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Massage Today
June, 2013, Vol. 13, Issue 06 >> Vitamins / Supplements

Key Nutrients for Maintaining Musculoskeletal Health

By Christopher Oswald, DC, CNS

As a chiropractor, I fully appreciate the amazing potential of manual therapy. Whether that therapy is a chiropractic adjustment, therapeutic massage, or some of the many other effective body work options; people generally have a wonderful response.

From time to time though, we all run into an individual who doesn’t respond to our therapy as we would expect. This can be very frustrating as you are providing something to them that you know should be making a big difference, but for some odd reason they just don’t respond and they may think that massage or body work is just not the right option.

In my clinical experience, I have come to realize is that these "non-responders" are the people who need the most help, but the problem is that their body is so malnourished, there is no support for the underlying biochemistry to respond to the exact therapy they need. When their bodies are supported with appropriate nutritional supplementation, the newfound results are, at times, amazing. Think about this for your own health as well.

Nutritional support for musculoskeletal health may target many physiologic functions due to the multifactorial nature of pain, inflammation and tissue abnormality underlying musculoskeletal conditions. Sometimes, optimal support focuses on addressing a unique factor involved in someone’s disease, such as chronic inflammation underpinning rheumatoid arthritis or providing targeted nutrition for joints affected by arthritis. For this article, I will be focusing on a more general approach to musculoskeletal health support that can be beneficial to the majority of your massage clients.

One of the first concepts to consider is generalized support of the tissues. Within my practice, I have noticed that without base nutrition people cannot respond to the more specific therapies. Through the proper application of a high quality multi-vitamin mineral complex, it can be nearly assured that your client will be receiving the proper base nutrition to have an appropriate response to any manual therapies you perform.

Fish oil is another general recommendation that will benefit most of your clients. While research has shown a myriad of positive health benefits, there have also been some fairly specific benefits to overall musculoskeletal health. In regards to fish oils being beneficial for musculoskeletal health, many people understand that they promote an anti-inflammatory effect within the body, but do you really know why and how effective they can be? A study in the Journal of Nutritional Biochemistry from 2010, discusses the endocannabinoid signaling system and its role in musculoskeletal health and osteopenia. This system is activated and suppressed by the balance between omega-6 and omega-3 fatty acids.  The standard American diet (SAD) today is extraordinarily high in harmful omega-6 fatty acids and is almost devoid of the healthy omega-3 fatty acids (which are primarily found in fish oil, but can also be found in cod liver oil, krill oil, flax and others). This system has been found to be more active under the presence of high levels of arachidonic acid (omega-6), which will ultimately result in muscle atrophy and osteopenia. The researchers found that when omega-3 and omega-6 fatty acids are balanced, this problem is corrected and healthy muscle development and bone modeling occurs.

Vitamin D supports many functions throughout our bodies, but has some significant effects on musculoskeletal health. People with adequate vitamin D status seem to benefit from a protective effect against muscle weakness and bone fractures. There are a variety of additional nutrients that support the health of the musculoskeletal system. Two which I have come to use quite regularly in practice are bromelain (from pineapple) and proteolytic enzymes, which both have a systemic effect. When used away from food (30 minutes prior to eating or 90 minutes after), the systemic effect is one that helps to break down the exudates that our cells release following any type of injury or insult. Some studies suggest that use can reduce swelling, pain and inflammation. The mechanisms that have been proposed to support this activity include a reduction in PG-E2 production and through the modulation of adhesion molecules and supporting appropriate cytokine balance.

Vitamin C is another nutrient that can be very beneficial in the support of soft tissues throughout the body. This is essential for the adequate formation of collagen and L-carnitine. Collagen is a major component of all of our connective tissues and therefore is an essential component to maintain to ensure the integrity of our musculoskeletal systems. Carnitine is also very essential as it plays a key role in the transport of fatty acids into our mitochondria. Without this nutrient our body would have a very difficult time utilizing our fat stores to produce energy to initiate muscle contraction. Research has found that vitamin C can help to decrease muscle soreness after exercise and speed up our muscles recovery to full strength.

When you successfully combine nutrition and manual therapies (such as massage therapy), the results for your clients can be absolutely amazing. Remember to stay within the limits of your scope of practice for your specific state. Suggest a client might need to see their medical provider or a chiropractor who can counsel them on proper nutrition. Nourishing the bodies of the people that you work with will provide them the extra advantage of having adequate levels of the proper nutrients to ensure an appropriate response to the therapy that you have been providing them.

Christopher Oswald, DC, CNS, is currently in clinical practice in both Wisconsin and Minnesota, as well as a 2007 graduate of Northwestern Health Sciences University. Upon graduating, he started a private practice with a focus on using a functional medicine to approach tissue health, adrenal health, GI health, weight loss, and optimizing sports performance. Along the way Dr. Oswald has learned how to effectively address many of the underlying concerns with chronic health problems with a combination of chiropractic care, lifestyle changes, and specific nutritional protocols. He can be reached at .


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