Healing Choices, Part 1: The 4 Modalities of Healing and What to Do First

“My shoulder is really sore, I think it might be injured, what should I do?” Here’s how to approach healing an injury – the 4 modalities I recommend, plus ICE and REST!

“My shoulder is really sore, I think it might be injured, what should I do? Do you think I need to see a massage therapist, an acupuncturist, a chiropractor, or a physical therapist?”

This is a fairly common question for me to get, and probably one most CrossFit coaches and Brazilian Jiu-Jitsu instructors will hear from their athletes. In any contact sport or competitive sport for that matter, there are bound to be sprains, strains, and other injuries. What does not seem to be common knowledge however, is how to treat them and who should treat them.

As an acupuncturist myself, I tend to point my athletes in the direction of the “alternative” therapies listed in the initial question before sending them off to see an Orthopedist or surgeon. For that reason I will focus on those four healing modalities – massage, acupuncture, chiropractic, and physical therapy – for the purposes of this series of articles. (There are, of course, extremely talented healers in all walks of both alternative and Western medicine and I don’t want the choice of focus here to imply otherwise.)

My first and immediate response to the initial question posed is always the same, and comes in the form of two questions:

“Have you taken any rest?”

And then the big one.

“Have you iced your injury?”

This is a lot like your refrigerator repairperson asking you if your refrigerator is plugged in when you call them and tell them it’s not keeping things cold. Let’s start there before we get all crazy with diagnosis’s and referrals to professionals who will ask the same question.

The vast majority of the time, the answer to that question is a blank stare and slightly confused, “No, do you think that will help?”

I had a frustrated athlete come to me last week because his shoulder isn’t healing as fast as he’d like it to. He’s been seeing a physical therapist for a few weeks. Here’s how our conversation went:

Me: “What did your PT recommend that you do?”

Athlete; “He told me to stay off of it for four to six weeks.”

Me: “Well, have you?”
“Sort of” – was what I got back.

“Didn’t you do 100 burpees for time on Saturday?” my brilliant investigative questioning continues.

A sheepish, “Yes,” was his reply.

“Weren’t you just doing heavy thrusters?” (I’m shocked that the Santa Barbara PD detective bureau doesn’t consult me more often)

An even more sheepish, “Well…yes,” was what I got back.

So there we have it.

Please always remember the basics of healing. Pain is not the problem; pain in itself is not something to “cure.” Pain is simply your body’s way of letting you know what you’re doing at the moment isn’t all that awesome and it would like you to take a short break before it needs to make the message louder and more apparent to you.

Rest is the most vital aspect of healing, and one you have complete control over regardless of where the injury is. Rest does not mean four to six weeks of Ding Dongs and Married With Children reruns on the couch, it simply means not directly using the affected area.

Next on the healing spectrum, even before we break out the phone book and start calling doctors is – icing your injury.

Ice is the greatest active healing weapon in your arsenal and one that can be employed both prophylacticly and during the acute or immediate phase of injury. Much of the pain we feel from an injury is due to the ensuing inflammatory response. If you put 20 people, each of whom weigh 150 pounds into a 10 x 10 room, things are going to be tight. If those 20 people suddenly triple in size, there’s going to be some pain.

Icing an injury for 20 minutes is a great way to get that inflammatory response to reverse itself, even if only for a short time. I recommend to my both my patients and athletes the same protocol I follow myself – 20 minutes of ice, followed by 20 minutes in a hot shower, twice a day.

The ice does a great job of collapsing the inflammation and deflating the 20 people in my shoulder’s room. Following the treatment up with some heat (please make sure you don’t burn yourself – wait a few minutes for the sensation to come back to your skin) increases the blood flow to the area, bringing in freshly oxygenated blood and removing any waste that has been trapped by the inflammation. This combination is your own due diligence before reaching out to the healing community.

Most adults have heard of the R.I.C.E. (rest, ice, compression, elevation) principle with injuries, but not many people follow even the first two steps. Make it a habit of utilizing this world wide principle and watch your healing time increase and your time on the bench decrease.

Don’t miss part two – learn when to choose acupuncuture, chiropractic, physical therapy, or massage: Healing Choices, Part 2: Choosing the Right Treatment