The other day, I was reviewing an article someone wrote about how to exercise, while allowing a knee ligament injury to heal. This was always a difficult problem to explain to patients.

On the one hand, you wanted that ligament to heal, which normally required rest. But on the other hand, you didn’t want the knee joint to get stiff, from lack of movement.

It was tricky to explain to frustrated patients, because the answer is not readily apparent. The answer is to do BOTH, at the same time.

Now, I’m sure you’re thinking, “How can you do two, apparently mutually exclusive actions, simultaneously?” The answer lies in a property of the injured tissues, and other tissues, as well.

It turns out that whenever you apply tension or compression to any tissue, you generate a tiny electrical current within that tissue. In bone, this is how trabeculae (the tiny, internal bone struts in “spongy” bone, that enclose the marrow) that support body weight are uniformly aligned along mathematical lines of force.

The secret is called the piezoelectric effect. Mechanical force causes all the molecules in hard or soft tissues, to line up in one direction, like thousands of tiny magnets. This effect of “the body electric” not only causes the bony trabeculae to line up according to lines of compression and tension on the long bones, but also promotes healing and strength within tendons and ligaments that support the joint.

So the trick is to stimulate this effect, to promote early healing, but still maintain joint motion, while the healing is ongoing.

To do that, you need to protect the damaged ligament from further injury or stresses, but still allow motion in the normal plane. If this is the goal, the way to do this is to use a brace.

Braces compensate for absent or injured ligaments. By preventing abnormal side-to-side motion, that would stress the ligament, but allowing normal flexion and extension, a hinge brace maintains motion, but protects the healing ligament.

Braces are just another of the non-surgical options that you can use to heal a knee injury and reduce knee pain that I present in my newest healing program, HOW TO AVOID KNEE SURGERY.

http://www.drbillsclinic.com/avoid_knee_surgery.html

During my practice, one of the biggest problems I had to deal with was the idealistic orthotist (brace maker). See, they wanted to create a structurally correct, optimally leveraged and often, too heavy brace, for the patient. And technically, they would be correct.

For some injuries, the brace had to be as long as the entire lower limb, to be truly effective, by getting enough leverage to adequately protect the ligament injury. There was only one problem-the patients would NOT use it. It was too cumbersome and heavy. So it would sit in the corner, like a very expensive planter, and would not be used.

Obviously, this was not a good idea, because the patient would then not do well and would continue to have pain.

So, knowing this from prior experience, I would instead order a shorter hinge brace, that I knew the patient would use. This drove the orthotists crazy. They would call me and try to explain the principles to me (as if I didn’t know them). I always listened with tolerant amusement, as they were so earnest.  I knew they meant well, so I did let them live.

But I then had to explain to them that it was better, if not ideal, to give the patient a less than optimal brace that they would use, rather than a perfect brace, they would NOT.

They had to agree, if grudgingly. First, because I substantially outranked them and it was my patient. Second, because I WAS right. Something is better than nothing. Right?

Well, in later years, the orthotists’ arts finally caught up with my patients’ needs. They finally began to use light weight plastics, carbon composites and aluminum alloys for Hinge braces and ACL braces.  Made a world of difference, combining strength with lightness.  Much more “user friendly,” as they say.

And those braces allow for gentle motion after ACL, or collateral ligament surgery. And that motion generates that piezoelectric effect in the tissues, which aligns the molecules of fibrous tissue, giving maximum tissue strength and flexibility, with minimum bulk of the healing tissue.

You can enhance healing further by controlling inflammation. One natural way to do that is to use my POWERHOUSE OMEGA FORMULA, a premium, enteric coated, pharmaceutical grade fish oil, packed with concentrated omega-3 fatty acids.

http://www.favoriteformulas.com

Braces and pharmaceutical grade fish oil are just two of the many non-operative methods in HOW TO AVOID KNEE SURGERY

http://www.drbillsclinic.com/avoid_knee_surgery.html

There are plenty more, including some you’d never guess. But they all work, as proven, effective methods to relieve pain and restore function, without surgery. See for yourself…and stay OUT of the operating room.

I also want to wish Governor Arnold Schwarzenegger a very Happy Birthday! He was born the day after me, lo those many years ago. While he’s drifted a bit to the Left in recent years (nudged by his wife, no doubt), his is the quintessential American story and I wish him good health and happiness.  Til next time, my friend, be well.

Yours for a pain-free tomorrow and your optimal health,

Dr. Bill

“The Wellness Warrior”             TM

On a Tuesday night, more years ago than I can actually believe, I was born into this vale of tears. Since I am an official Baby Boomer (not part of the leading edge, but close behind them), I am part of a generation that famously said, “Don’t trust anyone over thirty.”

Well, time has a way of making your earlier pronouncements look pretty foolish, in retrospect. Fact is, I’m a little past thirty, now, both my age and my waist, and it’s hard to believe just how much water has run under the proverbial bridge.

I wasn’t able to attend my 40^th high school reunion, though I’ve since reconnected with people who I’ve known since grade school! One of my friends, who did attend, emailed me that he went in and had no idea who those “old, bald people” were. HA!

Time will try to have its way with us. But we don’t have to just sit back and take it. No.

Today, we know a lot more than we did when I was a boy, about preserving health and longevity. We now know that we can reduce our risk of death from heart disease (the number one killer, world wide), lower blood pressure, reduce or reverse arterial plaque formation, lower triglycerides, thin the blood, reduce inflammation and relieve joint and back pain, all with omega-3 fatty acids, like those in my premium, enteric coated, pharmaceutical grade fish oil, POWERHOUSE OMEGA FORMULA.

http://www.favoriteformulas.com

Recent research has confirmed that fish oil can also lengthen the telomeres of our DNA, those important DNA “ends,” which govern cellular division, and therefore, can literally reverse aging. Man! I wish I’d been taking these since childhood. But, we do what we can, right?

How about exercise? Apart from a good, low glycemic, high protein, slow carb, whole fresh foods diet, high in vegetables and fruits (see my Magic Bullet Fat Loss Program at: http://www.favoriteformulas.com/magicbulletfatloss ), there is nothing closer to an all around “Fountain of Youth” than daily exercise.

That’s why I do my daily walks and my knee pain exercises from my newly expanded, completely redone PAIN-FREE PROGRAM

http://www.drbillsclinic.com/exercise_eliminate.html

While it IS true that the program was designed to alter the dynamics of the painful knee, to relieve or prevent knee pain, it’s also true that these exercises work the largest muscle groups in the body. This makes them ideal to build muscle, which helps to burn fat and raise the metabolic rate.  

Exercise also literally makes you “younger,” by boosting your immune system, enhancing your metabolism and optimizing your circulation and cardiovascular and pulmonary systems. It also improves your mood, reduces depression and produces endorphins in the brain. Closest thing to a cure-all we have.

So there are lots of methods that we can use to be sure that, even if we get older, we don’t have to get old.

Even though I’m one milestone closer to my first 100 years, I feel better than I have in years and optimistic for the future. I can’t wait until tomorrow, ’cause I’m getting better every day!

And since it IS my birthday, I’m granting myself special dispensation today, to go out with the bride and celebrate-Still alive… and living with style! Til next time, my friend, be well.

Yours for a pain-free tomorrow and your optimal health,

Dr. Bill

“The Wellness Warrior”             TM

It must have been the mid eighties when I heard about this, from an old, now departed friend. Dr. Jim was a colorful character, that’s for sure. He had what we sometimes referred to, charitably, as a “checkered career.”

He started out as a family practitioner in Smithtown, a few years before I arrived on the scene. He originally was in with a partner, if memory serves, but he eventually went out on his own. A person of strong opinions and restless intellect, he rubbed more than a few of the old dogs in town the wrong way. You could say he was a bit eccentric.

He rapidly tired of the mundane in Family Practice and went back into training, to become one of the only specialists in Physiatry, or Rehabilitation Medicine on Long island, at that time. Now, most of the old guard internists and surgeons had barely ever heard of Physiatry, much less met a specialist in the field. But he built a practice based on auto accidents, worker’s compensation cases and disability claims.

Later on, he developed alliances with the neurologists, neurosurgeons…and me. Very few of the other orthopods had much use for him.

When I became Chief of Orthopaedics in 1984, he was one of my most ardent supporters. I never understood why he took a liking to me, but he certainly seemed to. And I’ve always been someone who would take all the friends I could get.

For my part, I respected his knowledge and appreciated his strong opinions, even when I didn’t agree with him. Maybe I wasn’t intimidated by the force of his personality, or his intelligence, having adequate confidence in my own. And I found his eccentricities funny and refreshing. I also almost always learned something from him.

One such thing I now pass on to you.

I had a patient at that time who had developed chronic anterior knee pain, pain in the front of the knee, just below the kneecap. Clinically, it looked like patellar tendinitis, with tendinosis demonstrated on an MRI scan.

The difference between the two is this: tendinitis describes an inflammation of the tendon (or the sheath around the tendon), while tendonosis is a chronic degeneration of the substance of the tendon.

This is an area where, for whatever reason, the fibrous tissue of the tendon has become degraded and mushy soft (this shows up on an MRI scan, but is invisible on x-rays). This area of weakness and degeneration can eventually lead to a rupture of the tendon.

I had tried everything to help this woman: exercise, anti-inflammatory medications, splinting, local heat-all to no avail. But when I happened to mention this to Dr. Jim, he suggested prolotherapy, a little known method to relieve knee pain and pain in other fibrous structures, like tendons and ligaments.

I had never heard of it, so he explained it to me. It involves the injection of a noxious substance directly into the weakened area of the tendon. Because this would hurt, this is usually combined with local anesthetic.

In this case, and in most cases, this irritant is a sterile, highly concentrated sugar solution, but sometimes pumice, mustard, or other irritant compounds are used.

This irritant provokes a strong inflammatory response in the body. And the body responds to the inflammation by a proliferative reaction-that is, it causes a lot of increased cell growth: far more cells develop than normally do. In this response, fibrous cells of the tendon to grow and multiply, then produce more fibrous tissue, making the tendon even stronger than it was before, much like a weld in steel is stronger than the rest of the metal.

Hence the name, prolotherapy, is short for “proliferative therapy.” To find a practitioner who performs these injections, try your local physiatrist, or orthopaedist (some of whom are trained in the technique). It doesn’t heal everything, but it’s a great method for the right case of chronic degenerative sprains or tendinitis.

This is just one of the many alternative, non-surgical methods I reveal and explain in my newest healing program, designed to relieve knee pain: HOW TO AVOID KNEE SURGERY

http://www.drbillsclinic.com/avoid_knee_surgery.html

There is no such thing as a minor surgery, when it’s happening to you. So you lose nothing by trying one or several of these proven methods, before subjecting yourself to the risks and potential complications of surgery.

You might think it odd that a surgeon is suggesting non-surgical methods, but I must tell you, I always did. No good surgeon wants to do surgery unless it’s indicated and nothing less invasive will do.

As far as inflammation is concerned, these days, I use my own brand of enteric coated, pharmaceutical grade fish oil, POWERHOUSE OMEGA FORMULA,

http://www.favoriteformulas.com

packed with highly concentrated omega-3 fatty acids, which are proven to reduce inflammation, naturally, without significant adverse side effects, like NSAID medications have.

In addition, I often use my new JOINT HEALTH FORMULA,

http://www.favoriteformulas.com/jointhealth

with the addition of New Zealand Green Lipped Mussel extract, a unique marine formulation, that has profound anti-inflammatory properties, in addition to omega-3 activity, for my arthritic knees.

You see, there are many non-operative methods out there. You need to try them, before you accept that surgery is the only way.

However, only your own doctor, who has examined you and who can speak to the factors of your specific case, can advise you, as an individual, what is best for your own case.

Regarding my old friend, Dr. Jim, unfortunately, a sudden heart attack robbed us of his eccentric brilliance, at far too young an age. Wish he’d been using my fish oil. He might still be with us.

Til next time, my friend, be well.

Yours for a pain-free tomorrow and your optimal health,

Dr. Bill

“The Wellness Warrior”            TM

July 26, 2010

Over the weekend, I was watching one of the news shows. The host was interviewing Tommy Thompson, the former Commissioner of Health and Human Services. The topic was the new mandate from Big Brother that beginning in 2014, all electronic health records must record your height, weight and BMI (Body Mass Index).

Well, Mr. Thompson, to his credit, thought that was a terrible idea. But, as he elaborated on his argument, it became apparent that his objection was that the BMI is not an accurate indicator of someone’s state of obesity and fitness.

The BMI was first proposed back in the 1800′s. It compares your height, in inches, with your weight, in pounds. This results in a number, the Body Mass Index, which can be graphed. It has been determined that above a BMI of 25 to 29, you’re considered to be overweight. From 30 and on up, you’re considered obese.

You may have seen one of these charts, all decked out in pretty colors, in your doctor’s office. To see where you fall, you find your height along the left hand axis and your weight along the bottom. Where they intersect-that’s your BMI. And it’s helpfully categorized by a swathe of color, so you can see instantly whether you’re obese, overweight, or “normal.”  

There’s only one problem. It’s NOT an accurate indicator, as I mentioned above. Why? Because it treats men, women and children the same-they are not the same. It also treats athletes and non-athletes the same-and they are not.

According to the BMI, a champion bodybuilder, say Arnold in his prime, or a star athlete (Lance Armstrong, Kobe Bryan, or pick one) is obese!  Now, when a guy is all muscle and has, like, 2% body fat, he may be heavy, but obese he ain’t. Same thing with women, who are supposed to be carrying more fat than a man, and children, whose proportions are far different than adults.

Now, as a crude measurement, BMI is OK-so long as you realize its limitations. But now, you’ve got the wizards of the Federal Government mandating this in your medical records. Electronic (which is to say, digital) records.

That fills me with confidence that they’ll be secure from prying eyes. How about you?

This is the same government that recently lost a computer with thousands of social security numbers and files, that cannot run the Post Office efficiently, that is effectively bankrupt. And how about hackers?

And what about your HIV status? Or that hepatitis C, you may have floating around on your chart. Want all that made public?

This is only the beginning.

Mr. Thompson, bless him, objected to this. But NOT because it’s none of the government’s business, but because it isn’t an accurate indicator of fitness.

Oh yeah. He’s perfectly fine with the idea that the government can mandate and store these records on you. Why…the intention is good. It’s for your own good, after all. But he contends that a better way to measure fitness would be body composition analysis-how much actual fat you’re carrying. THAT is what the government should be storing.

Unbelievable. In the United States of America.

He misses the point.

Yes, retrievable electronic medical records would be very convenient, even life saving, in some instances. They could theoretically be accessed by any doctor you authorized, anywhere in the world. Your allergies, medications, prior illnesses, surgeries, genetic markers, all there at the tap of a key. Except… it’s none of the government’s business!

Does the idea of a huge Federal bureaucracy, compiling health data on you, unnerve you? It should. One more piece of your liberty… gone. The fig leaf of your privacy is shriveling. What’s next, mandates on what you must and mustn’t eat? Oh wait. They’re already doing that.

Look, I told you some time ago, if they seize control of health care, they seize control of your entire life. It was never about health care. It was always about control.

If they’re paying for it, they control it. It’s “The Golden Rule”-he who has the gold, rules. And it hasn’t even been a year since they rammed through Health Care. I can’t even imagine what the next couple of years might bring.

It’s not that I don’t agree with persuading you to eat right, exercise daily, control your weight. That’s what I’m doing here, every day, because I want you to be fit and healthy and strong. I want you to “live long and prosper,” to coin a phrase.

But it is and should be YOUR CHOICE. Not a bureaucrat’s. Your records are yours and should be between you and your doctors. IT’S NOT THE GOVERNMENT’S BUSINESS!

Well, while we’re watching these chilling developments play out before our unbelieving eyes, I strongly suggest that you start taking my advice. Ditch those bad habits, like smoking, drinking to excess, illicit drugs, if any, and eating artificial, sugar-laden crap. Get your weight down and your fitness level up.

You can start with my POWERHOUSE OMEGA FORMULA

http://www.favoriteformulas.com

a premium, enteric coated, pharmaceutical grade, third party assayed fish oil extract, brimming with health giving omega-3 fatty acids. They can help you drop your trigylcerides, lower your blood pressure, thin your blood, normalize your heart rhythm, slow or reverse arterial plaque formation and reduce your risk of heart attacks and strokes. They even help to lengthen your telomeres (end caps on your DNA, correlated with cell division) to keep you younger and improve your mood.

Use any diet you like, so long as it works. You might want to try my Magic Bullet Fat Loss Program, which includes methods I’ve used myself, to lose and keep off over 55 pounds.

http://www.favoriteformulas.com/magicbulletfatloss

And I would recommend you exercise daily, or close to it. That can be a walk, or a swim, or a program of progressive resistance exercises, like my newly updated PAIN-FREE PROGRAM & DVD

http://www.drbillsclinic.com/exercise_eliminate.html

which use isometrics, body weight exercises, free weights and machines, in combination, for strategic muscle strengthening and stretching. They not only work the largest muscle groups in your body, to increase your metabolism and your fitness, but they also alter the dynamics of the knee, to prevent or relieve knee pain.

And finally, go to see your doctor (and dentist) and take care of whatever you need to…while you still can. Your health is in your own hands. It’s YOUR business. No one else’s. And it’s a whole lot easier (and wiser) to preserve it, while you still have it, than to try to regain it, once lost. Think about it. Then, DO it. Til next time, my friend, be well.

Yours for a pain-free tomorrow and your optimal health,

Dr. Bill

“The Wellness Warrior”             TM

As any longtime reader of my emails knows, I have always promoted the concept of individual evaluation and treatment for ACL (anterior cruciate ligament) injuries. This has always been true, even when I was in practice. I always believed that ACL reconstruction was overdone in this country.  

In many cases, especially when the patient was middle aged, and either sedentary or a “weekend warrior,” I encouraged them to try a course of specific exercises, designed to dynamically compensate for the lack of ACL function. These involved resistance exercises, like leg curls, for the hamstring muscles.

You can find these and many other knee pain exercises and stretches in my PAIN-FREE PROGRAM and DVD:

http://www.drbillsclinic.com/exercise_eliminate.html

This knee exercise regimen was supplemented by the use of an ACL brace, designed to provide the mechanical stability, that the cruciate deficient knee lacks. They wore the brace all the time, except in the shower and in bed.

If, despite this regimen, someone experienced continued knee pain, giving way, or instability in their desired sports activities, or especially if they were unstable with normal, daily activities, or they couldn’t tolerate the brace, only then did they become candidates for ACL reconstruction surgery.

This excepted real athletes, who needed to be at peak performance, quickly. They did require early intervention. But for everyone else, I usually liked to try the exercise and brace approach, first.

It was a lot more conservative approach than most of my colleagues practiced. Ironic, if you realized that virtually ALL my practice was dedicated to surgery of the hip and knee (and that ACL surgery is a great operation, a terrific technical exercise and a lot of fun to do).

But I always believed that a good, solid reputation is built by doing what is right for the individual patient, not a cookie-cutter template, that always results in surgery.

Part of acquiring a track record of great results is what we call in the trade, “proper patient selection.” That means that you need to pick for surgery only those patients for whom surgery is the correct option. You then are much more likely to get a good, or excellent result, assuming excellent technical execution of the selected surgical procedure (naturally).

Well, that was my approach for knees with torn ACL’s, in average people. And it worked just fine, for many, many years. Now, there is clinical evidence that suggests that I may well have been right.

In the most recent edition of the New England Journal of Medicine, a new Swedish study has demonstrated that patients who had a course of rehabilitation (ie., exercise), after ACL rupture, did just as well as those who had early surgical reconstruction of the ACL.

This is directly counter to the trends of the past couple of decades, wherein early ACL surgery has been promoted as the optimal treatment.

The study involved 121 Swedish amateur athletes, between 18 and 35, were mostly soccer players, with some volleyball players, who had new, complete ruptures of the ACL. They were randomly divided into two groups: half got immediate ACL surgery, plus postop physical therapy. The other half were treated only with rehabilitation, two or three times a week, over a course of five to seven months, for a total of about 60 sessions (on average).

Two years later, both groups were clinically evaluated for knee pain, performance in sports and daily activities. Both groups demonstrated about the same amount of improvement.

In the physical therapy group, approximately 40 percent went on to have the ACL surgery within the two years of the study and it is speculated that more will probably do so, after that. But those who eventually had surgery turned out no better than those who didn’t.

Now, this was only a two year study, so they need to follow these patients for a longer time, to see if there is any difference in longer term results. Knees which are treated with exercise only may be more susceptible to meniscal injuries, or arthritis. But, time will tell.

Richard Frobell, of Lund University Hospital in Sweden, an author of the study, noted in an AP interview that: “It seems that if you start out with rehabilitation only … you have a good chance of ending up with an equally good outcome as if you had early ACL surgery.”

He went on to say that “maybe we will be surprised that a lot of people actually do not need an ACL reconstruction.”

Ya think?

I thought that over 25 years ago! Look, it’s a given that if you rupture your ACL, you’re going to get arthritis. The only questions are, how early and how bad? So the rationale for surgery was to raise the level of functioning and performance, because the cruciate deficient knee doesn’t perform as well as the reconstructed knee.

That’s still the rationale for the serious athlete. But that’s not most of us. For the average person or the more casual athlete, my old, non-surgical approach seems to be “new” again. Time has certainly vindicated my approach to this problem.

Anyway, if you are interested in a host of non-surgical options for ACL injuries, as well as torn menisci, sprains, arthritis and other well-known causes of knee pain, get my newest, comprehensive  healing program, HOW TO AVOID KNEE SURGERY

http://www.drbillsclinic.com/avoid_knee_surgery.html

It’s full of tips, tricks, treatments and alternative, as well as mainstream, methods to stay OUT of the Operating Room.

For example, a popular mixer drink can be used as a safe, natural muscle relaxant. The omega-3 fatty acids in pharmaceutical grade fish oil act like anti-inflammatory agents, similar to NSAID medications, but without the dreaded adverse side effects:

http://www.favoriteformulas.com

And it includes a selection of the most effective knee pain exercises, to prevent, reduce, or eliminate pain.

The point is, you DO have options. And now, there’s one more piece of evidence that conservative treatment may be all that you really need. That’s good news, in anybody’s book. Til next time, my friend, be well. And have a great weekend!

Yours for a pain-free tomorrow and your optimal health,

Dr. Bill

“The Wellness Warrior”           TM

It’s been a while since I gave you some straight dope on knee injuries and conditions, which is the main reason many of my subscribers are here. Between the building insanity of the Health Care Reform Bill (now law), as people begin to discover that all those assurances about keeping your own doctor, not having any “rationing” and other provisions were all misleading, if not outright lies, I’ve been focusing of late on general health and weight loss.

The other reason for that is the focus brought to bear by the First Lady on obesity (childhood and otherwise) and the Administration, which is now trying to dictate what you eat! And how much!

Mind you, I’m in agreement with many of their conclusions. I just don’t think it’s the business of the Federal government to dictate what I or you eat, or how much. Persuasion, yes…coercion, NO!

Anyway, for today, let me return to my primary raison d’etre-knee pain. Last week, I came across another web site about knee pain. I’m always looking for new information and even other authorities, in other disciplines, for other points of view, or new alternative techniques, or other helpful methods or resources that I might bring to your attention.

Now, I like to think I have a pretty open mind, especially for a surgeon with real, bona fide, top flight credentials and decades of clinical experience in mainstream Medicine and Surgery. The only thing I ask of any new or alternative methods is that they be based in reality and that they work. I don’t think those are unreasonable requirements.

So, I was a bit taken aback by a headline I recently saw that proclaimed that “bone-on-bone is B.S.” as a source of knee pain. Say, WHAT?!

Look, as a real doctor, who has actually seen and felt the inside of a knee many thousands of times, first hand, I think I know a few things that anyone who has NOT had that experience simply cannot know. Yes, I’m open to the idea that other influences, like chronic strains of muscles, ligaments and even “imbalances” of muscles around the joint, may play A role in eliciting arthritic knee pain. But not THE role, as the primary cause.

I think it’s ridiculous to suggest that a knee which has “worn down” to bone-on-bone is “B.S.,” as a cause of knee pain.

This descriptive term is one in which the articular cartilage has eroded away, exposing the bone on both sides of the joint, hence, “bone-on-bone.”  It’s called end stage osteoarthritis (ESOA). And it hurts like Hell!

The subchondral bone (including all its millions of naked nerve endings) is fully exposed to both friction and chemical irritants. Think of a naked nerve fiber being rubbed between two pieces of sandpaper and you’ll get some idea of what it must feel like.

That’s what causes pain, even at rest, or without weight bearing.

The suggestion that destruction of that protective coating plays a subservient role to these other, relatively minor factors, in the very severe knee pain that can result, is simply… absurd.

You can read more about arthritis and its precursors, like chondromalacia, and even see intraoperative pictures of them (so you, too, can actually see what we’re talking about) in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN

http://www.drbillsclinic.com/eliminate_knee_pain.html

This little volume is packed with information and advice from across the entire medical spectrum, including the latest mainstream conventional treatments, as well as alternative and complementary measures.

For example, it’s well known that the omega-3 fatty acids in fish oil have potent anti-inflammatory properties. And extracts of the New Zealand Green Lipped Mussel have an additional, unique anti-inflammatory effect. These can be had, in pharmaceutical grade supplements, in my POWERHOUSE OMEGA FORMULA and my JOINT HEALTH FORMULA:

http://www.favoriteformulas.com

http://www.favoriteformulas.com/jointhealth

As for muscle imbalances, which are often touted as the cause of all manner of joint pains, yes, there are often muscle imbalances around the knee-sometimes as the cause and sometimes the result of knee pathology.

And yes, they can be addressed with special exercises, isometric and isotonic, as well as stretches, which eventually change the pull of those muscles, as they are strengthened, and ultimately, resolve those imbalances.

The exercises in my PAIN-FREE PROGRAM are the very same exercises I’ve used on my own knee patients… and myself. So I’m living proof that they WORK.

http://www.drbillsclinic.com/exercise_eliminate.html

I have no problem with anyone that can help someone feel better. Hey, if any art or technique can help ease pain, I’m all for it.

But don’t defy logic, biology, biochemistry, physiology, pathology, mechanics and clinical experience with exaggerated claims for dubious alternative treatments, or run down known medical facts, just to impress the credulous.

Try to remember that not everything on the web is factual. So, let the reader beware! And do your homework, learn the facts, before you believe anything you read. Til next time, my friend, be well.

Yours for a pain-free tomorrow and your optimal health,

Dr. Bill

“The Wellness Warrior”                 TM

Nearly every week, I get a host of emails asking me a variety of questions. Whenever possible, I try to answer them as quickly as I can. I’m always mindful that many people who write to me have serious trust issues with some of the doctors they’ve met in the past, some of whom might be treating them right now.Many of my colleagues are not great communicators, even if they are good physicians. So there’s often a “trust deficit” that I need to overcome. On the other hand, there’s a lot of nonsense on the web and many people are only too willing to believe what sounds good, even if it’s “factually challenged.”

Striking that balance, telling someone the truth, while keeping their trust and disabusing them of nonsensical information, is sometimes difficult. But, that’s the business, here.

A pretty common problem, that I’m asked about all the time, is how someone who is very, very heavy for their size can even begin to reclaim their health. Beginnings are the most difficult thing of all, even harder than bringing something to completion.

Many people in that situation feel that they’re so far gone, that there’s just no hope. They’re so overwhelmed by the enormity of the task in front of them that they’re paralyzed into inaction.

They believe there’s no way they can overcome what they’ve done in the past. It’s impossible! So why even bother?

They become depressed, feel that it’s all over for them and reach for a pastry, to comfort themselves.  See, I do understand. I’ve been there, emotionally. And I’ve been there for others in the same proverbial boat.

Here’s the secret: you need to desire fat loss and the good health it brings MORE than the comfort (or despair) of the status quo.

In line with this theme of the difficulty of beginning, here’s a recent email that I received, from the husband of a woman who is in that situation, together with my reply, that will illustrate one way how you can do this.

For purposes of privacy, I’ve deleted the names, but the emails are real.

“Dr. Bill:

 I really appreciate your advice on anything dealing with joints, especially knees.

 The reason for me subscribing to your web page is my wife. She has osteoarthritis, but she is also obese (5′ 2″ and weighing over 280 lbs.). It’s hard for me to help her with any advice, because I know that it’s all mainly due to her weight.

Question: What would be the most practical exercise for her to find some relief? She cannot walk very far, due to the pain.  

Thank you.” Here is my reply: 

“If you have access to a swimming pool, let her walk in the pool, up to her chest. The water will buoy her weight, allowing her to burn up some fat.  If this is not available, get her a recumbent bicycle, available at most sporting goods stores, or Sears. Daily sessions will help, without stressing her joints.  Also, try to get her to walk, using two canes, like an alpine skier. The canes will help relieve some of her weight, at least on her hips, knees and ankles.  I’m sure you know this, but if you love her and want to keep her alive, she MUST get some of that weight off. She probably already has type 2 diabetes and likely high blood pressure, as well. 

A higher protein, lower carbohydrate diet, with lots of water, will help. Try my Special Report at: http://www.favoriteformulas.com/magicbulletfatloss  

Get her in to see a good doctor, ASAP, and get her appetite and her diet under control. Her life is at stake, here. No kidding. Good luck! Let me know how she does.

All the best,

Dr. Bill”

The problem here is that of a woman so obese that she can’t even walk without pain on her arthritic joints. So the solution is to kill her appetite, reduce her intake and boost her metabolic rate, without aggravating her overloaded joints with impact activities.

Protein and slow carbohydrates (by which I mean low glycemic carbs, that do NOT provoke a sudden surge of insulin secretion), with lots of water for hydration and healthy fats (including the essential fatty acids in fish oil, like my premium, enteric coated, pharmaceutical grade POWERHOUSE OMEGA FORMULA) 

http://www.favoriteformulas.comare the best combination for a diet that reduces hunger and stimulates glucagon secretion (the hormone that opposes insulin and also reduces appetite), as well as promoting fat loss.

Once sufficient weight has been lost, regular walking (with canes, if needed) can be added as a regular, daily activity. When one can walk at least 30 minutes a day, on a regular basis, resistance exercise can and should be added, to further boost metabolism and to build muscle.

Muscle is built by working against a load. And the more muscle you build, the better. Muscle burns energy, so muscle burns fat.

Any kind of resistance will do–body weight, free weights, machines, isometrics, or any combination of these, like the specially modified knee pain exercises in my newly updated and completely redone PAIN-FREE PROGRAM & DVD.

http://www.drbillsclinic.com/exercise_eliminate.htmlAlthough these exercises and stretches were designed to alter the dynamics of the knee joint, they also work the largest muscle groups in the human body, so they’re ideal for boosting the basal metabolic rate and building muscle, for long term increased fat burning capacity.  

Try these weight loss principles for yourself and see if I’m not right. Til next time, my friend, be well.Yours for a pain-free tomorrow and your optimal health,

Dr. Bill

“The Wellness Warrior”             TM

Got an unexpected email, just the other day, over the weekend. It was from Jerry, one of my old friends from my orthopaedic residency at St. Luke’s Hospital Center. Jerry was the third resident of our year, along with my pal Ben and me.

Ben and I were close to the same age and had a natural affinity. Jerry was considerably older than we and always seemed to be the odd man out. We weren’t really like the three musketeers; it was more like 2 plus 1, if you get what I mean. Not that we weren’t all friendly. But Jerry was just different from the two of us. We just never knew why.

The guy was a very nice, funny and affable man, who could speak Spanish like a native (although, I’m told, with a distinct Mexican accent), a real asset at St. Luke’s, right on the edge of Spanish Harlem and Morningside Heights, in New York City. But Wild Bill Fielding, our Chief, always seemed to give Jerry a hard time.

Ben and I were always sticking up for him with the boss. And poor Jerry always seemed to do something to get the old guy’s goat. He was constantly criticizing him, often times unfairly, so it seemed to us. So we felt honor bound to defend him.

After the completion of our residency program, we all went our separate ways.

Ben went out to California, after completing Sports Medicine fellowships at the New England Baptist in Boston (where I did my year as an Aufranc Fellow in joint reconstruction) and the Jobst Sports Medicine Institute in California. He’s currently a Big Kahuna in the Arthroscopy Association of North America, an instructor for their continuing education courses and a former team physician for the Olympic Diving Team. We’ve seen each other on occasion, at CME courses, and stay in touch by email.

Jerry went out to El Paso, Texas, right on the border with Mexico, where he established a huge practice from both sides of the border. I saw him and his lovely wife Lynn in Boston, at one of the Harvard Hip Courses, to which I used to go every year, until my injury caused me to stop doing surgery. Then, it kind of seemed beside the point. Anyway, I think that was in 2000, or 2001, or so. Hadn’t seen or heard from him since.

So it was a surprise to get an email from him, out of the blue. He included his phone numbers and invited me to call. I emailed back with my numbers. And then, I got a call that same day.

Wow. A voice from the past…but I immediately recognized him, even after all those years. He’s been on the move, visiting old friends, and may be coming to the Orlando area, sometime in the next few months. So, he thought he’d call me and see if I’d be interested in having dinner with his wife and him, when they are in town.

Seems he’s had a pretty eventful life, since we met last. His daughter had given birth to a child with a cerebral bleed, which caused him to close his practice and move to Houston, to be close to his daughter. That kid is doing remarkably well. Now, she’s just had triplets. So he’s really into being a grandparent.

Then, we got around to comparing notes on our respective lives and catching up. I learned a few things I never knew. The most important was that he was apparently in Viet Nam for a few years. He never spoke about it. But it explains a lot about the emotional separation, between Jerry and Ben and me, that we never understood. And, of course, it explains our age discrepancies.

But here was the kicker. Turns out that he had this secret social relationship with Dr. Fielding that we never had an inkiling about. They apparently went to museums together, out drinking and so on, as friends. We never had a clue. And Fielding’s seeming “picking on him” all the time was apparently a ruse, so that we’d never know he had any outside relationship with Jerry.

Well, that certainly worked. I never knew. Neither did Ben.

Click. It was like the last tumbler of a lock finally snapped into its slot. All of a sudden, lots of little things, that we interpreted one way, fell into place with this new insight. And I understood the wisdom of his keeping this from us, at that time. It all suddenly made sense…and I felt a lot more benevolent toward my old Chief. And I was grateful that Jerry finally let me in on the secret after all these years. How about that?

For my part, I told him about my years in practice as a joint specialist, the Chairmanship of my Department, my years as Associate Professor at Stony Brook, my wife and my cats, who have shared my life with me. And I told him about the defining moment of my current situation, the fall and the spinal fracture that ended my surgical career.

Then, I told him about the web sites and my quest to share my medical knowledge and skill via my programs, CD’s and writings, like my popular and newest healing joint pain program,                      HOW TO AVOID KNEE SURGERY

http://www.drbillsclinic.com/avoid_knee_surgery.html

I also told him about my supplement company, Dr. Bill’s Favorite Formulas, Inc., the source for the finest in enteric coated, pharmaceutical grade fish oil and the purest, most highly bioabsorbable CoQ10 on the market:

http://www.favoriteformulas.com

http://www.favoriteformulas.com/CoQ10formula

He was very supportive and thought that these were great ways to use my accumulated experience, since my disability prevents me from doing surgery. Then, he added that he was going crazy and being bored to death, because of not being able to practice orthopaedics. He’s a pretty high energy guy.

So, he’s currently been boning up on his didactic orthopaedic knowledge and he’s toying with the idea of…going back into practice, if you can believe it! He’s already set financially, so I guess what’s coming down the pike for doctors’ reimbursements, thanks to the obamanation of the new Health Care “Reform” Law, doesn’t matter to him. He’d rather be doctoring.

Well, we each serve as we can. When I hear from Jerry again, I’ll be sure and let you know. Til next time, my friend, be well.

Yours for a pain-free tomorrow and your optimal health,

Dr. Bill

“The Wellness Warrior”               TM

Have you ever passed by a young woman who was really overweight and idly thought to yourself, “Gee, if she were only 50 pounds lighter, she’d be a real knock-out?” Now, as a happily married man of 36 years and counting (and it does take some work, believe me… but mostly on her part), you might reasonably ask, why are you looking at young women?

To which I reply, “Hey, I’m getting older, but I’m not OLD. And I’m not dead, yet, either.” Any guy that claims he never looks at another woman is either lying, or he’s just not telling the truth.

And as an artist, I appreciate the aesthetics of a beautiful face and body. This, of course, is not the sole determinant of attraction. There is the old “great personality” factor.

When we were kids, that was code for, “she’s a dog.” But as with many things that our little pea brains couldn’t fathom at the time, turns out that’s really true. Time and experience have taught many of us that a warm, giving, loving personality can be very sexy and can make a woman, who is objectively plain, very attractive, indeed.

But since we’re talking about a chance passing in a public place, I can only appraise what I can see.

Prime example was a very heavy young woman I saw at the mall the other day, while I was walking. It’s been like high 90′s to even a 100 lately, so walking outside is not a great option, unless you want to get rapidly dehydrated. But the mall, it’s air conditioned, there’s always something going on and lots of people coming and going. In short, it’s not boring and it’s comfortable.

I was about mid way through my power walk, when I saw this very large girl coming toward me.

Now, she was easily 100 pounds overweight. But here’s the thing-she had really very fine features. I mentally stripped away those extra pounds and, based on her bone structure, I saw that she was a real beauty. Or at least, she would be, if she ever got serious and burned off that extra flabbage.

Are most guys going to go through that exercise, or hang around her long enough to find out what kind of person she is? You know the answer.

Fat chance! (So to speak.)

Now, I have to ask myself, why would a girl, who must be able to see what I saw in a glance, not do whatever it takes to reveal who she really is? Answer: because it ain’t easy.

All this is just on the basis of appearance, not health. But with all that is now known about obesity and its relationship to heart disease, cancer, high blood pressure, diabetes, lung disorders, arthritis, back pain, even depression, weight loss-or more properly, fat loss-should be a priority. Yet, until one is faced with a health crisis, or an actual disease, all of us tend to put off that diet, or delay starting that exercise program.

It’s just human nature. Most of us would be far more motivated by an appeal to our appearance-vanity, if you will-than our health.

I believe that’s because the threat to our health is an abstraction, a possibility somewhere in the vague future, that we believe might, or might not, actually happen. But appearance is right there, in front of us, now.  It’s a whole lot more immediate. And, because it appeals to our deepest sense of self, it’s a much more powerful stimulus.

Illogical? Yes. But it is what it is. I say, if it takes appeals to your vanity to get you to do something good for your health, which is a whole lot more important in the long run, so be it.

The important thing is to start. NOW.

Start by drinking lots of pure water. When I began my quest to lose weight, I gave up ALL sodas (or, “pop” as they call it here in the South), regular, sugar-loaded sodas AND diet sodas, both.

Then, begin to eat a bit of protein at each meal, with complex carbohydrates (fresh, non-starchy vegetables and whole fruits), lots of fiber and healthy fats. You will need to supplement your diet for the essential fatty acids, EPA and DHA, and the best source for these, bar none, is pharmaceutical grade fish oil, like my own  DR. BILL’S POWERHOUSE OMEGA FORMULA

http://www.favoriteformulas.com  

This is a natural, strategic way to gradually reduce caloric intake, reduce hunger, reduce insulin spikes and promote glucagon secretion, which cause your body to burn fat and discourage fat deposition. You can read more about the specifics in my recently released Magic Bullet Fat Loss Program:

http://www.favoriteformulas.com/magicbulletfatloss

With the diet under control, you need to boost your metabolic rate. And the best way to do this is to exercise daily, or pretty close to it.

Walking is something everyone can do. Walk with a brisk speed, like you have somewhere to go. Breathe deeply and pump your arms. When you can do a good walk for 30-40 minutes at a clip, then, add some resistance exercises, to build muscle and strength. 

More muscle means more demand for energy, ie. Fat. The more muscle you have, the more fat you’ll burn. It’s that simple.

One good way to do that is with my PAIN-FREE PROGRAM: 

http://www.drbillsclinic.com/exercise_eliminate.html

Although these exercises were designed to reduce and eliminate knee pain, they involve some of the largest muscle groups in the body. So they are also ideal for hiking up your basal metabolic rate (BMR).

Naturally, I recommend that you get a thorough medical check-up first, before attempting any drastic change of diet or habits. You don’t want to find out the hard way that you have some disease that could be made worse by your efforts. So get your doctor’s blessing before starting any program. But I’ll bet your doc will be thrilled that you’ve decided to be proactive in your own health care and will help you, every step of the way.

So don’t be like that potentially pretty but fat girl, who could be so much more than she is. Give your body and your health the chance they deserve. Take action, now. You’ll be glad you did. And your poor aching joints will thank you, too.

Til next time, my friend, be well.

Yours for a pain-free tomorrow and your optimal health,

Dr. Bill

“The Wellness Warrior”        TM                

As I’ve been warning for the last couple of years, now,the tentacles of unrestrained government into the field will have a dreadful effect on your heath care and your life in general. Today, the Obama Administration issued “new rules” for all new health insurance policies written after September that mandate that all screening tests and preventive care will be made available without additional cost, ie., no co-pays.

Now, I hate co-pays as much as the next guy. But the fact is, the insurance companies are corporations that are in business to make money for their shareholders. If they are not permitted to make money, they will go out of business. Simple as that.

Gee, guess that means that we’ll all have to be herded into a government controlled health plan, after all, just like a number of us have been predicting, despite all the protestations from the White House and its apologists. All those promises from the campaign, about how you can keep your current plan, if you like it…hey it’s not the Administration’s fault if the companies all, like, go out of business, right? Who knew?

Well, actually, we did. This has been the plan all along. (Not that I would say I told you so, but…).

But I’m sure a number of people will be shocked…SHOCKED, I tell you, that yet another promise is going down in flames. Just wait til we’re ALL paying that “millionaire’s tax” to pay for this mess.

This is of a piece with that end run around Congressional oversight over the 4^th of July recess (3 days!) of Dr. Donald Berwick, Harvard admirer of socialist medicine, revolutionary thinker and now the head of the federal Centers for Medicare and Medicaid Services (CMS). You owe it to yourself to see what this guy has said about YOUR individual health care. See Daniel Henninger’s excellent piece in yesterday’s Wall Street Journal, Berwick: Bigger Than Kagan for some illumination on what this guy has planned for you. Some “change,” huh?

http://online.wsj.com/article/SB10001424052748703792704575367020548324914.html?mod=djemEditorialPage_h

However this health care debacle turns out, one thing is certain-there is a coming paradigm shift in Medicine, from treating disease, after the fact, to preventing disease. When we were in Medical School, Preventive Medicine was about as bopring a field as you could hope to imagine. It was largely about epidemiology, sanitation, vaccination and other Public Health matters.

Today, it’s a whole lot more personal. And the powers that be have decided that your yearly Pap smear, or physical exam, or chest x-ray or mammogram, etc. is just too damn expensive. As for getting that heart surgery, if you’re above some arbitrary age guideline, forget it. As Obama once famously said, “Just take a pill.”

It’s a brave new world out there, my friend. They are about to crown mediocrity King (and low mediocrity at that).

Well, I DO think that prevention will save us. But not what THEY call prevention. What I propose is that you give your body the chance to heal itself. If you treat it right, you CAN prevent many diseases.

I’m always harping about weight loss (nothing worse than a convert, is there?) because it has so many health ramifications, for so many systems, including your weight bearing joints. It’s been shown that increased weight, along with impact exercise (like running) can accelerate any pre-existing degenerative changes. True, by themselves they won’t actually cause arthritic change. But most of us middle aged types already have degenerative changes of our joints, of which we are not aware (they’re subclinical).

Non-impact exercises are best, because they have all the strengthening and metabolic advantages of other exercises and none of the downside.

Some of the very best and most effective no or low impact exercises are those in my PAIN-FREE PROGRAM and DVD and my newest healing program, HOW TO AVOID KNEE SURGERY:

http://www.drbillsclinic.com/exercise_eliminate.html

http://www.drbillsclinic.com/avoid_knee_surgery.html

Combine these proven, excellent exercises with the positive, youth-enhancing effects of my pharmaceutical grade fish oil and other pharmaceutical grade supplements…

http://www.DrBillsFormulas.com

and adhere to a low/moderate fat, high protein, slow carbs, whole foods diet, with lots of pure water daily, and you’re more than half-way to heading off disease and prolonging your life. Get a checkup NOW, while you still can. And get any tests, or screening exams you may need in the next few years. Who knows if they’ll be available to you in the future? Don’t put it off. Get them done.

Good health is your birthright-but the older you get, the harder it is to maintain. Get started now. Because, regardless how this contentious Health Care debate turns out, the truth is, the only one you can really depend on is…YOURSELF.

Take care and have a great weekend, my friend. Til next time….

Yours for a pain-free tomorrow and your optimal health,

Dr. Bill

“The Wellness Warrior”           TM