Tiger Woods has done it again! Only a couple of months after arthroscopic surgery on his left knee, for “cartilage damage,” he came from behind to win the U.S. OPEN. Wincing in obvious pain throughout the tournament at Torrey Pines, San Diego, Tiger fell behind earlier in the game, with a couple of bogeys, but then went on to pull even, with a couple of simply spectacular shots, that apparently defied the laws of physics, and resulted in eagles. After 90 gruelling holes of golf, Tiger finally clinched the title from opponent Rocco Mediate in sudden death on the 91st hole. This is one for the ages!
 
So Tiger pulls it off again, against a great player, with a real physical and mental handicap. He’s now won his 3rd U.S. Open and his 14th Major Title, hot on the heels of Golfing Great Jack Nicklaus’ Lifetime 18 Major Titles. And Tiger is only 32 years old (though I bet his left knee is a lot “older”). 

I’m not a big golfer, personally (tough to do when you have a fractured spine and crushed discs), but I fiercely admire excellence and achievement, especially when wrested from adversity. This was the third time that Tiger had this same knee operated on. He had a benign tumor removed in the late nineties, and arthroscopy in 2002.
 
If you were watching him walking in the Masters, he was wincing and in obvious pain from that left knee. It’s very possible that the distraction lost that tournament for him, but even there, he almost pulled it off and finished second. This guy is unbelievable! No matter
how you cut it, he is a true champion.
 
The “cartilage damage” referred to could refer to degenerative or traumatic damage to the articular cartilage, manifested as shredding, crevasses or flaps. If widespread, this could be consistent with arthritic changes, despite the fact that Tiger is only 32 years old. On the other hand, it could refer to a tear or degenerative shredding of the meniscal cartilage. No real details have been made available, so it’s anyone’s guess. But his pathology was likely one of these, or both.
 
What happens when the cartilage is damaged? Well, in brief, whether from direct impact, or from slow, progressive degeneration, the ice smooth resilient articular cartilage coating of the bearing surfaces of the knee joint become softer than normal and eventually begin to fragment and shred. Once the cartilage is physically disrupted, this unravelling of the protein fibers of collagen (that normally give support) speeds up and progresses. This is discussed and illustrated in detail in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN (see it at   http://drbillsclinic.com/eliminate_knee_pain.html)
 
If the damage is to the crescent-shaped meniscus, it’s usually a tear. Thing is, any cartilage damage is a problem because cartilage, once physically broken or torn, cannot heal without very sophisticated surgical techniques (at least with current technology).  But there are a number of supplements, herbs, OTC medicines, and even food choices that can have a positive or negative influence on inflammation and
pain.
 
When Tiger was walking the links in pain, something within his knee was catching in that joint, causing traction on the capsule of the joint and/or the lining membrane. Problem is, if the thigh muscles are weakened by the persistent pain, they can’t stabilize the joint and help absorb the shock of walking (especially up and down the rolling hills of a golf course).
 
The solution, both before and after knee surgery, is to strengthen the thigh muscles, the quadriceps, so they will be able to absorb shock and supplement the ligaments to priovide optimal stability. To do that, a number of exercises designed to increase muscle tone, strength and power, and stretches for the antagonists on the opposite side of the thigh, are necessary. But not any old squatting motions will do. No, you need to strengthen your thighs strategically, based on the type of pathology you have. 

As an orthopaedic surgeon and, more important, as a knee surgery patient myself, I’ve collected the best and most effective exercises, specially modified to prevent or eliminate knee pain, in my PAIN-FREE PROGRAM  http://drbillsclinic.com/exercise_eliminate.html
 
Using a combination of the movements described in my PROGRAM, anyone can improve the stability of their knee and relieve their pain. Of course, as I mentioned yesterday, you actually have to DO the exercises. Nothing happens without effort. But if you do them, your thighs will grow strong and your knee pain will get better and better. 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
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