Resources - Injuries

Inflammation

by Jake Kennedy, RPT

Why does it still hurt? How come it hurts more in the morning? Why did it happen if I didn't do anything different? These commonly asked questions can be answered by understanding the process of inflammation.

Inflammation is the body's natural reaction to any injury. It is the buildup of fluid and cells around the injury site, and is often referred to as "swelling." At times it is clearly visible, as in an ankle sprain, other times it remains hidden, as in lower back pain.

When inflammation occurs, swelling and pain may increase significantly. A minor decrease in swelling can set off a great deal of pain or a great deal of relief. This also explains why a runner thinks an injury has healed, yet gets injured again when returning to the sport.

If you suffer from inflammation, consider alternative exercises and consult your physical therapist or physician. Remember that you must keep your heart rate within the target range (about 70 percent of your maximum heart rate). Great alternatives include biking (three to five miles equals a one mile run), cross country skiing (one mile equals a one mile run), swimming, rowing or using the Stairmaster.

Runners can sometimes feel fine during exercise and still be injuring themselves. If you are working too hard for your heart and lungs, you usually know it. You cannot breathe and usually you get a "stitch" in your side. If you're working too hard for your muscles and joints, inflammation starts to build up. When you stop, the blood flow slows down. The swelling is allowed to slowly collect. Eventually, the brain sets off the process and you can feel the injury. Many times you don't know there is a problem until after your workout or the next morning. This is because while you are exercising, the extra blood flow will keep the inflammation moving.

In the first three to four days after a traumatic injury, you should ALWAYS ice the injured area. If there is still active bleeding from the original injury, heat may make things worse by opening up the blood vessels. Meanwhile, ice initially slows down blood flow and constricts vessels. After the first week, you can apply either ice or heat.

After you return to exercising after an injury, ICE should ALWAYS be used after your activity. If there is still active inflammation (i.e. pain two to three hours after activity), ICE should again be the treatment of choice. ICE should NOT be used immediately before exercise due to increased injury to cold structures. Heat may feel better by relaxing muscles and increasing outside blood flow. Ice feels good because it "numbs" the pain and indirectly increases outside blood flow.