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A Language to Diagnose With Kelly Starrett: Part 8 by Kelly Starrett - CrossFit Journal

In HD Videos, Mobility, Reference

December 22, 2011

Video Article

Join Kelly Starrett, owner of San Francisco CrossFit and creator of MobilityWOD, as he teaches coaches and their athletes how to diagnose dysfunction at CrossFit South Bay.

In Part 8, Starrett discusses the RICE protocol to treat acute injury: rest, ice, compression and elevation. Starrett adds the 24-Hour Rule for how to reintegrate after injury.

“Something is good to go pretty much when you can load it up and 24 hours later you still don’t have a problem,” he says.

This test allows you to see if there is any latent swelling. Starrett calls swelling “insidious” and explains how and why it occurs, how it’s helpful and how it can lead to more problems if it persists.

Starrett discusses how to manage swelling appropriately and cautions the use of anti-inflammatory drugs without doctor supervision. He also discusses the benefits of ice and describes his icing protocol. Finally, he suggests using intermittent compression.

“We’ve gotta deal with pain and we’ve gotta deal with swelling somehow, and I want to kind of have the effects of the swelling and the inflammatory response, but I want to kind of minimize the kind of detrimental effects,” he says.

13min 31sec

HD file size: 295 MB
SD wmv file size: 162 MB
SD mov file size: 149 MB

Please note: These files are larger than normal Journal videos. For smoother viewing, please download the entire file to your hard drive before watching it (right-click and choose Save Link As...).

Additional reading: Hamstrung by Kelly Starrett, published July 1, 2007.

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6 Comments on “A Language to Diagnose With Kelly Starrett: Part 8”


wrote …

I'm a firm believer in cold showers. Has a similar effect to ice baths. Even better in winter.


wrote …

Hey, what about hemp ointment?


wrote … are my recovery/mobility SiFu! thanks for all you do sir. Love the chinese spoon torture/therapy :) the sh#t works. my wife loves to do that for me, don't know how I should take that haha.

have a great holiday and new year Team!


wrote …

You're the best K-STAR. I would love to hear more on ice baths. How often, how long, what temp etc. So many contradictory takes on what is effective.


wrote …

Ice is one of, if not the best form of an "anti-inflammatory". Before beginning my practice as a physical therapist, I worked as an athletic trainer for athletes at the University level as well as high school level. Ice baths/whirlpool/slush baths/etc... were a daily event for my athletes. This modality may be used on a large scale, ie full body (minus the head, never a good idea!) to small scale, ie small bucket for isolated joints such as the hand-wrist/ankle-foot. Kelly referenced even an ice cube in a paper towel, paper cup method ("ice massage") if you have some extra paper cups around. There are however, some safety concerns with applying ice, such as duration, area of tissue in contact with cold modality,thickness of tissue, area of tissue submerged in ice bath, medium used between cold modality and skin, type of cold modality being used (reusable freezer packs, ice cube, water submersion, etc...) each have specific properties on how it will effect tissue temp. Before recommending a cold modality to an athlete, research each type and indications/contraindications for them. As Kelly mentioned, you can get burned from cold if the modality is in contact with the skin for too long and/or improperly applied. Know your stuff before advising. Test it on yourself. Experiment with each type so you know first hand what it feels like. You will then be able to describe the sensations that your athletes will go through (especially first timers).
Ice/cold is a great and highly effecting modality to use, especially with the Crossfit athlete. When applied correctly, can aid in tissue recovery, providing an optimal environment for happy tissue!
Common temps ive used with ice baths are around 50-55 degrees. Duration would depend on size of my athlete as well as amount of body actual submerged in the water+ice. ie, A 225# hoss would most likely need to spend more time submerged than a 110# gymnast(that being the only variable) More superficial tissue on a larger individual, which would physiologically take longer to drop the temp compared to a smaller body type. Time wise, again depends on above noted. But, a general time frame for application is no longer than 15-20min. (own personal bias). There is a point at which the tissue has a reverse affect to prolonged exposure to cold as a "protective mechanism" called Hunting response. Also, there are certain medical conditions where ice/cold is contraindicated ie: nerve sensitivity, neuropathy, Raynaud's.
This may seem like quite a bit to know, but again, its the responsibility of the coach to safely and accurately give sound advice to their athletes.
There's more to it than just saying "put some ice on it".


wrote …

love to hear more about compression garments, should they be used after exercise and for how long, when we talk about compression garments do you just mean skins or body science ones? socks, full length upper body or leg ones?

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