BJJ and pain management

I’m turning 36 in two weeks (yay birthdays!), and one thing that has been on my mind for the last 2 weeks is pain. Specifically, two weeks ago I sprained my ankle. Then last night I got back on the mats and was paired up with 3 white belts. Two had been in BJJ for less than 2 weeks, and one is an older guy who is likely due for a promotion of some kind. The two white belt guys were young – maybe 20, and honestly, when you don’t have (much) technique you use what resources you have – which in their cases were strength and energy. Oy vey. I was sincerely exhausted by the end of the night, and this morning I am feeling serious muscle aches.

So what do I do? In the past I used to take advil or ibuprofen or any other pills in a bottle. Hey – anti-inflammatories are for inflammation, right? So I did end up taking two NSAIDs one day after spraining my ankle. Then I started coming across articles like these:

Get Off Ibuprofen, People! This was the first article I read about that. The main idea of the article: “Taking an anti-inflammatory drug of any kind makes tendons and ligaments weaker, and stops muscles from getting stronger.” Whoa. That sucks. It went on to say “NSAIDs have been shown to delay and hamper the healing in all the soft tissues, including muscles, ligaments, tendons, and cartilage. Anti-inflammatories can delay healing and delay it significantly, even in muscles with their tremendous blood supply” I DO NOT LIKE THAT! I immediately regretted taking those stupid Ibuprofen.

Okay, that was just some Crossfit blog. What does the science say? Oh – that there is mounting evidence that NSAIDs impairs bone healing.

I then came across this article – a runner’s wiki. This one cited several credible articles, including from nih.com and from sports journals. In it it mentions “Another study on muscle damage and NSAIDs showed impaired recovery in the early stages of healing.” It does suggest that if you feel the need to take some pills, that acetaminophen is better than ibuprofen.

Here’s a sciency article about sports injuries and NSAIDs. It includes some fancy pictures and charts, so clearly they know what they’re talking about (he he he I kid I kid). It references 22 different articles, and looks sound as far as that goes. I don’t trust articles that claim science things and don’t cite their sources – like the first crossfit journal.

So what is a girl in pain supposed to do?

The way I figure it, I have a few options:

1. Suck it up. Just sit tight and deal. Enjoy the fact that your muscles hurt because you’re freaking using them (okay, that’s for post-workout pain, not really sprained ankle pain).

Ahahaha Thanks to Fitocracy for pointing this out to me

2. Ice. I did use my ice packs a number of times on my ankle.

3. Massage/stretching. I’ve gotten to where I like this feeling of stretching it out and even using my foam roller to squish out the pain!

4. Time off. Not forever – but on super achy days, I will just rest. Also, my cat really likes this option.

5. Fish oil. This stuff is perfect for everything!

6. Sauna/hot tubs. I freaking love heat for muscle aches.

I think I have just gotten used to having aches and pains. Aside from my herniated disc, I really haven’t been in SO MUCH PAIN that I really need pills. I think that in general, our society has tricked us into thinking that OMG ANY PAIN IS INTOLERABLE! MUST TAKE PILLS NOW! And I’m not okay with that any more.

What are your thoughts on pain management? What do you do? Are you taking (gasp) ibuprofen for pain? If so, did this at all make you rethink it?

  1. I definitely took too much ibuprofen as a high school athlete with knee problems and migraines, but now I’m completely off it (except for maybe once a year for a migraine). However, a few years back I had some painful knee inflammation and broke down and took a couple pills, expecting to have to go to the doctor the next day. The pain and inflammation was gone in a couple hours and didn’t come back. Based on this purely anecdotal evidence, I’d say that it can definitely help if used strictly as an anti-inflammatory rather than general pain management.

  2. Oh, and ice +whirlpool is a great combination as well. I enjoy the Korean saunas so much when I’m training that I feel guilty for going during training layoffs (like now).

  3. I don’t like taking any pain pills. I will if my doctor tells me to for broken bones or badly injured joints. And I will if I have a migrane. But I will absolutely not train if I am full of meds.

    • I definitely took it for my back when my disc herniated. I literally could not move and was crying from the pain. In that case, pump me full of ALL THE MEDS. But for just achiness or painful muscles, definitely pass.

  4. I love soaks with epsom salts. I hyper-extended my finger in jitz last month and the salts help with loosening up my finger from being in a splint. I got some strong NSAID from my Doctor to help with swelling and it helped some, but I looked it up and found out theres withdrawal symptoms associated with that med so ewww!

  5. I am of the suck-it-up camp. If really sore, I occasionally use Tiger Balm or Salon-pa’s, or lie in a hot bath. I rarely take pills- only if I’m hurting so bad that I don’t feel like going back to class, then I will resort to an aspirin or ibuprofen so as to get back to the mat.

    • Yay for Tiger Balm. My doctor friend says it does nothing, but I say – it looks Chinese and stings, therefore must be doing magic. hahaha. Even if it’s just a psychological effect, I do think it has an effect.

  6. Wow…been taking it for a hyperextended wrist…cutting back and going back on just the good old zheng gu shui. Love that stuff!

    • Zheng gu shui? I had to google it. Is it similar to tiger balm? I do have two small jars of that stuff and it’s awesome. Again – something I forgot to include in my list! Argh.

  7. If there are lady grapplers trying to get pregnant reading this– they should know that NSAIDs like ibuprofen can impair ovulation, too… fyi ๐Ÿ™‚

    • ICE. And then heat. Epsom salt compresses. TENS Unit. Massage. Enough sleep / rest. To keep the joints and connectors slippery and flexy, FLAX SEED daily is great. If you need an intensive treatment, you can steep 2Tablespoons of it in a hot water, use a metal tea strainer. Leave the seeds in the hot water [ideally with a tea, Yogi DETOX is awesome] for 10 min. The take out, you will notice it’s gel-like, funny texture. Drink 1-2 cups/day for 2 weeks and you’ll notice the difference. Little less intense than the oil.
      As for supplements, MSM is amazing. One pill a day. Chloroxygen is a dark green supplement. Increases red blood cell count, all of this stuff is at your natural food store. With the chloroxygen, only a 4oz water + dropperful daily MAX. Drink like a shot.
      Listen to your body and be nice to yourself.

      • I do take flax seed, and sometimes even flax seed oil, but have never heard of this. I don’t mind the oil, though.

        I take MSM, chondroitin and glucosamine. I find that it really helps with joint achiness.

  8. Yeh I injured myself almost 2 weeks ago doing BJJ. I tore the cartilage that connects ribs and sternum… Ouch!! I have been icing and eating Ibuprofen! You definately open my eyes and now I must take a Patrick Swayze moment from Road House. “Pain don’t hurt.” or as my wife would say, ” Leather up nancy boy!”

  9. I do hot yoga. It combines the sauna/hot tub with the stretching and helps with alignment after a lot of rolling. It has done a lot for me in terms of fitness and strength to which helps prevent pain. I also get a massage every 4-6 weeks – from a really good sports massage therapist. I stay away from pain meds other than for immediate injuries. Knowing when your body has had enough and simply needs a break is most important in staying healthy and safe.

  10. I only use pain killers for headaches. Muscle pain, joint pain, etc… I just ignore. If the pain isn’t bad enough for me to seriously contemplate an ER visit then it’s not bad enough for medication.

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  12. Actually, evidence on whether nsaids are good or bad is very mixed. Some have even shown that NSAIDS can increase strength and size or have no effect as well.

    http://www.ergo-log.com/glucosamineathletes.html
    Ibuprofin is listed

    http://muscleevo.net/increase-muscle-mass/
    lists examples of studies showing positive, negative, or no effects.

    When you look at these studies they often have few people. These are generally termed as pilot studies. These mainly test the waters to see if spending money on further research has merit. Larger studies need to be conducted with more people so the effects of genetic outliers can be averaged out by more typical results.

      • Yes I do take Nsaids and like you I was very worried. In December I injured my back doing deadlifts and I am still taking pain killers 3 months later. I was worried about healing until saw this recent study:

        http://jbjs.org/article.aspx?articleid=1106109

        Apparently most of the studies that stated it had a negative effect, have been done on animals not humans, and in humans, it seems that is not the case. Remember that aspartame debacle? People kept saying it causes cancer when it only has been shown in mice, and only when mice consume several times their body weight. If you were to consume twice you body weight in multivitamins ,comparatively, you would kill your self thousands of times over from vitamin toxicity. Vitamins still sound far more benign than aspartame. Remember just because something is “natural” does not mean it is better than something synthetic.

        • Thank you so much for sharing! I rarely am in so much pain that I need pain meds – it’s been liberating trying to get in touch with my body and listen to it rather than trying to suppress it, which is the ONLY response I’d had in the past. My shoulder, however, was acting up earlier this month and i absolutely did grab the pain reliever and was so thankful it was there.

          ^_^ I definitely know about the natural thing not necessarily being better than synthetic. There are natural poisons as well! ^_^

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  14. for soreness and stuff it’s never even occured to me to use painkillers. I don’t mind that kind of pain unless it’s so bad that it stops me from functioning normally. as for other kids of pain; I use pain killers waaaaay too often for headaches. even if the pain in itself doesn’t really bother me I find headaches too distracting. also always used pills to deal with my period cramps unil recently. I discovered that I am in fact capable of controlling that pain with the help of stubborness, breathing exercises and telling myself things like “I’m stronger than the pain”.

    • I’m dealing with a painful shoulder. I should really get it looked at. ๐Ÿ™