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. 🙂
If you have followed my blog or taken a peek inside my book, you may already know my belief that food is true medicine. I don’t feel I can over emphasize the significance of diet as the single most critical component of managing our health.
We have never needed an understanding of this more than we do right now.
Over half of Americans have type 2 diabetes or insulin resistance (pre-diabetes) ; almost half have hypertension or high blood pressure, and 3 out of 4 are obese or overweight. These sobering statistics have only worsened during the pandemic. Diet and lifestyle are the main causes of the rise in these numbers. Yet, statistics have shown that those with the worst outcomes from covid 19 and those who have required hospitalizations are those with these very conditions. In fact, nearly two thirds of covid cases requiring hospital care are attributable to obesity, high blood pressure, diabetes or heart disease.
We also know that changes to diet and lifestyle, even without weight loss can rapidly improve inflammation markers and health outcomes. Read that again. The reality is we can not have a disease defying, healthy body while ignoring the direct connection between food and the current and future state of our health.
In my last blog, Build a Foundation for Health, part one, I discussed the primary driver of most chronic diseases, and degenerative diseases of aging. It is our daily choice of nutrition as well as stress, toxins other lifestyle habits that are fueling inflammation.
If we are consuming literally pounds of food every day, how can we continue to deny its impact on our health and longevity?
The question I am asked frequently is what about vitamins and supplements? What should I be taking? What role do supplements play in safeguarding my heath?
My short answer is food (must come) first!
Rule #1: We can not rely on supplementation if our diet is atrocious! It is akin to bailing water from a sinking boat without first patching the gaping holes!
We should be receiving most or all of what we need from a healthy diet, high in phytonutrients, micronutrients, dietary fiber, vitamins and minerals. Notice I say ‘should’. The average american does NOT. Just 1 in 10 adults meet the minimum requirement for fruit and vegetable consumption. The risk for type 2 diabetes, cardiovascular disease and some cancers increases dramatically as fruit and vegetable consumption goes down.
This is a problem with many threads. It is often based on cultural, socio-economic status, and lack of affordability and availability or access to fruits and vegetables . We need to expand access and affordability in our communities and improve educational outreach efforts. Rather than subsidizing giant fast food companies and falling prey to the endless media promoting food propaganda on television and radio, we need to step up our advertising and education for healthier options. Enacting simple changes can potentially reduce Health care costs and the scourge of chronic disease that is lurking in our future.
Of course, personal choice is always involved. We can not deny that we have grown fond of the synthetically engineered, highly palatable food-like substances concocted by food scientists, and recognize how they have hijacked our brains’ reward centers! Standing alone, change is difficult, but even more so because of the addictive nature of foods and the cravings they create. We understand that human nature is not fond of change, and therefore making changes to lifestyle and diet is also a deep dive and multifaceted issue. That is a topic for another discussion and one that I address in my book.
It is also true that agricultural and food manufacturing practices have changed dramatically. Our genes have not. The types of ‘foods’ we have access to now are quite different than 75-100 years ago. While we may not have a shortage of foods in most parts of our country, we have a shortage of nutrient dense foods in favor of calorie-dense, manufactured foods. Our bodies barely recognize much of what we are consuming.
There are very real and verifiable nutrient deficiencies in our population and not just in communities where healthy food is scarce. Deficiencies exist despite most of us having access to food on demand. Many highly processed foods contain added sugar, harmful inflammatory seed oils, chemical flavor enhancers, and other undesirable additives. These are considered anti-nutrients and rob the body of essential minerals and vitamins. Foods are grown in nutrient depleted soils and sprayed with an array of chemical fertilizers, herbicides, and pesticides.
Deficiencies are prevalent with the use of alcohol, common over the counter and prescription drugs, which further aggravate many common deficiencies. Symptoms of deficiency are not always readily apparent. Many biochemical and metabolic pathways will be disrupted or halted if certain nutrients are not present to act as co-factors in the reactions. The first sign of trouble may be symptoms of fatigue, frequent infections, headaches, mood changes, high blood sugar, high blood pressure, cardiac arrhythmias or breakdowns in some other area or system of the body.
How are these “diagnoses” treated in mainstream medicine? Often with more drugs that bring with them additional health concerns. Unfortunately, in our current medical disease care system we are not looking for root causes or underlying factors that are literally interrupting the body’s ability to heal and function as designed.
What are the common nutrient and micronutrient deficiencies?
Unless your diet is absolutely healthy at least 90% of the time, meaning it is rich in phytonutrient and fiber rich plant foods, and quality protein sources, you may have a nutrient deficiency brewing. In this case, it becomes necessary to understand what the body is lacking and supply it for the body to function optimally. The body has miraculous healing properties when we remove the bad and provide the good.
Here is a short list of the common deficiencies and the potential side effects of deficiency.
- Magnesium: It is estimated that at least 60% of the population is deficient in this important mineral. It is difficult to get enough magnesium from diet alone. Magnesium is a cofactor in an estimated 400 reactions in the body. Magnesium is depleted by sugar, alcohol, caffeine, stress and many common prescription and over the counter medications.
Magnesium has important metabolic functions and regulates our response to stress. Magnesium helps manage insulin levels in the body and can prevent blood sugar and insulin spikes. Magnesium is a big player in blood pressure control, preventing high blood pressure especially when combined with enough potassium in the diet.
A Magnesium deficiency is associated with decreased immune cell activity and an increase in inflammation. Magnesium is critical for proper electrical and mechanical functioning within nerve and muscle tissues. It is a natural relaxant and is helpful for anxiety, muscle cramps, migraines, and insomnia.
What are a few of the symptoms of Magnesium deficiency?
Muscle cramps, anxiety, migraines, high blood pressure, muscle pain ( fibromyalgia), type 2 diabetes, insomnia, and osteoporosis.
2. Vitamin D: This powerhouse vitamin functions as a hormone, having body wide effects. Vitamin D supports blood glucose balance, the brain ( mood, memory and cognitive function), the cardiovascular system, the skeletal system ( increases calcium absorption strengthening bones), the muscular system ( increases muscle strength) and the immune system. There are over 70 clinical trials underway worldwide looking at the role of vitamin D to prevent and treat covid-19. A recent study reported that 82% of people hospitalized with severe covid infections were vitamin D deficient compared to 47% of controls in the general population. A major study conducted in 2017 involving over 11,000 patients showed Vitamin D supplementation protected against upper respiratory infections.
It is challenging to obtain adequate vitamin D by diet alone. Exposing the skin to sunlight is your best bet however if you are over 50, have dark skin, or are obese you are less efficient at producing Vitamin D.
What is the correct dosage of vitamin D? Dose should be determined by your doctor after a blood test called the 25 hydroxy vitamin D test. If you have not had one lately, you can request one at most labs.
3. Co-enzyme Q10 is the important anti-oxidant produced in the body that you may not be familiar with. This is an important cofactor for the generation of energy within energy factories in the body called mitochondria. Levels of this anti-oxidant decline with age and are depleted by many common medications such as statin drugs ( Lipitor_) used for reducing cholesterol. Co Q 10 is an important molecule in every cell in the body and most notably for energy generation in heart, kidneys and brain. Heart muscle mitochondria MUST have CoQ10 to function. Indeed, statin users and heart-failure patients share something in common – they’re both deficient in CoQ10. It has been shown in double blind studies to improve insulin sensitivity, improve glucose tolerance and reduce toxic free radicals. It has demonstrated effectiveness in the treatment of migraines and periodontal disease. The active form of Co Q10 is called Ubiquinol, and is much better absorbed.
4. Omega 3 Fatty acids ( DHA, and EPA) are the anti-inflammatory fatty acids our body requires for healthy cell membranes, normal communication between cells, healthy brain function, normal platelet function, healthy blood vessels and blood flow, and the regulation of harmful blood fats such as triglycerides. Omega 3 fats can target inflammation and neutralize free radicals that lead to aging and disease.
Our diets consist largely of omega 6 fats which are pro-inflammatory. All processed foods and fast food establishments use industrialized seed oils such as canola, corn, sunflower and soy. These polyunsaturated fats ( PUFAs) increase inflammatory cytokines and free radicals, accelerating the aging of membranes and tissues. Free radicals are damaging to vessels and impair circulation to the heart, and brain and increase the risk of obesity, stroke and diabetes. Omega 6 oils must be balanced with omega 3 fats to prevent the disastrous inflammatory effects on muscle, bone, blood vessels, the heart, liver, kidneys and brain.
Support your cardiovascular and nervous system appropriately with an anti-inflammatory and antioxidant rich diet and the use of purified omega 3 (EPA & DHA) supplementation.
Of course there are many other potential deficiencies not listed here, and these are based on the current state of health and symptoms. Specific recommendations for nutrients are based on certain conditions. For example, osteoporosis requires many different nutrients for prevention, management and reversal. Type 2 diabetes is often reversed with a combination of proper diet, supplementation and lifestyle changes.
For prevention of infections such as covid, and the multitude of other respiratory viruses we are exposed to, certain nutrients such as N-acetyl Cysteine ( or reduced glutathione- a powerful antioxidant and detoxifier), Vitamin C ( therapeutic doses) Zinc and Quercetin ( an anti-inflammatory plant flavonoid) which acts as a zinc ionophore, have already proven to be highly beneficial.
In addition, each person is genetically unique and many of us have something called SNPS, or Single Nucleotide Polymorphisms. SNPs are common genetic variations where one piece of DNA is altered from its original copy. These tiny amino acid base pair changes can impact the way the body produces energy and whether the body can detoxify itself and even how it responds to stress, drugs and foods. We are truly unique so our diet and any supplementation should reflect these differences. True health care is not “one size fits all.”
The real magic pill we are seeking, the one that will reduce a tremendous amount of chronic disease can be found at the end of our fork. Getting our nutrition right is crucial, supplementation is available to round out the deficiencies that may be present from our unique genetics, drug or toxin overload and finally, to mitigate the side effects of living an increasingly stressful lifestyle.
There is much we can do to support our health, prevent disease, and bolster our immune system. We do not have to accept sickness as our fate. We deserve better. This is a valuable mission and undertaking that is worthy of our understanding and attention.
I am delighted to announce that My Amazon bestselling book, Staying Healthy, Living Longer- 7 Powerful Principles for a Healthier You! is the WINNER of the 2021 International Book Award for the Healthy aging over 50 category!
It is available on Amazon: https://amazon.com/dp/b08vc6pywj/
Available on my website and also at Barnes and Noble and Independent book sellers.
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It’s that wonderful time of the year for pumpkin-flavored everything, ghosts, ghouls, and skeletons decorating our living spaces! With Halloween right around the corner, I thought it might be fitting to dedicate a blog to “Building a Better Skeleton” and what we can do to ward off the “scary trends in our bone health.”
Let’s get the scary news over with first.
To start with, we have a serious problem with bone thinning in the United States. The National Osteoporosis Foundation reports that at least half of the U.S population over the age of 50 has osteopenia (pre-osteoporosis) or osteoporosis.
The National Osteoporosis Foundation estimates 54 million Americans are affected by osteoporosis and low bone density conditions, and if this trend remains unchanged it is predicted to increase to over 64 million by 2030. Those who sustain a hip fracture due to osteoporosis have a 15-20% mortality rate due to complications, while those who survive, less than half of them will regain full independent function.
OK, now for the good news.
What if I told you that your bony skeleton was designed to remain strong for your lifetime? Could it be that what you believe about aging and bone health is oversimplified and no longer scientifically accurate? Yes, both statements are true!
I have spent the last few years, learning what the science is saying about maintaining strong, fracture resistant bones as we get older.
I am excited to say that I have dedicated an entire chapter to the condition, Osteoporosis in my soon to be released book, Staying Healthy, Living Longer, 7 Powerful Principles to a Healthier You! due to be released this January 2021.
This blog will give you a quick peek into the primary factors affecting whether you will have strong, healthy bones as you age or be part of a growing population of those diagnosed with bone thinning, osteoporosis, or frailty.
Bone density is measured most commonly with a special kind of x-ray called a DEXA scan. This stands for Dual X-Ray Absorptiometry. The DEXA can will give you a number called a T-Score.
For those not familiar with the terms, Osteoporosis, literally means ‘porous bones’ and is diagnosed when a bone density scan T-score measures a -2.5 or less. ( more negative). Osteopenia is when a T score is -1.0 to -2.5. This is considered early-stage or ‘pre-osteoporosis”. Anything over -1.0 ( less negative) is considered normal bone density. A T score is calculated by comparing your bone density to that of a 25-30-year-old or those who should be at “peak bone mass”.
I want to mention here that the time to start thinking about your bone health is when it is the last thing on your mind. Early childhood. Building healthy bone early in life is an insurance policy against loss of bone in adulthood.
A bone density or DEXA scan is recommended for all those in menopause especially when risk factors are present. An important point to remember is that a T score is a snapshot of what has already happened to the structure of your bone and is not a current picture. In other words, It tells a story of what has already occurred and not what is occurring.
Bone mass as represented by a bone density ( DEXA) scan, does not directly translate to bone strength or the bone’s ability to resist fracture under normal daily stress. Many other variables must be considered.
Also, it is important to note that these scans ( T scores), look only at the quantity of bone and not the quality of bone. That is an important distinction that must be understood. You can have a lower bone density, yet have strong and resilient, fracture-resistant bones, or a higher bone density and have older bone that has not undergone reabsorption, that is prone to microfractures and failure.
Normal bone is a living, dynamic tissue. It responds to the stress placed upon it ( weight-bearing loads and resistance training) by strengthening and increasing its density and resiliency. It also responds to nutritional factors, body-wide inflammation, hormonal factors, gut health and even mental-emotional stress.
Normal bone undergoes remodeling as do all tissues. Old bone is reabsorbed by the body by specialized cells called Osteoclasts and new bone is laid down in its’ place by cells called Osteoblasts. Many factors affect these cells and the rates of remodeling, reabsorbing, and rebuilding.
Let me begin by stressing that Osteoporosis, like many chronic and progressive conditions, is not an isolated disorder. Bones exist within bodies and therefore, Bone health is highly reflective of general health.
What are the risk factors for Osteoporosis? Risk factors can be divided into “Fixed” and “Modifiable.”
There are some “fixed risk factors” that we have little or no control over. Such things as having a smaller body frame, being female, early or surgical menopause, and prolonged steroid use for an auto-immune disorder, and history of a family member with an early bone fracture.
However, many of the factors that increase our risk of osteoporosis and bone fracture are modifiable, lifestyle factors. These same modifiable, lifestyle factors are in play for many of the chronic diseases of our time. They share common pathways, therefore, bone thinning can indicate the presence of other health conditions.
Does Osteoporosis have symptoms or early warning signs? Rarely, but there are some subtle clues. One of the hallmark signs are changes in posture. In therapy I look for a rounding of the upper back. There may also be loss of height, periodontal disease, and loss of grip strength.
Here is a short list of the many factors that we can control.
- An Inflammatory diet,- what most of us are eating
- Poor nutritional status or nutrient deficiencies ( Mineral deficiencies, Vitamin D….)
- A Sedentary lifestyle and inadequate weight-bearing exercise; loss of lean muscle, also called Sarcopenia
- Excessive soda or alcohol consumption
- High-stress levels ( increased cortisol)
- Leaky gut, food sensitivities, and Celiac disease.
- Certain Medications
- Hormonal Imbalances
- Smoking
In part 2 of this short blog, I will focus on just two of the many factors that are controllable or modifiable; nutrition, and exercise. I will briefly discuss ways of preventing bone loss, building healthy bone with diet and exercise, as well as preventing falls and fractures.
http://www.mdtherapyandwellness.com
“Having Healthy strong bones for life, is possible and starts with what you are doing right now.'”
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We are in chaotic and uncertain times. There is a wave of expanding collective anger and pain that is palpable.
It is an understatement to say we are all being challenged to salvage some sense of peace when confronted with social and political unrest entangled with financial, personal, and health worries. I have seen a great deal more emotional stress, headaches, neck pain, back pain, and overall bodily discomfort in my patients. It is never too long that emotional pain becomes physical pain.
We seem to have hit a pivotal point in society where hatred, destructive dialogue, division, anger, and blame are at an all-time high. Civility, kindness, acceptance, and love are strangely absent. Today and every day, we have a choice to make.
The news and social media are the platforms for expressing this discontent and anger. It has morphed into a means of spreading fear and mistrust or canceling anyone who thinks differently from us. Name-calling, ridiculing, and brandishing opinions as though they are Truth and fact has become a common thread perpetuating this growing anger and unrest.
We seem to have lost the ability to have intelligent conversations with those of differing opinions and beliefs, insisting that others who believe differently than us are “wrong”. There is vehement push back, resistance, self-righteous attitudes, and defiance when our beliefs or opinions are challenged or not accepted as universal Truth. Our ego tells us that if perhaps we shout loud enough we will change the minds of those who think differently. We instinctively know and have seen historically that this is false.
It becomes easy to bully, belittle, dehumanize, and lump groups of people into ‘categories’, as if to ‘shield’ ourselves, simply because they think differently than we do. This is a form of bullying. In doing this, we are perpetuating the negativity, anger, hate, and division that is already escalating. We have now become part of the problem.
The news and news media have always portrayed the lowest common denominator of human existence and is designed with one objective in mind: to activate the portion of the brain ( Amygdala) that creates fear.
More than ever, news media and social media bombard the fear brain, inciting anger, divisiveness, and “me against them” thinking and mistrust of others. This promotes a stress response in the body by upregulating our “fight, flight, freeze, and fear”, Sympathetic nervous system. This is our built-in survival mechanism however, it is not meant to be responding every day, all day to perceived ‘threats’. The consistent hyperarousal of this nervous system is responsible for many chronic health conditions, including heart disease, high blood pressure, diabetes, compromised immunity, depression, anxiety, muscle tension, chronic pain, and insomnia.
I sat quietly this morning in solitude considering the choices we have and the lessons we can learn during times of testing.
We have a choice to reduce the amount of time we spend watching the news or engaging in the various forms of social media. Setting time controls and boundaries can go a long way toward restoring our inner peace. Those who watch the most news, experience the greatest levels of anxiety.
We have a choice to disengage when someone is choosing to express vitriol, name-calling, personal attacks, and other bully tactics. There is no place for this in any relationship or even when expressing our views on a social platform.
We can make a choice to refuse to be offended, as carrying an offense and being easily offended brings the heavy burden of resentment and bitterness, stealing our health, peace, and joy. When we are easily offended our rational brain is hijacked, and our emotional and fear brain is in the driver’s seat. We are essentially giving our control over to someone else, allowing them to influence our reactions and remarks. We may strike out in defense as I have seen countless examples of those who have said they “Can’t be friends with someone who votes for so and so, or who believes such and such.”
We can choose to have an open mind and hold space for duality; simply understanding that two very different ideas can co-exist at the same time while understanding that there is rarely one truth that summarizes a complicated issue. As Steve Jobs has said, “Have strong opinions loosely held.”
We can choose to allow a larger perspective, as pettiness and insisting we are right, cancels our joy, and contracts our world. We need people with other viewpoints to expand our thinking. We don’t have to change our minds but new knowledge can expand our minds if we are secure enough to receive it.
We can choose to have healthy boundaries especially with those who for whatever reason, are angry or abusive. We may have to take inventory of the types of interactions we engage in, protecting ourselves as needed. Distancing from toxic relationships may be necessary if boundaries for decent behavior are not respected. Those who attack or hurt others are often experiencing pain themselves, we can have empathy. Empathy builds resilience.
We can choose to focus on the good that we can do; how we can contribute our energy positively to the greater good or a cause that is important to us. Other questions we can consider: What can I do to lift up myself and others? What is within my control and what is not? How are my underlying beliefs and prevailing thoughts contributing to my unrest, worry, anxiety, and stress? Ultimately, it will be our health that is negatively impacted.
We can choose to make peace our primary goal. If we can cultivate ways of choosing peace, safeguarding peace, and residing in a place of peace, despite external circumstances, we become a very powerful agent for change. Developing healthy habits that protect our peace of mind, may mean limiting the time we spend watching or engaging with news and social media. Instead, we can use our time to listen to soothing music, take a walk in nature, express ourselves in a journal, play with a pet, pray or meditate, or simply breathe.
We can choose to nurture our faith rather than our fears. This is not an easy task at times such as this, but this is precisely when it becomes most valuable.
” When you judge another person, you do not define them. You define yourself…When you respond with hatred to hate, you’ve become part of the problem which is hatred, rather than part of the solution, which is love. Be a person who refuses to be offended by anyone, anything, or any set of circumstances.” – Wayne Dyer.
This above quote by Dr.Wayne Dyer holds tremendous wisdom. Indeed, It is a very difficult call for us to uplevel our responses in a time of chaos and uncertainty. If we can achieve it now, it will be a skill that we can turn to, again and again during other trials.
“I have told you these things so that in Me you may have perfect peace. In this world, you will have tribulation and distress, but be courageous and filled with joy, for I have overcome the world.”- John 16:33
Faith>Fear💕
Mary
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
Holistic Therapist 