 Poster: A snowHead
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Not sure what's considered best these days.
To me it's always been ice for immediate injury, pain, swelling etc; heat for post acute phase, stiffness, general tired muscles etc. Never had to deal with anything more long-haul before.
So, with a slowly-healing knee ligament injury ( or few  ), after a small but tiring walkette which has twinged the knees and tired the slowly-restrengthening leg muscles generally, which is best; or what order?
Same question re post general exercises, static cycling, squats & hammy work - not much swelling, general knee soft tissue aches & some soreness, lasting overall leg muscle tiredness...
Seems odd to want to constrict off blood flow then encourage it - or vice versa - although both serve their purpose, I know.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Ice for immediate injury..reduces blood flow and therefore swelling. No good for healing. Heat for longer term...increases blood flow so the magic blood pixies can do their healing thing.
Ice plunge bath can be invigorating. It certainly wakes you up.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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If injured, ice should be used initially, as Thorny said. If general recovery is what's needed, then an ice bath is marginally better than hot bath. It's why elite athletes use it. For mere mortals, a hot bath is not far off and is more pleasant. What doesn't do a lot of good imo, are the various hot and cold PR sprays, which don't penetrate far enough to have the proper effect.
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You need to Login to know who's really who.
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Just an update on this.
Asked my physio, a knee specialist, and he said that there's a debate going on now as to the value of ice with swelling - close down blood supply vs increase it, I guess. He didn't go into much detail.
As for my post-exercise twinges and painful soreness, he said to do whatever I felt helped best. I had been applying gel ice packs, but swapped to hot microwaved wheat bags. My knees (and tired leg muscles generally) seem to like those much better; are less stiff certainly. So it's heat for healing from now on, I think - unless maybe it's very painful: then I'll try ice 
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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| Grizzler wrote: |
Just an update on this.
Asked my physio, a knee specialist, and he said that there's a debate going on now as to the value of ice with swelling - close down blood supply vs increase it, I guess. He didn't go into much detail.
As for my post-exercise twinges and painful soreness, he said to do whatever I felt helped best. I had been applying gel ice packs, but swapped to hot microwaved wheat bags. My knees (and tired leg muscles generally) seem to like those much better; are less stiff certainly. So it's heat for healing from now on, I think - unless maybe it's very painful: then I'll try ice |
As I understand it, initially the Ice (and anti-inflammatories) is simply to control inflammation/swelling....but once you get past that, you want to get blood to the area, through heat.
Over the years, I have come down on the side of, "Do as much as you are comfortable with".....and always listen to your body. ie. Don't fill yourself with strong painkillers and carry on (which we've all done).
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You'll need to Register first of course.
You'll need to Register first of course.
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Ice in the G&T while sitting in a hot bath works for me.
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@welshskier, can I swap for a bottle of sweet bubbly in an ice bucket? 
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@Grizzler,
No. You need gin.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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@musher,
Or, I believe, lemsip....
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I Was on another thread about ice being harmfull in many cases... its being looked into by some austrailian study groups. Looking at alternative ways of reducing inflamation and get better blood flow to the affected area..
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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@musher, you really don't want to meet me on gin... It does nasty things to my alreadysometime-psychotic psychology 
@yorkshirelad, yes, my physio rasied a similar point, and with a background in biomedical science areas it interests me too (kind of why I raised the original thought/question). Yet it still seems recommended for swelling reduction in days long post injury or surgery, not just very initial acute phase.
Course, Ibuprofen, Diclofenac et al are now falling out of favour too (certainly as oral administration and for me I don't think that the topical applications - Voltarol etc - do much if anything) and I have met advice in the past that they shouldn't in any case be used in early days of sprains etc (so that the natural healing process can take place uninterrupted), so I wonder if we'll end up back at square 1 with hot compresses, or back to cabbage leaves, vinegar and brown paper, or...? Well, maybe the body is pretty good at working out what it neds all by itself most of the time, and it's just us stupid rushing humans who are too keen to get it back functioning at activities which it doesn't want to do yet (never mind maybe hurt it in the first place).
On the original reason for the query, I seem to have overdone something in my knee rehab over the last few days - irritated it anyway, lots more pain and bit of internal swelling - and I went back to icing it for a couple of sessions (after the hot wheat bags didn't work) and it seems to have helped, I think. So that's me confused again.. 
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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Try cider vinegar compress.... worked well for my knee
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Try cider vinegar compress.... worked well for my knee
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You know it makes sense.
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My late father-in-law, an osteopath and physioterrorist, with a strong interest in Sports medicine recommended ice for the initial acute phase of an injury, and then alternate heat and cold during the healing phase. Seems to work for his son who seems to get more than his fair share of sporting injuries
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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| yorkshirelad wrote: |
| Try cider vinegar compress.... worked well for my knee |
What are the benefits of a cider vinegar compress? Never heard of it 
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Poster: A snowHead
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| Hells Bells wrote: |
| .....physioterrorist, ...... |
I knew there was I reason I avoided going to them..
After the initial ice, heat period if I still had stiffness, slight pain, no inflammation, I would use an ultrasound massager with some aloe vera gel (assuming I did not have any aquaeous ultrasound gel to hand).
I have two of them, one is a battery operated toy which does work but is nothing like the mains connected beast. (1MHZ, with 3 settings and a pulse setting too for really deep muscles)
I might also use a percussion massager, of which I also have two (one battery operated which is light massage, and a beast which I use on buttocks and hamstrings)
A foam roller for general massage, or a shiatsu cushion.
I use the foam roller about 2-3 times a week.
For knees, I would concentrate on hamsting and quad join points and heat them up with a ultrasound massager. For me it tends to be the attachment areas which toughen up with age. Ultrasound helps increase collagen!
I would also get some resistance bands, and stretch your hamstrings using resistance. Lie on your back, and lift legs up straight with a resistance band under your feet which you pull on with your hands.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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| Bigtipper wrote: |
| Hells Bells wrote: |
| .....physioterrorist, ...... |
I knew there was I reason I avoided going to them..
After the initial ice, heat period if I still had stiffness, slight pain, no inflammation, I would use an ultrasound massager with some aloe vera gel (assuming I did not have any aquaeous ultrasound gel to hand).
I have two of them, one is a battery operated toy which does work but is nothing like the mains connected beast. (1MHZ, with 3 settings and a pulse setting too for really deep muscles)
I might also use a percussion massager, of which I also have two (one battery operated which is light massage, and a beast which I use on buttocks and hamstrings)
A foam roller for general massage, or a shiatsu cushion.
I use the foam roller about 2-3 times a week.
For knees, I would concentrate on hamsting and quad join points and heat them up with a ultrasound massager. For me it tends to be the attachment areas which toughen up with age. Ultrasound helps increase collagen!
I would also get some resistance bands, and stretch your hamstrings using resistance. Lie on your back, and lift legs up straight with a resistance band under your feet which you pull on with your hands. |
I occasionally go to a Physical Therapist....a Lady that runs marathons and has the physique of a Racing Snake.....but wouldn't be out of place in Guantanamo Bay, torturing terrorists.
On coming in the door, she gives you a stick to bite on, saying, "You might find this helpful!"....I've had her reach across the massage bed, grab the far edge with her free hand, so she could put extra pressure under the bony elbow that was dug into somewhere painful.
She does a 2 hour session, using Ultra Sound to heat the muscles....when you can't handle any more, she goes back to the U/S, to soften the muscle further, before digging in again. She does about a months work in 2 hours! Masochists only need apply! 
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Have a look on the internet, but apple cider vinigar draws out the swelling, if you cant or dont want to take tablets its good way of reducing swelling without harming the surrounding tissue.. some say it has its roots in the old nursery rhyme, but a lot of old remedies do actually work, some dont though, !!! And some act like a plecibo... but if your body heals its self with the effect of a harmless plecibo i suppose its better than taking tablets that could have a side effect ... each to his own though
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You need to Login to know who's really who.
You need to Login to know who's really who.
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Have a look on the internet, but apple cider vinigar draws out the swelling, if you cant or dont want to take tablets its good way of reducing swelling without harming the surrounding tissue.. some say it has its roots in the old nursery rhyme, but a lot of old remedies do actually work, some dont though, !!! And some act like a plecibo... but if your bidy heaks its self with the effect of a harmless plecibo i suppose its better than taking tablets that could have a side effect ... each to his own though
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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| yorkshirelad wrote: |
| Have a look on the internet, but apple cider vinigar draws out the swelling, if you cant or dont want to take tablets its good way of reducing swelling without harming the surrounding tissue.. some say it has its roots in the old nursery rhyme, but a lot of old remedies do actually work, some dont though, !!! And some act like a plecibo... but if your bidy heaks its self with the effect of a harmless plecibo i suppose its better than taking tablets that could have a side effect ... each to his own though |
If it's good enough for Ranulph Fiennes....
http://www.dailymail.co.uk/health/article-1053045/Sir-Ranulph-Fiennes-I-beat-arthritis-vinegar-cure-passed-mother.html
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You'll need to Register first of course.
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@yorkshirelad, yep, wasn't joking when I suggested vinegar (good enough for Jack & Jill ), ditto cabbage. Lot in some of these old home / hedgewitch remedies. Do you use heated compress?
@Bigtipper, can a layperson buy ultrasound, if so where, how much etc? Seems to be helpful to me via physio; would use at home if was strong enough to be able to be of use (but if so, is it safe to be sold to any old person??)
@Hells Bells, I am tending towards this on a day by day basis, as per what my knees and/or easily-tiring rehabbing muscles seem to be communicating what they need. Is your recommendation for alternate days, alternating treatments per day or..?
Saw Orthodox Consultant today, BTW - he's of the cycle, exercise and keep on icing school; there is still swelling at 7 weeks post injury & expected to be for many more weeks or months, so he favours ice to treat swelling still. Physio is more on fence & says whatever I feel works best.
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www.ebay.co.uk/itm/1Mhz-ULTRASOUND-ULTRASONIC-MASSAGER-PAIN-THERAPY-ANTIAGING-WRINKLE-LOSS-MACHINE-/271371316026?hash=item3f2efdab3a:g:ANUAAOxyB9RS04gy
There are many contra-indications to the use of ultrasound, so you should read up on its use before you use it. There are also specific places on the body you should never use ultrasound. The gonads being one, the neck another, eyes other ones.
" ...It should not be used in areas where bones are growing. If a patient uses a pacemaker, it is not recommended to use this kind of treatment in the thoracic part of the body, as the pacemaker may be affected in those cases. Ultrasound devices should not be used where a fracture is healing, it should not be applied close to a patient’s eyes, and it should not be used over the uterus region of a pregnant woman. Therapists should be careful not to use ultrasound in patients who suffer from vascular disease and who have ischemic tissue. In this case, cells could die because of the blood supply’s inability to keep pace with the increased metabolic demand from tissues affected by the treatment."
".. Ultrasound should not be used to treat local pain without the patient first receiving a thorough diagnosis, and the cause of the pain has been confidently determined. It should not be used when there are cancerous lesions on or near area to be treated. If a patient shows symptoms of carrying serious infectious diseases or in cases where the patient should be avoiding excess heat or fevers, it is not advised to use therapeutic ultrasound."
Given these contra-indications, use of ultra sound on knees, hamstrings, and buttocks, without a thorough diagnosis of a condition which is muscle wear and tear, seems a relatively safe practice. However, a physioterrorist would disagree, just as qualified electricians would advise against fitting your own DIY solar system on a stand alone basis. In other words it can be dangerous if you do not read up on what you are about to do.
Using ultra sound when you have no diagnosis of cancer, is just something you have to risk. Just as you would if you signed a disclaimer with a physio.
ps. avoid lymph nodes as well...
pps. try having bone broths daily
www.nourishedkitchen.com/the-benefits-of-bone-broth/
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After skiing I fill the tub with cold tap water and sit in it up to my waist. My semi pro sportswoman daughter in law says benefit is all in the first 12 minutes. The irony is that by that time it's no longer painful. It certainly increases surface blood flow judging by the bright red color of the skin. If you want to try it, get in quickly. I found it progressively less shocking each day. I'm not experiencing any stiffness the following morning. I've tried it with and without a long hot shower immediately afterwards but can't decide if there is any difference. I'd say hot shower is the way to go.
Anecdotally, I had several ultrasound treatments from an NHS physio on a deep down hip injury and it just made the pain 10 times worse so I discontinued.
Always take a physio's advice. If the exercise makes it worse, discontinue. If it makes it better, keep going.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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After injury latest protocol?
If no surgical reconstruction and swelling is not compromising circulation, organs etc
No ice
No Non steroidal anti-inflammatories
No heat
Elevation
Rest
Return to mobility until pain point asap
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Regarding the temperature of the ice bath: If you fill a bath with English summer tap water and throw in a few ice cubes, it could still be 13C. Here in Meribel, at the end of winter, the tap water feels like 5 degrees, which is ideal for my 12 minute immersion. At work we use an ice-water slurry, which is a bucket of crushed ice with water added. The temperature is exactly 0C. I can't keep my hand in it for more than a second and I guarantee that the ice baths of the elite athletes are not this cold. To set the world record Lewis Pugh swam in water at -1.7C after decades of training aided by an abnormal physiological ability to generate heat.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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Summer time in Scotland I would sometimes if the weather was warm enough sit in the river for half an hour after a run. The temperature would be below 15C usually in the river, and if you sit in some rapids you get a little massage as well as cold therapy.
I have never tried it in winter, as the river gets too high, and it would be very cold. (however probably warm enough to make a river source heat pump very warm and efficient)
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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RICE
Rest
Ice
Compression
Elevation
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| ronniescott wrote: |
| After skiing I fill the tub with cold tap water and sit in it up to my waist. |
Sounds like a great addition to a holiday, I must try it.
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You know it makes sense.
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Definitely! I only exercise twice a year when I ski and I would otherwise have stiff legs the next morning.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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| Gored wrote: |
RICE
Rest
Ice
Compression
Elevation |
The above was first coined by Dr. Gabe Mirkin. But for almost 10 years now he's been saying icing is wrong as it delays recovery. Also I think it's fairly widely accepted that you want to be moving/exercising again as soon as the pain allows, rather than total "rest"
The updated version is PEACE AND LOVE
Protection
Elevation
Avoid anti inflammatories
Compression
Education
Load
Optimism
Vascularisation
Exercise
The concept is pretty simple. Icing reduces inflammation. Inflammation is a trigger to the recovery process. So therefore perhaps not a good thing and why the new guidelines suggest avoiding all anti-inflammatories.
Of course there are exceptions where stopping inflammation is most important for good recovery. For example I know someone who dislocated his shoulder in a car crash and there was so much inflammation they couldn't put it back in for a few days.
Anecdotal experiences are completely pointless to the discussion of recovery. 99.9% of soft tissue injuries heal just fine on their own with no intervention. You will never know if whatever you apparently swear by actual helps at all, for all you know you would have healed just as fast (if not quicker maybe) by doing absolutely nothing.
The obvious things - sleep, reducing stress, good diet probably do more than anything else.
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Poster: A snowHead
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I just re-read the posts by the OP. Like someone said above, find what works for you, if you can. Following a skiing Achilles rupture I developed tendonosis during rehab, which took 3 years to resolve in the end. During that time I got conflicting advice: operate, don't operate, massage: what! you're rubbing it, leave it alone at once; ice it, heat it, eccentric lifting, concentric lifting. In the end, the one that worked for me was isocentric excercise.
I have a suspicion that it might have been time that fixed it in the end. One thing I know for sure is that the blood supply to a tendon is pathetic and a ligament is even worse. I would advise frequent exercise below the pain threshold.
Personally, I use 400 mg ibuprophen at bed time. The rational is that it's analgesic effect won't cause me to over use the injury because I'll be asleep. But that is just my own folk remedy.
My orthopedci surgeon told me that I would be back skiing and running quicker if I had my foot amputated. I was shocked at first because I thought he was offering to do that. Later I understood that he was saying that the tendonosis rehab was likely to take longer than an amputation rehab. A ligament rehab might therefore have a similarly long time scale and you should guard against letting your frustration fool you into trying to exercise the injury away. If that was possible, I would not have these countless niggles.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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@ronniescott,
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My orthopedci surgeon told me that I would be back skiing and running quicker if I had my foot amputated. I was shocked at first because I thought he was offering to do that. Later I understood that he was saying that the tendonosis rehab was likely to take longer than an amputation rehab.
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Blimey. That's the sort of misunderstanding that could put one right off orthopaedic surgeons!
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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You need to Login to know who's really who.
You need to Login to know who's really who.
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Ice = new injuries
Heat = old injuries
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FAQ
and after much trial and error (and aches and definitely-irritated muscles, ITBs & tendony-type bits, and a very sore fib head) I must conclude that I am still none the wiser!
