If you’ve ever been injured before, I’m sure you’ve heard of the term: “inflammation”. Even if you haven’t been injured before, you’ve probably heard it from doctors, friends, family, commercials, as something that is to be avoided at all costs.

Or is it? What is inflammation, anyway? Is it actually as bad as everyone makes it sound?

There are two main types of inflammation: Acute and Chronic

Acute inflammation is actually a GOOD thing. Just keep this in mind: our bodies are made to heal, and for most injuries, that starts with the inflammatory process. Acute inflammation happens right after an injury, and is the start of the healing process as well as your body’s way to ward of infection. Think back to the last time you had a bump, cut, or the last time you sprained an ankle. Right after you injure yourself, you may see and feel immediate warmth, redness, and swelling, pain and loss of function. A normal inflammatory cycle should last about 7-10 days. During this time, here’s what’s happening under your skin:

1. After an injury, specific immune cells release signals to the body to begin the inflammatory cycle.
2. Blood vessels in the injured area dilate (vasodilation), causing increased blood flow to the region.
3. This contributes to the swelling in the region as proteins, other inflammatory cells and fluid leak out of the vessels.
4. Other inflammatory cells that come to the area have a variety of different purposes: Some come as soldiers to ward off bacteria or “foreign invaders”, some are there to clean up damaged cells, and some are there to monitor the situation.
5. That sensitivity or increased pain you may feel immediately after an injury is also due to a mediator released at the time that increases the sensitivity of nerves in the injured area.

So what why are people freaking out about inflammation? Why do you see so many commercials about “anti-inflammatory” diets, or why are all of our problems and pain blamed on “inflammation?

Well, too much of a good thing is never really a good thing, and sometimes your body may overreact to injury, infection, threats, or even perceived threats. When inflammation becomes chronic, that’s when those “clean up” cells can’t find anything to clean up, so for people with chronic inflammation, these cells start going after your own healthy cells and tissues. In these instances, action needs to be taken to decrease inflammation in the area. For some people, chronic inflammation may actually not be localized just to an injured area, but rather through the entire body. This can be from repetitive injury, as well as repeated exposure to even perceived threats, such as stress and anxiety. Having systemic (whole body) chronic inflammation isn’t great, and can increase your risk of health issues such as heart disease, Alzheimer’s, arthritis and cancer. This is where those anti-inflammatory diets or foods, and healthy, lifestyle choices are very helpful for many people.

For some people with injuries that happen over repeatedly in the same area, the inflammatory process never gets to resolve before it’s started all over again, leading to chronic issues. In those cases, things such as steroid injections can used to tramp down the inflammatory process. There are other treatments where “restarting” the inflammatory cycle helps. In these cases, the tissue is actually irritated to the point where the inflammatory process starts over again, but this time, you can monitor the progress and prevent it from getting chronic.

For repetitive injuries, the best thing to do is to find out what is causing the injury in the first place. One of the most common and well known injuries of this type is tendonitis, which is inflammation of a tendon. Let’s take tennis elbow as an example. Tennis elbow is when the tendons of the forearm that attach to the outside of the elbow are injured repeatedly, leading to chronic inflammation of the tendon, which may cause long term damage to the tissue. For some people, one steroid injection is enough to abolish the inflammation and pain forever. However, most people may have a period of relief with the injection followed by return of their pain. Why is this? Well, it’s not that the injection “wore off”, it doesn’t quite work like that. Rather, after the injection took care of the lingering inflammation, that person returned to doing the same activity that caused the inflammation in the first place, effectively re-injuring that area, and restarting the chronic inflammatory cycle.

Lets take our tennis elbow problem as an example. If you’ve actually gotten tennis elbow from playing tennis, it may be that you have weakness in your shoulder, or even through your hips or core so that on the follow through of your swing, you’re putting way more force through the tendons in that region than what it is built to handle. After a match, it’s sore, tired, inflammed. But you play tennis about 3 times a week, so every time you play, you’re overloading that tendon, causing injury, which causes inflammation.

In summary: Inflammation is good right after an injury, but bad if it lingers on for too long. If you’ve got chronic or recurring pain in an area that just does seem to go away permanently, take a look at how you’re doing certain activities, as well as how you’re managing things such as stress, anxiety, or depression. If you’ve got questions, I’m here. Feel free to shoot me any questions through the contact form, or leave a comment below!