Rotator Cuff Surgery Recovery Timeline

What’s the timeline for rotator cuff surgery recovery? Find out what causes rotator cuff tears, what nonsurgical options you may have, and how long it takes to rehab after an arthroscopic repair procedure.

What does shoulder surgery for a torn rotator cuff tendon entail, and how much time does it take to make a full recovery? We have the details of what happens during a rotator cuff injury, the symptoms you need to identify as quickly as possible, plus what you can expect from the rotator cuff surgery recovery timeline.

The Shoulder Joint and the Rotator Cuff: An Anatomy Overview

Rotator cuff tears are rather common, sometimes seen in sports medicine due to injury (tennis, anyone?), and sometimes the result of the natural wear and tear of aging or repeated use. Problems arise when the front of the scapula rubs against or cuts into the tendon, causing inflammation and partial or complete rotator cuff tears.

The rotator cuff stabilizes the shoulder joint, allowing for shoulder movement and granting the arm enough strength and power to pitch a ball, swing a sledgehammer, or playfully toss a child over your head.

There are four muscles and their respective tendons (which connect muscle to bone, whereas ligaments connect bone to bone) associated with the rotator cuff, all responsible for the lifting and rotating motion of your arm. Here are those muscles.

  • Subscapularis: The muscle that helps rotate the arm inwards and is located at the front of the shoulder.
  • Supraspinatus: A small shoulder muscle of the upper back that helps to lift or elevate the arm.
  • Infraspinatus: A thick triangular muscle that hovers wing-like over each shoulder blade and externally rotates the arm and stabilizes the shoulder joint.
  • Teres minor: This muscle is located at the back of your shoulders and enables the arm to rotate outwards.

The rotator cuff itself is the link between the humerus bone (upper arm) and your shoulder blade. Also present in the joint are lubricating sacs called bursae that help to cushion and lubricate this joint and many others throughout the body. When the shoulder is injured, the bursa sacs may become inflamed and contribute to shoulder pain.

The Shoulder Joint and the Rotator Cuff: An Anatomy Overview

Rotator Cuff Tear: Types

When the rotator cuff tendon is torn, the arm it’s attached to loses a large amount of function, halting your normal activities in their tracks—movements as common as turning the steering wheel of your car or fishing your keys out of your pocket. Rotator tears vary in severity.

  • Partial rotator cuff tears: An incomplete tendon tear is not good, but the tendon repair prospects are much better as the tendon is not completely severed.
  • Complete rotator cuff tears: Most rotator cuff tears, unfortunately, are complete tears (also known as full-thickness tears) that require a surgical procedure to repair.

Rotator Cuff Tears: Causes and Symptoms

Many actions or accidents can cause rotator cuff tears, including falling down on an outstretched arm (an acute tear that may come with a dislocated shoulder or broken collarbone) or shoulder injury caused by aging and overuse (a degenerative tear).

Repetitive stress can contribute to degenerative damage. This stress can come from sports like rowing, baseball, tennis, and weightlifting, which involve the same motion performed again and again. Another contributing factor could be the development of bone spurs (bone overgrowth) that then irritate and fray your tendons as you move about normally. Yet another factor could be the loss of ample blood flow to the area caused by aging that slows down healing and allows minor damage to compound like accruing interest.

Regardless of what causes your rotator cuff injury, it’s important to identify the symptoms as soon as possible to prevent possible irreversible damage. These include:

  • A crackling sensation when you move your shoulder (crepitus)
  • Weakness in lifting or rotating the arm
  • Pain at rest and/or at night (especially when lying on the afflicted shoulder)
  • Pain when lifting or lowering the arm
  • Sudden, intense pain at the time of injury, possibly with a snapping sensation

It’s easier to identify an acute tear than an injury due to overuse, as those symptoms have a slow onset and can easily be attributed to general aches. Degenerative pain is often easily masked via the use of over-the-counter pain medications like ibuprofen, at first.

If your shoulder pain persists and NSAIDs like aspirin no longer work for pain management, it’s a sign that there’s an underlying issue and it’s advised that you see a medical professional, an orthopedic surgeon, or even a physical therapist as soon as possible for advice.

Rotator Cuff Tear Diagnosis

A doctor will most likely begin the diagnostic process by taking your medical history and asking specific questions about the nature and duration of your shoulder pain.

Next may be a physical examination to test your shoulder strength, and imaging tests like X-rays and MRIs may be ordered to decide whether you need a surgical procedure and what type of surgery is best for your condition. That decision will hinge on your general health, activity level, the size of the tear, and more, all issues that must be addressed one-on-one with your health care provider.

Rotator Cuff Treatment Options

A tear to the rotator cuff muscle or tendon may not be able to heal on its own, but every case varies.

  • Nonsurgical treatment options: If you’re one of the lucky 80% of patients who do not require surgical intervention, your treatment options may involve modifying your activities (no more tennis), relying on anti-inflammatory medications or supplements, taking up strengthening exercises recommended by a physical therapist, steroid injections, or just plain old-fashioned rest.
  • Surgical treatment options: Doctors may try nonsurgical options first, but if those fail to be adequate enough or the injury so severe that surgery is the only hope you have of restoring functionality, then arthroscopic surgery may be needed to reattach the rotator cuff tendon to the arm bone (arthroscopy is also known as keyhole surgery, more on this below).

The highlights of nonsurgical remedy include avoiding potential risk factors like permanent stiffness, infections, complications from anesthesia, or lengthy recovery time. However, sometimes surgery is truly the only option, and fortunately there are ways to safely speed up your recovery time.

Rotator Cuff Tears: Causes and Symptoms

Rotator Cuff Tear Surgery

Rotator cuff repair surgery is performed under general anesthetic to help relieve pain and restore full motion to the arm and shoulder. A nerve block is often performed prior to the anesthesia, a procedure that temporarily blocks the shoulder and arm’s feeling, allowing for less pain medication to be necessary during the procedure and recovery. This reduces grogginess post-op and is far safer for the patient.

Arthroscopic rotator cuff repair, aka keyhole surgery, is another way physicians help their patients avoid unnecessary pain, lengthy follow-up rehab, and excessive scar tissue. Arthroscopic procedures are done with minimally invasive tools and techniques, avoiding large incisions, reducing infection opportunities, and shortening recovery times.

While you’re under the knife, a small “keyhole” incision is made, and the surgeon reattaches the tendon to the bone using precise arthroscopic instruments (like an arthroscope). Sometimes the bursa (one of over 150 lubricating sacs throughout the body) is removed during the procedure to help reduce inflammation, and the bone above the bursa may be resected to clear extra space for the tendon to move without bone interference.

Dissolving stitches are then utilized so there’s no need for subsequent surgery to remove them, and with such a small incision, patients are able to return to normal bathing quickly after they are sent home.

Rotator Cuff Tear Surgery

Rotator Cuff Surgery Recovery Timeline

Even in the best-case scenario with top-of-the-line techniques, recovery still takes time. Here’s a breakdown of the timeline for rotator cuff surgery recovery.

  • Week 2: Bandages can be removed 2 weeks after an arthroscopic procedure. You will need to attend physical therapy rehab during this time (and for at least 4 weeks) to regain your strength. You may be prescribed drugs to help with pain relief.
  • Week 4: The sling you’ll be given to help support the weight of your arm may be set aside after a month of recovery. You can also drive a car again if you’re able. This is an excellent time to switch to a hydrotherapy (water) exercise program.
  • Week 6: You can return to minor daily activities, but your strength and range of motion will still need more recovery time before you can return to sports or jobs that require heavy lifting.
  • Week 8: Once you’re 2 months post-op, it’s time to start targeting function-specific power with active motion exercises, and you may return to work and sporting activities if you and your doctor feel it’s advised.

Recover Better, Faster, Stronger

Full recovery may take up to 6 months to feel like yourself again after a surgical repair. What may help speed up recovery and more importantly a rapid return to full strength is targeted amino acid supplementation. Rebuilding soft tissues like muscles, collagen, and connective tissues require first and foremost the nine essential amino acids that humans cannot synthesize themselves. Your doctor may advise consuming a protein shake each day to increase your supply of these amino acids, but an essential amino acid supplement can do the same much faster.

Nerve Regeneration: Is It Possible to Reverse the Effects of Nerve Damage?

Have you suffered a nerve injury? Are you dealing with the symptoms of nerve damage? While nerve regeneration may seem like fantasy, the science suggests that we really do have the ability to heal injured nerves.

With an estimated 20 million Americans suffering from peripheral nerve damage and millions more dealing with spinal cord injuries, researchers are constantly looking for new ways to address the effects of nerve damage. And while we still have a long way to go, significant advancements have been made in the pursuit of nerve regeneration. In this article, we’re going to take a closer look at these advancements and discuss the causes and symptoms of nerve damage and what you can do right now to help heal injured nerves.

Your Nervous System: The Basics

Although most of us probably think of the brain and spinal cord when we think of the body’s nervous system, the truth is that the nervous system is made up of two separate but interrelated components:

  • Central nervous system
  • Peripheral nervous system

While the central nervous system is indeed the portion of the nervous system that includes the brain and spinal cord, the peripheral nervous system is the part of the nervous system that houses the nerves, which serve to communicate with both the central nervous system and each other.

The nervous system can be further subdivided into two other major components:

  • Somatic nervous system
  • Autonomic nervous system

The somatic nervous system is also known as the voluntary nervous system, while the autonomic nervous system is sometimes called the involuntary nervous system. Both are part of the peripheral nervous system.

The somatic nervous system carries sensory and motor information back and forth between the central nervous system and the nerves connected to the muscles, skin, and sensory organs.

As you might guess, the autonomic nervous system is responsible for regulating the functions of the body that are largely outside conscious control, including things like heart rate, digestion, and respiratory rate.

Anatomy of the Nervous System

The Anatomy of a Nerve

The nerves themselves are made up of two basic cell types:

  • Nerve cells (neurons)
  • Glial cells

Nerve Cells

Neurons are the parts of nerves responsible for transmitting and receiving electrical impulses. They’re also similar to other cells in that they have a cell membrane, nucleus, cytoplasm, and organelles. However, neurons have two things other cells in the body don’t:

  • Dendrites
  • Axons

It’s the responsibility of the dendrites to transmit electrical impulses to the spherical part of the neuron that holds the nucleus—the cell body. By contrast, the axons are responsible for transmitting information away from the cell body, to other neurons.

There are also three basic neuron types:

  • Sensory neurons (afferent)
  • Motor neurons (efferent)
  • Interneurons

While sensory neurons are responsible for transmitting nerve impulses from the sense organs to the central nervous system, motor neurons are responsible for sending impulses from the central nervous system to the glands and muscles. And interneurons have the honor of transmitting information between sensory and motor neurons.

Fun Fact: Millions of years ago a virus inserted its genetic code into the genome of four-legged animals and rewrote how neurons communicate. It’s now thought that this ancient virus may be responsible for the rise of human consciousness.

Glial Cells

Glial cells surround the neurons and make it possible for them to do everything they do. Not only do glial cells provide physical support to neurons and protect them against infection, but they also ensure that they receive beneficial nutrients by connecting them to blood vessels.

There are several different types of glial cells, each with its own specific action, but one of the most important is the Schwann cell, which is commonly found in the axons of peripheral nerve fibers.

It’s the Schwann cells that are responsible for forming the myelin sheath—the insulating fatty acid layer that protects and insulates the nerve fiber and helps speed up the transmission of nerve signals. The Schwann cells also form another layer that’s known as the neurilemma.

Found only in the peripheral nerves, the neurilemma covers both the myelin sheath and the gaps in the sheath where the axon is exposed (nodes of Ranvier), thus providing an added layer of protection.

Interestingly, the neurilemma is also known to play an important role in peripheral nerve repair.

When a peripheral nerve is damaged, the neurilemma forms a tube through which axonal regeneration can occur. This process takes place as long as the neurilemma and cell body remain intact.

Unfortunately, the myelin sheaths of the central nervous system arise from completely different types of glial cells—oligodendrocytes—which means nerve fibers aren’t protected by a neurilemma and thus don’t possess the same regenerative powers.

This is why spinal cord injuries can be so devastating and why there’s much greater hope for functional recovery after a peripheral nerve injury.

The Anatomy of a Nerve

What Causes Nerve Damage?

It’s estimated that the human body contains over 100 billion nerves. With a figure that large, it’s not surprising that things can go wrong and nerves can become damaged.

But what causes nerve damage?

There are a number of determinants that can cause nerve injuries:

  • Compression: Pressure from surrounding structures can squeeze and irritate nerves. Nerve fibers can also undergo traumatic compression as a result of a crush injury.
  • Severing: Nerves can be cut during surgery or a traumatic event.
  • Stretching: Some traumatic events can stretch a nerve to the point where it becomes injured.
  • Burns: Severe burns can damage nerve fibers.
  • Disease: Autoimmune diseases, cancer, diabetes, and HIV can all cause damage to nerve fibers.
  • Toxins: Heavy metals and even some medications can damage nerve fibers.
  • Malnutrition: Deficiencies of certain vitamins and minerals, including vitamin B12 and copper, can lead to nerve damage.

Symptoms of Nerve Damage

With over 100 billion nerves, each involved in the proper functioning of different parts of the body, it should come as no surprise that a variety of symptoms may present themselves after a nerve injury. However, the type of symptoms seen will depend on the nerve involved and where it’s located.

For example, damage to an autonomic nerve may result in the following symptoms:

  • Dizziness
  • Incontinence
  • Erectile dysfunction
  • Difficulty swallowing
  • Problems digesting food
  • Sluggish pupils
  • Problems regulating body temperature
  • Exercise intolerance
  • Inability to sense pain

Damage involving a motor nerve may produce symptoms indicative of problems with motor function, including:

  • Weakness
  • Muscle atrophy
  • Paralysis
  • Cramps
  • Fasciculations (twitching)

Nerve damage resulting from injury to a sensory nerve can produce the following symptoms:

  • Burning
  • Tingling
  • Numbness
  • Sensitivity

Nerve Damage: Causes and Symptoms

Nerve Regeneration: Is It Possible?

As mentioned earlier, the peripheral nerves are surrounded by a neurilemma that enhances peripheral nerve regeneration after an injury.

But how exactly does nerve growth occur?

In a study published in the journal Cell, researchers noted that the axonal growth capabilities of the peripheral nervous system are so remarkable that the nerve stumps of cut nerves can actually reconnect themselves and begin functioning again.

They also noted that Schwann cells remain relatively quiet until an injury occurs and then revert back to a state similar to stem cells and, with the help of fibroblasts, go to work at the injury site, regenerating axons in the denervated area.

Similarly, a review published in the International Review of Neurobiology noted that, while axon regeneration and reinnervation do occur in the peripheral nervous system, functional recovery is frequently poor after severe injury.

However, if Schwann cells are switched to a stem cell–like state, growth factors such as brain-derived neurotrophic factor (BDNF) are secreted, and if the proteins that make up the extracellular matrix are present at the nerve stump, regrowth of axons is enhanced.

These studies offer fascinating insights into the mechanisms of nerve regrowth in the peripheral nervous system—plus tantalizing clues regarding how best to support nerve regeneration.

But equally exciting are recent studies that have taken these findings and applied them to the study of potentially new methods of approaching spinal cord injuries.

In one of the most compelling examples, scientists used an animal model to determine the underlying biological mechanisms necessary for the regeneration of nerve fibers after a complete spinal cord injury.

Using a variety of growth factors, researchers were able to turn on the genetic program that encouraged axonal growth, establish an environment conducive to growth, and program the path along which growth was to occur.

Although this study marks the first of its kind, the results were so impressive that a small study involving patients with spinal cord injuries is now being conducted.

6 Ways to Help Heal Injured Nerves

While new breakthroughs in the treatment of spinal cord injuries may be much closer than they once were, we’re still living in an age in which peripheral nerve injuries are much easier to address.

In fact, there are a number of techniques that can encourage neural regeneration and functional recovery.

1. Surgery

Nerve injuries that are the result of compression can often be corrected with surgical repair. For example, in severe cases, surgical decompression can be used to take the pressure off the ulnar or median nerve.

Likewise, cases of nerve transection can be corrected by splicing the cut nerve ends or by using a nerve graft.

Interestingly, a severed nerve tends to heal more quickly than a nerve that’s been damaged by compression, but in both cases, healing should take place within a period of about 4 to 12 weeks.

2. Exercise

As you might imagine based on our earlier discussion of glial cells, exercise is one of the best ways to encourage nerve regeneration. Regular exercise not only stimulates the muscles affected by a nerve injury, but it also increases blood flow, which brings beneficial nutrients to the injury site.

While any activity that gets you up and moving can encourage nerve growth, nerve damage resulting from conditions like peripheral neuropathy can affect balance and coordination. Therefore, if you have any questions regarding potential safety issues, be sure to speak with a qualified health care professional before engaging in any exercise program.

3. Vitamins and Minerals

As mentioned, a number of vitamin and mineral deficiencies can lead to nerve damage.

  • Vitamin B12: Deficiencies of this water-soluble vitamin are actually more common than you might think. In fact, it’s estimated that the majority of adults over the age of 65 are vitamin B12 deficient. What’s more, because vitamin B12 is found exclusively in animal-based foods, both vegetarians and vegans may be at risk of deficiency.
  • Thiamine: Also known as vitamin B1, thiamine is an important part of healthy nerve function.
  • Vitamin B6: Like thiamine, vitamin B6—also known as pyridoxine—is required by the nervous system for proper functioning.
  • Vitamin E: A deficiency in this fat-soluble vitamin can lead to symptoms of peripheral neuropathy.
  • Copper: Deficiencies in this important mineral are linked to peripheral nerve damage and diseases of the spinal cord.

Interestingly, while deficiencies of vitamin B6 and copper can cause nerve damage, an excess of either can be equally harmful. So if supplementing with these nutrients, be sure to stay within recommended intake guidelines.

4. Alpha-Lipoic Acid

Numerous studies have found that the antioxidant alpha-lipoic acid may be effective in delaying or even reversing diabetes-associated peripheral neuropathy.

A review published in the Review of Diabetic Studies noted that alpha-lipoic acid increases the production of glutathione—the body’s master antioxidant—and helps reduce pain, abnormal sensations, and numbness.

5. Omega-3 Fatty Acids

We mentioned earlier that the myelin sheath that protects nerve cells is composed of fatty acids. So, as you might imagine, it’s not surprising that omega-3 fatty acids have been found in studies to play a protective role against nerve damage.

For example, a study published in the Journal of Neuroscience noted that polyunsaturated fatty acids like omega-3s are essential components of the phospholipids that comprise the myelin sheath.

What’s more, they exhibit both neuroprotective and neurotrophic properties, which researchers hypothesize could lead to positive effects on neural regeneration.

6. Amino Acids

Known as the building blocks of protein, amino acids are required for almost every biological process that takes place within the body.

Not only are amino acids—especially the nine essential amino acids, which we must obtain from the foods we eat—required for the creation and maintenance of muscle, but they’re also necessary for the production of neurotransmitters and hormones.

Earlier we mentioned a study that found that switching on Schwann cells, secreting growth factors, and ensuring the presence of an extracellular matrix at the nerve stump can enhance nerve regeneration.

Interestingly, both the extracellular matrix and the growth factors are made up of proteins. Which means that the body must have a sufficient supply of amino acids to build both of these substances.

What’s more, studies have found that two specific amino acids, acetyl-L-carnitine and N-acetylcysteine, may have a particularly important role to play in nerve health.

Both of these amino acids act as antioxidants, but acetyl-L-carnitine has been found to be effective in reducing neuropathic pain, while N-acetylcysteine has been shown to decrease pain and improve coordination.

A review published in the Journal of Pain Research noted that acetyl-L-carnitine has been found in clinical trials to be safe and effective for both neural regeneration and the improvement of nerve conduction parameters.

Similarly, a study published in the journal Laryngoscope Investigative Otolaryngology found that N-acetylcysteine was effective in facilitating facial nerve recovery following a crush injury.

There’s no denying the fact that we still have a long way to go before we fully comprehend all the intricacies of the nervous system, but it’s clear that the body has a tremendous ability to heal itself.

While some nerve injuries may still be beyond our ability to heal, science has shown us that there are many ways we can support our body’s innate healing system.

If you’re currently suffering from symptoms of nerve damage and have questions regarding any of the information discussed in this article, don’t hesitate to seek further guidance from a qualified health care practitioner.

Hysterectomy Recovery Tips: 7 Steps to Better Healing and Faster Recovery

Hysterectomy is a major surgery that takes time to recover from properly. But by following a few simple steps, it’s possible to speed healing and shorten recovery time. In this article, we offer up 7 hysterectomy recovery tips to help get you on the road to feeling like yourself again.

A hysterectomy is a major surgical procedure that requires a significant recovery period. However, regardless of the type of hysterectomy you have, there are steps you can take to ensure the smoothest recovery possible. In this article, we’re taking a look at seven hysterectomy recovery tips that can help you heal faster and get back to your normal routine again.

When Is a Hysterectomy Necessary?

There are a number of reasons why a hysterectomy may become necessary, but the most common reason is uterine fibroids.

While up to 80% of women will have at least some fibroids by the time they reach age 50, many will never experience symptoms. Of those who do, only a small fraction have symptoms—especially pain and heavy vaginal bleeding—bothersome enough to warrant a hysterectomy.

Other medical issues that may lead to a hysterectomy include:

  • Endometriosis: This painful condition occurs when the endometrial tissue grows outside the uterus and begins to attach itself to other structures, such as the fallopian tubes or ovaries.
  • Adenomyosis: Similar to endometriosis, adenomyosis occurs when the endometrial tissue ends up where it should not be. However, in the case of adenomyosis, the tissue begins to grow into the muscle wall, or myometrium, of the uterus.
  • Cancer: Approximately 10% of hysterectomies are performed due to cancer of the reproductive organs.

Types of Hysterectomies and Hysterectomy Procedures

Most people think of a hysterectomy as the removal of the uterus. And while that’s technically true, a woman’s diagnosis, symptoms, and personal preference will dictate exactly which organs are removed.

  • Partial hysterectomy: During a partial hysterectomy, the uterus is removed, but the cervix is left in place. This procedure is sometimes called a supracervical hysterectomy.
  • Total hysterectomy: During a total hysterectomy, both the uterus and cervix are removed.
  • Radical hysterectomy: The most extreme form of hysterectomy is the radical hysterectomy. During this procedure—which is usually reserved for advanced cases of cancer—the uterus, cervix, supporting ligaments, and upper portion of the vagina are removed.

During a total or radical hysterectomy, a bilateral salpingo-oophorectomy, or removal of the ovaries and fallopian tubes, may be performed as well.

In addition to the various types of hysterectomies, there are different ways the procedure itself may be performed.

  • Vaginal hysterectomy: The least invasive of the three types of hysterectomy procedures, a vaginal hysterectomy is performed entirely through the vagina and requires no external incisions.
  • Laparoscopic hysterectomy: This minimally invasive procedure is performed with the use of a lighted camera (laparoscope) inserted via the belly button and additional instruments inserted through two or three small incisions made in the lower abdomen.
  • Abdominal hysterectomy: The most invasive type of hysterectomy procedure is the abdominal hysterectomy, which is performed via a vertical or horizontal incision in the lower abdomen.

When Is a Hysterectomy Necessary?

Potential Hysterectomy Complications

A hysterectomy is a very common type of surgery and is generally considered quite safe. However, as with all procedures, complications may occur. These include:

  • Anesthetic reaction
  • Infection
  • Heavy bleeding (hemorrhage)
  • Damage to bowel or bladder
  • Deep vein thrombosis (blood clot)

Menopausal Symptoms After Hysterectomy

Many women who undergo a hysterectomy experience symptoms of menopause afterward. Unfortunately, this is true even if the ovaries are left intact.

Why?

The ovaries receive part of their blood supply via the uterus. When the uterus is removed, their blood supply becomes compromised, and there’s a risk the ovaries could fail within 5 years.

Symptoms of menopause include:

  • Hot flashes
  • Night sweats
  • Vaginal dryness
  • Irritability
  • Insomnia
  • Discomfort with sexual intercourse

Potential Hysterectomy Complications

7 Hysterectomy Recovery Tips

Recovery time following a hysterectomy is affected by many factors, including overall health and the type of approach used for the surgery.

While women who undergo a vaginal hysterectomy may be back to their normal activities in as little as 2 weeks, women who have a laparoscopic or abdominal hysterectomy may be looking at a recovery period that lasts 2 to 4 times as long.

But regardless of the type of hysterectomy, there are steps every woman can take to limit the side effects of surgery and speed up recovery time.

1. Get Plenty of Rest

One of the most important things you can do after any surgery is rest. Proper sleep is especially important because the body uses the time you’re not awake to repair and restore itself to healthy function. It’s also the time when hormones are balanced and the immune system gets a boost. So, after a hysterectomy, be sure to get plenty of sleep. It will help you heal faster, protect you from infection, assist you in coping better with hormonal fluctuations, and even lift your mood.

2. Prevent Constipation

With any surgery comes the added risk of constipation. Changes in food and fluid intake, decreased physical activity, and side effects from both anesthesia and narcotic pain medications all play a part.

While minor bouts of constipation are generally nothing more than a nuisance, severe constipation after surgery can lead to excessive straining, which may damage incisions.

But postoperative constipation can be reduced or even avoided by following a few simple steps.

  • Drink lots of fluids. Drink at least eight 8-ounce glasses of water each day—more when taking narcotic pain medicines.
  • Up your fiber intake. Eat plenty of fiber-rich fruits and vegetables and take fiber supplements.
  • Eat multiple small meals. Eating four to six smaller meals throughout the day can help keep your system primed and functioning normally.
  • Balance your microbiome. Taking a probiotic supplement and eating more yogurt and other probiotic-rich foods can help keep your GI tract in balance and bowel movements soft and regular.
  • Start walking. While vigorous exercise should be avoided after a hysterectomy, taking regular walks can help get your GI tract moving again. Plus, it’s a great way to boost mood and regain your energy.
  • Use a stool softener. Physicians often prescribe stool softeners after surgery to help patients avoid straining. When taken regularly, they may help head off constipation before it starts. And, when more help is needed, they can be used with over-the-counter laxatives.

3. Eat a Healthy Diet

Like rest, your body needs plenty of nutrient-rich whole foods to support the processes that keep your tissues and organs functioning normally. So try to limit your intake of processed foods and instead focus on eating a diet that emphasizes lean protein, fruits, vegetables, healthy fats, and whole grains.

4. Take Amino Acids

While whole foods are rich in vitamins, minerals, and phytonutrients, they’re also a source of protein-building amino acids. These building blocks of life are needed by the body for almost every biological process.

It should come as no surprise, then, that providing the body with an ample supply of amino acids can actually shorten the time it takes to recover from surgery. However, as with most things, balance is key.

So if you decide to supplement with amino acids after a hysterectomy, be sure to look for a formula that offers a balanced ratio of all nine essential amino acids.

5. Wear Loose-Fitting Clothing

If you had a penchant for tight-fitting clothing prior to undergoing a laparoscopic or abdominal hysterectomy, you need to think about putting that particular love on hold for a while.

Although it may seem obvious, to ensure your incisions heal properly, you need to keep the pressure off and allow air to circulate. So instead of tight jeans and skirts, opt for comfy, loose-fitting clothes.

6. Properly Care for Wounds

If you have a laparoscopic or abdominal hysterectomy, your health care provider will discuss how to properly care for your wounds following surgery, so be sure to follow their instructions closely. And don’t hesitate to contact them if you notice increased pain, redness, swelling, or discharge around any of your incisions.

7. Be Patient with Yourself

For many women, having a hysterectomy is more than just your average surgery. While it’s the second most common surgery in women after cesarean section, the hormonal changes that come with a hysterectomy that includes removal of the ovaries can be intense.

The circumstances under which a hysterectomy with ovarian removal is performed can also affect a woman’s response after surgery.

A woman who undergoes a hysterectomy to stop pain and menstrual periods so heavy they led to an inability to leave the house and anemia may feel such a huge sense of relief after surgery that any symptoms of menopause are negligible.

But a woman who’s had her uterus and ovaries removed as a result of cancer may instead feel a profound sense of loss that only amplifies her menopausal symptoms.

While it can be helpful to keep in mind that any menopausal symptoms you’re going through will fade in time—and that you’ll soon adjust to life after menstrual cycles—if you’re experiencing symptoms of depression or other difficulties that seem to be getting worse instead of better, don’t hesitate to speak with your health care provider.

7 Hysterectomy Recovery Tips to Speed Healing and Feel Better Faster

Pain on Inner Side of Knee: What Could It Mean?

Pain on the inner side of the knee could be as mild as a sprain or serious enough to require surgical intervention. Find out what could be causing inner-side knee pain and what your treatment options may look like.

Knee injuries are quite common in sports medicine and can be caused by an accident, injury, or the wear-and-tear of aging. The first step in making a full recovery is identifying the cause of knee pain right away before the injury worsens and possibly becomes irreversible. If you’re looking for what may cause pain on the inner side of the knee, look no further: we have a comprehensive review of what may underlie your inner knee pain below.

The Anatomy of the Knee

Let’s start with a quick review of the knee before we hone in on the inner knee area, as each part of this joint is intrinsically connected to the rest.

  • Bones: The bones of the knee joint include the femur (thighbone), tibia (shinbone), and the patella (kneecap). They give the knee structure.
  • Muscles: The muscles involved in the knee joint include the quadriceps (top of your thighs), hamstrings (back of your thighs), and the calf muscles (the gastrocnemius, soleus, and the tibialis posterior). These muscles allow for movements like standing, sitting, walking, jumping, running, and flexing.
  • Tendons: The tendons of the knee attach muscle to bone and include the quadriceps tendon that connects the quadriceps muscle to the kneecap and the patellar tendon that attaches the kneecap to the shinbone (technically making it a ligament, but it’s called the patellar tendon all the same).
  • Ligaments: Ligaments are connective fibers that attach bone to bone, and after the dubiously named patellar tendon, there are four main ligaments of the knee: the ACL (anterior cruciate ligament) that runs centrally through the joint connecting the thigh and shin bones; the PCL (posterior cruciate ligament) that is larger and stronger than the ACL and runs along the back of the knee between thigh and shin bone; the LCL (lateral collateral ligament) that stabilizes the outside of the knee; and the MCL (medial collateral ligament) that stabilizes the inside of the knee.
  • Tissues: Other connective tissues in the knee include cartilage caps that prevent the thigh and shin bone from grinding together, the meniscus that sits between those cartilage caps, and the knee bursae (fluid-filled sacs that help lubricate many joints, including the knee).

The Anatomy of the Knee

Evaluating Pain on the Inner Side of the Knee

Knee problems are quite common due to the nature of the joint. Our ankle, knee, and hip joints are tasked with supporting the weight of the entire body when walking, sitting, and moving throughout the world, but the knee in some ways is the most confined. The hip is a ball-and-socket joint with a wide rotation range, and the ankle, though functionally an up-and-down-style hinge joint just like the knee, nevertheless can also rotate the foot in ways the knee joint cannot move.

This rigidity in the knee gives us the support we need to stand but is also vulnerable to sudden switching movements that can cause slips and injuries among the bones and tissues of the joint. These injuries can result in pain and sometimes permanent loss of function, and this is why it’s important to quickly identify knee pain.

When it comes to pain on the inner side of the knee, here are some important distinctions.

  • Medial knee pain is the term most frequently used to describe inner knee pain. “Medial” means “middle,” which seems like a misnomer, but because the inner-knee tendon is known as the medial collateral ligament, it is aptly termed in health care settings.
  • Pain to the inside of the knee may be gradual (as with tendonitis from overuse) or sudden (as with a ligament tear), and may be perceived as an aching or sharp pain. Knowing how to describe the nature of your pain helps with diagnosis.
  • Pain above the knee or within the knee may have entirely different causes than inner knee pain, so be as precise as possible in the location of your pain, as it may lead to faster and more successful treatment. Inner knee pain could be a torn meniscus injury. Inner kneecap pain is also distinct and could be due to patellofemoral pain syndrome, aka runner’s knee, (which includes front of the knee pain as well).

Evaluating Pain on the Inner Side of the Knee

Pain on Inner Side of Knee: Common Causes

Here are the most common causes of pain on the inner side of the knee.

1. MCL Injury

A sprain or tear to the medial collateral ligament (MCL) causes pain at the inside of the knee. MCL injuries are often caused by either a direct impact to the ligament (say if you were accidentally kicked during a soccer match) or a sharp, twisting motion (again, one that is common in a sport like soccer, basketball, or football). A fall could also cause this sort of injury, making it an injury more likely to be suffered by elderly adults.

2. Pes Anserine Bursitis

Bursae sacs are found throughout the body in over 150 locations, including in the shoulders, hips, and knees. The pes anserine bursa is the sac located on the inner side of the knee, and if it becomes irritated or inflamed, you’ve got a case of pes anserine bursitis. This condition may present as swelling, stiffness, or pain, and is a frequent complaint of runners and other athletes. Pes anserine bursitis usually requires no further treatment beyond rest and at-home self-care.

3. Meniscus Tear

Menisci are rubbery pads of cushioning tissue that help absorb shocks in your joints. There are two menisci located in each knee: one on the lateral or outer side of the knee, and one on the inner side known as the medial meniscus. Should the medial meniscus become damaged, you may experience instability, swelling, and pain on the inner side of your knee.

4. Rheumatoid or Osteoarthritis

Arthritis is an umbrella term that covers different types of the disease and can afflict just about any joint in the body.

  • Rheumatoid arthritisInner side of the knee pain could be a symptom of this autoimmune disease that attacks the body’s joints and causes painful inflammation. Managing rheumatoid arthritis requires a doctor’s advice and guidance, even if it’s mild enough to treat with over-the-counter anti-inflammatories such as ibuprofen or even natural anti-inflammatory remedies. Without professional medical supervision from a rheumatologist, this condition could worsen drastically.
  • Knee osteoarthritisWhile osteoarthritis can afflict many joints throughout the body due to aging (it’s known as “wear and tear” arthritis or degenerative joint disease), osteoarthritis of the knee may manifest as pain at the inside of your knee.

5. Medial Plica Syndrome

Medial plica syndrome is a specific version of synovial plica irritation that can manifest as pain throughout the knee joint (such as inner-side knee pain, pain behind the kneecap, anterior knee pain, etc.). The synovial plica is the inner surface of the synovial membrane of the knee joint, and it can become irritated or inflamed in response to injury. This may be the only cause of your knee pain, or it could be one symptom of a more serious underlying cause.

Treatment Options for Inner Knee Pain

Whatever the cause or causes of knee pain, once you’ve consulted a medical professional, you’ll receive specific advice. Here is a quick overview of the variety of treatment options that may be suggested at that time.

  • RICE: For mild injuries, you may be sent home with instructions to Rest, Ice, Compress, and Elevate your knee joint.
  • Physical therapy: Your doctor or physical therapist may suggest targeted stretches to help you build leg strength around bad knees to ensure that you heal properly and prevent future injury.
  • Knee bracesKnee sleeves and braces help stabilize the knee while you heal and help prevent re-injury as you return to sporting or daily activities. You may choose to wear knee sleeves while working out indefinitely, as they can provide extra support to your knee going forward.
  • Surgery: A ligament injury like an MCL tear may require surgery to repair and specific rehab advice post-op.

The Inner Side Track

Pain on the inner side or inside of your knee can be debilitating, and in some cases (if left untreated) permanent. For these reasons, it’s important to identify the cause of the pain and find the most effective solution for it as soon as possible.

Patellar Tendon Tear: Symptoms, Treatment and Recovery

Patellar tendon tears: learn what causes these injuries, how to recognize the symptoms, and what to do while recovering to best support your knee joint, including knee sleeves, targeted stretches, and amino acid supplementation. 

In a lot of ways, our bodies are strung together like a puppet or marionette, the strings being our tendons, ligaments, and other connective fibers and tissues. An injury, rupture, or tear to any one of these “strings” can slow down or even incapacitate the body. Tendons are the strings that connect muscles to bone, and yet the patellar or patella tendon, though so named, is actually a ligament in the knee. This article has the details regarding what causes a patellar tendon tear, how to identify it, plus how best to recover your full range of motion.

Tendons vs. Ligaments: The Anatomy of the Knee

The knee joint is the meeting place of various bones (the thigh bone, shinbone, and kneecap, otherwise known as the patella), muscles (quadriceps, hamstrings, and calf muscles), and connective tissues (tendons, ligaments, cartilage, and more). The muscles are connected to the bones via tendons, while the bones are connected to each other via ligaments.

The patellar tendon is often referred to as the patellar ligament because it connects the  bottom of the kneecap to the top of the shinbone (bone to bone connection). However, it is actually an extension of the quadriceps tendon, which connects the quadriceps muscle to the shinbone, which is why patellar tendon (muscle to bone connection) is the more popular terminology and the one most commonly used in sports medicine and orthopedics. Working in concert, these connective tissues allow us to straighten our knees.

What Is a Patellar Tendon Tear?

A patellar tendon rupture or tear can range from mild to severe, partial to complete. Patellar tendonitis, for example, is the result of microtears sustained during misuse, overuse, or overextension, and while it often causes symptoms of knee pain, that pain is mild in comparison to what’s felt during a partial tear of the tendon or a complete tear, which rips the soft tissue of the tendon into two distinct pieces.

A complete tear of the patellar tendon indicates a detachment of the kneecap from the shin and is accompanied by an inability to straighten your knee. This medical condition requires immediate intervention from an orthopedic surgeon, as sometimes a piece of the patella bone may break off along with the tendon and cannot reattach on its own.

Patellar Tendon Tear: Causes

Sports players have higher risk factors for knee injuries, as do the elderly who may suffer from accidental falls. Here are some of the common causes of complete rupture or tear of the patellar tendon.

  • Injury: A sports collision, fall, or car accident could cause violent injury to the front of the knee, as could landing badly from a jump—most patellar tears happen when the knee is bent and the foot is planted on the ground, as when impacting from a jump or an accidentally missed step downstairs.
  • Tendon weakness: Chronic patellar tendinitis (also spelled tendonitis) weakens the tendon over time and is the culprit behind the condition colloquially referred to as “jumper’s knee.” A weakened tendon is more likely to tear than a strong, healthy one.
  • Joint weakness: If the knee joint is in a weakened state due to osteoporosis or osteoarthritis (degenerative joint disease), injury to the patellar tendon and the other ligaments in the joint is more likely to occur.
  • Steroids: Steroid use or corticosteroid injections are known to weaken the patellar tendon and surrounding tissues, which increases the risk of injury or tear.
  • Reduced blood supply: Chronic conditions that may reduce necessary blood supply to the knee and weaken the area include rheumatoid arthritis, metabolic disease, diabetes mellitus, chronic renal failure, hyperbetalipoproteinemia, systemic lupus erythematosus (SLE), or infection.
  • Surrounding surgery: If you need to undergo a knee surgery such as anterior cruciate ligament reconstruction or total knee replacement, you may be more prone to injuring your patellar tendon during recovery.

What Is a Patellar Tendon Tear?

Patellar Tendon Tear: Symptoms

The first step to regaining full recovery of your range of motion is to quickly identify an injury to the patellar tendon. The symptoms of a partial or complete patellar tendon tear may include:

  • A popping or tearing sensation at the time of injury
  • Pain and swelling of the knee
  • Bruising
  • Tenderness
  • An indentation below the kneecap where the tendon may have torn
  • A traveling kneecap (the patella may move up into the thigh area if it is no longer attached to the shinbone)
  • Cramping
  • Inability to straighten your knee, difficulty walking, or a buckling or “giving way” sensation under weight-bearing

Patellar Tendon Tear: Diagnosis

Once you’ve noticed an issue and you visit a medical professional for advice, the diagnosis of a patellar tendon tear may include the following.

  • Medical history: By taking a verbal medical history, doctors may quickly narrow down the possible causes of the knee pain you’re experiencing. According to the American Academy of Orthopaedic Surgeons, questions may include, “Have you had any previous knee injuries?” and “Do you have any medical conditions that affect your knees?”
  • Knee extension test: The physical examination may include a knee extension test to isolate whether you’re dealing with quadriceps tendon rupture or a patellar tendon injury.
  • Imaging tests: X-rays may be ordered to rule out or determine the extent of bone involvement in your injury, while an MRI (magnetic resonance imaging) can help the doctor visualize the state of your soft tissues at the location of the tear and recommend treatment options.

Patellar Tendon Tear: Treatment

Depending on your age, activity level, and the nature of your patellar tendon tear, treatment options may vary.

  • Nonsurgical options: Using orthotics such as a knee brace or attending physical therapy appointments can help a partial tear heal or correct patellar tendinopathy before it leads to more serious damage.
  • Surgical options: A complete tear most likely requires surgical repair to reattach the tendon (though it may not be possible if you’re in ill health, are immunocompromised, or if there isn’t enough healthy tissue remaining to reattach).

Reattaching a torn tendon has the best results if it’s done as soon as possible after the injury, because a delay could give the tendon time to begin scarring, tightening, and shortening, making it impossible to reconnect the ends cleanly. Such a situation may require a tissue graft from another part of your body or from a donor body (an allograft) to make up for the missing distance.

During the procedure, the surgeon sutures the tendon together and drills holes in your kneecap to then anchor those sutures to the bone for increased stability. Patellar tendon repair is delicate work that requires achieving the correct tension to maintain the extensor mechanism of the knee, which consists of the interworking relationship between the quadriceps muscle, the quadriceps tendon, the patella, the patellar retinaculum, the patellar tendon, and the surrounding soft tissues. It’s also important for the doctor to closely match the tension of your injured knee with the range of motion you have in the uninjured knee (assuming of course that your injury isn’t in both knees, as it might be if your knees collided with the dashboard in a car accident).

Your doctor will discuss with you beforehand the materials used in the procedure. Wire sutures or cables will need to be later removed with another surgery but are more stable for the initial recovery. Dissolvable sutures mean no future removal surgery, but may not be strong enough to hold your particular injury in place.

Patellar Tendon Tear: Recovery

Complications even after a successful surgery could involve weakness in the joint and a partial loss of your range of motion. Reinjury is more likely in this instance, so recovery support is essential. Here are some recovery tips that may help in both surgical and nonsurgical patellar tendon tear recovery.

1. Amino Acid Supplements

When healing soft tissue like tendons, ligaments, and muscle, proper amino acid support is imperative; specifically, the nine essential amino acids that we can only acquire from outside the body, either protein foods like meat, eggs, dairy, and beans, or supplements.

Without a sufficient supply of all these amino acids, our bodies often harvest healthy cells to rebuild new tissues, so in any instance of recovery (and especially after surgery), it’s important to increase your protein consumption and ensure that you have a comprehensive amino acid intake.

Even with the best of luck and no complications, complete recovery takes an average of 6 months, with some patients needing a year or more to return to their pre-injury activities. Supplementing with amino acids can help shorten your recovery time.

2. Targeted Stretches

It’s recommended that you consult a licensed physical therapist at least once even if your knee pain is only the result of mild patellar tendonitis. While there are stretches we can suggest, a trained physical therapist can evaluate your individual needs and limits, plus correct your form so you don’t accidentally damage your body by performing the stretches incorrectly. The most commonly advised exercise in an instance of patellar injury is straight-leg raises, seen here:

You can strengthen your legs around bad knees and prevent pain by following these instructions.

  1. Lie on your back on a floor or firm, flat surface, and bend one knee at a 90-degree angle, planting that foot on the floor.
  2. Contract the quadriceps (front of the thigh) in your straightened leg to stabilize the leg before lifting it.
  3. While inhaling, lift your straight leg 6 inches off the ground and hold for 3 seconds.
  4. While exhaling, lower the leg slowly back to the floor.
  5. Relax, and then repeat at least 10 times before switching and doing the same with the other leg.

3. Support Gear

Wearing a knee sleeve while you recover and during future sporting activity helps keep the knee in place while it heals and lends extra strength and support that may help you avoid reinjuring the patellar tendon or other parts of the knee joint due to patellar weakness.

Trounce Patellar Tears

Full recovery from patellar tendon tears is very doable, as most people return to all their former activities in the long run. The leg may feel stiff going forward, but that is a small complaint in the grand scheme if you can return to beloved sporting activities and daily movements again. Once your recovery is underway, be sure to give your knees and tissues the TLC they need with targeted nutrition, exercise, and support going forward.

How to Suture a Wound: Laceration Repair and Recovery

What materials are available to suture a wound, what techniques are best used (when and where) to minimize scarring, and what can you do to lower the risk of infection and speed up healing? Find out.

The basics of laceration repair have been more or less the same for over a century, but wherever there is room for improvement, medical professionals are ready to adapt. The development of synthetic skins and tissue adhesives, dissolvable stitches, and safe topical anesthetics have refined the process of wound management. This article is a comprehensive review of how to suture a wound and promote optimal recovery.

Wound Physiology

Proper wound care involves supporting hemostasis, minimizing scarring, and avoiding wound infection. Lacerations may afflict the dermis, epidermis, subcutaneous layer, and the deep fascia, which is why it may be necessary to irrigate deeper wounds to clean and sterilize beneath the skin edges. Here’s the breakdown of these layers.

  • Dermis and epidermis: Together, these two layers constitute the skin and are clinically indistinguishable from one another (though they are microscopically distinct). Shallow cuts to the dermis may be best treated with a bandaid or steri-strip.
  • Subcutaneous layer: This is the layer beneath the skin of fat (adipose tissue), nerves, hair follicles, and blood vessels. Deeper wounds that require sutures often have a better cosmetic result if the stitches are placed in this layer.
  • Deep fascia: This is the muscle layer beneath our skin and fat that may require intensive suturing.

The Healing Process of Skin

The skin heals itself in five steps.

  1. Coagulation: The first response to a wound is blood coagulation wherein platelets aggregate and clot to stop bleeding and summon an immune response.
  2. Epithelialization: In the epidermis, cells begin to regenerate and reknit the skin back together.
  3. New blood vessel growth: In the first 4 days following injury, new blood vessels are synthesized to replace the damaged tissue.
  4. Collagen formation: Collagen regeneration helps restore tensile strength and flexibility to the skin. This process may take place for up to a full year depending on the wound’s severity.
  5. Contraction: In the initial 3 to 4 days after injury, wound thickness concentrates in the center in a process that is not fully understood by doctors except for the consequence of changing the appearance of scarring.

This healing process may be interrupted by infection and can also be influenced by factors such as underlying tissue trauma, denervation, body temperature, and ischemia (a restriction in blood supply to the tissues).

Suture techniques can be employed to take ischemia into consideration, like the vertical mattress suture (discussed in further detail below). Identifying and removing any foreign bodies from the wound and employing tetanus shots can help reduce the risk of damaging infections.

Wound Physiology

Suture Materials

Once the area has been cleaned and prepared, your health care provider has a choice of suture materials, many of which have pros and cons depending on the area that needs repair. Here’s a quick overview of those options.

Absorbable Sutures

  • Catgut: These sutures are derived from cattle or sheep vessel linings (intima) and can retain tensile strength for up to 2 weeks of skin closure. Follow-ups for suture removal are usually recommended within the first week once natural healing has taken hold.
  • Polyglactin 910 (Vicryl): This is a synthetic suture that is braided and lubricated with improved tensile and knot strength over catgut. It’s considered best for subcutaneous sutures.
  • Vicryl Rapide: A fast-absorbing suture that is favored for skin closure as it will “fall off” within 7 to 10 days without requiring suture removal. It’s particularly useful for sutures that need to be placed under casts rather than employing nonabsorbable sutures.
  • Poliglecaprone 25 (Monocryl): A monofilament that provides easier handling and pliability, best used in cases of facial lacerations and subcuticular running sutures (more on suture types below).
  • Polyglycolic acid (Dexon): The first absorbable synthetic suture made of a braided polymer. It has since been improved upon to reduce snagging and binding when wet.
  • Polydioxanone (PDS): With more tensile strength than Vicryl, this monofilament may help reduce infection potential with a lower friction coefficient than Vicryl.

Nonabsorbable Sutures

  • Silk: A natural product, silk has the lowest tensile strength among nonabsorbable stitching materials. It is now rarely used due to the availability of superior materials.
  • Nylon (Dermalon, Ethilon): The original synthetic suture, nylon has high tensile strength, low cost, minimal tissue irritation, and excellent elasticity.
  • Polypropylene (Surgilene, Prolene): A synthetic plastic suture with high tensile strength much like nylon. Its plasticity allows it to expand to allow for wound swelling. It comes in blue coloring that is useful for visibility during removal.
  • Polybutester (Novafil): A synthetic copolymer monofilament with greater elasticity than polypropylene or nylon, which leads to lower amounts of scarring.

The type of suture material selected depends on many factors, including the location of the laceration, the likelihood of infection, the potential for wound dehiscence, and whether a follow-up appointment for removal is viable.

How to Suture a Wound: Techniques

How to Suture a Wound: Techniques

The name of the game when it comes to wound healing is skin closure, and yet there are several ways to sew up a laceration. Here are some of the leading suturing techniques.

  • Percutaneous skin closure: This is the simple interrupted suture frequently used in emergency medicine on uncomplicated wounds like, say, cutting yourself so badly with a kitchen knife that it requires a trip to the ER. The tip of the needle penetrates the skin’s surface, loops evenly with the opposite side of the wound and as widely/deeply as required by the size and location of the laceration. The suture continues for as many stitches as are required to fully cover the wound edges.
  • Dermal closure: The dermal or buried suture is meant to hold the wound closed just below the dermal-epidermal divide and is used when wounds are so deep that closing the layer overtop the wound would leave “dead space” open underneath. This wound requires absorbable sutures and the knot needs to be buried deep so it won’t interfere with healing on the top of the skin surface. This stitch is perfectly suited for thoroughly cleaned wounds, but the higher the risk of contamination, the higher the risk of infection.
  • Running suture: Best for the rapid closure of long wounds, the running suture evenly distributes tension and is a variation of the simple interrupted suture.
  • Subcuticular running suture: Often used on facial lacerations to minimize scarring, it involves running a continuous stitch in the dermis, and then closing the outer edges of the wound with adhesive tape.
  • Vertical mattress: For wound edges that are at risk of folding into the wound, the vertical mattress technique (also known as the vertical Donati stitch) closes both the deeper layers and the surface layer of the wound at once.
  • Horizontal mattress: A horizontal mattress suture everts the stitch (turns it upside-down like a series of saddles that run under the wound). Wound eversion allows the tension of the suture to be placed farther away from the primary closure point.

Wound Closure Aftercare

Wound healing is primarily done by the body’s own regeneration mechanisms, the reformation of collagen and the reknitting of the skin on a cellular level. However, there are ways you can improve the healing process: the first is by never attempting self-suture unless you’re in extremely dire circumstances (stranded during an emergency perhaps), and the second is by embracing the following tips.

  1. Amino acid supplements: Healing means tissue rebuilding, and tissue cannot be rebuilt without all nine of the essential amino acids (EAAs). Increasing your protein food intake, consuming protein shakes, or even better, taking a fully balanced EAA supplement helps you heal a sutured wound faster.
  2. Proper dressing and bathing: Antibiotic ointments and gentle cleaning of the area help reduce the risk of infection and inflammation. Follow the doctor’s instructions on when and how to wash and dress your wound.
  3. Tetanus prophylaxis: This is the fancy name for a tetanus shot. It helps boost your immune system’s defense while you’re in a vulnerable state of healing.
  4. Antibiotics: A doctor may prescribe preventative antibiotics to take in the initial healing phase, again to lower the risk of infection as much as possible, and especially in cases like wounds resulting from an animal bite or cut from a dirty or rusty object.
  5. Anti-inflammatories: To reduce the pain felt at the wound site, over-the-counter or natural anti-inflammatories may be beneficial.

Take Care

Be sure to attend any follow-up appointments and to adhere to all wound care advice given by your doctor, as it could mean the difference between a quick recovery and a life-threatening infection. Beyond that, boost your nutritional intake with amino acid foods and supplements to supply the building blocks needed to synthesize new tissue, and enjoy a speedy recovery.

Constipation After Surgery: What Causes It and How to Treat It

It’s uncomfortable and downright unpleasant, but the truth is many people deal with constipation after surgery. However, with the right preparation and these seven tips, you can reduce or even eliminate your chances of experiencing the misery that is postoperative constipation.

Having surgery is stressful enough, but the constipation that often comes afterward can make the experience even more unpleasant. If you’re preparing to have surgery or are already in the recovery phase and having trouble having a bowel movement, this article will help you understand what causes constipation after surgery and what you can do to get back to having normal bowel movements again.

What Causes Constipation After Surgery?

Unfortunately, there are a number of factors that increase your chances of developing postoperative constipation.

Food and Fluid Intake

Many types of procedures require that you not eat or drink anything immediately prior to the procedure and eat and drink only minimally afterward. Such dietary changes can throw your body off and affect your normal bowel habits. What’s more, not drinking enough water adds less fluid to your feces. This can lead to hard stool, which makes it more difficult to have a bowel movement.

General Anesthesia

Many types of procedures require the use of general anesthesia. Besides putting you to sleep, general anesthesia also paralyzes your muscles. That includes the muscles that control peristalsis. And it can take several days after surgery for the intestines to fully wake up again.

Narcotic Pain Medication

One of the most common causes of constipation after surgery is the use of narcotic pain medications. Similar to the way general anesthesia paralyzes the gut, narcotics slow the gut down. This results in increases in both transit time and absorption of fluid into the bloodstream. Which means it not only takes longer for food to move through the gastrointestinal (GI) tract, but stool is also harder and more difficult to pass.

Lack of Physical Activity

It may not be the first side effect that comes to mind, but the physical inactivity that comes with surgery also plays a role in postoperative constipation. This is because exercise increases blood flow and stimulates the central nervous system, which helps the gut function normally. This is also what makes exercise helpful in the treatment of chronic constipation.

Predisposition

Individuals who are prone to having difficulty achieving regular bowel movements are more likely to suffer from postoperative constipation.

5 Common Causes of Postoperative Constipation

Symptoms of Constipation

While everyone’s bowel habits are different—and every individual recognizes what’s normal for them—there are certain symptoms of constipation to look out for when you’ve had surgery.

  • Passing fewer than three bowel movements a week
  • Straining during bowel movements
  • Having hard stools
  • Experiencing a sudden drop in the number of bowel movements
  • Bloating
  • Increased gas
  • Abdominal pain
  • Rectal pain
  • Feeling of incomplete emptying

7 Ways to Prevent and Treat Constipation After Surgery

If you’re still a few days out from a planned surgical procedure, the good news is that you have time to tune up your colon so it’s better prepared to deal with the side effects of general anesthesia, narcotic prescription drugs, and postoperative inactivity.

How do you do this?

Make sure you’re eating a high-fiber diet that’s rich in fruits, vegetables, and whole grains. And be sure you’re drinking plenty of water too.

The more fiber and fluid you can get into your system prior to surgery, the less chance you’ll have of experiencing hard stools after your procedure.

If you missed the opportunity to up your fluid and fiber intake prior to surgery, there are still some things you can do to help stave off postoperative constipation.

1. Drink Plenty of Fluids

Making sure you’re getting plenty of fluids every day is just as important after surgery as it is before. While water is usually best, fruit juices like prune juice can also be helpful in the management of constipation.

While most experts recommend drinking approximately 64 ounces of fluid each day, if you’re taking narcotic pain medications after your surgery, you’ll need to be drinking even more than that.

In addition, although it’s traditionally been thought that caffeine following surgery is a recipe for dehydration and constipation, studies are beginning to suggest that, on the contrary, caffeine may actually help prevent constipation.

For example, a meta-analysis published in the journal Scientific Reports found that drinking a cup of coffee the morning after surgery reduces the:

  • Amount of time it takes to have a bowel movement
  • Amount of time it takes for gas to return
  • Length of time it takes to return to solid food
  • Length of hospital stay

What’s more, a meta-analysis published in the Cochrane Database of Systematic Reviews found that chewing gum after surgery may also help wake up the GI tract by stimulating the same reflexes associated with eating and thus hasten the return to normal bowel movements.

2. Increase Fiber Intake

In the same way that increasing fiber intake prior to surgery can help you avoid postoperative constipation, upping fiber intake after surgery can also help you keep your GI tract running normally.

In addition to fruits and vegetables, fiber supplements like psyllium powder (found in Metamucil) can also be helpful. Just remember that increasing fiber intake without also increasing fluid intake can lead to constipation. So don’t forget to stay hydrated.

When you’re recovering from surgery, it’s also a good idea to limit or avoid foods—think dairy products and processed foods—that are known contributors to constipation.

3. Eat Frequent Smaller Meals

Instead of overwhelming your system with three large meals, try eating frequent smaller meals instead. Eating smaller portions of food regularly throughout the day can also help keep your GI tract stimulated and encourage regular bowel movements.

4. Try Probiotics

The human GI tract is made up of trillions of different types of microorganisms, both good and bad. When the GI tract is functioning normally, the good microorganisms keep the bad ones in check. And this, in turn, helps keep us healthy and our bowel movements soft and regular.

So taking a probiotic supplement or eating plenty of probiotic-rich foods, including yogurt, sauerkraut, kimchi, and kefir, may help you avoid constipation after surgery. In fact, a meta-analysis published in the American Journal of Clinical Nutrition found that probiotics can “improve whole gut transit time, stool frequency, and stool consistency.”

5. Get Moving

We discussed earlier that physical inactivity after surgery is one of the main contributors to postoperative constipation. So anything that gets you up and moving after your procedure will help get your GI tract functioning normally again.

Of course, if you’ve just undergone an operative procedure, we’re not talking lots of heavy aerobic exercise. But, if it’s all right with your health care provider, even walking around the hospital or your house can help get things moving again.

6. Keep Extra Help on Hand

Sometimes dietary changes and physical activity aren’t enough to overcome postoperative constipation, so your health care provider may prescribe a stool softener, such as Colace (docusate), or recommend an over-the-counter laxative, such as:

  • Senokot (senna)
  • MiraLAX (polyethylene glycol)
  • FiberCon (calcium polycarbophil)
  • Milk of Magnesia (magnesium hydroxide)

Laxatives—especially stimulant laxatives—are most often used only as needed, but stool softeners can be used proactively to head off symptoms of constipation before they begin.

For all but the most severe cases of constipation, the combination of stool softener and laxative should be sufficient to achieve a normal bowel movement. However, if more help is needed, a suppository, such as bisacodyl (Dulcolax), or Fleet enema can be used as well.

7. Take Amino Acids

They may not be the first thing that comes to mind when thinking about ways to prevent and treat postoperative constipation, but amino acids are involved in almost every biological process that goes on in the body and play a crucial role in gut health.

In fact, amino acids help maintain proper functioning of the GI tract and even support healthy gut flora—which, as we discussed earlier, is vital for maintaining normal bowel movements.

What’s more, studies show that taking in a balanced supply of amino acids has the added benefit of helping speed recovery from surgery.

When to Contact a Health Care Professional

With proper care, postoperative constipation can be reduced or even eliminated. However, some people may experience severe constipation after surgery that’s difficult to treat. Without proper attention, prolonged chronic constipation can lead to complications, including:

  • Fecal impaction
  • Anal fissures
  • Hemorrhoids
  • Rectal prolapse

In addition, excessive straining while trying to have a bowel movement can cause heart rhythm abnormalities in susceptible patients or excessive stress on surgical incisions.

Therefore, if, after several days, you don’t find constipation relief with conservative measures or you experience sudden abdominal cramping or pain or blood in your stool, don’t hesitate to contact your health care provider immediately.

7 Ways to Prevent and Treat Constipation After Surgery

Pinched Nerve in Hip? Everything You Need to Know About Treating and Preventing This Common Condition

Pinched nerve in hip? This common condition can be painful and frustrating to treat. However, with conservative care and targeted exercises, most cases of pinched nerves can be easily treated in the comfort of your own home.

If you’ve ever dealt with a pinched nerve in your hip, you know how painful, frustrating, and downright depressing it can be. But the good news is that there are a number of effective techniques available that can help you take care of the condition right in the comfort of your own home. So come with us as we discuss what causes a pinched nerve in the hip and what you can do to treat the pain you’re having now and prevent it from coming back later.

Pinched Nerve in Hip: What Causes It?

Whether it’s your back, neck, hip, or hand, if too much pressure is applied to a nerve, its normal function is disrupted and the nerve is said to be pinched.

How does a nerve become pinched?

It depends on where in the body the problem occurs.

For example, a herniated disc can pinch a nerve when the bone or cartilage of the spine comes in contact with the nerve root. By contrast, a pinched nerve resulting from carpal tunnel syndrome may be caused by a nearby tendon sheath, bone, or ligament rubbing against or pressing on the nerve.

A similar process can occur in or around the hip.

Common Symptoms of a Pinched Nerve

When a nerve is pinched, pressed on, or otherwise irritated by the surrounding bone or soft tissue, a number of unpleasant symptoms may result. Common symptoms you may notice include:

  • Tingling
  • Numbness
  • Decreased sensation
  • Muscle weakness
  • Aching hip or leg pain
  • Burning pain in the affected area
  • Sharp pain in the groin, hip, or thigh

Risk Factors for a Pinched Nerve

Regardless of where it occurs, a pinched nerve doesn’t just happen. Something needs to trigger it. Risk factors for developing a pinched nerve in the hip include:

  • Improper sleeping position
  • Sedentary lifestyle
  • Obesity
  • Diabetes
  • Pregnancy
  • Bone spurs
  • Herniated disc
  • Traumatic or overuse injuries

What Causes a Pinched Nerve in the Hip?

Diagnosing a Pinched Nerve in the Hip

Most cases of pinched nerves resolve quickly and leave no lasting damage. However, if the root cause of the nerve compression isn’t resolved, permanent nerve damage and chronic pain may result.

So if you’re experiencing symptoms of a pinched nerve that don’t respond fairly quickly to conservative treatment, you should see your health care provider. After performing a physical examination and speaking with you about your symptoms, they may recommend diagnostic testing. This may include:

  • Ultrasound: This noninvasive procedure uses sound waves to look for areas of nerve compression.
  • Magnetic resonance imaging (MRI): Unlike an ultrasound, an MRI uses large magnets to create a much more detailed image of the affected area.
  • Electromyograophy (EMG): This minimally invasive test looks for disruptions in the electrical activity in muscles via the use of a small needle electrode inserted through the skin.

Pinched Nerve in Hip: Conservative Treatment

Unless you’ve suffered a serious injury or have a disc injury that’s threatening permanent damage to your spinal cord, the good news is that all but the most severe cases of pinched nerves can be successfully treated at home using conservative treatment options. These may include:

  • Rest: Avoiding as much as possible any activities that lead to an aggravation of nerve pain symptoms can relieve irritation on the nerve and allow it to heal.
  • Anti-inflammatory medications: The use of over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen and ibuprofen or natural anti-inflammatories like turmeric can assist with pain relief and help reduce swelling around the nerve.
  • Hot and cold packs: The use of hot and cold packs increases circulation and brings vital nutrients to the affected area, which can assist with swelling and pain.

Diagnostic Tests for a Pinched Nerve in the Hip

7 Exercises to Help Treat and Prevent a Pinched Nerve in the Hip

Because a pinched nerve in the hip is often caused by irritation from the surrounding soft tissues, exercises that gently stretch the muscles and tendons can be a great way to take pressure off the nerve.

However, it’s important to remember that the operative term here is gentle—aggressive stretching or vigorous exercise will only exacerbate the problem. With that in mind, we now offer these seven exercises proven to help treat and prevent the pain of a pinched nerve in the hip.

But, as always, if you have a medical condition that may affect your ability to safely perform any of these exercises, or if you simply need more guidance, be sure to speak with a health professional before proceeding.

1. Piriformis Stretch

A common cause of nerve pain in the hip is piriformis syndrome—a painful condition that’s grown in tandem with the prevalence of sedentary lifestyles. In piriformis syndrome, a tight piriformis muscle rubs against the sciatic nerve, causing hip pain and symptoms of sciatica.

However, it’s relatively easy to stretch the piriformis—and there are a number of ways to go about it.

The following version of the piriformis stretch can be performed on the floor or even your bed. Just follow these guidelines:

  1. Lie down and draw your knees up until your feet are flat on the floor (or other surface).
  2. Cross one leg until the ankle rests just above the knee of the opposite leg.
  3. Slide the opposite foot closer to the body.
  4. Grasp the supporting leg under the knee with your hands or a strap and pull it toward you.
  5. Hold the stretch at the position that works best for you for 15 to 30 seconds.
  6. Repeat 3 times on each side.

A variation of the piriformis stretch called the lying crossover stretch can be performed by following these guidelines:

  1. Repeat steps 1 and 2 above.
  2. Grasp the knee of the crossed leg and pull it up and over toward the opposite shoulder.
  3. Stretch can be altered by keeping the supporting leg up or sliding it out straight.
  4. Hold the stretch at the position that works best for you for 15 to 30 seconds.
  5. Repeat 3 times on each side.

A third variation of the piriformis stretch is performed sitting up. To try this version, simply follow these guidelines:

  1. Sit up straight with one leg straight out and the other crossed over at the knee.
  2. Keep foot of crossed leg flat on the floor.
  3. Place the opposite elbow on the outside of the knee of the crossed leg.
  4. Hold the stretch for 15 to 30 seconds.
  5. Repeat 3 times on each side.

You can also stretch your piriformis while seated in a chair. Although you may not think a seated stretch would be very effective, it actually works quite well for the piriformis—and it can be performed just about anywhere. To perform this stretch, follow these guidelines.

  1. While seated in a chair, cross one leg over the other until the ankle rests just above the knee of the opposite leg.
  2. While sitting straight up, grasp the ankle and knee of the crossed leg and lean forward.
  3. For a deeper stretch, place your hand under the knee of the crossed leg and lift it toward you as you lean forward.
  4. For an even deeper stretch, rotate the body toward the knee of the crossed leg as you lift it toward you.

2. Hip Flexor Stretch

Another muscle that’s commonly implicated in hip pain is the iliopsoas. This muscle functions as the body’s main hip flexor, but when we sit for any length of time, it becomes shortened and tight. To stretch the iliopsoas muscle, follow these guidelines:

  1. Kneel with one leg in front of you, foot flat on the floor.
  2. Place your hands for support above the knee, tuck your pelvis, and press the hips forward.
  3. Hold the stretch for 10 to 30 seconds.
  4. Repeat on each side.

3. Outer Hip and Gluteal Stretch

When the gluteal muscles and muscles of the outer hip are tight, they can cause hip and low back pain. By stretching these muscles, you can relieve the tightness that contributes to pinched nerves.

An outer hip and gluteal stretch can be performed either lying or standing. To perform the floor version, simply follow these instructions:

  1. While sitting on the floor, cross one leg in front of you at a 90-degree angle and stretch the opposite leg behind you.
  2. Bend forward at the waist, centering your hips and flattening your back.
  3. Find the position that’s most comfortable for you and hold the stretch for 15 to 30 seconds.
  4. Repeat on each side.

For the standing version of the outer hip and gluteal stretch, follow these guidelines:

  1. While standing, pick one foot up and cross it over the opposite leg, resting the ankle above the knee.
  2. Holding this position and keeping your abdominal muscles tight, bend down as if you’re sitting in a chair.
  3. Find the position that’s most comfortable for you and hold the stretch for 10 to 30 seconds.
  4. Repeat on each side 2 to 3 times.

4. Sciatic Nerve Flossing

It may sound like a dental procedure, but nerve flossing is a specific set of movements that helps free entrapped nerves by causing them to glide back and forth through the tissues impinging on them. In other words, the nerve acts like a piece of dental floss sliding between your teeth.

Nerve flossing can be performed a number of different ways, so let’s cover a couple of them.

The first technique can be performed using these guidelines:

  1. While sitting on a surface that allows your legs to swing freely, flex your head forward while bending the affected knee back and pointing the toes.
  2. Next, straighten your leg and point your toes while simultaneously tilting your head back until you’re looking at the ceiling.
  3. Perform these movements slowly and repeat 10 times.

You can also perform nerve flossing using this technique:

  1. Lie on your back, raise one leg, and place your hands behind your raised knee.
  2. Pull your toes toward you and lift the leg, making sure to keep the femur (thighbone) straight.
  3. Continue raising the leg until you begin to feel tension in the hamstrings or tingling in the leg.
  4. Back off from the point of maximum tension by approximately half an inch and pump the foot 5 times, keeping the tibia (shinbone) straight.
  5. Lower the leg and repeat movement slowly 10 times.

5. Cat Camel Stretch

Another version of nerve flossing is called the cat camel stretch. Unlike the previous techniques, which focus on the whole body, the goal of the cat camel stretch is to increase flexibility in the spine, especially the lower back.

To perform the cat camel stretch, simply follow these guidelines:

  1. While kneeling on all fours, slowly and gently arch the back and then lower again until the back is concave.
  2. After a few repetitions, increase the movement by simultaneously arching the back and lowering the head and then lowering the back while raising the head until you’re looking at the ceiling.
  3. Perform the movement slowly and repeat 15 to 20 times.

6. McKenzie Press-Ups

A simple exercise to improve the mobility of your lower back and relieve symptoms of sciatica is the McKenzie press-up. To perform this exercise, follow these instructions:

  1. Lie face down on the floor with the legs relaxed.
  2. Place the palms face down on the floor at about shoulder level.
  3. Press the upper body up, keeping the hips on the floor and the lower body completely relaxed.
  4. Repeat 10 times.

7. Bird Dog Stretch

The bird dog stretch is a deceptively simple stretch that helps strengthen the so-called posterior chain—the muscles that run along the back of the body.

To perform this stretch, follow these guidelines:

  1. Kneel on the floor on all fours.
  2. While keeping your weight evenly distributed, simultaneously lift the right arm and left leg until both are parallel to the floor.
  3. Repeat on the opposite side.
  4. For an added challenge, bring the opposite knee and elbow together before performing the bird dog stretch on the opposite side.
  5. Perform three sets of five repetitions on each side.

A Word About Trigger Point Therapy

If you’re prone to pinched nerves, you might also want to look into learning a little something about self-applied trigger point massage.

What is trigger point massage, you ask?

Many of the same risk factors that predispose an individual to a pinched nerve can also predispose someone to developing myofascial trigger points—small, tightly contracted knots within a muscle.

These tiny areas are known as trigger points because circulation to them is restricted, cutting off the flow of oxygen and vital nutrients. This, in turn, leads to referred pain, which may affect both muscles and joints.

Over time, trigger points can affect the function of the muscles around them, which can lead to symptoms of a pinched nerve.

While trigger point massage is relatively easy to do—and makes a great companion to all of the exercises listed above—there is a small learning curve. Therefore, if you’re interested in this proven pain relief technique, we recommend picking up a copy of the excellent reference guide the Trigger Point Therapy Workbook by Clair Davies.

By following the above techniques, signs and symptoms of a pinched nerve should begin to disappear within a few days. However, if pain is severe or doesn’t improve, don’t hesitate to speak with a qualified health care professional about further treatment.

Pinched Nerve in Hip? Try These 7 Exercises and Start Feeling Better Fast!

Silymarin: A Promising Treatment for Liver Disease and Much, Much More

Milk thistle has been used as a treatment for liver disease for thousands of years. And now studies are suggesting that its main component, silymarin, may have beneficial effects that go far beyond liver health. Let’s explore the many benefits.

Silymarin has been revered for centuries for its hepatoprotective properties. And, more recently, its potential protective effects on the entire body have been the subject of numerous investigations. In this article, we’re going to take a closer look at this powerful substance, find out what the studies have to say about the possible effects of silymarin, and uncover whether silymarin offers hope in the treatment of liver disease—and more.

What Is Silymarin?

Although the milk thistle plant (Silybum marianum) is sometimes known as silymarin, the term silymarin more correctly refers to an extract of the seeds of the milk thistle.

Like its parent plant, silymarin is made up of several different components, the eight most important of which are:

  1. Silybin A
  2. Silybin B
  3. Isosilybin A
  4. Isosilybin B
  5. Silydianin
  6. Silychristin
  7. Isosilychristin
  8. Taxifolin

Silybin A and B are commonly known as silibinin, which is also thought to be the major active ingredient in silymarin.

Silymarin is what’s known as a flavonolignan—a term that reflects the fact that it’s composed of two different polyphenols:

  • Flavonoids
  • Lignans

Polyphenols are the largest known category of plant chemicals. They’re known to act as both antioxidants and anti-inflammatories and have even been shown to slow down the proliferation and growth of cancer cells.

The antioxidant activity of polyphenols makes these plant chemicals effective scavengers of free radicals—unstable oxygen molecules that are linked to diseases associated with oxidative stress, including heart disease, type 2 diabetes, cancer, and Alzheimer’s disease.

Lignans, in particular, are also known for their ability to act as phytoestrogens. These phytonutrients are known to play a role in modulating hormonal imbalances, which may help reduce the risk of certain types of cancer.

What Is Silymarin?

Health Benefits of Silymarin

While silymarin is best known for its role in protecting against liver damage, including that caused by non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease, and hepatitis C, its polyphenolic nature means it has the potential to positively affect a number of health conditions.

But what exactly does the science have to say?

Let’s take a look.

Liver Health

The main mechanism by which silymarin and its components are thought to affect liver function is via the decrease in the production of free radicals and lipid peroxidation.

For example, a study published in the World Journal of Hepatology noted that silymarin inhibits the production of free radicals associated with the consumption of toxins like alcohol and acetaminophen and thus decreases lipid peroxidation and cellular damage.

Researchers also noted that silymarin increases the production of glutathione—the body’s master antioxidant—in the liver. What’s more, silymarin increases protein synthesis by liver cells called hepatocytes, which helps boost the liver’s innate immune response.

In addition, a clinical trial published in the Journal of Hepatology found that patients with liver cirrhosis who were given 140 milligrams of silymarin 3 times a day had significantly longer survival rates than patients who received a placebo. What’s more, researchers noted that silymarin treatment had no noted side effects.

A review published in the journal Molecules noted that the antioxidant, anti-inflammatory, and antifibrotic properties of silymarin make it useful in the treatment of conditions frequently associated with liver damage, including chronic liver diseases.

Studies have found that this hepatoprotection may extend to cases of acute and chronic hepatitis C as well. For example, a study published in the journal Hepatology found that silymarin helps block entry of hepatitis C into liver cells as well as cell-to-cell virus transmission.

Interestingly, a milk thistle extract called Legalon SIL, which is a proprietary form of silibinin given as an intravenous injection, has been found in studies to effectively reverse mushroom poisonings related to ingestion of Amanita phalloides—the death cap mushroom.

How does it work?

A study published in the journal Current Pharmaceutical Biotechnology noted that silibinin interacts with specific hepatic proteins to block cellular uptake of amatoxin, which in turn halts the progress of liver failure, thus allowing the patient to recover.

Brain Health

The potential effect of silymarin on brain health has been investigated as well, and researchers have discovered that the same properties that make silymarin a potentially valuable tool in the treatment of liver disease may make it useful for the brain.

For example, a review published in the journal CNS Neuroscience & Therapeutics noted that the neuroprotective effect of silymarin may be attributed to its antioxidant activity as well as its ability to modulate cellular apoptosis, inflammation, and amyloid plaque deposition.

Researchers even went so far as to say that silymarin’s properties make it a potential “wonder drug” in the treatment of neurodegenerative disorders—though they did note that flavonoids generally have the ability to cross the blood-brain barrier, this capacity should be established in silymarin prior to clinical studies.

Endocrine and Heart Health

Silymarin’s ability to mitigate oxidative stress has made it of interest to researchers studying ways to prevent and treat both diabetes and heart disease.

In a randomized controlled trial published in Phytotherapy Research that looked at the effects of silymarin on patients with type 2 diabetes, researchers found that treatment with silymarin 200 milligrams 3 times a day for 4 months resulted in significant decreases in fasting blood sugar, hemoglobin A1c, total cholesterol, triglycerides, low-density lipoprotein (LDL)—the so-called “bad” cholesterol—and the liver enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT).

These remarkable results hold promise not only for those diagnosed with type 2 diabetes but also for the millions suffering from heart disease, insulin resistance, or fatty liver disease.

Immune Health

Earlier we noted that silymarin has been noted to boost protein synthesis in the liver and thus stimulate the liver’s innate immune response. This positive effect on the liver has been found in some studies to extend to the immune system as a whole.

For example, a study published in the journal Medical Science Monitor found that a standardized milk thistle extract boosts the proliferation of lymphocytes as well as several markers associated with an increase in overall immune response.

Skin Health

The antioxidant activity of silymarin may also have a role to play in skin health. A study published in the journal Molecules found that silymarin was effective against UVA radiation and the enzymes that break down collagen and elastin—proteins that give skin firmness and elasticity.

Another study published in the International Journal of Oncology that utilized an animal model found that topically applied silymarin provided photoprotection to the skin and inhibited carcinogenesis.

These findings led researchers to conclude that silymarin may be a useful addition to standard sunscreens and may have a potential place in the treatment of skin diseases associated with UV radiation.

Interestingly, silymarin’s antioxidant activity may also make it a possible treatment for acne.

For example, a clinical study published in the Journal of Clinical & Experimental Dermatology Research found that patients with acne vulgaris who were treated with silymarin 70 milligrams 3 times a day, in the form of the dietary supplement Legalon, experienced an astonishing 271% increase in serum levels of glutathione and a 53% decrease in acne lesions.

Cancer

As just noted, silymarin has been found in studies to protect the skin from dangerous UV radiation—a known risk factor in skin cancer. In addition, studies have demonstrated that it may be a useful adjunct to the prevention and treatment of other types of cancers as well.

For example, a review published in the Journal of Biomedical Research noted that silibinin exhibits significant preventive and therapeutic activity against numerous epithelial cancers, including colon cancer. What’s more, researchers noted that silibinin interferes with the proliferation and growth of colon cancer in several ways:

  • It induces cell cycle arrest.
  • It causes cell death.
  • It interferes with cellular metabolism.
  • It inhibits signaling and regulatory pathways involved in angiogenesis, inflammatory responses, and tumorigenesis.

In addition, a review published in the journal Cancer Letters noted that a number of studies have established the role of silymarin in the prevention and treatment of a number of other cancers, including prostate, ovarian, lung, bladder, and breast cancers.

As you can see, the benefits of silymarin, as documented in multiple studies, are potentially vast. However, it may be possible to get even more out of this remarkable flavonolignan by ensuring you’re receiving a balanced supply of amino acids.

Why Amino Acids?

The role of amino acids in creating the proteins that build our muscles and ensuring the proper functioning of almost every biochemical process has earned these organic compounds the deserved title of “the building blocks of life.”

What’s more, amino acids are so crucial to life that all the organs and tissues in our bodies must have a balanced supply in order to function properly.

Which means that having a steady supply—especially of the nine essential amino acids, which our bodies can’t form on their own and must receive from foods and supplements—is important not just for our overall health but also for supporting the body during times of disease.

In fact, numerous studies have documented the effects amino acids have on everything from Alzheimer’s disease to heart failure, diabetes, and fatty liver disease.

So if you’re currently suffering from liver disease—or any of the other conditions studies have found may benefit from silymarin treatment—don’t hesitate to speak with a qualified health care professional about the potential benefits of adding silymarin and a balanced essential amino acid supplement to your therapy regimen.

10 Health Conditions That May Benefit from Silymarin Treatment

Cellular Regeneration: The Minute Mechanics of Healing and Longevity (Plus How to Support Them)

Cellular regeneration: discover what scientists have revealed in animal studies of limb and tissue regeneration, and how that information can potentially help in areas of human health, healing, and longevity. 

Regenerative medicine is a branch of research that specializes in tissue engineering and tissue regeneration. It is molecular biology that focuses on restoring and rejuvenating cells, tissues, and organs to help either return or establish normal functioning. Whether this is done in the hopes of wound healing or in an anti-aging effort, the science is microscopic, and yet you can help maintain certain aspects of cellular regeneration. Read on to learn how, plus discover the different types of amazing cellular regeneration that occur throughout the animal kingdom.

The Body’s Regenerative Capacity

Your body is regularly engaged in tissue repair and replacement. Muscle cells deplete and are replaced, skin cells are in a constant state of turnover, and the endothelial lining of your blood vessels is regenerated thanks to stem cells produced by your bone marrow (adult mesenchymal stem cells, distinct from embryonic stem cells).

This is not unique to humans. Animal models have shown that creatures such as frogs and salamanders can regenerate whole body parts if they’ve been damaged, and among invertebrates (animals without spines), flatworm (planarian) regeneration is far more impressive than synthesizing a new salamander limb—flatworms can regenerate their heads or tails if they’ve been bisected from either end.

Cell regeneration occurs as a reaction to damaged tissue or apoptosis (cell death), and regenerative biology is a complex balance that involves stem cell proliferation and cell dedifferentiation (the process by which a cell changes from one cell type to another by regressing from a specialized cell back into a state more reminiscent of stem cells, and then specializing again to be repurposed).

The science in this area seeks to clarify these operations with the hopes of improving healing outcomes and extending a healthy life indefinitely (maybe even forever).

The Body's Regenerative Capacity

Cellular Regeneration: The Line Between Fact and Fiction

Science fiction seems too good to be true, but sometimes nature still outperforms imagination. Take the TV series Doctor Who wherein a Time Lord from a distant planet regenerates his (or more recently her) entire body. Real-life creatures are able to do better than the Doctor, regenerating whole body parts that are identical to the ones they’re replacing.

Regenerating complex tissue structures has long been an interest of scientists, specifically how to safely influence DNA, RNA, and cell signaling pathways without causing overexpression and possibly cancer formation. We’ve got the scoop on some of the most fascinating areas of cellular regeneration research.

1. Restoring Life from Death

Scientists are finding that programmed cell death (apoptosis) may be part of what triggers regenerative responses in wound healing and tissue repair. Identifying the local responses at the amputation site of regenerative animals helps scientists understand how such seemingly miraculous regeneration is possible. One long-known example is Hydra.

Hydra is a freshwater polyp from the same family as sea anemones, corals, and jellyfish known as Phylum Cnidaria. In the 1700s, this was the first instance of scientific research in animal regeneration.

Hydra’s form consists of endodermal and ectodermal layers divided by an extracellular matrix of neurons and interstitial stem cells that generate neurons and other cell types (such as germ and gland cells). Small pieces of Hydra tissue can regenerate the entire rest of the organism, forming a whole new, symmetrical, and functioning animal.

In studying the different response pathways associated with head and foot regeneration of the organism, many different lines of communication were identified as unique, especially to head regeneration. However, the precise signaling that activates these separate lines of regeneration at the site of injury are yet to be determined, despite hundreds of years of scientific exploration.

Beyond Hydra, other animals also display mechanisms for regeneration, like planarians, Xenopus (aquatic frogs), and newts. Scientists have learned that caspase inhibitors can block the tail regeneration of Xenopus larvae, impeding the apoptosis signaling that is also essential in Hydra regeneration. Nerves fail to reach towards the amputation site, proliferation is inhibited, and while it’s still unclear exactly how caspase interrupts this process, the fact that it does helps narrow the scope of research into what causes successful regeneration.

What is clear is that cell death signaling plays a direct role in promoting regeneration and wound healing. In Drosophila (small fruit flies), larval wing discs are able to regenerate fully sized wings after being hit with radiation that kills over 50% of the cells. Apoptosis signaling is also known to factor into liver regeneration in mice (activating what is called the “phoenix rising” pathway). All of these findings help clarify the role that dead and dying cells play in regenerating new life and limb.

2. Creating Spare Parts

The examples of regeneration mentioned above often involve replacing an amputated limb or tissue structure, which requires the production of new cells. That means a great number of undifferentiated cells are dispatched to the injury site. These are known as regeneration blastema, which scientists are still exploring in relation to whether they are pluripotent (able to give rise to all cell types in the body like embryonic stem cells), multipotent (able to differentiate into multiple cell types, but not all, like adult stem cells), or have more limited potential.

These new cells can come from multiple sources, either the transdifferentiation/dedifferentiation of mature cells into stem cell-like precursors, deployment of a resident stem cell population, or the division of terminally differentiated cells (see our article on the Hayflick limit for more information on the limitations of differentiated cell division). Which modes are used depend on the species of lifeform and the tissues within that lifeform that are required.

For example, transdifferentiation and stem cells are both involved in the regeneration of Hydra. Freshwater planarians regenerate via stem cells, specifically mesenchymal stem cells (neoblasts), cells that cause certain repairs and regenerations in humans as well. Injecting fresh neoblasts into planarians that have been lethally irradiated can restore their regenerative capacity.

When speaking of vertebrates, there is still so much that scientists have yet to pin down. For example, plenty of vertebrate tissues have adult stem cells that help maintain homeostasis and tissue turnover, but their role is not exclusive, as other cell types are used in different circumstances. For instance in liver healing and regeneration, liver progenitor cells are the source of new hepatocytes in cases of chronic liver disease, but liver mass restoration after injury or partial hepatectomy is due more to proliferation from the remaining hepatocytes.

In zebrafish, heart regeneration is accomplished via the dedifferentiation of existing cardiomyocytes, which proliferate to create new cardiomyocytes to replace the lost heart tissue mass. In lens regeneration in newts, pigmented epithelial cells create a new lens via transdifferentiation, meaning they first dedifferentiate, then reenter the cell cycle and reemerge as new lens cells. Dedifferentiation also plays a role in appendage regeneration in axolotls and newts (urodele amphibians).

The stem cells present in the skeletal muscles of newts help to contribute to new tissue and muscle fiber creation during the limb regeneration process. For what helps contribute to human muscle fiber regeneration, read on to the final section of this article and learn what scientific understanding of animal regeneration helps teach us about human health and longevity.

3. Getting Some Nerve

For all the cells, signals, and pathways that work perfectly in concert to regenerate whole organisms and tissue structures, the entire operation often relies on having enough nerve. The clearest example is found in amphibians. Experiments have shown that denervated limbs fail to regenerate, proving that regeneration is reliant on sufficient innervation.

Researchers postulate that, since regenerative capabilities crisscross throughout the animal kingdom, there may have been many regenerative mechanisms that were lost to evolution. All of this effort into understanding the development and loss of cellular regeneration abilities feeds the same well: a need to know about the growth factors and molecular mechanisms that control cell fate, guide progenitor cells, and control the regenerative processes of all animal kind.

Cellular Regeneration: The Line Between Fact and Fiction

Tissue Regeneration and Amino Acids

Though human beings cannot regrow identical limbs or whole organs, there are places of regeneration in the human body that can be supported through good health and targeted medicine. One of those areas is liver regeneration and healing. Another is muscle repair and muscle tissue turnover that involves a constant cycle of cell death and cell regeneration. While it would be nice if all our muscle fiber types functioned this way (like the heart which unfortunately must carry the scars it receives), there are ways you can help support tissue regeneration and wound healing in your skeletal muscles—with amino acids!

  • Post-exercise support for aged skeletal muscleThis 2017 experiment found that essential amino acid (EAA) supplementation helped amplify skeletal muscle satellite cell proliferation in older men.
  • Leucine-enriched recovery: Emphasizing the specific essential amino acid leucine has been proven to help suppress exercise-induced muscle damage markers in the blood of younger men, preventing tissue damage before it occurs.
  • Accelerated wound healing: Evidence shows that dietary supplementation with EAAs helps accelerate wound healing in rat models of undressed wounds, with researchers concluding that this could also be a therapeutic approach in humans as well.
  • Collagen deposition: Researchers discovered that a specialized amino acid mixture of arginine, HMB, and glutamine was a safe and effective means of increasing wound repair in humans.
  • Limb preservationThough humans do not have the capacity to regenerate limbs, amino acids have been studied in relation to patients with limb-threatening diabetic foot ulcers. Researchers concluded that the amino acids associated with wound healing in diabetic foot ulcers differ from those reported for traditional traumatic wounds, suggesting a direct diagnostic and therapeutic connection between the two.

Tissue Regeneration and Amino Acids

Regeneration Research

The topic of cellular regeneration among the animal kingdom is vast and still not perfectly understood. Scientists are spurred to explore farther and deeper than ever to see if what is found among animals might translate to improved human health, healing, and longevity.

Cells with regenerative capabilities and the processes by which these abilities are activated and carried through to a successful result have been studied for centuries of cell biology, but are still not fully understood. What we do know is that the more humans understand the world, the better we are able to adapt to it, and that adaptation means taking advantage of the small regenerative capacity we do have to extend and improve our lives.