The first 24-48 hours after sustaining a soft tissue injury are crucial in ensuring the best outcome for healing. As a general rule, management for most injuries is as simple as remembering two simple acronyms – POLICE and HARM.
| HARM | Avoid Heat, Alcohol, Running and Massage in the first 72 hours |
|---|---|
| Why | These can increase swelling and bleeding in fresh soft tissue injuries |
| Instead | Protect, gently move within pain, compression and elevation |
| After 72 hours | Gradually load and return to activity |
HARM stands for Heat, Alcohol, Running/ exercise, and Massage. HARM represents four factors that you should avoid in the early stages of injury in order to maximize healing and recovery. Whilst the concepts behind RICE all tend to focus on minimizing bleeding and swelling, the acronym HARM covers factors to avoid – all of which will increase circulation to the damaged area.
Heat– Heat will cause blood vessels to dilate which in turn will increase the flow of blood to the area.
Alcohol– Similar to heat, alcohol has an effect of dilating blood vessels, which in turn will increase the flow of blood to the area. Avoid drinking alcohol in the initial stages of healing any injury.
Running/ exercise– An increase in heart rate increases the flow of blood around the body, which will cause blood to accumulate in the area faster. Take the opportunity to rest.
Massage– Massaging the area, once again, will stimulate the flow of blood to the area. Avoid massage in the initial stages of injury.
Our Approach
Dublin Sports Injury Clinic is a physiotherapy clinic based at 56 Fitzwilliam Square, Dublin 2. We have a holistic approach to our assessment and treatment. The initial assessment helps us to explore the cause of your injury and help you to get pain free shortly and stop any further injuries. We will design a customized training program for you to start with, and we will coach you and monitor your progress closely. We will prescribe relative rest or modified activities as required. Depending on the individual requirement, we apply manual therapy accompanied by stretching to restore tissue elasticity and reduce the strain in the muscle-tendon unit with joint motion.
Next step
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Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. You can contact us if you would like to book an appointment or get some advice from our therapist.
Frequently asked questions
Should I ice an injury?
Ice can ease pain in the first few days, but it is not essential and should not replace gentle movement.
When should I start moving after an injury?
Usually within the first few days, guided by pain. Early movement helps tissue heal.
Should I take anti-inflammatories straight away?
Some guidance suggests avoiding them in the first 48 to 72 hours for soft tissue injuries. Check with your GP or pharmacist.
References
- Dubois B, Esculier JF. Soft-tissue injuries simply need PEACE and LOVE. Br J Sports Med. 2020;54(2):72-73.
- Bleakley CM, et al. PRICE needs updating, should we call the POLICE? Br J Sports Med. 2012;46(4):220-221.
- van den Bekerom MPJ, et al. What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults? J Athl Train. 2012;47(4):435-443.
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