Preventing Sports Injuries | Johns Hopkins MedicineSports injuries comprise damage to the body that happens during a sports activity or some form of physical exercise. The injury forces cessation of the activity due to physical discomfort or pain.

Examples of the most common sports injuries are tennis elbow, bone fractures, dislocations, runner’s knee, torn ligaments, ankle sprain, torn Achilles tendon, and others.

Chronic vs. Acute Injuries

Sports injury treatment distinguishes between two broad categories of sports injuries: acute and chronic injuries. Knowing which type of injury you are dealing with can help you decide on the appropriate treatment.

Acute sports injuries happen suddenly due to a specific incident, such as a fall or an aggressive tackle. They cause sudden severe pain and swelling.

Chronic sports injuries usually happen gradually over time due to overuse or strain of a particular part of the body. Examples are tendinitis, stress fractures, and shin splints. Examples of acute injuries are sprains and dislocations.

Treating Minor Sports Injuries

Every injury is different and requires a specific strategy for optimal healing. The most well-known method for treating minor injuries is the RICE method, which stands for rest, ice, compression, and elevation.

There are other methods as well, such as the PEACE and LOVE protocols

The RICE method is a protocol for injuries that individuals can follow at home to reduce swelling and ease pain. Let’s look at the four steps in more detail.

RICE Protocol

1: Rest

In this context, rest means not using the affected body part for at least 48 hours. Rest can prevent further damage, while continued movement can worsen the injury and even aggravate it. In fact, a minor injury can turn into a major injury if proper care is not taken.

The best is to avoid putting any stress on the injured area for a day or two. If you injured a foot or a leg, don’t put any weight on it. If you have to get about, use a cane or a similar device to take some of the strain.

2: Ice

The application of ice is standard procedure for inflammation and swelling in case of an acute injury. It’s advised to apply the ice for no longer than 20 minutes at a time and never directly to the skin.

A cold gel pack or a plastic bag filled with ice and covered with a towel is best for the purpose. Don’t leave the ice on indefinitely – the skins should have time to warm up between ice treatments.

3: Compression

Compression is applied by wrapping the injured area with an elastic medical bandage. The wrapping must be snug but not tight – if it’s too tight, the blood circulation will be affected. You will know the wrapping is too tight when the skin turns blue or starts feeling cold or numb.

4: Elevation

The last step is to raise the injured body part higher than your heart. You’ll immediately feel some relief from the pain and throbbing because the blood will not be flowing towards the injury. You may have to lie down and prop the injured part up on a pillow to achieve this higher elevation.

P.E.A.C.E. Protocol

While the R.I.C.E. method has been the go-to protocol for treating minor sports injuries for decades, research has found that it may not be optimal for supporting the healing process. Scientists at the University of British Columbia, Vancouver, British Columbia, have suggested two other protocols: PEACE for immediate treatment after the injury and LOVE for long-term management.

PEACE stands for protect, elevate, avoid, compression, and education.

1: Protect

To limit further injury, minimize movement for one to three days. Rest should not be extended beyond three days, as it can weaken tissue strength.

2: Elevate

Keep the limb above the level of the heart to help gravity move fluids out of the tissues.

3: Avoid

This protocol avoids the use of anti-inflammatories. While relieving pain, these medications also inhibit inflammation. Scientists now believe the body uses inflammation to repair damaged soft tissues and shouldn’t be inhibited.

This method also eschews the use of ice. While ice is mainly used for pain relief, it might also affect the body’s inflammatory response, new blood vessel formation, and young muscle fibres.

4: Compression

Taping or bandaging can be used to help limit swelling and tissue bleeding.

5: Education

Every sports doctor should educate patients on the advantages of an active approach compared to passive modalities like electrotherapy or acupuncture. These modalities don’t significantly improve pain and function and may ultimately prove counterproductive.

Patients should be educated on their condition, particularly load management, and the limitations on external fixes that can lead to them becoming reliant on therapy. Setting realistic recovery expectations rather than focusing on quick recovery is crucial and can prevent expensive interventions like surgeries.

LOVE Protocol

After the first few days, the approach changes to the LOVE protocol, one of nurturing the injury to full recovery.

The acronym stands for load, optimism, vascularisation, and exercise.

1: Load

This is an active approach to promoting movement and exercise as soon as possible. Putting weight on the injured area without worsening pain promotes repair and the rebuilding of tissue, tendons, muscles, and ligaments.

2: Optimism

Beliefs and expectations have been shown to affect therapy outcomes. Optimistic expectations are associated with positive outcomes while catastrophising about the event, depression, and fear can impede recovery.

3: Vascularization

This step involves some form of aerobic exercise a few days after the injury to increase blood flow to the injured limb and affected structures. Starting movement and aerobic exercise early promotes physical function and return to work.

4: Exercise

Exercise is necessary to restore mobility, strength and balance after an injury. Pain should guide the level of exertion – no pain, no gain, is not an attitude that should be encouraged.

Treating Major Sports Injuries

Severe sports injuries like an obvious fracture, or a joint dislocation, require immediate professional treatment. Persistent swelling, or severe pain that doesn’t ease in a few days also requires professional attention. Injuries that at first appeared insignificant may later turn out to be more serious, so always be alert to the signals of your body. If you live in Singapore, get in touch with a sports clinic in Singapore.