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Knees, Snowboarding, and Such - cellophane
the story of an invisible girl
renniekins
renniekins
Knees, Snowboarding, and Such
I couldn't fall asleep last night, so at 2am I pulled out my laptop and, spooning with the cat in my heated bed, we read up on treatments for damaged knee cartilage. We weren't too pleased with any of the answers, but I'm thinking that perhaps I should try supplements. These are things I found mentioned in a study, saving for my own future reference: glucosamine (1500 mg), chondroitin sulfate (1200 mg), Celecoxib / Celebrex.

I had a blast skiing last week (and still need to write up a report of my awesome vacation!), but my left knee did not enjoy it as much as the rest of me did. (Even with the rooster injections -- actually I'm not sure that those did much of anything. It's hard to tell, since skiing is not something I do regularly enough to compare.) I didn't injure it or anything, which is good, but the act of skiing left it swollen and sore enough that I was limping significantly when walking around afterward.

We met a British couple at an apres ski, both of whom are "boarders". Snowboarders, that is, but that's not a cool enough word I guess. The guy said that snowboarding is much easier on the knees than skiing, because there is little-to-no twisting action. He also joked that while skiing is a sport, snowboarding is a lifestyle. I can see that!

I've never much liked the idea of snowboarding, because while they look cool going down a mountain, they look kind of hobbled and clumsy otherwise. Dragging that big board around on one foot, sitting on their butts in the snow to strap back in. However now I'm starting to reconsider. If it's easier on my knee, maybe that's the answer to having fun on snowy mountains with my friends without getting hurt. I'm only 37, but I think my knee is more like 57. I don't want to give up recreational sports, but I do need to find a way to enjoy them pain-free. Or at least mostly pain-free. So I'll give it a shot.... I've convinced M to try renting a snowboard and taking a lesson with me. I can at least find out if the act of boarding is gentler on my knee cartilage, then decide if I actually want to switch from a sport to a lifestyle or not....

This morning I had trouble getting up for work. What a surprise, after being up half the night! After great struggle, I dragged myself out of bed, forced a bowl of cereal down my throat, and hurried through the shower. My car is only a few dozen feet from my porch, but it's 8 degrees fahrenheit outside. By the time I settled myself at the steering wheel, my hair had frozen. Crunchy...brrr!

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Comments
madtechie2718 From: madtechie2718 Date: February 4th, 2009 05:16 pm (UTC) (Link)
I rate the Glucosamine/Chondroitin supplements very highly - wheras I was getting serious pain in rt hip and lt knee after 3 or 4 miles hiking several years back, I now suffer no pain at all, no matter how far I go.

NSAIDs I'm rather more cautious about, due to stomach probs, though Celebrex/Celecoxib is much better tolerated than others.

P's boss is a professor in arthritis/rheumatology and speaks well of the supplements route too, though I was first put onto the stuff by a colleague who moved to the Royal National Orthopaedic Hospital - she said that many of the senior staff over 40 (especially the sporty types) take it.

The bioavailability of the pills is relatively poor and 2-3 months may pass before you see any significant improvement.

Bioavailability of the liquid form is 3 - 5 times better, so you might be best advised to start on that. Make sure you don't have a shellfish allergy and, of course, talk to your doc.

Glucosamine has suffered from a lot of over-hype form fringe-medicine, but is now becoming more established as a mainstream treatment.

I probably can't send you a link to the journal directly, as it is only available to registered machines, but a brief precis of the article in The Lancet (one of the premier medical journals around) may help if the link doesn't work:

http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673600036102.pdf?id=0e96c9e6421f9512:79975f33:11f41fdf0b2:1d631233767502203

***
Background
Treatment of osteoarthritis is usually limited to short-term symptom control. We assessed the effects of the specific drug glucosamine sulphate on the long-term progression of osteoarthritis joint structure changes and symptoms.
Methods
We did a randomised, double-blind placebo controlled trial, in which 212 patients with knee steoarthritis were randomly assigned 1500 mg sulphate oral glucosamine or placebo once daily for 3 years. Weightbearing, anteroposterior radiographs of each knee in full extension were taken at enrolment and after 1 and 3 years. Mean joint-space width of the medial compartment of the tibiofemoral joint was assessed by digital image analysis, whereas minimum joint-space width—ie, at the narrowest point—was measured by visual inspection with a magnifying lens. Symptoms were scored by the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index.
Findings
The 106 patients on placebo had a progressive joint-space narrowing, with a mean joint-space loss after 3 years of −0·31 mm (95% CI −0·48 to −0·13). There was no significant joint-space loss in the 106 patients on glucosamine sulphate: −0·06 mm (−0·22 to 0·09). Similar results were reported with minimum joint-space narrowing. As assessed by WOMAC scores, symptoms worsened slightly in patients on placebo compared with the improvement observed after treatment with glucosamine sulphate. There were no differences in safety or reasons for early withdrawal between the treatment and placebo groups.
Interpretation
The long-term combined structure-modifying and symptom-modifying effects of gluosamine sulphate suggest that it could be a disease modifying agent in osteoarthritis.
***

Other studies (that I do not have to hand) find that the uptake is improved with Chondroitin added to Glucosamine, most authorites recommend that.

This is for Osteoarthritis, Rheumatoid is a completely different disease and I suspect that such good results mmay not be achieved - if any at all.

Edited at 2009-02-04 05:19 pm (UTC)
renniekins From: renniekins Date: February 11th, 2009 01:54 am (UTC) (Link)
Thanks for your message and information! I've ordered some liquid supplements this stuff), to see if it'll help any. Here's hopin'....

It is osteoarthritis -- actually the wording seems a bit weird to me, calling it a "disease" when it's really "damaged tissue from banging together too much". I guess to me a disease means a bug, not just wear and tear.

Anyway. Whatever it is, hopefully I can get it to stop hurting without needing to give up too many things that I like to do.
dagibbs From: dagibbs Date: February 4th, 2009 05:30 pm (UTC) (Link)
Wear a helmet. No, seriously, wear a helmet. I mean it.
devnul From: devnul Date: February 4th, 2009 05:54 pm (UTC) (Link)
+5

And if you do take a hard fall and hit your head hard enough to jar it, even if you think you're fine, double-check your teeth. Have M help. Maybe even go to a dentist.

It turns out S cracked a tooth back in late December up at Sugarloaf but had no idea until a few weeks ago when some bacteria got into the crack and it ended up infected (and has since been root-canal'd).

renniekins From: renniekins Date: February 4th, 2009 06:37 pm (UTC) (Link)
Ow ow ow ow!
devnul From: devnul Date: February 4th, 2009 05:52 pm (UTC) (Link)
It will be pretty significant on your left knee if it's your left leg that has to stay buckled into the board when you're on the chairlift.

Start out by figuring out if your stance is normal or goofy. Imagine the board going the long way down the mountain. Which feels more natural to you - having your left leg forward, or your right? Normal stance has your left leg in front, while goofy stance puts your right leg in front. Here's a picture.

So if you're normal stance, and your left leg is in front, be really, really careful with that knee on the chairlift.

renniekins From: renniekins Date: February 4th, 2009 06:40 pm (UTC) (Link)
Fortunately I had already determined that I'd be "goofy", from childhood skateboarding, even before I thought about the fact that my front foot would have the board attached on the lifts! Yikes, I'm glad that works out properly at least.

I've been reading some instructions and watching some youtube, to see if snowboarding seems good to me.
devnul From: devnul Date: February 4th, 2009 06:43 pm (UTC) (Link)
Excellent! That will work out great for you, then.

And of course rule #1 is ... don't go down square and scrape all the snow off the trails!
:)

From: (Anonymous) Date: March 25th, 2009 06:23 pm (UTC) (Link)

Osteoarthritis/Snowboarding

I've had to recently quit snowboarding after 20 yrs due to osteoarthritis in my knees. I'm 61 so I guess I can't complain, but it and ice skating were my only winter sports.

I think snowboarding is less hard on your knees, but it still puts impact loads on them. I'd recommend soft boots and snow.
renniekins From: renniekins Date: March 26th, 2009 05:09 am (UTC) (Link)

Re: Osteoarthritis/Snowboarding

Thanks for your input! I'm only 37, so I'm hoping that despite a very beat-up knee I can enjoy winter sports for lots more years. Just gotta figure out the secret... Hopefully switching to snowboarding will help.
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