A Guide to Acute Injury Management

upmc headerEarly diagnosis, treatment and the appropriate progression of rehabilitation following an injury is vital for any athelete who wants to return to training as soon as possible whilst at the same time, minimizing the risk of their injury keeping them out of races or training any longer than needed.

Whatever the type of injury – a cut, muscle or neural strain, ligament sprain or fracture, many of the underlying stages of healing are the same. The correct implementation of the principles of PRICED and No HARM are essential during the initial 48-72 hours when managing acute injuries.

Initial Caution

Always exclude serious injuries which may require medical attention, before following the PRICED Regime.

Symptoms to be wary of include (not exclusively):

  • Severe pain which does not ease with time
  • Sudden and severe swelling
  • Deformity or misalignment of the injured part
  • Severe loss of the ability to use the part
  • Strong guarding of the affected limb
  • Guarding or crunching at the site of injury

If you have any of the above or are worried, consult a medical practitioner or attend Beacon Emergency department. Beacon Emergency Department operates a walk-in service and is open Monday to Saturday 8am-8pm, excluding bank holidays.

  • Beacon Emergency Department 01-2939999.

PHASE ONE

PRICED

Protect

Once an injury has occurred, it is vital that the affected body part is protected from further injury and therefore, delayed healing.

  • Abrasions / lacerations should be covered
  • The injured part should be supported by taping, bandaging or bracing
  • Weight bearing / use of the body part should be avoided.

Rest

  • Resting the affected body part for 48-72 hours after your injury is vital in order to prevent further swelling, bleeding and damage to the tissues. As a general rule, during the first 48-72 hours, if it hurts, it’s probably not good for the injury.

ICE

  • Apply ice to the area for 10-15 minutes every hour for the first 48-72 hours after injury. Ice helps prevent further bleeding, reduces inflammation and pain and is helpful in shortening recovery time. (Note : using ice for longer than 15-20 minutes can cause the opposite desired effect and result in increased swelling)
  • Use a gel pack from the freezer (obtainable at most pharmacies) or use a bag of frozen peas. Whatever you use, you should wrap it in a damp tea towel. Avoid applying frozen objects directly to the skin as it can cause an ice burn.

Compression

  • Use either a wide, firm elasticated bandage or some correctly sized elasticated tubing. Both should be available from pharmacies. Apply compression above as well as below the actual area that is injured. When using an elasticated bandage, it is important to start applying compression further away from the body and work closer, with slightly less compression the closer you get to the body so that it doesn’t act as a tourniquet.
  • Ensure that the bandage is not too tight by checking for numbness, tingling or a blue tinge to surrounding skin or nearby extremities.
  • If you can apply compression and ice at the same time this will increase the effectiveness of both these treatments of reducing extra bleeding and swelling

Elevation

  • Raise the injured part above the level of the heart whenever possible during the first 48-72 hours. As a general rule it is recommended that you elevate the part for 10 minutes in every hour. So perhaps coincide this with when you are applying ice.

Diagnosis

  • Make an appointment to see a Chartered Physiotherapist (Beacon Physiotherapy 01 2936692) as soon as possible after your injury. Early diagnosis and correct management are the fastest route to recovery.

PRICED should be used in conjunction with No HARM factors

No HARM

No Heat : No hot baths or showers, no adding heat to the area. Heat will increase bleeding and swelling and worsen pain and stiffness during the initial 48-72 hours

No Alcohol : Alcohol increases bleeding and swelling which delays healing

No Running : Exercise increases the blood flow to the area plus can strain the injured tissues (rather than strengthening them) thereby making the injury worse and delay healing

No Massage : Again, this can increase swelling and bleeding by essentially opening up healing blood vessels and stimulating the body to produce more swelling.

PHASE TWO

Rehabilitation & Return to training

In order for your rehabilitation to adequately prepare you for return to training, it will require the supervision and management of a chartered physiotherapist.

The aim of rehabilitation is to restore the athlete to full fitness, which includes:

  • Recovery of full muscle strength (as a rule of thumb, the strength required will be greater than you had previously in order to prevent recurrence of injury)
  • Restoration of full range of movement in the joint
  • Recovery of co-ordination and balance (when a soft tissue is damaged, the ability of the sensory receptors in the tissue to tell the brain where the body part is in space is also reduced and requires specific rehabilitation)
  • Aerobic fitness – this will be maintained initially by low impact aerobic work and progressed to more demanding activities
  • Multi-directional, sport specific drills
  • Gradual re-introduction to training sessions

If all of these requirements are achieved (pain-free) the athlete may return to his or her sport.

Some teams require a player to complete a full fitness testing session before being allowed to return to sport. This is usually decided between the physiotherapist and coach and will be organized by them.

If a full fitness assessment is required this can be provided by the Physiotherapists at The Beacon Hospital or by contacting your local chartered Physiotherapist.


Beacon Physiotherapists are all highly qualified chartered physiotherapists and most importantly dedicated specialists in their individual areas of physiotherapy.

The philosophy of Beacon Physiotherapy is to assess and treat the underlying cause of problem, not just your symptoms.

We are ideally located on the 2nd Floor in the Beacon Hospital.

Our clinic facilities include a very large exercise studio and private consultation rooms. Car parking is available on site and our clinic is wheelchair accessible.

To make a Physiotherapy appointment, please call our scheduling office on 01-2936692

Or visit www.beaconphysiotherapy.ie

 

 

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