Joint Rehab

Whether your joints are feeling the sting of age or you're working hard in the gym, these key supps can help blunt the pain and start the rebuilding process.

By Dwayne N. Jackson, PhD | April 4, 2016

By now, most of you are months deep into your 2016 fitness goals, and many of you are seeing great success. But another great number of you is likely experiencing the painful wear and tear that comes with hard-charging workouts, your joints creaking and aching from the daily calculated trauma.

No pain, no gain, right? You should know better by now: Joint pain isn’t a badge of honor. It can be a serious sign of overtraining or simply a decline in joint health that can limit the intensity of your workouts and undercut muscle growth. In fact, tough guy, working through joint pain is a guaranteed way to sideline your training and eventually cause long-term joint damage.

The most common approach to tackling joint issues is to take over-the-counter drugs aimed at decreasing inflammation and pain. Although medications such as ibuprofen, naproxen and acetaminophen do a great job, they only mask the symptoms of underlying problems. They can also have significant deleterious side effects, and may even hinder muscle recovery and growth. Thankfully, there are a number of natural supplements that can manage symptoms of joint pain and regenerate weak and damaged joints without affecting recovery and hypertrophy.

Joint supplements tend to be marketed toward and used by “casualties” of past joint injuries and/or those who are getting a little long in the tooth. However, most joint supps provide a layer of protection regardless of your age or injury status. Read on to find out how you can avoid having your joints go up in smoke.

Anti-Inflammatory Support

In a nutshell, training for muscle growth creates inflammation which, ironically, is necessary for maximizing development. Nonetheless, when you overdo it, excessive joint inflammation can occur and may derail subsequent workouts. This is why we recommend specifically managing joint inflammation with supplements like these.

Methylsulfonylmethane (MSM)

MSM is a sulfur-containing compound normally found in many of the foods we eat. It’s chemically related to dimethyl sulfoxide (DMSO), a popular topical treatment for arthritis. DMSO actually breaks down to become MSM in the body after it crosses the skin. Oral MSM provides the body with organic sulfur that improves blood flow and decreases joint inflammation. A pilot clinical trial, published in Osteoarthritis and Cartilage in 2006, reported that MSM (3 grams twice per day) improved symptoms of knee pain and physical function in subjects with osteoarthritis in just 12 weeks without major adverse events.

Dose: Recommendations vary from 6 to 15 grams per day, usually divided into three daily doses taken with meals. It can take up to three months to feel benefits. Take MSM with chondroitin and glucosamine for best results.

Pomegranate Extract

The pomegranate originated in what’s now Iran and has been used in traditional medicine for thousands of years. Today, it’s often called a superfood due to its high concentration of antioxidants and healthy polyphenols. Pomegranate extract exerts anti-inflammatory actions by inhibiting the activity of several inflammatory factors including nuclear factor κ-light chain-enhancer of activated B cells (NF-κB), cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2). In one study, prodelphinidin, a tannin found in pomegranate, inhibited the production of such inflammatory factors in human chondrocytes, the cells that make up joint-cushioning cartilage.

In a recent study published in Chemico-Biological Interactions, a polyphenol found in pomegranate called punicalagin was reported to inhibit the activity of MMP-13, an enzyme that breaks down collagen (a major constituent of joint cartilage). Pomegranate supplementation also inhibited inflammation and decreased cartilage degeneration in arthritic rats. Scientific extrapolation leads researchers to conclude that supplementing pomegranate extract will also help reduce human inflammation, which your screaming, squatted-into-oblivion knees will appreciate.

Dose: Due to differences in potency of extracts among manufacturers, take as directed.

5-Loxin

This patented gum resin extract taken from the ancient herb Boswellia serrata has novel anti-inflammatory properties. Its actions are due to its ability to block 5-lipoxy-genase, a key enzyme involved in the biosynthesis of leukotrienes, which are considered potent mediators of inflammatory and allergic reactions.

In 2008, a double-blind, randomized, placebo-controlled study published in Arthritis Research & Therapy illustrated that 5-Loxin safely reduces pain and improves physical function in knee osteoarthritis sufferers. Researchers noted significant effects in as few as seven days of treatment and concluded that 5-Loxin may exert its beneficial effect through management of inflammation and improvements in joint health by reducing degradation of cartilage.

Dose: Due to differences in potency of extracts among manufacturers, take as directed.

Analgesic Support

The primary purpose of these supplements is to reduce the amount of pain you feel. When you’re injured, pain is a signal to stop doing what caused the problem in the first place. But the body can sometimes be a little overenthusiastic on this front, creating more pain and inflammation than is necessary. Analgesic supplements can help blunt pain so you don’t suffer while you’re recovering, but they shouldn’t be used to override common sense that tells you to rest the injured joint or area.

S-Adenosylmethionine (SAMe)

SAMe is a naturally occurring compound found in almost every tissue and fluid in the body. It plays a role in the immune system and maintains important brain neurotransmitters, including serotonin, melatonin and dopamine. Its production is tightly linked to the human body’s vitamin B12 and folate (B9) levels.

SAMe is a natural painkiller that has been shown to be as effective as the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen and naproxen at relieving pain and stiffness from knee, hip and spine osteoarthritis.

Dose: Take 200 to 800 milligrams two to three times per day on an empty stomach. Start with a low dose to avoid stomach upset and work up based on need. To enhance absorption, try taking SAMe with vitamin B12, folic acid, methionine and trimethylglycine (betaine). Some users feel immediate relief, but it may take a few days or even weeks to get the maximum effect. SAMe is safe and tolerable, and has fewer, less consequential side effects than NSAIDs.

Rosehip Powder

Extracted from fruits of the rose plant, rosehip powder has been used extensively in traditional medicine. It’s a concentrated source of antioxidants that include vitamin C, lycopene, carotene and flavonoids, as well as the polyphenols quercetin and ellagic acid. This combination is believed to ease joint inflammation and prevent joint damage. Rosehip extracts have been shown to blunt the expression inflammatory agents in cells within cartilage.

Scientific support for its pain-relieving effects comes from a recent meta-analysis of randomized, controlled trials published in 2012, which concluded that rosehip powder reduced pain and led to decreased use of analgesics in osteoarthritis patients. Some osteoarthritis sufferers report pain relief of up to 90 percent.

Dose: The most promising data come from research that used 20 grams per day split into four, 5-gram doses with meals. Analgesic effects are usually noted within two weeks.

Meriva

Curcumin is commonly found in turmeric and curry-based foods but has recently been in the experimental spotlight as a supplement to increase health and well-being. Meriva is a proprietary lecithin formulation of curcumin, which has been reported to have pain-relieving and anti-inflammatory properties.

A recent study published in the Journal of Pain Research reported that taking 2 grams of Meriva (corresponding to 400 milligrams curcumin) was as effective for pain relief as a standard (1 gram) dose of acetaminophen. A 2010 review on the efficacy of Meriva concluded that it’s a potent and safe agent for the management of osteoarthritis and inflammation and for overall improvement in quality of life. Based on these studies, Meriva seems like a safe alternative to anti-inflammatory and analgesic drugs.

Dose: Based on research, take 500 to 1,000 milligrams twice per day with food.

Cartilage Support

Taking these supplements can help your body maintain healthy cartilage, the flexible connective tissue that’s necessary for strong joint function. They’re particularly beneficial for protecting your joints from injury and helping the body repair cartilage that has been worn away by time, intense training or other lifestyle factors.

Glucosamine Sulfate

This aminosaccharide is an important precursor to glycosaminoglycans like chondroitin (see below). This amino sugar is also an integral component of the shells of crustaceans (shellfish), the source from which glucosamine sulfate supplements are generally derived. In the body, glucosamine is an important component of synovial fluid, the body’s natural joint lubricant. It’s also a major structural component of cartilage. Having plenty of this lubricant and structural integrity help maintain smooth joint-cushioning cartilage.

Taking a glucosamine supplement has been shown to increase sulfate uptake and boost synovial fluid production in joints, plus help generate new cartilage by activating cells called chondrocytes. These actions slow cartilage degeneration, repair connective tissue and keep the joints moving smoothly. In a recent clinical trial published in Annals of the Rheumatic Diseases, subjects with chronic knee pain who took a combination of glucosamine and chondroitin over two years were shown to exhibit significant improvements in joint health as indicated by decreased joint space narrowing.

Dose: Take 1.5 to 2 grams per day in three divided doses with food. Glucosamine is commonly stacked with chondroitin (see below) for synergistic joint protection. It can take up to three months to feel benefits, but some users notice a difference after only a few days.

Chondroitin Sulfate

Like glucosamine, this glycosaminoglycan plays an important structural role in joint cartilage. Chondroitin supplements are generally made from isolating the compound from animal cartilage, and it’s commonly combined with glucosamine and used to treat osteoarthritis and joint inflammation. Advanced lifters find this supplement beneficial for treating and avoiding joint problems.

Dose: Take 1 to 1.5 grams per day in three divided doses with food. Chondroitin and glucosamine (above) have a synergistic effect, so take them together. As with glucosamine, it can take up to three months to notice benefits, but some report feeling benefits sooner.



About the Author

Dwayne N. Jackson, PhD

Dwayne N. Jackson, PhD, is a professor and scientist in medical biophysics at one of Canada’s top medical schools, the University of Western Ontario. He has over 12 years of university education in physiology and has attended the University of Ottawa, the University of Western Ontario and the Yale School of Medicine. He also has over 20 years of competitive and recreational bodybuilding experience and is an expert in the areas of performance nutrition and supplementation.