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Optimizing Knee Health

OPTIMIZING KNEE HEALTH

By Dr. Zoltan P. Rona

Dr. Zoltan P. Rona practices Complementary Medicine in Toronto and is the medical editor of “The Encyclopedia of Natural Healing.” He has also published several Canadian best selling books including “Return to The Joy of Health”.

Over 5 million people in Canada and the U.S. seek medical attention each year for a knee problem. That’s according to the American Academy of Orthopedic Surgeons, a group of specialists who often perform a variety of surgical procedures on knees or prescribe strong painkillers with unwanted side effects like stomach ulcers. Osteoarthritis, ligament tears and other types of joint trauma account for the vast majority of these cases. Some knee problems result from wear and tear of parts of the knee, such as occurs in osteoarthritis. Other problems result from injuries that force the knee beyond its normal range of movement. If you want to minimize your chances of visiting the knee surgeon for an experience under the knife, there are quite a few things you can do on your own or with the guidance of a natural health care provider.

When it comes to knee health, if you do not use them, you lose them. You must exercise. Warm up before strenuous exercise by walking on grass or other soft surfaces or riding a stationary bicycle. Then do stretches. Do not stretch without a warm up because stiff, cold muscles are more prone to injury. Stretching the quadriceps (front of the thigh) muscles and the hamstrings (back of the thigh) reduces tension on the tendons and relieves pressure on the knee during vigorous activity.

On at least two days a week when you are not competing or vigorously exercising, work at least an hour to strengthen all the leg muscles by doing specific exercises such as leg lifts with weights, walking up stairs, walking on a treadmill with a high incline or riding a stationary bicycle. Working out with weights has been proven to benefit the knee, but this is best done with the supervision of a personal trainer or kinesthesiologist.

Use properly fitting athletic shoes. Problems with flat feet and excessive pronation (feet turning inwards) are common knee stressors that can be prevented by getting fit for special shoe inserts called orthotics. This is a service that is provided by a sports medicine specialist, podiatrist or a chiropractor. /

If you are overweight, realize that this puts extra stress on your knees. Longer warm-ups, increased water intake as well as diet and special food supplements should be strongly considered both to lose weight and enhance knee health.

The following recommendations are general guidelines only and should be modified depending on individual food tolerances or allergies as well as health history, degree of knee dysfunction and individual goals.

Nightshade foods (tomatoes, potatoes, peppers, eggplants, tobacco) might have to be eliminated by those who have joint pains associated with their consumption. There are certain foods (beef, pork and dairy, for example) that are pro-inflammatory: they increase the inflammatory response due to their content of certain types of fats (arachadonic acid and saturated fats) that increase the body’s production of pro-inflammatory hormones called prostaglandins.

Other foods, like fish (cod, trout, salmon, halibut and herring), flax and hempseed, are anti-inflammatory in that they have the reverse effect. Moreover, the foods in the prohibited category are the most allergenic and therefore the most likely to aggravate the inflammatory response. If you are not sure what foods or substances you might be allergic to, see a natural health care provider for an individualized diet. For more information on diet, menus and meal suggestions, see my book, “Osteoarthritis” (Alive Books Healthy Living Series, 2001).

Allowed Foods and Beverages (provided you are not allergic to them; eat organic whenever possible)

Carotene-containing foods like sweet potatoes, carrots, spinach, cantaloupe, kale, squash and pumpkin

Rice cakes, rice cereals and rice crackers

Vitamin C- and antioxidant-containing foods like citrus fruits, broccoli, strawberries, melons, Brussels sprouts and cabbages

Popcorn (no butter or salt added)

Buckwheat, quinoa, corn or rice pasta

All fresh fruits and dried fruits

Lamb, poultry, fish and seafood, preferably organic (they must be well cooked)

Organic fruit juices (freshly juiced) but just one glass per day if you have a high triglyceride blood level

Soy (although this ubiquitous legume’s health benefits are controversial), rice or almond milk

Small amounts of nuts (except peanuts and cashews which are high in mold content); best nuts are walnuts, pecans, macadamia, pine nuts and almonds

Sunflower and pumpkin seeds

Pure, filtered or ozonated spring water (It is important for adults to drink at least eight large glasses each day.)

What to Avoid

Wheat and other gluten-containing grains (barley, oats, rye, spelt, amaranth, millet and kamut)

Milk and dairy products

Eggs

Sugar

Artificial sweeteners (stevia is a good non-sugar sweetener)

All alcoholic beverages including beer and wine

Caffeine (coffee, regular tea, colas, chocolate)

Soft drinks and tap water (unless filtered or ozonated); avoid distilled water because it is devoid of minerals and can lead to mineral deficiencies

All foods containing artificial flavorings, additives and preservatives

Beef, pork, cold cuts, fried foods and salty foods

Coconuts

Peanuts, cashews and their products

Supplements

Knee cartilage injuries or osteoarthritis can be repaired with the help of the following supplements (taken for at least 3 months):

Glucosamine sulfate – 500 mg. 3 times daily

Chondroitin sulfate – 500 mg. 3 times daily

MSM (Methyl Sulfonyl Methane) – 3000 mgs. 3 or more times daily

SAMe (S-Adenosyl-Methionine) – 200 mg. 3 times daily

Vitamin C – 1000 mg. 3 times daily

These nutrients take a minimum of 8 weeks to work.  They reduce both pain and inflammation and may be taken safely for years, if needed. People with sensitive stomachs should make sure they take these supplements with food.  The odd individual may need to use something like DGL lozenges (deglycyrrhizinated licorice) to prevent heartburn while using these natural anti-inflammatory nutrients.  They may be used in one-third these dosages for people who have healthy knees but wish to prevent injuries.

If inflammation is a big issue, the most effective natural anti-inflammatory supplement is pancreatin (pancreatic digestive enzymes). When taken during or after meals, pancreatin helps break down protein, carbohydrate and fat in meals. When taken on an empty stomach (1 hour before or 3 hours after meals), pancreatin works very much like a very strong anti-inflammatory drug. The usual effective dose is 5 tablets 3 times daily between meals. At the first sign of a knee injury, taking 10 such enzyme tablets several times daily helps speed healing. Brand name examples of pancreatin include Wobenzyme, Intenzyme Forte and Pancreatin 840.

Acute injuries to the knee and even chronic knee pain caused by arthritis, meniscal tears and ligament damage can also be helped by hyperbaric oxygen, a treatment that speeds healing dramatically by exposing an individual to high oxygen levels at a very high pressure. This is a treatment modality that is growing in popularity amongst professional athletes and will soon be more commonly used by the general public.  

Strong muscles joints and ligaments require adequate amounts of minerals, especially copper (1 – 2 mg.), zinc (15 mg.), manganese (15 mg.), calcium (1200 mg.), magnesium (400 mg.) and boron (3 mg.).  In the diet, they are available by eating fresh nuts, seeds, greens and non-citrus fruits. Potassium (1000 mg. or more) is also essential and widely available by eating citrus and tropical fruits.

Other natural food supplements or herbal remedies that have success in reducing knee pain, swelling and inflammation include:

Bromelain (a pineapple enzyme) – 500 mg. 3 times daily between meals

Curcumin(a turmeric extract) – 500 mg. 3 times daily

Niacinamide – 500 mg. – 2 capsules up to 4 times daily

Omega-3 fatty acids (fish or hempseed derived) – 3000 mgs. up to 3 times daily

Vitamin E– 800 IU up to 5 times daily

Boswellia– 500 mg 3 times daily

Yucca – 500 mgs. 3 times daily

Cat’s Claw – 500 mg. 3 times daily

Hyaluronic acid – 50 mg. 3 times daily

Consult a natural health care practitioner for an individualized supplement program.

References 

Rona, Zoltan P. Osteoarthritis, Treat and reverse joint pain naturally.  Vancouver: Alive Books, 2001.

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Bates CJ, Levene CI. The effect of ascorbic acid deficiency on the glycosaminoglycans and glycoproteins in connective tissue. Bibl Nutr Dieta 13:131-143, 1969.

Conte A, Volpi N, Palmieri L, et al. Biochemical and pharmacokinetic aspects of oral treatment with chondroitin sulfate. Arzneim Forsch 45:918-25, 1995.

Drovanti A, Biganamini AA, Rovati AL. Therapeutic activity of oral glucosamine sulfate in osteoarthrosis: a placebo-controlled double-blind investigation. Clin Ther 3(4):260-272, 1980. 

Setnikar I, Pacini MA, Revel L. Antiarthritic effects of glucosamine sulfate studied in animal models. Arzheim-Forsch 41:542-545, 1991a.

Gualano M, Stramentinoli G, Rossoni G, Berti F. Antiinflammatory activity of S-adenosyl-L-methionine:interference with the eicosanoid system. Pharmacol Res Commun 15:683-688, 1983.

Marcolongo R, Biordano N, Colombo B, et al. Double-blind multicentre study of the activity of S-adenosyl-methionine in hip and knee osteoarthritis. Curr Ther Res 37(1): 82-94, 1985. 

Stone MH. Implications for connective tissue and bone alterations resulting from resistance exercise training. Med Sci Sports Exerc 20(5):S162-S168, 1988.

MacIntosh A. Stretching: a therapeutic exercise. Townsend Lett Apr 97:32-34.