The musculoskeletal system provides structural support for the body’s natural movements. The skeletal system, specifically, is also necessary for the proper placement and protection of the vital organs within. As its name suggests, the musculoskeletal system includes the muscles and skeleton (bones). It also includes the structures that allow your bones and muscles to move comfortably, like cartilage to cushion the joints, tendons connecting muscles to bones, and ligaments connecting bones to one another.

Aside from its structural purposes, the skeletal system provides red blood cells to the body, made in bone marrow. It also serves as a reservoir or storage system for minerals, which are released from bone when circulating levels dip below a certain threshold.  

What are the most common problems in the musculoskeletal system?

The ability to move freely and comfortably has a significant impact on your quality of life. Consequently, musculoskeletal issues are the leading contributor to disability, worldwide, and often negatively impact one’s mental wellbeing [1]. There are over 150 different diagnoses that fall under the “musculoskeletal health” umbrella. They can affect people of all ages, and approximately one in four people live with a musculoskeletal pain condition [1]. The most common musculoskeletal conditions are osteoarthritis, pain associated with the spine (back and neck), fractures associated with bone fragility, injuries, and systemic inflammatory conditions such as rheumatoid arthritis [1].

Estrogen is a protector of bone strength, as it stimulates the action of osteoclasts (cells that build new bone). Both males and females produce estrogen at a baseline level throughout adult life (the baseline is higher in females). After menopause, however, female estrogen production steadily declines. Associated with this change is a dramatic increase in low bone mineral density, osteoporosis, and osteoarthritis occurring in postmenopausal females [2,3]. 

How can I support my musculoskeletal system?

Listening to your body is so important, and certain types of pain indicate that something is not right. If you start to feel pain in your musculoskeletal system, be sure to consult a physician rather than pushing through the pain for your work or exercise routine. You may need guidance determining the difference between soreness from lactic acid build-up and an injury that needs rest or physical therapy. If you have already been diagnosed with osteoporosis, be sure to get specific, professional guidance for any new exercise.

With that said, regular, low-impact exercise with a complement of weight training and stretching can be a terrific way to support the preservation of musculoskeletal health. Bones, like muscles, need exercise to stay strong. While younger people who exercise typically reach a higher peak in bone mass and density, everyone’s bones begin to decline in the third decade of life. Exercise can help to slow this decline [4]. A combination of weight-bearing (hiking, dancing, playing tennis, etc.) and resistance exercises (like yoga, pilates, and weight-lifting) are the best for your bones [4]. While activities such as swimming and bicycling are great for your muscles and have cardiovascular benefits, they do not necessarily target bone strength. They can, however, help to stabilize your body and support coordination, preventing falls and bone breaks. 

Nutrition for the Musculoskeletal System

When it comes to musculoskeletal health, calcium and vitamin D are the heavy hitters. Calcium makes up more than 65% of adult bone mass and is absolutely critical for muscle and nerve function [5]. Vitamin D is required to absorb that precious calcium from the diet. Many people are calcium deficient due to dairy product avoidance or lactose intolerance. Diets that are very high in protein or sodium can also cause excess calcium excretion by the kidneys. In this case, even when intake is sufficient, dietary calcium is not efficiently stored in the bones. 

Vitamin D insufficiency can also lead to calcium insufficiency. Although vitamin D is not technically essential, making it within the body requires a certain amount of time spent in direct sunlight. Living a mostly indoor lifestyle, wearing sunscreen, or living in climates where sun exposure is rare, are a few common reasons one might become vitamin D insufficient. Vitamin D and calcium supplements can help to balance dietary or lifestyle-related needs for these nutrients.


Often, you will see calcium supplements offered as a combination of calcium and magnesium, sometimes with the addition of zinc. Zinc can help stimulate bone formation and mineralization, and inhibit bone resorption (breakdown) [6]. Magnesium is an essential mineral that is involved in over 300 biochemical processes within the body. In relation to the musculoskeletal system, magnesium is needed for calcium absorption, muscle and nerve function, formation of new bone, and impacts the activity of parathyroid hormone (a regulator of calcium homeostasis) [7]. 60% of the body’s magnesium is stored in bone. When magnesium intake is low, the body will break down bone to release stored magnesium, thereby reducing bone mineral density. Unfortunately, magnesium deficiency affects up to 50% of the US population [7]. Without sufficient magnesium levels in circulation, calcium and vitamin D supplementation is much less effective [8]. 

A study conducted in postmenopausal women showed that supplemental calcium (as calcium citrate/malate) plus trace minerals (zinc, manganese, and copper) were far more effective in maintaining BMD than calcium alone [9]. As such, Metabolic Maintenance® developed the Rebuild® and Rebuild® Plus (with added vitamin D) supplement formulas based on these findings, specifically to support bone health in individuals at risk for osteoporosis.


At least 20 million Americans suffer from osteoarthritis (OA) and many more suffer from non-arthritic joint pain [10]. The dietary supplements glucosamine and chondroitin sulfate are well known as safe and effective options for symptom management for patients with osteoarthritis or cartilage-related joint pain. Chondroitin is a gel-forming polysaccharide macromolecule that contributes to the cushion-like characteristics of cartilage. Glucosamine is an amino sugar that helps to maintain the strength and structure of cartilage, contributing to both the resiliency and shock-absorption properties of cartilage. Glucosamine and chondroitin can help delay long-term knee OA cartilage loss and reduce pain, stiffness, functional limitations, and joint swelling [11-13]. Hyaluronic acid has also been shown to support tissue hydration and joint lubrication [14].

Since its discovery, SAMe (S-Adenosyl-L-methionine) has been extensively studied for its ability to promote a positive mood and emotional balance. In the midst of mood-related research, scientists noted that SAMe treatments also lead to improved arthritis symptoms – an unintended, positive side effect. SAMe can be about as effective as standard anti-inflammatory drugs in easing the symptoms of osteoarthritis [15,16]. SAMe has now been touted in the US for over 20 years as a supplement that promotes joint health, comfort, and mobility [17]. Similar to glucosamine and chondroitin, the response to SAMe is very long-lasting and suggests that this nutrient has a deeper impact on osteoarthritis than simply relieving symptoms. It is likely that SAMe also has a protective effect against damage to cartilage [15].


As mentioned earlier, strong, healthy muscles are great for moving your body around, but they also protect your stability and bone health. When it comes to providing your muscles with nutrients they need for growth or maintenance, the story is much more complicated than “protein”. Protein is important, but the types of amino acids available from that protein may be more important. While there are nine essential amino acids that must be consumed from the diet, the three branched-chain amino acids leucine, isoleucine, and valine may be the most productive when it comes to building new muscle in response to resistance training [18].  

Calcium is the main regulatory and signaling molecule for all muscle fibers. The ability of muscle fibers to contract and relax is therefore dependent on the availability of calcium to muscle cells. Muscle plasticity, response, and function are all closely linked with, and highly dependent on the function of the calcium cycle [19].Magnesium is also involved in numerous processes that affect muscle function. These processes include oxygen uptake, energy production, and electrolyte balance. Due to these roles, studies have shown that magnesium may aid in the relief of leg cramping for adults, with even more significant benefits during pregnancy [20,21].

The relationship between magnesium status and exercise has also received a great deal of research attention. Exercise tends to induce a redistribution of magnesium in the body to accommodate changing metabolic needs. There is evidence that even a slight magnesium deficiency can impair exercise performance and exacerbate the negative consequences of strenuous exercise (e.g., oxidative stress). Strenuous exercise increases the loss of magnesium through urine and sweat, so magnesium requirements are about 10-20% higher when working out intensely [22].

Shifts in potassium during high-intensity muscular activity or exercise may also be a substantial contributor to fatigue in skeletal muscle (as opposed to the heart, where potassium balance is controlled much more effectively) [23]. Microdialysis studies have demonstrated that muscle activity is associated with elevated extracellular potassium concentrations. This effect could play a major role in the development of muscle fatigue and reduced excitability [23].

Maintaining a constant, normalized state of cellular zinc nutrition, or homeostasis, is also essential for the function of the muscular system [24]. Boron and chromium are also essential components of human muscle tissue and the cellular signaling systems necessary for proper muscle function [25,26].

As such, Metabolic Maintenance® offers the Spaz-Out® Mineral Muscle Recovery formula containing all of the above minerals. Take after a workout to support electrolyte balance, building of new muscle, and recover without cramping. BAM® Balanced Amino Maintenance formula can provide the substrate to build and repair your muscles while supporting all protein synthesis needs throughout the body. 


  1. World Health Organization (WHO). “Musculoskeletal conditions”. World Health Organization Newsroom Fact Sheets. November 26, 2019.
  2. Cauley, Jane A. “Estrogen and bone health in men and women.” Steroids vol. 99,Pt A (2015): 11-5. doi:10.1016/j.steroids.2014.12.010
  3. Roman-Blas, Jorge A et al. “Osteoarthritis associated with estrogen deficiency.” Arthritis research & therapy vol. 11,5 (2009): 241. doi:10.1186/ar2791
  4. NIH. “Exercise for Your Bone Health”. NIH Osteoporosis and Related Bone Diseases National Resource Center. Accessed October 15, 2020.
  5. NIH. “Calcium and Vitamin D: Important at Every Age”. NIH Osteoporosis and Related Bone Diseases National Resource Center. Accessed October 15, 2020.
  6. Yamaguchi M. Role of nutritional zinc in the prevention of osteoporosis. Mol Cell Biochem 2010 May;338(1-2):241-54.
  7. Castiglioni, S.; Magnesium and osteoporosis: current state of knowledge and future research directions; Nutrients 2013 (5): 3022-33.
  8. Anne Marie Uwitonze, Mohammed S. Razzaque. “Role of Magnesium in Vitamin D Activation and Function.” The Journal of the American Osteopathic Association, 2018; 118 (3): 181 DOI: 10.7556/jaoa.2018.037
  9. Strause, L., et. al.; Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals; J Nutr. 1994 Jul;124(7):1060-4.
  10. Wandel, Simon, et al. “Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis.” Bmj 341 (2010): c4675.
  11. Raynauld, Jean‐Pierre, et al. “Long‐Term Effects of Glucosamine and Chondroitin Sulfate on the Progression of Structural Changes in Knee Osteoarthritis: Six‐Year Followup Data From the Osteoarthritis Initiative.” Arthritis care & research 68.10 (2016): 1560-1566.
  12. Hochberg, Marc C., et al. “Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib.” Annals of the rheumatic diseases (2015): annrheumdis-2014.
  13. Zeng, Chao, et al. “Effectiveness and safety of Glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of osteoarthritis of the knee.” Scientific Reports 5 (2015): 16827.
  14. Pavelká, Karel, et al. “Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study.” Archives of internal medicine 162.18 (2002): 2113-2123.