RICE Treatment for Swelling

The RICE (rest, ice, compression, elevation) method commonly used after many types of body injuries, particularly sports injuries, is recommended by physicians and physical therapists everywhere, and for good reason.  Hands down, when performed after an acute injury, the RICE treatment is the best way to reduce pain and discomfort for the patient and prevent further damage to an already injured area.  In this post, we will discuss the process the body goes through after a joint is first injured, along with a discussion of each phase of the RICE method in order for patients to further understand how, when properly executed, each RICE step can help them recover as quickly as possible.


Anatomy of an Injury

When an individual incurs a soft tissue injury such as an ankle sprain or perhaps a strain of another area such as a knee or elbow, the body immediately develops an internal response.  Blood vessels near the injured area go through a process called “vasodilation”, increasing blood flow in and around the injured area.  As the capillaries around the damaged muscle, tendon, or ligament open they release histamines and other toxins, all of which can cause redness, pain, and swelling.  On the plus side, increased blood flow around an injured area delivers increased oxygen and nutrients to help repair the injured tissue, as well as carry away metabolic wastes and excess fluids.  However, although the increase in blood flow is the body’s attempt to begin the healing process, the greater the swelling of the injured area, the greater pain and discomfort experienced by the individual.

Step 1 – Rest

The “R” in the RICE method of injury treatment stands for “rest”.  If an individual continues to use an already injured part of their body, they will only increase the likelihood of increasing their pain and increasing the level of tissue damage.  The best way to speed the healing process in order for an individual to get back to their normal activity level is to rest the injured area, especially in the first 24 to 48 hours after an injury.

Step 2 – Apply Ice

The second step of the RICE method is the application of ice to the injured region.  Applying ice reduces redness, pain, and inflammation by slowing down the flow of blood to the injury, thus reversing the vasodilation process.  Ice should never be applied directly to bare skin.  Instead, wrap ice in a towel or washcloth and only apply it for a period of 10-15 minutes at a time, with a break of about 10 minutes in between.  The ice pack should feel cool to the skin, not freezing.  Repeat the ice on/ice off process as much as possible within the first 24-48 hours after injury.


Step 3 – Compression

The third step in the RICE method is compression or bandaging of the injured area.  Snuggly wrapping the injured ankle, knee or elbow helps to reduce swelling as well as reduce pain and discomfort.  A medical bandage such as an ACE bandage is a great choice for wrapping injuries.  The bandage should be secure but not so tight as to cut off blood flow.  Loosen the bandage if the underlying skin turns blue or feels cold, numb, or tingly.

Step 4 – Elevation

Elevating the injured body part above the level of your heart helps to decrease blood flow, thus helping to reduce pain, inflammation, and swelling.  Elevating an injured body part above the heart harnesses the natural effect of gravity by making it harder for the excess blood to travel to the injured area. In addition, gravity also helps speed the histamine and toxin-filled blood down and away from the injury.

The best way to elevate an injured area is to rest in bed or on a couch and prop up the injured body part with pillows underneath.  With rest and elevation for the first 24-48 hours, along with ice and compression, individuals can maximize their body’s ability to heal while reducing their pain and discomfort.

Pro Tip:  If you have a lower extremity injury be sure to regularly pump your ankle.  This will cause your calf muscles to assist in pushing excess fluid away.  For an upper extremity injury, squeezing a stress ball will have a similar effect.


If you would like to know more about treating strains and sprains, please contact Cawley Rehab at 570-208-2787 or email us at:  cawleyptfrank@gmail.com.

Written by:  Dr. Tim Dymond DPT