Episode #55:

Purpose Driven with Malcolm Cook

I love bringing you fitness-related topics and my guest this week, along with his wife, has pioneered a safe space and an approach to fitness that encourages and empowers all kinds of people, but especially women. As we get older, looking after our bodies matters more and more, so I’m thrilled to bring you this conversation about purpose-driven fitness.

My guest to discuss this topic is fitness expert, world-ranked CrossFit competitor, and co-owner of LivingStone Athletics, Malcolm Cook. I first met Malcolm and got to know him when he was my regular surgery tech, but we’ve taking a step out of the OR this week to discuss purpose-driven fitness.

Tune in this week to discover how to bring more purpose to your fitness journey. We’re discussing practical tips for building strength and avoiding injury as we get older, and Malcolm is diving into what purpose-driven fitness entails and how we can bring more purpose and presence to our lives as a whole.

WHAT YOU’LL DISCOVER



What Malcolm and his wife Michelle have created at LivingStone Athletics.



The support and intentionality it takes to encourage others in the fitness space.



Our thoughts on longevity and living a long life.



Why maintaining our muscle strength matters more as we get older.



The kinds of exercises that strengthen and condition your body the most.



How to build muscle over time while mitigating fatigue and injury.



What purpose-driven fitness is and Malcolm’s tips for being more purposeful.

FEATURED ON THE SHOW



LivingStone Athletics: Website | Facebook | Instagram | ClassPass



Episode #53: Female Fitness Through All Ages and Stages with Michelle Cook



Peter Diamandis



Peter Attia



The Untethered Soul by Michael Alan Singer

TRANSCRIPT

Malcolm: One of the things that we practice is really realizing that every-body's at a different place, but that they have the ability to reach ultimate movements and to some degree, you know what I mean? So.

Dr. Crockett: From wherever they are.

Malcolm: From wherever they are.

Welcome to Becoming Virtuosa, the podcast with Dr. Susan Crockett. You are listening to episode number 55, Purpose Driven, an interview with fit-ness expert, world ranked CrossFit competitor, and the co-owner of Living-Stone Athletics, Malcolm Cook.

Welcome to Becoming Virtuosa, the podcast that encourages you to be-come your best virtuosa self. Each week Dr. Susan Crockett goes where the scalpel can't reach, exploring conversations about how to be, heal, love, give, grow, pray, and attune. For the first time ever, she's bringing the per-sonal one on one teaching that she shares with individual patients to you on this broader platform. A weekly source of inspiration and encouragement designed to empower you.

By evolving ourselves as individuals. We influence and transform the world around us. Please help me welcome board certified OB-GYN specializing in minimally invasive GYN surgery, internationally in the top 1% of all GYN ro-botic surgeons, a certified life coach, and US News top doctor, your host Susan A. Crockett, MD.

Dr. Crockett: Today, Malcolm and I are going to talk a little bit more about purpose driven fitness, about his gym. He owns LivingStone Athletics here in San Antonio along with his beautiful wife. He and I know each other though from the surgery world.

So I think this is really cool because those of you who are watching the show for a while know that this show is not about surgery. We are going with a scalpel can’t reach. That's our tagline.

Malcolm: I love that.

Dr. Crockett: But Malcolm and I might talk a little bit about the scalpel be-cause he and I have known each other for nine years.

Malcolm: Nine years. Yes, it's been about that long.

Dr. Crockett: From the operating room.

Malcolm: That’s our relationship, where it started from right?

Dr. Crockett: Yeah, from the scalpel. From you handing it to me in the oper-ating room.

Malcolm: Exactly. From you saying scalpel and then here you go.

Dr. Crockett: Yeah. So Malcolm was my regular surgical tech when I was in the beginning of my robotic surgery practice. It's been really exciting to see him and Michelle grow as they've developed their fitness career. He still comes in and operates every once in a while. But we have some really great conversations in the OR about all kinds of stuff that's not the OR.

So, when we were planning on creating the show, I really wanted somebody to be able to talk about fitness on the show because this shows about be-coming the best version of ourselves. I've got the food thing down pretty well, the whole food plant-based thing. I'm really good at the sleeping part, which is part of it. But the fitness thing, I need some help.

So I wanted to start by kind of picking up where we left off with Michelle. We talked a little bit about just the client culture in your gym. About how you're family oriented, that you've created this safe space. But one of the most im-portant things that she talked about was the relationship between men and women and that encouraging women in the gym and in life. I just I think you're just a poster child for that. So.

Malcolm: Wow, thank you for that compliment very much. But are you talk-ing about championing women into fitness?

Dr. Crockett: Yeah.

Malcolm: Yes, absolutely. My wife is in incredible shape. But it's been over this journey of her kind of evolving, like I've seen her go from basically struggling to eat certain foods to make it into the gym, things like that. Then she now is pushing me out of the way to get to like the assault bike or to the whatever it might be exercise equipment.

But what I've seen her do is transform her body by doing that, and I'm so grateful as far as like being able to have the opportunity to just be around her and have that space of inviting her in. Because initially I started doing the gym and getting into fitness, and she was a little bit rebellious to it. I don't know if rebellious is the right word. I guess it would be like I don't know if I want to go as much as you.

Dr. Crockett: Well, she had a different career. You guys weren't doing it to-gether in the beginning either.

Malcolm: Yes, yes, exactly. So after a while, I've just seen her evolve and it's been so great. I don't know that I would want a world without her there, but I know, but it's amazing to see her grow and to become more confident at the stage in life she's in. I think that's the biggest reward for me is to see her, to feel like she's just getting started, and the sense of like man, she's in her mid-40s, approaching her 50s, and realizing like man, I've still got a lot of life and vitality in me.

Dr. Crockett: How are we going to be in that second half of life as women?

Malcolm: Exactly, yeah.

Dr. Crockett: How do we even have those conversations with the men in our lives? So I think this is a really cool example. I'm grateful for you coming on the show and actually having a conversation about having that conversation with your wife. So it's not just that you're supportive of each other, which is just a beautiful thing to watch you guys together.

But the intentionality that you have to lift each other up and to lift her up, and that you also see the benefit of that because she's healthier and stronger because you're supporting her. So that helps you have a healthier, stronger wife going into the second half of life.

Malcolm: Absolutely. Yeah. I've heard you mentioned before that you want to live to be 120 years old. That's actually something I believe in very, very much is longevity. I want her there with me to do that. I think she might actu-ally outlive me, but it's really a thing of us supporting each other more than anything because she's very supportive of me as well.

Dr. Crockett: Yeah. So that's a wonderful thing. I know you and I have had conversations about the podcasts that we listen to. So we're sitting there operating on patients. We start talking about what have you listened to, or what are you doing in your gym or your other business? So Peter Diaman-dis is one of the ones that first gave me the idea of becoming interested in sustainability or longevity medicine.

Malcolm: Okay.

Dr. Crockett: I heard him do a podcast with it was either Rich Roll or Lewis Howes or somebody where he was talking about the window of time where we're close to being able to live a year for every year we grow older. So there's like this convergence of how much health we can gain from healthier being or healthier technologies, how we eat, and take care of ourselves.

With artificial intelligence coming in and medical technology and genetics becoming the way things are, unless we die from like a trauma or something like that, we're getting very close to being able to live a year for every year we grow older. That point is like within 10 years or something crazy like that.

Malcolm: That's amazing. Yeah.

Dr. Crockett: It was kind of crazy.

Malcolm: I'm so excited to hear that.

Dr. Crockett: Right? Okay, so exercise is one of the big parts of that be-cause maintaining our muscle strength is really important to maintaining our flexibility and our ability to not fall and to not die from traumatic causes as we get older. So I wanted you just talk a little bit about the physiology of working out and who are you listening to on the podcast? What are you learning?

Malcolm: So a big one for me is Peter Attia. I just heard him, and also just chatting with you in the OR as well, but really about building like a base of strength or muscle for yourself as you get older, right? Continuing to live with that base of strength as something you can carry on because one thing that I specifically would like with Michelle that I've seen.

I've heard like Peter Attia talk about it, but I've seen real time and specifically to a woman, my wife, is that she's really built a base of strength. I've noticed her health and vitality improve. It's amazing just to watch real time how that's actually happening.

Dr. Crockett: It’s important, especially for those of us in midlife life. I mean, anytime in life, but especially as we're transitioning. So how long did it take her and what kind of intensity? Like what did you guys do for her to be able to have that transformation? I'm so curious.

Malcolm: So in terms of building that base of strength, I think the one thing when it comes to working with any type of client, whether it's male, female, all ages, but specifically in relation to people getting older is realizing that it takes time. So knowing that as you age, you want to do something now to carry you into those later stages of life.

But realizing that as you start to build that strength base for yourself, and, of course, you want to do mobility along with this as well. That's a really im-portant thing. So mobility with strength is something is just as important right? Because obviously as you build strength, you want to be like lack of mobility is also the risk of potentially breaking bones or getting into an unfa-vorable position with your body and risking injury and stuff like that.

But the thing that I would say is like as you build your strength, or as I've seen people build strength over time, it's one of those things where you see on a day to day basis that it's okay. Or how should I say this? How do I want to frame this?

It's really one of those things where by doing back squats, by doing dead-lifts, by doing shoulder presses, all the stuff that we would in the gym as trainers have athletes do, that it's moving with compound joint movements on your body so that way you can start to develop that skeletal muscle. So, in turn, it would start to basically increase your body strength and vitality.

So over time, you would start to notice like man, I feel strong. I'm able to move on to like a greater movement. I'm able to have more endurance in other areas of my life. There's a lot of crossover there too you know.

Dr. Crockett: I'm going to back up just a second. What's a compound movement?

Malcolm: Yeah, a compound movement is going to be something like a back squat. So like, for example, if you're squatting with weight on your back, and you squat, it's two or more joints involved in an actual lift.

Dr. Crockett: Okay. So it's not just an isolated single joint. It's when you're using multiple different joints.

Malcolm: Exactly, exactly. So one of the big things I think a lot of people have done in the past that they've done like single plane. They've done like curls or like leg extensions, things like that. They definitely have their place for like rehab. I've used that a lot to help rehab joints for clients and things like that because you definitely need that. But when it comes to compound joint movements, that's going to really help with like testosterone production.

Dr. Crockett: Really?

Malcolm: Yeah, absolutely. There's definitely been the science behind that that’s shown that specifically, I mean, I know that you're going to know this better than I will as far as like well when it comes to women and also in like latter stages of life pre-menopausal and perimenopausal and stuff like that.

But specifically, when it comes to men, I know that, and also younger wom-en as well, is that it will increase testosterone production for them when you do movements that are a compound joint movements.

Dr. Crockett: Well, it also works more than one muscle at once. I've heard that from multiple sources. So I've been, I need to get in the gym. I know I need to do strength training. I'm a triathlete who's not training. I haven't trained for over a year.

Malcolm: Nice. I didn't know that. Wow.

Dr. Crockett: You didn't know that? After all these years.

Malcolm: I didn’t know you were a triathlete. Yeah.

Dr. Crockett: So I love triathlon training because I like to be outside. No of-fense to the gym, but I like to be outside. I like that I can do a run one day, a bike another day, and swim and work different muscle groups, and not just this same muscle groups over and over again.

Malcolm: I love it. Yeah.

Dr. Crockett: So but my base for my strength right now and my cardio is so low that I really can't even do that. So I've been studying and working on my motivation. You have to have the idea of doing it before you can actually move, but I'm confused about the menopausal thing. Because I have some sources that say we ought to just be doing like the phase two cardio where it's like relative low intensity and just get out and do a walk. That's all you need, which is more attractive to me because I have a harder time with re-covery. I want to touch on that too, inflammation and recovery.

Malcolm: Okay yes.

Dr. Crockett: But and then I'm seeing some newer stuff that says no, we ought to be doing the high impact training, and that we need to be lifting heavy things and really going to muscle fatigue. That's harder for me to consider because it sounds like it hurts.

Malcolm: So I would 100% agree with all of it. The reason why I say that is because I've seen, working in the space of fitness, all of it works. But I think it definitely has its time and place though. So one of the things I think is so important is understanding where you are as an individual as far as like your fitness level, what's going on as far as your body and the stages you're in, in life.

So by doing that, then you can just realize that you're not going to dive in and go super hard because one, you risk injury. But at the same time, it's going to allow you, again, to build over time. You know what I mean? I just believe in that I believe and making it not only from the physical standpoint, but from the mental standpoint of it being tolerable to yourself. I've seen that work with a lot of athletes.

I call all my clients athletes because I really believe that everyone has the potential to become an athlete. Really one of the big things, and this is not a plug for my gym or anything, but one of the things that we practice is really realizing that everybody's at a different place, but that they have the ability to reach ultimate movements to some degree. You know what I mean?

Dr. Crockett: From wherever they are.

Malcolm: From wherever they are. That you will have a starting point, but that you can get to a place. When it comes to, like you had mentioned earli-er, about like moving heavy loads, I do agree with that because that's where you're going to get the production of testosterone. You know what I mean?

Dr. Crockett: Okay. We need that even as women.

Malcolm: Yes.

Dr. Crockett: We don't make as much as men. In fact, men will continue to, their testosterone will dip in mid-life, but then it continues to increase actual-ly until.

Malcolm: Awesome. That's so good to hear.

Dr. Crockett: Women don't do that. Women, when they go through meno-pause, their testosterone production from their ovary drops off, and then it doesn't go up towards the end of life. So, and testosterone is so important for that muscle and strength building. So for you to say that the heavy weight lifting helps with that, we're tapping into our adrenal source at that point. I think that's probably going to be key for menopausal strength and muscle building.

Malcolm: Do you give or do you prescribe any kind of testosterone for women as they, you do?

Dr. Crockett: Our clinic does. I focus mostly on surgery.

Malcolm: Okay.

Dr. Crockett: But I have three nurse practitioners that work for me. One of them is doing her Functional Medicine degree, and she does our hormone replacement therapy, bioidenticals.

Malcolm: I think that's amazing by the way.

Dr. Crockett: She's incredible. Her name is Sybil, and yeah, she does tele-health. So, yeah, if y'all need help with that.

Malcolm: I mean I think it's so smart. You're out doing what you do, and then having that as well.

Dr. Crockett: Well, I think people need it. So I think the hormone replace-ment thing is very important. Testosterone, I don't think is for all women. It's not as consistent. It doesn't have the same reproducible effects in women as it does in men, like dose related effects. It's not so clear, a linear associa-tion between giving the testosterone and having libido and physical like muscle strength.

In women, we can see some negative effects. So it's not my favorite go to. I feel much more strongly about estrogen replacement with progesterone. Testosterone is kind of third on my list for women who want it mostly for vi-tality in gym, I think is really good. But, again, in small doses. We don't want to grow a beard. We don't want to have a deep voice. It can kind of mess you up a bit.

Malcolm: For sure. For sure. Absolutely.

Dr. Crockett: But yeah, I think it's appropriate in cases. But I really try to fo-cus more on what we do have, which is the adrenal function. I want to switch gears and talk about recovery. I just struggle so much of that. I start-ed doing cold plunging after listening to Andrew Hubermann stuff a little while ago, about a month ago. I found that that's really helpful for me be-cause I get so. I don't have any autoimmune disorders, sorry.

Full disclosure you guys, like I don't have, thankfully knock on wood, like rheumatoid arthritis or anything like that. I'm relatively healthy. I'm really healthy. But I still like two days after a workout, man, it just I'm so stiff and so sore. So tell me what you recommend, or what you've seen helps?

Malcolm: Absolutely. I think that's a great question. Because that's going to be like limiting you from the frequency by which you train, right?

Dr. Crockett: It has.

Malcolm: Yeah. So yeah, absolutely. One of the big things at the gym that I tell people is, there's a couple of things. If you have access to obviously like heat and cold where obviously water is going to be the most penetrating cold. That is huge. But a lot of people don't just because that's not the norm as of now. But I believe it's going to change, you know what I mean? You're going to start to see that a lot.

Dr. Crockett: I think it's picking up.

Malcolm: I want a couple at the gym actually. Cold dunk tanks, yeah.

Dr. Crockett: So I do a 50 something degree tank for five minutes. Then I go in a sauna for 15 minutes, and then I go back in the tank for three to five minutes.

Malcolm: Very cool. Yes.

Dr. Crockett: It feels amazing. I feel great. So.

Malcolm: So I think that's fantastic. I believe the with also doing zone two, that's going to be a powerful tool. The reason I've seen zone two work with me and also some of our competitive athletes, but even athletes that are not competing. They're telling me exactly what you're saying. Like hey, I've done two days, and I just do not, I don't want to get out of bed. I just want to sleep.

I tell them to start doing a minimum of 20 minutes of zone two up to about 40 minutes. It just depends on their time and whether they can concentrate and just stay there and do that. But I mean, obviously Peter Attia talks about like mitochondrial density and stuff like that. You know how that works for like longevity and everything, but what I've experienced is it makes your body efficient for evacuating lactic acid.

So, that's the big thing about it. It's going to take a little bit to build to that. The good thing about zone two is it's not like super taxing on the body. So you can do it more frequently. I would say to get like the perfect timeframe, I've heard two to three days a week you want to be doing that with strength training. Peter Attia talks about that kind of stuff a couple of days a week with strength training. But what I've experienced in the gym, the athletes that actually do that, I've noticed that they've been able to clear a lot of that lactic acid.

Dr. Crockett: Which is what makes us feel sore.

Malcolm: Exactly.

Dr. Crockett: They can clear it easier.

Malcolm: Yes. So it is a process. Like your body becomes more efficient over time though. That's the thing. So once you start to develop that, it'll start to do that. I've noticed it with myself. So I do zone two probably three days a week. Michelle does zone two like five days a week.

Dr. Crockett: Wow, okay.

Malcolm: Yeah. So it's a very powerful tool. It's also what's really great about it too is it'll also give you like long, slow endurance increase like for the men-tal gain for that, but also increasing your capacity there as well. Because it is 70% of your heart rate, 70 to 77% of your heart rate maintaining that. That's the best way to do it anyway.

Dr. Crockett: So that you can kind of be more gentle. So I love that we've gotten kind of through this arc in talking with you about doing the exercise, getting, well, first setting the stage for the gym being a supportive place. Just the amazing work that you do around this being a purpose driven call-ing on your life to getting into the physiology. I was talking with Michelle about the feminine hormones and that side of it, and then talking a little bit about the rest of recovery. Well, we talked about recovery a little bit.

I want to end on rest and the purpose driven thing, kind of come back to that a little bit. So we always do with our guests a meal before the podcast here, like we did today with you guys.

Malcolm: So good.

Dr. Crockett: Thank you. It's fun though because we have the conversations that we cultivate the show from, and we get to know each other and have a good time. So one of the things that came out in our pre-show conversation was this idea of meditation and being still. We were talking about how hard that is to do in our world. I think it dovetails nicely into the idea that you guys about everything here being in your lives being purpose driven and the people are first.

It's such a loving centered place where you're reaching out to others. It hap-pens to be through the fitness and the fitness industry. So I put my little, we have our little mascot here, our little gnome. I put him on the be still block to-day to remind us about that.

Malcolm: He's very calming. He seems like he's being very still and in such a good way as an example for us.

Dr. Crockett: Yeah. So when I talk with people about meditation in the office, I think that's a big part about recovery, even the physical recovery, but more so mental with stress, right?

Malcolm: Yeah.

Dr. Crockett: I put some books back over you. The one that I recommend all the time is the Untethered Soul. I think a lot of times in our Western Chris-tianized culture, we hear meditation and we think oh, they're going to try to put some other religion on me or it's going to go against my beliefs, or I don't know how to do it. Or I have to pick up my phone or my brain won't shut off.

I think that book by Michael Singer is really helpful to kind of explain those more Eastern ideas with how we can incorporate it into our Western philos-ophies. But this idea about be still crosses all kinds of religious cultures. Christian, Jewish, Buddhist. So the way I like to teach people is that it's the listening part.

Malcolm: Yes.

Dr. Crockett: So we're talking about prayer being, a lot of times we're asking for things. But in order for you guys to have your purpose driven gym, your purpose driven fitness, you had to develop that ability to be still and to actu-ally hear what the incoming messages from God, universe, whatever people want to call it, what those things are. So how do you practice that? How did you get to the purpose driven thing with your practice?

Malcolm: I love this subject by the way. Thank you for bringing it up. Be still. With me in particular, I would say that it is probably one of the hardest things for me to do. So I realized that about myself some years back. I'm 50. So I would say around late 30s I realized like man, I just need to reflect and sometimes just stop and be still. So I started the practice of that by starting my mornings with being still, you know what I mean?

You brought up the message of contemplative prayer. Right? So I started doing that, well nothing's, I don't believe anything's by accident, but kind of by accident back then by just finding a place of really adding sort of like this recharge to my mind in my heart, right? Because yeah, right? Yeah, be-cause I realized that if I'm doing, doing, doing right, if I'm going because in my heart and soul, I want to provide like for my wife. I want to do all these things that are my purpose.

But, and for me a lot of times, it's like I have these tasks and these things to do. But what's going to give me what I need in order to do those things. I re-alized that man, being still has like this power to hear from something that's much greater than me. I receive these things. Sometimes it's just like I per-sonally believe in Jesus, and I believe in that power. So for me, it's just like you are loved.

Dr. Crockett: Oh my gosh. That’s so powerful.

Malcolm: Man, that's been a huge tool for me to continue to go. I also be-lieve I have some people think this is kind of, I don't know, brutish in a way, but if it's framed properly, it's actually really great. I believe that in that time, like what is it to be a warrior and receiving that. Like, I come from a military background, and it taught me a lot.

But by hearing that and knowing what that is, and that's being able to be of service and love and do these things and show up all the time for the people I love and you know who I want to be. I believe the warrior is, it's not just a male. It's male, female. But like, for me it's like receiving the confirmation of like that from God, from the Holy Spirit. You know?

Dr. Crockett: Yeah. It's such a nice balance between the moving and the be-ing still, being able to do your purpose and hear the next step.

Malcolm: Yeah, absolutely.

Dr. Crockett: Wonderful. What a wonderful way to end our series of inter-views together. Yeah. Thank you so much. Thanks for being on the show, you and Michelle, and thanks for all you're doing in our community. You want to tell our audience one more time where they can find you?

Malcolm: Oh, yeah. We are in downtown San Antonio near the Pearl Brew-ery. We are on Facebook and also Instagram and at livingstoneathlet-ics.com.

Dr. Crockett: LivingStone Athletics. Thank you all for joining in. I hope you found this conversation enlightening and helpful for you. If you liked it, would you drop us a like or comment, maybe share it with a friend if you think they could use similar information. If you've got ideas about other things we should talk about on the show, drop them in the comments below. Let me know. I'd love to hear from you. Until next week, take care. I'll see you next week. Bye.

Thanks for listening to this episode of Becoming Virtuosa. To learn more, come visit us at DrCrockett.com, or find us on YouTube for the Dr. Crockett Show. If you found this episode helpful or think it might help someone else, please like, subscribe, and share. This is how we grow together. Thanks, and I'll see you next week. Love always, Sue.

DOWNLOAD THE TRANSCRIPT