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Pro sports teams have access to every recovery device, supplement, and performance tool on the market. In this episode of OffTheCharts Health, Dr. Amy Papermaster sits down with Dr. Nate Whitney, a Major League Baseball physical therapist and former professional center fielder, to evaluate elite recovery options together. We cover: A day in the life across 162 games, no weekends or holidays off Prevention vs. rehab, and the "subclinical injury"Why he is careful about correcting a healthy elite performer's "impairments"Position-specific breakdown: catchers' knees and ankles, outfielders' running volume between innings, pitchers' elbowsTommy John and the velocity paradoxThe 30 percent one-year spike in oblique injuriesSupplements in the clubhouseYouth sports specializationMental health in the clubhouseThe modalities: scraping, cupping, needling, myofascial release, red light laser, PEMF, force plates, GPS, wearables, etc.Why the fundamentals done well are the real cutting edgeThe unsolved data problemFOLLOW & CONNECT: Substack NewsletterLinktreeEducational content only. Not medical advice. Views are my own.

Ryan Roe, PA-C, ATC is one of two full-time medical providers caring for nearly 700 student-athletes across 20 varsity sports at the University of Texas at Austin, currently the top-performing collegiate athletics program in the country. You might spot him on the Texas sideline in an SEC football game and he's the person the athletes come to for health and wellness. We cover: A day in the life caring for nearly 700 elite college athletesThe multi-disciplinary integrated care model at UT Athletics: physicians, PAs, athletic trainers, dietitians, mental health providers, sports scientists, physical therapistsWhy this model works, and what it would take to bring it into everyday healthcareConcussions: how evaluation and return-to-play have evolved, and what the NFL research is teaching college programsRED-S (Relative Energy Deficiency in Sport) in female athletes, and why "not having a period" was normalized for far too longHormonal contraception in athletes and how it complicates the RED-S workupMental health, the NIL era, and the pressure on 17- to 25-year-olds performing under the world's camerasSports science: catapult load monitoring, force plates, DEXA, wearablesRecovery science: cold plunge, sauna, red light, hyperbaric, contrast baths, and what the evidence supportsSupplements, NCAA regulations, and what's off-limits even when it's over-the-counterRegenerative medicine: PRP, PPP, stem cells, BMAC, peptides, and where the wild west begins“Back to basics” are sometimes the most important tools Sign up for more at OffTheCharts.Health

Dr. Lucy McBride has practiced primary care internal medicine in Washington DC for 25 years, writes the weekly newsletter 'Are You Okay?' to 41,000 readers, hosts a hit podcast, and has been featured in The Atlantic, The Washington Post, USA Today, CNN, MSNBC, and PBS. Her new book, Beyond the Prescription, is a framework for thinking, asking better questions, and becoming a more informed and empowered participant in your own health. We cover: Who she pictured reading the book, and what was missing from the shelfBecoming the "CEO of your own health", and what that looks like in practiceThe two forces pulling patients apart: a healthcare system that misses the human, and a $6.3 trillion wellness industry "weaponizing partial truths"The middle path she offers between medical maximalism and wellness cultureThe Four I's framework: informatics, inputs, infrastructure, and insightHealth data, biographic data, and the story that rarely makes it into the chartHow childhood, everyday habits, and lived experience show up in your labsNutrition, protein, and our relationship with foodSupplements, the illusion of certainty, and how to be an informed consumerHow to partner with health tech and wearables as a clinical tool without letting them run your lifeMovement as medicine, injury, and caring for your physical container in midlifeThe serenity prayer, unwinnable battles, and where agency actually livesMental health is health: the mind-body connection, the unconscious, and the stories we tell ourselvesThe patient personality and how the version of yourself who shows up at the clinicHer vision for the future of primary care, and where AI can help Beyond the Prescription is out August 11th wherever books are sold! Find Dr. McBride's newsletter and podcast at lucymcbride.com. Sign up for more at OffTheCharts.Health

A quick note: This episode was recorded just days before PCOS was officially renamed PMOS, polyendocrine metabolic ovarian syndrome, in a global consensus published in The Lancet in June. You'll hear us use PCOS throughout the conversation. Same condition, new name, and funny enough, we spend part of the episode talking about how much the old one never quite fit. PCOS, now PMOS, affects 10 to 13 percent of women, roughly 1 in 8. It is the most common endocrine condition in women, and it is still underdiagnosed and often misunderstood. Dr. Madeline Kaye is a board-certified OBGYN whose grandfather trained under Dr. Irving Stein, one of the two physicians PCOS was originally named after (Stein-Leventhal syndrome). Generations later, Dr. Kaye is doing the careful, comprehensive work this condition requires. We cover: The renaming of PCOS to PMOS and what it reflects about the scienceWhat PMOS is and how it is diagnosedWhy insulin resistance sits at the center of so many symptomsThe hormonal dance of a normal menstrual cycle and what goes wrong in PMOSIrregular periods, acne, unwanted hair growth, hair loss, weight, sleep apnea, and mood disordersWhy women with PMOS carry a higher premenopausal risk for endometrial cancer, and how to protect against itBirth control: band-aid or true treatmentLifestyle as the foundation: nutrition, exercise, sleep, and stressSupplements: what do we think about inositol (dose, ratio, what to expect), vitamin D, berberine, and spearmint tea?Metformin, GLP-1s, and the new oral options changing the gameFertility considerations and how to optimize before conceptionSpironolactone and the androgen symptom toolkit Sign up for more at OffTheCharts.Health

The average woman with vulvar lichen sclerosus waits 5 to 15 years for a correct diagnosis. Most see three or more providers along the way. One in three women lives with a vulvar condition at some point in her life, and uncommonly is told what is really happening to the skin of the most sensitive area of her body. Dr. Melissa Mauskar is a board-certified dermatologist at UT Southwestern, a leading vulvar disease researcher, and the founder of one of the few specialty clinics in the country dedicated to vulvar dermatology. She has built her career around finding the answers women have been told do not exist, and her work is changing what these women can expect from medicine. We cover: Why the vulva is its own organ and behaves differently than skin anywhere else on the bodyLichen sclerosus: who gets it, what it actually is, and the 1 to 3 percent prevalence that doesn't get spoken about enoughThe autoimmune debate and what the research is showing nowLichen planus, eczema, psoriasis, and Crohn's on the vulvaWhy the diagnostic delay is so long, and what is being done to close itTopical steroids: how to use them correctly, and the myth that they thin the skin when there is disease presentCompounded and emerging treatments, including JAK inhibitors and the international clinical trial Dr. Mauskar is leadingThe vulvar microbiome and hormone research that may rewrite how we treat these conditionsSurgical considerations and when to optimize before any procedureVulvar irritants, allergens, and the over-the-counter products doing more harm than goodDiet, irritants and allergens connectionVulvar cancer surveillance and what women need to knowThe new clinical trials and research consortium reshaping the field Sign up for more at OffTheCharts.Health Find Dr. Mauskar's work at melissamauskar.com

Autoimmune diseases affect roughly 5 to 10 percent of the U.S. population, and women carry about 80 percent of the burden. The science is clear that chronic stress and adverse childhood experiences raise the risk in a dose-dependent way, with each additional ACE increasing autoimmune disease prevalence by about 10 percent. A large Swedish cohort found a 36 percent higher risk of autoimmune disease in adults with stress-related disorders, rising to 46 percent for those with PTSD. That's what the science says. Sara Hirsh Bordo went further. Filmmaker, founder of Women Rising, and author of Autoimmunity & The Good Girls, she funded the first survey at the intersection of female empowerment and autoimmunity in 1,000 American women and found a striking pattern: more than 6 in 10 with autoimmune disease were the eldest or only daughter, and more than half were raised as the family caretaker. Her thesis: a self compromised creates immunity compromised. We cover: The eldest daughter, only daughter, lifelong caretaker patternHow chronic self-betrayal correlated with Sara's own diagnoses and relapsesReframing self-prioritization as foreign, not wrongThe little-T trauma of being raised to fear disappointing othersPracticing safe disappointment as a muscle to rebuildThe body speaks story, not just scienceRaising daughters who can fall, get dirty, and get back upImperfection as the path forwardReadiness, healing, and what it takes to live differently Autoimmunity & The Good Girls is available now wherever books are sold. A portion of Sara's proceeds benefit the Society for Women's Health Research. Sign up for more at OffTheCharts.Health

Dr. Tim Porter is a board-certified pediatrician and co-founder and Chief Medical Officer of Modern Pediatrics, a concierge house call practice serving Central Texas and the Dallas metropolitan area. Same-day messaging, in-home visits, someone always on call, and a model built around removing the barriers between families and their pediatrician. Tim is also one of the country's most thoughtful voices on infant sleep, having worked with thousands of families navigating the hardest stretch of parenting. We cover: Why Tim left traditional pediatrics to build ModernWhat concierge pediatrics looks like for a familyThe peace-of-mind piece: knowing someone is always thereWhy pediatrics is the perfect fit for the concierge modelThe science of infant sleep from birth through age fourWhy babies cluster feed at night (and why it happens with formula too)Avoiding the overtired stateSleep training: extinction, gradual extinction, what the attachment research showsCapping naps, drowsy but awake, feeding to sleep, holding babies to sleepThe biggest infant sleep myths that need to go Sign up for more at OffTheCharts.Health

Dr. Caitlin Giesler is a board-certified cardiologist, fellow of the American College of Cardiology, and founder of The Heart Center for Women in Austin. She left the traditional system to build a practice where women get an hour, get answers, and get someone who picks up the phone. Heart disease is the number one killer of women, more than all cancers combined. Women have been under-researched, over-dismissed, and misunderstood. Dr. Giesler does not stand for it. We cover: Why heart disease is the leading cause of death in women but the message isn't landingHow women's hearts are biologically different and why microvascular disease is missedSex-specific troponin thresholds and the heart attacks women are sent home withPregnancy as a cardiovascular stress test (preeclampsia, gestational hypertension, gestational diabetes)Perimenopause, menopause, and what estrogen loss does to the heartHRT and the heart in 2026: timing hypothesis, transdermal vs oral, the FDA black box removalPalpitations, chest pressure, anxiety in menopause and when to push for a workupAdvanced labs: hs-CRP, ApoB, lipoprotein(a) Coronary artery calcium scoring, the mammogram of your heartStatins for women: muscle aches, brain fog, and the real conversationPCSK9 inhibitors and other options when statins aren't toleratedThe statin-Alzheimer's connection and vascular health as brain healthCalcium, vitamin D, K, omega-3s, CoQ10 and the supplement landscapeGLP-1s and cardiovascular benefitVO2 max, weighted vests, strength training, and the Life's Essential EightOral microbiome, periodontal health and the heartAutoimmune disease, inflammation, and HSCRPTakotsubo (broken heart syndrome), MINOCA, ANOCA, SCAD: the female-predominant conditions you've probably never heard ofMental health, depression, PTSD and cardiovascular riskWarning signs of a heart attack in womenWhat concierge cardiology offers women who want more than 15 minutes Find Dr. Giesler at HeartCenterForWomen.com Sign up for more at OffTheCharts.Health

What is normal for penis size? Why do most men seeking enhancement fall in the normal range? And do men talk about any of this? Dr. Tyler McClintock is a board-certified urologist at Midtown Urology in Austin, and specializes in men's sexual health, including erectile dysfunction and penile enhancement. We cover: Normal penis size: flaccid and erect measurementsGrower vs shower: what the research showsBody image, locker room comparisons, and male insecurityPenile girth enhancement: what Phallofill is, how it works, who is a candidateHyaluronic acid filler for the penis: procedure, recovery, resultsDo women report girth matters more than length?Erectile dysfunction (ED): prevalence, causes, progression with ageViagra, Cialis, and how these medications workWhy only a very small percentage of men with sexual concerns seek helpUse it or lose it: protecting penile length over time Sign up for more at OffTheCharts.Health (http://offthecharts.health/)

Leaking when you laugh? Pain during sex? Pressure down there that won't go away? Told to just do kegels and it's not working? Dr. Kimberlee Sullivan is one of the most respected pelvic floor physical therapists in the country. She's spent over two decades treating the conditions no one talks about and built her career making this care accessible to more people. She now leads clinics at Origin and still sees patients because she says it reminds her why she does this work. We cover: What pelvic floor physical therapy actually is and what happens at your first visitKegels: when they help, when they backfire, and why many people do them wrongLeaking urine, bladder urgency, and incontinence after pregnancy or with agingPelvic floor exercises that can helpPain during sex, vaginismus, and conditions doctors dismiss as "all in your head"Postpartum recovery and how the U.S. is behind other countriesTight pelvic floor vs weak pelvic floorHow to find a pelvic floor PT near you and what virtual pelvic floor therapy looks like Sign up for more at OffTheCharts.Health Find Origin at theoriginway.com

His brother was misdiagnosed for over a year while cancer spread. One blood test could have caught it. That experience pulled Jani Tuomi out of fintech and into healthcare, where he co-founded Imaware, one of the first companies to bring lab-grade autoimmune and cardiovascular screening to your home with a finger prick. He has since helped build companies across ALS therapeutics, neurotechnology, and physician workforce, including Coya Therapeutics, Coherence Neuro, and Matchday Health. We talk about the difference between screening and diagnosing, what to look for before you trust an at-home health test, and why your doctor might throw out results that don't meet a specific standard. Jani now invests in early-stage health tech founders in Austin, co-authors the Austin Bio and Health Report, and is working to make the city a national leader in health innovation. If you have ever wanted more answers about your own health than you were getting, this one is for you.

Povilas Sabaliauskas is a biomedical engineer who spent years working on implantable nerve stimulators before co-founding Pulsetto, a wearable vagus nerve stimulation device designed to reduce stress, improve sleep, and calm the nervous system. The vagus nerve is the longest nerve in your body, running from brainstem to gut, touching your heart, lungs, and digestion along the way. It is the main driver of your parasympathetic nervous system, the off switch. And most of us never flip it. We cover: What the vagus nerve actually does and why it mattersHow vagus nerve stimulation works (and how it differs from a TENS unit)The science behind Pulsetto and what clinical evidence supportsWhere wellness claims outpace the researchImplantable vs wearable devices and who benefits from eachThe personal story behind Pulsetto: his father's illness, cluster headaches, and 100+ VCs who said noRegulatory challenges of selling a wellness device that affects health outcomesStress, anxiety, sleep, inflammation, and yes, sexual health Sign up for more content on OffTheCharts.Health Check out Pulsetto here Discount Code: OFFTHECHARTS

Dr. Kelly Pretorius is a PhD-trained pediatric nurse practitioner, Assistant Professor at Baylor College of Medicine and The University of Texas at Austin, and expert in pediatric injury prevention. She's spent nearly 20 years working in pediatric healthcare, from Duke's NICU to Rady Children's Hospital to Texas Children's Hospital, and her research focuses on the leading causes of preventable death in children: sudden unexpected infant death, drowning, poisoning, and firearm injuries. She talks about what the research actually says on safe sleep, firearm safety, and media use and screens for kids, while staying honest and vulnerable about the reality of being an exhausted parent. The 5 C's of Media Use from the AAPNIH Safe to Sleep CampaignSafe sleep resources Sign up for more content on OffTheCharts.Health

Join Dr. Amy for an essential conversation about gynecologic cancers with Dr. Priyanka Kamath, a gynecologic oncologist at Texas Oncology, a national leader in cancer care that has contributed to the development of more than 100 FDA-approved therapies. From cervical cancer (the only major cancer we can prevent with both a vaccine and screening, now with FDA-approved self-collection for HPV testing) to ovarian cancer's lack of screening tests, to uterine cancer's rising incidence, this episode covers what every woman needs to know. Dr. Kamath breaks down how different cancers spread through the body, warning signs to be aware of, and evolving treatment approaches. Whether you're looking for prevention strategies, understanding symptoms that matter, or learning about treatment innovations, this conversation delivers. Sign up for more content on OffTheCharts.Health

Dr. Uchenna "UC" Ossai, a licensed physical therapist, ASECT-certified sex counselor, and founder of YouSeeLogic, joins in on the conversation nobody gave us growing up…the real talk about sexual health, pleasure, and why we're all more confused than we need to be. They break down the science of the clitoris and orgasm, explore desire, and tackle the uncomfortable truth about faking it. From anatomy basics we should have learned decades ago to what actually influences libido, Dr. Ossai brings her expertise in pelvic health and sexual education to answer the questions we're all thinking but hesitant to ask. Whether desire has changed, you're curious about what's "normal," or you're ready to understand your body better, this episode delivers the sex-ed. Sign up for more content on OffTheCharts.Health