Performance Medicine Isn’t Just for Athletes

Advanced testing is easier than ever to obtain. The real challenge is turning those results into better health, strength, and longevity.

I see a familiar pattern. A patient comes in having already done the testing elsewhere: a DEXA scan, a VO2 max assessment, a full lab panel, maybe a movement screen. They hand me a folder, or more often a PDF, full of numbers. Bone density by region. A VO2 max in milliliters per kilogram per minute. Grip strength. A dozen biomarkers flagged high, low, or borderline.

Then I ask the obvious question: what changed after you got these results? Most of the time, the honest answer is nothing.

This is not a knock on the testing. Advanced diagnostics, including DEXA scans, VO2 max testing, and comprehensive laboratory analysis, have become far more accessible over the past several years, and that is a genuinely good development. The problem was never the data. The problem is that testing has been treated as the destination, when it is actually the starting line.

Testing Is No Longer the Differentiator

A DEXA scan, a VO2 max test, and a comprehensive lab panel are not rare or exotic anymore. Performance labs, longevity clinics, and even some gyms now offer versions of all three. Throughout the Bay Area and beyond, advanced testing has become widely available, making the testing itself far less of a differentiator than it once was.

What is not being commoditized is what happens in the weeks and months after the results come in. That is where I’ve chosen to put my attention, because it is where outcomes are actually made or lost.

A Number Is Not a Plan

A VO2 max of 34 tells you where someone’s aerobic capacity sits relative to age and sex norms. It does not tell you which zone 2 protocol will move that number, how many sessions a week are realistic given their travel schedule, or how to progress the plan without provoking an overuse injury three weeks in. A DEXA scan showing low appendicular lean mass tells you a person is at risk for the kind of sarcopenia that erodes independence and shortens healthspan decades later. It does not build the resistance training program, coordinate it with a healing shoulder, or make sure the person actually shows up to session six.

Interpreting a result is a clinical skill. Turning that result into a program someone will actually follow, one that accounts for their injuries, their calendar, and their tolerance for discomfort, is a different skill entirely. Most testing stops at the first one.

Where the Follow-Through Actually Happens

At CrescendoMD, when someone comes through performance testing, the result is the beginning of the conversation, not the end of it. I work directly with the trainers, physical therapists, and other specialists a patient is already seeing, or connect them with professionals whose expertise matches what the testing reveals. If a movement assessment turns up a hip mobility deficit that is limiting squat depth and loading the lower back, that finding goes straight to the person coaching their lifts, not into a file. If a VO2 max result calls for a structured aerobic base-building phase, I want to know what the actual weekly plan looks like, not just that “more cardio” was recommended.

I stay personally involved in that loop. Not as an occasional check-in months later, but as someone tracking whether the plan is working, adjusting it as new data comes in, and staying in direct contact with the trainers and therapists doing the hands-on work. That is a meaningfully different model from ordering a panel of tests and reviewing the results once a year.

This Is Not Just for Elite Performers

None of this requires being a competitive athlete. A background in performance training applies just as directly to a 58-year-old rebuilding strength after a knee replacement, or to a busy executive whose travel schedule has quietly eroded the fitness base they once took for granted. The tools, movement assessment, structured programming, and measured progression are the same regardless of the starting point. What changes is the goal, not the rigor. Performance medicine is ultimately about improving healthspan and preserving function over a lifetime, not simply optimizing athletic performance.

What This Looks Like in Practice

In practice, this means testing is ordered with a specific clinical question in mind, not simply to generate more data. Whether the assessment includes DEXA, VO2 max testing, movement analysis, or comprehensive laboratory evaluation, every result is intended to guide a meaningful intervention. The findings are translated into an actual weekly plan, developed in coordination with the trainers, physical therapists, and other professionals already working with the patient, or with new specialists brought in when appropriate. Progress is monitored over time, adjustments are made as strength, fitness, and health evolve, and I remain personally involved throughout the process rather than handing off interpretation and follow-through after the initial review.

Good testing deserves a plan that matches its quality. A number without a follow-up plan is just an interesting fact about yourself. The value isn’t in knowing your VO2 max. It’s in what happens the Monday after you find out.

Dr. Schraga is a concierge physician at CrescendoMD in Portola Valley, California, and a Certified Strength and Conditioning Specialist (CSCS). He specializes in performance medicine, longevity medicine, and concierge primary care for individuals and families across the San Francisco Peninsula, including Atherton, Woodside, Menlo Park, Palo Alto, and Los Altos.