On Injury & Inflammation, Part I: the good, the bad...and a badly sprained ankle.

We all hear about how inflammation is bad stuff. In a way, some people see all inflammation as a bad thing,  but providing we give ourselves proper time for recovery and adaptation there are instances where inflammation is the right thing to push our fitness to the next level. Other times inflammation results in acute injuries and overtraining.
Recently, I dealt with the frustration of a bad sprain in my ankle (not appropriate inflammation!). "Oh Patrick, we ALL get them. Shake it off." Unfortunately, this was my first ankle sprain EVER. I'm not known for the most stable feet on the trail, but I'm certainly known for the most durable ankles. I was horrified with the swelling, bruising, and aching pain that developed from the trauma. The blessing is that I was able to get off my feet and control the swelling and inflammation through ice, elevation, fluids, and plenty of anti-inflammatory foods/supplements. I had a pretty tough time with several of the ankle tendons and saw PT for rehab who diagnosed it with a class II mid-ankle sprain.

An introduction to inflammation: Welcome to my world
I deal with inflammation on a daily basis whether it is through seeing a patient with systemic body infections in the ICU or my aching muscles/tendons that are feeling the strain of training load. In medicine, we try to limit the damage done by the inflammation brought on by disease process and/or trauma. Whereas in sport, we focus on creating inflammation (workout) -- but not too much--and the ability to adapt from those stresses (recovery.

How inflammation develops in the athlete
The very event of "working out" generates inflammation in the body. The movement of substrate, fluid shifts, and blood gases create a volatile environment in which our body is perfectly adapted to deal with. Yes, that's right: exercise is natural. Back before we all worked behind desks or machines,  many people called it manual labor or daily farm chores. But one should never be afraid of exercise doing them harm!
The element of work is quickly followed with the period of recovery and subsequent adaptation-- substrates from food, hydration, and intracellular mechanisms (the details of which are for a different post!). Work followed by rest; we adapt from the stresses on our body. In the case of an athlete this adaptation means performance gains.

How inflammation can hurt us
There must be a time of recovery from the stresses of training. Adaptation is only after the body is ready for more work. Increasing volume, intensity, or having a change in the kind of activity (including spraining your ankle, doh) too quickly means the stress mounts up faster than the body can adapt. In the athlete this detrimental event can be seen as a drop in performance (HR, watts, pace, etc.) or outright injury.


So how do we keep inflammation in check and use it to our benefit? check out Part Two