The most important time in the treatment of soft tissue injuries is the first 24-48 hours immediately following the injury.
When soft tissue is injured there is also damage to the blood vessels in the area and this can lead to swelling. Swelling and increased pressure in the area of injury can lead to inhibition of healing, pain and muscle spasm. Therefore, every effort should be made to decrease the amount of bleeding at the site of injury.
For the first 48 hours of any soft tissue injury, the following principles should be followed;
Rest – Continued movement of the injured part will lead to increased bleeding and swelling.
Ice – The application of ice will lead to decreased pain and cause constriction of the blood vessels, thus reducing bleeding and swelling, muscle spasm & inflammation. Ice should be applied for 20 minutes every 2 hours.
Compression – Application of a firm bandage can help to decrease bleeding and swelling. Compression should be applied firmly but not so tightly as to cause pain or pins and needles/numbness in the area. The bandage should start just below the injured area and cover the entire area.
Elevation – Elevation of the part above the heart helps to reduce blood flow to the injured area and therefore swelling.
Diagnosis – Early diagnosis of the injury will facilitate good rehabilitation and early return to sport or work.
In the first 48 hours of an injury the following should be avoided;
Heat, Alcohol, Massage, Exercise
These modalities will increase circulation and lead to more bleeding and swelling
Jonathan Smith
Director of Thorpes Physiotherapy