Sprained joints and RICE

Why is it advisable to completely rest a sprained joint for x amount of time? I understand the logic behind the ice and elevation and compression of the joint.

I’m assuming (though I could be totally wrong) that the pain and stiffness is solely becuase the irritation and consequent swelling of the ligaments in a joint. Wouldn’t it be best, then, to do everything in one’s ability to keep the joint loose? Wouldn’t mild, gentle use prevent more swelling and stiffening of the joint?

The sprained ligaments are weak, and provide little if any support. Continued use prolongs the healing process.

Resting it will minimize the blood flow to the area. In the early hours after the injury, the capillaries are more permeable due to trauma, so if the joint is active, more blood will flow to it, and more blood will leak out. The injured area gets sufficient oxygen and nutrients from normal resting flow.

In the short run, the cells and other chemicals emitted by blood factors are very irritating, and can aggravate not only the swelling, but can cause more tissue damage.

So, rest, ice, compression, and elevation are best. And aspirin should probably be avoided in the early hours also, as it will inhibit blood clotting. The jury is still out on other NSAIDS like ibuprofen and naproxen, but I know at least one orthopedist who just recommends acetaminophen for the pain, not NSAIDS. At least until about 48 hours have passed.

And for the above reasons, ice is better than heat early on. It constricts the blood vessels, and minimizes leakage. Heat increases the blood flow. that’s fine once the acute inflammation has died down; say after 36-48 hours. But while it may feel good to heat it right after the injury, it may prolong healing.

All these tips are just general principles, and should not be used to go against specific recommendations by one’s own physician regarding one’s own problems.


My own experience with a sprained ankle was that even when the joint felt mostly healed, it was still very easy to re-injure it if the “rest” advice wasn’t taken very seriously.