Does Hyperbaric Treatment Heal Sprains?

The Utah Deseret News reported on a game where teens scratched letters into their arms. In March, a 14-year-old girl playing the game became infected with necrotizing fasciitis, commonly called "flesh-eating bacteria."

The bacteria don't eat the skin as the name seems to say, but release toxic factors, which quickly destroy skin and muscle, causing pain, disfigurement, and a high death rate. Necrotizing fasciitis is a serious infection. The teen needed over 60 hyperbaric treatments and several surgeries. Hyperbaric oxygen treatment is done in a small room or chamber. The air pressure inside is increased so that the person can receive more oxygen. One or more people can get treatment in the chamber at once. The post Does Hyperbaric Oxygen Help Exercise Ability? explains more of how it works.

Hyperbaric oxygen treatment is effective against necrotizing fasciitis and infections like gangrene in several ways. The bacteria involved are susceptible to high oxygen pressure, the low oxygen area of the infection is raised to a level where the body's white cells can do their job to clear the bacteria, higher oxygen pressure prevents white cells from sticking to vessel lining, and a few other nice effects to be covered in future posts.

Given that hyperbaric oxygen speeds healing in certain infections, crush injuries, problem wounds, diabetic ulcers, thermal burns, ionizing radiation injury, refractory osteomyelitis, osteoradionecrosis, and compromised grafts, it has been hoped by some that it would also be useful for sprains and muscle injury.

One study by diving medicine pioneer Dr. Fred Bove (my advisor for one of my dissertations) and his colleagues, found no effect of hyperbaric oxygen treatment on time to recovery for ankle sprains (Am J Sports Med. 1997 Sep-Oct;25(5):619-25). Another study by Dr. Michael Bennett and colleagues reviewed known past studies using randomized trials of hyperbaric oxygen on soft tissue injury (ankle sprain and medial collateral knee ligament injury) and muscle soreness after exercise. They found there was was not enough evidence that hyperbaric treatment helped ankle sprain, acute knee ligament injury, or soreness (Cochrane Database Syst Rev. 2005 Oct 19;(4)). Dr. Brad Bailey of San Diego did a review of the utility of hyperbaric oxygen for sprains and sports injuries and found no benefit for soreness, but a few studies that showed benefit in acute sprains and strains. There may be aspects of injury, not previously looked at, that may be helped. These are being looked at in newer studies. The next post will cover them.

You can do much to rehab sprains on your own. Posts with helpful information to prevent and rehab sprains are:
How To Treat Ankle Sprains and Prevent Them
and
No More Ankle Sprains Part II.

Labels: hyperbaric, injury, performance enhancing modality, soreness, sprain

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Teen Dies After Using Muscle Soreness Rub

A New York teen cross-country runner is reported to have died after using large quantities of a muscle soreness rub. According to various news stories, the medical examiner concluded she died after using too much Bengay cream containing methyl salicylate.

Methyl salicylate is a natural oil of wintergreen (betula oil) found in plants. It is used in many muscle rubs and creams to dilate blood vessels to bring blood to the area and redden the skin.

Deaths are rare, but salicylate poisoning is not rare or unknown. Poisonings using medicated oils account for "48% of acute salicylate poisoning cases treated in the general medical ward of the Prince of Wales Hospital" in Hong Kong (Vet Hum Toxicol. 1996 Apr;38(2):133-4.) Another study comparing severe salicylate poisoning from aspirin or topical oils found that the oils pose "the threat of severe, rapid-onset salicylate poisoning" because of the concentrated form and lipid solubility of the methyl salicylate in the rubs (Postgrad Med J. 1996 Feb;72(844):109-12.)

Some muscle rubs and balms contain other toxic ingredients, such as turpentine oil and camphor. The various preparations all "work" in various ways to relieve pain or mask it. I will cover more about the different soreness creams and preparations from around the world, their ingredients, and how they work in posts to come. The book Healthy Martial Arts covers ingredients in detail, how they work, and more on soreness and training.

Soreness in the muscles is common and normal after energetic activity. Muscle soreness does not just occur in the out-of-shape. However, your joints should not be sore after workouts.

If your joints (not muscles) are sore after activity, you may be using body mechanics that put joints in positions that grind or rub. You may also be shifting weight off your muscles onto your joints to make the exercise easier. Your joints should not be sore, hot, or swollen after any activity.

Here are a few ideas to avoid joint pain during or following activity:

To reduce knee joint stress during daily good bending (half-squat):
Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
and Bending Right is Fitness as a Lifestyle

Reduce knee joint stress in full squat:
Achilles Stretch in the Bathroom

Reduce knee joint stress when running, walking, jumping:
Healthy Knees

Reduce lower spine stress when reaching, running, walking:
Back Pain in Pregnancy - and Why Men Can Get It
the post tells why and has links to show how to restore the spine to neutral to stop the pain then and there,
and Change Daily Reaching to Get Ab Exercise and Stop Back and Shoulder Pain

Reduce lower spine stress when sitting and bending:
Disc Pain - Not a Mystery, Easy to Fix

Reduce upper back and neck pain:
Are You Making Your Exercise Unhealthy?

Shoulder and rotator cuff:
Safer Overhead Military Press
and Upper Back Exercise and Neck Pain Prevention Too

Click the labels under each post to show all posts on that topic.
Sincere wishes to the family of this young girl.

Labels: drugs, fix pain, injury, performance enhancing modality, soreness

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