If you think osteoarthritis is something that afflicts only ripening baby boomers and nursing-home residents, sit down and talk with former world-class gymnast Bart Conner someday, if the opportunity ever presents itself. Conner, who more than 20 years ago took home two Olympic gold medals and was considered one of America's top all-around athletes, today can hardly take out the garbage. He was diagnosed with osteoarthritis in his mid-20s.
Or talk with professional tennis phenom Martina Hingis, who, at 21, had to take a hiatus from the game due to severe pain in her left ankle, knee and hip. Her doctors say she already may be showing signs of osteoarthritis in her injured joints.
You can even talk to any bodybuilder who has been training heavy for many years. They'll tell you about their joint problems!
Indeed, a growing number of strength athletes in their 20s and 30s are discovering, first hand, that osteoarthritis isn't just a problem for grandma or grandpa anymore. A study from the University of Washington supports many other studies that show athletes, including and especially
who hit it hard day in and day out, are at high risk for the
debilitating joint disease
At present, doctors believe that
osteoarthritis afflicts more than 20 million Americans
. By 2020, that number is expected to reach 40 million. Indeed, some researchers think we're headed for a full-blown epidemic of degenerative joint disease. Results of an October 2002 nationwide survey from the Centers for Disease Control and Prevention show that 69.9 million adults--or one-third of the U.S. adult population--suffer from arthritis or chronic joint pain symptoms.
How joint disease can bring your training to a "grinding" halt
Osteoarthritis is a degenerative joint condition characterized by the erosion of the cartilage at the ends of the bones. Cartilage is the shock absorber of the joint and without it, joint problems can occur. Due to wear and tear on the joints, the once tough and slippery cartilage that separates the bones may become soft, frayed and thinned--it basically wears through like an old sock, leaving rough boney surfaces to grind on one another every time the joint moves. Scientists have also recently identified a host of other things that can cause cartilage degradation and osteoarthritis. Weak quadriceps muscles (for the knees) can stress the joint. Eroding cartilage can cause painful bone spurs but changes in bone structure can actually erode cartilage as well. When cartilage erodes, certain immune cells come in and help get rid of that tissue but they also seem to attack healthy joint tissue which can cause inflammation. Finally, certain genes play a role in predetermining cartilage status. Left untreated and unchecked, this can become very debilitating for the hard-training athlete. Chronic osteoarthritis has ended the careers of numerous athletes, including, perhaps, future Hall of Fame quarterback and two-time Super Bowl Champion John Elway, formerly of the Denver Broncos. Many close to John say he still had the "want" to play another year or two, but his joints just couldn't take the punishment. Elway was sacked an NFL-record 559 times.
Treatment and preventative options
Along with an estimated 5 million other Americans, Elway takes two nutrients called glucosamine and chondroitin sulfate, which taken together or separately are now America's top-selling joint supplements. The two nutrients naturally found around cartilage cells have been shown in clinical trials to be effective for people with osteoarthritis by alleviating symptoms and perhaps even repairing battered joints. Let's take a closer look at these and a few of the other
top joint products
and the research surrounding their use.
Glucosamine, a naturally occurring compound comprised of glucose and a derivative of the amino acid glutamine, is an integral part of all forms of connective tissue in your body: cartilage, ligaments and tendons. It can even serve as a precursor to synovial (joint) fluid by stimulating something called glycosaminoglycans (GAG's). Most of the glucosamine on the market is commercially derived from shellfish so if you have an allergy, it may be best to avoid.
Double-blind studies have shown that
glucosamine may be more effective than ibuprofen for relieving the pain and inflammation of osteoarthritis
. And although the pain-relieving effects of glucosamine don't seem to be as immediate as with analgesics, the important point here is glucosamine may work quite differently to relieve pain, according to some research, by actually regenerating cartilage--and thus, repairing the arthritic damage.
In on study published in the January 27, 2001 edition of the scientific journal
, a team of researchers from the Bone and Cartilage Metabolism Unit of the CHU Centre Ville in Liege, Belgium, tested glucosamine on 212 people with osteoarthritis in their knees. Subjects were given either a placebo or 1,500 milligrams of glucosamine daily over three years. By comparing a series of knee X-rays among patients who consumed glucosamine or a placebo, researchers reported that by the end of the study, patients taking glucosamine experienced a 20 percent to 25 percent improvement of their symptoms, while the placebo group experienced a slight worsening of symptoms. The X-rays showed that joint spaces in the untreated patients had narrowed by an average of .31 mm, compared to no significant joint-space loss among those who supplemented with glucosamine.
"We have reported here that long-term administration of glucosamine sulphate can prevent joint structure changes -- with a significant improvement in symptoms," notes lead study researcher Dr. Jean Yves Reginster.
While it isn't clear how exactly
works, the authors suggest the long-term effects they recorded could be due to the supplement's positive effects on cartilage regeneration, including stimulation of anabolic activities, such as the synthesis of compounds called "proteoglycans": this ultimately results in
improved joint function
Earlier studies have also shown promising findings, but each called for long-term trials to confirm the results. According to the Council for Responsible Nutrition (CRN), this rigorously conducted study reported in The Lancet answers the call.
Chondroitin sulfate is a component of a biological polymer (polymers are substances with a high molecular weight), which is derived from tissue, such as ligaments, tendons and cartilage.
is popularly used because some research shows it may strengthen and add flexibility to the protein filaments that compose connective tissues. Research also shows the nutrient may reduce inflammation and inhibit the production of enzymes that weaken connective tissue by attacking tendons and ligaments. It may therefore be effective for use in rehabilitating and even preventing some types of injuries, such as torn ligaments and tendons or damaged cartilage.
In an earlier study on osteoarthritis patients, a group of French researchers found that
oral chondroitin sulfate
may be an effective pain-relieving agent. From cartilage samples taken at the end of three months of therapy, researchers have also found that chondroitin users appear to experience less tissue damage.
Research has shown that
chondroitin may be even more effective when combined with glucosamine
. In fact, the combination may have synergistic effects, according to some research. In a 2000 review of the scientific literature on glucosamine and chondroitin published in the highly reputable Journal of the American Medical Association (JAMA), researchers from The Arthritis Center at the Boston University School of Medicine write, "Trials of glucosamine and chondroitin preparations for osteoarthritis symptoms demonstrate moderate to large effects ", they continue, "some degree of efficacy appears probable for these preparations."
Another review of the glucosamine and chondroitin research published in the 2001 edition of the Bulletin on the Rheumatic Diseases, the researchers note, "The notion that glucosamine and chondroitin might have disease-modifying effects in osteoarthritis is highly appealing and supported by preliminary data."
New published research (2005) from the Czech Republic confirms that the glucosamine/chondroitin combo can relieve pain and improve range of the joint motion as well as have mild anti-inflammatory effects.
The best of the rest
Several studies have shown this nutrient may work to not only suppress inflammation but also block pain at the source. Nexturine seems to inhibit the gene expression of an enzyme called COX-2, which is responsible for producing the sensation of pain in joints and muscles. Nexrutine may actually help decrease muscle and joint soreness, without the negative effects of NSAIDs (non-steroidal anti-inflammatories, such as ibuprofen). Recent research shows NSAIDs may interfere with muscle growth and recovery and perhaps even increase the rate of breakdown of cartilage in joints of people suffering from joint problems.
Type II collagen:
This nutrient, derived from the cartilage of chicken, has been shown in a number of studies to help ease symptoms of certain arthritic conditions, primarily those from rheumatoid arthritis but also osteoarthritis. Although, other research has shown only small and inconsistent benefits from oral supplementation with type II collagen. In a 1993 study of 60 patients published in the journal Science, researchers from Boston's Beth Israel Hospital found that 80 percent of the subjects experienced decreased joint swelling and tenderness after three months of supplementation, compared to only 13 percent in the placebo group. "Four patients in the collagen group had complete remission of the disease," the researchers report. One study published in 2000 entitled "Role of collagen hydrolysate in bone and joint disease", reviews how collagen can be a powerful tool in helping with osteoarthritis and even osteoporosis. The researchers of this study state "Its high level of safety (hydrolyzed collagen) makes it attractive as an agent for long-term use in these chronic disorders." The mechanism of action seems to be in its components. Type II collagen contains
HA (hyaluronic acid)
which can support proteoglycans and glycosaminoglycans (GAG's) in the joint matrix thereby increasing synovial (joint) fluid and supporting cartilage synthesis in the joints. This can enhance a joint's shock absorption capabilities as well as lower the chance for deterioration.
In rheumatoid arthritis, natural collagen within the joints is gradually destroyed, apparently because an immune-system attack floods the area with tissue-destroying white blood cells. Researchers believe type II collagen may stimulate a natural mechanism in the body that tones down the white blood cell attack on the patient's own collagen.
This healing nutrient is a metabolite of DMSO (dimethylsulfoxide). DMSO is used to relieve joint and muscle pain and is generally applied topically. MSM is a major sulfur donor and according to a published review study in the Alternative Medicine Review Journal, it is a volatile component in the sulfur cycle--and increases in serum sulfate explain many of MSM's therapeutic effects. Sulfur is very important for the maintenance of connective tissue.
CMO (Cetyl myristoleate):
This oil/fatty acid based nutrient seems to act as a
agent. In fact, it is patented in its use for osteoarthritis and rheumatoid arthritis. Several studies show that it enhanced mobility in patients with osteoarthritis. One of these studies published in the Journal of Rheumatology in 2004 also showed greater ulilateral balance with CMO. Another study published in the same journal in 2002 also stated that "CMO may be an alternative to the use of nonsteroidal antiinflammatory drugs (NSAID's) for the treatment of osteoarthritis."
Omega 3 Fatty Acids:
There are two types of Essential Fatty Acids (EFAs) -- linoleic acid (omega-6 fatty acids) and
linolenic acid (omega-3 fatty acid)
. When it comes to joints and inflammation, the Omega 3's are very important. These include fish oils (EPA and DHA). Omega 3's can also be found in good amounts in flax seed oil. There is a class of hormone-like fatty acids called prostaglandins in the human body, and they are divided into three series. Series 1 promotes performance. Series 2 disrupts performance. And, series 3 blocks the formation of series 2 prostaglandins. Obviously, you want to boost series 1 and series 3; you do this by consuming EFAs, especially the Omega 3's. In addition to reducing inflammation of joints and muscles, these key nutrients help with muscle building, weight loss, healthy skin, neurological function, and support healthy cholesterol levels. The latest research (presented at several scientific conferences including FASEB in 2005) suggests EFAs, particularly Omega 3's, play a vital role in mediating the excessive inflammation we get from muscle damage.
Omega 3 supplementation
may be one method that can reduce the often excessive inflammation that follows exercise. This can allow athletes to recover faster and lower their chances of future joint problems.
Key Vitamins and Minerals:
plays an important role in collagen synthesis and also has antioxidant effects which may lower the risk of free radical damage of the joints. Manganese, silica, and boron also play important co-factor roles in optimum joint and bone function.
Note: JOINT COMMAND contains these powerful joint support nutrients!
M. Cazzola, et al., Oral Type II Collagen in the Treatment of Rheumatoid Arthritis: A Six-Month Double Blind Placebo-Controlled Study, Clin. Exp. Rheumatol. 18.5 (2000) : 571-577.
Drovanti, et al., Therapeutic Activity of Oral Glucosamine Sulfate in Osteoarthritis: A Placebo-Controlled, Double-Blind Investigation, Clin. Ther. 3.4 (1980) : 260-272.
Mazieres, et al., Le Chondroitin Sulfate Dayns le Traitment de la Gonarthose et de la Coxarthrose, Rev. Rheum. Mal. Osteoartic. 59.7-8 (1992) : 466-472.
V.R. Pipitone, Chondroprotection with Chondroitin Sulfate, Drugs Exp. Clin. Res. 17.1 (1991) : 3-7.
M.J. Tapadinhas, et al., Oral Glucosamine Sulfate in the Management of Arthrosis: Report on a Multi-Centre Open Investigation in Portugal, Pharmatherapeutica 3 (1982) : 157-168.
J. Theodosakis, et al., The Arthritis Cure (New York: St. Martins Press, 1997).
D.E. Trentham, et al., Effects of Oral Administration of Type II Collagen on Rheumatoid Arthritis, Science 24;261.5129 (1993) : 1727-1730.
J.Y. Reginster, et al., Long-Term Effects of Glucosamine Sulphate on Osteoarthritis Progression: A Randomized, Placebo-Controlled Clinical Trial, The Lancet 357.9252 (2001).
Moskowitz RW. Role of collagen hydrolysate in bone and joint disease, Semin Arthritis Rheum 30(2):87-99 (2000).
Hesslink R, et al. Cetylated fatty acids improve knee function in patients with osteoarthritis,J Rheumatol. 29 (8):1708-1712 (2002).
Parcell S. Sulfur in human nutrition and applications in medicine,
Altern Med Rev. 7(1): 22-44 (2002).
Simanek V, et al., The efficacy of glucosamine and chondroitin sulfate in the treatment of osteoarthritis: Are these saccharides drugs or nutraceuticals?
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 149 (1):51-56 (2005).