If there are any concerns regarding the extent and nature of an injury the players GP/Consultant must be
consulted.
MANAGING SOFT TISSUE INJURIES
Pictures showing common sites of muscle tears and strains
From Sports Injuries
Principles of sports injury management
1. Minimise the extent of initial damage.
2. Reduce associated pain and inflammation
3. Promote healing of damaged tissue
4. Maintain or restore flexibility, strength, proprioception and overall fitness during the healing phase.
5. Functionally rehabilitate the inured athlete to enable return to sport
6. Assess and if possible correct any predisposing factors to reduce the likelihood of recurrence.
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Initial Treatment
The most important time in the treatment of soft tissue injuries is the 24 hours immediately following the injury.
When soft tissue is damaged blood vessels are usually damaged too.
Blood accumulates around damaged tissue and compresses adjoining tissues which causes compression of healthy tissue and further damage. Swelling and increased pressure may inhibit the healing of damaged tissue, cause pain and lead to muscle spasm.
RICE
So every effort should be made to reduce the amount of bleeding at the site of injury. The most appropriate method of doing this is: RICE
R- Rest
I- Ice
C – Compression
E- Elevation
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Rest
Stop immediately following injury as continued active movement of the injured part will result in increased bleeding and swelling.
Ice
The application of ice immediately after injury results in a reduction of pain and contraction of blood vessels. This reduces bleeding and swelling. Ice reduces the metabolic rate of tissues thus lowering the demand for oxygen and nutrients. Ice may also decrease muscle spasm in surrounding muscles
The length of time for which ice should be applied depends to a certain extent on the size of the injured area and the depth of the injured structure, but convention suggests 15 minutes every 1-2 hours initially. The frequency of application can be gradually reduced over the next 24 hours.
Cooling sprays are often used in the immediate treatment of injuries, particularly when local pain relief is required. However these sprays do not seem to affect deeper tissues.
Ice should not be applied where local tissue circulation is impaired – Raynards disease, peripheral atherosclerosis or to patients who suffer from cold allergy.
Compression
Compression of the injured area reduces bleeding and minimises swelling. Compression should be applied during and after ice application.
Elevation
Elevation of the injured part reduces blood flow to the injured area and encourages return of venous blood.
Treatments that should be avoided on the initial phase (first 24 hours) are:
• Heat – including hot baths
• Heat rubs/ liniment
• Vigorous massage
• Moderate to intense activity
Contrast Baths
Contrast baths decrease swelling by alternating heat and cold to create an alternating mechanical force. Theses baths are used after the acute phase of injury to reduce swelling. The injured part is immersed in a hot bath for 4 minutes followed by a cold bath with ice water for 1-2 minutes. This should be repeated three to seven times. A cold bath should be used to finish.