Ice or heat compress for an injury? This is probably the most common questions I get asked in sports medicine. Not only is this a controversial topic between doctors and therapists around the world, but the opinions also seem to vary by country and modern research.
Most trainers, doctors and physiotherapists would agree that the common way to approach an acute injury is the famous P.R.I.C.E. therapy (Protection, Rest, Ice, Compress, Elevate). As for more chronic pains, the choice seems to be debatable. But what’s best?
The body’s natural healing response:
The body always responds to an injury with a predictable inflammatory response that includes pain, heat, swelling and redness, as the first step towards healing. The release of chemicals and the compression of nerves in the area of the injury cause pain. Swelling is the result of the increased movement of fluid and white blood cells into the area of inflammation letting your immune system know to bring extra attention to the injury. The pain and swelling can keep the athlete from using the injured part, serving to protect it from further injury. Redness and heat are caused by increased blood flow. Your body’s only desire at this point is to rest and recover.
A TCM perspective:
In Traditional Chinese Medicine (TCM), we view any sort of physical pain as a blockage, a stasis of Qi (energy) and blood to an area. This excess blockage of Qi and blood can be caused by an external trauma to a specific area such as a sport injury, a fall, or an accident. There’s also chronic pain due to poor circulation occurring from conditions caused by a deficiency of Qi & Blood or even Cold stagnation. This long term pain (over 6 months) can be felt in overuse of tendons, ligaments, joints and even bone such as in tendinitis or backaches.
So let’s go back to our initial question of the topical application of Heat or Cold for an injury.
Ice will definitely reduce the swelling, inflammation and pain for a certain amount of time but is this the right strategy? Cold physiologically causes dilation of the more profound arterial system, bringing fresh oxygenated blood to the injury and superficial vasoconstriction, which has an anti-inflammatory and analgesic effect. Although this might feel good after injuring yourself, this turns off your body’s natural healing response thus putting the healing on hold. Putting topical cold compress to the affected area for an extended amount of time delays the deep down healing that needs to happen for a full recovery. This also gives your body a false sense of health and you might go back into action too soon, resulting in chronic nagging injuries or all too often arthritis later in life.
The physiological effects of heat therapy on the other hand, augments your body's healing response. Increasing tissue temperature, just like your body’s natural response to an injury, stimulates vasodilation and increases blood flow which promotes healing by increasing the supply of nutrients and oxygen to the site of the injury. Although this seems counter intuitive to what we’ve been told to do, you should put heat immediately on the site of injury to increase blood flow and tissue repair. Although heat may increase symptoms such as light throbbing, swelling and redness at the beginning, rest assured this temporary discomfort will actually speed up the healing process and allow the area of injury to heal up much better and faster in the long run. Heat usually feels soothing right away on an injury, just how a hot shower makes your whole body feel good.
Turn up the heat with treatments:
Today in a Traditional Chinese Medicine (TCM) clinic, we use acupuncture & moxabustion along with infrared TDP lamps to help increase the flow of Qi and Blood and relieve pain. We use a combination of warm blood moving herbs, such as turmeric and ginger, taken as an internal herbal remedy tea to remove stagnation & relieve pain. There’s also topical ointments and medicated plaster like my favorite Zheng Gu Shui ointment also created with warm blood moving herbs. All these common warm treatment therapies used in TCM significantly helps accelerates the healing process from acute to chronic injuries.
In my experience, when my patients start putting heat on their injuries, their pain is reduced significantly and they recover much faster. If thousands of years of empirical evidence of Traditional Chinese Medicine is not enough to convince you then try it for yourself. It’s OK (but not ideal) to put cold for the first few hours to relieve the immediate swelling and pain if it feels good but then switch to heat to rev-up the healing.
My favorite heat therapy is the electric plug-in heat pad which produces dry-heat. You can easily find one at any drug store and control the heat output with the different settings. They usually go for $25-$40 and will last many years. They are also very practical for menstrual pains, sore back, stomachache or any other physical pain. Use it for about 20-30 minutes a 3-5 times a day on the affected area where the skin should turn warm and pink.
I’m definitely a try it to believe it type of person and I really wish I knew this earlier on in my snowboard career as it would've saved me a lot of unnecessary lingering pain and faster healing time.
Listen to your inner doctor, your body’s wisdom always knows what is best for you.
Dr. Dominique Vallée, TCM, R.Ac
Headache, dizziness, nausea, forgetfulness, insomnia, feeling emotionally unstable, confusion, complete exhaustion, difficulty talking or moving, anxiety, depression… These are just some symptoms that may accompany a concussion.
Hopefully you will never feel any of these symptoms, but realistically you probably know at least one person that has suffered from a concussion and that has lingering post-concussion symptoms.
I’m just recovering from a concussion stemming from what I thought was a mild car accident which unfortunately has turned into major post-concussion debilitating symptoms. Recovering from this unexpected concussion has made me think about all my friends that have suffered over the years from snowboard crashes or other accidents and were left wondering what to do. These are not just helpful tips that I’ve studied, researched and asked concussion experts, but also strategies that I’m actually practicing today which I believe have made a huge difference in speeding up my recovery.
Concussions are mild traumatic brain injuries that are fairly easy to get due to our anatomy. Our massive brain, which sits on top of our little neck, is often affected by a direct impact or jolt to the head or body. More and more research are now showing that neck injuries can be the source of many concussion symptoms.
Unfortunately, most people that suffer from a concussion don’t follow the proper steps, if any, to recover from what can feel like a dark downward spiral of unexplainable painful, emotional and debilitating symptoms. Many concussion sufferers often have symptoms lasting months or even years. For proper recovery, 70% of the healing has to be done by yourself with diet, lifestyle changes and exercises while the other 30% is with the help from your practitioners, supplements and herbal formulas.
Just like a snowflake, there are no two concussion alike. There is no precise timeline for recovery and only you know how you feel, and what makes you feel better or worse.
Whether you’re an athlete that got hit while playing or just suffered from a car accident, these helpful steps will help you heal and find the support you deserve following a concussion.
1- See your doctor: When it comes to your brain, don’t take any chances, especially if a direct hit to the head or loss of consciousness occurred. If a concussion occurs while you're doing a sport, don't keep playing! Seek medical attention so that you don't risk worsening your injury. The doctor may assess your cognitive functions and at least have a recorded baseline if symptoms persist or get worse. It can take 1-2 weeks before post-concussion symptoms appear. Concussions are often not revealed by standard structural metro-imaging such as MRI or CT scans.
2- Food is medicine: The fastest way to heal from any injury is to go on an anti-inflammatory diet. Super clean eating: Avoid high carb and high calorie meals, absolutely no processed foods, no sugar, no gluten, no dairy, no peanuts. Plan for 3 well balanced meals a day + healthy snacks if needed. Your diet should be filled with steamed vegetables, well sourced meat & fish, legumes, nuts, seeds, fruits, plenty of good oils, natural spices and sea salt. Reducing the inflammation in your brain and body is key for a fast recovery. Maple syrup and raw honey are a healthy anti-inflammatory superfood alternative for sweeteners. No caffeine as it stimulates the brain too much. Keep it simple. Try to keep eating this way until you are symptom free for ten days. No cheating.
3- NO ALCOHOL! I can’t stress this enough, not only does alcohol increase inflammation in your body but it affects the blood brain barrier often setting you back days if not weeks behind. The same goes for recreational drugs of any kind.
4- Less is definitely so much more: Your body is a self healing machine. Chemically, your brain doesn’t respond the same after a concussion where the nerve cells are damaged through stretching and twisting resulting in a chemical release and subsequent local brain/nerve depression. Your brain is constantly stimulated by your sense organs, responding to every stimulus around you at all times. Stop using your phone, computer, and social media as the screen over stimulates your brain and often leads to more severe symptoms. Avoid driving, especially long distances and social settings with lots of people and loud noise. A dark room with no stimulus and lots of sleep is often the best way to go, especially for the first few hours up to 2-3 days depending on your situation. It’s important to get back to normal regular daily activities a few days after, DO NOT OVER REST.Do not seek out any sort of treatment for the first week after your accident as this just add stimulus for the brain to metabolize which could drive further inflammatory cell damage. Taking a Traditional Chinese Medicine herbal formula to help relieve pain, move blood and relieve stagnation formulated for post-concussion syndrome might be very beneficial to reduce symptoms and side-effects.
5- Keep a symptom diary: As your memory might be foggy or completely absent from the time of the accident, try to remember what happened or have someone that was there write it down. When symptoms start appearing, write down what brought them on, what you were doing and what you did after. How long the headaches, nausea, dizziness, confusion last and what makes it better? Write down as much as you can everyday including emotions as you might be feeling over emotional. It’s normal to feel like you’re just a shell of yourself. Your brain is playing tricks on you and it will get better. This diary of timelines and symptoms not only can help you to look back and see your progress or setbacks but let your doctors and practitioners understand your situation better. If you can’t write, ask someone to do it for you or do a voice recording with your phone.Be honest in your notes!
6- Let’s talk about it: What’s difficult about brain injury is that they are very subjective, meaning that only you know how you feel. Post-concussion syndrome strongly affects your emotions, energy, thinking, memory, creativity and much more. You might feel like you’re not yourself, and you are trying to be normal yet the people around you don’t know or understand how you're feeling as there are no visible injuries indicating that anything is wrong with you. You might be more irritable, and/or short tempered for no reason. Talking to the people around you such as family, friends and colleagues is crucial. Try to explain to them how you feel, your progress, your setbacks, your needs. If you don’t talk about it, how can people know how you are truly doing? Reach out to support groups, you’re not alone.
7- Be gentle with yourself: Know your limits and honour them. It takes time for nerve cells to re-establish normal functions. Some symptoms might come and go fairly quickly such as nausea, dizziness, blurry visions, emotional instability. Others might linger or even come back weeks to months later. Be sensitive to what aggravates your symptoms and what releases them. Altered brain blood flow quickly follows a concussion, as do changes in brain energy consumption, avoid over exerting yourself as your brain is in an energy crisis. A change in lifestyle is needed, reducing work or school hours with scheduled rest time during the day and earlier nights to bed. Pace yourself by taking BRAIN BREAKS by closing your eyes, taking deep breaths to recharge, don’t allow yourself to get overwhelmed. Everyday do an activity that brings you great joy. The most important healing time occurs while sleeping between the hours of 10pm-2am. An earlier bed time is highly recommended, try mindful meditation before bed. Mediation is proven to accelerate healing and connects your left and right brain hemisphere along with countless calming and healing benefits.Recovery is most effective when symptoms exacerbation is avoided.
8- It takes a team to succeed: A week after your injury, it’s time to seek out regular treatments by your favourite practitioners to help accelerate your healing. Traditional Chinese Medicine helps to remove blood and energy stagnation caused by the injury, get fresh blood to your brain and loosen neck tension, release pain and create the ideal gentle combination for healing with acupuncture, cupping and guasha. There are many acupuncture points and meridians that target the brain and stimulates healing and helps reduce symptoms and neurologically balance your nervous system. Other very valuable treatments such as chiropractors, osteopath, cranio-sacral therapy, neurologist, psychologist just to name a few. Try to find practitioners that specialize in concussion rehabilitation and combine therapies. There are also many concussion clinics in most cities. There’s a 90% success rate for people who get treatments within the first month of the accident. The longer you wait, the longer it might take to make a full recovery.
9- Let’s get physical: Depending on the severity of your symptoms, it’s important to return to activity of daily living soon after your concussion. Start taking walks close to home 1-3 days after your injury, preferably in parks or forests so you can go back as soon as it becomes too tiring for you. Start by doing tasks or activities for 5-10 mins and then progress depending on symptoms. When your symptoms are less severe, it’s time start working out. High Intensity Intervals Training (HIIT) is best to build your stamina, balance and coordination and get the most amount of oxygen and blood flow to your muscles and brain. Cardio training can deplete oxygen too quickly from your brain and set you back. Exercise can help you get over symptoms such as headaches, nausea, and give you more energy. It’s important to know your limits but also to test them and push through your symptoms. Normally 20-30% of your daily calorie intake is used by your brain, but reduced brain blood flow leads to brain energy demands exceeding their supply, so pace yourself!
10- Nurtured by nature: Nature restores mental functioning in the same way that food and water restore bodies. After your concussion you might be naturally drawn to the natural peacefulness of nature. Finally, more and more modern research, with the leaders being Japan and Germany, are proving the incredible benefits of spending time deep in nature. Within minutes of natural therapy, patients showed lower blood pressure, lower pulse rates, and lower cortisol levels, all markers of reduced stress levels. People with brain injuries have been shown to recover 70% faster with almost no side-effects while simply walking alone in the forest as their only rehabilitation. Same studies are shown for stroke, cardiac and severe pulmonary disease patients. Actually, spending time in nature has a similar effect as meditating on your brain. Do your HIIT workouts in the park or forest, go for walks, do yoga, have a picnic, go camping, take a vacation in a cabin by a lake. Not only will your symptoms probably diminish or disappear but you’ll heal faster.
11- Be patient: There will be good days and bad ones, setbacks, frustrations and highlights. Just take it one day at a time. You might feel like you’re putting your life on hold, having to be antisocial, taking time off work or school, but taking the proper time and steps to heal your brain WILL pay off. In TCM, we say to give 100 days to heal from any injury. This holds true for bones, ligaments, tendons and brain. However, your head traumas might take more time depending on your age, number of concussion previously had and present state of health and diet while the injury occurred. You have to be your own cheerleader and celebrate the successes rather than the failures. Meditate and picture your brain healing, your neurons regenerating and making new connections while you feel healthier than ever. The power of visualization is extremely powerful.
12- Helpful supplements:
Curcumen (derivative of turmeric): taken with meals with pepper and oils for better absorption, helps with headaches and pain and is a strong anti-inflammatory.
Ginko Biloba: improves cognitive functions.
High potency fish oil: Anti-inflammatory, brain protecting and cognitive boosting benefits.
Japanese Ashitaba & Lions Mane mushroom: Special TCM herbs known to have important neuroregenerative properties among other benefits.
You have a new brain, one that may think, dream and process a little differently. You must take the proper steps and time to heal. Please take care of your brain as it’s the most important real-estate in your body.
Dedicated to Mercedes Nicoll & all my friends that have suffered in silence,
- Dominique Vallée, R.TCM P.
Helpful Apps and Information:
A non-profit that aims to improve the quality of life of people affected by traumatic brain injury--from concussion to severe injury. LoveYourBrain is the message that embodies their positive approach to brain injury prevention and recovery. Please take the time to watch Kevin’s Pearce powerful HBO documentary The Crash Reel.
The Meditation Podcast on iTunes: Free. A useful tool for guided meditation and many to choose from. www.themeditationpodcast.com
Yin, Restorative Yoga and yoga breathing practice: deep mindful breathing exercises along with gentle yoga classes can be a fun healing activity that can be done in the comfort of your home. Classes, often free or minimal first month fee for online classes.
HEADWays: free App concussion management and information.
Lumosity: www.lumosity.com & App: Fun brain exercise that will help you train your brain and see your progress. Look for “courses” with TBI specific content.
Breathe2relax: very useful free app to practice breathing exercise to help release stress and improve mood and energy.
High Intensity Intervals Training workout example (HIIT):
get the free Nike + Training App for more ideas.
Start with 20 sec on/10 sec rest. 3 sets with 2 minute break between. Work your endurance up to 1 min on/20 seconds rest between exercises.
4- Ab crunches
5- Jumping Jacks
6- Renegade row
7- Mountain Climbers
8- Body Weight Squats
10- Skater Hops
The weather is starting to heat up and all you’re craving is that ice cold water to quench your thirst. While drinking cold beverages might be the norm in our modern time, here are some few thoughts to ponder on why drinking warm water may change your health.
Drinking warm water ( 37-55 Celsius) has been recommended for thousands of years in Traditional Chinese Medicine (TCM) for numerous health benefits.
Long term, drinking of cold water, anything below body temperature (37 Celsius) or even room temperature (22 Celsius), creates the basis for unwanted symptoms such as pain and chronic diseases to develop. Cold water internally constricts, slows and shrinks your digestive organs thus leading to many potential problems. Think about what happens when you jump into a freezing cold lake or shower; your muscles tighten and it becomes hard to move as your blood vessels constricts to keep warm. The same happens to your digestive system when you introduce cold water into your body.
Here are 8 reasons why you should start drinking warm water:
1- Increase hydration and cooling
Although it might not feel as satisfying as drinking ice cold water, warm water hydrates the body immediately as it is absorbed by the body without having to be metabolized and warmed up. Cold water actually makes you warmer as your core needs to heat up the water to 37 degrees before it can hydrate the necessary organs. You’re better off splashing cold water on your face or skin for a cooling relief.
2- Boost digestion & metabolism
Perhaps you’ve heard the popular myth that drinking cold water will help you lose weight? It couldn’t be further from the truth! It actually weakens your digestive system, which leads to chronic sluggish and poor digestion leading to weight gain. Drinking warm water can boost digestion by giving your digestive system a much deserved break. This can help relieve abdominal pain and bloating, abdominal gas, relieves loose stool and constipation, increase evacuation, and it can help you lose weight, have glowing skin and boost energy.
3- Faster recovery and post-workout hydration
During exercise our body pushes out the internal heat to the surface of the skin creating sweat and heat sensation while your core body temperature stays the same if not slightly cooler. Drinking room temperature or iced water after exercise tends to shock the organs that have been working in overdrive. Drinking plenty of warm water will help the body naturally cool down while being able to start the recovering process and flush out lactic acid.
4- Increase blood circulation and relieve pain
By giving your body the warmth it continually craves, your organs can function optimally instead of feeling like they are worn out by being kept on ice from drinking cold water. Drinking warm water not only helps your body digest properly but it promotes your blood running smoothly as it is not constricted by cold water. Having good blood circulation keeps your heart happy and helps relieve common symptoms such as chronic cold hands & feet, varicose veins, relieve chronic pain and arthritic pain.
5- Relieves menstrual cramps
If you regularly suffer from menstrual cramps, read up ladies! Yes, drinking warm to hot water regularly, especially 1 week prior and during your period may save you some serious monthly pains. In Traditional Chinese Medicine this makes perfect sense as the uterus is easily affected by not only exterior cold (weather) but interior cold as well. Pain in the uterus is viewed as poor circulation of energy and blood most often caused by ingested cold.
6- Late afternoon energy boost
Feeling tired around 3-5pm? In TCM, every organ has its time of day and this is the Bladder Meridian time. Drinking 1 or 2 cups of warm water can solve afternoon slumps often attributed to being dehydrated giving your whole body a hydrated energy boost.
7- Children's cure for digestive issues
Children get affected quickly by their environment and diet. Children often suffer from stomachaches, constipation or loose stools that can be solved by drinking plenty of warm water. It’s the #1 easiest and healthiest way to treat most of their digestive issues.
8- Hydration is key for longevity
Dehydration of organs can occur from long-term drinking cold/cool water as the cold contracts and slows organ functioning decreasing detoxification, digestion and excretion. Dehydration may not show up however until you start to drink warm or hot after years of drinking cold or room temperature water. As the internal organs are activated to “wake up” from their cold-induced slumber, you might be more thirsty. Expect thirstiness to last 15-30 days or more as your body adapts.
Warm water intake applies for all climates from tropical to cold countries. You might want to drink more hot water during cold winter months. Start by having 1-2 cups of warm water first thing in the morning. Give it a try for at least 2 weeks and see the positive changes you can make on your overall health.
With thoughts of warm hydration,
R. TCM P.