How Modern Movement is Hurting Us: The Orthopedic Surgeon Who Quit Surgery | Joshua John-Ram Schacter

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 ever? 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, we have to really differentiate. I want to say I'm an orthopedic surgeon. I've done 15,000 orthopedic surgeries. So, but I'm not a general surgeon. I don't work on hearts or brains. So when you say surgery, we're going to talk about Joint surgery, right? Musculoskeletal. That's what I know about, man. So, and I'm going to tell you that our system is broken. It's just, 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. Um, I was the director of an orthopedic center of excellence for hip and knee replacement for a decade. Um, and over the time when I've practiced orthopedic surgery, I have seen the amount of surgery done increase dramatically. Um, and we're doing surgery on joints which, which are, which are in some cases not to the end stage, right? Um, for instance, what do you mean by the end stage?

What does that mean?

Yeah, so when we do a knee replacement, it's a wonderful procedure except it's, you know, in terms of success, a knee replacement can be great. But if you don't have bone-on-bone arthritis, if you don't have a lot of joint destruction, if you're only sort of in the moderate phase of arthritis where you have a 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 and more aggressive with surgical interventions in this country. About 35% of joint replacements as of 2018 were done before completely medically necessary. Um, 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, just, I'll just I'll just prescribe antibiotic. You know, is it, is it, is it lack of— is it just the system doesn't want to take time to really like naturally support the person? Or, or, or why do you 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 of the biggest moneymakers in a hospital system. Ah, ding, right? So, and more and more surgeons nowadays are employed by hospital systems. And I'm sorry, brothers, You're, you're working for— you're, you're working for an evil empire in a lot of cases. Some of you may be very happy. Um, and so when you're employed in a situation where your, 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 so that is a pressure on, on modern orthopedic surgery. But we really, in my opinion, we don't— we're not using the solutions that, that we, that we evolved with, right? We're not, we're not optimizing our own regeneration. We're not intervening before the joints are, are too far gone. And we're doing damaging treatments to joints now that are temporary, like steroid injections, right? And certain types of medications. And we're sort of giving people maybe one or two steroid injections, ordering a very short course of physical therapy, asking them to make no you know activity modifications or looking at their 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, you know knee pain come to an orthopedic surgeon's office and. You know, they'll look at an x-ray. They may order an imaging study. You know, and then you, if you have moderate arthritis, you might get a steroid injection. Come back in three months and see me. I'll give you another steroid injection. And 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 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 2 visits. 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 are, why are musculoskeletal 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 place. There's more people are technically being more active, at least I think, but there's also more and more awareness around warming up. There's more awareness around recovery and strength, you know, like, like taking time off. So, 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, in a normal running stance, normal squats. You know, our activities now, our daily life is hard on our joints. Sitting in a car for hours at a time is not good for your joints, right? They need to move. They need to be there. They have joints, have no direct blood supply, so they need to be moved and they need to be moved in an appropriate way. And I think Also, that inflammation is this very modern problem, and even though we're really looking—I mean, a lot of us really care. Like a lot of us really care about how we move and what we eat, and it—you know—we're thinking really critically about our joints and our own health. But in our society, our diet is so inflammatory and toxic, right? In in in America. Processed foods are an epidemic and they're causing really severe problems in our health. And we see that manifested in the joint as well. Inflammation in your joint has a lot to do with what you put in your mouth.

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 do potentially with the 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 processed 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, right? Your ligaments don't heal the way they should. And so we develop these, you know, chronic problems, and we see them in younger and younger people nowadays. Used to be that you'd see, you know, a lot of shoulder pain in older folks, but now we're seeing it in younger and younger populations. And part of that is because we're using—we're living vicariously through our kids in in high school sports, right? 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? Like, I feel like a pain, like when you have pain, that should be almost like you're listening like that. That 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're feeling pain and that they're almost regulating and thinking, oh, well, I'll just keep working through that pain. They're not listening. Is that the issue that's going on, or?

Well, I think, I think we do listen to pain. There's, there's lots of, there's lots of business for orthopedic surgeons. So in a way, people are listening to their pain. They're, but they're really going down a road that's destructive, um, if they go the modern medical route of joint pain treatment. And we can get into that in a second, but the question is, Are we not listening enough or are we listening too much? Um, I think pain is one of those, is one of those things that, that it's, it's of course subjective to everybody. Um, it depends on what type of activity you're doing if it hurts. You know, working out through pain, through an injury that's getting worse is certainly not listening to your body, right? So if you have some soreness one workout, And the next workout you don't have that soreness. Well, that's not something that we need to be super concerned about. But if you have a joint pain that's getting worse through your activity, then a typical timeframe that I have people look at, if they're able to, if they're able to deal with it, 4 to 6 weeks is a good time to listen to your body and try to do things besides see someone like me. But after 6 weeks of pain, Then it's a good idea to get another set of eyes on it, right? To look, to look a little deeper into that pain, right? I don't think we need to live for months with pain.

How did you get into this line of work? What kind of, what brought you down this path? Where did you experience a lot of pain growing up that made you go, oh, hey, I want to become a doctor that supports, you know, joint surgery so that no one else experienced what I did. Or what was your, what's your story with that?

Uh, so, you know, I grew up in central Oklahoma where my dad's a chiropractor. So the musculoskeletal system is really interesting to me. I grew up, you know, in anatomy labs and with him going through chiropractic school. And so I was exposed to that at a very young age and I wanted to be a doctor. I didn't decide I wanted to be an orthopedic surgeon until I was in medical school. I've always been an athlete. I was a competitive surfer when I was young. I've always been a mountaineer. I've mountain biked, climbed. Now I kiteboard all over the world and fly my paraglider, but I really love being active. And to me, orthopedic surgery being surgery of the joint, it seemed like a cool job where I could help people and I wouldn't have to deal with the mind because in medical school, I was pretty close-minded about the impact of the mind and, uh, in, in actual healing. Um, I thought I could just work on, on bones and joints and I could be a carpenter.

So when you were younger, you saw healing primarily through, through practicality, like practical, like surgical terms, right? Yeah. You, you almost saw anything that had to do with brain, you know, mind over matter. You were like, that's woo woo. Is that, is that kind of what you're saying?

Very much. That was, that was really my approach in medical school. Now, bear in mind that medical school is just the beginning of learning what you don't know. So, so, you know, at first I thought, you know, I really didn't like my psychiatry rotation. I thought that that was pretty boring. Um, but I really loved the idea of, one, using a hammer at work every day. Um, it was fun. And then 2, I really liked the idea of being able to change people's lifestyles, like to help them live better, right? Right? To walk again is incredible. You know, 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. Um, and so, and it was also very competitive, and I'm a competitive guy, and so I wanted to be in a, in a sort of a high-profile specialty.

So that's Josh out of 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, um, just doing mindfulness can help us change our habits. It can impact our, you know, stress system. We know that, that, you know, 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, you know, the community being out a North Peak surgeon in this community, you've operated on everybody's like uncle, mom. You can't you get stopped in the grocery store like three or four times. Oh, you took care of my son. It's it's a wonderful experience. But what I saw was that positive, you know, when I can give a positive experience as a physician, it carried it. 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, not just the patient themselves. And as I went in practice, I just really got much more interested in how do I, how can I help a patient's healing journey with the By, by being supportive of the way they think about it, you know, by helping them frame it. And now we know, since we do regenerative medicine and we do functional medicine in my clinic, I don't do surgery anymore. Regenerative medicine is our, our minds are so powerful that they affect the ways that our cells behave, right? And so the way that you perceive your, 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, is just an application of our, of, of the strength of the mind, right? The, the, the human mind is so incredible that we had to, you know, I think we had to insult it and downplay it by naming it the placebo effect. It cures cancer, man. Come on. I mean, like there's a certain amount of people who are cured of cancer when they try the saline treatment. So I think it's incredible.

Yeah, absolutely. And I love though that your journey started out kind of more, hey, this pays really well and like, this is how I want to contribute to society to like, no, no, now I don't want to just make more money and contribute to an individual. I want to change spans of generations. I want to support communities. And to me, it's almost like the release of ego, right? Like that whole process of as we age, we're less egotistical and we're 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-sized one. My ego was, was fairly large. And, you know, you learn things through life. I, you know, my wife Amber has the breast cancer gene, and I was at sort of the height of my power as an orthopedic surgeon. I was the chairman of our department. I was, you know, I was running this orthopedic center of excellence. I was doing 1,000 surgeries a year. I was working 70 hours. And, uh, you're really feeling in my power as a surgeon. Now, I was not spending any time with my kids. 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. And 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 going through menopause, risk of cancer, 15 surgeries, all of these things. That changed the way that I saw what I was doing in in in the world. That changed the way that I saw you know myself as an 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 going to do five and ten you know joint replacements a day. There's no time to take care of the human in that scenario if I'm seeing 50 patients a day and my PA's seeing 30 and I'm 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, type of activity. This, this, this needs to be well thought out and, 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, uh, I'm grateful that you had, that you came out of that experience with This new awareness. Um, I think everyone in your life is probably grateful that, because, and everyone you touch as a surgeon is, is, is probably grateful for that because it sounds to me like you, you recognize that the system was out of, out of, or was misaligned with humanity. That, that almost like it was, the system was, was focusing on the transaction or the procedure. And leaving the human aspect of it, uh, disregarding it, you know, leaving it by the wayside.

Medicine is completely transactional. And the traditional system is transactional. 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 trans— that's a transactional relationship. That's all medicine sees, you know, Americans as right now. And that's 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, in the, in the wellness movement and the functional wellness movement To to see just how broken the system is, and just how just I'm just fucked up. The whole thing, the whole thing is. You you don't get to spend any time with your primary care doctor. Your you know the people in my community talk about they 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, there's fifteen 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 see that day because he's 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 no discussion of your diet and there's no discussion of your actual metabolic health. They do these very basic labs. They look at a very superficial view of the patient and it shows that 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. Yeah. It's, it's tragic because we're, we're all feeling the effects of this. How can you support empowering those people that are listening to this episode?

Well, I think I can, I can support them by saying that longevity has some very simple, very simple foundations. It's how do we move? What do we put in our bodies? And how do we rest? Right. So, and it's, you know, if we, if we really think about what you do every day, James, With your business and empowering people's nutrition, 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 we're 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 8 hours. Not everybody has to sleep 8 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, is actually sleep deficit. And then the consequences to that, 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 3 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 really only— I was listening to a podcast today and the scientist was saying your genetics are really only 3 to 7% 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 our 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 are ancestral. life was like. So what's one movement you wish everyone would start doing again, like our ancestors did?

Dude, I'm telling you, this just sounds so weird. I've traveled in Asia and 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've 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? Like being able to squat and maintain a squat is such a healthy movement for your low back, for your hips, for your knees, for your ankles. I would love to see more people doing deep squats and having— and from a young age. The problem is we can't take, you know, 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 squat 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? Yeah, you might sometimes do like, you know, sitting on your, 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, 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 Yeah, you're right.

It's painful if you're, to your point, if you didn't start young and it is fascinating because speaking of like the Asian culture, like I've specifically seen old men or old women squatting. Like it's, that's incredible. And here we are, you know, 30, 40, 50-year-olds, 20-year-olds, and we can't do it. No, no.

And the, in those cultures, in this where you see these older people squatting, you know, this very natural movement, there's not as high a, you know, there's certainly not as high a rate of joint replacements. You know, they, they're not having as many surgeries. If you look even at, like, and I don't know if this is connected to squatting, but But if we look at our ancestors, you know, indigenous populations don't have a huge rate of arthritis, probably because of the way they move. And you could argue, well, they don't have as high a life, as long a lifespan, but even older skeletons don't show as much arthritis in indigenous populations. I think it's multiple things, but I think, you know, you have an 80-year-old person who can squat all the way 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, a young child, what, what kind of, what, what are 2 or 3 movements that you would encourage them from a young age? Clearly one might, would be squatting. What would the other 2 be?

I love, you know, young age. I think a natural squat to maintain that is great. I love it when kids run and play. Like, their natural movement is their own. So you really— I don't really want to modify how kids are are moving. We, 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 think letting that process be natural is the most important part. Now you have to support it. And I think a lot of times If, if, if I could make one modification to what we do with kids is screens. I was at the airport the other day and my wife and I are walking down, we're going to the TSA line and I look over and there's a young family, um, and a, you know, 3-year-old, he's laying on his belly watching an iPad.

Right.

And 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, I see it. I've seen it in my younger colleagues. I've seen it. 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. I think it's damaging our kids. Um, well, I really would like to see that go in the other direction.

I think you're right though. Like, in a sense, okay, you're not— 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're on screens, you don't move.

No, no, we, we're, we're, we are using these screens, um, 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, and exhausted mothers will definitely not agree, um, but I would argue that, that it's very unnatural for a human being to sit the first part of their development and, and watch a screen. That's not That's not how we evolved to be, you know, physically successful.

Okay. So let, let's move on to like 20-ish to 30-ish age. So clearly we want to be thinking about diet because you talked about how certain foods are going to be causing inflammation and then affecting the joints. What other, what movements should maybe that age group be thinking about that? Because really what I'm trying to get at is like, What kind of prevention can we naturally— 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's a big question.

Um, so boil it down to a couple, a couple of things.

I don't think you can break it down to the different decades. I think we need to, to— I need to— we need to lift heavy weights. With good technique and ensure that we have good mobility. So a combined system of movement is—it's probably what's going to be the best for for most people, and that is going to involve a mix of high-intensity exercise, you know HIIT training type workouts, weight-bearing exercise, weightlifting type exercises. for strength and to prevent muscle loss, maintain our bone health. And then a type of flowing movement like yoga, something to really stretch the joints and maintain the, the, the compliance of the ligaments, to maintain elasticity of our tissues, um, to keep us stretchy, right? The, the, the 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. But it's very powerfully impactful. So that combination, so we need to do something that's metabolically active like High-intensity exercise. We need to maintain our aerobic capacity. We need to build our musculoskeletal system by loading it with weights. And then, we need to maintain that tissue's compliance. We need to maintain our mobility. So, we need to stay limber.

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 active is there as you get older? Because it's something I've always reflected back to my daughter. Like, I was always like, to my oldest daughter, I'm like, you need to walk to school. And she's like, but it's cold, or it's this or that. And she's complaining. I'm like, no, no, but you need to be in the habit 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 30s or your 40s? It's going to be harder. Because in a sense, doesn't the body have a memory?

Oh yeah, the body has a— that's— yeah, your body has 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 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, you know, has to have playdates 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, you made her in like the winter?

Well, I mean, when it's snowing we don't, but, 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 to, like, she's an artist. She likes to sit and draw in bed, like, listen to music. Like, she doesn't, she's not inclined to join an athletic club or team. Like, she's not inclined to be as physical as, let's say, I was taught when I was younger. And I'm here, I am in my 50-year-old self going like, but, but honey, like, it's really hard to learn to be active. Like, You have to, like, I believe you have to start young in terms of the mindset of like using that body. If it's not a natural inclination, you have to almost will yourself to do it at a younger age because it's just gonna get harder as you get older. That's kind of the point I'm trying to make.

Very much. If you don't get in the habit of, of, of being active at a young age, then certainly it's really hard to start that habit later. I read a, I read a, a story about a guy who didn't start weightlifting until his mid-70s though. So, I mean, you know, is now lifting heavy weight and doing all this crazy stuff. I don't think it had— that means that we can't ever make a habit, but it definitely makes it harder if you don't start young. And if we don't support our kids in having sort of active habits, um, not in— but in your daughter's case, like, not everybody wants to be on the soccer field. Um, the, the, when I talk to parents about this, I always encourage them to, you know, find something that's active that you're, that really sparks your kid. Maybe, maybe it's not soccer, maybe it's band and we can do marching band. That's active. Um, maybe it's dance, maybe it's mixed martial arts. Um, 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 going to be another question of mine is that, so, you know, we were talking about, you had mentioned heavy weights, doing some stretching like yoga, like in terms of supporting like 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're stretching your mind and they're— and you could even say that they're fun. I don't know if they're fun to you, but they could— like, I look, I hear the things you do and I'm like, that sounds fun. Right? So Where do you see that being important? Like that, like, do you think it's important for not just mind health, but physical health to like make sure that it's that mindset of enjoying whatever it is you're doing? Do you think that's going to help you age better and continue moving even, even more as you, as you get older?

Yeah. For me, you know, adventure is, is expansive. We know that as we age, our thought patterns tend to become more rigid, right? That's pretty well recognized. And I think we all feel that. An important point of longevity is that if our minds will age much slower and become much rigid, much, you know, much less rigid, If we have new expansive experiences. And so I'm lucky and I do have fun. Like I've, I paraglide all over the world, big mountain ranges in the Andes and the Alps. And, you know, 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, with the earth, with the sky, with the elements, with rock and trees and in a natural environment that is deeply immersive. And that is, I feel really good for my brain. It really helps my brain to use all of its functions at the same time because we're making decisions at the same time as we're making small motions at the same time as we're 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's good for their body. And that's the— that I think my take-home for other people, you might not paraglide, you might not surf, but doing something that is good for your mind as well as good for your body at the same time gives you magnet— 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 physical plus a mental activity, right? Surgery is a physical plus a mental activity. And so are the things that I love to do.

Now, you told me that you're no longer doing surgery. What What, um, what, what caused that result?

I think a big point of it is, is my reaction to the fact I don't believe that a lot of orthopedic surgery— surgeries that are done today are, are strictly necessary. We're doing scopes on arthritic knees. We've known that that's not a good, good idea since, you know, 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 doing 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 was employed by. And so when I came out into my private practice, I was really interested in finding regenerative ways to treat joints that, that that don't lead us down a surgical pathway or that at least prevent us from needing surgery for a while. And so that's—

What are some of those non-surgical— 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, how should they be, what, what else should they be considering or how should they be rethinking what their doctor's saying?

Well, they, what we do at Pinnacle Integrative Orthopedics, which is, which is my practice that I have here in Wichita Falls, um, is we use the body's own ability to heal itself. We magnify that. And, we use 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 just to help with knee pain but help with type 2 diabetes and gut problems and hormone axis issues and issues of bone loss and loss of muscle mass. Yeah. When we combine those approaches, we can be really successful in treating the joint. And with the joint itself, we can use multiple different treatments to prevent or delay surgery. We can use the patient's own blood and make PRP, platelet-rich plasma. We can use bone marrow and create and take stem cells out of the bone marrow or the fat cells. And then we can treat the joint in a way that we can actually Slow down the progression of arthritis is 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 steroid injection that he gives you is actually damaging to the joint itself. It's like a steroid 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.

Really?

Yeah, that's what it does to the joint. It basically tricks our joint into thinking there's not a problem. And, by dampening the inflammatory process, it'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 joint. It damages the surfaces of the cartilage themselves. And if you get more than 2 or 3 steroid injections in a year, it's been shown to progress your arthritis quite rapidly. So, wow. We want to do things that, 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, because I even, I'm thinking of a conversation I just even had a week ago with somebody where they have, oh, it's a hip thing. Yeah. So they, he was in a lot of back pain and he said, yeah, it's 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, he just saw it as like, that's the only answer. And I think most people are being suggested that, and I think most people are being conditioned to believe that. So how should people be rethinking that? So if, 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. So, and, and we've been conditioned as Americans to think that our health is worth a $20 copay and that's it, right? And we've also been conditioned that we either get a pill to fix our problem or we have a procedure to fix our problem. 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, that we take care of ourselves for the long term rather than just look for a short-term or right-now fix, right? So if you are being told that you need a joint replacement, there is definitely a chance that you would benefit from a joint replacement. But if you have a second thought about getting that, then you should certainly look for options that like what we do. Look for regenerative options. Look for non-surgical ways to, to help yourself. Um, I think a big way that you, you should— we should think about joint pain is actually the whole system. See, the joint— joint pain is not a joint-only problem. It's a system problem. Um, and it's, it's oftentimes you can have an arthritic knee in a, in a, in 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 compromised that we have a real problem. And part of the issue is that the traditional system doesn't address that underlying problem. It'll help you fix the knee in a lot of cases, but then you still have the inflammation, you still have diabetes, you still have 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 a— is it— well, maybe it's not just a surgery that I need. Maybe I need to think more about regenerating my joint or, or healing my joint pain. Maybe I need to think about what are the— some of the other ways that I can help with my joint 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 pain 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 because most people, You know, we only, we only, we only know to make a change when we have contrast, right? And most people, all they do is they see their, their doctors or their orthopedic surgeons. Like, 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.

Right.

So there's no way the system's going to change until people recognize there is another path. And, 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 down the other path. So I, I love that you're, I love that you're bringing awareness of these other paths, mindset, and And as we talked about, kind of having fun really does seem like we're losing a lot of that, um, awareness of lightening our mindset and, and lightening our physical, like lightening 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, go, go, right? It's like, 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're gonna better digest that meal than if you're not. And I have to wonder if the same goes for your physical body. Are your joints gonna be more limber? Are you gonna, you know, are you gonna be just kind of more, if you're more at ease and lighter energetically, Is your body going to move better?

I haven't seen any like studies on that. I'm, there might be, but my heart and my experience says yes. You can see it in your own loved ones and family members. We see this sense of, of heaviness. Well, 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 lighter when they're in a positive space. So I do believe that mindset drastically impacts the way 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 who don't. People who are generally positive versus people who are negative. I think that's really fascinating. It also is very telling. I mean, we write the reality of our lives every moment with our choices and the way that we choose to view what we do. And what we do with our health is, of course, A story that we write ourselves, right? It is the ultimate 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'm going to move just a little bit more, to I'm going to eat organ meats to add my essentials. I really do believe that health is an intention. And it's so 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 the 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 the most important. section segment, and we lose it. We lose it a lot.

Well, I love this. I've really enjoyed talking about this. I know that having, you know, 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 orthopedic surgery has become such a money-making industry and In such a, like, 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 life, my lifetime. And I know you could say, well, it's your age, but my guess is that it's actually, no, it's probably because this system, to your point of what you started out saying, is this system is pushing more and more people towards orthopedic surgery. So clearly, like, there is a There's a disconnect going on with ancestral movements and modern lifestyle. So I'm really grateful for this conversation and in helping people rethink, you know, 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, but I'll just, 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 back. 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's 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 we how we see the world for sure, and sitting together and looking in each other's eyes I think is a great place to start.

I love it. Well, I'm so glad that as a doctor, someone a surgeon, someone that started out with huge ego and just wanting to make money, that you've come you've come to the place where you're now you are about looking at people in the eye, and you are about bringing the humanity and. And, and looking at the system from the whole versus just the joint. So I, I think you, you know, you really showcased a beautiful journey, Josh. I appreciate you, uh, you know, vulnerably sharing it. And, uh, 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. Um, because I, I, I think it's important that your light get brighter so that maybe you, you shine it onto someone that needs to hear it or see it.

Yeah.

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 with 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 Pinnacle 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 TikTok. I'm everywhere. Come stalk me.

And, and, and can they find any of your paragliding videos? Do you ever put those out?

Yeah, it's on there. Well, that's, uh, you can look on my personal page. I've got a bunch of paragliding on there.

Yeah, that's, I've seen some of y'all, so I recommend checking them out. They're really, really stellar. Uh, thank you, Josh. Appreciate you coming on and appreciate you.

Appreciate you, brother.

Uh, thank you all for, uh, just joining us on this episode of Everyday Ancestral. Remember, stay curious and, uh, tell a friend about us. We want to, we want to, um, keep expanding this message of, of bringing ancestral ideas into this modern society. Thank you. 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 eatpluck.com. And hey, if you know someone who'd get something out of this, share it with them too. Stay curious, live well, and keep it ancestral.