Exercise: The marathon myths:Alternatives for exercise-related injury

Simply being aware of the possibility of injury may be the best way to avoid it. However, if you do sustain an injury during exercise, consider the following alternative treatments:

* Use good fats for inflamed joints. The benefits of essential fatty acids (EFAs), particularly omega-3, in the treatment of sore and inflamed joints have been well recognised for many years. While EFAs cannot rebuild degenerated cartilage, bone or synovial membranes, they can be effective in relieving the pain and reducing inflammation. Many studies have shown benefits in treating arthritic joints with both omega-3 and omega-6 fatty acids (Arthritis Rheum, 1990; 33: 310-20; Eur J Clin Invest, 1992; 22: 6878-91; Arthritis Rheum, 1995; 38: 1107-14; Br J Rheumatol, 1994; 33: 847-52; Arthritis Rheum, 1996; 39: 1808-17). As you need to take very large doses of these EFAs, consult an experienced physician.

* Avoid non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. If you do sustain an injury, use the time-honoured RICE method to recover: Rest, Ice, Compression and Elevation. Avoid using NSAIDs to combat pain and do not take them ‘just in case’ as a prophylactic as there is no evidence they will be effective (Int J Sports Med, 1999; 20: 98-102). In fact, long-term NSAID use prevents your body from repairing soft tissue damage and inflammation and, thus, prolongs your injury (Lancet, 1985; ii: 11-3; J Bone Joint Surg, 1973; 55B: 246-51).

* Try glucosamine. Joints require glucosamine to work well and prevent injury. The body makes glucosamine from glucose and the amino acid glutamine. However, those who are very physically active may find it hard to make enough to meet their needs. Most of the research into this supplement has been done with osteoarthritis patients. One study found glucosamine sulphate more effective than the NSAID Advil (Curr Med Res Opin, 1982; 8: 145-9).

But research into athletes is also revealing. In one study, athletes who had cartilage damage to the knee took 1500 mg of glucosamine for 40 days, followed by 750 mg for a further 100 days. This regimen completely cured 76 per cent of the participants (Bohmen D, ed, ‘Treatment of chondropathic patellae in young athletes with glucosamine sulfate’ in Current Topics in Sports Medicine, Vienna: Urban & Schwarzenberg, 1984).

* Pay attention to your moods. The early signs of overtraining are often not physical, but emotional, because of the way that overtraining can alter the hormonal balance and blood levels of important nutrients such as the amino acid tryptophan (Br J Sports Med, 1992; 26: 233-42; Int J Sports Med, 1997; 18: 270-5). If a programme of intense exercise leaves you feeling less than radiant, consider cutting back.

* Prevent injuries by:

a) being aware of old injuries, which could be worsened by certain activities, and making sure that these are either healed or rehabilitated before you begin a new activity;

b) choosing exercise that is appropriate to your fitness level;

c) wearing protective gear that is appropriate to the activity;

d) being aware of your strengths or weaknesses when switching from one type of exercise to another – for example, runners may have good cardiovascular function and strong muscles in the lower body, but no upper body strength, so taking up a sport such as tennis, which places more emphasis on the upper body, could be a recipe for injury.