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Management of Injuries


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Management of injuries

Acute injuries: (new injuries)

· Signs and symptoms: Redness, swelling, pain, dysfunction (difficult to walk/run)
· What is a sprain? It is an injury to a ligament (attaches bones together).
· What is a strain? It is an injury to a muscle or tendon (moves your body and attaches muscle to bone)
1. A muscle, tendon or ligament consists of fibers such as in a rope. When injured, think of a rope that has been cut with a blunt scissors.
· Different grades of strain and sprain?
1. Grade 1: Less than half of the fibers are torn
2. Grade 2: More than half of the fibers are torn
3. Grade 3: The whole ligament or muscle is torn
· What is a contusion? It is a bump/knock/bruise of a muscle, bone or ligament due to blunt trauma such as a clash of knees, Motor vehicle accident, fall ect.

First 7 days
· Remember the word: “PRICER”
· Prevention: The key to avoiding most injuries is preventing it through adequate warm-up & warm-downs, nutrition, correct equipment, being well-conditioned.
· Rest: Don’t train/play with an injury. Protect yourself from further injury by wearing a protective brace.
· Ice with compression: Ice the injured area for 10 minutes. Do it every 2 hours.
· Compression: Collect a compression bandage from me to prevent swelling
· Elevation: When you are sleeping/sitting the injured part must be elevated higher than your heart to decrease swelling.
· Referral: Come see me for treatment
· NB. Don’t rub your injury with anything like deep heat. It will cause further bleeding in the injured tissue.
· Rather use a topical cooling gel, like iceman or herbal ice
· Alcohol slows down your healing time
· Don’t massage over the area!!
· If necessary I’ll strap the injured area before a match or competition
· Drink 1 analgesic pill (panado,codein) 3 times per day for first 24 hours after your injury.
· After 24 hours: drink 1 anti-inflammatory pill (cataflam D/brufen/dicloflam) 2-3 times per day for 7 days.
· Put a transact patch over the injured area for 3 days
· For 3 days put recovery ice cooling compression bandage over the area for 2 hours and replace with a new one.

Do the following when pain subsides or after approx. 7 days for at least 4-8 weeks:
· Ice 5 minutes, then heat over the area for 5 minutes every 2 hours.
· Rehabilitation: Exercises and stretches to strengthen injured area and prevent re-injury.
· Rehabilitation will usually start early in your recovery process, depending on how severe the injury is.
· This is very important to prevent reoccurrence of the same injury.
· Returning to training too quick, too soon will result in re-injury!
· Thus be very careful in returning to training and remember that people differ.
· Most important thing is to listen to your body!

Chronic and/or Overuse injuries (old injuries (persisting for longer than 3 weeks) –
They are usually called a Bursitis or Tendinosis

Bursitis: Inflammation of the little bag with body fluid between certain bones and tendons.
Tendinosis: Degeneration and pain in the tendon due to overuse.
Signs and symptoms: Vague, dull, deep pain. Diminishes or disappears during training, but pain returns when stopped. Swelling seldom.
Shoulder, Groin, hamstring, kneecap, , elbow, achillis most common areas

Management: Basically the same as with acute injuries, but focusing more on rehabilitation and alleviating the cause of the injury such as:
· Inadequate warm-up & warm-downs, poor nutrition, incorrect equipment, ill-conditioned.
· Poor flexibility, poor core stability.
· Biomechanical problem such as flat feet, bow legs or knock knees, leg lengths difference.
· Overtraining
· Muscle imbalances
· Starting full training too soon after acute injury

Any questions, feel free to come see me any time!!

The most important thing to know is: PREVENTION IS BETTER THAN CURE!!!

Regards
David van Wyk
BPhyst (UP)
MPhil (Sport Physiotherapy) (UCT)

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