Sports and soft tissue injuries are unpredictable and often devastating. You cannot foresee them, mentally prepare for them and it can be daunting to figure out where to turn next. Whilst professional athletes will have an entire entourage of medical support to guide them, the average person can be left in a position of uncertainty and with a painful injury that lingers for far longer than necessary, often never fully healing.
This article will break down exactly what to do in the instance of a devastating soft tissue injury, from the moment of occurrence to each different phase of rehabilitation and getting back to full function. This overview is a broad framework applicable for every type of soft tissue injury with a progressive approach to restore function, promote healing, and prevent further injury.
Note: this guide is not applicable for bone injuries or soft tissue injuries requiring surgery. To read more about this on our blog please click here.
The Stages of Soft Tissue Injury Rehabilitation
A soft tissue injury can be broken down into 5 phases. Each phase has a different focus point and assistance from different healthcare professionals.
PHASE 1
ACUTE PHASE
Healthcare Provider: Medical/Triage
Timeframe: 1-7 days
Injury: Bruising, Swelling, Sharp Pain, Muscular/Ligament/Tendon Damage
Aim: Reduce inflammation, control pain, protect the injured tissue from further damage
This stage begins immediately after the injury and lasts for a few days to a week. Rest, ice, compression, and elevation (RICE) are commonly used during this phase. The injured limb may be immobilised using a splint, brace, or crutches.
PHASE 2
SUBACUTE PHASE
Healthcare Provider: Medical/Physiotherapist
Timeframe: Week 1 - Week 4
Injury: Reduced inflammation, reduced function, pain still present
Aim: Promote healing, restore range of motion, prevent muscle atrophy (wastage)
Therapeutic modalities such as heat, ultrasound, or electrical stimulation may be used to enhance blood circulation and tissue healing. Gentle stretching, joint mobilisation, and isometric exercises may be introduced, depending on the severity of the injury.
PHASE 3
INTERMEDIATE PHASE
Healthcare Provider: Physiotherapist AND Professional Personal Trainer
Timeframe: starting between week 2-4, up until week 8
Injury: Tissue is healing, very little pain, usual joint movements still not possible
Aim: Improving strength, flexibility, and balance, restore functional movement patterns
Controlled weight-bearing exercises, resistance training, and proprioceptive exercises are gradually introduced. Physical therapy exercises and modalities are customised to address the specific needs of the individual and the injured area.
PHASE 4
ADVANCED/RETURN TO FUNCTION PHASE
Healthcare Provider: Professional Personal Trainer
Timeframe: Around Week 6 - Up until Week 12
Injury: No pain, range of motion largely restored, function still limited
Aim: Return to full daily function
The intensity and complexity of exercises are increased to simulate the demands of daily life and/or the sport. Plyometric exercises, agility drills, and sport-specific movements are incorporated to improve power, speed, and coordination.
PHASE 5
RETURN TO SPORT PHASE
Healthcare Provider: Professional Personal Trainer
Timeframe: 12+ weeks
Injury: No pain, no restrictions, basic function is possible
Aim: Return to Sport with greater capacity than Pre-Injury (come back stronger)
Sport-specific training, fine-tuning skills, and gradually increasing the intensity of training. The focus is on achieving optimal performance while minimising the risk of re-injury. The individual is closely monitored for any signs of pain, weakness, or instability. A comprehensive evaluation by a professional is usually conducted to ensure readiness for competitive play.
BREAKDOWN
The above framework will provide clarity on where you are in your post-injury rehabilitation journey and what should be next to come based on current injury severity. Each stage will be important to utilise the appropriate healthcare professional to ensure personalised guidance and progress on full healing and recovery.
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