Shoulder Joint Pain – Is This Why You Have It?

shThe shoulder joint proper, or glenohumeral joint, is unique in its ability to move in multiple planes in large arcs (the hip, ankle, wrist and jaw also move in multiple planes, but less so).  It consists of the head of the humerus (upper arm bone) and the scapula (shoulder blade).  The humeral head inserts into a shallow indentation of the scapula called the glenoid fossa, and is positioned there by the capsular ligament (labrum) and rotator cuff:  the tendons and muscles surrounding the glenohumeral joint that are responsible for moving it.  These muscles are the:

  • Supraspinatous
  • Infraspinatous
  • Subscapularis
  • Teres Minor

Each of these muscles start (originate) somewhere on the scapula, and connect (insert) around the humeral head.  The orchestration of muscle firing is what gives the glenohumeral joint its impressive range of motion.

But because of the wide range of motion, there is greater risk of stress to this joint.  For example, a tennis serve, golf swing and baseball pitch are (typically) repetitive movements that can cause accelerated  wear and tear to the rotator cuff.  The tendons, capsular ligaments and cartilage lining the joint surfaces can tear, resulting in pain, inflammation and limited mobility.

A ligament can thicken and get pinched by the bony structure  just above the humeral head called the acromion as the arm is abducted (raised).

However, there are many cases of people who have no history of such trauma to their shoulder, yet still develop shoulder pain.  What can be the cause?

How Lack of Motion Can Lead to Pain

While shoulder joint-dependent sports like tennis and golf can lead to joint damage, the exact opposite is true as well:  shoulder relative immobility can lead to joint pain.  Here’s how.

The shoulder joint is a synovial joint.  Synovial joints are enclosed by a capsule lined with synovium, a thin layer of tissue containing special cells that secrete synovial fluid.   Synovial fluid, which is viscous in nature (like egg yolk consistency) is comprised mainly of hyaluronic acid and lubricin, two components whose functions are to absorb shock and reduce friction.

Not only is the synovial fluid responsible for smooth joint movement, it also provides nutrients and oxygen for chondrocytes and fibroblasts— the specialized cells that make the cartilage material (matrix)– and serves as the means to remove waste products from the joint capsule environment.  As you can imagine, synovial fluid is critical to the proper functioning of the joint.

As the humeral head glides over the glenoid fossa of the scapula, the pressure squeezes out old synovial fluid from the cartilage lining and the cartilage then absorbs fresh synovial fluid.  And here is where the problem lies.

If the shoulder joint is not moved enough, the cartilage lining the joint will deteriorate faster.  The synovial fluid becomes more stagnant, less of it is produced, and the chondrocytes that make the cartilage start to die leading to thinner, weaker cartilage that is more susceptible to tearing and pitting.

Think about it– if you don’t play sports or exercise, there is little need to raise your arm above shoulder level throughout your day.  Most of the things in life we handle are below shoulder level.  Raising your arm from your side to pointing straight up represents a full arc, where much of the surface of the humeral head glides over the glenoid fossa of the scapula, “bathing” it in fresh synovial fluid.  This movement is what is missing for those who have “sedentary shoulders,” which is the case when you sit at a desk and type away at the computer— there is minimal to no shoulder joint movement during typing.

People in this situation are more prone to “frozen shoulder,” or adhesive capsulitis, and then degenerative joint disease and eventually chronic shoulder pain and limited shoulder mobility.

The solution is, of course, to move those shoulders frequently!   Here is a video of exercises that will do the job quite nicely:

 

An Overlooked Preventive Health Measure (and contributor to ongoing health problems)

You do it every day (I hope), but are your doing it correctly?

germsWe all know that certain germs can cause disease and even death  if they manage to enter your body and overcome your immune defenses.  Meningitis, staph infections, tetanus, and pneumonia are just a few.  Bacteria cause disease by rapidly dividing and secreting toxins that are harmful to your cells; or the disease comes as a result of your body’s immune response to these toxins (for example, fluid build-up in the lungs from pneumonia).

Your body is constantly defending itself from pathogenic bacterial invasion.  It’s a survival mechanism encoded in your genes.

The part of your immune system that prevents bacteria from gaining entry is called non-specific immunity, which means it is present all the time and not activated by a particular pathogen.  They are present in areas of your body where there is a high concentration of germs:

  1. Skin – your skin is a layer of hardened, dead cells that bacteria cannot penetrate, unless there is a cut.
  2. Eyes – your tears wash out bacteria and have enzymes that kill them
  3. Mucus membranes – mucus lining your nasal passageways, trachea, lungs, mouth and GI tract form a barrier to bacteria. The upper and lower respiratory tract have tiny hairs (cilia) that move the mucus to the back of the throat for swallowing into the stomach where they are neutralized.
  4. Reproductive tract – the vagina and urethra, in addition to having mucus membranes are acidic, which prevents bacterial growth
  5. Large intestine – this organ relies on “good” bacteria colonies to prevent “bad” bacterial colonies from multiplying.
  6. Mouth – saliva washes bacteria down the throat for neutralizing in the stomach; friendly oral bacteria prevent bad bacteria from overpopulating.

When bacteria do make it through these barriers, the “big guns” of your immune system take over the job of destroying them — your white blood cells, antibodies and other immune factors.

So, what is the “underrated” preventive health measure I am referring to?

It has to do with #6 – your mouth, or oral cavity.

The teeth, gums, tongue and oral lining are chock full of bacteria.  The food you eat, especially if it is not recently cooked and hot (such as a cold deli sandwich or salad) contains all kinds of germs from handling; some pathogenic like E. coli, salmonella, or campylobacter.

If you don’t brush and floss adequately after a meal (especially one high in sugar and grains/wheat) and as a result have poor oral hygiene–cavities, plaque build up, gingivitis, white tongue– you are creating perfect conditions for continuous bacterial toxin infection.  The bacteria multiply and can enter your bloodstream via bleeding gums and aggressive dental procedures such as tooth extractions, root canals, and deep cleaning/ periodontal work.

And are you aware that harmful bacteria may survive your stomach acid and make their way into your circulation?

Although the vast majority of swallowed bacteria are killed by stomach acid (except H. pylori, which can survive in the stomach), it’s not always the case.

Realize that the level and strength of stomach acid and digestive enzymes vary depending on what’s currently inside your stomach.  Large meals, especially if they are diluted with water (drinks consumed with the meal) will dilute the strength (concentration) of stomach acid.    And, some people do not produce enough stomach acid altogether.   This can present an opportunity for pathogenic bacteria to pass into the gut and settle anywhere in your body– heart, liver, brain, etc.  And, if you have a stomach ulcer, bacterial access to your bloodstream is more direct.

Pathogenic agents [bacteria]  may also remain at their primary oral site but the toxins liberated can reach an organ or tissue via the bloodstream and cause metastatic injury. Finally, metastatic inflammation may result from an immunological injury caused by oral bacteria or their soluble products that enter the bloodstream and react with circulating specific antibodies to form macromolecular complexes. – Microbes Infect. 2000 Jul;2(8):897-906.

This means that it’s entirely possible to develop systemic inflammation via your body’s immune response to bacterial toxins coming from your mouth.  And, you and your doctor may not be aware of the connection.

If you have cardiovascular problems, you are at a higher risk:

 in patients with ineffective heart valves or vascular diseases, bacteremia [bacteria in the blood] can be a potential danger, leading most commonly to infective endocarditis and myocardial or cerebral infarction. Other forms of systemic diseases such as brain abscesses, hematological infections and implant infections have also been related to oral microorganisms. – Endod Dent Traumatol. 1994 Apr;10(2):57-65.

The Bottom Line:

Be aware that harmful bacteria on your teeth, gums and tongue can make it into your body via the blood vessels in your gums and stomach so pay extra attention to maintaining excellent oral hygiene.

pic

I personally spend about 15 minutes brushing, flossing and using a rubber-tipped gum instrument to clear out food debris everywhere it can be found — between teeth, behind teeth, at the gum line, and on the tongue.

tn

I make sure to brush my tongue until it is all pink, with no white residue residue remaining (towards the end of brushing my teeth, I often add a little bit more toothpaste to my toothbrush just for the tongue, which I do last).  White film on your tongue is comprised of microscopic food particles that are being digested by bacteria, enabling them to thrive and multiply, so make it a point to get as much of it off your tongue as you can.

If you don’t feel like “100%,” have low energy,  brain fog, or often get sick, then it may be that germs in your mouth are making their way into your body and creating inflammatory havoc.  Don’t let your mouth be a breeding ground for bacteria that are out to make you sick!

THOROUGHLY brush and floss in the morning and after your last meal of the day; and also after lunch mid day if you can– it’s a low cost, highly effective preventive health measure that should be a permanent part of your daily routine.

 

How Do You Strengthen a Knee?

knee-anatomyYour Knees:  Be Nice to Them, or Pay a Price Later…

Of all the joints in your body, your knees take the most beating.  That is why they are designed as they are:  very thick and broad to support shock and much more than the weight of your body (such as when running).  They are “heavy duty” joints, compared to your finger joints and shoulder joints.

The upper part of the knee joint surface is the distal femur(upper leg); the lower part is the proximal tibia (lower leg).  The distal femur is made up of two, parallel rounded ends called condyles.  They rest on top of the meniscus— the cartilaginous pad covering the proximal tibia that guides the condyles as they glide with knee bending and extension.

The main ligaments that hold the knee together are:

InternallyAnterior cruciate ligament (ACL) and Posterior cruciate ligament (PCL).  They are called “cruciate” because they cross and form an “X” to limit forward and backward movement of the femur relative to the tibia; i.e. stabilize the knee in that plane.

ExternallyMedical collateral ligament (MCL) and Lateral collateral ligament (LCL).  Medial means “inner”, so the MCL connects the femur and tibia on the inner side of your knee; Lateral means “outer”, so the LCL connects the femur and tibia on the outer side of your knee.

Since you can’t control and contract ligaments voluntarily (they are not like muscles), how do you strengthen your knees?

The answer:  strengthen the muscles that MOVE the knee.  After all, a joint like the knee is not just two bone surfaces that contact each other– it includes the muscles that move the joint (by the way, tendons are the ends of the muscles that connect it to bone; they can be long like the patellar and achilles tendons, or they can be short and wide like the gluteus maximus tendon).

The primary movers of your knee are the quadriceps muscle (your thigh muscle) and your hamstrings.    The quadriceps originates from the front of your pelvis (ilium – the pointy bone on either side of your pelvis), travels down and in front of your femur bone; transitions into the superior patellar ligament; connects to the patella (knee cap), and then reforms into the inferior ligament where it attaches to the proximal tibia.

The hamstrings originate from the back of your pelvis (ischial tuberosities– the “seat bones”), run down and behind your femur bone, divide just above the back of the knee passing the sides of the knee, and connect to the proximal tibia from the back.

When the quadriceps shortens with a concentric contraction, it extends (straightens out) the knee.  When the hamstrings shorten, it flexes (bends) the knee.

Here are the Knee Strengthening Exercises:


1.  For the Quadriceps:  sit in a chair, knees bent, feet touching the floor.  Make sure your sacrum is up against the back support of the chair and your are sitting with your torso erect (good posture).  Next, raise your right foot off the floor and extend your knee so that your leg is straight out in front of you, parallel to the floor.   Hold this position for as long as you can.  You’ll notice that your thigh muscle will tighten (isometric contraction), which is what you want.  Switch legs; do about 4-6 repetitions per leg a few times a day.  You can increase the intensity of the exercise by wearing ankle weights (2-5 pounds).

You’ll probably notice that one quadriceps muscle is weaker than the other (you struggle more holding that leg straight, and can’t hold it up as long as the other).  Focus your strengthening on that particular leg.

2.  For the Hamstrings:  Put on ankle weights.  Lie down on your stomach (can be on your bed or carpet) in a comfortable position, body straight, legs together.  Lift the right leg slowly, past 90 degrees, then ease it back down even slower.  Do about 10-20 reps; switch legs.  You can also choose to alternate legs each repetition.

As we get older (especially for men) we lose muscle mass (muscle atrophy) and gain fat cells.  Studies show that the quadriceps muscle is especially affected.  If you are over 40, compare the thickness of your quadriceps muscles to what they were like in your 20s.  This is a big reason why professional athletes gradually lose their agility and performance (their legs “go”), leading them to retire and let the young guys/ gals take over.  It’s also another reason why we are more prone to tripping/falling as we get older.

So, strengthen those knees!  Strong, stabilized knees may save you from knee replacement surgery in your later years.  And this means strong and responsive (to changing loads) quadriceps muscles.

Stay tuned for more exercises that will benefit your knees, hips and entire musculoskeletal system.

 

 

 

The Plant That Can Knock Down Muscle Pain

comfreyThe comfrey plant, also known as black root, slippery root, and Consolidae Radix in the herbology realm, has chemical properties that make it effective for reducing soft tissue pain and skin irritation.

Comfrey is a perennial plant native to parts of Europe and Asia that prefers dark, moist soil.  It contains poisonous substances called pyrrolizidine alkaloids that are toxic to the liver; as such, oral products containing comfrey are banned in the U.S. and most of the world.  Topical products (ointments, liniments) such as Kytta-Salbe (Merck) and Res-Q (Burt’s Bees) contain between 1-20% concentration.

The good stuff?  Comfrey roots and leaves contain allantoin, a substance that helps new skin cells grow, along with other substances that reduce inflammation and keep skin healthy.   It is especially helpful for  moisturizing skin and softening it by promoting the shedding of old skin and stimulating growth of newer cells underneath.   Allantoin is also thought to combine with irritants of inflammation and neutralize their effects.  It is found in many cosmetic products including skin lotion, lipstick, toothpaste and shampoos.

Comfrey ointments have been used to heal bruises as well as pulled muscles and ligaments, fractures, sprains, strains, chafed skin, itching and osteoarthritis.

Guidelines for using Comfrey-containing products:

Children

  • Never give a child comfrey by mouth. Do not put creams or ointments with comfrey on a child’s skin.

Adult

  • Never take comfrey by mouth. Severe liver poisoning and even death may occur.
  • When using herb and leaf ointments, creams, and other preparations for the skin, follow these safety recommendations:
  • Never apply comfrey to broken skin.
  • Use only small amounts of creams with comfrey for no longer than 10 days at a time.
  • Do not use any comfrey product for more than 4 – 6 total weeks in a year.

Precautions

  • Comfrey has toxic substances that can cause severe liver damage and even death. You should never take comfrey by mouth.
  • The toxic substances in comfrey can be absorbed by the skin. Even creams and ointments should be used for only a short time, and with your doctor’s supervision.
  • Do not use comfrey on open wounds or broken skin.
  • Do not use comfrey if you have liver disease, alcoholism, or cancer.
  • Children, the elderly, and pregnant or breastfeeding women should not use any comfrey products, even ones for the skin.

Possible Interactions

  • Because it may raise the risk of liver damage, comfrey creams or ointments should not be used with other medications that may also affect the liver, such as acetaminophen (Tylenol). If you take any medications, whether prescription or over the counter, ask your doctor before using comfrey.
  • You should not use some herbs that have also been known to cause liver problems, such as kava, skullcap, and valerian, while using comfrey ointments or creams, due to their additive effects.

So, if you recently sprained your ankle, stubbed a toe, developed tennis elbow or have general joint pain, give comfrey a try, but make sure to follow the above guidelines for usage.  I recommend you use it in conjunction with ice and heat– be careful not to overdo it, though.

Source: Comfrey | University of Maryland Medical 

 

 

 

 

Try this Trick to Stop Pain

pvc1Make Your Pain Go Away With a Magic Wand….Really!

The next time you strain a muscle, give this “health hack” a try.    You can even try it now if you experience chronic pain in your shoulder, elbow, wrist, hip, knee or other body part– it may not work, but then again, it may work like magic.

First of all, let’s cover some background.

The human body is indeed electric – cells can be negatively or positively charged.   This is one of the many methods the body uses to move things within it, like nerve impulses and cell membrane permeability.

When a cell is negatively charged, it is usually associated with less blood circulation, less heat, and less pain.  It is also in a more alkaline state.

When a cell is positively charged, it is usually associated with increased blood circulation, more heat and pain.  It is also in a more acidic state.

So, what if you could change the positive polarity of cells in an area of pain and inflammation?

Well, you can by harnessing static electricity.

Here’s the hack:

Take a section of white PVC pipe, 1″ or 2″ diameter, about 1 foot long.  You can find some at any hardware store like Home Depot that has a plumbing section.

Get some wooly material, like a sweater (not cotton); or some gaudy colored, synthetic fur often used in costumes.  Those tend to depart with their electrons quite easily for some reason.

Take the wooly material and rub the PVC pipe with it a couple of times, then run the pipe over your painful area, close to it but being careful not to let it touch your skin.  Make about five passes  back and forth, then repeat the process 3-4 times (rub it with the wooly cloth again).

The electrons will jump into the painful site and may be able to neutralize some of the positively charged cells causing all the havoc in there!

If you’re using it for a headache, wave the wand over your forehead and eyes, and back of neck.   Find a way to keep your hair down so it doesn’t stick to the PVC wand and nab all the electrons– use a woman’s hair band, or tie it in a ponytail.

Give it a try– the worst that could happen is that it won’t make a difference (or you could be zapped).  The best that could happen is that it knocks down your pain, without you having to take toxic medications.

 

What’s the difference between Complementary and Alternative medicine?

People Have Many Choices When it Comes to Healthcare

It’s not big news that traditional medicine is now often practiced alongside “unconventional” or “non-traditional disciplines such as acupuncture, nutritional/herbal therapy, bio feedback, Ayurveda, chiropractic, massage, meditation and others.

When I say “unconventional,” of course I am referring to procedures outside traditional medical procedures– prescription drugs, injections, surgery, and so on.  These unconventional treatments are referred to as either “complementary” or “alternative.”

Complementary medicine refers to unconventional treatments that are done in addition to traditional (allopathic) medicine.

Alternative medicine is refers to unconventional treatments done in place of traditional medicine.

The term “medicine” when used in this context refers to the discipline and all that it encompasses; it doesn’t imply medications.

So, acupuncture can be complementary or alternative; it depends on how it is being used in the treatment plan.

The entire field of unconventional treatments is referred to as “CAM-”  Complementary and Alternative Medicine.

The Guiding Principles of Complementary and Alternative Medicine

1. They tend to emphasize disease prevention in their approach.

2.  Natural healing – they teach that your body has the ability to heal itself, and the CAM treatment simply facilitates this.

3.  CAM providers see themselves as facilitators in your health with what they do.  They emphasize that it is the body’s own reparative and regenerative qualities that do all the healing.

4.  Holistic care – the focus is on treating the “whole person,” and not just the area of complaint/ affected organ or body part.

After two decades since the National Center for Complementary and Alternative Medicine (NCCAM)  was established in 1991 (first as the Office of Alternative Medicine), the new buzzword in this arena is Integrated Medicine

Integrated (or Integrative) medicine is where traditional medical practitioners (M.D.s, D.O.s) practice alongside CAM practitioners — acupuncturists, massage therapists, chiropractors, yoga practitioners, Ayurvedic and mind-body practitioners.  The goal of integrated medicine is to treat the whole person – mind, body and spirit – not just the disease by combining the most up-to-date medical protocols with the best of nontraditional therapies.

A Word of Caution

One important note; however, regarding CAM:  the field includes a diverse number of disciplines beyond “first tier” CAM.  Some of these disciplines can seem, and are, questionable in nature; i.e. “snake oil.”  If you are going to seek CAM, it’s best to go to a first-tier practitioner.  Finding an integrated clinic with a medical director (M.D.) is also a good choice.

While those in CAM tend to not demand as vigorously as medical practitioners scientific proof to validate their methods, honoring the body’s complexity and mystery, it is still important to have some peer-reviewed studies that support the efficacy of the CAM procedure at least for some conditions; and good anecdotal, correlative studies that show a pattern of success in treating disease.  Thus, one should avoid “second-tier” disciplines that have zero mention in medical journals.  This is a consumer protection issue.

Bottom line:  Complementary and alternative disciplines can be found in most major cities across the United States and the world.  They tend to be especially helpful for treating chronic disease that has not responded well to traditional medications.

The Five Pillars of Health

As I enter mid-life, I can now say that I have spent most of my life learning about health — how a  body becomes diseased and degenerated; and how it can be made to resist becoming diseased and degenerated.

My learning is from formal training (Doctor of Chiropractic degree), numerous seminars, clinical experience in private practice, reading medical journals, subscribing to “natural” health authority sites, and sometimes trial and error.   When you are in a field for this long, all the bits of information come into focus.

Here is what optimal health basically boils down to:

#1Mindset:  All the knowledge in the world can be of no use if you do not have the right mindset to get healthy.  We humans are a product of a  lifetime of environmental programming.  We tend to cling to routines that we are comfortable with.  We even tend to adopt the mannerisms of those who we hang out with the most.   So if one is unable to break free of health-destroying habits, then the battle is lost.  In order to open  the door to optimal health, one must find a way to change his or her mindset and replace unhealthy habits with healthy ones.

#2Nutrition:  It’s simple:  Out of all the things you can do to influence your health, the food you choose to eat has the strongest influence, hands down (if you don’t include stopping tobacco and alcohol habits).  You’ve got to make whole, naturally-occurring, unadulterated food staples form the bulk of your diet in order to achieve optimal health.  If it needs a food label to identify “ingredients,” then it doesn’t meet the definition.

#3Movement:  Our bodies were designed to move, not sit.  We are bi-pedal with long legs, compared to other mammals.  This means lots of walking, and occasionally running.  Movement strengthens our musculoskeletal system.  It burns body fat.  It improves cardiovascular fitness.  So, if you don’t have a physically demanding job that involves using your whole body, you’ll need to exercise regularly to make up for it.

#4Rest:  Humans need 6-8 hours of sleep per day.  It helps maintain a good circadian rhythm.  It makes it easier for your body to regenerate itself.  It gives your organs well-needed rest.

#5Social Well-Being:  We are also social creatures who benefit from contact with other humans.  Being isolated and not being able to communicate with others can have a detrimental effect on mental health.  Recall how it feels when someone puts their hand on your shoulder as a genuine gesture of support.  Or when you had a long day, and get a hug from someone.  It’s energizing.

That’s about it; everything else is secondary.  Satisfy all five of these pillars of health, and you may not have to visit a doctor for decades.  Seriously!