Best approach to treat acute soft tissue injuries

Updated: Sep 26, 2019

It's now all about PEACE & LOVE.





Welcome to yet another acronym in how to treat an acute muscle , tendon or ligament injury. First it was R.I.C.E , ( rest , ice,compression & elevation), then P.O.L.I.C.E, ( Protection, Omptimal Loading, Ice , Compression & Elevation) and now we have PEACE & LOVE.


So as John Lennon once sang lets give peace a chance .


P.E.A.C.E is important in the first few days or week post injury.


P is for protect.

As a rule of thumb the injured structure or area should be protected to minimize further damage. This may be as simple as using strapping to restrict range of motion or using crutches to take weight off the injured area.


E is for elevate.

Despite a lack of concrete evidence elevation is useful especially in the presence of significant swelling.


A is for Anti-inflammatories

Inflammation is a necessary part of tissue repair so anti-inflammatories will impede the bodies natural healing response. There is also evidence that persistant use of anti-inflammatories can slow down muscle tissue repair.


However there is a cost / benefit approach. Short term use of anti-inflammatories can be useful to help promote function and keep pain and inflammation at a more tolerable and OPTIMAL level. Also in acute tendonopathy Anti-inflammatories can be a great adjunct to get you out od the angry acute phase. This is a different scenario to a muscle pull or tear.


I recommend the use of ice in soft tissue injuries before Anti-inflammatories so we can optimize fuction and inflammatory response.


C is for Compression

Along with elevation this is useful to minimize excessive swelling. Evidence suggests that in ankle sprains compression can get people weight bearing quicker.


E is for Educate

The more you know about the condition and the expected healing process the better the outcome. It's amazing how much taking the fear out of a problem can make a difference to recovery process.


So after the first week to 10 days all you need is L.O.V.E as the beatles once sang.


L.O.V.E


L is for load

Loading or strength work is essential in the repair of tissue. Exercise is a form of mechanical pressure and this is what stimulates our tissues to repair from injury and get stronger and healthier again.

Using the Golidlocks theory its getting the amount just right without setting you back, then progressing back to the level you require.


O is for Optimisim

It has been shown in many studies that a postive approach and attitude towards injury , illness or surgery is assocaited with better outcomes.

I really like the phrase "the gift of injury". This is about using a time of injury as an advantage to address the chinks in your physical armour. Sort thise out and come back bigger and better than ever.

For example we may work on somebodys core strength while they are in the early stages of ankle injury, or address balance issues while working on a shoulder problem.


V is for vascularisation.

Time to drop the C word ...Cardio.

If you can do cardio without aggravating the inury this can help by increasing the vascularisation of the tissue promoting better healing. High intensity cardio also increases the amount of tissue repairing chemicals in the body and importantly endorphins for pain relief and just feeling positive.

E is for Exercise

Exercises help to restore mobility, strength and proprioception early after injury are vital. Pain should be avoided to ensure optimal repair during the first 1-3 weeks of recovery, and should be used as a guide for exercise progressions.


If there is one thing missing from this is IF IN DOUBT CHECK IT OUT. Its always worthwhlie getting an opinion regarding diagnosis and prognosis rather than a wait and see approach.


Managing soft-tissue injuries is more than short-term damage control its about getting you back to a place to prevent them happening again and makng you stronger , fitter and more robust than ever before.


So as John Lennon once sang " give peace a chance".

Any concerns about an acute injury you can give us a call or book in to see us here

Cheers

Dave



Here's John Lennon singing about soft tissue injuries



Dubois B, Esculier J

Soft-tissue injuries simply need PEACE and LOVE

British Journal of Sports Medicine Published Online First: 03 August 2019. doi: 10.1136/bjsports-2019-101253



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