Turmeric seems to be hit or miss. Helps some and indifferent with others.

My whole point the foam roller is that it is not the be all and end all and don’t do it in pain. Glad you understand the limitations!

rock on and thanks for the comments!
Mike T Nelson

Glad you are loving the R Phase! Nice! Are you going to the R Phase Cert? It is a blast and let me know if you have any questions on it.

Thanks for the great NSAID info! I actually agree with about 95% of it. I am not personally a big fan of them for many of the reasons listed above. Although I think that acutely they may serve a use to keep people from associated pain from certain movements (again, be VERY careful during this time if you still lift or play) while not affecting hypertrophy perhaps.

I personally like to use other options such as turmeric, cat’s claw, fish oil and proteolytic enzymes at high doses between meals.

Rock on and thanks again
Mike T Nelson

I subscribe to the Crossfit Journal, which is an awesome online resource. The following information is from a discussion about NSAIDs and injury healing. The comments are from Kelly Starrett, DPT, a brilliant physical therapist, athlete, and owner of Crossfit San Fransisco. It is a little long, but cites many studies and medical journal articles.

“2) The technical evidence about NSAID’s affecting tissue healing IS what I’m basing my discussion on. My friends know that I was all about the Ibu until I began working as a physical therapist in a world class Sports Medicine clinic where:
Minimizing NSAID’s use was the clinical standard for care (ligament ruptures, tendon ruptures, tendonopathies, surgical reconstruction, etc). This is directly in response to the literature (best practice) and the clinical experience of nearly 20 years of treating high level sports injuries. (About a billion famous high end athletes were treated there as well as normal folks). This clinical experience coincides with the literature: For example, the following is a study that reports faster return to duty with the use of NSAID’s in a good study.
But reports (even in the abstract) that quote: “Interestingly, subjects treated with piroxi cam showed some evidence of local abnormalities such as instability and reduced range of movement.”

A Randomized Controlled Trial of Piroxicam in the Management of Acute Ankle Sprain in Australian Regular Army Recruits
The Kapooka Ankle Sprain Study
Mark A. Slatyer, BMedSci, BMed, PhD, FAFPHM

3) Tylenol is horrible stuff. So dangerous in fact that the FDA changed the dosages because it is the number one way to kill your liver. No question here.
Again, the best practice in the clinical setting in which I was part was to treat swelling with ice, and tylenol (under an Md’s guidance) for pain. Never, never drink and take tylenol.

4)You bring up an excellent point about the “other issues” of taking anything for pain. Ibuprofen has been shown across the board to be murder on the stomach and be the number one cause of bleeding stomach ulcers. I have personally witnessed several athletes in the clinic taking hidden ibu (not cleared with their doc and not cases of poly-pharmy) end up in stomach surgery after becoming anemic secondary to GI bleeds.

5) There is good evidence that Ibu/nsaids mess with renal function and may lead to hyponatremia.

NSAID use increases the risk of developing hyponatremia during an ironman triathlon
WHARAM Paul
(1) ; SPEEDY Dale B. (1) ; NOAKES Timothy D. (2) ; THOMPSON John M. D. (3) ; REID Stephen A. (4) ; HOLTZHAUSEN Lucy-May
Medicine and science in sports and exercise 2006, vol. 38, no4, pp. 618-622

Additionally, the evidence is strong that NSAID’s like ibu put significant downstream load on the kidneys. Since many of us are running around with high CPK levels secondary to our hard training, taxing kidney function probably isn’t necessary.

6.) My doctoral training includes courses in pharmacology and histopathology. The mechanisms of prostaglandin suppression and the subsequent halting of the inflammation cycle are well known. What is not well known, because the long term longitudinal studies in humans are hard to come by, is what the long term effects of nsaid use are. Clinically, first hand, I’ve seen stress fractures, heal cord ruptures, rotator cuff tears that existed in the presence of athlete typical self-medicating nsaid dosages. (I know it’s only “black box” clinical experience and not and RCT.

7) Are other alternatives to nsaids suggested in the this CLIP of a 7 hour lecture? No. In the other parts of the lecture, yes. Of course.

An excellent editorial from this Feb 2009 in the American Journal of Sports Medicine draws many of the same conclusions.
Feeling No Pain
Bruce Reider, MD
Am J Sports Med February 2009 vol. 37 no. 2 243-245
–Nsaid use is extremely widespread
–Nsaid use should be used cautiously because of potential downstream effects.

9) Where the “hell” this advice comes from: Kelly Starrett DPT, formerly a full time sports medicine practicing therapist a world class sports medicine clinic called The Stone Clinic. Now in private practice. Everyone in that lecture knew this. I’m sorry it’s not clear. I can certainly see that it would be even more disconcerting if this was just coming from Kelly Starrett Crossfit Coach.

10) Good point about hand ripping and liver failure.

11) This video tells you several other factors that affect tissues healing times.
Again, it is the opinion of the practice group (MD’s) of which I’m part that due to the scientific literature and long/vast clinical experience, NSAIDS affect tissue healing.

Effect of ibuprofen and diclofenac sodium on experimental would healing.
Dvivedi S, Tiwari SM, Sharma A.
Indian J Exp Biol. 1997 Nov;35(11):1243-5.Links

The Role of Nonsteroidal Anti-Inflammatory Drugs in the Treatment of Acute Soft Tissue Injuries
Jay Hertel, MEd, ATC
J Athl Train. 1997 Oct–Dec; 32(4): 350–358.

Indomethacin and Celecoxib Impair Rotator Cuff Tendon-to-Bone Healing
David B. Cohen, MD*, Sumito Kawamura, MD§, John R. Ehteshami, MD|| and Scott A. Rodeo, MD
The American Journal of Sports Medicine 34:362-369 (2006)

Effect of ibuprofen on the healing and remodeling of bone and articular cartilage in the rabbit temporomandibular joint.
Obeid G, Zhang X, Wang X.
J Oral Maxillofac Surg. 1992 Aug;50(8):843-9

Anti-inflammatory treatment of muscular injuries in sport. An update of recent studies.
Almekinders LC.
Sports Med. 1999 Dec;28(6):383-8.

Inhibition of tendon cell proliferation and matrix glycosaminoglycan synthesis by non-steroidal anti-inflammatory drugs in vitro.
Riley GP, Cox M, Harrall RL, Clements S, Hazleman BL.
J Hand Surg Br. 2001 Jun;26(3):224-8.

The Mechanisms of the Inhibitory Effects of Nonsteroidal Anti-Inflammatory Drugs…
Harder and An J Clin Pharmacol .2003; 43: 807-815
And:

Comprehensive Sports Injury Management
By Jim Taylor, Kevin R. Stone, Michael Mullin, Todd Ellenbecker, Ann Walgenbach
Pg.s 77-85
Isbn 0-89079-891-5″