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Back in Action: A 5-Step Injury Recovery Plan

At a time when regular exercise among Americans seems to be at an all-time low, those who take the time to work out have reason to be proud. When exercise leads to a strain, sprain, or overuse injury, the pain is not only physical but psychological. Though it's easy to start feeling down when you can't invigorate yourself with your usual walk, run, or swim, don't fall into the "Why me?" trap. Instead, consult your doctor and follow these steps. You'll be hightailing it through the park or pool -- or sharing your war story with your buddies at the gym -- in no time.

1. RICE it.

The immediate response to most common sports injuries is often called the RICE approach. (This isn't the right way to treat a broken bone or any injury that leaves you out of alignment or unable to support your weight; these problems call for emergency care.) RICE stands for rest, ice, compression, and elevation. Rest doesn't mean you take a nap; it simply means you must stop doing whatever led to the injury. As soon as possible, apply an ice pack wrapped in a thin towel (never apply ice directly to the skin) for 20 minutes; continue icing the injured area for 20-minute periods, four to eight times a day, over the next two days. At the same time, you want to put some gentle pressure on the area (that's the compression part), perhaps using a wraparound elastic bandage from the drugstore. (This helps limit swelling, but if your circulation is impaired, you're overdoing it!) Elevate the area, too, so it's above your heart; if you hurt your ankle or knee, you may find it easier to lie down.

This sounds like a lot of things to do at once, but if you take it one letter at a time and remind yourself that you're already beginning your recovery, you won't lose heart. A convenience that any athletic person may want to keep on hand is one of the widely available gel packs that fasten around a knee or elbow with Velcro. You stow it in your freezer, and it covers the "I" and "C" of RICE in one step.

2. Pop the right pills.

Unless your system doesn't tolerate over-the-counter pain relievers, it's a good idea to take a short course of one that reduces inflammation, like aspirin, acetaminophen, or ibuprofen. One or two tablets every four to six hours for five to seven days is recommended. You can stop sooner if the pain and swelling go away. Over-the-counter doesn't mean utterly safe, though; if you regularly take any other drugs (including alcohol), consult your doctor first.

3. Get out the heat pack.

Once the swelling has gone down (usually about 48 hours after the injury), it's time to apply moist heat to your sore spot. That's because you've reached a point in the process where increasing circulation to the area can hasten repair. Use the type of heating pad that comes with a spongy insert that you can dampen with water; a cheaper option (though it won't stay hot for long) is to wet a washcloth and stick it in the microwave for a minute. If you're inclined to try an alternative medicine approach, sprinkle a little comfrey on your warm compress; some herbalists say it relieves inflammation. (Never apply it to broken skin, though.)

4. Try gentle stretching.

You now want to carefully test out your range of motion in the injured area. Ask your doctor, a physical therapist or professional trainer to recommend a couple of simple moves, and do them slowly, never going to the point of pain. If the area feels stiff, apply moist heat before you try anything. Then let your body's reactions be your guide. Stretching will bring down inflammation of the connective tissues and actually speed the healing process.

The old wisdom was that you should stay off a pulled muscle or sprained joint until you no longer felt the slightest twinge, but now you are advised to begin with gentle movement earlier. One study found that people who spent a week or more resting after an ankle sprain had more pain and a higher rate of re-injury than those who were up and moving sooner. So keep on doing gentle movements that feel comfortable. If you accidentally aggravate the area, look at it as a learning experience ("Okay, it hurts when I do that too much") instead of getting upset; apply an ice pack, and try again in a day or so, when it feels better. If you don't feel better in a week or two, or if the pain becomes more severe, call your doctor.

5. Adjust your workout.

As you ease back into being physically active, modify your workouts to avoid re-injury. This may simply mean reducing the length of your sessions or your previous level of intensity, or it may call for switching to an activity that won't stress the vulnerable area. If you're a runner with a hurt knee, for example, you could try cycling, using a rowing machine, swimming, or running in the pool -- whichever feels best to you.

In addition, do some specific strengthening exercises for the muscles that support the area you injured. Again, if it's your knee, you want to build up the thigh muscles (inner, outer, and back) of both legs; balanced strength here can guard your knees against future harm.

Pat yourself on the back. If you're feeling no pain, you did it: You're ready to revel in your favorite workout! Start with a shorter and less vigorous version, if you haven't already been doing that as part of your rehabilitation; gradually work up to your former time span and intensity.

Take a moment, too, to appreciate your body's remarkable healing powers. Getting over an injury isn't exactly fun, but it does renew your appreciation for the pleasures and well-being that an active lifestyle can bring.


American Academy of Orthopedic Surgeons, Sprains and Strains: What's the Difference? October 2007.

U. S. Food and Drug Administration. FDA Advises Dietary Supplement Manufacturers to Remove Comfrey Products from Market. July 2001.

PDR Health. Comfrey.

American Cancer Society. Comfrey. November 30, 2009.

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Sprains and Strains. April 2009.