What is R.I.C.E. and why do you need it?  One of the most recommended icing techniques for reducing inflammation and treating minor injuries is R.I.C.E., an acronym for rest, ice, compression and elevation.  Best used for pulled muscles, sprained ligaments, soft tissue injury, and joint aches.  Applying R.I.C.E. treatment will decrease pain, inflammation, muscle spasms, swelling and tissue damage.  It achieves this by reducing blood flow from local vessels near the injury and decreasing fluid hemorrhaging as a result of cell damage. 

To administer R.I.C.E. use the following guidelines suggested by the American Academy of Orthopaedic Surgeons:

Rest: Stop using the injured body part immediately.  If you feel pain when you move, this is your body sending a signal to decrease mobility of the injured area.

Ice: Apply an ice pack to the injured area, using a towel or cover to protect your skin from frostbite.  The more conforming the ice pack the better, in order for the injury to receive maximum exposure to the treatment. 

Compression: Use a pressure bandage or wrap over the ice pack to help reduce swelling.  Never tighten the bandage or wrap to the point of cutting off blood flow.  You should not feel pain or a tingly sensation while using compression.

Elevation: Raise or prop up the injured area so that it rests above the level of your heart.

How long should ice be applied while practicing R.I.C.E. for it to be effective?  Nationally certified sports massage therapist, Laurel J. Freeman, B.A. offers this advice on the Road Runner Clubs of America website concerning the four stages of ice therapy:  “There are four official stages to ice.  The first stage is cold, the second is burning/pricking, the third stage is aching, which can sometimes hurt worse than the pain.  The fourth and most important stage is numbness.  As soon as this stage is achieved, remove the ice.  Time duration depends upon body weight.  Twenty to thirty minutes should be the maximum time per area.  If it is necessary to reapply ice, let the skin go to normal temperature or go back to the third stage of aching.”

It is generally recommended to practice R.I.C.E. at intervals of 4 to 6 hours for up to 48 hours after an injury.  Heat treatments are appropriate for some injuries, but should only be considered after inflammation has receded, approximately 72 hours after an injury.  If the body part does not respond to R.I.C.E. therapy within 48, it would be wise to consult your health care provider in the event a serious injury has occurred such as internal bleeding or a broken bone.

For minor injuries, use R.I.C.E. instead of plain ice!

Sources:

Ice Therapy by Laurel J. Freeman, B.A., Footnotes, Road Runner Clubs of America

Rice: Rest, Ice, Compression, Elevation, University of Iowa Health Care

Sprained Ankle, Your Orthopaedic Connection, American Academy of Orthopaedic Surgeons

Giving Injuries the Cold Treatment, Bryant Stamford, PhD, The Physician and Sportsmedicine, March 1996