Personal Trainer Javeno McLean on Helping Clients Find Physical and Emotional Strength

Episode Transcript

Dr. Correa:
From the American Academy of Neurology, I'm Dr. Daniel Correa.

Dr. Nath:
And I'm Dr. Audrey Nath.

Dr. Correa:
This is the Brain & Life podcast.

Dr. Nath:
Okay, Daniel. I want to hear, you were formerly military, you do a lot of exercise and things. Tell me about your weightlifting life.

Dr. Correa:
I learned some weightlifting when I was wrestling in high school, but when I was in the military, I just got caught up in all the CrossFit rage that was going on in the late 2000s. And during one of the times, I jumped in with one of these gyms. We ended up doing a lot of these high-intensity workouts without really understanding well all the techniques.

Dr. Nath:
Oh, yeah.

Dr. Correa:
Yeah, I ended up doing these crazy pull-ups that I overextended my shoulder on one side and partly tore my rotator cuff. So my experience was the importance of having a good trainer who showed you the skills.

Dr. Nath:
Oh, wow. Okay. So you have a CrossFit war story. So I did get to talk to an absolutely incredible trainer, Javeno McLean. He's in the UK. And what makes him so unique is, sure, he's won competitions, he does power lifting, he knows all those things. But he has gone out of his way to work with people with various neurological disabilities as well as other health issues and elderly folks to get them in the gym, and as he puts it, "Just forget everything for an hour and move." And it is such a fun story, and he provides this service for free. This guy is amazing.

Dr. Correa:
That's amazing that he's figured out a way to get it free to the community and just encourage more people to be more active because it's important for all of us, but especially when you already have a mobility limitation. It's essential.

Dr. Nath:
So he and I we're talking about things like plasticity and how he would get people to think of movements, and then over time get small movements to happen where people were working without thinking about it. So after that, I spoke with one of my attendings from residency, Dr. Gottfried Schlaug, and he is a motor recovery expert. And we talk all about the link between thinking and moving and planning, and we had a lot of fun. And on March 30th, we're going to hear from Richard Engel, Chief Foreign Correspondent for NBC News about his son's struggle with Rett syndrome.
We have never done this before on the Brain & Life podcast. Today I'm going to be speaking with a power-lifting champion. That's right. I have so many questions. Javeno McLean is himself an accomplished, power-lifter, winning first place in the power-lifting European championships held in Manchester last August. He's had a career in fitness for over a decade, but his own trophies and awards aren't why we're talking to him today. Javeno did something he totally didn't have to do to give back. He opened a gym exclusively for people with disabilities and the elderly, and it's free. This is in Manchester, England. I'm going to let Javeno tell us about how this all came to be. Welcome to the podcast.

Javeno McLean:
Thank you for inviting me. I can't wait to talk to you.

Dr. Nath:
Of course. So I have so many questions about this. First off, how did you start a gym for people with disabilities? How did that even happen?

Javeno McLean:
Well, long story short, it's actually 22 years I've been in this industry, Audrey.

Dr. Nath:
Two decades.

Javeno McLean:
22 years. I'm only 37, and I started this a long time ago. I started 22 years ago, and for 22 years-

Dr. Nath:
My goodness.

Javeno McLean:
I'm very proud of the fact I've never charged a penny for anybody with a disability-

Dr. Nath:
How do you do that?

Javeno McLean:
... or even cancer. Because I want to help people, man. Do you know what, Audrey? We live in a society, we live in a world where money is God. Everyone worships money a bit too much. And if I want to help somebody from the purest part of my soul, there's no ATM, there's no cash point. It's just me and another human. So that's what I brought, believe, man. And anybody who needs help, somebody who's going through cancer, somebody who's got a disability, somebody who's going through their hardest challenges that life can throw at them, I don't need your money. I just need you. I just need 30 minutes, and I guarantee I can make you smile, I can make you laugh, and I can make you want to come back again. Do you know what I mean?

Dr. Nath:
This is, to me, incredible because you, yourself, personally come from a very high level of competition for weightlifting. And what you're describing is working with people with various limitations and disabilities. That seems like such a difference. But to you, is the process very different when you're training someone with disabilities?

Javeno McLean:
Oh, yes. It is. A little bit about my history, power lifting is something that I've only done recently. I was a professional cricket player, and that's where I've been a professional high-level athlete since I was 11 years old, Audrey. I remember being eight years old doing a hundred press-ups a day, doing 200 sit-ups a day at eight years old. But cricket was my first love, but it wasn't my true love. And even though I was an elite athlete, Audrey, it got to the point where I got more satisfaction out of what I could do with other people than myself. So every team that I played on, respectfully, not boastfully, no way in showing off, I was always the best athlete. I was always the strongest, fittest. Got a contract to play in India and then an opportunity came about where the condition or the trainer got injured and had to go away.
So they said to this little loud mouth Jamaican boy from Manchester, "Do you want to take over the team, the conditioning and get the team fit?" And in six weeks, I got more enjoyment and satisfaction about what I could do with other people. And to be honest, that was when I realized that I got so much more satisfaction about ... Me getting in shape is easy. That's not impressive. But if I've got somebody who's down in the dumps, somebody who needs a bit of ... Do you know what I mean? They need to get back up, get back to themselves, get back to some happiness, get back to smiling. They don't do this no more, Audrey. With COVID and all this stuff that's been going on in the world, people have lost the ability to smile-

Dr. Nath:
That's right, we don't see faces.

Javeno McLean:
Of course, they lost the ability to smile through exercise. But me training people with disabilities started so long ago, and it started with one occasion. I didn't go out purposely to do it, Audrey. It came. It organically just happened, and it was so powerful I realized that I have to continue. Long story short, I was watching a young boy in a wheelchair doing an exercise session with a trainer. He was in a wheelchair and I'm watching a session. He was so bored. He was lonely. The trainer was so patronizing in the way he spoke to him.

Dr. Nath:
Oh no. Ugh, yeah.

Javeno McLean:
When the trainer went to the restroom, I seen this young boy, he got up out of his chair, he walked over to our drink and pour himself a drink. And I said, "Yo." So I went into the room and I said, "Don't you ever, ever let a another man dilute your power and take away your power. If you know can get up out of that wheelchair, you get up out of that wheelchair." And I said, "You've been lifting the two pound weights for 30 minutes. I know you've got more." And I told him. So when the trainer came back in, I said to the trainer, "Don't worry, I've got this." I said, "You go." I made him do things that I knew he could do. I made him do things that were challenging. I made him do things that I wasn't sure he could do. But at the end of the session-

Dr. Nath:
And he probably didn't know he could do. Yeah.

Javeno McLean:
Exactly. I didn't know. But I was okay knowing that I know what I'm doing and I know I can keep him safe. And I think as a young man, "That wheelchair doesn't define you. That wheelchair is just a part of you. So don't ever let nobody in this world you have to stay there. You have to do that. There's so many more things you can do. Let's discover them." And when his parents came in, Audrey, and I'm not going to lie, his dad was a big man. He came over to me and he looked like a motorbike biker with all these tattoos, and he gave me the biggest hug.

Dr. Nath:
Oh, wow.

Javeno McLean:
And me and him cried for about 20 minutes. And his mother came over and then she cried, and she said, "Nobody has ever spoken to him the way you did." So I said, "What do you mean?"

Dr. Nath:
Oh, wow.

Javeno McLean:
Because people patronize disabled people, people belittle disabled people, honestly. They've always said a lot of people in wheelchairs can actually stand up. They just need the wheelchair for certain things, and nobody ever spoken to him in that way. And they were so impressed and we were so emotional. And it didn't scare me, Audrey. Even though I've never met this boy, I knew from the minute I seen him, he could do more than what he was doing, and I wasn't afraid to get that out of him.

Dr. Nath:
Yeah. I'm curious. A lot of times when people are speaking with people who have some sort of weakness or disability, they may say, "You should try some light stretching exercises. Try some yoga. Try some water aerobics." We don't normally think about weightlifting. Why does weightlifting work so well?

Javeno McLean:
Well, this is the thing. It's not necessarily weightlifting. It's resistance training. And you've got to understand the approach that I use, Audrey. I don't want to scare people. So I understand that you wording, the way you introduce exercise to people, it can be very damaging if it's done wrongly. So what I try and do my best is with the weightlifting, I disguise it in a way where there's so much fun and energy, they don't even realize that they're doing it. And this is why when you you see some of my videos, if you do watch them, it's just fun and energy, because if you have the right environment, you can disguise it in a way that these people will do amazing things and not even have a clue what they're doing. And that's the key.

Dr. Nath:
That is very creative because I can see that, I mean, as someone who doesn't really do these things, the idea of weightlifting or power lifting, it can seem very intimidating. But then you can present it in such a way that it's like, "Oh, this is the kind of thing that I would do in my everyday life. I do these activities, and I'm doing a version of them here."

Javeno McLean:
And to be honest as well, though, Audrey, I'll probably say 30% of the stuff that I do is actually weightlifting. The over 70% is mobility. It's just keeping the brain healthy, it's keeping the mind healthy. It's all of the other things. It's not just about the weightlifting, and I'm so glad this podcast came because I know that there's a lot of neurologists on here, and that there is so important to me. A lot of my clients are stroke survivors.

Dr. Nath:
Yes.

Javeno McLean:
So lifting weights is beneficial to an extent. But it's more beneficial for me to disguise the exercise in a way where it's reconnecting the mind, the brain, and the muscle connectivity. So I have to be very creative in a way I do that as well.

Dr. Nath:
There's something to that. When we think about people who have had stroke or injury to one part of the brain, in children, we think about there being something called neuroplasticity, or the idea being that the brain can rewire around injury. And in little kids and in children, we definitely see this, but there's some evidence that there's some degree of plasticity in the brain of adults. And that's pretty much exactly what you're saying is that by engaging that limb that may be weak, that you may be able to engage the brain and other parts of the brain that are still healthy to essentially try to take over that activity. And you've just intuitively figured that out, essentially.

Javeno McLean:
I'm so glad you brought that up. My stroke clients, stroke survivors, who, oh my God, it's so frustrating for me. So I know how it is for them where one of my beautiful ladies, and gorgeous lady and beautiful hair, she got a look of perm. She's always dressed up nice. She's got jewelry. She had a stroke during COVID. She was a very active lady. And for four months, as I'm saying to her, "Listen, if I tell you to do this, even if I don't visually see it, think about it."

Dr. Nath:
Try. Exactly. Yeah.

Javeno McLean:
It may take 1,000 efforts of you to think and move your shoulder, think and move your shoulder, and then for a good three months, nothing happens. And then eventually, one beautiful, magical day, she got it up. I was so happy, man.

Dr. Nath:
Oh, there's nothing like that.

Javeno McLean:
It's amazing, Audrey. But the fact is, I can't sit with you for three months and explain the science. That's not going to captivate you.

Dr. Nath:
Nope.

Javeno McLean:
So in those three months, while I'm working at the science of it, let me just put a smile on your face. Let me tell you some jokes. Let me play the music that makes you want to dance. Let me do everything that caters to you while all the other things in the background chip away. So it's a time in procedure, but at the end of it, when amazing things happen, it's amazing.

Dr. Nath:
There's so much to unpack here about stroke and stroke rehab that you're talking about, and patients do tell us about how slow and painstaking and frustrating it can be to be working with the affected limb, especially when it doesn't do the thing that it could do so easily just a week ago or a month ago. And I think what you're saying is the power of distraction with music and with conversation to help people through the drudgery, really, of having to, like you said, maybe 1,000 times over and over and over again, do a particular exercise. But that's what it takes. And you have managed to figure all this out that with the power of distraction and thinking of other things, that can help people through this process of rehab.
I wanted to say something to you, I read this in an article that you were working with a boy with cerebral palsy, and after working with you and getting stronger, was then able to pursue other interests in life and was able to start baking and doing other things that had nothing to do with the gym. But because he got stronger, he was able to do that. So this can impact people's lives in so many different ways, more than just physical strength or one limb being stronger. This can enrich people's entire lives.

Javeno McLean:
Of course, it is. Of course, it can. And it's so powerful, Audrey.

Dr. Nath:
Javeno, thank you so much for joining us. And I want to give regards to your family and your kids and all the Jamaican family that you have around you that is your support. I'm serious. Thank you.

Javeno McLean:
Thank you so much, Audrey.

Dr. Nath:
And we will put in the show notes, places to find you online, okay? So people can follow your work and see what you are talking about.

Javeno McLean:
Thank you, Audrey.

Dr. Nath:
Can't get enough of the Brain & Life podcast? Keep the conversation going on social media when you follow @BrainandLifeMag or visit brainandlife.org. As your hosts, We would also like to hear from you on Twitter @NeuroDoctorCorrea and @AudreyNathMDPhD. To learn more about neuroplasticity and what Javeno was talking about with motor recovery, I could not pass up the opportunity to catch up with vascular neurologist and scientist, Gottfried Schlaug, MD, PhD, who was previously one of my attendings back at Beth Israel Deaconess Hospital in Boston, and now he's a professor of neurology at UMass. He has an extensive research career studying all kinds of things like music, the brain, neuroplasticity. So basically all of my favorite things. Welcome to the podcast, Dr. Schlaug.

Dr. Schlaug:
Thank you very much, Audrey, for having me. It's a pleasure.

Dr. Nath:
I really wanted to catch up with you because Javeno was talking about some really interesting things. He was saying that he would work with patients with a stroke and have them think about a movement over and over and over again before finally seeing a movement. What is happening in the brain by having someone who has an injury think about something and then be able to do it? What do you think is happening?

Dr. Schlaug:
Well, I would love to see that. But I think, in general, it probably reflects this idea that we may have to use as many senses as we can. And that may be visual, auditory, somatosensory sensors to tap into the motor system to help the recovery process. So imagining movements has been studied, but most of the time it has to be coupled with actually physical training of those imagined movements. There have been, actually, a well known research study where they just looked at performance and throwing hoops in baseball, and one group was just imagining doing it, and the other group was really practicing very hard and doing all of the throws. And then the third group was one we used something of both, imagining it as well as physical practice. And that group was actually doing the best.

Dr. Nath:
That's so interesting with basically throwing a baseball. So basically either thinking about it or doing it, or some combination of both. I'm just curious, in this study, were these stroke patients or were these normal controls?

Dr. Schlaug:
No, these were just ... I don't know any more if these were normal college aged kids, but they were healthy individuals.

Dr. Nath:
So basically there may be something to thinking about the thing that you're trying to do for somebody who may have an impairment as well as trying their best to move that limb. And I'm sure you've probably seen this yourself in your own stroke practice too, right?

Dr. Schlaug:
We've seen this actually in several domains. So I not only study motor recovery, but also language and speech, motor recovery. And then motor recovery is definitely the aspect of imagining the movement, thinking about the movements, planning it is very important. And in aphasia and in speech recovery, it's actually you hear this inner voice, you hear yourself speak. And when you do that, you actually are able to get some things out much more easily. And it's the same thing that is true with motor recovery. If you can incorporate the imagination of movement and thinking about movement, that should have a beneficial effect.

Dr. Nath:
You mentioned how motor recovery and various recoveries after strokes and other lesions can include the recovery of the ability to speak for various reasons. And you've had research that shows ... You're mentioning creativity or imaginative, that with music, that there's times that music in some ways can bring out a language ability that other sorts of more standard therapies could not. What is up with that and what have you tried?

Dr. Schlaug:
I should just mention two general concepts. So there are systems in the brain that have become so specialized and localized and lateralized that if you suffer an injury through those kinds of systems, and actually it's like individual finger movements is one of those systems. Depending on where that injury is, it's very difficult to use other systems or redundant systems to help you out. Now with regard to fine finger movements, we are really at a difficult point. There needs to be some biological substrate that is still intact that connects those finger movements to the spinal cord.

Dr. Nath:
Okay. Yeah.

Dr. Schlaug:
And we haven't fully understood what are some of the redundant system, alternative systems that we can use? Now for speech motor recovery, it's somewhat at the other extreme of this because both sides of the brain can actually make vocal sounds. You can completely anesthetize one side of the brain through various methods, and you can still make sounds with the other side. So both sides have still a rudimentary ability to make sounds. And that is something that one can utilize in, let's say, helping people to recover from speech motor function.
And certainly, if you would have an extremely young individual, let's say in their teens, who may have suffered a really bad stroke on the left side of their brain, they will definitely learn over time to speak through the right side of their brain. And it turns out that singing or music activities is one way to facilitate that process, to engage the right side of the brain more than you would typically do it. And there's lot of research that's going on to try to understand what aspects is it, and it has probably something to do with slowing things down, with having some melodic contour to it and maybe some rhythmic activity to it as well. So it is a vehicle to use music or to use singing to engage some of these redundant or alternative systems in the brain to facilitate the recovery process.

Dr. Nath:
I see what you mean. And essentially, that music and some of the components of music like tone, pitch, and rhythm may be tapping into parts of the brain that might not have been affected in a stroke in somebody, for example.

Dr. Schlaug:
Besides that, music obviously is an extremely rich stimulus. So it's not just the harmony, the rhythm, and the meter and the pitch. It also is if the musical pieces that we know, we have an emotional connection to it, we can actually tap into the reward system by having music that finishes in a certain way. The brain rewards us if we can predict how something is going to finish or how something is going to progress. So from that perspective, music and music making and using musical stimuli is a very rich stimulus.

Dr. Nath:
That's so interesting, not just the rhythm and the tone that I was thinking of, but reward centers that you can then also tap into when helping somebody recover. It's so interesting you were talking about how if there was a younger person whose brain maybe isn't fully done yet, I guess as we might say in pediatric neurology, that there's ways that they can recover from very significant injuries to the brain. But I think what's also interesting is that you're saying that there may be some, for language, for example, that the other side of the brain, in quotes, even in an older person may be able to be tapped into. So it's not necessarily that someone is a done-deal after a certain age, that you're still able to see some of these gains in older folks with strokes, and I think that's really cool.

Dr. Schlaug:
So I think the two principles to think about is, depending on where the lesion is in the brain, does the system that is affected by that lesion still have some residual function that could be utilized? And that frequently depends on, "Are there some long track motor fibers that are still intact, or are there some alternative systems, some alternative motor tracks that still use the same pathway that could be utilized?"
And then there's this other component that has something that determines recovery, which is the brain's ability to just recover from an insult. I think in that perspective there are numerous components there. So one has to do with the skill that you're trying to recover. Does that skill have more regions in the brain that could potentially be engaged in that skill? So we call this redundant systems. But within that same list of things, clearly age is important because the younger a brain is, maybe the more redundantly it is organized or maybe the more plastic a brain is. And then when you go to the other extreme, maybe the older someone gets, maybe the more health problems they have.
If you have high blood pressure, diabetes, and high cholesterol and had previous small strokes, your brain may not be as healthy anymore as it could be. So brain health, in that perspective, if you define brain health more like what is the total lesion burden that you have in the brain? So from that perspective, brain health has a contributing factor. You could also define brain health is, in a sense, that if you take a normal healthy person, how healthy is the function of their brain? Have they created a brain through learning skills and education and activities that you're doing that has a built-in plasticity, that has a built-in redundancy? So maybe the more activities that we do, maybe the more practice that we do of a particular skill when we are still healthy, maybe that could be something that pays off if you actually suffer an injury to the brain.

Dr. Nath:
I see. So we need to start working on this stuff now.

Dr. Schlaug:
Yeah. Yes, exactly.

Dr. Nath:
We can't just hit the gym after the stroke and hope for the best. We need to start working now to make our brains healthy. And I think you're right. I think that by taking care of our brains and sleeping and optimizing the brains that we do have, then if an injury happens, we have more spots to try to rewire to, essentially.

Dr. Schlaug:
Yes. Yes. And I know that you're a musician as well, and I'm too. So, I mean, musicians are like one group that one could look at. You could also look at people that just do athletics and do motor activities in various ways. So if you have these kinds of experiences throughout your lifetime, does it change structure and function in your brain that could potentially then be beneficial? Does your brain become less lateralized? Do you build up more communication between various parts of the brain by engaging in these kinds of sensory motor activities with both hands or both feet? And is that helpful whenever you suffer a stroke or bleeding in the brain or stuff like that?

Dr. Nath:
So basically we should always be learning something new.

Dr. Schlaug:
Yes.

Dr. Nath:
And you would be open to power-lifting with Javeno, essentially.

Dr. Schlaug:
I haven't really studied the particular aspects of power-lifting, but I would generalize it more in saying any kind of sensory motor activities is probably good.

Dr. Nath:
Yeah. I would love to hear what you think about the future because you are a researcher. For looking 10, 20 years in the future with stroke and motor recovery, what do you see on the horizon?

Dr. Schlaug:
So I think we have to be realistic in various ways. So the realistic part of this is we have to get better at making predictions about what somebody's potential is for recovery after they have suffered an injury. And there is research going on in this already that takes various information into account. Does somebody still have some residual ability left? What is a brain's or that person's brain's ability to recover? Are they very plastic? Have they redundant systems? And then, realistically checking, if you make these predictions and if you see them again in three months, have they fulfilled these predictions, or are they not doing as well, or are they doing better?
Now of course it would be really great to study those people that do better to try and figure out what they're doing, but you can also learn from the people that don't even get to what you were predicting them because something happened. Was it because they had an intercurrent illness, something happened in the recovery process, or maybe they didn't even get any rehabilitation at all. So that is developing models and being realistic. And then with regard to if you have your natural recovery curve, what can you do to get a better outcome? And I think that's a lot of us who are very excited about this, to try and figure out what could be done. I and others study brain stimulation, but we-

Dr. Nath:
That's right.

Dr. Schlaug:
... frequently use brain stimulation in combination with something else. So brain stimulation in combination with really intense occupational or physical therapy. You could think of brain stimulation in combination with motor imagery.

Dr. Nath:
Like thinking about doing the activity, is what you mean by motor imagery?

Dr. Schlaug:
Yes. Thinking about doing the activity or having a combination of thinking about activity plus actually doing the activity, and then at the same time trying to figure out which regions in the brain has critical importance, and can we somehow make these regions in the brain work harder? That's what brain simulation frequently is about. Can we specifically target the drivers of this recovery process?

Dr. Nath:
And just briefly for our audience, what do you mean by brain stimulation?

Dr. Schlaug:
So there are various ways that we can stimulate the brain. In general, we differentiate between what we call noninvasive brain stimulation and an invasive brain stimulation. Invasive brain stimulation would be actually sticking an electrode into the brain and stimulating electrically, frequently, particular regions in the brain. Non-invasive brain stimulation is actually having something on the outside and you make some assessment and assumptions about, let's say, "Where does the motor region localize to on your scalp?" And there are ways that one can get very close. So if you know where's the motor represented on your scalp, you could then apply, let's say, electrical stimulation to this location or you could apply magnetic stimulation, which ultimately is electric as well, and make that current or that pulse travel through the scalp, the skull, into the brain, and excite particular targeted regions of the brain.

Dr. Nath:
That is very exciting stuff and it's very cool that there are options to do that noninvasively, and that way we can try some of these things on different populations of people with strokes and various injuries to see how we can get this to work. So that's really cool. Well, I just want to say thank you for joining us and giving us some glimpse into the future of what recovery will look like. But from what it sounds like, we need to think of what we want to do and still practice it, right?

Dr. Schlaug:
That's what I would say, yes.

Dr. Correa:
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Personal Trainer Javeno McLean on Helping Clients Find Physical and Emotional Strength

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