Great article. We learned quite a bit about Ken Knight’s theories in modalities class.
I never said anything about the vasoconstriction “pumping” swelling out of the area. I stated that the increase of blood flow from dilation allows an increase of white blood cells to the area which cleans damaged muscle cells and stimulate regeneration of new cells. I know the lymphatic system, not the blood vessels, drain the waste byproduct from the area. Constriction of the blood vessels doesn’t pump anything out of the area, but rather inhibits the amount of blood flow to the area, therefore controlling the amount of swelling (not reducing the amount).
There is a third question here, beyond blood and lymph, which was mentionned on the EMS thread- Biologically Closed Electric circuits. The effect of various modalities on this deepest form of circulation - promoting nutrient and waste transfer by aligning the + and - charge on the proper sides of the Ion Pumps. What will the effect of contrast be here? Might this explain experiences in the field?
Clemson,
you said that anything under 10 minutes is just to help muscle spasm. What is the difference between muscle spasm and inflamation of the muscle. My thinking was that we ice to control inflamation due to microtrauma after a workout so that in controlling inflamation the blood vessels do not constrict. If constricted the blood would have a tought time or rather take longer to get through the blood vessels when trying to transport nutrients for recovery.
So if triggering the Hunting Response eventually causes the blood vessels to dilate which allow more blood to bring nutrients to the area can you explain how this is bad?
I didn’t say that this is bad, but it can be contraindicated when trying to inhibit swelling. If you are not worried about swelling, then heat would be a better option for vasodilation and nutrient delivery. The points is that once the hunting response has set in, the edema control properties of ice would be reduced.
I just finished reading over the EMS thread (very interesting info). As an athletic trainer, I have never used stim for strength developement, with the exception of using Russian stim to reeducate an injured muscle. Everything that I do with EMS is to promote healing.
Most therapeutic units are combo units, which include ultrasound, premod, Russian, IFC, and hi-volt stim. Hi-Volt stim may be similar to the ART physiology described in Supervenom’s article on the EMS thread. Hi-Volt uses the positive or negative charge of transudate or exudate edema (dependant on whether the injury is acute or chronic) to pump the waste byproduct from the injured area. In college, we had a Hi-Volt unit connected to the cold whirlpool. the current was transmitted through the water and only the individual wearing the dispersive pad completes the current.
The only problem with using Hi-Volt for contrast treatment is the efficiency aspect. Every time you switched between hot and cold you would have to reset the machine and it’s setup.
ok then I think I am misunderstanding what is exactly happening when swelling occurs. I thought that when swelling occurs the diameter of the tissue increases but the pathway through actually becomes constricted. Picture a thick hose with a very narrow hole in the middle (the outside casing is thick/sweling)compared to a hose the same diameter but with a bigger hole in the middle (the outer casing is thinner). That is always how Ive thought of swelling. The bigger the hallway the more room blood has to flow hence more blood flow. But when the tissue gets swollwen althoght the foundation is getting bigger the hallway is actually being closed in on.
Sorry if i made this sound confusing. Please help me out.
You are close, the concept is correct but missing a certain perspective. Take your hallway example. Let’s say that the walls are made of a 2 layer surface. The inside layer is a somewhat rigid, but flexible material. The outside layer is made of an elastic rubber surface. If the inner wall tears and an opening is formed, people are pushed into the new hole from the pressure of other people. The outer elastic layer stretches as more people are pressured into the hole. The people inside the hole have nowhere to go, so they begin to pressure back into the walls in all directions. This pressure causes the inside wall to constrict the original hallway and reduce the flow of people. (this is not my best explaination, but hopefully you get the picture)
Now there is a difference from this type of blood vessel constriction and actual vasoconstriction. This constriction by pressure is a natural occurance in the body (one of the body’s processes to control swelling). Vasoconstriction/dilation can be caused by either chemical or thermal means. When applying heat or cold the smooth muscle which makes up the blood vessels will contract or relax to regulate the blood flow. By using heat and/or cold we optimizing the healing environment. These vessel wall changes autoregulated by the body, and can offset pressure from edema.
If this is too confusing, let me know and I’ll reword it.
I somewhat understand I like the example you used. What are these structures of the muscle inner and outter layer called which we are refering to? Is it the epimesium and perimysium or the endomesium?
Also, if you can explain the difference between what is occuring when going into an ice bath during say a 10 minute duration as opposed to when the Hunting Response takes effect that would be great.
With the small size and low stim level required for recovery, why not separate the sessions? (Obviously assuming this is done by the athlete at night away from the clinic setting) I’ve found units as cheap as 80 bucks would do this job, so it’s feasable to have a number of units available. Now we need time limits for the hi-volt. What do you recommend?
The inner wall would simply be the wall of the blood vessel. The outer wall would be the damaged cells and the facia surrounding the injured area.
As the body reponds to cold, the blood vessels constrict so that the blood is more abundant around the vital organs for survival purposes. The cold begins to effect the nerves in the immediate area. The nerves are somewhat thermal regulated. They have an optimal temperature that optimizes impulse rate (this is one reason that a warmup is needed). As the temperature decreases, the impulse slows and can be inhibited. For this reason, cold possesses an analgesic effect. The pain receptors are “numbed” by the cold. All of this will occur within the first 10-15 minutes. About this point, the body realizes that the cold is either:
1.) focused on a specific area, or
2.) not intense enough to cause damage to vital organs.
Once the body realizes that the core is safe, it’s next task is to thermoregulate the area of decreased tissue temperature. To prevent frostbite the blood vessels dilate in attempts to warm the area. At this time, the effects of cold will deminish, but are still present.
If you have access to all the equipment, then I would suggest seperating the two treatments as you vary your regeneration means. The time perameters for hi-volt would be dependant on the other modalities used. Anywhere between 10- 15 minutes is sufficient. The current for hi-volt is constant, and there is no ramping. If you are interested in other perameters (frequency, waveform, etc.) i can look it up for you. The combo units that I use at work are preset, so I have not reviewed that stuff since college.
So to make things simple it seems like the ice for 10-15 minutes controlls swelling and gets things somewhat back to normal for recovery but when the hunting response sets in it causes dilation and makes the blood vessel even bigger than normal which is actual swelling and too much fluid transport.
The blood vessels may not dilate beyond their “normal” diameter, But you understand the idea. The hunting response can cause wanted or unwanted responses depending on the situation.
CWI (cold water immersion) has been researched in great detail and I am confused on what people are saying here. Someone state a temperature, duration, and physiological response that improves a specific therapuetic goal and we can get closer to the truth. I gave a protocol I know will reduce edema and inflammation at deep layers for athletes based on clinical research and my own validation by athletes. A lean sprinter with great capillary density from tempo can get 15-20 minutes of CWI work and achieve great results. I do think going cold first followed by EMS would be effective. The edema research is clear and the voices of athletes loud. Perhaps someone can show me what happens with 10 minutes? Any research? Spasm Quick is tension that slows down repair and recovery, and controlling the muscle tension is vital.
Clemson,
What I know is from college modalities class, so I would have to try and dig up any research you want. As it seems that you have a greater physiological understanding of the cellular response (I’ve only been doing this for 3 years professionally), what do you feel happens in that first 10 minutes of either cold whirlpool or an ice pack? Do you see any benifit to using EMS at the same time as cryotherapy? What we learn in college can often be outdated, so if any of my previous info has been proven wrong or misleading, please let me know.
CNS restoration and muscle repair are not the same as most of us know. The problem is that Charlie will post a protocol and people will do it blinded. It’s like going to a clinic and someone shows a variation of an exercise and now everyone is balancing on airex pads.
In the CFTS, Waldemar explains he has to adjust the length tension relationship with the athlete with massage and hydro/thermo therapy. If one does an ice massage he or she will create a nervous system response that will help lengthen the tissue via two mechanisms. First cold expands molecular structures…but if we did that we would kill off the athlete since 20 degree icebaths for 5 hours will make you freeze like Dr. Evil (no pun Charlie with your avatar) still, the nervous system becomes slightly numb, resulting in relaxation post “thaw”. I do know that cold is necessary to prevent edema formation since only time and low intensity movments can reduce edema when it forms. Preventing swelling is vital after competitions and maximal speed work such as Special endurance runs of high quality.
EMS does work and what is interesting is the research on EMS and Edema post exercise/trauma. For some reason, the researchers love to use blunt weapons to trauma rabbits, rats, and other animals to see if they can help repair them with CWI and other cold means. They even used acid agents to stimulate burns. Using both means the same day is very effective since in reality few athletes will want to go through the burden of multiple cold water immersions. Research from Ho and Townsend state that 4 30 minute sessions provided the greatest response, but looking at the math the significance of only one long session of 20-30 minutes removed the inflammation and prevented nearly as much edema. Add in doing EMS and bodyblade work the next day you can move the free proteins out of the system.
Currently we are not seeing elite athletes taking advantage of heat, cold, EMS, and even rest and nutrition. Dazed mentioned he saw many sprinters at McDonalds multiple times, proof that talent is huge and we are not at a limit in the game of performance…By the way why was he there? Either he eats there, hangs out there instead of starbucks, or shamefully flips burgers there. Still, Dazed made some observations of how athletes are limited to bad devices.
You hit it right on the nose here. I won’t even get started on this matter. As for your first statement, I would hope that most educated people understand that R&R and therapeutic methodology differ tremendously. I am familiar to the therapeutic side of all of this, but the restoration and regeneration (in regards to sports performance) part is fairly new to me. I am in the process of discovering many new techniques.
How does the cold expand the molecular structures? Is this what you consider the relaxation of muscle tonus, or is it the actual muscle fibers expanding? I know all too well the complications that swelling can cause if not controled. All that time and effort put into rehab can be dramticly decreased by simply controling the swelling within the first 24 hours. Are these the only benifits that you see from ice for R&R?
What about performing EMS while doing cryotherapy, as in my previous example of Hi-Volt while in the cold whirlpool? Is this worth it, or is it a waste of time? By doing this you have the thermal regulation of the swelling, added to the electrical charge which mechanally pushes the transudate edema out of the area. Is this removing too much edema, or is it an efficient means of flushing out the waste byproduct of damaged tissue?