In physiological joints, the ends of your bones are covered by a layer of resilient elastic tissue, called cartilage. Cartilage acts as shock absorber, spreading the load evenly across your joints and allows your bones to slide over one another without friction.
Your joints are exposed to constant wear and tear throughout your life, causing low-level damage, pain and inflammation. In healthy joints, your body repairs this damage and reduces the inflammation itself before symptoms appear.
However if cartilage becomes more seriously damaged symptoms, according to the NHS, can include;
* joint pain – worsen with weight bearing activities but also when resting
* swelling – usually develops after a few hours or days
* a clicking or grinding sensation but also sometimes locking, catching, or giving way
Cartilage damage is one of the most common injuries in sports, and mainly occurs in your ankles, knees, hips and shoulders. Unfortunately, there is no cure for cartilage injuries, however, by understanding the triggers and having a plan you can see significant improvement in pain, function and training, as prevent problems starting.
How to prevent cartilage injuries and alleviate symptoms
1. Rest: Protect the affected joint from further injury and avoid any high impact activities until the pain and inflammation reduce.
2. Know your risk and triggers: Being aware of the risk factors associated with cartilage damage like overuse, sports that place repetitive stress on the joints (e.g. running) and increased body weight, will help you prevent your symptoms from flaring up.
3. Behavioural changes: Positive behavioural changes can affect how often symptoms flare up.
* Pace your activities throughout the day and don’t exert yourself by trying to tackle everything at once.
* Wear comfortable shoes with soft thick soles that will act like shock absorbers for your ankles, knees and hips.
4. Weight loss and diet: Maintaining a healthy weight is essential for optimum health — more weight equals more pressure on the joints and will result in greater damage to the cartilage.
Ideally a healthy and balanced meal which incorporates all the major food groups: unrefined carbohydrates and grains, protein like lean meat, fruit, vegetables and dairy products.
Avoid consuming sugary fizzy drinks because can trigger the release of inflammatory "messengers" the cytokines, which increase the risk of cartilage damage by 63%.
5. Physiotherapy and exercise: The key is to focus on physical activities that increase the strength and tone of your muscles, as this will help support your joints.
Swimming – instead of running – has been found to be the lowest impact activity which is ideal because the water supports the weight of your body, relieving the strain on your joints while allowing you to strengthen all muscles.
6. Pain reduction: Sports massage can help reduce the tension and restore balance, but also acupuncture as an alternative treatment option can also help to further reduce pain and stiffness.
Painkillers like paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) are used as the gold standard for reducing pain, stiffness and swelling.
7. Check your diabetes status: Researchers in France found that high blood sugar levels promote the production of enzymes that break down cartilage. In another study, German researchers found that how your body metabolises blood sugar directly and affects joint integrity, independent of body weight.
If you have any concerns at all, like with any health issue, seek medical advice from a qualified medical practitioner, whether that's a doctor or physiotherapist.
Georgios Grigoriou is a senior physiotherapist with Capital Physio
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