Over my career I have often been asked what is the best strategy for healing, especially when it comes to recovering from injury. For many, there are a lot of mis-perceptions on the subject of when to rest, when to use ice or heat, when to seek treatment and when to resume physical activities. I would like to share my experience on this matter.

This topic becomes quite relevant for many this time of year. The spring season brings forth longer days, warmer weather and a renewed desire to get outside, train and generally become more physically active. If your a hockey or basketball sports fan, it also happens to coincide with playoff season. And that also means a higher risk of injuries.

The primary innate nature of the human condition is for survival. The basic instinct is for self protection and self preservation. That translates in an instinctive need to avoid any risky, potentially harmful activities that can cause further damage. Once an injury has occurred ( or even perceived to have occurred), the natural behavioral response leans towards rest and avoidance.

So when is this the right choice? And for how long?

The answer is simple. Immediately following acute injury. An sudden, abrupt injury is always accompanied by the acute inflammatory response if severe enough. This may be marked by sudden sharp pain, a burning/aching response, bleeding or bruising and lots of redness and swelling.This is the time that the R.I.C.E. approach for healing is applied. That stands for rest, ice, compress and elevate. This may be broken down as follows:

1.Rest- Totally abstain from the activity for the duration of the inflammatory response. This may take days to weeks depending on severity of the injury. This doesn’t always have to take the form of lying down however additional sleep may prove beneficial in promoting the initial healing and reduce the interval of the acute phase.
2.Ice- Very important to immediately follow as soon as possible to prevent nerve swelling and further tissue damage. The proper application of ice is as important as the therapy itself and has often been mis-prescribed. Here is the rule:

If an injury is abrupt or sudden, apply ice (NOT HEAT!) for 10 minutes on and 10 minutes off. This may be repeated for up to 3 intervals at a time.

Never apply ice directly on the skin for prolonged periods.

The reason that ice application should be limited to 10 minutes at a time is because of a self protective response that is called the Hunting reaction. When the body is first exposed to sudden cold, there is vasoconstriction of the blood vessels surrounding the area. This is the desired effect of icing an injury in order to reduce the swelling. However, if the application is prolonged greater than 10 minutes, an undesired vasodilation of the blood vessels follows. This becomes counterproductive to the intended swelling reduction. The purpose that this self protective Hunting reaction serves is to protect the extremities from frost bite should one be exposed to extreme cold for prolonged periods. That’s why our ears and hands become red when exposed to cold air for an extended time. The shunting of additional blood serves to warm the exposed area and prevent damage. However, for the purpose of treating a sprained ankle or pulled muscle, the goal is to minimize blood to the area in order to decrease the swelling.

3. Compression- The purpose of compressing an injury is to stabilize the area from further damage and also assist in reducing the inflammation. An acute sprain may cause weakened or damaged ligaments and may not be stable enough to support any weight bearing, should that be temporarily necessary. The use of a tensor bandage provides stabilizing additional support while also applying steady restriction of the blood vessels in the surrounding area. A note should also be made not to apply compression bandages to tightly or for too long because moderate blood flow is still necessary for the appropriate circulation and later healing process.
4 Elevate- The purpose of raising the injured area over the level of the heart is that it gravitation-ally reduces the blood flow to the injured area, thus reducing the swelling and pain and making it more difficult for blood to reach the area. If injuries are more severe, then it is recommended that elevation be performed between 2 to 3 hours per day.

For precautionary reasons, it is best to seek professional medical attention to properly diagnose the extent of an acute injury. The warning signs for emergency intervention are an inability to weight bear, numbness, gross discoloration, excessive swelling, misshapen features or excessive blood pooling. It should further be recommended to seek professional attention should the swelling and pain persist for more than 5 days.

So what happens next after the acute phase has ended and the swelling and pain have reduced. Is it time to get back on the horse?

This is a very important question to consider if you are an athlete, a performer, a health professional or any person in training or in a therapeutic program. A reasonable balance point is necessary to be determined if one hopes to resume all the benefits of the prior activity before the injury or mishap, and regain the rhythm that was a vital part of the prior success.
So how does one determine that balance point? When does too much rest become rust? Stay tuned for next weeks blog when I examine an appropriate strategy for regaining ones rhythm while still respecting the innate instinct for self protection to future harm

Please share

Have you experienced a recent injury or chronic mishap in the last 4 months that has gone un-diagnosed or undetected? Have you not had a full recovery response yet?

By |April 2nd, 2019|Posture Doc Articles|0 Comments

About the Author:

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Dr. Guy Bahar is “The Posture Doc”. He has developed the “Bahar Posture Training Method” for correcting posture with visible, measurable results, used exclusively in his Richmond Hill Clinic. You can reach Dr. Bahar at The Posture Clinic 905-731-7443, www.postureclinic.ca

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