P.R.I.C.E. or Protection, Rest, Ice, Compression, Elevation
P.R.I.C.E. is still the recognised first approach to treatment of any acute injury and includes protection, rest, ice, compression and elevation.
“P” is for Protection
This usually relates to on the field of play – Protect the injured area to prevent further injury.
“R” is for Rest
Allow an injury time to heal. Don’t be brave and play through the pain. Allow rehabilitation time for even a small injury. So rest from sport, but do the exercises you are given, this does not mean you must sit down and do nothing, if the injury is to your upper limb, as soon as you can run without pain then start running.
“I” is for Ice
Apply ice, an ice pack, or even a pack of peas on the injury. This reduces the pain and inflammation. It is advisable to wrap the ice pack in a cloth to prevent cold burns on the skin. Never sit on or put compression on to an ice pack, I have seen some nasty ice burns from people sitting on or leaning against an unprotected ice pack. Apply for 10 – 20 minutes every 2 – 3 hours in the first 3 days. You can reduce the frequency when swelling subsides.
“C” is for Compression
Compression of the injured area will help reduce swelling. Use a stretchy bandage, or tubi- grip. Ensure that when applying compression there is more pressure on the bandage below the site of injury and that it gradually reduces as the bandage comes closer to your chest – this is to ensure that there is no tourniquet effect which would cause swelling below the site of injury, I have seen cases where swelling gathers around the knee and causes problems there when the injury was in the thigh. Never apply a non-stretchy bandage around a limb in a continuous strip as this could cause a tourniquet.
“E” is for Elevation
Elevate the injured area so that it is above the heart to reduce the flow of blood to the area and reduce swelling, too often the limb is only raised level with the hip, this does not facilitate drainage of excess fluid in the injured area. Do not elevate an injured area if this causes excessive pain. Elevation is the final phase of the P.R.I.C.E. treatment regime for the acute injury.
Acute Injury Treatment in Kilkenny Physio Clinic includes
Manual Lymphatic Drainage (MLD)
If the physiotherapist has shown you how to do Manual Lymphatic drainage, do this as prescribed. Since we began introducing MLD to the acutely injured athlete we have observed a significant reduction in unnecessary side effects of acute injuries.
Anti-inflammatory gel can be applied to the injured area after 24 hrs. It is not advisable to apply anti-inflammatory gel or take anti-inflammatory medication within the first 24 hours after acute injury as the body’s natural response to any injury is to produce a local inflammatory reaction which is a necessary part of the healing process after any acute injury.
Acute Injury Advice
A chartered physiotherapist will be able to give you specific advice regarding your injury. Do not wait until the injury settles or the swelling goes down, it is only a myth that a physiotherapist can not treat you at this stage. In Kilkenny Physiotherapy and Sports Injury Clinic we believe that the earlier we see you with an acute injury the better as we can give you specific exercises and advice for your injury, strap it in the correct way, give you alternative safe activities to do while your acute injury is healing and we can help speed up your return to sport by preventing you from doing things which will ultimately delay your return to sport.
H.A.R.M. factors FOR ACUTE INJURY
H.A.R.M. stands for Heat, achohol, running and massage and these are not recommended in the first 48 hours after any injury as they have a harmful effect as below.
“H” is for Heat
Never apply heat to an injured area in the first 48 hours. There is a natural inflammatory process which must occur, after any acute injury, in order for healing to begin to take place. Heating the injured area while this process is taking place will cause increased blood flow to the area and increase the damage done.
“A” is for Alchohol
Alcohol is harmful to any acute injury. It may cause increased bleeding in the area. Unfortunately quite often at the end of a season if a player sustains an injury in their last event of the year, they can neglect the acute injury and indulge in a few pints, it really is best not to do this as it can slow down the recovery process.
“R” is for Running
Activity on an acute injury will increase the blood supply to the area and worsen the injury. We say running with reference to a lower limb acute injury, but if it is an upper limb injury then using the arm should be avoided.
“M” is for Massage
Under no circumstances should the area be massaged in the first 24 hours as this will increase the swelling and bleeding in the area. I have seen cases where a kindly “bagman” may “rub it out”, and I have seen a case where a player was rushed to hospital when his leg swelled up due to massage on an acute injury. He subsequently spent several days in hospital on a drip to stop the bleeding.
This does not include Manual Lymphatic Drainage which is only superficial and will help draw swelling away from the area.
© Theresa McGinn Acute Injury Care