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RICER First Aid: Sprains & Fractures

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Sharon McCulloch

RICER is an acronym for a method of treating acute injuries like sprains and strains. Throughout this article, we will uncover some interesting facts and frequently asked questions about the RICER method for Sprains and Fractures. We also cover soft tissue injuries in our first aid courses, which you can book by clicking this link.

So what exactly does r.i.c.e.r mean? R stands for Rest, I stands for Ice, C stands for Compression, E stands for Elevation, and R stands for Referral. This technique helps reduce pain and swelling and promotes healing.

RICER first aid is the steps used to manage acute soft tissue injuries. Following the RICER first aid steps can help reduce swelling and promote faster soft tissue injury healing. When someone experiences an acute soft tissue injury, such as an ankle sprain or knee sprain, it’s important to administer immediate first aid to alleviate discomfort and encourage healing. 

What Are The RICE Steps In First Aid?

RICER First Aid acronym 

Ricer stands for

Rest – Encourage the casualty to stop any activity and make them comfortable. This means minimising movement to prevent further damage to the area.

Ice – Apply an ice pack wrapped in a cloth to the injured area. This helps to reduce pain, inflammation, and swelling by constricting blood vessels and numbing the area. It is important to wrap the ice pack in a cloth to avoid direct contact with the skin before you apply ice, which could cause frostbite. 

Compression – If available, apply an elastic compression bandage over the injured area to limit swelling and provide support. Applying the compression bandage not too tightly to promote blood flow is important, as it’s important to increase circulation. A compression bandage that is too tight could further damage the area and cause additional pain, but it is important to compress the injured area firmly. Ensure the skin is clean and dry.

Elevation – Keep the injured area elevated, above the heart height if practical – which helps reduce blood flow and limit swelling. 

Refer Refer the injured person to a medical professional such as a doctor, to have the area looked at, especially if the injury is severe, persistent or accompanied by unusual symptoms such as numbness, tingling or loss of movement.

Following the R.I.C.E.R protocol can help reduce pain and swelling and promote faster healing of acute soft tissue injuries. If the injury is extreme or persistent, seeking medical attention is essential to ensure proper management and avoid complications.

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What Is H.A.R.M?

H.A.R.M. is a first aid acronym to remember the activities to avoid after an acute soft tissue injury. It stands for

Heat: Avoid applying heat to the area as it can increase inflammation, worsening the injury.

Alcohol: Avoid consuming alcohol or applying it to the area, as it can increase bleeding and delay healing.

Running or Exercise: Avoid physical activities that may cause further damage.

M – Massage: Avoid massaging the area as it can cause further damage to the tissue.

Massage: Avoid massaging the area as it can cause further damage to the soft tissue.
Avoiding H.A.R.M. activities and using the harm protocol can help prevent additional damage and promote faster healing of soft tissue injuries while keeping the casualty comfortable.


Joints are the points in the body where two or more bones meet. They allow motion and flexibility in the body, enabling us to perform various activities such as walking, running, and lifting objects. Joints can be classified into three main types based on the degree of movement they allow: immovable (synarthrosis), slightly movable (amphiarthrosis), and freely movable (diarthrosis).

The most common type of joint in the body is the synovial joint, characterised by a joint capsule filled with synovial fluid that lubricates and nourishes the joint. Our body has different types of synovial joints, such as hinge joints, ball-and-socket joints, and pivot joints, each with its unique structure and range of motion. Maintaining healthy joints is essential to overall physical health, and this can be achieved through regular exercise, a healthy diet, and proper joint care.

RICER first aid strains Joint Injuries

Common Joint Injuries

Joint injuries are quite common and can be caused by various factors such as trauma, overuse, or degeneration. RICER is crucial when dealing with these common injuries. The most common joint injuries that require RICER intervention include sprains, strains, dislocations, soft tissue injuries and fractures. Still, it’s crucial you know your first aid for Australia’s most common sports injuries to be able to assess and treat each situation appropriately.

Prompt RICER application is essential to prevent long-term damage and ensure a full recovery from joint injuries. Joint injuries can cause various symptoms, such as discomfort, swelling, stiffness, and reduced mobility. Depending on the severity, management typically involves a combination of rest, ice, compression, elevation, pain management, and physiotherapy. Remember, RICER is the key to managing joint injuries effectively and preventing more damage.

Signs And Symptoms Of Dislocations

A dislocation generally occurs when a bone is forced from its normal position within a joint. The signs of dislocation can vary depending on the injury’s location and the dislocation’s severity. Still, some common signs and indicators include

  • Pain: Dislocations typically cause significant sudden pain, which may be intense. It will generally worsen with movement or when pressure is applied.
  • Swelling: Dislocations can cause swelling and bruising around the joint, which may result from damage to the surrounding tendons, ligaments and soft tissues.
  • Deformity: A dislocated joint may appear visibly deformed or out of place. In some cases, there may be a visible bump or protrusion where the bone has moved out of its normal position.
  • Limited range of motion: Dislocations can cause a loss of mobility in the affected joint. The joint may feel stiff and may be difficult to move, or it may feel unstable or loose.
  • Numbness or tingling: Dislocations can sometimes cause nerve damage, resulting in numbness, tingling, or weakness in the injured limb.
  • Weakness: Dislocations can cause weakness or instability in the affected joint, making it difficult to bear weight or perform everyday activities.

Management Of Dislocations

When managing a dislocated joint, RICER first aid should be applied immediately to reduce the ache and swelling and promote proper healing.

In some cases, imaging tests such as X-rays or MRIs may be necessary to assess the extent of the damage and determine the appropriate treatment plan. Pain relief medication may be prescribed to alleviate discomfort, and an ice pack or a cold compress may be applied to reduce swelling.

After the joint is back in place, immobilising the area with a sling, brace, or cast is crucial to promote healing and prevent further injuring yourself, ensuring you keep the injured area elevated. Physical therapy and rehabilitation, including exercises, will help to restore the range of motion, strength, and function of the affected joint may also be recommended.

Surgery may sometimes be necessary to repair any damage to the joint or surrounding tissues and facilitate the healing process, so seeing a doctor is important if needed. Remember, RICER is key in managing a dislocated joint and ensuring a successful recovery.

Sprains And Strains

A sprain occurs when a ligament (tissue that connects bones) is stretched or torn, while a strain happens when a muscle or tendon is stretched or torn. Dislocations happen when a bone is displaced from its normal position in the joint, while fractures refer to the breakage of bones within the joint.

Signs And Symptoms For Strains And Sprains

Strains and sprains are common injuries that can affect anyone, from athletes to everyday people. The signs of strains and sprains can vary depending on the severity of the injury. Still, some common indicators include

  • Aches: Strains and sprains can cause mild to serious discomfort depending on the extent of the injury.
  • Swelling: The area may be swollen and tender to the touch.
  • Stiffness: The area may be stiff and difficult to move.
  • Bruising: The injured area may develop bruises or discolouration.
  • Limited range of motion: The injured area may have a limited range of motion or be difficult to move without pain.
  • Weakness: The area may feel weak or unstable, making it difficult to bear weight or use normally.

It is important to note that strains and sprains can range from mild to severe and can take time to heal, so seeing a doctor if symptoms persist is recommended. Early diagnosis and injury management can help prevent further damage and promote a quicker recovery. Remember, if you suspect a strain or sprain, use RICER immediately and seek medical attention to have it checked. 

Management Of Strains And Sprains RICER Treatment

RICER stands for Rest, Ice, Compression, Elevation, and Referral. The first step is to rest the area to prevent further damage and promote healing.

The second step is to apply ice or a cold compress to the area for 20 minutes every 2-3 hours to reduce pain and swelling. Compression should be applied using a bandage or wrap to support the affected area and reduce swelling. The area/affected limb should also be elevated above the heart to reduce swelling. Prompt RICER is crucial in managing strains and sprains to ensure a successful recovery and prevent further injury.

Soft Tissue Injuries

Soft tissue refers to the body’s muscles, tendons, and ligaments, which can become injured through overuse, trauma, or degeneration. These injuries can cause pain, swelling, and a limited range of motion. Acute soft tissue injuries can include strains, sprains, and contusions. 

The severity of a soft tissue injury can range from mild to extreme and take time to heal. Damage to soft tissue typically involves RICER first aid, which includes rest, ice, compression, elevation, and referral to a trained medical professional. Seeking prompt medical attention to have your injury checked and deciding on a treatment plan can help promote proper healing and prevent further injury.


A contusion, also known as a bruise, is caused by a direct impact or force on the body that results in bleeding and compression of the underlying soft tissue. Although the skin is not broken, the area may appear discoloured due to the bleeding and become swollen. Contusions can vary in severity, and some may take longer to heal than others. Rest and ice are often recommended to manage the symptoms and promote healing. However, if the contusion is extreme or you have concerns about the injury, it’s best to consult a healthcare professional for appropriate treatment.

How Do You Reduce Swelling Fast?

Soft tissue injuries, such as sprains, strains, and bruises, often result in swelling. To reduce swelling, it is recommended to apply ice or a cold pack to the affected area for 15-20 minutes several times daily. Elevating the injured area above the heart level can also help reduce swelling. Over-the-counter anti-inflammatory medications like ibuprofen can be taken to reduce inflammation and swelling. Gentle massage of the surrounding area can also help improve circulation and reduce swelling. Resting the injured area and avoiding activities that may aggravate the injury are important. If the swelling does not improve, seek medical attention.

What Injury Cannot Be Treated Using The RICE Method?

Do not use RICER if:

  • The injury involves an open wound or bleeding, which may require different procedures.
  • The affected area is numb or has lost feeling, which may indicate a more severe injury such as a fracture or dislocation.
  • The injury is suspected to be worse than a simple strain or sprain, which may require immediate medical attention.
  • The injured person has a medical condition that affects circulation, such as peripheral artery disease, as the RICE method may impede blood flow and worsen the condition.

Can Too Much Ice Make An Injury Worse? And When Should You Not Use ICE?

Yes, too much ice can make an injury worse. While ice can help with discomfort and swelling by constricting blood vessels and slowing down the inflammatory process, excessive use of ice can have negative effects.

While the RICER method is commonly used to treat soft tissue injuries such as strains and sprains, some situations may not be appropriate.

Prolonged exposure to ice can cause tissue damage and even frostbite. Additionally, if ice is applied too long, blood flow to the area can be reduced, impeding healing. Overuse of ice can also cause stiffness and hinder the area’s range of motion.

Why Does My Injury Hurt More After ICING?

Some common reasons your injury hurts more after icing the area are

  • Nerve sensitivity,
  • Cold-induced Vasodilation,
  • Delayed inflammation,
  • Incorrect icing technique.

How Long Should You Rice An Injury?

You can use the RICE method for up to 72 hours after an injury.

Does Ice Help Swelling After 3 Days?

Ice can still help reduce swelling even after 3 days, but the effectiveness may depend on the severity and duration of the swelling, as well as the underlying cause of the swelling.

Is RICE Evidence-Based? 

Recent research has challenged the efficacy of the RICE protocol and questioned its use as a standard treatment approach.

Disadvantages of the RICE method
Several studies have found that ice may not be as effective as previously thought in reducing inflammation and pain after an injury. 

Disadvantages Of The RICE Method

Several studies have found that ice may not be as effective as previously thought in reducing inflammation and pain after an injury.

Does Ice Delay Healing?

Some studies have found that the cold temperatures from the ice may decrease blood flow to the affected area, which can slow down the healing process by reducing the delivery of oxygen and nutrients to the area. Additionally, some studies have suggested that ice may also inhibit the activity of immune cells involved in the healing process.

However, it’s important to note that the use of ice in injury management is still a topic of debate among healthcare professionals, and there may be situations where it is still appropriate to use. It’s always best to consult a healthcare professional for guidance on the best treatment approach for your injury.

What Happens If You Ice More Than 20 Mins?

It’s important to follow the recommended guidelines for icing an injury, which typically involves applying ice for 15-20 minutes each time, with at least an hour break between applications. If you have concerns or questions about using ice to treat an injury properly, it’s always best to consult a healthcare professional.

Is Heat Better Than ICE For Injury?

Injuries often lead to inflammation and swelling, and ice is used to reduce this swelling by cooling down the affected area. On the other hand, heat can cause the opposite effect and is not recommended during the acute phase of an injury. Heat therapy is better suited for use during recovery as you work to regain your full strength and mobility.

What Is The New RICER Protocol?

The P.O.L.I.C.E. (Protection, Optimum Loading, Ice, Compression, Elevation) protocol is a recent update to the RICE method. It is now used to treat ankle sprains, knee sprains, tendonitis, back pain, bruises, and contusions.

The content on this website offers general insights regarding health conditions and potential treatments. It is not intended as, and should not be construed as, medical advice. If you are facing a medical emergency, dial 000 immediately and follow the guidance provided.

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