The Rules of RICE

Despite its recent bad press, inflammation is actually completely normal and important for healing when it is acute. The heat, swelling, and redness that make inflammation uncomfortable are actually a desired outcome. During an acute inflammation, blood vessels dilate to rush chemicals that kill bacteria and initiate tissue healing to the injured area. This usually lasts for 24 to 48 hours after the injury, but should be completely resolved within 2 weeks. If swelling is lasting longer than that amount of time, it is possible that inflammation has become chronic or stuck.

Whether inflammation is acute or chronic, the common initial treatment is RICE: Rest Ice Compression Elevation. The combination of these interventions helps to keep swelling in check and to ensure progression through the inflammatory phase to other phases of healing. During the initial 24 hours, RICE should be avoided unless swelling is particularly excessive. Again, inflammation is a vital phase of healing and inhibiting it too soon can actually delay recovery. Begin the following protocol only after 24 hours have passed or when swelling is severe.

Rest: Try to stay off of the injured extremity until swelling has decreased. This does not mean no movement – it is good to move the joint gently through pain free range of motion. It does mean avoid putting pressure on the muscle or joint with weightbearing activity.

Ice: Apply a cold pack covered in a thin towel to the area for at least 15 minutes, but no more than 20 minutes. You may repeat as necessary after every 45 minutes. Cold packs that conform to your body are the most effective. If you don’t have a commercial pack, you can make your own by creating a 3:1 mixture of water to isopropyl alcohol in a ziplock bag and freezing it.

Compression: Using a compressive bandage or stocking will help to control swelling by moving fluid away from your extremities toward your abdomen. Compression should be tight enough to provide gentle pressure, but should not cut off circulation to distal tissue. Follow the instructions below for using an ACE bandage for compressive wrapping.

Wrapping should be tightest at the point furtherest from your abdomen and gradually decrease in pressure.

Wrapping should be tightest at the point furtherest from your abdomen and gradually decrease in pressure.

Elevation: Keep the injured extremity elevated slightly above heart level if possible to assist with drainage of fluid toward the torso. This may be done as long as tolerable and no numbness or tingling occurs.

by Birgit

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