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常在河边走，哪能不湿鞋？对不断冲击自己身体极限的攀岩者来说，受伤与否只在一线之隔。很多办法可以避免受伤，充分热身，姿势正确，最重要的是——别太拼命！不过，这里要讨论的是受伤以后的治疗，热敷？冷敷？还是先冷敷后热敷？
缘起是在抱石吧和手套、小河的争论。以我多次的拉伤、挫伤、韧带撕裂的治疗经历来说，结论是明确无疑的——RICE（R-rest休息，I-ice冷敷，C-compression加压包扎，E-elevation提高患肢），冰敷、冰敷、冰敷！我需要的只是找到证据来说服他们。
要点
冷敷是急性损伤最有效的急救方法，可减轻疼痛，收缩血管，限制对受伤处的供血，减轻肿胀。每次运动后冰敷对疲劳积累导致的受伤，如手指关节侧付韧带疼痛也有帮助。运动前不能冷敷。
热敷可加速局部区域的供血，舒缓紧张的肌肉。一般对慢性损伤或没有肿胀的伤痛实施，运动前热敷有助于增加肌腱的弹性，但运动后不能热敷。
如何冰敷
1，应立即实施，48小时后效果急剧减弱。
2，不停地移动冰袋，不要停留在一个位置。
3，抬高患处，高于心脏
4，冰敷15－20分钟，时间过长可能导致冻伤
5，两次冰敷时间间隔至少45分钟
6，一天可实行多次，只要患处温度回复，触之有正常的感觉。
小贴士
传统方法：装有碎冰的袋子
最好：纸杯装水放到冰箱里
富于想象力的：冰冻的玉米棒子或豆子。
链接：
http://orthopedics.about.com/cs/sprainsstrains/ht/iceinjury.htm
http://scc.uchicago.edu/heattherapy.htm
http://www.sportsinjurybulletin.com/archive/heat-therapy-ultrasound.html
原文选摘
Heat vs. Cold Therapy for Injuries
Should you ice injuries or apply heat?
Most athletes know that you should apply ice to an acute injury, like a sprained ankle, but you might also have heard that heat can be used on injuries as well. How do you know when to use heat and when to use cold?
Acute and Chronic Injuries
There are two basic types of athletic injuries: acute and chronic. Acute injuries are sudden, sharp, traumatic injuries with a rapid onset (within 48 hours) and possibly severe pain. Typically, acute injuries result from some sort of trauma such as a fall, sprain, or other impact.
Chronic injuries are slow to develop, can come and go, and may cause dull pain or soreness. They are often the result of overuse but sometimes develop when an acute injury is left untreated.
Acute injuries are usually easy to identify because of the sudden onset.
Signs and symptoms include pain, tenderness, redness, skin that may be warm to the touch, swelling and inflammation. If you have swelling, you have an acute injury.
Cold Therapy
Cold therapy with ice is the best immediate treatment for acute injuries because it can reduce swelling and pain. Ice is a vasoconstrictor (causes the blood vessels to narrow) and it limits bleeding at the injury site. Apply ice to the affected area for 10 to 15 minutes at a time. Allow the skin temperature to return to normal before icing a second or third time. You can ice an acute injury several times a day.
Cold therapy is also helpful in treating some overuse injuries or chronic pain in athletes. An athlete who has chronic knee pain that increases after running may want to ice the injured area after each run to reduce or prevent inflammation. Never ice a chronic injury before exercise.
The best way to ice an injury is with a high quality ice pack that conforms to the bady part being iced. Two such products are ColdOne Cold Therapy Wraps and SnowPack Cold Therapy products. You can also get good results from a bag of frozen peas, ice massage with water frozen in a dixie cup (peel the cup down as the ice melts) or a basic bag of ice.
Read more about how to safely use ice on injuries.
Heat Therapy
Heat is generally used for chronic injuries or injuries that have no inflammation. Sore, stiff, nagging muscle or joint pain is ideal for the use of heat therapy. Athletes with chronic pain or injuries may use heat therapy before exercise to increase the elasticity of joint connective tissues and to stimulate blood flow. Heat can also help relax tight or spasmed mucsles. Do not apply heat after exercise.
Because heat increases circulation and raises skin temperature you should not apply heat to acute injuries or injuries that show signs of inflammation. Safely apply heat to an injury 15 to 20 minutes at a time and use enough layers between your skin and the heating source to prevent burns. Moist heat is best so you could try using a hot wet towel. Specialty hot packs can be purchased or you may use a heating pad. Never leave heating pads on for more than 20 minutes at a time or while sleeping.
Because some injuries can be serious, you should see your doctor if your injury does not improve or gets worse within 48 hours.
How To Ice An Injury
From Jonathan Cluett, M.D.,
Your Guide to Orthopedics.
FREE Newsletter. Sign up now!
Icing an injured body part is an important part of the acute treatment process. Learn how to properly ice your injury.
Difficulty: Average
Time Required: 15 minutes
Here's How:
1. Icing is most effective in the immediate period following an injury. The effect of icing diminishes significantly after about 48 hours.
2. Apply ice directly to the injury. Move the ice frequently, not allowing it to sit in one spot.
3. Keep the injured body part elevated above the heart while icing--this will further help reduce swelling.
4. Ice for 15-20 minutes, NEVER LONGER. You can do more damage, including frostbite, by icing for too long.
5. Allow area to warm for at lease 45 minutes before beginning the icing routine again.
6. Ice as frequently as you wish, so long as the area is warm to touch and has normal sensation before repeating.
Tips:
1. Ice Option 1 -- Traditional: Use a ziplock bag with ice cubes or crushed ice. Add a little water to the ice bag so it will conform to your body.
2. Ice Option 2 -- Best: Keep paper cups filled with water in your freezer. Peel the top of the cup away and massage the ice-cup over the injury in a circular pattern allowing the ice to melt away.
3. Ice Option 3 -- Creative: Use a bag of frozen peas or corn from the frozen goods section. This option provides a reusable treatment method that is also edible.
Heat Therapy
What is heat therapy used for?
Heat can reduce muscle spasms, reduce joint stiffness, and make soft tissue more limber. Heat can be used to help loosen tight muscles and joints during a warm-up period before exercise. For example, you may put moist hot packs on tight leg muscles before running, or on your shoulder before throwing, or on tight neck or back muscles.
When should I use heat?
Use heat for stiff muscles and joints when you are trying to make them more limber. Do not use heat in the first few days after an injury or while your injury has any swelling because heat increases blood flow and can worsen swelling.
How should I use heat?
Moist heat is more effective than dry heat because it penetrates more deeply, which increases the effect on muscles, joints, and soft tissue. Use it for 15 to 20 minutes or longer if recommended by your health care provider.
Moist heat from towels soaked in hot water or warmed in a microwave are useful, but the towels usually lose their heat within 5 to 10 minutes. Commercial moist heat packs are more convenient and provide longer therapy. Some commercial heat packs are designed to fit specific parts of your body. Hot tubs or whirlpools
are also useful.
Heat creams and ointments are popular but don't provide heat very deeply into muscle tissue. The massaging effect of putting the cream on is helpful. Avoid getting these creams into your eyes or on sensitive skin.
Can there be any harmful effects from heat therapy?
Heat increases the blood flow to an injury and can worsen swelling. Heat packs that are too hot or left in place too long may cause burns.
If you have further questions about heat therapy, please speak with the SCC Nurse at 702-1915 during business hours or make an appointment with the SCC Sports Medicine provider (702-4156).
Written by Pierre Rouzier, M.D., for McKessonHBOC Clinical Reference Systems |
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发表于 2004-7-7 20:34
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