What is RICE-treatment?

On the court Sophie is lying in agony. Something has happen! Is it a sprained ankle, a pulled muscle or something else? The match is stopped and you bring the player to the replacement area (is possible). Otherwise call for an ambulance or a doctor.
Now you ask the player where it hurts, and if it is a sprained joint or pulled muscle, the RICE treatment can be started.
Locate how much damage without doing it worse. There is no reason to turn a sprained finger around and ask if it hurts - of course it hurts. In stead press gently around the injured area and ask the player where the center of the pain is.

By injuries in joints and muscles the tissue is damaged by twisting, tearing or pressure. The pain occurs because the small nerve fiber in the area is effected and the small blood vessels will also be damaged and blood will seep out into the surrounding tissue. At the same time injuries in joints may cause an accumulation of fluid and due to this an increased pressure occurs in the area and together with the bleeding the pain will grow due to the increased swelling. Therefore first aid is first of all to limit the bleeding, so that the swelling does not grow too big. If you can reduce the swelling you also reduce the time for the injury to heal.

The RICE-principle consist of:
R - Rest (stop all activity)
I - Ice (cooling)
C - Compression (pressure/tight binding with an elastic bandage)
E - Elevation (lift the injured area up)

REMEMBER - RICE-treatment must not be performed directly on open wounds)

REST
In order not to mage the injury worse, the injured area must be spared at once. The pain is the body's warning signal that something is broken and must be taken seriously. Many exited trainers and players think, that when it doesn't hurt so much anymore they are ready to play on, but here it is the trainers responsibility to take care, that it does not happen, if the injury has caused swelling or continued activity causes pain. When the player is brought down again because of a weak, injured ankle the damage is often much worse. Make sure that the injured player is brought home, especially if it is the legs that are injured. Nor is it wise to let a player with sprained wrist drive home on a bicycle. Get in contact with the parents or others if possible and inform them what has happened.

If there is a suspicion that the injury is worse that it looks, then a visit to the casualty department can be recommended. In this case it is important that the parents are contacted and you can tell about your suspicion. They will then arrange that the player be brought to examination. If you cannot get in touch with the parents the responsibility is yours and you must arrange the player be brought to the casualty department.

ICE
Cooling down is the next point in the treatment. Use a thin piece of cloth to place between the skin and the cooling bag in order to avoid frost damage on the skin - or better - wrap an elastic binding around the spot. Then place the ice bag on the injury and wrap the rest of the elastic binding around the ice bag so it is completely covered. By this the ice bag keeps it's cooling effect longer (see Compression). The treatment with ice should last for about 30 minutes - with deeper injuries longer yet.

COMPRESSION
Compression means pressure from the outside and is the most important part to reduce the bleeding. The pressure prevents further seeping of blood. The pressure must be held for about 30 minutes together with ice. After that the pressure must be maintained the first 24-36 hours, maybe longer, if there is tendency to further swelling.

Tip: By an injury on the ankle it is good to know if the pain is greatest if the foot is turned inwards or outwards. If the pain is greatest if the foot is moved outwards, the binding is placed in such a way, that it draws the foot away from the hurting.

Attention: The compression must not be so strong that the blood transfer is stopped. If a blue colour appears or a feeling of numbness occurs, the binding must be loosened. The binding must anyhow be loosened or removed under sleep.

ELEVATION
Elevation means raise of lift the injured place in the air. This reduces the blood pressure in the injured area and the risk of blood seeping reduced. At the same time it has a pain relieving effect. If the effect of lifting the injured area have any effect, it must be above heart level - at best 30 cm or more, as it reduces the pressure. The lesser pressure - the lesser bleeding.

When must you as a trainer take action with first aid? The question is difficult to answer, as it always depends on the concrete situation. Often it is difficult for even an experienced person to give full information about an injury after the accident. A front fall on the hands may give a sprained wrist, but it can also break the "boat bone" in the wrist. The symptoms are the same, but such a fracture can be difficult to see even on an X-ray picture. Fact is however that a minor injury can develop to a serious injury by continued activity and no treatment. The main rule must therefore be: Rather give first aid once to many than once to few.

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