Recently I came down with something that gave me a stuffy nose, sore throat, a bit of an ear ache, a slight fever and, well, just overall achyness. I wasn't dying but I was certainly not feeling good enough to participate in the Olympic Tri I was scheduled to do that morning. One of the recommendations I received from well wishers was to take some tylenol for my fever as it would make me more comfortable. When I heard this I immediately recalled the words of my good friend Dr Steve Johnson "you have a fever for a reason, its meant to kill off the invaders, let your body do what it needs to. Do you think your are smarter than your body?? It has gotten us through a couple million years I think it should know what its doing!"
Yeah...So where are you going with this Bobo?? Well it got me to thinking (and wondering) about another of our bodies responses and how we treat it. Inflammation and icing, or cyrotherapy if you will. It has always seemed a little counterproductive to me to combat the bodies normal response to any issue that arises. Tylenol for fever, ice for swelling, pepsi for a hangover. Is icing something we should actually be doing? Whose idea was this anyways? Couldn't the ice be better used in frozen margaritas? So here is some of what I found:
Inflammation is a necessary and normal response to an injury. The process increases blood flow to the area bringing healing nutrients to the damaged tissue as well as increases lymphatic flow away from the area removing damaged cells. You know what else inflammation does? It makes the boo boo hurt! If you have an area that hurts you will be less inclined to want to use it and therefore your body has the time it needs to fix it. Using an injured area can make the initial problem much worse. So far so good, I like what I am hearing.
Lets take a step back and talk about the lymphatic system. It is a secondary circulatory system that runs throughout your body helping to drain fluids and blood byproducts back into your bloodstream. Once those items have been delivered to your primary circulatory system they are either re-used or disposed of as necessary. Now this system is not directly attached to the heart and does not have valves in it. It is a free flowing low pressure system. If there is inflammation in an area the pressure of that swelling will cause flushing out of the area by the good out lymphatic system. But research has shown if you decrease that swelling it slows the outward flow and then, once the ice is removed, it causes the system back wash to the area actually increasing recovery time. And as we all know back wash sucks.
Most patients report the damaged area felt better after icing. But additional studies show there is no improvement in range of motion or decreased healing time with icing. It just decreases the swelling so you felt better so that us type A's triathletes could go out and exercise with our injuries sooner. No Bueno!
Interestingly compression without ice did not seem to have the same negative effects on recovery times that icing and compression did. But again the caveat is that with compression we improved how the area felt and then went and did our 56 mi bike/10 mi run brick anyways.
Now in all the studies and research there was a line were inflammatory response got out of control. That the inflammation itself began to restrict blood flow to the area and lymphatic flow out of the area. Unfortunately no study pointed to where this line of critical inflammation was drawn. But again they point to mild compression and elevation as the key treatment for this dilemma. Noticeably anti-inflammatories were not thought of very highly in how we treat inflammation. Besides there inherent side effects they again they masked and decreased our bodies response to the problem, decreasing healing and lengthening recovery times. When icing was recommended it was for very short periods of times (10 mins) and only for one application.
Finally having dealt with the medical field for a long, long time as well as having read tons of research papers and gone to paid for pharmaceutical conferences it comes down to a basic understanding of our bodies. If we catch something, hurt a joint or pull a muscle a healthy body is its own best friend. We are generally in good condition and are able to muster a stout defense to the insults our bodies receive. Don't try and mask or control your bodies response. Give it time, let it do its work and skip the schedule brick for that day and while your are recovering perfect that margarita recipe.
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