Fixes for Joint Issues: A list of Some Basics

Thread starter #1
Every few months or so, a post seems to come along saying something along the lines of “should I do PRP or Stem Cells or Nandrolone or anti-inflammatory injections or [insert something exotic here] for joint issues”. While all of these and others likely have their place, they are often either expensive, invasive or dangerous, somewhat immature or non-standard, or in the case of Nandrolone, widely reported to revert back to a problem state after a period of improvement if the treatment is stopped.

As someone who has struggled to overcome joint issues from a head-to-toe history of injuries and has tried many different things, I thought I’d put together a list of basics that are worth trying before getting into more exotic things. I am not criticizing any of the above, but rather saying that it makes sense to get the basics in place first so that you at least don’t constantly re-injure a joint before moving on to more exotic treatments if the basics don’t provide a fix.

Please note that the benefit and risk of each of these will vary from person to person and I present these simply to create basic awareness and to put them in one thread rather than chasing threads around. As always, you should do your own research to determine if they may be right for you. Here they are:
  • Fix your form, posture and gait. If you are, for example, walking or running with your feet out of alignment (I would guess at least 50% of people do this) then nothing else is going to work until you fix your form. Same goes for lifting, biking, etc. I found the books of Pete Egoscue and his Egoscue Method very helpful for finding and fixing flaws in my gait which fixed my knees completely at the time that was a problem for me.
  • DMSO – almost no one mentions it these days but DMSO is an amazing healer and my first go-to chemical.
  • Aspirin instead of Ibuprofen – I have found that Ibuprofen is a big help in the short term, but it doesn’t seem to provide a permanent fix. Chris Masterjohn makes a case in the video in the following link that Aspirin is a better choice Why Aspirin Goes Best With Bicarbonate and Glycine | Chris Masterjohn, PhD
  • Food sensitivities – Eliminate grains (especially wheat) and whey protein. These seem to be a common cause of inflammation that particularly affects the joints. Many people overdo whey protein and end up giving themselves a sensitivity to it and I have found that for me it seems to be a negative for my joints. I have also noticed that many on the Carnivore diet report improvements in joint function (I would guess due to something they removed from their diet.) A related point is to ensure your nutrient intake is complete, especially glycine.
  • Slow Negatives – Slowly lowering a moderate weight through the range of motion that is a problem seems to be very helpful, especially when there is a muscular component to a joint issue. The slow-lifting zealots, like most zealots, have IMO ruined a message with a grain of truth in it by over-selling it, but I think it is still a very effective tool in some situations. I would also stress slow negatives even when a joint is not an issue as this has been shown to give better gains in many situations.
  • Muscle Activation Therapy/Techniques – Similar to slow negatives, moving light weight through every possible range of motion for a joint, especially those that hurt has been essential for me for resolving shoulder issues. Indian clubs or the Should Rok are other options as well. Similarly for me, abbductor/adductor work has been very effective for hip issues. I have sensed that when a joint is injured, the body shuts down the muscles around it, but they don’t always reactivate when the joint is healed, and working them with light weights seems to be very effective in re-habing the joint.
  • For knee issues, try making front squats your primary (or only) knee movement – Most people think that front squats are harmful due to the range of motion, however I have found them to be very therapeutic and my knees (which used to be a problem) now feel best when I focus on front squats. They seem to help my back as well. Back squats and leg presses seem to bother my knees however.
  • Ensure balanced muscles around a joint – Many people only work quads but not hamstrings, or only do presses but not pulls. Fix that.
  • Allow adequate healing time – Joint tissues (tendons, ligaments, cartilage) have a much slower metabolic rate and less circulation than muscles, and consequently take much longer to heal. I had hip and shoulder injuries that took 18 months to fully heal.
  • Virtual PRP – This means working a joint several times a day in a way that gets a lot of blood into the joint. For me, I did 40 second sprints on my recumbent bike as recommended by Stan Efferding in his video on fixing knee issues and I found it to be very helpful. It helped my conditioning as well.
  • Virtual Surgery – I think this concept originated with Stu McGill who is mandatory reading on the topic of injuries, especially his book The Gift of Injury and the various podcasts featuring him. The basic concept here is to skip surgery and go straight to the rehab program, and see if the rehab alone fixes the problem.
  • Avoid joint-wrecker machines and movements – Speaking of Stu McGill, another of his insights that helped me was to avoid the full range of motion when doing leg presses if it rolls up your lower back. Other things that bother many people include the Smith Machine, dips, behind the neck presses and pull-downs, pullovers and pec-decks. I’m not saying not to do these things but be aware that they can easily over-stretch a joint. Some people will need to avoid bench presses. I personally substituted decline presses for dips and my shoulders thanked me for it. Additionally, some movements are just not meant for some people. Look for alternatives if this is you.
  • Use higher reps for a while – Most people emphasize reps in the 3-12 range however there can be a lot of advantages to reps in the 20-30 range. There is some evidence that longer set times create a training stimulus that shorter sets do not. In any event, it can allow you to continue to train while reducing stress on your joints.
  • Stretching – I hate stretching as much as the next person, but it has been a big help for my knees and shoulders. If you feel like your kneecap or the tendon below it is a problem, I have found stretching the front of the leg to be a big help for that.
  • Chains or bands – If the lower range of a motion causes pain but the upper range does not, try using chains or bands to add resistance in the upper range. Bands alone are also worth a try. In general using a wider range of activities (e.g. sled pulling, sprints, ruck marching, strongman throws, etc.) rather than just the typical strength moves is a good idea
  • TB500, BPC-157 and GH secretagogues – Believe the hype. Especially for TB-500.
  • Be cautious about repetitive motion and joint trauma – For example, digging with a shovel or building a deck can create damage that lasts for months. Investing in knee-pads, a roller seat or whatever is appropriate to take stress off of your joints when doing physical labor is well worth it IME.
  • CBD oil – While not joint-specific, CBD oil has been a big help for me and seems to have anti-inflammatory properties that reduce excess (as opposed to necessary) inflammation. Some people also find benefit from Cissus Quadrangularis and Kratom, however I don’t know enough about those to know if they are actually resolving a cause or just suppressing pain, whereas CBD oil seems to address a root cause. Either way I would try those long before I would try any of the nastier pain suppressants and if pain is a major issue, suppressing it temporarily may allow one to do some of the other things on this list that will address a root cause.
  • Oxytocin – While a bit more speculative and less clearly a fix vs a pain suppressor, I would still give Oxytocin a try if joint replacement was the next alternative or other things here didn't give a complete resolution. The anti-aging research on Oxytocin is very intriguing.
  • Lose unnecessary body fat – Duh. I know it’s easier said than done but excess inflammation and stress on joints will negate the benefit of other potential fixes.
Ok, this is certainly not a complete list but something to start with.
 
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#2
This is the one I had to do and it worked for me.

Food sensitivities – Eliminate grains (especially wheat) and whey protein. These seem to be a common cause of inflammation that particularly affects the joints. Many people overdo whey protein and end up giving themselves a sensitivity to it and I have found that for me it seems to be a negative for my joints. I have also noticed that many on the Carnivore diet report improvements in joint function (I would guess due to something they removed from their diet.) A related point is to ensure your nutrient intake is complete, especially
 

Jones

New Member
#7
Great write up! I've had a bad shoulder for 17 years, tried everything under the sun. Let a colleague inject ozone into my shoulder joint, hurt like hell for 24 hours, I was pretty pissed off that I got it done, and then the pain was gone for the first time in months (I was in a flare). Pain relief lasted about 2 months at which I was able to start strengthening it again (first time I could reach above my head in 9 months). I did not in a million years believe an ozone injection would do a damn thing.

Constant stretching and posture work, every single day was the other crucial part of my therapy.

Just felt I needed to share that story. And would love to hear what has worked for others.
 
#8
Great post, especially for us over 60 guys. This is what has worked for me for the past 3 years:
  • Chains or bands – If the lower range of a motion causes pain but the upper range does not, try using chains or bands to add resistance in the upper range. Bands alone are also worth a try. In general using a wider range of activities (e.g. sled pulling, sprints, ruck marching, strongman throws, etc.) rather than just the typical strength moves is a good idea
  • TB500, BPC-157 and GH secretagogues – Believe the hype. Especially for TB-500.
I have been working exclusively with bands for 3 years and have recently returned to dumbells for a few things, but 75% of what I do is bands and pushups. Certain exercises I loved and was raised on are things of the past. BPC 157 helped heal my non repaired shoulder and I will look into TB 500. CBD 35 mg before bedtime also works for me.

I am fortunate that one of my sons is a doctoral student in physiology and is always available for consults and corrective exercise suggestions. Recently he suggest bridging, and I do neck bridges every other day. Strengthening gluts and hip has done wonders for my lower back and, surprisingly, has alleviated a lot of hip pain. I will stretch, but I prefer corrective exercises. Another great piece of advice is the part about high reps. This leads to hypertrophy, joint lubrication, and range of motion. Max lifts, quick motions, and grinding out reps are off the table for me. Time under tension builds muscle mass and I want as much lean muscle as I can get as insurance for aging. Body weight stuff is also good for balance and the ability to move. Falls are the number one reasons for nursing home admissions and the loss of independence.

This post is an example of the great advice we all have come to expect on this forum.
 
Thread starter #10
@Jones:

Very interesting. Thanks for posting that. I'd be very interested in any links you found to validate that approach. I've heard several discussions from Ozone practitioners (most recently Frank Shallenberger on the Bulletproof podcast) and I've never heard of injections other than IV and rectal. I saw injectable veterinary Ozone supposedly for sale but I couldn't find anything to validate it in humans or anything else. My understanding is that Ozone works through oxygenation which would likely mean that HBOT and EWOT should both have benefit which is likely safer that local Ozone injections, but I don't know for sure.

Also, the needle injection itself would be a form of Dry Needling which is a very intriguing approach (similar in MOA to prolotherapy) where an insignificant minor injury is created in order to stimulate the body to marshal a repair response which will hopefully also fix a larger injury in the same region.

On a related point, I would highly recommend anyone considering any advanced therapies to listen to the two recent podcasts with Dr. Matt Cook on Ben Greenfield's podcast. He goes over just about everything to do with stem cells and other advanced therapies.
 
Thread starter #11
@mountainman,

Yes, great points. Back issues are a whole chapter in themselves. I had back pain all of my life until about 15 years ago when I discovered a thing called a lumbar extender which creates a bend loosely similar to bridging but much more focused, and it completely fixed me. I have heard of others having similar experiences with inversion tables, wall walks and bridging, so again, it is a case of starting with the basics first. I also find front squats create a similar sort of therapeutic bend in the spine/hip area provided one uses a proper vertical form which usually involves narrow foot spacing and a lot of leg/foot flare.

I would doubly recommend people with back issues read and listen to everything from Stu McGill.

Quality shoes that are right for your body profile are also really important (as is avoiding shoes as much as possible).
 
Thread starter #12
Also, regarding hips, I've been battling hip/hamstring injuries recently and the abductor/adductor machines have been key for me. They seem to reactivate muscles and stimulate the joint the way dumbbells through a variety of motions do for the shoulders.
 
#13
Also, regarding hips, I've been battling hip/hamstring injuries recently and the abductor/adductor machines have been key for me. They seem to reactivate muscles and stimulate the joint the way dumbbells through a variety of motions do for the shoulders.
Nothing is better for shoulders than bands, nothing. If physical therapist use them, then they can be safe. I had four staples put in 3 years ago and was out of commission with them for 5 months. Bands got them back.
 
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