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-   -   Glucosamine--Magic bullet or snake oil? (http://tt.tennis-warehouse.com/showthread.php?t=445225)

lobman 11-08-2012 01:41 PM

Glucosamine--Magic bullet or snake oil?
 
I know it's been mentioned in the past, but what do you know and/or think about the effectiveness of glucosamine on knee problems, specifically tendonitis? I've done some research and the studies are mixed and most of those studies focus on reducing the pain of osteoarthritis. Some studies suggest that it slows or prevents degeneration of joint cartilage and even strengthens cartilage. Other research says it's no better than a placebo. I've been taking glucosamine sulfate for several years and until just recently have had no real knee problems. Lately, though, I've developed patellar tendonitis (self-diagnosed) that isn't responding much to the RICE treatment. So, I'm wondering--keep taking it; try higher dosage; try different producer; ??? BTW, if not better soon I am going to get it checked by my ortho doc. What say you about this stuff?

mikeler 11-08-2012 04:01 PM

I just started taking glucosamine sulfate again a few months ago. It seemed like it helped my knees. I did not take it for a few days recently and my knees did not feel as good. It seems to work for me.

user92626 11-08-2012 04:26 PM

I've been taking glucosamine pills for years. I really can't tell for sure the benefits particulary from it but I have always been strong and could play for hours without any knee issues. On other side, I don't see any down side other than the (minimal) cost of the pills. I would advise you take them. For knee health, imo, the best bet is to lose weight, proper warmup and never go out on fatigue. I always try to eat something, feel energetic before hitting. Tiredness, exhaustion will cause your knees to go jello and risk injuries.

TonyB 11-08-2012 04:27 PM

I had knee problems a few years ago. Serious pain. It LITERALLY felt like my left knee was on fire every minute that I was on the court. I thought it was my sneakers, so I switched and it helped a little. But the pain was still there. I could not sleep comfortably, I had to sleep 100% on my back to relax my knees overnight. I could not stand up straight for more than 10 minutes at a time. I actually thought it might be early-onset arthritis, it hurt so bad. I finally considered going to the doctor for possible surgery. I took glucosamine/chondroitin for a few months, thinking it would help "rebuild" my knee. These were HUGE horse pills, too. It did nothing whatsoever.

The best benefit that I found was doing knee strengthening exercises and non-impact activities. I stopped playing tennis for 6-8 weeks and just worked on non-impact strength. I stopped taking pills entirely. My knees healed perfectly and I've never had a problem since then, even after re-starting tennis and playing hard for the last 4 years.

Most people who take these pills also do other rehab activities. They are also more careful when playing tennis or doing other sports. So, it's not really clear whether the pills do anything at all.

Bottom line: forget the pills and work on strengthening the musculature around the knee. Stop impact-heavy activities (even tennis). Once you are COMPLETELY pain-free, then start playing again at a reduced pace. Gradually build up to full-speed.

Chas Tennis 11-08-2012 04:51 PM

Quote:

Originally Posted by lobman (Post 7003103)
.............................. Lately, though, I've developed patellar tendonitis (self-diagnosed) that isn't responding much to the RICE treatment. ...................................

You can distinguish between patellar tendinitis and patellar chrondromalacia? One is mostly a tendon injury and the other is mostly a cartilage injury. ?

http://en.wikipedia.org/wiki/Chondromalacia_patellae

I'm not sure of my facts but I thought that research finds glucosamine in cartilage. The typical rationale for using many supplements is - if it known to be present or needed in the tissue, add it to your diet. I have not seen or remember that glucosamine is found in tendons. See Correction Reply #19.

If you stress injured tendons you run a risk of developing chronic tendinosis.

See recent thread on tendinitis and tendinosis. http://tt.tennis-warehouse.com/showthread.php?t=442912

Stop stressing your unknown injury and see a well qualified Dr.

SystemicAnomaly 11-08-2012 07:54 PM

It is my experience that glucosamine in conjunction with MSM and/or chondroitin can, indeed, be effective for joint pain due to osteoarthritis or cartilage damage. Can't say for certain how effective it is for tendon issues. I would suggest further reading. Here are a couple of non-technical links:

http://www.livestrong.com/article/49...ne-tendonitis/

http://www.targettendonitis.com/gluc...or-tendonitis/
.

Ramon 11-08-2012 08:05 PM

I found that it's definitely not a magic bullet but it does help. Honestly, the closest thing to a magic bullet is probably NSAIDs (aspirin, ibuprofen, etc.), but you really don't want to depend on them. I've had knee problems in the past, but I've dealt with it using a mix of exercises (including deep squats, calf raises, and reverse calf raises) and natural supplements (including glucosamine, collagen, and herbal remedies like tumeric).

scotus 11-08-2012 08:27 PM

Depends on individuals, I guess.

Some of my friends swear by it, but it has never done me any good, and I have taken various brands & formulae in both solid and liquid forms.

NLBwell 11-08-2012 08:57 PM

My father had excellent results with it with his knees. I'm trying it right now for knee cartilage problems and it seems to be helping. Never heard of using it for tendonitis.

WildVolley 11-08-2012 09:42 PM

I'm agnostic on Glucosamine. From what I've seen, the studies have been mixed and some show no repair in knee cartilage, while at least one double-blind study did show statistically significant reduced pain.

I'm more interested in Chondriotin Sulfate and Hyaluronic Acid than Glucosamine. Chondriotin sulfate was studied in the 1970s as a heart disease cure and showed promising results in animal models and even in some human studies. Unfortunately, I don't think any quality follow-ups on this have been given. It doesn't seem to have any negative side-effects.

I've also had people swear they have gotten results from supplementing Knox gelatin. I've started supplementing gelatin and Chondriotin to help with an ankle injury. Too early to tell if it is effective, but it is inexpensive.

pvaudio 11-08-2012 11:09 PM

No studies showing one way or the other. Snake oil, that I think is too far in the other direction. Much like most health supplements, there is a scientific reasoning behind why it should work. Whether or not it does is a different story. People tout the benefits of antioxidants, so foods like avocados, pinto beans, acai berries, pomegranates, red wine and nuts sell like crazy. Yes, this is true that they are packed full of antioxidants. 99% of the population has no idea what an antioxidant even does, and there are no evidence that people with diets high in such food live longer. What is the truth is that the country pushing these trends is the US, and we're not even in the top 35 in life expectancy. Japan, which for decades has been either first or second, shows something interesting in its diet in that it has very little red meat, but high fish. The other top 10 nations, 3 of which are the so-called old-world wine countries, likely do have some correlation between red wine and life expectancy. But it does not explain the "French diet" phenomenon where they eat a high amount of fat but yet live for huge periods of time.....but it does. The fat comes from dairy and fish, they eat far less sugar and far FAR less processed food. The point I'm trying to make here is that supplements while they may have some evidence are not as good as making wholesome changes. That means therapy and avoiding the things which cause severe flares.

pvaudio 11-08-2012 11:13 PM

Quote:

Originally Posted by Ramon (Post 7003605)
I found that it's definitely not a magic bullet but it does help. Honestly, the closest thing to a magic bullet is probably NSAIDs (aspirin, ibuprofen, etc.), but you really don't want to depend on them. I've had knee problems in the past, but I've dealt with it using a mix of exercises (including deep squats, calf raises, and reverse calf raises) and natural supplements (including glucosamine, collagen, and herbal remedies like tumeric).

Not exactly, because they do not address the cause of the problem. You take NSAIDs for tendinitis and bursitis because they allows you lower pain levels to do the therapy you need to recover. It's whatever you were doing before that caused the inflammation that needs to be removed or remedied through therapy so that it no longer causes said inflammation.

Before someone posts 100 links saying that NSAIDs are part of tendinitis recovery, I know this since I have been through years of physical therapy on my shoulder before they realized I'd actually torn something. It's just like cortisone shots in that they help reduce the pain and inflammation so that you can strengthen the joint in question.

Ramon 11-09-2012 03:52 AM

Quote:

Originally Posted by pvaudio (Post 7003769)
Not exactly, because they do not address the cause of the problem. You take NSAIDs for tendinitis and bursitis because they allows you lower pain levels to do the therapy you need to recover. It's whatever you were doing before that caused the inflammation that needs to be removed or remedied through therapy so that it no longer causes said inflammation.

Before someone posts 100 links saying that NSAIDs are part of tendinitis recovery, I know this since I have been through years of physical therapy on my shoulder before they realized I'd actually torn something. It's just like cortisone shots in that they help reduce the pain and inflammation so that you can strengthen the joint in question.

I know that any drugs including NSAIDs and cortisone can be dangerous. That's why I don't take cortisone, and I only take NSAIDs sparingly. When you say that it's about removing what caused the inflammation, I think that includes hitting aces and chasing down balls that normal people wouldn't get.

For me, it's all about personal choice. If a baseball pitcher or a pro tennis player knows that without these drugs they won't make money, it's their choice, and we all know which choice they will be making.

For us normal guys, it's usually more of a choice that involves being able to compete with your friends and doing well at local tournaments at your level versus slowing down your game and playing with the older country club players. I'm not making the choice for anyone.

Maui19 11-09-2012 04:38 AM

I started taking Glucosamine/Chondroitin (and later Hyaluronic Acid) back when I started to have cartilage problems 12 years ago. I had two surgeries and continued knee pain. Since then, I have had no problems (knock on wood) despite being very active (running, hiking, basketball->tennis, etc) and becoming a geezer. I think it has definitely helped me.

ollinger 11-09-2012 07:33 AM

Very equivocal data suggesting some value in arthritis, no decent evidence for tendonitis. And you wouldn't expect it to be of value in tendonitis, as the tendon isn't constantly remodeling itself like the articulating surface of a joint.

GuyClinch 11-09-2012 09:28 AM

Yeah sadly not sure the stuff works.. And like Ollinger says it absolutely won't work for tendon issues. I am not going to lie I do take it sometimes..

I have noticed that for me joint issues are the biggest problem I have.. <g> So snake oil or not - want to try it some.

2ndServe 11-09-2012 11:19 AM

Quote:

Originally Posted by TonyB (Post 7003347)
I had knee problems a few years ago. Serious pain. It LITERALLY felt like my left knee was on fire every minute that I was on the court. I thought it was my sneakers, so I switched and it helped a little. But the pain was still there. I could not sleep comfortably, I had to sleep 100% on my back to relax my knees overnight. I could not stand up straight for more than 10 minutes at a time. I actually thought it might be early-onset arthritis, it hurt so bad. I finally considered going to the doctor for possible surgery. I took glucosamine/chondroitin for a few months, thinking it would help "rebuild" my knee. These were HUGE horse pills, too. It did nothing whatsoever.

The best benefit that I found was doing knee strengthening exercises and non-impact activities. I stopped playing tennis for 6-8 weeks and just worked on non-impact strength. I stopped taking pills entirely. My knees healed perfectly and I've never had a problem since then, even after re-starting tennis and playing hard for the last 4 years.

Most people who take these pills also do other rehab activities. They are also more careful when playing tennis or doing other sports. So, it's not really clear whether the pills do anything at all.

Bottom line: forget the pills and work on strengthening the musculature around the knee. Stop impact-heavy activities (even tennis). Once you are COMPLETELY pain-free, then start playing again at a reduced pace. Gradually build up to full-speed.

what specific exercises where you doing to strengthen the knees? I have patella tendonitis where if I split step or jump once I land the lower knee cap hurts. Softer insoles and knee braces have helped a lot but it's still painful even when I split step.

Chas Tennis 11-09-2012 01:16 PM

Information - Knee cap injury caused by tight rectus femoris & other issues
 
Quote:

Originally Posted by 2ndServe (Post 7004571)
what specific exercises where you doing to strengthen the knees? I have patella tendonitis where if I split step or jump once I land the lower knee cap hurts. Softer insoles and knee braces have helped a lot but it's still painful even when I split step.

Have you had tendinitis diagnosed by a Dr?

I have had some pain under my knee caps. I believe that tight/short rectus femoris is a contributing issue to knee pain for me. My MRIs have shown pathology that is a cartilage injury. Does not hurt much to play but I worry about future if not corrected.

http://www.mrtherapy.com/articles/article3.html

Test for tight hip flexors, rectus femoris & iliotibial band -

This video shows how to evaluate the flexibility of muscles in your hip area. These muscles have a lot to do with the posture of your leg and stresses on joints. The video shows how to test the flexibility of the 3 areas of the pelvis- 1) hip flexors (illiopsoas), 2) rectus femoris (also a hip flexor but this one is a two-joint muscle), and 3) iliotibial band. The details of leg angles are important in the videos. (These muscles can create posture problems that cause extra stresses on the knees.)

http://www.youtube.com/watch?v=NbRXi-nZVJs&feature=plcp

Read the section under "properties" for age and activity related tightness.
http://en.wikipedia.org/wiki/Iliopsoas

http://www.emedicinehealth.com/iliot...article_em.htm

(To check terms Google the term. Always read the Wikipedia entry.)

A paper on knee issues -
http://www.aafp.org/afp/2007/0115/p194.html

Sports medicine group at Johns Hopkins Sports Medicine where I have gone for two meniscus injuries, now resolved. Some information on common sports injuries-
http://www.hopkinsortho.org/conditions_diseases.html

Chas Tennis 11-12-2012 06:21 AM

Correction - glucosamine may be in tendon healing ??
 
In reply #5

"I'm not sure of my facts but I thought that research finds glucosamine in cartilage. The typical rationale for using many supplements is - if it known to be present or needed in the tissue, add it to your diet. I have not seen or remember that glucosamine is found in tendons. "

I just found some other information probably (?) associating glucosamine with tendon healing. ??

glucosamine is listed as part of the family of "Glycosaminoglycans"
http://en.wikipedia.org/wiki/Glycosaminoglycan
"Members of the glycosaminoglycan family vary in the type of hexosamine, hexose or hexuronic acid unit they contain (e.g. glucuronic acid, iduronic acid, galactose, galactosamine, glucosamine)."

Glycosaminoglycan was mentioned as part of the healing process in this very technical and difficult to follow article on the details of tendon healing
http://www.ismni.org/jmni/pdf/24/14MAFFULLI.pdf
pages 182, 185 and others.

[While reading the .pfd if you right click and select "Find" you can enter Glycosaminoglycan and it will be found in the .pdf document.]

pvaudio 11-12-2012 05:40 PM

Quote:

Originally Posted by Ramon (Post 7003899)
I know that any drugs including NSAIDs and cortisone can be dangerous. That's why I don't take cortisone, and I only take NSAIDs sparingly. When you say that it's about removing what caused the inflammation, I think that includes hitting aces and chasing down balls that normal people wouldn't get.

For me, it's all about personal choice. If a baseball pitcher or a pro tennis player knows that without these drugs they won't make money, it's their choice, and we all know which choice they will be making.

For us normal guys, it's usually more of a choice that involves being able to compete with your friends and doing well at local tournaments at your level versus slowing down your game and playing with the older country club players. I'm not making the choice for anyone.

You misunderstand what I'm saying. Here's my story: I blew out my shoulder from serving. One of two things would have prevented this: changing technique, or strengthening my rotator cuff and increasing flexibility. Anatomically, my motion was nowhere NEAR the extent of professional players (external rotation did me in), but for an amateur, like you said, it was too much. What I'm getting at is if you're having problems with your shoulder, knee, whatever it is, if you can do therapy, then do it every single time. If your cartilage is simply degrading, then that's NOT what to do. That's how I ended up having terrible ROM in my right shoulder. I had a tendon tear, but before they detected it, I did years of PT and my ROM would only get worse. I was simply building up scar tissue around the area. Now, thankfully, the tear has healed, but the scar tissue still remains. But had I done the strengthening exercises when I was say 15 (when I first started noticing that if I went for too much I would get a shoulder twinge), I wouldn't be where I am now. All of the NSAIDs and cortisone in the world made me feel better, but they did nothing to improve the state of my shoulder. All I'm advocating is that instead of looking to meds first, perhaps you can get healthier and prevent future injury. :)


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