May 15
“We investigated whether a single 60 min bout of whole-leg, lower pressure external pneumatic compression (EPC) altered select vascular, metabolic, antioxidant and inflammation-related mRNAs. […] An acute bout of EPC transiently upregulates PGC-1α mRNA, while also upregulating eNOS protein and NOx concentrations in vastus lateralis biopsy samples” —view article on pubmed.
-Study: PERISTALTIC PULSE COMPRESSION OF THE LOWER EXTREMITY ENHANCES FLEXIBILITY – Journal of Strength & Conditioning Research 2014 Apr; 28(4):1058-64
“This study investigated the effects of peristaltic pulse dynamic compression (PPDC) on range-of-motion (ROM) changes in forward splits. […] PPDC provides a means of rapidly enhancing acute ROM requiring less discomfort and time.” —view article on pubmed.
-Study: PERIPHERAL CONDUIT AND RESISTANCE ARTERY FUNCTION ARE IMPROVED FOLLOWING PERISTALTIC PULSE COMPRESSION – European Journal of Applied Physiology 2015 May 16
“The purpose of this study was to determine the acute effects of a single bout of peristaltic pulse EPC on peripheral conduit and resistance artery function. […] Acutely, whole limb, lower pressure EPC improves conduit artery endothelial function systemically, but only improves RH blood flow locally (i.e., compressed limbs).” —view article on pubmed.