Nutrition: Keep joint pain at bay

23 comments
By Christine Bailey, Cycling Plus | Monday, Mar 15, 2010 4.00pm

Thankfully cycling is one of the sports least affected by joint pain due to its lack of impact and the fact that the bike takes most of your weight. But that doesn’t mean cyclists are immune to joint pain.

Many joint problems are related to arthritis – notably osteoarthritis and rheumatoid arthritis. Osteoarthritis tends to be more common as you age because the bones in joints deteriorate or change shape through wear and tear, but it can also affect athletes and keen exercisers through joint overuse.

Most commonly, osteoarthritis is typified by a reduction in cartilage in the joint cavity that leaves the area prone to further degradation from bone-on-bone contact. Arthritis can also be caused by injury. Disgraced pro rider Floyd Landis is such a case, after a broken hip led to osteonecrosis – a condition where the head of the femur starts to die due to a lack of blood supply.

With rheumatoid arthritis the synovial fluid is affected, making joints less flexible – a classic example of an autoimmune disease in which the immune system attacks the body’s own tissues. Another joint problem is gout, caused by an increased concentration of uric acid in the body. The acid then turns into microscopic crystals which collect around the joints, often starting in the big toe.

As joint conditions affect the synovial fluid and cartilage, resulting in inflammation, a nutritional approach focuses on supporting and promoting the production of these two substances, together with anti-inflammatory measures.

What to feed your joints

Salmon & other oily fish (mackerel, sardines, herring, fresh tuna, trout, kippers, anchovies, halibut): Rich in omega 3 fats, which have anti-inflammatory effects and have been shown to ease symptoms of both osteoarthritis and rheumatoid arthritis. A good source of protein for the repair of damaged joints, plus vitamin D.

Ginger: Root ginger contains gingerols, active components that are thought to stop the body producing inflammatory substances. Try adding fresh root ginger to hot lemon and water, curries, stir fries, ginger tea, breads and cookies.

Turmeric: Turmeric contains the potent ingredient curcumin which is thought to protect against inflammation and may help relieve the pain and stiffness of arthritis. Add liberally to curries, tagines and soups.

Cherries: Rich in antioxidants, particularly anthocyanidins to help prevent and repair the damage caused by free radicals. The flavonoids present in cherries inhibit inflammation and reduce levels of uric acid in painful joints so they’re particularly beneficial for gout sufferers.

Beta carotene-rich foods (sweet potato, carrots, kale, melon, mango, butternut squash, papaya, cantaloupe, apricots): Carotenes including beta cryptoxanthin are shown to reduce inflammation and help reduce the pain of rheumatoid arthritis.

Nuts & seeds: Good source of vitamin E, essential fats, zinc, biotin – all important nutrients needed to produce anti-inflammatory prostaglandins. Eat a selection such as walnuts, pumpkin seeds, flaxseed, sunflower seeds, sesame seeds, almonds, cashew and brazil nuts.

Berries: Packed with vitamin C, a key nutrient needed for the production of collagen, which is a major component of cartilage. Also rich in anti-inflammatory bioflavonoids which help inhibit enzymes that break down collagen – try to eat a cup of berries daily.

Oats & wholegrains (brown rice, quinoa, lentils, dark green leafy vegetables): Good sources of magnesium needed for the production of hyaluronic acid, which forms the major part of synovial fluid within the joints as well as being needed for the production of cartilage. Rich too in selenium, low levels of which have been linked to the severity of osteoarthritis.

Eggs: Rich in sulphur and amino acids that are needed for the production of keratin.

Milk, cheese, yoghurt: Rich in calcium, important for healthy bones, especially for RA sufferers. Also contain magnesium, folic acid and vitamins. Eat low fat or skimmed varieties as saturated fat can increase inflammation.

Supplementary helpers

In addition to a good diet, there is evidence that some supplements will help keep your joints moving smoothly.

Glucosamine sulphate & chondroitin: Glucosamine is an amino sugar that occurs naturally in the body. It is a key component of cartilage and helps form elastin and collagen and does appear to help reduce joint pain, tenderness and swelling for many people. A common dose is 500mg three times a day. Glucosamine is often combined with chondroitin although solid evidence of chondroitin’s efficacy is hard to find.

Essential fats: Fish oils and the omega 6 fat Gamma Linolenic Acid (GLA) are important for all aspects of joint health, especially in relieving inflammation. Look for a supplement with at least 450mg of DHA and EPA.

Joint nutrients: Niacinamide acts as an antioxidant helping to limit inflammatory processes. Other important nutrients include vitamin C, A, E and trace minerals selenium, zinc, copper and boron. Look for a multi-vitamin containing these nutrients.

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User Comments

There are 23 comments on this post

Showing 1 - 23 of 23 comments

  • having just done a paper on osteoarthritis and researching different treatments I would have to point out there is no evidence for the effectiveness of glucosamine.

    Nearly all the successful trials have been sponsored by Rotapharm, who manufacture glucosamine and are rather suspect and poorly conducted. It is just a very well marketed placebo and a waste of money.

  • Did you see this paper by Oxford Uni Scientists ?...

    Bandolier was surprised to find as many as eight randomised trials. While it is possible to criticise all of the trials to some extent, as a group they are no worse than others used to support commonly-used therapies. There is a consistent thrust of efficacy over placebo, and an inability to distinguish glucosamine from NSAID. But all trials were relatively short-term, and longer-term observations for adverse effects would be welcome.

    The bottom line is that there is a body of evidence supporting the efficacy of oral and intramuscular glucosamine in arthritis

    and surely Matt Brash can't be wrong!

  • trtimothy i was interested in your comments regarding glucosamine.What is your opinion on fish oil capsules?i have been using Sci Mix Tri Omega capsules to aid joints.Am i wasting my money?

  • Well my dog could hardly walk with hip joint problems, after a few days of glucosamine tablets, walking fine, after a few weeks, running about again!

    I'd call that clear evidence they work.

  • I'd say the dog story just about seals it. Clinical trials with a sample of one family pet usually settle most scientific debates.

  • This isn't a scientific debate, it's just some coments by people who THINK they know some science!

  • I have bad Knee pain due to torn acl and cartiledge trim, started taking glucosamine and I'm mainly now pain free, I used to limp at the end of a workday due to the pain and have to take ibruprofen to get to sleep

    if you ask me it works

  • well a systemic review of the 20 best conducted studies revealed no evidence of glucosamine having any benefit over a placebo(http://www.ncbi.nlm.nih.gov/pubmed/15846645). The only ones that did show any evidence were run by the manufacturers of glucosamine tablets and rather suspect. Obviously if you find benefits for something you might as well use it although sugar tablets will probably give the same benefit. Also as your ACL healed pain would have decreased anyway so could it not just have been coincedence??

    As for Omega 3 tablets there is evidence that this is protective of joints and also protects against dementia. Just check the ingredients and make sure you're getting a good deal pricewise. Also get your hands on a ZipVit trial box as it has lots of cycling related goodies including fish oil capsules..can be got off the ZipVit website sport section.

    Also consider that GP's are told not to prescribe glucosamine as there is no evidence and NICE do not recommend it. It's up to you though....

  • Interesting. Perhaps the author could comment?

    Trtimothy, you have done a paper? Does that mean that you conducted a systematic review of the available literature and published in a peer reviewed journal?

    The placebo effect is often overlooked in all but the best designed clinical trials, but there is no doubting that it plays an important role in many treatments. Unlikely in the case of our friendly poodle though. Not direct evidence though!

    NICE guidelines are always good insofar as they are produduced objectively, but they balance the efficacy of the cost of a treatment with its cost. Remember though that most articles we see on new treatments or ergogenic substances are generated by pharm' companies publicity departments.

    I am a scientist, with a better than average knowledge on all things cycling, but i believe that a healthy balanced diet with minimal supplementation is probably as good as anything. If you believe something works tho, it probably will.

  • Yet again when it strays into the subject of health BikeRadar publishes an article of pseudo-science, debatable science and hearsay largely regurgitated from the adverts of supplement suppliers.

    If you are going to write stuff such as this you need to provide a caveat that much of it is unproven or untested. The argument about glucosamine and chondroitin is referenced above but most of the comments about anti-oxidants and various minerals and vitamins are just nonsense. Just because a substance is involved in the production of, say, collagen does not mean that a) taking more of it is required or b) that taking excess will make repair it or that c) symptoms will be reduced.

    You also fail to mention that excess supplementation of some substances can be harmful.

  • Interesting article as far as it goes.

    As a criticism - I understand that the claims for 'antioxidants' are also unproven or they may even be harmful (those valid studies not backed by supplement manufacturers or celebrity nutritionists that is...). I can't see how 'antioxidants' can function or provide a benefit as we depend for oxidants for our bodies to work, mind you, I'm not a trained scientist.

    On a personal note, I have used Glucosamine off-and-on when I experience knee pain and have found it to be slow acting but useful (it normally takes 3 to 5 weeks for the pain to go away). However I have also have to admit that this slow improvement is probably most likely to be due to combination of the placebo effect, I get fitter and that; “time is a great healer". In the spirit of adventure I aim to conduct a mini-trial of my own- next time I get knee pain I'm goint to NOT use clucosamine to see if they get better on their own and if they do how-long it takes.

    Pure research eh!?... :-)

  • I have moderate to late stage osteoarthritis from an immune response and have to say that glucosamine as never done anything for me. Hemp oil has good effect as does fish liver oil. But regular exercise has a positive effect, though don't negate anti inflamatory medication.

  • I'm not sure who originally said this but it is worth repeating. The plural of 'anecdote' is not 'data'.

  • "Milk, cheese, yoghurt: Rich in calcium, important for healthy bones, especially for RA sufferers"

    That's interesting. Since I cut out dairy products, my knee pain issues dissappeared. Further reading shows that diary is linked to loss of calcium in the bones...

  • when I stop taking glucosamine after about a week my knees get painful again, like a burning sensation with with a gritty feeling

  • This is an important article for this 65 year old mountain biker. How can I get a printed copy?

  • +1 for the Glucosamine sulphate & chondroitin, i have been taking it for about 5-6 weeks now and my knee pain/discomfort has all but gone. shoulders pains also gone,

    good stuff!

  • White Willow Bark Extract might make a good addition to your supplement list. It's the original Aspirin (acetylsalicylic acid) with out the gastrointestinal toxicity (irritation) and risk of GI bleeding of pharmaceutical aspirin.

  • Only eat farmed salmon (and other endangered fish for that matter)!!

  • a good read is dr michael colgans optimum sports nutrition.he is a nutritionalist and biochemist to many top athletes and explains many of the myths when it comes to both nutrition and supplements.

    probably the most informative book ive ever read.

  • A good read, full of valuable advice. One thing to add is that its worth noting that electric bikes can be of great benefit to cyclists recovery from an injury or surgery - because they enable you to gradually build muscle tone and fitness without putting too much stress on joint. Clearly the dietry advice you give would be fantastically helpful to such a process as well. I found some useful information on the role electric bikes can play in regards to rehabilitation here: http://www.theelectricbikeco.com/electric_bicycles/rehabilitation-and-fitness

  • I take a daily glucosamine and cod liver oil capsule. I dont know wether they work on my knee or on my mind I just know they work. Placebos are great.

  • FlexoplexAwesome post ,All the given information is so informative for us ,I really appreciated from your information. I will bookmark it,and sharing it with my friends.Thanks.

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