I switched to trail and found I stopped getting injuries related to lateral stabilization of my hips and legs.

I've come to think it's because the trails challenge those stabilizers sufficiently so they get trained properly rather than... I don't know, repeatedly being irritated by running too straight for long periods of time?

I'm not a kinesiologist so I have no idea what the real difference is, but I do know I get hurt far less on the trails than I did on pavement.

One possibility is that I go slower overall so I can't push the limits of some muscle and tendon groups like I could on pavement. Everything gets more equally pressured, but less on average.

You're not wrong, but most of us don't live near a good dirt running trail so we have to drive to reach the trail head. When we have to squeeze in a run on workdays it becomes a choice between running on the street versus not running at all. Mud is also a problem for trail running in areas that get much rain.

Yes, I noticed this too. I ran a lot in high school / university, and for some reason we mostly ran on the roads. In my late 20s a doctor told me my knees sounded like they were "65".

I read a book my Michael Colgan at the time, and he mentioned training athletes on the trails as much as possible to reduce injury, so I gave it a try ...

That was 25+ years ago. At first people looked at me strange, like I was running from an animal. But its common now, and I'm still running on the trail, and knees seem OK.

Yes of course, you can still trip, step on a snake, etc, but its a different kind of injury. You are adapting gait and balance constantly which is nice too.

Running on the trail is much more interesting, with constant change, ups, downs, variations. Whereas running on grass / asphalt I can go into autopilot mentally and start ruminating, this is harder on the trail and I am more in a state of "here and now".

Trail running is fun. But it’s probably not the surface but the technique change, that gets rid of the pain. I’m currently going through the process of shifting my running technique to where I push rather than pull myself forward and it’s a revelation. When your foot lands in front of your center of gravity, it necessarily brakes your forward movement. All that momentum has to go somewhere, eg get absorbed by your joints. Changing this makes you more efficient as well as reducing strain on the soft tissue.

Trailrunning is less harsh on joints for sure, but certainly not easier based on the times of anyone who's run trail vs road events over any distance.

Mud, obstacles, and terrain that hasn't been bulldozed and rolled to be pan-flat make it much slower.

I'd worry about sprained ankles on a false step or a slippery leaf-rock trap. Is there a technical approach to running in these conditions?

Why not take up cycling?

Alternatively rubber tracks also are great, if you have one nearby.

Some anecdotal knowledge I can share on why they used to say wait as long as you can for a hip replacement:

We were told this was because it used to be that they could only do the hip replacement surgery once, and the replacement joint would only last around 20 years max.

So basically it had to be for the expected life span of the patient!

But now this is no longer true. Well, in Australia at least with access to modern replacement parts, surgical techniques and specialists!

I could be muddling it up a bit, so happy to be corrected :-)

The body is very weird and finds ways to compensate

I had a football injury when I was 13 that badly damaged my knee meniscus (though I didn’t know it at that time). At 16, I had a complete menisectomy - total removal of the lateral meniscus in my right knee

I was told that I would need to get a transplant and/or new knees in 10-15 years. I was also told that I shouldn’t put too much strain on the knee

I’m now 38 and my knee is mostly…fine. I can run, squat a reasonable amount of weight, walk for miles. Only thing I can’t do is fast directional changes (like in football) or bending down on the lateral side of my right knee

My plan is to extend this as long as possible and hopefully in 10 years, they’ll have tech to fix this for good

I'm constantly telling people to look up physical therapy movements/stretches for whatever they've got going on. Slept wrong? Tweaked your neck? You absolutely do NOT have to suffer with that until it goes away on its own, they can show you how to fix it.

If your insurance covers it, go see one! Them being able to actually see and feel what's going on specifically with you makes them markedly better at their jobs.

When doing stretches, don't forget the opposite side of the equation which is strength.

Not the "I'm going to bench 200lbs" type strength, but the musculature that supports movement.

It's quite easy to always focus on stretching, but not build the muscles that support good movement. You can turn yourself into a floppy noodle, which brings on more injury.

Please share which stretches helped you.

This has been my experience with every sports of weightlifting injury I've had and I'm in my 40s. The body wants to heal or at least compensate in some way. Light activity is often better than rest. I've got a knee that is acting up a little bit but I think I've figured out how to keep it healthy while running.

I f'd my knees running track in HS - i suspect some kind of structural problem that alters the way my knees move. Sr year wsa awful, i was just about crawling to class in the morning. MRIs showed nothing and I learned to live with it and eventually it got better when I stopped running.

10ish years later I had started riding my bike a lot during the dotcom explosion induced downtime, I kept it up after I was employed again. Knee pain came back. Went to the ortho again, this time was told "oh you have a torn meniscus, lets go fix it.

So I went under and woke up to be told that my meniscus was fine, and that I had worn grooves through the cartilage and into the bone - doc told me to never run, jump, ski, ride, etc. I was to sit on the couch.

Somehow I ended up taking karate, and the knees hurt for a bit, but the stretching we did helped loosen up my hams and quads. It didnt make the knee pain go away, but it made it tolerable in that it no longer affected my day to day.

When you're a hammer, everything starts to look like a nail. Good thing you were able to find a good alternative solution. I suspect a lot of ailments could be resolved with non-medical interventions, but there's little money to be made there and also, a lot of people want the perceived "easier" way out.

I had a similar thing happen. What multiple doctor visits could not even diagnose was fixed with resistance band side walks.

Hey, could I ask which stretch it was?

thanks for sharing, that’s wild! i’ll definitely take stretching more seriously now

Can you please share which stretches helped?

I'd say spinal and optic nerve regeneration is more "final" than cartilage.

Alzheimer's and similar, matter a lot too. Brain controls body.

A recent meta analysis suggests the positive results for collagen are mostly funding bias. See discussion here:

https://massresearchreview.com/2025/09/29/connecting-the-dot...

I have been taking collagen, but will likely stop.

Among endurance athletes collagen supplements have become increasingly popular the past couple years -- from what I understand the evidence is kind of mixed though

e.g. https://thefeed.com/products/pillar-performance-collagen-1?v...

Evidence seems to be lacking though. Do you have any specific source in mind?

The joint at the base of my thumb started telling me it's 60 years old. I stopped being able to open jars easily last year and would like to get my grip strength back.

I've torn mine as well and am yet to get it repaired. Did you get surgery? Anything working for you?

The supplementary material is freely available here:

https://www.science.org/action/downloadSupplement?doi=10.112...

It identifies the compound used as SW033291. Searching for it on clinicaltrials.gov gives no hits.

Lots of folks are pointing this out, but it's not like there isn't evidence to suggest this will also apply to humans.

> Human knee tissue collected during joint replacement surgeries also responded positively to the treatment. These samples, which include both the joint’s supporting extracellular scaffolding, or matrix, and cartilage-producing chondrocyte cells, began forming new cartilage that functioned normally.

Too bad that as a mouse you die after two years tops.

Top comment my whiskered friend.

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Yeah, a lot of healing mechanisms are also behind many tumor/cancer factors. There's a lot of reasons behind aging phenomenons, and a lot are self protective. It's not given all of the aging is intended and can't be reversed, but a lot of it is there for biological reasons.

Glad to hear you’re feeling better! How did you find out the root cause and treatment?

Yea, same here, following the studies had helped me fix a 18 year old shoulder tendon issue.

I owe that research group a lot.

At this rate we're going to have mice outliving humans by 2100

Just think of mice as the staging environment for production humans.

“A pill-based version of the same therapy is already being tested in clinical trials aimed at treating muscle weakness associated with aging.”

And you've been to a physio?

As far as I recall, the treatment I was prescribed for the same thing was mostly eccentric single leg squats, ideally on a 30 degree angled board.

And rest...

Have you tried mechanical keyboards? They were a life saver for me. I can type more than 100k keystrokes/day without any pain whatsoever.

I would say mechanical keyboard (used ErgoDox for years, now I use a Lily58). Now I would say learn how to make AI type for you.

I think it really depends on your age and underlying cause.

Everyone with it I've ever talked to said staying moving is important: "motion is lotion."

My elderly family use lots of anti-inflammatory drugs (NSAIDS) and one of them is on Prednisone.

Two of my friends with rheumatoid arthritis (only in their 30's) are on an injectable immunotherapies (DMARDs) that have been life changing for them.

Disclaimer: not a doctor, just have lots of sore friends/family and an interest in this stuff since I have a torn ACL and fear the future.

Arthritis is a general term; need narrow down for useful advice on managing symptoms.

Two most common types are osteoarthritis (wear-and-tear associated with aging and/or injuries) and rheumatoid arthritis (autoimmune).

I only know about age-related knee osteoarthritis to try to help my mom manage her symptoms, so I'll share my understanding of treating that.

High ROI, low cost: - weight management. Extra lbs are extra stress on the knees, plus I suspect chronic inflammation associated with being overweight can exacerbate arthritis independent of mechanical stress. - exercise, specifically low impact cardio and any pain-free strength/hypertrophy work targeting the musculature around the knees (mainly quads).

Variable ROI, low cost: - NSAIDs, specifically topical to focus on treatment area and reduce impact on GI system/kidneys. - curcumin, mixed evidence but some people report benefits.

Variable ROI, high cost: - PRP injections. Apparently the quality on these varies dramatically by provider. Would recommend doing research and comparing multiple providers if possible. - Knee replacement. Far from a panacea; you'll lose range of motion forever, plus plenty of other trade-offs. Most people recommend putting this off for as long as possible.

Also interesting is low dose radiation treatment for knee OA. More affordable than other procedures and has some promising research.

Not much else on the novel treatment front that I've found. Curious if anyone thinks I've missed anything worthwhile.

I have had hip osteoarthritis for five years and have followed my plan here - https://joelx.com/joels-hip-osteoarthritis-diet-nutrition-pl.... I feel vastly better and can even ski now.

I've had arthrosis in both knees for several years (due to a combination of youthful sports injuries and overweight). A few years ago I saw a knee specialist who predicted I was due for knee replacement sometime soon.

On the advice of a massage therapist I instead started a habit of using a home cycling machine for half an hour each morning. So far, it has worked wonders for me, and I hope I can hold on for a decade more, by which time the injection mentioned in the article might be ready for humans.

Diclofenac (voltaren) is a topical NSAID that can be useful for managing symptoms. Over the counter in the US.

I'd like to think orthopedists would rather be overjoyed at this. My wife had her knee and hip done by a cracking orthopedist, and his primary concern was her quality of life. He even went to the state physicians' board to argue that her hip surgery should be considered necessary rather than elective for purposes of COVID restrictions, so that we could get it done months before it was originally scheduled.

afaik surgeons are able to perform quite a few types of surgeries, obviously the ones working on brains more advanced than ones working on knees it's probably only a few years to transition to a different type of category.

Almost certainly. Ankles also rely upon hyaline cartilage (as opposed to fibrocartilage). I found this out when I had microfracture surgery for a bad ankle injury.

Looking forward to this therapy. My fibrocartilage is wearing out!

Here for the same question! Broke my left ankle three times as a football (soccer) playing youth who cared not for rehab! Now stuck with limited range of monitor and arthritis in my foot / ankle.

Always a good call out, but also:

> Human knee tissue collected during joint replacement surgeries also responded positively to the treatment. These samples, which include both the joint’s supporting extracellular scaffolding, or matrix, and cartilage-producing chondrocyte cells, began forming new cartilage that functioned normally.

Just think of mice as the staging environment for production humans.

let me be excited for things!