The One Thing Even Athletes Get Wrong About Inflammation

You can’t swing a kettlebell without seeing something in the news about inflammation these days. There’s a good reason for that: Inflammation--the body’s catch-all response to damage of any kind, from a sprained ankle, to disease, to muscle tears from exercise--is probably the single best overall measure of health we have. It’s been linked to everything from cancer and heart disease to dementia and chronic fatigue. In fact, your overall level of inflammation is highly predictive of how long you’ll live, according to one recent study.

A growing body of evidence also shows that inflammation levels are closely linked to recovery from exercise. People with chronic inflammation were less able to increase or maintain their muscle mass in response to resistance training, according to a 2017 study on hospital patients in Medicine & Science in Sports & Exercise. Excessive training, or overreading, can lead to elevated levels of pro-inflammatory gene expression, according to one study.

So how do you manage inflammation, so you can maximize your gains from exercise and live a long, vibrant life? The most important thing to remember is that inflammation, the body’s response to protect against infection and repair damage, isn’t always the enemy. You want to live a healthy lifestyle that keeps your inflammation level low most of the time– but acute spikes are good and necessary.  

Distinguish between the 2 types of inflammation

When the body’s inflammatory response is activated, blood rushes to the affected body part(s) to deliver nutrients, platelets, and disease-fighting T cells and white blood cells. Inflammation can be either acute (short-lived) or chronic. Acute inflammation is caused by a short-lived stressor such as an injury, hard workout or short-lived illness, while chronic inflammation is caused by poor health overall--in particular, by stress, lack of sleep, or a poor diet.  

Related: What is the Best Diet for Fat-Burning and Performance?

Additionally, inflammation can be either localized to a given body part, or systemic--spread throughout the body. Localized inflammation is usually acute and systemic inflammation is usually chronic.  However, exercise does cause a degree of systemic inflammation, as can some infections, or short-term stressors such as jet lag or simply having a really rough week.  

The biggest misconception about inflammation

Years ago, I read several articles which suggested that you should take an aspirin after workouts to dull the post-workout inflammatory response, allowing your body to recover faster from the workout. I tried this, and it didn’t really work for me.

Now I know why: that post-workout inflammatory response isn’t an undesirable side effect of exercise: it’s part of the body’s anabolic signaling. In fact, acute post-exercise spikes in IL-6, a (usually) inflammatory protein, were positively correlated with muscle growth, according to one study. It’s unsurprising then that a multitude of studies have found mostly negative effects on muscle growth and exercise performance from taking anti-inflammatory drugs or antioxidants.  

The takeaway here is that inflammation is part of the body’s anabolic signaling process.   Strength coach Brad Pilon advises that to aid muscle growth, you want your baseline levels of inflammation to be low, but you also want inflammation to spike as high as possible for a short period (12-24 hours) after each workout.

Doctor’s orders: Keep your baseline level of inflammation low 

How do you do that? First, make sure you’re at a healthy body fat percentage. That means below 15% for men and 22% for women. Most people overestimate their body fat percentage, and odds are you’re doing it too. The best option here is to ask your doctor for a DEXA scan (about $40-$100).  

Second, eat your fruits and vegetables– most health organizations recommend about 4 servings of vegetables and 3-4 servings of fruit a day.  

Third, make it a priority to sleep 7-9 hours a night, every night.  Mediators of inflammation are altered by sleep loss. A regular bedtime helps keep your body’s defenses primed.

Finally, do everything you can to keep stress to a minimum. Use all the PTO days. Meditate.  Cut the source of stress that’s plaguing you out of your life, if you can, to minimize chronic, mild inflammation and the stress-related diseases it’s associated with. 

What to do about inflammation from exercise

Based on the research: essentially nothing. Don’t take active measures to reduce inflammation from exercise, like a post-workout cold bath, drinking CBD oil or anything like that. Avoid taking anti-oxidants and NSAIDs like aspirin or ibuprofen for a few hours before and 12-24 hours after a workout.

Related: 5 Steps to Preventing Chronic Inflammation

If you need a painkiller, opt for acetaminophen (Tylenol) as long as you don’t have liver issues and aren’t drinking. It’s the one common OTC painkiller that isn’t also an anti-inflammatory.  

DO get a good night’s sleep after a workout. Sleep reduces inflammation, yes, but it does so by fixing the damage that caused the inflammation in the first place. That’s a good thing. Same for recovery meals.

How to deal with inflammation from an injury

This depends on whether the injury is open or sterile– that is, whether your skin is broken. If your skin is broken, the immune response from inflammation is a very good thing and you don’t want to disrupt that, at least early on.

With a sterile injury (say, a twisted ankle) though, inflammation can be excessive, and that’s where the traditional advice--take NSAIDs, apply cold, elevate the injured body part--come in handy. Once the initial, highly painful phase has passed, a gentle self-massage can also soothe the affected area and increase blood flow without inflammation.

Why the distinction? As physique coach Menno Henselmans puts it, the body doesn’t always distinguish between open and sterile wounds, and tends to overreact to sterile wounds like sprains and bruises. The accompanying immune response can be excessive, given that pathogens aren’t getting into your body.

That said, target your treatment to the affected area, relying on remedies like topical NSAID creams and cold wraps instead of oral NSAIDs. Topical creams provide similar pain relief to oral painkillers, but with fewer side effects and they do less to interfere with inflammation in the rest of your body.