Remember the treatment is RICE: that's Rest, Ice, Compression and Elevation. And you can add to that some anti-inflammatories if there are no contraindications like tummy ulcers, allergies to such tablets or brittle asthma. Don't forget common sense. After an injury alcohol opens up blood vessels and makes you bleed more. Standing at the bar has a nasty gravity effect on lower limb injuries. Dancing at the nightclub warms up an acute injury and causes more bleeding. Ice without compression causes reflex warming when you remove the ice and can cause more bleeding and swelling at the site of the injury. Early treatment can prevent longterm problems.

Fractures

So what can you expect if you get a fracture or a break ? (did you know they mean the same ?)

Well make sure your doctor treats you and not the fracture, and definitely not the X-ray!These days Sports Injuries should be treated according to the individual patients needs with treatment being tailored to the individual athlete.Having said that if you break your wrist you can expect to be in a plaster cast for 6 weeks. If you break your ankle or lower leg you can expect to be in a cast for 12 weeks. If you are a child halve the time and if it is your granny double it.

Ankle Sprains

Ankle Sprains are probably the commonest injuries befalling rugby players. Warning signs include inability to weight bear after the injury, bony tenderness as distinct from soft tissue tenderness which will always be present. Immediate rest, ice compression and elevation are vital. Sometimes immobilisation for a few days in a cast and non weight bearing with crutches may be helpful for bad sprains where there is a lot of swelling. Early mobilisation is the key to recovery. Get walking on it as soon as you can. Take anti-inflammatories for 5 days. Physiotherapy will be a big help. On return to playing or training think about taping your ankles if someone can do it properly for you. Laced ankle supports may be helpful afterwards if there has been a severe sprain.

Knee Injuries

Knees that swell up immediately after injury are bad news and may reflect a fracture or a joint full of blood from a cruciate ligament injury. knees that swell up over night may be more in keeping with a cartilage tear which may of course settle down with rest. The most common injury ios a medial ligament injury which is on the inside of the knee and gives stability to that side. We rarely repair tears of this ligament these days but you can expect a rest of from 1 to 6 weeks.

Minor Head Injuries

This is a very difficult topic to deal with. Unfortunately beaurocrats seem to have overtaken the medical experts here. It now seems mandatory to miss 3 weeks if concussion is diagnosed. The problem is in diagnosing this injury. To often we see a player with a bit of a knock being labelled by self appointed guardians as concussed. Reviews from the medical literature suggest that these mandatory 3 weeks is probably over the top. Probably patients should have frequent neurological and cognitive assessments by an appropriately qualified doctor who can make an informed decision on when a player is fit to return to sport. In fairness this 3 week rule probably covers and protects most athletes in an environment which is short on appropriately qualified doctors. So better safe than sorry. So if your club does not have a suitably qualified doctor and 'someone' says you are concussed then 3 weeks will protect you. On the other hand if you feel fine and all this concussion buisness seems a bit dodgy then consult a senior doctor who knows what he is about BUT be prepared to accept his decision if he says you are not fit even though you think you are.

Wounds

Wounds that require stitches should ideally be stitched within 6 hours of the injury otherwise they are more prone to infection. Sensible players will check their cover against tetanus before the start of the season. If as a player you have not had a booster within the last 10 years then you should ask your GP for a booster injection. You may still need a booster if your wound is a particularly dirty one and you have not had an injection for 5 years. Stitches will be in place for 7 - 10 days. It is not a good idea getting them removed the day of a match. Wait until the next day instead. Get your wound cleansed properly and sutured by a professional and resist the amateur Jim'll fix it in an away club. While convenient at the time you may regret it later.

Blood in the Urine

It is not uncommon to get a kick in the back or flank (albeit accidently!) while playing rugby. While the temporary pain resulting from a kick may pass off and leave an ache players are somewhat disconcerted to find they pass blood when they go to the toilet after the game. No cause for alarm. Yes it does need to get checked out and you will need either an ultrasound or a special x-ray called an I.V.P. which means getting a dye injected into a vein. In most cases the bleeding settles down within a day and requires no treatment but you MUST consult a doctor if you pass blood.

Chest Pain

Okay, this one is aimed at the vice presidents and other alickadoos. Chest pain coming from the heart is usually central and feels like a tightness, a pressure or someone placing a brick on your chest. It often comes on with exercise and will be relieved by rest. The pain may radiate into the jaw, the back or the arms, most commonly the left arm. There are a number of risk factors which make you more likely to suffer 'angina' or get a heart attack. These include a history of cigarette smoking, high blood presure, a high cholesterol, a family history of cardiac disease and a stressful lifestyle. If you develop these symptoms you should take an aspirin and consult a doctor. If the pain lasts more than 20 minutes and is associated with sweating or shortness of breath or nausea then you should get to hospital as soon as possible. Do not put these symptoms down to 'indigestion'. Remember all our friends who have died from not seeking help early enough. . All welcome.

Fractured Jaw

Equally it is not uncommon to sustain a punch or blow to the jaw while playing rugby. Often the pain is more noticeable after a game. Classically it feels like you have been to a dentist and your teeth do not meet together properly. You may not be able to open your mouth properly and speaking will be difficult. (although this could clearly be an advantage to us if it was to happen soemone like Bernard mcNally for instance!) There will be tenderness particularly on one side of the jaw often near the ear although suprisingly the blow may have been to teh chin. You will need a specialised x-ray called an "orthopantomogram" or an O.P.G. Very few A&E departments can do this x-ray at weekends or at night time. If it happens during the week you may bypass a delay for yourself by going to St James's as this is where most of the maxillofacial surgery is done in Dublin and you are likely to be referred there for follow up. If it is broken you may require surgery or wiring of your teeth together. Either way if your jaw is broken you can forget about playing for 6 weeks.

A-C joint injury

The Acromio-clavicular joint is a at the end of your collar bone. It is a very common injury with rugby players and happens when you fall onto the point of your shoulder. Most of us put our hand out to break a fall but some are to selfish to pass teh ball and hold onto it as they get tackled landing on the point of their shoulder. The force involved is enough to 'pop' th ejoint or at least strain it. There will be very marked tendernes at the end of the collar bone and trying to touch the opposite shoulder with your hand will be almost impossible because of pain. There may also be some swelling after a few hours which goes down after a few days and can leave a permananent step on top of the shoulder. You should have an x-ray just in case you have broken the tip of the collar bone instead. Bad luck if you have. It happened me and takes longer to settle down. Treatment is a sling for a few weeks. We used to operate but have given that up nowadays.

Info. Kindly provided by Kevin Mc Carthy