If you think you have sprained your joint or strained your muscle you should remove yourself any imminent danger [ie. the rugby pitch], elevate the limb using a pillow [or anything else you have available] along the length of the limb and place a cold pack on the injury.
Ideally use a ready-made ice pack or a packet of frozen peas wrapped in a soggy tea towel. Ice cubes in a plastic bag can be used with a soggy tea towel but be careful of ice burns. In a pinch use a cold wet towel or immerse your injury in cold water [use a basin for a hand and a clean toilet for an ankle].
Ice burns occur when an ice pack or commercial cold pack is left on for more than 10 minutes. Check your skin every 5 minutes. Your skin should go pink, not red and if it goes white, you could 'burn' your skin.
With the cold pack on, gently move the affected joint in all directions as much as possible, within your pain limits, for a minute or so. Make sure the ice pack does not fall off by wrapping a towel around your limb. It also soaks up the melted ice! After 10 minutes, remove the ice pack and again gently move the affected joint. If it is a lower limb injury, see if you can put some gentle weight on it and try walking a normally as possible.
Depending on the site of your injury, if you can walk reasonably well or move your arms well enough to control a steering wheel you may drive. If you have a long journey or you are concerned that driving will aggravate the injury or you are in any doubt about your ability to control the car, arrange for a lift.
Swelling is part of the healing process and is quite natural. However, it also hinders circulation to the injury and therefore gross swelling will slow down your healing processes. Bruising also often occurs and it is caused by small blood vessels bursting during the injury, but do not worry, your body will naturally heal these blood vessels.
To limit swelling elevate your limb as much as possible. Use a pillow along the length of the limb making sure that all the joints are comfortable. Ideally your foot or hand should be above your heart so that the swelling can go back into your circulation. Apply ice 3 times a day and gently exercise the joint, moving it [under its own steam] through a full range of movement every 2 hours or so. If it is a lower limb injury, walk as normally as possible but do not walk for long distances.
Wear a correct sized 'tubigrip' bandage to give the swelling some compression. These are available at most pharmacies and please ask advice about which size to get.
You may need to take some 'over the counter' painkillers. However, do not dull the pain to such an extent that you have no pain and do not forget that alcohol [and other 'illegal' drugs] will also mask the pain. The pain will tell you how much you can do so - listen to your body.
Whether or not you can work will depend on the type of work you do and where. If you have a long journey to work or you work in an active industry you may have to take some time off. Bear in mind the activities you have to do at work and see whether you can do those activities without causing an increase in your pain. Then you can work. If you have a desk job and a lower limb injury, try to arrange to have your foot elevated at work.
Once you have regained most of your movement and can walk without a limp you need to increase the severity and amount of exercise that you are doing. You can also reduce the treatment of the ice pack, elevation and compression as the swelling goes down.
Once you can move your limb fully and without pain, you can start using gentle weights or theraband to increase your strength. Try lifting some light weight objects, gradually increasing the weight as your injury improves. If a common day activity, such as turning on the taps, opening jars and doors etc, cause pain, practice that activity, gently at first, then with more force. If you have injured a muscle, you will need to stretch that muscle.
There is nothing wrong with the rest of your body! Keep your fitness going by swimming, cycling and weights to the non affected parts of you, assuming that none of these activities causes an increase in your pain.
By this stage you should be ready to start practicing the skills of your sport so you can return to training. When you can do a full training session, without significant pain the next day, you should be able to return to your sport. If you play a team sport always make sure that you are the extra player. Ask to go on the pitch at the start and see how you get on. If you feel pain, feel your condition getting worse, or feel your performance is letting the side down, ask to come off the pitch. If you are playing an individual sport, play a friendly match that you don't mind loosing. Don't start with you archrival or best friend and become overly competitive!
Remember - listen to your pain. If you get significant pain or it worsens during an exercise or activity, stop. If you get pain the next morning, you have done too much. Take your rehabilitation back a stage and only increase it when your pain calms down.
Remember - healing times. Even a minor injury will take 6 weeks before it is fully healed. A more major injury will take up to 3 months. Pushing yourself to return to sport too quickly will cause more problems than it's worth.
If you are unsure of the stretches you need to do, require further exercises or cannot progress to this stage, please phone Lea Valley Physio for an appointment
Copyright © Sandy Culpitt 2006 Lea Valley Physio
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