Knee Pain vs. Knee Injury: Causes and Joint Health Strategies

Introduction to Natural Facts Podcast 0:00

Now there's interesting study came out and said that supplementing glucosamine increased quality of life. In fact, in the study, they phrased it differently. They said that all cause mortality. So all causes of problems, whether that's your lung, whether that's bowel, whether someone has cancer, whatever the cause of someone not living long, when they took glucosamine, they had a 5% decrease in all-cause mortality. What that means to me is when you take your joint formulas and you therefore stay walking and active, all health problems will be less.

Welcome to the Natural Facts Podcast. I'm your host, Dr. David Wickenheiser. I'm a naturopathic physician with over 30 years of clinical experience. I have a focus on natural and regenerative medicine. Through this podcast, I will be your guide, helping you to make sense of conflicting healthcare choices. Welcome to the Natural Facts. I'm Dr. David Wickenheiser, naturopathic physician and your host of the Natural Facts Podcast. This is the second of four interviews I recorded with Dr. Sharon Livingston for the Verve podcast.

This episode is on knee pain versus knee injury. Hello and welcome to The Verve with your host, Dr. Sharon Livingston. In this special series of interviews, Dr.

Knee Pain vs. Knee Injury 1:32

Sharon talks with Dr. David Wickenheiser. Dr. Wickenheiser is a naturopathic physician and an expert on natural remedies for better health and disease prevention. And now, here's Dr. Sharon. Hi, everyone. It's Dr. Sharon again with Dr. Wick. Today, we're going to be talking about knee pain versus knee injury. And Dr. Wick, the reason that I'm bringing this up is that I was telling a few people yesterday about what we were doing, and they went, oh, wow, I've had knee pain, but I didn't think I had an injury.

And I thought, hmm, does knee pain necessarily indicate that there has been an injury? And so I wanted to ask you about that. Well, Doc Sharon, it is a challenge to know exactly the cause of a dysfunction within the body. And something like knee pain has many different causes. Certainly, if you've fallen, if you have twisted your knee, if you have overextended in some other way, you can, of course, have traumatic causes of knee pain. But there are other reasons. Pain is a sensation sent by nerves from an area of your body to the brain so you perceive pain.

And those are actually through receptors called nociceptors, where their noxious inputs come to the brain. But those nociceptors can be stimulated, turned on, not just by trauma, but by infections, by allergies, and other reasons that activate those nerves. So it's interesting to me, in my mind, all of those might constitute an injury. But I guess I'm not defining injury properly. Perhaps the classic idea of an injury is wear and tear. So you actually had a trauma where energy was put into your body.

Perhaps you fell off your bike and that put energy in. Or there can be other types of trauma. Technically an infection would traumatize the body. Technically an allergy would traumatize it. But these are really operating in the background. They're not in the foreground. So people would not know that. There is another part here however, and that is the formation of scar tissue from past injuries. That's quite an interesting phenomenon. If there is knee pain, does that necessarily mean that there is swelling?

Does that necessarily mean that there are other indicators that would be akin to an injury? Perhaps, see the inflammatory response of the body, inflammation, pain, redness, heat and swelling, those four outward symptoms tell us that we have released chemicals in our body to turn on healing. Those outward symptoms tell us that we need to support the body to help to heal. Now sometimes people don't have inflammation and need it. They could have old injuries like I mentioned with scarring and that can limit their function and predispose them to having more pain in the future.

But it's really a question of figuring out what's happening. And part of that is a physical diagnosis, laboratory diagnosis, possibly blood tests, looking with an ultrasound, finding out what's happening within the knee to find out where you're going to go next for further testing perhaps or to start treatment. There doesn't have to be inflammation for one to feel pain. Well pain is part of the four parts of inflammation but you don't have to have a healing response just to have pain. Now ideally you should be responding to any kind of a pain signal with that And it can be just a perception.

We've seen that in a number of different circumstances. And it's quite interesting how the array of nerves, whether they're deep or whether they're just under the skin, there's two different groups of nerves. Those groups can communicate back and forth. There can be even confusion in the body. And so you don't actually have trauma. You're not actually attempting to heal. You've just got nerve confusion that there are things like perineural injections to get that to reset and calm down. So how important is it to differentiate the cause of pain?

Oh, it's critical because if there's first off a structural issue, if there's damage, let's get it healing. If there isn't damage, if it's just a confusion of nerves, let's get the confusion out. That perineural injection of dextrose 5% water just under the skin will remove that nervous confusion. And we often take that out of the picture to know if in fact there is something deeper. Now, of course, we start with an ultrasound exam and a physical exam, but those are not always conclusive.

Causes of Knee Pain and Diagnosis 6:12

So we have to treat each person as an individual and get the problems out in sequence. And when we do that, we get down, and as they say, drill down, get down lower to the true cause of any kind of challenge. So if you've got pain, it may not mean that you obviously have some kind of injury, it could mean just confusion. Okay. So let's just go over that again. There are some things that are going to be obvious that were an injury. When I fell on my knee, clearly I injured it. Yes. And the result of injury would be a combination of things like pain and then swelling, which is part of the inflammation response, right?

Yes. Part of what I'm concerned with some of the older patients that we've got is that they don't mount an inflammatory response. their bodies are not strong enough to do that. So it's really important to find out with each individual, are they able to respond? Can they respond to the therapies we do? Do we have to step back and do other things like get up their healing potential with good food, with managing their stress, with getting some kind of activity? If they're living on the couch, you're not going to heal well.

So that's all part of the assessment of, gee, where are we going to go next? Excellent. Okay. So let's just review the different kinds of problems that one might have in a knee. You said them before, but I just want to go over them one more time. So one could be an injury, like, you know, you took an impact on that knee, you fell on it or you twisted it or something like that. Yes. The other could be wear. Is that correct? Yes, so if the person's out of alignment, they're very bow-legged, or they've got fallen arches, that can lead to misalignment and wear in the joint.

Okay, so there's wear, there's injury, and then what were the other ones? The next one's infection. There's various infections that we all face that if they're out of control, some of them can affect the joint, and really you have to go after that infection if your joint pain is due to that cause. Okay, and was that it? Were there three or were there four? There's four. Food allergies, certain foods like tomatoes, white potatoes, peppers, eggplant, the whole nightshade family of plants, they can cause problems with your joints and especially the knees as well.

So when we're thinking about healing, when it's an injury, what kind of things should we be thinking about? Well, we need to think about the structure of the joint. So the first thing I want to know is through something like an x-ray is, okay, were the bones injured? And if the bones are fine, which they often are, then it's soft tissue. It's the ligaments, tendons, muscles associated with the knee. And if they are injured, then we need to turn on the healing process, which there are little cells called fibroblasts.

Blast cells make tissue. So they'll lay down collagen and actually regrow the injured part of your knee in the soft tissue, whether it's ligaments, whether it's tendons, whether it's even the muscle fibers. You can get healing and regeneration at that level. And really, you should get that regeneration to get true healing. Good. Okay. And then? So to turn on that healing, to get that natural response where if you've got a tear, if you've got a stretch, if you've got lax ligaments in the knee and that leads to more misalignment, by turning on those fibroblasts we can move ahead.

Now sometimes the fibroblasts will turn on on their own if we do the first step which is to feed your body and feed specifically the connective tissue of the knee. So nutrition has to be the first step. How do you do that? What foods feed connective tissue? Well, we can use pills. We can cover that in a moment. But we have to start with like feeds like. And this is where a lot of people right now are going with the current somewhat of a fad, but it's really true value for our bodies.

Healing Injuries with Nutrition and Bone Broth 10:12

And that's bone broth. Have you heard of bone broth? I have heard of bone broth, actually. That is so funny that we're mentioning this. I'm helping a company that works with bone broth. They create bone broth. So yeah, I do know about bone broth. Good, because bone broth is one of those key traditional foods. Whether you're looking at the traditional Chinese medicine traditions, whether you're looking at some of the Korean traditions, even North American throughout Europe, who doesn't have soup bone soup as part of their kitchen recipe list?

And when you have that kind of food, when you simmer the bones, some people roast them first, then you simmer them in water, a little bit of vinegar, That leaches out the nutritional value from the bones and from the connective tissue around it into the soup stock. You use that with vegetables and whatever else you want to make soup with. And that nutritional value that came out of those bones is perfectly suited to feed your bones and connective tissue. This is just so ironic because literally at 2 o'clock today, I'm talking to a man from Kettle and Fire who makes organic bone broth.

And it is just so funny that that's what came up today. So tell me more about bone broth because I've been reading about it. I've used bone broth myself. I haven't used it consistently, but now you're making me think I should. Well, everyone should have some soup in their diet. And it should be from a stock. Perhaps you make a bunch because it can be a bit of a hassle to make it on your own. Make a bunch, freeze it. And if that's not convenient, get it from a quality company. And the bone broth, if you look at certain traditions like Chinese medicine, And if you look into Qigong, which is building up energy in your body, one of the parts of Chinese lifestyle, and then traditional, and then over to Tai Chi to move the energy once you've built it up in your body, that is claimed to be built up in the bone marrow.

So there's a key life essence in your bone marrow. Now what we know is that the blood moves through the bone marrow. All of us have blood moving through the bone marrow. There's a lot of key value in their food value. That's why we get stem cells from bone marrow when we're doing stem cell treatments and other processes like that. So feeding our bones from other bones by way of soup is a very good way to add into our lifestyle a preventative and a supportive simple lifestyle benefit. Here's a question I have for you about that.

I used to have chicken soup every Friday night. My mother made chicken soup, you know, she put the whole chicken in, she would cook the soup all day long, then we would have that from Friday night through Saturday night. But it was a big deal to have that chicken soup with like the chicken in the pot kind of thing. How different is it to just drink bone broth or warm it up and have it as soup compared to adding vegetables and putting the chicken in there or putting meat in there? Does it matter?

Does it have to be just the bone broth or can you have it as soup? Well, I prefer to have things that are fun, that are good, that taste good. And you can do both, and you should do both. You should have the basic stock, which is from whatever source you've got, whether that's beef, bones, chicken, whichever source you want. And then, of course, add in all the other substances, your carrots, your onions, all the different vegetables that you like. And if you want to add in some meat, if you want to add in whatever else, of course, But you can personalize it so that you don't get tired of it.

Right. So some people just drink the broth every single day because they want to get all those nutrients. Exactly. And other people, even the name bone broth is kind of strange to them. So they kind of avoid it. You don't have to drink it as bone broth. You can always have it as soup. Or am I wrong? Always, because the minerals, the nutritional value in there, what's been extracted out of what was original bone and the connective tissue, the tendons, all that, what's over the bones, what's holding it together, all of that nutritional value will go into the liquid.

you don't have to add more in you can just drink it straight it's whatever you're doing whatever you feel like doing if you just want to have a cup of of the bone broth i'm not a real fan of calling it bone broth although everybody does i just want to call it a soup bone soup but some people want to just take it as a liquid fine but But if you want to add more things into it, I'm a more of a traditionalist. I want to add vegetables. I want to add maybe some pearl barley, some other substances in there that is real food.

I like adding real food into my life. It just seems easier. Now a lot of people like taking pills and there are times when we need to do that and there are supplements for building up your joints that are in pill form. But when we start with the lifestyle of bone broth, we simply don't have to use as many pills. I think that is so cool. So ideally, I'm just curious about this now. Ideally, if I kept a stock of nice organic bone broth, whether it was chicken or beef or whatever, in my refrigerator, and I don't have time to cook soup, I don't have time to do all of that, how much of that should I be consuming each day?

Generally, I would suggest that people start with a maintenance dose, if you want to call it that, of a cup of bone broth per day. Does it have to be hot? Can I drink it cold? Will I be grossed out if it's cold? I mean, is it better hot? Can I add salt? These are all questions that are so individual, Doc Sharon, that I would suggest you try it out different ways. And some of it depends on how they prepared the bones before they do the simmering. And so if you roast your beef bones and then you simmer it, people have told me that it tastes more like gravy.

I don't quite notice that, but whatever you test out and verify to yourself, And some days you'll be different. There's times when you really don't feel good, you got a bit of a sinus headache. Well, hot is going to be better. There's times in the summertime where cold soup is quite refreshing. So try it out different ways and you'll have to let me know how it goes. I'm going to do it. I love synchronicity, you know, when things come together at the same time. There's always reasons for things like this.

I love it. I love it. There's magic to it all, isn't there? there is if you open your eyes and watch you can see it now let's talk a little bit about supplements because the bone broth is a great place to start but some people need a little bit more and there's a couple of supplements that are quite important one is going to be a substance called MSM and it's in a lot of bone formulas that are in pills and that's methyl sulfonomethane, it's a long fancy name, you don't need to know that, just capital MSM that even taking two to four grams a day which is usually a gram per capsule, that will increase the elasticity and the healing potential

Joint Supplements and Glucosamine Benefits 17:00

of ligaments and tendons throughout your body. I'm going to do it. I still got that knee thing going on. Absolutely. Okay, good. What else? Next one, of course, glucosamine. Now, there's an interesting study that came out that I just read about a week ago that talked about glucosamine, most common is glucosamine sulfate. We know that that's commonly in joint formulas that help to build up the cartilage that may be damaged in, say, your knee. Now, this interesting study came out and said that supplementing glucosamine increased quality of life In fact, in the study, they phrased it differently.

They said that all cause mortality, so all cause is a problem, whether that's your lung, whether that's bowel, whether someone has cancer, whatever the cause of someone not living long, when they took glucosamine, they had a 5% decrease in all cause mortality. What that means to me is when you take your joint formulas and you therefore stay walking and active, all health problems will be less. So is 5% worth it? Oh, yeah. Yeah, yeah. That can be the tipping point. We look at a tipping point. A 5% plus or minus can be all it takes to give you another 10 years of quality life.

Awesome. Awesome. Okay. So there's MSM, there's glucosamine, and are there any other ones? Well, we've got our classics. We've got calcium supplementation along with magnesium and vitamin K. Now there's a bit of a challenge here because people were supplementing just calcium, which was raising the level in our bloodstream, and a study had come out a number of years ago, three years ago, where high calcium alone was increasing hardening of the arteries, which is a problem. Certainly you don't want to take pills to create a problem.

This was solved by taking vitamin K and vitamin D. Now the challenge here is, the pills are there and that's really good and there's certain dosages for all those supplements, but vitamin K is in leafy green vegetables, which is probably, after bone broth, your next best source of good calcium to build up your bones. So getting your calcium and your vitamin K in your daily salad is a good way to go. So interesting. You know, I went through a number of years where I had kale juice every single day, every single day.

You know, I heard that kale was like the most important thing you could eat because of all the nutrients, how dense it was in nutrients. And after my divorce, I don't know what happened. I just stopped drinking kale juice. I have not had kale in over two years. Now, that's crazy. Why am I doing this? Well, it is crazy, but there's grieving patterns, there's people that are not always tuned into their bodies, and there's many reasons why. But, kale, as a substance, as a food, is very good for us, but you've got to have some cautions here.

Because it is from the cabbage family, it is of a certain type of nutrition that having it raw is not always the best. Sometimes blanching it gives you better access to the nutrition inside of it. But however you do it, if you lightly blanch it and it turns brighter green and you put it in a salad, if you make kale chips out of it, which is kind of cool to do, I've had them, I like them. Kale is good feelings for yourself so when you start getting more positive you'll take it. The irony here is most people when they're not feeling good don't take care of themselves.

So to have a ritual where you're saying well I really feel down and I feel like eating sugar and drinking coffee all day, well let's get you some kale chips and tomorrow you'll feel so much better. It's so interesting. You know, I have a coaching practice in addition to the interviewing and podcasting work that I do. And I help people with eating disorders. And I have one person who wanted me to help her. Just yesterday, she said, listen, I was doing okay, I was doing okay.

Calcium, Vitamin K, and Healthy Habits 21:00

And then I ate a whole bowl of ice cream. What could I do to stop myself? I said, why don't you text me before you have it? I mean, it's such a simple thing to do, but people don't do the obvious sometimes because they don't really want to be helped. They want to have that pleasure that's going to cause them a lot of pain afterwards, but they don't want to stop themselves. It's just so interesting how we get in our own way of feeling good at times because we want to rebel or be naughty or have immediate gratification.

Interesting though, right? Well, it is because so many of the advertising giants in the world work on that. And it's almost like you deserve this guilty pleasure of chocolate. Well, yeah, chocolate can be okay, but two pounds a day is not a good thing. And yet some people I know are consuming that much. So when you put ritual into your life and you make sure that you feed yourself a minimum of good things, you have that bone broth, you have your multivitamin, you have good oils in your diet, you make sure you have that salad.

Yes, I'm going to have a beer for lunch, but I'm going to have the salad. Yes, I'm going to have a barbecue steak, but I'm sure as heck going to have vegetables with that. This is all about balance and having the discipline. Even if you're gonna go and drink too much beer, well, have some water. And so have your guilty pleasure, but balance it out with enough support that will bring you back again sooner. So how to make discipline fun. That's gonna be a topic I think we should talk about. Let's remember that.

Because I think that when discipline sounds like hard work and it's like daddy pulling out a strap from the old times or something, it makes us seem really harsh. When in fact, when we do these rituals, if we make them a little bit more fun and remind ourselves that we're really doing something very positive that's going to feel so good and it'll be fun in some way. I have to figure out how we talk about the fun aspect of it. Yes. I know that when I get up in the morning and I go for a long walk or I go to the gym and I do the thing in the gym that is a little bit easier to start with.

That's kind of fun. And I'm doing something good for myself. So if I can figure out how to reward myself with what is a discipline, then it changes the whole way I feel about myself and about doing that. So I don't know. I think we should talk more about that. I think we will because fun is critical. because it's a change of state. I always look for fun ways or even productive ways of goofing off because it's a change of state. I work for many hours in a stretch on different projects. And there's times when I'm losing productivity.

I've got to get up, go and do something else. I'll go clean. I'll go shopping, something else. And I think that there's a lot of ritual to health and eating the right things that just like brushing your teeth. I mean, if you had to think about brushing your teeth, you probably wouldn't. But if we can reduce a lot of good activity to simple habits that you just go through your ritual, I think people would simply be healthier. That makes total sense. So we went off on a tangent on this one. We started out talking about the difference between knee pain and knee injury.

We talked about how we can think about the different causes of knee pain and what these ramifications and implications are of those. And then we started talking about supplementation and bone broth, which I think is just so much fun because of what I mentioned earlier. And now we're ending up on how to make taking care of ourselves a little bit more fun. And I think that that will be the topic of an upcoming talk that we have. I like your approach so much. It's very much in line with the way I like to look at helping people.

I love positive psychology, you know, rather than going, oh, you're bad and this is wrong with you and you've got to change it. It's let's leverage your strengths. Let's help you have a good life. Let's do all the things that make you feel better. so you can do what you really want to do with your life and have a really fulfilling life. So I love the fact that we are in sync with that. And I just want to thank you for making this so interesting. Well thank you for sharing your experiences as well because what can be dry, science and biology can be quite dry and people tune it out, but when we make it personal in a way that can solve an individual person's problems, because who hasn't had knee pain or knows somebody who's got knee

Wrapping Up and Next Episode Preview 25:36

pain right now, that's the critical part. If we can move ahead, implementation is a huge thing. So if we can implement simple things to make big changes, I think that will help a lot of people. You know, according to Carl Rogers, who I studied with and I got to actually work with before he passed away when I was still a puppy, he said the most personal is the most universal. And I really believe that. So if we can share our hearts and our concerns from a deep level, then everybody resonates with that.

They really understand. And the emotional aspect of it makes it come alive. Don't you think? Well, I think that's what being genuine is. When you're in touch with your own feelings, you can talk to other people about their feelings, and everybody connects on feelings. That's why everybody loves stories. That's why our culture is so in love with certain aspects of television. Now perhaps we get distracted, but if we can make it personal and productive, I think that's good for all of us. Well, we've had kind of a really friendly conversation today where we've gone on a few different directions, but I really enjoyed it.

Next time we're going to start talking about treatment. for knee pain and for knee injury. And we're gonna talk about the different treatments for the different aspects. There are a lot of different treatments, so we're gonna be focusing on each treatment separately, and there'll be a series of podcasts on the different treatments. So everybody, please come on back, stay tuned. We're gonna tell you about some very fascinating and wonderful ways that you can get through the problems with knee pain and with knee injury.

So again, Dr. Wick, thank you so much. I learn so much from you every single time and I look forward to our next talk. Dr. Sharon, we'll talk then. Okay, thank you. I hope you enjoyed this episode of the Natural Facts Podcast. To get access to my future episodes as soon as they're available, subscribe wherever you get your podcasts. For all of my podcasts, as well as detailed discussions and reports on healthcare issues that matter to you, go to www.thenaturalfacts.com. This is Dr. David Weckenheiser, naturopathic physician, guiding you to better health with the natural facts.