Hey guys! It is Ambassador Mel here from Mum Runner virtual events! As some of you may know I am a nurse, sports medic, personal trainer and the best of all, a runner. With this in mind, you can bet I have seen, dealt with and even had my fair share of sports related injuries including both soft tissue (sprains, strains, overuse injuries and even bruises) and broken bones.

This article will discuss the effective and widely use routine care for most sports injuries ‘R.I.C.E. Therapy’. We will discuss what each of the letters in the acronym mean and how this non-invasive, cost effective and simple therapy can help benefit and promote the healing process.

It is important to remember, that just because an injury cannot be seen, does not mean it is not there. If in doubt about an injury or if the swelling and/or pain does not improve over the following days or week, please see your doctor or visit your nearest hospital for further scans and diagnosis. The worst thing you can do is to leave an injury that needed further intervention, to heal the wrong way, or prolong the healing and be out of the game for longer because of stubbornness (Trust me, I know this from experience).

R – Rest.

Avoid weight baring exercises and limit movements that cause pain. For mobilisation, using crutches for lower limb injuries can assist with this step. This step should be implemented for at least the first 24 – 48 hours immediately post injury. Further movement can cause increased trauma to the area as well as delay healing.

Resting an injury allows the body to use the nutrients and O2 in the area for healing as opposed to movement. Resting also enhances the fibrin and collagen uptake to the the internal wound with minimal disturbances; this allows for optimal clotting and the beginning of the healing process (Lewis, Finlayson, & P, 2017).  

I – Ice

Also known is cryotherapy, the use of ice should be used for the first 24 – 48 hours immediately post injury. Cryotherapy should be used with a ratio of 20 min on/20 min off (Brinton, Fenton, & Meadley, 2019). It is important to note that ice should never be applied directly to the skin and although this is a standard dose, not all body types are the same and shorter periods or less applications should be considered if discomfort occurs. Extra caution should be used for people with impaired circulation (eg. Diabetes).

Cryotherapy helps limit metabolism to the surrounding tissues and promotes vasoconstriction in the affected area (Brinton, Fenton, & Meadley, 2019). By decreasing the blood flow to the area, this aids in reducing inflammation, oedema (swelling) and associated pain.

*Side note: Heat therapy, using warm compresses can be used 48 hours or so after injury. As this enhances vasodilation which results in an increase of blood flow to the area and helps remove any internal debris from the area caused by the wound rupture (Lewis, Finlayson, & P, 2017). *

C – Compression

By using an elastic bandage or a tubular compression bandage, compression should be applied to the site of injury. This occludes (obstruct, block) any ruptured blood vessels to the injury and reduces or stops internal bleeding. Compression also aids in the prevention of further oedema (swelling), helps support the injury/joint and helps reduce associated pain caused by mobility and inflammation (Jones & Rootham, 2019).

A compression bandage should be applied firmly however should not cut off circulation to your distal regions. Signs of circulation loss include, pale or purple tinged skin, cold to touch, numbness or tingles. If the compression makes the injury worse, visit your doctor for further scans (Elsevier Patient Education, 2020).

E – Elevation

Elevate the injured site above the level of the heart, or if a lower limp, above the pelvis. This step increases venous and lymphatic return, moving fluids away from the injury and reducing oedema (swelling) as well as reduces hydrostatic pressure, decreasing pain associated with engorgement (Lewis, Finlayson, & P, 2017).

Now we have discussed exactly what the acronym ‘R.I.C.E.’ means, how to apply it, why it is important and how it works, the next time you roll you ankle or suspect an injury, you will know how to implement this therapy and exactly how it is benefitting your healing process. Hopefully this will mean less time off your feet and out doing what you love.

References

Bergen, M. (2021). Ankle Sprain. In Ferri’s Clinical Advisor 2021. Philadelphia: Elsevier Inc.

Brinton, J., Fenton, W., & Meadley, B. (2019). Clinical Skills. In Emergency and Trauma Care for Nurses and Paramedics (3rd Edition ed., pp. 329-406). NSW: Elsevier Australia.

Elsevier Patient Education. (2020). RICE Therapy for Routine Care of Injuries. Elsevier Inc.

Jones, K., & Rootham, E. (2019). Minor injury and management. In Emergency and Trauma Care for Nurses and Paramedics (3rd Edition ed., pp. 407-445). NSW: Elsevier.

Levine, M. R., & Cheema, N. (2013). Soft Tissue Injury. In Emergency Medicine (2nd Edition ed., pp. 1568-1577). Philadelphia: Saunder.

Lewis, S. L., Finlayson, K., & P, C. (2017). Nursing Management: Inflammation and wound healing. In Lewis’s Medical-Surgical Nursing ANZ (pp. 188-209). NSW: Elsevier Australia.

Monahan, F. D., Neighbors, M., & Green, C. J. (2011). Musculoskeletal Disorders. In Manual of Medical-Surgical Nursing (7th Edition ed., pp. 567-619). Elsevier Inc.

Walsh, J. M., & Chee, N. (2018). Hand and Upper Extremity Injuries. In Pedretti’s Occupational Therapy (8th Edition ed., pp. 972-1003). Missouri: Elsevier.