Are bulletproof joints real?
7 evidence-based ways to build injury-resistant joints
Joints are the weakest link in our skeletal muscular system. If something is going to break, it’s probably a tendon, ligament or some connective tissue. Moreover, the risk of joint injuries and joint pain only increase as we age. Thus, unless you’re a genetic freak, you probably have some familiarity with joint problems.
Unfortunately, most people start looking into joint health after they are injured. This has certainly been the case for me.
While chasing a one-arm pull-up, I developed tendonitis in my elbow.
While learning how to run barefoot, I developed nagging pain in my knee and Achilles.
And after spending too much time hanging and traversing, I successfully pissed off my rotator cuff.
Because of all these setbacks, I’ve become obsessed with building stronger and more resilient joints. If you share that obsession, this is your article. I’m going to show you 7 evidence-based strategies you can use to bullet proof your joints and reduce your risks of another injury.
You’ll learn why you want to. . .
Of course, this is no substitute for a trained medical professional’s recommendation. If something’s broken or causing pain, find a qualified professional to get it fixed. Then come back and use these strategies to build injury resistant joints.
Let’s get started!
1) Get Lean
As you can probably imagine, obesity is a major risk factor for joint injury. It shows up in study after study after study. There are probably a couple reasons for this. First, you have the obvious increase in load. Our tendons and joint ligaments simply did not evolve to handle the extra load that comes with obesity.
One of the most common ways people are injured at an obstacle course race is coming down from a wall. They climb up fine. But when they drop down on the other side, they hit the ground and Pop! Something twists or even snaps. Naturally enough, your weight plays a big role in this.
Second, the general decline in health that comes with obesity may play a role. Things like chronic inflammation or the presence of disease may affect joint integrity. For example, one study showed that having type two diabetes increased your risk of shoulder tendonitis, and another study suggested a possible association between chronic inflammation and Achilles injury.
How much does obesity matter?
In a recent Delphi study, researchers asked an international panel of tendon experts to rank order risk factors for Achilles tendinopathy. They ranked obesity as the second highest risk factor for untrained/sedentary adults. (The top spot was taken by people who had previously injured their Achilles.)
Long story short, if you’re obese or even overweight, losing some fat is arguably the most potent way to reduce your risk of joint injury.
What if you’re already at a healthy weight? Is there any advantage to having an athletic physique?
I haven’t seen any studies suggesting that an athletic physique helps. (An athletic physique is going to be 9-14% body fat for men and 15-23% body fat for women. Think of it as roughly six-pack lean.) There may however be some indirect evidence.
Getting six-pack lean will reduce the load on your joints even further. Picture dropping down from an OCR wall with a 10-pound weight vest. Would it help taking it off? Probably. Would it help a lot? Probably not.
The Delphi study ranked overall weight as the eighth highest risk factor among athletes and exercise enthusiasts, assuming that they were following a smart program.
So it could help, but you have massive diminishing returns. It probably isn’t worth it on its own, but if you have other reasons to get six-pack lean, you may be doing your joints a favor.
How to get lean while injury proofing your joints
One way to slim down is by choosing higher quality food. Eating more fruits, vegetables, healthy fats and lean protein will help you lose weight without going hungry. Moreover, it may help your joints. A whole foods diet is anti-inflammatory which could lower any chronic inflammation that might be exacerbating your joints.
Moreover, your body can synthesize collagen (the building block of tendons and ligaments) from protein and vitamin C. So again, a healthy diet with plenty of protein will give your body everything it needs to build and maintain strong joints.
2) Use it or lose it
I remember reading Born to Run and immediately ordering a pair of minimalist shoes. This was over a decade ago, and I was at the beginning of my fitness journey. When the shoes arrived, I laced them up and headed out the door. They looked and felt like glorified socks, and I hadn’t ran barefoot since childhood.
I only made it half a mile, and my feet and ankles hated me for weeks. I could barely walk. Although I avoided injury, I didn’t try the shoes again for over a year.
The point here is that zero is an insanely problematic number. There is a world of difference between something and nothing. If you provide no stress for your tendons and connective tissue, they will atrophy and degrade. They will grow weak and become prone to injury.
This is why a pickup game of basketball in your 40’s can lead to a blown knee or ruptured Achilles. If you haven’t played basketball in 15-20 years, you are taking a risk. Your tendons are not what they used to be.
Moreover, being sedentary is associated with joint pain. This can create a vicious cycle. You keep to the couch because it hurts to move, and it hurts to move because you keep to the couch.
You’ve probably noticed mild versions of this in your daily life. You spend all day at your desk lost in work. When you finally stand up, you feel stiff. Maybe your joints even ache. Well, if you do this day after day, your joints will pay the price.
One study found that sedentary adults with knee osteoarthritis stood up more slowly, walked more slowly and had less functional knees then active adults with knee osteoarthritis. This was true even if they exercised regularly.
In other words, use it or lose.
Fortunately, if this is you, you’re not stuck. You can build back up, and a more active lifestyle can help enormously. Natural daily movement increases tissue turnover and blood flow in your joints. It also reduces pain and strengthens connective tissue.
Pro tip: even if you train regularly, building an active lifestyle will do your joints some good. I suggest focusing on the big three of an active lifestyle.
Walk. Go for walks whenever you can. If you have the time and ability, walk to the store. Take family walks and hikes. Walk the dog. Bonus points for doing it barefoot or in minimalist shoes.
Deep squat. Develop your deep squat until it becomes a rest position. If you can rest in a deep squat for several minutes at a time, you’ll do your knees, hips and ankles a mass good.
Hang out. Learn to hang from a bar. It will strengthen the connective tissues of your elbows and shoulders. You can buy a $50 pull up bar, hang it in a doorway, and hang out for a minute every time you pass by. Voila! Now you’re bulletproofing your shoulders in your free time.
After that miserable half mile, I spent years increasing my barefoot time. I used minimalist shoes at work, and I went for barefoot walks on the weekends. I eventually ran a marathon in those silly shoes, and then I moved on to ultra-distance events. It takes time. It can takes months if not years for connective tissue to become strong and robust. But the key here is that I didn’t rely on running alone. I also built a more active lifestyle.
3) Build thicker, stronger stiffer tendons
Suppose you need to pick up and carry a massive atlas stone at your next obstacle course race. Can your joints take it? How can you be sure?
One option is to build bigger, stronger and stiffer tendons with a bit of strength training. Lifting weights strengthens your connective tissues and bones, leading to joints that are more resilient.
Strength training also improves things like blood flow, joint stability and general function. For example, according to one systematic review (a review of 12 studies), strength training significantly reduces joint pain and improves function among people with knee osteoarthritis.
It’s also a very low risk sport when done correctly. Recreational strength training (not to be confused with competitive powerlifting) is one of the safest sports in the world.
How much weight should you lift?
Tendons and ligaments seem to respond best to heavy weights. A 2015 meta-analysis suggests that if you can lift something more than 10 times in one set, it’s unlikely to have a big impact on your tendons or ligaments.
This has two implications. First, if you need to rest a joint, you can reduce the weight and up the reps. This will allow you to build the muscles around the joint and increase blood flow to the joint without causing pain.
Second, if you never train heavy, you might develop a muscle tendon imbalance. Your muscle growth may outpace your joint growth. This could cause problems. One study found that strength imbalances between muscle and tendon was a risk factor for tendinopathy for young athletes.
Pro tip: you want balanced strength. The research is clear. Muscle and strength imbalances increase your risks of joint injuries. To minimize injury, you want to keep two points in mind.
A good program will work all your muscles, not just the ones you can see in the mirror.
A good program will include some heavier lifting to strengthen your joints.
4) Take it slow
Is this a familiar experience? You start running. It feels great. You’re adding miles and getting faster. Everything is going good, until one day you notice some pain in your knee. You think, “To hell with that!” And you keep training.
Instead of getting better, the pain gets worse, until one-day somethings snaps. Maybe you think, “well that’s why people say, never train through pain.”
But why do people say that?
There are actually two reasons. First, when you exercise your body produces all kinds of natural painkillers. This means it takes more “damage” to experience pain when you exercise.
Second, according to the “iceberg” theory, your tendons begin sustaining damage long before any pain presents itself. Pain is just the “tip of the iceberg”. By the time you feel that pain in the front of your knee, you’ve probably been damaging that knee for a while.
What does this mean practically?
If you’re experiencing joint pain, it’s time to reassess. It’s likely something is wrong.
If you’re running, build up slowly. It’s an industry standard that you should only add about 10% to your weekly running volume from week to week.
If you are strength-training, get your form right (see below). When done correctly, lifting is one of the safest sports out there.
5) Build unbreakable form
I’d like to show you two different ways that you can use proper form to injury proof your joints.
First, there really are safe and unsafe ways to move and train. We live in a golden era of exercise. Exercise scientists, biomechanics and coaches have spent decades breaking down human movement to find out what is and what is not safe.
Do they make mistakes? Of course. But we have never before had so much research to make informed decisions about how to train.
To illustrate this, let’s go back to that atlas stone. You’ve probably heard that you want to keep your back straight when picking up heavy objects. This is because research has shown that your spine breaks down under heavy shear forces.
Of course, it doesn’t always feel terrible at first. But remember the iceberg theory of pain above. It may feel fine for a few hundred reps, until one day it feels terrible.
Unbreakable form also means training for the movements you expect to encounter in life and sport. This includes more than just strength training or running. For example, if you like to run obstacle course races, you need to know how to land a jump properly.
In other words, to injury proof your joints learn how to move safely and effectively. YouTube is your friend, here. There’s an entire education online, if you take the time to find it.
Second, form breaks down with stress and fatigue. Back to that Atlas Stone. Maybe you dead lift with perfect form on your first set at the gym. But what happens on your last set? What happens out at an OCR? What happens after running 5, 10 or 25 miles? As you increase your fatigue and stress, do you keep your form?
In the book Building the Elite: The Complete Guide to Building Resilient Special Operators, authors Craig Weller and Jonathan Pope lay out strategies to build fatigue and stress resistant form. They call it movement fidelity, and there are two main takeaways.
Understand that your form breaks downs and becomes less safe as you fatigue or become stressed.
Pay attention to your form. How does it look at the end of your last set? How does it look at the race? If you pay attention and fight the tendency to become sloppy, you can steadily increase your fatigue and stress resistance.
This may sound like a minor thing. It isn’t. In my experience this can truly injury proof your joints. And if training for OCRs or elite military selection is your thing, then I highly recommend their book.
6) Become strong in all positions
You get strong within the range of motion you train. This is where mobility and strength meet. How deep is your squat? And how strong is your squat at various depths? If you only ever do quarter squats, you will remain weak in the bottom portion of a squat.
How does this matter for your joints?
Researchers don’t fully understand how this all works, but let me paint a picture using some of the theories being kicked around.
Imagine dropping down from a tall wall at an obstacle course race. As you land, you need to dissipate the energy. Imagine if all that energy goes straight to your joints. You simply relax your muscles and let your joints take it. I’d bet there’s a sickening pop that leaves you lipping off the course, wondering how bad the damage is.
This is because your muscles are attached to tendons, which then attach to your bones. When weak muscles are asked to handle large loads (like your legs absorbing a fall), it leads to a sudden jerk on the connective tissue.
Now picture the alternative. Imagine well-trained muscles that can absorb the energy of the fall. The process starts the moment you contact the ground. As your hips descend, your muscles lengthen and absorb the energy. The movement is smooth. There’s no jerking. No sudden surges of energy. Your knees are protected.
Think of it like this. Picture grabbing the towline at the bunny slope. You’re standing there on your skis and about to grab the rope that will take you up the hill. If you grab it really tight all at once, you’ll get jerked into motion. If you slowly increase your grip, you’ll slowly increase your speed up the hill.
This leads us to the heart of this strategy. Are your muscles strong the whole way, across their entire length? Are you strong in all positions? If you only train a limited range of motion, then the answer is no.
Pro tip: to become strong in all positions, use full ranges of motion and keep an eye on the strength curve and the resistance curve of your exercises.
Sorry, there’s no way around it. This is where things get a little complicated.
Focus on using a full range of motion. To become strong in all positions, you need to train in all positions. For example, a pullup should start at a full dead hang and go up until your chest touches the bar.
Understand your muscle’s strength curve. If you lift weights, then you’ve noticed that you often get “stuck” in the same places. That is to say that you’re consistently weakest in certain parts of an exercise. For example, your horizontal pressing strength is weakest when your hands are back by your chest (think of the bottom position of the bench press). This is known as a strength curve, and it means that any given muscle will be stronger in some positions and weaker in others.
Understand your exercise’s resistance curve. Strength exercises do not always offer consistent resistance. Think about a dumbbell bicep curl. Because of physics and gravity, it is easiest at the top and at the bottom. Meanwhile it’s hardest when the weight is out in front of you. This means that curls are great at training your bicep in the middle position, but they are next to useless at building strength in the top and bottom positions.
Match up the strength and resistance curves. Ideally, your muscles will face the right amount of resistance throughout their entire range of motion. In other words, there will be more resistance when your muscle is strongest and less resistance when you muscle is weakest. When you match a given muscle’s strength curve with a corresponding resistance curve, you get strong in all positions.
Incidentally this also builds more muscle. Have you ever seen guys draping chains over the bar when they bench press or using bands on their back squats? They do this to improve the resistance curve of those exercises. Adding chains to a bench press means the exercise gets harder the further you push the bar from your chest. As the bar rises, more chain is lifted off the ground thereby increasing the weight.
Sometimes you need to use multiple exercises. For example, Romanian dead lifts work your hamstrings, but they don’t work your hamstrings in all positions. They focus on your upper hamstrings. You can fill this massive gap, by adding a Nordic hamstring curl.
Even though they’re both hamstring dominate exercises, everything has changed. Instead of moving at your hips, you’re moving at your knees. And instead of focusing on your upper hamstrings, you’re focusing on your lower hamstrings. Filling this gap in your strength can make an enormous difference. One study showed that adding Nordic hamstring curls can reduce your chances of sustaining a hamstring injury by 51%.
Long story short, you want to build strength in all positions. It will protect your joints and reduce your risks of injury.
7) Surround your joints in muscle
The muscles above and below a joint each play a unique role in protecting that joint. Thus, you can bullet proof your joints by surrounding them in muscle. It’s way beyond the scope of an online article to go through all the muscles that surround each joint. So instead, to illustrate my point, let me share a personal story.
When I started my journey as a runner, the vastus medialis obliquus (VMO) on my left leg was visibly smaller than the VMO on my right leg. The VMO is the pear shaped muscle above your knee. It sits slightly towards the inside of your knee, and it’s responsible for keeping your knee cap in the right spot. A weak VMO can cause a shift in the way your kneecap tracks. And one study has shown that people with VMO atrophy are more likely to experience pain in the front of their knee.
I had a massive imbalance, and it played havoc with my gait and caused all kinds of problems. Over the years, I trained it, and many of my problems disappeared. My two VMO’s even looked similar. Thus, I was able to train for and run my first marathon.
When I signed up for my first Spartan Ultra 50k, I decided to take things further. The last thing I wanted was a blown knee at mile 28, so I went on the hunt for ways to bulletproof my knees even further. I found Ben Patrick (the knees over toes guy). If you haven’t already, check out his YouTube channel or Instagram.
I used a combination of ATG split squats, Poliquin Step Ups and Cyclists Squats to build all the muscles above my knees. And I used a combination of Tibialus Raises, KOT calf raises and regular calf raises to work the muscles below my knees.
After a few months, I could feel an enormous amount of strength and stability. In particular, I noticed a huge difference trail running and running downhill. When I got to the 50k, I had no knee issues.
Long story short, if you want to bulletproof your joints surround them in muscle.
Let me close with this. Connective tissue takes FOREVER to heal and strengthen. It’s on a completely different timeline than strength training or mobility. It requires patience. The vast majority of people will not follow through for long enough to see significant results.
Be the exception.
Be patient. For significant changes, think months if not years.
Thanks for reading!
Would you like help getting off the sidelines and into your own adventure? Check out my online coaching.
