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Sports Medicine | Feb 27, 2019

R.I.C.E. is the acronym best known for treating sprains and strains of the joints. Rest, Ice, Compression and Elevation are the four steps recommended to minimize swelling, reduce pain, improve appropriate circulation and speed healing. However, this process can often be overlooked or omitted in the case of the common turn of the ankle, leading to more issues as joints age.

The National Athletic Trainers Association notes that an estimated 28,000 Americans twist their ankle daily – amounting to more than ten million sprains or strains every year. For many athletes, ankle sprains seem like simply part of their chosen sport, as it is believed that up to 45% of sports injuries are related to the ankle. R.I.C.E. should always be applied promptly, but unfortunately many athletes fear being benched and ignore what they see as only a minor pain or inconvenience. According to International Ankle Consortium, many patients skip R.I.C.E. altogether when they suffer an injury to their ankle, choosing instead to “walk it off”.   

This can lead to serious issues later in life, as once the ankle is sprained, the chance of future sprains increase. Over time, the risk of osteoarthritis in the ankle joint keeps rising, so young athletes are well advised to take recommended course of action when an injury to the ankle joint occurs.

What is the difference between a strain and a sprain?

  • An ankle sprain occurs when there is a tear in the ligament
  • An ankle strain occurs when there is a tear in the muscle

The best course of action is to have an injured ankle joint examined by a professional as soon as possible after it occurs, to determine how badly the ligament or muscle has been injured. In most cases, R.I.C.E. will be recommended. The Mayo Clinic lists the R.I.C.E. protocol:

  • REST:  This doesn’t have to mean complete inactivity. Use of crutches can keep weight off of the injured joint, and activity can be resumed for the rest of the body, such as working out on an exercise bike using the uninjured leg and allowing the injured ankle to simply ride passively on the other pedal.
  • ICE: Ice the area as soon as possible after the injury, and repeat icing in 15-20 minute segments every 3-6 hours over the course of the next two days until swelling improves. Protect the ankle from direct contact with ice to avoid nerve damage.
  • COMPRESSION: A compression wrap or ankle sleeve made of elastic or neoprene is the best option for proper compression. Make sure the sleeve is correctly sized or the wrap applied correctly – circulation shouldn’t be cut off.
  • ELEVATION: The injured limb should be carefully raised above the heart whenever possible to help limit swelling; this can be accomplished with pillows stacked to form a ramp that raises the ankle at a gentle incline to avoid straining back muscles.

It’s always a good idea to have a sports or orthopedic specialist check out the ankle joint as soon as possible, to rule out more serious injury. Complying with R.I.C.E. recommendations before and after the doctor visit can allow the ankle to recover more quickly.