Every injury I treat in clinic started somewhere. The really painful long term problems are all usually as a result of poor injury management early on, meaning that the healing process isn’t allowed to do its thing. This aim of this article is to give you the knowledge to know what you should do in the event of an injury and will be especially useful for pulled muscles and strained ligaments that are common with knee injuries and rotator cuff injuries, as well as for general muscle spasms.

Please watch the video below, or read on for the written article.

Process of Healing

The healing process basically boils down to inflammation; whether you stub your toe or pull a muscle, there will a degree of inflammatory involvement. Inflammation is essentially a soup of different cells and molecules that allow the body to heal itself.

There are 5 symptoms that are signs of inflammation:

  • Redness
  • Heat
  • Swelling
  • Pain
  • Loss of function

Unfortunately, too much of some of these molecules can actually do damage to the tissue rather than heal it, plus persistent pain and loss of function and also lead to other long term problems. So when we talk about injury management, what we want is to encourage the good parts of the inflammatory process but limit the negative effects, which is a tricky balance!

Injury Management

So, what can we do? You might have come across the first aid acronym term RICE, which stands for

  • Rest
  • Ice
  • Compress
  • Elevate

And more recently, PRICE, where the extra P stands for ‘Protect‘. What these things aim to do is prevent further damage and aid the healing process. Now although this is the go-to system for injury management the evidence suggesting PRICE is effective actually not very good, mostly due to the fact the studies that explore them are poorly constructed, so any conclusions they make are basically thrown out.

However, each individual component (protect, rest, ice, compress, elevate) have been explored independently and these can be linked to improved recovery time.

P: So starting ‘protect’. It’s a pretty obvious one really; if you hurt yourself, you need to protect that area from further damage. Think about what happens if you catch your finger in a door – you’ll grab it and protect it. That’s instinct, it’s built in. But also on a wider level, if you twist your ankle then decide to go for a run the next day, then your subjecting it to more strain and just aggravating it. Chances are though you wont be able to run too far because the pain will stop you, and that’s the reason why we have pain, to help steer us away from hurting ourselves. So protect the injury, it’s pretty straight forward!

R: This can also stand for ‘restrict activity’. This is a little ambiguous as ‘rest’ means different things to different people. I think of it similar to protect – you want to rest whatever it is you hurt, so you don’t aggravate it. The problem also is, you cant completely rest something all of the time and will eventually need to start using it again, which is encouraged as it becomes like rehabilitation. So using a bad back as an example; initially you might need to just lay flat on your bad for a day or two and rest it completely, but then after that  you might want to get up and move around a bit to help the tissues loosen up. Now although you’re moving you’re still resting it from long car journeys, going to the gym, gardening etc. After that you might be able return to regular activity but still decide to rest it from heavy lifting at the gym. Again, it’s a bit ambiguous but it kind of comes down to common sense. I will also revisit this point later.

I: Whether or not to ice an injury is easily the most debated section of this article. The idea behind ice is that it causes the blood vessels to constrict which means less inflammation enters the damaged area, this means less pain and swelling, this is great for managing pain, but the problem is as I mentioned, inflammation heals the injury, so do we really want to discourage it? Will ice actually slow down the healing process?

The jury is still out, but there is a great study from 2016 that suggests cryotherapy (application of cold) could have a beneficial effect on inflammatory process without affecting the regeneration process after tissue injury. Although this study was carried out on rats, it’s still a high quality study and the results suggest it’s beneficial to ice an area if you injure it!

C: Compression refers to bandaging up an area or using elastic compression socks or other similar products. Similar to ice, it prevents the swelling by limiting the inflammation pooling too much in one area. For tissues to heal properly, its important that fluid is able to enter the site of injury, but its also important that it can leave. Too much swelling limits this movement of fluids, which is why it’s good to limit it. Also, if you’ve cut yourself and your bleeding, it’s pretty obvious as yo what you want to compress it. If you’ve ever accidentally cut your hand on something, first thing you do it grab it tight, to prevent excessive bleeding.

E: Elevation is very similar to compression as it prevents excessive swelling or bleeding. The idea is you elevate the damaged area higher than your heart, so if it’s your ankle you lay with your  foot up, or if your hand is bleeding you might want to compress it and hold it up. Now this is a little tricky if you’ve hurt your lower back, that where this doesn’t really work!

‘Rest’ or ‘Optimal Load’

I mentioned I wasn’t quite done with the Rest! As I said, it’s quite ambiguous as to how much rest is actually going to be needed. So ‘Rest’ has also been renamed to ‘Optimal Load’, meaning that you want to move it only as much as is necessary to encourage healing, but not to aggravate things. Now this is difficult to know exactly but that’s where professionals like me come in – we can give you instructions and exercises to restore function to damaged tissue.

When is a good time to seek out professional help?

Remember that this advice is just to help you tackle those little bumps and strains that we all get from time to time. If you’ve seriously hurt yourself, don’t try to go at it alone. If it’s an injury that just doesn’t seem to be getting any better after a few weeks then chances are it isn’t going to suddenly get better on it own, and you might need someone to help.

Hopefully this advice will help you out, but if you’re concerned about an injury then please don’t hesitate to contact me:

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