So I had one of those epic falls on the weekend. Trust me, you would have stopped to see if I was ok, and if you’re my sister, you’d have laughed. I was jumping to grab hold of a bar and missed. In my fall, I dislocated 2 fingers and really landed hard on my tailbone. I had to pop one of the finger back in place myself. (FYI- this is a good time to say that several thing I’ve done are not necessarily what is the best practice for injury. Case in point here, if you dislocate something, get to the hospital to have it reset, don’t do it yourself)
The first few hours were what any of us would do when hurt. I used the ice my friend brought me and let my husband set me up on the couch to relax while he made me lunch. I felt sorry for myself - a valid stage in my opinion - for a few hours and then started to come up with a plan. This was a crappy situation, but one that I can use to learn from. I've seen lots around in recent months about not using ice on injuries to control swelling. What?!
The use of ice on an injury has been around since the 70s. It's almost unquestioned. But in the last 10 years or so a growing number of scientific papers have shown that ice and immobilization can actually delay healing. (here's a link to one of those papers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396304/) in fact, even the man who coined the term R.I.C.E. (Dr. Gabe Mirkin) has changed his tune on it. Now, I think that there is a time and a place for using (or not using) ice and immobilizing or moving tissues. In my experience, each case is different. This time around, I wanted to try compression on swollen areas and non-painful movement for recovery.
I cut some strips off a theraband to use on my fingers. I wrap them starting at the tip of the finger and working down to the knuckle to create gentle pressure. The wrapping itself was a little tender the first couple of days, but the compression feels good. It's super supportive and brings down swelling fairly fast. While my fingers are wrapped, I gently move the joint where the fingers attach to my hand in both active (my muscles make the movement happen) and passive (I use my other hand to move the injured finger) ways. I only move in the range that is comfortable. Once the compression is off the fingers, I do the same range of motion movements in the knuckle joints.
Now the tailbone has been an entirely different experience. It's way too awkward to figure out how to compress (and I'm not sue I would even want that) and there is no way around moving without your pelvic floor muscles being active - trust me on that. Instead, I went to a pelvic floor physiotherapist. There's one right in Alliston, Dr Polina Provad. She is lovely, knowledgeable and helpful. She helped me to release tension that I was holding and made my first visit to a pelvic floor physiotherapist a good one.
If you are in pain and you need to find ways to move around and just get through day to day activities, you will compensate in your movement. It's actually a good thing that your body can compensate just for this reason. The bad part happens when you lose your ability to move in all kinds of different ways. Currently, I need to guard to get through some movements, but I don't want my body to hold onto this tension, so I've been working on finding a position that is really comfortable and then sending my breath all the way to my pelvic floor.
After I find some relaxation with breath in stillness, I see if there are small movements I can do with my pelvis in a very relaxed way while breathing slow and deep into my abdomen. Our bodies are constantly looking for threats (real or perceived) and we can do a lot to help ourselves by giving our body calming signals when we work through rehab of an injury. This turns down the threat response of muscle gripping and guarding and greatly improves outcomes. There actually is no pain in my tailbone or fingers. The pain is in my brain. I'm working to remind my brain that the threat is gone, that I'm ok and I am working to heal my injuries.
So there it is. How a yoga therapist works to heal an injury. I'm using compression, I got help from a professional, I'm doing lots of breath work and I'm incorporating non-painful movement as much as possible. What do you think of the ice dilemma?