The most recommended immediate treatment following a soft tissue injury to the knee is R.I.C.E. the acronym for:
Do not perform any motions which cause pain. Each time pain is felt,
the knee injury is continuing and delaying healing. Protect your injury.
Apply ice for 15-20 minutes to the injured area at least 2 to 3 times
a day. It is important not to ice longer than 15-20 minutes at a
time. Longer periods can produce skin irritation (cryoburn) and also
damage underlying tissues. The icing reduces swelling by constricting
the fluids the body rushes to the injury. Too much fluid (swelling)
can actually increase the severity of the injury and prolong healing.
Ice also acts as a temporary pain reliever by numbing the immediate
Wrapping the injury with a compression type of material also reduces
swelling for the same reasons as ice, but compression can be applied
for longer periods of time. It is important not to wrap an injury too
tightly as it can cut off circulation. Wrap the injury
just tight enough to keep the swelling from increasing while still maintaining circulation.
If possible keep the injured knee at about the heart level. This
keeps fluids from accumulating in the injury due to gravity. Often an
injury will throb when it is not elevated.
COLD COMPRESSION THERAPY
The combination of ICE and COMPRESSION is known as COLD COMPRESSION THERAPY. This therapy is useful after a soft tissue knee injury or knee surgery.
Recent published medical studies have shown that cold compression
therapy following total knee replacement and similar surgeries decease
time to heal, decrease amount of pain medication, decrease the time in
hospital, and increase range of motion (ROM) immediately following
surgery and again at 3 days and 3 weeks.
Surgical centers previously used a cold pump and pad devices to apply
cold compression therapy to the affected area, but recently the
Medical Insurance Carriers have denied reimbursement to the patient
for use of such devices citing it is a convenience item, an
unreasonable expense and do not view the devices as medically
necessary. The carriers advocate the use of cold compression therapy,
but favor the use of ice bags and stretchable bandaging as a more
This situation has left surgical centers with 'dead' inventory of such
devices. As a result, many surgical centers are purchasing
refreezable cold compression support wraps for their patients use.
These wraps are surgical quality and cost about the same as multiple
ice bags and stretchable bandaging. The wraps can be sent home with
the patient who finds them to be more convenient to use, thus will use
them more often; plus they are safe in that there is no possibility of
over icing. Medical Insurance Carriers accept the wraps as a
reasonable expense and medically necessary.
Two Cool Inc which manufactures Cold One® Brand ice compression wraps has developed a line of clinical/surgical quality ice compression knee wraps to accommodate knee surgery patients pre and post surgical procedure.
Consumer information on Cold One can be found at http://www.coldone.com
See a doctor if there is:
- Severe pain
- Joint is unstable and can't bear weight
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