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Published on August 1st, 2011 | by Papa Doc

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RICE – pre-game meal or something better?

RICE – pre-game meal or something better?

Everyone knows about RICE – or do they? Often, instructions for treating injuries include the acronym R.I.C.E. But what exactly is that, and more importantly, do you know why R.I.C.E. is so important? Let’s find out.

”R“ stands for rest, ”I“ stands for ice, ”C“ stands for compression, and ”E“ stands for elevation.

What’s important about each?

Rest is the single most important ”treatment“ for injury initially, but one of the truly under-used. Most healing is done in the injured part itself if left undisturbed. But ”wanna skate, can’t let my team down, so little time for skating, or I’m tough and can deal with the pain“ are among the excuses we hear. Unfortunately, a lack of rest early for a shorter period often leads to a longer down time later due to a nagging injury. Note: we stress rest of the injured part but not general inactivity. There are often alternative exercises that don’t stress the injured part but keep you in shape (i.e., aquatic aerobics or bike riding). You should talk with your medical team, trainer, or coach for suggestions.

Ice reduces both pain (by its local anesthetic effect) and swelling. Compression reduces swelling. Elevation reduces swelling. Note that the last three have in common – reducing swelling. Swelling of the tissues after an injury occurs from bleeding and tissue fluid leakage into the tissue injured. Swelling produces pain, slows healing, and reduces motion in the injured part.
How do you actually do R.I.C.E.?

In general, rest until pain gone or minimal AND doesn’t get worse with use. Consult with your medical advisors to get a time frame. You want to rest the injured area until use of injured part is full and relatively pain-free with normal activities and light non-contact practice.

Icing for 20 minutes every 2 – 5 hrs. (depending on the severity of the injury) is recommended until the pain is gone or minimal and swelling and bruising are pretty much gone. Although ice bags are the usual method, consider an ice bath or ice bucket for larger injuries. Ice baths (literally a bath tub full of water and ice) and ice buckets are brutal to get into, but after about 5 – 10 minutes, you’ll wonder why you haven’t done it before! These are particularly good for ankles, knees, hips, thighs, and backs.

Compressing the tissues to prevent bleeding and fluid loss into them is something we don’t do nearly enough. Compression right away can prevent swelling or reduce it significantly as well as ease pain. Using an elastic wrap type of compression for 24 – 48 hours is recommended. Depending on the area involved, you may need some padding to spread the compression evenly (e.g., around an ankle). We use diapers since they are relatively cheap, soft, and moisture absorbent. Larger and deeper bruises may benefit from compression wrapping for a week or so.

Elevating the injured part, where practical, to the level of the heart or above uses gravity to decrease the swelling more rapidly. This should be done as much as possible until the swelling has pretty much disappeared.

So have your pre-game meal and add RICE for a ”treat“-ment.

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