Advice From a Physio on How to Treat Minor Sporting Injuries

Minor injuries sustained from sporting activities, such as acute soft tissue injuries, sprains, and strains, are fairly common in both adults and children. But what’s the best way to treat these kinds of injuries for optimal recovery? It might not be what you think…let’s dive in and find out!

I’m sure you’ve all heard the common acronym R.I.C.E – Rest, Ice, Compression, Elevation. It’s common knowledge to put ice on an injury straight away, and there’s no doubt that doing this provides temporary pain relief and instantly makes the injury feel better. However, just because we are taking the pain away, it does not necessarily mean we are fixing or making the injury better. In fact, you can sometimes cause more harm than good. This statement is going to sound controversial and will go against everything you’ve previously been told, but you should not ice acute injuries or sore muscles!

For decades R.I.C.E has been the gold standard in acute management of sprains and strains. But where did this term come from? Dr Gabe Mirkin initially coined the term back in 1978 in his book “The Sports Medicine Book”. Since this time, the medical and physio community have religiously used this protocol for the treatment of all acute injuries. However, in 2015, Dr Gabe withdrew his original statement! Admittedly, he wrote, “subsequent research shows that ice can actually delay recovery.”

We’ve always been told that inflammation and swelling are bad things and that we need to minimise them as soon as possible to speed up recovery. However, inflammation and swelling are not bad things. In fact, they are very normal responses to an injury and very necessary. There are three stages of healing in the body: inflammation, repair, and remodel.

What happens in our body when we sustain an injury?

It’s time to get technical! When injury occurs, inflammatory cells called white blood cells move to the site of pain and begin the healing process. Specifically, miniscule cells called neutrophils are deployed to terminate bacteria if there is an open wound. Other cells called Macrophages also come to the injury site to remove the damaged tissue cells caused by the initial trauma. At the same time these cells also release an anabolic hormone called Insulin-like growth Factor (IGF-1) into the surrounding area that initiates the next phase of the healing process, muscle repair, and regeneration. To summarise, healing requires inflammation!

Following injury, the surrounding blood vessels dilate as part of the inflammatory response and the small capillaries adjacent to the damaged tissue expand to allow white blood cells to the area. This influx of white blood cells out of the capillaries also pulls additional fluid into the surrounding tissue. This accumulation is referred to as “swelling”. Swelling however, is there for a reason. It contains the waste by-product of the initial damaged tissue.

So, what happens when we put ice on our injuries?

Ice essentially restricts blood flow and reduces the ability of the white blood cells from getting to the injured area and clearing the waste products, therefore preventing the natural inflammatory process from happening. This in turn slows down and reduces the effectiveness of the repair and regeneration stages.

That leaves us with the big question. If we shouldn’t ice, what should we do?

ACTIVE RECOVERY! Evidence shows that exercises performed in a relatively pain-free manner not only accelerates the removal of swelling through muscle contraction, but also optimizes the healing process without causing additional damage. It may seem counterintuitive to move during an injury, but it’s actually the best thing to do!

Why? The smallest amount of muscle contraction can help remove swelling through the bodies lymphatic system, prevent disuse atrophy, and minimize pain. Therefore, simple exercises like calf raises can be beneficial for adults and children directly after sustaining an ankle sprain. As pain decreases, load should be increased to facilitate optimal healing. For example, someone with ankle pain may progress bodyweight calf raises from on a flat surface, to off a step, to eventually adding a weight. Whatever the injury location, light movement should be done as soon as possible to facilitate the healing process, with gradual loading within the pain limits.

What about more serious injuries?

Now this principle is not applicable to every injury – particularly more serious injuries. For example, if there is a suspected fracture or ruptured ligaments, this should be immobilised. You may also be thinking “but I see professional athletes using ice all the time”. This is because periodic use of ice may assist some athletes when they need to recover quickly from their performance between same day or week sessions and competitions. However, in the long term, regular use should be cautioned as the continued use of ice can be harmful on the natural adaptation process for developing muscle strength and hypertrophy. Therefore, for mild to moderate acute soft tissue injuries, sprains and strains, movement is the best recovery!

The ultimate goal following an injury is to get the good stuff to the injury site, and the bad stuff away from it. Movement achieves both of these. If you are ever unsure about a particular injury, we always recommend seeking the advice of a professional physiotherapist.

CREDIT: UFIT

Ufit.com.sg

UFIT are a team of experienced coaches and clinicians who provide an integrated health and fitness community for people striving to achieve their personal goals.

Whether it is training, nutrition, rehabilitation or performance, we believe everyone has greatness within them. We are committed to collaborating as a team to ignite and celebrate the greatness in everyone.