RICE stands for Rest, Ice, Compression, Elevation.
RICE is an acronym referring to the treatment used to treat soft tissue injuries such as sprains, strains, muscle pulls or tears, and should be applied as soon as possible to help prevent complications and help injuries repair faster, and in particular when inflammation is present.
It is also sometimes referred to as PRICE – P standing for Protection.
Where and How?
The first 24-48 hours of an injury are considered the critical period, and activities which cause pain to the affected area should be minimised during this period.
Without rest, continual strain is placed on the affected area which can lead to increased inflammation, pain and can potentially cause further injury. Resting is important in promoting effective healing, and to avoid abnormal repair.
Using a splint, sling or crutches may help to ensure the injured area receives adequate rest.
It is important to know when to stop, as minor injuries sustained during sporting activities could be minimised by not continuing the exercise at the first sign of injury.
‘Running off‘ an injury is a misconception, and NOT to be advised! Whilst it may appear possible to continue exercising on an injury immediately after, this can be down to the release of adrenalin and the functioning of nerves. Nerve fibres that respond to mechanical signals such as touch can over-ride the impulses from pain nerve fibres – a theory known as pain gate theory – combine this with other factors such as an athlete’s mentality to override the pain – ultimately an athlete can actually make an injury much worse. In this case, it is better to swallow your pride and stop short, than carry on and cause greater damage that can put you out of sport for a longer period of time, or in a worst case scenario; completely.
Ice is a great natural anti-inflammatory treatment – it can limit and reduce the swelling caused by reducing the blood flow to the injured area, and also provides some pain relief to the injury. It decreases the amount of bleeding by vasoconstriction , and reduces the risk of cell death by decreasing the rate of metabolism.
Ice should ideally be applied during the first 48 hours after injury.
Ice the sprain or strain for 20 minutes at a time every 3 to 4 hours – making sure not to exceed 20 minutes as this can damage the skin and can cause frostbite. Whilst reducing blood flow helps to minimise swelling, icing for too long can also be detrimental to healing – if the blood flow is reduced too much it can stop the delivery of essential nutrients and removal of waste products from the injured area, and so increase the injury period.
Cheap freezer packs can be created using bags of frozen vegetables – peas and sweetcorn work well! – alternatively most chemists sell freezer packs for injuries – these are usually soft gel packs which can be used both to freeze and heat. Keep moving the ice pack around the area during the 20 minutes. Make sure to wrap the ice pack in a towel, to protect the skin.
A good indicator is to allow the skin enough time to fully rewarm before icing the area again.
Compression helps to limit and reduce swelling, and can also provide pain relief by reducing the edematous swelling from the bodies natural inflammatory process.
Although swelling is inevitable, too much swelling can can cause loss of function, increased pain and restricted blood flow.
An easy way to compress the area of the injury is to wrap an elastic bandage around the swollen part, but making sure not to wrap the area too tight – the fit should be tight, but still allow for expansion when muscles contract and fill with blood. Wrap the area, overlapping the elastic wrap by one-half of the width of the wrap.
Elevating injuries help control swelling by reducing the blood flow to the area, and is most effective when the injury is raised above the level of the heart. For example, for an injured ankle, try to lay down with your foot propped on one or two pillows, and is particularly important at night.
Elevation is important as it allows for increased venous return of blood to the systemic circulation – meaning the circulation of blood flow back to the heart, to allow for quicker removal of waste products from the affected area, also resulting in less edema – accumulation of fluids in the body’s tissues.
Applying RICE relieves pain, and can help shorten the period of recovery, to soft-tissue injuries.
It is considered a first-aid treatment, rather than a cure, with the aim being to manage discomfort and internal bleeding.
Following an injury to the body, the body usually reacts with pain and swelling. This is generally as a warning to the body, to let it rest, so as not to further the damage.
During this process the muscles spasm, helping to create a natural splint for the affected area, however this can cause complications with blood flow, and causes further pain – by applying RICE, the body is allowed to rest and recover.
Along with the above treatment, it may be necessary to medicate with painkillers and anti-inflammatories – paracetamol and ibuprofen should be enough in most cases. However remember to check the dosage before medicating.
After the initial 48 hours, most sprains and strains should begin to heal. If pain and or swelling has not started to subside, make sure to see your doctor.
Once healing has begun, light massage can be used to help reduce the formation of scar tissue, and improve the tissue healing, along with gentle stretching to work on the range of motion in the injured area. Heat may also be helpful to increase the blood supply back to the area once the swelling has gone down.
After the injury has healed, you should then move onto exercises to strengthen the area, so as to prevent a repeat injury. Booking an appointment with a physiotherapist may help with the progress of strengthening.
And finally …
Top tips …
I’d recommend as a good home first-aid kit to keep three gel-packs as a precautionary measure; keep two in the freezer, so that there is at least one freezing whilst one is being used, and a third to be used as a warm compress.