This I presented at Bikram Yoga in Jan 2011

1. Injury Inflammation and food in the yoga praCTITIONER

2. Common injuries Patellofemoral syndrome (kneecap pain) Cervicalgia (neck pain flare up) Lumbago (low back pain flare up) Shoulder bursitis (rotator cuff impingement)

3. Shoulder R Party Pooper

4. The bursa -a sack of lubrication That’s old news!

5. Overinflated sack You change the mechanics if its over inflated!

6. Interpretation: Pain Stretch receptors turn on pain receptors

7. How can this happen Preexisting injury flared up in class Tight shoulders to start with, poor warm up Tadasana Bakasana

8. (not my top 10) Cervicalgia Disc “disease” Muscle spasm Trigger point! Topic: trigger points….. Discuss!

9. Trigger points = Janet Travell Neck pain Shoulder pain Arm pain Headache

10. Lumbago = Back pain Essentially same as cervicalgia Disc disease very real in the low back* *but the treatment is the same! Shhh ** aka pinched nerve, sciatica, bulging disc, slipped disc impingement

11. A surgical problem (but you wouldn’t be walking)

12. PFS (Patellofemoral Syndrome) Typically just as tracking issue The cap acts as a pulley The pulley has low friction surfaces If alignment and “chores” are kept, good for 80 years Warning Warning-push the alignment, the chores, the duty and “failure is eminent”

13. Rubbing leads to friction

14. Friction leads to damage (inflammation)

15. The Injury Px: It hurts when I do this…… Doc: So don’t do this……. -Henny Youngman

16. Electron microscope OF A TEAR

17. Soft tissue (ligament, tendon and muscle) gets over stretched and torn off its connecting points to bone. The tissue reacts by sending more blood to the area and heat/redness prevail Compensating areas start to fail when they can’t do the work of the originally injured part A twist, roll, bend or fall occurs with immediate pain 0 Stiffness and spasm set in by 1day Other areas start to spasm in 1week

18. When tissue is torn/stretched: Inflammatory phase starts day 0-5 Bleeding PMN’s Macrophages and platelets stimulates GF Proliferative phase from day 5-21 GF stimulates endothelial cells, fibroblasts and myofibroblasts Macrophages continue Maturation phase from day 21-whenever Fibroblasts Increased collagen and tensil strength The Problem

19. Inflammation When tissue damage occurs, the “cascade” starts Normal tissues *stomach *kidneys *platlets *endothelium Inflammatory sites *macrophages *synoviocytes *fibroblasts

20. The same process happens in heart disease!

21. Regular nsaids block here: Nonselective cox2 Normal tissues *stomach *kidneys *platlets *endothelium Inflammatory sites *macrophages *synoviocytes *fibroblasts

22. Steroids block here: corticosteroids Normal tissues *stomach *kidneys *platlets *endothelium Inflammatory sites *macrophages *synoviocytes *fibroblasts

23. Cox 2 blocks here: WITHDRAWN By FDA!!! Cox-2 Normal tissues *stomach *kidneys *platlets *endothelium Inflammatory sites *macrophages *synoviocytes *fibroblasts

24. Generic and Trade Names Diclofenac potassium fast release Diclofenac sodium delayed Etodolac Indomethacin Ketorolac Sulindac Tolmetin Mefenamic acid Fenoprofen Flurbiprofen Ketoprofen Oxaprozin Nabumetone Diflunisal Celecoxib Valdecoxib Meloxicam Piroxicam Cataflam Voltaren Lodine Indocin Toradol Clinoril Tolactin Ponstel Nalfon Ansaid Orudis Daypro Relafen Dolobid Celebrex Bextra Mobic Feldene

25. ROID’S Not anabolic’s Prednisone Medrol dose pack Kenalog Celestone

26. “Food as Medicine”hippocrates

27. The antiinflammatory diet andrewweil, MD Low glycemic index foods Oily fish at least 2x week 40 gm fiber daily Phytonutrients Limit red meat Limit processed food Push fluid (non caffeine non alcohol) -Nutritionist Andrea Klouda (630) 855-7907

28. Glycemic Index (just know the concept!)

29. For more info: American Diabetes Association 2006 Johanna Burani, MS, RD,CDE http://www.glycemicindex.com/

30. macronutrients Proteins 80-120gm daily Fats 67gm daily Carbs 160-200gm daily Fiber 40 gm daily ….minor details….

31. Micronutrients(daily) Vit C 200mg Vit E 400IU Selenium 200mcg Mixed carotenoids 10000-15000IU Vit D 2000IU ….minor details….

32. Phytonutrients Veggies from all parts of the color spectrum Organic when possible ($) www.ewg.com clean 15/dirty dozen Cruciferous regularly (cabbage family) Tea instead of coffee Red wine as the alcohol of choice if you use Plain dark chocolate

33. Environmental Working Group Non profit Provides resources for consumers Pushes national policy They even have a tuna calculator!

34. EWG’s dirty dozen Celery Peaches Strawberries Apples Blueberries (Domestic) Nectarines Sweet Bell Peppers Spinach Collard Greens/Kale Cherries Potatoes Grapes (Imported) http://www.ewg.org

35. EWG’s clean 15 Onions Avocados Sweet Corn Pineapples Mangoes Sweet Peas Asparagus Kiwi Cabbage Eggplant Cantaloupe (Domestic) Watermelon Grapefruit Sweet Potatoes Honeydew Melon

36. Dr Weil

37. vs USDA

38. Buyer beware!! Buyer beware!!

39. If all diet attempts fail –add Supplements Tumeric Vitamin D3 Omega 3 fish oil White willow bark, shark cartilage, oregano, ginger, holy basil Helicrysium, tea tree, traumeel, frankinsence. menthol, marjoram

40. Ayurvedic Medicine The antiinflammatory diet for the long run Specific supplements for the short run Topical oils Homeopathy Energy healing Massage (thai, deep tissue, hot stone, lymphatic) Dosha specific diet balance

41. Biological energies that govern function Vata-Space and Air Pitta-Fire and Water Kapha-Water and Earth Physical and Psychological Characteristics Comm0n Disorders of Imbalance Common Ways to Regain Balance The Doshas of ayurveda

42. Vata Physical Thin and bony Light Dry and rough skin Dry and brittle hair Hands dry Small dull dark Thin dark red lips Tongue dry pale grey coating Variable appetite Poor digestion, weak fire Prone to constipation Irregular mensecrampy Vigorous exercise Insomnia Pulse slithers Fast speech Variable sex appetite

43. Stong communicator Artistic Adaptable Emotionally sensitive Spiritually inclined Sensitive to subtle energies Charismatic Alert Vata Psychological

44. Arthritis Muscle stiffness Headaches Constipation Chronic fatigue Dry scaly skin Dizzy, ringing ears Intolerance to cold Food allergies (wheat dairy) Vata Disorders/Imbalance

45. Gentle exercise Meditation daily Specific diet Time in nature Eat in peace Bright warming colors (orange and green) Massage daily (warm oil sesame) Lavendar cinnamon oils for aromatherapy Spend time with grounding pitta and kaphas Vata Balance

46. Vata pacification Favor warm oily heavy Dairy Avocado, banana, cherries, mango Asapragus, beets, carrots Mung, dahl, tofu Rice and wheat Cardamon, curmin, ginger, cinnamon, salt, nutmeg chopra center

47. Pitta Physical Medium build developed Medium height Hair fine light Oily skin, acne Hands hot and sweaty Eyes medium penetrating bright Teeth yellow and prone to decay Tongue moist pink yellow coat Strong appetite Strong digestion gerd Soft loose regular Regular mense longer Vigorous exercise Sexual arousal Light sleep not disturbed Sweat easily Pulse strong stable

48. Intelligent penetrating ideas Courageous High acheiver Articulate Organized planners Able to focus on single objective at hand joyful Pitta Psychological

49. Overly intense Manipulative Stubborn/arrogant Jealous/materialistic Loud aggressive Controlling of others Egotistical critical judgemental Suppressive of emotion Demeaning Pitta Disorder/Imbalance

50. Avoid stimulants Eat in peace Meditate time in nature Calming exercises Cooling colors blue green white Rest Learn to appreciate kapha and vata types Cool showers and oils like sandalwood Massage oils like coconut Journal to get in touch with emotions Pitta Balancing

51. Pitta pacification Cool foods and liquids Milk, butter, ghee Grapes, melons, cherries, apples, ripe oranges Asparagus, cucumbers, potatoes, broccoli, green beans All beans except lentils Rice, wheat, barley, oats Coriander, cumin, fennel, sugar chopra center

52. Kapha Physical Heavy bones broad frame Heavy often obese Shorter or taller than average Oily smooth skin Thick oily hair curly Hands cool clammy Eyes large and calming Tongue pink white coating Mod appetite Slow metabolism Well formed stool Mensereg mod cramp Slow graceful mvmt Steady desire for sex Deep sleep Pulse smooth swanlike

53. Patient sweet forgiving Emotionally stable loving Desire to help Calm loyal Accepting of others Stamina Homebodies romantic sensual Long term memory good listener Satisfied with life Kapha Psychological

54. Greedy hoarding Unable to say no Easily attached to people and things Overly passive, fearful of letting go Unable to express thoughts or emotion Introverted depressed Complacent slow to understand Kapha Disorder/Imbalance

55. Avoid luxurious lifestyle Focus on nonattachment in daily life Time for introspective activity writing meditation Stimulating activities (vigorous yoga) Bright colors red orange purple gold Enlivening music Observe seasons and adjust diet and life accordingly Flower essense myrrh eucalyptus cedar aroma Vary daily routine Kapha Balancing

56. Kapha pacification Light dry warm foods Low or non-fat milk Apples, pears All vegetables except tomatoe, cucumbers, sweet potatoes All beans except tofu and soybean Barley, corn, millet, buckwheat, rye and oats All spices chopra center

57. Sweet Sour Salty Bitter Pungent Astringent Food tastes in Ayurveda

58. DrSaguil favorites Traumeel by Heel (homeopathic cream) PanAway by Young Living (essen oil) Turmeric FSE by New Mark (cap) Vitamin D3 by NaturesSunshine (tab) Super Omega 3 EPA by NS (cap) *many companies are great! *many more are not so great!

59. Q & A Xiexie!! Merci!! Salamat!! Cheers!! Kwakwha!! Gracias!! Arigato!! Mahalo!! Danke!! Anugurihiitosumi!!

61. Enrique (Ric) Saguil, MD First Health Associates 2010 Arlington Heights Road Arlington Heights, IL 60005 (847) 593-3330 heal@herbal411.com