Acute Sports Injuries: What to Do in the First 72 Hours
Acute sports injuries — muscle strains, ligament sprains, joint impacts — demand a clear and evidence-based response in the immediate aftermath. What you do (and don't do) in the first 72 hours significantly influences how quickly you recover and whether complications develop. The old RICE protocol has been substantially updated by the current evidence, and understanding the newer framework is worth your time if sport is a regular part of your life.
PEACE & LOVE: the updated framework for acute injury management
The PEACE & LOVE framework replaces the outdated RICE model. In the acute phase: Protect the area from aggravating loads (but don't immobilise completely), Elevate if there is swelling, Avoid anti-inflammatory medications in the first 72 hours (inflammation is a necessary part of healing), Compress to manage swelling, and Educate — understand that pain doesn't equal damage. After the acute phase: Load progressively, Optimise activity levels, adopt a positive Vascular approach, and Exercise to rebuild capacity.
The key shift is away from treating inflammation as the enemy. In the immediate post-injury window, the inflammatory response is the healing response. Aggressive use of ice and anti-inflammatory drugs in the first 48-72 hours may actually impair the tissue repair process.
When to get an acute injury assessed
Red flags that warrant prompt assessment include inability to weight-bear, significant joint deformity, immediate and diffuse swelling (suggesting haemarthrosis), and persistent neurological symptoms. For most sporting injuries across Berwick and South-East Melbourne, a clinical assessment within the first few days is ideal — not to restrict recovery, but to accurately grade the injury and plan the rehabilitation.
If you've sustained a sporting injury and want a clear assessment and plan, book at RISE Sports & Spinal. We'll grade the injury, identify red flags, and get you started on recovery immediately.
How to load an acute injury correctly — the questions practitioners should be asking
The PEACE & LOVE framework is useful, but application requires clinical judgement. In the acute phase, "optimal loading" means identifying the highest load the tissue can tolerate without provoking inflammatory response beyond what is productive — not maximum tolerable pain. For muscle strains, this is often pain-free isometric contraction within the first 48 hours. For ligament sprains, it is early range of motion within protected limits. For joint injuries, it is assessing whether weight-bearing with support is possible. The specific loading prescription varies by tissue type, injury grade, and individual presentation.
At RISE Sports & Spinal in Berwick, acute injury assessment prioritises grading the injury accurately — distinguishing between grade one, two, and three presentations — because this determines the timeline and the rate of loading progression. Imaging is ordered when clinical findings suggest a more severe injury requiring different management. For athletes across the Berwick and Casey region who have sustained acute injuries during sport, prompt assessment means a more accurate prognosis, a clearer management plan, and a faster return to competition than the common approach of waiting to see how it settles.
Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.
