There is often some confusion about the most appropriate first aid action when someone has suffered a soft tissue injury. Is it best to apply heat or ice? It is very important to get it right, as the course of action decided upon will greatly impact the length of time for recovery.
What is soft tissue?
Soft tissue is a broad term covering any part of the body which is soft. That is, not hard like bone. I agree with the classification given on the PhysioWorks website for Soft Tissue:
Ligament (connecting bone to bone)
Tendon (connecting muscle to bone)
Other Soft Tissue (e.g. fat, myofascial tissue, joint capsules, skin and other connective tissues)
Commonly a soft tissue injury is described as a strain or a sprain, and there is a difference. According to Better Health: ‘A sprain is a joint injury that involves tearing of the ligaments and joint capsule. A strain is an injury to muscle or tendons’. If you suffer a sprain or strain to a soft tissue the immediate action is to seek prompt medical attention for an accurate diagnosis and specific care. When an injury occurs, damaged soft tissue can bruise, swell, bleed internally and externally. However in the interim before professional care you can follow these general first aid guidelines appropriate for all soft tissue injury. For the first 3 days after an acute injury it is best to use the R.I.C.E. method.
Rest is vital to protect the injured muscle, tendon, ligament or other tissue from further injury. Avoid placing weight on the area and restrict its use immediately.
Never apply ice directly to the skin. When icing an injury, chose a cold pack, crushed ice wrapped in a thin towel to protect the skin. Never leave ice for more than 20 minutes at a time and then leave off for long enough for the skin to re-warm before reapplying.
Compression helps to limit and reduce swelling, but don’t put it on too tight. If you feel the area throbbing, or if the area feels too tight, remove the bandage and reapply it a little looser
Elevating an injury helps to control swelling. It is most effective when the injured area is above the heart so it may be required to lie on you bed to achieve this.
After a day or two of applying R.I.C.E., most soft tissue injuries will begin to heal. But if with using R.I.C.E. the swelling and pain associated with the injury isn’t decreasing I’d strongly encourage you to seek professional diagnosis and care. Once the injury has moved out of the Acute stage with swelling and bleeding has stopped, then heat may be helpful. Moist heat will increase blood supply to the damaged area and promote and spread healing process. At the moment the R.I.C.E. approach is the one recommended by most experts, although with more research it may be improved for effectiveness.