In addition to the steps outlined in P.R.I.C.E, additional treatments can help alleviate symptoms.

  • Patients in need of pain relief can use over-the-counter creams, patches, acetaminophen, or non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen or ibuprofen.
  • To reduce the build-up of fluid that leads to swelling (edema), patients can try light massage around the head and/or gentle range-of-motion exercises for the affected joints and soft tissue.
  • Isometric muscle contractions can improve and maintain strength and function. For example, a patient with a leg injury can repeatedly flex and relax the calf and thigh muscles while sitting still or lying down; the leg muscles “fire” and are exercised even though the leg itself does not move or bear weight.

A medical professional may be able to suggest treatments specific to particular person or injury.

Things to Avoid

Some treatments can cause more harm than good. Below is a list of things that can aggravate an acute injury:

  • Hot water exposure or heat treatments to the injured area
  • Stretching, movements, or weight bearing activity that is painful
  • Aggressive, deep massage
  • Ice or commercial cold packs placed directly on the skin
  • Advice contrary to common sense or widely accepted principles of basic injury care

Patients who are unsure how to treat their injury should contact their doctor’s office.

Seeking Definitive Sports Medicine Care

Many sport and exercise injuries do not require an emergent office or hospital evaluation. Nevertheless, in order to have the most accurate diagnosis and best recommendations for an expedient and safe return to your activity, seeking a consultation from a well trained, experienced sports medicine physician is recommended for most sports and exercise injuries. A sports medicine physician can:

  • Accurately define the location and severity of your injury.
  • Perform in-office diagnostic musculoskeletal ultrasound, order x-rays and other imaging studies.
  • Give the most accurate estimates of healing and return to activity timeframe.
  • Recommend more advanced management, such as immobilization, bracing, orthotics, protected weight bearing, medications, injections, or surgery.
  • Discuss sport specific skills, cross training, weight and cardiovascular workouts that are safe to perform despite an injury.
  • Communicate effectively with coaches, athletic trainers and family, if necessary.
  • Devise rehabilitation protocols customized to the injury, sport and player position.
  • Provide recommendations/orders for other treatments, including physical therapy, occupational therapy, massage therapy, Graston technique, kinesio-taping, Active Release Therapy, acupuncture, and/or osteopathic or chiropractic manipulation.
  • Offer strategies for nutrition, dietary supplements and injury prevention for sports and exercise enhancement.
  • Guide gradual return to sport and activity through regular ongoing follow-up visits.

Acute injuries vary greatly in presentation, severity and recovery time. Athletes with mild to moderate injuries can use the P.R.I.C.E. protocol to alleviate symptoms. When symptoms persist or symptoms are severe, the patient should contact a sports medicine doctor or other medical professional for advice.

References

Kannus P. Immobilization or early mobilization after an acute soft-tissue injury? Phys Sportsmed.2000 Mar; 28(3):55-63

Starkey C. 2012 Athletic Training and Sports Medicine: An Integrated Approach (5th Edition), American Academy of Orthopaedic Surgeons

Kerr KM, Daley L, Booth L, Stark J. PRICE Guidelines: Guidelines for the Management of Soft Tissue (Musculoskeletal) Injury With Protection, Rest, Ice, Compression, Elevation During the First 72 Hours (ACPSM) ACPOM.1998; 6:10-11.

Anderson M, Parr G. 2012 Foundations of Athletic Training (5th Edition), Lippincott Williams and Wilkins. Deal DN, Tipton J, Rosencrantz E, Curl WW, Smith TL. Ice Reduces Edema: A Study of Microvascular Permeability in Rats. J Bone Joint Surg. 2002; 84-A: 1573-1578.

Schaser KD, Vollmar B, Menger MD, Schewior L, Kroppenstedt SN, Rashke M, Lubbe AS, Haas NP, Mittlmeier T. In Vivo Analysis of Microcirculation Following Closed Soft-Tissue Injury. J Orthop Res. 1999; 17:678-685.

Algafly AA, George KP. The Effect of Cryotherapy on Nerve Conduction Velocity, Pain Threshold and Pain Tolerance. BR J Sports Med. 2007; 41:365-369.

Andersson S, Fredin H, Lindberg H, Sanzen L, Westlin N. Ibuprofen and Compression Bandage in the Treatment of Ankle Sprains. Acta Orthop Scand. 1983; 54 (2): 322-325.

Heere LP, Piroxicam in Acute Musculoskeletal Disorders and Sports Injuries. Am J Med. 1988;84(5A): 50-55.

Zhang Y, Shaffer A, Portanova J, Seibert K, Isakson PC. Inhibition of Cyclo-oxygenase-2 Rapidly Reverses Inflammatory Hyperalgesia and Prostaglandin E2 Production. J Pharmacol Exp Ther. 1997;283(3):1069-1075.

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