The Tim Ferriss Show Transcripts: Dr. Stefi Cohen — 25 World Records, Power Training, Deadlifting 4.4x Bodyweight, Sports Psychology, Overcoming Pain, and More (#491)

Please enjoy this transcript of my interview with Stefi Cohen (@steficohen), a 25x world-record-holding powerlifter and the first woman in the history of the sport to deadlift 4.4x her body weight. She is a doctor of physical therapy, author, co-host of the Hybrid Unlimited podcast, and business owner passionately educating people with her NO BS, evidence-based view on all things training and nutrition.

Stefi is the co-owner of Hybrid Performance Method, where hundreds of thousands of strength seekers go monthly to find progressive strength training and nutrition programs plus tons of free articles and videos. Stefi is a creative mind and loves collaborating with the Hybrid team and partners to develop powerful content, inspired fashion, and both fitness and nutrition tools for a stronger life.

Stefi is also the co-author (with Ian Kaplan) of Back in Motion, now available for pre-order.

Transcripts may contain a few typos. With some episodes lasting 2+ hours, it can be difficult to catch minor errors. Enjoy!

Listen to the episode on Apple Podcasts, Spotify, Overcast, Stitcher, Castbox, Google Podcasts, or on your favorite podcast platform.

#491: Dr. Stefi Cohen — 25 World Records, Power Training, Deadlifting 4.4x Bodyweight, Sports Psychology, Overcoming Pain, and More
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This interview was transcribed by Rev.com.

Tim Ferriss: Hello, boys and girls, ladies, and germs. This is Tim Ferriss, and welcome to another episode of the Tim Ferriss Show, where it is my job to interview and attempt to deconstruct world-class performers of all different types, from all different fields. My guest today, Stefi Cohen, S-T-E-F-I, Cohen. On Instagram @StefiCohen. She is a 25-time world record holding powerlifter, and the first woman in the history of the sport to deadlift 4.4 times her body weight. We will give some examples of what that might mean. I weigh around 170 pounds, so that means I have to deadlift, I think, around 748 pounds. I’ve got a ways to go, but we’re not going to turn this into my therapy session just yet. Stefi is a doctor of physical therapy, author, podcast host, and business owner, passionately educating people with her evidence-based view on all things training and nutrition.

She’s the co-owner of Hybrid Performance Method, where hundreds of thousands of strength seekers go monthly to find progressive strength training and nutrition programs, plus tons of free articles and videos. Stefi is a creative mind. Loves collaborating with the hybrid team and partners to develop powerful content inspired fashion in both fitness and nutrition tools for a stronger life. Her new book is Back In Motion, which we will certainly talk about at one point.

And you can find her all over the place. Website, hybridperformancemethod.com. Instagram, if you want to be both impressed, astonished, and maybe feel like you need to put in some more work, you can go to Instagram @StefiCohen. Again, that’s S-T-E-F-I. You can find her on YouTube easily. She has a podcast, Hybrid Unlimited. 

Stefi, welcome to the show.

Stefi Cohen: Thank you so much, Tim. Thank you for having me. I’m super excited to be here.

Tim Ferriss: I’m excited to have you on. I’ve been texting with some mutual friends of ours. I want to give credit where credit is due to Matt Vincent for initially suggesting that this happen. For those who don’t know Matt, incredible athlete, Highland Games, and beyond. Also, an all around wacky hilarious character, who despite being built like a grizzly bear, can also out mountain bike me over many, many hundreds of miles, which really broke my spirit. But, that’s a separate story.

Stefi Cohen: Is that so?

Tim Ferriss: Yeah, I was like, he’s going to look like a bear on a tricycle. Definitely I won’t be in last place; he just had knee surgery. And then smoked, completely smoked me. Kelly Starrett, also. And I have an embarrassment of riches here in terms of questions for you, because I have done my homework, I believe, and there are an infinite number of directions we can go. I thought we would start, and I very rarely start biographically, but I think here it could be interesting, at least it’s my curiosity. Where were you born? And what was your childhood like?

Stefi Cohen: I was born in Caracas, Venezuela, South America. I’m a Venezuelan Jew, so I was born in a very traditional household. Most of my childhood, I spent playing soccer. I played soccer for the national Venezuelan soccer team, which sounds a lot more impressive than what it actually was like. There was not a lot of funding from the government for professional sports back home, so we played in dirt fields. We played in a field that was located at the military base, which was interesting. And just traveling in the inner parts of the country was super eye opening for me, given that I come from a more kind of sheltered family environment.

My dream with soccer was always to get into a D1 team, or play professional soccer. I really wanted to play professionally in any capacity for a long time. Ended up moving to the States. Looking for a soccer scholarship, moved to San Diego. I guess I don’t know how far you want me to go there, but that’s where I come from.

Tim Ferriss: Yeah, we’re going to go pretty far with it. For those who have never been to Venezuela, and you’re actually the second Venezuelan-born guest I’ve had on the show. The first is Jason Silva, who is definitely Venezuelano.

Stefi Cohen: Okay.

Tim Ferriss: I would love to just hear you describe what your experience was like, or rather, the reasons for leaving Venezuela, and at what age.

Stefi Cohen: I don’t have many memories of Venezuela as a peaceful, tranquil, friendly country. When I was already grown up, when I was 10, 12, the country started getting pretty dangerous. There was a lot of political and economical unrest. There was a lot of divide between social classes. There was a lot of corruption, dictatorship disguised as a socialist government. Growing up there is very differently than anything in any other country really. Talking about bulletproof cars, I’m talking about bodyguards. Talking about constant fear anytime you get out of your house to either be kidnapped, either be shot, either be armed robbed, either be, I don’t know, taken into your house and getting everything stolen from you. It’s a very kind of high stress, high alert way to live, and I guess when you don’t know anything better, that just becomes your norm. When you grow up in an environment that’s a certain way, you grow up to accept that, that’s just, I guess, how the world works.

So, very sheltered. You’re always spending time within the same groups, with the same people, going to and from the same places. Not really socializing much outside of that. You live in your little kind of crystal ball, essentially. And, at the time, I think this was 1998 or 2002, I can’t remember which one of those elections was, when there was a civil war. Chavez, the president at that time, didn’t win the elections, and there was this huge civil war. A ton of people died. My dad was in the protest. I went to the protest. It was very graphic. It was a very interesting time to live and very interesting experience as well. I guess that’s when that all happened, and I guess Chavez got back into power somehow, even though he wasn’t elected by the people.

At that time, it was very clear to me and my family that there was just not going to be anything that could save that country. The wrong people are in power, and the wrong people will seemingly continue to be in power, and there’s nothing that anybody can do. So I actually was one of the first of my circle of friends to venture out of the country, and make the decision to move out of the country. It was a time where people were still a little bit optimistic. There were elections coming up again. A little bit, there were some things to look forward to, but my mom didn’t want to take the risk. And she was actually the one that encouraged me to apply for a scholarship in the US, and to make the decision to move, which was very difficult, especially given that, you know how I said that when you live in such a sheltered environment, stepping outside of that kind of comfort zone is terrifying. It makes you feel really vulnerable and afraid, I guess.

I was 17 when I moved out of Venezuela, and it was tough because at that time, like I said, we were still optimistic that things could get better. So it almost felt like I was giving up on my country. I’m very patriotic about my country. I’m assuming like a lot of people are. When you grow up in a country, you develop emotions and sentiment towards the place that you grew up, that gave you everything. So I felt like I was giving up on my country, and felt bad for a little bit. But, then the country just continued to trend downwards into what it is today, which is absolutely awful, and 20 times worse than what it was when I left 10 years ago.

Tim Ferriss: Where did you land when you first moved to the US?

Stefi Cohen: I landed in Miami. It’s actually a funny story. I was so upset that my mom convinced me to move. And we were in the shuttle at the airport, at the Miami International Airport, and I was just crying hysterically. If you didn’t know what was happening, you could have sworn that my mom was kidnapping me or something. I was so mad, and maybe not mad at my mom, but mad at the situation. Mad that I was forced to leave my country. Mad that I had it all. I was a really good soccer player. I was the team captain of the national team. I had a name for myself there, and I just felt like I was forced out of my country, and forced to start over, and it wasn’t my decision.

It wasn’t the route that I really wanted to take. I wanted to stay there with my friends, with my family, with my soccer team. I calmed down, landed in Miami, and then I went to San Diego. That’s where initially I got into school.

Tim Ferriss: San Diego. Beautiful place. Let’s flash forward, just to not continue sequentially. We’re going to bounce back and forth. Can you please describe for people some of your records, and at what body weights those records were achieved?

Stefi Cohen: I guess I’ll speak of the most monumental ones, or the most historic ones. I was the first woman to deadlift, I guess, four times my body weight first at a powerlifting competition. And that was, I weighed 120 pounds and I deadlifted, I guess, over 500. Then, I beat that record weighing again, 120 or 123, deadlifted 545 pounds. You don’t really know what your body’s capable of until you actually do it. There’s a lot of limitations that are placed upon yourself based on what other people are doing. I remember the first time I deadlifted 400 pounds when I said I was going to deadlift 500 pounds. Everyone thought I was crazy, that it was impossible, that there’s no way I could do it at that body weight.

And then look, magical things happen. And I trained really hard, obviously trained intelligently, and was able to achieve things that no other woman had ever been capable of doing. What’s interesting to me, and I don’t know if maybe there’s a name for this phenomenon or something but, after I did that, there were several girls that were able to achieve that 500 pound deadlift mark. As soon as people see that there’s something that is humanly possible, it’s almost like it gives them the strength, or it allows them to be able to chase those same goals.

Tim Ferriss: Yeah. It’s like Roger Bannister and the four-minute mile.

Stefi Cohen: Right. Exactly.

Tim Ferriss: Same story.

Stefi Cohen: Exactly. Outside of that I’ve broken, I guess, 25 world records in powerlifting in three different weight classes. I’ve cut down all the way from 135 pounds all the way down to 114. Broken squat, deadlift, and total world records there. Broken a few world records in the 133 class, and then some in the 132 class. I have also the highest deadlift in that class as well.

Tim Ferriss: What are your other lifts? What are some of your other personal best, personal records, PRs in bench, squat, or any other lifts that you want to mention?

Stefi Cohen: Yeah. My best squat is 510 pounds at 120 pounds body weight, and bench is 242 at 120, as well.

Tim Ferriss: Sorry to laugh. It’s just, I’ve been having this year, so I may turn this into a pro bono consulting session. I’m 43. I’ve been having this year where all of these injuries are cropping up. I’m feeling like an older version of Leonardo DiCaprio in The Revenant, dragging one leg behind me like some broken horse. I’m listening to these numbers and I’m like, you know, I’m sitting in a pretty tall building. I should just throw myself off — 

Stefi Cohen: Oh, my god.

Tim Ferriss: — throw myself off the deck right now. These are just insane numbers. Now, let me tilt the microscope a bit, because I want to ask you, and this might be a way of exploring some of these lifts and explaining what they mean to people. We know quite a few people in common. One of them you’re probably closer to him than I am, but he was in my last book, Tribe of Mentors, Ed Coan. Ed Coan. Could you describe for people who Ed Coan is, and what is most impressive about him to you? I think this will be a way of then coming back to some of your achievements and approaches.

Stefi Cohen: Yeah, absolutely. Man, Ed is known as the greatest powerlifter of all time. He has that. He’s earned that title. He’s been given that title by pretty much everyone within the powerlifting community. I think what separates him from everyone else is just how consistently he was able to show up and perform at his best, throughout the years. I don’t know how many years he competed, maybe 20 years, which is crazy. Anyone who’s ever attempted to get stronger, any person who’s listening to this, just try training for more than two years. When progress starts slowing down, when you start coming into the gym and feeling like crap, and not able to perform your best, you start accumulating injuries. It takes years for you to see even a five-pound increment in any of the lifts. Just the amount of mental fortitude, mental strength that you have to have in order to just keep showing up, and hoping that what you’re doing is taking you closer to your goals or pushing you in the right direction, is unbelievable.

I’ve spoken to Ed extensively about his mindset, and about what some of his training theories were in his training methods. And he pretty much just said that he — I asked him if he ever stopped making progress, and he said, “No.” He said, “Any time my progress would slow down, I would go in and really take a look at what areas of weaknesses I had, and I would tackle them with the same intensity that I tackle my “on” season.” Or, like seasons where you’re preparing for a powerlifting meet. And he would repeat that over and over and over again. Obviously, look, Ed is not from this world, man. That guy, his body, seriously.

Tim Ferriss: That is like the pot calling kettle black, a bit. I should also just say real quickly, no relation. You are Cohen, C-O-H-E-N. He is Ed Coan, C-O-A-N. But yes, he is an alien for sure.

Stefi Cohen: The resiliency his body has, and his ability to just tolerate just beating his body down with weights, is remarkable. It really is. So he’s a specimen.

Tim Ferriss: I recall a few of the things he said to me when we were chatting. And one was that he would plan out his entire, I want to say season, or a year in advance, knowing with absolute certainty that he would be able to make every attempt. I thought that was really thought provoking, considering that the way a lot of people train is that they may not even take notes at all. But, they go into the gym and decide what they’re going to do. Maybe they have some rough outline, but they don’t have that type of programming that is laid out in events.

Stefi Cohen: He had a top down approach to training. He kind of reverse engineered his program. He would say, okay, so if I want to deadlift 700 pounds, that means that I have to be able to deadlift 650 for three, which means that I have to do 625 for five. And then, he would reverse engineer from there, which I think is really interesting.

Tim Ferriss: You and he seemed to be, how should I put this, designed for, obsessed with, specialists in the deadlift. Ed is known for, I can’t remember what the lift was, 902 at 200, or 190 or something insane. And you have these ant-like multiples on your lifting. You’re just a little human female Venezuelan ant.

Now there are many people who — we should also take a moment just to explain the deadlift for people. Could you explain the deadlift, what that actually means, and then the competition deadlift, let’s just say. And then next, could you tell me what are some of the things that distinguish a person who trains, and I’m just going to leave weight classes out of this for a minute, because it’ll make it a little complex. But, people who, say, train up to a deadlift of four or 500 pounds, versus those people who get to, we could look at it as a multiple of body weight, but someone who gets up to two X body weight, versus someone who gets to three or four times body weight. What are the differences in how they approach the deadlift?

Stefi Cohen: The deadlift, there’s not much to it. There’s a bar on the floor, and the goal is to pick it up until your knees and hips are locked out all the way. I think it’s one of the most impressive feats of strength. I think universally speaking, people consider that the ultimate test of strength. That’s why it’s so celebrated. There’s two methods of deadlifting. You can either have a conventional style of deadlift, which is with your hands outside of your feet. And then there’s the opposite, which is a Sumo deadlift, where your hands are inside within your feet. And that’s it as far as what the deadlift is.

Tim Ferriss: Yeah. For a visual for people, if you imagine, like you said, there is a loaded bar resting on the ground. It has plates on either end. You walk up to it. If it’s conventional stance, then you’re going to, again, this is oversimplified, but have your feet roughly hip distance apart, and you’re going to almost squat down, again this is very simplified, and grab the bar with your arms on the outsides of your knees. In a Sumo stance, your feet are going to be turned out slightly. There’ll be much further apart, and you’ll almost look like you’re doing a really wide plie from ballet when you go down to grab the bar between your legs. Hands under your shoulders, roughly in both cases.

Okay. So then, we have all these folks doing God knows what, and eventually they muscle their way to maybe, maybe, maybe a 2X deadlift. But, perhaps they’re not approaching it in a very organized way. Then you have people who are able to do significantly more, two and a half, three times, and then you get into the rarefied air of doing what you do.

How do people make that leap, crossing the chasm to those higher weights? What are the things that are different?

Stefi Cohen: I think the main thing has to do with it’s physics, with leverage. Some people are really gifted when it comes to proportions. I think I’m one of them. I think that really makes a difference when it comes to being able to break that two, three, four, five times body weight mark is your leverage, is your proportions.

There is a guy, I believe it’s in the USAPL, who, man, he has a really odd in terms of proportions looking body. He has a very short, extremely short torso, and he has super long arms. And, when he locks out the deadlift, it just seems like the barbell moves just a few inches off the ground. I’m pretty sure that guy has done five times body weight. I’m pretty sure. You would have to fact check me on that.

But, I think obviously some people it’s genetics. Some people can train so hard. Some people can train the exact same way as Ed Coan, maybe have him as a coach, and never achieve half of what he achieved, or never lift a quarter of how much Ed lifted. And I think a big part of it is your proportions, your leverages. And then, when we get into genetics as well, muscle fiber type composition, your ability to learn new skills, et cetera.

Tim Ferriss: Just to kind of draw a circle around the genetics, certainly you have genetics is a huge component, like you mentioned. You see a lot of championship bench pressers, at least in the men’s category, who have a lot of girth. And the distance the bar travels is a real factor. So if you can put in a huge arch and also have a gigantic belly on you, then it can be very, very helpful on a lift like the bench press. Or, you have someone like Ed Coan, who is five foot six, but I’ve seen photographs of him putting his hand against the hands of NBA players, and they have roughly the same size hands.

Stefi Cohen: Huge hands, yeah.

Tim Ferriss: Yeah. Yeah. So his ability to hold a standard size bar, relative to his body weight, is just going to give him incredible advantages. But — 

Stefi Cohen: Yeah, because. Sorry, go ahead.

Tim Ferriss: Yeah, I was just going to say. Well, I want you to continue, because I’ve had too much caffeine. But I’d love to draw a circle around the genetics, and recognize those for being as important as they are. But then to talk about not the attributes, which people can’t mimic, they are not going to get a muscle fiber transplant. But, some of the technologies, and approaches, and programming, and the methodologies that, say, you’ve used. I’d love to talk about. But, what were you going to say?

Stefi Cohen: What was I going to say? Yeah, I think that the more specialized, you know how people, what’s that saying about talent and working hard when where talent? Hey, hon, do you know?

Speaker 1: Hard work beats talent.

Stefi Cohen: Hard work beats talent when talent doesn’t work hard? Okay. That saying. I’m really bad at memorizing sayings and quotes, but you know what I mean.

Tim Ferriss: I do.

Stefi Cohen: But, when it comes to power lifting, you can want it all you want. You can work as hard as you want, but because it’s such a specialized sport, having the right attributes for the sport is even more important. So, for example, say you want to be a, I don’t know, a football player. There’s many positions within football that might be in line with what your current skills and abilities are. And you might actually be able to outwork your way into a pro team by gaining more speed, by being stronger, by being able to cut sharper, by, I don’t know. You can gain an advantage in so many different areas or categories within the skills that you need to succeed in football. Whereas, in powerlifting there’s really not much. You either have the capability to get stronger, or you don’t. You either have the proportions to be able to move the bar in the most efficient way, or you don’t.

Tim Ferriss: True fact, as Kelly Starrett would say. All right, let me make this even more concrete. A few years ago, I did a triple with 475 or so on a trap bar, a hex bar, depending on what term people want to apply. That, at the time at least, training over say a six month or year long period doing mostly just pulls to the knees based on a program popularized by a sprint coach named Barry Ross. That was basically my ceiling. And I probably weighed 180 at the time, so I’m not winning any multiple awards. But I have very, very small hands. My proportions are not really built, I wouldn’t say, terribly well for the deadlift. But, I also didn’t have a coach. I didn’t have any real eye to the detail of training for the deadlift. So, if I came to you, I show up with a hobo stick and a little satchel with my lunchbox at your gym, and I’m just like, “Please save me. Make me a better deadlifter.” How would you start?

Stefi Cohen: I would start by looking at your form. Looking at your technique, and seeing if there’s anything there that I can improve. Things like bringing your feet width in, maybe changing your hand position, improving the angle of your torso, maybe looking at your starting position. I would start there. And obviously, programming is the biggest factor to look at, as well. How whether or not you’re implementing progressive overload into your training. How hard are you training? Are you going to failure? There’s many, many variables that we can look at. 

And if you want, I can get into a training methodology portion of the question that you asked a little bit ago.

Tim Ferriss: Yeah, let’s get into it. Let’s just start with one factor throughout there. Do you train to failure? Do you train to failure?

Stefi Cohen: Yes.

Tim Ferriss: Or, do you train to failure often? You do?

Stefi Cohen: Yes.

Tim Ferriss: Okay.

Stefi Cohen: I come from an Olympic weightlifting background. I guess I did Olympic weightlifting for about four years, and it was mainly Bulgarian style lifting. I don’t know if you’re familiar with that, but that just involves daily maxes, is what you call daily maxes. So, obviously, the amount you can lift in every session is going to vary, based on just your nervous system readiness, how tired you are, how well you recovered from the previous sessions. But, ultimately what you’re trying to do, is lift as much as you can in any one particular session.

Tim Ferriss: Was this started in Venezuela, or in the US? Or, somewhere else?

Stefi Cohen: It was here. My Olympic weightlifting coach is Cuban, and their training philosophies come from Eastern Europe as well.

Tim Ferriss: Is that Camilo?

Stefi Cohen: Camilo, yeah.

Tim Ferriss: Camilo Garcia.

Stefi Cohen: Camilo Garcia. Yeah, so that was kind of my initial introduction into strength training, which obviously led me to train in a certain, or I kind of picked up certain things from that, and also learned why they might not be the best.

Essentially, people in Bulgaria, Russia, the system to find the best athletes is a little bit different than it is here. Basically, they’re putting a lot of people through extremely rigorous training, and the people that you see succeed are very few. I’m talking about 0.0001 percent of all the kids that they put through these training programs make it through. So it’s you either thrive under those conditions, or you break.

Tim Ferriss: Yeah, it’s like hell week, or BUD/S training, Navy SEALs.

Stefi Cohen: Yes. It works, but it’s not the best way, and I don’t think that a lot of people are built to withstand that amount of beating. So the way that I modified that, combined my experience with, I guess, my academic training which is, I have a background in exercise physiology, and then I have my doctorate in physical therapy. I’ve been able to implement a little bit from practical with what the science says. In terms of training to failure, there’s a lot of controversy when it comes to what the minimal effective dose of training is. There’s pretty much two separate camps. One that is all about accumulating volume, just doing very low, not very, but low load, high volume style training in hopes of sparing your body, your tissues, and decreasing your injury risk.

And then there’s the other one. That’s the Bulgarian-Russian that goes all the way to the other extreme, which is if your goal is to get stronger, then you have to train in a way that’s conducive to the adaptations that you’re trying to elicit. If you’re trying to get better at your one mile, you’re trying to beat your one mile run, you’re going to run one mile often. So same principle here. If you’re trying to get a better one rep max squat, you’ve got to be squatting to a daily max, or a really high intensity often.

Where my training philosophies fall is somewhere down the middle, and it’s the same way with pretty much everything in my life. I try not to swing in one particular direction. I try to stay unbiased, and I try to learn a little bit from everyone, from every camp, and then apply it to myself and to the people that I coach. As far as the way that I train and coach other people, it’s a mix.

Tim Ferriss: Could you give us an example of a competition training split for you? And then we can just walk through what some of the workouts look like.

Stefi Cohen: Yeah, for sure. In preparation for a competition, you essentially break down your training into four blocks. You have your GPP, your general physical preparedness phase, where you’re essentially just accumulating volume and improving your aerobic capacity, your ability to do multiple reps. This is a high volume phase. Then, you move into a more specialized block where you start getting rid of all the fluff in your programs. You start decreasing the amount of cardio. You do the amount of exercise variability, and you start increasing the frequency of the main lifts. You start squatting, benching, and deadlifting more, because those are the three lifts that are tested in competition. 

Then, you go into the intensification phase, which is where you start increasing the intensity. So you start getting into the 85, 90, 95, 100 percent, of the three main lifts, and pretty much do nothing else other than that, maybe a little bit of core, a little bit of back, just because you have to start focusing and hyper specializing more into those three things that you’re going to be tested on. Then, you go through a two-week deload period, where you pretty much cut everything that you’ve been doing in half by 50 percent, and then you’ve got your competition. And it’s funny because when you get to your competition, it’s like you’re the strongest you’ve ever been after going through that process, but you’re also the least human that you’ve ever been, as well, like going up a flight of stairs, is excruciatingly tiring. You — 

Tim Ferriss: Because you’re so specialized at them.

Stefi Cohen: Yeah. You do condition in every other area, you move like you’re made out of tinfoil, like you’re made out of metal, and seriously, it’s awful. Then there is trying to shit, so there’s that.

Tim Ferriss: Oh, yeah. My friend, Mark Bell, you may have met before. He’s hilarious talking about that, going through his fat and skinny phases, when he’s big, and having trouble tying his shoes, and it’s really a high degree of specialization. And then, if you look at — let’s just take — you could pick any of those phases, but let’s just say, maybe the intensification phase, what does a week of training look like? How are things spread out?

Stefi Cohen: Personally, I like squatting two or three times per week. Deadlifting one time per week and benching three to four times per week. So, and then to the vacation face, you’re basically staying within nothing more than five reps. So I tend to — when I’m squatting five reps, so, okay. Let’s make it easier. So, say Monday, Wednesday, Friday, I’m squatting, I’m doing five reps, then three reps, then two reps, on those days. And so the reps go down, but the intensity goes up as the week goes by. Then, if I’m following that split, then I’ll likely deadlift closer to my least intense squat day. So I likely deadlift within the beginning of the week, if I’m going to split it that way, so that I’m not so tired by the end of the week, and can actually see what I’m capable of doing in the deadlift. And then bench, I usually keep it a lot higher volume, even during an anticipation phase.

I think that especially for a woman, because we — I don’t know what the phenomenon is. I actually want to get into that, because I don’t have an answer, but something about the bench press and women, we just make progress a lot slower, and I think in terms of absolute strength, we rarely reach it, so we can get away with pretty much anything. We’re doing higher volume, lower volume, more sets, more reps, whatever it is. And it doesn’t seem to impact the way that we recover from these sessions.

Tim Ferriss: If we’re looking at the whole picture, you’ve mentioned longevity in sport, in the context of Edcon competing for some ungodly number of years, 20 years, and how you contend with plateaus or very slow progress injuries, and certainly, he’s no stranger to injuries. And when you have a leg buckle under 900 pounds or a thousand pounds, I mean, things don’t always — you don’t always just jog away from one of those. How has rehab, or prehab been included or thought of as a component of your training and your, I suppose athletic life, in general?

Stefi Cohen: I’m a little bit adverse to those terms, because I think they’re oftentimes used out of context and for the wrong purposes, especially by medical professionals, physical therapists, chiropractors, but I think it’s — look, rehab, prehab, are essentially training. So it falls into periodization. It falls into how are you organizing your training to make sure you’re actually going through the appropriate phases to set you up, to be able to withstand the — so that your tissues essentially, can tolerate the amount of load that you’re placing on them. This is something that I actually love talking about is: why do injuries happen?

Most people think that they can prevent injuries through stretching or they can prevent injuries through doing prehab or corrective exercises. And that’s nothing more than someone trying to position themselves in a way that makes them seem like they know something that you don’t, and positioning themselves as if they’re some sort of like, I always say this, the Sherlock Holmes of injuries. They can pinpoint the exact area of weakness that you have, that will lead to an injury.

And that type of thinking is overly simplistic and it’s outdated. We like to think that we have the answers for everything, and maybe that happens because humans want to know of the exact cause of things, and then maybe healthcare practitioners feel pressured to have to give this very specific and concrete answers, when in reality, injuries are multifactorial and more often than not, identifying the exact source of an injury, or why it happened, or what tissue is injured, is very, very difficult. So the best way that I can explain this is injuries, not most times, always happen when the load that you’re imparting on tissues exceed their tolerance. So it’s a — the way I visualize it, it’s a two-part equation. We have load in one side, you have tolerance on one side. So it becomes about managing external forces and building internal tolerance to those forces.

So, when I talk about load, it’s everything I spoke about, how you organize your training, whether you’re going through the right phases and you’re progressively increasing the amount of weight that you’re lifting to allow your tissues to be able to withstand those forces. Then, on the same topic of load, say that you start having an area or a tissue that’s starting to get irritated, how — well, you have to think about how are these forces being dispersed within your body. Maybe the way that you’re lifting, say that people have SI joint pain. So why are most of the forces — 

Tim Ferriss: SI joint. Can you just — that’s a sacroiliac joint, right?

Stefi Cohen: Yeah.

Tim Ferriss: So could you just tell people where that is, if they were into look it on their own bodies?

Stefi Cohen: Yeah. So your sacroiliac joint is pretty much on your hip. So if you were to put your hands on your hip, with your thumbs facing backwards, it’s essentially where your thumb ends up naturally, when you put your hands on your waist.

Tim Ferriss: Mm-hmm (affirmative).

Stefi Cohen: It’s a common area that gets hurt when you’re lifting weights. But anyway, so what I’m saying is, sometimes when that happens, it’s also a matter of, where are those forces being dispersed within your body and why is that one area taking up most of that load? So how can you — so a corrective exercise is essentially figuring out what exercises you can do that would spare the irritated tissue.

That’s what a corrective exercise is. And then, as far as increasing the tolerance, then again, that just goes — you’ve got to reduce workload or modify workload, so that your tissue skin actually have time to repair from your previous training days and be able to continue to repairing, healing, and then doing it all over again. But that is the essence of injuries, and anyone that tells you anything more complex or that tries to tell you that there’s a — that your multifidus is irritated, or is inflamed, or that you’re — whatever, like people just get so caught up on just these details that matter very little, when it comes to creating a plan of care for a patient.

Tim Ferriss: Let’s use a real or hypothetical example, but it’s — have you battled with, say low back injury, or other injuries that we can use as a case study?

Stefi Cohen: Yeah. Oh, my God. That’s the — that was my inspiration for writing my book.

Tim Ferriss: If you could talk to what you have done following an injury and how it differs from what might be common approaches. I think that’d be very helpful for people.

Stefi Cohen: So I’ll give you guys a little background on the type of injury I had and then I’ll get into some of the things that I did to get out of it essentially. So I was in my first year of physical therapy school, the first time that I had a seemingly career-ending injury. For some reason, we attach so much emotion to a low back injury, and this is — I’m assuming it’s mostly cultural and societal based. It’s just the fear surrounding back injuries, that’s been perpetuated by healthcare professionals and doctors based on many, many things that I actually talk about in my book. 

The first time, I remember, it was chronic in nature in the sense that it was just getting increasingly worse, every training session, and I guess any high-level performer athlete, would relate to this in the sense that you — at the beginning, when you started experiencing aches and pains, you try to ignore them, try to convince yourself that is not as bad as it seems, and you just try to look for ways to continue training, because you think it’s part of the game. You think that no pain, no gain.

These are all things that are so deeply ingrained in our beliefs as athletes, that we have a hard time taking a step back, because we’re afraid of exposing our weaknesses, or we’re afraid of quitting, or were you afraid of letting our coach, or of our coach thinking that we don’t want it enough. And so we just tend to ignore the signals that our body is sending us. So that’s exactly what I did. Even and what’s funny, is that even I had a pretty solid understanding about the human body, and injuries, and how this all works. And even then, I was just so — it wasn’t such denial of what I was experiencing, that I just essentially kept increasing the amount of painkillers that I was taking, and didn’t change anything else, kept showing up to training, kept training as hard as I was before it just started.

Maybe tying my belt a little bit tighter, you wearing my belt a little bit sooner. And like I said, increasing the amount of painkillers I was taking, and it was a recipe for disaster. I spent several months training in excruciating pain to the point where it started affecting my activities of daily living. I was having a hard time putting my socks on, or putting my shoes on. I remember waking up in the morning, just so stiff. I looked like I was 120 years old. I could barely move, I needed to have assistance doing many things, and what’s crazy, is that I still thought that it was normal. I’m like, I’m a powerlifter, and I’m expected to feel this way. And that just led to this one lift, one time.

I was, I remember, I unwrapped the bar, I was going for a three-rep max personal best, and I unrack the bar. I felt more wobbly than normal in my low back, I lowered the bar down, and at the bottom of the lift, I just felt a snap on my back or — yeah, just something really wrong. So I tossed the bar onto the pins, fell down onto the floor, and laid there for 45 minutes, without being able to move, without being able to take my belt off, nothing, just completely just paralyzed by pain. And obviously, at that point was — oh, I actually know. You would think that I would take a step back then. I actually took — I think I took a week off and then went to San Diego to compete in the biggest powerlifting competition of the year. I actually called — 

Tim Ferriss: Stubborn!

Stefi Cohen: I know. I called Ed when that happened, and I called Mark Bell, called both of them, and I asked them what they would do. And I asked them if they’ve competed injured, and they both said yes. So I was like, man, if they can do it, I can do it. Like there’s — I’m a week out of a competition, yeah. I got really hurt, but whatever, I’ll just — I’ll suck it up, and then I’ll rest afterwards, kind of thing. So I did it, I competed, it was the worst competition in my life. I bombed out on an international stage. It was pretty embarrassing.

Tim Ferriss: Bombed out, means you didn’t make your attempts.

Stefi Cohen: Exactly.

Tim Ferriss: Mm-hmm (affirmative).

Stefi Cohen: And that was my wake-up call. That was the moment when I was like, okay, I actually have to do something. I have to do something to fix this, or to get out of pain. And that’s when my quest for figuring out low-back injuries came in. I had obviously, had access to a lot of seemingly great physical therapists, given that I was in a top 10 nationwide program for physical therapy, and I was able to ask for different opinions from a lot of people. And what was surprising to me was that I was constantly getting different answers. They didn’t seem to have really anything in common, and it was just so evident to me that no one really knew what they were talking about. Really. I would just get a different diagnosis every time I would go to talk to a different person.

I got no consistency in my — in terms of their responses. So imagine that, right? I’m the patient in this case, and I’m going to what I would consider the most powerful figures of authority that I had access to professors that I look up to, professors that are PhDs, that are doing research, maybe some that were biomechanics, some that were doing — some that are spine specialists, and still, I was not getting — one, I wasn’t getting any relief, and two, I wasn’t, again, I wasn’t getting any consistency in their answers. So that’s when I started reading a ton about it and obsessing about it, to the point where I thought I should write a book to help clear up some of the confusion that, not only clinicians are experiencing, but obviously, patients. And I think part of that problem lies in — I’m lucky in the sense that I practice physical therapy in the non-traditional sense, because I don’t see patients.

I spend most of my time reading research, which was again, is one part of evidence-based practice. I guess, I practice on myself, and on people that are around me, but you know, most clinicians between patients and paperwork and all the things that they have to do in a day, they don’t really have time to dive into the research like I did. This book took two years to write and we pretty much go back 5,000 years to understand where our beliefs come from, and how science has evolved, and how pain science has impacted some of the recommendations and how it’s changed over the years, so that hopefully, we can have a more unified approach when it comes to lower back or back rehab, essentially.

Tim Ferriss: Well, I have a million questions and I want to make sure we offer some specifics to folks who may want to get some tactical advice, realizing that you don’t see patients, but I want to take this in a few different directions. So the first is your experience with this injury, paralytic on the ground, in pain, you compete, bomb out. Certainly, I would say didn’t do yourself any favors with the back by doing that. What were some of the things that insights or training approaches that ended up really making a difference for you, especially with the lack of diagnosis, because I think a lot of people listening or lack of consensus and diagnosis, right? So I’m looking at some notes from your book, which I don’t think are verbatim, but they’re really important, I think just to underscore for folks. So there’s one paragraph that really jumped out at me and I’m just going to read this here.

“Medicine is a science of uncertainty and an art of probability.” In other words, the Ostler maxim. “3,000 years into an effort to unlock the mystery of pain continues to produce more noise in signal. There’s still no discernible cause for back pain in 95 to 99 percent of cases, yet it continues to be the leading cause of disability worldwide.” So this is a very depressing paragraph for a lot of people, but I want to break it into two pieces. Number one is that when people say “science proves” or “studies show,” you should always look at the source material, because science, or I should say more accurately, really good research, and studies really just indicate the probability of something being true.

Stefi Cohen: Exactly.

Tim Ferriss: It’s — and so you have to really understand that you cannot say definitively, or you should be very cautious of saying definitively. This proves this, you have an inflamed sartorius muscle, and that’s referring to your left shoulder, which is causing your right testicle to swell, which is causing your right eye to hurt.

Right. But you hear that kind of shit all the time, and it’s like, wow, okay. I had no idea that that cascade was so powerful, and there are good PTs and very good doctors out there, but you should be aware of complicating to profit, right? Or if a medical professional is aware that you are shopping for a certain diagnosis, eventually you will find someone who is willing to give you the diagnosis that you think you have. So you have to be very cautious, but breaking it into this. So that’s just overview comment on the limitations of what people consider science. Yeah.

Stefi Cohen: And even — Tim, even when it comes to scientific research, there’s actually studies and I don’t have the name of it here, but there’s actually studies that prove that more often than not, the results of a study are likely incorrect or non generalizable, so — 

Tim Ferriss: Yeah, that’s the replication crisis. It’s the ability to replicate studies and the outcomes of studies, is abysmally difficult.

Stefi Cohen: Exactly. Exactly.

Tim Ferriss: That’s a whole separate thing. It’s such a bummer. We need more money in funding replication studies, but there’s so little career and status incentive for academics to focus their own personal resources on replication, that we end up in this really gnarly situation. Let’s jump to the second part, which is more personalized for a lot of people listening, and that is, there’s no discernible cause for back pain in 95 to 99 percent of cases. So a lot of people listening to what you said, and hearing that, will say, “Well, fuck! If you can’t figure out what’s causing it, how can you possibly fix it?”

Stefi Cohen: Yeah.

Tim Ferriss: Right. So then let’s use that as a leaping point to what did you do that helped? What are the things that you ended up finding really had a valuable bang for the buck?

Stefi Cohen: So let’s go back just briefly on our terminology, the words that we’re using. So when you say, “What can we do to fix it?” I don’t like when people, even when people say that, because that implies that something’s broken.

Tim Ferriss: Whip my ass into shape! I want you to tell me better words to use, because the words — the limits of our words are the limits of our world, right? So strike that from the record.

Stefi Cohen: I would just say, how can we decrease your symptoms, or how can we decrease your discomfort? There’s nothing to fix, especially when it comes to, like I said, 95 percent of those cases. We’re moving further away from the mechanistic views of the sources of back pain. So all this means is, we come from a background where, when it comes to the neurophysiology of pain, we used to tie the severity of the symptom to the amount of damage in our body, and with the evolution of pain science, especially now that it’s kind of permeating more into the physical therapy realm, and fitness, and sports, now we understand that pain isn’t directly tied to tissue damage. So we essentially, we’re overly relying on diagnostic tests like the MRI or the x-rays, because it’s essentially, it gives you a really good picture of what’s inside, but it completely takes out of the equation, the subjectivity of pain.

So we know just based on research, that — or based on studies, that 37 percent of 20-year-olds have asymptomatic degenerative disc disease and disc herniations, and that — those numbers bump all the way up to 84 and 94 percent for 20, 30-year-olds, sorry, for people over 80 years old. So it’s just that what you see on the inside is more — a better way to look at it, is as just wrinkles on the inside, things that happen naturally from aging, and we need to stop to detach the emotions that we have with, I guess, those images, because they don’t really tell you much about what the person is experiencing.

Tim Ferriss: That was another line from the notes on your book that I highlighted, which is “Pain isn’t a reliable sign of damage.”

Stefi Cohen: Exactly.

Tim Ferriss: Which is very counterintuitive, right? Because you cut your finger when you’re cutting carrots with a knife and you’re like, cut, hurt, pain, cause, effect, and end of story, right? It’s just not that simple.

Stefi Cohen: No, of course. And like I said, look, there’s two views. There’s a mechanistic, and then there’s the pain science. So again, I fall somewhere in the middle. I wouldn’t — I would never say that there’s no way that nothing’s going on underneath your skin. I’m sure that there’s some cases where there’s an actual structure that’s getting irritated, that somehow got hurt, and that is the source of pain. But in 95 percent of cases, we really don’t know what the source is, and I don’t think that should be discouraging. I think that should be encouraging because, now you can relate your pain experience to most cases. It’s always good when you fall within the lines of the probability and not when you’re outside, that’s when you’re in trouble, because you’re a special case. You don’t want to be a special case.

Tim Ferriss: Well, you’re right. You said you’re in the middle. You’re like the Goldilocks of powerlifting and pain science — you’re always in the middle. So let’s get into some specifics. I think this is super fascinating. So we’re not going to use fix, we’re going to talk about decreasing symptoms of pain, right? And I think what you also said, is that like, hey, if you’re within one standard deviation to the middle, that’s actually really good news. If you’re in the group that is 90 to 99 percent of cases having no discernible cause, that’s actually not necessarily a bad thing. If you’re like seven, if you’re three, five sigma out and you’re missing 10 vertebrae, then you really have a major issue going on.

Stefi Cohen: Exactly.

Tim Ferriss: So let’s talk about some of the actions you took or things you stopped that had — that made a real difference for you.

Stefi Cohen: Yeah. Okay. So in terms of — this is something — on assessment, it’s something that you can do on your own, is instead of focusing on what needs fixing or what is the failing structure, you can focus on things that are a lot more actionable in your assessment or your therapist, or whoever’s doing it for you, or yourself. And the things that I look at, are first, a directional preference. So essentially what that means is, are you flexion or extension intolerant? So does it hurt when you bend forward or does it hurt when you bend backwards? That’s the first thing that you need to figure out and you’ll know.

Tim Ferriss: And this is for overall back pain, or lower back pain? What type of pain are we talking about? How does it present?

Stefi Cohen: This is more specific to low back pain, but it — 

Tim Ferriss: Back pain, okay.

Stefi Cohen: Directional reference that it would literally apply to any injury. Does it hurt when you bend your knee or when you extend your knee? Does it hurt when you rotate your neck to the right, or when you rotate your neck to the left? So it’s just kind of like you’re checking in with yourself to see what are the positions that increase your symptoms, and what are the positions that decrease your symptoms? That’s essentially all that it is.

Tim Ferriss: Mm-hmm (affirmative).

Stefi Cohen: Then within direction, there’s also compression versus shear, especially when it comes to the low back. So compression, you can do an easy test just by sitting on a chair, and you put your hands underneath the chair, and you push yourself, your buttocks towards the chair, creating compression. So are you intolerant to compression, or is it more shear?

So bending forward, say with a light object on your hands, farther away from your body, does that increase your pain more? So just checking in with yourself to gain more understanding about the things that improve your pain, or decrease your pain. Then, what are some of the postures that increase the painful sensation? So is it sitting down? Is it standing up? Is it walking a lot? Is it not walking a lot? Is it running? Is it lifting? Is it…? What are you doing in the day-to-day that exacerbates your symptoms?

And finally, figuring out what your current load tolerance is, especially if you’re a lifter. I guess this doesn’t apply if you’re not a lifter, but if you are a lifter, you have to figure out what your margin of error is, when it comes to your injury. When are — when do your symptoms start appearing? Is it at 50 percent? Is it at 60 percent, 70 percent, 80 percent, 90 percent? When do they start appearing? And during the time where your symptoms seem to be heightened, then that’s a good time for you to stay underneath that — that margin of error and stay underneath that, the pain threshold. So you can essentially teach your body how to get out of pain.

Tim Ferriss: Do you have an opinion of, just as another point of reference, healing back pain, The Mind-Body Connection by John Sarno, do you have any opinion of, that book comes up a lot in conversations about back pain, do you have any commentary?

Stefi Cohen: I actually haven’t read it. I’ll have to get back to you on that.

Tim Ferriss: Okay. No problem. So TBD. I just want to add a small bit of commentary about pain, because I like a lot of people was very mechanistic for the majority of my life. If something hurts, something must be broken, or torn, or strained, let me find that problem, and fix that problem, and pain will disappear. And I had chronic severe pain in my left mid back for many years, and I think it was initially caused by an acute incident, specifically, a closet fell off a moving truck, and I caught the closet, which was, I don’t know, 100 plus pounds, really large, and it twisted my torso to one side. It was a bad, bad injury, but that pain then recurred for many, many years, and I didn’t experiment with, and I’m not advising this to people listening, but so that could speak to the experience intelligently from firsthand experience, did a series of five ketamine infusions, intravenously that at one point, and the intention was not at all to look at chronic pain, but it is used for, in some cases, chronic pain.

That didn’t mean anything to me at the time, because I hadn’t done the reading, and I came away from my experience past that week, overall, not feeling like I could recommend ketamine therapy outside of someone with acute suicidal ideation, where I think it does have real applications, but about a week later, I realized that my mid-back pain had completely vanished, and it did not come back. This is like a year-and-a-half now and counting, and it just — and there are theories around ketamine’s effects on NMDA receptors, and so on, that account for this, but it’s thought to almost provide a hard reset for some of these pain pathways.

And again, I’m using terminology that perhaps I shouldn’t, but that you can, in some way, paste over these ruts that have been created in terms of repetitive circuits that cause these experiences subjectively pain, but the idea that I could have an infusion, a couple of days, and then walk away and have this pain just vanish, even though it is in the short term and anesthetic, was so mind blowing to me, that there would be durability to that effect. So it’s caused me to think about pain completely differently.

Stefi Cohen: Yeah. That is super interesting. I actually would love to read more about ketamine specifically for persistent pain, but it just goes to show just how powerful our brains are, right? If you’re experiencing persistent pain, our bodies adapt to literally anything. So it would make no sense that you have something broken or something that needs fixing for two plus years, even for more than six months, it’s already a stretch. So it just goes to show how — in your case, was the ketamine infusion, but anything that breaks the pain cycle, is positive in terms of delivering a more positive response to pain, because essentially, you start forming these habits that are tied to your experience with pain. It’s not more of a sensation anymore, it is about the perception we have and the experiences that we have, that literally alter the way that we feel, and think, and sense threat from the environment.

Tim Ferriss: So we were talking about your assessment, right? The general parameters for doing an assessment. And I’m sitting here with a couple of injuries right now, thinking about this, I feel like my wrist, and my left hip, and all this, I ate an orange, and went to bed, and woke up with a neck injury, kind of thing. I don’t know what the hell is going on, but the point is, we’re talking about an assessment after an injury, for people who are thinking to themselves, I would like to make an investment in making my body more resilient, so that the likelihood of having a back injury is lower. Are there any recommendations that you would have for those people, any often collected types of strengthening or anything really that come to mind?

Stefi Cohen: Yeah. I mean, according to the literature, it’s not so much a strength thing. It’s not either a stability thing. That’s another hole that we can get into, but I mean, the best way, I guess, to prevent any injury, is, I guess, back injuries, is endurance. So there’s a bunch of studies done on construction workers, and other forms of labor workers, and they determined essentially that the ones with the most back endurance, and they measured this via doing hold-back extensions. So how long can you hold a back extension? So it’s not necessarily for strength, but more so, how long can you hold a certain posture and they — 

Tim Ferriss: For duration.

Stefi Cohen: For duration, yeah. So they determined that those with the most back endurance were the most resilient to back injuries, and then it goes back to positions, postures, and movements that you practice. So a lot of people, for example, when people want to get into running, running is accessible to everyone, right? You just put a pair of sneakers on and you go out and run. The thing that happens with that is that you didn’t appropriately expose yourself to the mileage that you were going to do or the terrain. And so making sure that there’s an appropriate, again, an appropriate progression in what you’re doing, and you’re practicing those specific movements, those are going to be the movements that are safe for you.

So there’s also research studies done where you change the way that people lift things. So again, this was, I think it was construction workers again, where — have you seen how they lift? They have their back rounded and they’re picking up super heavy stuff and their form “looks” bad because we have this idea of what good form is versus what bad form is that is totally, I mean, arbitrary based on, I don’t know what who said. They say, people love to say, “they” say that’s bad form. I don’t know who “they” is.

But essentially, these people have trained those positions, those posture, those movements that way for their entire life. Therefore, those are the positions that they are the strongest in. So when it comes to modifying the way that you lift or the way that you pick up things, or the way that you pick up your baby or the way — you don’t need to move like anyone else, you need to move like yourself. Whatever you’ve been doing for a long time that hasn’t given you problems, then that’s the way that you should continue moving.

Tim Ferriss: Yeah, just a quick side note on the form, do you know that they, the Illuminati of the internet who were like, “That’s bad form.” I remember, and again, I’m talking out my ass because I’m such a junior varsity tourist when it comes to any type of strength training, but I’m a fan of strength training. I try not to have too strong an opinion about anything, so I’m not qualified, but I remember the first time I saw, and I maybe pronouncing his name incorrectly, but Konstantīns Konstantinovs deadlifting raw with a rounded back set up.

Stefi Cohen: How crazy.

Tim Ferriss: Right. And he has a rounded back setup. Everybody should look this guy up. He is fucking, I mean, he’s a superhero, it’s unbelievable.

Stefi Cohen: No belt, either.

Tim Ferriss: No belt.

Stefi Cohen: No belt.

Tim Ferriss: No belt and he’s just a complete beast. And I don’t know how much he can deadlift. It’s just like 420 plus kilos, I mean, which is raw without a belt, but he sets up and he rounds his back. And so you see that and you see him clearly as this master or technician of the deadlift and there are all these millions of variations that he also uses in training and you’re like, okay, who’s going to tell this guy that he’s lifting incorrectly, right?

Stefi Cohen: Yeah, because look, we have this obsession with not rounding when we bend forward. Again, one of those beliefs that have been perpetuated over the years coming from probably someone interpreting a research paper incorrectly. But yeah, I mean that is a very advanced deadlifting technique that he developed. He skillfully developed throughout the years in order to make that position his strongest position and the least likely position for him to get hurt.

Now, the obsession of keeping your back straight when you deadlift is silly because even when you can’t observe that there’s rounding in the lower back, your spinal segments are at about 60 to 70 percent inflection, even when you’re not seeing any flexion happening. When your back is in “neutral,” your back is bent, your spinal segments are already, they’ve changed in the angles that they’re in. They’re already flexing. So there’s nothing necessarily inherently wrong with that. There’s no instability going on, because essentially what is stability? That’s funny, that is what got me into this whole topic, people talking about low back stability, you got to improve stability, stability, stability of the segments. That was something that was so hammered in our brains in physical therapy school that I had to go back and see what the fuss was about when it came to that.

But essentially, stability, we need to understand the differences in concepts between stability and robustness when it comes to back pain so that we can understand essentially what their recommendations would be. So in terms of definitions, robustness, and I like to bring the analogy of comparing an oak tree to a willow tree. So in terms of robustness is your ability to cope with disturbances in your environment. So an oak tree will be a lot more robust than a willow tree when wind blows onto it, versus stability is just the ability of a system to return to normal after a disturbance.

So the notion that back pain or people who get hurt deadlifting or doing anything lack stability is unfounded, because as biological beings, we have the capability to either up-regulate or down-regulate the amount of tension that is in our muscles at any given time in proportion to the task that we’re doing. So the amount of stability that you need to lay on your couch is different than the amount of stability that you need when you’re something up, not to mention it’s difficult to measure, no one knows how much stability you need or anything like that. So we are capable of strengthening and stabilizing any position as long as it’s the position that we’re training, if that makes sense.

Tim Ferriss: Yeah, that makes sense. Let me ask a question, I think you’re going to hate, if you don’t mind.

Stefi Cohen: Go ahead.

Tim Ferriss: You’re going to be, “Ah, this fucking guy!” All right. So I recall this must’ve been around 2008, 2009, I was probably, let’s just for the sake of simplicity, say the fittest and certainly the strongest that I’ve been in the last 10 years or so. And I felt very resilient, very robust in terms of injury prevention. I just did not get injured a lot, despite doing a lot of training. At the time, and it’s so difficult, maybe impossible to say, or identify single causes and effects, but nonetheless, I had, at the time I had quite a bit of interaction with Gray Cook, who has the Functional Movement Screen and so on.

I was using Turkish get-up, single leg deadlift, and chop and lift quite a bit. And so he uses the Turkish get-up as a diagnostic tool, he also uses it as a corrective tool, maybe that’s the right way to phrase it. But I found these exercises to be extremely helpful for checking a lot of boxes at once in terms of time invested and benefits. Are there any exercises or types of training that you would put in that bucket for yourself?

Stefi Cohen: I think part of the reason why you had a positive experience with those movements by implementing them into your existing training has to do with movement variability. So what happens when we look at people who are hurt, one of the things that jumps out the most is the lack of movement options that they have, lack of movement variability. So the more hurt that you are, the less movement options you have. So essentially you’re expanding your movement vocabulary by incorporating movements that challenge you in different planes, your ability to resist forces that are coming different ways by holding a kettlebell in the overhead position, the chop that’s working on the transfers plane, you’re working on your rotators, your spinal stabilizers.

So I think the reason why that worked for you is essentially because you increased your movement vocabulary and you were giving your body more options for movement where it felt non-threatened and it felt safe. So almost any movement has the capability to do that, and that’s why I emphasize the importance of having a GPP, a general physical preparedness face to any program. And that’s something that really gets lost in overspecialized sports like powerlifting and Olympic weightlifting is that people think that they have to be doing squat, bench, and deadlift all the time and don’t find time or ignore the fact that they have to include other movements in order to maintain their longevity, and in order to boost their own tissue tolerance and their ability to remain injury free.

Tim Ferriss: It’s true outside of powerlifting too, right? I mean, if you take someone who has any type of repetitive movement — could be tennis. If you’re just a recreational tennis player and amateur, which almost everyone is going to be, and you’re hitting in a very comfortable plane of motion with your forehand and backend, and then you’re limiting your exercise to that. And then one day of this heated scrimmage with a friend and you get thrown out of that normal plane of motion, if you’re not supplementing that with additional colors on the palette, right, in the form of some type of general physical preparedness, then there’s a decent chance you’re going to get injured.

Stefi Cohen: Beautiful.

Tim Ferriss: Right?

Stefi Cohen: Exactly.

Tim Ferriss: And I say that with confidence because that’s, I think what just happened to me.

Stefi Cohen: But then that goes to show that there’s no magic exercise. I love talking about the McGill Big Three. So for anyone who doesn’t know, Stuart McGill is one of the most well-known authors when it comes to low back pain and research. And a lot of people put these three exercises on a pedestal and view him as this guru because somehow the bird dog, the dead bug, and the side plank became the best way to cure all back pain. But, and I’m thinking — 

Tim Ferriss: Hold on one second. So the bird dog, I know people can look it up, we’re not going to get into it. Side plank, I know. What is the dead bug? Sounds like something I’d be really good at!

Stefi Cohen: So literally, I mean, how you would encounter a dead bug when they’re on their back and they’re flailing their arms in the air, that’s what doing dead bug looks like.

Tim Ferriss: You just stick your arms and legs straight up in the air while you’re on your back?

Stefi Cohen: Yeah. And so you alternate right arm back, left leg out and then alternate back and forth like the dead bug.

Tim Ferriss: Okay. Okay, got it.

Stefi Cohen: And that’s the thing, right? I always like to understand why. So when I first learned about those movements, I’m like, okay, I mean, these provide me with relief, but why? Is it because these are some magical movements, or…? What is going on here? I think the assumption that a lot of people make is that that improves core stability because they assume that that’s the missing link. And that’s, again, that’s dangerous because it goes back to perpetuating that fear that people have about their spines, and it leads to people being extremely overprotective in their strategy.

So what actually happens with these three exercises, the dead bug, the bird dog, and the side plank, is that the reason why they decrease pain symptoms is twofold. The first thing is you’re essentially providing a positive movement experience again. If you’re having an acute bout of back pain or if you’ve been in pain for a while, it’s about finding a position that doesn’t increase your pain symptoms. The other one is a very well-documented phenomenon called exercise-induced analgesia, which is basically when you’re contracting a muscle isometrically, there’s muscle spindles and chemo receptors within your muscle that send signals to the brain to down-regulate the pain signal. So it provides you with a temporary reduction in pain symptoms.

So it’s not that they’re magical, it’s just that they work based on these two mechanisms. Not because they’re improving stability, not because you’re unstable and now you’re stable, not because it’s magical, but because of these reasons. So same with those three movements that you were doing by Gray Cook.

Tim Ferriss: Yeah. Well, any really good doctor I respect in the large group of doctors I’ve met — most of which I think are way over their skis in terms of confidence — the best doctors and the best scientists also will say something along the lines of 50 percent of what we know is wrong, we just don’t know which 50 percent, right? And that’s especially true when trying to identify mechanisms, right? Most of the things, including many pharmaceuticals, work not because we understand how they work, but despite the fact that we don’t really know how they work. So I think that’s also true with a lot of these exercises in terms of the effects that they seem to impart.

Stefi Cohen: Absolutely.

Tim Ferriss: Let me ask you a totally different question, and this is about visualization or motor imagery. So I read in a Muscle & Fitness piece, your description of visualization. A lot of people will have heard this term before, right? But let me just read this paragraph because I want to zoom in on the second part of this, and feel free to fact check this if it isn’t accurate, but here’s what it says and pretty sure this is attributed to you. “Visualization, or what’s called motor imagery, is crucial, so when you’re under the bar, you know exactly what to do. The more detail you go into, the better—walking or driving to the gym, putting your shoes on, the sounds, putting chalk on your hands, grabbing the bar, the smell of the iron, the feeling in your hands, and a successful execution of the lift in detail.”

Now this will sound familiar to a lot of folks, right? If they’ve ever watched the aerial skiers, the acrobats in the winter Olympics preparing before a run, or divers, or really any high level athlete, they will recognize visualization of that type on some level. Then we continue to the second part of the quote from you, which is: “The second part, which I believe to be even more important, is visualizing a negative outcome. We don’t want to plan for it, but we need to prepare for it so we know how to react. Can you keep it together and try again, or will you crumble under pressure?” I’ve never read anything like this before. Could you please elaborate and give an example of that second part, visualizing a negative outcome and how you use that?

Stefi Cohen: Yeah, absolutely. So I think part of the way that we react to certain situations is related to how prepared we are for that situation. And when it comes to negative outcomes, especially as athletes, we’re told to always keep a positive attitude, we’re always taught to think positively, to not think about anything going wrong. And I think that does a disservice because things are going to go wrong at one point or the other. It doesn’t matter what your winning streak is, whether you’re a boxer, an MMA fighter, a powerlifter, there’s going to be a point where it’s not going to go your way. And how you react to that is dependent on how prepared you are to deal with that situation.

So I actually started working with a sports psychologist after I bombed out of that meet that we were talking about, because you start doubting yourself, you start doubting your ability to make lifts on a platform. Pressure starts setting in, you have all these expectations by other people by yourself. It really terrified me to go back on the platform after that happened, I was embarrassed. I was really embarrassed. Instead of avoiding those thoughts, the thought of things going wrong was: what was in my mind every single day after that? Well, what if that happens to me again? And then I asked myself the question, well, what if that happens to me again? How am I going to respond? I should probably have a plan of what I’m going to do if that ever happens again.

So I started visualizing, like I said, negative outcomes. So I go through the same beginning of the visual imagery, starting from putting my singlet on, putting my shoes on, they call my name, the bar’s loaded, go onto the platform. I say it’s a squat. I squat and I miss, okay, what am I going to do? And I just played with different scenarios of how I was going to react to a situation like that. What’s interesting is that — 

Tim Ferriss: What would be some examples of how you might respond, that you would visualize?

Stefi Cohen: So how I’ve responded in the past was I’ve cried hysterically, terrified that I wasn’t going to make my next attempt. I’ve been really angry. I would assign the blame to someone else, oh, it’s my coach’s fault for picking the wrong weight or it’s the judge’s fault, they didn’t see the — it was actually a good lift, it’s their fault for not seeing it. They don’t like me. The person who wrapped my knees, they don’t know what they’re doing. My left part of my knee was hurting me. I would’ve just assigned a blame to something external to someone else and subsequently just be upset or sad or angry or whatever it might be.

Tim Ferriss: And so, when you’re visualizing these negative outcomes, are you visualizing those responses or different responses?

Stefi Cohen: So I would practice going through different scenarios, and when I arrived at one that I thought would be the best course of action, and that’s what I stick to. What’s interesting is that the next time I competed, the same competition, just the following year, and I got up there, I was more prepared than I had ever been. I had been doing sports psychology for an entire year. I took time off after my injury, I was feeling strong. I was making a ton of progress, feeling confident, and I got up to the platform and I missed my first squat attempt, which is something that I had done in training for five reps. So it’s relatively light. Something that you can do for five reps, is like you’re 80, 85 percent and I missed it on depth.

So the judges from the side didn’t think that my hip crease was below my knee, that’s how they determine depth, and they gave me red lights. And previously I would have reacted to that very upset. I would have blamed them for not seeing the right thing or whatever. And I mean, I just totally brushed it off. I felt like I had been there a million times. My fiance was there, he’s all worried about how I’m going to react, because in previous situations I would have been very upset and it would have thrown me completely off my game. Instead, I just laughed it off and I was like, I’ve been here before, I know exactly what to do. Don’t worry.

Tim Ferriss: What had you rehearsed for that situation that you landed on as your choice?

Stefi Cohen: Exactly that I know what to do, that I trusted my capabilities, that I was prepared, that I had trained really well, that I was feeling strong. I just kept repeating that to myself that it was just a fluke, that I’m going to go back up there and I’m going to crush the second attempt. What is funny is I went up for the second attempt, and got red lighted again. So at that time, I mean, I was pretty much reliving my experience from the previous year, the US Open.

Tim Ferriss: And you get three shots, is that right?

Stefi Cohen: You get three shots, yeah. But same thing, I was totally calm, collected. I just didn’t, again, my perception of that failure was completely different. I just thought of it as part of the game, as something that happens. That doesn’t mean anything about my strength levels. It doesn’t mean anything about my abilities as an athlete, but what does determine what my ability is as an athlete are: how can I respond to unfortunate situations during training? How fast can I pivot, right? How fast can I adapt to the competition standards, because judges are different every time, bars are different, platforms are different. So the better athlete is the one that can adjust to those changes in competition standards the fastest. And so that’s what I did.

Tim Ferriss: So you left us with a cliffhanger. So you got red lights for two attempts; what happened for your third attempt on the squat and what happened for the lift or — excuse me — for the meet?

Stefi Cohen: Yeah. So I actually ended up going up in weight even though I had missed my first two attempts, just because I was that sure that I could do it. I just, I knew it. I’d been there before in my mind. So I went up in weight and I ended up making it.

Tim Ferriss: Were there any other particular tools or benefits, maybe tools that you brought with you after doing a year or roughly working a year with a sports psychologist?

Stefi Cohen: We worked a lot on, especially being someone that’s so open on social media, I felt like a lot of the pressure that I was feeling was imparted on me by just externally, but it’s made up in my mind, right? I felt like everyone was expecting something from me. So I guess it was just circling back at what my why is, why am I doing what I’m doing? What am I trying to prove? Is it for myself? Is it for other people? And just always trying to circle back and remember why I started this journey and what does it mean to me and just trying to stay — 

yeah, and another thing I guess was working on staying positive when you encounter bad training days, because a lot of people see your Instagram or your YouTube videos, your training, and they think that you never have bad days. That you have some superhuman willpower and motivation, and the reality is that, we all experience the same things. We all go through days or weeks or months or years where we are completely unmotivated and we don’t want to do a certain thing. So working on how to stay positive when things don’t go your way, when training sucks, when you don’t make progress, when you fail reps, every session, when you feel like absolute crap, when 50 percent feels like 110 percent, how do you stay positive and how are you able to show up to the gym the next day without bringing that baggage from the previous session onto your next session?

A story that really resonated with me was, and I forgot where I read this, what book it was, but it was about a professional golfer that he would literally not admit to himself or the media or anyone that he had lost a game. He would just totally erase that fact from his memory and just continue on as if nothing happened. And I started doing that. And honestly, my training started going so much better once I was able to let go of my disappointment on a particular session and once I stopped generalizing about outcome in a session to my entire block or I stopped thinking that — I stopped overly thinking about what that meant in terms of who I am as an athlete or as a person.

Tim Ferriss: You mentioned books, so I’m going to grab that. Are there any particular books that you’ve gifted the most to other people or recommended?

Stefi Cohen: Yeah. So The Obstacle Is the Way by Ryan Holiday.

Tim Ferriss: Yeah, he’s my neighbor. He’s about 40 minutes from where I’m sitting — 

Stefi Cohen: No way.

Tim Ferriss: 40 minutes from where I’m sitting right now, yeah.

Stefi Cohen: I love that book so much, man.

Tim Ferriss: Yeah. Yeah, it’s excellent. Any others that come to mind?

Stefi Cohen: Yeah. Then I have With Winning in Mind. I’ve pretty much gifted that one to any high level athlete that I’ve been able to befriend, because I think it’s just such a powerful lesson. I read it a long time ago, but it’s a really amazing read, and then Extreme Ownership by Jocko.

Tim Ferriss: Jocko Willink, Extreme Ownership. So if we go back to the second one, just because I didn’t recognize it, what was the second title again?

Stefi Cohen: Yeah, it’s With Winning in Mind by Carol Dweck, I believe. Or no, no, it’s not Carol Dweck, don’t quote me. Like I said, I don’t memorize things.

Tim Ferriss: So With Winning in Mind: The Mental Management System, Lanny Bassham.

Stefi Cohen: Lanny Bassham.

Tim Ferriss: Does that make sense?

Stefi Cohen: Yes.

Tim Ferriss: Yup. What do you like about that book?

Stefi Cohen: Carol Dweck is the one from Mindset. Yeah, it’s Mindset.

Tim Ferriss: Yes, mm-hmm (affirmative).

Stefi Cohen: The premise of the whole story is about how you manage your mind within your training, within your journey to stay positive and to continue doing what you love doing despite obstacles. That’s the premise of the book. I wouldn’t be able to tell you details, but it really changed the way that I approached my training and the way I perceived ups and downs.

Tim Ferriss: Cool. Yeah, I’m looking at it here. It’s short, it’s about 162 pages, and I’ll give a brief description for folks. “In the Olympic sport that is most dependent upon effective and precise mental management and parentheses rifle shooting, Olympic gold medalists, Lanny Bassham, B-A-S-S-H-A-M proved he was the master…” and then it goes on and on. That sounds like one to pick up.

Stefi Cohen: And it’s short, so most people will read it.

Tim Ferriss: Now you said you don’t memorize stuff, and yet you have a doctorate in physical therapy. And now that, which on one hand, I think is you believe to have been a great investment of time, but my understanding is that you did not take the licensing exam. You didn’t do what was expected of you afterwards. So why did you do it? Why did you go through it and how did you do it without memorizing? You must’ve memorized a hell of a lot.

Stefi Cohen: And I forgot it immediately after. I swear my brain is just wired a little bit different, man. It really is. I’m a lot better at critical thinking. I’m a lot better at just understanding a concept as a whole and then giving it my own twist and applying it to real life situations. So when it comes to hardcore memorization, for example, memorizing exact ranges of motion of each joint or developmental stages in children, I’m not good at that. I couldn’t tell you a single thing about any of that.

Tim Ferriss: Well, it makes me think this could be an apocryphal story about Henry Ford, I think it was, and someone asked him if he knew the vice-president of blah, blah, blah, or something like that and he couldn’t name the person. And this other guest who had made fun of him was getting up on his high horse and Ford was like, “That’s why I have a library, so I don’t have to clutter my head with those details.”

Stefi Cohen: That resonates with me.

Tim Ferriss: So why did you pursue your DPT?

Stefi Cohen: So initially, I come from a family that values high level education a lot, a family of lawyers and doctors. And I think that from a very early age, I guess I started associating the word success with a high degree like a high level of education, either going to a medical school or at least, at the very least getting a doctorate or a master’s or something like that. So part of it, I think, was just pressure from my family initially. And I guess personally, it’s something that I also value, the prestige of being able to say that you’re a graduate from a top school and that you were able to complete a program that only one percent or less of the population gets into, that to me all sounded amazing. I love a challenge, so that was part of the reason.

The next part was anything that I get into, I want to make sure that I’m giving it my best effort. So if being in fitness, if being in strength and conditioning was my goal, if I wanted to be a trainer or whatever it was, the highest degree or highest level of learning that I could do was a doctorate level degree, physical therapy seemed like it would give me the tools to be the best trainer, the best coach, the best athlete that I could be. So that was part of the reason. Now, when I was in my first year of grad school, I started my own business, but hold on before I go there.

So first year of grad school, I had already gone through one of my clinical rotations. And honestly, I just was having such a — I had a, not a great experience in grad school, mainly because of the system, right? I felt like, or not I felt, I knew because I was able to prove it that most of the information that was being thrown at us was extremely outdated. And pretty much the purpose of all of it was one to test your commitment to the profession, to test how bad you wanted it. You’re taking, I don’t know something ridiculous like eight classes or yeah, six to eight classes a semester and there’s just so much information that I didn’t find applicable at all and was just so outdated. And professors were so resistant to challenges.

I’d be that person sitting in the back row, raising my hand and challenging something that the professors said factually or with a lot of confidence, and they wouldn’t like that. They don’t like when they’re being questioned. They don’t like when there’s a student that doesn’t believe what they’re saying and asks things that they don’t know how to answer. So there was a lot of resistance there in school with my professors. And then when it came to practice, when I went on to my first clinical rotation and experienced a little bit of what the general field of physical therapy is like, it just, wasn’t what I thought it was going to be.

When you’re in a big clinic, you’re expected to see at least two patients at a time. I didn’t feel like patients were receiving the best service or the best care at all, because you’re so all over the place having to do your notes and all of this. I remember this one experience I had with my first evaluation that I ever did. I was in the room with my patient, and I do everything by the book, right? So you have this steps A, B, C, D, E steps that you have to do when you’re taking a history and you’re doing your exam, you’re doing your evaluation, you’re doing your follow-up questions, then you’re doing your special tests and then you give a diagnosis.

So I went through all of it, perfectly, did my special tests and got something that made no sense. I got all positive tests or three positive, one negative that didn’t make sense with any diagnosis that I had studied in my book. I excused myself for a second, for the patient I said, hey, I’ll be right back, go outside, I talk to my instructor, my supervisor, and I say, “Hey, man, I did all these special tests, nothing makes sense. I don’t know what’s wrong with this person’s shoulder.” And he just says, “Well, make something up. Just give him a diagnosis, any.” I was just so shocked.

I was so shocked because I used to look up to him, right? He was a mentor, he was a supervisor, he was an instructor. And the fact that that was his answer, and coupled with just the experience I had with my back pain and the lack of consistency in responses, it just made it so evident that school wasn’t doing what it was supposed to do for people. That we were going into a practical field with no practical knowledge, essentially. We have a bunch of knowledge that is only useful for one thing, and that’s to pass the licensure test. So that’s why I didn’t go that route.

Tim Ferriss: Who are some of the people out there, if any come to mind, who have a doctorate in physical therapy, whose insights or work you track or admire? Who you think do good practical work?

Stefi Cohen: Greg Lehman is the first one that comes to mind.

Tim Ferriss: How do you spell that?

Stefi Cohen: Greg and Lehman, L-E-H-M-A-N.

Tim Ferriss: Why do you say that?

Stefi Cohen: I think the first degree he got was in chiropractic. So he went through school, got his chiropractic degree. Then he went on to getting a doctorate in biomechanics, and then he went back to physical therapy school. So in terms of a breadth of experience and knowledge and different camps of thought, he has it all, right? He has the perspective as a chiro. He has a perspective as a scientist, conducts research in biomechanics, and understands the physics of the body. And then physical therapy, which is more of a science of movement.

So I mean, his lectures are absolutely amazing. He’s able to incorporate a little bit of everything into the way that he treats and has a really interesting perspective. I’ve actually had a few sessions with him. They’re all done over Zoom. I think he very rarely practices in person. Very rarely puts his hands on anyone because his whole thing is how can you deliver, or how can you place the power on the patient instead of positioning yourself as a guru, as like someone that people — 

Tim Ferriss: The savior PT.

Stefi Cohen: A savior, right? So it’s about giving the power to the patient and it should be about patient self-reliance, about them building a sense of autonomy and self efficacy as early as possible instead of having them be overly reliant on you as a therapist. So most of my sessions were an hour, an hour and a half long, and there were long discussions about a lot of things, because there’s a lot of things that affect your perception of pain like we were saying. So stress, my environment, my coping strategies, perceptions on movements, and all of these things.

A great example is, for example if you have a paper cut on your finger, like how much importance are you going to place on that, you personally? You probably put a bandaid on it and move on and not think about it until it heals, and then the bandaid falls off and then you’re fine. But a violin player gets a paper cut on the finger that they use to press on those strings and their response to pain, and their association with that injury, is going to be completely different to yours. Because within the context and within his profession, that means a lot more to that person. So it’s important.

So, going back to Greg, he plays a lot of importance on those conversations. Like what does an injury mean to you in the context of your life?

Tim Ferriss: That’s smart.

Stefi Cohen: Yeah. And it’s super, super interesting the way that he treats.

Tim Ferriss: What have you changed your mind on in the last handful of years? Anything stand out?

Stefi Cohen: Yeah. I love telling this story. When I was in college and I stopped playing soccer. I was kind of like on this quest to rediscover myself and finding what the next thing was going to be. Same as far as what profession I wanted to get into. You know, you’re thrown in college and you’re expected to know what you want to study. That’s crazy. I think there’s only a handful of people that know with absolute certainty who they want to be when they grow up. It’s like you’re a plastic surgeon. Like those kids were playing with surgical kits when they were three, and just know that that’s what they love and that’s what they’re passionate about. Or have been conditioned to think that that’s what they want.

Either way, that wasn’t my case. I didn’t know. I had a very vague idea of where I wanted it to be. I knew I wanted to be a public figure. I knew I wanted to lecture. I knew I wanted to write a book. I knew I wanted to be a professional athlete, but I wasn’t necessarily attached to any one route or any one path. So I spent a long time in this discovery period or sampling period where I would get into something. I would try it, sometimes for a long time, sometimes for a short time. And then I would quit and move on to the next thing. But it was strategic quitting. I just didn’t know it at the time. The person I was dating at that time, my ex-boyfriend, one time I remember I got a specialized bike because I wanted to get into triathlons. And he criticized that a lot.

He said, “Stef, why are you investing so much money into a bike when everything you try, you quit almost immediately? You’re a quitter.” And that was, that was shocking to me, especially coming from someone so close to me, that he was calling me a quitter. And I didn’t identify myself as a quitter. I would feel like it was the complete opposite. You know, I’m resilient, I’m persistent. I’m consistent. I’m not a quitter. But I was, right? Like within the classical definition of quitting. Yeah, I was. I was trying a bunch of different things and quitting a bunch of things. But, like I said, it was more strategic than anything. I was just trying to discover myself and what I’m good at.

The way I think about it is there’s kind of like in my head, how I separate it, is there’s three kind of components to finding something that you’re good at. You have your skills, your talents, and your passions. And what you’re essentially trying to do is find the best balance of the three. And you shouldn’t hope to put, again, all of your eggs in one basket. It’s not only about what you’re passionate about, which is part of the worst advice that people can give you, is do what you love.

I couldn’t disagree with that more, because it’s about finding that balance between your skills. So your skills are something that you can work at, that you see progress when you practice it. Your talent is an inherent ability. So something that you’re born with. For example, I was born physiologically to have the capability to get stronger. So that’s a talent I have. That’s something that you can’t really teach.

And then a passion is something that you’re interested in. The funny thing is that when your skills and talent match up, you can start developing a passion for that, because everyone likes to be successful. So you can start developing a passion or a love for something that you didn’t know you were passionate about just because you’re standing out from the crowd.

So for me, that sampling period was so important because I was able to find stuff that I was really, really good at. Sports that I was really, really good at, and a profession that I was really, really good at, because I was curious, because the way that I think about things was scientific. And I was able to excel in those things because I sampled. So the notion that winners never quit is just so flawed. It’s such a fallacy, and it does such a disservice to people. Because it discourages people from trying new things, because they’re afraid that they’re not going to like it, or they’re going to be bad at it, or they’re afraid to fail.

And the reality is that it’s a good thing. It’s a good thing, especially when you quit for the right reasons. So what are the right reasons for quitting? It’s when you identify that there’s like an upper limit for where you can get. You identify maybe something within yourself that you won’t be able to overcome, that you just won’t be able to be better than your competition. Versus quitting for the wrong reasons, which is quitting when you first encounter resistance. That’s cowardly because things are going to get tough at some point. You’ve just got to know, you’ve just got to be very strategic, again like I said, of when you’re quitting and not being afraid to quit for those reasons.

I think I read this on, I believe it’s The Dip by Seth Godin, the sunk cost fallacy. So it’s basically when you’ve invested some time or money into something, it kind of tricks you into not wanting to leave it, because perceptually you’re like, “Oh, I’ve already spent all this time.” It’s what happened to me in PT school. I think that’s one of the reasons why I didn’t quit, was because I had already invested a year of my life and a year of tuition into that. And I was like, I might as well stay. Obviously there were other reasons for me to stay and it ended up being really positive for me. But that’s what keeps people in jobs they hate. That’s what keeps people from not taking a risk and starting their own business, or not switching sports, or careers, or friendships, or partners.

Tim Ferriss: So winners never quit and quitters never win: false, in the life experience of Stefi Cohen. And by the way, yeah, she’s broken 25 world records. So most of y’all can just shut the fuck up. So yeah. Although it does take a certain sensitivity and a degree of refined perception and self-awareness to identify what you are good at and not trick yourself into thinking that you are just sampling, when in fact you are stopping due to pain, or discomfort, or setbacks, or plateaus, right? So it does require a certain amount of reflection to go through that sampling period, and then double down and triple down on a few areas, or one area where you truly have an advantage that you can learn to love. It does take some awareness.

Stefi Cohen: Absolutely. And you’ll make that poor decision sometimes. For example, I think I made the wrong decision when it came to soccer, because the reason why I stopped playing soccer I think wasn’t the right one. If there’s one thing I could change about my past, it would have been to try harder.

Tim Ferriss: With soccer.

Stefi Cohen: Yeah.

Tim Ferriss: Well, let’s talk about something that popped up when I was texting with a few people who know you. Adee Cazayoux prompted me to ask about time management, because whether it was all time well-invested or not, you completed your doctorate while training to break 25 world records and simultaneously creating a successful business, which I think we haven’t spent a whole lot of time on. But you have built and scaled a business very successfully.

So you’re doing all of those things simultaneously, at least at one point in time. How do you think about time management or what are some of the key components to doing that much simultaneously? What sacrifices are made, or how would you encourage people to think about it? Because that does seem to be unusual, the capacity to do that.

Stefi Cohen: Actually, I love this question because I have a very non-traditional answer. I think a lot of, quote-unquote, high achievers or high performers have this seemingly very well-constructed and organized weekly, monthly, yearly schedules, where everything’s planned. They have like times where they do certain things, and times where they don’t. Times where they, whatever. Like they seem to be very organized. And for a long time, I tried to be that way. Read things like The Seven Habits of Highly Effective People and The 4-Hour Workweek. And I was always — 

Tim Ferriss: That second one, terrible advice.

Stefi Cohen: Yeah. And I just felt so frustrated because I didn’t feel like I was like everyone else. So to a certain extent, I felt like I was an imposter. You know, I’m a lazy, successful person. That’s how I would feel. I’m pretending that I have all the habits of all these successful people, when in reality I’m not like them. I do things very differently. I don’t do well with inflexible schedules. I don’t have an agenda that’s all color-coded and highlighted. I don’t have a morning ritual. I really don’t. I’m more like a free spirit. I’m a procrastinator. I’m unorganized. My mind is all over the place.

Tim Ferriss: Hold on, though. That having been said, it’s not like you’re just eating Cheetos and watching reruns of Seinfeld, smoking out of a bong all day.

Stefi Cohen: No.

Tim Ferriss: When you’re getting a DPT, and the training, and the successful business done at the same time. So as a free spirit, how the hell does that get done?

Stefi Cohen: Right. So I mean, for the longest time, I tried to be like other people, and I just found that it wasn’t going to work for me. So the way I do things, is I focus on the task at hand. So what do I need to do right now to either finish a project or to move in the right direction? And I do that. I used to cycle it based on prioritizing. So for example, while I was in physical therapy school, I knew that there would come weeks of increased workload when I was doing practicals, or there was a thesis, or there were midterms or final exams. I knew those times were high stress, and I knew that whether I liked it or not, I was going to have to spend extra time inside studying, which is why I actually built a home gym in my living room when I was in PT school, in a second floor apartment. It’s probably not the smartest thing to do,

Tim Ferriss: Your neighbors downstairs loved you.

Stefi Cohen: They hated me. They thought I was insane. But yeah, that’s what I had to do. So when those times would come in, pressure was on, was time to study, I would just come to terms and accept that training was going to take the back seat. And Hybrid, my business, was going to take the backseat for those two weeks while I focused on this one very important thing, which is staying in school, which was more difficult than it sounds. Because they had a very strict policy where if you got anything less than a 75 percent on any test, you would get kicked out, which I did.

Tim Ferriss: We’re going to have to come back to that. Okay. Continue.

Stefi Cohen: So yeah, I just focused on the task at hand. If there were tests coming up, I would focus all my energy on that. And I would train as much as I could, whether it was a 10-minute workout or a 20-minute workout, it didn’t matter. And I didn’t feel pressured to spend any more time at the gym because I knew that once the midterms or finals were done, I was going to have more time. And then when that was done, I would double down on my training and on my business. So I would skip class. I would spend four or five hours at the gym. I would do double sessions when I had the time. So I just basically played it by ear. I did what I had to do when I had to do it, and somehow everything got done.

Tim Ferriss: Well it sounds like me, correct me if I’m wrong, but you are very good at single-tasking, right? You’re not multitasking. You’re not doing 17 different things in a given day. You are identifying for the next two or four weeks, or two months or four months, whatever it might be, what the most important thing is to move forward. And then you just basically drop everything else. Maybe not drop, but you focus almost all of your energy on that one thing.

Stefi Cohen: Exactly.

Tim Ferriss: You get kicked out of school. This is for getting less than 75 on a test?

Stefi Cohen: Dude, that was a horrific experience, let me tell you. So I’ve never failed a test in my life. Even though in college I wasn’t that applied. In high school, I wasn’t that applied. I somehow always passed my tests. You know, I’m like a B plus student, and somehow I failed this test of the silliest class ever. You know that class that you think to yourself, “Ah, this is such an easy test, I don’t even have to study?” That was that type of class. I took my test. I disconnected completely. I went to Canada for Christmas, with Hayden, with my fiance. Didn’t think about school at all.

Then all of a sudden I get back home two or three weeks later. And there’s a pile, a pile of letters from the head of the school, the head administrator of the school. And I’m like, “Oh, my God, it’s not good.” I opened them up, and basically it was the first one that said, “Hi, you have seven days to submit an appeal. You failed,” I think it was Treatments and Evaluation class, “with a 74. You have to submit an appeal in seven days, otherwise you’re going to be dismissed from the program.” And then there was letters like every day after that day saying, “We haven’t heard from you. We’re taking you out of the roster. We’re taking you out of the class. We’re kicking you out of the program because we didn’t hear from you,” essentially.

And that was the most terrifying moment of my life. I just felt like such a loser. You know, getting kicked out of school, that’s big. So anyway, I made an appointment to speak with the head of admissions, and to speak with the entire committee of academic review. And they ended up giving me an appointment, given me an opportunity to appeal given the circumstances. I didn’t really know that they were trying to contact me. I just kind of disconnected. I didn’t expect to fail a test, I guess.

And I sat down in a room with, I guess there were 15 or 20 professors. There was a round table, huge round table. And I’m in the middle and pretty much I’m just being asked, why do I deserve a second chance? Why they should let me back in? What do I think I failed? What am I going to do different? But the question, or the statement I guess, that stood out to me the most was this one professor, his name’s Dr. Fiebert, which by the way, I love him now. And I think I love him more because he challenged me.

I guess that’s how I perform my best, when there’s a challenge, when people don’t believe in me. So he stared at me right in the eye and he goes, “Stef, I just think the problem here is that you’re not as strong as a student as you think you are. And I think you’re going to have to make a decision between becoming a professional athlete or becoming a professional student. But I don’t think you’re capable of doing both.”

And I just looked at him in the eyes and I said, “Professor Fiebert, with all due respect, I appreciate your criticism, but I have to disagree with that statement. I think what happened was a fluke. I think I’m more than capable as a student. I think I’m more than capable to do both things. I just wasn’t focused on the right thing. Something happened with that test. I didn’t focus enough. I didn’t study enough, but I think I’m capable of doing it.” And they ended up granting me a second chance.

That was my second semester of grad school, and from there on my professors were like all up in my ass basically, until I graduated. Because they just thought I was this rebel. I would get to school, more often than not late, probably from training, with a barbell in my hand because I would train at noon as well. So I would take the lunch break to train.

Tim Ferriss: You carried your barbell with you?

Stefi Cohen: Carried my barbell.

Tim Ferriss: “Don’t mind me. I’m just carrying my barbell around the class.”

Stefi Cohen: “Don’t mind me. There’s nothing to see here.” Yeah. And meanwhile, my spine professor would be like, “You’re going to break your back doing all those deadlifts.” You know, people thought I was crazy. But yeah, I made it. I didn’t fail a single more test for the entire three years. It was honestly the most stressful three years of my life, just because I felt like that getting kicked out was so eminent. I just felt like I was one slip away from being kicked out.

Tim Ferriss: Waiting for the other shoe to drop.

Stefi Cohen: Yes. But I made it.

Tim Ferriss: But you made it. You made it and much more. So let’s do a few more questions, and then we can bring round one to a close. I know we didn’t get a chance to talk about diet. You are exceptionally expert in diet. So we haven’t had a chance to discuss that. We haven’t had a chance to talk about boxing. There’s a lot we could explore that we’re not going to have a chance to explore today.

But let me ask you two things. Aside from school and the failing of that test, do you have any favorite failures that you learned a lot from, or that set you up for, in some way, later success? Could be also a dark period, but just anything particularly challenging that comes to mind that in some way ended up helping you?

Stefi Cohen: Yeah. So actually my favorite quote, and this is the only quote I have memorized, is “Each fresh crisis is an opportunity in disguise.” I can’t remember where I first read it, but it resonated with me so much, because honestly every single time I’ve failed at something it’s been the best, worst thing that has ever happened to me. It’s opened so many doors and so many new opportunities. When you look for them, they’re there. So I think every single time I’ve experienced any sort of failure, I’ve been able to get out of it better than ever.

So I guess obviously one of the biggest ones was getting kicked out of school, and just having to reframe how I thought about school, and how I studied, and my habits, and how I organized my study and my training. But aside from that, I mean, there’s many. Moving to the US on my own. Starting with a 2.5 GPA, not knowing if I was going to be able to stay in school. Not understanding the language. Having to take multiple steps back in several classes. Retake classes that led me to discover other passions. What else is there? I don’t know.

Tim Ferriss: Well, your bombing out in that competition probably in some way.

Stefi Cohen: Yeah. Failed relationships. Infidelity issues with partners that led me to kind of rediscover myself, and change my perceptions on relationships, and what kind of things I can do better to be a better partner. Friendships ending. Failed friendships. Failed relationships with my family, with my dad. That all ended up teaching me a ton. You know, I think that society glorifies happiness. Society glorifies being in a good mood, and being happy, and being positive. And fails to acknowledge the important lessons that happen when you’re going through dark periods of time, when you’re going through tough times. I mean, those are so important.

Look. At the beginning of this year when the pandemic first started, I did my last powerlifting competition of this year in February and my back pain got exacerbated a lot. I did a massive weight cut. I cut like 20 pounds in a period of like two weeks. I broke some world records, and then my back was flared up worse than ever. And it’s upsetting. It’s frustrating, especially after I wrote a book about back pain and I’m having a hard time managing it.

So I fell into this really deep depression because I felt like my identity was being stripped out of me. My identity as an athlete. My identity as a high-level top performer. My identity as an authority in academia when it comes to back pain, when it comes to injuries, when it comes to strength training. I felt like I didn’t know what I was talking about anymore, because I couldn’t even figure it out for myself. Couple that with the pandemic, everything closing off, I felt like my life was just kind of spiraling downwards out of control.

I spent a couple of weeks like that, just feeling pity for myself, feeling really bad about the situation, about the cards that I was dealt, about my back, about potentially not being able to lift again. I didn’t know about the livelihood of my business. How is the pandemic going to impact my income? And all of these other things that just created an insurmountable amount of anxiety for me. I think it’s just part of the process to go through a couple of weeks, or a month. I do believe it’s important to give yourself a time cap for how long you’re going to feel bad for yourself, because otherwise you just ended up stuck in that phase for way too long. So I remember just making the conscious decision to stop feeling bad about myself and about my situation, and trying to see the positive and the opportunities that lied within that.

So when it came to sports, I bought a boxing, a heavy bag, and I put it in my garage. That led to Karim, my new coach, reaching out to me and wanting to make me a pro fighter. That opened the possibility for me to get into a new sport. And then the pandemic closed the door for networking, for example. That was a big part of how I gained exposure. I traveled for podcasts. I lectured. I appeared on YouTube videos. That was a big part. Competitions were canceled. So I initially was really worried about how that was going to impact my ability to continue growing my business and growing my social platform, and I guess my personal brand.

So I doubled down on other things. Like we created a whole series of masterclasses that we’re starting to offer. We created five courses. We finished our coaches certification for Hybrid, where we’re writing a manuscript, a full textbook. We invested in our team. We found new software developers. You know, we did so many good things for the business that I guess we wouldn’t have done if everything stayed the same. And it ended up being everything was okay.

And I think it’s that change of mindset, that change of trying to find the opportunities within what seems like the worst thing that could’ve ever happened to you. And they’re always there. It’s just a matter of changing your attitude, your perception of what failure is, and finding ways to see, the beauty in that failure, and what kind of opportunities present on the other side.

Tim Ferriss: Each fresh crisis is an opportunity in disguise. Good advice. Good maxim for life in general, and fingers crossed for 2021. But no matter what transpires, yeah, always looking for the opportunity hidden in the crisis. Excellent advice. Stef, this has been so much fun. People can find you all over the place. Hybridperformancemethod.com. Instagram @StefiCohen, S-T-E-F-I C-O-H-E-N. On YouTube, you have your podcast Hybrid Unlimited. Is there anything else you would like to say or ask of the audience, any closing comments, anything at all that you’d like to share before we bring this first conversation to a close?

Stefi Cohen: I think the only thing that I wasn’t able to address, because we kept getting sidetracked on side stories was the summary of recommendations that you were asking me. Like, what do you do when you have an injury? Like step-by-step? Do you want me to go through that quickly?

Tim Ferriss: Yeah!

Stefi Cohen: I’ll do just one, two, three, four, five, six, like the bullet points.

Tim Ferriss: Lightning round.

Stefi Cohen: Yes. So when you’re hurt, these are the six things that you should be doing in any injury. This applies to any injury. The first thing is stop doing what hurts. It seems like common sensical, but at the same time is something that a lot of people trick themselves into thinking they don’t need. That’s definitely always the first step. So take a step back, and don’t be afraid of taking some time off. You know, you take one step back, two steps forward kind of thing.

Don’t underestimate isometric exercises, or seemingly simple exercises, because it’s all about delivering positive movement experiences when you’re in pain. So it’s about finding movements that feel good to you, and that don’t exacerbate your pain.

Increasing the amount of aerobic activity that you do. So walking more, moving more in general. There’s a saying in PT that’s I think overstated, but motion is lotion. And that is true. You know, the more that you move, more blood flow goes into your joints, the better it is and the more you avoid that deconditioning loop. Because what a lot of people tend to do when they’re in pain, is they stop moving altogether because they think that that’s what they need. But bed rest and immobilization is all outdated. You want to move as much as you can essentially.

Using pain to optimize your movement. The way that I think about it is kind of like a stoplight. Zero to three to pain means go. Two to three out of 10 of pain means go. Three to six means warning. And over six means definitely don’t do that. So use pain to inform your training decisions and the movements that you do.

Once you’ve done all of that, you’ve got to turn off the pain alarm. So for a period of time, it’s okay to avoid certain movements, but then you shouldn’t be avoiding movements forever. So starting to expose yourself to tolerable ranges of motion, and tolerable movements that don’t make your pain worse, so that you can get back to the movements that you used to do, that bring joy to your life.

And then understanding. The final one is understanding that tissue adaptation takes time. Sometimes we’re married to these very rigid healing times that we see on the internet. We’re like, “Okay, how long does it take for an elbow injury to heal? Okay. Two to four weeks.” Then four weeks go by and you’re still in pain, and you think something’s wrong with you. But oftentimes nothing’s wrong with you. You just have different sensitivities to pain in different ways that we deal with it, and different healing times. So just don’t rush the process and understand that everyone experiences pain and injuries at a different speed. That’s it.

Tim Ferriss: And that’s it. The new book is Back In Motion.

Stefi Cohen: Back in Motion.

Tim Ferriss: I’ve been very impressed with a lot of the writing, and can’t wait to see what you do next. Especially with boxing. Looking forward to seeing the infighting. And I would not want to get punched by you so I will run on the sidelines, clapping like a fanboy. We’ve mentioned a couple of different options for people to find you. Are there any other places or resources you’d like to mention?

Stefi Cohen: No, that’s all. Covered them all.

Tim Ferriss: That’s it. All right. Well, Stef, thank you so much for taking the time today to be on the show. And to everyone listening, we will have links to all the topics, all the people, all the books, all the exercises, and so on that came up today. You will be able to find those as usual at tim.blog/podcast. And until next time, each fresh crisis is an opportunity in disguise. Keep it in mind. Enjoy variability. Pay attention to your GPP, and thanks for tuning in.

The Tim Ferriss Show is one of the most popular podcasts in the world with more than 600 million downloads. It has been selected for "Best of Apple Podcasts" three times, it is often the #1 interview podcast across all of Apple Podcasts, and it's been ranked #1 out of 400,000+ podcasts on many occasions. To listen to any of the past episodes for free, check out this page.

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