Each and every time we head for a workout (gym or otherwise), we go with intention to make improvements. I don’t know too many people that are performing regular exercise out who aren’t trying on some level to get better, whether it be a better physique, better health or better performance in a sport. Better muscle equals a better physique, better health and better performance! Therefore, at least some of your workout time is dedicated to developing muscle, even if you don’t think so. Those who never lift a weight and focus on cardio training are still developing some level of muscle efficiency, even if not a larger muscle. To recap, if you’re training in the gym or in a sport, you NEED better muscle. With this in mind, I want to explain why one of the things you may be doing very often can be absolutely sabotaging your muscular improvement.
First, let’s have a short lesson on muscle physiology. Anytime we subject our body to intense training, we are actually inducing a level of trauma to the muscle. While this sounds like a bad thing, I promise you it’s good for improvement. This damage then activates parts of the muscle cell called “organelles” to activate “satellite cells” located on the outer part of the muscle cell membrane. The satellite cells then head on over to the site of muscle damage, where they work on repairing. Often, the satellite cells give rise to immature myoblastic cells that may fuse together with the existing muscle fiber, causing a certain level of cellular growth, which is called hypertrophy. They can then further increase muscle cell cross sectional area by differentiating (turning) into myofibrils and create new nuclei. Finally, satellite cells also can create new muscle fibers in response to resistance training, which is called hyperplasia. The end result of a few more complex processes is that the muscle becomes more effective at contracting and further repairing, thus making a stronger and more efficient muscle! The take home message is that satellite cells are pretty important in muscle repair, recovery and improvement!
What are you doing that is disrupting with this process? Look no further than your medicine cabinet to find the answer. It’s your pain reliever. The typical way that athletes deal with pain is to pop a few Advil, Tylenol or Aleve. Why is this a problem? The satellite cell pathway described above relies on the presence of growth factors. One of the growth factors are inflammatory prostaglandins. NSAIDS like ibuprofen, acetaminophen and naproxen inhibit the cyclooxygenase (COX) enzyme and therefore inhibit prostaglandin synthesis. Other studies have shown that the COX-1 and COX-2 pathways are specifically related to satellite cell activity. Bottom line, those little pills you take are NOT helping you recover. They may dull some pain, but don’t count on them helping you become a better athlete. In fact, they may indeed DESTROY your otherwise good results!
What should you do then? Fantastic alternatives to NSAIDs for pain relief are some of the things I often talk about.
- Massage Therapy: This can help bring additional oxygen to the muscles and stimulate the removal of the chemicals believed to cause Delayed Onset Muscle Soreness (DOMS).
- Graston Technique: This technique used by chiropractors, physical therapists and other body-work specialists uses metal tools to mobilize soft tissue and minimize new and existing scar tissue formation. While official “Graston” tools are only available to professionals, many other devices that can do the job are on the market as well. Lately, it has been a popular home-care option, although I frequently caution my patients that without training, these instruments used incorrectly can cause more damage than stimulating repair.
- Chiropractic Care: By influencing the range of motion of the joints, chiropractors allow the body to function at its peak potential. The joints of the spine are known to directly affect the nervous system and therefore will affect pain levels. Most top-level athletes (Tom Brady, Tiger Woods, Jerry Rice, Phil Heath, etc…) see their chiropractor at least a couple times per month!
- Topical Pain Reliever: KinetiCream is a topical pain reliever that I developed along with other physicians. KinetiCream has specific ingredients that are known to produce anti-inflammatory effects in the tissue just minutes after application. The ingredients are shuttled into the joints via transdermal carriers. Why is this not the same problem as the NSAIDs? Because by using a topical, you are able to target the joint rather than using a systemic drug that doesn’t discriminate joint from muscle. I do not recommend using KinetiCream on the muscles shortly after a workout. If you do want to use it on a sore muscle, wait for 24 hours. This way, the prostaglandin activity will have already taken place and the muscle cell repair process will not be interfered with.
Hopefully, you will take this information into consideration the next time you reach to the cupboard for that “quick fix” for pain. I didn’t touch on the negative side effects to the liver, kidneys or stomach that NSAIDs are known to have, but if your goal of training is improvement, do I really need to?
References (A couple of many):
Local NSAID infusion inhibits satellite cell proliferation in human skeletal muscle after eccentric exercise – Journal of Applied Physiology November 1, 2009 vol. 107 no. 5 1600-1611
High doses of anti-inflammatory drugs compromise muscle strength and hypertrophic adaptations to resistance training in young adults – Acta Physiol (Oxf). 2018 Feb;222(2). doi: 10.1111/apha.12990. Epub 2017 Nov 30.