Have you ever been told to “R.I.C.E it” after you’ve been injured? What about doing no H.A.R.M?
R.I.C.E and H.A.R.M are handy acronyms used to assist in the initial management of musculoskeletal injuries – but what do they involve?
R.I.C.E stands for rest, ice, compression and elevation and is to be performed for 2-3 days following the initial injury. It can help reduce pain, swelling and inflammation at the injury site.
H.A.R.M stands for heat, alcohol, running, and massage and is a guide for what NOT to do when managing an injury. After following R.I.C.E it’s important to do no H.A.R.M.
Following R.I.C.E and avoiding H.A.R.M after an injury will significantly increase your chances of a complete recovery.
As with all injuries, it is important that you rehabilitate them properly to restore full function.
To put it simply – if it hurts, don’t do it!
Rest involves protecting the injured area by avoiding activities that increase pain levels. This doesn’t mean you shouldn’t move at all, it means you should avoid things that noticeably increase your pain either during or after the activity.
It may also involve using a gait aid (e.g. crutches), a brace or taping to reduce load and further protect the injured area.
The best way to apply ice is using crushed ice through a damp tea towel/cloth or a plastic bag. Ice can be applied directly onto the skin – it may not be comfortable, but it is effective!
As a general rule, ice should be applied for 20 minutes every 2 hours (including nights!). This time may change depending on the method of ice application as well as the site of the injury, and how close it is to the surface of the skin. Ice reduces the injured tissues’ temperature, decreasing pain and the extent of damage in the tissues surrounding the injury.
This is simple: use a bandage (most commonly a tubular bandage or ‘Tubigrip’) during daylight hours to reduce swelling. If you experience pins and needles, numbness, or colour change in the skin, the bandage is too tight and needs to be removed! Remember to remove it at night.
By elevating the injured limb above your heart, (e.g. resting a sprained ankle on a pillow while lying down), inflammation and swelling in the injured area are minimised.
Applying heat to an injury increases blood flow to the region, increasing the swelling. Avoid hot baths/showers, hot water bottles, wheat bags and liniment rubs in the first 48-72 hours post-injury.
Drinking alcohol after an injury similarly affects the body as heat, increasing swelling by dilating your blood vessels. Minimising swelling is important in speeding up your recovery process, so it is best to avoid alcohol post-injury.
Any form of exercise too soon is detrimental to the healing tissues. Blot clot/haematoma formation may be compromised – blood flow will increase to the region, and healing times will be longer.
Your Physio will advise you on a suitable return to exercise program for your individual recovery.
Massage performed over the affected area may increase trauma and swelling if not carried out by a professional. Oedema massage performed by a qualified Physiotherapist reduces the swelling and small vessel bleeding in the area.
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