RICE

Original Editor - The Open Physio project.

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Introduction

RICE is an acronym that stands for Rest, Ice, Compression and Elevation and is a way to remember the correct management in the first 24 hours following acute soft tissue injuries involving damaged blood vessels. Minimising bleeding inthis way at the injury site is important because the application of a more aggressive intervention, for example, Massage, will cause further tissue damage. When used appropriately, the RICE approach can improve recovery time and reduce discomfort.

Rest

Rest to reduce the likelihood of further damage to the tissues through increased bleeding, avoid Weightbearing or any strenuous activity involving the injured part, which will increase the time required for tissue to repair.

Ice

Ice will reduce tissue metabolism and also cause blood vessel constriction which will in turn slow down and prevent further swelling, an important consideration when beginning active ROM exercises after the initial period of rest has passed and when pain has been reduced. Note: applying ice for an extended period of time may be detrimental, as blood flow will be reduced excessively and skin burns and nerve damage may occur. There is no good evidence for how long or how often ice should be applied, but systematic reviews suggest that intermittent, 10 minute ice treatments are most effective.

Compression

Compression serves to prevent further Oedema (swelling) as a result of the inflammatory process and also by reducing bleeding. An elasticated bandage should be used to provide a comfortable compression force without causing pain or constricting blood vessels to the point of occlusion. Bandaging should begin distal to the injury and move proximally, overlapping each previous layer by one half. It can also serve to provide minimal protection of the injured body part from excessive movement, although this is not it's primary purpose.

Elevation

Elevation will prevent swelling by increasing venous return to the systemic circulation, and reducing hydrostatic pressure thereby reducing oedema and facilitating waste removal from the site of injury. Ensure that the lower limb is above the level of the pelvis.

Variations

• HI-RICE - Hydration, Ibuprofen, Rest, Ice, Compression, Elevation.
• PRICE, Protect, Rest, Ice, Compression, Elevation (i.e. using crutches to protect the painful part from further injury).
• PRICES - Protection, Rest, Ice, Compression, Elevation and Support (e.g. bandaging or taping).
• PRINCE - Protection, Rest, Ice, NSAIDs, Compression, and Elevation.
• RICER - Rest, Ice, Compression, Elevation, Referral.
• POLICE - Pause, Optimal Loading, Ice, Compression, Elevation.

Recent Related Research (from Pubmed)

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References

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• Brucker, P. & Kahn, K. (2006). Clinical Sports Medicine (third edition). McGraw Hill Australia, Pty. Ltd.
• RICE (medicine). (2008, October 21). In Wikipedia, The Free Encyclopedia. Retrieved 09:02, January 17, 2009, from http://en.wikipedia.org/w/index.php?title=RICE_(medicine)&oldid=246661676