The Best Exercises For Muscle Building, Health & Longevity - Dr Peter Attia
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Dr. Peter Attia outlines his approach to building muscle, health, and longevity through four primary pillars: strength, stability, VO2 max, and Zone 2 training. Regarding strength, he emphasizes generating force within a specific rep range of five to fifteen repetitions rather than pursuing one-rep maximums or maximal loads below three reps. His overarching principle involves maintaining zero to two reps in reserve on every set, avoiding the ego lifting that leads to form breakdown or injury. While bodybuilders often utilize supersets and drop sets to failure, Attia argues that true strength training requires transcending ego limits to ensure consistent safety and effectiveness across different session volumes, whether performing eighteen working sets for lower body days or twenty-four for upper body sessions. A significant portion of his regimen is dedicated to stability, which he describes as often misunderstood by both gym enthusiasts and cardio specialists. Attia uses a compelling analogy comparing street cars with high horsepower but loose chassis to track cars that are lighter with stiff suspensions; just as the race car wins on corners due to better traction rather than raw speed alone, human movement relies on minimizing energy leaks caused by joint laxity or poor neuromuscular control. He illustrates this concept through his own history of injuries and his work with Michael Stromness, a practitioner of Dynamic Neuromuscular Stabilization (DNS). This methodology focuses on relearning fundamental movement patterns that were genetically programmed in early childhood but often corrupted as adults developed bad habits over time. To address these stability issues, Attia integrates dedicated DNS training twice weekly alongside daily stability exercises performed between main lifts or during off days. He highlights the importance of working with qualified practitioners like Kyler Brown to rebuild proper alignment and control, noting that complex movements such as pull-ups can transmit excessive force into vulnerable joints if scapular stability is lacking. His rehabilitation journey following an Achilles rupture taught him critical lessons about balancing strength development with plyometrics and addressing specific muscle imbalances; for instance, he had to aggressively strengthen his left calf after overshot loading the right leg during recovery from surgery in the UK. One of Attia's favorite lower-body movements is the box step-up, which academic literature suggests recruits significantly more glute fibers than exercises like donkey kicks or bridges. However, individuals with highly flexible ankles, such as former swimmers who may be prone to snapping their Achilles tendons, must exercise caution during this movement. To prevent knee valgus and excessive stress on the front of the leg when driving knees over toes due to dorsiflexion flexibility, Attia works on strengthening the soleus muscle to counteract these tendencies. He stresses that while videos can offer guidance, learning DNS principles under professional instruction is essential for safely updating one's neuromuscular "software" and avoiding injury while optimizing long-term physical performance.
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so you've got four pillars strength
stability VO2 max zone two yep strength
and stability talk to us about that
um so strength is probably the easier
one for people to understand
um you know that's basically your
ability to generate Force
um and of course within strength you
have different you know different areas
of strength so I don't do a lot of
maximal stuff anymore so in other words
I'm rarely
If Ever I don't think I really ever go
below three reps so the the heaviest I
will go is five reps stuff so I'll do
you know I'll do dead lifts 35 ish
um that's why you've done that you don't
get one RM because you're not doing it
but I can sort of predict it because I
do use a velocity tracker so have you
seen these yeah the bus speed things
yeah yeah so I do measure bar speed
um so I can have a prediction of it I
can have a prediction of one RM
um
but yeah usually I'm sort of in the 5 to
15 rep range when I'm training so I'm
basically but but what I'm always trying
to do is make sure I'm somewhere between
zero and two reps in reserve
so that's I'm really training off reps
in reserve okay that's my overarching
principle of training is so so even if
I'm at five I'm probably training to one
to two rep in reserve
if I'm at 15 I'm still one to two reps
in reserve this the bodybuilders out
there that want to do supersets and drop
sets to failure that are tearing their
hair out at the moment
yeah I'm sure and again I there are
absolutely sets where I do go to failure
but the truth of it is it's very hard to
go to failure all the time I I think I
think if people are being brutally
honest with themselves like they still
had another one or two reps left every
time yeah I don't I I mean I
I I know what it's like to go to failure
um and you don't you you only have so
many of those matches every day
um so I don't even try to play that game
I just sort of say like
I know I've learned that I've got if I
stop now there's only two more I would
get before I would violate my form so
badly that I would either injure myself
or you know just effective transcending
ego lifting is uh one of the most
difficult things that you can do forget
about the consistency and all of that
it's transcending ego lifting
um
strength formulating a strength protocol
across the week what are you
prioritizing you're prioritizing large
lifts are you prioritizing session
length etc etc yeah it first of all
there's quite a bit of
um variability in my in my training
um but generally I'm doing four days a
week and not generally I'm always doing
four days a week and it's two days lower
body two days upper body now I I used to
I've for Years also done three days of
mixed longer sessions but I prefer what
I'm doing now I prefer doing two lower
body days two upper body days and
uh yeah I prioritize big lifts and I'm
sort of working on like so today I had
24 working sets uh of of upper body uh
you know on Monday I had
18 sets of lower body 18 working sets of
lower body
and probably on Friday it'll be a little
bit more volume it'll probably be 22 to
24 sets of lower body uh working in that
five to Fifteen yes uh which is Ish RP 8
e eight eight eight and a half yeah yeah
sometimes maybe as little as seven on
some things especially if you've had the
night's sleep yeah the night before
yeah
um
what when you're looking at movements
for instance what was your session this
morning can you remember in terms of
exercises yeah so uh I did floor presses
uh dumbbells yep yep I did
um pull Downs I did incline press
I did row
I did
um
um like incline curl
uh overhead tricep extension
and um and then a preacher curl you know
it's not a true preacher bench but
hanging over a bench doing a preacher to
create the same angle yep and then uh
laying tricep extension and then always
in between them I'm doing stability work
so we didn't come to stability but I'm
doing I do two dedicated days of
stability a week so Tuesday Thursday I
do a full dedicated hour of stability
training and then on the off days it's
not Tuesday Thursday I'm getting in at
least 20 minutes of stability per day on
on either side of the exercise like
throughout the workout so the stuff that
we've gone through so far
the gym Bros will still understand what
cardio is the cardio Bros will still
understand what lifting is
nobody understands what balance training
is yeah no one understands what what are
the principles behind this no one's ever
thought about stability training before
uh how do you integrate it into your
workouts and then also what does a
dedicated session look like
yeah it's very difficult to explain
um it's actually I think it was the
hardest chapter in the book to write
truthfully
um because
it's
it's not it's it's hard enough to show
people in videos or to have friends over
who want to work out with me and put
them through the exercises that's
actually very difficult
um so
you know I lead with an analogy in the
book where I talk about the difference
between streetcars and track cars
because I'm a car nut and I being on the
racetrack is probably one of my favorite
things to do and
um so so the analogy I give is is this
which is
um
if you took if you take a street car
with very high horsepower and you put it
on track and you let it race against the
track car which is lighter less
horsepower typically for a given engine
size or for a given class size slick
tires on it which one's going to be
faster I mean it's no comparison right
the track car rips the streetcar into
Oblivion even though by the way the
street car will go faster in a straight
line
so the example that I use in the book is
a real example I compare at the time
this is you know seven or eight years
ago my streetcar at the time was like a
an actually a modified e92 M3 so nice
I've modified it changed all the airflow
that thing was putting out
475 horsepower big German based yep and
at the time my track car was a spec E30
M3
I'm sorry not even an M3 just a spec E30
okay right but everything's stripped out
roll cage is in stiff as hell
165 horsepower
engines in it oh this is the stock
engine
yeah it's a six in line right okay yeah
yeah so so you've got the this the stock
165 horsepower engine it's very light
the car weighs like probably 2 400
pounds versus the M3 is 3 400 pounds
m3's got street tires on it this one's
I'm running you know probably Hankook
slicks on it but to your point the
chassis stiff as a button suspension
super stiff and yeah I was going faster
in the straightaways in the M3 but my
lap time was two seconds faster which on
a track is might as well be a day yep
um in the spec E30
and of course what does it come down to
it's cornering speed what does cornering
Speed come down to it comes down to of
the 165 paltry horsepower in that engine
every little bit of it is making it
where it belongs remember what is the
name of the game in driving a race car
it's all about friction it's all about
power loss it's all about transmitting
what's happening in the crankshaft to
the tire tire to the street that's it
you only have four points of contact
with the outside world nothing else
matters and so again we're not talking
about aerodynamics because these aren't
Aero cars right so in the in the
streetcar first of all I have much more
slippage at the tires
because I've got I'm not running slicks
secondly the chassis is so loose right
swallowing all over the place I've got
all this all this energy loss with
energy leaking out of that car not
making it to the surface of the track
it's like having laxity in a joint
that's right so every time you're
hurting your knee you're hurting your
elbow something's hurting that's an
energy leak
so again even if one doesn't care about
performance just from an injury
perspective this is something we want to
avoid we want to avoid it and again my
introduction to stability only came the
hard way it's not like I was born out of
the womb realizing this was an important
thing I mean I had to go through
horrible injuries to finally arrive at
this place where I said you know I'm
tired of being in pain I'm tired of the
fact that my elbow hurts when I do
pull-ups and you know oh like half the
time I deadlift or squat my back hurts
you know my SI joint hurts the next day
like it was just kind of tired of that
and then I got very fortunate and that I
landed
um in the in the company of a guy named
who I write about in the book briefly
his name is Michael stromsness and um
he's a practitioner of something called
DNS Dynamic neuromuscular stabilization
and very first time I met him you know
at the time I was like
my main complaint was uh basically my
right SI joint and my right elbow I had
tennis elbow having never played tennis
and he said all right you know take your
shirt off and hop up on the bar and do
some Pull-Ups so I I did and rattled off
you know 15 pull-ups or something which
I could do easily at the time
um and he's like oh that's horrible like
those are those are and by the way these
are good form pull-ups I'm not doing
like bro pull-ups where I'm like jerking
up and down I'm doing like full
extension up like everything perfect and
he's like yeah you have no capacity to
control your scapula so your scapula is
winged and in doing so you are
transmitting all of that Force into your
elbows you cannot retract your scapula
you don't have the control you don't
have the stability in the scapula so
you're leaking energy through your
scapula in your arm so to make a very
long story short that that which started
in 2017
um just took me so far down the rabbit
hole of not just DNS but other other
schools of thought I would later go on
to meet someone named Beth Lewis through
Michael who
um you know has has her own expertise
around
um other other disciplines and we
basically just started piece by piece
rebuilding my movements and by the way
that meant spending a year not doing
pull-ups and not dead lifting as I
re-learned how to how to align my body
again and so today
I'll still spend two days a week working
with a guy here in Austin named Kyler
Brown who's amazing
um working on just dedicated DNS things
and again if you watched the exercises I
was doing you would be thinking what is
he doing
you know like why is he doing you know
why is he in these baby positions like
moving in these odd ways but a lot of
what DNS is based on is the idea that up
until we were about two years old we all
moved almost perfectly
most of our movement patterns that are
corrupt which we all have as adults only
started to kick in once we were about
two
uh maybe one but but generally about two
so so there's a very predictable you
know neuromuscular set of or sequence of
movements that are genetically
programmed into us the ability you know
the way a child reaches for something
the way a child rolls the way a child
stands the way a child you know gets
into a bare position all of these things
are basically hardwired into us and the
goal of this type of training is to
basically provide a software update on
the crappy software we've ins you know
we've we've overridden that system with
let's say someone doesn't live in Austin
doesn't have access to your very smart
friend there are lots of DNS
practitioners across the country but you
would advise doing this with instruction
I think so yes I think the complex and
nuanced and yeah I think DNS is
um is very difficult to learn
um I shouldn't say that I haven't tried
to learn it off you know videos and
online and there might be ways to do it
but but I think you know trying to find
a practitioner is a good way to start
um and then once you have it going it's
it's always great to to to you know
continue on your own and there's a lot
of stuff I do with my friend Kyler
that's not DNS I mean you know one of
the issues I've been having injury-wise
I have very flexible ankles I think a
lot of former swimmers do and so one of
the drawbacks of that is
when I do freaks I love doing box
step-ups we're both Cut From the Same
Cloth I knew that you were a massive fan
of these they're my favorite movement
for the lower body I absolutely love I
love doing them in all regards I love
doing them very very heavy I love doing
them very very slowly all these things
well because my ankles are so flexible
and I can really really dorsiflex I have
a tendency sometimes when I'm because
like as you know when you're when you
want to do a step up the real key to it
is pre-loading the glute and the ham
correct not bouncing off the floor
that's right so so to pre-load you want
to be able to shift forward and glide
the femur back that creates an enormous
stretch eccentric stretch so that that
front leg is loaded boom you pop up okay
well in doing so I often will drive my
knees so far over my toes because I have
the flexibility of my ankles but
sometimes I'll develop a little bit of
discomfort there in the front so one of
the things I'm working on with Kyler is
Soleus strengthening to actually
counteract that move movement bring it
back yeah and so the amazing exercises
that he has come up with for me to do
these you know to do solely a
strengthening which um again you have to
you have to be very deliberate about
doing that it's easy to strengthen your
gastrocs uh the Soleus requires more
effort I learned this intimately during
my Rehabilitation absolutely I overshot
it actually it was hilarious so um
this is not a good time to snap an
Achilles but during Cove it wasn't bad
um and I overshot it on my right leg
which is the one that snapped and I
ended up having to then work on my left
more aggressively to catch it up because
I'd ended up building up a a calf that
was bigger I mean I learned so much man
from that the first thing was I had a 13
day wait period because I was doing it
on the NHS although I managed to find uh
one of the top three surgeons in the
entirety of the UK through a friend who
was on the NHS to come and do my
reattachment which was really really
great it felt like being um fitted in at
the end of the day with a barber that
needs to do the haircut and I was
waiting around all day all day all day
and then it got to the very end and we
he had to run it back and I had to go
back tomorrow I've been fasted all day
because I was going to go into General
and it's like blah blah blah anyway
um
a bunch of the things that I learned
from that coming out the other side were
how important it is to be able to deal
with not just strength but plyo
especially for that ankle position but
what I'm thinking here when when you're
talking about your challenges with box
step ups there's a guy called Dr Eddie
Joe PhD on Instagram now he took a
massive Hiatus for like three years but
he did these really great breakdowns of
academic literature in infographics
which lend themselves to Instagram very
nicely and I'll never forget this one
from nearly four years ago I think and
there'd been a study done looking at
muscle fiber recruitment for glute
exercises and you know you look at the
glute Factory bum lab things for girls
that want big glutes or me that's
increasingly realized that my back gets
better the bigger that my bum gets
um and glute Bridge donkey Kickback side
raises all manner of Fantastical
exercises that that girls do and he'd
ranked them by uh the amount of muscle
fiber recruitment the top five exercises
were step UPS or step up variations it's
like Step Up
cross body step up like lateral step up
something something something and then
maybe hex hex bar deadlift was
in the sort of upper middle uh deadlift
another one and then you get down toward
like glute Bridge Kickback and it's at
25 and I think it's 95 on this
particular scale of this number would
Step Up So for anybody that wants to
improve like lower body power I just I
absolutely adore that movement and it's
so easy to do we
um you know in the first iteration of
writing the book I had intended to put
so much detail in about instruction on
like kind of the most important
movements in the end it was getting too
long so what I did is I ended up
creating videos for a handful of them
and one of them is the step up so
there's a pretty good video
um on this like the book will Point
people to where to go on our site to see
it and it's I just watched it yesterday
it's a pretty good instructional video
is it you doing it it's me doing it with
Beth and I talking through how to do a
step up cool uh weighted unweighted low
box High box the whole thing eccentric
concentric what are the pitfalls how do
you you know how do you unload the ribs
to you know you know do them incorrectly
and all that stuff so what's happening
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