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I'm athletic and my joints hurt

Summary
reading time
8 min
publication date
27 november 2018

Osteoarthritis is not a fate: lifestyle rules combined with well-chosen dietary supplements help fight erosion and limit pain and stiffness.

You are on a mountain road, you left home 45 minutes ago with your bike. You have climbed this hill several times, but today, it's different. Your knee is hurting you, a sharp and bitter pain. Your joint feels rusty. For the first time, you finish the climb on foot, limping. It might be the beginning of osteoarthritis...

While exercise is beneficial for joints, it can cause micro-traumas that wear down, damage cartilage, and lead to osteoarthritis.

This is not fate: lifestyle rules combined with well-chosen dietary supplements help fight erosion and limit pain and stiffness.

What is a joint?

Joints are connections between two bones. They can be:

Immobile like cranial structures,

Slightly mobile like between two vertebral discs,

Mobile like the knee, between the tibia and femur,

It is these latter ones that are generally referred to when talking about joints, and they are the ones that usually cause us pain.

These so-called "synovial" joints consist of:

  • A first layer: the joint capsule which, along with ligaments, stabilizes the joint and helps prevent sprains,
  • A second layer: the synovial membrane which secretes synovial fluid - this fluid is to the joint what oil is to mechanical systems,
  • Cartilage that allows the smooth ends of the bones to glide well between them,
  • Internal shock absorbers and stabilizers: fibrocartilages (for example, menisci in the knee).
  • It is by causing micro-injuries to the cartilage due to repeated movements that sports can lead to joint pain, at any age. This is then called osteoarthritis.

How do joint pains manifest?

The alteration of cartilage causes pain. Thinned, cartilage no longer fulfills its role of facilitating movements as well. The production of synovial fluid, which serves as a lubricant, is reduced. So during movements, the constituent bones rub against each other with less protection from the cartilage.

Unlike mechanical pains (sprains, ligament ruptures, etc.) that occur suddenly during exertion, joint pains occur more insidiously and slowly, and above all, manifest differently:

  • They mainly occur during the day and do not wake you up at night (except possibly when changing position),
  • They increase with exertion and are relieved by rest,
  • They are more significant towards the end of the day,
  • Cracking is frequent,
  • "Stiffness" is often necessary in the morning,
  • Stiffness sets in,
  • There may sometimes be some inflammatory signs (swelling, heat, redness).
  • These pains occur preferentially and depending on the sport practiced at the shoulder, hip, or knee.

They should be distinguished from arthritis, which is caused by autoimmune diseases and tends to be more present at rest and to wake up at night.

Clinical examination, blood tests (sedimentation rate and CRP, which are normal here since it is not an autoimmune disease), and imaging will confirm the diagnosis.

The causes of joint pain in athletes

The causes of joint pain in athletes are multiple and are often additive:

  • Female sex: women are generally more affected than men. Morphological factors come into play here (for example, the width of the pelvis which induces different constraints on the knees) as well as hormonal factors from menopause where women are no longer protected by estrogen (1).
  • Age,
  • Overweight: excess weight naturally increases the constraints on the joints of the lower limbs. Furthermore, too much fat in the body tends to increase the inflammatory terrain and maintain it.
  • Family history: genetic heritage influences the strength of the cartilage.
  • Intensive and/or high-level sports: naturally, the more sport is practiced (especially pivot sports: tennis, football, dance...), the more repeated constraints on the joints, the more the cartilage deteriorates.
  • Significant joint stress (strength professions).
  • Morphological anomalies: if the bones are not perfectly oriented, mechanical constraints can increase considerably. This is the case, for example, with bow legs that pull the kneecap outward. This will cause the kneecap to "rub" asymmetrically and wear out prematurely.
  • History of meniscectomy - the meniscus is a fibro-cartilage, it no longer fulfills its role as a shock absorber and stabilizer, the cartilages take over and wear out prematurely.
  • History of anterior cruciate ligament rupture.
  • Poorly treated and/or repeated sprains: in case of inadequate management of the injury, the ligaments remain stretched and the coordination defective. With each new twist, the cartilage hits and damages itself. (2)(3)

Finally, the practice of certain sports (4) is particularly criticized because of joint hypermobility and repeated impacts:

  • Running
  • Dance
  • Basketball
  • Soccer
  • Gymnastics
  • Rugby
  • Racket sports
  • Preventing and relieving joint pain in athletes
  • Keep moving

Osteoarthritis or the fear of osteoarthritis should not prevent you from moving! On the contrary! It is crucial to maintain regular physical and sports activity to maintain joint health. Of course, avoid anything that causes pain and disciplines that are responsible for cartilage wear. It is recommended to combine strength training, stretching, and aerobic exercise. This winning trio has shown its functional interest in terms of pain or mobility. Yoga, Tai Chi, Qi Gong, swimming, walking, cycling, and strength training are to be favored.

Watch your weight

It has been shown that being overweight by 5 kg increases the risk of osteoarthritis by 40% (5) and that moderate weight loss (5 to 10 kilos) is enough to reduce symptoms of knee osteoarthritis (6). Furthermore, body fats tend to increase inflammatory processes: irritating substances circulate in greater numbers in the blood. They stimulate white blood cells that are more likely to degrade the cartilage of all joints. In this metabolic context, uric acid - whose production will be maximized with physical activity and by the acidity of the body, accumulates in crystals. These crystals damage the cartilage and invade the joint with white blood cells. These, to "digest" these aggressive crystals, also attack the cartilage.

It is therefore important to maintain your ideal weight by monitoring the contents of your plate (especially by limiting rapid sugars and saturated fats) and by maintaining physical activity.

  • Adapt your diet

To limit pain and control inflammation, be sure to adopt a diet rich in:

Omega 3 - these "good fats", unlike Omega 6, have anti-inflammatory properties (7). Focus on nuts and flaxseeds, rapeseed oil (uncooked), or fatty fish (8). Avoid omega-6 providers as much as possible: sunflower, corn, and grape seed oils or processed fatty products like chips.

Fruits and vegetables. Try to consume 8 to 10 servings per day. They provide not only vitamins and essential minerals for good bone health but also antioxidants (vitamins C, E, carotenoids, polyphenols). These substances help fight reactive particles called free radicals, associated with all inflammatory and painful phenomena. In terms of vegetables, think of cruciferous vegetables (cauliflower, broccoli, red cabbage, white cabbage, black radish, turnip, rutabaga...), peppers, tomatoes, garlic, artichokes, or spinach

Sources:

(1)Peggy Sastre, le sexe des maladies, Guide Favre, 2014
(2)Activité physique et arthrose. Dr. Christophe Popineau, IRBMS 15.07.2013
(3)Arthrose du sportif, Dr Stéphane Casua, Santé Sport Magazine, 3 novembre 2014
(4)DELARUE YOHANN Facteurs de risques de l’arthrose Douleurs, 2005, 6, 1, cahier 2, pp 1s4- 1s6 (5)LAADHAR L, ZITOUNI M et coll. Physiopathologie de l’arthrose. Du cartilage normal au cartilage arthrosique : facteurs de prédisposition et mécanismes inflammatoires. La Revue de médecine interne, 2007, n° 28, pp 531-536.
(6)RENAULT A Musculation « facteur de santé ». Cinésiologie, 2006, 45ème année, n° 225, pp 116-117. En outre, un excès de graisse tend à augmenter les processus inflammatoires
(7)Wall R, Ross RP, Fitzgerald GF, Stanton C. Fatty acids from fish: the anti-inflammatory potential of long-chain omega-3 fatty acids. Nutr Rev. 2010 May;68(5):280-9. doi: 10.1111/j.1753-4887.2010.00287.x. Review. PubMed PMID: 20500789
(8)Proudman, S. M., James, M. J., Spargo, L. D., Metcalf, R. G., Sullivan, T. R., Rischmueller, M., ... & Cleland, L. G. (2013). Fish oil in recent onset rheumatoid arthritis: a randomised, double-blind controlled trial within algorithm-based drug use. Annals of the rheumatic diseases, annrheumdis-2013.
(9)Arulselvan P. Role of Antioxidants and Natural Products in Inflammation. Oxid Med Cell Longev. 2016;2016:5276130. Review. PubMed PMID: 27803762; PubMed Central PMCID:PMC5075620. (10)Ramadan G, Al-Kahtani MA, El-Sayed WM. Anti-inflammatory and anti-oxidant properties of Curcuma longa (turmeric) versus Zingiber officinale (ginger) rhizomes in rat adjuvant-induced arthritis. Inflammation. 2011 Aug;34(4):291-301
(11)Fibre-rich diet linked to lowered risk of painful knee osteoarthritis (BMJ)
(12)Rochcongar, P., De Labareyre, H., De Lecluse, J., Monroche, A., & Polard, E. (2004). L'utilisation et la prescription des corticoïdes en médecine du sport. Science & sports, 19(3), 145-154.
(13)Ziltener, J. L., Leal, S., & Fournier, P. E. (2010). Non-steroidal anti-inflammatory drugs for athletes: an update. Annals of physical and rehabilitation medicine, 53(4), 278-288
(14)Pillon, F., & Allaert, F. A. (2013). Arthrose, le rôle des compléments alimentaires dans la prévention et la diminution de la douleur. Actualités pharmaceutiques, 52(526), 41-43.
(15)Trentham, D. E., Dynesius-Trentham, R. A., Orav, E. J., Combitchi, D., Lorenzo, C., Sewell, K. L., ... & Weiner, H. L. (1993). Effects of oral administration of type II collagen on rheumatoid arthritis. Science, 261(5129), 1727-1730.
(16)Chevalier, P. (2008). Glucosamine: non efficace aussi pour la coxarthrose. MinervaF, 7(9), 144.
(17)Pillon, F., & Allaert, F. A. (2013). Arthrose, le rôle des compléments alimentaires dans la prévention et la diminution de la douleur. Actualités pharmaceutiques, 52(526), 41-43.
(18)Grant, L., McBean, D. E., Fyfe, L., & Warnock, A. M. (2007). A review of the biological and potential therapeutic actions of Harpagophytum procumbens. Phytotherapy research, 21(3), 199-209
(19)Grant, L., McBean, D. E., Fyfe, L., & Warnock, A. M. (2007). A review of the biological and potential therapeutic actions of Harpagophytum procumbens. Phytotherapy research, 21(3), 199-209

 

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