Now that we know running is probably good for the knees, the question arises: how is it possible that Clark Kent is totally unrecognizable as Superman merely by donning a pair of nerdy glasses and a suit? And where would he change now that phone booths are obsolete? Ok so the real question is: what else is good for the knees? For many people the answer seems to be supplements, namely glucosamine and chondroitin. But are these a miracle cure, or do they belong in back in the closet next to the Epsom salt my mom made me use?
Fortunately, this question has been asked before, and was answered in the form of the GAIT study, a landmark study of the effects of glucosamine and chondroitin supplements on knee arthritis which can be read here. By way of introduction- as we discussed before- osteoarthritis is a breakdown in the cartilage of any joint, and the condition is especially prevalent in the knee, leading to significant pain and disability. While conservative treatments are available, no treatment has been shown to actually replace the lost or damaged cartilage. Glucosamine and chondroitin are components of cartilage, and it is thought that after ingesting supplements containing those ingredients they will then be incorporated into damaged cartilage, thus reversing the damage. Although it is unknown where those supplements go after being swallowed- are they actually incorporated into the joints, or perhaps continue down the pipeline all the way into the East River.
And it’s more than a few people who believe in this treatment- $753 million dollars’ worth of glucosamine and chondroitin supplements were sold in the US in 2012. However, my dear NYC podiatry patients, don’t get your hopes up too high. In the GAIT study, a group of over 1,500 subjects took either glucosamine, glucosamine + chondroitin, a placebo or an anti-inflammatory medicine. The anti-inflammatory group experienced good statistically significant pain relief; the supplement and placebo groups- not so much. And a follow up study examining the effects of glucosamine and chondroitin on knee cartilage also failed to demonstrate a significant benefit.
These supplements are not harmful, however they have yet to be demonstrated to be beneficial. There are also inconsistencies in the amount of actual supplement within each preparation, since the industry is less tightly regulated than the pharmaceutical industry- and that says a lot. So, if you are trying to prevent knee or foot or ankle arthritis, keep active, wear proper shoes, and for cartilage sakes, man, get orthotics! Should you take glucosamine supplements? Well it couldn’t hurt, but I cannot enthusiastically endorse the idea.
See you in the office.
Ernest Isaacson
