Mending Muscle

Velodrome at the national cycling centre
Photo credit: Ashley Ambrose

With the buzz of the Rio 2016 Olympics still in the air and the hype for the Paralympics building, plenty of us have been inspired to get off the sofa and try something new. For me that meant a trip to the National Cycling Centre here in Manchester for my first taste of track cycling. There’s nothing like hurtling around a velodrome at high speed on a bike with no brakes to get your pulse racing! I’d definitely recommend giving it a go if you enjoy a sweaty adrenaline kick. But as I’m sure many amateur athletes are finding, following in the footsteps of Olympic greats comes with physical payback.

Between the hard work pedaling and  my unflinching grip on the bike’s handlebars,  I was pretty sore the day after my velodrome adventure. My first reaction was to reach for the ibuprofen, but that may not be as helpful as I hoped. Why? We’re back to the usual culprit: the immune system.

Exercise affects the immune system in many ways. We know endurance exercise like running and swimming can increase numbers of white blood cells like T cells, Natural Killer cells and Monocytes in the body, but the effect on health is less clear. Some studies suggest exercise can kick your immune cells into gear to fight cancer and infections (1). Others suggest it actually helps reduce chronic inflammation, effect which could fight metabolic diseases like type 2 diabetes (2).

But does it work the other way around, could your immune system affect your recovery from exercise? Experiments on mice and humans have found that muscle damage attracts a particular kind of white blood cell, the macrophage. We’ve talked before about macrophages in infection, they ‘eat up’ bacteria by a process called phagocytosis. Phagocytosis is also useful for getting rid of dead or damaged cells from your body, for example damaged muscle cells after exercise. Depending on the chemicals they make, macrophage can be called pro- or anti-inflammatory. Pro-inflammatory macrophage produce chemicals called cytokines which boost immune responses in a similar way to bacterial or viral infection, driving swelling and calling more white blood cells to the scene. These are often seen early on after muscle injury and encourage the making of more muscle cells. Anti-inflammatory macrophage make cytokines which calm down the immune response and are seen later in the healing process. Stopping either type can slow down or stop muscle healing. (3). This is the potential problem with ibuprofen, it’s a an anti-inflammatory drug, it acts against pro-inflammatory macrophage.

Does taking ibuprofen actually hinder muscle recovery? There have been a lot of studies on different people doing different kinds of exercise. Most experiments showed that non-steroidal anti-inflammatory drugs like ibuprofen don’t do much to get muscles working at full power again. Timing might be important. Pro-inflammatory macrophage are more important early on in the response so it may help to wait until later with the ibuprofen. Some experiments did show that the medicine helped the perception of pain, but not all of them even had this effect (4).

In short, ibuprofen might help, it might not. All we know is that once again it looks like your immune system is important for this bit of every day life. However you are choosing to recover, I hope you keep using that Olympic energy to give your body a new challenge and your immune system a good workout.

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