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isobars



Joined: 12 Dec 1999
Posts: 14050

PostPosted: Fri Dec 13, 2013 8:51 pm    Post subject: Reply with quote

Don't forget that ice, like NSAIDS, dramatically impairs healing, according to many but not all studies, by eliminating IGF-1 from the injury. The primary reason for ice is to reduce significant swelling immediately following an acute injury, but it's often hard to draw a line between that and chronic swelling. The usual guideline is 2-3 days, but I'm sure that varies for many reasons.

One source:
Sometimes, Inflammation is a Good Thing (When it produces insulin-like growth factor-1)
by Michael Todd Sapko, MD, PhD

Researchers from the Cleveland Clinic and University of California, San Francisco have demonstrated something that may sound counterintuitive: sometimes, inflammation is a good thing. In fact, in the case of damaged muscle,this study shows that inflammation is a critical part of the healing process. Without inflammation, damaged muscle does not regenerate nearly as well. Moreover, these researchers showed that a substance called insulin-like growth factor-1 is critical to muscle regeneration.

How does one stop inflammation?

Experimentally demonstrating the critical importance of inflammation in muscle regeneration is no small feat. For example, how do you block inflammation? One could use anti-inflammatory drugs, but even then the inflammatory process is inhibited, rather than stopped. Dr. Lu and colleagues used a very special mouse, called a knockout mouse, to turn off inflammation. Knockout mice are genetically engineered to lack a specific gene. In this case, mice were engineered to lack the gene that codes for a protein called CC Chemokine receptor 2 or CCR2. That means these mice grow up without making the protein CCR2.

Before you think to yourself “so what?” you should know that CCR2 is a pretty important protein. While it might not sound very impressive, not having CCR2 is a bad situation for these special mice. If you damage their muscles experimentally, say by depriving the muscles of oxygen or injecting them with a toxin that kills muscle cells, they cannot mount an inflammatory response like normal mice would. Because they do not have CCR2, injured muscle is unable to recruit immune system cells called macrophages. Macrophages are the cleanup crew of the body. They “eat” dead cells and dying tissue (like dead muscle cells). It has been speculated that macrophages also release other factors that promote muscle regeneration.

A mouse without an inflammatory response

In the experiment, scientists injured muscles in normal (wild type) mice and CCR2 knockout mice with barium salt solution. They allowed the mice time to heal, including time for the inflammatory process and muscle regeneration to take place. As expected, knockout mice had essentially no inflammation present. This is mainly because the cleanup crew (a legion of macrophages) was never called to the scene. Likewise, knockout mouse muscle did not regain its pre-injury size and remained smaller than normal mouse muscle.

Three days after the injury, the researchers noticed that macrophages called to the scene in normal mice excreted large amounts of a substance called insulin-like growth factor-1 or IGF-1. Since there were no macrophages recruited in knockout mouse muscle (How could they? They do not have CCR2 receptors), IGF-1 levels in those mice stayed low. Could IGF-1 be playing a role in muscle regeneration after injury?

The most extraordinary finding of the paper was that when IGF-1was injected into the injured muscle of knockout mice, even though they still had no macrophages present, muscle regeneration was nearly completely restored.In other words, IGF-1-treated CCR2 knockout mice were able to regenerate their muscles even though inflammation did not recruit macrophages to the injured muscle.

Macrophages are recruited during inflammation and release a key healing substance: IGF-1

Taken together, this is extremely strong evidence that macrophages must respond to the site of muscle injury for normal muscle healing and regeneration. In addition, the key substance released by these responding macrophages is IGF-1. Therefore, IGF-1 plays an integral role in muscle healing and regeneration.As the authors conclude in their paper, IGF-1 may represent a clinically useful tool to promote acute skeletal muscle injury repair.

How can we apply the results of this research right now?

For years we have been told that first aid for a muscle injury is RICE: Rest, Ice, Compression, Elevation. However this research suggests that applying ice and other anti-inflammatory interventions may be the exactly wrong thing to do after an acute injury. Swelling and pain can be very disconcerting for patients and using RICE can shorten both the duration of swelling and pain, which is probably why it has been traditionally used.However ice and anti-inflammatory drugs like NSAIDs block the inflammatory response. They slow the recruitment of macrophages to the site of injury and, as such, those macrophages cannot release IGF-1 into the affected tissues.

While ice and NSAIDs may make you feel better after an injury, by using those agents, you are preventing the body from repairing itself. At best, this greatly prolongs healing. At worst, you may not regain the full potential of that injured muscle. Resting an injured muscle (temporarily) is still sound advice, but now we know that it is best to skip the ice.

1.    Lu H, Huang D, Saederup N, Charo IF, Ransohoff RM, Zhou L. Macrophages recruited via CCR2 produce insulin-like growth factor-1 to repair acute skeletal muscle injury. FASEB J. Jan 2011;25(1):358-369.

Source: http://drwheatgrass.com/info/newsletters/sometimes-inflammation-is-a-good-thing . It then progresses into a sales pitch, but the part presented here has been reported in dozens of news sources, so it sounds persuasive.
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coachg



Joined: 10 Sep 2000
Posts: 1997

PostPosted: Sat Dec 14, 2013 2:00 am    Post subject: Reply with quote

And the bait has been cast. Who's going to take the first bite? Rolling Eyes

Coachg
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isobars



Joined: 12 Dec 1999
Posts: 14050

PostPosted: Sat Dec 14, 2013 9:13 am    Post subject: Reply with quote

That's exactly why I included the reference: it's not bait: it's information, to be accepted or rejected on an individual basis. I can't argue one way or the other because I've not researched it in depth, but any of you are welcome to present opposing research to us or directly to the researchers named here. IMO, for my personal use, it makes a lot of sense and most of my medical providers, from PTs to ortho surgeons, concur with it once the initial post-injury or post-op swelling abates.
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beaglebuddy



Joined: 10 Feb 2012
Posts: 689

PostPosted: Sat Dec 14, 2013 4:42 pm    Post subject: Reply with quote

That's interesting information Mike and it does seem to make sense.
From age 20 to 40 I had low back pain and when it got bad ice was the only thing that helped and often after a long day of work I would ice my back just to feel better.
I use ice more like a pain killer than for therapy. Right now it's the only way I'm able to get to sleep. I don't really want to go down the road of prescription pain killers, even one aspirin often upsets my stomach.
The MRI did show swelling so I suppose that's good in a way.
Ice or Oxy? which is worse?
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slinky



Joined: 24 Aug 2007
Posts: 412
Location: Old Saybrook Ct.

PostPosted: Sat Dec 14, 2013 5:54 pm    Post subject: Reply with quote

Ice is obviously better, it's not addicting! It can work to speed healing. The key is to not keep the ice on the injury too long. Something like 20 min on, 20 off. This helps increase blood flow to the injured area. It's the only thing that works for my lower back when I have a spasm that won't let up.

I was on oxycodone for a few months. It's hell don;t do it! It can ruin your life!

Check out wheatgrass. I think I saw something in one of isobars links . It really helps! Or at least it does for me.

Suggested reading: "Arthritis interupted" by Dr. Stephen Sinatra.

Food is the best medicine money can buy.

You maybe down, but you are not out. Turn your life around. In a year or two you just might feel better than you ever have!
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madmax7



Joined: 07 Mar 1997
Posts: 556
Location: So Calif

PostPosted: Sat Dec 14, 2013 6:44 pm    Post subject: Hip Reply with quote

There's a website surfacehippy that can help your research

I was diagnosed w both hips being bad at 35, I lived w pain for 10 years, waited a bit too long, but that's what Docs suggest for hip replacement

At 46 got hip Resurfaced. Not Replaced!

4 weeks of PT, was off crutches and back to work in 2 weeks (out of hospital in 2!days), windsurf in 4 months and kiting in 6

Also playing basketball in 8 months

As they say research Doctors. Come to Mainland for a week to get done

Good luck. Max
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isobars



Joined: 12 Dec 1999
Posts: 14050

PostPosted: Sat Dec 14, 2013 6:56 pm    Post subject: Reply with quote

slinky wrote:
Ice ... It can work to speed healing. The key is to not keep the ice on the injury too long. Something like 20 min on, 20 off.

Check out wheatgrass.

Food is the best medicine money can buy.

I'm pretty sure I read somewhere that the IGF-1 suppression from ice can last for days; the 20/20 regimen doesn't solve that problem.

I plan to check out that wheatgrass option next time I encounter chronic pain. So far I've stalled mine for > a decade (crumbling C6 vertebra) with targeted strengthening and, yes, stretching.

Within reason, I submit that exercise is a better "medicine" than food.
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beaglebuddy



Joined: 10 Feb 2012
Posts: 689

PostPosted: Thu Dec 19, 2013 1:39 am    Post subject: Reply with quote

I saw the Dr. today, the news was not good. He feels that repairing the torn labrum by scope will not help the pain, he feels the pain is the result of osteoarthritis, the cyst and bone spurring also from the arthritis, basically my hip is worn out.
I'm stuck in limbo between having it scoped and replacement, because I am "only" 50 they don't like to do replacements on "younger" people because they will wear out a replacement hip in 10 years.
He recommends a shot which will be guided by an xray machine, the shot will relieve pain for 3 to 6 months but I can only have two shots or it may start to damage ligaments and muscle. Not a good day.
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PeconicPuffin



Joined: 07 Jun 2004
Posts: 1207

PostPosted: Thu Dec 19, 2013 8:54 am    Post subject: Reply with quote

May I respectfully say that it doesn't sound like you're talking to a top sports orthopedic surgeon? The answer you got seems very 15 years ago. I don't know where you are, but as someone else suggested earlier, travel to get to the best people possible. In New York City there is the Hospital for Special Surgery, Lenox Hill Orthopedics, and NYU, all of which regularly handle sports surgery for professional athletes (my shoulder was done by one of the New York Jets surgeons.) They are set up for the latest techniques.

BTW I know someone your age who is now wavesailing on two replacement hips...and ripping.

beaglebuddy wrote:
I saw the Dr. today, the news was not good. He feels that repairing the torn labrum by scope will not help the pain, he feels the pain is the result of osteoarthritis, the cyst and bone spurring also from the arthritis, basically my hip is worn out.
I'm stuck in limbo between having it scoped and replacement, because I am "only" 50 they don't like to do replacements on "younger" people because they will wear out a replacement hip in 10 years.
He recommends a shot which will be guided by an xray machine, the shot will relieve pain for 3 to 6 months but I can only have two shots or it may start to damage ligaments and muscle. Not a good day.

_________________
Michael
http://www.peconicpuffin.com
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beaglebuddy



Joined: 10 Feb 2012
Posts: 689

PostPosted: Thu Dec 19, 2013 2:08 pm    Post subject: Reply with quote

As Madmax7 said hip resurfacing looks to be the way to go for a "younger" person like myself.
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