Injury and Recovery

Ice Bath

Aside from sliothars, ice packs must rank highly on the ‘miscellaneous’ expenses sheet for any hurling team (or any sports team for that matter). But are they even necessary?? Do they help or hinder the recovery process? Should physio’s/physical therapists use them as placebo’s or is educating our players better for their long term development? Let’s look at the facts first………..
sprained ankle infographic

We use ice packs and anti-inflammatories to reduce swelling but did you know that this may hinder the recovery process?

My father had his hip replaced recently and he was prescribed to take anti-inflammatories for the next 6 weeks. I could understand the dated logic of this but couldn’t disagree more with it.

Inflammation happens almost immediately and for very good reason when we are injured. It’s an immunity response to aid in the healing process.

INFLAMMATION IS NECESSARY FOR HEALING.

And we constantly try to reduce swelling believing it’s the right thing to do!

You’ll see from the picture below that inflammation is the first step in the healing process. Swelling immobilises joints too (think of a swollen knee meaning you can’t bend it after an ACL tear). It’s a natural support bandage!

inflammation

Inflammation can take time to reduce. It depends on the severity of the injury, the personal recovery process, diet and lifestyle including stress, alcohol intake and smoking as they can all contribute to a delayed healing time.

Remember your first aid training and I’m sure the section on strains and sprains contained information on RICE as part of the treatment protocol. Remember what it means? I’ll tell you anyway!RICE

R – Rest
I – Ice
C – Compress
E – Elevate

The basic principles behind each part of the treatment are:

REST – stop doing what you are doing
ICE – for pain relief (this will also reduce inflammation immediately after an injury BUT is only for 5 minutes and may be worth it if you’re in severe pain)
COMPRESS – For 2 reasons; stabilise a joint or encourage oxygen uptake in muscle strains
ELEVATE – Can aid circulation and return of inflammation bi-products.

But there’s also a new train of though which I happen to agree with and it involves replacing RICE with MEAT…….YUM!

Actually it has nothing to so with nutrition. But like, in nutrition circles, more people are increasingly having higher protein intake and ditching the starchy carbs, I see that in injury treatment more people start replacing RICE, with MEAT.

We know what RICE stands for so here’s a breakdown of what MEAT stands for:Steak

M – Movement
E – Exercise
A – Analgesics (painkillers)
T – Treatment

MOVEMENT – Controlled movement of the affected body part can stimulate blood flow, reduce the formation of inappropriately aligned collagen fibres (scar tissue), and effectively improve recovery time.

EXERCISE – Exercise(s) (closely linked with movement) prescribed by a professional and within pain free range can have a positive effect on recovery and reduce “rehab” time prior to returning to full activity.

ANALGESICS – Analgesics (painkillers) should replace anti-inflammatories as they can reduce acute pain. Preferably taken if at rest and therefore no fear of causing damage by not feeling pain while on the move.

TREATMENT – Treatment may not always be necessary but speak to a therapist about your injury and go from there.

Makes sense right? To keep a joint or muscle moving (if possible) after acute injury? Inflammation will decide your range of motion if the injury is very serious such as an ACL tear.

THE GREATER THE INFLAMMATION, THE GREATER THE TISSUE DAMAGE

Ice or cold therapy and complete rest can reduce the blood flow and lymphatic drainage from an injured site whereas controlled exercise can increase blood flow, aid in lymphatic drainage and preserve neuromuscular control.

Compression, as explained above, can be unnecessary. If you can walk on a sprained ankle, do it! Yes it might be slow and uncomfortable but the benefits of retained motor control and muscle mass is worth it.

Lastly, the use of painkillers and anti-inflammatories (analgesics):

  • Don’t use anti-inflammatories. There I said it!
  • Use painkillers only when at rest. Using painkillers while on the move may mean you are in pain, doing damage, but unable to feel it.

Your GP will tell you to use RICE, your physio may tell you to use RICE, your mother will tell you to “put your feet up and use ice”. Your coach will tell you to ice an injury daily, rest up and come back in a few weeks having completed no exercise. Will it do you any harm to listen? No.

Will it benefit you to tell them there’s a better way to recover – YES!

Replace RICE with MEAT today!

Rice v Meat

P.S. Ice Baths Aid Recovery – FACT OR FICTION??

Cut the bravado, the ego and the macho bullshit because full body ice baths are ill-advised. If your calf is sore place a pack on it. Don’t submerge yourself until you’re just shy of hypothermia!

ice-bath

Full body ice baths are NOT recommended by me. They can be more harmful than helpful. They drastically reduce bloodflow and CAN cause heart issues.

For injured areas use localised ice packs for pain relief only in the immediate aftermath of an injury for 5-10 mins. After tough training sessions a gradual cool down including light Cardio and plenty of mobility work is waaaaaaay more beneficial.

Your diet, sleep and movement patterns will determine your recovery time much more than freezing your balls off in a cement tub or wheely bin up to your neck in ice cold water!

References/Credits:
The inflammation diagram was taken from this article: worth a read if what I wrote here was interesting to you: www.goodfoodeating.com/4728/what-is-inflammation/
Mark Caulfield

Mark Caulfield PT Personal Trainer and Neuromuscular Physical Therapist based in Waterford, Ireland