When you feel the pain of an injury, stop whatever you are doing. Use the next few minutes to assess the damage and let the initial pain settle. Then try to move the injured part gently. If the pain becomes worse, you may be increasing the internal bleeding and swelling. To prevent further damage it is necessary to rest the injured part for 24 hours. To achieve this you may need to use a walking stick to reduce the weight you take through your injured let or sling to support your injured arm.

When applying the principle of rest following injury it is not necessary to completely stop all activity. The injured part should only be rested to the extent that all painful activities are avoided. This is called relative rest. For example, if following an ankle sprain walking does not cause any pain, continue to walk short distances as comfort allows. Maintenance of your general fitness by activities which do not aggravate your injury will assist the early recovery of full function.

Both ice and cold therapy are very effective in reducing inflammation. Ideally, ice or cold therapy should be applied immediately following injury, as this assists to decrease soft tissue damage, pain and muscle spasm.

Ice therapy involves the use of ice to obtain cooling of the injured area. The following methods of applying ice are recommended.

• Place crushed ice with a little water in a plastic bag. Then place the bag containing the ice inside another plastic bag and mould this over the injured area.

• Mould a packet of frozen vegetables over the injured area.

• Place a commercial therapeutic ice pack on the injured area following the manufacturer's instructions.

Cold therapy provides less cooling of the injured area than ice therapy. It is therefore more suitable to apply cold therapy to children, the elderly and persons with a thin, fragile or sensitive skin. The following methods of applying cold therapy are recommended:

• Place a cold, damp flannel over the injured area. The flannel can be cooled by dipping it in ice-water. When the flannel warms up replace it with a cold one.

• Place the injured area in a bucket containing water with a few ice cubes. This is useful for foot and hand injuries.

• Place the injured area under cold running water. This is useful for minor injuries or when other options are not available.

1. Ice can burn. To avoid this, protect your skin with a layer of insulation before applying ice therapy. Use a covering of oil, a paper towel or a damp cloth. Check your skin after three minutes. If your skin has become white, stop the ice therapy and use cold therapy instead.
   
2. Both ice and cold therapy may give some initial discomfort. This should wear off in a few minutes. If, with the use of ice therapy, your skin is becoming numb or increasingly painful, stop the ice therapy and use cold therapy instead. If with the use of cold therapy, your skin is also becoming numb or increasingly painful, stop the cold therapy and seek advice from a physiotherapist.
   
3. Apply ice or cold therapy for no longer than 15 minutes. Prolonged application will be of no further benefit.
   
4. To obtain the maximum benefit, apply ice or cold therapy every three hours. The ideal time to apply ice or cold therapy is after each exercise session.

Compression is the application of pressure over the injured area by bandaging. This is an invaluable and often overlooked first-aid measure. It is the most effective way of reducing internal bleeding and swelling, particularly if applied within the first few minutes following injury.

1. Use a bandage that will mould well around the injured area, providing a firm and even pressure. Elastic bandages are preferable to other types of bandages. Crepe bandages are acceptable but quickly lose their stretch and, consequently, their effectiveness. As an emergency measure, a bed sheet or towel can be torn up and used as a bandage.
   
2. Bandage a good distance above and below the injury site, working from below upward.
   
3. Apply the bandage firmly and comfortably. If it is too tight, particularly at night, it may cause pain or numbness. If it is too loose, it will not be effective.
   
4. Wear the bandage day and night.
   
5. Remove the bandage before ice or cold therapy and re-apply it immediately afterwards. Re-apply the bandage on rising in the morning and whenever the bandage has become loose or the pressure uneven.

Immediately following injury, elevate the injured limb above the level of your heart to limit the development of swelling. Elevate your injured limb at every opportunity for as long as the swelling continues. Raising the injured limb above the level of your heart may be impractical at work and in other situations, but remember that some elevation is better than none at all. For example, resting your injured ankle on a chair will still provide effective elevation.

1. At the time of injury, immediately stop your activity. To prevent further damage, restrict any activity that is painful.
   
2. Apply ice or cold therapy as soon as possible after the injury has occurred.
   
3. Apply compression, using a bandage, immediately following ice or cold therapy.
   
4. Elevate your injured area above the level of your heart at regular intervals during the day. This provides an excellent opportunity to apply the ice or cold therapy and compression whilst resting your injury.
   
5. As your pain and swelling decrease, reduce the application of ice or cold therapy to twice daily. When your daily activities are no longer painful, stop the ice or cold therapy.
   
6. Continue with compression and regular elevation until the swelling has disappeared. Compare your injured side with the other side to determine whether swelling is present or not.

If you have specific training questions please send email to trainer@activeankle.com