What You Should and Should Not Do After An Injury

What You Should and Should Not Do After An Injury

Treating and rehabilitating injuries is the main part of my job. If my patient has taken the right steps in response to their injury, it is far easier for me and much less frustrating for them. There are also a lot of common mistakes people make that can make it much worse.

The following advice can be quite literally life-changing, so take some time to memorise the information below and you’ll know what to do the next time you suffer an injury.

Rest, Ice, Compression, Elevation

RICE is an easy to remember acronym that will help you to take care of your injury properly, even if the pain is making it hard to think. It will help you give your body the best chance to heal and avoid any excessive inflammation which might cause more damage.

* Rest means reducing the amount of load and motion in the affected area. The worst thing you can do if you’re injured is to try and power through it, which can quickly turn an easily treatable niggle into something that could require months of rehabilitation.

* Ice is the application of an ice pack or even a bag of frozen vegetables to cool down the affected area. This provides some pain relief and also causes constriction in the surrounding blood vessels, which can reduce inflammation without eliminating it. What you shouldn’t do is apply heat to an acute injury. Heat can be helpful to relieve post-exercise soreness but will increase blood flow to an injured area and therefore increase the inflammatory response which will exacerbate symptoms like pain and swelling.

* Compression is applying external pressure to the affected area using compression bandage or sports tape. This provides a number of benefits, such as reducing swelling, impeding movement and providing support which enables your body to lay down effective early scar tissue and start the healing process.

* Elevation means resting the affected area above the level of your heart. Again, this helps to reduce extra blood flow and therefore swelling and inflammation without eliminating them entirely.

Avoid Anti-Inflammatories for 48 Hours After Injury

One of the most common misconceptions we physios encounter is the role of anti-inflammatories in pain relief and injury recovery.

Inflammation is the body’s natural healing response to cell damage. Uncomfortable side effects are a result of increased blood flow which contains white blood cells to clean up any damage as well as other chemical mediators to stimulate new healthy tissue growth.

Whilst a too large or prolonged inflammatory response can slow down your healing or cause more damage, it is a necessary part of recovery from injury.

There’s ongoing debate over how soon after injury you should take anti-inflammatories, as there is a line after which inflammation goes from helpful to unhelpful. I advise my patients to wait about 48 hours after an acute muscle or ligament injury.

You certainly shouldn’t be taking anti-inflammatories immediately after an acute injury no matter how irritated the affected area feels. That’s why the ice, compression and elevation components of RICE are so important: they inhibit inflammation but do not eliminate it, letting the immune system do its job without going overboard.

But You Can Take Painkillers

Over-the-counter analgesics like paracetamol– on the other hand – are usually safe to take after an injury as they block the pain signal from the affected area to the brain without inhibiting the healing response.

If the injury is more severe, you may be advised to take codeine, though as an opiate it can have adverse effects on your mental state and cause addiction.

Pain relief helps make the recovery period less unpleasant, and it can also be vital to the rehabilitation process as it enables the reintroduction of movement that may otherwise be too painful to bear.

For some, a common alternative remedy to pain and part of post-sport rituals or celebrations is alcohol. Alcohol does act as an analgesic but it’s also a vasodilator, which means that it increases blood flow. The relief you might get from drinking a few beers after a game may seem worth it in the short term, but you’ll be far worse off the next day.

Deep massage should also be avoided for the first 48-72 hours after injury as well because it will cause more blood and inflammatory products to rush to the injured area.

See a Physiotherapist As Soon As Possible

Many simple injuries can have long term negative effects on your movement or health of the affected area if not treated correctly. While RICE alone can be adequate for mild injuries, any injury that’s more severe or particularly any injury affecting a joint needs to be carefully managed to prevent compensatory movement patterns, muscle imbalance and/or recurring injury.

I stress “as soon as possible” because early assessment means early intervention, which can resolve injuries quickly. Waiting for weeks or months after the injury can in turn mean weeks or months or rehabilitation.

So don’t take any risks: if you’re injured and need urgent attention, book an appointment by calling 020 7937 1628 or emailing info@westlondonphysio.co.uk, and I’m always happy to give advice at liam@westlondonphysio.co.uk


Liam McCloskey – Musculoskeletal Physiotherapist – BSc(Physio)(Hons) MCSP HCPC