Post Injury Phase Of Treatment & Management

Newsletter module No 3:

Post Injury Phase Of Treatment & Management:

There are five identifiable phases of post injury management. The phases will not be constant or uniform and will depend on the degree of injury, the tissue involved and actions by the player and medical team post injury.

Phase 1 Phase 2 Phase 3 Phase 4

Phase 5

Immediate Post Injury Phase (0-20 minutes post injury) Acute Phase (up to 48-72 hours post injury) Sub-Acute Phase (3 days up to 10 days post injury) Active Rehabilitation Stage Mobilising exercises for joint range. Strengthening exercises. Functional Rehabilitation Training Stage

During each of the above stages there must be clearly identifiable objectives directly relating to the players injury state and goals for progression and improvement.

Objectives of treatment (Acute Phase)

Control the bleeding and swelling Relieve pain Protect from further damage Sound home advice Correct measurement and use of walking aids (non-weight bearing walking).

This phase is characterised by pain, swelling, and heat, discolouration of area and loss of function. Inflammation is the body's response to tissue injury caused by, pressure, friction, repeated load and overload, and external trauma.

The Effects of Acute Injury:

This depends on the degree of damage.

Immediately

Pain Bleeding from torn blood vessels of damaged tissue Followed by coagulation Subsequently

Inflammation

Redness due to vaso-dilation of blood vessels

Heat Pain Swelling Reduction or loss of function

o Redness / Discolouration - Due to dilation of nearby undamaged blood vessels.

o Heat- Due to vaso-dilatation of blood vessels and increased metabolism o Pain- Of an aching type due to tension in the area from swelling and chemical

changes. o Swelling- Oedema of the tissues caused by bleeding and seepage of plasma

like fluid from dilated capillaries. o Reduction / Inability to function- This will depend on the degree of injury.

The degree of injury will dictate the severity of signs and symptoms.

1st Degree- Minor damage to tissue. 2nd Degree- Moderate damage to tissue. 3rd Degree- Major damage to tissue.

PRICE:

The `PRICE' treatment regime is used in the management of acute injury:

Protection

Injured part should be immobilised by a pressure bandage or support bandage to assist.

Rest

In the first 48 hours post injury rest is a most valuable contribution to the healing process. All activity or positions causing discomfort, pain and swelling should be avoided.

Ice will produce local blood vessel

Ice

diameter narrowing causing a reduction

in swelling and heat. It will also cause

sensory numbing of the area to reduce

pain. Ice or cold should be applied to the

injured part until the area is numb.

This will be for 15-20 minutes every 2 `waking hours'. When icing a joint, the ice should be removed every 5 minutes and the joint gently moved within a pain-free range.

Compression

It is important to protect the skin from `skin burn' by the ice, by containing the ice in a damp towel or by applying a frozen gel pack.

A compression bandage should be applied (2-3 layers of cotton wool and crepe bandage): The compression bandage may be worn for up to 24 hours before reapplication and offers counter-pressure to the injured site, reducing blood flow and swelling. It is important to check the player's circulation after bandage application; this can be done by squeezing and releasing the player's nail bed.

Elevation

The limb should be placed in an elevated position (above the heart) which assists with the return of blood and fluid to the heart from the injury site. It reduces the formation of further swelling.

PRICE ? The protocol for immediate treatment of injury

Protect Rest Ice Compression Elevation

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