Rehabilitation of soft tissue injuries can be complex. If you have a twisted ankle, shin splints, or a strained muscle, when should you see your healthcare provider? If you take care of your injury yourself, what sort of treatment should you follow?

The first step toward recovery is to stop what you’re doing. Trying to finish your tennis match or 5K run may make your injury worse. Continued activity may also increase your recovery time and turn a little problem into a big one.

Some injuries obviously need medical attention. Severe bleeding, obvious deformity in the bone or joint, or significant swelling and pain are signs of serious problems. Even injuries that feel like muscle pulls, strains, and sprains can turn out to be breaks (fractures) or tendon tears. That’s why it’s best to get a diagnosis from your healthcare provider (yes, we’re part of your healthcare team).

I’m sure you’ve heard of R.I.C.E – Rest, Ice, Compression and Elevation.  We’ve been saying this and using it for years, however newer research says this might not be the right thing to do. Although widely known, the evidence for R.I.C.E. is limited.  This approach may focus on acute management, and in the process, ignore sub-acute and chronic stages of tissue healing.

The BJSM includes the importance of educating patients and addressing psychosocial factors to enhance recovery. In addition, while anti-inflammatories show benefits on pain and function, there is evidence of potentially harmful effects on optimal tissue repair.

The British Journal of Sport Medicine proposes and shows a slightly different approach:

P: Protection – Avoid activities that increase pain in the first few days of the injury

E: Elevation – Elevate the injured extremity higher than the heart as often as possible

A: Avoid Anti-inflammatory – They have been shown to stunt or slow the healing process

C: Compression – Use compression to help circulation of fluid back toward the heart and lungs

E: Education – You know best. Avoid unnecessary treatments and let nature and your intuition do its thing

THEN:

L: Load – increase your load bearing gradually using pain as your guide

O: Optimism – Condition your brain for optimal recovery by being positive

V: Vascularization – Pain-free cardiovascular activity to in crease blood flow to repair tissues

E: Exercise – Restore mobility, proprioception, strength, and function as guided by your health care team 

What are your thoughts? We’d love to hear them.

Reference: (https://bjsm.bmj.com/content/bjsports/54/2/72.full.pdf)