Howard Luks is an orthopaedic surgeon with almost 30 years of experience, and a good deal of his week is spent telling people they do not need an operation. We work through the joints that bring most people into a clinic, knees, shoulders, Achilles tendons and ankles, and separate what a scan is actually telling you from what it is being used to justify.Almost everyone over 40 has something on an MRI that will be described as a tear. Very few of those people need surgery, and plenty have no pain at all. Howard's case, drawn from three decades in clinic and the sham-surgery and physiotherapy-controlled trials behind it, is that our language has raced ahead of the biology, and that the words we use change how people move and live.What We Cover Why "tear" and "bone on bone" are the wrong words, and what they do to a person's behaviour What sham surgery trials showed for meniscus tears, rotator cuff tears and bone spur removal How metabolic health shapes both your pain and your ability to heal after surgery Why tendons respond to load rather than rest Cortisone, PRP, stem cells and peptides: what the evidence supports and what is marketing Ice, anti-inflammatories and ankle sprains, and why early movement beats a boot Plyometrics, balance and power, and why they matter more than strength after 50This is a conversation about being careful with language and honest about uncertainty, and about keeping your capacity so you can keep doing the things you care about.To connect with Howard Luks, read his writing on Substack or find him on X and Instagram.If you enjoy the show, please leave a rating and review on Apple Podcasts or Spotify. It genuinely helps other people find these conversations.Want to support the show?The best way to support the show is to use the products and services offered by our sponsors. To check them out and enjoy great savings, visit theproof.com/friends. You can also support the show by leaving a review on the Apple Podcast app and sharing your favourite episodes with friends and family.This episode is brought to you by:38TERAConsider 38TERA's DMN prebiotic supplement a daily multivitamin for your gut. Formulated by yours truly and gastroenterologist Dr Will Bulsiewicz. Use code THEPROOF for a discount at checkout.38Tera ships to the United States, Australia, and New Zealand.Eight SleepUpgrade your sleep with the Pod 6 by Eight Sleep. Clinically validated to deliver up to 1 extra hour of quality sleep per night through temperature control and biometric tracking. Use code THEPROOF at eightsleep.com/theproof for up to $200 off. You get 30 days to try it at home and return it if you don't love it.Eight Sleep ships to the U.S. (excluding Alaska, Hawaii, and territories), Canada, Mexico, most of the EU, the U.K., Australia, the UAE, Saudi Arabia, and Switzerland.MomentousMy go-to supplement brand for protein and creatine is Momentous. Use code THEPROOF for up to 35% off your first order at livemomentous.com.Momentous ships to many countries worldwide depending on local import regulations.IM8With 92 nutrients, including Vitamin B12, Iodine, Selenium and Vitamin D, in highly absorbable forms, IM8 Daily Essentials is the perfect all-in-one daily multi-vitamin to ensure you meet your daily micronutrient needs. IM8 is offering an exclusive 10% off your first order with a free welcome kit when you enter the promo code SIMON at checkout on im8health.com.IM8 ships to 27 countries including the U.S., Canada, the U.K., Australia, and many regions across Europe, Asia, and South America.Function HealthTake charge of your health with advanced blood testing and personalised insights. Function Health offers a practical way to track key health markers such as cholesterol, blood sugar, and more. Learn more and join at functionhealth.com/simonhill for a $25 credit toward your membership. Only available to those living in the United States.Function Health ships to 48 U.S. states, excluding Rhode Island, Hawai‘i, and Puerto Rico.WHOOPWhoop, the most advanced fitness and health wearable available. Your personalised fitness and health coach to recover faster, sleep better, and train smarter. Claim your first month free on join.whoop.com/simon.Whoop ships to 56+ international markets, including the US, Canada, most of Europe, Australia, New Zealand, UAE, Singapore, and parts of Asia.Simon Hill, MSc, BSc (Hons) Creator of theproof.com Host of The Proof with Simon Hill Author of The Proof is in the PlantsSubscribe & Connect: YouTube Apple Podcasts Spotify Instagram: @simonhill Twitter: @theproof Facebook: The Proof with Simon HillNourish your gut with my Plant-Based Ferments Guide and download my Two-Week Meal Plan.