What do papaya and pineapple have in common besides being tropical fruit?
They contain potent vegetarian proteases. A protease is an proteolytic enzyme that helps break down protein.
How does this relate to healing from orthopedic injury or surgery? A lot actually.
Proteolytic enzymes aids in breaking down animal proteins when ingested, but also mediates tissue repair and break down of cellular debris associated with inflammation metabolism.
Common medications to address symptoms of pain following orthopedic injury or surgery are those targeted to reduce inflammation. The problem, is that these same medications that reduce pain via inflammatory regulation also impair healing, disrupt the integrity of the gut, and increase the risk for cardiovascular events. Fortunately there is a natural remedy that does not have the negative side effects.
Turmeric is an Indian spice from the ginger family used in curry. It is the spice that gives curry its yellow color. Curcumin is derived from turmeric and is the most active form. This is important because oral absorption of curcumin tenst to be poor due to its low solubility and instability in the intestinal environment. Yet, as an herbal remedy, it is historically used as an antiseptic, antibacterial, anti-inflammatory, pain killer.
Did you know that one in four Americans suffer from pain per the National Center for Health Statistics? Pain is the primary reason for seeking health care services. In 2010, the annual cost of pain was greater than the annual cost of heart disease, cancer and diabetes COMBINED. This pain is often caused by chronic inflammatory conditions like arthritis.
Common treatments for painful and inflammatory conditions includes Non-steroidal Anti-Inflammatory (NSAID) medications like Advil or Motrin or Celebrex. The mechanism of action to decrease pain is in the NSAIDs ability to block the COX-1 or COX-2 pathway which is why it reduces inflammation and pain. A common side effect of NSAIDs is gastrointestinal disruption especially with chronic use. More recently there was a study published demonstrating an increased risk of cardiac arrest with the use of NSAIDs.
This is a topic near and dear to my heart. I have been hesitant to share this condition because it honestly scared me to death when I first learned about it. In time, not only have I healed, but the more I understand the condition the more empowered I become to prevent it from coming back.
This is a lengthy research report, so bear with me as the details are important. I will describe the condition leaky gut (or increased intestinal permeability), how it is linked to your immune system, why it matters, causes and solutions.
***You have been warned***
Leaky gut is more specifically described as increased intestinal permeability. It is a descriptive term related to the small intestines having a reduced barrier function. This condition is not a diagnosis alone, but has been linked to many illness and symptomology.
Osteoarthritis (OA) is the most common diagnosis that can affect any joint, but most often in the knees, hips, spine, small joint of the hand. Hallmark symptoms of osteoarthritis pain and stiffness of the joint. It is considered a degenerative disorder that results from the breakdown of the cartilage that provides the smooth surface of the joint for motion and acts as a cushion. This disease affects about 27 million Americans. Causes and risk factors for developing osteoarthritis are genetics, obesity, and overuse. 1
The pathophysiology link between obesity and osteoarthritis is related to both the direct excess of mechanical loads on the cartilage, but also the adipose tissue releasing leptin. In both scenarios, there ends up being an increase in inflammation, which helps to drive the tissue breakdown. 2 To describe this further, I often discuss with patients the “coin analogy.”
Metabolic Syndrome (Met S) affects nearly 47 million Americans. 1 The prevalence of arthritis is 52.5 million US adults between 2010-2012. This is estimated to rise to 78 million for Americans aged 18 years or older by 2040 per the Centers for Disease Control and Prevention. 2 These numbers are staggering in so much as it would seem lucky for you not to get either Met S or some form of arthritis. The question becomes whether or not having Met S may increase your risk of developing arthritis and how to avoid both problems.
“To (eat gluten) or not to (eat gluten)? That is the question”
Celiac Disease and Non-Celiac Gluten Sensitivity
The gluten protein has gotten a lot of press lately. The question is how to decide if gluten is a problem for you or not. Gluten containing grains are widely consumed and provide an estimated 50% of caloric intake worldwide. 1 Gluten is a family of toxic proteins found in wheat, barley, rye, and grains such as oats, barley, spelt, kamut and triticale. 1 Given the widespread use of gluten containing foods, it is of no surprise that in the past 20 years there is an increase in not only celiac disease, but other gluten related disorders. Although this was once thought to be a rare illness and mostly ignored, it is now becoming more widespread worldwide especially as other countries adopt the Standard American Diet.
Life requires movement.
What Is Movement?
Movement is defined as an act of changing physical location or position. For me as a physical therapist, the movement you do throughout the day must include full range of motion of the joints. Our standard American life tends toward spine flexion in the form of sitting in front of a computer, in a car, on a couch watching TV, and lifting, which is all flexion. It is not that sitting alone is a problem as much as chronic sitting means you are not moving your joints through their full range of motion.
A healthy joint is a flexible joint. When you stop moving joints, the tendency is for them to get stiff, soft tissue shortens, and you lose range of motion. Once the motion is lost, the strength of the muscle supporting that joint begins to weaken. It is a vicious cycle.
This blog was written as a summary for a talk given to young female volleyball players on December 12, 2015.
Many things have changed since my athletic days. I’d argue that my Crossfit participation reminds me of my athletic days, yet I don’t consider myself an athlete anymore. Why? Because I only do Crossfit twice a week and I don’t compete. It is a means to stay fit and healthy. A majority of my time is spent on mothering and physical therapy “performance.” However, I will argue that my ability to participate in Crossfit at my young age of 39 years old, is directly related to a few things that I WAS NOT doing when I was actually competing in high school and college athletics.
With age comes wisdom, right? What I know now, I wish I knew then? What might I have been able to accomplish athletically?
It doesn’t matter because what I know now helps me stay fit and healthy enough to participate in Crossfit, mother three kids, run a physical therapy practice, work towards a Master’s of Science in Holistic Nutrition, write a blog every once in a while….. My optimal performance in these tasks requires optimal nutrition.
(This was a previous guest blog I wrote for my friend Dr. Kristin Prentiss Ott, MD on www.kristinprentissott.com October 2015)
My past work experience has included years working in the hospital including the surgical wards. Now, I specialize in outpatient orthopedic physical therapy. I see mostly patients who want to avoid surgery. I am a proponent of keeping the body intact whenever possible. However, there are times when accidents happen or it is necessary to have surgery in order to get back to living life.
Sometimes it happens.
You take good care of yourself and exercise regularly, but then you fall skiing and tear your ACL. Often, to keep up that same level of activity, the ACL will need to be surgically repaired.
Or you may have been a college athlete that played football and now have severe hip arthritis in your 60s that requires a total hip replacement.
Like I said, sometimes it happens. And if you are going to have surgery planned or not, here are a few tips to help you to optimize recovery, not faster, but optimally.
I was honored to be accepted to write a guest blog for Robb Wolf. It was fun for me to re-live my athletic days, but also draw from my experiences in order to help past, current and future athletes. Read on for more details here: Robb Wolf
As a physical therapist, many of my patients have arthritic disease of the joints. During my traditional education I received minimal education related to the importance of vitamin D and calcium except that they are important for bone strength, and deficits are in part what lead to osteoporosis (thinning of the bones). However, I am interested in what role vitamin D and calcium play in arthritic conditions, and if there is a link to joint health and vitamin D and calcium.
Osteoarthritis (OA) is one of the more challenging diagnoses to successfully treat as a physical therapist. In trying to find a more effective way to educate and treat patients, I went to Pub Med to find complimentary approaches to OA.
Guest Blog from Grant Glass, PT, CIMT, OCS, CAFS, GPS
Did you know that your gut microbiome can also impact inflammatory arthritis disorders?
Rheumatoid Arthritis, an inflammatory arthritis disorder, is a debilitating autoimmune disease where the body’s immune system attacks its own tissue, typically the small joints of the hands and feet. Traditional treatments include medications, physical therapy and surgery to control symptoms and prevent joint damage. Recent research is indicating that probiotic intervention holds promise to decrease disease activity score and inflammatory cytokines (TNF alpha, IL-6, IL-10).1
Can what I eat really decrease my inflammation from osteoarthritis?
Yes, it can help! What you eat can have a positive effect on the inflammatory process associated with Osteoarthritis.
This graphic from an article published in the International Journal of Molecular Sciences in 2013 demonstrates where along the inflammatory pathway each nutritional component inhibits inflammation. The nutraceuticals or components of whole foods like, resveratrol, polyhenols (including epigallocatechin 3-gallate (EGCG)), curcumin, ginger, Glucosamine/Chondroitin sulfate, pomegranate, and rosehip can help to limit inflammation.
Dr Carolyn Dolan DPT, Cert MDT, MSHN
Where physical therapy, nutrition and lifestyle meet, because how you live your life determines whether or not you soar. Inspiring action with information so you can reduce pain, optimize healing and improve function naturally during recovery from injury, surgery or painful condition. This is a website for the open-minded; obstinate need not apply.