Dealing With an Acute Soft-Tissue Injury

AJ Lamb,
MS, CSCS, PES supervisor/senior exercise physiologist at Zarett Rehab & Fitness
Joe Zarett, physical therapist and founder of Zarett Rehab & Fitness

It happens to most of us. We feel a pull or a tweak as we are exercising or recreationally playing a sport. We typically want to finish what we’ve started, but there is uncertainty differentiating a minor pain from a potential injury. This is challenging when dealing with soft-tissue ailments. A soft-tissue injury can include any strain or sprain of a muscle, tendon or ligament. The musculotendinous junction—the region where a muscle and tendon meet—is a common site for muscular strains as it is the intersection of absorbing and developing force during athletic movements (jumping, sprinting, etc.). Ligament sprains are typically seen when a joint does not absorb force appropriately and an excessive range of motion over-stretches a ligament.

These things happen, despite how fit you are and how diligently you warm-up. The acute stage refers to the time period immediately following the incident. Consider this the following hours, days or even a few weeks. This should not be confused with chronic ailments that have persisted for months or even years. In the acute stage, you should be as proactive as possible with the hopes of managing this injury appropriately, therefore not further exacerbating the issue.

Pop. You feel a wince of pain come on as you clutch your thigh in discomfort. The best thing you can do is take a breath and calm down. At this point you are overridden with emotions, not just pain, but social pressure from those around you. Something has occurred, but you may be unsure to what level this injury is or will affect you. Below are five basic insights on how to safely manage soft-tissue injuries in the acute stage:

  1. Assess. Take a moment to mentally rethink what just happened. Was there a collision, did you fall, did you slip? Observe and palpate the area that is believed to be injured.
  2. Protect. Protect the region by sanitizing and cleaning any open wounds. If it is a lower extremity injury, minimize weight-bearing movements to only the necessary levels. A few minutes later try to grasp the magnitude of what just happened. Be overly cautious by trying to avoid increasing pain. The initial hours after a soft-tissue injury can be very telling of the severity. It is most typical that the body will initiate healing with localized swelling to the area.
  3. Pain and Fluid Management. The purpose of icing an injury during this period is two-fold: first to help tolerate levels of pain and secondly to control the level of swelling so that movement is not inhibited by fluid pooling. After this initial eight-hour period, ice could potentially be interfering with the healing process, rather than helping. Therefore, the usage of ice is typically recommended for only the first eight hours; however, the following days are specific to the advice given by a medical professional and the uniqueness of the circumstance. If it is a lower extremity injury, elevating the limb while seated or lying may be additionally helpful.
  4. Move Wisely. As time goes by, stay mindful of your symptoms. If there is an onset of nausea, fever, or pain radiating to different body parts, pick up the phone and see a doctor. Otherwise, try to strike a balance between staying as active as possible without increasing symptoms and allowing appropriate rest. Here are a few general tips for some different body regions:
  • Shoulder: Avoid over-head activity and other pain-inducing movements. Prop the arm into a tolerable position with a pillow while seated or lying down.
  • Lower back: Avoid being seated or lying down for too long. Walking for short, frequent intervals can be great, without further increasing symptoms.
  • Lower extremity: Walking around (weight bearing activity) will probably make matters worse; but small movements while lying or in a seated position (non-weight bearing activity) may be very helpful. Additional foam rolling on the adjacent areas may be beneficial as well, if tolerable.
  1. Make an Appointment. Be proactive to get out in front of the issue. Suppose a day or two has gone by and symptoms are improving—well that’s great. This sounds like an excellent time to begin a guided physical therapy program. The last thing you want to do is jump back out on the court prematurely and re-injure this vulnerable area. Minimize your risk and see a professional who can evaluate and treat your issue. The best option is always to act conservatively and seek a medical practitioner’s treatment immediately.