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.
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 – 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 say you can ice an injury for up to 30 minutes at a time but no longer, commonly 10-15 minutes is recommended . This should be done in the first 24-72 hours. You can apply an ice-pack regularly but 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 it reduces the amount of cells that die as a result of the trauma and therefore limits tissue damage. The ice pack reduces the bleeding and swelling and means that the injury is less extensive than it would be, so the sooner you ice it the better! After 48-72 hours you don’t need to ice it anymore unless you think you are causing new swelling by loading it too much too early!
Compression – applying a compression bandage to the 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. This helps to drain swelling away from the area and reduces bleeding in the early phases. This combined with compression and ice packs maximises your recovery rate from the injury.
72 hours after injury is a great time to see the physio for a specific diagnosis & to build a tailored rehab program for the injury, but it’s what you do in the first few days that helps change the prognosis for how it will take you to get back rehabbed to training and competition.
Pete Jowsey MSc MMACP MCSP HCPC www.pjphysio.co.uk