RICE and MICE

Home Treatment for Strains and Sprains Swift and correct treatment of strains and sprains is of great importance if one is to ensure a quick recovery and minimise any lasting problems. Applying appropriate treatment to such injuries is fairly simple, but without the correct knowledge it is easy to do more harm than good. Ideally, an acute injury should be seen as soon as possible by a medical practitioner. However, there is unlikely to be one around when the injury occurs, and in the case of a minor injury people often choose not to see one. This page describes how to treat strains and sprains immediately and during the following days. Bear in mind, however, that although these are the most common of injuries, there can be no guarantee that your injury is a strain or sprain without consulting a medical professional. Strains are the result of tearing of the fibres of a muscle or tendon. They are the most common type of acute injury, caused by over-stretching or impact. Symptoms are bleeding, swelling, pain, dysfunction, heat and redness.

Sprains are the result of a tear in a ligament that supports a joint, caused by a joint being forced beyond its normal range of movement. Symptoms are usually more severe than those of strains. There is considerable swelling and bruising, and much more pain and dysfunction with any attempt to put movement or pressure through the joint. Strains and sprains can be dealt with using the following methods:

The RICE procedure should be followed for the first 24-48 hours after the injury, depending on the severity. RICE stands for:

REST	It is important to get as much rest as possible in the early stages in order to allow the body to heal. Avoid the temptation to move the injured part in order to see if it still hurts.
ICE	Ice should be applied directly to the injury site as soon as possible, as it reduces bleeding and swelling by slowing down blood circulation, and also relaxes the area by reducing pain. Ice or cold packs are cheap and effective. Cold sprays are only worth using if nothing better is available. Ice should be wrapped in a wet cloth to prevent skin burns. Cold should be applied only for limited periods of time (as little as 5 minutes for a small area like the wrist, up to 20 minutes for a large area like the thigh), as too long an application will cause the body to compensate by pumping more blood into the area. When the ice is removed, the skin should look pale. If the skin is red it means that the ice has been applied for too long. Ice can be re-applied once body temperature has returned to normal.
COMPRESSION	Compression should be applied to the injury as soon as possible in order to reduce bleeding. It is best applied using a firm pad over the injury site, with a strapping around it to hold it in place. Ideally compression should not be applied round a whole limb, and certainly not so tightly as to starve other areas of blood.
ELEVATION	Elevation of the injured area should be practised as much as possible in order to help with the removal of swelling from the area through gravity. An arm or leg should be comfortably supported at a level above the torso. Professional massage at this stage, while not strictly necessary, may help to bring down the swelling.

Once signs of inflammation have gone, and heat and redness are much reduced, the MICE procedure should be followed until the injury is healed. MICE stands for: Mobilisation Ice Compression Elevation

MOBILISATION	You can begin by taking the injured part through its full range of movement, avoiding any movements that cause pain. This will prevent wasting of the muscles through lack of use. Once it can be done easily (it could be days before this is the case, so be patient) you should gradually try to increase the range of movement. Then once basic function of the injured part has been restored, it can begin to undertake more exercise. It will take time for the injury to get back to normal strength, so only light, simple exercise should be used at first, gradually building up. If pain is experienced at any time during exercise, it should immediately be stopped. If the pain disappears after 20-30 seconds, the exercise can be continued with caution. If the pain persists, however, then the injured part should be rested immediately for 24 hours, following the RICE procedure, after which exercise can be resumed at an easier level.
ICE	Treatment with ice should continue for about a week, depending on the severity of the injury. After roughly 4-5 days, heat treatment such as hot pads can be applied, provided that inflammation has stopped. This helps the injury by stimulating circulation and thus oxygenating and nourishing the area. Alternating between hot and cold treatments for a minute at a time can also be highly effective.
COMPRESSION	This should be continued for a few days, then gradually reduced to no more than a support bandage as the condition improves.
ELEVATION	This should be done as often as possible until all signs of swelling, heat and redness have disappeared.

How to treat your own strain or sprain