Principles of Injury Management – Acute Soft Tissue Injuries

July 17, 2018

 In the next two parts of the blog I am going to try and give some advice on the two most common types of injuries runners will suffer.

  • Acute soft tissue injuries – such as hamstring pulls/strains or ankle sprains

  • Overload Injuries – such as tendon injuries, shin splints, runners knee.

We’ll start with acute soft tissue injuries; muscle strains or pulls are much more likely to occur with sprint or speed training when the load or force required from a certain muscle exceeds its capacity at that given moment. Acute ligament injuries, such as an ankle sprain are most likely to occur when training on uneven ground or when sudden changes of direct are required.


What I will cover here is the initial management in the first few days after the injury.


I’m sure most people will have heard the acronym RICE before, with the letters standing for REST, ICE, COMPRESSION, ELEVATION. In the early days after a soft tissue injury this is adequate advice to follow, BUT, with lots of injuries it has been shown that early movement and early commencement of rehabilitation can vastly reduce the time needed to return to sport/running.


With my clients I use the updated acronym POLICE.









You can see the ICE elements are the same, with acute soft tissue injuries the quicker you can control any bleeding/swelling and pain the better. The use of ice packs or frozen peas (not directly on the skin), compression and elevation are very useful in those first few days. Rest has now been replaced by Protection and Optimal Loading.


Protect emphasizes the importance of preventing further tissue damage, for mild injuries it may be okay to keep walking around on the injury guided by pain but for more severe injuries the use of a support or crutches for a few days may allow you to offload the injured area but keep engaged in daily activity. This is likely to be better that complete rest for limiting loss of strength in other areas and has mental benefits as well.


Optimal Loading can help to stimulate the healing process, tendons, muscles, ligaments and all other soft tissues require some load to help stimulate healing. It can also help with swelling management as muscles such as the calf muscles can act as a pump to help remove swelling.


The key word here is Optimal, for some this may mean no loading, some injuries do require protection and time to recover such as fractures or complete tendon ruptures. For some injuries getting going sooner will facilitate a quicker return to running. The decision on how much protection and how much loading is required will always need to be made on an individual basis.


With acute soft tissue injuries that have obvious swelling/bleeding and limited mobility I would always recommend seeing an appropriate healthcare professional for advice.


In the next part of the blog I’ll discuss more common overload injury management and then we’ll move on to some specific injuries.


As always thanks for reading.


Twitter: @quinn_physio



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