Please help! I have injured my knee!

"Hi Gary Me again! My old knee injury (sprained or damage to the anterior cruciate ligament & medial collateral ligament) appears to have flared up so was wondering if you could recommend anything to help with the inflammation? and whether you think i should go back to physio?

It is pretty minor compared to what i experienced years ago & was at its worst on Monday but has calmed down a bit thanks to wearing a stocking all day/night. The inside of my knee seems a little swollen & it feels tight at the back to the point that it is hard to completely straighten or kneel. I could still run quite happily on Tuesday but after realising my knee was a bit swollen have decided to stop until its back to normal. In terms of the cause I am not sure as have not had a sprain as such. However, my knee did start to 'click' a lot more (& is clicking quite a bit now) when I started to do single leg extensions where my leg/knee is at a 90degree (sitting on a gym machine) & I lift a 5kg weight with toe slightly pointed out.

This exercise is part of the program that my trainer at the gym (Chek Practitioner with Diplomas in Rehabilitation & in Sports Medicine from Otago Uni) designed & apparently works to strengthen the inside of my knee. She also just started me on a new exercise with the swiss ball where my torso is on the ground but lifted up in the 'bridging' position & my calves are on the swiss ball & i have to lift one leg up at a time & hold it for 5 seconds so as to apparently strengthen my core, butt & hamstring. i have found this exercise really hard & pretty much strain the balancing leg so i can keep the lifted leg up in the air.

The trainer is convinced that these exercises could not have caused my knee to flare up unless i was incorrect in my technique & suggested it might be a hamstring insertion (whatever that is!)& thought i should try antiflam cream & seeing a physio in a few days if it had not self-corrected. but as she has overrided my old physio exercises & your advice to do 1/4 squats (she got me doing full squats with minimal weight)

I'm now confused as don't know if i can trust that she knows what she's talking about or who i should ask....except you! all i know is that my knee has been fine for the past 5 years & now its not!

Pretty gutted as i ran 9k for the first time in 5 1/2 years last week! any suggestions would be greatly appreciated."
"R"
Gary Moller comments:
"R", The swelling is telling you that your knee has been injured somehow and the swelling is your body's way of restricting movement.

Knowing your history of knee injury, it is possible that the damage to your knee ligaments previously and possibly to the knee cartilage makes the joint vulnerable to further damage.

It is possible that some of the exercises that you describe doing could have irritated the knee joint.

Your anterior cruciate prevents forwardsliding of the tibia on the femur, especially when the large quadriceps contract. The medial ligament prevents the knee from buckling inwards. Between all of them, the ligaments hold the knee joint snug and secure. The articular cartilages form a shock absorbing dish between the bones of the knee joint (tibia and the femur). It is possible that you damaged one or two of these cartilages when you sprained your ligaments.

When you are doing any kind of strengthening exercises using the big thigh muscles you should be weight bearing. This is because the knee bones are held firmly in place in the dished cartilages. If you do leg exercises such as leg extensions on a leg extension weight machine, the lower leg will be hanging free, gapping the joint and throwing stress on already damaged or stretched ligaments. The joint cartilage is vulnerable to further damage as the joint is gapped and twisted.

I would be very careful of the Swiss Ball bridging exercise that you describe because the knee could gap and twist. If you want to work the hamstring and butt, do standing dead-lifts with a barbell or dumbells; but make sure you get expert instruction in safe technique, lest you do your back in!

Stick to weight-bearing exercises such as squats and never go beyond right angle knee bends when under pressure. Deep knee bends may strain the ligaments and pinch the cartilages. The best machine in the gym for you for strengthening the quads is the incline leg press. Avoid the hack squat, including wall squats with a Swiss Ball behind your back. These throw excess strain on the front portions of the knee, including the undersides of the kneecaps. You don't need this.

Always get professional instruction by a weights expert and review your technique regularly.

Ice may help with the swelling but I am not a fan of it. Elevation, plus rhythmic exercise is best. Massage the knee, thigh and calf.

Exercise in warm water to manage swelling and to maintain strength, endurance and flexibility.

Take a glucosamine and chondroitin formulation and MSM and take generous doses for as long as there is pain and swelling. Use these in preference to pain killers and anti-inflammatories. Add 2,000mg of vitamin C per day. Copious amounts of fish and flax oil and especially Evening Primrose Oil have natural anti inflammatory qualities while not compromising healing. These natural supplements will assist healing. Continue normal doses for at least three months after the knee has settled.

Contact me if the knee does not settle significantly by next week.

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Choosing the right Omega 3 oil

There are many different kinds of Omega 3 oils to choose from nowadays. In this video, I run through several of your choices.

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The role of vitamin E on the anti-atherosclerotic effect of fish oil in diet-induced hypercholesterolemic rabbits

The role of vitamin E on the anti-atherosclerotic effect of fish oil in diet-induced hypercholesterolemic rabbits was studied in male New Zealand white rabbits.
..... These results suggest that vitamin E and/or fish oil attenuate atherosclerosis in high cholesterol-fed rabbits; vitamin E and fish oil potentiated the effect of each other. Furthermore, without sufficient vitamin E supplementation, rabbits treated with high cholesterol plus fish oil will show an elevation of plasma creatine kinase activity." _______________________________________________

Gary Moller comments:
Just how much research on male NZ rabbits applies to you is open to debate. My partner keeps telling me I'm like a rabbit, so I am taking it seriously!"

This New Zealand research adds to the growing body of evidence that diet and supplementation strategies have important effects on health risk, including cardiovascular disease.

As a matter of interest, Creatine Kinase (CK) is an enzyme that operates within cellular energy pathways. Elevated levels of CK in the blood may be an indication of muscle damage, such as may be caused during intense exercise, over-heating or heart attack (muscle is rich in CK so damage to muscles releases CK into the blood). Marathon runners have been known to be hospitalised in the days following a marathon because of extemely elevated CK levels, triggering fears that the runner is undergoing a heart attack! Of course this is not the case, but this is still very unsettling. But this is still confirmation of the damage a hard run does to the body and the need for additional anti-oxidant supplementation.

This study indicates that vitamin E and fish oil may be beneficial if you are undertaking intense exercise, bruising muscles, exercising in the heat, or if you have high cholesterol levels. Vitamin E is a powerful anti oxidant that helps the body neutralise the flood of free radicals that are produced from tissue breakdown before they can do damage to healthy, previously unaffected tissues. Fish oil has many health qualities, including anti-inflammatory qualities and stabilisation of heart electrical activity.

Rancid cholesterol and other fats in the blood stream act as free radicals. Vitamin E again reduces damage to the arterial walls due to its powerful anti-oxidant qualities.

Vitamin E with fish oil are at their most powerful in terms of protection when combined. The vitamin E also serves to prevent the fish oil from oxidising while it is circulating in the body. Fish oil can be purchased with added vitamin E, or if the cheaper fish oil only product is purchased, it is recommended that natural vitamin E be added to the diet. The same can be said for additional vitamin C. Read this article here.

Purchase quality natural vitamin E only. I have serious reservations about the efficacy of cheaper synthetic forms of vitamin E.

Quality fish oil and natural vitamin E are available from www.myotec.co.nz

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Link

Are omega-3 products really the good oil?

Consumers buying foods with omega-3 may not be getting the good oil they think they are says Rufus Turner, a lipids scientist with Crop & Food Research. He and colleague, Dr Carlene McLean, have studied commercially available fish oil in New Zealand, that’s been manufactured overseas. They found it contains varying levels of primary and secondary oxidation products
"These oxidised products result in variations in the quality of fish oils and may explain the mixed results in international human clinical trials investigating omega 3 health benefits” Dr McLean said. Recent results from international cellular, animal and human trials indicate that the oxidised products in fish oils may have potential carcinogenic and pro-inflammatory actions. These products have the potential to increase the risk of atherosclerosis and thrombosis and reduce the potential benefits of omega-3 fatty acids..
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Gary Moller comments:
While there are undoubted health benefits from consuming fish oil, it is clear that not all fish oils are the same. If the oil is of a poor quality it is possible there will be no health benefits and possible harm. If you are buying fish oil:

• Do not buy product that has been sitting about on a warm, brightly lit shop shelf


• Purchase a known brand that is from a store that you know has high rates of product turnover


• Preferably purchase fish oil that has added vitamin E which stabilises the oil, preventing oxidation and/or


• Take a capsule of natural vitamin E with your fish oil


• Once opened, keep the fish oil capsules sealed tight and stored in a dark cool, dry place and


• Consume the lot in good time, rather than leaving capsules lying about for several weeks

Note: The fish oils that are stocked at www.myotec.co.nz are leading brand New Zealand products. Only small stocks are held and these are turned over quickly. For the industry response to the report above, read this.

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Link

Omega Oils - Flax vs Fish Oil

Despite diminshing fish stocks, the push is on to have us consume more and more fish oil. Apparently fish oil is superior to plant derived omega oils like flax seed and evening primrose oil. Is this true, or is it merely big budgets getting in the way of the facts? I am not convinced that one source is superior to the other from a health point of view, although I am tending towards being in favour of flax seed oils. What I am convinced about is that these oils, regardless of their source, are of undoubted benefit and the list of benefits grows by the day. Here are some basic facts about fish and flax oil ingredients:

• Flax seed contains Omega-3, 6 & 9; fish oil only has secondary Omega-3
• Flax Boost (A blend of flax seed, black currant and star flower) contains secondary Omega-3 EFA (Steriodonic Acid), as well as primary Omega-3 and Omega-6 EFAs. Taking these secondary EFAs means the body means your body does not have to perform the conversion from primary to secondary EFAs.
• Fish oils are often recommended because they contain Omega-3 derivatives EPA and DHA, rather than the Omega-3 precursor Alpha Linoleic Acid (ALA) found in flax seed oil. The thinking is that if these derivatives are taken directly, the body does not have to make them from the precursor.
• It is however beneficial to consume some ALA because it is thought to have some specific functions in the body.

So, if that has left you confused, don't worry. The guts of this is that it is a good idea to get your healthy nutritients from a variety of sources, rather than one alone. Your body will take care of the rest!

Having said this, flax seed has some emotional and convenience advantages (I am referring to Waihi Bush flax seed in particular) because:

• It is organically grown and free of pesticides, heavy metals etc
• It is from a sustainable source
• It is a vegetarian source
• Fish stocks need preserving - not further depletion
• Toxic residues concentrate in fish stocks, although we are assured that fish oils are free of these
• Flax seed oil is rich in natural vitamin E
• Flax seed is pleasant tasting, so can be used as a butter substitute on bread, drizzled on salads, or simply taken straight from the bottle
• Gram-for-gram flax seed oil is much, much cheaper

For a selection of quality Omega oils go here

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Fish oil saves eyesight

Two recent studies show that eating fish frequently and not smoking may significantly reduce the risk of developing age-related macular degeneration (AMD).

The researchers from the Massachusetts Eye and Ear Infirmary, affiliated with Harvard Medical School in Boston, found that current smokers had a 1.9-fold greater risk of developing AMD, while past smokers increased their risk 1.7-fold, compared to nonsmokers. The study also found that those who ate the most fish -- at least two weekly servings -- reduced their risk of AMD by 45 percent over those who had less than one weekly serving.

Australian researchers at the University of Sydney also recently completed a five-year study of 2,900 people 49 and older, and found that people who ate at least one weekly serving of omega-3 fatty acid-rich fish -- such as salmon and mackerel -- reduced their risk of developing AMD by 40 percent.

Source: http://www.newstarget.com/019605.html

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Gary Moller comments:

I have had several inquiries recently about what can be done for AMD. Unfortunately, there are no cures. However, there are several things that you can do to reduce your risk, slow and possibly slow the progress of this disease.

What is AMD?

Macular degeneration is a progressive eye condition. It may affect as many as 14%-24% of the population aged 65-74 years and 35% of people aged 75 years or more.

The disease attacks the macula of the eye, where our sharpest central vision occurs. Although it rarely results in complete blindness, it robs the individual of all but the outermost, peripheral vision, leaving only dim images or black holes at the centre of vision.

Although it rarely causes total blindness, AMD robs those affected of their sharp central vision and can dim contrast sensitivity and colour perception. It destroys the clear, "straight ahead" central vision necessary for reading, driving, identifying faces, watching television, doing fine detailed work, safely navigating stairs and performing other daily tasks we take for granted. Peripheral vision may not be affected, and it is possible to see "out of the corner of your eye". The impact of developing AMD can be devastating to those who were independent and active prior to the onset. Their visual world gradually diminishes into a vague blur, making ordinary daily activities challenging

Fish oil and other preventive measures

• Eat fish 2-3 x per week
• Take a daily fish oil supplement and/or flax seed oil
• Get lutein for eyes by eating yellow veges and raw egg yolk (check my Super Smoothie recipe)
• Eat daily dark coloured berries
• Eat daily high anti-oxidant foods, including carrots, peppers, all fruit, red grapes and dark, leafy vegetables
• Take a broad spectrum anti-oxidant daily, especially if you have a health condition like diabetes
• Consider taking a nutritional formulation that contains lutein and bilberry. NutraVision for example
• Ensure that health conditions like diabetes are managed to perfection
• Do not smoke and avoid 2nd hand smoke and other environmental pollutants
• Avoid cheap hydrogenated oils including corn and safflour oil
• Avoid highly processed (junk) foods, especially those cooked in cheap oil
• Do daily moderate exercise

The anti-oxidants (which includes lutein) are very important for eye health by soaking up free radicals before they can damage the sensitive tissues of the eye. These are especially important for diabetics. Excessive exercise does not improve health and there is evidence that overdoing it may accelerate ageing possibly by flooding the body with free radicals.

To be of any worth, these measures need to be part of a life-time commitment to a healthy lifestyle that are put in place for years - not just weeks and months.

As I have already said, none of these measures will "cure" the condition; however, your risk of developing AMD will surely be greatly reduced and health in general will be damn good!

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