The Shocking Truth About Joint Pain and Unnecessary Surgery with Dr. Joshua John-Ram Schacter

Introduction to Ancestral Healing 0:00

Welcome back to Everyday Ancestral, where we challenge modern norms with timeless wisdom. Today's world has more gyms, gear, and gadgets than ever before, so why are we in more pain than never? My guest today is Dr. Josh Schachter, an orthopedic surgeon who's seen firsthand how modern life breaks the body. and how ancestral movement, alignment, and recovery might be the keys to healing it. Whether you're dealing with chronic pain, recovering from injury, or just trying to move better and feel stronger, this episode will shift how you think about your body from a machine to a masterpiece that's always adapting.

So let's dive in. Are most surgeries actually necessary? Or is the system overreacting to fixable problems? So I think we have to really differentiate. I wanna say I'm an orthopedic surgeon. And I've done 15,000 orthopaedic surgeries. But I am not a general surgeon, I don't work on hearts or brains. So when you say surgery, we're gonna talk about joint surgery. Musculoskeletal, that's what I know about me. and I gonna tell you that our system is broken. It's completely broken, We are we are living in a system in the traditional orthopedics in The United States where a vast number of surgeries that are done in this country are Done before they're medically necessary And joint replacement surgeries in particular are a concern to me personally I was the director of an orthopaedic center of excellence for hip and knee replacement for a decade And over the time when I've practiced orthopedic surgery,

Why Joint Surgery Is Overused 1:35

I have seen the amount of surgery done increased dramatically. And we're doing surgery on joints, which are in some cases not to the end stage, right? For instance, about- What do you mean by the ends stage? What does that mean? Yeah, so when we do a knee replacement, it's a wonderful procedure except it, you know, in terms of success, a replacement can be great. But if you don't have bone-on-bone arthritis, if don t have a lot of joint destruction, If you're only sort of in the moderate phase of arthritis where you have little bit of cartilage inflammation or irritation, then doing a joint replacement on those knees is not as successful and it's happening more and more often as we're being more aggressive with surgical interventions in this country.

About 35% of joint replacements as of 2018 were done before completely medically necessary. And that's really a concerning statistic. Why do you think doctors are jumping to surgery? Is it similar to like antibiotics where they're just like, oh, I'll just prescribe antibiotics? You know, is it just the system doesn't want to take time to really like naturally support the person or why do think this is happening? Well, we're seeing more and more, I mean, first of all, orthopedic surgery is one of the biggest drivers, it's one the of biggest money makers in a hospital system.

Ah. Bing, right? And more surgeons nowadays are employed by hospital systems. And I'm sorry, brothers, you're working for an evil empire in lot of cases. Some of you may be very happy. And so when you're employed in a situation where your specialty is a big cash cow, then there's definitely a push for you to do more surgery in the organization. Interesting. In those big hospital systems. And that is pressure on modern orthopedic surgery, but we really, in my opinion, we're not using the solutions that we evolved with.

We're not optimizing our own regeneration. We are not intervening before the joints are too far gone. And we are doing damaging treatments to joints now that are temporary like steroid injections and certain types of medications. giving people maybe one or two steroid injections, ordering a very short course of physical therapy, asking them to make no activity modifications or looking at their metabolic system as a whole. And then we're recommending surgery because these very limited measures we've tried for the past three months failed.

It's really common to see a person with knee arthritis, knee pain come to an orthopedic surgeon's office And they'll look at an x-ray. They may order an imaging study. And then if you have moderate arthritis, you might get a steroid injection, come back in three months and see me. I'll give you another steroidal injection. If it doesn't get better, then we do surgery. Right? In a lot of cases, we'll order physical therapy, but it's maybe, you know, for patients to fail physical, therapy can be as little as two visits with a physical therapist and they document that the patient is not a rehab potential because they continue to have pain after two.

And then we recommend surgery. Is anyone asking the question of like, well, why are we experiencing so much pain? Like I think of Like why why our muscular skeletal issues skyrocketing even though we have more fitness options and we Have we we? Have more systems in place, you know, if anything, there's more gyms in places more people are technically being more active at least I Think but there is also more and more Awareness around warming up. There's more awareness around recovery and strength, you know, like like taking time off.

So what is where is the disconnect happening you think the problem is There's a couple. We know that joints are really built for use and a certain type of use, the way we evolved, right? You know, in a normal walking stance and in normal running stance, normal squats, you know our activities now, our daily life is hard on our joints. Sitting in the car for hours at a time is not good for your joints, they need to move, joints have no direct blood supplies, so they needed to be moved, and they had to moved in an appropriate way.

And I think also that inflammation is this very modern problem.

Inflammation, Diet, and Chronic Pain 6:32

And even though we're really looking, I mean, a lot of us really care. A lot us care about how we move and what we eat. We're thinking really critically about our joints and our own health. But in our society, our diet is so inflammatory and toxic. In America, processed foods are epidemic and they're causing really severe problems in our health. And we see that manifested in the joint as well. Um, inflammation in your joint is a lot to do with what you put in. Interesting. So, so in a sense you're saying like we're seeing specific types of injuries that maybe we didn't see, I don't know, 25, 30 years ago, and it has to potentially with the food systems.

Absolutely. Oh, yeah. Absolutely it has to do with our own metabolic systems and how you know, we're all get in modern America We're eating processed a lot of us are eating process food in the majority of our meals those foods have been shown to be inflammatory and when you're in a chronic inflammatory state when You have a high degree of inflammation Your tendons don't heal the way they should Your ligaments don't heal the way they should. And so we develop these chronic problems and we see them in younger and younger people nowadays.

It used to be that you'd see a lot of shoulder pain in older folks, but now we're seeing it in the younger populations. Part of that is because we are living vicariously through our kids in high school sports. We're having more injuries. But then also their diet, their metabolism, is damaged by their environment and what they're putting in their bodies. What do you think people are getting wrong about pain? a pain, like when you have pain that should be almost like you're listening. Like that, that's should just be a clue of like, Oh, something's going on.

Let me check that out. But are people actually doing that? Or do you think they're, they are feeling pain and that they almost regulating and thinking, oh, well I'll just keep working through that pain. They're not listening? Is that the issue that is going? Well, I think, we do listen to pain there's, There's lots of business for orthopedic surgeons. So in a way, people are listening to their pain, but they're really going down a road that's destructive if they go the modern medical route of joint pain treatment.

We can get into that in the second, Are we not listening enough or are we listening too much? I think pain is one of those things that it's of course subjective to everybody. It depends on what type of activity you're doing if it hurts. Working out through pain through an injury that's getting worse is certainly not listen to your body. So, if you have some soreness one workout and the next workout you don't have that soerness, well that's not something that we need to be super concerned about, but if have a joint pain that is getting worse through your activity, Then a typical timeframe that I have people look at if they're able to deal with it, four to six weeks is a good time to listen to your body and try to do things besides see someone like me.

But after six of pain, then it's a idea to get another set of eyes on it. To look a little deeper into that pain. I don't think we need to live for months with pain How did you get into this line of work? What brought you down this path? Did you experience a lot of pain growing up that made you go, oh, hey, I want to become a doctor that supports joint surgery so that no one else experienced what I did? Or what's your story with that? I grew up in central Oklahoma. My dad's a chiropractor. The musculoskeletal system is really interesting to me.

I grew up, you know, in anatomy labs and with them going through chiropractic school. And so I was exposed to that as a very young age and I wanted to be a doctor. Competitive surfer when I was young I've always been a mountaineer of mountain bike, you know climbed now I you have kiteboard all over the world and fly my paraglider But I really love being active and to me orthopedic surgery being the being surgery of the joint it seemed like You know a cool job where I could help people and I wouldn't have to deal with the mind.

I Because in medical school, I was pretty close minded about the impact of the mind in actual healing. I thought I could just work on bones and joints and I can be a carpenter. So when you were younger, you saw healing primarily through practical, like surgical terms, right? Yeah. You almost saw anything that had to do with brain, mind over matter, You were like, that's woo woo. Is that kind of what you're saying? Very much. That was really my approach in medical school. Bear in mind that medical is just the beginning of learning what you don't know.

So, you know, at first I thought, I really didn't like my psychiatry rotation.

Listening to Pain and Early Intervention 12:14

I though that was pretty boring. But I really love the idea of one, using a hammer at work every day. It was fun. And then two, I like the ideas of being able to change people's lifestyles, like to help them live better, right? To walk again is incredible. If you break your femur, your thigh bone, you're really happy with your orthopedic surgeon. And those are big wins that I really loved during my training. It was also very competitive and I'm a competitive guy and so I wanted to be in a sort of a high profile specialty.

So that's Josh at a medical school. What's what's josh nowadays like then? Because clearly you've expanded that perspective. The mind is so important for healing joint pain. For one thing, just doing mindfulness can help us change our habits. It can impact our stress system. We know that just good sleep habits and mindfulness, can reduce our inflammatory markers by up to 30% without doing anything else. Like that's bananas. But the mindset is such an important part of patient success. And after I have been doing this, you know, when I went out into practice in here in Wichita Falls, Texas, in a small town, the community, being out at North Peak Surgeon in this community you've operated on everybody's like uncle, mom.

You get stopped in the grocery store like three or four times. Oh, he took care of my son. It's a wonderful experience. But what I saw was that when I can give a positive experience as a physician, not only did it change that person's life, but it really helped their family. So the whole mindset of the community even is important, and not just the patient themselves. And as I went in practice, I just really got in much more interested in how can I help a patient's healing journey by being supportive of the way they think about it, by helping them frame it.

And now we know, since we do regenerative medicine and we function medicine in my clinic, I don't do surgery anymore. Regenerative Medicine, our minds are so powerful that they affect the ways that our cells behave. And so the way that you perceive your treatments has a big impact on how well those treatments heal you. In a sense, what I hear you saying is the placebo effect is real, like that if you believe it, it's true. Yeah, exactly. The placebo effect is just an application of the strength of our mind, right?

The human mind is so incredible that I think we had to insult it and downplay it by naming it the placebo affect. It cures cancer, man. Come on. I mean, there's a certain amount of people who are cured of cancer when they try the saline treatment. So I thinks it's incredible. Yeah, absolutely. And I love though that your journey started out kind of more, Hey, this pays really well. This is how I want to contribute to society to like, no, now I don't want it. Just make more money and contribute. To an individual.

I wanna change spans of generations. Want to support communities. It's almost like the release of ego, right? Like that whole process of as we age, we're less egotistical and we are more like thinking more about the whole. And that's been my personal journey for sure. I mean, there is nothing, I know that surgeons aren't known for their egos, but I had a pretty good size. my ego was, was fairly large. And you know, you learn things through life. I, my wife, Amber has the breast cancer gene and I was at sort of the height of my power as an orthopedic surgeon.

That was the chairman of our department. You know I running this orthopaedic center of excellence. So I doing a thousand surgeries a year. Was working 70 hours and really feeling in my powers as a surgeon now I not spending any time with my kids.

Josh Schachteru2019s Background and Medical Training 16:48

My wife, you know, at that time was certainly not feeling close to me. You know I'm spending all my time working. And she had this breast cancer. She has this Breast Cancer gene and she was diagnosed in when she turned 31. At the age of 31 at the height of my power as an orthopedic surgeon, she has all of these surgeries which changed her body and put her into menopause and sitting with her through the experience of those surgeries and that time in her life where she changed very rapidly from this young vivacious mother of 31 to at 32, she's gone through menopus, risk of cancer, 15 surgeries, all of these things.

That changed the way that I saw what I was doing in the world. That change the that way I see myself as a surgeon. And, and also it changed the way that I think about how we take care of people, because at that time I was like, we're going to operate on you. We're gonna do five and 10, you know, joint replacements a day. There's no time to take of the human in that scenario. If I'm seeing 50 patients a and my PAC in 30, I am doing 30 or 50 surgeries a week. And the blessing of Amber's illness was that it forced me to slow down and say, Whoa, There's some other ways to look at this.

Medicine is not this high volume, high return type of activity. This needs to be well thought out and slower and we need to spend more time getting to know our patients and their biology and how we can make interventions without just jumping to the next surgery. Yeah, man, that's really, I'm grateful that you had that, you came out of that experience with this new awareness. I think everyone in your life is probably grateful of, because in everyone you touch as a surgeon is, is. Is probably a grateful for that because it sounds to me like you, You recognize that the system was out.

out of or was misaligned with humanity. That almost like the system was focusing on the transaction or the procedure and leaving the human aspect of it, disregarding it. You know, leaving it by the wayside. Medicine is completely transactional. The traditional system is transactational. You go to your doctor, you pay your copay, You sit for hours. They see you for 15 minutes, they give you a drug, They schedule your follow-up. That's a transact, that's transactinal relationship. that all medicine sees, Americans as right now.

And that is a real shame. And it took me leaving that traditional system and coming into the functional space and starting to really be involved in the wellness movement and the Functional Wellness Movement to see just how broken the system is and just fucked up the whole thing is. You don't get to spend any time with your primary care doctor. You know, the people in my community talk about they have to schedule to see their doctor nine months from now. They can't see him when they're ill. When he sees them, it's 15 minutes, check in on all of their medications.

Their doctor's in a huge hurry because he's got a quota of patients he has to that day because, he is an employee. And he very superficially goes over their symptoms, gives them a medication and then they're out the door. And that's just not giving anybody the care they need. There's no discussion of the, in most cases, unless you have a very special doctor, there's not discussion your diet and there is no discussions of your actual metabolic health. They do these very basic labs, they look at a superficial view of a patient and it shows.

In America, we have some of the worst public health in the developed world. Yeah, which is ironic when we're one of The Wealthiest Nations. It's tragic because we are all feeling the effects of this. How can you support empowering those people that are listening to this episode? Well, I think I can, can support them by saying that longevity has some very simple, very, simple foundations. It's how do we move? What do you put in our bodies and how we rest? Right. So, and it's, you know, if we, really think about what you do every day, James, with your business and Empowering people's nutrition,

Mindset, Placebo, and Regenerative Medicine 22:08

I think, is a really big part of what we need to recognize in America is that our food industry is actively trying to poison us and that sticking to whole foods and paying attention to what were putting in our bodies is extremely important over the long term, starting at a young age. Right? The second thing is that we need to get more rest, and that doesn't mean, hey, I want you to sleep a full eight hours. Not everybody has to stay eight-hours, but we're not resting through the evening. Sleep disturbance and sleep problems are rampant.

It's one of the largest causes of mortality. You know, it's actually sleep deficit. And the consequences to the metabolism. And then how do we move? A habit of more natural movement, like a habit, of maintaining our muscle mass and staying active are really critical. And those three things are very simple, but our society and the way that modern life works all conspires to work against them. So, you know, your genetics are only I was listening to a podcast today and the scientist was saying your genetics are really only three to seven percent of your overall longevity unless you have a serious disease that's inherited.

And so the rest of it is are all things that we can modify using our environment and our mindset and actions. Fantastic. I love this topic. So what's one movement you wish everyone would start doing again like our ancestors did? Because you talked about ancestral movements, ancestral patterns or movement patterns, right? That our ancestral life was like. What's what what one moment you wished everyone was start to do again, like your ancestors? Dude, I'm telling you, this sounds so weird. In Nepal when I was flying my paraglider in Nepal.

I noticed that like people would like they don't sit down they squat They squat down with each other. And I've seen that in countries in South America. I have seen it in other places around the world. Squatting is actually a really, and they squat with great posture because instead of sitting, they're actually squatting there, right? Being able to squat and maintain a squat is such a healthy movement for your low back, for you hips, your knees, or your ankles. from a young age. The problem is we can't take 50 and 60 year old people and be like, hey, you're not very limber.

Go ahead and try this deep squat. It's something that we would have to have as a habit and work our way towards if we're older, myself included. But I would love to see a deep squats more often. Yeah, it's funny you bring up squats because that is... That's a fascinating one because it's true, right? If you think about it, we didn't have chairs way back in the day. So how would you just hang around the fire? You might sometimes do like, you know, sitting on your butt and cross-legged or something like that, but most people would probably be squatting.

Indigenous cultures squat and they squat in community. It's like you'll see, I've seen 30 people just talking Sitting in that squat for a while, like an hour, I couldn't hold that position myself. I don't think a modern American could for that long. Yeah, you're right. It's, it's painful if you to your point, if he didn't start young and, and. And it is fascinating because speaking of like the Asian culture, or like I've specifically seen old men or old women squatting. Like it starts incredible.

Here we are, 30, 40, 50 year olds, 20 year old, then we can't do it. No, no. In those cultures, where you see these older people squatting, this very natural movement, There's certainly not as high a rate of joint replacements. They're not having as many surgeries. If you look even at, and I don't know if this is connected to squatting, but if we look at our ancestors, indigenous populations don' have a huge rate arthritis. probably because of the way they move. And you could argue, well, they don't have as high as long a lifespan, but even older skeletons don' show as much arthritis in indigenous populations.

I think that's a multiple things, you have an 80 year old person who can squat all the down. Yeah, that is very interesting. It really is. What are some, Like you said, you have kids, like with all this knowledge and the change that you've gone through in your lifetime, if you were to have a kid today, uh, a young child, what, kind of what are two or three movements that would encourage them from a younger age? Clearly one might would be squatting. What would the other two be? I, I love, young age.

I think a natural squat to maintain that is great. I love it when kids run and play. Like their natural movement Their own so you really I don't really want to modify how kids are are moving we we We grow up knowing how to move our bodies and we forget at some point, right? Like the most natural movement I think is are these you know, these toddlers as they're learning to walk And I I take letting that process be natural is the important part now you have to support it and I Think a lot of times If I could make one modification to what we do with kids is screens.

Personal Transformation and Systemic Problems in Medicine 28:38

I was at the airport the other day and my wife and I are walking down, we're going to the TSA line, and there's a young family and a three-year-old, he's laying on his belly watching an iPad. Right? It just brought to mind, I wonder how long that kid spends on the iPad. And that family, to be fair, that may obviously, you know, That's a unique situation, but we, our kids, see it. I've seen it in my younger colleagues. My kids spent too much time on screens, But the very young spending a lot of time On screens and not moving to their full potential I think is damaging us.

It's damaging our Kids. Well, really want to see that go in the other direction. I think you're right though, like in a sense, okay, you know, You're saying like, I don't want to say change kids from moving, but what needs to change is our encouragement to create an environment where they need to move. And if you are on screens, and you don´t move, No, no, we are using these screens as a distraction so that we don�t have to chase our kids. But the chasing our kids is good for the kid and it's good.

For us too. Right. So like that we need that movement as well. Yeah. Yeah, yeah. I mean, exhausted mothers will definitely not agree, but I would argue that it's very unnatural for a human being to sit the first part of their development and watch a screen. That's not how we evolved to be physically successful. Okay, so let's move on to 20ish to 30ish age. So clearly we want to be thinking about diet because you talked about how certain foods are going to causing inflammation and then affecting the joints.

What other, what movements should maybe that age group be? Thinking about that. Cause really what I'm trying to get at is like, What kind of prevention can we naturally, w what does natural prevention look like through the different decades? Oh, that's a complicated, we got a lot of time to be here because that is a big question. You boil it down to a couple of things. I don't think you can break it to the different decades. We need to lift heavy weights with good technique and ensure that we have good mobility.

A combined system of movement is probably what's going to be the best for most people. And that is going involve a mix of high intensity exercise, you know, HIIT training type workouts, weight bearing exercises, and weight lifting type exercises for strength and to prevent muscle loss, maintain our bone health. type of flowing movement like yoga, something to really stretch the joints and maintain the compliance of the ligaments, to maintain elasticity of our tissues, um,to keep us stretchy, right?

The changes that we see over with age is we all get stiffer. Well, if we can do something at a young age and develop habits to combat that, If you look at people who do yoga into their 70s, they have much less joint pain, particularly back pain. It's very powerfully impactful. So that combination. And so we need to do something that's metabolically active, like high intensity exercise. We need the maintainer aerobic capacity. You need build our musculoskeletal system by, by loading it with weights, and then we to maintain that tissues compliance.

When you maintain our mobility. Would you agree that it's hard to. learn to be active and better to start being active at the youngest age possible so that you, to your point, the habit of being actively is there as you get older. Because it's something I've always reflected back to my daughter. I was always like, through my oldest daughter, I'm like you need to walk to school. And she's like but it cold or it this or that. She's complaining. No, no, but you to need be in the habits of using your body now because if you don't do that now, You think it's going to be easier when you're in your thirties or your forties?

It's gonna be harder. Cause in a sense, doesn't the body have a memory? Oh yeah. The body has a, that's yeah, your body as a. Memory for sure. 100%. You and, and activity levels are personality dependent too. Some people are not naturally as active as others. Um, but we know that people who grow up on a farm or tend to be much more active, you know, at an earlier, younger age, right? You know country folks versus somebody who grows up in a city and, has to have play dates and is more limited in how they can get outside and do things.

Um. I, I have a question though, like you're making your daughter walk to school. Don't you live in Boston? Just outside. Yeah. I mean, but you made it in like the winter. Well, I think when it's snowing, we don't. But more to what you just said is what we're doing. What I'm trying to educate her on is that she, her personality is such where she is more used, like she's an artist. She likes to sit and draw on bed, listen to music. Like she doesn't, she not inclined to join an athletic club or team.

be as physical as let's say I was taught when I as younger and I'm here I am in my 50 year old self going like, but, honey,

Longevity Basics: Food, Sleep, and Movement 34:48

like it's really hard to learn to be active. Like you have to, I believe you to start young in terms of the mindset of like using that body. If it not a natural inclination, you almost will yourself to do it at a younger age because it just going to get harder as you get older. That's kind of point I trying to make. Very much. If you don't get in the habit of being active at a young age, then certainly it's really hard to start that habit later. I read a story about a guy who didn't start weightlifting until his mid seventies though.

So, I mean, you know, is now lifting heavy weight and doing all this crazy stuff. That means that we can't ever make a habit, but it definitely makes it harder if you start numb. And if we don' support our kids in having sort of active habits. But in your daughter's case, like not everybody wants to be on the soccer field. When I talk to parents about this, I always encourage them to find something that's active that really sparks your kid. Maybe it's not soccer, maybe it is band and we can do marching band, that is active.

But maybe its dance, mix martial arts. But having habits of being fit and moving our bodies at a young age is extremely important. Well, I'm glad you actually brought this up, because that was gonna be another question of mine, is that, so what you know, we were talking about, you had mentioned heavy weights, doing some stretching, like yoga, in terms of supporting longevity and optimal health, right, for your joints and your skeletal muscles as you age. Where does, I mean, you are someone who paraglides, like you do all these adventure kind of sports that in many ways aren't just physical, but they're creative.

Like they are stretching your mind and you could even say that they were fun. I don't know if they fun to you, But they could, Like I look, and I hear the things you're doing. And I'm like, that sounds fun, right? Where do you see that being important? Do you think it's important for not just mind health, but physical health to make sure that mindset of enjoying whatever it is you're doing, do think that's going to help you age better and continue moving even more as you get older? Yeah, for me, adventure is expansive.

We know that as we age, our thought patterns tend to become more rigid. That's pretty well recognized. I think we all feel that. An important point of longevity is that if our minds will age much slower and become much less rigid if we have new expansive experiences. So I'm lucky and I do have fun. I paraglide all over the world, big mountain ranges and the Andes and Alps. At the foothills of Mount Everest, I've been all-over and it is fun, but what I love about flying and flight sports and extreme sports in the mountaineering realm are that you're you're getting to have deep and impactful experiences with your environment, with nature, that is deeply immersive, and that I feel really good for my brain.

It really helps my brains to use all of its functions at the same time, because we're making decisions at same times as we are making small motions, at a same as time as were making larger motions. And those types of activities like paragliding or kiteboarding and surfers, anybody that loves to do that at a certain level will agree that it's good for their brain, just like it is good their body. And that I think might take home for other people. You might not paraglide, you might no surf, but doing something that is for your mind as well as good as your body at the same time magnifies the benefits.

it increases the benefits of that activity. So, and for a lot of people that might be gardening, it's a physical plus a mental activity, you know, cooking is a physically plus mental active, right? Surgery is physically a plus of mental activities. And so are the things that I love to do. You told me that you're no longer doing surgery. What caused that result? I think a big point of it is my reaction to the fact I don't believe that a lot of orthopedic surgeries that are done today are strictly necessary.

Ancestral Squatting and Childhood Movement 39:58

We're doing scopes on arthritic knees, we've known that that's not a good idea since the early 2000s when there was this massive study that came out that showed it was no better than a sham surgery. We're doing certain types of shoulder surgeries and, you know, we're during joint replacements too early and that really started to stick for me. I was doing a lot of surgery, I felt very pushed to do surgery by the hospital that I'm employed by. And so when I came out into my private practice, I was really interested in finding regenerative ways to treat joints that don't lead us down a surgical pathway or that at least prevent us from needing surgery for a while.

What are some of those non-surgical, like I'm just thinking about the person who is getting told by their doctor, hey, you need to have this hip replacement or this knee surgery or whatever, knee replacement. How should they, if they'd heard this episode before that, or even maybe they just got told that. What else should be considering or how should the be rethinking what their doctors saying? Well, what we do at Pinnacle, Integrative Orthopedics, which is my practice that I have here in Wichita Falls, is we use the body's own ability to heal itself.

We magnify that. to treat joint pain and to heal the whole person. So we use functional medicine approaches. We take into account the WHOLE metabolism, not just the joint itself. And so this allows us not to just help with knee pain, but help type 2 diabetes and gut problems and hormone access issues. issues of bone loss and loss of muscle mass. So when we combine those approaches, we can be really successful in treating a joint. And with the joint itself, you can use multiple different treatments to prevent or delay surgery.

We can the patient's own blood and make PRP, platelet-rich plasma. We can use bone marrow and take stem cells out of the bone or the fat cells, and then we can treat the joint in a way that we actually slow down the progression of arthritis is the goal, right? And to nourish that joint and prevent further damage. In the traditional world, when you go for that first opinion to your orthopedic surgeon, and he says, well, you have arthritis, it's too far gone to do anything, I can give you a steroid injection.

Well, that steroids injection that he gives you is actually damaging to the joint itself. It's like, a steroids injection in your joint is like if your kitchen's on fire, And you're like, Oh, fuck it. I'll turn this smoke alarm off. So that's what a steroid does. You know, that is what it does to the joint. It basically tricks our giant into thinking there's not a problem. And by. dampening the inflammatory process that's going for a very small amount of time, and then you'll typically have a rebound where it's even worse.

And not only that, but these steroid injections that a lot of, you know, traditional medical practices are doing have been shown to damage the joint structures. It damages the tissue around the joints, it damages surfaces of the cartilage themselves, And if you get more than two or three steroidal injections in a year, It's been showed to progress your arthritis quite rapidly. So we want to do things that support your joint health and healing rather than damage it and force you into surgery that you might not have needed if you hadn't started down that path.

I wonder, cause I even, I'm thinking of a conversation I just even had a week ago with somebody where they, they have, um, Oh, it's a hip thing. Yeah. So they, he was in a lot of back pain and, and he said, yeah, that's pretty, pretty intense. Like I've had it now for long enough. He said I, oh, I just need to get a HIP replacement. like he, just saw it as like, the only answer. And I think most people are being suggested that, And most are conditioned to believe that. How should people be rethinking that?

So if someone is telling you that, hey, this is the only answer, what do you want to tell them right now? First of all, not every pain needs surgery. And we've been conditioned as Americans to think that our health is worth a $20 copay and that's it. Right? And, we have also been condition that we either get a pill to fix our problem or we had a procedure to fixed our problems. And what I would want to tell people is that, let's think out of the box with our health, because it's much, much more important that we take care of ourselves for the long term, rather than just look for a short term or a right now fix.

So if you are being told that you need a joint replacement, there is definitely a chance that would benefit from a replacement. But if have a second thought about getting that then you should certainly look for options that like what we do. Look for regenerative options, look non-surgical ways to help yourself.

Exercise, Mobility, and Lifelong Activity Habits 45:48

I think a big way that we should think about joint pain is actually the whole system. See, the joint, joint is not a joint only problem, it's a system problem. And it oftentimes you can have an arthritic knee in a in a person that doesn't bother them because the rest of them is not inflamed. It's when our system is compromised and the joint is compromise that we have a real problem. And part of the issue is that the traditional system doesn' address that underlying problem, it'll help you fix the knee in lot of cases, but then you still have the inflammation, you have diabetes, these other metabolic issues.

And if we don't take care of those, you're not going to do as well after a surgery either. So look at it as a whole system issue and start to think of it, as, well, maybe it's not just a surgery that I need. Maybe I or healing my joint pain, maybe I need to think about some of the other ways that I can help with my joints pain. Right? Mindfulness. It's interesting, they did a study on meditation and chronic pain and daily meditation practices of 20 minutes helped people with chronic pains reduce their pain levels by like 20 or 30%. Yeah, I love that you're introducing these thoughts to people.

Because I think this is what's important. We only know to make a change when we have contrast, right? And most people, all they do is they see their doctors or their orthopedic surgeons. Those are the only people they're seeing. And if that person is not speaking about it the way you are, then they only see one path. So there's no way the system's going to change until people recognize there is another path. And maybe we should first explore the other paths before we go down this path of, oh no, I have to have surgery.

Like maybe there isn't a have-to, but you don't know until you try or explore, you know, go on the path, so I love that you're bringing awareness of these other path mindset and, and as we talked about kind of having fun really does seem like we're losing a lot of that awareness of lightening our mindset, enlightening why we have to be physical. Like, I think everyone, even myself, like I go to a gym and it's like 45 minutes, go, right? It's, get it done. But there's a certain, I have to wonder if it's similar to when you sit down for a meal.

If you're in parasympathetic state, you gonna better digest that meal than if you are not. And I to have wonder, if the same goes for your physical body. Are your joints gonna be more limber? Are you going to be just kind of more, If your more at ease and lighter energetically, is your body gonna move better? I haven't seen any studies on that. There might be. But my heart and my experience says yes. You can see it in your own loved ones and family members. We could see a lot of sense of heaviness in the way that people move now.

Everybody feels lighter when they're happy, and everybody feels light when in a positive space. So I do believe that mindset drastically impacts the ways that we move. It also drastically impacts our own health. So it's also been shown very clearly that people who have a positive outlook on their health live a substantial amount longer than people don't. People who are generally positive versus people are negative. I think that's really fascinating. It's very telling. the reality of our lives every moment with our choices and the way that we choose to view what we do.

And what what do with their health is, of course, a story that game that you can play with the universe. You can impact your health in a number of different ways. And it can be anywhere from, I'm going to drink less to I am going move just a little bit more to, you know, organ meats to add my essentials.

Adventure, Regenerative Care, and Alternatives to Surgery 50:48

I really do believe that health is an intention. Even more so when we're doing the types of procedures that I do with regenerative medicine. But mindset is the basis of everything we do. And that is that big take home for me as a physician from that little kid that was in medical school to the kind of grizzled bearded veteran that I am today is, that that piece is most important section, segment, and we lose it. We lose a lot. I love this. I've really enjoyed talking about this, I know that having an orthopedic surgeon on Everyday Ancestral might seem like a stretch, but I think it's really important for us to be thinking about, well, what are ancestral movements and what is happening in that orthopaedic surgery has become such a money-making industry and such I think I've met probably more people in the last 10 years that have had surgeries from an orthopedic surgeon than I ever have in my lifetime.

And I know you could say, well, it's your age, but my guess is that it is actually no. It's probably because this system, to your point of what you started out saying, is this is pushing more and more towards orthopaedic surgery. So clearly there is a disconnect going on with ancestral movements and modern lifestyle. So I'm really grateful for this conversation and in helping people rethink what an ancestral movement is, what our mindset can be, and maybe also the questions we should be asking prior to going down the path of surgery.

So I really appreciate that. Thank you for coming on the show. I typically ask everyone this final question, but in a sense you have answered it, I'll just ask it and see if your answer is different than squatting. If you could wave a magic wand and bring back one ancestral practice, what would it be? Spending a dark night around the fire with your close family. Speaking truth to your loved ones and telling stories. That's what I would really bring. Love it. Yeah, so important. So important connecting.

Not like where you see people go to dinner and everyone's on a phone, you know, and no one's talking. No one is connecting like, yeah, very,very different. And how sad if we have generations that miss out on that, which we probably already do. Yeah, we try. We try really, I think we can all be a little bit more intentional about how we communicate with the people that we love around us and how. How we see the world for sure. And sitting together and looking at each other's eyes, is a great place to start.

I love it. Well, A doctor, someone, a surgeon, uh, Someone that started out with huge ego and just wanting to make money that you've come, you come to the place where you're now. You are about looking at people in the eye and you are bringing the humanity and, and looking the system from the whole versus just the joint. So I. I think you really showcased a beautiful journey, Josh. I appreciate you, you know, vulnerably sharing it. And I'm hoping maybe there's an orthopedic surgeon out there that's not in that place that hears this and says, oh, well, maybe I should start exploring that.

I think it's important that your light get brighter so that maybe you shine it on to someone that needs to hear it or see it. So thank you. Thanks for coming on. And thank You all. Actually, before we go, actually, so where should people go if they want to kind of connect with you? Because they can connect to you, they don't have to live in Wichita Falls to work with You, right? No, we have people fly in from all over the world to Wichita Falls, Texas, which I didn't imagine in the business plan, but the furthest that we've had so far is South Africa.

You can connect with us. It's www.pinnacleorthoWF.com or Pinnacles Sports Medicine. Um, you can look me up at Dr. Joshua Schachter on Instagram and Facebook and we at PINNacle Integrative orthopedics on Facebook. We also have a YouTube channel at dr. Joshua Schachter. I'm on tick-tock. Um everywhere come stalk me And in can they find any of your paragliding videos you ever put those out yeah, it's on there Well,

Mindset, Connection, and Closing Thoughts 55:28

that's not you can look on my personal page. So I've got bunch of paraguiding on their Yeah, I've seen some y'all, so I recommend checking them out. They're really, really stellar. Thank you, Josh. Appreciate you coming on and appreciate you. I appreciate your brother. Ah, thank you all for just joining us on this episode of Everyday Ancestral. Remember, stay curious and tell a friend about us. We want to keep expanding this message of bringing ancestral ideas into this modern society. Thank you so much for joining me on Everyday Ancestral.

If you enjoyed this episode, hit subscribe so you don't miss the next one. You can find the show notes, links and resources mentioned at eatpluck.com. That's E-A-T-P-L-U-C-K dot com. And hey, if you know someone who gets something out of this, share it with them too. Stay curious, live well, and keep it ancestral.