If you’ve ever sprained your ankle or injured your elbow, you probably know that it’s been standard practice for decades to apply ice after injury to decrease swelling and pain. Dr. Gabe Mirkin coined the acronym “R.I.C.E.” in 1978 (Rest, Ice, Compression, Elevation), and this concept became the standard in treatment of acute injuries and post-surgical patients.
While there has been some debate about whether cold therapy should be used for all musculoskeletal injuries, most healthcare practitioners would agree that proper use of ice or cold therapy can reduce swelling and pain. Here are a few reminders about using cold therapy:
- Apply ice for no longer than 20 minutes at a time.
- Allow your skin to return to room temperature before applying ice again.
- Place a thin towel between the ice pack and your skin to prevent irritation and even frostbite.
- And never ice prior to activity — doing so may cause further injury.
Another option is combining cold therapy and compression. Studies have shown that people who use cold therapy and compression therapy together, as opposed to just one of those therapies alone, recover from their injuries significantly faster. Compression, particularly intermittent compression, works to push swelling out of the injured site. This can limit tissue damage and aid in the removal of cellular debris and waste in the body. Active compression therapy mimics the body’s natural muscle contractions, pumping swelling out of the injured area. This increases blood flow and delivery of oxygen to the site, stimulating tissue healing and optimizing lymphatic drainage.
It has become almost routine for patients undergoing some types of surgeries (such as ACL repairs or joint replacement) to receive cold compression therapy post-operatively in the hospital or surgi-center through mechanical devices designed for this purpose. Some patients also receive treatment from these machines at home or in skilled nursing facilities in the weeks immediately following surgery, as ordered by their physician. In recent years, these devices have become available for people who wish to use this therapy at home for injuries, such as sprains, fractures and tears, for chronic pain and swelling, or to help reduce muscle soreness and fatigue.
For minor aches and pains, icing afterwards may be enough to keep your body healthy and to avoid serious injury. However, keep an eye out for the following red flags:
- Pain that gets worse instead of better
- Pain after resting for a few days, or when you wake up
- Chronic swelling in your joints, or bruises that don’t heal
- Knees or elbows (or other joints) that lock or are unstable
Any of these problems is a sign that you need to consult with a doctor or physical therapist about your pain or swelling. Trying to treat such issues at home with ice, compression and anti-inflammatories could end up making your problem worse instead of better.
There is and has been a long-term debate about the merits of using heat or ice as a treatment after injury. Despite years of research, education, and even anecdotal evidence from healthcare professionals and trainers, much confusion has surrounded the issue.
To this day, the conventional thinking has been that ice should be used in the first 24-48 hours after injury to decrease inflammation (swelling) and pain. In 1978, Dr. Gabe Mirkin coined the term “R.I.C.E.” (Rest, Ice, Compression, Elevation), and this concept became the standard in treatment of acute injuries and post-surgical patients.
Recently, however, many studies have been performed to investigate what exactly the role of ice is in decreasing inflammation and pain, and whether or not it does in fact aid in recovery of tissues. Like so many other previously held beliefs, very good contemporary research over the last decade has been progressively disproving this conventional wisdom. Unfortunately, new information is slow to spread, and it is always challenging to change long-held paradigms and to shift to the more current thinking. Read More
In today’s world, there are so many demands on our time, pulling us in different directions. It’s often tempting to stay up late or to get up early just to get things done. So why is this bad for us?
Sleep gives our body the chance to maintain and repair our basic systems. Muscles, hormones, the brain and nervous system, the digestive tract — they all need a chance to recuperate from a hard day’s work. This is why a lack of sleep affects both our mental and physical health. It is associated with increased risk of obesity, cardiovascular disease, type 2 diabetes and system-wide inflammation. Lack of sleep can also affect our immune system, our cognitive abilities (i.e., our mental capacity), and our mood and mental health. Read More
Fibromyalgia is a condition that, for many people, is associated with more questions than answers. However, physical therapists, as experts in musculoskeletal problems, are an important resource for people who have fibromyalgia.
Let’s start with what fibromyalgia is: Due to its varied symptoms, fibromyalgia can be difficult to diagnose. People with fibromyalgia usually have widespread pain throughout the body, often accompanied by tender points, muscles and joints that are particularly susceptible to pain and movement. According to the Mayo Clinic, “Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.”
Other symptoms can include insomnia, fatigue, muscular stiffness (especially in the morning), headaches, forgetfulness and cognitive difficulty (sometimes referred to as “fibro fog”), and tingling in the extremities (the hands and feet). The symptoms sometimes begin after a traumatic event, like a car accident or an invasive surgery, or they can develop over time. It’s most often diagnosed in women, but 10-20% of those suffering from fibromyalgia are men. You may also be at risk if family members have been diagnosed with fibromyalgia, or if you have a rheumatic condition like rheumatoid arthritis or lupus.
Read More
Arthritis is one of the more common conditions, especially as people age. According to the CDC, as many as 50 million adults in the U.S., or 1 in 5, have been diagnosed with arthritis, and the numbers are expected to grow as our population ages. While there are many types of arthritis, the most prevalent is osteoarthritis, caused by the wearing away of cartilage in joints, especially the knees and hips.
Arthritis can be extremely painful and often debilitating. According to David P. Thompson, a physical therapist at Allegheny Chesapeake Physical Therapy (a Physiquality member in Pennsylvania), “Patients with arthritis frequently report a variety of symptoms, including pain, stiffness, swelling, warmth in the joint, aching, joint deformity, difficulty with bearing weight, trouble with walking, and general loss of function.” Read More
We’ve all seen professional athletes push through pain, playing with sore muscles, injured joints and even broken bones. No pain, no gain, right? Wrong. More healthcare providers and professional trainers are acknowledging that rest is a key component of any exercise regimen.
Daniel Butler, a certified health fitness specialist, is a personal trainer at the Take Charge Fitness Program, a wellness facility run by Clinton Physical Therapy Center (a Physiquality network member in Clinton, Tennessee). Daniel explains, “The act of working out is a traumatic experience for your body. Muscles suffer micro tears, joints and connective tissue are put under stress, and our immune system is temporarily weakened.” Read More
