Initial Injury Treatment

Musculoskeletal injuries are extremely common in sports. What you do with in the first 24-48 hrs can help or harm you. Immediate first aid efforts should be directed toward controlling hemorrhage and associated swelling. The primary goal directly after sustaining an injury is to reduce the amount of swelling resulting from the injury. If swelling can be controlled initially, the amount of time required for injury rehabilitation will be significantly reduced. The initial management of musculoskeletal injuries should include these 4 techniques: rest, ice, compression, and elevation (RICE).

  1. Rest
    Rest after any type of injury is an important part of any treatment program. Once the body is injured, it immediately begins the healing process. If the injured part does not get to rest and continues to be stressed then the healing process never gets a chance to do what it’s supposed to do. The time for rehabilitation is extended the longer it takes the body to get the healing process started. Give the injured area at least 72 hours of rest before a rehabilitation program is started.
  2. Ice
    The initial treatment of acute injuries should be the use of cold. Get ice on the injured area soon as possible. If heat is used in the initial injury phase then the amount of swelling will increase. The ice/cold will help to decrease pain and promote local constriction of the vessels, thus controlling hemorrhage and edema. The cold will slow down metabolism and the amount of cellular death in the injured tissue as well as help protect the healthy tissue. Ice/cold is also used to decrease muscle guarding which accompanies pain. Its pain-reducing effects are probably one of its greatest benefits. A good rule of thumb is to apply a cold pack to a recent injury for a 20 minute period and repeat every 1-1.5 hours throughout the waking day. Depending on the severity of the injury this process could last from 72 hours up to 7 days if needed. Be careful to not leave the frozen type gel packs directly on the skin for prolong periods of time. The gel has a lower temperature hand stays cooler longer than ice and can cause a burn if left on too long.
  3. Compression
    It is extremely important to get some compression on the injured area soon as possible. Immediate compression on an injured area will assist in decreasing hemorrhage and hematoma formation by reducing the space available for swelling to accumulate. An elastic wrap applied to the injured area can be just as important in the fight to decrease swelling as the use of ice. It may be helpful to wet the elastic wrap to facilitate the passage of cold from ice packs.
  4. Elevation
    Along with cold compression, elevation reduces internal bleeding. The injured part should be elevated to eliminate the effects of gravity on blood pooling in the extremities. Elevation assists the veins, which drain blood and other fluids from the injured area, returning them to the central circulatory system. The greater the amount of elevation of the injured body part the greater reduction in swelling. The injured part should be elevated for most of the initial 72 hour period after injury. It is particularly important to keep the injury elevated while sleeping.

Even with proper conditioning, equipment and other precautions you may still get injured. The initial treatment (RICE) will give your body the most optimal environment for it to do what it does extremely well and heal its self. If you choose to ignore your injury and just hope for the pain and swelling to go away on its own, you may end up with a chronic problem that could end up sticking around for a long long time.

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