July 2013

Weekend Warrior Injury Care Basics for the Lowcountry

Author: John P. Batson, M.D., FACSM


Much of sports medicine deals with relatively simple injuries (sprains and strains) that can be treated if you follow some basic concepts. RIICE (Relative rest, ice, immobilization, compression and elevation) is an old injury care mnemonic that still can be used by athletes and weekend warriors today.

Relative rest. Sometimes it is obvious when you are injured you are unable to participate in the activity. If you have sharp pain or the injury feels worse after the activity, it is advisable to rest. For ankle and knee injuries if you are limping you should be resting. Relative rest means participating in some activities, but nothing that causes pain. Runners may still be able to bike; golfers may be able to chip and putt; tennis players may be able to play mini tennis. The key is you should be getting better and better. If the injury is not healing or feels worse, more rest is needed.

Immobilization. If you have an injury to a joint (e.g. knee or wrist), often a brief period of immobilization is helpful with pain control and to reduce swelling. A sling can be used for shoulders or elbows. Splints are great for wrist and finger injuries. Crutches may be needed to help rest a leg injury. Your doctor may suggest a cast or removable splint if a bone is injured or the joint injury is more severe. As the injury heals, gentle range of motion is usually beneficial. Some splints for ankles and knees are very functional and can allow a quicker return to sports.

Ice and Heat. In most cases, ice is a better option for injuries. Ice constricts blood vessels and thus helps with inflammation and swelling. Ice also slows nerve signals so can directly help with pain control. It is helpful with acute injures such as sprains and strains and fractures. Ice can also be used during the rehab phase after therapy or sports to prevent recurrent swelling and pain. Heat has its benefits as well. After the acute (early) phase of an injury, heat can be used prior to rehab or sports to increase blood flow to the injured area. This is helpful to improve range of motion of joints or assist muscles to be ready to work. For arthritis, heat helps with range of motion, especially in the morning or after periods of rest. Heat can also be used to help resorb bruises and blood collections after the acute phase (3-4 days). With both heat and ice, it is important to protect the skin and not place the source of ice/heat directly on your body. Usually 20 minutes is all that is needed, and this can be repeated multiple times in the day.

Compression. Providing compression after an acute injury can help control swelling. Controlling swelling helps with pain control and will allow a quicker return to activities. Ace wraps and neoprene sleeves are used for compression. It is best to have a professional (sports medicine doctor, physical therapist or certified athletic trainer) show you how to wrap an injury, because if not done properly, it could increase pain and cause other problems (such as reducing blood flow to the arm or leg).

Elevation. For arm or leg injuries, elevation can help control swelling. As with proper compression, elevation helps with pain control and allows for a speedier recovery. The key with elevation is that the affected area must be placed above the level of the heart. Throwing your arm on a desk or your leg on the coffee table may not be adequate.

Following the RIICE strategy will hopefully allow you to recover quickly and return to exercise or sports. Other simple lifestyle modifications can help as well. Staying hydrated can assist during the recovery phase, as can obtaining adequate sleep. Taking a multivitamin can provide anti-oxidants which help with inflammation and recovery. Adequate healthy protein can help rebuild damaged tissue. Certain medications (Tylenol and Motrin for example) can help with pain and inflammation. It is best to take these after seeing a sports medicine physician who can review your past medical history and determine which medication is the safest. Joint or spine injuries which do not respond to basic injury care should be seen by a sports medicine physician. Sports medicine physicians hold additional certification after completing fellowship training specifically in sports medicine.

When to see a sports medicine physician:
• Pain or swelling in a joint lasting more than a week
• Joint injuries which now feel loose or unstable
• Pain over a bone suggesting there may be a fracture
• Low back or neck pain associated with weakness, numbness or tingling
• Pain associated with redness or warmth.

For more information, contact Lowcountry Spine and Sport, located at 300 New
River Pkwy, Suite 37, in Hardeeville, (843) 208-2420 or visit online at
spineandsportmd.com.

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