Fixes for Joint Issues: A list of Some Basics

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I just found out my hip pain was caused by low ferritin even with normal hemoglobin and hematocrit and no blood donation. So, check your ferritin level!


Last month I checked my ferritin with an Iron panel, it was virtually the same as in 2018. So no problem there.

I checked because I felt unusually fatigued, but now I think it might have been I had covid back in March. Now i feel pretty much back to normal.

Iron and TIBC 168-305-4884-0
Iron Bind.Cap.(TIBC) 384 ug/dL 250-450 CB
UIBC 264 ug/dL 111-343 CB
Iron 120 ug/dL 38-169 CB
Iron Saturation 31 % 15-55 CB
Ferritin, Serum 168-305-4884-0
Ferritin, Serum 126 ng/mL 30-400 CB

But thanks, I didn't know low ferritin could cause hip pain.
 
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I spoke too soon. Supplementing iron glycinate did not work. It was wishful thinking.

I am going through deep tissue and chiropractic adjustments. I also do hip flexor stretching.
 
I spoke too soon. Supplementing iron glycinate did not work. It was wishful thinking.

I am going through deep tissue and chiropractic adjustments. I also do hip flexor stretching.
In your journey to feel better, at some point I would consider Rolfing if you can find no other relief. It is a type of deep tissue massage that aims to balance the body. It's a specific modality that requires 100s of hours of training on top of a massage license.

For example I had bad pinching pain in my hips several years ago and could not figure it out. Squatting was very painful for example. Turned out I had super tight glute medius that was greatly jamming the head of my femur into my acetabulum during squatting especially. I also had a very tight obturator internus that made it hard to control rotation of my leg causing another problem in my hips.

My Rolfing guy helped me understand how tightness in one area of the body can cause a cascade of problems resulting in pain somewhere else that isn't obvious.
 
Every few months or so, a post seems to come along saying something along the lines of “should I do PRP or Stem Cells or Nandrolone or anti-inflammatory injections or [insert something exotic here] for joint issues”. While all of these and others likely have their place, they are often either expensive, invasive or dangerous, somewhat immature or non-standard, or in the case of Nandrolone, widely reported to revert back to a problem state after a period of improvement if the treatment is stopped.

As someone who has struggled to overcome joint issues from a head-to-toe history of injuries and has tried many different things, I thought I’d put together a list of basics that are worth trying before getting into more exotic things. I am not criticizing any of the above, but rather saying that it makes sense to get the basics in place first so that you at least don’t constantly re-injure a joint before moving on to more exotic treatments if the basics don’t provide a fix.

Please note that the benefit and risk of each of these will vary from person to person and I present these simply to create basic awareness and to put them in one thread rather than chasing threads around. As always, you should do your own research to determine if they may be right for you. Here they are:
  • Fix your form, posture and gait. If you are, for example, walking or running with your feet out of alignment (I would guess at least 50% of people do this) then nothing else is going to work until you fix your form. Same goes for lifting, biking, etc. I found the books of Pete Egoscue and his Egoscue Method very helpful for finding and fixing flaws in my gait which fixed my knees completely at the time that was a problem for me.
  • DMSO – almost no one mentions it these days but DMSO is an amazing healer and my first go-to chemical.
  • Aspirin instead of Ibuprofen – I have found that Ibuprofen is a big help in the short term, but it doesn’t seem to provide a permanent fix. Chris Masterjohn makes a case in the video in the following link that Aspirin is a better choice Why Aspirin Goes Best With Bicarbonate and Glycine | Chris Masterjohn, PhD
  • Food sensitivities – Eliminate grains (especially wheat) and whey protein. These seem to be a common cause of inflammation that particularly affects the joints. Many people overdo whey protein and end up giving themselves a sensitivity to it and I have found that for me it seems to be a negative for my joints. I have also noticed that many on the Carnivore diet report improvements in joint function (I would guess due to something they removed from their diet.) A related point is to ensure your nutrient intake is complete, especially glycine.
  • Slow Negatives – Slowly lowering a moderate weight through the range of motion that is a problem seems to be very helpful, especially when there is a muscular component to a joint issue. The slow-lifting zealots, like most zealots, have IMO ruined a message with a grain of truth in it by over-selling it, but I think it is still a very effective tool in some situations. I would also stress slow negatives even when a joint is not an issue as this has been shown to give better gains in many situations.
  • Muscle Activation Therapy/Techniques – Similar to slow negatives, moving light weight through every possible range of motion for a joint, especially those that hurt has been essential for me for resolving shoulder issues. Indian clubs or the Should Rok are other options as well. Similarly for me, abbductor/adductor work has been very effective for hip issues. I have sensed that when a joint is injured, the body shuts down the muscles around it, but they don’t always reactivate when the joint is healed, and working them with light weights seems to be very effective in re-habing the joint.
  • For knee issues, try making front squats your primary (or only) knee movement – Most people think that front squats are harmful due to the range of motion, however I have found them to be very therapeutic and my knees (which used to be a problem) now feel best when I focus on front squats. They seem to help my back as well. Back squats and leg presses seem to bother my knees however.
  • Ensure balanced muscles around a joint – Many people only work quads but not hamstrings, or only do presses but not pulls. Fix that.
  • Allow adequate healing time – Joint tissues (tendons, ligaments, cartilage) have a much slower metabolic rate and less circulation than muscles, and consequently take much longer to heal. I had hip and shoulder injuries that took 18 months to fully heal.
  • Virtual PRP – This means working a joint several times a day in a way that gets a lot of blood into the joint. For me, I did 40 second sprints on my recumbent bike as recommended by Stan Efferding in his video on fixing knee issues and I found it to be very helpful. It helped my conditioning as well.
  • Virtual Surgery – I think this concept originated with Stu McGill who is mandatory reading on the topic of injuries, especially his book The Gift of Injury and the various podcasts featuring him. The basic concept here is to skip surgery and go straight to the rehab program, and see if the rehab alone fixes the problem.
  • Avoid joint-wrecker machines and movements – Speaking of Stu McGill, another of his insights that helped me was to avoid the full range of motion when doing leg presses if it rolls up your lower back. Other things that bother many people include the Smith Machine, dips, behind the neck presses and pull-downs, pullovers and pec-decks. I’m not saying not to do these things but be aware that they can easily over-stretch a joint. Some people will need to avoid bench presses. I personally substituted decline presses for dips and my shoulders thanked me for it. Additionally, some movements are just not meant for some people. Look for alternatives if this is you.
  • Use higher reps for a while – Most people emphasize reps in the 3-12 range however there can be a lot of advantages to reps in the 20-30 range. There is some evidence that longer set times create a training stimulus that shorter sets do not. In any event, it can allow you to continue to train while reducing stress on your joints.
  • Stretching – I hate stretching as much as the next person, but it has been a big help for my knees and shoulders. If you feel like your kneecap or the tendon below it is a problem, I have found stretching the front of the leg to be a big help for that.
  • Chains or bands – If the lower range of a motion causes pain but the upper range does not, try using chains or bands to add resistance in the upper range. Bands alone are also worth a try. In general using a wider range of activities (e.g. sled pulling, sprints, ruck marching, strongman throws, etc.) rather than just the typical strength moves is a good idea
  • TB500, BPC-157 and GH secretagogues – Believe the hype. Especially for TB-500.
  • Be cautious about repetitive motion and joint trauma – For example, digging with a shovel or building a deck can create damage that lasts for months. Investing in knee-pads, a roller seat or whatever is appropriate to take stress off of your joints when doing physical labor is well worth it IME.
  • *** oil – While not joint-specific, *** oil has been a big help for me and seems to have anti-inflammatory properties that reduce excess (as opposed to necessary) inflammation. Some people also find benefit from Cissus Quadrangularis and Kratom, however I don’t know enough about those to know if they are actually resolving a cause or just suppressing pain, whereas *** oil seems to address a root cause. Either way I would try those long before I would try any of the nastier pain suppressants and if pain is a major issue, suppressing it temporarily may allow one to do some of the other things on this list that will address a root cause.
  • Oxytocin – While a bit more speculative and less clearly a fix vs a pain suppressor, I would still give Oxytocin a try if joint replacement was the next alternative or other things here didn't give a complete resolution. The anti-aging research on Oxytocin is very intriguing.
  • Lose unnecessary body fat – Duh. I know it’s easier said than done but excess inflammation and stress on joints will negate the benefit of other potential fixes.
Ok, this is certainly not a complete list but something to start with.
Great ideas! Thank you for posting
 
DMSO – almost no one mentions it these days but DMSO is an amazing healer and my first go-to chemical.

How is this taken for maximum benefit?
 
I have no basis for saying what would create maximum healing, but I have seen others and myself have spectacular benefit simply by putting DMSO cream on the offending area. One should plan on it taking several weeks to work, but it is a must-try in my experience.
 
Every few months or so, a post seems to come along saying something along the lines of “should I do PRP or Stem Cells or Nandrolone or anti-inflammatory injections or [insert something exotic here] for joint issues”. While all of these and others likely have their place, they are often either expensive, invasive or dangerous, somewhat immature or non-standard, or in the case of Nandrolone, widely reported to revert back to a problem state after a period of improvement if the treatment is stopped.

As someone who has struggled to overcome joint issues from a head-to-toe history of injuries and has tried many different things, I thought I’d put together a list of basics that are worth trying before getting into more exotic things. I am not criticizing any of the above, but rather saying that it makes sense to get the basics in place first so that you at least don’t constantly re-injure a joint before moving on to more exotic treatments if the basics don’t provide a fix.

Please note that the benefit and risk of each of these will vary from person to person and I present these simply to create basic awareness and to put them in one thread rather than chasing threads around. As always, you should do your own research to determine if they may be right for you. Here they are:
  • Fix your form, posture and gait. If you are, for example, walking or running with your feet out of alignment (I would guess at least 50% of people do this) then nothing else is going to work until you fix your form. Same goes for lifting, biking, etc. I found the books of Pete Egoscue and his Egoscue Method very helpful for finding and fixing flaws in my gait which fixed my knees completely at the time that was a problem for me.
  • DMSO – almost no one mentions it these days but DMSO is an amazing healer and my first go-to chemical.
  • Aspirin instead of Ibuprofen – I have found that Ibuprofen is a big help in the short term, but it doesn’t seem to provide a permanent fix. Chris Masterjohn makes a case in the video in the following link that Aspirin is a better choice Why Aspirin Goes Best With Bicarbonate and Glycine | Chris Masterjohn, PhD
  • Food sensitivities – Eliminate grains (especially wheat) and whey protein. These seem to be a common cause of inflammation that particularly affects the joints. Many people overdo whey protein and end up giving themselves a sensitivity to it and I have found that for me it seems to be a negative for my joints. I have also noticed that many on the Carnivore diet report improvements in joint function (I would guess due to something they removed from their diet.) A related point is to ensure your nutrient intake is complete, especially glycine.
  • Slow Negatives – Slowly lowering a moderate weight through the range of motion that is a problem seems to be very helpful, especially when there is a muscular component to a joint issue. The slow-lifting zealots, like most zealots, have IMO ruined a message with a grain of truth in it by over-selling it, but I think it is still a very effective tool in some situations. I would also stress slow negatives even when a joint is not an issue as this has been shown to give better gains in many situations.
  • Muscle Activation Therapy/Techniques – Similar to slow negatives, moving light weight through every possible range of motion for a joint, especially those that hurt has been essential for me for resolving shoulder issues. Indian clubs or the Should Rok are other options as well. Similarly for me, abbductor/adductor work has been very effective for hip issues. I have sensed that when a joint is injured, the body shuts down the muscles around it, but they don’t always reactivate when the joint is healed, and working them with light weights seems to be very effective in re-habing the joint.
  • For knee issues, try making front squats your primary (or only) knee movement – Most people think that front squats are harmful due to the range of motion, however I have found them to be very therapeutic and my knees (which used to be a problem) now feel best when I focus on front squats. They seem to help my back as well. Back squats and leg presses seem to bother my knees however.
  • Ensure balanced muscles around a joint – Many people only work quads but not hamstrings, or only do presses but not pulls. Fix that.
  • Allow adequate healing time – Joint tissues (tendons, ligaments, cartilage) have a much slower metabolic rate and less circulation than muscles, and consequently take much longer to heal. I had hip and shoulder injuries that took 18 months to fully heal.
  • Virtual PRP – This means working a joint several times a day in a way that gets a lot of blood into the joint. For me, I did 40 second sprints on my recumbent bike as recommended by Stan Efferding in his video on fixing knee issues and I found it to be very helpful. It helped my conditioning as well.
  • Virtual Surgery – I think this concept originated with Stu McGill who is mandatory reading on the topic of injuries, especially his book The Gift of Injury and the various podcasts featuring him. The basic concept here is to skip surgery and go straight to the rehab program, and see if the rehab alone fixes the problem.
  • Avoid joint-wrecker machines and movements – Speaking of Stu McGill, another of his insights that helped me was to avoid the full range of motion when doing leg presses if it rolls up your lower back. Other things that bother many people include the Smith Machine, dips, behind the neck presses and pull-downs, pullovers and pec-decks. I’m not saying not to do these things but be aware that they can easily over-stretch a joint. Some people will need to avoid bench presses. I personally substituted decline presses for dips and my shoulders thanked me for it. Additionally, some movements are just not meant for some people. Look for alternatives if this is you.
  • Use higher reps for a while – Most people emphasize reps in the 3-12 range however there can be a lot of advantages to reps in the 20-30 range. There is some evidence that longer set times create a training stimulus that shorter sets do not. In any event, it can allow you to continue to train while reducing stress on your joints.
  • Stretching – I hate stretching as much as the next person, but it has been a big help for my knees and shoulders. If you feel like your kneecap or the tendon below it is a problem, I have found stretching the front of the leg to be a big help for that.
  • Chains or bands – If the lower range of a motion causes pain but the upper range does not, try using chains or bands to add resistance in the upper range. Bands alone are also worth a try. In general using a wider range of activities (e.g. sled pulling, sprints, ruck marching, strongman throws, etc.) rather than just the typical strength moves is a good idea
  • TB500, BPC-157 and GH secretagogues – Believe the hype. Especially for TB-500.
  • Be cautious about repetitive motion and joint trauma – For example, digging with a shovel or building a deck can create damage that lasts for months. Investing in knee-pads, a roller seat or whatever is appropriate to take stress off of your joints when doing physical labor is well worth it IME.
  • *** oil – While not joint-specific, *** oil has been a big help for me and seems to have anti-inflammatory properties that reduce excess (as opposed to necessary) inflammation. Some people also find benefit from Cissus Quadrangularis and Kratom, however I don’t know enough about those to know if they are actually resolving a cause or just suppressing pain, whereas *** oil seems to address a root cause. Either way I would try those long before I would try any of the nastier pain suppressants and if pain is a major issue, suppressing it temporarily may allow one to do some of the other things on this list that will address a root cause.
  • Oxytocin – While a bit more speculative and less clearly a fix vs a pain suppressor, I would still give Oxytocin a try if joint replacement was the next alternative or other things here didn't give a complete resolution. The anti-aging research on Oxytocin is very intriguing.
  • Lose unnecessary body fat – Duh. I know it’s easier said than done but excess inflammation and stress on joints will negate the benefit of other potential fixes.
Ok, this is certainly not a complete list but something to start with.

Amazing list.

Spot on, and not influenced by medical dogma.

I would add NOT USING AN AI and freely letting estrogens creep up along with androgens.
 
Another thing I learned about in a different thread is supplementation with palmitoylethanolamide, aka PEA. I've been using this for about three months and the correlation with reduced pain and enhanced mobility is pretty remarkable. Aside from its possible analgesic effects it may be able to reduce inappropriate inflammation. "Some primary research reports support the conclusion that PEA levels are altered and that the endocannabinoid system (ECS) is 'imbalanced' in acute and chronic inflammation. ... PEA downregulates hyperactive mast cells in a dose-dependent manner..."[R] There does not seem to be safety data on long-term use, but at least it's an endogenous substance.

This should not be confused with another useful supplement with the PEA initialism: phenethylamine.
 
PEA is one of the little known anti-inflammatories. I have limited experience with it orally and topically and it does suppress my inflammatory red-face reactions to eating sugar. It is classified as a "mast cell stabilizer" i.e. interferes with the mast cell degranulation. I suspect this is a general immune suppression effect, not only on "hyperactive mast cells".
 
 
@Nelson Vergel, I've never heard of ecdysterone before - did that study ever go anywhere? It sounded too promising not to pursue further, but I was unable to find any continuing research - all of my search hits pointed back to that same summary. Serious arthritis has be very interested...
 
Where do you guys get these (I know there are a bunch of sites, but which ones to trust?). Also, what kind of combination or monotherapy protocols work for you?
I am having horrible problems this month with my hip flexors. Sitting all day in front of the computer and probably these new cushy shoes did it. Getting deep tissue massages and stretching have helped but the pain is still there.


Here is a site I would try. I know the guy who owns it and he is a stand up guy.

use code “Billy” for 15% off


 
I have no basis for saying what would create maximum healing, but I have seen others and myself have spectacular benefit simply by putting DMSO cream on the offending area. One should plan on it taking several weeks to work, but it is a must-try in my experience.
Hmm. I purchased a 70/30 mix of DMSO and Aloe Vera. Not really noticing any differences. However I have seen and read testimonials of success mixing drops of DMSO in water. Might have to try pure liquid DMSO and mix it with distilled water.
 
I also wanted to add that a TotalGym machine works wonders and can be used for both rehab and muscle growth. I picked up on at a garage sale to work on a rotator cuff injury and felt so good using it I kept up with it for my regular lifting program. You can get a weight bar to add plates or also attach bands to increase the resistance. It’s amazing what it can do and how it can make you feel. My current routine is a day of totalgym and then a day of ballistic kettlebells (swings, snatches, or clean and jerk) and I made better gains than I have in 30 years.
 
Beyond Testosterone Book by Nelson Vergel
I also wanted to add that a TotalGym machine works wonders and can be used for both rehab and muscle growth. I picked up on at a garage sale to work on a rotator cuff injury and felt so good using it I kept up with it for my regular lifting program. You can get a weight bar to add plates or also attach bands to increase the resistance. It’s amazing what it can do and how it can make you feel. My current routine is a day of totalgym and then a day of ballistic kettlebells (swings, snatches, or clean and jerk) and I made better gains than I have in 30 years.
Yes,, many purists and crossfitters love to bash machines however I found them to be totally essential to rehabbing my joint injuries. For example, the abductor/adductor machine was a big help for my hip injuries and the pull-down machine was great for putting light weight on my shoulders and back before I could do pull-ups again. The dip machine was the only pressing movement I could do through a full range of motion when my shoulders were injured.
 
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