Acute Injury Treatment, initial injury treatment (What To Do)

You know when an injury occurs. There may be pain, swelling, bruising or even bleeding. The first and best thing to do is to apply the 5 step PRICE regime. This is the most effective injury treatment protocol that can save you a lot of time, not to mention the pain and frustration that comes with an injury.

It is a tried and tested treatment for reducing pain and swelling to minimize the effects of the injury. It prepares the body for the next stage of treatment in addition to help the healing of the tissue. Many sports injuries such as muscle strains, sprains and fractures heal faster when the PRICE-regiment is used immediately after an injury. Warning

80% of cases that end up at our practice is due to poor management of the initial injury.

Protect

Protect the injured joint, muscle, nerve or tendon from getting worse by using strapping or a brace. Splints can also be used to prevent movement of the injured area and provide support in an effort to minimize the tissue damage. Immediately protect the area until you are able to get to a medical professional.

Protection also includes resting the limp using crutches for the legs and a sling for the arm. We use it to ‘immobilize’ your limbs, by restricting movements and preventing you to use it.

Rest

Forcing yourself to go on when there are signs of an injury is not only damaging to the tissue but also unwise.”No pain, no gain” does not apply here. It prevents healing from taking place.

Rest is important to allow the injured muscle, tendon or ligament to reattach and heal. Try to avoid any activity or movement that produces or brings on the pain for the first 3 days and after that, you need to start moving or other problems will develop.

If you are unsure what to do, rater contact us and we can guide you.

Ice

Cold provides short-term pain relief by limiting the bleeding around the injured tissue. The bleeding from ruptured arteries and veins will cause an increase of pressure surrounding the injured tissue which will also decrease the blood flow around the injured tissue. The first priority is to stop the bleeding as fast as possible.

Wrap an ice pack or ice cubes in a towel, wet the towel and place on the skin. Never apply ice directly to the skin (it can cause burns). Apply the ice for 15 minutes on, 20 minutes off. Repeat 5 times per day for the first 3 days.

Initially the ice will cause the superficial arteries and vein to constrict and close up. This will prevent the blood seeping out into the surrounding tissue. You will also experience a redness and ‘warm’ feeling after the ice as been applied. This is when the body reacts by sending cells to clean up the injured tissue and start repair. Warning

Never apply heat (and heat rubs) to an acute injury in the first 48 hours. The heat encourages bleeding and could be detrimental if used too early.

Compression

Using a Compression bandage, elastic strapping, neoprene sleeve or brace will reduce the bleeding and swelling which occurs when cells and other substances rush to the site of an injury. Applying compression will also help to prevent the blood from pooling in you limbs and reduce the pain. Take care not to over-tighten the bandage, as it will restrict blood flow.

Elevation

Resting with the injured part above the level of the heart is the best means of relieving swelling. In order to effectively use gravity, the injured area must be above your heart to assist in the drainage of excess swelling. For example lie on your back with your foot resting on a chair to drain your legs.

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What you need to look out for

If the pain gets worse within the first 24 hours, we recommend you give us a call and we can give you advise how to proceed.

Danger signs

Severe swelling (not going down)
Visible deformity
Unable to move
Severe bleeding
Redness and puss oozing from skin
Open wound

The Sports Physiotherapist knows

It is important to check with your physiotherapist or doctor as soon as possible. Mild injuries may need no further intervention than the above, but this decision should be made by a professional.

Then we work on the sports field we try to assess the damage right there on the field, because in most cases the swelling can prevent us from testing and even doing scans on the injured area. This is so important because we can immediately determine what structures have been damaged by doing a few stress tests and feeling over the injured area.

When the swelling sets in it gets more difficult to pinpoint the site and structures that were injured, so if you leave it for too long, you’d have no choice but to wait until the swelling has subsided before the treatment can be targeted to a specific structure.

If I do nothing, will it heal by itself?

In our experience patients walk through our doors daily that left their injuries untreated. These patients’ injuries take longer to heal, not to mention the lingering pain and compensatory problems that has developed. It is important to remember that symptoms lasting longer than two weeks are much harder to solve.

If you are unsure what to do, rater call us and we can guide you.

Patients that don’t opt for treatment can develop the following:

Abnormal Scar tissue formation which causes abnormal movement patterns leading to a cascade of compensatory mechanisms.
Joint stiffness due to immobility and causes abnormal joint movement, stressing adjacent joints even more.
Muscle weakness which leads to other muscles working harder to perform that muscle’s function and putting more strain on the surrounding muscles.
Joint laxity that can lead to unstable joints.

Surgery and Orthopaedic conditions we treat

Physiotherapist are trained in a wide variety surgical procedures that require a physiotherapist’s help. Our main function in the team are to ensure the surgery has been successful and to monitor the progress of your condition.

Physios are responsible to guide you through the rehabilitation process and show you what to do and what not. We know what happens during the operation, so we can test the structures that were changed or altered. Our understanding of the cellular and chemical processes that are happening inside your tissue are exceptionally well therefore, we can help you. Note

Surgery is only half way, Physiotherapist help your body adapt to the change

Surgeries that we frequently see in our practice

Knee arthroscopy
Shoulder arthroscopy
Knee ligament repairs (ACL,PCL,MCL,LCL)
Shoulder rotator cuff repair
Knee Meniscus repair
Hip replacement
Shoulder acromioplasty
After open reduction internal fixation of fractures
Knee replacement

Why see a physiotherapist after surgery?

Monitor your progress and make sure your healing is on track
We will warn you of the dangers of certain activities or movements that you should avoid for a few weeks after the surgery
Accelerate and guide the tissue healing using machines like Ultrasound , Laser and Electrotherapy
Exercises to strengthen, shorten and stabilize a joint to restore the normal movement that must take place.
Assess and treat the compensatory movements, muscle spasms and other problems arising from the surgery.
Strap and tape the joint to support and protect it
Acupuncture or Dry Needling
Massage and Soft tissue mobilization
To regain the full range of movement after surgery we show you dynamic, static and ballistic stretches
We will guide you through a weekly progression of rehabilitation exercises to regain full function.
Physiotherapist assist in rehabilitation of surgery and orthopeadic conditions

Most Common Sports Injuries:

Fractures and Rehabilitation

To see our detailed descriptions and recovery times of certain fractures, click here.

PRICE protocol – Summary

Key	Action
P	Protect	Protect the joint by taping, splinting or using a brace to prevent pull on the injured ligaments.
R	Rest	Using crutches with partial weight bearing will rest the joint, muscle, tendon, ligament and aid in the healing. Crutches will help you to get around without putting weight on your leg.
I	Ice	This reduces pain & inflammation and speeds up the healing process. For at least the first 3 days or until the swelling goes down, apply an ice pack for 20 minutes every two hours. Always keep a towel between the ice and your skin (to prevent a clod burn), and press the ice pack firmly against your skin.
C	Compress	This can be done either with taping or tube grip bandage and helps to control swelling. In our experience, taping and strapping is much more effective at preventing certain joint movements compared to generic ankle braces.
E	Elevate	Elevation during rest periods also helps to control swelling, bruising and promote healing. Raise your injured limb above the level of your heart for 15 minute intervals during the day.