SPORTS MASSAGE PHYSIOTHERAPY D Gurr

Sport Injury and their assessment

A note for coaches by Dave Clifford

  • How do I know if it is an injury?
  • First talk to the swimmer to find out about the onset of the pain. Get them to describe the type of pain.
  • A Sharp or stabbing pain is usually a Ligament injury
  • A Shooting or Burning pain is usually nerve damage
  • A Toothache type pain is Muscle damage.

Immediate Pain

If the swimmer can pin point the exact start of the pain i.e. Straight after a collision or they felt a sharp stabbing type pain in a particular muscle during strenuous exercise then this is most likely an acute injury. The first aid for this is R,I,C,E.
  • Rest, stop doing the aggravating exercise or activity till the pain stops. In the case of a muscle rupture this will be between 12 and 48 hours. When I say stop and rest I mean stop and rest. Discourage them from testing the joint or muscle till they are sure there is no pain. If they try to use an injured limb too soon and the pain returns they have to restart the recovery clock, another 12 to 48 hours.
  • Ice, Place ice on the affected area, not next to bare skin. Wrap the ice in a wet towel or cling film. keep the ice moving so that the skin does not get frost damaged. The purpose of the ice is to stop the swelling by constricting the blood vessels. If ice is left on too long it will encourage the body to try to warm the area by sending more blood. This will cause more swelling. Keep an eye on the skin colour. The colour should be light pink. If a dark pink or red colour appears stop icing till the skin warms back up. If swelling is continuing re ice. The maximum application time is 15 minutes and the injury can be re-iced every 1 to 2 hours.
  • Compress, Apply strapping. This will help support and protect any joints as well as reducing any swelling. The strapping should allow a little movement to prevent stiffness e.g. Tubigrip, Bandage or Elastoplast.
  • Elevate, With all bleeding and swelling the limb should be elevated above the heart so that gravity can help reduce the amount of swelling by reducing blood flow.
The more an injury is allowed to swell the longer the recovery time.

Paracetomol can be given during the first 24 to 48 hours and Ibuprofen can be given after 48 hours.

Gradual pain

If the pain has come on near the end of an activity, overnight or is intermittent and the swimmer has been doing more training that they are used to then this is most likely an Over Use injury. This is also an acute injury and should be treated with R,I,C,E.

Over use injuries are usually minor. They are caused by damage to individual muscle fibres. This is on a microscopic scale and will not cause any pain. With a muscle fibre ruptured it means the surrounding muscle fibres have to do more work. The ruptures build up till there is enough damage to cause discomfort. By using the RICE treatment the damage can be minimized and can heal practically over night. If left to accumulate more serious pain and dysfunction will follow.

If the pain gets worse even though the area is being rested and iced then medical attention should be sort as more major muscle damage may have occurred.

Delayed pain

Mild discomfort or soreness can be caused by increasing training load over a short period of time. This is known as Delayed Onset Muscle Soreness (DOMS) and can be treated with stretching, heat, ice or a combination of heat and ice whilst continuing training.

What should I ice?

What not to ice.

Muscle spasm   Cold hypersensitivity
Acute swelling   Reynauds syndrome
 Inflammation  Circulatory insufficiency
Contusion
Acute injuries
Painful areas pre/post stretching or massage

With any acute injury AVOID Heat, moderate or intense activity and massage in the first 24 hours.

How do I know if the injury is acute or not.

Lightly apply enough pressure to the injured area to cause mild discomfort, 4 out of 10 on a scale if 0 is no pain and 10 being intense pain. Keep the fixed pressure on for 10 seconds then ask the swimmer if the pain has increased or decreased. If the pain has increased then the injury should be treated as an acute injury.