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Keeping inflammation and swelling to a minimum is vital to healing and pain management. While there are a number of medications available for this purpose, like all drugs, they come with a set of potential side effects. In the first few weeks after surgery, anti-inflammatory medications are prescribed and are an important part of the healing process. Likewise, the use cold therapy in the form of cold packs or ice water circulating machines is routinely used. Personally, I try to avoid using drugs and their potential side effects when not absolutely necessary. As a long term strategy, I prefer the use of food based anti-inflammatory's (see SUPPLEMENT page) and the liberal use of ice packs. These packs contain a kind of gel that once removed from the freezer, will stay cold and yet be flexible enough to conform to the area to which they are applied with the help of an elastic bandage. The use of bags of frozen peas is another effective method. Ice cubes or snow in a plastic bag also works, but the resulting melt water can be messy. I only use that option when ice packs are not handy and it is better to use that method than to wait until you can get to your ice packs. I apply cold therapy as soon after an injury, skiing or other strenuous activity as possible. I find the sooner the better works best. The accepted protocol is to ice for 20 minutes and then remove for 20 minutes. This produces a kind of flushing effect by contracting the tissues and then allowing them to expand again which creates a kind of fluid pumping action. This fluid exchange allows the body to more effectively counter the effects of swelling which are pain and stiffness. UPDATE As indicated on the supplements page, there are several food-based anti-inflammatory options available to replace or reduce the need for anti-inflammatory drugs. While the new class of drugs, the so-called COX-2 inhibitors are more effective with fewer side effects than older anti-inflammatory medications, they still present unacceptable side effects for many people. Vioxx, in fact, has been recalled due to it's dangerous side effects. Additionally, while they effectively inhibit the COX-2 enzyme (which is associated with the inflammatory process), there is some evidence that suggests they may inhibit the growth of new cartilage...essential to joint function. For a year, I have been using a supplement that contains the pulp and rind of the mangosteen fruit (Garcinia Mangostana). This rain forest botanical has a long history in folk medicine among the people of Southeast Asia and now has 30+ years of scientific research to substantiate it's remarkable reputation as a "good for what ails you" wonder of nature (click on the first 6 items on my links page to go to abstracts of medical studies on PubMed). One of it's many reputed uses is as an anti-inflammatory. As it's summer, surfing has replaced skiing as my 'thrill' sport 'till the snow flies again. Of course, I'm still bicycling regularly. My right knee does not like the rotational forces encountered in surfing and it let's me know with pain and swelling following a surf session. I must constantly ice after surfing. That was until I started taking mangosteen daily. Amazingly enough, the anti-inflammatory effect is so pronounced, that while I still sense a little soreness (to be expected with my many surgeries), I have not needed an ice pack at all unless it was a particularly vigorous day of wave riding. This anti-inflammatory effect carries over to my recently repaired right shoulder, a sore left wrist and a ganglion cyst in my left ring finger. All have responded with a marked reduction in pain, swelling and stiffness. Additionally, two people I have told about mangosteen have had a complete remission of their chronic and severe gout symptoms. To me, this confirms mangosteens' claims as a potent anti-inflammatory...and that's just one of this potent botanicals medicinal uses.
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