Even though I am a big fan of structured exercise, the truth is "structured" exercise may not be needed to benefit our health, longevity and function. The key may be more in just moving frequently throughout our day with our "activities of daily living." The problem is we rarely have to do anything that is important for our survival anymore except pick up a fork or a spoon to eat. So our movement of daily chores or to "hunt and gather" are generally gone so we "plan" our exercise somewhere in our day instead of it being part of our day without thinking about it.
Read About This Topic...
Dr. Daniel Lieberman is a professor in the Department of Human Evolutionary Biology at Harvard wrote a very interesting article entitled "Just Move: Scientist Author Debunks Myths About Exercise And Sleep."
Some Key Points - Functional Exercise
Leisure time sitting appears to be the problem, not work related sitting. He coins a term "interrupted sitting" as being a beneficial practice...to get up about every 10 minutes to do something. Seems pretty easy. In hunter-gatherer "camps" people get up every few minutes to take care of the fire or a child or some simple tasks.
Another difference in these hunter gatherer populations is they don't sit with their back to a chair. It's sitting "backless" which helps strengthen our back muscles and posture. Makes too much sense! As we speak I am scooting my butt to the end of my desk chair. Until recently most human beings sat pretty much on the ground, or if they did sit they used stools or benches or something that was backless. Only rich people had chairs!
Weak Back Muscles Increase the Likelihood of Back Pain!
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Knee Pain and Arthritis and Exercise
In terms of "wear and tear" of the joints leading to arthritis people who run more are NOT more likely to get arthritis in their knees. In fact, they're actually get slightly less.
Shock Wave Therapy (EPAT or Extracorpeal Shock Wave Therapy ECSWT) for Knee Arthritis
That said the most common injuries for runners is knee injuries/pain and also problems such as shin spints, achilles tendon problems and plantar fasciitis. These latter three conditions are very responsive to Shock Wave Therapy (ECSWT) which I do in the clinic with our focused and radial devices. Call me if you have any of these conditions. Usually it takes 3-5 weekly treatments for the best results and 20-30 minutes per body part. (NOTE: I use a combination of this radial device, the vibrator (V-Actor) and the focused device which was not seen in these videos to treat these problems. Difference between radial and focused shock wave treatments).
Knee Pain and Anti-Inflammatory Diets
I also encourage people to go on anti-inflammatory diets because food can cause (knee) pain.
Options:
1) Eat of BED Diet Food List - page 2 of handout and/or
2) Water fast 4-7 days and/or
3) Fasting Mimicking Diet (can get Prolon 5 day program online or at our office at discount) and/or
4) Eat for 7 days only whole fruits and non-starchy vegetables (avoid nightshade family -
See BED Food List - page 2) - steamed, water stir- fried, roasted, baked, raw and/or grilled (no oil frying)
5) Inflamx (anti-inflammatory pea and rice protein meal replacement - try All Spice first) 2 scoops 2-4 times per day mixed with water initially for 4-7 days (available from our office). If you can do it solely for 4-7 days then add non-starchy vegetables and whole fruit plus the Inflamx.
Evaluating Your Gut for Knee Pain
If you have lots of GI symptoms (gas, bloating, constipation, diarrhea, GERD) after food elimination you might get a comprehensive stool exam to see if there isn't something to treat in your gut like yeast, a parasite, an overgrowth of normal bacteria or lack of digestion. (G.I. Effects Stool Analysis ). We can order this and give you a kit in the office. Medicare pays for this test and your PP0 may pay part of it. Takes 1 day to do and 3 weeks to come back. Heeling the gut can reduce the inflammation that is aggravating your knee pain.
My Knee Journey...
I have had 7 knee surgeries in my life. First playing football at U.C. Davis back in the dark ages where they yanked out your entire medial meniscus (1977ish) and then 3 medial meniscus tears on my right knee "trimmed" arthroscopically 20 years or so ago on 3 different occasions (Aikido - a Japanese martial art where you are on your knees alot...and dancing and runner) and then ACL reconstruction on both knees a month apart in 2006-2007.
An Xray on my left knee, the original football injury which has also had an ACL repair, showed "bone on bone" a year or two ago. But I have NO knee pain. I do have fluid accumulation below my left knee cap for the last couple of years but again no pain or instability. My point is this...just because you have something on an Xray or MRI doesn't mean you have to get it surgically dealt with. NOW IF YOU HAVE PAIN then you have to do something. Hopefully you do some of the non-invasive lifestyle things below to reduce your pain before even thinking about surgery.
There may be a day when I have to have something done on my knee (s) but if there is no pain and I remain active doing things I love to do (run, walk, weight train, stretch and hopefully dance sometime again) then I will keep doing the things I am doing to 1) reduce inflammation in my body and joints - a low allergy, whole food, plant based diet 2) keep doing weight bearing exercise as long as it doesn't hurt....daily 3) Keep doing strength training on my quads and calves 4) Keep doing stretching and also doing plain old full squats with no weights daily as long as there is no pain 5) Treat myself weekly or biweekly with ECSWT and see if it makes any difference in the fluid build up below my knee cap, and even if it doesn't it may have some preventive effect since EPAT stimulates new blood vessel growth, tissue repair, anti-inflammation and breakdown of fibrous tissue.
SIMPLE EXERCISES FOR YOUR KNEES
Wall Sit - Sit with your back flat against the wall with your legs at 90 degrees like if you were sitting in a chair against the wall (but there is no chair underneath you) . Make sure your knees are directly over your feet/ankles not ahead of them. Sit against the wall for as long as your thighs can make it. Repeat 3 to 4 times. Your thighs should burn.
Calf Raises - Get on your tip toes and flex your calves and thighs. Hold 3-5 seconds and repeat times ten.
Straight Leg Raises - Flex your quads (thigh muscles) while laying down and elevate your flexed leg 10 times without letting your legs hit the floor.
Lock Knees with Knee Extensions
- For those of you who use leg machines in the gym when you do a leg extension while sitting lock your leg out for 5 seconds with a flexed quadracep muscle. Then let the leg go down. Bring it back up and lock your thigh with leg extended and then hold for 5 seconds then repeat.
Supplements
Algal Oil (omega-3 fatty acids from algae) 2-4/d
Curcumin/Turmeric (MERIVA is a good trademarked and tested product) 500-2000 mg/d
Magnesium chelate 200-500 mg/d
Vitamin B6 (in a B complex of 50-100 mg/d)
Vitamin C - 1000--4000 mg/d
Vitamin D - 2000-5000 IU/d
Other products that can be used include glucosamine and/or chondroitn sulfate, haluronic acid, collagen, Wobenzyme
A Whole Life Approach for Reducing Pain...
Consume a whole food, anti-inflammatory, low allergy, mostly plant-based diet; looking at gut
health to reduce inflammation (food intolerance, fiber for the microbiome, medication reduction,
pathogens in gut); reducing environmental toxins in some cases (metals, mold, etc. ); improving
blood flow to the whole body by reducing or reversing heart and vascular disease; and normalizing
blood sugar and insulin resistance which reduces inflammation, improves nerve health and blood flow; and do self-help exercises PLUS Shock Wave Therapy (EPAT) can be beneficial to speed the process of pain reduction. But if nothing else at least go on the BED - Basic Elimination Diet for 2 weeks. Many of you will be surprised how much of your pain is reduced.
REFERENCES
Knee Pain Helped By Shock Wave Therapy
Dose-related effects of radial extracorporeal shock wave therapy for knee osteoarthritis:
A randomized controlled trial. J Rehab Med. 2021 Jan 13;53(1):jrm00144. CONCLUSION: 1 of 4 treatment groups, which varied in terms of shock intensity (0.12 mJ/mm2, lower density, or 0.24 mJ/mm2, higher density) and shock number (2,000 impulses or 4,000 impulses), or to a placebo control. Each group received 4 sessions of radial extracorporeal shock wave therapy, one week apart. Scores decreased more at higher densities of shock intensity than at lower densities, while there was no significant difference between the 2,000 and 4,000 shock conditions. Moderate-intensity radial extracorporeal shock wave therapy was effective, and a higher density might be more efficacious in alleviating pain in knee osteoarthritis.
Comparison of the effects between low- versus medium-energy radial extracorporeal shock
wave therapy on knee osteoarthritis: A randomised controlled trial. J Taibah Univ Med Sci. 2020 May 15;15(3):190-196. CONCLUSION: The radial extracorporeal shock wave device was placed firmly on the most tender points at the level of the medial tibial plateau in a continuous movement. Group A received low-energy radial shock wave therapy (2000 shock/session [10 Hz]; EFD, 0.02 mJ/mm2), Group B received medium-energy radial shock wave therapy (2000 shock/session [10 Hz]; EFD, 0.178 mJ/mm2), and Group C received sham shock wave therapy (2000 shock/session [10 Hz]; EFD, 0 mJ/mm2) once per week for 4 weeks. Low- and medium-energy radial extracorporeal shock wave therapies are effective modalities in the treatment of KOA, with medium-energy radial extracorporeal shock wave therapy considered superior to low-energy radial extracorporeal shock wave therapy.
A Randomized Controlled Trial on the Effects of Low-Dose Extracorporeal Shockwave Therapy in Patients With Knee Osteoarthritis. Arch Phys Med Rehabil. 2019 Sep;100(9):1695-1702. CONCLUSION: ESWT of 2000 pulses at 8-Hz frequency at 2.5 bars of pneumatic pressure with the first 1000 pulses evenly distributed to pain points (the maximum number of pain points is 4) with the the remaining 1000 pulses being delivered sliding back and forth on the patellofemoral and tibiofemoral borders. (radial SWT device).
Radial extracorporeal shock wave therapy for disabling pain due to severe primary knee osteoarthritis. J Rehabil Med. 2017 Jan 19;49(1):54-62. CONCLUSION: Three sessions of rESWTeach one week apart at 2,000 rESWT impulses per session with a positive energy flux density 0.10-0.16 mJ/mm2) or placebo treatment showed statistically significant improvement only in mean WOMAC scores for pain and a few of the pressure measurements suggesting to be successful in treating disabling pain due to primary knee osteoarthritis substantially higher energy flux densities are necessary for treatment success in this condition.
Efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a randomized controlled trial. Surg Res. 2013 Dec;185(2):661-6. CONCLUSION: 4000 pulses of shockwave at 0.25 mJ/mm 2 weekly for 4 weeks was effective in reducing pain and improving knee function better than placebo. (focused SWT device).
WHAT TO DO RIGHT NOW?…
Change your diet. Get some exercise. Strengthen your thighs and calves. Take a few nutrients.
Consider shock wave therapy for your knees (EPAT).
CALL ME WITH QUESTIONS OR MAKE AN APPOINTMENT...916-489-4400
Be Thankfull!
Kirk Hamilton PA-C
Prescription 2000, Inc.
Health Associates Medical Group
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 489-4400 (w)
krhammer@surewest.net
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com