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Fit for Life: Preventive medicine for joint pain and strain

Aaron Brouwer Instructor Canwest Fire, B.C.

As firefighters, we push our bodies to the limit. Our job is strenuous and physically demanding so it’s natural that we will feel aches and pains, especially in our joints.  There are several things we can do to help relieve joint pain, such as strength training, wearing footwear with good cushioning, icing our joints and taking glucosamine and chondroitin sulphate. 

Glucosamine is a natural substance in our bodies that plays a role in cartilage construction. According to Principles of Anatomy and Physiology, 8th Edition, “Cartilage consists of a dense network of collagen fibres and elastic fibres firmly embedded in chondroitin sulphate, a rubbery component of the ground substance. Whereas the strength of cartilage is due to its collagen fibres, its resilience is due to chondroitin sulphate”. Essentially, cartilage is the tough connective tissue that provides cushion around the joint end of our bones. Glucosamine is required for the production of glycosaminoglycan, a molecule needed to form and repair cartilage and other body tissues. As we get older, the production of glucosamine slows, so adding glucosamine supplements to our diets can be beneficial. Principles of Anatomy and Physiology says chondroitin sulphate “is a jelly-like substance that provides support and adhesiveness in cartilage, bones, the skin and blood vessels.” Chondroitin sulfate gives cartilage elasticity.

Studies have shown glucosamine to be very helpful to patients with osteoarthritis. One in 10 Canadians suffers from osteoarthritis; it affects men and women equally and usually develops around the age of 45 but can occur at any age. By the age of 40, 90 per cent of the population will demonstrate some symptoms of osteoarthritis. Symptoms of osteoarthritis include pain and stiffness in any weight-bearing joint such as knees, hips and spine. Osteoarthritis causes breakdown of the cartilage in these joints, making them more susceptible to injury.

The causes of osteoarthritis are heredity (defect in one of the genes responsible for making cartilage), obesity (the extra weight puts extra stress on joints), joint overuse and injury. Joint overuse and injury are our main concerns as firefighters. Joint overuse occurs from repetitive bending of the joints, especially in the knee. Firefighters overuse knee and hip joints when we climb ladders, walk up stairs, drag hoses and in other firefighting duties. It is important that we strength train as this will strengthen the muscle around the joints and provide stability. Make sure you have proper fitting boots that are in good condition; this will provide cushioning to reduce the stress on bones and joints.

Swimming is one of the best exercises to help strengthen the muscles around the joints. It is considered low impact because it puts minimal stress on joints.

According to the University of Maryland Medical Center any injury to knees, back, or bones near a joint puts us at higher risk for osteoarthritis. “Studies on glucosamine have shown that it provides several benefits to osteoarthritis patients including reduction of pain, improved function and mobility and slowed progression or even prevention of joint destruction when taken for three or more years.  In comparison to other anti-inflammatory drugs, glucosamine took longer to begin working, however the pain control lasted longer and caused fewer side effects” (Univeristy of Maryland Medical Center). There are no food sources of glucosamine; the supplements are made from the outer shells of shrimp, lobster and crab. The recommended dose is 1,500 mg a day. It can take several months to notice a difference. If after eight weeks you don’t experience any difference in your symptoms you should seek alternative methods for relief. Do not use different forms (tablets, powder or liquid) of glucosamine at the same time as this increases the risk of an overdose. 

If you decide to take dietary supplements the Arthritis Foundation’s website www.arthritis.org) suggests you:

Choose products sold by large, well-established companies that can be held accountable;

Read the product labels carefully to make sure the ingredient lists make sense to you and ask your pharmacists for help;

Be sure to consult your doctor before trying these supplements;

Make sure that you know the cause of your pain – if it is not osteoarthritis then dietary supplements may not help.

Glucosamine has only a few possible side effects such as stomach upset, heartburn, indigestion, gas, bloating and diarrhea. If you experience these symptoms try taking supplements with food or try a different brand. Since glucosamine is an amino sugar, diabetics should monitor their blood sugar levels regularly.  People with shellfish or sulphur allergies should consult with their doctors before taking glucosamine. 

Glucosamine does not cure arthritis, but can slow its progression. Glucosamine and chondroitin sulphate have been shown to support lubrication of joints, keeping them rolling smoothly. Dietary supplements are not for everyone; just because they work for one person doesn’t mean they will work for you. Consult your doctor before adding any supplements to your diet. The effects of years of exercise and firefighting on top of the natural aging process put firefighters at higher risk for osteoarthritis. By taking proper care of your joints now you decrease the risk of arthritis later in life and ensure a retirement you can fully enjoy.