The Physician and Sportsmedicine
Menubar Home Journal Personal Health Resource Center CME Advertiser Services About Us

[HEALTHTRACK]

On the Mend

HEALTHTRACK - JULY 96
A SUPPLEMENT TO THE PHYSICIAN AND SPORTSMEDICINE FOR THE WAITING ROOM


If you're one of the many people who find that a good half-hour workout every day or two clears the mind and relaxes the body, a minor injury that derails your exercise program may come as a shock. The point of exercise, after all, is to have fun, reduce stress, and stay healthy. But if you do get hurt, the shock may be less severe if you know something about injuries and how to deal with them. By understanding how an injury affects both your BODY and your MIND, you'll be better equipped to recover.


Getting Your BODY Back on Track

When you are injured, you'll be likely to get back to your workout sooner if you actively help your body recover than if you wait for the problem to go away on its own.

Acute Injuries

An acute injury is one that's caused by a single incident, such as an ankle sprain. Acute injuries usually trigger immediate pain and swelling. If you suffer an acute injury that causes severe pain, or if pain and swelling last more than 2 or 3 days, you should see your doctor. Otherwise, your best bet is to use the "RICE" approach: rest, ice, compression, and elevation. These steps prevent further injury and limit pain and swelling:

  • Rest. Stop using the injured part, or at least reduce the stress on it. If you're in a game, don't try to keep playing.
  • Ice. Chilling the injury helps reduce both pain and swelling. Take a bag of ice (or frozen vegetables), wrap it in a towel, and hold it against the injured part for 10 to 20 minutes at a time (less for bony areas, more for fatty areas), with at least 10 minutes between applications. If possible, do this several times a day.
  • Compression. Wrap the injured part in elastic bandaging or a similar material.
  • Elevation. If possible, raise the injured part above the level of your heart. Compression and elevation both help prevent swelling and may speed healing.

It may not be practical to do all of these things, but the more you can do, the better. You can also take a nonprescription pain-reliever such as aspirin, acetaminophen, ibuprofen, or naproxen (if these are safe for you).

After 2 or 3 days, as swelling subsides, you may find it helpful to use a heating pad or warm water instead of ice. Warmth reduces stiffness and promotes healing by increasing blood flow to the injured part. But don't use heat in the first couple of days, because at that stage it promotes swelling.

Steps to relieve pain and swelling are only half of treatment. The other half is activity. With most minor injuries, "early mobilization"—getting the part moving again as soon as this is possible without increasing pain—will speed healing.

The general recipe for early mobilization is to start with gentle range-of-motion exercises and then move on to stretching and strengthening exercises as pain allows. For example, if you have a sprained ankle, you may be able to work on range of motion in the first day or two by gently tracing letters with your big toe. Once your range of motion is fairly good, you can start doing gentle stretching and strengthening exercises. The key is to avoid motions that cause pain.

Overuse Injuries

Overuse injuries, also called "chronic" injuries, are caused by repeated motions over time rather than by a single incident. Two common examples are knee soreness in runners and elbow pain in tennis players.

Many of these injuries are caused simply by doing too much or doing it too hard. Just stopping your activity or cutting back for a while may solve the problem. As in acute injuries, ice and nonprescription pain relievers often help as well.

If rest, ice, and pain relievers seem to eliminate the soreness, you can try gradually resuming your normal exercise or sport. Be sure to warm up with light activity (such as walking or slow cycling) before your regular workout, and do gentle stretching exercises both before and after.

But if pain and soreness don't go away, or your activity brings them back, it's time to see your doctor. Sometimes, an underlying problem must be corrected before an overuse injury will heal. The problem could be a lack of strength or flexibility in a certain muscle group, a slight anatomical defect, the wrong shoes, incorrect technique, or a playing surface that's too hard or uneven.

Depending on the injury, your doctor may have you do special exercises, wear orthotics in your shoes, replace equipment, or suggest changes in your technique. In most cases these kinds of steps will solve the problem.


Make Up Your MIND to Get Well

An athletic injury can be an emotional as well as a physical setback. The pain and swelling may be in your ankle, knee, or shoulder, but healing depends partly on what goes on in your head.

That's because an injury that limits your activity can feel devastating. It may hurt your social life, interfere with your work and home responsibilities, and, if you're a confirmed exerciser, take away your best stress-relief tool. You may feel overwhelmed as you face the challenge of keeping your life more or less normal while you recover.

The good news is that recognizing the psychological and emotional dimensions of injury can help you get on the road to recovery. Positive thinking and an intelligent approach to healing will help you return to action sooner. Below are some ways you can meet the challenge.

Knowledge and Planning

Successful recovery begins with understanding your injury. It helps to know as much as possible about the nature and extent of the injury, how long recovery is expected to take, and what you need to do to recover.

The best way to learn these things is to work with your doctor and other healthcare professionals to develop a plan for your recovery. Consider yourself a vital participant in the planning. Although you may not be a medical expert, you know best how the injury and the recovery strategy will affect your daily life.

Attitude Adjustment

Certain attitudes and ways of relating to yourself and others will enhance your recovery:

  • Think of your injury and pain as things that will go away. Write down some positive statements about your ability to cope and recover, and repeat them daily.
  • Let your emotions help guide you through the recovery process. Use your desire to recover as a way to help you connect with your sense of self and healing power. If you feel overwhelmed, nurture yourself any way you can; when you feel emotionally strong, use that energy to move forward.
  • Try to maintain your sense of identity and importance by doing things that help you feel good about yourself.
  • Allow yourself to ask and receive help from others, and don't neglect to express your needs and concerns to your healthcare providers.

Healing Techniques

Three standard techniques for relaxation and meditation are useful in recovering from injuries:

Progressive Relaxation. Alternately tense and relax your muscles, moving from your head to your feet. Memorize the feeling of relaxation, and try to reproduce that feeling whenever possible.

Breathing. Use controlled breathing to modify stressful feelings and your response to pain. Fill your lungs completely by extending your stomach as you inhale, and exhale completely. Imagine an inflow of healing energy as you inhale and a release of any negative energy as you exhale.

Positive Visualization. Use visualization and imagery to create an inner climate of healing. Start by becoming as relaxed as possible: Music, progressive relaxation, and controlled breathing may help with this. Then, imagine a positive, nurturing scene or process. Some people like to visualize a healing color or sound moving slowly through their body. Others prefer to focus on the injury site and create a healing image, such as "enriched blood flow."

Use this technique to create a meditative, self-hypnotic state focusing on healing. Practice it every day. This approach may also help distract you from pain and help you fall asleep.

Prepared by Robert Roos


RETURN TO PERSONAL HEALTH INDEX

HOME  |   JOURNAL  |   PERSONAL HEALTH  |   RESOURCE CENTER  |   CME  |   ADVERTISER SERVICES  |   ABOUT US  |   SEARCH