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OA Action #2: Learn to Control Inflammation on Your Own (warning- you may need to learn to rest!)


Inflammation is one of the buzzy concepts that gets such a bad rep in our modern fitness and health culture. And yet inflammation is totally normal. We certainly need to learn how to recognize when we have it and live with it and it is a key component to our healing processes.


When we have an injury, fluid connective tissues (blood and lymph) bring cells into the damaged area to help us with repair processes and debris clean up.

Interestingly, and unfortunately, inflammation is not really addressed in conventional western medicine. It is only a select few (PTs specializing in lymphatic massage following lymph node surgeries), who are usually adept in treating inflammation adequately (!!!) No worries though- you can learn to treat and care for your inflammatory processes yourself.


If you have arthritis, learning to identify inflammation at your joints and regulate your own inflammatory response is a crucial point (and the second action step in our cycle) that you as a mover can work with, to kick yourself off of the degenerative carousel.


There will be signs that you are in an inflammatory phase. You may notice any of the following:

-swelling

-throbbing/aching around a joint line

-warmth at the skin around the affected area (to test this, lightly press the underside of your wrist to the affected area, and then to the other side. Notice any differences)

-increased pain from baseline - (especially at night or at rest)


Strangely, your inflammation does not mean any new damage has incurred, but simply that you are in an inflammatory phase of your cycle. This usually is set off by overdrawing your account (by not doing enough of the activities that deposit into your body’s account and or by making too big of a withdrawal).


Common subjective reports that relate to overdrawing a body account are:

“I was feeling great so I gardened for 4 hours” (someone with positional back sensitivity)

“I had to rush right off of the plane into a long meeting at the office”(someone with sensitivity in their back to loading)

“My ankle was feeling so good, I went out surfing despite knowing I’m not ready to”

I narrowly avoided this subjective last week. Sometimes, I actually have to write a note on my keys so my inner PT can communicate with my other selves!

Most people who live on anti-inflammatories, have not yet learned the checkbook theory, and are constantly overdrawing their physical accounts. They don’t get enough rest for their tissues, they overdo beyond what they are strong enough for. Indeed, these are the folks doing spinning classes one month out of joint replacements. This kind of overdoing is for taxes- not for the physical body. Do not follow the voices that are calling you to overdo! This is the fastest way to accelerate your arthritic cycling. Instead, quite literally, take a chill pill. Learning to heal your inflammation is the sure fire way to reduce the chances of arthritis after an injury, to reduce the swiftness of arthritic cycling once you have it. Reducing your own inflammatory process is the best way to promote health in your physical body. Here's how you do it.


You can work with this inflammation once you notice you have it using the P.R.I.C.E. method- Protection, Rest, Ice, Compression, Elevation. The PRICE method uses physical positions and supports to pulse extra lymph fluid (and exudate from swelling) away from the injured site and back to the heart. This is the fastest and best way to promote healing in your body.

*Though I am writing about P.R.I.C.E. in the context of osteoarthritis, please know that you use this following any injury to promote health and healing.


Protect:

This is the biggest piece missing when I listen to patient reports. We tend to roll like this: I fell and hurt my ankle, I cared for it for the rest of that day. The next day I was feeling better, so I did 2 or 3x as much as the first day. (I just did that a couple of months ago).

In reality, you want to protect tissue by using a brace, unloading tissue so that it can recover (such as with walking poles or a walker). One of the happy byproducts of using a brace, is that it signals to everyone else to stay away from your injury (this was super important when I had patients that used crowded BART trains to commute in San Francisco). There is no shame here. Protection should occur in commensurate amounts to the swelling and discomfort that you notice.


Rest:

Rest seems obvious, but again, most of us skip this step. Many people think rest equates to weakness, and should be avoided at all costs. Nothing could be farther from the truth. In fact, the strongest athletes on the planet all have very nuanced and skilled capacities around rest. Without rest you cannot execute.

When I see a client who is hell bent on not resting (after an injury, even after a surgery such as a fusion or joint replacement) I can almost guarantee that person will damage their surgery/ hardware, continue in chronic pain, and not recover/ heal well. Witnessing patients who will not rest is one of the biggest head scratchers to PTs and doctors.