Host: Welcome to the Lifelong Wellness podcast where we talk to wellness professionals from many walks of life from around the world and get their insight into living healthier. I’m your host, Wes Malik. Several months ago we talked to Bill Parravano about knee pain. And during our conversation, when our conversation ended for our listeners, we went on to continue talking about knee pain. And we discovered, both of us, that we had not covered all the areas that we should have and that's why we set up a follow-up podcast to the initial one to talk about eliminating knee pain without drug, shots, surgery or painful physical therapy. Bill Parravano is also known as “The Knee Pain Guru” and that's his website and that's where he can be found on social media. He's got decades of work behind knee pain and he's understood knee pain to a level that I think many people have not. He spent most of his life studying this. He's a martial artist, he’s got a lot of bodywork experience, understanding movement and tension patterns that lead to physical pain. And Bill actually believes the nervous system holds the keys to the body’s healing. Now, to talk about that we have Bill. Let's welcome him to our podcast. Alright Bill, welcome to the Lifelong Wellness podcast, how are you doing today?
Bill: Good, Wes. How are you?
Host: Very good. It’s been many months since we last spoke. And when we spoke last, we went into how you got into working on your own knees and your knee and getting the knowledge and the insight on how the nervous system plays a very large part in fixing knee problems and pain that people have. And we talked at length about that several months ago so thank you very much for that. And today we have you back on the show to talk further about knee pain because there's a lot of questions and a lot of areas that we possibly didn't cover and maybe we can go over a couple of things that we did last time as well and discover new things as well.
Host: Now, last time we spoke about a lot of, you know, how you got into this, but what is the biggest challenge most people have in eliminating knee pain, you think?
Bill: With that, they have to work harder, they have to push through the pain to get out of pain. You know, it’s kind of infusing our culture. Pain is a weakness leaving the body. Just do it. No pain, no gain. We have this saying that we hear and a person in pain, the mentality is, “Öh, in order to get better I need to force my knee to do something that is going to cause it to hurt.” And that, generally, reinforces what I referred to as a pain tension loop. The pain tension loop is the knee hurts, it tenses up because it hurts which is a normal natural response to pain. The tenser it gets, the tighter it squeezes on the nerves that are causing the pain that the person is trying to get out of.
Host: So, what is the remedy to that then? What do you do about that?
Bill: Well, it’s changing the neurological response which is a fancy term, a fancy way of describing you get the knee to relax. And you get the knee to relax by getting the pressure off of the nerves. The nerves that are causing the pain, the nerves that are causing the knee to be tight. And when the knee relaxes because we are creating comfort in the knee, it engages the nervous system in a way that it allows this cascading effect throughout the entire body of not only the knee to relax but the rest of the body to relax as well.
Host: Now, a month’s knee injuries and knee pain, of course, there are different types of injuries, there are different types of knee pain. I mean, there are different things that can go wrong in their…Is it all the time that this method can work or is it only in particular cases of a specific type of knee pain that this relaxing of the nervous system works?
Bill: Well, relaxing the nervous system is going to help knee pain across the board.
Bill: However, not all knee pain is created equal, like you’re just saying. It’s important to determine that if something is broken or torn in the knee, you have a torn meniscus, you have a torn ligament or a torn tendon, you’ve broken or fractured a bone in the knee cap or in the leg or in and around the knee that can cause pain. So, comfort or relaxing the tension, changing neurology in the knee joint is going to help everybody across the board. However, whether or not the pain comes back is going to be determined by if something is broken or torn. Meaning like…The knee can be comfortable, there’s something aren’t that’s broken or torn in the knee. We can get the knee more comfortable, we can reduce the level of pain that it experiences, but the moment the knee moves into a range of motion that irritates that whatever is broken or torn, the knee pain’s going to come back pretty quickly. And there are some people that fall into that category, which is why it's so crucial that they go to a doctor and they get a diagnosis by getting an X-ray or CT scan, MRI, something like that to determine if something is broken or torn or not. However, there’s another side of that equation where there’s a lot of people who have gone to the doctor and they’re not getting answers. It’s like they don't know why the knee hurts. They’re going to the physical therapy and they’re being forced to push through the pain. Some clients I’ve worked with even had to take painkillers in order to get through physical therapy. You have lots of people on the other side of surgeries to repair what was broken or torn, including knee replacement surgery and they’re still in pain. So, make sure you want to question what gives. Why is this experience pain? Why it still exist?
Bill: And that’s where we get back to the source of all pain is going to be nerve irritation. It’s going to be nerves that are being squeezed but are sending a signal that the knee hurts which causes that pain tension loop that affects where the knee tenses up to protect the experience of pain. The body also compensates as well.
Host: Usually a physical injury of the knee like when you’re playing football or extended use of your knee. For example, if you’re a roofer and you’ve got to be on your knees or you're lifting, you know, 50 lbs. bags all the time and you’re using your knees a lot during the course of your career, let’s say you’re in construction or some other similar form of career. Usually, people complained of later on in their, you know, after five or several years of work like that or injury like that they complain of knee pain. Did you come across people like that as well?
Bill: Oh, absolutely.
Bill: There’s a lot of people that many times situations like that are diagnosed as arthritis.
Bill: The person has arthritis and all diagnosis of arthritis is dehydrated joint. The joint actually doesn’t have enough lubrication in it. And it’s because of that pain tension loop that when the knee squeezes tight, it squeezes out the synovial fluid which is supposed to be there to lubricate the joint to make the gliding of the bones on top of the meniscus. And in all of the components of the knee being able to move so easily. But when you’re having a person like that, a roofer, they’re lifting lots of heavy objects every day what happens is the body gets under stress. The body has to be pushed and it’s not that the body can’t be pushed, we don’t have a body recovery mechanisms set up in place or they don’t have the proper maintenance of the use of the body in that repetitive environment that allows the knee joint to recover. And it gets into that pain tension loop, the joint gets dehydrated, the joints begins to wear, the pain begins to increase and as we age it gets more and more difficult for the body to recover after those long days of work. That person will go to a doctor, the doctor will go, “Oh, you have arthritis and we can give you an injection in the knee” and then the idea of the injection is to lubricate the joint. A mechanism that the body has the capability of doing itself if we remove the tension that is going on in the knee as well as in the body that’s causing the synovial fluid to be squeezed out of the joint.
Host: So, what is the…Now, this is the million-dollar question. How do you work with people on correcting that? How do you fix the association of the relaxation of the nervous system and the knee and the joint?
Bill: It’s actually very simple. The process is very simple, it’s through comfort. If I had someone who’s in excruciating knee pain, their experience of their knee in their mind is going to go is exactly where the knee hurts, exactly where the pain is, exactly what motion when they move when they squat, they twist, they go upstairs, they go downstairs to where the knee hurts. What they don’t tell me and what they don’t tend to pay attention to is where the knee doesn’t hurt. That’s where comfort comes in. And when we begin to take our focus off of where the pain is and put it on where the pain is not, that’s where the magic happens within the neurology of the body because the body is able to let go of this tension. And the only person that can feel where the pain is not, is the person who’s feeling the pain. I know it may sound like a few planned words, like trickery or something like that, however it’s not. It’s actually, all of the areas in our movement of what we don’t pay attention to. And when I work with clients, when I work with people who are suffering from knee pain, our focus is to begin or my focus is to begin to take their attention off of where their knees hurt and begin to get a dialogue with them about where their knees, where the knee doesn’t hurt. Where we can begin to explore and engage the neurology in their body where their knee feels good, where the knee feels comfortable, where it feels less tight, less tender, less achy. And what ends up happening is we shift neurological states in the body. The body has two primary neurological states, a fight or flight state also known as a sympathetic state and it also has a rest and relaxes state, a parasympathetic state. And when the body is in pain it’s immediately in a sympathetic state, that fight or flight state. I begin to work with that dialogue with clients to walk them through those areas where the body is in that rest and relax state. And I give specific videos that will base on where they’re saying their knee hurts, I will give them specific video modules to watch that gets the pressure off and eversion making the experienced relief within seconds if not minutes.
Host: So, you’re saying it’s a state of mind more than, you know, it's actually being the pain there, it’s a state of mind, right?
Bill: That’s a component.
Bill: State of mind is absolutely a component because you have…I’ve worked with people, actually, I didn’t work with them very long because their state of mind was such that they wouldn’t even be willing to look at the possibility that the way they view their knee was different than what they’ve been told. So, having an open mind that this is a possibility has to be like a pre-requisite. We can’t work with someone who is not even open to having a, you know, nervous system stage shift so the body relaxes and letting go of the tension. So the mindset or their state of mind is absolutely crucial. However, a person can’t just sit there and meditate and think when are you going to feel better without bringing something to the physical body so the physical body can experience relief to reinforce the mindset that we’re claiming the person needs in order to believe to happen.
Host: So, does that involve any exercises or any kind of movement?
Bill: The physical piece works with the intrinsic movement of the joint.
Bill: There are two different types of movement with the joint. There’s the gross motor movement of the knee joint so the knee joint can extend and it can bend. The intrinsic movement of the joint is slight rotation in the joint, slight forward and back movement, side to side, and apart together. Those intrinsic movements are what squeezes on the nerves and cause the pain.
Bill: And the limits, the gross motor movement which is the extension and fraction of the leg. So, when we begin working with those intrinsic movements, we find these places where we get the pressure off of the tiny little nerves that only the whiff of an eyelash. And what happens is we start changing that neurological state in the knee as well as in the body so is to speed up the recovery time. So, we get better results in a shorter period of time with a lot less time managing and effort.
Host: This definitely sounds like something you can’t do on your own. This is definitely something that you need help with. Where can we find this kind of help? Is it just you who does this or are there other people out there? Do doctors know about this?
Bill: Well, the concept originated from osteopathy. Osteopathic physicians, they have a concept called Structure Governs Function, that’s one of the basic tenants of osteopathy. The work that I learned had its origins in osteopathy which was called Ortho-Bionomy, another modality of bodywork. And it’s all based on putting the body in a position of comfort and the neurological reflexes will engage to let go of the tension. When I injured my knee, my goal was to get my knee back to normal so I could go back to judo and throw people. That was my main love.
Bill: However, when I learned, when I started studying Ortho-Bionomy it was about learning, I would learn how to work on someone else. And there’s a little bit of disconnect because I want to get my own knee better.
Bill: So, there wasn’t exactly a direct connection between knee learning as modality as bodywork and me being able to work on myself which is why I developed the program that I teach clients online on how they can do it for themselves. Where they can figure out if their knee cap hurts they can work with a Module 8 in the Pain Pattern Interrupt section. If the inside of their knee hurts they can work with Module 40, which will take the pressure off of the meniscus. Before having pain in the back of the knee like a Baker's cyst, they can work with Modules 1 and Modules 2 and that begins to relieve that tension in the back of the knee. So, it’s very specific based on where the experience of pain or discomfort is showing up in the knee.
Host: It must be difficult working with clients remotely and not physically be there.
Bill: At first it was because at that time I hadn’t created the videos that I can now point clients to work with them. So, I was trying to walk them through with this experience on the phone and it was a little bit of a very challenging at first. Then I started creating the videos that clients can work with. I can give them the videos, they can watch the videos in their own time and then work with their knee to get relief and we would just have check-ins to see what they noticed, what their awareness was between our calls to know-how, “Well, the pain went away for a little bit and it came back”. Well, now let’s talk about your water intake because water plays a huge role. We’re talking about arthritis being a dehydrated joint. So we need to look at water as far as why the knee didn’t stay out of pain. Or maybe we need to look at supplementation aspect of it, certain supplements that would help the body absorb the water better. Maybe the knee, the hamstrings are too tight so we need to stretch a little bit. Maybe there’s the mobility we need to take into consideration because the tension in the hips and lower back are contributing to what’s going on in the knee. So, it’s a very dynamic process and it’s based on the client showing up, giving feedback, doing the homework, and reporting results to see how we move them from a place of being in pain to getting them out of pain.
Host: So, diet also plays a role amongst the many factors that you work on. It’s not only just the knee, the diet. What’s usually wrong with people’s diet or what do you usually recommend people to change or to add or subtract for knee pain?
Bill: Good question. Let’s zoom out and look at the bigger picture. If there are swelling and inflammation locally in the knee, there’s a good chance because of the stress that the body is under, it’s also experiencing global or systemic inflammation throughout the body. Which means systemic inflammation or inflammation throughout your entire body can happen as a result of stress, it can result because of our diet, it can result because we didn’t drink enough of water, it can happen because of the whole host of life just happening like all of this shelter in place right now, just that stress of daily life of it’s like, “Oh, I can’t go out of my home”. That can cause a level of systemic inflammation in the body. So, now your knee is trying to heal the inflammation locally in the knee at the same time addressing the systemic inflammation in the body. And there are not enough resources that could be…We can begin tweaking the diet to reduce foods that contribute to inflammation. You know, the typical standard American diet, fast food, burgers and fries, lots of sugar, processed foods, foods or diced in colorings and adding some preservatives. Those things make it more difficult for the body to recover and heal what’s going on not only in the knee but also in the entire body. The more we can switch over to the organic, live, fresh produce, foods that we can consume that would help our body recover and regenerate faster, regenerate the cells faster. That’s going to help the systemic inflammation in the body as well as the local inflammation in the knee.
Host: That’s really interesting and that’s very good information, very good advice that you got across. I appreciate that that’s very good. Amongst the other parts, that’s one part of that whole framework that you work on. You mentioned a little while ago, I want to touch and I was hoping you could expand on it a little bit more. Your program, how many modules does it contain or have?
Bill: There are several hundred videos, several hundred modules and it depends on what a client is showing up with…Several hundred modules can be a little bit overwhelming. What I do is on our checkings, on our calls, twice a week I give them maybe 3 or 4 videos, 3 or 4 modules they need to work with. That is what’s going to make the biggest difference in their knee between now and the next time we talk. And this cuts out the guesswork, we get clearer and really focused on what needs to happen. And I will know based on their feedback on the next call as to how what they did worked. Because we get out of it…With the program, we aren’t focusing so much on pain as we are informed that we’re driving from the nervous system. Because if I give you Module 40 to work with that spot that hurts on the inside of your knee and the pain doesn’t change, then I have a whole set of questions I’d ask you about you doing Module 40 that way. If the pain moved, then my questions would be geared towards where did it move to and what module I can give you that would relieve the pain in that knee spot. If the pain got worse, it doesn’t mean what you did was wrong it just means we’ve uncovered a layer of compensation pattern in your knee or in your body that your knee is now able to feel. The underlying pattern that has been going on for probably a very long time then we could begin to address more comprehensively with some of those other things we’ve talked about like water and nutrition, reducing inflammation, doing supplementation.
Host: A little bit of trial and error in the beginning until you focus on what the actual issue is.
Bill: Absolutely. Absolutely.
Host: I have a general observation about people in life and that is people, you know, complained of knee pain. I’ve talked to many people who have, you know, when you’re at the dinner table they bring up, “Oh, I used to be able to do this and now I get to take it easy because that happened”, “Oh, I used to do this and that, you know, sell refrigerators and now I don’t because of this and that”. You talked to a lot of, you know, people who are retired. You know, they’re in their 60s, they’re in their 70s. And a lot of people have just kind of given up. Do you come across people like that and they’re like, “Well yeah, I’m just, you know, live with this now”. What do you say to them? How do you motivate them to say, you know…First of all, the question should be, is it possible for them to actually, you know, recover from their knee pain? I’m pretty sure what your answer is going to be, but I like to hear it from you. And secondly, how would you motivate them to, you know, work on this?
Bill: Well, I believe even the worst-case scenario that a person has not given up hope. There’s some part of them that still believes that their knee can get better. And what needs to happen is we need to nurture and support that part of them that still believes, that still believes that their knee can get better. And what ends up happening is the person that is giving up hope or at least says they give up hope, they’re saying that as a way of reaching out for support, reaching out for attention. And if we focus on that part that is going to give up hope or that just reinforces them to give up hope we could continue to plant that seed of like “There’s a light at the end of the tunnel”. I can’t tell you how many countless people I have had show up that were diagnosed with bone on bone, that was perfect candidates for knee replacement surgery, that are still moving around eight years later on comfortable knees.
Bill: And it’s very, very cool because those people that threw out the, you know, what the doctors were saying as far as like, “Oh, there’s nothing you can do. This is what we’re going to have to end up with. You just let me know when you can’t take the pain anymore”. And when they’ve gotten to that point on the road, they’re like, “Gee, I can’t just live like this. The pain’s excruciating, it’s horrible. What if I did focus on comfort? What if I did start doing this a couple of times a day more often when my knee hurt?”. And my knees started changing. We just nurture that and water that and support that mentality in a way that all of the sudden they started seeing change. Now, the physical experience of discomfort is also supporting that mental belief that it’s possible. And then it becomes a positive feedback loop of what we create more comfort in the knee and now the mind believes it more. It’s totally possible. Yes, and this happened to my knee 20 years ago, 30 years ago. When I was a teenager I was in my 20s or playing college or high school ball or whatever it is. And now we’re beginning to reverse that process and mobility returns, energy returns, they sleep better, they have this experience of like, “Wow! Some just let go in my back and I can bend over easier and touch my toes because I’m not afraid of my knee hurting. And if my knee does hurt I know the things to do to get it out of pain”. And that becomes the reality, that becomes the direction that we’re moving instead of, “It’s hopeless and helpless. There’s nothing we can do. That’s just what happens when we get older’.
Bill: The reality you want to live in.
Host: That’s wonderful. That is really, really wonderful. Lots of people just, maybe they don’t give up but they’re like, “You know what? This is a part of my life” and they accept it. And they’re like, “Okay. Well, I’m going to start living like this now. This is just going to happen”. Even though everyone does go to doctors, they do get, of course, there are different treatments. Now but you, just want to make sure we are very specific, you don’t prescribe drugs or injections or shots or surgery or any of that sort, right?
Bill: That’s correct. No drugs, no shots, no surgery, no physical therapy, things with physical therapy anyway. I’m giving clients simple things that they can do in the comfort of their own home or I make it adaptable to if they stand at work or they sit a lot at work or they walk a lot because of work. I make it adaptable to where their life is or what their situation is. And the more information they’re able to share about where they’re running into challenges with their knees, the more I’m able to go, “Oh, let’s try this”. See how it goes and then report back in.
Host: Bill, usually what advice would you give if somebody who wanted to, you know, work on this just a little bit on their own? Let’s say they don’t want to come to you or another professional like you and there’s no other way but you still wanted to help them. What advice would you give them? What would you say to them just to start off with?
Bill: Start drinking more water and see what happens.
Bill: I know it sounds ridiculously simple.
Bill: However, most of us are walking around kind of like dehydrated. And a lot of pain that we feel in our physical body is the result of the body being chronically dehydrated. We’re supposed to be 80% water and when that drops down below a certain ratio or certain percentage, it makes it more difficult for all the functions in the body to work, including the joints. And you just increase your water intake and see what happens in a day or so, see how your knee feels. And the big piece is not only to do it, but it’s also to pay attention to the to follow on of what happens once you implement something. That’s where a lot of people make mistakes. They think well it’s just a fluke or the knee was out of pain and they won’t keep up with drinking the water. And when the pain comes back they’ll think, “Well, it doesn’t work”. And that’s not just how, you know, our body’s a system. It’s just not how it works. We have to do maintenance on our cars, on our houses, on our jobs, on our relationships and our body is no different.
Host: And it’s the most neglected part. We usually neglect ourselves and keep ourselves as the lowest priority when it comes to all these things in life.
Bill: Isn’t that the truth. (laughing)
Host: Bill, when we talked last time and when we talked today, I want to make sure that I didn’t leave anything out and we didn’t, you know, stir the conversation to something that was important that you wanted to get across to our listeners. Does anything come to mind that you like to talk about or tell our listeners?
Bill: Yes, absolutely and something’s that’s really deemed present for me recently is whenever we experience a thought or emotion, it creates tension in our physical body in someplace. So we have…We lose our job, we have financial stresses, we have relationship stresses, whatever that is. If we slow down, that’s a big if, if we slow down and pay attention, kind of scan our body, there’s always a place where this tension will show up. Meaning, if a person is sitting a lot and they’re having a stressful conversation on the phone, there’s a good chance that you have this stress and tension showing up in your hips and lower back. Or some people clench their fists when they get stressed out or they clench their jaw. And when we begin to make those connections between the experience of our daily life and how pain shows up on our physical body we could begin to see how we can utilize shifting the neurological states in the physical body that can change our mind and our emotions as well. It’s been fascinating for me lately because so many people are so at each other’s throats about so many different things. (laughing) Right now, it’s up as the days go by.
Host: It’s the battle of ideas. That’s what it is.
Bill: Yes and what we can begin doing is by creating comfort in the part of the physical body where we’re feeling this stress and tension and discomfort start to well up in us. Some it could be our chest, our neck or our jaw, lower back, legs. And we could begin working with these patterns that just don’t serve us. And when you go and check for long enough it manifests in pain, in disease, in discomfort, you name it. All of the issues that we would see manifest in our body are a result of tension that gets stuck somewhere, someway somehow.
Host: That’s an excellent take on, you know, what people are experiencing. Bill, how can our listeners get in touch with you?
Bill: The best way would be to head over to my website, thekneepainguru.com. And I have over a decade worth of content on there, 2008 was when I started. They can also find me on, let’s see, on YouTube, Facebook, Twitter, and Instagram.
Host: Is it just The Knee Pain Guru on all of them?
Bill: That’s correct. Yes.
Host: Okay, wonderful. That is so fantastic. Bill, thank you so much again for taking out the time to talk with me and our listeners again about knee pain and sharing your insights. And I hope that there’s a lot of people out there who are living with, you know, knee pain and or any other condition can work on their selves and feel better because, you know, that’s the goal. And that’s what we’re, you know, hoping to accomplish and I hope, you know, if there’s somebody who gets in touch with you can get some relief and find some comfort as well.
Bill: Awesome. Yes, thank you. Thank you, Wes.
Host: Alright, Bill. Thank you very much for being on the Lifelong Wellness podcast. Stay safe and, you know, we still got an uphill battle in the US and in Canada against COVID-19. So, you know, make sure that you’re washing your hands and spreading the correct amount of information, socially distancing yourself and, you know, teaching everyone around you about these things as well.