Helios Natural Healthcare

Overuse injuries occur when connective tissues, such as muscles, tendons and ligaments, are damaged as a result of repetitive motion over the course of time. These injuries occur in occupational, recreational, and ordinary daily activities. With normal use, tissues adapt to the stresses placed on them, and are able to return to their normal form when given time to rest and repair. When increased demand is placed upon them, however, and/or sufficient rest is not allowed, these tissues begin to fatigue. For these cases in which injury results, the rate of tissue damage simply exceeds the rate of adaptation and healing.

Overuse injuries have traditionally been treated as inflammatory conditions, even though they rarely show the signs generally present with inflammation, including swelling, heat, and redness of the surrounding tissues. Rather, the prevailing symptoms are pain, painful weakness, and decreased range of motion. One study that looked at surgeries for tendon pain found little evidence of inflammation, but obvious signs of frank tissue damage, including thin, frayed, and fragile tendon fibrils that were separated from one another. Current therapies for overuse syndromes recognize that these conditions have a non-inflammatory basis, and, for this reason, concentrate on supporting repair and overall physical condition of these tissues.

Focused nutritional support has been shown to hasten the tissue repair process, expedite healing time, and prevent further injury. The following are recommendations for addressing connective tissue overuse injury.

Dietary

• Ensure adequate hydration: Dehydration places additional stress on tissues, especially the collagen containing connective tissues, which are comprised of 60 to 80% water. Tension that is provided by water pressure in these structures enables them to be strong, somewhat flexible, and to function at full capacity. As a rule of thumb, the number of ounces of water taken in per day should be equal to 1/2 of your body weight. For example, a 120 pound person should drink about 60 ounces of water per day. Clear juices, teas and other beverages count towards this volume, as long as they are free of caffeine and alcohol.

• Fish: 2-4 servings per week. Fish is an excellent source of omega-3 fatty acids, which help to boost the immune system, increase pain tolerance, and prevent overproduction of inflammatory chemicals. Avoid completely, or limit to one 8 oz. serving per month, large fish that tend to live longer and are known to contain high levels of mercury. These include canned white tuna, swordfish, shark, bass and brown trout. Fish with the highest concentrations of omega-3’s are salmon, mackerel, and anchovy. Remove the skin, and bake or broil the fish for best health benefit.

• Flax seeds: 5-7 servings per week. A vegetarian source of omega-3 fatty acids, flax seeds can be found in a variety of breads, cereals, crackers and other grain products.

Supplementation

• Daily Multivitamin that contains 100% RDA of most ingredients, particularly the antioxidants (A, C, E, and Selenium), those that support overall bone and muscle health (calcium, magnesium, and vitamin D), and vitamin B6 for promotion of collagen repair. Make sure to choose a natural vitamin with high bioavailability of the nutrients, such as those available at Whole Foods Market or Pharmaca Integrative Pharmacy.

• Fish or Flax Oil. Dose: 1 gel capsule or 1 tsp of oil, 2-3 times per day, as an alternative to adding these as foods to your diet. Both are available as straight oil that can be taken by the teaspoon, or in a gel capsule form. Cod liver oil is another good source of omega-3’s and is available in several flavors for increased palatability. Flax oil is available for use in salad dressings or as a dip for bread, but is not suitable for cooking. Be aware that most healthy fats, such as those present in fish and flax oil, turn rancid quickly, within about 6 weeks of pressing. To prevent spoilage, purchase only refrigerated flax oil stored in black containers, keep your flax oil in the refrigerator with the lid on tight, and minimize exposure to heat, light, and air. Allergic reactions to flaxseed have occasionally been reported, but are considered very uncommon. At the time of writing, there were no well-known drug interactions with flaxseed oil.

References
1. Oregon Department of Human Services. Expectant Mother’s Guide to Eating Fish in Oregon. 2006.
2. Khan, K., et al., Time to abandon the “tendinitis” myth. BMJ, 2002. 324(7338): p. 626-627.
3. Laker, S. and W. Sullivan, Overuse Injury. eMedicine, WebMD, 2006.
4. Mindell, E. and V. Hopkins, Prescription Alternatives. Second ed. 1999, Los Angeles: Keats Publishing.
5. Oregon DHS Environmental Toxicology Program, Fish Advisories: Consumption Guidelines. 2006.
6. Souza, T., Differential Diagnosis and Management for the Chiropractor. Third ed. 2005, Boston: Jones and Bartlett Publishers.