Heath Cogswell

In 2013, we compared arthroscopic partial meniscectomy to sham surgery. Result: no benefit.

Ever wonder where "OKC knee ext is bad for the ACL" came from? Well, for the most part, it's this 1995 article in AJSM. We know strain on ACL⬆️as you move closer to ext, but strain w/ OKC knee ext + 45 N load only ⬆️strain 4%. GAIT has shown 3x that. You should do OKC knee ext.

On day 1 of my high school history class, our professor got up and said You are 15 or 16 years old. 200 years ago people your age were married, planted crops, had children, and built a cabin by winter. You can do your homework. The bar set for you historically is embarrassingly low. You are not dealing with regional famine or plague. You do not have to save your family from marauders or go into battle to destroy your enemies. You have to sit down and learn from someone who cares about you in a safe, air-conditioned room. You have no excuses.

The best opening scene to any show ever.

What people think universal healthcare does: - Provides "free" medical care for all - Eliminates medical bankruptcies - Creates efficient single-payer system - Reduces overall costs through economies of scale What universal healthcare actually does: - Forces productive citizens to subsidize others' poor health choices through taxation - Creates artificial scarcity through price controls and rationing - Eliminates price signals that coordinate supply and demand - Generates massive waiting lists and deteriorating quality You're not getting "free" healthcare. You're getting Soviet-style central planning applied to life-and-death decisions.

The math on this project should mass-humble every AI lab on the planet. 1 cubic millimeter. One-millionth of a human brain. Harvard and Google spent 10 years mapping it. The imaging alone took 326 days. They sliced the tissue into 5,000 wafers each 30 nanometers thick, ran them through a $6 million electron microscope, then needed Google’s ML models to stitch the 3D reconstruction because no human team could process the output. The result: 57,000 cells, 150 million synapses, 230 millimeters of blood vessels, compressed into 1.4 petabytes of raw data. For context, 1.4 petabytes is roughly 1.4 million gigabytes. From a speck smaller than a grain of rice. Now scale that. The full human brain is one million times larger. Mapping the whole thing at this resolution would produce approximately 1.4 zettabytes of data. That’s roughly equal to all the data generated on Earth in a single year. The storage alone would cost an estimated $50 billion and require a 140-acre data center, which would make it the largest on the planet. And they found things textbooks don’t contain. One neuron had over 5,000 connection points. Some axons had coiled themselves into tight whorls for completely unknown reasons. Pairs of cell clusters grew in mirror images of each other. Jeff Lichtman, the Harvard lead, said there’s “a chasm between what we already know and what we need to know.” This is why the next step isn’t a human brain. It’s a mouse hippocampus, 10 cubic millimeters, over the next five years. Because even a mouse brain is 1,000x larger than what they just mapped, and the full mouse connectome is the proof of concept before anyone attempts the human one. We’re building AI systems that loosely mimic neural networks while still unable to fully read the wiring diagram of a single cubic millimeter of the thing we’re trying to imitate. The original is 1.4 petabytes per millionth of its volume. Every AI model on Earth fits in a fraction of that. The brain runs on 20 watts and fits in your skull. The data center required to merely describe one-millionth of it would span 140 acres.

BREAKING: The Trump Administration announces the 2025-2030 Dietary Guidelines for Americans, putting REAL FOOD back at the center of health. 🇺🇸 REALFOOD.GOV

Last quarter I rolled out Microsoft Copilot to 4,000 employees. $30 per seat per month. $1.4 million annually. I called it "digital transformation." The board loved that phrase. They approved it in eleven minutes. No one asked what it would actually do. Including me. I told everyone it would "10x productivity." That's not a real number. But it sounds like one. HR asked how we'd measure the 10x. I said we'd "leverage analytics dashboards." They stopped asking. Three months later I checked the usage reports. 47 people had opened it. 12 had used it more than once. One of them was me. I used it to summarize an email I could have read in 30 seconds. It took 45 seconds. Plus the time it took to fix the hallucinations. But I called it a "pilot success." Success means the pilot didn't visibly fail. The CFO asked about ROI. I showed him a graph. The graph went up and to the right. It measured "AI enablement." I made that metric up. He nodded approvingly. We're "AI-enabled" now. I don't know what that means. But it's in our investor deck. A senior developer asked why we didn't use Claude or ChatGPT. I said we needed "enterprise-grade security." He asked what that meant. I said "compliance." He asked which compliance. I said "all of them." He looked skeptical. I scheduled him for a "career development conversation." He stopped asking questions. Microsoft sent a case study team. They wanted to feature us as a success story. I told them we "saved 40,000 hours." I calculated that number by multiplying employees by a number I made up. They didn't verify it. They never do. Now we're on Microsoft's website. "Global enterprise achieves 40,000 hours of productivity gains with Copilot." The CEO shared it on LinkedIn. He got 3,000 likes. He's never used Copilot. None of the executives have. We have an exemption. "Strategic focus requires minimal digital distraction." I wrote that policy. The licenses renew next month. I'm requesting an expansion. 5,000 more seats. We haven't used the first 4,000. But this time we'll "drive adoption." Adoption means mandatory training. Training means a 45-minute webinar no one watches. But completion will be tracked. Completion is a metric. Metrics go in dashboards. Dashboards go in board presentations. Board presentations get me promoted. I'll be SVP by Q3. I still don't know what Copilot does. But I know what it's for. It's for showing we're "investing in AI." Investment means spending. Spending means commitment. Commitment means we're serious about the future. The future is whatever I say it is. As long as the graph goes up and to the right.

Here’s how shitty our healthcare system is Order a lab through insurance. Insurance refuses to pay. Sends patient bill for $200. Without insurance and contracting with lab, same EXACT test is $5.

Recovery Stages After Anterior Cruciate Ligament Reconstruction 🦵 pubmed.ncbi.nlm.nih.gov/41314701/

Absolutely cracking article on peripheral neuropathy AKA polyneuropathy. One to save & return too. A related podcast too.

Metabolic disorders and pathophysiologies have many detrimental effects and are associated not only with tendinopathies but also with chronic #pain and are highly likely to be causal for these. This new review finds that diabetes has crazy effect sizes for many types of tendinopathies from trigger finger OR=~3.8 to Achilles tendinopathy OR =7.2 to medial epicondylitis OR = ~11.3 ! There are other weaker associations. Open access in the comments.

As a parent with 2 young kids I hate 3:30p games. Kids are waking up from their naps pretty much right at kickoff, and I have to balance trying to be a good dad and playing with them, and trying to watch as much of the game as possible.

This is actually a good statement from Bernie Sanders Worth the watch

🚨 BREAKING: President Trump pushes back on Florida removing all vaccine mandates, including for schoolchildren. He says some vaccines are a must. "I think we have to be careful. You have some vaccines that are so amazing. The Polio vaccine I think is amazing. A lot of people think that COVID [vax] is amazing. You know, there are many people that believe strongly in that." "But you have some vaccines that are so incredible. And I think you have to be very careful when you say that some people don't have to be vaccinated. It's a very tough position." "Initially, I heard about it yesterday. And it's a tough stance. You have vaccines that work. Just pure and simple, they work. They're not controversial at all. And I think those vaccines should be used otherwise some people are going to catch it and they endanger other people. And when you don't have controversy at all, people should take it."

Teaching to address overdiagnosis ebm.bmj.com/content/ebmed/… Via @DerekGriffin86

🔥Thriving with chronic pain🔥 4 key themes based on experiences of individuals living with chronic pain 1 - Attitudes towards pain & impact on life Embracing pain acceptance, reframing the experience, & choosing to focus on life beyond pain were crucial for thriving 1/4 👇

Casey Means Says Berries Are Going To Make You Fat! Casey means is back on her BS. Honestly, as someone who comes from a conservative household, I am EMBARASSED by the nominations from the republican party, especially Casey Means being nominated as surgeon general because she consistently does NOT understand science In this video she claims that fructose is why bears eat berries because it helps fatten them up for winter & that’s why we should avoid fructose 1Do I need to point out the obvious that we aren’t f***ing bears? 2Do berries & fruit make people fat? Unequivically NO. In research studies where people eat more fruit, they have LESS body fat, BETTER insulin sensitivity, & better overall metabolic health (PMID: 29643151, 26996228, & 31139631) She then claims that high fructose corn syrup is 1000x (she fabricated this number) more potent than regular fructose & is associated with violence WATCH OUT FOR THE FRUCTOSE RAGE! The reality is that people in lower socioeconomic areas are MORE likely to consume more HFCS & people from lower socioeconomic status are 700% MORE likely to engage in violence, but oh yea… it’s the fructose rage Casey 🙄(PMIDs: 19631043 & 25147371). Just for comparison the increase in risk with HFCS consumption is an 11% increase in fighting (PMID: 32150827) meaning that the increase in violent behavior associated with HFCS consumption is COMPLETELY explained by the confounding variable of socioeconomic status Also HFCS is not magically fattening, in studies that replace HFCS of fructose containing sugars with other sources of sugar or carbohydrate but keep calories equal there is no effect on body fat or markers of health (PMIDs: 30463844, 26358358, 28536126, & 22351714) Until you are willing to go back to school to learn how to properly assess scientific research Casey, you need to SIT DOWN

If you love conspiracy theories, you are more likely to be narcissistic (A thread) Conspiracy theories cause harm to people and turns them into ‘victims’ preventing them from taking action! If you believe some influencers, everyone is lying to you: doctors, food companies, pharmaceutical companies, the government, and the media... You're being poisoned, brain-washed, and made sick, all because of a supposed money trail that benefits some nebulous “Big ____ (medicine, pharma, media, etc.).”

🧠 How much of physio treatment outcomes come down to contextual effects — not just the treatment itself? Spoiler: It’s more than you think. @JaredPowell12 breaks down this study for you 📚 Get the full Research Review — free with your 7-day trial: 👉 physio.network/manual-therapy