Q: I found out I have degeneration in my knee caps. I have full thickness fissures in my left patella. Anything you recommend for pain, inflammation, irritation in joints or regrowing/strengthening bone/cartilage?
A: What a juicy question! I can use it to demonstrate so many points! I know this answer is sort of long and complicated, but I think it will help not just respond to the question in depth, but also give a glimpse behind the curtain of how a holistic practitioner thinks a case through. This is exactly the sort of concern that demonstrates how important it is to take an individualized approach. I view the body as an ecological system. This means there are many access points, many factors to consider.
So, first off, this question was asked in a facebook comment thread. I’d like to start by addressing that. Lots of people will throw out an herb or a quick fix. I understand the impulse, I do. I’m tempted sometimes to do it myself. And every now and then, there’s something that works that way. In general, though, herbalism and holistic health approaches work better when they are given context. “Holistic” means the whole needs to be considered, not just the part. When we practitioners grumble about social media herbalism, it’s not that we are trying to guard and withhold our knowledge, it’s that herbalism really doesn’t work as well that way. It’s like just playing those few peak notes of the guitar solo, out of the context of the song. Those few notes here, the thing that first pops into my mind, is “silica-rich herbs, like gotu kola, horsetail, cucumber and lettuce.” I hope by the end of this post, you’ll see why I didn’t just say that on facebook and move on.
Next point. My herbalism teacher, Michael Moore, taught us to ignore the primary complaint. And that’s exactly what I’m going to do here. It sounds counterintuitive, I know. The metaphor I imagine (back to rock n roll guitar) is someone wanting help with a few notes of a particular song, thinking they just need to play it better. I think of myself as being like the guy at the instrument repair shop. Maybe you need to work on how to play that solo, fine. But is the neck twisted? Do the pickups need to be replaced? How long has it been since you changed the strings? Let’s make sure all the basics are in order before we even think about the music. In this case, I’m ignoring the patella fissure and looking at connective tissue and inflammation first.
Regardless of what the connective tissue problems are, I’m going to start with basic underlying nutrition. You build your connective tissues (mostly collagen) out of protein. So, first question – are you getting enough of all of the amino acids? Do you eat animal protein? If not, do you make sure to combine proteins? I see a lot of claims about how broccoli and seaweed are really high in protein. Sure, but that’s a little like saying you’ve got plenty of paint when you’ve only got red and black. You need all the colors. All the time. And then if you are getting enough of all the essential amino acids, are you digesting them well? It doesn’t matter what goes in your mouth, if the gut is not able to absorb well. So first I’d want to sort all that out.
Digestion, connective tissue repair, inflammation – all these link into nervous system. What are your stress levels like? Do you sleep well, meditate, spend plenty of time in rest-and-digest mode, as opposed to fight-or-flight? Do you watch scary zombie movies late at night? Do you get enough cuddling and time in nature? Do you notice when you feel frazzled and do something about it? Or do you just push through? Do you get enough physical activity? I’d want to look at your lymphatic flow. From a certain angle, that’s the foundation of the whole system.
Once we’d talked about all this, I’d emphasize that of all the various health goals, building stronger connective tissue is probably the one that most requires consistency. I think of it as being like knitting. You can’t just skip a row without destroying the structural integrity of the whole. Do you binge? On sugar, or alcohol, or late nights, or TV shows, or boot camps? Do you deprive yourself with fasting, or cleanses, or diets? If so, then I’d encourage you to develop steadier habits. Provide the fuel, building blocks, waste removal, rest, and stimulation that your tissues need every day, every day, every day.
Here’s how I look at inflammation: it IS the healing process, or at least a part of it. It is cells saying “HELP!” So why are they hurting? What if they are right? What if there is really something wrong? They are like crying babies. Instead of just making them shut up, let’s ask “Are you hungry?” “Is your diaper poopy?” “Do you need a nap?” “Is something poking you?” “Do you need a hug?” When tissues are inflamed, they are trying to DO something. Can that something be helped along to completion? Can this problem be solved? Sometimes it can’t, but it often can. Once again, same stuff as for connective tissue repair, make sure to establish basic health supporting habits to give the opportunity for inflamed areas to heal.
That said, the body can lose its ability to shut off inflammation once it has been triggered, even after the problem has been addressed. It’s easy to become omega-3 fatty acid (ESSENTIAL fatty acid) deficient in modern society if you aren’t paying attention to it. Then you won’t have the building blocks to make your own antiinflammatory hormones. So I’d pay special attention to that when looking at your overall nutrition.
So, you see how different people with this same problem might leave my office with very different to do lists? It’s like a choose-your-own-adventure book. It all depends on where the blocks are in your own personal ecology. I hope this helps you develop a strategy for addressing your problems with your knees by building up an overall foundation of health. It’s a long term approach, but then life is a long term game. And I hope it shows that herbalism isn’t so much about picking the “right” herb as it’s about having an overall plan and using the herbs as needed to implement the plan. Best of luck and please let me know how you do and if you have more questions.