Injury management

Injury management involves identifying, treating and recovering from an injury. The sooner you rest and treat the injury, the less time you will be in pain or discomfort, and the sooner you will be able to return to your activity.

On this page

  1. Assessment
  2. Treatment
  3. Rehabilitation
  4. T.O.T.A.P.S.
  5. R.I.C.E.D.
  6. H.A.R.M.

Assessment

Injuries need to be evaluated as soon as possible using D.R.A.B.C. (Danger, Response, Airway, Breathing, Circulation). If emergency treatment is not needed, T.O.T.A.P.S. is an effective tool for further assessment.

These guidelines do not apply for assessing head injuries, concussion, or suspected spinal injury. For more information, see Concussion.

Treatment

A soft tissue injury such as a sprain, strain or bruise (identified using T.O.T.A.P.S.) should immediately be treated with the R.I.C.E.D. procedure. Avoid the H.A.R.M. factors for 72 hours after the injury.

Rehabilitation

Rehabilitation focuses on restoring the player’s sport-specific abilities to prevent re-injury and encourage the best possible performance.

Rehabilitation has three phases:

  1. Acute
  2. Rehabilitation
  3. Return to play

Phase 1: Acute

Control and reduce the symptoms of an injury (pain, swelling, bleeding) by following the R.I.C.E.D. procedure and avoiding any H.A.R.M.-ful factors.

Phase 2: Rehabilitation

During the rehabilitation process, the player needs to restore and maintain:

  • range of motion
  • coordination and control
  • strength and endurance
  • balance
  • fitness
  • confidence.

Phase 3: Return to play

Restore sport-specific skills and techniques such as jumping, throwing, and kicking. When the sport-specific skills can be performed at the same level as they were before the injury, the player can return to the activity.

T.O.T.A.P.S.

T.O.T.A.P.S. is an effective injury assessment tool.

Keyword

Action

Talk
  • Ask the player what happened.
  • Where does it hurt?
  • What kind of pain is it?

Observe
  • Look at the affected area for redness or swelling
  • Is the injured side different from the other side?

Touch

Touch indicates warmth for inflammation, and also assesses pain.

Active movement

Ask the injured player to move the injured part without any help.

Passive movement

If the player can move the injured part, ask them to try to move it through its full range of motion.

Skill test
  • Did the active and passive movements produce pain? If not, can the player stand and demonstrate some of the skills from the game carefully?
  • If an injury is identified, remove the player from the activity immediately.

R.I.C.E.D.

The R.I.C.E.D. method of injury treatment can relieve pain, limit swelling and protect the injured tissue, all of which help to speed healing.

Keyword

Action

Rest
  • Rest reduces further damage - stop activity as soon as the injury occurs.
  • Avoid as much movement as possible to limit further injury.
  • Don’t put any weight on the injured part of the body.

Ice
  • Ice cools the tissue and reduces pain, swelling and bleeding.
  • Place ice (wrapped in a damp towel) onto the injured area. Don't put ice directly onto bare skin.
  • Hold the ice pack firmly in place with a bandage.
  • Keep ice on the injury for 20 minutes every two hours, for the first 48 hours.

Compression
  • Compression helps to reduce bleeding and swelling.
  • Ensure that bandaging is not so tight that it cuts off circulation or causes tingling or pain past the bandage.
  • Bandage the injury between ice treatments.

Elevation
  • Elevation helps to stop bleeding and reduce swelling.
  • Raise the injured area on a pillow for comfort and support.
  • Keep the injured area raised as much as possible.

Diagnosis

Consult a medical professional (such as a doctor or physiotherapist) especially if:

  • you are worried about the injury
  • the pain or swelling gets worse
  • the pain or swelling has not gone down significantly within 48 hours.

H.A.R.M.

Avoid these factors for 72 hours after the injury.

Factor

Reason to avoid

Heat

Heat increases the bleeding at the injury site. Avoid hot baths and showers, saunas, hot water bottles, heat packs and liniments.

Alcohol

Alcohol increases bleeding and swelling at the injury site, and delays healing. It can also mask the pain of the injury and its possible severity, which may result in the player not seeking treatment as early as they should.

Running

Running or any form of exercise will cause further damage. Players should not resume exercise within 72 hours of an injury unless a medical professional says it is alright to exercise.

Massage

Massage causes an increase in bleeding and swelling, and should be avoided within 72 hours of the injury. If the injury is massaged within the first 72 hours, it may take longer to heal.

Last updated:20April2009