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Aug. 4, 2025 - Rubin Report - Dave Rubin
01:02:31
Dave Tries Controversial New Medical Tech — Was It a Miracle or a Bust?
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dave rubin
18:08
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dr richie striano
35:20
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Speaker Time Text
unidentified
Doc, how you doing?
dave rubin
I came down at the end after playing about three hours on a layup, crushed my knee.
I heard pops, cracks, crinkles, crunches like glass and popcorn as if you stepped out in a bag.
I'm actually kind of speechless.
Like, I thought probably I was never playing again.
You have stuff inside of you that can heal yourself.
I mean, it's completely counter to the way we do medicine, which is we're going to, you know, use some pharmacology to put something in you, hopefully to fix you, versus, oh, it's in you already.
That's just a radically different way of looking at things.
dr richie striano
With ultrasound, we can zoom in right up close and personal and see the individual fibers that make up the tissues.
So you see how this is nice and homogenous, evenly grayed down through here.
And then right here, there's a little black spot.
That's a couple of broken threads.
Come under the curl.
Perfect.
Inject.
And so what I really want is for everyone who needs it, this is my mission to make people move.
Movement is life.
And if you can't move, you can't live.
dave rubin
All right, guys, it's August, which means I'm off the grid.
I do hope that AI Dave has been keeping you abreast of what's going on in the world, although Real Dave has no idea.
But as we tape this, it is the end of July.
And I'm actually completely thrilled to sit down with this man, a doctor who I now consider a friend, Dr. Richie Striano, the man who saved Dave Rubin's knee.
It is good to see you.
dr richie striano
Thank you.
Wonderful.
Thanks for having me.
dave rubin
So we are going to talk stem cells for about a half hour.
We're going to talk a little bit about my journey.
And I really wanted to use my unfortunate knee crushing incident as a learning experience for all of my viewers because it was a learning experience for me.
And I thought when I first took a phone call with you that you were such a good explainer of what is, you know, fairly complex science and technology and everything else.
And fortunately, the results of what you did with my knee have been spectacular.
So before we get into any of that, why don't you give me a little bit of a bio?
And I should note that I got in touch with you through our mutual friend Tony Robbins.
And when you have a medical emergency, to have Tony on your phone to point you in the right direction is clearly the way to go.
But why don't you give me the Richie Striano minute or so medical bio and then we'll dive into stem cells?
dr richie striano
Sure.
So I'm certified in diagnostic ultrasound image.
And what that means is that I can see up close the details of structural tissue, such as ligaments, tendons, joints, cartilage, the meniscus, et cetera, because I'm going to talk about the knee today.
And unlike an MRI, which gives you a big image from up on high, like when you first log into Google Maps, with high-definition ultrasound imaging, I can zoom in, go in the kitchen, and tell you what you're having for breakfast.
So the detailed imaging, I can see the individual fibers that make up the tissue that are structural in the function of the knee joint.
And the second part of that is I trained at the Mayo Clinic, Andrews Orthophedic Institute, Thomas Jefferson Medical College, the Orthobiologic Institute, MSKUS, and have published multiple journals in peer-reviewed clinical studies on the knee and the shoulder.
I've participated in over 35,000 procedures and have been doing this for 25 years and specifically with stem cells, really since they broke the scene in 2012.
Exclusively stem cells, exclusively adipose tissue.
So I specialize in adipose tissue, and the reason for that is adipose tissue has more than 100 times the stem cells than bone marrow in an adult.
And adipose tissue has an entire community of regenerative cells in addition to the stem cell itself, each of which provides a biological benefit in terms of cellular and structural function.
I call it the reef.
And that's because if you think of it as a coral reef, when you look at a coral reef, you'll focus on one or two of the shiniest fish.
And the other members of that biological ecosystem are frankly ignored.
But they all contribute to the life of that reef, the organisms, the bacteria, the structural support from the coral, the different creatures that live in that reef.
Without those, the fancy fish would be dead, right?
Without structure, nothing would function.
Without the bacteria and other elements of that reef, the ecosystem would break down and would die.
And that's the benefit of fat.
You have that entire biological ecosystem preserved intact that now can be deployed into a joint or a tissue.
dave rubin
Right.
Okay.
So let me pause you there before we get a little ahead of ourselves because I want to do kind of like stem cell 101 and then we can get into the types of stem cells and the types of procedures.
So the procedure we did was adipose tissue, meaning it was fat from my back.
And we're going to show images of some of these things and the process and all of that.
But before we do anything else, can you just tell me, well, okay, so 2012 stem cells, obviously it'd been on your radar first, but like what got you interested in this?
And what was the real breakthrough that made people realize, boy, you have stuff inside of you that can heal yourself.
I mean, it's completely counter to the way we do medicine, which is we're going to, you know, use some pharmacology to put something in you, hopefully to fix you, versus, oh, it's in you already.
That's just a radically different way of looking at things.
dr richie striano
Right, exactly.
So the issue that came to me was basically what I call stabilization, which is that with physical therapy, rehab, other types of treatments, the joints, the spine, the knee remains unstable.
It may get some temporary pain relief.
These therapies are looking at pain relief mostly, and they do not alter the progression of arthritic or damage in the joint.
So that's what became my mission.
Like, what the heck is going on that these people need physical therapy for the rest of their life or whatever.
And they don't stabilize.
unidentified
Right.
dave rubin
So basically before this, before this, just for a layman's version, somebody would hurt their knee and basically they would maybe get a steroid shot and do some therapy, but that's not going to heal the actual tendons and the things that you're talking about.
dr richie striano
Correct.
Those therapies like physical therapy, Taking non-steroidal anti-inflammatory drugs, which have downstream side effects to the gut.
And then when you look at steroid injections, they destroy cartilage if you get them over a longer period of time, which is the exact opposite of what you want to do when you're addressing an inflammatory situation.
So the issue became that we have what I call tweeners.
These are people in between the diagnosis of osteoarthritis in the knee and the eventual time that an orthopedic surgeon is going to recommend putting in a new one.
And so, what is that treatment gap?
It could be 10 to 15 years in clinical studies, and there are no other alternative treatments used.
These treatments can actually alter and turn back the clock on the osteoarthritic progression and proven to grow cartilage, regenerate tendon, ligament, muscle, nerve, etc.
So that's really where it began.
And then my exploration started with no one knowing anything.
No one was studying the instability, just, you know, the painkillers and injecting the knee with steroids, which is what the orthopedists do.
And so little by little, I began to study structural tissue.
And you could look at abnormalities.
You could do muscle testing.
You could palpate.
You could do a physical exam and see that a ligament is bad or a muscle is bad, et cetera.
But what the heck do you do about it?
And how do you see where it's bad?
So what was interesting, the paradigm shift, I was in New York with my wife, and she was doing a breast ultrasound, looking for lumps and bumps and stuff.
And the light went off.
And I said, holy cow, breast is soft tissue.
Everything I'm trying to figure out is soft tissue.
So I bought an ultrasound machine to her dismay because they were so expensive.
They were the size of a Volkswagen at the time.
And now we're going back like 2007.
And I couldn't see anything, right?
I put it on a patient, had no idea what I'm looking at.
Stuff is everywhere, but it just kind of looks cool, right?
Like, you know, when you look over the surface of water, you put a mask on and look down, and it's like, oh my God, what's under there?
But I realized that my patients had MRIs that clearly the radiologist showed an abnormality, porn rotator cuff or something.
So I said, well, I know there's one.
So let me go to that tendon and see if I can find it, which I couldn't.
And then eventually I did.
So when I found the first one, I printed it and I put it in a book.
And I began to accumulate my own encyclopedia of abnormals because in orthopedic imaging with ultrasound, there was no data.
No one was doing it until eventually the Academy of Registered Diagnostic Medical Sonographers offered credentialing in orthopedics.
It was always, you know, gynecologic, cardiac, et cetera.
And so that began in 2010.
I was in the first group to pass that test.
And so I'm certified in that.
And like I said, I've been doing, as part of the treatment protocol you got, beginning with a live point of care diagnostic imaging of every single structure that contributes to joint function.
We use the same imaging to be able to inject structures and abnormalities that I can see as small as a half a millimeter.
dave rubin
Yeah, I mean, well, it was just incredible watching you do the procedure and how you found every little tear.
I mean, I think there was about a dozen of them and each one you went to specifically.
So let's pause on me for a moment.
I want to punt that portion of the conversation.
But basically, so, okay, so you've got the ultrasound machine.
You're learning this new technology.
No one's really done it before.
Like this, this is healing things in kind of a new way.
Can you just explain the difference?
Because I think a lot of people still hear stem cell now, and they think either this is placenta-based or there's some other third, one way or another, it's a third party, or it was a baby that was born that no longer survived or something like that.
So can you kind of lay out what the categories are of stem cells?
Again, we did adipose, so we'll end on that one because that'll then get us to what you did with me.
dr richie striano
Right.
So first, what is a stem cell?
Right.
So a stem cell is a very smart, specialized cell that is repairing damage in tissues and organs in your body every day.
And it's smart.
It interprets the environment it's in and the environment is smart and talks back.
That's called crosstalk, crosstalk.
And then based on that, signaling takes place.
So the stem cell can differentiate into tissue.
And the stem cell can produce substances that regenerate tissue.
There's stem cells from bone marrow, stem cells from fat, and then you have donated stem cells like umbilical cord stem cells.
So those are basically the three main categories.
The difference with fat, as I said, is the community of regenerative cells.
And as you get older, the level of stem cells in bone marrow rapidly decreases and they become senescent.
Fat has more than 100 times the number of stem cells as bone marrow, and they do not exhibit the same senescence.
So they're livelier, more prolific.
They've got their brains together more.
And so they function better.
dave rubin
So in essence, it didn't matter that me at 48 was getting these stem cells like as if I'm getting 48-year-old stem cells because there's more of them.
They're operating better.
So it's similar to had I done this if I was 24, getting it from myself.
unidentified
Right.
dr richie striano
But the older patient I've treated was 96.
She had torn rotator cuffs on both sides, could only move like a penguin.
And she responded very well.
She got to hear, which changed her life, right?
She didn't get to normal.
She got to 90 degrees.
She's 96 with torn cuffs.
Her husband's an MD, brought her back a year later just to keep it going, so to speak.
dave rubin
I saw, I didn't even go in for my shoulder with you, and you know what you've done to my shoulder.
I mean, I could barely move my arm like this, and I'm completely, I'm wearing a jacket right now, so it looks a little stiff, but like, I'm completely pain-free.
So, okay, so you specialize in adipose stem cells, which are from your own fat.
So now you get a call from a random guy, happens to be me.
Tony sends you, says, hey, I should call you.
I described what happened.
I told you I took the MRI and everything.
And I said I heard pops, cracks.
It was like stepping on glass.
I really thought I was never playing ball again.
I didn't know if I was going to walk for the rest of the year.
This is back in February.
And immediately on the phone, you were like, no problem, we can fix this.
It's not a big deal, blah, blah, blah.
How did you, How are you just so confident that when a random person calls you and say, I crushed my knee, I heard every pop and crack that nobody wants to hear that you can actually fix it properly.
dr richie striano
Well, keep in mind.
dave rubin
I don't even know if I had sent you an image at that point.
I think maybe right after that, I sent you the image.
dr richie striano
Well, with every patient, first I do a history, right?
So I've got to listen to exactly what you're feeling.
You know, I can't read a picture and determine what restrictions you have in terms of your quality of life and activity, which is my main point.
We want quality of life, activity, stability, strength, support, and, of course, pain relief.
And so the issue became, because I've published clinical studies, even with international colleagues and presented on the knee joint at international conferences.
I know from my own data collection and those of others that we have an 85% response rate.
With every patient, with every medical procedure, there's a failure rate.
It's not magic Pixie does.
So I need to let the patient know that the worst possible scenario is it may not work.
They don't break anything.
They can't ruin anything.
So that's what gives me the confidence.
And then your age and the amount of issues that were taking place in your knee increase the confidence because you're athletic, you're thin, and you're fit.
You're healthy, right?
And so when you put these contributing factors together, you elevate the potential response rate.
dave rubin
So I show up, you bust out the MRI machine, the gel, all of the stuff.
We start looking at each individual, each individual tear.
We do the adipose stem cells.
So now they've taken it out of my back.
You spin it in the centrifuge, correct?
dr richie striano
Yeah, so the first thing, if I can explain the approach that I've developed.
So the first thing is point-of-fear ultrasound.
Now, osteoarthritis of the knee is no longer considered a disease of cartilage.
It's an inflammatory disease that affects the entire joint, every structure, muscle, ligament, tendon, nerve, the meniscus, et cetera.
So the old thought that it's a disease of cartilage is wrong.
It's an inflammatory disease.
And for many, many years, I've been developing an approach where, you know, like an orthopedic does one shot in the side of their knee and you go home, I expanded it because of my knowledge of imaging, looking at these different structures and seeing damage inside and outside that joint.
Now it's recognized that all of those structures that have to coordinate and cooperate in order for that knee to function are involved in the loss of function.
So first it starts with imaging of every single structure in and out before, while you're in the office.
The second part of that is that once we have that, a math is developed of every single area where there's damage, as little as a half a millimeter, and those become targets for the injection.
Next, we take out the fat, and through a new technology, we are able to isolate 90 to 150 million clinical-grade pure stem cells and all the other guys in the reef.
So they're all in that basket of goodies.
And then I have to calculate how much volume goes in each of these tissues, right?
I'm fat.
I have a bigger appetite than you.
Maybe not because I've seen your tomahawks, but I'm still promised one.
dave rubin
You are getting, believe me, if I owe anyone a Tomahawk steak, it's you.
You're getting one.
dr richie striano
Yeah.
So then I calculate the volume.
Muscle likes more than a tendon, a tendon, you know, likes more than the meniscus, the joint to fill the joint and reduce the inflammation that causes the progression of the disease.
And so then I calculate the volume.
So I need to make.
dave rubin
Yeah, and you were literally doing the math in front of me to figure out exactly what was what.
And we also, I'm sure you're going to get to this, but we also did some intravenously as well.
dr richie striano
Yes.
That's a separate part.
So now you're looking at longevity and systemic inflammation.
First, we're going to address the orthopedic side.
And so I have to make the calculations as to how many CCs of stem cells I need to fill each and every one of those targets.
And I always leave extra because when we do the injection, a tear, as an example, could spread open like you're blowing up a balloon.
And then I need to put more in so that we fill the entire area.
And ultrasound is streaming video.
So we see the stem cells leaving the needle and going into the issue.
So every single structure is filled completely with the exact amount of stem cells it wants to have.
So its appetite is cleared.
Once we've done that, then second, hyperbaric therapy.
I could do a whole interview on hyperbaric therapy.
It increases oxygenation, enhances the function of stem cells.
And a very, very important organelle called mitochondria.
They even talk about dysfunctional mitochondria leading to aging.
So the mitochondria is the battery inside of a cell.
And so by enhancing mitochondrial function, you basically recharge or jumpstart the dying batteries in a cell, like turning up the dimmer switch.
You light up six cells.
They regenerate.
The stem cells are asking them to regenerate.
The hyperbaric is helping them by boosting them and giving them support.
And then the last thing was the Genesis laser, the laser developed by the NASA scientist that emits all wavelengths of light.
Each wavelength of light enhances the function of the stem cell, increases oxygenation, regulates the immune system, boosts mitochondrial function, delivers increased blood flow, which is essential for oxygen because the lack of oxygen is disease, right?
Inflammation, reduced oxygen, you have a disease start.
So each of these layers adds to each other and has its own clinical benefits in and of itself.
And that's what I call the multi-layer treatment that I've developed that we did with you and that we do.
dave rubin
So I know people may sound, may think this is crazy, but I walked out of your office and my knee already felt better and my shoulder absolutely felt better.
And I was walking on the beach the next day.
Yeah, I had a little limp still, but I genuinely can't believe it.
And just to give people a little bit of the timeline on this, we did the procedure on April 10th.
A month later, you were texting me for a while, just checking in with me.
But about a month later, you were like, you know, when are you going to play again?
And I was like, what do you mean?
Like, I don't think I can play for months.
And you were like, no, you could probably start testing it out.
And by the end of May, I was playing five on five full court, which I'm still doing, as hard as I've been playing.
I'm not 25 anymore, but it's still something.
How do you even, how do you even have the confidence to say to somebody that had the amount of terrors that I had and everything, oh, okay, I don't need to see again.
You just tell me how you feel and just get out there and let's see what happens.
dr richie striano
Well, remember, I have the clinical data on over a thousand knee joints.
So I see through orthopedic scoring the improvement at different points and different benchmarks in time.
So a large amount of cases improve within the first seven to 10 days.
The second part is I become a concierge doctor to every patient I treat.
So you have access to me literally seven days a week.
You know, I want to do this.
Is that okay?
Because I want to ensure your best outcome.
So, you know, I don't love them and leave them.
I'm a pain in the ass maybe at times, but I stay with everyone because the case personally, that's just who I am.
And so within the first seven to 10 days, we typically see improvements, some overnight, like Tony Robbins described in his book.
And it could take longer.
So the thing to understand is it's a bell curve.
If a patient takes longer to begin to see the benefit, that doesn't mean that their ultimate outcome won't be in the 85th or 90th percentile.
It takes longer.
That's okay.
There's biological plateaus where patients plateau.
They don't feel they're getting any better again.
And then there's another boost.
We don't know why, but I see that plateau with myself, colleagues across the field, even though they don't do what I do, but colleagues across the field, it's a biorhythm of some sort.
It's just unexplained, but it takes place.
dave rubin
And so six weeks later, I'm on the court.
I'm doing what I did before, which was I wrap my knee in an ACE bandage.
Basically, I wear a compression sleeve on my knee and I'm wearing the brace with hinges.
And I tell you, I'm going out to play, and you said, great.
And then I came back.
I texted you.
I said, I played pretty well.
I'm out there again.
And you said, get rid of the, get rid of the brace.
And I was like, there's no way.
I've been playing with this thing for 10 years.
Anyway, for a month or two, even though you told me to get rid of it, I still played with it.
I just couldn't.
I couldn't let it go.
It was like my safety blanket or something.
Finally, two weeks ago, I got rid of it and that's gone now, too.
I mean, I've been using that thing for over a decade.
It's just incredible.
It's not even a question.
I'm just telling you, it's just incredible.
dr richie striano
You know, I see this with some of the pro athletes I've treated, you know, astronauts who have to go through physical function testing.
So the point is, I want you to test the stability, right?
And then I'm with you right afterwards to make sure the residuals aren't severe.
And then based on the aftermath, we step it up, right?
And then we play every three days or maybe every two days or, you know, instead of three hours, an hour and a half.
At first, I think we were shooting baskets.
unidentified
Yeah.
dave rubin
Yeah.
No, we went.
We did just some shootarounds first and then a little half court and then eventually full court.
And now I'm running as hard as I can.
dr richie striano
And I must admit, you were amazing.
I think you shot four, you know, swishes in a row from a good distance.
dave rubin
That's my doctor right there.
He's the shot doctor.
dr richie striano
Yeah.
dave rubin
So it's great because I can see that none of as surprising as all of this has been to me, this whole process.
Again, I never thought I was going to play again.
That's how bad the pops and the terrors were.
I told you a guy that wasn't even playing, who was off the court, was screaming because how loud the pops were.
To you, none of this is surprising.
This is basically what you do.
So what do you want to happen now to make stem cells kind of scale?
Like when you mention stem cells to people, everyone says this, well, how much?
How much did it cost?
Because obviously there is a cost that, you know, you can do PRP for, I don't know, 850 bucks.
You can do some other peptide things that are obviously going to be cheaper if you're into some of this alternative stuff.
The cost is still there.
What do you need to happen?
And I know you're opening a clinic now down in Stewart, Florida, not too far from us.
Florida's also changed some of the rules just in the last couple of weeks as it relates to stem cells.
So we're leading on that too.
We lead on an awful lot here.
So maybe you want to talk about some of those rules.
But what do you need to happen so that this can become more of a household procedure instead of people just getting that cortisone shot and feeling like they're okay, even though they've actually, as you said, not really fixed anything?
dr richie striano
Right.
So let me just speak to one point, which is that the financial part hurts me because only wealthy patients can get treatment.
And that kills me.
I hate turning people away because there's something they need that will change their quality of life, but they can't pay for it.
And so what I've done as an example with the 9-11 firefighters is developing a program to help these guys because their lungs are shot and the disabled veterans, because they're largely ignored, obviously they've got orthopedic issues off the charts and they can benefit from stem cells.
So the first thing is in joining and going into this clinic in Stewart, my rule is that I'm the director of the program in my niche of stem cells.
So now I can reduce pricing.
I can change pricing.
I'm not, you know, at the mercy of what the clinic wants to charge, right?
Some of these clinics, you know, I know a clinic that charges $45,000 just to do an intravenous of the same thing you got.
And, you know, without orthopedics.
And, you know, I think that's insane.
So the bottom line is now I can help patients afford treatment more.
You know that anyone that talks to me from you gets a huge discount on the cost of their stem cells.
And so what I really want is for everyone who needs it, this is my mission to make people move.
Movement is life.
And if you can't move, you can't live, right?
I don't care who you are.
And so that's the mission.
I'm now joining a clinic where I can participate in the financial aspects of more people get it.
And the problem in the U.S. is that it's the Wild West.
You go to a weekend seminar.
The next day, a dentist or, you know, a radiologist is doing stem cells because they can make a lot of money doing it.
And they buy frozen umbilical four tissues through the mail, which is not allowed.
And when I was on the board of the Orthopedic Foundation, Cornell, Texas AM, we tested all of these tissues in independent labs.
They're all dead, DOA.
And so that's another big issue, whether you have viable stem cells to begin with.
The second thing is, is the doctor experience, you know, like if you're going to get a robotic procedure, you want the guy that's on board in a thousand, right?
So, you know, I came home from a weekend course.
He's never studied interventional ultrasound.
They don't use imaging.
He hasn't studied advanced injection techniques.
So the second part of it is when patients come to me, you know, Doc, I did stem cells and it didn't work.
And then I got to go into the whole thing.
Where did they come from?
Who did it?
Did they do the ultrasound?
What kind of stem cells were they?
Did they come in the mail by Amazon?
Did he take them from you?
And then what was the technique?
How many injections did you get?
And how did he know where the needle went?
You know, you can't do an injection.
You know, I shoot in competition.
You can't shoot blindfolded and expect to hit a target, even though a blind squirrel gets a nut once in a while.
If you can use a high-powered scope, why wouldn't you?
And that's ultrasound.
So ultrasound and the advent of the approach and the stem cells were a paradigm shift in regenerative or so for somebody that's watching this that they don't have a bum shoulder, their knee is not blown out.
dave rubin
They've managed to make life work for them so far without any major things.
One of the other things that we discussed that I was surprised about is you guys are now finding all sorts of other benefits, cognitive and otherwise.
And that's partly why people are doing intravenous stem cells.
So should people be thinking about this more as preventative?
I mean, if you're just middle-aged and you basically feel okay, should you be considering stem cells intravenously once a year?
Should you be jumping in a hyperbaric chamber and recharging those batteries that you refer to?
I mean, again, there's a cost, obviously, but if everything being equal, is this something that you do once a year?
Do you hop in the hyperbaric chamber?
Do you inject yourself, et cetera, et cetera?
dr richie striano
Yes.
Well, I have someone else do it, but, you know, like a knee joint, I'll inject my own knee.
So here's the issue.
And I'll be quick about this.
The change in a joint begins with inflammation of the synovial membrane, the capsule.
It's called synovitis.
Once that's inflamed, it showers the joint with inflammatory cytokines.
These are like termites, and they begin to eat away at the cartilage.
They poke holes in it, and then that process begins.
When that starts, you can't see it, right?
It's not visible.
It's the very beginning of something.
And what happens is by the time enough cartilage is reduced, so you can see it on an x-ray and ultrasound, et cetera, it's already been there for up to four years, the inflammatory process.
Next, you look systemically.
So intravenous stem cells reduce systemic inflammation, which is the foundation for everything that goes wrong.
They enhance your longevity because they have an anti-aging benefit on the brain, tissues, and organs.
So one of the thought processes is, in terms of theoreticals, there's four major age-related diseases, right?
Cancer, cardiovascular, diabetes, and dementia, right?
Those are the four major guys.
If you're doing intravenous anti-aging and you're able to influence the pineal gland in the brain, which is your biological TikTok on getting older, and you're able to improve your cellular age, not your birthday age, right?
Your cellular age as your cell age, the mitochondria, all of that stuff.
So if you can improve that and increase longevity, think of an electric car, right?
It goes so far, and then its batteries run down.
Mitochondria, cellular energy, inflammatory, immunological, all of the pieces of that tie that are going to eventually cause you to die.
So if you're an electric car, after so many mileage, if you can recharge your battery like a car, would you go further?
And if you do go further, then would you completely avoid age-related diseases?
So this is the theory of longevity.
If we increase your health and increase your longevity, then you don't develop the major age-related diseases that we all look at as normal.
As you get older, you're going to get dementia, right?
As you get older, you know, you're going to have cancer somewhere or diabetes or, you know, cardiovascular disease because your arteries are going to accumulate plaque and, you know, inflammatory processes in your cardiovascular system.
Well, that doesn't have to be, right?
You can influence tissues and organs with stem cells.
We know that.
The doubters think, well, you know, that's impossible.
But when you publish and look at the amount of clinical studies, not mine, don't take my word for it.
Do your own research.
And you can see that the benefit of these stem cells in clinicalstudies.gov, looking at everything from Alzheimer's to cancer and everything else, this is the paradigm.
I believe the future of medicine is going to be biological.
dave rubin
So what would you say to someone who has the means?
And again, as this becomes more ubiquitous, obviously the costs will go down and some of the other things that you're personally doing on the cost side.
But what would you say to someone who's rolling into 50 years old in terms of, say, once a year, come get some intravenous stem cells?
Let's just keep everything on the up and up.
dr richie striano
Maybe every couple of years.
I don't think you have to spend the money every year.
You know, but it's like longevity insurance.
Depending on the cost, you break it down monthly.
It could be cheaper than, you know, your carpen.
dave rubin
Yeah.
I mean, sign me up, man.
Did we hit the basic stuff here?
I didn't want to overwhelm people.
You have a wonderful way of explaining some pretty complex stuff here.
Did we miss anything major?
dr richie striano
Well, just so you know, it's a multi-layered approach like a layer cake.
Each layer has its benefit to the overall taste of the disease, right?
So diagnostic ultrasound, interventional, adipose tissue cells, the full collection.
Then you have the calculation, hyperbaric, laser, aftercare coaching.
That's it in a nutshell.
dave rubin
And it works.
You can put that on your website right there in quotes.
It works because I'm playing again.
Dr. Striato, or as I call you, Richie, I owe you a tomahawk, my friend.
dr richie striano
Please call me Richie.
Thank you so much.
And it's a pleasure helping you.
I'm very grateful you invited me on your show and to help people take note of the fact that there is a way out.
And it's regenerative medicine.
You don't need to suffer.
dave rubin
And by the way, we should note that your website and your so your new clinic is opening soon and your website is drrichystriano.com, which we'll link to right down below.
dr richie striano
Right.
And the email, because it's being reconstructed, is drrichistriano at gmail.com.
And anyone contact me.
I do.
dave rubin
You're going to be a busy man after putting your email up on this show.
Good luck.
dr richie striano
Well, the bottom line is you can talk to me and contact me.
I don't charge.
dave rubin
Thanks, Doc.
dr richie striano
Okay, buddy.
unidentified
Waiting for the call to find out what draft pick I'm going to be in the doc.
dave rubin
How you doing?
All right, there we go.
Yeah, now I got you.
How are you?
unidentified
I'm doing right.
How you feeling?
dave rubin
I don't know.
You tell me.
How am I feeling?
unidentified
Actually, based on this, I would imagine not too better.
You'd be feeling a little bit better to know that, yes, you have a large effusion.
So you got a lot of fluid in there, which we saw.
dr richie striano
Yeah.
unidentified
However, all we see really is an MCL sprain and then inflammation of the ACL, the aspect of the ACL.
Now, you had a complete ACL tear.
How long ago?
dave rubin
It was 10 years ago in August, August of 2015.
unidentified
And it was a complete or partial?
dave rubin
It was complete.
And then when I, about four years ago, when I did PRP for the first time, they told me it was gone altogether, that there was nothing left in there.
Does that make sense to what you're seeing?
unidentified
Unfortunately, I only have access right now to an employee because the portal is down.
I can't see the images.
But based on what the radiologist is telling me, is there CNA single signal inside the ACL suggestive of sprain.
But what doesn't make sense is then it would be seeing a large number of fibers in the ACL.
And if you're saying that you had a complete tear to do the aberrated ACL, I wouldn't expect to get that kind of read.
dave rubin
And anything on the meniscus?
unidentified
No, no tear into the meniscus.
Really?
Yeah.
dave rubin
So, all right, so putting aside the ACL thing for a second, let's say it's either gone, which is what I thought, or it's just sprained.
So I could deal with either one of those.
So if this is just a sprain of the MCL, that makes sense to you relative to all the pops and the crunching.
unidentified
You'd be surprised.
MCL sometimes can be, you know, it can be very uncomfortable and you can be out for a bit.
Now the pops and crunches, it's always hard to say what that is.
Sometimes that could be bone on bone.
It could be sliding of the knee that you hear.
It doesn't necessarily mean that you have an absolute meniscus injury or bite care of a ligament.
So based on what we're seeing here, it's just a lot of fluid and MCL sprain.
So that's certainly good news.
dave rubin
Yeah, I mean, that's amazing.
And worst case scenario is I go back to not having an ACL, which is what I thought, or I do have an ACL that maybe we can do some therapy on or something.
dr richie striano
Correct.
unidentified
Either way, we can do some therapy.
It's going to be like, you know, with the MCL sprain, probably, you know, two to four weeks and then doing a little bit of therapy and hopefully you'll be back to playing ball and doing what you were doing before.
Oh my God.
dave rubin
I mean, I can't.
I'm shocked.
I'm beyond shock considering what it sounded like and everything else.
Oh man, this is great.
Thank you so much.
unidentified
Sure.
Just let you know my partner, Dr. Perez, be here tomorrow.
So I'll let him know and this way he'll aspirate your name.
dave rubin
Okay, awesome.
Thanks so much, Doc.
I appreciate it.
unidentified
You're welcome in.
dave rubin
Okay.
Bye-bye.
unidentified
Great.
That's amazing.
dave rubin
I mean, I don't even know what to say.
Actually, wait.
I'm actually kind of speechless.
Like, I thought probably I was never playing again.
Like, I really thought meniscus tear for sure.
This question about my ACL, which the other doctor, and I remember seeing the image four or five years ago, that the ACL was completely gone.
Now they're seeing it as a sprain.
I don't know what that's about, so we'll check the images.
But I really thought the MCL was like cut in half.
I heard it was like stepping on a bag of like popcorn with glass in it.
That's what it genuinely sounded like.
This guy James, who I play ball with, he's like, I've never heard anything like that before.
So he heard it.
He wasn't even guarding me.
He was standing by like the free throw, and I was underneath the hoop.
I'm so thrilled.
I don't even know what to say.
I'm actually, this is amazing.
And maybe a simple guy like me, 48 years old with a busted knee, still can be in the WNBA.
We'll find out.
unidentified
wow All right.
All right.
dave rubin
It is bright and early in the morning.
A beautiful day in the free state of Florida.
And we are driving from Miami to Naples.
We have just entered Alligator Alley, where they're not only alligators, but there's also Panthers.
That's true.
There was a Panther Reserve that apparently they closed.
And now there's Panthers just wandering around.
You've also got your snakes and your iguanas and other assorted animals.
There's also a Florida State Penitentiary and a Tesla charging station.
So anything could happen over the next couple hours, but we're going to get to Naples.
And we're doing some stem cells in the knee today.
I'm going to do stem cells directly in the knee.
Apparently, I'm doing them intravenously.
I'm going to be in a hyperbaric chamber, a whole bunch of stuff.
I've got a banged up ACL, banged up MCL.
Something's going on with some of the tendons in there.
It's a mess.
unidentified
But supposedly, this doctor is the best of the best.
dave rubin
And we're going to, as my friend said to me, it's pretty cool that, you know, in the old days, you'd either just get surgery or they would put something into you, right?
Like they have to put some kind of medication into you or put some kind of fake knee or something.
And now you can use your own body, your own stem cells, which come from your fat, to repair yourself.
So pretty cool.
And we'll see if we make it.
unidentified
Uh-oh, Panther, Panther Alert, Panther Alert.
dave rubin
That was Joe.
That was Joe.
No Panther story.
unidentified
Wait.
dr richie striano
Are you the madman?
dave rubin
How you doing?
unidentified
How you doing?
I'm doing well, man.
dave rubin
It's pleasure, Striano.
This is Joey and Joseph.
dr richie striano
Nice to meet you.
unidentified
Nice to meet you.
dr richie striano
They always say different, you know.
You know, every monster comes from an egg.
And that's where you want to kill them.
So just like they said.
dave rubin
Well, I think the monster's been released here already.
So this, I think we're still in the egg.
dr richie striano
Well, they're saying your meniscus isn't torn.
unidentified
Yeah.
dr richie striano
That doesn't mean it doesn't have small defects.
unidentified
Yeah.
dr richie striano
You know, like if a pebble hits a windshield, you get a little spike.
unidentified
Yeah.
dr richie striano
And then it begins to spread over time.
So you want to seal it at the beginning, even though it has some dumb image.
unidentified
Well, it actually in the last two days has been bothering me a little bit more than it was.
dave rubin
I think I probably pushed it a little too far walking around the world and whatever.
dr richie striano
So we'll put that up here.
Okay.
unidentified
See what happens.
dr richie striano
Okay, so quick explanation about diagnostic ultrasound.
So an MRI gives us a view up on high.
It could tell us there's a tear in the meniscus, a rotator cuff tear.
With ultrasound, we can zoom in right up close and personal and see the individual fibers that make up the tissues, which are like strands on a rope.
It's called an extracellular matrix.
dave rubin
So I will tell you one other thing.
So right now, even when you were touching right now, so that hurts more on this side, for sure.
But when it first happened, it mostly hurt here.
And what I've noticed, I said to you in the last couple days, it's been hurting more, and it's more in the back.
dr richie striano
So you're describing the sum of all parts.
dave rubin
I guess so.
dr richie striano
Right.
dave rubin
And I've noticed my kneecap feels a little loose, maybe, or something like that.
Yeah, but it's crazy.
It doesn't look.
unidentified
I mean, it looks pretty good, right?
dr richie striano
Yeah, I've got nice looking legs.
dave rubin
They always said you have great knees.
dr richie striano
There you go.
I brought some spare parts in case.
dave rubin
Oh, in case we need to get it.
dr richie striano
Just in case this doesn't go well.
So here's a normal one.
dave rubin
That's the bang up.
dr richie striano
And my name is actually Dr. Smith, Justin.
dave rubin
Oh, yes, got it, got it.
In case anything goes horrific.
dr richie striano
So I'm just going to start looking inside your joint.
Okay, so I'm just going to give you a quick explanation here while we're on.
Okay, so this is subcutaneous fat here.
This is part of the tendon.
These are the muscles leading to your kneecap, which is right here.
This is your femur, your leg bone.
This dark area is the joint capsule.
It comes actually above the knee.
There's no ultrasound image down here because ultrasound doesn't penetrate bone.
It's like sonar.
It goes down, bounces off, and returns the signal to my probe.
Right here, you can see these individual strands.
That's the fiber network, the extracellular matrix that makes up this tendon.
So you see how this is nice and homogeneous, evenly grayed down through here.
And then right here, there's a little black spot.
That's a couple broken threads.
That area probably measures not even a half a millimeter.
unidentified
Wow.
dr richie striano
But we can see it.
So we're going to explore these tissues.
So these guys are broken up where they attach to your kneecap, your patella.
So right away we know that's an issue.
dave rubin
That's probably why I'm feeling this weirdness in my kneecap.
dr richie striano
Well, we've got to fix it.
Right?
You see these little teeny holes in there?
Is that normal?
No.
Is it torn?
No.
Is it cracked?
Yes.
It's even bulging a little.
unidentified
See?
dr richie striano
Okay.
I'm going to lay you down.
I just want to look at your hamstrings.
unidentified
Yep.
dr richie striano
And then we're done with your knee.
dave rubin
Right.
So that's what you're looking at this right now.
dr richie striano
Yeah, the back of the knee.
Yeah, hamstrings are important.
dave rubin
Right.
dr richie striano
especially because you run and jump.
So right here, underneath your hamstrings.
I'm going to tilt that.
So this is the back of that ball.
Right?
This is cartilage.
And now here comes your hamstring.
Look at all this junk.
This is below it.
Right?
So subtendinous inflammation interruption of the normal echo texture, the normal view of what these tissues should look.
unidentified
Yeah, that way it feels totally fine.
dr richie striano
This is the bicep tendon.
Right?
So you're actually watching all of that slide under a bone and make sure it doesn't get stuck or bunch up.
There's a fancy name for this guy, corporate process.
unidentified
Right, so I feel it.
dave rubin
I don't feel it at all when I go this way.
unidentified
I feel it more when I go out.
dr richie striano
It's called a unidirectional instability.
And that's a series of ligaments.
So you see the tip of that supraspinagus, but it's intact.
It's there.
It's just in trouble in here.
So all this means is there's some fraying going on.
And you just want to get that, you know, when a patient says, you know, I was fine, I reached behind my seat and then it snapped.
But the rope was fraying, like when you see someone hanging off a cliff in a movie.
Until finally the last triangles and it's the death dive.
All right, so we're set.
So now the good part comes.
So with a fluid that contains lidocaine and anesthetic, we're going to take some fat out.
Not a lot, so you're still going to look the same.
unidentified
Do a little video counting.
dr richie striano
And then there's this amazing technology that is now legal in the U.S. where with this time machine, it can take all of the cells out of fat and leave that reef intact so that we can distribute it systemically for all the benefits I explained, as well as in direct injection into all of these tissues.
So there'll be a bunch of little injections.
It's not that they hurt.
We're going to raise a little lidocaine.
We don't put the lidocaine where we put the cells because lidocaine is cytotoxic.
So that's also an issue when people get stem cells and they say it didn't work.
You know, did the doctor fill it up with lidocaine?
And, you know, like the pool, and then put the stem cells in the pool.
unidentified
Right.
I've got a pretty good threshold, so I'll be okay.
Yeah.
dr richie striano
I put them in, then I killed them.
I did great, but you didn't get it.
Sorry.
unidentified
You're right.
Oh, so that's the Up to three atmospheres.
Wow.
dr richie striano
This is like what's in the hospital.
So you lay in the tooth.
unidentified
Yeah.
dr richie striano
We can harass you.
You can't get out.
unidentified
You can watch Fox whenever you want.
And you lay.
dave rubin
I'm going to put on MSNDC to really get my juices full.
Will that help in anyway?
Maybe we just put the view on.
Just see what happens.
dr richie striano
Oh, they're smart as hell, aren't they?
I can't even believe people watch that crap.
dave rubin
I think I know the red doctor.
dr richie striano
You relax.
And this is going to supercharge you.
So hyperbaric is oxygen therapy.
That's what it's all about.
That's why it helps heal wounds and all of these other things.
So this is going to drive oxygen in everywhere right after we put the stem cells in and circulated them to recharge your body.
unidentified
Now we're going to dump them with oxygen.
dr richie striano
And they're all going to be like, wow.
unidentified
Wow.
Alright, so basically what we're going to do is we're going to extract your own stem cells from your plant tissue.
Okay, so what's going to happen is I'm going to make two little incisions on the back, just small little incisions.
It doesn't require a stitch or anything.
I'm gonna put some nomen medication on it.
We're gonna wait a few minutes.
And then with a very small cannula, I'm going to aspirate manually your fat.
Okay, after that, we're done.
I'm gonna take about an hour and a half to put your article tissue into a centrifuge and they're gonna incubator and basically gonna activate those stem cells.
So I'm going to start putting the local anesthetic in here.
If you feel a little discomfort, it's gonna be very momentary right now.
Okay?
But it should dissipate really quick.
So let me know how you're doing.
I don't feel anything.
Good.
Tiny bit.
Tiny bit.
this is really the most discomfort you're going to feel okay Good.
So if you want to look at this, he has two tiny little.
That's all it is.
Oh, that's it?
That's it?
That's all he got.
Two tiny little marks.
See, it's nothing real here that you can tell much, other than you know, a little bit of swelling.
Obviously, you have the local anesthetic in there, but it's almost nothing.
And those two tiny little holes still close up.
It's comfortable like this.
A little tiny touch, too.
Yeah, that's how you turn it up.
Okay, that's good.
Okay.
Perfect.
Got it.
dave rubin
I've never felt slimmer.
I didn't know I was getting a tummy tuck, also.
unidentified
You're looking good.
Yay!
Well, those are spanks.
dave rubin
That was definitely worse for you than it was for me.
unidentified
Oh, it was pretty brutal looking at that.
dave rubin
Yeah, you can't even have no idea what she was doing, really.
Just feeling some pushes.
dr richie striano
Good thing she knows.
unidentified
Yeah, I guess she does.
dr richie striano
Yeah, your machine does.
unidentified
An activator.
It's all gone in the incubator for 50 minutes.
dr richie striano
Go down.
There you are.
See you.
Inject.
Film this, dear.
unidentified
Okay.
Only no deeper than this.
No, you're good.
dr richie striano
Fire away, see?
unidentified
A lot of pressure?
dr richie striano
Yeah.
dave rubin
It's not even that it's so painful, it's just it's like intense pressure.
You're just not used to like pressure.
unidentified
But it gets better, right?
dr richie striano
Yeah, not John Flora.
unidentified
I'm worse than that.
I can't see, so you don't know how much.
Sorry.
Are you there?
dr richie striano
I am.
unidentified
And come under the crow.
A little more.
dr richie striano
Perfect.
unidentified
Inject.
Maybe half a minute.
Yep.
dr richie striano
Right there.
unidentified
Look at that.
dave rubin
I feel right.
I feel right.
unidentified
I've got my pink knee sleeve.
My pink thing here.
Oversized shirt, big shorts.
dave rubin
It's nice knowing all of you.
unidentified
If you want, I can...
I'm a little closer.
So what's happening right now is I'm going into this machine And there's an avatar of me that's on a planet called Pandora.
And I'm going to live with the natives, get to know their ways, and eventually lead my people into destroying.
Well, I probably said too much.
Okay.
Let's see on the other side.
dave rubin
Hey, well, now what are we doing?
dr richie striano
Nothing.
You get out of my face.
unidentified
That's it.
dr richie striano
You're done.
unidentified
All right.
dr richie striano
You've got.
dave rubin
Yeah, I got a little.
unidentified
Wait, I was about to say I got a little bit.
dr richie striano
Oh, I'm going to work on it.
dave rubin
Yeah, I was about to say I have a little more motion.
I thought I did when I put my shirt on, but maybe that.
unidentified
Just sit up a second.
dr richie striano
Just go to raise your arm again.
dave rubin
Oh, wow.
unidentified
More round.
Wow, you know what you're doing.
Look at that.
That's crazy.
It's like magic.
dave rubin
Wow.
unidentified
How'd you do that too?
dr richie striano
You're a comedian?
I'm a magician.
Yeah, don't really do it.
unidentified
So he is licensed.
We literally have to learn how to do it.
dave rubin
Look at that.
unidentified
You went like, oh, yeah, and now you're able to literally.
Alright.
dr richie striano
I could have sent him home with one wing, but then he'd be swimming in circles.
dave rubin
They told me I can't swim for a couple days anyway, so that's alright.
unidentified
Is there anything I need to know about resting or anything?
So now I'm moving, it's just like I gotta just wait till I feel better and then I can just do your thing, normal activity only.
Yeah.
dr richie striano
And that's fine.
unidentified
Yeah.
dr richie striano
So just for a few days, just normal activity.
Tyler and all of you have pain.
unidentified
Yeah.
dr richie striano
No end set yet.
dave rubin
I mean, I was not, when I came in this morning, I was not putting my leg fully straight like that because it was hurting in the back.
unidentified
It's completely fine.
dave rubin
That seems crazy.
It's crazy.
dr richie striano
Crazy looks crazy.
unidentified
That's nuts.
dave rubin
How could that possibly be?
dr richie striano
It can.
unidentified
Wow.
dr richie striano
Well, again, you know, we treated all of the structural tissues that had trouble.
unidentified
Yeah.
dr richie striano
Not just one shot and go home.
unidentified
Yeah.
Wow.
dave rubin
Do you think I could really play in a couple weeks, probably?
dr richie striano
Hell yeah.
unidentified
That is nuts.
Thanks.
I have some more pleasure.
Wow, this is unbelievable.
Because my plans really took care of me.
dave rubin
Alright, guys, this is a super exciting day for me.
I'm about to get back on the basketball court basically for the first time since mangling my knee.
That was the end of February.
Today is May 16th, so it's only a couple months later.
And at the end of February, I was playing ball.
You guys know the story.
I came down at the end after playing about three hours on a layup, crushed my knee.
I heard pops, cracks, crinkles, crunches, like glass and popcorn as if you stepped down in a bag.
There was a guy that wasn't even on the court who was like, holy cow, did you hear that?
It was terrible.
I thought I was never going to play again.
Anyway, that was the end of February.
Then on April 10th, I went and I got stem cells.
It was really, really an incredible procedure where they took fat from my back, they spin it in the centrifuge, do all kinds of stuff.
I had about 15 tears, like micro tears in my knee.
The doctor directly injected each one, Dr. Richie Striano, who's like a revolutionary in the industry, and we're going to do an interview with him.
We did it there.
Turns out I also had a big tear in my shoulder from something else.
We did it there.
My arm's working.
Look at that.
I got an arm that works.
My arm was only going up to here.
Try playing basketball when you can only do that.
Try picking up kids when you can only do that.
Anyway, now today is May 16th.
So just about five weeks, barely five weeks after I did the stem cells.
And I've been working out a little bit.
I did play a little two on two, which probably wasn't the wisest thing to do two weeks ago, but it was kind of slow motion.
But today we're running some drills.
I'm going to run some drills with Joey, who works for me, who's a hell of a player.
And then two days from now on Sunday, I'm going to play 5 on 5 full court again.
And we just wanted to track this entire thing because the idea that you can seriously rip a lot of stuff in your body and then heal it with your own body's stuff.
No surgery, no medication, none of that stuff, is pretty awesome.
So had to bust out.
Got some new sneaks, got some new kicks for this.
I'm a Jordan guy, old school.
These are beautiful.
These are beautiful if we're doing it.
I'm an unboxer too on YouTube now.
So these are the new kicks I'm very excited about.
Got to get some new sneakers for when you make the return to the court.
And then even though technically my knee should be as strong as my other knee right now, I am a little nervous.
So I'm going to do the same routine that I normally would do if I was playing beforehand because I had a bit of a weak knee before from some other basketball injuries.
So I wrap this baby.
And then I have a sleeve, which this is just kind of adds a little compression to it.
The company, as you can see, is Mick David.
No relation to me, half McDonald's, half David.
unidentified
There you go.
dave rubin
So we do that.
So that's pretty tight already, and I'm sure I'd be fine.
But just because we're taking all the precautions, I bust out the titanium.
What was Wolverine's claws made out of?
Admantium.
That's what this is made out of right here.
unidentified
Little Admantium over there.
dave rubin
Get that baby on.
Oh man, it's been a while.
I miss this.
I really miss this.
And again, I really probably don't need this stuff, but we're going to at least go with it for today.
Then we'll try out the new kicks.
unidentified
All right.
Notice I do the double, the double loop when I'm tying my shoes.
All right.
dave rubin
We got shoes.
We got a knee.
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