Avoid Knee Surgery With This Proven Strategy (Over-50s Specialist Physio)
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A diagnosis of knee arthritis can be very worrying, but it doesn’t necessarily mean a knee replacement surgery is inevitable. Here’s how to keep your knee better, for longer (and potentially, for life):
Flexing your good health
You know we wouldn’t let that “proven” go by unchallenged if it weren’t, so what’s the evidence for it? Research (papers linked in the video description) showed 70% of patients (so, not 100%, but 70% is good odds and a lot better than the alternative) with mild to moderate knee arthritis avoided surgery after following a specific protocol—the one we’re about to describe.
The key strategy is to focus on strengthening the quadriceps muscles for joint protection, as strong quads correlate with reduced pain. However, a full range of motion in the knee is essential for optimal quad function, so that needs attention too, and in fact is foundational (can’t strengthen a quadriceps that doesn’t have a range of motion available to it):
Steps to follow:
- Improve knee extension:
- Passive knee extension exercise: gently press your knee down while lying flat, to increase straightening.
- Weighted heel props: use light weights to encourage gradual knee straightening.
- Enhance knee flexion:
- Use a towel to gently pull the knee towards the body to improve bending range.
Regular practice (multiple times daily) leads to improved knee function and pain relief. Exercises should be performed gently and without pain, aiming for consistent, gradual progress.And of course, if you do experience pain, it is recommend to consult with a local physiotherapist for more personalized guidance.
For more on all of this plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Treat Your Own Knee – by Robin McKenzie
Take care!
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Food and Nutrition – by Dr. P.K. Newby
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The “What Everyone Needs To Know” part of the title is the name of a series of books, of which this one, “Food and Nutrition”, is one.
In this case, the title is apt, and/or could have been “What Everyone Really Should Know”, or “What Everyone Would Like To Think They Know But Have Often Just Been Bluffing Their Way Through The Supermarket Aisles”.
The chapter and section headings are all in the forms of questions, such that all-together in such volume in the table of contents, they’re reminiscent of the “Jonathan Frakes Asks You Things” meme.
But, this serves a dual purpose—for one, it makes the whole book one big FAQ, which is a very convenient format. Furthermore, it prompts a little thought on the part of the reader before each section, if we indeed question for ourselves:
- Are fertilizers in farming friend or foe?
- How have the Digital Revolution and Information Age impacted our diet?
- Are canned and frozen foods inferior to fresh?
- Does snacking or meal timing matter?
- What are cereal grains and “pseudograins”?
…And so many more. But what’s best about this is:
Dr. Newby doesn’t reference her own preferences, or even have a particular way of eating she’d like us to adopt. She just lays out the science to answer each question, as discovered by high-quality studies and a general weight of evidence.
Bottom line: this book can level-up your nutritional knowledge from bluffing to really knowing! A worthy addition to anyone’s bookshelf.
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Menopause: 50 Things You Need to Know – by Dr. Felice Gersh
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Can you list 50 important facts about the menopause? If not, you’ll surely find things to learn in here.
The book is divided into three main sections:
- What to expect in perimenopause
- What to expect in early menopause
- What to expect in late menopause
Each section comes with an alarming array of symptoms, ranging from perimenopause fatigue and acne to late menopause tooth loss and vaginal prolapse. This is not to say that everyone will experience everything (fortunately), but rather, that these are the things that can happen and should not arrive unexpected.
Helpfully, of course, Dr. Gersh also gives advice on how to improve your energy and skin health, as well as keep your teeth and vagina in place. And similar professional insights for the rest of the “50 things you need to know”.
The style is like one big (182 pages) patient information leaflet—thus, very clear, explaining everything, and offering reassurance where possible and also what things are reasonable cause for seeking personalized medical attention.
Bottom line: if menopause is in your future, present, or very near past, this is an excellent book for you.
Click here to check out Menopause: 50 Things You Need To Know, and know them!
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Is it OK to lie to someone with dementia?
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There was disagreement on social media recently after a story was published about an aged care provider creating “fake-away” burgers that mimicked those from a fast-food chain, to a resident living with dementia. The man had such strict food preferences he was refusing to eat anything at meals except a burger from the franchise. This dementia symptom risks malnutrition and social isolation.
But critics of the fake burger approach labelled it trickery and deception of a vulnerable person with cognitive impairment.
Dementia is an illness that progressively robs us of memories. Although it has many forms, it is typical for short-term recall – the memory of something that happened in recent hours or days – to be lost first. As the illness progresses, people may come to increasingly “live in the past”, as distant recall gradually becomes the only memories accessible to the person. So a person in the middle or later stages of the disease may relate to the world as it once was, not how it is today.
This can make ethical care very challenging.
Pikselstock/Shutterstock Is it wrong to lie?
Ethical approaches classically hold that specific actions are moral certainties, regardless of the consequences. In line with this moral absolutism, it is always wrong to lie.
But this ethical approach would require an elderly woman with dementia who continually approaches care staff looking for their long-deceased spouse to be informed their husband has passed – the objective truth.
Distress is the likely outcome, possibly accompanied by behavioural disturbance that could endanger the person or others. The person’s memory has regressed to a point earlier in their life, when their partner was still alive. To inform such a person of the death of their spouse, however gently, is to traumatise them.
And with the memory of what they have just been told likely to quickly fade, and the questioning may resume soon after. If the truth is offered again, the cycle of re-traumatisation continues.
People with dementia may lose short term memories and rely on the past for a sense of the world. Bonsales/Shutterstock A different approach
Most laws are examples of absolutist ethics. One must obey the law at all times. Driving above the speed limit is likely to result in punishment regardless of whether one is in a hurry to pick their child up from kindergarten or not.
Pragmatic ethics rejects the notion certain acts are always morally right or wrong. Instead, acts are evaluated in terms of their “usefulness” and social benefit, humanity, compassion or intent.
The Aged Care Act is a set of laws intended to guide the actions of aged care providers. It says, for example, psychotropic drugs (medications that affect mind and mood) should be the “last resort” in managing the behaviours and psychological symptoms of dementia.
Instead, “best practice” involves preventing behaviour before it occurs. If one can reasonably foresee a caregiver action is likely to result in behavioural disturbance, it flies in the face of best practice.
What to say when you can’t avoid a lie?
What then, becomes the best response when approached by the lady looking for her husband?
Gentle inquiries may help uncover an underlying emotional need, and point caregivers in the right direction to meet that need. Perhaps she is feeling lonely or anxious and has become focused on her husband’s whereabouts? A skilled caregiver might tailor their response, connect with her, perhaps reminisce, and providing a sense of comfort in the process.
This approach aligns with Dementia Australia guidance that carers or loved ones can use four prompts in such scenarios:
- acknowledge concern (“I can tell you’d like him to be here.”)
- suggest an alternative (“He can’t visit right now.”)
- provide reassurance (“I’m here and lots of people care about you.”)
- redirect focus (“Perhaps a walk outside or a cup of tea?”)
These things may or may not work. So, in the face of repeated questions and escalating distress, a mistruth, such as “Don’t worry, he’ll be back soon,” may be the most humane response in the circumstances.
Different realities
It is often said you can never win an argument with a person living with dementia. A lot of time, different realities are being discussed.
So, providing someone who has dementia with a “pretend” burger may well satisfy their preferences, bring joy, mitigate the risk of malnutrition, improve social engagement, and prevent a behavioural disturbance without the use of medication. This seems like the correct approach in ethical terms. On occasion, the end justifies the means.
Steve Macfarlane, Head of Clinical Services, Dementia Support Australia, & Associate Professor of Psychiatry, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Apple vs Pear – Which is Healthier?
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Our Verdict
When comparing apple to pear, we picked the pear.
Why?
Both are great! But there’s a category that puts pears ahead of apples…
Looking at their macros first, pears contain more carbs but also more fiber. Both are low glycemic index foods, though.
In the category of vitamins, things are moderately even: apples contain more of vitamins A, B1, B6, and E, while pears contain more of vitamins B3, B9, K, and choline. That’s a 4:4 split, and the two fruits are about equal in the other vitamins they both contain.
When it comes to minerals, pears contain more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. A resounding victory for pears, as apples are not higher in any mineral.
In short, if an apple a day keeps the doctor away, a pear should keep the doctor away for about a day and a half, based on the extra nutrients ← this is slightly facetious as medicine doesn’t work like that, but you get the idea: pears simply have more to offer. Apples are still great though! Enjoy both! Diversity is good.
Want to learn more?
You might like to read:
From Apples To Bees, And High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
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Metabolical – by Dr. Robert Lustig
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The premise of this book itself is not novel: processed food is bad, food giants lie to us, and eating better makes us less prone to disease (especially metabolic disease).
What this book does offer that’s less commonly found is a comprehensive guide, a walkthrough of each relevant what and why and how, with plenty of good science and practical real-world examples.
In terms of unique selling points, perhaps the greatest strength of this book is its focus on two things in particular that affect many aspects of health: looking after our liver, and looking after our gut.
The style is… A little dramatic perhaps, but that’s just the style; there’s no hyperbole, he is stating well-established scientific facts.
Bottom line: very much of chronic disease would be a lot less diseasey if we all ate with these aspects of our health in mind. This book’s a comprehensive guide to that.
Click here to check out Metabolical, and let food be thy medicine!
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We Are Such Stuff As Fish Are Made Of
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Research Review: Collagen
For something that’s a very popular supplement, not many people understand what collagen is, where it comes from, or what it does.
In a nutshell:
Collagen is a kind of protein. Our bodies make it naturally, and we can also get more in our diet and/or take extra as a supplement.
Our bodies use collagen in connective tissue, skin, tendon, bone, and cartilage. It has many functions, but a broad description would be “holding things together”.
As we get older, our bodies produce less collagen. Signs of this include wrinkles, loss of skin hydration, and joint pain.
Quick test: pinch the skin on the middle of the back of one of your hands, and then watch what happens when you get low. How quickly and easily did your skin returns to its original shape?
If it was pretty much instantanous and flawless, congratulations, you have plenty of collagen (and also elastin). If you didn’t, you are probably low on both!
(they are quite similar proteins and are made from the same base “stuff”, so if you’re low on one, you’ll usually be low on both)
Quick note: A lot of research out there has been funded by beauty companies, so we had our work cut out for us today, and have highlighted where any research may be biased.
More than skin deep
While marketing for collagen is almost exclusively aimed at “reduce wrinkles and other signs of aging”, it does a lot more than that.
You remember we mentioned that many things from the bones outward are held together by collagen? We weren’t kidding…
Read: Osteoporosis, like skin ageing, is caused by collagen loss which is reversible
Taking extra collagen isn’t the only way
We can’t (yet!) completely halt the age-related loss of collagen, but we can slow it, with our lifestyle choices:
- Don’t smoke tobacco
- Drink only in moderation (or not at all)
- Avoid foods with added sugar, and high-processed foods in general
- Wear sunscreen when appropriate
Can I get collagen from food?
Yep! Just as collagen holds our bodies together, it holds the bodies of other animals together. And, just like collagen is found in most parts of our body but most plentifully in our skin and bones, that’s what to eat to get collagen from other animals, e.g:
- Chicken skin
- Fish skin
- Bone broth ← health benefits and recipes at this link!
What about vegans?
Yes, vegans are also held together by collagen! We do not, however, recommend eating their skin or boiling their bones into broth. Ethical considerations aside, cannibalism can give you CJD!
More seriously, if you’re vegan, you can’t get collagen from a plant-based diet, but you can get the stuff your body uses to make collagen. Basically, you want to make sure you get plenty of:
- Protein (beans, pulses, nuts, etc are all fine; it’s hard to go wrong with this)
- Vitamin C
- Vitamin D
- and Zinc
Just be sure to continue to remember to avoid highly-processed foods. So:
- Soy mince/chunks whose ingredients list reads: “soya”? Yes!
- The Incredible Burger or Linda McCartney’s Sausages? Sadly less healthy
Read: Advanced Glycation End Products in Foods and a Practical Guide to Their Reduction in the Diet
Meat-eaters might want to read that one too. By far the worst offenders for AGEs (Advanced Glycation End Products, which can not only cause collagen to stiffen, but also inactivate proteins responsible for collagen repair, along with doing much more serious damage to your body’s natural functions) include:
- Hot dogs
- Bacon
- Fried/roasted/grilled meats
Is it worth it as a supplement?
That depends on you, your age, and your lifestyle, but it’s generally considered safe*
*if you have a seafood allergy, be careful though, as many supplements are from fish or shellfish—you will need to find one that’s free from your allergen
Also, all collagen is animal-derived. So if you’re a vegan, decide for yourself whether this constitutes medicine and if so, whether that makes it ethically permissible to you.
With that out of the way:
What the science says on collagen supplementation
Collagen for skin
Read: Effects of collagen supplementation on skin aging (systematic review and meta-analysis)
The short version is that they selected 19 studies with over a thousand participants in total, and they found:
In the meta-analysis, a grouped analysis of studies showed favorable results of hydrolyzed collagen supplementation compared with placebo in terms of skin hydration, elasticity, and wrinkles.
The findings of improved hydration and elasticity were also confirmed in the subgroup meta-analysis.
Based on results, ingestion of hydrolyzed collagen for 90 days is effective in reducing skin aging, as it reduces wrinkles and improves skin elasticity and hydration.
Caveat: while that systematic review had no conflicts of interests, at least some of the 19 studies will have been funded by beauty companies. Here are two, so that you know what that looks like:
Funded by Quiris to investigate their own supplement, Elasten®:
A Collagen Supplement Improves Skin Hydration, Elasticity, Roughness, and Density
Funded by BioCell to investigate their own supplement, BioCell Collagen:
The Effects of Skin Aging Associated with the Use of BioCell Collagen
A note on funding bias: to be clear, the issue is not that the researchers might be corrupt (though that could happen).
The issue is more that sometimes companies will hire ten labs to do ten research studies… and then pull funding from ones whose results aren’t going the way they’d like.
So the “best” (for them) study is the one that gets published.
Here’s another systematic review—like the one at the top of this section—that found the same, with doses ranging from 2.5g–15g per day for 8 weeks or longer:
Read: Oral Collagen Supplementation: A Systematic Review of Dermatological Applications
Again, some of those studies will have been funded by beauty companies. The general weight of evidence does seem clear and favorable, though.
Collagen for bones
Here, we encountered a lot less in the way of potential bias, because this is simply marketed a lot less. Despite being arguably far more important!
We found a high quality multi-vector randomized controlled study with a sample size of 131 postmenopausal women. They had these women take 5g collagen supplement (or placebo), and studied the results over the course of a year.
They found:
- The intake of the supplement increased bone mineral density (BMD)
- Supplementation was also associated with a favorable shift in bone markers, indicating:
- increased bone formation
- reduced bone degradation
Read: Specific Collagen Peptides Improve Bone Mineral Density and Bone Markers in Postmenopausal Wome
A follow-up study with 31 of these women found that taking 5 grams of collagen daily for a total of 4 years was associated with a progressive increase in BMD.
You might be wondering if collagen also helps against osteoarthritis.
The answer is: yes, it does (at least, it significantly reduces the symptoms)
Read: Effect of collagen supplementation on osteoarthritis symptoms
In summary:
- You need collagen for health skin, bones, joints, and more
- Your body makes collagen from your food
- You can help it by getting plenty of protein, vitamins, and minerals
- You can also help it by not doing the usual Bad Things™ (smoking, drinking, eating processed foods, especially processed meats)
- You can also eat collagen directly in the form of other animals’ skin and bones
- You can also buy collagen supplements (but watch out for allergens)
Want to try collagen supplementation?
We don’t sell it (or anything else), but for your convenience…
Check it out: Hydrolyzed Collagen Peptides (the same as in most of the above studies), 90 days supply at 5g/day
We selected this one because it’s the same kind used in many of the studies, and it doesn’t contain any known allergens.
It’s bovine collagen, meaning it’s from cows, so it’s not vegan, and also some subscribers may want to abstain for religious reasons. We respect that, and/but make our recommendations based solely on the science of health and productivity.
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