The tips for Sports Injury Treatment when the injured body parts can be used almost normally

(1) To accustom the injured tissues to being without support. This is achieved by using an elastoplast or crepe bandage support. Both types of support allow considerable freedom of movement, but provide the injured structures with a certain degree of stability. It is never advisable to take away all support from the injured tissues before they have recovered completely. If this is done the injured part tends to swell when used, owing to a leakage of the blood

fluid from the capillaries into the tissue spaces. The swelling gives rise to considerable pain and stiffness. The leakage of the blood fluid is due to a loss of tone of the capillary walls, which have become accustomed to the firm support of the original strapping.

(2) To disperse any residual effusion or thickenings. This is accomplished by the auto-massage pressure of the strapping or crepe bandage. When strapping is used the massage can be localized most effectively by strapping over a pad of adhesive felt. Heat treatments, remedial exercises and deep massage are also of great value.

(3) To strengthen the muscles of the injured part, and to restore full joint movement. The player practices all types of strengthening and mobilizing exercises, including weight-resisted exercises. Usually the supporting bandage or strapping is removed for the treatment session; it may be retained for the stronger exercises.

(4) When Sports training is started, please pay attentions to prepare the injured part for the normal stresses and strains of the game or event. This is done by the player resuming training and carrying out all the normal movements which are expected of him. The Injured part should be supported by a firm strapping, to prevent a recurrence of the injury.

For two to three months after the injury has recovered fully the player should have the injured part strapped firmly each time he takes part in a game or event. The time factor, of course, will depend on the severity of the original injury.

The treatment for 24 to 36 hours after sports injury, until injured body parts can be used almost normally

(1) To disperse the traumatic effusion, i.e. (a) to spread the free blood fluid into the surrounding tissues, so that it mil be drained away by the uninjured lymphatic vessels and veins, and (b) to assist the drainage of any excess amount of synovial fluid . This aim is accomplished by the use of strapping and various forms of physiotherapy.

Strapping. The injured part is strapped firmly and the player encouraged using it as normally as possible; in injuries of the lower limb this usually includes walking. The pressure of the strapping on the moving muscles and joints acts as a most efficient form of auto-massage, which improves the circulation and the lymphatic drainage of the part.

To increase the effect of the massage the strapping may be applied over a pad of adhesive felt, which is positioned over the injured tissues.

Two types of strapping may be used: (a) Zinc oxide adhesive plaster, and (b) Elastoplasts combined with supporting strips of zinc oxide plaster. Support is necessary until the traumatic effusion has been completely dispersed; this may take anything from two or three days to two weeks or more, depending on the severity of the original injury.

Protecting the skin. The skin is often sensitive to the adhesive spread, or may be irritated by the strapping being changed frequently, as when daily massage is given. To protect the skin the strapping may be applied after the injured part has been covered by a few turns of ordinary cotton bandage, which has been previously soaked in cold water. The strapping must overlap the bottom and top edges of the cotton bandage by about i to I in., so that it is securely fastened to the skin.

When using elastoplasts another method of protecting the skin may be tried. The non-adhesive side of the strapping is applied to the skin; the reinforcing strips of zinc oxide plaster are then arranged over the adhesive surface. Any areas which are left uncovered are powdered with talcum powder to make them less sticky.

Joint injuries. In dealing with a joint injury which is associated with a large synovial effusion strapping is not used. A pressure bandage is applied to the joint, the injured limb is rested, and the controlling muscles exercised by static contractions and other non-weight-bearing exercises which do not cause movement of the affected joint.

Physiotherapy. Massage, exercises, contrast baths, faradic stimulation and anodal galvanism may be used to disperse the traumatic effusion. Two or more of the treatments are generally used in combination, and the choice depends on individual preference and the stage of recovery. In the early stage, for example, anodal galvanism, faradism and contrast baths may be employed; later, massage and exercises.

(2) To prevent movements which might stretch the damaged structures and break down the delicate repair tissue which joins the ends of the torn fibers. This aim is achieved, as far as possible, by arranging the strapping so that it holds the injured tissues in a relaxed position. With many muscle injuries this is not practicable, and the therapist has to support the affected muscles in a circular manner, and instruct the player not to put them on the stretch.

(3) To assist repair. The aim is accomplished by the measures which have been previously outlined for improving the circulation and preventing the damaged structures from being stretched. Some form of heat therapy may also be used to improve the blood supply of the injured part-short-wave diathermy, infra-red radiation, radiant heat or hot packs.

(4) To strengthen the muscles of the affected part, especially those which may have been injured. The player practices some simple remedial exercises which do not stretch the damaged structures or require too much muscular effort; in practice this means exercising within the limit of pain.

(5) To maintain the normal range of movement of the joint or joints of the injured part. This is done by using exercises of the type suggested above. Unless the joints are exercised their movements may be seriously limited by the formation of thickenings and adhesions.

Immediately treatment after the sport injuries for about 24 to 36 hours

(1) To limit the traumatic effusion (swelling), and so restrict the amount of “Sticky” blood fluid in the tissue spaces. This is achieved by applying a pressure bandage to the injured part. A calico or crepe bandage is used over several layers of cotton wool, each layer being compressed by turns of bandage; it is essential that the turns cover the injured part adequately, and extend well above and below it. In general calico bandages are used when treating joints and crepe bandages when dealing with muscle injuries.

Strapping should not be used to limit traumatic effusion in the early stage of injury; it may produce an uneven, cordlike compression, which may increase the effusion. It should be noted, however, that when an injury does not appear to be of a severe nature, and it is considered essential for the individual to continue to use the injured part, an elastoplasts strapping is used instead of a pressure bandage. The principle of allowing an injured player or athlete to resume activity immediately after an injury is basically unsound, and should not be accepted by the trainer or therapist unless he is acting on medical advice.

Ice-Cold Water. When pressure has been applied the injured part may be immersed in ice-cold water for about 10 to 20 minutes; if immersion is not practicable the bandage may be soaked, the water being applied with a sponge for the same length of time. The wet bandage is then removed, and a new pressure bandage applied. The cold water relieves pain, and may help to check effusion by causing a local constriction of the capillaries.

Local Injections of Hyaluronidase. In recent years many doctors have used local injections of hyaluronidase to accelerate the dispersal of traumatic effusion. The injections are used in conjunction with the other forms of physical treatment mentioned in this section.

(2) To prevent movements which might stretch or strain the injured structures and so (a) cause a recurrence of the bleeding, or (b) pull the ends of the torn fibers apart and so hinder repair. This aim is accomplished by supporting the damaged structures with the pressure bandage in such a way that they are completely relaxed, and then to resting the injured part. The type of rest required will depend on the severity of the injury; in injuries of the lower limb it may vary from complete rest in bed with the limb raised on pillows (to assist circulation and aid drainage of inflammatory exudates) to semi-rest, e.g. walking with crutches without taking weight on the injured limb. la injuries of the upper limb a triangular sling may be used to provide rest.

(3) To relieve pain. To a certain extent this aim is achieved by the measures which are taken to fulfill the previous aims pressure, support, cold applications and rest. In addition some type of pain-relieving drug (e.g. aspirin) may be prescribed by the doctor. It should be noted that when rest in bed is required for an injury of the lower limb a considerable amount of discomfort and pain is often experienced if the bedclothes are allowed to rest on the limb. A bedclothes support should be improvised by putting a large cardboard box or a pile of books on the mattress at the foot of the bed.