Joint health, from the inside out

Editor’s Note: This issue, we present the first of three Training Tech Tips in conjunction with the nonprofit ProHealth Lab, in Park City, Utah.

Climb long enough, and you’ll experience setbacks: tendonitis, torn pulleys, injured tendons/ligaments, joint pain, or shoulder injuries. They’re our war wounds from battling gravity. But just as year-round conditioning is important to stave off injury, so, too, is “training” from the inside out.

Besides the obvious — following a healthy diet (protein, fruits and veggies, whole grains) and not overtraining — you can also optimize training and recovery with supplements that promote tendon, ligament, and cartilage health. Research has shown that glucosamine/chondroitin, omega-3 fatty acids, vitamins/minerals, and antioxidants are your best bets. Equally important is avoiding regular use of meds that mask pain (see “NSAID Sandbag,” right). Here, some recommendations:

Connective Tissues
Before we get too deep, let’s look at the structures climbers rely upon.

Cartilage: This dense connective tissue, present in the intervertebral discs, articulation surfaces of bones, and attachment points for certain tendons and ligaments, has no blood vessels, so it might heal marginally. Still, healing of recent cartilage trauma is possible — if you supply the key building blocks glucosamine/chondroitin and vitamin E.

Tendons: These tough bands of fibrous connective tissue link muscle to bone. If you’ve ever blown a pulley tendon or (worse) your bicep tendon, you’ll know all too well that these heal glacially— they don’t see a lot of oxygen. During healing and strength building, tendon cells require antioxidants and collagen-building nutrients like vitamin C, zinc, copper, manganese, and glucosamine.

Ligaments: These fibrous tissues connect bone to bone, to stabilize joints (e.g., elbows and knees). Ligament health depends largely on nutrition — similar to tendons, ligaments become stronger and more resistant to injury with regular training and optimal nutrition. Following injury, ligaments might take six months to heal fully, during which time they’ll need extra nutrients. Feed them vitamins C and E, glucosamine, and healthy proteins.

Bone: Without our skeletons, we’d be jellyfish. Good nutrition increases the intrinsic strength of bones, making them more resistant to traumatic fractures, stress fractures, and bone bruises. Bone depends not only on calcium and magnesium, but also vitamins C, D, and K, potassium, zinc, copper, and manganese.

Supplement Options
Glucosamine/Chondroitin: The molecules glucosamine and chondroitin comprise the cartilage matrix found in joints. Here, the cartilage undergoes constant breakdown and repair, but with climbers, there’s often more of the former than the latter. Many climbers in fact suffer from wear-and-tear arthritis (osteoarthritis), which occurs when the joints’ smooth cartilage deteriorates, leading to pain, swelling, and even deformity. Glucosamine and chondroitin supplements, however, can push that balance toward repair.

In the National Institute of Health’s 2006 GAIT study, combined therapy with glucosamine and chondroitin significantly improved pain and function in 79 percent of subjects with moderate to severe osteoarthritis pain, outperforming the prescription drug Celebrex (only 69 percent of Celebrex users showed improvement). Optimal doses are 1,500mg a day glucosamine and 1,200mg a day chondroitin sulfate.

Vitamins C and E: Everyone knows exercise is good for you, but it also creates damaging molecules called free radicals — the more food and oxygen we process into energy, the more free radicals and risk of oxidative damage to our cells. Antioxidants such as vitamins C and E, alpha-lipoic acid, and coenzyme Q10 neutralize free radicals, reducing damage to connective tissue. During intense training, aim to take 750mg vitamin C, 400 IU vitamin E (alpha-tocopherol), 25mg CoQ10, and 100mg alpha-lipoic acid.

Omega-3 Fatty Acids: Omega-3 fatty acids, such as in high-quality fish oils, reduce joint stiffness and pain, strengthen grip, and improve healing. Omega-3s also decrease inflammation and inhibit enzymes that destroy cartilage. Look for the following in an omega-3 supplement: 1) high levels of combined EPA (700mg) and DHA (500mg), the two omega-3s known for their health benefits, 2) molecular distillation, which removes any heavy metal or PCB contaminants, and 3) no fishy taste.

As director of the ProHealth Lab, Thomas Rosenberg, MD, developed Nutriex supplements (nutriex.com) to improve athletes’ healing and recovery. An orthopedist and knee specialist, Dr. Rosenberg has been a team physician to the US ski, speed-skating, and snowboarding teams.

NSAID Sandbag
If your finger and elbow joints trouble you (that “creaky, achy” feeling you get from too much climbing), avoid continual use of drugs like Celebrex, ibuprofen, naproxen, etc. In aching athletes, these nonsteroidal antiinflammatory drugs (NSAIDs) mask the pain of micro-trauma to tendons and joints but offer no protective effect (see diagram, right). While handy occasionally — NSAIDs are OK for the three days post-injury — it’s not recommended you use these on a regular basis.

Why? Well, studies show that NSAIDs might inhibit bone and cartilage healing and, with long-term use, contribute to cartilage breakdown. Experimental evidence, however, has shown that glucosamine and chondroitin can counteract some of the negative effects of NSAIDs, though not the other potential adverse effects such as drug interactions, high blood pressure, kidney damage, and bleeding ulcers. —TR