Don't Ice An Injury!

In an effort to be more contentiousness with my blogging, I have decided to make it a goal to post at least once a week. My friend Heather Bergeron at http://www.hbunfiltered.com (check out this blog,it is funny and informative on all things crossfit and any other thing she can think of) posts once a day, NO.Matter.What. So, being realistic, I think that once a week should be manageable. We'll see.

 

 I have gotten a bunch of messages from other Crossfitters, who have bad knees, who have asked about working out with a knee replacement, what made me get the knee replacement, how my knee feels now, etc....

Truthfully, I got the first knee replacement because I couldn't do most crossfit workouts without modifying or without pain and, just walking across the street had become a bit of a chore. I probably could have gone on with my life, limping and just riding the exercise bike, and warded off a replacement for quite a few years. At that time in my life though, that wasn't an option. I was willing to take any measure to try to get back into the "game". (Being able to walk without pain was a bonus)

These days, my left knee is starting to hurt and I have started to wrap my head around getting my second knee replaced. It won't happen though until it is an absolute necessity. Walking will have to be a chore, crossfit impossible and working difficult. Then, I will have the surgery.  Since I know what to expect now, it will be a well thought out decision. I am very happy with the results from the first surgery but, it is a long and tedious recovery. One I am not in a hurry to repeat if I don't have to. 

One of the things I did during my recovery was ice, ice, ice, and more ice. Recently I have been hearing and reading that ice might not be the way to go during a long term recovery. A number of different articles suggest that:

1. "Topical ice applications can cause muscle damage, fatigue, and delayed recovery in elite athletes"

2. " Ice applications can negatively affect athletic performance"

3. " Ice Also Reduces Strength, Speed, Endurance and Coordination"

4. " Ice hinders healing by decreasing blood flow"

5. “Immobilization and rest delay soft tissue healing (I have firsthand experience with this theory. I went to crossfit within 3 weeks of my surgery and back to work within 6 weeks. I definitely felt better moving.)

Read this entire article HERE.  

It is very technical but if you read through it it does make sense. 

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Another article I found was on the website "Mark's Daily Apple" . This article is much more user friendly and suggests that, while ice immediately after an injury may reduce pain, it does not appear to help in the healing process and may in fact hinder it. 

 

 “Ultimately, I don’t think icing is as unequivocally detrimental to the healing process. It can certainly reduce pain and, if that’s the only way for you to get the tissues moving, that’s a good thing (as long as you don’t move too much too fast and end up re-injuring the weakened tissue). And it can likely prevent secondary tissue damage, particularly if you apply it shortly after an acute injury. But the extended, constant, day-in day-out cryotherapy that some of us feel is absolutely necessary anytime a tissue feels less than perfect? No. It seems clear to me that compression and mobilization of the injured area are likely more important and effective than ice"

Mark also mentions that KStar ,Kelly Starrett of Mobility Wod fame ,does not like the use of ice. See his video HERE 

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Finally, to totally confuse the issue I found one additional theory, METH. Movement,Elevation,Traction, and Heat. He hypothesizes that: 

"Furthermore, compression can shut down blood flow to the area, whereas traction will release the pressure. Movement will encourage blood that's rich with healing factors such as oxygen and white and red blood cells to flow to the area"

 

To read this article please click HERE

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So, are you totally confused?  Bottom line, the use of ice should be kept to a minimum. Keep moving and maybe employ moist heat. I think that I'll follow this advice after my next surgery.

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ROM. What does it mean?

Range of Motion. It is a constant refrain from the Surgeon and the Physical Therapists. When you get a new knee you have to be able to bend it similarly to someone who has a healthy knee. This is a bit of a problem after the surgery. The knee is manipulated roughly, the bones are sawed and drilled into, the skin is forced and stretched back, and all the soft tissue around the knee is bruised and bumped. (see a video here). As a result there is a lot of swelling and aggravation, a lot!
To achieve a suitable ROM you have to continually do exercises that stretch the new knee and it's ability to bend. This hurts, again, a lot!

But, the point of this post is not to say how hard this process is but how much easier it is ,I believe, due to Crossfit.  I left the hospital able to achieve 90 degrees and now I can bend it up to 128 degrees. I have been able to go back to work at 5 weeks when it is usually recommended that a patient wait at least 8-12 weeks before they return to work. From a Knee Replacement Forum: "But I need to warn you that a mere 6 weeks may not be long enough. This is tough surgery and if someone has told you that you'll be back at work and recovered that soon, they have done you a great dis-service. We usually tell folks to plan on 12 weeks before going back to their job. And, even at that, you need to plan for a phased in return to work....part days and/or every other day for several weeks." I totally and completely believe that my speedier recovery is due to the shape I was in prior to surgery thanks to 2 years of Crossfit.  I think I was stronger both physically and mentally. Crossfit does that to you. Anybody who has done Murph, Fran, etc.. can attest to that.

While I have to admit I am still in the "what the hell have I done to myself" phase. I truly believe that being in "Crossfit" shape has increased my ability to be up and about working and lightly working out immeasurably.
So, stay in shape and recover quicker. But even better, take care of your joints so you never have to wonder how fast you would recover. I think I'd rather do Murph than do this again.

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