Reducing swelling after a fall

[Tyler]

So... as much as I hate to admit it, I biffed it on a training run this morning and my knee is in much pain. X-rays and an examination showed that I don't have any fractures or seriously damaged tendons/ligaments.

I was hoping to race this weekend (sort of my peak race for the winter), and as far as I can tell, the swelling is the only thing holding me back from running. Besides icing it to death and taking near-lethal doses of ibuprofen, is there anything I can do to reduce the swelling? Apparently cortisone is out of the question. I really want to race this weekend, are there any other sorts of  magical treatments I can do to get myself there?

[Carolyn Herlin]

I've heard that an ingredient called arnica, which is in some lotions/rubs, helps. I've used a product called All Terrain Recovery Rub, which I got at Whole Foods, for sore muscles and it has helped. I've never tried it with swelling, but a friend of mine used something else with arnica (I don't know exactly what it was) after removal of vericose veins and reported reduced swelling and bruising. Just an idea.

[adam]

Tyler, be careful with over icing...that can cause more problems if you leave it on too long.

Try talking to Dr. Draper in the RB. He might be able to help with some ideas.

[Tyler]

Adam, how do you know if you're over-icing? I've had great results in the past from going to sleep with frozen vegetables on injuries - it ices for a couple hours before the vegetables thaw. With this injury, I've been keeping ice on it for an hour at a time. There's cloth between the ice and my skin, and I don't notice any adverse affects.

[Jon Allen]

Frostbite = overicing.  Trust me, I have iced my ankles too long and given myself localized frostbite.  I actually formed some ice under my skin that I could move around.  I think veggies heat up fast enough that you don't have to be worried, but just keep it in mind.  Oh, and I didn't keep cloth between my skin, which probably didn't help.  I don't suggest repeating my mistake (and please don't ask how many times I did it). 

[adam]

The vegetables are good because they thaw out, like you said. That means they aren't risky in terms of icing too long. Generally for lower limbs you want to ice for about 20 minutes at a time, with breaks in between (can be 5, 10, 15, 30 minutes, whatever you want), then repeat. This gives you time to move around a little, let your body temp come back to normal, which aides in healing.

Icing reduces swelling, especially for injuries that just happened. It also numbs the pain and slows the bruising. It does this because reduced temperatures lead to vasoconstriction (reduction in the diameter of the blood vessels). Less blood flow to the area means less inflammation. It also means a reduction in the blood flow to the nerves associated with that area, making the area numb.

This is where over-icing may cause problems (outside of course, the frostbite or ice burn issues). Icing for repeated, extended periods of time may numb the area so much that you may need a day or two or even more to be able to fully use that limb at its optimal capacity- meaning it moves slower, making you move slower. Just remember to ice in moderation. Your body can only heal so fast.

[Tyler]

Okay, that makes sense. If icing is especially useful right after an injury, when does alternating ice and heat become effective?

Adam, is Dr. Draper the kind of guy who doesn't mind helping random students? What's the best way to contact him?