If you are asking the above question, the first thing you should ask yourself is, “How did the joint deteriorate and become bone on bone in the first place?” I hear many different answers to this question. Typically people tell me age; however, I tend to doubt age is the primary cause. I’ve seen people of the same age, some of whom are running marathons, and others who are getting joint replacements. Furthermore, if age is the underlying factor, then why aren’t both knees or hips degenerative? In fact, why aren’t all the joints deteriorating (shoulders, knees, hips, elbows etc).
Typically, if you are experiencing joint degeneration, I find it’s due to the joint being in a faulty position creating muscle imbalances that cause wear and tear (or vice versa). These incorrect joint positions and movement patterns will continue to cause stress and lead to degeneration until they are fixed. Take the picture below for example: Which position of the femur and tibia do you think will cause the least joint deterioration at the ankle/knee/hip?
Postural therapy can alleviate pain symptoms and reduce wear and tear at a joint because it assesses the alignment of “each” load bearing joint, not just the one where the symptom is occurring. We must not forget, “Muscles move bones;” therefore, if we are going to attempt to realign faulty joint positions, (such as A and C above), we must influence the muscular system if we want to achieve a “long term” fix. If a postural menu is written correctly, it will not only address the joint position, but dysfunctional movement patterns as well. Surgery can alleviate current pain symptoms, but future ones are bound to reoccur if these underlying dysfunctions are not dealt with. . Postural therapy is a non-invasive way to attack the dysfunctions that are causing the joint imbalances in the first place. This being said, postural therapy is not a quick fix; It takes commitment, self-motivation, and consistency.
If you are already experiencing complete degeneration of a joint, for example if a knee or a hip is bone on bone and there is no cartilage left, it is possible that a full joint replacement is in order; however, regardless of whether your doctor finds that surgery is necessary, the misalignments and muscular imbalances still exist and must to be dealt with for long term physical health and to prevent further issues.
There are many variables that contribute to pain and surgery is never the ONLY option. The only way you can be sure you are making the right choice is by being sure you have explored all other avenues first. I have seen many people avoid surgery by realigning their body and creating more functional movement patterns. I have also seen people who have benefitted from surgery. Regardless, there is a substantial benefit to going into a surgery in better alignment.
Of course, it’s best to begin a corrective exercise program before pain symptoms become too severe. If you are truly listening to your body, and issues are addressed before the body has had time to break down the cartilage, a good alignment program can help to avoid chronic pain and many unnecessary surgeries. The underlying message here is: Listen! When in pain, your body is smart enough to send you a signal something is wrong. It’s your job to listen to your body and address any issues before they lead to irreversible symptoms.
In summary, by working on correcting the misalignments that are causing pain symptoms and leading to joint degeneration, pain can be diminished and surgery can be avoided. Once again, if surgery does become a viable option, recovery will be much faster and you should feel stronger if the body is in better alignment and functional movement patterns have been restored.
So, at this point it’s up to you to determine the approach that makes the most sense. You can find out more about postural therapy on my website at www.alignedfit.com. You can also purchase the book, “Pain Free” or “Health through Motion” by Pete Egoscue for more information.
Lisa Decker M.S.
PAS, CES, PES, CPT, CAMQ