Form & Function MD

05/07/2026

I’ve been an orthopaedic surgeon for 27 years.
Here’s what ultra-processed food is doing to your joints — long before you feel pain:
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🔥 Chronic inflammation
Ultra-processed diets are associated with elevated inflammatory markers like CRP and IL-6. That inflammatory signal targets synovium and accelerates cartilage breakdown.
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🦴 Cartilage glycation
Repeated blood sugar spikes → advanced glycation end-products (AGEs). These cross-link collagen, making cartilage stiffer, more brittle, and less resilient.
There’s no procedure that reverses that biology.
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⚖️ Omega imbalance
The target ratio is ~4:1. Modern processed diets push that toward 15–20:1. That imbalance fuels pro-inflammatory eicosanoids — affecting tendon health, healing, and pain.
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💪 Muscle loss (earlier than you think)
Processed diets + insulin resistance → impaired muscle protein synthesis. Less muscle = less joint protection, worse outcomes, higher injury risk.
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🦠 Gut → joint axis
Certain emulsifiers and additives disrupt the intestinal barrier. Result: low-grade endotoxemia → systemic inflammation → joint symptoms.
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Every processed meal is a deposit into an inflammatory account.
You don’t notice the balance — until you do.
Evidence over ego.
📌 Save this. Share it with someone who thinks joint pain is just aging.

05/04/2026

Your cardiologist and your orthopaedic surgeon are looking at the same problem from different angles. Here’s what they’re both seeing.
The connections most people never make:
🔴 Inflammation → Drives atherosclerosis AND accelerates cartilage breakdown. Same fire, different rooms.
🔴 Grip strength → One of the strongest predictors of cardiovascular mortality AND fracture risk. A simple measure of how long—and how well—you’ll live.
🔴 Sedentary lifestyle → Weakens your heart AND accelerates bone and cartilage loss. Stillness is expensive.
🔴 Vitamin D deficiency → Associated with impaired cardiac and bone health. One deficiency, two systems affected quietly.
🔴 Poor sleep → Elevates cardiovascular risk AND impairs musculoskeletal tissue repair. Your body doesn’t choose which system to neglect.
🔴 Smoking → Hardens your arteries AND reduces bone density and tendon healing. No system is spared.
🔴 Chronic stress → Drives hypertension AND breaks down collagen throughout your body. Your tendons and your heart are both paying for your cortisol load.
✅ Exercise → Improves cardiac output AND builds bone density through mechanical loading. One investment, every system benefits.
The body doesn’t have departments.
What breaks your heart is breaking your bones. What protects one protects the other.
Move. Sleep. Eat real food. Manage stress.
This isn’t cardiology. This isn’t orthopaedics.
This is biology.
Evidence Over Ego.

04/30/2026

04/30/2026

Muscle isn’t cosmetic. It’s survival.
It’s your most powerful metabolic organ—and most people are letting it disappear.
What strength training actually treats:
1. Blood sugar dysregulation
Muscle is your largest insulin-sensitive tissue.
Every contraction pulls glucose out of circulation—no insulin required.
2. Chronic inflammation
Contracting muscle releases myokines (IL-6, irisin) that lower systemic inflammation.
Your muscles act like a pharmacy.
3. Cognitive decline
Exercise increases BDNF in the hippocampus.
Low muscle mass = faster cognitive aging.
4. Bone loss
Bone responds to load.
Muscle contraction is the signal. Not calcium.
5. Falls and fractures
Falls are the leading cause of traumatic death over 65.
Muscle and grip strength are the most modifiable risk factors.
6. Early death
Grip strength predicts mortality better than many traditional risk markers.
Weakness is not benign.
The prescription:
Lift. Eat protein. Stay consistent.
This is medicine. Most people just don’t treat it that way.

04/27/2026

27 years of orthopaedic surgery taught me this — chronic inflammation drives most of what I treat. 7 sources. All modifiable.
1. Ultra-processed foods (high omega-6, low nutrient density)
Metabolically disruptive and directly pro-inflammatory.
Fix: Prioritize whole foods. Use olive oil, avocado oil, butter. Read labels — these ingredients are everywhere.
2. Visceral fat
Metabolically active tissue that releases inflammatory cytokines continuously.
Fix: Resistance training + adequate protein are foundational. Cardio helps — but it’s not enough alone.
3. Gum disease (periodontal inflammation)
Linked to systemic inflammation and worse musculoskeletal outcomes.
Fix: Daily flossing + regular dental care. Oral health is not optional.
4. Chronic stress
Sustained cortisol elevation impairs collagen synthesis and tissue recovery.
Fix: Sleep, boundaries, and stress control aren’t optional — they’re physiologic.
5. Poor gut health / low dietary diversity
Associated with systemic inflammation and immune dysregulation.
Fix: Increase plant diversity, fiber, and fermented foods. Reduce ultra-processed intake.
6. Alcohol (dose-dependent effect)
Impairs sleep quality and recovery; chronic use is associated with worse bone and muscle health.
Fix: Less is better. Zero has benefits.
7. Excess added sugar
Associated with formation of advanced glycation end-products (AGEs), which affect collagen structure.
Fix: Focus on whole-food carbs. Minimize added sugars. You can’t out-operate a pro-inflammatory lifestyle. Neither can your body. But you can change it.

04/25/2026

For years I carried camera gear the wrong way.
The solution is two options — and you only need one.
A roller bag. Carry-on only. First in the overhead. Thousands of dollars of gear that never leaves your sight. Nothing on your spine during travel.
A properly designed backpack with a hip belt. Load transfers off your spine onto your hips. That’s not a comfort feature. That’s load mechanics.
Most people choose one. For Alaska — I’m running both.
Both bags are from