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Knee injury
09.17.18|Posted by Ascenti Team

How to treat a soft-tissue injury, sprain or strain 

Sprains, strains and other soft-tissue injuries can be painful, frustrating and sometimes hard to shake off. Find out the best way to effectively treat your injury here.

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 72 hours?

You should follow the ‘POLICE’ steps within the first 72 hours of your injury:

Protection

Stop any activities that you may be doing and protect the area, especially if you are playing sports. 

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.

Optimal Loading

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 protect the area.

For example, if you sprain your ankle you may still be able to use the rest of your leg and move around gently.

Evidence has found that complete immobilisation of an area or bed rest is not good and that optimal loading can stimulate healing. 

Ice 

Icing the area can reduce inflammation, swelling and help with any pain. 

  • 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 up to 15 mins and remove if it gets painfully cold.
  • 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.

Compression

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.

Elevation 

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 72 hours if swelling is a problem.

What activities should I avoid?

During the first 72 hours you should remember the ‘NO HARM’ protocol. This means no:

  • Heat 
  • Alcohol 
  • Running / exercise 
  • Massage 

These activities may prevent or slow down the healing process.

How should I manage my injury after 72 hours?

You should use the ‘MICE’ approach to manage the area beyond the initial 72 hours. The swelling should have improved by this point.

Movement

During this period, the injured area will still feel quite sore, weak 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.

Ice 

Continue to use ice to ease pain and discomfort.

Compression

If you have been given a compression bandage or brace it is helpful to continue to use this when you are up and about, but make sure you remove it regularly to perform movements.

Elevation 

You may still feel that elevating the area a few times a day is helpful to ease pain and manage the swelling but this should be done less often now.

Over the next few weeks your symptoms should show signs of improving quite rapidly. If you 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.