Meaning of R.I.C.E.
The most important time in the treatment of acute soft tissue injuries is in the 24 hours immediately following injury. When soft tissue is injured, blood vessels are usually damaged too.
Thus, blood accumulates around damaged tissue and compresses adjoining tissues, which causes secondary hypoxic injury and further tissue damage. Consequently, every effort should be made to reduce bleeding at the site of injury. The most appropriate method of doing this is summarized by the letters RICE.
- R – Rest
- I - Ice
- C – Compression
- E – Elevation
Rest
Whenever possible following injury the athlete should cease activity to decrease bleeding and swelling. For example, with a thigh contusion, bleeding will be increased by contraction of the quadriceps muscle during running. Where necessary, complete rest can be achieved with the use of crutches for a lower limb injury or a sling for upper limb injuries.
Ice
Immediately after injury, ice is principally used to reduce tissue metabolism. Ice is also used in the later stages of injury treatment as a therapeutic modality.
Ice can be applied in a number of forms:
- Crushed ice can be wrapped in a moist cloth or towel and placed around the injured area, held in place with a crepe bandage.
- Reusable frozen gel packs.
- Instant ice packs that do not need pre-cooling.
- Ice immersion in a bucket (useful for treatment of injuries of the extremities).
- Cold water and cooling sprays, which are often used in the immediate treatment of injuries but are unlikely to affect deeper tissues.
Although there is no high-quality evidence for how long, and how often, to apply ice after an acute injury, a systematic review suggested that intermittent 10-minute ice treatments are most effective at cooling injured animal tissue and healthy human tissue. Many practitioners apply ice for 15 minutes every I -2 hours initially and then gradually reduce the frequency of application over the next 24 hours.
Ice should not be applied where local tissue circulation is impaired (e.g. in Raynaud’s phenomenon, peripheral vascular disease) or to patients who suffer from a cold allergy. Other adverse effects of prolonged ice application are skin burns and nerve damage.
Compression
Compression of the injured area with a firm bandage reduces bleeding and, therefore, minimizes swelling. Compression should be applied both during and after ice application; the width of the bandage applied varies according to the injured area.
The bandage should be applied firmly but not so tightly as to cause pain. Bandaging should start just distal to the site of bleeding with each layer of the bandage overlapping the underlying layer by one-half. It should extend to at least a hands breadth proximal to the injury margin.
Elevation
Elevation of the injured part decreases hydrostatic pressure and, thus, reduces the accumulation of interstitial fluid. Elevation can be achieved by using a sling for upper limb injuries and by resting lower limbs on a chair, pillows or bucket. It is important to ensure that the lower limb is above the level of the pelvis.
Other minimizing factors
In the initial phase of injury (first 24 hours), heat and heat rubs, alcohol, moderate/intense activity and vigorous soft tissue therapy should all be avoided? Whether or not electrotherapeutic modalities (e.g. magnetic field therapy, interferential stimulation, TENS) provide effective pain relief and reduction of swelling in the initial period is a subject of debate.
It is usually suggested to exercise R.I.C.E. at duration of 4 to 6 time for up to 48 time after an damage. Heat therapies are appropriate for some accidents, but should only be regarded after swelling has receded, roughly 72 time after an damage. If the part of one’s body does not reply to R.I.C.E. treatment within 48 time, it would be sensible to seek advice from your doctor in the occasion a serious damage has happened such as inner blood loss or a damaged cuboid.
At Alliance Physical Therapy Our team works with individuals who have undergone a total hip or knee replacement with arthroscopic or other surgeries, sustained trauma to a bone, or have a bone or soft tissue disease. We focus on helping patients regain their strength, mobility and endurance so they can return home and resume their regular routines.For More Information Call At: 
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