In a recent issue of New York Times Magazine, a Mount Sinai hospital advertisement was headlined: "Knees are like car parts. It's better to get replacements from the original manufacturer."1
Huh? Meet soccer player Philip Pizzano whose knee injuries prompted osteochonditis. When microfracture surgery accelerated his pain, the solution was an allograft transplant.
Curious to know if Phil sought ABT or acupuncture? I called him. Phil knew nothing about acupuncture until he experienced a "lot of complications after surgery" that made him "feel lopsided." When physical therapy wasn't enough, friends nudged him toward acupuncture.
He praises Yuka Hagiwara LAc of NYC, whose needling helped alleviate the plantar fasciitis he experienced in his right foot that bore all his weight after (left) knee surgery. At 38, Phil is finally painfree and able to resume an active life. No more soccer but he's ardent about CrossFit training.
How About Those Aching Knees?
Phil's story isn't typical but it highlights a combo of knee therapies. Prevention is best, with cross training, stretching, building up the quads, and avoiding excessive weight gain. The National Center for Complementary and Integrative Health (NCCIH) advocates acupuncture for osteoarthritis of the knee.2
Many of my generation of Zen Shiatsu practitioners know the "knee dilemma" because of training, teaching and working on our knees on futons and tatami mats. Little did we know decades ago of the hazards ahead.
Our Dojo Training
In our training in the late 1970s-early 80s, the "form" required deft, Qi-inspired floor movements, seiza position and hours in Zen meditation. We slept on futons and ate cross legged at low tables. Even those of us who cycled, ran, did weights and practiced Qigong, faced knee problems after a couple of decades, and swapped work futons for tables. I advise all my students to cross train and include tables and chairs in their Shiatsu practice.
We attract clients with similar problems. We innovate treatments out of our raw experience. We talk in shorthand. About swollen knees, cluster varicose veins behind our knees, dancing patellas, pain caused by cold, damp weather conditions, water-on-the-knee, and the after effects of bicycle, or skiing, accidents.
Several years ago after teaching through a grueling Berlin winter on hard mats, I developed such knee pain and swelling I consulted an orthopedic surgeon in Basel Switzerland before my next workshop. He took one look at my knees and said, "What's this work you do?" He thought I was crazy. He prescribed intense physical therapy.
Within a week I received regular acupuncture and Shiatsu from Wilfried Rappenecker — founder of Shiatsu Schule Hamburg where I taught after Basel. My Swiss colleagues gave me a gel made from sea mussels and advised me to lather my knees with it every night — front and back. Such relief ! I recommend the gel to friends and clients on both sides of the Atlantic.
Insights Prompted by A Bike Accident
After a bike accident caused a compression fracture of the head of my tibia, I traveled across Europe and taught in a leg brace, jumping on and off the floor — one leg extended! A helpful exercise evolved spontaneously to alleviate stiffness and discomfort.
Balancing on my good leg, I performed circular midair movements with my leg in a brace by using the pull of gravity. It was fun, easy to do anywhere at anytime, even at the airport. This ensured hip flexibility — and taught me the value of using one set of joints to help the next in line. Every hip circle moved Qi down to my knee and on to my ankle joint.
I visualized Qi descending internally from the core of my hip, through femur to knee, then through tibia and fibula to ankle and metatarsals. Invaluable!
My great Shiatsu colleague and physical therapist, Bernhard Ruhla of Dresden Germany, performed daily isometric exercises with me when I taught for his group. Ruhla also advised me to walk barefoot and climb plenty of stairs.
Tips For Chronic Knee Pain
Another wonderful Shiatsu and Qigong colleague, Inge Berlin, a global teacher of physical therapy — taught me her "bounce" technique. Bounce? Cup your hands under the client's thigh in supine position, keep your hands on the table and elevate your fingertips into UB 36. Then bounce down the length of your client's leg UB to UB 60, pausing on UB 40 and UB 57. Repeat on the other leg. Then focus on points I have found most useful for a variety of knee problems. Points surrounding the knee:
Some 700,000 knee replacement surgeries are performed in the U.S. each year.2 I advise clients, family members and friends to try every form of therapy before opting for a knee replacement.
My Swiss nephew faced such a choice but experienced intense pain after surgery, so I worked on him in his hospital bed in Basel. I performed ST and GB Shiatsu on the opposite leg, followed by on-and-off-the-body meridian-and-acupoint Qi-focus around the replaced knee and his feet. He was quick to tell me which points best alleviated pain.
After watching me work, his physical therapists invited me to teach the techniques to the entire physical and occupational therapy departments. They marveled at the simplicity.
References
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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