The 11 Pillars are the foundation of our protocol that will provide you with the most comprehensive view of your health. 

Read on to take a deep dive into the physiology of the 11 Pillars...

The 11 Pillars are not a new concept in Human health and performance. If you have a background in CrossFit you would be familiar with the 10 General Physical Skills. 

If you are an astute listener of Andrew Huberman, you would be familiar with Andy Galpin's 9 Physiological Adaptations. Peter Attia has something similar with his four pillars framework for exercise.

Any student who took an Exercise Physiology class would have been exposed to the concept of the components of fitness in some aspect. 

There are some variations, but we have curated our list to 11 highly influential components.

On a broad scale, you can categorize a pillar as Health biased or Performance biased. It is not that a health biased component doesn't impact performance and vice versa, it is just that the health biased components have a greater impact on general health than physical performance. 

For example aerobic endurance is incredibly influential on both... but due to the significant impact on cardiovascular and pulmonary health and well-being, it is categorized as health biased. 

Aerobic

A health biased component of fitness that is also referenced as cardiovascular fitness or aerobic fitness and expressed as VO2max. This is your body’s ability to take oxygen out of the atmosphere and utilize it in the muscles. Therefore, it represents the capacity and health of your lunges, heart, vascular system, and muscles (cardiovascular, cardiopulmonary, and muscular systems).

Arguably the single most important health-related pillar due to its link to risk for disease and death. Did you know that your VO2max will naturally decline with age? At a rate of about 1% per year after age 45. Therefore, it is important to maximize your VO2 before that age (ideally in your 20s), and be ready for an uphill battle later.

High measurements of VO2max are associated with higher quality of life and longer span (as well as a decreased risk of heart disease, diabetes and obesity).

Low measures of VO2max are a risk factor for heart disease, diabetes and obesity. 

What’s the best way to improve your aerobic fitness? There certainly is incredible debate on what is best. However, there are two clear methods to yield the best results. The first is zone 2 training. At least two sessions per week of 45-50 minutes in Zone 2 (roughly 65% of your VO2max and 80% of your Heart Rate Max) has been proven to maximally improve metabolic health through the biggest increases in fat burning and lactate clearance.

However, with minimal time commitment, high intensity interval training packs a greater bang for its buck. Sessions as short as 1 minute of max effort row or bike as well as the fan favorite Tabata intervals can greatly improve aerobic endurance with minimal time.

Agility 

A performance biased component of fitness, agility is the ability to efficiently change direction. This requires acceleration, deceleration, and high levels of dynamic stability. Power and quickness also factor into agility. One of the primary pillars assessed at the NFL combine, it is an extremely important trait for high level sport performance.

While the average person does not experience the same need for agility as a running back, all people need to be able to evaluate an environment and change direction without losing balance or falling over.

Low measurements of agility will be of concern for any individual looking to maintain some level of athleticism in their youth but more importantly for older individuals, as they must manage forces to avoid falls and injury (and mortality) from unplanned situations.

What’s the best way to improve agility? You’ll need to find some open space such as a field or basketball court. Start with some short 2-way drills before your work up to larger, multi-directional drills. You should also research proper stopping, cutting and landing mechanics. Exercises like depth drops have great carry over to agility.

If you have the space, basic agility drills can be used as conditioning to finish a workout.

For example, 10 sets of 10 yard lateral shuffle (5 right and 5 left) with a 1:1 work to rest will integrate some basic agility into your workout.

Anaerobic

A secondary component of muscular fitness with muscular strength, this health biased component of fitness is about the rate of decline in a muscle’s force production. It is correlated to living quality and musculoskeletal health. Muscular fitness is essential for health as it determines movement capabilities and greatly controls posture and stability.

Stability, absolute strength, neural efficiency, aerobic capacity and metabolic tolerance all impact anaerobic endurance. 

High levels of anaerobic endurance indicate an efficient neuromuscular system that can be felt with both greater cardiovascular endurance performance, sport performance and general health.

Low levels of anaerobic endurance are associated with an increase in injury during sport and linked to functional decline and loss of independence in the elderly.

Unlike aerobic endurance, a single metric like VO2max cannot show the full picture. Therefore, it is important to focus on improving all force production endurance across all muscles.

This is best improved with high rep sets with little rest periods. Best results are often experienced with bodyweight movements like pull-ups, push-ups, dips and squats. For example, 4 sets of max reps pull-ups with 20-30 seconds rest. 

Balance 

The nervous and vestibular systems play the largest role in balance, which is an essential performance component that is needed on a daily basis to manage posture, movement and function. Proprioception plays a key role as does strength balance. Balance is the ability to maintain equilibrium – standing still or moving without falling. It correlates strongly with sports performance and geriatric fall risk.

In fact, sometimes it is better to think of balance as the ability to manage forces which are trying to disrupt stability.

Low balance is associated with an increased risk for injury during sports, decreased athletic performance, decreased power output, decreased strength output, and importantly for older individuals, an increased risk of falls.

What’s the best way to improve balance? Depending on your capacity, single leg balance drills can play a role. But more importantly in the long run will be static-dynamic drills like Overhead Bulgarian squats, plank marches, and any other single leg exercise.

Practicing change of direction or agility drills will also require, and improve, balance.

Composition 

A health component that is the ratio of fat mass to fat-free mass (bone, muscle, organ etc). This can be lowered by either gaining muscle or reducing fat. With higher levels of body fat, disease, and premature mortality risk increases. A long-term goal should be to decrease body fat below 20%.

Higher body fat percentages, especially in the thigh, are important predictors of gait-speed decline. This indicates a potential that higher fat can decrease mobility with age. 

Both lean and fat mass can affect metabolic function. A new classification termed Normal-weight obesity represents individuals who are normal weight, but carry too much fat relative to muscle mass… aka Skinny Fat. Lean mass is crucial as well as decreasing fat mass.

How can you lose fat and add muscle mass? Luckily we know the answer. Lift weights, eat healthy, stay active. However, if you find that you are starting to gain more and more fat, you need to start prioritizing general physical activity (more walks etc) and eating healthy while in a caloric deficit.

There are only easy answers, no easy ways to fix body composition.

Flexibility 

A health component of fitness also called joint-specific range of motion. Correlates with movement function, bodily pain, and musculoskeletal and joint health. The three key factors are muscle tissue pliability, skin elasticity, and viscoelasticity of muscle connective tissue (fascia). However, your end range positions are most greatly controlled by the nervous system - it has to be comfortable with your muscles at end range.

Flexibility is greatly impacted by the age-associated decrease in activity and reduced tissue hydration.

While one of the most undervalued pillars by many, you should not be one of the many. Flexibility directly impacts movement freedom and posture. Those with better flexibility can move better… whether it is during a golf swing, sprint, just going for a walk around the block. Flexibility is integrated with joint function and chronic pain.

Low levels of flexibility can increase the risk for both biomechanical injuries and metabolic issues. Both directly, such as atherosclerosis. And indirectly, since individuals that have less flexibility tend to have more pain and move less and therefore an increased risk for metabolic / cardiovascular disease.

Flexibility directly improves arterial pliability, thus decreasing the risk of cardiovascular disease and resulting mortality risk.

How do you improve flexibility? If you do not consistently put your body (joints and muscles) through their natural range of motion, you will lose that capacity. Your workouts and especially your warm-ups should always promote full ROM as should your recovery stretching sessions. Exercises the focus on putting a single arm or leg full through ROM will help, as will integrating both dynamic and static stretching sessions.

As little as 30 seconds once per day has been shown to induce plastic changes to muscle tissue - improving flexibility. 

Power 

A performance component of fitness that is extremely important in both athletes and aging individuals. Power is force times distance over time.  Power is expressed with fast movements where recruitment patterns elicit the fastest development of force.

Power obviously plays a large role in sports performance, but also has a tremendous impact on tasks of daily living as you age. For example, relatively high power is required to get out of a chair. This might not impact a 30 or 40 year old, but due to sarcopenia, the age associated with loss of fast twitch muscle fibers, the power required to get out of a chair is a challenge for many older individuals to muster.

A low score in power output is a potential concern for both longevity and athletic performance. If force generation falls below a certain threshold, you would be unable to execute your desired action… like getting up out of a chair.

Power training needs to vary completely based on your capacity. For example, practicing getting out of a chair quickly is power training for many elderly. Conversely, Olympic lifts, jumps, bounds and sprinting are all examples of power training for athletes. Resistance training alone will help improve power output, but training should have an emphasis on power to optimal results regardless of age. 

Quickness 

A performance component that is an expression of power, speed, strength and balance. Elite quickness indicates you are a well-rounded individual as you are someone that can accelerate to a high velocity in a short period of time.

Quickness is measured in distances under 40 yards, as most athletes do not reach full speed until 40+ yards of sprinting. For sports, if speed kills, quickness is the weapon of choice. The best athletes do not need to be the fastest overall if they are quick.

The key component of quickness is your ability to forcefully drive your body off the ground - ground reaction force. This is why both exercises like squats and jumps improve quickness.

Low levels of quickness does not necessarily pose a threat to increased risk of disease, but since quickness is an expression of power, speed, strength and balance, it would behoove you to identify what underlying component is holding you back.

Training quickness is best done by not only training the other components but working in short bursts of speed in a variety of directions like 5 and 10 m sprints. Furthermore, small games like 4 v 4 soccer or flag football improve not only quickness, but skill levels and cognitive performance, with carry-over into other activities as well. 

Skill 

A performance component that can be expressed with a variety of tests relative to the athlete. Skill is the ability to efficiently perform a task integrating body movements. Hand, eye, and motor unit coordination contributes to force production during any skill or task and requires a synchronicity of neuromuscular recruitment patterns.

Testing skill should vary based on your individual physical hobbies. For example your Golf Handicap or belt color for Tae Kwon Do can certainly count as tests of skill.

Since skill is a representation of hand-eye coordination, low skill does not necessarily indicate an increased risk of disease, but can indicate underlying conditions outside of being unathletic.

High performance in skill assessments indicates that you have high levels of hand-eye coordination and accuracy relative to your chosen assessment. High skill across multiple tests indicates an innate athleticism. Increases in skill-level correspond to faster cognitive processing on and off the field as well. 

How do you become more skillful? Practice.  

Speed 

A performance component that requires high power and relative strength, expressed at bodyweight through locomotion. Elite speed indicates you can utilize your muscular fitness into performance. Like power, speed of movement depends upon neural recruitment patterns and adequate muscle.

Speed is crucial to athletic performance and also correlates to function at older ages. Preventing speed decline as you age should be a high priority.

Low speed can be a sign of low power or strength, and just a general indicator of performance decline.

Increasing your top speed gets harder and harder the faster you get. The fastest athletes are powerful and stable and have obtained near flawless levels of stride rate and stride length to be fast. As you journey to increase speed, you will find that it is the manifestation of your power and strength training along with sprinting drills that allow you to improve your speed.

Start small, but gradually work at top speed sprinting into your workouts.

Strength 

Muscular strength is defined as the body’s ability to exert a single, maximal contractile force. Literature will cite grip strength as a correlate to overall strength, but any experienced exerciser knows that different movements entail different muscular and joint actions.

To exhibit high levels of strength requires strong neuromuscular activation and coordination. Strength is associated with general function, musculoskeletal disease risk, injury risk, and quality of life.

Low measurements of strength display an increased risk of musculoskeletal disease and quality of life.

To improve strength, one needs to lift heavy relative to their capacity. This is best accomplished with squats, presses, pulls and lifts that use a barbell. However, any exercise performed at a heavier load will theoretically improve strength.