Your muscles, tendons and ligaments are what we call soft-tissues.
Sometimes soft-tissues become injured, sprained or strained, due to a sudden movement, too much force being put on them or because of repeated activity.
We call these problems acute soft-tissue injuries and we often see these injuries as a result of playing sports or accidents.
The immediate pain and swelling can be worrying, but it’s important to remember that the majority of soft-tissue injuries will heal and recover well if you treat them correctly.
How serious is my injury and when will it heal?
Soft-tissue injuries are usually graded from 1-3 by physiotherapists and healthcare professionals.
The vast majority of soft-tissue injuries are grade 1 or 2, and if you had a grade 3 injury you would most likely be in A&E or seeking help immediately.
- Grade 1 – Used to describe a mild sprain, strain or tear. These injuries will present with swelling and tenderness, but usually heal within 2-3 weeks with the right care at home.
- Grade 2 – More extensive damage and with more soft-tissue involved. These injuries can take between 4-12 weeks to recover fully and may require input from a physiotherapist.
- Grade 3 – Used to describe a serious or complete rupture or tear, sometimes accompanied by a bone break. These injuries require urgent medical attention, X-rays and sometimes surgery.
If you are worried about your injury then you can seek urgent medical advice by calling the NHS helpline on 111 or by visiting A&E.
What should I do within the first 1-3 days? During the first three days of an injury your body enters what we call the ‘inflammatory stage’. This stage is often the most painful and needs the correct management, known as PEACE:
P Protection - avoid activities and movements that increase pain for the first few days
E Elevation - elevate the injured limb higher than the heart as often as possible
A Avoid taking anti-inflammatory medication as they can reduce tissue healing. Avoid icing for more than 5 minutes.
C Compression - use a compression bandage or taping to reduce swelling
E Education - your body knows best. Avoid unnecessary treatments and medical investigations and let nature play its role.
What else should I avoid?
During the first 3 days after an injury you should remember the ‘NO HARM’ protocol. This means no:
- Running / exercise
These activities may prevent or slow down the healing process.
What should I do after the first three days?
After this time, and for the next 7-14 days the injury needs LOVE:
L Load - let pain guide your gradual return to normal activities. Your body will tell you when it’s safe to increase load.
O Optimism - condition your brain for optimal recovery by being confident and positive
V Vascularisation - choose pain free cardio-vascular/aerobic activities to increase blood flow to repairing tissues
E Exercise - restore mobility, strength and balance by adopting an active approach to recovery.
Here’s some more information about some of these stages:
Avoid any activities that increase pain and protect the area from further damage. However complete rest should be minimised as this can also delay repair.
Move your injured part little and often into directions that do not cause sharp pain when you are sitting down or when there is no weight going through the area. Do not move into any positions that caused the injury in the first instance. For example, if you twisted your knee, don’t twist it into the same direction or position again.
The use of a brace or splint may be helpful depending on the severity of the injury.
Keep the affected area supported and higher than the joint above it.
For example, if the injured area is your ankle then sit with your leg out straight supported on a pillow to raise it higher than your knee. This will prevent excessive swelling.
This should be done as much as possible in the first three days if swelling is a problem.
Avoid anti-inflammatories and icing for long periods
Icing the area can help with any pain relief, but it may also interfere with healing tissues if applied for long periods. If you’d like to use ice for pain relief, follow the steps below during the first three days, after this time you can use ice for up to 20 minutes.
- Rub some barrier oil or moisturiser on the area you are going to ice. This can be olive oil, vegetable oil, almond oil or whatever you have. This helps to avoid any sticking.
- Wrap crushed ice, frozen peas or a chill pack from the freezer in a clean and damp tea-towel.
- Place over the area and secure with another towel.
- Never place your calf or thigh on top of the ice, always place ice on the body part as the extra compression can increase the risk of an ice burn.
- Leave for 5 mins and remove if it gets painfully cold (after three days this can be left for up to 20 minutes).
- Repeat every 2 hours for acute or severe injuries or 3-4 times a day for less serious injuries or complaints.
- The skin will look pink when you remove the ice but this is normal.
Do not apply ice if you have any loss of sensation or numbness in the area, extreme sensitivity to cold, poor circulation in your hands or feet, Raynaud’s disease or broken skin.
Some people find a compression bandage or support helpful in the early stages of a soft-tissue injury. This is optional, not essential, and should not be used if you are also elevating the area.
Then after three days…
This is a technical way of saying keep the area moving as much as you are able to and within your comfort zone. You can still do this with the use of a brace or splint to support the area.
During this period, the injured area will still feel quite sore, weak, swollen and difficult to move.
This is the time when small, controlled movements can really help the healing tissues form in the right direction and pattern to ensure the newly healed area becomes flexible and strong like the original tissue was.
Frequent movements in all of the directions that the area will move into will help. This should not be against any weight or pressure, just gentle repeated movements every few hours.
Over the next few weeks your symptoms should show signs of improving quite rapidly. If your pain is persisting beyond this time or if you have any concerns or questions, contact Ascenti for further assessment and treatment.
When should I seek additional help?
Most minor acute soft-tissue injuries will heal well on their own if you treat them correctly, but sometimes you may need additional support to rehabilitate the area fully.
If you have seen no improvement to your injury within 3-4 weeks despite following the recommended guidance then you should speak to your physiotherapist or GP.