Sports Injury Treatment
The most common sports injuries are bruises, muscle strains and ligament sprains. This sports injury treatment guide is intended to provide information to help the injured recreational athlete understand the first of three stages in the process of healing sports injuries – inflammation – and the treatments available to minimise the time that they are out injured.
Note: This guide focuses on more minor soft tissue sports injuries, as more serious sports injuries should be dealt with by medical staff in a hospital. Regardless of the severity of injury, rehabilitation of a sports injury should always be supervised by qualified medical professionals (doctors, physiotherapists or athletic trainers) to ensure patient safety and a fast return to sports. From an athlete’s perspective, inflammation is characterised by pain, localised swelling, heat, redness and a loss of function.
The Body’s Response to Sports Injury
A bruise or ‘contusion’ is damage to small blood vessels which causes bleeding within the tissues. A muscle strain is a small tear of muscle fibres and a ligament sprain is a small tear of ligament tissue. The body’s response to these sports injuries is the same in the initial period immediately following the traumatic incident – inflammation.
All of these traumatic injuries cause damage to the cells that make up the soft tissues. The dead and damaged cells release chemicals, which initiate an inflammatory response. Small blood vessels are damaged and opened up, producing bleeding within the tissue. This causes localised swelling. In the body’s normal reaction, a small blood clot is formed in order to stop this bleeding and from this clot special cells (called fibroblasts) begin the healing process by laying down scar tissue.
Too much of an inflammatory response in the early stage can produce too much swelling and scar tissue, which means that the healing process takes longer and a return to activity is delayed. The sports injury treatments described in this guide are intended to minimise the inflammatory phase of an injury, to limit swelling and scar tissue formation so that the overall healing process is accelerated.
What can you do?
During the early stage following a sports injury the principles of treatment are the same for most injuries. They are given the acronym ‘PRICE’, which stands for:
These principles of treatment will be adapted by the healthcare professional treating your injury, depending on the exact injury that you have sustained. Your therapist will also give you advice to follow at home, such as which position to rest in and which specific movements to avoid.
The PRICE protocol is continued while the pain, heat, redness and swelling symptoms of inflammation are still present. These symptoms should improve day by day when following the PRICE protocol. Any injury which does not respond to the PRICE protocol treatment should be reassessed by a doctor.
The injured tissues should be protected from further damage. A Removable Plastic Cast is ideal for foot injuries and ankle injuries. It provides the same protection as a plaster cast but it is lightweight and can be removed by the patient.
All English Premier League football players use removable plastic casts when they suffer a significant ankle and foot injuries. In the case of more severe injuries, crutches should also be used.
Knee injuries can be protected with the use of a suitable knee brace. Wrist braces are available for the protection of wrist & hand injuries.
Rest from sports is essential, but even walking on a sports injury may cause further damage and should be avoided if it is painful. Pain relieving medication prescribed by a doctor may also be necessary.
Elite level athletes use ice in the treatment of injuries in order to get fit as soon as possible. Ice therapy provides numerous benefits:
- Ice therapy relieves pain by slowing down the rate at which pain signals are sent to the brain via nerve endings and by providing an alternative stimulus to the brain other than the painful stimulus from the injury.
- Ice therapy causes blood vessels to constrict, therefore reducing blood flow from damaged vessels.
- By reducing blood flow it decreases the amount of swelling in the injured part.
- Ice therapy cools the tissues, which reduces the metabolic rate of inflammatory chemical reactions. By slowing these inflammatory reactions, ice therapy decreases ‘secondary cell destruction’ which is the death of cells surrounding the injury that weren’t directly damaged by the initial injury. This restricts the tissue damage to the smallest possible area.
Various methods of applying ice therapy:
Instant Cold Packs
Instant Cold Packs don’t require any freezing, so they can be easily transported and stored. A chemical reaction causes them to be become instantly cold. They are ideal for instant pain relief when you’re on the move.
A reusable, fabric Ice Bag can be filled with ice cubes, crushed ice or ice water, for the safe application of ice therapy without skin burn.
Reusable Hot/Cold Packs
Reusable Cold/Hot Packs can be warmed up or frozen, and the special gel they contain then retains its temperature for around 30 minutes, making them great for home use. To avoid ice burn, the ice pack should be covered by a cloth that has been immersed in cold water.
Hot/Cold Therapy Wrap
A Cold/Hot Therapy Wrap can be used to secure ice packs in place, making the ice therapy much more effective. They also avoid the risk of ice burn without the need for wrapping the cold pack in a cumbersome cloth.
Continuous Ice Therapy & Compression Device
The Aircast Cryocuff is the most effective method of providing ice therapy and eliminates the risk of ice burn and peripheral nerve damage. It can provide continuous ice cold water and compression for 6 to 8 hours and significantly reduce pain and swelling.
It is the ultimate ice therapy home treatment and the professional’s choice for foot and ankle injuries, knee injuries, shoulder injuries and wrist and hand injuries.
Ice application relieves pain and is thought to reduce bleeding in the damaged tissue. The duration that ice is applied depends on the area of the body that is injured. Generally, for a muscular strain, ice is applied for 20 minutes with 2 hour intervals in between.
Dangers to be aware of:
Never apply ice directly to the skin as it can cause an ice burn. Ice should not be applied to the following vulnerable areas, as it can cause damage to peripheral nerve tissue:
- the neck
- the upper part of the collar bone
- the bony aspects of the elbow
- the front of the hip region
- the outer side of the knee
Ice therapy should not be applied to the kidney region, under the back of the ribs.
The use of ice therapy should ideally be under the direction of a Chartered Physiotherapist and should be avoided where patients have extreme reactions to cold, have high blood pressure, impaired sensation or circulatory problems.
A swollen ankle or swollen knee is a sign of a significant sports injury. The swelling may be caused by bleeding in the joint or inflammation of the joint. If this swelling is allowed to consolidate it can produce excessive scar tissue which seriously lengthens the rehab period.
Compression during the early stages helps to resolve swelling and is essential for a good outcome. Compression is provided for the ankle by the use of a Removable Plastic Cast which has inflatable air cells to massage out swelling, together with intermittent use of an Aircast Ankle Cryocuff to provide ice and compression. Alternatively use the PhysioRoom.com Sprains & Strains Repair Kit for ice and compression during the early stages following injury.
A Cohesive Bandage is ideal for providing compression to any injured body part. Cohesive Bandage conforms to the body, but doesn’t stick to skin or hairs, making it the ideal choice for applying a compression strapping. Gentle compression is all that is required. Circulation and sensation should not be impaired by a compression strapping.
By elevating the injured body part above the level of the heart it makes it easier for blood and tissue fluid to drain away from the injured area. This prevents a build up of fluid and is particularly important for foot and ankle injuries.
Elevation also relieves pain. By helping to drain fluid, it reduces the pressure within the tissues and relieves compression on nerves that would be very painful if the part was not elevated.