The P.R.I.C.E Is Right!
Man, I wish I had come up with this acronym. If Bob Barker only knew....
PROTECT- (I would add PREVENT...that's worth at least 10 cents)
REST- (active rest is key)
ICE- (not heat?)
COMPRESSION (squeezing out the juice)
ELEVATE (you mean, gravity can be your friend?)
Since common sense seems to flee even the most erudite amongst us when we're
caught off guard, we'll be writing a mini-series on injury and post-injury management over the next few blogs. If you're active, it would behoove you to read on, since you've probably been injured in the past and maybe in the same region over time. Obviously, the guidelines I've provided are general, and always free free to email me if you have a specific concern.
Some of the more common questions we come across as far as immediate injury and post-injury management are, "Should I heat or ice?" "Should I stretch?" "Can I still workout?"
Of course, seeking medical attention should always be on the forefront of your mind when there's severe pain...and not how the injury is going to affect your beachbody in the making!
Protect
This is a huge part of the initial recovery process. Using immobilizing aids such as, splints, crutches, slings can be essential in getting you to recover quickly and give your body a chance to drive the necessary chemically-mediated responses to the injured region. Taping, such as Kinesiotaping (well, at least it looks cool) and McConnell taping (my personal fave for most joint or tissue injuries to the extremities)
usually work great for temporary or short term use for a few reasons-
one, to keep you mindful of your injury (and hopefully, hinder you from
doing something dumb). Two, to support the injury during necessary activity in the acute phase (like walking...not running) and physical
activity beyond the subacute phase (10-14 days post-injury). Three, to
help you gain some sympathy from your co-workers and/or loved ones
(results not guaranteed).
If It Hurts, Don't Do It
Duhhh....Stop
"testing" out the injured bodypart; if lifting your arm to certain point
causes pain, don't lift beyond that...I even amaze myself about how I
obsess over trying to test out my fresh injuries (oh, I practice what I
preach all right...). When you constantly move a joint or contract a
muscle that's been injured, you run the risk of prolonging the acute
phase, which sets you back further from getting back to what you love to
do.
Active Rest
This
means, avoid continuing the activities or movements that caused your injury, but
doesn't necessarily mean you need to stop being active. For example, if you
sustain an injury to your ankle, it doesn't necessarily mean you can't
do an effective upper body cross training workout (Click to watch...and yes, I have two stunt doubles performing in my stead. Special thanks to John Kim and Dr. Taylor Lee).
Stretching?
Resounding "No". Surprised? Avoid stretching during that first two weeks of an injury. You won't give scar tissue the chance to start layering and webbing around the injury. It's like picking at a fresh scab. Ouch. After that two week time period, yes, definitely a graded stretching approach would be absolutely beneficial and necessary for healing and PREVENTION.
Ice or Heat or Both?
The general
"medical" recommendation out there is to ice
for the first 72 hours after an injury. Apparently, there is a
questionable benefit of using ice after this time period. I disagree.
Being that the
acute stage of a musculoskeletal injury is about 7-10 days, controlling
inflammation is absolutely necessary. I think it's good to mention
here that
inflammation itself is not a bad thing. We need that initial
inflammation after an injury to get the healing process started. In addition, guiding the
inflammation to lay down scar tissue in a more orderly fashion (ie, more
along the lines of the existing fibers and less haphazardly) is the first step in preventing
future injuries to the same area; I'll discuss this more in a future blog.
So, when should I use straight up heat? Like I said, I'm a big
fan of icing long after the
acute phase of an injury. I reserve the recommendation to heat for
people who have complaints of long-standing stiffness or muscle/joint
aches not related to an immediate injury. We've also recommended heat
(like a hot shower or moist heat) modality just prior to stretching
out in the morning or at night to get a little more flexibility into the area.
Ok, when would I use both ice AND heat? There's
debate on this, but we use it quite a bit at Maven. In simplified
terms, a heat-ice-heat combo works, theoretically, by inducing a
compression effect on superficial blood vessels, which would allow for
excess fluid in a swollen region to be resorbed by the lymphatic system; essentially, you're creating a poor man's version of a compression sleeve at the level of the superficial tissue.
Elevating the injured limb also facilitates this fluid resorption as gravity promotes the excess fluid to head back towards the heart.
Compression (using the GameReady, for example) further expedites the reduction in swelling. We frequently recommend compression garments as well.
Anti-inflammatories
You should discuss with your physician what the best choices are for you regarding types of anti-inflammatories, especially if you're on other supplements or medications. People often ask us if anti-inflammtory meds "mask" the pain. No, they do not. Some of the heavy duty pain-killers like Percoset, morphine, or Vicodain would be on that pain-masking level. As with ice and active rest, anti-inflammatory meds (ibuprofen, acetomeniphen, diclofenic sodium, eg) have been shown to actually work on helping injured tissue lay down scar tissue in a more organized fashion.
When To Seek Immediate Attention
If any of these symptoms ring a loud bell for you, stop reading this blog and seek medical attention...NOW!
-burning pain
-pain that is constant whether you move or rest
-pain that wakes you up at night
-chest pain
-inability to bear weight
-numbness and tingling in any given area (especially the left arm)
-redness,warm or hot to touch, and swollen
-loss of bowel or bladder function
Part 2: Eatin' for Healin', up next time....
