Oh My Joints!

The more complex a joint, the more likely it will get injured in sport. Knees are the most complex. Followed by the ankle and shoulder.

All the synovial joints rely on the integrity of their cartilage for healthy movement. Cartilage is the soft tissue layer on either side of the joint that cushions the ends of the bones. Bones have a slick of synovial fluid between them that lubricates the moving parts and enables them to slide freely.

Sports are tough on cartilage, continually creating rough spots and wearing it out. Sports are also tough on the synovial fluid. Whenever the intensity of your exercise causes the rate of wear and tear to exceed the maximum rate at which you can produce new cartilage and synovial fluid, you get inflammation, pain, and stiffness of the joints (2).

Synovial fluid, a complex mixture that contains a viscous gel.  Hyaluronic acid is the water-holding molecule.  One gram will hold more than a thousand grams of water.  Its gel structure retains the water that cushions nerves and joints, and also provides the shape and form to the human eye and skin. The harder you exercise the more hyaluronan you use. Your hyaluronan acid decreases with aging, and not collagen as frequently claimed, this is the main cause of wrinkles and fine lines.

Science has discovered natural substances that speed the body’s processes of renewing cartilage and synovial fluid, and inhibit their decline. Here are the best of those substances that research shows improve cartilage and lubrication of joints in controlled trials.

1. Collagen- Athletes certainly need the extra collagen in their joints, and should do everything that can maintain it. Athletes can preserve collagen levels in joints by eating a diet high in free-range poultry, wild fish, and shellfish or through supplementation (3-5). I
2. Glucosamine sulfate – Glucosamine taken as a dietary supplement increases glucosamine levels in joints (7-13).
3. Chondroitin sulphate – Taken as a supplement, chondroitin sulfate has been successful in increasing the quality and volume of new cartilage in numerous controlled trials over the last 20 years (13-17). Research recommends that athletes routinely use glucosamine sulfate and chondroitin sulfate daily.  Overall research recommends doubling normal doses of each daily when doing intense training, such as runs longer than 15 miles in preparation for a marathon, or the four weeks before a big game.
4. Hyaluronan- A major component of the synovial lubricating system of joints is hyaluronan. For 50 years, researchers have been using various formulations of hyaluronic acid to determine if it will increase production of synovial fluid. The big problem has been absorption, because hyaluronic acid is usually a whopping molecule, seemingly too big to pass through the gut wall.  So the usual therapy used with patients involves injecting the hyaluronan directly into the joints. Some oral formulations now offer small molecule hyaluronan to overcome the absorption problem.  Recent reviews of the evidence, however, indicate that even large molecule hyaluronan taken by mouth does increase synovial fluid in joints (7). Research recommends supplementation of hyaluronic acid for athletes.
5. Methyl-sulphonyl-methane (MSM) – To make new cartilage, the body also needs a lot of sulfur, which is likely why the sulfate form of glucosamine is the most successful in creating cartilage. Combined with alliums in the everyday diet to increase availability of sulfur, runners have had great success with sulfur especially for knee pain. If you are not getting sufficient alliums, that is onions, garlic, or leeks every day, then you will need to take daily supplements of basic sulfur as MSM.