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SOFT TISSUE INJURY – MOIST HEAT, MOVEMENT, SUPPLEMENTS, NOT R.I.C.E.
Lawrenceville, NJ (Dr Simone) – Inflammation plays an important role in an acute soft tissue injury. After a few seconds of vasoconstriction, inflammation causes vasodilation resulting in greater blood flow to the site of injury that brings beneficial white blood cells (that release digestive enzymes), plasma proteins, and chemical mediators. This results in swelling. These beneficial agents begin to repair and also destroy and wall off harmful chemicals. Some of the swelling is decreased by the lymphatic vessels, by muscle contraction, and by elevation of the site. However when inflammation continues too long, these chemicals can cause damage to healthy cells.
The usual R.I.C.E. approach (Rest Ice Compression Elevation) to treat soft tissue injury can delay repair and recovery.
Rest? Sure, but prolonged rest is harmful. Rest can cause atrophy and weakness, so get the joint moving to enhance healing. Prolonged rest results in muscle, tendon, and ligament atrophy that can lead to weakness and re-injury. So never use complete rest as a mode of treatment. You need to get the joint moving through its normal range of motion preferably by passive movement initially, i.e. another person moving the joint for the injured person or that person if able, move their injured joint with their uninjured upper extremity.
Ice? Sure, but only during the first few minutes to determine if there is a broken bone (examination, X-ray, etc). Once the injury is determined to be soft tissue, stop using ice because ice restricts blood flow and thereby restricts the healing and repair process. Icing also renders the injured area inactive for many minutes and that time could be used to enhance mobility.
Compression and Elevation are marginally effective at best. Overall, R.I.C.E. generally delays repair and recovery.
CONCLUSIONS 1) MOIST HEAT AND MOVEMENT will enhance blood flow to bring in mediators that are beneficial and remove those that are harmful.
2) GET THE JOINT MOVING through its normal range of motion. Initially this should be done by passive movement initially, i.e. another person moving the joint for the injured person or the injured person if able, move their injured joint with their uninjured upper extremity. Then movement of the joint in all directions with gentle traction (using color-coded rubber bands) will speed recovery and re-align injured muscles, tendons, ligaments, and nerves.
Dick Hartzell has many videos on YouTube.com demonstrating how to use Flexbands to heal injured sites.
3) SUPPLEMENTS: Energy Molecules without Stimulants
Alkaline Bicarbonate Base – no acid
Antioxidants: beta-Carotene 30 mg/day; Vitamin C 1000 mg/d; Vitamin E 1000 IU/d; Selenium 200 mcg/d.