Treating Sprains and Strains Using R.I.C.E.

Exercise and recreation are essential and fun activities that we need and should find the time for every week. However, with these activities comes a certain level of risk which can be followed with injury. Twisting an ankle while hiking or participating in a sporting activity, even straining a muscle while running, swimming, or lifting weights. There are many injuries that are just unavoidable with an active lifestyle. Injuries can cause a major setback in training programs, take away time from work and other important commitments in your life. Sometimes injuries can have lasting physical symptoms and effects that can cause atrophy, weakness, and chronic pain. Following the “RICE” principle can help you to avoid some of these undesirable symptoms and gain back precious time and training.

RICE follows four simple principles to help with any acute injury. It stands for “rest”, “ice”, “compress”, and “elevate”. The following instructions are proven and used by sports medicine professionals in every level of competition. RICE can significantly help you to get back to activity and continue to enjoy your exercise and recreation. The earlier you start RICE the less recovery time you will need.

Resting can be a confusing and misunderstood principle in recovery. The type of rest and duration are dependent on the injury severity and location. The basic guidelines are to stop using the injured body part, and if the severity requires you may need to splint or demobilize it. For example, if you have sprained your ankle while playing Frisbee it doesn’t mean you have to rest or sleep until it gets better. Resting would include not using it, so walking with crutches or a scooter. It could also call for a boot to protect and stabilize the foot and ankle. Rest should be followed until the pain from the injury is no longer present when preforming normal functions like walking.

Ice is the most important principle in RICE to follow in a timely manner. Ice implies cold, and therefore could be a cold pack, slush bucket, or a frozen vegetable bag. Crushed ice has been found to be the best modality to use over the others and it can be applied directly to the skin. Ice is used to decrease pain by numbing, but more importantly reduce secondary injury which will significantly decrease recovery time. The parameters for icing is to put ice onto the injured body part and keep it there for 20-30 minutes, every 2 hours, for the first 24 to 48 hours. Using an ice pack needs a layer between the skin and ice pack to avoid burns, so it doesn’t have the same cooling effect as ice. This step is critical for any injury, remember to find some ice as soon as possible!

Compression is an intertwined principle with icing. Compressing the injured body part with an ace wrap should be done any time you are not icing. After your 20-30 minutes of ice wrap the injured area starting with wrapping tightly below the injury and gradually looser as you wrap up away from gravity. It is critical to always have it wrapped especially at night when you are sleeping. Compression should be used as long as possible until the swelling is gone. Swelling is a byproduct of almost every injury and can be one of the symptoms, paired with pain, most debilitating to returning to normal function. Swelling causes pain, loss of motion, and slower healing. Compression and not icing, will help to decrease the unavoidable swelling and edema due to injury.

Lastly, elevation is another principle that helps with swelling. Compression and rest should be combined with elevation to reduce swelling at the injury site. Keeping the body part wrapped and elevated allows gravity to work for you and pull the liquids away from the injury which will help you to return to normal pain free activity quicker. Don’t elevate so high that the elevation will slow the delivery of blood to the area. Blood carries important healing components and it will have to fight against gravity which could slow down healing. Putting a pillow or two under the extremity during the night is a good way to elevate.

Remembering these easy and simple principles of RICE can facilitate your injury recovery time, decrease your pain as well as decrease your chances of long term chronic pain and disabilities. It is important to remember each step and start them as quickly as possible.