In this episode of Thrive with Cate, Cate Stillman speaks with Dr. David Middaugh, a leading expert in physical therapy and muscle imbalance correction. As the founder of El Paso Manual Physical Therapy and a YouTube educator with over 740,000 subscribers, Dr. Middaugh shares groundbreaking insights on how to prevent hip and knee replacements by addressing muscle imbalances. They discuss why most joint pain is misdiagnosed, how modern lifestyles contribute to arthritis, and how simple strength and mobility exercises can reverse damage before surgery becomes necessary.

What You’ll Get Out of Tuning In:

1. The Root Cause of Hip and Knee Arthritis – Learn how muscle imbalances lead to joint degeneration and why surgery is often not the best solution. (00:05:35)

2. How to Strengthen the Right Muscles to Reduce Pain – Discover why glute activation is key and how to stop overusing your quads. (00:12:12)

3. The Role of Sitting in Joint Deterioration – Understand how prolonged sitting weakens the body and contributes to chronic pain. (00:06:45)

4. Debunking the "Bone-on-Bone" Diagnosis – Find out why imaging tests don't always reflect pain levels and what you should really focus on. (00:31:49)

5. Preventing Future Surgeries – Learn how to maintain joint health and avoid secondary surgeries after a hip or knee replacement. (00:19:40)

Highlights:

1. The Truth About "Bone-on-Bone" Diagnoses: Dr. Middaugh explains why many people with severe-looking X-rays have little to no pain, while others with mild arthritis suffer greatly. (00:31:49)

2. How Sitting Ruins Your Muscles: Prolonged sitting weakens the glutes and forces the quads and hip flexors to overcompensate, leading to imbalances and joint damage. (00:06:45)

3. Healing Through Muscle Activation: Strengthening the right muscles—particularly the glutes—can relieve pain and restore mobility without surgery. (00:12:12)

4. Surgery vs. Rehabilitation: A discussion on why surgery should be the last resort and how physical therapy can often reverse the need for it. (00:27:41)

Notable Quotes:

1. "Your muscles determine how much pressure is in your joints. If you fix the imbalance, you reduce pain—even if you’ve been told it’s ‘bone-on-bone’." (Dr. David Middaugh, 00:12:12)

2. "Sitting all day is the modern disease. It weakens your glutes, tightens your hip flexors, and sets the stage for arthritis." (Dr. David Middaugh, 00:06:45)

3. "If you’re going to have to strengthen these muscles after surgery anyway, why not do it now and see if you can avoid surgery altogether?" (Cate Stillman, 00:07:45)

4. "Pain is not just about structure—it's about movement. If you correct how you move, your pain will often disappear." (Dr. David Middaugh, 00:19:40)

Links 

 

Dr. David Middaugh

• Visit Dr. Middaugh’s Website

• Explore Joint Health and Surgery-Prevention

• Follow Dr. Middaugh’s Facebook and Instagram

Cate Stillman

• Explore Wellness Pro Academy

• Discover wellness in 2025 through Thrive with Cate

• Meet the microbiota-gut-brain axis

• Founder of Yogahealer, ClubThrive.Global, and Wellness Pro Academy

• Author of PRIMAL HABITS, Uninflamed,  Body Thrive, Master of YOU, and more!

This episode is a game-changer for anyone dealing with joint pain, arthritis, or considering hip or knee surgery. Dr. Middaugh’s insights highlight how movement, muscle balance, and the right exercises can significantly reduce pain and improve function—often eliminating the need for surgery.