Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
28 Jan

Dear Mark: Adding a Workout to an Active Life and Topical Wound Ointments

bandagefingerWe’ve got a nice pair of questions for today’s Dear Mark. In the first, a young woman who’s perhaps the most intuitively active person I’ve ever heard about asks whether or not she should incorporate a dedicated, formal workout to her schedule of skiing, playing with dogs, hiking, manipulating heavy bags of dog food (in a physical sense, not an emotional sense), yoga, and rafting. You guys might be able to guess the gist of my response, but read on to find out what I say. In the second, a guy asks about topical ointments that promote wound healing. As a response, I discuss the standard over the counter ointments (antibiotic ointments, petroleum jelly-based ointments) as well as the more “natural” alternatives like honey, coconut oil, and garlic.

Let’s go.

Hi Mark,

I was wondering if playing replaces workouts. I am lucky to be able to play a lot (well it wasn’t lucky, I planned it this way). Winter and spring I am usually skiing 2-3 times a week. I camp out at the ski area/resort, ski sidecountry and backcountry. So I do a lot of skiing and hiking in my ski boots with a backpack to get to the steep and deep. I hike my dogs anywhere from 30 minutes to 2 hrs a few or more days a week and daily in the summer. I manage a pet resort on the weekend. I usually work 3- 12 hour days on my feet playing with dogs, lifting dog food bags (5-60#), shoveling poo (glamourous!), etc.  In summer and fall I replace skiing with just as much backpacking (I will stay out in the mountains all of my days off) and a little rafting. Sometimes if I feel tight, I might do a little 15 minutes of yoga once or twice a week. I mostly take a none-day once a week when I do absolutely nothing except sit at my house and try to veg out. Well sort of a veg out; this is usually my dogs big walk day and I clean my house, stock wood, catch up on some reading, craft some moccasins, and make more adventure plans! I am 32, 5’3″ and a steady 107 lbs. I was a vegetarian for 12 years and thank goodness for all that is playful, started eating meat 2 years ago. I sleep very well, I might need more of it than others (10-12 hrs a night) but I don’t drink coffee (yuk!) to get up in the mornings. I last longer than all of my ski gang, and my hiking partners although I go to bed a lot earlier than them. Sometimes I eat as much as my 220 lb husband. I don’t think I need to add any workouts but, sometimes feel a bit lazy for not. And, I am afraid I might lose weight if I do. I feel no desire to be ‘ripped’, I just want to have the stamina and strength to ski forever! So, would playing replace work outs? Would it be beneficial to add a workout?

Cheers!

Krystal

Let me get this straight:

You ski 2-3 days a week for half the year. This involves carrying your skis by foot as you trudge up hills and through powder to reach the best spots.

For the other half the year, you backpack in the mountains and go river rafting.

Once or twice a week, you do yoga.

You go on hikes upwards of 2 hours long 2-3 times a week in spring, winter, and fall, and you hike every day in the summer.

Weekends, you work long hours playing with an entire resort full of the close descendants of quadrupedal carnivores. One popular game in dog society is tug-of-war, a full body ordeal. You also perform power cleans with sixty pound bags of kibble and do weighted shovel exercises.

On your rest days, you do chores, carry wood, and go on dog hikes.

You sleep 10-12 hours a night and occasionally eat more than your 220 pound husband without gaining weight.

Your fitness and strength levels appear to be superior to those of your peers.

And you think you might need to add a dedicated workout to maintain your current level of fitness? I’d say you’re doing better than most. I’d say you absolutely don’t need to include a formal workout. In fact, I’d say you shouldn’t include one, because it might actually be detrimental to your goals. Less is more, especially when you’re already so active.

You’re staying in shape the way humans have been built to stay in shape: by maintaining a steady flow of low-level activity punctuated with acute bouts of high intensity. Most importantly, you’re doing the most sustainable workout imaginable – one that you truly love doing. I wish I could maintain a schedule like that. Keep it up!

Hi Mark,

I was curious about your thoughts on first aid for minor cuts. If you are out running barefoot, or climbing trees, you’re bound to have some scratches! Would you recommend products like antibiotic ointments that you would rub into a cut to make it heal faster? Or do you know of something possibly more natural?

Thanks for all that you do!!

Rob

Antibiotic ointments like Neosporin are certainly good at preventing infection, they can certainly make cuts heal faster by preventing or stopping bacterial infection, and plenty of people will absolutely vouch for their efficacy, but they don’t always perform very well in clinical trials. In one recent study of different ointments’ influence on wound healing time, Aquaphor Healing Ointment, whose active ingredient is simple petroleum jelly, beat both Neosporin and Polypsorin (an antibiotic ointment containing fewer antibiotics than Neosporin). Other studies have had similar results, concluding that petroleum jelly was just as effective than the more expensive antibiotic ointments. Antibiotic ointments also bring the potential for skin irritation or allergic reactions, a problem more inert ointments generally do not have; another study found that Aquaphor Healing Ointment also caused less irritation than antibiotic ointments.

As to the gushing reports of Neosporin’s powers, I suspect a lot of it stems from lack of a proper control group. If all you ever put on your wounds is Neosporin and every wound has healed, you’ll assume that it “works,” even if it isn’t actually doing much. There’s also the chance that “dirty” wounds, like you might get out in the real world, are at a greater risk of infection and may benefit from topical antibiotics, whereas the controlled environments of clinical trials remove the risk of bacteria. There’s also evidence that antibiotic ointments are increasing the prevalence of antibiotic-resistant bugs, including MRSA. That said, I find it likely that Neosporin works better than nothing at all, particularly if the wound is infected or at risk for infection (which you won’t know unless you test the wound).

Honey works well on wounds, acting as a broad-spectrum antibacterial agent and as a promoter of tissue healing. Thanks to many factors, including the antioxidant compounds, acidity, natural hydrogen peroxide content, osmotic effect, and as-yet unidentified compounds, it appears to stimulate tissue growth, reduce scar tissue formation, and increase epithelialization. The honey doesn’t even need to be raw as long as it’s actual, real honey (although unfiltered, raw honeys may have more bioactive compounds, also known as “impurities”). The only side effect of topical honey is, to my knowledge, incitement of pooh bears. If you ever cut yourself walking through the woods of Sussex, England, skip the honey – particularly if you see any bipedal piglets wearing pink horizontal striped singlets. Though normally plush and giggly, the pooh bear is a fearsome predator when in the throes of honey lust. Don’t let the baby T fool you.

Coconut oil is a potent antibacterial agent, mainly because of its medium chain triglyceride content (PDF). Since it’s MCTs we’re after, it shouldn’t matter much if you use refined or virgin coconut oil. That said, virgin coconut oil may have some extra bioactive compounds that affect the healing effect; sure enough, one study found that virgin coconut oil improves wound healing time partially due to “the cumulative effect of various biologically active minor components present in it” in addition to the MCTs.

Allantoin, a compound found in comfrey root, seems to speed up the healing process. This comfrey ointment gets very good reviews.

Garlic is another one, especially aged garlic extract (extract from garlic aged at least 20 months, giving it a higher phenolic content).

There’s also the timeless classic that spans species: wound licking. Most saliva has healing properties, whether canine, murine, or hominin. A dog’s saliva is antibacterial (against e. coli and s. canis), certain types of rat saliva promotes wound healing, human saliva contains healing-promoting histatin, and nerve growth factor, which stimulates wound healing, is produced in the saliva of most mammals. There are lots of other possible explanations for the beneficial effect of licking – the physical removal of dirt and debris from the wound, for one – but it’s pretty clear that we’re drawn to lick our wounds because it helps in some fashion.

I won’t go into an exhaustive list of all possible natural alternatives, because there are way too many. Some are bunk, some are legit. I’d even wager that most plant-based compounds have potential to help, even if an effect has yet to be shown in a clinical trial, simply because plants tend to contain bioactive compounds, oftentimes antimicrobial (to, you know, protect the plants from microbes). Antibiotic ointments and the aforementioned petroleum jelly ointments won’t win you any friends at the food co-op, but they also appear to be better than nothing.

Cleaning the wound with soap and water (or even just water), keeping it moist, and keeping it covered are probably more important to the healing process than what ointment you use.

Hope my answers helped! Thanks for reading and be sure to leave a comment with your own Dear Mark questions.

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. We love Manuka honey for scrapes and cuts. It’s honey made from bees that have feasted on the tea tree plant. We use coconut oil to remove the adhesive of the bandage. Works like a charm for ouchless removal. I’ve also used both in combination to relieve dry, cracked itchy winter toes. Amazing stuff. Why would you use chemicals and petrol products?

    Laura wrote on January 29th, 2013
  2. I have always wondered why someone doesn’t make a non-petroleum based antibiotic ointment for the hippy crowd. Say in a base of pharmaceutical lanolin? I’d buy it. I’d also buy a non-petroleum version of Tiger Balm.

    Rachael wrote on January 29th, 2013
  3. I used to make a moisturizer with aloe, vitamin E oil, and a couple drops of lime essential oil (for the nice smell).

    Now, I mix up MCT Oil, coconut oil and a drop of vanilla extract for my lip balm (it doesn’t stick around, but it tastes great and works well. Maybe someday I’ll add some beeswax.)

    For my body and face moisturizer, I mix MCT oil and coconut oil and vitamin E oil. Yes, it’s oily: mornings, I slather it on (esp. face, neck, and chest — I’m an old lady), then brush my teeth and hair, then use a towel to wipe off the excess oil. Saw my mom recently (after a couple years) and she was amazed at how wonderful my skin looked. After a shower, I also use it lightly on legs and arms; it is absorbed quickly enough so I can get dressed without getting my clothes oily.

    Elenor wrote on January 29th, 2013
  4. Oh, I also very often get ‘under the fingernail’ infections after gardening. (I think my immune system doesn’t like the soil-bugs here in the South!)

    So, when I garden, I wear double surgical gloves, and when I come inside, I wash my hands and then use alcohol to carefully clean around and under my nails; then use antibiotic ointment to prevent infection. (The doctor, when the infection hits, “makes” me take antibiotics AND an antifungal. {shudder} And I do because it’s been a bad — and “topically unreachable” — infection!)

    Obviously, I’m still trying to recover my health (and immune system) after decades on the SAD. But, since I’ve done the alcohol and antibiotic creams, I haven’t had any bad infections. (Could also be my blood sugar is lower.)

    (And, now, mostly, I avoid gardening. {sigh})

    Elenor wrote on January 29th, 2013
  5. Really Krystal? You needed to submit that question to MDA??

    mars wrote on January 29th, 2013
  6. Tea tree oil is harmful to dogs so please dont use tea tree oil + dig licking to treat cuts!

    mars wrote on January 29th, 2013
  7. Bentonite Clay. I have used this on 2 bad wounds including a white tail spider bite with necrosis, and a bad infection setting in on a deep gash to an elbow (family members). Many, many more beneficial applications. Worth checking out.

    chocorama wrote on January 29th, 2013
  8. Has anyone else noticed since going primal that their cuts heal really fast!

    I recently cut my thumb quite deeply, within less than a minute it had stopped, I put a plaster on just to minimise risk of infection but in regards to bleeding nothing!

    I’ve also started eating a lot more saturated fat as well over the last 6 months predominantly from grass fed butter, at least 50+g a day so maybe that is one of the reasons as well!

    Goran wrote on January 29th, 2013
  9. Lavender essential oil (theurapeutic grade like Doterra) works amazingly for cuts/scrapes/burns. Apply to bandage and then over wound. It can also be mixed with coconut oil.

    primalmontana wrote on January 29th, 2013
  10. Coconut oil:
    Best all-around treatment for anything.
    Cleared up my dry scalp in one application.

    Fred Timm wrote on January 29th, 2013
  11. I recommend Propolis for cuts and inflammation – that’s homeopathic and produced by bees. It’s antibiotic, antiviral and antimicotic – I just love the stuff. But since I’m new to the whole stuff, I’m not certain if it’s really primal – but I would think so.

    Newbie wrote on January 29th, 2013
  12. You have to make sure that the dog donating the saliva isn’t rabid though.

    Koen wrote on January 29th, 2013
  13. I recently discovered argan oil, and I’ve been amazed–it cleared up a patch of eczema I’ve had on my face for over a year. The steroid cream the derm prescribed did nothing for it. It’s awesome just as a general moisturizer for face and body, too!

    Connie wrote on January 29th, 2013
  14. We also use Calendula in lotion form. Used it to help heal a scar (and stop itch) after surgery.

    Trudy wrote on January 29th, 2013
  15. Aquaphor is incredible! It heals wounds quickly and prevents scarring if you apply it immediately after the wound and cover it. Works every time.

    Tiff wrote on January 29th, 2013
  16. The nitrites in saliva are also anti-bacterial. The level of nitrites in saliva is a hundred times higher than the blood level. For small cuts, my best treatment is my pit bull. Her licks perform 2 functions: debridement and disinfection.

    Ed wrote on January 30th, 2013
  17. We get black salve from a trusted source and use it for nearly anything topical ranging from cuts, scrapes…my son just had a wart on his thumb…gone in 3 days. It goes on the dog when she gets nicked up out in the woods. We use colloidal silver but haven’t done the topical gel version, only liquid for eye irritation etc.

    Matt wrote on January 30th, 2013
  18. Hi Mark,

    I’m wondering if you or one of your staff members have tried a primal version of the SNAP challenge (http://frac.org/initiatives/snapfood-stamp-challenges/). How realistic do you think it is to eat primally on $5 per day, even if you know to cook?
    Teri

    Teri wrote on February 1st, 2013
  19. Krystal, if you’re reading this, you’re a champion. That’s an excellent mix of activity.
    I don’t put much faith in over the counter ointments for the most part. I think Polysporin and After-Bite have helped me a bit but I stopped using them a few years or so ago and only used them regularly when I was a kid. I contracted a nasty case of athlete’s foot in both feet from wearing used boots while camping for four weeks in teen rehab (that was a little over four years ago – my feet have been feeling a little itchy or practically rotting slightly regularly since, though they’ve improved a bit lately. Maybe that’s because I’ve spent most of my time living outside (or in an unheated, somewhat run-down shelter)and often getting cold feet since mid-December. I spend most of my time wearing boots and the skin on my feet gets moist from sweat and snow – a few times lately I’ve taken my boots and socks off after a long time and my foot skin has looked like puffy white elephant skin so I’ve been managing with a little less warm gear and sleeping barefoot to let my skin dry out. I think the low temperature might inhibit fungal growth. I tried some anti-fungal cream and it reduced the symptoms but didn’t cure the infection. I tried honey and it worked a bit but I didn’t stick with it since I didn’t want to waste delectable honey on my feet. The best remedy I’ve tried was peeing on my feet in the shower. It just takes a rinsing over the course of a couple weeks and athlete’s foot is almost eradicated and mostly prevented for a while after.
    The anti-septic I’ve found to be best so far is hydrogen peroxide. Nothing like a good HO burn on an infected wound. I’ve also used it as mouthwash, both watered down and at the regular dilution. But, overall, I don’t resort to any sort of anti-septic or ointment to heal.. I just let my body do what it does! And I’ve gotten tons of minor wounds from my activities over the years. Animals don’t go to the pharmacy when they get a little scratch.

    Animanarchy wrote on February 1st, 2013
  20. While I’m no expert I think smothering an initial cut with oil, any kind of healthy oil, is a key step. What petroleum jelly does is smother any harmful bacteria deposited when the cut was created. It also moisturizers and as someone mentioned that is the ideal state if a cut to heal. I have been making my own lotion lately, with olive oil, coconut oil, cocoa butter and beeswax (all organic) and it works great on healing any scrapes and scratches I pick up, including cat scratches that I get a lot of. I have not had to try it on any deep major cuts however.

    Carol wrote on February 3rd, 2013
  21. I’m surprised urine didn’t make the list of all natural antibiotic ointments!

    Auggy wrote on February 3rd, 2013
    • Nothing I’ve found works better. Sometimes you just need some of that
      “same organic matter as everything else” food.
      Hence my breakfast: bee pollen, at least part of the humbly cure for the mumbly, stumbily infrastructural discomforts that come from a fermented food binge.

      Animanarchy wrote on February 5th, 2013
  22. Mark,

    I have read alot about how we should be sprinting once every 7-10 days. In my old pre-primal days, I would ride the elliptical everyday until the wheels would fall off 6 days a week, which is not ideal at all.

    I just started playing basketball again and I play about 3 times a week, full-court, for at least 2 hours because I love the game (Play). I also do full-body workouts for about 2-3 hours per week. Do you have any tips that could help me maximize my primal fitness efforts? I feel like the up and down of full court basketball for 6+ hours a week could possibly result in chronic cardio. Any helpful hints?

    Andy wrote on February 5th, 2013
  23. What exactly is the mechanism by which using an antibiotic on your finger increases resistance among the population? So if I have nasties in my finger and I kill them, then unrelated nasties will not be susceptible to my killing method? Unless I misunderstand, it sounds like a stretch.
    What makes bacteria susceptible is an enzyme that metabolizes the antibiotic in an unhealthful manner. Eventually, bacteria that do not possess that enzyme become more prevalent and the antibiotic does not work on them. But nothing has changed. There always was a resistant population and a non-resistant population.

    Joshua wrote on February 15th, 2013
  24. This is a great article. I’ve been using soap and water to clean wounds and a little Neosporin. I have a cut on my hand that is impossible to keep the cream on and I didn’t want to apply too much Neosporin. Now I can just apply aquaphor. Kids love that we don’t have to clean out minor cut with alcohol or hydrogen perioxide.

    Debbie wrote on April 6th, 2013
  25. We use honey and Tropical Traditions coconut oil for everything. In fact, I had the start of Impetigo (sp?) on my face yesterday and it’s gone today. My husband used to be on a prescription for this. I love what we are learnin

    Read more: http://www.marksdailyapple.com/antibiotic-ointments/#ixzz2WbBIBTgA

    Jon son wrote on June 18th, 2013
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  27. Coconut Oil is fantastic for healing wounds. But I find Active Manuka Honey to be the absolute best for treating any wounds for humans and animals!

    Michael wrote on August 11th, 2014

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