WHOOP Podcast - Playing the Long Game: Embracing Aging with Dr. Vonda Wright

Episode Date: January 31, 2024

On this week’s episode, WHOOP VP of Performance Science, Principal Scientist, Kristen Holmes is joined by orthopedic surgeon and longevity expert Dr. Vonda Wright. The double board-certified orthopedic sports medicine surgeon has over 20+ years of experience working with athletes and leaders across the sports and business industries. Kristen and Dr. Vonda will discuss Dr. Vonda’s mission (4:10), if aging is a disease (8:25), investing in longevity (11:33), exercising for longevity (16:01), how age and sex impact longevity (22:25), healthy muscle tissue leading to longevity (24:10), nutrition’s impact on aging (28:11), tactics to changing behaviors (36:40), and life as a surgeon and team doctor (48:37).Resources:Dr. Vonda's Website Support the showFollow WHOOP: www.whoop.com Trial WHOOP for Free Instagram TikTok YouTube X Facebook LinkedIn Follow Will Ahmed: Instagram X LinkedIn Follow Kristen Holmes: Instagram LinkedIn Follow Emily Capodilupo: LinkedIn

What's up, folks? Welcome back to the WOOP podcast. I'm your host, Will Ahmed, founder and CEO of WOOP, and we're on a mission to unlock human performance. Got to start by congratulating a high-performing WOOP member, Patrick Mahomes, a partner to WOOP in a long time, whoop-aware, unbelievable performance he's putting together in his career,

as if it wasn't enough to have your first six years as a starter going to the a fc championship game he is now going to the super bowl for his fourth year in five seasons that's pretty unbelievable and just watching the game on sunday it felt very reminiscent of tom brady and the paths where it's like you don't know if they've got the best team you don't know if they're going to be able to persevere against the team with a bunch of better record et cetera, et cetera, and yet they just find a way to win. Congratulations, Patrick, rooting for you this coming Super Bowl. All right, now to the podcast.

On this week's episode, we've got WOOP VP of Performance Science, principal scientist, Kristen Holmes, joined by orthopedic surgeon and longevity expert, Dr. Vanda Wright. The double board certified orthopedic sports medicine surgeon has over 20 plus years of experience working with athletes and leaders across the sports and business industries. Dr. Vonda has cared for athletes and active people of all ages and skill levels, including the Division I, Georgia State Panthers, Penguins, elite developmental hockey teams, University of Pittsburgh Division I athletes, World Rugby Sevens, and Olympic track and field. Kristen and Dr. Vonda discussed Dr. Vonda's mission as an aging and longevity expert.

If aging can be considered as a disease, that's a good question, how you could invest in your longevity. Dr. Vonda discusses exercises and how age and sex impact longevity, how to improve your healthy muscle tissues, nutritional behaviors impacting aging, tactics to changing behaviors, and how Dr. Vonda mentally and physically prepares for surgeries and operations. If you have a question was answered on the podcast, email us, podcast.com. Call us 508 443-4952. Here are Kristen Holmes and Dr. Vonda Wright. Dr. Vonda Wright is a double board certified orthopedic sports medicine surgeon specializing in shoulder, hip, and knee orthoscopy for athletes and active people of all ages.

Her pioneering research in mobility and musculoskeletal aging is changing the way we view and treat the aging process. And her passion for advancing her field is absolutely evident in her expertise with cutting-edge orthobiologic. techniques, including PRP for arthritis. So with 20 plus years of experience in clinical research, Dr. Wright inspires, educates, and motivates people to better themselves by, you know, regularly speaking at conferences and nonprofits and women's leadership organizations and, you know, super active on, on Instagram and has personally been such an inspiration for me.

Dr. Wright, welcome to the Woot Podcast. I'm so excited to be with you today. Oh, I know. I'm like really excited for this conversation. I, you know, I think when we, when we think about, you know, aging and longevity and, you know, there's so much information out there, it's, it's a pretty noisy space. But I think it's folks like you who are really helping, I think, you know, individuals understand, you know, where exactly to apply effort and, and how to, and just a framework to think about aging. And I think that's maybe where I love to start is, is, you know, you kind of have this, I think, really. frankly inspiring point of view on on aging and longevity. And I guess I'd just love to understand how you define it. But maybe before you do that, I'd love to just know what your mission is. Yeah. You know what? It is a, it is a amazing privilege, actually, to be a surgeon and to be in a space where the very toolbox of how I get to function every day, whether it's in my clinic or whether it's speaking around the country, whether today I'm in scrubs. I was in the

operating room. My vision for why I continue to show up every day is because I know that by saving mobility, I am going to save people from the ravages of chronic disease. Because listen, I'm a good carpenter. I grew up on a farm in Kansas. These hands can make a bunch of stuff. And my brain sees in 3D, but that would never, ever, ever be enough for me. But it is enough. for me to know that when I make someone walk again or give them back their shoulders so that they can work again, that they will no longer by force have to just sit on a couch and wither away, that I'm going to save them from the ravages of chronic disease. And sometimes people look at me like I've got a little unicorn because they're like, ah, you're an orthopedic surgeon. What are you

talking about? I am so critically, and look at me getting all hyped up already. concerned about sedentary death syndrome in this country and abroad. It's not just this country, but mostly in this country, that when I got out of my fellowship in 2004, I immediately began studying musculoskeletal aging because I never believed, never, ever, one and a half seconds that we are destined to go from the vitality of youth down some slippery slope to frailty with nothing, nothing to prevent that. I have never believed that. And maybe that's because, you know, my father, who's now 86 years old, who was a lifelong

runner. And back in the 70s when I was a child, it wasn't very common to see a 60-year-old runner. And we would celebrate that person. We're like, oh, my gosh, look at her running up. So I always knew that that kind of musculoskeletal longevity. was something to celebrate. So when I became capable of studying it, we published a variety of studies that really proved

that there is not a direct downhill trajectory when we invest every day in our mobility. And our own research in the group that we formed called Prima, the Performance and Research Initiative for Masters Athletes in a variety of studies over time showed that we are not destined to lose our lean muscle. muscle mass. We can restimulate muscle stem cells, which are now the hot satellite cells, right? We've renamed them. They're hot. We can preserve our bone density. We proved a long time ago

that there's a direct relationship between physical activity and executive brain function. And then when I left my lab in 2018, we were beginning to look at the why. And we started talking about this protein called Clotho, which is the longevity protein. It's been known for about 30 years, but this protein has a receptor on every cell. And so if you don't have Clotho in a mouse, if you're a mouse, you die young but very old. So what we discovered as a why does musculoskeletal activity help prevent the disc decline? is because how is clotho stimulated to be transcribed, skeletal muscle contraction? And I'm like, oh my God, Kristen, no, it's so easy.

I'm not just a fitness chick telling people to go move around. I am directly have a biochemical link between moving and vitality to prevent frailty. Isn't that worth getting up for? Yeah, I mean, that is, it's, I love how you've framed that. And I think it's, you know, aging in some ways is modifiable. I mean, would you go so far as to say that aging is, in fact, a disease? Oh, well, listen, I know that something, yeah, I know the biohacking community, which I have been in deep with and at the conferences, believe it's a disease.

I think, listen, this is my perspective on aging. From the minute of our conception to the ultimate moment of our death, whether that's at, 81, whether it's 110 or 114 or as some guys believe 120 or, you know, in the Old Testament, Methusa lived 724 years. That's a lot of time to work in our lifetime. It is the most natural thing we do. I don't think it's aging that we hate. I think it's how we age that we hate.

Aging is the most natural part of living. So let's do it, right? Let's do it one day at a time. But what we hate is what we see as those days accumulate, right? And if we're not investing every day in our mobility, the reason I started researching this is because I did not believe that there was nothing we could do about it. And in fact, that's what it shows, is that we can modify the trajectory. And hopefully my goal now is to equalize the health span and the lifespan, right?

so that every day until our last breath, we're healthy, vital, active, joyful. And, you know, we have a beautiful, we have a beautiful example of that in popular culture. Now, Queen Elizabeth just died at 97. On Tuesday, she saw the prime minister of her country, and on 97, she just went to sleep, right? Continuing to function every day. So is aging a disease? I think aging is the most natural thing we do every single day. aging without purpose, aging without investing energy back into our health, that's the

disease, the giving up, the not reinvesting. You know, my daily mission is to help people invest every day in their health, right? I don't think I answered your question, but I refuse to assign it to disease status because the disease is treated with a pill. Great, great, everyday aging is not treated with a pill. It's treated with our lifestyle. Yeah, there's a quite a famous longevity expert who kind of, who uses that phrase aging is disease. So I was very curious to kind of get your perspective on it. Yes, I know him. And I think, I know, I know. We all know. Yeah, yeah. So, yeah, I was just curious to get your thoughts on that, you know, because it kind of, when I hear it, it rubs me the wrong way a little bit. And yeah, I was just curious how you think about that. So if I

heard you're right. So it's essentially the cause of aging is this kind of time-dependent accumulation of, I guess, cellular damage. So we kind of understand the cause of cellular damage. How do we actually prevent cellular damage? Maybe we can kind of go through just all the things that we can do daily that are accessible to us. And maybe that's where we start. You know, what is democratically available to everyone? Listen, so I think you cannot live in this country unless I cannot imagine a place where you will not heard, just very basic right or wrong tenets of exercise is good for you, or read in some magazine on the shelf. You don't even have to open the magazine. You can just read what's on the front cover. Oh, to get the idea that there are things that we should be doing, like moving, and we should

be diet conscious. And even if you don't know the specifics, you cannot live in this country without knowing some tenants that, but here's what I have found is either people are incredibly confused about what is good for us or it's generational. I mean, at this point, we have three or four generations of people who have now lived in a very cyclically unhealthy way, right? Their great grandmothers were unhealthy, dying in metabolic disease. And it becomes just this family, my family's big-boned air caps, that no such thing is big-boned people. big-boned. If four generations of people are living together in community unhealthily by metabolic standards, it's the norm, right? It becomes the normal thing. So how would they know other than they know

if they've looked on any TV? So I don't, so I think the first thing that we can do to change the trajectory of our health is to become educated, to really seek out knowledge. You know, if you wanted, I use these examples, if you wanted to buy the best new car, or you want to, wanted to research a vacation, you would be all over self-educating. So I don't know why in this vessel of our life that we live in, that we just take it by chance. But number one, let's educate ourselves. And we have to vet it.

You know, we have to get it from good sources. And if that means listening to you cite the research or it means opening books like mine that are cited with research, then that's what we have to do. That's number one. Number two, I think we have to pivot our mindset that aging in a decrepit way is not just what happens, that it's natural. Why are you starting, why are you fighting it? I'm actually not fighting it.

I am optimizing 1,440 moments. I get it. I'm about to turn 57 years old. I get that that is a lot older than I was 40 years ago. But I don't look at that number in a fatalistic and number. way, I realize that continuing to pivot forward, that every day still there's lots of things I can do to feel amazing and have this kind of weird energy that I have all the time, right? So that's number one, number two, number three, okay, you do not have to.

And I know it's so confusing because five years ago, everybody was doing high intensity interval training every single day. And you know what it got them? I was one of them. You know what it got us, it gets me left Achilles tendonitis and right hip flexor pain. It gets everybody that works out at my office is in a performance center. They're hurt every three weeks and they're coming and have to see me, right? I never bought into that trend. You are so smart. But now we know that a lot of good can come from simple things like walking, fidgeting, chronic mobility, moving around constantly. It doesn't have to be rocket science. So moving. I'd love to just. talk a little bit more about exercise because I think there is, you know, as it relates specifically

to aging and longevity. I just want to like dig into that a little bit. So, you know, you said skeletal muscle contraction. So obviously lifting weights is really important. Oh, let's do that. So yeah. So just so as a, you know, as as a person who, number one, practices what she preaches, you obviously have, you have a very deep understanding of the human body and its processes and injury prevention and longevity and aging. So, yeah. What would you say is the appropriate kind of, if we're thinking about aging gracefully and really thinking about from the perspective of health span, you know, what is the appropriate type of lifting?

You know, how do you think about raw strength versus functional? And then the cardiovascular parameters, you know, how do you think about, you know, high intensity versus, you know, low intensity and, yeah, kind of go from there? So when I originally wrote for the public in the early two, thousands. At that time, I was encouraging more functional strength and functional motion and body weight and always encouraging lifting off a machine. Like I'm not a big fan of machine. So barbells, dumbbells stuff around the house. Lifting anything. In fact, I never said lifting. I always called it carrying a load. Because if you have a 40 pound toddler, that's a load, right? Just carry that person around.

Yeah. So, and I still believe in that. And I think that is an amazing. way for people who have never stepped away from the couch to start. We have to have to have mobility of our joints. We have to be able to squat down, you know, from a standing position. So to get mobility through our joints. And we can talk a little bit about what happens to our joints with aging if you want. But so that is still that. But if, but at this point, my perspective on what I currently prescribe to people who work with me and whether they're my patients or they come one on one in my longevity programs, what I ask them to do.

So from an aerobic perspective, a mobility perspective, number one, the whole fidgeting all the time, good. Number two, I no longer ask people to gun it every single day because in my perspective and with, you know, some of the research that's out, they're going to end up hurt all the time. So I do ask people to work out at base training heart rates. So that is a lower heart rate, three hours a week. there's some debate, and people debate me online about what it actually means to be zoned to, but about 65 to 70% of your max, your current heart rate max.

Now, I have the privilege of being able to measure my lactate threshold here, so I know exactly when I started accumulating too much acid in my blood, but three hours a week of that. And that's basically you can just, you can have a conversation. You're feeling relatively comfortable. So that could be walking fast for some folks. It could be just a kind of a good clip in a jog for people who are really fit. So Zone 2 is going to be different. It's going to vary for person to person in terms of how they get to that 60% or 70% max heart rate.

I find when I do it, for the first seven or so minutes, it takes me a minute to get my heart rate up to about 130, which is where I live in this zone. but then for the next 30 or so minutes, I'm fine. I could have this conversation. And, you know, I do this now at an incline. I wanted to make it hard. As I got in better shape, I'm going to make it harder. And that's what you have to do is just increase the intensity as your heart adjusts. But in the last five to seven minutes, I actually break a little sweat.

So I'm stimulating some kind of metabolism as I'm doing that. And so I do that at 45 minutes at a time, sometimes 6. But twice a week, Kristen, I want to do enough stimulation to stimulate satellite cell reproduction. I want to increase my mitochondrial flexibility. So I sprint twice a week. And sprinting for every person, whenever I say that out loud, they're like, well, what is, how fast do I need to go? Well, it's really maximum effort because my sprinting is not going to look like a sprinter sprinting. My sprinting is just me, hoffing it as fast as I, I punch it up to 11 on the treadmill,

and I try not to fall off the back. But I only do it 30 seconds at a time, and then I completely recover. And that helps us with inflammation. It helps us stimulate enough muscle fibers that we actually will stimulate muscle protein synthesis. We will stimulate satellite cell replication. So that's why I do that. So base train, sprint. And I only do that twice a week with the sprinting.

So that's how I prescribe the mobility part. For the weightlifting part, again, if you're just beginning, anything is good. Get to know your body. Get to know your mobility. But then when you want, in midlife, especially for women, if you want to build power, I'm not interested. I do increase the size of my muscles, but I'm not interested in hypertrophy. I'm actually interested in more powerful muscles so that I don't fall down from a standing position

and can't get up. Or I can run up a flight of stairs. Or if I need to, I can sprint. I insist on heavy lifting with low reps. So I define that. It's defined by my strength conditioning coach personally and those in this building is three to six reps for four sets. I've just evened it out. I do four reps. four sets of primary lifts. On my upper body, it's push-pull, so bench-press pull-ups, and then on my legs, it's back squats, dead lifts. And then the accessory lifts that support those compound motions, which are also very good for neuromuscular pathways,

things like for my upper body, biceps, triceps, lats, delts, I do eight reps, three sets at weights heavy enough. And that's how I prescribe right now. because I'm trying to stimulate power for aging. Right. So would you say that these just these types of movements are going to help the cells communicate more effectively? I think when you provide that much stimulus with the heavy, the low reps, heavy sets, it does all the replicative type things.

But it does actually, the way, I don't have to tell you this, the way muscles work is it's one nerve to a bunch of motor end plates. And by providing that much stimulus, you are increasing the amount of muscle bundles with one nerve, right? So you're just increasing the power from one single stimulus. And that's what I'm looking for, is not endurance per se, not hypertrophy per se, but power. Are there any sex differences that you feel like we should call out. And maybe just really briefly the difference between a 25-year-old female, you know, male versus female versus a 50-year-old female who's gone through menopause and maybe a 50-year-old man. Like what are just some of the kind of sex differences that you,

that you know of and just, you know, age-related differences? Yeah. So if you look at midlife in particular, we'll start with the 50-year-olds, right? So women in midlife, life must lift heavy because the little bitty weights, high reps are not going to give you enough stimulation to build the power that we need. Now, there are other researchers who believe that for men, they don't need to do the really, really heavy low rep, that even eight reps is good for a midlife man. So that is a sex difference there. For the younger people, I think for younger women, they can lift heavier, more reps. But, you know, and in younger men, they can haul around anything they want because of their overabundance of testosterone, frankly. So, I mean,

but in midlife, it's, it is really critical for women, in my opinion, to lift heavy. Yeah. Yeah, definitely. And maybe just talk a little bit about, you know, we're trying to improve the quality of our tissue. So maybe just frame it out like, or talk a little bit about what that actually means. So everything that you're talking about is a path to that, right? So what's the association between, you know, quality, healthy muscle tissue and longevity? Well, let's talk about, if we're going to talk, let's talk about midlife women, right? Because we can, I mean, men do not lose their testosterone in the precipitous way the midlife women do. But midlife women, starting around 45-ish, on average, start to have wild fluctuations in their levels.

of estradiol on progesterone until at 51 when on average the ovaries retire we no longer make estradiol and when that happens there are estrogen receptors if we want to talk just musculoskeletal on every tissue on muscle on cartilage matrix tendon and ligament not so much but here and bone bone is a stimulated the relationship between bone breakdown and bone bill changes without estrogen. You have greater, you still have both, but the bone breakdown is higher, is higher without estrogen. So when we're talking about tissue health, without one of the cardinal hormones that we make and then lose, we can lose up to 20% of our bone density precipitously around perimenopause to menopause. And it's hard to get back. Number two, we

have an increased loss of lean muscle mass, that's why it's important to consider all these two things, as well as the cartilage matrix has both alpha, estrogen, alpha, and beta receptors, and when those receptors are not filled, the downstream matrix support cannot happen. And we know that women over 50 have much more arthritis than women below 50. And until 50, men have more arthritis, but after 50, women's cartilage breaks down rapidly. So that is one set of tissue functions that happen due to estrogen. But so then how do we rebuild that? Well, number one, we have to consider whether HT is for you.

But aside from that, that is only one little part of midlife, making sure we are lifting heavy enough to stimulate satellite cells, activation, and proliferation, to lift hard enough to stimulate muscle protein synthesis, to do the kind of base training we've now just discussed with the sprints to give mitochondrial support. But even more than that, some of the reasons why we slow down with aging has to do with endurance capacity. Our VO2 max decreases, right? So sedentary people will lose 10% of their VO2 max, which is their oxygen diffusion capacity, a real sign of fitness. You'll lose 10% per decade after 25 if you're sedentary.

It's remarkable. It's wild. It's wild. But then if you invest in your training, you don't have to be an elite athlete. You can cut that in half, right? Right. It's amazing. What's up, folks?

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Okay, let's talk about diet real quick. We really got into exercise, which is great. You know, just time back, you know, we're trying to, okay, how do we prevent aging? You gave us, I think, just a great summary of how we need to think about exercise in the context of healthy aging. What's your take on diet? I don't believe in diets per se. In fact, I don't call the way I prescribe, and this is a number. other mindset perspective, I call this a lifestyle, right? I live this way. So how do I live?

Well, I live eating a high protein diet, not a crazy high protein, but I try to get a gram of protein per ideal pound of me. And so many, and so many women in particular, but people in general, because they're not aware of what they're actually putting in their mouths, don't get enough protein at all. And we cannot synthesize muscle without enough building blocks. And I don't actually care whether you get it from animal protein or plant protein. I just need you to get a gram per ideal pound. And that's what I try to do myself. Number two, I do not restrict fats per se, but I choose only healthy fats like avocado fat, right? But I do, I'm very conscious because I, We were talking earlier, I've worn a CGM for most of the year, and I know how extremely sensitive

that I am to simple carbs and what it does despite blood sugar, which there, you know, you could talk and probably have a whole show about how sugar ravages your body. So I encourage everyone to trade simple sugar, simple carbs, for complex carbs and fiber, meaning I like myself to try to get 25 grams or more fiber a day. Sometimes that's hard unless you're really conscious of it. But if you eat a cup of beans, you eat half an avocado and some chia seeds, you'll get close, right? And then plus or minus supplementing. And that's how I handle my carbs.

I have completely eliminated simple white sugar and any of its cousins, which is the natural kind. I remind people that simple white sugar is made out of beets. and sugar cane, which are plants, right? So they're actually natural. But I also encourage people to read the back of any packaged food that they want to eat. If you're eating whole, fresh foods, no need. But when it comes in a package, you must read the back because there are on average 16 pounds of added sugar in our process diet a month.

And so those are the awarenesses that I ask myself. and other people to have to be conscious. The other thing that people are really shocked out when I talk about it is you actually have to eat more sometimes to lose weight because I had a woman come through my office last week who her basal metabolic rate was 1056. 1056, right? For those of you listening, that is a really low basal metabolic rate. And so we were talking about how to increase the protein in her diet so that she could build more muscle so that she can increase her basal metabolic rate so that she has something to rely on in sickness and in health, right? And it takes more food to build the muscle that will increase your health. Does that make sense? So excess glucose.

What happens to that? And how does that impact ourselves? Because I think that that's a good way. It might be, it's kind of how I think about it, you know, like do I have excess energy? You know, like, I'm just trying to use all the food I put in my body. I'm trying to use it, you know. So in our bodies are miraculous mitochondria. Everybody knows about our mitochondria now, which are organelles that live within each, live in cells, lots and lots of them in skeletal muscle. I am not going to get into the Kreve cycle. Do not forge it like that. But we can use carbohydrates, fat, and amino acids or protein for fuel. But the vitamin, mitochondria work at a steady rate. It has a rate. It doesn't increase its rate. It does what it does, right? So it doesn't

matter if you put three cents worth of sugar in as simple carbs, or you put $25 worth of sugar in as simple carbs. Your mitochondria are just going to do their thing at their rate. So as your gut breaks down whatever carb you put in, or God forbid, you drink simple glucose, fructose and juice and it just goes right in, that load has to be dealt with because the body does not want it circulating. So there are poor pancreas pours out the insulin if your pancreas is still working, trying to get the glucose out of your blood. And it will put it first as fuel for ATP production via the mitochondria. But then it's got all this extra stuff circulating. It's got to put it somewhere so it starts shoving it into fat cells. It starts storing it in your liver. It starts and you're just overworking to store all this

glucose away. Well, I'm going to tell you for sure that your body will store it anywhere. We think of it of storing it in our adipose tissue that hangs around. But I'm going to tell you, I find fat in shoulders. I find excess fat in knees. skeletal muscle tissue that is not supposed to be fatty infiltrated, if your body is desperate to store it, we'll put it anywhere. So that's number one. Number two, when we have too much glucose circulating and our pancreas cannot keep up, we become insulin insensitive. So the more it's working, the less sensitive it becomes. And that is how we develop pre-diabetes and diabetes. we just become insulin and sensitive because of the overload we've given our bodies for so long.

The sugar circulating in the body causes extreme inflammation. I call it being well-sweetened or something. So, for instance, things like frozen shoulder are due to inflammation of the synovial tissue, due to the high levels of sugar. And that can happen in any musculoskeletal tissue. the spikes in blood sugar that we get from eating simple carbs, then can give us, and then what our body does is work really hard to lower it. It gives us these peaks and crashes.

The crashes then do two things. It gives us brain fog. It makes us exhausted, and it makes us seek more sugar. So our brains love the stimulation that we get from the pleasure centers when we eat sugar. And so when I detox people from sugar, about day four, I always say, don't, don't be surprised when you find yourself standing in front of the pantry looking for something. You don't even know what you're standing there about. It's your brain wanting that hit. Thank you for outlining that.

I think it's helpful for people to understand some of the mechanism. You know, so they can, and just some of our default tendencies, you know, and we are actually charge. trying to clean up our diet a little bit, you know, we're going to have these moments where we're particularly vulnerable, you know, as we're trying to change behavior. And that, and, you know, you touch on this and really to degree in both of your books, Guide to Thrive, I think in, in particular, you know, this is really a book about how to kind of transform yourself for the better and, you know, in just six months. And you talk a lot about this kind of four-step plan, vision, action attitude and achievement.

And so I'd love, you know, when people are deciding that, hey, you know what, I really want to, I want to age in a, you know, in the healthiest way possible. And this is going to meet an overhaul in a lot of my, you know, current behaviors and lifestyle and even patterns of thinking, I guess in researching that book and just your own life experience and just all the experience you have with patience, like kind of how do you, What are some of the best tactics that you can recommend for folks who are trying to change behavior? I wrote Guide to Thrive because I realized looking around that we plan everything in our lives. If we're in business, we have a strategic plan, whether it's for the next quarter, for the next five years.

We have strategic plans. We plan our kids' education, our education. We probably plan our neighbor's kids' education or whatever. you know, very few people did I ever meet that had a strategic plan for their health and addressed health in the same important way that we devote to other things that are important to us. So that's what I borrowed from business and learned how to write a strategic plan and these are the steps. So step number one is to create a vision. I think a lot of times we'll pick up a new book or a magazine or like, oh, that Campbell Soup Diet sounds good, let's do it.

I always contend that unless we understand if we have a vision, we will pick up another program, a thing, and do it, and that's a brick. And we'll do something else, and that's a brick. And the grapefruit diet's a brick, and name your thing. And then all we'll be left with is a pile of bricks, not a monument. So I feel like creating a vision gives meaning to otherwise meaningless things in our lives, right? So that's when we started out this conversation, why do I get up in the morning and put metal in bones or whatever?

It's because I know that by saving mobility, I'm saving lives, right? So from this perspective, when you create a vision for your health, there are several things you can do, but you have to go way back and you have to sit quietly and understand who you really are and what you really want and why you're going to put the work in. because if you just say, nothing I ever talk or write about is about putting on a little black dress and going to my 50-year high school reunion. It is never going to be about that, right? It is about how do you want to feel? Who am I as a person? What do I really value? And those, that interrogation of yourself will then inform the vision, right?

So who are you? What have you devoted your life to? does that reflect your vision or external forces because you've had no vision, right? And that's hard conversations to have. What do you really want? Who are you? So you write that down. And then you can craft your health vision. I just did this really interesting experiment, writing out what I want for the next 40 years,

because I'm about to turn 57, and I realize that 40 years of what I potentially have left, right, because I want to live at least until 97, just because I want to bug the heck out of my youngest child, is equal to the adult life I've had since I was 17. So what am I going to do with my second lifetime? So that's the kind of exercise to do when you're creating a vision. And then I suggest step three, examine yourself, think about what you want to be in the future. You've got to pass it by somebody who really knows you because you can think all these things and you can make all these visions but if somebody who truly knows you you know i may say i give this example all the time i love to sing i love music i love performing and i'm really good in the shower and in church

but i'm never going to be madonna pat benatar all the stars of my my generation right i'm never going to be that. So somebody needs to say to me, I hear you saying that, but your life has not reflected that so far. So, you know, that feedback. So create a vision. A vision without action is just words on a page and useless. So create a vision. Step two is take action. Taking action needs to be specific and in very specific actionable steps. So that's why in the book I break it down into moving and eating, giving very specific guidelines for, in this, just like we spoke about before. I went so far in that book is to tell you what to do every day. In my first book, Fitness After 40, I just gave people great information because the truth is my patients are smart. But I found

that people prefer to be told what to do every day unless they're far down the road. So action, moving, eating, very specifically, we set it up in short-term goals. So first two weeks, second two weeks. And that's how I encourage people to do it. When I have a lifting schedule now, there are three weeks sets. Every week, for three weeks, I'm going to do the same thing, and then I'm going to change. So that's how we talk about action. The third step, create a vision, take action, is look at your attitudes. Not only how do we get joy out of the health process, but more importantly, what are the barriers that have kept us circulating in the last six months of our lives for our whole lives? And here's what I've discovered. Tell me what you think of this. I think

that no matter what our vision is, what actions that we step up to for a short amount of time, that until we pivot our attitude or do the work that we need to, we will always revert to the last place we felt safe. So if we feel safe when we're binge eating on the couch because we feel safe then, that's what we're going to revert to. Because new habits are stressful, right? So part of addressing attitudes is really why have I been doing the same thing every six months my whole life?

What is it I'm returning back to? And maybe not everybody has that, but I see repetitious habits time and time again. And why is there such dropout rate on so many great exercise programs? And I just think it's people go back to what makes them feel safe. So we have to redefine safe. I am safest as a nearly 57-year-old woman when I can run and sprint and lift and do anything I want to do because I'm strong enough, that is safe

to me. I am not frail. Does that make sense? Yeah, it sure does. And I think a lot of folks, I think what you're talking about is, you know, it does require some introspection and it requires a level of work that some folks just haven't, haven't done, you know? And maybe you don't even realize that, you know, it's okay to have a point of view about your own life, you know, and it's okay to shed old ways of thinking and old, you know, patterns of behavior. And I think what happens is we just kind of mindlessly accumulate habits over time, you know, and they kind of become, we become that habit, which is scary, right? And some of those habits are serving our greater purpose and our vision, like you point out.

and then some of those habits and behaviors, patterns of thinking are not serving us our greater purpose. And I think to your point, kind of going through that really hard work of saying, okay, what is really serving me and what isn't? You know, and then the education that you started the podcast, you know, people have to educate them on themselves on, okay, what actually is required? If I want to change some of these habits, I know they're not serving me. What do I replace them with? You know, what am I replacing if I'm binge eating on the couch? And that makes me feel kind of temporarily safe. What am I going to replace that with? Because there's going to be that same exact moment that happens where you're feeling unsafe, you're feeling stressed. That's been

your go-to to deal with those emotions. What are you going to replace it with when that moment arises? Yes. And you have to have a strategy around that. You do. And sometimes you have to pre-think it. You have to, if I find myself here, what is my action step to get out. And I'm going to take it one step further. Tell me what you think about this. I think sometimes you have to replace the people that surround you, not your family, but who is keeping you back? Maybe your family. Who is keeping you back? What attitudes are they, you know, are they peer pressuring you into things that you are trying to change? How do you surround yourself, I'm not saying that everybody around me has to do the heavy stuff that I do,

but they need to not get in my way. And so they need to support your values. They do. You know, you have defined what is important for you to live the best version of your life. And you need to surround yourself who people are going to support that. And I think, I think, frankly, you need to be relatively ruthless about that. Because if you don't, you're going to feel that internal tension all the time. And I just think, that that's a really, when we talk about aging, that will accelerate aging. It will. And I think we can't feel sorry for letting someone go. I mean, I sound ruthless here, don't I? I haven't done this lately, but twice in my life. I've let friendships just dwindle

because the goodness that I could offer them and they were supporting me was just no longer there. And I saw it dragging me down. So, and I don't. think that as your people are listening to me, oh, that evil woman, that you have to be mercenary, but you have to identify the vision that you have, what it's going to take to get there, the why, and if it's not, if someone is always making fun of you for trying to do your very best, that is not serving you, right? So I think even going further, right, to people surrounding yourselves. And then finally, the fourth step, create a vision. take action, see what I'm doing with my little A list for me to remember, change attitudes,

is then you have to assess where you've gone, make adjustments, and then reward yourself. You've done a great job, right? So every little periodic time, and it doesn't mean reward yourself with bad behaviors, but for me, it's a pair of nice shoes or it's a little weekend with my family or something, but reward it. And this is a business plan for health. That's amazing. I thank you for kind of going deep in those four areas. I think that would be enormously helpful for people who are really trying to carve out a plan and create a lifestyle,

to your point. This isn't about just making it through a couple months with a certain behavior. This is really about adopting a way of being in the world, which is fundamentally a different mindset or a different perspective on kind of health and longevity. in terms of, so you have incredible lots of experience, you know, dealing with all ages and skill levels, you know, you've worked with Division I athletes, you've worked with, you know, professional athletes, Olympic athletes, you've worked with the Atlanta Ballet. So, you know, you're a surgeon, you know, working with all these. You're a team doctor, right?

So what have you found, you know, how do you yourself prepare for the rigors? of surgery. And orthopedic medicine is considered, you know, very difficult, you know, and, and, yeah, so just we're really curious kind of what you do to get your mind right. So to get my mind right is, number one, I am always prepared. You know, the reason it takes seven years of residential training and then we learn across a lifetime is, I've never met a doctor or a who is not a lifetime learner. I mean, yesterday I found two hours that were something canceled. I had two hours.

And I'm like, oh, my God, I get to go on Ovid and PubMed and look up some stuff because I love to learn. You know, I tell my youngest child, if nothing else, I'm a good student. So number one, I prepare by learning. When I have a case I haven't done for a while, that's what we do. We go learn. We always are advancing techniques we do. I mean, this is a conversation for another day, probably.

But I just started doing surgery with needles. I don't even make incisions anymore. So always challenging myself. So that's number one. Number two, what's interesting is, you know, even though I'm my sports surgeon and a lot of my work is arthroscopic, I'll give you an example. When I do shoulder surgery, which is what I did this morning, people start out laying flat on a bed, but I do my surgery with people sitting up.

And so I physically, Vanda Wright, 5-4, will get up under the bed, release the latch, and I don't know what to call it. It's not a squat. It's not a deadlift. I am squatting on the ground, pushing the 300-pound person up. That is the requirement of my job. And, you know, I'm a strong little person. You are.

Yeah. But around mid-law, around menopause time, there was one day in the OR when for the first, the first time in my life, that was hard. And I thought to myself, oh, my God, this is as strong as I'm ever going to be unless I really focus. And that's when I went back to powerlifting. So I power lift three times a week now. And I do this lift as heavy as my bones will let me, which is what I say. I check my bone density. I know I've got good bone density. So I lift as hot heavy as I can to build the power. So it's it's a forever learning. It's staying strong enough. And then it's funny. It's funny to when the same thing happens in surgery that happens

with pro athletes when you hear them describe getting into a flow state and the world slows down and the sounds are muffled. And for that critical portion of the case, like there is no conversation we're not talking about anything i'm so present at what's going on in my hand and so that's how i mentally prepare by preparing mentally get into flow state and then physically stay strong as a bull right i've got to stay strong but that serves my longevity then doesn't it it sure does yeah and i you know it's it's i've always a big part of my life's work has been just trying to i think demystify this notion that, you know, the zone is something that just happens to us, you know, every, you know, every few months, we just kind of land in it, you know, where, you know,

it's really my belief that you can create conditions where the zone and flow become a part of your every day. You know, it's a matter. It's how you sleep. It's how you eat. It's how you recover. It's how you train, you know, optimizing this interplay between the cardiovascular and the nervous system. It is like to me it's it's it is is not something that happens to us. It's something that we intentionally create daily with our behavior. So when we enter into that moment we're engaged in our craft, it's there for us, right? It's everything that we do in the lead up. And that's what I hear you saying and and what I see online, you know, is, is you are living these behaviors that allow you to show up for your craft in a way that puts you in the top, you know, point 0.01% in the

world in terms of what you do well and you know what you just said it's interesting and it goes back to resolutions and habits is that ritual matters so this training to be in the zone it's you're right i just don't it just doesn't come upon me we get into a ritual and then we we arrive there because of the sequential things we do it's right it's why pro athletes are superstitious they know that putting on the socks at this time, drinking the coffee, will lead them down the path so that they're there when they need it, right? Same thing with surgery. So what are you obsessing over right now? I am, so the intersection of my work, as you've now heard, has always been musculoskeletal aging and then the orthopedic side. I am now obsessing. I've added midlife,

women in particular, but men also, to this Venn diagram of my life, because every single day, Kristen, and I'm a sports doctor, but every single day, frail people walk into my office, hunched over using appliances. And I stop and I think, what were they like when they were, these are retired executives and women who have been vibrant. And now they're frail. And I stop for a little bit and I think, what were they? Because sometimes they talk about it. And I am obsessed under my watch.

I always say that, not on my watch. I love it. Not letting people become frail because, you know, there's a definite interplay between sarcopenia and osteopenia. The bones and the muscles talk. They will go away with the. purposeless passing of time, even in men who have more testosterone than women, if we are not conscious of it. And so not on my watch are we allowed to become frail old people because we can't live in the house as we raised our children. We can't even open the pickle jar, right? You're going to

fall and break your hip and end up in my ED. 50% of you will never return to pre-fall function. 30% of you will die. And so if we know, Kristen, if we know that by starting to pay attention, if not before, at least by 40-ish, come on, people, by 40-ish, we can pre- Let's get our shit together here. We can so, yes, I say that all the time. We can so prevent a lot of this frailty that ends us up dying of a hip fracture, living in nursing homes, frankly, losing our brains. Right.

So that is my obsession. Listen to me, go on and on. I love it. No frailty on my watch. That is a beautiful obsession, and the world is better off because of your obsession. So we're so grateful. This has been such a fun conversation. I could just talk, I could just continue asking you questions for hours.

But I'm just so grateful that you spend. this time with us. And I know our members are going to really love hearing your perspective. So thank you. Well, thank you so much for having me. It's a privilege. Thank you to Dr. Vonda Wright for joining the podcast, all things aging, longevity, health optimization. A lot of great things to take away from that. If you enjoyed this episode of the podcast, please subscribe to the WOOP podcast. Leave a rating or review. Check us out on social at Woop, at Will Ahmed, at Kristen underscore Holmes 2126. Have a question. What's the answer on the podcast, email us podcast at whoop.com. Call us 508-443-4-9-5-2. If you want to join

WOOP, you can check it out for free 30 days, free trial membership. That's just whoop.com. New members can use the code will, W-I-L, to get a $60 credit on WOOP accessories. All right, folks, that's a wrap. Thank you for listening. We'll catch you next week on the WOOP podcast. As always, stay healthy and stay in the green. Thank you.