The P.R.I.C.E. Principles

What Are The PRICE Principles?

Protection
Rest
Ice
Compression
Elevation

The PRICE principles should be applied as early as possible after injury and continued for the first 24-72 hours. PRICE contains the key components required to prevent further injury, limit swelling, decrease pain and help the healing process. When applied correctly PRICE can significantly reduce the recovery time needed for an injury.

PRICE Principles Demonstration


Protection

Protection of the injured area, by limiting movement and use, is vital for preventing further damage. Protecting the area will enable the healing process to start efficiently and effectively. There are a number of ways to protect an injured area, such as a support or splint.


Rest

It is crucial to know when to stop your activity and allow adequate time for the injured area to heal. Repetitive minor injuries often result in a more severe injury, leading to even more time out for rest and recovery.

When a minor injury is sustained during activity there is often an urge to ‘run it off’. This is the assumption that by continuing to participate in the exercise, the injury will simply go away; this is rarely the case and is not advisable as it will likely worsen the injury.

The amount of rest required will depend on the severity of the injury and the type of tissue damaged. For example, a severe ankle sprain that makes walking difficult will need to be completely rested. Whereas a minor “tweak” of a muscle will only require modified activity; no action that uses the injured muscle.


Ice

Cold therapy (cryotherapy) is one of the most widely known and used treatments for acute sports injuries. It is cheap, easy to use and requires very little time to or expertise to prepare. The application of ice to an acute injury can substantially decrease the extent of the damage by:

  • Reducing pain (the pain gate theory).
  • Decreasing the amount of bleeding by closing down blood vessels (vasoconstriction).
  • Reducing muscle spasm.
  • Reducing the risk of cell death (necrosis) by decreasing the rate of metabolism.

Cryotherapy can easily be applied using a bag of crushed ice, frozen peas or a cold pack. It must then be wrapped in a damp tea towel to form a barrier between the bag of ice and the skin; this reduces the risk of an “ice burn”. Do not leave the ice on for more than 15 minutes.

Some areas of the body have superficial nerves just below the skin which can be damaged by applying cold therapy. Ice should not be applied directly to the:

  • Neck
  • Collar bone
  • Front of the hip bone (ASIS)
  • Outer bone of the elbow/knee (Lateral Epicondyle)
  • Kidneys (located just below the ribs towards the back)

Compression

Applying compression to an injured area minimises the amount of swelling that forms after an injury. Compression will increase the pressure within the tissue, thus narrowing the blood vessels (vasoconstriction) and preventing excessive bleeding. It will also reduce inflammation by moderating the amount of fluid (exudate) that the body produces to protect the injured tissue, which can significantly reduce the overall healing time.

Compression can be applied through a number of methods. The most effective is simply an elasticated compression bandage that fits around the affected limb. Compression bandages are easy to apply and the elastic material provides sufficient pressure whilst also allowing for the injured limb to swell slightly.

When applying a bandage you should start at the point furthest away from the heart (distal). Ensure that each turn of layer partially overlaps the previous layer. For example, if you are compressing a thigh then you would start above the knee and work up towards the hip. This encourages swelling to move back towards the heart/centre of the body and be reabsorbed. Ideally, compression should be combined with cold therapy, either manually or by wrapping the ice pack in a bandage.

It’s important that the compression is not too tight and stretches sufficiently, otherwise further damage can occur. A “pins and needles” sensation or skin discoloration/coldness in the area or extremities means the bandage is too tight. Before sleeping the compression should be removed and then re-applied in the morning.


Elevation

Elevation allows gravity to help drain fluid (exudate) away from the injured area. This aids in decreasing swelling and may in turn decrease the pain associated with swelling. For lower limb injuries, keep the ankle elevated above the level of the hip. For upper limb injuries, keep the arm elevated in a sling or rested on a pillow.


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