Acute Injury Management

By Hannah Longega, Physiotherapist, Action Potential Clinic, Kingswood. Follow Hannah and other members of the clinic

Congratulations if you were one of the 12,000 people who took part in this year’s Bristol 10k. Whilst we sincerely hope you feel fantastic and haven’t injured yourself on the way round, here are our top tips of what you can do to help yourself on the way to recovery if you have felt that dreaded twinge today.

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Whilst most people have heard of PRICE (Protection, Rest, Ice, Compression and Elevation) for management of acute injuries you may not have heard of POLICE. This latest acronym has resulted from research by Bleakley et al 2012 who have suggested this update on finding that complete rest for a prolonged period may be harmful.

Protection:

Use braces, bandages, tape etc. to protect your injury whilst it heals. Exactly which option you use depends on the injury and so it can make it difficult to decide which one to go for, so speak to your health care professional if you are at all uncertain. In short this step helps prevent the injury from receiving too much loading in this early stage, which can lead to more damage being created.

Optimal Loading:

Optimal loading has replaced rest in this acronym.

 What does it mean?

It means avoiding movements in the direction of the injury or any strenuous activity involving the injured part at this early stage. Then as you recover progressively increasing the load that you put through the area.

 Why has it replaced rest?

  • It has been found that too much rest can lead to joint stiffness, muscle weakness and tightness.
  • Optimal loading has been found to restore strength and the structure of the injured area and to stimulate healing.
  • The right amount of activity can also help decrease swelling by using the muscle for instance the calf to move the swelling up the body when they contract.

However, the amount of loading put through the area varies depending on the injury so seek help from a healthcare professional if you’re at all in doubt. As a general rule of thumb do as much as you feel able but don’t push through the pain.

Ice:

As a general rule apply ice to the injured area for 10-20 minutes wrapping it in a damp, clean tea towel.

A few precautions with ice:

  • Do not apply to a numb area or an open wound
  • Take care not to get ice burn. So don’t apply ice directly to the skin, or leave it on for a prolonged period of time.

Compression

Make use of tubigrip or kinesiotape in order to prevent further swelling. In the clinic when we use tubigrip we tend to apply a double layer making sure that although the area feels compressed it is not painful and that there is good circulation below the bandage. We tend to recommend taking the bandage off at night for comfort.

We also make use of kinesiotape and have seen some great results including when Jake Hayes (chiropractor) injured his ankle training for the London Marathon this year. Whilst he had to take time out of his training the tape helped him back on track to run London in 2:43!

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If you are unsure about how to apply this, seek advice from your healthcare professional.

Elevation:

This can be an effective way to decrease the pain and the swelling.

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