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Health, Beauty & Fashion

Heal injured joints

While ice helps injured joints, heat may worsen the problem.
The Straits Times - July 28, 2011
By: Jonathan Liautrakul
| More
Heal injured joints

If you have ever sprained your ankle, you probably would have been given conflicting advice and been caught in this dilemma: apply heat or ice?

The correct answer is ice, experts say.

Dr Patrick Goh, a sports physician at Mount Alvernia Hospital, said: 'Early application of heat may result in a longer healing time.

'Heat application is not recommended in the early stages of an injury - within the first two to three days - when there is active inflammation.'

Applying heat to the affected area may cause blood vessels there to expand and increase blood flow to the area which, in turn, will increase swelling.

Heat is useful only in situations involving painful muscle spasms, such as back injuries or chronic joint injuries, that are slow to heal. In such cases, heat helps to reduce stiffness and provide relief.

For common joint injuries such as sprains, dislocations and ligament tears, the Rice (Rest-Ice-Compression-Elevation) technique is the best immediate treatment.

The most commonly injured joints are the ankle and the knee, said Dr Bryan Tan, associate consultant at the department of orthopaedic surgery at National University Hospital.

For these joints, injury symptoms may include a 'pop' sound, followed by pain, swelling and, in some cases, feeling unstable while walking.

The patient should first stop exercising that joint and rest it. He should then apply ice wrapped in a towel to the joint, said Dr Tan.

This involves pressing the ice firmly onto the affected area for 15 to 30 minutes or using the ice to massage the area for seven to 10 minutes, said Dr Jason Chia, a sports physician who heads the sports medicine and surgery clinic at Tan Tock Seng Hospital.

The patient should then use a bandage to continue applying pressure to the injured joint.

An indication that too much pressure has been applied is when the part beyond the bandage looks a little blue or feels numb or painful, said Dr Goh.

Finally, keep the limb with the injured joint elevated by placing supports, such as pillows, under it, said Dr Tan.

The injury is usually serious if the pain persists for more than a week or if there is severe swelling and bruising, said Dr Tho Kam San, an orthopaedic surgeon at Mount Alvernia Medical Centre.

Dr Tan Jee Lim, an orthopaedic surgeon at Gleneagles Medical Centre, said that, in general, you should get an injured limb checked by a doctor early.

'Injuries should be assessed by a doctor as you do not want to delay taking care of potentially serious injuries that could have benefited from early intervention,' he said.

Which expert to go to?

Orthopaedic surgeon
Consult an orthopaedic surgeon if you have a serious joint injury, such as ligament tears or dislocations and fractures.

Sports physician
Go to a sports physician if your joint condition does not warrant immediate surgical intervention. The physician can treat the injured joint with non-surgical methods, such as bracing.
He may also prescribe specific exercises to improve joint stability and flexibility, said Mr Khalid Anuar, principal physiotherapist at Tan Tock Seng Hospital.

See a physiotherapist if you are recovering from a serious injury. The physiotherapist can develop a rehabilitation programme to strengthen muscles and joints and prevent further injury, said Mr Lim Hun Teck, principal physiotherapist at Raffles Hospital.

General practitioner
a general practitioner (GP) if you experience frequent pain and swelling of the joints for more than 48 hours after physical activity.
The GP can prescribe medication to reduce the joint inflammation.
Mr Lim said: 'If the GP feels there are other serious conditions, he will refer you to the appropriate specialists.'



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