I took the liberty of copying this from Bill Hartman's "Your Golf Fitness Coach" newsletter. It looked like a great FAQ topic applicable to a much wider audience.
Ice, Ice, Baby!
I got a question regarding the treatment of acute sports injuries and thought it would make a great topic for this issue of the newsletter. Seeing as more folks will be practicing and playing more golf as the weather warms up for spring, it’s important that you take care of all your sprains, strains, and boo-boos that can occur even when you’re properly prepared to play.
What I’m going to do is briefly explain what happens during an acute injury and then give you some solid guidelines to treat it based on the current research.
What happens during an acute injury?
Whether it’s a sprain (ligament injury), strain (muscle or tendon injury), or a contusion (a direct blow or compression) there is structural tissue damage to the muscles, tendons, and/or ligament. There can also be damage to the nerves and blood vessels that supply these areas. This is the primary traumatic damage.
The primary damage results in cellular debris that must be removed before the new cells and tissues can replace the damaged ones. The broken nerves send pain messages to the brain, and broken blood vessels leak blood into the spaces around the surrounding undamaged cells. The bleeding causes swelling, but this is brief as a clot is formed just like when you cut your skin. This clotting results in a hematoma which is a fancy name for the cellular debris and blood left after the clot forms. It’s the body’s natural process to then remove this hematoma so healing can begin.
The problem with this process is that blood flow to the good tissue surrounding the injury site is slowed down and less blood gets to this tissue because of the damaged blood vessels. The cellular debris and protein-rich contents of the damaged cells also cause more fluid to pass from the blood stream into the injured area. That means less oxygen to the good tissue that can result in what’s called a secondary hypoxic (lack of oxygen) injury. In addition, the enzymes the body sends out to break up and digest the cellular debris can destroy surrounding good tissue if they are allowed to come in contact.
This simply means that even more tissue becomes damaged and more swelling occurs not from the direct cause of the injury (strain, sprain, or contusion) but rather from the natural processes associated with inflammation.
Ice to the Rescue
By now I would hope that everyone has hear of applying ice to an acute injury as soon as possible.
Here’s why.
Ice slows down the metabolism of the undamaged tissues and prevents further damage that can result from the secondary hypoxic injury mentioned above. It also reduces the amount of swelling (caused by edema). By the way, once the swelling is there it’s there, ice doesn’t actually get rid of swelling. It simply prevents further accumulation of fluid.
Guidelines for Ice Application
Apply ice intermittently. A good guideline is to apply it for 30 minutes every 2 hours. If you’re still very active during this acute phase, apply ice every hour as the tissues rewarm faster. DO NOT APPLY ICE CONTINUALLY AS IT IS UNNECESSARY AND MAY RESULT IN FROSTBITE!
Continue ice applications for 12 to 72 hours depending on severity (more severe = longer treatment period).
You may begin gentle progressive movement of the injured are 1-24 hours after injury after applying ice. The movement is a great way to accelerate the clearance of cellular debris. Just don’t be so aggressive that you cause further damage.
Follow the guideline of RICE (Rest, Ice, Compression, Elevation) to help control edema.
REST – reduce the overall use of the injured body part to prevent further damage
Ice – apply ice based on the guidelines above
Compression – use an ace wrap to compress the area
Elevation – keep the injured body part raised higher than the heart
When to Apply Heat
Don't apply heat until the circulation is somewhat repaired (about 72 hours) or again you'll get the secondary hypoxic injury.
When you're just dealing with soreness in the post injury period (at around 10 days), use heat to deal with the soreness. Muscle spasm will respond best to cold, but you can then use a combination of heat, flexibility training, and cold to control pain and restore normal function to the injured area.
I hope this gives you some incentive to treat your injuries appropriately, however minor, to keep you in your best condition to play your best golf this season.
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