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May 2003 Issue
Can reading a book avert knee surgery?
by Michael Fick
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Have you ever had a joint hurt or wear out? Do you plan to live to the ripe old age of 15? Do you get any exercise, even just walking to the fridge or pointing the remote at the TV? Are you one of those strange people who dislike excruciating, crippling pain? Do you have kids? Can you spell osteoarthritis, or at least OA? If your answer to any of these is, “Yes”, your next step should be buying the book, Wear and Tear by Dr. Bob Arnot. You can spend $25 at your local bookstore, or buy it here for $17.50. It’s worth any price, since 85% of us get OA by retirement age already, and its onset is happening earlier and more often at an alarming rate.

Dr. Bob has been an obsessive, serious, competitive exercise freak for decades. When it began to cripple him, he hired assistance to research all the medical science and alternative medicine to find the best methods of preventing, halting, even reversing the pain and progression of OA (discussed in this column in March). The results helped him achieve a vast improvement in his short and long term health and mobility -- breakthroughs he says beats what surgeons can do in some cases -- and a book that presents what he learned in terms you and I can understand and use. Even though I’ve read a great deal on this topic because I’ve also played relentlessly for over 50 years, almost every page of this book contained something new and useful about my aches and pains. I probably wouldn’t have many of them if I or my parents had read this when I was 10, and I expect to reduce some of mine significantly even now with the help of this book.

Or so the book says. After all, hundreds of books promote hundreds of very convincing lines of verbal snake oil. Is this real, or just more self-help pap?

For one thing, the book’s bibliography is very lengthy, detailed, and impressive. For another, Dr. Bob’s approach is logical, requiring no leaps of faith. Third, his information and advice are well supported by mainstream medical information. His book condenses a huge amount of solid information in one place in language and a format suitable for you and me. One of its major benefits is its logical, useful presentation of OA causes, progression, and symptomatic relief … even prevention, which is a recent concept in OA.

The book’s title refers not only to the purely mechanical, usually long-term joint damage which leads to chemical changes which trigger and define OA, but also to damage to the bones, ligaments, and tendons intersecting at a joint. Because OA can be so crippling, can occur so early in life, and can often be prevented or dramatically reduced with relatively simple methods, it is one of the aging effects most urgently in need of your attention. We are punishing our joints at record rates with rampant obesity at one extreme and obsessive, early overactivity at the other extreme, and it is causing OA decades earlier than just a generation ago. I.e., kids are now getting OA before their parents, even their grandparents, and it’s often avoidable.

Arnot offers both short-term and long-term solutions. The book describes six quick steps for immediate relief, adds much more information for weekend warriors or full-time amateur jocks like myself and for longer-term relief in general, and will be useful to everyone from professional athletes to dedicated couch potatoes. It includes self-tests of several varieties to identify your personal needs, then offers proven, user-selectable menus of easily accessible solutions tailored to those needs. Here’s a quick tour of the book’s topics.

People described as heel-pounders walk heavily, striking the ground hard and shocking their knees hard enough to produce OA as soon as early adulthood. You’ll learn why and how to walk with less impact and how to correct your gait and/or shoe problems to save your knees. Walking on springs, not 2x4s, is far cheaper and far less painful than knee surgery.

Tendons and muscles not used over their full range of motion (ROM) stiffen, thicken, and shrink, and their routine regrowth produces far less resilient substitutes, further reducing their ROM. This downhill spiral concentrates life’s wear and tear onto a very reduced segment of each joint’s cartilage “bearings”, wearing holes in them to trigger OA. Civilizations which routinely squat for many daily activities never get the crippling, excruciating hip OA so common to advanced societies. Get on the floor and see if your flexibility meets norms presented in this book; if not, limber up or expect trouble. Proper stretching restores full motion, spreads out the loads of life for far greater joint longevity, and feels good. Many doddering old folks dodder because they don’t exercise or even stretch, not because they’re old. Proper stretching not only feels good; it’s also a free way to avert pain and disability.

But ordinary stretching isn’t enough for many of us. Important before we ruin our joints and muscles, and often effective even after pain dominates our lives, Bikram yoga has proven to extend professional athletes’ competitive lives by years. It often eliminates OA patients’ need for pain-killers, early retirement from competition, surgery, and disability. The descriptive list of Bikram’s benefits runs several pages, followed by selected yoga exercises. I’m not “into” yoga, meditation, crystals, or gas line magnets for my car, but this book and my aching joints may push me over at least the yoga line. The price of yoga is surely right.

Perceptible misalignments from hips to heels – called bow legs or knock knees if visible – often offer two primary outcome choices: a) simple, early, cheap, painless, permanent correction, or b) appreciable risk of years of pain and potential surgery. The key word in that sentence is “choices”. Simple shoe inserts can sometimes fix knee problems surgeons have given up on.

Muscle strength imbalances easily correctable by a little exercise can avert decades of pain, surgery, and lameness. When muscles holding a joint in place weaken, the joint gets sloppy, allowing bones to meet at spots they weren’t designed to meet. The result often becomes agonizing; the prevention is a few simple exercises, done in a manner to eliminate joint risks and promote joint health. Just 10 minutes a week strengthening our thigh muscles (no, not running) may avert knee replacement decades down the road.

Obesity crushes knees and ankles, crippling countless patients unnecessarily. Losing just ten pounds cuts pain by 50%. Just playing more or eating fewer calories can avert or reduce serious debility and even prevent surgery … which is only partially successful anyway.

Pain-killers help us keep going, but mask joint-pounding activities. Learn the right ways to use drugs and/or supplements for effective joint protection. OA may be the only disease which is more safely and effectively treated by OTC supplements than by prescription medicine. The up-to-date good, bad, and ugly of everything from aspirin to hyaluronic acid is discussed.

The right sports for you – your “soul sports”? -- are great fitness motivators and life-enhancers, but the wrong ones for you can cripple. Learn to identify the right sports – and shoes for those sports -- for yourself and your kids before the wrong ones do harm. Don’t quit a sport you love because it hurts; learn to do it right, then switch to a sport better suited to your body and age only if truly necessary.

If you hate pain, enjoy walking in the mall or competing in the Iron Man Triathlon, and/or want to run up stairs or just stroll on the beach pain-free until you drop dead from Big Macs, read this book. Maybe the only thing worse than wear and tear from harmful activity is atrophy from no activity.



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