Sport Dimensions

Initial Injury Management

It’s fair to say that anybody who has participated in sporting activity for long enough will most likely have picked up an injury or two along the way. Often sporting activity isn’t even nessescary for an injury to occur… accidents happen.

As a population we’re not all Physiotherapists, Rehabilitation Specialists or First Aiders, however it is of upmost importance to know how to effectively manage these injuries from the moment they occur to the point when you reach professional assistance.

This knowledge of initial injury management is important, as the better managed the injury is in the early stages often directly effects the rate and quality of recovery and repair – in other words the better you manage your injury in the first place, often the quicker you will get better!

So what do we all need to know?

PRICE
Protection, Rest, Ice, Compression, Elevation

Protection: The clue’s in the title for this one. The objective here is to protect the injured part – to reduce the risk of further injury or undue pain. Protection can be accomplished in various ways depending on the body part to be protected. A supportive wrap for an ankle or wrist, crutches for an unknown leg injury, splint for a suspected fracture of the wrist, a sling for an arm, or simply a clean gauze dressing to cover a cut or abrasion.

Rest: In many cases, injuries will require rest they heal, or receives additional assessment. For example if an ankle is sprained in a game, and the player is unable to run, jump and perform skills required for the game, then a period of rest from the sport is required as part of the healing, rehab and recovery process. Rest qualifies as time away from a particular activity to permit recovery. However “rest” DOES NOT mean doing nothing, the term active rest is perhaps more appropriae, in many cases the sooner you get an injury moving (limited by pain) the sooner you can begin an effective rehabilitation program.

Ice: Ice is the body’s friend when dealing with soft tissue injuries like sprains, strains and contusions. When the body sustains an injury to the soft tissue, capillaries are damaged, tissues are stretched or torn, and the the body releases fluids (blood, tissue fluid) into the injured area as the initial response. In many cases the body overreacts and significant swelling and bleeding occur. Excessive swelling can actually delay the recovery and slow the healing process. The goal here is to minimize the swelling, and reduce the pain that follows injury. Cooling of the tissues slows the body’s reaction to the injury. Normally Ice is applied to the area with a thin layer of protection to prevent skin from freezing, for a time period of 10-20 minutes every 2 hours or so. It can be secured with elastic wraps or rolls of thin cellophane wrap. The are many forms of ice or cold applications. I always believed that crushed ice is best, as it conforms well to the body part, is easy to apply. Frozen “blue gel” packs from the freezer at home are very cold, and hold sub zero temperatures longer, creating a greater risk for freezing the skin. Be aware also that Ice directly from your freezer is much colder than ice from your cooler at the field.

Some guidelines to follow when applying ice:

• Time of application can range from 10-15 minutes for thin tissues (ankles), to 20-25 minutes for thicker tissues (quadriceps, hams). Can be applied every 2 hours.
• Use a thin layer of protection between the ice and the skin. Do not overprotect the skin with a thick dry towel, as this insulates the cold too much from the area and no benefit is achieved. A thin damp towel is best.
• Inspect the skin before and after icing.
• Extra protection may be used of bony prominences….areas where bones are just under the skin.
• Special caution should be taken with chemical cold packs from the freezer.
• Ice can be effective for several days after the initial injury, not just the old “24 hrs” that we used to believe.

Compression: Another way to reduce swelling is to apply some form of compression to the injured part. This applies primarily to sprains and strains of the extremities. Remember, reducing swelling means a quicker return to activity. Elastic wraps are normally the most effective way to achieve this compression. The sooner the compression is applied, the more effective it will be. Caution needs to be given to avoid excessive compression which might compromise normal blood flow to an area.

Elevation: This goes hand in hand with compression, and also applies to the extremities. Here we use gravity to slow the flow of fluids to an injured area and therefore reduce the resultant swelling. Elevation, slows the flow of fluids to the injury site, and permits fluids to drain back into the primary circulation of the limb and into the body core.

Following the simple PRICE principal will,  in most cases of soft tissue injury, be the most appropriate immediate injury management strategy to employ until such time the injury is assessed by a professional.