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RICE treatment: why it works so well for minor injuries

July 21st, 2016 | 3 min. read

By Rob S Williams, MD

RICE-treatment-for-leg-rest-ice-compression-elevation

RICE treatment, or RICE therapy, is the immediate application of Rest, Ice, Compression, and Elevation to a minor soft tissue injury like a sprain. RICE is a popular first aid treatment designed to help manage swelling, pain, and blood flow.

It has the advantage of being simple enough that anyone can use it — on the athletic field, at the site of an accident, or at home.

RICE treatment: how to do it

RICE treatment is a first-aid treatment for soft tissue injuries like sprains, strains, and bruises — for example, sprained ankles, sprained knees, or muscle strains. It's best used immediately after sustaining an injury and should be stopped within two days (48 hours).

RICE has its origins in sports medicine and is commonly used by high school athletes, weekend warriors who get hurt over-exercising, or anyone who sprains or "rolls" an ankle (one of the most common non-sports injuries).

RICE treatment involves four steps:

icing injured knee

  1. Rest. First, protect the injury from additional strain. Stop activity right away and take pressure off the injured limb (for example, take your weight off your ankle or stop using your arm). If possible, rest the injury for 24 hours to 48 hours, or until you can see a doctor and/or use the limb or body part without feeling pain. 

  2. Ice. To minimize swelling and pain, apply a cold pack or bag of ice to the injured area. Do not apply cold directly to skin; wrap in a towel or cloth or apply over clothing. Ice injuries for 20 minutes three times per day, or alternate between ice and no ice for 15 minutes at a time until the swelling goes down. As with rest, ice the injury for up to 24 to 48 hours.

  3. Compression. To further reduce swelling, compress the injury by wrapping it firmly, but not too tightly, with an elastic, Ace-style bandage (wrapping too snugly may cut off blood flow and actually increase swelling). An elastic bandage is important because it can expand, allowing blood to flow through the injury area. You'll know the bandage is too tight and vessels are restricted if you experience an increase in pain, numbness, tingling, cooling skin, or swelling in the area below the bandage (farther from the heart). Compression can usually be removed after 48 to 72 hours.

  4. Elevation. Lastly, using pillows, elevate the injury at heart level or above. Doing so aids circulation by allowing your blood to cycle through the injury area and back towards the heart. Elevation prevents additional swelling and pain.

RICE TREATMENT: why it works

RICE-treatment-ankle

RICE reduces blood flow to the injured area, which keeps post-injury swelling and pain from becoming excessive.  

Why is controlling swelling and pain so important?

  1. Excess swelling can lead to loss of function. RICE treatment keeps the injured body part flexible so you can use it again sooner. 

  2. Excess swelling can cause a great deal of pain. RICE relieves pain. The ice in particular helps with soreness and inflammation.

  3. Excess swelling can slow blood flow through the vessels. All injuries need adequate blood flow to heal. However, in the case of bruises or sprains, too much swelling can slow blood flow and keep blood and nutrients from getting to where they're needed. This vessel constriction can lead to additional tissue damage or other complications (especially in the extremities, like feet and fingers). RICE (especially the ice) reduces swelling and promotes circulation of the blood to the injury site.

Recent studies have shown that patients with sprains may heal faster if they begin gently exercising their injured limbs as soon as possible. In fact, some experts believe the "R" in RICE may be unnecessary after the first few minutes, and recommend using the injured limb the same day, with the help of a brace or splint.

However, too much swelling and pain can make weight-bearing and movement difficult. It's hard to walk on a sprained ankle, for example, when you're in excruciating pain or when swelling has made the joint too tender and stiff too bend.

RICE is a key part of getting patients past the initial pain-and-swelling hurdle so they can start exercising and begin healing. 

Remember, RICE is first aid — not an ongoing treatment.

Note, RICE shouldn't be used indefinitely. Stop after the first two days, unless otherwise directed by a doctor. If you keep using RICE you may delay the natural inflammation and healing process.

However, if used immediately after a sprain or strain and for up to 48 hours after injury, RICE therapy tends to get people back "on their feet" faster.

If you have a sprain or strain, call Coastal Orthopedics. Located in Corpus Christi, our orthopedic specialists can examine you, assess your condition, and discuss which treatment is the right choice for you. We also offer knee conditioning, shoulder conditioning, and other programs that can help get you back into shape after injury. Telephone: 361.994.1166.

 

Article written by: Rob Williams, MD

 

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Rob S Williams, MD

Dr. Williams has been practicing orthopedic surgery in Corpus Christi since 1998. After graduating from Texas Tech hereceived his medical degree from the University of Texas at San Antonio. At the prestigious Campbell Clinic located at the University of Tennessee, Dr. Williams completed not only an Orthopedic Surgery Residency, but an additional year of Fellowship Training in Spine Surgery. Dr. Williams is dedicated to creating an excellent patient experience in the office or in the surgery suite.