When you suffer an acute injury, how you manage things in the first stages can make all the difference in terms of your recovery. An acute injury is when you sustain a trauma to your body either from your own movement, or from an external force, like rolling your ankle, straining a muscle or falling onto your outstretched hand. An acute injury can be mild, moderate or severe, like a sprain, tear, or fracture, for example.
Despite some good intentions and many people being familiar with RICE (rest, ice, compression, elevation), we often have patients who inadvertently make things worse in the early stages of their injury. Here are some key pointers for those moments after an acute injury to help reduce your recovery timeframes and improve your outcomes.
1. When to go to A&E
If it swells and bruises quickly, or if you can’t put any weight or pressure on it at all afterwards, head to your closest Accident and Emergency clinic to rule out a fracture or significant muscle tear. In the absence of any significant injury, it will be helpful to just get set up with a brace, sling, moonboot or crutches.
Rest is often a hard one to apply but remember, it can be “relative rest” which means you just allow the injured part of your body to be offloaded. In the lower body this might mean crutches or putting your leg up. In the upper body it might be a sling or a splint. Pain is our body’s way of asking us to stop using that area, so avoiding aggravating activities in this instance is wise. It doesn’t always mean that you need to give up any form of exercise. Pool-based exercise or use of a stationary bike can be useful for maintaining fitness while nursing an injury back to health.
3. Ice / heat
If you have sustained an injury like a rolled ankle or a fall onto your outstretched hand and have pain and swelling, there is evidence to suggest that ice can be a beneficial component of your acute injury management and should be applied one to two times daily for 10-20 minutes. If you have sustained an injury like a strain to your neck or lower back and are suffering from pains associated with muscle spasm, then heat will probably give you greater relief. These two modalities can often be used interchangeably depending on which provides the best relief for the individual, but in cases of significant swelling, I would tend to opt for ice.
Physiotherapists cannot prescribe oral anti-inflammatories, but you can buy them over the counter at your pharmacy and even in your supermarket. Some doctors prefer that patients avoid these medications in acute injuries that involve fracture as they believe it hinders tissue repair. Some advocate their use to shorten timeframes and manage pain. The use of these medications should be case-by-case and discussed with your health professional, but if a fracture has been ruled out, it is probably safe to try.
Particularly true in the lower limbs where swelling responds to gravity, a compression bandage can help reduce the pain and loss of range associated with inflammation and assist in the lymphatic drainage up the leg. With rolled ankles, injured knees, calf/hamstring tears and the like, get a compression bandage on them early to prevent having to manage that stubborn swelling down the track.
Massage will not repair damaged tissues. And certainly, deep tissue massage is not advised for an acute traumatic injury. But soft tissue work can be very beneficial in managing range of motion, pain, and reducing secondary muscle spasm. Get a professional to do this one, particularly if you suspect significant underlying tissue damage.
If in doubt, call one of us at Healthzone Physio for a chat about the best place to go, or come in and see us for some early stages of acute care.
Contact HealthZone Physiotherapy today on: (09) 477 2098