Acute Injury – Phase I
Inflammation Stage: 24 – 72 Hours Post-Injury
Soft tissue injuries are generally categorized into 3 phases, depending on the time since injury and the subsequent healing processes that are occurring at that specific time. The replacement of damaged, dead cells can happen in two ways: by regeneration in which the necrotic cells are replaced by new cells that form similar tissue as the original; or by repair in which injured tissue is replaced with scar tissue. A soft tissue injury that just occurred is termed acute. The pain, bleeding, and swelling are at their worst. Your body’s main objective is to protect yourself from further damage.
Blood clotting and localized inflammation begin to stop the bleeding and limit range of motion. The usual time frame for your acute symptoms to settle is two to four days post-injury, but this can vary depending on the severity of trauma and how you treat your injury.
Inflammation is a biological response of tissues and cells to injury and cellular damage. This acts as a protective attempt by the body to remove the injurious stimuli and to initiate the healing process. The problem is that the receptors involved in pain are also present in inflammation. Their activation causes an inflammatory reaction. These chemical signals released by damaged cells result in dilation of blood vessels, accumulation of white blood cells, warming of tissue and swelling.
Initial Injury Management:
There is an easy way to remember how to immediately begin treating that painful pulled muscle. R.I.C.E. is an acronym that many sports trainers and athletes use as a reminder of what to do for sports injuries. It stands for rest, ice, compression, and elevation.
- Rest – Give your body a chance to heal properly and avoid any activity that hurts. The worst pain will be over the initial 24-48 hours. Bracing and support may be needed at this time to avoid painful inflammation.
- Ice – Ice packs cause vascular constriction which can help reduce the inflammation in the surrounding tissue that has been injured. Ice packs are most effective in the first 24-48 hours post-injury. Intervals of 15 minutes on (or until the skin is numb) followed by 15 minutes off works best. Cold, moist ice works best when three to five reps are performed.
- Compression – Wraps and compression bandages also help to reduce the swelling and inflammation to an injured area. Compression wraps work best for the extremities, especially foot, ankle, and knee injuries that are weight-bearing joints.
- Elevation – Elevation of the injured area above the heart is a good general rule when possible. Again, limiting inflammation is the benefit which in turn helps to reduce pain signals.