#264 ‒ Hip, knee, ankle, and foot: common injuries, prevention, and treatment options
Release Date: 07/31/2023
The Peter Attia Drive
In this quarterly podcast summary (QPS) episode, Peter summarizes his biggest takeaways from the last three months of guest interviews on the podcast. Peter shares key insights from his discussions with Jeff English on the journey to healing from trauma; Ashley Mason on improving sleep and CBT-I; Sanjay Mehta on misconceptions around radiation and its use in cancer therapy and treating inflammatory conditions (such as arthritis and tendonitis); Sean Mackey on understanding and treating acute and chronic pain; and Susan Desmond-Hellmann on insights from her extraordinary career that pertain...
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Susan Desmond-Hellmann is a physician and scientist whose remarkable career has spanned clinical medicine, oncology, biotech innovation, and global health leadership. In this episode, Susan shares insights from her journey training in internal medicine during the early AIDS crisis, treating HIV-related cancers in Uganda, and developing groundbreaking cancer therapies like Herceptin and Avastin. She reflects on her leadership roles at UCSF and the Bill and Melinda Gates Foundation, offering lessons on guiding large-scale health initiatives, navigating uncertainty, and fostering scientific...
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Sean Mackey is a professor of pain medicine at Stanford University and the director of the Stanford Systems Neuroscience and Pain Lab, where his research explores the neural mechanisms of pain and the development of novel treatments for chronic pain. In this episode, Sean joins Peter for a wide-ranging discussion on the multifaceted nature of pain—as both a sensory and emotional experience—and its evolutionary purpose as a critical survival mechanism. He dives into how pain is transmitted through the nervous system, the different types of pain, and why different individuals perceive...
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Sanjay Mehta is a radiation oncologist with over 25 years of experience, and is currently the president of Century Cancer Centers in Houston, Texas (). In this episode, Sanjay explores the rapidly evolving field of radiation oncology, addressing common misconceptions about radiation exposure. He delves into radiation’s critical role in modern oncology, examining recent advancements that precisely target tumors while minimizing damage to surrounding healthy tissues and reducing side effects, with specific insights into breast, prostate, and brain cancers. Sanjay discusses fascinating...
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Ashley Mason is a clinical psychologist and an associate professor at UCSF, where she leads the Sleep, Eating, and Affect (SEA) Laboratory. In this episode, Ashley provides a masterclass on cognitive behavioral therapy for insomnia (CBT-I), detailing techniques like time in bed restriction, stimulus control, and cognitive restructuring to improve sleep. She explains how to manage racing thoughts and anxiety, optimize sleep environments, and use practical tools like sleep diaries to track progress. She also offers detailed guidance on sleep hygiene; explores the impact of temperature...
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Jeff English is a trauma-focused clinical counselor with extensive experience working with adults, teens, families, and groups across various settings, including career counseling, life coaching, addiction recovery, professional workshops, and private practice. In this episode, Jeff shares insights from his work as a trauma therapist, exploring how moments of perceived helplessness shape behaviors and how adaptive strategies can become maladaptive over time. He discusses the concept of the “trauma tree,” examining its roots (causes) and branches (consequences), and highlights a powerful...
info_outlineThe Peter Attia Drive
In this quarterly podcast summary (QPS) episode, Peter summarizes his biggest takeaways from the last three months of guest interviews on the podcast. Peter shares key insights from his discussions on diverse topics such as aerobic efficiency and VO2 max with Olav Aleksander Bu; insulin resistance with Ralph DeFronzo; economics of the US healthcare system and cost-saving strategies with Saum Sutaria; diagnosis and treatment of autism, ADHD, and anxiety in children with Trenna Sutcliffe; and strength training with Mike Israetel. Additionally, Peter shares any personal behavioral adjustments...
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Adam Cohen is an orthopedic surgeon with expertise in sports medicine. In this episode, Adam breaks down the anatomy of the lower extremities: the hip, knee, ankle, and foot. He explains in detail the common injuries, sources of pain, and what leads to the development of arthritis. He lays out the non-surgical and surgical treatment options as well as the factors that determine whether surgery is appropriate. The discussion includes various procedures like hip replacement, knee replacement, ACL reconstruction, repair of meniscus tears, and more. Additionally, Adam sheds light on the utility of biological therapies like stem cells and platelet-rich plasma (PRP) and how they compare to more traditional approaches.
We discuss:
- Anatomy of the hip, hip dysplasia in infants, and the development of arthritis [3:00];
- Diagnosing hip pain in people under 50, stress fractures in the femoral neck, and more [11:15];
- Common hip injuries, gender differences, and problems that occur when the hip isn’t formed normally [19:30];
- Advancements in hip replacement surgery [25:15];
- Common hip problems in people over age 60 [27:30];
- The importance of muscular strength around the hips for injury prevention [30:30];
- Hip fractures due to osteopenia and osteoporosis [36:00];
- The utility of biological therapies like stem cells and platelet-rich plasma (PRP) [40:30];
- Cortisone as a treatment to delay the need for surgical intervention [53:30];
- Anatomy of the knee [56:30];
- Are activities like running that amplify forces bad for the knee? [59:45];
- Risk of future knee issues and arthritis following an ACL tear or other substantial knee injury [1:04:30];
- How the ACL injury happens and how it is repaired [1:08:30];
- Arthritis of the knee [1:19:00];
- Meniscus tears: how they happen and when surgery is appropriate [1:21:30];
- Total knee replacement: when it’s appropriate and how the recovery process compares to hip replacement [1:30:30];
- Learning from elite athletes, heart rate recovery, V02 max, and other metrics [1:58:45];
- Surgical vs. non-surgical approaches to various knee injuries [1:40:45];
- Achilles tendon: tendinitis, rupture of the Achilles tendon, and prevention strategies [1:44:15];
- Anatomy of the ankle and foot [1:49:00];
- Common injuries to the ankle and foot [1:51:15];
- Tips for finding a good orthopedic surgeon [2:01:45]; and
- More.
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