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.
Your websites are the first to give me real hope in the last 18 months and I am so happy I found you and your work. I am 35 and been struggling with my health and have been in pain literally, for the past year and half.
I have started a healing regiment based on your suggestions which I am certain will work including changes in diet (no carbs till further notice!), pressure point therapy, improved diet and supplements to help boost my recovery and overall chemical imbalance.
Just to give you an idea of what I´ve been dealing with, I went from easy running 2 days a week and walking for about 1-2 hrs a day plus yoga twice a week to having difficulty walking, (forget running), difficulty falling and staying asleep, constant UTIs and yeast infections, mood swings, migraines, back pain, neck pain, numbness, tingling and “funny bone” pain on my right side, sciatic or pain in the sciatic nerve, muscle tightness in my glutes, bouts of diahrrea and painful tension building in muscles after any prolonged activity (sitting, walking, standing, even laying in bed) and a relief feeling from popping of leg/hip joints on both sides which I cannot figure out! Most of my pain is on my right side from my face down to my toes! I tried chiropracters, deep tissue massage, accupuncture and tried returning to yoga and stretching on myown in the hopes that I would “readjust” whatever was off or in the wrong place, which is what it feels like. Sitting is amost unbearalbe. My chiropracter finally said she couldnt figure out what the problem was and told me to go to a medical doctor who said I had fibromyalgia. An xray said I was fine.
I dont want to tire you with the details of all the things I know I did and stopped doing to get to this point, but a lof of it has been ignorance, as I felt stretching was something I needed to do to heal. I am so gratefu for the information you so generously share with the world!
I have begun to follow your suggestions and its very easy as all of this finally makes sense and have begun to feel much much better, however sitting is still very painful and once the pain sets in I tend to suffer for days. I´m sure I have an injury I need to heal from, but I have to sit from time to time and although Im attempting to work while standing, this is not always possible. Do you have any suggestions for sitting positions while healing from piriformis/ hip flexor damage?
Regarding stretching, I wanted to ask if the popping is something I need to avoid. After sitting or standing for a while, but especially sitting, my hips and right leg especially ache, I feel like I can´t straighen up my body sometimes I get a biting or itching sensation in my sacrum, Laying down flat on my back while putting left knee towards right side in a short twist wil produce a popping or clicking sound that comes from my back it seems and it happens on both sides. Once the popping comes, I feel relief, but your video on stretching specifically makes note on how bad of a strecht this is.
Can you tell me what the popping could be and if its best to avoid altogether or if its actually a good thing, as it provides some relief?
I apologize for taking so long with my explanation, but I have been to so many people and the information you provide is so on point I couldn´t help but ask! I live in Nosara, Costa Rica, a very remote jungle community which makes it impossible for me to visit you or any other practitioner in you could recommend in the states.
Thank you for your time and for making this information available to people like me, who believe in holistic medicine and the power of the body to heal itself!!!
Check out this video and see if it helps. http://sock-doc.com/2011/08/piriformis_low-back-pain_sciatica/
Is chronic stress really the cause of MOST injuries? Interesting do you have supporting evidence?
Dr. Stephen Gangemi says
It’s my clinical experience. Take it or leave it as you’d like.