How this started
I've been a physical therapist for twenty-four years. For most of that time, I practiced the way I was trained — evaluate the structure, address the impairment, build a program, progress it. And for a lot of patients, that works. The shoulder heals. The back settles. They go home.
But somewhere around year ten, a pattern started to bother me. A certain kind of patient who wasn't getting better the way they should. Motivated, compliant, doing the work — and still stuck. Inflammation that wouldn't settle. Healing that stalled. Pain that was disproportionate to the structural findings on imaging.
I kept asking myself: what am I missing?
The answer, it turned out, wasn't a better manual therapy technique or a more creative exercise prescription. It was everything happening upstream. The inflammatory environment the tissue was trying to heal in. The nervous system state the patient was spending 23 hours a day in. The nutritional building blocks — or lack of them — available for repair. The sleep quality determining whether any of the recovery work was actually sticking.
Standard PT didn't have a framework for any of that. Functional medicine did.
"I didn't leave physical therapy. I went looking for the other half of the picture — and found that the two fit together better than I expected."
The education I gave myself
I want to be clear about something: my functional medicine education has been self-directed. That's not a disclaimer — it's relevant context for how I think about this work.
I didn't attend a weekend seminar and call myself a functional medicine practitioner. I spent years reading the primary literature, following the clinicians doing serious work in this space — Dr. Peter Attia, Dr. Sara Gottfried, Dr. Paul Saladino, Chris Kresser, Mark Hyman, Dr. David Perlmutter, the Institute for Functional Medicine — and applying what I was learning in my own life before I ever brought it into my clinical thinking.
I tracked my own labs. I experimented with nutrition protocols. I paid attention to what actually moved the needle and what didn't. The knowledge I have in this area is hard-won, tested personally, and held with the appropriate level of humility about what we know and what we don't.
I also made a deliberate choice around the time I was deepening this work: I let my OCS certification lapse rather than spend the recertification hours on continuing education that felt increasingly disconnected from the questions I was actually asking. That was a trade-off I made with clear eyes. The clinical foundation the OCS represented — orthopaedic examination, differential diagnosis, evidence-based practice — didn't go anywhere. I just stopped paying to have someone else's framework validate it.
What going gluten-free taught me about listening to patients
The most important thing that happened to my clinical practice in the last decade wasn't a course I took or a paper I read. It was removing gluten from my own diet.
I was skeptical. I'll say that upfront. The clinician in me knew the research on non-celiac gluten sensitivity was messy and contested, and I had the usual professional wariness about patients who attributed everything to food. Then I tried it anyway.
The personal turning point
Within weeks of going gluten-free, the bloating I had normalized as just how I felt was gone. The low-grade brain fog I had accepted as a fact of adult life lifted. My recall sharpened. My motivation — not energy exactly, but the drive to engage, to start things, to follow through — came back in a way I hadn't realized was missing. My quality of life improved in ways that were not subtle and not placebo.
That experience changed how I listen to patients. Not because I now tell everyone to go gluten-free — I don't. But because I understood from the inside what it feels like to have a systemic issue that doesn't show up on standard bloodwork, that your doctor won't bring up, that the medical system has no good framework for addressing, and that is quietly degrading your daily function.
A lot of my patients live in that space. They feel it. They mention it in passing and then watch to see if I'll dismiss it. I don't dismiss it anymore.
Gut health, intestinal permeability, systemic inflammation, and their downstream effects on musculoskeletal healing and pain — these aren't fringe topics to me. They're personal. And that makes me a better clinician for the patients navigating the same territory.
Who I read, and where I push back
Naming your influences is cheap. Reading them critically is the actual work. So here is who I read, and where I part ways with them.
Peter Attia. Trained in surgery at Hopkins before moving into longevity medicine. He is the most careful person on this list about evidence quality, and the most willing to say out loud that a study is weak or that he has changed his mind. What I take from him is the framing more than any protocol: ApoB instead of total cholesterol, and VO2 max and strength as the two things that most reliably determine how the back half of someone's life goes. That second part is our territory as physical therapists, whether we claim it or not.
Sara Gottfried. Harvard-trained MD, board-certified in obstetrics and gynecology, doing precision medicine work at Jefferson at the time of writing this. She writes about female hormones with more scientific care than that subject usually gets. I came to her work sideways, through patients — the perimenopausal women in my clinic with frozen shoulder, tendinopathy that would not settle, and bone density nobody told them to think about until it became a problem. Estrogen does things to connective tissue. My PT program never taught me that, and it should have.
David Perlmutter. Board-certified neurologist. Grain Brain is the book that made me actually run the gluten experiment I described above, so I owe him the honesty of saying I think his strongest claims run out ahead of the evidence. The mechanism he was arguing for — that what happens in the gut shows up in the brain — has held up better than his critics expected. The certainty he argued it with has not.
Chris Kresser. Not a physician, and he is the first to say so — a licensed acupuncturist with a master's in Chinese medicine who went on to build one of the more serious functional medicine training programs available. I keep reading him because he is the most likely person in this field to publicly take apart a study his own audience badly wants to believe. His work on gut health is where I started, and it is still where I send people first.
Mark Hyman. Founded the functional medicine center at the Cleveland Clinic, which did more to make this work institutionally respectable than anything else in the last twenty years. He is at his best arguing about food policy and the American diet at scale, where the argument is genuinely important and genuinely his. He is at his least useful once the supplement line enters the conversation. I read him with that filter on.
Paul Saladino. Psychiatry training, best known for making the carnivore case in The Carnivore Code and then walking a fair portion of it back in public as his own position moved toward animal-based eating with fruit and honey. I do not follow the protocol and I would not put a patient on it. I read him because a well-argued extreme is a useful way to find out where your own thinking is soft, and because watching someone revise a public position in real time is rarer than it ought to be.
The Institute for Functional Medicine. Less a person than a structure. The Matrix — the systems-level organizing tool they teach — is the part I actually use. Not as a protocol to work through, but as a guard against anchoring on the first plausible explanation. When a patient is not healing and I cannot say why, it is a checklist against my own tunnel vision.
None of these people agree with each other. Put Attia and Saladino in a room and you will lose an hour to saturated fat. That is most of the point. I am not looking for a camp to join. I am looking for mechanisms I can test — in myself first, and then carefully in how I reason about the patient in front of me. What survives that gets used. What doesn't, doesn't.
Why I built this site
There is no shortage of functional medicine content on the internet. What is genuinely scarce is functional medicine content written by someone who understands movement, loading, tissue physiology, and rehabilitation from twenty-four years of clinical practice.
Peter Attia is brilliant on longevity science. Andrew Huberman explains neuroscience better than almost anyone. Ben Greenfield covers more biohacking ground than is probably wise. None of them can tell you how to apply any of it with the patient in front of you in the PT clinic on a Tuesday morning — because none of them have done that work.
That's the gap this site is built to fill. Not as a replacement for PT, not as a departure from evidence-based practice, but as the integration of two frameworks that were always meant to work together.
If you're a physical therapist who has had the same nagging feeling I had — that there has to be more to it than this — you're in the right place.