A healthy living blog from Marshfield Clinic

RICE or MICE? Treating strains and sprains

Woman with leg pain - RICE vs MICE treatment

In general, meet in the middle between rest and motion when caring for a sprain or strain.

RICE: rest, ice, compression, elevation.

MICE: motion, ice, compression, elevation.

How can two acronyms to treat a sprain or strain start with complete opposite steps – rest versus motion?

It’s all relative. Don’t practice absolute rest, and don’t overdue movement.

“For any acronym like this, you should use whichever is easiest for you to remember,” said Mary Repking, a Marshfield Clinic physical therapist.

Comparing RICE and MICE

As many doctors recommend RICE, as MICE. It’s more important to use the acronyms as guides rather than absolutes.

“In RICE, rest should really be defined as ‘relative rest,’” Repking said. “Don’t use the joint like you normally would. Give it time to heal.”

Similarly, the same is true for motion.

“It’s easy to be overcautious when you first get hurt,” she said. “Your instinct might be to stop moving the limb all together, which isn’t necessary. If you sprain your ankle, you can still work your knee and hip.”

In general, meet in the middle between rest and motion.

Rest means performing motions that don’t put so much stress or weight on the joint. A good example is writing the alphabet with your foot when you have an ankle injury.

“You can self-regulate this exercise,” Repking said. “Start with small letters and work toward larger letters as your ankle heals.”

This video series offers other range of motion exercises to help strengthen and keep your ankle flexibility as it heals.

Ice, compression and elevation

Remaining steps for each acronym are:

  • Ice: Apply cold to the injury for a maximum of 20 minutes. Allow your skin to return to normal color before reapplying.
  • Compression: Apply compression to hold the ice to the injury and after icing. This helps provide extra support which helps minimizes swelling.
  • Elevation: Keep the limb 12 to 18 inches above the heart. This reduces blood pressure to the injured tissues and helps decrease swelling.

Some acronyms combine RICE and MICE, but switch the order. CRIME, for instance, means compression, rest, ice, motion and elevation.

Again, perform the method that works best for you when you need it.

When should you see a doctor?

If you can otherwise perform normal activities, sprains and strains will respond to this conservative care in two to three weeks.

“If you’re feeling progressively worse and can’t do normal activities like working a full day or walking to the bathroom on your own, the sooner you see your doctor, the better,” Repking said.

These acronyms do not apply when you hear a pop or tear at the time of injury. Both are reasons to get an X-ray, she said.

Additionally, you should monitor swelling. Significant swelling is good reason to see your doctor.

“Substantial swelling does not guarantee a break or tear, but it can be a good sign the injury’s more serious,” Repking said.

Recommended from Shine365:

Heat vs. ice? Learn more.

Four steps to ankle injury recovery (Video playlist)

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