The importance of the first minutes, hours and days of an injury

Sustaining an injury is commonplace in sport. What happens in the first few minutes, hours and days can play a big part in how well we recover. The injury needs to be diagnosed and understood, for example an ankle twisting beyond the normal range of movement that results in a sprained ligament. As important is our response to the injury, what action we take and what we think about it. This blog explores these points with the aim of clarifying good practice in the first instance of an injury.

Our response to an injury includes how we protect the area, how we communicate that we are injured and the thoughts going on in our head. All are influential. How we protect a new injury is often by holding it, perhaps rubbing the area, limping, applying a bandage or using a set of crutches. This is very useful as the healing process begins immediately and the tissues need this protection to enable this activity. Communicating our pain and injury is individual. Some will cry out, use a facial expression, raise an arm to call the bench for help and others will suppress the urge to call out or use other ways of minimising body language. However, it is often difficult to do this with the acute pain of a freshly sprained ligament or strained muscle. Finally, the thoughts running through our head will vary but could include ‘What have I done?’, ‘What does this mean to my career in football?’ or ‘Not again!’. These thoughts are really important as they will be the conscious reflection of our beliefs about the situation. Our beliefs in turn, drive behaviours and consequently what we do in our injured state. In essence, what we do early on can impact upon the course of the recovery.

In the early stages, having a good understanding of what has happened, what has been injured and the extent of the injury is important from a reassurance viewpoint. Often the responses of the body to an injury are normal yet unpleasant. We need to know what is normal and what may not be normal so that the latter can be dealt with effectively. We also like to know what it is that needs to be done. For these questions to be answered we make a prompt visit to a healthcare professional. Rapid pain relief helps to take a positive stance on managing the early stages and indeed, high levels of uncontrolled pain can lead to beliefs and behaviours that are unhelpful. This is a pertinent point that I would like to emphasise. Gaining a realistic and accurate view of the situation with a good management plan promotes adaptive behaviours and responses that means you are doing everything that you should to support the healing and recovery. Developing fears of movement, catastrophising about the pain and excessively worrying about the injury usually lead to persisting problems. Clearly the former is a better scenario.

In summary, we must think about the early stages of injury management and have a clear strategy. This must include a good explanation of the problem, relevant investigations if required, a management plan that works with the healing process and monitoring of any thinking that could impact upon one’s choices.

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