My wife has degenerative disc disease (DDD). I am quite impressed with your thorough research and your synergistic approach to the problem. However, like many other treatises, everything seems to apply and point to knee and hip problems. Is there proof (not just assumption that if it works for one thing it will work for another) that your approach is as effective with spinal problems? The doctor says that my wife has spinal stenosis. The pain goes down her right leg. It has been in her ankle at times and in her arm. I guess my real question is whether following your exercise program for strengthening the muscles as opposed to a supervised swimming program is worth the effort?

Strength training will help the legs recover some muscle that is lost secondary to spinal stenosis, and it will also help with functional capacity -- walking, etc. It will not reverse the underlying problem in the spine, which can sometimes be reversed surgically. Indeed, one will see much more strength gain from strength training than from swimming. The changes we saw in strength in people with arthritis were about 60% with strength training vs. 9% with swimming, at a rate of twice per week for 12 weeks.