Protection.  Protect the injured part from further damage by stopping the activity.  The extent of protection required will depend upon the severity of the injury. In the early stages the level of pain experienced can be used as a guide. Protection methods can include partial weight bearing (with crutches), arm support with a sling, strapping or taping, and should be applied using recognised first aid techniques.  Any protection must be able to allow for swelling of the injured part.

Rest. Rest is important to allow the healing process to begin without disruption.  Straining the area should be avoided during the period one to five days after the injury, depending upon severity.  Most injuries will benefit from gentle movement even during the early stages, but advice should be sought from a physiotherapist as to which exercises are most appropriate and those which should be avoided.

Ice.  Cooling the injured area helps to reduce internal bruising and swelling.  Ice should be applied immediately following injury.  The most effective application is crushed ice in a damp towel for a period of 20 to 30 minutes.  Ice should not be applied directly to the skin as cold tissue injury may result.

Compression.  Compression should be used to limit swelling of surrounding soft tissue and is achieved using elastic bandages or neoprene supports.  It should be applied as soon as possible after ice application and be kept in place for the first 72 hours after injury, when not lying down.  Compression should not be used at the same time as elevation.

Elevation.  The injury should be elevated above the level of the heart as soon as possible, again to limit the swelling of surrounding soft tissue.  Recommended duration is 72 hours following injury.  Avoid going from an elevated straight to a downward position as there is evidence of a rebound effect that can actually increase swelling.

The following symptoms may indicate severe injury and if you experience them you should go to the Accident and Emergency department of your local hospital without delay:

• Severe pain that does not settle
• Immediate and profuse swelling
• Deformity
• Extreme loss of function
• Muscle spasm that prevents movement
• Grating sensation at the site of injury
• Abnormal movement at the site of injury

The next step is to get an accurate diagnosis of the injury and the best way to speed recovery.  Physiotherapists are the acknowledged experts in the medical profession in dealing with musculoskeletal injuries.  You can self-refer or book directly with Witney Physiotherapy Centre and it is not necessary to delay by getting a GP appointment first. You should aim to consult a Chartered Physiotherapist 48 to 72 hours after the injury has occured.  This will allow time for the initial swelling and pain to subside and many minor knocks and strains will have recovered without intervention by this stage.

By considering the mechanism of injury and examining the injured part, the physiotherapist will ascertain which structures have been damaged.  In some circumstances, further investigations such as x-ray or MRI scan may be required and the physiotherapist can make the appropriate referral.

After diagnosis, your Chartered Physiotherapist will decide an appropriate course of treatment and advise upon the best level of activity throughout the recovery process.