Getting Back on the Horse-Returning From Sport Injury

When we get hurt on the field of play or in the game of life there are several strategies (icing, massage, muscle activation, nutrition) we can use that help the body recover. [1] [2] But how do you know when it’s time to “get back on the horse” and return to action, is it simply when the pain goes away?

Keep in my mind that I am referring to soft tissue injuries that are mild in nature.  Addressing the protocol of return from a more traumatic injury such as a surgery or broken bone is beyond the scope of this article.

In professional sports and even most college and high school athletic programs an athlete has to be cleared by a trainer or coach before they are deemed suitable for return to play.   An athlete will take part in some type of agility test to determine if the are favoring the injured area.  The trainer/coach will carefully watch for subtle compensations that the athlete may be using to avoid stressing the previously injured area.   If the athlete is not able to move the way they did pre-injury they most likely won’t and should not be cleared to play.

If an athlete lacks the confidence to run aggressively and then stop quickly to make a change in direction it may be an indication that the injured area is not strong enough yet or the athlete may be fearful of re-injury.  This “mental” block can be quite a substantial one to overcome particularly for younger athletes with a first time injury.  In their attempt to avoid pain they may start to develop poor movement habits that could lead to a more serious injury while also hindering their long-term athletic development.  

When an athlete doesn’t play reflexively and is overly cautious they tend to move in a very choppy almost robotic manner.  This alters their body awareness and balance and could leave them vulnerable to a “big” hit because they lack that sixth sense to avoid collisions.  That aspect is often overlooked but body awareness and coordination may be an athlete’s best shield against on-field injury.

As is often the case the middle school aged children are often neglected in this regard.  Most middle schools do not have access to an athletic trainer that can test an athlete to ensure they are ready for return to play.  This is why it’s important that coaches and parents carefully monitor the way their young athletes move at all times, even when they are healthy?  You need to have some type of baseline to compare their return from injury status to.  Complicating the challenge for this age group is the pain, discomfort and disruption to body control that accompanies the adolescent growth spurt.

It should also be noted that even though an athlete passes a return to play test with flying colors the real test comes during game play.  Even a well designed agility test and the keen eye of a seasoned coach won’t be able to make up for the speed of the game.

Game action is the real test for the athlete returning from an injury.  Everything happens much faster in the game, it’s chaos and in this environment the athlete must be mentally sharp and confident that there body will be able to answer their every call instinctively without delay.

As parents and coaches we need to ensure that we keep a watchful eye on our young athletes at all times and just as importantly we must foster an environment that encourages non-judgmental communication.

We should be aware of the child who may seem timid and is not able to regain the “intensity” or “aggressiveness” they displayed before an injury that very likely left a painful memory.

Consider the following scenarios:

"It still hurts"

The first factor could quite simply be that the child still experiences pain as they are trying to play. If the young athlete feels empowered as a member of their own re-habilitation team, they will be more likely to let you know that "it still hurts". The fix here is simple; go back to the doctor or get a second opinion.

"I'm all done"

This factor is a little more difficult to rule out. In our efforts to promote our children through sport we sometimes forget that they are not little adults. Their likes and dislikes are fickle at best as they move through development and maturation. Today's favorite activity may be tomorrow's memory. Your child/athlete may be trying to let you know that they have simply lost interest in this sport and don't know how to tell you for fear that they will let you down.

As leaders of young athletes we need to create an environment where they feel like they can speak up on their behalf and be open about what they are feeling. Coaches and parents need to affirm the child’s feelings by letting them know that they are rational and normal. Then we need to guide them along with a return to play strategy (progressive goal setting) that honors each child’s unique situation understanding that sometimes the emotional and mental healing requires more time than the physical healing.

Reference:

[1]http://nowforeverfit.blogspot.com/2013/02/just-ice-itpaininjury-management.html

[2]http://nowforeverfit.blogspot.com/2013/02/nutrition-for-injury.html

Nutrition For Injury

Pain and discomfort from an injury is something we all want to avoid and due to being a participant in the game of life you are bound to have your share of bumps and bruises along the way.   That said, when we do get hurt we want quick relief so we resort to strategies such as ice/heat, massage, muscle activation/light stretching and non-steroidal anti-inflammatory such as ibuprofen.  Over the past few weeks I covered all of these strategies and when and if they should be applied. [1][2]

When we do suffer an injury inflammation is our body’s natural response to initiate the healing/recovery process.  The initial inflammatory response helps to drive the “groceries” in and drive the “garbage” out.  However chronic and out of control inflammation could stall the recovery process and also damage non-injured tissues surrounding the site of trauma.  So we need to make sure we mange the delicate inflammation balance.  Think of inflammation like a wood burning stove if the light is just flickering that’s not enough and if the fire is out of control it’s very dangerous.  What we need from the fire or inflammation process in this case is a nice balance that provides just the right amount of heat and light.

Does the food we eat play a role in how we mange the inflammation in our bodies? If you consume a lot of processed foods your body is more prone to inflammation and if you throw an injury on top of that you could skew that delicate inflammatory balance toward the out of control range. And there are many foods that can help control excessive inflammation and restore that delicate balance. Food also provides the building blocks for the tissues and bones in our bodies.  So when tissues are damaged and in need of repair and regeneration the food we consume provide the raw materials required to rebuild our bodies.

The answer to the above question then is a definitive yes! Nutrition can be a big player in your ability to recover from an injury.

Step one in using nutrition to improve injury recovery is to eat more “good” fats while reducing fats from highly processed foods.  Eat more olive oil, avocado, ground flax seeds or flax seed oil, chia seeds, nuts such as pecans, almonds and walnuts.  Processed vegetable oils like corn, canola, safflower, cottonseed and soybean should also be greatly reduced.  Egg yolks from pastured raised hens and fatty wild-caught fish such as salmon also provide recovery-boosting fats.

Even though these “good” fats create an anti-inflammatory response in the body, this response doesn’t interfere with repair; rather, it only helps with injury healing and tissue regeneration.

The following foods are also rich in natural inflammation-modulating agents:

Curry powder/turmeric

Garlic

Pineapple

Cocoa (unprocessed powder or dark chocolate)

Green Tea

Blueberries

Energy needs increase during acute injury repair

Cutting down  drastically on the amount of food you eat after you are injured is another sure-fire way to stall your recovery.  You may not need as much food as when active but providing your body with enough fuel to carryout the recovery process is crucial.  Consider the following example of a young male athlete. He’s 14 years old, 5’6″ and 140 lb.

Basal Metabolic Rate - 1611 kcal/day (the rate at which energy is used by an organism at complete rest)

Energy needs when sedentary - 1933 kcal/day (activity factor of 1.2)

Energy needs with daily training/competition - 2739 kcal/day (activity factor of 1.7)

Energy needs during recovery - 2319 kcal/day (activity factor of 1.2 and a 20% increase in metabolism due to injury)

As coaches and parents we need to monitor our young athletes to ensure they are eating enough while injured.  Young athletes may be concerned about gaining weight while sedentary and they also likely will have less of an appetite because they aren’t as active. 

Injury repair requires more protein

To ensure a quick recovery, make sure to get higher protein intake consistently. Protein digests into amino acids that are needed to repair damaged tissues. 

Vitamins and minerals are nutrients required in small amounts for metabolic reactions that occur during the recovery process. You can ensure adequate vitamin and mineral intake by consuming a “rainbow” of colorful fruits and vegetables.  This will go along way toward preventing any deficiencies.  Fruits and veggies also contain powerful antioxidants that help control excessive inflammation.

According to Dr. John Berardi (PH.D. Nutrition)

While it is important to prevent any vitamin and mineral deficiencies there are a few vitamins and minerals that may require additional supplementation. Here’s a brief list of the vitamin and mineral supplements that help with acute injury recovery:

Vitamin A – 10,000 IU/day for 2-4 weeks post-injury

Vitamin C – 1000-2000 mg/day for 2-4 weeks post-injury

Copper – 2-4 mg/day for 2-4 weeks post-injury

Zinc – 15-30 mg/day for 2-4 weeks post-injury

Calcium and iron deficiencies are, like zinc deficiencies, quite common. Because they’re important for bone health, athletes who are deficient in calcium and iron are more likely to suffer stress fractures.

Thus, while these two minerals may not play direct roles in injury healing, they play a large role in prevention. Get enough calcium and iron, preferably from whole foods rather than supplements.

Ensure that injured athletes eat enough calories and protein, by using some simple strategies:

FREQUENCY

Eat every 3-4 hours.

PROTEIN

Each meal/snack should contain complete protein including fish, lean meats, grass fed and organic dairy, eggs.

VEGETABLES AND FRUIT

Each meal/snack should contain 1-2 servings veggies and/or fruit (1/2 – 1 1/2 cups or 1-2 pieces) with a greater focus on veggies.

STARCHES

Additional carbohydrates should come from whole grain, minimally processed sources like whole oats, yams/sweet potatoes, beans and legumes, whole grain rice, quinoa, etc. The athlete should eat fewer starches when not training (such as during injury recovery), and more when training (unless they want to lose fat).

FATS

Eat at least 2-3 of these healthy fats each day: avocadoes, olive oil, mixed nuts, fatty fish (such as salmon), flax seeds, and flax oil, whole eggs.

Waiting until you are hurt to start eating nutrient dense foods is not the recipe for a quick recovery.  The best strategy of course is prevention and by consuming a variety of whole foods consistently it will ensure that if you are injured you have the raw materials on hand to fuel the recovery process efficiently.   

Reference:

[1]http://nowforeverfit.blogspot.com/2013/02/just-ice-itpaininjury-management.html

[2]http://nowforeverfit.blogspot.com/2013/01/stretch-to-win.html

Cherrios Trusted or Tainted

Breakfast cereals have been a staple of children’s morning nutrition for decades and some brands have been around for so long they carry a sort of “halo” and because of this halo effect are assumed to be “good for you.”

California's Proposition 37, which would have required genetically engineered (GE) foods to be labeled as such and prevented GE foods from being mislabeled as "natural," was defeated back in November due to massive donations from multinational corporations that hide GE ingredients behind natural labels and "wholesome" advertising.

One such company was General Mills, the maker of Cheerios.

General Mills donated more than $1.1 million to the 'No on Prop. 37' campaign to defeat the GE labeling law recently got a taste of the backlash from their support for the legislation.  Just one day after General Mills’ Cheerios brand released a Facebook app allowing “fans” to “show what Cheerios mean to them,” the app was abruptly pulled due to thousands of angry consumers using it to create anti-GMO (genetically modified organisms) statements and lashing out against the company’s apparent hypocrisy.

Two of the first three ingredients in Cheerios and Honey Nut Cheerios are cornstarch and sugar—two ingredients that might be genetically engineered (a majority of corn-based ingredients and sugar from sugar beets on the US market is now GE).  The fact that General Mills would rather pay millions to hide that their products contain GE ingredients rather than give you the choice to buy something else, or reformulate their product without GE ingredients is quite telling. [1]

All that said, it’s unlikely eating Cheerios on a regular basis will have any detrimental effects on your health especially in the short term but as the use of GE ingredients becomes more prevalent we should be aware that GE’s are very likely present in many of the foods we have consumed for years.

So what’s the big deal about GE food anyway?  Isn’t it just a more efficient way to provide food to more people for less money?

Consider the following:

A two-year long French feeding study designed to evaluate the long-term health effects of a genetically engineered corn found that rats fed Monsanto’s maize developed massive breast tumors, kidney and liver damage, and other serious health problems. The major onslaught of diseases set in during the 13th month.

Female rats that ate genetically engineered corn died 2-3 times more than controls, and more rapidly, while the male GE-fed rats had tumors that occurred up to a year-and-a-half earlier than rats not fed GE corn.

According to results from a 10-year long feeding study on rats, mice, pigs and salmon, genetically engineered feed causes obesity, along with significant changes in the digestive system and major organs, which include the liver, kidneys, pancreas, genitals and more.

The EPA admits there’s “mounting evidence” that Monsanto’s insecticide-fighting YieldGard corn is losing its effectiveness in the Midwest. Last year, rootworms resistant to the toxin in the genetically designed corn infested fields in Iowa, Illinois, Minnesota and Nebraska.

Genetically engineered foods are responsible for development of resistant weeds and pests; increased pathogenic virulence; degradation of soil quality; reduced nutrient content in food; exponential rise in infertility and birth defects; and reduced crop yields, and more. [2]

I know we aren’t rats but the question that has to be asked given the evidence is it this stuff worth eating when you have better options?

Before I get into the better options some thing else that should be noted in regard to breakfast cereals.

All but a few brands of breakfast cereal–even so-called organic health food cereal–are produced by a process called extrusion that subjects the grains to very high temperatures (Grape Nuts is one exception – it is not extruded but baked).  Analysis of the grains after extrusion indicates that the industrial process breaks up the carefully organized proteins they contain, creating neurotoxic (damaging to nerves) protein fragments.  Since organic whole grains are higher in protein, it is very likely that extruded health food cereals contain higher levels of these toxic protein fragments than refined grains that are lower in protein. [3]

One of the cereal makers with the aforementioned “halo” is Kashi. I contacted Kashi to ask what varieties of their cereals were extruded.  The list included the bulk of their offerings except for the Autumn Wheat variety.  I should also note that like General Mills, Kashi also supported the defeat of the anti-GE legislation.

Last year, a report from the Cornucopia Institute titled Cereal Crimes exposed how most "natural" brands are actually just charging you more for what often amounts to genetically engineered ingredients. This is in all likelihood part of the reason why so many "natural" brands spent millions of dollars to defeat California's GMO labeling campaign.

According to the report:

"[There is a] vast differences between organic cereal and granola products and so-called natural products, which contain ingredients grown on conventional farms where the use of toxic pesticides and genetically engineered organisms is widespread... Our analysis reveals that "natural" products — using conventional ingredients — often are priced higher than equivalent organic products. This suggests that some companies are taking advantage of consumer confusion."

This is significant, because surveys have shown that more consumers pay attention to the "100% Natural" claim than the "100% Organic" label. In one such survey, 31 percent of respondents said the "100% Natural" label was the most desirable eco-friendly product claim, compared to just 14 percent who chose "100% Organic." Food companies clearly know this, and they're cashing in on your confusion. The truth is, synthetic ingredients and additives, toxic pesticides, fumigants and solvents frequently show up in products bearing the "natural" label, while these are strictly prohibited in organic production. But the most disturbing finding presented in the Cereal Crimes report related to the presence of genetically engineered ingredients found in so-called all-natural foods:

"The Cornucopia Institute sent samples of breakfast cereal to an accredited and highly reputable GMO testing laboratory. Samples were tested for the exact percentage of genetically engineered corn or soybeans, using the most sophisticated and accurate tests commercially available.

The results were stunning. Several breakfast cereal manufacturers that market their foods as "natural," even some that claim to avoid genetically engineered ingredients and are enrolled in the Non-GMO Project, contained high levels of genetically engineered ingredients." [4]

Remember: "Natural" Label Does NOT Prohibit Genetically Modified Ingredients.

The USDA certified organic label is your best guarantee that the food was produced without:

Toxic pesticides

Genetically engineered (GE) ingredients

Carcinogenic fumigants

Chemical solvents

This peace of mind is something the "100% Natural" label will NOT give you. Genetically engineered (GE) ingredients are of particular concern when it comes to food products like breakfast cereals and granola bars, because, in the US, the vast majority of the most common ingredients in these products — corn, soy, and canola — are genetically modified.

In Lieu of GMO Labeling, 100% Organic is Your Only Assurance

Once you realize that much of the "natural" claims are hype, it becomes easier to navigate around the deception. To find brands that are committed to sustainable organic agriculture and avoiding genetically engineered ingredients use Cornucopia's Cereal Scorecard.

Another factor to consider is the fact that many small family farms actually adhere to fully organic practices even though they may not have gone through the expense of obtaining organic certification. So labels aren't everything when it comes to healthful food. But if you're going to shop by the label, make sure it's the certified 100% organic label.  Until or unless we get GMO labeling in the US, the 100% USDA Certified Organic label is the only assurance you have that the food you buy does NOT contain genetically engineered ingredients.

Better Options

To find the highest quality cereal options checkout the Cereal Scorecard below.  While you may find many cereals that are not made with GE ingredients a vast majority will still be extruded.  I would encourage you to read Is Breakfast Cereal Toxic below for more information.  The best option is to make your own cereal using whole grains.  An example is good old-fashioned slow-cooking oatmeal. And despite what the name implies it doesn’t have to take a long time to prepare.  Before you go to bed simply soak a serving of oats in a glass container (I pour boiling water over it submerge it).  Come morning simply empty the container into a pot and heat it up to the desired consistency.  I know oatmeal can be a tad boring for you and your family but I have become quite skilled over the years with “spicing it up.”

Try these options:

Dark chocolate

Cocoa Powder

Almond/Peanut Butter

Mashed Pumpkin

Nuts

Molasses and Ginger (tastes like gingerbread cookies)

Cinnamon

Apple Sauce

Berries

Bananas

Stevia or Maple Syrup to taste

For added protein and a dose of energy sustaining fats I will beat an egg and add it directly to the oats.  I will cook this for a few minutes while stirring and then add the other ingredients after it’s cooked.  Mix and match, you’ll be amazed at the varieties you will come up with.

Additional Resources:

Cereal Scorecard

http://cornucopia.org/cereal-scorecard/

Is Breakfast Cereal Toxic?

http://nowforeverfit.blogspot.com/2012/05/are-breakfast-cereals-toxic.html

Reference:

[1]http://articles.mercola.com/sites/articles/archive/2012/12/18/general-mills-cheerios.aspx?e_cid=20121218_DNL_art_1

[2]http://articles.mercola.com/sites/articles/archive/2012/09/22/superbugs-destruct-food-supply.aspx?e_cid=20120922_DNL_art_1

[3]http://nowforeverfit.blogspot.com/2012/05/are-breakfast-cereals-toxic.html

[4]http://www.cornucopia.org/2011/10/natural-vs-organic-cereal/

Icing, does it really help? (Pain/Injury Management)

Have you ever been out for a run or playing a little soccer with the kids when all of a sudden you tweak a muscle in your leg or roll your ankle?  Your first thought may be, “I need to go ice this!”  Icing an injury is after all what you have always been told to help get the swelling down and to dull the pain.  In fact, the oft-disseminated acronym in the sports medicine world is R.I.C.E., which stands for rest, ice, compression and elevation.

When an idea has seemingly been in circulation forever it endured the test of time and survived the scrutiny or it just may be due for a re-evaluation.  Dogma is never an effective argument to continue with a treatment such as icing an injury especially when you consider what actually happens when you do apply ice.

I think we can all agree that the human body has an amazing ability to heal it’s self if we allow it to.  Inflammation and swelling are the body’s natural response to an injury.

I think there is some merit to icing acute injuries (it just happened as a result of a specific action) and cold-water full or partial submersion for the purposes of recovery after training, but constant use of icing to dull pain is counterproductive. It essentially numbs the area, but also limits blood flow, which is the mechanism through which healing agents are delivered to the site of the injury.

Pain can be our friend.  It is a signal to our brain that something is not right.  If we ignore this call by numbing the pain with drugs or ice it’s similar to covering up the warning light on your dash that alerts you to a potential problem with your engine.

If you continue to drive the car you will eventually damage the engine and possibly even blow it out beyond repair.  If you ignore the pain in your body and continue to push your way through an injury eventually you will develop compensatory patterns to work around the pain and discomfort.  These altered body mechanics will overload areas that pick up the slack for the weak/injured area and a bigger problem usually ensues.  You can always get a new engine for your car, this is the only body you’ve got so don’t bury your head in the sand by ignoring the pain!

I am not a rehab and pain management specialist but I do have plenty of in the trenches experience dealing with my own bumps and bruises.  Cold showers particularly after a rough workout has always worked for me in managing soreness.  I tried snowboarding a few years ago and I fell down and crashed, often!  I knew I was going to be hobbled the next day unless I took aggressive precautions.  As soon as I got back to the house I jumped in a cold shower for 5 minutes.  I focused on more vulnerable areas around the knee, hips and lower back.  The only area I neglected was around my wrist joint (from breaking the falls with my hands) and guess what hurt the next day?  My forearms were on fire but the rest of my body was fine.

Another key ingredient in my recovery in this instance; I did not sit around and allow my body to get stiff.  I continued to move around for the rest of the afternoon and did some very mild mobility exercises.  Muscle activation helps drive blood in and out of the system.  The muscles serve as a pump, they bring groceries in (nourishment) and flush the garbage (waste) out.

There is basically a three-step process that must occur for an injury to heal.  The first step in the healing process is the inflammatory response followed by repair of the tissue and finally remodeling of the tissue.  Ice sends the nourishment in the wrong direction so it prevents or delays step one from occurring.  And if the inflammatory response is delayed the other two can’t happen and recovery takes longer or is never completed.  This is why rushing back to soon before an injury has had the opportunity to heal usually leads to a re-injury.

So what do the pain experts say?

I contacted two rehab specialists in the area and asked for their opinion:

When it comes to acute injury, then there is a possibility of inflammation and that is why it is very important that the player rest that joint and ice it to prevent further damage and to reduce the swelling. After about 48 hrs then you can use some isometric exercises without aggressive motion thru the joint and you can use heat if there is no swelling. That is in general; of course every injury is different.

M. Fahmy, OMPT Specialists

Ice for the first 48 hours, then after that, use heat. Don't stretch the muscle. Once the acute irritation dies down, we use gentle transverse friction massage to the muscle belly with it in the shortened position. This restores tissue alignment and allows the muscle to "fatten" when it contracts. The inability of the muscle to "fatten" with contraction is usually what causes ongoing pain after an injury.

S. McLaughlin, Michigan Institute of Human Performance

The consensus is that immediately following a mild acute injury icing is advised to control excessive inflammation, swelling and pain.  Then after the injury has settled down after 48 hours don’t just sit around.  Light muscle contraction and or gentle massage will help drive the groceries in and the garbage out and allow the body to repair and ultimately remodel.

If you constantly have to ice your back, neck or other area of discomfort to manage pain you should not ignore this signal.  Chronic pain is usually the result of incomplete recovery, over-use or poor posture and muscle imbalances.  That pain won’t go away until you get to the root of the problem.  While inflammation is essential for the repair process chronic inflammation can slowly chip away at tissue and movement quality.  And poor movement in addition to weak muscles and stressed connective tissue is a recipe for serious pain down the road.

It’s okay to experience a little soreness after a tough workout, this usually occurs within the first 24-48 hours post training. This soreness should be mild in nature but can be quite severe if you dramatically increase the intensity of your training (New Year’s Resolution!).

If you do experience this soreness the protocol is similar to that of an acute injury:

• ·      Ice/Cold Showers within the first 24-48 hours
• ·      Light mobility exercises (think active stretching, not static holds)
• ·      Gentle massage
• ·      Treading water in a warm therapy pool is also good option
• 
  

As a general rule prevention is the best strategy to avoid pain and soreness:

• ·      Follow the 10 percent rule: do not increase exercise intensity, frequency, or duration more than 10 percent a week.
• ·      Allow for weekly mobility/flexibility time in your workout schedule.
• ·      Cool down after vigorous exercise by jogging, walking, or slow-lap swimming.
• ·      Use Hot/Cold Contrasts in the shower finish with cold.
• 
  

Also getting adequate rest /sleep is critical to not only recovery but also injury prevention as well. Adolescent athletes who don't get enough sleep at night might be placing themselves at risk for a sports injury, researchers recently revealed at a presentation at the American Academy of Pediatrics.

"Adolescent athletes may benefit from additional sleep as they get older. We'd like injury prevention programs to focus on sleep education."

Matthew Milewski, MD, of Children's Hospital Los Angeles [1]

In my 10-14 age group many of the children (particularly the girls) are experiencing knee pain.  It would be easy to dismiss this pain as nothing more than just the typical aches that accompany growth and maturation but it is very important to listen to the child and acknowledge their discomfort.  I absolutely want my kids to tell me if they have pain so I can ask leading questions to determine if it may be something more than just their “growth spurt.”  It’s incredibly important to catch potential developmental problems in their infancy when they are much easier to counter-act.  No need to go overboard and worry yourself sick about every little aches and pain but by watching how they move and listening to them you can learn a lot.

Treatment of growing pains depends on how much pain your child has. The following things may ease discomfort and help your child feel better:

• ·      Massaging the legs.
• ·      Stretching the leg muscles. This may be difficult/uncomfortable for younger kids.
• ·      Place a warm cloth or heating pad on the sore leg. Be careful not to burn the skin and do not use during sleep.
• ·      Most kids won’t respond well to ice.  But if they can tolerate it apply ice wrapped in a towel to the sore area a few times each day. This can help to relieve pain and discomfort.
• 
  

When Should You Call the Doctor?

When deciding whether to call the doctor, it's important to remember that growing pains are almost always felt in both legs. Pain that is only in one leg may be a sign of a more serious condition. Call your health care provider if this happens.

It's also important to remember that growing pains affect muscles, not joints. And they do not cause limping or fever. [2]

In summary if you think icing works for you than continue to do so for mild injuries.  Earlier studies have found little benefit from icing after exercise, but also few negative side effects. [3][4] That said icing prior to exercise or sport should be avoided!  That should be apparent but cooling will negatively affect your muscle coordination, spatial awareness and dull your motor reflexes. [5]

Next week I will examine nutritional strategies that can be used to recover from injuries.

Afterthought

Ibuprofen (brand names Advil, Motrin) is a non-steroidal anti-inflammatory drug (NSAID) commonly used by athletes, both before and after workouts.

Taking ibuprofen before a workout in order to reduce muscle soreness has been linked to intestinal leakage and systemic inflammation; when used chronically, ibuprofen may lead to intestinal permeability, allowing bacteria and digestive enzymes to leak into your bloodstream regularly.

Using ibuprofen chronically prior to your workouts may also reduce the absorption of key nutrients, particularly after exercise, which may make it harder for your muscles to regenerate; further, this practice has not been shown to reduce muscle damage or soreness. [6]

"We've learned through our conditioning that we just ignore the pain, or we take a medication to suppress the pain, which is no more than saying to the body, 'Shut up. I don't want to hear about it,' which allows the problem to become more advanced. When you take anti-inflammatory and pain pills for a condition that you're dealing with athletically, all that you do is set the body up for more damage, because you override the protective mechanism of your body.” [7]

Dr. Craig Buhler, Advanced Muscle Integration Technique (AMIT) Practitioner

The best strategies (rest, nutrition, corrective exercise) to help reduce muscle fatigue and soreness are those that will help to address some of the underlying causes; drugs do not fall into this category.

Reference:

[1]http://www.medpagetoday.com/MeetingCoverage/AAP/35466

[2]http://children.webmd.com/guide/growing-pains

[3]http://www.ncbi.nlm.nih.gov/pubmed/22121908

[4]http://www.ncbi.nlm.nih.gov/pubmed/15496998

[5]http://well.blogs.nytimes.com/2012/01/04/why-ice-may-be-bad-for-sore-muscles/

[6]http://fitness.mercola.com/sites/fitness/archive/2012/12/21/ibuprofen-use.aspx?e_cid=20121221_DNL_art_2

[7]http://fitness.mercola.com/sites/fitness/archive/2013/01/04/advanced-muscle-integration-technique.aspx?e_cid=20130104_DNL_art_1