2. Medical and Nutritional Supplements
Before using any of the drugs or supplements
discussed here (or anywhere else for that
matter) first be sure that they are going
to be legal to use in triathlon or whatever
sport you are going to be participating in
your state and also in the location of the
event. Generally, the list of banned substances
should be uniform internationally but that
might not always be the case. In Australia
the body responsible for drug testing in
sport is the Australian Sports Drug Agency. They provide a publication on banned substances
called Drugs in Sport Handbook. As well, make yourself aware of any known
side effects these drugs or supplements may
have. This might take some research on your
part but think of it as a responsibility
that you owe yourself. Some of the sites
provided on the links page will help, or
go and see your doctor or health professional
if unsure.
I take a glucosamine sulphate and chondroitin
sulphate supplement. There is various research which indicates there has been a measurable
improvement in joint function for some arthritis
sufferers. I was skeptical at first but found
some benefit initially taking shark cartilage
tablets (which contain these compounds).
I tried other products too. I tried a glucosamine
chloride supplement from the pharmacy but
found it was not as good as one that contained
both glucosamine and chondroitin in sulphate
form along with vitamin C and zinc and manganese
co-factors. It is not exactly cheap but at
around $40 AUD per month it is not excessive.
There is also a compound called "Lyprinol"
and apparently is extracted from green lipped
muscles found in New Zealand. It was covered
on some current affairs programme here (Australia)
on TV but I never could find any. One pharmacist
told me it had been banned by the New Zealand
Government, which is where it was produced.
I lost interest and didn't pursue it further
as I found some relief with the compound
I mentioned.
Of course there are a range of drugs used
as pain killers and other anti-inflammatories
(both steroidal and non steroidal) that are
regularly prescribed by the medical profession
to treat arthritis. I have not used these
and I don't like the idea of relying on pain
killers and the like except for temporary
and short term relief. By all means, though,
investigate these too. If they are necessary
and can be restricted to very limited use
and that sees you through a race (provided
they are not banned substances), it might
be the best option.
3. Equipment Changes
Suspension is the key! Yes that's right put
springs on your shoes. Well, not quite, but
while on the subject of shoes you need to
make sure you use one with good shock absorption
qualities - stay away from running flats,
they don't have the support and absorption
qualities to be kind to your joints. In any
event they are only meant for shorter endurance
events. Anyway, I really mean suspension
for the bike.
Softride are the most well known suspension
beam bikes. I've included a couple of their
frames below. There are variations on this
type of design. Zipp had a beam bike too,
originally they used the Softride suspension
beam (originally called the Allsop suspension
beam), but they moved to a different beam
but it still would provide shock absorption.
Trek too have a suspended beam design bike,
this is their Y66 model for triathlon, which
no longer appears to be marketed, though
it may still be available as a special order.
The Trek Y66 |
Trek now market their Hilo range as triathlon
specific.
It is not necessary to go to the expense
of changing frames to get suspension, as
there are now a range of quality lightweight
suspension seat posts. Both USE and RockShox
make good suspension posts, both road versions
come in at around 300g. If anything USE's
is a shade lighter. I actually train on a
Softride and race on a Trek OCLV carbon fibre
frame with a USE RX Shokpost. Carbon fibre
frame material is also a little more compliant
than aluminium.
Pictures of some suspension seat posts are
just below the Softride frames.
|
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| The original Softride beam design |
The new Softride beam design |
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 |
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| RX Shokpost 294g 1.5" travel |
XCR Shokpost 356g 2.3" travel |
SX Shokpost 374g 2.1" travel |
Rock Shox seat posts |
Aluminium frames are very stiff and transmit
every bit of road shock to the rider's
pelvic
area (no good for arthritic hip joints).
Which will in time have an effect,
a negative
one. From my own experience within
three
months of riding an aluminium frame
I developed
acute pain in my arthritic hip and
found
climbing, out of the saddle, excruciating.
That problem was eliminated by adding
a suspension
post. I can still ride a rigid post
in an
aluminium frame but only infrequently
and
depending on the road surface for distances
between 40 -100km.
Now there are even suspension saddles on
the market which again may eliminate the
need to buy a suspension seat post. Koobi
manufacture a model called the PRS which
they claim specifically eliminates the need
for a suspension seat post [Triathlon & Multi Sport Magazine Vol. 6 No. 4, April 2003, Melbourne Australia,
p.35]. Selle Italia also make a saddle that
absorbs shock too. It is called the Octavia.
Of course any equipment that makes you go
faster for less effort has got to help the
overall stress you place on your joints.
So the nice to have things like race wheels
are going to benefit you just like everyone
else. Of course these toys for the bike don't
come cheap but they are very nice to have.
Look at things like aerodynamic changes,
which includes not just wheels and aero bars
but overall bike position and even the frame
profile. In non-drafting triathlon the choice
of frame design is not limited by UCI rulings
(ITU only adopted them for draft permitted
triathlons, like formula 1, which are for
elite triathletes only), so you can experiment
as much as your budget allows. Just remember
in any positional changes to accommodate
any constraints that you have due to injuries.
Comfort has to be included.
4. Changing Sports
Give up triathlon! Take up road cycle
racing
as a change. Even participate as part
of
a team in a triathlon event, just exclude
running from your regime of exercise
and
you may be able to avoid surgery for
the
rest of your life and avoid any further
arthritic
degeneration of the affected joints.
Water
sports are definitely a lot gentler
on the
joints, up to point. I know a lot of
boardriders
with crook knees after years and years
of
surfing on high performance short boards.
Tommy Carroll's knee problems, though
not
arthritic, are well documented. Of
course
there are other water sports apart
from surfing,
like sailing, swimming, water polo,
and so
on.
I retrospect if I had given up triathlon
I would probably be able to ride a
lot better
now but I wanted to do an Ironman and
keep
doing triathlons. After ten years I
feel
I have done enough now and probably
will
just cycle, as well as do some more
surfing.
Without doing any running I think I
can improve
my cycling to some extent anyway as
running
really takes it out of me these days
and
does adversely affect my cycling. I
might
even take up kayaking. However, I know
I
am still not ready for golf!
5. Surgery
You might prefer surgery than to give
up
triathlon. I did. I will however stop
running
after 8th April 2001 (this will be,
or was,
my last Ironman and only my second).
Through
surgery you may get a temporary lease
of
further life out of the joint, although
of
course this depends on the procedure.
Osteotomies
will keep the old joint but realign
it so
that the major load bearing points
are changed
to areas where there is a good cartilage
surface. This kind of surgery is very
invasive,
very painful, and requires a long recovery
period. In my case, as I'd expect in
other
cases too, the range of movement may
be altered.
I am no longer able to sit on the floor
cross
legged, so you had better work out
with your
orthopaedic surgeon just what kind
of range
of movement you can expect with the
particular
translocation or realignment that will
be
applied to the joint in question. Limb
shortening
and lengthening is also not uncommon.
My
right leg is now about 2cm shorter
than it
used to be but it used to be 1cm longer
than
my left anyway. This is a small discrepancy
and has been easily accommodated with
an
orthotic wedge inside the heal of my
right
shoes.
Joint replacement procedures, with
the current
technology, means that it is all over
from
a sporting aspect. They really are
for less
active people and are more for pain
relief
and through this giving improve mobility.
Although there are many different types
of
prosthetic replacement joints. Their
construction
and materials vary and some undoubtedly
will
be better than others. I have heard
of athletes
with hip joint replacements continuing
to
cycle and I know of two. One case appears to be still competing in audax events.
There is has been some experimentation
with
cartilage grafting. Some cartilage
is extracted
and then crushed up and a culture grown
to
produce more cells (this is called
autologous
chondrocyte implantation or ACI). These
cells
are then grafted or injected into the
affected
joint and the cartilage regrows and
repairs
itself. I have seen one case where
this was
used in a knee. I have yet to see more
data
and more cases.
There is new research with stem cells
that
shows some promise in the future of
being
able to grow replacement limbs and
organs,
how this can be adapted to joint replacement
or repair is just beginnning to be
seen.
There has been some work with mesenchymal
stem cells which has been successful
in generating
fibrous cartilage (mainly composed
of type
I collagen) which is useful for small
defect
repairs but is inferior to arcticular
hyaline
cartilage (mainly composed of type
II collagen).
Articular hyaline cartilage is what
covers
the ends of the bones in moving joints
like
knees and hips. It has spongey qualities
and can take heavy load bearing, and
provides
a smooth surface for smooth and frictionless
movement. Gene therapy is used to create
hyaline like cartilage cells using
transforming
growth factors (TGF-B, TGF-S). In one
case
stromal cells, which would have become
fat
cells were transformed into chondrocytes,
that is, cartilage cells - this has
implications
for ACI. Morphogens (such as rhOP-1
aka rhBMP-7)
and how they are affected by modulators
(such
as Chondroleukin aka CL) appear to
be the
key to promoting stems cells to differentiate
into chondrocytes, which looks promising
and may well provide "self healing"
capabilities for humans with respect
to cartilage
repair and regeneration.
As new treatments come to light I will
update
this section. By all means send me
an email
if you see or hear of any. Also check
out
the news page for any news or articles.
6. Give Up Sport
Sadly there might come a time where
sport
might have to given up completely.
The only
way to avoid the disappointment that
will
come with this moment is to plan for
it and
work out what other things you want
to do.
The world always needs more crusaders,
pioneers,
researchers, poets and comedians. You'll
think of something, I know I always
do when
I am locked into the heavier training
segments
of the year when I have to pass up
on numerous
offers and opportunities to do things
that
training commitments just won't allow.
There
is always something that can be thought
of
that you would do if it weren't for
all the
training. One thing I always wanted
to do
is learn French and do a bit of travelling
and maybe even go back to university
and
get a masters or Ph.D. Anyway think
about
it now. Even non arthritic athletes
eventually
give up competing.
7. Become a Substance Abuser
This was actually meant to be a joke
but
sadly this might end up being true
for some
people. Seeking professional help is
always
a good start. Use your imagination
and accept
help and you will find other constructiive
pursuits.
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