Injury Management

Andy Howse tells us about all things Injury! Read on to find out how to treat an injury, when to seek Physio advice and how to prevent injuries from occurring: 

When are you injured?

An injury is normally always associated with a loss of function (being unable to use that limb or joint) and is accompanied by pain.  Often injuries are acute (come on suddenly) or can be chronic (appear gradually over time).

Some examples are:

How do I treat an acute injury?

Firstly it is very important to get an accurate diagnosis of the injury.  Bristol Physio is here to help!

Also worth noting that the management of an acute bout of back or neck pain can be very different. 

Analgesia (medication) to help the pain is often useful but should be directed by the appropriate health care professional. 

In physiotherapy we use the principle of PRICE:

P - Protection

R – Rest

I – Ice

C – Compression

E – Elevation

If we use the example of a twisted ankle on a basketball court.

Protection –          Player is stopped from playing and is removed from the court.  They may not be able to walk therefore they may need to use crutches for a period as long as a physiotherapist or doctor has instructed them to do so.  You need to protect the area from further damage.

Rest –                     They will have to rest for a period of anything from 1 week to a couple of months depending upon the severity of the injury.  Rest will allow the tissue to heal properly.

Ice –                        Immediate application of ice (ideally with a bag of ice) to the ankle joint is a very good idea.  Make sure you protect the skin and put a towel or something between the skin and the ice to avoid ice burns.  Keep the ice on for a maximum of 20 minutes but you can repeat this every hour if you need.  Ice helps keep the swelling to a minimum.

Compression -      In physiotherapy we would either use a special type of bandage or a tubigrip which helps to compress the area.  If you don’t have this then you can use tights or compression garments such as ‘Skins’.  Compression helps to reduce the swelling from building up.

Elevation -             This involves the leg being rested ideally higher than the body to allow the swelling to return back up the leg.

As you can see, initially you want to try to reduce the swelling.  You should not:

• Put heat on the area.
• If it is a muscle you should not stretch it even if it feels ‘tight’.

How do I treat a chronic injury?

In a lot of instances these are more difficult to treat than the acute injuries and certainly can take longer to heal.  Sometimes players can continue to play with these injuries and other times it is not possible to do so.  You need to seek the advice of a therapist who can correctly diagnose the cause of the injury and give you advice on how best to manage the injury.  Often the recovery from such injuries will be longer than with acute injuries and can involve specific strengthening exercises.  The causes of chronic injuries maybe faulty technique such as landing incorrectly, or they could be due to weakness in certain areas leading to over loading a particular muscle or joint.

Occasionally the pain from these injuries will be accompanied with swelling therefore the PRICE principle still applies.

Why should I get an expert to assess the injury?

Physiotherapists and sports therapists are experts at assessing and treating injuries.  After any injury you may need help to improve certain movements.  In the twisted ankle example, there maybe lack of range to the joint range, weakness to the muscles that control the ankle and foot and the balance of the individual would be affected.  In ankle sprains there is a 50% chance of a re-occurrence of the injury if it is not treated properly.  Not getting the issue treated properly first time can lead to other issues in the future and this is where we come into play (Sports Injury Specialists). 

What will likely happen with physiotherapy treatment?

Most of the time the physiotherapist will aim to improve range of movement, give you strength exercises to increase overall ankle strength and look to improve balance with other exercises.  The exercises will have to be one outside of treatment time and be aware that the average length of time to build up muscle strength is between 2-3 months. See more here about what happens in a physio appointment.

Does growth affect injuries?

Yes it often does.  When you have a growth spurt the body will take a while to adapt and grow muscle around the bones.  This can lead to overuse injuries and stress on certain areas.  This is commonly the cause of pain to the patella tendon just below the kneecap.

Are there ways of avoiding injury?

Injury prevention programs are key to trying to avoid injury.  These programs can be tailored to individuals or individual sports and are often focused on certain joints or muscles.  They can involve a mixture of stretching, strengthening and balance improvement in certain areas.  Have a look at this video for an example. 

Recovery from training sessions and matches is very important to maintain good healthy muscles and joints.  Recovery includes good rest, good diet and not over loading the body with too much training or too many matches.

Listening to your body is important as well.  If something is tight or painful then avoid making it worse by training again. Instead you could check out some ways to reduce this tightness. Sometimes our bodies need a rest.  Good overall fitness and good strength is very important to allow you to perform to the highest level and to recover quickly.   

Obviously the better your conditioning, the better you will function, the better you recover and the more you reduce the risk of injuries….and injuries will be the one thing that stops you from completing your activities!