What are your thoughts? Why do such seemingly innocuous interventions sooth our patients so?
What can an Ace Wrap really do? As a physical therapist, I see many patients with joint-related complaints, usually pain or feelings of instability Some have seen their PCP or specialist, others came to me first. Most have gotten advice from friends, family, and the dreaded Dr. Google and come to me with ideas as to what is wrong with their body part. Some resort to an old-fashioned Ace Wrap or pull on elastic sleeve-type support that they purchased at a drug store. I was always pretty skeptical about these products, believing that they could offer nothing in the way of real support, but yet time after time my patients tell me stories to the contrary.
“The pain is less”
“I feel like I have more support”
“C’mon, its nothing but an elastic sleeve or wrap. There are no metal stays on the inside/outside of the knee to keep it from feeling unstable”, says I.
But these things work, or seem to work, which makes them work, right? Why so? It could be a placebo effect. They are doing something for themselves that they feel will be helpful, therefore it becomes helpful, which is not a bad thing. The slip on brace or wrap could make them more mindful or cautious about the ways they move, so as not to trigger the pain. But as I have moved beyond the explanatory models given to me for the myofascial release and manual therapy I utilize, I have been given keys to how self interventions like these may work. Readers of this blog will find many past articles where I outline these concepts, as will therapists who have taken one of my seminars. Both an elastic wrap and pull on elastic sleeve provide some measure of grip to the skin via the elastic components of the applied product. This may be little different than the skin stretch I advocate in my classes and that was taught to me by Diane Jacobs, PT. It also greatly resembles the simple method of taping I use for pain. A light skin stretch, neuromodulatory in nature, often lessens pain and can calm the nervous system (Ruffini stimulation decreased sympathetic dominance), so maybe elastic wraps and sleeves do the same?
What are your thoughts? Why do such seemingly innocuous interventions sooth our patients so?
For now,
Walt Fritz, PT
Jesus quoted the saying “Physician cure yourself.”
So having greater knowledge of anatomy and physiology, When we chose to do self treatment, try these appliances. Can you develop a protocol for using them that a client can get the best result from their purchase?
Try applying it in a manner that is contrary to the force usually used in treatment. Does that make it ineffective or aggravate the condition ?
Does the appliance give symptom relief but not reach the cause of the symptom?
Client gets a sling for there arm at the drug store and it takes away the upper arm shoulder pain but it always comes back when they don’t wear it. Their question is why. Your analysis reveals that thy have a long standing antalgic rotation/lean at the lumbosacral junction. Therefor the symptomatic pain is from repetitive abduction/extension of the shoulder to counter balance the center of gravity.
Client education then commends them for finding symptom relief but advises them that if the symptom persists they should seek help to find the cause which is often far removed from the symptom.
PERSONALLY SPEAKING, I sprained my foot last week and have been experimenting as you would expect–gotta’ be able to work, after all.
Compression, compression, compression… works like a charm. It equalizes pressure; It helps the natural inflammation to keep the injury protected from errant movements; It interferes with the “drag” on the touch receptors that movement would create.
That RICE thing–is right on! Believe me. I’ve been working but could not have managed without the good old fashioned elastic wrap!
Great comments and plausible ideas. What folks think the WHY is may have little to do with the real WHY, but our believes drive much of this.