Rest, Ice, Compression and Elevation (RICE): A First Aid Staple

The first four steps of first aid for injuries such as ankle sprains are known by the acronym "RICE," which stands for rest, ice, compression, and elevation:

• Rest. When your child is injured, small blood vessels at the injury siterupture and cause tissue bleeding, which, in turn, causes bruising andswelling. Because the swelling can produce more damage than the initialinjury, it is important for your child to stop exercising immediately because moving forces more blood into the damaged area. Not only is rest important in the period immediately after your child is injured, but adequate rest is necessary before your child returns to sports. Returning too soon from an injury can cause further damage and result in a chronic, long-term condition, such as chronic ankle instability, even permanent disability. (Note: not all kids swell; even if there is no visible swelling or bruising, pain is an indicator of injury and means that rest is needed)

• Ice. Apply ice continuously for the first 15 minutes to keep the swelling down, then 10 minutes on, 10 minutes off for the first hour. Wrap the ice in a towel or elastic wrap before applying to the injured area. Do not apply the ice directly to the skin [see sidebar]. Because ice is so important, make sure that someone brings ice to every practice and game. Bettter yet, to be on the safe side, bring your own! Remember: ice is the best anti-inflammatory around; if pain returns when your child returns to play, kids should use it liberally.

• Compression. To prevent swelling, wrap the injured area with an elastic ("ace") bandage. Make sure the wrap is snug, but not so tight as to cut off circulation. (i.e. fingers and toes turning blue)

• Elevation. For leg injuries, raise the injured area above the athlete's heart to keep more blood moving to the injured area. This helps prevent painful swelling in the immediate post-injury period.