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RICE Therapy- Help! My arm's fallen off!
"First Aid" from Sports and Work Injury Theory
by Dr. Gary Eaton

This isn't one of Paul's vegetarian recipes involving chilies and bush cooking. It's how to tend those aches and pains that come along from time to time. When you've pushed it a little beyond the limit and your body is rebelling, here are a few tips to get your body back on your side direct from our very own "DoubleDoc" Feelgood. This article applies to minor aches, pains, and soreness. Specific items will be addressed as Gary and I expand the series. If you're thinking about it too, the answers "No!" Gary can't do anything about Paul's socks. ~Eric

You've just thrown a personal best in the preliminaries of the distance competition qualifying for the finals in two days! Yeah Baby! Everything's going your way. As you raise your arm in triumph, it promptly falls off! Noooo! Actually, it's still attached, but there's a sore area. Whew! There's no chance of professional help, and you want to keep from making it worse before the finals.

What would be a good physical strategy?

R.I.C.E. THERAPY to the rescue!

"R" is for REST. This is physiological rest like a splint, cast, crutch or bed rest. The goal is not using the affected area until full evaluation and a more definite treatment plan is determined.

"I" is for ICE. More specifically, DO NOT USE HEAT. Cold is applied with an insulating layer of towel or as an immersion (maybe in cool stream water) for 15 to 25 minutes then removed for at least as long before re-application. Cold reduces swelling, retards pain and inhibits inflammation. Use of focal heat, like an electric heating pad, could be dangerous. Heat can cause burns and it increases swelling. Just avoid heat. A couple of days after the injury one might soak the whole body in a hot tub without adverse results.

"C" is for COMPRESSION. This includes proper application of an elastic bandage or neoprene splint. Not too tight! Be careful not to impede circulation and to re-check for impaired blood flow or abnormal sensation periodically after application. Loosen or remove as necessary. It's too tight if you go numb distal (away) from the wrap, if it changes color, or gets cooler than the other side of the wrap. Compression is probably of more value for the first day or two after injury or re-injury. If you're not sure what's "too tight", be safe and loosen it.

"E" is for ELEVATION. Keeping an injured extremity above the heart can control swelling, bleeding and after-effects of an injury. Keep this in mind.

Simple "R.I.C.E. therapy is sensible initial treatment while getting to proper medical care. Apply as many of these methods as you safely can, and you may reduce the aggravation of the injury and keep your arm attached.

Gary Eaton D.O. is a board certified physician in the US specializing in Physical Medicine & Rehabilitation (PM&R) and Pain Medicine. He worked for nearly 10 years as a firefighter and paramedic. Beginning to fly fish as a teen in Colorado with a Herter's bamboo 5wt (which he still has), in the last few years he's been instructing formally and earned his CCI certification from the FFF in 2006. "I continue to learn."

The information contained in this writing is general in nature and does not imply a doctor:patient relationship of any sort. All are advised to seek qualified medical help before instituting any treatment measures. Health conditions of a particular individual could make all or part of the information provided inappropriate for a given person. The author,, and affiliates assume no liability nor responsibility regarding this information or it's use.

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