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December 18, 2009
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When You’re Hurt

Let’s face it.  Anybody that moves has the potential to be injured.  Injuries happen… accidents occur.  The goal is to recover as fast as possible, and get back to moving and playing!

IMG_2807Injuries can be easily put into two categories:
Acute:  occurs as a result of an incident, such as rolling your ankle while making a defender look silly on the soccer field, twisting your knee after slam dunking a basketball, hitting a 300 lb running-back head on or with daily activities such as lifting that monster load in the laundry basket or pushing the lawn mower through thigh-high grass.
Chronic:  occurs slowly over time as a result of poor mechanics, being out of condition, or not allowing yourself adequate rest periods between work-outs or athletic endeavors.

We’ll stick with acute injury care in this article.  When an acute injury occurs, there is a tearing of the cell walls that make up muscle, ligaments, tendons, arteries and all the other tissues that surround the injured area.  Within these cells are chemicals that stimulate your body to respond to the injury.  This initial response is to isolate the injured area, which is characterized by vaso-constriction (shrinking or tightening of blood vessels) and stimulation of pain.  This initial response lasts about 15-20 minutes, and is the important time frame to get a diagnosis, before the swelling and spasms set in.  After this initial isolation phase, the arteries dilate (open up), and the swelling begins full force!  The inflammatory phase continues for about 48 hours.  Muscle guarding, also referred to as splinting or spasming, can also occur at this phase.

The original principle behind acute injury care became known as RICE (rest, ice, compression and elevation), and was later renamed as PRICE (protection, rest, ice, compression and elevation).

  1. Protection:  taping, bracing and splinting the injured area to allow the healing process to begin, and to restrict any further P1000495damage to the already injured tissues.
  2. Rest: to allow the healing process to begin, and to restrict any further damage to the already injured tissues.
  3. Ice:  Injured tissues need lots of oxygen for survival and healing, but local oxygen is diminished with swelling and the injured tissues begin to starve (called “secondary hypoxia”). Ice slows down local metabolism, thereby reducing the need of the injured tissues for oxygen.  Ice also aids in slowing down the influx of inflammation, thereby reducing the amount of swelling that needs to be removed after the acute inflammatory phase is complete.
  4. Compression:  Some authors claim this is the most important part of acute injury care, as light compression limits the amount of inflammation that occurs, just like the ice does.  (Remember, inflammation is needed as part of the healing process from acute injury, as the chemicals and proteins that arrive as a result of the injury stimulate the body to start the healing process, but too much swelling can starve the local tissue of oxygen and can inhibit local muscle function, causing further damage and delayed healing.)
  5. Elevation.  Sitting on the couch with your foot propped up on the coffee table is not enough!  Elevation means getting your injured part above the level of your heart.  This uses gravity (gravity works!) to pull the swelling out of the injured area and to aid in the healing process.  It can’t overcome the force generated from the heart unless it is higher than your heart.  (Lie down on the floor and place your foot up on the couch.)

Early active range of motion can also helps with the healing process, but you should seek attention from your physician, physical therapist or athletic trainer prior to initiating this process to determine the proper time, range, etc.

With any injury, these are general guidelines.  If you think your injury is more serious, seek attention immediately from your physician, physical therapist or athletic trainer.  In any life threatening injury, dial 911 or seek care from an emergency medical specialist.

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