Welcome to Advance Physical Therapy, Inc. Newsletter
No one likes to hear that their joints are "wearing thin" from repetitive overuse or due to years of neglect. Whatever the reason may be, most of us are likely to experience some level of bone and joint stiffness, aching, decreased movement and strength that limits us from feeling eighteen years old again. Listening to our bodies and acknowledging the early signs and symptoms can be very beneficial in preventing long term joint degeneration. While we may not have control of how genetics may affect how our joints "wear and tear" over time, there are other factors that we can learn from to treat our joints and prevent further degeneration.

Often times patients will ask us if we could provide the "quick fix," or the "magic cure" to an old joint problem yesterday. After all, we live in Silicon Valley and we've come to expect revolutionary advances at a drop of a hat that should fix the world's problems and all sorts of joint problems. Unfortunately, the quick-fix-magic-pill has not been found and medicine has not caught up with our hopes for tissue regeneration...yet.

In this newsletter, we will discuss how physical therapy, nutrition and proper joint protection can optimize joint and cartilage health so that we can stay moving longer!

To Your Health,

Advance Physical Therapy, Inc.
 Risk Factors of Osteoarthritis

An estimated 27 million Americans have osteoarthritis. The symptoms of pain and stiffness can be caused by bone on bone contact from the breakdown of the cartilage that lines the joint surfaces. Although any joint arthritis is troublesome, as in the fingers and wrists, the pain of arthritis is even more debilitating in the weight bearing joints of the knee and hip, which explains why more than 800,000 Americans have hip and knee replacements each year.

There are several factors that affect your risk for developing this painful condition. Let's look at each of them.

1. Being overweight is the biggest risk factor. David Hunter, an associate professor of medicine at the Tufts University School of Medicine and chief of research at New England Baptist Hospital in Boston asserts "If people could control their body weight adequately, we could reduce the prevalence of osteoarthritis by 40 or 50 percent." Since the articular cartilage in the knee, for example, acts as a shock absorber, the increased stress on it from excessive loading causes it to degrade, since it wasn't intended to withstand that much force. The inflammatory response that ensues further erodes the cartilage.

2. Injury. A Washington Post survey of retired NFL players found that nearly 9 in 10 report suffering from aches and pains on a daily basis, and 91% attribute it to their football days. College and professional sport participation aside, after age 35 or 40, active adults are more likely to "quietly tear" a meniscus, the small cartilage discs that absorb shock and distribute weight across the knee joint, simply due to aging tissue. Indeed, as we age, it takes less and less vigor to tear cartilage. Osteoarthritis results from multiple small or large insults to the cartilage.

3. Like heart disease and diabetes, our family history also explains why we suffer from arthritis. A tendency to be bow-legged or knock-kneed is an alignment issue we inherit. So is the general curvature of our spines and shoulder girdles. Being overweight, or having weak muscles will speed the wear and tear on the joints.

4. Being female puts us at risk, as well. Teen-aged girls are 8-10 times more likely to tear an anterior cruciate ligament in the knee. Monthly estrogen and progesterone fluctuations weaken ligaments. In the knee, the wider pelvis and resulting alignment of the hip and knee will require that certain muscle groups work harder to maintain proper mechanics around the joint. If these predisposing factors are not identified early, injury, and ultimately, the degenerative change of arthritis can occur.
Manual Therapy Improves Degenerative Joint Pain

The first line of defense is not to neglect or ignore joint pain that doesn't resolve on its own after a week or two. Usually, minor aches and pains do subside with rest but if joints persist to have pain that is sharp, dull or throbbing with or without movement, with weight bearing or non-weight bearing activities (walking, squatting, transitioning between positions), and/or if there is presence of swelling, it is important that you consult with your physician and physical therapist for a thorough assessment to identify the specific cause(s) of the joint pain. If joint pain is left untreated, persistent inflammation can result in further deterioration of the cartilage around the joint surface which can lead to increase pain, inflammation, and immobility. Pain and immobility leads to muscle guarding, poor muscle contraction and coordination, muscle weakness and fatigue which then can perpetuate a vicious cycle of pain, stiffness and further cartilage breakdown.

And while degenerative joint pain may be a result of genetics, overuse, trauma, or from sedentary living, it is important to understand what we can do to slow down joint and cartilage degeneration that is within our control. Physical therapy provides the resources necessary to effectively treat and improve bone, muscle and joint health. A thorough physical therapy evaluation will determine the causes of joint pain and identify the specific areas of cartilage breakdown, muscle weakness and imbalance and poor postural and joint alignment. Next, specific treatment techniques are implemented to minimize excessive compression (weight bearing pressure) on cartilage and joints. These techniques include joint mobilization to improve joint alignment, soft tissue mobilization to reduce muscle imbalance, strain and tension, dosed medical exercise to strengthen and coordinate muscle recruitment necessary to stabilize joints from further degeneration. Appropriate nutrition, ergonomic, posture/body mechanics education are addressed to maximizing joint protection and preservation.

The key to treating degenerative joint pain is to address the symptoms early on and seek professional assistance to determine the extent of the injury. Early intervention is the best way to preserving joint health and function.

Please contact us if you have any questions regarding how physical therapy can help you treat degenerative joint pain.
If we can answer any questions or field any topics of interest regarding  physical therapy, health and wellness or about our programs, please contact us. We'd love to hear from you.
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Are All Omega 3's and Fish Oil the Same?

When it comes to omega-3 fish oil supplements, not all products are created equal. A high-quality product can mean enjoying all of the clinically-researched benefits of omega-3s. An inferior product can mean exposing your body to unwanted toxins or oxidative rancidity, with few beneficial results.

With a little education, you can be confident when shopping for an omega-3 supplement and learn about what differentiates a high-quality fish oil supplement from the rest.
Of utmost importance in a good fish oil is freshness. A fresh product will not only taste great, but will also be more effective. Since fish oil, like fish, begins to deteriorate as soon as it is exposed to oxygen, look for products that are processed in an oxygen-free environment. Purity goes hand in hand with freshness. Because of environmental contaminants, all fish oils must be purified during processing. The selection of fish species that are naturally low in toxins and sourced from clean waters (wild caught sardines, anchovies, Arctic Cod, Alaskan salmon) is the first step. Utilizing a gentle, chemical-free, reduced-heat processing protocol results in excellent purity levels.

Purity and freshness can be proven. Some manufacturers have their products tested by independent agencies and make the test results available upon request. Don’t be afraid to call and ask for the test results on the products you are considering. Once you have determined that a product is fresh and pure, there is another important quality to look for. How well will your body absorb the oil? Obviously, the benefits of omega-3 nutrition can only be enjoyed if your body actually absorbs these essential fatty acids. The natural, molecular form of fish oil is called the “triglyceride form.”  Many fish oil products are manufactured in a new-to-nature ethyl ester form. Look for the triglyceride form, which has been shown to be up to 70% better absorption rate by the body.

Potency is another consideration. Experts recommend a daily dose of at least 500 mgs of the combined omega-3 essential fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Some people with specific health challenges are advised by their doctor to take 2–4 grams a day. Don’t just look at the milligram size of the soft gel, check product labels to be sure you’re getting adequate levels of EPA and DHA.

With these tips in mind, you should be able to face this supplement choice confidently and choose a high-quality omega-3!
Ultimate Omega® by Nordic Naturals® is an example of a high-quality fish oil. A concentrate in the triglyceride form, it contains 650 mg EPA and 450 mg DHA. Third-party test results proving industry-leading purity and freshness levels are available for every bottle.
Natural Food Remedies and Supplements to Prevent and Slow Degenerative Joint Changes

Natural Medicine for Osteoarthritis
There are many effective natural treatment options for osteoarthritis. Prevention is always the goal with natural medicine. Once symptoms develop, however, there are specific natural remedies and diet changes that have proven to be effective in stopping and, in some cases, reversing the damage and discomfort associated with degenerative joint disease.

Osteoarthritis & Diet Recommendations
Include the following foods in your diet: fresh vegetables, fruits (especially pigment-rich berries since they contain anthocyanidins, which enhance collagen matrix integrity and structure), whole grains, flax seed oil, deep ocean fish (anti-inflammatory omega 3 oils), nuts, soy products and beverages (hormonal support), drink 2 liters of fresh water daily. Include extra fiber in your diet by adding 1 Tbs. psyllium seed husk fiber and/or 5-8 Tbs. of Flax seed meal and/or oat bran daily to your diet. And remember to increase your water intake to keep things moving.

Avoid or significantly reduce the following in your diet: sugar, refined flour products, processed foods, fast foods, saturated fats (animal and dairy products), hydrogenated oils, and nightshade vegetables (tomatoes, peppers, eggplant, potatoes and tobacco), shell fish (clams, crab, lobster, shrimp), caffeine (coffee, tea, soda).

Osteoarthritis & Nutritional Supplementation
The following nutrients have been shown to be deficient in patients suffering from osteoarthritis, so the following supplements are effective in treating osteoarthritis:
  • Vitamin C: 1000 mg 3 times a day with meals
  • Vitamin E: 400-800 IU daily
  • Zinc: 30 mg daily
  • B6: 50 mg daily
  • Copper: 2 mg daily
  • Boron: 5 mg daily
  • Glucosamine Sulfate: Although previous studies shows that this joint cartilage precursor may promote cartilage regeneration in affected joints, relieve pain, and repair damage, recent research questions its full effectiveness. Some people with osteoarthritis experience an improvement in symptoms after at least 6 weeks of taking this supplement. The usual recommended dose is 500 mg, taken 3 times a day.
  • S-Adenosylmethionine (SAM): SAM improves swelling, early morning stiffness, range of motion, and pain. Take 1000 mg daily for 2 weeks, then 200 mg, twice a day.
  • Flax Seed Oil: Flax seed oil is an anti-inflammatory. Take 1-2 Tbs daily.

2944 Broadway Street                         1208 E. Arques Avenue Suite #105
Redwood City, CA 94062                     Sunnyvale, CA 94085

(W) 650.261.0330                                 (W) 408.720.8225
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