This month, we are investigating Iliotibial Band Syndrome or more commonly know IT Band Syndrome or ITB Syndrome.

How do you know if you have IT Band Syndrome?

Those with ITB syndrome typically experience pain on the outside of the knee, increased pain with repetitive knee motions, increased pain with walking or running uphill, walking stairs or increased pain at the hip on the outer thigh.

What causes IT Band Syndrome?

The iliotibial band (IT Band or ITB) is an extension of the band (a long tendon) that extends down from a hip muscle called the tensor fascia lata (TFL). Starting at the hip, extending along the side of the thigh and attaching just below the front side of the knee, the ITB has a big impact on both joints.

Those with a lack of flexibility of the TFL/ ITB muscle, bowlegged or people with foot problems may be predisposed to chronic ITB syndrome.

What causes lack of flexibility in the ITB?

There is not a one size fits all answer to this question.  The most common reason for tightness in the ITB is compensation for weak Glute muscles, particularly a muscle called the Gluteus Medius (Glute Med).  The Glute Med can become inactive or weak for a number of reasons; two of the most common are restriction in the hip joint and ankle problems (sprains and weak arches).

When the Glute Med stops firing properly, the TFL will work overtime to pick up the slack and essentially doing a job that is wasn’t designed to do. As with any overused muscle (or person), it becomes irritated. The irritation from repetitive knee flexion and extension causes inflammation and stiffness to occur especially in activities such as running and biking.

How do we treat ITB Syndrome?

Our first job is to get you out of pain and once we accomplished that we need to correct the patterns that brought this problem about.  There are a number of therapies that we utilize to relieve tension in the ITB.  See the following videos for explanations of these therapies.

This video demonstrates using the Fuzion tool on the ITB/TFL

In this video we look at multiple uses of the foam roller including the stretching of the ITB.

This video shows a wall stretch for the TFL/ITB

Our next step is to correct the patterns and muscle imbalances.  There are a number of compensatory patterns that can lead to ITB Syndrome, but we will cover the treatment of the most common which is Glute Med insufficiency.  Glute Med insufficiency will lead to instability in the hips which can be seen below in this video.

When we see hip instability like we do in this video we know that we have Gluteus Medius insufficiency which we can remedy a number of ways.  Our two favorite exercises for this muscle are called “clamshells” and “speed skaters.”   You can see examples of these exercises below.

Because the tight tendon rubs against the thigh bone and pulls tight on the knee, inflammation of this area will lead to pain, which also needs to be addressed.  To reduce the inflammation, it is important to fill your diet with foods that have anti-inflammatory agents.  Here is a recipe that includes a number of anti-inflammatory herbs and spices: Yellow Thai Curry.

This month’s newsletter, we focused on iliotibial band syndrome (ITB Syndrome), and seeing that it causes such inflammation, I wanted to think of a recipe that would include the most anti-inflammatory spices in it. Twelve spices with very high anti-inflammatory properties are: ginger, turmeric, black pepper, cinnamon, rosemary, basil, cardamom, chives, cilantro, cloves, garlic, and parsley. Mmm! I just love flavor! So it works out well for me to eat these foods… I hope you do too! The first type of meal that came to my mind that includes a number of these spices was… curry.

The word curry means ‘sauce’ and has immense popularity in Thai, Indian, and Japanese cuisine. This blend of spices varies depending on the cook and can be individualized to your own taste. If you are not so sure about trying curry, rest assured, I used to be as well until a few years ago. I was on a trip in New Zealand, and a friend from India convinced me to try Indian curry… it was love at first bite! I have now tried other types of curries, really enjoy them, and even try to make it. I have found that I particularly enjoy most Thai curries as they typically have a hint of sweet and spicy. This yellow curry recipe is a classic Thai dish that can easily be adapted to the flavor profile you prefer and the veggies you have on hand. My recipe includes chicken, but it can very easily be made vegetarian, or vegan. Remember to let veggies be the main show (as this is where most of the nutrition you need is) and the meat be a side. Let me know what you think!

Ingredients:

• 1 stalk fresh lemongrass
• 4 cloves garlic
• 1 thumb-size piece of ginger, minced
• 1 small onion
• ½ – 1 tsp. dried crushed chili, depending on heat desired
• ¾ tsp. turmeric
• 1 tsp ground coriander
• 1 tsp ground cumin
• ¼ tsp cinnamon
• 1/3 tsp white pepper
• 2 Tbsp soy sauce or Bragg liquid aminos
• 1 Tbsp lime juice
• 2 Tbsp brown sugar
• 1 can coconut milk
• 1 cup chicken or vegetable stock
• 3 chicken breasts, cut in roughly 1 inch cubes
• 2-3 potatoes (can mix sweet and white potatoes), cut in roughly 1 inch cubes
• 1 can chickpeas, drained and rinsed
• ½ – 1 can diced tomato, depending on preferred taste
• handful fresh Thai basil

Preparation:

1. Preheat oven to 375 degrees.
2. Peel off and discard the outer woody layers of the lemongrass and place cut the stalk about 5 inches from the bottom. Place that in a blender or food processor (the greener top of the stalk is too tough to eat but can be used in potpourri or tea). To the lemongrass, add garlic, ginger, onion, chili, turmeric, coriander, cumin, cinnamon, white pepper, soy sauce, lime juice, brown sugar, and coconut milk. Blend until a fragrant, even sauce is made.
3. Pour sauce to a 9×13 casserole dish. Add the chicken stock and stir to combine. Mix in chicken, potatoes, and chickpeas. Cover and bake for 45 minutes. Remove from oven and add tomatoes, then cover and return to oven for 15-20 more minutes.
4. Remove from oven and check the chicken. If the meat is tender and juices run clear, the dish is cooked. If not, stir and return to oven for another 10 minutes.
5. Top with a handful of lightly-chopped Thai basil, serve with rice, and enjoy…mmmm!

View more videos at: http://nbcnewyork.com.

Flu influenza spreads around the world in seasonal epidemics which slows down our busy lives and results in 250,000 and 500,000 deaths every year! Typically occurring between October–March (for our area), the flu outbreak typically coincides with flu vaccinations being pushed at us from all angles. I’ve always been a bit skeptical about getting the flu vaccination and have often gotten sick from the shot. After doing a bit of research, a key vitamin (one of our favorite here at Compass) has proven to be more effective than the flu shot.

Flu shots were originally recommended only for the elderly and youngest children, but each year, the recommended age range grows. Though those groups are at more risk, the flu shot shouldn’t be the only strategy recommended against the flu. In fact, there is a lack of evidence for it being beneficial, receiving the vaccination poses great risk to the consumer, and you might not even be protected from the correct strain of flu! Because there are so many strains of the virus, officials must select the 3 strains they think are most likely to circulate. The vaccines are then grown in fertilized chicken eggs for up to eight months. Formaldehyde (a known cancer-causing agent) is used to inactivate the virus. Aluminum (a neurotoxin that may play a role in Alzheimer’s disease) is added to promote an antibody response. Other additives in the flu vaccine include Triton X-100 (a detergent), Polysorbate 80, carbolic acid, ethylene glycol (antifreeze), gelatin, and various antibiotics that some are allergic to! I was stunned when I saw this list of chemicals!

In an article titled Avoid Flu Shots, Take Vitamin D, by Dr. Donald Miller, he states that there is some evidence that flu shots have caused Alzheimer’s and the mercury levels in the vaccination has also been implicated as a cause of Autism. In addition, he states that “Three serious, acknowledged adverse reactions to the flu vaccine are joint inflammation and arthritis, anaphylactic shock (and other life-threatening allergic reactions), and Guillain-Barré syndrome.” Guillian- Barré syndrome is a paralytic autoimmune disease. It is rare that something as severe as these reactions would happen to you, but I would rather risk getting the flu or using something else much more trustworthy than risking Alzheimer’s, arthritis, paralysis, or other reactions!

So what is a recommended, healthy, and safe alternative to the flu shot? Vitamin D. As the sun shines down on you, UVB rays interact with the skin, and particles of a cholesterol derivative open to form vitamin D! Amazing, isn’t it?! Vitamin D regulates many processes in your body, acts as an antiviral, makes natural antibiotics, and keeps inflammation down. In twenty minutes of sun exposure for a fair skinned person (more for those with darker skin), 20,000 IU of vitamin D are produced at which the body stops synthesizing it for the day.

Depending on what you read, daily vitamin dosage recommendations can range from under 1,000 IU to over 20,000 IU.  Personally I feel that 5,000 units per day is sufficient unless you’re fighting off an infection in which case I recommend 15,000-20,000 IU.  There have been no cases of Vitamin D toxicity in the literature and Vitamin D can be found in prescription form with up to 50,000 IU.

In the winter months sun can be hard to come by especially when you’re covered head to toe.  If you are unable to get in the sun each day, look to supplements or foods rich in vitamin D, including wild Alaskan salmon and mackerel.  For a list of foods high is Vitamin D click here.

Here is Katie’s 100 pushup video that she took on Christmas day in Florida. She started with 10 pushups and ended up with, well you’ll have to watch the video.

Cubital tunnel syndrome (CTS) is the second most common nerve entrapment that happens in the arm, with carpal tunnel syndrome being the most common.  It is commonly known as cell phone elbow because it effects people who spend a lot of time with their elbow flexed.  This is the position that you would hold your cell phone.

CTS is caused by pressure to the ulnar nerve that happens at the cubital tunnel which you can see here to the left.   The Ulnar nerve runs down the middle of your arm from your neck all the way to your fingers.

Symptoms:

The most common symptoms include pain and numbness over the pinky finger and the inside of the ring finger.  Often people will wake up with this sensation because their sleeping with their elbow in a flexed position (bringing your first up to your shoulder).

Treatment:

A thorough diagnostic work up is necessary to determine if the cause of the symptoms is cubital tunnel syndrome (CTS) or possibly a condition that mimics CTS.  If it is determined that CTS is the diagnosis the treatment options vary from conservative to invasive.  The first step is to limit or eliminate the behavior that is perpetuating the problem.  Most often this is a repetitive movement that involves flexion of the elbow.

There are conservative therapies for CTS that don’t require injections or surgery.  A recent study in the Journal of Manipulative and Physiological Therapies showed that patient with mild to moderate symptoms favored well from CTS.

If you are looking to relieve sinus pressure, nasal symptoms, or allergies, irrigating your nasal passage via a neti pot might be a good option. This salt water flushing loosens and thins mucus, making it easier to expel which can reduce and eliminate the root issue of recurrent sinus issues. Antihistamines, antibiotics or even surgical interventions resolve the symptoms but may fail to stop the cycle at the cause. As the mucus releases, cilia in the nasal passage are able to function more efficiently to rid excess mucus toward the throat or the nose to be expelled. Note, though, that it is crucial that you only use sterile water!

Because the solution flushes the nasal cavity, if contaminated water is used, it obviously poses great threat to your sinuses and potentially to your brain!  Because tap water can be home to any number of contaminants, it is extremely important to use only sterile, distilled or boiled water (that is cooled after) for nasal irrigation. In two reported cases, a contaminating amoeba, named Naegleria fowleri, enters the nasal sinus then traveled to the brain where it causes primary amebic meningoencephalitis (PAM), which destroys brain tissue. In both of these cases, it resulted in death.

Although this fatal ameba is rare, it is important to use save practices when using a nasal irrigation. When choosing water to irrigate with, be sure to use distilled, sterilized, adequately filtered or previously boiled water. You can perform this nasal irrigation up to four times a day until your symptoms improve. Generally, if you follow the instructions carefully and continue the routine until all your symptoms resolve, it is a very effective, and safe, technique.

This is a wonderful TED video put on by an MD who was diagnosed with Multiple Sclerosis that left her in a wheel chair.  Through making some minor changes in her life she was able to start walking and even ridding her bike again. She has a powerful message about the health of world.

We have come to the end of the year ready to celebrate and relax with loved ones. In the midst of the hustle and bustle that comes with the season, striving for the Paula Dean’s Christmas dinner, the Pottery Barn home, and Martha Stewart’s gifts puts a great deal of (unnecessary) pressure on us. It is quite easy to lose our sense of self, time, and money, and therefore I’d love to share a few ways to keep balanced (and sane) during the holiday season.

Instead of trying to create elaborate meals on your own while everyone else is cozy by the fire, have guests pitch in a dish of their favorite holiday side that can be easily warmed up. It could be an added bonus to have each person bring copies of their recipe to share.  This cuts down on your time in the kitchen as everyone can share their favorite holiday dish along with nostalgic memories they have associated with it.

Have children in the family that have a ton of things given by extended family? Take a family outing to see the lights in a festive neighborhood, a trip to the zoo, or the children’s museum as their holiday gift.  It will be something they remember long after the games and toys have lost their luster and it can be nice to experience the holidays from a child’s point of view.

Not sure what to give the person that has everything?  Coupons for an outing or donating to their favorite cause in their honor goes a long way.  Or simply writing a heartfelt letter letting them know how much they mean to you can really mean the world to them.

Enjoy exercise as a family!  Build a snowfort (if we get any snow this winter) and make snow angels or the funniest snowman!  Playing outside can help burn off the extra calories we consume during the holidays and just participating in a group activity can lift any spirit.  Also now is a great time to take advantage of later store and mall hours for quick power walking and getting last minute supplies.

Last of all: choose to be joyful! There is a difference between happiness and joy; while happiness comes and goes typically according to circumstances, you can choose to experience joy in any circumstances as you take your focus off of the now and look at how it fits into the big picture. When the ham is overcooked or the shopping lines are long… choose to be joyful! Exercising the facial muscles by smiling triggers ‘feel good’ chemicals in our bodies which in turn actually gives us more to smile about!

As always, let us know if you find other ways to balance your wheel and have a wonderful Holiday!!