We all like to think that when we go to a doctor, we are going to get good treatment and hopefully a resolution to our injury. Unfortunately, that resolution doesn’t happen as often as it should, leaving patients fed up and frustrated with their injuries. Doctors end up trying to mold the diagnosis into what they happen to be trained in, instead of what the problem truly needs.

What if I were to tell you the most common musculoskeletal problem could be what’s causing a majority of your pain? What if I told you it is completely reversible with the right treatment?

How Do I Know If I Have Adhesions?

Do you have any of the following?

• Pain
• Decreased Range of Motion
• Weakness

If so, chances are you have adhesion, which is a technical name for scar tissue. There are three common pathologies in the human body when it comes to injuries:

1. Adhesion
2. Weakness
3. Degeneration

It is almost completely impossible to have either weakness or degeneration without the presence of adhesion as well. People who try to argue that adhesion isn’t present or that it cannot cause pain, weakness, or decreased range of motion are wrong. In many surgical reports, surgeons note a high amount of adhesion present when trying to fix degenerated tissue. It is one of the most under-diagnosed problems. In many cases it doesn’t show up on MRI or X-ray and is usually completely missed during the diagnostic process.

What Is Adhesion?

The technical definition of adhesion is as follows:

It is a focal area of dense immature collagen fibers. The fibers are laid down by fibroblasts in response to either a hypoxic (lack of oxygen) environment from a crush/tear or sustained contraction (sitting all day at a desk).

The less technical definition goes like this:

It’s like someone poured glue inside the muscle. The only jobs muscles have to do are to contract and relax, but when adhesion is present it causes the need for more force to be applied to contract the muscle. This increased force leads to more tension and a higher production of inflammation in the area.

Adhesion isn’t the same as a trigger point. If we put a cell of a trigger point under a microscope, it would look pretty similar to a healthy muscle. Adhesion has a different look and feel to it. The tissue looks disorganized and the cells are not uniform. This can happen in a muscle, tendon, ligament, or even inside a joint.

When to Seek Help

You’ve already tried self-care to help with your injury, such as:

• Stretching
• Foam rolling
• Mobility work
• Self-myofascial Release
• Medication
• Corrective exercises
• Exercise modifications
• Self-taping

But that hasn’t made much difference. You’ve also enlisted the help of multiple musculoskeletal professionals, such as:

• Chiropractor
• Physical therapist
• Massage therapist
• Corrective exercise specialist
• Acupuncturist
• Primary care physician
• Orthopedic surgeon

But none of those options have worked, either. So if you’ve failed with self-treatment and professional treatment, what’s left? The key to fixing this problem is finding a practitioner who focuses on getting a tissue-specific diagnosis, preferably soft tissue dysfunction. The good news about adhesion is that it is completely reversible with the correct treatment. The point of any treatment is to reverse the pathology.

Finding a Care Provider

This is where it can be a little tricky. Look for these must-haves in getting resolution for your injury.

• Tissue-specific diagnosis. This is a key component of ensuring the right treatment. No treatment can begin unless you know what the problem is in the first place. The diagnosis needs to be complete and accurate. Simply stating something is tendinitis/bursitis/tight is incomplete and lacks true substance. The practicioner should know exactly what tissue is involved so they can get in there and fix it.
• The goal of the treatment. This should always be to remove the dysfunction and return normal capacity back to the muscle, which in turn should allow the area to function at a higher level and relatively pain-free. Trying to work around the injury can often prove to be a bigger problem down the road.
• Progress should be measurable. Everything should have a measurement or benchmark goal to help define where the treatment is going. Relying solely on the patient’s pain level can often lead the doctor in the wrong direction. Having specific, measurable results lets the patient and doctor know they are on the right path to fixing the injury. An example would be taking a measurement of ankle dorsiflexion. A “healthy” ankle needs at least 5 to 6 inches of dorsiflexion to have an optimal range. Until that range of motion is reached, you can’t have a fully functioning ankle. Clean tests determine discharge, not level of pain. If you don’t have full function and capacity in the muscle, the chance for re-injury goes way up.
• 10 to 12 visits. This is usually the sweet spot for fixing the majority of problems that walk through the door. Avoid practitioners who want to see you for anything over 24 visits right out of the gate, because chances are they aren’t the one to fix your problem. It shouldn’t be a long, drawn-out process that takes months. If the practitioner accurately diagnosed the injury and removed the relevant adhesion, the process should take around 10 to 12 visits if there are no other issues. If it is going to take a lot longer, it’s more likely that you have an irreducible block (see below), which won’t respond well to manual therapy. Or the diagnosis could just be wrong.

What About Irreducible blocks?

Irreducible blocks include disc injuries, labrum degeneration, tears, and cartilage damage. If these blocks are present it will shift the focus of the treatment and make it more into a long -term maintenance care. This longer approach will prevent the degeneration from getting any worse and keep you functioning at sub-symptom threshold. In some cases the blocks can be so bad that no amount of conservative care will fix it. These are the prime surgical candidates, which ends up being roughly ten percent of the population.

Save Yourself From Pain

If you find yourself not responding to your current treatment methods, be it self-treatment or professional help, perhaps it is time to consider what you are overlooking. If you have been dealing with an injury for a long time, you owe it to your body to get the problem accurately diagnosed and fixed.

The best soft tissue practitioners in the world will take the time to accurately diagnose your injury. They have the skills to apply the correct treatment to your specific problem. Trying to fix it yourself with various self-treatment methods or whatever the practitioner happens to be trained in will only produce temporary results, if any at all, leaving you frustrated and in pain again. Good luck!

More Like This:

• 5 Effective Ways to Move and Feel Better Today
• What Is Graston Technique? New Tools for Healing
• Active Release Techniques: Putting Tension on Injuries
• New on Breaking Muscle Today

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This inflammatory response in most cases will be the result of micro-traumas affecting muscles, connective tissue, joints, and bone. These micro-traumas are what allow your body to adapt and withstand a similar workout in the future. In fact, regular exercise can even help an athlete adapt enough to lower the level of inflammation in the body. But without the proper level of nutritional support or knowledge of the foods that could cause you inflammation issues, you could be fighting an uphill battle.

This week I will discuss what foods and supplements help to reduce inflammation and what foods could be causing increased inflammation in the body. Unless you are eating and supplementing to account for this, you could be seriously impeding your results and negatively impacting your training sessions.

Anti-Inflammatory Foods and Supplements

The following are some of the foods and supplements that should be added to your diet to help alleviate and control inflammation in the body.

1. Fish Oil – Specifically it is the EPA and DHA found in fish oil or from eating cold-water fish like tuna or salmon that has anti-inflammatory properties. The omega-3 fatty acid can help with joint swelling and inflammation generally caused by the over consumption of omega-6 fatty acids from red meat.

2. CoQ10 – This oil-soluble, vitamin-like substance can be classified as an antioxidant and significantly reduces inflammation and oxidative stress in the body, especially when combined with natural vitamin E. Unlike other antioxidants, CoQ10 can inhibit both the initiation and the propagation of lipid and protein oxidation in the body.

3. Probiotics – Probiotics from either supplements or fermented foods help to build immunity and control infection caused by underlying inflammation in the body by supplying the body with good gut bacteria.

4. Juicing – The process of juicing breaks the cell walls of fruit and vegetables, making the nutrients more accessible and allowing the body to quickly absorb mega doses of vitamins, minerals, and antioxidants, all of which can help combat inflammation.

5. Broccoli – Broccoli is an excellent source of vitamins C and K, beta-carotene, and calcium, giving this humble vegetable great anti-inflammatory properties.

6. Pineapple – Along with being packed with vitamin C, pineapple also contains bromelain. Bromelain helps to break down proteins, aids in digestion, reduces swelling, and can even improve blood circulation.

7. Ginger – Used for centuries for medicinal purposes, ginger shares many properties with NSAIDs (non-steroidal anti-inflammatory drugs), suppressing pro-inflammatory molecules known as prostaglandins with little to no side effects compared to NSAIDs.

8. Turmeric – One of the main spices added to curry, giving it its distinctive yellow pigment, turmeric contains curcumin. Curcumin blocks several inflammatory chemicals in the body. Like ginger it can prevent the production of prostaglandins and be used like NSAIDs with the added benefit of also being a great antioxidant.

9. Extra Virgin Olive Oil – Used in Mediterranean cultures, olive oil helps to fight inflammation in the body. The monounsaturated fats in olive oil are turned into anti-inflammatory agents that help to lower the risks of both asthma and arthritis, and even help to protect the heart.

10. Sweet Potato – Packed full of vitamins B6 and C, manganese, beta-carotene, and fiber, these amazing potatoes are a great addition to any diet. Working in concert, these nutrients are powerful antioxidants that help to heal inflammation in the body.

Foods and Supplements to Avoid

Although not all of the below will cause every person a noticeable issue, in a large portion of the population they do contribute extensively to increased inflammation in the body. A person may even have an issue and not be aware of it or attribute the cause to something else. Knowing what can increase inflammation is a handy tool. If you are already causing inflammation due to your training, there is no need to further increase the problem from uninformed or poor food choices.

The following are some of the biggest nutritional contributors to inflammation in the body:

1. Hydrogenated and Trans Fats – Found in margarine, baked goods, and many processed foods. The oils used are generally poorly made and inferior. Trans fats increase the levels of LDLs (bad cholesterol) while lowering levels of HDLs (good cholesterol) in the body. They have also been found to promote inflammation, obesity, and resistance to insulin.

2. Red Meat From Feedlots – Commercially produced meats are often fed grains like corn, increasing the omega 6 fatty acid profile. Overconsumption of omega 6 fatty acids in our diets promotes inflammation, as the the balance with anti-inflammatory omega-3 fatty acids is lost.

3. Fried Foods – French fries, onion rings, and potato chips are all highly cooked products due to deep-frying. This produces glycotoxins or AGEs (advanced glycation end products) that are known to be inflammatory. AGES have been implicated in everything from Alzheimer’s to cardiovascular disease.

4. Sugar – Sugar is not only an addictive substance but is highly inflammatory. This is because sugar raises insulin levels in the body that in turn trigger an immune response.

5. Dairy Products – The body often has issues in processing lactose and casein from dairy products. Most individuals probably don’t even know they have an issue. Stick with fermented dairy products, as they should result in a lessened inflammatory response.

6. Wheat Products – Gluten intolerance is quickly becoming a major issue in Western society. Wheat is highly inflammatory and acid forming to certain individuals. Not to mention a major portion of wheat production is genetically modified, so avoiding it where possible is a positive thing.

7. Alcohol – Enjoying the odd beverage generally isn’t an issue, but overconsumption can cause a major burden on your liver and promote unnecessary inflammation in the body.

Understanding inflammatory and anti-inflammatory foods is important. Knowing what can be used to help alleviate or exacerbate inflammation in your body might just be the key you have been looking for to boost your next work out and keep your body in tip-top shape.

References:

1. Akhtar, N.; Haqqi, T. M. (2012). “Current nutraceuticals in the management of osteoarthritis: A review.” Therapeutic Advances in Musculoskeletal Disease 4 (3): 181–207.

2. “Dr. Weil’s Anti-Inflammatory Food Pyramid.” Dr Weil. Retrieved December 20, 2012.

3. “Ginger.” University of Maryland Medical Centre. December 2010.

4. Mishra S, Palanivelu K (Jan–March, 2008). “The effect of curcumin (turmeric) on Alzheimer’s disease: An overview.” Ann Indian Acad Neurol 11 (1): 13–9.

5. Covas MI. “Olive oil and the cardiovascular system.” Pharmacol Res. 2007 Jan 30.

6. Lopez-Garcia E, Schulze MB, Fung TT, Meigs JB, Rifai N, Manson JE, Hu FB. “Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction.” Am J Clin Nutr. 2004 Oct;80(4):1029-35.

7. Wall R, Ross RP, Fitzgerald GF, Stanton C. “Fatty acids from fish: the anti-inflammatory potential of long-chain omega-3 fatty acids.” Nutr Rev. 2010 May;68(5):280-9.

Photos courtesy of Shutterstock.

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A variety of things occur to our body during and intense exercise. Muscle damage is one such event, and can result in the delayed onset muscle soreness (DOMS) with which we are all familiar. This muscle damage leads to inflammation that can persist for some time, and which may be responsible for signaling various recovery mechanisms in the body. A recent study in the Journal of Strength and Conditioning went into detail about each of these processes and how long they take.

In the study, researchers subjected the participants to a workout designed to induce a need for recovery. They then tested the blood of each subject three times that same day following the exercise. They tested again a full day, two days, and three days afterward. The participants were elite cyclists who did a squat and bench workout of six sets each, and then cycled for an hour. The workout was pretty intense, probably more so than a normal workout, but within the realm of something a person might actually do.

Researchers found that strength was reduced by about 14% three hours after exercise, but had returned to normal some time between twelve and 24 hours later. Good thing for those of us doing two-a-days.

Researchers also found injury markers in the blood, indicative of the muscular damage that had been done. These took longer to return to normal than the strength, being elevated still after a full day, but returning to normal after 48 hours. The researchers did note that other studies indicated these markers typically took longer to show up and then return to normal, being as long as 72 hours after exercise.

In addition to injury, participants experienced an immune response as well. First, there were neutrophils, which are a kind of white blood cell that removes cellular debris, essentially cleaning out the blood from damaging waste post exercise. These appeared within three hours and were gone after a day. This would indicate a good window in which to keep blood flow high through massage and other recovery means. You don’t want neutrophils to hang out for too long or they may damage the cells as well.

Second to appear were the lymphocytes, which didn’t begin showing up until twelve hours and stuck it through the three days of the study. These probably helped mediate larger cellular damage, but appeared to decline in the presence of antioxidants, and the researchers suggested that recovery was more or less complete by 72 hours.

Interestingly, researchers also learned that the inflammation caused by exercise was only local to the damaged muscles, and had no systemic effect after exercise. The oxidative stress markers also seemed to be non-existent, which they attributed to these particular athletes having a greater level of health.

Ultimately it was inflammation that carried the greatest recovery time within the 72-hour window. The inflammation was ameliorated by white blood cells carried in the blood, and I would guess could be hastened by methods that improve blood flow. I’d also suggest that this study shows people may be waiting too long between working the same muscle, which seemingly needs only about three days to recover.

References:

1. Artur Bessa, et. al., “Exercise intensity and recovery: Biomarkers of injury, inflammation and oxidative stress,” Journal of Strength and Conditioning Research, DOI: 10.1519/JSC.0b013e31828f1ee9

Photo courtesy of Shutterstock.

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