I don't like to run...

...but I sure love how I feel after a productive run, and I really like being able to fit into my clothes...

About 6 months back I started having an uncomfortable feeling in my knee.  I blew it off for a while, but it just wouldn't go away.  I made an appointment with my doctor just to be sure I hadn't really damaged anything.  She said it wasn't a meniscus tear and I had most like sprained my ACL (anterior cruciate ligament).  She sent me home with stretches and strengthening exercises, which I naturally didn't want to do, but occasionally did anyway.  But it wouldn't go away.  This thing was annoying beyond belief.  It didn't just bug me when I was running or walking, it was all day everyday, sitting, standing still, and then some in my sleep too.  Not that I wanted to overrule my doctor, but it just seemed like the pain was coming in a weird spot for it to be my ACL.  It was on the inside of my knee, but about 1-2 inches below the level of my knee cap.  And no matter what I did, or didn't do, it wouldn't go away.

I investigated further and finally came across information on "pes anserine bursitis".  They described the location where three ligaments converge and attach to your shin, on the inside just below the knee cap.  The ligaments are protected from rubbing on the bone with the aid of a sweet bursa (fluid filled sac) that lies between them and the bone.  Buy bad shoes, over-train, accidentally twist your leg while your foot remains planted, sport some tight hamstrings etc., and you can overstretch those ligaments and irritate the bursa.

Wait?  What?  Back that up?  Buy bad shoes???  AHHHHH!  Yup, 7-8 months prior I bought the worst pair of Adidas of my life and now I was suffering for it.  I love Adidas, they have never done me wrong, so when I saw a pair on sale I thought nothing of it, didn't even try them on.  I certainly wasn't over-training... I mean I'm no marathon runner and if my body can't handle 3-6 miles at a time without throwing in the towel, then I'm going to scream!

I read more on this pes anserine bursitis.  You have to rest the leg, stretch the hamstrings well, reduce inflammation... hmmm, rest the leg.  Rest is not something I relish in.  I'll sleep when I'm dead.  How was I going to keep myself on "the bench" for even a day after this thing felt better?  Our disgusting dog helped with that.  A while back (I'd say about 2 years now), I relayed a story of stress incontinence (http://www.mygradeabologna.blogspot.com/search/label/pee) for which I sought help and was granted the most miraculous "anti-pee-your-pants" device without surgery - and this thing changed my whole after mommyhood world.  It normally was stored in the safest of places  ;)  but on this particular day it was readily available in the shower and our adolescent dog was all over it.  Needless to say, after being able to run for the past 2 years without having to worry about wet pants, now I was back in that position again.  Anywhoo, certainly made it easier to rest my knee while I waited for an appointment to get a replacement device.

So I rested up, my knee felt 100% better, I bought new shoes, I got my new vagina accessory... and it was time again to go for a run.  Or maybe not.  I've been for 3 runs now, and the dull pain is starting to come back.  My knee doesn't feel swollen like it had before (though it was never really puffy, just didn't feel as bony as it normally does), but I know it's only a matter of time if I keep using it.  I'm frustrated.  I don't have time for this.  So I discussed it with a good friend who had knee trouble 100-times worse than mine.  She gave me some of the best suggestions, and the next time I see her she doesn't even know the sweet SWEET lovin' she's got in store.

She first suggested using Turmeric (which contains the active component Curcumin).  Now this I'm familiar with, because I'd been recommending it to a few people at the nursing home, and I had written up on it's uses as an anti-inflammatory spice, but I guess I was correlating it more to chronic systemic inflammation, not necessarily inflammation that occurs with exercise or arthritis - but she was so right to clear my head on that one - because Curcumin doesn't care what kind of inflammation it is, it helps with it all!  So I have some ordered and on it's way - and am so excited to test it out - though I will say I'm not looking forward to possibly orange-colored poop which can happen with so much Turmeric going through you.

hmmm, Curcumin BP?  Blood Pressure?  No that doesn't make sense.  Ah, BP stands for Black Pepper, they use that to enhance the absorption of it.

Then she suggested talking to a Physical Therapist about kinesio tape.  Years back when I played Rugby (and I mean forever ago in college) I used to get taped up a bit to support my dumb achilles tendons which had a tendency to strain.  I kind of thought it would be the same sort of situation, until I looked up a youtube video to see what she was talking about.  Found this one produced by KT tape, which is some awesome kinesio tape!

KT Tape Application for Pes Anserine Bursitis

Went to Walmart last night to see what was available.  They have tons, but I think next time I'll just order it off Amazon as the prices were pretty much the same and Amazon had a better selection.  There are 2 different types of kinesio tape, Cotton and Synthetic.  I would guess the kind used in the video was the synthetic.  I grabbed the cotton as it was cheaper and I just wanted to see if I could replicate the video, but next time I'm definitely going for the synthetic.  It stays on longer and provides more support.

 They have a variety of colors available.  I highly recommend going for a color as far away from your skin color as possible - because if you're trying to make it look less obvious, you're going to fail.  A flesh-toned tape is going to look like you had some sort of massive skin graft as opposed to looking like you applied the tape, on purpose, for an injury.  Just my opinion, but I'm usually right...  ;)

So I applied the tape, I think I did a pretty good job of mimicking the video.  And I can say that I instantly felt better.  It seems weird that tape could do that, no matter how fancy or flexible it is, but it really did.  It felt as though instead of those ligaments pulling at that sore spot by my knee, their pull was relocated further up my thigh which felt way better.  You don't take it off for a few days, which is fine with me.  It stayed on perfectly all night and I even slept better - maybe with 50% of the pain I was used to at night.  I'm in love.  If you have some other sort of injury, like a muscle or ligament strain, I highly recommend trying this stuff out.  KT Tape has tons of youtube videos to show you how to tape just about anything, or you could ask your favorite physical therapist to show you how.

The Dirty Dietitian

Where oh where has my motivation gone?  I find myself wrapping up my fall semester of classes and have pretty much lost all my momentum.  I'm still loving that I'm getting this degree and the material is certainly still very interesting.  I think I'm just ready to be done with these classes so I can move on to the next ones.  Big projects are coming due and a final exam next week will wrap things up.  I am amazed to find that I still have more space left in my brain for new information.  And I'm loving sharing everything I learn, though I have to remember that most people don't want to know all raw information I've put together. 

I decided, after my rant on shake diets, that rather than continue to be frustrated with the poor diet choices that others make I would instead start a little help page on Facebook.  I can post little tips each day and answer questions that people may have.  This way I can pass the information I gather along to those who want to know more about healthier eating/lifestyle.  There are a lot of people out there who want to make the best choices, but are not unhealthy enough to warrant an insurance-covered visit to a dietitian.  I've named my page "The Dirty Dietitian".  I wasn't feeling particularly clever, and figured this sort of summed up my take on nutrition education - delivery raw, crude, or "dirty" details.  Though as I think more about it now, it sort of sounds like some guy's fantasy.  Like after the Naughty Librarian would be the Dirty Dietitian?  Ah, whatever.  If I can manage to help even one person, then I'm content.

I Prefer to Chew My Food

Today's blog is a bitter rant.  And it's directed at a particular weight loss shake, who shall remain nameless.  It's not their fault that so many people are drawn to their claims of rapid, long-lasting results.  It's ours for being so quick to believe them.  I loathe these products.  They foolishly spit on my profession as if our recommendations for moderation are unnecessary and unsubstantiated.  They make you believe that consuming real food is passe, and the new era of slim bodies start with a blender and a few carefully chosen chemicals.

Each shake provides 90 calories.  If you mix it with skim milk that brings you up to 170.  So lets pretend that you only drank two shakes per day and then had an average dinner of 600 calories.  That's not even 1000 calories for the day!!  There's no miracle potion in the shake mix, it's just simple math.  If you are consuming less than you are expending in energy, then you will lose weight.  Now I will say that if someone handed me a meal to eat for breakfast and lunch and then told me I was on my own for dinner, I imagine having the plan and those particular guidelines would help me to stick to it.  But where does personal responsibility enter the equation?  They aren't teaching you how to eat healthy.  They aren't even teaching you to eat!  They encourage liquid meals!!  Don't we have teeth for a reason?  Are you aware that part of how our brain senses satiety is by how much it smells and chews a food?  So with this in mind, is that shake appeasing the brain when you don't chew the shake nor does the coldness of the shake encourage a lot of aroma?  Not so much.  What about nutrients?  The shake is sweetened with sucralose (Splenda) and has a few select vitamins, minerals and antioxidants.  So if we drink the shake and it contains beta-carotene, then it's the same as eating a carrot (or other Vitamin A rich vegetable) right?  Well what about the other 500+ carotenoids that the carrot contains?  Aren't these important too?  Can't get that in the shake. 

Hmmmm, "great tasting variety for just $2 a meal".  Well I'm pretty sure that doesn't include all the items you might want to add to your shake.  If you plan on concocting one of the recipes, it's going to run you more than $2 and it's also going to raise that calorie level.  I do like how the youtube video for this product runs through a dozen or so different foods, claiming you would have to eat a 3-15 of each of these to get the same nutritional value of a shake.  Last time I checked a lot of foods have a large variety of important nutrients, not just one as this video would have you believe.  For example cheese is not just a good source of Zinc, but it also has calcium so why are they suggesting that you also need to eat frozen yogurt to cover the calcium?  They showed bran cereal and bread for different nutrients, then later indicate all the prunes you need for fiber - but show no indication that you got fiber from the cereal and the 15 slices of bread.  How are people supposed to learn to eat a healthy variety when they are purposefully misinforming consumers so they can sell their product?  It actually made me think of an old Saturday Night Live commercial from back in the Phil Hartman era, for "Colon Blow" and "Super Colon Blow" where they were showing the number of bowls of fiber cereal you would have to eat to get the fiber benefit of theirs.  If a product was truly impressive, then it wouldn't need to over-sell itself like this.

What are you going to do when you stop?  Are you going to drink these shakes indefinitely?  Now, yes, I have not signed up so I cannot see behind the curtain to see what fabulous exercise and diet tips they are providing.  I just cannot stand to see so many people getting caught up in this sort of multi-level-marketing product.  I mean honestly, if they really just wanted to help people with weight loss and healthy changes, they wouldn't be encouraging rapid weight loss like this with the added appeal that you can get your program for free if you sign up your friends.

Leptin, the little brother of Ghrelin

Okay, so yesterday I ranted about ghrelin and importance of enough sleep to make sure you ghrelin stays manageable.  Ghrelin is what lets you know that you are hungry.  Leptin is opposing force of ghrelin.  Sort of like a little brother, it is always in competition with ghrelin.  But leptin does oh so much more.  Years back I recall a study being done with mice that showed those mice who didn't produce enough leptin were obese, and almost overnight people were trying to figure out how to gives themselves some more to help with weight loss.  Here's what we are learning about leptin.  Leptin is a hormone produced in our fat cells (adipose) that signals the brain that we are satisfied.  Leptin tries to help us maintain a leaner figure.  So, the more fat cells we have, theoretically the more leptin we are producing and thus the more satisfied we should feel.  Leptin also sends out a signal when we are eating.  So ghrelin tells us we are hungry, we eat something, and leptin tells us we are satisfied.  Seems simple enough.  The problem comes when we eat too frequently and/or we have too much fat tissue.  It seems that putting out large amounts of leptin would help us to lose weight because we would constantly be telling that part of the brain that we are satified - this is why everyone was so excited when the research first came out with those obese mice.  The problem is that the satiety center of the brain gets tired of listening to leptin yelling at it, and it starts to desensitize.  I liken this to when my boys are screaming/whining about pretty much anything and I start to tune them out.  This doesn't stop the boys from doing it, and it doesn't stop leptin from doing it either but it does make it harder to sense that we are satisfied.  So you would think we could just overcome this by continuing to send the brain more signals.  But our body is a wonderfully, mysterious thing.  While leptin is screaming at our brain, it's also working to tell our pancreas that we don't need quite so much insulin.  After all, we need insulin to process any carbohydrate we just ate, and if we're telling the brain that we are satified, then theoretically there won't be more carbs coming in and thus there won't be a need for more insulin.  You would think this is harmless, however constantly telling our pancreas that we don't need more insulin just keeps it alert.  It would be like putting a pot on the stove instead of keeping it in the cupboard - it's ready to be used even though you haven't called upon it to heat something yet.  So when food does enter our system and needs insulin to allow for utilization of all that nice energy, our pancreas has been sitting there, chomping at the bit - ready for action!  At a moments notice, it overwhelms the system with a push of insulin in an attempt to drive that nice sugar (glucose from carbohydrate) into our cells.  Too bad all that fatty tissue around our bellies makes it harder for insulin to get the job done.  Ah well, we'll just produce some more insulin (hyperinsulinemia) to bring down our blood sugar (hyperglycemia) all the while telling leptin to respond more because we are really satisfied but having trouble sensing it.

Phew, I'm out of breath just thinking about it.  Our body really is miraculous in the ways it tries to keep us on track.  Too bad we are so pig-headed that we constantly feel the need to work against it.  So what does all this mumbo jumbo above mean?  In order for us to improve the sensitivity of our brain, we are going to have to cut down on some of that fatty tissue we carry around, and stop constantly encouraging our pancreas to pump out more insulin... in other words, how about a little exercise and maybe no snacking between meals??  Seriously, everytime you put food in your system you are activating this pathway - don't you think it could use a little down-time between meals?  And... stop looking for that quick fix.  I mean really, if you're looking for a quick way to satisfy that part of the brain that leptin works with, I've heard a little crack/cocaine will do the trick too (note, I do not advise use of crack/cocaine for dieting purposes, just maybe for a hard day at work - hahahaha, okay not for that either).

A little heavy reading (pun intended)

So I'm reading pages and pages of research articles that have been done in the realm of sleep, sleep deprivation, and ghrelin.  Ghrelin is a hormone secreted by your stomach that lets your body know that it needs to eat something.  Ghrelin is complimented by Leptin which tells your body you are satisfied.  Okay, so what have I found so far.  Well, we need approximately 7 hours of sleep each night.  No kidding, right?  Getting more sleep than that and you are at risk for being overweight/obese.  Getting less than that... same problem.  But it's not just a matter of crawling into bed 7 hours before you need to wake up in the morning.  You also need to be getting quality sleep.  Quality sleep means you drift frequently from the lighter stages of sleep (stage 1 and 2) to the deepest stage of sleep (REM - rapid eye movement).  How can you tell if you're doing this?  Well, I found an application for my smart phone that senses it if you really want to test yourself.  Or if you share your bed with a very light sleeper you could ask them if you toss and turn a lot.  Movement during sleep (unless you have a sleep disorder) indicates you are in the upper levels of sleep, whereas sleep paralysis happens in REM sleep (thus you move about as much as a big rock).  Okay, so if you are getting 7 hours of quality sleep, with nice sleep waves, then you are setting yourself up for a good day with normal levels of ghrelin.  What happens if you aren't getting a good night's sleep?  Well, first thing in the morning your ghrelin levels will be depressed.  So the lower the ghrelin levels are, the less internal encouragement you have to eat.  Which sounds great... however, mid-afternoon into the early evening these ghrelin levels will spike up.  A low ghrelin in the morning lends itself to a high level at the time of day when we have the hardest time denying our cravings. 

Oh, but it gets better.  Okay, so let's say you are doing a great job getting plenty of rest at night.  This generally means that you would be on track for a great day with ghrelin showing up at meal times letting you know you're hungry but not encouraging you to overdo it.  For this next scenario, we are going to assume that you have started a diet and exercise program so you can shed a few extra pounds.  You've lost a little and are feeling good.  Now Mr. Homeostasis seems to want to add in his opinion.  Homeostatis is the body's natural way of trying to "maintain".  It doesn't like change and it wants things to stay just as they are.  In order for this guy to maintain your weight, he kicks in ghrelin as a last ditch effort to make you put that weight back on.  Ghrelin tells you that you are ravenously hungry and need to eat eat eat!!!  Everytime I think about this, all I can say is "where the heck was homestasis when I was putting the weight on????" and why didn't he want me to stay lean?  No use thinking about it now.  Just need to remember this information when you are starting to lose some weight and want your efforts to continue.  I think if you're anticipating that little push of hunger (from ghrelin) then you can be better prepared to handle it, instead of throwing in the towel and hitting up that bag of Halloween candy.

Coming soon, I will fill you in on the dirty little secret of gender differences in weight gain in regards to ghrelin.  Dumb female body!!!  For now, just "digest" the sleep and ghrelin tid bit.  It's exhausting to think about it.  Almost makes me want to take a nap (but don't since it doesn't count towards your 7 hours at night).