Rehabilitation

Tissue injury usually involves damage to small blood vessels that results in bleeding at the site of injury.  This bleeding leads to the five main signs of inflammation – heat, redness, swelling, pain and loss of function.

The inflammatory reaction is necessary as it is part of the natural healing process.  However, the body tends to overreact to sudden traumatic injury and as a result more inflammatory fluid accumulates than is necessary for healing.  This fluid contains a protein that turns into replacement ‘scar tissue’.  Too much scar tissue and adhesions may prevent the structure returning to normal function with reduced flexibility and this may lead to re-injury.  The advice below should be followed for 3 – 5 days depending on the severity of the injury.

Protect  -  Protect the injured tissue from undue stress that may disrupt the healing process and/or cause further injury.  Make sure the mode of protection can accommodate swelling.

Rest  -  This reduces the energy requirements of the area, avoids any unnecessary increase in blood flow, ensures protection of the area and optimises healing.  For example using slings, crutches or static rest (ie. sitting or lying down).

Ice  -  The ice helps constrict the blood vessels thereby limiting bleeding and reducing the accumulation of unnecessary scar tissue.  Crushed ice wrapped in a damp towel (to prevent ice burn) is best (ice cubes can be wrapped in the cloth and smashed against a wall to crush the cubes).  Ice should be applied immediately after injury for 20 minutes every 3 – 4 hours or no more than 5 – 10 minutes at a time on bony areas.

Compression  -  Simple off-the-shelf compression bandages such as Tubigrip and adjustable neoprene supports are adequate.  It is important to ensure the bandages are not too tight to cause pins and needles or any loss of feeling around the joint.

Elevation  -  Lowers the blood pressure and helps limit bleeding and encourage drainage of fluid through the lymphatic system.