 Knee by @nSeika Flickr Creative Commons 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.  Photo Credit: M Prince Photography Is it possible that bacteria could aid in healing from injury or surgery?
Yes. In fact it is important to promote the variety of bacteria in your gut to promote immune health, reduce pain and reduce risk of infection. As described in an earlier post about the leaky gut syndrome, supplemental recommendations that may reduce pain and improve healing are geared to promoting gut health. Specifically, the microbiome diversity is strongly linked to gut and mental health. This gut-brain connection is at the core of much of the research around supplemental probiotics. A literature review evaluated the research around use of probiotic use and migraine headache. The findings of improving gut microbiota and reducing inflammation may have positive effects on strengthening the gut and improving brain function. This is important to surgery/injury in that gut health supports brain health which thereby will have a positive benefit in the role of the brain in the pain experience.  Photo Credit: Vegan Feast Catering 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.  Photo Credit: Flight SLE 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. 
Improve Intestinal Integrity and Optimize Nutrient Absorption
I have written in the past about osteoarthritis and the contribution of metabolic health to joint health. You can read more here and here. You are also familiar with the leaky gut/intestinal permeability as a potential root cause of systemic inflammation and it's contribution to joint health among many other health related conditions. Although the primary source of healing the gut and improve your joint pain is to eat real food, move your joints through their full range, gentle exercise, and adequate restorative sleep, often supplements are needed to aid recovery. As I have mentioned before, SUPPLEMENTATION is only to aid in recovery of an already healthy lifestyle. If you suspect you have leaky gut, you can ask to be tested as described here.  Oh dear...the DIET bashing....AGAIN....
I have something I need to say about diets. Here me out. A diet as defined by the Webster dictionary is "a special or limited selection of food and drink, chosen or prescribed for health or to gain or lose weight." Many folks, whom may or may not understand the true purpose of a diet, are shaming very useful diet strategies because they are "difficult" to do and then discredit them. Check out the US News report. I think there is a misunderstanding about a diet versus lifestyle. An effective diet is NOT designed to be a lifestyle, but a TOOL to gain health. The "diet" is the tool designed to help you design your life, specifically related to what you put into your mouth, so that it can be a sustainable lifestyle. Many of the easiest and most popular diets are not healthy because they do not give you information about your body. Let me speak (write) clearly.... A diet is a TOOL to gain INFORMATION about yourself so that you can MODIFY your LIFESTYLE to fit your PERSONAL health needs. DIET = TOOL TOOL = INFORMATION INFORMATION => PERSONAL HEALTH 
Photo by Joy Weinberg, Creative Commons
You have worked hard to change your lifestyle by Eat Well, Move Well, Sleep Well and Soar On. Are you looking for something to support you as you get older to keep metabolically healthy, have optimal hormonal support, and brain health? Health of these systems will help to keep your detoxifications systems running, your inflammatory system operation normal, and well all things important to your body including your muscle and joints.
A SUPPLEMENT as defined by Wikipedia is: "something that completes or enhances something else when added to it" A good supplement is appropriate when it enhances the body's function ADDED to an already healthy lifestyle. It is NOT a replacement nor back up plan for poor lifestyle choices. This is why I DO NOT promote supplements until lifestyle habits have been adjusted for my clients and/or patients. Not before then. Only AFTER lifestyle modifications have become habit. Some folks can do this on their own, some need assistance. If you have already made adjustments to your lifestyle and think supplemental support would be helpful, then this is the blog is for YOU!  This past week I gave a talk to a small group of high school students in an elective class on nutrition. Relating to teenagers is not my specialty, especially since I was so shy during high school. Yet, with some advice from a dear friend on how to relate to teenagers by talking about how eating real food would allow you to "take a selfie without a filter" or "go to prom looking great" or "kick ass on that math test" or "improve your ability to compete against your schools rival" it actually went....um...ok?
It's hard to read these kids. One fell asleep. A couple watched me. A few did homework. I rallied, and engaged them enough with a few activities,....I think. In the end, I think I made them more aware. I focussed on why the SIMPLE choice is always the best and that packages are tricky. We focussed alot on sugar as well which is why the photo above. Yes, I purchased those things to make a point about how our food is often loaded with added sugar, and if it doesn't have added sugar, it is made with chemicals.  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.  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.
 Have you gone Gluten-free/Paleo and are frustrated that you still have pain?
In my integrative physical therapy and holistic health coaching practice I often get the clients who have failed other treatments to alleviate their painful symptoms. Yet, sometimes I also get those who have already gone “Gluten-free” and still have pain. Although, I will be the first to press the nutrition issue, it isn’t always the answer. Here are some common mistakes people make in going “Gluten-Free” which may be limiting your recovery of your painful condition. It could be one of these or many of these occurring at the same time limiting recovery.  “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.  It is a common experience that a problem difficult at night is resolved in
the morning after the committee of sleep has worked on it. —John Steinbeck Rest and Recovery I remember in college when my husband and I were dating, after basketball practice and dinner at the dining commons, we would ride our bikes to the library to study. He was a premed double major in history and human physiology, and I was majoring in bioengineering. We would often start strong in our studying, and then we’d literally take a nap—at the table. At the time, I thought it was weird. Now it makes more sense. As we were challenging our brains with different problems, not to mention after a hard practice and high-glycemic food, we would just need some recovery time. After a nap lasting less than thirty minutes usually, we would feel rejuvenated, restored, and ready for more studying until closing time. As I mentioned before, we have been boring for a long time. Thank you to Crossfit Initiative and Ty Jones for putting this together so it can be shared with others. References were omitted to keep the slides easier to follow, they are listed below.
Many of these topics are covered in more detail in How To Soar, coming soon. Eat Well. Move Well. Sleep Well. Soar on.  Life requires movement.
—Aristotle 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.  Cooking (from scratch) is the single most important thing we could do as a
family to improve our health and general well being. —Michael Pollan What Is Real Food? To put it simply, to eat well, you must eat real food, not something that only looks like food. Most of the food you eat must be in its natural or whole form, free of contamination, in order to maximize nutrient-richness and absorption. However, in today’s world, understanding what real food is has become a bit confusing. Real food is as close to its natural state as possible. It is simple. It is in its whole form and merely needs to be eaten or cooked for consumption and for the nutrients to be absorbed by the body. An example of real food would be broccoli. Broccoli can be safely eaten raw, or it can be gently cooked. An apple can also be eaten raw or cooked. The bioavailability of nutrients in a whole food is optimal for natural absorption.  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. Here is the interview from the Katie Coombs show Uncommon Sense. I am primarily in Segment 7 and 8. I wonder how many "ums" I actually said?
Hopefully this sparks questions for you. Please share and ask. I would love to hear your thoughts. Special thank you to Katie Coombs for the opportunity. http://www.katiecoombsuncommonsense.com/radio_9_26_15.html Did you know that fats, also known as lipids, are an important macronutrient that supplies concentrated energy, supports cellular health, and aids vitamin and mineral absorption? Fat is good for your health and healing in moderation, but not all fats are created equal.
Many of us were raised on the idea that consumption of fat (aka lipids), especially from animal sources, results in obesity and heart attack. Yes, an overconsumption of lipids, calories, or sugar results in obesity and potentially metabolic syndrome. However, the reality is that healthy lipid consumption does not equate to obesity or heart attack. In fact, healthy lipid consumption promotes cellular health, provides cellular energy, improves absorption of Vitamins A, D, E and K, provides the precursor (cholesterol) to many hormones, as well as supporting other metabolic processes. 1 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 In discussions regarding sugar, many people notice it everywhere. So, the question is how much is ok if you can’t avoid it 100%?
That’s a tough question to answer. It’s really a personal answer. Perfection is never the key in life, but thriving thru life is the goal. 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, MSHNWhere 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. |
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