>Gina Kolata of the NY Times reports that many athletes, both professional and amateur, often have difficulties in finding the right approach when they injure themselves. They spend thousands of dollars visiting physicians who are confident that they can help, but too often, the procedures are not very helpful.

Research clinicians are questioning the benefits of certain procedures recommended by physicians. Their concern is that there is little “credible evidence” to back up many of the methods that their colleagues use (1).

Most physicians would probably agree that the pain their patients experience is due to excessive levels of inflammation. Inflammation is essential for good healing, but it is just as important that inflammation be a controlled event.

“Inflammation is the immune system’s response to injury and infection, and quick decisions must be made when one or both are present. If the immune system detects an infection, it also looks for signs of injury (broken cell parts, spilled cell constituents). The reverse holds as well — after sensing an injury, the immune system searches for telltale signs of the presence of microbes launching an infection. In many cases, both an infection and an injury set off an inflammatory response. After massive tissue damage caused by trauma …, a systemic inflammatory reaction can set in (2).”

Tissue injury is associated with “an inflammatory soup bathing small nerve fibers”. The immune factors, cytokines, that make up this “soup” are initially pro-inflammatory (2).  They trigger inflammation, resulting in pain sensation that occur throughout the body, including in the brain.

When athletes are injured, the key is for the body to heal the injury, and then down-regulate, “calm-down”,  the inflammatory response and return to immune homeostasis.

(1) www.nytimes.com/2011/09/05/health/05treatment.html?ref=health
(2) www.gluegrant.org/inflammation101.htm
(3) www.ncbi.nlm.nih.gov/books/NBK57275/