Muscle Injuries – the Dos and Don’ts

General Medical

Dr. Preya Alexander

Strained sore muscles are a common reason we see patients in general practice. Sprained ankles, sore and strained shoulders/necks/lower backs, swollen knees, broken fingers– we see it all. 

Muscle injuries are common and often poorly managed by patients in the initial period because they’re not quite sure what they should be doing – heat, cold, rest, activity? It can get confusing. Lots of people have heard the acronym RICE but they don’t quite know how to implement it properly missing out on lots of the benefits. 

So here it is broken down – the do’s and don’ts after a muscle strain 

RICE – the things to ideally do immediately post muscle injury and HARM – the things to avoid 48 hours post muscle injury to avoid it from exacerbating further. 

  • Rrest is crucial after a muscle injury to avoid further worsening of the injury. Rest means avoiding things that can aggravate whatever injury has already occurred. It doesn’t always mean lying in bed for days with no walking at all – in fact that recommendation is very rare and for lower back strains in particular we encourage people to keep gently moving to prevent muscle stiffness as this may actually make pain worse.
  • Iice in the first 48 hours after a muscle injury can assist in reducing pain and swelling. Patients will often implement this but not for the recommended periods. Firstly, ice should not be directly applied to the skin as it can cause skin injury – either wrap in a towel or use a padded ice pack. Secondly, ice should be applied to the area of injury for 20-minute periods every 2 hours to get the full benefit.
  • Ccompression can help with swelling and pain also. For those with an ankle sprain compression can also assist with giving stability to the ankle joint to allow some gentle mobilisation. You can achieve compression with simple bandaging or compression devices fitted by a physiotherapist for instance.
  • Eelevation is key to managing lots of muscle injuries such as swollen knees, ankles and even fingers. Elevating the affected area above the level of the heart (particularly when resting or sleeping) can reduce swelling and hence, pain! 

Here are the things to ideally avoid in the 48 hours post a muscle injury to facilitate recovery 

  • Hheat should be avoided initially because it can worsen swelling. Heat application (with a heat pack or hot water bottle) increases blood flow to an area – and you don’t want that when an area is already very swollen and sore; it can make things worse! In the initial period after a muscle injury aim for cold therapies like ice pack application. Down the track for more chronic injuries you can apply whatever feels better – heating or cooling, whatever works for you. 
  • Aalcohol in the first 48 hours after injury can make swelling worse and so it is best to avoid it. Injuries can also worsen as people often reinjure themselves once they feel lubricated by a few drinks; whilst swanning around on the dance floor is awesome – it’s probably not the best thing for your sprained ankle!
  • Rreinjury should ideally be avoided so running/heavy lifting when you have a sore strained shoulder or back is not ideal!
  • Mmassage initially after an injury isn’t recommended – allow the muscles time to recover and for the swelling to ease. Treatment by a qualified practitioner such as a physiotherapist, however, can be very helpful. 

That’s it in a nutshell – how to best care for yourself after any muscle injury (fingers crossed us talking about it means you won’t have to deal with one soon!). 

Dr Preeya Alexander
Please note: Dr. Preeya's blog is general advice only. For further information on this topic please consult your healthcare professional.

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