The story below is from our July/August 2025 issue. For more stories like it, Subscribe Today. Thank you!
With expertise in sports medicine and joint care, Dr. James Farmer combines advanced surgical techniques and noninvasive therapies to help patients regain strength, mobility and long-term wellness.

Courtesy of Dr. James Farmer
Dr. James Farmer
Dr. James Farmer’s path to orthopedic surgery began with a fractured face — and an unexpected detour. “I started college as a business major disguised as a wannabe baseball player,” he says. “That dream ended when I fractured my face in practice.” The injury led him to change course, switching his major to physical therapy. After earning his degree, he served in the U.S. Air Force as a physical therapist — until a torn ACL during intramural sports pushed him once again. “It was then I decided to continue my education to become an orthopedic surgeon.”
Now, nearly 17 years into practicing in Roanoke, Farmer says he finds purpose in seeing people regain function and return to active, fulfilling lives. “I have had the privilege to serve as the team orthopedic surgeon for many local sports teams throughout my nearly 17 years in Roanoke including Virginia Tech, Roanoke College, Salem High School and the Salem Red Sox.” He adds, “I’ve also gotten to know thousands of patients and their families. In many cases, I’ve treated three generations — the young athlete, their parent and even the grandparent. Seeing people regain function and return to a quality lifestyle is what continues to drive my passion for this profession.”
Being recognized as a Top Orthopedic Surgeon, he says, reflects more than just personal achievement. “In life, team and individual sports, there are always others who help you achieve your goals. Our practice is the perfect example.We could not be recognized for the outstanding care we give our patients without a great person behind the desk, on the other end of the phone, taking X-rays, assisting patients in the clinic and making the office run smoothly.”
Farmer credits his wife and business partner Sheila Farmer as a major contributor to his success. “Our practices are synergistic and we complement each other in so many ways. To be recognized as a top provider is a great honor, which means we’ve achieved our goal of providing compassionate, competent and valuable care — or as our slogan says, ‘Sparking better living.’”
At Ignite Orthopaedic & Wellness Clinic, Farmer blends surgical expertise with a comprehensive approach to long-term wellness. “We strive to provide people with the tools to empower them to live healthier lives free from big pharma, but when necessary to provide them very effective and oftentimes cutting edge medical treatments and surgical solutions,” he says. The practice focuses on root causes like poor nutrition, hormonal imbalance and lack of physical training. “We start with treatments such as orthobiologic injections or shockwave therapy along with physical therapy to reduce pain, inflammation and promote healing. At the same time, we address the role of nutrition, gut health and when appropriate hormone optimization to provide long-term wellness benefits.”
Hormone optimization, he says, is another area that’s changing lives. “We’ve seen benefits in overall health, quality of life and disease prevention such as cardiovascular disease, osteoporosis and dementia.” While many providers remain hesitant due to the historically inaccurate conclusions of the Women’s Health Initiative study (which were later retracted), Farmer and his team are educating patients and providers on the safety and effectiveness of bio-identical hormone therapy.
As a sports medicine specialist, Farmer has seen many advancements in the field of arthroscopic management of knee, shoulder and hip injuries, and is especially excited about new tools and technologies in the field. “We can return most athletes back to their original level of performance, whether it is with surgery or nonsurgical treatments. In the field of general orthopedics, I am excited to offer robotic assisted total and partial knee replacements. This has been a very effective tool for the treatment of end-stage arthritis.”
Biologic treatments like platelet-rich plasma and umbilical cord–derived tissue are another frontier, using biologic treatments to promote tissue regeneration, healing and fighting inflammation. “These promote healing, reduce inflammation and are used in joints, soft tissue and even intravenously. Our shockwave therapy machine is the same used by many college and professional athletes.” Ignite also offers breakthrough infusion therapies for mood disorders, PTSD and chronic pain.
One myth Farmer would love to dispel? That orthopedic surgery always means surgery. “We all can’t bench press twice our body weight,” he jokes. “But seriously, not all orthopedic surgeons rush to operate. I try to exhaust all non-operative treatments unless surgery is necessary as the first treatment.”
Outside the clinic, Farmer keeps moving, usually alongside Sheila. “We enjoy time with family, being outdoors and exercising,” he says. The couple owns Catawba Equestrian Center and finds stress relief in the daily routines of the barn. “Being around horses is so therapeutic and helps ease the stress of owning and running a medical practice. We love living and working in Roanoke.”
The story above is from our July/August 2025 issue. For more stories like it, Subscribe Today. Thank you!