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We hope that you avoid injuries by taking good care of your
body and making sure you are in shape for the performing you
are doing. But if you are injured you should always seek
medical attention to insure that your injury is properly
diagnosed and treated by your health care provider. Many times
you are not able to see the doctor right away and if you
follow the simple rules if R.I.C.E. outline below your
traumatic injury may not take as long to heal and be less
painful until you get care. Please be reminded that this and
any other information on this web site should not be
considered medical advise as only you Medical provider can
provide that. Using any information on this web site
instead of seeking medical advise is not only unwise
but also could lead to more severe medical problems. Always
seek medical attention when injured.
PAPT’s
DANCER CARE PROGRAM
R.I.C.E
Rest
Ice
Compression
Elevation
An acute injury is
categorized as a traumatic incident (e.g. ankle sprain) and
can extend for at least 48 hours after the incident,
some-times longer. It is the most ideal time to utilize
RICE. RICE should be used as your first course of
action for all other injuries as well.
How to differentiate
injuries:
·
Quick
Swelling – if you
have an accident which causes a large amount of swelling
quickly, it is indicative of internal bleeding, possible
broken bones, or server tearing of ligaments. (An example is
twisting an ankle that results in the ankle swelling to the
size of a baseball within minutes of the injury). You should
always have this checked out by a medical professional and x-rayed to make sure there are
no broken bones.
·
Delayed
Swelling – if you
have an injury and the area doesn’t swell for a few hours or
until the next day, it is indicative of joint irritation.
This is usually not as severe as the above injury but if there
is a large amount of swelling or severe pain, you should still
have it checked by your physical therapist or doctor.
·
Muscle
Spasm or Bruise
– if the injury is traumatic but in the muscle belly, this can
lead to spasm of the muscle and pain. This should still be
iced and an attempt should be made to put the limb or body
area in a pain-free position. Proper positioning in addition
to ice can help relieve the spasm. This may also be a
muscle tear and should be assessed by a medical professional
(always
consult an MD or PT if you are unsure about the severity of an
injury)
Purposes
of RICE:
-
Prevent further injury
-
Decrease swelling
-
Decrease pain
-
Enhance healing process
1.
Rest
– As soon as you
injure a body part you need to rest it. That means no dancing,
acting, playing around, walking long distances or any activity
that will increase the circulation to the injured area. You
should rest it for at least 48 hours after an injury. This is
because if you have torn tissue and are bleeding inside your
body or leaking extra cellular fluid into the injured area it
can extend the healing process. The more blood and extra fluid
in the area the longer it take the body to remove it. After 48
hours of an acute injury you can usually start minimal range
of motion of the injured area, but avoid pain and make sure
you don’t overwork the area.
2. Ice
– As with rest, ice
should be applied for at least 48 hours. Ideally for 20
minutes every hour or as much as possible if not every hour.
This also helps reduce swelling and can help shorten the
healing process as well as give an analgesic effect for up to
2 hours. For the first 5 to 10 minutes the ice will be
uncomfortable but after that it will numb the area and it
should only be left on for 20 minutes maximum. You will feel
four steps when using Ice first you will feel cold then
burning, then aching and lastly numbness. Make sure that you
keep the ice on until you get to the numb stage. Also if you
are using artificial packs of ice from the freezer always make
sure they are covered or there is a cloth layer between your
skin and the ice pack, as it can cause frost bite if put
directly on the skin. It is always safest to use ice if you
can. Most of the instant ice packs that you break to make
cold are OK but only get cold enough for about 10 minutes so
you should use 2 of them to get enough cold for 20 minutes.
After 48 hours you can start doing contrast baths that will
also help pump excess fluids out of the area, since you
usually still can’t do much exercises at this time which is
the bodies natural pump. Always make
sure that you warm up
the area before attempting any exercises after icing.
Guidelines for Icing:
- It is
always safest to use ice if you can
- Apply
ice for 20 minutes every hour or as much as possible if not
every hour
- 20
minutes is the maximum time for icing (your body will go
into a hypothermic reaction if left on longer)
- You
will feel 4 steps in the following order when using ice:
- cold
-
burning
-
aching
-
numbness.
Home Instruction for Contrast
Baths
What
is Needed
Two
large pans or containers (at least 4 to 6 inches deep), hot
water (110° F), cold water (65° F), bath towel, and a canning
thermometer.
Preparation of Water
1) Fill
one container two-thirds full with heated water, (110° F).
2) Fill
the other container two-thirds full with cooled water, (65°
F).
Treatment
1)
Submerge either hands or feet into the water,
(3 minutes). Change to the cold water, (1 minute).
2)
Repeat Step #1 two more times.
3) End
treatment in the cold water.
3. Compression
- This is the
component of RICE that most people forget to do and is
probably the most important in minimizing the effects of your
injury. The sooner you use compression, the less swelling you
will have, and the faster you usually will heal. When applying
compression, the best device to use is an Ace bandage. Always
start wrapping from below the injured area up towards the
heart. Once you start wrapping, overlap the Ace bandage by
half its width with each circumference. Lastly, make
sure that you don’t wrap it to tight. The wrap
should be firm.
Guidelines
for Compression:
- The
best device to use is an Ace bandage
-
Always start wrapping from below the injured area up
towards the heart
- Once
you start wrapping, overlap the Ace bandage by half its
width with each circumference
- The
wrap should be firm and not too tight
What
to look for if it is wrapped too tight
·
Blue or purple
color below the wrap
·
Throbbing and
or pain in the area below the injury and wrap
·
The body area below the wrap becomes very cold
4.
Elevation
– This also helps you
decrease the amount of swelling, which in turn helps speed the
healing process. This is done mainly for the extremities.
Since the blood flow in the extremities travels down in the
arteries and then has to return back to the torso through the
veins, you can get pooling of blood and fluids with injuries
as these fluids are now outside the arterial/venous system.
This extra fluid has to travel through the lymph system to
return to the heart. By elevating the extremities so they are
above the heart the blood to the limb travels slower and the
lymph can travel to the lymph gland and then back to the heart
easier. This is why it is a good idea to continue to elevate
the extremity whenever possible until the swelling has
dissipated.
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