I am bone on bone in my knee. Is knee replacement my only option?

The other day I was talking to my Mom about a friend of hers that recently had her knee replaced.  Her friend was bone on bone and in a lot of pain.  I asked my Mom if the knee replacement had decreased her pain level, and her answer was no.  A few months post surgery things were great, but soon the knee pain started to return, along with some hip pain.

So why did the knee pain return?  I have no doubt that the surgeon did an excellent job, and the replacement knee is performing the way it was designed to.  However what the surgery and the new knee did not address is the misaligned position of the knee that ultimately caused the bone on bone condition.  Keep this in mind, it’s the position of the joint that is causing the condition of the joint.  In the case of my Mom’s friend her misaligned knee joint was causing the cartilage to slowly wear away until there was nothing left but bone on bone and a lot of pain.  Even though the knee was replaced this didn’t solve the underlying cause of the knee pain, it only treated the symptom.

Now I am not saying that getting a knee replacement is a bad idea.  In some cases an individual has no other option but to get the knee replaced.  What I am saying is that if you are going to replace the tires you need to also fix the alignment.  Let’s look at an example of this.

Take a look at the photos below.  These are x-rays (courtesy of Rick Mathes, Clinic Director of Egoscue Austin) of an Egoscue client who was dealing with bone on bone in his right knee, and had a lot of pain.  When looking at the x-ray it’s as if you are in front of the person so his right knee is on the left side of the photo.  Can you see the lack of space between the femur (thigh bone) and the tibia (lower leg bone) of his right leg?  There is no doubt that it is bone on bone in his right knee.

It was recommended by his doctor that he have the knee replaced.  While evaluating his options, a friend referred him to Egoscue and he decided to “give it a try.”  A little over a year later the client was feeling great, and had no knee pain.  He went to his doctor’s to get his knee re-examined and had some new x-rays taken (see below).

This is the same view as the previous x-rays.  Can you see the difference in the spacing of the femur (thigh bone) and tibia (lower leg bone) of his right knee compared to the previous x-rays?  The space has definitely been increased and the bone on bone condition is no longer there, and better yet the pain and limitation is gone.

What these x-rays prove is that the bone on bone and loss of cartilage were not the cause of the pain, they were the result of a knee that had gotten out of alignment.  Once the knee position was improved the knee was able to heal itself.  This client ignored the symptom, and put his focus towards the cause of his knee pain.  The results and proof of this change in focus speak for themselves.

What

Musculoskeletal pain is NOT caused by activity, age or genetics. What causes musculoskeletal pain is…

Matt Whitehead, Clinic Director of Egoscue Portland again puts out an awesome post about the true cause of musculoskeletal pain. The toughest part about getting yourself pain-free is being able to change your mind and start asking the question of “why does my knee, shoulder, hip, etc. hurt.”  Once you start to understand why the pain is there, fixing it is the easy part. Hope you enjoy the post, and if you want to reach Matt at the Portland Egoscue Clinic click here. Enjoy the post it is well worth the read.


I’m sure many of you saw the article (Treat Me, but No Tricks Please) in the New York Times about Physical Therapy this week. The author talks about how many of the treatments don’t seem to work or only offer short term relief. The article also talks about how there are many “voodoo” treatments offered now that have not been proven in studies to be effective and many insurance companies are choosing not to cover the cost. Whether you have plantar fasciitis, IT band pain, back spasms, or a bum shoulder many of the treatments like ice, heat, massage, and ultrasound are only trying to effect the symptom – not the cause of the symptom. And all too often the cause is blamed on activity, age, or genetics. If you know anything about Egoscue, then you know those all are myths. The activity is never to blame. Your age is never the cause. And genetics gave you red hair or blue eyes, but not a bad back.

To continue reading this post click here

Disappearing Varicose Veins

Great post from John Elder, Clinic Director of Egoscue Nashville.

I know it’s winter so you aren’t running around outside in your shorts or skirts, but as soon as January is over most folks around here make the change to spring and all that comes with it. It might be more of a mental change (hope?), but February brings the reminder that short and swimsuit season is just around the corner! So, how are those varicose veins treating you? For some of you they might be physically painful, but for the vast majority of you I would venture to guess that they are more painful to the eye than anything else. I’ve had clients who are embarrassed to wear shorts in the clinic because of what their legs look like due to their varicosities. If they aren’t comfortable in a one-on-one environment, think how self-conscious they must get in public.

To read the full post click here

The Magic Mouth Guard?

This is a great post from John Elder, Clinic Director of Egoscue Nashville.  The post talks about the new buzz in sports equipment.  A new mouth guard that helps to realign the jaw, and thus improve an individual’s athletic performance or does it?  Great read!

Posted on December 18, 2009 by egoscuenashville

This article caught my eye in the NY Times the other day.  The claim is that new technologically advanced mouth guards can actually increase your performance, make you stronger, jump higher, run faster, leap over buildings in a single bound, etc., etc.  Basically, as the subject of the article claims, the mouth guard makes you “Superman”.  The research indicates that as this mouth guard realigns the jaw into a more relaxed position, the athlete is then in a better position to get more oxygen into his or her lungs, and the body performs better.  While I don’t doubt the validity of this statement (actually, I agree with it 100%) or the statistics, I am a little leery about the artificial repositioning of the jaw/head to achieve the results.

Why not realign the whole body, rather than just spot-treating the symptom area?  Why not make sure the shoulders and hips are properly aligned so as not to compress the diaphragm?  And, let’s make sure the knees and ankles are doing their jobs from the ground-up to help provide a solid basis of support for the hips and shoulders.  Let’s take a real-life example from one of our clinics in Japan.  This is a before/after picture that absolutely blows my mind.  This is the difference in ONE VISIT.  She is a rice farmer and spends her days hunched over.  Look at the impact it has had on her body.  You think she doesn’t have some breathing issues, let along chronic pain?

Now, for an image that might resonate a bit better with you, think of the position of a cyclist.  Let your mind take you back to Lance Armstrong during the Tour de’France.  If you’ve clicked on the link to the full NY Times article above, you’ll notice the subject of the article is a cyclist.  Look at the position he’s in.  Wouldn’t it make sense that someone with a rounded upper back and a forward head like the person pictured above would have breathing issues?  The same is true for the subject of the article, it’s true for Lance Armstrong, and it’s true for the vast majority of us walking the streets today.  Our postures are compromised, and are bodies are becoming more and more inefficient.  In both examples–the Japanese client, and the cyclist–the thorax gets compressed, the lungs get compromised, the head comes into hard cervical extension in an attempt to look straight ahead, and the end result is extremely inefficient movement, but in this case specifically, inefficient breathing.

Now, I’m not saying that Lance Armstrong or the subject of the article aren’t amazing athletes.  You and I both know they are.  For my money, he’s arguably one of the greatest athletes ever.  What I am proposing is that I believe Lance can get evenmore from his body.  Bold statement?  Yes.  True statement?  Without a doubt.  For as good as he is, his body is moving inefficiently.  Check out these two pictures, and I’ll show you what I mean:

In the running photo, notice his everted (duck footed) left foot, and everted left knee.  If he’s running north/south (i.e. straight ahead), why are his knee and foot traveling east/west?  I’m also seeing an elevated right shoulder and his upper body is laterally flexed to his left.  Once again, he’s running north/south with an upper body that’s traveling east/west.  If the femur is externally rotated, the primary hip flexor muscle (iliopsoas), which attaches to the femur, the pelvis and the lumbar spine, isn’t working properly, and because the diaphragm attaches to the lumbar spine at essentially the same place as the psoas major, we can assume he isn’t breathing properly.  All we have to do is connect the dots…it’s just that simple.

Let’s take a look at the bike photo.  Left knee and foot are still pointed out to the side, although the degree of eversion is less here due to Lance being clipped into this pedals.  But, that begs the question: Where is the difference being made up?  His knee and foot want to evert, they just can’t.  Is he compensating in his hips?  Shoulder?  Mid-back?  Opposite side of his body?  Where is he compensating so that his body can get him from point A to point B?  I’d love to find out, because I guarantee it’s happening somewhere.  And, notice that if you look directly over his left shoulder, you can see the arch in his mid-back.  He’s extremely developed in his erector muscles (the muscles that run up and down his spine).  They are doing a HUGE amount of work for him; most likely more work than they are designed to do.  From the Egoscue perspective, this spells trouble.  It could result in hip pain, a herniated disc in his low back, even a torn rotator cuff, but regardless of the symptom location, it’s most likely on its way.

The bottom line is, don’t treat your symptoms, but instead cure the reason they are there. Trust me, you’ll thank yourself for it.  You’ll be pain free, limitation free and moving MUCH more efficiently.

Overcoming the thought “I’m broken” changes everything for Egoscue clients

This is from the Egoscue clinic in Portland Oregon.

Great testimonial I received from a client recently. She did so well as a client because she was willing to take responsibility for her health and give up her “story.” Anyone who is willing to do the same will also get better.

Thank you so much for your Egoscue coaching over the last several months. Your enthusiasm for healing really shines through in your sessions. I’ve enjoyed chatting with you about challenging the status quo. And most of all – thank you for giving me hope that ICAN live a pain free life. Escaping the victim mentality and regaining control over how my muscles feel has been truly liberating. I still have work to do – but I know I’m on the right path.


Does Santa Have Back Pain?

by David Smith, Clinic Owner and Director of Egoscue San Fransisco

How is it that after all these years Santa Claus can keep spreading cheer to children all around the world? You’d think at some point the jolly old man would have some aches and pains. In fact, according to common belief there are three major reasons why Santa should have pain: One is old age. He’s older than all of us ten times over which, according to some people, is a good enough reason for him to have all kinds of ailments including back or neck pain. Second is his activity level. He lifts heavy packages, carries an enormous bag of presents, scoots up and down chimneys and generally does things many of us wouldn’t even consider for fear of hurting ourselves. Third, he’s fat! Sorry, I mean horizontally challenged. There’s no way that man’s frame could support that much weight without achy knees or a herniated disc right? Wrong.

Age, activity level, and weight are never causes of musculoskeletal pain. Ever. We know this for several reasons. First, if age were the problem then everyone that age would have the same pain, but we know that a 20-year-old is just as likely to have back pain then an 80-year-old and there are plenty of 80-year-olds who don’t have pain! Next, if activity level is the problem tell me how there are 70-year-olds running marathons and doing Ironmans without any ill effects? In fact we have several clients who are doing ultra marathons pain free! Finally, in terms of weight, think about a really heavy car. The car’s right front tire is out of alignment which means it’s wearing out faster than the others. The extra weight on the car is causing that tire to wear out faster, but the problem is not the weight, it’s the alignment. Fix the alignment and the weight is now distributed evenly through all four tires without any extra wear and tear on any one of them.

This is good news for Santa who must be doing his Egoscue exercises to keep himself in perfect postural alignment despite being ancient, crawling up and down chimneys with those heavy presents, and eating all those cookies!

Happy Holidays Everyone!

Read Egoscue San Fransisco’s blog here.

Barefoot running vs. running shoes

This is a video that examines the difference in foot strike of a runner while barefoot and then when wearing a running shoe. Watch and then try it yourself, and see what differences you feel.

9 Kid Foods to Avoid

Great post from our Palm Beach Gardens clinic.  They posted this list from a Time Magazine article.  Very informative!  However I think I am guilty of eating a couple of these foods.

Click here to see the list, and read the article.

No Batteries Required

This post is courtesy of Paul Schell, Clinic Director of Egoscue Santa Monica.  To find out more info about Paul and his clinic click here

Technology can be a wonderful thing. Advances allow us to save time & energy while increasing conveniences in every-day life. We’re able to share emails like this at the click of a button. With that said, however, it is important to remember that there are many things in life that technologies cannot replace.

On the subject of musculoskeletal health, technology cannot usurp the body’s need for motion. For those still waiting for the wonder-pill to replace a brisk walk or waiting for surgical intervention to replace the need for a body to move better, the news is not good. When technology is inserted where nature and biology have already designed a body without flaws, the system is bound to be compromised.

Red RobotDon’t get me wrong, given the fact that surgical procedures have improved and are not as barbaric is a wonderful thing. And when needed, a successful procedure can seem miraculous. What I’m talking about here is attempting to replace proper function orfix improper structural alignment with surgeries that replace or remove parts.

Your body has basic requirements for maintaining health and eliminating pain. Movement is one of those requirements. (Think “Move it or lose it”). When we stop moving or ignore pain, we are doing a disservice to our body’s request for help. Finding the reason for the pain or why the running, walking or other activity is painful is necessary to get on the path towards fixing it (instead of waiting for surgery to fix it).

So, the message is simple. Listen to your body.When pain comes on, investigate why it is there and find that out before opting for technology to solve the issue. We all have been given a gift called healing. And the body can and will heal if we identify the reason for symptoms and give the body what it needs.