MANAGING ACUTE SOFT TISSUE INJURIES BY SUSIE MACPHEE
Ouch! So, you’ve just rolled your ankle, pulled your hamstring, or tweaked your shoulder. The question is… what do you do next? Well, the first step is to determine if this is something that needs immediate further care or diagnostics. Some signs that an injury is significant and will need follow-up at an urgent care facility are as follows: there is sharp unrelenting pain; sudden significant swelling with heat and immediate discoloration or that causes the skin to appear “glossy” or “shiny”; pain that makes you feel nauseous or light-headed; change in sensation to the area such as tingling, numbness, or radiating pain; or the inability to bear weight on an injured leg. If any of these are present, or you are unsure, you should access an urgent care facility as soon as possible.
Once it has been determined that your injury does not need immediate medical care, and movement will not cause further damage; it is time to decide how you are going to manage it. In order to know what to do, it can be helpful to understand what is happening in your body when you get injured.
When a muscle, ligament, or tendon is injured the body immediately begins the process of repairing that damage. It does this the same way it would fight an infection, by sending cells and proteins to the affected area to begin to repair the damaged tissue. The first phase of healing is called the inflammatory stage. There is increased blood flow to the area to help transport the inflammatory cells to the injured tissues. Swelling occurs after the inflammation response because there is an accumulation of waste such as dead cells and cellular fluid resulting from the injury repair process.
So now that we know what is happening, what is the best course of action to help aid recovery? Common practice has been to use ice, anti-inflammatories and rest to help reduce pain and swelling. However, these strategies can decrease the inflammatory response, limiting the effectiveness of the body to repair itself. Instead, there are ways to care for your injury that will help the healing work.
The first step is to stop exercising or activities that could cause further damage to the area. If walking is too painful, crutches may be needed to help you get around. If wrist, elbow or shoulder movement is painful, avoid carrying heavy loads. If you are able to adjust your work and day-to-day activities for the first few days following an injury it can help recovery in the long term.
This doesn’t mean that you should stop moving the area altogether. Pain-free range of motion activities early and often will help your body do the work of clearing out excess fluid to allow for the next stage of healing to begin. The key to these movements is that they need to be within a range that does not cause or increase pain, so even if you can’t move very much it is still good to do it. As well, moving the body parts that bracket the injured area can help. For example, if your ankle is injured, moving your toes and knee will help.
Other strategies that you can try include compression, such as with a tension bandage. Compression should not be applied too tightly, and should be removed at night. Elevation of the injured area is also tolerated well, especially for injuries to the legs. A great trick to elevate the legs without having to have your feet on a bunch of pillows, is to place some towels or pillows under the end of your mattress instead.
Managing the pain of your injury can be done with short periods of ice, under 10 minutes, if you find that it feels good. As well, analgesics that are not anti-inflammatory can help with pain management. Talk to your doctor or pharmacist if you are unsure of what to use.
If you have been injured and need help figuring out the best way to manage your recovery, an assessment with a healthcare professional such as the ones at Bragg Creek Physiotherapy can help you determine the next steps.
Susie MacPhee, BKin, CAT(C)
Bragg Creek Physiotherapy
www.braggcreekphysio.com
