Most people know the pain of an acute sprain, whether it be a twisted ankle or a torn back muscle. However, the information on how to treat such inju-ries is inconsistent; some practitioners advise heat and rest, while others suggest ice and exercise. So, you are entitled to ask: What do I do in the first few days post-Injury?
Rest or movement?
Rest from painful exercise is essential in the early injury stage.”No pain. No gain” does not apply. How-ever, complete immobilisation is rarely necessary. We call this active rest. A rule of thumb is that gentle movement of the injured area is usually beneficial as long as it does not reproduce your pain. You can also move the joints that are distal to your injury (e.g. move your ankle for a knee sprain) to encourage circulation. Stick to these hints for the initial two or three days. After that, you’ll need specific exercises to promote healing and prevent other problems from developing.
Ice or Heat?
Most practitioners agree that ice is preferable to heat for an acute sprain. Yet sometimes, particularly for back or neck sprains, heat is recommended. Why the difference?
A few guidelines will help you choose.
1. If the injury is swollen or bruised, ice is better.
2. If the injury happened as a result of high force, such as a fall, or high speed, such as a muscle tear, then ice is better.
3. If the injury started by itself, or came on gradu-ally, then it is harder to be definite. In this case, stick with ice if you can feel tender areas around the injury site. If not, try the test below.
4. Perform some gentle movement of the injury site, and note how far you move before it hurts. Then apply an ice pack for 30 minutes, and re-peat the test. If you can move further without pain, then stick with ice. If the movement was stiffer, then repeat the test with a warm heat pack.
Apply the heat or ice for about 30 minutes every two to three hours. If the injury is large or deep (e.g. a back injury) then apply the treatment for about one hour.
Should I elevate the injured area?
If your injury is swollen, then elevation in the first few days is very helpful. It will also help it to ache less. Think where your injury is compared to your heart. Gravity will encourage swelling to settle at the lowest point, so try to rest your injury above your heart.
A well-treated knee sprain
Should I use a Bandage or Support?
If the injury is swollen or bruised, then, yes, apply a compressive bandage or elastic support to the injury. This will help to control swelling and bleeding in the first few days. Some injuries, particularly those with instability, will benefit from more support such as a brace or rigid strapping tape. However, some injuries immobilisation can result in increased stiffness and weakness. In this case, check with your physio.
Correct initial management can make a big difference to your recovery, so please contact us at Bulimba or Mansfield if you are uncertain, and we’ll set you on the right track.
Please see here to learn more about ligament sprains.
Mansfield & Bulimba Physioworks 