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The Effects of Caffeine

Research has shown that energy drinks are the most popular supplement besides multivitamins in the American young adult population, with more than 30% using it on a regular basis. The primary uses for caffeine in energy drinks, coffee, and tablets is to reduce or control body fat, improve performance, and improve focus.

Caffeine alone has been demonstrated to have a significant effect on fat oxidation, reducing glycogen breakdown, and increasing metabolic rate. Many energy drinks with caffeine supplemented with herbal or synephrine significantly increase caloric expenditure and have a positive effect on metabolism. The role of the ingredients is not well understood. Studies have also shown that caffeine supplements combined with omega-3 fatty acids and several vitamins lead to significant decreases in body mass and body fat. Again, the mechanism for this is not well understood, so the possible exacerbation on conditions like anorexia are not known.

Another effect of caffeine is a delay in fatigue for endurance or resistance training. It won’t help improve your strength or your speed (its effect is mixed in scientific studies), but it does allow athletes to be active for longer periods of time. The idea is that caffeine stimulates exercise metabolism by enhancing fat oxidation, which preserves muscle glycogen. Energy drinks and caffeine also have a limited effect on improving focus, alertness, and reaction time; Red Bull has been demonstrated to have some enhanced effect on cognitive performance.

The dangers of caffeine are the same with any stimulant. The documentation doesn’t show a correlation between energy drinks and cardiovascular damage, but it can potentially exacerbate an underlying condition, particularly in energy drinks where caffeine is mixed with ephedra or other beta-agonists (which were banned by the FDA in 2004). Caffeine is also a diuretic, so it is linked to dehydration – a potential concern if used to improve athletic performance or as a weight-loss supplement, or if combined with alcohol. Caffeine can also have side effects such as headache or irritability, and overuse can be associated with withdrawal symptoms. From a biological perspective, it should also be noted that caffeine speeds the aging process and reduces the cell’s ability to repair DNA damage. It is commonly used by geneticists to stem the repair process in cells to study the effects of damaged DNA. So don’t abuse it.

Training with Acute Injuries

There’s a common misconception that someone should stop training when they have an acute injury. That is in fact wrong and it is a primary reason that people begin to ignore and resist medical advice. Forcing someone to stop training also adds to the psychological burden of being injured, the mourning of the loss of function and training time. It also atrophies the rest of the uninjured body.

So why should one train with an acute injury? There are several reasons. First, it promotes healing through increased blood flow and the body benefits from the cross-over effect, or the fact that training one side of the body will lead to similar adaptations in the other. It also keeps the body’s sense of training and discipline intact, a big problem that often occurs when a very serious injury or other event forces someone out of activity for a prolonged period of time. It’s far easier to keep someone’s training regimen in place if they’re continuing to train, even if it’s at a reduced level, than to bring them back and try to rebuild their old habits from scratch. More often than not, a person with too much time finds new ways to spend it and loses their desire to go back to rigorous training. There’s also the psychosocial aspect, that a person feels relieved to continue their training and be around their comrades. When a person leaves for a long time, you also have to consider the fact that the group will grow together without that person, sometimes making it difficult to accept them back into the group. Also, training reinforces the supporting tissues that take the lion’s share of the work and decreases compensatory patterning. In short, it helps to prevent bad habits that form when the body tries too hard to avoid putting pressure on injured limbs and return the athlete to normalcy and regular training more quickly, or teaches the person to deal with a newly weakened structure.

Mostly, training with an injury means you’re preventing rot. This goes with the new paradigm that every structure in the body is use it or lose it. The body is in a constant state of adapting to the habits and loads that the person puts on it. Start eating McDonald’s every day and stop working out, and the body’s metabolic rate will plummet as it starts to hoard fat and stop feeding muscle; after all, that’s what you’re telling it to do by your actions. If you aren’t stimulating your muscles at least twice a week, then they atrophy and reduce its level to whatever your new activities are.

The biggest thing you want is intensity. Get the body working hard and you will see dramatic improvement in healing time, confidence, and metabolism, as compared to a person who is idle and nursing an injury. You may need a new regimen and absolutely one that avoids re-injury, but you don’t want to kick someone out and let them feel sorry for themselves.

Keep in mind that this isn’t a talk for being stupid with your injury. You should be gritting your teeth through a certain level of pain, but it should be the pain of intensity and not the pain of re-injury. You can ignore calls to stop training and be completely idle, but you should be taking all the other advice of your health care professionals. If the doctor says you need ice and compression, then do it. At the very least, you can always go to the exercise bike, elliptical machine, or a swimming pool.

Don’t use Ibuprofen

This follows sports medicine research in the last several years. Basically, ibuprofen works as an anti-inflammatory by inhibiting the body’s natural reactions to injury, especially the chemicals that stimulate healing. People use it because it works as a miracle drug that stops pain, especially in acute joint injuries. The problem is that the pain is caused in part by healing and repair, something you shouldn’t inhibit. Research shows that ibuprofen may slow not only the healing of tissue injury but the body’s reaction to stimulation. Which means you’re not only slowing the healing but you’re telling the body not to adapt to training.

This is a difficult thing because ibuprofen was such a mainstay of the athletic community for the last few decades. But ibuprofen should only be prescribed by a physician. If pain needs to be reduced, then take tylenol and use ice. Realistically, any injury requiring tylenol needs to be looked at and evaluated as in the previous post, to prevent further injury.

I’ve made this mistake myself but I won’t be doing it any more. If you want ibuprofen, get it signed off by a doctor who is treating your injury. Don’t self-medicate with it.

Note: this applies to all NSAIDs, non-steroidal anti-inflammatory drugs.

Tissue Healing Phases

This is a summary of a video seminar that I watched on tissue healing. The reason it’s relevant is that most of the major injuries to tendons or ligaments don’t have a single cause. The structures in the body are designed to take loads from the body over the entire lifetime, so very few people experience the type of force that could immediately destroy them. The most common reason for major injuries is a breakdown caused by light injury complicated by constant re-injury over an extended period of time. This means major injuries are generally preventable by the treatment of moderate and light injuries, when athletes complain of pain but aren’t impaired.

New models for injury treatment are available and often fly in the face of traditional treatment. Ice packs for 20 minutes twice a day is now the bare minimum of treatment for a sprain, the equivalent to attending class in college but not taking notes, studying, or doing homework. Athletes often leave their pains untreated, especially if there aren’t easy answers, which is an indication for a more serious injury later on and a disgrace for the trainers and coaches of the injured athlete.

Tissue healing goes in three phases:

The first phase is the inflammatory phase, which is the body’s natural reaction to an injury and lasts 2-3 days. The body encapsulates and swells the muscle into a specific position because it opens the blood vessels to their maximum, which also stiffens the injured area into a rough splint. The problem is that the body is designed for maximum emergency measures, to try and heal the body as quickly as possible so that it can get back on the primordial trail. As with most things in life, the quickest solution is usually not optimal, because it’s not designed for permanent healing but to get the body up and running so the person won’t die in the next week.

The treatment is ice, which reduces the inflammation (i.e. the pain) and slows down the body’s response into a more measured and permanent healing. Folk sports medicine says that the best ice is frozen peas or blueberries, but those are actually the crappiest because they’ll thaw too quickly from the body’s heat. The best ice is actually frozen beef, if we’re specific, Trader Joe’s frozen bulgogi. The marinated Korean beef will stay frozen for hours at room temperature and won’t thaw or drip, better than any fancy chemical pack. A little dixie cup of frozen water is also pretty good, if you’re okay with wiping away water. Also, 5 minutes of ice massage is the equivalent to 20 minutes of laying ice on your body. Ice treatment should be an alternation of ice for 20 minutes and letting the body warm for about an hour. It should also be done before (ice massage half an hour before) and after workouts. DO NOT FALL ASLEEP ON THE BULGOGI OR IT WILL FUSE TO YOUR BODY. It’s kind of funny but you won’t laugh at how difficult it will be to thaw the meat and get it off of your skin and clean out ice sores if it happens.

The second phase is the proliferative phase, which lasts from 2 days to 2 weeks after injury. During this period, the body is starting to heal by remodeling the structures by either rebuilding it or replacing it with scar tissue.

The final phase is the remodeling phase, which generally lasts 2 to 6 weeks. The body is beginning to be pain-free and starting to restore function. The challenge is to avoid a cycle of inflammation, where the injuries are healed and then immediately re-injured. The cocktail of inflammatory treatments is not good for the long-term health of ligaments and tendons because it increases the necessity of scar tissue, which is both rougher (hence, more painful) and weaker than the original tissues. This is obviously dependent on the will and decision of the athlete – a professional athlete getting paid $15 million might have to suffer through the pain for a few months until the end of the season and hope that it doesn’t break down into a major injury. But the amateur athlete should come back slowly and treat injuries gingerly, adapting to the strength of their newly healed tissues and trying to gradually build it back up to normal.