What is Swelling? This is a very complex question with a variety of complex answers.
Swelling is essentially an excessive amount of fluid within a body’s tissue in response to some form of stimulus.
Acute trauma can cause swelling.
The swelling is part of the inflammatory process and is commenced by cells called dendrites and macropahages, that are already present in tissue. These cells cause vasodilation, which means dilation (opening) of the blood vessels. This allows more blood flow to the area (causing increased redness and heat).
With the increased flow through the blood vessels and increased permeability, there is leakage of plasma proteins, and this ultimately settles in the injured area and forms what we know as swelling or edema.
The most basic definition of swelling is that there is too much fluid for the tissue to be able to absorb. This is why the swollen area is larger than an unaffected limb. The swelling causes reduced range of motion too, due to the area not being able to move normally. The swelling also can cause pain, as there is an overload of stimulus to the nerves in the area, and they become hypersensitive. A smaller stimulus than usual is required to cause pain when the nerves are hypersensitive.
If an area is swollen, ultimately this will reduce mobility and cause an increased level of pain. This is why we use the RICE (Rest, Ice, Compression, Elevation) principle to reduce the amount of swelling and limit the inflammatory process as it begins, so that there is less fluid to work out of the area. This way a person can regain mobility at a much faster rate, not have the same amount of pain as when no RICE is done, and have a better functioning outcome.
RICE stands for Rest to unload the aggravated tissue; Ice to vasoconstrict, which is the opposite of vasodilate (Vasoconstriction compresses the blood vessels, reducing the increased blood flow and reducing the amount of plasma that leaks, reducing the amount of swelling); Compression constricts the area and forces out the fluid; Elevation then drains the fluid towards the heart, which simply acts as a pump and pumps the extra fluid to other areas of the body where it is found to be a waste product and expelled.
RICE is vital within the first 72 hours of when the inflammation begins, and the swelling will be most active. If you are adherent to the RICE principal, you can limit the swelling, improve function and return to normal activities as soon as the tissue has healed or been rehabilitated enough to withstand the load and force that motion and movement places upon it.
If you have questions about swelling or RICE, please contact me at Luke@JointVenturesPT.com.
Reducing swelling is not just to make the area appear better visually. The processes listed above create a chain of events that are inhibitory and slow all healing. If you have acute trauma, limit the swelling to expedite your road to recovery and create the best healing capacity you can achieve.