Acute Injury Management

Chartered Physiotherapists are commonly involved in the acute stages of an injury, often being the first professional a patient comes in to contact with. Acute injuries can occur in a number of different ways, either after a fall, a sporting injury or after an accident for example.

When we use the term “acute”, we are referring to the inflammatory process and the changes which occur within the tissues on a cellular level. Inflammation is a protective response by the body to remove the causative stimuli and initiate the healing process. Remember inflammation and infections are two different things.

5 Signs of acute inflammation:

• Pain (dolor)
• Heat (calor)
• Redness (rubor)
• Swelling
• Reduced function or range of movement (depending on location)

The inflammatory process

During the primary stages of an acute injury it is important to remember to address the symptoms of inflammation (5 signs above). Follow this simple method below for immediate management of any acute injury:

Rest: stop the activity you are doing and get into a comfortable position to offload the affected area, e.g. after a twisted ankle sit down or try not to weight bear too much on it
Ice: apply cold or ice to the affected area. This will act to reduce heat and swelling and slow the capillary blood flow 2. We advise to use an ice pack wrapped in a damp tea towel and gently apply it to the injured area for a maximum of 20 minutes and to repeat this every 1-2 hours during the first 48 hours after the injury. It is imperative you do not apply the ice directly to your skin as this can lead to burns and further injury 1. Do note however, if the ice is too cold you will not find it comfortable to keep it there.
Compression: this is useful to help manage the swelling. Apply a compressive bandage to the area, starting the bandage furthest away and working towards you. Check the area regularly to make sure that blood can still flow to the area; you do not want it to be so tight it becomes painful.
Elevation: raise the affected body part to encourage swelling to drain away. For instance, put your leg up on a pillow on the sofa (this obviously works best for injuries of the limbs.) Small, gentle movements will also aid lymphatic drainage of fluid and encourage the muscles around the area to contract to pump blood and fluid away from the area.

The period of inflammation and acute injury varies from person to person and is dependent on the type of injury sustained, the type of tissue injured (e.g. muscles, tendon or bone) and how quickly initial injury management is started.

Important Note
If you have recently sustained an injury than the information above could provide some help with your symptoms, however it does not act as a replacement to seeing a doctor or if severe, visiting A+E. If you are ever in doubt of what to do you can call one of the following:

• Your GP Surgery (most have an out of hours number for emergencies)
• Dial 999 to ask for an ambulance
• Dial 111 – this is the NHS direct line and is suitable for when you need medical help fast but is not an emergency or life-threatening situation. This number is useful to call if you are not sure whether you need to go to A+E or just don’t know who to call to seek help or advice from. This number is open 24/7 365 days a year and we highly recommend using it if you ever have any doubts at the time of an injury.

Our team of experienced Chartered Physiotherapists at Lilliput Health are always more than happy to help with any enquiries or to provide advice if you are not sure what is best to do.

For more information or help with an injury, call the clinic today on 01202 725090 or email us on info@lilliputhealth.co.uk .

References:
1 Bleakley, C.M., McDonough, S.M. and MacAuley, D.C. (2006) Cryotherapy for Acute Ankle Sprains: A Randomised Controlled Study of Two Different Icing Protocols. British Journal of Sports Medicine. 40, pg.700-705.
2 SUNITHA J. Cryotherapy- A Review. Journal of Clinical and Diagnostic Research [serialonline] April 5, 2010; 4:2325-2329.
3 Schaser, K., Disch, A.C., Stover, J.F., lauffer, A., Bail, H.J. and Mittlmeier, T. (2007) Prolonged Superficial Local Cryotherapy Attenuates Microciculatory Impairment, Regional Inflammation and Muscle Necrosis After Closed Soft Tissue Injury in Rats. American Journal of Sports Medicine. 35(1), pg:93-102.
4 Bleakley, C.M., Glasgow, P. and Webb, M.J. (2011) Cooling an acute muscle injury: can basic scientific theory translate into the clinical setting? British Journal of Sports Medicine. 46; pg: 296-298.
5 Bleakley, C.M. (2013) Acute Soft Tissue Injury Management: Past, Present and Future. Physical Therapy in Sport. 14; pg: 73-74.