Swelling

Swelling is one of the body’s common reactions to injury.

But what is swelling?

It’s a collection of excess fluid that leaks out of the body’s blood vessels into the spaces between cells. It tends to accumulate in internal cavities within the body, like the area just in front of the bone on the side of your ankle when you have an ankle sprain (for you anatomy nerds: it’s called your sinus tarsi and it’s located anterior to your lateral malleolus). Despite the bad rap that swelling often gets, it’s necessary. It can help to protect the injured body part from further injury, and it kick-starts the healing process.

Now, swelling can identified as either acute or chronic.

Acute swelling refers to the swelling that is associated with acute injuries, meaning that it’s the swelling that shows up within the first few days after an injury (like an ankle sprain). Acute swelling is usually what people think of when they think of “swelling.”

Chronic swelling is the term used to describe the excess fluid that lingers beyond the normal period of time that it takes to get rid of the initial swelling. This happens when the body does not heal properly. In these instances, the acute swelling starts when the injury happens, but it doesn’t effectively get the entire healing process started or the swelling interferes with the body’s normal way of healing. The exact processes inside your body that transition from acute swelling into chronic swelling aren’t exactly known. However, there seems to be a correlation between overuse of the body part in question and the presence of chronic swelling.

Medically speaking, there isn’t any specific timeframe that identifies the difference between acute swelling and chronic swelling. Generally speaking, sports medicine practitioners identify swelling as chronic when the normal stages of healing don’t follow the typical progression. Also, chronic inflammation can be identified by its most notable distinguishing characteristic: it is REALLY hard to get rid of once it has set in. Chronic swelling typically does not respond well (if at all) to treatments, either physical (massage, elevation, ice) or pharmacological (medication, including anti-inflammatories).

So, why do I hear people talk about swelling like it’s a bad thing?

Swelling becomes a problem when the body doesn’t follow the normal inflammatory response and healing process. When this happens and the body doesn’t get rid of the initial swelling from an acute injury, further pain and injury can result. Extra fluid in the area puts pressure on the injured tissues, surrounding healthy tissues, nearby nerve endings, and blood vessels in the area. This increased pressure slows down the healing process and can separate tissues. Additionally, swelling can restrict or completely shut off control of the nearby muscles, interfere with muscular reflexes, increase pain perception, and interfere with the body’s ability to get adequate nutrition to the injured area.

Swelling is often treated through the use of anti-inflammatory medication and RICE (Rest, Ice, Compression, Elevation).