Thursday, June 18, 2015

To Ice or Not to Ice.... Rebecca Dietzel shares her research for injuries

Injuries - is an ice pack the right tool for the job?

 On June 4th, 2015 I was able to attend a workshop given by Rebecca Dietzel*  here in New York City. Rebecca presented her (very thorough) research on the use of ice for injuries. This information is so important and useful for dancers that I had to try to summarize it so that others can apply the latest in scientific research in their dancing lives. Without giving away all of Rebecca's hard-earned research results, I'm simply going to share what to do in case of an injury.

 Rebecca pored over 350 studies on the use of ice after injuries and there has been information out for decades (since the 1970's!) that ice doesn't allow for the most optimal healing process to take place in the body. Even Dr. Gabe Mirkin, the doctor who invented the R.I.C.E protocol (short for Rest, Ice, Compression and Elevation), has said repeatedly that he now knows ice should not be used on injuries.

Here is Rebecca's new protocol for injuries: B.E.C.A.L.M
B = Breathe with slow inhale and longer exhale
E = Evaluate -      Ask, "Is the injury to soft tissue or bone?"
    Below are ways to diagnose a bone issue. If the injured person:
  • Is unwilling to move or bear weight on the injured body part
  • Is bleeding
  • Has suffered loss of  consciousness
  • Is experiencing sharp pain in a specific/bony spot
Then the injury is likely a bone issue (which should be immobilized/moved very little before traveling to get an xray).
C = Compression
     If there is a soft tissue injury, put the joint in neutral position and gently wrap with an elastic
     bandage. Use figure 8 diagonals for the wrap and do it snugly. (Just not so tight that the
     circulation is cut off . For instance, when wrapping an ankle, the toes shouldn't turn blue).
A = Able Actions
      If it is a soft tissue injury, slowly and carefully move the injured part to see what can be
     done pain-free. Repeat this after 1 minute even if pain-free range of motion is very small. These
     movements can help keep non-injured areas healthy. They also can also show if the injury is
     getting better (increase range of motion = better).
L = Lift / elevate
     Keep the body part elevated to limit swelling. This also helps the lymphatic system drain the
     injured area. Lie down if possible (ie - putting injured part up - on backpack, chair, or wall).
M= Minimal Ice
      Ice doesn't help the injury heal but it can help with pain. Find a balance between pain and ice use
      and follow the time rule for use of ice for pain:
          5 minutes maximum ice ON, 20 minutes OFF, 5 minutes maximum on
      (Also - menthol on the skin can help with pain and it starts with "M" too.)

At the end of the session with Rebecca we briefly discussed what we should have in our first aid kits (to replace those instant ice packs).
Here is the list we came up with: 

Elastic Bandages (at least 2)
     This can help keep swelling to the appropriate level.

 White Willow Bark Tincture
 This can be purchased at health food stores in their medicinal sections. Add the tincture to water.
This natural anti-inflammatory helps the body keep the swelling at an optimal level - not too much so that more injury occurs, but also not too little (which can interrupt the natural healing process in the body)

Menthol Tincture or Cream
The menthol can help with pain. Check in a natural foods store for skin cream/oil with menthol.

Notate range of motion just after injury and each hour/day afterwards. This can be shared later with a doctor/therapist to help diagnose injury. It can also help a dancer see improved results in a short time (thereby avoiding some stress/worry).

To get Rebecca's full info check out her site HERE

*Rebecca Dietzel is an anatomist and  biochemist. She received her Master of Science from Columbia University's Institute of Human Nutrition. She maintains private practices in New York City and Vermont teaching anatomy, physical re-educaiton and nutritional biochemistry. Rebecca is the nutrition consultant for Canada's National Ballet School, and co-author of A Dancer's Guide to Healthy Eating.

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