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August 07, 2019

Swelling. What do you do for it ? Everyday on social media I get an article sent to me, with this question.

Do I apply ice? Do I apply heat? Do I compress? Do I move it? The list of questions could go on, but lets make our best attempt to answer them!

Do I apply hydrotherapy?

For the longest time applications of ice have been used on acute injuries and heat on chronic injuries.

Ice or heat may be used to control pain or the perception of pain. If applications reduce your pain and make you more comfortable then I see value in it's use.

Secondly in cases where there is bleeding and the presence of swelling ice could be chosen over heat.

There is a difference between synovial fluid (essentially water) and blood, which causes bruising. While synovial fluid clears itself well, blood does not. In a acute scenario where bleeding is present, ice may be chosen to decrease the threat of further bleeding.

So my answer. IT DEPENDS!

Do I move it ?

Yes. Bracing and inactivity is a thing of the past. The best example of this is the world of orthopedic surgery.

Times by which limbs are being restricted in movement have drastically reduced. Early intervention, education and movement leads to better outcomes across the board.

So yes, move. Move pain free and move often. Place yourself in an environment that promotes comfort, whether it's a pool, non-weight bearing or weight bearing with assistance.

If you are nervous or the injury seems significant, seek professional guidance.

Do I compress it?

This is tricky. Compression works and it works well, but what about decompression?!

There are two systems in the body that drain fluid.

Veins are a closed system that return fluid back to the heart. If we compress or elevate this system we will help with fluid clearance. Down sides to compression include discomfort and reduced function.

Compression also eliminates our most effective fluid clearing system in the body, the lymphatic system. For this reason elevation in the place of (or alternated with) compression may allow for the best of both worlds.

The lymphatic system is the tortoise of fluid clearance in the body. It's slow and takes it's time, but does an amazing job at clearing fluid. The lymphatic system works in harmony with movement to drain fluid through a process called imbibition.

Imbibition is body movement causing pressure change that assists fluid clearance. For example, the majority of the joints in our body are nourished through pressure changes as we walk.

My option to stimulate this system is through using tape. Tape helps facilitate the lymphatic system, which responds to light touch, while maintaining functionality and preventing venous system collapse.

So try MED - Movement Elevation and Decompression and let me know what you think.

How are you managing acute swelling? We'd love to hear from you!!


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