Recovery from Exercise - no ibuprofen, no ice

[erugs]

From Dr. Gabe Mirkins site today. I have sometimes used ibuprofen after a strenuous hike but will think again about "Mountaineers Vitamin I." This is part of the article.

Researchers at McMaster University in Hamilton, Ontario have shown that deep massage after an intense workout causes muscles to enlarge and grow new mitochondria (Science Translational Medicine, published online Feb, 2012)....When you exercise intensely, you feel a burn in your muscles. When the burning lasts for while, you have significant muscle damage. Biopsies of muscles at that time show bleeding into the muscle fibers and disruption of the muscle fibers themselves. In response to muscle cell damage, your immunity produces certain proteins called cytokines that remove the damaged muscle parts. This increases swelling and delays healing.
Massage reduced these cytokines and, surprisingly, increased the size and number of new mitochondria more than exercising without massage. The previously held explanation that massage improves muscle blood flow and gets rid of lactic acid does not have firm research support. Furthermore, research from this same group shows that massage decreases blood flow to muscles after exercise, and therefore slows lactic acid removal from muscle after exercise.....
ICE AND NON-STEROIDALS BOTH DELAY RECOVERY FROM EXERCISE Massage is good because it increases mitochondria and healing. Ice and non-steroidal anti-inflammatory drugs, such as ibuprofen, block muscle repair and delay healing.

 

[Maddy]

Oh heavens...not again.

I have done my very own research. No ice, no non-steroidals, no hike. (I'm "dead" serious!)

Two days ago it came to my attention that bread will kill me.
Today it's one diet soda day by 47%. Non-steroidals are also a risk factor for cardiac events.
Will I be here to see what tomorrow brings? Combine this with all the other dire warnings in the news, I doubt it. My days are numbered.

 

[erugs]

Oh heavens...not again.

I have done my very own research. No ice, no non-steroidals, no hike. (I'm "dead" serious!)

Two days ago it came to my attention that bread will kill me.
Today it's one diet soda per/+ and non-steroidal increases my chances for an most undesirable coronary event by 47%.
Will I be here to see what tomorrow brings? Combine this with all the other dire warnings in the news, I doubt it. My days are numbered.

I know, I know. But because this was a recently published piece, I thought I'd post it. My father's career was in food technology as a chemist. He saw many trends come and go, and that added to my skeptical nature of accepting the "latest" but my natural inclination is to massge my legs when they are sore.

 

[Maddy]

I know, I know. But because this was a recently published piece, I thought I'd post it. My father's career was in food technology as a chemist. He saw many trends come and go, and that added to my skeptical nature of accepting the "latest" but my natural inclination is to massge my legs when they are sore.

Not criticizing. It's just came on the heals of my discovery that two more food items are killing me. At this age, I don't have time waste.
I have almost nothing left on my plate and now I can't hike if I take my pain meds. I suppose I could say, you come to that point in life where there is not much hope for "recovery" so you may as well ease the pain as much as possible. "Keep on keepin' on!"

 

[Tom Rankin]

I just saw a similar article in the NYTs.

 

[erugs]

So, there must be other pain meds besides ibuprofen. Is Aleve (naproxen) in that family? I have found that to be helpful but not immediately so. It seems to need time to reach its effect. Or how about Tylenol Arthritis? It is of a higher dose than standard Tylenol and is time released.

 

[David Metsky]

So, there must be other pain meds besides ibuprofen. Is Aleve (naproxen) in that family? I have found that to be helpful but not immediately so. It seems to need time to reach its effect. Or how about Tylenol Arthritis? It is of a higher dose than standard Tylenol and is time released.

Ibuprofen and Aleve (Naproxen Sodium) are both NSAIDs (Non-steroidal anti-inflammatory drugs) and have many similar properties. Aspirin is also an NSAID but from a different family. Tylenol is not an NSAID, and doesn't reduce inflammation so its impact on recovery might be very different.

My opinion is that these studies are seem fairly preliminary and there are several studies that would seem to contradict the results. I've had beneficial results from ice and Ibuprofen, and massage isn't very practical on a daily basis. I also use massage once a month or so when training so I see benefits from all these treatments.

 

[bikehikeskifish]

Massage is critical part of the professional bicycle racer's recovery. Without it, a three-week race like the Tour de France would be much harder, if not possible. Note that the article says the reasons why may not be scientifically supported, but it does seem to work. I remember back in the hay days of DEC we used to have a woman (Lee, remember her, Dave?) that gave chair massages down at the gym in the basement of ZK3. I'd have her do my legs as she was certified in sports massages as well.

These days, and since the problems with my knees in 2006-7, I use a foam roller and my own body weight for leg massages. It works pretty well, and I can do it while watching TV.

Here is a link

Tim

 

[Little Rickie]

Like a lot of things what works for one could hurt another. I look at information like this as ideas to experiment with on myself. What works keep, what doesn't stop. Simple, being intuned with your body is so much more important than take as bible all these conflicting studies.

 

[hikerbrian]

This paper (Massage Therapy Attenuates Inflammatory Signaling After Exercise-Induced Muscle Damage, Science Translational Medicine, 4 (119), 2012) does not say that ice and/or ibuprofen/NSAIDs delay recovery. In fact, to quote the paper directly,

"In summary, our findings suggest that the perceived positive effects of massage are a result of an attenuated production of inflammatory cytokines, which may reduce pain by the same mechanism as conventional anti-inflammatory drugs such as NSAIDs." [my italics]

Basically, this paper sets out to determine if massage actually does anything, and if so, what. They take a small group of young men (11 subjects - a VERY small data set, but useful in such an exploratory study), have them exercise, then give some of them massages. They took muscle biopsies at various points during the experiment. They then looked at a variety of biomarkers - biochemical signals in the body that would indicate something is happening. They find that massage decreases the level of certain inflammatory agents, but does not change lactate levels. Massage keeps you from experiencing inflammatory pain, but does not clear lactic acid (the burn you feel when you exercise). This type of response profile is very similar to what happens when you take ibuprofen. The authors make the case that massage should be considered a useful tool in patients that experience side effects from NSAIDs, and in areas of the body where there is poor blood circulation such as tendons, which would not experience very good exposure to oral NSAIDs.

So....this paper does not say you should stay away from ice or ibuprofen. It simply makes the case that massage may actually do something useful, beyond just making us "feel good." Perhaps, just maybe, it's a useful compliment to popping a pill; medical practitioners (and insurance companies) may want to pay attention.

 

[erugs]

Great, Brian - you read the article instead of just my attention-getting (maybe misleading, I agree) heading.

 

[hikerbrian]

No sweat - it's actually an interesting paper, but I know not everyone has access to it, which is why I responded. Having once or twice had my own science exaggerated by the press release, I'm sensitive to what is actually contained in papers that make the headlines.

 

[Stan]

That's it! Less exercise, more massage.

A few years ago I read a report from Stanford, I think it was a study by the medical and athletic departments, that stretching after exercise is just as important as stretching before. In fact, they had data showing that there were fewer injuries to people who stretched afterwards than people who only stretched before. Ever since, I stretch before and after ... so far so good. But, honestly, I don't stretch much before a hike, paddle or gardening ... the activity itself provides a form of stretching. I do stretch before and after more strenuous activity like running and soccer ... and often stretch for no reason at all other than to stay limber and flexible.

As for vitamin I, I don't take it much but when I do, I use it as a preventive rather than after the fact. Ibuprofen has long term effects on the liver ... an organ I'd rather save for processing products made from agave.

As for ice, I'm of the school that it relieves pain but actually delays healing so, again, I minimize it. Then there's the school that advocates alternating heat and ice but I can't say I've ever been in pain so long as to try that. My experience with post activity tequila tailgate is that it has worked as well as anything else.

Little Rickie hits the nail on the head, though, do your homework and figure out what works best for you.

 

[una_dogger]

I use a foam roller as well - works wonders

I especially like that the roller I use is called The Grid .

Both are interesting articles - thanks or sharing.

 

[erugs]

I knew that your hiking method had something to do with "grid."

 

[DougPaul]

Another publically available available article on the recent results on massage: http://www.sciencenews.org/view/generic/id/338108/title/Muscle_massage_may_speed_healing


It is my understanding that the purpose of icing it to reduce the swelling from traumatic injury and/or intense exercise. For instance, my PT had me ice my knee after she stretched it out will all her weight. (The full sequence was, warm up, self-stretch, exercise, PT stretch, and ice.) The NSAIDs also reduce swelling. (Ibuprofen is most effective if you start taking it a few days before the exercise.)

Note: The NSAIDs and acetaminophen (Tylenol) are powerful drugs and a significant percentage of liver failures are due to overuse.

For activities such as hiking, one can warm up by starting a little slower and speeding up as one warms up.

Doug

 

[una_dogger]

I knew that your hiking method had something to do with "grid."

No really, its called "The Grid"~

http://www.ems.com/product/index.js...e:PS10943751&gclid=CL7p-PWOkq4CFYXd4AodexSeJg

Its a dense foam roll around a hard plastic roll and it has all sorts of notches in it, sounds like a torture device?
It really works the deep tissues!

 

[Kevin Rooney]

No really, its called "The Grid"~

http://www.ems.com/product/index.js...e:PS10943751&gclid=CL7p-PWOkq4CFYXd4AodexSeJg

Its a dense foam roll around a hard plastic roll and it has all sorts of notches in it, sounds like a torture device?
It really works the deep tissues!

I use one of these to massage the IT bands:

 

[TEO]

I think that we're talking about two different types of pain.

Massage helps muscle recovery, and based on your synopsis of the article, this research is showing that ice & NSAIDs may inhibit muscle recovery. However, I think that most hikers and athletes use ice & NSAIDs to reduce inflammation in joints--think tendons, arthritis, etc.--and to reduce, as Doug says, swelling from trauma. For those purposes, ice & NSAIDs remain effective and for many, essential.

 

[Tito Alba]

I bought the book Massage for Cyclists by Roger Pozeznik and the checklists for pre and post ride massages are framed and hanging in my bathroom. The pre-ride massage sparks life back into legs and the post ride is self love for the spent. The book was ~$15 and a sound investment. I hike in winter and the carry over from the bike goes hand in hand (or foot).