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P.R.I.C.E.
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The acronym PRICE, is an easy way to remember
the four basic methods used to speed minor injury recovery (Protection,
Rest, Ice,
Compression, Elevation).
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PROTECTION
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During the entire rehab, and perhaps longer,
protect the injured area from being hit or bumped. A particularly risky
time is when you are starting to feel better and you forget about the
injured area. For example:
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REST
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Rest is important not only immediately
following the injury but also down the road as well. If you return to
activity too soon you will re-injury the affected area.
- Less severe injuries as well as some overuse injuries, may be rested by merely avoiding any activities which use
the affected body part.
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In order for a musculoskeletal injury to heal, it
needs to be immobilized for 2-3 days following the injury.
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Using the
injured "part" too early can increase hemorrhage, cause further
damage to the area, and prolong recovery.
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Wraps, tape, splints, casts,
canes and crutches can all help keep an injury immobilized.
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ICE
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The best line of defense in most acute, soft
tissue injuries is the application of ICE. Ice decreases swelling,
bleeding, spasm, pain and inflammation and should be applied within the
first 24-72 hours after injury. Here's a brief review of the how, why and
when of ICE therapy: (Do not apply ice directly on skin. Place a thin dish
towel or old t-shirt over injured area.)
- WHY ICE? Swelling causes a lack
of oxygen to local tissues which creates cellular damage. Ice
decreases swelling and bleeding by causing a constriction of blood
vessels; thereby, minimizing the damage. Pain is relieved directly by
its effect on pain receptors and indirectly by a decrease in swelling.
- HOW LONG TO ICE? The amount of
fat between the skin and the injured area and the depth of the injury
determines how long you apply ice. Little fat? A minimum of 10 minutes
will do. More fat? 20-30 minutes max. Brief applications until
numbness is achieved are effective for conditions such as tendonitis,
bursitis or ligament sprains. Longer durations are necessary for
muscle strains. But be careful. Icing an area for too long can cause
tissue damage.
- HOW OFTEN? Two to three daily
treatments for tendonitis-type conditions or superficial
muscle-strains; however, the greater the amount of pain and/or muscle
spasm, the more frequent the applications. Depending on the severity
of the injury, ice can be applied every 1-1 1/2 hrs.
- WHEN TO USE? Immediately after
an injury, up to 72 hours, and for relief of pain and swelling
associated with exercise.
Once the bleeding and swelling has
subsided (usually within 72 hours), "heat", in the form of hot
packs, hot towels, whirlpool baths, and ultrasound, can play an important
part in injury rehabilitation. Heat increases blood flow and the
"stretch ability" of tissues, decreases pain, muscle spasm, and
joint stiffness, as well as promotes soft tissue repair.
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COMPRESSION
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For an acute injury, immediate compression
is important. Direct external pressure applied to the injured area will
help decrease hemorrhage and bleeding.
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Compression can be applied during icing
as well. An elastic wrap can be wrapped around the affected limb, securing
the ice pack. Alternately, the wrap can be soaked in water and frozen.
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Compression should be continued
throughout the day. For difficult areas, such as around the bony areas of
the ankle, pads can be cut and held in place with athletic tape and/or an
elastic wrap.
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Compression should be removed at night and the affected area
elevated above the heart.
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ELEVATION
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Elevation also helps reduce internal
bleeding and swelling.
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The injured area should be elevated above the level
of the heart. This will decrease the bleeding, facilitate venous return,
and prevent the pooling of fluids in the injured area. This is especially
important at night when the body processes slow down.
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