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How Food Helps You Heal: Prospective From a Physical Therapist

Here is what happens when a new patient comes to MTI Physical Therapy. Most of the time, the primary reason a patient comes to see us is that they are experiencing pain. The physical therapist will examine the patient’s body and learn about the patient’s medical history to find the source and the contributing factors for the pain. The goal of the evaluation is to identify one or more “tissues” that have been injured. Common issues that lead to a patient coming to PT are bone, cartilage, ligament, tendon, bursa, muscle, nerve, etc. Tissue can be injured acutely, such as with an ankle sprain, or over a long period of time, such as neck pain from working at a computer eight hours a day from your couch.

No matter the cause, the injured area triggers mechanical and chemical reactions to initiate protection and healing of the area as well as signals to the brain which is interpreted as pain. The first few days of tissue healing is inflammation. This is a normal process of the immune system bringing in the resources the area needs to generate new tissue and repair the site of injury. For those of you who appreciate biology, this includes cells that destroy bacteria (neutrophils), clear up debris (macrophages) and produce new tissue (myofibroblasts). Physical therapists assist the body in this healing process through improving joint mobility, nerve communication, and coordination of the large and small muscle groups. Through hands-on techniques and exercise protocols, we can create an optimal environment for healing depends on the specific tissue(s) that are injured.

But what happens when you have had the same pain for a long time? Sometimes the body gets used to certain patterns of movement that it has adapted in order to protect itself from pain, which doesn’t allow normal movement to return which is necessary for full healing. Take an ankle sprain for example you limp initially to reduce the pain, which is a signal that there is too much load through the injured ligament. If you never return to walking normally though, that ligament will not receive normal tension that assists in healing and the rest of the foot can get stiff because the joint cartilage and capsules are not getting the motion and nutrients they need either. This can create a state of local, chronic inflammation that limits the healing process. As mentioned above, the goal of normal inflammation is to bring the working cells of the immune system to the afflicted area to promote healing. However, movement is a necessary factor in healing because it moves fluid and white blood cells in and out of the area to continue strengthening the new tissue. Without movement, byproducts of this healing response are not able to leave the area, which creates a different form of trauma to local tissue. This is the negative effect of inflammation that is so often discussed by medical providers, fitness gurus, and the focus of companies marketing their “anti-inflammatory” products and programs.

Now that we understand more about the role of inflammation in the body’s immune response and how it contributes to tissue break down when inflammation exists longer than the immune response calls for, let’s discuss why anti-inflammatory diets are the latest buzz words for managing pain and how they can help with injury recovery. There is a lot of information around food, diet, and nutrition and often it becomes misleading, contrary, and sensationalized. Common terms that come up often in “diet” marketing are anti-oxidant and free radicals which relate to this kind of inflammation. Let’s dive a little deeper into this topic, but first, let’s define a few terms before we move on.

Diet: “The kinds of food that a person, animal, or community habitually eats.” (“Diet | Definition of Diet by Lexico” n.d.) It is often used in the context of “fad diets” and has a connotation of a short-term change that you make. Yet your diet is simply what you regularly eat. For many, starting a new “diet” is daunting because we believe it needs to be a massive change of the routine. However, most people can see significant improvement with small changes. For example, some of those changes may include decreasing soda consumption, changing snacks from chips to vegetables or nuts, or simply increasing water intake. On the other hand, there are some specific medical conditions that require more significant and strict changes to a person’s diet which is beyond the context here.

Free Radicals: Free Radicals are products of normal metabolic processes and can be increased with environmental factors such as exposure to ozone, cigarette smoke, air pollutants, and industrial chemicals. They are molecules that have an unpaired electron which makes the structure unstable and able to damage all kinds of cells and foundational molecules necessary for normal body function.

Antioxidants: Antioxidants are molecules that are stable enough to donate an electron to the unstable free radical and reduce its ability to damage tissue. There is a balance in the body between free radicals and antioxidants.

Oxidative stress: Oxidative stress is when there are more free radicals than antioxidants, so they are not able to provide enough neutralizing effects.  Research now shows that oxidative stress plays a major role in many inflammatory diseases such as arthritis, diabetes, respiratory diseases, heart disease, stroke, gastric ulcers, hypertension, and neurological disorders including Alzheimer’s, Parkinson’s, and muscular dystrophy. (Lobo et al. 2010) There is a battle going on in each of us. Over time, the air we breathe and processed foods we eat to produce more free radicals that can march through the body and wreak havoc. But we can call in the antioxidant reinforcements by eating colorful, fresh foods to protect our brain, joints, and organs.

Without this explanation, antioxidants simply become another generic buzzword that we know is “good,” but do not understand why it is good for us. Antioxidants are the way the body fights against what we see as aging!

Here is a list of generally pro-inflammatory or anti-inflammatory foods — you can use this list to start the thought process for small changes you can make.

 

 

Over the last hundred years, our diet in America has changed drastically to more fast and processed foods. At the same time, science has been able to expand our understanding of what food is made of and how our body uses it.  Macronutrients (carbohydrates, fats, and proteins) are the foundations of food that we need in large amounts.

  • Carbohydrates are the primary resource for energy that can either be used immediately or stored.
  • Proteins help us to build new muscle, heal wounds and injuries, produce hormones to regulate sleep and mood, and regulate blood sugar and insulin.
  • Fat is a secondary energy source that also lubricates skin and membranes, supports immune function and transports vitamins.

Micronutrients are the compounds in food that we need in smaller quantities but are vital for daily life. Micronutrients are classified into two categories: vitamins and minerals. The list of vitamins and minerals is long but here are a few examples and what they do for us.

  • Vitamin A supports our vision, skin, hair, and bone health.
  • Vitamin B has many compounds but generally assists in metabolism and produces neurotransmitters for brain function.
  • Potassium is a mineral that assists in fluid dynamics, muscle contractions, and the beating of our hearts.
  • Iron is a mineral that transports oxygen throughout the body and builds compounds such as amino acids, hormones, and collagen.

Nutrient-dense foods where we can find these amazing micronutrients include colorful produce, spinach, broccoli, whole grains such as brown rice, oatmeal, and eggs.

The latest recommendation from Harvard’s School of Public Health offers specific guidelines for finding a balanced diet based on the best evidence for using food as fuel. These guidelines are called the Healthy Eating Plate; a diagram can be found below and more information can be found on Harvard’s website (“Healthy Eating Plate” 2012.)  The Healthy Eating Plate varies from the USDA’s MyPlate. MyPlate does not offer as many specifics regarding what foods are best to fill each quadrant with. As the saying goes, “not all calories are created equally.” We can eat food that gives us satisfactory energy, yet lacks the nutrients obtained from vitamins and minerals, which makes our body work best. The Healthy Eating Plate specifically outlines the best options to promote health through nutrient-dense foods. To see these differences clearly, Harvard provides a comparison between the Healthy Eating Plate and the USDA’s MyPlate (“Healthy Eating Plate vs. USDA’s MyPlate | The Nutrition Source | Harvard T.H. Chan School of Public Health” n.d.) The Healthy Eating Plate provides a great resource to start identifying those small changes to your diet that can have a big effect on your health, healing, and energy level.

Figure 1:Copyright © 2011, Harvard University. For more information about The Healthy Eating Plate, please see The Nutrition Source, Department of Nutrition, Harvard T.H. Chan School of Public Health, www.thenutritionsource.org, and Harvard Health Publications,

For most people, focusing on these guidelines will provide significant benefits, particularly in helping the healing process. Others may have food sensitivities, dietary restrictions, a complex medical history, or a long medication list, and will likely require a more specific plan that is available through a registered dietitian. Registered dietitians are certified healthcare specialists who are equipped to evaluate your current health, diet, and goals to develop a specifically prescribed plan to improve your health through your diet and eating habits. Whether your goals are to reduce the general body aches you feel on a daily basis, increase your energy level or maintain a healthy weight, there are changes you can make to your diet that are small yet mighty.

As physical therapists, we work closely with your other healthcare providers, including registered dietitians, to help you heal so that you can return to the activities you love. If you are experiencing pain, contact your local MTI Physical Therapy clinic today to schedule an assessment by a licensed physical therapist.

References:

  • “Diet | Definition of Diet by Lexico.” n.d. Lexico Dictionaries | English. Accessed May 12, 2020.
    https://www.lexico.com/en/definition/diet.
  • “Healthy Eating Plate.” 2012. The Nutrition Source. September 18, 2012.
    https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/.
  • “Healthy Eating Plate vs. USDA’s MyPlate | The Nutrition Source | Harvard T.H. Chan School of Public Health.” n.d. Accessed May 13, 2020.
    https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate-vs-usda-myplate/.
  • Lobo, V., A. Patil, A. Phatak, and N. Chandra. 2010. “Free Radicals, Antioxidants and Functional Foods: Impact on Human Health.” Pharmacognosy Reviews 4 (8): 118–26.
    https://doi.org/10.4103/0973-7847.70902.

Christy Houk, PT, DPT, OMT, is a Doctor of Physical Therapy who practices at MTI Physical Therapy’s Kirkland clinic. She became a physical therapist because she believes that the body has an amazing capacity to heal. Christy views her role with her patients as a chance to help their bodies heal in the way they were designed to. She finds that magic happens in the kitchen, on the stage, and in the mountains. When she’s not treating patients, you can find her trying new restaurants, listening to live music, at acting performances and hiking/camping/paddle boarding. If you have questions, you can reach her at christyhouk@mtipt.com.

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