Welcome to the Evolution of Medicine podcast! On this episode, James sits down with Julie Foucher-Urcuyo, MD, functional medicine physician, four-time CrossFit Games athlete, and host of the Pursuing Health podcast. Her talent and drive have made her well-known in both the functional medicine and CrossFit spaces, and she is poised to make a big impact in healthcare. It was an excellent conversation and I think you’ll learn a lot—enjoy! Highlights include:

  • Understanding the synergy of functional movement and functional medicine
  • Julie’s definition of CrossFit, and why she encourages people to look beyond common perceptions of the sport
  • How CrossFit and functional medicine compare when addressing misconceptions and educating people on the health benefits each provide
  • What it was like to pursue medical school while competing in the world of CrossFit
  • What we can learn at the cross-section of resilience, CrossFit and the future of medicine
  • And so much more!

Resources mentioned in this podcast:

James Maskell: Hello and welcome to the podcast. This week, we are speaking with Dr. Julie Foucher-Urcuyo, she is a functional medicine physician and also a CrossFit celebrity of sorts. You can check her out on Instagram, she has a huge following. She is a CrossFit star who is now trained in functional medicine and ready to make a big impact in healthcare. We talked about the synergy of functional movement and functional medicine and we talked about a number of things on the cross-section of resilience, CrossFit and the future of medicine. Really interesting half an hour, enjoy.

So, a warm welcome to the podcast, Dr. Julie Foucher-Urcuyo. Welcome, Doc.

Julie Foucher-Urcuyo: Thank you for having me. I’m excited to be here.

James Maskell: The tables have turned because I’ve been on your podcast [Pursuing Health] a bunch of times before and now finally I got you online.

Julie Foucher-Urcuyo: Right, you’ve been on twice. And I think that’s how we originally met is I started listening to your podcast and then eventually got connected with you. So it’s cool to come full circle.

James Maskell: Yeah, it really is. And I’m super excited today to connect because ultimately, I think it’s just sort of like a super interesting time to be having this conversation. Maybe let’s just start with a little bit of background as to how you ended up here and what you’re up to right now and sort of your journey to get here because I think for a lot of people it’d be pretty interesting.

Julie Foucher-Urcuyo: Sure. So my journey really in CrossFit and in medicine started around the same time when I was in college. I was at the University of Michigan-Ann Arbor, and I was about halfway through college so I was getting to the point where I was starting my applications for med school and it was at that time that I actually found out about CrossFit. I had done some sports growing up. I did gymnastics and track and field, but really struggled to figure out what to do for exercise once I was on my own in college and sort of reverted to the normal elliptical and treadmill and machines at our school gym and I knew that there was more. And so when I finally found out about CrossFit and joined the local CrossFit affiliate in Ann Arbor, it was an immediate fit for me and I knew that was something I would continue doing for the rest of my life.

And then really things kind of took off quickly. At first I was just doing it for my own health and to stay fit and then at that time it was 2009 when I started and a year later I found myself at the CrossFit Games, which was very different back then. It was sort of in the early days of the CrossFit Games, but I was lucky that that journey, I sort of continued on for the next few years as I then graduated from college and started med school. And really it had a huge impact on what I ended up doing with my career in medicine as well.

James Maskell: Yeah. So take us back then, I mean, for people who aren’t familiar, I guess I’d love to hear your sort of version of what you think CrossFit is and how you communicate it because I know in my community or in the community of practitioners there’s some people who know that it exists but don’t know that much about it, there’re some people that are very keen on it, there’re some people that are very anti it and I’ve heard every kind of idea of it over the last decade. So I’d love for you to share sort of how you identify what it is.

Julie Foucher-Urcuyo: Sure. It’s one of those really hot topics that I think people can have strong reactions to one way or another depending on maybe what they’ve seen or the way that they were introduced to it. And in a lot of ways it’s similar to functional medicine, I think sometimes people hear functional medicine, especially people in the medical community who are more conventional and they hear functional medicine and write it off right away but once they actually understand what it is, everyone can get on board with the principles of getting to the root cause of disease and trying to optimize health. And CrossFit is really similar in that a lot of people may see it first through the lens of the CrossFit Games or they may think, oh, it’s too intense or it’s too dangerous, or it’s only for really fit people but once you kind of pull back the layers and get to the root of what CrossFit is, I think it’s something that a lot of people can get on board with.

So there is a definition of CrossFit, which is a mouthful and I don’t think it does a great…is great of a job in a lay person’s way or in a conversational way of explaining what it is, but that definition is constantly varied functional movements done at high intensity. So if you break it down, basically, I think one of the key parts is you’re doing functional movements. So instead of doing things like I used to be doing in college where you’re on an elliptical or you’re on a machine and you’re doing these sort of gym moves, you’re actually doing movements that you do in everyday life.

So squatting, which is like standing up and sitting down off a chair or off the toilet, things like dead lifting, picking something up off the ground, shoulder to overhead or a press, putting something over your head onto a shelf, running, swimming, any kind of movement that you might have to do in everyday life. I mean, maybe not every one’s swimming, but you might have to do in everyday life, it’s isolating those movements. And what that does is that it then translates over into your life.

So, let’s say you’re moving your house and you need to pick up your couch, now you know how to deadlift. You can properly pick up that couch and have the strength to do it. Where I think it really comes into play especially as people age, a lot of the reasons why people end up in nursing homes or needing full-time care is because they’re no longer able to do their activities of daily living, they’re not able to go to the bathroom by themselves, shower by themselves, stand up and sit down without assistance. And what CrossFit does is it really focuses on those functional movements that if you build capacity there, if you can squat 200, 300 pounds when you’re 40, 50, 60 years old and you keep squatting, a lot of that capacity is going to stay with you as you age and you’re going to have no problem standing up and sitting down when you’re 90 or maybe 100.

James Maskell: That’s a really great way to describe it. And yeah, I think everyone who has probably worked with older people sees the value of that and maybe not even work with older people, but have parents who have got to a certain age see the value of that. And obviously muscle mass is and muscle, there’s a lot of science showing muscle and longevity and muscle and health have some pretty strong concepts. In fact, Jeff Bland shared last year at a conference that the greatest predictor of longevity was grip strength.

Julie Foucher-Urcuyo: Yeah, I believe it. I believe it and I think it goes underestimated a lot of times. I think we, especially in a conventional sense, we’re trained to think more about aerobic exercise and even just going straight to walking, but the strength part of exercise is so important and especially when you pair it with the functional movements, which require a lot more coordination and a lot more of the neurological response, it can become really, really powerful for just being able to do your activities of daily living like we talked about. And so CrossFit is not just the strength movements, but it’s pairing oftentimes we prescribe exercise in a do this many minutes of aerobic exercise, do this many minutes of strength training, but with CrossFit we really combine those so that you can do movements that are building strength and endurance or aerobic capacity at the same time and that’s where the intensity comes in and that’s where it really starts to replicate things that you might have to do in real life.

James Maskell: Super cool. So what is like being a medical student and sort of going on this journey to become a doctor with this secret cape that you pull out on the weekends and practice, do things differently than everyone else?

Julie Foucher-Urcuyo: Yeah. It was very interesting and such a cool experience. I mean, I’m so glad that I was able to do…still compete in CrossFit for several years while I was in medical school and I was very supported by my program and by my classmates. And so the first year of med school, it was back in 2011 or no, yeah, 2011, -12, and I knew I wanted to try to compete in the Games. Our med school, I kind of treated it like a job so I was there from 8:00 to 5:00 and then I went to the gym at night. And it did sometimes feel like this double life or having a different identity but I really liked it because it gave me a break because I think med school can be a really intense time, training can be really intense and so it gave me the opportunity to have a little bit of balance. And then my school was flexible in allowing me to add an extra year to my year of research that was already scheduled in our curriculum and by doing that I was able to stretch out my competition career a couple extra years as well.

James Maskell: So, would it be, so people who don’t know, like you kind of have like a cult following and CrossFit would you say is that fair? Everyone in CrossFit knows who you are.

Julie Foucher-Urcuyo: I don’t know if it’s a cult following, and I don’t know even if that’s true because it’s been now five years since I was competing. But yes, the CrossFit community I think is very connected and they definitely follow and support the athletes. And so I was competing for about a five-year span, 2010 to 2015 and since then, since having my podcast, I think that’s been a way I’ve been able to still keep in contact and keep in touch and contribute to the community. And it’s still super important to me and so it’s been good to still be a part of that even though I’m not competing.

James Maskell: So tell us about now you live in Cleveland and you end up going to Cleveland Clinic or training in Cleveland and you somehow end up at the Cleveland Clinic Center for Functional Medicine and it’s amazing how these time periods just overlaps for you to be kind of involved, right?

Julie Foucher-Urcuyo: Yeah. Oh, it’s incredible. I think about sometimes the ways that everything lined up, I feel so lucky. Like you mentioned, what is it like to go through medical school while you’re in this world of CrossFit? It basically in a lot of ways, made me think differently about what I was learning in medical school and I knew that there were a lot of things that were true about health that I wasn’t necessarily learning or at least seeing in medical school. So I’d go to my primary care clinic as a second year med student and we’d see your regular primary care patients coming in with high blood pressure, diabetes, high cholesterol, and we’d do the whole 15-minute “start exercising more and eat better.” And then they come back in six months and of course nothing would have changed and they would be needing higher doses of medication.

And then on the flip side, at nighttime I was going to the gym and I was training and really involved in across the community and there I was seeing people have dramatic lifestyle change shifts. So people that were losing tons of weight that were gaining a lot of confidence about themselves, that were coming off of medications, reversing diabetes. And so I knew that there was something to that, and that our medical system really was not set up well in order to create health and I knew the CrossFit piece of it was something that was really important, but there was still sort of a missing piece when it came to some of the other bridging between what I was learning in med school and what I was seeing happen in the CrossFit affiliate and when I first heard about functional medicine, it was like the light bulb finally clicked and everything fell into place and I finally had that system well, to think about how to create health and how to treat underlying causes of disease.

So it was actually, I remember this day so well, it was a 7:00 AM talk and I was on my research year, so I was not having to be at the hospital that early and I remember this email coming through saying, “Oh, there’s a talk by Dr. Mark Hyman.” And I had heard of his name maybe here and there, I had heard about functional medicine in passing, but I didn’t really know what it was but for some reason I felt this really strong pull to go to this talk. So I had done an early training session and I brought my clothes and showered and got dressed up to go to the hospital and go to this talk and it turned out that that was the talk that he was giving to introduce the Center for Functional Medicine, Cleveland Clinic and all the department heads, the different departments in the clinic were there, the CEO of the clinic at the time, Dr. Cosgrave, was there and it was a really big deal.

Julie Foucher-Urcuyo: And when he explained the framework for what functional medicine was and he went through how you use the timeline and the matrix and finally it felt like everything really sunk into place. And I remember talking to my husband afterwards and saying, “This is exactly how we’re going to practice medicine,” because it finally made sense. So I’m still so glad that I went that day and then over time being able to continue med school there and then do residency at the Cleveland Clinic. I’ve had some opportunities to rotate through and learn from the practitioners there at the Center for Functional Medicine, which has been amazing.

James Maskell: So yeah, so compare and contrast your experience with these residencies compared to the other people that you’d be going through this process with because ultimately you’ve kind of got this window in and do you feel like when you talk to your other classmates about this, are other people seeing the light or are people just sort of like making their way through the plan and not really thinking differently than medicine 15 years ago?

Julie Foucher-Urcuyo: I think people are seeing the light and I think especially this new generation of doctors, because I think they’re so much more in tune with the lifestyle factors that are so important. There’s so much more in tune with exercise and wanting to eat well and some of the problems with our food system. And so I think they are a lot more open and I think that they really like the concept of functional medicine, but I think there is still a challenge in just doing something that’s new, that’s outside of the norm, that’s not conventional. I think for a lot of people it’s hard to step outside of the traditional training track and think about doing something that’s so different because for so many years we are sort of trained in the medical system to do the next thing and jump through these hoops to get to the next stage. And you go to med school and then you apply to residency and then you apply to a fellowship and by the time you get out it’s almost like you don’t know which way is up and you don’t know what you’re even doing anymore.

And so I think for a lot of people it has to be a time where they’re able to take a step back and look at the big picture and kind of reconnect with their purpose and why they went into medicine is again. And sometimes it’s just hard for people to do that, I think as they’re going through training as they’re in the process. But I’m very hopeful about sort of the new generation of physicians because I think that they are much more open to it and I think that they realize a lot of the problems that are wrong with our system.

James Maskell: Yeah, absolutely. Well, look, there’s this one other group of doctors that I want to talk about, because I don’t know if people who listen to this understand this, but one of the things that’s happened in the last like couple years is the founder, I guess you can talk about it more clearly, but just I’ve witnessed one, the creation of CrossFit Health, which I think is interesting and it’s sort of a very punchy brand and we can talk about that, but then also these CrossFit Health doctors and what that is. And I think it’ll be interesting for our audience to understand how these two worlds are sort of interested in coming together.

Julie Foucher-Urcuyo: Yeah, definitely. So the founder of CrossFit, his name’s Greg Glassman and a couple of years ago he sort of got dragged into learning about a lot of the problems with our current state of medical science. And so it started because of a study that was done about it that ended up falsifying some injury data in order to sort of sway the outcomes of the study a certain way. And Greg was not happy about this because he doesn’t like anybody lying about data so he really started digging into it and it ended up in actually a huge lawsuit with the NSCA, the National Strength and Conditioning Association and the Journal of Strength & Conditioning, I believe that’s what it’s called. But along the way, he really learned a lot about the problems and the corruption that exists with medical literature, with science, with guidelines that are being influenced by food, soda companies. And it really opened his eyes and he decided that this was a big thing he wanted to shed light on.

And so, he created this branch of CrossFit called CrossFit Health, which is essentially trying to shed light on what he calls the ills of modern medicine. And it’s exposing a lot of this corruption and it’s really starting with the truth about what we’re dealing with and what’s actually going on. And so, for the past couple of years they’ve held a conference at the same time as the CrossFit Games, having a lot of speakers come and talk about these various topics. And then another initiative is that he wanted to educate physicians about some of this corruption and educate physicians more on what the true purpose of CrossFit is. So, he started offering CrossFit Level 1 seminars, which is basically our introductory seminar.

Anyone who wants to become a CrossFit trainer has to go to the seminar and it really, it gives a great overview for anyone who is a beginning trainer, but it also really gets into the methodology of CrossFit and the philosophy behind CrossFit and why we do what we do. And by bringing all these physicians together for these seminars, there’s been some really great networking opportunities and I think empowering a lot of these physicians who were previously isolated in their own communities and knowing that maybe they had a little bit different view on how to create health but not feeling like they could do anything about it or speak up in their own communities and now they’re suddenly connected and networked. And so he’s been basically offering the seminars for physicians and at the same time offering a lot of education about the corruption that’s going on in medicine.

And I’m not sure where it will go. We never really know. CrossFit itself kind of tends to take a very sort of natural approach where he just sort of lets things happen and unfold and so it’ll be interesting to see where things go over the next few years. But already I think a lot of positives have come from it. And certainly I think there’s tons of overlap between what we talk about in CrossFit and using CrossFit as a methodology for creating health and lifestyle change. And so I think if there are functional physicians who are interested in coming to the seminar, I think it would definitely be a good experience at least to learn what happens and what some of the philosophy is behind why we do what we do.

James Maskell: Yeah, and it seems to me that Greg is getting an education in functional medicine from you because it’s not like it’s kind of gone the other way yet either like CrossFit isn’t the organization isn’t so well-prepared for understanding functional medicine but between you and your husband I feel like he’s getting a crash course, right?

Julie Foucher-Urcuyo: Well, I don’t know about that, but I think it’s been interesting to see a lot of the overlap between functional medicine and CrossFit. So a lot of the speakers that Greg has had come and speak at these events have been also speakers that I’ve seen in the functional medicine space. So I think that we’re seeing a lot of the truth come to the surface through these two different arenas and so the people who are speaking the truth and who are really advocating for health are people that we’re seeing that are being given these platforms. So I think that’s been interesting for me to see too.

James Maskell: I mean, if you’re a doctor and you’re out there listening to this and you have old people in your practice that can’t stand up and sit down, is a CrossFit box of good place for them to develop those skills even if they’re older?

Julie Foucher-Urcuyo: Yes. That’s a great question. So, with part of this CrossFit Health initiative, there’s been a huge shift in the company to really focus more on the people who need CrossFit the most, which tends to be older populations or people with chronic disease. So right now at CrossFit headquarters, they’re running a huge program, what they call Special Population. So people who have any chronic disease or who are older and they’re taking them through basically modified CrossFit workouts and almost every affiliate, I can’t speak for every affiliate because they’re all different and they’re all independently run, but many affiliates do have programs or the ability to work with older populations as well. So if you are a functional medicine practitioner and you’re looking for a way to implement and exercise with your older, maybe more frail population, I would certainly consider reaching out to CrossFit gyms in your area and talking to some of the coaches and seeing what they have to offer because I think that is really the future of the affiliates and expanding.

When CrossFit started, it’s still relatively new, it’s about 20 years old, but the real boom has been in the last 10 years. And it initially of course attracted all the people who were already into fitness, surprise, surprise. But then it starts to pull in people who maybe never thought that they could exercise or never have exercised and to me, that’s the most powerful thing is to see someone who never thought that they could do a pull up learn how to do a pull up or to climb a rope or to lift a barbell. And so not everybody is necessarily going to learn to do those things or have to learn to do those things, but seeing people build their confidence by doing things they never thought that they could do and doing it in a group environment where they’re supported I think is really, really powerful.

James Maskell: Yeah. I want to talk a little bit about the group environment because I’m a member of a CrossFit box, it’s just down the road. They are not operating right now because obviously because of COVID, but I took my kettlebell home. I’m just not feeling the same motivation to swing that kettlebell as I would have to say because I did enjoy that group environment and I did find that I was stimulated more. I played a lot of team sports growing up, rugby, cricket, soccer, those are my things and so then coming into a world where exercise was very like one person running on a treadmill, I couldn’t have hated it more.

And so it took me a while to work out how to exercise in a world where I didn’t have a team necessarily, I wasn’t going to commit to playing cricket every summer. It was just a lot of time taken out once I had a kid, I didn’t really want to do all of that and I really found that going CrossFit 6:00 to 7:00 AM, I would feel good for the rest of the day and I felt like, yeah, the functional movements I could certainly see and I can see with my parents, right? That they need these functional movements and the things that they’re struggling with are exactly the things that you’re talking about there. And so, yeah, I guess the CrossFit box that I’m part of is trying to do a good job with doing virtual stuff but I feel like there is something about that magic of being in a small group that CrossFit was really able to tap that other things that have come after it have tried to kind of replicate. Would you agree with that?

Julie Foucher-Urcuyo: Absolutely. I think that is by far my favorite part about CrossFit and I think what makes it so special and what makes it really sustainable for most people is the community and the fact that there’s something about the magic of going through something really hard together because CrossFit workouts are not easy. It’s not like going to the gym and walking on the treadmill for 30 minutes. You’re going to be doing something that’s uncomfortable, it’s pushing you outside your comfort zone not in a dangerous way, but in a way that’s calculated and appropriate to gradually increase your ability.

But by going through that together, I think it really bonds people. I mean going through any experience where you’re vulnerable or you’re going through something that’s difficult I think it bonds people together. And so I think that’s part of why the CrossFit community is so strong and we are struggling now with this social distancing because people are being very creative now with their gyms about doing online classes and trying to stay connected virtually but it’s super hard. I think I find myself, it’s so much easier for me to just get to the gym and know that I’m going to be able to go through a workout with a bunch of other people and a trainer that’s leading me through it versus having to motivate myself to do something on my own. And so I’m definitely looking forward to getting back to that.

James Maskell: Yeah. It sounds like posttraumatic growth, right? Have you ever heard of that phrase?

Julie Foucher-Urcuyo: Yes.

James Maskell: It’s like post traumatic growth and that’s antifragility, it’s a resilience and ultimately that comes back to this Year of Resilience that we’re involved with. And I guess one of the reasons why I wanted to have you on is because I really do feel that the CrossFit for me is the most effective kind of resilience training that I’ve ever done as far as making myself resilient to a range of chronic illnesses and also improving function. And so I just thought we definitely had to have this conversation in the Year of Resilience and hopefully all the things that you said there about the lawsuit and what Mat Boulé shared in last month’s podcast help, maybe a lot of people to think that this is a dangerous sport realize that, I said to him the other day, that journal to CrossFit is the same thing as the AMA and chiropractic and quackery where like it was just an idea that was floated by the AMA to discredit the chiropractor and it’s a very similar kind of a concept for the CrossFit community and CrossFit to be sort of sloughed by the Strength and Conditioning Board. And so I hope that people listening to this, maybe want to give CrossFit another chance or see that functional movement and functional medicine has the same objective.

Julie Foucher-Urcuyo: Yes, there’s some much synergy. And I would just say that like I briefly mentioned, every CrossFit affiliate is different. So it’s not like a franchise, it’s not like an Orangetheory where you walk into one and it’s going to be exactly the same everywhere else in the country. But every affiliate is different so every owner can choose to…it’s really like a micropractice if you think about it, every owner of an affiliate can choose to run their affiliate however they want and however they feel is best for their community, which is amazing. But it also means there’s a lot of different approaches. And so if you walk into one affiliate and you just feel like this isn’t the right fit for me, don’t feel bad about that and don’t get discouraged. I always tell people to check out at least a couple affiliates in their area before they make a decision because they are also different and you’re going to find one that fits best for you or one trainer that you feel like you click most with and that’s going to be the right environment for you.

James Maskell: Absolutely. That’s great. Well look, I mean I appreciate you coming to be here part of the podcast and I assume with a residency coming to an end and with a history now in CrossFit and also this training in functional medicine that there’s a great blue ocean of opportunity in front of you.

Julie Foucher-Urcuyo: Yes. I’m very excited about it. So yes. Big things coming soon.

James Maskell: Amazing. Well look, thanks so much for being part of the Evolution of Medicine podcast, really appreciate all the steps that you’ve taken until to get here and I know that you’re getting started and to you and your husband it has been great to get to know you guys and super, super excited for what the future holds. And yeah, in this year of resilience being glad to be finding that there are so many groups in society who are actually really aligned. They don’t see themselves as aligned and they see themselves in some cases antagonistic.

And ultimately what I’ve tried to do through the Functional Forum is to really bring together groups of people who do have the same alignment and I really feel that in this next phase with the Functional Forum we’re going to be starting to bring together groups of practitioners in a more cohesive way than even the meetups were where local chapters can really form resilient groups for the future of health creation and salutogenesis and I would just encourage you if you’re part of one of those groups, really start to think about engaging the CrossFit community because it’s a salutogenic community as well and it’s all about health creation and this is the future of chronic disease and thank you for bridging that gap and thank you everyone here for listening. If you want to find out more about Julie and her work, you can go to pursuing-health.com. I’m your host James Maskell, this is the Evolution of Medicine podcast and we’ll see you next time.

Thanks for listening to the Evolution of Medicine podcast. Please share this with colleagues who need to hear it. Thanks so much to our sponsors, the Lifestyle Matrix Resource Center. This podcast is really possible because of them. Please visit goevomed.com/lmrc to find out more about their clinical tools like the group visit toolkit. That’s goevomed.com/lmrc. Thanks so much for listening and we’ll see you next time.

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