Treatments

PRICE

PRICE is an acronym used commonly in physiotherapy related to the management of acute injuries. It stands for:

Protect:

Following an acute injury, firstly it is extremely important to protect the injured tissue/joint/body part to ensure no further damage occurs. In the sporting environment this may be through a padded splint or bandage. In every day life this may be a plaster, a bandage, or by de-loading the body part/joint through applying a cast or brace. This allows the tissue to start the repair process and prevents further damage from taking place and making the injury worse. If you have injured your ankle whilst out or playing football then ensure you take all weight off it to prevent further damage. If you break a bone then protection can be applied through the use of a splint, ensuring the area is protected and will not be damaged further.

Rest:

This may include using a sling after a rotator cuff injury to the shoulder, by resting the joint in the very early stages it will allow the tissue to start the repair process without further damage occurring which would cause further complications.


Ice:

Ice is commonly used after an injury to reduce pain, reduce inflammation and swelling. Early ice application has been shown to reduce bruising and improve the repair process. Ice is used commonly for ankle sprains, knee ligament injuries and muscle tears, however the National Institute for Health and Care Excellence (NICE) guidelines for acute low back pain show ice should not to be used for acute low back pain, heat is the preferred method. There is debate to whether ice reduces swelling due to the mechanisms of how swelling is reduced in the body. There is the belief that ice does not help swelling as it shuts down the cells which drain fluid from the tissue (lymph nodes). It is thought that gentle muscle contraction is more beneficial to reduce swelling to the tissue as muscle contraction stimulates the cells (lymph nodes) to drain fluid from the area. Ice has however shown to reduce pain and bruising in tissues by reducing the cells activity. Intermittent ice application has shown to be more effective than continuous application, with 10 minutes on and 10 minutes off, every 2 hours for 24-48 hours after the injury.

Compression:

Compression has been shown to be effective in reducing bleeding to a tissue and consequently reduced swelling. Compression can be applied in the form of a tight support or bandage, however tubigrip is not effective as this is designed to expand with swelling and therefore does not apply the desired compression needed to have a positive effect on the repair process of the tissue. The bandage should be applied firmly, but no so firmly that it causes pain. If you have injured your ankle or knee ligaments following a fall or sports injury, then a tight fitting neoprene support will provide sufficient compression to reduce swelling and aid the repair process.

Elevation:

Elevation is commonly used after an acute injury or after surgery to reduce swelling to an area and allow the tissue to repair more efficiently. It is important that the body part is raised above the area to which the fluid is drained (lymph nodes located in the groin, shoulder, knee). If the ankle is injured it is important to raise the ankle above the knee and groin to allow the most effective drainage to the tissue. If the wrist or elbow is injured it is important to raise the limb above the shoulder to achieve the most effective drainage to the injured area. If you have strained your medial collateral ligament (MCL) in your knee, or undergone anterior cruciate ligament (ACL) reconstruction it is important to keep the knee elevated when possible. This can be done most effectively in lying on your back and putting your leg on a cushion or stool to raise your ankle and knee above your groin. If your have had surgery for carpal tunnel syndrome in your wrist or an ulnar nerve decompression in your elbow then it is important to elevate the area above your shoulder to achieve the most effective drainage. This can be done most effectively through using a 'Bradford Sling', this can be discussed further with you physiotherapist.

If you would like to discuss your problem before booking an appointment please give our physiotherapy team a call, we will do our best to help.