I’ve heard story after story of shod runners who had to stop because of their knees. Then, after switching to barefoot running, they are able to take it up again, because barefoot running really doesn’t allow the kind of heel strike that thuds up to the knees that you can only get from heeled, padded shoes.
So, what do you do with that already damaged cartilage?
Cartilage does not heal easily, since it does not have its own blood supply. In fact, folks thought that it just didn’t heal, and that damage done was damage forever. However, lately they are discovering that showed some healing can occur.
One of the most popular supplements are Glucosamine and Chrondroitan. It was first given to dogs, and it seemed to really help them out. These days you can find it everywhere. The studies on it, though, are not definitive. In fact, I just read of a recent one that purported to show no effect. I do take it anyways.
What I’d particularly like to draw your attention to, though, are studies on the NSAIDs (non-steroidal anti-inflammatories) we often take for pain. It turns out that many of them inhibit cartilage regrowth, and while they are relieving your osteoarthritic pain, furthering the destruction of the joint that is causing the pain. But there are a class of NSAIDs called selective NSAIDs that can actually promoted the growth of cartilage.
At this stage of the science, there are still quite a few gaps in the knowledge. There have been quite a few studies, and all of the results are not necessarily consistent. Nonetheless, there does appear to be a pattern emerging that certain NSAIDs cause the death of chondrocytes (the cells that produce new cartilage). Many of the studies have been done in vitro, not in vivo. That is, they’ve been done in test tubes, not live people. However, there are some in which MRIs have been done in people to try to verify the in vitro results.
The main result is that most of pain relievers you are familiar are the ones that kill your cartilage. Naproxen (Aleve), ibuprofen (Advil, Motrin), and piroxicam (Feldene) are on that list. The good ones are meloxicam (Mobic), celecoxib (Celebrex) and rofecoxib (Vioxx). Aspirin is neutral.
This information is taken from two papers, Do NSAIDs Affect the Progression of Osteoarthritis?, and Do NSAIDs Affect Longitudinal Changes in Knee Cartilage Volume and Knee Cartilage Defects in Older Adults?. The latter paper actually did MRIs to look at the knees to see what was happening.
Again, let me stress that the results of the different tests can sometimes be confusing (and I admit I might be one of the confused, so take a look at the papers yourselves and correct me if needed).
But given the results, I would not use naproxen or ibuprofen. Celebrex is still under patent and requires a prescription, so it is pretty expensive. I personally take meloxicam, another prescription drug, but generics are available so, under my drug insurance plan, it is pretty inexpensive.
Of course, as the ads say, discuss this with your doctor (in my case, I showed mine a copy of the studies). But as you get older and continue running, it is well worth keeping in mind that certain pain killers may also be killing the joint along with the pain.