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Article written by:

Adrian Deans
Senior Physiotherapist
B.Physio, Hydro. Cert., Member APA.

Well winter sport season is with us again and so too are the numerous sports strains and sprains that are a common occurrence.

As such it is timely to remind all athletes about acute injury management. Many people remain confused over when to use ice or heat and what is the best thing to do when an injury occurs.

Most soft tissue injuries result in damage to muscles, tendons or ligaments through impact or overstretching. This results in bleeding and the initial inflammatory response in the tissues. The best management for such injuries is remembered by the acronym R.I.C.E.R. The RICER regime should be followed for the first 48 hours following injury to reduce bleeding, swelling and further injury to the damaged part. This results in less tissue damage and an injury that is easier to rehabilitate and a quicker return to sport. R.I.C.E.R. stands for Rest, Ice, Compression, Elevation and Referral.

  • REST – rest the injured part from further sport participation and any other activity that would use that part. For a lower limb injury this may involve the use of crutches or a sling for an upper limb injury.
  • ICE – apply an ice pack wrapped in a wet cloth, for good cold penetration and decreased risk of ice burn, to the injury site for 20 minutes every two hours. This can be uncomfortable initially especially in the winter months but will soon go numb and is an important component in reducing bleeding into the tissues.
    • COMPRESSION – apply a firm broad elasticized bandage to the area to reduce swelling. This can be over the ice pack while icing but should not be so tight as to cause pain. Generally compression bandages should not be worn to bed overnight.
  • ELEVATION – elevating the injured part higher than the heart reduces blood flow to the area and encourages return of venous blood and lymph.
  • REFERRAL – Professional advice should be sought early to correctly diagnose the injury and order any further testing that may be required including x-ray. Your Physiotherapist can also direct the next phase of rehabilitation and return to sport.

Another acronym is also important to remember. During the first 48 hours you should do no H.A.R.M. That is apply no Heat, consume no Alcohol, do not Rub or massage the part, and avoid excessive Movement as these things can increase bleeding and swelling in an acute injury and make the injury worse in the long term.

Injuries are never fun but are a common occurrence in sport and even activities of daily living. Being fit for your sport, doing a thorough warm up and stretching routine prior to the event and using correct equipment can all help to minimise the risk of injury. But should they occur, following the correct RICER and no HARM routines will ensure minimising the injury and a quicker recovery.

Enjoy your winter sports everyone!

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