Joe

[SPORTSRADIO 94WIP @SportsRadioWIP]

LeBron James
Saquon Barkley
Joel Embiid
Jalen Hurts
Jaylen Brown
Bryce Harper
Tyrese Maxey
Kyle Schwarber
DeVonta Smith
Zack Wheeler

Name a better sports town.

[Josh Reynolds @JoshReynolds24]

If a giant ass version of this isn’t hanging off some building in downtown Philly, it’s the biggest miss on Nike’s end maybe ever…

MAKE IT HAPPEN @NIKE

[Joe @Joeydpt12]

@arielhelwani Enjoy it. No one celebrates a 2nd round win like Knicks fans. This is your championship round. You’ll be watching the Mets in a couple weeks!

[Josh Reynolds @JoshReynolds24]

If you’ve got 2 minutes, I highly recommend giving this a watch… Incredible words & tribute to Nick Nurse & his brother Stephen, who they lost during the Celtics series unexpectedly.

@notthefakeSVP doing what he does best here - Extremely well done 👏🏽♥️

[Barstool Philly @BarstoolPhilly]

What a ridiculous sequence by the Sixers

[Howard Luks MD @hjluks]

Don’t let your life "narrow."

I’ve been an orthopedic surgeon for 30 years. The thing I watch happen to people — more than any injury or surgery — is what I call the narrowing.

Most of my patients have no idea it’s happening. They think it’s just aging. It’s not.

The narrowing is the slow shrinking of what your body allows you to do — or what you assume your body can or should be doing at your age. You used to carry four grocery bags. Now you take two. You used to sit on the floor with the grandkids. Now you sit on the couch. The overhead bin in the airplane? Not anymore.

But... Nobody intentionally decides to narrow their life. Your body quietly loses some capacity, your daily choices adjust to the loss, and within a few years, the smaller version is your new normal. And many of us just normalize these changes.

Patients tell me about the narrowing every single day. They just don’t use that word.
They say, “I can’t do what I used to do.”
They say, “That’s just what happens at my age.”
And they say it as if it’s a fundamental law of physics.

Yes — some decline is real. VO2 max drops. Max heart rate drops. Strength drops. Power drops faster than strength. Proprioception drops. But the unavoidable decline is only a small fraction of what most people are actually losing. The rest, the part that turns a sixty-year-old into a frail seventy-year-old, is not aging. It is disuse.

The cruelest part is that people normalize it. They don’t question it. They talk about capacities they’ve lost as if losing them was scheduled.

Once the narrowing starts, it slowly accelerates on its own. You stop lifting heavy things. Your muscles lose fast-twitch fibers. You get weaker. You lift even less. You lose more. The loss feels like aging. You accept it. The loop tightens, and your world narrows.

VO2 max declines about 10% per decade in sedentary adults. Strength declines slowly starting in the forties. Power declines about twice as fast as strength after fifty. Bone density drops. Balance degrades. Get over it — you still have agency over all of these.

The slope and severity of each of those declines are profoundly modifiable with training. The sedentary decline curves are not the same as the natural human decline curves. They are the untrained decline curves.

Trained adults in their seventies routinely outperform untrained adults in their fifties. The body remains responsive to training well into the seventies and eighties. This is one of the best-established findings in the aging literature. But how many doctors tell their patients about this?

The patients who reverse the narrowing are not the ones with the best genetics, the best knees, or the best circumstances. They are the ones who decided to do something. Something made them stop accepting the losses as inevitable, and they started doing things differently.

What have you already stopped doing? Not what you can’t do, exactly. I'm not talking about old injuries that have ruined a joint, or those of you who have disabilities...

For the rest... the sedentary.... What have you quietly stopped doing over the last five or ten years, without ever making a real decision about it? And more importantly, did your body actually tell you to stop, or did you assume you needed to?

Much of the narrowing in your life right now is reversible. I have watched it happen in thousands of patients. It is not a miracle. It is just the body doing what the body does when you start asking it to do something again. The door you thought had closed is usually still open.

I am not a one-off. I am a sixty-two-year-old who decided not to let my life narrow, and who did the specific work to back up the decision, for long enough that the work is now visible from the outside. You can do this too. At any age, I am likely to be talking to. Start where you are.

In a relatively long post on SubSt, I discussed how my observations shape my training regimen below. This training is largely based on observing thousands of people over the last 25 years.
Link in reply...

[Howard Luks MD @hjluks]

Viruses and Joint and Tendon Pain
You had a cold two weeks ago. Nothing serious. But now your knee hurts more than it has in months. Your achilles is flaring. Your easy run felt like a half-marathon. You didn't do anything wrong. Here's what's actually happening...

[Joe @Joeydpt12]

@hjluks Would love to hear your thoughts on HIIT training (3x/week) and the cardiac adaptations derived from this plan. Feel like I get some of the weight lifting and aerobic benefit but wonder if I need to do another day or 2 of just lifting.

[Howard Luks MD @hjluks]

I'm a 62-year-old orthopedic surgeon, trail runner, and cyclist. I've also spent 30+ years watching people give up on their bodies too soon. And watching too many lives narrow.

Athletic performance doesn't have to decline sharply in midlife. Most of what drives that decline is addressable. We yield too much to age. Yes, aging brings changes. Lack of training brings far worse changes.

A few things worth knowing — The Midlife Athlete Playbook 🧵

[Life of a Philly Fan @PhillyFanLife]

There was a Gatorade shower before the 2 minute warning

The Chiefs didn’t make it past the 50 yard line until the end of the 3rd quarter

It was 34-0 at one point

It’s the final day as DEFENDING Super Bowl champs but never stop appreciating that journey
https://t.co/11T34JX255

[Howard Luks MD @hjluks]

Developing my Muscle Centric Medicine The musculoskeletal system (MSK) should be considered the central regulator and foundational layer of human physiology, influencing metabolism, disease risk, recovery capacity, and functional lifespan more than any other tissue network.

Sedentary behavior and modernity have contributed to the rise of numerous mismatch diseases, of which most have their root cause in MSK disuse/dysfunction.
Skeletal muscle and bone function as endocrine organs, producing myokines and osteokines that modulate glucose handling, mitochondrial efficiency, immune tone, vascular function, hormone signaling, and cognition.

Movement is biochemical, not just mechanical. It promotes physiological homeostasis. Locomotion preserves insulin sensitivity, lipid oxidation, endothelial health, cognition, heart health, GI system health, neurotrophic signaling, and immune stability — disuse reverses all of these.

Declines in muscle mass, power, and gait speed are early indicators of systemic aging. They often occur upstream of other common diseases. Strength and movement capacity are among the strongest predictors of morbidity, mortality, and independence. We need to be measuring and assessing this capacity far sooner, and far better.

Much more ... Link Below...

[Howard Luks MD @hjluks]

7 Things This 62-Year-Old Orthopedic Surgeon Would Tell His 30-Year-Old Self
I turned 62 this year. That's 32 years of orthopedic practice, thousands of patients, and enough pattern recognition to see who ends up on my surgical schedule at 60 and who's still hiking at 80.
If I could go back, here's what I'd tell my 30-year-old self:
1. Your joints have a finite number of hard efforts—budget them wisely
The runners you see at 75 aren't the ones who went hard every day at 30. Tissue capacity is a resource you spend, not a limitless well. Recovery isn't weakness, it's a strategy.
2. Muscle mass in your 30s is cognitive insurance for your 60s
The muscle (myokine)-brain axis isn't theoretical—you'll see it in your patients. Building capacity now means maintaining function later. Your central nervous system adapts faster at 30 than it ever will again. Use that window.
3. The patients who age well aren't optimizers—they're maintainers
Consistency beats intensity over 30 years. The boring habits compound. Your healthiest 75-year-olds never had perfect programming. They had sustainable habits that didn't require heroic willpower or constant optimization.
4. Learn to train around injuries now, not through them
Your ego at 30 creates your limitations at 60. Every tissue has a breaking point—inflammation doesn't make you tougher. The guys who "pushed through" are often the ones on your surgical schedule.
5. Metabolic health is invisible until it isn't
Your fasting glucose at 80 feels the same as 105—until it doesn't. Insulin resistance is silent for years before diagnosis. The lifestyle choices you make now about walking, eating, and moving determine whether your 60s are spent managing diabetes or staying off medications.
6. Horizontal movement > vertical achievement
The status you're chasing at 30 won't matter at 60. But your ability to hike, cycle, and play with grandkids? That matters immensely. Train for capacity, not PRs.
7. The injuries you ignore at 30 become chronic pain at 60
That shoulder twinge you're training through will limit your ability to lift your grandkid. Scar tissue doesn't heal like young tissue—it compensates. See the physical therapist now. You'll wish you had when you're sitting in my clinic.

[Josh Reynolds @JoshReynolds24]

Tyrese Maxey has the worst whistle in NBA history

Jalen Brunson has the best whistle in NBA history

Both are absolute 1000% facts & both are absolutely 1000% infuriating

[Howard Luks MD @hjluks]

In short, fragility is not something we start with. It is something we acquire when biological systems are denied the signals they evolved to require.

[Howard Luks MD @hjluks]

People talk about midlife like it's some biological graveyard, as if after 40 you're brittle, untrainable, and doomed to decline. That narrative isn't just depressing, it's wrong.

The body you have now is different, yes. But different doesn't mean damaged. It means adaptable under new rules. Hormones shift. Recovery lengthens. Stress hits harder. But your muscles, bones, and nervous system are still wired to respond to training.

Most "aging decline" isn't aging at all. It's inactivity… or lack of training. The drop in strength, balance, and energy that people blame on their birthday is often the result of not challenging the body anymore. When you stop asking your system to perform, it stops performing. That's not age, that's disuse. I see this in my office day in and day out.

Yes... We change with age. But not nearly as much as most yield to this concept.

Middle age isn't about reclaiming your 25-year-old self. It's about proving that "old" is more of a social construct than it is a biological death sentence. You're not nearly as fragile as you might think you are. You're not past your prime. You're actually more capable than you've ever been to train with intelligence and purpose, because now you understand how your body actually works instead of just throwing yourself at workouts and hoping for the best.

The only thing that's old is the mindset that says your best years are behind you.

[Sean Barnard @Sean_Barnard1]

It will get lost in the history books because of the meniscus issues shortening his season but I will forever stand 10 toes down that this was the best stretch of individual basketball ever played in the NBA. Artful and dominant on both ends of the floor every night

[Joe @Joeydpt12]

@MatthewBerryTMR Helped knock me out of the playoffs. And Dicker the kicker finished the job.

[ɹǝʇlnoԀ pıʌɐᗡ 🚴🏻 🇺🇸 🇦🇺 🇬🇧 @Retlouping]

Only 4.9% (95% CI ±2.4%, n=15) of MRIs appeared indicated. Patient demand, rather than clinical need, often influenced requesting. Causal structure-pain relationships are ambiguous, yet individuals often seek exact structural diagnoses

[Blake Burge @blakeaburge]

A major cheat code in life: Being a pleasure to deal with. Kind when others aren’t. Calm when things go sideways. Reliable under pressure. Intelligence alone is overrated. Be someone who lightens the load for folks around them. People value people who make their lives easier.