What happens after the first two to three days?

Assuming things go their usual course, the period after the first several days can be divided into several phases:

1) Pain relief (anti-inflammatory)
2) Stretching (passive)
3) Strengthening (active)
4) Return to activity (restorative)
5) Preventive

These are now discussed in greater detail.
What happens in the pain relief (anti-inflammatory) stage?
In this stage, anti-inflammatory medications continue to be important. Modalities such as heat, electricity, and ultrasound are often of great benefit in reducing inflammation in injured tissues. Rest and relative immobilization and inactivity of the injured structures continue to be paramount. Occasional injections or introduction of medication through electricity or ultrasound (iontophoresis or phonophoresis) are other adjunctive measures that are often useful.

What happens in the stretching (passive) stage?

In this stage, the main emphasis is on regaining passive range of motion in the involved tissues. This can be achieved through stretching exercises, often performed by the individual alone, under direction from physician and/or physical therapist. In more complex cases, the physical therapist may initiate the stretching-program and use techniques such as massage, mobilization, and rhythmic stabilization (contract-relax) techniques to gradually gain flexibility. Heat, electricity, and ultrasound are adjuncts in helping the patient make progress but this becomes less emphasized as the patient progresses. Stretching should be static and prolonged (sustained), not ballistic (lunging or bouncing). Sharp pain during end-range of motion is to be avoided.

What happens in the strengthening (active) stage?

In this stage, the patient begins actively exercising to regain strength and endurance in the injured structure and in surrounding muscles and tendons. At this point, modalities such as heat, ice, ultrasound, massage, and medications, all become less important. Emphasis is on a well-constructed and supervised strengthening program although the patient continues to maintain flexibility through this stage. It is important that the strengthening and endurance program be scientifically approached to assure continued healing of the injured structure while guaranteeing maximal return to prior function. The timing is crucial: Flexibility should be nearly full and virtually pain-free before serious strengthening is begun.

What is involved in the "return to activity" (restorative) stage?

In this stage, the patient learns to apply the flexibility and strength that has been regained toward the return to pre-injury lifestyle--occupation, avocation, sports, and exercise. It is vital that this be approached gradually, with some caution, and with the guidance of an experienced physician and/or therapist. The timing of return to various activities, limitations of the duration and intensity of the activity, and simultaneous continuation of flexibility, strength, and endurance exercises, all have to be well-constructed, For example, the patient may return a walking program before returning-to a running program, while at the same time doing aggressive stretching and strengthening of leg muscles. Or, the patient may return to doubles tennis or volleying before returning to competitive singles, while continuing specific strengthening exercises for forearm or shoulder muscles. Or, a patient may include zig-zag patterns of running in their training program before returning to soccer or football. In summary the peculiarities and complexities of each pre-injury activity must be contemplated so that the patient is best prepared to return to that activity.