What to do for a Sprain or Strain?
Updated April 2020
What should you do if you’ve had a recent injury, such as a ligament sprain and muscle strain? The best acute injury management is: POLICE.
The joint needs to be protected from further injury during the initial phase of recovery. Some examples of protecting could include crutches, bracing, splints, and taping. If you have a lower body injury that causes you to limp or is painful while walking you should be using a gait aid. It is important that your gait aid is properly fitted for you and that you know how to properly use it. Here is a link that outlines how to properly fit and use your aid.
Pain is your body’s way of telling you that something is injured. If you continually overload the tissues, it impairs their ability to heal. Each tissue type has a generalized healing timeline: soft tissue takes around 4-6 weeks and bone takes around 8-10 weeks to heal. These are general timelines and can be impacted by age, health status, medication, diet, and adherence to your rehabilitation program.
This means that, although rest is suggested following an acute injury, pain-free gentle movement still needs to occur. Motion is lotion. Motion increases joint lubrication and increases blood flow - both of which promote healing.
Rest from sport and aggravating activities is needed, but rehab exercises should be done starting as soon as possible after the injury. The most important thing to avoid during this stage is painful activities!
Ice + Compress + Elevate
These last 3 can be all done together and the combination helps to decrease swelling, which improves the healing process:
Icing should be done for 10-15 minutes at a time. You need to provide the skin with adequate recovery time between icing sessions - icing 1x/hour will allow for this. Be careful not to ice for too long as your skin can get an ice burn. To be safe you can wrap the ice pack in a wet towel which provides a barrier to the skin and the moisture will increase conduction.
Compression can be done through tensor bandaging or compression stockings/sleeves. These can stay on for longer periods of time. There is no magic number for how long compression can stay on for; generally, it will be most limited by comfort. Do not wear the compression overnight.
Things to watch out for to determine if the compression is too tight:
1. Changes in sensation below the compression - lack of sensation or tingling/numbness
2. Temperature/colour changes...if the skin becomes cold or blue/purple
3. Throbbing or increase in pain
All of these can be symptoms of the compression being too tight and it needs to be removed.
Elevate your injured body part above your heart to help decrease swelling. You may use things such as pillows, bolsters, or slings in order to help the injured body part rest in this elevated position. Elevation should be done more frequently when there is more swelling or if you have done a lot of activity in a day. Example: If you sprained your ankle a good option for elevation while lying on your back it placing 2-3 pillows under your foot to elevate or rest it on the arm rest of your couch.
Photo retrieved from: https://www.verywellhealth.com/how-to-use-crutches-2549326
HealthLinkBC has outlined a general guidelines for rehabilitation exercises following an acute ankle sprain. Your physiotherapist will be able to design and adapt a personalized rehabilitation program for you based on your specific injury and needs. Always check with your doctor or physiotherapist prior to starting a rehabilitation program to ensure that the exercises you are doing are suitable for you.
Jayme Gordon graduated from the University of British Columbia with a Master's degree in Physical Therapy. Prior to this she completed a Bachelor's of Science Kinesiology degree at the University of Victoria. She is a member of the Canadian Physiotherapy Association as well as the Physiotherapy Association of BC. Jayme has a passion for working with a diverse patient population ranging from athletes to community dwelling seniors. Book with Jayme today.