Nothing can stop the man with the right mental attitude from achieving his goal; nothing on earth can help the man with the wrong mental attitude.

In dealing with pain or suffering (whether it’s from your body’s parts being misaligned, your boss being an inhuman crankcase, or your brand new car falling to pieces), it’s important to remember that your attitude matters.

Now, anybody who really knows me knows that I have long had a bit of a pessimistic, skeptical streak in me, so don’t think I’m a gung-ho super optimistic nut-job.  FAR from it.  But let me share two quick scenarios with you before I tell you that optimism is a necessary part of dealing with chronic pain.

I once encountered a guy in a chronic pain workshop I was co-leading who had knee pain. It had been diagnosed as knee osteoarthritis. The doctors he’d talked with, the books he’d read, and the stories he’d heard all said knee osteoarthritis was hopeless. He asked me what I recommended for it. I told him that getting his hip joints to start moving in a functional way would take some stress off the knees which, it wouldn’t be far fetched to say, would help his knees feel a little less pain.

On a basic level, I was only asking that he believe that having his legs swing forward and backward while walking rather than landing with the knee pointing out to the sides would be beneficial. Walking with your knees pointing out to the side causes an obviously imbalanced impact on the knee joint and a shear at the medial aspect of the knee.  Dysfunctional hips could make his knees bend awkwardly in sitting so that even sitting could be painful…

But on a more important level, I was asking him to believe that a difference could be made to his diagnosed condition.

He responded with incredulity. “There’s nothing you can do about osteoarthritis. That’s what every expert in the world says. I’ve had consults with some of the best doctors.” And there was nothing I could say in that context to change his mind (though I did try and it did make for some awkward tension).

He didn’t believe he could get better, didn’t believe anything could be done, and probably figured I was full of some especially malodorous cow excrement.

I don’t know how he’s doing, but I’m guessing his situation’s not improved all that much.

I’ve also had many people come to my office and say, “I want to get better.  I know this is coming from my compensations around [injury or situation x], but the doctors and physical therapists say there’s nothing wrong with my body even though I can feel the pain.  I know something can be done, I’m just not sure what it is.”

These are the people who get better.  These are the people who figure out what the roots of the problem are and get on the path to solving it.  These are often the people who get better quicker.

So what I’m finding, and you can agree or disagree in the comment section below, is that Thomas Jefferson was right. Facing challenges, whether it be pain or something else is all about attitude.  Whether you believe your problems will end you or make you stronger, you’re going to be right. All you have to do is choose how you want to be right!

Over two years, the injured knees were assessed using a comprehensive numerical score that rated pain, function during activity and other measures. At the time of the original injury, the knee also had been scored.

At the end of the two years, both groups showed considerable improvement. The scores for the surgically repaired knees had risen by 39.2 points. The scores for the more conservatively treated knees also had risen, by 39.4 points.

In other words, the outcomes were virtually identical. Despite a widespread belief that surgery leads to a stronger knee, the results showed that surgically reconstructing the A.C.L. as soon as possible after the tear “was not superior” to more conservative treatment, the study’s authors wrote.

To read the rest of the article, click here to head over to the New York Times.

When pain is a result of poor posture, sleeping can often exacerbate the pain. Beds often tweak the body in ways that aggravate bad postural habits.

One that I often hear is back-sleepers using multiple pillows stacked up so high that their chins are tucked into their chests. These people generally have lots of neck and shoulder tension throughout the course of the day and have heads and necks that are thrust forward (mimicking their sleeping position!).

That issue has a quick fix, but there are other less well known issues that can hamper a good night’s sleep. Though I don’t have the time (or talent) to draw up a bunch of diagrams, Esther Gokhale has a book chock full of great tips that can help you adjust your sleeping position for maximum rest and recovery. It’s $16 from amazon.  It’s well worth it if you or someone you know needs to try to make their sleep feel a little more restful.

For people with chronic myofascial pain, simple adjustments like those in Gokhale’s book can be extremely helpful.

8 Steps to a Pain Free Back by Esther Gokhale

The knee was designed to be a “smart” knee — meaning it would have software built in that would make it function like a real knee. It would be able to sense and react to movements so that it would move the way a regular (organically grown) knee does.

But there was a major problem when trying to program the software for the knees.

They had to try to get the knee to learn how the individual wearer walked so it could accurately predict when the person was going to, say, go up some stairs or step off a curb so that it could react accordingly.  But here was the problem.

The person wearing the knee never moved exactly the same way.

Once the knee had “learned” how the person moved, the person was already moving a different way. The position they slept in at night would change the way they walked.  Sitting for a while changed the way they walked. There was nothing that DIDN’T affect the way the person walked.

So the end result was that the smart knee’s software would get consistently confused and gradually lock up into the flexed position until it could be reset.

Not ideal.

The moral of the story is that it makes more sense to do as much as you can to keep the biological knee you’ve got before having it replaced with a smart knee or a dumb knee because no matter how good technology is, it’s extraordinarily hard to replicate the intricate system of coordination going in on your organically grown body!

Get your body working right. Keep your joints feeling right. Keep your OEM parts!

The veins in my right arm in this picture show you what good circulation looks like for me.

I was a student at UCLA.  I worked in an on-campus computer lab.  One winter, I injured my right shoulder in mid-air while snowboarding.  I struggled to figure out how to help my shoulder heal, but nothing was helping.  Physical therapy wasn’t helping. Sitting on my butt, chatting online, and updating my friendster profile while eating ibuprofen wasn’t helping.

And then the pain in my wrists set in.  At first it wasn’t bad, but it got progressively worse.  My elbows started to get tender.  I could feel tendons snapping and popping every time I straightened my arm coupled with a squelching sensation.  My forearms felt sore — glowing with inflammation.  My fingers began to curl up.  My palms discolored to a sickly purple.  The veins that had once bulged on my forearms — a sign of fantastic circulation — disappeared and were replaced with a cold numbness from just above my elbow all the way down to my finger tips.

So began the struggle.  I started taking supplements.  Vitamins B6 and B12 helped for while.  I don’t know how they helped, but they took the pain down as if by magic.  And then, as suddenly as I’d found that they helped, they stopped helping.

So I tried acupuncture. I tried electro-acupuncture. I tried chiropractic. I tried Chinese medical massage, I tried herbal remedies.  I tried acupressure.  I tried shiatsu.  I tried eating a Chinese beef tendon dish (that my mother can cook quite well, thank you). I tried eating more meat.  I tried eating less meat.

I sought help from my doctor who told me my problem was overuse and repetitive motion.

So I cut back on the computer.  I cut back on any attempts to do exercise. I upped the ibuprofen dosage.

And nothing got better unless I kept myself off the computer as much as possible.  Five minutes was all it took to set my hands off into their cold, numb state.  My doctor assured me that it wasn’t carpal tunnel syndrome (the wrong fingers were going numb, after all!), so that all I had to do was wear a brace and rest until the inflammation magically disappeared.

As long as I didn’t need to do anything, this strategy worked quite well.  No computer, no pain. No exercise, no problem.  Until my knee started pinching, my feet started aching and going numb, my hips started popping, my neck started hurting, and my back got stiff…

Which is all to say that resting wasn’t the solution.  Fixing the posture was.  As far as the wrists and forearms were concerned, the problems started clearing up as my shoulders found the right position to be in and learned to maintain that position (with the help of my hips, legs, and back).  As many of my clients will tell you (and my friends and family as well), I now spend a good deal of time typing away on this machine called a computer.

And you know what? As long as I do the work away from the computer to maintain good posture, my forearm veins stay full of blood, and I survive and thrive in the 21st century!

After two weeks of doing his exercises, Mr. Twister's pictures showed a noticeable reduction in the twist in his torso that was making his left shoulder hang behind while walking and running. You can see the twist by looking at the severity of the shoulder slant and how long his left arm looks relative to the right.

“I’ve been working as a dentist for nine years. As a dentist, I’ve been suffering from poor posture and twisting of my body as a result of long hours of work. Not only was I discouraged about how my posture was getting worse, but I also noticed pain in my upper back and the heels of my feet. I am an avid runner and had been dealing with plantar fascitis for a few years. I tried going to chiropractors and kinesiologists with no results except a lighter wallet. I was referred to Matt and skeptically gave him a try.   He offered me a few stretching exercises to do every day.

After doing the stretches, I can now run longer and faster. I discovered that the foot pain was due to the twisting in my body and that it was (for years) misdiagnosed as plantar fasciitis. I am still doing the exercises and have noticed the forward head posture also decreasing. I’ve finally found someone who can help with the aches and pains that come from my posture problems!”

Think about this example. Your friend is lying in bed, sweating and coughing and complaining of congestion. His temperature is 103 degrees. He feels dizzy and weak and occasionally cold.

You would say he has a fever, right?

Now, would you say the fever is causing the headache? Would you say the fever is causing the intermittent feelings of cold? Would you say his hot forehead is caused by the fever?

It’s easy to let your tongue slip and say, “yeah, he has a headache from his fever” or “his forehead is hot because of his fever.”

But you’d be WRONG for the same reason diagnoses like “chronic fatigue syndrome” and “fibromyalgia” are wrong.

The reality is that a “fever” is just the name given to a set of conditions (namely, having a high temperature, feeling dizzy, getting chills, having a hot forehead, etc.). But that collection of symptoms isn’t caused BY the name. The name is just an easy way to refer to them as a group.  The fever is a phenomenon that’s caused by something else — an infection, generally.  It’s a symptom of something wrong.

Now I said that “chronic fatigue syndrome” and “fibromyalgia” are wrong.  Here’s what I mean.

The pain is a symptom of something wrong.  It isn’t the thing that is wrong.

But pain that is chronic, persistent, irritating, and consistent is starting to get names.  And those names make the pain sound like a disease.  And these pseudo-diseases are being treated as diseases to be managed with stronger pills and surgeries.

Chronic fatigue. Fibromyalgia. Regional pain syndrome.  Tennis elbow. Carpal tunnel.  Thoracic outlet.  These are all fantastic names.  Fabulous names, really, because they all sound so menacing.

What these names all have in common is that they are being used as disease diagnoses when they shouldn’t be.  None of these names even hints at the cause of the set of symptoms they describe.  Just look at the way they’re treated and discussed.

The same way fever doesn’t tell you the cause of the associated symptoms, the medical diagnoses for chronic fatigue syndrome doesn’t tell you the cause of your problem. Chronic fatigue doesn’t CAUSE you to be tired and in pain all the time.  Chronic fatigue is an easy name to refer to a situation where you’re in pain and tired all the time.  Now, lots of studies are done on the underlying physiology of the blood and the chemical levels and all that great fantastic stuff, but it’s all still just looking at a set of symptoms and hoping that addressing one of those symptoms will halt the progression of the other symptoms.  Since you don’t know the cause, all you can do is fuddle about with different treatments (mostly pills that disrupt the physiological changes that are happening).

Fibromyalgia doesn’t cause body-wide pain and tightness.  Fibromyalgia IS when your whole body hurts and you have lots of tightness. That doesn’t even begin to explain WHY everything hurts and is tight.  That’s a crucial, crucial distinction!  Without addressing the cause, all you can do is pop stronger pain pills to try to “manage” the disease…except the disease isn’t even a disease!  It’s a collection of symptoms.

Finally, take carpal tunnel.  Carpal tunnel doesn’t cause wrist pain.  Carpal tunnel IS wrist pain with impingement happening at the wrist.  But that still doesn’t tell you the cause of that impingement.  It just tells you that it’s happening, and that it’s also accompanied by pain.

That’s important for those who are now finding that carpal tunnel release surgery is only a temporary fix.

What’s important to note is that as chronic pain starts getting more and more names, people are getting more pills and more crazy surgeries. And yet the results are hit and miss or downright abysmal in terms of recovering quality of life.

Because of a simple misuse of words, these medical treatments aren’t treating diseases — they’re treating symptoms.  And the result is people with pain that never goes away and whose quality of life diminishes day by day.

It’s the diction of doom.  It’s like treating the fever without treating the infection.

Here are his pictures.  The picture on the left is the first day.  The picture on the right is after one week of doing “some” of his exercises on a daily basis (meaning he didn’t do all of them as he was supposed to).

Can you tell why his pain is getting better?  Just look at the curvature of his spine in the first picture versus the second picture, and it should be a little more obvious.  Look at how the curve of his spine affects the pooching out of his belly.  His body wasn’t working efficiently.  He was getting a lot of extra strain on his back because of its non-ideal position.

Now it’s moving closer to a more efficient posture that means, quite simply, less pain.

We learn wisdom from failure much more than success.  We often discover what we will do by finding out what we will not do.  ~Samuel Smiles

As we age, our bodies cease being able to do certain motions — not because age automatically means we can’t do certain things, but because we aren’t challenging our bodies to do the things we used to do.  Kids, for example, run, jump, skip, hop, climb, crawl, tumble, and roll all the time, and their bodies have no problem dealing with it. 

Over time, as they become acculturated to modern life, told to sit still, forced to slouch in a desk for hours on end, they lose the freedom of movement and the range of motion and resiliency that they had.  Those who remain athletic, keep their resiliency. Those who don’t, lose it.

For adults, the easiest way to test your musculoskeletal health is to see what your body can do!  If you find you can’t even stand up from your chair without pain and stiffness in your hips, you have learned a valuable lesson.  If you find you can no longer reach something in the top cupboard, you have learned a valuable lesson.  If you find you can’t lie in bed for 2 hours without severe pain somewhere in your body, you also have learned a valuable lesson.

For some the lesson is more subtle.  Maybe you can’t twist your upper body in one direction, or one arm just can’t reach over your head like the other.  Or one hip pops and pulls every time you try to do judo throw.  No matter what the “failure” is, the lesson is the same.

The lesson is that your body needs more movement, more testing, and more failure so that you can gradually coach and coax your body back to a healthier, more resilient, more mobile state.  It takes a lot of failure, a lot of time, and a lot of testing of your limits to find how to best work with your body, but ultimately it’s the only way to restore the youthful ease you once felt in your body.

The week leading up to the back pain, I had been sick. Too tired to move.  Too tired to leave the house.  Too sick to do anything but send a few emails, type some things up, and then take a nap.  I contorted myself on the bed, on the floor, and on the couch with my laptop and my iPod touch throughout the week, too tired to do any posture-restoring exercises to counteract all the slouching and twisting I was doing.

So when I woke up that Thursday with back pain, it wasn’t any wonder why.  A week’s worth of lounging, lazing, and generally being miserable had visibly distorted the balance of my muscles.  My posture had changed for the worse.  My shoulders were hunched.  My spine was curved.  My hips were twisted.  Apparently 7 days of lying in bed ISN’T good for your posture.

So I did what any posture alignment therapist would do in my position.  I panicked!

And then I did a few exercises to fix the posture (with what little energy I had).  In under 5 minutes, the back pain was gone, and I was ready to go about the business of getting back to full strength again.

Are you ready with a quick, simple plan of action for the next time you wake up with back pain (that does NOT involve pills!)?