Joint Health Center
In my Joint Health Center, learn all about:

• What To Do When the Joints Aren't Jumpin' 
• Top Ten Tips for Healthy Joints 
• Dr. Sinatra's Exercise Program — Just Do It! 
• Get a Leg up on Healthy Knees 

Dr. Sinatra's Top Recommendation for Joint Health

What to Do When the Joints Aren't Jumpin'

Remember the good old days when you could play and exercise seemingly for forever? We all could spend hours running, riding a bike, skiing, swimming, playing ball, dancing, gardening, or even jumping rope. I remember feeling invincible, like there was nothing I couldn't do…until one day when soreness set in. Then stiffness came along, with aching following closely behind and lasting for days. Like me, you now probably notice more cracking and popping in your joints. You also suffer stiffness when you wake up in the morning; and a general loss of fluidity in your movement.

Welcome to aging joints. No one likes to acknowledge the fact that as we age, we have to live with joints that no longer want to jump and move like they did when we were twenty. But aging can be a lot more graceful with some care and lifestyle changes.
At least 80 percent of people over age 50 have joints that aren't what they used to be—that's about 12 percent of the U.S. population. I could be counted among that group because my joints took a beating as a result of participating in high school and college athletics. The difference is that I don't suffer. I know what to take and when to take it for maximum joint mobility and comfort.

Your life can be miserable when your joints aren't operating as they used to. Many of my patients try popular medications for relief. While they usually work for the short term, you should never rely on them long-term due to their side effects, many of which are serious, such as gastrointestinal bleeding. On top of that, they don't get at the cause of your problem—they simply mask the symptoms.

Natural Solutions

The years and an active lifestyle can take their toll on your joints. The secret to healthy joints is to support your joints and their surrounding cartilage, from the inside out, with proven nutrients, like those below — available in my Joint Solutions.

Glucosamine sulfate is a natural glucose substance found in your joints that helps build cartilage and maintain joint fluid thickness and elasticity. This in turn helps to cushion the joints. 1200 – 1500 mg day is recommended.

Chondroitin sulfate works with glucosamine to lubricate joints and make tendons and ligaments more elastic.
Shark cartilage is a good source of chondroitin. I recommend at least 100 mg daily.

Sea cucumber extract is another source of chondroitin. Take at least 75 mg per day. I recommend the extract combined with glucosamine and other nutrients.

Uña de gato, also known as cat's claw, contains more than 40 compounds, several of which help joints. Begin with about 200 mg. You can safely take up to 3 grams daily. (Caution: Cat's claw activates your immune system, so if you've had an organ or tissue transplant you should not use this herb.)

White willow bark is a safe and effective natural cousin to aspirin.

Bromelain, an enzyme from pineapple, improves your circulation, speeding the removal of toxins that cause joint discomfort. Take 100-500 mg daily.

Boswellia is an extract of a tree that grows in the dry, hilly areas of India. Studies have shown that boswellic acids are helpful to joints. Take 900 mg daily.

Feverfew helps promote strong, healthy joints. Take 50-100 mg per day for prevention.

Yucca is an herb traditionally used by Southwestern Indians. It contains saponins, compounds that interfere with prostaglandins. Begin with 100 mg per day.

You can get a one-two punch if you take Joint Solutions with essential fatty acids (EFAs). This powerful combination lubricates your joints and builds cartilage. I've been using this combination with some patients, and the results have been astounding. It may take a few weeks for glucosamine to work, but the EFAs can help within one to two weeks because of their lubricating properties. EFAs can be consumed in supplements or through diet (fish, nuts, seeds, flax oil), but almost everyone needs to supplement because it's difficult to get adequate levels from diet alone. Look for a good fish oil supplement that delivers the optimal 2:1 ratio of EPA fats to DHA fats, like in my Norwegian Fish Oil, available in a softgel or an easy-to-swallow liquid.

Supplements Alone Can't Do It All
Of course, any health program should include:

• A high-quality multivitamin/mineral supplement.
• Gentle exercise to get blood flowing to your joints, particularly those that seem to cause you the most problems. Yoga, T'ai Chi, qi gong, and swimming are all excellent, safe activities for people who want to maintain healthy joints.
• A diet full of healthy oils and antioxidants. Olive, flax, and walnut oils are some of your best bets.
  

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Top Ten Tips for Healthy Joints

1. Take 250-500 milligrams glucosamine sulfate (GS) three times a day with meals. GS promotes healthy joint cartilage and maintains joint fluid thickness and elasticity.
2. For a one-two joint-promoting punch, eat plenty of essential fatty acids like fish (salmon and mackerel are best), raw nuts, seeds, and flaxseed. Put some ground-up flaxseed on your cereal or drink this delightful flax shake.
3. Combine GS with 200 mg - 300 mg chondroitin sulfate which promotes joint health and elasticity of tendons and ligaments, as well as natural anti-inflammatories like Feverfew, white willow bark, bromelain, boswellin and cat's claw.
4. Methylsufonylmethane (MSM) is an organic sulfur compound that has been used traditionally to help your body build cartilage, collagen, and connective tissue, all of which are necessary to keep your joints strong and pliable.
   
   I began using MSM after a particularly bad bout with my shoulder and I really attribute much of the improvement I experienced to this remarkable nutrient*—which is why I recommend 600 mg daily in new Joint Solutions.
5. Drink 1 or 2 cups daily of ginger or green tea, a natural inflammatory.
6. Exercise regularly at least three times a week — to increase muscle strength, and restore range of motion and flexibility.
7. Take a 4:1 ratio of omega-3 oils (fish and flax seed) and omega-6 oils (evening primrose, borage oil or black currant oil). In other words, if you consume 4,000 mg of fish oil, take 1,000 mg of one or a combination of omega-6 oils.
8. Avoid sodas, caffeine and chocolate.
9. Take 100 mg - 250 mg daily of the herb curcumin, a natural pain reliever without the tendency to trigger gastrointestinal bleeding.
10. Take 200-400 mg of SAMe 2-3 times daily for pain control.

To learn more about Dr. Sinatra's top recommendation for healthy joints, click here.

* Results not typical

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Dr. Sinatra's Exercise Program —
Just Do It!

Exercise. I can't think of another lifestyle modification with such immediate and long-lasting benefits for your health and well being. Even simple exercises strengthen your heart, circulatory system, bones and muscles, build stamina, and improve your state of mind.

Top ten reasons to exercise

1. Your heart will love you for it. Your heart will become more efficient, maintaining the same level of output with fewer beats per minute.
2. Your blood pressure will go down.
3. You'll minimize your risk for stroke.
4. You'll increase your muscle strength and restore your range of motion (flexibility).
5. You'll rev up your metabolism and burn calories, thereby losing weight.
6. You'll beat depression. Exercise releases endorphins and triggers release of the neurotransmitter serotonin, which lifts your mood.
7. Your blood sugar will go down, improving your body's regulation of insulin.
8. You'll age more gracefully and look and act younger than your years.
9. You'll fall asleep more quickly and sleep more deeply, improving your concentration and your memory.
10. You'll feel more amorous. Exercise not only increases your growth hormones, it improves your self-image, making you feel better about yourself.

Aerobic Movement: The Foundation

Did you know that 30 minutes of exercise will keep your metabolic rate up for another hour? So the longer you exercise, the greater the benefits.

You don't need a lot of fancy equipment. Nor do you need to join a health club. Just put on a pair of comfortable lace-up shoes and start walking.

If you haven't been active for a while, start out easy — just 10 minutes a day. (Please consult with your doctor before you initiate any exercise program.)

Your goal should be to add five minutes a week to your walking regimen, building up to 30 minutes total, five days a week. If you can devote more time to exercise, 45 to 60 minutes a day, so much the better!

Walk with friends to make it fun. If the weather is bad, head over to your local mall and get moving!

I'm a big fan of dancing. It's great exercise and reduces stress at the same time. You don't have to work up a sweat or push yourself until you're out of breath. Find your own rhythm and "go with the flow."

Dynamic exercise enhances well being and puts a spring in your step. Add a bit of stretching and yoga and spice it up with a bit of weight training to create a great exercise session.

Here's one way to get started: put on your favorite music, warm up with a good stretch and some deep-breathing, then walk for 10 to 15 minutes. Mix it up with some free weights, finish with a little yoga and stretching and cool-down.

Weight Training: Tone and Strengthen

I wholeheartedly endorse adding weights to your exercise regimen to promote a healthy heart and bones.

Not only does strength training increase endurance, it can promote healthy blood pressure and cholesterol levels and enhance your sense of well being.

Some researchers believe that strength training may also reduce subsequent cardiac events and the risk of sudden death.
And for those who are frustrated with the limitations heart disease has imposed upon their active lifestyle, strength training is a way to fight back. Many of my cardiac patients have discovered that they don't have to sit in the rocking chair for the rest of their lives!

Exercise Safely

Be alert to warning signs that you may be doing too much exercise. If you experience any of the following, stop immediately:

• Lightheadedness or dizziness
• Palpitations
• Shortness of breath (unable to carry on a conversation)
• Jaw pain
• Arm tingling or numbness
• Tight feeling in the lungs (bronchospasm)

Whatever form of exercise you choose, learn to listen to your body and be aware of any symptoms that come up during exercise or up to an hour afterward. If you feel ill, stop exercising and rest. If symptoms persist after three to five minutes of rest, seek medical attention immediately.

Thinking About Running?

I'm often asked about the health benefits of jogging. I advise against strenuous exercise like jogging or running, especially if you're just starting an exercise program. Studies have shown a connection between heart attacks and sudden exertion. Plus, the stress that jogging places on joints can aggravate mild arthritis and lead to premature cartilage deterioration.

Conversely, moderate exercise has been shown to reduce the long-term risk of coronary artery disease. The Nurses Health Study found that women who walked briskly at least three hours a week achieved results equivalent to jogging or aerobic dancing.

To learn more about Dr. Sinatra's top recommendation for healthy joints, click here.

Get a Leg up on Healthy Knees

As anyone over the age of 50 can attest, strong joints won't last forever. We all eventually experience the normal aches, pains, and stiffness that result from an active life.

Fortunately, there are a number of things you can do to help keep your joints strong and supple as you age. In my July newsletter, I included an article specifically on how to support the health of your knees

Rosita's Story

The program that I outlined in the article is one used by Dr. James Fox, a West Coast orthopedist who practices what I consider smart medicine. I first learned of Dr. Fox after the wife of a friend went to see him. Rosita is an ex-dancer who had been having problems with her right knee for years. She had already been on her own supplement and exercise program, but the problem persisted and she started having a hard time negotiating stairs. After looking at her MRI, Dr. Fox told Rosita that she couldn't be helped by arthroscopic surgery and, in fact, might be a candidate for a knee replacement.

Before going down that path, though, Dr. Fox asked Rosita to strengthen her legs by working with a physical therapist and doing aquatic exercises in a swimming pool three times a week for a month. Rosita did her month in the pool—walking forward, backward, and sideways, and doing assorted leg lifts and squats with the guidance of a physical therapist. When she returned to Dr. Fox, her knee felt much better and more stable.

Dr. Fox told Rosita to continue the aquatic therapy exercises for another month. After the second month, Rosita said her knee felt even better. He advised her to continue the water therapy indefinitely, and he gave her additional exercises to do out of the water. I'm happy to say that Rosita continues to make progress and is no longer a candidate for knee replacement surgery!

Rosita is a great example of how exercise—specifically those that strengthen the muscles around problem joints—can be a boon to anyone whose joints aren't what they used to be. Strengthening the muscles around the joint helps improve balance and movement, and thereby can help minimize the amount of additional wear and tear the joint suffers.

Trainers and Therapists Help with Exercise

As I mentioned, Rosita worked with a physical therapist to strengthen her legs. Your doctor may be a good source of referrals for qualified physical therapists. Another option is to hire a personal trainer who can show you not only how to exercise, but also how to effectively relax (via massage or meditation)—and serve as an overall health guide. Check with a nearby spa or sports medicine specialist for a personal trainer in your area, or contact the American College of Sports Medicine (www.acsm.org on the Internet, or by calling 317-637-9200).

Sometimes a trainer ends up being a cheerleader instead of a guide. When that's the case, you need to apply the brakes and remember you don't have a 20-year-old body anymore. I had a young trainer a few years ago and, with all the hip pain I had at the time, I just couldn't keep up with him. I dropped him. Now I have a trainer who is very considerate about my older joints and tendons. (When choosing a trainer, you may want to ask candidates how many clients they've worked with in your age group and/or with your condition—it will give you an idea of how “in tune” they will be with your needs.)

I personally like trainers who have relationships with physical therapists because there are times when you may strain a muscle and need advice that a physical therapist can give you. I found my personal trainer by word of mouth—from one of my fishing buddies. She (my trainer, that is) turned out to have a lot of knowledge about stretching, which is important to me. She also knows physical therapists, and she even wanted to teach me about supplements. That's the kind of whole package I like.

Orthopedists Who Practice Smart Medicine

Unfortunately, I don't yet know of a lot of orthopedists like Dr. Fox who forego the obvious conventional route in favor of having their patients use supplements and exercises to help support joint health and avoid surgery. I do, though, know that the following three orthopedists use nutritional and alternative medicine techniques in their orthopedic practice.

One is in Connecticut and the other two are in California (one of whom, of course, is Dr. Fox), but I'm on the lookout for more. If you know of one worthy of consideration, please let me know via my e-mail feedback box: feedback@drsinatra.com.

Richard Diana, MD
2408 Whitney Avenue
Hamden, CT 06518
Phone: 203-407-3500

Karl Epstein, MD
19231 Victory Blvd, Suite 155
Reseda, CA 91335
Phone: 818-344-8701

James M. Fox, MD (two locations)
22633 Ventura Blvd
Woodland Hills, CA 91364
Phone: 818-444-5100

8670 Wilshire Blvd. #203
Beverly Hills, CA 90211
Phone: 310-724-8975

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