Is there a formula that will increase your odds of strong healthy, fracture-resistant bones? How can you stay active and strong despite your chronological age? Is it possible to reverse muscle and bone loss and “age in reverse”? The answer to all of these questions is Yes!
As a physical therapist, I often see people for rehab ‘after’ they have sustained a hip, ankle, or wrist fracture. I see them after the diagnosis or the surgery. I often wish I had the opportunity to educate women ( and men) on the many factors that contribute to healthy and strong bones, joints, and muscles. The truth is it is much harder to recover from a fracture due to osteoporosis than it is to prevent one. It is far easier to prevent muscle loss, frailty, and falls if you take steps now.
The terms Osteopenia and Osteoporosis are simply medical labels given when a bone mineral density test or DEXA scan measures the quantity of bone and then categorizes the bone with a “T score”.
A T score of -2.5 or less ( more negative) is considered Osteoporosis, whereas a T score of -1.0 to -2.5 is considered osteopenia or “pre-osteoporosis.” Any score greater than -1.0 ( more positive) is considered normal. These scores are calculated by comparing your bones to that of a healthy 25 year old who is typically at the age of peak bone mass.
A T-score looks only at the quantity of bone present and does not measure or quantify the quality of bone. It may be surprising to learn that quantity of bone standing alone does not accurately determine the bone’s ability to resist fracture. In fact, it is the quality of bone that is a greater determining factor that most influences fracture tendency.
As I have said many times before these labels do not always provide an accurate representation of what a person’s actual fracture risk is or the likelihood of sustaining a fracture in the future. They will often instill unnecessary fear persuading people to take drugs that may or may not result in bones that are truly stronger and fracture resistant. I will not dive too deeply into the drug options for Osteoporosis but will only briefly discuss the current evidence.
The class of older drugs called Bisphosphonates, namely Fosamax, Boniva, Reclast, and Actonel prevent the breakdown of older bone. Normally, the older bone is less resilient and more fracture-prone, therefore the body will remove it and replace it with newer bone. Bone is living tissue and like all cells is replaced and cleared away routinely to make room for the new. By halting older bone breakdown the bone density will increase on a scan. Recall that bone density tests measure quantity, not quality of bone, and quality is an important factor in healthy, fracture-resistant bone.
The newer classification of “anabolic” drugs tricks the body into building new bone. These drugs Forteo, Tymlos, and Evenity, will temporarily increase bone density, however, all gains are lost when these drugs are stopped. They can only be taken for up to 2 years due to significant side effects. ( bone cancer and cardiovascular risks).
It may surprise you to know that many people with low-impact fractures are not in the osteoporotic density range but rather in the ‘normal’ bone density range.
Therefore, whenever I have the opportunity, I try to share basic knowledge of what the T-score means and what the critical factors are for maintaining and restoring healthy bone quantity and quality. I would like to present that the best options are not always drugs but rather, lifestyle changes that will have beneficial and lasting effects on bone density and overall health.
Since I have written at great length in previous blogs ( https://wordpress.com/block-editor/post/madicaro.wordpress.com/1236, and https://wordpress.com/block-editor/post/madicaro.wordpress.com/1257) and I have covered these factors extensively in my book, Staying Healthy Living Longer, I will only provide a basic review here.
Building Strong bones must begin early in life, however, it is never too late to reverse a trend of bone loss. Like most other diseases or disorders, frailty and bone loss are multi-factorial and these factors can be anything from heredity to lifestyle, diet, stress, medications, activity level, and toxins. What impacts the body as a whole will impact the bones. Systemic or body-wide inflammation has a damaging effect on all cells and systems of the body from the heart to the bones. This is why I stress the need to control systemic inflammation, as it is the primary driver of disease.
“Osteoporosis is another example of a disease of Inflammation and Oxidative damage. Inflammation is the driving force of bone breakdown and promotes the onset of Osteopenia and Osteoporosis.”-Staying Healthy, Living Longer-7 Powerful Principles for a Healthier You!
Before I discuss how we can build a healthier bone structure, I want to first emphasize that Health Care is Self Care.
Is it our annual doctor visits and the faithful refilling of pharmaceutical medications that insures us a disease-free life with healthy vitality? The correct answer of course is No! Our current health care model is not supportive of true health and has sadly regressed into a sick care system. Essentially, you wait for the symptoms to appear, then a pill or surgery is recommended to “fix” the problem.
There are, of course, exceptions as there are some novel drugs and surgical procedures that are truly life-saving and curative. Sadly, the vast majority of these drugs and interventions for chronic conditions will not provide you with better health any more than eating donuts will eliminate your sugar craving! Oftentimes, they leave new symptoms or imbalances in their wake. I believe there is a better way!
There is little to no attention or education provided on the underlying causes, prevention, or early interventions for many common conditions. I find this very frustrating. I see this play out time and time again with regard to bone health, and many other chronic diseases. If you intervene early on and proactively work toward building health as a daily mission, it will be less likely that you will need to treat disease later!
When I say Health care is Self-care I am implying that the seemingly insignificant choices we make, minute to minute and day to day, create a movement toward the healthy building, healing, and restoration of our body cells, or the opposite…deterioration. These choices require ongoing, intentional acts of self-love and self-care. These simple choices like compounding interest in our bank account have a profound impact on our long-term health. Little by little, a little becomes a lot!
We have to set ourselves up for success by adopting the habits or behaviors that reflect our desire to live our best life. That means that on a daily basis you pay attention to what you need to thrive.
I recommend starting with these 5 Foundational Pillars of Health.
1. Nutrients. Eating a nutrient-dense, whole food diet that supplies all micronutrients and minerals and reduces body-wide inflammation is critical. I cannot overstate that food is vital information for all of our cells. Food can either turn on genes that increase disease or turn them off. The constituents of the food we eat provide necessary information to activate aging pathways or promote regeneration, cellular repair, and health. Your bones are active living cells, just like your muscle and brain. They require specific and diverse nutrients in various quantities to clear away the old cells and rebuild healthy cells. This goes on every second of every day in an amazing interplay, all while you are unaware. Doesn’t that make you want to feed your cells what they need?
2. Exercise, This should include strength training, weight-bearing or skeletal loading exercise, cardiovascular, flexibility, and balance activities in a fun and sustainable way. Our bodies were made to move.
3. Stress management/Resiliency: This can be achieved through meditation, spiritual practices, breathwork, journaling, spending time in nature, engaging in comedic, artistic, or creative pursuits. These activities are associated with lower cortisol and stress hormone levels, decreased inflammatory markers, improved heart rate variability, reduced muscular tension, decreased insulin resistance, ( better insulin sensitivity and glucose tolerance), and reduced blood pressure. Elevated stress hormones like Cortisol, interfere with bone-building cells called Osteoblasts and will result in loss of bone mass. I guess you could say, stress is bad to the bone!
4. Sleep. Striving for 7-8 hours of quality sleep per night. This is when your body is able to heal, restore and rebuild. Sleep is elusive for many but is also undervalued as a primary pillar of a healthy body and brain.
5. Supplementation. It is nearly impossible to obtain optimal levels of certain nutrients from diet alone, even if your diet is healthy. There are many reasons for this. Minimum daily requirements of a nutrient are the bare minimum that is needed to prevent disease. It does not consider individual differences in gurt health, absorption, age, genetic tendencies, current health status, medications taken, and many other factors.
These 5 pillars are proven evidence-based interventions that focus on the factors that are within our control. They are cheap, have no negative side effects, and provide us with a wide range of benefits! Try to match that in a pill! These are also the key factors that optimize bone health and ensure that you can remain active in participating in the life you love. I discuss all of these and a few more in great detail in my book.
I believe we are on the precipice of understanding and reversing disease processes. It is an exciting time of discovering how components naturally present in foods can not only prevent diseases of aging but also reverse them! I love learning and sharing these discoveries.
Since many people ask what the best supplements are for building healthy bone I have included a few recommendations.
**It is recommended that you check with your doctor or licensed health practitioner before starting any new supplementation program, especially if you are on prescribed medications. **
There is a whole symphony of essential nutrients that are required for building healthy bones. There are many excellent bone-building products available. Any supplement you decide on should be pure, preferably with minimal additives or binders, and be third-party tested.
There are 10 nutrients that have been studied for building healthy bones and reducing inflammation. They are best taken together with a healthy diet. This is of course, in addition to the other Pillars discussed.
The products I recommend can be found under Protocols for Osteoporosis on my Fullscript dispensary page. Many of the products have all of these nutrients in the correct combinations so you don’t have to take them individually. These are suggestions only and I provide a variety of options. Some products have all or most of these 10 nutrients contained and some have only a few but have other beneficial compounds.
- Vitamin D
- Calcium
- Magnesium
- Vitamin K-2
- Boron
- Lysine
- Vitamin C
- Strontium
- Silica
- Zinc
You can access the link to Fullscript and look for the protocol for Osteoporosis through my website. A 20% discount is automatically applied to any order.
Helpful Resources
Please reach out with any questions you may have. I 🧡 questions!
Share this health blog with anyone you think can benefit.
Blessings & Health,
Mary
madicaropt511@gmail.com
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Are you ready to show yourself some love, take back control of your health, and learn the tools for healthy aging? Check out my Amazon best-selling book, Staying Healthy Living Longer- 7 Powerful Principles for a Healthier You! It has won 3 awards in the “Health over 50” category!🧡
I think it is a great time to delve into common causes and misconceptions surrounding back pain! Afterall, it is the greatest source of misery and most common reason for visits to the doctor. Over 80% of the population has experienced or will experience back pain in their lifetime. Back pain is often the primary reason for lost productivity and avoidance of exercise, and enjoyable pursuits.
In the last several months I have seen an unprecedented uptick in patients reporting increased back, neck and hip pain. In this newsletter, you will hopefully have a better understanding as to why this is the case.
When you see the doctor with complaints of pain, a general diagnosis of back or neck pain is often given. These labels often come after a 10 minute examination and possibly an xray or scan to rule out an infection, fracture, tumor or other anomaly.
Unless something anomalous or abnormal shows up on a scan the diagnosis of ‘back pain’ tells us little about WHY the individual is having pain. In order to effectively treat a set of symptoms we need an understanding of the possible causes of the symptoms. The diagnosis alone doesn’t tell us anything. We need to view back pain in the context of the whole body. We need an understanding of the mechanisms that lead to pain.
Lets first discuss a common misconception or misrepresentation of the cause of chronic back pain. Chronic pain, in general is pain that has persisted for over 4 months. The most common explanations given for back pain are : arthritis, degenerative disc disease, bulging disc, and spinal stenosis.
It may be temporarily reassuring for the patient to have a ‘reason’ for their experience of pain, but upon hearing this diagnosis, the patient begins to focus on these imaging findings; sometimes obsess, is a better word! This leads to fear of movement, restriction in activity level, and anticipation of a negative outcome. As you might imagine this can become a self fulfilling prophecy and a deterrent to improving the patients comfort and getting them back into living their life. It turns out that over emphasizing the ‘label’ is often a roadblock to returning the patient to a full, active life.
Research indicates the conditions mentioned above standing alone do not cause severe, ongoing pain. In fact, many of these ‘findings’ within the general population are often a result of normal wear and tear on the body and are present in most adults over the age of 35, even in those who are not experiencing pain. Yes, no pain. In fact, nearly 85% of people with neck and back pain do not have clearly identifiable structural causes for pain on an xray or scan!
In my experience, I have also witnessed this phenomena. Those individuals with no identifiable abnormal findings have debilitating back pain and those with severe degenerative changes as seen on a scan, have little to no pain. Seems quite the enigma. It is always a challenge to help patients see the multitude of contributing causes to their pain. But once I do, it is rewarding to see how this knowledge alone changes the outcome to a positive one.
So now that we know that the label of bulging disc, or degenerative arthritis may not be the sole reason for the pain, what is really going on?
Only until we understand the “why” can we make an attempt at changing the symptoms. I will attempt to simplify the cause of chronic pain and the possible reasons why so many of us experience it at one time or another. I discuss the contributing factors in much greater detail in my book.
I will outline 5 primary reasons for neck and back pain. Most pain is due to a unique combination of at least these 5 factors. For the purpose of keeping this brief, I will describe 3 that I feel are very important.
1. Physical changes: This includes adaptive postural changes and movement patterns that are programmed in the nervous system. Check your posture right now as you are reading this. Remember, changes in alignment lead to changes in function. Are you seated upright with normal curvatures of the neck and low back? Or, Is your head forward, shoulders rounded, and lower spine in a C-configuration? Now consider how many hours you are seated in this posture daily, weekly and monthly, and what that will mean for your spine, discs and nerves long term?
Also included in the category of physical changes is weight gain that is concentrated in the abdominal area. This is particularly problematic because it is the location of our center of mass. Excessive loads on vertebral and soft tissue here can cause early degeneration and pressure on pain sensitive tissues and nerves. In addition, visceral fat or deep abdominal adiposity is associated with high levels of circulating inflammatory cytokines. Inflammation is the root cause of many of our chronic pain and health conditions. Finally, was there a surgery or trauma to an area of the body? It may be possible that scar tissue, adhesions in the fascia and connective tissue may be placing pressure on organs, joints and restricting normal movement. This may definitely be a contributing factor.
2. Health and fitness status. What is the state of your general health and fitness? Strength of supporting spinal and hip muscles as well as the aerobic and oxygen capacity of muscle is critical for warding off back pain. Muscles require continuous optimal blood flow and oxygen or will become hypoxic and painful. Joints require movement or will become stiff and painful. Joints also require muscles that are balanced, free to move and support normal joint alignment. If they are weak, or tight and short they simply can not function normally.
Again, if you have low fitness status or high levels of body wide inflammation, you will be more prone to experiencing pain. The changes to our normal activity and routine over the last year and a half may be contributing to a rise in complaints of pain. Many of my patients could not attend fitness classes or participate in sports. They literally took to the couch and gave up all activity. In the several months of inactivity they lost muscle, strength, endurance, stamina and many gained between 10-20 pounds. Many of us were left to adjust to uncertain and difficult situations with little or no support.
To determine if your lifestyle is promoting or discouraging inflammation, I suggest reading my previous blogs and also the information contained in my book, Staying Healthy, Living Longer. In my book, I discuss the leading causes of inflammation in the body and the drivers of pain and disease, most of which are within our control.
“The real act of discovery consists not in finding new lands, but in seeing with new eyes.”– Marcel Proust
4. Emotional and mental, this includes Stress Physiology and the Nervous system:
This is a significant yet often overlooked factor in back pain. There are numerous, ongoing studies and research in pain neuroscience that support and uphold the impact of stress on the nervous system, and therefore every tissue in the body. This has such a profound connection to bodily pain, that clinically we use a biopsychosocial model to treat chronic pain. This multidisciplinary model takes into account previous trauma, adverse events, the patients’ interpretation of the events, into designing a treatment plan for the pain. Stress can be from childhood events, from an illness or recent traumatic experience, and current ongoing stress for which you see no resolution.
There is a strong relationship between chronic pain and medically unexplained symptoms and a hyper vigilant state in the nervous system (Psychophysiologic Disorders Association -PPDA). A dominant “fight, flight and freeze” response of the Sympathetic Nervous System is exhaustive to the body and prohibitive to blood flow and healing. Additionally it promotes states of muscle tension and poor tissue blood flow impeding oxygen to the tissues.
Early adverse life experiences contribute to what we call somatization later in life. Somatization is the development of physical symptoms from emotional subconscious mechanisms. These are real symptoms. There is no such thing as imaginary pain. These events set up neurological pathways in the brain and nervous system that cause erratic and abnormal firing of sensitized nerves. There is considerable evidence that adverse early events ( namely in childhood) are strongly linked to chronic pain, musculoskeletal symptoms and headaches. Fear exacerbates pain because it arises from the same brain region. The patient is usually unaware that this is occurring as many of these emotions are repressed.
When organ disease or structural abnormalities have been ruled out with testing, what is remaining is more than likely somatization type disorders. Studies have indicated that as many as 40% of visits to a primary care doctor for pain complaints are linked to repression of emotions or past trauma. Self awareness, and an understanding of this concept alone can free you from a pain cycle that has not been responding to other treatments.
For additional help in understanding this I would recommend additional reading: The Mind Body Prescription, Healing the Body, Healing the Pain (Dr John Sarno, MD) and They Can’t Find Anything Wrong! ( Dr, David Clarke, MD). I also explain this in greater detail in my book.
I feel that the events of the last 18 months have heightened the experience of anxiety and fear and exacerbated safety issues, ramping up the sympathetic nervous system for many people. This may be one of the reasons many are reporting more pain.
And the last 2 factors,
4. Nutritional state. I can spend quite a long time on this one.
5. Psycho-social and environmental factors.
When you understand these contributing factors you can take back control and learn the tools and practices you need to take care of yourself and get back to living your best life!
If you would like a bit more information on back pain, Sign up here to receive a free chapter download entitled, “The Scourge of Back Pain…Getting back in the Game”, from my new award winning, Amazon best selling book, Staying Healthy Living Longer! It is is also available at Barnes and Noble and independent bookstores!
You will also receive my monthly newsletter directly to your inbox and be the first to receive information on newsworthy health topics , seminars, books, and discounted professional product formulations offered through Fullscript, geared toward specific conditions.
Coming in October, I will showcase best practice supplement formulations for preventing and treating the conditions of Osteoporosis, and Osteopenia, (low bone density.) Stay connected!
Until next time, stay healthy and keep your heart happy. 🙂
Exciting Update on Book Launch!
Regardless of how you have classified this past year, “good”, “terrible” or somewhere in between, it is now for all of us, in the rear view mirror. The infamous year, 2020, is in the history books and we are now about 2 weeks into a New Year. As humans we have always looked forward to new beginnings and a fresh slate on which to construct a better way. What is your vision and hope for this year?
We can only thrive when we have hope and trust that our actions will move things in a positive direction. We may not be able to control many things that are happening all around us, but we can control our thoughts and actions.
Now more than ever in my career, I am seeing a genuine interest among people, in building better health and reducing the chances of disease. Despite this, I am also seeing now more than ever, increases in physical pain and ailments like back pain, neck pain, and muscular pain. What is contributing to the rise in chronic pain in general?
There is no simple answer for this. What we do know is that since the arrival of this virus, people are experiencing heightened levels of stress, anxiety and fear. There have been increases in consumption of sugars, alcohol, and processed, comfort foods with concomitant decreases in exercise, positive social interactions, and outdoor recreation. Can this unfortunate combination of conditions increase inflammation and with it, the bodily response of pain?
I believe it can. Let me explain just a couple of the mechanisms at work, so we can focus on solutions.
- Diet is the number one cause of systemic inflammation, which is the precursor to disease and pain. This is an undisputed fact. Processed foods, are notoriously high in inflammatory omega 6 fats like the seed oils ( corn, sunflower, safflower, grapeseed, soybean…) and low in anti-inflammatory omega 3 oils such as avocado and olive oils. In addition, processed foods have an abnormally high content of sugar and simple carbohydrates. Sugar and it’s counterparts, brown rice syrup, and corn syrup are inflammatory to cells, causing a rapid rise in insulin, promoting insulin resistance or pre-diabetes. Many of these foods are void of nutrients, cause nutritional deficiencies, and yet are high in caloric density.
2. Exercise and Muscle Building activities are Anti-inflammatory and provide a host of countless benefits. Exercise is a potent outlet for stress reduction, release of toxins, oxygenation to the tissues, improved lung and cardiovascular capacity, and improved function of mitochondrial cells ( our energy manufacturing cells) and therefore energy production. Exercise enhances mobility, strength and bolsters the immune system, provided it is not a prolonged or extreme intensity. Exercise, especially when outdoors in the sunshine, improves mood, stress coping skills and reduces pain perception. Strength training enhances how joints function, reduces the strain on the joints and often prevents or halts the progression of arthritis.
3. Stress, you will often hear me say, is the Unofficial Grim Reaper. What does this mean?
Unabated, chronic stress and worry pack a perilous punch of lowering the immune system, ramping up inflammation, increasing the incidence of insomnia, and escalating chronic pain and disease. Need I say more? Our perception of the events that are occurring around us gives rise to a physiological response by the body. If our interpretation of events is negative, resistant, critical, angry, or feeling victimized, the resulting biological response will be elevation of blood pressure, elevation of blood sugar, activation of the fight or flight mechanism, and reduction of immune disease fighting cells.
Many of us are living in the future or past and are precariously perched on the edge of our worries and fears. The brain is designed for our survival and therefore fear and worry may easily be our default mode. Our minds are the first frontier to conquer if we are to be successful in any area of our life. Our minds will offer up many thoughts in the course of a day, we don’t have to believe them all. Although difficult, we can choose the thoughts and beliefs that move us in a positive direction.
If you are finding that your health goals are off to a slow start or if you are feeling mentally or physically unprepared to tackle the habits and behaviors you need to succeed, you are in good company.
Here are 5 simple ways you can move toward a healthier future and manage pain significantly better.
- Move. Exercise, even if it to simply get outside and walk. Perform body weight exercises, or work out with resistance bands or weights. Since many gyms are closed, this will be challenging, but you knew that already. Do it anyway. Even if 10 minutes twice a day is all you can do.
- Meditate. Start and end the day with 5-10 minutes of mindful breathing and visualization. Perhaps include a meditation like the loving kindness meditation. Many studies have demonstrated that meditation is highly effective for chronic pain, especially when exacerbated by stress. It changes the structure and function of the brain by decreasing activity in the fear brain and brains’ pain processing center.
- Nutrition first. This must be a priority! Reduce inflammatory sugars and omega 6 inflammatory oils. Stop eating nutrient void, dead, processed foods from a box or bag. Instead, eat lean protein sources and increase vegetable intake. This is not a diet, it is a decision. Watch your motivations for eating, often they will circle back to an emotional state. Understanding this is the first step to over ruling it.
- Stay hydrated. Our organs, tissues, discs and cartilages are 60-80% water and we require adequate water for normal functioning of our cells and detox organs. Dehydration contributes to pain and stiffness.
- Sleep, Rest, Relax. Seems easy enough but for many who find themselves in the midst of challenges, or experiencing pain, it is far from easy. Sleep is restorative to the body and reduces pain. You have to move your nervous system away from ‘fight or flight’ or the state of sympathetic dominance, toward the parasympathetic state of ‘rest, repair, and digest’. If you want to feel your best, you MUST make sleep and relaxation a priority! For starters, turn off all electronic devices at least 1 hour before bed. Stop watching the news, which is designed to hijack your fear brain and cause rumination and anxiety. Create a space that is conducive to sleep and relaxation. Use your favorite music track, nature sounds, essential oils, a cool, dark atmosphere, a weighted blanket, centering meditation and/or prayer or a warm bath of Epsom salts. Find something that is most comforting for you, that promotes peace and tranquility.
Be kind and gentle with yourself as you embark on change. Small steps, repeated consistently over time, reap BIG results. Every new day is a gift that we are given. We get to choose how to show up.
I am excited to announce that my new book, Staying Healthy, Living Longer 7 Powerful Principles for Living Longer! will be released within the month. This book will deconstruct the mysteries of why we are tired, overweight, in pain, or simply not feeling our best. You will learn the tools you need to transform your health and achieve a longer, healthier life!
You can pre-order my book NOW! (with discounts) at https://www.amazon.com/dp/B08VC6PYWJ/
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website:https://mdtherapyandwellness.com, or email: madicaropt511@gmail.com
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Today I am hoping to shed some light on this increasingly common source of joint pain. We may have experienced twinges of knee pain in the past after an aggressive hike or perhaps we are now in the throws of seeking answers to unrelenting knee pain.
Your doctor can quickly provide you with a “diagnosis” and perhaps offer as a solution in the form of an injection, a prescription for pain and anti-inflammatory medication or of course the most invasive of treatment options, surgery.
In some cases surgery is unavoidable and may feel like the only option.
These cases are more the exception than the rule.
Surgeries to repair, for example, an acutely torn ligament or meniscal tear may be both necessary and wise especially if the individual is young, active and would like to return to high level of function and sports.In this case a surgical repair or reconstruction will provide the best shot at maintaining a normal active lifestyle with the fewest limitations.
What is most alarming is the current trend increase in elective total knee joint replacement surgeries in the last 20 years. The average age for total joint replacements is decreasing, even while most joints only have a life span of only 15-20 years.
A study presented at the 2014 American Academy of Orthopaedic Surgeons (AAOS) meeting highlighted the rising numbers of knee replacement surgeries. When researchers reviewed hospital discharge data for more than 2 million people undergoing this procedure, they found the rate of knee replacements jumped 120 percent over a 10-year period!
The overall increase was steep, but it was even more pronounced in younger age groups. While the number of surgeries increased by 89 percent among those ages 65 to 84, they increased by 188 percent in 45- to 64-year-old patients!
Knee joint revision surgeries are also on the rise for this very same reason.
Studies have found that 85 percent of knees last 15- 20 years, and the AAOS estimates 10 percent of patients will need a revision at some point. The younger patients are when they undergo the first surgery and the longer they live afterward, the more likely they will be to need revision surgery.
Studies have shown The number of revision surgeries increased 133 percent during one study period, particularly among younger patients.
So the question I want to attempt to answer is Why is there such an increase in Knee Pain and Medical procedures to Manage it?
WHATS BEHIND THE INCREASE IN KNEE PAIN?
Although there are many potential causes, I will outline and discuss a few of the highlights:
1.MUSCLE IMBALANCES AND ALIGNMENT ISSUES:
This is a very common underlying factor in the etiology of knee pain that is often “overlooked” by orthopedic surgeons and can eventually lead to uneven wearing down of the cartilage or meniscus of the knee joint leading to early degeneration.( arthritis)
Although the knee joint is a rather simple hinge type joint it relies on ligament ( bone to bone connections) and tendons ( muscle to bone connections) for stability, support and mobility.
Proper functioning of the knee joint depends on a dynamic interplay of all muscles connecting above and below, think foot and hip. The knee is often times caught in the crossfires when foot or pelvic/hip alignment are creating dysfunction and a bio-mechanical nightmare at the knee. For example, an overly pronated (flat) foot, a leg length discrepancy or pelvic rotation can result in excessive loads and pressures at the knee joint.
The most common culprit in the onset of knee pain are weak hip stabilizers, a weak core, weak Quadriceps, namely the VMO, tight hamstrings, tight Ilio-tibial band (side of the leg) and tight hip flexors. These muscle imbalances lead to most forms of the knee complaints we see in therapy including the common Patello-femoral pain in younger athletes. Mal-alignments at the pelvis, foot and ankle will change the ground reaction forces and increase compression forces at the knee and the patella or knee cap. Once you have an understanding of how your alignment and muscles are creating an unhealthy movement pattern, you can begin to work on changing the dynamics through specific targeted, exercise, muscle energy techniques to correct alignment issues, and kinesio taping and orthotics, if necessary.
2. SEDENTARY LIFESTYLE, POOR DIET, EXCESS WEIGHT:
There can not be a discussion of tissue breakdown, inflammation, and arthritis without discussing other major players, as there is never only 1 player in a team sport and complex system like the human body.
I will call these 3 ‘The Unhealthy Triad” and this includes excess weight, poor diet and a sedentary lifestyle, all of which are preventable contributing factors.
First and foremost and because it is the easiest to correlate with joint degradation and arthritis, is EXCESS WEIGHT or increased BMI.( Body mass index)
Breakdown of cartilage or cartilage degeneration is often seen in Osteoarthritis. Inevitably it also involves the synovial membrane and thickening of the sub-chondral(underlying) bone. This is also enhanced by active inflammation as the body attempts to ‘repair’ or clean up the affected area by sending in inflammatory proteins and other molecules.
Excessive joint loading is a primary factor when discussing arthritis of the knee. The end goal is to reduce joint loading so to preserve the joint cartilage and stave off arthritis. Weight reduction is obviously one critical component to unloading the knee joint. Under normal walking conditions the load felt at the knee joint is 3-5 times that of body weight for level ground walking and up to 8 times for downhill walking! So even carrying an extra 10 pounds on the body can be felt at the knee joint as an additional 40-80 pounds!
Most of this is felt at the medial ( inside) knee compartment, which not surprisingly is the first knee compartment to show signs of arthritis. In Physical therapy we often suggest joint “off-loading” support in the form of knee braces that reduce compartment load, using a cane on the contra-lateral side,and heel wedges to alter foot mechanics.
Of course, Nothing will be as effective as weight loss in the management of knee OA.
Now that we addressed that rather difficult topic, lets discuss sedentary lifestyle.
While the aggressive athletic warriors ( you know who you are) have their share of wear and tear, sprains and strains and injuries, which can lead to early onset of arthritis, the opposite scenario is the “desk dweller” or couch potato who sees little if any physical activity. Loss of muscle strength, power,endurance and mitochondria ( muscle fueling powerhouses) diminish with low activity. This will directly affect the health and integrity of the weight bearing joints. So when it comes to health of the joints and activity and exercise, it is advisable to maintain muscle mass, power, flexibility and strength through exercise, walking, cycling or a combination of high and low impact exercise. As is most things in life, it’s all about striking a balance.
Last but not least in this triad, is diet. As the saying goes: “You can’t exercise your way out of a bad diet.” The diet that most of us are consuming looks less and less like real whole food. We are growing ‘attached’ ( addicted might be the better choice of words) to the processed, packaged, preservative laden, highly palatable pseudo foods that line grocery store shelves and fast food markets.
What does this have to do with my joints, you may ask?
The diets most Americans are consuming is highly INFLAMMATORY, calorie dense, nutrient poor, highly oxidative and damaging to the cells of our body.
Many studies have shown that years of eating habits such as this will lead to early degeneration of joints, increased inflammatory processes in the body, which spells double trouble for all body systems = DISEASE!
Regulating oxidation and inflammation can improve health, vitality and longevity. Oxidation to put it plainly is our cells “rusting” from the inside. While some oxidation is a normal part of cellular metabolism, too much, too quick, without a balance of antioxidant rich foods contributes to disease.
Foods that are anti inflammatory and loaded with anti oxidants should be the focal point of every meal. Dark leafy greens, brightly colored vegetables and fruits, seeds, nuts and omega 3 rich fish is a great place to start.( see below)
A recent study looked at the anti-oxidative and anti-inflammatory effects of Vitamin E on knee tissue of patients with late stage osteoarthritis of the knee.
Those in the study taking the Vitamin E had decreased inflammation and decreased oxidative stress,and improved clinical symptoms, identifying Vitamin E as a “disease-modifying agent for Osteoarthritis.”
What are some examples of other potent anti-oxidant foods: Carotenoids: Carrots, squash, broccoli, sweet potatoes, tomatoes, kale, collards, cantaloupe, peaches and apricots (bright-colored fruits and vegetables!),purple grapes,pomegranate, cranberries, green tea, Vitamin C: Citrus fruits like oranges,lemon, and lime etc, green peppers, broccoli, green leafy vegetables, strawberries and tomatoes
Vitamin E: Nuts & seeds, green leafy vegetables, and finally my favorite of all: Red wine 🙂 (in moderation of course!)
There are just a few of the more common issues we encounter. There are many more possibilities for the onset and progression of knee complaints and in Physical Therapy we investigate the many contributing and causative factors providing conservative solutions for those who wish to avoid surgery.
If a patient wishes to be intentional and implement the suggested positive behavioral, dietary and lifestyle changes and therapeutic measures suggested in therapy, improvements can be seen in the form of increasing physical function decreased pain and improved mental health, vitality and quality of life.
Stand up, learn what you can do and take action, Knee pain doesn’t have to sideline you from enjoying life.
Be blessed, be well.
If you have any questions, feel free to contact me and I will try to assist you :
http://www.mdtherapyandwellness.com
madicaropt511@gmail.com
4 STRATEGIES TO MOVE FROM RESOLUTIONS TO REAL SOLUTIONS.
A brand new year with a fresh crop of 365 new opportunities to begin again….Instead of Resolutions, begin the year with Real Solutions.
Like most people you may be starting the New Year with motivations running high and a sense that a new crop of 365 days was just what you needed to propel yourself toward healthier habits. You may have set a few worthy goals such as lose 20 pounds, begin a certain diet, exercise more, eat healthier foods, manage stress.. and so forth. And if you’re similar to most people by mid January you will begin to feel a sense of ‘love lost’ when you think about those ‘resolutions’. If The sparks that ignite your motivation, begin to fizzle out with the holidays fireworks,.you are in good company. When it comes to life changes, most people have the attention span and focus of a squirrel, and when it comes to will power, well, that is not as powerful as we had hoped.
In fact, most people who begin a “diet” or attempt a lifestyle change will be unsuccessful without the right tools. When it comes to having the right tools, and understanding what leads to success, there is some good news and some bad news.
I will give you the bad news first.
There may be reasons why you have fallen short when trying to change a habit, but they are not excuses.
Now here’s the good news:
There may be reasons why you have fallen short when trying to change a habit, but they are not excuses. Thankfully, you are still responsible, and what you acknowledge you can change. It does require personal accountability.
It sounds simple, and it is, but simple does not mean easy.
I have outlined 4 simple strategies that will put you on solid ground and move you forward. That is where we want to go, right? Therefore, looking back or dwelling on past failures is no longer an option. That would be like trying to drive your car, looking in the rear view mirror. We recognize that nothing good will come from that!
1. YOU WILL CREATE WHAT YOU BELIEVE-
There is no other force as powerful, creative or destructive as your thoughts and own belief system. Therefore, if you have struggled with maintaining weight loss, or a healthy eating lifestyle, the question you need to ask is: Do I believe that I deserve to lose weight and feel good? This is not a question you pose to your head, but to your heart. Your intellect will always tell you what you want to hear, but the heart knows only the truth.
“You cannot solve your problem with the same mind that created it.”
If you are not getting the right answers to chronic, recurrent, problems, this may simply mean you are asking the wrong questions.
| “You cannot solve your problems with the same mind that created them.”-Albert Einstein |
In order to achieve any lasting changes in your diet, exercise or lifestyle factors, you have to dig deeper and ask some difficult questions to uncover the limiting beliefs or lies that are keeping you from rising higher. Some, or most of our limiting or destructive beliefs are subconscious, but specific tools and an honest inventory will help in Identifying, Acknowledging, Challenging, and Releasing these automatic negative thoughts and allow you to create a greater vision for yourself. Your belief system is directly related to your thoughts. Guard your mind like Fort Knox.
The battle is won or lost in your mind, so that is where it must begin
2. GET CLEAR, GET COMFORTABLE:
I would encourage you to get a clear vision of what you want for yourself. This will be your mental map or GPS. You can be assured that you will have times when you will fall of the track, not if, but when. Here’s the point, Just because you get derailed, you don’t have to crash. Immediately, divorce yourself from the tendency to nurse the bad feelings, feel guilty, blame or engage in self- recrimination. Having a vivid vision of what you desire for your self will keep you from losing momentum during the challenging times. There are many ways to do this. Some people do well with meditation, picture boards, positive affirmations, visualization, journaling and writing out their goals. Daily. You must be vigilant, bad habits die hard.
The second part of this exercise is to assign a numerical value to how comfortable you are that you will follow through with the goal. For example, if your goal is to ” exercise 5 times per week for 1 hour” and you assign a 2 to your comfort level ( 0 to 10, with 0 representing not comfortable at all) this is NOT a worthy goal for you at this moment. Modify it until you are at an 8 or better on the comfort scale. Your previous goal may change to, “I will walk for 20 min a day, 4 days a week.” Then give it life by putting it on your calendar. And finally, Don’t break a date with yourself, you are important.
3. WILL POWER IS NOT VERY POWERFUL.
The nature of will power is that it is not a powerful motivator or catalyst for change in the long run. Psychologists and life coaches know this. It may get you started initially, but it is rarely a faithful friend to the end. Instead, you have to cooperate with some natural laws at work here. I will outline a few.
Our brains are wired to seek pleasure and avoid pain. Pretty basic for survival, back in the day. The main motivator for any behavior is based on this principle and so self- gratification and self- protection are the two most powerful activists. Unfortunately, portions of our brains, ( namely, the Amygdala and Nucleus Accumbens) are easily hooked on various forms of pleasure, some good, some not so good.
In the ‘not so good ‘category are sugary, salty and fatty foods which trigger the same centers in the brain as some drugs. The food industry knows the sneaky secrets to turn on the reward centers in your brain and activate the release of the neurotransmitter, Dopamine. In fact, Dopamine is often referred to as the “Master Molecule of Addiction.” Studies have shown that while animals will work hard for a sugar or fat reward, they will work the hardest for a combination of sugar and fat. An example in the ‘good’ category are people that obsessively engage in rigorous exercise to achieve an endorphin release. The so called “runners high.”.
So what does this all mean for us common mortals? Why are bad habits, like not exercising, eating poorly or smoking, so hard to change despite the knowledge of their deleterious effects and contribution to disease? No, it does not mean you are “weak” lacking in willpower and doomed to failure!
Many health coaches and scientists have studied this question and countless methods to facilitate lasting behavioral change. A fairly daunting task, for sure. Lately, many theories converge on the principle of Love versus Fear. What does love have to do with it, you ask? Everything we do comes through motivation from either love or from fear. If you are not enjoying your life, or if fear is an emotion you feel more often than love, joy or peace, then you are probably operating from a primitive, lower brain function which seeks to avoid pain and seek gratification through external means.
The take home message is that all lasting change starts with self – love. The love of self, knowing and accepting your true nature and spirit of greatness, gives rise to love of others and thrusts you to a higher level of function. If love, the most powerful force there is, becomes your primary moving and motivating force, you will naturally seek and gravitate toward healthy foods, habits and the positive reinforcement they create, which is feeling good, healthy, vibrant and strong. That is our birthright. Furthermore, “Nothing succeeds like success.” As you create positive habits, they reinforce themselves. It is true freedom to make choices that are life enhancing and that affirm self- love.
Think back to the last time you felt pure contentment, a lightness of being, joy or peace, what were you doing? DO more of that! It’s time to give yourself permission to re- discover or find ways of creating more joy. If you are feeling stuck, don’t forget to check in with your belief system, strategy #1.
“Everything we do comes from either Love or from Fear.” – Arlosky
4. START SMALL, END STRONG
The most common mistake when embarking on a life change for health or personal reasons is to set goals that are unreasonably difficult to stick with and therefore will have a limited degree of success.
An example is beginning a ‘diet’ that is based on the principle of deprivation and elimination. I am certain you can relate to this. You can also most certainly guess why this sort of plan is doomed to fail. If food is a source of pleasure for you and you decide to eliminate every food you are currently considering ‘bad’, you will be miserable. Remember what happens when your brain is miserable? It is pleasure seeking and pain avoiding by nature. Is it any wonder why most diets fail? A simple rule that I will share, is to consider that there are NO foods that are off limits. ( exception of course, are foods that you may have an allergy or intolerance to, and these often times are the very ones you are craving).
Does that mean you can have your fill of donuts and French fries? Of course, the answer is a resounding NO!
As a general rule eating ‘clean’ 80-90% of the time allows time for your body to chemically adjust and down regulate the dopamine and hormonal systems ( insulin, leptin) of reward, cravings etc. Have you ever noticed how when you eat sweet or fatty food, you crave more sweet and fatty food? The formula your body uses is as follows: eat junk, want junk. It’s not in your imagination. It’s a downward spiral due to changes in the chemical and hormonal systems of the body. Your body is very much like a chemistry lab and is inherently good at maintaining status quo and enhancing survival mechanisms.
Do not despair, eating clean is a way of life that will eventually be as automatic as brushing your teeth.
Concentrating on building your meals around Seasonal, Organic, Unprocessed, Local (SOUL) food is the foundation of healthy eating.
Concentrate on building your meals around Seasonal, Organic, Unprocessed, Local ( S.O.U.L) food .This is the foundation of life- long, healthy eating habits. Increase your consumption of vegetables, fruits, healthy fats and oils. Consume foods in their most natural and unaltered states. For example, a baked sweet potato, not French fries. Use the method of ‘crowding out’, that is, filling up on the most “nutrient dense” and healthy foods first and thereby reducing the consumption of the calorie dense, processed, and unhealthy fare. Remember you will always allow yourself the 10-20% ‘free choice’ for a night out or a special occasion. No guilt allowed! EVER!
Make it a practice to increase consumption of water, drinking at least ½ ounce per pound of body weight. A simple practice that has enormous, far reaching health benefits.
Beginning an exercise program gradually, and ramping up intensity slowly, is the kinder more sustainable approach. This will allow you to feel the positive changes without experiencing the negatives of forcing your usually sedentary body to complete a full session of P 90X.
If you are new to exercise, use your smart phone’s app to track the number of steps you take in a day. Set a goal to increase the number of steps weekly until you reach 6,000 steps per day, which is the average for most people, or strive for the 7,000 to 8,000, recommended by the CDC. (Centers for Disease Control). Eventually you may get to 10,000 steps or beyond which is associated with the most health benefits.
Following these simple, real solutions will provide the spring board that moves you forward and allows you to experience success. Success experienced early in the process of life change, is indicative of future and continued success.
If you desire to see yourself in a better place this time next year, you must begin to make different choices. Quite simply, if you desire a different outcome, you have to make a different choice. One small, next right choice at a time, one day at a time.
If you keep your vision in front of you, state your intentions,stay focused on the feelings of accomplishment and the health benefits that will inevitably follow, you are sure to end 2017 a happier, healthier you!
Who needs resolutions anyway?
I would love to help you make this transformation a reality. If you have particular health, fitness or rehab issues that you need assistance with, contact me: email: madicaro511pt@gmail.com
Visit my website or contact me for New Years “Commitment to Wellness“, 2 for 1 packages!
Website:http:// http://www.mdtherapyandwellness.com
BE WELL, BE BLESSED.
Is it time for spring cleaning? The season of new life and new beginnings always give rise to our innate need to purge the old and welcome the new. Our physical, mental and spiritual selves may be feeling that need as well.
In our increasingly stressful and toxic world, the need to detox your life is more important than ever. Perhaps it may mean a new exercise regime? Healthier eating habits? Managing stress and screen time? Consciously reducing exposures to drugs, chemicals and environmental toxins? The best formula for success and optimal health is a combination of all of the above.
Our bodies have miraculous detoxification and restorative powers, however there has never been a time in our history that we have been inundated with such an onslaught of environmental and chemical toxins, beyond our bodies’ ability to neutralize and eradicate them.
Of the more than 82,000 chemicals registered for US commerce and ubiquitous in our, food, air and environment roughly only 7% are subjected to safety testing! These toxins accumulate in our tissues (adipose) when the body is unable to keep up with the constant exposure. Many are xeno-estrogens,( endocrine hormone disruptors) neuro toxins ( brain and nervous system toxins) and contribute to cellular death, inflammation, and DNA changes. This combined with poor nutrition, elevated chronic stress and detrimental life style habits ( smoking, over eating, lack of exercise) and you have a recipe for chronic illness and disease.
For optimal health, seasonal mind/body detox should be an integrated part of living a healthy lifestyle. This means assisting your body and mind by eliminating chemical poisons and anything that contributes to elevated stress or negativity. Just as a toxic body affects our mental states, a distressed mind compromises our physical health. A well designed, supervised, seasonal cleanse, can support the natural detoxification pathways of the body and be a catalyst for a healthier,happier life journey. Consider this “Spring Training” for your body and mind that will ultimately lead to greener pastures.
Take a peek at my presentation on “Detoxification and a Sample 3 day cleanse
A new year Toxic load and helpful cleanse – Copy
Link to slides: http://1drv.ms/1JcyhBd
Visit my website: http://www.mdtherapyandwellness.com
Holistic Therapist 