Let’s face it, getting injured, even if it’s minor, is a major downer. You don’t have to be a serious martial artist or athlete to know that injuries are part of the training process. The good news is that having an effective recovery strategy will help you heal more quickly and get back on your feet sooner. So put a plan into action, get back on the mat, and don’t let minor injuries hold you back from getting after your goals!
The Difference Between Acute & Chronic Injuries
Acute injuries usually happen with little or no warning, have immediate or rapidly developing symptoms, and last anywhere from a few days to a few weeks. The most common types of injuries in martial arts are to soft tissue areas — bruises caused by blunt contact, strains to muscles, and mild sprains to joints like fingers, wrists, ankles, and knees.
Chronic conditions, on the other hand, take time to develop, are long-lasting, and potentially get worse over time. Chronic injuries are caused by muscle imbalances, faulty movement patterns, and training errors.
Since acute and chronic injuries vary greatly, they require different treatments. In this article, we’ll explore how to recover from acute injuries like muscle strains and mild sprains.
RICE vs. MICE
RICE is an acronym for Rest, Ice, Compression, and Elevation. A long held practice in treating sprains and strains, the RICE method was first introduced by Dr. Gabe Mirkin in 1978. His book, Sportsmedicine, became a best seller and RICE has been incorporated into first aid courses ever since. In more recent times, however, a growing body of doctors and exercise physiologists recommend using the MICE method, where rest is replaced with movement.
Rest vs Movement
After an acute injury, advocates of RICE generally recommend a rest period of 24-48 hours. Think of a mild to moderate ankle sprain that might happen as a result of landing a jumping kick. In this example, you might be told to “lay off it” for a few days because it’s believed that continued use will not only increase pain, but delay healing and even make the injury worse.
However, you might do well to get moving sooner than you think. Movement, also called mechanotherapy, encourages the immediate but gentle restoration of active range of motion. Activity improves blood flow to an affected area, which brings oxygen and removes metabolic waste. Inactivity, on the other hand restricts blood flow and causes tissue atrophy.
So in the case of that ankle sprain, it doesn’t mean returning to jumping kicks right away. Instead, you could introduce gentle massage and perform unweighted ankle circles.
Best Practice: For mild sprains and strains, gently reintroduce movement to an injured area and incorporate light stretching. These techniques have proven to shorten the healing time.
To Ice or Not to Ice?
According to WebMD, ice is the tried and true method for reducing pain and swelling. Also known as cryotherapy, icing an injury numbs the affected area and causes vasoconstriction (the narrowing of blood vessels) which leads to reduced inflammation.
Advocates of the RICE method generally recommend that ice be applied immediately to an injured area for 20 minutes, every 2-3 hours, for the first 24-48 hours.
So let’s say you tweaked your wrist while punching the heavy bag. You might immediately reach for the ice pack and apply it to the injury. However there isn’t sufficient evidence that shows the application of ice will be a helpful treatment. The resulting vasoconstriction reduces tissue oxidation and inhibits the inflammatory response necessary for healing. Gary Reini, author of the book Iced, argues that icing an injury delays healing, and Dr. Mirkin, who is credited with the RICE protocol, also concedes that ice delays recovery.
According to Dr. Mirkin, “Since applying ice to an injury has been shown to reduce pain, it is acceptable to cool an injured part for short periods soon after the injury occurs. You could apply the ice for up to 10 minutes, remove it for 20 minutes, and repeat the 10 minute application once or twice. There is no reason to apply ice more than six hours after you have injured yourself.”
So, if you’ve just injured your wrist and you want to calm the pain, ice can work to give some immediate relief, but stop using it after a few hours.
Best Practice: Use ice sparingly after an acute injury to alleviate pain but avoid it for prolonged periods of time because it will delay recovery.
Perhaps you tweaked your knee while practicing takedowns in submission grappling class. The next day your knee is sore, so you grab your trusted knee sleeve and put it on so you could get right back into training and not miss a workout. A few weeks later your knee is feeling better but you’re still using the brace for some added support and stability.
It might shock you to know that using a brace could be making the problem worse! In a study conducted by the International Journal of Sports Physical Therapy, it was found that extended use of braces resulted in increased muscle atrophy. Also, as noted earlier, a reduction in blood flow results in an extended healing duration.
Compression could be an effective treatment but only if it’s used properly. As long as it doesn’t restrict circulation, a brace can provide support and stabilization to an injured area which enables some movement. A wrapped injury is also a great reminder to take it easy.
So use a brace during a workout to add some extra stability to that hurt knee, but don’t use it indefinitely. If your injury isn’t better and you’re relying on the brace a few weeks later, you should see a healthcare professional.
Best Practice: A brace or wrap supports injured tissue and will help with the gentle reintroduction of movement. However, make sure it’s not too tight and refrain from using it for extended periods of time.
Elevating the injured area will help to reduce excess pain and swelling. This means raising the injured body part above the level of your heart level so that gravity can move fluids away from the sore area.
The key to remember is that elevating an injury is used to reduce excess swelling. Since swelling is part of the natural healing process, a certain amount is an indication that the healing process has begun.
Whether you’ve tweaked a joint or pulled a muscle, if you are experiencing swelling or pulsating pain, elevate the injury to relieve the symptoms. It can be as simple as propping up the injured area on a pillow while lying on your bed or sofa.
Best Practice: To reduce excess swelling and the throbbing pain associated with an injury, elevate the area above the heart level for alternating periods of 2-3 hours.
When to Use Heat
As a result of practicing your dot chui (spinning backfist), you feel a twinge in your lower back. The pain isn’t severe, but it aches enough that when you get home you grab the heating pad to treat your injured muscles.
Heat therapy, also called thermotherapy, should be used for chronic injuries or on tight, sore muscles—but never on acute injuries. The application of heat to an acute injury will only make swelling worse. Heat therapy shouldn’t be used on open wounds or immediately after exercise either. In addition, those who have preexisting conditions such as diabetes, vascular disease, and multiple sclerosis should consult a doctor before using heat therapy.
In the event that you’ve suffered from a strained lower back (or any other muscles for that matter) avoid using heat therapy immediately afterwards. Wait until the swelling has gone down (usually a few days) and then apply heat to improve circulation, loosen up the stiff area, and increase muscle flexibility.
Best Practice: With an acute injury, apply heat therapy only after the initial swelling has gone down—usually 24-72 hours afterwards. It seems to be most effective when applied for 15-20 minutes at a time.
A New Paradigm
Being mindful and learning under the supervision of an experienced instructor can reduce the likelihood of getting injured while training. Martial arts can be both fun and safe when practiced correctly.
However, if you’ve suffered from a mild sprain or muscle strain remember: “Movement is best, not rest.” Ice can be applied to an injury in a very limited capacity to alleviate pain. Compression in the form of a medical wrap is useful as long as it doesn’t restrict circulation and isn’t used for extended periods of time. Elevate your injury to help reduce pain and unnecessary swelling. Lastly, apply heat only after swelling has gone down.
Adopting a new paradigm for treating acute injuries has benefits beyond helping to heal more quickly. Since the world of exercise science is evolving rapidly, we would all benefit from having an open mind about changing some of our long held practices. Challenging our assumptions can unlock new ways of thinking and problem solving, which is healthy for mind and body.
by Ben Stanley
Note: The content contained in this article is for informational purposes and is not intended to replace medical advice. If you are injured you should always seek treatment from a qualified physician or healthcare provider.
Pt 2 Recovering from Chronic Injuries
Pt 3 How to Mentally Overcome an Injury