I am often asked by parents what to do in the early stages when their child sustains an injury. My response will differ based on a multitude of factors, such as the mechanism of injury, the physical structures that are likely to be damaged and the chronicity of the injury (is it a fresh injury of is it an old irritation that continues to niggle).
The safest bet is to book in to see your dance physiotherapist to have the injury examined earlier rather than later, to accurately diagnose the injury and establish a clear and structured plan for management from the outset. The physiotherapist will be able to assess the injury and determine the most appropriate and individualised course of treatment, which gives the dancer the best chance at making a successful and timely recovery.
However, it is not always possible to get to the physio straight away. The acronym RICE – rest, ice, compress, elevate – is well known amongst active people these days, and more importantly, amongst dance teachers who are often the first person on the scene when a young dancer injures themselves in class. The practise of ceasing the activity and resting immediately whilst icing, compressing and elevating is a good first step in managing an acute injury.
A slight update to the RICE acronym is POLICE – protect, optimal load, ice, compress, elevate. But what exactly does this mean, and how do we go about it? Here are some practical, tried and tested tips (although general in nature) based on my experience as a dancer and physiotherapist working predominantly with young dancers.
First and foremost – protect the dancer and injured body part from further damage. This might be through splinting or immobilisation, using tape or a brace. Try to limit the risk to other parts of the body; for example, with an ankle injury which is causing the dancer to limp, there is likely to be compensatory loading through adjacent joints, so using crutches until further examination can be carried out might be necessary.
Take enough weight and load off the injured area so as to not aggravate the injury or cause discomfort, but continue to move and exercise the unaffected areas as able. For example, if you have a sore toe and only one tiny portion of your body is injured, it is crucial to continue working the rest of your body or modifying certain activities with the aim of preserving strength and condition. Keep working the ankle, the knee, the hip, the body. Whatever is uninjured!
The idea is to cool down the tissues, to constrict blood vessels with the aim of stemming bleeding into the injured area, as well as limit the accumulation of inflammatory fluid. Icing is also a non-invasive and non-chemical alternative to oral analgesics, so safe for people with medication allergies or those wishing to avoid synthetic drugs. We only need to cool the skin and tissues slightly; there is no need to induce hypothermia and risk an ice burn – ouch!
- Apply an ice pack to the painful area – the most effective ice pack is a bag of frozen peas or plastic bag full of semi-crushed ice blocks (it stays colder for longer and can mould around body parts)
- Keep ice on for 20 minutes, then remove for 40 minutes
- Repeat this every 1 to 2 hours for the first 2 to 3 days
Cold water bathing is extremely helpful for toe, foot and ankle injuries, as the cold water gets into all the nooks and crannies around the foot and between the toes. The gentle pressure around the limb is also helpful, and whilst uncomfortable for a short period of time, has a profound impact on recovery – ever wondered why the footballers wade in freezing cold Port Phillip Bay in the depths of winter…?! The dosage is slightly different compared to icing:
- You may only need 3 to 5 minutes at a time, then 3 to 5 mins out, and repeat this a few times to accrue a total of 20 minutes in the water, then 40 minutes out
Applying a firm (but not tight!) compression bandage to the injured area provides a physical barrier for swelling accumulating. If the limb is to be completely immobilised, applying the bandage all the way to the extremity for uniform compressing down the length of the limb. Remember to check the skin regularly – if the skin has changed colour or appears blotchy or shiny, it can be a sign that the compression is too tight and circulation is being compromised.
When resting, have the entire limb supported above the level it attaches to the body. For example, for a knee injury, have the entire leg elevated so the foot and knee are resting above hip height, supported on a pile of cushions or pillows, including at night time when sleeping. This becomes challenging for a back injury – sometimes we need to get creative with positioning!
Need some personalised advice on injury management? Get in touch!
The methods outlined above are intended as a guide only and are provided on the basis the reader will be responsible for assessing the relevance and accuracy of the content in reference to their specific situation.