One Year of Training at 63 Reveals Surprising Aging Insights
Interesting post today. I’ve written about how and why I trained at 62. Now I’m turning 63 and I always look back… But this post is different. It isn’t a rehash of the same program with a new number at the top. It’s what a year of actually living that program taught me — what held, what changed, what surprised me, and what my aging biology had in store for me. If the first post was the plan, this one is the honest accounting of the previous year. https://t.co/SwQBeeXEIU
X‑rays Mislead Knee Osteoarthritis Treatment Decisions
Osteoarthritis Of The Knee... Thread #1... of 4 "Bone on bone." "Your cartilage is worn away." "You have the knee of a 90 year old." I've heard these phrases bantered about thousands of times in 25 years. They are very common...
Most Tendon Pain Is Self‑Inflicted—Here’s Why
Tendon pain is the most common reason people come to see me. Most of it is self-inflicted — from doing too much, too soon, or from doing too little for too long. Let's review what most people (including many doctors) don't understand...
Consensus on Amyloid Hypothesis Delayed Alzheimer's Breakthroughs
The Amyloid Hypothesis: How Research Consensus Cost Us Decades. A Dive Into The Likely Contributors to Alzheimer's... https://t.co/ctsXwZPJTX
Training at 62 to Prevent Gradual Decline
Why I Train This Way at 62 1/ I’ve been an orthopedic surgeon for nearly 30 years, and over that time, I’ve watched something happen to many of my patients that isn’t dramatic or sudden, but ends up being far more...
Bones Remodeled Constantly: Your Skeleton Evolves
The skeleton you are walking around in today is not the one you had ten years ago. Most of it isn’t even the one you had three years ago. Your bones are continuously being broken down and rebuilt by an...
Early Heart Rate Spike Is Normal, Not a Problem
Aerobic base building - the Cliff Notes version. This is for two groups: those just starting out and those who've been sidelined for a while. You lace up, head out, and ten minutes in, your heart is pounding, and you're breathing...
Intensity Sits Atop Foundation, Not Building It
Intensity does not build the foundation. It sits on top of it... Module 6: Intensity and Locomotion. https://t.co/jGp9VQeU4a
Muscle‑Brain Dialogue Holds Key to Dementia Prevention
Your muscles and your brain are in constant conversation. Most people have no idea this conversation is happening — or what's at stake when it goes quiet. Many of you fear dementia far more than a heart attack or a diabetes...
Squat‑Induced Heart Rate Spikes Aren’t Cardio
I hear this every week in my office: "Doc, my heart rate hits 150 during squats — that's cardio, right?" No. And if your cardiologist hasn't explained why, keep reading. 🧵
Educate, Don't Convince: Respect Patient Autonomy in Surgery Decisions
Yesterday's post prompted a number of practitioner responses expressing frustration that "patients don't listen to them". Well.... that's okay. One of the hardest conversations in this profession is between the patient who wants something done and the surgeon who...
Atraumatic Joint Pain: 5 Surgeon Tips You Need
Having been an orthopedic surgeon for 30 years...5 things I wish someone had told you before you walked into my office — in atraumatic joint and tendon pain. Most of you will present with atraumatic joint and tendon pain... traumatic injuries...
Progressive Load, Not Rush: Protect Your Season
When intensity is layered onto a system that is not prepared, the result is predictable. The cardiovascular system adapts quickly, but connective tissue does not. Tendons, fascia, cartilage, and bone all require time and progressive loading to develop resilience. When...
Training for Life: Fitness That Fuels Longevity
I’ve had the privilege of practicing in the same region for nearly 25 years. I’ve gotten to know many of my patients well. Some thrive despite the years; many don’t. Long ago, that observation started to quietly shape how I...
Holistic Training Counters Aging’s Multi‑Faceted Decline
Training for life means deliberately resisting the narrowing that accompanies aging without training. It means building and maintaining the full spectrum of physical capacity: aerobic base, strength, power, rotational core, lateral movement, balance, and landing mechanics. Not because any single...
Science-Backed Training Week Explained: Methodology Revealed
Long post. What my training week looks like… and why it looks like this. Sometimes understanding the science and theory helps anchor the methodology. Link for there 👇 https://t.co/2Xzne078WC
Your 70‑year‑old Self Depends on Today's Activity
A patient asked me yesterday why so many orthopedic surgeons seem to be in good shape. I told her... Because we know what happens to the human body when we're not. We see it every day. The loss of muscle that...
Tennis Elbow Affects Everyone, Not Just Athletes
Why Does My Elbow Hurt So Much? Tennis elbow affects 1–3% of the population at any given time. Over a lifetime, virtually everyone will experience it. The vast majority of people who develop it have never played tennis. They are carpenters,...
Perimenopausal Women Remain Grossly Undertreated in Orthopedics
Nearly 30 years in orthopedic surgery. Another pattern that is impossible to ignore. Perimenopausal women are some of the most undertreated patients I see. One unfortunate paper is blamed... but often, it's because the conversation never happens. https://t.co/6m6AxUhRKF
Train for Longevity: Modular Fitness for Ageless Resilience
I've spent decades watching people limit themselves, not because their bodies failed them, but because they believed their bodies were fragile. So I built something different. A modular training library for people who want to stay capable, resilient, and independent as...
Age 62: Keep Moving, Learning, and Embracing Fatherhood
I turned 62 this year. Still running trails, still on the bike, still in the gym. Still making mistakes and learning from them. A few thoughts on fatherhood, time, and what it means to keep moving forward when some things are...
Perimenopause Is a Metabolic Shift, Not Just Hormones
Perimenopause is not just a hormonal event. It's a metabolic one. Estrogen decline affects muscle, bone, tendons, cardiovascular capacity, and insulin sensitivity — often simultaneously. Most women aren't told this. Most training advice doesn't account for it. Here's what the evidence...
Exercise Fuels Brain Health Through BDNF and Metabolism
Exercise doesn't just strengthen your body — it changes your brain. Resistance training and aerobic activity promote BDNF production, improve brain glucose metabolism, and appear to reduce the risk of cognitive decline. The muscle-brain connection is one of the most important...
Vienna Locals: Best Early‑morning Routes From This Spot?
Anyone from Vienna ?? From this position, where would you walk or run in the early morning? https://t.co/Ke9X0VlVAr
Muscle Power Predicts Mortality Far Better than Strength
Wow... Power training and longevity Araújo et al. followed 3,899 people — mostly middle-aged and older adults — for a median of nearly 11 years. They compared two metrics head-to-head: muscle strength and muscle power. Men in the lowest power category were...
Strength Training: Key to Longevity and Joint Health
Strength training might be the single most potent habit for aging gracefully and extending lifespan. It certainly appears to be one of the best methods to prevent the need for joint replacement surgery. After 30 years of practice, there’s no...
Bone‑building Exercises Work at Any Age
6 exercises to build bone density. Don't think you need them? You're wrong. Think you're too young? Wrong again. Think you're too old? Wrong. https://t.co/ZyqvbJDgy1
Too Many Opinions, Too Few Answers: Trust Physical Therapy
Fun day .. “You’re my 5th opinion.” Knee injury These are usually a problem. Previous 4… -Only one exam -All repeated X-rays -2 MRIs. - One Special NY hospital often insists their MRIs...
Heavy Strength Training Reduces Osteoporosis Mortality Risk
Please stop telling people with osteoporosis not to lift anything heavy... I've heard it from docs, PTs, Trainers, etc... This might seem protective... but it's not. This risk calculation... A hip fracture in an older adult carries a one-year...
Prioritize History and Exam Before Trusting MRI Findings
The irony I find myself returning to is that MRI technology has not made us better diagnosticians. It has, in many cases, made us worse ones, because the image is so concrete and the language of the report so authoritative...
Whey’s Insulin Spike Isn’t Bad—Focus on Ratio
Well. Here the good “Dr” isn’t entirely wrong. But his believers are getting the wrong message. If you’re avoiding whey protein because “it spikes insulin,” you’re optimizing for the wrong variable. Yes, leucine stimulates beta cells directly. Yes, insulin...
Walking Alone Won’t Prevent Knee OA—Add Strength Training
All these budding exercise physiologists and strength coaches. 🤦♂️🤦♂️ This is made up slop. Walk all you want. None of your muscles are working hard when you’re walking and your adductors are firing too. Is walking enough? No. You need strength...
Goofy Trail Warm‑Up That Activates All Systems
What does your warm-up look like? Every time in the gym or on the trail. This is mine. I might look goofy on the trail... but this gets the relevant systems warmed up. https://t.co/wHA2KNgOvU
Midlife Joint Pain Signals Systemic Decline, Not Isolated Injury
I’ve been an orthopedic surgeon for nearly 30 years, and a few patterns have become impossible to ignore. One is that many musculoskeletal problems in adults aren’t sudden injuries. They’re the moment when declining capacity and awful metabolic health finally...
ICloud-Synced Downloads Folder Lost Spotlight Search
Mac Air... my download folder- which syncs to icloud isn't searchable any longer. What's going on?
Harder Than Expected: Stop Overexerting for Upper Management
Will admit. These weren’t as easy as I thought they’d be ;-). Don’t do as much power or eccentric work for the uppers anymore. Was trying to mix it up. https://t.co/3ioCvmksg5
Muscles Play a Crucial Role in Brain Health
Our muscles influence the health of our brains in ways we are only beginning to understand. The muscle-brain connection. Post #3 in my series. https://t.co/IPMvZ5weLG
Weekly Drill Restores Directional Stability in Aging Bodies
We lose many abilities as we age. One is the ability to change direction and remain stable. This drill, done once a week, helps. This isn’t about speed. The cones are only 12-15’ apart. This is about the transition from...
Knee Pain Signals Years of Inactivity, Not Surgery Need
The hardest conversation I have in my office isn't about surgery. It's about time. A 58-year-old sat across from me with knee pain. She’s otherwise healthy, but menopause has been rough on her. Her MRI shows some cartilage changes — age-appropriate,...