OUCH! I’VE JUST PULLED A MUSCLE OR LIGAMENT – WHAT SHOULD I DO??
By Alison Quinn Clinical Specialist Chartered Physiotherapist
We’re going to focus on return to sport and injury prevention in September. But before we start on that, what happens if you’re unlucky enough to have injured yourself already? With return to school and regular sport routines in the last week we’re already seeing the injuries arrive at the clinic. One young GAA player pulled his hamstring at a match last week, and in his own words - “I felt a niggle during the game and I knew I should have come off, but I stayed on, did one big kick, felt it go and had to come off”. This is a fairly common story.
So, what should you do when you feel something “go” in your muscles or joints?
You’ve probably heard of the phrase RICE – Rest, Ice, Compression, Elevation – this has been updated over the years and we can now think of injuries as needing PEACE and LOVE! For the first few days after injury (the acute phase) the tissues need PEACE and after that it needs LOVE. Let’s start with some tips on how to achieve PEACE for your injury to promote good initial healing.
Protect- restrict movement for 1 to 3 days to allow the tissues to rest, start healing and avoid re-injuring
Elevate- the limb above the level of the heart so for example lie flat with your legs up on pillows
Avoid- anti-inflammatories – it's natural for the body to go through various stages of inflammation to repair the tissues and it is thought that anti-inflammatories may disrupt this process by taking them too early. However, if you are in a lot of pain, consult your GP or pharmacist for other methods of pain relief
Compression – a bandage like a tubigrip can be used to apply some compression. Don’t have it too tight though and take it off when you are elevating the leg or in in bed
Education – this comes from your physio! You need to get the area moving once the initial few days of rest is over – tissues respond to loading but it needs to be done in the right way, at the right time and that’s our job!
The jury appears to be out on the use of ice after injuries of Ice in terms of current research. It probably has more of a pain-relieving effect than anything else. The general recommendation is 10-20mins every few hours. Sometimes it's not appropriate to use ice, for example, if you have poor circulation. Gel cold packs may not be as cold as ice but they are handy to use. If you can’t quite bare them from the freezer then just pop them in the fridge and it’ll give the cold feeling without that extra cold!
So, what’s the bottom line – if you get an injury, start by resting it and get the right advice quickly so you know what to do next to start good healing, get you back to sport in time and decrease the chance of re-injury. Remember - injuries are different, sports are different and each of us is different so you need the right approach for you. Injuries that are not treated properly in the beginning can turn into chronic injuries which can be more complex to treat and can take longer to sort out.
So how is our Gaelic footballer with the hamstring injury – we got him to rest the hamstring for a few days, and then started safely loading the tissue again. He’s not ready to return to sport just yet as the load will be too high on the hamstring but we’re going to get him back as quickly and safely as possible.
More on tips on how to LOVE your injuries later this week and how to prevent hamstring injuries next week.
Get in touch if you have any questions about how to manage any recent injuries.
References
Dubois B, Esculier J Soft-tissue injuries simply need PEACE and LOVE British Journal of Sports Medicine 2020;54:72-73
Bleakley PD, Philips P et al for the Association of Chartered Physiotherapists in Sports and Exercise Medicine (ACPSM). Guidelines on the Management of Acute Soft Tissue Injury Using Protection Rest Ice Compression and Elevation. London:ACPSM,2011