How To Judge The Severity Of A Recent Injury

When you’ve suffered a new injury the first thing that comes to mind is, how bad is it?’. This question then leads you to the course of action you take. Physiotherapist, Simon Chambers discusses the signs and signals your body gives you and what to do in response to them.

Sprains and strains or acute injuries’ are a normal fact of life and likely to be more common now there is such a big focus on public health and getting everyone moving. The human body has a remarkable capacity for healing and most injuries will get better without any further intervention, and it is sometimes difficult to know if you need to seek help or not. 

You can usually treat common injuries yourself by: 

  • resting the affected part of the body for the first 48 – 72 hours following your injury 
  • regularly applying an ice pack to the affected area during the first 48 – 72 hours to reduce swelling 
  • using over-the-counter painkillers, such as paracetamol or ibuprofen, to relieve pain 

Depending on the type of injury, it can take longer to make a full recovery. At Pure Sports Medicine we believe recovery journeys following injury would greatly benefit from personalised treatment plans. In the early stages it’s important not to do too much too soon – aim to increase your level of activity gradually over time. If you are struggling to return to your previous level of activity, then it is advised that you see a physiotherapist to help understand the reasons why this is happening. The main reason will be that something is disrupting the normal healing process and delaying the natural recovery time. This is usually the case in people with poor movement patterns, training error or just pushing too hard too soon. 

In clinic we see these types of injuries daily, more often than not we are able to reassure our patients that there are no signs of significant injury and we can make simple recommendations to ensure a full recovery. 

When seeing a healthcare professional at Pure Sports Medicine you will be given a personally tailored treatment plan. This will chart out your recovery so it is easy to understand. You will be given exercises specific to you and your injury and this may be done in combination with other treatments like acupuncture, Soft Tissue Massage and joint manipulation. One of the other key components in treating your injury would be education. Patients that understand what is going on with their injury stand to recover better than those that don’t. We talk about healing times and consider these when mapping out your treatment plan. Clinicians consider the 4 phases of healing for all injuries. There is some variation in time frames depending on the tissue type/​function, blood supply to the area and our ability to protect the injured tissue. 

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Phase 1 — Bleeding
Tissue damage will result in bleeding, with the more vascular tissues (muscles) bleeding for longer than less vascular tissues (ligament, cartilage). This is the shortest phase, usually only lasting 4 – 6 hours.

Phase 2 — Inflammation
Inflammation is an essential process of tissue repair. The build- up of fluid (swelling) at the injury site brings cells that consume debris and the dead tissue. Once the damaged tissue is removed, the remaining tissue is prepared for rebuilding. This stage reaches a maximum 1 – 3 days post injury before gradually reducing over the next few weeks. This is the most painful phase and arguably the most important. If you push too hard too soon then you can unnecessarily prolong this stage and effect any future improvements. 

Phase 3 — Proliferation
The proliferation phase involves specialised cells called fibroblasts that accumulate around the injury site. Their job is to reconstruct damaged blood vessels and lay down collagen to rebuild the damaged tissue. This is the key phase to start building exercise tolerance back up again.

Phase 4 — Remodelling
The collagen laid down within the proliferation phase is disorganised, randomly oriented, and needs to mature and be remodelled. By applying gentle force such as stretching, contraction and weight-bearing pressure to the healing tissue, this helps to align the collagen fibres to run in line with the direction of tension and reduce occurrence of scar tissue. This phase can extend over 12 months depending on size and type of injury. During this phase it is key you are still sticking to your rehab, at this stage you should be largely pain free and exercises should be progressive as this will help the remodelling process. Without adequate tissue remodelling, you may be at risk of recurrence. 

In some cases, acute injuries can be more serious, these would involve, fractures, dislocations, cartilage injuries and sudden severe back pains. Here are 3 examples of signs that would suggest you need to seek help from a healthcare professional. 

  • You have Injured you knee at the weekend playing football, the knee is bruised and swollen, you are unable to move the knee normally and you are struggling to put your full weight on the affected leg. At the time of the injury you may have felt a pop or a tear, potentially during a forceful twisting movement.
  • You have had a sudden onset of back pain that also can be felt into your legs. You are getting symptoms like pins and needles or numbness and pain doesn’t improve with rest and pain killers.
  • You have injured your shoulder after falling over, you are able to move your arm, but the shoulder is catching’ or feeling stuck in certain positions. There is bruising down the arm and it feels unstable. 

There may even be a sub-group of injuries where the pain improves quite quickly but other signs remain for example, the knee joint still feels unstable and swollen. This along with noticeable bruising at the time of the injury would still suggest there was significant structural damage regardless of whether you are in pain or not. These signs would suggest that your injury needs expert assessment. In most cases you will make a full recovery under the guidance of a Physiotherapist. There are only a small percentage of people with these types of injuries that will then need to be referred on for further intervention. 

In the event the Physiotherapist feels the need for a second opinion on your injury before moving on with rehabilitation we have Sport, Exercise & Musculoskeletal Medicine Consultants in each clinic. Our SEM Consultants have great links to surgeons in London who, together with scans or other necessary imaging, would be able to give you a well-rounded opinion on your injury, and start you on the best recovery path for you. 

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