Fire & Ice – How Do We Treat Our Ailments

Likely, We’ve All Experienced

A sprained ankle, wrist, tight shoulders or hips, or a variety of uncomfortable (and sometimes painful) minor injuries from everyday life or our work in the gym.  Anyone who’s taken an injury treatment class, passed any personal training program, or has been in the world of health and fitness for an extended period of time is familiar with using the acronym R.I.C.E. for treating the sprains and minor injuries.

For those who don’t know, R.I.C.E. stands for:
R – rest
I – ice
C – compress
E – elevate

My aim with this post is to investigate how we treat our minor injuries, my experience with various techniques, and point you in some directions for your consideration.

Lets Clear Up One Thing

I’m talking about a sprained ankle, some ropey tissue in your shoulder, or a swollen elbow after a hard pullup day.  If you have incurred major structural damage to a bone, joint, or connective tissue or ligaments then I recommend you seek a medical professional to investigate the extent of the damage and advise you with a professional opinion on the fix for that injury.

The Most Important Question To Ask Is

What is my goal when it comes to my injury?  Do I want to stop the pain?  Maybe I want to restore range of motion?  Or perhaps I’m interested in reducing swelling?  First up, we should think clearly about what we need to do to fix the given problem, and then do a sanity check to make sure what we are doing makes sense.

Commonly Recommended Treatment

We’ve got ice and compress covered in our R.I.C.E. acronym, but I’m also going to talk about heat.  And to me, it makes sense to look at it is a treatment first.

Heat Example:

My left shoulder hates me.  Seriously, I think it does.  I have an issue keeping it externally rotated when we are doing cleans (especially moderately heavy ones) and this often times causes the tissue lying between my deltoid and pectoralis major to ball up, get really tight, and make me uncomfortable.

This injury incurs no swelling and it really only hurts when I move my arm above my head.

So lets look at my goal when I go about fixing this problem.

Goal: Remove giant knot of ropey tissue between deltoid and pectoralis major on left shoulder (frontal side of course) and restore pain free full range of motion in shoulder joint.

Since we’re not dealing with swelling, the most effective fix I’ve found for this little problem is heat.  I’ll soak it in a hot shower or cover it with a heating pad for 5 to 10 minutes and then go to work on the tissue with a lacrosse ball, foam roller, or have a super friend dig their fingers in there.

What’s going on internally?  Heat is dilating my blood vessels and allowing increased blood flow (bringing oxygen and nutrients) to the affected area.

Typically, 3 cycles of heat for 5 minutes / smash for two minutes twice daily for a couple days restores my shoulder to normal feel and function.  Goal met.

Takeaway: If you’re dealing with knotted tissue and not swelling, using heat to increase blood flow and something solid to get in there and work the tissue over is a good way to go about fixing the problem.  My favorite tools are heating pad, foam roller, and lacrosse ball (or golf ball, or tennis ball).

Elbow Swelling or Tennis Elbow

Remember this workout?  Well I do.  It left my left elbow swollen and so sore that I couldn’t straighten my arm.  Seriously.  It was bad.

So what was going on?  Well, in my haste to blast through those pullups so rapidly, I put some serious strain on my left elbow and likely caused some localized damage to the tissue in there.  In response, my body’s inflammation system triggered and sent in the repair crew to clean the mess up.  It was a Monday, and I worked out Monday evening, went home, ate dinner, and went to bed.  So the arm wasn’t mobile all night.

Next morning, my elbow hurts and it’s a little swollen.

Goal here:  Mitigate pain in left elbow, reduce swelling, restore full ROM without pain.

Now, if we follow our R.I.C.E. formula, the I shouldn’t move the elbow, I should ice it, apply compression, and keep it elevated.  Lets talk about these.

Resting doesn’t seem to fit my goal of reducing the swelling.  This, to me, doesn’t constitute a serious injury where moving the joint will produce more damage.  And I know that to force the swelling back out of the joint through the lymphatic system I need muscle contraction to occur which means I need to move.

Ice may partially achieve my goal.  Ice will numb the area, providing temporary relief of the pain my elbow is in.  Also, cold will constrict the blood vessels in the area, limiting any damaged blood vessels in the area from leaking blood into the system which may reduce the swelling.  So icing kind of sort of surficially solves the problem, but to me doesn’t seem like it really achieves the goal and gets to the root of the problem.

I’d been reading and watching some different opinions in regards to icing vs. compression and movement.  I thought that this time I would try and achieve my goal by leaving ice out of the equation and instead opting for a compression and movement solution.

These guys make a compelling argument against icing an injury and I thought that this would be an opportune time to experiment with a voodoo compression band you may have seen us using here at the gym.

I wrapped my elbow, starting below the joint and wrapping toward my heart (this is important due to the way the lymphatic system works), and then gently moved it through as great of ROM as I could for about 3 minutes (until my hand started to turn white from the compression cutting off circulation).  I unwrapped the elbow and left the joint unwrapped until color in my hand returned, moving my elbow joint normally.  I then repeated this process about 5 times twice that day.

After this treatment, the swelling reduced completely, my elbow hurt A LOT less, and I could once again straighten my arm.  I repeated this the next day and my left elbow was all good again.  I was very impressed by the effectiveness and speed at which I’d recovered.

The Argument is Compression Over Ice

Ice may produce a desired effect in regards to numbing the area and reducing a little swelling.  But my opinion is that it is an incomplete solution.  If you want the “sciency” breakdown of why working with your body’s system is a superior way to go, watch the linked video above.

I was very skeptical of the compression bands, but to be honest the more I use them the more I like them.  My elbow incident helped convince me that a minor injury can be treated by moving the body (within reason) and using the muscles to help force the swelling back into the lymphatic system.

My recommendation is that if you get a sprained ankle or elbow, or you have a tight shoulder, knee, shin, etc… talk to Chris, Annie or I.  We’ll gladly wrap you up and help you work through it.  Definitely don’t think your only option is to take a week off and stock up on ice!

The O-Board Says…

A. Sprints!

B. For Time
100 Squats
75 Situps
75 Double Unders
50 Pushups
50 Pullups
25 Burpee Box Jumps

Posted by: Stets