Supporting Bone, Joint and Tendon Health Across the Aging Continuum

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Dr. Martin GallagherBy Martin P. Gallagher, MD, DC

Most patients tend to think that the loss of strength, sub-optimal conditioning and pain are a natural extension of the aging process.  However, most experts would now agree that the complications of aging, such as arthritis, tendonitis, bursitis, back pain and loss of muscle mass, can be minimized with an anti-aging health plan.

So, whether your patients are well conditioned athletes, or “weekend warriors”, attention to the role of conditioning, diet and specific vitamin therapies are essential to maintain healthy aging and avoidance of drugs, surgery and disability.

DIET

The anti-aging plan begins with the “anti-inflammatory diet”. This low carbohydrate diet emphasizes the role of organic fruits, vegetables, nuts, seeds, olive and coconut oil, wild-caught fish and free-range animal proteins. Avoidance of “inflammatory” foods like refined carbohydrates (white flour, sugar, high-fructose corn syrup, soft drinks, processed animal proteins, etc.) is critical for bone, joint, ligament and tendon health.

Most Americans eat the “SAD” diet (standard American diet). This diet is a “pro-inflammatory” diet that is high in refined carbohydrates, unhealthy fats and processed animal protein. The result is chronic pain, obesity and increased susceptibility to joint, tendon, ligament and bone-related disorders. The pro-inflammatory diet also has a negative impact on the gut (our immune systems live here and every neurotransmitter is produced here), leading to intestinal dysbiosis. Gut dysbiosis is now linked to such diverse conditions as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), migraine, arthritis, multiple sclerosis, dementia, cancer and cardiovascular diseases.

Consuming fermented foods (including sauerkraut, kimchi, yogurt, kefir, etc.) and naturally occurring fats (such as wild-caught salmon, cold-water fatty fish, free-range meats, avocados, raw nuts and seeds, olive and coconut oil) are critical for brain function, satiety and weight control. Fermented foods also provide probiotics to the gut, promoting neurotransmitter health and decreased inflammation.

Seventy percent of the brain is made up of fats and replacing this fat daily with anti-inflammatory omega-3 fatty acids (EPA/DHA) decreases brain inflammation that is now linked with migraine, dementia, depression, anxiety and a host of other disorders. Given this, fish should also be in the diet.

Ensuring our patients remain youthful and functional as they age requires that they follow diets similar to what I have listed above. You can also refer your patients to the Mediterranean diet, the Ornish plan and the Paleo diet. Add spices and herbs to your diet. Curry and ginger, for instance, have anti-inflammatory and powerful antioxidant effects.

Screen Shot 2016-03-17 at 11.57.30 AMExercise

As your patients age, exercise plans will need to be adapted according to the fitness capability of each individual. Mobility decreases with age. Ligaments and tendons shorten, and disc and cartilage thickness diminishes with the aging process. The effects of wear-and-tear exercises such as heavy weight training, running and cycling often need to be replaced or augmented by yoga, t’ai chi, swimming, dancing and other exercises that emphasize balance, mobility, flexibility and the delicate interplay of the body, mind and emotions. You can also use “burst” exercises with any of the exercise choices that your patients prefer to maintain cardiovascular fitness and joint health.

We often think of exercise as a purely physical event. Although it is certainly critical to our well-being, incorporating meditation, prayer, breathing exercises and other forms of mindfulness training is of equal importance.

Treatment for both chronic and acute mobility issues

Spinal and extremity chiropractic manipulation, along with medical acupuncture, is an important prescription for your patients suffering from pain, impaired mobility and inflammatory conditions. Both activate the brain to produce endorphins, or anti-inflammatory substances, as well as mechanoreceptors, which increase mobility and decrease pain. Some patients, however, have complicated musculoskeletal conditions (chronic back pain, arthritis, bursitis, partial tears of ligaments, tendons, etc.). These patients usually have weak or loose ligaments, tendons and joints. They are “hypermobile”. Patients in this group, which is more common with trauma and aging, require Regenerative Injection Therapies (prolotherapy, PRP and ozone). Regenerative injection therapy is a non-drug injective therapy that allows the ligaments, tendons, joints and even bone to “re-grow” and repair. 

An anti-inflammatory diet and exercise therapy should be augmented with vitamin therapies that specifically target joint and bone health. Critical to this prescription is vitamin D3 (5,000 IU), vitamin K2 (200 mcg), EPA/DHA (2,000–4,000 mg), chondroitin/glucosamine (1,000 mg), multi-strain probiotics (50 billion CFUs), joint/ligament and tendon formulas (MSM, curcumin, resveratrol, etc.) and a multiple antioxidant daily multivitamin with extra magnesium and vitamin B complex.

In the final analysis, lifestyle modification should not be limited to diet and exercise alone. We need to augment our aging patients with specific types of diet interventions and exercises that are age appropriate and emphasize flexibility and strength. Additionally, we should prescribe specific vitamin therapies, meditation and appropriate rest. Noninvasive therapies should be encouraged, including, but not limited to, chiropractic treatment, acupuncture, massage and prolotherapies.

Martin Gallagher, M.D., D.C., M.S., ABIOM is triple-licensed as a board certified family physician and integrative medicine practitioner, physician acupuncturist and doctor of chiropractic. He is the director of Integrative Medicine at Medical Wellness Associates, a multi-disciplinary medical center outside Pittsburgh, PA. Dr. Gallagher is an associate professor at West Virginia University’s Department of Family Medicine, a medical advisor to Douglas Laboratories and the author of several books, including Dr. Gallagher’s Guide to 21st Century Medicine.