Understanding Your Fascia
Fascia may be the missing piece for your lingering injury
Published
June 10, 2011
You've got this injury you just can't shake.You take time off. You ice and stretch and do all the right things but you're still limping home. You spend too much time trying to articulate your particular brand of hurt to those loved ones who still put up with you. You follow referrals to physical therapists and massage therapists and you'd 
go to an aromatherapist if it'd help you run again, but nothing does. You diagnose yourself on WebMD: You're a structurally flawed human being for whom recovery is impossible.
DON'T GIVE UP YET
The answer may be right under your fingertips. About 2mm under your fingertips, to be precise. Under your skin, encasing your body and webbing its way through your insides like spider webs, is fascia. Fascia is made up primarily of densely packed collagen fibers that create a full body system of sheets, chords and bags that wrap, divide and permeate every one of your muscles, bones, nerves, blood vessels and organs. Every bit of you is encased in it. You're protected by fascia, connected by fascia and kept in taut human shape by fascia.
Why didn't anyone mention fascia earlier? Because not many people know that much about it. Fascia's messy stuff. It's hard to study. It's so expansive and intertwined it resists the medical standard of being cut up and named for textbook illustrations. Besides that, its function is tricky, more subtle than that of the other systems. For the majority of medical history it's been assumed that bones were our frame, muscles the motor, and fascia just packaging.
In fact, the convention in med-school dissections has been to remove as much of the fascia as possible in order to see what was underneath, the important stuff. That framed Illustration hanging in your doctor's office of the red-muscled, wide-eyed human body is a body with its fascia cut away; it's not what you look like inside, but it's a lot neater and easier to study and it's the way doctors have long been taught to look at you. Until recently, that is.
In 2007 the first international Fascia Research Congress, held at Harvard Medical School, brought about a new demand for attention to the fascial system. Since then fascia has been repeatedly referred to as the "Cinderella Story" of the anatomy world, speaking both to its intrigue and the geekiness of those who study it. While you may not share the medical and bodywork communities' excitement over mechanotransduction and the contractile properties of myofibroblasts, think of it this way: Fascia is a major player in every movement you make and every injury you've ever had, but until five years ago nobody paid it any attention. And now they're making up for lost time.
FASCIA FUNDAMENTALS
What exactly does it do? It wraps around each of your individual internal parts, keeping them separate and allowing them to slide easily with your movements. It's strong, slippery and wet. It creates a sheath around each muscle; because it's stiffer, it resists over-stretching and acts like an anatomical emergency break. It connects your organs to your ribs to your muscles and all your bones to each other. It structures your insides in a feat of engineering, balancing stressors and counter-stressors to create a mobile, flexible and resilient body unit. It generally keeps you from being a big, bone-filled blob.
"Fascia is the missing element in the movement/stability equation," says Tom Myers, author of the acclaimed book Anatomy Trains. Myers was among the first medical professionals to challenge the field's ignorance of fascia in the human body. He has long argued for a more holistic treatment, with a focus on the fascia as an unappreciated overseer. "While every anatomy lists around 600 separate muscles, it is more accurate to say that there is one muscle poured into six hundred pockets of the fascial webbing. The 'illusion' of separate muscles is created by the anatomist's scalpel, dividing tissues along the planes of fascia. This reductive process should not blind us to the reality of the unifying whole."
go to an aromatherapist if it'd help you run again, but nothing does. You diagnose yourself on WebMD: You're a structurally flawed human being for whom recovery is impossible.DON'T GIVE UP YET
The answer may be right under your fingertips. About 2mm under your fingertips, to be precise. Under your skin, encasing your body and webbing its way through your insides like spider webs, is fascia. Fascia is made up primarily of densely packed collagen fibers that create a full body system of sheets, chords and bags that wrap, divide and permeate every one of your muscles, bones, nerves, blood vessels and organs. Every bit of you is encased in it. You're protected by fascia, connected by fascia and kept in taut human shape by fascia.
Why didn't anyone mention fascia earlier? Because not many people know that much about it. Fascia's messy stuff. It's hard to study. It's so expansive and intertwined it resists the medical standard of being cut up and named for textbook illustrations. Besides that, its function is tricky, more subtle than that of the other systems. For the majority of medical history it's been assumed that bones were our frame, muscles the motor, and fascia just packaging.
In fact, the convention in med-school dissections has been to remove as much of the fascia as possible in order to see what was underneath, the important stuff. That framed Illustration hanging in your doctor's office of the red-muscled, wide-eyed human body is a body with its fascia cut away; it's not what you look like inside, but it's a lot neater and easier to study and it's the way doctors have long been taught to look at you. Until recently, that is.
In 2007 the first international Fascia Research Congress, held at Harvard Medical School, brought about a new demand for attention to the fascial system. Since then fascia has been repeatedly referred to as the "Cinderella Story" of the anatomy world, speaking both to its intrigue and the geekiness of those who study it. While you may not share the medical and bodywork communities' excitement over mechanotransduction and the contractile properties of myofibroblasts, think of it this way: Fascia is a major player in every movement you make and every injury you've ever had, but until five years ago nobody paid it any attention. And now they're making up for lost time.
FASCIA FUNDAMENTALS
What exactly does it do? It wraps around each of your individual internal parts, keeping them separate and allowing them to slide easily with your movements. It's strong, slippery and wet. It creates a sheath around each muscle; because it's stiffer, it resists over-stretching and acts like an anatomical emergency break. It connects your organs to your ribs to your muscles and all your bones to each other. It structures your insides in a feat of engineering, balancing stressors and counter-stressors to create a mobile, flexible and resilient body unit. It generally keeps you from being a big, bone-filled blob.
"Fascia is the missing element in the movement/stability equation," says Tom Myers, author of the acclaimed book Anatomy Trains. Myers was among the first medical professionals to challenge the field's ignorance of fascia in the human body. He has long argued for a more holistic treatment, with a focus on the fascia as an unappreciated overseer. "While every anatomy lists around 600 separate muscles, it is more accurate to say that there is one muscle poured into six hundred pockets of the fascial webbing. The 'illusion' of separate muscles is created by the anatomist's scalpel, dividing tissues along the planes of fascia. This reductive process should not blind us to the reality of the unifying whole."
BUT, THAT'S THE OLD NEWS
What rocked the medical community's world was this: Fascia isn't just plastic wrap. Fascia can contract and feel and impact the way you move. It's our richest sense organ, it possess the ability to contract independently of the muscles it surrounds and it responds to stress without your conscious command. That's a big deal. It means that fascia is impacting your movements, for better or worse. It means that this stuff massage therapists and physical therapists and orthopedists have right at their fingertips is the missing variable, the one they've been looking for.
WHAT DOES THIS HAVE TO DO WITH YOU?
Grab hold of the collar of your shirt and give it a little tug. Your whole shirt responds, right? Your collar pulls into the back of your neck. The tail of your shirt inches up the small of your back. Your sleeves move up your forearms. Then it falls back into place. That's a bit like fascia. It fits like a giant, body-hugging T-shirt over your whole body, from the top of your head to the tips of your toes and crisscrossing back and forth and through and back again. You can't move just one piece of it, and you can't make a move without bringing it along.
Now, pull the collar of your shirt again, only this time, hold onto it for eight hours. That's about the time you spend leaning forward over a desk or computer or steering wheel, right? Now, pull it 2,500 times. That's about how many steps you'd take on a half-hour run. Your shirt probably isn't looking too good at this point.
Fortunately, your fascia is tougher than your shirt is, and it has infinitely more self-healing properties. In its healthy state it's smooth and supple and slides easily, allowing you to move and stretch to your full length in any direction, always returning back to its normal state. Unfortunately, it's very unlikely that your fascia maintains its optimal flexibility, shape or texture. Lack of activity will cement the once-supple fibers into place. Chronic stress causes the fibers to thicken in an attempt to protect the underlying muscle. Poor posture and lack of flexibility and repetitive movements pull the fascia into ingrained patterns. Adhesions form within the stuck and damaged fibers like snags in a sweater, and once they've formed they're hard to get rid of.
And, remember, it's everywhere. This webbing is so continuous that If your doctor's office were to add a poster of your true human anatomy, including its fascia, fascia is all you'd see. Thick and white in places like your IT band andplantar fascia, less than 1mm and nearly transparent on your eyelids. And within all that fascia you have adhesions and areas of rigidity. You likely have lots of them.
But, this isn't bad news. Every bit of the damage you've caused your fascia is reversible, and every one of the problems it's caused you were avoidable. You take care of your muscles with stretching and foam rolling and massage. You take care of your bones with diet and restraint. You never knew that you needed to take care of your fascia, but now you do. You may just shake that nagging injury after all.
How to Care for Your Fascia
MOVE IT OR LOSE IT: Sticky adhesions form between fascial surfaces that aren't regularly moved, and over time these adhesions get strong enough to inhibit range of motion. Take a few minutes first thing in the morning to roll around in bed and really stretch out, head to toe, just like a cat after a nap.
STAY LUBRICATED: Just like every other tissue in your body, your fascia is made of water. It works better, moves better and feels better when it's wet. So, drink!
STRETCH YOUR MUSCLES: When your muscles are chronically tight the surrounding fascia tightens along with them. Over time the fascia becomes rigid, compressing the muscles and the nerves.
STRETCH YOUR FASCIA: Once your fascia has tightened up, it doesn't want to let go. Because the fascia can withstand up to 2,000 pounds of pressure per square inch, you're not going to force your way through, so stretch gently. Fascia also works in slower cycles than muscles do, both contracting and stretching more slowly. To stretch the fascia, hold gentle stretches for three to five minutes, relaxing into a hold.
RELAX! If you spend all day tense and tight at a desk, ice baths may not be the best thing for you. Fifteen to 20 minutes in a warm Epsom salt bath can coax tight fascia to loosen up, releasing your muscles from their stranglehold. Make sure to follow it up with 10 minutes of light activity to keep blood from pooling in your muscles.
USE A FOAM ROLLER: Like stretching, using a foam roller on your fascia is different than on your muscles. Be gentle and slow in your movements, and when you find an area of tension hold sustained pressure for three to five minutes. You may practice self-massage with the same rules.
RESPECT YOUR BODY: If you're attempting to run through an injury, or returning from one with a limp, beware: Your fascia will respond to your new mechanics and, eventually, even after your injury is gone, you may maintain that same movement pattern. That's a recipe for an injury cycle. It's better to take some extra time than to set yourself up for long-term trouble.
SEE A FASCIAL SPECIALIST: If you have a nagging injury, or just don't feel right lately, see if your area has a fascial or myofascial therapy specialist. There are different philosophies and methods, ranging from Rolfing, which is very aggressive, to fascial unwinding, which is very gentle. Some methods are similar to massage, while others concentrate on long assisted stretches. Talk to the therapist to see what you need and want. Some osteopaths, chiropractors, physical therapists and massage therapists are beginning to embrace fascial therapies, so ask around.
SEE A MOVEMENT EDUCATION THERAPIST: The Alexander Technique and the Feldenkrais Method are the two best known of this sort of therapy, long embraced by dancers and gymnasts. They use verbal cues, light touch and simple exercises to lessen unconscious destructive movement patterns that may be irritating your fascia.
What rocked the medical community's world was this: Fascia isn't just plastic wrap. Fascia can contract and feel and impact the way you move. It's our richest sense organ, it possess the ability to contract independently of the muscles it surrounds and it responds to stress without your conscious command. That's a big deal. It means that fascia is impacting your movements, for better or worse. It means that this stuff massage therapists and physical therapists and orthopedists have right at their fingertips is the missing variable, the one they've been looking for.
WHAT DOES THIS HAVE TO DO WITH YOU?
Grab hold of the collar of your shirt and give it a little tug. Your whole shirt responds, right? Your collar pulls into the back of your neck. The tail of your shirt inches up the small of your back. Your sleeves move up your forearms. Then it falls back into place. That's a bit like fascia. It fits like a giant, body-hugging T-shirt over your whole body, from the top of your head to the tips of your toes and crisscrossing back and forth and through and back again. You can't move just one piece of it, and you can't make a move without bringing it along.
Now, pull the collar of your shirt again, only this time, hold onto it for eight hours. That's about the time you spend leaning forward over a desk or computer or steering wheel, right? Now, pull it 2,500 times. That's about how many steps you'd take on a half-hour run. Your shirt probably isn't looking too good at this point.
Fortunately, your fascia is tougher than your shirt is, and it has infinitely more self-healing properties. In its healthy state it's smooth and supple and slides easily, allowing you to move and stretch to your full length in any direction, always returning back to its normal state. Unfortunately, it's very unlikely that your fascia maintains its optimal flexibility, shape or texture. Lack of activity will cement the once-supple fibers into place. Chronic stress causes the fibers to thicken in an attempt to protect the underlying muscle. Poor posture and lack of flexibility and repetitive movements pull the fascia into ingrained patterns. Adhesions form within the stuck and damaged fibers like snags in a sweater, and once they've formed they're hard to get rid of.
And, remember, it's everywhere. This webbing is so continuous that If your doctor's office were to add a poster of your true human anatomy, including its fascia, fascia is all you'd see. Thick and white in places like your IT band andplantar fascia, less than 1mm and nearly transparent on your eyelids. And within all that fascia you have adhesions and areas of rigidity. You likely have lots of them.
But, this isn't bad news. Every bit of the damage you've caused your fascia is reversible, and every one of the problems it's caused you were avoidable. You take care of your muscles with stretching and foam rolling and massage. You take care of your bones with diet and restraint. You never knew that you needed to take care of your fascia, but now you do. You may just shake that nagging injury after all.
How to Care for Your Fascia
MOVE IT OR LOSE IT: Sticky adhesions form between fascial surfaces that aren't regularly moved, and over time these adhesions get strong enough to inhibit range of motion. Take a few minutes first thing in the morning to roll around in bed and really stretch out, head to toe, just like a cat after a nap.
STAY LUBRICATED: Just like every other tissue in your body, your fascia is made of water. It works better, moves better and feels better when it's wet. So, drink!
STRETCH YOUR MUSCLES: When your muscles are chronically tight the surrounding fascia tightens along with them. Over time the fascia becomes rigid, compressing the muscles and the nerves.
STRETCH YOUR FASCIA: Once your fascia has tightened up, it doesn't want to let go. Because the fascia can withstand up to 2,000 pounds of pressure per square inch, you're not going to force your way through, so stretch gently. Fascia also works in slower cycles than muscles do, both contracting and stretching more slowly. To stretch the fascia, hold gentle stretches for three to five minutes, relaxing into a hold.
RELAX! If you spend all day tense and tight at a desk, ice baths may not be the best thing for you. Fifteen to 20 minutes in a warm Epsom salt bath can coax tight fascia to loosen up, releasing your muscles from their stranglehold. Make sure to follow it up with 10 minutes of light activity to keep blood from pooling in your muscles.
USE A FOAM ROLLER: Like stretching, using a foam roller on your fascia is different than on your muscles. Be gentle and slow in your movements, and when you find an area of tension hold sustained pressure for three to five minutes. You may practice self-massage with the same rules.
RESPECT YOUR BODY: If you're attempting to run through an injury, or returning from one with a limp, beware: Your fascia will respond to your new mechanics and, eventually, even after your injury is gone, you may maintain that same movement pattern. That's a recipe for an injury cycle. It's better to take some extra time than to set yourself up for long-term trouble.
SEE A FASCIAL SPECIALIST: If you have a nagging injury, or just don't feel right lately, see if your area has a fascial or myofascial therapy specialist. There are different philosophies and methods, ranging from Rolfing, which is very aggressive, to fascial unwinding, which is very gentle. Some methods are similar to massage, while others concentrate on long assisted stretches. Talk to the therapist to see what you need and want. Some osteopaths, chiropractors, physical therapists and massage therapists are beginning to embrace fascial therapies, so ask around.
SEE A MOVEMENT EDUCATION THERAPIST: The Alexander Technique and the Feldenkrais Method are the two best known of this sort of therapy, long embraced by dancers and gymnasts. They use verbal cues, light touch and simple exercises to lessen unconscious destructive movement patterns that may be irritating your fascia.
Meditation Found To Increase Brain Size
Mental calisthenics bulk up some layers
By William J. Cromie Harvard News Office
People who meditate grow bigger brains than those who don't.
Researchers at Harvard, Yale, and the Massachusetts Institute of Technology have found the first evidence that meditation can alter the physical structure of our brains. Brain scans they conducted reveal that experienced meditators boasted increased thickness in parts of the brain that deal with attention and processing sensory input.
In one area of gray matter, the thickening turns out to be more pronounced in older than in younger people. That's intriguing because those sections of the human cortex, or thinking cap, normally get thinner as we age.
"Our data suggest that meditation practice can promote cortical plasticity in adults in areas important for cognitive and emotional processing and well-being," says Sara Lazar, leader of the study and a psychologist at Harvard Medical School. "These findings are consistent with other studies that demonstrated increased thickness of music areas in the brains of musicians, and visual and motor areas in the brains of jugglers. In other words, the structure of an adult brain can change in response to repeated practice."
The researchers compared brain scans of 20 experienced meditators with those of 15 nonmeditators. Four of the former taught meditation or yoga, but they were not monks living in seclusion. The rest worked in careers such as law, health care, and journalism. All the participants were white. During scanning, the meditators meditated; the others just relaxed and thought about whatever they wanted.
Meditators did Buddhist "insight meditation," which focuses on whatever is there, like noise or body sensations. It doesn't involve "om," other mantras, or chanting.
"The goal is to pay attention to sensory experience, rather than to your thoughts about the sensory experience," Lazar explains. "For example, if you suddenly hear a noise, you just listen to it rather than thinking about it. If your leg falls asleep, you just notice the physical sensations. If nothing is there, you pay attention to your breathing." Successful meditators get used to not thinking or elaborating things in their mind.
Study participants meditated an average of about 40 minutes a day. Some had been doing it for only a year, others for decades. Depth of the meditation was measured by the slowing of breathing rates. Those most deeply involved in the meditation showed the greatest changes in brain structure. "This strongly suggests," Lazar concludes, "that the differences in brain structure were caused by the meditation, rather than that differences in brain thickness got them into meditation in the first place."
Lazar took up meditation about 10 years ago and now practices insight meditation about three times a week. At first she was not sure it would work. But "I have definitely experienced beneficial changes," she says. "It reduces stress [and] increases my clarity of thought and my tolerance for staying focused in difficult situations."
Controlling random thoughts
Insight meditation can be practiced anytime, anywhere. "People who do it quickly realize that much of what goes on in their heads involves random thoughts that often have little substance," Lazar comments. "The goal is not so much to 'empty' your head, but to not get caught up in random thoughts that pop into consciousness."
She uses this example: Facing an important deadline, people tend to worry about what will happen if they miss it, or if the end product will be good enough to suit the boss. You can drive yourself crazy with unproductive "what if" worry. "If, instead, you focus on the present moment, on what needs to be done and what is happening right now, then much of the feeling of stress goes away," Lazar says. "Feelings become less obstructive and more motivational."
The increased thickness of gray matter is not very much, 4 to 8 thousandths of an inch. "These increases are proportional to the time a person has been meditating during their lives," Lazar notes. "This suggests that the thickness differences are acquired through extensive practice and not simply due to differences between meditators and nonmeditators."
As small as they are, you can bet those differences are going to lead to lots more studies to find out just what is going on and how meditation might better be used to improve health and well-being, and even slow aging.
More basic questions need to be answered. What causes the increased thickness? Does meditation produce more connections between brain cells, or more blood vessels? How does increased brain thickness influence daily behavior? Does it promote increased communication between intellectual and emotional areas of the brain?
To get answers, larger studies are planned at Massachusetts General Hospital, the Harvard-affiliated facility where Lazar is a research scientist and where these first studies were done. That work included only 20 meditators and their brains were scanned only once.
"The results were very encouraging," Lazar remarks. "But further research needs to be done using a larger number of people and testing them multiple times. We also need to examine their brains both before and after learning to meditate. Our group is currently planning to do this. Eventually, such research should reveal more about the function of the thickening; that is, how it affects emotions and knowing in terms of both awareness and judgment."
Slowing aging?
Since this type of meditation counteracts the natural thinning of the thinking surface of the brain, could it play a role in slowing - even reversing - aging? That could really be mind-boggling in the most positive sense.
Lazar is cautious in her answer. "Our data suggest that one small bit of brain appears to have a slower rate of cortical thinning, so meditation may help slow some aspects of cognitive aging," she agrees. "But it's important to remember that monks and yogis suffer from the same ailments as the rest of us. They get old and die, too. However, they do claim to enjoy an increased capacity for attention and memory."
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Sitting risks: How harmful is too much sitting?
What are the risks of sitting too much?
Answer
from James A. Levine, M.D., Ph.D.
Researchers have linked sitting for long periods of time with a number of health concerns, including obesity and metabolic syndrome — a cluster of conditions that includes increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol levels.
Too much sitting also seems to increase the risk of death from cardiovascular disease and cancer.
One recent study compared adults who spent less than two hours a day in front of the TV or other screen-based entertainment with those who logged more than four hours a day of recreational screen time. Those with greater screen time had:
- A nearly 50 percent increased risk of death from any cause
- About a 125 percent increased risk of events associated with cardiovascular disease, such as chest pain (angina) or heart attack
The increased risk was separate from other traditional risk factors for cardiovascular disease, such as smoking or high blood pressure.
Sitting in front of the TV isn't the only concern. Any extended sitting — such as behind a desk at work or behind the wheel — can be harmful. What's more, spending a few hours a week at the gym or otherwise engaged in moderate or vigorous activity doesn't seem to significantly offset the risk.
Rather, the solution seems to be less sitting and more moving overall. You might start by simply standing rather than sitting whenever you have the chance.
For example:
- Stand while talking on the phone or eating lunch.
- If you work at a desk for long periods of time, try a standing desk — or improvise with a high table or counter.
Better yet, think about ways to walk while you work:
- Walk laps with your colleagues rather than gathering in a conference room for meetings.
- Position your work surface above a treadmill — with a computer screen and keyboard on a stand or a specialized treadmill-ready vertical desk — so that you can be in motion throughout the day.
The impact of movement — even leisurely movement — can be profound. For starters, you'll burn more calories. This might lead to weight loss and increased energy.
Even better, the muscle activity needed for standing and other movement seems to trigger important processes related to the breakdown of fats and sugars within the body. When you sit, these processes stall — and your health risks increase. When you're standing or actively moving, you kick the processes back into action.
Six Common Surgeries That Are Often Unnecessary
Dr. Mercola suggests that it’s worth getting a second opinion before you have virtually any non-emergency surgery. However, if you’re scheduled for one of the following procedures, it becomes even more imperative to seek another expert’s opinion, as these surgeries carry a high risk of being done without medical necessity.Yes I realize there is a cost and significant hassle factor, but I strongly encourage to do your due diligence. The extra time and resources you invest in confirming the necessity of the surgery could have a major impact on your ability to enjoy the rest of your life.1. Cardiac Angioplasty, StentsThis invasive procedure involves inflating a thin balloon in a narrowed artery to crush plaque deposits; a stent (a wire mesh tube) is often then left behind to keep the vessel open. When used during a heart attack, an angioplasty can quickly open a blocked artery to lessen the damage to your heart, and when used in this way can be lifesaving.However, oftentimes heart disease patients receive angioplasties even though they have not had a heart attack -- a decision that goes against the latest medical guidelines. One 2011 study found that 12 percent of all angioplasty procedures (in cases that did not involve an acute heart attack) were not medically necessary.4 Separate research also revealed that angioplasty offers no benefit compared to less invasive treatment of heart disease.2. Cardiac PacemakersPacemakers are used to correct heartbeat irregularities, but research shows that more than 22 percent of these implants may be unnecessary.3. Spinal Fusion Back SurgeryIf you have low back pain and see different specialists you will get different tests: rheumatologists will order blood tests, neurologists will order nerve impulse tests, and surgeons will order MRIs and CT scans. But no matter what tests you get, you'll probably end up with a spinal fusion because it's one of the "more lucrative procedures in medicine," author Shannon Brownlee says – even though the best success rate for spinal fusions is only 25 percent!According to one review, more than 17 percent of patients told they needed spinal surgery actually showed no abnormal neurological or radiographic findings that would require surgery.4. HysterectomyThe surgical removal of the uterus may be recommended inappropriately in 70 percent of cases, often because of a lack of adequate diagnostic evaluation and failure to try alternative treatments before the surgery. Some surgeons also remove healthy ovaries during hysterectomy as a ‘precaution,’ sometimes without the patient providing their consent or being informed as to the severe adverse effects the ovariectomy may produce on their remaining quality of life.5. Knee and Hip Replacement, and Arthroscopic Knee SurgeryPatients who were informed about joint replacements and alternative treatments had 26 percent fewer hip replacements and 38 percent fewer knee replacements than those who did not.9 Arthroscopic knee surgery for osteoarthritis is also one of the most unnecessary surgeries performed today, as it works no better than a placebo surgery.Proof of this is a double-blind placebo-controlled multi-center (including Harvard’s Mass General Hospital) study published in one of the most well-respected medical journals on the planet, the New England Journal of Medicine(NEJM) over 10 years ago.10Recent research has also shown arthroscopic knee surgery works no better than placebo surgery, and when comparing treatments for knee pain, physical therapy was found to be just as effective as surgery, but at significantly reduced cost and risk.11 And yet another study showed exercise is just as effective as surgery for people with chronic pain in the front part of their knee, known as chronic patellofemoral syndrome (PFPS), which is also frequently treated unnecessarily with arthroscopic surgery.126. Cesarean SectionCesarean delivery is the most commonly performed surgical procedure in the US and rates are increasing. But research shows rates vary 10-fold among hospitals, even among low-risk pregnancies,13 suggesting that practice patterns, not necessity, are driving these high surgery rates.According to the World Health Organization, no country is justified in having a cesarean rate greater than 10 percent to 15 percent. The US rate, at nearly 32 percent, is the highest rate ever reported in the US and is higher than in most other developed countries.
Copyright 2007 by the President and Fellows of Harvard College
