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Here's How To Resolve Acute Swelling And Inflammation

 

We have all experienced swelling at some point, whether from ankle sprains, ACL reconstruction, shoulder surgery, tennis elbow, or just swollen ankles from sitting around too much. Sometimes it just goes away, other times it seems to linger. Should you ice? Rest and elevate? Should you do exercises for swelling or inflammation? Should you just ignore it? Is it really that bad?

What is swelling and inflammation?

Research is very clear that swelling causes more problems than just looking puffy. Yes - inflammation is good!!  It is a very important piece of healing. Inflammation is an increase in blood flow to a specific area, thereby providing nutrients to help heal the injured area. However, while this process is necessary, it has a tendency to hang on a  bit longer than it should when we sit at the TV/computer for too long, when we ice, or when we continue to irritate the area. (Yes - ice impedes your inflammation response, but that's a debate for another day). Because while increasing the amount of healing nutrients is good for the healing process, it needs a way to exit. When the exit is blocked or when the process is prolonged, inflammation becomes troublesome. 

So, while we can appreciate the positive effects of inflammation, we want to facilitate the entire process so it doesn't slow or stop. We can help this process with general movements and exercises for swelling.

A WORD OF CAUTION:

Inflammation is a sign that the body is dealing with something - YOU NEED TO FIX THAT SOMETHING!! If you don't, the inflammation will just come back, or worse you'll have severe side effects. So don't just jump to exercises for swelling and inflammation before you know what is causing it. ALSO - excessive swelling can be a sign of cardiovascular disease. This is not the place to start for that; go see your Medical Doctor.

Personal experience with chronic swelling and NOT fixing the underlying problem:

I broke my ankle January 2010, but it was misdiagnosed as an ankle sprain. So I trained for and completed the San Francisco Marathon 7 months later. The entire 7 months, I had inflammation to the point of pitting edema. I could push my finger into my ankle and a finger print would stay for well over 30 seconds. Yes, this is bad and a warning sign of many, many terrible things. Because I saw this, I knew something else was wrong. Two MD appointments later, I was scheduled for surgery. Apparently I had chunks of bone floating in my ankle, several ligament tears, and muscle strains. 

If I had just continued to work on the inflammation, I would have never found the underlying problem and would still be dealing with it (or worse). 

MAKE SURE YOU DEAL WITH THE UNDERLYING PROBLEM.

How does swelling resolve?

Very basically and under normal circumstances, the return pathway takes fluid and waste products from the interstitial space (outside the blood vessels) into the veins and lymph vessels. This puts the fluid back into the circulatory system to be recirculated or disposed.

However, problems occur when this system is disrupted. Abnormal swelling occurs when the return of fluid is limited. The stagnant fluid is now stuck and swelling increases. Basically, we have more traffic going in (more nutrients go to the healing site) and very limited traffic going out - a traffic jam but with fluid instead of vehicles.

The pathway to the circulation system is more or less passive - these vessels don't have much blood pressure or muscles to push the fluid along. To move the fluid through the lymph and blood vessels, the system relies on compression and relaxation of the surrounding muscles. Like a pump, muscles squeeze the vessels to push the fluid forward; one-way valves prevent backflow. This is a normal process that is repeated constantly.

When the surrounding muscles are not involved in the process, the fluid becomes stagnant and congested. When are the muscles not involved? When we rest too much, sit at the computer for too long, or ice the swollen region.

So, long story short - remember the RICE (Rest, Ice, Compress, Elevate) treatment that was supposed to be the best thing for injury? Doesn't actually work as we initially though it did. And it probably even slows the healing process.

How can we resolve swelling quicker?

The key to resolving swelling, then, is to get the muscles working. Not at 100% maximal workload, but enough to get the fluid moving along in the correct direction. We want to activate the surrounding muscles while allowing that region to heal properly. Although being local is more effective, the muscles targeted don't necessarily have to be pinpoint specific to the area of swelling. If that region is too painful or injured, work the muscles above and below that level. For example, if you just had an ACL reconstruction and your cannot move (in a brace, too painful, or specific orders from the MD), start by working the toes, foot and ankle. Then skip the painful area, and work the hips or even low back. This sequence will get the fluid moving much better than the Rest, Ice, Compress, and Elevate (RICE) protocol. In short, you need to be doing exercises for swelling and inflammation.

Sample exercises for swelling and inflammation

Any movement is good for inflammation. BUT, always follow your healthcare practitioner's advice. Your injury may have specific restrictions to follow. Obey those restrictions. The following exercises are general guidelines and suggestions that might be good for you; they also may not be good for you. I don't know your story so I cannot be specific to you. Want to tell me your story and get specific work? Schedule a Physiotherapy Evaluation to work with us. These are just a few of the movements I encourage my patients to use when appropriate. 

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