Wednesday, May 13, 2015

Early Management of Strains & Sprains

By Dr. Greg Lusk, DC
Injuries to muscles (strains) and ligaments (sprains) are something that each of us will experience at some point in time despite our best efforts to be safe and smart with participation in activities.  In the event you sustain an injury, there are five simple rules, collectively known as the PRICE principles, to follow in the first 72 hours post injury to maximize your rate of recovery. Consult a health care professional for an assessment and further guidance if you are unsure of the severity of your injury.

A sling, brace, or elastic wrap can be used to help immobilize the injured area and protect it from suffering more damage.  It's also important to avoid aggravating activities which may impede healing or worsen the injury.

R is for REST

The injury needs time to heal so you want to avoid activities that may interfere with this process. If you experience pain, swelling, or discomfort, stop the activity.  However, it is important to do some form of exercise that does not bother the injured area (e.g. go for a walk if you hurt your wrist) to keep up your cardiovascular fitness and prevent other muscles from becoming weak and de-conditioned. 

Movement around an injured area also helps flush out swelling by way of skeletal muscle contractions (i.e. “muscle pumps”) on the lymphatic system.  This further reduces pain and facilitates the healing process.

I is for ICE

Apply ice as soon as possible to the injured area  To avoid ice burns to the skin wrap a bag of crushed ice or frozen peas in a damp towel so there is no direct skin contact.  The 10/10/10 method of applying ice is recommended, which calls for 10 minutes of ice, followed by 10 minutes of rest without ice, and then another 10 minutes of ice.  You should repeat the cycle as many times as possible during the first 72 hours after an injury.  Ice reduces pain and possibly inflammation.  Consult a health professional before applying ice if you have diabetes, vascular disease or altered sensation.


Compression helps to stop swelling. When wrapping with an elastic compression (i.e. tensor) bandage, begin at the end furthest away from the heart.  For example, when wrapping an ankle, begin at your toes and work your way up the calf.  Be careful to not wrap too tightly as this may impair blood circulation.  If pain increases, the area becomes numb, or swelling occurs below the wrapped area, loosen the bandage.


Elevate the injured area, especially at night, by propping it up with pillows or towels.  If possible, have the injured area rest higher than the level of your heart as gravity will help to reduce swelling by draining excess fluid.

After the first 48 hours, start moving and using the injured area.  Gradual improvements in joint mobility (without pain) should be noticed.  You can start moving the joint in a non-weight bearing position first and progress to weight bearing as tolerated and if applicable based on the area of your injury.  If your injury is not improving by the fourth or fifth day, consult a qualified health professional. 
This article is for general information purposes only and is not to be taken as professional medical advice.