Managing Acute Injuries

Acute injuries are inevitable for people of all fitness levels. For years, the mainstream belief on how to manage an acute injury was the R.I.C.E protocol.

♦ Rest: Restrict the injured area from any movement

♦ Ice: Apply cold therapy to decrease inflammation

♦ Compression: Apply a compression wrap around the area to reduce swelling

♦ Elevation: Elevate the injured part while lowering pressure in the blood vessels to minimize swelling

While these steps have been the most popular approach to treat acute injuries, they are not necessarily the best way to optimize healing. To better understand why, let’s look at the body’s natural healing process.

1. Hemostasis – immediate aggregation of platelets and other inflammatory cells at the site of injury to create a blood clot and prevent further bleeding
2. Inflammation –migration of white blood cells to the injured site to remove pathogens and dead tissue and produce healing growth factors
3. Proliferation – reconstruction of blood vessels and tissue
4. Remodeling – re-alignment of new cells into an organized fashion to create a mature strong structure

The typical R.I.C.E protocol disrupts the natural healing process prolonging recovery. Applying cold immediately after an injury restricts blood flow to the area slowing down cellular metabolism. Inhibiting blood flow prevents the collection of white blood cells which further slows down the cleanup process leaving an accumulation of dead tissue. This also minimizes the amount of healing and growth factors to rebuild the injured tissue.

Gentle movement, opposed to complete rest, promotes blood flow supplying oxygen and nutrients to the injured site. Movement also stimulates the lymphatic system to reabsorb fluid and white blood cells once they are finished cleaning up the damaged tissue. Gentle movement helps regenerating tissue grow in an organized fashion during the remodeling phase.

Seeking early care from a physical therapist after an injury can speed the healing and recovery process. Gentle manual therapy and range of motion can stimulate the lymphatic system to reduce swelling and minimize pain. Gradual and progressive loading of the tissue will aid in the re-organization of new tissue and create a strong foundation for the mature muscle/ tendon/ ligament.

⊗This is not medical advice for all injuries. If you experience significant trauma seek immediate medical help. 

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Written by Hannah Sweitzer