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

January 2, 2009 

Ever get up in the morning and feel a dull ache in your knees? I know I do, or did, before I started using the conservative treatments that I now teach in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN  http://drbillsclinic.com/eliminate_knee_pain.html
 
The REASON for the ache is usually some form of joint inflammation. This sensitizes these nerve endings so they respond to the atmospheric pressure. That’s why they ache more in damp weather (when the barometer falls).
 
The most common cause of knee pain that I saw in my years of orthopaedic practice was a degenerative disease of the kneecap called chondromalacia patellae.
 
Chondromalacia patellae is a Greek term for “soft cartilage of the kneecap.” If you have pain when you kneel, squat, climb stairs, run, jump, or even when you sit with your knees bent for long periods, the odds are good that the cause is CMP.
 
I’m very familiar with this, as I have it myself.
 
This disease is often progressive and the softening gradually evolves into shredding of the smooth cartilage surface, so it breaks up like “crabmeat.” This is the cause of crunching and grinding that you feel when the knee is bent under load, as when climbing stairs or getting off a chair or toilet.
 
So, what to do?
 
If you have pain in front of your knee, the first thing to do is avoid those activities and positions that seem to cause the pain. 
 
I know this seems ridiculously basic, but you would be amazed at how many people make themselves much worse, by continuing to do what caused their problems to start with. 
 
Next, try to keep your knee straight. This applies much less pressure on the kneecap, and thus, gives it a chance to heal.
 
In the days to come, I’ll give you more information on this condition and teach you what you can do to relieve your pain. But if you want the full story, run on over to my web site and grab a copy of DR. BILL’S LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN, right now, at   http://drbillsclinic.com/eliminate_knee_pain.html 

Well, that’s all for now. But I’ll be back soon with more on knee pain and some tips to help you get rid of it.
 
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 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, 2009 by William Thomas Stillwell, MD, FACS
All rights reserved

I got up this morning prepared for a marathon day.  And, it didn’t disappoint. The bride has decided to move a bunch of our stuff to the Northern Command in Southampton. So the moving guys showed up, as expected, this morning. I barely made it out of the shower when they were knocking at the front door.
 
So the bulk of the day was spent making and taping cardboard boxes, packing china, crystal, artworks, and lots and lots of books. While the moving men were active with all this activity, I was emptying and winnowing all the files and papers in my home office file cabinet. 
 
Now normally, I’m awful at this type of thing, because I can’t go through three pieces of paper without starting to read some of it. Then, I get hooked on what I’m reading, or “discover” something that hasn’t seen the light of day for years–”Oh, THAT’S where that was…” So I’m about as inefficient at packing as it’s humanly possible to be.
 
These moving guys, who do this all the time, can empty an entire bookcase, hell, an entire room, while I’m still fooling around with my files. Their secret is that they’re detached. They could care less what they’re packing, so they pack quickly. 
 
We’ve used this bunch before and we trust them. These are experienced and seasoned moving veterans, one guy in his 40′s and the other, who is the driver, just 50. Despite the constant physical nature of their job, though, neither one is obviously muscled. There’s nothing to indicate the incredible level of wiry strength they can easily summon. The driver is only 130 pounds and wears the same size pants he wore in high school.
 
Yet, I’ve seen him hoist weights that seem to dwarf him, and carry them out to the truck, like they were nothing. The little guy’s as strong as an ant. Sure, part of it is technique, proper body mechanics and the knowhow, born of experience. But most of it is the functional total body strength that results from repeatedly handling awkward loads, in real life situations and day to day activities. 
 
This kind of strength can’t be built in a gym, lifting free weights that isolate specific muscles in limited arcs of motion. To develop this kind of functional strength, if you’re not a mover, or other physically active professional, you need to train your body as a functional unit. And in my experience, there’s no better way to do this than Matt Furey’s International Best Seller, Combat Conditioning. See what I mean at http://drbillsclinic.com/combat_conditioning.html
 
This was supposed to be a “little move,” only some of our stuff, not the bulk of it. But it still took two full days and they used up all the boxes they had brought, mainly on my books–I have a huge library, full of arcana from all over, covering many diverse subjects, as I have very broad and wide ranging interests. So, I had to run out to Home Depot and buy a whole lot more of them.
 
When the guys were finished packing up all our stuff, it was time to load the truck. They had hired some local talent to speed things up a bit. While that was going on, the driver got me aside and said, “Hey, doc, can I ask you a question?”
 
Now, if you ask any doctor, they’ll tell you that we get this all the time. Many of them hate it. But not me. I always felt it was a privilege to be able to help someone with what I know. Turns out he had a common problem–pain in the kneecap, worse when he was driving his big eighteen wheeler truck for hours on end.
 
Odds are good he had chondromalacia patellae, a degenerative softening of the kneecap cartilage, sometimes due to injury, or aging, but at least half the time, for no apparent reason. You can learn more about this and other conditions that cause knee pain in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN   http://drbillsclinic.com/eliminate_knee_pain.html
 
I advised him to get a pillow and put it under his thigh while driving his big rig, and to push the seat way back, so his knee can be held straight. This allows the kneecap to “float” and usually relieves the pain. I also advised him how to use OTC medications safely, but effectively, and how to combine them with some proven alternative treatments for fast pain relief. See how in detail at http://drbillsclinic.com/avoid_knee_surgery.html
 
It took til after 8 o’clock tonight, but they got it done. So they’re starting out back to New York tonight. The bride and I will collect our next batch of cats and start our trek tomorrow. It’ll take all weekend, since we have to stop every eight hours or so to let the cats out, to run and use the kitty box, eat and drink. But hopefully, by Monday, we’ll be there to accept delivery of all our stuff on the other end.
 
I’ll talk to you then. Meanwhile, have a great weekend, and 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

I was notified by my email account that my account was in danger of becoming completely filled and was advised to purge some of the emails that I had let accumulate. In the process of winnowing those that I still wanted to save from those that could be safely eliminated, I came across a few that I thought might be instructive for you.
 
Every so often, I get emails from some poor souls who are suffering with persistent, or progressive knee pain. They ask for help in relieving their pain and in many instances, are fearful of knee surgery. This is one such exchange, which I pass on for the lessons it entails. I have deleted any reference to the author’s origin or identity, for reasons of privacy, and some products this person was using, but otherwise the emails are as they were written. 
 
I’ll have a few comments after you read this:
 
“Dear Dr Bill
 
I came across your website and am writing to ask your advice on which of your books would help me the most (I have spent $$$$$ on lots of so-called self-help measures, like anti-inflammatories, painkillers, etc).
 
I have what surgeons call very “mobile” knee caps. It stems from being very slightly knock-kneed. About 15 years ago (when I was in my twenties), my right knee was operated on,­ after it started to track incorrectly as a result of a fall. 
 
I had a “lateral release” arthroscopy. I was advised to have another on the left knee (I never did). Today, both my knees are extremely sore and painful. I used to do yoga, but stopped two months ago, as it was too painful for my knees.
 
The last month or so, both my knees have buckled and collapsed at the same time on two separate occasions, leaving me to collapse in a heap and barely able to walk. My right knee (the one operated on) is by far the worst. It is sore, inflamed and very painful. My left knee is not so inflamed, but is also very sore and painful.
 
I swim about once a week and exercise on steps in the pool to try to build the strength up in my legs. My knee surgeon once told me we generate four times our body weight to get up the stairs! The pain in my knees prevents me from exercising more, ­even walking. When my knees collapse, I am forced to use a cane to get around for a few weeks.
 
More recently, a GP suggested getting the meniscuses in my knees trimmed so that I can walk better. Given the experiences of my last knee operation, naturally I am not inclined to have more surgery!
 
I would welcome your advice and especially advice on which of your books may help me the most.
 
And I am a vegetarian, so fish oil is out of the question.
 
Thanks for your help and I look forward to hearing from you.
 
Kind regards…”
 
Here was my response:
 
“Sorry to hear of your problems. Your story is a common one, though. Your pain is coming from chondromalacia patellae, a degenerative softening of the cartilage in back of the kneecap. This is caused by the loose (hypermobile) patellae, which in turn is due to lax ligaments and weak muscles.
 
The best value book of mine that will help you is the newest one: HOW TO AVOID KNEE SURGERY http://drbillsclinic.com/avoid_knee_surgery.html
 
That includes herbs, alternative measures, and a selection of exercises that should improve your condition, by strengthening the VMO muscle.
 
Instead of fish oil (given that you’re a vegan), try FLAX SEED OIL, as a source of omega 3 fatty acids. Other herbal anti-inflammatory measures are in the book as well. 
 
Good luck. Hope this helps.
 
Best wishes,
 
Dr. Bill”
 
Well, she took my advice and this was her follow-up email:
 
“Thank you so much for getting back to me so quickly (and in the middle of the night??) with useful information and advice.
 
I’ll definitely order the book – although I’m inclined to order the Little Green Book, as well
 (http://drbillsclinic.com/eliminate_knee_pain.html ).
 
I don’t know much about your background, but from what I’ve read so far, you truly appear to be an ethical doctor with the highest level of integrity and one that is willing to readily share his knowledge: that in itself is remarkable as well as highly reassuring.
 
This morning, I tried the leg raises you suggested in one of your articles (with one knee bent) and immediately felt the legs were stronger. 
 
Everyone else who has told me to do leg raises in the past has suggested raising both legs at the same time (which I would do for a while, but then give up because of the strain on my back). One physician suggested raising the legs with the head held up (which then puts a strain on the neck!) You are the only one who recommends bending one knee, while raising the other leg.
 
For the first time in a long time, I have confidence that – thanks to you – I can beat this problem, without knee surgery.
 
I will keep you posted of my progress and hope you won’t mind if I contact you again should I have any questions. And of course, I’d be more than happy to provide a testimonial in due course!
 
Thanks again for your help and advice.”
 
And if you have knee pain ruining your life or the life of a loved one, don’t suffer. Help me to help you. Get my new program. Click here, NOW:   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 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

About seven months ago, now, I wrote you about one of the girls that works in the salon, where I get my hair cut. Her name is Nanetta, and she’s a nice, attractive, middle aged, fairly tall and big boned, broad shouldered woman, a bit overweight for her size, perhaps, but not too bad. 
 
Well, last March, I wrote about her complaints of knee pain, mainly in the anterior compartment (the front of the knee). It was my feeling that she probably had some chondromalacia patellae, a degenerative softening of her retropatellar cartilage. That’s the usual cause of anterior knee pain, though not the only cause. 
 
I had though that was what she had, though, because she also had difficulty climbing stairs, both pain and weakness. Generally, when you have weakness of your quadriceps muscles associated with kneecap pain, chondromalacia is a good bet. You can learn more about CMP and the other causes for knee pain at   http://drbillsclinic.com/eliminate_knee_pain.html
 
In any case, I started her on some of the basic knee exercises that I teach in my PAIN-FREE PROGRAM at
 http://drbillsclinic.com/exercise_eliminate.html
 
Yesterday, since I had a little free time and since I was beginning to look “shaggy,” I decided to visit the local salon for a trim. As it happened, Nanetta was on duty and said she could take me right then, if I’d come straight over. So, I did.
 
After the usual pleasantries we exchanged, she got down to it. While she was restoring my tonsorial contours, we chatted about this and that. Then, I asked her, “So, how are your knees doing?”
 
And she replied, “You know, I hadn’t thought about it, but they haven’t bothered me for a couple of months now.”
 
“No kidding?’ I said. “Well did they just get better on their own, or did you actually DO what I told you to do?”
 
“No, I really DID do the exercises you gave me,” she said. “They were really tough, at first, even the basic ones. But then, they started to get easier and the pain just went away. In fact, I hadn’t even thought about the pain until you asked me about it.”
 
“Well, I guess the stuff works, huh?” I said.
 
“Yeah, it really does. Thanks so much. I feel much better now…”
 
So here we have it, my friend, “living proof” that the exercises from my PAIN-FREE PROGRAM are safe and effective. They’re specially modified to prevent or eliminate knee pain of all types. And they’re “field tested,” because they’re drawn from the same exercises I used to treat my own patients, and those I used on my own knees, too. They worked for Nanetta’s knees and they’ll work for yours, as well. Just click on this link for your own copy:    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

Just yesterday, I came across an article on one of the sports blogs about the various knee injuries seen with a number of sports, including basketball, soccer and football. With the Olympics in full swing, it’s easy to focus on the more dramatic sports that get much of the press, when it comes to knee injurues, acute and chronic.
 
But surprisingly enough, one of the most frequent causes of chronic and acute knee problems is… GOLF! Now, golf is a gentleman’s (or gentlewoman’s) game, no doubt about it. And it looks like the players mainly walk around, when they’re not riding in their electric golf carts. They don’t even carry their own golf bags–a caddy does that for them. But if the knee problems generated by this sport aren’t as dramatic as some, they’re no less real. 

You see, golf applies more subtle forces across the knee joint, that are often internal. Walking on uneven terrain, rolling hills, even sand traps, induces the same irregular joint forces as walking on a beach. And the torque, or twisting forces, imposed on the knees with every drive are tremendous.  In fact, it’s that twisting stress, with full body weight on the knee, from every swing of the driver that’s responsible for most of the injuries.
 
You normally don’t even think in terms of golf injuries until some high profile player, like Tiger Woods, is knocked out of competition by his bad knees, or some specific knee injury. But the danger is always there, maybe especially for the average player, who isn’t conditioned as well as the professional athletes.
 
You go into any golf club or country club locker room and all you’ll hear about is aches and pains of shoulders and knees. Well, part of that is simple aging. Lots of boomers and seniors play golf, which aggravates dormant conditions, like arthritis, or synovitis, or chondromalacia patellae (for a complete run-down of the many problems of the knee, in layman’s language, see my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN   http://drbillsclinic.com/eliminate_knee_pain.html ).
 
But part of it is newer injuries, like ligament sprains or ACL tears, or especially torn menisci, caused by that repetitive twist. Pain in the knee is so common in this sport that I call this chronic knee pain “Golfer’s Knee.”
 
While Tiger had a completely ruptured Anterior Cruciate Ligament, as well as a meniscus tear and articluar cartilage damage, all of which require surgery, in many cases, proper conservative treatment of Golfer’s Knee can avoid knee surgery. As it happens, my latest publication provides golfers and anyone else with all the tricks, tips and effective techniques from across the entire medical spectrum, conventional, alternative and complementary. It’s called HOW TO AVOID KNEE SURGERY  http://drbillsclinic.com/avoid_knee_surgery.html
 
Acute pain is treated first by anti-inflammatory measures and joint stabilization, while long term treatments focus on specialized exercises and stretches, to improve strength and stability. These are supplemented by nutritional measures, herbs and nutriceuticals, to enhance healing and retard the development of arthritic changes. 

Yes, there are situations where surgery is needed. But my goal is to teach you how to prevent an UNNECESSARY surgery, of which there are far too many. So, if you have knee pain, from Golfer’s Knee, or any other source, learn how to relieve your pain and restore your function, with the best conventional and alternative non-surgical methods. Go see how at   http://drbillsclinic.com/avoid_knee_surgery.html
You’ll be glad you did. 

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

Over the weekend, like many other people, I’m sure,  I periodically tuned in to the Olympics on NBC. The other night, I watched as Mariel Zagunis beat a much taller, larger woman, in the sabre fencing competition, with lightning quick stabs. Not quite like the flamboyant displays of Errol Flynn, or more recently, Antonio Bandaras as Zorro, but effective, nonetheless. 

She then went on to beat her own team mate, Sada Jacobsson (ranked world number one) 15-8 in the finals competition to win the gold medal, the first US gold in Beijing. In fact, the USA swept the women’s individual sabre competition.
 
Now, fencing isn’t usually a sport that holds my interest. It just happened to be on the TV when I tuned in. But I was captivated by the jittery, lightning quick moves displayed by the combatants. It certainly was different from what we’ve come to think of as fencing. And I was particularly struck by the role of the knees in executing these lunges.
 
I could easily imagine how strong their legs must be to hold that en guarde position and then rapidly uncoil to lunge forward in the thrust past the opponent’s sword. It all depends on their knees. 

Now imagine how different the results would have been if Mariel Zagunis, or any of the other competitors, had serious knee pain. No contest. They simply couldn’t do it.  Any attempt to lunge forward in that case would cause a quick, stabbing pain in the front of the knee and abort any attack. And of course, if it were real sabres in a real duel, that would result in death.
 
Well, the reason these world class competitors are able to execute these lunges is because the years of exercise have strengthened their knees and stabilized their kneecaps, so they don’t develop chondromalacia patellae, or degenerative disease, which cause the anterior compartment pain in the knee. You can learn more about the various disease that can cause you pain at
http://drbillsclinic.com/eliminate_knee_pain.html
 
Same thing in Women’s soccer, which I watched the next day. The continual conditioning of these athletes is what helps to protect them from injury. Now, soccer, which requires running, sudden changes of direction and rotational movements, like pivoting and twisting, often with all the body weight on one foot, is a sport that subjects it practitioners to a much higher risk of injury than fencing, which involves chiefly linear movements. Like professional American football, soccer players often get torn menisci and ruptured anterior cruciate ligaments(ACL) from these torsional forces.
 
While you can’t play these aggressive competitive sports and not expect that you might be injured, you can minimize the risk by strengthening all the muscles around the knee, especially the VMO. Quarter squats, terminal extensions with resistance, Hindu squats, all are excellent exercises for creating a margin of safety for the athlete. And the same exercises are fundamental in treating knee pain for the long term.
 
After an injury, the initial treatment is aimed at reducing the resultant tissue inflammation. But after the initial swelling, fluid build-up and redness of inflammation have receded, it’s important to rehabilitate the knee with a variety of exercises to enhance stability, ensure central patella tracking and increase strength.
 
These and other specially modified knee exercises, which are designed to prevent or eliminate knee pain, are the core of my popular PAIN-FREE PROGRAM. See it at http://drbillsclinic.com/exercise_eliminate.html
Choose your own selection from the recommended exercises. Do these exercises at least three times a week, and they will relieve your pain and literally transform your life. Try it and see for yourself.
 
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

“Everyone…this is Bill.”

 ”Hi, Bill.”

 Just kidding. This has nothing to do with THAT twelve step program. It has to do with one way you can get rid of your chronic knee pain. 

You see, if you’re a boomer, like me, or just a guy or gal who has annoying or even severe anterior knee pain, most likely, it’s because of a kneecap problem. And most kneecap problems are NOT due to injury, but rather to a weakness of the quadriceps muscles in the thigh.
 
Why should this be so? Well, just think about it for a minute. Today, many people live in single story homes, drive everywhere they go, and haven’t been on a bicycle since their early teens. Eventually, this sedentary lifestyle catches up with you and, as you age, the cartilage behind your kneecap begins to soften, or worse. We, in the trade, call that chondromalacia patellae: literally “soft cartilage” in Greek.
 
This is a degenerative disease, kind of a first cousin of arthritis. And, oddly enough, up to a certain point, it’s actually reversible. The key is to reverse the muscular weakness with exercise. Now, I know this is anathema for a whole lot of folks, but it’s hard to overstate the importance of exercise in preventing, or eliminating knee pain.
 
I saw a great example of this in my first year of practice. The Hospital Administrator of St. John’s Episcopal Hospital came in for a late evening appointment. For political reasons, he had to avoid the appearance of favoritism to any single office. But, hey, he had knee pain, did his homework, and decided that I could help him. Hence, the late visit.

He had begun having pain in the front of his knee, as well as giving way. He was afraid that he had torn a meniscus and that he would need surgery. It was enough of a worry for him that he wanted to be treated by the best available surgeon, if that indeed turned out to be necessary (that would be me). So, despite his misgivings, he came in.

After his initial history, I did a thorough examination of his knees. Sure enough, he had temderness under his kneecap, and more diffuse tenderness at his inner (medial) joint line. But most striking of all was quad weakness that was amazing! I mean, he couldn’t even begin to resist my efforts to bend his straightened knee. Anyone’s thigh muscles should be strong enough to resist an examiner’s arm–there’s no comparison in the relative strength of these muscles. I was dumbfounded. I’d never seen that level of weakness in an otherwise healthy, fairly normal, middle aged man. It was bad enough that I actually worried about a potential neurological disease, at first.
 
Turns out that he almost never did any exercise, not even stair climbing. Well, that was better than a neurological disease. At least it was potentially reversible. But, it required a real effort on his part and a real change in behavior. I started him on a course of Physical Therapy, including the exercises that eventually became my PAIN-FREE PROGRAM  http://drbillsclinic.com/exercise_eliminate.html
 
In addition to quad setting and straight leg raising, quarter squats and leg extensions, I had him climb stairs. All these exercises helped him strengthen his quadriceps, especially the VMO. And as his strength improved, his pain simply went away. He was amazed and, as you might expect, very, very happy. He had avoided surgery, or even an arthrogram (this was in the early eighties, before MRI’s were available. Naturally, from this point on, I was “golden” with this guy. But the key thing is the importance and the potency of simple exercise in the relief of knee pain.
 
This is a simple test you can try yourself, if you have anterior knee pain. Try climbing a staircase–most have twelve, sometimes thirteen, steps, and do it for repetitions, several times a day. Give it a week or so, and I’ll bet you feel better. Not perfect perhaps, but better. This twelve step program is a good way to strengthen those quads. That’s why I included stair climbing in my PAIN-FREE PROGRAM, which you can see at
 http://drbillsclinic.com/exercise_eliminate.html   as well as a number of other excellent exercises to prevent or eliminate your knee pain. Give it a try!
 
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

April 17, 2008

The Pope is in Washington for his first visit to the good ol’ USA. And I have to tell you, it was refreshing to hear about America’s greatness from an infallible source. God knows we don’t hear about it from our own press corps, or many of our politicians and candidates for President. No, Pope Benedict XVI was on the money about us and our national character, and the good we have done in the world. No, we’re not perfect –far from it. But at least we TRY. Like Churchill said, “democracy is the worst form of government, except for all the others.” We have the freedom to succeed and the freedom to screw up and fail. But even our failures imply an implicit acknowledgement of what correct standards should be. And that’s what the Pope represents–defined standards of behavior. 

Now, I don’t agree with all his positions, but at least he has some and he’s a passionate and articulate advocate for them (in many languages, I might add). I should also add that I’m not a Catholic, myself. They barely let me into a church, these days, for fear of lightning, or the roof falling in . But I admit, I’m a fan of this guy. 
 
It’s true that doesn’t have the warm and fuzzy, saint-like prescence of his predecessor; he’s a man of intellect and reason. But he has the courage to face down the most outrageous excesses of today’s world, bloodthirsty religious extremism for example, and call it what it is. That alone is worth a lot, in a world that seems obsessed by excusing and fawning over terrorists, dictators, and totalitarian regimes. Witness almost any resolution of the feckless UN for a validation of that observation.  In short, he represents civilization, and he’s not afraid to call the enemies of civilization what they are. I admit,  I admire that.
 
So, I was truly appalled by those who criticized him as a representative of the Catholic Church, for which they bear some animus. What they are actually angry about is being called on their own positions and being found wanting, by someone who is an acknowledged moral authority. It’s not enough that they have the freedom  to do as they please. No, they have to have moral vindication of their positions, even if it’s a brittle and hollow one. So they mock and belittle this decent and learned man, and fail to acknowledge the good he stands for. And the press allows this, even tacitly agrees with it. Because they know that they can do this with impunity, and no one is going to saw off their heads, or kill other people at random, in mindless riots at the insults.
 
It is true that the Catholic Church has plenty of its own disgraceful periods to atone for–the Inquisition comes to mind. But we need to remember that we must go back quite a few hundred years for these episodes and that, though it represents its perception of the Divine, it
is still an institution of men, who are not. And today, if you choose not to believe, they will pray for you, and feel that it’s your loss; you won’t be murdered for your lack of faith.

I think he represents the best of our civilization, even though I disagree with many official Church positions.  The good that the Church has done outweighs the harm it has done, on balance (kind of like the USA).  And lest we forget, it was through the Church that we have any knowledge at all of the history and wisdom of the ancient world, that would otherwise have been lost forever in the Dark Ages. 

Now, I’m not prosletizing for anyone. My own view is, believe what comforts you. It makes no difference at all to the universe, as it is. Sooner or later, we are all  going to die, and then, we will KNOW. So why waste what precious time we have on this world, arguing and slaughtering each other over what CANNOT be proven?  To believe without proof is the essence of faith, is it not?
 
I remember one time during my years in practice the Catholic chaplain, a monk, who was a very good, kind and wonderful man, came into a room where I was seeing my own patient, to see him, wish him well in his upcoming surgery and provide some spiritual support.  The patient in the next bed, a self-professed “born again”  Christian, just started criticizing the Catholic Church, the chaplain, as its local representative and in general, mouthing off.  The good friar took this with gentle equanimity, excused himself and left. I however, as a less evolved being, was furious FOR him. Only my professional discipline kept me from reaming this moron a new one. How dare he! 

Here’s a good and decent man, the friar, who has taken and KEEPS vows of poverty, chastity and piety (talk about medieval–I would fail all three), administering comfort and spiritual aid to a troubled soul, and this pompous a-hole decides one day that he’s going to be “born again”
and he believes this qualifies him to criticize the friar, who has PAID for his beliefs, in the coin of his life.  The friggin’ nerve of this guy! 

While I’m sure there are many devout people of good will in the fundamentalist Christian churches, I’ve always viewed the “born again” like the late, great William F. Buckley, Jr., who said, “I don’t need to be born again. I got it right the first time.”
 
And, as has been my experience with anyone, of any faith, that claims a hotline to the Almighty, this obnoxious guy seemed to have forgotten that the essence of his professed faith is… LOVE. Well, following the example of the good chaplain, I let him live.
 
You see, it doesn’t matter to me that another person has a faith different from mine, or that I might not agree with its theological niceties. What matters to me is the commitment, the genuine dedication to an ideal.  That’s what I revere, what I admire. And for that reason, I used to give “professional courtesy” to pastors, rabbis, priests, nuns and bishops. I would have done so for any Muslim imams, or Buddhist monks, if I had any. 

I saw a surprising number of people in the religious life–the kneeling, you see. All that kneeling and genuflection takes a toll after a while. Many of them had severe knee pain from chondromalacia patellae or patellofemoral arthritis. You can learn about these at  http://drbillsclinic.com/eliminate_knee_pain.html    Many times, I could treat them with conservative measures, like the exercises in my PAIN-FREE PROGRAM   http://drbillsclinic.com/exercise_eliminate.html    At other times, they needed surgery.

But I was always impressed with their unfailing acceptance of their condition, their serenity, their appreciation of whatever was done for them and their patience with human limitations: their own, the nurses’, and mine.  Their uniform lack of fear, and their complete lack of antagonism, so common among patients today, was striking in its absence. What a tribute to their faiths. And what a pleasure they were to care for. There’s a lesson here for everyone, whatever our beliefs. God bless them all–and may their tribe increase. 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