Arfon Physiotherapy

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Management of Soft Tissue Injury with P.R.I.C.E.R

Protect Rest Ice Compression Elevation Referral

PROTECTION

Should be applied during the early stages of the healing process, the duration to be indicated by severity of pain and extent of injury (3-5+ days).

Avoid the complete immobilisation of the part where possible, and should be capable of accommodating swelling e.g. crutches, splints, taping and braces

REST

Should be immediate after injury.  Stress on injured tissue should be avoided in the early inflammatory stages and the duration will vary from 24 hours to a week depending on extent of injury.

Isometric work may be performed within limits of pain, and overall activity should be reduced to avoid an increase in metabolic rate and an increase in blood flow

ICE

Should be applied immediately, use a damp towel and oil between ice and skin to avoid ‘ice burn’.  Maximum time 30 minutes.  In the first 24 hours no more than 5 minutes at a time repeated often.  After 24 hours, 10 -20 minutes every 2 hours, depending on the amount of subcutaneous soft tissue.  The ice should cover the entire area of injury.

Do not use ice if you have lost sensation or suspect nerve damage or have any contraindications to the use of ice.

COMPRESSION

Should be applied from distal to proximal, in a spiral fashion with overlap.  Uniform pressure should be applied.  Compression should extend well above and below the injured area.  Must be capable of accommodating swelling.

Reapply after 24 hours for first 72 hours, remove compression immediately if you suspect the distal circulation is decreased.  Ensure to protect susceptible anatomical points e.g. suitable materials – cohesion bandage, tubigrip, elastic adhesive bandage.

ELEVATION

As much as possible in the first 72 hours with support, and as soon as possible after injury.  Be aware that quick reversal of elevation can increase swelling – rebound phenomemon, if possible to sustain elevation then do not apply compression simultaneously.

REFERRAL

If in doubt consult a medical professional as soon as is practicably possible.  In the event of having any recurrent problem, prevention is better than cure – find out what is happening.

Never H.A.R.M an injury

No Heat, no Alcohol, no Running (or exercise sufficient to cause stress on tissue), and no Massage.

All of the above will potentially increase the circulation to an area which is not viable and therefore increase swelling and bruising, resulting in the injury taking longer to recover.