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Treatment for soft tissue injuries

Brad Walker provides a guide to cutting your recovery time from injury by days, if not weeks!

I get many questions from people asking about specific treatments for sports injuries, like running injuries and other common pulled muscle complaints. The unfortunate thing about most of these requests is that the injury occurred some time ago. This time-lapse between the injury occurring, and treatment starting is the biggest obstacle to a complete recovery. As always, before I sit down to write an article, I like to spend a few hours surfing the net for information that relates to the topic I am going to write about. In most cases, I find a great deal of useful information that relates to what I am looking for; but not this time. What I did find was a lot of information related to treating specific sports injuries long after they had occurred. However, I found very little information regarding the immediate treatment of sports injuries. This was quite disappointing because if people are only treating injuries long after they have occurred, they are putting themselves at a significant disadvantage.

Before we start

The type of sports injuries I am referring to here is soft tissue injuries, which are very common in most, if not all sports. Examples of common soft tissue injuries would include things like hamstring tears, sprained ankles, pulled calf muscles, strained shoulder ligaments, corked thigh, etc. Remember a sprain refers to a tear or rupture of the ligaments, while a strain refers to a tear or rupture of the muscles or tendons. The sort of injuries I am NOT talking about here are injuries that affect the head, neck, face, or spinal cord which involve shock, excessive bleeding, or bone fractures and breaks. The treatment of these types of injuries goes way beyond the simple soft tissue injuries that I am discussing here.

Priority Number 1 The priority when treating any sports injury is, "Do No Further Damage." Therefore, before we get into the treatment of soft tissue injuries, there is one crucial point that I should discuss first.

Before you start treating any injury, whether to yourself or someone else, first STOP and take account of what has occurred. Consider things like; is the area safe from other dangers? Is there a threat to life? Is the injury severe enough to seek emergency help? Then, using the word STOP as an acronym to;

  • S: (stop) Stop the injured person from moving. Consider stopping the sport or game if necessary
  • T: (talk) Ask questions, e.g. what happened? How did it happen? What did it feel like? Where does it hurt? Have you injured this part before?
  • O: (observe) Look for things like swelling, bruising, deformity and tenderness
  • P: (prevent) Remember, do no further damage. Prevent further injury.

Once you have taken a few moments to make sure the injury is not life-threatening, it is time to start treating the injury. Remember, the sooner you start treating a sports injury, the more chance you have of a complete recovery. The longer you wait, the worse it is going to be.


Without a doubt, the most effective, initial treatment for soft tissue injuries is the R.I.C.E.R. regime. This involves the application of (R) rest, (I) ice, (C) compression, (E) elevation, and obtaining an (R) referral for appropriate medical treatment. Where the R.I.C.E.R. regime has been used immediately after the occurrence of an injury, it has been shown to reduce recovery time significantly. R.I.C.E.R. forms the first, and most important stage of injury rehabilitation, providing the early base for the complete recovery of the injury.

When a soft tissue injury occurs, there is a large amount of uncontrolled bleeding around the injury site. This excessive bleeding causes swelling, which puts pressure on nerve endings and results in increased pain? It is this process of bleeding, swelling, and pain that the R.I.C.E.R. regime will help to alleviate. This will also limit tissue damage and help the healing process.

The "How To"

R: (rest)

The injured area must be kept as still as possible. If necessary, support the injured area with a sling or brace. This will help to slow down blood flow to the injured area and prevent any further damage.

I: (ice)

This is, by far, the most important part. The application of ice will have the most significant effect on reducing bleeding, swelling, and pain. Apply ice as soon as possible after the injury has occurred.

How do you apply ice?

Crushed ice in a plastic bag is usually best. However, blocks of ice, commercial cold packs, and bags of frozen peas will all do fine. Even cold water from a tap is better than nothing at all. When using ice, be careful not to apply it directly to the skin. This can cause "ice burns" and further skin damage. Wrapping the ice in a damp towel provides the best protection for the skin.

How long and how often

This is the point where few people agree. Let me give you some figures to use, as a rough guide, and then I will provide you with some advice from personal experience. The most common recommendation is to apply ice for 20 minutes every 2 hours for the first 48 to 72 hours. These figures are a good starting point but remember they are only a guide. It would help if you consider that some people are more sensitive to cold than others are. Also, be aware that children and older people have a lower tolerance to ice and cold.

Finally, people with circulatory problems are also more sensitive to ice. Remember to keep these things in mind when treating yourself or someone else with ice. My recommendation is that people should apply ice for as long as it is comfortable. There will be a slight discomfort from the cold, but as soon as pain or excessive discomfort is experienced, it is time to remove the ice. It is much better to apply ice for 3 to 5 minutes a couple of times an hour, than not at all.

C: (compression)

Compression achieves two things. Firstly, it helps to reduce both the bleeding and swelling around the injured area, and secondly, it provides support for the injured area. Use a wide, firm, elastic, compression bandage to cover the injured part. Make sure you bandage both above and below the injured area.

E: (elevation)

Raise the injured area above the level of the heart at all times. This will further help to reduce the bleeding and swelling.

R: (referral)

If the injury is severe enough, you must consult a professional physical therapist or a qualified sports doctor for an accurate diagnosis of the injury. With an accurate diagnosis, you can then move on to a specific rehabilitation program to reduce your injury time.


Before we finish up, there are a few things that you must avoid during the first 24 to 72 hours after an injury. Be sure to avoid any form of heat at the injury site. This includes heat lamps, heat creams, spars, Jacuzzi, and saunas. Avoid all movement, massage of the injured area, and excessive alcohol, as these will increase the bleeding, swelling, and pain of your injury.

Article Reference

This article first appeared in:

  • WALKER, B. (2007) Treatment for soft tissue injuries. Brian Mackenzie's Successful Coaching, (ISSN 1745-7513/ 39/ February), p. 4-5

Page Reference

If you quote information from this page in your work, then the reference for this page is:

  • WALKER, B. (2007) Treatment for soft tissue injuries [WWW] Available from: [Accessed

About the Author

Brad Walker is a prominent Australian sports trainer with more than 15 years of experience in the health and fitness industry. Brad is a Health Science graduate of the University of New England and has postgraduate accreditations in athletics, swimming, and triathlon coaching. He also works with elite level and world champion athletes and lectures for Sports Medicine Australia on injury prevention.