In this first article we decided to review the principles of managing acute injuries. How an injury is managed within the first 24-48 hours after sustaining it will significantly influence the outcome and time needed to recover. The principles of PRICER and no HARM will help to prevent further injury and ultimately lead to better and quicker healing. The main aim of treatment at this stage is to manage pain, inflammation and swelling.
Let’s get started:
P – Protect. It’s important to protect the affected area from further injury. This can be done by using crutches or wearing a protective brace.
R – Rest. Immediately cease the activity that you are participating in and rest the affected body part for the next 24-48 hours. Movement should only happen in pain free range as excessive movement will only lead to more pain and swelling.
I – Ice. This might be one of the most important steps to follow. Ice should be applied for 10-15mins every 2 hours for the first 48 hours. It will aid in relieving pain as well as minimising swelling. You can apply it in various ways but avoid placing ice directly on to the skin as it could burn.
C – Compression. If you have access to elastic bandage (crepe bandage) this should be used to provide compression to the joint, it will minimize swelling and provide extra stability. Ensure the bandage is not to tight – causing numbness, tingling or a blue tinge to the skin.
E – Elevate. Raise the injured joint above the heart at all times or at least 10mins every hour. This will reduce swelling and minimize pain.
R – Refer. As soon as possible go see a Physiotherapist or Doctor to evaluate the extent of the injury and to advise you on further management.
If followed correctly the above guidelines should help you on your way to a speedy recovery by minimizing inflammation, reducing swelling and controlling pain. Now that you have a list of things to do, here is a list of things NOT to do.
The no HARM principles:
No Heat – Avoid hot baths and showers as adding heat will lead to dilation of vessels and promote swelling.
No Alcohol – Alcohol has a similar effect to heat, promoting swelling and delaying healing.
No Running – Avoid running or any other aggravating activity, you could cause more damage.
No Massage – Massage will increase blood flow to the area and thus cause more swelling.
We are often asked about the use of anti-inflammatory medication following an acute injury. At PhysioPRO we do not advise using them in the acute phase because although we are trying to minimize inflammation we do want the process to take place to a certain degree. Inflammation is the body’s defense mechanism and plays a vital role in the healing process, so please don’t see it as a negative effect. Acute, controlled inflammation is ok (and needed) when it gets persistent then anti-inflammatory medication can be discussed with your treating practitioner. If the injury is quite severe anti-inflammatories could be prescribed by the practitioner immediately. Each injury should be assessed and treated accordingly as people and injuries are all unique. The above are merely guidelines.
We hope that this has given you an insight to managing any acute injury. If you are at all unsure about the severity of an injury please get to a trained healthcare professional as soon as possible.
Erik Kruger & Riccardo Vaccaro