Most sports injuries, muscle tears and sprains can be classified as soft tissue injuries. The initial assessment, diagnosis and management of these soft tissue injuries can be critical to the recovery of the injury. Rapid assessment of the injury should be sought by a Chartered Physiotherapist or suitably qualified professional.
The P.R.I.C.E regime is widely used in the management of joint and soft tissue injury in the first 72 hours to: reduce pain, limit swelling/bleeding, protect from further damage etc.
Protection Rest Ice Compression Elevation
This is required to protect the injured tissue from undue stress which may disrupt the healing process. Very weak bonds form in the injured tissues quickly after an injury, if these bonds are broken by stresses this can lead to re-inflammation and a slowing of the healing process.
Protection can be administered in different ways. A plaster cast can be applied, taping an area, the use of crutches (in a lower limb injury) and the use of slings (in upper limb injury).
This is required to reduce the demands on the damaged tissues and thus avoid any increased blood flow, which can cause more swelling. It also prevents undue stress on the injured area which can break the fragile bonds that form initially. Rest may be selective, some general activity may be allowed.
This is used to reduce the temperature at the injury site and limit bleeding by causing constriction of local blood vessels. It can be applied by placing a pack of crushed ice/frozen peas in a damp towel over the area for 10 minutes per application. A rest period of 30 minutes between 10 min application is advised to allow the circulation to local tissues to recover.
This is applied to limit the amount of swelling. Swelling is caused by fluid that leaks from the injured tissues into the surrounding area. Controlling the amount of swelling reduces the amount of scar tissue formed and therefore leads to a quicker recovery. Compression can be used with special compression bandages.
By elevating the injured area, the pressure in the local blood vessels lowers & helps to limit bleeding into the area. It will also increase the drainage of the fluid and so limit and reduce the swelling. Elevation of the injured area above the heart is ideal.
There are a multitude of different types of muscle, tendon and sports related injuries, some of which are covered separately. Most soft tissue injuries can be classified into three different grades.
Grade I – A very mild injury that is a result of soft tissues (muscle, tendon, ligament, fascia) being stretched. There is minimal swelling and bruising but pain can be present. No joint instability is present and there is minimal muscle spasm or loss of function.
Grade II – A more moderate injury where there is actual tearing of the soft tissues. Moderate swelling, bleeding and pain is present. Some joint instability and loss of temporary function may be felt.
Grade III – Involves a complete tear of the soft tissues. There is significant swelling, bruising and pain with major function loss. Severe instability and muscle spasm can be felt. Immobilization and/or surgery may be required.