New Pain Research

[fe.RMT]

some new Canadian based pain research with some implications for cautious rest when injured:

http://saveyourself.ca/articles/why-doe ... o-much.php

"One minor practical implication of the study is that it punctuates the importance of resting injuries and avoiding re-injury (see The Art of Rest). If neutrophil over-reactions drive a vicious cycle of inflammation, than it is clearly wise to be quite cautious not to damage any cells in a troubled area, or, worse, re-injure already-damaged cells. This made all kinds of sense before, but it makes even more sense when you know that a spike in inflammation while healing from a (closed) injury is not actually a functional, helpful process in any way — not a healthy, natural part of healing, as inflammation is often given credit for — but actually a destructive annoyance that significantly postpones full recovery without any compensatory benefits. Thorough and genuine resting has always been an underrated strategy for chronic, slow-healing injuries, and now we have a powerful reason to take it seriously. Avoiding mobilizing your neutrophils!"

[Jwolf]

Very interesting- thanks for that.

Also a good explanation for the need to ice and otherwise bring down the inflammation response. Some people worry about masking pain or think that the inflammation is productive in the healing process. But really it seems that inflammation has no protective or positive effect at all on internal injuries.

[दिवंगत]

Yes, very interesting.

I'm not in any way educated in the subject so this is an off-the-top-of-my-head question; does this have any bearing on how, why or whether ART works?

[Jwolf]

I'm not in any way educated in the subject so this is an off-the-top-of-my-head question; does this have any bearing on how, why or whether ART works?

I don't think so (Terri can correct me if I'm wrong), because the idea behind ART is to break down adhesions and scarred tissue-- nothing to do with the more acute neutrophils (or "inflammation response").

But... aggressive ART can CAUSE an inflammation response, so it's important to attend to this so as to not restart the cycle.

[PinkLady]

I know all the ART practitioners I have gone to refuse to work on an injury that is still in its acute traumatic stage.....aka, while it's still in the inflammation response. While ART can produce surface bruising and mild discomfort, if it inflames the injury to inflammation I suspect that means the ART was either done far too soon (so, the injury is still 'acute') , or far too aggressively.

For myself, this underscores something - if it hurts and something is injured enough to have an inflammation response - sit on y'er keister till it's better!

[Jwolf]

For myself, this underscores something - if it hurts and something is injured enough to have an inflammation response - sit on y'er keister till it's better!

Don't just sit there; Ice, ice baby...

On a more serious note I suspect this is how I majorly f$&d up my foot last year. I had some aggressive ART which did more harm than good.

[trixiee]

Wonder if that's why my knee is still so f'd up? I've never really stayed off of it...

[jamix]

I recall a study which showed that anti-inflammatory drugs taken two weeks before a marathon helped speed up the healing process afterwards.

[fe.RMT]

I'm not in any way educated in the subject so this is an off-the-top-of-my-head question; does this have any bearing on how, why or whether ART works?

I don't think so (Terri can correct me if I'm wrong), because the idea behind ART is to break down adhesions and scarred tissue-- nothing to do with the more acute neutrophils (or "inflammation response").

But... aggressive ART can CAUSE an inflammation response, so it's important to attend to this so as to not restart the cycle.

There are (agressive) techniques used in massage that have a side effect of creating small scale inflammation, however the larger 'good' of freeing the adhesion or realigning the scar tissue (scar tissue can't be eliminated) is worth the short term and VERY local inflammatory response. I can't speak for ART (at least not until after March) but the techniques (based on what I have had done) are very similar to that type of massage. This is part of what informed consent is about - "There is a chance that this will temporarily cause inflammation, but the result will be better mobility etc. Do you understand that? Do you have any questions about that? Are you OK to proceed?" Allowing your client to do a kind of cost/benefit analysis.

This type of massage is only done on chronic injury sites and is contraidicated in the presence of inflammation, acute/sub acute injuries. There is also a protocol to be followed with that type of massage - heat, general massage work, the deeper frictioning work, stretch, then apply ice. The ice (used for less than 3 minutes and applied very locally via ice cube massage) is to help scale down the inflammatory response. A similar protocol has never been followed by any ART provider I have seen.

[Jwolf]

There is also a protocol to be followed with that type of massage - heat, general massage work, the deeper frictioning work, stretch, then apply ice. The ice (used for less than 3 minutes and applied very locally via ice cube massage) is to help scale down the inflammatory response. A similar protocol has never been followed by any ART provider I have seen.

No, I've often been told to ice the area when I get home... but I didn't realize how important this was to the healing process.

[fe.RMT]

There is also a protocol to be followed with that type of massage - heat, general massage work, the deeper frictioning work, stretch, then apply ice. The ice (used for less than 3 minutes and applied very locally via ice cube massage) is to help scale down the inflammatory response. A similar protocol has never been followed by any ART provider I have seen.

No, I've often been told to ice the area when I get home... but I didn't realize how important this was to the healing process.

It isn't a type of massage that is done often... it has a very specific purpose and is only useful on discrete areas of scar tissue because the movement involved is quite small and it would take a long time to cover a larger area. Also, most clients won't tolerate the work for more than 5 minutes or so. To 'break' tissue creates an inflammatory response. It's inevitable... even if it is fibrous scar tissue.

[jgore]

ART: in war zones these techniques are called torture. But the end result is so worth it.

[getfit]

Back when I had my hip injury a few years ago (which lasted for months), I received very aggressive ART. It left me with a lot of bruising and very sore, it also did not work well, as the hip pain was still there weeks later. ART had worked miracles on my IT Band, but not so much for my hip When I finally got in to see an Orthopeadic surgeon, it was her opinion that the aggressive treatment probably prolonged the inflammation in the area and that's the reason it was taking so long to heal. So I basically stopped all treatment, took a prolonged break from running, but kept stretching and icing the area. I still think ART can be a very useful treatment, but I believe inflammation in the injured area should be reduced first. Someone mentioned anti-inflammatory drugs before a marathon may help with recovery. I never thought about this until now, but I was taking them for a few weeks before my recent 1/2 marathon for tennis elbow. My recovery following my 1/2 was great and I had hardliy any soreness or stiffness following my race. I chalked this up to better training, but now I'm wondering if they may have helped.