If a severe injury is suspected the individual should be referred immediately to either an A&E department, or an experienced practitioner in the management of soft tissue injuries.
If possible, apply cold in the form of ice immediately after an injury. The aim is to reduce local tissue temperature, reduce pain and cause vasoconstriction (narrowing of the small blood vessels) in the area which can help to minimise and control swelling. It is important not to apply the ice for too long as this can cause the opposite effect in the circulatory system i.e. vasodilation (opening the blood vessels) which can increase swelling. So, short, regular bursts of icing are recommended in the region of 10-12 minutes every one to two hours. Chipped or crushed ice in a damp towel or j-cloth appears to be the most effective application. A damp towel or cloth should always be placed between the cooling agent and the skin to prevent an ice burn.
The PRICE guidelines are very helpful for the first 48-72 hours following a soft tissue injury-Protection, Rest, Ice, Compression & Elevation.
The aim is to
- reduce local tissue temperature
- reduce pain
- limit and reduce inflammatory fluids into the area or injury
- reduce metabolic demands of the tissues
- protect the damaged tissue from further injury
- protect the newly-formed soft tissue fibres from disruption
- promote collagen fibre growth and realignment
- maintain general levels of cardio-respiratory and musculoskeletal fitness / activity.
Support the injured part to protect against further damage.
The type of protection required will depend on the site and nature of injury. This may range from protection from full weight-bearing e.g. crutches, to general support e.g. slings, to specific support for the injured structure e.g. taping/braces.
Should be applied to the injured part immediately following injury.
Stress on the injured tissue should be avoided during the early stage of the healing process.
Elastic bandages and tubigrip appear to be the most effective form of compression. It is important that these are not applied too tightly so as to overly constrict the circulation and should not be worn overnight unless under medical guidance.
Elevate the injured part as soon as possible following injury ideally above the level of the heart.
Ensure that the elevated part is adequately supported e.g. with pillows.
If the limb can be maintained in elevation do not apply compression at the same time.
For non-acute injuries such as neck or back pain
Many people find heat helpful - a hot water bottle wrapped in a towel or heat packs or patches. It's important that they are not too hot to avoid a skin burn especially applied over bony areas, less sensitive areas and in older people (skin can be thinner and more fragile).