Being injured really isn’t any fun. I am often asked on social media “I’ve injured my *insert your injury*. What should I do to recover?” The problem is that by the time you ask a random question on Twitter, you’ve likely already done several things that will prolong your recovery.
Four of the most common things that people do wrong can easily be remembered by the phrase: Do no HARM. (Heat/Alcohol/Running/Massage)
We all know the old mantra of things you should do: Rest, Ice, Compression, Elevation (RICE). The aim of the RICE regime is to protect the first (primary) injury and limit the secondary injury by protecting tissue from further trauma and reducing bleeding and swelling. Excessive bleeding/swelling can cause lots of pressure in the muscle or joint. This increased pressure can cut off the blood circulation and oxygen supply to adjacent cells and you can end up with more damage than what the original injury actually caused (= secondary injury).
The four components of HARM should all be avoided during the first few days of injury, because they will very likely increase the extent of your injury and prolong your recovery.
Do not apply heat to a fresh injury that you've sustained less than 7 days ago.
When you sustain an injury, you also tear several blood vessels in that area. If you’re lucky, you only tear a few small ones. If the area swells up quickly, it is likely that you’ve torn a rather large one. Your aim should be to try and stop the bleeding as quickly as possible. Heat leads to an increase in blood circulation in that area and will obviously have the opposite effect – causing your injury to worsen as explained above.
Ice should be your weapon of choice for an acute injury and you can read more about how to safely apply ice here. Damaged blood vessels can continue to be weak and leak for a few days after injury, so it is best to avoid heat for at least a week (this may vary according to the extent of your injury).
It is also thought that heat can increase the inflammatory response. While inflammation is a very important part of the healing response, excessive inflammation can actually lead to more tissue damage.
Alcohol has a blood thinning effect which means that it decreases your blood’s ability to form clots. The longer it takes for your blood to clot, the more you will bleed into the injured area and the worse your injury will get.
My advice would be to definitely stay away from alcohol for 24 hours after injuring yourself. Consider abstaining for 72 hours if your injury swelled up quickly (which may indicate damage to a slightly larger blood vessel).
Running is bad for acute injuries (injuries that are less than 5 days old) for 2 reasons:
The first is rather obvious. If you have injured any structure in your lower body, that structure is now weaker and you may tear more muscle fibres if you continue to use it. You may not realise this when you are healthy, but running is actually a full body activity. It uses a lot of shoulder and spine movement and you may even make injuries in those areas worse if you continue.
One may be tempted to think “I’ve injured my arm, I should be OK to carry on running.” But, this may be a bad idea for a similar reason as the 2 cases above. Running will increase the blood circulation in the whole body. This will lead to increased bleeding and swelling at the site of injury and ultimately increase the extent of your injury regardless of where it is.
When you sustain an injury, that area is weak and the new cells that form can easily be torn or damaged. You can read a more detailed description of how healing takes place here.
For this reason massage within the first 5 days of sustaining an injury is a taboo.
After this period, it should be applied with great care and with very graded pressure. Very light strokes should be used during the first few weeks and DO NOT ALLOW ANYONE TO DIG INTO A MUSCLE within the first 3 to 4 weeks of tearing it. All pressure should be comfortably uncomfortable.