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