Saturday, March 15, 2014

The One Thing I Hope We All Can Agree On

Anyone who’s been reading this blog for a while knows that I have a lot of, er, unconventional opinions.

Even those who largely agree with me probably draw a line somewhere: “I like his message about hope, and the ability of cartilage to heal, but his skepticism about stretching? Eh, I don’t know about that.” Or maybe you agree with me about stretching, but not about glucosamine most probably being a dud.

I hope there’s one thing -- or actually four things -- that we all can agree on. I made them into one short chapter in Saving My Knees. And, since the book’s publication three years ago, my conviction that these four matter hugely for those trying to heal bad knees has only increased.

These four things I mentioned in my “golden rules for fixing bad knees” chapter. To me they are almost like “Thou shalt” commandments. Of course you’d be hard pressed to find anyone sensible who disagrees with any of them, except I doubt you’ll find many people who believe in them with the same fervor I do.

#1 Use it or lose it.

In the immediate aftermath of a traumatic injury, when your knee has swollen to the size of a soccer ball, moving it admittedly isn’t a good idea. But when you have a more persistent, achy, low-grade knee pain, it seems to me that motion must be at the centerpiece of any plan to heal.

It has to be the proper amount of appropriate motion, for sure. But without movement, joints decay. Trying to avoid using your bad knees will only make them weaker, not stronger.

#2  Lose weight.

This is the easiest no brainer in the world of knee pain.

Don’t misunderstand me. I’m not saying losing weight is easy. It certainly isn’t.

What I’m saying: This is the one bit of advice no one disputes and there is no ambiguity about how to execute on this recommendation either.

For example, the advice to “strengthen your quads” is almost universally advocated (not by me, but by most everyone else). Still, there is considerable ambiguity about how to do this. What kinds of exercises? How often? When do you increase the intensity?

Taking glucosamine, on the other hand, doesn’t really involve ambiguity on the “how to execute” part -- you just take the required dose each day. With glucosamine, the problem differs; it’s that plenty of people dispute the supplement’s efficacy.

For losing weight, on these two points, there’s no dispute and no ambiguity. Many studies have shown that shedding pounds helps lessen knee pain and improve functioning of the joint. And losing weight is about as unambiguous a concept as they come. If you weigh 190 lbs. this week and 189 next week, you’re losing weight. If you still weigh 190 next week (or say 191), you’re not.

#3 Get on cartilage time (or however you prefer to express this).

In other words: Healing bad knees takes a long time (longer than doctors and physical therapists currently prepare you for, in my opinion). Make your peace with that upfront or you’re going to have a lot of frustration.

I still like the simple example I used in the book of hard-boiling an egg. Suppose you set out to discover whether such a thing is possible -- but you remove the egg from the boiling water after two minutes. Now, if you repeat the experiment 100 times, failing each time, should you conclude, “I’ve just proved it’s impossible to hard-boil an egg”?

Clearly, of course not. You’re judging success on the wrong time scale. Similarly, when trying to come to a fair judgment on whether bad knees can heal, you need to use the right time scale -- which my experience anyway showed is much longer than most people think.

#4 Listen to your knees.

I hope everyone who read my book at least came away with the message that “Listen to your knees” means much more than “If an activity hurts, don’t do it.” I think that often you may be further damaging your knees and setting back your efforts to heal even before you feel pain during an activity.

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