The Best Training Parameters to Strengthen Joints

In an effort to save humanity from the perils of joint pain, osteoarthritis, hypermobility, and ligament tears, I’m embarking on the journey to figure out what is the best damn training program to strengthen one’s joints.

The Universal Solution for Strengthening Joints… Movement!

Let’s start out with the obvious. Can someone who’s a couch potato pull off the same feats that a professional strongman is able to perform? No way in hell – at least not without risking injury! So, with this logic, we can say athletes and sportsmen will naturally have stronger cartilage, ligaments, and tendons than sedentary office workers who sit at a desk from 9 to 5.

It’s even been observed that between construction workers and sedentary workers. The dudes in manual labor are the ones with a higher rate of collagen turnover as well as having heavily-adapted joints. (Kuiper et. al)

Door hinge - strengthen jointsIf only my joints were this fancy…

So people who are big and strong have big and strong joints – that’s nice and all, but we want to know more. We’re interested in determining the best parameters for a training program to induce stronger connective tissue. Simply, we want to strengthen the joints! Anyway, let’s examine the details.

What’s Better for Joint Health, Volume or Intensity?

As, we’ve just established, movement and load stimulates connective tissue to grow stronger. It’s a fact. It has been observed in tendons that physical training will result in a net increase in collagen synthesis. (Langberg H, et. al) That sets us in the right direction. We need to train to strengthen joints. Unfortunately, we still need to figure out the specifics of such a training program.

In your typical strength training program, there will be two major variables at play: volume and intensity. Volume represents the number of reps performed, and intensity represents how heavy the weight is that is used (or, how close it is to your 1RM). Thus far, conventional wisdom has stated nothing about how much volume or intensity we should use to strengthen joints. These are the training parameters we’ll try to establish.

It should be understood that the tissues associated with the joint – the tendon, the ligament, and the cartilage – have the potential of healing at different rates, because they each receive nutrients from the blood supply in a different manner. Although, it must be stated that each heal quite slowly due to the lack of direct blood-supply.

Anyway, the tendons receive nutrition from the neighboring muscle tissue that it’s attached to. The ligaments receive nutrients/blood from the vessels found in the synovial membrane that they are found near. The cartilage receives its nutrition from the vessels from the synovial membrane, via the synovial fluid.

So, it makes sense to see how the relationship of volume and intensity affect these tissues individually,
rather than just find some studies that discuss “joints” in a general fashion.

Let’s look at tendons first. In one case, moderate exercise and volume (about 67% of 1RM) resulted in a spike in collagen synthesis post-workout. (Miller BF, et. al) Another study, observing the patella tendon in patients, found that the tendons adapted to various intensities, volumes, and contractions over time. (Malliaras P, et. al).

On to the ligaments. Only one relevant study was found, but its findings are interesting. Post ACL-surgery patients were put on an exercise program (low-intensity and high-volume vs. moderate-intensity and moderate volume), and researchers found that both groups improved, and neither group had more joint laxity than the other. (Bieler T, et. al)

Now, we look at cartilage. Running (high volume, low-to-moderate intensity) has been shown to increase the thickness of cartilage in young dogs. (Kiviranta I, et. al) A lifetime physical activity assessment of elderly folks has shown that moderate volumes of miscellaneous activity (intensity unknown- we’ll assume an average of moderate-intensity) are associated with a reduced risk of knee osteoarthritis. (Manninen P, et. al)

So, the conclusions for the few studies I brought out prove that any kind of volume-to-intensity relationship will result in adaptation for the connective tissues. This still leaves us a bit in the dark in terms of specificity for a training program, but consider this: how frequently, in your experience, is it that someone gets injured walking versus lifting something heavy?

Come To the Dark Side… the Volume-Laden Dark Side…

It’s always when someone is moving furniture, lifting bags of soil, carrying another person, etc. that you see injuries happen. Essentially, it is heavy load (or high-intensity) that bears the greatest risk of injury. Sure, common injuries occur at lower-intensity and high-volume, such as shin splints with runners or carpal tunnel with office workers, but these issues are usually slow in their onset. Also, realize that other factors allow these injuries to occur, such as poor posture and movement patterns – this increases the stress “per repetition”, effectively making these activities “higher intensity”. For example, a runner who heel-strikes instead of toe-strikes instantly increases the amount of “shock” his or her legs experience per step, turning a low-intensity exercise into a higher one, technically.

My point is, I believe lowering the intensity and increasing the volume for a training program allows us to reduce the risk of injury, especially if it’s observed that any any combination of volume and intensity will strengthen joints.

Interestingly enough, researchers surveyed bodybuilders and powerlifters regarding their history of injuries, and found that powerlifters experienced twice the rate of injury that of bodybuilders. (Goertzen M, et. al) Bodybuilders typically use a program that has moderate volume and intensity, whereas powerlifters chase after heavy weights at the cost of reps. This further asserts my point that backing off the intensity, even if a little bit, allows for more lee-way when it comes to sparing and strengthening the joints.

Bodybuilder“My tendons and ligaments are just as big.”

Another interesting point to consider – there is a huge discrepancy between the total tonnage (total reps X weight), or TT, of a given powerlifter’s workout and a bodybuilder’s workout. If someone’s 1RM for the squat is 400 lbs, an example of his powerlifting routine would be 5×2 at 95% (380 lbs), and an example of his bodybuilder routine would be 3×10 at 70% (280 lbs). The TT for the former is 3800 lbs, and for the latter it is 8400 lbs. That is over double the total tonnage the bodybuilder routine has over the powerlifter routine, despite theoretically having a lower risk of causing injury. This isn’t conclusive of anything, but is something incredibly interesting to ponder about.

An Intriguing Observation on Hormones and Joint Repair

Whilst searching for studies on exercise and joint health, I stumbled upon a few that discussed the relationship between hormones and collagen synthesis.

Odd as it seems, exercise stimulates a lower spike in collagen synthesis in women than it does in men – meaning, women recover and strengthen joints at a lesser rate than men do. (Miller BF, et. al) If you examine men and women, what is the immediate difference you can find just by looking at them? It’s their gender, and hormones are responsible for this. It’s obvious that women have less testosterone and androgens than men do – what if this were to be a characteristic for decreased collagen synthesis?

Solely increasing the presence of testosterone has not been shown to increase collagen synthesis in vitro. However, an anabolic steroid stanozolol has proven its ability to heal wounds in collagen-containing tissues, and it is hypothesized that this is because this steroid stimulates the release of TGF-beta1, the chemical supposedly responsible for increasing collagen synthesis. (Falanga V, et. al) Despite testosterone’s lackluster effects in the previous study, injections of this hormone have actually been observed to increase TGF-beta1 in castrated rats. (Olsen NJ, et. al) Castration leads to reduced testosterone production, and there was already a decreased level of TGF-beta1 in these rats. Interesting.

Whether increased testosterone is important for collagen synthesis or not, who the hell knows. It probably won’t hurt to have a little extra test in our blood naturally, and moderate volume hypertrophy-style training increases testosterone, as well as human growth hormone, in trainees. (Kraemer, Ratamess) Even if testosterone has zero impact on the rate of collagen synthesis, it’s already widely-known that HGH positively affects it. (Doessing S, et. al) Seriously, once you get old, your doctor will give you a prescription for HGH for the purposes of “anti-aging” – basically, it’s an expensive way to keep your skin looking younger. Or, you can just do back squats for sets of 10. That’s yet one more point on the scoreboard for the bodybuilder’s program.

Conclusion

So, we know the following are true:

  1. Any form of exercise strengthens joints.
  2. Less volume and more intensity poses a greater risk for injury.
  3. More volume with moderate intensity increases testosterone and HGH.

Logic states that training like a bodybuilder, with more volume and less intensity, is the way to go to protect and strengthen joints.

This type of training may be at odds with your current goals (maybe you’re an athlete needing explosiveness, maybe you don’t want hypertrophy), but the research is something to consider if you desire to keep your joints strong and healthy in the long run.

References:

1. Kuiper JI, et. al. “Serum markers of collagen metabolism: construction workers compared to sedentary workers.Occupational & Environmental Medicine. 62 (2005): 363-367. Web.

2. Langberg H, et. al. “Training-induced changes in peritendinous type I collagen turnover determined by microdialysis in humans.The Journal of Physiology. 534 (2001): 297-302. Web.

3. Miller BF, et. al. “Coordinated collagen and muscle protein synthesis in human patella tendon and quadriceps muscle after exercise.The Journal of Physiology. 567 (2005) 1021-1033. Web.

4. Malliaras P, et. al. “Patellar tendon adaptation in relation to load-intensity and contraction type.Journal of Biomechanics. 46.11 (2013): 1893-1899. Web.

5. Bieler T, et. al. “The effects of high-intensity versus low-intensity resistance training on leg extensor power and recovery of knee function after ACL-reconstruction.BioMed Research International. (2014). Web.

6. Kiviranta I, et. al. “Moderate running exercise augments glycosaminoglycans and thickness of articular cartilage in the knee joint of young beagle dogs.Journal of Orthopaedic Research. 6.2 (1988): 188-195. Web.

7. Manninen P, et. al. “Physical exercise and risk of severe knee osteoarthritis requiring arthroplasty.Rheumatology. 40.4 (2001): 432-437. Web.

8. Goertzen M, et. al. “Injuries and damage caused by excess stress in body building and power lifting.Sportverletz Sportschaden. 3.1 (1989): 32-36. Web.

9. Miller BF, et. al. “Tendon collagen synthesis at rest and after exercise in women.Journal of Applied Physiology. 102.2 (2007): 541-546. Web.

10. Falanga V., et. al. “Stimulation of Collagen Synthesis by the Anabolic Steroid Stanozolol.Journal of Investigative Dermatology. 111 (1998): 1193-1197. Web.

11. Olsen NJ, et. al. “Testosterone induces expression of transforming growth factor-beta1 in the murine thymus.The Journal of Steroid Biochemistry and Molecular Biology. 45.5 (1993): 327-332. Web.

12. Kraemer, WJ, and Ratamess, NA. “Hormonal responses and adaptations to resistance exercise and training.Sports Medicine. 35.4 (2005): 339-361.

13. Doessing S, et. al. “Growth hormone stimulates the collagen synthesis in human tendon and skeletal muscle without affecting myofibrillar protein synthesis.The Journal of Physiology. 588 (2010): 341-351. Web.

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