Me knees!

[Oscar's dad]

For some years now both of my knees crackle as I sit down, it's noticeable when I plant myself on the bog    I've never been that bothered and put it down to aging (I'm 52).  But recently I've been getting some twinges and minor discomfort which is a worrying development.

So I'm now taking these ...



I've only been taking them for a week so haven't noticed any improvement which is to be expected I suppose.

Does anyone have any thoughts or useful experiences to share?

[caerau]

The effectiveness of these is hotly debated - lots of pseudoscience and lack of real scientific back up as far as I know.


In my non-expert but actually-practising-bioscience/chemistry opinion (take that as you will) - such supplements are pure placebo - with the possible exception of chondroitin although its benefits are not known hard and fast and real known affects are thin very thin.


Your body has metabolic pathways that make the raw materials for collagen and other connective tissue from very small molecules that it obtains from you eating food.  Collagen is a protein your digestive system will break down in the stomach and intestines to its component amino acids which are then further metabolised either upward into new protein (not just collagen) or downwards to more fundamental small molecules.  I do not believe for one moment that collagen you eat ends up directly into collagen in your joints (it doesn't remove skin wrinkles for example - those are caused by subcutaneous collagen degradation over time) - glucosamine is a sugar your body will quite happily make all the time as it will other sugar molecules like chondroitin.


Of course there are those who swear by it and all power to them if they like taking them and think it's working.  There's nothing wrong with that.

[Ruthie]

My knees have made fabulous crunchy noises for years.  I regard this as bonus musical entertainment.  HTH.

[Oscar's dad]

In my early 20s I was a sailmaker so spent much of the day on my knees which I don't think has helped.

[IJL]

Glucosamine used to be very commonly prescribed for joint issues.  After a while it was found to have no impact at all and it is now what is called a black drug.  That means that should I prescribe it an accountant with a blunt instrument will seek me out to discuss the error of my ways

[Oscar's dad]

So what should I do or take?  I know several cyclists, runners and fitness coaches who have developed knee problems as they have got older and would like to avoid the problems they have experienced if I can.

[caerau]

I would see a doctor and see what they say (this may not help of course - they may just tell you it's wear and tear and do nothing) as the first option.


The jury is still out on chondroitin containing supplements - there have been fairly large scale double blind type trials with it - though the FDA in the USA refused a license so...
It may have a small but nevertheless significant effect.

[caerau]

If it actually is arthritis onset (it may not be) then a NSAID like ibuprofen is recommended - not so much for the pain but to reduce inflammation - which is what causes the damage mostly.

[L CC]

I have wear and tear arthritis damage in my knees and intermittently take all the placebos, on the basis that a) it might work b) it won't hurt and c) Mr Smith is paying for them.

[Biggsy]

Cracking noises don't necessarily mean much, but of course any pain should be taken seriously.  Simply reducing my cycling mileage has improved my knees.  Saddle position is very relevant as well.

[Ham]

FWIW, at about your age - so <cough> years ago (less than 10  ) I started chomping 3 of these http://www.healthspan.co.uk/products/joint-physio-glucosamine-plus each morning, mostly to keep Mrs Ham company - especially as I was finding it increasingly difficult to do things like squatting and rising - creaky and painful.

After about three months I noticed I was squatting much easier and the nagging knees had gone, and it remains so to this day. I would say that it helps me, but Mrs Ham has no such clear cut view - but she has more serious issues than just vague inflexibility and discomfort.

My conclusion is that while the science may well de dubious, it appears to help some people whether placebo or not, I am one of those people and so it is worth my while continuing.

The Healthspan ones were chosen (a) because of the full range constituents (b) because they said you could take the dose all together rather than at three times in the day (c) because they were cheapest. If you fancy using them they do a referral scheme which gives me credit and you £5 off - this link will take you there as my recomendee. They always have money off codes that give you a couple of quid off, signing up to their emails is the easiest way to get them.

[Ham]

Oh yeah, and what Biggsy says, too. What glucosamine seems to help with is the background niggles not the I've-asked-my knees-do-do-more-than-they-wanted-to stuff. And, as he says, saddle height is key.

[Oscar's dad]

Interesting stuffs - thanks.

My cycling mileage is not massive although I do go spinning which I think batters your knees more than normal riding. I've also been doing MetaFit which involves a lot of jumping about so l might knock that on the head. Later this month myself and some chums are riding up north on ridiculously loaded bikes over lots of lumpy bits so it will be interesting to see how the knees cope. In the meantime I shall carry on taking the tablets.

[jiberjaber]

Steve, Bad Science by Ben Goldacre is an interesting read on such things like this, both the science covered by our bioscience and doctor contributors plus the 'placebo' (or not) effect as noted by Ham are discussed in the book. 

There can also be a multitude of other influences which might occur at the same time as taking the supplement which result in improvement but hard to isolate what... its a really complex and interesting area to try and unpick - plus the psychosomatic interaction isn't totally ruled out either.

The book is often on cheep but seems to be full price at the moment, worth keeping a look out for a read: https://www.amazon.co.uk/gp/product/B002RI9ORI/ref=kinw_myk_ro_title

I am no fan of pills unless they actually do something (Ibuprofen etc ), but Mrs Jiber seems to swear by them... and it would appear some do feel they work when science is at odds with the result.... if people are happy to buy them and there's no ill side effects, then crack on.... I think where I would draw the line is if my taxes were paying for them.... but that's an entirely different debate

[simonp]

I used to, but I stopped, deciding it was a waste of money.

[Asterix, the former Gaul.]

Interesting stuffs - thanks.

My cycling mileage is not massive although I do go spinning which I think batters your knees more than normal riding. I've also been doing MetaFit which involves a lot of jumping about so l might knock that on the head. Later this month myself and some chums are riding up north on ridiculously loaded bikes over lots of lumpy bits so it will be interesting to see how the knees cope. In the meantime I shall carry on taking the tablets.

I think you are right about spinning.  I like cycling in mountainous areas with touring gear and have this crazy idea that it does my knees good. It doesn't seem to have done them any harm so far anyway.  Building work that I do means a lot of jumping up and down and that's not so good - for my ankles mainly. 

[Wowbagger]

Glucosamine used to be very commonly prescribed for joint issues.  After a while it was found to have no impact at all and it is now what is called a black drug.  That means that should I prescribe it an accountant with a blunt instrument will seek me out to discuss the error of my ways

When my arthritis kicked off, the rheumatologist suggested I might like to consider taking condroitin/glucosamine tablets. I did for a while, but didn't keep it up.

My bro-in-law, a pharmacist, pointed to a Lancet article which suggest that there is a beneficial effect for arthritis sufferers. As he said, it's pretty unusual to have a double-blind test on something that isn't a patented medicine, which I believe this was.

http://www.thelancet.com/pdfs/journals/lancet/PIIS0140673600036102.pdf

It's 15 years old, so there might well be more up to date stuff around. Mine is rheumatoid, and that test was for osteo suffers.

[Oscar's dad]

I gave up on the tablets after taking two packets worth as I wasn't noticing any improvement.   The Up North Tour in June passed without any knee issues which was good.

Oddly my knees having been playing up again over the last week or so. I started spinning again in September so wonder if that's the problem. I will monitor the situation and decide what to do. I'd like to carry on spinning because although I hate it my performance on the road is much improved.

[ElyDave]

Trust Me I'm A Doctor did this one a few weeks back.

Their trial was exercise vs a placebo.

Exercise worked best, but surprisingly the placebo had a significant effect.  FWIW I used to take these, but stopped, my knees have got no worse.  I think yoga has had more effect