How to Move Your Knees in Quarantine

First, an update from last time, and thanks to all those who have expressed concern:

We live on Long Island’s north shore, in Nassau County: a beautiful place, God’s own heaven on earth it sometimes seems.

But Nassau County, as of today, has almost 14,400 cases of Covid-19. That’s more than the vast majority of U.S. states. Per capita, that’s even more than New York City. All this infection has blown up in a county I can drive across in less than half an hour. It’s a bit frightening.

But I don’t feel stress. My family, for now, is healthy. My 6-year-old son, who has pronounced anti-social tendencies and sometimes lives in a box house I helped him build, is flourishing and doesn’t seem to care if he ever sees a school again. :)

My wife is Chinese, and her mother keeps calling and asking if she is okay. She said the Chinese don’t understand why America wasn’t more prepared for this. We saw the images coming out of Wuhan. But that’s a story for another day, and perhaps another blog.

Today I want to briefly address this problem: how do you move your knees enough when you’re inside most of the time?

This is the easiest question for me to answer, because early in my knee recovery, much of my self-administered treatment came in my apartment. When I realized that walking, walking, walking outside was actually making my knees worse, I realized I had to severely cut back.

So I started doing walkarounds around my apartment. I’d just walk back and forth, every 10 minutes, then rest my knees in a comfortable position (e.g., I’d lie on my back with my knees slung over the edge of a couch). I lived in a small apartment, so there wasn’t a lot of room to move. But you really don’t need a lot of room.

The thing is, it’s nice being able to walk outside. You can enjoy the sunshine, the flowering trees, the birdsong. But you can also move in a space as small as a jail cell. It just takes some imagination and persistence to find ways to move your knees.

So how about all of you? How have your activity routines changed during these unsettled times? Drop a comment below; I’d love to hear from you! 

The Only Post I Can Write Right Now

I was thinking about what to write about this week and realized there is only one thing to write about, and that’s what everyone is thinking and talking about.

I live on Long Island, in New York. In my county of some 1.4 million people, there were perhaps a handful of coronavirus cases a little more than a week ago. Today there are almost 2,000.

I have seen the panic: long store shelves completely bare of toilet paper; pasta and rice stocks wiped out. I have also seen the blithe indifference to the danger, in a video of a crowded Florida beach during spring break. College students milled about in close proximity to total strangers.

I have two thoughts, and there is a connection to knee pain, and getting yourself in the right frame of mind to win a long battle against what seems like a formidable foe.

First, this is a time to make decisions based on reason, not emotion:

This virus is only rarely a death sentence. Many mild cases aren’t being counted in the tallies of total cases because of poor testing. That skews the “case fatality rate” misleadingly higher. In South Korea, whose widespread testing has been praised, I recently saw a death rate of 0.7 percent, which means 7 people in 1,000 die. Many of those who don't make it are older or have underlying health problems.

One thing to take some solace in: there are either no, or very few, children under the age of 10 who are dying.

Yet this epidemic remains a very, very serious problem. A lot of people, young and old, are winding up in the hospital and are being put on ventilators to help them breathe. This is not a run-of-the-mill flu, and that cannot be overstated.

The nature of this crisis threatens to overwhelm the health care system in America. We don’t have enough ventilators, enough masks, enough tests. Our government, sadly, wasted a couple of months when it knew the virus was spreading abroad and when it could have been preparing.

Second, a for-profit health care system, like the one in the U.S., is the worst possible one to have at a time like this:

Americans who feel secure knowing they have employer-paid health insurance should pause and think again. What if they lose their job, as so many are now? Or what about the tens of millions of people who don’t have health insurance, who will avoid getting tested and try not to go to the hospital to avoid being saddled with a $34,000 bill they can’t pay?

They may be in the Target where you’re buying your groceries. They may be delivering that Amazon box to your doorstep, even if they’re sick, because they can’t afford to take a day off. They may contribute to the spread of the virus because they are effectively outside the health care system.

This is tragic, insane really (as I’ve said before) for a nation this rich to have health care that only works for part of its population. We really need to fix that. We need to take care of everyone. In addition to that, we can have an extra layer of private insurance, if people really want that.

In the meantime, much like conquering knee pain, it’s to our advantage to take a positive attitude toward beating this virus. Right now life is surreal. We’re living through what feels like a bad movie. But we shouldn’t panic. The road ahead may be tough at times, but we’re tougher.

And Now for Something Different ...

I thought I’d try something different today.

Every day, people who are brand new to the world of knee pain are anxiously sorting through advice and ideas from websites they have frantically skipped through, hoping to find the formula for what works.

So what I’d like to do is invite people to submit questions below, related to knee pain. They can be questions directed toward me, and my book, or can be just questions about knee pain, and any of the problems related to it.

Obviously, this exercise is more suited for first-time visitors, but others feel free to jump in as well.

Then, what I’ll do in successive weeks, is pull out questions and devote blog posts to them. In cases where I don’t have answers, I’ll invite other people here to chime in.

One of the strengths of this blog, I think, is the community of rational, inquisitive, determined knee pain sufferers who regularly drop in.

Let’s see how it goes! What people care most about, I’ve found, are specific answers to specific questions, and in many cases, their questions are shared by many others.

When a Bad Knee Just Gets Worse

I came across this tale recently. It begins with our protagonist limping a little.

A few Tuesdays ago, I noticed Joel limping a bit, dragging his right leg. I asked him what was the matter. “Knee’s a little sore. Don’t know what I did,” was his response.

“Maybe you should rest it,” I suggested. “Do you need some ice?” 

“No, I don’t need ice. Good grief. Geesh. You think I’m a weakling?” he grumped.

Now what happens?

This is an interesting juncture for someone who has just developed knee pain seemingly out of the blue. The sudden, unexplained onset of knee pain can be frightening. It’s one thing if you bang your knee hard against something and then it becomes sore. A simple line can be drawn between cause and effect.

But if you can’t even recall what you did? Yikes. That’s not a good sign.

Well, Joel decides his leg needs more exercise. He chooses to walk downtown to run errands instead of drive. The next morning? Yup, you guessed it:

The knee is swollen. The limping is worse.

So he drags himself around the house for a while. He rests on the couch, an ice pack over the hurting joint. He starts wearing shorts, because his jeans won’t slide up over his swollen knee. His wife (narrating all this) gets exasperated with him.

Finally he breaks down and sees a doctor. An MRI is done. The report comes back with a lot of impressive-sounding jargon like:

“Large joint effusion,” “periarticular fluid signal and edema, greatest in the popliteal fossa and lateral soft tissues,” “subcutaneous edema in the prepatellar region, complex cystic structure along the later [sic?] popliteal fossa, adjacent to the lateral head of gastrocnemius.”

Of course the effusion and edema just mean that Joel has swelling. His doctor tells him the test confirms that his knees are getting old and orders medication for swelling and pain. And that is pretty much where the story ends.

But after reading this, I found myself thinking: Where did things go wrong for Joel, and why?

Things really went wrong when he decided he needed more exercise. So think about this in terms that have become familiar to visitors to this website: Joel’s envelope of function had narrowed. His knee joint hurt. It was less capable of handling stress.

So what does he do? He goes out and stresses it more than he would during a normal day when it wasn’t hurting!

Where the heck is the logic in that? What could have possessed the poor guy?

Here we can only speculate, but:

What’s the message you hear constantly from physical therapists trying to rehab bad joints? You need to strengthen your legs to protect the joint! Build up your leg muscles!

One can just imagine poor Joel Googling around for answers for his condition, landing on this message repeatedly – strong muscles protect weak joints! – and deciding, by God, he was going to strengthen those leg muscles and banish that knee pain!

Building up leg strength is a great idea ... before you have bad knees. Once you do, you need to move much, much more carefully. This is something that Joel has now presumably learned. That, and an MRI often isn’t really very useful. :)

Open Comment Forum: What Discovery Has You the Most Excited?

Okay, I'm going to hand the controls over to all of you.

As I've said a number of times, as I move farther away from my knee pain days, and as I exhaust new subjects to write about, and also -- frankly -- as I find myself increasingly strapped for time, I am writing shorter and also letting all of you talk among yourselves more often.

At this point, turning over the comment section to readers and letting you discuss issues that you're having, with people chiming in to suggest ideas, is probably most valuable.

So here's a question to get everyone started (or feel free to ignore this suggestion, and just talk about whatever you want to!): What's the discovery you've come across, say in the last five or six months, that has you the most excited when it comes to healing your knees?

It could be a scientific discovery. Or if you want to broaden the topic a bit, it could be an article you came across or a personal story you read about a knee pain sufferer who tried something that worked that you think may work for you too.

Anyway, open comment forum, so everyone's welcome to share their thoughts on anything!

Cheers, and I hope everyone is doing well in the new year.

The Villain in the Story: Inflammation

I’ve written about chronic inflammation a number of times. It’s sort of like writing about the hazards of being overweight, a subject that I think deserves multiple posts, even if they do become a bit repetitive.

My thoughts returned to inflammation recently because of an article in the New York Times that I happened to see in a newspaper I scavenged one day on my commuter train into the city.

Near the top is this paragraph, written with plenty of dramatic flair:

Specialists in the biology of aging have identified a rarely recognized yet universal condition that is a major contributor to a wide range of common health-robbing ailments, from heart disease, diabetes and cancer to arthritis, depression and Alzheimer’s disease. That condition is chronic inflammation, a kind of low-grade irritant that can undermine the well-being of virtually every bodily system.

Chronic inflammation is a dangerous beast. It’s hard to understate this. I had it. It started in my knees and, I’m convinced, spread in small, practically undetectable ways throughout my body. I say this because at one point (as readers of my book know), I went in for a blood test, thinking I might have rheumatoid arthritis, after experiencing weird problems with multiple joints.

My blood test was excellent: no signs of systemic inflammation. However, I am still convinced that there was something going on throughout my body that was related to my troubles with my bad knees. A knee doesn’t exist in perfect isolation. It’s not walled off from the rest of the body.

At one point I had bursitis in an elbow. And I had throbbing, constant back pain.

Now, being blissfully free of knee pain for a decade now, I see the inflammatory aspect of the condition as even more alarming than I did back then. To escape knee pain, I think it’s partly a race against time, if you have constant burning, or inflammation. You need to get beyond that, and as soon as you can.

Inflammation of course is a natural reaction by the body to injury, or even to vigorous exercise. What becomes a problem is when the inflammatory response doesn’t die down, when whatever is prompting the reaction continues to fire up the immune system. It becomes a problem as we age, the Times notes, because “immune responses become less regulated.”

So what’s the solution? The Times mentions five recommendations:

* Fix your diet. A diet focused on fruits and vegetables is less inflammatory than one full of foods that are heavily processed, deep-fried, or sugar-sweetened.

* Lose weight.

* Make sure you get enough sleep.

* Minimize mental stress in your life.

* Be careful about overuse of antibiotics, antacids and nonsteroidal anti-inflammatories. They can kill off good bacteria in your stomach and lead to a “leaky gut” that lets bacteria loose in your body that encourage inflammation.

* Exercise regularly.

How do you rank on these five recommendations? Personally, I know I could be better. My diet isn’t great, but I am very fastidious now about maintaining a lean weight. On sleep, I slip behind (like most people) during the workweek. Sometimes I feel stress building up.

Where I can excel now, thank goodness, is in exercising. I work out hard on the weekends.

What about you? What steps are you taking to control out-of-control inflammation?

The Best Knee Pain Book You Can Buy (No, Not Mine)

While poking around Amazon recently, I noticed that Doug Kelsey’s books are now listed there, and for less than $10.

Wow, I thought (for the record, as long-time visitors know, I’m certainly not Doug’s publicist, but I found a stirring message early on in his blog writings that convinced me my knees could heal and that sustained me through many bleak nights).

Kelsey was originally selling the “90 Day Knee Arthritis Remedy” for $28.95, as I wrote here in May 2014.

At that almost-30-bucks price, I thought it was already a bargain. I mean, you’ll typically pay $40 for a copay to see a specialist who will review your knee history for all of 5-10 minutes, then probably tell you to visit a physical therapist or write you a prescription.

But at $9.95, it’s a must buy if you’ve got knee pain. Kelsey’s book has lots of exercises. Plus, he understands the challenge of chronic knee pain and knows that the situation is far from hopeless. You can get better! And yes, without surgery.

At this point I probably am sounding too much like his publicist. But let me tell you why:

I wrote a book about my story that chronicles a long journey into and out of the depths of chronic knee pain. I certainly think it has a lot of value. But still, I’m not a doctor or a physical therapist. I’m a journalist: bright and curious, I hope, but not a trained medical professional.

Kelsey is though. And he’s a damn smart one.

Early-stage knee pain sufferers are beset by confusion and a welter of conflicting messages. Glucosamine works! No, it doesn’t! You should stretch! Stretching doesn’t matter! Take this supplement! Supplements don’t work!

Your head can start spinning. What you really need most, I’m convinced, are some ways to move and nourish that sick knee joint without causing pain. Kelsey’s book will give you the exercises you need and explain a whole lot more too about your condition.

My two cents anyway. Now, for 993 more cents, you can own his book in your Kindle library. ;)