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' elbows
• Tommy John and the velocity paradox
• The 30 percent one-year spike in oblique injuries
• Supplements in the clubhouse
• Youth sports specialization
• Mental health in the clubhouse
• The modalities: scraping, cupping, needling, myofascial release, red light laser, PEMF, force plates, GPS, wearables, etc.
• Why the fundamentals done well are the real cutting edge
• The unsolved data problem

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Educational 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 athletes
• The multi-disciplinary integrated care model at UT Athletics: physicians, PAs, athletic trainers, dietitians, mental health providers, sports scientists, physical therapists
• Why this model works, and what it would take to bring it into everyday healthcare
• Concussions: how evaluation and return-to-play have evolved, and what the NFL research is teaching college programs
• RED-S (Relative Energy Deficiency in Sport) in female athletes, and why "not having a period" was normalized for far too long
• Hormonal contraception in athletes and how it complicates the RED-S workup
• Mental health, the NIL era, and the pressure on 17- to 25-year-olds performing under the world's cameras
• Sports science: catapult load monitoring, force plates, DEXA, wearables
• Recovery science: cold plunge, sauna, red light, hyperbaric, contrast baths, and what the evidence supports
• Supplements, NCAA regulations, and what's off-limits even when it's over-the-counter
• Regenerative medicine: PRP, PPP, stem cells, BMAC, peptides, and where the wild west begins
• “Back to basics” are sometimes the most important tools

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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 shelf
• Becoming the "CEO of your own health", and what that looks like in practice
• The 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 culture
• The Four I's framework: informatics, inputs, infrastructure, and insight
• Health data, biographic data, and the story that rarely makes it into the chart
• How childhood, everyday habits, and lived experience show up in your labs
• Nutrition, protein, and our relationship with food
• Supplements, the illusion of certainty, and how to be an informed consumer
• How to partner with health tech and wearables as a clinical tool without letting them run your life
• Movement as medicine, injury, and caring for your physical container in midlife
• The serenity prayer, unwinnable battles, and where agency actually lives
• Mental health is health: the mind-body connection, the unconscious, and the stories we tell ourselves
• The patient personality and how the version of yourself who shows up at the clinic
• Her 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.

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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 science
• What PMOS is and how it is diagnosed
• Why insulin resistance sits at the center of so many symptoms
• The hormonal dance of a normal menstrual cycle and what goes wrong in PMOS
• Irregular periods, acne, unwanted hair growth, hair loss, weight, sleep apnea, and mood disorders
• Why women with PMOS carry a higher premenopausal risk for endometrial cancer, and how to protect against it
• Birth control: band-aid or true treatment
• Lifestyle as the foundation: nutrition, exercise, sleep, and stress
• Supplements: 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 game
• Fertility considerations and how to optimize before conception
• Spironolactone and the androgen symptom toolkit

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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 body
• Lichen sclerosus: who gets it, what it actually is, and the 1 to 3 percent prevalence that doesn't get spoken about enough
• The autoimmune debate and what the research is showing now
• Lichen planus, eczema, psoriasis, and Crohn's on the vulva
• Why the diagnostic delay is so long, and what is being done to close it
• Topical steroids: how to use them correctly, and the myth that they thin the skin when there is disease present
• Compounded and emerging treatments, including JAK inhibitors and the international clinical trial Dr. Mauskar is leading
• The vulvar microbiome and hormone research that may rewrite how we treat these conditions
• Surgical considerations and when to optimize before any procedure
• Vulvar irritants, allergens, and the over-the-counter products doing more harm than good
• Diet, irritants and allergens connection
• Vulvar cancer surveillance and what women need to know
• The new clinical trials and research consortium reshaping the field

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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 pattern
• How chronic self-betrayal correlated with Sara's own diagnoses and relapses
• Reframing self-prioritization as foreign, not wrong
• The little-T trauma of being raised to fear disappointing others
• Practicing safe disappointment as a muscle to rebuild
• The body speaks story, not just science
• Raising daughters who can fall, get dirty, and get back up
• Imperfection as the path forward
• Readiness, 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.

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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 Modern
• What concierge pediatrics looks like for a family
• The peace-of-mind piece: knowing someone is always there
• Why pediatrics is the perfect fit for the concierge model
• The science of infant sleep from birth through age four
• Why babies cluster feed at night (and why it happens with formula too)
• Avoiding the overtired state
• Sleep training: extinction, gradual extinction, what the attachment research shows
• Capping naps, drowsy but awake, feeding to sleep, holding babies to sleep
• The biggest infant sleep myths that need to go
  

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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 landing
• How women's hearts are biologically different and why microvascular disease is missed
• Sex-specific troponin thresholds and the heart attacks women are sent home with
• Pregnancy as a cardiovascular stress test (preeclampsia, gestational hypertension, gestational diabetes)
• Perimenopause, menopause, and what estrogen loss does to the heart
• HRT and the heart in 2026: timing hypothesis, transdermal vs oral, the FDA black box removal
• Palpitations, chest pressure, anxiety in menopause and when to push for a workup
• Advanced labs: hs-CRP, ApoB, lipoprotein(a)
• Coronary artery calcium scoring, the mammogram of your heart
• Statins for women: muscle aches, brain fog, and the real conversation
• PCSK9 inhibitors and other options when statins aren't tolerated
• The statin-Alzheimer's connection and vascular health as brain health
• Calcium, vitamin D, K, omega-3s, CoQ10 and the supplement landscape
• GLP-1s and cardiovascular benefit
• VO2 max, weighted vests, strength training, and the Life's Essential Eight
• Oral microbiome, periodontal health and the heart
• Autoimmune disease, inflammation, and HSCRP
• Takotsubo (broken heart syndrome), MINOCA, ANOCA, SCAD: the female-predominant conditions you've probably never heard of
• Mental health, depression, PTSD and cardiovascular risk
• Warning signs of a heart attack in women
• What concierge cardiology offers women who want more than 15 minutes

Find Dr. Giesler at HeartCenterForWomen.com

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