Without our framework - our skeletons -- our bodies would be just so much meat-flavored Jello. They would quiver as our muscles twitched, but since the muscles would be merely Jello anchored to more Jello, no net motion could result. If our skeletons were rigid, rather than articulated by joints, we may be upright - until we fell over -- but we'd still be motionless. Look at how long it takes a frozen leg of lamb to walk to the market to buy the mint jelly.
Notice how it always comes back to food. There's a reason for that: animals without an articulated skeleton are primarily prey, not predator. When's the last time you saw escargot catch a meal?
Our various joints are quite different from one another, but their basic concept is common to every joint from our jaw to our toes: ligaments bind two or more bones together to form a joint, and muscles anchored by tendons span the joint to move it. Joints can last a lifetime, or they can submit to traumatic injury, long-term degradation, and/or disease far too soon. Hard, proper, frequent use seldom injures joints, but abuse often leads to injury or failure. Abuse includes imposing too much or too frequent impact, bending the joint in unintended ways, using it despite pain, and obsessive overuse.
The most common joint injury is a sprain -- a ligament stretched until it tears partially or ruptures altogether as we force a joint to bend too far or in a wrong direction. Ankles and knees are very common sprain sites, partly because they carry most of our weight. Their first line of defense against that form of abuse is pain, which commands us to stop abusing them.
Proper sprain treatment can mean the difference between a week or two versus a year for recovery, maybe even prevent a lifetime of weakness in that sprained ligament. The October 2000 issue of this column addresses treating a sprained ankle; the same concerns and concepts apply to treating most joint injuries.
Knees are made to bend in one half of one plane, like a door hinge, but not to exert or resist twists. Plant a foot and try to rotate on it, or bend it any wrong way, and the ligaments holding that knee together may tear or even sever, leaving the knee crippled for now and possibly weak and unstable forever. Any kind of uncontrolled fall, whether in sports or just on a wet floor, can take out a knee. Our joints are strongest and most stable in their middle range of motion. At full extension and full bend (flex), they are less stable and more subject to injury. Whenever possible, adjust your work and play technique or equipment to use your joints in their intermediate range if using them with great force or in an uncontrolled environment. When you do injure one, don't be macho/stupid: give it RICE, see a doctor if there's any doubt, and let it heal before using it at full strength again.
Joints don't need traumatic injuries in order to fail. Degradation due to chronic overuse and/or impact -- especially if compounded by obesity and/or aging -- disables millions of joints. Some orthopedic physicians say their Jaguars are funded by their running patients, because running pounds the life out of our lower joints. There are many far better ways than running to lose weight and strengthen our hearts and bodies; and it achieves little else (for the unaddicted), builds no significant skeletal muscles, and, especially in the elderly, can waste away the upper body.
Shoulders, especially past middle age, get increasingly unstable and trouble-prone if neglected. The primary key to strong, stable, healthy shoulders is strength-building exercise, especially for the rotator cuff, which holds the shoulder joint in place (see the August 1999 column).
Chronic lack of water, nourishment, or exercise harms joints. They rely heavily on lubrication, which is water-based. Good 24/7 hydration is thus very important to the health of our joints. Some, most notably the knee, are surrounded with an enclosed internal capsule containing synovial fluid, which lubricates and nourishes the joint when circulated by activity. And strong muscles help support their joint.
Exercise makes an astounding difference in preserving joint and muscle health, but cannot completely overcome the effects of age on muscles, tendons, ligaments, and cartilage. Old bodies may need more warming up and stretching than young ones, but then they can still cut loose and play hard. Many of those stiff, doddering elderly people we see every day hobbling down the street have done that to their joints and muscles by lack of exercise, and can fortunately reverse those effects, even by functional decades, if they get motivated enough to exercise.
Joint degradation cripples more slowly than trauma, but just as effectively. All our joints are susceptible to osteoarthritis (OA) -- degradation of the cartilage that cushion and separate the bones that meet at that joint. When the cartilage wears away to allow bone-on-bone contact, the pain is severe and debilitating. OA is very often preceded, thus probably exacerbated and maybe even triggered, by an old injury at that site. Surprisingly enough, the primary preventative and "cure" for OA is usually more exercise. Besides keeping the joint lubricated, nourished, and strong, it also keeps the remaining cartilage pliable and more resistant to impact than cartilage hardened by disuse.
There might be such a thing as too much exercise in some extreme cases, but few people simply wear out a healthy joint. The bigger threats to joints and muscles come from over-intense weekend bursts, pain dismissal, high-impact sports such as running and football, obesity, and even simple hazards like high heels and platform shoes. It's tough to wear out a healthy joint that's uninjured and properly used and cared for, and they need exercise to remain healthy.
Most of the over-the-counter remedies that claim to prevent and/or heal OA are unproven. MSM has not been proven effective or safe; glucosamine/chondroitin shows some promise but its major clinical trial results are not expected until Mar 05; and DMSO has been proven hazardous to animals (that's us!).
The primary joint-degrading disease is rheumatoid arthritis. Its pain and ultimate deformation shut the affected joints down temporarily, then permanently. Three primary lines of defense against RA include antibiotics, immunosuppressants, and omega 3 essential fatty acids (see the August 2002 column). It's often caused by mycoplasma (a bacteria) infection, which may be completely cured if diagnosed and treated with antibiotics (primarily minocycline) early enough to prevent joint damage. If an individual case of RA is truly due to immune system hyperactivity (we should demand analysis and proof of the cause of any rheumatoid arthritis we come down with), aggressive treatment - usually immunosuppressants and maybe steroids - must begin before irreversible damage occurs to effect a cure. In either case, eating a better balance of omega 3 and omega 6 oils may mitigate the resulting joint inflammation.
We'll have to end it here with those care and treatment basics, because this topic is huge. The following links provide immediate access to well-organized, easily understood, thorough details on all our joints:
- http://www.nlm.nih.gov/medlineplus/bonesjointsandmuscles.html and
- http://www.merck.com/pubs/mmanual_home/contents.htm, Section 5.
Beyond that, you can query Google on such topics as joint health, or on specific problems such as knee injuries or arthritis. Put on your hip boots first and stick to professional medical sites such as those discussed in the June 2001 column.