Acute Injury Management: What Does the Acronym PRICE Stand For?

When dealing with a sports injury or similar type of injury, many people are familiar with the R.I.C.E. protocol for injury care. R.I.C.E. stands for Rest, Ice, Compression, and Elevation and has long been used when treating everything from sprained ankles to banged up knees. With acute injury patients, experts recommend adding “P” for protection because protection of the area it absolutely vital in the healing process. It is important that this is implemented as soon after the injury as possible and it should be maintained for anywhere from 24 hours to 72 hours afterwards. Of course, this depends on the severity of the injury.

P is for Protection: Injuries hurt and pain can be a good thing because it prevents you from further injuring that area. It encourages you to protect it.

It is important to listen to your body and protect the injured area through full or partial immobilization and restricted use. The way you do this depends on the body part.

An arm or shoulder injury can be protected with the use of a sling. An ankle injury may require a brace or splint and you may have to avoid or limit weight bearing for a while. This means using crutches a walker, or a cane.

R is for Rest: The body needs rest in order to heal. This could mean complete rest, but in many cases it means what is known as “relative rest.” This means that it allows for enough rest to heal but is not completely restrictive which could slow or inhibit recovery.

This means avoiding activities that are stressful to the area to the point that they cause pain or that they might compromise healing. Many times, though, some movement is a good thing, even beneficial. Some gentle movements can actually speed recovery.

Isometric contractions of the muscles and joints that surround the injury and even some range of motion exercises can help. The key is to keep the movements gentle and to listen to your body for guidance on how much and how far to push.

I is for Ice: Cryotherapy, or cold treatments can come in the form of actual ice, or there can be other types such as a cold soak. When treating acute injuries at home, the best known, and probably easiest way is to put some crushed ice in a freezer bag with a zip lock closure and wrap it in a small towel to keep the pack from directly touching the skin.

Frozen vegetables, like green beans, peas, or edamame work well too – just remember to use the towel as a barrier between the skin and the pack. You should not use the pack more than 10 to 15 minutes as a time. The recommended cycle is 10 to 15 minutes on and 1 to 2 hours off.

In some cases, you may not be able to apply ice directly to the site. In those cases, you can apply the pack at the joint above the affected area. For instance, a tightly wrapped ankle can still benefit from ice, you just apply the ice pack to the back on the knee on the same leg.

C is for Compression: A compression wrap can offer mild support and reduce swelling. Typically, an elastic bandage is used to compress or apply pressure to the injured tissue.

When applying a compression bandage, start it several inches below the area that is injured. It should be applied directly to your skin.

Use some tension as you wrap, but not to the point that it cuts off circulation (characterized by tingling or numbness and the soft tissue should not change color). Wrap the bandage in a figure eight configuration or spiral, depending on the area, stopping a few inches above the injury.

E is for Elevation: When an injured joint or extremity is not elevated, fluid can pool in the area and swelling can occur. This can lead to increased pain and limited range of motion. Elevation helps prevent these things from happening and can even help to speed up recovery.

The key to elevation is positioning the injured area at a level that is above the heart. The most effective way to accomplish this is to keep the area elevated as much as possible while awake and prop it up with pillows while sleeping for at least the first 24 to 48 hours. Some injuries may require more time though, so listen to your body.