Musculoskeletal Injury Management

1. Management: Acute Musculoskeletal Injury (first 72 hours after injury)
   1. Home management
      1. Local Cold Therapy (as well as other RICE-M modalities)
      2. Gentle active range of motion
      3. Isometric Exercise
   2. Physical therapy modalities (daily for 5 days)
      1. Electrical Muscle Stimulation
      2. Pulsed ultrasound
      3. Gentle massage
   3. Therapeutic Goals
      1. Decrease swelling and pain
      2. Improve range of motion
      3. Speed healing
2. Management: Subacute Musculoskeletal Injury (3-14 days after injury)
   1. Home management
      1. Local Heat Therapy
      2. Active range of motion and Stretching
      3. Isotonic Exercise
   2. Physical therapy modalities (three times weekly for 2 weeks)
      1. Electrical Muscle Stimulation
      2. Iontophoresis
      3. Massage and joint mobilization
   3. Therapeutic Goals
      1. Improve range of motion and function
      2. Improve muscle tone
3. Management: Chronic Musculoskeletal Injury (Beyond 2 weeks after injury)
   1. Home management
      1. Contrast Bath
      2. Muscle strengthening and joint stabilization
      3. Active range of motion and Stretching
      4. Isotonic Exercise
   2. Physical therapy modalities (twice weekly for 4 weeks)
      1. Continuous Ultrasound Therapy
      2. Transcutaneous electrical nerve stimulation (TENS)
      3. Myofascial release techniques
   3. Therapeutic Goals
      1. Normalize tissue length
      2. Normalize Activities of Daily Living
4. References
   1. Rand (2007) Am Fam Physician 76::1661-6