Asheville is a pretty active town. We tend to walk more than most Americans (I think) and we enjoy taking advantage of the beautiful hiking, biking, running, climbing and boating opportunities in the area. Unfortunately for many of us, this leads to sore muscles and painful joints. Having seen the commercials, we often turn to non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen, ibuprofen, ketoprofen or aspirin to handle this inconvenience. In fact I know of cyclists and runners who eat so much ibuprofen it should be considered a dietary staple! Vitamin I, they like to call it. But…

One of the problems with long term use of NSAIDs is that they actually interfere with your ability to rebuild the cartilage that is necessary for healthy joints, leading to loss of cartilage. As the cartilage plate thins, inflammation and joint degeneration worsens, usually leading to even more dependence on the NSAIDs for relief until nothing is effectively able to take the pain away and the use of the joint is completely lost.

Another major issue with high dose and/or long term use of NSAIDs is the damage to the GI tract. According to the American College of Gastroenterology, NSAID use is the second leading cause of ulcers. In addition to the dangers of internal bleeding, perforation of the bowel, or obstruction of the bowel from an ulcer, digestive function is reduced by the damage and leads to decreased absorption of nutrients which in turn leads to decreased function of other organs and tissues.

Many people have become aware of the risks associated with NSAID use and have turned their attention toward NSAID alternatives. Every health store in town peddles dozens of alternatives to NSAIDs. Rather than going into all the nifty alternative therapies, I want to take some time to discuss the often overlooked side of all this. What people tend to forget, is that pain is just the messenger… don’t kill the messenger!

Until you find out why your knee hurts or what is causing your back to spasm, doing things to take away the pain and continue on with your life will only lead to further damage. I’m not saying you should go around in pain all the time or that taking these pain medications isn’t ever a wise decision. However, if the pain is managed without ever attempting to address why you hurt in the first place, you run the risk of progressively making the problem worse or even overlooking a potentially deadly problem; for example, cancer can hurt and feel just like a typical muscle strain.

If you are an active person and keep injuring joints or straining muscles without having high speed collisions with other people, your pain is probably coming from the way you move yourself around. A very quick assessment of how well you perform fundamental movement patterns such as lunging, stepping over, squatting, holding yourself in the top position of a pushup, etc., can point out even subtle dysfunction in the way you move or imbalances between the left and right side.

Research suggests that imbalances between the capabilities of the left and right side of your body are more predictive of future injury than any other factor except a past history of injury. If your fundamental patterns are solid and you don’t have a left-right imbalance, then the next place to look would be your specific activity mechanics. Running coaches, cycling coaches, ergonomic specialists for your job, etc, can all provide important and helpful feedback relative to this kind of issue. Once you understand the reason you are hurting, it would be very appropriate to focus on taking steps to reduce your pain so that you can correct the dysfunctional movement.

Lastly, a diet high in vegetable oils, trans-fats/hydrogenated and partially hydrogenated oils, grain-fed beef and fish, grain-fed dairy and processed foods is pro-inflammatory. A diet low in vegetables, cold water fish, grass-fed herd animals, fermented foods, and undamaged olive oil is pro-inflammatory. If either of these lists accurately describes your diet more than 80% of the time and you have recurring aches and pains, you will do yourself a very big favor by making some changes to increase vegetable intake, increase grass-fed animal products, increase unheated olive oil intake, and lower your consumption of processed foods and vegetable oils.

Taking NSAIDs or alternative anti-inflammatories in the face of a pro-inflammatory diet and poor movement patterns is going to prove about as effective as bailing a torpedoed boat with a thimble! On the other hand, following a diet as described and having a good screening and some corrective exercise is the equivalent of avoiding the torpedo altogether.

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