Cortisone is an anti-inflammatory medication introduced over 60 years ago; when injected in joints it reduces pain, and in topical form relieves the itchiness of rashes. Like any "miracle" drug,
cortisone's widespread usage has sparked concern [bold added]:
When tissues are overused, overstretched or torn, the cells of those tissues release factors that recruit blood vessels, stem cells and healing factors. With that rush of fluid, the tissue temporarily swells. Over time, with the laying down of new collagen, the protein that makes up most of our body, the injured tissue heals. Some tissues heal normally others with scar tissue that over time often can remodel into normal tissue.
Cortisone shuts down this cellular recruitment process, reducing swelling, but unfortunately inhibiting healing. The result is the weakened tissues stay in the weakened state for a longer period of time, sometimes exposing the athlete to repeat injury or permanent damage. This panacea drug has always had this hidden harmful risk. If used too often or in the wrong place such as the Achilles tendon, the tissues can completely rupture and never return to the full, uninjured state.
When I suffered a leg injury
last November, I declined to take cortisone for the swelling but did subscribe to physical therapy and laser treatment for tissue repair. The pain is gone; the muscle is still a little weak but getting better with strengthening exercises.
The cortisone era is over. We have realized that the best response to tissue injury is to stimulate stronger healing, to feed the cells that are trying to repair the injury, and to recruit more progenitor or stem cells to guide the complex healing process. This tissue stimulation is done by a combination of careful early tissue mobilization, often performed by expert physical therapists, by early joint- and tissue-controlled exercises that stimulate repair rather than irritate the injury, and by direct application of growth factors and sometimes stem cells.
No comments:
Post a Comment