"Evolutionary considerations suggest that the inflammation and pain associated with sprained ankles are adaptive responses to promote healing, and that suppressing them would be detrimental to long-term functionality of the joint. I have searched the literature to find out whether any evidence indicates that treatment of sprained ankles with ice, compression, anti-inflammatories, and analgesics promotes or hinders healing and long-term functionality of the joint. In particular, I have been looking for comparisons of treated individuals with untreated controls. I have not found any and am coming to the conclusion that this widely advocated expert opinion is a detrimental holdover from ancient Greek medicine, which often confused the return of the body to a more healthy appearance with the return of the body to a state of health."Highly intriguing. What other "basic common wisdom" have our scientific institutions accepted (out of precedent) without actually testing (at least not in the past 500-1,000 years)?
Becky's comment (/response) is highly illuminating, and worth the read. Thanks Becky!
6 comments:
I appreciate your question, but have to offer a counter perspective in response to the particular argument which inspired it.
It's so tempting to conclude that evolution results in the BEST possible solution to a problem, but this is rarely the case. Evolution merely represents an ADEQUATE solution to a problem, one that allows an individual with that trait to survive just long enough to reproduce.
The inflammatory response to tissue tearing is an archaic solution to an ongoing problem. Stretch receptors detect a problem and flood the area, first with chemicals that trigger a pain response (i.e. stop doing that thing that injures yourself) and then with chemicals that act like a biological epoxy that immobilizes the joint in the extremely long process of connective tissue healing. The joint also assumes that you're going to be stupid and do it again, so this process lays down tough scar tissue to permanently limit the range of available motion. In some cases, the muscle tissue will permanently adhere to the joint capsule. Oh, and just to add insult to injury, during the immobilized healing time, the surrounding muscles become weak or shortened, making them inefficient. Not to mention that the weird movements now required to move will likely wreak havoc on the rest of the body's joints down the line. This was a perfectly adequate solution when the only object was basic survival.
The modern age, like it or not, has allowed us to be concerned with the individual's quality of life. We're not satisfied with the adequate healing powers of the body, but look for the optimal conditions of healing. These include controlling inflammation, splinting, and exercises to maintain a joint's full range of motion with the goal of restoring normal movement.
I'd also like to note that this research does exist, there are case studies all over rehab literature. It may be difficult to find current comparative studies with an experimental design because these principles are so fundamental to rehab practice that it would be considered unethical to withhold treatment and wouldn't make it through the review boards.
No doubt, there are practices in which "progress" probably interferes with the body's natural abilities, but this is not one of them.
Thank you for filling in info that Paul Ewald either lacked or didn't care to present.
"Evolution merely represents an ADEQUATE solution to a problem, one that allows an individual with that trait to survive just long enough to reproduce."
That's a very good point, as well.
You're more than welcome- I couldn't resist, probably because the heading "Them Nutty Geeks" includes me...
Geek or Greek? Greek geek?
Pledge week was months ago.
Damn. No frat parties for me, then.
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