By Dr Laurie Teitelman, ND
Many of my patients complain how their sports injuries are killing them. How exactly do icing and painkillers affect the healing process? Most athletes are familiar with the ‘RICE’ rule for dealing with minor sprains and strains: rest, ice, compression and elevation, with the latter three tactics aimed at minimizing inflammation.
A recent study published at the Cleveland Clinic adds to growing evidence that swelling actually plays a critical role in healing soft-tissue injuries. The result is a tradeoff where one must weigh the short-term and long-term benefits: reducing swelling with ice or taking anti-inflammatory medications may ease your pain now, but will actually slow down your ultimate return to full strength.
Now this leaves us all mixed up, since if we are looking to adapt best in the long run, RICE may not be the ideal first choice. This research comes from a study comparing two groups of mice, one of which was genetically altered to not produce swelling; sure enough, the non-swelling mice demonstrated their inability to heal muscular injuries!
What’s going on here? When you sustain an injury, your body’s first response is to send damage-control cells (macrophages) to clear away the injured cells by literally eating and digesting them. This initiates a complex process of repair and regeneration that triggers inflammation and swelling, in part because macrophage-induced damage pokes holes into the cell membranes of muscle tissue, allowing fluid to rush in. What the Cleveland study showed is that these macrophages, in addition to causing swelling, are also the primary source of “insulin-like growth factor-1 (IGF-1),” which speeds up muscle regeneration. If you take away the swelling via macrophages, you also lose the growth factor.
Clinical evidence has shown that injections of cortisone, a powerful anti-inflammatory steroid, brought initial relief for tendon injuries such as tennis elbow, but produced significantly worse outcomes six and 12 months later, compared with patients who did nothing or performed physiotherapy exercises. Imagine what is happening to those professional athletes who often load up on painkillers and cortisone in hopes of returning to the action ASAP? Even over-the-counter non-steroidal anti-inflammatories (NSAIDs) such as ASA and ibuprofen (Advil) have been found to delay the eventual healing of muscle, tendon and ligament injuries. One alternative could be to use acetaminophen (Tylenol) for pain relief, since it doesn’t have an anti-inflammatory effect.
There are some doctors using healthier and more natural alternatives to these conventional treatments, such as vitamin B12 injections. Not only do these injections come with little to no side effects, but they also appear to hasten muscle healing while allowing the inflammatory reaction to proceed naturally. Getting a good dose of the B vitamins also helps your liver detoxify, protects your cardiovascular and neurological systems, as well as a myriad of other benefits. Many of the Everlast Nutrition products found in the FitLine contain healthy dosages of B vitamins; vitamin B12 in particular. Each of the delicious Everlast Energy Bars is packed with 200% daily value (DV) of Vitamin B12, and the Energy product, which naturally increases energy and maximizes performance, contains over 16,666% DV of Vitamin B12!
Seeing as this evidence remains preliminary, for acute injuries like a pulled muscle or a twisted ankle, do what is necessary to control the pain – but not more. Keep in mind that going through the inflammatory process is a natural, normal and healthy part of healing.