By Michael Hall
ice, at least AFTER the inflammatory phase has settled down. The same goes for immobilisation and anti-inflammatories. Why? Because ice (cold) slows down the healing rate1, prolonged immobilisation causes joint degeneration and muscle wasting2 and anti-inflammatories have been shown to delay healing in acute ligament, muscle and tendon injuries. 3,4,5,6,7,8
As mentioned in my last blog on What to do if you get injured, immediately following injury a short period of Protection, Rest, Ice, Compression, Elevation, Referral (PRICER) IS the most effective means of reducing the complications of the bleeding and inflammatory phases of healing, namely those of excessive swelling, excessive tissue breakdown by the immune system and the release of free radicals as part of this process.
However, for soft tissue injuries, using ice and immobilisation should be limited to the first few days following injury.9 Immobilisation enables a tissue framework to form across the injured tissue, knitting the damaged ends together and increasing the strength of the healing tissue so it can withstand greater muscle pulling (tension).9,11
Complete immobilisation is mostly needed for acute broken bones (fractures). For muscle and other soft tissue injuries, early active protected (using taping or bracing) movement into directions which are pain free and which dont stress the injured tissue has numerous benefits including improving circulation, preventing joint stiffness, reducing swelling, accelerating healing and stimulating a better, stronger tissue repair. 5,8,10
However, care must be taken when moving an injured tissue. Probably the number one cause why people dont get better from injury or dont get better as quickly as they should, is because they re-injure the damaged tissue. In the early stages, any movement must therefore be pain free and feel almost too easy. Progression in movement must only take place, after it has been established how much movement is safe for the injured tissue.
As with early protected movement, applying heat (packs, etc.) for 15 minutes hourly (once the acute inflammatory process has settled) is one of the best ways to increase cellular activity and accelerate tissue repair. Heat brings oxygen and nutrient laden blood to an area, thereby optimising nutrient and waste product exchange. Heat also accelerates cellular activity, increasing the rate at which new tissue is laid down.11
Heat can be both superficial (heat packs, ray lamps etc.) or deep (ultrasound, short wave therapy etc.) with generally, deeper heat applications being more beneficial with deeper tissue injuries. As with any application of heat, care must be taken to check your skin every 5 minutes to avoid burns.
One of the biggest barriers to healing is excessive swelling which can cause oxygen starvation (hypoxia) to the injured tissue. It follows therefore that reducing swelling and optimising circulation will accelerate tissue healing and repair.
There a number of ways of reducing swelling and improving circulation.
1. Not aggravating the injured tissue;
2. Keeping the body part elevated above heart level will promote fluid drainage;
3. Moving the body part within pain limits enhances the effect of elevation as the contraction of muscles promotes fluid movement;
4. Compression garments with pressures ranging from 30 mm Hg to 60 mm Hg;
5. Lymphodema massage, a gentle stroking massage that moves fluid back towards the heart;
6. Bodyflow, a muscle stimulating technology that has been proven to accelerate healing and speed recovery from injury and intense exercise, by reducing swelling and enhancing circulation. It has been used by the English Olympic team as well as many AFL clubs to promote a faster recovery and enable earlier preparation for the next event.
The beauty of Bodyflow is that it is portable, meaning that you are able to apply it to yourself anytime, anywhere. At Bodywise Health, we have found that by using Bodyflow in the first couple of weeks following an injury, this has translated into faster recovery times from injury, often cutting days and sometimes weeks off normal recovery times.
There is no doubt that there are many things that you can do to assist in your own recovery from injury. And, if performed correctly, they will save you time and money as well as the disappointment of not being able to participate in the activities that you want to do. Treating an injury earlier and correctly, really does give you the biggest bang for your buck in terms of outcomes for effort. You have only one life. Dont spend it on the sidelines any longer than you have to.
I hope that this article will help you to achieve a better faster recovery from your injury.
If you are injured and would like to know what is the best and fastest way to get better, please call 1 300 BODYWISE (263 994) for your FREE assessment and advice.
Director Bodywise Health
- Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft tissue injury. Am J Sports Med 2004;3(1)251-61.
- Brukner and Khan and Colleagues. Clinical Sports Medicine. McCraw Medical. 4th Edition, 2012.
- Tischoll P, Jung A, Divorak j. The use of medication and nutritional supplements during the FIFA World Cups 2002 and 2006. Br J Sports Med 2008:42:725-30.
- Derman, EW. Pain management in sports medicine: use and abuse of anti-inflammatory and other agents. Sth African Fam Prac 2010;32(1)27-32.
- Wharaam PC, Speedy DB, Noakes TD et all. NSAID use increases the risk of developing hyponatremia during Ironman Triathalon. Med Sci Sports Exerc 2006;38(4):618-22.
- Paolioni JA, Milne C, Orchard J et al. Non steroidal anti-inflammatory drugs in sports medicine guidelines for practical but sensible use. Br J Sports Med 2009;43(11);863-5.
- Ziltenher JL, Leal S, Fournier PE, Non-steroidal anti-inflammatory drugs for athletes: an update. Ann Phys Rehab Med 2010;53(4);278-88.
- Alaranta A, Alaranta H, Helenius L. Use of prescription drugs in athletes. Sports Med 2008;38(6);449-63
- Jarvinen TAH, Jarvinen TLN, et al. Muscle Injuries: optimizing recovery. Best Prac Res Clinis Rheumatol 2007;21(2):317-31.
- Kannus P, Parkkari J, Jarvinen TLN et al. Basic science and clinical studies coincide active treatment approach is needed after a sports injury. Scand J Med Sci Sports 2003;13(3):150-4.
- Jarvinen TAH, Jarvinen TLN, et al. Muscle Injuries biology and treatment. Am J Sports Med 2005;33(5)745-64.