SaveYourself.ca • Sensible advice for aches, pains & injuries
Mon Jan 2nd @ 6:30am
About a year ago, I wrote an article about some fascinating new science showing why your immune system routinely, cheerfully reacts to internal injuries where there is no possible risk of infection — a previously unexplained phenomenon from the X-files of physiology. Neutrophils are the culprits, and it turns out that they are doing it because they overzealously react to a cellular component, mitochondria, as a foreign organism. This intriguing science had great power to explain some kinds of pain. Nifty stuff. The article: Why Does Pain Hurt So Much? How an evolutionary wrong turn led to a biological glitch that condemned the animal kingdom — you included — to much louder, longer pain
That “feature” of biology is really crappy, but it gets worse, as strongly suggested by some more new immune system science. As if overzealous neutrophils aren’t bad enough, they actually get busier when you exercise moderately — the holy grail of health and fitness, the single best thing you can do for your health. This is just not fair! It’s like a horror movie monster that gets bigger when you attack it. As nicely summarized by Alex Hutchinson, a 2011 study in the journal of Medicine & Science in Sports & Exercise by Syu et al shows that:
Regular, moderate exercise boosts the ability of the neutrophils to get to infection sites quickly (chemotaxis) and attack the bad guys (phagocytosis). And in fact, the neutrophils are still ultra-alert for a couple of months after you stop training. In addition, the researchers found that regular exercise extended the life of the neutrophils.
Busier, more effective, longer-lasting neutrophils sounds great to most people, and this science has been reported widely as “good news.” But a “boost” to immune function is never as simple as it sounds or all good news, and the counterintuitive price of better infection-fighting could be vulnerability to repetitive strain injury, slower healing, and pain chronicity A “boost” to immune function is never as simple as it sounds or all good news, and the counterintuitive price of better infection-fighting could be vulnerability to repetitive strain injury, slower healing, and pain chronicity. — by reacting more strongly to aseptic cellular trauma, as well as real pathogens.
Put these two pieces of science together, and you have an explanation for one of the great catch-22s of the human condition: exercise is good for you, but it often hurts more than it seems like it should. Athletes and active people are prone to many poorly defined aches and pains — not just the entirely predictable delayed-onset muscle soreness, which may itself be partly due to neutrophil activity, but a panoply of not-quite-injuries, undiagnosable annoyances that hurt too much for too long, but then either fade away just as you’re starting to wonder if you need to see someone about it, or they get eclipsed by something else. Many active people know all to well what I mean: pains that are more than DOMS, but less than injuries, although some of them turn out to be the early warning signs of problems that escalate and become major hassles, significantly restricting performance and competitiveness — and sometimes even driving people away from exercise altogether, because the cost is just too high.
And that cost may well be higher for some people than others. It’s hardly a reach to guess that this self-defense system is probably more active in some people than in others. Just as science has shown that certain foods really do taste unpalatably bitter to some people with unlucky genetics, it’s likely that the consequences of exercise are genuinely more uncomfortable for some people.
The hopelessly simplistic claim of immune “boosting” is one of the most prevalent bogus concepts in all of quackery and health fraud, right up there with “balancing” and “detoxifying.” The immune system is far too complex to be turned up like a thermostat for general benefit, and every change in immune function has unpredictable side effects. This is an important general point that doesn’t just apply to today’s example of immune “boosting,” but basically all of them. See Dr. Harriet “SkepDoc” Hall’s excellent article, Boost My Immune System? No Thanks! Dr. Hall also posted about inflammation on ScienceBasedMedicine.org just last week.
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8:11 Finally, video! Readers have been asking for years, and I finally started producing videos in the fall of 2011. This one bundles three runner’s knee myths into one video. Watch it! (There are also individual IT band syndrome myth videos. See my YouTube channel for more.)
There are also 262 more articles and eight big tutorials on the website, plus dozens more timely updates and “posts.” See the complete categorized index, or get some reading recommendations for patients or professionals.