What is the inflammation?
Injuries would be the biggest enemy for Athletes. And also for fun runners it would be the hard time if you can’t run. Although there are various types of injuries, the radical causation is inflammation. And, on the contrast, there are cases which inflammation causes an injury. Even in terms of a stress fracture, the fractured bone doesn’t hurt but tissues and/or muscles which are around the fractured bone hurt because of inflammation. Sometimes a runner who has a stress fracture is able to keep training by treating muscles and tissues which are around the fractured bone by massage, acupuncture etc. and meanwhile the fractured bone gets healed.
From now on I’m will explain the mechanism of inflammation.
The mechanism of inflammation
You get a pulled muscle during running. Then a lot of immune cells for example platelets, white cells, lymphocytes, neutrophils, monocytes gather round in the damaged spot to stop internal bleeding and clean up damaged cells. To send these immune cells, a lot of blood flow comes into the affected part. Blood vessels and capillaries get expanded and more body fluids go into the inside of cells. As a result expanded cells, blood vessels and capillaries stimulate the end of the nerve and you feel a pain. Then other than a pain, redness, hotness and swelling are companied. That’s the classic inflammation.
As I mentioned above, inflammation is also one of the healing process. After immune cells clean up damaged cells, capillaries and collagen start rebuilding up and cells regenerate properly.
Low level inflammation
Inflammation which is acute and companied with redness, hotness and swelling is also healing process while there is another inflammation which is chronic and has no hotness, redness and swelling. This is not only necessary for healing process but also makes the end of the nerve compressed, sends warn signals to the brain and makes you feel a pain. As a result the brain sends more immune cells to the affected part, cells and blood vessels get expanded, the end of the nerve gets compressed and you feel a pain. In short you are in a negative chain reaction because of this low level and chronic inflammation. It’s same with allergy which causes sneezing, nasal congestion etc. in other words it’s an overreaction. Actually, this low level and chronic inflammation can be the causation of cancers, Alzheimer, myocardial infarctions, strokes and arteriosclerosis.
In my personal opinion, most of injuries which long distance runners get are caused by low level and chronic inflammation. Are there people around you who say ‘’I have had a pain in the right knee for three months, although I have been able to run’’, ‘’My plantar fascia has hurt for one year’’ or ‘’Once my body gets warm, I feel nothing but after running and in the beginning of running, my legs hurt’’. Or are you the person?
Low level and chronic inflammation
In the last article, I wrote there were two types of inflammation : 1. acute inflammation which companies with a pain, swelling, redness and hotness, 2. chronic and low level inflammation which have no classic signs of acute inflammation. As I said in the last article, from now on I will write about the latter type of inflammation.
Haven’t you ever had such a question ‘’ Cells regenerate in 2 to 3 months. Then why some injuries keep going on more than 3 months? Even if I can keep running, in some cases I keep having a small pain, why?’’.
The reason is that simply the cells don’t regenerate properly. There are two types of cell regeneration : 1. apoptosis and 2.necrosis. Apoptosis is also called program death. It’s programed by DNA. Old cells automatically regenerate without any inflammation. It becomes smaller and smaller (these small cells are called apoptotic bodies) and finally white cells and phagocytic cells eat them.
While necrosis is caused by damaged DNA and companied with inflammation. At apoptosis old cells divide into apoptotic bodies slowly and finally are eaten by white cells and phagocytic cells while at necrosis old cells divide into small fragments, as if it’s suicide bombing. New inflammation is caused by necrosis and the chained reaction happens.
Mitochondrial DNA plays a key roll for causing apoptosis. Mitochondria are small organs which exists in a cell. It works for producing aerobic energy. If mitochondrial DNA works properly, apoptosis can happen and make healing process keep going on. But there is something which damages mitochondrial DNA. That’s free radicals.
In addition, people who are fighting against free radicals have to fight against more free radicals because more free radicals are produced in an inflammatory spot because of the inflammation. Furthermore, free radicals can damage fats and proteins in cells and promote aging. Also it can be the causation of arthritis, arteriosclerosis, cancers, myocardial infarctions and strokes.
Free radicals are produced by white cells to kill germs like virus or bacteria and also by every respiration. However since our ancestors started making energy in the aerobic system (before this, they lived only by anaerobic energy), they developed the system which makes these free radicals not toxic by anti-oxidative enzyme such as superoxide dismutase, catalase and glutathione.
But,,, as you smart readers are guessing, the story is more complicated. That’s why low level and chronic inflammation keep going on. I will explain that a little more next time.
''Better Training for Distance Runners'' written by David Martin, Ph.D. and Peter N.Coe
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