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The Peter Attia Drive

#232 ‒ Shoulder, elbow, wrist, and hand: diagnosis, treatment, and surgery of the upper extremities | Alton Barron, M.D.

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.77.3K Ratings

🗓️ 28 November 2022

⏱️ 218 minutes

🧾️ Download transcript

Summary

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Alton Barron is an orthopedic surgeon specializing in the shoulder, elbow, and hand. In this episode, Alton breaks down the anatomy of the upper extremities and discusses the most common injuries associated with this area of the body. He explains in detail how he examines the shoulder, elbow, and hand to find the source of the pain and lays out the non-surgical and surgical treatment options as well as the factors that determine whether surgery is appropriate. Additionally, Alton describes the surgical procedures that, when done appropriately, can lead to tremendous reduction of pain and improvement in function.

We discuss:

  • Alton’s path to orthopedic surgery [3:45];
  • Evolution of orthopedics and recent advances [8:45];
  • Anatomy of the upper extremities [13:30];
  • Rotator cuff injuries, shoulder joint dislocation, and more [21:15];
  • Peter’s shoulder problems [31:30];
  • The structure of the biceps and common injuries [35:30];
  • Labrum tears in the shoulder and natural loss of cartilage with usage and time [38:15];
  • Shoulder evaluation with MRI vs. physical exam, diagnosing pain, and when to have surgery [41:30];
  • How anatomical variation can predispose one to injury and how screening may help [50:30];
  • Pain generators in the shoulder, and the important nuance of the physical exam [56:00];
  • Frozen shoulder [1:05:15];
  • Shoulder pain that originates in the neck [1:11:15];
  • Surgical treatments for a labral tear, and factors that determine whether surgery is appropriate [1:16:00];
  • Repairing the rotator cuff [1:29:15];
  • Are platelet-rich plasma (PRP) injections or stem cells beneficial for healing tears? [1:38:15];
  • Repair of an AC joint separation [1:45:15];
  • Total shoulder replacement [1:55:45];
  • The elbow: anatomy, pain points, common injuries, treatments, and more [2:05:30];
  • How Tommy John surgery revolutionized Major League Baseball [2:17:15];
  • History of hand surgery and the most significant advancements [2:22:15];
  • The hand: anatomy, common injuries, and surgeries of the hand and wrist [2:29:30];
  • Carpal tunnel syndrome [2:40:00];
  • Other common injuries of the hand and forearm [2:47:15];
  • Grip strength [2:55:15];
  • Arthritis in the hands [2:59:30];
  • Trigger finger [3:07:45];
  • Nerve pain, numbness, and weakness in the upper limbs [3:14:00];
  • The Musician Treatment Foundation [3:22:00];
  • Gratitude and rucking [3:34:15]; and
  • More.

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Transcript

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0:00.0

Hey everyone, welcome to the Drive Podcast.

0:13.0

I'm your host, Peter Atia.

0:14.8

This podcast, my website, and my weekly newsletter, I'll focus on the goal of translating

0:18.7

the science of longevity into something accessible for everyone.

0:22.4

Our goal is to provide the best content in health and wellness, full stop, and we've

0:26.6

assembled a great team of analysts to make this happen.

0:29.4

If you enjoy this podcast, we've created a membership program that brings you far more

0:33.2

in-depth content if you want to take your knowledge of this space to the next level.

0:37.3

At the end of this episode, I'll explain what those benefits are, or if you want to learn

0:41.1

more now, head over to peteratiamd.com forward slash subscribe.

0:46.3

Now, without further delay, here's today's episode.

0:51.0

I guess this week is Alton Barron.

0:53.0

Alton is a board certified fellowship trained shoulder elbow and hand surgeon with clinical

0:57.8

practices in both Austin and New York City.

1:00.1

He specializes in both routine and complex problems of the upper limb.

1:04.4

Alton is also my surgeon.

1:06.1

Some of you may recall, I had shoulder surgery in March of 2022, and I've kind of documented

1:13.0

that recovery process along the way and promised to do kind of a deep dive on the upper

1:18.6

extremity.

1:19.6

In this episode, we focus our entire conversation on the upper limb going from the elbow, the

1:24.6

shoulder to the hand and the wrist, as well as the nerves located throughout that track.

1:29.3

Now, for each of these, Alton goes through the structure, the anatomy, the various things

...

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