“Inflammation… It’s Not a Bad Thing”

Clinicians are supposed to be evidence-based, but we’re not. We are sheep that follow the herd. Or, as a friend of mine from the University of Illinois often says “follow the Sacred Cows”. I am just as guilty. We go through the same mundane and antiquated treatment protocols that we always have. We don’t want to change our ways because that is what we are comfortable doing and that is what our patient expects. It takes a global paradigm shift in order for us change how we practice. Can a paradigm shift finally be underway in how we treat inflammation?

As followers, I knew our mindset toward ice and anti-inflammatory medication would only change if mainstream media started sharing the data. Now, this is just one story, but it is in the New York Times. Perhaps more articles like this will reach the public. Better yet, perhaps stories like this can appear on TV, like Dr. Oz or GMA. For now, I am just happy it’s finally being shared with the public and I look forward to more. A change will be coming folks. Below is a link to the NY Times article, with the best line saying: “There’s a reason for the inflammation” in the body after exercise, she says. “It’s part of the regenerative process and not a bad thing.”

I recall sitting in the Long Beach State Athletic Training room in 2006 and 2007 challenging student athletic trainers and athletes about the overuse and misuse of ice and anti-inflammatory medication. All I asked was, why? They could never give me a rationale answer. These were very smart students, but they did as taught and regurgitated content learned from class.

Over the years, I continued to look at the research and realized that inflammation is a good thing and we shouldn’t be so hasty to stop it. I learned that the RICE treatment principle and NSAIDs are wrong. Prostaglandins and other inflammatory mediators are necessary to initiate the tissue healing. Inflammation triggers gene transcription, gene up-regulation, protein synthesis, and creates an environment for stem and progenitor cells to become new tissue. Why would we want to stop or impede this process?

No matter what I did or said, and no matter what evidence I shared, the inflammation stigma would not stop. Even the physician who coined the acronym RICE retracted his statement. Through his research, Dr. Mirkin found that ice was bad for healing. Still, nobody listened. I realized that a dogmatic polarization existed and ice and anti-inflammatories medication would continue to be revered as a cure-all no matter what. Hopefully, this New York Times articles opens more eyes.

Bring On the Exercise, Hold the Painkillers https://nyti.ms/2tL7pcS

5 thoughts on ““Inflammation… It’s Not a Bad Thing”

  1. Mark Montimurro

    I might add that a professional massage might also be of great benefit. It increases red blood cell production that rushes to the site of inflammation thus increasing the amount of healing oxygen. I am forever urging my clients to ‘leave the ice in the freezer, where it belongs’. Movement and activity are key in these injuries and in overuse scenarios. I remember reading on this very blog a certain field study about a classic ‘rolled ankle’, wherein ankle pumping accelerated healing by many weeks.

  2. Marti

    That is a nice one, Josh. I trust you keep doing well. However, I do not understand that despite the great findings, Dr. Lipman seems to suggest the use of acetaminophen and ice bath as possible alternatives to ibuprofen. As for the acetaminophen, we could consider its side-effects (https://www.drugs.com/sfx/acetaminophen-side-effects.html). As for his alleged comment: “I often tell people, think ice baths”, we could reconsider Dr. Mirkin’s retraction (http://www.drmirkin.com/fitness/why-ice-delays-recovery.html). Well, it seems that the current medical paradigm is the real problem. Until the paradigm shift is complete, we seem doomed to live with a “psychoscotomized” mind-set. I mean, we seem to be forced to replace a falsehood with another falsehood. Goodness me!

  3. chad nowlin

    That’s a great article for the medicinal side of decreasing inflammation. It sucks that the last sentence says to use ice baths. Still a big problem!!

  4. Scott Leach

    A few weeks ago I managed to have a fall whilst out running and badly stubbed my big toe, to the extent that I worried it was broken for a while. I have long known the thinking against ice and NSAIDs but have not done a trauma injury to myself in a long time, although I have done this type of injury many times over the years. This time I treated it with heat. I would normally have expected the type of injury I did to take several weeks to heal. With heat the speed of the healing was remarkable. I was able to return to running within days. I can’t believe the years I wasted putting ice on injuries!

  5. Daniel Jacobs

    I agree with you, Josh, that Ibuprofen and other painkilling drugs that suppress inflammation do more harm than good — and that icing a muscle or tendon injury blocks, rather than stimulates healing. (I favor hot baths mixed with Epsom salt, an antioxidant; therapeutic massage; and application of vitamin E oil with mild heat).

    However, I feel you overstate your case by insisting that “inflammation is a good thing” in general. There is nothing good about the chronic inflammation of asthma, arthritis, or arteriosclerosis. Even in situations where inflammation yields benefits such as muscle healing and clearing of damaged cells, the inflammatory response can spiral out of control, generating a flood of free radicals that damage living cells and vital tissue. Thus the need for antioxidant prophylaxis and therapy to control even the “best” inflammation.

    Cancer chemotherapy tends to trigger inflammation and massive production of free radicals, leading to its toxic side-effects. Therapeutic injection of vitamin C (as sodium ascorbate), by scavenging free radicals and controlling inflammation, can reduce the toxic side-effects of chemotherapy and improve the prognosis of cancer patients. See “The Effect of Intravenous Vitamin C on Cancer- and Chemotherapy-Related Fatigue and Quality of Life”: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4199254/


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