Physiotherapy at the Rio Olympics – lessons in Injury Treatment

Every Olympian’s goal is: Citius, Altius, Fortius  – Faster, Higher, Stronger.  Unfortunately as athletes continue to push the limits in their quest for sporting excellence they put a lot of strain on their bodies and injuries do occur.

The International Olympic Committee have published a booklet for athletes competing in Rio titled “The Role of Sports Physiotherapy.”  This booklet aims to raise the awareness of athletes and their entourage about the importance of physiotherapy not only at the time of competition but also through all stages of the athlete’s sporting career.

We thought we would share the section on Physiotherapy Treatment and Rehabilitation, which specifically deals with treating injuries. This advice is relevant for all injuries and we encourage our patients to take this advice.

SOURCE: The Role Of Sports Physiotherapy, International Olympic Committee, 2016.

“The first 24 hours immediately following the injury is the most important time to manage soft tissue injuries. Every effort should be made to reduce bleeding at the site of the injury, the most appropriate method is by adopting the PRICE regime.

Protect

Rest

Ice

Compression

Elevation

Why should athletes apply the PRICE regime?

The objective of the PRICE principle is to:

• Limit the extent of the injury.

• Reduce and control swelling.

• Allow return to sport and training in the shortest time possible.

 

The PRICE regime should be used for the first 24 to 48 hours.

Protect

When Injury Occurs how can athletes protect against further damage?

The athlete is strongly recommended to protect the injury from further injury or more extensive damage. The rational for protection after an acute soft tissue injury is to minimise the bleeding and prevent excessive distension at the injury site. For these reasons protection and soft tissue unloading is required in the acute stages. This means that stopping exercise is not sufficient, the athlete needs to stop all loading of the injured area e.g. in the case of an ankle soft tissue injury instead of standing the athlete should protect the area by taking body weight off the ankle by sitting or more ideally by lying down.

Rest

Is Rest necessary?

Immediate rest is essential. The athlete should stop the activity or exercise as continuing with exercise may cause further bleeding and damage. Resting not only form sporting activities but also resting from functional activities such as walking around is highly recommended during the first 24 hours following a lower limb soft tissue injury. Complete rest can be achieved by the use of a crutch for lower limb injury.

Ice

What methods should Athletes use?

Crushed ice wrapped in a moist cloth placed around the injured is more effective in reducing tissue temperature than gel packs or chemical cold packs. In the event of crushed ice not being available athletes should use whatever form of other cooling agents are available, cold pack, freeze spray, instant ice packs, cold water, ice–cups etc.

How should ice be applied?

Applying the ice with compression is more effective in reducing swelling, which can be done by tying the ice pack firmly to the injured part.

How often should ice be applied?

Although there is no high quality long term evidence to suggest how long and how often ice should be applied after injury a systemic review suggests that ice should be applied for 10 minutes, then check the skin, if you do not have skin irritation the ice can then be reapplied for a further 10 minutes. Ice should be applied every 1 to 2 hours initially and gradually reduced in frequency of application over the next 24 hours.

Be aware of the dangers of applying Ice!

• Ice should not be applied where local tissue circulation has been impaired.

• Prolonged ice application may cause skin burns and or nerve damage.

• Ice may temporarily impair muscle strength and may also cause temporary numbness, for these reasons it is very important to continue to rest in between icing sessions.

Compression

How should Compression be applied?

In between icing sessions you should continue to apply ice with appropriate pressure on the injured area. This can be done by:

• Wrapping a bandage firmly around the injured area in order to apply compression.

• A strap type bandage can be applied starting beyond the point of the injury and working towards the heart.

• The bandage should overlap by one-third to a half inch width and should extend to at least a hands breath proximal to the injury margin.

Or

• Using a cold therapy with compression cuff, this equipment is available in the physiotherapy department at the Olympic polyclinic.

Elevation

How should the injured area be elevated?

Keep your injured part elevated in order to reduce swelling. In the case of a leg injury you should ideally keep the leg elevated above the level of your heart by lying on the ground and resting your leg on a stool, sports bag etc. In the case of the arm or hand place your arm in a sling, if not available lie on the ground and place your arm on the sports bag, bench etc.

Seek Expert Advice

After you’ve applied the PRICE regime you should seek medical attention from your team physician or physiotherapist as soon as possible. As soon as your injury has been evaluated and diagnosed you will then be advised of the best course of treatment and management to ensure your return to sport as soon as possible.”

If you require any further information on any of the above, please do not hesitate to contact us at Impact Physiotherapy.