October 15, 2023 • 20 mins
Isn't it likely that osteoarthritis is due to unaddressed muscle imbalances?
It seems to be the case clinically. This is a case from this past week of an 87 year old woman with constant knee pain that has her now in a wheelchair.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:01):
Welcome to the Acupuncture Outsider podcast.
My name is Richard Hazel and in the time it takes for you to commute to or from work,
I hope to have shared something of interest about orthopedic acupuncture using motor points,
trigger points,
(00:23):
myofascial slings,
uh neuro functional acupuncture segmental treatments.
Anything that crosses my mind that seems to be of interest.
I hope you'll enjoy it.
Hello and welcome to another episode of The Acupuncture Outsider.
(00:46):
This is Richard Hazel.
I hope I don't sound too um groggy,
but I had a tooth extracted yesterday.
I spent the whole day on a liquid diet and just feeling a little bit fatigued,
maybe not as energetic as I would like to feel.
(01:09):
But um I wanted to talk about a patient that I saw on Friday.
Um her daughter brought her in with extreme pain.
Um She is about 88 or 89 years old.
(01:29):
Her daughter had her in a wheelchair because her knee pain is so bad that she can't even bear weight on her knee.
Um And when I talked to her about her knee,
she,
she said it's always a six or seven on the va pain scale.
So,
(01:50):
um,
even,
even when not moving,
even just sitting,
she is at a six or seven.
So,
pretty tough.
Um,
she has osteoarthritis in both knees.
They said both knees are quote unquote bone on bone.
She has been through physical therapy,
(02:11):
cortisone injections,
nerve ablation.
Um,
just about everything that doctors could think of to help and it has not helped and in fact,
has progressed and become worse and because of trying to walk with a,
either a crutch or a cane,
(02:33):
I think a crutch,
um her right shoulder was giving her a lot of pain.
So both keep her awake at night,
which is the biggest concern.
She can't sleep or she can't sleep well.
And so her,
so her,
it's her right knee that hurts her right hip has previously been replaced,
(02:55):
but she has no pain in her hip and her right um rotator cuff is a full thickness tear of the supraspinatus.
Um So she's,
and she,
so she's had shoulder problems for quite a while,
but lately her shoulder pain is worse and she can't sleep.
(03:18):
Um So I was talking to her and her daughter about her right knee and I said,
I saw the check mark on my intake form that you said joint replacement and it's not a knee replacement.
I'm gonna tell you,
I think it's the hip re that was replaced on the side of pain.
(03:42):
She said,
yes,
absolutely.
And her,
then the woman that I was treating said,
but my hip doesn't hurt at all.
My hip is fine.
I said,
ok.
Um I'm glad it doesn't hurt,
but my guess is it's so tight that it's not stabilizing you and if it's not stabilizing then that's going to put strain on your knee.
(04:04):
Um,
specifically,
I was thinking of hip abduction and the it band and if that becomes weak,
the knee wants to fail inward in a valgus strain.
And a lot of her pain was medial knee pain though.
She did have lateral knee pain right in the eye of the knee where the tendon of the it band crosses the knee.
(04:27):
So,
um,
so I said,
ok,
in the future,
we're definitely gonna treat some of the underlying weak muscles.
But right now,
I wanna get you as much pain relief as I can just know,
I know there's more we need to do so that the pain doesn't come back.
Um,
we,
I wanna work on your low back and your neck as well.
(04:54):
Um,
but right now,
let's focus on your pain and get you,
uh,
pain relief.
And also considering she's almost 90 I really didn't wanna do too much.
And I told her you're in a lot of pain,
you're in excruciating pain,
nonstop.
Your body is in a sympathetic dominant state,
(05:16):
fight or flight.
There's a lot of adrenaline running through your system.
When I give you some pain relief,
you're gonna feel wiped out tired because your body is going to go more into a parasympathetic dominant state or at least come to a balance.
(05:38):
And without that adrenaline,
you're gonna realize how tired you are.
Especially without sleep.
So I want you to know that after today's visit,
if you just need to go to bed,
that's ok.
It's normal,
especially as you,
as we get older,
our recovery time is longer.
So I just want you to know I'm doing as much as I need to do to get you out of pain without doing too much because it's going to be fatiguing for you when your body balances out.
(06:11):
So,
and I told that to her daughter to just remind her,
um it's ok if you're tired and we and I intentionally set her follow up for two weeks out.
Not,
not the next week because I know her healing time will be longer and she may actually not feel much improvement in the first couple of days after treatment.
(06:32):
I'd like to see how long it takes for her to feel better,
um,
less sore.
So that I'm not treating her maybe seven days after the first treatment and she's still sore from the first treatment.
Um And that,
and that was my concern once I realized how ischemic,
(06:52):
her hip abductors were.
Um So I'll tell you what I did.
I,
I treated her quads and gricius if you know my episode about the my controversial knee pain treatment where I'm just like,
OK,
just do these points and then,
uh and then they'll feel better or very often feel better.
So I did the quads,
(07:13):
I did the rectus fem,
the vastus lateralis,
vastus medialis and the gricius to start.
She also was showing knee pain that seemed more like the upper tibialis anterior area and the upper area in that like spleen nine area,
(07:35):
basically tibialis posterior seemed to be the big,
the big uh sources of pain in that area.
So I treated her tib posterior and her tib anterior.
Um So then,
um,
so then she was on her side and I treated her.
(07:58):
Oh OK.
I said I was gonna treat two points and then I,
I decided when she was on her side that I needed to treat four.
So I said sorry,
I lied about that,
but it's only four points.
Um Because when she was lying on her side,
her gluteus minimus area was rock hard.
(08:18):
Her TFL area was rock hard.
She had,
uh she winced when I pushed on her gluteus medius and pure formi.
So I said,
ok,
we've got more here than I thought we're going to do all four of these points.
And she had nice movement of the needles after a couple minutes.
(08:42):
So I was really happy to see that.
Um That's a really nice,
healthy response,
especially for someone in their eighties.
And a after I left,
I left the stem going while we talked for about up to five minutes,
maybe it was three or four minutes.
And then I saw that her TFL just was not moving much.
(09:03):
Took all the needles out,
put one needle into the TFL,
used my pointer to stimulate it and then was able to actually wake up her TFL in a really good way.
It really loosened up and softened in such a good way.
And to the point where I was actually seeing the it band,
um pulsing while working on her TFL.
(09:26):
And I pointed that out to her daughter.
So she could see how this really affects the knee.
Um So that's what we did for the knee,
for her right shoulder.
All of her pains seem to be anterior in the deltoid and the coral brachialis and then her media like middle deltoid,
(09:52):
uh was definitely causing pain into her arm.
So that's what I treated the middle deltoid,
the anterior deltoid,
the cortico brachialis.
And she seemed then to also have little tight band in her anterior deltoid that was still giving her pain.
So I took a chance and I got a little twitch out of it.
(10:16):
Um I,
I was,
you know,
in my head debating,
ok,
she's like almost 90 should I do a trigger point on her first visit?
And then I'm thinking,
but she's not sleeping because of this pain.
So let's just take the risk and hope that it helps and it,
it did it,
she could definitely feel less pain.
(10:37):
She felt some soreness but she felt less pain.
So,
you know,
um,
and I warned her and her daughter that she may have some,
she may have some discomfort for a day or two.
And if she is able to take uh an ibuprofen,
she should do so.
Um,
and she do,
apparently she does take ibuprofen.
(11:00):
So I said,
ok,
so you're having a lot of soreness from treatment because we're waking up a lot of these muscles,
then just take an Ibuprofen,
use heat heat pad.
Um,
you know,
any sort of massage you can do,
but really,
you know,
just know that you'll feel better.
It's just,
you're gonna,
it's gonna take you a day or two to recover.
(11:22):
Um,
and is,
and while she was lying on the table with the bolster under her knee before I started the treatment,
I asked her if,
if she still was having knee pain and she was,
um,
once I was treating the needles were in,
I asked her and she had zero pain in her knee and when she was able to sit up with her daughter's help and I stepped out so she could change clothes and get on,
(11:52):
get into her wheelchair.
Um,
she said she felt better.
She said,
you know,
thank you.
That really did help.
So we'll see,
we'll see,
I'm,
I'm guessing,
and I asked her for a vast scale and I think she said a two or a three and that's really the best I could hope for knowing that there was definitely some inflammation and some tendon,
(12:14):
uh,
tendinopathy,
maybe tendonitis.
Um I'm not hoping for zero pain on someone in their eighties who's been in pain for quite a while.
Um,
and we'll be working with some of the,
the,
the sensitized lumbar segments,
I'm sure.
(12:35):
But the goal for that visit was get her so she can sleep at night and then she can heal and then we can move forward and do more.
Um,
but,
uh,
but it made me really sort of reflect.
I was talking to her about it.
I said,
listen,
you know,
um,
it's really,
(12:56):
really common that,
uh,
ageism affects the,
uh,
doctor's interest in pursuing anything beyond just normal standard of care.
They're not going to say,
ok,
what if it's something else?
What if it's muscular?
(13:16):
Um,
they're,
you know,
they're pretty much gonna stick with their standard of care.
Um,
and I think,
I think ageism definitely affects a lot of my seniors um,
care because very often if they had the same presentation at 40 years old that they have at 80 I really think that the doctors would think more about what else could be going on here.
(13:44):
Um I will say that they did send her to physical therapy.
So that's a good thing.
Um Why was the physical therapy not s uh successful?
Probably because her muscles had become so tight and ischemic that they couldn't be exercised into strength.
(14:04):
They were,
they were way too tight.
I think it probably was causing her more pain to,
to do the physical therapy than it was helpful.
So,
but,
you know,
once you get the muscles back to being healthy,
then physical therapy is very important because you do want the person to have some,
(14:26):
some core stability to avoid uh having uh the future pain.
So,
but I just,
I,
I see it all the time that,
that people are told,
you know,
something to the effect of,
well,
at your age,
this is to be expected.
Like you're,
she's having pain in a 67 on a constant basis and they kind of throw up their hands and say,
(14:52):
well,
we've tried everything,
you know,
um medication,
injections,
nerve ablation.
Um And so,
you know,
there,
uh apparently there,
the daughter said she's going for a surgical consult for that knee that she's scheduled for that surgical consult.
(15:16):
Um because they're kind of at the point where they think,
well,
maybe we just need to replace the knee um because she's bone on bone.
And I said,
ok,
you know,
I'm not opposed to getting a consultation.
Um It's,
you know,
you guys need,
need to know what's going on.
There should be some imaging now and see what's going on.
(15:37):
But um the interesting thing is that both knees are bone on bone and only one of them hurts and the one that hurts is on the same side as the hip replacement.
So there is,
there is an argument to be made that we should try a few sessions of acupuncture before you decide to do surgery.
(15:59):
In my experience.
If the surgery is being done because of unaddressed muscle imbalances,
then you're just gonna be right back here after the surgery because the muscle imbalances will not have been corrected by the surgery.
And you're gonna go into the same problem that you had before.
(16:20):
Um,
because those muscles are still not stabilizing.
So,
um,
it's definitely worth us,
uh,
trying to correct muscle imbalances to see how much that relieves the pain before a knee replacement on someone in her late eighties.
Um,
so that was,
(16:41):
um,
that was what I was doing on Friday and it,
um,
you know,
it just made me think about our whole health care system,
especially in the US.
Um,
we're so fixated on medication that we don't see the issues that are being caused by a mus musculoskeletal imbalances,
(17:06):
postural issues,
ergonomic issues,
post injury,
muscle shortening.
We just see everything as something that has inflammation or a neuropathy that needs uh,
a medication to block the pain as opposed to asking why is that nerve causing problems?
(17:31):
Why is there tingling in that Lim limb?
Why,
you know,
why is there nerve pain?
Hm.
Um,
unfortunately,
our medical system just sort of throws it up its hands and says,
well,
we looked at the spine and that seems fine.
So,
I don't know what your problem is.
(17:52):
Um,
or,
or,
you know,
someone's in a lot of pain after they've had a major,
uh,
surgery.
So they've had their hip replaced and they're still in pain and then,
then,
you know,
eventually doctors do another MRI and they say no,
this,
this is beautiful.
My work is beautiful.
I don't know what your problem is.
(18:13):
And then if you happen to be over 65 then the next part is well at your age or we would recommend that you lose some weight.
Um,
they weight gets blamed a lot for hip,
knee,
ankle foot issues and while it absolutely can make things worse,
(18:36):
um,
very often it's just muscular issues causing the problem and not the person's weight.
Um,
because there's plenty of pretty heavy people walking around without knee pain,
ankle pain,
joint pain.
So,
um,
it can be done and when the muscles are healthy,
(18:58):
then,
um,
it is fine.
So it's just unfortunate because I just think there's this missing,
um,
area in our medical,
you know,
expertise that,
um,
we,
we absolutely need,
especially for our seniors.
We can't keep putting everyone on medications for everything.
(19:22):
So many my intake asks like,
what medications are you on?
And then,
and,
and it's like a list,
it's like this huge list of medications.
I'm like,
oh my God,
you know,
um,
some people do need medication but I think a lot of times when people are in pain,
they're on a lot of medications that are related to their pain.
(19:46):
And wouldn't it be great if we started treating the muscles so that they didn't have to be on all those medications?
Um,
all right.
Anyway,
so that's,
uh,
that's my,
um,
that's my take on it,
my two cents.
Um,
I hope you have a great week and I will talk to you soon.
Welcome to the Acupuncture Outsider podcast.
My name is Richard Hazel and in the time it takes for you to commute to or from work,
I hope to have shared something of interest about orthopedic acupuncture using motor points,
trigger points,
(00:23):
myofascial slings,
uh neuro functional acupuncture segmental treatments.
Anything that crosses my mind that seems to be of interest.
I hope you'll enjoy it.
Hello and welcome to another episode of The Acupuncture Outsider.
(00:46):
This is Richard Hazel.
I hope I don't sound too um groggy,
but I had a tooth extracted yesterday.
I spent the whole day on a liquid diet and just feeling a little bit fatigued,
maybe not as energetic as I would like to feel.
(01:09):
But um I wanted to talk about a patient that I saw on Friday.
Um her daughter brought her in with extreme pain.
Um She is about 88 or 89 years old.
(01:29):
Her daughter had her in a wheelchair because her knee pain is so bad that she can't even bear weight on her knee.
Um And when I talked to her about her knee,
she,
she said it's always a six or seven on the va pain scale.
So,
(01:50):
um,
even,
even when not moving,
even just sitting,
she is at a six or seven.
So,
pretty tough.
Um,
she has osteoarthritis in both knees.
They said both knees are quote unquote bone on bone.
She has been through physical therapy,
(02:11):
cortisone injections,
nerve ablation.
Um,
just about everything that doctors could think of to help and it has not helped and in fact,
has progressed and become worse and because of trying to walk with a,
either a crutch or a cane,
(02:33):
I think a crutch,
um her right shoulder was giving her a lot of pain.
So both keep her awake at night,
which is the biggest concern.
She can't sleep or she can't sleep well.
And so her,
so her,
it's her right knee that hurts her right hip has previously been replaced,
(02:55):
but she has no pain in her hip and her right um rotator cuff is a full thickness tear of the supraspinatus.
Um So she's,
and she,
so she's had shoulder problems for quite a while,
but lately her shoulder pain is worse and she can't sleep.
(03:18):
Um So I was talking to her and her daughter about her right knee and I said,
I saw the check mark on my intake form that you said joint replacement and it's not a knee replacement.
I'm gonna tell you,
I think it's the hip re that was replaced on the side of pain.
(03:42):
She said,
yes,
absolutely.
And her,
then the woman that I was treating said,
but my hip doesn't hurt at all.
My hip is fine.
I said,
ok.
Um I'm glad it doesn't hurt,
but my guess is it's so tight that it's not stabilizing you and if it's not stabilizing then that's going to put strain on your knee.
(04:04):
Um,
specifically,
I was thinking of hip abduction and the it band and if that becomes weak,
the knee wants to fail inward in a valgus strain.
And a lot of her pain was medial knee pain though.
She did have lateral knee pain right in the eye of the knee where the tendon of the it band crosses the knee.
(04:27):
So,
um,
so I said,
ok,
in the future,
we're definitely gonna treat some of the underlying weak muscles.
But right now,
I wanna get you as much pain relief as I can just know,
I know there's more we need to do so that the pain doesn't come back.
Um,
we,
I wanna work on your low back and your neck as well.
(04:54):
Um,
but right now,
let's focus on your pain and get you,
uh,
pain relief.
And also considering she's almost 90 I really didn't wanna do too much.
And I told her you're in a lot of pain,
you're in excruciating pain,
nonstop.
Your body is in a sympathetic dominant state,
(05:16):
fight or flight.
There's a lot of adrenaline running through your system.
When I give you some pain relief,
you're gonna feel wiped out tired because your body is going to go more into a parasympathetic dominant state or at least come to a balance.
(05:38):
And without that adrenaline,
you're gonna realize how tired you are.
Especially without sleep.
So I want you to know that after today's visit,
if you just need to go to bed,
that's ok.
It's normal,
especially as you,
as we get older,
our recovery time is longer.
So I just want you to know I'm doing as much as I need to do to get you out of pain without doing too much because it's going to be fatiguing for you when your body balances out.
(06:11):
So,
and I told that to her daughter to just remind her,
um it's ok if you're tired and we and I intentionally set her follow up for two weeks out.
Not,
not the next week because I know her healing time will be longer and she may actually not feel much improvement in the first couple of days after treatment.
(06:32):
I'd like to see how long it takes for her to feel better,
um,
less sore.
So that I'm not treating her maybe seven days after the first treatment and she's still sore from the first treatment.
Um And that,
and that was my concern once I realized how ischemic,
(06:52):
her hip abductors were.
Um So I'll tell you what I did.
I,
I treated her quads and gricius if you know my episode about the my controversial knee pain treatment where I'm just like,
OK,
just do these points and then,
uh and then they'll feel better or very often feel better.
So I did the quads,
(07:13):
I did the rectus fem,
the vastus lateralis,
vastus medialis and the gricius to start.
She also was showing knee pain that seemed more like the upper tibialis anterior area and the upper area in that like spleen nine area,
(07:35):
basically tibialis posterior seemed to be the big,
the big uh sources of pain in that area.
So I treated her tib posterior and her tib anterior.
Um So then,
um,
so then she was on her side and I treated her.
(07:58):
Oh OK.
I said I was gonna treat two points and then I,
I decided when she was on her side that I needed to treat four.
So I said sorry,
I lied about that,
but it's only four points.
Um Because when she was lying on her side,
her gluteus minimus area was rock hard.
(08:18):
Her TFL area was rock hard.
She had,
uh she winced when I pushed on her gluteus medius and pure formi.
So I said,
ok,
we've got more here than I thought we're going to do all four of these points.
And she had nice movement of the needles after a couple minutes.
(08:42):
So I was really happy to see that.
Um That's a really nice,
healthy response,
especially for someone in their eighties.
And a after I left,
I left the stem going while we talked for about up to five minutes,
maybe it was three or four minutes.
And then I saw that her TFL just was not moving much.
(09:03):
Took all the needles out,
put one needle into the TFL,
used my pointer to stimulate it and then was able to actually wake up her TFL in a really good way.
It really loosened up and softened in such a good way.
And to the point where I was actually seeing the it band,
um pulsing while working on her TFL.
(09:26):
And I pointed that out to her daughter.
So she could see how this really affects the knee.
Um So that's what we did for the knee,
for her right shoulder.
All of her pains seem to be anterior in the deltoid and the coral brachialis and then her media like middle deltoid,
(09:52):
uh was definitely causing pain into her arm.
So that's what I treated the middle deltoid,
the anterior deltoid,
the cortico brachialis.
And she seemed then to also have little tight band in her anterior deltoid that was still giving her pain.
So I took a chance and I got a little twitch out of it.
(10:16):
Um I,
I was,
you know,
in my head debating,
ok,
she's like almost 90 should I do a trigger point on her first visit?
And then I'm thinking,
but she's not sleeping because of this pain.
So let's just take the risk and hope that it helps and it,
it did it,
she could definitely feel less pain.
(10:37):
She felt some soreness but she felt less pain.
So,
you know,
um,
and I warned her and her daughter that she may have some,
she may have some discomfort for a day or two.
And if she is able to take uh an ibuprofen,
she should do so.
Um,
and she do,
apparently she does take ibuprofen.
(11:00):
So I said,
ok,
so you're having a lot of soreness from treatment because we're waking up a lot of these muscles,
then just take an Ibuprofen,
use heat heat pad.
Um,
you know,
any sort of massage you can do,
but really,
you know,
just know that you'll feel better.
It's just,
you're gonna,
it's gonna take you a day or two to recover.
(11:22):
Um,
and is,
and while she was lying on the table with the bolster under her knee before I started the treatment,
I asked her if,
if she still was having knee pain and she was,
um,
once I was treating the needles were in,
I asked her and she had zero pain in her knee and when she was able to sit up with her daughter's help and I stepped out so she could change clothes and get on,
(11:52):
get into her wheelchair.
Um,
she said she felt better.
She said,
you know,
thank you.
That really did help.
So we'll see,
we'll see,
I'm,
I'm guessing,
and I asked her for a vast scale and I think she said a two or a three and that's really the best I could hope for knowing that there was definitely some inflammation and some tendon,
(12:14):
uh,
tendinopathy,
maybe tendonitis.
Um I'm not hoping for zero pain on someone in their eighties who's been in pain for quite a while.
Um,
and we'll be working with some of the,
the,
the sensitized lumbar segments,
I'm sure.
(12:35):
But the goal for that visit was get her so she can sleep at night and then she can heal and then we can move forward and do more.
Um,
but,
uh,
but it made me really sort of reflect.
I was talking to her about it.
I said,
listen,
you know,
um,
it's really,
(12:56):
really common that,
uh,
ageism affects the,
uh,
doctor's interest in pursuing anything beyond just normal standard of care.
They're not going to say,
ok,
what if it's something else?
What if it's muscular?
(13:16):
Um,
they're,
you know,
they're pretty much gonna stick with their standard of care.
Um,
and I think,
I think ageism definitely affects a lot of my seniors um,
care because very often if they had the same presentation at 40 years old that they have at 80 I really think that the doctors would think more about what else could be going on here.
(13:44):
Um I will say that they did send her to physical therapy.
So that's a good thing.
Um Why was the physical therapy not s uh successful?
Probably because her muscles had become so tight and ischemic that they couldn't be exercised into strength.
(14:04):
They were,
they were way too tight.
I think it probably was causing her more pain to,
to do the physical therapy than it was helpful.
So,
but,
you know,
once you get the muscles back to being healthy,
then physical therapy is very important because you do want the person to have some,
(14:26):
some core stability to avoid uh having uh the future pain.
So,
but I just,
I,
I see it all the time that,
that people are told,
you know,
something to the effect of,
well,
at your age,
this is to be expected.
Like you're,
she's having pain in a 67 on a constant basis and they kind of throw up their hands and say,
(14:52):
well,
we've tried everything,
you know,
um medication,
injections,
nerve ablation.
Um And so,
you know,
there,
uh apparently there,
the daughter said she's going for a surgical consult for that knee that she's scheduled for that surgical consult.
(15:16):
Um because they're kind of at the point where they think,
well,
maybe we just need to replace the knee um because she's bone on bone.
And I said,
ok,
you know,
I'm not opposed to getting a consultation.
Um It's,
you know,
you guys need,
need to know what's going on.
There should be some imaging now and see what's going on.
(15:37):
But um the interesting thing is that both knees are bone on bone and only one of them hurts and the one that hurts is on the same side as the hip replacement.
So there is,
there is an argument to be made that we should try a few sessions of acupuncture before you decide to do surgery.
(15:59):
In my experience.
If the surgery is being done because of unaddressed muscle imbalances,
then you're just gonna be right back here after the surgery because the muscle imbalances will not have been corrected by the surgery.
And you're gonna go into the same problem that you had before.
(16:20):
Um,
because those muscles are still not stabilizing.
So,
um,
it's definitely worth us,
uh,
trying to correct muscle imbalances to see how much that relieves the pain before a knee replacement on someone in her late eighties.
Um,
so that was,
(16:41):
um,
that was what I was doing on Friday and it,
um,
you know,
it just made me think about our whole health care system,
especially in the US.
Um,
we're so fixated on medication that we don't see the issues that are being caused by a mus musculoskeletal imbalances,
(17:06):
postural issues,
ergonomic issues,
post injury,
muscle shortening.
We just see everything as something that has inflammation or a neuropathy that needs uh,
a medication to block the pain as opposed to asking why is that nerve causing problems?
(17:31):
Why is there tingling in that Lim limb?
Why,
you know,
why is there nerve pain?
Hm.
Um,
unfortunately,
our medical system just sort of throws it up its hands and says,
well,
we looked at the spine and that seems fine.
So,
I don't know what your problem is.
(17:52):
Um,
or,
or,
you know,
someone's in a lot of pain after they've had a major,
uh,
surgery.
So they've had their hip replaced and they're still in pain and then,
then,
you know,
eventually doctors do another MRI and they say no,
this,
this is beautiful.
My work is beautiful.
I don't know what your problem is.
(18:13):
And then if you happen to be over 65 then the next part is well at your age or we would recommend that you lose some weight.
Um,
they weight gets blamed a lot for hip,
knee,
ankle foot issues and while it absolutely can make things worse,
(18:36):
um,
very often it's just muscular issues causing the problem and not the person's weight.
Um,
because there's plenty of pretty heavy people walking around without knee pain,
ankle pain,
joint pain.
So,
um,
it can be done and when the muscles are healthy,
(18:58):
then,
um,
it is fine.
So it's just unfortunate because I just think there's this missing,
um,
area in our medical,
you know,
expertise that,
um,
we,
we absolutely need,
especially for our seniors.
We can't keep putting everyone on medications for everything.
(19:22):
So many my intake asks like,
what medications are you on?
And then,
and,
and it's like a list,
it's like this huge list of medications.
I'm like,
oh my God,
you know,
um,
some people do need medication but I think a lot of times when people are in pain,
they're on a lot of medications that are related to their pain.
(19:46):
And wouldn't it be great if we started treating the muscles so that they didn't have to be on all those medications?
Um,
all right.
Anyway,
so that's,
uh,
that's my,
um,
that's my take on it,
my two cents.
Um,
I hope you have a great week and I will talk to you soon.
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
The Nikki Glaser Podcast
Every week comedian and infamous roaster Nikki Glaser provides a fun, fast-paced, and brutally honest look into current pop-culture and her own personal life.