Paul Joyce has a completely torn rotator cuff and no plans to have it repaired. He plays golf most days, and the swing itself does not bother him. What used to be excruciating was turning the steering wheel on the drive over.
He had a shoulder replacement on the schedule and cancelled it. Now he comes to Dave instead. That is how this week’s Pain 2 Power opened, before turning into an hour on peptides, GLP-1s and hormone replacement therapy with the man a lot of doctors quietly learn this material from.
By The First Rehabilitation Team · Reviewed by Dr. Dave Kashuba, Ph.D.
What a peptide actually is
Mike started where these conversations should start and almost never do. What is a peptide? Paul Joyce, who runs New Life HRT, gave the short version. “A peptide is a chain of amino acids. A short chain of amino acids, usually under 50, that are bound together,” he said. They carry messages about repairing injury, losing weight, and mood, and he counts around 150 of them.
Dave filled in where the weight loss drugs came from. GLP-1 stands for glucagon like peptide, which your gut already makes, though your own clears too fast to do much. The version in the medications was modeled on a compound found in the Gila monster, which stays in the body long enough to keep working. And no, Paul confirmed, you are not injecting lizard venom. He gets asked constantly.
The weight comes off with muscle attached
Here is the stretch that walks straight into our gym. Dave sees people well into a course of a GLP-1 who have lost the weight and started to look frail, because nothing else about how they eat or train has changed. “It’s going to make you better, but it’s not gonna make you healthier if you don’t do something more with it,” he said.
Paul agreed flatly. “You definitely have to make sure you’re getting enough protein,” he said, and when Dave asked whether the loss includes muscle, the answer was “Yeah, you lose a lot of muscle.” He was describing himself as much as his patients. He started at 209 pounds, weighs 153 now, and says he took it too far. He stopped about a month before the show and his appetite is still catching up.
Lean mass matters more the older you are. Strength is what gets you off a low couch, up a curb, and back onto your feet after a stumble. Lose enough and a trip that used to be nothing becomes a fall. Holding onto it while the scale moves is ordinary work, resistance training and protein, and the first half of that is what our wellness gym and physical therapy teams do all day.
Six websites, six sets of problems
The most useful part of the episode was about where people buy this stuff. Search for a peptide online and you will find it sold cheap, labeled not for human consumption, for research purposes only. Paul had six of those sites tested.
All six came back with flaws he called major. Heavy metals in some. One carried a low level of bacteria. One was sold as retatrutide and turned out to be underdosed semaglutide, a different drug altogether. He has since served as an expert witness in an Atlanta case against a company using a fabricated certificate of analysis, the document these sellers hold up to look legitimate and, he says, often just invent.
The regulated end of the supply chain looks different. Everything he uses comes from a 503A or 503B compounding pharmacy, FDA inspected and DEA licensed. Of every thousand vials produced, a hundred go to an independent lab for sterility and potency testing.
Three weeks without pain, still no strength
Back to that shoulder. Paul started BPC-157 while the surgery was still on the calendar, and within about three weeks, on his account, the pain was gone. The strength did not come with it. “But I’m still weak. I have no strength in my shoulder,” he said. “I can’t even lift my arm up some ways. But there’s no pain anymore.”
We meet that gap every week. A cuff that is fully torn does not knit itself back together because it stopped hurting, so pain leaving is the moment to start rehab rather than skip it. Paul took the first road. “So I started going to Dave, and it’s been a Godsend,” he said. “My shoulder is, like, a lot better.” The work is range of motion plus the muscles around a tear that will not close on its own, which is most of what shoulder rehab looks like when surgery is off the table.
One thing worth saying plainly. BPC-157 is not FDA approved, Paul said so himself on air, and we do not prescribe, sell or advise on any of it. Peptides and hormone replacement belong in a conversation with a physician who runs your bloodwork. What comes after, the strength and the movement, is ours.
Listen to the full conversation on the Pain 2 Power podcast page, watch past episodes in our video library, and see what patients ask us most in the physical therapy FAQ. If you are dropping weight and want to keep the strength, or your shoulder hurts less than it did and still cannot do what you need, call us at 561-624-4263 or request an evaluation.
This article is general information, not medical advice. Every situation is different, so please consult a qualified professional about yours.