Any type of physical training can result in an injured joint or limb. Sometimes, pain and swelling occur immediately — for example, after you throw a roundhouse kick and feel your pivoting knee pop. On other occasions, the symptoms become apparent over time. An example is tennis elbow that results from too many hook punches and jabs. Whenever any kind of dojo injury happens, remembering RICE can be helpful.
It takes only a split second for an injury to happen. Doing the right thing afterward will minimize your downtime.
“R” stands for rest.
Stop whatever you’re doing. In a tournament setting, ask the event medic, if one is available, to perform an initial assessment. In a dojo, signal for help. At home, you’re on your own — which is a good reason to have a cellphone handy.
Trying to shake it off so you can resume activity can make the injury worse. Note that my advice to avoid resuming activity also applies to walking after sustaining a leg injury: If it hurts when you put weight on it, don’t.
“I” stands for icing.
An acute or chronic injury will often cause swelling. For example, if you dislocate your kneecap, your entire knee will become swollen — rather quickly. Inflammation is the body’s way of reacting to injury. The increased blood flow to the affected area facilitates repair and healing.
Inflammation can be associated with elevated temperature, so icing the area can help. Remember not to put ice directly on your skin; use a towel in between or opt for a commercial device that provides continuous cooling via a sleeve that’s wrapped around the affected area.
“C” stands for compression.
This is important if you’re suffering from superficial bleeding. By applying direct pressure over the cut, you can slow or stop blood loss.
Compression also can be used for a swollen joint, but know that the application of excessive pressure can be uncomfortable. Even worse, such compression can interfere with circulation. To avoid that, use enough compression to get the job done without causing discomfort.
“E” stands for elevation.
Whether it’s your arm or leg, keep it elevated to reduce swelling and pain.
Ever wonder why a person with a broken wrist has to wear a cast and keep the limb in a sling? The cast aligns the bone for proper knitting, and the sling keeps it high enough to prevent swelling and minimize discomfort. Ideally, the affected area would be positioned above your heart, but that’s often impractical during everyday activities — which is why slings are used.
A knowledge of dojo first aid can come in handy for yourself or your training partner.
What about heat?
Generally speaking, heat is not used — at least, not right away — on an acute injury. Ice is more appropriate when a swollen joint is involved because it reduces inflammation, swelling and pain. However, heat does have a role in treatment — later, when you’re recovering from the acute phase.
Heat modalities are often used by physiotherapists as part of overall treatment. Its application causes blood vessels to dilate, thus improving circulation in the area. When a muscle or muscle-tendon unit is warmed, it also allows greater stretching, which can help improve range of motion in an injured and stiff joint. The heat has to be applied carefully, however, with the optimal temperature depending on the individual.
An example of when heat can be used after an acute injury involves martial artists who have hurt a hand or wrist. They’re likely to have to wear a cast for many weeks, and when it’s removed, the joint will probably be quite stiff. One kind of therapy entails soaking the wrist in warm water. That helps the soft tissues relax and stretch.
Word of caution
If you try using heat at home to treat arthritis in a joint, don’t perform any aggressive stretching or manipulation because it can worsen the disease. Simply applying heat, however, can make you feel better.
About the author: Robert Wang, M.D., is a Fellow of the Royal College of Physicians and Surgeons of Canada. He’s an orthopedic surgeon specializing in sports medicine.
Photos courtesy of Century Martial Arts