Tuesday 24 July 2018

4 Reads For Acute Injury Management

Summer time always has us more active, whether it's sport, play, or even just yardwork. This increase in activity comes with some inherent risks, as you know, such as rolled ankles, wrenched backs, and pulled hamstrings.

One thing asked of me quite often is advice regarding acute injury management. In the hours and days following a fresh injury, what can be done? Rest, ice, compress, and elevate, as we are classically taught? Well...maybe. We're starting to refine a little bit since the 80's, however. Below are four pointers and quick reads on the topic.

1) Understand How Pain And Spasm Work

Even when true tissue damage doesn't occur, pain and muscular guarding in response are possible to still happen in the event of sudden trauma. This pain, itself, is enough to freeze many of us in our tracks, and every time we feel that pain, our bodies are likely to start guarding even more in order to protect itself.

Understanding how the cycle of pain and spasm works is helpful in helping us to get past it, because it gives us assurance that not all pain is necessarily indicative of increasing tissue damage; it's simply our body's reactionary mechanism to the experience. By breaking this cycle - or minimizing it in the first place - we can rapidly improve our rate of recovery. Which brings us to...

2) Ice It, But Not Too Much

The jury on the topic is still out, but more and more, professionals are starting to agree that ice is useful, but only to an extent in the event of injury.

Icing can definitely help to minimize the onset of the pain-spasm cycle. Decrease the pain at its earliest onset and decrease the body's guarding response to it! In addition, preventing excessive inflammation and swelling is important to ensure that fresh circulation and nutrients are able to enter the damaged tissue to promote healing.

However, new schools of thought are now starting to look at the fact that too much ice can, understandably, prevent that healthy circulation that the injured area needs. Restricting bloodflow, as you can imagine, isn't the most productive toward healing. With that being said, opinions are leaning toward using ice in the newest acute stage to prevent that excess of inflammation, but then allowing more minor amounts of inflammation to continue - and only icing as needed for pain management - in order to recover more quickly.

3) Rest, But Only As Much As Needed

Obviously, a decrease or modification of physical activity is going to be needed, as it's important to not further the injury more. The thing to realize, though, is that too much prolonged rest is not the most beneficial prescription for injury, despite what many walk-in clinics will suggest.

When we rest for too long throughout the body's very, very metabolically-active healing process, we are depriving it of one of the ingredients that it needs to create healthy, new tissue. The lack of movement means a lack of muscular pump and blood flow, which is needed for an optimal recovery time. Muscle tone, thus, can be lost as well, deconditioning the body and even increasing the potential for reinjury. Finally, as scar tissue develops to bridge the gap where the damage occurred, immobilization can deprive the area of the motion it needs for that tissue to align along the needed directions of stress. This decreases the end-result durability of that scar and can increase long-term levels of discomfort. And so finally...

4) Get That Body Moving!

The sooner you can start mobilizing the injured area, the better. Complete absence of pain is not a requirement to starting to move, with minor amounts of discomfort being expected and perfectly fine. Early range of motion and proprioceptive work is vital to prevent restrictions from developing, and gradual return of resistance for maintenance of strength, endurance, and power.

If one exercise hurts too much, then modify and regress it. If absolutely every single movement to the area is agonizing, then continue to exercise above and below. The body craves for continued use as closely resembling full function as possible, as that's how we retrain it to get back there.

And that's where Athletic Therapy comes in. Excuse the plug.


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