Inspired living

Solving a case of gammy knees


“I’m so worried about Todd,” his mother sighed. “Sport is his entire life. He’s totally passionate about pursuing a career in football. Unfortunately, he seems to be prone to sore knees. He’s had to rest up a few times and this does help the pain, but as soon as he resumes soccer practice the problem comes back.”

Todd was 13 years old, much more conscious of the benefits of healthy eating than most lads his age and physically a good specimen. “It started in just one knee,” his mother continued, “but now both knees hurt.”

On examination, the area below Todd’s kneecaps was tender when pressure was applied. Anatomically, this is the tibial tubercle and the condition is actually quite common in young boys (less so in girls). It is often associated with a growth spurt. The tendon that attaches the quadriceps muscle to the knee joint tightens up, placing a strain on the growing bone. Movements that involve muscle contraction aggravate the condition and activities such as climbing stairs, running, squatting and kicking a ball result in inflammation, swelling and pain.

Young bodies often don’t yield nearly as many clues as an older, time-dented version, so more information was required in an attempt to shed light on the cause of Todd’s sport-disrupting knee pain.

Todd’s mother had a history of Crohn’s disease, vascular fragility and diabetes. She was also taking thyroid medication. On the paternal side, there was a strong tendency to raised cholesterol, asthma and cardiovascular problems.

Significant findings in relation to Todd’s own biochemistry included:

  • Marked sensitivity to inhaled air pollutants, especially smoke from all sources
  • Elevated hair lead level
  • Sensitivity to mercury, especially methyl mercury
  • Coxsackie virus sensitivity
  • Vitamin A deficiency
  • Vitamin C deficiency
  • Selenium deficiency
  • Mixed tocopherol deficiency
  • Gluten sensitivity

Although Todd ate more fresh produce than teenagers in general, his choice was rather select, definitely leaning to sweet-tooth gratification where fruits were concerned and avoidance of sulphur- and selenium-rich vegetables. He wasn’t at all keen on the brassica family such as Brussels sprouts, broccoli and cauliflower. He avoided garlic and onions and found chewing nuts difficult because of his braces.

The picture that gradually emerged was of a family missing out on a cluster of very basic and vital nutrients. Selenium is found in all tissues of our bodies.  However, the mineral is concentrated most highly in kidneys, pancreas, spleen and liver. Clinical experience has shown that sufferers of coeliac degeneration are at high risk of selenium deficiency, possibly because of poor absorption.  It has also been my experience that people sensitive to environmental chemicals and mercury have a much higher requirement for selenium-rich foods such as broccoli, Brazil nuts, cashews, celery, garlic, turnips, onions, free-range eggs and fresh fish, especially sustainably caught tuna.

So-called vitamin E is, in fact, a group of mixed tocopherols and related tocotrienols. They function as effective lipid-soluble antioxidants, inhibitors of platelet “stickiness”, free-radical scavengers, cell-membrane stabilisers, circulatory stimulants, supporters of drug metabolising genes and nerve protectors.

In supplemental form, they have proved invaluable in cases of cardiac muscle insufficiency, chronic liver ailments, connective-tissue disorders, nerve damage, abnormal platelet aggregation, stroke prevention, red blood-cell haemolysis and fragility, loss of deep-tendon reflexes, diabetic retinopathy and macular degeneration, poor wound healing, cholesterol reduction and skin cancer.

Research has shown that human cells grown in a medium enriched with extra vitamin E divided and lived much longer than cells grown in ordinary laboratory culture “broths”. This is worthy of attention seeing that vitamin E is used by virtually every tissue in your body. Because the bulk of vitamin E is stored in muscles, and because nutritional deficiency has been implicated in many muscular and neuromuscular problems, Todd was advised to take a supplement temporarily while getting used to increased, natural food sources including raw whole almonds, hazel nuts, pistachio nuts, fresh corn on the cob, biodynamic egg yolks and sunflowers kernels.

Most vitamin E supplements invariably concentrate only on the alpha form (d-alpha tocopherol). However, in nature, vitamin E actually is made up of alpha, beta, delta and gamma tocopherol fraction. In Todd’s case, I recommended a level of 400iu of mixed tocopherols morning and night for three weeks, together with 50mcg of selenium in the form of selenomethionine, three times daily.

Selenium, the vitamin E family and vitamin A have a synergistic effect. It’s well known that vitamin E augments the antioxidant effect of selenium and a study carried out in Finland demonstrated that men who died of smoking-related cancer had lower serum levels of selenium, vitamin A and vitamin E than a healthy control group.

At a follow-up appointment two weeks later, Todd was already showing marked benefit from his supplements and more varied food intake. Accordingly, his selenium boost was reduced to once a day but vitamin E was kept at the same dosage.

Selenium is a very important nutrient, particularly in today’s cancer-riddled society. There is a wealth of epidemiological data showing that adequate tissue reserves of selenium correlate with a lowered cancer risk. It has been known since 1969 that the blood levels of cancer patients are low in selenium. Modern refined foods are largely stripped of their selenium content. In fact, researchers found that processed foods measured 61 per cent less selenium than their fresh, unrefined counterparts. Milling grains alone results in a 50 per cent loss of this essential trace element.

Two weeks later, Todd’s mother called about a problem of her own. She reported that both Todd’s knees were fine, with no pain or discomfort. He was training full-on again and he’d added cycling and jogging to his keep-fit repertoire. Selenium supplementation was tapered off and discontinued and Todd’s gammy knee problem never recurred.


Karin Cutter runs a naturopathic clinic in Port Macquarie, New South Wales. T: 02 6582 4435


Karin Cutter

Karin Cutter ran a naturopathic clinic in Port Macquarie, NSW, Australia.