When Should I See the Doctor?
I will limit my discussion here to what I know best (probably something I should always do but don’t!) which are orthopedic injuries.
*Severe Pain: Particularly if it does not improve after the initial injury. It is common to experience quite a bit of pain with an initial injury but then it improves. If pain is severe and remains at that level or gets worse, get medical attention.
*Loss of Function: It is common to not want to move a body part when it is first injured. Get medical care if someone refuses or is unable to move an injured limb or pain is significantly increased when they do.
*Obvious Deformity: If the shape of a body part looks dramatically abnormal seek medical attention. When appropriate, compare an injured limb to a non injured limb.
Shock Symptoms: With a severe injury the body can develop shock. If the person experiences any of these symptoms- dizziness, light- headedness, nausea- cool and damp skin or weak and rapid pulse get them medical help immediately.
*No Improvement or Worse: Most injuries follow a typical healing pattern. Usually, after a day or two things are feeling better. If pain, swelling or level of function stay the same or get worse it is time to call the doctor.
P.R.I.C.E Immediate Care For Injuries.
P- PROTECTION: First, make an evaluation of the seriousness of the injury. If there is loss of function, deformity or severe pain contact emergency services. If none of the above exist, find a way to protect the injury. This might mean using crutches if you cannot bear weight without pain or a limp. It might mean using a sling if you are unable to use your arm normally. In the acute stages of an injury, it is important to prevent any movement that causes pain, further irritation and delays healing. The acute injury stage usually lasts from 1-3 days. Once you have returned to activity, protection may still be necessary for a period of time. For example, a 2nd or 3rd degree ankle sprain involves some ligament tearing. Complete healing for those ligaments to get their normal tensile strength back may be 6 months or more. During this time it is advisable to wear a sports brace or support.
R-Rest: This does not mean laying on the couch watching tv or playing video games! What it means is preventing any additional movement or activity that would aggravate the injury. It is estimated that for ever day, a body part is immobilized, you lose 3% of it’s strength. If you are a competitive athlete, you cannot allow this to happen. Think of this time period as “Active Rest“. I know it sounds like an oxymoron but it is critical during this “down” time to do anything and everything you can to maintain your fitness level. If you are able to, you should run on a treadmill, ride a bike or swim. You should also lift weights to prevent strength loss. Exercises specifically designed to rehabilitate your injury are appropriate here as well.
I- Ice: There is no exception here. During the initial 1-3 days of an injury apply ice in 15- 30 minute intervals. Less time for areas with little muscle and fat like the hand or foot and more time for a back injury. Ice controls the inflammatory process, resulting in less tissue irritation and swelling and pain. Ice can be applied using a wet towel to increase cooling. If possible apply ice all the way around the injured body part. Once you have returned to activity use ice when you have finished to control pain and swelling which often occurs during the early return to play time period.
C: Compression: This is an important and often neglected step. During the initial stages of injury, wrap a compression bandage around the injured body part. This is especially important for injuries to the hands, feet and ankles. Start the wrap 4″-6″ below the injury and finish the same distance above. Create a pressure gradient by making the pressure furthest away distally from the injury the greatest and gradually less as you wrap proximally toward the body. Swelling often becomes the biggest obstacle to normal function and return to activity. Applying compression to an injury helps reduce swelling greatly. You can wear a compression wrap at night. If at any time the area feels cold and/or numb loosen the wrap.
E: Elevation/Early Exercise: For injuries to the hands, ankles and feet this is essential to control swelling. Elevation means keeping the injured limb above the heart. In this way you allow gravity to drain the swelling away from the injured area. Start rehabilitation exercises early. In many cases, exercises can begin in 1-3 days after injury. Doing this will help preserve strength, flexibility and coordination.