MORE ON RECOVERY...

The primary goal of training is to stress the systems and structures of the body enough to cause adaptation. As the body adapts, it is better able to meet the challenge of subsequent stresses (training or racing), resulting in improved performance. If the body is stressed beyond it's ability to withstand or adapt to the stress, decreased performance will result. Therefore, athletes and coaches sometimes walk a fine line between optimal and excessive stress. In order for athletes to maximize their training, they must commit to actively managing their recovery. With this in mind, consider the effects of anger control, psychosocial stress and non-steroidal anti-inflammatory drugs (NSAIDs) on the healing process:

Anger & Psychosocial Stress

A recent article by the BBC, picked up on Joel's blog, reported on a study which examined the link between anger control, and the time it took for a blister to heal. The authors induced a blister on the forearms of 98 people, and monitored the healing process over 8 days. They found that "individuals exhibiting lower levels of anger control were more likely to be categorized as slow healers", and these same individuals also had a higher cortisol response to the initial injury. People who demonstrated good anger control healed significantly faster than those who had poor anger control.

("Deb" is probably not a fast healer)

Likewise, several studies demonstrate that psychological stress can result in reduced immune function, or more frequent and severe bouts of asthma in asthmatics.

The take home message for athletes is not that they should avoid stressful situations - that would be impossible - but rather that by learning to manage their response to stressful situations, they can give themselves a better chance of staying healthy and adapting appropriately to training.

NSAIDs
Products that contain ibuprofen are part of a class of drugs knows as NSAIDs (e.g. advil, motrin), and are available without prescription. Some athletes may take NSAIDs to combat the pain of DOMS (delayed onset muscle soreness) following difficult or novel workouts, while others sometimes take NSAIDs during long distance events to manage muscle pain. There is a growing body of research indicating that NSAIDs interfere with the normal regenerative process in muscles, tendons and ligaments (but not bone), essentially halting the critical processes which lead to adaptation. For a quick opinion on NSAIDs and recovery, follow this link. For a short review in a peer-reviewed journal, refer to A.L. Mackey's "Use of anti-inflammatory medication in healthy athletes - no pain, no gain?" (Scand J Med Sci Sports 2007: 17:613-614). For those who think they can use acetaminophen (eg. Tylenol) instead, the effects of acetaminophen on soft tissue recovery seem to be similar to NSAIDs.

The take home message for athletes is that NSAIDs are probably not beneficial for the management of minor aches and pains due to training, as the adaptive processes in soft tissue are hindered. Athletes should employ the RICE (Rest, Ice, Compression, Elevation) approach for minor issues, and seek professional medical advice for chronic or more severe injuries.