Acute Sports Injuries: What You Need To Know!

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Sport and physical activity is a vital component of achieving good health.

Children and young people will not only reduce their risk of chronic illness, mental illness and obesity but also develop healthy lifestyles, friendships, life skills and a strong sense of belonging and community. 

Top ten most popular sports and activities (5-14 years)

1. Swimming
2. Soccer
3. Netball
4. Australian football
5. Tennis
6. Basketball
7. Cricket
8. Martial arts
9. Rugby league
10. Gymnastics/ trampolining
Source: ABS data, Year Book 2008  

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Chronic vs acute

There are two kinds of sports injuries: acute and chronic. An injury that occurs suddenly, such as a sprained ankle caused by an awkward landing, or straining your shoulder in a tackle is acute.
Chronic injuries are caused by repeated overuse of muscle groups or joints. Poor technique and structural abnormalities can also contribute to the development of chronic injuries. This blog will discuss acute injuries       Emergency situations

Most competitive sports at junior and senior level have a designated trainer. As a physiotherapist attending my son’s soccer and later footy games that was usually me. They should have at least a Level 1 sports trainer certificate. Indoor facilities such as basketball or multisport venues should have a  trainer on site plus access to ice and bandages. Every team should be equipped with a basic first aid bag.
Injuries must be assessed and the severity will determine if the player can continue, needs first aid, or in the case of serious injury calling an ambulance.

Call an ambulance for:
-prolonged loss of consciousness
-neck or spine injuries
-broken bones
-injuries to the head or face
-eye injuries
-abdominal injuries.

We’ve all been there. Playing a sport and suffering an injury or watching our kids or friends play and seeing them injured. This can be a very concerning time.

The purpose of this blog is to clarify how to

  1. Identity a ‘red flag’ injury and management
  2. Discuss the important immediate and follow up steps that must be taken to ensure that an injury heals well. This means the player can back on the field participating again as soon as possible, reducing recovery time and minimising the risk of re-injury.

Top ten most commonly injured body parts during sport

1. Hand, includes fingers6. Face, excludes eye
2. Ankle7. Foot, includes toes
3. Wrist8. Head, excludes face
4. Knee9. Forearm
5. Shoulder10. Elbow

Body region injured, Victorian emergency department presentations, 2004-2006.
Source: Victorian Injury Surveillance Unit, Monash University Accident Research Centre


In the case of a less serious injury the PRICER and No HARM protocols should be used.
These simple acronyms are the keys to successful injury management.

ProtectionThe first principle is protection. The purpose of protection is to avoid further injury to the area by protecting the injured structures. The type of protection used varies depending on the injured area but may include supportive bandaging, the use of slings and supports and crutches for a lower limb injury.

Rest –. Keep the injured area supported. Avoid using the injured area for at least 48-72 hours as continued activity will increase bleeding and damage.

Ice – Apply ice to the injured area for 15-20 minutes, every 2-4 hours for the first 48-72 hours after injury. Ice reduces swelling, pain and bleeding. Ice can crushed or placed in a wet towel or plastic bag. Alternatively, a frozen pea packet or a cold pack wrapped in a wet towel can be used. Check the skin to ensure that there is no ice burn from prolonged application.

Caution: Do NOT apply ice directly to skin.

Compression – Apply a firm wide elastic bandage over the injured area, as well as above and below. Where possible hold ice in place with the bandage. Between ice treatments maintain bandage compression. Applying a bandage will reduce bleeding and swelling and also provides support for the injured area.
Caution: Ensure the bandage is not too tight. Some signs of the bandage being too tight may include numbness, tingling or skin becoming pale or blue. If these symptoms and/or signs develop remove the bandage and reapply again firmly but not as tightly.

Elevation – Raise the injured area above the level of the heart at all times. A pillow can be used to provide support and comfort. Elevating the injured area reduces bleeding, swelling and pain.

Referral – Arrange to see a qualified health professional (doctor or physiotherapist) as soon as possible. This will determine the extent of your injury and provide advice on the treatment and rehabilitation required.

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No H.A.R.M.

No Heat – Applying heat to an injury increases bleeding. Avoid hot showers or baths, saunas, spas, hot water bottles, hot linament or heat packs. 

No Alcohol – Alcohol increases bleeding and swelling which delays healing. It can also mask pain and severity. 

No Running – Running or exercise increases blood flow to the injured site. This can make the injury worse and delay healing. 

No Massage – Massage or the use of heat rubs increases swelling and bleeding. 

By applying RICER and No HARM techniques you will be able to recover from your injury faster and get back to the sport or activity you love doing sooner. 

Early and correct use of RICER and NO HARM factors is essential for the initial management of a soft tissue injury.

RICER & NO HARM should be continued for 48-72 hours.


In our experience there are many precautions necessary to reduce the risk of acute injury.

  • Safe playing environment
  • Appropriate equipment including protective aids such as mouthguards
  • Conditioning and fitness preparation for the sport
  • Medical or trainer coverage
  • Specific supervised warm up routine
  • Adequate hydration and prevention of heat stress
  • Frequent player substitutions to avoid fatigue based injury

In clinic, the first priority of treatment for an acute injury is reducing strain or load on the injured part and surrounding tisues.
Healing time for injuries can vary, but a treatment plan based on objective measures of improvement is essential. This also applies to more serious injuries once a medical clearance is given to start rehabilitation.
When the acute phase has passed your physiotherapist will  use treatment and graduated exercise to improve the injured tissues capacity to take loading in preparation for a safe return to training and sports-specific drills.

A safe return to sport is based on objective improvement and a safe gradual increase in
training load. The decision should be made in conjunction with the treating therapist, player, parent and coach. A supervised treatment program is the best way to successfully return to sport and communication is all important.

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