Andrew O'Neill - Chartered Physiotherapist
I spent a year in Limerick in an orthopedic hospital. We use to call December and January silly season due to the unbelievable spike in fractures, sprains, and all round fall-related injuries. What caused the spike? Well, the weather was partly to blame, mainly due to frosty or icy footpaths and generally people simply slipping. Of course, christmas shenanigans on Christmas nights of were also, unfortunately, a major part of the increase of people that came through the hospital doors. Similar scenes will have occurred last week and this week due to the heavy snow!
I felt it might be a good time to discuss what to do if you feel you have fallen, landed awkwardly or twisted an ankle for example! This article will also serve as a guideline to those who injure a joint playing sport also. The types of injuries I am discussing are what we call acute injuries and will focus on joint injuries. An acute sports injury is one in which there is a specific mechanism of injury (hit by the ball, plant, and twist, collision with an opponent) and an immediate onset of symptoms including swelling, pain, bleeding and possible deformity. The same can be said for fall-related injuries.
A number injuries can be considered acute including:
• Sprains (injury to ligaments)
• Strains (injury to muscles)
• Contusions (bruises)
• Subluxation (partial dislocation that reduces itself)
If you or somebody you know were to suffer an injury like these it is important to know when to get to the A&E department or when you can do something about it yourself with what we like to call the P.R.I.C.E principle. This stands for:
Firstly, if you see any deformity in the joint you or another person has injured - go to an A&E department. If you cannot put any weight on the ground - go to an A&E department. If you have extreme swelling and pain - go to an A&E department. If it’s a thing that you didn’t initially go to an A&E department and the pain has not reduced somewhat and has persisted 24-48 hrs later - go to an A&E department.
I have had plenty of joint injuries playing a sport such as an ankle and wrist sprains. Not all of these have required me to get an x-ray. So try and be smart about it. Am I in a situation similar to above in the last paragraph or do I feel using something like the P.R.I.C.E principle may help me reduce the pain symptoms. It’s quite simple to use. PROTECTION - clean the injury and protect it, if it there are any cuts or bruises. REST - time can be a great healer, don’t keep moving around with the joint sore, give yourself a rest. ICE - the only way to reduce swelling and in turn reduce pain apply 5-10 min at a time. COMPRESSION - Also very important to reduce swelling and will give the joint a sense of protection. ELEVATION - this will allow the swelling to dissipate into the bloodstream further reducing pain.
Once pain and swelling have reduced, you will probably find the joint will be stiff. This is the when you need to get it assessed by a physiotherapist. Too often we see people come into clinic months after the initial injury in chronic pain, something that could have been avoided if the were to get the correct type of hands-on treatment and exercise therapy.