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.

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.

Nutrients for keeping your arteries healthy flexible

As we get older our arteries tend to lose their flexibility. They harden. This shows as an increase in blood pressure. If we were listening to the pulse of hardening arteries through a stethoscope we would hear a hard wooden knock as compared to a soft thud as the heart ejects each pulse of blood into healthy arteries.

Maintain sexual performance by looking after your arteries

Sexual drive and performance relies on the healthy functioning of a number of mind and body systems, including healthy circulation - the ability of the arteries to contract and relax freely. This applies as much to women as much as it does to men, so strategies to improve arterial health should be beneficial for your sex life as well!

All is not lost. Every part of your body is renewed with even the bones being completely replaced about every 6-7 years or so. So, one can assume that arteries can be softened up to some degree if the conditions are right. This starts with good nutrition and we now know nowadays that there are several nutrients that are beneficial for keeping arteries healthy:

Vitamin E
Vitamin E has been used for decades, if not longer, for softening scar tissue. Numerous studies have confirmed the benefits of vitamin E in improving arterial health. This ability to maintain normal blood vessel tone may partly account for vitamin E's benefits in preventing cardiovascular diseases. There has been some adverse, confusing publicity about vitamin E recently. Do not worry; the bulk of the evidence is in favour of the health benefits of natural vitamin E. Stay away from synthetic vitamin E.

Vitamin C
Vitamin C is essential for maintaining healthy collagen tissue. The extreme of unhealthy collagen due to vitamin C deficiency if scurvy. Arteries are made up of collagen among other substances. Vitamin C can also provide some protection of the blood vessels against homocycsteine which is one of the most reliable predictors of heart disease.

L-Arginine
This amino acid is the precursor to nitric oxide, and it is known that nitric oxide can increase the flexibility of arterial walls. Nitric oxide increases endothelial flexibility, and studies have found L-Arginine supplements helpful in angina pain and congestive heart failure. As people age the production of L-Arginine decreases and many experts believe this is responsible for many degenerative processes related to aging. Natural sources include: Nuts, sunflower seeds, sesame seeds, chocolate, popcorn, raisins, brown rice, carob, gelatin desserts, oatmeal, whole wheat bread, and protein rich foods including whey protein.
Vitamin C may further improve the activity of L-arginine.

Garlic
Garlic is rich in antioxidants and increases nitric oxide production. When cloves are chewed, crushed or cut, they release a sulphur-bearing compound called allicin - the chemical that gives garlic its pungent taste and smell. And it's the allicin that scientists have discovered is the magic ingredient thought to be responsible for garlic's many therapeutic qualities. Kyolic garlic and garlic oil are both potent sources of the active ingredients of garlic.

Alpha-Lipoic AcidThis antioxidant has long been used to treat symptoms of diabetic nerve disease. Alpha-lipoic acid works together with other antioxidants such as vitamins C and E. It is important for growth, helps to prevent cell damage, and helps the body rid itself of harmful substances. It has recently been shown to be beneficial for blood vessel health. Good food sources of alpha-lipoic acid include spinach, broccoli, beef, yeast (particularly Brewer's yeast), and certain organ meats (such as the kidney and heart).

Evening Primrose Oil (EPO)
EPO is rich in the essential gamma-linoleinc acid (GLA), a very valuable fatty acid that is not found in many plants. It has numerous vital functions in the body. GLA is an essential fatty acid that the body does not manufacture. This fatty acid is known to help prevent hardening of the arteries, heart disease, eczema, cirrhosis, rheumatoid arthritis, menopause, PMS, multiple sclerosis, and high blood pressure. It has a positive effect on sex hormone response including the hormones estrogen and testosterone, aids in lowering cholesterol levels, and is important in treating cirrhosis of the liver. Research also demonstrates that primrose oil helps relieve pain and inflammation.

Flavonoids
Flavonoids are a family of more than 5,000 potent antioxidants found in fruits and vegetables. Studies are showing the importance of these antioxidants for maintaining cardiovascular health, including healthy blood vessels.

Good sources of flavonoids include all citrus fruits, berries, onions, parsley, legumes, green tea, red wine, seabuckthorn, and dark chocolate. I especially recommend dark berries like blue berries, black berries and boysenberrries.

Fish oil and flaxseed oil
Omega 3 fatty acids have also been proven to work wonders for your heart, arteries and veins that make up your cardiovascular system. They help to lower cholesterol, tryglicerides, LDL and blood pressure, while at the same time increasing good HDL cholesterol.

Minerals, including magnesium
Low mineral levels, particularly magnesium, can result in increased arterial muscle tension and an irregular pulse. Supplementation with magnesium can include a bone broth and a nightly soak in a warm bath of Epsom Salts. A bone broth is also a wonderful natural source of gelatine

Monitor cardiovascular health
If you have high blood pressure, or a heart condition and you are intending to try natural therapies including nutritional supplementation, it is important that you monitor your heart health. Do this daily using a digital blood pressure monitor. Consult your doctor and discuss your plans. Heed any advice given.

These nutrients are good for you when taken according to professional guidance. Even if there is no measurable benefit in cardiovascular health from taking these, you may find a pleasant offshoot: healthy skin, hair and nails!

Omega 3 Oils and Menopause

Maintaining a proper balance of dietary fats may ward off much of the symptoms, including bone loss associated with menopause and post-menopausal life. Researchers have found that diets with a low ratio of omega-6 fatty acids to omega-3 fatty acids minimised the bone loss typically brought on by estrogen deficiency, which is common in post menopausal females. Omega-6 fatty acids are typically found in foods such as grains and beef, while omega-3 fatty acids are found in foods such as walnuts and salmon.

While both types of fats are essential for human health, diets with a high ratio of omega-6 fatty acids to omega-3 fatty acids are often associated with cardiovascular disease, cancer and inflammatory and autoimmune diseases. A low ratio of omega-6 to omega-3 fatty acids, however, is believed to promote cardiovascular health, improve memory and, as the current study shows, protect bone health.

Most menopausal women do not get an adequate supply of essential fatty acids. These fatty acids help by producing compounds similar to hormones that help maintain membrane function, cut down on swelling and inflammation, constrict blood vessels, control pain, support the body’s natural immune response, prevent blood clots, and so on.

Omega 3 fatty acids are highly beneficial for skin, hair and nails, both ingested and as a skin moisturiser applied directly to the skin twice daily.

While the traditional oil for menopause is Evening Primrose Oil, it is best to mix and match your sources including fish oil, flax seed oil, evening primrose oil, olive oil and so on. These oils are available for delivery worldwide from http://www.myotec.co.nz

Which flax oil is best for you?

Evening primrose oil and premenstrual discomfort

Gary,
After reading your article in your web-site about Primrose Oil, I decided to try this if I would notice any difference when having my periods. So I took this a month prior to my period. During the week prior to my period, my breast are very sore (even though you would not think I had them, looking at me, but I do !!!) and when going for runs or cycling, my limbs are very sore and I'm a lot slower for that week duration, if running, I usually end up walking as my legs don't want to run and everything hurts.

I can confirm, that after taking Primrose Oil for the first time ever I did not experience any soreness in my breast which is great, as this is an indication when I know that I'm definitely going to have my period. To add to this, I also did not experience sore limbs while running and cycling which I can't believe, as that week is always a drag and I can't wait for my period to arrive for relief of resolving the soreness in my bones.

I just wanted to let you know, for those women out there, who experience soreness, I definitely recommend Primrose Oil, to be honest, I did not think this was going to work and am amazed it has, I'm enjoying running now. Thanks Gary for your advice and I hope other women will try this to believe this. It definitely worked for me.

Signed anonymous
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Gary Moller comments:
Diet and PMT are linked. To what extent, is the debate. Evening Primrose Oil (EPO)has been traditionally used to lessen PMT symptoms. While the research evidence is still undecided, the anecdotal reports, such as the one above, are convincing.

EPO is similar to other Omega 3 oil sources, like flax seed and fish oil; but it differs by being very rich in GLA which has a number of physiological functions that are thought to reduce PMT symptoms.

For very relevant information read my new pages about menopause here.

The idea is to take about 1,000mg per day with food thorughout the month, but to step this up to 3-4,000mg during the 10 or so days before and then during your period. Once the period os over, drop back to 1,000mg.

Even if it does nothing for your PMS, it is still great for keeping skin healthy!