Joints occur where two bones meet and are linked with tough connective tissues called ligaments. Joints make the skeleton flexible; without them, movement would be impossible. Joints allow our bodies to move in many ways. Some joints open and close like a hinge (such as knees and elbows), whereas others allow for more complicated movement. A shoulder or hip joint, for example, allows for backward, forward, sideways, and rotating movement.

Muscles pull on joints allowing us to move. They are connected to bones by tough, cord-like tissues called tendons. Strains occur when muscles or tendons are overstretched. Sprains are an overstretching or a partial tearing of the ligaments. Strains usually happen when a person takes part in a strenuous activity where the muscles haven’t properly warmed up or the muscle is new to the activity (such as a new sport or playing a familiar sport after a long break). Sprains, on the other hand, are usually the result of an injury, such as twisting an ankle or knee.

As with muscle injuries, scar tissue will form at the injury sight of a sprain and needs to be aligned with surrounding structures through manual therapy like massage and regular movement exercises to maximize function. However, joint injuries have other issues as well and are more of a challenge in some ways primarily due to how they are fed by the circulatory system.

The muscle belly is the most contractile part of the muscle and gets the best blood flow. The tendon is not as contractile and gets limited blood flow. Ligaments get even less blood flow and they don’t really contract at all… they merely connect. In order for healing to occur nutrients must be coming in and waste products must be taken away but with limited circulation tendon and ligament repair happens very slowly. Although the inflammatory process can be very helpful initially, the body tends to overdo it’s response and the longer waste products and inflammatory substances remain in contact with joint structures, the more irritated those structures can become. So the best way to help facilitate joint healing is to maximize circulation and the best way to do that is with hydrotherapy (or the therapeutic application of hot and cold packs). Hydrotherapy is usually simple, occasionally time consuming but always worth the effort!!

If you happen to injure a joint, any joint, the best thing to do in the first 48-72 hours is RICE

Rest the area as much as possible,
Ice in 10 minute applications to limit inflammation,
Compress the area to add support and
Elevate to reduce circulation.

For a more detailed description of the steps needed to facilitate and speed recovery please refer to the article How Your Muscles Heal: Strains & Tears – How to Accelerate Healing. Almost all the steps are the same to heal muscles as joints. Just be prepared for the process to take longer when a joint is injured due to it’s lack of circulation.

After the initial inflammatory response has subsided, that’s the time to consider using a combination of hot and cold therapy to help maximize circulation INTO the joint and facilitate waste disposal OUT of the joint. This is called CONTRAST hydrotherapy.

The following is a step-by-step guide on how to do it using a wrist injury as an example.

STEP 1 – Standing at your kitchen sink, run the hot water to a temperature that is as hot as you can comfortably tolerate. Place your arm under the flow of water moving back and forth from your fingertips to your elbow for at least 1 minute but not more than 2 minutes. You can stop for a few seconds on the wrist each time you pass over it.

STEP 2 – Continue moving your arm under the flow of water but change the temperature to as cold as it will go. Continue for at least 30 seconds but not more than 1 minute. Again, pause at the wrist each time you pass it for added effect on the injury sight.

STEP 3 – Repeat the above steps two more times. In other words, a total of 3 hot and 3 cold cycles…

HOT, COLD, HOT, COLD, HOT, COLD

STEP 4 – On the last cold application, allow the arm to stay under the cold water for as long as it takes to get a little numb. This may take as little as a minute but possibly longer. The injury will feel cold, then burn, then ache and finally feel a bit numb.

STEP 5 – When you’re done, allow the arm to air dry or, if you must, pat it dry with a towel but DON’T RUB IT. You want the circulation to restore itself without external help.

The above sequence should be repeated daily, preferably at night before going to bed, for at least 4-5 consecutive days. A fresh injury may need less extreme temperatures due to sensitivity but an older or chronic injury will benefit the most from a greater temperature difference between the hot and cold applications. As always, if you are in any doubt as to the nature or severity of your injury, consult with a health care professional first before taking any steps on your own

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