Getting old / Bad Knees

[Pappy13]

I don't think you're gonna find a product that shows a clear cause and effect.  If it existed, we would all know about it.

My suggestion is to do the things that have been suggested like warm up/stretch before the activity, wear a protective sleeve which supports the joint and therefore provides a bit of pain relief and then use ice and/or heat after playing to help with pain and swelling and promote faster recovery.

Other than that, you might as well just get used to it.  As you get older your body just generally doesn't hold up to physical activity as well as it did when you were younger and takes longer to recover.  Combine those 2 things together and you simply notice pain and/or discomfort that you never noticed before.  It was probably always there to some extent, but it was very mild and you quickly recovered from it so it's a non-issue.  It's not a non-issue any more.  Now if it were a shooting type of pain or something, that might be a problem that can be fixed, but just general soreness is probably not something that can be fixed.

[fyo]

You seem to be skeptical about a lot of medical things.  Glucosamine is a joint lubricant.

Well... Glucosamine is a precursor to glycosaminoglycans, which is a building block of cartilage. The human body isn't normally deficient in glycosaminoglycans, so it's unclear why / if taking a precursor as a supplement should have any positive effect.

I'd be interested to see if these double-blind studies which you refer to were taken over an extended time.  Taking glucosamine for a week, or even a month, likely won't yield a markable difference, and I doubt anyone will invest a year into some random study.

You doubt anyone will invest a year into some random study?? Really? So you think medicine is generally tested just for a day or two?

Sorry if that seems a bit "snarky", but that's a pretty... odd... stance.

Yes, the trials do indeed last more than a week. Here's a reference to a large systematic review (review of many trials):

http://blogs.telegraph.co.uk/news/andrewmcfbrown/100053833/glucosamine-supplements-for-arthritis-do-not-work-new-study-shows/

The article itself, published in the respected British Journal of Medicine, is available here:

http://www.bmj.com/content/341/bmj.c4675.full

Although probably not free if you don't have access through a research institution

Anyway, the trials included have treatment durations of up to 156 weeks.

The study found NO effect (beyond that of placebo / fake pills) for glucosamine, chondroitin, or their combination on joint pain. This lines up well with an older Cochrane Review (non-profit that does a huge amount of systematic reviews) which found no effect unless results from "studies of poor quality" (i.e. improper blinding or other issues) were included, but even then the effect was only "inconclusive".

Perhaps even more interesting, and more damning for the prospects of glucosamin supplements, is another study I read recently (I too have had problems with my knees / ankle recently, so the subject is of some personal interest) where they injected a glycosaminoglycan directly into the knee in order to promote cartilage growth. This should, all things considered, be considerably more effective since it's applied locally and is actually the building block itself instead of a precursor to it.

Unfortunately, that study too found little or no effect on joint pain.

Now, that doesn't mean you should give up on glucosamine. Sure, what you are experiencing is PROBABLY placebo, but:

1) So what? The side effects are minimal...
2) Maybe, just maybe, there is a small sub-group (under-represented in the studies) where glucosamine does have an actual effect. This is completely unproven and pure speculation on my part, of course.

The latter does actually happen, though. One significant recent case was with salt and high blood pressure. It turned out that only a subgroup reacted to increased salt intake with increased blood pressure. For the vast majority (something like 80%), increasing or decreasing the amount of salt in your diet does absolutely NOTHING for you blood pressure. However, if you are one of the 20%, the effect is very real.

[Landshark]

I'm 52 and take a men's health multivitamin and a fish oil supplement every day.  Additionally, I take my boat out at least once a week.  Makes for good exercise.  I do feel age catching up to me but not as much as most guys my age.

[Pappy13]

You might also consider taking a pain reliever prior to the physical activity, however I don't recommend that really.  Pain is actually there for a reason.  It's your bodies way of telling you to take it easy.  Taking a pain reliever prior to physical activity might cause you to push yourself further than you would had you not taken the pain reliever and cause you a lot more discomfort after the activity and take longer to heal.

My wife has had bad knees since high school.  About 10 years ago we played co-ed softball and she played catcher and her knees really started to be bothersome because of all the bending.  She consulted a doctor who told her that he could fix her knees, but she couldn't ever play softball again as the problems would just return.  He told her to just tough it out as long as she could and when she was ready to stop playing softball come back.  I think if he knew about a wonder drug he would have told her about it. Well she wasn't ready to stop playing, so she just lived with the pain for a couple more years and then we quit playing softball. 

[Brian Fein]

"joint pain" is a relatively broad term.  Pain could be caused by a number of things, from strained ligaments or tendons to missing or damaged cartilage.  I don't think anyone ever claimed glucosamine or chondroitin is a cure-all for all joint pain.

Therefore, how is "joint pain" classified in these studies? 

I really don't want to get into this again, because I always catch hell for the following statement.  However, just as Dave believes that many medical solutions are mumbo-jumbo, I think the placebo effect is too readily indicated as fact, and refers to a psychological effect related to just taking pills.  I don't think that it is as widespread as many people would have you believe.  While the effects of these things may be negligible over short periods of time, perhaps the data collection methods aren't precise enough in these studies (ranking pain intensity subjectively from 1-10, etc) to be able to detect a legitimate effect.

[JVides]

Dave, I am just (very) recently 36, and I know what you mean regarding the knees.  The other day, I jumped down from a height of 6 + feet and immediately felt it in my knees.  I don't know how much or how little supplements will help you, but I know that the combination of weight loss and routine stretching helps way more than any supplement/lubricant you could take.

I know I move much better at 215 (my high-school DE weight) than I do at 235 (my fat-ass accountant weight)...

[SportsChick]

As someone who has major orthopedic issues, I have had three different orthopods recommend taking glucosamine AND chondroitin together for my lack of cartilage. At 31, I know I'm going to need a total knee replacement and a total ankle replacement at some point. However, for me, I can't swallow the pills. They make me gag. They're like horse pills.

[Brian Fein]

If Dave loses any more weight he's going to disappear.

I played football a while back, probably about a month ago, and my left knee was KILLING me for like a week afterwards.  I hadn't played in literally years before that.  I really think that using it more would loosen it up.  Like when you go to the gym for the first time in a while, you're sore for a week afterwards, but it stops hurting after a few more times.

[StL FinFan]

^ I think that depends on the source of the pain.

[fyo]

Therefore, how is "joint pain" classified in these studies? 

In this case, we're talking about people with reduced cartilage. Exactly the type of thing glucosamine is supposed to help. There are similar studies for arthritic pain, with the same results.

I really don't want to get into this again, because I always catch hell for the following statement.  However, just as Dave believes that many medical solutions are mumbo-jumbo, I think the placebo effect is too readily indicated as fact, and refers to a psychological effect related to just taking pills.

I'm not sure I get what you're saying... In these studies, the subjects are given pills that are either fake or glucosamine. Neither the patient nor the doctor / whomever knows what pill is given to which patient (the definition of a double blinded study). The patients are then asked to rank their pain, subjectively (how else?), on a scale (the ones I looked up were 0-20, 0-60, and 0-100). The placebo effect is DEFINED as the effect of the pill with the control group (i.e. the ones taking the placebo). If the real deal isn't doing any better than the fake (regardless of how good or bad the fake is doing), it's not providing any REAL relief. I.e. any effect is purely something you're convincing yourself of (and studies have shown conclusively that the better an effect you EXPECT, the better an effect you actually feel from the placebo).

While the effects of these things may be negligible over short periods of time, perhaps the data collection methods aren't precise enough in these studies (ranking pain intensity subjectively from 1-10, etc) to be able to detect a legitimate effect.

The "negligible over short periods of time" argument has already been debunked. These studies run for years.

How else would you rank pain, if not subjectively by some scale? We can always discuss the number "levels", but even in the 0-10 (which is fewer than I've seen in any of the studies)... if the "drug" isn't reducing the pain enough that I would consider it a point lower, is it really fair to call it a legitimate effect?

[Dave Gray]

My problem isn't so much joint pain afterwards.  I can deal with that.

I'm more concerned about lack of ability during.  When I'm running from first to second base and pulling up, it's increasingly harder to stop.  ...granted, that's a very high impact activity.