After years of being involved in amateur sports, as players, coaches, bystanders and parents, there are a few things we at Barossa Physio have learnt about managing first aid on the side lines. As we move into our winter sport season, I thought I'd share some tips we have collected, and answer some of the questions we get asked frequently in our practice. Remember, this is general advice only, and if you are in doubt, refer to the trained professionals that will hopefully be available somewhere at the venue.
This is also not meant as a First Aid guide. If you are interested in more in depth knowledge, you may like to upgrade your skills with a First Aid course, or Sports Trainers Course. We can direct to the right courses if you are interested.
Do you leave a shoe on if someone has sprained an ankle?
For most ankle sprains, leaving a shoe on or off is not going to have any impact on the injury or it's healing. If there is an obvious derangement of the ankle (ie: you think the joint is dislocated or rearranged in some way) then it is a good idea to leave everything where it is, and call for a Health Professional or ambulance. Swelling is the body's first healing response, and lots of swelling just means lots of healing is happening. Removing the shoe can make it easier to apply ice, but ask the injured person to remove their own shoe rather than you pulling the shoe and potentially causing more pain!
Speaking of ice (nice segway!)...
When do you apply ice, how...and for how long?
Currently the Australian Physiotherapy Association (APA) and the South Australian Sports Medicine Association (SAMSA) endorse 20 minutes of ice every 2 hours, with a cloth or fabric barrier to protect the skin.
BUT……..if you look at some recent research and questioning of traditions, it may be that we should be asking, “should we ice an injury at all??”.
There is a move to replace RICE (Rest Ice Compression Elevation) with MEAT (Movement Elevation Analgaesia Treatment).
Until the research becomes clear, we at Barossa Physiotherapy suggest the first line of management be:
7-10 mins of ice, each hour, providing it is giving some pain relief. (Apply through fabric/cloth).
Compression, with a strong bandage or tubigrip, again for comfort (it should feel better).
Elevation (this does not include having it up on a barstool at the bar!!)
Early, active movement.
Have the injury assessed by a professional (someone like us!!) as soon as you are able, to determine the best way to manage it. Even if the injury seems minor, there are a lot of strategies that can speed up your recovery.
Avoid HARM (Heat, Alcohol, Running or Massage)
And no, in most cases you probably don’t need an xray!!!
If you are interested in the science, you could read this article or visit here.
If the player is intending to continue playing, then your only action would be to cover up wounds or seek a qualified person to strap for support if necessary. Otherwise, if ice has been applied, the player should not return to the playing field or court.
Do they need crutches?
If the injured player is able to bear weight on their limb, then crutches shouldn't be necessary. Incorrect use of crutches can lead to poor movement patterns that can slow the return to normal movement and hence to sport.
If they can't weight bear, crutches can help unload the joints to allow early healing. If crutches are needed, then we would say that proper assessment and rehabilitation is also needed, and that you should book to see a physio as soon as possible.
How do I tell if someone has concussion?
Any knock to the head, or fall where the head is hit on the ground is sufficient to cause concussion. If you are on the sidelines as a First Aider, or Primary Care Person, the "Concussion Recognition Tool 5" is useful in recognising and managing suspected concussions and head injury. This is freely available via the British Journal of Sports Medicine website or click here for a copy of the PDF. Most trained First Aiders and Sports Trainers involved within your club (if you have them) should be aware of this tool and the recording sheets required.
Speaking of Primary Carers, if you are given this role on a Saturday, we have a handout guide that you may find useful. It is designed for the netball clubs within the Barossa, Light and Gawler netball associations, but many of you may find it useful if you attend sport in any capacity. If you would like a copy, contact us via email and we can send it to you. We hope to supply this to all teams within our association.
How long before a concussed player can return to sport or exercise?
This is really a question that cannot be answered in any general sense. Each code of sport has it's own protocols, but it is vital that someone who has a concussion is also managed by a doctor or physio. They should be tested for Post-Concussion syndrome, and given rehabilitation exercises to assist their recovery and testing to determine their return.
Will using "anti-inflammatories" (eg NSAIDs like Nurofen) delay the healing process?
The question of pain relief really should be answered by a Pharmacist or doctor. There has been some suggestion that NSAIDs (Non Steroidal Anti Inflammatories) can slow healing. At this stage there is no substantial evidence we are aware of that shows anti-inflammatories in acute soft tissue injury will delay healing (full article can be found here .) There is evidence that they should not be used when fractures are healing.
Remember that ice has an analgesic effect, and may be just as effective in relieving pain as drugs!! (Keep it simple).
Some final things we would love to share...
From personal experience suffering significant injury (yes, we have been there, rolling around on the ground making a right spectacles of ourselves), here are a couple of tips on how to approach an injured player:
Approach them calmly and don't fire questions at them if they are screaming or struggling to breath.
Help them slow their breathing down, and reassure them that you are there to help.
Tell them to catch their breath, and then tell you what is hurting when they are ready.
Keep others from crowding the person, or attempting to move or stand them up.
Allow the most qualified person to direct everyone's actions - we don't need 6 people giving advice.
Call for someone to help if you are not sure what to do.
There are some good First Aid phone Apps (we have used one from Australian Red Cross; for Concussions look at "HeadCheck" and check out strapping ideas on "Strappt") and they can help in an emergency, or you can use them to learn about first aid.
We hope this has been helpful. Remember, no online advice (even ours!!) replaces trained and skilled assessment so defer all queries to a qualified person.
If you have any general questions, please feel free to contact us via Social Media or the website. For specific queries, please phone and we can chat, or arrange an appointment.
Thank you to all those volunteers who help out at sporting events, and hope this helps keep everyone moving well and staying well.
Happy Exercising everyone!