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Early Days of Injury

9th March, 2012

We have discussed the RICE principles in the previous Guildford blog, but I have further advice for your early management of injury.

In the first few days of injury, a question that Physiotherapists are frequently asked is how much should I be doing and how much should I rest? I will attempt to guide you here with some general rules to help you speed up your recovery...

 

Traditional advice following back injury was to rest for a couple of days in bed. This may seem archaic but it was not so long ago, in 1997 that a review of research was carried out to highlight that bed rest was not the right advice.

Current research shows us that it is better to keep active, to prevent the secondary issues of deconditioning, joint stiffness, increased muscle tightness and collections of swelling. However, it is important not to push yourself to be active if this causes an increase in pain.  Forcing yourself to walk and limping as a consequence is likely to cause more secondary problems. Limping will rapidly become your normal way of walking. You've been warned!

Key points to consider:

1) Simple analgesics (paracetamol for example) may help to reduce the pain and help you to move with greater ease. Clients of mine often stress their preference not to take medication that is only masking their pain.

It is true that pain is a warning sign and therefore has a protective role. Once you are aware of the injury however and you've worked out which movements or activities are worsening it, you will know what to avoid. The pain itself is an unpleasant sensation that most people will manage better without. Pain in addition can cause an overprotective response and therefore hold you back. Using basic pain control to mask or reduce the pain enough to start moving freely will help you be active quicker.

Remember, a simple medication such as paracetamol is not addictive, though you must respect the dose guidelines given on the packet.

2) Move in pain free directions. In the case of most injuries, at least one movement feels easier than another. For example with a new onset of neck pain, you may be able to look down easier than you can look up or look over your shoulder. In this instance, it is advisable to gently look down and back to the middle a number of times every hour. Small, pain free movements approximately 3-5 times (more if this eases the pain) will help to keep your joints moving, reduce muscle stiffness and reduce collections of fluid.

3) Relative rest. As discussed in a previous Guildford Blog, avoiding or significantly reducing the painful activity is important for recovery in the early days. Depending on the extent of your injury, you may need to rest more than normal. For example, if sitting with your head supported helps reduces your symptoms, you're likely to benefit from adding more of this 'relative rest' into your day. Do not however get stuck in one position for too long.

Disclaimer: Every injury is slightly different. The advice given here is general.

If you are concerned about your injury, or you'd like assistance in diagnosing and treating the problem area, please contact us for a Physiotherapy assessment.

Jo Lamplough, MSc, BSc (HONS), MACP, MCSP