Soft tissue injuries are one of the most commonly encountered by physiotherapists. Appropriate first aid management undertaken at the time of injury helps reduce the pain and discomfort caused by damaged tissue and inflammation, prevents further injury, minimises scar tissue formation, and will ultimately speed up recovery.

The RICE Regimem.

For the first 48-72 hours following acute inury, all soft tissue injuries should be treated with the RICE regimem. "RICE" is an acronym for:

• Rest
• Ice
• Compression
• Elevation

Rest.

Resting the injured part will prevent further tissue damage, allow blood clots to stop bleeding from damaged vessels, and help reduce overall blood flow to the damaged part, thus helping to minimise bleeding and swelling.

Ice.

Icing the injured part also helps to reduce swelling and bleeding by reducing the blood flow to the injured part. It does this by causing constriction of the blood vessels and increasing the viscosity of the blood.

Ice also helps to reduce pain by inhibiting the release of pain causing chemical irritants at the site of injury. Pain may also be decreased via the so called "pain gate mechanism". Stimulation of cold nerve receptors may act to help "block out" the signals to the brain from the pain receptors.

An ice pack can be made simply by placing a quantity of crushed ice into a plastic bag. Never apply an ice pack directly to the skin, as ice burns (frost bite) can occur; a damp towel or bandage should be applied to the skin first.
Ice should be applied for 20-30 minutes every 2-3 hours.

Ice should not be used in the case of vascular disease, elderly, diabetics, or any other condition in which circulation is compromised.

Compression.

This is one of the most important parts of the regimen. Applying an elastic bandage to the injured part will considerably reduce the amount of swelling and bleeding at the injury site.
When applying a bandage, enusre that it is firm but not too tight. Signs that a bandage is too tight are numbness, tingling, or the part distal to the bandage turning cold or pale.

Elevation.

Elevating the part above the level of the heart while resting also helps reduce the blood flow to the area, thus controlling swelling and bleeding.