Archive for May, 2009
Monday, May 25th, 2009
For me it was during a session of kickboxing. As I returned a foot to the floor after kicking the bag, I felt the sensation I came to know from my investigations as “stone bruise”. A perfect description for the acute pain that shot from my heel.
Maybe for you it began as you swung your legs out of bed to start the day and you had to hobble to the bathroom because you could not put weight on one heel. I assumed I had bruised my heel from pounding my naked feet on the floor over and over as I practised my kicks.
The trouble was, it didn’t get better despite laying off kicks in the gym. In fact, it got worse. At first the problem was no more than heel pain first thing in the morning that rapidly disappeared as I went about my personal training business. Then it became chronic, and I realised I had to do something about it. I’ve spent several months treating it and I’m happy to announce I have it on the run and want to share my experience with you and perhaps help you too.
Firstly, I did what most of us do in this information age. I googled “heel pain”, somehow knowing plantar fasciitis would pop up because my mother suffered it and I tend to reprise her ailments.
Now, heel pain points to other conditions as well, so ultimately one should seek medical advice but I figured I would tackle this on my own first. Ah, yes - there was plantar fasciitis in all its painful glory - affecting the middle-aged (me, and many of you), those with flat or excessively-arched feet (mine are pancakes), and those who spend a lot of time on their feet on hard surfaces (my feet ache just thinking about how long I spend on them).
The plantar fascia is the strong and tight tendon that runs from the heel to the balls and toes of the feet and supports our foot arches. When it becomes inflamed, due to degeneration of the fat pads of the feet as we age, excess wear and tear, biomechanical faults that lead to abnormal pronantion (rolling out of the foot) or possibly a combination of all three, the result is the same - heel pain.
Treatment? Here is the bit that really interested me, because I needed to get past this pain so I could get back to all the things that make life enjoyable for me. like kickboxing, dancing, and most of all, not hobbling around in pain most of the time.
I did not particularly want to spend lots of money or experience anything particularly invasive, both surgically or pharmaceutically so I ran down the list of treatments and put them in the “No way”, “I’ll try that”, and “Yes - that sounds good” categories:
No Way!
Non-steroidal anti-inflammatory drugs - To me, these treat the symptom and don’t address the problem.
Corticosteroids - As above, especially as the disclaimer accompanying their use was - “Repeated steroid injections may result in rupture of the plantar fasciia.” Clearly not a desirable outcome.
Ultrasound - It is ineffective, apparently.
Prolotherapy - Even though the prestigious Mayo Clinic endorses this treatment, the injection of non-pharmaceutical and inactive material to treat pain and strengthen connective tissue did not appeal.
Extracorporeal shockwave therapy (ESWT) I just skimmed over the description of this one, knowing it was not for me. It inflames the area to increase the healing benefits of increased blood flow.
Local anaesthesia - Repeated injections can lead to (ouch, here it comes) pain, bleeding, neuritis and infection. No thanks.
Most of these treatments are for long term plantar fasciitis that has not responded to other procedures design to heal connective tissue. I have had plenty of injuries and fixed them over time with more homespun remedies like rest, stretching, icing and heat so surely these would help?
I’ll Try That
Ah, yes, good old R.I.C.E (Rest, Ice, Compression, Elevation) popped up.
Heel inserts. I’d had some custom-made through a chiropractor before - they cost $400 and broke down after several months but I spotted some off-the-shelf ones for a tenth of the price and gave them a go. It seems so many of us experience heel pain that there is a strong need for this product. Mine have arch support and, after several days of wear were quite comfortable.
Ice - My old friend. I always keep ice cubes in the freezer and often find myself dumping two trays of them into a hand towel and wrapping them around sore bits. This time I started a regular evening routine of wrapping the ice-filled towel around my ankle and balancing my heel over the iceberg, rocking and pressing. What relief! It’s usually recomended that you only ice for 15 to 20 minutes but I did it for hours, figuring the thicker skin under the heel could take it.
Heat - I have treated so many injuries with intermittent heat and ice that I used this technique for my sore heel. It’s usually only your dominant foot that develops the complaint. I find heat plasters very effective so took to wrapping one I cut to size under my heel and wore it all day, then reverted to ice at night.
The nice thing about the heat plaster is even if you discontinue it, your shoe insert will have absorbed the heating medium (capsicum oil in my case) and will provide residual comforting heat for days afterwards.
Yes, I’ll try that
One suggestion I found intriguing was to freeze a water bottle or paper cup of water and roll that under the foot and heel, providing icing and massage at the same time. I didn’t get a chance to try that because I spent 10 days in Thailand and took advantage of cheap massage to have foot massage one day, traditional Thai massage the next. The traditional is fantastic, the foot massage a disappointment - just a skin polish really.
When I got back I tried massaging the underside of my foot with my own hands, then remembered the rolling frozen water bottle (or frozen can of orange juice in another suggestion). I cast around for an object I could use to massage my own foot and heel and came up with a decorative glass egg made from ground beach glass that I had bought on a previous trip to - you guessed it - Thailand.
Bingo! By securing it in the folds of a towel and rocking, rolling and pressing my foot on it I gave myself the best foot massage I have ever had. By this stage my heel pain had improved quite a bit but recovery had plateaued. Egg massage gave me almost instant relief. It was painful at first, to find sore areas and press on them but the round shape of the egg allowed lots of possibilities. The broader cross section placed transverse across the heel and arch was ideal for rolling, placing it longitudinally was ideal for rocking, and using the pointier end was ideal for pressing.
It may be a coincidence that my plantar fasciitis was healing as I took the glass egg cure, but I don’t think so. Stone or pebble massage has a long tradition in various cultures. I had visions of Captain Cook having his debilitating sciatica being cured in one long 24-hour session by Tongan women who tapped, pounded and massaged his lower back and buttock area with river stones. He declared himself cured afterwards and never suffered from it again.
I consider myself cured but still wear my shoe inserts, and roll that blessed glass egg under my stockinged or bare foot as required. That’s usually after boxing, dancing or being on my feet for a long time. It’s good to be back on them with minimal discomfort.
Look around your home for a rounded object for self-treatment. It could be a golf ball, stone, or pebble. Put it in the freezer for a while, heat it in a pan of simmering water, or coat it in liniment and go to work. Study the anatomy of the foot and visualise the broad, fleshy insertion of your tendon as it meets the heel.
Don’t neglect the other non-invasive therapies but I really think this one is the breakthrough as it allows you to use the pressure you can tolerate on the areas you know need it most.
Good luck!
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Tuesday, May 12th, 2009
A lot of people take vitamins for general health, many take them periodically in large dosages to hasten recovery from a cold, and others take them as part of preventative or curative programs for cancer or heart disease.
Is this medicalisation of vitamins of any use?
A new study adds weight to the growing consensus amongst research doctors that vitamins are a waste of time and money, and in fact may be doing more harm than good.
It’s natural to embrace all possibilities when one is grappling with a disease like cancer but the use of vitamins to prevent it, let alone cure it, is a concept slowly joining the sanguine realms of faith healing and quack cures.
A big, long-term study of post-menopausal women by the Fred Hutchinson Research Center in Seattle, published in the Archives of Internal Medicine in February 2009 sought to determine risk factors for cancer, heart disease and bone health.
161,808 women participated in the study over an eight year period. Because 41% of those women took multivitamins, it gave lead study author Dr Marian L. Newhouser the opportunity to contrast their results with the control group of women who did not take vitamins. If the 41% of women showed statistically significant lowered risks for cancer, then a conclusion could be drawn that vitamins reduce cancer risk.
Unfortunately they didn’t.
Those women were no more likely to avoid diagnosis of cancer, whether endometrial, colorectal, stomach, kidney, bladder, ovarian, lung or breast than those who didn’t take multivitamins. In fact, taking multivitamins did not help prevent heart attacks, strokes, or blood clots or reduce the risk of death from any cause during the study interval.
Studies like this keep piling up but the medicalising of vitamins continues to grow in the retail sector and the imagination of consumers.
Other studies have focused on popular supplements like selenium, beta-carotene and vitamins E, C, D,B6 and B12, probing their cancer-preventing qualities and have come up empty-handed.
Now this is perplexing, given that many other studies have shown that diets high in micronutrient-rich fruit and vegetables do in fact reduce cancer risk.
Dr Newhouser of the Fred Hutchinson study suspects that the absence in multivitamins of other bio-active compounds in foods, like anti-oxidants and a host of phytochemicals are the key to understanding why vitamins alone are of no apparent use in preventing cancer. These compounds help absorb vitamins and activate them in the body. They act synergistically with each other and a range of nutrients in a way far more complex than we are currently able to determine.
I don’t see the problem here.
If studies show vitamins taken on their own are of limited or no use to the body but are biologically active when consumed in the food that contains them, then bon appetit!
It’s actually very liberating to know that nature has us covered, and supplies us with all the nutrients we need in tasty packages. Giving up vitamins and eating more fruit, vegetables, grains, legumes, nuts and seeds will save us some money too. The Nutrition Business Journal estimates that of the $23 billion dollars Americans spend on nutrition supplements, one third of that was on vitamins.
The body needs 13 vitamins and 15 minerals to be healthy and functional and those requirements are easily supplied by filling your plate with fruit, vegetables and grains. It is very rare in prosperous societies to have a case of vitamin deficiency.
Special vitamin requirements, such as folic acid for expectant mothers and the vitamin K given to newborns to prevent bleeding will probably always have a place but the rest of us gain little or no benefit from multivitamins.
Even the elderly and ageing among us.
We have special needs and can be prone to undernutrition but this is more likely to come from declining eating habits. It’s more important for anti-agers to concentrate on healthy whole foods than on perusing vitamin bottles. Getting the appetite and digestion going with regular exercise is important too.
Another study indicates that vitamins may even be harmful to us.
Analysis in 2009 of a previous study looking at the effects of folic acid (Vitamin B9) and aspirin on prostate cancer brought up a disturbing finding. 843 men had taken one mg of folic acid daily - more than twice the amount recommended for men and for women not pregnant or nursing. Not only did the folic acid not reduce risk for prostate cancer, it increased risk by 163%.
Perhaps taking vitamins is not so benign after all. Another study found high dosages of beta-carotene promoted lung cancer in heavy smokers.
Release yourself from the clutches of Vitamania and indulge in nature’s packaging instead.
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Monday, May 4th, 2009
When the Spanish brought the potato from Peru to Europe in 1570 it met with little fanfare. Whoever slipped that lumpy tuber into a pocket of his doublet did not know the value of the New World novelty would be greater than all the silver and gold plundered from the Aztec and Inca empires. It would take two centuries for the “root of the wretched” to overcome the suspicion that surrounded it and take its place as Europe’s premier famine-proofing staple, population booster, and human fuel of the Industrial Revolution.
By contrast, the sweet potato gained instant acceptance and royal patronage. King and Queen Ferdinand and Isabella of Spain welcomed it into their court, Henry VIII gorged on sugary, spicy sweet potato pies, and when Sir John Falstaff in Shakespeare’s “The Merry Wives Of Windsor” anticipates bedding two women at once, implores the sky to rain (sweet) potatoes.
Perhaps it was the sweet potato’s putative aphrodisiac qualities that created this culinary class distinction. It wasn’t until the ordinary potato’s French champion, Antoine Augustine Parmentier, convinced Louis XVI and Marie Antoinnette to wear its distinctive blue flower that it achieved some measure of social respectability.
The sweet potato was from the lush tropics of the Caribbean and Central America, not the arid, windswept Andean altiplano of the ordinary potato. It’s taste suited the palate of Europe’s elite, high on the excitement of new flavours like chocolate, vanilla and sugar; its courts awash with marzipan, jellies and gingerbread.
European taxonomy tainted the potato by its consignment to the diabolic nightshade family. The solanaceae include the tomato, eggplant, capsicum, tobacco, mandrake, henbane and deadly nightshade. While the first four of this group found acceptance, the potato took a long time to throw off its image as, in the words of nineteenth century social theorist John Ruskin, a “scarcely innocent underground stem of a tribe set aside for evil.”
The potato plant was a savage-looking thing. The tuber, of grotesque appearance, had a strangely satanic underground growth habit and reproduced from a piece of itself. Surely the Devil’s magic.
By the time of Catherine the Great’s Russia, European pundits thought the potato corrupted the blood and promoted lust, peasants feared it would spread diseases like scrofula,tuberculosis and leprosy, and upper classes saw it as the food of livestock, the poor, the downtrodden and the lazy. After all, an acre planted with potatoes and manured needed little attention until harvest when it met the protein and energy needs of more than ten people for a year.
The potato is a low-cost, quickly-prepared food, requiring little fuel to convert it to a filling snack that can be eaten in its own packaging. It supplies all nutrients except Vitamins A and D and calcium, easily supplied by milk. One fresh potato contains about 30milligrams of Vitamin C and kept the Irish peasantry scurvy-free. If ever there was a food designed for human consumption it is the humble potato.
Yet, it is under attack again, in the guise of over zealous application of the Glycemic Index.
I dabbled in the GI last post, and follow up on its absurdly contradictory and complex irrelevance here, captured in the prism of its prime enemy, the ordinary potato.
If you’ve followed my articles you’ll see how I emphasize healthy diet as one of the pillars of anti-ageing. Keeping body fat levels to a healthy minimum is also an important strategy as we age, and many of us turn to the latest diet advice to achieve this. It’s my argument that foods have to be seen in a cultural and historical perspective as well. It seems today’s labs-eye view of foods consigns the potato to the dustbin it has taken centuries to crawl out of.
The same potato prejudice that is reflected in perjoratives like “couch potato”, “potato head”, and “sack of potatoes” underpins the GI’s modern appraisal of the spud, and goes further, warning of its disease-causing potential.
Eating lots of bread, rice and potatoes, all “high GI” foods can predispose one to diabetes, obesity and heart disease, according to GI experts.
To recap, the GI, originally intended to research carbohydrate foods for diabetics in 1980, measures the amount a food raises blood glucose over two hours against a standard of 50g of pure glucose or white bread. When glucose enters the blood, insulin follows to put that glucose away in cells for energy use. It’s the argument of the GI diet that too much insulin too soon is a dangerous precusor to disease.
Many studies show that when traditional foods are replaced by high-sugar, refined foods health deteriorates and I have no argument with that. To elevate the potato to the top of the GI hit parade, however is an absurdity that shows the whole approach to be faulty. Potatoes rate at 85, or 105, or 132, or whatever, depending on cooking times, crop variation and individual metabolic variation, while white, refined table sugar is a “moderate” GI food at 58 and presumably more healthy and less disease-preventing than the potato. How can this be true?
Worse still, the sweet potato retains its aristocratic aura and is an acceptably “moderate” G I food. Depending of course on which part of the world your sweet potato is from. GI values vary from 48 (Canada) to 78 (New Zealand).
White potato varieties show a large variation too, but most, like Russet (111) and Pontiac (85) are relegated to the no-no category.
Now this food phobia is just crazy and has to stop. Embrace the potato of all varieties for the low-fat, high-fibre nutritious package it is and always has been. At least for the 7000 years of its cultivation that we know about.
There is no evidence that the potato made anybody sick. Unless they ate green ones. Solanine is the toxic steroidal alkaloid potatoes produce when exposed to sunlight, probably to protect them against predation. It makes potatoes taste bitter, so who would eat them in that state?
The Incas operated a sort of proto-welfare state in which stone storehouses held food reserves for the population in times of famine. They chose to store chuno, or freeze-dried potato, prepared by letting moisture-rich potatoes freeze, then crushing them underfoot. They kept in a sealed room for ten years. Andean peoples were noted for their vigour at high altitudes and were neither fat nor diabetic.
When Arthur Young was sent from England to Ireland for an agricultural survey in 1770 he found the hard-working Irish labourer eating up to five or six kilos of potatoes a day, and little else, apart from some skim milk and perhaps some green vegetable. He found the Irish attractive, energetic and fertile and could not agree with his contemporaries that the potato was “unwholesome food.”
“I will not assert,” he said, “that potatoes are a better food than bread and cheese, but a bellyfull of one was much better than a half a bellyfull of the other.” Not only did he stick up for the potato, he implied that the Irish poor ate better than the English poor did.
My advice is to ignore the scaremongering of the GI and similar diets that warn people off time-proven plant foods forming the basis of a healthy anti-ageing diet.
It’s what goes on those potatoes that really makes the difference.
Avoid drenching potatoes in butter, oil or fat from roasting meat (yes, it tastes good). Eat as many potaoes as you like as long as you prepare them in the following way and make them part of a balanced meal. Their fibre and starch content will make it hard to eat too many.
Greg’s roast potatoes
Wash and chop potatoes (of any variety). Leave skins on for more nutrients and flavour. Spray lightly with olive oil and pop on a sheet of baking paper on a tray in a 200 degree oven for 45 minutes. Add golden, roasted chunks to salads and frittatas.
Greg’s “Smashed” potatoes
Wash and chop potatoes and add to boiling water. Allow two medium potatoes per person. Boil until tender (the skins will start to separate). Drain, add one teaspoon of chopped capers, one tablespoon of olive oil, and one tablespoon of yoghurt per serve. Squeeze over the juice of half a lemon, add a couple of twists of black pepper and “smash” the potatoes with a large spoon as you blend the mixture.
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