January 8, 2010

As luck would have it, everything seems to break down, or go wrong, all at the same time. Ever notice that? We’ve just finished the stress of the Holidays, gotten past the loss of our oldest cat, Misty, had and dealt with my recovery from recent surgery and… wouldn’t you know it? The toilet breaks down and was running and running and running….and it’s only a week into the New Year.
 
Now these are old toilets, original equipment in this house, which makes them about 19 years old. So even the old bolts are rusted. Because they’re located in guest rooms, on the second floor, they don’t get much use. 
 
We only found out there was a problem when my wife decided to sleep up there, so as not to inadvertantly injure me during sleep, in my postop recovery (belly’s still pretty sore, but getting better, daily). Naturally, with me physically out of action and my wife lacking the physical strength to turn a rusted bolt, or even turn off the water, we had a problem.
 
So, we called our plumber. Normally, he would come right over. But, as we were in the midst of a true “when it rains, it pours” episode, he was tied up installing a massive water heater for a hotel, in which 4,000 people had no hot water. Figures, right?
 
So, he sent over an assistant today. Nice guy. John’s his name. He’s only 28, next month. And he’s making his living as a plumber. We took him up and showed him the problematic toilet.
 
He knelt on the marble floor, while he opened the commode and saw what was what. Turns out that, given the age of the old unit, it would be smarter to simply replace the old appliance with a new one. Figures, right? 
 
He turned off the water, so at least we weren’t still wasting it, by letting it endlessly run. But because he was a young guy and a nice guy, I decided to give him some free advice, that will make a big difference to his future comfort.
 
You see, a plumber, like a bricklayer, roofer, rug layer, or any trade that must kneel on unyielding surfaces to do their work, all have the same problem. They MUST assume that position, but it eventually causes severe knee pain. That’s the plumber’s dilemma. Here’s the solution:
 
Never, NEVER kneel on a hard floor, especially marble, concrete, brick, porcelain tile, or even wood, without a knee pad, of some kind. Here’s why.
 
The knee joint is designed to bear weight from top to bottom, NOT front to back. In other words, the kneecap (patella) is not designed to directly bear the stresses of weight bearing. This has consequences for the protective cartilage coating behind the kneecap, over time.
 
These abnormal forces may lead to degenerative softening of that cartilage coating, leading to knee pain due to chondromalacia patellae. I describe this and what to do about it in great detail in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN, which you can get here:  http://www.drbillsclinic.com/eliminate_knee_pain.html   and the specific, startegic exercises, that can relieve that knee pain over the long term, are outlined, step by step, in my newly re-written, greatly expanded PAIN-FREE PROGRAM & DVD, which was designed as the perfect companion to the Little Green Book.
 
http://www.drbillsclinic.com/exercise_eliminate.html 
 
In the short term, knee pads are the way to go. The problem is that for some, like this guy, John, the straps of knee pads pinch and bind the backs of their knees, thereby discouraging their use.
 
So, instead, he should use a small pad upon which he can kneel, either cloth, a section of carpet, or a gel pad. In any case, the object is to spread out the body weight over a larger area. This effectively reduces the unit stress on the relatively small kneecaps, same principle as snowshoes, reducing pain and preventing compression damage to the retropatellar cartilage.
 
Simple. Easy. Cheap. And, most important, effective. And likely to keep this young man from developing knee pain and arthritis in the years to come. Keep this in mind, whenever you have a similar home care project, that requires kneeling. 
 
And be sure to take my POWERHOUSE OMEGA FORMULA,   http://www.favoriteformulas.com   an ultra pure, enteric coated, pharmaceutical grade fish oil, with maximal omega-3 fatty acids and potent, proven anti-inflammatory properties, that reduce joint pain, back pain and have numerous heart, brain and blood vessel benefits. I take it, twice a day, every day (at least when I’m not pre-or post-surgery). You should, too.
 
Well, that’s my tip o’ the day, my friend. Have a great weekend and be well. Talk to you again real soon.
 
Yours for a pain-free tomorrow and your optimal health,
 
DR. BILL
 
“The Wellness Warrior” TM 
 
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 conventional and alternative treatments and exercises to relieve knee pain without surgery click on http://drbillsclinic.com/avoid_knee_surgery.html 
 
P.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, 2010 by William Thomas Stillwell, MD, FACS
All rights reserved

 Over the weekend, my wife decided she needed a trim, so we went to our favorite salon. Who should we meet while there but Nanetta, the girl I wrote about last week, with the painful knees. While I was paying for my wife’s haircut, I casually asked Nanetta how her knees were doing.
 
“Oh, they’re still hurtin’ me” she said.

“Did you do what I told you to do?,” I said.
 
“Well, not really,” she said. “I mean, I have to stand up in here all day. And I had to climb four flights of stairs over the weekend. So they’re really hurting me, now,” she finished.

“Yeah, I understand that you have to stand to work, but have you done anything that I told you to, last week?” I asked. “You know, like applying local heat, or doing quarter squats to strengthen your knees, or using anti-inflammatories…ANYTHING?”
 
“Well, no, not really,” she replied.
 
“OK. Well, you know, if you don’t change anything, nothing is going to change for you,” I said, gently.  “At least try climbing stairs the right way, for a  start, to keep from aggravating the problem. When your knees are hurting, pick the one that hurts the most and call that one your “Bad” leg.  “When you have to climb stairs, go UP to HEAVEN with the GOOD leg; DOWN to HELL with the BAD leg.”
 
I then explained that this simple alteration in her behavior would have a significant impact in relieving her pain. The idea is that the “bad” leg, the one with the most painful and disabling kneecap pathology, is kept straight during this method of climbing stairs, and this, in turn, allows the cartilage of the kneecap a chance to heal, or at least avoid continued aggravation.

She promised to give it a try, but I have my doubts. This was just the latest example of the rule that says that people don’t value what they don’t pay for. I’ve lost count of how many times people I’ve met in informal settings completely disregarded my advice, and then, wondered why they simply didn’t get any better.
 
Even in my practice, many times a patient would come to see me, pay for x-rays, pay my initial consultation fee, pay in lost time and lost wages they didn’t earn during the consultation and examination, listen intently to my instructions, and then completely ignore them. They’d come back the next followup visit and sheepishly admit that, no, they hadn’t taken the medicine, and no, they didn’t follow the instructions, and so on. Then, they’d say, “So, doc, how come I still have this pain?”
 
I generally let them live….But it points out the utter disregard many people have for good solid advice, that they’ve paid good money for.        I guess I shouldn’t be surprised that advice they DIDN’T pay for is ignored, as well. It’s a perversity of human nature, I guess.
 
In later years, I didn’t even get upset at them in the office. I would just smile gently and say, “You know what? I’m not the one who’s in pain. YOU are. If you don’t care, why should I? If you want to pay me for my advice and then ignore it, so you have to keep coming back, to pay me again and again, fine with me. That’s how I make my living.” 

Oftentimes, this little speech would snap them out of it and they’d realize that they were sabotaging themselves. Other times, they’d stay stuck in the same self-defeating pattern, until they got tired of coming or finally wised up.
 
The point is, the best information and advice in the world will not help you, if you fail to ACT on it.
 
I’ve boiled down an incredible amount of medical knowledge and clinical experience and condensed it in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN  (http://drbillsclinic.com/eliminate_knee_pain.html)
to make it easily accessible for you and to give you a number of options for relieving your pain. In the same way, I’ve selected and specially modified the exercises in my PAIN-FREE PROGRAM, which you can see at
http://drbillsclinic.com/exercise_eliminate.html   but if you don’t apply what I teach, none of this can help you. 

I think it was Einstein that said that the definition of insanity was doing the same thing over and over again and expecting a different result. If you don’t resolve to make some changes; if you don’t DO anything, then you can’t be surprised if you don’t get any better.
 
I’ve done my part. The rest is up to YOU. 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