Choosing the Right Treatment: Injury Management Techniques
September 7, 2017
When it comes to injuries in gaming, there’s a lot of confusion as to how to prevent and manage issues in the short term. This is a by-no-means-comprehensive guide to when to use various interventions to address gaming-related pain. All of these interventions are to manage symptoms, not to resolve causes. It’s impossible to permanently resolve symptoms without also addressing root causes (such as muscular strength and endurance). Long-term recovery and prevention must also involve training for muscular strength and endurance, but that’s outside of the focus of this article. For now, let’s look at some of the most common ways to manage pain while gaming.
Manage an Injury Using ICE
Ice is used to address pain. More specifically, ice is used to address pain associated with inflammation or swelling. Right after an injury, like spraining your ankle or banging your thumb with a hammer, inflammation serves a purpose. Inflammatory factors are involved in the killing off and clearing out of damaged tissue, which needs to be removed before repairs can occur.
The problem with inflammation is when it lasts longer than the time period when it’s useful (typically, about 48-72 hours after injury). When inflammation becomes chronic, it inhibits healing and recovery, rather than promoting it. When that happens, ice is useful to reduce swelling. It decreases local blood flow, helping to reduce the total amount of fluid in the area.
If you’re having pain because of inflammation or swelling, ice is the right choice. You don’t want to use heat, as that will increase blood flow and result in more fluid, more inflammation, not less. Ice should be applied for 20 minutes continuously. There should always be something between the ice pack and your skin (like a paper towel). You should go through 4 phases of sensation: cold, aching, burning, and then numbness. It is ok and, in fact, normal, to feel some amount of discomfort while icing before achieving numbness.
Leaving ice on longer than 20 minutes or icing without something between the ice pack and skin can result in skin damage. Taking ice on and off repeatedly while icing will result in no useful or meaningful change in inflammation. You can use either real ice or an ice pack, as long as what you’re using is truly frozen (so no, cold water is not sufficient).
When to use HEAT on injuries
Heat is also used to address pain, but, as stated above, should not be used for inflammation-related pain. Heat is better for pain related to muscular tension or tightness, especially in conjunction with stretching or massage. Heat should only be applied for 10-15 minutes, and always with something between the heat source and your skin. Heat can be more helpful in most cases of recovery that are more chronic or have been present for over 6 weeks as this promotes increased blood flow which allows for increased healing.
Hand warmers are one recommendation as they remain portable and convenient and newer models such as the linked Occupa hand warmer come with a variety of temperatures and can be charged at any point unlike old fashion hand warmers that were single use. Another option remains a microwavable hot pack or a hand warming pouch that will now encompass the hands/wrists or arms to keep them warmer for a set duration.
A general rule of thumb is that heat is likely more helpful prior to or during active tasks like gaming or exercise whereas ice can be helpful afterward. It would not be a good idea to use ice before activity as this could put you at greater risk for injury. If you’re a gamer who often have cold hands while gaming then click the link here.
Stretching is particularly effective when done in conjunction with heat. At the very least, stretching should never be done on cold muscles. You should always do something to warm up your muscles and increase blood flow before stretching, either passively (with heat) or actively (with a mobility warmup). If you’re unsure of where to begin then check out this article here.
Generally, when we talk about stretching in the context of gaming, we’re talking about static stretches–holding a position for a prolonged period of time. Static stretches should be held for at least 30-60 seconds without “pulsing” or “bouncing”; they should be sustained and steady. Stretches shouldn’t cause sharp pain or tingling/numbness, and what is “just enough” of a stretch for one person may be too much of a stretch for another person. On any given day, multiple factors play a role in how much is a sufficient stretch; you should never over-force a stretch.
For example: after an outing with friends to bowl or go rock climbing you may feel the forearm flexors to be tight and painful. Stretching in this instance would still be helpful, however you likely would not be able to stretch to the same degree without pain as you could previously.
MASSAGE with tools
Massage is particularly useful for muscles that it’s difficult to stretch, such as back muscles, wrist/finger extensor muscles in the forearm, and the palmar muscles of the thumb (thenar eminence). It can be difficult to massage your own muscles without stressing other muscles, so tools like foam rollers, trigger point canes, or even tennis balls can be useful. Oftentimes therapists will use instrument assisted tools like Graston in order to save our own hands from really getting deeper in there to work the muscle.
Foam Roller
The foam roller is good for the larger muscles of the back or legs, but not quite as good for the upper back and neck muscles whereas instead a trigger point can or tennis ball may be more effective. To use a foam roller simply lay the foam roller on the ground and put the sore muscle on top of this while using gravity and your bodyweight to provide the pressure. Foam rolling can be great to work the legs (quadriceps, hamstrings, calves, and IT band) as well as the back.
TheraCane
A trigger point cane is a curved stick with protrusions that can be used to massage areas of tension. It’s designed specifically for trigger points, more colloquially known as muscle knots, but can also be used to massage tense muscles in general without requiring excessive work or force from other muscle groups. The theracan is nice as it allows someone to get to harder to reach areas that many people are unable to target.
Recommended use: 1x/day for several minutes working areas of the neck/back specifically over tender points
Cupping
Cupping has been around for a while, but was really made popular when Michael Phelps displayed the marks left behind while competing in the 2016 Olympic games. Cupping has shown to help with pain management by increasing blood flow, reducing muscle tension, and stimulating the body’s natural healing processes. Cupping is a safe alternative to other forms of massaging and requires little if any clinical understanding or knowledge to utilize. Cupping tools are generally lower cost at around $15-30 for a nice set.
Here’s how it works: The suction from the cups draws blood to the affected area, bringing fresh oxygen and nutrients to tissues. This helps reduce inflammation, stiffness, and muscle fatigue. It works similarly to deep tissue massage but uses suction instead of pressure and can be passively applied. By lifting the skin and tissue, cupping releases adhesions and knots in muscle fibers. The negative pressure stimulates sensory nerves, which can disrupt pain signals sent to the brain while also releasing endorphins (natural painkillers).
Kinesiotape
Kinesiotape (KT) is another popular tool seen widely around sports with some athletes. Kinesiotape can help manage pain through a variety of philosophies such as providing support to an irritated muscle or tendon, reducing swelling, helping to correct poor posture, and even stimulating sensory receptors.
1. Lifts the Skin to Improve Circulation & Lymphatic Drainage
- The tape’s elastic properties create a small amount of space between the skin and underlying muscles.This reduces pressure on blood vessels and lymphatic channels, allowing better circulation and reducing swelling and inflammation.
2. Provides Support Without Restricting Motion
- Unlike traditional athletic tape, KT tape is flexible and moves with the body while providing stability to muscles and joints. For someone in pain this can be a tool used to help offload the muscles/tendons for the time being and can be better in most cases than a splint as it still allows for use whereas a splint restricts any motion. Imagine that without any support the wrist is doing 100% of the work necessary to move a mouse. Now if someone is in pain, adding tape over and along the irritated muscles/tendons can help to offload the muscle action required. Meaning that now the muscles of the wrist may only be doing 80% of the workload while the other 20% if being supported through the KT.
3. Reduces Pain by Stimulating Sensory Receptors
- The tape stimulates nerve endings in the skin, which can help block pain signals from reaching the brain (similar to how rubbing a sore spot reduces pain). It may also encourage endorphin release, acting as a natural pain reliever.
4. Improves Muscle Activation & Posture
- The tape can be applied in ways that encourage better muscle engagement or relax overactive muscles. This can helps with postural correction and reducing strain on overworked areas.
If you’d like to learn more about kinesiotape then check out this article here.
Massage Gun
Massage guns have been very popular as of late as they provide a nice percussion to the muscle and the tool does most of the work for you. Similar to other forms of massage the idea is to increase blood flow, decrease stiffness, and bring more oxygen and nutrients to sore muscles. A massage gun is likely not something to be used on the hand or smaller areas of the body as there is less muscle or tissue to work on. One mistake that some will make is massaging over joints without much soft tissue covering. In this case it is unlikely for it to feel good or even be helpful at all and may even make pain worse. Massage guns can range significantly in price finding some for as cheap as $30 where some may range up to a few hundred dollars.
Recommended use: 1x/day for several minutes working areas such as the glutes/hamstrings, calves, quads, check (pec minor), forearm, and back.
Tennis/Racquet Ball
A tennis ball or racquet is also a useful option, and one that’s slightly more portable for tournaments. Place the ball between your back and the wall, and use your own body weight to apply pressure. You can also use a tennis ball to massage your forearm or palm muscles; use small, slow circles. Be careful not to apply too much pressure, but also the pressure should be significant enough to be somewhat uncomfortable. Tennis or racquet balls are also nice because of ease of accessibility considering how cheap a pack can be.
Recommended use: 1x/day for several minutes working areas of the neck/back, forearm, or palm specifically over tender or stiff points.
Baoding/Golf Balls
Baoding balls or golf balls can also be used in place of a tennis ball for hand and forearm massage, as well as for hand strengthening exercises. However, you need to be even more careful with these, as they have significantly higher density than tennis balls and can more easily cause bruising.
Recommended use: 1x/day for several minutes working areas of the forearm and hand specifically over painful or stiff areas.
Instrument Assisted Tools
Similar to the purpose of baoding balls or tennis balls or other tools listed above these tools are intended to make the massage easier on you! Oftentimes in rehab a therapist may complete some massage as part of their session using tools such as Graston or GuaSha. Through using tools such as this we are able to get deeper into the sore muscle/tissue and create microtrauma to the body. This then leads to a cascade of benefits from increasing blood flow and oxygen to the area while breaking up fascia restrictions. This can help with feeling looser and having less pain following. Instrument assisted soft tissue mobilizations (IASTM) tools like Graston can be very expensive however this is not a necessary purchase and can just as well get by using a GuaSha tool as well which now is around $10.
Recommended use: 1x/day for several minutes working areas of the forearm and hand specifically over painful or stiff areas.
- Ice: use for acute or inflammation-related pain; 20 minutes continuously
- Heat: use for chronic or muscle tension-related pain; 10-15 minutes continuously
- Stretching: use for muscle tension after muscles are warmed up; hold 30-60 seconds
- Massage tools: use for muscle tension after muscles are warmed up; have care for bruising and select based on recommendations however for some it may come down to personal preference
These are tools at the end of the day and often go into assisting in one’s recovery as well as future prevention. Hopefully this article shows you a variety of ideas that you may have heard of or known about, but found yourself not knowing the “why” it works. Make sure to give some a try and find what works for you!
Reminder, injury management techniques like these shown here can be effective and helpful, however they will not be the cure for the issues at hand. This will still require exercises to be a part of the program to help aid in recovery through building muscular endurance or working to stretch tight muscles. If you’d like to learn more about effective exercises to complete to actually address the cause then check out the link here.
Otherwise feel free to check out our Troubleshooter program below.
Disclaimer: The information provided here is made available for the sole purpose of providing general information about ergonomics. It is not intended to diagnose or treat any injuries, illnesses, or conditions, nor should it be interpreted as such. If you are experiencing pain, excessive fatigue, or other health issues, consult a medical professional in person. The information provided by the author and contained in this article does not serve or purport to serve as a substitute for the advice of a qualified practitioner.
ReferencesCupping for Patients With Chronic Pain: A Systematic Review and Meta-Analysis
Cramer, Holger et al. The Journal of Pain, Volume 21, Issue 9, 943 – 956
Managing your pain
Manage an injury using ice
When to use heat on injuries
Stretching is important
Massage with tools
Conclusion
References