Joint Injuries

JRS rules! This is good stuff. what do you think of using heat on things like bruises (like from contact in sparring)? I've read that heat on muscle bruises is VERY bad.

anymore on this JRS? :) thanks man


...The body goes through three stages of healing. Inflammation, Repair and Reconstruction. I'll give a brief overview of each and what to expect to do in each stage. The timelines I'll give are for muscle injuries and you can expect to approx. double or triple this timeline with tendon or ligament injuries since they have poor blood supply and don't heal as well or as quickly.

Inflammation: This stage of healing occurs within seconds of the occurance of the trauma. This stage sends out chemical messengers that tell the body to begin forming a blood clot in the area and also sends out a call to other cells that will be the ones that bring in the new tissue to help with the repair of the injury. The problem is that the body has no feedback to say when to stop this phase, so it usually goes overboard. This is also most of the reason for the pain that we feel in the injured area. Compression and elevation are just general ways to help with the control of inflammation. You can typically expect this stage to last 3-7 days. It's best to not have much motion in this stage since the new tissue is just being laid down and is not ready for any stress.

At this stage avoid resistive training and ice regularly. This takes from 3-7 days.

Repair: This stage is when the new tissues are being laid down and begin to knit together to form the new tissue in the area of injury. This stage typically lasts from the 8th day to about a month. Early in this stage you can begin gentle pain free stretching and isometric exercises to begin the strengthening process. But, if it hurts then STOP doing it, that just means you are damaging the newly forming tissues. As this stage progresses you can move from isometric exercises to bodyweight exercises and eventually to dynamic resisted exercises.

In this stage you can stretch a BIT more agressively as the pain subsides and you can begin with isometrics and progress to pain free resisted exercise. Continue to use ice after training or stretching whether it hurts or not.


This is great.. You're tha man


More to come later.


This is just along the lines of what I'm looking for, please do continue...thx.


...To immobilize (, brace, splint, tape, cast, etc.) or not to immobilize? If the doctor doesn't make this decision for you then you can use the information below to decide which may be best. Each side has it's advantages and disadvantages. By immobilizing a joint the restriction of motion allows for more complete tissue repair in the affected area. Also the addition of support from an outside source helps to minimize the chances of re-injury during the healing stages. However, when you immobilize you allow for lost strength in surrounding tissues due to atrophy as well as loss of some range of motion due to scar tissue formation. Some of the connecting tissues in our bodies have to be laid down in a specific direction in order to allow for their normal amount of elasticity and movement. However, the body does not do this automatically. When new tissue is made it is laid down in a random mat-like pattern. Then as you move the tissues they align properly and gain their proper movement. When these tissues do not get moved properly they retain their matwork pattern, adhere together in this formation and this is what we call scar tissue. Certain forms of massage, Active Release Technique, Manipulation under anesthesia, and forced stretching are some ways of dealing with scar tissue. So, if you choose to immobilize a joint know that you may have to deal with scar tissue later. When you do NOT have a joint immobilized you can SLOWLY and GENTLY stretch an injury within it's PAIN FREE range of motion to help aid blood circulation and prevent toe formation of scar tissue. However, if you stretch into the point of pain you will be tearing the newly forming tissue and be setting back your healing time.

When possible, move an injury as much as you can WITHOUT pain. Be sure to tape or brace during unstable conditions like walking in snow, on uneven terrain or when sparring.



Injuring a knee, ankle, wrist, etc. is inevitable in training. I'm familiar with R.I.C.E., but I was wondering about wrapping an injured joint. How long should you keep a wrap on, for stability and so on? Is it better not to wrap and let the joint remain mobile, maybe work itself out and stretch? Any thoughts?

This post is a good opportunity to give a general overview of the treatment of minor injuries. This might be a bit long, but I hope to provide some information that can be used by a lot of forum members. I'll break this post up into different sections so it's a bit easier to read. For those of you not interested in the specifics of why I'll put a quick one or two sentence synopsis of what to do at the end of each section. Hopefully this post will get archived. As an aside I do physical therapy for a living so I'm familiar with the general outline of what most in my field will do to treat these types of soft tissue injuries.

Keep in mind, none of this advice is meant to take the place of medical advice you've recieved from your hands on health care professional. They can see and feel things in hands on situations that can have them want to correctly totally contradict the general advice given here.

Your specific question is another of those questions that doesn't always have a concrete answer. So, you'll get varying opinions from various qualified people in the health care profession. I'll give you my take on how to treat, and the reasons why I do it the way I do.

When you injure soft tissue the bodies first response is inflammation. This is a good thing as it brings chemical and cellular messengers to the injured site to stop localized bleeding and to signal the body to send in the cells needed to make new tissues or mend injured tissues. However, the body usually goes overboard on it's inflammatory response and inflammation is also one of the causes of pain. throughout our whole body we have nerve cells that are sensitive to pressure. Lots of blood in an area causes pressure on these cells and they send a pain signal to the brain. The use of ice or a cold pack will quell this increased blood flow and it also slows the transmission of tha pain signal along the nerve. Those are the reasons people say to use ice for pain and inflammation. In the normal course of an injury the inflammation stage lasts from two to seven days. The controversy comes about when you begin to discuss the use of heat. Disclaimer: In this post, when I speak of heat I only mean in the context of using a hot-pack. My opinions are different for other forms of heat treatment such as diathermy and ultrasound. The thought from the pro-heat camp is that you increase circdulation and since blood is what carries the oxygen and nutrients to tissues to help them heal you can speed the healing process. Also, heat just feels good, it provides a soothing effect. The anti-heat camp (to which I belong) believes that once you have used cold to get past the inflammation stage that the use of a hot-pack will do little to increase the circulation enough to be of substantial benefit in speeding tissue healing. Also, a hot-pack will only send heat to a depth of 1-2 cm. below the surface of the skin, and most soft tissue injuries occur deeper than this. Also, if you're just recently out of the inflammation stage and are progressing into the next stage of healing then the increased circulation can send you back to the inflammation stage which will actually slow healing and can cause more pain. The times that I use heat is when I plan on working a range of motion on a fairly fresh injury or on a patient that has recently had surgery that requires range of motion therapy; such as a post-op shoulder patient. I'll use heat to loosen and soothe the area before treatment, BUT, I'll then use ice at the end of a session to calm the circulation and pain in the area at the end of the session.

My personal advice...Use ice continously for 20 minutes on and 20 minutes off for the first 3-7 days of an injury. Then for the next two weeks even if there is no pain ice the area after any activity that stresses it; whether it hurts or not. Heat...unless it becomes a chronic condition you'll never have need for it.


Thanks for the information!