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RICE Your Strains and Sprains

The weekend basketball game turned painful when your ankle twisted and popped. You hobbled off the court and your friends told you to RICE your ankle. RICE stands for Rest Ice Compression Elevation.

According to Randall Howell, DO, FACOEP, Director of the Emergency Room at Barnes-Jewish West County Hospital, RICE should start immediately after a minor injury, such as a sprain, strain, bruising or a pulled muscle to help relieve pain and keep the area from swelling. When there is an injury, he says, fluid can collect in the area of the injury. This extra fluid causes swelling and, if there is enough extra fluid, the pain may worsen. The earlier the RICE treatment is started after an injury, the better it works.

Dr. Howell says, “Do all four parts of the RICE treatment together. If there is still pain when using the injured part after one or two days, call your physician. If the injury is serious, such as internal bleeding or a broken bone, do not wait -- go directly to the emergency department.”

Rest: Reduce or stop using the injured area for 48 hours. If you have a leg injury, you may need to stay off of it completely.

Ice: Put an ice pack on the injured area for 20 minutes at a time, four to eight times per day. Areas with little fat and muscle, such as fingers or toes, should only have ice on them for about 10 minutes. Use a cold pack, ice bag, or a plastic bag filled with crushed ice that has been wrapped in a towel. A one-pound package of frozen corn or peas makes a good ice pack. It is lightweight, conforms to the injured area, is inexpensive and reusable. Applying ice more than 20 minutes may cause cold injury. Frozen gel packs are colder than ice, so they should only be left on for 10 minutes.

Compression: Compression of an injured ankle, knee, or wrist may help reduce the swelling. You can use bandages such as elastic wraps, special boots, air casts and splints. Ask your doctor which is best. Wrap the injured area with an elastic bandage, but not so tightly that the blood is cut off. It should not hurt or throb. Fingers or toes beyond the bandage should remain pink and not become "tingly." The elastic bandage should be taken off every four hours and reapplied.

Elevation: Keep the injured area elevated above the level of the heart. Use a pillow to help elevate an injured limb.

To make an appointment with Dr. Randall Howell or a team of Washington University emergency physicians call 314-996-8472.

Patients are seen at:

Barnes-Jewish West County Hospital
Emergency Room
12634 Olive Blvd.
St. Louis, MO 63141

Randall Howell, DO, FACOEP

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