Knees'n'Ankles

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Knees'n'Ankles

Postby stepbystep » Mon 05 Apr, 2010 5:33 pm

A recent topic on weight got me contemplating body mass index and all that bollocks...
My problem is that after long or unduly rough or 'crazy' walks I have suffered sore knees and ankles.

A couple of things I feel may be contributing to this is;
a) new boots - Scarpa Trek Pro's - stiff but pretty tough, the old Garmont's 'felt' better
b) fatigue to said joints through age and/or bodily abuse

So..........without going into too much detail as people are very different in many ways(physically)
What do you do to keep these essential regions healthy - I'm interested in any form of medicine herbal or traditional.
What has worked for you, what have you heard works, and why?

P.S. I am 36 - 5'10" - 80kg, have worked and played hard all my life :shock:

Cheers, sbs
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Re: Knees'n'Ankles

Postby tasadam » Mon 05 Apr, 2010 6:41 pm

stepbystep wrote:A couple of things I feel may be contributing to this is;
fatigue to said joints through age


stepbystep wrote:P.S. I am 36

Watch it! :twisted: lol
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Re: Knees'n'Ankles

Postby stepbystep » Mon 05 Apr, 2010 8:04 pm

tasadam wrote:
stepbystep wrote:A couple of things I feel may be contributing to this is;
fatigue to said joints through age


stepbystep wrote:P.S. I am 36

Watch it! :twisted: lol


Yeah, thanks for the contribution Adam :roll: :roll: :roll:
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Re: Knees'n'Ankles

Postby tasadam » Mon 05 Apr, 2010 8:07 pm

stepbystep wrote:Yeah, thanks for the contribution Adam :roll: :roll: :roll:

I'm having one of those days...
viewtopic.php?p=43236#p43236
viewtopic.php?p=43238#p43238
Better go find something more constructive to do.
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Re: Knees'n'Ankles

Postby Taurë-rana » Mon 05 Apr, 2010 8:22 pm

tasadam wrote:
stepbystep wrote:A couple of things I feel may be contributing to this is;
fatigue to said joints through age


Um, like he said :lol:
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Re: Knees'n'Ankles

Postby Taurë-rana » Mon 05 Apr, 2010 8:25 pm

stepbystep wrote:What do you do to keep these essential regions healthy - I'm interested in any form of medicine herbal or traditional.

Nurofen, Celebrex, walking poles. Staying active helps my knee a lot - not doing much then doing a big walk obviously asks for trouble as you get older. Making sure the muscles supporting the joints are strong is important.
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Re: Knees'n'Ankles

Postby Taurë-rana » Mon 05 Apr, 2010 8:27 pm

Taurë-rana wrote:
tasadam wrote:
stepbystep wrote:A couple of things I feel may be contributing to this is;
fatigue to said joints through age


Um, like he said :lol:


Actually this was the reply I got from my doctor to a similar question when I was younger than you.
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Re: Knees'n'Ankles

Postby photohiker » Mon 05 Apr, 2010 10:09 pm

Agree with the comments about conditioning. Don't expect to be able to jump up on the spur of the moment and do an extreme walk without a bit of suffering.

The other thing is to start noticing how you treat your knees. Watch for impacts and try to eliminate them. I nearly gave away snow skiing a few years ago because my knees were giving me grief - but then I decided to stop jumping on every dimple and take less air all the time (honestly, I used to spend more time in the air than on the snow) :) - miracle, I can go a week or more without becoming a cripple. The older you get the less shock they can take, so feed them less shock.

And don't hammer down hills - guaranteed to stress those joints.
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Re: Knees'n'Ankles

Postby davidmorr » Tue 06 Apr, 2010 12:06 am

stepbystep wrote:What do you do to keep these essential regions healthy - I'm interested in any form of medicine herbal or traditional.
What has worked for you, what have you heard works, and why?
When going downhill, never put your foot down with your leg straight and knee "locked". If you do, it is incredibly jarring to the joints, especially the knee.

Try to have your leg slightly bent so that when your weight lands on it, it flexes a bit, taking the shock out of the step. It seems awkward at first, but it soon becomes a habit.

And something I read a couple of years ago about dehydration. When you are dehydrated, most parts of your body are dehydrated too, including your joints. Keeping hydrated ensures that your joints are full of fluid, their natural cushion.

Medicines - no. Better to avoid the damage in the first place. Physical damage can rarely be fixed by medication no matter what the drug companies tell you. My personal experience with a number of different problems over the years is that stopping all medicines usually produced the biggest improvement!

Cheers

David
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Re: Knees'n'Ankles

Postby stepbystep » Tue 06 Apr, 2010 8:04 am

Thanks guys,
I suspect I need to loose 10kg and adjust walking style a bit, and go slower downhill for sure.
Has anyone had success with glucosamine? I've heard conflicting reports.

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Re: Knees'n'Ankles

Postby Jellybean » Tue 06 Apr, 2010 8:15 am

stepbystep wrote:Thanks guys,
I suspect I need to loose 10kg and adjust walking style a bit, and go slower downhill for sure.
Has anyone had success with glucosamine? I've heard conflicting reports.

Cheers


If you're carrying a bit of extra weight, losing some will definitely help, as will adjusting your walking style (as mentioned above). Using two poles to help take your weight (and reduce the load on your knees) can also help on steep descents.

I have arthritis quite badly in one knee (my orthpod told me I have the knee of a 70 year old woman, even though I'm only mid 40s; result of an active life). I have been taking fish oil and glucosamine/chondroitin for several years now (on the advice of my orthopod) and have found it helps alot (greatly reduces pain and stiffness). It doesn't seem to have any effect on ankles or hips.

Cheers,

JB
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Re: Knees'n'Ankles

Postby stepbystep » Tue 06 Apr, 2010 8:28 am

Jellybean wrote:
stepbystep wrote:Thanks guys,
I suspect I need to loose 10kg and adjust walking style a bit, and go slower downhill for sure.
Has anyone had success with glucosamine? I've heard conflicting reports.

Cheers


If you're carrying a bit of extra weight, losing some will definitely help, as will adjusting your walking style (as mentioned above). Using two poles to help take your weight (and reduce the load on your knees) can also help on steep descents.

I have arthritis quite badly in one knee (my orthpod told me I have the knee of a 70 year old woman, even though I'm only mid 40s; result of an active life). I have been taking fish oil and glucosamine/chondroitin for several years now (on the advice of my orthopod) and have found it helps alot (greatly reduces pain and stiffness). It doesn't seem to have any effect on ankles or hips.

Cheers,

JB


Thanks JB,
Can't bring myself to use poles, I feel like I have less balance using them and think they are a hassle - will take gluc advice on board as well though.
Other than walking I have this devastating addiction to good food and lots of it, must address this to lose the extra kg's :(
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Re: Knees'n'Ankles

Postby Taurë-rana » Tue 06 Apr, 2010 9:21 am

stepbystep wrote:Has anyone had success with glucosamine? I've heard conflicting reports.
There was a study a few years ago that showed that it regrows cartilage in hips, I haven't heard about knees but presumably if it does it in hips it would in knees. I've been taking it for a number of years and I think it helps, but I know people who swear by it including my mum who was a GP and now has arthritis.

Can't bring myself to use poles, I feel like I have less balance using them and think they are a hassle.


They can be a hassle in scrub or on a narrow track, but I find the benefits are so great that it's worth the bit of effort working out how to attach them easily to the pack. Part of using then is learning how to use them effectively, including putting your hands in the straps properly -this makes a big difference as a lot of your weight is supported by the straps and it makes the poles more stable to use. I didn't take them with my on my last trip, and probably wouldn't have used them much but once we got out of the scrub on the day we came off the range I begged to borrow somebody else's pole so I could get down the last slope for lunch.

I would have been in excruciating pain without them coming down Mt Eliza after NE Ridge, I shudder to think what it would have been like. Poles will keep me walking a lot longer than I will be able to without them. With respect, I believe it would be worth you at least borrowing a pair and learning how to use them properly before rejecting the idea.

Other than walking I have this devastating addiction to good food and lots of it, must address this to lose the extra kg's :(
Or do lots more exercise to make up for it!
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Re: Knees'n'Ankles

Postby johnw » Tue 06 Apr, 2010 10:15 am

Taurë-rana wrote:
stepbystep wrote:Has anyone had success with glucosamine? I've heard conflicting reports.
There was a study a few years ago that showed that it regrows cartilage in hips, I haven't heard about knees but presumably if it does it in hips it would in knees. I've been taking it for a number of years and I think it helps, but I know people who swear by it including my mum who was a GP and now has arthritis.

Have you found any side effects from taking glucosamine? I have bad knees, mainly from running, but now also showing signs of osteo-arthritis in other joints. Not major but starting to affect my ability to some extent. I don't like taking things regularly but may need to look at doing so eventually.
John W

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Re: Knees'n'Ankles

Postby Taurë-rana » Tue 06 Apr, 2010 10:19 am

I haven't had any side effects, but I know it can cause diarrhoea initially in some people - they have to build up to it. Actually I think that might be the condroitin which is also useful.
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Re: Knees'n'Ankles

Postby photohiker » Tue 06 Apr, 2010 11:02 am

stepbystep wrote:Can't bring myself to use poles, I feel like I have less balance using them and think they are a hassle


I've 'had' poles for a few years, but never really used them properly - mostly, I agree with you, they are a hassle and not worth the bother. The problem is to use them effectively you need to wear the strap correctly and hold it just so etc. etc. PIA. My knees aren't that bad. :)

A month or so ago, I bought some PacerPoles (just the standard alloy), and they are a revelation by comparison. Mostly because of the handle shape:

Image

No steenking straps needed. While out training, I have been on some narrow paths on steep hillsides (cliffs even) and I have noticed that the poles improve stability, especially if there is wind or loose footing. On overgrown tracks the tips get caught in the undergrowth which can be painful, sometimes it is better to just put them away. The poles themselves seem to be better made and more substantial than my Black Diamond poles, but I haven't had the opportunity of bending one yet. Spares are available. I also took the opportunity of buying the Camera Mount and Modifying it to take a kirk plate for quick release - the screw-on arrangement of the standard mount was too painful for me, I don't think I'd use it much.

Image

I've decided to take them on the TGO, so I'll be able to share a more thorough opinion on them upon my return, but so far, thumbs up!
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Re: Knees'n'Ankles

Postby johnw » Tue 06 Apr, 2010 11:13 am

Taurë-rana wrote:I haven't had any side effects, but I know it can cause diarrhoea initially in some people - they have to build up to it. Actually I think that might be the condroitin which is also useful.

Thanks Rachel. Yes from a quick bit of research it looks like Glucosamine sulphate and Chondroitin sulphate seem to have shown the best results so far, but both can cause some stomach upsets. From my point of view may be worth the risk to see if it helps me.
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Re: Knees'n'Ankles

Postby davidmorr » Tue 06 Apr, 2010 11:29 am

Jellybean wrote:Using two poles to help take your weight (and reduce the load on your knees) can also help on steep descents.
A lot of people recommend poles to "take some of your weight". If you do this, what is happening is that you are transferring weight from the heavy duty limbs that are intended for carrying you (legs) to limbs that are not designed to take weight in this fashion (wrists, arms and shoulders). While it is not likely to damage the joints by jarring, it could put unexpected strain on muscles and tendons not used to it. At the very least, your posture is likely to change to a hunched-over style which cannot be good for you.

Poles are definitely useful for stability - they make you into a tripod or tetrapod which is a very stable structure. This added stability may help knees and hips by allowing a more controlled descent rather than the big steps and jarring stop each time without them.

Cheers

David
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Re: Knees'n'Ankles

Postby Jellybean » Tue 06 Apr, 2010 11:45 am

johnw wrote:
Taurë-rana wrote:I haven't had any side effects, but I know it can cause diarrhoea initially in some people - they have to build up to it. Actually I think that might be the condroitin which is also useful.

Thanks Rachel. Yes from a quick bit of research it looks like Glucosamine sulphate and Chondroitin sulphate seem to have shown the best results so far, but both can cause some stomach upsets. From my point of view may be worth the risk to see if it helps me.


Hi John,

I've never had any side effects from the gluc/chondroitin. I highly recommend that you take it in conjunction with Fish Oil (has an anti-inflammatory effect). (Fish oil also seems to provide some cardiovascular benefits as well as having a beneficial effect on skin, hair and nails - at least that's my experience.

Cheers,

JB
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Re: Knees'n'Ankles

Postby photohiker » Tue 06 Apr, 2010 11:46 am

davidmorr wrote:
Jellybean wrote:Using two poles to help take your weight (and reduce the load on your knees) can also help on steep descents.
A lot of people recommend poles to "take some of your weight". If you do this, what is happening is that you are transferring weight from the heavy duty limbs that are intended for carrying you (legs) to limbs that are not designed to take weight in this fashion (wrists, arms and shoulders). While it is not likely to damage the joints by jarring, it could put unexpected strain on muscles and tendons not used to it. At the very least, your posture is likely to change to a hunched-over style which cannot be good for you.


It's a case of transferring some load from a limb with a worn joint to one without a worn joint, so that the walker can progress on the bushwalk in less (or no) pain. I don't think anyone is suggesting using poles as crutches. Of course, training is key to improving tone in the areas that will be carrying more load. There is another benefit worth mentioning - walking all day with your arms swinging by your side causes minor swelling of the hands - I've noticed this especially around my wedding ring. Using poles (even without bearing weight) eliminates this and keeps the circulation going, possibly keeping hands warmer as a result.

PacerPoles tend to give you a bit of extra push, even on the flat. I don't think they save energy expenditure, they just move some of it from your legs to your upper body. Ultimately, if you are pushing hard, I think you would go faster with PacerPoles, but you would probably tire faster too.
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Re: Knees'n'Ankles

Postby Jellybean » Tue 06 Apr, 2010 11:54 am

davidmorr wrote:
Jellybean wrote:Using two poles to help take your weight (and reduce the load on your knees) can also help on steep descents.
A lot of people recommend poles to "take some of your weight". If you do this, what is happening is that you are transferring weight from the heavy duty limbs that are intended for carrying you (legs) to limbs that are not designed to take weight in this fashion (wrists, arms and shoulders). While it is not likely to damage the joints by jarring, it could put unexpected strain on muscles and tendons not used to it. At the very least, your posture is likely to change to a hunched-over style which cannot be good for you.

Poles are definitely useful for stability - they make you into a tripod or tetrapod which is a very stable structure. This added stability may help knees and hips by allowing a more controlled descent rather than the big steps and jarring stop each time without them.

Cheers

David



Completely agree with the comments of others that using poles properly (including straps) can actually increase, not decrease your stability. That's certainly my experience and I find they're worth the hassle (for example of having to carry them on duckboard or narrow tracks or in scrub).

With regard to your comment above David about using poles "to take your weight", I guess that's a potential problem, however I find using poles with "anti-shock" mechanism (I guess a shock absorber for your poles) and careful use of the poles (I also have some shoulder problems from old sports injuries, so am careful how I use them) prevents this. I also definitely don't walk with a "hunched over style" (and this shouldn't ever happen if your poles are adjusted to the right length) - I personally only use the poles to help absorb my weight on really steep sections for very short periods of time. They do, however, save my knees and greatly increase my stability. I always take them when I know there's steep country to be traversed, especially on multi-day walks.

Cheers,

JB
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Re: Knees'n'Ankles

Postby Jellybean » Tue 06 Apr, 2010 12:05 pm

photohiker wrote:It's a case of transferring some load from a limb with a worn joint to one without a worn joint, so that the walker can progress on the bushwalk in less (or no) pain. I don't think anyone is suggesting using poles as crutches.


Spot on! :wink:
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Re: Knees'n'Ankles

Postby Penguin » Tue 06 Apr, 2010 12:39 pm

Great thread.

I have a buggered knee and a slightly buggered knee - buggered is a medical term by the way :lol:

The damage is caused by an inflammatory condition - good meniscus, so glucosamine will not help at this stage.

A few years back I thought this would stop me hiking and I had atleast one orthopod view that I should stop.

I have taked arange of pills adn potions, all with limited effect apart from prednesolone - which is not good for you in the long run.

A walking pole has been my saviour. Tried two - was all over the place. With one I get the tripod effect as my balance is worse with less knee flexiblity. I have teh ople in my left hand - my right knee is the worse. It took me about 12 months to learn how to use the pole for me. Down hill it gives balance adn takes the "jarring" way. I now try to land on the balls of the feet so that the calves can take soem of the shock away from the knees. Plenty of lod fashioned gym work has given
felexiblity and strenght in my shoulder to take the extra weight.

Up hill the pole helps the right knee for the bigger steps as I no longer have the strenght in the knee if I have too much of a bend.

On the flat the pole is superfluous for me, just try to walk like a Victorian English gentleman.

Still have to take NSAID's or COX 2's at times - but did the Southern Range okay last year. Even can do some boulder hopping now.

Two things for the young folk - keep the weight down and don't take your knees for granted. Bouncing on them skipping downa boulder fields is fun, but if you do this all the time you will suffer in the long run.

Sorry for the long post but a pole, a lighter pack and gym work have kept me hiking, when some medico's would have warned me off. My GP is happy for me to go, but then he does go hiking with me......

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Re: Knees'n'Ankles

Postby Taurë-rana » Tue 06 Apr, 2010 1:03 pm

Penguin wrote:Tried two - was all over the place. With one I get the tripod effect as my balance is worse with less knee flexiblity.


Different strokes for different folks :D I tried one pole and my balance was all over the place, two poles work well for me. Going down steep uneven tracks on day walks I often put all my weight onto the poles and swing down - so much more comfortable for the knees, gives the shoulders a bit of a work out but that's OK. I find my balance is better walking with poles as well - if I get off balance I can just quickly put a pole down to get right rather than using my ankles/knees/hips to get me back in balance.
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Re: Knees'n'Ankles

Postby johnw » Tue 06 Apr, 2010 1:46 pm

Jellybean wrote:Hi John...
I've never had any side effects from the gluc/chondroitin. I highly recommend that you take it in conjunction with Fish Oil (has an anti-inflammatory effect). (Fish oil also seems to provide some cardiovascular benefits as well as having a beneficial effect on skin, hair and nails - at least that's my experience.

Thanks JB. I should probably do something about the problem sooner rather than later, as I'm getting discomfort more often. Both knees are stiff and sore today just walking around at work after a fairly active weekend.
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Re: Knees'n'Ankles

Postby Turfa » Tue 06 Apr, 2010 8:01 pm

FWIW here are my suggestions. Have a dodgy knee myself from skiiing silliness when younger.

1. Get your pack weight (& body weight) down. Don't carry more on those dodgy knees than you have to :-)

2. Do some strengthening exercises to help stabilise the joint. Be serious about this & see a professional for advice (physio etc.)

3. Use walking/hiking poles. They not only will reduce the wear & tear on your bad joints, they can also let you get yourself back out of the bush if you do have any injury.
Use 2 poles, learn how to use the straps correctly (this is critical ! and makes a huge difference to their effectiveness) and give yourself time to get used to them. I hated mine when I first tried them as I found I really had to concentrate on every step & they would seem to catch on every little stick & tussock. Now it is a totally unconscious action when using poles & even some scrub does not seem a problem.

Cheers,

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Re: Knees'n'Ankles

Postby north-north-west » Tue 06 Apr, 2010 8:06 pm

Penguin wrote:A walking pole has been my saviour. Tried two - was all over the place. With one I get the tripod effect as my balance is worse with less knee flexiblity. I have teh ople in my left hand - my right knee is the worse. It took me about 12 months to learn how to use the pole for me. Down hill it gives balance adn takes the "jarring" way. I now try to land on the balls of the feet so that the calves can take soem of the shock away from the knees.

Yep, I can't manage two, either. Feels wrong and unbalanced - it's also too cumbersome when trying to take photos. one's essential for my knees and hips on the downhills.
As for how you're 'supposed' to use them, I wouldn't have a clue, but have worked out my own system, which suits me. I have wrist tendonitis, so I can't grip the poles firmly - I put the weight on the strap via the ball of the hand and just use a very light finger grip to move and place the pole.

Must dig out those glucosamine capsules. I know they're here somewhere . . .
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Re: Knees'n'Ankles

Postby Penguin » Tue 06 Apr, 2010 9:24 pm

north-north-west wrote:
Penguin wrote:A walking pole has been my saviour. Tried two - was all over the place. With one I get the tripod effect as my balance is worse with less knee flexiblity. I have teh ople in my left hand - my right knee is the worse. It took me about 12 months to learn how to use the pole for me. Down hill it gives balance adn takes the "jarring" way. I now try to land on the balls of the feet so that the calves can take soem of the shock away from the knees.

Yep, I can't manage two, either. Feels wrong and unbalanced - it's also too cumbersome when trying to take photos. one's essential for my knees and hips on the downhills.
As for how you're 'supposed' to use them, I wouldn't have a clue, but have worked out my own system, which suits me. I have wrist tendonitis, so I can't grip the poles firmly - I put the weight on the strap via the ball of the hand and just use a very light finger grip to move and place the pole.

Must dig out those glucosamine capsules. I know they're here somewhere . . .


Most of the time I do not think abou the pole. I use the strap going up hill but prefer to put the head of the pole in the ball of my hand going down hill. Also my right hand is free to use the bush "funiture" on rough tracks and places with no tracks.

I have seen an Aus study from a teaching hospital that showed on Xray growth of menicus in knee joints with errosive damage by taking regular glucosamine. I do not know about any other supplements.

The best thing is to find out how you should use the poles then modify that to suite yourself - i suppose the trick is to be open to whatever can help.

P
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Re: Knees'n'Ankles

Postby stepbystep » Thu 08 Apr, 2010 8:12 am

Thanks for all the input folks,
I will take all advice on board, still can't bring myself to use poles yet and will work on the other issues.
My pain problems aren't really too severe and I was most interested in others long term management as I want to still be walking in 30 years!
Ultimately I'm only getting pain when covering 15+km or more with vertical gain(and loss) of over 1000metres.
I think until I get my weight down to 70-ish kg I will probably keep my walks within the boundaries I have set.
I will get on glucosamine. Something else I have discovered is that regular use of chilli and turmeric in cooking has positive anti-inflammatory effects.
Studies on Fish Oil seem inconclusive - most fish oil in caps appears to be taken from fish farms and these fish are fed all sorts of crap with potential side effects down the food chain.
There is a liquid form that has good reviews but is v. $$$
Other fish oils appear to be synthetically produced - also a concern, so maybe I will just eat more fish!

Cheeers, sbs
The idea of wilderness needs no defense, it only needs defenders ~ Edward Abbey
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Re: Knees'n'Ankles

Postby Taurë-rana » Thu 08 Apr, 2010 9:41 am

stepbystep wrote:My problem is that after long or unduly rough or 'crazy' walks I have suffered sore knees and ankles.


I think you answered yourself to a certain extent right there anyway - don't walk with crazy people! Not that I would mention any names :wink:
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