Exercise: The Under-Prescribed Anti-Inflammatory

By: Dr. Kane Thompson PT, DPT, ATC

Exercise: The Under-Prescribed Anti-inflammatory. Often times pain and swelling is immediately associated with needing your over the counter NSAIDs or prescribed medications. First of all, inflammation is a normal response that acts to jump starts the healing process. Inflammation gets a bad rep because this term gets correlated with pain and swelling. Also, chronic inflammation is another instance where inflammation is thought of in a negative light.

However, we need to look at inflammation under the scope that the glass is “half full” and “not empty”. Often times pain/swelling/inflammation is perceived under the following thought process, “My ankle is swollen – don’t touch.” or “My shoulder hurts and I don’t want to move it.” However, this is the perfect instance where therapeutic exercise should be implemented especially under the PT scope of practice. Therapeutic exercise is an overlooked tool that can be used to manage healing and inflammation.

Barry McLeod-Hughes, PT, wrote in an article for PTinMotion, “Exercise reduces inflammation by increasing local circulation, if done in a certain way.

Simply stated, these are:

1.) Slow, gentle, and repetitive movements.

2.) Discomfort yes, pain no.”

In cases following post-operation muscle firing and movement from exercises can promote healing by increasing blood flow to the healing tissue, but also it can act as a pump to flush extra unwanted swelling out of the area. Exercise is beneficial in cases of chronic inflammation as well. Exercises have shown to act as an anti-inflammatory modulator in cases of Cardiovascular disease and Type II Diabetes.

For instance, studies have found a small protein, also known as Interlukin-6, to be released during muscle firing/exercise into our blood stream. Interlukin-6 is relevant because it has anti-inflammatory effects by stimulating other anti-inflammatory proteins in our blood stream to further decrease inflammation within our system.

Also, Interlukin-6 inhibits pro-inflammatory proteins such as TNF-alpha (Tumor Necrosis Factor-alpha). This is relevant because high levels of TNF-alpha have been shown to predict the risk for myocardial infarction, play a direct role in metabolic syndrome, cause direct and indirect insulin resistance, and demonstrates a key role in linking insulin resistance to vascular disease. Therefore, promoting activities such as exercise can jump start an internal and systemic response that inhibits inflammation, promotes healing, and fights against chronic diseases such as Type II diabetes and cardiovascular disease.

References:

McLeod-Hughes B. APTA – PTinMotion. Viewpoints: Letter: Anti-Inflammatory Benefits of Therapeutic Exercise. April 2016.

Pedersen Klarlund B. The Biochemical Society. The anti-inflammatory effect of exercise: its role in diabetes and cardiovascular disease control. 2006. Vol. 42 (105-117).