As the weather starts to warm up and people start spending more time outdoors, the amount of sprains, strains and injuries also start to increase. It happens. But it’s what you do after the injury occurs that can be a game changer in your healing. Let’s dive a little deeper.
Using ice to treat acute injuries, as well as chronic pain and swelling, is commonplace in the modern medical and physical therapy model. It has long been the accepted treatment option (actually only since the 1970’s). Ice temporarily reduces pain and seems to speed healing by reducing swelling. But is it really beneficial and does it really help our body heal these injuries?
Likewise, NSAIDs (nonsteroidal anti-inflammatory drugs), those over-the-counter anti-inflammatory medications like aspirin, ibuprofen and others, are generally taken or suggested to be taken when someone is injured. But are they actually beneficial for healing the injury, or do they cause damage?
From the viewpoint of East Asian Medical theory, treating injuries with ice and NSAIDs is the worst thing we can do. Inflammation is an automatic response of our immune system, which orchestrates a healing process. Inflammation is not a pathological process. Inflammation is a healthy, natural, correct, perfect process that your body engages automatically with no help from you or your doctor. Our bodies are really, really good at healing themselves and it is unwise to interfere in their repair process.
As you read further, remember what you learned in elementary school science: cold slows things down; heat speeds things up.
Let’s look at the example of a sprained ankle. When you sprain your ankle three things occur in rapid succession – pain, swelling and heat. These are not the injury. They are your body’s response to the injury. They are the hallmark of an inflammatory response which protects the injury from further damage and begins the process of healing. The tearing, stretching and bleeding of the soft tissues are the actual injury. Because the body knows what to do to heal itself, it is a mistake to intervene with a known suppressive therapy. Applying ice and or taking anti-inflammatory medications disrupts the repair process, slows it down and impedes the speed and completeness of healing.
East Asian Medicine describes the inflammatory process as a response to an outside threat by our Wei Qi (defensive energy.) When Wei Qi collects in an area it causes pain, swelling and heat. These symptoms serve to defend against further injury and repair damaged tissues.
The heat is critical to healing because it is the activity of the Wei Qi repairing the tissue and clearing waste products. Applying the cold therapy of ice to heat cools it and, in this case, drives it away from the injury site, pushing it inward to the joints. When Wei Qi is active in joints, it represents what modern medicine calls arthritis, also known as inflammation of the joints. The real effect of ice is to trade short term pain for incomplete healing of soft tissue and the initiation of arthritis in the joint. Does this sound like a trade off you want to make?
And think about this…why do we put dead bodies on ice? Ice is cold, so it slows or halts the metabolic process of decomposition that is present in any dead organism. This is why remains of such old animals and humans have been found in glaciers. Every physical therapist knows that ice applied to any body part for too long can cause frostbite, which is tissue death. Does it really make sense to use ice to slow down the active metabolic process of healing?
There is no modern scientific research that shows that ice helps the healing process. In reality, research shows that the cold of ice reverses the flow of lymphatic drainage, the circulatory system that transports damaged cells and waste away from an injury site. This reversal increases fluid congestion which slows or halts the healing process. Cold also impedes transport of macrophages and growth factors to the damaged area. The function of macrophages and growth factors is to clean up damaged tissue and stimulate new cell growth. The long term issues that many athletes have with injured ligaments and tendons are not due to their injuries, but to the retardation and incompleteness of healing caused by the therapies themselves.
NSAIDs disrupt the signal that coordinates cell messaging in the inflammatory process. This means that it short circuits the healing process, turns it off and ends tissue repair. This is not speculation, it is the known mechanism of these drugs published in medical literature. NSAIDS therefore create underfunction of the inflammatory response and are considered, like ice, a cold therapy by Chinese medicine. Again I ask, does this sound like something you want to do to your injured ankle?
But what about the latest fad of ice baths? Well, the truth is that the science behind ice bathing is murky at best. There are some immediate benefits when submersing your body in water that is about 59 degrees Fahrenheit, including the reduction of inflammation. But this is very short-lived and can actually cause more damage than good. As the tiny capillaries in the extremities collapse and redirect blood back to the core of the body, frostbite and the potential for issues like neuropathy increase. Also, anyone who has ever jumped into a cold body of water can attest, your body goes into a state of shock before it starts to adapt. This shock can actually cause fatalities like heart attacks in some people. So while your favorite celebrities and athletes may be promoting regular polar plunges, it is not really advisable or necessary for most people.
So what should you be doing for a sprain or an injury? Well, the outdated way of handling is was something known as R.I.C.E., which stands for rest, ice, compression and elevation. Professional sports teams have begun to see the light on ice and NSAIDs and are using less of them. This should be a clue to all of us that it is not good medicine. They want their athletes to be in the profession for the long haul. They are beginning to see that the accepted dogma of R.I.C.E. is at least partially wrong. The rest and ice can actually make things worse.
When you have a painful and ugly injury, there is something better to try. The first thing to do is trust your body to perform its perfect healing response. Apply the new acronym A.R.I.T.A. – Active Recovery Is The Answer. That’s right, stay in motion! You can support the healing process by continuing to move the muscles around the injury. Muscle contraction is what causes lymphatic circulation. This is the system that clears the fluid congestion at an injury site. Clearing the congestion allows renewed blood flow and reduces pain. Moving the injured limb to the extent that you can will accomplish this. Massaging lightly from the injury toward the torso also assists lymphatic circulation. An acupuncture treatment as soon as possible after the injury can dramatically reduce pain by enhancing lymph and blood circulation.
Most importantly, trust your body! It is a fantastically complex, resilient organism that has been functioning for millions of years without help from medical procedures at every turn. And utilize alternative healing wherever you can. You’ll be surprised how quickly you can recover.