'Motion is lotion': Experts encourage movement to aid injury recovery
Movement helps avoid lethargy, while aiding the body's natural healing, experts say
When Katherine Valentine, an avid runner, biker and mountain climber, tried to adjust her position in her chair last fall, she wound up with "stabbing pain" through her shoulder.
"I'd been climbing the night before absolutely fine, but apparently sitting at my desk did me in," the Calgary resident said.
"It was really embarrassing."
While Valentine knew she should take it easy when injured, she felt restless being sedentary.
On her physiotherapist's advice, she found a middle ground between exercising safely while injured versus not moving at all.
Experts suggest almost anyone recovering from an injury should engage in lower-impact physical exercise, encouraging a "motion is lotion" approach to emphasize the need to keep the body moving if possible.
"Any time you move your body, you increase your circulatory flow," Dr. Laura Cruz, a sport and exercise medicine physician in Toronto, told The Dose's Dr. Brian Goldman.
Not only does movement avoid lethargy, simple physical activity can also aid the body's healing processes, she said.
"You're getting more blood to the injured area, it's going to get better faster."
Want to improve your recovery? Think PEACE and LOVE
For decades, physicians addressed injuries by applying the R.I.C.E — rest, ice, compression and elevation — treatment method, suggesting patients rest, apply ice to the injured area, compress the area to decrease swelling and internal bleeding, while elevating the affected limb above heart level. However, some physicians are adjusting their guidance.
Cruz says patients should instead think about PEACE (Protection, Elevation, Avoid anti-inflammatories, Compression and Education) and LOVE (Load, Optimism, Vascularization and Exercise.) The acronyms were coined by Jean-Francois Esculier, a clinical professor of physical therapy at the University of British Columbia, and Blaise Dubois, a physiotherapist and the founder of The Running Clinic, which offers continuing education to health-care professionals, in a journal editorial.
PEACE and LOVE encourages relative rest — protecting the body by reducing activities that cause pain for the first few days of an injury, before slowly reintroducing activities that place a load on the body.
While the body needs to take a break to recover, some amount of stress is needed to encourage the body to heal, according to Clare Ardern, an assistant professor at the University of British Columbia's department of physical therapy.
"Relative rest … doesn't mean stopping everything altogether," she said.
For instance, rather than going for a run, which can aggravate an injured ankle, Cruz says patients can go on a walk.
Swimming is also an effective way to move the whole body without too much strain.
"Even sitting in a chair reclining on your couch, you can do bicycling moves semi-reclined, weightlifting — little weights, a jug of water, kettlebells — whatever," Cruz said.
"It's a great time to work on strength training and flexibility."
The PEACE and LOVE approach also suggests patients avoid anti-inflammatories, Cruz said. While medication like ibuprofen and naproxen can alleviate pain, some research suggests that medication and icing affected areas can "slow down that initial healing phase," according to Cruz. However, the studies note both can fit into a multi-prong approach for treating some injuries.
"The folks who really overload and take lots of medications, lots of ice and then go out and try and do anything and everything without being mindful are at risk of worsening their injury," Cruz said.
Despite PEACE and LOVE's emphasis on movement, the approach to recovery depends on the severity of the injury.
Cruz cautions that head injuries and broken bones need to be respected and patients should consult with their health-care providers to determine how to keep moving and whether it is safe to do so.
Psychology is as important as physiology
While physical movement is essential to recover from injury, Cruz says there's an equally important psychological element to consider.
"Helping [people] understand the natural process and the things that they can do that will help them feel that they're active participants and not just a victim of their injury, I think that's really key."
Even patients who experience life-changing injuries can see an improvement in recovery if they receive appropriate counselling and guidance, she said.
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"When people have a sense that there's a plan and a treatment protocol to follow, that structure is very reassuring."
Rather than exercising normally and risk making an injury worse, Valentine now finds a suitable physical activity that encourages movement, without aggravating her body further.
"From that point onwards, every time I've got injured, I've looked at it as, what activities can I adapt to, so I can keep moving and doing things."
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