back to list In this first stage of healing, you will have an increase in circulation near the site of the injury. Along with this there will be swelling, or edema, which is caused by the cells that have been broken during the injury. The first goal is to try and limit the amount of swelling that occurs. When there is too much swelling, more cells become damaged and more swelling occurs. This sets up a vicious cycle of swelling – damaged cells – more swelling – more damage. To limit the degree of damage, we usually recommend RICE. RICE is not something you eat; it stands for Rest, Ice, Compression and Elevation. You want to rest the area that is injured. Continued activity will cause more damage to the injured structures and consequently more swelling and tearing of cells. Ice, in the form of cold packs, will cause local contraction of blood vessels and reduce pain. A good starting point is to use ice for 20 minutes every hour immediately after an injury for four to five hours. The effects of the ice will last for 15-30 minutes and will be gone within an hour. For three days after the injury, continue using the ice three to four times a day. If you have Raynauds (hives from contact with ice), diabetes, or any vascular disease, do not put ice on your skin. Instead, place a cold cloth over the area of injury and call us for additional help. The letter C stands for compression. Wrapping the area of injury with an elastic wrap will help to limit the amount of swelling. For example, if you have turned your ankle and it is starting to swell, put an ice pack around the ankle and wrap up the ankle and lower leg with an elastic bandage. This will help to limit the swelling and allowus to do a better job of speeding your recovery when we examine and treat the injury. Finally, the E stands for elevation. If it is possible, raise the injured part above the level of your body. If you injured your ankle, raise your leg above your pelvis. If you injured your wrist, support your arm above the height of your shoulder. This allows gravity to help remove the swelling. During the injury, the breaking of blood vessels initiates several chain reactions. A clot is formed from proteolytic enzymes released by cells called platelets. Your body creates a clot or mesh where the vessels have become broken. The lymphatics, the sewer of our vascular system, become blocked with these clots. Substances known as bradykinins, whichcause pain, are released due to the injury and cause vasodilation and increased permeability of local arterioles. Other factors are released locally to breakdown severely damaged tissue and prevent infection. During this phase of injury, it is important to limit the inflammation. Some inflammation is essential and unavoidable. Too much inflammation causes more swelling and injury. Controlling this inflammation and speeding recovery depends on more than just taking an anti-inflammatory drug. Your body uses enzymes to help clear up damaged tissue and speed the recovery. A good example is a multi car accident on a large highway. The traffic will get backed up for miles on the side of the accident, and on the other side with people looking at the accident. Due to the damage done, your body attempts to block off damaged vessels so that more blood doesn’t escape. Getting the wrecked cars off the road is one of the first things that has to be done to get the roadway open. Enzymes accomplish this. Your body makes some, but taking more of them speeds up the removal of the damaged tissue and reestablishes the normal blood flow to and from the injury site. To summarize, the primary goal after an injury is to limit the amount of injured tissue. To do this, remember the acronym RICE: • Rest – stop moving the injured area • Ice – apply cold packs of ice • Compression – wrap up the area if possible • Elevation – elevate the injured area if you can Call the office and we will examine the injured structures to see the extent of the injury. Depending on what is found, we may suggest nutritionally supporting your own production of anti-inflammatories, or taking enzymes to speed the healing process. If they are indicated, studies have shown that healing times may be reduced up to 50% with similar reductions in pain and swelling. They must be started as soon as possible. This is not a time to wait and see if you feel better in a few days, as the window for starting the treatment is very short.
Injuries - Part I
The most common injuries seen in the office are those that are due to straining of muscles, ligaments and tendons. As a group, these are known as connective tissue. When an injury occurs, the first stage of healing is called the reaction phase. This stage can last for up to seven days. The length of time depends on the extent of the injury and what you do to speed the healing process.
R I C E
Rest
Ice
Compression
Elevation
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