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Muscle soreness from exercising and using NSAIDS-Part 2 · Scientific Health: Education and Human Performance

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  Warning. The following presentation contains information that might contradict what you
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  have previously heard or believed to be true about how the human body works and contains
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  material that is not suitable for closed-mind and individuals. Enjoy.
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  And the way we get over it is by controlling inflammation. And this is where we can follow
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  our rice acronyms. We can rest a little bit. Rest doesn't mean staying on the couch. It
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  simply means not working at the level that caused the injury. We may need to ice a little
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  bit. We may need to compress the area a little bit. We may need to elevate the area a little
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  bit, particularly if we're looking at the lower extremities, the legs and the thighs
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  and the hips. Resting gives me a chance to recover. It gives me a chance to allow for
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  the tissue to undergo its repair signals. Ice compression and elevation is going to
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  control the amount of fluid moving into the tissue. And by controlling the amount of fluid
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  moving into the tissue, it's going to allow me to control inflammation. But we can add
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  something to this. We can add anti-inflammatories. Our body naturally has an anti-inflammatory
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  hormone and that's cortisol. Cortisol does a very good job at helping you control inflammation.
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  But the problem is that the response that we see in an attempting to control inflammation
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  and attempting to get over injury is going to be a positive feedback loop, which means
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  we're going to keep getting more and more and more and more of the response in an attempt
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  to get rid of the stress signal, which is the injury from workout. When we have too much
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  cortisol, even though we're going to be controlling inflammation, we'll take a look at the cascade
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  of how cortisol works here in a second. Cortisol will also break down additional proteins.
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  It breaks apart proteins in an attempt to help with fuel. It's going to break down proteins
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  so that we get amino acids available to be used in energetic pathways. And if we're going
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  to try to resolve our response within the skeletal muscle to build muscle in response
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  to the workout, we want to control how much cortisol is there. And so we can use other
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  things to help control how much cortisol is there. And that's where the rest is compression
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  elevation can help out, as well as the anti-inflammatories. And so let's take a look at how cortisol
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  is going to go about helping to control the inflammation. And let's take a look at some
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  of the drugs that we might be able to take to help us out in terms of helping cortisol
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  do its activity. So we don't get too much cortisol so that we get the anti-inflammatory response
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  that we want, but not breaking down all of the proteins that cortisol might break down.
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  So the first thing that's going to happen is that cortisol is going to activate anti-inflammatory
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  genes. It's going to activate what's referred to as P-PARS and an iKappa B protein. And
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  what those genes and proteins do is it's going to reduce inflammation by reducing the type
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  of proteins that will be produced by the cells to regulate how much inflammation is taking
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  place. Some of this does it by blocking the NF Kappa B that gets activated by the immune
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  cells. But the other thing that's going to happen is it's going to block or refer to
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  as repress secondary proteins, which includes the interleukins in particular interleukin
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  one, as well as the receptor for interleukin one. It's also going to reduce the amount
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  of an inflammatory protein known as COX COX. By blocking COX, by blocking IL-1, by reducing
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  our responsiveness to IL-1, by reducing our responsiveness to the COX protein. What we
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  end up doing is we end up reducing the total amount of inflammation taking place. But the
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  other thing we do is reduce the amount of histamine and other pain signal proteins from
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  being released, which is going to reduce the level of pain being felt. And by reducing
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  the level of stress, we reduce the level of cortisol. That's another way in which the
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  ice within the rest ice compression elevation can help out. When we ice an area down, we
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  cool the area. As we cool the area, what we're able to do is we're able to reduce the rate
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  at which the neurons in the area are sending pain signals, which is going to help with
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  the numbing of an area following an ice treatment. So we've worked out, we're a little sore.
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  We want to help our body out with getting rid of that soreness. So we say, okay, we're
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  going to help out our cortisol. One of the easy ways that we can help out our cortisol
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  is by taking over the counter anti-inflammatories, which are sometimes referred to as the NSAIDs,
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  the non-steroidal anti-inflammatory drugs. And these are the commercial names, things
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  like Aleve, Tylenol, Advil, or commercially referred to as or scientifically referred
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  to as or pharmacologically referred to as naproxen, that's the Aleve, ibuprofen, that
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  would be the Advil, and Acetaminophen, that would be the Tylenol. And what the NSAIDs
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  are doing is that they're going to function as a complement to the cortisol. They're going
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  to help cortisol out. They're going to help cortisol out in two distinct ways. They're
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  going to work to block prostaglandin release, and they're going to work to block COX-1 and
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  COX-2, the COX proteins, from signaling to cause inflammation. What these do is that
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  they're going to allow for a reduction in inflammation, and we can reduce inflammation.
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  What we're able to do is we're able to get back to a normal cell function sooner. The
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  other thing that the NSAIDs will do is that they're going to regulate secondary signals
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  coming away from macrophages, from our T cells and from our B cells, that are referred to
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  as complementary proteins. These are proteins, these are hormones, that the cells release
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  in an attempt to activate additional immune response, to activate more inflammation, in
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  particular to distinct cell damage signals known as LPS. If I can reduce the responsiveness
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  to LPS, I'm able to slow down the rate of immune inflammation response so that I don't
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  get excessive response, but just the right amount of response. This is where I can go
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  from having a positive feedback, more and more and more and more and more and more response
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  in an attempt to get rid of the stress, to having a partially negative feedback response
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  where I'm going to try to trigger just the right amount of response, where I'm not going
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  to be too much response or too little response, I'm going to be just right response.
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  So we've had this tissue overload. We've had muscle overload, we're now responding to
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  the damage. We're having inflammation, the inflammation is taking place, we're trying
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  to resolve the inflammation. Now I need to get changed within the muscle so that I'm
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  no longer going to get damaged, based off of the load that caused me to get damaged
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  in the first place. So to the tension overload, I'm going to get additional myofibrocytes,
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  I'm going to get additional proteins within the sarcomere, within the contractal unit
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  of the skeletal muscle, so that I'm able to get more active tension. Since I have more
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  active tension, I have to get tissue, the connective tissue, that's going to be more
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  resistant to stretching to provide more passive tension so that I don't have an excessive
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  length I have to overcome, because I'm being stretched out too much at the initial part
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  of the contraction. If it's because of excessive workload, where it's not because I'm doing
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  a single rep beyond what I'm capable of doing, but because I'm doing one or two or five or
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  ten additional repetitions, what I'm going to do is I'm going to get a change in my metabolism.
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  I'm going to get a change in the amount of enzymes that I have available to me, so I
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  can keep my energetic pathways going. I'm going to see more creatin kinase, I'm going
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  to see more of my AMPK, I'm going to see more of the anaerobic metabolism enzymes, more
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  pyruvate kinase, more lactate dehydrogenase, more phosphofritol kinase within the glycolysis
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  pathway. I'm going to see more of the mitochondrial enzymes available to me so I can do more
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  ATP or longer periods of time so that I'm able to extend my workload. The two changes
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  that I see is going to allow me to have larger muscles, but also muscles that can work for
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  longer periods of time. I have this damaged muscle, I have this damaged muscle, I have
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  to overcome this damage. What's happening is that we have the immune response. The immune
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  response is first going to try to brace the area. Once I've braced the area and once I've
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  been able to clear out the damaged tissue, I will now start to have the myoblasts become
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  muscle cells themselves. I'm going to activate the satellite cells to actually become skeletal
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  muscle, to start to add myonuclear domain to the skeletal muscle itself, to start to
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  activate fibroblasts to start to develop collagen and elastin, titan and dystrophin,
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  and link proteins within the skeletal muscle itself. We don't have any actual functional
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  muscle cell right now. We're working towards having functional muscle cell. We're still
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  kind of sore. We're undergoing our DOMs at this point in time. This is where we have
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  to make sure we're controlling the amount of inflammation taking place. If we start
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  having inflammation taking place during the resolution phase, the skeletal muscle itself
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  will be disrupted and will be replaced with connective tissue that doesn't provide for
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  the correct amount of tensile strength, the correct amount of contraction strength and
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  can lead to additional muscle damage as well as a reduced range of motion for that muscle.
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  Once I have reestablished the muscle itself, I'm now going to start to grow the muscle.
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  I'm going to grow the muscle. I'm going to undergo hypertrophy so that I'm able to
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  produce more strength than what was able to be produced previously in order to allow for
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  greater strength within the contraction so that I don't get the same damage that I had
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  previously. I'm going to start to grow. I'm going to start to grow. I'm going to start
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  to grow. During this growth phase, we're getting an increase in what's referred to as protein
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  synthesis. This is where I want to make sure that nutritionally, I have additional protein
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  and additional carbohydrate and additional lipids available to allow for this growth to
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  take place. This is a highly energy dependent pathway. It's going to take a lot of fuel
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  in order for me to get to grow. I keep growing and I get larger muscles. I get greater cross-section
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  within the muscle fibers themselves. I get greater cross-section within the muscle fascicles
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  themselves. I get greater cross-section within the entire skeletal muscle. I'm going to keep
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  growing so that I get full resolution. I get a large enough muscle where I am able to balance
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  out how much muscle is now available to me to what was the load that caused the damage
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  to take place. I'm going to grow so that I got about a 10% to about a 20% window of
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  overshoot. If I broke at or if I had damage at 100, the resolution will allow me to not
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  experience damage until I get to between 110 and 120. What is happening is I start getting
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  more sarcomaer, more of the contractile units within the skeletal muscle itself, more both
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  contractile proteins, the actin and the myosin, plus more structural proteins, the collagen,
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  the elastin, the titan, the dystrophin, and the linking proteins, they're going to hold
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  the actin and the myosin together so that when contraction takes place, I'm able to
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  produce a larger amount of tensile strength, both passive tensile strength within the connective
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  tissue as well as active tensile strength within the actin and the myosin within the skeletal
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  muscle itself doing its active contraction. What I end up doing is I'm going from having
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  my pre-trained muscle to my post-trained muscle. My muscle has now adapted. It's gotten larger.
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  The goal that we tend to look at when we start lifting weights is to have larger muscles in
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  order to be able to produce more strength. The way we're able to produce more strength is to go
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  through the inflammatory response and allow for resolution to take place to provide for a larger
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  cross-sectional muscle. We can do this and we can get to this point by utilizing the insets,
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  by utilizing the ibuprofen, by utilizing the deproxen, by utilizing the synamenophen within
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  the recovery phase. There is some evidence to point out that use of the insets prophylactically
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  that is as a preventative treatment has some benefit in terms of regulating how much inflammation
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  takes place within the exercise bout. But what we do know is that the insets, regardless of whether
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  we're going to take it prophylactically, take it before we work out or take it as a treatment
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  to damage taking place within the muscle fall workout is that it's going to limit
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  prostaglandin release. It's going to inhibit the cox pathways. We do see with the prophylactic
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  consumption of insets a reduced oxidative stress. We do see that with the prophylactic
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  consumption of the insets a reduced loss of strength development. That means that we're
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  able to keep strength at or near the level that we had prior to. We see improved range of motions,
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  which means we're not going to have the loss of movement that we would normally see if we did
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  not take the insets. We see an increased rate of resolution and greater protein synthesis
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  taking place following the workout. We see an improved response to our anti-inflammatory
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  hormones, our IL-6, our IL-10, as well as our growth factors such as insulin-like growth factor,
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  as well as mechanical growth factor, as well as growth hormone, and our androgens like testosterone
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  or a genal androgen, sometimes referred to as DHEAS, all of which allow for an improved performance
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  in the skeletal muscle, improved gains from resistance training,
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  reduced DOMS, where DOMS is resolved sooner,
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  as well as improved performance within the exercise bout.
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  And so the outcomes that we get is improved muscle function
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  earlier relative to not having treatment with the insets,
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  and greater strength development within the session,
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  where the evidence that is being shown is at over-the-counter levels of consumption of the
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  insets, not at prescription level therapeutic interventions of the insets.
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  We'll talk a little bit more in another talk on some of the concepts as it relates to the
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  anabolic response in the nutritional aspects, as well as some nutritional aspects that might assist
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  with the resolution of the inflammation taking place from exercise. But thanks for listening.
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  Hopefully you picked up a few new things. I look forward to having you come back for more.
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