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By Karen Casanovas
For Senior Voice 

Managing pain and fatigue from injuries


August 1, 2022 | View PDF

Q: I was recently treated in the emergency room for falling when stepping out of a boat. One week later, my ankle is still painful to touch and I am tired.

A: Thankfully you were treated by medical professionals in the ER soon after your fall. Rest, ice, compression and elevation should be applied up to 48 hours after an injury such as yours.

An acute injury is defined as a sudden, sharp, traumatic injury that causes pain. Impact or trauma from a fall, strain, sprain or collision can cause an acute injury. Signs and symptoms of an acute injury are pain, tenderness, redness, skin that is warm to the touch, swelling and inflammation.

The acronym for treating acute injuries is R.I.C.E. (like the care you received in the ER) and stands for:

Rest, vital to protect the injured muscle, tendon, ligament or other tissue from further injury. 

Ice, to reduce pain and help control initial swelling. Apply ice or cold pack for 15 to 20 minutes per hour, but in order to prevent skin damage do not exceed that time limit.

Compression, can help limit swelling, which is known to delay the healing process. Besides limiting swelling, compression also slows hemorrhage.

Elevation, limits fluid retention and slows hemorrhage. Elevation is most effective when the injured area is raised above the heart level.

With your emergency medicine treatment a certain benefit was expected, and if you were functionally stable prior to your incident, no doubt the constant discomfort is annoying. If you had multiple dependent functions prior to falling, future mobility becomes more challenging.

In clinical practice and common use, recovery means “a getting back or regaining, recuperation”. The definition of “recovered” can be interpreted differently by different people. Expectations for function after a serious fall injury must be based in part on a clear understanding of pre-injury function. If a person experiences a traumatic fall or injury and was already severely disabled prior to the incident, there is lesser chance of recovery. But if recovery means a general “return to pre-injury status,” then the probability of getting back to that same level of function is the same for a disabled person as for most other older persons.

The science behind rest and recovery

Feeling tired after an injury is normal, thus in the healing phase you may be sleeping more. Inflammation following an injury can be painful and uncomfortable, causing fatigue. Lingering tiredness can be constant in the weeks after a fall, and limit your activities. Your nervous system is overwhelmed by trauma and you may experience persistent and relapsing exhaustion. Pay attention to the physical sensations in your body, such as tight muscles or headaches, in addition to your tiredness. You may be feeling a bit out-of-sorts or defeated right now during your limited mobility period.  Know that physical and emotional pain are normal parts of the recovery process. Continue to get plenty of rest and keep hydrated. Water flushes toxins out of the body, transports nutrients into the cells and helps regulate body temperature and your pH balance —which reduces inflammation. Water also curtails muscle soreness and body tension.

Even being slightly dehydrated—as little as 2% of normal fluid loss—takes a toll on your energy levels. Dehydration causes a reduction in blood volume, which makes the blood thicker. This requires your heart to pump less efficiently, reducing the speed at which oxygen and nutrients reach your muscles and organs, which in turn causes lack of energy.

Sleep and hydration play a crucial role in regenerating your cells. The hormone prolactin, which helps regulate inflammation, is also released while sleeping. If you are not getting enough rest, you are more likely to experience inflammation in the body, which can make injury repair and rejuvenation more difficult.

Take care and I wish you a smooth road to recovery.

Karen Casanovas is a professional healthy aging coach in Alaska helping individuals or families collaborate, find resources and design a plan for thriving and living well whether age 35, 50 or 90. Contact her through her website,


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