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We are in chaotic and uncertain times. There is a wave of expanding collective anger and pain that is palpable.

It is an understatement to say we are all being challenged to salvage some sense of peace when confronted with social and political unrest entangled with financial, personal, and health worries. I have seen a great deal more emotional stress, headaches, neck pain, back pain, and overall bodily discomfort in my patients. It is never too long that emotional pain becomes physical pain.

We seem to have hit a pivotal point in society where hatred, destructive dialogue, division, anger, and blame are at an all-time high. Civility, kindness, acceptance, and love are strangely absent. Today and every day, we have a choice to make.

The news and social media are the platforms for expressing this discontent and anger. It has morphed into a means of spreading fear and mistrust or canceling anyone who thinks differently from us. Name-calling, ridiculing, and brandishing opinions as though they are Truth and fact has become a common thread perpetuating this growing anger and unrest.

We seem to have lost the ability to have intelligent conversations with those of differing opinions and beliefs, insisting that others who believe differently than us are “wrong”. There is vehement push back, resistance, self-righteous attitudes, and defiance when our beliefs or opinions are challenged or not accepted as universal Truth.  Our ego tells us that if perhaps we shout loud enough we will change the minds of those who think differently. We instinctively know and have seen historically that this is false.

It becomes easy to bully, belittle, dehumanize, and lump groups of people into ‘categories’, as if to ‘shield’ ourselves, simply because they think differently than we do. This is a form of bullying. In doing this, we are perpetuating the negativity, anger, hate, and division that is already escalating. We have now become part of the problem.

The news and news media have always portrayed the lowest common denominator of human existence and is designed with one objective in mind: to activate the portion of the brain ( Amygdala) that creates fear.

More than ever, news media and social media bombard the fear brain, inciting anger, divisiveness, and “me against them”  thinking and mistrust of others. This promotes a stress response in the body by upregulating our “fight, flight, freeze, and fear”, Sympathetic nervous system. This is our built-in survival mechanism however, it is not meant to be responding every day, all day to perceived ‘threats’. The consistent hyperarousal of this nervous system is responsible for many chronic health conditions, including heart disease, high blood pressure, diabetes, compromised immunity, depression, anxiety, muscle tension, chronic pain, and insomnia.

I sat quietly this morning in solitude considering the choices we have and the lessons we can learn during times of testing.

We have a choice to reduce the amount of time we spend watching the news or engaging in the various forms of social media. Setting time controls and boundaries can go a long way toward restoring our inner peace. Those who watch the most news, experience the greatest levels of anxiety.

We have a choice to disengage when someone is choosing to express vitriol, name-calling, personal attacks, and other bully tactics. There is no place for this in any relationship or even when expressing our views on a social platform.

We can make a choice to refuse to be offended, as carrying an offense and being easily offended brings the heavy burden of resentment and bitterness, stealing our health, peace, and joy. When we are easily offended our rational brain is hijacked, and our emotional and fear brain is in the driver’s seat. We are essentially giving our control over to someone else, allowing them to influence our reactions and remarks. We may strike out in defense as I have seen countless examples of those who have said they “Can’t be friends with someone who votes for so and so, or who believes such and such.”

We can choose to have an open mind and hold space for duality; simply understanding that two very different ideas can co-exist at the same time while understanding that there is rarely one truth that summarizes a complicated issue. As Steve Jobs has said, “Have strong opinions loosely held.”

We can choose to allow a larger perspective, as pettiness and insisting we are right, cancels our joy, and contracts our world. We need people with other viewpoints to expand our thinking. We don’t have to change our minds but new knowledge can expand our minds if we are secure enough to receive it.

We can choose to have healthy boundaries especially with those who for whatever reason, are angry or abusive. We may have to take inventory of the types of interactions we engage in, protecting ourselves as needed. Distancing from toxic relationships may be necessary if boundaries for decent behavior are not respected. Those who attack or hurt others are often experiencing pain themselves, we can have empathy. Empathy builds resilience.

We can choose to focus on the good that we can do; how we can contribute our energy positively to the greater good or a cause that is important to us. Other questions we can consider: What can I do to lift up myself and others? What is within my control and what is not? How are my underlying beliefs and prevailing thoughts contributing to my unrest, worry, anxiety, and stress? Ultimately, it will be our health that is negatively impacted.

We can choose to make peace our primary goal. If we can cultivate ways of choosing peace, safeguarding peace, and residing in a place of peace, despite external circumstances, we become a very powerful agent for change. Developing healthy habits that protect our peace of mind, may mean limiting the time we spend watching or engaging with news and social media. Instead, we can use our time to listen to soothing music, take a walk in nature, express ourselves in a journal, play with a pet, pray or meditate, or simply breathe.

We can choose to nurture our faith rather than our fears. This is not an easy task at times such as this, but this is precisely when it becomes most valuable.

” When you judge another person, you do not define them. You define yourself…When you respond with hatred to hate, you’ve become part of the problem which is hatred, rather than part of the solution, which is love. Be a person who refuses to be offended by anyone, anything, or any set of circumstances.” – Wayne Dyer.

This above quote by Dr.Wayne Dyer holds tremendous wisdom. Indeed, It is a very difficult call for us to uplevel our responses in a time of chaos and uncertainty. If we can achieve it now, it will be a skill that we can turn to, again and again during other trials.

I have told you these things so that in Me you may have perfect peace. In this world, you will have tribulation and distress, but be courageous and filled with joy, for I have overcome the world.”- John 16:33








We have merely one day within the calendar year dedicated to reflecting on gratitude, yet it has been my discovery that gratitude is one of the most powerful shifts we can make toward greater health and happiness. This one day that centers around food and football hardly seems sufficient given that gratitude is the antidote to so many of the ills that plague us as humans and within society.

In the vast majority of people that I see in the clinical setting, it is easy to see that much of the human race drags through long and sometimes tiresome days filled with more obligations and demands than our time, energy and patience can withstand. Others are challenged on a daily basis with illness, pain or failing health. This time of the year is particularly hard for anyone who has endured a loss of any kind, be it a loved one, a job, or their health. Psychologists recognize that the holidays are understandably difficult to navigate when we are missing a loved one. I agree it seems to require superhuman ability to muster gratitude even while feeling a deep sense of loss.

Despite all of this and every good reason to the contrary, our challenge is to develop a spirit of gratitude, despite our current state of affairs. Can we allow our pain and gratitude to co-exist, holding space for both? I believe we must.
For many of us, gratitude is an afterthought reserved for occasions when we receive good news relating to something we hoped for that comes to pass for ourselves or our loved ones. The birth of a child, a new job opportunity or a good health report from the doctor are experiences that easily promote a sense of gratitude.

The true test of character is what we do in moments of pain or disappointment. It is human nature to take for granted the simple blessings we all have and instead to focus instead on what is lacking or what we feel we are missing in our own corner of the world.
The rise and popularity of social media have created a false sense of deprivation and a sense of entitlement.
We view the lives of others through a make believe lens of perfection seeing only the grandeur of their experiences and then proceed to evaluate our own lives based on this highlight reel.

Gratitude can only arise from a present moment acceptance and contentment. Regardless of the current situation, we find ourselves in, gratitude says, “I accept what is”. “It is enough”, and affirms what good can be gleaned even from our disappointment or difficulty. Whenever we are in ‘non-acceptance’ of anything,  it is nearly impossible to be grateful.

Give thanks in all circumstances, for this is God’s will for you in Christ Jesus.”- 1 Thessalonians 5:18

There is scientific evidence supporting the health and psychological benefits of cultivating a grateful spirit.  We create our biological internal chemistry with our thoughts and therefore a simple shift in our thinking and how we view a situation can have a significant impact on our health.  Research strongly suggests that focusing on gratitude can improve our heart health, our emotional and our physical wellbeing.

Similar to a garden that must be tended to, our minds need to be pruned of the weeds of criticism, judgment, blame, lack, and inadequacy. Since all life abhors a vacuum, while we prune these tendencies, we need to replace them with continual thoughts of thanksgiving and a redirection of our focus to our blessings. We must actively and mindfully shift from focusing on what’s wrong with something, and an attitude of rejecting or defending, to one of acceptance and appreciation. Gratitude alone packs the power to open the channels of health, abundance, peace, and joy.

You cannot be simultaneously angry and grateful, nor can you have a critical spirit and a grateful one at the same time. I challenge you to try.

A spirit of gratitude must be cultivated and practiced daily, even multiple times a day, in order to become our nature and part of our personality.

Today, as we prepare for the upcoming holidays with many obligations and distractions, I will encourage you to invest time in two simple activities that can strengthen your gratitude muscle. The activities like bookends to your day, involve spending time developing gratitude at the start and ending of each day.

Before you get out of bed in the morning, intentionally and visually in your mind’s eye, remind yourself of at least 5 things for which you are thankful. Be as specific as possible. Allow the warmth and peace that accompanies those feelings to blossom, and linger there, savoring them for a few moments.  Writing them down is even better as the mind responds strongly to our written words.

Lastly, Reserve the last 10 to 15 minutes of the day to quiet the mind and review the day. If there were any circumstances or situations that you encountered that were less than favorable, ask what you could learn from them. Reflect for a moment on what they can teach you and open up your heart and mind to receive whatever that lesson might be. Then, once again direct your mind to the present moment and reflect on all of the good in your life, reminding yourself that you have much to be grateful for even in the midst of any turbulent or difficult times.

These two simple practices may not be easy at first. Unless you are a naturally grateful person, your mind will gravitate to what is wrong or lacking and will tend to reject what you are suggesting and insist on grumbling instead. Continue anyway and persist in reciting all that you have to be thankful for.

“Let gratitude be the pillow upon which you kneel to say your nightly prayer.”- Maya Angelou

Lastly, I wish all of my friends and family bountiful blessings of health, peace, and joy!

If you enjoyed this post, please share it with your tribe.

Join me for a brand new class offered in 2020 entitled: 7 Keys to Managing Pain and Disease and Living ‘Younger’ Longer.”

Date and Time: February 18, 2020, from  1-3 PM @ Grand Learning, SunCity Grand, Surprise, AZ

Also, for the Thanksgiving holiday,  I am offering additional savings for all supplements purchased through Fullscript. Formulations that are condition-specific for osteoporosis, and arthritis and for general health and wellness using the link below.



Here we are on the cusp of another holiday season and the beginning of the Winter solstice. Many of us are fully immersed in the holiday madness and mayhem, and what we are feeling right now, has much to do with how much of our ” to do list” has been checked off: that is, the shopping, wrapping, cooking, baking, decorating and more shopping. For many, this time of the year also excavates nostalgic feelings, sentiments and memories of years gone by. Buried deep in the psyche, most every other day of the year, are the stark reminders of that empty seat at the table; those we have loved so deeply that are now only with us in spirit, children that have grown and moved away, or maybe an illness that has challenged our way of life. It can be any Memories that surge to our consciousness and beg for attention despite the ‘busyness’ of the season. For anyone that deals with a chronic illness, or has lost a loved one, this can be a particularly difficult time of the year.

Why is it that around this hectic and stress filled time of the year when we most need to care for ourselves, physically, mentally and emotionally, instead,we are most prone to self neglect and self sabotage? Neglect, that is, of healthy eating, exercise routines, or tending to our own emotional and spiritual needs. While, we are surrounded with seemingly limitless opportunities to indulge our appetites with cookies, pie, stuffing, mashed potatoes and other comforting foods, at the same time we have literally no time to exercise, take a yoga class or even take a deep breath! If I can point out the obvious, this is not a good combination of events but quite frankly, a recipe for disaster!

While this may be a chaotic time on many levels, and certainly a catastrophic time for our diet and weight goals, it doesn’t have to be. I would like to share some thoughts on caring for yourself during a time when it is most needed and necessary!

1.Everything is Exactly as it should be: This is the first premise and the foundation of all others. This of course, is most relevant when we are in the midst of a personal struggle or difficult time. In essence, acceptance of how things are, right here and right now, unloads a tremendous burden from our vigilant, over active mind or “ego” that wants to be in constant control, demanding an explanation for the events we can’t seem to control. The difficult part of acceptance is that many times, things don’t look the way we think they ‘should.’ It’s that curse of expectation, and sometimes we have to recognize that while we may not understand everything, or even like what’s happening, that it will all be fine in the end. The only solution that will bring peace at times like these is to fully surrender to what is. This is not an act of passivity but of faith and wisdom. Most importantly, this is really an act of self love. A gift you can give yourself, moment by moment, one day at a time, starting now. This takes rehearsal and practice and for many of us, LOTS of rehearsal and practice! OK, now that we have that one out of the way..

2 You are What you Eat. We have all heard some variation of this saying. Most recently I read a quote from an unknown author that stated: “You are what you eat, so don’t be fast, cheap, easy or fake!” All kidding aside, while we all realize that this is true on some level, as a student of nutrition, I now have facts to back this up! With every single food choice we make, we are either creating health or creating disease. It may seem pointless to bring up healthy eating at this time of the year, while we are in the midst of numerous, taste bud pleasing items at every turn. In fact, the majority of people will deal with the 10-15 pounds that will accrue between Thanksgiving and Christmas with a new list of diet and exercise resolutions for the New Year. Does this sound vaguely familiar?

I will bring up just 2 major points: The first point: You will eventually get good at whatever you practice the most. Practice makes perfect, and what we practice most, become our habits. Remember practicing shooting baskets on the basketball court or spending hours at the piano? Our choices become our habits and our habits determine our destiny. What habits are you practicing right now? Indulging in foods you know are unhealthy will reinforce the habit of eating unhealthy. This will certainly make for a challenge after the New Year when you, once again, swear off or otherwise deprive yourself of anything ‘fattening’. We all know that will power isn’t very powerful, after all, and in the long run doesn’t work. Willpower is a relatively new concept, designed for the fast food world in which we currently live. Cave men and  cave women did not have or need will power. They hunted and gathered day and night on foot, and then indulged in satisfying fare and robust flavors of fresh meat and produce. As you can clearly see, if you are eating natural, real, whole foods there is no need for will power. They were not tempted by the endless array of Krispy Kreme, McDonalds or Starbucks Mocha Frappaccinos available on nearly every block. Food manufacturers employ food scientists who have figured out which combinations of foods will ‘hook’ our taste buds creating a cycle of cravings that virtually never ends. Our taste buds have been sensitized and hijacked to crave food-like substances that are sweet, salty, and chemically flavor enhanced. These foods create a physiological need and biological demand that clamors for satisfaction. Therefore, soon after eating these types of foods you will be craving your next ‘hit’. The pleasure centers of the brain respond in typical addictive fashion, and studies have indicated that the combination of sugar , salt and fat are most addictive, as much as 8x more addictive than cocaine! So as you can see, will power was never meant to be an effective tool against the fabricated, factory created, highly palatable,”pseudo foods” of today. Hence, one of the many reasons why diets that are very restrictive and that rely on will power so often fail.

So, what is the best option, when we are surrounded by endless temptation? For some it might be extra long and intense work outs at the gym, after a day of ‘poor eating’. This is only half the solution. Unfortunately, as Dr. Mark Hyman, MD director of the Cleveland Clinic for Functional Medicine has said: ” You can’t exercise your way out of a bad diet.”

Studies have confirmed that a refined carbohydrate, high sugar diet is associated with higher rates of depression and anxiety. This is due in part, to stress on our adrenal glands and other endocrine glands. In addition, sugar is considered an “anti-nutrient”, meaning it depletes other valuable nutrients from our bodies. For example, for every molecule of sugar you consume, it takes 54 molecules of calming magnesium for your body to process it. Sugar and unhealthy fats are also inflammatory and can increase pain in the body. Sugar also damages are brain and memory, is associated with irritability and fatigue. Clearly, not something we need this time of the year, or any time for that matter! We  should already recognize that sugar is the culprit for elevated triglycerides, and higher rates of heart disease, and the epidemics of insulin resistance and diabetes. These diseases of lifestyle and diet are on the rise. Sugar and unhealthy fats in processed foods also change your healthy gut bacteria in favor of  unhealthy. These unhealthy, pathogenic bacteria begin to outnumber the healthy bacteria and they prefer and demand more sugar and processed foods, creating sugar and junk food cravings. If this sounds like a damaging and viscous cycle, you would be correct. So the message is clear, practice choosing healthier options now, avoidance or complete abstinence is not always necessary but conscious, present moment awareness is. If you make the choice, in advance, to have pie, make a decision to have pumpkin OR pecan, but not both. You can not wait until you are facing the tempting array of goodies and hope that “will power” will win the war. You will lose this battle 100% of the time.

Moderation is really the key to all things, and you are solely responsible for the choices you make and ultimately how you will feel mentally and physically. We have eaten our way into this conundrum by choice, so we need to eat our way out! Get better at making choices from a place of strength and power and self love, knowing that we are creating our lives, one simple choice at a time. I encourage you to start practicing better habits now for a better and healthier life in 2018 and beyond.

The second point: The most limiting and detrimental emotion when it comes to establishing and practicing better habits, is self recrimination. You will never motivate yourself to form healthier habits from a mental state of guilt, shame, fear, anger or any other negative emotion. If you are a stress eater, worry eater, anxiety eater or anger eater, you will understand this concept. These feelings will often lead to over eating when the underlying issue is not acknowledged, accepted or expressed. If you can make an honest assessment of what you are feeling and why, bringing yourself back into the present, you will often make discoveries and be rewarded with clarification, insight and the impetus to make better choices. The only real lasting change will come from a place of self love, self acceptance and compassion. Pledge to free yourself at last of the negative tape that replays in your own mind, and understand there are no mistakes or failures, only learning opportunities. The battle is won or lost in your own mind. Learn to use the delete button on your thoughts, and use in relentlessly.

3 Distractions lead to Disappointment: We are bombarded with so many stimuli simultaneously we can not appropriately or effectively mentally or emotionally process it all, therefore, leading to feelings of being confused, overwhelmed, derailed and disappointed. These distractions can cause disconnection from self, and will lead you astray, away from your purpose and passions, if you choose to let them.

We need to continually remind ourselves why we are here, (what is our purpose and intention) and why we are doing what we do. ( MOTIVATION). Although it may seem impossible this time of the year, spending time away from the commotions of life for self connection, might be in order.  During a time of reflection,  We should be reminded that our single greatest purpose (always) is to serve others, love unconditionally and be a blessing when we can. To be the light that the world so desperately needs.

At the end of another year, and as a new year approaches, we should be reflecting on personal growth. What one or two things would you desire to see positive changes in for the New year? Your desired goal may be to lose 20 pounds, learn specific exercises you can perform to manage or eliminate knee or back pain, take control of your mental and physical health, nurture the important relationships in our lives or maybe eliminate the drama or negativity. There is no shortage of issues that any one of us is facing at any given time. Once you decide what you would like to see transformed, create a “statement of intent” with small step by step goals to guide your transformation. Enlist a friend or accountability buddy, to tell about your plans to transform this area of your life. These steps will act as your GPS and keep you from sliding back into more familiar ,but less than favorable habits. Take some time right now, even amidst the hustle and bustle of the season and tune in to what you most desire to see in your life. What will you need to do beginning today to see your vision come to fruition? When you encounter obstacles or setbacks, and you undoubtedly will, do not judge yourself harshly but instead, make the necessary course correction, similar to your car’s GPS which states in the most pleasant sounding voice: “In 500 feet, make a legal U -Turn”, . Develop a focus so sharp that will guide your choices, not permitting anything into your force field that will move you away from your desired goal. Lastly, release your tight grip on the reins and you will enjoy the ride and journey much better!

Another important point to reflect upon, the message of love and peace that entered the world on a dark December day over 2,000 years ago. We can allow this light to sink down into our heart and spirit, giving us a peace that the world can not give.

Right now, as you are reading this, make a decision to experience this season of hope and peace however it feels right to you. Chaos, and commotion may certainly be all around you, but you  alone have the choice whether or not you let it on the inside.


“I Bring you Tidings of Great Joy, which will be for All People.”  – Luke 2:10



Mary Dicaro, PT, CSCS,CHN

Please visit my website: or attend an upcoming seminar in February.   I would be happy to help you on your wellness journey!

sedona snow

“Enter His gates with thanksgiving, and His courts with Praise! Give thanks to Him: bless His name!” Psalm 100:4

Thanksgiving, a time we dedicate in the space of our busy lives to pause and consider all that we have to be thankful for.

On this day many will fondly look back on the events of the past year and have hearts filled with joy for the blessings that have been bestowed upon them, counting our family, friendships, work opportunities, health and prosperity.
Many more will instead be entering this holiday season and this day devoted to giving thanks, with far more than their share of hardship, struggle,worry, loss and pain. Can we really be expected to “Give Thanks” for such times as these?
Surely, this is not for the faint of heart or those of little faith. The natural tendency is to complain, worry, and even curse over the details of our lives that have been ‘less than the best’. It is certainly not easy to feel grateful when you are feeling pain. Yet, it may be the only way through to the light on the other side.
Gratitude is the spiritual panacea for what we feel is still lacking in our lives. Many of us can look back at the trauma and losses we have felt this past year and see in hindsight how our souls have grown, how we have learned to care for the deeper parts of ourselves. We recognize how it has increased our resiliency as well as the truth that, try as we might, we are always in need of God’s grace and His grace is always sufficient, when we seek it. Our faith becomes a precious gift at these times.
The truth is pain and gratitude can co exist. We can choose to seek the good in whatever our circumstances, and practice radical acceptance and gratitude for all that is part of our lives right now.
It is seeing and holding the pain and it’s antidote paradoxically, and yet we discover that the moment we express gratitude over our circumstances is the same moment in which they are transformed.
A study published in “Psychosomatic Medicine” showed that the expression of gratitude through journaling has a significant impact on bio-markers of inflammation and improved parasympathetic heart rate variability in patients with stage B Heart Failure. This is an encouraging association and is correlated with the mind-body connection of positive emotions such as gratitude and the impact they have on physical health.
Gratitude is a gift for us to open every day, not just on this one day a year.
It is a gift we need to give ourselves, not just when we ‘feel’ like it, when things are humming along, but rather choosing to be grateful each and every day regardless of our current circumstances. In giving gratitude for what is, even during the tough lessons, we are making a choice to see the good in our lives, starting today and that is the greatest transformation there could be.

Wishing all a Blessed and Happy Thanksgiving!

Today I am hoping to shed some light on this increasingly common source of joint pain. We may have experienced twinges of knee pain in the past after an aggressive hike or perhaps we are now in the throws of seeking answers to unrelenting knee pain.
Your doctor can quickly provide you with a “diagnosis” and perhaps offer as a solution in the form of an injection, a prescription for pain and anti-inflammatory medication or of course the most invasive of treatment options, surgery.
In some cases surgery is unavoidable and may feel like the only option.
These cases are more the exception than the rule.
Surgeries to repair, for example, an acutely torn ligament or meniscal tear may be both necessary and wise especially if the individual is young, active and would like to return to high level of function and sports.In this case a surgical repair or reconstruction will provide the best shot at maintaining a normal active lifestyle with the fewest limitations.
What is most alarming is the current trend increase in elective total knee joint replacement surgeries in the last 20 years. The average age for total joint replacements is decreasing, even while most joints only have a life span of only 15-20 years.

A study presented at the 2014 American Academy of Orthopaedic Surgeons (AAOS) meeting highlighted the rising numbers of knee replacement surgeries. When researchers reviewed hospital discharge data for more than 2 million people undergoing this procedure, they found the rate of knee replacements jumped 120 percent over a 10-year period!

The overall increase was steep, but it was even more pronounced in younger age groups. While the number of surgeries increased by 89 percent among those ages 65 to 84, they increased by 188 percent in 45- to 64-year-old patients!

Knee joint revision surgeries are also on the rise for this very same reason.
Studies have found that 85 percent of knees last 15- 20 years, and the AAOS estimates 10 percent of patients will need a revision at some point. The younger patients are when they undergo the first surgery and the longer they live afterward, the more likely they will be to need revision surgery.

Studies have shown The number of revision surgeries increased 133 percent during one study period, particularly among younger patients.

So the question I want to attempt to answer is Why is there such an increase in Knee Pain and Medical procedures to Manage it?


Although there are many potential causes, I will outline and discuss a few of the highlights:

This is a very common underlying factor in the etiology of knee pain that is often “overlooked” by orthopedic surgeons and can eventually lead to uneven wearing down of the cartilage or meniscus of the knee joint leading to early degeneration.( arthritis)
Although the knee joint is a rather simple hinge type joint it relies on ligament ( bone to bone connections) and tendons ( muscle to bone connections) for stability, support and mobility.
Proper functioning of the knee joint depends on a dynamic interplay of all muscles connecting above and below, think foot and hip. The knee is often times caught in the crossfires when foot or pelvic/hip alignment are creating dysfunction and a bio-mechanical nightmare at the knee. For example, an overly pronated (flat) foot, a leg length discrepancy or pelvic rotation can result in excessive loads and pressures at the knee joint.
The most common culprit in the onset of knee pain are weak hip stabilizers, a weak core, weak Quadriceps, namely the VMO, tight hamstrings, tight Ilio-tibial band (side of the leg) and tight hip flexors. These muscle imbalances lead to most forms of the knee complaints we see in therapy including the common Patello-femoral pain in younger athletes. Mal-alignments at the pelvis, foot and ankle will change the ground reaction forces and increase compression forces at the knee and the patella or knee cap. Once you have an understanding of how your alignment and muscles are creating an unhealthy movement pattern, you can begin to work on changing the dynamics through specific targeted, exercise, muscle energy techniques to correct alignment issues, and kinesio taping and orthotics, if necessary.

There can not be a discussion of tissue breakdown, inflammation, and arthritis without discussing other major players, as there is never only 1 player in a team sport and complex system like the human body.
I will call these 3 ‘The Unhealthy Triad” and this includes excess weight, poor diet and a sedentary lifestyle, all of which are preventable contributing factors.
First and foremost and because it is the easiest to correlate with joint degradation and arthritis, is EXCESS WEIGHT or increased BMI.( Body mass index)
Breakdown of cartilage or cartilage degeneration is often seen in Osteoarthritis. Inevitably it also involves the synovial membrane and thickening of the sub-chondral(underlying) bone. This is also enhanced by active inflammation as the body attempts to ‘repair’ or clean up the affected area by sending in inflammatory proteins and other molecules.
Excessive joint loading is a primary factor when discussing arthritis of the knee. The end goal is to reduce joint loading so to preserve the joint cartilage and stave off arthritis. Weight reduction is obviously one critical component to unloading the knee joint. Under normal walking conditions the load felt at the knee joint is 3-5 times that of body weight for level ground walking and up to 8 times for downhill walking! So even carrying an extra 10 pounds on the body can be felt at the knee joint as an additional 40-80 pounds!
Most of this is felt at the medial ( inside) knee compartment, which not surprisingly is the first knee compartment to show signs of arthritis. In Physical therapy we often suggest joint “off-loading” support in the form of knee braces that reduce compartment load, using a cane on the contra-lateral side,and heel wedges to alter foot mechanics.
Of course, Nothing will be as effective as weight loss in the management of knee OA.

Now that we addressed that rather difficult topic, lets discuss sedentary lifestyle.
While the aggressive athletic warriors ( you know who you are) have their share of wear and tear, sprains and strains and injuries, which can lead to early onset of arthritis, the opposite scenario is the “desk dweller” or couch potato who sees little if any physical activity. Loss of muscle strength, power,endurance and mitochondria ( muscle fueling powerhouses) diminish with low activity. This will directly affect the health and integrity of the weight bearing joints. So when it comes to health of the joints and activity and exercise, it is advisable to maintain muscle mass, power, flexibility and strength through exercise, walking, cycling or a combination of high and low impact exercise. As is most things in life, it’s all about striking a balance.

Last but not least in this triad, is diet. As the saying goes: “You can’t exercise your way out of a bad diet.” The diet that most of us are consuming looks less and less like real whole food. We are growing ‘attached’ ( addicted might be the better choice of words) to the processed, packaged, preservative laden, highly palatable pseudo foods that line grocery store shelves and fast food markets.
What does this have to do with my joints, you may ask?
The diets most Americans are consuming is highly INFLAMMATORY, calorie dense, nutrient poor, highly oxidative and damaging to the cells of our body.
Many studies have shown that years of eating habits such as this will lead to early degeneration of joints, increased inflammatory processes in the body, which spells double trouble for all body systems = DISEASE!
Regulating oxidation and inflammation can improve health, vitality and longevity. Oxidation to put it plainly is our cells “rusting” from the inside. While some oxidation is a normal part of cellular metabolism, too much, too quick, without a balance of antioxidant rich foods contributes to disease.
Foods that are anti inflammatory and loaded with anti oxidants should be the focal point of every meal. Dark leafy greens, brightly colored vegetables and fruits, seeds, nuts and omega 3 rich fish is a great place to start.( see below)

A recent study looked at the anti-oxidative and anti-inflammatory effects of Vitamin E on knee tissue of patients with late stage osteoarthritis of the knee.
Those in the study taking the Vitamin E had decreased inflammation and decreased oxidative stress,and improved clinical symptoms, identifying Vitamin E as a “disease-modifying agent for Osteoarthritis.”
What are some examples of other potent anti-oxidant foods: Carotenoids: Carrots, squash, broccoli, sweet potatoes, tomatoes, kale, collards, cantaloupe, peaches and apricots (bright-colored fruits and vegetables!),purple grapes,pomegranate, cranberries, green tea, Vitamin C: Citrus fruits like oranges,lemon, and lime etc, green peppers, broccoli, green leafy vegetables, strawberries and tomatoes
Vitamin E: Nuts & seeds, green leafy vegetables, and finally my favorite of all: Red wine 🙂 (in moderation of course!)
There are just a few of the more common issues we encounter. There are many more possibilities for the onset and progression of knee complaints and in Physical Therapy we investigate the many contributing and causative factors providing conservative solutions for those who wish to avoid surgery.
If a patient wishes to be intentional and implement the suggested positive behavioral, dietary and lifestyle changes and therapeutic measures suggested in therapy, improvements can be seen in the form of increasing physical function decreased pain and improved mental health, vitality and quality of life.
Stand up, learn what you can do and take action, Knee pain doesn’t have to sideline you from enjoying life.

Be blessed, be well.

If you have any questions, feel free to contact me and I will try to assist you :

Most Americans have had the common, unpleasant experience of a pulled muscle, a sprained ankle or another injury that has temporarily sidelined their activities and impacted their quality of life. But another estimated 100 MILLION Americans are affected by Chronic pain, which is pain lasting more than 3 months, that is particularly challenging and life altering.

The increasing and widespread use of narcotic drugs to treat this puzzling condition demonstrates the poor management by traditional methods. What exactly is going on with the epidemic of pain in our society?

In this informative class I will explore the complex and many potential causes of Pain and attempt to decipher the difficult pain conditions such as Fibromyalgia, Chronic low back pain and Arthritis.

I will discuss 7 Causes and offer Strategies for Prevention and Management, including: nutritional interventions, exercise and Physical Therapy and lifestyle modifications that will have positive impact on symptoms. This will represent an INTEGRATIVE approach and will include the latest developments in mind body and conventional medical interventions.


WHERE: Sun City Grand
WHEN: February 1, 2017, 10:00-12:00
19781 N Remington Dr.. Surprise
623 546-7470

If you have any questions, you can reach me via my website:
or email:

I am excited to announce a new class in 2017! “Effective Techniques for Tight Muscles”, will attempt to solve the mystery of why muscles become stiff, sore and painful and often times resist our best efforts to stretch them.

Listening to many of my patients’ requests, questions and frustrations led me on a quest to uncover the mystery of the well known, tight stiff and achy muscles that seem to be epidemic in our society.

This class will provide the attendee with an understanding of the possible causes of “stiff”, or “tight” and painful muscles. This common and sometimes misunderstood condition is often the primary culprit underlying neck, back and hip pain, even sciatica. You will learn how to ‘tame’ the tightness and spasms, balance the muscles and enjoy more freedom of movement. Techniques will include types of effective stretching, foam rolling, trigger point release and the stress/relaxation response techniques.

DATE: March 1,2017
Time: 10:am-11:30am
Where: Chaparral Center – Havasupai-Maricopa Double Room, Sun City Grand
CALL: 623 546-7470 to register or register in person



4 STRATEGIES TO MOVE FROM RESOLUTIONS TO REAL SOLUTIONS. A brand new year with a fresh crop of  365 new opportunities to begin again….Instead of Resolutions,  begin the year with Real Solutio…

Source: From Resolutions to ‘Real’ Solutions….


A brand new year with a fresh crop of  365 new opportunities to begin again….Instead of Resolutions,  begin the year with Real Solutions.

Like most people you may be starting the New Year with motivations running high and a sense that a new crop of 365 days was just what you needed to propel yourself toward healthier habits. You may have set a few worthy goals such as  lose  20 pounds,  begin a certain diet, exercise more, eat healthier foods, manage stress.. and so forth.   And  if you’re similar to  most people by mid January  you will begin to feel a sense of ‘love lost’ when you think about those ‘resolutions’.  If The sparks that ignite your motivation,  begin to  fizzle out with the  holidays fireworks,.you are in good company.  When it comes to life changes, most people have the attention span and focus of a squirrel, and when it comes to will power, well, that is not as powerful as we had hoped.

In fact, most people who begin a “diet” or attempt a lifestyle change will be unsuccessful without the right tools. When it comes to having the right tools, and understanding what leads to success, there is some good news and some bad news.

I will give you the bad news first.

There may be reasons why you have fallen short when trying to change a habit, but they are not excuses.

Now here’s the good news:

There may be reasons why you have fallen short when trying to change a habit, but they are not excuses. Thankfully, you are still responsible, and what you acknowledge you can change. It  does require personal accountability.

It sounds simple, and it is, but simple does not mean easy.

I have outlined 4 simple strategies that will put you on solid ground and move you forward. That is where we want to go, right? Therefore, looking back or dwelling on past failures is no longer an option. That would be like trying to drive your car, looking in the rear view mirror. We recognize that nothing good will come from that!


There is no other force as powerful, creative or destructive as your thoughts and own belief system. Therefore, if you have struggled with maintaining weight loss, or a healthy eating lifestyle, the question you need to ask is: Do I believe that I deserve to lose weight and feel good? This is not a question you pose to your head, but to your heart. Your intellect will always tell you what you want to hear, but the heart knows only the truth.

“You cannot solve your problem with the same mind that created it.”

If you are not getting the right answers to chronic, recurrent, problems, this may simply mean you are asking the wrong questions.

 “You cannot solve your problems with the same mind that created them.”-Albert Einstein

In order to achieve any lasting changes in your diet, exercise or lifestyle factors, you have to dig deeper and ask some difficult questions to uncover the limiting beliefs or lies that are keeping you from rising higher. Some, or most of our limiting or destructive beliefs are subconscious, but specific tools and an honest inventory will help in Identifying, Acknowledging, Challenging, and Releasing these automatic negative thoughts and allow you to create a greater vision for yourself.   Your belief system is directly related to your thoughts. Guard your mind like Fort Knox.

The battle is won or lost in your mind, so that is where it must begin


I would encourage you to get a clear vision of what you want for yourself. This will be your mental map or GPS. You can be assured that you will have times when you will fall of the track, not if, but when. Here’s the point, Just because you get derailed, you don’t have to crash. Immediately, divorce yourself from the tendency to nurse the bad feelings, feel guilty, blame or engage in self- recrimination. Having a vivid vision of what you desire for your self will keep you from losing momentum during the challenging times. There are many ways to do this. Some people do well with meditation, picture boards, positive affirmations, visualization, journaling and writing out their goals. Daily. You must be vigilant, bad habits die hard.

The second part of this exercise is to assign a numerical value to how comfortable you are that you will follow through with the goal. For example, if your goal is to ” exercise 5 times per week for 1 hour” and you assign a 2 to your comfort level ( 0 to 10, with 0 representing not comfortable at all) this is NOT a worthy goal for you at this moment. Modify it until you are at an 8 or better on the comfort scale. Your previous goal may change to, “I will walk for 20 min a day, 4 days a week.” Then give it life by putting it on your calendar. And finally, Don’t break a date with yourself, you are important.


The nature of will power is that it is not a powerful motivator or catalyst for change in the long run. Psychologists and life coaches know this. It may get you started initially, but it is rarely a faithful friend to the end. Instead, you have to cooperate with some natural laws at work here. I will outline a few.

Our brains are wired to seek pleasure and avoid pain. Pretty basic for survival, back in the day. The main motivator for any behavior is based on this principle and so self- gratification and self- protection are the two most powerful activists. Unfortunately, portions of our brains, ( namely, the Amygdala and Nucleus Accumbens) are easily hooked on various forms of pleasure, some good, some not so good.

In the ‘not so good ‘category are sugary, salty and fatty foods which trigger the same centers in the brain as some drugs. The food industry knows the sneaky secrets to turn on the reward centers in your brain and activate the release of the neurotransmitter, Dopamine. In fact, Dopamine is often referred to as the “Master Molecule of Addiction.” Studies have shown that while animals will work hard for a sugar or fat reward, they will work the hardest for a combination of sugar and fat. An example in the ‘good’ category are people that obsessively engage in rigorous exercise to achieve an endorphin release. The so called “runners high.”.

So what does this all mean for us common mortals? Why are bad habits, like not exercising, eating poorly or smoking, so hard to change despite the knowledge of their deleterious effects and contribution to disease? No, it does not mean you are “weak” lacking in willpower and doomed to failure!

Many health coaches and scientists have studied this question and countless methods to facilitate lasting behavioral change. A fairly daunting task, for sure. Lately, many theories converge on the principle of Love versus Fear. What does love have to do with it, you ask? Everything we do comes through motivation from either love or from fear. If you are not enjoying your life, or if fear is an emotion you feel more often than love, joy or peace, then you are probably operating from a primitive, lower brain function which seeks to avoid pain and seek gratification through external means.

The take home message is that all lasting change starts with self – love. The love of self, knowing and accepting your true nature and spirit of greatness, gives rise to love of others and thrusts you to a higher level of function. If love, the most powerful force there is, becomes your primary moving and motivating force, you will naturally seek and gravitate toward healthy foods, habits and the positive reinforcement they create, which is feeling good, healthy, vibrant and strong. That is our birthright. Furthermore,  “Nothing succeeds like success.” As you create positive habits, they reinforce themselves. It is true freedom to make choices that are life enhancing and that affirm self- love.

Think back to the last time you felt pure contentment, a lightness of being, joy or peace, what were you doing? DO more of that! It’s time to give yourself permission to re- discover or find ways of creating more joy. If you are feeling stuck, don’t forget to check in with your belief system, strategy #1.

“Everything we do comes from either Love or from Fear.” Arlosky 


The most common mistake when embarking on a life change for health or personal reasons is to set goals that are unreasonably difficult to stick with and therefore will have a limited degree of success.

An example is beginning a ‘diet’ that is based on the principle of deprivation and elimination. I am certain you can relate to this. You can also most certainly guess why this sort of plan is doomed to fail. If food is a source of pleasure for you and you decide to eliminate every food you are currently considering ‘bad’, you will be miserable. Remember what happens when your brain is miserable? It is pleasure seeking and pain avoiding by nature. Is it any wonder why most diets fail? A simple rule that I will share, is to consider that there are NO foods that are off limits. ( exception of course, are foods that you may have an allergy or intolerance to, and these often times are the very ones you are craving).

Does that mean you can have your fill of donuts and French fries? Of course, the answer is a resounding NO!

As a general rule eating ‘clean’ 80-90% of the time allows time for your body to chemically adjust and down regulate the dopamine and hormonal systems ( insulin, leptin) of reward, cravings etc. Have you ever noticed how when you eat sweet or fatty food, you crave more sweet and fatty food? The formula your body uses is as follows: eat junk, want junk. It’s not in your imagination. It’s a downward spiral due to changes in the chemical and hormonal systems of the body. Your body is very much like a chemistry lab and is inherently good at maintaining status quo and enhancing survival mechanisms.

Do not despair, eating clean is a way of life that will eventually be as automatic as brushing your teeth.

Concentrating on building your meals around Seasonal, Organic, Unprocessed, Local (SOUL) food is the foundation of healthy eating.

Concentrate on building your meals around Seasonal, Organic, Unprocessed, Local ( S.O.U.L) food .This is the foundation of life- long, healthy eating habits. Increase your consumption of vegetables, fruits, healthy fats and oils. Consume foods in their most natural and unaltered states. For example, a baked sweet potato, not French fries. Use the method of ‘crowding out’, that is, filling up on the most “nutrient dense” and healthy foods first and thereby reducing the consumption of the calorie dense, processed, and unhealthy fare. Remember you will always allow yourself the 10-20% ‘free choice’ for a night out or a special occasion. No guilt allowed! EVER!

Make it a practice to increase consumption of water, drinking at least ½ ounce per pound of body weight. A simple practice that has enormous, far reaching health benefits.

Beginning an exercise program gradually, and ramping up intensity slowly, is the kinder more sustainable approach. This will allow you to feel the positive changes without experiencing the negatives of forcing your usually sedentary body to complete a full session of P 90X.

If you are new to exercise, use your smart phone’s app to track the number of steps you take in a day. Set a goal to increase the number of steps weekly until you reach 6,000 steps per day, which is the average for most people, or strive for the 7,000 to 8,000, recommended by the CDC. (Centers for Disease Control). Eventually you may get to 10,000 steps or beyond which is associated with the most health benefits.

Following these simple, real solutions will provide the spring board that moves you forward and allows you to experience success. Success experienced early in the process of life change, is indicative of future and continued success.

If you desire to see yourself in a better place this time next year, you must begin to make different choices.  Quite simply, if you desire a different outcome, you have to make a different choice. One small, next right choice at a time, one day at a time.

If you keep your vision in front of you,  state your intentions,stay focused on the feelings of accomplishment and the health benefits that will inevitably follow, you are sure to end 2017 a happier, healthier you!

Who needs resolutions anyway?

I would love to help you make this transformation a reality. If you have particular health, fitness or rehab issues that you need assistance with, contact me: email:

Visit my website or contact me for New Years “Commitment to Wellness“, 2 for 1 packages!



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