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DrRic Injury inflammation and Food in the Yoga Practitioner (slide share edition)


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This I presented at Bikram Yoga in Jan 2011

Published in: Health & Medicine
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DrRic Injury inflammation and Food in the Yoga Practitioner (slide share edition)

  1. 1. Injury Inflammation and food in the yoga praCTITIONER<br />
  2. 2. Common injuries<br />Patellofemoral syndrome (kneecap pain)<br />Cervicalgia (neck pain flare up)<br />Lumbago (low back pain flare up)<br />Shoulder bursitis (rotator cuff impingement)<br />
  3. 3. Shoulder<br />R<br />Party Pooper<br />
  4. 4. The bursa -a sack of lubrication<br />That’s old news!<br />
  5. 5. Overinflated sack<br />You change the mechanics if its over inflated!<br />
  6. 6. Interpretation: Pain<br />Stretch receptors turn on pain receptors<br />
  7. 7. How can this happen<br />Preexisting injury flared up in class<br />Tight shoulders to start with, poor warm up<br />Tadasana<br />Bakasana<br />
  8. 8. (not my top 10) <br />Cervicalgia<br />Disc “disease”<br />Muscle spasm<br />Trigger point!<br />Topic: trigger points…..<br />Discuss!<br />
  9. 9. Trigger points = Janet Travell<br />Neck pain<br />Shoulder pain<br />Arm pain<br />Headache<br />
  10. 10. Lumbago = Back pain<br />Essentially same as cervicalgia<br />Disc disease very real in the low back*<br /> *but the treatment is the same! Shhh<br /> ** aka pinched nerve, sciatica, bulging disc, slipped disc<br /> impingement<br />
  11. 11. A surgical problem (but you wouldn’t be walking)<br />
  12. 12. PFS (Patellofemoral Syndrome)<br />Typically just as tracking issue<br />The cap acts as a pulley<br />The pulley has low friction surfaces<br />If alignment and “chores” are kept, good for 80 years<br />Warning Warning-push the alignment, the chores, the duty and “failure is eminent”<br />
  13. 13. Rubbing leads to friction <br />
  14. 14. Friction leads to damage (inflammation)<br />
  15. 15. The Injury<br />Px: It hurts when I do this……<br />Doc: So don’t do this…….<br /> -Henny Youngman<br />
  16. 16. Electron microscope OF A TEAR <br />
  17. 17. Soft tissue (ligament, tendon and muscle) gets over stretched and torn off its connecting points to bone.<br />The tissue reacts by sending more blood to the area and heat/redness prevail<br />Compensating areas start to fail when they can’t do the work of the originally injured part<br />A twist, roll, bend or fall occurs with immediate pain 0<br />Stiffness and spasm set in by 1day<br />Other areas start to spasm in 1week<br />
  18. 18. When tissue is torn/stretched:<br />Inflammatory phase starts day 0-5<br />Bleeding<br />PMN’s<br />Macrophages and platelets stimulates GF<br />Proliferative phase from day 5-21<br />GF stimulates endothelial cells, fibroblasts and myofibroblasts<br />Macrophages continue<br />Maturation phase from day 21-whenever<br />Fibroblasts<br />Increased collagen and tensil strength<br />The Problem<br />
  19. 19. Inflammation<br />When tissue damage occurs, the “cascade” starts<br />Normal tissues<br />*stomach<br />*kidneys<br />*platlets<br />*endothelium<br />Inflammatory sites<br />*macrophages<br />*synoviocytes<br />*fibroblasts<br />
  20. 20. The same process happens in heart disease!<br />
  21. 21. Regular nsaids block here:<br />Nonselective cox2<br />Normal tissues<br />*stomach<br />*kidneys<br />*platlets<br />*endothelium<br />Inflammatory sites<br />*macrophages<br />*synoviocytes<br />*fibroblasts<br />
  22. 22. Steroids block here:<br />corticosteroids<br />Normal tissues<br />*stomach<br />*kidneys<br />*platlets<br />*endothelium<br />Inflammatory sites<br />*macrophages<br />*synoviocytes<br />*fibroblasts<br />
  23. 23. Cox 2 blocks here:<br />WITHDRAWN<br />By FDA!!!<br />Cox-2<br />Normal tissues<br />*stomach<br />*kidneys<br />*platlets<br />*endothelium<br />Inflammatory sites<br />*macrophages<br />*synoviocytes<br />*fibroblasts<br />
  24. 24. Generic and Trade Names<br />Diclofenac potassium fast release<br />Diclofenac sodium delayed <br />Etodolac<br />Indomethacin<br />Ketorolac<br />Sulindac<br />Tolmetin<br />Mefenamic acid<br />Fenoprofen<br />Flurbiprofen<br />Ketoprofen<br />Oxaprozin<br />Nabumetone<br />Diflunisal<br />Celecoxib<br />Valdecoxib<br />Meloxicam<br />Piroxicam<br />Cataflam<br />Voltaren<br />Lodine<br />Indocin<br />Toradol<br />Clinoril<br />Tolactin<br />Ponstel<br />Nalfon<br />Ansaid<br />Orudis<br />Daypro<br />Relafen<br />Dolobid<br />Celebrex<br />Bextra<br />Mobic<br />Feldene<br />
  25. 25. ROID’S<br />Not anabolic’s<br />Prednisone<br />Medrol dose pack<br />Kenalog<br />Celestone<br />
  26. 26. “Food as Medicine”hippocrates<br />
  27. 27. The antiinflammatory diet andrewweil, MD<br />Low glycemic index foods<br />Oily fish at least 2x week<br />40 gm fiber daily<br />Phytonutrients <br />Limit red meat<br />Limit processed food<br />Push fluid (non caffeine non alcohol)<br />-Nutritionist Andrea Klouda (630) 855-7907<br />
  28. 28. Glycemic Index (just know the concept!)<br />
  29. 29. For more info:<br /> American Diabetes Association 2006<br /> Johanna Burani, MS, RD,CDE<br /><br />
  30. 30. macronutrients<br />Proteins 80-120gm daily<br />Fats 67gm daily<br />Carbs 160-200gm daily<br />Fiber 40 gm daily<br />….minor details….<br />
  31. 31. Micronutrients(daily)<br />Vit C 200mg <br />Vit E 400IU<br />Selenium 200mcg<br />Mixed carotenoids 10000-15000IU <br />Vit D 2000IU<br />….minor details….<br />
  32. 32. Phytonutrients <br />Veggies from all parts of the color spectrum<br />Organic when possible ($) clean 15/dirty dozen<br />Cruciferous regularly (cabbage family)<br />Tea instead of coffee<br />Red wine as the alcohol of choice if you use<br />Plain dark chocolate<br />
  33. 33. Environmental Working Group<br />Non profit<br />Provides resources for consumers<br />Pushes national policy<br />They even have a tuna calculator!<br />
  34. 34. EWG’s dirty dozen<br />Celery <br />Peaches <br />Strawberries <br />Apples <br />Blueberries (Domestic) <br />Nectarines <br />Sweet Bell Peppers <br />Spinach <br />Collard Greens/Kale <br />Cherries <br />Potatoes <br />Grapes (Imported)<br />
  35. 35. EWG’s clean 15<br />Onions <br />Avocados <br />Sweet Corn <br />Pineapples <br />Mangoes <br />Sweet Peas <br />Asparagus <br />Kiwi <br />Cabbage <br />Eggplant <br />Cantaloupe (Domestic) <br />Watermelon <br />Grapefruit <br />Sweet Potatoes <br />Honeydew Melon<br />
  36. 36. Dr Weil<br />
  37. 37. vs<br />USDA<br />
  38. 38. Buyer beware!!<br />Buyer beware!!<br />
  39. 39. If all diet attempts fail –add Supplements<br />Tumeric<br />Vitamin D3<br />Omega 3 fish oil<br />White willow bark, shark cartilage, oregano, ginger, holy basil<br />Helicrysium, tea tree, traumeel, frankinsence. menthol, marjoram<br />
  40. 40. Ayurvedic Medicine<br />The antiinflammatory diet for the long run<br />Specific supplements for the short run<br />Topical oils<br />Homeopathy<br />Energy healing<br />Massage (thai, deep tissue, hot stone, lymphatic)<br />Dosha specific diet balance<br />
  41. 41. Biological energies that govern function<br />Vata-Space and Air<br />Pitta-Fire and Water<br />Kapha-Water and Earth<br />Physical and Psychological Characteristics<br />Comm0n Disorders of Imbalance<br />Common Ways to Regain Balance<br />The Doshas of ayurveda<br />
  42. 42. Vata Physical<br />Thin and bony<br />Light<br />Dry and rough skin<br />Dry and brittle hair<br />Hands dry<br />Small dull dark<br />Thin dark red lips<br />Tongue dry pale grey coating<br />Variable appetite<br />Poor digestion, weak fire<br />Prone to constipation<br />Irregular mensecrampy<br />Vigorous exercise<br />Insomnia<br />Pulse slithers<br />Fast speech<br />Variable sex appetite<br />
  43. 43. Stong communicator<br />Artistic <br />Adaptable<br />Emotionally sensitive<br />Spiritually inclined<br />Sensitive to subtle energies<br />Charismatic<br />Alert<br />Vata Psychological<br />
  44. 44. Arthritis<br />Muscle stiffness<br />Headaches<br />Constipation<br />Chronic fatigue<br />Dry scaly skin<br />Dizzy, ringing ears<br />Intolerance to cold<br />Food allergies (wheat dairy)<br />Vata Disorders/Imbalance <br />
  45. 45. Gentle exercise<br />Meditation daily<br />Specific diet <br />Time in nature<br />Eat in peace<br />Bright warming colors (orange and green)<br />Massage daily (warm oil sesame)<br />Lavendar cinnamon oils for aromatherapy<br />Spend time with grounding pitta and kaphas<br />Vata Balance<br />
  46. 46. Vata pacification<br />Favor warm oily heavy<br />Dairy<br />Avocado, banana, cherries, mango<br />Asapragus, beets, carrots<br />Mung, dahl, tofu<br />Rice and wheat<br />Cardamon, curmin, ginger, cinnamon, salt, nutmeg<br />chopra center<br />
  47. 47. Pitta Physical<br />Medium build developed<br />Medium height<br />Hair fine light<br />Oily skin, acne<br />Hands hot and sweaty<br />Eyes medium penetrating bright<br />Teeth yellow and prone to decay<br />Tongue moist pink yellow coat<br />Strong appetite<br />Strong digestion gerd<br />Soft loose regular<br />Regular mense longer<br />Vigorous exercise<br />Sexual arousal<br />Light sleep not disturbed<br />Sweat easily<br />Pulse strong stable<br />
  48. 48. Intelligent penetrating ideas<br />Courageous<br />High acheiver<br />Articulate<br />Organized planners<br />Able to focus on single objective at hand<br />joyful<br />Pitta Psychological<br />
  49. 49. Overly intense<br />Manipulative <br />Stubborn/arrogant<br />Jealous/materialistic<br />Loud aggressive<br />Controlling of others<br />Egotistical critical judgemental<br />Suppressive of emotion<br />Demeaning<br />Pitta Disorder/Imbalance<br />
  50. 50. Avoid stimulants<br />Eat in peace<br />Meditate time in nature<br />Calming exercises<br />Cooling colors blue green white<br />Rest<br />Learn to appreciate kapha and vata types<br />Cool showers and oils like sandalwood<br />Massage oils like coconut<br />Journal to get in touch with emotions<br />Pitta Balancing<br />
  51. 51. Pitta pacification<br />Cool foods and liquids<br />Milk, butter, ghee<br />Grapes, melons, cherries, apples, ripe oranges<br />Asparagus, cucumbers, potatoes, broccoli, green beans<br />All beans except lentils<br />Rice, wheat, barley, oats<br />Coriander, cumin, fennel, sugar<br />chopra center<br />
  52. 52. Kapha Physical<br />Heavy bones broad frame<br />Heavy often obese<br />Shorter or taller than average<br />Oily smooth skin<br />Thick oily hair curly<br />Hands cool clammy<br />Eyes large and calming<br />Tongue pink white coating<br />Mod appetite <br />Slow metabolism<br />Well formed stool<br />Mensereg mod cramp<br />Slow graceful mvmt<br />Steady desire for sex<br />Deep sleep<br />Pulse smooth swanlike<br />
  53. 53. Patient sweet forgiving<br />Emotionally stable loving<br />Desire to help<br />Calm loyal<br />Accepting of others<br />Stamina<br />Homebodies romantic sensual<br />Long term memory good listener<br />Satisfied with life<br />Kapha Psychological<br />
  54. 54. Greedy hoarding<br />Unable to say no<br />Easily attached to people and things<br />Overly passive, fearful of letting go<br />Unable to express thoughts or emotion<br />Introverted depressed<br />Complacent slow to understand<br />Kapha Disorder/Imbalance<br />
  55. 55. Avoid luxurious lifestyle<br />Focus on nonattachment in daily life<br />Time for introspective activity writing meditation<br />Stimulating activities (vigorous yoga)<br />Bright colors red orange purple gold<br />Enlivening music<br />Observe seasons and adjust diet and life accordingly<br />Flower essense myrrh eucalyptus cedar aroma<br />Vary daily routine<br />Kapha Balancing<br />
  56. 56. Kapha pacification<br />Light dry warm foods<br />Low or non-fat milk<br />Apples, pears<br />All vegetables except tomatoe, cucumbers, sweet potatoes<br />All beans except tofu and soybean<br />Barley, corn, millet, buckwheat, rye and oats<br />All spices<br />chopra center<br />
  57. 57. Sweet<br />Sour<br />Salty<br />Bitter<br />Pungent<br />Astringent<br />Food tastes in Ayurveda<br />
  58. 58. DrSaguil favorites<br />Traumeel by Heel (homeopathic cream)<br />PanAway by Young Living (essen oil)<br />Turmeric FSE by New Mark (cap)<br />Vitamin D3 by NaturesSunshine (tab)<br />Super Omega 3 EPA by NS (cap)<br />*many companies are great!<br /> *many more are not so great! <br />
  59. 59. Q & A<br />Xiexie!!<br />Merci!!<br />Salamat!!<br />Cheers!!<br />Kwakwha!!<br />Gracias!!<br />Arigato!!<br />Mahalo!!<br />Danke!!<br />Anugurihiitosumi!!<br />
  60. 60.
  61. 61. Enrique (Ric) Saguil, MD<br />First Health Associates<br />2010 Arlington Heights Road<br />Arlington Heights, IL 60005<br />(847) 593-3330<br /><br />