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NSAIDS not effective for soft tissue injuries
NSAIDs Hamper Ligament and Tendon Healing
Commonly used NSAIDS, Ibuprofen, Advil, Motrin, Naproxen, Aleve, Naprosyn, Celebrex.
The following statement comes from a well-known sports medicine book that has gone through five printings. “In spite of the widespread use of NSAIDs there is no convincing evidence as to their effectiveness in the treatment of acute soft tissue injuries.” (Bruckner, P. Clinical Sports Medicine. New York City, NY: McGraw-Hill Book Company, 1995, pp. 105-109.)
This is a true statement, but definitely not strong enough. More appropriate would be something like, –In spite of the widespread use of NSAIDs there is substantial evidence that they hamper soft tissue healing.–
NSAIDs have been shown to delay and hamper the healing in all the soft tissues, including muscles, ligaments, tendons, and cartilage. Anti-inflammatories can delay healing and delay it significantly, even in muscles with their tremendous blood supply. In one study on muscle strains, Piroxicam essentially wiped out the entire inflammatory proliferative phase of healing (days 0-4). At day two there were essentially no macrophages (cells that clean up the area) in the area and by day four after the muscle strain, there was very little muscle regeneration compared to the normal healing process. The muscle strength at this time was only about 40 percent of normal.(Greene, J. Cost-conscious prescribing of nonsteroidal anti-inflammatory drugs for adults with arthritis. Archives of Internal Medicine. 1992; 152:1995-2002.)
The authors concluded that NSAIDs might delay muscle regeneration, when their study did in fact show delayed muscle healing. But you know politics…
Another study confirmed the above by showing that at day 28 after injury the muscle regenerative process was still delayed. The muscles of the group treated with Flurbiprofen (NSAID) were significantly weaker. The muscle fibers were shown under the microscope to have incomplete healing because of the medication. (Almekinders, L. An in vitro investigation into the effects of repetitive motion and nonsteroidal anti-inflammatory medication on human tendon fibroblasts. American Journal of Sports Medicine. 1995; 23:119-123.)
The key question regarding the healing of sports injury is, “What exactly does any therapy do to the fibroblastic cells that actually grow the ligament and tendon tissue?” Treatments that stimulate fibroblast proliferation will cause ligament and tendon repair and will help the athlete heal (such as Graston Technique see my website or www.grastontechnique.com). Therapies that kill or hamper fibroblastic growth will be detrimental to the athlete.
It is clear that NSAIDs inhibit the fibroblastic growth process and thus diminish an athlete’s chance of healing. NSAIDs are used because they decrease pain, but they do so at the expense of hurting the healing of the injured soft tissue.
Do you see the difference between pain relief and healing? The athlete needs healed tissue. Up until the present, too many studies were advocating NSAID use when it came to ligament injuries, because they were such great pain-relievers, when in fact they were and are stopping the healing mechanisms of the body. Any technique or medication that stops the normal inflammatory process that helps heal the body must have a long-term detrimental effect on the body.
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