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You and your team can be game changers when it comes to managing sports injuries. Victoria Goldman highlights the key prevention strategies, treatment options and recovery tips to help customers stay fighting fit 

When people head into a new year, improving their fitness levels tends to be high on the agenda. According to a YouGov survey in December 2024, 17 per cent of Britons want to get fitter or exercise more in 2025. 

But not everyone who sets a New Year’s resolution will stick with it. Research by YouGov in December 2023 a year earlier found that the exact same percentage of Britons abandon their resolutions within a month or less, including those relating to fitness! 

People often give up regular exercise because of an injury. However, a five-year study led by researchers at the University of Bath, published in October 2023, found that the risks of serious injury from most sports and exercise are astonishingly small, and the benefits of taking part in fitness activities far outweigh the dangers.

Fitness activities, such as running, golf, dance classes and gym sessions, were least likely to result in an injury – football had a much higher injury rate, yet it was still relatively small (6.56 injuries per 100,000 participants each year). 

Research data usually focuses on sports injuries treated in A&E departments and does not take into account any injuries that are self-treated or managed within primary care settings. Many people with more minor sports injuries may visit a pharmacy for advice and to buy suitable products.

“With increased education of the public to visit community pharmacies for healthcare advice, pharmacy staff will inevitably deal with a range of common sports injuries,” says Helen Underwood, a former NHS physio, first aid expert and founder of First Aid company Underwood Training. 

“Often gained when playing sport, these injuries could also happen on the high street outside the pharmacy – consider someone slipping on the ice and snow in recent weeks. The first aid treatment and advice is the same despite the mechanism of injury.”

Managing common injuries

To assess a sports injury, Helen Underwood says pharmacy teams should ask how it occurred, to ascertain whether any fall or impact was involved. “Ask about their level of pain and whether they are experiencing any loss of function,” she says.

“If the customer has a lot of pain and/or swelling and a limited range of movement, it might be that there is a more serious underlying injury such as a fracture – in which case the best course of action would be to recommend that the casualty visits a minor injuries centre.” 

Many people experience aching muscles and joints after exercising and this can often be easily prevented. “Starting any new exercise puts new demands and stressors on muscles and joints, which increases the risk of delayed onset muscle soreness (DOMS), as well as injury,” says pharmacist Mark Burdon.

“Pharmacy teams should be encouraging people to recognise their own body’s limits and not push themselves too far, especially at first. Good warm-up and cool-down routines will minimise the risk of injury and pain.”

Sprains and strains (injuries to a muscle, tendon or ligament) are particularly common, especially in people who do not exercise regularly, due to reduced muscle strength and limited flexibility.

Poor exercise technique can put more pressure on the joints or muscles, while inappropriate footwear can increase the risk of ankle sprains and strains. 

Plantar fasciitis tends to occur in people aged 40 to 60 and also in up to 10 per cent of regular runners. It causes intense heel pain during the first steps of walking or after a period of inactivity.

A minor injury will usually heal after a few weeks, or even within a week, with self-help measures and following the PRICE procedure (see page 24).

More severe injuries will take longer to heal with an increased risk of re-injury in the first four to six weeks. While most sports injuries are not serious, some may be misdiagnosed or can cause complications if they are not treated properly. 

“Most muscle sprains and strains and fairly minor and will recover with the right self-care management and treatment,” says Burdon. “If the customer’s pain is so severe that they can’t move that part of their body or they can’t bear weight, customers have severe swelling, discolouration, red, hot joints or bleeding, or if the pain doesn’t respond to self-care treatments, pharmacy staff should direct them to their GP urgently.”

Training opportunities

Underwood says that pharmacy teams need to be able to talk a customer about basic first aid techniques and advise on resting and reducing their activity. Underwood Training provides in-person and online first aid training, including an additional sports injury module to sit along its Emergency First Aid at Work course. 

“If a pharmacy is able to direct customers to appropriate physiotherapists/sports therapists who are local to them, this may be appreciated,” says Underwood.

“For pharmacists wishing to upskill their staff in basic first aid advice, linking with their local first aid training provider to collaborate for CPD on this and other topics could be invaluable.” 

Emma Hammett, CEO of First Aid for Life, says that many community pharmacists haven’t had any first aid training for years and would benefit from a refresher course.

“The perception from the general public is that community pharmacists, especially high street pharmacists, will be able to help in medical emergencies, including sports injuries,” she says. 

“But while pharmacists may sell suitable equipment, such as ice pack wraps, analgesics and supports, they are often not qualified to give specialist advice. We train pre-reg pharmacists through the universities but there is no obligation for them to provide first aid in a pharmacy.”

First Aid for Life runs an in-person Emergency First Aid at Work (EFAW) – for Sports course, which includes breaks and soft tissue injuries.

“Since pharmacists are generally very busy, they may find an online course (e.g. at our onlinefirstaid.com) more useful,” says Emma Hammett. “We have an online course specifically for-pharmacists. First Aid for Life (firstaidforlife.org.uk) also runs a full range of regulated and non-regulated first aid and mental health first aid courses.”

Lindsey Fairbrother, community pharmacy owner and East and North Midlands regional representative for Community Pharmacy England, says pharmacies could contact local or national sporting groups to find out what they recommend. 

“Use personal knowledge and interests as well as pharmacy expertise,” she says. “Find out what each member of the pharmacy team is interested in, such as running or cycling. They could read up on the topic so they are better informed to help customers deal with injuries relating to that particular sport or type of exercise.”

Following PRICE

Pharmacy teams should be recommending initial PRICE self-management approach for an acute sports injury, as long as there are no red flag symptoms. 

Protection – protect from further injury (e.g. using a suitable support)

Rest – avoid activity for the first 48 to 72 hours
 “Higher impact activity and sports should be avoided for a minimum of two to three days and definitely while there is still warmth and swelling at the injury site,” says Underwood. “‘Working through the pain’ will inevitably increase the severity of the injury.”

Ice – use an ice pack or spray or apply ice wrapped in a damp towel for 15 to 20 minutes every two to three hours during the day for the first 48 to 72 hours

“If applied too often and for too long, the deeper tissues can be cumulatively overcooled, and this can lead to frostbite,” says Underwood. “It is important that tissues regain their normal temperature before being re-cooled.”

Heat shouldn’t be applied for the first 48 to 72 hours. “Heat will cause vasodilatation and will increase swelling,” she points out. “After the inflammation has occurred and when the injury is no longer warm (advise a person to compare skin temperature with the opposite limb), heat can be useful in the rehabilitation phase for the stretching of muscle as the fibres are healing.”

Compression – use an elastic bandage or elasticated tubular bandage to support the injury and control swelling (but not when sleeping)

If there is any increase in pain or swelling, or if the swelling persists, the customer should consult a physiotherapist, GP or minor injuries unit. “If supplying a customer with a support bandage, assist them with purchasing the correct size,” says Underwood. “Advise them to wean its use after the initial 24 to 48 hours, and to seek further medical review if there is any increase in pain or swelling or if the swelling persists.” 

Elevation – keep the injured area elevated and supported on a pillow until the swelling is controlled.

Underwood also recommends a final R – ‘Refer for Rehabilitation’. “It’s imperative that customers are encouraged to return to their sporting activities steadily after injury,” she says.

“The assistance of a physiotherapist or similarly qualified healthcare professional can play dividends in preventing the reoccurrence of injury.”

Pharmacy products

Hammett stresses that being better first aid trained can help pharmacy teams sell suitable products with more confidence and know when to advise customers to go to A&E. “Being knowledgeable will help to make sure that no damage has been caused,” she says.

“It also means that pharmacies will know which are the best products to stock. Pharmacy teams can encourage customers to come back within a time frame, to make sure they are feeling better, which may then lead to further sales of other products.”

The first step in pain management following a minor sports injury should be paracetamol or a topical nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen gel.

Oral NSAIDs such as ibuprofen can be used if needed. Compression bandages can also be useful in providing support for injuries such as sprains, so stocking a range of sizes will be helpful.

“Pharmacy staff should recommend over-the-counter pain relief medications such as paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen,” says Kenny Chan, Numark lead information services pharmacist.

“Always check about any existing medication or conditions the patient may have to reduce the chance of an interaction. Additionally, staff can suggest topical pain relief creams or gels that contain menthol or capsaicin. They should also be familiar with natural remedies and supplements that may be effective.” 

Since topical products are a first-line option, pharmacies should ensure they stock a variety of formats. “Our research shows that 98 per cent of people say they want something that is powerful, and they also want it to be fast-acting, long-lasting and easy to apply,” says Elaine Walker, senior brand manager for Deep Heat and Deep Freeze.

“People are often looking for trusted, convenient soothing relief. Everyone’s daily life and activities are different, and product formats need to match the different needs, so having a choice of formats like our Deep Heat and Deep Freeze ranges is important – sprays, gels, rubs, belts and patches.”

Fairbrother says that it’s also essential to recommend a quality support. “This is particularly important if people want to start exercising again straightaway,” she says.

“At least they will be using a support to provide some form of protection. However, different supports are suitable for different parts of the body and different types of injury, so it’s important to stock a range of products.”