Breaking The Injury Cycle

The one thing that so often prevents an athlete from reaching their next level of performance is an injury. Yet, many athletes are constantly injured season after season. Many more seem to be nursing that bum knee or weak ankle. Healing an injury one hundred percent involves a lot more than exercise rehab and anti-inflammatory drugs. Making sure all injuries stay at bay is a stress level and nutrition matter.

Building on what I talked about in previous articles, chronic stress is the cause of most injuries. You do not just wake up one day with a sore knee or neck; and you do not “catch” ITB syndrome or pull a hamstring one day while running because you just overdid it on that particular day. Chronic stress for the most part leads to these injuries. But let’s not worry about how to fix a particular injury, but all your injuries to some extent, hopefully fully. Let’s build a stronger foundation in yourself, so you can also prevent injuries from occurring in the first place, and spend more time training than not.

Chronic stress, whether from overtraining, lack of sleep, ingestion of too much caffeine or refined sugar, or an emotionally unstable job or relationship, leads to hormonal imbalances. The hormone cortisol increases as a result. This decreases tissue insulin sensitivity – a phenomenon termed “insulin resistance.” It is very important because it leads to the decreased absorption of glucose into the body’s cells. When glucose doesn’t enter the cells, not only is energy production impaired, but joints ultimately cannot be repaired.

Usually far before an injury is evident, there are many little nagging symptoms present – maybe a stiff neck, a sore shoulder while swimming, a twitching muscle while running, or a spasm in a gluteus muscle on the bike. Most importantly, because the cells are starving for sugar that is sitting right outside the doorway in the bloodstream waiting to be let in, (yet insulin is just so insensitive!), you CRAVE SUGAR. You may crave it throughout most of day, and especially right after a workout or after a meal. You may be irritable and moody from the roller coaster blood sugar level hitting more high and low peaks than most Internet stocks of early 2000. Over time, your muscles may start to spasm or cramp up. They may also experience what some physicians describe as “restless leg syndrome” because no one really knows exactly what causes the legs to ache so deeply at night. This is very commonly due to a deficiency of magnesium or zinc, needed to activate the glucose once inside the cell.

But before getting to the interesting part, we have to step back a bit. When it comes to repairing an injury, or making sure an injury doesn’t surprise you tomorrow, the most important chemical process pertinent is that of sulfation. Once you hear that word, and you’ve understood the part about glucose, you may be starting to put these two together by thinking of the supplements glucosamine sulfate and chondroitin sulfate. Chondroitin sulfate is the substance made naturally in your body when dealing with the production of cartilage. Glucosamine is an intermediate step along this production pathway, whose main goal is to make chondroitin sulfate. If this step is blocked along the way at any point, then the chondroitin sulfate won’t be made. The point here is not to supplement with either of these products. It is to figure out how to make it on your own, every day, naturally. Supplementing with either glucosamine or chondroitin is sometimes a good idea following an injury, but taking some every day will not prevent most injuries. Additionally, taking either product every day as a supplement is really missing the big picture by not answering the question, “Why am I not making it in the first place?”

When a person is under manageable stress levels, glucose is easily allowed into the cells so it can ultimately make glucosamine and then chondroitin. The chondroitin is then made into chondroitin sulfate, allowing for joint repair, only when sulfates are available. So the first step is make sure the glucose is there. This is going back to the stress of life, the stress of training. You may be eating a lot of carbs and still not getting the glucose into your tissues, or you may not be eating many carbs at all and have plenty of glucose in your tissues. It is not the amount, but the stress level. Again, high stress = high cortisol = decreased glucose absorption = inability to make glucosamine = an injured athlete, one soon to be injured, or one unable to fix their injury.

The second goal in the body to make all this work is to make sure that the sulfates are available. Sulfates are present in foods such as broccoli, cauliflower, garlic, cabbage, onions, radishes, and mustard. But more importantly, sulfates are depleted during high stress levels also because they are needed to detoxify cortisol in the liver. The key is to not use more up than you take in. Even more interesting is the fact that NSAIDs restrict sulfate availability, so cartilage cannot be repaired. That is a shocking fact for many people who are trying to help their injury with these drugs, yet are actually doing more harm than good by depleting their sulfate levels. Research shows that NSAIDs are only beneficial 2-3 days after injury. Taking them longer, or for the many that take them every day, is inviting greater problems later in life. Deficiency of the trace mineral molybdenum also inhibits sulfate availability.

Once the glucose gets there, because it was allowed inside the tissue from manageable stress, (normal cortisol levels), it trickles down and ultimately makes chondroitin. This looks for the sulfur, (which is present when there are also low stress levels and no signs of NSAID abuse), to make chondroitin sulfate, the ultimate prize in injury repair.

Not only does the viscous cycle of stress need to be broken so the above chemical processes can take place, but the viscous cycle of joint damage must be stopped. The injury that causes inflammation, pain, and muscle imbalances leads to altered joint mechanics, which ultimately leads to further joint damage. This causes a person to want to take more NSAIDs and/or increases their emotional stress level, as well as physical stress. This can lead to impaired digestion, (decreased glucose absorption), and an unhealthy diet to make up for a depressed mood, (the person craves more refined sugars). The excess chemical and emotional stress, added to the injury’s physical stress and drug use, further inhibit joint repair, resulting in more tissue damage, inflammation, and pain. Round and round it goes. So take a step back. Assess the situation. Think it through. Break the cycle, and set a new PR.

For even more detail on repairing your joints, check out my article on SOCK-DOC here.