Understanding first aid for soft tissue injuries

You’ve seen it referred to many times in these columns. Rice is not just a dietary starch staple, but an acronym that stands for rest, ice, compression and elevation — a first line of defense for any soft tissue injury (sprains, strains, contusions and pulled muscles), dislocations and some fractures.

Early treatment with RICE — as soon as possible after the injury — relieves pain and swelling, and promotes healing and flexibility to return our young athletes to the games they love. Fractures, sprains and strains need to be immobilized and dislocations reduced or put back into the joint, but RICE helps minimize swelling regardless of the injury.

Our athletic trainers are well-schooled in the application of RICE during games and practice, but RICE is a therapy that should be continued at home to maximize its effectiveness.

Let’s break down each of its four components to show how they should be used and why they are beneficial.

REST — it only makes sense to rest the injured muscle, tendon, ligament or other tissue to protect it from further injury, and speed healing. We often see our trainers helping an injured player off the field to avoid putting weight on the injured body part. Sometimes, we may need crutches to keep weight off the leg, knee, foot or ankle. An injury to the hand, wrist, elbow or arm may require a cast or splint to immobilize the injury, making sure it is adequately rested.

ICE — Sudden exposure to cold reduces blood flow to the injured area by contracting the blood vessels and capillaries. Blood collecting around the injury lengthens the time it takes for the injury to heal. Constricting the blood vessels limits the accumulation of fluid around the injury site to reduce swelling and provide short-term pain relief.

Ice can safely be applied by wrapping cubes in a towel or using an ice pack. Even a bag of frozen vegetables will get the job done. For injuries to small areas such as the finger or toe, you can soak them in a bucket of ice water. We do not recommend applying ice directly to the skin. Ice should be applied to the injury for 15-20 minutes at least three times a day. Allow the skin to warm before you reapply.

COMPRESSION — Light pressure from an elastic wrap, such as an ACE bandage, prevents blood and other fluids from accumulating at the injury, which retards healing and fails to decrease swelling. If the bandage is wrapped too tightly, swelling can increase. Increased pain and throbbing are indications that the compression needs to be rewrapped more loosely.

ELEVATION — Make gravity work for you. Elevation of the injured area at or above heart level pulls fluid away from the damaged site to control swelling and enhance healing. In some cases, the injured body area can be elevated by propping it on a pillow.

RICE is considered first aid treatment although the therapy probably will continue after you see your physician. Some soft tissue injuries take weeks to heal. Once the pain and soreness goes away and the swelling subsides, you’ll most likely need physical therapy to strengthen and stretch the damaged tissue, and regain flexibility.

Non-steroidal anti=-inflammatory medications (NSAIDS), such as Advil, Motrin and Aleve, may also help reduce pain and swelling, but we do not recommend aspirin to our young athletes because it raises the risk of Reye’s syndrome, a rare but deadly disease that causes swelling of the brain and liver.

If you hurt after playing or practice use RICE to minimize the pain and seek medical attention as necessary to be back in the game.

Dr. Sergio Ulloa, DO, is an orthopedic surgeon and sports medicine with OhioHealth Orthopedics and Sports Medicine. He also serves as a team physician for the Ohio University athletic department. You can send him an email at [email protected]

In a first aid course in Canberra with Canberra First Aid we will explain soft tissue injuries and the differences between these and broken bones. We will also teach you how to treat sprains in a first aid course in Canberra.

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