Five Things You Need to Know About Joint Health

With posture like this, no wonder he didn't get away with it.
Darn meddling kids!

There are a few things that clearly mark "older" people in our society: demanding that loud rock and roll music be turned down, random shouting at neighborhood children to get off the lawn, and inexplicable and unwelcome aches and pains cropping up in various parts of our body.

Today, I'm going to cover an issue that is near and dear to those of us who are north of 40: our joints. Specifically, how to keep them healthy and pain free. Because the last thing we want is to get fired up to get back into the gym and, three days later, limp home defeated.

For me, I've dealt with lower back pain, some cranky hip flexors, and a right shoulder that reminds me every so often that I've got to check my ego on the bench press. But, the truth is, joint pain is not an inevitable and natural accompaniment to aging, as many of us have come to accept. Instead, it's the price we pay for extended bouts of inactivity and insufficient nutrition.

A few words about pain

Before we get into the heart of the post, let's talk about dealing with pain. Training involves pushing your body, making it adapt to new conditions. Some pain goes along with that, most notably Delayed Onset Muscle Soreness (or DOMS). DOMS is that sweet, sweet pain you get when you overdo it or when attempting something that your body hasn't been conditioned to do.  The only real way to treat it is to keep moving.  But it's important to recognize when you're dealing with ordinary pain and when you're facing a potential injury.

If your pain is very specifically localized and sharp and/or is accompanied by numbness or tingling, see a doctor or chiropractor before continuing your training program. Muscle strains and sprains don't have to keep you out of the gym entirely. Just throttle the weight back and lift carefully. Some exercises may need to be dropped for a while until the pain goes away, but in many cases, the combination of regular icing and lighter weight will get you through.

If you are feeling pain after a workout, treat with ice, not heat. Ice will reduce inflammation and swelling, which takes pressure off the joint.

1. Joint Health Basics

I'm going to focus on the "big three" - shoulders, knees, and hips, as these seem to be the most common problem areas that crop up.

The health of your joints is based on four basic elements: bone, cartilage, synovial fluid, and supporting tissue (tendons and muscles). In the joint itself, the bones are "capped" with a thin layer of cartilage that is the first line of friction protection in the system. Between the two bone surfaces is a thin layer of highly viscous fluid that functions much the same way as motor oil does in an engine cylinder, keeping the two bone and cartilage surfaces from coming into direct contact with each other.

Around your joints are systems of muscles and tendons that keep the bones in the proper position to each other.

2. Warming Up

Warming up seems to have become a bit passé in many circles. If you're squeezing in a training session before work or over lunch, it may seem like a no-brainer to skip it all together. But warm-ups play a very important role in preventing injury and reducing pain. The way your joint systems work, the act of movement itself causes a "splashing" effect of the synovial fluid, improving the coating quality on the joint surfaces. This is what is commonly referred to as "lubricating the joints." A light run at low to moderate pace for five minutes or some light calisthenics like jumping jacks will provide the kind of movement needed to get things going. Warmed up muscles are also less likely to strain or cramp during exercise.

Please note that this is not about stretching. Stretching before lifting actually reduces your ability to lift. Think about it: the act of lifting itself centers on contracting your muscle fibers. Why would you pull them further apart? Stretching itself is also not a long-term answer to improved range of motion. Practicing the motion often with proper form and manageable weight is your key to increased range.

3. Eating for Happy Joints

I don't know why I'm still surprised when my research continually leads me back to the same themes. But, yet again, our Standard American Diet as recommended by the ADHA has yielded some unfortunate consequences.  As a result, coaches, trainers, and medical professionals also recommend a nutritional component to support joint health.

Joint fluid and cartilage health is dependent on two primary macronutrients: sufficient protein and fat intake. Omega-3s are critical to the generation and replenishment of the essential synovial fluid. So, the low/no-fat, high carbohydrate diet pushed for decades hasn't done us any favors in the joint department.

Additionally, one of the main coincident symptoms of metabolic syndrome (the precursor to type II Diabetes, estimated to affect some 25-30% of adult Americans) is chronic inflammation throughout the body's systems. And the primary culprit in metabolic syndrome: a chronic overload of refined, processed carbohydrates in the form of white flour and sugars. Metabolic syndrome is characterized by insulin resistance, and one of the most important treatments decreasing insulin resistance is regular exercise, resistance/weight training in particular.

So, as with so many things associated with the chronic health conditions of our times, you are either subject to a self-perpetuating spiral or, if you turn it around, a synergistic set of factors that will slow and even reverse the damage we have done to ourselves. Your joints hurt because they are inflamed and they are inflamed because you haven't been fueling your body correctly, and you don't want to exercise because you don't have the energy and the pain is unpleasant. But - get on a training program and correct your nutrition plan, and the issues will likely resolve themselves.

Finally, proper hydration is essential for producing and replenishing synovial fluid, along with just about every other function the body performs. I know it's simple, but it bears repeating all the same. Drink lots of water.

4. Improving Supporting Muscles

For many of us that have either forgone exercise entirely or gone for the American Heart Association's universal prescription of light to moderate cardio three times a week, we haven't used our muscles for much. As I said earlier, strong muscles and connective tissue are a critical element in healthy joints. This involves a number of smaller supporting muscle groups that we don't normally think about. The best thing you can do is to work to make these muscles stronger.

For the shoulders, specialized "prehab" exercises will help build the necessary strength and support. They're not sexy, but neither is wincing when you put your shirt on. Here are a few that are simple to perform with light dumbbells or resistance bands:

• Internal Shoulder Rotation: Lie on your back on a bench or balance ball (for dumbbells) or standing with a resistance band anchored at the midpoint to create tension. Keeping your elbows fixed at your sides and your lower arms at a 90 degree angle from your body, slowly rotate the arm from the side to the front.  The only thing that should be moving is your shoulder joint.  Return to the side and repeat for 15-20 reps on each side.
• External Shoulder Rotation: This is the same as internal rotation, only reversed.  Lie face down or place the resistance band so it crosses your body from its anchor point.  Slowly rotate the arm from in front of you to the side and return.
• The Halo:  Performed with a kettle bell or exercise plate, the key to this exercise is the range of motion you can accomplish, not the amount of weight you can support. Raise the weight overhead with two hands and the elbows bent, move the weight in a circular motion around your head, mimicking a halo. Try to make as big a circle as possible. Do 20 reps and switch direction. You can also do one repetition in one direction, and then do the next repetition in the opposite direction.

For the knees, barbell squats are a fantastic way to build strength. If you're not ready for the squat rack yet, then the leg extension machine and lunges are good bets too, but they're no substitute for the kind of motion and stability involved in squats, even light weight ones.

The hip flexors are a special case. Most of us that have spent hours upon hours in front of a computer or at a desk have lulled our hips into a virtual immobilized stupor. For me, this translated in some chronic lower back pain right around my tailbone, which took an hour or two every morning to loosen up. Learning how to move and engage them takes a little practice. My recommendation here: take some yoga classes. There is no quicker way to learn how to engage muscles you didn't know you had than a basic yoga class.

And, last but not least, form, form, and form. There are so many poor examples of lifting out there that can really set you up for some major pain, particularly as you move to heavier weights. Keeping your elbows in tight during bench press or push-ups, making sure your grip is the proper width for shoulder presses, and keeping your knees lined up during squats are just a few. Get a trainer or review a reputable program and have a spotter to make sure you're getting it right.

5. Joint Supplements

Glucosamine and Chondroitin:  According to an article by the American Association of Orthopedic Surgeons, "One meta-analysis of randomized, placebo-controlled clinical trials from January 1980 to March 2002 found glucosamine to have “highly significant efficacy” for all outcomes, including joint space narrowing and Western Ontario MacMaster University Osteoarthritis Index (WOMAC)."  Chondroitin, has not had the same level of clinical success, but users still report a reduction in pain associated with joint movement after taking the supplement.

Omega 3 supplements:  As already mentioned in the nutrition section, fatty acids such as Omega 3s are essential to joint health.  If you're not getting enough through your diet (most of us aren't) then a high quality supplement isn't a bad idea for a number of reasons.  Just remember, it's fish oil, so if you're allergic to seafood, you need to stay away.

So, let's recap:
Warming up, eating the right components to support your joints, doing some prehab work for trouble areas, and, if needed, supplementing with glucosamine and/or Omega 3s are your best prescription to keep your pain down and your training on track.  When you're not sure if it's "normal" pain, see a doctor (which we are not). But if it's just plain ol' DOMS, get back on the horse; it will get better.

Now, get off my lawn!