Thursday, May 20, 2010

How to cure a sports injury

I always chuckle when I see an advertisement for a new and improved laundry detergent. I know that even as this product is being hyped as the best under the sun, it will next year be relegated to the rubbish pile. Then, the newer and improved detergent will again be 25% more effective, producing brighter colours, etc.
I feel the same way about first aid for sports injuries. One year we are told to quickly apply heat then ice; the next year it's ice for 48 hours then heat for 48 hours; lately we are advised to alternate between heat and ice every 2 hours for 24 hours. Last year's surefire solution is replaced by this year's new and improved remedy.
Here's what I read on a popular Internet site: "Applying ice to a soft tissue injury can help reduce swelling and inflammation by reducing blood flow to the injured area. Ice also provides temporary pain relief after an acute or traumatic injury. In order to get the best result, it's important to ice the injury during the 48 hours after the injury, before the swelling becomes advanced."
Why would you want to reduce swelling and inflammation anyway? Why reduce the flow of blood just when it is most needed? What causes inflammation and is it good for us or not?
Inflammation is the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue. In the absence of inflammation, wounds and infections would never heal and progressive destruction of the tissue would compromise the survival of the organism.
After reading this formal definition, it may seem as clear to you as to me that acute inflammation is just what we need after an injury (chronic inflammation is another issue). Our bodies probably developed this inflammation response over millions of years of trial and error (if you believe in Darwin's theories of evolution). Any maneuver that an individual may attempt will necessarily interfere with this natural, protective response and in my opinion will always result in the injury taking longer to heal.
When we are injured, we absolutely want our bodies to heal quickly. It seems our bodies also want to heal themselves quickly as the resulting inflammation increases blood flow (which is why the injury turns red and feels warm) bringing the necessary nutrients to the injured site, and equally importantly, removing the cellular debris and other detritus away from the site. The area is tender and sometimes painful. Why? To remind us to rest the injured part and avoid physical stress. When the pain subsides, we can slowly start to use the injured area again. In this respect, pain is our friend, letting us know when we should take a break from activity or else risk further injury.
While we are discussing inflammation, you may be interested to know that there is a relatively unknown and hugely successful cure for many cases of chronic pain. It is called prolotherapy, short for proliferation therapy. Prolotherapy involves the injection of an irritant solution into the area where connective tissue has been weakened or damaged through injury or strain. Many solutions are used, including dextrose and lidocaine (a commonly used local anesthetic). The injection is given into joint capsules or where tendon connects to bone. Many points may require injection. The Injected solution causes the body to heal itself through the process of inflammation and repair. That is, the injected solution irritates the site, much like an injury does, which causes inflammation. Healing results naturally and permanently, even after years of suffering from chronic pain!
So please, do not apply ice to an injury, why add insult to injury?

1 comment:

  1. Hi Barry, I disagree. When an area is initially insulted, either by surgery (incision) or trauma (sprained ankle) the area should be iced to decrease damage to the tissues that are affected. After the first 24-48 hours, then apply heat. It is true that you want your body to respond to the insult and by applying ice, it can limit the area of damage. I have worked as an orthopedic and post surgical nurse for 14 years, and I am now an advanced practice nurse (family nurse practitioner). What are your references for your information?

    ReplyDelete