Introduction
RICE is an acronym for Rest Ice Compression and Elevation.
This system is used as current best management practice within the first 24-48 hours after acute soft tissue injury. It is important to minimize bleeding and swelling in the injured area, as applying more aggressive interventions, such as massage, can lead to further tissue damage. when Proper use of the RICE method can shorten recovery time and reduce discomfort.
Rest
Today, we have a fair amount of scientific evidence (mostly experimental) to support this treatment. The most convincing evidence for rest comes from studies on the effects of immobilization on muscle healing. Short-term fixation is beneficial, but It should be limited to the first few days after injury. [1]. This allows the scar tissue to connect the injured muscle stump to withstand the force of the contraction without rupturing again. By limiting the fixation period to less than a week, the adverse effects of fixation can be reduced is minimized. The meaning of rest is relative to the injured area but involves functions such as weight bearing or any other strenuous activity that involves increasing blood flow to the injured area.
Ice
Ice therapy, also known as cryotherapy, decreases tissue metabolism [2] and causes vasoconstriction. This physiological change slows down and prevents further swelling—an important consideration for early-mobility ROM workouts after the initial period of rest. Ice also reduces the spread Nociceptive nerve stimulation to the brain can reduce pain and muscle spasms. [3] However, prolonged application of cryotherapy may be detrimental to the healing process. Injury may worsen if blood flow is excessively reduced with risk of skin burns and nerve damage Increased with the extension of ice application time. Evidence on the appropriate dose of cryotherapy for acute injury is limited, but a systematic review suggests that 10 minutes of ice combined with 10 minutes of no ice is most effective [4]. Remember, no For the optimal dose to be applied to all body parts, as a clinician, one should use clinical judgment and consider the specifics of each case.
Caution should be exercised when using cryotherapy in persons with cold allergies (eg, Raynaud’s syndrome, diabetic cold urticaria, paroxysmal cryoglobulinuria) and in patients with circulatory insufficiency. It is recommended to wrap the ice cubes in a damp towel or cloth Minimize the risk of superficial nerve or skin damage. A broader reading on cryotherapy is recommended.
Compression
Compression prevents further edema (swelling) caused by the inflammatory process and also reduces bleeding at the site of tissue damage. An elastic bandage should be used to provide comfortable pressure without causing pain or constricting the blood vessel to that point of occlusion. The dressing should start at the distal end of the injury and move proximally, overlapping halfway with the previous layer. It also provides minimal protection for injured body parts from excessive movement, although that is not its primary purpose.
Some examples of compression bandaging:
Elevation
Elevation prevents swelling by increasing venous return to systemic circulation and reducing hydrostatic pressure, thereby reducing edema and promoting waste removal from the injury site. Make sure your lower body is above pelvic level.
Variations
- HI-RICE – Hydrated Ibuprofen Resting Ice Compress High.
- Price Protect Rest Ice Compression Elevation (i.e. using crutches to protect the painful area from further injury).
- Price – Protective rest ice compression elevation and support (eg wrap or taping).
- PRINCE – Protective Rest Ice NSAID Compression and Elevation.
- RICER – Rest Ice Compression Elevation Recommended.
- Police – Protection for optimum loading ice compression altitude.
RICE for Ankle Sprains
The RICE protocol is widely used in the management of acute ankle sprains.
Although there is not enough evidence to suggest the use of RICE for ankle sprains. Recommendations Treatment decisions must be made on an individual basis, carefully weighing the relative benefits and risks of each option, and must be based on expert opinion and national guidelines. [5]
The RICE protocol does not accelerate recovery, but it is still a reasonable intervention for short-term pain reduction. [6]
It can be used in patients with grade I and II (partial and incomplete tears), while grade III tears may require surgical intervention. [7]
References
- ↑ Tero A. H. Järvinen, Teppo L. N. Järvinen, Minna Kääriäinen, Hannu Kalimo and Markku Järvinen, Muscle Injuries : Biology and Treatment, The American Journal of Sports Medicine 2005 33: 745
- ↑ 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.
- ↑ Järvinen TA, Järvinen TL, Kääriäinen M, Aärimaa V, Vaittinen S, Kalimo H, Järvinen M, Muscle injuries: optimising recovery, Best Pract Res Clin Rheumatol. 2007 Apr;21(2):317-31.
- ↑ Brucker, P. & Kahn, K. (2006). Clinical Sports Medicine, page 130.
- ↑ Van Den Bekerom MP, Struijs PA, Blankevoort L, Welling L, Van Dijk CN, Kerkhoffs GM. What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?. Journal of athletic training. 2012 Jul;47(4):435-43.
- ↑ Chen ET, McInnis KC, Borg-Stein J. Ankle sprains: evaluation, rehabilitation, and prevention. Current sports medicine reports. 2019 Jun 1;18(6):217-23.
- ↑ Wolfe MW, Uhl TL, Mattacola CG, McCluskey LC. Management of ankle sprains. American family physician. 2001 Jan 1;63(1):93.
