You know, I did a little known rehabilitation thread over on the MAN-UP thread for a shoulder injury (rotator cuff), however...similar supplement information would likely apply to you as I have actually too have since applied much of that information to a football knee injury of my own.
First, check out this thread:
http://www.manupdb.com/viewtopic.php?t=1068
A quick-hit summary of the products I suggest for joints is with two basic joint goals in mind -
1. REPAIR
2. ANALGESIA (Pain Relief / Inflammation Reduction)
and are as follows:
THE REPAIR AGENTS
1. Glucosamine/Chondroiton:
Rationale for Use: Likely the most popular, both are natural building blocks used to repair connective tissue such as cartilage, tendons and ligaments. Because your body is slow to make glucosamine, taking it as a supplement speeds joint and tendon healing.
Chondroitin is an advanced molecule, created when many glucosamine molecules stick together. It is closer to being cartilage than glucosamine is, but isn't as well-absorbed (only 10 percent to 15 percent is absorbed, compared to 90 percent to 98 percent for glucosamine). Chondroitin is also a bit more expensive at about $1 per gram, whereas glucosamine goes for about one-third less. As a result, chondroitin is sometimes not marketed as aggressively, but evidence suggests it's as good or better at supporting connective-tissue renewal as glucosamine.
I am NOT, however, fond of supplemental response supplied by the oral ingestion of the aformentined said agents (this is glucosamine included), I DO think that research supports the use of such items in topical preparations with improved efficacy, if true efficacy can be claimed in the first place.
Both supplements have been used successfully to reduce osteoarthritis symptoms and to speed healing of joints. However, chondroitin has the unique ability to distract enzymes bent on destroying cartilage, causing them to target chondroitin instead. The chondroitin that gets chewed up is then converted to ordinary glucosamine and used to heal joints and tendons.
2. Vitamin C / Hydroxyproline / Hydroxylysine:
Rationale for Use: Each of the aforementioned 3 agents are actually quite imperative in any kind of tissue (namely as collagen is concerned) growth/repair. The amounts of vitamin C required for human health are far from established; the picture gets even trickier when considering wound/tissue growth/repair. Linus Pauling's suggestion that human needs for this vitamin probably have been underestimated by a factor of 10 or more has frequently been ignored or refuted by rhetoric rather than by sound experimentation. The thinking was still enough to gain Pauling the Nobel Prize and I am convinced as a water-soluble concern for true overdose is limited, so my own orthomolecular dosing parameters will be established for this trial.
There is also some suggestion that the use of the said agents can aid in analgesia. The presentation of cartilage auto-antigen (types II, IX, and XI collagen, aggrecan, and link protein), in conjunctionwith a major histocompatibility class II receptor by theantigen-presenting cell, is believed to initiate the inflammatory cascade. Offering up the repair agents sometimes thwarts this in adequate cross-linking of the collagen strands in repair. I am still using this as a repair agent. Hopes that it may offer analgesic response would simply be added benefit.
These particular agents will all be taken through oral route as I like the essential oral bioavailability in contrast to the aformentioned gluc/chond agents.
3. Hyaluronic Acid:
Rationale for Use: Hyaluronans are large polysaccharide molecules found naturally in the synovial fluid, which help to create a viscous environment cushioning joints and preserving normal function. Hyaluronans are used extensively in the management ofosteoarthritis of the knee and clinical trial results have documented their effectiveness for this indication. One of the nice things is that the growing body of evidence also supports use of the hyaluronic acid stucture in treatment of chronic pain versus the acute inflammatory variety.
Usually the growing body of research centers on the use of said agents through injection, a route I am trying to essentially avoid. That said, oral bioavailability has been shown as less than stellar. Again, this leaves us with few options to increase the efficacy of the said agent - that of which I am going to try also centers on transdermal.
THE ANALGESIC AGENTS
1. Methylsufonylmethane (MSM):
Rationale for Use: I think this agent has great potential as a organic sulfur donor which is the kind that the body can absorb and use and this in turn can reduce inflammation. The best thing about it, all acute, intemediate, and long-term studies indicate that MSM exhibits very low (virtually nil) toxicity NO MATTER HOW IT IS ADMINISTERED. How low? Some authors describe it as similar to that of water (but even water can be abused).
One of the most significant applications of MSM is that of pain reliever, due to a demonstrated ability to alleviate pain associated with systemic inflammatory disorders. People with arthritis report substantial and long-lasting relief while taking daily doses ranging from 100-5000 mg.
The beneficial effect here is due in part to the ability of MSM to sustain cell flow-through, allowing harmful subbstances such as lactic acid to flow out while permitting nutrients to flow in, thereby preventing the pressure buildup in the cells that causes joint inflammation in joints and elsewhere. [please note: Some of the substances in Clout and Body Octane, which I will also be using along side this trial also accomplish this in part!]
The nerves that sense pain are located primarily in the soft tissues of the body, such as the muscles. Many types of pain can be attributed to a pressure differential involving the cells that make up these tissues. When the outside pressure drops, the cells become swollen and inflammed. The nerves register the inflammation, and pain is experienced. Often, contributing to the pain are rigid fibrous tissue cells, which lack flexibility and permeability - kind of like that in the supraspinatus tendon. MSM has been shown restore flexibility to the protein layer of the cell walls, allowing fluids to pass through more easily. This softens the tissue and helps equalize pressure, treats the cause of inflammation, UNLIKE ASPIRIN, which treats the symptom by shutting off the nerve.
2. FISH OIL:
Rationale for Use: A standout among joint supplements is fish-oil extract, more specifically, the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid. Both EPA and DHA fight joint-damaging enzymes called collagenases and reduce inflammation, factors believed to play a role in joint aches and pains, including arthritis. As a result, fish oil is a great supplement for the active guy who wishes to reduce joint and tendon pain and prevent any damage.
In fact, a number of top-notch clinical trials, including one published in Journal of Rheumatology, have found that about six grams of fish-oil extract per day reduces symptoms of rheumatoid arthritis (which is essentially joint inflammation raging out of control). To get the equivalent amount of omega-3s from your diet, eat fish twice a week (see table for best choices). For instance, two nine-ounce salmon steaks a week provide about 42 grams of fish oil.
[Please Note: Part of my Omega-3 requirement will come in the form of BIG FISH from MAN Vaporize, of course, but I will get to the doses I will be using below.]
3. S-adenosylmethionine (SAMe)
Rationale for Use: For those familiar with my writing, you know I am A HUGE FAN of SAMe use for many ailments, and joint pain is one. Although many will likely critique that the dose needed to achieve joint releif based on very early clinical trials and the essential high cost of this support supplement will not warrant it's use in many people, I am going to use it DESPITE COST at a trial mimicking dose for true efficacy as this joint pain has gone on far too long as discussed above.
4. Celadrin (The registered proprietary blend of various cetylated, esterified fatty acids (cetyl myristoleate, cetyl myristate, cetyl palmitoleate, cetyl laurate, cetyl palmitate, cetyl oleate)
Rationale for Use: It is actually suggested to be superior to ALL of the aforementioned agents and has a couple of clinical trials to boot in the Journal of Rheumatology (although no head-to-heads so I am still employing the other agents). The great part is that both trials were double-blinds unfortunately one was an oral preparation and the other a topical. To further this, there were two trials in the Journal fo Strength and Conditioning also showing efficacy in replicated fashion to the topical, however, I will already be using a topical preparation for this trial so I am going to be trying it as an oral and based on structure alone - theory would likely dictate the oral bioavilablity to be sufficient as well as the first trial.
All of this suggested, I am going to ingest a dose that mimics the clinical trial in the Journal of Rheumatology to offer up aid.
PLEASE NOTE:
The thing with the Fish Oil and the oral Celadrin is that they MUST be adjusted into my caloric intake for the duration of the trial - which will likely sit at 68 days. Why 68 days? This mimics the upper-limit of some study protocols as listed within the information above...While some study info is based on shorter time protocols, I am emeshing the longest trial with the basis of an adequate exercise protocol/treatment plan.
...
07-06-2007, 10:14 PM
Joint Support
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