Acute injury management

Unfortunately soft tissue injuries are common in sports and in life. Having some basic knowledge of how to deal with them when they occur can help you recover and get back to injury faster. Often how you manage the injury in the first few days will have a big impact on your level of pain and on your recovery time.

When you suffer a soft tissue injury your body has a well evolved system of repairing the damage. This is controlled by our immune system. The initial response from the immune system is an inflammatory response. Don’t be alarmed, this is normal and essential for healing. The most obviousresult of the inflammation that we can see is swelling. This is caused by a dilation of the capillaries in the area of the injury to increase the blood flow. Along with this increased blood flow the capillaries become more permeable, allowing fluid and importantly immune system cells to move into the injury site. These cells are responsible for removing necrotic (dead) tissue and starting to lay down new connective tissue.

Your initial injury management can have an effect on this response and also have an impact on how we perceive pain associated with the injury. A commonly used acronym to describe the early management of a soft tissue injury is POLICE (Protect, Optimal Loading, Ice, Compression, Elevation). This is a positive step forward from the old RICE acronym (Rest, Ice, Compression, Elevation) which often resulted in people resting and immobilising the injury far too much.

POLICE

PROTECT

Refers to protecting the injury from further damage. Placing excessive stresses on the injured tissue will result in further inflammation and more tissue damage. Protect rarely requires complete rest and immobilisation, it could simply involve stopping your sporting activity and avoiding the most painful activities and movements. Sometimes bracing, crutches or taping could be helpful.

OPTIMAL LOADING

This is the interesting part. Putting forces through the injured area can be useful for the healing process even on day one of your recovery. Complete rest is often not required and performing gentle movement from early on can help to promote healing and reduce pain experienced. All connective tissues require regular loading for them to stay healthy, even injured tissue. Early movement can help to reduce other negative effects that are common with injury such as muscle inhibition, weakness and stiffness. This may involve very gentle and cautious movement of an injured area done for 5-10 minutes every six hours to begin with or protected weight bearing using crutches. If you are unsure of what optimal loading means for your injury, ask a Sports Physiotherapist.

ICE, COMPRESSION, ELEVATION

Apply ice to the injured area for roughly 20 minutes every couple of hours. This is mainly to assist in reducing pain.

Compression of the injured area and elevation can both help to control the amount of swelling. How dilligent you are with these interventions should be based on the amount of swelling that you are experiencing.