Getting rid of pain …a “non-corrective exercise” approach

Posted on 21. Sep, 2010 by in Back to Health, Blog

Corrective exercise is a term that is thrown around a lot these days. In many cases the people performing “corrective exercise” seem to be crossing that line between exercise and therapy and that is a very dangerous line to cross. In any case, that is a topic for a different day.

People have physical pain all of the time and many times there is no one around to show them what to do to make the pain go away and make things better. I think we get too far ahead of ourselves these days and start prescribing all kinds of corrective exercise without thinking about the basics…and trust me, many people do not know the basics. With this in mind, I thought I would scale back a bit and write about dealing with physical pain, without corrective exercise. In other words, what can you do first, in the middle and last separate of the exercises. With that said, I am not saying in any way that corrective exercise or physical therapy is bad or not needed…it is! In this case, I am only writing about the basics that many people have not learned or have forgotten.

Ice or Heat?

To some of you out there this might seem like a dumb topic. For sure, everyone knows when to ice and when to heat, right? You would be surprised just how many people get this wrong.

It is pretty simple…use ice, or cold therapy for the first 48-72 hours after an injury, or re-injury. You are usually safe to use heat by the after the third or fourth day. It is really that simple. You never want to use heat immediately after a new injury or even after a re-injury. In my mind a re-injury counts as a new injury, so with that said, go back to the rule.  Using heat for a fresh or new injury can and usually will make things worse, and slow down the healing that needs to take place during this important time. In most cases, after three days of cold therapy, heat can be introduced.

Here is the second rule: When in doubt, use ice or cold. You usually cant go wrong with using cold treatment, but you can by using heat. So, if you are not sure, go with cold for another day or two. It is still going to help and usually will not hurt.

What kind of Cold and Heat?

For cold, I am old-school…I like crushed ice in a bag and the bag put directly on the injury. No towel, no barrier. 20 minutes on the spot and you are good. When I worked at the high school as an athletic trainer, I used to get in arguments with the school nurse because she was telling my athletes that they needed to put a towel between the skin and ice. Although that might make things “easier” on the person, it is not the best way to transfer cold to the spot. Put it on the skin, unless you have some kind of allergic reaction to ice.

For heat, I like moist heat. If you can find a hot pack that you place in water and then heat up, that is usually the best. In the same regard, a hot bath works very good too. Regular hot pack can work, but I have found that moist heat is the best. Now, for heat, you will want to put a towel or two between the skin and the hot pack. You can get burned if you don’t do that. So be careful. Again, 20 minutes is usually the best length of time.

Anti-inflammatory Drugs?

Some people live every single day by popping Advil or Tylenol. These over the counter anti-inflammatory medications do have their merit, but at the same time don’t so as much as many people think.

Basically, most of these over the counter meds help cut your pain and inflammation. That is a good thing, right? Well yes, most of the time. The problem is, people become reliant on these medications and don’t so what is required to solve the actual problem in the first place. Remember, these meds will help get rid of pain temporarily and also help cut inflammation a bit. Both are good things, but soon the drugs wear off, and down the road, they don’t work as well as they once did.

Most physicians will recommend that people with pain or injuries take some over the counter anti-inflammatory medications for the first few days to help with the pain and inflammation, but beyond that, they need to see a physician or qualified medical professional.

Immobilizing or splinting

If you are injured, when should you splint or immobilize the area? That is very hard to answer without knowing the extent of the injury. It is always advisable to see a doctor first. However, if you don’t have access to someone your trust, then when in doubt, splint it. The key is not to splint it all day long and allow some time during the day with the splint or immobilizing unit.

Immobilizing or splinting the joint will help reduce the chance of injuring it more and also help keep the pain and inflammation down. It is recommended that splinting for most things be for a day or two, until you see a qualified professional. People can and do splint or immobilize too long in some cases. Leaving a joint or body part immobilized too long, without any kind of movement, stretching, or range of motion, can actually make the situation worse. Some slight movement, small stretching, or basic range of motion, within pain free limits, is advisable. Over splinting or over immobilizing can cause major problems down the line.

The best way to know is to find someone that you trust (i.e. your physician) and check with them.

Cutting the Inflammation

If you could cut down the inflammatory reactions, pain would decrease and healing would speed up in many cases. Let’s be clear however, inflammation is natural and necessary. This is how your body heals. It is the length of time and the kind of inflammation that can delay healing and cause excess pain. With that said, it is always advantageous to limit and try to control the inflammation as much as possible. Ice and heat, as already mentioned, as one way to cut back on the inflammation. Another way is immobilization. However, one of the best ways to limit inflammation is rarely talked about and that is simply elevation. Elevating the injured area (i.e. ankle, knee, elbow, shoulder) over the level of the heart will dramatically slow down the blood flow and the inflammation. Nothing beats gravity, nothing.

So to review, to cut inflammation make sure you use ice and heat in the right manner, and also learn to immobilize the area correctly, while also getting some basic movement going. Finally, elevate.

All of these things are basic. If you already knew all of this, I apologize, but this wasn’t written for you or to impress you. For those of you that didn’t know all of this, I hope it will help you make better decisions regarding your pain and injuries.

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