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How to manage a Soft Tissue Injury – Advice has changed.

So first of all what is a soft tissue injury?  Basically, it’s anything where the soft tissues (not the bone or skin) are injured.  Predominantly in physiotherapy we are talking about muscles, ligaments and tendons, your general sprains and strains.

Not so long ago the consensus on management could be memorised with variations of the word RICE,





However recently that has changed, as more and more research is coming out saying ice is not useful in the management of soft tissue injuries and can in fact be detrimental to the healing process. 

So what now: 

Recently some researchers published a new pneumonic in the British Journal of Sports Medicine


This means the first thing to do is prevent further injury by protecting the injured area, so avoid things that make it feel worse in the first few days.  e.g. if you have a sprained ankle and it hurts to run – don’t run.  Then try and elevate the injured area, above the heart is ideal. 

Avoid anti-inflammatories this is something many people are not aware of us, that includes things like Nurofen and Voltaren.  Inflammation is an important part of the healing process; it allows all the right chemicals to come to the injured site to facilitate healing.  Ice should only be used sparingly for pain-relief if needed. 

Compression can be used where safe and practical, e.g. a compression bandage, tubigrip or strapping.  Make sure its not tight enough to cut off circulation.  Watch the colour of toes and fingers below the compression to ensure they still have a blood supply.

Education is where your health professional comes in, they can advise you on the next steps to manage your injury and help you to gradually load the injured area to get you back to what you want to do.  Staying positive and gradual loading are the keys to getting you going. 

Remember injuries mostly heal, but they do take time.  There is not really any speeding up of the healing process but making sure you look after the injury in the initial stages will mean you can get back to activity as soon as possible.  Stay positive and keep active and think PEACE & LOVE when you are injured.


Blaise Dubois, Jean-Francois Esculier, 10.1136/bjsports-2019-101253, Aug 2019


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