Tendinitis: The mouth connexion

2014-04-19 07.25.12

I had a severe flare up of quadriceps tendinitis while in Kirkwall, Orkney Islands

For about seven or eight years, I’ve suffered from recurring tendinitis in multiple locations: both achilles heals, rotator cuff, neck, both quadriceps, and extensor (big toe). I’ve only received treatment from chiropractor who applied electric acupuncture to the affected site. Inflammation has been a symptom of my tendinopathy–that’s how I know it is not tendinosis (on the difference, see: Tendinopathy: Why the Difference Between Tendinitis and Tendinosis Matters). Last Fall, I had my worst bout of tendinitis while visiting the Orkney Islands. On the top floor of the Orkney Museum, I took a little rest on a couch. When I stood up, I felt a shooting pain in my knee, which I later determined was quadriceps tendinitis.

Because it is almost invariably a condition that manifests itself upon the occasion of using a tendon’s services, conventional wisdom treats tendinitis as a sports or repetitive use injury. At blame are overuse, lack of stretching, bad posture, or bad form.  Aging also gets blamed (see Chronic Tendonitis Causes and Treatment), so it becomes part of the popular and circular understanding that if you have tendon problems it is a sign that you are getting old. This is a kind of bigotry of low expectations. When it comes to treatment, doctors prescribe rest, icing, non-steroidal anti-infammatory medications (NSAID), and steroids–and possibly surgery. Prevention focuses on good posture, stretching, and prevention of overuse.

It really makes one feel very old not being able to walk up and down stairs, get into the shower, or sleep normally. In my late 40s I reminded myself of my diabetic grandmother who went up and own stairs slowly and carefully. But Grandma Ruth was in her 70s. What was my problem? In 2011, I remember not being able to sleep because I couldn’t turn my head. I could barely bend my neck down to get in a car nor turn my head to look out back–not without pain.

Last Fall, my Orkney Island quadriceps injury worsened to the point that even a slight bending of my left knee was extremely painful, and so I went to see my chiropractor. He required that I get an ultra sound, and for that I had to see my doctor who offered me a powerful NSAID, but I was happy with the over-the-counter Ibuprofen that I was taking. She said to take it round the clock. The ultrasound showed nothing conclusive, but by that time my knee was improving a little and my chiropractor decided he could treat it with electric acupuncture, which led to a recovery until I tried to use the tendon again, and the pain and inflammation revived. I had at that point been on a low carbohydrate high fat diet for ten months, to the great improvement of my health. And so I decided that if I had been able to improve my health so much, then perhaps I could find a dietary solution to my tendinitis. So I began to search the internet for a solution, and I learned, not surprisingly, that a primary cause of tendinitis is the mouth.

More specifically, I learned that it is what we put in our mouth, the food we eat or fail to eat, or indeed toxins we consume, that have a profound influence on the health of tendons. The most helpful website was that of the Tendonitis Expert, Joshua Tucker, who provides a specific list of dietary supplements to heal tendons. It was Tucker from whom I first learned of a condition called “Leviquin Tendinitis” One of the mechanisms is that Cipro depletes the body of magnesium which is necessary for mitochondrial health and when mitochondria become unhealthy, connective tissues become weak and are susceptible to damage. I’d likely taken Cipro at least six times over the last decade coinciding with my devastating bouts of tendinitis.

A few weeks earlier I had seen the amazing video by Dr. Terry Wahls, Minding your Mitochondria:

So I began to eat organ meats and take the supplements that Tucker recommended: vitamins A, C, D, E. I also took CoQ10 (Ubiquinol) and R-Lipoic Acid (R-LA), for my mitochondria, and several fish oil capsules every day. I also began to skip breakfast, having only a high fat coffee in the mornings (called “intermittent fasting”).

My bouts of tendinitis started to be further apart and less severe. Then in May, after Dr. Wahls book, The Wahls Protocol came out, because I still had recurring tendinitis (now with my right quadriceps), I decided to embrace her strictest regimen (Wahls Protocol Paleo Plus) to heal, if possible, the damage that Cipro had done. On her way to recovery from multiple sclerosis, Dr. Wahls became a specialist in functional medicine, which looks upon chronic disease as a single disease with multiple expressions, such as diabetes, cancer, and auto-immune diseases. She writes, most poignantly:

When chronic disease is the result of a deficiency, drugs aren’t going to solve the problem. As I’m sure you realize, multiple sclerosis is not a deficiency of the latest multiple-sclerosis-disease-modifying drug like Copaxone, just as fatigue is not a deficiency of wakefulness-promoting drugs like Provigil or even caffeine, and depression is not a deficiency of antidepressants like Prozac. No, these problems are not deficiencies of drugs, but they are triggered by deficiencies in your cells that lead to broken biochemistry and impaired signaling between your cells. When you look at chronic disease in this way, it’s obvious that you should treat the cellular deficiencies that cause diseases to develop in the first place instead of just treating the symptoms, which is what most conventional pharmaceutical treatments do.

In this way of thinking, tendinitis is not due to lack of NSAIDs, surgery or steroid treatment: it is instead a result of toxins and nutritional deficiencies. Conventional therapy and electric acupuncture may aid in the relieving of pain or the localized healing of specific injury, but it is not able to prevent later injuries because it doesn’t deal with the ultimate nutritional causes.

In my view, here are the causes of my tendinitis:

  1. Cipro treatments and fluoridated water were toxic to the mitochondrial health of my tendons.
  2. High blood sugars resulted in glycative (sugar) damage of capillaries so that my body was unable to nourish tendons properly.
  3. Stress to the tendons revealed weak tendons and brought out the tendinitis and inflammation. Stress could be brought on by walking, cycling, basketball, weight training or other activity.

Since adopting the Wahls Protocol, I eat organ meats regularly, especially pork heart and grass-fed beef liver and heart. I include bone broth. Eliminated are potential anti-nutrients, especially sugar and gluten, but also dairy, eggs and peanuts. I also consume Dr. Wahls’ recommended leafy greens, sulfur vegetables, and coloured berries and vegetables. I take regular seaweed and wild fish. For the last two months I’ve been taking only purified water. The Wahls Protocol Paleo Plus is a very high fat, extremely low carbohydrate diet. Mitochondria experience great oxidative damage due to glucose metabolism and they thrive particularly on a high fat, ketogenic diet.

In conclusion, I am seeing a great improvement of my tendons. I even played basketball four out of the last five days and I can still walk. The measures I’m taking to improve the nutrition to my tendons seem to be really helping, and I will plan a canoe trip next summer in Algonquin Park–the first one in over a decade. I hope my tendon testimony will encourage others who suffer from tendon problems to consider a good nutrition protocol, like the Wahls Protocol, the most important step in healing. At very least, one should be wary of Cipro, and diabetics need to get their blood sugars under control through a low carbohydrate high fat regimen.