Printable View
Been following this website for a while: mobilitywod.com. Loads of great stuff about getting your body working the way it should. This recent post:
http://www.mobilitywod.com/2012/08/p...ooo-wrong.html
looks interesting. Not looked in detail at it yet, but the stuff this chap says is usually well worth a look at.
Anyone heard anything similar?
It is a no brainer, but up to now everyone always laughed at me when I said don't ice, use heat in stead... you want to increase circulation to promote healing and reduce swelling... so for that you need increased bloodflow, which drives the flow of lymphatic fluids which drain a swollen area. Movement within your range of movement is always advised as well, again as it drains swelling. Do not rest unless it is actually impossible to move because of pain or a fracture... Gentle compression is another way of getting rid of swelling, as it literally pushes the swelling away from the compressed area... Ice has only ever helped with pain, as it anaesthetises the iced area, hence giving a false sense of improvement... In fact it slows down healing and merely numbs the pain!
Quote:
Originally Posted by jackd
Talking specifically about Acute injuries for the moment- that is something that you have JUST done....
Its not that Ice merely numbs the pain. The idea is also not necessarily to slow down bloodflow or stop inflammation completely.
Inflammation is indeed the bodys response to injury, and is part of the healing process. However, when injured there is such a thing as excessive inflammation - which is too much exudate- which prevents bloodflow and also which prevents movement- and it is also the swelling of the area which stimulates pain receptors which produces the pain - which is indeed where the elevation and compression- as mentioned above comes from, to assist in lymphatic drainage to help reduce the swelling, and therefore the pain.
(unless, of course, there is also an underlying traumatic injury as well, which is also creating pain- which will induce swelling, and thus- more pain).
one of the things with the Ice is that it lowers the metabolic rate of the tissues that have been injured, the hotter they are, the more oxygen they need - more than can be replaced by any elevated blood flow that heating further will produce. Non-icing, and indeed heating the injured area will increase the metabolic rate further and cells will then die from lack of oxygen- this is secondary cell necrosis- which, generally, you want to avoid.
Ice slows down the metabolic rate, helps control excessive swelling (which is caused more by exudate- rather than increased bloodflow), and using Huntings Response brings blood back into the area after the tissues have been cooled- and thus the cooled tissues with the now lower metabolic demands are getting a decent blood flow, aren't burning themselves up and destroying themselves and the blood can actually get to the tissues it needs to as opposed to being blocked by the excessive amount of exudate which was causing the swelling.
Although this is an interesting article, as ever, other clinical studies should probably be looked at ~ Hocut et al Am J Sports Med from 1982 and Sloan J, Hain R, Pownall R Archives of Emerg Med 1989 Cold vs heat for grade 3 ankle sprains. Return to activity with grade 3 was 14.8 days for heat, 11 days for cold. Grade 4 was 30.4 days for heat, 13.2 days for cold. - which would seem to indicate that icing is a good thing.
As I say, the whole idea of heating an acute injury is an interesting concept, but for now, if I see an acute injury, its going to get iced, compressed and elevated, with ice being on for 20mins and off for 2 hours. and after 36hours it'll be ice+ heat + pain free movement.
Yes, excessive amounts of icing would be a bad thing, but heating in an acute stage of injury would equally, not be so great either.
Sock Doc website has some interesting theories on this and other sports injuries. Worth a look... http://sock-doc.com/2012/07/first-ai...ice-heat-rice/
Zephr that sums up the way our club Physio treated my ankle. Initially icing in the first few days and elevation. Then reducing the icing, with heat afterwards and mobility gradually. The ice gradually withdrawn and the heat gradually increased.
He applied pressure through a sort of finger massage twice in the first week.
It worked a treat for me. Back running in 10 days for what would normally be 3 weeks. In fact last time I didn't go to him, thinking I could do it myself, but it wasn't as effective as I lacked the ability to apply the pressure as well and I also missed out on some ultrasound.
I would add, that for my back issue he warned against ice altogether and advocated heat only.