A Word About Inflammation: Hallmarks of a New Injury and 6 Ideas to Manage it
The initial steps of any rehabilitation program are often the most important. The goal should be to regulate the healing process and prevent ongoing injury from occurring. We have one major process that spearheads this effort--our good friend inflammation. Inflammation is like that friend you need around to keep life fruitful and interesting but will get you in trouble if you spend too much time with them. Let me help you understand this troublesome friend of ours.
Similar to time spent with inflammation, too much time spent with your uncles has you sliding down ice walls hurting yourself unnecessarily. But take it from Mia, the best medicine is to keep moving.
What is Inflammation?
Inflammation is normal. It is the first immune response to injury that will initiate the healing system. It is made of cells that destroy dead and damaged cells, rebuild damaged tissue, and regulate temperature and environment of the area preventing further harm. The increased pressure from added fluid and heat to an injured area creates pain responses in our brains. Some of the inflammatory cells increase your body’s sensitivity to pain as well. These signals alert the brain appropriately so there is a heightened sense of caution being preached through our body. Thanks inflammation, you are awesome!
Problem Inflammation
The problem with inflammation is it is not very smart. While it is absolutely necessary and will show up in the face of any injury or disease, at times it can become inappropriate or excessive creating additional problems if not treated properly in those first 1-4 weeks. After the initial, acute inflammatory process, which lasts 7-10 days, inflammatory signals in the area start to fade away, and the swelling slowly starts to go away. If the original pain-generators (I.E.: the stressors that caused the injury) are not continually stimulated, the injury will heal effectively, and those particular pain signals will lessen over time until the pain and inflammation is gone.
For example, your back goes out on Monday, you ice and exercise, eat the right stuff for 7 days straight while preaching to yourself that this is NOT a problem and you ARE going to get through this quickly; the expectation is that by the following Monday or Tuesday, you are starting to feel a little less pain, the swelling has gone down, you are using the injured area more often, and each day seems to be a little better. This is normal when the appropriate steps are taken. If not, inflammation will continue to be signaled into the injured area past 10 days and the acute inflammation and pain does not go away--This is not normal and potentially harmful.
Chronic Inflammation
Chronic inflammation is the result of that pain pattern being continually recreated beyond the first couple weeks and the appropriate exercise, joint movements and anti-inflammatory treatments are NOT happening.
Inflammation is very powerful and has the capability of destroying dead and foreign tissues. Not being very smart, those same components of inflammation will destroy healthy tissues and weaken the joints/bones/muscles around the area if not properly addressed early in the healing process. Chronic conditions like osteoarthritis, tendinitis, shin splints, and tennis elbow are what result from poor movement patterns over time or injury that was not treated properly right away.
Often the negative consequences of a particular inflammatory process (I.E.: can’t play with your kids because of your back pain), can actually create more neural connections between your brain and that pain stimulus making you even more sensitive to it…This creates an abnormal pain-loop and continuous inflammation that will eventually break down tissues and consume your mind if not treated properly.
Prevention
The goal is to return your tissues back to their previous activities as soon as is safely possible. With most injury, this can start during the first 7 days. I know sometimes it is difficult to believe that your ankle needs to bear weight within days after a high sprain, but creating any sense of normalcy is what tells your brain where you want to go and will initiate appropriate healing responses.
With that being said, I wanted to discuss what your initial response to an injury should look like. Everyone will be slightly different. Every injury is unique and every individual has unique circumstances and sensitivities to pain. But there are always things you can do in the face of injury that will quickly help you get back moving and prevent your inflammation and pain from becoming chronic.
*Remember, some inflammation is necessary for a handful of reasons while too much inflammation for too long is destructive to surrounding tissues.
*Avoid movement and weight bearing through unstable joints; for example: A broken leg that has not been properly casted or splinted is NOT something you want to put weight on in the first 7 days.
*Use caution and seek the advice of a specialist if you aren’t sure.
6 holistic Anti-Inflammatory ideas
1. Full Joint Motion: bend/straighten, open/close, shorten/lengthen, rotate left/right. These are slow movements that have little to no resistance. Keep your injury at least partially supported during exercises. They should be performed numerous times throughout your day. Slowly progress towards working against gravity or with any sort of weights and bands. Not only does this promote healing by creating normal movement patterns and teaching your body how to heal, but it literally will pump fluid in and out of the area eliminating swelling and replenishing your tissues appropriately.
2. Weight Bearing: Putting normal forces through the joint alerts your brain to heal the tissues within and around that area and gives your body a sense of what “normal” activity feels like. Move slowly initially, but start progressively putting weight through joints that are affected by physical injury. This a good practice even when you aren’t injured to promote healthy joints and prevent various injuries.
3. ICE-Heat-ICE: Ice will reduce the heat and push away some of the swelling in the area, which will help decrease pressure and pain. Applying heat will stimulate the healing process by telling your brain to provide more nutrients and healing cells. However, this will increase the overall swelling if applied too often or without also applying ice frequently. Usually Ice should come last if you plan on resting afterwards. Heat if you plan on exercising afterwards. I know we all love heat…it feels lovely. Just remember how it’s affecting your inflammation!
4. Diet and Topical Treatments: Anti-inflammatory substances are naturally found all over the place: essential oils, creams, balms, all-natural leafy vegetables, specific fruits like blueberries and pineapple will help lower your body’s inflammation throughout. Turmeric, ginger, garlic, and black pepper are some great spices that will help reduce bodily inflammation and probably make your food taste betterJ.
*Remember there are also foods that will increase inflammation in our bodies--processed foods, vegetable oils, sugar, artificial sugar and additives, dairy, process meats, and anything high in saturated fat like meat from grain-fed animals. Minimize your consumption of these, especially when dealing with injury or disease to help regulate the inflammation.
5. Activity Adjustments: If you have an injury that is continually stressed by your daily routine, then its time to think about an adjustment to your routine. If you sit all day and you have a sore back that gets worse when you sit, then its time to talk to your employer about a desk that elevates allowing you to sit or stand.
*Remember routines over time if not deviated from enough will result in broken down tissues. Change positions often and keep moving!
*The power of rest cannot be underestimated when your body is healing. Periods of rest and good nights of sleep will help promote healing as well. Find that balance!
6. Positive Self-Talk and Re-Framing: When the injury arises, understanding why there is swelling and pain with an optimistic reaction to those symptoms will result in the body eliminating the inflammatory process much quicker and effectively. Worrying about the effects of the injury leads to avoidance behaviors (staying away from activities that you like in fear of them causing your pain), which perpetuates the inflammatory process even more.
If your symptoms have become chronic, these techniques will still be effective, but will require even more specificity as there is a heightened sensitivity to the pain signals. I would be happy to work with you on these symptoms. Skilled professionals like myself can be great resources to help adjust or change physical activity so you are managing your injuries appropriately.
Contact me for a consultation, remember I am mobile and will come to you!
-Michael
