3 Ways To Naturally Reduce Hot Flashes

3 Ways To Naturally Reduce Hot Flashes

Living With Hot flashes

doesn't have to be difficult

Hot flashes can strike with little or no warning. They can be extremely uncomfortable, embarrassing in certain situations, and affect your quality of life. Unfortunately, hot flashes are an unavoidable regular occurrence for most, if not all, perimenopausal and menopausal women.

Menopause happens in three stages:

  • First, perimenopause is when the body’s production of estrogen begins to slow. This stage can last for a couple years. 
  • Menopause actually begins when a woman has not experienced a menstrual cycle in over a year. 
  • Postmenopause is when the time after menopause has ended – the symptoms will begin to lessen. However, some symptoms, such as hot flashes, mood swings, or night sweats can still continue for up to two years after menopause has technically ended.

This means that many uncomfortable symptoms - such as hot flashes - can last for many years as you travel through the cycles of menopause and beyond.

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Here are three simple ways you may potentially reduce the number and severity of the hot flashes you experience:

  1. Make lifestyle changes. A simple way to help get through your day while experiencing hot flashes is to give yourself the ability to cool yourself off whenever it becomes necessary. Making simple wardrobe changes like wearing layers every day makes it easy to take off a cardigan, light jacket, or scarf whenever a hot flash begins. Other lifestyle changes, including quitting smoking, losing weight, or increasing your daily activity with short walks or exercise routines can help lessen the frequency of hot flashes. 

  2. Try supplements, vitamins, and herbal remedies. Black Cohosh has received a lot of attention for its possible effects on hot flashes. Evening Primrose Oil, which you can find in most drugstores, is also a botanical that is believed to relieve hot flashes. Other possible remedies include sage, ginseng or hops.  Menopause is, essentially, the symptoms of a hormone imbalance as your body changes with time. Herbs and supplements that promote balance can be helpful additions to your wellness routine and make your symptoms less severe. 

  3. Reduce stress. Did you know that hot flashes can be caused by outside factors? Anything from stress at work, tight clothing, taxing physical activity, or too much caffeine or alcohol can trigger a hot flash. You can reduce stress and anxiety by slowly building up an exercise regimen, especially yoga and walking, or engaging in something else low-stress; gardening or a similar hobby works well. Techniques such as meditation can also help. Sleep is very important for stress reduction and adaptation; you can receive more sleep by using melatonin as a sleep aid, or start taking CBD as it has proven anti-anxiety and potential sleep benefits.

Well Theory: a Better Way to Wellness

a surgeon developed solution that’s different

As with all new therapies, you should always consult your physician prior to beginning a new wellness regimen – especially those that include supplements.

You have to make sure that your new supplements don’t interact negatively with any medications you’re on, and the best way to do so is consulting your prescribing physician.  If your physician does not know, engage a natural medicine knowledgeable doctor as soon as possible.

You can download our free Menopause Guide for even more helpful tips, tricks, and resources for managing your menopause symptoms successfully!

Surgeon Formulated
For Your Peace of Mind

Natural Ingredients + Cutting-Edge Medical Breakthroughs.

  • 100% NATURAL

Why You Should Consider A Multivitamin Before Surgery

Why You Should Consider A Multivitamin Before Surgery

Why You need a daily multivitamin

before getting surgery

When you are about to undergo surgery, you are usually given a pre-operation checklist for certain things to do or avoid as you prepare for your procedure. This can include things like a round of preemptive antibiotics, not eating certain foods or fasting 12-24 hours before your surgery, etc.


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It’s important to take your surgeon’s advice while you’re preparing for your surgery. Not only are surgeons skilled enough to understand the science behind these procedures, they are also experts in the science behind healing. Nutrition is a key factor in repairing tissues affected by surgery, and starting a supplement regimen is a great way to make sure your body is optimized and ready to begin the healing process.

healing after surgery

and getting back to normal

The healing process after your surgery centers on the building of collagen – which is the main component in many tissues, such as your skin, tendons, muscles, ligaments, cartilage, blood vessels, bone, and more. Basically, any tissue that can be affected by surgery – “surgically traumatized tissue” – needs collagen to rebuild. The production of collagen, and the overall healing process, happens in three stages after surgery:

  • Inflammatory phase (up to 5 days): Right after surgery, the body forms a blood clot to stop bleeding. Infection-fighting cells and debris-cleaning cells are sent to the surgical site. Redness, swelling, and inflammation ensues.
  • Proliferative phase (2 days – 3 weeks): Fibroblasts, specialized collagen-forming cells, start building tissue at the surgical site.
  • Remodeling phase (3 weeks – beyond): Over time, the body slowly replaces the collagen that was initially formed at the surgical site with stronger collagen – to strengthen the tissue at the surgical site and promote better function over time.

Without proper nutrition, this healing process can take longer and may even encounter complications. A balanced diet, including essential vitamins and minerals, is extremely important for your healing experience to go smoothly. This is why many surgeons will recommend a multivitamin or specialized supplement regimen before and after surgery.

The right amount and combination of supplements can greatly impact your surgical recovery in a positive way. But you shouldn’t start a supplement regimen without guidance.

Inform (And ask!) Your doctor

about supplements

While most supplements should be safe and beneficial to take as you’re preparing for surgery, there are some supplements that could actually harm your recovery process. For example, certain herbal supplements and over-the-counter drugs can reduce your body’s ability to clot blood – an essential component of a smooth recovery. Other supplements can interact negatively with other medications your surgeon may recommend for your healing process.

Your doctor would be more than happy to recommend certain vitamins and minerals to promote healing, and can tell you which supplements to avoid or discontinue while leading up to surgery. You should bring up supplements during your pre-op consultation to make sure there are no delays, as it can take a week or more for any medications to fully leave your system.

Surgeon-Designed Multivitamin

for your peace of mind

If your doctor prescribes many different vitamins and minerals, your pre- and post-op supplement routine can get expensive, and complicated, very quickly. It’s far easier to carefully choose an inclusive multivitamin and have your doctor confirm that none of the ingredients would interfere with your procedure.

In her years of practice, orthopedic surgeon Dr. Meredith Warner found herself prescribing many different supplements and multivitamins to help her patients prepare for surgery. She specializes in surgical procedures impacting the foot – which contains nearly one-fourth of all bones in the human body. The foot is a complex, flexible structure that contains bones, joints, and more than 100 muscles, tendons and ligaments… all working together to enable movement and balance.

For procedures as high-stakes as these, she believes that proper preparation is essential for ideal outcomes for her patients. This is why she created a multi to support the connective tissue in your body. It contains highly fortified ingredients ideal for pre- and post-surgery recovery, including Calcium Citrate, Magnesium Oxide, Full Spectrum Hemp Powder, Vitamin C (ascorbic acid),Vitamin D3 (cholecalciferol), Zinc Gluconate, and more.

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CBD Vitamin + Multivitamin by Well Theory

One convenient daily serving has everything she recommends her patients take daily to promote surgical recovery and overall musculoskeletal health. Gain peace of mind before your procedure by using our breakthrough formulation that was completely designed for orthopedic conditions.

More Details About Dr. Warner's Custom

designed connective tissue vitamin

These ingredients work best together – while each is a necessary supplement on its own, together they pack a powerful punch.

Full Spectrum Hemp Powder

Hemp interacts naturally with your endocannabinoid system to add a long-lasting anti-inflammatory, tons of antioxidants, and a pain-relieving component.

Vitamin C

Vitamin C promotes proper collagen formation and helps with wound healing, supports the joints, and contributes to healthy bones & teeth.

Calcium Citrate

Calcium Citrate helps promote healthy bone growth, and is integral to nerve signaling & muscle contractions.

Vitamin D3

Vitamin D3 aids in your body’s ability to absorb calcium and supports nerve health. Important to almost every human system.

Magnesium Oxide

Magnesium Oxide also regulates magnesium levels to reduce muscle cramps, fortifies the bones, and is essential for nerve and muscle function.

Zinc Gluconate

Zinc Gluconate is an awesome assistant for wound healing and connective tissue - and also promotes tissue growth and development.

Promoting balance + health at a cellular level is key to maintaining function for many years to come, and recovering from any procedures you may need in the future. Choose the Well Theory Bone & Joint Health Multi to help achieve baseline wellness and promote cellular health.

5 Most Common Causes of Knee Pain

Knee pain can be unbearable but can be even more frustrating if you don’t understand what is causing or why it’s not getting better. Unfortunately, most pain related to your knees gets worse over time. What can start out as stiffness or aches can, if left untreated, turn into a problem that can only be fixed with surgery. Sometimes, icing or over-the-counter medications may help. Other times, therapy or braces may be needed.

Recovery is determined by the condition and its severity. However, the first step in recovery is understanding what’s causing your pain in the first place.

Meniscal Tears

The sturdy and flexible, hard tissue that covers the ends of our bones is known as cartilage. Knee cartilage is supported by two menisci (semicircular cushions of collagen between the cartilage surfaces): the medial and the lateral meniscus. This information is essential because this is where most “tears” take place within the knee.

A meniscal tear is about as painful as it sounds – causing the torn edged to get stuck in the joint, creating a “catching” sensation in joint. Meniscal tears cause swelling and can sometimes lock the knee.


One of the most common causes of knee pain and disability is arthritis. As a general inflammatory condition, arthritis is split into three common types when it comes to knee pain: rheumatoid, post-traumatic, and osteoarthritis. While these all differ based on how they’re caused and what they affect, the most common of the three is osteoarthritis, which is the continual wear-and-tear of cartilage in the knee joint.

Osteoarthritis has a strong genetic component. Most frequently seen in older individuals, osteoarthritis can cause limited range of motion, tenderness, and weakness in the knees. No matter what form of arthritis is present, they all share the common characteristic of stiffness and swelling, making it hard to bend the knee. There is no cure for osteoarthritis at this time; however, there are several treatment options available to treat the symptoms.


Ligament Injuries

Ligaments connect the thigh bone (femur) to our lower leg bones (tibia). Ligaments hold our bones together and keep them stable. Most common in sports injuries, ligament sprains and tears can occur in the medial collateral ligament (MCL), posterior cruciate ligament (PCL), and anterior cruciate ligament (ACL). This type of injury can create severe pain and is characterized by the swelling and instability that these injuries cause. These injuries often need bracing and therapy and may require therapy.



Inflammation of the knee can become a problem for most as it is often the result or cause of other conditions such as arthritis, tendonitis, injuries, tears, etc. Inflammation can affect tendons, ligaments, cartilage, muscles and much more. While the pain you experience from inflammation can vary from mild to severe, you should always make sure to treat it before it gets worse. Chronic inflammation can often lead to more damage, increased pain, and a loss of cartilage. With inflammation, the body produces proteins and chemicals that promote swelling and pain.

Patellar Fractures

The kneecap acts as a protector to the knee, so a break within it is often caused by a fall onto the knee or against the dashboard during a vehicle collision of some kind. For those whose bones are weakened from osteoporosis, a fracture can occur by just misstepping, making it difficult or impossible to walk and straighten the knee. The patella increases the efficiency of the quadricep muscles and is often under a lot of stress. There are many other fractures of the knee possible as well.

Unless it’s a dislocation or fracture, the causes of knee pain may all seem the same to you. It’s difficult to honestly know what your condition is without seeing a professional. Don’t try and self-diagnose, or sweep the issue away, as untreated knee pain can only get worse over time. Contact a specialist today if you’re experiencing any knee pain or discomfort and so that you can start moving toward recovery.

Our Bone & Joint Health Multi is a great option for steadily improving joint health + function every day. Orthopedic surgeon Dr. Meredith Warner designed this multi based on what she recommends for her patients with musculoskeletal conditions – especially those who are considering surgery – so they can recover, faster. 

Shoulder Pain and Common Shoulder Problems

Are You Experiencing Intense Shoulder Pain?

There are a few signs you should look out for when determining whether to visit your doctor for a shoulder injury. The first and most immediate sign is extreme pain. If you’re experiencing severe pain as you move or touch your shoulder, it’s time to visit the doctor.

Before scheduling a visit, you may look at your shoulder and note any visible deformities. Your blood vessels and nerves may be damaged if you feel numbness, tingling or cold near the site of injury.

If your shoulder is injured due to trauma, we suggest seeking medical care immediately.

If you’ve been enduring persistent shoulder pain, that has worsened over time call a doctor immediately. Most home treatments are ineffective for serious shoulder injuries, and professional guidance may be necessary to ensure a safe recovery.

A waiting period helps some people determine whether they’ve severely damaged their shoulder. However, you shouldn’t wait longer than a few days if your shoulder is deformed, experiencing loss of feeling or extreme pain.

Again, if there has been trauma or there is moderate to severe pain or numbness and tightening, a professional assessment should occur as soon as possible.

Most Common Shoulder Injuries

People experience many types of shoulder injuries every year and identifying the true condition you’re experiencing is the most efficient route to finding the best treatment.

A rotator cuff tear is one of the most commonly reported forms of a shoulder injury. The condition is caused by tears or strains and often occurs with bursitis or tendinitis.

Frozen shoulder, which causes the tissue in the joint to thickens and tightens, is also one of the more common causes of shoulder pain. Frozen shoulder also presents a loss of motion.

Professional treatment is certainly required for these conditions.

Long-term conditions, like arthritis, cause persistent shoulder pain and are best treated with a professionally-developed treatment regimen.


Why Should You See an Orthopedic Surgeon?

Orthopedic doctors specialize in treatments related to the injuries or damage to the musculoskeletal system, including the shoulder.

Every day these doctors work with patients with injuries that have made it difficult to perform daily activities, suffer from chronic pain, and experience a decreased range of motion.

Orthopedic doctors can identify the source of your shoulder pain and develop a specific treatment path for you.


Care for Shoulder Pain & Shoulder Injuries?

Shoulder pain can result from a number of different causes, including arthritis, tendonitis, and joint dislocation.

Damage can occur from lifting heavy weight or through sports-related injuries, creating a dislocated joint or fracture. If you are experiencing any severe pain, visible muscle deformities, or persistent pain that has worsened over time, you should seek medical care immediately.

The severity of pain and damage to bones or joints will allow specialists to prescribe operative or non-operative treatment plans to help you return to a pain-free life.

Well Theory’s surgeon-curated line of products was designed to give you a safe + natural alternative to invasive measures. Use our cream and spray to gently, safely, and naturally soothe away topical aches and pains. Expertly crafted with soothing lidocaine, menthol, pure Hemp CBD isolate, and a carefully selected blend of essential oils.

Easy and Natural Tips to Heal That Bruise

Muscle contusions (bruise) are common in athletes but also in everyday people. In fact, are the second most common cause of sports injuries. Contusions typically heal quickly without forcing the athlete to take extensive time off. However, severe contusions can cause deep tissue damage and keep them out of the game for months.


Contusions occur after a blow from a blunt object strikes the body and crushes the muscle fibers and connective tissue without breaking the skin.

A contusion can happen from falling or pushing against a hard surface. A contusion can be as traumatic and painful as a tear or break (fracture); however, they are often underestimated since they can’t be seen.


Contusions are known to cause swelling and pain near the area of injury. Damaged blood vessels result in a bluish discoloration. A pool of blood can collect within the damaged tissue and form a bump. The muscle may feel weak, stiff and sore days after the injury is incurred. If damage is extensive a broken bone, sprain, tear or other injury may also be present.

Contusions of the abdomen may damage internal organs. Contusions in superficial locations, such as the shin (tibia) or elbow can have blue, black, brown and yellow discolorations for weeks.



The RICE (Rest, Ice, Compression, Elevation) formula can be applied to the contusion. Some doctors may recommend an non-steroidal anti-inflammatory drug like ibuprofen. The first 24 to 48 hours after the injury RICE will be the best method to employ for relief. If a large hematoma doesn’t disappear within a few days a doctor may need to drain it surgically. Compression marments are extremely effective to treat contusions.



Within a few days the inflammation should start to go down and the injury should feel less painful. A doctor may recommend gentle heat to the injury at this point. Activity levels can be increased gradually. Returning to sports or everyday activities may take several weeks. Putting too much stress on the area before it has healed can lead to scar tissue and more problems.

A doctor may recommend gentle stretching exercises to restore range of motion. Weight bearing and resistance exercises should be considered after range of motion has improved. Physical therapy is an excellent treatment for contusion; a professional therapist can optimize the muscles recovery and function.


Compartment syndrome and Myositis Ossificans can occur in serious cases. Compartment Syndrome may require surgery to drain excessive fluids and swelling to the muscle. This is a serious condition that usually causes extreme pain. Immediate attention is required. The condition is caused by rapid bleeding, a build up of fluid, and can disrupt blood flow.

Myositis Ossificans is a condition in which the bruised muscle grows bone instead of new muscle cells. RICE can help this condition and improve flexibility; surgery isn’t usually required. Myositis ossifican is common in the thighs of football players; however now all uniforms have padding on the front of the legs.

Use Well Theory’s surgeon-curated cream and spray to gently, safely, and naturally soothe away topical aches and pains. Expertly crafted with soothing lidocaine, menthol, pure Hemp CBD isolate, and a carefully selected blend of essential oils.

For more information on Muscle Contusions visit the American Society of Orthopaedic Surgeons.

Reduce Orthopedic Arthritis Pain with a Few Simple Exercises

You can do orthopedic exercises for yourself at home – and reduce your arthritis pain safely and effectively. The following exercises for arthritis help patients to become stronger and more flexible, while increasing endurance and balance.

Resistance Training for Orthopedic Strength

Stronger muscles can act as ‘shock absorbers’ for your joints (just like the shocks in a truck). By lifting something heavier than the joint itself, you can improve strength. This can often be done using just your own body weight.


To build the strength of your quadriceps (thigh muscles), you can do simple squats out of a chair:

  • Sit in a chair
  • Lean forward
  • Stand up

For a variation that strengthens the same muscles, you can lean against a wall with knees slightly bent. Hold this position for 10 seconds, stand up, rest a bit and repeat!

Stretching to Improve Flexibility

Everyone knows stretching is good for our bodies, but many think of Cirque du Soleil when discussing flexibility. Even a small increase in stretching can prevent orthopedic problems like arthritis from progressing and can help the pain. It can be done whenever you think about it. A good stretch begins by moving the joint to a position where you feel that it has been stretched, hold for 10 seconds and then push very slightly more. Heating before stretching and then icing afterwards helps as well.


Sample Exercise: Hip and Knee Stretch

You may only be able to reach your knees when you begin; even moving to the mid-calf will be great for arthritis in the hips and knees.

  1. Sit on the floor and reach for your toes until you feel a comfortable stretch.
  2. Hold for 10 seconds
  3. Push slightly more into the stretch
  4. Release


Aerobic Exercise for Endurance

Motion is key to orthopedic health. Joints that do not move will deteriorate and become even more arthritic joints. Low impact aerobic exercise such as walking, swimming, and bicycling will strengthen your heart and lungs, allowing you added energy throughout the day. Endurance depends on how much oxygen gets to the muscles and joints, and how the muscles and joints use that oxygen.

Sample Exercise: Walk

The impact of running will negatively affect your arthritic joints, but walking will not and actually helps the joints. Walking for 20-30 minutes at least three times a week is recommended.

Balance for Even Weight Distribution

Balance involves the ability to maintain one position for a long time without falling. It is a variation of endurance, and improves with better strength and flexibility. Balance is very important for joints as it allows for an even distribution of weight. When weight is evenly distributed then cartilage is not as easily damaged (causing orthopedic ailments such as arthritis). Yoga and Tai chi are both good ways to improve balance, and reduce the rates of hip and wrist fractures.

Sample Exercise: Tree Pose (Yoga)

  1. Stand on one leg
  2. Place the sole of the other foot on the standing calf, making sure to not let it rest on a joint like the knee or ankle
  3. Focus on a spot on the wall and hold still
  4. Leave the toe of the other foot on the ground and place the heel against the ankle

By doing these few simple exercises in a short amount of time at home, you can gain relief from the pain and discomfort of arthritis.

Incorporate this routine and other simple exercises (as recommended by your physical therapist or orthopedic doctor) into a regular, daily routine to experience greater strength, endurance, and flexibility for improved health and movement!

Use our Bone + Joint Health Multi to improve joint function and holistically reduce inflammation naturally over time! This multi contains surgeon-curated ingredients handpicked to improve your musculoskeletal health, fill gaps in your diet, and reduce pain + inflammation throughout your body.

What is CBD?

What is CBD?

Dr. Warner Here -

I am a board-certified orthopedic surgeon practicing in Louisiana. I founded Well Theory to bring you a safe, natural, and holistic option for pain relief and improving your day-to day health without undergoing invasive procedures.

What Is CBD

& is it safe?

Cannabinoids are naturally occurring plant-based substances that can modify human health and wellness.

There are hundreds of phytochemicals present within the plant Cannabis sativa. Most of the cannabinoids, especially CBD, are not psychoactive. That is, they will not get one ‘high.’ CBD will however, improve overall health and can help a great deal with the symptoms associated with pain.


How CBD Works

and how it can reduce pain + inflammation

CBD has been shown in various clinical trials to have few if any, harmful side effects – especially when compared to pharmaceuticals developed to address conditions CBD was being tested for.

CBD works in humans by modulating the human body’s innate endocannabinoid system. Throughout the human body there exist endocannabinoid receptors in enormous amounts. These receptor types (G-protein coupled) are in fact the most numerous of receptor types. The endocannabinoid system has receptors on many tissue types throughout the body that exert their effects and influence things like the inflammatory response, hunger, mood, and more. CBD is particularly active on immune system cells.

The endocannabinoid system is an endogenous (native to the human body)
system lipid signalling pathway.

The endocannabinoid system is composed of the ligands (substances that bind to receptors), the receptors and the associated enzymes that make and destroy the ligands. This system is involved in the function of the following separate systems of the body: peripheral nervous, autonomic nervous, endocrine, central nervous and immune systems.

There is therapeutic potential for substances that affect this human system. In numerous studies, CBD has been shown to:

  • Eases Pain
  • Stimulates Bone Growth
  • Suppresses Muscle Spasms
  • Reduces Risk of Nerve Damage
  • Reduces The Risk of Artery Obstructions
  • Slows Inflammation
  • Suppresses Muscle Convulsions
  • Reduces Blood Sugar Levels
  • Eases Nausea
  • Decreases Pressure In the Blood Vessels

CBD And The Medical Community

We believe that there is ongoing participation of the endocannabinoid system in many physiologic processes, such as the inflammation and pain. Therefore, by maintaining the proper balance and function of the endocannabinoid system, one can modify these symptoms, improve quality of life, and reduce the consequences of aging. We believe that CBD has this power and is an excellent plant-based adjunct to a thoughtful wellness regimen.

“My goal is to help people age better, age fitter, and enjoy their old age. We’re all going to get old. You can’t stop that

Meredith Warner, MD

Choose Well Theory

for your peace of mind

Do you suffer from pain and are tired of taking heavy pharmaceuticals? Have you exhausted every treatment with no relief in sight? Try Well Theory, Dr. Warner’s line of holistic pain-fighting products, and start curating full-body wellness today.

Dr. Meredith Warner

Orthopedic Surgeon

About the author

Dr. Meredith Warner is the creator of Well Theory and The Healing Sole. She is a board-certified Orthopedic Surgeon and Air Force Veteran. She is on a mission to disrupt traditional medicine practices and promote betterment physically, spiritually and mentally to many more people. She advocates for wellness and functional health over big pharma so more people can age vibrantly with more function and less pain.

At Well Theory, Our surgeon-designed products are FDA Registered and formulated to help people:

  • Manage the symptoms of musculoskeletal pain
  • Recover vibrantly from orthopedic related surgeries
  • Fill the gaps in our daily diets
  • Manage pain associated with inflammation

Surgeon Formulated
For Your Peace of Mind

Natural Ingredients + Cutting-Edge Medical Breakthroughs.

  • 100% NATURAL

Anterior Knee Pain and Patellofemoral Arthritis

Many people with pain in the front of their knee spend months or years without a true diagnosis or treatment plan. Often they are pushed from doctor to doctor, and occasionally are even relegated to pain management. Most patients with pain in the front of the knee, or anterior knee pain, however, are active and do not want to be medicated forever. The problem with anterior knee pain is that it is a difficult diagnosis to make and there are many possibilities.

One of the problems with medicine in the era of healthcare reform and ‘big-box’ medicine is that physicians no longer perform actual physical examinations.

Usually the doctors have a quota of patients to see that day that limit a visit to 8 minutes or so and the majority of that time may be spent documenting the visit in the electronic record.

While this satisfies the government and permits payment for the visit, too often the patient remains without a diagnosis simply because no physician ‘laid hands’ on them.

Anterior knee pain can be diagnosed with a good history and good physical exam with occasional confirmation via imaging. Make sure that your doctor performs a good physical examination of the knee prior to dispensing advice or treatment.

Arthritis is the common term for damaged cartilage. Cartilage is the substance that covers both sides of a joint. A joint is a connection between two bones that allows movement. Cartilage provides both a slick and strong surface that allows the two bones to slide against each other for motion and a surface that accepts impact and protects the surface bone beneath the cartilage.

As cartilage breaks down or after it is damaged, arthritis ensues. Once there is arthritis, the surface is not as strong and is not as frictionless as it should be. Movement becomes less efficient and also painful. Patellofemoral arthritis is a problem between the cartilage surface of the underside of the patella (knee cap) and the front-side of the femur (thigh/knee).


Patients with this problem often report pain, effusions or swelling and mechanical symptoms such as popping, locking or catching in the front of the knee.

Pain is actually coming from the bone under the cartilage and the surrounding soft-tissue as cartilage itself lacks nerves. By lacking nerves, cartilage cannot itself feel pain; however, the bone underneath and the tendons, muscle and ligament around that cartilage certainly can produce pain. Arthritis is more often than not due to life itself or age-related. However, occasionally trauma or injury can cause and progress the symptoms of arthritis.

For trauma to cause arthritis the cartilage itself must fracture (break) or have an identifiable impact injury. This can happen from patella dislocations or subluxations, osteochondral defects, fractures of the knee or patella, or constant improper loading of the joint due to abnormal mechanics and alignment of the knee. Instability of the patellofemoral joint is a problem and can sometimes progress to arthritis if not identified and treatment in a timely fashion. The patellofemoral joint sustains the most load and wear during activities such as ascending or descending stairs and/or squatting. When the knee flexes (bends), this joint undergoes more and more load and deformation. Maximum contact occurs at 90-degrees of flexion, but begins at 20-degrees.


The goal of treatment is to restore normal function (if possible) and reduce pain.

Usually, nonoperative treatment is the best course of action. This usually involved physical therapy, gait analysis and correction, orthotics and bracing, medications (topical and oral) and flexibility improvements. Soft-tissue balance of the knee capsule and surrounding ligaments and tendons is very important. Generally, this balance is difficult to achieve with a home-exercise-program and formal therapy or chiropractic care is necessary. In addition, the knee functions better if the hip motion and strength is optimized; this too requires formal analysis and correction.

Another method to treat arthritis of the patellofemoral joint is through viscosupplementation. This involves injections of hyaluronic acid directly into the knee itself. This substance improves the viscosity of the joint fluid. Improved viscosity allows better resistance to compressive forces. The injection also acts as an anti-inflammatory treatment and reduces the inflammation associated with arthritis. This inflammation is a source of both pain and swelling. Also, the viscosupplementation provides supplemental nutrition to the knee cartilage; this is especially important for areas as small and as hard to reach as the patellofemoral joint. Hyaluronic viscosupplementation is an excellent treatment method for arthritis of the patellofemoral joint.

Surgery has historically not had great results for this problem. Today there are newer technologies and better reported outcomes.

However, it should still be considered a last resort. There are procedures to restore the cartilage that involve cartilage substitutes and one’s own cartilage transferred to any significant lesions on the patella.

There are procedures to realign the patella and its tendons such that the biomechanics of the knee joint change. This typically involves actually removing the bone where the patellar tendon attaches and physically moving it over and then reattaching it with a screw. This type of surgery is done to unload the patellofemoral joint and reduce the forces across that joint.

Arthroscopy is utilized to perform what is known as ‘chondroplasty’. This is basically a procedure whereby the damaged cartilage is literally removed from the knee. This is very difficult to achieve due to the anatomy of the patella; the results have been limited and there are many times poor functional outcomes of that surgery. Also through the arthroscopy, the structures stabilizing the patella can be released to effect an offloading. This is known as a ‘lateral release’. Occasionally this procedure is accompanied with a partial resection of the patella.

Anterior knee pain is very common and very debilitating. Many patients spend years without a proper diagnosis or treatment plan. The physical examination should be thorough and supplemented with advanced imaging such as MRI or CT scan. Treatment should be nonoperative if at all possible. Surgery is possible, but functional outcomes are not guaranteed and the procedures require a great deal of technical expertise and significant rehabilitation afterward.

Looking for an alternative to surgery that will help you reduce your arthritis symptoms naturally? Download our free Arthritis Guide and start managing your symptoms today!


Accelerate Recovery, Start Rehabilitation Today

Despite popular belief, rest isn’t the quickest route to recovery.

New research out of Copenhagen shows immediately beginning rehabilitation after an injury may allow patients to recover faster and return to their daily activities much sooner than we once thought.

A study Dr. Meredith Warner recently stumbled upon in the New England Journal of Medicine took fifty athletes and separated them into two, randomly assigned control groups. Each athlete suffered an acute injury of the thigh or calf muscle and was then randomly assigned to begin an early (two-day post injury) or delayed (9 days post-injury) rehabilitation program. These patients didn’t receive any analgesic medications or nonsteroidal anti-inflammatory drugs throughout the study.

The researchers followed these athletes for 12 months during their recovery.

They all went through the same rehabilitation program, monitored closely by a physical therapist. During the first week of training they performed daily static stretching, and during the next phase, they practiced daily isometric exercise. In the final weeks, the athletes performed functional exercise combined with heavy strength training three times a week.

Following the rehabilitation period, results showed athletes who began rehabilitation two days after injury returned to activity about 20 days sooner than those who delayed therapy for nine days.


For even the average person, a delay in rehabilitation can prolong pain and delay recovery. During recovery, especially for acute muscle injuries, it is advisable that patients begin rehabilitation as soon as possible. Muscles do not respond well to inactivity following an injury. Starting therapy sooner can help guarantee success and recovery throughout the treatment journey.

Give recovery your best shot with Well Theory’s tips, resources, and wellness solutions. Try out our Bone & Joint Health Multi to improve your overall health and joint + muscle function.

What is Hallux Rigidus & Your Options For Treatment

Dr. Meredith Warner is an orthopedic surgeon and founder of Well Theory, your resource for maintaining and promoting full body wellness and improving function as you age.

The MTP joint or the metatarsophalangeal is on of the most common sites of arthritis in the foot. Located at the base of the big toe, this joint is important because it must bend every time that you take a step. Once arthritis sets in and the joint begins to stiffen, walking can become particularly painful.

When two bones meet and move together, that is called a joint. The ends of the bones are coated in cartilage which is very smooth and allows motion. Eventually, this may cause reactive bone spurs to develop. In hallux rigidus a prominent spur will develop in the top of the bone and the joint. This spur prevents the toe from bending as much as it needs to when you walk; resulting in hallux rigidus or a stiff big toe.

Hallux rigidus generally develops in adults between the ages of 30 and 60 years old. While there doesn’t seem to be any scientific reason as to why it affects some individuals and not others, it is thought to result from differences in foot anatomy that increase stress on the joint. In addition, some specific injuries to the toe can damage the articular cartilage and cause hallux rigidus.


  • Swelling around the great toe joint
  • Pain in the joint when active, especially when walking
  • A bump that develops on top of the foot at the joint
  • Stiffness in the great toe coupled with the inability to bend it up or down
  • Hallux rigidus often looks like a bunion


If you begin to find it difficult to bend your big toe up and down or you are walking on the outside of your foot as a result of the pain in the toe, please contact us right away. Hallux rigidus is easier to treat when the condition is caught in the early stages of development. If you wait until the development of bone spurs that are visible in the form of bony bump on the top of your foot then the condition will be far more difficult to treat. However, it is still treatable with the right skills and technology.

Your doctor should examine your foot and will look for any evidence of bone spurs. She will also check the toe for mobility and to see exactly how much movement can be achieved without pain. X-rays will pinpoint the size and location of any bone spurs, as well as, the progression of any degeneration within the joint space and cartilage. X-rays are helpful to determine the overall architecture of the foot and to plan surgery or treatment.


Non-Surgical Treatment

Anti-inflammatory medications may assist in reducing swelling and easing the pain of hallux rigidus. Applying ice packs or taking hot and cold baths may also control the symptoms and reduce swelling and inflammation for short periods of time. Your physician will likely recommend wearing a stiff-soled shoe with a rocker or roller bottom design or even a shoe with a steel shank or metal brace. This type of design supports the foot while walking and also reduces the amount of bend in the big toe. Taping often helps. In addition, physical therapy can be very successful in treating this condition.

Surgical Treatment

Arthrodesis: Fusing the bones is recommended when there is severe damage to the cartilage. The damaged cartilage is removed and screws, pins or a plate are then used to fix the joint in a permanent position. The bones grow together over time. While this procedure has traditionally been the most reliable in terms of reducing pain, it is important to note that you will not be able to bend your big toe at all. Fusion should be a last resort procedure only.

Cheilectomy: This surgery is recommended for patients with mild to moderate damage. This procedure removes the bones spurs and a portion of the foot bone, so that the big toe has more room to bend. An incision is made at the top of the foot. It is important to note that while most patients do experience long-term pain relief after the surgery, the toe and the operative site may remain fairly swollen for several months post-op. When one has a cheilectomy it is expected that another treatment will eventually follow.

Arthroplasty: This procedure is best suited for patients who do not place many high impact functional demands on the feet. Arthroplasty is a joint replacement surgery in which the joint surfaces are removed and an artificial joint is then implanted. This procedure may relieve pain and preserve some joint motion. It is possible to remove one side of the joint or both sides. The surgery is successful for pain relief but often the will eventually need to be changed or revised.

Cartiva: Unlike traditional fusion procedures, Cartiva eliminates your joint pain without sacrificing the natural movement of the foot. The minimally invasive procedure places an implant, composed of a biocompatible organic polymer, that functions similar to that of natural cartilage. The procedure allows the foot full weight-bearing capacity shortly after surgery. Cartiva can be implanted with a block of regional anesthesia. Cartiva is a technology that is innovative and can reduce pain while preserving more normal foot motion.

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