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Glucosamine, Chondroitin supplements for Joint Pain in Downtown Winnipeg

If you work in Downtown Winnipeg, you experience the ‘hardness’ of your daily commute. It is a ‘concrete jungle’, and the impact on your feet, knees, hips and back can be felt on a daily basis.

We all know someone who takes ‘vitamins’, or some kind of ‘supplement’ with the latest health benefit.

I get asked almost everyday about ‘glucosamine supplements’ for arthritis, joint pain, etc. Those ‘horse pills almost choked me’ exclaimed one patient, ‘how much do I need to take to even notice a difference in my knee pain?’, ‘where can I get those pills that supposedly help my joints?…are common questions in Downtown Winnipeg.

In a 2010 British Medical Journal, one of the most reputable of all scientific journals; an article published this conclusion:

“Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space. Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged.”

So is it fair to conclude that it’s not worth taking glucosamine, and/or chondroitin supplements?

Maybe.

May I present the evidence to people to let them make an informed decision. I have seen patients describe dramatic reductions in pain after taking G&C. If the supplement helps your symptoms it may be worth continuing it, especially if stopping taking it causes an increase in pain. I’ve also seen many report no change and complain about the ongoing cost. 1 or 2 have reported occasional side effects, although these supplements are generally considered fairly safe to take.

Other studies have shown more promising results, with Bruyere et al. (2008) concluding G&C may reduce the need for total joint replacement. It’s worth noting however, that in terms of quality of evidence, a systematic review of multiple research papers is usually considered better evidence than an isolated study. A recent analysis by Lee et al 2010 did show that G&C may slow progression of osteoarthritis (as measured by X-ray change) although it required taking it daily over 2-3 years.

But Sawitzke et al. 2010 found “no clinically important difference in pain or function” when compared to placebo. The Cochrane Review (2009) – Glucosamine Therapy for Treating Osteoarthritis had somewhat mixed results but concluded it may reduce pain and improve function.

Prices of G&C vary a great deal. Most clients speak of Costco having ‘bulk’ prices, while Walmart still has the edge on discount pricing for ‘reasonable amounts’. But physicians I have questioned here in Winnipeg, some at our best sportsmedicine centres, still recommend greater than 1600 mgs per day, over greater than an initial 6 week period to judge the supps usage.

Personally, I have recommended our local Winnipeg stores, like Guerrilla Jacks and Sunrise Health; as there is still nothing like more opinions and education about your health.

So the question you need to ask yourself is, am I willing to spend that much on a treatment that might help or may make no difference to my pain or the progression of arthritis?

Words of caution: If you are planning to take supplements to treat arthritis or other conditions discuss this with your GP or Pharmacist.

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Seasonal Back Pain during Golf? Physiotherapy Winnipeg yourPhysio.com

Again? that seasonal back pain is back…and consecutive golf games are impossible, not to mention your regular league match at any of the golf courses in Winnipeg. One likely culprit; your hip flexors! Yeah, those muscles that lift your knee towards your chest are connected to your back, specifically your lower lumbar spine and pelvis.

During the downswing, the obliques and hip flexors are highly activated, creating a crunch-like position as your hips extend and your pelvis tilts (your belt buckle stays level, pointing forwards) while your chest remains over the ball.

The hip flexors are an important part of your core, working to maintain posture, generate power, stabilize the body, and to decelerate the lower body for efficient energy transfer coming into impact.

Maintaining the quality and function of your hip flexors is very important for maintaining posture through the downswing and impact, especially with the longer clubs, where the greater length of the club’s shaft increases the forces that must be absorbed by the body.

Your hip flexors attach from your spine to your legs.  When they are weak, they are not able to withstand the high forces of the longer clubs and are unable to hold your spine angle.  This results in early extension (loss of spine angle) as the hip flexors lengthen under high loads, resulting in a loss of spinal posture before impact.

 

The Foam Roller Hip Flexor Exercise is a great self-massage exercise that will give your hip flexor muscles (in the front of your hips) a deep and effective sports massage, thus improving the health and quality of your muscle tissue and helping you to perform better.  It will also alleviate soreness and make your muscles feel better.

The foam roller is available at most yoga studios or medical supply stores in Winnipeg; you may even get it covered by insurance! The movement over the roller overloads the muscle tissues through compression, causing your nerves to relax, signalling muscle spasms to shut off, pumping blood and and getting your lymphatic system flowing, to help muscle recovery and regeneration.  You’ll work out those knots (muscle adhesions) in your muscles caused either by inactivity, by the repetitive strain of the golf swing, or by walking a tough golf course.  This will enable you to stretch the muscles back out to their original length, making them more pliable and functional.

Be careful! if the back pain is acute, do not attempt this exercise without first talking to yourPhysio; exercises can be modified and tailored to your injury, and reduce your pain.

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Winnipeg Soccer, as outdoor ends, indoor begins and the knee injuries need Physiotherapy

It’s almost the end of September in Winnipeg, and its all too common on the soccer field and basketball court.  An athlete jumps to get the ball, lands and blows out a knee. And most of that time those athletes are girls. Girls are four to six times more likely to suffer a certain kind of knee injury than boys, according to Mayo Clinic research.

Your Physio Winnipeg always concentrates on proper training, biomechanics and technique of exercise, otherwise, why do it if you’re going to hurt yourself.

When an athlete cuts, pivots or jumps, the athlete puts stress on the ligaments of the knee; Medial, Lateral and especially the Anterior Cruciate Ligament or ACL in the knee.  If the knee collapses inward during these moves, that ligament can tear, along with severe injury to the surrounding soft tissue.

ACL injuries are especially a problem for girls, possibly because of the angles of their leg bones or imbalanced muscles around the knee. But proper biomechanics, education and training can help prevent ligament injuries.

Train to jump properly, and actually practice to inherit a good habit; “Legs shoulder width apart. you have to jump as high as you can and when you land you have to land straight and your knees can’t go in or out,” explains Winnipeg physiotherapist, Chris Bisignano.

At the heart of research now is jump mechanics and landing mechanics.  These drills teach how to move more safely and will strengthen the muscles around the knees.

Ligament injuries can mean a trip to the operating room and reconstructions are not minor.  Recovery can keep you out of the game for nine months to a year.  But injury prevention training, and cross activity training can keep kids in the game. Westwood High School in Winnipeg, actually has a “high performance training or phys ed” class for its athletes. “They give their kids some training techniques I would never try in practice,” says Bisignano, “but its excellent training to be involved in to prevent injury”.