Treat sprains & bruises at home!

Rice! It’s a staple food… It’s the surname of a helicopter-hopping TV legend! And it’s a handy mnemonic that helps you remember an immediate, easy way to treat injuries to soft tissue. R.I.C.E. stands for Rest, Ice, Compression and Elevation. So… Let’s take a look at what that all means and how it can make the home treatment of an injury more effective. Keep in mind, though, that R.I.C.E. is very much a first-aid treatment – not a miracle fix!

REST

The R in R.I.C.E. calls for ‘Rest’ – and the importance of this should really be self-evident! You simply cannot carry on doing everything that you would normally do following an injury. That’s not to say, however, that you should do nothing at all while recuperating. Many muscular injuries need you to keep moving in order for the muscles to retain their strength…

The key to knowing how much rest is appropriate is to pay careful attention to your body. Ease off activity that hurts the affected area until the pain mostly subsides. Gently exercise the area by carefully and attentively moving it in a way that lets you know if it still hurts – without going the whole hog! So with an arm injury, for example, you’d obviously avoid carrying heavy shopping but, after a couple of days’ rest, you might then slowly move the arm a little and pay attention to how much it hurts, if at all. A cautious attitude is key!

ICE

Icing an injury is also known by the fancy name of ‘Cryotherapy’… And if you’ve ever grabbed a bag of frozen peas and plonked it on an injury, then you’ve already tried it in a crude form. Professional athletes and others who think, ‘I can’t afford to take a chance on getting this wrong’ tend to come to the clinic for treatment, but here’s our advice on ‘first-aid icing’…

Why ice a bruise? Well, ice not only decreases the temperature of the tissues but also constricts blood vessels around the injury. In turn, this reduces the flow of blood to that area – so icing a bruise or sprain helps it heal faster! It also decreases the swelling, reduces pain and aids the body’s lymphatic drainage.

Before you dash off and stick your bruise in a freezer, though, you need to remember that you mustn’t put ice directly on your skin!* Rather, dampen a tea towel or tee-shirt or some such, then wrap it around a bag of frozen peas or similar. Place this ice pack on the injured area…

For the first few moments, you might think that this is ineffective because the ice isn’t that cold… Keep the pack where it is, held firmly – but not so that it hurts. You might soon notice the ‘okay’ feeling fading as the cold really kicks in!

Keep the pack where it is… It needs to stay put for fifteen to twenty minutes or so. In any case, after a period of ‘just cold’, you may feel something more like a burning or prickling sensation. This is quite normal and the feeling soon segues into an aching before, finally, becoming numb. That’s precisely what we’re aiming for! Once the area turns numb, take off the pack. You can repeat this process once an hour for the first 24 – 48 hours but no more. Over icing may slow your recovery.

What can you use as a pack? The classic ‘first-aid’ solution often tends to be a bag of peas from the freezer! It doesn’t have to be peas of course – but they do seem to be the default… Possibly that’s because they’re often sitting in the freezer anyway. It may also be because, after a quick ‘scrunch’, peas adjust rather conveniently to the size and shape of the injured area. You can’t apply a frozen turkey in quite the same way!

Alternatives: Perhaps inevitably, there’s a large range of products that are available to help you ice an injury… From disposable chemical pouches that work only once, to reusable packs of gel that go cold in a freezer – and heat up in a microwave! Some are good and some aren’t. So what should you use as a treatment? Well, put it this way: we have high-end equipment for treating patients and serious conditions here at the clinic… But, in terms of immediate first aid, it’s often a bag of peas for us, too!

When shouldn’t you use ice? Swelling tends to be an immediate problem, but can be an issue for up to six weeks after injury. Beyond that icing’s not really of use. In any case, though, there are no circumstances under you should treat any kind of head swelling yourself. Go to the hospital! Might you be wasting people’s time? Yes – but you pay for that time in taxes: don’t take any chances if you’ve clonked your head. Get it checked.

Those with poor circulation should give icing an injury a miss because of the way it works – see ‘Why ice a bruise?’ above. Also, those who have poor skin sensitivity might end up doing more harm than good. The other exception to cold treatment is your back. We give advice for back pain in our Info Sheet here http://bit.ly/1lhJtVL but – specifically relating to cold therapy – your back will more likely respond to heat than cold. That’s because the source of back pain can be quite deep: the cold probably won’t reach it in the same way that heat does.

*The only exception to the rule about putting ice directly on your skin this is if you’ve been encouraged to use ‘Ice Cube Massage’. This involves a taking a WET ice cube – that is to say ice that is starting to melt – and MOVING it on and around a localized source of pain. This therapy, usually prescribed by a physio, is safe as it continues only for a few minutes and must be stopped as soon as the area goes numb, or when the ‘red’ part of the cooling process happens. Ask us for more info on this!

COMPRESSION

This part of the treatment aims to further reduce the inevitable swelling. That’s essential because excessive swelling causes pain and loss of function. You can achieve an agreeable amount of compression by using an elasticated bandage.

This should fit snugly enough to stop the muscles moving too much and yet still allow expansion when your muscles fill with blood. If the bandage you use is too tight, it can do more harm than good… Similarly, there are no circumstances under which you should attempt to use plastic bandages or fabric tapes – from sport and athletic taping – without expert advice.

Sport and Athletic Taping? Yes! Now, ordinarily we like to give as much info as possible about the treatments we offer… However, the use of these tapes is deceptive in the simplicity of its appearance. Unqualified and incorrect taping may lead to further injury. Only proper application of the tape is completely safe, and ensures that it won’t worsen the condition or cause skin irritation. The correct application also makes sure that movement in the area of the injury is beneficially controlled… Drop us a line to find out more about how Sport / Athletic Tapes can help you.

ELEVATION

The last way to help reduce swelling in a bruise trauma is to elevate the injured part. This reduces blood flow to the painful area. Of course, this advice assumes that the injured area is easy to raise – but you understand the principle! Keep the affected area raised above the level of your heart for two or three hours a day. If you can’t comfortably raise the area in such a way, then at least try to keep it parallel to the floor.

There are a number of variations and add ons to R.I.C.E. but we tend to think of this as the essential info. One important question we do get asked a lot, though, is: ‘Can I also use a heat pack?’ And the answer is… ‘Yes and no!’ Ice is better immediately after you injure yourself because heat can encourage bleeding. Stick with cold treatments for at least 48 hours so that you don’t make it worse, and the pain and swelling can begin to abate.

After the first 48 hours or so – and when the injury no longer ‘feels’ hot – it’s probably okay to use heat treatments such as those you warm up in a microwave, wheat packs, sprays, gels and rubs, etc. They all aim to help stimulate blood flow, but do follow the manufacturer’s directions carefully.

So… That’s R.I.C.E. in a nutshell! Please remember that the information we give in Bob’s Bones is very general: we’d much rather see you in person so we can give one-on-one advice. Sloane Square Clinic cannot be held responsible for action or inaction based on these sheets! And remember, this month’s Bob’s Bones was brought to you not only by the letters R, I, C and E but also the numbers 4 and 8!