True story: one day I am hiking the mountains of western Montana and standing at the top of one wondering why so many of the trees are dead. I hear a thunderstorm in the distance and realize I am standing on the top of a lightning rod and that is why all the trees are dead! I run full blast down the mountain. Now it’s not a real big mountain and no way do I get completely to the bottom, but by the time I get out of dangers way, my hips are killing me. I’ve always been prone to hip arthritis; my mother had both replaced. Swimming seems to keep mine wealthy. Anyway, at the time I’m swimming at a health club that has a small cold pool: 55 degrees. I immerse myself to the waist in this pool: it’s like my whole body has been placed in a vice. The pain is incredible for a few minutes then not too bad. I get out into a warm pool. My body turns vibrant red as blood flows into the area. I repeat the cold pool, warm pool a couple more times; by the end of it all my hips are fine. So what’s going on?
There are three sets of blood vessels supplying your body: arteries, veins and lymphatics. These also directly supply the joint capsules and their associated fluids, synovial fluid. Ice water, cold, cause vasoconstriction of these vessels; heat causes vasodilation. So imagine a vascular pump pushing fluid out and allowing new fluid to come in. This is actually what happens in a joint.
Now arthritis, at least in horses, is primarily traumatic in origin. Pounding on the joint irritates the cartilage which produces inflammatory enzymes which not only cause pain and joint swelling, but more inflammation which most importantly leads many times to degradation of the joint. Although humans, such as myself, can suffer from traumatic arthritis, the most serious is rheumatoid arthritis, which is different all together as the body actually attacks itself. That is a different type of arthritis.
So ice, and mixed with warmth, actually flushes these inflammatory enzymes from the joints not only alleviating the inflammation but also preventing further inflammation. That is why old school racetrackers have all their horses practically living in an ice filled turbulator. Swimming, as alluded to, a passive non-weight bearing form of joint movement, also helps to flush out old fluid and bring in new healthy fluid. Of course, new school horsemen often resort to anti-inflammatories; some directly in the joint and some systemically. And there is no doubt thoroughbred racehorses get traumatic arthritis, particularly the hocks and not uncommonly the coffin joints, as well as the critical areas: the knees and the ankles. We will cover these medications and joints, and how they are affected in future readings.
April 28, 2017
H.O. Ferguson, DVM