It could be the Tuesday afternoon in the gym when you are bench pressing when you feel a weird pinch in your shoulder or the Saturday morning indoor soccer match where you sprain an ankle trying to dribble past the defender. It doesn’t quite matter what causes an injury for you there is one thing I can say for sure – injuries tend to be a real pain – stopping us from doing our daily duties, competing, and sometimes changing lives forever. The process tends to look different for each person and many times every injury, but there is a frame work I am confident many injuries will follow. But before we get too far in to this framework we should first explore a general idea of different types of injuries.

Types of Injuries

Acute

Chronic

Sprain

Strain

Nerve

Fracture

Indicators of Injury

While injuries tend to be spastic and sporadic in nature there are still a few key indicators that increase our chances of getting injured.

Previous Injury

Fatigue

Poor Load/Intensity Tolerance

Inadequate Strength and Poor Exposure

Immediate Action

Pain Management

Swelling Management

Red Flags

To see a doctor or not?

How to find a good rehab practicioner/manual therapist

Move vs. Rest

Ice or Don’t

Really this depends. I am not one to recommend ice typically, and for the majority of my career I would say this reigns true. There tends to be skewed thoughts in the literature to whether or not the application of ice works, but for me I like to think about it as simple as I possibly can. Ice shrinks yes, but ice shrinks things that move the inflammation from an injury. If I shrink all of the blood flow then it is that much harder to move fluid from the injury site. If my goal is to feel better faster vs. feel better right now then I am likely going to delay icing anything. I have found that the quicker one can get rid of the inflammation the better an injury starts to feel, and once it starts feeling better we can continue to progress forward.

Often I then get asked about heating after an injury, and I would say that I confidently do not feel this does anything net positive or negative. Now with my personal opinion out of the way I would say let’s follow the same methodology as we did with ice. Heat will do the opposite of what ice will do yes that I get, but one of the fundamental problems with either application is they are a passive modality. When applying heat and just sitting there then we are locally allowing the inflammation to move but only quickly and in one area…this leads me to the hypothesis that inflammation will just pool over where was just heated. Yes in theory it is more in line with the thought process away from ice, but not much different overall.

Now having said all this – it all comes down to a big ‘ole… IT DEPENDS. Yes, it depends. The factors are long, but to name a few. How fast do you need/want to feel better? Does the managing the pain now matter more? Do you have an event/match/game/etc?

If you do not care about it blowing up on you a little bit that night and maybe taking a few more days to a couple more weeks to have full normal function then feel free to ice that thing up stat!! If those things do matter to you then keep reading and follow the outlined steps that follow.

How to Progress

Plyos/Move Fast/Endurance

How to still do the things I want to do?

Returning to play/competition/performance

Future Reduction/Final Thoughts

Listen one of the greatest indicators of any injury is a previous injury to the site, and this doesn’t appear to be changing anytime soon. The fortunate piece of this is injuries give us a guide when planning out our strength training. I have always been one to think that good strength and conditioning and good injury rehabilitation are nearly identical. Keeping bang for buck exercises in your programming, warm-up, or isolated in their own dedicated time window is a good idea.

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