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Slip and Fall? Managing Acute Injuries

By: Dr. Elizabeth Braley, PT, DPT, OCS, CSCS

Injuries happen and with winter weather there is an increased risk of slips and falls on ice. Acute injuries are the recent ones, compared to chronic injuries which have gone on for months or years. Knowing when to head to the doctor for additional workups and what to watch for can help you avoid further injury and get your recovery started. A few big concerns after a fall could be traumatic brain injury/concussions, fractures, circulation issues due to significant swelling and shock.


If someone hits their head or sustains a whiplash type injury assessing for concussion is important. Concussions are mild traumatic brain injuries. The brain typically appears normal on imaging like MRI or CT scan which makes diagnosing a concussion difficult. Especially in the presence of fractures, concussion diagnosis is often missed. Concussion symptoms may include headache or head pressure, dizziness or balance problems, nausea or vomiting, mental fog, feeling hazy, feeling groggy, vision changes (double or blurred vision), light or noise sensitivity, feeling off or not right. Make sure the person gets physical and mental (cognitive) rest especially the first 24-48 hours after head injuries. If they vomit more than once they should seek urgent medical care. Most concussion symptoms will resolve within the first 1-2 weeks. However, symptoms that linger can be improved with physical therapy. If you or someone you know is experiencing symptoms from a concussion be sure to make an appointment with us.


After any fall it is possible to sustain fractures, bruises, muscle strains and ligament sprains. Fractures are diagnosed by x-ray. It can be difficult to know if you have sustained a fracture, but it is important because fractures often need to be protected with casting or bracing to heal appropriately. In severe cases, some types of fracture need to be realigned with surgery. There are evidence based “rules” to help clinicians decide when x-rays are necessary.

For example, the Ottawa Ankle Rules help clinicians determine when foot and ankle x-rays are needed. If you can’t bear weight for 4 steps on your foot/ankle after an injury or your foot/ankle is tender along bones it is best to get an x-ray. When in doubt, get it checked out.

Initial treatment of muscle and ligament injures includes rest, ice, protection with brace, sling or crutches as appropriate. Time will help these bumps and bruises heal, but when they are lingering on you may need help getting things moving again. Therapists can help identify what needs to be stretched and what needs to be strengthened after an injury.

Circulation issues

After injuries with severe swelling health care professionals need to monitor for changes in circulation. Large amounts of swelling can compress nerves and arteries causing numbness/tingling and lack of blood flow respectively. Hands and feet are most susceptible. If hands or feet change color, feel cold to the touch or start to lose sensation it is recommended to get them checked out. A prolonged lack of blood flow to an area can cause additional damage to the tissues in the area.


Shock is an acute medical condition often associated with a fall in blood pressure, irregular breathing, pale skin, nausea, rapid pulse, chest pain, lightheadedness, anxiety, confusion, and dilated pupils. I think most people think of shock after severe injuries, but it can occur with sudden emotional stress as well. The magnitude and attitude a person has about their injury may cause them to experience shock. If you notice someone dealing with signs of shock it is best to call for emergency medical services since shock can be very serious.

Before patients return to sports it is important they are pain free, there is no swelling, have normal symmetrical range of motion, full strength, and pass functional testing which can be performed by a therapist.

At the Green Room we hope you stay healthy! Knowing how to manage injures and getting in to start rehabilitation can make your recovery process occur faster. Which gets you back to living your best life!



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