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Sports injury treatment: what to do in the first 72 hours
14 September 2026 · 11 min read
What you do in the three days after a rolled ankle or pulled hamstring shapes the weeks that follow. Here's what helps, what doesn't, and when it needs checking.
Why the first three days matter
Spring in Goulburn means footy and netball finals, cricket pre-season and the first warm runs along the Wollondilly. It also means rolled ankles, pulled hamstrings and corked thighs — mostly on a Saturday, thought about properly on Sunday night.
Good sports injury treatment starts before you see anyone. The first 72 hours don't decide the outcome, but they set up the weeks that follow. The aim is simple: protect it, keep swelling in check, and work out whether it needs looking at.
A sprain is a stretch or tear of a ligament. A strain is the same thing in a muscle or tendon. Either way there's some bleeding into the tissue around it. That becomes the swelling and bruising you see over the next day or two. Healing starts on its own; your job is to give it decent conditions.
The first 72 hours: protect it, elevate it, compress it
First, check the warning signs in the X-ray and doctor section below. If any apply, get it looked at before anything else.
For the first one to three days, the tissue wants protecting, not fixing. Ease off the movements that hurt and stop what caused it — but don't strap yourself to the couch. Short, gentle movement within comfort usually helps.
Compression and elevation are the two things most people skip. A firm bandage or sleeve, and the limb above heart level, both work on swelling. Neither is proven beyond doubt, but both are low-risk and likely help. Loosen the bandage if the toes or fingers throb, tingle or change colour, and take it off overnight. Ice eases pain early but doesn't speed healing, so it's the least important of the three. If you use it, wrap it in a damp cloth, never straight on the skin, and keep to short spells.
On anti-inflammatories: the reflex is to reach for them straight away. There's a reasonable case that routine use in the first few days may not help healing. They aren't an automatic step — talk to your GP or pharmacist, and don't stop anything you've been prescribed without asking.
- Protect — ease off what hurts for one to three days, but keep gentle, comfortable movement going
- Elevate — above heart level as often as you can, especially the first two days
- Avoid reaching for anti-inflammatories by default — ask your GP or pharmacist what suits you
- Compress — a firm bandage or sleeve, snug but not numbing
- Educate yourself — most sprains and strains heal well without scans
What not to do in the first few days
The old advice was rest and ice for as long as it took. That's been revised. These habits can add to the bleeding and swelling early, or just add days.
- Bare ice on the skin, which can burn — always wrap it in a damp cloth
- Icing around the clock — it adds little beyond short-term pain relief
- Complete rest — a week on the couch leaves the joint stiff, weak and no closer to sport
- Running it off, or playing the second half — loading a fresh tear can turn small injuries into bigger ones
- Heat in the first two to three days — hot packs, baths and heat rubs can push more blood into tissue that's already bleeding
- Alcohol in the first day or two — it can increase swelling and blunt your judgement about how much to do
- Deep massage on the injury itself early on — save it for later, once the bleeding has settled
When a sports injury needs an X-ray or a doctor
Most sprains and strains don't need an X-ray or a hospital. Some do. A limb that's clearly out of shape goes straight to an emergency department (ED). Otherwise, check the list below. Each item says whether it's a GP, ED or 000.
Call 000 if bone is visible or there's a deep wound over a suspected break. Call 000 too if bleeding won't stop with firm pressure, or the person can't be moved safely. The same goes if the foot or hand below the injury turns pale, cold, numb or discoloured.
Head knocks need their own rules. Headache, nausea, dizziness, confusion or memory gaps after a knock can be signs of concussion. Any suspected concussion means no more play that day. If in doubt, sit them out. See a GP as soon as possible — ideally that day or the next, not just before going back. Don't drive until symptoms have cleared and a doctor has said it's OK. Someone should stay with them for the first 24 hours.
Call 000 after a head knock if they were knocked out, even briefly, or have a seizure. Call too for a severe or worsening headache, vomiting, drowsiness, double vision, or growing confusion or agitation. Numbness, tingling or weakness in the arms or legs is also a 000 call. So is a visible dent or deformity in the skull. If there's neck pain or tenderness, call 000 and don't move them.
- Not being able to take four steps on it, straight after or when you try later — see a GP or go to ED for a possible ankle, foot or knee X-ray
- Tenderness on the bone itself, not just the soft tissue, at the back edge or tip of either ankle bone or along the inner or outer midfoot — see a GP or go to ED for a possible X-ray
- A knee injury where the kneecap or the bony point just below the knee on the outer side is tender, it won't bend to a right angle, or you're 55 or older — see a GP or go to ED for a possible X-ray
- Pain or tenderness in the wrist or at the base of the thumb after a fall onto an outstretched hand — see a GP the same or next day to rule out a scaphoid fracture, which is easy to mistake for a sprain
- Pins and needles or numbness that don't settle once you're off it — see a GP the same day
- A pop, then a knee that swells up within a few hours — get it assessed within a few days by a GP, ED or our Goulburn physios for a possible ligament tear
- A pop or kicked feeling at the back of the heel, then weak push-off or no tiptoe on that side — see a GP or go to ED the same day for a possible Achilles rupture, even if you can walk and swelling is mild
- A sudden pop or sharp pain high at the back of the thigh near the buttock, often from slipping into the splits or a forced stretch with the knee straight, then heavy bruising or trouble walking or sitting — see a GP or our Goulburn physios within a few days, not weeks, for a possible hamstring tendon avulsion
- A shin, calf, thigh or forearm that keeps getting tighter and more painful over hours, out of proportion to the knock — go to ED
- Worsening pain, dizziness or blood in your urine after a hard knock to the ribs, belly, side or lower back — go to ED, or call 000 if they're breathless, pale, drowsy or fainting
- Unexplained calf pain, swelling, warmth or redness, especially after time in a boot, on crutches or not moving much — see a GP the same day, or call 000 for sudden chest pain or shortness of breath
- Neck pain or tenderness after a tackle, fall or collision, or back pain with tingling, numbness or weakness in the arms or legs — call 000 and don't move them
Sprain treatment after day three
If nothing on the warning list applies, the job flips once the swelling stops climbing — usually after the first few days. Sprain treatment after day three is about load, because tissue remodels and gets stronger in response to it. Gentle, progressive movement helps the tissue lay down new fibres in the right direction. Walking with as little limp as you can, or easy ankle or knee bending, is enough to start.
Let pain guide the dose. Mild discomfort during and shortly after is acceptable; pain that spikes, or is worse the next morning, means back off a step. Expectation matters too. People who expect to recover, and move early, tend to do better than those who guard the injury for weeks.
Keep the rest of you going. Blood flow helps healing, and within a few days most people can manage a bike, a swim or an upper-body session. Then it's exercise proper: range, strength, balance and control, built up in steps. Physios sometimes call this staged approach PEACE and LOVE — protect and settle it early, then gradually load it back up.
Seeing a physio in the first week
Ideally you're assessed within the first week. If something on the warning list applies, do what that item says first — GP, ED or 000. Our Goulburn physios pick it up from there.
If it happened on Saturday and you're in on Monday, that's fine. Two days of protection, elevation and compression is the right start. A mild sprain and a bad one can look much the same on day two. Grading it properly gives a rough idea of how long you're out. After that, the markers — not the calendar — decide when you step up.
If you're paying privately or claiming through your health fund, you don't need a referral to book at our Goulburn clinic. If it happened at work, tell your employer as soon as you can. Then tell us it's WorkCover when you book, and bring your claim number if you have it. Your GP fills in the Certificate of Capacity, which sets out the treatment you're approved for. Most sessions need insurer approval before they start. If it was a NSW car accident, just tell us it's CTP when you book. We'll check the current rules with your insurer. Early treatment can start before the claim is approved.
Our sports injuries page covers how assessment and treatment run. For the first visit itself, wear shorts or loose clothing, and bring the details that fade by the following week.
- Footwear — the boots or runners you were wearing when it happened
- What happened — the movement, any pop or snap, how fast it swelled, whether you played on
- What you've done since — ice, strapping, any medication, and how walking and sleeping have been
- Paperwork — any X-ray or scan reports, and letters from a GP or ED
Sports injury rehabilitation and return to sport
Pain settles first and is the least reliable marker of readiness. Strength, balance and changing direction when you're tired come back later — and they're what protect you in a game. Re-injury risk tends to be highest soon after returning. A sprained ankle also stays more likely to go again for months afterwards — one reason recurrences are so common.
Sports injury rehabilitation runs in stages, not by the calendar. Walk without a limp. Jog in straight lines. Add speed, then cutting and hopping. Then sport-specific drills, full training, and only then a match. Each stage has a marker — a hop test, single-leg balance, strength close to the other side — before the next.
For a footy or netball player mid-finals, that's a hard conversation. Have it with our Goulburn physios after a proper grade, not on a hunch. Sometimes the answer is a brace and a limited role. Sometimes it's sitting out a game or two to be right for the rest of the finals.
