Enhancing Joint Health through Physiatry, CrossFit, and Metabolic Health

Dr. Amy West, a Sports Medicine Physiatrist, is at the forefront of a paradigm shift in understanding the root causes of joint pain, tendon issues, and other musculoskeletal problems.

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Link to Video Interview, Research and Show Notes: https://bit.ly/3U5RIaS

Show Notes:

02:00 CrossFit trains all three energy pathways: glycolytic, anaerobic, and aerobic. It is based on function. Physiatry and CrossFit focus on function and living better. 08:00 Metabolic health impacts recovery, injury propensity, pain levels and physical function. Leptin worsens osteoarthritis and pain issues. 12:15 Osteoarthritis is from the dysfunction of chondrocytes within the joint from inflammation and fragility of cartilage within the joint. Metabolic disease causes a downward spiral. There is more inflammation and more cartilage damage and more boney hypertrophy. 14:00 Trigger finger is often a first sign of metabolic disease. Tendons are also impacted by the inflammation of metabolic disease. Healing process is impacted by the chronic inflammation of metabolic disease. 14:54 Bone and bone density are impacted inflammation. This can appear as stress fractures. Treat the fracture and the reason why. 17:00 Hemoglobin A1C is a marker of overall glycation in the body. Non-painful things become painful with increased glycation. 17:30 The burden of age-related changes is dependent upon your metabolic state and physical wellbeing. 96% of American adults have some sort of metabolic dysfunction, making them predisposed to accelerated aging and physical decline. 23:00 Time is a major reason for not exercising. Short 20-minute bouts of more intense exercise are easier to fit in and you get the same metabolic benefits in a shorter time. 23:40 Functional movement training increases strength and supports life functions. It uses multiple joints and practices coordination. 24:30 Heavy resistance training induces the benefits of bone density and muscle integrity. 24:45 Osteosarcopenic obesity: as you gain weight, you lose muscle mass and bone. 26:00 Weakened tendons, tendonitis, and fibrosis are often a result of chronic inflammation from metabolic dysfunction like diabetes. Arthritis is the leading cause of disability in the US. 27:25 Cortisone is a potent anti-inflammatory that brings short-term pain relief. It can raise blood sugar. Repeated cortisone injections can further degrade cartilage, worsening arthritis. You can build up a tolerance to it. 29:00 Hormones affect joint pain. Menopausal decreased estrogen levels correlate to increased joint pain. 29:40 Turmeric, omega 3s, vitamin D anti-inflammatory effects can be effective in a person with a small amount of inflammation. 31:00 PRP can be beneficial in the right patient with mild arthritis or chronic tendinopathy. It is only as good as whatever is attached to it. PRP efficacy depends upon your metabolic health. 34:10 Athletes have more muscle mass around the joints making the joint more functional and eases the load bearing on the joint. Muscle secretes myokines, which affect pain perception. 34:50 Chronic inflammation from metabolic disease around your joints can affect levels of inflammation and how the inflammation is received by your brain. It can affect brain serotonin signaling. 36:00 Low carb diets produce less leptin signaling which reduces pain and inflammation signaling. 39:50 Dr. West prioritizes protein. Traditional medicine protein recommendations are just enough to keep you alive. Protein helps with satiety and powers workout gains. 41:25 Animal protein, over plant protein, can help you feel stronger. It is challenging to get enough plant protein without eating a lot of carbs. Chronic vegan/vegetarian dieting can cause collagen and bone breakdown. 50:30 Eccentric loading of the Achilles tendon can help build capacity and be more effective than chronic stretching. Tight hamstrings can be addressed with hip extension, pelvic tilting, and hip adduction. 55:25 There can be some risk to doing isolated heavy bicep work. You can develop bicep tendonitis. Over time, it can result in rupture of the bicep tendon. 58:36 Shoulder: Drill down on technique before adding load or intensity. 01:00:10 Hanging is important for grip strength and being able to manage your own body load. 01:01:10 Deadlift/hip hinge can be done using a platform to limit range of motion to maintain form. Push with your legs rather than pulling with your back. 01:02:30 Have a physical biomarker. Do an annual measure of functional movement or movements to track your strength and fitness, along with your labs. Continue to improve. Physical goals are important. 01:06:30 Coca Cola/Gatorade has invested heavily in healthcare, exercise science and exercise guidelines. Fitness professionals are pressured not to make nutritional recommendations. Coca Cola is involved in the American Cancer Society and American College of Cardiology.