Surgery For Achilles Tendon May Not Improve Recovery

Readers have been asking about fixing Achilles tendon tears. They ask if tears can heal without surgery. Tears, even complete tears, can heal with the right rehab therapy even without surgery. A recent study of 92 patients made news when it concluded, "Surgical and nonsurgical treatment were equally effective for patients with acute rupture of the Achilles tendon."

Dr. Katarina Nilsson Helander, MD, of Kungsbacka Hospital in Sweden reported at the March 2010 American Academy of Orthopaedic Surgeons meeting, that outcomes and rates of re-rupture did not differ significantly through 12 months between patients getting surgery and those with physical rehab alone. Within 72 hours of injury, the 97 patients were randomized to surgery (48 patients) or no surgery (49 patients), followed by two weeks in a firm cast, then six weeks in an adjustable brace that allowed some movement of the foot. Both groups reported increased physical activity over time. All underwent identical rehabilitation programs. Complications in the surgical group included one contracture of the tendon, two wound infections (one deep and one superficial), and two nerve disturbances. Thirteen patients had concerns about the scar, 10 for cosmetic reasons and three for scar contracture and pain. Both groups were still below pre-injury levels at one year.



There is currently no consensus whether surgery plus physical rehab, or physical rehab alone is the favorable approach. That means, if you go to a doctor with your Achilles tear, you may be told that surgery is the only way, even though you may get the same results without the surgery. Many people hope to have surgery and be done with their problem, not knowing they will need the same physical therapy either way. Complications such as incision-healing difficulties, infection, contractures, re-rupture of the tendon, atrophy, complications and illness from anesthesia, bleeding, clots, scar pain, nerve pain, can arise from surgery. Drugs required during and after surgery can create new illnesses and further drug prescriptions. Surgical and healing outcomes vary with the skill, luck, and patient load of the operating team that day.

It is not new information that surgery may not always be required. Several studies conclude that non-surgical treatment yields similar results:
Soccer player David Beckham underwent surgery last week after tearing his left Achilles' tendon playing for AC Milan against Chievo. The news reported that the surgeon, Dr. Sakari Orava, said that, "The operation went smoothly and nicely" but that Beckham would not be able to play in this year's World Cup, saying "No,....healing (from the surgery) takes a long time."

You have choices if surgery is not right for you.


Fitness Fixers To Keep Your Achilles Healthy:

• Better Achilles Tendon Stretch
• Fast Fitness - Built In Functional Achilles Tendon Stretch
• Fast Fitness - Better Standing Hamstring, Achilles, and Inside Leg Stretch
• Functional Achilles Stretch
• Friday Fast Fitness - Partner Achilles Tendon Stretch
• Achilles Stretch in the Bathroom
• Plantar Fasciitis Part I
  

Supportive Shoes Increase Tightness and Problems

• Which Shoes Help Exercise, Fall Prevention, and Ankles?
• Kneecap Tracking - Don't Miss These Reasons It Doesn't Get Better
• Why So Many Aerobics Injuries?
  

Fitness Fixers on Surgery:

• Knee Tracking Surgery - Tracking Outcomes
• Knee Surgery - Arthroscopy Results No Better than Pretend Surgery
• Surgery for Knee Arthritis, Meniscus, Unnecessary
• Anterior Cruciate Ligament (ACL) Surgery Unnecessary
• What Works Better Than Knee Surgery?
• Another Reason to Avoid Surgery - Catching Fire "A Bigger Risk Than Thought"
• Prevent Back Surgery
• Fix Disc Pain Without Surgery
• Studies Say Back Surgery Not Needed

Labels: achilles stretch, drugs, injury, surgery

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Hospitalization Increases Fractures In Elders

A study of men and women over age 70 found two to three times more bone fractures occurred following a hospital admission compared to not being in a hospital. The risk of new fracture was greatest during the first year after hospitalization and increased with the number of times a patient was hospitalized. This included increased numbers of hip fracture, which leads to a fatality within the year in about 30% of people over 50.

Study authors stated, "Because the risk of fracture is greatest soon after hospital discharge, assessment and interventions to reduce risk should be started during the hospital stay or shortly after discharge. Evaluations should include measurement of bone mineral density, assessment of the risk of falling and vision testing." According to the authors, appropriate treatment for these patients include calcium and vitamin D supplements; bisphosphonate drug treatment, such as alendronate (Fosamax) or risedronate (Actonel); vision correction if needed; and physical therapy, including walking programs and exercises to improve flexibility, strength and balance.

1. Being in a hospital is often joked about as being unhealthy. It is also a reality:
2. When people are sick, it is not the time to keep them sedentary, indoors, eating institutional food, out of fresh air and sunlight, and taking medicines that reduce bone density and increase pain syndromes.
3. Lack of standing and activity quickly reduce bone density.
4. Several commonly prescribed medicines directly reduce bone density and cause stomach and body pain. Instead of stopping these medicines, others are given, which further depress health, and the mistake of further unneeded and unhealthful drugs.
   
5. It is a circular problem when people feel they must reduce activity to prevent falls and injury.
6. What is needed is the right, carefully supervised, healthy movement to give the physical skills that prevent falls, the stiffness that results in more pain and lack of function, and reduction in bone density, balance, strength, and mobility crucial for basic health.

Fitness Fixers For Healthier Options:

• Prescription Acid-Reducing Drugs Produce Heartburn and Dependency
• Common, Missed Cause of MusculoSkeletal Pain - Your Drugs
• FDA Orders Suicide Risk Warning for Common Back Pain and Migraine Drugs, and Others
• Stomach Acid Drugs Increase Osteoporosis and Hip Fractures
• Exercise is More Important Than Calcium Supplements for Bones
• Collapsing Astronaut Gives Healthy Reminder

Random Fun Fitness Fixer

• Fast Fitness - Open Your Eyes and World View

Labels: aging, balance, drugs, injury, osteoporosis, practice of medicine, strength, surgery

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Prescription Acid-Reducing Drugs Produce Heartburn and Dependency

In a study of acid-suppression drugs, healthy adults with no previous symptoms developed

"heartburn, acid regurgitation and dyspepsia" after a course of the drugs. Forty percent of 120 volunteers taking anti-heartburn drugs called proton pump inhibitors (PPIs) had a rebound increase in gastric acid secretion, resulting in acid levels above their starting levels.


Gastroenterology is the official journal of the American Gastroenterological Association (AGA) Institute. A comment appearing in the Journal stated there is, "Evidence that proton-pump inhibitor therapy induces the symptoms it is used to treat." Gastroenterology. 2009 Jul;137(1):80-7, 87. McColl KE, Gillen D.

PPI drugs for gastrointestinal symptoms are highly prescribed. Study authors stated, "This might lead to PPI dependency and thus have important implications."

In the previous Thank You to Grand Rounds, I noted that several prescriptions drugs are known to cause increased symptoms, rebound, even the original problem - Thank You Grand Rounds 5.50, Medicine & Technology.

It is becoming known that PPI drugs do not prevent the source of the problem, so may not be needed in the first place. It does not seem necessary to start a course of drugs that perpetuates your symptoms, even causes the problem itself. The Fitness Fixer article Stomach Acid Drugs Increase Osteoporosis and Hip Fractures explains more.


Related Fitness Fixer:

• Stomach Acid Drugs Increase Osteoporosis and Hip Fractures
• Exercise is More Important Than Calcium Supplements for Bones
• Common, Missed Cause of MusculoSkeletal Pain - Your Drugs
• FDA Orders Suicide Risk Warning for Common Back Pain and Migraine Drugs, and Others
• Forensic Anthropology and Bone Density

Unrelated Random Fitness Fixer:

• Married 63 Years With Good Balance

Labels: digestion, drugs, fix pain, injury, practice of medicine

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Common, Missed Cause of MusculoSkeletal Pain - Your Drugs

Three years ago, I started a series of Fitness Fixer posts about the extensive phenomenon of muscle, joint, and body pain occurring from common prescription drugs. The editors at that time asked me to defer writing about it. I have been watching the medical reports grow, substantiating the numbers and secondary problems of chronic pain from common medicines. This is a short summary, with more coming this summer.

Major side effects of body and muscle pain from common prescription drugs are not rare as once thought. Misdiagnosis of this pain is common. Unnecessary treatments, surgeries, and more drugs are often given. Exercises and stretches do not stop body pain from drugs:

• Statin drugs for cholesterol are a frequent cause of muscle and joint pain, and sometimes, numbness or tingling in the fingers or toes
• Common prescription drugs for anxiety and depression. Even though this class of medicines may be prescribed for nerve pain, they can cause nerve and muscle pain as side effects
• Ritalin (methylphenidate hydrochloride) and related drugs
  
• Some prescription allergy medicines such as Allegra (Fexofenadine)
• Prescription acid prevention medicines called PPIs - proton pump inhibitors (Nexium, Prilosec, Prevacid, Zoton, Inhibitol, and others). PPIs have also been shown to greatly increase risk of hip fracture
• Erectile enhancing drugs
• The calcium channel-blocker drug verapamil
• The antibiotics erythromycin and clarithromycin
• Some HIV medications
• Prescription medicine for constipation like Zelnorm (Tegaserod), irritable bowel, and others digestive complaints.
• Migraine and headache prescriptions
• Medicines for fibromyalgia
• Even many medicines for pain, sadly have pain both as direct side effects and rebound pain, increasing drug dependence and pain cycles
• There are several more prescription drugs that cause more problems than they relieve. List your additions in the comments below.
  

Often the need for the original medicine can be stopped with simple healthy changes. Motivated people can address and change the original problem, making their life better and more active than before instead of paying for more medicines and the problems that come with them.

Two of my books teach how to fix pain and mention specific drugs and what to look for:

• Fix Your Own Pain Without Drugs or Surgery. Each chapter on each kind of pain gives a list of drugs that are known to cause pain.
• Health & Fitness THIRD ed - How to Be Healthy Happy and Fit For The Rest of Your Life. Several chapters include drug information pertinent to the condition covered, plus several chapters on general health, offering many ways to avoid needing the original medications.
• Click the link www.DrBookspan.com/books.

Related Fitness Fixer:

• Stomach Acid Drugs Increase Osteoporosis and Hip Fractures
• FDA Orders Suicide Risk Warning for Common Back Pain and Migraine Drugs, and Others
• Human Growth Hormone
• Doctor Fakes Benefits in 21 Pain Pill Studies

Labels: arthritis, blood pressure, digestion, dizziness, drugs, fibromyalgia, fix pain, headache/migraine, practice of medicine

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How Effective Are Medical Treatments For Back Pain?

Many well-known conventional treatments for injured athletes and military personnel came from ways to keep wounded combatants able to continue fire, not to maximize their long-term survival or later health.

Years of my career laboratory research was improving physical training for athletes and military, and developing injury protocols that were healthy, not just a remedy for the moment. I also found that much good sports medicine for athletic motion was never applied to the more common body motions needed all day. Not only can the athletes benefit, but everyone else. Many patients and readers have success using my improved non-surgical methods, and write us their stories (click for reader stories). Many more have success without writing about it. Other readers asked about various medical (surgical/drug) treatments, and why don't I use them.

Thank you to my colleague Fabrice Czarnecki. M.D. emergency room physician, for sending me a report, recently published in a prestigious medical journal. The work was a systematic review of the "benefits and harms of nonsurgical interventional therapies for low back and radicular pain."

The medical methods they looked at were local injections, botulinum toxin injection, prolotherapy, epidural steroid injection, facet joint injection, therapeutic medial branch block, sacroiliac joint injection, intradiscal steroid injection, chemonucleolysis, radiofrequency denervation, intradiscal electrothermal therapy, percutaneous intradiscal radiofrequency thermocoagulation, Coblation nucleoplasty, and spinal cord stimulation.

Their results: "For sciatica or prolapsed lumbar disc with radiculopathy, we found good evidence that chemonucleolysis is moderately superior to placebo injection but inferior to surgery, and fair evidence that epidural steroid injection is moderately effective for short-term (but not long-term) symptom relief. We found fair evidence that spinal cord stimulation is moderately effective for failed back surgery syndrome with persistent radiculopathy, though device-related complications are common. We found good or fair evidence that prolotherapy, facet joint injection, intradiscal steroid injection, and percutaneous intradiscal radiofrequency thermocoagulation are not effective. Insufficient evidence exists to reliably evaluate other interventional therapies.

What does all that mean? They summed it up in their conclusions: "Few nonsurgical interventional therapies for low back pain have been shown to be effective in randomized, placebo-controlled trials."


Medical reports on these methods (as well as general strengthening exercises) frequently show what is called a scattershot success - meaning if you try it on hundreds of people, it's bound to hit a few of them. Often these hits (moderate improvements) are about the same as chance or as time passing and the person heals on their own over the weeks of the treatment and recovery. Use those medical treatments if you believe in them and prefer them.

I prefer a direct approach:

1. Instead of shots to anesthetize the area, or surgery to remove or fuse an area, retrain movement to be healthy so that you no longer injure the area and it can heal.
2. Instead of medicines to mask the damage you cause, stop the damage.
3. Stopping damage does not mean stopping movement, activity or fun. Use healthy body mechanics to become able to do more than before.

Continue Activities You Love

• Autumn Yard Work - Limiting the Person Instead of the Injury Again?
• When Did Health Become Thinking Out Of The Box?
• Why So Many Aerobics Injuries?
• What is "Fitness as a Lifestyle?"

Notice Damaging Body Mechanics

• Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats?
• Prevent Back Surgery
• Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch
• What Does It Look Like to Not Use Abdominal Muscles?
• Simulation Suit To Feel the Pain of Osteoarthritis
• Are You Making Your Exercise Unhealthy?

Fixing Damage Without Surgeries, Injections, or Drugs

• Innovation in Abdominal Muscles
• Surgery for Knee Arthritis, Meniscus, Unnecessary
• Stomach Acid Drugs Increase Osteoporosis and Hip Fractures
• Studies Say Back Surgery Not Needed
• Anterior Cruciate Ligament (ACL) Surgery Unnecessary
• Fix Disc Pain Without Surgery
• FDA Orders Suicide Risk Warning for Common Back Pain and Migraine Drugs, and Others
• Doctor Fakes Benefits in 21 Pain Pill Studies
  
  
  Coming next - Common, Missed Cause of MusculoSkeletal Pain - Your Drugs.
  
  
  
  ---
  Questions come in by hundreds. I make posts from fun mail. Before asking more, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own.
  Subscribe to The Fitness Fixer, free. Click "updates via e-mail" (under trumpet) upper right.
  See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
  

Labels: drugs, fix pain, lower back, military fitness, surgery

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Neutropeptide Y Generation for Healthier Stress Response

Yesterday's article, Extending The Envelope - Military and Civilian, told some of my career work to improve and strengthen human ability. Today, a study from Fort Bragg on Green Berets.

A study of soldiers at Fort Bragg, North Carolina, found that Special Forces soldiers produced more of a molecule called Neuropeptide Y in their blood than regular soldiers. Neuropeptide Y is generated by the body to calm the brain in times of extreme stress.

The Special Forces soldiers mobilized more neuropeptide Y than ordinary soldiers, and were able to sustain it for longer periods. It was concluded that higher levels make them more resilient to post-traumatic stress disorder (PTSD) than the average soldier. Neuropeptide Y returned to normal levels within 24 hours in the Special Forces subjects, but dipped below normal in the control subjects of regular soldiers.

Army Special Forces personnel are also known as Green Berets. It is not known whether the Green Berets' better ability to generate the peptide and endure trauma was something they came in with, which made them more likely to pursue becoming a Green Beret, or had been acquired or enhanced through training. The researchers said, "If we could bottle this, or if we could train people to mobilize their own neuropeptide Y, that would be primary prevention for PTSD - a very exciting approach."

Labels: drugs, military fitness, performance enhancing modality

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Extending The Envelope - Military and Civilian

When I worked as a military research scientist, strong brave men got hazardous duty pay to spend a day with me.

I measured what humans can do, physically and mentally, and how to make them better at it. I tested pilots undergoing acceleration to see what determined susceptibility or resilience to blackouts and other g-force effects. I tested combat swimmers to see what makes them swim faster, farther. I worked on modalities to prevent astronauts' bones from de-mineralizing, because without the pull of gravity, muscles do not make the bones retain calcium. After weeks in space, astronauts return with the equivalent of years of bone loss. I worked on countermeasures. I tested ground troops to see how much they could carry and why.

My work trains the person, making him self-contained and able to withstand harsh conditions without special clothing, tools, or pills. Another department works with garments that help resistance against temperature, weaponry, and other effects. Another group are the 'gadget guys' making yet more things I have to make the guys able to carry around. Another department is pharma-chemicals - what drugs they could develop and administer to block need for sleep and food, heighten focus, or increase strength or speed. Some heart drugs are long-known and used for steadying the marksman's hand by decreasing the contractile pulse of the heart.

Click the labels under this article for more Fitness Fixer on each topic. I have written several posts, with more to come, on my work to "extend the human envelope."

• Look for tomorrow's post for one of the things the pharmaceutical groups work on - Neutropeptide Y Generation for Healthier Stress Response.
• More in Extremes, Survival, Injuries, Faster Higher Stronger - Fitness Fixer

Labels: aerospace, drugs, g-force, military fitness, performance enhancing modality, stress, swimming, tests of fitness/health

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Fast Fitness - Make Your Own Muscle Soreness Rub

Here is Friday Fast Fitness - by special request of martial arts students starting my summer semester university class this Tuesday - Make a quick soreness relief rub at home:

Labels: arthritis, drugs, fast fitness, green fitness, martial arts, soreness

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Doctor Fakes Benefits in 21 Pain Pill Studies

A news report published in several publications including The Wall Street Journal stated that anesthesiologist Scott S. Reuben faked data so that it would seem that benefits occurred from painkillers like Vioxx and Celebrex. The studies had been published in several anesthesiology journals between 1996 and 2008.

Dr. Reuben had been a paid speaker for Pfizer, a powerful pharmaceutical company, and Pfizer paid for some of the research.

The journal Anesthesiology has retracted three of Dr. Reuben's articles. The journal Anesthesia & Analgesia has retracted 10 of Dr. Reuben's studies and posted a list of 11 of his studies published in other journals.

Jacques E. Chelly, head of acute interventional postoperative pain service at the University of Pittsburgh Medical Center, said that the situation has prompted his hospital to review the protocols it uses to treat patients for pain, because Dr. Reuben's work was so influential in establishing them.

Editor James C. Eisenach warned in an editorial in the journal Anesthesiology, stating:

"these retractions clearly raise the possibility that we might be heading in wrong directions or toward blind ends in attempts to improve pain therapy."

Other Problematic Drugs. Vioxx and Celebrex are not the only highly prescribed drugs that have been found less effective than advertised. Several major drugs prescribed for pain/fibromyalgia and headache were later ordered by the FDA to carry a Suicide Risk Warning:

• FDA Orders Suicide Risk Warning for Common Back Pain and Migraine Drugs, and Others

Where Does Some of the Information in Medical Books Come From?

• Fitness Myths - How Many Legs Does a Dog Have If You Call the Tail a Leg?
• Can We Teach Young Doctors to Be Healthy?
  
• What Medical Students Told Me About Nutrition

Healthy Ways To Stop Sources of Pain. Specific well-known medications and surgeries have found to be no more effective than less expensive and disruptive methods:

• Prevent Back Surgery
• Fix Disc Pain Without Surgery
• Studies Say Back Surgery Not Needed
• Surgery for Knee Arthritis, Meniscus, Unnecessary
• Anterior Cruciate Ligament (ACL) Surgery Unnecessary
• What Works Better Than Knee Surgery?
• Autumn Yard Work - Limiting the Person Instead of the Injury Again?

Labels: drugs, fix pain, practice of medicine, surgery

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FDA Orders Suicide Risk Warning for Common Back Pain and Migraine Drugs, and Others

The FDA issued a public health alert today based on their review of 199 clinical trials. Specific drugs for epilepsy and psychiatric disorders are often prescribed to patients with migraine, back and body pain. The FDA review was released last January, and showed that patients taking those drugs had "almost twice the risk of suicidal behavior or thoughts than patients taking a placebo."

One of the drugs on the warning list is Neurontin (Gabapentin). Patients with back and various nerve and diabetic pain are commonly prescribed this drug. More drugs on the list are frequently prescribed for fibromyalgia and other pain: Lyrica (Pregabalin), Topamax (Topiramate), Celontin (Methosuximide), Felbatol (Felbamate), Zarontin (Ethosuximide) and others.

Here is a list of the medications required to add the warning:

* Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR)
* Clonazepam (marketed as Klonopin)
* Clorazepate (marketed as Tranxene)
* Divalproex sodium (marketed as Depakote, Depakote ER, Depakene)
* Ethosuximide (marketed as Zarontin)
* Ethotoin (marketed as Peganone)
* Felbamate (marketed as Felbatol)
* Gabapentin (marketed as Neurontin)
* Lamotrigine (marketed as Lamictal)
* Lacosamide (marketed as Vimpat)
* Levetiracetam (marketed as Keppra)
* Mephenytoin (marketed as Mesantoin)
* Methosuximide (marketed as Celontin)
* Oxcarbazepine (marketed as Trileptal)
* Phenytoin (marketed as Dilantin Suspension)
* Pregabalin (marketed as Lyrica)
* Primidone (marketed as Mysoline)
* Tiagabine (marketed as Gabitril)
* Topiramate (marketed as Topamax)
* Trimethadione (marketed as Tridione)
* Zonisamide (marketed as Zonegran)
Some of these drugs are also sold generically.

I will be covering migraine and other headache in the future. Instead of drugs to mask back pain, neck pain and various musculoskeletal and nerve pain, fixing the cause is healthier than drugs. By no longer injuring the area, the pain will stop and the area can heal. It is not matter of choosing between pain and often worse problems from the treatment.

To stop common causes of pain, and the need for drugs, start with these:

• Disc Pain - Not a Mystery, Easy to Fix
• Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch
• The Cause of Disc and Back Pain
• Fix Disc Pain Without Surgery
• How Much Inward Curve Space Should There Be In The Lower Back?
• Fast Fitness - Prevent Back Pain When Rowing
• Fix Scoliosis and Arthritis Pain, Fix New Orleans
• Prevent Knee Pain When Rowing
• Prevent Main Factor in Back Pain After Running and Walking
• Prevent Back Surgery
• Gaze Perseid Meteors Without Neck Pain
• Prevent Neck Pain and Get Upper Back Exercise Carrying Backpacks
• Upper Back Exercise and Neck Pain Prevention Too
• Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
• Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part I
  
• Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part II
• Cauda Equina - Result Not Cause
• Healthy Mother's Day
• Stomach Acid Drugs Increase Osteoporosis and Hip Fractures
  
  

Also recommended, available from my BOOKS page - www.DrBookspan.com/books:

• Fix Your Own Pain Without Drugs or Surgery
• Health&Fitness - How To Be Healthy Happy and Fit For The Rest of Your Life. THIRD edition.
• The Ab Revolution - No More Crunches No More Back Pain THIRD edition.

Labels: diabetes, drugs, fibromyalgia, fix pain, headache/migraine, injury, lower back, practice of medicine, stenosis, upper back

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Fast Fitness Halloween

Here is Fast Friday Fitness - Encourage health, not disease on Halloween.

Instead of junk candy, what about:

1. Give "Pledge to be Drug Free" stickers. If you don't have preprinted stickers, easily make some with blank stickers or labels, colored markers, and help of children (yours or neighbors).


2. Give small toys, available inexpensively in bulk. One choice is small blocks of modeling clay with a list of suggestions what kids can make - sculpt your dream profession, favorite person, flower... Toy, office, and hobby stores sell pre-packaged boxes of small cans of clay at economical prices. (Use some to make your high tech balance trainer.).


3. If you don't distribute treats this year (or any year) put a sign on your gate or door to Trick or Treaters with a healthy message - "Be drug free," "Always say 'please and thank you,'" "Please look both ways before you cross the street," or other good message.

If nothing else, not giving junk candy may cut down on visitors to your house :-)


If you are dressed as something scary, show kids that even scary things act well and do good. Try healthy Halloween games to teach manners, such as, "You've Been Boo'd" with a good deed. In this game, you say something nice to someone or let someone in line ahead of you, tell them they have been "boo'd" and they are next to pass it on.


More Healthy Halloween choices:

• Exercise Common Sense Discipline - Turn Down Halloween Junk Food
• Is Your Health Food Unhealthful
• Mischief is Not Good Exercise - Halloween Ahimsa
• Happy Birthday Happy Halloween

Labels: children, drugs, fast fitness, holiday

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Not Old for the Olympics Part II

Yesterday's post, Not Old for the Olympics Part I, told of athletes competing in the highest level athletic events over many years as they get older. The ability to keep physical skills by training is not new or unusual. To keep physical skills, you must continue to use and practice them.

One of my students, Leslie, was featured doing 30 pushups in the March post Are You Stronger Than A 67 Year Old Lady?


Leslie can now do 40 pushups easily, and says her goal is 45 for her 68th birthday this October. I didn't have a camera with me to record her 40 pushups last week in class before posting this post, but will try when I get back from the Wilderness Medicine conference.

Leslie says she wants me to tell all of you that she could not do any pushups when she started working with me. She says it was my training in functional daily movement that made the difference, instead of doing artificial exercises in "sets and reps" for isolated body parts. She says the last 5 of the 45 pushups are hard, but she perseveres and keeps smiling, knowing discipline needs training. Bookmark her movie so you can do your 30 pushups every day with her.

When Dara Torres made the news by qualifying for the Beijing Olympics, the first comments by the masses included that performance enhancement drugs were probably needed. Torres employs a head coach, a sprint coach, a strength coach, two stretchers who moved to Florida to stretch her daily, two masseuses, a chiropractor, a nanny, and household help, with costs estimated at least $100,000 per year, plus the support of family, friends, and good sponsors. You don't win an Olympics alone, but it does not require drugs to get better over years of training. Torres trains hard, and has a team of trainers and people who stretch her, using many of the conventional moves that "work" at the price of her 13 surgeries for injuries.

There are people who state that it is unfair and unethical to use performance-enhancing drugs, but they wear or allow a one thousand dollar engineered bathing suit like the new Speedo LZR. When I was competing, swim goggles were considered an unfair advantage. Mark Spitz won his record setting medals without even wearing goggles. When I was competing, it was considered unfair for an American athlete to earn any money from athletics. No sponsors were allowed. Athletes swept floors to earn money to compete. Today they are not only sponsored and advertised, pro athletes arrive at events with chauffeurs from their villas.

Is it fair to be taller, a trait which favors speed in swimming? Some who say performance-enhancing drugs are wrong will eat engineered food, and use expensive altitude chambers and other training devices. Is it fair to other competitors when one swimmer has a rich family who gives up all to support their dreams? It is considered unfair doping to use certain steroids to hasten healing of internal injuries and soreness from intensive training, but not if you use them to heal skin erosions from the same hard training. Drugs are vilified in some sports, glorified in others, and routinely used in the business and military world for increased concentration and competitiveness, and reduction of hunger and fatigue.

Debate continues about ethics. Two truths are important to remember - Performance enhancing drugs are not necessary to win or to achieve the highest goals of competition. There are women swimmers today who without any drugs are breaking records of men swimmers of the 70's who used steroids. Performance drugs are not healthy. The purpose of athletics is not just to mindlessly best the person next to you. A higher view is the beauty of clean healthy athletics.

Related Fitness Fixer on exercise and aging, and enhancing drugs:

• Exercise and Aging - Don't Limit the Patient to Limit the Pain
• Why So Many Aerobics Injuries?
• Human Growth Hormone
• Rocky IV and Healthier Exercise
• Metabolism - How to Lose Weight and Save Money

Labels: aging, drugs, Olympics, performance enhancing modality, swimming

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Tour De France 2008 and Increasing Aerobic Capacity

The Tour de France is a 23-day bicycle race. This year it runs from July 5 to 27, 2008. It is a stage race, broken into individual races, from one town to another. The number of stages has varied over years since the tour began in 1903. Course distance runs approximately 3,000 km (1,864 mi) through most of France and often through one or more adjoining countries.

Some of the essence of "le Tour" was incorporated in the synthpop song "Tour de France," a 1983 hit single by the German group Kraftwerk. They put the motto of France in krautrock (krautrock is considered a fun and positive term by enthusiasts): Liberté, égalité, fraternité, French for liberty, equality, good company - which is the point of much of the race.

The Tour de France is a difficult event. Even with light bicycles designed for each stage, it is still grueling. Athletes must train for exceptional aerobic ability.

Cardiovascular endurance, also called aerobic capacity, determines how long you can continue activity at your chosen pace. When you exercise, your body needs more oxygen, so your cells extract more of the oxygen your blood provides. Aerobically fit people can extract more oxygen when exercising, and so, can do more exercise. Average exercise needs about 10 times more oxygen supplied to your active tissues, than at rest. Heavy exercise can increase need to around twenty times. If you do not have high enough capacity from training, you will be too out of breath to continue. World-class athletes have been recorded to reach over 30 times their resting rate.

With regular endurance activities, such as biking, running, swimming, your body makes many changes that improve function. You increase blood volume, the number of oxygen-carrying blood cells, expand the network of blood vessels, reduce incidence of vessels clogged with fatty deposits, increase number of cellular organelles and enzymes your body uses to process oxygen into energy, and other physical improvements, to be covered in future posts.

Breathing in more oxygen won't increase your ability to extract more oxygen. For that you need training. When your body senses it needs more oxygen than it is getting - during hard aerobic exercise or exposure to altitude - the kidneys secretes a natural human hormone called erythropoietin (EPO). EPO stimulates the bone marrow to make more red blood cells. Everyone can do this on their own through regular aerobic training. When some people want more EPO, they may try blood transfusions, called Transfusion Doping, an illegal procedure to increase maximum oxygen carrying ability. They may also inject various kinds of synthetic human erythropoietin. Whether having the money and access to these substances is fair play is topic of many debates in sports ethics. More important is that they are not healthy. Blood can thicken and cell count increases to a dangerous level leading to cardiac problems. Deaths have occurred in young athletes from blood doping practices. There have been experiments with artificial oxygen carriers based on recombinant, bovine (cow), and human hemoglobin or perfluorocarbons. These substances have potentially lethal side effects including renal toxicity, increased blood pressure, and immune depression. Champions don't need them. You don't need them.

Posts to come will cover more on performance enhancement, drugs, supplements, Le Tour and other bike races, The Olympics and other events. Posts on supplements and performance enhancing drugs:

• Human Growth Hormone
• Nutrition for Endurance Swim Training
• Get Muscles for Christmas

Books that cover aerobic training and performance enhancement are Health & Fitness THIRD edition (good for general populations) and Healthy Martial Arts (more for athletes of body and mind).

Labels: aerobic, altitude, biking, drugs, endurance, performance enhancing modality, Tour De France

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Technical Difficulties

Articles intended for yesterday and today could not be posted. Blogger is having technical difficulties. No photos or graphics are uploading to Fitness Fixer. The scheduled posts that describe healthy use of kettlebell weights would not be as fun or understandable without seeing the photos. They will come, hopefully soon. Until then, try this remarkable site www.bonkersinstitute.org.

Bonkers Institute was sent to me by reader Dr. Ern Campbell, a good man, who runs the immense resource of the Scubadoc diving medicine site and forum, scuba-doc.com. I am one of the site's diving medicine advisors.

The Bonkers Institute site, on the surface, seems to be funny stories. Look closely to realize how they intelligently expose critical topics. From their "about" page, they explain that they bring to light "shameless disease mongering and unprecedented pharmaceutical profiteering."

"...Our mission is to expose fraudulent medical pseudoscience wherever it is found… We march into the field of battle armed with a powerful weapon: our sense of humor. Fighting pseudoscience with pseudoscience…"

Labels: drugs, education, mind, scuba

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Junk Food Through Your Skin?

We live part of each year in Asia. For a few months, I was posting articles for you from various villages. The town shower of one is pictured at right - not the hut, the outdoor green post with hose. Imagine what the Internet café was like.

On the flights over, our only bag was lost. US transportation security required us to check our sole knapsack, since it had a small gift for friends containing liquid. It never reappeared. We don't need "things" and it was just as easy to make our own soap, comb, and toothbrushes as carry them.

In Western stores, I am astonished by the number of "personal care items." Not just shelves full, but aisles. Each promising better hair, skin, nails, and other parts, but with ingredients that are not healthy for your body, produced in ways that pollute the world, and packaged in plastics that are unhealthy to produce, pollute when discarded, and which apparently leak chemicals into the product that can be absorbed through your skin - see Green Water. A study commissioned by the Organic Consumers Association found that even shampoos, body washes, and lotions labeled "natural" and "organic" can contain unhealthful, even carcinogenic compounds.

I feel high maintenance just carrying a toothbrush. Then we arrived without even that. What freedom.

We made simple hand sanitizer from coarse salt, rubbed between the palms.


For body, face, and hair, we picked aloe leaves, squeezed out the gel inside, and rubbed directly on - see Fast Fitness - Aloe Inside and Out. It dries non-sticky, and makes your hair shiny, clean, and healthy. We used the rest of the gel in food and drink for healthy digestion.

Bamboo is easily made into cooking pots (photo above left). We also visit our favorite bean sprout PadThai restaurant - an outdoor wok on wheels run by a friend. Paul is always popular when we travel (photo at right). The others are not sitting; Paul is really that tall, and has to duck those umbrellas, doorways, and ceilings.

Baking soda and salt makes clean toothpaste. Even without them, a short branch called a neem stick with one end mashed until fibrous, makes a soft, effective bristled toothbrush. Neem extract is said to be a good antiseptic, and effective against various health ills and germs.

After a long day at work and after hard training, instead of hand lotion, you can rub sesame or other light healthy cooking oil onto your hands and feet. You can scent it with mint leaves, citrus peels, spices, and flowers. More ideas in Healthy Mother's Day.

I don't use sunblock, even in the tropics. I do use something to stop some of the unwanted effects of too much sun, but I do not want to block the Vitamin D and other helpful effects of sunlight. Vitamin D deficiency can lead to osteoporosis (thin, brittle bones) and osteomalacia (rubbery, demineralized bones). Vitamin D deficiency is associated with increased risk of a few types of cancer, including lung cancer. Studies find that people with low blood levels of vitamin D were more likely to have high blood pressure, cardiovascular disease, cystic ovary, and type 2 diabetes. Another study found that a number of patients with aches and weakness were vitamin D deficient and concluded, "A lot of 'fibromyalgia' may be D deficiency."

Instead of blocking or deflecting UV rays using chemical sunblocks that may contain chemicals that I am not sure are healthy, I mix my own, that I hope stops the oxidizing effects and makes my own body better able to stop skin cancer mechanisms. I mash together fresh coconut pulp, green tea, vegetable sprouts, mashed turmeric root, and aloe gel. Here is how to get a simple fresh aloe - Fast Fitness - Aloe Inside and Out.

A study by Johns Hopkins researchers, reported in the Proceedings of the National Academy of Sciences (October 30, 2007, vol. 104, no. 44, 17500-17505) found that rubbing an extract made from broccoli sprouts on your skin may help prevent skin cancer from high levels of ultraviolet (UV) radiation. Broccoli, and the sprouts in particular, contain a chemical called sulphoraphane, which is found to activate cancer-fighting enzymes in your own cells throughout your body, not only skin cells.

Instead of chemical anti-mosquito products, we try various things. Marigold flowers rubbed on the skin seem to work for us. I don't seem to be "sweet," and mosquitoes often ignore me while going after Paul. We have heard various theories from locals. One is that he eats sweet rice while I eat more garlic. Various grasses rubbed on the skin also work well for us.

There are vines growing in Thailand with beautiful purple flowers. When you rub them on wet hair, it leaves your hair soft and shiny and sweet smelling, but the bugs do not like it. There are other vines that, when mashed with water made effective gentle soap and mosquito control combined.

In Asia, martial arts training is often more rigorous and disciplined than is common in the states. After hard evenings of training, I would sit by a candle made from oil and tightly wrapped bamboo leaves, and rub salt and oil into my, and Paul's, tired feet. Bliss.

• You can exercise for your health. Why undo that by eating junk food - Is Your Health Food Unhealthful
• or by adding junk food to your brain through thinking unhealthful thoughts - Healthier Heart
• or with junk food directly through your skin.

The biggest worry for Paul is just ducking the doorways.

Labels: cancer, diabetes, digestion, drugs, fibromyalgia, fix pain, green fitness, nutrition, osteoporosis, sunlight

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Sinus and Head Colds

Several readers asked what else they can do for painful head and sinus congestion, because after two+ weeks of medicines and doctor visits, they were no better, or were worse. Common treatments do not work as claimed, including decongestants and sprays, and can cause sinus pain to continue and recur.

What Are Sinuses?
The sinuses in your head are eight spaces in your skull behind your eyes and nose. They produce mucus, and that is good. Mucus produces antiseptics, and traps and filters germs and particles that you don't want to pass into your respiratory system and the rest of your body. Sinusitis occurs when one or more of your sinus cavities become inflamed.

Inflamed by Inhaling Things
Sinuses can become inflamed without any germs causing it, for example from inhaling particles, allergens, or liquids up the nose. If you have ever "gotten water up your nose" in a pool, you have felt the results. The practice of irrigating the nose and sinuses with salt-water sprays is often prescribed for sinus congestion, and even for preventive "maintenance," but it removes important protective mucus layers and natural disease-fighting compounds, and is irritating in itself. Some people regularly spray the sinuses using a variety of squeeze bottles, or a device called a neti pot. It is an unnecessary practice, and does not prevent the underlying cause of sinus pain. It sets up an addictive cycle of rebound congestion and irritation, and increased risk of infections and discomfort to follow.

Another contributor to rebound congestion is regular use of camphor inhalers. Sniffing camphor is a widespread practice throughout Asia, where decorative camphor containers shaped to fit the nose are sold in most grocery, pharmacy, and convenience stores. Camphor irritates mucus membranes causing a cycle of irritation, more camphor inhalation, and more congestion. Some people develop a habit of inhaling camphor, thinking it is for their congestion, not realizing they have a substance inhalation addiction called "huffing."

Decongestants
Decongestants are a big money item in drug store sales. They are not the best treatment for sinus pain and congestion. You are already too clogged up. You do not want more "drying out." The clogged areas would do better becoming more dilute by drinking hot liquids, not by becoming more gummy and concentrated with the "drying out" of a decongestant. After the decongestant wears off, a rebound can occur of more congestion. Taking more decongestant perpetuates a negative cycle, and can raise blood pressure. Cough syrups and pills that contain dexomethorphan (DXM) to block coughing are not as effective for coughs as hoped, but are popularly abused by kids looking for a cheap, easily available "high" ("rhobotripping") with unhealthy physical and psychoactive effects.

Infections and Antibiotics
Sometimes sinuses fill with bacterial or viral fluid. Antibiotic do not help against sinusitis, even the kinds colonized by bacteria. Antibiotics can kill your body's good "bugs" or weaken them, leaving you susceptible to stronger bad bugs, who learn how to live and multiply in your body. Antibiotics taken orally reduce the needed numbers of beneficial flora that normally live in your GI tract. The nutritional and immunogenic products that they normally make in your body are not made, and the organisms responsible for several illnesses can rapidly reproduce and get out of control. An example is antibiotic-associated Clostridium difficile (C. difficile) colitis, an infection of the colon that occurs primarily among patients exposed to antibiotics. More than three million C. difficile infections occur in hospitals in the U.S. each year. He number is growing. An estimated 20,000 C. difficile infections occur each year in the U.S. outside the hospital - directly caused by taking antibiotics.

Healthier Ways to Decongest and Sooth:

• Hot steamy showers and baths.
• Hot facial compresses.
• No need for fancy vaporizers with chemicals (more camphor or other irritants to inhale). Put on a kettle or any pot of water and heat until steaming. Stand at a distance where you feel the warm steam, without standing close enough for any chance of burns. No need to bend over as in the photo at right. Stand in healthy comfortable position for your back and neck.
• Eat spicy foods that you like, such as wasabi or chili peppers.
• Drink hot peppermint tea, or other warm, aromatic teas with lemon.
• Reduce irritating particles (rugs, cats, junk piles, cigarettes, or whatever concentrates trigger irritants).
• A walk outdoors in fresh air and sunshine helps clear breathing and pain.
• Do any fun exercise to heat your body. Increasing body temperature loosens clogging secretions and generates heat shock proteins that have been found to be pretty good for you. The post Exercise and Cancer touches on the basics of heat shock proteins.
• The post Fast Fitness - Quick Warm Up gives a quick method to increase body temperature to warm up.
• The post Regular Exercise Reduces Cold and Flu Incidence lists good practices to lower risk and increase resistance to infectious diseases.

More information on preventing and resolving sinus problems, things to know about antibiotic use, and other infectious topics are in the book Healthy Martial Arts.

Labels: breathing, children, colds/flu/infectious, drugs, heat, neck, nutrition, smoking, warmup

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Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part II

In Part I of this post on Monday, photographer Bernie tells of fixing years of pain that doctors told him only surgery would fix, even after three surgeries. Here is a look "behind the scenes."

10 March 2005, Bernie e-mailed me:

"I've had this persistent paresthesias for 4+ years. I just learned about you yesterday. Where are your back & spine classes held. Tomorrow, I'm having lumbar myelogram & CT at (top name deleted here) Hospital. Before I consider anything else, I want to learn about your methods."

I wrote back with class information. I had two classes coming up. One was the next month. The second would be in early May and only a few blocks from where he lived. I told how we work to see change in pain right in class. I asked him to let me know the test results and that I hoped to see him in class.

20 March 2005 he wrote back:

"Thanks for asking, I never expected you to keep in touch. The myelogram and CT showed moderate central spinal stenosis at L4-L5. Severe facet joint arthropy & hypertrophy of ligamentum flaxa causing compression of the lateral recesses stenosis of L5 on both sides, kinking of L5 nerve root sleeves on both sides. I have a copy of the xray, showing the "hourglass" at L4-L5

"(name deleted) is the attending, 3-B Orthopaedics. He said the next step is surgery, by ( ), at ( ) Hosp. I asked if strengthening of my upper body would help support my spine. He said "try it" so I'll be at physical therapy next week to start.

"I have a commitment for the weekend of April 2-3 so can't attend that class, much as I'd like to. Since I live at (close to) your class at Temple CC is my best chance of attending. Cordially, Bernie Cleff"

I checked back in to make sure he was signed up for the May class and to ask what he was doing in Physical therapy. He wrote:

29March 2005
"The phys therapy that I'm getting concentrates on my core muscles. Thanks for getting in touch...very kind of you."

I wrote back saying that conventional core exercises were not the best thing. Usually they are forward bending actions that will further compress the discs, the nerves, and also do not retrain the abdominal muscles in the way they work when you go about daily life. Strengthening does not automatically support the spine. I wanted to make sure that he had my Ab Revolution book, which was then out in a training manual version. He said he had it with him for PT. I found out two years later that they had the book, but they were not using it, and were doing traditional forward bending abdominal exercises.

10 May 2005, the day after the Fix Your Own Back Pain workshop was held, Bernie wrote me,

"Hello, I did sign-up for your class at TUCC on Monday 5/9, but I was too tired to attend. On top of that, I am scheduled for spine surgery at ( ) on Wed 5/11/05, with ( ). After having 2 epidurals and physical therapy I decided to go for the surgery. My nerve that is pinched is in the shape of an hourglass (at L4- L5) and (the doctors told him) that no body position or exercise changes are going to help at this time. Both legs are numb and I am walking like a drunk. It is kind of you to keep in touch. I hope to meet you at your fall class."

Days later, Bernie had the surgery. He tells about it, and his next two years, in Part I of this story. The doctors all considered his surgery a "complete success." They said the surgery went completely according to plan, with no complications. His recovery was in line with expected results. The fact that his pain returned, was worse, and complicated by limited movement from his plates and screws and other surgical hardware not a factor to them. They felt the limited movement was beneficial and a goal of the surgery. The commonly held idea is to stop motion in the area to stop the pain.

In late October of 2007. I arrived to teach the Fix Your Own Back and Neck Pain Workshop. I had 16 people waiting for me. One was Mr. Bernie Cleff, a funny white-haired muscular man of 80, who was in much pain.

We had a fun, energetic class. One of the students was a young man from India. He sat unsmiling as I mentioned various yoga poses that can injure discs in the neck. I explained that I am not against all yoga, and studied years to become a teacher myself. He sat unsmiling. We did three specific techniques to stop the neck pain process and a beautiful smile radiated from the young man from India. He had three herniated discs in his neck from his yoga practice of the specific moves I had mentioned, together with sitting badly at a computer for his work. He already knew those yoga moves hurt his neck. He had just been worried the pain would never stop. When the pain stopped right there in class, he smiled.

Another of the students was a golf pro, who I consulted with afterward to test out my work on lower back pain and golf. More on this in Lower Back Pain and Golf.

Mr. Cleff did great in the first class. This class was done over two weeks. I gave the students things to try during the week before the second (last) class.

Oct 25 2007, he wrote me:

"Today (Thursday) is my class day at The Clay Studio, working over the wheel for 5 hours. I felt good with very little noticeable pain. Usually after walking the 5 blocks from my home to the studio both my legs would tingle badly and I would stop to rest halfway. Not today. When I told my classmates about you phoning me to ask how I was doing with your exercises & stretching, they could not get over your caring. None of us had ever had a Dr. call to check-up. You are one hellova person and I'm thankful that I've met you.

"I've had my spine problems with the pinched nerves for a long time - roughly 4-5 years - and I'm slowly getting better since you came into my life. There is no other way to say it. Thanks Jolie."

He was improved in one class, and he felt that he was "slowly" getting better. I like an empowered student who does not want to dawdle to get better. The day after the second of the two sessions, Bernie wrote:

28 Oct 2007

"Last night, I walked about 7 blocks to restaurant AQUA (great value, low cost & delicious) and back home another 7 blocks.

"Upper back extension causes no pain, lower back does. I can do plank on elbows, holding for 60 seconds now, no pain.

"If you want to make photos of a geriatric doing your things, it's OK with me. as you've seen, I'm not bashful or delicate. I will work at getting better, my daughter is getting married January 5 and I want to be able to dance with her and my wife."

Bernie went back to his doctors to ask about a small amount of remaining pain. They told him he should have more surgery and gave him prescriptions. He wrote to ask me:

"On Nov. 2 I have a follow up with the spine surgeon (same guy) and on Nov 14 a consult with a Neurologist ( ). Do you have any suggestions about a pain med FENTANYL, which was suggested by a doc at the V.A."

I wrote back that Fentanyl is a surgical grade narcotic. It is used "off-label" for back pain and there have been deaths. I asked him to tell me more about what hurt, and when, so we could stop it without any harmful medicine, and also what the neurologist said.

14 Nov 2007, he wrote:

"I had an office visit with the neurologist at ( ), he said my twisted nerve at L5 will never get better and I will always have pain."

They told him to have another spine surgery, and take Fentanyl, and he will always have pain? Then why did they put him though all that surgery?

He wrote:

"Hello, I still have some tingling in both knees...but much better than 2 weeks ago! There has always been pain in my left flank between spine & hip, never told you because the knees were my greatest problem… The lower back pain persists, but only left side. When I do the trap stretch leaning to left--puts much pressure on that pain. Leaning to the right feels like a good stretch. Any additional suggestions?"

I found that that he was still doing "their" exercises. Conventional exercises of bending forward to stretch the hamstrings are often prescribed for back pain. The assumption is that tight hamstrings have something to do with back pain. However, bending forward is one major contributor of this kind of back pain. I changed how he stretched his hamstrings to one of the ways we did in class.

He was also continuing to overarch his lower back when walking, which was a large source of the tingling pain. When he used the Trapezius stretch, he was also overarching, which makes pain when bending to that side. This kind of pain is often confused for spinal stenosis. One classic sign of stenosis is pain when bending toward one side. However, the narrowing is not true stenosis, but just overarching which narrows and pinches the area. For someone who has stenosis, not pinching the area further with overarching is frequently enough to stop pain.

What was complicating everything was his surgeries. They were considered "completely successful." The two knee replacements were "completely rehabbed" meaning he could bend his knees enough to sit in a chair. He could no longer stretch the front of his hip enough to prevent the kind of tightness that encourages standing and moving in overarched position. The back surgery put a plate in his back to prevent much movement. That meant that even small overarching movements were enough to pressure the newly immovable area. The back hurt, and the tight back and hip were compressing nerves going down both legs.

After we fixed these issues he wrote two mails:

"Jolie You hit on the spot. I will keep at it gently."

and

"Jolie, a quick note to tell you today I walked 12 blocks, stopping to stretch hamstrings.. often on steps or fireplug....as you suggested...also lunge stretch. I will dance at my daughter's wedding. Much thanks.

"There will not ever be more surgery on my body."

For the flank pain, he had been for many tests, and was even scheduled for a kidney evaluation. The muscles in the area were so tight, that I biked over to his home to do a sports medicine technique to stretch it out for him, and checked his other stretches. I went over how to stretch the front of the hip without overarching his lower back. His sweet funny wife made me lunch. We got some fun photos of things as gifts for you, of fun stretches and activities.

He wrote:

"I've had x-rays, MRI, bloodwork, surgery, injections, no Dr. had any solution.
YOU HAD THE ANSWER. No wonder so many people have thanked you."

He did the work and gave me the credit. That's a good man.



Next:

• Bernie dances at his daughter's wedding in Cauda Equina - Result Not Cause.

Related:

• Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part I
• Overhead Lifting, Reaching, and Throwing - More Part I
• Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch
  
• Prevent Back Surgery
  

See Mr. Cleff Demonstrate:

• Fast Fitness - Quick Relaxing Hip Stretch
• Fast Fitness - Relaxing Hip, Leg, and Groin Stretch
• and Dynamic Partner Balance Challenge.
  
  

Labels: drugs, facet joints, fix pain, hamstring, impingement, injury, knee, lordosis, lower back, neck, practice of medicine, readers inspiring story, side, stenosis, stretch, surgery, yoga

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