Bye-bye, Food Pyramid

In a long overdue move, the United States Department of Agriculture (USDA) has gotten rid of the famous Food Pyramid that for close to two decades was supposed to tell you how to eat. The new symbol is a plate-and-cup that will hopefully be easier to understand.

Michelle Obama, Agriculture Secretary Tom Vilsack and Surgeon General Regina Benjamin got together to announce the new paradigm, but the message seemed to be a little contradictory. According to Ms. Obama, parents “don’t have time” to measure out portions of food…yet, according to Dr. Robert Post, Deputy Director of the USDA Center for Nutrition Policy, “We know that with proper planning, you can get enough protein” from a vegan diet.

Hmmm. I can tell you from personal experience that, once you have the scale, it takes about ten seconds to measure out a portion of anything. On the other hand, I know very few vegans who actually (a) combine plant proteins properly on a regular basis and (b) get enough overall protein into their bodies (which is probably why so many of them start looking gaunt and eventually go back to eating animal sources). I have nothing against any particular diet plan, so long as it’s healthy, but let’s be clear about the realities of eating. Weighing food takes almost no time at all, and there is no better way of coming to grips with the reality of what you’re putting into your mouth–it’s just that it’s a bit of a hassle.

Anyway, time will tell if this new plate-and-cup idea takes hold. Meanwhile, if you have long-term tendon problems, here are some food-based issues to consider:

If you are overweight, the first thing to look at is losing the excess poundage.
If you are underweight, are you getting enough good fats in your diet?
For any American male, do you eat a preponderance of red meat versus fish and nuts?

Any or all of these can be (and probably are) contributing factors to your tendon pain. Fixing them is one step toward having healthy tendons and preventing recurrences of tendonitis/tendonosis. For more information about nutrition and supplementation as they relate to having healthy tendons, check out my book Target Tendonitis.

Sign Language Tendonitis

Tendon problems aren’t just for athletes and computer programmers. It can strike people who you would never think would get it. One such group is sign language interpreters.

Just like anyone else who performs excessive repetitive motions, sign language specialists can develop tendon issues. Common problem areas are the thumb, wrists (similar to carpal tunnel syndrome), as you might expect, but also in the elbow flexors. Although it might be thought of as a sort of niche condition, the remedy is the same as for any other situation: icing, rest and NSAIDs for the short-term inflammation, and in more advanced cases a structured set of exercises performed in a particular manner to help reverse any actual tendon damage. (In this case you will actually have tendonosis, although most medical professionals don’t bother to make the distinction.)

If you work with sign language regularly, it would pay to treat your hands and forearms in much the same way an athlete does. Be sure to stretch your fingers, hands and forearms after long signing sessions. Pay attention to your nutrition, especially aspects that help prevent inflammation and support tendon regeneration. And try if at all possible to take regular breaks during work. Five to ten minutes every hour is a good rule of, er, thumb.

How to tell the difference between Arthritis and Tendonitis

The initial symptoms of arthritis and tendonitis can feel very similar, so here’s an easy home-diagnosis way to tell the difference: try taking glucosamine for two weeks. If it helps, you likely have osteoarthritis. If not, it’s more likely a tendon problem.

What’s the reasoning here? Glucosamine (often packaged with MSM and/or chondroitin) has been shown in quite a few scientific studies to help with cartilage formation. Cartilage is what your joints are made of, and what arthritis attacks, so upping the rate of production in turn helps your joints. End result: you feel better…if you have arthritis.

On the other hand, glucosamine will not help with collagen formation, and tendons are made of collagen. So it stands to reason that if you feel like you have “joint pain”, take glucosamine, and don’t experience any relief, one very likely culprit could be your tendons. (Tendon insertion points are often very close to joints and it can be difficult to tell exactly where the pain is coming from.)

Taking NSAIDs, using ice and so on can provide temporary relief for either condition, but since both arthritis and tendonitis are both the result of inflammation, using these treatments won’t help you distinguish between the two. And knowing which one you have is of course very important if you intend to treat the condition yourself.

If you do decide that you have a tendon problem, however, and you’ve had your pain for more than a couple of weeks, I caution you against assuming that the issue is tendonitis. More likely it’s tendonosis, which is an actual degeneration of the tendon. (This is especially true if you take NSAIDs and they don’t help.) If you think that this might be your problem, have a look at my tendon test. It’ll only take a minute, is completely free, will tell you whether you have tendonitis or tendonosis, and give you some options about what to do about it.

Nutrition for Tendon Pain

I recently received a question from someone who purchased Target Tendonitis. He asked about the advisability of fasting if you have tendonosis.

Although fasting can have some beneficial effects, I do not advise anyone who is suffering from tendon or fascia problems to do it. The reason is simple: your body needs nutrients to heal itself, and if you’re fasting you’re not providing it with the basic “stuff” that’s necessary to do the job. I recommend some nutritional supplements in the book, but these recommendations are based on the assumption that your basic nutritional needs are already being met. If they aren’t, the supplements aren’t going to do you much good by themselves. A diet that is lacking in vitamins, minerals or protein (to say nothing of all three at once!) is going to pose serious, serious problems when it comes to healing your tendons.

Assuming that your basic diet is okay, one thing you can do to help heal yourself if you have tendonosis or fasciosis is get a good kelp supplement and take it regularly. Kelp contains iodine, which is helpful for the formation of collagen, the basic building block of tendons and fasciae. My favorite out of the products listed on Amazon is Icelandic kelp, which is harvested during the cold months and washed in high-mineral fresh water, which adds further minerals to the already good mix that kelp naturally contains.

Note, however, that just taking a supplement isn’t going to be enough to cure yourself if you have long-term tendon pain. Anything over about two weeks is most likely going to be tendonosis, not tendonitis (I know, I know, but believe me, your doctor is wrong. Do the research yourself and see.), and in that case the collagen fibers in your tendon have become either bunched or damaged to the point that they are going to require actual realignment in order to work properly. This is what the exercises in Target Tendonitis provide (along with a lot more detail about the nutritional side of things), and why it has such a high success rate for people who haven’t seen much effect from nutritional therapies alone. A combined, holistic approach works much more quickly than any single measure.

Capsaicin for Tendonitis

I’ve been seeing a lot of talk around the internet lately about using capsaicin to relieve or cure tendon pain. The idea is that, applied topically, capsaicin will activate the pain nerves, but then make them less sensitive (through an overload effect), so as to reduce the overall amount of pain.

For example, this site says :

Capsaicin “numbs” the sensation of pain in joints affected by tendonitis. This effect occurs from capsaicin blocking the production of a neuropeptide named substance P, which is responsible for the sensation of pain.

and then lists this study as their reference: Deal, C. L. The use of topical capsaicin in managing arthritis pain: A clinician’s perspective. Seminars in Arthritis and Rheumatism. 23(6):1994;48-52, 1994. I won’t comment on the blockage of substance P, but I will say that this site doesn’t know what it’s talking about when it comes to tendons. First, tendons aren’t joints; the structures are completely different (collagen vs. cartilage). So the fact that something that works in a joint has absolutely no bearing on tendons, and talking about “joints affected by tendonitis” is simply wrong. Second, the study is about arthritis pain, not tendon pain. Sorry, but those are different, too.

So, one argument down. Another is that applying heat to a painful area can produce relief. There may be some merit to this idea. After all, people use hot-packs all the time. But the problem (as I mentioned in my post about menthol and tendon pain) is that capsaicin doesn’t produce any real heat. Sure, you’ll feel like something’s on fire, but no actual increase in temperature occurs. The capsaicin just causes your body’s heat sensors to react as though there was real heat.

To put it bluntly, using capsaicin for tendon pain is a bad idea. Icing a tendon can be a good modality for tendon pain that’s not too severe and hasn’t been around for long, but even that won’t be effective for persistent tendon pain. Heat…well, heat just isn’t on the scientifically-verified menu — not even real heat. Finally, there is absolutely no research showing that topical capsaicin creams and so on are effective, and anecdotal reports of trying to rub chili powder and so on directly onto the skin usually end badly.

If you have persistent, long-term tendon pain, it’s a good bet that you don’t have tendonitis, but tendonosis (take my free, one-minute test to find out which you have), and neither heating nor cooling is going to help much. Long-term pain usually means tendon degeneration, and for that you’re going to need some targeted exercises and a good nutritional strategy to rebuild the affected area. Target Tendonitis provides both, and comes with a 60-day money-back guarantee.

Menthol and Tendon Pain

Let’s talk about menthol.

Menthol is a naturally occurring compound that comes from mint plants. It produces a cooling effect by stimulating the cold receptors that people have on their skin, sort of a mirror image of how capsaicin stimulates the heat receptors. Capsaicin doesn’t actually raise the temperature of anything, but if you have a mouthful of hot peppers it sure can feel like it. In the same way, menthol doesn’t actually lower the temperature, it just makes your skin feel like it’s gotten cold.

What does this have to do with tendon pain? Well, there are a lot of tendonitis “treatment” products out there, generally sprays or creams, that contain menthol. These products often claim to provide “instant relief” from tendon pain with just a quick application of the product, and usually have lots of great testimonials from people who say that it’s the best thing since sliced bread. Admittedly, it does feel a little like putting ice on your problem area. There is a cooling sensation, which is pleasant, and after a while the area will become somewhat numb. So you feel better – at least for a while. (The critical difference here is that ice, by actually producing a lower temperature, has a beneficial effect on inflammation, whereas menthol has no such effect.)

But these sprays and creams can actually do more harm than good. For one thing, menthol has never been shown to have any real effect on the structure of tendons themselves. In other words, there is no healing action. None. If you get “relief” from the pain but still have the underlying problem, it becomes that much easier to ignore your body’s warning signs (which is what pain really is) and do something that’s really going to injure you. If that happens, you can easily go from having a painful – but healable – tendon to a ruptured tendon. And if that happens the only option is surgery.

Also, since you’re not actually treating the condition, you have to keep buying the spray or cream in order to continue to experience relief. I don’t know about you, but I much prefer to actually fix the problem so I don’t become a financial slave to some company that’s putting out a “feel good” spray.

Menthol can be great for providing temporary relief for temporary conditions like sunburn, and of course it makes chewing gum, toothpaste and so on taste better. But if you’re looking for tendon pain therapy, any product that has menthol in it should be avoided. Every one that I’ve seen so far has been a scam.