When you Injure Yourself Have RICE , RICE and More RICE.

Hello and welcome to Orthopaedics Made Simple , Making No Bones About It! This is Naveen , your bone and joint guy and in this episode I'm going to talk to you about the benefits of RICE , the primary and immediate factor in the treatment of any trauma.

Oh wait , wait it is not this rice 

But rather this one

Now for the details.

R for REST

If a person sustains an injury , the first principle should be 

This is a Latin phrase meaning FIRST ,DO NO HARM! So for any injury the first thing to be done is that place should be RESTED. This could mean avoiding movement in that are or restricting any load or pressure falling on to that area. The reasons why this immobilisation is important are 

1) Pain reduction

2) Prevent fractured bones from displacing

3) Reduce blood loss

4) Protect soft tissues

5) Protect vital organs and structures

Neck Splint

For instance a person sustaining an injury to the neck , all efforts should be made to ensure the neck is stabilised and any movement is avoided. Even a one inch movement in the neck bone could mean the difference between full recovery and complete paralysis or maybe even life and death.

Useful method for Shoulder and Arm and ElbowIinjuries.

If the upper limbs are injured please ensure that they are splinted and immmobilised in the methods given below , even using items like newspaper or cloth that are available at home

Newspaper and cloth splint for the Forearm

Those with injuries to the spine or back are to be carried carefully , preferably on a spine stabilisation board. if that is not available , at least a flat surfaced board which is level and does not let the patient move too much

Spine Transport Board

Those with lower limb injuries too are splinted and in addition no weight bearing is allowed.

Rest is also important as a part of the treatment for some conditions to let the affected parts heal better and faster. 

Lower Limb Splinting

And an important thing to be noted is Please , please do not rub or massage or apply anything on the injured part unless and until you are sure what it is. At SCOT we have seen a lot of patients whose injuries were worsened after undergoing such unwanted manipulations. I have seen fractures that would have healed easily being complicate because the patient's family decided to rub it with oil and turmeric.

I for ICE

Ice treatment is most commonly used for acute injuries. If you have had a recent injury (within the last 48 hours) where swelling is a problem, you should be using ice. Ice packs can help minimize swelling around the injury, reduce bleeding into the tissues, and reduce muscle spasm and pain.

Ice packs are often used after injuries like ankle sprains have occurred. Applying an ice pack early and often for the first 48 hours will help minimize swelling, and decreasing swelling around an injury will help to control the pain. Ice treatments may also be used for chronic conditions, such as overuse injuries in athletes. In this case, ice the injured area after activity to help control inflammation. Never ice a chronic injury before activity.

You can make ice packs with ice cubes in a plastic bag or wet tea towel; a pack of frozen peas or our milk packets are also ideal and can go in and out of the freezer. Never place ice directly on an injury; keep the pack moving to avoid ice burns. Never treat with ice for more than 30 minutes, and remove the pack immediately if the injury appears bright pink or red.

Precautions while using Ice Packs:

Don’t use cold packs:

• over areas of skin that are in poor condition
• over areas of skin with poor sensation to heat or cold
• over areas of the body with known poor circulation
• if you have diabetes
• in the presence of infection

There is always a query from patients who come to SCOT ,whether one should use Ice or Heat. Please note that Heat is used only for long term conditions and not for recently sustained injuries .

C for COMPRESSION

1. Most injuries tend to do well with Compression and the various uses of Compression are as follows:

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1. Less edema - Edema is the fluid collection and the fluid buildup can also slow down the healing process and inhibit the movement if the injury is at or near a joint. Compression combined with elevation can help reduce this excess fluid in the body.

1. More oxygen - Injured tissue requires oxygen for it to repair itself. However, swelling can inhibit the flow of blood to an injury, slowing down the healing process. Active compression helps improve blood flow, thereby enhancing the delivery of oxygen to damaged tissue.

1. Faster tissue repair - The combination of reduced swelling and delivery of oxygen and nutrients to the injury site enables more rapid tissue repair and an overall faster healing.

1. Less swelling - Inflammation and swelling are not only uncomfortable, they can also inhibit the healing process. Compression therapy is proven to help reduce swelling, especially in combination with cold therapy.

1. More nutrients - Active compression helps stimulate the flow of lymph fluid, which carries vital nutrients, to the damaged tissues surrounding the injury. Lymph fluid is also important for removing waste from cells and body tissues, an important function during the tissue regeneration process.

Compression also reduces bleeding in that area. The bleeding can be external or internal where the small blood vessels known as capillaries can be damaged and the continuously leak blood in to the injured area.

But the precaution is that the compression should not be too tight so as to compromise the blood supply or cause damage to nerves or the skin. Always look out for discolouration in the part after the compression , increase in pain or any tingling sensation or numbness.

E for Elevation:

Whenever and wherever possible if there is an injury , it can be a sprain or a fracture....always keep the injured part above the level of the heart.

Lower Limb Elevation

Upper Limb Elevation

This is important so as to reduce pain and also swelling. And the benefits of reduced swelling have been explained above.  The lower limbs can be elevated with the pillows keeping the patient in a lying down position. If elevation is a part of a prolonged treatment strategy then it is better to elevate the foot end of the bed with wooden blocks.

So that's it folks. remember RICE whenever there is an injury and that is the best you can do for the person sustaining the injury.. You can also catch my podcast on www.anchor.fm/orthomadesimple . If you have any queries please do leave them in the comments section below. www.ScotOrtho.com is our website

Until the next time .Keep Moving Always .....Without Pain