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The Essentials of Joint Health
by James F. Balch, M.D.

It's difficult to imagine what the aging process was like 100 years ago. A trying time, to say the least. Though it's difficult to pinpoint what the most challenging aspect might have been, it's safe to assume that joint pain ranked high on the list. After all, science was over 50 years away from even thinking that amino sugars, such as glucosamine, could stimulate joint repair.


As consumers in a much more modern era, we have fingertip access to a world of healing technology, ultimately affording us the opportunity to mend, cure, alleviate, improve, manage, and/or cope with practically any ailment age and aging may throw our way. Among the most notable are those that allow us to enhance the integrity of our joints. Skilled surgeons now routinely rebuild joint structures. Artificial limbs are becoming common. Then there is the wealth of dietary supplements created to significantly improve our ability to support healthy joint function.

With these advancements, the days of hobbling in pain are quickly going the way of the eight-track tape player. Yet with everything we've learned, there is still more that can be done to make our time on earth more comfortable. One is to better understand the nature of diminishing joint function and the anatomical scope of these abuse-prone structures.

By definition, a joint is a point of connection between two bones or elements of a skeleton. And while it's true that they are highly complex in structure, joints have one primary purpose: to enable movement between skeletal bones. The simple truth is that every moving part of our skeletal frame is reliant on how optimally our joints are functioning. When healthy, our joint range of motion moves freely, easily and unhindered. When damaged or in deterioration, the affects are often unbearable.

Cartilage can be one of the weaknesses in poor joint health. Located at the end of the bones, cartilage essentially allows us to walk, bend, run, jump, or flag down speeding taxis. This extremely dense, opaque connective tissue is composed of type II collagen, water, and proteoglycans, such as chondroitin sulfate. When healthy, these smooth elastic tissues allow connecting joints to move freely, without pain or discomfort. Healthy cartilage is highly durable, rubbery, and capable of withstanding remarkable amounts of shock.

How many times have you seen a child fall on their rear only to bounce right up? Or a youngster go airborne from a swing, only to land feet first, and scurry back to do it all over again? Or a high school football player's ability to take hit after hit for hours everyday? Our cartilage sounds indestructible, right? Think again. While we might chalk up the daredevil attributes to the general principals of youth, joint health can be credited to the quality of cartilage, bone structure, and joint integrity.

By adulthood, even the healthiest cartilage begins to show age. So while it's impossible to turn back time, there are measures that we can take to safeguard and restore the quality of our joints. Take just a moment to evaluate your daily regimen. Because if you aren't one of the millions of Americans already living with the frustration of stiff, painful joints, chances are it's only a matter of time. The following techniques can be helpful in preventing the deterioration of healthy joint cartilage, which in turn might make the basic activities of living all the more pleasant.


Let's begin with the obvious. Remember that articular cartilage is made up of cartilage cells in a jelly-like matrix containing a fibrous network of collagen proteins and proteoglycans. Excessive activity can result in biomechanical damage that stimulates the production of enzymes responsible for breaking down cartilage. As this cushioning surface erodes, bones become exposed and begin to grate against one another. Ultimately, this is what leads to swollen, painful joints. By respecting what our bodies can and can't do, unnecessary overexertions can be easily prevented. At a very basic level, this can provide us with some control over how fast (or slow) our connective tissues decline.


Perhaps the most interesting element of cartilage, is that it can hold incredible amounts of water. In fact, as children our cartilage is made up of approximately 85 percent water! As we slip into adulthood, the percentage declines. And by prime adulthood, cartilage may only consist of 75 percent water. By consuming adequate amounts of water every day, opposing surfaces stay hydrated and can glide smoothly across each other's plane. In contrast, dehydrated cartilage is subject to bone friction, joint pain, and cartilage deterioration.


It's very simple: the more cargo you're carrying, the harder your joints have to work to perform even basic tasks. Eating a diet rich in whole and unprocessed foods, exercising regularly, avoiding excess sugar, and getting plenty of rest is a good rule for the healthy, and even better for those suffering from stiff, painful joints.


In less than 10 years, glucosamine and chondroitin have become staple supplements for individuals suffering from joint pain. While research continues to evolve, scores of people have reported high levels of success by taking 1500 mg of glucosamine with 1200 mg of chondroitin daily. Glucosamine is a safe, natural amino sugar found within the body that serves as a precursor to chondroitin, a key component in cartilage that has moreover been touted as a way to reduce the pain and inflammation that accompany joint pain. It works by stimulating the production of glycosaminoglycans and proteoglycans—two key building blocks essential in the formation and repair of articular cartilage.

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