Sunday, April 27, 2014

Best Initial Knee Stretch "The Hammy" (Knee OA, Part 3)

Your hamstring tendons start on your pelvis and insert behind and below your knee. In almost every person, these tendons tighten with time.  Stretching your hamstring tendons is one of the best exercises you can do for your knee and back.  One study found "individuals with and without osteoarthritis of the knee are able to demonstrate immediate beneficial adaptations to a stretching intervention."

I recommend do a set of 3 hamstrings stretches, 3 times PER DAY.  Stretching multiple times per day is better than stretching only once a day or not at all.  You may be surprised with your improved flexibility if you are consistent about stretching.  See the video below for a simple stretch that can done anywhere.  I call it the "Hammy Stretch".

Start by placing your leg on a step, or low table.  Keep your back straight and your toes pointed toward the ceiling.  Then, simply hinge forward at your waist.  You will likely feel the stretch in the back of your thigh, knee and calf.

Consistency is the key to improvement.  Try this simple exercise and it will help your overall knee health and improve your ability to straightening your knee.  Hamstring stretching is like sunscreen, it is best to start early and continue to stretch throughout your life.

As always, check with your own doctor before beginning any exercise program.

Next time, we reveal the simple yet highly effective way to strengthen all of the muscle of your legs.


Sunday, April 20, 2014

Best Initial Knee Exercise: The QuadCrunch (TM) (Knee OA Part 2)

There are dozens of knee exercises you can do to strengthen the muscles around your joint.  One crucial muscle to strengthen is the quadriceps or "Quad".  Too often, however, this muscle simply does not cooperate.  We need a simple way to get started.  We need an exercise than can be done anywhere, anytime without any equipment.  Now, we have one, the QuadCrunch (TM).  

The QuadCrunch (TM) helps initiate and reinforce the contraction of the most important component of the Quad---the Vastus Medialis Obliquus or VMO for short.  

QuadCrunch (TM) Video

Simply, straighten out your leg and place your fingers over the inside portion of your thigh just above your knee.  This is where the VMO lives.   With your leg fully straight and your heel on the ground, push your leg toward the ground and try to contract the muscle.  If you are successful, you will see your kneecap move.  The reason to put your fingers on your muscle is to help your brain know it is contracting the muscle.  This helps reinforce the contraction.  

I recommending doing a set of 5 contractions, holding each contraction for 5 seconds, 5 times per day.  

This elementary exercise is often ignored but serves as the foundation for more advanced strengthening programs.  It can be helpful for people who want to strengthening their legs for any reason.  It may also be useful for patients with knee arthritis, patellofemoral pain, knee tendonitis and even meniscus tears.  (Always check with your doctor before beginning any exercise program)

Good luck and get started today.  Remember, this exercise can be done in shorts, pants and almost anywhere.  Simply place your fingers on your quad muscle and straightening your knee with your heel on the ground.  It is best if your are sitting on the edge of a chair.  

It is best to record how many sets per day you do.  That will help you be compliant with the exercise.  We will discuss exercise compliance more in a later post.  

Post any questions, comments or suggestions below.

Sunday, April 13, 2014

The Best Initial Treatment for Knee Arthritis (Part 1)

What is the best initial treatment for knee arthritis?

The answer is diet and exercise.

It isn't easy but diet and exercise are highly effective at reducing pain and improving function.  In a recent study of about 400 patients the combination of diet and exercise decreased pain scores by 45%.  This is impressive because most injection therapies improve pain by 30-40% and often only last 6 months.  This study showed benefits up to 18 months.   Patients who also completed both a diet and exercise program were able to walk 136 feet more than patients who only dieted during a 6 minute walking test. (Messier et al JAMA 2013)  This is a simple and inexpensive way to treat a problem that affects 10 million Americans and millions more worldwide.

Too often patients and clinicians fail to select this strategy.  Patients often do not recognize how overweight they are and may even get angry if their physician points it out to them.  Physicians lack the time and tools to appropriate help patients begin an diet and exercise program.  With 69% of Americans either overweight or obese, it is very likely that weight reduction should be part of most knee arthritis treatment plans.

So, here are some suggestions to get started.
(Always check with your own physician before beginning any program.)

Give your knee a pain rating from 0-10 overall as a baseline measurement.

1.  Weight yourself and calculate your Body Mass Index.  (BMI Calculator)
     Be honest about the weight.  Record your weight daily.

2.  Set a goal to lose 5 pounds in two months and KEEP IT OFF.

3.  Lose weight by trying the One Less Diet (TM)
     One less dessert, one less sugary soda, one less beer, one less bagel, etc
     Use any other safe and effective means to lose weight.

Weekly, update your pain rating for your knee.  After two months, compare your baseline weight and pain to your new weight and pain.  You may find that if you simply lose weight your knee will begin to feel better.  The side effects of losing weight will also be good for your heart and your waistline.

In the next post, we will discuss a simple exercise plan.


Tuesday, April 01, 2014

TIger Woods Back Surgery Video (Example)

Tiger Woods will miss the Masters for the first time in 20 years because of back surgery for a herniated disc.  He had the surgery on Monday in Park City, Utah and will soon begin rehabilitation.  There is no time table for his return.

Below is a video of my own back surgery for a discectomy that was done via small portal incisions about 5.5 years ago.  I was miserable prior to the surgery and am amazingly better.  Many thanks to my excellent surgeons and physical therapists.  View the video below to gain a better understanding of the mechanics of the surgery.

Video of Lumbar Disc Herniation Surgery

I wish Tiger the best of luck in his recovery.  I hope his surgery will allow him to return to the golf course soon but more importantly at a much higher functional level for a long time.

It is important to note that a variety of biologic treatments for this condition are presently in development.  Hundreds of professionals worldwide are working on these solutions.  For more information, visit:

More info via a detailed story about Tiger Woods and his back.

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