Upright Health » Philosophy

Running does not cause osteoarthritis

Matt Hsu, Certified Rolfer and Postural Therapist — Wed, 07 Dec 2011 08:07:26 +0000

The most common myth you hear out in the world about knee osteoarthritis is that running and jogging is what does you in. “It’s all the shock,” doctors say. “It’s just too much wear and tear,” friends say. Did you know that this conventional wisdom is actually wrong?

We recently posted a link on our Upright Health Facebook Page to an article in Proto Magazine, Osteoarthritis: Why Joints Fail, that discusses the modern research being done that shows that, contrary to popular belief, it’s not the running that’s doing you in.

Several studies have found that a lifetime of running—a perfect test for the “wear and tear” theory of osteoarthritis—doesn’t increase risk for the condition. In the most recent, published in 2008, researchers at Stanford University School of Medicine began tracking the health of 45 long-distance runners (average age: 58) in 1984. Nearly 20 years later, X-rays showed their joints were unaffected. “We can find no evidence whatsoever that there’s an increase in knee destruction in people who run for thousands and thousands of miles,” says study co-author James Fries, professor emeritus of immunology and rheumatology.

The rest of the article talks about various different avenues that are under investigation for the biochemical causes of osteoarthritis if you’d like to read it, but the big takeaway is this: running is not the villain. If you find running to be tough on your joints, don’t blame the activity itself.

As someone who used to be unable to walk down stairs without sharp pinching pain in my knee, let me tell you this: figure out what your body is trying to tell you and then address the problem carefully and logically!

How femoral acetabular impingement changed a life

Maryann, Postural Therapist — Fri, 18 Nov 2011 15:40:23 +0000

The arrow points to Maryann's left hip where damage was being done to the cartilage. The top line provides reference so you can see how far off her hips were misaligned.

In May of 2006, I had a breast augmentation procedure done. I was 25 at the time, and I had long been self-conscious about my breast size. The surgery went off without a hitch, and I was happy with this “better” version of myself. I have always been active and athletic, so I went right back into my exercise routine as soon as I could.

In July, only two months later, I sprained my foot jumping rope. A few months later, in November, I started to get pain in my knee, and at the base of my spine at the sacroiliac joint. At the time, I didn’t see the pattern to what was happening. I just thought I was getting old. I was getting lots of injuries that weren’t going away, so I just took it easy, hoping rest would make the pain go away. Eventually, in the winter of 2007, I went to try this thing called Posture Alignment Therapy to try to help get rid of the pain. The process was eye-opening. My attention was drawn to the imbalances in my body that hadn’t been there before (a hunched back, uneven shoulders, and a severe twist to the left through my whole body). I learned exercises that helped me stand up straighter and seemed to relieve some of my back and sacroiliac pain, but the relief never lasted very long. The pain started building up, and I had to take long breaks from surfing and running.

Then, in November of 2008 when I was on one of my usual runs, I was about six blocks from my house when my pelvis suddenly felt like it had slipped or dislocated. Thinking it was just a minor muscle pull, I stretched it out and pushed on with my run. After that run, my hip did not get better.

In January of 2009, I tried Egoscue again. Over the next several months, despite the postural exercises I was doing and the total break I was taking from all the running and surfing that I loved, my hip got worse.
By August of 2009, I was 27 years old, and I was in a wheel chair.

The next eight months of my life were filled with visits to every doctor and health practitioner imaginable. I consulted with over 30 healthcare professionals including medical doctors, surgeons around the country, chiropractors, physical therapists, acupuncturists, and spiritual healers. I had multiple X-rays, MRIs, CT scans and bone scans performed on my hip as well as other parts of my body. In a desperate attempt to treat the pain I underwent injections and tried many different combinations of pain killers and drugs. All to no avail.

In January of 2010, I finally got a diagnosis: Femoral Acetabular Impingement with a labral tear. The bones of my hip were rubbing against each other, tearing the cartilage. This was not what I wanted to hear. What I wanted to hear was why my hip joint was grinding itself away, but the doctors weren’t interested in answering that question. They recommended I try surgery, though there were no guarantees that it would work.

Desperate for an end to the pain, I went in for hip arthroscopy in Los Angeles with one of only a few specialists in the country who could perform the procedure.

The surgeon repaired the cartilage and reshaped the hip socket and femur so that they would not rub anymore. Within a month, however, I was back in a wheelchair.

This was the lowest point I had ever been in. The doctors were completely unable to help me, even with this surgery.

At this point I started thinking seriously again about what I’d seen happen to my body since the implants. My body had started to rotate. My upper back had gone into an extreme hunch. My left hip had elevated. In my gut, I knew that these things had all started after the breast augmentation. The doctors I consulted weren’t on board with my theory, but I pressed ahead with what my gut told me was wrong and had my breast implants removed in April of 2010.

I continued to do my postural exercises, and within 2 months, my hip pain was gone and I was back to enjoying my life.

I battled chronic pain, and rapidly deteriorating posture and physical health, and I came out on top. As a result, I have a unique insight and understanding of what it is like to deal with pain, physical limitations, and the devastating mental and emotional impact it can have on a person’s life. I have dedicated my professional career to helping people who want to be proactive about addressing the underlying cause of their pain or physical limitations. After recovering fully, and getting certified through Egoscue University as a Posture Alignment Specialist, today I am able to help people get out of pain using this unique form of exercise therapy.

How wrong are MRI’s?

Matt Hsu, Certified Rolfer and Postural Therapist — Mon, 14 Nov 2011 18:36:06 +0000

If an MRI told you had an ACL tear, you’d probably start looking for a good orthopedic surgeon. And who could blame you? But Steve Ganobcik, a recreational skiier who twisted his knee on the slopes, discovered first hand how MRI’s can be extremely misleading. After visits to two different orthopedists who both determined from MRI’s that he had a fully torn ACL, Steve visited a third orthopedist, Freddie Fu at the University of Pittsburgh, to see what he would recommend for treatment. What he learned knocked him off his feet.

From the New York Times:

…Dr. Fu told him his ligament was not torn after all. His pain was from a fracture in a long bone in the lower leg that the other doctors had also noticed was broken. An M.R.I. at the University of Pittsburgh confirmed it, showing a perfectly normal A.C.L. (Dr. Fu adds that Mr. Ganobcik’s original scans had an image that was ambiguous. He wanted a better one, to see if Mr. Ganobcik’s ligament had been partly torn and was healing or had never been torn at all. He would not need surgery with a partial tear, but he would need more careful recuperation.)

Two scans. Three doctors. Two doctors convinced he had an ACL tear and only one who figured out with physical examination that a full ACL tear was impossible. Careful rehab was all that was needed.

Another doctor, James Andrews in Gulf Breeze, Florida, has also noticed instances of the unreliability of MRI’s like this in his practice as well, and decided to test the reliability of MRI’s by taking 31 healthy, asymptomatic professional baseball pitchers. None of the pitchers had reported any shoulder pain whatsoever. None.

But the M.R.I.’s found abnormal shoulder cartilage in 90 percent of them and abnormal rotator cuff tendons in 87 percent. “If you want an excuse to operate on a pitcher’s throwing shoulder, just get an M.R.I.,” Dr. Andrews says.

Neither of doctors suggest that MRI’s are not medically useful for serious situations, it’s that they are overused and overtrusted. Just like studies that have shown that MRI’s are not reliable for finding the cause of back pain, Dr. Andrews’ study and Dr. Fu’s experience show that MRI’s are not reliable for figuring out what’s wrong when a shoulder hurts.

This should provide some solace for those out there who think an MRI can tell you why you experience pain. The results are in: they don’t.

Read the full New York Times article to read about another study on MRI’s and find out what makes doctors use MRI’s even when they know they don’t need them.

See Matt run.

Matt Hsu, Certified Rolfer and Postural Therapist — Mon, 12 Sep 2011 15:13:37 +0000

Okay, so not really “run,” but skate. This video is the answer to one of the questions I hear the most often, and it’s one of the questions I think most deserves an answer.

“How did you end up doing this, Matt?”

Watch this video and find out!

Special thanks to Angelo Arias, Scooter Vaughan, and Adam Hout for their camera work and shooting assistance on the ice!

A post-vacation thank you note

Matt Hsu, Certified Rolfer and Postural Therapist — Wed, 27 Jul 2011 20:11:06 +0000

Just got this wonderful little note from a client last week. She had been struggling with back and hip pain and sciatica-like issues before coming to Upright Health. After several months of postural exercises, she was confident that she’d be able to enjoy a vacation to England and France with her daughter. Here’s her quick report on how she did…

Hi Matt,

Just got back from England last night. Two trans-atlantic flights, miles and miles and miles of walking, sleeping in an unfamiliar bed, away from my tower (a therapy device she now owns): I did absolutely fantastic!!

I only had 2 minor episodes of achey back. The first one was our second day in Paris. Our tour to Versailles was canceled due to a strike, so we found ourselves alone in Paris for 12 hours on foot. My back was a little achey, so we stopped along the Seine and I did air bench (an exercise she learned while coming to Upright Health) against a building. The street was deserted due to it being Bastille Day. Feet slipped out from under me and I was on my butt! Tried an area where there was more traction, and my back was fine in under 2 minutes. Another day I had some minor discomfort but again, the air bench worked in just a couple of minutes. Thanks for teaching me how to take care of myself! I hope all is well with you!

~Syl

Stories like this make my day!

Muscle imbalances throw your mind off-kilter

Matt Hsu, Certified Rolfer and Postural Therapist — Wed, 06 Jul 2011 17:57:48 +0000

Your posture says a lot about muscular balance. It is a visual representation of how well your muscles coordinate with each other. That’s useful information if you’re a paleolithic guy or gal running around on the plains, but it’s also useful information for job seekers and business people negotiating deals in conference rooms.

Researchers at the Kellogg School of Management at Northwestern University in Illinois found that undergraduates who were posed in “expansive” positions — arms extended and one leg casually crossed over the knee — scored higher on variables measuring their sense of power, abstract thinking and willingness to take action than their peers posed in “constricted” positions, with hands under their thighs, dropped shoulders, and feet scrunched together.

via To Nab That Job, Check Your Posture – Health News – Health.com.

That’s right. Physical positions of constriction actually constrict you mentally and emotionally. Your ability to think creatively and take action decisively are hampered by your inability to position your body properly.

This is something you can easily test on yourself. In fact, you’ve probably already tested it on yourself.

If you walk into a room with your shoulders rounded, your head and neck jutting forward, and your tail tucked under, how do you feel? How “in control” do you feel of a situation when you’re in that posture? If you feel out of control and a little fearful, it’s not a coincidence. In fact, if you are able to adopt a more expansive, powerful posture (and many successful business and salespeople know this), you can change how you feel.

…power poses change functions in the endocrine system. Testosterone levels increased in both men and women, and levels of cortisol (the stress hormone) declined after subjects had been placed in “expansive” body postures…

You can actually position your body for less stress. How’s that for a cheap stress-reliever? How much of a benefit would that be for you when you’re trying to make a sale or land a promotion? How would it change your life to be able to relax at the end of a long day just by positioning your body properly?

Well, not only does your posture affect how you feel about yourself, it affects how others feel about you.

When you see someone walk into a room in a constricted posture, what is the impression you get of that person? How likely are you to willingly take instructions from someone who looks like they are too balled up to even breathe properly? How likely are you to hire someone who looks like they’re a frightened, wounded animal? Not too likely. And that’s the point this study makes:

…job seekers and frustrated middle managers trying to get ahead during the recession might want to size up their body language before asking for a new position.

Though muscle imbalance might keep your body from speaking the language you want it to, it’s important to remember that you can retrain your body to be able to reduce stress, expand your creative mind, and help you take decisive action.

Life can get better even after failed surgery

Matt Hsu, Certified Rolfer and Postural Therapist — Wed, 08 Jun 2011 20:35:43 +0000

If you know anyone who’s had the misfortune of going through back or hip surgery only to find that the surgery did very little to help their pain or even made the pain worse, they need to see this video. If you know someone who’s been diagnosed with spinal stenosis, they need to see this video.

After two unsuccessful surgical attempts to get rid of her back, hip, and leg pain, Sylvia turned to Upright Health. Her doctors had first blamed her vertebral discs and then shifted the blame to her hip joint. Once both had been surgically altered, they blamed her spine and told her that there was no hope of getting better since she must have a spinal stenosis.

By learning how to unwind the muscular imbalances that were twisting her body into pain, she got rid of her walking cane in three weeks’ time and got back to doing the things she loves.

The answer to one woman’s frozen shoulder

Matt Hsu, Certified Rolfer and Postural Therapist — Tue, 17 May 2011 23:27:41 +0000

You can’t tuck your shirt into the back of your pants anymore. It’s impossible to reach up into the cupboard for a coffee mug. Your shoulder hurts, and it hurts bad when you try turning, raising, or rotating your arm. You’re not alone.

How would you like to be a part of a much happier gang? How about the group of people who recover from frozen shoulder on a speedier time table than 1 to 3 years without surgery?

Meet Debbie:

I had fallen off my bike last September resulting in a fractured shoulder, sprains, strains and inflammation. I had several weeks of physical therapy but continued to have very limited range of motion. I went several more months with pain when pulling on clothing, drying my hair, opening doors, etc. I went back to my M.D. for a “second round of physical therapy” which started this March. I continued to get some additional range of motion, but was still limited. I remembered that Matt had helped me significantly with a knee injury about a summer or two back. It took about 3-4 months on my knee, but I had gone from significant pain when walking downhill back to hiking peaks with virtually no pain at all! So, I scheduled an appointment for a myofascial release massage.

When Debbie came in, I hadn’t seen her in a year. From her pictures from the year before, I had an idea of what was going on. When she showed up and told me that her shoulder had been diagnosed with “encapsulitis” (AKA frozen shoulder) and that massage therapists and physical therapists had been focusing on stretching out the shoulder and working out the “scar tissue,” I knew her shoulder wasn’t the problem. Whenever I hear the word “scar tissue” as a justification for a hands-on therapy, I get very suspicious (but that’s a post for another day). Her shoulder was a symptom of a problem somewhere else.

Matt could see just by looking at me that the problem was more to tightness in my lower back and not so much the shoulder. He worked on my back and within about 15 minutes, my shoulder had opened up allowing a very noticeable amount of improved range of motion! Who would’ve thought!

So what tipped me off? Debra’s torso was visibly rotated. Her whole upper body was twisting to the left (right shoulder and chest more forward than the left). The muscles of her mid and lower back on the left side were much more prominent than those on the right, indicating a big, big muscular imbalance.

Now, if you want to see what a difference a twist can make, try this out yourself. Twist your upper body to the left, and then GENTLY see what happens to your range of motion when you reach back to tuck your shirt into the back of your pants. Notice how your shoulder can’t seem to do it? Now untwist and relax. Raise your right arm up to the side as far up toward the ceiling as it can go. Now twist to the left and try it again. See what happens to your range of motion?

That’s what a big deal a rotation can be. It can FREEZE your shoulder!

He reviewed my exercise regime from the last time I was there and suggested some more exercises. I am 100% confident that if I use these exercises daily that I will retain full range of motion. I can already feel that the muscles in my back have released and my shoulder is nearly pain-free. These exercises work!! ~ Debbie Tarczy

With a few simple exercises and a little reordering of her routine, Debbie is now able to progressively build balance back into her back muscles so that her shoulder muscles can re-learn their full range of motion! There was no scar tissue stopping her, just faulty alignment elsewhere in the body.

Remember, each human body is ONE unit. All parts of the body have the ability to affect other parts of the body. The next time you hear “frozen shoulder,” remember to think beyond the shoulder (and at least as far as the back!).

Here’s the answer to an age-old question

Matt Hsu, Certified Rolfer and Postural Therapist — Fri, 06 May 2011 01:35:42 +0000

How did my posture get this way?!

When people come to Upright Health, they know (or strongly suspect) that their posture is a part of the pain equation. They want to try to fix the posture and nix the pain, and the question that they need answered is “how did my posture get this way?”

It’s an important question with a very important answer.

For many, the simple answer is just “genetics.” I have heard doctors, chiropractors, and physical therapists give this answer. “The way you stand and move is genetic. The end. Sorry. Tough luck. Pay at the front desk.”

Thankfully, this opinion is slowly dying out.

What’s becoming more and more obvious to those who study it is that posture is largely a result of training. Your body learns to look and move the way it does. Irregular static and dynamic posture is a reflection of muscle imbalances.

That means that if you fix the muscular imbalances, you fix the posture!

So where do the muscular imbalances come from? Here’s the list from the National Academy of Sports Medicine (NASM):

Habitual movement patterns
Altered movement patterns from repetitive movement
Altered movement patterns from injury
Altered movement patterns from surgery
Altered movement patterns from incompletely rehabilitated injuries

It’s all about how you move. Once your body starts moving in non-ideal ways, it leads to a cycle of issues. Having a habit of sitting for 8-12 hours a day can set you up for altered movement patterns that then lead you to an injury on the weekend. The next week the injury doesn’t hurt but you’re still slightly limping around as a compensation…which sets up your muscles for another injury in six months. Sound like fun? No. Sound familiar? You bet. It happens to people living in modern society day after day after day.

The trick is to intervene in that cycle! Once you reintroduce positive, healthy movement patterns, your body starts to rebuild the appropriate muscular balance so that you can look, move, and feel the way you’re supposed to.

I know many of my clients have noticed many parts of this 5 point list, so if any of you guys and gals want to share some examples, please feel free to do so in the comments section below!

What do the MRI’s on my wall mean?

Matt Hsu, Certified Rolfer and Postural Therapist — Thu, 28 Apr 2011 22:09:53 +0000

I keep three MRI slides on my wall. When people first walk in, they tend not to notice them, but they’re part of the very foundation of Upright Health. Without them, Upright Health might not even exist.

In my senior year of college, I did a study-abroad program in Germany. At that point, I had already been as sedentary as one can be without going completely insane for three years. My doctors, chiropractors, and acupuncturists had all told me to rest, rest, and rest some more so that my wrist, elbow, and shoulder pain would go away.

Nobody really explained what good “rest” looked like, so I figured sitting on my butt, not playing sports, not running, not lifting weights, and just sitting in front of my laptop was a good way to rest. Occasionally, I’d try to play hockey or go for a job but it never went all that well. My shoulder would never take it so well, and I always felt short of breath.

So there I was in Bayreuth, Germany — resting. I started getting cabin fever, sitting in my dorm room as the frigid spring thawed into moderately warmer summer. I decided to head out for a jog with a friend of mine, and I found that my left knee kept giving me this pinching sensation. I’d had knee discomfort in the past, and it tended to go away with exercise, so I figured once I got the blood flowing, the pinching would go away.

It didn’t.

Fifteen minutes of warmup jogging, and my knee was still pinching.

So I stopped.

I had also brought my roller hockey equipment with me to Germany (even with chronic pain, I never traveled without my hockey gear), hoping I’d find time and health enough to play. I found that even when I skated gently on flat land, the knee pinched.

So I stopped.

And I discovered on a brief trip with friends to do some sightseeing in Hungary that my left knee pinched quite a bit. I could not walk on flat land for more than ten minutes without pinching in my knee. Stairs made my knee so uncomfortable that I had to use my traveling companions as crutches to get down stairs.

I couldn’t very well stop walking altogether.

When I got back from that short trip to Hungary, I went straight to a doctor. He ordered MRI’s. After a nap in an MRI machine, I went home.

When I returned to the doctor’s office to discuss the findings, he examined my knee, looked at the MRI’s and gave me his firm diagnosis.

Keep in mind I’d been resting for 3 years already.

Keep in mind that it only took a few minutes of walking to set off the knee.

Keep in mind, again, that my chief activity for 3 years had been sitting on my butt.

Now, here is what the doctor told me:

“Your knee looks okay. You’re just using it too much. It’s repetitive strain. You just need to rest it.“

And that’s when I realized that the answers I was being given made no sense at all. The MRI’s on my wall are the symbol of the last straw for me. They are proof that a high tech scan can tell you absolutely nothing about a knee with pain. They are a reminder that the current medical approach to chronic pain and injury make very little sense, and that even the best of technologies can’t help you solve a problem if you aren’t looking at it from the right angle.

In the end, my body did need more rest AND more movement. It needed constructive rest and constructive movement. My body needed to be retrained to work the right way. More rest at the computer was making my whole body worse. More rest and exercise that restored my posture has put me back on the ice three to five days a week with no problems for my left knee.