Sports Injuries, Soft Tissue Injuries and Early Phase Treatment
A guide to cutting your recovery time by days, if not weeks!
by Brad Walker | First Published August 26, 2001 | Updated September 14, 2017
I get a lot of questions from people asking about specific treatments for sports injuries, like running injuries and other common pulled muscle complaints. The unfortunate thing about most of these requests is that the injury occurred some time ago. This time lapse between the injury occurring, and treatment sort, is the biggest stumbling block to a full and complete recovery.
If you suffer from sports injuries or are seeking to prevent their occurrence it is important to follow the information in this article. In addition, adding a few simple stretches to your fitness program will also help. To get started on a safe and effective stretching routine that’s just right for you, check out the Ultimate Guide to Stretching & Flexibility.
As always, before I sit down to write this newsletter, I like to spend a few hours surfing the net for information that relates to the topic I’m going to write about. In most cases, I find a great deal of useful information that relates to what I’m looking for; but not this time.
What I did find, was a lot of information which related to treating specific sports injuries long after they’d occurred. However, I found very little information relating to the immediate treatment of sports injuries. This was quite disappointing, because if people are only treating injuries long after they’ve occurred, they’re really putting themselves at a great disadvantage.
What follows is a complete three part series of the most appropriate initial treatments for all soft tissue, sports injuries. This information will definitely cut your recover time by days, if not weeks.
Before we start!
Lets have a quick look at the type of injuries I’m talking about. The type of sports injuries I’m referring to here are the soft tissue injuries, which are very common in most, if not all sports. These injuries include sprains, strain, tears and bruises that affect muscles, tendons, ligaments and joints: The soft tissues of the body.
Examples of common soft tissue injuries would include things like hamstring tears, sprained ankles, pulled calf muscles, strained shoulder muscles and tendons, corked thigh, etc. Remember a sprain refers to a tear or rupture of the ligaments, while a strain refers to a tear or rupture of the muscles or tendons.
The sort of injuries I’m NOT talking about here are injuries that affect the head, neck, face or spinal cord. Injuries that involve shock, excessive bleeding, or bone fractures and breaks. The treatment of these type of injuries goes way beyond the relatively simple soft tissue injuries that I’m discussing here.
Priority Number 1
The first priority when treating any sports injury is, “Do No Further Damage.” So before we get into the treatment of soft tissue injuries, there’s one important point that I should discuss first.
Before you start treating any injury, whether to yourself or someone else, first STOP and take account of what has occurred. Consider things like; ..is the area safe from other dangers? ..is there a threat to life? ..is the injury serious enough to seek emergency help? Then, using the word STOP as an acronym;
S: (stop) Stop the injured person from moving. Consider stopping the sport or game if necessary.
T: (talk) Ask questions like; ..what happened? ..how did it happen? ..what did it feel like? ..where does it hurt? ..have you injured this part before?
O: (observe) Look for things like swelling, bruising, deformity and tenderness.
P: (prevent) Remember, do no further damage. Prevent further injury.
Once you’ve taken a few moments to make sure the injury isn’t life threatening, it’s then time to start treating the injury. Remember, the sooner you start treating a sports injury, the more chance you have of a full and complete recovery. The longer you wait, the worse it’s going to be.
What is R.I.C.E.R.?
Without a doubt, the most effective, initial treatment for soft tissue injuries is the R.I.C.E.R. regimen. This involves the application of (R) rest, (I) ice, (C) compression, (E) elevation and obtaining a (R) referral for appropriate medical treatment.
Where the R.I.C.E.R. regimen has been used immediately after the occurrence of an injury, it has been shown to significantly reduce recovery time. R.I.C.E.R. forms the first, and perhaps most important stage of injury rehabilitation, providing the early base for the complete recovery of injury.
When a soft tissue injury occurs there is a large amount of uncontrolled bleeding around the injury site. This excessive bleeding causes swelling, which puts pressure on nerve endings and results in increased pain. It is exactly this process of bleeding, swelling and pain which the R.I.C.E.R. regimen will help to alleviate. This will also limit tissue damage and help the healing process.
The diagram below is a comparison of the same injury treated with the R.I.C.E.R. regimen and without. The top row of pictures show the effects of a soft tissue injury when the R.I.C.E.R. regimen is not used. While the bottom row of pictures show the effects of a soft tissue injury when the R.I.C.E.R. regimen is used.
The first diagram in the series shows a rupture in the soft tissue immediately following an injury. 24 hours later, when R.I.C.E.R. has not been used, there is a large amount of uncontrolled bleeding and swelling. However, in the bottom diagram, the application of rest, ice, compression and elevation has significantly reduced the amount of bleeding and swelling.
Picture courtesy of Dr. Barry Oakes, MB, BS, MD, F.A.S.M.F. Senior lecturer in the department of Anatomy, Monash University, Victoria, Australia.
How to apply R.I.C.E.R.
R: (rest) It is important that the injured area be kept as still as possible. If necessary support the injured area with a sling or brace. This will help to slow down blood flow to the injured area and prevent any further damage.
I: (ice) By far the most important part. The application of ice will have the greatest effect on reducing bleeding, swelling and pain. Apply ice as soon as possible after the injury has occurred.
How do you apply ice? Crushed ice in a plastic bag is usually best. However, blocks of ice, commercial cold packs and bags of frozen peas will all do fine. Even cold water from a tap is better than nothing at all.
When using ice, be careful not to apply it directly to the skin. This can cause “ice burns” and further skin damage. Wrapping the ice in a damp towel generally provides the best protection for the skin.
How long? How often? This is the point where few people agree. Let me give you some figures to use as a rough guide, and then I’ll give you some advice from personal experience. The most common recommendation is to apply ice for 20 minutes every 2 hours for the first 48 to 72 hours.
These figures are a good starting point, but remember they’re only a guide. You must take into account that some people are more sensitive to cold than others. Also be aware that children and elderly people have a lower tolerance to ice and cold. Finally, people with circulatory problems are also more sensitive to ice. Remember to keep these things in mind when treating yourself or someone else with ice.
Personally, I recommend that people use their own judgement when applying ice to themselves. For some people, 20 minutes is way too much. For others, especially well conditioned athletes, they can leave ice on for up to an hour at a time. The individual should make the decision as to how long the ice should stay on.
My personal recommendation is that people should apply ice for as long as it is comfortable. Obviously, there will be a slight discomfort from the cold, but as soon as pain or excessive discomfort is experienced, it’s time to remove the ice. It’s much better to apply ice for 3 to 5 minutes a couple of time an hour, than not at all.
C: (compression) Compression actually achieves two things. Firstly, it helps to reduce both the bleeding and swelling around the injured area, and secondly, it provides support for the injured area. Simply use a wide, firm, elastic, compression bandage to cover the injured part. Make sure you bandage both above and below the injured area.
E: (elevation) Simply raise the injured area above the level of the heart at all possible times. This will further help to reduce the bleeding and swelling.
R: (referral) If the injury is severe enough, it is important that you consult a professional physical therapist or a qualified sports doctor for an accurate diagnosis of the injury. With an accurate diagnosis, you can then move onto a specific rehabilitation program to further reduce your injury time.
Before we finish up, there are a few things which you must avoid during the first 24 to 72 hours after an injury. Be sure to avoid any form of heat at the injury site. This includes heat lamps, heat creams, spa’s, Jacuzzi’s and sauna’s.
Avoid all movement and massage of the injured area. Also avoid excessive alcohol. All these things will increase the bleeding, swelling and pain of your injury. Avoid them at all costs.
The above information takes care of the first 48 to 72 hours. Follow the above advice and you’ll cut your recovery time by days, if not weeks. But what happens after R.I.C.E.R.? There’s still a little way to go before you’re completely over that injury. Click here to view part 2; the next phase of your rehabilitation.
About the Author: Brad is often referred to as the "Stretch Coach" and has even been called the Stretching Guru. Magazines such as Runners World, Bicycling, Triathlete, Swimming & Fitness, and Triathlon Sports have all featured his work. Amazon has listed his books on five Best-Seller lists. Google cites over 100,000 references to him and his work on the internet. And satisfied customers from 122 countries have sent 100's of testimonials. If you want to know about stretching, flexibility or sports injury management, Brad Walker is the go-to-guy.