Your Two Secret Weapons For Sport Injury Care

I once spent over 2 hours in the ER for the doctor to take 5 minutes to look at my ankle and tell me the same tidbit I've written out for you down below. I later received a bill for over $200 for that 5 minutes of doctor-ly wisdom. (I'm giving it to you free of charge)

The R.I.C.E.R. method and the Vascular Flush are two very important tools when treating an injury or preventing a flare-up in an old (chronic) injury. Now perk up your ears this is a valuable lesson and some people (like myself and other sport and health professionals) have to pay a lot of mullah and spend many hours in school to learn about these two vital recovery tools!

First of all remember that you are never to use a vascular flush during the first 72 hours of an injury or during an acute stage of a chronic injury. Please refer to my other article “Oops I injured myself” if you need a refresher on identifying the different stages of injury.

R.I.C.E.R.

When a soft tissue injury occurs there is a large amount of uncontrolled bleeding around the injury site. This excessive bleeding causes swelling. This swelling puts pressure on nerve endings and results in increased pain. It is exactly this process of bleeding, swelling and pain which the R.I.C.E.R. regime will help to alleviate. This will also limit tissue damage and help the healing process.

Rest

It is important that the injured area be kept as still as possible. If necessary support the injured area with a sling or brace. This will help to prevent any further damage and slow down blood flow to the injured area.

Ice

This one is a biggie! If you remember nothing else, remember the simple application of ice/cold packs can go a long way towards keeping an individual comfortable. Not only will it help to alleviate any symptoms of pain that are already being experienced, but it will help to prevent a significant amount of the tissue fluid accumulation (swelling) from occurring as well as numb pain and control bleeding. This in turn will significantly shorten the duration of any injury-related disabilities (time off from work or athletic duties) and hasten a return back to full function.

Always protect skin from tissue damage by wrapping the ice pack in a thin towel, or my favorite is a t-shirt. Apply ice for 20 minutes every 2 hours for the first 48 to 72 hours. Use your judgment, for some people 20 minutes is way too much. For others, especially well conditioned athletes, they can leave ice on for up to an hour at a time.

You should apply ice for as long as it is comfortable. There will be a slight discomfort from the cold, but as soon as pain or excessive discomfort is experienced, it's time to remove the ice. It's much better to apply ice for 3 to 5 minutes a couple of times an hour, than not at all.

Compress

Compression achieves two things. It helps to reduce both the bleeding and swelling around the injured area, and it provides support for the injured area which helps prevent further damage. Simply use a wide, firm, elastic, compression bandage to cover the injured part. Make sure you bandage both above and below the injured area.

Elevate

Simply raise the injured area above the level of the heart at all possible times. This will further help to reduce the bleeding and swelling.

Referral

It is important that you consult a professional physical therapist or a qualified sports doctor for an accurate diagnosis of the injury. With an accurate diagnosis, you can then move onto a specific rehabilitation program to further reduce your injury time.

Be sure to avoid any form of heat at the injury site for the first 24 to 72 hours after an injury. This includes heat lamps, heat creams, hot tubs, Jacuzzi's, heating pads and sauna's. Applying heat may actually slow healing during the first 72 hours after an injury takes place.

Please, at all costs avoid all movement and massage of the injured area. Also avoid excessive alcohol. All these things will increase the bleeding, swelling and pain of your injury.

Vascular Flush

A vascular flush is a contrast of hot and cold hydrotherapy treatments. The cold water causes the vessels in the area to constrict, the hot causes the vessels to dilate, thus creating a localized temperature pump for the lymphatic system and blood stream without stressing muscle tissue. This is just the action your body needs to speed healing! The pumping motion flushes wastes and acids from the tissues, replenishing the area with freshly oxygenated, nutrient-rich blood.

It is called a “Vascular Flush” because that is exactly what is happening on the molecular level. You are flushing wastes and acids that cause stiffness, pain, adhesions, muscle spasms and other myofascial conditions away by increasing the lymphatic and blood flow. This increase in nutrition brings the benefits of faster regeneration of overworked, strained or sprained muscle tissue, an increase in response rate, metabolism, flexibility and awareness, a decrease for potential and related injuries and a decrease in pain and discomfort.

Flushes are great for periods of stress on your body like before and/or after working out or after a repetitive activity that is a strain on an area of the body. It’s best to implement this method at a time of day that is convenient for you and easy to make into a routine, like first thing in the morning before you get busy with your day and/or at night before you settle in. One of my instructors from my massage school days taught me to always do a vascular flush on my arms and hands after a long day of massage. I simply fill a tub with ice water and another with warmish hot water- I set them side by side and just alternate between the two (this was one of the most valuable lessons I learned in massage school). If I skip this treatment I will definitely feel the effects of being a massage therapist the next day. We’re talking achy hands, irritated elbow joints and a fragile demeanor!

You always want to use a 3:1 ratio for 3 cycles:

(30 seconds cold : 10 seconds hot)

(3 minutes cold : 1 minute hot)

(3x hot/cold, hot/cold, hot/cold)

Your heat source should be around 105 F and please remember to always end on cold and never go longer than (6 minutes cold : 2 minutes hot). Sometimes you will have a difficult area like your low back or shoulders and will need to do this in a shower or with ice packs and a moist heat pack. Any way you are able to do this is fine just as long as you get it done. Remember accomplishing these two techniques can take day and sometimes weeks off of your recovery time!

Related Articles: Oops I Injured Myself, Sport Injury Prevention

Oops, I Injured Myself or (Damn, That Hurts!)

So you followed all the suggestions in the Injury Prevention article and you still managed to hurt yourself. Well pay close attention because the treatments outlined in this article are categorized by acute, sub-acute or chronic, depending on the symptoms and the stage of healing you are in. It is very important to know the difference, because each stage is treated very differently and the treatments are not interchangeable and will make an injury worse when used in the wrong stage. After you have thoroughly familiarized yourself with the different stages of injury you will find detailed instructions on how to apply R.I.C.E.R. and a Vascular Flush in the next article “Your Two Secret Weapons Against Sport Injuries”

A textbook definition of an acute injury is defined as the first 72 hours after an injury. However, it's more accurate to define the stage of healing by the symptoms you see and feel, rather than a textbook definition of when a specific stage begins and ends.

For example if you sprain your elbow playing tennis and continue to swing a racket around, your acute stage could last longer because you're irritating the tissue and prolonging the inflammation and other symptoms. Or if you have an old (chronic) injury and it flares up, it is considered acute again.

I have provided an outline of the different stages of injury, the proper treatments and detailed instructions for each treatment.

Acute Injury

Acute phase of an injury is usually defined as the first 72 hours after an injury. It can take 24 to 72 hours for enough tissue fluid to accumulate in order to cause symptoms of pain and stiffness (from swollen muscles). This is why many people frequently do not see their physicians immediately after an accident or injury - it simply doesn't hurt enough (or it may not hurt at all) initially.

Symptoms of the acute stage are inflammation (redness and swelling), sudden/severe pain, stiffness, bruising (red, black or blue), muscle spasms and tissue tenderness.

Treatment: R.I.C.E.R



Sub-Acute Injury

Typically defined as 3 days to 3 weeks after an injury. Inflammation begins to decrease, your range of motion increases, bruising will begin to look more yellow, green and brown. Your body is generating new tissue in the form of very fragile scar tissue.

Treatment: R.I.C.E.R. and Vascular Flush



Chronic Injury

Defined as any time after 3 weeks. Signs of inflammation and bruising are gone. Pain with movement is dull/achy but not sharp. May experience pain at the very end range of movement and/or dull ache at rest. Scar tissue has matured.

Treatment: Ice, Vascular Flush and Moist Heat

When to Use Ice:

During Acute Stage (immediately up to 72 hours after an injury)

• To decrease swelling and inflammation
• To numb pain
• To decrease muscle spasms
• To treat an acute burn


During Chronic Stage (after inflammation subsides, usually 4 or 5 days after injury)

• To manage pain and possible swelling
• After an activity or workout involving an overuse injury to decrease pain and swelling
• To treat joint swelling due to inflammatory arthritis

When to Use Heat:

During Chronic Stage (after inflammation subsides, usually 4 or 5 days after injury)

• To warm up stiff joints and aid in joint mobility
• To decrease chronic muscle spasms
• To aid in stretching tight muscles
• To warm up the affected area before an activity or workout involving an overuse injury

Related Articles: Sport Injury Prevention, Your Two Secret Weapons In Sport Injury Care

Sport Injury Prevention

This guide is to help you properly treat injuries with a goal of preventing a chronic injury. Let’s start with how to prevent an injury in the first place. If you are already injured please read the next article in this series “Oops, I Injured Myself” for proper treatment of soft-tissue injuries.

Conditioning

Proper aerobic and cardiovascular conditioning is vital for preventing injury, but sports-specific training is also imperative. Weekend warriors are usually not well-conditioned and may not be proficient in the sport they are playing. They predispose themselves to injury and are notorious for their high rates of injury. So please set a comfortable and consistent pace and ease into exercise.

Trying to "play your-self into shape" is a mistake. Pro basketball players don’t become pro because they play a ton of basketball all week. They incorporate targeted drills and muscle strengthening programs in their training schedule (e.g., rotator cuff strengthening so they don’t throw out a shoulder; quadriceps and patella femoral strengthening exercises to protect the knees; ankle strengthening and stabilizing exercises that involve quick change of direction, etc.). Sports-specific drills will also help you become more proficient at your sport.

Warm-up and Stretch Properly

Warm muscles are pliable and less susceptible to injury. A normal “warmed-up” muscle has elastic properties, much like a rubber band, that has some degree of resiliency or give when stretched. A "cold" or tight muscle, however, has characteristics resembling scotch tape - when stretched, it eventually has to tear. A proper warm-up is essential for injury prevention.

Simply walking or jogging in place may be adequate, while sometimes starting your sport or activity at a slow pace may also be appropriate. For example shoulder rolls and windmills before tennis. Stretching should follow the warm-up period. Stretching is not a warm-up and should only be done after you have warmed up. A few simple stretches specific to your activity will help maintain overall flexibility and reduce your risk of injury while improving overall exercise performance.

Stretching after exercise while the muscles are warm and flexible will help any micro tears that may have occurred to heal better. If you have a history of previous injury to certain muscles or joints, warming up and stretching these areas is important in order to prevent repeat injury.

Avoid Overtraining and Training Errors

If exercise hurts you are probably doing something wrong. A common misconception is “more pain, more gain” athletes with high consecutive days of training have more injuries. Some soreness is common after exercising, but if it continues, you are pushing too hard. You are not going to make up for 6 months of couch time with one crazy intense workout that leaves you laid up on the sofa panting “no pain, no gain” for the next five days!

When it comes to exercise, you need an appropriate balance of training and rest. Injuries can occur when the volume or intensity of training is excessive, causing damage to tissues that cannot be adequately repaired during a training cycle.

If you are noticing decreases in training capacity, persistent muscle aches and pains, changes in mood or sleep patterns, or an increased incidence of injuries, then you are over-training. This undesirable situation can be avoided with proper modifications in your training regimen to prevent overtraining.

Training errors can also predispose you to injury. Avoid progressing too much too soon. Increases in the volume and intensity of your workout should be made in a gradual, progressive manner. Know how to properly use equipment and always use proper form. If you are un-able to keep proper form then back off with the weight. Set training goals and remember that they are goals not starting points.

Avoid Playing When Extremely Tired or in Pain

Do not try to push through pain or continue exercising or playing when exhausted. Pain is an indicator of a problem or potential underlying injury. I once slipped and painfully jammed my knee. I felt that I had to finish what I was doing so I kept on going. The next day I couldn’t bend my knee and I still have occasional flare ups to this day because I never iced or properly treated this injury (please read “Oops I injured myself” for proper injury care and how I could have prevented this from progressing into a chronic injury). You need to pay attention to the warning signs that your body provides!

Fatigue has been shown to be a significant risk factor in athletic injuries. For example studies have shown that ski injuries peak in mid- to late afternoon when skiers are more tired. I know this first hand, I still suffer from a neck injury I sustained over three years ago because I took one last run down the mountain while exhausted (obviously my judgment was bad and my reaction time even worse). There is nothing wrong with relaxing in the lodge while your friends finish up. Please curtail your activity when tired to prevent fatigue-related injuries.

Related Articles: "Oops, I Injured Myself" and "Your Two Secret Weapons In sport Injury Care"

Why I Am A Massage Therapist

I feel good when I massage people. That’s why I became a massage therapist…

I remember how I felt the first time I received a professional massage. I was stressed, feeling very murderous, tired and achy with five hours left on my shift at work. A massage therapist happened to be there and noticed my agitated mood and offered to give me a massage. I figured I didn’t have anything to lose and it would give me an excuse to stand idle for a few minutes. (I'm a little lazy)

My whole demeanor changed with just 10 minutes of my neck and shoulders being massaged. I was amazed at how uplifting it was. I felt my stress melt away as it became replaced with an optimistic, tingly feeling all over. I even scrapped my plans for murdering somebody that night. (sometimes I don't like people)

I was energized and happy… from a massage?!?

Who knew a few minutes of massage could do this! I felt better all over even though I had only received massage on my neck and shoulders. That was a powerful experience for me and a huge changing point in my life. I knew right then that I wanted to be able to make other people feel the way I did at that very moment. That summer I quit my job, enrolled in massage school and never looked back as I embarked on my new career in helping people feel better.

I massage because it makes me feel better when someone rises from the table feeling less depressed and overwhelmed with life. I like hearing about how their aches and pains are gone and they feel rejuvenated.

I know each and every one of my clients and I look forward to your visits. It makes me happy when I see one of you make progress in your recovery from chronic pain or an injury. This is why I chose massage, nothing profound or enlightening but just simply knowing the physical and mental benefits of massage and wanting to help other people. (sometimes I'm not lazy and I like people)

Well this is my experience with massage and I would love to hear your comments about your personal experience with massage either as a massage therapist or someone who has personally felt a mental or physical difference after receiving a massage.

Thanx -Helen Knight