Most of us will experience a soft tissue injury (sprain or strain) at some time. How well we manage that injury in the early stages will often determine the extent of the injury and time required for recovery.

Let’s consider the case of Bob. Bob recently got hit in the thigh by a fast moving cricket ball. He immediately experienced excruciating pain and had trouble walking . His pain improved after a few minutes and he was able to limp around . Bob decided that he could continue to play and did so until his thigh got painfully tight and it was difficult to move . He saw a physiotherapist on Monday morning. He was limping badly, and had had 2 sleepless nights. His physiotherapist diagnosed a quadriceps haematoma. He required 3 weeks of rehabilitation and it was a full 5

weeks before he could to return to sport .

Bob made a number of mistakes right from the onset of his injury. He underestimated the severity of the blow and did not undertake the appropriate first aid measures in those first few critical minutes .As a result he amplified the effects of the initial injury.

Bob failed to realize that the blow caused tearing of small blood vessels in his thigh muscle and that blood was leaking into the surrounding muscle tissues. Bob’s insistence on continuing to play increased the blood leakage significantly complicating the injury.

Bob made a number of mistakes. What should he have done?


RICE treatment remains the mainstay of acute soft tissue injuries at all sporting levels.

The immediate goal is to stop further tissue damage and minimize the bleeding into the soft tissues.

Very simply, the more blood released into the tissues the longer the recovery time.

REST as soon as the injury occurs. This reduces the risk of further damage and also limits further bleeding .

ICE contracts the blood vessels, limiting blood flow to the damaged area. Injuries should be iced for 15 minutes( ice wrapped in a wet towel) every 2-4 hours and this may need to be continued over a 24-48 hour period COMPRESSION reduces blood vessel leakage by increasing the pressure in the surrounding tissues. A compression bandage is the best option and should be kept on between icing .

ELEVATION of the injured part above the level of the heart reduces blood flow to the area.

DIAGNOSIS is an important part of the management. Remember pain levels are not always an accurate gauge of the severity of your injury. Your GP or Physiotherapist can ensure you get the most appropriate care for your injury. AVOID Alcohol, massage, stretching, aspirin and heat in the first 1-3 days. All of these mediums increase blood flow and may increase tissue swelling.

Bob missed 5 weekends of sport when it is likely he could have been back on the field within 1-2 weeks if he had taken the simple steps outlined above.

Remember the RICE rules and help your recovery.

Mike Stewart is a Physiotherapist at the Oamaru Physiotherapy Clinic. He has post graduate qualifications in Manipulative Physiotherapy and Sports Medicine and is a Registered Physiotherapy Acupuncturist.

He has toured as a Physiotherapist with the Maori All Blacks for the last 14 years.

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