August September 2024 - 26

Therapy Focus
REVITALIZE
RECOVERY
Increasing blood flow when treating
injured athletes
By Gina Myers, Director of Research Incrediwear
I
n seeking the best outcome for their clients, athletic
trainers use a variety of modalities aimed at facilitating
recovery and providing the greatest opportunity for
a successful return to sport. Advanced technology and
understanding of the drivers of healing and performance
have opened new frontiers, with some of the best athletes
in the world now playing at the highest level within days of
what would previously have been a career-ending injury.
Since 1978, when Dr. Mirkin invented the Rest, Ice,
Compress, Elevate (R.I.C.E.) method to manage injuries,
R.I.C.E. has been the standard of care and is a universal
approach throughout sport and medical communities.
Mirkin has since redacted the manuscript, admitted the
entire concept was made up before they completed medical
school, and is a vocal advocate against R.I.C.E. and provides
evidence-based approaches to facilitate and improve healing.
A growing body of evidence demonstrates the poor
efficacy and even detrimental outcomes of using this
methodology. An overwhelming lack of clear evidence
in support of the R.I.C.E. approach has steered leading
physicians, athletic trainers, and entire hospital systems
away from the method in favor of approaches that are
shown to support healing and improve outcomes.
CIRCULATION IS THE KEY
Most important among these is the almost universal
benefit that comes from increasing circulation. Why
26 | Training & Conditioning | August/September 2024
is increased circulation important? A closer look at
the inflammatory response to injury reveals both the
importance of a mediated inflammatory response as well
as the importance of avoiding the chronic inflammatory
states that often follow.
When tissue damage or injury occurs, a host of
inflammatory markers and immune modulators are recruited
to the area, delivered by the bloodstream, and released
by the tissue. Subsequent cascades resulting from cellular
metabolites, cytokines, and increased genetic expression
of immune regulators amplify the inflammatory response.
This process continues in a positive feedback loop signaling
more inflammation, ultimately resulting in swelling, pain
from the release of inflammatory pain signals including
prostaglandins, and eventual tissue damage.
One of the most essential functions of the endogenous
immune response to injury is to increase blood flow to the
affected area. The importance of circulation cannot be
overstated. Increased circulation of blood and lymphatic
fluid increases the availability of oxygen, nutrients,
immuno-modulatory molecules, and repair enzymes,
all while removing metabolic waste products as well as
byproducts of tissue damage and regeneration.
Delivery of oxygen and nutrients to the cells promotes
cellular function, energy production by mitochondria
and new cell generation, protein synthesis, and eventual
tissue repair.
August September 2024

Table of Contents for the Digital Edition of August September 2024
