Sunday, May 27, 2012

Joints - The Why, WOMAC, & Wow

Fixx Your Joints

Don't let knee problems sideline you
 There are many popular joint supplements on the market; the most popular are simple NSAID's (non-steroidal anti-inflammatory drugs) such as aspirin and ibuprofen.  The problem with these drugs is their huge lists of risk factors associated with their use, especially long term.  This is again another reason why natural supplements can come to be significant players in the joint pain relief market.  Advanced Muscle Science launched their new joint pain relief product called Joint Fixx.  It's the first dietary supplement in the bodybuilding industry to include ASU or Avocado Soybean Unsaponifiable.  ASU is simply a residue from the oils of avocado and soybean oils, in a 1:2 ratio (Msika P) (CG.).  The exact component in ASU, that plays a role in joint repair is unknown, but speculated to likely be related to the sterol content in the oils of both avocado and soybean (Lippiello L).  We will discuss ASU in more depth in a future installment, but in the meantime it’s more important that we understand how some joint pain manifests itself in bodybuilders and weight trainees in general.

The Why

When you think of things like osteoarthritis you often first associate it with “grandpa’s joint problems”.  But even as a young healthy weight trainee osteoarthritis can severely impact your training and progress towards your goals.  There are many hypothesizes about the exact cause of osteoarthritis, but in general it is believed to be the overall “wear in tear” of the joint.  Wear and tear is directly influenced by things such as age, family history, and for us load (ex, weight training, sports, etc.).  You have probably heard before that improving strength, and body composition is good for your joints.  And this is true up to a limit.  Low Impact sports such as running seem to help in many cases.  However high impact sports such as football, baseball (pitching elbows), and soccer players have been linked to increased risk of osteoarthritis.  Injury only adds further issues.  Remember that old high school football knee injury that put you on the bench a few games?  Well one review states that 80% of football players with previous knee injury have evidence of osteoarthritis 10 to 30 years later (Buckwalter JA).  Knowing this, now look back at all those heavy squat sessions, nagging injuries, bothersome shoulders and elbows, and you will quickly realize that osteoarthritis may be a very real issue in your future. 

The above illustration demonstrates the fine balance between repair and destruction of joint tissues.  Osteoarthritis occurs when even with increased repair; it cannot keep up with the level of destruction (Dickson).   


One way to determine the severity and existence of osteoarthritis is by completing a short questionnaire known as the WOMAC or Western Ontario and McMaster University Osteoarthritis Index (Bellamy N).  This can be a visual or Likert based scale that includes 24 simple questions, split into three sections that are simply designed to measure levels of pain, stiffness, and functionality.  For an example of a 5-point Likert based WOMAC simply search for WOMAC in Google (or click here).  The visual scale is simply a 100mm bar (for each question), with a high end and low end.  The individual completing the survey simply marks the bar at whatever point they feel is the pain level for that specified question.  To score the visual WOMAC, they simply measure the distance from the end of the left side of the bar to the participants mark.  The distances are then added up just as the Likert scores are added up to determine a total score.  In both scoring methods a higher score indicates a greater severity and likely hood of osteoarthritis.  Most importantly is that the WOMAC is used extensively in research to determine various levels of joint pain.  It should be mentioned that it is predominantly (and intended) for use in people with knee and hip pain. 

The Wow

Because the WOMAC extensively utilized in the field of research it allows us to not only test ourselves, but also review existing research with comparable participant groups and compare the WOMAC results (before and after testing).  In the next blog installment we will look into how much products like Joint Fixx, can improve joint pain, as well as how it’s ingredients have faired in WOMAC scored research.  In the mean time, we encourage those who have yet to try Joint Fixx to take a self-administered WOMAC exam, purchase a bottle of Joint Fixx, and re-take the test.  We would be more than interested in hearing before and after scores, as well as how it has faired in improving any joint pain you were experiencing. 


Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. "Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee." J Rheumatol (1988): 1833–1840.
Buckwalter JA, Martin JA. "Sports and osteoarthritis." Curr Opin Rheumatol. 5 (2004): 634-9.
CG., Frondoza. "Response to letter to editor entitled: "Avocado/soybean unsaponfiables, ASU Expanscience, are strictly different from the nutraceutical products claiming ASU appellation" (4365)." Osteoarthritis Cartilage. (2008): 1590-1.
Dickson, Gillian Hosie and John. Managing osteoarthritis in primary care. Hoboken: Wiley-Blackwell , 2008.
Lippiello L, Nardo JV, Harlan R, Chiou T. "Metabolic effects of avocado/soy unsaponifiables on articular chondrocytes." Evid Based Complement Alternat Med. (2008): 191-7.
Msika P, Baudouin C, Saunois A, Bauer T. "Avocado/soybean unsaponifiables, ASU EXPANSCIENCE, are strictly different from the nutraceutical products claiming ASU appellation." Osteoarthritis Cartilage. (2008): 1275-6.


  1. This is very helpful. I especially suffer with hip pain, occasionally knee pain. It's a common thing in my family and i'm considering getting one of those recliner chairs for the elderly early on, so that it's there and ready for when it becomes impossible to stand up.

  2. Thanks for this post. This is really helpful in fighting from pains. WOMAC is used extensively in research to determine various levels of joint pain. It should be mentioned that it is predominantly (and intended) for use in people with knee and hip pain.

  3. Your article very well and good, bringing inspiration to many. I hope people visit my website.
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