Understanding your pain

Acute Phase of an injury

This is the time period from when the injury first occurs to approximately 2-4 days following.

Seek urgent medical assessment if your injury was caused by trauma or impact, resulting in a click or a crack with immediate swelling and or consequent bruising, as well as difficulty weight bearing or loading.

The first 48hours is usually the key time to act on the POLICE method:

[Bleakley et al. published in 2012, in the British Journal of Sports Medicine]

Protect

Avoid stretching, twisting or over-exerting the area, which could worsen the injury. Stretching is often something people rush to do but wait 48hours before doing this if pain and/ or swelling is present.

Optimal Loading

If you hear a click or crack, combined with pain on loading and immediate swelling it is best to seek medical opinion. ‘Optimal loading’ for this severity of injury would most likely be no loading or partial loading with supports to ensure the injury heals quickly and avoids additional stress. Elbow crutches or an aircast boot are some of the types of support that may be required. An x-ray at A&E may be offered to assess for boney injury and medical staff will provide appropriate guidance.

If weight can be tolerated on the area it is best not to avoid this and to use supports to assist best possible movement during the first 48hours without overloading or stressing other areas as well as the injury site.

Ice

Although the research may not be conclusive, ice can provide a light relief from the pain of an acute injury and therefore assist the ability to optimally load without compensation. The general accepted guidance for ice is to use, with careful caution to avoid ice burns, for 10-20 minutes 3 times per day for up to a week after the injury.

Do not apply to areas that are numb due to risk of ice burns and stop applying ice if there are any negative effects such as increase in pain, swelling or skin soreness. Ice should be discontinued as soon as the pain reduces.

Compression

The use of compression is to control swelling and can protect the area from stressors, such as over stretching, during this acute phase. Further use of compression beyond the acute phase can be detailed by a professional on examination (see link at the bottom of the page to arrange an appointment).

A simple tubigrip bandage can be used and should provide a feeling of support without discomfort or pain. Ensure there is good circulation above and below the bandage and generally it is recommended to remove the bandage at night for comfort when sleeping.

GAME READY Ice and Compression is available at Complete Active and is an extremely effective tool to managing swelling and pain - Enquire via our contact page.

Elevation

Elevation can be effective in reducing swelling and pain. You can combine it with gentle exercises that aid circulation such as moving the ankle up and down or tightening the thigh muscles to straighten the knee for lower limb injuries.

Subacute phase of an injury

If pain and restriction of mobility continues for longer than a week following injury seek assessment by a professional to diagnose exactly what the nature of the injury is.

Early assessment and professional guidance on an injury can prevent it from lasting months rather than weeks and get you back to activity as soon as possible, or provide you with guidance on investigations alongside a clear recovery pathway and realistic expectations.

Chronic phase of an injury

Chronic refers to an injury that has lasted more than 6-8 weeks. Physiotherapy assessment at this phase can help to decipher what has gone wrong with the healing process and how to progress with recovery.

If there is no indication of ongoing acute injury or instability, physiotherapy will be aimed at assessing your movement patterns, particularly the movements you feel are affected or compromised by the injury. A combination of strengthening around the proximal regions (spinal, shoulder girdle, hips, pelvis) and gaining good awareness and control from the feet upwards will be taught using video analysis or other visual aids, as well as proprioceptive tools such as Rock Tape. This will be combined with manual therapy or a range of treatments appropriate for reducing pain, myofascial tension or joint stiffness.

The goal will always be to gain the best possible outcome to achieve full return and optimal performance in your chosen activity or sport.