Is ice always the best option for treating an acute injury with swelling and pain? Did you know that using ice could potentially delay your recovery process? Ice is often the first thing people apply to sprains and bruises, but this approach has recently been questioned. Let’s look at the updated principles of acute injury management and compare Eastern and Western medicine perspectives to find the best ways to treat sprains and bruises for optimal recovery.
Dr. Gabe Mirkin, a sports medicine physician, introduced the principle of acute injury management known as “RICE” in 1978, which stands for Rest, Ice, Compression, and Elevation. However, reviewing the findings of ongoing sports medicine research, he found that while icing can reduce pain and inflammation, it can also prolong recovery time. Therefore, he decided to reexamine the acute injury management principle he had proposed years ago.
New Principles for the Treatment of Acute and Subacute Soft Tissue Injuries
The British Journal of Sports Medicine published new treatment principles for exercise-related soft tissue injuries in April 2019, which removed ice as a treatment method. The new acronyms for treating injuries are PEACE and LOVE.
PEACE for Acute Injuries
PEACE refers to the treatment principles for acute injuries. Typically, the acute phase lasts around one to three days after the injury, but the duration may vary depending on the extent and severity of the injury.Protect
It is crucial to reduce the load and restrict movement for one to three days to avoid and minimize tissue bleeding, prevent distension of injured fibers, and reduce the risk of aggravation. However, it is important to note that rest should be done in moderation, as prolonged rest can negatively affect tissue strength and quality. Once the pain has subsided, it is safe to begin appropriate exercise.Elevate
Elevating the injured area higher than the heart level can facilitate blood flow and reduce swelling.Compress
Applying pressure to the injury with elastic bandages can help reduce joint swelling and tissue hemorrhage.Educate
Encouraging patients to take an active approach in managing their pain and educating them on proper techniques can help promote quicker injury healing.LOVE for Subacute Injuries
The absence of pain does not necessarily indicate that the injury is fully healed. It is crucial to continue actively managing the injury to restore it to its pre-injury state. Following the principles of subacute care can help accelerate recovery.Patients can begin subacute injury management if there are no symptoms of redness, swelling, or burning sensation after the acute phase.
Load
Many people believe that resting is the best thing to do after an injury. However, once the initial pain and swelling have subsided, it is essential to gradually bear weight on the injured area to stimulate tissue repair and remodel the capacity of muscles, tendons, and ligaments, provided that the injury is no longer painful.Optimism
Maintaining psychological stability and actively addressing and managing pain can positively impact injury healing and sometimes even play a pivotal role.Vascularization
Engaging in an appropriate amount of aerobic exercise can help promote blood circulation, which is beneficial for injury recovery.Exercise
Early movement is beneficial after an injury, as appropriate rehabilitation can help heal tissue and shorten the recovery period.In the past, treatment principles primarily focused on managing the acute phase of injury but neglected to consider the impact of this phase on the subsequent subacute and chronic phases.
Inflammation Plays a Role in the Body’s Natural Healing Process
When tissues are traumatized or damaged due to intense exercise, the body will initiate an inflammatory response, which activates its immune system for self-treatment. The process is similar to the body’s physiological mechanism to kill bacteria.When bacteria enter the body, the immune system transports cells and proteins to the infected area to kill them. Similarly, when muscles and tissues are damaged, the immune system sends the same inflammatory cells to the injured area to promote healing. This means the body’s immune response to infection and tissue damage is the same.
Cold Compress Prevents Healing Cells From Entering Injured Tissues
A 2014 study published in the Knee Surgery, Sports Traumatology, Arthroscopy journal found that icing an injury can cause vasoconstriction and prevent the delivery of healing cells. The study also showed that blood vessels take hours to reopen after icing, which can lead to tissue death due to inadequate blood supply and even permanent nerve damage.Switch to Warm Compress During the Acute Phase of Injury
The use of ice packs for sports injuries has been widely circulated for a long time, and the medical and sports communities have differing opinions about whether to remove them during treatment.While ice packs can alleviate the redness, swelling, and pain caused by sports injuries during the acute phase, there is controversy over whether they may delay the healing process. Therefore, taking a middle-of-the-road approach and using a warm compress is recommended.
The warm compress method is quite simple:
1. Soak a cloth in room temperature water.
2. Apply the wet cloth to the injured area.
3. Leave it on for 10 minutes, then remove it for five minutes.
Acute Ankle Sprain Healed in 1 Week With TCM Treatment
A male high-school student twisted his ankle after exercising and applied ice to the injury for two to three hours a day for two to three consecutive days. After a month, his ankle joint muscles and ligaments became stiff, and his calf and foot formed a rigid “L” shape, making walking difficult. He then visited a traditional Chinese medicine (TCM) practitioner. After one week of taking traditional Chinese medicine that promotes blood circulation and soaking the feet in ginger water, his ankle joint regained flexibility.Management Principles for Acute and Chronic Ankle Sprains
Management Principles for Acute Phase Ankle Sprains
1. TCM dynamic qi therapy involves pressing and rubbing the Waiguan acupoint (SJ 5) on the opposite forearm while moving the affected limb. For example, if the left foot is sprained, press and rub the Waiguan acupoint on the right forearm while moving the joints of the left foot.
2. Use a warm compress instead of a cold compress.
Management Principles for Chronic Phase Ankle Sprains
1. Soak your feet in ginger water.2. Kneel and sit with your buttocks on your heels.
Copy
