Whether you’re a competitive athlete or someone who overdid it at the weekend, sports injuries and exercise-related muscle pain are common experiences. Knowing the right approach in the first 24–72 hours makes a significant difference to how quickly and completely you recover.

Acute Soft Tissue Injuries: POLICE Not RICE

The old RICE protocol (Rest, Ice, Compression, Elevation) has been updated. Current best evidence supports POLICE: Protection (prevent further injury without total immobilisation), Optimal Loading (controlled early movement maintains blood flow and tissue repair), Ice (cooling for pain relief and to limit swelling), Compression (reduces oedema), Elevation (above heart level to assist fluid drainage). The shift is away from complete rest towards early, gentle movement within pain limits — complete immobilisation delays recovery.

Ice vs Heat

Ice is appropriate for the first 24–72 hours of an acute injury — it reduces pain and limits swelling by vasoconstriction. Never apply ice directly to skin (wrap in a damp cloth). 15–20 minutes on, minimum 20 minutes off to prevent ice burns. Heat is more appropriate for chronic muscle tension, stiffness, and delayed-onset muscle soreness (DOMS) — it improves circulation, relaxes muscle spasm, and reduces stiffness. Heat pads, warm baths and heat patches (ThermaCare) are effective for this purpose.

Topical Anti-Inflammatory Products

Diclofenac gel (Voltarol) — an NSAID gel that penetrates to the site of injury, reducing prostaglandin production locally. Multiple high-quality RCTs demonstrate efficacy for soft tissue injuries, joint pain, and arthritis — with far lower systemic absorption than oral NSAIDs, meaning fewer gastrointestinal risks. Apply 3–4 times daily to the affected area. One of the best-evidenced topical pain treatments available OTC. Ibuprofen gel (Ibugel, Nurofen Gel) — well-evidenced for soft tissue injuries and localised joint pain. Ketoprofen gel (Oruvail) — prescription only in UK but available OTC in some European countries; strong evidence. Menthol-based products (Deep Heat, Ralgex, Bengay) — counter-irritant effect via TRPM8 cold receptors creates a cooling/warming sensation that modulates pain perception. Less potent than NSAID gels but very safe and immediate effect.

Delayed-Onset Muscle Soreness (DOMS)

DOMS develops 24–72 hours after unaccustomed or eccentric exercise (downhill running, resistance training). It is caused by micro-tears in muscle fibres triggering an inflammatory repair response — and is a normal, necessary part of building stronger muscles. It is self-limiting within 3–5 days. Management: gentle movement (speeds recovery), warm bath or heat application, light massage, cherry juice (contains anthocyanins with anti-inflammatory properties — good RCT evidence for DOMS specifically). Avoid complete rest — passive recovery is significantly slower than active recovery.

Browse Pain Relief at Huncoat Pharmacy. Related: OTC Pain Guide, Heart Health.

At Huncoat Pharmacy: Browse sports injury & muscle pain products.