Stupidly, I went over the bars last night and bashed my knee on rock. My knee swelled up and is painful so I’ve been doing the ice and elevation thing today. I started wondering why it is that we aim to reduce inflammation and swelling. Logically, you’d think that the body knows best how to heal an injury, but we over-rule that by taking steps to reduce inflammation.
I’m desperate to get my knee right ASAP, with various MTB trips coming up

Simply put why do we try to reduce it?

1) it hurts, it’s caused by your body floading the damaged area with blood and associated white cells to help your immune system, there are other fluids too but pain of course is an evolutionary method of stopping us causing further harm by stopping you doing the same thing again.

2) “body knows best” is a falsehood, people die from their body’s reaction to attack regularly in the form of shock, in this case prolonged swelling can cause all sorts of problems.

The best method is PRICE – the first two are Protect and Rest – two things MTBers are terrible at, I’m as guilty as anyone else – first Alps trip I twisted my ankle on the second day, rested for a day, got bored and took huge amounts of anti-inflammatory meds, iced it till it went down, strapped snd rode for the rest of the week, it took weeks to heal properly when I got home.

Reducing the swelling allows you to keep the joint moving, if only a little; if you don’t it’ll seize up and getting movement back will be harder in the long run. Ibuprofen is as good as anything, it’s an anti-inflammatory as well as a painkiller, and putting some Voltarol on will help reduce the discomfort.
I smacked my left knee on the ground several years ago, bike went out from under me at walking speed, hit the centre of the kneecap on Tarmac. Never been right, knee is a different shape, and there is permanent discomfort, downright painful at times, it’s put me off riding, because I don’t know why both wheels went out when I was upright travelling slowly, and I’ve lost my trust in it, afraid I’ll come off again and do even more damage.
Ibuprofen and Voltarol are a permanent part of my life, now, so be careful and look after your knees.

Logically, you’d think that the body knows best how to heal an injury, but we over-rule that by taking steps to reduce inflammation.

The swelling is part of the damage not part of the healing process.

CountZero – Member
Reducing the swelling allows you to keep the joint moving,

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This is ultimately it, first thing I always do when I get injured is try to keep moving. Promotes healing much much quicker if you ask me.

Drac – Moderator

The swelling is part of the damage not part of the healing process.

Hmm- my doctor said that nsaids hinder healing? Not so much because of the swelling itself but just as a side effect.

Sometimes, swelling is nice (behave!). I always reckon it’s when the swelling goes down that broken ribs kick your arse.

Heard conflicting stuff from physios over the years, depending on various research. Some favour the “letting nature take its course” and some like to effectively reverse that.

Do what you think works best seems to be the only consensus

There is a growing body of evidence to suggest that all the steps we take to avoid inflammation are not necessarily the best thing to do.

Have a quick search on google and you’ll see plenty articles rubbishing PRICE.

My thoughts are that protection to a degree is reasonably wise, rest is never going to happen and can lead to behavioural changes, ice is good at numbing pain but does next to nowt for inflammation, compression is a waste of time, elevation is never done for long enough to make any difference.

Movement and letting whatever systems the body has in a particular area do the job of moving fluid about and listen to what your injury is telling you is about the best idea.

The advice from my physio was that take anti inflammatory, but not too soon. A little swelling early on seemed to be ok, so long as you then take steps to keep the joint moving.

Interesting set of replies thanks.
What got me thinking was a book a read recently about the evolutionary perspective on medicine, which considers things like fever, which in many cases is useful because the increased body temperature is bad for the infecting bacteria or viruses. That is to say, sometimes the body does know best.

That’s not to say I’m rubbishing modern medicine, though!

Hmm- my doctor said that nsaids hinder healing? Not so much because of the swelling itself but just as a side effect.

There is some trend toward this now yes. Wanmanlung covers it though, it’s a sensible combination but total rest hasn’t been suggested for a long time.

On a similar note there’s research now suggesting that reducing pyrexia in infections may not be the best approach as bacteria thrive at normal body temp. Raising it a little kills them so the pyrexia is the bodies defence toward this. Still needs more research though.

The surgeon told me to avoid NSAIDS for 6 months after my spinal fusion surgery as there is evidence that they hinder the growth of bone grafts.
About pyrexia, that’s what I said 2 posts above. Interesting.

Yeah for bone healing very much the recommendation now is to avoid NSAIDs.

Sorry vickypea I missed your post on pyrexia.