RICE For Faster Recovery From Injury
The actions you take immediately following an injury and during the 24 to 48 hour period that follows can have a significant effect on the overall healing time. For common injuries such as sprains where damage to the muscle, tendon or ligament fibres has occurred, the R.I.C.E method is a tried and tested means of minimising further damage and speeding up recovery.
R.I.C.E is an abbreviation for Rest, Ice, Compression & Elevation and it is the first thing that should come to mind after sustaining injury.
Rest
As soon as an injury has occurred, the body takes steps to initiate the healing process. Firstly it stops bleeding by clotting the blood in the area of the injury and then it starts to repair the damaged tissue by creating a mesh of new fibres. These fibres of this scar tissue are initially very weak which is why rest is so important in the early stages.
Stop training and avoid putting too much weight or stress on the affected area. This doesn’t mean you have to stay in bed or spend weeks on crutches but for the first 24-48 hours following the injury you should try and rest it as much as you can.
Ice
The cooling effect of ice has many beneficial properties; firstly it provides a degree of pain relief and more importantly it reduces swelling by causing the blood vessels to contract removing fluid from the injured area in the process.
The sooner ice is applied after receiving the injury, the more effective it will be. There are numerous ways in which ice can be applied, what’s best will depend on the location of the injury and what is available at the time. For wrist and ankle injuries, submerging them in a bucket of iced water can be an effective solution, as are commercial ice packs which remain flexible after being stored in the freezer.
Given that most injuries tend to occur when such options may not be available, a bag of frozen peas from a supermarket or some ice from a pub wrapped in a plastic bag or t-shirt will work almost as well.
The injury site should be iced for a 15-20minute duration, and should be allowed to naturally return to a normal temperature before re-applying. Any longer than this could potentially cause skin damage. You should avoid direct contact between the skin and ice for the same reason. As with all things you should listen to what your body is telling you as a guide. A bit of tingling associated with the cold temperature is to be expected but if the application of ice is causing excessive pain or redness then it would probably be a good idea to stop.
Compression
Many consider compression to be the most important aspect of the R.I.C.E technique. Compressing the injured area prevents fluid from building up in the spaces between the cells which in turn reduces the amount of swelling.
As well as causing discomfort and reducing range of motion, swelling around the site of an injury causes what is known as secondary tissue death. This is where cells die from a lack of oxygen and nutrients because of an increased demand from the healing process combined with a decrease in supply caused by the restriction of blood flow from the swelling.
Applying compression very soon after the injury will help to reduce the amount of swelling and thus will reduce the damage caused by secondary tissue death. Doing this within the first hour of receiving the injury has the potential to reduce the recovery period by as much as two weeks.
It can be difficult to apply both ice and compression to the same place at the same time; putting the ice inside will reduce the effectiveness of the compression and doing the opposite will reduce the effectiveness of the ice.
Return to Fitness (UK) sells a product by 'Coldone' which combines the two but they are not particularly cheap, and unless you are particularly paranoid or lucky the chances are you won’t have one available to you at the time you need it most.
The best solution will depend to a degree upon the exact circumstances and exactly what is available to you. Considering how quickly swelling often occurs the most effective solution would probably to sort out the compression first with whatever is available and then go and find some ice afterwards. Of course if you happen to be in the arctic or an ice factory then giving ice the higher immediate priority may yield a better result.
Elevation
Elevating the injured area slightly higher than the heart will help to reduce initial swelling as well as speeding up the removal of fluids which have already gathered. As the body's system for removing fluid from injury sites is passive (i.e does not have an active pumping mechanism for removal), positioning the injury so that gravity pulls fluid away from it will help speed up the recovery process.
In addition to the R.I.C.E technique, anti inflammatory drugs such as Ibuprofen can also aid the healing process and are often recommended by doctors.
Summary
This article has been pieced together as a result of personal experience and web research. Immediately following a sprain-like injury R.I.C.E is the best possible thing to enable the recovery process to get off to a good start. It goes without saying that this is no substitute for professional medical advice and if you have bones protruding sideways through your skin or anything like that then the chances are your injuries are well beyond the scope of advice provided in this document!
Further information on the subject can be found at:
http://www.sports-injury-info.com/rice.html