What to do in the first 72 hours

This might be stating the obvious, but if you’re bleeding profusely, having trouble breathing or any parts of your body are turning blue – then dial 111… NOW! Sorry we’ve just got to say that stuff these days.

But if you’ve just done a soft tissue injury; if you think you’ve pulled a muscle, torn a tendon, or just given yourself a really good bruising, here’s what you should do in the first 24 hours: It’s easily remembered by the mnemonic acronym: RICER – Rest, Ice, Compression, Elevation, Referral.

Rest

This reduces further damage. Avoid as much movement as possible to limit further injury. We say relative rest as some movement often helps flush of inflammation from the injured area. In the case of low back pain we know that bed rest is a big no-no. So if your back is injured keep moving and avoid staying in one position for a prolonged period.

Ice

Apply an ice-pack to an injury for 20 minutes every 2 hours. Continue this treatment for the first 48 -72 hours. Ice cools the tissue and reduces pain, swelling and bleeding. Place cold pack wrapped in a towel onto the injured area. Don’t apply cold pack directly to the skin. Extra care must be taken with people sensitive to cold (such as children) or with circulatory problems.

Compression

Covering the injured area as well as the areas above and below in a compression bandage or Tubigrip (a compression sock sized to fit the injured area). Compression reduces bleeding and swelling. Check the bandage is not too tight- your can do this on arms or legs by gently squeezing a finger or toe and seeing how long it takes to the white tissue to turn back to pink. If it takes longer than on the non injured side it’s too tight.

Elevation

Elevating the injured area will help to stop bleeding and swelling. Place the injured area on a pillow for comfort and support. It’s most important to have the injured part about your heart, so if it’s your shoulder you have injured no elevation is necessary unless you’re hanging upside-down! For knees and ankles placing your leg on the back of the couch as you lie length ways on it is a good way of elevating above your heart (but sitting on a chair with your leg on another chair isn’t).

Referral

Sometimes you’ll be lucky and the next morning it’ll feel 100%. But if it doesn’t – or if you’re just not sure – it’s best to refer the injured person to a qualified professional. This is where you just have to listen to your body – if it’s healing slower than you’d expect – or if it’s getting worse – then it’s time to go see a qualified professional such as a doctor or physiotherapist for precise diagnosis, ongoing care and treatment..

This is where we come in- we understand that having a soft tissue injury isn’t just about your ankle or back but also about you! Injuries can be emotional because they stop us getting out and above with our friends and family. Proper management involves a complete rehabilitation plan so that you know where you are going and what you need to do to get a full recovery.

You don’t need a doctor’s referral in New Zealand to see a physiotherapist. If you have had your injury in NZ then ACC will assist with the cost of your treatment- we can help you out with the paperwork when you come in for your assessment.

Oh yeah, and as far as things not to do go, we’ve got an acronym for that too: HARM.

Heat

This increases bleeding in the injured area, so avoid hot showers, baths and heat rubs for at least 72 hours after injury. That’s not to say don’t bathe, just don’t overdo it!

Alcohol

Although you may feel like a stiff drink to settle your nerves after an accident, alcohol leads to increased bleeding and swelling and can increase your recovery time. Alcohol may also reduce your ability to protect your injury.

Running

Running or any vigorous physical activity can increase damage for up to 72 hours after injury – go for a nice relaxing walk instead!

Massage

Massage increases bleeding a swelling at the injured are and should be avoided for at least 72 hours. If you do choose to have a relaxation massage in this period, ask the therapist to avoid the limb that is injured.