For Immediate Treatment Of A Sports Injury, Think R.I.C.E.

This may be obvious to the seasoned athlete but it is worth discussing the significance and reasons behind following the RICE protocol after injury, later on you will appreciate the benefits of this simple form of first aid.

The first 24 hours – Remember this is the most critical time for treatment, immediately after an acute soft tissue injury. When you injure a soft tissue such as a muscle, ligament, or tendon there is a very likely chance of injuring blood vessels too. As a result blood gathers around damaged tissues causing compression within the neighbouring tissues, which causes a secondary ‘Hypoxic’ injury that deprives the tissues of oxygen, causing more harm. As a result, every attempt should be made to decrease the bleeding at the injured area. This is where RICE comes in, a simple mnemonic to summarise 4 actions to take after injury:

Rest

Ice

Compression

Elevation

So why follow RICE and what does it do?

Rest

Where possible following injury, you should try and stop activity to reduce the bleeding and swelling. If you injured say, the muscles in the back of your lower leg (calf) bleeding will increase as you exercise these muscles whilst running. If your injury is so severe that you cannot walk without limping, then a rest from weight bearing can be achieved by using crutches for a lower body injury or a sling for an upper body injury.

Ice

Straight after injury ice is mainly used to slow down the rate at which the soft tissues work and respire. Later on after the acute phase of injury, ice may be used as therapeutic treatment for its pain-relieving affect. There are numerous ways to apply ice, this could be crushed ice wrapped in a damp cloth or tea-towel, reusable frozen gel packs or immersing injured area in a bucket of icy water. Cold water and cooling sprays are often used but these rarely penetrate enough to affect the deeper tissues. Opinions vary for how long and how often to apply ice, but a useful guide is to generally apply ice for 15 minutes every 1-2 hours, steadily reducing the time of applications over the next 24 hours. Care should be taken to protect the skin with a towel or similar barrier to avoid the ice burning the skin or causing nerve damage. People with cold allergy or peripheral vascular disorders such as Raynaud’s phenomenon should not apply ice to treat an injury.

Compression

Compression of the injured area with a firm bandage reduces bleeding and, as a result decreases swelling. It is important to apply compression during and after the application of ice, so make sure a bandage is applied throughout. The size of the bandage is dependent on the size of the injured area and should be cut accordingly. Tubigrip type bandages come in a variety of sizes and widths. The bandage should feel firm but not so tight that it aggravates painful symptoms. If bandaging from a roll, the application should start at the furthest point away, wrapping each layer so it overlaps the layer below by half and should continue to extend upwards to at least one hands width higher above the margin of the injury.

Elevation

Elevating the injured area can be accomplished by using a sling for upper limb injuries and by resting the lower limb on a chair, cushions or bucket. For this to be effective the lower limb must be elevated higher than your hips/pelvis, this enables gravity to draw away fluid accumulation at the injured area and therefore decrease pressure within the fluids that bathe all the surrounding tissues around the injury.

Remember this advice is for a soft tissue injury, If you are in any way concerned that your injury is more severe in nature, it is vital that you seek medical advice immediately.

Once you feel more comfortable and the initial swelling and inflammation is more bearable it is then time to seek the advice from a musculo-skeletal specialist such as an Osteopath, Physiotherapist, or Sports Therapist.

Follow the advice of an injury professional, in addition to therapy, you may need to do exercises and follow a rehab programme.

Finally, whatever you do avoid the temptation to return to your sport too soon. Be guided by your therapist and rest for as long as is required, or you could end up doing more damage and need even longer away from activity.

At Chart Clinic, we are happy to discuss your individual situation and advise you the best course of action for your injury, so do feel free to get in contact.

Reference:

Brukner and Khan, Clinical Sports Medicine 3e, McGraw-Hill Professional (2007)