A reasonable proactive approach to your healthcare and its delivery helps create a healthier and more meaningful lifestyle

We are pleased to be able to offer you some insights into common and not-so-common running injuries. Please remember that our discussions are intended to be general in order to appeal to a wide ranging audience. We are not intending to be comprehensive or exhaustive of a single topic. If you disagree with a comment, would like further subject elaboration, or would like to request a specific topic, please E-mail: nsosc1@shawcable.com

Today’s goal is to provide some insight into the principles of initial self management and how to determining when more comprehensive, professional consultation is necessary.

First principles whether a soft tissue or bony injury, begins with the often poorly understood acronym RICE; this is the principle behind all of the progressions which most effectively facilitate recovery from injury. You are probably familiar with Rest, Ice, Compress, Elevate. However, do you understand its application?

PRINCIPLE #1 REST
Rest does not imply that you are to terminate all activity and take a break from training. In fact, our philosophy is to encourage non-provocative activity, though possibly modified. Our principle of “REST” is to place the injured tissue, whether muscle, tendon or ligament into a position of least tension/strain and then to facilitate maintenance of that position with external assistance. Experiences have suggested that injuries which have become chronic were inappropriately rested, either by resting completely, or by not resting at all. REST is not the stopping of activity and becoming inactive.

PRINCIPLE #2 ICE
The first thought(s) following onset of pain or irritating discomfort is to apply ice, and this is correct. In fact, if you are unsure whether ice or heat is most effective, remember to ALWAYS TRY ICE FIRST. You cannot go-wrong with ice. However, please do not “fall asleep” while resting on an ice pack. It may be applied frequently, in fact as often as hourly. But never for a period of time greater than 20 minutes. Following the first 72 hours from injury onset, progression from ice to a “contrast” (cold / hot) is appropriate.

PRINCIPLE #3 COMPRESS
Compression is the element of RICE that has been least used in our experience. It is important to remember that compression is a key factor in keeping swelling down to a minimum and expediting the healing process. Controlling swelling allows for greater degrees of freedom in the effected joint. Circumferential compression is most effective in conjunction with ice. Circumferential compression will have its most observable impact within the first 24 – 48 hours following acute injury. It is during this period in which the maximal volume of swelling will be progressing. Preventing the swelling from becoming maximal, allows the therapist to proceed more quickly because, simply, we do not then need to reverse the swelling which has accumulated. Obviously, the more peripheral the injury, the easier it is to apply circumferential compression may be applied, usually with tensor bandages

PRINCIPLE #4 ELEVATE
Elevation, the last but not least important principle of RICE, has an important role in the movement of the interstitial fluid out of the injured area. Elevation combined with circumferential compression within the first 0 – 48 hours is most efficient. If, after training, you visibly see swelling persisting in the injured area continue to elevate the affected extremity (combined with ice if necessary). Often the “E” for elevation may be modified to read, Elevation/Exercise. As many of you are aware, you will not escape our “grasp”, without being provided a regimen of exercises to facilitate the above-recommended protocol.

CONCLUSIONS:
It is not necessary to suffer with an acute or chronic injury. If you are not sure of the correct approach to use, please phone. Also, if an injury has not cleared or does not appear to be resolving with the above-mentioned principles, do not “leave it.” You may require more assistance than is possible to provide on the written page.

Gavin Robertson R.M.T
A graduate from the West Coast Collage of Massage Therapy, has been practicing massage therapy in North Vancouver for the last seven years. He continues to upgrade his skills in sports massage therapy. Gavin enjoys working with the dedicated athletes of the North Shore and beyond. Gavin continues to educate his clients and others that “self care is health care”.

John McCordic B.Sc. (P.T)
A leader in the Physical Therapy field for 19 years. John has earned his degrees in kinesiology and physical therapy from the Universities of Waterloo and Toronto, respectively. He continues today to pursue extensive private study in the fields of exercise physiology, biomechanics, and the applied analysis of muscular imbalances.

Tim Hunt B.S.R.
Born and raised in West Vancouver, Tim received his degree in physical therapy and occupational therapy from UBC, and owned a successful Vancouver, private practice. Tim believes in the philosophy of active exercise rehabilitation. He combines therapeutic exercise and his excellent manual skills in order to facilitate people to recover from their injuries he applies a ”whole body” approach to treatment.

North Shore Orthopaedic & Sports Clinic personnel are available for athletic event coverage, or to present informational talks to your group. Please E-mail us at: nsosc1@shawcable.com

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