Running injuries 101

Just Say No to Ice & Anti-inflammatories.

Heal Faster

The primary reasons injuries often take people several weeks to several months to deal with are;— Multiple uses of ice, anti-inflammatories, and anything else that decreases blood flow to a healing tissue, and/or decreases immune cell function in and around a healing tissue…..will also account for a slow recovery time. Rest and stretching are usually insufficient to improve the tissue’s ability to withstand training loads.
— Providing a low or no stimulus for healing. Doing so-called “strengthening exercises” with little or no weight//resistance [ie. use of rubber tubing, etc]. The amount of weight/resistance determines the amount of stimulus for cells that are responsible for healing.
— Doing a bunch of reps and sets of “strengthening exercises” with no progressive increase in weight//resistance as strength of the tissues increase.
— The frequency of application of a strengthening stimulus is a major determining factor on the rate of healing. If you’re seeing a physical therapist, chances are you’ll be going only once or twice a week. If this is the only time that strengthening of the tissue is being induced, recovery will take quite a few weeks.
— Recurrent attempts to return to training before the tissue has acquired the strength necessary to endure their training loads..Say No To Drugs

Following the initial 24-48 hour period of injury, application of heat stimulus (5 – 10 minutes limb water submersion 100-105 degrees F) should be used to increase blood flow and energy production for repair processes. Ingestion of NSAID’s (anti-inflamatories) should be avoided since this will impair recovery, and potentially mask pain, leading one to believe it is ok to return to training.

Never…ever….under “any” circumstances…allow a doctor to inject the tissue with cortisone or any other substance that is well known to cause degradation of collagen and other tissue proteins…”The use of nonsteroidal anti-inflammatory drugs for the treatment of tendon inflammation might increase the levels of leukotriene B4 within the tendon, potentially contributing to the development of tendinopathy.”

“This finding is of interest because NSAID’s are routinely used in clinical practice for the symptomatic treatment of tendinopathy, such as inflammation and pain.”

“..the increased LTB4 level due to treatment with NSAID’s could potentially exacerbate the situation by leading to neutrophilic infiltration and lymphocytic activation, paradoxically causing further inflammatory and degenerative changes in the tendon.””..the results of this study suggest that the routine use of COX inhibitors for the symptomatic relief of inflammatory tendon conditions might inadvertently worsen the processes responsible for the development of tendinopathy.”

Zhaozhu Li, et. alInflammatory Response Of Human Tendon Fibroblasts To Cyclic Mechanical StretchingThe American Journal Of Sports Medicine..Volume 32 #2….2004…page 435 – 439———–

“Prostaglandins….potent modulators of inflammation……inhibitors of prostaglandin synthesis known as non-steroidal anti-inflammatory drugs [NSAID’s]…”

“Skeletal muscle regeneration comprises several overlapping cellular processes, including inflammation……””Prostaglandins may regulate muscle regeneration….”

“Prostaglandin synthesis is catalyzed by……cyclo-oxygenase [COX], which are inhibited by anti-inflammatory drugs.””COX-2 dependent prostaglandin synthesis is required during early stages of muscle regeneration and thus raise caution about the use of COX-2 selective inhibitors….”


The COX-2 Pathway Is Essential During Early States Of Skeletal Muscle Regeneration

American Journal Of Cell Physiology…..Volume 287…..2004….C475 – 483————-

iceing = cryotherapy — just say no to cryotherapy……….

“….the administration of nonsteroidal anti-inflammatory drugs or cryotherapy are common clinical practices to control the inflammatory process following connective tissue injury. However, there are contradictory conclusions on the potential of anti-inflammatory strategies to either prevent nonspecific damages or accelerate healing after acute tendon or ligament trauma.”
“Cumulative evidences also show that, apart from releasing catabolic enzymes, inflammatory cells can ultimately favor tissue healing through different biological processes.”
“Indeed, after the clearance of pathogens and other signals of danger, neutrophils will undergo apoptosis and be engulfed by phagocytic macrophages. Macrophages will then release growth factors that can stimulate fibroblast proliferation, collagen synthesis, and angiogenesis during the early phase of healing.”D.Marsolais, et alInflammatory cells do not decrease the ultimate tensile strength of intact tendons in vivo and in vitro: protective role of mechanical loading

Journal Of Applied Physiology…….Volume 102 #1……January 2007… 11 – 17