Acute Injuries Rapid Response
GRSM is committed to providing a Rapid Response in assessing and treating Acute Injuries that have been referred by Physicians.
Features of the GRSM Acute Injuries Rapid Response Program
- Sports Medicine Physician (OHIP-covered) appointments usually within 24-48 hours (Mon. – Fri., subject to patient availability)
- Physiotherapy, Chiropractic and Bracing (non-OHIP) appointments also usually within 24-48 hours (Mon. – Fri., subject to patient availability)
- As per our reputation, we continue to focus on Sports and Exercise injuries and the Highest Quality of Care
- Focused treatment geared towards rapid and safe return to full daily, work and sports abilities
- Proactive individualized plans for prevention of future injuries
**Please note that a referral from a medical doctor is required for participation in this program**
The Ultimate Guide to Acute Injuries
What is an Acute Injury?
“Acute” sports injuries are those that have occurred recently, usually defined as having occurred in the previous 48-72 hours. Examples of acute injuries include tendon strains, ligament sprains, muscle strains, muscle contusions and bone fractures. Most acute injuries heal better when treated early (within the first few days of being injured). One such factor includes the “acuteness” of the injury and how quickly an injury is treated.
How are Acute Injuries Treated?
In general, any acute injury should be treated with the “RICE” principles (Rest, Ice, Compression, Elevation). Rest in sports medicine may range from doing a different non-painful activity to using crutches depending upon the severity and type of injury. Icing is very important with acute injuries as ice helps to decrease swelling and inflammation. NEVER use heat for an acute injury (heat will increase inflammation and swelling). Ice should be applied for approximately 15 minutes at a time, every hour during the day if possible, with a towel or layer between the ice and skin to help prevent frostbite. Compression helps to control swelling and can usually be accomplished with a tensor bandage (very important for ankle sprains and muscle contusions). Elevation helps to control swelling of the affected area.
Common Acute Injury Examples
Ankle Sprains
Ankle sprains usually rehabilitate faster with early intervention. An ankle sprain that is treated early (within the first 24 to 48 hours) usually heals faster than if there is a delay in treatment. Ankle sprain treatment consists of icing, compression, anti-inflammatory medication, physiotherapy and athletic therapy. These measures help to control swelling and pain, regain range of motion, and preserve strength and balance sense. This early treatment usually results in faster healing and earlier return to sport or activity. A moderately severe ankle sprain that has not been treated early often develops a “boggy” swelling that is a lot more difficult to resolve. Prolonged ankle swelling leads to more pain and slower return of range of motion and function (or participation in pre-injury sport or recreational pursuits).
ACL Tears
A ligament is a rope-like structure that holds two bones together. In your knee, there are four main ligaments. The ACL is one of those ligaments and acts to prevent the tibia (shin bone) from shifting too far forward in relation to the femur (thigh bone). The ACL also helps to prevent rotational movements between these two bones.
Muscle Contussions
Another example involves deep thigh muscle contusions (deep bruising). These injuries can often lead to severe stiffness in the quadriceps muscle if not treated with compression and appropriate range of motion exercises in the early stages.
How Does Physiotherapy Help Acute Injuries?
Physiotherapists are well-trained and are very knowledgeable in assessing and treating acute injuries. They can usually identify worrisome injuries and help you sort out the diagnosis and what to do. Physiotherapists are essential for treating most acute injuries as they help to decrease swelling, decrease pain and improve the mobility of the injured joint. As you start to improve, your physiotherapist will then progress you on strengthening, balance and functional exercises so that you can regain full athletic ability in a safe and rapid manner. Your physiotherapist will give you expert guidance through the rehab process from the point where you are in severe pain all the way to the stage when you are getting back to your previous level of sport or activity.
When Should You See a Doctor for Your Acute Injury?
Deciding whether or not an injury requires medical attention may be difficult. Some signs to look for that should prompt a visit to a physician include: rapid swelling, moderate or severe amount of swelling, inability to walk (if injury is to lower extremity), inability to move the joint in a full range of motion (e.g., not able to move shoulder around in a full circle, not able to fully bend or straighten a knee), extreme pain or pain at rest, and deformity of a limb. Even without any of these features, if an injury does not improve significantly after a couple of days of rest, or if an athlete is just very confused about what should be done, he or she should seek the advice of a physician who knows how to assess and treat sports injuries.
Early assessment and treatment of acute injuries is essential for fast healing and early and safe return to sport and activity
Best Physiotherapy Treatment for Ankle Sprains?
Ankle sprains are common in sports that involve a lot of running and sudden turns. Despite being common, ankle sprains are often undertreated which can sometimes lead to long-term problems such as a “loose” ankle and recurrent sprains.
What is an Ankle Sprain?
The typical ankle sprain occurs when you “go over on the outside of your foot” (inversion of the ankle). Pain is felt on the outside (lateral) part of the ankle, and swelling occurs in moderate and severe cases. There is usually tearing of the anterior talofibular ligament (ATFL) and sometimes the calcaneofibular ligament (CFL). The ligaments function to hold the bones of the ankle together.
When Should You See a Doctor After an Ankle Sprain?
You should probably consult with a Sports Medicine Doctor if you are unable to walk without a limp, if you have tenderness of any of the ankle bones, if you have significant swelling, or if you are just unsure about what to do. A doctor will be able to tell whether you need x-rays or whether you have a more severe or complicated injury. Regular ankle sprains have to be differentiated from other injuries such as bone fractures, Achilles tendon ruptures and syndesmosis (“high ankle”) sprains.
What is the Best Treatment for Ankle Sprains?
Lateral ankle sprains respond well when they are treated “aggressively”. Apply ice as soon as possible (15 minutes, every hour for the first 3 days). Do NOT apply heat, as this will make the swelling worse. Use a tensor bandage to provide moderate compression (loosen at night). Keep the ankle elevated. These measures are important and will assist in decreasing the swelling. The quicker you can get rid of the swelling, the faster you can return your ankle to its full function. Your physician may prescribe anti-inflammatory medication, which has been shown in research to help with sprains (if started within the first 48 hours).
Should You Wear an Ankle Brace?
An ankle brace can be worn to support the ankle during the healing process. The best ankle braces have very supportive strapping around the ankle and have snug lacing. Good ankle braces are more supportive than simple sleeves. When the injury has healed, the brace may then be worn to protect the ankle from further injury.
Why Physiotherapy is Very Important for Most Ankle Sprains?
You should probably consult with a sports medicine physician if you are unable to walk without a limp, if you have tenderness of any of the ankle bones, if you have significant swelling, or if you are just unsure about what to do. A physician will be able to tell whether you need x-rays or whether you have a more severe or complicated injury. Regular ankle sprains have to be differentiated from other injuries such as bone fractures, Achilles tendon ruptures and syndesmosis (“high ankle”) sprains.
How Long Does It Take to Recover From an Ankle Sprain?
Depending on the severity of the ankle sprain, return to sport may vary from a few days to eight weeks or more. This timing also depends on what type of sport or exercise you are returning to. In complicated cases, special tests such as a bone scan or magnetic resonance imaging (MRI) may be necessary to detect other injuries such as small bone and cartilage chips within the ankle joint. The majority of ankle sprains heal well, especially if they are treated properly, with emphasis on the prevention of future injuries.
How Are Deep Muscle Bruises or Contusions Treated?
Muscle Contusions are common injuries in sports such as hockey, football and soccer. Because they are common, people often do not give muscle contusions enough “respect”. That is, they say “it’s just a bruise… I can play with a bruise”. This is often not the case.
What is a Contusion and How Does it Occur?
Contusions involve direct contact to the muscle which results in damage to the cells and blood vessels within the muscle. This injury is different from a muscle strain which generally refers to a “pulled” muscle and is not an injury from direct contact.
Muscle contusions can occur from direct contact with anything on the ice… sticks, net posts, boards, puck and other players. The most common location is the thigh quadriceps group of muscles. These muscles are at the front of the thigh and, when contracted, cause the knee to straighten. Common mechanisms include low hip checks and getting “knee-ed” by another player.
With a contusion, bleeding that occurs in the muscle can collect in the form of a hematoma (like a large blood-filled cyst). Sometimes, the bleeding can track to the surface and show up under the skin. The bleeding and swelling can take up space and cause the whole muscle to feel tight.
How Severe Can Contusions Be?
Thigh contusions occur in varying severities. Mild contusions only involve minimal bleeding and muscle injury. The injured player usually is able to continue playing and may only notice the pain after the game. Moderate contusions often cause a significant limp and the player usually has difficulty bending the knee (by bending the knee, the injured quadriceps muscles are stretched which causes pain). A With severe contusions, there is considerable disability. The player often cannot bear any weight on the injured leg and has great difficulty bending the knee. There will often be a lot of tightness in the thigh.
What Complications Can Occur From Muscle Contusions?
If the muscle is not given a chance to heal, then a calcium deposits can form in the muscle hematoma. This condition is called “myositis ossificans”. Athletes can miss many months of their season if myositis ossificans occurs because this complication is difficult to treat and takes a long time to heal. Recurrent injury can also cause re-bleeding which increases the chance of myositis ossificans. Also, if there is an enormous amount of bleeding, then the pressure build-up within the muscle compartment can lead to severe tissue damage. This condition is called acute compartment syndrome.
How Do You Treat Muscle Contusion?
What should you do if you get injured with a muscle contusion? All recent contusions should be treated with ice, approximately 15 mins. per hour for the first 24-48 hours. Although “every hour” is very difficult to achieve, you should ice as frequently as you can. Compression is very important. Compress with a elastic tensor bandage, using a foam padding beneath the tensor where the contusion is to add to the compression effect. The compression should be firm but not too tight or else you will get numbness and swelling in your foot (not a good thing!). The compression and icing help to stop the bleeding.
Whatever you do, do NOT apply heat in the early phases of injury since heat can actually increase the bleeding and worsen the injury. Also, do not use anti-inflammatory medication such as ibuprofen (Advil, Motrin) and aspirin which can thin the blood and also increase the bleeding.
For mild contusions, if you do not have any pain in walking, running or jumping, and you have full strength and range of motion of your knee, then you probably do not need any further treatment. If, however, you have a worse injury and you are limping, you should be assessed by a sport physician. If you have a noticeable limp, crutches should be used until there is no pain walking.
How Can Your Physiotherapist Help Your Muscle Contusion?
Physiotherapists are well-trained and are very knowledgeable in assessing and treating acute injuries such as muscle contusions. They can usually identify worrisome complications and help you sort out the diagnosis and what to do. Hour physiotherapist will help you to decrease swelling, decrease pain and improve your mobility. As you start to improve, your physiotherapist will then progress you on strengthening, balance and functional exercises so that you can regain full athletic ability in a safe and rapid manner. You physiotherapist will give you expert guidance through the rehab process from the point where you are in severe pain all the way to the stage when you are getting back to your previous level of sport or activity.
When Can You Return to Sports After a Muscle Contusion?
Deciding on when to safely return to playing hockey can be a little tricky. Re-bleeding is common a week after the initial injury. Moderate and severe thigh hematoma can often take weeks to heal. Special “doughnut” padding should be used to help prevent re-injury. Your sports medicine physician and physiotherapist can give you expert guidance.
How Are ACL Tears Treated?
“I blew out my knee!” Have you ever yelled out this phrase? Traumatic knee injuries are very common in sports such as football, hockey, soccer and basketball (sports that involve pivoting). One of the more serious injuries involves the anterior cruciate ligament (ACL).
What Is the Knee ACL?
A ligament is a rope-like structure that holds two bones together. In your knee, there are four main ligaments. The ACL is one of those ligaments and acts to prevent the tibia (shin bone) from shifting too far forward in relation to the femur (thigh bone). The ACL also helps to prevent rotational movements between these two bones.
How Do ACL Tears Happen?
Sports that involve a lot of pivoting, stops and starts, landing jumps, and contact between players have a higher risk of ACL injuries. Usually, if you tear your ACL, there is considerable pain, swelling that occurs quickly, and occasionally a “pop” sensation.
How is an ACL Tear Diagnosed?
A doctor who has experience at diagnosing ACL injuries should be able to tell the extent of injury through physical examination. ACL tears can be a complete or partial (“stretching”). Only rarely would special tests such as magnetic resonance imaging (MRI) be required to diagnose an ACL tear. X-rays are usually done to make sure that you have not sustained any bone injury.
How Do You Treat an ACL Tear?
The initial treatment of ACL tears involves measures to decrease the swelling such as frequent icing and using a non-steroidal anti-inflammatory medication (e.g., naproxen). Physiotherapy is very important in regaining your knee range of motion and preventing excessive muscle wasting. Often, the physician will prescribe a temporary brace for the first two weeks to protect your knee. Once your knee starts to settle down, the physiotherapist will show you some particular strengthening (especially hamstring strength) and balance exercises, which are very important in the rehabilitation of your knee.
What is the Best Physiotherapy for ACL Treatment?
There are many factors that will affect your decision for which physiotherapist you see for your injury. Regarding ACL tears, you should seek a physiotherapist who has expertise in treating sports injuries and specifically treating ACL tears. The basic treatment for ACL tears can be straightforward, however, if complications arise or if you are trying to optimize the recovery of your knee, you should seek a physio with extra skill and knowledge in this area. For example, once the recovery process is underway you will need to progress to doing some complex neuromuscular retraining exercises that are specific for your sport or activity which are based on current research validated recommendations. Also, after surgery, you need to carefully guided through the post-surgical recovery process by your physiotherapist to prevent stiffness and to optimize strength and function for a full return to sports.
What is the Best Physiotherapy for ACL Treatment?
There are many factors that will affect your decision for which physiotherapist you see for your injury. Regarding ACL tears, you should seek a physiotherapist who has expertise in treating sports injuries and specifically treating ACL tears. The basic treatment for ACL tears can be straightforward, however, if complications arise or if you are trying to optimize the recovery of your knee, you should seek a physio with extra skill and knowledge in this area. For example, once the recovery process is underway you will need to progress to doing some complex neuromuscular retraining exercises that are specific for your sport or activity which are based on current research validated recommendations. Also, after surgery, you need to carefully guided through the post-surgical recovery process by your physiotherapist to prevent stiffness and to optimize strength and function for a full return to sports.
How Long Does it Take to Recover From an ACL Tear?
For an isolated ACL tear, your knee should be feeling much better within 6 weeks (no pain or swelling because the inflammation has settled down). Unfortunately, the torn ACL does not usually heal or “tighten up”. Once an ACL is completely torn, it stays torn.
Is Surgery Needed for ACL Tears?
Depending on your sport or activity level, you may have to have surgery to reconstruct your ACL. Surgical reconstruction comes the closest to getting your knee back to normal. If your sport does not involve any pivoting (e.g., road cycling) then you probably will not need surgery (unless your knee gives out with daily activities which can sometimes happen!).
Surgery is usually the best option for individuals who play football and other pivoting and contact sports. In the realm of sport injuries, ACL surgery is a fairly large procedure since the surgeon has to be skilled at this type of procedure. You have to be very dedicated to working hard at physiotherapy for several months after surgery, to help ensure a successful outcome.
In general, the earliest you can return to contact & pivoting sports after ACL surgery is six months. Often, this period is closer to nine months. Going back too early can result in re-injury since the reconstructed ACL will not be strong enough. Usually, you will be using the ACL brace after surgery, during the rehabilitation, and for the first year afterwards.
Does a Brace Help ACL Tears?
An ACL brace can help to prevent this knee instability. A physician may prescribe a special custom-fit ACL brace. This type of brace can be used on a daily basis in the rehab period and later to help to prevent knee instability in high risk situations such as pivoting or contact sports. In general, these braces are well-tolerated since they are custom-fit and made of strong light-weight materials such as titanium and carbon-fibre.
Services
Our mission is to help athletes and active individuals achieve their sports and exercise goals!