Priority Number 1
The first priority when treating any sports injury is, "Do No Further Damage." So before we get into the treatment of soft tissue injuries, there's one important point that I should discuss first.
Before you start treating any injury, whether to yourself or someone else, first STOP and take account of what has occurred. Consider things like; ..is the area safe from other dangers? ..is there a threat to life? ..is the injury serious enough to seek emergency help? Then, using the word STOP as an acronym;
S: (stop) Stop the injured person from moving. Consider stopping the sport or game if necessary.
T: (talk) Ask questions like; ..what happened? ..how did it happen? ..what did it feel like? ..where does it hurt? ..have you injured this part before?
O: (observe) Look for things like swelling, bruising, deformity and tenderness.
P: (prevent) Remember, do no further damage. Prevent further injury.
Once you've taken a few moments to make sure the injury isn't life threatening, it's then time to start treating the injury. Remember, the sooner you start treating a sports injury, the more chance you have of a full and complete recovery. The longer you wait, the worse it's going to be.
R.I.C.E.R.
Without a doubt, the most effective, initial treatment for soft tissue injuries is the R.I.C.E.R. regime. This involves the application of (R) rest, (I) ice, (C) compression, (E) elevation and obtaining a (R) referral for appropriate medical treatment.
Where the R.I.C.E.R. regime has been used immediately after the occurrence of an injury, it has been shown to significantly reduce recovery time. R.I.C.E.R. forms the first, and perhaps most important stage of injury rehabilitation, providing the early base for the complete recovery of injury.
When a soft tissue injury occurs there is a large amount of uncontrolled bleeding around the injury site. This excessive bleeding causes swelling, which puts pressure on nerve endings and results in increased pain. It is exactly this process of bleeding, swelling and pain which the R.I.C.E.R. regime will help to alleviate. This will also limit tissue damage and help the healing process.
The "How To"
R: (rest) It is important that the injured area be kept as still as possible. If necessary support the injured area with a sling or brace. This will help to slow down blood flow to the injured area and prevent any further damage.
I: (ice) By far the most important part. The application of ice will have the greatest effect on reducing bleeding, swelling and pain. Apply ice as soon as possible after the injury has occurred.
How do you apply ice? Crushed ice in a plastic bag is usually best. However, blocks of ice, commercial cold packs and bags of frozen peas will all do fine. Even cold water from a tap is better than nothing at all.
When using ice, be careful not to apply it directly to the skin. This can cause "ice burns" and further skin damage. Wrapping the ice in a damp towel generally provides the best protection for the skin.
How long? How often? This is the point where few people agree. Let me give you some figures to use as a rough guide, and then I'll give you some advice from personal experience. The most common recommendation is to apply ice for 20 minutes every 2 hours for the first 48 to 72 hours.
These figures are a good starting point, but remember they're only a guide. You must take into account that some people are more sensitive to cold than others. Also be aware that children and elderly people have a lower tolerance to ice and cold. Finally, people with circulatory problems are also more sensitive to ice. Remember to keep these things in mind when treating yourself or someone else with ice.
Personally, I recommend that people use their own judgement when applying ice to themselves. For some people, 20 minutes is way too much. For others, especially well conditioned athletes, they can leave ice on for up to an hour at a time. The individual should make the decision as to how long the ice should stay on.
My personal recommendation is that people should apply ice for as long as it is comfortable. Obviously, there will be a slight discomfort from the cold, but as soon as pain or excessive discomfort is experienced, it's time to remove the ice. It's much better to apply ice for 3 to 5 minutes a couple of time an hour, than not at all.
C: (compression) Compression actually achieves two things. Firstly, it helps to reduce both the bleeding and swelling around the injured area, and secondly, it provides support for the injured area. Simply use a wide, firm, elastic, compression bandage to cover the injured part. Make sure you bandage both above and below the injured area.
E: (elevation) Simply raise the injured area above the level of the heart at all possible times. This will further help to reduce the bleeding and swelling.
R: (referral) If the injury is severe enough, it is important that you consult a professional physical therapist or a qualified sports doctor for an accurate diagnosis of the injury. With an accurate diagnosis, you can then move onto a specific rehabilitation program to further reduce your injury time.
Before we finish up, there are a few things which you must avoid during the first 24 to 72 hours after an injury. Be sure to avoid any form of heat at the injury site. This includes heat lamps, heat creams, spa's, Jacuzzi's and sauna's.
Avoid all movement and massage of the injured area. Also avoid excessive alcohol. All these things will increase the bleeding, swelling and pain of your injury. Avoid them at all costs.
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