RICE: Difference between revisions
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== Introduction == | == Introduction == | ||
'''RICE''' is an acronym that stands for '''R'''est, '''I'''ce, '''C'''ompression and '''E'''levation | '''RICE''' is an acronym that stands for '''R'''est, '''I'''ce, '''C'''ompression and '''E'''levation. This system is used as current best management practice in the first 24 hours following an acute soft tissue injury. Minimising bleeding and swelling in this way at the injury site is important because the application of a more aggressive intervention, for example, [[Massage]], will cause further tissue damage. When used appropriately, the RICE approach can improve recovery time and reduce discomfort. | ||
== Rest == | == Rest == | ||
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== Ice == | == Ice == | ||
Ice therapy, also known as cryotherapy reduces tissue metabolism <ref>Bleakley, C., McDonough, S. & MacAuley, D. The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. ''American Journal of Sports Medicine'', 2004; 32(1):251-61.</ref> and causes blood vessel constriction. This physiological change slows and prevents further swelling - an important consideration for early active ROM exercises after the initial period of rest. Ice also decreases the proprogation of nocioceptive neural stimuli to the brain which can reduce pain and muscle spasm. | Ice therapy, also known as [[cryotherapy]] reduces tissue metabolism <ref>Bleakley, C., McDonough, S. & MacAuley, D. The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. ''American Journal of Sports Medicine'', 2004; 32(1):251-61.</ref> and causes blood vessel constriction. This physiological change slows and prevents further swelling - an important consideration for early active ROM exercises after the initial period of rest. Ice also decreases the proprogation of nocioceptive neural stimuli to the brain which can reduce pain and muscle spasm. | ||
However, applying cryotherapy for an extended period of time can actually be detrimental to the healing process as blood flow can be excessively reduced and the risk of skin burns and nerve damage increases. There is limited evidence surrounding [[Cryotherapy Guidelines|dosage for cryotherapy]] in acute injury however systematic reviews suggest that 10-minute ice treatments combined with 10-minute periods without ice are most effective<ref>Brucker, P. & Kahn, K. (2006). ''Clinical Sports Medicine'', page 130.</ref>. Keep in mind that there is no optimal dosage that will be ideal for all body locations and as a clinician, one should use one's clinical judgement and consider the specific details of each case. | |||
Practice caution when using cryotherapy in people who are hypersensitive to cold (e.g. Raynaud’s syndrome, diabetes, cold urticaria, paroxysmal cold hemoglobulinuria) and patients' who have a circulatory insufficiency. It is recommended that the ice is wrapped in a damp towel or cloth to minimise the risk of superficial nerve or skin damage.Wider reading into cryotherapy is recommended. | |||
== Compression == | |||
Compression serves to prevent further [[Oedema]] (swelling) as a result of the [[Inflammation|inflammatory]] process and also by reducing bleeding at the site of tissue damage. An elasticated bandage should be used to provide a comfortable compression force without causing pain or constricting blood vessels to the point of occlusion. Bandaging should begin distal to the injury and move proximally, overlapping each previous layer by one half. It can also serve to provide minimal protection of the injured body part from excessive movement, although this is not it's primary purpose. | |||
== Compression | |||
Compression serves to prevent further [[Oedema]] (swelling) as a result of the [[Inflammation|inflammatory]] process and also by reducing bleeding. An elasticated bandage should be used to provide a comfortable compression force without causing pain or constricting blood vessels to the point of occlusion. Bandaging should begin distal to the injury and move proximally, overlapping each previous layer by one half. It can also serve to provide minimal protection of the injured body part from excessive movement, although this is not it's primary purpose. | |||
== Elevation == | == Elevation == | ||
Revision as of 12:02, 3 August 2018
Original Editor - The Open Physio project.
Lead Editors
Introduction[edit | edit source]
RICE is an acronym that stands for Rest, Ice, Compression and Elevation. This system is used as current best management practice in the first 24 hours following an acute soft tissue injury. Minimising bleeding and swelling in this way at the injury site is important because the application of a more aggressive intervention, for example, Massage, will cause further tissue damage. When used appropriately, the RICE approach can improve recovery time and reduce discomfort.
Rest[edit | edit source]
Rest to reduce the likelihood of further damage to the tissues through increased bleeding, avoid Weightbearing or any strenuous activity involving the injured part, which will increase the time required for tissue to repair.
Ice[edit | edit source]
Ice therapy, also known as cryotherapy reduces tissue metabolism [1] and causes blood vessel constriction. This physiological change slows and prevents further swelling - an important consideration for early active ROM exercises after the initial period of rest. Ice also decreases the proprogation of nocioceptive neural stimuli to the brain which can reduce pain and muscle spasm.
However, applying cryotherapy for an extended period of time can actually be detrimental to the healing process as blood flow can be excessively reduced and the risk of skin burns and nerve damage increases. There is limited evidence surrounding dosage for cryotherapy in acute injury however systematic reviews suggest that 10-minute ice treatments combined with 10-minute periods without ice are most effective[2]. Keep in mind that there is no optimal dosage that will be ideal for all body locations and as a clinician, one should use one's clinical judgement and consider the specific details of each case.
Practice caution when using cryotherapy in people who are hypersensitive to cold (e.g. Raynaud’s syndrome, diabetes, cold urticaria, paroxysmal cold hemoglobulinuria) and patients' who have a circulatory insufficiency. It is recommended that the ice is wrapped in a damp towel or cloth to minimise the risk of superficial nerve or skin damage.Wider reading into cryotherapy is recommended.
Compression[edit | edit source]
Compression serves to prevent further Oedema (swelling) as a result of the inflammatory process and also by reducing bleeding at the site of tissue damage. An elasticated bandage should be used to provide a comfortable compression force without causing pain or constricting blood vessels to the point of occlusion. Bandaging should begin distal to the injury and move proximally, overlapping each previous layer by one half. It can also serve to provide minimal protection of the injured body part from excessive movement, although this is not it's primary purpose.
Elevation[edit | edit source]
Elevation will prevent swelling by increasing venous return to the systemic circulation, and reducing hydrostatic pressure thereby reducing oedema and facilitating waste removal from the site of injury. Ensure that the lower limb is above the level of the pelvis.
Variations[edit | edit source]
- HI-RICE - Hydration, Ibuprofen, Rest, Ice, Compression, Elevation.
- PRICE, Protect, Rest, Ice, Compression, Elevation (i.e. using crutches to protect the painful part from further injury).
- PRICES - Protection, Rest, Ice, Compression, Elevation and Support (e.g. bandaging or taping).
- PRINCE - Protection, Rest, Ice, NSAIDs, Compression, and Elevation.
- RICER - Rest, Ice, Compression, Elevation, Referral.
- POLICE - Pause, Optimal Loading, Ice, Compression, Elevation.
References[edit | edit source]
- Brucker, P. & Kahn, K. (2006). Clinical Sports Medicine (third edition). McGraw Hill Australia, Pty. Ltd.
- RICE (medicine). (2008, October 21). In Wikipedia, The Free Encyclopedia. Retrieved 09:02, January 17, 2009, from http://en.wikipedia.org/w/index.php?title=RICE_(medicine)&oldid=246661676
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