Increase Height And Grow Taller Using Chondroitin And Glucosamine (Breakthrough?)

Just yesterday a reader of the website sent to me over the email link a very interesting video and a story from The Daily UK. On the video a fully grown man who is very bulked up from weight lifting talked about him increased his height in his usual sneakers from a little over 6′ 3″ to 6′ 4.25″, which he says would be a 1.25″ increase of height over a time span of 2.5 months. The Youtube video is from link HERE. The Account name is “ugoarimo” which the speaker shorten to just “ugo” from the beginning of the video. It seems that he had symptoms of knee pain resurface from high school days so he decided to take start taking the glucosamine sulfate and chondroitin.

Now, from a completely scientific point of view, I have seen at least 2-3 PubMed studies where patients with degrading thickness of articular cartilage in their knees resulting in knee pain had a reduction in knee pain after taking the glucosamine supplement for about 2-3 months. That could indicate that maybe, just maybe the glucosamine can actually no just halt the decrease in thickness of the articular cartilage, but also increase the thickness. However , that should still not explain why this man on the video claimed that his height increase by 1.25″ which is far beyond what I have thought glucosamine supplement could do.

So a little more about this guy who calls himself “ugo”. His other name that he goes by is The Black Spiderman. He seems to be some type of nutrition and fitness celebrity because on his Facebook page he has over 22600 likes. On his Twitter account he has over 17500 followers. He describes himself as a Physique Competitor/Model and BJJ Black Belt so he definitely tries to stay in shape. The video was published in July 2012 and he has almost 240 videos on his youtube account as of this time. On the other videos, he is not promoting any type of health supplement or multivitamin so if I was to say he was just another internet marketer trying to sell a product which is ineffective, I would have to second guess myself because I might be wrong.

The Science and Actual Study: From the article below…”The supplement is an amino acid made from combining sugar and glutamine. It is combined with sulphur to form glucosamine sulphate.” It seems that the key is to take the glucosamine sulphate. It is thought glucosamine improves water retention in the discs, which is likely to reduce wear and tear on the vertebrae. In the study, 36 people were asked to take the supplement for 4 weeks. Half of them took 1500mg of glucosamine sulphate daily. There was a control group given a placebo. The results seem to show that the group taking the Glucosamine Sulfate supplement at 1500 mg daily for about 1 month saw an increase in height of about 2-4 millimeters, which to me is very difficult to determine whether it could be from measurement error or real height increase. What is quite conclusive about the benefits of this supplement is it “halted the progression-of osteoarthritis in the knees of patients taking it daily for a few years“. If I was a betting man, I’d say that the height increase can be that the height decrease throughout the day was decreased and that some lost height was restored but the body in general never increased in height. However, I might be wrong. In the comments “Ugo” states that he started to experience bilateral knee pains just like in high school when he was still growing. [Note: They are referring to glucosamine sulfate, NOT glucosamine chondroitin.]

Additional Notes: Under the video where the comments are we see that a few people responded to him and said ….”Dude, i grew an inch. I accidentally bought the sulfate kind but i guess it still works. I’ve been taking like 3 2000mg pills a day (1 in the morning, 2 before bed) with meals for about 2 weeks. Basically ever since i saw your vid. I know it’s probably the cartilage in my spine regenerating, but idgaf. So thanks bro! I’m gonna keep taking this until i see no more changes“. So apparently another guy increased his height by 1 inch from taking the glucosamine sulfate at 2000 mg 3 times a day for only 2 weeks! Most of the other commenters called this guy a liar and said he didn’t grow but he seems to have a rather stoic and poker faced attitude to the accusations so judging him only by his actions and reactions to other people calling him a fraud, I’d say that I’m on the side that believes in what he claims, at least right now.

The thing is The Black Spiderman (as he calls himself) cites a link http://www.dailymail.co.uk/health/article-142809/Can-pill-make-taller-weeks.html which made me even more curious. Here is the entire article below…


Can a pill make you taller in four weeks?

by JENNY HOPE, Daily Mail

Can a pill really make you taller?

Glucosamine – a popular dietary supplement that seems to prevent the wear and tear of ageing joints – may also help people to grow taller.

New research suggests glucosamine sulphate, a naturally occurring building block for cartilage, can prevent shrinkage of the spine.

Top athletes have used glucosamine for years – and latest research shows the overthecounter supplement appears to protect cartilage tissue in the spine to the extent that it leads to an increase in height.

Glucosamine sulphate is believed to recondition cartilage tissue, rather than just counter the pain caused when joints naturally suffer osteoarthritis with increasing age.

Dr Peter McCarthy, from the Welsh Institute of Chiropractic at Glamorgan University, who carried out the study, said people taking glucosamine for four weeks grew taller.

It is thought glucosamine improves water retention in the discs, which is likely to reduce wear and tear on the vertebrae. As we age, we lose the ability to manufacture sufficient levels of glucosamine.

Dr McCarthy said: ‘It’s the first time research has shown that glucosamine, a nutritional supplement, can lead to an increase in height. We believe it has a direct effect on spinal joint tissues by preventing water loss from the cartilage in the discs.’

Glucosamine helps form new connective molecules that make vital links between cells and tissue, especially in cartilage.

The supplement is an amino acid made from combining sugar and glutamine. It is combined with sulphur to form glucosamine sulphate.

The new study involved 36 volunteers, half of whom took 1500mg of glucosamine sulphate daily. The remainder took a placebo pill manufactured to look the same.

After four weeks, two independent examiners found a slight increase in height among those taking the supplement.

There was no significant difference among those taking the placebo pill, says a report in the European Journal of Chiropractic 2002.

Dr McCarthy said: ‘The increase was not huge – it was between two and four millimetres – but this is a significant finding-Osteoarthritis affects an enormous number of people.

‘Glucosamine could be helping to reverse the pressures caused by standing upright. It could also be regulating the production of cartilage components. Supplemenation may either increase the total body height of the average person or reduce the amount of normal spinal shrinkage during the day.’

Thousands of people regularly use the supplement, which was introduced to Britain by David Wilkie, the former Olympic gold medal swimmer and managing director of Health Perception, which manufactures an oral supplement and a gel formula which can be rubbed into a painful joint.

Wilkie discovered glucosamine while training in the U.S. and has used it for more than 20 years.

Glucosamine is the preferred treatment for arthritis in Spain, Portugal and Italy.

Research in The Lancet medical journal last year found that the supplement halted the progression-of osteoarthritis in the knees of patients taking it daily for three years.

England rugby star Lawrence Dallaglio has taken glucosamine for years and believes it contributed to his comeback after injury. He said: ‘It works for me, but it’s good to see research which actually proves it’s having a beneficial effect.’

Read more: http://www.dailymail.co.uk/health/article-142809/Can-pill-make-taller-weeks.html#ixzz2CrRc9OOp
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The Connection Between Aggrecan, Chondrogenesis, And Height

Protein_ACAN_PDB_1tdqA compound or protein that I have been reading a lot about in the literature is aggrecan and it seems that have some direct influence and effect on chondrogenesis and the overall height. This is my attempt to do some basic research on Aggrecan.

I start off by just reading the Wikipedia article on aggrecan to get a general idea on what it is and what it does. The first few sentences makes me realize that aggrecan may be a not more important than I had previously believed.

“Aggrecan also known as cartilage-specific proteoglycan core protein (CSPCP) or chondroitin sulfate proteoglycan 1 is a protein that in humans is encoded by the ACAN gene. This gene is a member of the aggrecan/versican proteoglycan family. The encoded protein is an integral part of the extracellular matrix in cartilagenous tissue and it withstands compression in cartilage…Aggrecan is a proteoglycan, or a protein modified with large carbohydrates”

We remember that in at least the hyaline type cartilage found in the epiphyseal growth plates, the chondrocytes did excrete two main types of waste which would go on to make the extracellular matrix of the cartilage, type II collagen and proteoglycans. I had only briefly touched on looking at proteoglycans in the past in a very early post “The Effect On Height By Proteoglycans“. Looking back on these older posts I realize that I had no idea what I was doing or researching and understood very little of the details and mechanics of the cartilage that form the growth plates. I was trying and that is what I think is important.

From the name itself of aggrecan “cartilage specific proteoglycan core protein” it suggest that this type of protein is a type of proteoglycan which is either mainly or only found in cartilage. The fact that another name for it is chondroitin sulfate proteoglycan 1 shows that it may be similar to to the glycoaminoglycans we saw in the past or the non-sulfated type like the hyaluranon (aka hyaluronic acid)

From Wikipedia…

Aggrecan is a high molecular weight (1×106 < M < 3×106) proteoglycan. It exhibits a bottlebrush structure, in which chondroitin sulfate and keratan sulfate chains are attached to an extended protein core.

Aggrecan has a molecular mass >2,500 kDa. The core protein (210–250 kDa) has 100–150 glycosaminoglycan (GAG) chains attached to it. Along with type-II collagen, aggrecan forms a major structural component of cartilage, particularly articular cartilage.

What we are seeing is that aggrecans make up a huge major component in the matrix of most cartilage. When originally we were looking at the composition of cartilage, we only called them by the names, Collagen Type 2 and Proteoglycans. Now we can be more specific in seeing that one major type of proteoglycan found in at least articular cartilage is the aggrecan. The aggrecan itself seems to be much bigger than any glycoaminoglycan we saw before. There is a core protein part, and from the core protein projects about a couple hundred GAG chains, many of them being chondroitin sulfate and keratan sulfate.

If we remember from our past research on trying to find some type of supplement which can possible increase height, two major contenders were glucosamine sulfate and hyaluronic acid while another type, the chondroitin sulfate was very big as well. What we see from supplement stacks used from GrowTallForum.com was the use of glucosamine and chondroitin being used extensively. This suggest that GAGs have been the major source type of biological protein we were taking. At some point, after doing research on all three components, I tentatively decided that glucosamine sulfate and hyaluronic acid were two of three types of supplements which had the best chance of leading to some height increase for physically mature adults, even though those results might have been only a few milimeters of extra height at best.

It seems that overall, the aggrecan has 4 major areas, with 2 areas being on the N end and one area in the C end. There are areas in the compound called G1, G2, and G3 which have the function of chondrocyte apoptosis, hyaluronan binding, aggregation, and cell binding.

From the section for functions….

Aggrecan plays an important role in mediating chondrocyte-chondrocyte and chondrocyte-matrix interactions through its ability to bind hyaluronan

I am not sure about this but I would be willing to make a guess at this point that when the wikipedia article is referring to chondrocyte-chondrocyte interactions, the issue of orientation and chondrocyte arrangement might be included. One of the domains called G1 seems to bind to hyaluranon and proteins and form big complexes of protein that is 3-parts. This might involve a hyaluranon-aggrecan-protein system.

This next part in the wikipedia article was extremely englightening…

Aggrecan provides intervertebral disc and cartilage with the ability to resist compressive loads. The localized high concentrations of aggrecan provide the osmotic properties necessary for normal tissue function with the GAGs producing the swelling pressure that counters compressive loads on the tissue. This functional ability is dependent on a high GAG/aggrecan concentration being present in the tissue extracellular matrix.

This shows that there is a clear direct link between having extra aggrecan & GAGs and resisting the loss of height from intervertebral disk compression from gravitational loading. This is not only the first indication that taking certain GAGs may indeed lead to certain height increase like chondroitin sulfate and hyaluronic acid, but that any process to increase aggrecan especially in the cartilage that are part of a joint can lead to some height increase.

At the end of the clinical significance section it says…

Osteoarthritis is characterized by the slow progressive deterioration of articular cartilage. Cartilage contains up to 10% proteoglycan consisting of mainly the large aggregating chondroitin sulfate proteoglycan aggrecan.

It seems to validate the idea that the majority of proteoglycan types found in cartilage is the aggrecan. Since chondroitin sulfate does form a huge part of the chains that make the globular parts of the aggrecan, maybe taking chondroitin sulfate and keratan sulfate can really do lead to at least some decreased height loss from intervertebral decompression throughout a day.

Conclusion:

From only a quick analysis of just the Wikipedia article on aggrecan, I am willing to guess that this large complex of a protein is critical in giving the structure and strength of cartilage in general. I would say that aggrecan can lead to some height increase if one can get enough of hyaluranon and aggrecan in the right cartilage regions in one’s body. I am quite confident in showing that getting enough GAGs and aggrecan into one’s system can possibly lead to lead height loss throughout the day and may also help prevent the onset of osteoarthritis.

Increase Height And Grow Taller Using Chitosan

Another compound I have heard people claim could possibly increase height was over the compound Chitosan. When I first googled “chitosan grow taller” the first link was to the site GrowTall.com

The website states that chitosan is a type of “fiber” that is made from crustacean shells from a chemical process. Besides being found in shrimp, lobsters, it seems that chitosan can also be found from teh plastic part of the squid we remove which can not be eaten. The first thing that comes to my head is to remember that a lot of high increase pills have a compound made from seashells as well based on calcium, usually calcium carbonate. From high school biology we remember that human digestive systems can’t digest fibers unlike most plant eating animals like cows which have 4 stomachs. The chitosan would go into the intestine area, bond with ingested fats, and come out when we go #2 in the bathroom.

The website suggest that chitosan might be useful for weight loss, can be used in wound treatment (ie closure) and that it should not be used by children and/or pregnant women due to growth retardation. This claim would mean that chitosan would actually make growing children shorter than they would actually be, which is the opposite of what we are looking for. As fror doasge, 3-6 grams of the compound can be taken each day with food. It seems chitosan has the ability to remove the body of certain minerals which again shows that it is a compound that is more likely to retard and stunt growth that promote it. The fact that it is stated that it can be used for woud healing may indicate it does have some angiogenic properties.

As for medicinal or therapeutic uses, some studies suggest it can possibly lower cholesterol as well as treat kidney failure. For the kidney failure, the chitosan is said to combine with an toxic compounds and this causes the toxins to be excreted out when the chitosan as a fiber is excreted. From a very syperficial level, that is a reasonable scientific guess as why researchers may think it helps with kidney failure.

As for the claim that it is used to treat wounds and help in wound healing/closure, the idea is that along with the plasma, the chitosan may be able to bind to whatever usually like blood and plasma that comes along to close wounds and help built new tissue. That other idea is that chitosan may be able to kill some bacteria (like Strep) and yeast (like Candida)

Some studies claim it helps prevent or treat tumors, which would suggest that it is more catabolic in nature which is against what most height increase products would claim.

From the website GrowTall.com…

Animal studies suggest that some forms of chitosan may help to prevent bone loss;… however, because chitosan also interferes with mineral absorption, the net effect in humans might actually be to increase bone loss…

Safety Issues 

There is significant evidence that long-term, high-dose chitosan supplementation can result in malabsorption of some crucial vitamins and minerals including calcium, magnesium, selenium, and vitamins A, D, E, and K.33,34 In turn, this appears to lead to a risk of osteoporosis in adults and growth retardation in children. For this reason, adults taking chitosan should also take supplemental vitamins and minerals, making especially sure to get enough vitamin D, calcium, and magnesium.

The overall conclusion on this resource is that chitosan is more like to remove important minerals for bone instead od prevent bone loss. If this is the case, for children who are still growth, that can indeed interfere with with the endochondral ossification process. Let’s  not forget that while a lot of our research now is on cartilage and cartilage regeneration, for us to have the height we already do, it does involve the fact that calcium and otehr hard deposits have been layered and grown on top of each from the natural height growing process. Bone and mineral loss is a problem for people still growing.

However, the effects on people who are finished done growing who wish to do exercises to lengthen long bones may be the exact opposite. I do note that there has been some weak positive correlation with the idea that weaker bones with lower BMD (bone mass density) may mean that they are easier to change and be melleable (if only a little) to some bone modeling loading. If chitosan can remove the minerals in the bones that make them so hard, it might indeed assist in some techniques we have talked before like the shinbone method, in inducing microfractures, and the LSJL method.

As for the conclusion of this source on Chitosan, I say that there is a slight chance that Chitodan may help people who are already finished with the natural growth process grow taller if they take it long enough and but also did some type of bone remodeling exercises.

A post on the prospective affects by Chitosan was looked at already by HeightQuest.com in “Height increase with Chitosan?” .

Analysis:

His main point is to get the chitosan to actually go into the blood stream for some effect instead of getting it completely passed through the digestive tract without it ever getting used. The difficulty is to get the chitosan content into the bone marrow. From one study he quotes “Effect of dietary supplementation of chitosan and galacto-mannan-oligosaccharide on serum parameters and the insulin-like growth factor-I mRNA expression in early-weaned piglets.” Chitosan might help because it will “encouraging epiphyseal bone marrow stem cells to become a more rounded pro chondrogenic shape

The last resource I would raise is another result found from Google on a forum thread from Soompi HERE. A member named Jaeho would write…

Also, my mom ordered Royal Jelly and something called SmarTall. SmarTall is apparently the kids’ version of Royal Jelly. My brother and sister have been taking SmarTall for 2 days.

I also searched Chitosan online, but all the sites say it’s a weight loss pill and that it’s a scam… BUT in Korea, it’s marketed as a miracle product that cures all sorts of health problems. I can’t find anything on SmarTall though.

Anyway, I asked my mom why she bought SmarTall and she said it was like Royal Jelly for children… but it’s for height too? Well, the name gives it away… lol. From a first guess

Analysis: 

It would seem that chitosan is being marketed in east asian countries like Korea for being a sort of miracle pill that has multiple therapeutic benefits. It’s claims to help people loss weight makes it very attractive to the Korean people who are well known by being very appearance conscious. There is no claim that chitosan has any effect on height but there is another product that is Royal Jelly derived called SmarTall being sold (at least back in 2006) in Korea which is given to kids to help them grow taller. The conclusion here is that Chitosan has no height increasing properties.

If we type in the term “chitosan height increase’ into google instead what we find are studies which do suggest that chitosan does have some height and size increasing ability but those are just for vegetables, specifically grains.

A link to a webpage on Vanderbilt University HERE shows that people have already looked into chitosan quite extensively and summarized its properties and possible effects. They conclude with….

“Although companies selling chitosan claim that the product is very effective and claim to have medical research about how well their product works, the medical studies show that when taken alone, chitosan has not been proven to help a person lose weight, increase their HDL cholesterol, or decrease their LDL cholesterol. Instead, chitosan can cause unwanted gastrointestinal cramps and constipation”

Conclusion: 

Chitosan may be harmful to growing children in terms of growth retardation from its ability to absorb important minerals the body and bones need when the person is still growing. After the person is finished growing, there might be a small chance that a person can use chitosan’s mineral absorbing properties to make bones less hard and easier to model so it might be possible to use it with some bone loading technique to lengthen bone.

Using BMP-6 To Differentiate Adipose Derived Adult Stem Cells Into Chondrocytes And Cartilage Regeneration

Me: This post is to show that another option of growth factors we can use to turn the adipose derived adult stem cells into chondorcytes is to use BMP-6. Remember that in the long bones of adults, the marrow is considered yellow and mostly made of fatty acids. The study showed that TGF-Beta1 has also been shown to work, causing the expresion of cartilage specific genes an proteins like aggrecan and type II collagen. There was actually 5 growth factors all looked at in this study. They are looking at the chondorgenic potential of these on ADAS cells in alginate beads
  • 1. TGF-Beta 1
  • 2. TGF-Beta 3
  • 3. IGF-1
  • 4. BMP-6
  • 5. Dexamethasone
The two main points from the study are.
1. BMP-6 up-regulated AGC1 and COL2A1 expression by an average of 205-fold and 38-fold, respectively, over day-0 controls, while down-regulating COL10A1 expression by approximately 2-fold.
2. BMP-6 is a potent inducer of chondrogenesis in ADAS cells, in contrast to mesenchymal stem cells, which exhibit increased expression of type X collagen and a hypertrophic phenotype in response to BMP-6.
So for future reference, we realize that if we wanted to inject the BMP-6, we would put it in the bone marrow part, not the epiphysis part since the MSCSs only caused COL10 expression and hypertrophic phenotype. Any height increase method we create will have growth factors added in certain areas in certain combinations in certain sequences,
From PubMed study link HERE
Arthritis Rheum. 2006 Apr;54(4):1222-32.

Potent induction of chondrocytic differentiation of human adipose-derived adult stem cells by bone morphogenetic protein 6.

Estes BT, Wu AW, Guilak F.

Source

Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.

Abstract

OBJECTIVE:

Recent studies have identified an abundant source of multipotent progenitor cells in subcutaneous human adipose tissue, termed human adipose-derived adult stem cells (ADAS cells). In response to specific media formulations, including transforming growth factor beta1 (TGFbeta1), these cells exhibit significant ability to differentiate into a chondrocyte-like phenotype, expressing cartilage-specific genes and proteins such as aggrecan and type II collagen. However, the influence of other growth factors on the chondrogenic differentiation of ADAS cells is not fully understood. This study was undertaken to investigate the effects of TGFbeta1, TGFbeta3, insulin-like growth factor 1, bone morphogenetic protein 6 (BMP-6), and dexamethasone, in various combinations, on the chondrogenic potential of ADAS cells in alginate beads.

METHODS:

The chondrogenic response of alginate-encapsulated ADAS cells was measured by quantitative polymerase chain reaction, 3H-proline and 35S-sulfate incorporation, and immunolabeling for specific extracellular matrix components.

RESULTS:

Significant differences in chondrogenesis were observed under the different culture conditions for all outcomes measured. Most notably, BMP-6 up-regulated AGC1 and COL2A1 expression by an average of 205-fold and 38-fold, respectively, over day-0 controls, while down-regulating COL10A1 expression by approximately 2-fold.

CONCLUSION:

These findings suggest that BMP-6 is a potent inducer of chondrogenesis in ADAS cells, in contrast to mesenchymal stem cells, which exhibit increased expression of type X collagen and a hypertrophic phenotype in response to BMP-6. Combinations of growth factors containing BMP-6 may provide a novel means of regulating the differentiation of ADAS cells for applications in the tissue-engineered repair or regeneration of articular cartilage.

PMID: 16572454   [PubMed – indexed for MEDLINE]    Free full text

Using Microspheres With TGF-Beta1 And Chitosan To Differentiate Adipose Derived Stem Cells Into Chondrocytes And Repair Cartilage Defects

Me: This seems to suggest that we can create these hybrid microspheres which are just basically encapsulations or coatings of some collagenous fibrous material with TGF-Beta1 and/or Chitosan put inside and put it into the intermedullary cavity to get what little stem cells inside to differentiate into chondrocytes since the adult bone marrow is not red but yellow which is fatty acids and anything that is derives from fatty acids.

I have written in another article over the ability of BMP-6 to turn adiposed derived adult stem cells into chondrogenic in phenotype unlike for mesenchymal stem cells. It seems that the winner in this study was the hybrid microsphere with TGF-beta 1 and chitosan inside. This helps me further in deriving a height increase method. I know now that we can create microspheres for injection close to the bone marrow. Personally I would use the TFG-Beta 1 with Chitosan first which has a lesser chondrogenic effect and then added the BMP-6 encapsulations for further chondrogenesis.

From PubMed study link HERE

Joint Bone Spine. 2010 Jan;77(1):27-31. Epub 2009 Dec 22.

Cartilage regeneration using adipose-derived stem cells and the controlled-released hybrid microspheres.

Han Y, Wei Y, Wang S, Song Y.

Source

Department of orthopaedics, Xijing Hospital, The Fourth Military Medical University, West Road Changle, Xi’an, China. yishenghan@homtail.com

Abstract

OBJECTIVE:

This study was to evaluate the effect of hybrid microspheres (MS) composed of gelatin transforming growth factor-beta (TGF-beta1)-loaded MS and chitosan MS on the enhancement of differentiation of adipose-derived stem cells (ASCs) into chondrocytes in pellet culture in vitro and the reparative capacity of pellet from ASCs and the hybrid MS-TGF used to repair cartilage defects in vivo.

METHODS:

The morphology of the controlled-released MS was observed with scanning electron microscopy (SEM) and mechanical property was also tested in this study. In vitro TGF-beta1 release was evaluated by an enzyme-linked immunosorbent assay. The protein expression of Collagen II was tested by Western blot. In addition, a preliminary study on cartilage regeneration was also performed in vivo.

RESULTS:

When chondrogenic differentiation of ASCs in both MS was evaluated, the protein expression of Collagen II became significantly increased for the hybrid MS-TGF, as compared with the gelatin MS-TGF. Mechanical result showed that the hybrid MS was superior to the gelatin MS. Observation of histology in vivo demonstrated that the pellet from ASCs and the hybrid MS-TGF promoted cartilage regeneration in the defects of articular cartilage much better than other groups.

CONCLUSION:

Our study demonstrated that the pellet from ASCs and the hybrid MS-TGF can provide an easy and effective way to construct the tissue engineered cartilage in vitro and in vivo.

Copyright 2009. Published by Elsevier SAS.

PMID: 20022784   [PubMed – indexed for MEDLINE]

High Impact Sports Improves Bone Strength And Bone Geometry

Me: It is important to note that only two sports were compared side by side, specifically soccer and swimming for the first study. What we see is that when the swimmers and soccer players are compared to control groups, the loading from weight by the soccer players resulted in an increase in bone mineral density (BMD) which results in an increase in bone strength, and increased thickness of the cortical area. Apparently the bone strength of swimmers seems to be even lower than the controls, which makes sense since we have seen astronauts who go into space will increase in height from decompression of spine but will drop dramatically bone mineral density, bone loss, and bone strength. This might suggest that the viscoelastic nature of water might do a similar effect on the human body allowing for it to expand longitudinally in the water but probably goes back to normal when the swimmer gets out of the water just like how the astronaut gets back to their normal height after spending time back on earth. We know the loading from soccer leads to stronger bones and thicker bones. However we are not clear whether it would lead to longer bones as well, which is what we have been trying to achieve.

For the second study, it seems that with old age, the medullary cavity decreases in apposition and increase in size. Exercise can help increase the endocortical apposition and cortical area from the inside thus resulting in slight shrinkage of the cavity. With boys, during puberty and post puberty, the periosteal apposition is higher than the cortical resorption so for males, the cortical area is larger. With females from the tennis study, the periostral apposition is also higher from exercise and loading before puberty but the cavity seems to increase from endocortical resorption. What is important to note is that the rising estrogen levels in the pubertal tennis players will result in less bone sensitivity to loading. 

From PubMed study link HERE

J Bone Miner Metab. 2011 May;29(3):342-51. Epub 2010 Oct 21.

Bone geometry and strength adaptations to physical constraints inherent in different sports: comparison between elite female soccer players and swimmers.

Ferry B, Duclos M, Burt L, Therre P, Le Gall F, Jaffré C, Courteix D.

Source

Laboratoire Interuniversitaire de Biologie des APS, EA 3533, PRES Clermont Université, Université Blaise Pascal, 24 avenue des Landais, BP 80026, 63177 Aubiere Cedex, France.

Abstract

Sports training characterized by impacts or weight-bearing activity is well known to induce osteogenic effects on the skeleton. Less is known about the potential effects on bone strength and geometry, especially in female adolescent athletes. The aim of this study was to investigate hip geometry in adolescent soccer players and swimmers compared to normal values that stemmed from a control group. This study included 26 swimmers (SWIM; 15.9 ± 2 years) and 32 soccer players (SOC; 16.2 ± 0.7 years), matched in body height and weight. A group of 15 age-matched controls served for the calculation of hip parameter Z-scores. Body composition and bone mineral density (BMD) were assessed by dual-energy X-ray absorptiometry (DXA). DXA scans were analyzed at the femoral neck by the hip structure analysis (HSA) program to calculate the cross-sectional area (CSA), cortical dimensions (inner endocortical diameter, ED; outer width and thickness, ACT), the centroid (CMP), cross-sectional moment of inertia (CSMI), section modulus (Z), and buckling ratio (BR) at the narrow neck (NN), intertrochanteric (IT), and femoral shaft (FS) sites. Specific BMDs were significantly higher in soccer players compared with swimmers. At all bone sites, every parameter reflecting strength (CSMI, Z, BR) favored soccer players. In contrast, swimmers had hip structural analysis (HSA) Z-scores below the normal values of the controls, thus denoting weaker bone in swimmers. In conclusion, this study suggests an influence of training practice not only on BMD values but also on bone geometry parameters. Sports with high impacts are likely to improve bone strength and bone geometry. Moreover, this study does not support the argument that female swimmers can be considered sedentary subjects regarding bone characteristics.

PMID: 20963459        [PubMed – indexed for MEDLINE]

Changes in bone geometry during growth

Growth in the external size of a long bone, its cortical thickness and the distribution of cortical bone about the neu- tral axis is determined by the absolute and relative behavior of the periosteal and endocortical bone surfaces along the length of the bone8,13. Before puberty, periosteal apposition accounts for most of the increase in cortical area, this is part- ly offset however by the enlarging marrow cavity due to endocortical resorption. The net result is an enlarged corti- cal area located further from the neutral axis, leading to increased resistance to bending4. Late in puberty, periosteal apposition continues and is now accompanied by endocorti- cal apposition14, leading to an increase in cortical thickness.

The temporal sequence of events in boys tracks that of girls before puberty. Sexual dimorphism occurs during puberty and is characterized by boys exhibiting greater perisoteal expansion late in and post-puberty, and the absence of any endocortical contraction. Thus, in boys, the net result is the attainment of a greater cortical area that is located further from the axis of rotation compared to girls13.

The skeleton’s temporal sequence of events due to growth are not only surface-specific but also region-specific with more rapid maturation of distal than proximal regions. Distal segments of the appendicular skeleton mature before the proximal segments14. Similarly, contraction of the medullary cavity occurs in a distal to proximal pattern8,14.

The effect of additional loading on bone geome- try during growth

If additional loading does enhance the effect of growth then it would follow that exercise during childhood would result in an increase in periosteal but not endocortical apposition. Late in puberty, and in the immediate years following puberty the predominant effect would be narrowing of the medullar cavity due to endocortical apposition. This maturity-dependent preferential change in cortical surfaces with mechanical loading has been demonstrated in animals15-17. Younger animals showed greater periosteal expansion, while older animals showed greater medullar cavity narrowing. Reduced mechanical loading through limb immobilization or weightlessness also leads to preferential changes at the cortical surfaces: younger animals show a greater periosteal response (inhibition of bone formation), while older animals showed a greater endocortical response (increased resorption)7,16,18.

The results of human studies however are equivocal; for instance, consistent with this proposal is the finding that pre- pubertal female gymnasts had a larger total bone area (periosteal expansion) of the forearm despite a smaller stature19. While the playing arm in adult tennis players resulted in no detectable change to the total bone area of the radius, it did however result in thicker trabeculae20. Exercise also led to medullary contraction (but no periosteal expan- sion) at the tibia in adult military recruits21. In contrast, load- ing in pre-pubertal female gymnasts and non-athletic boys resulted in increased cortical area at the mid-femoral shaft due to endocortical contraction, not periosteal expansion2.

The aforementioned inconsistencies in the literature are likely to partly reflect the limitations imposed by two-dimen- sional measures (i.e., X-ray) of a three-dimensional struc- ture (i.e., bone). Radiographs and dual energy X-ray absorp- tiometry (DEXA) provide a two-dimensional projection of bone in the coronal plane which integrates periosteal and endocortical changes in the medio-lateral, not antero-poste- rior direction. Predicting changes using two-dimensional projections makes the flawed assumption that the bone is cylindrical and that the osteogenic response is uniform. These measurements in one plane do not provide informa- tion about changes that may occur cross-sectionally because of bone modelling. The cortical bone could be contracting in one plane but expanding in the other to resist bending moments. For this reason analysis of the cross sectional bone geometry is imperative. Furthermore, inferences from one or two measures at a site may not provide an accurate representation of changes that occur along the length of the bone8,22. Measuring techniques (MRI or CT) that provide a cross sectional view in the transverse plane is required for a more accurate assessment of surface specific changes in long bones. MRI is useful (particularly in children) because of the ability to collect images along the whole length of the bone without any radiation exposure.

In a recent study, MRI was used to compare the side-to- side differences in bone traits in the arms of competitive female tennis players during different stages of maturation8. The key findings were that loading did magnify the structural changes produced during growth. Prior to puberty, loading

magnified periosteal apposition along the length of the shaft; at the mid-humerus loading resulted in increased endocorti- cal resorption (medullary expansion). During the post-puber- tal period loading magnified the effect of endocortical appo- sition (medullary contraction), which makes an important contribution to cortical thickness in females. In fact, endo- cortical apposition accounted for most of the greater side-to- side difference attained in the post-pubertal years.

Most of the structural changes due to loading occurred early in the pre-pubertal years because adaptive changes in response to loading were sufficient to reduce the strains in bone that may lead to microdamage if not decreased23,24. The only additional benefit achieved from tennis training later in puberty was contraction of the medullary cavity. The rising estrogen levels during puberty are thought to lower the bone (re)modeling threshold on this surface, and thus sensitize bone next to marrow to the effect of mechanical loading25. Interestingly, medullary contraction did not confer any addi- tional increase in the structural rigidity of the bone.