Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
1 Jul

Dear Mark: Bee Products, Unable to Squat After Knee Injury

For this week’s edition of Dear Mark, we’ve got a two-parter (although the first question has several parts to it). First up is a question about bee products and their effects (or non-effects) on human health. Are they miracle supplements? Are they all hype? Or is the truth somewhere in between? Find out below. Then, I try to help out Dan, a guy with a bum knee who, before injuring himself, based his entire workout routine around the back squat – which he can no longer perform safely. He wants to figure out a way to work out his lower body without the almighty squat at his disposal. Luckily, there are ways, which I’ll discuss below.

Let’s go.

Hey Mark,

I wanted to get your opinion on all the various bee products out there like pollen, royal jelly, propolis, honeycomb, etc. You did a post on honey already, but what about the other stuff? Is it worth looking into? There’s a lot of hype surrounding them and I know you can get to the bottom of it. Thanks!

Kim

Let’s start with pollen. Bee pollen is just what it sounds like: the plant pollen picked up by hairy bee legs in the course of their travels, mixed with regurgitated honey and nectar and enzymes and microbes, and rolled into a little ball. These little balls, packed with protein, B-vitamins, sugar, fatty acids, minerals, and other components that won’t show up on FitDay, serve as food for the hive’s inhabitants. No two pollen balls are alike, of course, so it’s impossible to say with any shred of confidence that “bee pollen contains this, this, that, that, and those in these specific amounts.” Bee pollen is a diverse mix of nutrients. Sounds interesting, for sure, but does it do anything?

Well, if you’re allergic to pollen, like millions of people with hay fever are, taking bee pollen could induce allergic reactions in you. Several studies suggest this, including one in allergic children and one in a single person taking a pollen supplement. I doubt it’s as grave a public danger as some would suggest, but that doesn’t mean it’s not a possibility worth consideration. I was unable to find any study showing that bee pollen supplements can have the opposite effect and ameliorate pollen allergy symptoms.

Another common claim for pollen is that it improves athletic performance, acting as an ergogenic aid. This review summarizes the evidence of that claim:

  • One study found that bee pollen increased the work capacities of weight lifters, although the increase was not statistically significant.
  • Another study found that college swimmers derived no benefit from pollen. Neither hemoglobin, red blood cells, nor overall performance were affected by bee pollen supplementation in any direction.
  • In cross country runners, bee pollen had no effect on performance, blood potassium levels, or hemoglobin.

There’s very little, if any, evidence for this claim.

That said, bee pollen does seem to be an interesting blend of antioxidant compounds. It’s basically a melange of plant residue, of phytonutrients and polyphenols and flavanoids from all across the land. Like most other plant phytonutrients, I could see it having some beneficial physiological effects that simply have yet to be catalogued. There’s already limited evidence that certain components of bee pollen are helpful against prostate cancer.

Onto royal jelly. If bee pollen is the meat-and-potatoes of the hive, royal jelly is the colostrum. It’s what baby bees eat in order to grow big and (relatively) strong, and it seems far more promising than bee pollen, with some very interesting properties.

For one, it contains primarily medium chain fatty acids, which some researchers think are responsible for the health effects of royal jelly. One in particular, 10-Hydroxy-trans-2-decenoic acid, has been shown to modulate the immune system, protect human skin against UVA damage, prevent endotoxin-induced inflammation, prevent the ability of cavity-producing bacteria to adhere to tooth surfaces, and increase collagen production. All that said, most of these studies were done in vitro, rather than live humans or animals, so take the results with a grain of salt.

In mice, oral doses of royal jelly increase expression of a neurotrophic factor. In other words, eating royal jelly may improve brain function. There are lots of anecdotes on health and supplement forums from people who report improved cognition after taking royal jelly for awhile. But you know what they say about anecdotes.

I’d say it might be worth trying if you can get a good deal. Royal jelly tends to be fairly expensive.

Honeycomb is the real deal. It’s a complete food, especially if you take it like the Hadza take their honeycomb: with vast numbers of bee larvae still attached. It’s packed with minerals, protein, B vitamins, antioxidants, fatty acids, and, yes, sugar, but a whole foods version of sugar with a very different metabolic effect. If you can get your hands on real honeycomb teeming with larvae, go for it!

Propolis is the glue that holds the honeycomb together. It’s a resinous mixture gathered from various plant and tree saps that plugs any unwanted entrances to the hive, provides structure, prevents diseases and parasites from entering, inhibits microbial infections, and reduces vibration. Propolis is also one of the richest sources of polyphenols, presumably because it’s basically an extract of dozens of plant essences. This one seems to have some merit.

There appear to be great potential benefits if in vitro studies pan out in humans, and the phytonutrient profile of bee products is quite broad and varied, but overall I’d say the evidence is inconclusive.

Dear Mark,

Recently, I tore the meniscus in my left knee. I’d previously been really into barbell lifting, particularly the squat. Basically, my whole workout regimen revolved around being able to squat. I had surgery, but I’m still not really ready to get back under the bar. Now I never feel like I’ve gotten a good workout. How do I keep from going crazy and is there a way to replace the squat?

Help!

Thanks,

Dan

Ha, if there’s one downside to the Internet’s obsession with the back squat, it’s that people feel they’re wasting their time in the gym if they don’t – or can’t – squat. That’s ridiculous. The squat is an incredible exercise, don’t get me wrong, but its absence does not necessarily nullify the effectiveness of a workout regimen. There are lots of things you can do to get a really strong lower body that don’t involve placing a bar across your back.

So, first of all, try to relax. You can still get a great workout.

Cycling sprints

Get a bike, sit astride it, and then pedal really really hard for a little while. Rest, repeat. There’s no other form of “cardio” with the cycling sprint’s potential toward leg hypertrophy and strength development (unless you’re doing something like lifting weights faster). If you don’t believe me, get a load of these. Yeah, yeah, those guys also do squats and stuff, but all that cycling plays the biggest role. Very few of my old endurance buddies would ever be called “muscular,” but the cyclists all had well-defined, sizable legs that dwarfed the rest of their bodies (without ever sniffing a squat rack).

  • Ideally, you’d do this on an actual mobile bike, but a stationary bike works too.
  • In my experience, the hardest bike sprints take place on slight inclines. You don’t want it so steep that you’re chugging along, barely able to pedal. You want it to be subtle, almost so subtle that you can’t even tell it’s uphill until you start pedaling. 
  • Slightly stand in your seat. Life your butt about an inch off the seat when you pedal. This seems to really put the focus on your thighs.
  • Don’t just “push” with your quads. Actively “pull” with your hamstrings, and don’t forget about your glutes. After a session of proper cycling sprints, your entire lower body should be fried.
  • Play around with gears until you find the right one for you. You want a nice balance of speed and effort, so that you can go really fast against a fairly high level of resistance.
  • For strength gains, fully recover in between sprints. For hypertrophy, shoot for a bit less rest.

Single leg work

Some people with knee injuries who can’t squat find they can do lunges, step-ups, or Bulgarian split squats without any pain. And some are the opposite: they can squat, but single leg work kills their knee. The reason for this probably comes down to how you squat, how the weight is distributed across your tissues, as well as the nature of your specific injury. One advantage of single leg work that might affect knee pain? It’s way easier to keep your torso upright during a lunge, step-up, or split squat.

Leg press

Before I’m consumed by a cloud of waxy maize, whey protein hydrolysate, and creatine given life by the raw anger of the Internet strength training community, allow me to explain myself. The leg press requires a machine, yeah. It’s not a squat, sure. You miss out on the upper body involvement, okay. But it’s a compound movement nonetheless. You’re using the entirety of your lower body to press a heavy weight. It may be inferior to the squat in terms of athletic and strength development, but it’s no slouch – and it’s a lot harder to mess up.

Don’t neglect the posterior chain

Knee injuries often limit knee flexion exercises like the squat while leaving the ability to perform hip extension exercises like deadlifts relatively untouched. So do them. Romanian deadlifts, kettlebell swings, traditional deadlifts, single leg deadlifts, whatever you prefer. If you can’t squat, your posterior chain – the glutes and the hamstrings – still require your attention. Plus, simply working your legs with a relatively heavy load without stressing the injured joint will help that joint get back to health, just from the movement and gentle stimulus.

That said, I would suggest that you try to maintain squat mobility throughout all this. Practice your Grok squat, as long as it doesn’t hurt your knee. You don’t have to add weight (just yet or ever), but you should be able to squat comfortably. It’s a good goal. Make sure you’re not just squatting wrong before you write yourself off.

That’s it for today, guys. Keep the questions coming and thanks for reading!

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. To bee or not to bee? My sense of humor is in question!

    Groktimus Primal wrote on July 1st, 2013
    • Sweet!

      Nocona wrote on July 1st, 2013
  2. Have to agree with the kettlebell recommendation. Swings are a great way to get in a short efficient whole body work out… But need to be properly trained with impeccable form of course.

    Bjjcaveman wrote on July 1st, 2013
    • Agree also with the kettlebells. i have a bad elbow (long story) and when it was really bad I had to stop completely doing pullups and hand stand pushups. I dedicated the time to several kettlebells exercises and wow, the effect was incredible, got a lot of strength and mobility

      wildgrok wrote on July 1st, 2013
    • No, you don’t. If you are using very heavy KB’s (which few people do), then yes, you want to use proper form. As long as you aren’t going crazy, doing hundreds, watching a couple youtube videos to get the basic technique down should be fine.

      me wrote on July 2nd, 2013
  3. Honeycomb with bee larvae still attached? No thanks. Tongue-in-cheek comment from Mark perhaps, but I’d rather get my vitamins and minerals elsewhere. Besides, if the bee population is really in as much trouble as I keep hearing, we shouldn’t be eating their young or decimating so much of their food supply.

    Shary wrote on July 1st, 2013
    • Actually, I think the more we eat, the more demand will go up, hence…More people will work to save the bees. Two ways to look at it!

      Nocona wrote on July 1st, 2013
    • yummy larvae …

      wildgrok wrote on July 1st, 2013
    • They eat it in Thailand. They cook it wrapped in banana leaves. It’s really good.

      Scott wrote on July 1st, 2013
  4. Waiting until I was fully recovered from knee surgery was key in my ability to do squatting motions again…crazy, I know…

    Graham wrote on July 1st, 2013
  5. I have always wondered about royal jelly, thanks for the clarification.

    Michelle wrote on July 1st, 2013
  6. I agree with nearly everything Mark says. To replace the squat – Trap Bar deadlift (also known as the Olympic Hex Bar.) Kettle Bell deadlift. If you don’t know how to do KB swings, learn the Goat Bag swing. Heavy Farmers walks. Bad knees often like reverse lunges. Hire a good Physical Therapist who deals in sports injuries to assess your squat form, preferably one who can administer the FMS. Why did the meniscus tear is a question I would like to see answered if it was me. Was it catastrophic, or long term due to poor hip and ankle mobility? I personally advise my clients against the leg press. It puts the back in a bad position and uses more leverage than strength. The Grok Squat vid is good advice. You may just need to regress to the lightest, simplest forms for a while. Relearn your movement patterns and you will rapidly get back to where you were.

    Chris Buck wrote on July 1st, 2013
  7. I also had surgery for a torn meniscus several years ago and key to my complete recovery (and the ability to do the heaviest squats of my life) was doing exactly what Mark recommends: using the bike to stay mobile and regain full range of motion and using the leg press and other exercises to maintain strength. I also did a lot of balance work on the Bosu. My trainer also took that time to teach me to bench press; a nice new challenge. Going slow and steady and not rushing back too quick really paid off.

    Susan wrote on July 1st, 2013
  8. I have never cared if any of the hype regarding bee pollen is true. I think it’s delicious. Oh, and thanks for the picture of the big beefy man-thighs. Made my morning.

    Diane wrote on July 1st, 2013
  9. Well, I have been using Bee Pollen and Bee Propolis for years. Personally… Any natural food substance that has all known vitamins, minerals and then some in a perfect balance… has to have some health giving benefits in my book… regardless of what the “experts” say. And as for Bee Propolis… Well, my own use proves that if I will take it at the first sign of a throat infection then I can beat the infection without Antibiotic using only the Propolis caps. I will take 2-3000mg every 2-3 hours for at least 2 days. If I an unable to get the propolis within 24 hours of the first sign of infection, then I usually will end up having to get antibiotic. You must catch it early as the Bee Propolis is natural. That’s been my experience. Hope it helps.

    Marco wrote on July 1st, 2013
  10. Hey for the torn meniscus guy:

    I had that issue, I had the arthroscopic surgery and you know what?
    It was magic! My right knee (the one with the surgery) is my good knee now. If I could get the surgery also in the left knee I would do it in a second.
    Just give it time, do your physiotherapy, you will be good as new or better.
    The only thing I get is sometimes a pop sound (no pain at all), and I was warned in advance it would happen.
    Right now I can do squats, jumps and Zumba!
    May the orthopedic surgeons and their magic tools live forever in Walhalla!

    wildgrok wrote on July 1st, 2013
  11. Any apiary will tell you that having larvae in the honeycomb is NOT a good thing. Screens are used to keep the queen out of the comb. Plus, a beekeeper would not want to harvest the larvae since they are future brood. So lucky my brother has hives! Best recipe for comb: slice of cucumber topped with some goat cheese, piece of comb and a walnut or pecan.

    Katie C. wrote on July 1st, 2013
    • Not any apiary in Tanzania, apparently.

      NN wrote on July 1st, 2013
  12. Mark and the Worker Bees,

    Great stuff as always. One quick clarification on the statement about royal jelly being “what baby bees eat to grow up to be big and (relatively) strong”…this is not exactly true. It’s actually quite a bit more profound than this.

    Royal jelly is what is given to the bees chosen to be queen bees…thus the “royal” moniker. The quote and link below offer a nice explanation.

    “The larvae that develop into workers and queens are genetically identical. But as a result of the royal jelly diet, the queen will develop functional ovaries and a larger abdomen for egg laying, while worker bees remain sterile. She’ll also develop the necessary behaviors to act as queen, such as killing rival queens, making communication sounds known as “piping,” and going on “mating flights.” The queen is fed royal honey exclusively for the rest of her life.”

    -http://learn.genetics.utah.edu/content/epigenetics/nutrition/

    For me, this example from nature is a wonderful metaphor about the behavior and lifestyle power of living primally. Maybe we are all royalty waiting to be crowned once we empower our epigenome with the high quality nutritional signaling that comes from living in accord with the ideal potentialities inherent to the bodies and ecosystems our ancestors passed down to us?

    May we each find our inner kings and queens!

    Hal Knowles wrote on July 1st, 2013
  13. I had torn meniscus in each knee 1.5 years apart. It was a good year after the second surgery that I was able to do a proper squat. Give it time. You’ll get there!

    Liza wrote on July 1st, 2013
  14. Couldn’t agree more with the advice re: cycling and rehab therapy. I’m 47 and about 5 months out from ACL/meniscus surgery. I’m back to Crossfit 3-4x a week, and am gaining strength back in all my lifts, especially the squats. It will take time, and patience, but you will be back to squattting again. Be diligent(but smart. DO NOT over do it) with your rehab. Good luck!!!

    Dennis wrote on July 1st, 2013
  15. Bee propolis really stops a sore throat ! One os the best medicines in Nature!

    eny wrote on July 1st, 2013
  16. Regarding the gentleman with the knee problem. Have you gone to PT? If not that might be a good place to start to make sure you get all of your range of motion back. Another good alternative is a book you can buy on Amazon. It’s called Treat Your Own Knee by Robin McKenzie. It’s written for patients and shows you how to help treat and keep your knees healthy.

    Gerry wrote on July 1st, 2013
  17. Cycling sprints are great. Just go out for a ride doing about 120 beats per minute average and go for it on the short (400 yard) uphill bits. The reserve you get by only being at 60-65% of MHR most of the time allows you to keep the same speed over hills, railway bridges, etc. or even go a bit faster.

    Strava and similar apps on your smartphone are fun addition because there are defined sections on there that people have ridden and set times. And if you don’t fancy a full long ride then go out, warm up and do a couple of the sprints local to your house (or define new ones). It’s great when get a top 10 and even better when you get a KOM/QOM (top time).

    lee wrote on July 2nd, 2013
  18. I’ve never really taken notice of bee pollen, or honey, or any kind of bee products really. It only really started to be taken notice by me when we went on a family trip to Thailand and we go happened to be ‘tricked’ (I say tricked cause the salesman was really good) into buying some royal bee pollen. Of course, after going through buyer’s remorse, I finally tried some and I have to say I have ever since been having regular pollen!! :D

    Avery wrote on July 2nd, 2013
  19. If you leave bee pollen in yogurt for a while it will dissolve. It tastes really good.
    I’ve eaten a fair share and believe it’s a healthy food. Ginseng and bee pollen or royal jelly are two of my favourite supplemental foods.
    I read that Bruce Lee used to drink a ginseng royal jelly mixture.

    Animanarchy wrote on July 3rd, 2013
  20. How do those cyclists find jeans that fit?!

    tigerchik wrote on July 3rd, 2013
  21. Bee’s Knees! First the knees, I had med/ meniscus tear/surge. two years ago and ended up with chronic, sharp pain at about a 20 degree bend (in flexion and extension). This seem to have developed from all the months of pain protective, movement patterns that I had habituated during recovery. Its resolution required lots of work on a foam roller(I.T. band, etc.) and work on the gnarly bits with a lacrosse ball. All while pursuing enhanced ROM, “primal squat”, strengthening, etc… . It took time, but my knee is great now. Now the buzz on bee pollen. I used local bee pollen many years ago to try to affect some change in seasonal allergies that would hit me hard for a few days in the late summer. If memory serves me, I started taking it in the spring and ended up having very mild allergic reactions off and on throughout the summer, but my typical severe reaction(to ragweed) was seasonally absent.

    Russ wrote on July 4th, 2013
  22. Bee propolis was really helpful for a long standing herpes simplex sore I had that nothing else seemed to fix. it stung but the sore was gone in days, after years of fluctuating via diet, stress-management anti-virals etc.

    Anon for this one! wrote on July 5th, 2013
  23. i accept the challenge to find a study in support of this folk remedy for allergy – in short it does seem to have a scientiffic basis if you need such a thing, stops your mast cells from releasing their payload. you need to pay to read the whole study.

    J Med Food. 2008 Mar;11(1):14-20. doi: 10.1089/jmf.2006.163.
    Inhibitory effect of honeybee-collected pollen on mast cell degranulation in vivo and in vitro.
    Ishikawa Y, Tokura T, Nakano N, Hara M, Niyonsaba F, Ushio H, Yamamoto Y, Tadokoro T, Okumura K, Ogawa H.
    Source

    Atopy (Allergy) Research Center, Juntendo University School of Medicine, Tokyo, Japan.”The inhibitory effect of BP on mast cell degranulation by preventing IgE binding was confirmed by the reduced levels of protein tyrosine phosphorylation, which occurred as downstream events in activated mast cells via Fc epsilon RI. These results first revealed that the anti-allergic action of BP was exerted by inhibiting the Fc epsilon RI-mediated activation of mast cells, which plays important roles, not only in the early phase, but also in the late phase of allergic reactions.”

    carolyn wrote on July 9th, 2013
  24. This is very helpful! I tore my acl and meniscus and had surgery about 7 weeks ago. I still can’t squat, which is killing me because I use to love going to my bootcamp classes that focused on squats, burpies, etc.

    lil wrote on August 6th, 2013
  25. Thanks for this — I was wondering about royal jelly, so I googled and was glad to see you’d addressed it.
    Eating bee pollen landed me in the ER, due to an anaphylactic reaction. I hesitate to say it was a blessing in disguise, but it prompted investigation into a honeybee allergy, which I had vaguely wondered about because of what had happened the last time I had been stung (almost passed out).
    Anyway, I was indeed allergic, so was able to begin venom immunotherapy. After 3 years of that, I no longer react anaphylactically to actual bee stings (litmus test last year in my garden!).

    I had decided to try the bee pollen just as a general health supplement, not for allergies.
    For allergies, try a strong Nettles tea — a couple Tbsp dried nettles in a cup of boiling water, cover, let steep at least 15 minutes, then strain and squeeze out all the liquid from the nettles. Drink.
    For me this worked a lot better than Claritin (loratadine, 10mg) for when I would get my venom immunotherapy shots.

    Lindsey wrote on June 30th, 2014

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