It’s just after noon on the day of All Hallows Eve and I’m just getting ready to put the finishing touches on the Halloween decorations at the front door. Though we have no kids of our own (unless you count our “hairy children”), we love giving stuff to the kids who come around to play Trick or Treat. We get a big kick out of it and it’s become one of our favorite holidays.
 
This has always been a special night for us, especially here in this gated community. It’s a riot to see tiny little children, all decked out in teensy little Batman or Superman outfits, or draped in a ghostly sheet with strategically placed eye holes, come up to the front door with their candy bags, full of treats. 
 
The really little ones are often driven up to the front door by their parents, in golf carts decked out in spider webs and orange and black. Gangs of the older ones come by later, some in minimalist costumes, others really elaborate regalia.
 
A couple of years ago, a beautiful girl who had to be seventeen or eighteen came up dressed as Queen Nefertiti, floor length golden lame pleated dress, gold pectoral, golden sceptre and flail, and a tall, cylindrical, flat topped white crown of northern Egypt–just stunning. My wife had to remind me that she was young enough to be my GRAND daughter.  Killjoy! 
 
For our part, we have the walkway to the front door lined on either side with electric holographic pumpkins, that bathe the walk in eerie orange light. On the right is a near life-size whimsical witch, riding a broom, with a peaked black broad brimmed hat, right out of The Wizard of Oz, carrying a bag with a black cat and a little pumpkin in it. On the left, a five foot tall dancing skeleton, in a black pin striped zoot suit and hat, that sings a repetoire of rock tunes. In the center, a skull shaped bowl full of goodies on a pedestal, with a skeletal hand that jumps out, if someone takes a treat. Should be good for thrills and plenty of laughs.

This year, we got a ton of candy and other truly horrible non-nutritious treats for the little demons (hey, c’mon– your only a kid once, right?).  Nothing worse than running out and then some little waif comes up and you have to scramble to find something to give ‘em.
 
Now I have to go get a replacement spotlight at Home Depot to highlight the skeleton. The other spot, on the witch, is still working, though. So, we’re almost ready for the onslaught. Most of them will show up after the Annual Halloween Party at the golf clubhouse. Then, we’ll start to see the pale ghostly lights of the silent golf carts making their rounds.
 
It all reminds me of Halloweens of years past… 
 
I remember trick or treating in my old neighborhood, as a kid back in Brooklyn, on 88th Street. Hoboes were in fashion then, as costumes, together with mummies, vampires, ghosts and Frankenstein’s monster. Costumes then were all hand made. The neighborhood was all rows upon rows of attached homes, on both sides of the street, so we could walk between 3rd Avenue and 4th Avenue, going from door to door, on our own street and collect quite a haul. Usually made ourselves sick, eating all that crap, but hey, you’re only young once and it was great fun.
 
During my years in practice, every Halloween, Mike, one of the Anesthesiologists, would always dress up, in full costume, no less, to put patients to sleep. It became a tradition at the hospital and the patients, especially the kids and their parents, loved it. He made everyone smile and took a little of the tension out of the sterile OR setting. Then, he’d go on rounds in the Pediatric Ward– the kids were always thrilled. It spread a little happiness to children trapped in the hospital on this “kids’ holiday.”
 
One year, he came in dressed in drag. He even shaved his moustache for the occasion. That was a scream. We all got a great kick out of Mike. It was such a great get-up that he had to go around to all the nursing floors, the ICU and CCU, and even the Physical Therapy Department (where a number of my patients were being treated with the forerunners of the exercises I teach today in my PAIN-FREE PROGRAM at http://drbillsclinic.com/exercise_eliminate.html ).  Funny thing was, he made a damn good looking woman(well, except for the hairy chest…)!
 
So, now the sun is getting high in the sky. In just a few more hours, it will finally set and our streets will soon be overrun with the goblins, ghosties, ghoulies and things that go bump in the night. They’ll be free to plunder our little “village,” once again…. So Happy Halloween, my friend, to you and yours!
 
Just think, in a little over three weeks, it’ll be Thanksgiving! It goes so fast, now…cherish each day while it’s here. Til next time…
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

I started my practice in orthopaedic surgery as an employee of a group practice in the summer of ’79.  While I was in my fellowship training, I truly had no idea where I was going next. I always believed that the right answer would just “show up.” I don’t know if I was just being open to the Universe, or I was just too lazy to make solid plans. But I just had no idea where I wanted to go.
 
I considered staying in Boston, where I thought and still do think that Medicine is practiced at the very highest levels. But, I also wanted to return to New York, which was home. I just believed something would eventually turn up. I had faith that it would.
 
Meanwhile, I continued with my duties as an Aufranc Fellow at the New England Baptist Hospital. I was happy there. We were doing cutting edge clinical research on joint replacements and the treatment of their failures. It was a stimulating time to be in joint reconstruction, a revolutionary time, and I was fortunate to be standing by the side of some of the greatest orthopaedic surgeons of the day–masters of their art and acknowledged authorities in major joint reconstruction.
 
Cross fertilization of ideas and an academic environment, dedicated to the highest ideals of Medicine and Surgery, it was a heady brew for a young and idealistic surgeon, I can tell you. I had nothing but the highest regard and admiration for all my teachers, not only as physicians and surgeons, but as humanitarians and people. It was like being in a think tank, with guys who practiced the ideals of the19th century, together with the science of the 21st century. These were not only teachers, but models of how the physician should behave.
 
I admit, I bought it all–hook, line and sinker, as they say. I was prouder than I could say to be a part of it all. I was so wrapped up in the whole mystique of training at the Baptist that I rarely even thought about what comes next. 
 
Then, one day, I read something that said they had no fellowship trained joint surgeons in Southampton, Long Island. Well, it wasn’t The City, or Boston, but it WAS in New York, so what the hell… I thought I’d go see about it. Well, I first met with the Hospital Administrator in Southampton Hospital. Even then, I was aware of the area’s reputation as a playground for the rich and famous. Of course, what I DIDN’T know was that those rich and famous people didn’t stay in Southampton for their health care. They went into New York City, by and large.  It was impossibly naive, but hey, I was a kid. What did I know? 
 
Anyway, the Administrator set up a meeting with the Board of Directors for them to meet me. And then I started getting phone calls to bail out on my fellowship and start working right away. No, I wasn’t about to do that. The fellowship was a rarity in that time. I wouldn’t dream of giving that up. What were they thinking?
 
Then, came the day of the meeting, and after arranging time off from my duties, flying into New York, driving out from La Guardia in pouring rain and waiting endlessly in the anteroom, outside the meeting room, I saw the doors open and everyone leave. The Administrator came out and told me they were so busy discussing other topics, they just didn’t have time for me. I’d have to come back again.
 
“What?! Are you kidding me?” I said. Suddenly “the scales fell from my eyes,” as it were. The callous disregard for my time, the offhand disrespect, were stunning to me. It was, as they say, a rude awakening.
 
If this was how they treated me BEFORE I committed to a home, and a career in this town, I could only imagine how they would treat me AFTER I had committed.  Well, better to know NOW. So, since I was on the Island, I called Rod Turner, my professor in Boston, and asked him about the local University (SUNY at Stony Brook). A call from him to the Chairman there secured me an impromptu interview, which led to another meeting with a community pediatric orthopaedist in Smithtown, later that day.
 
He agreed to see me reluctantly, as a favor to his friend, the professor, but amazingly, we hit it off so well, that despite his earlier misgivings (and, I found out later, his promise to his friend to “get me out of town”), he offered me a job on the spot and invited me and my wife to dinner. And that was the beginning of my career…. 
 
Funny, but it seems that sometimes, it all turns on a dime. All this happened in just one day. Must have been Fate.
 
At the other end of that career, one split second, a fall, an injury and my surgical career was over. It’s ironic that someone who had such facility with the art of surgery would end up teaching people how to stay out of the operating room (to see what I mean go to http://drbillsclinic.com/avoid_knee_surgery.html )  But life is like that. “One never knows, do one?”
 
If you or your loved ones have knee pain, but want to stop the pain WITHOUT SURGERY, you need my latest program:     HOW TO AVOID KNEE SURGERY. Order it here at   http://drbillsclinic.com/avoid_knee_surgery.html
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

This morning, I was in my study reading my emails and trying to get rid of the extraneous crap that has a way of clogging up my Inbox. I’m sure you have the same problem. I was happily deleting a list of messages, when I came across one article that caught my eye.
 
The email edition of a local newspaper had a headline about ‘Jumper’s Knee.” So I read it and, as far as it went, it wasn’t bad. But naturally, it didn’t do more than give a cursory list of conservative treatments, without explaining how they help.
 
Well, maybe that’s too much to expect from a newspaper, or maybe that’s just beyond the scope of the article. But the fact is, this is a condition that’s all too common today and the average person has no idea they may have this, or what it means. They just know their knee hurts and that it won’t go away.
 
Jumper’s Knee is a layman’s term for Patella Tendonitis, an inflammatory condition of the fibrous cord that connects the kneecap to the upper tibia, or shinbone. Usually caused by repetitive trauma, it can linger and last for months, if it isn’t recognized and treated appropriately.
 
You see, any sport or other activity that involves running, with rapid changes of direction, like soccer or basketball, or sudden explosive jumps (not surprising, given the name of the condition), can avulse (fancy word for “pull out”) some of the tiny fibers that attach the tendon to the kneecap on one end, or from the shin bone, on the other end. Even though you couldn’t see any disruption from either bone, were you to look, microscopically a few of these fibrils have been pulled free. And that causes a localized inflammation, which in turn causes pain and tenderness.
 
As I’ve said before, pain is spontaneous–hurts all by itself. Tenderness has to be elicited–only hurts when it’s pressed or squeezed on examination. Either way, though, this condition hurts. And it hurts MORE when you try to use the knee.
 
So, what to do? Well, with any inflammation, you need to rest the tendon. But that doesn’t mean that you can’t get out of bed. No. There are ways to keep you fully functional, while still giving the damaged tendon a chance to heal. A patella strap is one such method. 
 
Then, there are a number of conservative, non-surgical methods to reduce local inflammation that I’ve reviewed here, again and again. Short term treatments for the acute knee (the RICE protocol) are pretty much common knowledge these days. But it’s the long term treatments that follow the acute period that make all the difference.
 
I reveal not just one protocol, but many–an actual menu of conventional and alternative treatments, which often work best together, in my best selling LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN  http://drbillsclinic.com/eliminate_knee_pain.html  Stripped of the technical medical jargon, the basic principles of each disease or traumatic condition that cause knee pain are easily understandable and provide a foundation for you to select treatments, from across the entire medical spectrum, that WORK, to give you RELIEF OF KNEE PAIN–FAST.
 
And once the treatment has worked and your pain is gone, my PAIN-FREE PROGRAM exercises will help to keep you that way, for good. See how here, at  http://drbillsclinic.com/exercise_eliminate.html

Together, these two programs give your pain a one-two punch that will knock it out, for good! And keep it from coming back….
 
So whether you’re a Boomer couch potato turned weekend warrior, or a regular “jumpin’ jack flash” on the basketball court, if you have jumper’s knee, or any other kind of knee pain, these programs will help you, like nothing else out there. Click on the links for knee pain relief, NOW:  http://drbillsclinic.com/eliminate_knee_pain.html        http://drbillsclinic.com/exercise_eliminate.html
 
Til next time my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill

P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

Hope you had a nice weekend. I know I did. But when I woke up this morning, I had a problem I haven’t had for a long time–a wry neck. Why? Well, I was doing a bit of unaccustomed activity, namely vacuuming the house. And with a bunch of cats flinging litter over the side of their boxes all the time, that’s a necessary evil more frequently than I would like.
 
Felt fine at the time. No soreness, no stiffness, no problems apparent. But this morning, as I tried to roll over and get out of bed–OUCH! Stabbing pain and spasm in my upper back, just at the base of the neck. If this were to follow the old pattern, it would gradually tighten, all throughout the day, and suddenly spasm in certain positions, like when I would try to rapidly turn my head.
 
This was a chronic recurrent problem during my surgical career. You may not think that surgery is stressful to your muscles, but you’d be wrong. Orthopaedic surgery, which often requires the surgeon to lug around some pretty large and heavy legs, is extremely physical. And the surgeon is required to get into some pretty awkward positions, to get at the parts of the joint that’s being fixed. You don’t think of that, because when you see a photo of surgery, it’s sanitized and usually features actors or models. I assure you, the reality is very physical indeed.
 
In addition to the actual physical labor involved, and this was the biggest factor for me, the near constant tension of personal responsibility for the patient. Whatever goes on, your fault or not, is your responsibility. It’s the “Captain of the Ship” concept. And it’s that subtle tension that permeates every waking moment, always in the background, always there, that makes the vulnerable neck prone to spasm.
 
I remember during my first rotation as an intern, my chief resident, Fred, asked me about some adverse effect that affected one of my assigned patients. I don’t even remember what it was, after all this time, but I protested, “It wasn’t my fault.” He replied, and this burned its way into my brain and lasted for the rest of my surgical career, “Stillwell, it ain’t your fault, but its YOOORE responsibility” (delivered in a real Southern drawl).  Indeed. From that time onward, I took that to heart. So that subtle tension was ALWAYS there.
 
In fact, when I saw some of my friends in the OR, after my retirement, almost to a person, they remarked on how relaxed I looked. First time they’d ever seen me when I wasn’t carrying that burden.
 
In addition, it seems I had a couple of bulging discs in my neck, which I’m sure played a role as well. In fact, if you ever experience stabbing pain along the upper back, just along the border of your shoulder blade (ie., medial border of the scapula) that’s a classic pattern for a C5-6 radiculopathy (pain caused by pressure on the C5-6 nerve root, as it emerges from the spine, usually a bulging or herniated disc). I can vouch for that, personally. It’s true.
 
So, what happened this time? Well, besides the vacuuming, I think I slept in an awkward position, giving those chronic discs in my neck a chance to get pinched, get inflamed and cause mischief. Given that it rarely happens these days, I should be grateful. But, hell, it HURTS. So here’s what I did, and what you can do if it happens to you.
 
First, I mobilized both my shoulders, rolling them forward and backward. Most wry neck cases (also called torticollis, in medical lingo) involve spasm of the trapezius, the large muscle that attaches to the base of the skull, both shoulder blades, and then sweeps down to the middle of the spine. So this movement helps to loosen up that muscle.
 
Then, I rolled my head slowly in each direction, again to break up spasm and loosen up the trapezius. You can actually feel the muscle stretch as you do this.
 
Then, I used a powerful vibrator to massage the site of maximal spasm. Now, to do this, you need one of the long wand-like electric vibrators, with a club-like head. The idea is to increase local blood flow to the spastic areas and relax the spastic muscles. Hand massage, by a significant other or a professional, is also very effective.
 
Local heat, local applications of magnets (yes, this DOES work) and medications and diet to reduce inflammation and relax muscular spasm are also helpful. Oddly enough, even though this regimen is for your neck, it’s effective for local inflammation and spasm anywhere, and in any joint.  This is how a sore neck is like a painful knee.

This regimen is reviewed in great detail in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN http://drbillsclinic.com/eliminate_knee_pain.html  
 
And it works. If it didn’t, I wouldn’t be able to sit and write this email. So, whether you have a wry neck or a painful knee, the principles are the same and this combination of methods will work for you. You can see for yourself and try it at http://drbillsclinic.com/eliminate_knee_pain.html 
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill 
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

Just a few minutes ago, while sitting in my study and reviewing my emails, I came across an article on one of the health care alerts about Tiger Woods. You may recall that Tiger has been out of the tournament circuit since his ACL reconstruction. As a result, we haven’t seen or heard much from him or about him in recent months. And the sport of Golf has been the poorer for it.
 
He made history by winning the Masters, against an outstanding opponent, while in constant pain from a double stress fracture of his tibia AND a chronically torn Anterior Cruciate Ligament. Despite wincing in obvious pain, he never gave up. He never considered quitting. He said he just put the pain aside and focused on his goal. No question but that he has the heart of a champion.
 
He was asked about whether or not he thought he’d be ready to compete this Spring. And, not surprisingly, he said he would be. He also reported how hard he was working on his rehabilitation. He obviously truly understands the necessity of doing the hard work of exercise, after a major joint reconstruction, in order to get an excellent postop result.
 
There are a number of lessons to be learned from Tiger’s behavior and his attitude. First, he accepts the reality of his situation and pays the freight up front. He pulled out of further competition this year, in order to give himself the best chance of a good long-term result with surgery he realized was unavoidable. 
 
His case is an excellent example of a truly necessary surgery. There are times when the mechanical problem demands the mechanical solution, especially when the patient is an athlete, making high level demands on the injured knee during his sport.
 
Next, he recognizes the need for HIS commitment to the aggressive postop rehabilitation program. Exercise is key to an excellent result. This is especially true after ACL surgery, where some of the most common complications include a stiff knee (arthrofibrosis), with loss of motion, recurrent instability and weakness. It’s only through range of motion exercises and strategic strengthening exercises that the potential created by the surgeon can be realized.
 
Finally, his attitude is exemplary. The man always focuses on his future goal. He never even considers not achieving it. In his mind, it’s not a question of IF he recovers and returns to his sport, but WHEN. There is little you can’t accomplish if you BELIEVE you CAN and WILL achieve your goal.
 
So don’t be surprised when he comes back, stronger than ever, next year. In his mind, he’s already SEEN it, he’s already DONE it.
 
Now, on the other hand, over the years, I’ve seen a number of patients who had a chronic ACL injury who were not athletes. They had no pain, no history of instability, like giving way or falling, and they were doing just fine with normal, everyday activities. In these people, although some surgeons would talk them into ACL surgery, I always tried them first on a strict regimen of exercises, like those in my PAIN-FREE PROGRAM, which you can see at  http://drbillsclinic.com/exercise_eliminate.html
 
You see, there are people who have alignment of their capsular tissues (meaning the direction the fibers run) that can compensate for an absent ACL. These combine with other factors, such as the position of the MCL attachment, and are collectively called “secondary restraints.” They provide another level of stability, even without the ACL. In these people, surgery may indeed be unnecessary. They may do just fine with a number of the non-surgical methods I present in HOW TO AVOID KNEE SURGERY, which you can get here at  http://drbillsclinic.com/avoid_knee_surgery.html
 
The key is that you need to distinguish between what is necessary and what is unnecessary surgery. And the way to do that is to see how you do with a conservative, non-surgical program, first. Hey, like a haircut, you can always cut more, but once cut, you can’t put it back. So, to relieve knee pain and restore knee function, go to   http://drbillsclinic.com/avoid_knee_surgery.html
 
And it should go without saying that you should get a professional evaluation, preferably by an orthopaedist, if you have persistent symptoms, especially buckling or giving way, or if you have snapping, catching or locking of the joint. Those are mechanical signs and may need further evaluation. Get your doctor involved early. And don’t be afraid–no one can operate on you, or make you do anything you don’t want to do. But that’s the best way to get all the facts. THEN, you can decide what you want to do.
 
That’s it for today, my friend. Til next time, be well.
 
Yours for a pain-free tomorrow, 
 
Dr. Bill

P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

 In the Fall of 1973 I was a straight surgical intern at the Medical College of Virginia in Richmond. I had barely survived my first two months of training, given my gross disorganization, inefficiency and sheer terror that I would kill some poor patient by what I didn’t know. 
 
But gradually, apparently by osmosis, I learned what I needed to know, somehow developed patterns of ruthless efficiency (quite contrary to my nature) and logical analysis that remain with me to this day. Against all odds, I had survived and I had evolved into a pretty competent fledgling surgeon.
 
Having recovered from the prolonged anxiety attack that characterized my first two months, I looked forward to my new assignment at the local private hospital. 
 
What many people don’t realize is that interns are “farmed out” to a number of different affiliate hospitals during their training. This was to provide us with different perspectives and adequate clinical experiences, and provide those hospitals with the closest thing to slave labor,  since the Civil War.

So there I was, in my freshly startched white uniform, as I walked into the hospital’s surgical ward for the first time. As I walked into the Nurses’ Station for the first time, an elderly nurse, all in white, even stockings, with a stiff, starched nuses cap (nurses wore caps in those days) first noticed me and cried out, “Doctor on Deck!” 
 
And with that, everyone currently seated, all the nurses and orderlies writing or reading charts, who were in the Nurses’ Station, immediately jumped up in unison and stood at attention, facing me!
 
I naturally wondered who they were standing for and turned around to see who it was that commanded this almost military reaction. I figured, I should probably be at attention, too. Imagine my surprise when there was no one else there.
 
I was pretty dumfounded, that’s for sure. It never even occurred to me that they were standing for ME. The elderly nurse came over and took me in hand, and said, “Welcome, Doctor.” Wow. I couldn’t believe it. “Hi. I’m Bill Stillwell,” I said.  “Just call me Bill.”
 
“No,” she said, “you’re Doctor Stillwell, now.”  Apparently, I was expected to be a bit more formal than I was used to. With that, she turned to the other nurses, mostly female, but with a few males and orderlies, as well, and said, “This is Dr. Stillwell, our new intern.”
 
Much to my surprise, no one burst out laughing at me. Apparently, they were quite serious.

Now, I’d always been a pretty informal guy. Airs of any kind were not tolerated in my family or by my friends, and despite my abilities, I completely accepted these values. They were part of me and my world view. It would never have even dawned on me that I would or should command this level of deference. I mean, I was still a wet-behind-the-ears, junior doctor in training, hardly worthy of this display, and, to my mind, hadn’t earned their respect. So this was a brand new experience. In short, I was in shock.
 
The senior nurse smiled at me and took me aside. She advised me that I was in charge now, so it was appropriate that my subordinates show me respect. I still couldn’t wrap my head around it. This was obviously someone’s idea of a joke. I had no idea what I was doing and said so. The nurse said, “You know more than you think…”
 
Over the next couple of months, especially at night, she guided me, by asking innocently phrased questions that gave me an idea of what I should be doing, but without ever undermining my “authority.” We both knew that I was clueless, but she was very adept at teaching me, without seeming to. That old nurse taught me plenty and I owed her a lot. We both knew it.
 
At the end of my rotation, I thanked her for all her help and guidance. She smiled and told me that I had become a good doctor. “At least you listened,” she said. “Why wouldn’t I?” I replied. She was the only one of the two of us who had any idea of what they were doing. But apparently, some prior interns had resented her help and had refused to listen. Ego, I guess. Damn fools….
 
From that time onward, I was always a staunch nurse’s advocate. I never forgot that debt of gratitude. I don’t even remember her name, but I will never forget what she did for me and for the thousands of patients that my life eventually touched. 
 
The moral of this story is that you have to be open to help, when it’s offered. When you open yourself up to someone who has been there, to someone who KNOWS, then, with luck, you might actually learn something. That’s why, when I wrote my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN, which you can get at this link: http://drbillsclinic.com/eliminate_knee_pain.html   I wrote from the perspective of a surgeon AND a patient, who has undergone knee surgery, myself.  I also made sure to speak in your own language, NOT “medicalese.” 
 
I made it the hallmark of all my healing programs to get rid of the mystery and the obfuscating vocabulary, so you can access the underlying principles, which are actually pretty simple, once you understand them. You see, if you know WHY to do something, you’re much more likely to do what I tell you. And therefore, much more likley to get better, FAST.
 
So, if you want to relieve your knee pain and restore your function, then click here for FAST RELIEF:
http://drbillsclinic.com/eliminate_knee_pain.html
 
Have a great weekend, my friend. And be well. Talk to you again next week.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

You may have noticed that yesterday’s email was a bit late–like, it wasn’t broadcast until after midnight, which pissed me off to no end. Fortunately, that was just after midnight EDT, and many of my subscribers reside all over the world, in other time zones. So only the east coast people were affected. But it was still mega annoying.
 
Thing was, I had it written and ready to go much earlier in the day, but my terrific merchant service, 1shoppingcart was on the fritz. “Error” kept coming up, every time that I clicked on the appropriate button and tried to send the email. Very frustrating, to say the least. So I saved my work, by clicking on “save draft.” And then, clicked off, hoping that whatever the problem was would be resolved with a little time.
 
Later, about 11PM my time, I logged back in, clicked on the “saved drafts” button, so I could retrieve the email and send it off, and guess what? The damn thing had ERASED 80% of my email! AAAAARRRRGGHHH!  I HATE when that happens! Must have been gremlins in the shopping cart….
 
Anyway, I had to rewrite nearly the whole damn thing again, from memory. Luckily, my memory isn’t shot just yet I was retyping frantically, with my rudimentary hunt and peck skills, re-saving every paragraph or so, just to be on the safe side. And I finished before midnight. YEAAA! Only, the line-up of others ahead of me pushed its transmission to after the witching hour. C’est la guerre….
 
Well, I guess I should be thankful that this doesn’t happen ALL the time. Anyway, when I was so rudely interrupted by the gremlins, I was telling you about my friend, who had recurrent knee pain. He initially had a very good response to the specially modified knee exercises I teach in my PAIN-FREE PROGRAM, at http://drbillsclinic.com/exercise_eliminate.html
 
But, like many people, he felt so good, he became lax and gradually stopped doing them. After all, he felt good, no pain, so the knee must be OK, right?
 
Err….no, sorry. The problem he had was a chronic degenerative condition. And that doesn’t disappear, just because you’ve compensated for it and relieved the resultant pain. So, absent the beneficial effects of exercise, the kneecap gradually fell back into the  abnormal tracking pattern that caused his problem to start with. Whether his actual disease was chondromalacia, or osteoarthritis of the patellofemoral compartment, the final result was recurrent anterior knee pain. 
 
As I mentioned, there are two fundamental components to treating this condition: 1.exercise and 2.measures to reduce inflammation. And they must be addressed simultaneously. 
 
Fortunately, there are many ways to combat inflammation. Conventional conservative treatments, home remedies, over the counter medications (with proper precautions), as well as a number of proven alternative treatments, which work by different mechanisms, can have a  synergistic effect to relieve knee pain. I cover a number of these, with specific instructions how to use and combine them, in my newest healing program,  HOW TO AVOID KNEE SURGERY, which you can get at http://drbillsclinic.com/avoid_knee_surgery.html
 
Long term, there is no better treatment than exercise.  That’s why I include a Baker’s Dozen of the most effective, proven knee exercises and stretches in this new program, as well. Or you can get the full range of exercises and stretches in the PAIN-FREE PROGRAM, at   http://drbillsclinic.com/exercise_eliminate.html  But either way, exercise is key in getting and maintaining complete pain relief and restoration of full knee function. 
 
If he follows my advice, my friend should get relief of his recurrent knee pain in short order, probably less than seven days. But to keep it, he’s got to do the work…and keep doing it.
 
You can get away with a lot and slack off when you’re young. Young tissues are forgiving. But as you age, more conscientious efforts are required. If you don’t do the necessary work, you will pay the price. It’s as simple as that.
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill

P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

This past weekend, I was at a business/marketing meeting in Tampa. One of the attendees was a fellow I had advised in the past, and one who had used the recommended exercises in my PAIN-FREE PROGRAM  http://drbillsclinic.com/exercise_eliminate.html/.  He’s  a few years older than me, but in otherwise good shape.
 
Up to now, he had done pretty well. So well in fact, that he has written a testimonial for me, which I will post, once he sends me a photo of himself to run with it. But, like many of us (me too) he got a little bit complacent and slacked off the exercises. 
 
Sure enough, he started to develop recurrent symptoms. ”Hey, what’s that vague ill-defined knee pain?” he wanted to know. I shouldn’t wonder. 
 
Knee pain, especially low grade, achey pain, is often diffuse and ill-defined. That is, unless there’s a specific injury that causes a sharp, acute pain, associated with damage to specific structures. These would be things like a fall, twist or sprain of ligaments, or strain of muscles, a tear of the meniscal cartilage, a rupture of the ACL, degenerative diseases (like chondromalacia or it’s cousin, osteoarthritis), or inflammatory conditions, including rheumatoid arthritis (and its relatives, psoriatic arthritis, lupus, spondylitis, etc.)infectious arthritis (Lyme Disease, staph or strep infection).
 
Why do these conditions cause this low grade ache? In a word, SYNOVITIS. This is an inflammation of the lining membrane of the joint. Now, synovitis is a very non-specific response to ANY stimulation, regardless of what it is–IT HURTS. The membrane also becomes thicker and more swollen, actually grows in volume, becomes red (from dilated blood vessels) and produces an excessive amount of joint fluid (which it normally makes in very small amounts, to lubricate the articular cartilage and nourish the cartilage surfaces). Lay people call this “water on the knee.” 
 
Since I was there with him, I examined my friend’s knee, right there in the conference room. Very few findings, though. Some loss of the last few degrees of motion at the extremes of flexion and extension, maybe five degrees at each end, consistent with the thickening of the synovial membrane. And he had a little bit of pain under the kneecap, when pressure was applied. Pretty much, that was it. Of course, I had no x-rays or MRI images to examine.
 
My impression was that he had developed a recurrent case of chondromalacia patellae–softening of the cartilage of the patella. Either that,or it’s first cousin, osteoarthritis. So, what to do?
 
First, he needs to resume the exercises I teach at http://drbillsclinic.com/exercise_eliminate.html  Exercise is the overall best method for long term pain relief of the knee.
 
Next, he needs to get on the anti-inflammatory regimen I present in detail in my newest healing program, HOW TO AVOID KNEE SURGERY, at  http://drbillsclinic.com/avoid_knee_surgery.html
 
With luck and some work, he should get fast pain relief in as little as one week. If he does the work…
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill

P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

Well, I’m back in my study this morning, after being at a business/marketing meeting this weekend in Tampa. Since I live in the Orlando area, it’s a straight shot for me, driving along I-4 West. Takes about an hour and forty minutes to two hours, depending on traffic, especially through the city of Tampa. Compared to my recent drive to Southampton, New York, this is a snap! 
 
Given my personal history of knee pain and arthroscopic surgery, this would be a real trial causing nagging aching and swelling of the knees.  But I actually practice what I preach– I use all the tips I’ve passed along to you to reduce your knee pain, while driving. You can see all of these in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN, and you can get your own copy at
 http://drbillsclinic.com/eliminate_knee_pain.html   These tips were a life saver during the long haul to New York, but they’re pretty useful for shorter drives, too. Try them yourself and see.
 
Anyway, I was catching up on my email and other correspondance when I came across an advertisement that promised to END ARTHRITIS PAIN FOREVER. Hmmmm… It sounds like they’re promising a CURE. But what do they really mean?
 
Here’s the thing: I spent a quarter century treating people with various forms of arthritis. And as a surgeon, I’ve actually SEEN the damage that arthritis does, first hand. That’s intimate knowledge of the destruction that these diseases (note, it’s NOT just one disease, but MANY) can wreak on joints. This is direct experience of seeing and feeling those destroyed joint surfaces, with my own hands, that even rheumatologists don’t have, unless they’ve personally scrubbed in on open joint surgeries.
 
Based on that experience, I can tell you this–there is NO CURE for the most serious forms of arthritis, osteoarthritis and rheumatoid arthritis (and other inflammatory forms), at this time.
 
But the ad says they cured “rheumatoid arthritis SYMPTOMS.” That implies that they cured rheumatoid arthritis, doesn’t it? But, I assure you, no one to date has done so.
 
So again, what do they REALLY mean? Is is just false advertising? No, not really. But it IS deliberately misleading. 
 
You see, when most people think of arthritis, they think of the “wear and tear” arthritis you get as you get older, in other words, osteoarthritis. When you talk about rheumatoid arthritis symptoms, you suggest (without quite saying so) that you are talking about rheumatoid arthritis. But when you read the ad copy, you find out that what they’re really describing is the arthritis of LYME DISEASE, which is due to a bacterium and therefore CAN be cured. 
 
Are the SYMPTOMS the same as rheumatoid arthritis? In the short term, yup. But will the same treatment, antibiotics, actually cure rheumatoid arthritis or osteoarthritis? Nope.
 
This is just a classic case of advertising leading you to draw inaccurate conclusions, based on false assumptions. They are NOT lying. But they ARE trying to fool you. And if you don’t know any better, you’re going to fall for it. These guys are GOOD at this.
 
To help you sift the truth from all the B.S. out there, you need someone who KNOWS on your side. If you had read my newest healing program, HOW TO AVOID KNEE SURGERY, which you CAN, if you go to  http://drbillsclinic.com/avoid_knee_surgery.html you would know better. 
 
With treatments drawn from across the entire medical spectrum, conventional, alternative and complimentary, you can finally understand WHAT TO DO, and HOW TO DO IT to relieve your pain and restore your function. And WHY, as well. So don’t be fooled. Arm yourself with the best health resource you can get to get rid of your knee pain, FAST, with easy, proven methods that WORK. Go to  http://drbillsclinic.com/eliminate_knee_pain.html
 
That’s all for today, my friend. I’m going out for a walk in this beautiful weather. There ARE advantages to being in Florida, at least at this time of year   Til next time, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill 
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

So this morning in my study, I was going over a number of health related blogs, reviewing them for any potential for commentary and teaching points. A number were pretty good, most often involving the back injuries one sees in sports or exercises or stretches for general fitness or specific injuries. A few had to do with joint replacements of the hip and knee, which happened to be my specialty in practice. 
 
But then, I read one that was incredible. Not good incredible, as in ‘Wow! How amazing!” but incredible as in, “I can’t believe they have this thing out there on the web!” It concerned ACL injuries and rehabilitation and it was so full of factual errors and frank mythology that I couldn’t believe it.
 
I wanted to tactfully reply, correct the most obvious misconceptions, hopefully without insulting the author, or hurting his feelings. It wasn’t a scam, or a deliberate attempt to misrepresent facts for some nefarious purpose. It was obvious that the author was sincere. He was just wrong.
 
For example, one guy said that an ACL rupture wasn’t painful. In fact, it’s one of the most painful and disabling injuries you can suffer. What he meant was that a CHRONIC ACL disruption is painless–the damage has already been done. But the resulting instability, the “wobbly knee” that results from absence of the ACL, CAN indeed cause pain, from secondary tears of the menisci, synovitis, and arthritis.
 
Further, there ARE some people with an ACL injury who DON’T require surgery. This fact is almost entirely ignored in these articles. Specific exercises, especially leg curls and calf exercises, can often compensate for people who make low demands on their injuredknee. The point is, there are options that can be offered.
 
Unfortunately, it was a major pain to reply. First, you have to register in order to reply. Then, the registry doesn’t accept the information and erased all the info I had just input. Finally, I just gave up in disgust. Too bad. Some people are going to read that blog and accept what it says uncritically. As a result, they’ll absorb information that’s just incorrect. And who knows what the consequences will be?
 
Funny thing is, people will believe almost anything they read on the net, even though it’s well known that there’s no filter. That’s one of the internet’s chief charms. But it’s also one of its chief problems, when you really have a need to know the facts about a topic. Without a bit of comparative research on your own, there’s often no way to tell what’s fact and what’s fiction.
 
You may read it on a website, but “it ain’t necessarily so.” But the written word has power to persuade, whether it’s accurate or not. So, especially in seeking medical information, it’s best to go with a trusted source. Hey, that’s one of the major reasons for the existence of Dr. Bill’s Clinic. I’m here to try to provide some guidance and practical advice, based on my nearly quarter century in clinical practice in orthopaedic surgery. That’s why I wrote my healing programs: to help those of you with knee pain, grinding, instability, arthritis, water on the knee, deformities, and any other problems with a variety of treatments, conventional, alternative, and complimentary, from across the entire medical spectrum.
 
DR. BILL’S LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN is a concise, but complete guide to all the root causes of knee pain and the treatments that I know from experience, professional and personal, do work. You can get your own copy, including an audio CD, at  http://drbillsclinic.com/eliminate_knee_pain.html
 
But, just so you know, the LGB does NOT include the recommended knee exercises. Those are given in a separate companion manual: DR. BILL’S PAIN-FREE PROGRAM, a selection of exercises and stretches that helps to prevent or eliminate knee pain–once & for all! You can get it here, at this link:   http://drbillsclinic.com/exercise_eliminate.html
 
Most recently, based on what people seemed to want, I created my newest healing program, HOW TO AVOID KNEE SURGERY, in both written and audio CD formats. This is a blend of the former two programs, and in addition, adds a great deal of new material, especially on herbs and nutriceuticals and other alternative treatments to help you avoid the unnecessary knee surgery, or at least delay the most invasive procedures, like total knee replacement, in the case of end stage disease, like arthritis. 
 
If you’ve been thinking about having surgery, but would like to delay or avoid it, you can get it here: http://drbillsclinic.com/avoid_knee_surgery.html
 
So, above all, don’t believe everything you read. DO your due dilligence before you accept whatever is out there on the net. The right advice can make a big difference in your life, but you need to be sure of the facts, before you act.
 
Well, that’s it for today. Til next time, my friend, be well. And have a great weekend!
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved