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Connective tissue
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I seem to get injuries frequently in tendons and ligaments, often for silly things that [I think] shouldn't cause injuries. I am wondering if I lack something nutritionally. What is the best food or supplement to ensure that raw materials for connective tissue strengthing are in good supply?
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Re: Connective tissue [pedaller] [ In reply to ]
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Officially the jury is still out on this one, but here are some commonly used supplements.

Knox NutraJoint. Basically it's gelatine with some vitamins and minerrals. Or just use plain gelatine. Many weight lifters/power lifters swear by it.

Glucosamine with or without Chondroitin. Avalilble everywhere from Sam's club to Walgreens.

MSM (Methylsulfonylmethane) comes encapsulated by itself or compounded with Glucosamine and or Chondroitin. Sulfer containing compound that supposedly reduces joint pain and adds elasticity to connective tissue.

I take all this stuff and it seems to help.

Richard
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Re: Connective tissue [pedaller] [ In reply to ]
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Like the previous poster that jury is still out on the usefulness of taking supplements such as chondroiton etc. There are a variety of reasons that good double blinded studies are not done on nutritional supplements but that is another huge can of worms

I think that your post gets to something that is often glossed over in this day and age of super foods and super vitamins. If you are not eating well (or not eating enough) and you are overly stresed (this includes mental as well as excessive physical stress) your body will cause hormaonal imbalances that can lead to decreased healing and in some circumstances active degredation of your body.

Raw materials by themselves will not force your body into making the materials if your body is not in a position or state to do that...

If you are getting hurt I would do these things in what I think are descending orders of importance:

1. assess your training (are you going too hard, fast, etc)
2. Is your equipment in working order (shoes worn out, ill fitting bike, etc.)
(1 and 2 are equally important, and are relatively easy to fix)
3. Are you eating enough (calorically and nutritionally)

if you aren't eating enough I would first try to add nutrition through food instead of supplements...

I guess the point I was trying to get to is supplements are not benign. Just becuase they are natural does not mean that they cannot cause harm. Many supplements can cause a greatly increased load on your liver and kidneys and can thus be detrimental.

If you are going to take a supplement, start on the lower end of the recommended dose for the first couple of weeks until you feel like it is not hurting you...

I feel that nutrition is a very hard thing to change. (anyone heard of new years resolutions) becuase so much of it involves social / lifestyle change. There are so many stumbling blocks such as work, tiem to cook, planning out meals etc. But this should not stop you from trying.
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Re: Connective tissue [taku] [ In reply to ]
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I concur...taku. However, I do believe (it's been 10+ yrs. ago since I last did some serious research) that CS and GS did have some serious research done on their effectiveness. Most (if not all) of the research was done in Europe.

Most of the claims made of CS and GS regarding it's effectiveness is (more or less) accurate. Unfortunately, most of the cure claims are not. My experience with CS and GS is equivalent to those same effects of NSAID's but without as serious of stomach problems (not to say it has no effect on my stomach - just less of an effect).

I guess the bottom line is (IMHO) that CS and GS are non-prescription anti-inflamatories which in most athletes situation leads to a masking of problems. It doesn't eliminate the most common culprit... misuse and overuse. The magic pill of eternal youth doesn't exist. However, CS/GS do have value (similar to NSAIDs) but only if used properly and for the right reasons. The right reason being to reduce the effects of an injury (which would include rest) and not intended turn you into a super athlete.

Pain is that part of the body that not only reflects signs of improvement, but can reflect signs of abuse. Knowing the difference is what determines an athletes ability to perform consistently and through out all stages of their life.

FWIW Joe Moya

As I always say, "my plan isn't to beat my competitor, but (rather) to out live them."
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Re: Connective tissue [Joe M] [ In reply to ]
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Very Very well put... for those of you wanting to look at the original paper

also be cognizent of the fact that these studies were done on patients with osteoarthritis (degenerative knee disease) this may not be the casue of your knee pain

Unique Identifier
7002479


Medline Identifier
81065906


Record Owner
NLM


Authors
Pujalte JM. Llavore EP. Ylescupidez FR.


Title
Double-blind clinical evaluation of oral glucosamine sulphate in the basic treatment of osteoarthrosis.


Source
Current Medical Research & Opinion. 7(2):110-14, 1980.


Abbreviated Source
Curr Med Res Opin. 7(2):110-14, 1980.


NLM Journal Code
dux, 0351014


Journal Subset
IM


Country of Publication
England

Abstract
The efficacy and tolerance of oral glucosamine sulphate were tested against placebo in a prospective double-blind trial in 20 out-patients with established osteoarthrosis. Two capsules of either glucosaminene sulphate (250 mg) or placebo were administered 3-times daily over a period of 6 to 8 weeks. Articular pain, joint tenderness and restricted movement were semi-quantitatively scored 1 to 4 every 3 days, and individually averaged over the treatment period (overall composite score). Possible side-reactions were similarly scored upon positive questioning of the patients. Haematology, erythrocyte sedimentation rate, urine analysis and X-rays were recorded before and after treatment. Significant alleviation of symptoms was associated with the use of the active drug at the prescribed dose. Similarly, patients given glucosamine sulphate experienced earlier alleviation of symptoms compared with those who had placebo. The use of glucosamine sulphate also resulted in a significantly larger proportion of patients who experienced lessening or disappearance of symptoms within the trial period. No adverse reactions were reported by the patients treated with glucosamine, and no variation in laboratory tests was recorded.
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Re: Connective tissue [taku] [ In reply to ]
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That's basicly what I remember... What might also be noted is that the study used glucosamine sulphate NOT Glucosamine HCL ... The HCL version of GS has not been tested (if at all) as thoroughly as GS. The HCL version is what most people find on the shelves in Walmart's and other discount stores. It's much cheaper. But hasn't been proven to work. Some have theorized that the HCL version may not be as effective and would require a larger dosage (Why? because the HCL is a much bigger molecule - I know of no research to back this up)... so, basicly you will need to spend more than you might think. So, the real question becomes - is it cheaper if you need to use more and it may not work as well?

I stopped using GS and CS because prescription drugs are actually cheaper for me than the non-prescription GS/CS. What gives? It's call a really good Prescription Card (and quit a few Doc friend's samples). Also what makes GS and CS less appealing for me is the newer generation NSAID's. They have fewer side effects than the older NSAID's and actually do work quicker and faster. (for me at least) CS and GS take a MUCH longer term usage to take effect. In short, the newer NSAID's are (for me) actually cheaper and more effective within a shorter period of time.

However, I do believe that CS and GS have a place on the athlete's shelves. But, it's use should be placed on the same level as prescription drug use.

FWIW Joe Moya
Last edited by: Joe M: Jan 15, 03 20:51
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glucosamine concerns [ In reply to ]
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There are two reason I do not take glucosamine.

First, there have been studies that show it reducing joint pain, as noted. But I have also read a study abtract that looked at the effect of glucosamine on the joints of race horses. Basically, they had a glucosamine group and a control group. The glucosamine group seemed to have more joint mobility. However, looking at the joints during autopsy, the glucosamine group had developed lots of scarring in the connective tissues.

That scared me off because I don't want to have a few years pain-free, but develop scar tissue in my knees as a result. No one really knows what the impact of 5,. 10 , 15 years of glucosamine usage will be.

Second, glucosamine is being linked to developing insulin resistance and diabetes. This article explains it much better than I can. And Johns Hopkins does not seem like a "quack" source.

http://www.johnshopkinsinternational.com/english/media/prtrigger%20of%20insulin%20resistance.asp



--

~~Bob
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Re: Connective tissue [pedaller] [ In reply to ]
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I use Cod Liver oil. It smells bad, but it tends to reduce my joint pain. I have no scientific data whatsoever to back this up.

***
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Re: Connective tissue [pedaller] [ In reply to ]
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This may be too easy but I would speculate that you are chronically underhydrated. The theory goes that tedons etc are poorly endowed with cappilaries and are the first things to be affected by dehydration. Make sure you are fully hydrated, clear urine, before examining supplements. Remember that controlled studies show proper hydration to have a huge impact on performance.
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Re: gluco.concerns - Now THAT is interesting [Bob] [ In reply to ]
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I wonder if that would make a stronger case for CS instead of GS usage. By the same token, I don't remember finding much research on CS's effectiveness.

But, I do believe the source you sighted simply reinforces my belief that GS is a drug that has the potential of being both positive and negative. This would be the case for most drugs.

Good ref. sighting. Thxs.

Joe Moya
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Re: gluco.concerns - Now THAT is interesting [Joe M] [ In reply to ]
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A sports med physician I work with explained that glucosamine sulphate does act as a mild antiinflammatory, as you have previously stated, but that it also appears to promote cartilage growth (which NSAIDS don't). I also thought he had said that NSAIDS do not retard joint degeneration (observed in OA) while GS does.

I haven't read anything on how GS works. Anyone else have a comment on it's mechanism? If it does promote cartilage regrowth, I would suspect it would be a better choice than NSAIDS (even this new generation).

Richard
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Re: Connective tissue [pedaller] [ In reply to ]
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Pedaller, I am in the process of recovering from a medial lateral ligament injury. I asked the PT about nutrition and supplements and his response was that the vast majority of these types of injuries come from overuse, improper technique, improper equipment, muscular weakness, a physiological imbalance, or all of the above. Now, that was his educated opinion, and I'm sure that there will be a lot of disagreement. He spent a lot of time giving me muscle strengthening exercises, looking at my feet, my knees, and my running shoes. Again, when I asked him about supplements and diet, he felt that was not a primary factor, except for water which he felt was very important. I am almost fully recovered now, starting back slowly and doing my exercises. Just my $.02
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Re: gluco.concerns - Now THAT is interesting [Richard_M] [ In reply to ]
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Richard

I have heard that claim regarding cartilage growth, but I have not seen any research to back that up. It's seems that it is possible some people may have experienced miraculous cures from degeneration of bone/cartilage (similar to cancer patients being cured after treatments that historically only prolong life or reduce effects of cancer). But, I don't believe it can restore cartilage in a general population basis. If so, I believe that would be consider a miracle drug and used exclusively for curing many types of skeletal degeneration illnesses.

On the other hand, I have heard of claims where it suppose to slow down degeneration of cartilage... that may be more reasonable of a claim. And yet, I know of no know study suggesting this. Perhaps, some reading this thread can point one out ( my brief use of med. search engines (medweb & medexplore) doesn't seem to indicate such a study - of course, I may be looking in the wrong place).

As for the "mechanism" of how GS works, I believe it was my friend (whom happens to be an internal med. MD) said today at lunch, "I don't believe they really know why GS works for some people." Which means, the mechanism may still be a mystery.

And yes, if it did promote cartilage growth it would be better than NSAID's. Heck, it would be medical wonder drug.

FWIW Joe Moya -> not a doctor = not paying malpractice insurance.
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Re: Connective tissue [TriDad] [ In reply to ]
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Not to nit pick but it is the medial collateral ligament... Sometimes referred to as the MCL
not the medial lateral...

This may help you find information on the internet...

Your post gets to the heart of the matter with these types of injuries... there are many many many many many causes of the same condition, the same injury can be due to trauma, misalginment leading to over use, congenital, etc. etc. etc. This is why one shold be careful giving medical advice over the internet without a proper examination.

That is why the most prudent and accurate advice someone could give over the internet is SEE YOUR DOCTOR... then is they are unresponsive SEE A DIFFERENT DOCTOR. There are basic cuidelines and advice that you can give over the internet but the it is important to understand the limitations of advising over the internet

glad to know that you are feeling better.
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Re: Connective tissue [taku] [ In reply to ]
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I whole heartedly agree that advice given over the internet is not the way to treat yourself. One should seek a direct assessment from a qualified health care professional.

With regards to nutrition: Apparently, in Canada anyway, family doctors have to take one course in nutrition. Physiotherapists have to take none. So I'd advise anyone serious about nutritional concerns to consult with a registered dietician.

For musculoskeletal examines I would recommend seeking an assessment by a sportsmed physician, physical therapist or athletic therapist. A responsive family doctor will recognize the need for this and refer early after an injury presents itself.
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Re: Connective tissue [Richard_M] [ In reply to ]
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Just so you know in the US, a basic course in nutrition is required as part of the curriculum. Some schools do not have a separate nutrition course however it is part of the required knowledge for our liscencing exams.

Having gone through said course, the message we got from the dieticians and the conclusion that the majority of us took was that, physician's should asses whether their patients need nutritional counseling (almost everyone) and those patients should be referred to a nutritionist.

One more thing, when I said go to the doctor, unless it is an acute injury, don't go to the Emergency Room, they are not equipped, nor do they want to deal with your chronic sore knee. However if your chronic sore knee suddenly hurts like mad... or something to that effect it would be appropriate. A general practiitioner is much more capable and probably more willing to asses treat and refer your chronic pains

When you go to the doctor, and you do have dietary issues, bring the topic up yourself... doctor's are not clairvoyant. If after voicing your concerns and he or she is not willinng to listen... then maybe you should consider going to another doctor
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Re: Connective tissue [taku] [ In reply to ]
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taku, I agree that for a specific ailment it is best to have a professional diagnosis. My problem is that I get similar problems popping up in different places in the body, including those not regularly used (eg, wrist, when I haven't been on a bike in months). Mostly it is the tendons that seem to have problems. The severity varies. I am wondering if my diet is lacking something that makes me more susceptible. The posts on stress (I guess lack of sleep qualifies), hydration (I'm not always attentive enough, though I try) and GS (I just bought some to try it out) have been helpful and I will make some adjustments accordingly.
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