Joint Health After 40: What I Wish I Knew Sooner
- R. Murray
- Apr 3
- 4 min read
Updated: Mar 26
I first heard the term femoroacetabular impingement.... FAI.... during a workup for hip pain that I had been dismissing for about two years. I am a physician. I know better. And yet there I was, having sat with a symptom I would have investigated immediately in a patient, because I was too busy and too accustomed to ignoring my own body.
FAI is a structural issue where abnormal contact between the femoral head and the acetabulum causes friction and, over time, damage to the cartilage and labrum. It is increasingly recognized in active adults and is often attributed to hip morphology combined with certain movement patterns. In my case.... years of clinical work, long hours on my feet, not enough mobility work, and the particular way I move.
The diagnosis sent me down a rabbit hole that I wish I had entered a decade earlier. Not specifically about FAI, but about joint health in general.... how we maintain it, how we lose it, and what the evidence actually says about preserving it.
What No One Told Me About Joints in My 30s
The cartilage in our joints does not have a direct blood supply. It gets nutrition through synovial fluid, the lubricating fluid inside joint spaces, which moves into cartilage through the mechanical loading and unloading of movement. This means that joints need movement to stay healthy. Sedentary loading (sitting for hours in the same position) is actually more damaging than active movement, because it deprives cartilage of the nutrient exchange it depends on.
I spent my 30s thinking that joint health would take care of itself as long as I wasn't doing anything overtly destructive. I wasn't. But I also wasn't doing anything proactively supportive. That gap matters.
What Changed My Approach
After the FAI diagnosis, I started working with a physical therapist who specializes in hip and pelvic mechanics. This was the single most impactful thing I did.
She assessed how I move, not just whether I had strength or flexibility. The findings were humbling. I had significant hip flexor tightness from years of sitting. My glute activation was poor, which meant surrounding structures.... including the hip joint itself.... were compensating. My movement patterns had adapted to protect the painful area in ways that created new problems elsewhere.
We built a program focused on three things: mobility, stability, and load management. This is not complicated, but it requires consistency. I still do 15-20 minutes of hip and core work most mornings, and the difference in how I feel is significant.
The Supplement Question
This is where I have to be careful to be honest rather than just enthusiastic.
The supplement evidence for joint health is genuinely mixed. Here is what I have concluded after reviewing the research and consulting with colleagues in sports medicine and rheumatology:
Omega-3 fatty acids: Good evidence for anti-inflammatory effects relevant to joint health. EPA and DHA specifically. I take these as well.
Glucosamine and chondroitin: More contested. The large GAIT trial showed modest benefits in a subgroup with moderate-to-severe knee pain. For mild pain or prevention, the evidence is weaker. I don't currently take these, but I don't dismiss them either.
Turmeric/curcumin: Reasonable anti-inflammatory mechanism and some positive trial data, though bioavailability is a challenge without a good formulation. Worth discussing with your own physician if inflammation is a factor in your joint symptoms.
Movement Is the Foundation
I want to be clear that no supplement replaces movement as the primary intervention for joint health. The physical therapy work.... the daily mobility routine, the gradual reloading of the hip, the attention to how I sit and stand at work.... has done more than anything else.
What the supplements do, in my experience, is support the tissue alongside that work. They are adjuncts, not substitutes.
What I Wish I Had Done at 35
Started mobility work before I had a reason to. Hips, thoracic spine, ankles.... the areas that stiffen with age and with the particular demands of clinical work.
Invested earlier in understanding my movement patterns, not just my fitness metrics. Cardiovascular fitness and strength are important, but they don't protect joints if you move in dysfunctional ways.
Paid more attention to load management. Intensity and volume matter. The body adapts to stress; the problem comes when stress accumulates faster than the capacity to adapt. This is true for training, and it is true for the physical demands of a long career in medicine.
A Note on FAI Specifically
FAI management has evolved significantly. Not everyone with FAI needs surgery. Conservative management.... physical therapy, activity modification, and in some cases injection-based interventions.... is appropriate for many people. If you are dealing with unexplained hip or groin pain, I would encourage you to pursue proper imaging and evaluation rather than waiting it out the way I did. Earlier diagnosis means more options.
Where I Am Now
The hip is better. Not perfect, not what it was at 30, but functional and improving. The daily routine has become non-negotiable, like brushing my teeth. I move differently now.... more deliberately, with more attention to how I load and unload the joint.
I am also more honest with myself about what my body needs. For years I had operated as though my body was exempt from the advice I gave patients. It is not. We are physicians, not machines. The body that takes care of patients also needs to be taken care of.
If you are in your 40s and starting to feel the early whispers of joint complaints, please do not wait for a diagnosis to start paying attention. The investment in mobility, movement quality, and foundational support now will matter enormously in the decades ahead.
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This post reflects my personal experience and is for informational purposes only. It is not medical advice. Please consult your own physician before making any health decisions.
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