Many athletes ignore injuries and joint pain. That’s not actually all that unexpected. Running to the hospital every time you get a bump or bruise can be a waste of time, so it often makes sense to take a few days to see whether something will resolve on its own. But, of course, there comes a time when the cost of ignoring a nagging injury or issue is higher than the hassle of actually dealing with it… or when the injury is bad enough that you know you need to get evaluated as soon as possible.
 
Obviously one could write textbooks covering myriad injuries, but for the purpose of this article, we’ll focus on ones that involve inflammation. You wouldn’t know it from the numerous articles and posts emphasizing anti-inflammatory foods that have made their way across the health blog-o-sphere, but inflammation isn’t always bad. Essentially, it’s your body recruiting immune cells to various tissues in your body. That said, too much inflammation can cause joint pain, which can really put a damper on your training (and sometimes on your everyday life).
 
In any case, here’s what to do:
 
Step 1: Get an Official Diagnosis
 
If you have a nagging injury that’s not going away with first aid basics (like RICE or perhaps NSAIDs) and you can afford to see an actual doctor and get MRIs or X-Rays or whatever tests they recommend, this is an ideal first step. Sometimes the diagnoses don’t tell you very much about the actual issue you have, and sometimes the solutions doctors give (like just stopping an activity, or opioid painkillers) are bullshit, but a diagnosis is a good place to start.
 
Step 2: Do Some Research
 
It can be astonishing how little information doctors give you about injuries or conditions that you supposedly have, and even when they do share a lot of information, it’s not always easy to know how it’ll apply to you and your sport.
 
Asking about random injuries to strangers on Reddit or various forums is not only unwise but also a little bit ridiculous, but since you completed step 1, you can now ask the world whether they’ve done Sport X after Injury Y or with Condition Z and maybe get some good feedback. You can check in with people you know, too, who are more likely to share details and information that others might withhold.
 
Plus, you can research supplements you’re interested in. (If you need a quick review on how to read a scientific study, read part 1 and part 2 of my series on that. It’s also worth noting that you often need to look at multiple studies to put research in context, but doing research will at least give you a starting point and questions to ask).
 
You can also find research studies on treatments you’re looking into for your particular condition. Unfortunately, sometimes it costs around $30 to $170 for a single article, even if the study is publicly funded, and even though the study authors don’t receive a penny of the fee. More and more journals are offering free access to research studies, and librarians can often dig up studies for free when you can’t. Other options to try to include Google Scholar, contacting the study authors or financial sponsor directly, or asking your bestie who’s in grad school for a quick favor.
 
Step 3: Evaluate What You Find
 
After getting a dismal diagnosis and spending hours on end Googling it and talking to friends and strangers, you may want to try treatment after treatment that you’ve heard about online.
Your best bet is to try just one thing at a time, rather than throwing spaghetti on the wall and seeing what sticks.
 
That’s because changing more than one variable at a time can make it difficult to see what’s working. It also gets pretty expensive. And if things end up getting worse, it’s hard to tell whether it’s from those stretches you found online that you totally overdid or those sketchy supplements you bought on T-Nation.
 
So, take a look at all of the studies you have, and all of the suggestions you’ve gotten, and try to prioritize them in some way. Personally, I look for studies that focus on mobility, range of motion, etc. rather than pain (since pain is so subjective). In addition to the articles cited above regarding the evaluation of studies, we’ve also written about medical decision-making. It’s ultimately up to you if you want to stick to the tried and true, try something expensively experimental or do something in between.
 
You’ll also want to evaluate the types of changes or treatments to consider.

• Movement changes: It’s pretty amazing how even excruciating pain can disappear after a good physical therapist susses out the root of an issue. Obviously, the quality of PTs varies (just like personal trainers or coaches or anyone else), but before you decide to go under the knife, you might want to give this a try. Often what you think is a problem with one joint stems from another, and your diagnosis is moot once full function is restored and you’re pain-free, simply by correcting poor mechanics or bad movement patterns
• Dietary changes: Often people with so-called “chronic conditions” no longer have symptoms once they make dietary changes, whether that’s cutting out grains, dairy, and hydrogenated oils, eating more fruits and vegetables, adding foods rich in omega-3 fatty acids and sulfur, or drastically reducing sugar. Then there are foods that seem to aggravate certain conditions in some people (such as bananas and potatoes).   Worth trying for a month or two to see if it’s effective.
• Adding supplements: There are a million other supplements, salves, and herbs that are said to treat inflammatory conditions, with varying degrees of science behind them.  Curcumin is a good supplement to research for inflammatory conditions. Cannabidiol oil, AKA CBD oil, is a non-psychoactive concentrate that can be used topically or internally. It appears to be legal if derived from hemp. Finding unbiased information about it online isn’t easy, but it’s a good one to research.
• Other treatments: If you’ve been around the fitness world for a long time, you’ve likely seen various trends come and go. These range from acupuncture to cryotherapy and include various forms of torture bodywork, such as ART, Graston technique, fascial manipulation, the list goes on and on. With some treatments, you can tell right away whether or not you’re getting results. Other times, things can be a bit more subjective. And sometimes, it can take multiple sessions to get results. For example, cold laser (also known as Low Level Laser Therapy, or LLLT) is regularly used for inflammation, pain, and injuries to promote healing and tissue repair, but it can take three or more treatments to see results (and practitioners sometimes recommend as many as 10). Of course, cold laser is not without its skeptics, but there’s also more positive research on specific conditions. In any case, various types of bodywork and/or alternative therapies may be worth a shot, especially if other approaches haven’t done the trick.
• And, of course, drugs and surgery: When evaluating whether to take a drug or go under the knife, a statistic you should ask for (one that most docs don’t like talking about) is the number needed to treat, or NNT: the number of people that need to take a drug or undergo a surgery before one person is helped. Also find out the side effects and percentage of patients in which they occur. Then you can decide whether the potential benefits outweigh the potential damage.

Step 4: Evaluate your results. Repeat as necessary.
 
Those dietary changes that worked for a friend or that supplement your teammate swears by may not do the trick for you. Same with whatever treatment or modality you decide on. I recommend taking notes after treatments with your thoughts and also tracking your own progress. After enough time has lapsed, you can take a step back and look at your results. This will allow you to evaluate whether you’re making progress or not, and use that to guide your decisions about whether to continue with what you’re doing, try something else, or both. One mistake to try to avoid is to stop what’s working as soon as you feel better, because sometimes there’s still some underlying issues that need a bit more time even if you can’t feel it.
 
Step 5: Transitioning Back to Your Sport
 
Whether you’ve taken time off or not, you may need some help transitioning from where you are now to what your performance used to be. This can be challenging because many medical practitioners are completely clueless about sports, just as many coaches are unfamiliar with specific limitations due to injuries. It’s not uncommon for doctors or physical therapists to either recommend something completely unrealistic (like telling young athletes to avoid lifting more than 20 lbs. forever) or provide a series of exercises and then tell athletes that they’re “done” even when there’s still a wide gap between where they are now and where they used to be (or where their teammates are). While talking to athletes you trust who have dealt with similar injuries or conditions can also be helpful, working with a coach who’s in touch with your physical therapist can come in particularly handy, so long as they’re both invested in your recovery. Another option is working with a physical therapist who is extremely familiar with your sport.
 
Whatever you decide to do and whatever you’re dealing with, godspeed. Best of luck in your journey.