Necessary Foundation on Injury Management

People are very bad at this. Even on the most basic level of knowing what an injury is, people are all sorts of backwards. Like this: tendonitis. Everyone thinks they have this. I promise you don't. Tendonitis doesn't exist. "Itis" means inflammation, so it would be inflammation of a tendon. And this is funny because there's no physiological mechanism that can ever cause a tendon to become inflamed. So the most common thing people think they have, they don't. This means that your friend's tennis elbow probably doesn't even deal with the tendon at all. It's probably more of an irritation of the epicondyle, the part of the bone that the tendon attaches to. And then these people who don't know anything try to correct me- "no it's the tendon, I can tell." Okay, if it's the tendon, it's tendonosis- damage to your tendon. It's not inflamed, it's all torn up and stuff. That's vastly worse.

And then when I try to tell them how to heal it, these same people who refuse to believe that tendonitis doesn't exist try to explain to me that ice doesn't help and heat does. These people are so staggeringly annoying, I can't stand it anymore. I honestly think they should be shot. Not killed or anything, just maybe with a pellet gun in the fingers or the bottom of the foot or something. Something severe enough to teach them a lesson without really hurting them. And the lesson is this: don't act like you know something when you clearly don't. I hate this. I don't have a problem with you being unintelligent because I'm positive you're good at other things. Maybe you're good at not having sleeping problems, or hopscotch or something. Not physiology though. Unless you're good at that, don't pretend like you are. I don't know much about the luge or credit card debt. And I don't have to pretend like I do to feel good about myself. Learn how to not be a moron in this way, and I'll teach you everything you need to know about injuries starting now:

First lesson: You can't really "speed up" healing. You only have the option to not slow it down. People don't seem to get this. The body has set designated processes it must go through in a sequential order and there's nothing you can do to change that. The leukocytes aren't coming until the signal is sent by the macrophages, and then there's the travel time through the blood, etc. You can't really speed this up. All that you have the power to do is either interrupt that process (contraindication), or not interrupt it (good). Putting heat on a fresh injury is contraindication. Putting ice on it is good. All medicines and potions and remedies (ice included), if they're doing anything at all, they're helping to not get in the way of the body's natural healing process. Anyone or anything that says it "speeds up healing" is lying or doing something resembling lying.

That said, realize that ice does a lot. Icy Hot does less. We'll start with Icy Hot. You're better off just shaking your injury, that does the same thing. It deals strictly with the priority of pain reception. Let's say you hurt your hand. When you shake it, you activate the proprioceptive fibers, which can transmit messages s much as 100 times faster than the pain fibers. So your body ends up receiving a larger stimulus from the shaking than the pain- hence you feel the shake instead of the pain. Now this is nice, but it's not healing anything. Same goes for Icy Hot. It's nice while healing nothing. Basically for a few dollars you no longer have to shake your body part for the comfort and relief.

With Icy Hot however, it diverts pain signals with new pain signals. It's just that these new ones are more superficial and therefore easier for your body to interpret. This superficial pain rule works on everything. Think about this: you're having a heart attack- this deals with deep pain receptors. Because the pain fibers are deeper, they can't really interpret anything, so the tiny spot on your heart you should feel ends up being felt all over your chest and stomach, and down your arm, and basically all over your body. Opposite that, if you get a splinter, you know its exact location.

You take this physiological response into the injury realm, and you get make believe healing powers. I guarantee the pain receptors associated with the injury are deeper than your skin surface, where the Icy Hot is creating irritation. And unless the deep pain is absolutely agonizing, your body's only going to pay attention to one at a time, and that's the most superficial. Therefore creamy icy lubes end up on the market, where the active ingredient is the same thing that makes peppers hot. But people think it works because once you lather it on, it diverts your body's attention to the more focal pain.

Icy Hot does has the possibility for one advantage though. If your muscle is in spasm, spasm causes ischemia, ischemia causes pain, which causes further muscle spasm, which causes further ischemia, more pain, spasm, and so on. If you can stop one of these little events in the trauma-pain cycle, you can break the loop, allowing your muscle to relax and begin healing if healing is necessary. If you're experiencing this cycle, Icy Hot has the possibility of halting the pain long enough to break this cycle at least on some level. Not something to really count on though, considering ice pretty much halts everything guaranteed. And with that, we're done talking about Icy Hot, and now talking about ice. Ice is good. It does plenty more than just this. We have to start talking about the process of healing though to understand the benefits of ice.

If you become injured, healing happens within three phases. The first of these is the acute inflammatory phase- which can last up to a week. That little trauma cycle coupled with an inflammatory cycle is your basic initial injury response. You have to stop these little cycles, and then once you do, you hit the proliferative phase. This is essentially the repairing of damaged tissues and can last anywhere from a few days up to a few weeks. Then the final phase starts when it doesn't hurt anymore and you're doing the final healing adaptations while throwing down a little scar tissue. It can actually last for up to a year, but probably won't take that long.

During the last two phases, it's not that interesting, you just realize that you're more susceptible to injury during them, and refrain from being a moron. If you're doing some sort of activity or movement that bothers the injury, you're doing the wrong activity or movement. Stop it. Same goes for testing the injury. Don't be the guy who's always flexing the injured muscle to see if it still hurts. If you do that, you're just interrupting the healing process and causing it to hurt for way, way longer.

The initial phase is what's fascinating because there's a couple cycles working. The one we haven't talked about yet, the inflammatory cycle, being the most important one. What's going on here deals with swelling being the cause of cellular death.

It happens like this: you injure something. The injury kills cells. These killed cells have their membranes destroyed. This releases chemotoxins called histamine, prostaglandins, and bradykinins. These chemotoxins cause pain and irritation, but they also act as a marker for white blood cells to come to the area to help heal it, dilating the vessels so that the white blood cells can get there faster. This increases swelling in the area. Increased swelling limits the amount of oxygen delivered to the non-destroyed cells via hemoglobin in the red blood cells. Cellular metabolism needs exist in these living cells. These needs are not met due to the constriction of incoming oxygen. This causes more cells to die. More cell death causes more chemotoxins to be released. More chemotoxins means more swelling. More swelling means more cells not meeting metabolic needs. This means more cellular death, which releases more chemotoxins, and so on. The cycle continues for quite a while and you won't begin healing until you stop this.

Icy Hot will not stop this. Ice will. Ice does a lot. First it will constrict the blood vessels to limit further incoming swelling. This will slow down the cycle. But it also lowers cellular metabolism, so the oxygen demands of the cells under restricted red blood cell delivery are lower, and therefore, still met. Then lastly, ice reduces the nerve conduction velocity, so your pain signals aren't transmitted as fast, limiting the ability for muscle spasm and interrupting the trauma-pain cycle. So everything you need to happen in order to heal, ice will do it for you. Without ice, your healing is interrupted. And applying heat will do the exact opposite of ice obviously- causing metabolic demand to be nowhere near met, while swelling comes in faster, killing more and more cells at a borderline exponential rate. Heat is bad. If someone tells you to put heat on it, you should consider spitting in their face. I've honestly heard doctors recommend using hot tubs. They should have lost their license for that. You should not even be showering for several days. Are we good?

Okay, so now you know how to make your body start healing itself regardless of what you do to it. It doesn't really matter what the injury is, you know what to do first. After this, the later stages of healing become more injury specific. The specific stuff isn't essential for you to know to be a decent human being however. The previous stuff is. But if you're interested in knowing what to do to finish the healing off yourself without needing anyone's help, go ahead and move right along down the line of injury articles.





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