Patient information · Musculoskeletal
Soft tissue injury
sprains, strains and how they heal
A soft tissue injury is damage to a muscle, tendon or ligament rather than to bone. Swelling, bruising and pain are all part of healing. What speeds recovery is protecting the area early, then getting it moving again sooner than most people expect.
Get it looked at urgently if
- you cannot put any weight on it, or cannot take more than a few steps;
- the limb or joint looks bent, twisted or out of shape;
- the area is numb, tingling, cold, pale or blue;
- you heard or felt a snap or pop at the moment of injury and it swelled immediately;
- you cannot move the joint at all, or the pain is severe and not helped by painkillers;
- the skin over the injury is broken, or the injury happened at speed or from a height.
Any of these may mean a fracture or a complete tear and needs examining, usually with an X-ray or scan. We offer same-day appointments and on-site imaging. In an emergency, call 999 or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
What to expect
Most soft tissue injuries settle over one to six weeks. How long depends on which tissue was damaged, how badly, your age and your general health. Swelling that comes on within the first day, bruising that appears a day or two later and tracks downwards with gravity, and muscle spasm around the area are all normal.
The first 72 hours
The aim early on is to limit bleeding and swelling into the tissues without letting the area stiffen up.
- Protect. Avoid movements that provoke sharp pain. Use crutches, a splint or a sling only if you have been given one and only for as long as advised.
- Move early and gently. Complete rest for more than a day or two weakens muscle and thickens scar tissue. Small, pain-free movements several times a day are better than staying still.
- Ice for comfort. Wrap an ice pack or a bag of frozen peas in a damp towel and hold it on for 10 to 20 minutes, repeating every two to three hours for the first day or so. Never put ice straight onto skin, and check the skin regularly. Do not use ice if you have poor circulation or reduced sensation in the area.
- Elevate. Support the injured part above the level of your heart where you can — a lower limb raised on cushions, an upper limb on a pillow across your chest.
- Compression is optional. A support bandage can feel comforting, but there is little evidence it speeds healing. If you use one, it should never be tight enough to cause throbbing, numbness or colour change.
What to avoid in the first 72 hours — HARM
- H Heat
- Hot baths, saunas, heat packs and heat rubs all increase blood flow and swelling.
- A Alcohol
- Increases swelling and bleeding, and dulls the pain that would otherwise stop you overdoing it.
- R Re-injury
- Going back to sport or heavy work too early is the commonest reason a simple sprain drags on for months.
- M Massage
- Vigorous massage directly over the injury aggravates the damaged tissue early on. It has its place later.
Pain relief
Paracetamol at the dose on the packet is usually enough. Anti-inflammatory medicines such as ibuprofen, taken by mouth or rubbed on as a gel, can help once the first couple of days have passed.
Anti-inflammatories do not suit everyone. Check with a pharmacist or with us first if you have asthma, stomach ulcers or indigestion, kidney problems, high blood pressure, or if you take blood thinners or other regular medicines.
Getting moving again
- Start gentle movement and stretching as soon as you can do it without sharp pain — usually within the first few days.
- Mild discomfort during and after exercise is expected and is not damaging. Pain that is sharp, or that leaves the area more swollen the next morning, means you have gone too far too soon.
- Build up in small steps: range of movement first, then strength, then speed and direction changes if you play sport.
- Do not go back to full sport until you can move the joint freely, take full weight on it, and trust it.
Not improving after two weeks, or the joint feels unstable? Book an appointment. Our physiotherapy and orthopaedic teams can assess the injury, perform ultrasound on site and arrange MRI through our imaging partners if needed, and set you up with a rehabilitation plan.
Seen today, not next week
Same-day appointments most days, seven days a week, 9am–7pm, on Whitechapel Road.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.
Also able to advise
Your own GP · Your local pharmacist