Why I Say Little About Diet/Something About Diet

I have the opportunity to work with a handful of high level athletes. These individuals (and their parents) regularly make great sacrifices of time and comfort in order to achieve exceptional performance on the athletic field. I hope they learn a process that will stick with them after their athletic careers.

I also train and rehab a few middle-aged folks interested in improving their health, ability to function well, and their general awesomeness. They reserve an hour or two of their busy weekly schedules to spend time with me.

Nutrition is important for both of these groups. In all instances, it would be a shame to spend all that time and effort in training and come up short on the nutrition front. Your diet needs to match your training goals. But rarely do I broach the subject.

One human telling another what and how much they should be eating strikes me as an extreme over-step.  Twenty three year-old fitness gurus do it all the time on social media. In the end,  only -you- will truly know what works best for you. It’s a process that requires months and years of attentive experience.

Besides that, the whole subject is…touchy. What we eat is rooted in culture and expectation, emotion, billions of dollars the food industry spends on marketing (not just talking about fast food, but also “healthy” food chains), a boat load of science and even more quackery. Body image, self confidence, and control issues abound. When something…anything is wrong with your heath or general life, someone will tell you assuredly that the problem is because of your diet (whether or not that may be the case.)

Some people have a predisposition to weight gain, be it good (lean) or bad (fat) weight. Others struggle to gain but have an easy time staying lean. Lastly, everything from genetics to socioeconomic status to personal preference has legitimate implications on what “good” advice would look like.

And finally, this is not my specialty. My expertise is physical rehabilitation and optimizing human movement. Contrary to what the social medias would have you believe, neither a semi-related degree nor a set of abs justify making proscriptive statements on someone else’s diet.

With that being said-here is something about diet. ; )

-For weight loss and weight gain (both optimal performance and getting jacked), diet is critical. Don’t let anyone lead you to believe that a -precision- workout and training plan is the most important thing. Your diet is more important than your exercise regimen.

-The -quality- of weight gain and loss is going to be dictated by what you do. Gaining muscle requires consistent strengthening exercise. Carrying muscle helps tremendously with losing weight (fat) and keeping it off. Having strength, balance, mobility, and a tolerance for discomfort (all from your training program) help you to be capable of doing more, and feeling like doing more during the 98% of life spent outside of your workouts.

-There is a lot ($) to be made in the next diet fad. “Eat this during these specific time intervals, avoid eating that, and make sure to count and monitor this while supplementing your diet with that specific brand of these supplements.”

There is not much money to be made in telling people to get the basics dialed in for at least three months before even considering anything else. The basics?


  1. Choose minimally processed foods when possible.
  2. Load up on fruits, vegetables, and lean proteins.
  3. Limit but do not altogether quit treating yourself. You cannot have it all. But you can and should live a little.
  4. Focus on altering behaviors and patterns far more than specific macros, calories, or ingredients. Commit to a plan for your goals and be mindful
  5. Measure your foods for a short time to get an idea of portion sizes etc. But other than that, quit stressing about it. No measurements for you!
  6. Willpower comes and goes three times a day. Create and lean on good habits to carry you through.
  7. One metric worth the time and effort to track is simple: the ratio of eating well to eating poorly. Most adults will make tremendous progress if they eat well 9 out of 10 times and sometimes eat what they feel like. Tie a string on your fingers if you need to.
  8. Limit your options to a handful of good choices, in just about any way that you see fit. You do not need a 500-page diet book to do this for you! “Bored and satisfied” works a lot better than hungry and always having to think about what you are eating.
  9. Shut the TV and phone off and get some sleep! This is critical for all health and performance goals. Because, hormones and stuff. Plus, your resolve to stick with any goal and plan will be all the greater.
  10. Practice gratitude, for our perspective is truly rare and skewed. Many people throughout most of history ate what and when they could to survive.

[For related reading, I do offer my own Diet System…found here.]

For gaining -lean- bodyweight. Plan ahead to eat a lot of nutrient dense foods often. If you are hitting the weights regularly, between 12 and 25 years of age, and taking in -mostly- quality calories, your body will have a VERY hard time putting on anything but muscle. Treat yourself sporadically, around 10 to 20% of the time, depending on your needs and inclinations.

For losing weight but keeping muscles, dial in your life patterns so that you are not often caught off guard. Don’t obsess over the details, and eat like an adult. Most -good- foods have a mix of protein and fat and carbs. You know what crap is. Paleo or low carb/low sugar bars, cookies and cakes are still crap.  You will find that avoiding crap is a lot easier when you know that you can treat yourself 5 to 10% of the time, depending on your needs and inclinations.

So, there you have it. Remember, I’m just a guy with an opinion ; )

Thanks for asking!

For further reading from a team of legitimate experts, two of my favorite sources are Precision Nutrition and Examine.com. Read these thoroughly before you listen to supplement canisters and the Shaklee or GNC sales reps.

Are Stem Cells Snake Oil?

Stem cells make for great discussion of the modern day marketing of medicine.

For some, stem cell injections are a broad and exciting field of scientific inquiry and pain relief. For others, they are pure snake oil sold for approximately $2000 per vial.

So which one is it?

Whatever the case, the advertising gives an easy “tell.” Is the doctor or medical facility making unreasonable claims and guaranteed promises that play off fear, desperation, and the plain realities of aging? Being more realistic and careful with promises makes for ho-hum marketing. But what kind of outfit would you really want to work with?

When a product or procedure is marketed as a  -new- -miracle cure-  -for everyone with…-  you should be skeptical. This includes physical therapy! A local colleague of mine (rhymes with Schmadden) has built a large profit margin and entire team of physical therapists in part through the advertising slogan “Pain Free [Back/shoulders/knees/feet].”

Either his entire team of physical therapists, including all the new graduates, have far superior clinical skills than I, or there are a LOT of people walking around central PA who are a bit disenchanted because the treatment didn’t live up to the promise of pain free.

People with joint aches and pains frequently ask whether or not stem cells may help their condition.  I’m rarely optimistic about these types of treatments, and I have yet to hear from anyone who has experienced significant or long lasting benefit. That doesn’t mean they are worthless, or that all marketing is bad.

Shouldn’t we be asking some questions first. Why are we doing this? How does it work? How much and for how long is it likely to help? Are there side effects?

Stem cells have been claimed to help cartilage, bone, tendon, and ligament problems. That’s a lot of different tissue, with different metabolism, and different response to hormonal factors and mechanical loading, to begin with. A person with knee pain may not care if the target tissue for treatment is ligament or cartilage, or if the injection is placed inside or outside of the joint capsule. But to scientists, doctors (and physical therapists) this is basic and essential information to define before making any recommendations.

Some literature shows that stem cells can help with specific issues, such as mild to moderate cases of knee osteoarthritis and elbow tendonitis. But when you look closely at the studies, they show much variety in terms of what exactly is being injected, how the formula is produced, and where and how often it is being injected.

If you don’t believe me, that’s what people like this team of researchers in that “bizz” are saying:

We still do not know exactly how and why the injected cells -may- aid in recovery. Are the stem cells integrated into the damaged tissue? Do they provide support or stimulate the existing cells to heal? The research does show that milder the arthritis, the more likely the benefit. Multiple injection into one site leads to increased risk of adverse reactions. When and where the injections are effective, the benefit usually lasts for six to twelve months. One study showed that stem cells are slightly more beneficial than corticosteroid injections.

All that being said, I would like my skepticism to be proven wrong. I have a stiff and sometimes painful arthritic hip. I’m certainly in favor of finding new ways to help people feel and function better. As a physical therapist, my primary problem with Stem Cell injections is that it’s just…so…


Joint wear and tear, whether over a day or a lifetime, never exists in isolation. But passive and less-than holistic solutions seem to be the American way.

Imagine two very real scenarios.

34 year old patient suffered a knee sprain 10 years ago, and now shows mild knee arthritis and a tear of the meniscus. He has good alignment, strength, and range of motion at the other joints and is reasonably active, neither an exercise addict nor a couch potato. His pain persists despite refraining from high impact exercise.

54 year old diabetic patient with knee pain is 35 pounds overweight, has inflexible and weak hips, has minimal great toe extension and walks with his feet turned outward which places a twisting force at the knee joints with every step.

Which of these patients has a greater likelihood of experiencing a year of modest benefit from stem cell injections? Doctors and medical centers can and should address these types of challenges when recommending this type of treatment. Some may be realists, and others will advertise like stem cells will fix everything.

As usual, the actual science makes for less than stellar marketing. Until more is known regarding the particulars of stem cell injections, you should probably try to identify and address postural issues and movement dysfunction ; ). If you do, I guarantee health, happiness, fame, and fortune ; )

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Further reading-

Does Intra-articular Platelet-Rich Plasma Injection Provide Clinically Superior Outcomes Compared With Other Therapies in the Treatment of Knee Osteoarthritis? A Systematic Review of Overlapping Meta-analyses.
Campbell KA1, Saltzman BM2, Mascarenhas R3, Khair MM2, Verma NN2, Bach BR Jr2, Cole BJ

Arthroscopy. 2015 Nov;31(11):2213-21. doi: 10.1016/j.arthro.2015.03.041. Epub 2015 May 29.
Does Intra-articular Platelet-Rich Plasma Injection Provide Clinically Superior Outcomes Compared With Other Therapies in the Treatment of Knee Osteoarthritis? A Systematic Review of Overlapping Meta-analyses.

World J Stem Cells. 2014 Nov 26; 6(5): 629–636.
Published online 2014 Nov 26. doi: [10.4252/wjsc.v6.i5.629]
PMCID: PMC4178263
PMID: 25426260
Stem cell application for osteoarthritis in the knee joint: A minireview
Kristin Uth and Dimitar Trifonov

J Knee Surg. 2018 Nov 13. doi: 10.1055/s-0038-1675170. [Epub ahead of print]
The Use of Platelet-Rich Plasma in Symptomatic Knee Osteoarthritis.

Stem Cell Res Ther. 2016 Sep 9;7(1):131. doi: 10.1186/s13287-016-0394-0.
Secreted trophic factors of mesenchymal stem cells support neurovascular and musculoskeletal therapies.
Hofer HR1, Tuan RS2.

Happy Entropy

…And that is why the Blessed will say “We have never lived anywhere except in Heaven, : and the Lost, “We were always in Hell.” And both will speak truly.”
– – – – -CS Lewis, The Great Divorce

Last week at the Dillsburg Farmers Fair, I looked at a series of dilapidated houses lining Baltimore Street. Normally they would be an eyesore, but they fit perfectly well in October; as if someone went all-in for Halloween.

A rotten faced Jack-o-lantern supervised the street from the porch next to me. My face was literally a battleground between a couple faint tangential sun rays and the crisp breeze. Second-hand cigar smoke overwhelmed the smell of decaying leaves.

‘Tis the season for entropy. It’s a time to consider the rot, rust, cold, and systems winding down to the end of their season. Do we deny the dark? Should we fear God as anti-autumn?

Sometimes Halloween seems like the new (cultural) Christmas. There’s tradition and community togetherness with only a small fraction of the materialism, pressure and obligation. In our small development, neighbors that are seldom outside and drive by without so much as a nod are suddenly welcoming and generous with their time.

Fall is a humbling reminder of our brevity, our limitations, and the ultimate fate of our corporeal being. This is reality, not dabbling in the occult. There is too much evil among the living during all seasons to worry about the Field of Screams and whatnot among the dead.

Must we deconstruct the heebie-jeebies? Shouldn’t apparitions reflect light (to be seen) -or- be able to walk through walls?  Why would they ever be seen in clothing? Does ghost clothing also go to the “other side” and defy the basic laws of matter? The physical form and function of most monsters and zombies would never work anatomically. Something limping and bumbling along like that could easily be avoided before getting close to your brains.

But seasonal affective disorder is very real. And our ability to consider mortality and wonder what’s next – this I take seriously. Have you ever attempted to truly plumb the depths of a rotten jack o’lantern?

To me, the most frightful, hideous idea is a world where entropy is the bottom line, cold, black, and eternal. Winter is indeed coming.

But then so is the light! All you ever need to do is wonder why and from where came the light!

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He has made everything beautiful in its time. He has also set eternity in the human heart; yet[a] no one can fathom what God has done from beginning to end.                                  Ecclesiastes 3:11