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Web: www.riseley.com.au Email: mail@riseley.com.au Phone: 1300 747 353 |
| As Cold as Ice... | Issue: 21-Feb-12 |
With the winter sport season on the horizon it is important for all players to understand the importance of early management of muscle and joint injuries. The demands on the musculoskeletal system and the contact nature of winter sports such as rugby and football mean the body's soft tissues are subject to injuries such as muscle tears and contusions (corkies). To ensure that you miss as little playing time as possible the management of swelling and pain in the first three days is extremely important.
In This Issue:
With acute injuries (within 72hrs) the body undergoes an inflammatory process. This process is in place to allow sufficient healing to the injured tissues. The swelling associated with this process creates a painful stimulus. In the first three days it is important to know what to do and not to do to allow for sufficient healing process. This is the first step to rehabilitation and if the foundations are not sound then the other phases of rehabilitation, such as regaining range and strength will be delayed. These two mnemonics can help you remember: RICE and HARM.
R – rest from any activity that increases your pain. It is also important to avoid activity that causes an increase in pain or ache after that activity with rest (such as the following night or morning). Ideally lie down in a comfortable position to minimize bleeding, swelling and further damage. Rest may also involve the use of crutches, a protective brace or tape.
I – ice the injured area for 20 minutes every 2 hours. Use crushed ice or an ice pack wrapped in a damp tea towel.
C – compress the injured area with a compression bandage to minimize swelling making sure that the bandage is not too tight and cutting off your circulation. Remove your compression bandage for sleeping.
E – elevate the injured area above the level of your heart (provided this does not cause an increase in pain) for as long as possible to minimize bleeding and swelling.
Stay away from -
H - heat increases blood flow and swelling.
A - alcohol increases blood flow and swelling, and can make you less aware of aggravating your injury.
R - Running or activity needs to be avoided.
M - massage promotes blood flow and swelling and can increase damage if begun too early.
R – rest from any activity that increases your pain. It is also important to avoid activity that causes an increase in pain or ache after that activity with rest (such as the following night or morning). Ideally lie down in a comfortable position to minimize bleeding, swelling and further damage. Rest may also involve the use of crutches, a protective brace or tape.
I – ice the injured area for 20 minutes every 2 hours. Use crushed ice or an ice pack wrapped in a damp tea towel.
C – compress the injured area with a compression bandage to minimize swelling making sure that the bandage is not too tight and cutting off your circulation. Remove your compression bandage for sleeping.
E – elevate the injured area above the level of your heart (provided this does not cause an increase in pain) for as long as possible to minimize bleeding and swelling.
Stay away from -
H - heat increases blood flow and swelling.
A - alcohol increases blood flow and swelling, and can make you less aware of aggravating your injury.
R - Running or activity needs to be avoided.
M - massage promotes blood flow and swelling and can increase damage if begun too early.
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The treatment of tendons has been a difficult topic for physiotherapists over the years. More recently, research has been undertaken to develop effective treatment strategies. The findings of this research have shown that for tendinopathies (tendon pathology) the best line of treatment is an eccentric exercise program.
Stanish and Curwin were two researchers who developed a routine of stretch, eccentric exercise, stretch then ice. The eccentric exercise would promote healing within the tendon however a side effect would be pain. The ice is used to suppress the pain so more eccentric exercise can be performed on consecutive days. Achilles Tendonitis and Jumpers Knee are two conditions that respond very well to the the Stanich and Curwin program. It is also important to note that the use of anti-inflammatories in tendinopathies is not appropriate and may stunt the healing process. |
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There is confusion as to which modality you should use for low back pain. Ice is generally prescribed for acute episodes (first 72hrs) and heat for anything longer.
The theory behind icing early is to quell the inflammatory process reduce pressure and thus reduce pain. Forty eight hours after the injury there is more chance that you will develop secondary muscle spasm and the injured tissue will heal itself, thus heat is used for more chronic disorders. It also depends on what structure is injured. For ligament strains or disc derangements ice is an appropriate choice however some may argue that these structures in the back are too deep to be affected by superficially placed ice packs. Muscle spasm is a common secondary issue for these disorders which is more appropriately treated with heat.
With low back pain it is always beneficial to visit a physiotherapist to assist in determining which modality to use. Trialling both modalities to see which one gives you best relief may be necessary.
The theory behind icing early is to quell the inflammatory process reduce pressure and thus reduce pain. Forty eight hours after the injury there is more chance that you will develop secondary muscle spasm and the injured tissue will heal itself, thus heat is used for more chronic disorders. It also depends on what structure is injured. For ligament strains or disc derangements ice is an appropriate choice however some may argue that these structures in the back are too deep to be affected by superficially placed ice packs. Muscle spasm is a common secondary issue for these disorders which is more appropriately treated with heat.
With low back pain it is always beneficial to visit a physiotherapist to assist in determining which modality to use. Trialling both modalities to see which one gives you best relief may be necessary.
Below are a few simple things you can do to prevent injuring yourself or to protect yourself from re injury:
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Currently available at Riseley Physiotherapy is a Sports Ice Bag which can be used to provide instant cold therapy part of the RICE care mentioned in our article.
Sale Price - $20.00 with funds going to Wembley Baseball Club for the purchase of new equipment. |
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Come and meet our newest masseur, Luke Colasante, who is a qualified remedial masseur. He has extensive experience in injury management and preventative programs with the Fremantle Soccer Club and in 2010 toured Malaysia as part of the HPC Development Squad (Malaysian National Tour) supplying sports and remedial massage treatments for both pre and post games.
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