The therapy most often taught to deal with acute injury uses the acronym RICE: Rest, Ice, Compression, and Elevation. While it is important to give an injured body part rest, it is equally important to not rest it too much. The R in RICE should stand for Range of Motion, according to many sports therapists. In fact, the developer and main teacher of Soft Tissue Release, Stuart Taws, uses the acronym MICE (Movement, Ice, Compression, and Elevation) for his method of therapy.
Almost any person that hears the word “surgery” automatically assumes that bed rest will be next. This is due to the fact that almost all hospitals enforced bed rest after surgery for many years. Because of resting too long, patients had big adhesions that took a long time to heal.
Patients now recover more quickly, since they are encouraged to utilize mobility opportunities following a surgery procedure. In fact, a patient who has had knee surgery will be put into a device that flexes and extends the knee on a continuous basis to keep adhesions from forming.
Adhesions, resulting in an inhibition of normal range of motion, can occur if an area is given too much rest after an injury. The client may accept the reduced range of motion as normal. It is common to not notice any difference at all. This is one of the reasons that people regularly re-injure an area that was formerly injured.
To know how and how much to move an injured area, you need to know how the body responds to injuries and about the inflammatory process's different stages.
The beginning stage of inflammation is the reactive or acute stage. Redness and swelling will occur because of vascular changes during this stage and are likely to extend over a three to four day time-period.
In this stage, range of movement is decreased due to swelling, as well as muscle spasms and intentionally or unintentionally guarding the area to prevent further injury and pain. To help reduce the swelling during this stage lymphatic massage is suggested. After the muscle spasm has been reduced, gentle movement may be conducted.
Regeneration is phase two in inflammation. This step can last for several weeks. While this phase is ongoing, collagen formed by fibroblasts helps to reconnect tissues that have been torn apart. Collagen fibers are formed in a random fashion, and may block movement when they intersect muscle fibers or other tissues. At this time, motion is essential to ensure that the collagen fibers align with the muscle and fascia so that movement is facilitated.
Remodeling and scar maturation is the last stage of inflammation. During this phase, the patient needs to move the area on a regular basis so that scar tissue doesn't restrict future movement or lead to unpleasant scars. After scar tissue forms, deep massage work must be utilized to break it up.
Taking the following things into account, movement should be done.
Gain a full understanding of the history of any former injuries and the symptoms that are being experienced at this time. You should use active movement, resisted muscle tests, and passive range of motion assessments to determine the health of the area. If you suspect that a muscle tear has occurred, avoid resisted muscle testing.
Once you have gathered the client history, start with passive movement. Gently examine and work limitations in the range of motion. The patient should not endure any pain during this process.
Do not move a joint beyond its normal range for motion. Look at the opposite, unaffected side to determine the patient's normal range of motion.
The muscle may be pressed into while being stretched. This process is referred to as passive stretching. This process ensures that collagen fibers that cross the grain of the muscle are broken while those that run parallel to the muscle fibers are not. If pain free, the person can return to active movement.
You can press into the muscle while the recovering client is actively stretching it. The muscle being stretched, because of reciprocal inhibition, will become more relaxed, as the client will be using the antagonist muscle. This process is more effective than passive stretching.
At this point, you should start slowly with passive movement, and then graduate towards active and resisted movements, remembering to stay within the comfort range of the client. Motion is quite effective in accelerating your clients' healing process.
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