The Paul and Howard Show

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

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

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

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 

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.

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.

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.

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.

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.

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.

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.

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.

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/

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.

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.

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.

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.

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.

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.

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.

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.

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).

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).