Sprains
Sprains are caused when the ligaments that hold bones together are forced beyond their normal range, leading to stretching or tearing. Sprains are more significant injuries than strains and may result in permanent damage if not managed properly.
Strains
A strain is a simple soft tissue injury affecting muscle, usually caused by overstretching. Strains will usually heal by themselves, although there may be complications if tendons (which attach muscle to bone) are involved.
Signs and symptoms
- Loss of power or ability to bear weight
- Pain and tenderness at the site
- Possible discoloration
- Swelling
Management
The RICER and no HARM approach to soft tissue injuries aims to minimise bleeding, swelling and further tissue damage. Remember to provide reassurance and gain the person’s consent to provide emergency care before taking the RICER and no HARM approach.
R-I-C-E-R
R – rest
- Reassure the person and advise them to sit or lie down, then not to move while supporting their injury in a position of least pain.
I – ice
- Apply cold packs or ice wrapped in a damp cloth to the site of the injury.
- A cold compress may be used at irregular intervals for periods of 5–15 minutes to reduce pain and swelling.
C – compression
- Wrap a compression bandage around the injured area to reduce movement and swelling at the site of injury.
- Check that circulation is present beyond the bandage to ensure it is not too tight – press on the nearest fingernail/toenail to see if the blood circulation returns after applying pressure.
- Also check the colour, warmth, movement and sensation in the area above and below the compression bandage.
E – elevation
- Elevate the limb to reduce swelling, bleeding and blood flow to the area. This will also help relieve pain.
R – referral
- Refer the person to a medical practitioner for definitive diagnosis and continuing management.
H-A-R-M
In the first 2–3 days, it is important that the person does not do any HARM to their injury.
H – heat
- Avoid any type of heat that will increase blood supply to the area and, consequently, will increase bleeding.
- Avoid hot showers and baths, saunas.
- Avoid using hot water bottles or heat rubs.
A – alcohol
- Avoid consuming alcohol as this may increase swelling.
R – running
- Avoid exercising the area too soon as this may aggravate and worsen the injury.
M – massage
- Avoid any form of massage, as this will increase swelling and bleeding.