I noticed this thread and thought I would re-post the following that I wrote for IF. I hope it's found helpful although it contradicts a lot of things posted here particularly the first aid pieces on the first couple pages. I would like to point out though that in those articles that still believe in R.I.C.E. and NSAIDS treatments, the references are fairly old. The newest one I noticed were at least 9 years old though most are older, some dating back as far as 1976. The following represents the current thinking on these treatments.--
Iron
I realize this runs contrary to what is popularly believed but taking anti-inflamatories (NSAIDS) such as aspirin, ibuprofen, Naproxen (Aleve), Ketoprofen, advil et al not only doesn't help the healing process but is actually detrimental to it.
Also the time honored use of R.I.C.E. (rest, ice, compression and elevation)is likewise out-dated and detrimental to the healing of muscle, tendon, and ligament injuries. Neither of these treatments should be used as the following will show.
Concerning Anti-inflamatories [NSAIDS (Non Steroidal Anti-Inflammatory Drugs)]
First of all NSAIDS don't heal anything.(1) They inhibit pain and the other immune responses such as redness, swelling, fever, etc. It's this immune response brought on in part by prostaglandins that do the healing. If you hamper the prostaglandins, you hamper the body's way of healing itself. There's a purpose for the redness swelling, pain, fever, etc.
NSAIDS reduce the pain, swelling, fever, etc. by inhibiting the synthesis of prostaglandins. Prostaglandins are responsible for the activation of the inflammatory response, production of pain, swelling, fever, etc. When tissues are damaged from an injury or an illness, white blood cells flood to the site to try to minimize tissue destruction. Prostaglandins are produced as a result.
A couple studies have shown this:
1. NSAIDs have been shown to delay and hamper the healing in all the soft tissues, including muscles, ligaments, tendons, and cartilage. Anti-inflammatories can delay healing and delay it significantly, even in muscles with their tremendous blood supply. In one study on muscle strains, Piroxicam (an NSAID) essentially wiped out the entire inflammatory proliferative phase of healing (days 0-4). At day two there were essentially no macrophages (cells that clean up the area) in the area and by day four after the muscle strain, there was very little muscle regeneration compared to the normal healing process. The muscle strength at this time was only about 40 percent of normal. (2)
2. Another study confirmed the above by showing that at day 28 after injury the muscle regenerative process was still delayed. The muscles of the group treated with Flurbiprofen (NSAID) were significantly weaker. The muscle fibers were shown under the microscope to have incomplete healing because of the medication. (3)
(1) "In spite of the widespread use of NSAIDs there is no convincing evidence as to their effectiveness in the treatment of acute soft tissue injuries." Bruckner, P. Clinical Sports Medicine. New York City, NY: McGraw-Hill Book Company, 2004, pp. 105-109.
(2) Greene, J. Cost-conscious prescribing of nonsteroidal anti-inflammatory drugs for adults with arthritis. Archives of Internal Medicine. 1992; 152:2002.
(3) Almekinders, L. An in vitro investigation into the effects of repetitive motion and nonsteroidal anti-inflammatory medication on human tendon fibroblasts. American Journal of Sports Medicine. 2003; 23:119-123.
NSAIDS carry other risks also.
NSAIDs can cause stomach ulcers and related conditions because — in addition to suppressing the prostaglandins associated with inflammation and pain — they decrease production of a prostaglandin that protects your stomach lining. This allows gastric acid to erode the lining and cause bleeding and ulcers. A type of bacteria called Helicobacter pylori causes almost two-thirds of all ulcers. Most other ulcers are caused by NSAIDs.
The Food and Drug Administration (FDA) is now requiring expanded information about the risk of gastrointestinal bleeding on the labels and package inserts of both nonprescription and prescription NSAIDs.
NSAIDs have anti-clotting effects, so you may notice that you bleed or bruise more easily. Large doses of NSAIDs can also lead to kidney problems and fluid retention. NSAIDs can cause liver function test abnormalities, as well as ringing in the ears, headache, dizziness and drowsiness. Mouth sores and skin rashes also can occur while taking NSAIDs.
The FDA recently called for label changes on all over-the-counter and prescription NSAIDs to include information about potential risks heart attack and stroke, and rare but serious skin reactions from using such drugs.
I use Tylenol (acetaminophen). Tylenol is not an NSAID but it does reduce pain and fever. Unlike NSAIDS though it doesn't inhibit prostaglandins or reduce inflammation.
Concerning R.I.C.E. treatment:
Ice slows the ambient cellular metabolism and blood circulation significantly, thus adding to the slowing of healing.
The cells that make up ligaments, tendons, and organs are extremely temperature-sensitive. The metabolic rate at which these cells function is directly proportional to the temperature in their environment.
For each 10 degree drop in temperature, there is a more than two-fold decrease in the cell metabolism. Conversely, in order to increase cell metabolic rate the temperature of the tissue must increase.(1) That's why warming up is effective.
On the other hand, cooling tissue will decrease that cell's metabolism, slowing blood circulation and slowing healing.
In fact, Dr. Sherwin Ho and associates of the University of Hawaii in a landmark study showed that icing a knee for 25 minutes decreases blood flow and skeletal metabolism another 400 percent!(2)
The same study showed that the average decrease in arterial blood flow was 38 percent, 26 percent in soft tissue blood flow (ligaments), and 19 percent in bone uptake (which is a reflection of changes in both the bone blood flow and metabolic rate.) The net effect would be impaired or at best, delayed, soft tissue healing.(2)
Do you see the difference between pain relief and healing? The athlete needs healed tissue. Up until the present, too many people were advocating NSAID and ice use when it came to ligament and muscle injuries, because they were such great pain-relievers, when in fact they were and are stopping the healing mechanisms of the body. Any technique or medication that stops the normal inflammatory process that helps heal the body must have a long-term detrimental effect on the body.
In short, the body knows better than we do how to heal itself. Now, if pain is unbearable or if swelling is so bad that it may injure an adjoining organ, you may have no choice but to ice or use NSAIDS. However it is always done at the expense of slower healing and slower muscle growth.
(1) Guyton, A. et al. Textbook of Medical Physiology. Philadelphia, PA: W. B. Saunders, 2006, p. 620.
(2) Ho, S. Comparison of various icing times in decreasing bone metabolism blood flow in the knee. American Journal of Sports Medicine. 2002; 18:376-378.
For further references check out:
http://www.caringmedical.com/sports_injury/nsaids.asp
[url]http://www.findarticles.com/p/articl...20/ai_98464592[/url
Is Popular Opinion Wrong About Treating Injuries?
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