The Dr. Gabrielle Lyon Show

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The Joint Health Blueprint: Preventing Arthritis, Frozen Shoulder, and Bone Loss as You Age

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Dec 30, 2025

Guest

Jocelyn Wittstein

Guest

Gerard (Orthopedic/Sports Medicine Specialist)

Dr. Gerard, an orthopedic and sports medicine specialist, and Dr. Jocelyn Wittstein, a bone health expert, share invaluable insights on joint and tendon health. They discuss the importance of progressive overload for tendons, impact training for osteoporosis prevention, and the hormonal connections to conditions like frozen shoulder. Dr. Wittstein highlights the higher arthritis risk women face post-menopause, while Dr. Gerard explores the intricacies of tendinopathy and effective recovery strategies.

02:29:50

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INSIGHT

Tendon Adaptation Lags Muscle Growth

Tendons adapt far slower than muscle, often taking six to nine months to remodel to a new training stimulus.
Progressive overload must include tendons, ligaments, and joint capsules, not just muscle, to avoid injury.

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ADVICE

Periodize Training; Track To Avoid Injury

Periodize and deload: plan goals for 2–3 month blocks then reduce volume to recover connective tissue.
Track progress so you don't keep loading until you injure yourself.

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ADVICE

Use Impact Plus Strength For Bones

Combine strength training with targeted impact (flight) exercises several days a week to improve bone density.
Small doses like ~50 jumps per session a few times weekly can increase bone mineral density.

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Tendon Basics and Viscoelasticity

01:07 • 4min

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Why Muscle and Tendon Must Adapt Together

05:31 • 1min

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Progressive Overload for Connective Tissue

GLP-1s, Weight Loss, and Bone Health

11:25 • 3min

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Impact Training to Prevent Osteoporosis

14:39 • 4min

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Medication vs. Mechanical Loading for Bone

The History of Muscle and Ancient Views

21:13 • 4min

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Muscle as Gift: Supercompensation Explained

25:19 • 11min

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Defining Impact Exercise for Bone

36:33 • 3min

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Designing Programs for Bone and Muscle

39:22 • 11min

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Youth Activity and Lifetime Bone Density

50:19 • 8min

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Contraceptives, Perioperative Clot Risks, Nicotine

Why Tendinopathy Limits Progress

01:02:04 • 17sec

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Tendon Pathology and Cellular Response

01:02:21 • 2min

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Percutaneous Tenotomy, 10X, and PRP Use

01:03:52 • 6min

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Tendon Tears: Prognosis and Repair Timing

01:09:56 • 5min

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Common Injury Patterns: Shoulder and Patellar Tendinopathy

Medications and Metabolism that Harm Tendons

01:24:56 • 2min

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Nutrition and Supplements for Tendons

01:26:43 • 44sec

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Hormones: Thyroid, Estrogen, Testosterone Effects

01:27:27 • 4min

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Frozen Shoulder and Menopause Arthritis

01:31:21 • 8min

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Estrogen Therapy, Joint Pain, and Studies

01:39:20 • 8min

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Osteoarthritis, Inflammation, and Sex Differences

Diagnosing Tendinopathy: Imaging Choices

01:52:55 • 28sec

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Mobility vs. Stability Two-by-Two

01:53:23 • 6min

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Stretching, PNF, and Eccentrics Explained

01:59:24 • 11min

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Training Strategies: Zone Two, HIIT, and Kettlebells

02:10:14 • 11min

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Clinical Philosophy: Root Cause and Antifragility

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If you are only focusing on building muscle, you are missing half the equation for long-term mobility. In this mashup episode, Dr. Gabrielle Lyon brings together top orthopedic experts to discuss the critical importance of joint and tendon health.

While muscle develops relatively quickly, your tendons and ligaments can take 6 to 9 months to fully adapt to a new training stimulus. This gap is where most injuries happen. We dive deep into the biological mechanics of tendons, the"athletic accommodation timeline," and why you must progressively overload your connective tissue—not just your muscle bellies.

You will learn:

The Menopause Connection: Why women face a 30% higher risk of arthritis and rapid bone loss after age 50, and the role of estrogen in joint inflammation.
Osteoporosis Prevention: Why high-impact "flight" exercises (jumping) are more effective for bone density than traditional lifting alone.
The Frozen Shoulder Mystery: How to identify the warning signs and why this condition is often linked to hormonal shifts rather than trauma.
Injury Recovery & Prehab: The truth about PRP, needle tenotomy, and the "anti-fragility" mindset needed to build a resilient body.
The History of Muscle: How ancient Greek views of "pneuma" and the "gift of strength" shaped our modern misunderstanding of movement.

Stop training until you break. Learn how to track your progress, prioritize stability over raw mobility, and design a life built for anti-fragility.

0:00 - The Gap Between Muscle and Tendon Adaptation

1:32 - What Are Tendons? Visco-Elasticity and Force Dissipation

4:36 - The Rotator Cuff: Stabilizing the "Golf Ball on a Tee" 6:40 - The Athletic Accommodation Timeline: Why 6-9 Months Matters

8:36 - Progressive Overload for Connective Tissue, Not Just Muscle

11:36 - GLP-1s and Bone Health: Does Ozempic Increase Fracture Risk?

14:34 - Preventing Osteoporosis: The Power of Impact Training

18:15 - Bisphosphonates vs. Mechanical Loading for Bone Quality

21:10 - The Hidden History of Muscle: From Galen to Ancient Greece

26:48 - The Myth of "Pneuma" and the Soul in the Muscle

30:55 - Supercompensation: The "Gift from Zeus" in Performance

36:35 - Defining Impact Exercise: Why "Flight" is Better for Bones

39:48 - Building Your Base: Why Bone Health is Won Before Age 30

42:38 - Oral Contraceptives and Peroperative Blood Clot Risks

45:21 - The Hard Truth: How Nicotine Destroys Orthopedic Healing

47:55 - Testosterone and Muscle Mass vs. Bone Density in Women

51:41 - Relative Energy Deficiency in Sport (RED-s) and Stress Fractures

55:53 - Long-Term Menopause Consequences: Mobility and Hip Fractures

1:01:58 - Tendinopathy Treatments: Needle Tenotomy, 10X, and PRP

1:07:26 - Full Thickness vs. Incomplete Tendon Tears

1:12:05 - Prehab is Real: The Push-Up with a Plus and Skater Squats

1:13:58 - The Biomechanics of the Gate Cycle & Pelvic Stability

1:17:31 - Medications that Destroy Tendons: Fluoroquinolones & Statins

1:20:02 - Corticosteroids: Balancing Short-Term Relief with Repair Issues

1:24:12 - Nutrition for Joint Health: Collagen, Vitamin C, and Leucine

1:27:11 - Thyroid and Sex Hormone Influence on Tendon Metabolism 1:31:50 - The "Menopause Arthritis" Phenomenon

1:54:04 - Mobility vs. Stability: The 2x2 Evaluation Table

2:11:06 - Zone 2 vs. HIIT: Raising the Ceiling of Human Performance

2:24:21 - Anti-Fragility: Using Stressors to Get Stronger

Thank you to our sponsors:

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Find Dr. Jocelyn Wittstein at:

Duke Health - https://www.dukehealth.org/find-docto...

Instagram - @jocelyn_wittstein_md

The Complete Bone and Joint Health Plan - Find it at Amazon and Barnes & Noble

Find Gerard D'Onofrio, MD

Web: https://www.summithealth.com/doctors/provider/1376049130

LinkedIn: linkedin.com/in/gerarddonofrio27

Find Dr. Gabrielle Lyon at:

Instagram:@drgabriellelyon
TikTok: @drgabriellelyon
Facebook: facebook.com/doctorgabriellelyon
YouTube: youtube.com/@DrGabrielleLyon
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Apply to become a patient – https://drgabriellelyon.com/new-patient-inquiry/
Join my weekly newsletter – https://institute-for-muscle-centric-medicine.ck.page
Pre-order my new book - https://www.amazon.com/exec/obidos/ASIN/1668085623

Disclaimers: This episode includes paid sponsorships.

The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.

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