Forget the R.I.C.E Method: Part 2 of 3

Since swelling inside of the injured tissues is a byproduct of the inflammatory pathway, it is important to note this process can either be expedited or delayed. But the next logical question should be: Do we want to delay the inflammatory process after an injury?

If you’ve read my earlier blog in this series (if not, no worries, you can read it HERE), you’ll know how I am not a fan of icing after an injury. Ice certainly delays and reduces the amount of swelling after an injury has occurred.

In order to unpack this even more, we must travel down to the cellular level. When an injury occurs the following inflammatory mediators immediately increase in the body:

Can going gluten free reduce inflammation?

We have been tracking the effects of gluten, especially the protein within gluten - gliadin, for quite some time now in clinical practice. The research world has looked at a variety of other proteins in wheat which might also trigger a serious inflammatory cascade.

One such protein is amylase-trypsin inhibitors (ATI). This protein has been shown to spike both the inflammatory pathway and the global immune response. This is one reason why going gluten-free before surgery can potentially reduce your post-operative swelling significantly.

Just as an aside, on a purely anecdotal basis, a close friend of mine tore his ACL while playing professional soccer in Australia. He returned home for surgery and post-op rehabilitation. He went gluten-free leading up to his surgery and the doctors were astounded at how little post-op swelling he had. To this day, he still credits going gluten-free as a major contributor to his successful recovery from the operation.

According to Hyde and Gengenbach, magnesium is the second most abundant intracellular cation next to potassium, and is a cofactor in more than 300 metabolic reactions. Other words, magnesium is basically involved in every metabolic pathway.

For example, connective tissue relies on a healthy supply of magnesium. Tissue such as elastin, glycoproteins, proteoglycans, and collagen all depend on magnesium for proper healing.

Magnesium deficiencies have been linked to depression, fibromyalgia, and myofascial pain syndrome (MPS). It appears the United States possesses one of the lowest baseline magnesium levels in the world since 1900. An inadequate intake of magnesium has been shown to be pro-inflammatory.

Researchers Weglicki and Phillips found that feeding rats a magnesium-deficiency diet increased their Substance P levels within 5 days. Substance P is a biomarker for the pro-inflammatory state.

Again, not to bore you with biochemical details here, but you could literally (not figuratively) eat your way through the healing journey by avoiding dairy and gluten and increasing your magnesium intake. See? No ice needed.

This one will take some math, so get out your phones (I almost said calculator, but everyone just uses their phones these days, right?!).

If a person is tall, enjoys soccer (especially Liverpool FC), his favorite human is Mary Kate, and he just so happens to weigh… let’s say 185 pounds (because he actually weighs 185 pounds). Here’s how this gets all worked out:

185/2= 92.5 ounces of water each day, which equates to ~6 16oz bottles of water.

In a counter-intuitive way, drinking more water helps reduce soft-tissue swelling. Here’s how that’s even possible: When you are dehydrated, your body acts to retain as much water as possible to the vital cells functioning. When you are hydrated, the swelling goes down safely because of the sheer volume and motion of the fluid dynamics in the body. Most notably, the lymphatic system, when triggered by muscle contractions, picks up a significant amount of tasks of reducing swelling. This can only happen if you are hydrated!

This one might come as a surprise, but sleep has been the best kept secret for professional and high-achievers. It has been said that LeBron James slept 12 hours a day (not consecutively) during the Los Angeles Lakers' run to the NBA Championship in 2020.

If you, like many of our patients, are in need of some ideas, tips and strategies to sleep more soundly and for longer, I would highly recommend you listen to this interview I had a few years ago with Jason Silvernail, PT. Jason outlines the exact strategy high performance individuals and high achievers do every day to sleep soundly. Here’s a hint: They establish a routine!

When our sleep is irregular, we rely heavily of caffeine and adrenaline. Both are useful resources in which we can use to accomplish large amount of tasks and activities - for a period of time! Once we hit our threshold and the adrenaline and caffeine ware off, we are left with these pro-inflammatory chemical mediators. We know that too little sleep causes an immediate influx of prostaglandins and proinflammatory cytokines. Similarly to dietary triggers, too little sleep triggers the same pro-inflammatory pathway in the body. It’s also a doom loop, whereby too little sleep causes an increase in inflammation, which causes an increased sensitivity to nociceptors, which causes difficulty sleeping. Some patients have even reported a condition known as hyperalgesia, where even the feeling of the bedsheets at night causes a massive increase in pain and discomfort.

Now, there is good news!

The Anti-Inflammatory Checklist