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R.I.C.E. is Nice

By Alan Williams, PT, OTR/L, ATC, CSCS

One thing I always tell my patients when they begin therapy is that as soon as they get well enough to no longer need my services, then I kick them out (in a nice way, of course). My goal as a physical therapist is to help you get stronger and feeling better so that you can get out of my office and on with your life. But because getting on with your life requires you to learn how to manage your condition yourself, I’m big on patient education. That way, when you feel the pain starting to creep back, you’ll know exactly what to do.

R.I.C.E. is an acronym taught in basic first aid classes to help people remember the steps to take when treating a minor injury (like a sprained ankle or a pulled muscle) or a chronic pain condition (like arthritis or tendonitis). It stands for Rest, Ice, Compression, and Elevation.

Rest: Rest is perhaps the most important element of R.I.C.E. Without proper rest, your injury won’t have time to heal completely. This is may seem like a no-brainer (if you sprain your ankle, of course you’re going to rest it, right?), but many people are tempted to “get back out there” after only a short rest period. However, returning to your normal activities too quickly will not only prolong your condition, it may worsen it, resulting in permanent injury.

So how long do you need to rest? That depends on whether your injury is acute (short term) or chronic (long term). In general, the longer you’ve had the injury, the longer you need to rest it. This may mean 1-2 weeks for an acute injury (like a pulled muscle) or 3-6 months for a chronic condition (like golfers’ elbow, tennis elbow, shin splints, and carpal tunnel syndrome). And when you do return to your normal activities, do so slowly; you’ll need to gradually rebuild to your former level of strength and range of motion.

Ice: Temperature is an underappreciated form of pain control. Ice therapy (whether in the form of chemical ice packs, ice cubes in a baggie, or a full on ice bath) reduces swelling and inflammation, calms irritated nerve fibres, and speeds healing. Apply ice directly to the injury for 20 minutes at a time and repeat throughout the day. However, if you’re using a chemical ice pack, be sure to use a thin barrier (such as a pillowcase) between the ice pack and your skin; chemical ice packs sometimes reach temperatures below 32 degrees Fahrenheit and may cause burns. Ice therapy can be uncomfortable for those who aren’t used to it or don’t know what to expect. The progression will be: 1) you’ll feel cold, 2) it will hurt or burn, 3) it will go numb. Don’t quit before you reach the most beneficial numb stage.

Compression & Elevation: When an injury occurs, the muscles, tendons, and ligaments involved swell up and sometimes bleed internally. This squeezes nerves (causing pain) and blood vessels (reducing blood flow and slowing healing). By wrapping the injured area with a bandage (tight enough so that you feel gentle pressure but not pain) and elevating it above the level of your heart, you encourage the dispersal of any accumulated fluid in the area, reducing swelling, inflammation, and pain.

By using R.I.C.E., your injury should feel much better within seven days. However, if you see little or no improvement in that time, or experience sudden or severe pain, fever, or loss of function, see your doctor – you may have a more serious injury. Remember that R.I.C.E. is only an appropriate treatment for minor injuries. Head and neck injuries, broken bones, and severe bleeding require emergency medical treatment.

I love when my patients become empowered to take control of their own medical destinies. Use R.I.C.E. on your minor aches and pains, and visit your physical therapist to learn how else you can better manage your physical conditions.

Don’t let an injury hold you back. Call 463-0022 today for your FREE Pain Assessment!