Protection – Try to protect the injured body part. For example, wearing a good sports brace, don’t overuse the injured limb, even use a crutch for a few days if you are limping badly. There is good scientific evidence that this is ideal early management for a new injury.
Optimal Loading – Many people think you have to completely rest a new injury; this is not the case. As soon as you are able to it is a good idea to load the injury gently within tolerance (so not wincing in pain, moving very abnormally, guarding it, or limping!). Gradual loading of soft tissue injuries has been show to promote a faster healing rate than complete rest, just don’t load it too much too soon. Let the pain levels and the quality of your movement guide you.
Ice – There's some fresh debate about whether it's best to cool new injuries. Please read my 2022 blog to understand this more. If you do decide to cool a new injury, take a packet of frozen peas, wrap them in damp tea-towel, and apply to the injured body part. Use a pack of peas big enough to cover the painful, swollen part and a bit more. National Guidelines have stated that you can ice an injury for up to 30 minutes at a time but no longer; commonly 10-15 minutes is used. If applying ice-packs always have at least an hour’s gap between one ice pack ending and the next beginning. Icing a soft tissue injury as soon as you can after injuring is proposed to reduce the amount of cells that die as a result of the trauma and therefore limits the total amunt of tissue damage. The ice pack reduces the bleeding and swelling and means that the injury may be less extensive than it otherwise would be. There is now some debate as to whether long term tissue strength may be not quite as good however. After 48-72 hours the rationale for using ice packs for longer than 8-10 minute applications decreases, unless you think you are causing new swelling by loading it too much too early.
Compression – There is low level evidence that applying a compression bandage to an injured body part reduces swelling and helps push swelling away from the injury site. If it is too tight you will get pins and needles or cold, numb peripheries (hands or feet) . Remove the compression if this happens! Compression garments can also be used but need to be good quality purchases to provide enough compression to make a difference.
Elevation – Rest the limb supported above the rest of your body (and above your heart preferably) for periods during the first 24-72hours. Again, there is low level scientific evidence that this helps to drain swelling away from the area and reduces bleeding in the early phases. This combined with compression can help your body clear swelling from a limb.
72 hours after injury is a good time to see a sports physiotherapist to identify what type of injury has occurred, for specific diagnosis, & to build a tailored program for the injury.
Identfying the exact type of pain problem you have is key to optimal management.
Pete Jowsey MSc MMACP MCSP HCPC www.pjphysio.co.uk