Proper management during the first 24-48 hours is imperative to expedite return after the injury as quickly and as safely as possible. Refer to the PEACE & LOVE Approach for acute care of the injury. If there is any noticeable deformity, seek out either Urgent Care or an Emergency Department, depending on severity (see Where Should You Go? page for more information). 

After any injury, follow up with your athletic trainer as soon as you can. 

Immediate Care: 

A couple of key takeaways from "PEACE & LOVE": 

• Ice and cold treatments are not necessary and can disrupt inflammation, angiogenesis, and revascularisation, delay neutrophil and macrophage infiltration as well as increase immature myofibers, potentially leading to impaired tissue repair and redundant collagen synthesis and prolonging return to sport

• Only take Tylenol/Acetaminophen for the first 24-48 hours as needed to manage pain

• Swelling is good so avoid NSAIDs (Nonsteroidal anti-inflammatory drug) like Advil/Motrin/Ibuprofen, Aleve/Naproxen Sodium, etc. until at least 48-hours post-injury

• Limit walking for the first 24-48 hours post-injury

Subsequent Care: 

After waiting 24-48 hours after injury, complete these stretches & exercises on your own for the recommended sets, reps, & frequency, provided you are pain-free or pushing yourself to the point of pain. If necessary, see the athletic trainer for more exercises or if exercises need to be modified. The descriptions of each phase are meant to be a guide and if the athlete is having difficulty or ease with completing the listed exercises, they can choose a different stage more appropriate. If swelling/bruising are still present, please incorporate the "Immediate Care" exercises into your exercises at each stage. 

Stage 0 Exercise Circuit - 2×/Day (Typically in the morning and at night) - Complete with every stage

• Towel Scrunches 2×5: https://youtu.be/XEJYq1HBtHY

• Toe Raises 2×15: https://youtu.be/gRHg6v6-szc

• Eccentric Calf Raises 2×30 repetitions each leg, complete on a stair while holding on to a railing: https://youtu.be/gEgx0qJp3HM

Stage 1 Exercise Circuit - 2×/Day - If experiencing pain while fully weight-bearing completing activities of daily life and not participating in practices or competitions

• Seated Calf Raise 2×15: https://youtu.be/3ZRe_QpvRPg (No weight)

• Seated Rotate-In Calf Raise 2×15 (Same as first, rotate foot in 45 degrees)

• Seated Rotate-Out Calf Raise 2×15 (Same as first, rotate foot out 45 degrees)

Stage 2 Exercise Circuit - 2×/Day - If pain-free while fully weight-bearing completing activities of daily life and participating in a modified capacity (pain-limiting activity)

• Standing Calf Raise 2×15

Stage 3 Exercise Circuit - 2×/Day - If pain-free while fully weight-bearing completing activities of daily life and participating in practices or competitions

• Single Leg Standing Calf Raise 2×15 each side: https://youtu.be/QEILIo9Kzlw

• Single Leg Rotate-In Standing Calf Raise 2×15 each side: (Same as first, rotate foot in 45 degrees)

• Single Leg Rotate-Out Standing Calf Raise 2×15 each side: (Same as first, rotate foot out 45 degrees)

• Single Leg Bent Knee Standing Calf Raise 2×15 each side: https://youtu.be/_VEku5gTQeU

• Single Leg Balance 2×15 sec (or as long as possible) each side: https://youtu.be/ZLxyh_PEstI