An acute sports injury usually occurs suddenly when exercising. Acute injuries usually are associated with a mechanism of injury. There is often a sudden and severe pain that is noticed. Swelling is also often present. The extent of swelling and how quickly it is seen depends on what type of tissue was injured. Tissues with a good blood supply, such as bone, muscle and ligaments, will often swell more quickly than cartilage injuries which has a more limited blood supply. Often the movement of the area is affected as well as a feeling of weakness. In extreme cases visual deformities may be noticed in the affected area. Examples of acute injuries include sprained ankles, a dislocated shoulder and a tear of the anterior cruciate ligament (ACL).
Chronic injuries happen after you play a sport or exercise for a long time. Chronic injuries often present during the exercise or the activity. An aching symptom is often described and there may be swelling observed or felt. Chronic injuries generally are associated with symptoms that have exceeded expected tissue healing time. Prior to sustaining the injury, there may be indications that a problem is developing which can include an increased recovery time after the sport or activity.
Managing your Sports Injury
The initial treatment for a sports injury is to stop the activity. Never try to play through the pain of a sports injury. Continuing to exercise with pain can cause further damage resulting in a longer recovery time.
Some injuries can be managed safely on your own
Some injuries require immediate attention and should be checked by a qualified physiotherapist or medical professional that has had training in assessing sports injuries. If your injury is causing
- Severe pain,
- If you can’t put weight on the area,
- If an old injury starts to swell or hurt as you start to increase your activity level or
- If you are starting to develop changes in sensation in the area a feeling of giving way or being unstable on the area
If you have not noticed the above problems then you may not require immediate attention. The common advice provided for years has been that treatment of an acute injury should include:
Resting the injury
Different injuries will require different degrees of rest. Severe injuries may require a brace or crutches. Milder injuries may require only avoiding the aggravating movements.
Although called into question for routine treatment of all injuries, in the first 48 hours ice can be the treatment of choice especially if there is a significant amount of heat and swelling in the injured area. Ice has a pain numbing effect and will reduce swelling in the area to reduce the pain in the injured area. Care should be taken when using ice on areas with poor blood flow as this can result in a delayed healing response. Maximum cooling is generally achieved within 15-20 minutes of application. Icing can be repeated as symptoms dictate.
Putting a compression bandage such as a Tensor or using a compression type brace can help to support the injured area and to reduce swelling. Your physiotherapist can help you choose the one that’s most appropriate for you and your injury.
Elevating the acute injury assists with reducing swelling. Keeping the injured area above the level of your heart when possible helps to prevent swelling from accumulating in the area, this helps to reduce swelling and pain. The combination of Rest, Ice , Compression and Elevation are often abbreviated to RICE.
RICE or MEAT
RICE is the most common advice given for an acute injury. The belief was that inflammation and pain need to be reduced to allow for a better outcome. This guideline has been called into question with recent evidence showing the benefit of early movement, exercise as tolerated, analgesics to treat pain and treatment focused on improving blood flow to the injured tissues and restoring early movement. This combination of Movement, Exercise, Analgesics and Treatment is abbreviated to MEAT. Research shows a faster improvement with symptoms and earlier return to play with the MEAT protocol for ankle sprains.
Physiotherapy for your Sports Injury
Appropriate assessment by a physiotherapist with training in assessing and treating sports injuries is important to get you back to the activities that you love to do. Acutely injured areas are assessed using techniques to determine the injury source and to rule out injuries requiring further medical intervention. Treatment may be specific to the injured area but may also involve providing you with exercises that will maintain fitness level and conditioning without aggravating the injury. As your pain symptoms reduce more aggressive exercises will get you back to sport conditioning level and will address the flexibility, strength and control of movement required to reduce the chance of re-injury. Your physiotherapist can help you at all phases of the injury.
Prehab before the injury happens
Often flexibility, muscle imbalances and movement restrictions can be contributing factors to the chronic injury or reasons for poor healing from the acute injury. Once an injury has occurred, return to play is determined in large part by the ability of the injured tissue to heal and for pain levels to reduce. It’s often more advantageous to address some of the predisposing factors to injury before starting a new activity, sport or in your sports off-season. Remedial exercises and stretches can often resolve underlying problems before the injury starts so that long absences from your sport and activities can be avoided.
Not sure where to start?
If your pain is not responding to traditional approaches there may be additional factors or compensations that are involved. Our physiotherapists, massage therapists and naturopathic doctors have the training and experience to identify these factors and get them resolved. Get in touch with us to get back in control of your symptoms!