Moreover, the metabolism of the cartilage may be impaired and the degenerative process accelerated with the use of drugs like aspirin and ibuprofen.

Other conventional approaches include topical rubs containing menthol, which produce a temporary and paradoxical hot-and-cold sensation that helps to relieve the pain of muscle strain. For severe pain, prescription medications, such as paracetamol (acetaminophen) combined with codeine or with hydrocodone may be recommended. Strains may also be treated with muscle relaxants such as cyclobenzaprine (Flexeril), carisoprodol (Soma) and baclofen (Lioresal).

However, some of these approaches may not reduce the inflammation or get rid of the problem. They may lessen or even deaden the pain, but this doesn’t mean the injury has healed. Continuing to exercise a muscle that is injured can make the problem worse.

Pain is an important mechanism as it lets us know when something is wrong in our body. It makes much more sense to repair the damage rather than to simply ignore the injury that is present.

Aspirin vs enzymes In this respect, more than any other branch of medicine, sports medicine has been quick to adopt the concepts of holistic healing. The need to get athletes back on their feet as quickly and in as good a shape as possible has meant that sports physicians have been driven to embrace the idea of working with the body, and not against it.

A good example of this is the increasingly widespread and popular use of proteolytic enzymes - substances that digest protein - to prevent and also heal athletic injuries.

Enzymes control the chemical reactions that take place in all organisms; they build new proteins, cells, tissues and organs. They also act as catalysts, working in a ‘lock-and-key’ fashion to change the structure of molecules by splitting them or combining them. More than 3000 different enzymes have, so far, been identified in the human body.

All living material contains enzymes, and supplements derived from a variety of sources can mimic some of the body’s own enzymatic activities. Enzymes such as bromelain and papain are derived from pineapple and papaya (paw-paw), respectively. Other enzymes, such as amylase and lipase, are derived from bacteria whereas others, including trypsin, chymotrypsin and pancreatin, are taken from animal, usually porcine, sources.

Though not a feature of conventional treatment, the therapeutic effectiveness of enzymes is so well understood in sports medicine that Olympic athletes in many countries rely on them to aid stamina and healing.

Research into enzymes stretches back 40 years or more (Clin Med, 1968; 75: 35-42). Supplemental proteolytic enzymes have been shown to support and accelerate the natural inflammatory process without letting it get out of control. By using enzymes such as bromelain, papain, trypsin and chymotrypsin, athletes can reduce inflammatory damage, and speed the healing of bruises, swelling and other injuries (Am J Physiol, 1997; 273: G139-46; Fortschr Med, 1995; 113: 303-6; Med Sci Sports Exerc, 1992; 24: 20-5). Specifically, enzymes can:

* break down proteins in the blood that cause inflammation, and facilitate their removal via the bloodstream and lymphatic system * remove fibrin, the clotting material that prolongs inflammation * clear away oedema (excess water retention) in the areas of inflammation * counteract chronic, recurrent inflammation, a primary cause of chronic degenerative joint diseases.