Overcoming Tendonitis – by Dr. Steven Low & Dr. Frank Skretch

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If you assumed tendonitis to be an inflammatory condition, you’re not alone. However, it’s not; the “-itis” nomenclature is a misnomer, and while one can rarely go wrong with reducing chronic/systemic inflammation, it’s not the cure for tendonitis.

What, then, is tendonitis and what does cure it? It’s a non-inflammatory proliferation disorder, meaning, something is growing (or in this case, simply being replaced) in a way it shouldn’t. As to fixing it, that’s more complex.

This book does cover 20 interventions (sorted into “major” and “minor”), ranging from exercise therapies to surgery, with many things between. It also examines popular myths that do not help, such as rest, ice, heat, and analgesics.

The style of this book is hard science, but don’t worry, it explains everything along the way. It does however mean that if you’re not very accustomed to wading through scientific material, you can’t just dip into the middle of the book and be guaranteed to understand what’s going on. Indeed, before even getting to discussing tendonitis/tendinopathy, the first chapter is very reassuringly dedicated to “understanding the levels and classification of evidence in studies”, along with the assorted scales and guidelines of the Center for Evidence-Based Medicine.

The rest, however, is about the etiology, diagnosis, and treatment of tendonitis and tendinopathy more generally. One interesting thing is that, according to the abundant high-quality evidence presented in this book, what works for one body part’s tendonitis does not necessarily work for another body part, so we get quite a part-by-part rundown.

Bottom line: this book has a wealth of useful, applicable information about management of tendonitis, making it indispensable if you or a loved one suffer from such—but settle in, because it’s not a light read.

Click here to check out Overcoming Tendonitis, and overcome tendonitis!

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  • Let’s Get Letting Go (Of These Three Things)
    Dr. Mitika Kanabar’s wellness guide: Release tension, ditch unhealthy diets, and reduce screen time for a better you.

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  • 4 things ancient Greeks and Romans got right about mental health

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    According to the World Health Organization, about 280 million people worldwide have depression and about one billion have a mental health problem of any kind.

    People living in the ancient world also had mental health problems. So, how did they deal with them?

    As we’ll see, some of their insights about mental health are still relevant today, even though we might question some of their methods.

    Jr Morty/Shutterstock

    1. Our mental state is important

    Mental health problems such as depression were familiar to people in the ancient world. Homer, the poet famous for the Iliad and Odyssey who lived around the eighth century BC, apparently died after wasting away from depression.

    Already in the late fifth century BC, ancient Greek doctors recognised that our health partly depends on the state of our thoughts.

    In the Epidemics, a medical text written in around 400BC, an anonymous doctor wrote that our habits about our thinking (as well as our lifestyle, clothing and housing, physical activity and sex) are the main determinants of our health.

    Bronze statue of Homer on Greek island of IOS
    Homer, the ancient Greek poet, had depression. Thirasia/Shutterstock

    2. Mental health problems can make us ill

    Also writing in the Epidemics, an anonymous doctor described one of his patients, Parmeniscus, whose mental state became so bad he grew delirious, and eventually could not speak. He stayed in bed for 14 days before he was cured. We’re not told how.

    Later, the famous doctor Galen of Pergamum (129-216AD) observed that people often become sick because of a bad mental state:

    It may be that under certain circumstances ‘thinking’ is one of the causes that bring about health or disease because people who get angry about everything and become confused, distressed and frightened for the slightest reason often fall ill for this reason and have a hard time getting over these illnesses.

    Galen also described some of his patients who suffered with their mental health, including some who became seriously ill and died. One man had lost money:

    He developed a fever that stayed with him for a long time. In his sleep he scolded himself for his loss, regretted it and was agitated until he woke up. While he was awake he continued to waste away from grief. He then became delirious and developed brain fever. He finally fell into a delirium that was obvious from what he said, and he remained in this state until he died.

    3. Mental illness can be prevented and treated

    In the ancient world, people had many different ways to prevent or treat mental illness.

    The philosopher Aristippus, who lived in the fifth century BC, used to advise people to focus on the present to avoid mental disturbance:

    concentrate one’s mind on the day, and indeed on that part of the day in which one is acting or thinking. Only the present belongs to us, not the past nor what is anticipated. The former has ceased to exist, and it is uncertain if the latter will exist.

    The philosopher Clinias, who lived in the fourth century BC, said that whenever he realised he was becoming angry, he would go and play music on his lyre to calm himself.

    Doctors had their own approaches to dealing with mental health problems. Many recommended patients change their lifestyles to adjust their mental states. They advised people to take up a new regime of exercise, adopt a different diet, go travelling by sea, listen to the lectures of philosophers, play games (such as draughts/checkers), and do mental exercises equivalent to the modern crossword or sudoku.

    Galen, the physician
    Galen, a famous doctor, believed mental problems were caused by some idea that had taken hold of the mind. Pierre Roche Vigneron/Wikimedia

    For instance, the physician Caelius Aurelianus (fifth century AD) thought patients suffering from insanity could benefit from a varied diet including fruit and mild wine.

    Doctors also advised people to take plant-based medications. For example, the herb hellebore was given to people suffering from paranoia. However, ancient doctors recognised that hellebore could be dangerous as it sometimes induced toxic spasms, killing patients.

    Other doctors, such as Galen, had a slightly different view. He believed mental problems were caused by some idea that had taken hold of the mind. He believed mental problems could be cured if this idea was removed from the mind and wrote:

    a person whose illness is caused by thinking is only cured by taking care of the false idea that has taken over his mind, not by foods, drinks, [clothing, housing], baths, walking and other such (measures).

    Galen thought it was best to deflect his patients’ thoughts away from these false ideas by putting new ideas and emotions in their minds:

    I put fear of losing money, political intrigue, drinking poison or other such things in the hearts of others to deflect their thoughts to these things […] In others one should arouse indignation about an injustice, love of rivalry, and the desire to beat others depending on each person’s interest.

    4. Addressing mental health needs effort

    Generally speaking, the ancients believed keeping our mental state healthy required effort. If we were anxious or angry or despondent, then we needed to do something that brought us the opposite of those emotions.

    De Morbis acutis et Chronicis by Caelius Aurelianus
    Watch some comedy, said physician Caelius Aurelianus. VCU Tompkins-McCaw Library/Flickr, CC BY-NC-SA

    This can be achieved, they thought, by doing some activity that directly countered the emotions we are experiencing.

    For example, Caelius Aurelianus said people suffering from depression should do activities that caused them to laugh and be happy, such as going to see a comedy at the theatre.

    However, the ancients did not believe any single activity was enough to make our mental state become healthy. The important thing was to make a wholesale change to one’s way of living and thinking.

    When it comes to experiencing mental health problems, we clearly have a lot in common with our ancient ancestors. Much of what they said seems as relevant now as it did 2,000 years ago, even if we use different methods and medicines today.


    If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

    Konstantine Panegyres, McKenzie Postdoctoral Fellow, researching Greco-Roman antiquity, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Get Better Sleep: Beyond “Sleep Hygiene”

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    Better Sleep, Better Life!

    This is Arianna Huffington. Yes, that Huffington, of the Huffington Post. But! She’s also the CEO of Thrive Global, a behavior change tech company with the mission of changing the way we work and live—in particular, by challenging the idea that burnout is the required price of success.

    The power of better sleep

    Sleep is a very important, but most often neglected, part of good health. Here are some of Huffington’s top insights from her tech company Thrive, and as per her “Sleep Revolution” initiative.

    Follow your circadian rhythm

    Are you a night owl or a morning lark? Whichever it is, roll with it, and plan around that if your lifestyle allows for such. While it is possible to change from one to the other, we do have a predisposition towards one or the other, and will generally function best when not fighting it.

    This came about, by the way, because we evolved to have half of us awake in the mornings and half in the evenings, to keep us all safe. Socially we’ve marched onwards from that point in evolutionary history, but our bodies are about a hundred generations behind the times, and that’s just what we have to work with!

    Don’t be afraid (or ashamed!) to take naps

    Naps, done right, can be very good for the health—especially if we had a bad night’s sleep the previous night.

    Thrive found that workers are more productive when they have nap rooms, and (following on a little from the previous point) are allowed to sleep in or work from home.

    See also: How To Nap Like A Pro (No More “Sleep Hangovers”!)

    Make sure you have personal space available in bed

    The correlation between relationship satisfaction and sleeping close to one’s partner has been found to be so high that it’s even proportional: the further away a couple sleeps from each other, the less happy they are. But…

    Partners who got good sleep the previous night, will be more likely to want intimacy on any given night—at a rate of an extra 14% per extra hour of sleep the previous night. So, there’s a trade-off, as having more room in bed tends to result in better sleep. Time to get a bigger bed?

    What gets measured, gets done

    This goes for sleep, too! Not only does dream-journaling in the morning cue your subconscious to prepare to dream well the following night, but also, sleep trackers and sleep monitoring apps go a very long way to improving sleep quality, even if no extra steps are consciously taken to “score better”.

    We’ve previously reviewed some of the most popular sleep apps; you can check out for yourself how they measured up:

    Time For Some Pillow Talk: The Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down

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  • Slowing the Progression of Cataracts

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Understanding Cataracts

    Cataracts are natural and impact everyone.

    That’s a bit of a daunting opening line, but as Dr. Michele Lee, a board-certified ophthalmologist, explains, cataracts naturally develop with age, and can be accelerated by factors such as trauma, certain medications, and specific eye conditions.

    We know how important your vision is to you (we’ve had great feedback about the book Vision for Life) as well as our articles on how glasses impact your eyesight and the effects of using eye drops.

    While complete prevention isn’t possible, steps such as those mentioned below can be taken to slow their progression.

    Here is an overview of the video’s first 3 takeaways. You can watch the whole video below.

    Protect Your Eyes from Sunlight

    Simply put, UV light damages lens proteins, which (significantly) contributes to cataracts. Wearing sunglasses can supposedly prevent up to 20% of cataracts caused by UV exposure.

    Moderate Alcohol Consumption

    We all, at some level, know that alcohol consumption doesn’t do us any good. Your eye health isn’t an exception to the rule; alcohol has been shown to contribute to cataract development.

    If you’re looking at reducing your alcohol use, try reading this guide on lowering, or eradicating, alcohol consumption.

    Avoid Smoking

    Smokers are 2-3 times more likely to develop cataracts. Additionally, ensure good ventilation while cooking to avoid exposure to harmful indoor smoke.

    See all 5 steps in the below video:

    How was the video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!

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Related Posts

  • The Missing Links – by Drs Phillip Meade & Laura Gallagher
  • Codependent No More – by Melody Beattie

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This is a book review, not a book summary, but first let’s quickly cover a common misconception, because the word “codependent” gets misused a lot in popular parlance:

    • What codependence isn’t: “we depend on each other and must do everything together”
    • What codependence is:“person 1 has a dependency on a substance (or perhaps a behavior, such as gambling); person 2 is trying to look after person 1, and so has developed a secondary relationship with the substance/behavior. Person 2 is now said to be codependent, because it becomes all-consuming for them too, even if they’re not using the substance/behavior directly”

    Funny how often it happens that the reality is more complex than the perception, isn’t it?

    Melody Beattie unravels all this for us. We get a compassionate and insightful look at how we can look after ourselves, while looking after another. Perhaps most importantly: how and where to draw a line of what we can and cannot do/change for them.

    Because when we love someone, of course we want to fight their battles with them, if not for them. But if we want to be their rock of strength, we can’t get lost in it too, and of course that hurts.

    Beatty takes us through these ideas and more, for example:

    • How to examine our own feelings even when it’s scary
    • How to practice self-love and regain self-worth, while still caring for them
    • How to stop being reactionary, step back, and act with purpose

    If the book has any weak point, it’s that it repeatedly recommends 12-step programs, when in reality that’s just one option. But for those who wish to take another approach, this book does not require involvement in a 12-step program, so it’s not a barrier to usefulness.

    Click here to check out Codependent No More and take care of yourself, too

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  • The Sweet Truth About Glycine

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    Make Your Collagen Work Better

    This is Dr. James Nicolantonio. He’s a doctor of pharmacy, and a research scientist. He has a passion for evidence-based nutrition, and has written numerous books on the subject.

    Controversy! Dr. DiNicolatonio’s work has included cardiovascular research, in which field he has made the case for increasing (rather than decreasing) the recommended amount of salt in our diet. This, of course, goes very much against the popular status quo.

    We haven’t reviewed that research so we won’t comment on it here, but we thought it worth a mention as a point of interest. We’ll investigate his claims in that regard another time, though!

    Today, however, we’ll be looking at his incisive, yet not controversial, work pertaining to collagen and glycine.

    A quick recap on collagen

    We’ve written about collagen before, and its importance for maintaining… Well, pretty much most of our body, really, buta deficiency in collagen can particularly weaken bones and joints.

    On a more surface level, collagen’s also important for healthy elastic skin, and many people take it for that reason alone,

    Since collagen is found only in animals, even collagen supplements are animal-based (often marine collagen or bovine collagen). However, if we don’t want to consume those, we can (like most animals) synthesize it ourselves from the relevant amino acids, which we can get from plants (and also laboratories, in some cases).

    You can read our previous article about this, here:

    We Are Such Stuff As Fish Are Made Of

    What does he want us to know about collagen?

    We’ll save time and space here: first, he’d like us to know the same as what we said in our article above

    However, there is also more:

    Let’s assume that your body has collagen to process. You either consumed it, or your body has synthesized it. We’ll skip describing the many steps of collagen synthesis, fascinating as that is, and get to the point:

    When our body weaves together collagen fibrils out of the (triple-helical) collagen molecules…

    • the cross-linking of the collagen requires lysyl oxidase
    • the lysyl oxidase (which we make inside us) deanimates some other amino acids yielding aldehydes that allow the stable cross-links important for the high tensile strength of collagen, but to do that, it requires copper
    • in order to use the copper it needs to be in its reduced cuprous form and that requires vitamin C
    • but moving it around the body requires vitamin A

    So in other words: if you are taking (or synthesizing) collagen, you also need copper and vitamins A and C.

    However! Just to make things harder, if you take copper and vitamin C together, it’ll reduce the copper too soon in the wrong place.

    Dr. DiNicolantonio therefore advises taking vitamin C after copper, with a 75 minutes gap between them.

    What does he want us to know about glycine?

    Glycine is one of the amino acids that makes up collagen. Specifically, it makes up every third amino acid in collagen, and even more specifically, it’s also the rate-limiting factor in the formation of glutathione, which is a potent endogenous (i.e., we make it inside us) antioxidant that works hard to fight inflammation inside the body.

    What this means: if your joints are prone to inflammation, being glycine-deficient means a double-whammy of woe.

    As well as being one of the amino acids most key to collagen production, glycine has another collagen-related role:

    First, the problem: as we age, glycated collagen accumulates in the skin and cartilage (that’s bad; there is supposed to be collagen there, but not glycated).

    More on glycation and what it is and why it is so bad:

    Are You Eating Advanced Glycation End-Products? The Trouble Of The AGEs

    Now, the solution: glycine suppresses advanced glycation end products, including the glycation of collagen.

    See for example:

    Glycine Suppresses AGE/RAGE Signaling Pathway and Subsequent Oxidative Stress by Restoring Glo1 Function

    With these three important functions of glycine in mind…

    Dr. DiNicolantonio therefore advises getting glycine at a dose of 100mg/kg/day. So, if you’re the same size as this rather medium-sized writer, that means 7.2g/day.

    Where can I get it?

    Glycine is found in many foods, including gelatin for those who eat that, eggs for the vegetarians, and spinach for vegans.

    However, if you’d like to simply take it as a supplement, here’s an example product on Amazon

    (the above product is not clear whether it’s animal-derived or not, so if that’s important to you, shop around. This writer got some locally that is certified vegan, but is in Europe rather than N. America, which won’t help most of our subscribers)

    Note: pure glycine is a white crystalline powder that has the same sweetness as glucose. Indeed, that is how it got its name, from the Greek “γλυκύς”, pronounced /ɡly.kýs/, meaning “sweet”. Yes, same etymology as glucose.

    So don’t worry that you’ve been conned if you order it and think “this is sugar!”; it just looks and tastes the same.

    That does mean you should buy from a reputable source though, as a con would be very easy!

    this does also mean that if you like a little sugar/sweetener in your tea or coffee, glycine can be used as a healthy substitute.

    If you don’t like sweet tastes, then, condolences. This writer pours two espresso coffees (love this decaffeinated coffee that actually tastes good), puts the glycine in the first, and then uses the second to get rid of the sweet taste of the first. So that’s one way to do it.

    Enjoy (if you can!)

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  • Green Curry Salmon Burgers

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    These lean and healthy burgers are as quick and easy to make as they are good for entertaining. The serving-bed has its nutritional secrets too! All in all, an especially heart-healthy and brain-healthy dish.

    You will need

    • 4 skinless salmon fillets, cubed (Vegetarian/Vegan? Consider this Plant-Based Salmon Recipe or, since they are getting blended, simply substitute 1½ cups cooked chickpeas instead with 1 tbsp tahini)
    • 2 cloves garlic, chopped
    • 2 tbsp thai green curry paste
    • juice of two limes, plus wedges to serve
    • 1 cup quinoa
    • ½ cup edamame beans, thawed if they were frozen
    • large bunch fresh cilantro (or parsley if you have the “soap “cilantro tastes like soap” gene), chopped
    • extra virgin olive oil, for frying
    • 1 tbsp chia seeds
    • 1 tbsp nutritional yeast
    • 2 tsp black pepper, coarse ground

    Method

    (we suggest you read everything at least once before doing anything)

    1) Put the salmon, garlic, curry paste, nutritional yeast, and half the lime juice into a food processor, and blend until smooth.

    2) Remove, divide into four parts, and shape into burger patty shapes. Put them in the fridge where they can firm up while we do the next bit.

    3) Cook the quinoa with the tablespoon of chia seeds added (which means boiling water and then letting it simmer for 10–15 minutes; when the quinoa is tender and unfurled a little, it’s done).

    4) Drain the quinoa with a sieve, and stir in the edamame beans, the rest of the lime juice, the cilantro, and the black pepper. Set aside.

    5) Using the olive oil, fry the salmon burgers for about 5 minutes on each side.

    6) Serve; we recommend putting the burgers atop the rest, and adding a dash of lime at the table.

    (it can also be served this way!)

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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