Orthopedics :: Continue To Use RICE? Ice Actually Prolong The Healing
Jan 9, 2014
Recently one of my guys injured his knee in what we assess to be a strained MCL. I'm a combat medic, not a DPT, so I began to look into rehab/treatment plans. Naturally, the RICE (Rest, Ice, Compression, Elevation) protocol was highly referenced. However, there is also a large group of health professionals that actually advise AGAINST using ice to combat swelling. They question the efficacy of interrupting the body's inflammatory response, and they also contend that ice increase permeability of the lymphatic system INTO the injured area instead of out. This is in sharp contrast to everything I've been taught about treating inflammation as a result of ortho trauma or joint damage. Is there any validity to the argument that Ice actually prolongs the healing process? Or should I continue to use RICE?
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Just a little background over the past 5 weeks.
I fell over and broke my left humerus 5 weeks ago yesterday. Initial visit to A&E which resulted in X-rays and put in a collar and cuff for the first 4 days.
I then visited Orthopedics and more X-rays taken and put into a Brace.
I was in the brace until week 4, when it was replaced by a plaster U slab as the brace was causing my arm and hand to be considerably swollen. My U slab had to be changed twice due to it moving constantly in this time and in my opinion not isolating the break.
I had an appointment yesterday at Orthopedics where it was replaced yet again, and told my next appointment is on the 18th of December.
My concerns,
Various different stories told as to healing times.
I am 5 weeks since the break, when will they decide if it needs operating.
I am taking serious pain relief which is barely touching it, and causing sickness.
Its seems like i am being a nuisance asking questions or going back to the hospital, am i being paranoid.
I have managed to take pictures of the X-rays every time they have been taken and week 5 looks the same as day 1.
I know Orthopedic Surgeons undergo the same training. I have a problem that my Surgeon is a lower limb specialist. I have asked to see the Surgeon who specialises in my the area of my break, but only to be told that they are all the same.
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I've been taking bisoprolol 2.5mg for about 2 years for my S V T. I'm 30
it's been a lifesaver for me. has all but stopped my palpitations. I'm now 17 weeks pregnant and have just been transferred from midwife led to consultant led at maternity .
she has told me she wants me to stop taking it because their is a small chance i could have a small baby.
i am so worried that my quality of life is going to go back to heart racing and feeling faint.. and feeling awful again...my doctor told me I could continue it. has anyone other ladies took this when pregnant. I get regular scans and baby is big for dates.
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I will have been taking Omprazole for a year a at the end of this December and although I realise that many people have been taking it longer, I wonder how long I will be taking this drug. Has anyone any thoughts on the operation that you can have to cure Hiatus Hernia, as this is what my Doc suspects I have. He has mentioned it as a thought for later, and although I am not keen on the idea of operations, I find it a sobering thought that I if I don't have the operation, will I be on this drug for life!?
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I have a 6 months baby. Still breastfeeding. My cycle is 7 days late. I decided to do home preg test and is positive. I texted my doctor. She said I can still breastfeed my baby. Has anyone experience this before. Okay to continue breastfeeding?
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I had 2 small (one is about 2mm the other about 1mm) pinkish bumps on my penis skin for several months (I guess more that 6 months). When magnifying, you can see some whitish matter inside the bump. Suspecting about MCV (molluscum contagiosum virus) I waited to see if they disappear and finally went to my derm. Without any hesitation, we was immediate in diagnosing MCV. He gave me a solution of potassium hydroxide (KOH, 1 mL solution with 50 mg of KOH, to use it very parsimoniously as very irritating, 2x/day on the MCV).
I did not start yet and decided to read a bit before and check your experience:
I frequent saunas, gyms and had different sex partners but always had safe sex and very cautious and clean, yet ..
How can my derm be so sure and exclude more serious things as HPV?
IMPORTANT: how I can minimize the chances to spread it when starting with the KOH. DO I NEED TO ALWAYS COVER IT WITH A SMALL BAND-AID after appliance?
Can I continue to have safe sex (condom) with my partner?
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I have had low back pain with sciatica off and on for years . 3 months back I had an acutely painful episode which stopped me from going to work for 5 days. Subsequently a MRI showed disc prolapse L5/S1. I am 40 yrs old and am an active squash player. I went back to playing squash after taking a 6 week rest but my back seized up again. I am told I am not 'ripe enough ' for surgery .My dilemma is that if I don't keep active playing squash, a part of me would possibly die. I would like to hear from folks who have a prolapsed disc but continue to play squash.
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I am 1 month and 10 days pregnant and i took cycotec 1 orally and inserted 2 in my vagina.I had spotting atfer 8hrs and til 3-4 days it stop. And now i am confused did it affect my pregnancy? If i will continue my pregnancy is there a high risk that the baby might have deffects?
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Should I continue taking metformin during pregnancy?
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Since college and then 7 years afterwards, I was lacking a period. Then one day it came back. Wanting to know what happened, a gyno doc diagnosed me with PCOS. Also, the years without a period causes hyperplasia(crowded cells in the uterine lining, the form I had has a slight risk of cancer.) I was treated with provera pills to force a period for a while and the hyperplasia was reversed. I was also diagnosed with mild diabetes and I'm on metformin. When my doc found out I was sexually active and on metformin he encouraged me to be treated by depo provera. Also affecting things I take a drug called trileptal. Trileptal prevents most hormonal birth control from working and it is suggested depo to be given more often while on trileptal.
Anyway the problem is I'm started to get periods when I didn't before on depo and I'm acting all hormonal when I am not suppose to. It's so bad I'm getting breakthrough bipolar symptoms right before these periods. But my gyno says there is no way that is happening and my psych symptoms have nothing to do with the depo because hormone fluctuations are impossible on depo.
I want to go off depo, but my doctor is insistent that if I go off it my periods will stop again and I'll get hyperplasia again and get cancer. But there is no sign of my PCOS and I'm bleeding on depo, now that my pcos is treated why would my periods stop and the hyperplasia come back? I didn't take the depo and a main reason is I'm thinking about a child. Why would he push depo so heavily? Should I get the shot?
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just wondered if anyone feels that age contributes to the healing process. I have noticed that so many of you on the forum are pretty young. 50-60's. I am 71 and find that even though I have done well(read previous entries) I find that at 4 months, I still tire a lot.
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I seem to have "aggravated" my ankle that is healing from ORIF done on 05/07/14. I have Lortab for pain which i am going to take but I just wanted to know if there is anything else I could try for the pain and discomfort. I will be doing hot/cold therapy later tonight.
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I had an operation to remove a pilonidal sinus on 24th july. 5 months on and I don't really feel any better off. I didn't say anything when I first discovered the problem as I didn't think anything of it. I only said something once I found out my brother had the same problem! I must have had the sinus for around 2 years before I had the operation, something which I deeply regret now. The wound was a very deep one and I was expecting it to be a long while before it had fully healed, but not this long! I was told by the nurses about 2 months ago that it was only a few weeks away from being fully healed, but it got infected and has set me back a long way. I have to say I do feel a little let down by the nurses I have been seeing. Fair enough they have a tough job but I have questioned quite a few of their decisions during this recovery period. Surely they should be able to see an infection developing on a nearly recovered wound. The fact I was the one who had to push for antibiotics to cure the problem is worrying. I feel I have been palmed off in other ways too. Since the infection, there seems to be little or no healing, and despite persistence from myself to either see the surgeon again or visit a wound clinic they have been very reluctant to do anything. The inconsistency with the nurses has also been a major concern of mine. One day I will see a nurse who says it's not looking great, and the next, I will see someone who hasn't seen it for months, which gives me no idea of how it's doing.
In the last few weeks, I have discovered a lump at the base of my spine, and looking at information on the internet, I'm pretty sure it's a cyst. The annoying thing is that I have told the nurses 3 times about this lump and they either say they don't think it's anything to worry about or they simply don't know what it is. I need closure on this issue and have booked another appointment with the doctor to get to the bottom of it. (I saw him 3 weeks ago with the nurse and he said the wound was looking ok, and that I should give it another few weeks to see if there has been any improvement). There is also a pretty strong odour which is embarrassing. I've got to do something to try and cure the problem. It's driving me crazy and I can't see an end to the problem right now. I'm going to request either being referred back to the surgeon or to a wound clinic. Have any of you been to wound clinics that you would recommend? What are the processes involved? Are they effective?
This problem has kept me from doing some of the things I love, such as playing football, for almost half a year now and will inevitably be longer. There's only so many jokes you can make about it before the depression and annoyance kicks in. It's really getting me down at the minute. Luckily I'm taking a gap year this year and will be going to uni next year, which will hopefully give me time to recover from this nightmare. (Hopefully being the major word!!)
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It has been just over 5 weeks since I flailed off of my ottoman, fighting a cockroach, and landed on the side of my foot. I do not have health insurance and was first trying not to spend the money, if not needed, on a specialist. I was given a boot and have been in it consistently for 4 weeks. Now, I am getting a little bit worried after a couple of X-rays and, also, the fact that it is not showing healing. It is displaced, with an offset of 4mm on the top view and 8mm on the side view and there is some splintering within (according to radiology notes from the hospital).
I just recently went to a highly recommended Orthopedic doctor and after looking at the two X-rays I had previously, and taking a new one in office, says that he does not recommend surgery. He did explain that I may be looking at 3 more months of healing but that it would heal on it's own. I can understand the fact that it has been 5 weeks and that opting for surgery now would be a huge step backwards in the muscle and tissue healing that has inevitably taken place.
My concern is: I am a runner. This bone, to me, looks terrifying and to think it will stay that way forever and only fill in where it is positioned now seems it will only give me problems in the future. I don't know if I should bypass his recommendation and opt for surgery to have the bone set in the correct alignment and know that I will not have future problems or just let it to what it's going to do. I do know that nothing is 100% and even surgery can mean a long healing process. I guess I am hoping for more opinions on the matter, so please help, if you can.
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Hi, so I am now 19 years old, and I got circumcised two years ago, when I was 17, because I had phimosis.
Though the scarred area should be long healed by now, I think mine has been very slow. It is still a little red, especially when I get erections, and there are still marks from the stitches.
I would like to change this and make it fully blended, and I was wondering how can I do this?
I did use an antiseptic cream for a while, till I later found out that this can slow the healing process. Could this be the main reason?
Also, if I use Vaseline petroleum jelly, would that be helpful at this point.
Thanks.
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I have a spiral fracture of the Tibia. It has been fixed with a plate however the surgeon left a gap in the bones. (This gap was not present in the original x-ray prior to surgery). After 12 weeks there is no sign of the bone healing. I sort a 2nd opinion & was advised that the bone is unlikely to heal because of the gap & further surgery was recommended to join up the gap & possible a bone graft.
What is the conventional thinking on this? Should bones be fixed touching to heal?
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I am getting a lot of light yellow fluid from the open wound. The open wound is red inside with slight whitish at the tope lining borders. Is my wound healing?
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I broke my ankle 3 weeks ago now by rolling out wards stepping down a step I broke my tibia and fibula think it is a bimalleolar fracture? I had a half cast on for a week then a full cast and after a week put into an air boot. I have struggled to put weight on my foot and still need the crutches but tonight examining my ankle I've noticed I still have lots of bruising and swelling on the able it also looks deformed like a bone is sticking out prominently and feels hard to touch there is still pain and I also can't bend the last three toes on my foot.
I'm really concerned this isn't normal and the ankle isn't healing properly or the cast was taken off too soon does any one have advice? There was concerns I would need surgery but was given the all clear last Friday. I've also been discharged by the fracture clinic for no follow ups which I thought was also strange.
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Broke my foot 5th metatarsal. At 4 weeks not healing yet,i'm now in an aircast from a hardcast. This is week 6. Foot at night just burns and burns. I don't get much sleep and now i have a deep aching.along with the burning. I was told no weight on it but i can walk on the heel only if necessary. Why now at 6 weeks is it hurting and burning?.
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I had my vasectomy 3 weeks ago and the left side has healed beautifully. The right side however has a donut shaped wound and string has come out and is hanging.
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I broke my 5th metatarsal on 16 December, it is now 23 February. Someone came down on it very heavily in high heels and broke it, spiral fracture, slightly displaced. I didn't realise it was broken at first, just thought it was swollen and bruised...and boy was it bruised! Never seen anything like it! Anyway, did the usual, rest, elevation, compression and ice and kept hobbling about, using the opposite side of my foot to hobble round the house...after all it was Christmas and I didn't have time to rest! Luckily could stay pretty much in the house so didn't do massive amount of walking...and couldn't get a shoe on anyway! Did mention it to a locum doctor on 23 Dec, but had gone about something else, and he dismissed it without looking at it, just telling me to RICE it..which I already was.
After a day or so, bruising still horrendous, I decided to see my usual doctor who referred me immediately to get it x-rayed. This was on 28 Dec..and the fracture showed up to my shock. X ray technician mentioned going straight to A and E but then said all they would do is make me an appointment at the fracture clinic, which I may as well get from my doctor, when the information about my fracture had got to my doctor (and no, I couldn't have the letter to hand in, it had to go by snail /Royal Mail) I had started by now to use crutches...no weight bearing on bad foot at all.
A week later, as soon as I could (bank holidays delayed information getting to doctor and hence consultation) I saw my doctor who phoned the hospital after reading the letter to make me an urgent appointment with the consultant for the following Monday (this was Friday)
I went and saw him and to my shock he was very, to me , pessimistic and not a little rushed. Told me it was a nasty fracture, difficult to heal, and I might very likely end up having two operations, one to put pins and plates in and one to take them out. Oh..and the plate would stick out of my (slim) foot and there was a high risk of infection etc as we were operating on bone. However, he told me I could still go to work, drive (this was my clutch foot) as long as it wasn't for long (work is 10 minutes drive away) and elevated and rested foot at every opportunity....and it might be an idea if I used crutches and didn't put weight on it BUT he didn't put it in an air boot or cast. (which concerned me a little)
This I did, but no real improvement, in fact it got worse, swelling up, pins and needles in toes and very sore and swollen behind toes, on ball of foot. Went back again to hospital, saw a different doctor, who told me I should be off work, not driving, moving as little as possible and keeping foot above heart level. For at least a MONTH!
So...I have done that. Googled the injury to death, scaring myself and becoming depressed over what I have read. Rested completely, didn't put any weight on it , crawled and used a pair of crutches at all times, slept with it elevated, sat with it elevated, compression bandage at times, rubbed comfrey oil on it twice a day , used epsom salt baths (used to lose the circulation and it also helped a little with swelling), tried to keep my leg muscled with scissor action exercise etc Wore hiking/timberland boots (still doing this) It was still sore and swollen however behind the toes, so much so I wondered if there was other damage, but have now realised this was a result of not using my foot on the floor at all.
NOW....9 weeks from when I first injured it, I have been told this week I can put a little weight on it and start to walk, even though the bone hasn't joined up AT ALL, no callus etc on the x-ray the consultant reckons there is fibre etc holding it and I am now ready to walk on it. (I was prepared for there to be no sign of healing ..research on internet again!) It isn't sore to touch although aches a little (almost a burn) now I am walking on it..but I have read this can be a sign of healing.
I am walking about with either one or no crutches,taking it very slowly, but I cannot believe I am actually walking on it, I can stand on both feet in the shower etc.....I NEVER thought this would be the case after only 8 - 9 weeks after all I had read on the internet...and those weeks felt interminable! I have broken bones in my foot before but have never been as disabled with it as with the 5th metatarsal break, and never felt so depressed over an injury after googling it all. So, I didn't have an air boot, nor a cast, which seems to have worked for me, although it was very hard work getting about on crutches or crawling (calloused knees now!) and mentally , although I kept reminding myself it wasn't a life threatening condition, it still got me down at times as there didn't seem to be any improvement.
In my experience, yes it has taken a long time to get better...and I am still not there by any means...haven't walked out of the house yet...but I feel I AM on the road to recovery, which is the main thing. I won't be running (which I do) for quite a while I think, not doing a lot of long distance walking but at least I am getting better. After reading such a lot of depressing and pessimistic posts on this injury I felt I had to post a more optimistic one..and I hope at least some of you out there have just as good a recovery if you have fractured your 5th metatarsal.
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