Initial Injury Management - Self Help Guide Part 1
Updated: Aug 3, 2020
Hi all! This is the second blog of our 'Self Help Injury Blogs'. Advice without the marketing!
This time, we are talking about managing injuries inside the first 24-48 hours and WHAT TO DO! This will be helpful if you a parent looking to manage your child's injury or even your own injury, before you are able to see a specialist!
WANT A QUICK SUMMARY? Scroll straight to the bottom of this blog!
Your probably telling yourself, "well its RICE? Rest Ice Compression & Elevation". Things have changed a little since the olden days of frantically looking for those frozen peas in the freezer and considering whether roasties will make the cut instead! Today, therapists are more inclined to use POLICE. No, this doesn't include calling 999 but instead thinking about the addition of 'Protection' and 'Optimal Loading'.
A brief period of immobilisation (casts, splints, rigid braces) is believed to be helpful by preventing excessive blood and other injury healing chemicals rushing to the area (haematoma). If the excessiveness of the haematoma isn't reduced, it could be likely that the scar within the connective tissue (muscle, tendon) could be unnecessarily larger. Although it is beneficial to do this, excessive immobilisation (i.e. too long) can be detrimental and cause prolonged immobilisation stiffness and muscle strength losses. Up to 48 hours of immobilisation is usually the sweet spot however, you will then need to see an MSK specialist who will then be able to assess the injury and determine if it may require longer.
This has replaced 'rest' in our acronym. This is because as previously mentioned, too much rest is actually detrimental for the optimal healing process. This section explains that essentially, it is beneficial to get the limb moving and taking very small amounts of weight early to help with things like tissue regeneration, reducing swelling and recovery time. This not only means that you lose less muscle strength but you also can get back to your normal functional activities, like working, driving and walking, earlier than when you may have had the limb in a cast for too long, and that's good right? Pain free movement and weight baring is great for injuries HOWEVER, away from basic stuff, you may need to see a specialist to assess the current level of damage and discuss what activities may be detrimental to the healing process.
Ice Ice Baby! This stuff is great and has been used for years on injuries like ankle sprains and shoulder injuries for pain relief. How does it work? Its believed that ice decreases swelling via vasoconstriction (narrowing of the capillaries) and also creates something called 'analgesia (an-al-jeesia)' this is the reduction of pain sensation in a localised area. Ice (within a bag with cloth separating the skin and bag) should be applied for 20mins every 2 hours, for the first 24-48hours after an injury (10 mins on, 10 mins off). There are a few cases where this may differ (for example Raynaud's Phenomenon) so getting in touch with a therapist if your not sure, is a great idea.
As part of the original RICE protocol, this is used to help reduce the amount of excessive swelling but keep the correct pressure inside the injury area helping the healing process. You can combine this compression with things like ice bandages, but applying pressure with ice within a bag works just as good.
Elevating the limb helps reduce the accumulation of fluid. This is traditionally achieved by making sure the limb is elevated higher than the pelvis.
P - Ensure you try and immobilise the injured limb for up to 48 hours by either using a strapping/brace or simply moving the area a little less than normal, especially staying away from painful movements.
OL - Don't fully stop using the limb, keep it moving within pain free ranges and try and put some weight on it if you can.
I - ICE the area for 20mins (10 mins on, 10 mins off, then back on for a further 10mins). Do this every 2 hours or until the pain has reduced significantly.
C - Use compression sleeves, socks or straps if you have them handy.
E - Elevate the limb if possible but don't forget to keep it moving.
Completing these steps will help you onto the road of recovery! If you have any worries within the first 48 hours or indeed after this time period, don't forget to go and see a specialist.
*Disclaimer: The information which is summarised herein does not constitute professional advice, injury diagnosis, treatment or rehabilitation and is general in nature. It does not consider specific circumstances and the information within should not be acted on without an appointment with a qualified musculoskeletal practitioner. All information included in this, and future blogs, is for entertainment purposes only.