.Why you won't see us prescribe rest often after an injury?
The docs at Performance Health rarely prescribe rest when it comes to an injury, but why? Physical medicine has created a rift in today’s society when it comes to appropriate treating methods for your common everyday injury such as sprains/strains, overuse injuries, or your general aches and pains. With a lack of understanding of new advancements in medicine, we start to see patients getting mistreated using old and outdated methods of training, rehabilitation, and injury prevention.
We’re here to keep you up to date on the most appropriate care.
New evidence is coming out daily refuting old training and rehabilitation methods that can slow progression and hinder the athlete or patient from getting back to their normal daily activities.
One of the most consistent and outdated methods of treatment is the utilization of rest when a patient/athlete is injured. We understand that some cases will require rest, but a majority of the time that is the complete opposite of what the injury needs.
The most common method and acronym that most everyone understands is “RICE”; or Rest, Ice, Compression, and Elevation. Through research, we have found that this treatment might not be the best recovery method for all injuries. Some researchers have even changed this acronym into “MICE”; or Movement, Ice, Compression, and Elevation and If you’ve heard us talk much even MICE is out. We use “PEACE and LOVE” instead. Protect, Elevate, Avoid Anti-Inflammatories, Compression, Education, Load, Optimism, Vascularisation, Exercise
Movement, not rest.
Recovery after an injury is improved with movement, not rest.. With the immediate but gentle restoration of active range of motion with the gradual introduction of functional activities. When we tend to rest, inactivity will shut the muscle down, restrict blood flow, and the tissue will begin to atrophy. Where in contrast, activity improves blood flow, which brings oxygen and removes metabolic waste. The movement also stimulates tissue healing and promotes faster healing according to several researchers.
Lately, ice and anti-inflammatories have shown to slow down the healing process with long-term use. Ice will tend to vasoconstrict or reduce blood to the area, in turn, reduces tissue oxygenation and inhibits the inflammatory response need to initiate healing, so you may hear the docs recommend ice for a couple of days, but we tend to stray away from that once we have you moving and incorporating exercises. There has been no evidence showing non-steroidal anti-inflammatories improve the outcome of acute sports injuries or reduce swelling. This is a point to show that movement is still the best option when it comes to healing from an injury.
What we do differently.
Excluding any type of serious injury that we may suspect is going on, we tend to get patients moving post-injury and doing ranges of motion exercises as soon as possible. For example:
Foot and ankle injuries: introduce CARs (controlled articular rotations) or the ABCs
Knee: Stationary bike or walking in the pool
Shoulder: CARs, ROMs, pendulums, wall walking
Back: walking, swimming, yoga
We tend to minimize the use of braces or shoulder slings to encourage movement and maintain the patient’s range of motion. When we use these items, we tend to become dependent upon them and we are trying to reinforce you and your body to do the work.
We recommend compression of an area if we are seeing a good bit of swelling, and elevation if you would like to, but we tend to prefer to use movement as the best tool to help reduce swelling and flush out fluid in a certain area.
An object in motion will stay in motion.
That is Newton’s first law of motion. If you are currently dealing with an injury that you just cannot shake, know there are better alternatives out there. Understand there are healthcare professionals out there that want to see you improve, see you healthy and active, and see you enjoying life with fewer medications and injections. We at Performance Health can help you and we are more than willing to help you!
If this is you and you need some help answering questions or figuring out how to fix this, please do not hesitate to call the office or set up an appointment with us. The office number is 513.463.3011 and we are looking forward to your call.
“Movement is Medicine, and Motion is Lotion”
References:
Wharton J, Wharton P. The Whartons’ stretch book: featuring the breakthrough method of active-Isolated stretching. New York: Times Books; 1996.
Khan K, Scott A. Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair. J. Sports. Med. 2009;43:247-251. (Request with CPSBC or view UBC) DOI: 10.1136/bjsm.2008.054239
https://blogs.bmj.com/bjsm/2019/04/26/soft-tissue-injuries-simply-need-peace-love/
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