Sports Injury First Aid

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Injury First Aid Follow the advise of your doctor. These instructions are supplemental. Chronic injuries may require physical therapy after doctor's diagnosis. R.I.C.E. Treatment Rest, Ice, Compression, Elevation First aid for strains, sprains, contusions, dislocations, or uncomplicated fractures Rest Stop using injured part Continued activity could cause further injury, delay healing, increase pain, and stimulate bleeding Use crutches to avoid bearing weight on injuries of the leg, knee, ankle, or foot Use splint for injuries of the arm, elbow, wrist, or hand Ice Hastens healing time by reducing swelling around injury Sudden cold contracts blood vessels Helps stop internal bleeding from injured capillaries and blood vessels Keep damp or dry cloth between skin and ice pack Do not apply ice for longer than 15 to 20 minutes at a time For 3 days after injury Apply every hour for 10 to 20 minutes Apply ice after 3 days as long as pain or inflammation persist Apply at least 3 times throughout the day for 15 to 20 minutes Compression Hastens healing time by reducing swelling around injury Decreases seeping of fluid into injured area from adjacent tissue Use elasticized bandage, compression sleeve, or cloth Wrap injured part firmly Do not impair blood supply Too tight of compression may cause more swelling Wrap over ice Loosen the bandage if it gets too tight Elevation Elevate injured part above level of heart Decreases swelling and pain Use objects and pillows for props Some texts advocate PRICES (P=Protection, S=Support) Medication Some doctors may recommend the use of a non-steroid anti-inflammatory such as ibuprofen through out the duration of the injury. Check with your physician. Heat Treatment Causes delay in healing if applied too soon after an injury Wait at least 72 hours (3 days) Wait until swelling is gone Some experts recommend going back and forth between cold and heat treatments. Management of Inflammation decrease healing time decrease scare tissue formation decrease chances of reinjury Recovery There will be a prolonged healing time if usual activities are resumed too soon Proper care and sufficient healing time before resuming activity should prevent permanent disability if it is a first time injury. If it is a repeat injury, complications are more likely to occur.

Strain Injury to the muscle or tendon. Pain with moving or stretching the affected muscle or muscle spasms. Acute strains are caused by over stress or direct injury. Chronic strains are caused by overuse. Mild strain (Grade I): Slightly pulled muscle with no tearing of muscle or tendon. No loss of strength Ability to produce strong yet painful muscle contractions Requires self care through rehabilitation after doctor's diagnosis Average healing time: 2 to 10 days Moderate strain (Grade II): Tearing of muscle, tendon or at the bone attachment Weak and painful attempts at muscular contraction Requires physical therapy after doctor's diagnosis Average healing time: 10 days to 6 weeks Severe strain (Grade III): Rupture of muscle-tendon-bone attachment with separation Extremely weak yet painless attempts at muscular contraction Requires surgical repair and physical therapy after doctor's diagnosis Average healing time: 16 to 10 weeks Sprain Violent overstretching of ligament in a joint. Pain, tenderness, swelling or bruising at joint. Mild strain (Grade I): Tearing of some ligament. No loss of function Requires self care through rehabilitation after doctor's diagnosis Average healing time: 2 to 6 weeks Moderate strain (Grade II): Rupture of portion of ligament resulting in some loss of function Requires physical therapy after doctor's diagnosis Average healing time: 6 to 8 weeks Severe strain (Grade III):: Complete rupture of ligament or complete separation of ligament from bone. A sprain-fracture occurs when the ligament pulls loose a fragment of bone 1+ Joint surfaces displaced 3-5 mm 2+ Joint surfaces displaced 6-10 mm 1+ Joint surfaces displaced 10+ mm Requires surgical repair and physical therapy after doctor's diagnosis Average healing time: 8 to 10 weeks Injury Information Acute (traumatic injury) Chronic (overuse injury) Account for more than 50% of injuries in primary care practices Classification Stages: Pain after activity only Pain during activity. Does not restrict performance Pain during activity. Restricts performance Chronic persistent pain, even at rest See a qualified physician if you have an injury. Only a physician can give diagnosis and prescription for injury. Educate yourself about your injury. See medical links. One starting place on the internet is the Merck Manual's Orthopedic Injuries. A medline or PubMed search can give you ideas about your condition and therapeutic modalities. Several medline links can be found on the ExRx.net. A university library will provide a wealth of information. You may not be able to checkout resources if you are not a student, but you can read and copy materials. Griffith, H.W., (1986) Complete Guide to Sports Injuries, The Barkley Publishing Group, Kemper, D.W., (1999) Healthwise Handbook, Healthwise Publications, 14. Crown LA, Hizon JW, Rodney WM, (1997) Musculoskeletal Injuries in Sports, The Team Physician's Handbook, Mosby, 2: 361-370.