Injuries

 

R.I.C.E. stands for Rest, Ice, Compression, and Elevation. Doing these things helps limit pain and swelling after an injury. R.I.C.E. also helps injuries heal faster. Use R.I.C.E. for sprains, strains, and severe bruises or bumps. Follow the tips on this handout and begin R.I.C.E. as soon as possible after an injury.

 Rest

Pain is your body's way of telling you to rest an injured area. Whether you have hurt an elbow, hand, foot, or knee, limiting its use will prevent further injury and help you heal.

 Compression

Putting pressure (compression) on an injury helps prevent swelling and provides support.

  • Wrap the injured area firmly with an elastic bandage. If your hand or foot tingles, becomes discolored, or feels cold to the touch, the bandage may be too tight. Rewrap it more loosely.

  • If your bandage becomes too loose, rewrap it.

  • Do not wear an elastic bandage overnight.

 Ice

Applying ice right after an injury helps prevent swelling and reduce pain. Don't place ice directly on your skin.

  • Wrap a cold pack or bag of ice in a thin cloth. Place it over the injured area.

  • Ice for 10 minutes every 3 hours. Don't ice for more than 20 minutes at a time.

 Elevation 

Keeping an injury raised helps reduce swelling, pain, and throbbing. It also speeds healing. Elevate the injured area whenever possible.

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Important Note: Do not give aspirin to children or teens.

Strains and sprains happen when muscles or other soft tissues near your bones stretch or tear. These injuries can cause bruising, swelling, and pain. To ease your discomfort and speed the healing of your strain or sprain, follow the tips below. Remember, a strain or sprain can take 6 to 8 weeks to heal.

To help reduce pain and swelling, ice, wrap, and raise the injured area.

To help reduce pain and swelling, ice, wrap, and raise the injured area.

Ice First, Heat Later

  • Use ice for the first 24-48 hours after injury. Ice helps prevent swelling and reduce pain. Ice the injury for no more than 20 minutes at a time.

  • Apply heat after the first 48 hours. Heat relaxes muscles and increases blood flow. Soak the injured area in warm water or use a heating pad set on low for no more than 15 minutes at a time.

Wrap and Elevate

  • Wrap an injured limb firmly with an elastic bandage. This provides support and helps prevent swelling. Don't wear an elastic bandage overnight.

  • Elevate the injured area to help reduce swelling and throbbing. It's best to raise an injured limb above the level of your heart.

Medications

  • Over-the-counter medications such as aspirin, acetaminophen, or ibuprofen can help reduce pain. Some also help reduce swelling.

  • Take medications only as directed.

  • Rest the area even if medications are controlling the pain.

Rest

  • Rest the injured area by not using it for 24 hours.

  • When you're ready, return slowly to your normal activities. Rest the injured area often.

  • Don't use or walk on an injured limb if it hurts.

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Treatment depends on where and how badly your ankle has been broken. A cast may be used to hold the bone in its proper position for healing. Sometimes the sections of broken bone must first be realigned. This is done by a process known as reduction. The type of reduction is based on how far the bone has moved from its normal position.

Sites of common ankle fractures

Sites of common ankle fractures

 

Closed Reduction

If you have a clean break with little soft tissue damage, closed reduction will probably be used. Before the procedure, you may be given a light anesthetic to relax your muscles. Then your doctor manually readjusts the position of the broken bone.

Open Reduction

If you have an open fracture (bone sticking out through the skin), badly misaligned sections of bone, or severe tissue injury, open reduction is likely. A general anesthetic may be used during the procedure to let you sleep and relax your muscles. Your doctor then makes one or more incisions to realign the bone and repair soft tissues. Screws or plates may be used to hold the bone in place during healing.

Casting the Fracture

To make sure the bone is aligned properly, an x-ray is taken. Then the ankle is put in a cast to hold the bone in place during healing. You'll probably have to wear the cast for 4 to 8 weeks. For less severe fractures, a walking boot, brace, or splint may be all that's needed to hold the bone during healing.

The Road to Healing

Once your fracture has been treated, your doctor will tell you how to help it heal. You may be told to limit ankle use, take medications, and elevate the foot. If you have a cast, remember to keep it dry.

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The ankle is one of the most common places in the body for a sprain. Landing wrong on your foot can cause the ankle to roll to the side. This can stretch or tear ligaments. Ankle sprains can occur at any time, such as when you step off a curb or play sports. Once you've had an ankle sprain, you may be more likely to sprain that ankle again.

When Ligaments Tear

Your ankle joint is where the bones in your leg and foot meet. Strong bands of tissue called ligaments connect these bones. Muscles run from the lower leg across the ankle into the foot. The ligaments and muscles help keep the ankle joint stable when you move. If you twist or turn your ankle, the ligaments can stretch or tear. This is called a sprain. A sprain can be mild, moderate, or severe. This depends on how badly the ligaments are damaged.

Symptoms

Your symptoms depend on how badly the ligaments are damaged. You may have little pain and swelling if the ligaments are only stretched. If the ligaments tear, you will have more pain and swelling. The more severe the sprain, the less you'll be able to move the ankle or put weight on it. The ankle may also turn black-and-blue, and the bruising may extend into the foot and leg.


Treatment will depend on how bad your sprain is. For a severe sprain, healing may take 3 months or more.

Right After Your Injury: Use R.I.C.E.

Rest: At first, keep weight off the ankle as much as you can. You may be given crutches to help you walk without putting weight on the ankle.

Ice: Put an ice pack on the ankle for 15 minutes. Remove the pack and wait at least 30 minutes. Repeat for up to 3 days. This helps reduce swelling.

Compression: To reduce swelling and keep the joint stable, you may need to wrap the ankle with an elastic bandage. For more severe sprains, you may need an ankle brace or a cast.

Elevation: To reduce swelling, keep your ankle raised above your heart when you sit or lie down.

Medication

Your doctor may suggest an oral anti-inflammatory medication, such as ibuprofen. This relieves the pain and helps reduce any swelling. Be sure to take your medication as directed.

Contrast Baths

After 3 days, soak your ankle in warm water for 30 seconds, then in cool water for 30 seconds. Go back and forth for 5 minutes. Doing this every 2 hours will help keep the swelling down.

Exercises

After about 2-3 weeks, you may be given exercises to strengthen the ligaments and muscles in the ankle. Doing these exercises will help prevent another ankle sprain. Exercises may include standing on your toes and then on your heels and doing ankle curls.

Ankle Curls

  • Sit on the edge of a sturdy table or lie on your back.

  • Pull your toes toward you. Then point them away from you. Repeat for 2-3 minutes.

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A sprain injures ligaments (tissue that connects bones to bones).

A sprain injures ligaments (tissue that connects bones to bones).

A strain injures muscles or tendons (tissue that connects muscles to bones).

A strain injures muscles or tendons (tissue that connects muscles to bones).

Most minor strains and sprains can be treated with self-care. But if you have torn tissue or damaged blood vessels, nerves, or bones, be sure to call your doctor. Recovering from a strain or sprain may take 6-8 weeks. Your self-care goal is to reduce pain and immobilize the injury to speed healing.

Call Your Doctor If:

  • The injured joint won't move, or bones make a grating sound when they move.

  • You can't put weight on the injured area, even after 24 hours.

  • The injured body part is cold, blue, or numb.

  • The joint or limb appears bent or crooked.

  • Pain increases or doesn't improve in 4 days.

  • When pressing along the injured area, you notice a spot that is especially painful.

Support the Injured Area

Wrapping the injured area provides support for short, necessary activities. Be careful not to wrap the area too tightly. This could cut off the blood supply.

  • Support a wrist, elbow, or shoulder with a sling.

  • Wrap an ankle or knee with an elastic bandage.

  • Tape a finger or toe to the one next to it.

Use Cold and Heat

Cold reduces swelling. Both cold and heat reduce pain. When using cold or heat, always place a towel between the pack and your skin.

  • Apply ice or a cold pack 10-15 minutes every hour you're awake for the first 2 days.

  • After the swelling goes down, use cold or heat to control pain. Don't use heat late in the day, since it can cause swelling when you're not active.

Rest and Elevate

Rest and elevation help your injury heal faster.

  • Raise the injured area above your heart level.

  • Keep the injured area from moving.

  • Limit the use of the joint or limb.

Use Medications

  • Aspirin reduces pain and swelling. (Note: Don't give aspirin to a child 18 or younger unless prescribed by the doctor.)

  • Aspirin substitutes can reduce pain. Some substitutes reduce swelling, too. Ask your pharmacist which substitutes you can use.

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A joint is the place where your bones come together. Normally, bones glide smoothly within your joints, allowing a wide range of motion. But a bone can be pushed or pulled out of position. This is known as a dislocation. Dislocation prevents normal joint movement and can be very painful. Prompt treatment is crucial.

An X-ray of a dislocated shoulder joint.

An X-ray of a dislocated shoulder joint.

 

Causes of Dislocations

Dislocations can happen to almost any joint. But they're most common in the shoulder, jaw, elbow, and finger. Dislocated elbows occur most often in children. Many dislocations result from trauma, such as a blow or fall. But some can happen during normal activities. You can dislocate your jaw just by yawning or laughing. And a shoulder can dislocate during the act of throwing a ball.

When to Go to the Emergency Room (ER)

A dislocation needs emergency care. Injuries that aren`t treated promptly take longer to heal and may result in lasting damage to the joint. Seek medical help right away if you:

  • Have severe pain in a joint.

  • Can't move the joint normally.

  • Can see the misplaced bone.

  • Have numbness or tingling.

  • Have a break in the skin over the painful joint.

To help reduce swelling and pain due to a dislocation:

  • Apply ice to the joint (keep a thin cloth between the ice and your skin).

  • Raise the injured area above heart level if you can.

What to Expect in the ER

  • You will be given pain medication to make you more comfortable.

  • The joint will be examined and an x-ray may be taken to check for fractures or other injuries.

  • The joint is put back into place.

  • A dislocated finger or elbow may be splinted to keep it from moving while it heals. An injured shoulder may be placed in a sling.

  • A second x-ray may be done before you leave the hospital.

  • In some cases, you may be referred to a bone specialist (orthopaedist). He or she will make sure you heal properly.

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When one car hits another, each person's body is thrown toward the impact, then away from it. This is whiplash. Even at slow speeds, the wrenching force puts stress and strain on the spine, especially the neck. The weight of the head stretches and damages muscles and ligaments, and may pull spinal bones out of line.

Symptoms of Whiplash

A wide array of symptoms can follow an auto accident. Symptoms may appear right away, or may not show up for weeks or even months. An injury may be present even if you don't have symptoms. This is called "hidden" whiplash. If symptoms are present, they may include:

  • Pain, especially in your neck, shoulder, arm, or lower back

  • Arm or leg numbness

  • Stiffness

  • Headache

  • Dizziness

Treating Whiplash

You may be asked to do one or more of the following:

  • Ice the injured area for 24 to 48 hours. Do this for 20 minutes. Repeat 5 times a day.

  • After 48 hours, apply moist heat on the injured area for 20 minutes. Repeat 5 times a day.

  • Wear a cervical collar for as long as recommended.