We all have had some fall or other type of strain that we know doesn’t qualify for a trip to the emergency room, but puts us in a lot of pain and limits our actions. By example, about 10 years ago I had a fall on a icy ski slope and strained my groin. It was the last run of the day, so I had to drive home with a swollen thigh. I could barely put any weight on the leg as I got out of the car. Just about any movement hurt. I didn’t want to just go to bed with it in this condition. In the past I woke up stiff as a board. So I did some very slow mini moves that gradually got the muscles to relax. As I gained more confidence I was more aggressive about moving quickly but always staying away from any discomfort.
Satisfied that nothing was severely damaged I went to sleep. I gave myself the experience that it was improving quickly. The next day the leg was totally fine. I was able to run several miles on it the next day. The accident was a non event. I was impressed at how well this worked even as a 50 plus adult. I use it regularly in my clinical practice. It is very dramatic in producing results and speeding up the healing process.
Since then I have applied this strategy many times. I tore a quad muscle in a fall, had a whiplash, many minor back strains, and the after effects of 2 marathons I completed in my 60s. Quick recovery isn’t just for kids. In particular I am pleased that my patients are able to solve many similar traumatic events. In a nut shell what are the elements that make this approach work? *
- Use the old standard RICE. This acronym stands for Rest, Ice, Compression and Elevation This is basic first aid. Rest does not mean being totally immobilized. It just means take it easy on yourself. Ice can be a cold pack or ice cube massage to a very tender spot. Compression is usually an elastic bandage, elevation is have the injured area higher than your heart.
- After you decide that the injury doesn’t require medical treatment find any safe movement initiated anywhere in your body that goes through the injured area . If you can’t send a movement through the injured area in any direction, move the body part adjacent to it. For example, if you have a low back strain, try moving your head and neck, gradually getting your ribs to move a little. Gradually you may be able to relax enough to move your back.
- Whatever you do, the goal is to feel safe. Very safe. Err on the side of ” less is more”. A safe 1 inch move trumps a 10 inch uncomfortable one.
- Take your time. Give your brain the time to make the conclusion that it is okay to relax the area.
- Take frequent rests. Respect yourself. Imagine you are the mother of a crying child. Muscles are very much like children. They like love, attention. acknowledgement, and kindness, They want to be taken seriously, to be listened to.
- The further away from the site of injury you start the movement the safer it is. If it is an ankle sprain you may start with moving the hand on the opposite side. At some point in moving that hand the arm, shoulder, spine, pelvis and finally the injured leg may start to move without pain. Your brain perceives this as a much safer path than starting by moving the injured ankle.
- Movement in any given direction tends to help movement in other directions. Side bending may help rotation. Sitting side bending can help standing side bending. Find the most comfortable position. Be creative.
- If no physical movement feels safe use your imagination to do it mentally. Breathe into the area. Expand it mentally with you in breath. Imagine it deflating on the out breath. Somehow get in touch with that site.
- Ideally do this protocol as soon as possible, but definitely before going to sleep. It is a lot like getting back on the bike you just fell off. The last thought before you drift off is that you body is already getting better. Convince yourself if you can that you have not done any serious damage.
- 10. In summary, after an injury do what ever it takes to have the experience that the injury is already getting better. Do this as soon as possible. Definitely before bed time. Use small safe mini movements to assure that that the area doesn’t lock up, complicating the recovery. Remember we are designed by nature to heal, let it happen. Being afraid to move can dramatically slow the recovery.
*For those needing more evidence of this approach you can check the clinical guidelines of the National Committee on Quality Assurance ( NCQA ) for low back pain. This is an organization that applies evidence based medicine from analysis of the existing clinical research to establish the most effective medical protocols. It certifies a wide range of health care organizations. Its leadership consists of medical doctors, PhDs, and leaders of the health insurance industry. It is their recommendation to have doctors and chiropractors advice against bed rest and for early return to normal daily activities. My above guidelines refine the way you return to regular activities.