Your Health Matters
By Claudia Parks, R.N.

TREATING YOURSELF WITH R I C E: Sprains and strains are the most common miseries that afflict the human frame. They include a host of ailments ranging from twisted ankles to wrenched knees, tennis elbow and bursitis stiffened shoulders; they generally strike some part of a joint, harming the ligaments that hold it together, the muscles or muscle tendons that move it or the various cushions that smooth the motions of these parts.

Not everyone knows the proper treatment for a sprain. Too many people, confronted with a twisted ankle, either plunge it into warm water or try to walk it off, or both. Wrong! Heat, unlike cold, encourages blood flow and promotes swelling, while walking it off risks complications.

Part of the confusion comes from the similarity between two words, strain and sprain, and the frequent difficulty of distinguishing one disorder from the other. A strain is any damage to a muscles, or to the tendon anchoring a muscle, that generates pain; it is what you feel when you strenuously exert a muscle that is not accustomed to heavy demands, as when lifting a heavy suitcase, or engaging in an active sport without adequate preparation. They almost always afflict areas near a joint, but not inside it. Strained muscles or tendons will almost certainly repair themselves if given a period of rest without further aggravation.

A sprain, by contrast, is damage to the ligaments, the connectors that bind up joints. It occurs when ligaments are partially or completely torn, and harm is usually done through an accident or because of a sudden blow of the kind often suffered in sports.

A sprain is generally more dangerous than a strain. Any weakening or failure of a ligament may cause further damage by leaving the joint improperly aligned, endangering other parts of the joint such as cartilage. A sprain also generally takes longer to heal. Severe sprains are often difficult to distinguish from fractures- the doctor must order an X-ray to know for sure.

R I C E: The main symptom of all strains and sprains is the same- pain of motion- and the initial treatment is the same. For many of these injuries the initial treatment is all that is needed. Four basic elements are involved: Rest, Ice, Compression and Elevation, best remembered by the acronym RICE. Do this treatment immediately! Do not wait! The quicker the better!

In some cases the first part of self-treatment- staying still- may prove difficult. REST means do not use it! Get off of an ankle- stop wiggling your wrist- don't try to "work it out"!

Get some ICE. Some form of cold is almost always available- a bag of ice cubes, even a cold can of soda. Ice acts as a local anesthetic, relieving the immediate pain of the injury. Second, ice slows or stops internal bleeding from the damaged tissues by forcing blood vessels to contract. This contraction counters the painful swelling, which is caused by blood from surrounding tissues leaking into the damaged area. Never apply ice directly to the skin. Place cubes or crushed ice in a plastic bag and wrap the bag in a towel.

The third component of self-treatment, COMPRESSION, also halts swelling. To compress the injury, wrap an elastic (Ace®) bandage snugly, but not too tight! In applying both cold and compression, take care not to aggravate the injury. Every half hour remove the ice and unwrap the compression bandage to make sure that blood circulation is not impaired: after 15 minutes reapply both bandage and ice.

The fourth element, ELEVATION, is particularly useful in reducing the swelling of ankle and knee injuries. The best elevation should be higher than your "heart level"! Raising a hurt elbow or wrist about heart level helps reduce swelling. If it is impractical to keep the arm that high, a sling will help by reducing blood flow and preventing unnecessary movement.

It is "vital" to follow the RICE treatment on all sprains and strains- IMMEDIATELY! You may need to be off of your ankle or not use your wrist for several days- don't rush it! Many doctors will order warm soaks after 3-4 days- which can help the body to absorb the bruising/swelling. You can take acetaminophen (Tylenol®) or ibuprofen, etc. for pain. You will need to be your judge- it takes time to heal!

Even if you are going to the doctor or ER for your injury - do the RICE treatment--immediately! Splint what appears to be a broken bone, ice and elevate!

Claudia Parks, RN, is a former doctor's office and emergency room nurse and retired as an educator from Fulton County Schools. She writes Your Health Matters as a public service; the information here is designed to help you make informed choices about your health. It is not intended as a substitute for the advice of your physician. Claudia and her husband now make their home in the north Georgia Mountains. Claudia can be reached at yhm@windstream.net.