Sprains and strains are common injuries in many sports and part of the specialty treatment area of sports medicine. In addition to other care given for sprains and strains, cold compresses are often used as soon as any bleeding has been controlled.
When a person twists an ankle or knee, the tissues underneath the skin are injured. Blood and fluids seep out from the torn blood vessels and cause swelling to occur at the site of the injury. Once bleeding has been controlled, cold can be applied to make the broken blood vessels constrict, thus limiting further blood and fluid loss.
Cold has been widely used as a first response to a sprain or strain, but recent research has shown that cold is best used only after any internal bleeding has been controlled, as cold inhibits clotting initially. For example, a likely ankle sprain requires initial first aid for the damage to internal blood vessels and muscle fibres, and cold can then be used in the second stage of treatment as an aid to recovery.
A sports physician often advises applying ice to the injury after the initial first aid has been given. Ice packs may be applied for 10 minutes at a time and continued periodically for up to 72 hours or until the tissues are no longer hot to the touch. After that, heat applications may be prescribed. Heat speeds up the chemical reactions needed to repair tissue. White blood cells move in to rid the body of infections and other cells begin the repair process. Even though heat has a later role in treatment of an injury, always apply cold before heat and consult your doctor for clearance to start.
Some musculoskeletal injuries are obvious because they involve severe deformities such as protruding bones or bleeding. Also, the victim may be in much pain. Do not be distracted by pain as such injuries are rarely life-threatening. Complete the primary survey and care first for any life-threatening conditions. Then complete the secondary survey and care for any other injuries. Call for an ambulance, especially if:
If an ambulance is on the way, do not move the victim unnecessarily. Control any bleeding and take steps to minimise shock. Monitor the ABC.
Sometimes it is difficult to tell whether an injury is a fracture, dislocation, sprain or strain. When in doubt, always treat such an injury as a fracture.
Injuries to muscles, ligaments and other soft tissues can occur with or without a fracture. If you do not suspect a fracture, control bleeding with rest, ice, compression and elevation. Apply ice after bleeding is controlled. A useful acronym to remember is RICE.
Avoid any movements or activities which cause pain. Help the victim into the most comfortable position. If you suspect head, neck or back injuries, leave the victim lying flat.
Once any bleeding has been controlled, apply a wrapped ice pack or cold compress. Cold helps reduce swelling and eases pain and discomfort.
Apply a firm supporting bandage to give an even pressure over the injured area. Use light padding under the bandage if the pain is severe.
Elevating the injured area helps slow down the flow of blood and reduces swelling. If possible, raise the injured area above the level of the heart. Remember, do not attempt to elevate a part you suspect is fractured until it has been splinted or fully immobilised.
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