
The Paul and Howard Show
By Paul Kedrosky and Howard Luks
The latest thinking on health, fitness. exercise, and injuries, with Paul Kedrosky and Howard Luks. Paul Kedrosky is a frequently injured athlete who, when he isn’t rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.

Fitness and Heart Rate: What You Should Track -- and Why
In this episode Paul and Howard talk about fitness and heart-related measures, from resting heart rate to heart rate variability. We will get into this topic in much more detail in some upcoming episodes.
Topics:
Recovery heart rate: Why it matters and how to measure it
Resting heart rate's importance in health and fitness
Heart rate variability as a proxy for stress and fitness
Related Readings:
Heart rate variability (HRV) for monitoring health
Zone 2 heart rate training for longevity and performance
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
Crossing the Chasm by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3562-crossing-the-chasm License: http://creativecommons.org/licenses/by/4.0/
Marty Gots A Plan by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4992-marty-gots-a-plan License: http://creativecommons.org/licenses/by/4.0/
Disclaimers apply and can be heard at the end of the episode
31:08
April 19, 2021

Why Does My Knee Hurt?
In a continuing series, Paul and Howard talk about parts of the body that sometimes hurt. This time we're on about Why Knees Sometimes Hurt. There is a Fairly Crap Transcript™ here.
Topics:
What pain in the knee means
Where the most common injuries mean
Why surgery isn't generally required
Arthritis and the knee
Related Readings:
Knee injuries and treatment informaton
Exercise and knee arthritis pain
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
Crossing the Chasm by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3562-crossing-the-chasm License: http://creativecommons.org/licenses/by/4.0/
Marty Gots A Plan by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4992-marty-gots-a-plan License: http://creativecommons.org/licenses/by/4.0/
Disclaimers apply and can be heard at the end of the episode
28:54
April 01, 2021

Metabolic Syndrome, Part II: Managing Metabolic Syndrome
In the second of a two-part series, Paul and Howard talk about metabolic syndrome, in particular about how its effects can be reduced, and even eliminated. There is a Fairly Crap Transcript™ here.
Topics:
What metabolic syndrome is, a review
How "area under the curve" influences fixing the problem
The relative role of diet, exercise, drugs, and surgery in managing some of the causes of metabolic syndrome
Related Readings:
How diet affects our metabolic health
Metabolic syndrome
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
Crossing the Chasm by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3562-crossing-the-chasm License: http://creativecommons.org/licenses/by/4.0/
Marty Gots A Plan by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4992-marty-gots-a-plan License: http://creativecommons.org/licenses/by/4.0/
Disclaimers apply and can be heard at the end of the episode
33:04
March 03, 2021

Rest, Recovery, and Exercise Addiction
We have a new podcast episode out: Rest, Recovery, and Exercise Addiction.
Overview:
Paul and Howard talk about rest, recovery, and exercise addiction. We range across its causes, diagnosing it, and its consequences. There is a Fairly Crap Transcript™ here, as well as—drum roll!—a tool we created to help you assess how fatigued you are from your exercise program.
Topics:
What is exercise addiction? Who has it?
How do I know if I'm fatigued?
What is rest anyway?
How is rest different from recovery, if at all?
Readings:
Enhancing your exercise recovery
Training errors and other causes of tendinopathy in runners
31:25
February 23, 2021

Metabolic Syndrome, Part I
In the first of a multi-part series, Paul and Howard talk about metabolic syndrome, from its rise, to its prevalance, to its causes, and its consequences. There is a Fairly Crap Transcript™ here.
Topics:
What is metabolic syndrome?
How is it diagnosed?
The causes of metabolic syndrome
The rise to prevalence of metabolic syndrome
Related Readings:
How diet affects our metabolic health
Metabolic syndrome
LDL and ApoB Exposure and the evolution of heart disease
10 Techniques To Help You Thrive With Knee Arthritis
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
Crossing the Chasm by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3562-crossing-the-chasm License: http://creativecommons.org/licenses/by/4.0/
Marty Gots A Plan by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4992-marty-gots-a-plan License: http://creativecommons.org/licenses/by/4.0/
Disclaimers apply and can be heard at the end of the episode.
29:26
February 12, 2021

Coronavirus and Fitness: One Year Later
Paul and Howard talk about personal fitness and mental health, one year after coronavirus lockdowns began. There is a Fairly Crap Transcript™ here.
Topics:
Assessment through quick condition tests
The importance of having fitness objectives
What have we learned about injuries and therapies because of pandemic
Mental health, the other epidemic
Related Readings:
Niall Moyna's minimum fitness test
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
Crossing the Chasm by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3562-crossing-the-chasm License: http://creativecommons.org/licenses/by/4.0/
Marty Gots A Plan by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4992-marty-gots-a-plan License: http://creativecommons.org/licenses/by/4.0/
Disclaimers apply and can be heard at the end of the episode.
34:28
February 01, 2021

Ep 20: AMA on Strength, Longevity and Fitness
Paul and Howard take listener questions about strength, longevity, and fitness. There is a Fairly Crap Transcript™ here.
Topics:
How to stay motivated
What being fit means
How to sneak in enough activity
Related Readings:
Muscle mass, strength, and longevity
Which Comes First, Cardio or Weights
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
Crossing the Chasm by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3562-crossing-the-chasm License: http://creativecommons.org/licenses/by/4.0/
Disclaimers apply and can be heard at the end of the episode.
30:40
December 05, 2020

Muscle Mass, Strength, and Longevity
Paul and Howard talk about the relationship between muscle mass, strength, and longevity. There is a Fairly Crap Transcript™ here.
Topics:
Why muscle mass is important, and not just for bodybuilders
The loss of muscle with age, the technical term for which is sarcopenia
The many consequences of loss of muscle tone are many, from strength, to metabolic syndrome, to Alzheimer's
How you can preserve muscle tone without going to a gym, and do it as efficiently as possible
Related Readings:
Muscle mass, strength, and longevity
Changes in Body Composition Measures With Risk of Heart Failure and Myocardial Infarction in Type 2 Diabetes
Stronger legs: Six reasons you should start squatting today
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
Crossing the Chasm by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3562-crossing-the-chasm License: http://creativecommons.org/licenses/by/4.0/
Marty Gots A Plan by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4992-marty-gots-a-plan License: http://creativecommons.org/licenses/by/4.0/
Disclaimers apply and can be heard at the end of the episode.
35:00
November 10, 2020

Mitochondrial Health: The Path to Longevity and Performance
Paul and Howard have a special guest, the amazing Dr. Inigo San Milan from the School of Medicine at the University of Colorado, one of the top researchers in the world on this topic. We talk about all aspects of mitochondrial health, from what that means, to what we can do about it, to how mitochondrial health differs between us and top athletes. There is a Fairly Crap Transcript™ here.
Topics:
What are mitochondria and what do they do
Mitochondrial health for longevity and for performance
How top athletes differ from you and me in terms of mitochondrial health
The merits of Zone 2 training
Dr. San Milan's role as a fitness coach for 2020 Tour de France winner Tadej Pogačar
Related Readings:
Metabolomics of Endurance Capacity in World Tour Professional Cyclists
Assessment of Metabolic Flexibility by Means of Measuring Blood Lactate, Fat, and Carbohydrate Oxidation Responses to Exercise in Professional Endurance Athletes and Less-Fit Individuals
Why do our cell's power plants have their own DNA?
Introduction to cellular respiration
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
Crossing the Chasm by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3562-crossing-the-chasm License: http://creativecommons.org/licenses/by/4.0/
Marty Gots A Plan by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4992-marty-gots-a-plan License: http://creativecommons.org/licenses/by/4.0/
Disclaimers apply and can be heard at the end of the episode.
34:06
November 02, 2020

Athletic Shoes: Their History, Benefits, and Consequences
Paul and Howard talk about shoes and their consequences.. There is a Fairly Crap Transcript™ here.
Topics:
Why do we wear shoes?
The evolutionary history of the foot
The anatomic consequences of shoe wear
Mistakes people make buying athletic shoes
The explosion is athletic shoe varieties, from minimalist shoes, to maximalist shoes, and everything in-between
Common shoe-related foot injuries
Related Readings:
Born to Run
Daniel Lieberman's Skeletal Biology lab
A history of the running shoe
Kiss, God of Thunder
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
Crossing the Chasm by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3562-crossing-the-chasm License: http://creativecommons.org/licenses/by/4.0/
Marty Gots A Plan by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4992-marty-gots-a-plan License: http://creativecommons.org/licenses/by/4.0/
Disclaimers apply and can be heard at the end of the episode.
32:43
October 09, 2020

Ep 16: Inside the Black Box of Anesthesia: Why We Do It, How It's Changing, and What the Future Looks Like
Paul and Howard talk about surgical anesthesia with a special guest: Jon Bauman, Chief of Anesthesiology at St. John's Riverside Hospital in Westchester, New York. There is a Fairly Crap Transcript™ here.
Topics:
What is anesthesia? Are you asleep? Where does your brain go?
What do anesthesiologists do when patients are out?
Local, regional, and general anesthesia
The future of anesthesia, both in terms of technology and anesthesiologist careers
Related Readings:
The Butchering Art, by Lindsey Fitzharris
A history of anesthesiology, Wood Library-Museum of Anesthesiology
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
Crossing the Chasm by Kevin MacLeod
Link: https://incompetech.filmmusic.io/song/3562-crossing-the-chasm
License: http://creativecommons.org/licenses/by/4.0/
Marty Gots A Plan by Kevin MacLeod
Link: https://incompetech.filmmusic.io/song/4992-marty-gots-a-plan
License: http://creativecommons.org/licenses/by/4.0/
Disclaimers apply and can be heard at the end of the episode.
33:31
September 29, 2020

Rotator Cuffs: Why They Go Awry, and What You Should Do About It. Or Not.
Paul and Howard talk about rotator cuffs, those four muscles around your shoulder that often go awry and sometimes really hurt. There is a Fairly Crap Transcript™ here.
Topics:
What are rotator cuffs anyway?
Tossing, tools, and trees: the evolutionary history of shoulders
What happens if part of your rotator cuff goes, you know, missing?
Pretty much everyone over 45 has rotator cuff problems. Most don't notice.
The future of fixing -- and/or not fixing -- rotator cuff problems
Related Readings:
Shoulder MRI Findings in People with NO Shoulder Pain: Are Some Tears “Normal”
Calcific Tendonitis — What is it?
Fossil hominin shoulders support an African ape-like last common ancestor of humans and chimpanzees
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
Crossing the Chasm, Kevin MacLeod. Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0
Disclaimers apply and can be heard at the end of the episode.
32:16
September 24, 2020

Episode 14 (A Brief Audio Footnote): A Deeper Dive Into Pulmonary Function and WIldfires
We got lots of questions on our recent episode about air, exercise, and wildfires, so here is a short, deeper dive into the topic. We gave Howard the episode off, so I have a special guest, Christopher T. Migliaccio, a Research Assistant Professor in Immunology at the University of Montana. His main research interest is how environmental particulates in the respiratory system affect pulmonary immunology, and he is doing ongoing work on the effect of wildfires on pulmonary function. There is a Fairly Crap Transcript™ here.
Topics Covered:
Lung immunology and the role of macrophages
The medium-term health effects of multi-day exposure to smoke, based on a cohort study of Montana's 2017 wildfires
Consequences of particulate for lung infections, from influenza to coronavirus
Related Links
Christopher T. Migliaccio main page
Research profile
Alveolar Macrophages in Lung Inflammation and Resolution
Montana 2017 wildfires
Credits
Crossing the Chasm Kevin MacLeod Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Wholesome by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/5050-wholesome License: http://creativecommons.org/licenses/by/4.0/
10:40
September 18, 2020

Air & Exercise: Breathing in an Age of Wildfires and Coronavirus
Paul and Howard talk about air, exercise, lung function, and breathing in an age of wildfires and coronavirus. There is a fairly crap transcript here.
Topics:
Viruses and exercise
A primer on lung function during exercise
How much outdoor exercise is safe when air quality is lousy
Best ways to limit your pollutant exposure
Related Readings:
Can air pollution negate the health benefits of cycling and walking?
Air Pollution–Mediated Susceptibility to Inflammation and Insulin Resistance: Influence of CCR2 Pathways in Mice
Should You Stop Exercising During Wildfire Season?
Ambient Particulate Air Pollution and Daily Mortality in 652 Cities
Companies/Products Mentioned:
Plume Labs
IQAir
Blue Air
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
Crossing the Chasm Kevin MacLeod Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Wholesome by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/5050-wholesome License: http://creativecommons.org/licenses/by/4.0/
Disclaimers apply and can be heard at the end of the episode.
28:58
September 16, 2020

Lifespan & Healthspan: The Science(s) of Healthier Aging, From Cells to Centenarians
Paul and Howard talk about healthy aging, from cell death, to diet, to centenarians, and exercise in-between. Financial geek that he is, Paul sneaks in a little riff about pension fraud too. There is a fairly crap transcript here.
Topics:
Healthspan vs lifespan, squaring the curve
Cellular housekeeping and whether it can be catalyzed
Diets -- good, bad, and simple
What we can learn from centenarian studies, and where are their flaws
Readings and Books Mentioned:
Muscle mass and longevity
Squaring off the lifespan curve
Metabolic health and our muscles, tendons, and joints
Supercentenarian and remarkable age records exhibit patterns indicative of clerical errors and pension fraud
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
Crossing the Chasm Kevin MacLeod Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Disclaimers apply and can be heard at the end of the episode.
31:42
September 12, 2020

The Doubt Industry, Coronavirus, and Dr. Google
Paul and Howard talk about the doubt industry, medical skepticism, and Dr. Google as a force for good. Sometimes. Maybe.
Topics:
How views of medicine have changed over the last hundred years
What is causing the current wave of medical skepticism? Data democratization vs ... other stuff
Effect sizes, blockbuster therapies as parachutes, and the decline thereof
The future of medical democratization
Readings and Books Mentioned:
‘But I Saw It on Facebook’: Hoaxes Are Making Doctors’ Jobs Harder
Merchants of Doubt: How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Climate Change
Difficult Conversations: How to Discuss What Matters Most
The Butchering Art
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
Crossing the Chasm Kevin MacLeod
Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Wholesome by Kevin MacLeod
Link: https://incompetech.filmmusic.io/song/5050-wholesome
License: http://creativecommons.org/licenses/by/4.0/
Disclaimers apply and can be heard at the end of the episode.
29:17
September 02, 2020

Imaging Injuries, or Why You Can't Unsee an MRI
Paul and Howard talk about sports injury imaging, from x-rays and MRI, to ultrasound.
Topics:
What are the main tools for imaging injuries?
When are these tools most useful? When are they not?
Why Paul thinks he should be on a frequent imaging program
The future of imaging, from machine learning, to handhelds, to potentially doing it less routinely
Readings:
You cannot unsee your MRI report
Should We MRI All Patients With Joint Pain?
Video: How dangerous are magnetic things near an MRI?
Bios:
Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.
Music & Disclaimers:
"Crossing the Chasm" Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Disclaimers apply and can be heard at the end of the episode.
30:52
August 22, 2020

I'm Injured, You're Injured, We're Injured: Some Personal Perspectives
Paul and Howard talk about their own current injuries, how and why they happened, why it's frustrating, and what they're doing to get past it. Maybe.
Topics:
What happened to Paul (plantar fasciitis) and to Howard (stress fracture)
Why these injuries happened
How we respond to injuries, a phases of grief model, with some shouting
Getting to the other side of being an injured athlete
Readings:
Ginger Runner: I'm Injured, and It's Ok!
Running. Back to Basics. Base Building
Music & Disclaimers:
"Crossing the Chasm" Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Disclaimers apply and can be heard at the end of the episode.
32:34
August 12, 2020

Why Do Injuries Happen, How Do You Know, and How Do You Make Them Go away?
Paul and Howard talk about injuries, how and why they happen, and why they keep coming back.
Topics:
Why injuries happen
Acute vs chronic injuries
The origins of overuse problems
Training errors and injury cycles
Becoming a resilient athlete
Readings:
Running. Back to Basics. Base Building
Training Errors and Other Causes of Tendinopathy in Runners
Music & Disclaimers:
"Crossing the Chasm" Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Disclaimers apply and can be heard at the end of the episode.
32:26
August 05, 2020

The Fine Art of Balancing
Paul and Howard talk about balancing, but not the financial kind.
Topics:
How we balance
Why balance is overlooked but so important to health and fitness
Why falls are so common and so hard on people as we age
Myths about balancing
How to improve your balance
Readings:
Resistance and balance exercise to live longer and healthier
Balance exercises
Music & Disclaimers:
"Crossing the Chasm" Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Disclaimers apply and can be heard at the end of the episode.
28:25
July 27, 2020

Unlearning Medicine: Reversals, Placebos, and Natural experiments
Paul and Howard discuss how medicine is changing, and how some common procedures and ideas that were once accepted practice are being abandoned. They also talk about the merits of shouting at your legs, and whether it's possible to mainline red wine.
Topics:
Why some procedures become accepted practice, despite poor evidence
The "six weeks" myth in recovering from a soft tissue injury
Examples of common procedures being rethought, or abandoned altogether
Some candidates for future medical reversals
How the coronavirus is creating a natural experiment in which procedures are necessary
Readings:
Fear and surgical decision making
Medical Reversal: Why We Must Raise the Bar Before Adopting New Technologies
Natural experiments
Music:
"Crossing the Chasm"
Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 3.0
http://creativecommons.org/licenses/by/3.0/
Disclaimers apply, and can be heard at the end of the episode.
28:59
July 22, 2020

Running, Knees, and Osteoarthritis
Paul and Howard talk running, knees, and osteoarthritis.
Topics include:
Does running cause arthritis?
Can I run if I have degenerative osteoarthritis?
Biomechanical models of the knee
Repairing the knee
What we can learn from professional athletes, if anything
Bios:
Paul Kedrosky is a frequently injured athlete and a venture capitalist. Howard Luks is a top sports orthopedic surgeon.
---------------------------------
Music:
"Crossing the Chasm"
Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 3.0
http://creativecommons.org/licenses/by/3.0/
Disclaimers apply, and be heard at the end of the episode).
27:59
July 10, 2020

Coronavirus, exercise, and injury
Paul and Howard talk about the effects of the current epidemic on exercise, fitness, and injury. Topics include:
The difficulty some people have had getting enough exercise
Overuse injuries
The worried-well and over-thinking things
Going to gyms in a pandemic
Hikers with sharp sticks
Lung function and pulse oximeters
Bios:
Paul Kedrosky is a frequently injured athlete and a venture capitalist. Howard Luks is a top sports orthopedic surgeon.
---------------------------------
Music:
"Crossing the Chasm"
Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 3.0
http://creativecommons.org/licenses/by/3.0/
Disclaimers apply (at the end of the episode).
37:14
June 06, 2020