ninearms wrote:IME cold to reduce swelling, then heat to restore movement. However, somewhere in the depths of this site there's a Gelert megapost (or two) explaining both approaches.
Gelert wrote:The way it works is this.
You injure yourself, by whatever means, you incur yourself a soft tissue injury. Your body responds by mounting an inflammatory response - the doctors who get latin call it rubor, dolor, calor, tumour.
This isn't for laughs or because your body is set up to be annoying, it's got an useful point. The redness and heat come from increased bloodflow to the area. The tumour (swelling) bit comes as plasma and leukocytes infiltrate tissue. The dolor comes from the fact that there is pressure and heat being put on the affected body part.
The bloodflow is there to get the plasma and leukocytes to the problem, and they're there to help fix it. At the heart of it, inflammation is well-meant. Inflammation is the dark side of healing processes, crudely put. Unfortunately, it tends to be too aggressive, and results in pain and further tissue damage. This is why we control it.
The reason why I mentioned the 24h-48h cut off for RICE and brufen, in line with accepted, evidence based medicine guidelines is that within that 24-48h period after injury or aggravation, laying off RICE (or HI-RICE, PRINCE, RICER, variations thereof) is usually indicated, as if it has been done correctly, the worst inflammation is past, and decreasing bloodflow is at the cost of delivery of nutrients, growth factors, removal of wastes and the beneficial side of inflammation. This is why we allow some degree of subacute inflammation.
The trouble with RICE is that it is epically misunderstood within the general sporting public as people think it means what it says on the can.
People interpret it as licence to sit at home watching daytime TV with the body part elevated, bandaged very tightly and packed with ice (more often than not, applied directly to the skin...)
Which it should never be. Even when RICE is applied, R means not doing anything that causes acute pain, not arse on sofa, Ice is only applied for up to 20 minutes, tops - the rest is off to allow bloodflow and prevent ischaemia - Compression, should be done gently, and the E bit should not limit you to the sofa.
It's a first aid procedure for acute inflammation due to soft-tissue injury, not a cure-all. This is why RICER is a better acronym - the final R standing for "Refer" - go to the doctor.
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