Healthy Joints for Life: An Orthopedic Surgeon's Proven Plan to Reduce Pain and Inflammation, Avoid Surgery and Get Moving Again

Healthy Joints for Life: An Orthopedic Surgeon's Proven Plan to Reduce Pain and Inflammation, Avoid Surgery and Get Moving Again

by Richard Diana


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No surgery. No medication. No drastic measures. Just healthy joints—for life!

In this groundbreaking book, leading orthopedic surgeon and former NFL player Richard Diana, M.D., applies his unique experience and training to tackle join pain. Based on cutting-edge research that has clarified the crucial role of a molecule known as NFkB in regulating inflammation, Dr. Diana's proven eight-week program teaches you to harness the power of this research to reduce inflammation, relieve pain and rejuvenate your joints.


• Which delicious foods reduce inflammation

• Simple exercises tailored to your ability

• The right supplements to help increase your mobility

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Product Details

ISBN-13: 9780373892709
Publisher: Harlequin
Publication date: 01/28/2014
Edition description: Original
Pages: 352
Sales rank: 512,162
Product dimensions: 6.10(w) x 9.00(h) x 1.50(d)

About the Author

RICHARD DIANA, M.D., retired from the Miami Dolphins after Super Bowl XVII to attend Yale School of Medicine. He has been an orthopedic consultant to several collegiate athletic programs as well as to the Boston Red Sox. Dr. Diana is a board-certified surgeon and has been named a Top 100 Doctor in America. He is a clinical instructor at Yale School of Medicine and attending surgeon at Yale-New Haven Hospital.

Read an Excerpt

Let me tell you about my mother. By the time I graduated from medical school, my sixty-two-year-old mother had already suffered through several surgeries for her rheumatoid arthritis (RA), a despicable form of arthritis where the body attacks its own joints as it would invading bacteria. The resulting inflammatory response is incredibly intense. Multiple joints swell, hurt, and degenerate.

Her treatments were torturous. Regular injections of gold and methotrexate gave her nausea and headaches but didn't reduce her pain. Anti-inflammatory medicines gave her an ulcer. Nothing stopped the aggressive progression of her joint pain and joint destruction.

I was a budding doctor, working around the clock to learn all the answers about how to treat and heal medical conditions. Seeing her suffer from the disease was excruciating. Seeing the treatments make her worse was beyond heart-wrenching. I desperately wanted to help, but her aggressive RA wasn't going to wait for me or medical research. Or anything else. After treatments with countless medications failed miserably, she had surgery to reroute and repair ruptured hand tendons. Her left wrist had to be fused. As a result, she fed herself with difficulty and could barely hold a cup of water. Even before the hand surgeries, standing had become so painful that the ends of several eroded bones in both of her feet had to be removed. Like a relentless tide, the disease slowly but persistently ate away at her joints.

By her seventieth birthday her knees were bone on bone and her hips were equally bad. Her inactivity led to other medical problems, like diabetes and heart disease, so she wasn't healthy enough to have replacement surgery, and she could barely walk by the end. Sadly, my most intimate moments with my mom consisted of me draining the fluid from her swollen knees and shoulders. RA deprived my mother of some of the best days of her life, and all I could do was watch in horror. I was a grown man, a surgeon, and an ex-NFL player, and I cried for my mother-and my kids saw me. They saw my mother, they saw my helplessness, and they understood what RA was doing to all of us.

Because of my mother, I came to hate inflammation and joint pain and what they can do to a person. I will never forget what they did to my mother.


For four decades I've been witnessing the devastating effects of inflammation and joint pain both personally and professionally. For years I've been studying the science behind inflammation and devising ways to defeat it. I now have a battle-tested, scientifically sound game plan to deal with joint pain and inlammation.

As for this book, it will be my job to make the science behind joint pain understandable and interesting. I will spare you most of the gory details but will arm you with enough knowledge so you can better understand what is happening to your joints and how my program will help them. I'll tell you some stories from the NFL, college football, and my medical training and practice. I'll keep it simple and clear. Once you understand my program and put the plan into action, you will start to get your life back. You will start controlling your joint pain, and your joint pain will stop controlling you.

Almost every day of my life as an orthopedic surgeon, I'm asked what it was like to play in the Super Bowl. It always amazes me how important and alluring that one event is. Many of my patients think it's cool that I'm the only orthopedic surgeon to have ever played in the Super Bowl, but the Super Bowl has much greater importance to me than that.

The play-offs for the 1982 season were the first time that my parents ever flew on a plane. Those few weeks were some of the most exciting weeks of their lives. They were on TV, were interviewed by reporters, and were treated like royalty all because their son was playing for the Miami Dolphins in Super Bowl XVII. They came to practices, took pictures with legendary Dolphin coach Don Shula, and met the guys on the team. They sat on the fifty-yard line. For a short time they were treated like the celebrities that I always thought they were, and that meant more to me than anything.

The thing I remember most about the Super Bowl was a conversation that I had right before the game with the captain of our team, Bob Kuechenberg, or "Kooch," as we knew him. Kooch was making the rounds, trying to make sure everybody was ready. He approached me and said, "Rookie, you've been doing it all year for us. Now it's time to help the other guys do it, too." It was just five seconds of encouragement accompanied by a tap on the back. But it made me think like I hadn't before about my role as a player and a leader. It was time for me to step forward and become a team leader. The Super Bowl was the day when I realized that following was not good enough. My mission in life was to help people. hough football was the earlier and greater passion in my life, medicine became my ultimate vocation. Helping people would be my life's mission. Going through medical school, internship, and residency took a long ten years, and as a med student, intern, and resident, I was closely monitored and rigorously tested along the way. In school I wasn't exactly in a position to be a leader. But over the past two decades, I've helped a lot of people, and with this book I hope to help many more. Of course, Kooch couldn't have known what direction my life would take, but I'm convinced that when he spoke to me right before the Super Bowl, his words foreshadowed that my ultimate accomplishment would be leading people with joint pain toward pain relief.

In 2010 the Miami Dolphins invited players from the 1983 and 1985 Super Bowl teams for a reunion. Since my retirement twenty-seven years prior to the reunion, I'd been back to Miami only once, for Dan Marino's retirement celebration. On the light down I thought of all the sweat, pain, and violence we, as players, endured during our quest for the Super Bowl. We learned that success in football comes from dedication, intensity, focus, and passion. It was understood that while we might lose, we would never be outworked. We had an incredible commitment to one another and, of course, to winning. I shuddered as I thought about what we did to our bodies to play the game of football-to win.

It was wonderful to reunite with my teammates. In so many ways nothing had changed, and in so many other ways everything had changed. After retiring from the NFL I became an orthopedic surgeon, applying those principles learned from football to helping those with musculoskeletal problems. At the reunion, I learned quickly that most of my teammates suffered terribly from years of abusing their bodies. Several had knee and hip replacements, two had back fusions, most suffered with neck arthritis, and virtually everyone limped or at least complained of joint pain. Some had put on a few-or more!-pounds. Previous studies on ex-NFL players revealed that those extra pounds were often associated with life-threatening heart disease. I worried about these men, who, decades ago, were my family.

All of us had aged in those intervening decades, and in talking with my teammates, I realized that I had the ability to do something to help them not only with their joint pain but also with a potential scare: heart disease. Those talks with my teammates spawned the idea for this book.

During many nights of research and writing, it became obvious that while my teammates inspired Healthy Joints for Life, this book is long overdue for anyone and everyone who has joint pain and wants to avoid surgery. As an added bonus, the diet, exercise, and supplement recommendations are heart-healthy and cancer preventative, too.

I am conident that Healthy Joints for Life will reduce your joint pain and improve the quality of your life and perhaps even its length! With each chapter, the reward of joint-pain relief and improved health is that much closer. When you can walk on a beach or visit a museum without pain, you will be thankful. When you can make the long walk from the parking lot to see your children or grandchildren play a sport, you will know it's worth it.

Now that you know a little bit about my background, let's take advantage of my discoveries and get to work making your joints feel better.

Understanding Joint Pain

INFLAMMATION: The Cornerstone of Disease

I'm going to start you on the road to joint-pain relief with one simple statement: to control joint pain, you need to control inflammation. Get used to hearing about inflammation, because you are going to learn more about it than you ever imagined. Before you finish this book, you will understand many molecular details of inflammation, as well as some of the most obvious outward symptoms of joint pain, and how and why inflammation drives it. You are going to learn that when you reduce inlammation, you will significantly reduce your joint pain.

Inflammation is the body's mechanism of fighting infection, responding to irritants or injuries, and initiating healing. It comes in many forms. Its manifestations can be as straightforward as the swelling of a sprained ankle or as subtle as the slow, insidious development of joint-surface wear and tear that we call arthritis. Sometimes inlammation is good and necessary. In fact, inlammation plays a key role in the life-sustaining process of fighting infections. But in the case of joint pain, inflammation becomes excessive and it doesn't know when to stop. It's out of control, kind of like I was when I played on special teams for the Miami Dolphins.

Despite being small by NFL standards, I played on a lot of special teams for the Dolphins. One of my tasks was being a wedge buster on kickofs. he wedge buster is the guy who runs down the ield as hard as he can-talk about overzealous-and slams into the opponent's "wedge" of big, tough behemoths who block for the kickoff returner. After smashing the wedge, he tries to tackle the ballcarrier. he job of wedge buster is usually reserved for the craziest guys on the football team. Typically, these guys are beasts who are not on a life path to Mensa. heir marbles are a bit shaken up, partially because their brains were scrambled by gigantic hits while playing on special teams and partially because, well, they started out a little crazy. To run down the field at absolute full speed and slam into an opponent without regard to the well-being of your own body or your opponents' takes a certain perversity-not to mention a total disregard for life and limb. (Unfortunately, we are learning through research that by sustaining gigantic hits while playing on special teams, there may be future devastating brain effects.)

Well, there I was, a Yale graduate and a molecular biophysics and biochemistry major, and I had all sorts of regard for life and limb, but at the same time, I had a job to do. Oddly enough, I loved that job. I loved the contact, the intensity, and the camaraderie. Much more so than the average guy, I loved to smash into people.

During the last preseason game of 1982 I was sent out to wedge bust against the New York Giants. I was the second man to the right of the kicker, a prime spot for making tackles. Before each kickoff I tried to work myself into a frenzy by reciting some of Clint Eastwood's lines from The Outlaw Josey Wales. "When things look bad, and it looks like you're not gonna make it, then you gotta get mean. I mean plumb mad-dog mean. 'Cause if you lose your head and you give up, then you neither live nor win. hat's just the way it is." Other guys would psych themselves up by whacking their helmets until their ears rang. I psyched myself up by reciting lines from Clint Eastwood movies. I never looked at my routine as particularly crazy, but I guess in some ways I was really diferent from many of my teammates.

So there I was, reciting Clint Eastwood lines, smashing into freakishly large and strong brutes, fearing for my life, loving every minute of it, and at the other end of the kickoff was the Giants' mega-money first-round draft pick-a big, fast running back out of the University of Michigan named Butch Woolfolk.

Woolfolk caught the ball at the goal line, at least ten yards to my left, and within ive strides he was running full out. A hole opened at the fifteen-yard line, and Butch was nearly through it when I closed on him from the opposite side and hit him full speed with my helmet, making contact directly on his left hip.

Butch went flying five yards sideways with three twists and a flip. Fireworks went of in my head. Butch, who was tough as nails, got up quickly without the hint of a limp. Proudly, I staggered off the ield with a serious headache. Clearly, Butch's hip was harder than my head.

Inflammation run amok is even more dangerous to your body than Butch Woolfolk was to my head. But we can take care of it. he way we control inlammation is by controlling the way cells use molecules to communicate inlammatory signals.

This probably sounds complicated and technical, but don't worry. I'm not going to take you through all the biochemistry behind cells and molecules and how they work to create inflammation. I'm simply going to help you understand what inflammation does to the body-particularly your joints-and how it can be reduced and potentially stopped.


Nearly any injury or disease that strikes the body involves inlam-mation. Inflammation afflicts the heart with heart disease and other organs with cancer. It can be the reason why your teeth fall out or why your toe hurts when you stub it.

What's ironic is that although there are multiple diseases where inlammation plays a role, inlammation is still a mystery to many. Mainstream doctors haven't fully embraced the inflammatory theory of disease or spread the news to the public, because when most doctors went through medical school, they weren't taught about the impact of inflammation on the body. That is starting to change and will continue to change over the next decade, particularly because, more and more, inlammation is being identiied as the core cause of so many diseases and illnesses.

Remember, inflammation isn't all bad. We could not cope or survive without the inflammatory cycle. If we stopped inflammation completely, we would die. That's why my program seeks to balance inflammation. Swelling is an important part of the inflammatory process. he right amount of swelling facilitates healing. Too much swelling slows healing. Trauma is a typical cause of swelling, but trauma isn't the only cause of swelling or inflammation. Sometimes swelling sneaks up on us, because it begins at the cellular level and we don't feel it until it causes a joint to swell, degenerate, and hurt; heart arteries to narrow and clog (heart attack); lung airways to constrict (asthma); or damaged cells to multiply out of control (cancer).

What causes inflammation? Mechanical stresses from obesity, pollution, job stress, fast foods, and food additives, to name a few. Over time, these irritants can deviously brew in our cells, leading to many insidious diseases, including joint arthritis. A key to maintaining health is balancing the positive and negative effects of inflammation. And the most significant negative effect of inflammation that I want to eliminate, or at least reduce, is joint pain.

Our overall health and the reduction of joint pain are dependent upon keeping inflammation in balance. Monitoring inflammation is a 24-7 job. By following my program, you'll balance inflammation and reduce joint pain.

Table of Contents

Introduction xi

Part 1 Understanding Joint Pain 1

Chapter 1 Inflammation: The Cornerstone of Disease 3

Chapter 2 Joints: How They Work and What Can Go Wrong 19

Chapter 3 Eat: Foods That Reduce Joint Pain 41

Chapter 4 Support: Supplements 89

Chapter 5 Move: How Exercise Helps You Move Better and Feel Better 139

Part 2 The Healthy Joints for Life Program: Eight Weeks to Reduce Pain and Inflammation 185

Chapter 6 Ready: Before You Begin 187

Chapter 7 Week One 211

Chapter 8 Week Two 219

Chapter 9 Week Three 223

Chapter 10 Week Four 229

Chapter 11 Week Five 233

Chapter 12 Week Six 237

Chapter 13 Week Seven 241

Chapter 14 Week Eight 245

Appendix I The Cell Science Behind It All 251

Appendix II How the Healthy Joints for Life Lifestyle Works To Battle Heart Disease and Decrease Cancer Risk 291

Resources 303

Bibliography 305

Index 321

Acknowledgments 331

About the Author 335

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