Running injuries usually involve inflammation, right? Over our years working one-to-one with clients we’ve found that injured runners often make mistakes in dealing with that inflammation in their efforts to avoid pain and heal more quickly. One of the most common mistakes is to take NSAIDs (non-steriodal anti-inflammatory drugs) such as ibuprofen, naprosin, acetaminophen, or aspirin.
“Wait a minute!” you say. “My doctor told me to take that! Everybody takes those!” That’s certainly the case but it’s beginning to change due to a number of research studies that indicate that NSAIDs also interfere with the healing process, are quite hard on the kidneys and liver, and seem even to interfere with muscle adaptation to exercise – meaning that if you’re training for something or even doing corrective exercise to help recover from injury you may not get stronger from doing it like you otherwise would.
This information is not brand-new. In the New York Times Well blog in 2009 Gretchen Reynolds wrote an article discussing research showing ultramarathoners who took ibuprofen during a race developed increased inflammation, impaired kidney function, and endotoxemia. She expands on this in her book, where she devotes an entire chapter to the issue. Sports scientist and blogger Steve Magness recently posted this discussion of current research on inflammation, injury, adaptation, and the use of anti-inflammatories, along with these comments:
“We’ve swung too far to the black and white thinking that inflammation is something that we always need to get rid of… In terms of using NSAIDs, it appears to me that the consensus at this time is that they probably impair at least some muscular and skeletal adaptations. My advice would be to stay away unless you have a very high amount of acute inflammation. “
In fact, inflammation is part of our healing process. Here’s an excellent and very readable account of how inflammation is involved in healing from Mark Sisson of the blog Mark’s Daily Apple.
So as you can imagine, popping Advil at the first sign of pain or as an ongoing way of dealing with an overuse injury is not going to help you heal; quite the contrary. At the bottom of his article Mark lists the main reasons inflammation spirals out of control. We can add to this list continuing to move in a way that damages your body, as is the case with overuse injuries that recur every time you run… even if you take time off to let them heal.
In our practice we help a lot of runners with overuse injuries change how they run so they stop creating the stress that causes their pain. However some runners are more prone to these problems, sometimes these problems flare up for no apparent reason, and some people recover from them much more quickly than others. I’ve been working on understanding the reasons for these variations for as long as I’ve been working with runners – that’s a decade this year. Along the way I’ve met various experts who’ve helped me with it, including NYC chiropractor Scott Zinberg, holistic podiatrist Robert Kornfeld, and nutritional biochemist Rebecca Dietzel, who first taught me the basics of inflammation and the connection to diet, and who I’m now privileged to have working with The Balanced Runner™ US in our New York City office.
Understanding what affects inflammation in a runner’s body is key. Runners need a healthy, strong healing system that allows them to recover fully and get stronger from exercise, heal from injury, and not carry residual or chronic inflammation that prevents recovery. In other words, as a runner you need acute inflammation and if you take anti-inflammatories you’ll rob yourself of it! And you need to avoid chronic inflammation which comes mostly from what they call “lifestyle” issues, particular rest, stress, and diet. Food intolerances and the major elements of the standard western diet all feed chronic inflammation, while healthy eating protects you and quells chronic inflammation. The great thing about “anti-inflammatory” foods is that they don’t interfere with the acute inflammatory response the way drugs do while they help quell chronic inflammation – clearly what every runner needs!
So avoid the pills, remove the stressors from your running form and from your lifestyle, learn how to eat an anti-inflammatory diet, and enjoy the benefits to your performance and your overall well-being. And if you need help with any of these things, just shoot me an email at firstname.lastname@example.org.
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Jae Gruenke, GCFP, is a running technique expert and Feldenkrais Practitioner. Known as a “running form guru,” she is the Founder and CEO of The Balanced Runner™ in New York City and The Balanced Runner UK. She has helped runners from beginner to Olympian improve their form to become pain-free, economical, and fast.