Inflammation is an odd beast. We’ve been getting some questions about it in the community, but most members are approaching it dead backwards. I don’t blame them—it’s totally counterintuitive.
I mean, inflammation is bad… right? Unhealthy foods cause inflammation, and if we eat too many of them, we can wind up chronically inflamed. Healthy foods, on the the other hand, are rich in antioxidants, and if we eat enough of them, it reduces our baseline inflammation.
Similarly, being obese can cause inflammation, and is linked with higher risks of morbidity. Being lean, however, reduces inflammation and is linked with improved long-term health.
We’re interested in building muscle, though, and lifting weights causes inflammation. In fact, lifting weights causes a lot of inflammation. So much so that lifting may become your main source of inflammation.
And inflammation is bad… right?
In this article we’ll discuss why inflammation exists and what role it plays in building muscle. Once we have the general principles down, we’ll cover common questions, such as:
- Is inflammation good or bad?
- Should we try to reduce inflammation?
- Are antioxidants good for muscle growth?
- Do Advil, Aspirin and other anti-inflammatory drugs affect muscle growth?
- Do post-workout saunas boost muscle growth?
- Are ice baths good for building muscle?
- How can you fix inflamed forearms (tendonitis)?
- What about shoulder pain and inflammation (shoulder impingement)?
Lifting Weights Causes Inflammation
The first thing to be clear about is the link between lifting weights and inflammation. Lifting weights really does cause inflammation. Our muscles begin to feel sore about a day after working out, that soreness peaks on the second day, and then begins to fade away. During this period, our muscles are inflamed. This is called delayed onset muscle soreness (DOMS).
Inflammation makes you look stronger. One benefit to this inflammation is that since the inflammation is in your muscles themselves, it makes them look a little bit bigger. This is why some people fear that they’ve lost muscle if they miss a workout or two. Their inflammation has faded away, and all of a sudden they look smaller. So in a sense, this inflammation can be good for encouraging people to stick with their habit of lifting weights—if you lift weights every couple days, you’ll look better simply due to your muscles always being a little bit inflamed. This is especially true if you’re doing full-body workouts, where all of your muscles will get inflamed after every workout.
But that inflammation is unhealthy, right? Shouldn’t we try to minimize it?
Before we try to answer those questions, let’s move on to the next problem. Inflammation hurts. This is a problem because our muscles grow best when we stimulate them 2–3 times per week, and if you’re crippled by muscle soreness, you might be tempted to delay a workout. And even if you drag yourself to the gym, you might be so sore that your workout performance suffers.
For example, let’s say that you want to bulk up, so you plan to do full-body workouts on Monday, Wednesday and Friday. But Wednesday’s workout is 48 hours after Monday’s workout, meaning that your muscles will all be at peak soreness. To make matters even worse, new lifters can be sore for up to a week. So even if you skip your Wednesday workout, your muscles might still be sore on Friday.
Again, this is an example of inflammation being bad, right?
What if we could reduce that inflammation? Would that better prepare us for our next workout?
But there’s a flaw in that line of thinking. These questions are being asked with all of the wrong assumptions. That’s why this is so counterintuitive.
Inflammation is an Adaptive Response
Yesterday afternoon, while in the middle of writing this article, my wife and I went to my son’s 6-month doctor’s appointment. He got a couple vaccines, and his doctor warned us that he might get a fever as his immune system flares up.
She gave us some fever medication to take home with us, but she told us to avoid using it unless we absolutely had to. After all, the vaccine is made to resemble a disease-causing microorganism, so it’s natural that his immune system would respond to it. In fact, that’s the whole point of the vaccine.
She reminded us that a fever is our body’s natural immune response, and we shouldn’t interfere with it unless we need to.
The fever isn’t the problem, the fever is the solution.
The more we try to micromanage our natural response, the more we anger father nature.
Now let’s go back to talking about inflammation. When we go to the gym, we stress our muscles. We do this on purpose to provoke our body’s adaptive response. Our body’s adaptive response to lifting challenging weights is to become bigger, stronger, and tougher.
Part of this adaptive response is inflammation.
Inflammation isn’t the cause of the damage. Lifting weights caused the damage. The inflammation is helping us repair that damage. If our muscles get damaged and our bodies didn’t respond, our muscles would just stay damaged. There would be no soreness or inflammation, just debilitation (study).
You’re probably familiar with that experience. In the hours after a challenging workout, your muscles are crippled. They’re damaged and depleted to the point that they’re weaker than they were before your workout. But there isn’t really any soreness yet.
You only feel sore when your body’s immune system kicks into gear, sending extra nutrients into those muscles to help them heal and grow (study, study, study, study). This is inflammation. This is the magic of having an antifragile body that can improve itself. How amazing, right? We have the ability to improve when we encounter stress. We are the mythical Hydra.
Stimulating that inflammatory response is the whole point of lifting weights, so the last thing we want to do is minimize it. We actually want to cherish that inflammation.
When Heracles chops one of our heads off, it hurts, but then we grow two more.
So how did Heracles finally defeat the Hydra? He chopped off the heads and then immediately cauterized the wounds. He interfered with the Hydra’s natural adaptive response. When we interfere with our inflammatory response, we’re essentially doing the same thing. We’re preventing our body from adapting.
If you’re new to lifting weights, you’re going to have a fairly extreme inflammatory response to lifting weights. You’re going to get quite sore, it’s going to be quite painful, and it can last up to a week… but that’s what allows us to make absolutely incredible adaptations:
I know this might look impossible. More about the science of newbie gains here.
As we gain more experience lifting weights, we grow tougher to the stresses that lifting inflicts. We begin to grow immune to it. Our muscles don’t get as damaged or as sore. Our immune systems don’t need to kick into gear. That’s good in the sense that we can lift all kinds of heavy things without sustaining damage or becoming sore. But it’s bad in the sense that it’s harder to stimulate new muscle growth. Our newbie gains are gone. At this point, it’s even more essential that we don’t mess up our body’s natural inflammatory response.
Let’s look at some examples of what can happen if you try mess with father nature.
Anti-inflammatory drugs (NSAIDS) and muscle growth
Many new lifters are crippled by muscle soreness, and many older lifters are nursing nagging aches and pains, so they take anti-inflammatory drugs to reduce their muscle soreness and joint pain. Non-steroidal anti-inflammatory drugs (NSAIDS) such as Advil, Aspirin, and Aleve are especially common. But what effect do they have on muscle growth?
In this study, the participants who took 1,200mg of ibuprofen per day only gained half as much muscle as the participants who took nothing. The drugs reduce symptoms of soreness, but they did so by reducing our ability to recover and grow (study).
Note that acetaminophen (Tylenol) isn’t an anti-inflammatory drug, and so you wouldn’t run into any of these issues with it. However, there’s another downside to lifting weights while taking any form of painkiller. There’s a reason we evolved to feel pain—because it’s a useful signal. It warns us away from inflicting harm on ourselves. For example, if you put your hand on the stove, it hurts, and so you shriek and yank your hand away before you get a burn.
Let’s imagine someone with a sore shoulder who takes some Tylenol before doing their bench press. They have a shoulder impingement issue, but the Tylenol kills the pain. They start to lift, and as their shoulder cries out in agony, the lifter isn’t listening. He grinds away at his rotator cuff, making it worse and worse (study). The next workout, he really needs to take some Tylenol. No good.
This isn’t to say that you should never take painkillers, just to say that you should try to avoid becoming reliant on them on a day-to-day basis. Taking some painkillers now and then, especially in lower doses, shouldn’t affect your muscle growth at all. For example, in another study, the participants using 400mg of ibuprofen per day grew at the exact same rate as the participants taking a placebo. However, that lower dose wasn’t enough to reduce muscle soreness, either. No harm, no benefit.
This means that you might be able to take a small amount of Advil (around 400mg) to cure your headache without it having any impact on your bulking routine. Just don’t try to reduce your muscle soreness with it. After all, a dose high enough to cure your muscle soreness will also be high enough to halve your muscle growth.
Similar problems arise if you try to use painkillers to numb the pain from chronic injuries, such as inflamed shoulders, knees, or forearms. If you succeed in numbing the pain, you’ll be making yourself more vulnerable to worsening the injury. In addition to that, you might be interfering with your body’s ability to repair the damage.
Antioxidants and muscle growth
Antioxidants are a healthy way to reduce inflammation and soreness… right? Antioxidants are indeed part of a healthy diet, and yes, they’re also healthy. That’s why it’s controversial to say that they might harm our ability to build muscle. Still, recent research into antioxidant supplements like vitamin C and E have shown that they:
- Harm our workout performance (study)
- Prevent us from recovering properly (study)
- Inhibit glucose metabolism and insulin signalling (study)
- Reduce our ability to build muscle (study)
So just like anti-inflammatory drugs, antioxidant supplements have a negative effect on muscle growth.
But keep in mind that this doesn’t make antioxidants unhealthy, and it doesn’t mean that you should avoid them. These studies were done using high doses of antioxidant supplements. You can still eat plenty of fruits and veggies, and you can still drink plenty of tea. Just don’t intentionally consume a ton of antioxidants as a strategy to reduce soreness.
To quote the researchers over at Examine.com:
Although antioxidants are an essential part of any diet, evidence is mounting that antioxidant supplements should be avoided in the hours around training time. It may also be wise to avoid daily very-high-dose antioxidant supplements if you’re aiming for maximum muscle growth.
You might even want to experiment with taking this idea a little further. Maybe you try avoiding meals rich in antioxidants right before and right after working out, and then having more antioxidants further away from your workouts. A post-workout pizza after your evening workout, but then fill your next day with fruits, veggies, and tea.
Is inflammation good or bad?
Neither. Or both. There’s a distinction between systemic inflammation that persists indefinitely, which is bad, and the acute inflammation that we get from lifting weights, which is good (study, study).
For your general health, it’s important to minimize your overall inflammation. Ideally you’d do this by addressing the root issue rather than just by taking drugs to treat the symptoms. For example, if you find yourself chronically inflamed because of poor sleep, better to fix your sleep than to start popping Advils all day long.
Here are some ways to keep your baseline inflammation low, which will improve your health and also your ability to build muscle:
- Get plenty of good quality sleep. The better you sleep, the more testosterone and the less cortisol you’ll produce. You’ll feel less inflamed, you’ll have more energy, you’ll lift harder, you’ll recover better, and you’ll build more muscle.
- Eat a diet that’s made up mostly of whole foods. If you’re wondering what a healthy bulking diet looks like, here’s our guide for how to eat more calories.
- Try to minimize chronic stress and anxiety in your life. Maybe that means meditation or prayer, or spending more time with loved ones. Regular exercise is also a great way to reduce feelings of chronic stress and anxiety.
With a low baseline level of inflammation, you’ll be ready to lift weights without feeling overwhelmed by the beneficial inflammation that will hopefully follow.
Are saunas good for building muscle?
Saunas are interesting. They temporarily boost our heart rate, increasing blood flow. Some preliminary research shows that this may reduce our baseline levels of inflammation (study). Other experts note that although saunas reduce soreness, they actually seem to increase inflammation in certain areas.
Either way, saunas don’t appear to harm muscle growth. If anything, they might even improve our ability to build muscle. After all, saunas improve our ability to pump blood and nutrients into our muscles, which is very similar to the positive role of inflammation itself.
I don’t want to make too many claims about saunas and muscle growth, though. The research isn’t very conclusive yet, so we’ll have to wait and see. I’ll keep this article updated.
Do ice baths improve muscle growth?
On the other side of the spectrum, we have ice baths. Despite being the exact opposite of a sauna, they’re also commonly used to reduce muscle soreness after lifting weights. Fortunately, there’s been some good research directly looking into ice baths and their effect on muscle growth and strength. Furthermore, all of the research lines up, leaving little controversy.
Ice baths have a fairly predictable effect on muscle growth once we understand the role of inflammation. By reducing inflammation, we’re reducing our ability to adapt to the stresses of lifting weights. So, unsurprisingly, research is showing that immersing yourself in cold water after working out will reduce your muscle and strength gains (study, study).
However, as with anti-inflammatory drugs and antioxidants, we need to keep in mind that the dose makes the poison. Having a long and painful ice bath after working out will directly harm your gains, but a short cool shower shouldn’t do much of anything. If you prefer cool showers to refresh yourself after lifting weights, no problem, just don’t take it to a painful extreme.
Inflamed Joints & Tendons, chronic injuries & other Hellish issues
Now let’s talk about another type of inflammation—the chronic inflammation that you get from joint issues, such as inflamed shoulders, or from tendon issues, such as forearm tendonitis. This inflammation isn’t good or bad. The inflammation itself is your body trying to fix the issue, which is good, but the issue itself is gradually wearing down your body, which is bad.
The stress of lifting weights can make your muscles stronger, your tendons tougher, and your bones denser. The point is to apply stress, then recover, then improve. But sometimes we don’t fully recover from that stress, leading to an accumulation of damage. This commonly happens in our shoulders, forearms, and knees. No good.
Forearm and elbow inflammation from bicep curls
Let’s start simple by using the example of bicep curls. The purpose of the lift is to stress your biceps (as well as your brachialis and brachioradialis). That stress will damage your muscles, then they’ll recover, and then they’ll grow. As you do this, the tendons and bones in your arms will grow stronger as well. And in addition to growing stronger, you’ll also grow tougher. The curls are causing inflammation, yes, but that inflammation will ultimately make you better than you were before.
This is all well and good, but in some people, doing bicep curls with a straight barbell can cause pain in their elbow joint. Similarly, reverse curls can cause their forearm tendons to rub painfully against one another. If they persist in doing those painful bicep curls year after year, they can wind up with a cranky elbow or chronically inflamed tendons in their forearms (tendonitis), which is bad. This ongoing, relentless stress is how you wind up with chronic injuries.
Your biceps hurting as you curl is perfectly fine. That’s where you’re trying to direct the stress. But if your elbows or forearms are screaming out in pain, something is wrong. This where the “no pain, no gain” approach to lifting weights can really mess people up. Some types of pain are fine, and we need to persist through them. Other types of pain are bad. If the pain doesn’t feel right, double check. Lifting is something you should be able to enjoy for a lifetime.
Also keep in mind that lifting is often a solution, not a problem. After all, even just repetitively using a mouse and keyboard can result in forearm tendonitis. For example, Jared wound up with severe tendonitis in both forearms from doing graphic design work, but then bulking up solved the problem. And most people get cranky knees and elbows from sports, such as tennis elbow from tennis / golfer’s elbow from golf, and again, lifting weights can provide the solution.
Consider that most physiotherapy is quite similar to lifting weights, often involving plenty of resistance training and even actual weightlifting.
How to approach chronic inflammation
In Jared’s case of forearm tendonitis, he was prescribed anti-inflammatory drugs to help him manage his intense pain. Another approach is to make sure that you aren’t wearing yourself down in the first place. With something like a bicep curl, that might mean using a curl bar or dumbbells instead of a standard barbell, allowing for a smoother range of motion. That way you can strengthen your forearm tendons instead of wearing them down.
In Jared’s case, as he fought to strengthen his arms, he ran into the issue of barbell bicep curls causing his issues in his forearms and elbows. By switching to other variations, such as dumbbell and cable curls, he was able to continue strengthening his arms, which eventually allowed him to overcome his tendonitis. (I’m not trying to make lifting weights sound like a panacea. This was just one aspect of his overall lifestyle changes. He also improved his diet and sleep, which were also essential parts of strengthening his tendons.)
Shoulder inflammation from the bench press
Let’s look at another example: the bench press. If you’re doing the bench press properly, you’re going to be stressing your bones, your tendons, your forearms, your triceps, the fronts of your shoulders, and most of all, your chest. (If the bench press isn’t stimulating your chest, check out our chest exercise article).
However, bench pressing is infamous for causing shoulder impingement, which is chronic inflammation in your shoulder joint. This is something I struggled with in the past. I had trouble lifting my arm up overhead, benching hurt, and I kept on getting sharp pains that would shoot through my shoulder.
Shoulder impingement is what happens when the bones in your shoulder joint scrape against the tendons, wearing them down until they become damaged. This makes the tendons inflamed, which makes them bigger, which makes the space even tighter. That makes them grate even more against your shoulder joint.
In my case, I was skinny, desperate, and an idiot, so I ploughed forward, continuing to grind away at the tendons in my shoulders. This, of course, made my shoulder impingement worse.
One cause of the issue is benching with poor technique. For example, if you bench with an excessively wide grip, or if you don’t pull your shoulder blades down and back, or if you don’t have a proper arch in your back. I was doing all of these things.
The importance of technique and muscular balance
Another way to wind up with shoulder impingement is by doing a workout program that doesn’t balance pushing and pulling, or internal versus external rotation. This can cause your shoulder to drift out of the proper position, making it more vulnerable to impingement. I was doing this as well.
The most common ways to manage that shoulder impingement is to either stop doing pressing movements or to take anti-inflammatory pills before working out. The problem with those approaches is that avoiding presses is going to make it hard to build strong pecs and shoulders, and taking anti-inflammatory pills is going to make it hard to build a strong anything.
We shouldn’t avoid or ignore the issue, we should to overcome it.
As stupid as I was to simply keep grinding away at my shoulder, at least I didn’t make the mistake of giving up entirely. I pressed on. And fortunately, right when my shoulder issue was at its worst, I came into contact with Marco.
Marco taught me how to bench press with better technique to reduce the stress I was putting on my shoulder joint. Then he helped strengthen my back with a variety of rows and external rotation exercises, pulling my shoulders back into the proper position, creating more space in the joint. This allowed my chronic inflammation to finally fade away.
The importance of exercise variety
Most interestingly of all, he taught me the importance of exercise variety. If you continue to grind away at the same lift, such as a wide-gripped barbell bench press, then you’re going to be stressing your tendons, muscles and joints in the exact same way over and over again. At first it helps you build muscle, yes, but then it becomes like Chinese water torture, where a small stressor applied a million times to the exact same area can destroy you.
First of all, Marco gave me workouts that had a greater variety of lifts in them. I wasn’t just doing the bench press anymore, I was also doing push-ups, landmine presses, and flyes. And every few weeks, he would vary the lifts. I’d use a slightly wider grip, or switch to a slightly different exercise. This not only prevented me from wearing down my tendons, ligaments, and joints, it also gave my muscles a new type of stressor to adapt to. That sped up muscle growth and stimulated muscle fibres that I’d been neglecting, giving me fuller muscles.
Over the course of a couple months, my shoulder pain went away, my chest filled out, and my bench press climbed from 185×5 to 225×5.
If you want to see what a good chest program looks like, I recommend checking out our War Chest program. It’s a workout program designed to help you build up a strong, full chest. But it does so in a way that also includes plenty of pulling and external rotation work, which will help to keep your shoulders healthy. We also go over how to bench press safely and effectively for chest strength and growth. (It’s a full-body workout program, but it’s designed to emphasize growth in your chest, shoulders, and upper back.)
If you haven’t gained a good 20–30 pounds yet and you want to take this approach with your entire body, check out our Bony to Beastly Bulking Program. We’ll help you gain 20+ pounds of muscle over the course of a few months, and we’ll do it in a way that will give you a stronger, tougher, and fuller body overall. Your body will surely burn with a Hellish fire, but it will be the good kind.
Even with chronic injuries, inflammation is just the symptom
Anyway, when it comes to both tendonitis and shoulder impingement, you can see that working out might be the cause, and inflammation might be the symptom. Still, that doesn’t mean that the inflammation is bad. In fact, the inflammation is your body struggling to fix the underlying issue. In many cases, it’s better to weed out that initial cause of the stress and destroy it right at its root.
That’s what worked for Jared’s forearms and my shoulders, anyway, and it’s the approach Marco takes when helping his clients rehab chronic injuries. And keep in mind that some of his clients are professional and Olympic athletes—their livelihood depends on them avoiding these career-ruining injuries.
Key points about inflammation & muscle growth
- Inflammation is an evolved adaptive response. It’s how our bodies heal and grow.
- Working out causes inflammation, and that’s good—it helps us build muscle.
- Minimizing inflammation with anti-inflammatory drugs, antioxidant supplements, or ice baths will directly harm our ability to build muscle. Inflammation is our ally against stress, not our foe.
- Saunas seem to have a mild positive effect on muscle growth, but this isn’t surprising given that they seem to improve blood flow, and may even temporarily increase inflammation.
- Chronic inflammation in a specific area is bad and should be avoided. If you notice that your shoulders, forearms, knees, or lower back is constantly sore and inflamed, it might be a sign that your lifestyle is tearing you down instead of building you up.
- When dealing with chronic inflammation, it might not be appropriate to attack the inflammation directly. If possible, try to weed out the root cause instead. For example, fix your shoulder impingement by improving your workout program instead of simply muting the pain with Advil.
- Be careful about working out while on painkillers. Pain tells you what to avoid. Without that signal, you might make yourself more prone to injury.
- It’s good for your muscles to get inflamed after a hard workout, but it’s not good to have high baseline inflammation overall. You can reduce your baseline inflammation with a good diet, plenty of sleep, and by reducing the chronic stress in your day-to-day life.
Overall takeaways about inflammation
As always, keep the big picture in mind. Try to lead a healthy lifestyle that isn’t leaving you feeling chronically inflamed. Sleep well, eat well, minimize chronic stress and anxiety.
Then, when it comes to lifting weights, embrace the inflammation and soreness in your muscles. That’s the good kind of inflammation. The whole purpose of your workout was to stress your muscles enough to provoke an adaptation. That inflammation is how your body responds to the stress. That’s how it delivers nutrients to the area, building your muscles up bigger and stronger.
Don’t take anti-inflammatory pills, don’t try to eat an overly anti-inflammatory diet, and don’t try anti-inflammatory recovery tricks like ice baths—especially right after working out. If you succeed in reducing your inflammatory response to lifting weights, you’ll be blunting your ability to build muscle.
However, you don’t need to be extreme about that advice either. Taking an Advil to cure a headache now and then won’t have any effect on your muscle growth (or soreness), nor will blending up some beets and kale into a smoothie. Just don’t make the mistake of intentionally trying to reduce your inflammation.
Finally, there are types of inflammation that we should avoid when lifting weights. We need to be mindful of wearing down your tendons, ligaments and joints in a way that results in chronic inflammation. To do this, make sure that you follow a balanced lifting program that works your body through a variety of ranges of motion. It’s important to stimulate balanced strength development so that your muscles hold your body in the correct position. You’ll not only prevent chronic injuries, you’ll also build muscle more quickly, and those muscles will be stronger and fuller.
It’s easy to imagine how you can improve your muscular balance if you build more muscle overall, such as with our Bony to Beastly Bulking Program. But you can even build a more “balanced” physique while over-emphasizing certain muscles and proportions. This is essential if you want to emphasize a v-taper to improve your aesthetics, or to improve strength in a certain area for a certain sport.
If you want to emphasize certain muscles, then you just need to develop strength in the antagonist muscles as well. For example, if you want a bigger chest, that will pull your shoulders forward. So you should also develop the muscles that pull your shoulders back, down, and up, building a bigger shoulder girdle overall. This will involve some overhead pressing, some horizontal rows, and some vertical pulls (such as chin-ups). You’ll probably also want some push-ups in there so that you can strengthen your serratus muscles, which are also key to developing good shoulder health. This is the approach we take in our War Chest Program for Stubborn Chests—we go hard after chest growth, but in a way that leaves you strong and healthy.
I really hope that helps.
I’ll post an article about muscle soreness soon, which is closely related to the principles in this article. Sort of a Part Two. Stay tuned!