The first 48 hours of Injury Management

June 21, 2017

So you’ve rolled your ankle, blown out your knee, fallen on your wrist.

Something. But something bad. Well it feels bad, but you really don’t know.

And it is hard to know. Bad pain and bad damage can feel identical.

So, what do you do?

Firstly, the obvious

Head injury, uncontrolled bleeding, huge skin damage, obviously broken bones, internal injuries, body parts that are detached, non responsive or otherwise.

Don’t muck around, Emergency Department.

But most of the time it’s not that stuff. Incident, pain, swelling, bruising, but your heading home rather than to ED.

In the first 48 – 72 hours after injury your brain reacts to signals from tissue and floods it with all the chemicals it needs to heal. Once they are there, you want them to disappear.

Swelling and inflammation are necessary for healing, but if it sticks around it will delay healing and hurt.

Most of you have heard of RICE, but it isn’t great. We need to be POLICED!!

No, i’m not saying you are all delinquents that need locking up, it’s another groovy acronym.

Protect – If you have damaged something, it needs protection from excessive and continued use. How much depends on what you have done (See D for diagnosis)

Optimal Loading – Again this depends on what you have done. Sometimes optimal is zero, but a lot of the time complete rest or non-weight bearing is bad for healing. (See D for Diagnosis)

Ice – all the time and as often as you can. If you’re serious, wake yourself up and ice it overnight. Like the song says – Ice, Ice, Baby! And not at the pub in the bucket of coronas.

Compression – Carrying some cohesive bandages is a great idea, limit the swelling. Not wrapped in your jumper, at the pub.

Elevate – Body part higher than your trunk. Again, couch any home, not chaise lounge at the wine bar

DIAGNOSIS!!!!!!!! – The human body is amazing in it’s capacity to heal. We at Newcastle Performance Physiotherapy, while very good, are unable speed up this process. The human person is by it’s nature a bit silly and can do millions of things to make this go slower. Here we make sure you know what is wrong, get investigations if you need and are doing the best you can to recover in the shortest possible time for the best possible result.

It used to be RICE, then POLICE now it’s POLICED!! The D is important. Get it looked at.

What not to do – the HARM!!!

No Heat – if you’ve injured yourself keep the hot packs, heat rubs, hot rocks whatever away from it.

Remember damage and pain are different. If you’ve got neck, shoulder, back pain but no traumatic incident, then absolutely heat it up. But things that swell and bleed, no Heat

NO ALCOHOL – Hard but true. A man/woman is not a camel, but if you have inflammation and swelling, booze will effectively turn the taps on to full and you will have a balloon where your knee/wrist/ankle used to be. The worst thing is it only takes a drink or 2! So, if you’re serious about getting back on to the field ASAP – no booze. nil. nada. XXXX gold does not count and should be banned for crimes against taste

No Running (or exercise – but HAEM looks silly)

This doesn’t necessarily mean total bed rest, but if stuff is swollen, painful, bleeding, exertion is going to make it worse. If you can’t afford to not be training – get it looked at!!!! (See D for Diagnosis)

No Massage

“Just rub it out, you’ll be fine” said a million old school trainers but no sports medicine practitioner ever. Massage promotes blood flow, increases transportation of inflammatory markers. Plus if you have damaged something serious, pushing it around doesn’t sound like fun.

Bonus Be Careful Material!!!

Anti-inflammatory medications (NSAIDs) are popular for use with sports injuries, but often they are not a good idea. At all.

Inflammation is part of the healing process, and while you want to go away fast, lots of tissue, conditions and body systems hate NSAIDs. They can delay healing, worsen medical conditions, lots of stuff. Sometimes they will help, but you need to be advised by a professional before taking them.

Remember – Ice, Ice, Baby!!!

The Golden Rule is – If it doubt, get checked out (by Newcastle Performance Physio, but that doesn’t rhyme)

We are so contactable it is not funny – phone, email, Facebook, our VIP client Facebook group “Performance Board”, website message function. Ask the question.

And please please please ask us before organising a scan

Until next time

Dave