Education

Clarifying the R.I.C.E. Method for Minor Injuries

When should you implement the R.I.C.E. method after a soft-tissue injury? RICE stands for rest, ice, compression, and elevation.

Most mild injuries, such as knee or ankle sprains or strained muscles, heal with RICE. Moderate sprains may also require a period of bracing or wearing splints. RICE is a simple way of reducing swelling, easing pain, and speeding up recovery.

If you have pain or swelling that gets worse, or doesn’t heal after using the RICE method, see a doctor. For those who exercise regularly, such as runners or cyclists, or those who take part in sports activities, stretching beforehand is a good way of preventing soft-tissue injuries.

“Especially as we get older, you have to take the some time to stretch,” says Derek Papp, M.D., sports medicine physician with Miami Orthopedics & Sports Medicine Institute. “You don’t have to necessarily do it before you go out. But do a light warm-up exercise — a light jog or short walk before you start running. Then do your stretching, and that helps avoid injuries.”

Here’s a rundown of R.I.C.E., with helpful tips for each of the four steps.

1: Rest: As soon as you’re hurt, stop doing the activity that brought on the pain and rest as much as possible, at least 48 hours. But don’t rest for too long. While resuming activities too soon can aggravate strains or sprains, too much rest can present issues such as stiffness or lack of proper circulation. Says Dr. Papp: “I tell my patients that have back pain to rest and take some days off, but you don’t want them to stay in bed for a week because that’s not helpful and you can get stiff.”

2. Ice: For reducing pain and swelling, ice always helps especially within 24 hours after the injury. Apply an ice pack (covered with a light, absorbent towel to help prevent burns to the skin) for at least 10 minutes. Repeat this as often as possible for the first 24 to 48 hours after your injury. “Ice can help with initial inflammation from the injury,” says Philip Depaola, physician’s assistant with Miami Orthopedics & Sports Medicine Institute. “Afterward, in a recovery setting, ice can help in calming down inflammation from any type of rehab procedure or physical therapy. But mainly it can help with that initial blood flow to the area that can cause swelling and pain.”

3. Compression: This refers to wrapping the injured area to prevent swelling. You can use an elastic medical bandage. Make the wrapping snug but not too tight. Over-tightening can interrupt blood flow. “Bandages or compression ‘sleeves’ are available at most drug stores,” says Mr. Depaola. “Swelling is going to be the main source of discomfort after any kind of injury.”

4. Elevation: Raising the sore body part above the level of your heart can reduce pain and throbbing. For example, you can put a sprained ankle on a pillow at a level above your heart. “Elevation is using gravity to limit swelling,” says Mr. Depaola. Elevation can also reduce bruising by making it more difficult for blood to reach the injury. Experts say it is best to elevate the affected area for up to 3 hours a day until the pain subsides.

If the pain or discomfort persists after going through the RICE steps, a sports medicine physician can evaluate the injury. Here’s what your physician can do:

• Diagnose the injury and give a good estimate of recovery time;
• Advise treatments;
• Customize a rehabilitation plan to the patient
• Ensure that rehabilitation will avoid a reinjury or an overcompensation injury;
• Provide recommendations for physical therapy;
• Provide performance-related advice for nutrition or supplements.

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