Patient Education

R.I.C.E.

Physiotherapy in Canada for Injury Care

Swelling can be managed by using RICE, which stands for Rest, Ice, Compression and Elevation.

REST

Resting an injury reduces pain and swelling, but knowing how long to rest is the key.  Minor problems can quickly worsen if a joint or limb is used too soon because further injury is caused.  For the initial 24-48 hours after an injury you will want to rest, but after that modified activities can be started.  Pain should be used to gauge the amount of activity you do following an injury.  If you experience pain while doing activities, then you are aggravating the condition and should stop and rest.  Generally, you should avoid strenuous activities or those that cause pain.

ICE

Ice is used to numb pain and reduce swelling.  Best results are achieved if crushed ice, either in a plastic bag or a towel, is applied directly to the injured area. When using frozen gel packs, a damp towel should be placed on the skin prior to application.  While they are reusable and economical they can reach a much lower temperature than ice and can cause frostbite if applied directly to the skin.  Instant, crushable cold packs are convenient, but can become expensive, and often do not stay cold long enough to be effective.  You will find that a bag of frozen peas is the best ice pack around. 

A good rule for acute injury management with ice is 15 minutes on, then approximately 15 minutes off, or until the skin temperature returns to normal temperature.  However, smaller body parts (i.e. finger and more superficial injuries) require a shorter time for ice treatment. For example, the recommended ice time for a sprained finger may be 5-7 minutes but an injury to your upper thigh could be 10 - 15 minutes. If the skin area you are icing becomes too pink the ice may have been on too long.  These applications can be frequent for the first 24-72 hours after injury.  Ice application is particularly effective if applied in combination with compression and elevation.


COMPRESSION

Wrapping an injured joint with a tensor bandage compresses the tissues which helps to decrease swelling.  If your fingers or toes turn blue or become numb, the wrap is too tight, and should be loosened and reapplied.  Always apply a tensor wrap starting at the lower part of you limb and wrap in a direction that works towards your trunk; i.e. to wrap your knee you would start below your knee and wrap towards your hip.  This directional wrapping encourages swelling to leave the area via the lymphatic system.  Compression wraps should be applied as soon as possible after an injury, and should be rewrapped every 2-3 hours.  Ice can be applied while the compression wrap is on.  Sleeping with a compression wrap is not advised as numbness or lack of blood flow could occur without notice leading to damage of the tissues.

ELEVATION

Lying or resting with the injured joint propped higher than your heart will also reduce swelling.  This enables gravity to help with the lymphatic drainage (decrease in swelling).
 
Besides RICE your doctor may offer other methods of reducing inflammation.

MEDICATION

Medications are often prescribed to decrease pain and inflammation.  You should always consult your doctor before taking any new medications.  Some medications can act as both pain-relievers and anti-inflammatories.

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