William M Weiss, MD MSc FRCSC FAANA FAAOS

William M Weiss, MD MSc FRCSC FAANA FAAOS Orthopedic Sports Medicine, Arthroscopy and Extremity Reconstruction including the Shoulder, Elbow,

11/18/2025

With reports from 17 training programs, combined with partner data, the COA is tracking workforce trends, guiding resource planning, and preparing for tomorrow, as many surgeons near retirement.
Check out the numbers and see what’s ahead. Link in bio.

11/15/2025

🚨 UTMB Health will be conducting our annual Disaster Day event today (Nov. 15) from 8 a.m. to noon at the UTMB Health Education Center and Levin Hall on the Galveston Campus, including the areas surrounding 11th and Market Streets.

This large-scale training exercise will involve students, faculty, and first responders in an immersive emergency response simulation. Please note: this is only a training exercise.

Expect to see first responders and emergency vehicles in the area, including nearby parking lots.

10/28/2025

Creatine goes well beyond the gym

Creatine is best known as a performance enhancer in sports. But growing research suggests its benefits may extend far beyond athletic performance with potential roles in mental health, stroke protection, and heart failure.

🧠 Mental Health
Creatine boosts brain energy metabolism and may influence neurotransmitters.

Early studies suggest it may have antidepressant effects.

Potential as an adjunctive therapy in major depressive disorder, especially in treatment-resistant cases.

🟢 Example: By stabilizing brain ATP levels, creatine may help support mood regulation.

🧠🩸 Stroke & Ischemia
In preclinical models, creatine shows neuroprotective effects:

Reduced infarct size (less tissue death).

Preserved mitochondrial function under oxygen deprivation.

Stabilized ATP, lowering oxidative stress.

🟢 Example: These findings suggest creatine could help protect the brain during ischemic events.

🫀 Heart Failure
Heart failure involves a chronic mismatch between ATP supply and demand in heart cells.

Creatine supports the Cr/PCr/ATP shuttle, restoring cellular energetics.

Clinical results are mixed, but the mechanistic rationale remains strong.

🟢 Example: By replenishing energy stores, creatine may complement conventional heart therapies.

Creatine is evolving from a sports supplement into a potential therapeutic tool. While more human trials are needed, evidence points toward its role in stabilizing energy metabolism, reducing oxidative damage, and protecting vulnerable tissues from brain to heart.

Some of my best work… scoping COVID! 😂
10/25/2025

Some of my best work… scoping COVID! 😂

🦠👾COVID-19🦠👾: A positive diagnosis within 6 weeks of arthroscopic knee surgery led to an increased odds ratio (OR 1.68) of a post-operative venous thromboembolism, which was not affected by presence of vaccination. https://doi.org/10.1016/j.arthro.2024.12.013 -19

10/23/2025

Is it time to reevaluate return to sport criteria after arthroscopic Bankart repair?💁In this study, 26 asymptomatic volunteers without a history of shoulder injury were unable to pass the post-arthroscopic Bankart repair return to sport protocol--with an overall pass rate of merely 47%. 💀 https://ow.ly/i7MM50XeJi2

10/21/2025

Understanding exercise intensity zones and physiological stress

This chart integrates sport science and exercise physiology terminology to explain how intensity, effort perception, and physiological stress align across different training zones. It bridges objective markers such as VO₂max and metabolic thresholds with subjective effort scales used in training and research.

1️⃣ Intensity continuum
Exercise intensity progresses from very low (sleep or inactivity) to very high (near-maximal effort). As workload increases, oxygen consumption (VO₂), heart rate, and perceived exertion rise along a continuous physiological gradient.
🟢 Example: Zone 1 (very light to light) corresponds to low heart rates and minimal lactate accumulation, supporting recovery and aerobic base development.

2️⃣ Metabolic thresholds
Two key thresholds define transitions between metabolic states.

Threshold 1 (LT1): the point where lactate begins to accumulate, marking the shift from easy to steady aerobic work.

Threshold 2 (LT2): the onset of significant lactate accumulation and a transition toward anaerobic metabolism.
🟢 Example: Training just below LT2 (“tempo” or Zone 3) improves endurance efficiency and lactate clearance.

3️⃣ Zone classification
Sport science often divides effort into five zones (Z1–Z5):

Z1–Z2: aerobic, low stress, used for long-duration or recovery work.

Z3: tempo or steady-state, moderate stress.

Z4: threshold, high stress near VO₂max.

Z5: supramaximal, brief, maximal exertion (HIIT, sprint intervals).
🟢 Example: Zone 5 training elicits rapid VO₂ kinetics and enhances anaerobic capacity but requires longer recovery.

4️⃣ Subjective perception (RPE and OMNI scales)
The Rate of Perceived Exertion (RPE) correlates closely with physiological strain. Moderate efforts feel “somewhat hard” (RPE 12–14), while near-maximal work rates (RPE 18–20) reflect lactate saturation and cardiovascular limits.
🟢 Example: Using RPE alongside heart rate helps athletes gauge training stress during environmental or fatigue-related variability.

5️⃣ Applied context
Understanding where intensity lies along the stress continuum informs training prescription, recovery management, and adaptation.
🟢 Example: Endurance programs often allocate ~80% of volume to low-intensity zones (Z1–Z2) and 20% to high-intensity zones (Z4–Z5) for optimal performance and resilience.

This framework connects metabolic physiology with subjective effort, helping athletes and practitioners quantify training load, manage fatigue, and optimize long-term adaptation.

https://journals.lww.com/acsm-msse/fulltext/2025/11000/physical_activity_and_exercise_intensity.25.aspx

10/17/2025

New results from the Canadian Health Measures Survey found that physical activity is declining among youth but remains stable among most Canadians. https://ow.ly/wBvX50Xe4fz

Healthy Canadians
Public Health Agency of Canada

10/16/2025

🚨 What is the effect of "exercise snacks" on fitness and cardiometabolic health in physically inactive individuals? 🏃‍♀️

📈 Improves cardiorespiratory fitness
⏰ Time efficient
💪 Easy to integrate into daily routine

NEW systematic review and meta-analysis 📄

https://bit.ly/46VFlEJ

10/07/2025

It didn’t start with a massive campus or cutting-edge tech. It started with 23 students, one building, and a whole lot of uncertainty.

In 1891, UTMB opened its doors as Texas’s first medical school, and from day one, students weren’t just sitting in classrooms. They were in the hospital, learning by doing.

No preclinical years. No shortcuts. Just hands-on medicine, because that’s what the state needed. 134 years later, that foundation still holds. Different tools, same mission.

The beginning might surprise you. [link in bio]

10/06/2025

"Injection-Based Therapies for the Management of Hip and Knee Osteoarthritis" by Seah et al.

Tap and read the full article https://bit.ly/4mpO2gq

10/01/2025

Muscles fade when they aren’t used. Balance is lost when it isn’t practiced. Independence slips away when strength isn’t preserved. Movement, even in its simplest forms, is the safeguard against decline.

10/01/2025

📱🦴 Surgeons on Social Media: What Patients Really Want

Our recent Editorial Commentary highlights a major disconnect:
Surgeons post research, surgical techniques, and academic achievements.
Patients? They want education—clear explanations of conditions, treatment, and prevention.

If the goal is patient engagement
➡️ teach > flex.

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Texas: Galveston, League City, Friendswod & Clear Lake
Galveston, TX
77555

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