Battling the Enemy to Health

I mentioned in my previous post that the true enemy to health is inflammation.

In order to battle this enemy effectively one really needs to figure out the things that trigger the inflammatory process in their bodies. 

How do you do this?

1. Have a general blood test done to note vitamin/mineral deficiencies as well having you blood inflammatory levels checked.  
2. Test for food allergies.
3. I had mentioned that inflammation can cause pain. If you are having pain, keep a journal and record your pain intensity, what you ate and your activities. See if there is a cause/effect relationship. 
4. Eat foods and take supplements that have anti inflammatory properties and avoid those that are know to cause inflammation. A good list for both can be found at:

http://www.chicagonow.com/clean-convenient-cuisine/2010/09/best-and-worst-top-10-most-inflammatory-and-anti-inflammatory-foods/

New research is showing benefits with taking Tart Cherry Juice. One study found it as effective as the prescription version of aleve.(naproxen)

In her book "Taming Pain", Cheryl Wardlaw, PT recommends purchasing Tart Cherry Juice Concentrate from a health food store and take 2 tbsps 30-45 minutes before bed. 

Note that if you are taking blood thinners you should consult your doctor before taking. 

One of my former patients began taking it last week and felt results immediately. He reported that he was able playing paddle ball without negative effects,  he had not been able to do this in months.

The True Enemy to Health

The true enemy to health is not: a sedentary lifestyle  gluten, soy, peanuts, high cholesterol, fats, or carbs or even sugar but the manifestation these things in the body, especially in certain individuals.

The true enemy to health is Inflammation.

Here are some interesting facts about inflammation:

1. There is a link to heart disease with increased inflammation
2. Inflammation is a direct cause of pain. Pain leads to immobility. 
3. In spinal cord injured patients, paralysis is caused by inflammation due the injury rather than direct damage to the spinal cord.
4. Stroke caused by bleeds and Spinal cord injured patients have greater return of function when steroids are given early to decrease the effects of inflammation.
5. Traumatic brain injured patient’s in the military are kept in a cold room to decrease inflammation.
6. People with autoimmune diseases have higher levels of systemic inflammation. 
7. Allergies cause inflammation.
8. For every cubic centimeter of inflammation a muscle shuts down by 1 percent.

Since the muscles that are closest to the joint where inflammation typically occurs, core muscles will shut down. Instability causes irritation and further inflammation. 

Inflammation causes Instability

We know that a person needs to have Stability in order to have mobility therefore, patients will lack range of motion secondary to instability caused by inflammation.

Inflammation causes decreased Range of Motion

Both Instability and a lack of Range of Motion Lead to Falls,

Therefore, Inflammation Leads to Falling

It is imperative that all health care professionals understand the direct and indirect effects of inflammation as well as the direct and indirect causes of it. In addition to other helpful diagnostic tests, we should request information about inflammation that can be detected by testing ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) in the blood. 

Also realize that whenever a patient sustains a trauma, undergoes surgery, has a poor diet and/or food allergies, they will become inflamed.  We need to not only need address the inflammation but also restore range of motion and stability in the system.

Barefoot running; the good the bad the stinky

Over the last few years, there has been a lot of controversy about barefoot running and minimalist shoes.

This phenomenon, however is not something new.

The first gold medalist in the modern Olympics marathon ran the event barefoot in 1960, as did Zola Budd the South African runner who ran the 1600 km event in the mid 80s.

Barefoot and minimalist shoe runners will insist increased comfort and decreased injury particularly up the kinetic chain.

The research supports that the barefoot running technique causes less force through the body by landing on the forefoot versus the rear foot and even supports the development of a better arch with this type of running style and footwear.

What the research is also showing is an increase in stress to the bones of the foot. In a study done on 36 volunteers who ran between 10-15 miles per week, post MRI showed an increase in bone injury in more than half the those running in minimalist shoes after 10 weeks.

Another argument in support of barefoot running is the tribes people in Mexico and Africa who are efficient barefoot runners.

I do believe that barefoot running works for them for several reasons:

1. They did not grow up wear shoes, their bodies are accustomed to walking, running and playing barefoot. Research has demonstrated that humans develop a more functional arch with barefoot activities before age 9.

2. They do not run on paved roads but softer surfaces than the concrete and tar that we run on. Not only does this translate to decreased forces through the body but also the development of the foot intrinsic muscles and more importantly mobility of the bones in the forefoot.

3. Lastly barefoot running emphasizes landing on the ball of the foot this is beneficial to those with a pronated foot or low arch as the foot moves into a supination during this phase of running. Those with a high arch or a supinated foot will suffer increase stress in this position.

I would therefore recommend minimalist shoes or barefoot running for those with a low arch or pronated foot versus those with a high arch. It would be interesting to see if the research could be broken down further to add foot type to the variables studied.

The mysterious cause of genu valgum

Despite experiencing a painful rehab, the majority of patients who have had Total Knee Replacements (TKR) usually report being happy with their surgery.

Recently, I treated a patient who was not responding favorably to this surgery. She was experiencing pain and swelling around her medial knee with both walking and stairs.

As with any other patient,  I observed her walking and going down a step. Like most people she hopped off the step at end range. When I observed her pelvis,  I noticed that when she flexed her trunk forward her knee would go into valgum .

Using the principles of Diagnostic Motion Evaluation (observation of quality of motion), I observed that her femur would move in adduction causing a valgus of the knee when she flexed her trunk forward at the level of  L4.

When I asked her if she had a history of an appendectomy, she confirmed that she had and wondered why I asked. I explained that she may have scar tissue from the appendectomy that resulted in a connective tissue restriction causing her femur to move into adduction and place a valgus pressure on her knee.

When I mobilized that area, sure enough her femur remained in neutral as she bent forward and her valgus disappeared.