It can be difficult to know what to do so here is our Clinical Lead Mark Reid with some quick pieces of advice on exactly what you should be doing to manage that injury in the early stages.
For many a decade the common advice that you will have no doubt heard to manage an injury of any sort is ‘RICE‘ – Rest, Ice, Compression, Elevation – but a little while ago this advice was updated to include the term Protection at the front making it ‘PRICE’. And because the medical professions love nothing more than a clever acronym this was then updated again to ‘POLICE’ – Protection, Optimal Loading, Ice, Compression, Elevation.
These updates to the general first-aid advice came about as our understanding of the pathophysiology of injury and the healing process improved. This advice is very general but it should serve you well so I wanted to go through what each section means.
Acute injury? CALL THE POLICE!!!
Protecting the area of injury from further harm is generally wise advice for the first few days after the injury has occurred as this is when the injured tissue is most vulnerable to further injury. Protection may mean temporarily adjusting your activity or avoiding certain activities that might unnecessarily expose is to further injury.
Completely resting after an injury is rarely the best strategy. Research shows that the earlier we begin to put pressure through the injured tissue the quicker it recovers. However, too much pressure and you expose it to greater harm. Try to gradually put more and more pressure through the injured area over time. And let pain guide you – a little bit of pain is nothing to fear, severe pain may be a sign that you’re putting too much pressure through it.
The benefit of ice has historically been oversold. We know now that it has only a mild effect on the amount of swelling after an injury, making it worthwhile but not essential. But what it does do well is reduce the pain in the area for a short time allowing you to practice more ‘optimal loading’. Apply ice to an injured joint for 15-20 min periods, always ensuring you protect the skin with a light towel.
Potentially overlooked as an intervention to reduce swelling the role of compression is to reduce the amount of space that the injured tissue can swell into. A light strapping with an elastic adhesive bandage can help to reduce the amount of overall swelling potentially providing a quicker recovery.
Arguably more important for lower limb injuries than upper limb, the role of elevating the injured joint above the level of the heart is to allow easier drainage of any swelling. If you are going to be resting the area it can provide a little assistance in getting rid of some swelling.
INJURY QUICK WINS
These miniature pieces of advice which are in no way a substitution for an actual assessment and subsequent advice from a suitably qualified professional but they can provide a quick reference on what to do in the case of an acute injury.
Ankle / Knee Sprain – This will often come with a significant amount of swelling and often bruising. If you are unable to weight-bear at all then take yourself to A&E and get it X-rayed to exclude a fracture. If you are able to weight-bear (albeit with significant pain) then aim to minimise swelling by elevating the leg, applying ice and adding some light compression to the area with some strapping if possible. Try and put as much pressure through the leg as pain allows, and gradually increase that pressure as pain eases over the next few days.
Acute Low Back Pain – The vast majority of low back pain, despite its initial severity is absolutely nothing to be overly concerned about. That said there are some signs you need to look out for – pain or numbness / loss of sensation referring into both legs simultaneously may require an urgent investigation, similarly if you experience any acute changes to your bladder or bowel control. In the absence of these symptoms, where the main problem is solely (often severe) pain in the lower back, the key thing is to keep moving! Go for a gentle walk or complete some light mobilising movements lying on your back, little and often is the key to this in the early stages. The worst thing you can do is stop moving, and overprotecting the back by avoiding any movement at all going through it can also delay that recovery.
Shoulder Pain – If it looks visibly deformed then seek medical attention to make sure it isn’t dislocated. However, if there has not been any direct trauma then this would be very rare. As we use the shoulder for just about everything avoiding the painful activities can be difficult. Certainly ignore the ‘elevation’ part of the POLICE advice, that’s going to be of little benefit. Try to gently move it in as big a range as possible. Temporarily avoid the overhead movements. If it’s sore to lie on then try lying on your other side and popping some pillows behind your back to avoid rolling back onto it in your sleep. After a few days of avoiding irritating it further symptoms should start to settle and you should start to try to use it as much as pain allows.
Acute Neck Pain – Similar to the lower back this is often nothing to be concerned about. If you have been involved in a trauma then do get checked out by a medical professional. However, if you’ve just woken up with a bit of a ‘crick in your neck’ then do not panic. These things are common and generally very short lived. Try to gently keep your neck moving as much as possible. Rotating your head left and right little and often, pushing into a little stiffness but not aggravating the pain significantly.