#426 Dr. Justin Farnsworth - Do You Really Need Surgery For Your Injury?

#426 Dr. Justin Farnsworth - Do You Really Need Surgery For Your Injury?

Author: Andrew Coates December 18, 2025 Duration: 57:42

Dr. Justin Farnsworth is a highly respected physical therapist who emphasizes strength training, movement, and education as foundational tools for managing pain and injury.

In this episode, Justin joins me to challenge some of the most deeply held beliefs in modern healthcare - particularly the assumption that pain automatically requires surgery or rest.

Justin brings clarity, nuance, and evidence to a conversation that affects almost everyone at some point in their life.

Justin and Andrew explore:
• Why surgery performs no better than placebo for many common injuries
• Which injuries truly require surgery and why elite athletes may make different choices than the general population
• New understandings around ACL injuries and how many can heal without surgery
• Why belief and expectation are often stronger predictors of pain than tissue damage
• Why not exercising is a greater long-term health risk than many feared behaviors
• How running can be protective for knee cartilage
• How to safely and progressively reintroduce running into your life
• How to train around pain without making it worse
• And much more


CHAPTERS


01:36 The Role of Imaging in Diagnosing Pain
02:54 Understanding Degenerative Conditions
03:37 The Placebo Effect in Surgery
04:21 FAI and Other Common Diagnoses
07:48 When Surgery is Necessary
09:18 The Importance of Second Opinions
24:20 Manual Therapy and Pain Management
28:53 Manual Therapy and Its Effects
29:23 Understanding ACL Injuries and Treatments
35:47 The Role of Exercise in Long-Term Health
38:37 Challenges and Solutions in Promoting Exercise
45:15 Running and Knee Health
54:23 Programming Around Pain


SUPPORT THE SHOW


If this episode helped you, you can help me by:
• Subscribing and checking out more episodes
• Sharing it on your social media (tag me - I'll respond)
• Sending it to a friend who needs this


FOLLOW ANDREW COATES


Instagram: @andrewcoatesfitness
https://www.andrewcoatesfitness.com


PARTNERS AND RESOURCES


RP Strength App (use code COATESRP)
https://www.rpstrength.com/coates

Just Bite Me Meals (use code ANDREWCOATESFITNESS for 10% off)
https://justbitememeals.com/

MacrosFirst - FREE PREMIUM TRIAL
Download MacrosFirst and during setup you’ll be asked “How did you hear about us?”
Type in: ANDREW

KNKG Bags (15% off)
https://www.knkg.com/Andrew59676

Versa Gripps (discount link)
https://www.versagripps.com/andrewcoates

TRAINHEROIC - FREE 90-DAY TRIAL (2 steps)

  1. Go to https://www.trainheroic.com/liftfree

  2. Reply to the email you receive (or email trials@trainheroic.com) and let them know I sent you


Andrew Coates hosts Lift Free And Diet Hard, a conversation grounded in the belief that strength and wellness are built on more than just routines. This podcast moves beyond quick fixes to examine the principles and personal stories that shape a sustainable, intentional life. You’ll hear from a variety of inspiring guests who share not only their expertise but also the real-world challenges and triumphs they’ve faced. The discussions naturally weave together the science of fitness with the practicalities of daily choices, offering a nuanced look at what it means to truly care for your physical and mental health. Each episode is designed to provide actionable insights you can use to navigate your own path, fostering resilience and confidence whether you're in the gym or the kitchen. By focusing on informed decision-making over dogma, the Lift Free And Diet Hard podcast becomes a resource for anyone looking to cut through the noise of wellness culture. Andrew facilitates these explorations with a focus on empowerment, ensuring every conversation adds a layer of understanding to the complex journey of building a strong, healthy life.
Author: Language: English Episodes: 100

Lift Free And Diet Hard with Andrew Coates
Podcast Episodes
#452 Elizabeth Davies - Training For Your Old Lady Body [not-audio_url] [/not-audio_url]

Duration: 47:29
Elizabeth Davies is the author of Training For Your Old Lady Body and famous for the quote:“Training for my summer body? Fuck no. I’m training for my old lady body. Dense bones, strong muscles, a healthy heart, good bala…
#451 Sheridan Skye - Is Resistance Training Safe During Pregnancy? [not-audio_url] [/not-audio_url]

Duration: 52:45
Sheridan Skye is a pre-and postnatal coaching specialist and educator and joins me to share her expertise about:Is resistance training safe for pregnant womenDo mom and baby have better outcomes when the mother works out…
#449 Gareth Sapstead - How To Transform Your Physique and Your Life [not-audio_url] [/not-audio_url]

Duration: 59:58
Gareth Sapstead, my long time T-Nation writing peer joins me to talk about his new book (which I contributed to) and share wisdom and experience about:-Where to start if you look in the mirror and you’re not happy with w…
#445 Susan Niebergall - Strong Instead of Skinny [not-audio_url] [/not-audio_url]

Duration: 53:41
Susan Niebergall - author and one of the most visible female fitness authorities in the industry - returns to share her wisdom on aging, strength, recovery, metabolism, and redefining what women should strive for physica…
#444 Nick Shaw - Where “Science Based Lifting” Went Wrong [not-audio_url] [/not-audio_url]

Duration: 1:06:39
Nick Shaw — CEO of RP Strength, author, and IFBB Pro Bodybuilder — returns to the show to discuss how the “science-based lifting” space evolved from education into competing ideologies.In this episode, Nick and Andrew br…