How should I manage my injury initially?
By Physiotherapist Steven Pacini
Nobody likes being on the sidelines as a result of injury. The best way to recover from any soft tissue injury is by using the RICER and NO HARM injury management approach. They help to prevent further damage and will mean less time away from your sport or activity.
- The first 48-72 hours are vital in the effective management of any soft tissue injury.
- Soft tissue injuries refer to all ligament sprains, muscle strains and muscle bruises (corks etc) and most bumps and bruises which occur in sport.
- The immediate treatment is RICER.
- RICER should be initiated immediately after injury and continued for 48-72 hours.
- To ensure a successful recovery, NO HARM factors should also be followed in conjunction with RICER. Early and correct use of RICER and NO HARM factors is essential for the initial management of a soft tissue injury. RICER and NO HARM should be continued for 48-72 hours.
H Applying heat to an injury increases bleeding. Avoid hot showers or baths,saunas,spas, hot water bottles, hot linament or heat packs.
A Alcohol increases bleeding and swelling which delays healing. It can also mask pain and severity.
R Running or exercise increases blood flow to the injured site. This can make the injury worse and delay healing.
M Massage or the use of heat rubs increases swelling and bleeding.
R Rest Place yourself in a comfortable position. Keep the injured area supported. Avoid using the injured area for at least 48-72 hours as continued activity will increase bleeding and damage.
I Ice Apply ice to the injured area for 20 minutes, every two hours for the first 48-72 hours after injury. Ice reduces swelling, pain and bleeding. Ice can be used in the following ways: • crushed or cubed ice in a wet towel or plastic bag. • frozen pea packet in wet towel. • cold pack wrapped in wet towel. Icy or cold water is better than nothing. Caution: Do not apply ice directly to skin.
C Compression Apply a firm wide elastic bandage over the injured area, as well as above and below. Where possible hold ice in place with the bandage. Between ice treatments maintain bandage compression. Applying a bandage will reduce bleeding and swelling and also provide support for the injured area. Caution: Ensure the bandage is not too tight. Some signs of the bandage being too tight may include numbness, tingling or skin becoming pale or blue. If these symptoms and/or signs develop remove the bandage and reapply again firmly but not as tightly.
E Elevation Raise the injured area above the level of the heart at all times. A pillow can be used to provide support and comfort. Elevating the injured area reduces bleeding, swelling and pain.
R Referral As soon as possible after injury arrange to see a qualified health care professional such as a doctor or physiotherapist. This will determine the extent of your injury and provide advice on treatment and rehabilitation required.