Most people know to ice as soon as possible after sustaining an injury, but did you know that if you ice correctly, you can often avoid more serious injury? By serious injury I mean the kind that causes recurring pain for weeks or more and won’t go away with just rest. The key is simple – as soon as you can, ice in a stretched position and ice until you’ve removed all excess heat from the injured area, so that it’s the same temperature as healthy tissue adjacent to the injury.
Icing in a stretched position is critical. For example, if you strained a hamstring, you would place the ice bag directly under the injury and sit on it, on the floor (or 2 chairs), with your leg completely straight and your torso upright against the wall (or chair back). A strained calf could require slightly different stretches: depending on which muscle is injured (there are several). The entire leg could be straight and the foot stretched back toward you with a strap. Or, the knee should be bent while the calf is stretched, and so on. If you’re not sure of the specific stretch for a certain muscle, (or if you don’t know which muscle is injured) ask any of our yoga instructors, personal trainers or massage practitioners.
Briefly, icing in a stretched position achieves two results. First, placing the muscle in a tight stretch causes newly forming scar tissue to be aligned parallel to muscle or tendon fibers. Icing ensures that the scar tissue hardens or cements in this proper alignment. Misaligned scar tissue can result in re-injury: recurring pain with a specific activity. (A massage practitioner trained in injury treatment can help to resolve the issue.) Second, icing until all excess heat is removed diminishes any secondary injury that may be caused by cell death due to lack of oxygen. (Swelling increases interstitial fluid between cells, spreading them farther apart so nutrients have to travel farther to get to cells.) Icing lowers the temperature and slows cell metabolism, decreasing the amount of oxygen needed to survive.
While we’re at it, stretching need not necessarily be part of your warm up. A “warm up” is just that – increasing the temperature in your muscles. A high velocity, low resistance activity is recommended, such as the stationary bike. Spin like crazy (with slight resistance) until you break a sweat – now you’re warmed up. While I recognize that for elite athletes stretching is a mandatory part of their warm up, it’s probably OK for the rest of us to save the stretching until after your athletic activity, when you are at your very warmest.
I’ll finish with a specific incident: while on break during my massage shift I passed one of our trainers in the juice bar. She had just returned from a run and was alarmingly incapacitated, hardly able to walk, and in a great deal of pain. “Bacon!!” she says, “You’ve got to fix me!!” I told her that, as she had just done it, there was nothing for me to fix yet (scar tissue was only just starting to form). I told her to ice herself in a stretched position. When I saw her next, she was lying on her belly, propped up on her elbows, (effectively stretching her hip flexors) resting on a bag of ice at her upper thigh/groin region. The very next day, she was moving with only the slightest limitation and fully recovered, needing no further treatment.