This morning, I was going through some old boxes stored in my garage (no basements in Orlando–the water table is so high that you can strike water eighteen inches into the ground). I’m trying to get rid of some stuff that has been lying around for far too long and to do that, I have to go through it all. I’m trying to be ruthless, but it’s hard.
 
I’m a “pack rat” by nature. I save books, old notebooks from school, articles, pages cut from magazines, illustrations that took my fancy, paintings, posters, art prints, sculpture, electronics, tools, guns, coins, items of clothing, weights, exercise equipment, office and tax records, you name it. Then, there’s the stuff my wife likes, like multiple sets of china, clothes, pocketbooks, and enough shoes to give Imelda Marcos a run for her money. And on top of all of that is furniture and more furniture. You name it, I’ve saved it. Never know when it might come in handy….
 
In digging through this stuff, it’s like being an archeologist, or treasure hunting. Every new box I open is filled with stuff. Everything I touch evokes a memory. Which is why it’s hard to part with this stuff–it’s like throwing away a part of my life, in a way. But it’s got to be done.
 
The trouble with stuff is that after a while, you don’t own your possessions–they own YOU. We’re now married for over 34 years and I still have stuff from Grammar School, Junior High, High School, College and Medical School for God’s sake! Little by little, like barnacles on the hull of a ship, the stuff accumulates. This, of course, makes every move a nightmare. So the stuff has to go.
 
But, as it’s contrary to my nature, I can’t simply pitch everything. No, I have to go through it, to be sure I’m not throwing away some long buried treasure from my past. It’s sick, I admit it. In my own defense, I don’t smoke, I don’t drink and I don’t fool around on the bride–hey, you’ve gotta do SOMETHING, right? Could be worse.
 
So, while I’m digging through the boxes, I came across my old bones collection, from the office: near perfect skull, probably a young woman, a femur, tibia, a vertebral body, a bag of foot bones. Thing is, these are REAL human bones. Can’t get these any more. The countries that used to produce them, chiefly India, under Indira Ghandi, outlawed the practice many years ago. 
 
Today, plastic models are the best a young medical student can do. Not the same thing, though–they can’t capture the subtle details, especially in the delicate internal bones of the skull. So I’m thinking, good thing I didn’t just throw these out. Can you imagine these bones coming to light in the garbage dump? I can see the cops knocking on my door now….
 
Then, I came across my old knee model. This IS plastic and shows the menisci and all the ligaments. I used to use this to explain why someone was having pain, to demonstrate which part of the joint was damaged. Then, under these items, I came across my teaching handouts. I used to give these to the patients as “take aways” so they’d remember some of what I told them during their office visits. Even though I could tell what was wrong with someone and formulate a treatment plan in under a minute, I would often spend the next hour or so explaining everything to the patient and family. But as studies done at the University of Florida showed years ago, people just don’t remember what they were told. They retain less than 27%, especially stuff like complications of surgery, after only 24
hours. 

So, my handouts were my way of reminding them. Each one was a single page, with all the pertinent information we had just discussed. One for each of the most common clinical problems I treated. And then, there was my physical therapy prescription. The therapist loved my Rx, because I gave them the diagnosis, the surgery (if any), with exactly what was done, and specified exercises and modalities to be done. This was the prototype of the exercises I teach in my PAIN-FREE PROGRAM, which you can get at
 http://drbillsclinic.com/exercise_eliminate.html
 
The therapists liked this because most docs sent them a prescription that said “P.T.” They left pretty much everything up to the therapist, who of course had NO clinical information about the patient. Incredible. How could they help, if they didn’t know what they were treating? Made no sense to me. So they generally gave the patients knee extensions, or leg presses with resistance, to strengthen the quads, followed by ice and later, hot packs and electrical stimulation. Hard to go too wrong with those.
 
The miracle was that many people got better, anyway. That’s a tribute to the power of exercise to relieve pain, even if done in a very general way. Better, by far, if exercise is done strategically, to alter the dynamics of the knee, according to the pathology causing the problem. That’s what the PAIN-FREE PROGRAM does. See it at http://drbillsclinic.com/exercise_eliminate.html 
 
Well, back to the junk heap. I’m sure I can get rid of a lot of this stuff. Just have to keep digging…. 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

You know, I can remember the first time I got the sudden onset of knee pain. That is, not counting the usual knocks, collisions and falls that any boy experiences, while growing up. I’m talking about the first twinge of the chronic knee pain that potentially remains with me today. 
 
I was working out on the leg press machine, in the physical therapy facility, that was part of the office complex I shared with the rheumatologists. This was in the mid-eighties, so I was still in decent shape and I would periodically hit the gym there, since it was so convenient and accessible. All I had to do was walk out the back door of my office, walk down a hall and there I was. 
 
The only problem was that I would sometimes bump into patients, being treated by the therapists, depending on what time it was. And they ALWAYS wanted to talk, or ask me a question they hadn’t thought of in the office, when they saw me officially. But, it was still a pretty easy way to get in a workout.
 
We had pooled our resources, the rheumatologists and I, to create this therapy center, as an extension of our offices, which were all under one roof, a building we had built for just this purpose. Just as we worked together, referring patients back and forth, depending on whether they had a medical or a surgical problem. It was a great partnership and the patients loved it, too.
 
They had their physicians, a surgeon, a laboratory for blood work and an exercise center, where physical therapy and occupational therapy could be done. It was “One Stop Shopping” for all the services that the arthritic patients needed and they all loved it. And so did we. 
 
As physicians, we had the luxury of an expert second opinion, or a preoperative evaluation, right next door. If an issue arose during a therapy session, a physician could be called over, right then and there, to see the patient and evaluate the problem, immediately. We sent patients between our offices, within the same building, saving the patients time and money, not to mention giving them immediate answers, and thereby allaying their fears quickly. It was a great arrangement, for everyone.
 
Or was, until that A-hole from California (naturally), Pete Stark, decided that it should be illegal for any physician to make an honest buck from any facility where he/she could refer his/her own patients. This resulted in the ”Stark Laws,” which forbade any self-referral, on the grounds that physicians would behave dishonestly given the chance (you know, kind of like some members of the U.S. Congress). 
 
How insulting! People’s lives balanced on the edge of my scalpel–I was trustworthy enough to answer for their lives, but not for making necessary, ethical referrals for a service I helped to provide. I admit the potential for abuse was always there, but ALL of Medicine is based on TRUST. No ethical physician would ever propose a treatment or make a referral that wasn’t warranted. I know I never did. And neither did my associates. What was so obnoxious about these laws was that they were based on the ASSUMPTION that we would do something dishonest. 
 
And, like most government solutions, it threw the baby out with the bath water. Patients were now obliged to travel all over for their labs and physical therapy. They hated it, compared to the ease and the efficiency, and overall better supervision and care, of having all the facilities under the same roof. And the irony was that in New York State, a physician’s prescription was required for a course of P.T. So we were allowed to indicate and prescribe treatment, but God forbid we should make an honest buck from it! 
 
Well, anyway, I was working out in the P.T. Center, as I often did when I had some down time at the end of the office day. I was on the squat machine, with a heavy weight doing short arc squats, with the minimal depth necessary for strengthening the quadriceps, but sparing the kneecap from maximal pressure. I was focused on getting through a set of these press-outs, when from across the room, Chris, one of the senior and most experienced therapists called out to me, “C’mon, you can DO IT! Go DEEPER!” And, without thinking, I DID.
 
Here I was, an orthopaedic surgeon, a knee specialist no less, and for all of that, my years of training, education and clinical experience were, for that one instant, disengaged and I was suddenly 18 again. I could DO IT…. 
 
Buried deep inside the mind and heart of every man is that inner teenager, that is forever 18, that remembers the strength and power of the first flush of youth, completely at odds with the reality of the middle aged body. I call it “The Curse of the Inner Teenager.” Well, my “teenager” heard Chris and woke up! And automatically took over. I responded, without pause, going deeper into the squat than I had ever intended, obeying that youthful competitive urge to excel. Then, suddenly…
 
“PING!” I felt the sharp, lancing pain under my right kneecap in the depth of the last squat and I snapped back to reality. I knew instantly what I had done. I had overloaded the cartilage behind my kneecap and SPLIT it, right in the center. And besides the pain, I knew it would never heal. I now had a physical rent in my retropatella cartilage, and this would become a degenerative disease, called Chondromalacia Patellae.  Steep price for a momentary lapse into stupidity, but that’s often how it is: One instant of dumb, a lifetime of grief. Dammit! I still have to work at preventing pain from this disease, ’cause once you have it, you have it for good.
 
You can learn more about this condition and many more in my layman’s guide, DR. BILL’S LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN. See it at   http://drbillsclinic.com/eliminate_knee_pain.html  With cures from across the treatment spectrum, conventional, alternative and complementary, this is a concise, but pretty complete guide for giving you pain relief and restored function for your problem knees. And it’s now available in an AUDIO CD format, as well, so you can listen and learn while in your car, your office, or anywhere else you can take a CD player.
 
And if you’d like to see what I did wrong, and what I SHOULD have done instead, you might benefit from the companion piece to my Little Green Book, DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, which you can get at this link:   http://drbillsclinic.com/exercise_eliminate.html   These are the specially modified exercises I used for my patients and myself over the years, to relieve pain and strengthen the knees. 
 
Better yet, get BOTH. For the information they contain, they’re dirt cheap. They were designed to work together, as companion books, and there are NO exercises in the Little Green Book. So save yourself a lot of time, trouble and expense. Click on the links to get FAST pain relief, NOW at:   http://drbillsclinic.com/eliminate_knee_pain.html
                               http://drbillsclinic.com/exercise_eliminate.html 
 
You’ll be glad you did and your knees will thank you, too. 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 16, 2008

You know, whenever we’d be in surgery, I’d have the radio playing, or if that was boring, some CD’s. Depending on my mood at the time, I’d ask the circulator nurse to play rock ‘n’ roll, or classical. My tastes ranged from early Beatles, Stones, The Moody Blues (I still think that “Nights in White Satin” may be the most sensual song ever written), Queen  (honestly, doesn’t everyone just love “Bohemian Rhapsody?”), Dire Straits (“Sultans of Swing”),  and Meat Loaf. In fact, after any major surgery was finished, “Bat Out of Hell” was my closing music. The idea was to close the patient’s incision and be entirely finished with the sutures, by the time the CD ended. That high voltage anthem to youthful angst kept me bookin’ along, I can tell you.
 
Sometimes, though, I’d ask them to play Beethoven, generally the 3rd Symphony, or the immortal 9th, anything by Bach, but especially the Brandenburg Concertos, or Handel’s “Water Music.” Right after the film, AMADEUS played, I was on a Mozart jag for months. And after I saw Phantom of the Opera, I’d have them play the entire score, over and over and over again. We’d actually have sing alongs in the OR, kind of like surgical kareoke.
 
Now all this may seem a little bit much for anyone who thinks the Operating Room is all serious and deathly quiet, with a loud beeping from the EKG in the background, and terse, staccato orders from the surgeon: “Scalpel… Sponge… Wipe.” I mean, nobody talks like that in the OR. I can tell you that although  there ARE some guys that do like to work in a scene like that, I always found that to be torture. I’d make fun
of anyone who tried to play that Hollywood scene in my presence, for sure. They would have to be pretty stuffy guys, to start with. All that crap you see in the movies is pure fantasy, to build up the drama. It’s usually much more like “Mash,” than “Not As A Stranger,” though that’s really a reflection of the personality of the surgeon, who is “captain of the ship,” once  surgery is underway. 

Personally, I hated dead silence and tension in my room (that is, any OR where I was working). Hey, if I had to be there, I wanted to have a good time, while I healed the lame and cured the sick. And the nurses, anesthesiologists, my assistant and the OR techs, all loved being in my room, ’cause they knew that the surgery would go smoothly and they’d enjoy spending their time in there, with us. 

I only remember two times in over 23 years in practice where I told them to shut off the music. When it really “hits the fan,” you DO need to concentrate. But the rest of the time, I liked the music in the background, and good conversation with my friends and coworkers, while I operated. In fact, when the patient was awake, under regional, epidural, spinal, or local anesthesia, we’d even offer a choice of tunes to the patient. 
 
What can I tell you–the music relaxed me, so the surgery would just flow. When you’re in “the zone” and you’re exercising your skills in an effortless flow, the result is going to be superb. If you’re comfortable and confident in your abilities (and lack of confidence was never one of my faults), you really don’t need to think much. You just do what you were trained to do, relax and let it flow through you….the goal is
effortless excellence.

This carried over into my office, too, where we played music, or a T.V. for the patients. Occasionally, we’d play DVD’s for them, as well. I always found that this  approach put patients at ease and made my job easier. Lots of folks came in, scared to death. Let’s face it, if you think about what I was actually doing to them, it IS scary. So I saw part of my job as putting their minds at rest, by instilling confidence in me and
by allowing them to relax in pleasant surroundings.
 
Right down the hall from my office was the Department of  Physical Therapy, where I was also the Medical Director.  I had the OR, my office and P.T. all in the same building (really cut down on my commuting time). I would often drop down there, between office visits to check up on my patients. After joint surgery, and even before, in many cases, the physical therapy was critical to a good result. I’ve seen many cases where the surgery was a success,  but the end result less than satisfactory, because of stiffness.

So I’d go down to encourage them and prod them, when necessary. I had a prescription specifically for my patients, that the therapists had to follow. Besides the usual range of motion and strengthening exercises, they had to stretch tendons and the iliotibial band, which might otherwise have a tendency to contract and limit motion. These exercises and stretches were the forerunners of my current PAIN-FREE PROGRAM     http://drbillsclinic.com/exercise_eliminate.html     And even here it was common to have music playing in the background (although they had to keep it down more than we did in the OR, so it didn’t sound like a party to the adjacent offices). 

Even today, I like to have something playing in the background, when I do my work, or my exercises. If you find that you’re having a hard time buckling down and doing your own exercises, try playing something you like on the radio, or CD player, and make it fun. If  it helps you relax, like it does for me, it’ll seem less like a chore, and more like a pleasure. And DOING the exercises is key, if you want to prevent or
get rid of your knee pain. And that’s the name of that tune! 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, my father-in-law, Charlie, who I told you about last week, my wife and I went to a local restaurant for breakfast. As we were being seated, a late middle aged woman came in, on a wheeled walker, who was just gigantic. She plodded forward, one deliberate, ponderous step at a time, the saddlebags of her thighs quivering with every footfall. She leaned forward, holding the handlebars of the walker (which actually had a side view mirror on it) and I had the distinct impression that she couldn’t stand up straight, if her life depended on it.
 
“What’s wrong with her?”, my wife whispered. “Well, if I had to guess, I’d say she’s probably got arthritis of her hips. That’s what’s pulling her forward like that, so she’s bent at the hips. They can’t straighten out any more.”
 
Then, we watched as the woman slowly transferred her bulk to the chair. Since she was seated right behind me, it was kind of hard to miss this operation. Between the woman herself, the walker and maneuvering room, she easily took up three quarters of the aisle between the
tables.
 
Suddenly, we all weren’t quite so hungry.

My wife caught me smiling as I remembered a day in the OR a few years ago, that this woman brought to mind. So, naturally I had to tell Charlie and her the story. 

My assistant, Izhar, was originally from Pakistan, although when he left, it was still a part of India. He was a very fine surgeon in his own right and he was the first new surgeon on the staff that I had approved, after I became Chief of Orthopaedics. He had a very impressive CV (curriculum vitae), had written a number of scientific articles in peer reviewed orthopaedic journals and had been Chief of his own orthopaedic unit in Zambia, Africa. 

He left everything he had behind and fled that country, with his family, when Idi Amin, next door in Uganda, was shooting up the place and killing people in the streets.  He came to the States and worked as a Fellow at the Hopsital for Joint Diseases in New York City. When he
came in for his interview, he was planning to go to work for one of the early HMO’s in Long Island. I had read his CV and I liked him instantly. I told him,  “You realize, you’re vastly over-qualified for these people…” 

I was right, too. I few years later, he resigned in disgust and opened his own private practice. I sent him a number of his first patients to help get him started.  And he eventually succeeded me as Chairman of the Department, after I retired. We worked together nearly all the time. But, despite his assimilation into our society and his subsequent citizenship in the USA, he remained a product of his own culture, in many ways.
 
Above all, he was brutally honest. No smooth talk, diplomacy and fancy dancin’ for him. He’d tell you, patients, other docs and anyone else exactly what he thought, no frills. Made sense, in a way: after you’ve had bad people shooting at you, what are words going to do to you?
 
Anyway, we were operating together one day and talking about how unreasonable some patients were in their expectations and how they were all too quick to blame someone else for their symptoms and other problems. He told us (me and the scrub technician, who was part of
our team) about an enormous woman who came to see him for knee pain.

After examining her, he was about to prescribe treatment when she said, “I don’t understand it. Why is this happening to me?” Without missing a beat, he looked right into her eyes and said, “What do expect? You’re fat as a pig!” The tech and I just broke down, laughing. I mean, tears were rolling down our faces. You really had to be there to hear Izhar’s tone, his accent and his dry delivery to really appreciate this, but, man, it was funny! Not kind, but honest.
 
The truth is, when it comes to weight, with rare exceptions we are all responsible for our conditions. In this example, the woman he saw had all this mass constantly pounding her hips, knees and ankles, with every step she took. No wonder that she was having pain. But until the good doctor gave it to her between the eyes, she didn’t seem to realize the obvious–that she was causing her own problems. Remember, every extra pound in body weight translates into about three to four times body weight force on the hips and knees, when walking and up to seven or eight times, climbing stairs.
 
So, he gave her some anti-inflammatory medicine (you can try the home version, without prescription, by going to
 http://drbillsclinic.com/eliminate_knee_pain.html ),  recommended a good diet and sent her to physical therapy for a course of exercises, like those I teach at   http://drbillsclinic.com/exercise_eliminate.html/.

And to this day, I still remember him and that story, every time I see a truly gargantuan person rolling in. 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

It was 1975, during my first residency year at St. Luke’s Hospital in New York, that I saw for myself, for the very first time, the destructive nature of a torn meniscus. While not as intense as internship, orthopaedic residency was still a lot of scut work for the junior guys on the team. In that year, that was me and my mates. But there were a few opportunities
for us to relax and have some fun. One of the ways was basketball games, between the orthopaedic residents and the general surgery guys.
 
One of the senior general surgery residents was a real good, aggressive player, who was terrific at jump shots. During one game, he suddenly twisted, and spun away, in an effort to avoid the player guarding him and set up a jump shot at the basket. Suddenly, everyone heard a loud “pop,” as he screamed in pain and fell to the floor. He wasn’t able to finish the game and, in fact, had to be helped off the court by two other players.  He had real difficulty putting any weight on his knee, as well as severe pain.
 
He had to sit out the rest of the game on the sidelines, with his leg elevated and packed in ice. Later on, he was carried in to see my old professor, Dr. Bob Zickel  (a very famous guy in orthopaedic circles), or “Zick,” as he was affectionately known. In those days, there was no such thing as an MRI scan. Plain x-rays, physical exam and clinical judgment was the extent of diagnosis, at that time. And according to Zick, one of the best and wisest clinicians around, our surgical pal had really done a good job on his medial meniscus. 

Zick ordered an arthrogram for the knee, to confirm his clinical impression. This was the test that was used, before there was such a thing as the MRI scan. These were specialized x-rays, taken after the knee was injected with an iodine-containing dye. Iodine blocks x-rays, so the liquid dye would outline all the normally invisible structures inside the knee joint, and sink into any abnormal crevices, like a tear in the meniscal cartilage, thereby making it visible. You got even more contrast and greater accuracy, if you also injected air into the joint. Only problem with this procedure was that it HURT, and of course, there was a small risk of infection from the needle. But it was pretty accurate.
 
Anyway, the test confirmed that sure enough, our friend had a nice “bucket handle” tear of his meniscus, and at that time, the only treatment was to surgically remove it. Well, the man wasn’t happy, I can tell you that! He was in this great training program and he wasn’t about to lose time by having surgery. Besides, his swelling and pain had gone down, and his knee was feeling pretty good, by this time. So, he refused surgery and went about his business for the next few weeks, including our basketball sessions.
 
But three weeks later, during a game, his knee locked up in flexion, and down he went. This time, he couldn’t even stand up and couldn’t straighten his knee. He was in agony. They carried him straight up to the OR, where I assisted Dr. Zickel in operating and removing the locked and torn meniscus. Here’s the thing: in just three weeks, the torn meniscus had severely shredded the cartilage coating of the femoral condyle. In other words, he got full blown arthritis in just three weeks!
 
That’s the danger of ignoring a torn meniscus. If not treated, it can destroy your knee. Fortunately, today we have MRI scans that are noninvasive, don’t hurt, and are super accurate at diagnosis, and surgical techniques to repair bad tears, instead of just removing them. You can learn even more about these injuries and many others  in my LITTLE GREEN BOOK, which you can get at    http://drbillsclinic.com/eliminate_knee_pain.html 

Our friend ended up doing well in the short term. He worked hard at the physical therapy, the forerunner of exercises I teach in my PAIN-FREE PROGRAM today, at   http://drbillsclinic.com/exercise_eliminate.html
But, he had severe and permanent damage. I lost track of him over the years since then, but I’ll bet he has a knee replacement by now. Well, it made an indelible impression on me. And I hope it made one on you, too. The lesson is, don’t ignore a knee injury–or you may pay a higher price than you needed to, in the future. 

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

While reviewing a number of news items and health related blogs, in preparation for my own blog, I came across an interesting study. This was done by Dr. Zhang and his coworkers at the University of Edinburgh, under the auspices of the Ostearthritis Research Society International. What Dr. Zhang and his collaborators did was to identify 25 different treatments used for the symptoms of osteoarthritis.
They divided them into non-pharamacologic, pharmacologic and surgery categories. So far, so good.
 
But what made this study uniquely useful was that they assigned each treatment a number, a percentage based on the available evidence for effectiveness in the literature. In other words, each method, drug, or surgery was an EVIDENCE BASED RECOMMENDATION. By referring to the number assigned, the reader can get a pretty good idea of how much evidence backs up each item, and can compare one 
against another.
 
In the past, most recommended treatments were based on individual experiences of the practitioner. Right or wrong, it was still anecdotal. But with this study, we can base recommendations on the collective experience and multiple sources of the medical literature. This adds a great degree of confidence in the expected results for a specific treatment. In other words, we’re not guessing what works–we now KNOW, based on evidence, not anecdote.
 
Among the non-pharmacological methods that enjoyed the highest levels of confidence were: EDUCATION & SELF MANAGEMENT (ie., what you’re doing right now): (97%), EXERCISE (96%), WEIGHT LOSS (96%), WALKING AIDS (like canes): (90%) and referral to
PHYSICAL THERAPY: (89%).
 
Imagine that! The very things that I’ve been telling you, the very things that I’ve always promoted, were the most beneficial to patients, based on all the available evidence. Am I surprised? No. But I am gratified to see the “occular proof,” as The Bard said. 

Some things are basic–not because they’re simple, but because they’re fundamental, the things on which everything else is based. These basics are available for you in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN, which you can get for yourself at http://drbillsclinic.com/eliminate_knee_pain.html
 
And the best exercises ever prescibed for the relief and prevention of knee pain are laid out for you at
http://drbillsclinic.com/exercise_eliminate
 
Everything I write has been based on evidence I’ve acquired through a lifetime of practice, the world orthopaedic literature, and my own personal experience, as a patient, myself. Don’t guess, when you can KNOW. Then, you can KNOW what it’s like to have your pain disappear!

That’s it for today, my friend. Til next time, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill

P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
http://drbillsclinic.com/advanced_masters.html

FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved