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Wednesday, 8 June 2011

Advice on treating acute injuries – the R.I.C.E protocol

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Injuries, like a sprained muscle, strained tendon, torn or damaged ligaments need immediate first aid treatment to help increase speed of recovery and reduce the risk of potential complications.
R.I.C.E. is an acronym for Rest, Ice, Compression and Elevation.
Injuries are frequently accompanied by pain, bruising, swelling, bleeding and inflammation. These are all natural responses of the body as a result of injury and are part of the healing process. By applying the four elements of the RICE protocol you can help to reduce pain or swelling and help to speed up recovery by aiding the healing process.
REST: stop the activity which caused the injury, and anything else that may further increase pain or exacerbate the injury. You may need to see a doctor or other medical professional – it is important to follow their guidelines as to when you may be able to resume activities.
ICE: applying ice to the injury site and immediate surrounding area has the benefit of reducing bleeding, swelling and pain. It is important to apply ice as soon as possible after the injury has happened.
How is Ice applied?
As a guide use cold packs indirectly (wrapped in a clean dry cloth to prevent skin burning) for 20 minutes every 2 hours, for the first 1 to 3 days. Crushed ice in a plastic bag (or a bag of frozen vegetables) works best as you can mould the bag around the injury site. 
Do not apply ice directly to the skin as it can cause ‘ice burns’. If your skin is sensitive to ice or you have circulation problems you may need to adjust the duration/frequency of ice application. Please use your own judgement as you know your body best. It is better to apply ice for a shorter duration and more often if you find the cold excessively painful. Remember though, it is ice, so it will be cold!
You may have heard that heat should be applied to an injury but this is not the case in acute injuries, which is usually during the first 1-3 days following injury. Heat can increase the level of bleeding and therefore cause an increase in swelling and pain. Heat is best applied once the injury is sub-acute (3-21 days after injury, depending on the severity).
COMPRESSION: is used to prevent and reduce any additional swelling by wearing an elastic compression bandage around the swollen area. The aim is to reduce swelling as much as possible as it can slow down the healing process. Some people may also experience pain relief from applying compression. If a throbbing sensation or feeling of tightness is experienced it means the compression is too tight and should be loosened off immediately.
ELEVATION: the final step in helping to reduce swelling and speed up your recovery. The injured area needs to be higher than your heart – this is because you want the excess fluids to drain towards your heart, and clearly gravity will help this immensely. For example, if your ankle is sprained you need to put your leg up higher than your heart; a good way is to lay on the floor with your leg on the sofa or bed – and ensure that the foot propped up on pillows higher than your knee.

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