RICER Soft Tissue Injury Management

3M Confidential1 . © 3M 2014 All Rights Reserved 3M and Nexcare are
trademarks of 3M.
Nexcare™ RICER Module 2014
TAPS Approval No.:
PP5543

trademarks of 3M.
Soft Tissue Injuries
Injuries that involve body tissues apart from bone are generally classified as soft tissue injuries. Sprains, strains and
bruises are all soft tissue injuries, although the cause and tissues involved in each injury are different.
A sprain is an injury that involves the partial or complete tearing of ligaments and other soft tissues around a joint,
such as an ankle or wrist. A sprain usually results when the bones that form a joint are forced beyond their normal
range of motion. The more ligaments that are torn, the more severe the injury.
A strain occurs away from a joint, and involves a torn or overstretched muscle or tendon, commonly in the calf, thigh
or lower back. Strains are often a result of overexertion e.g. lifting something too heavy or working a muscle too hard.
They can also result from sudden or uncoordinated movements.
A bruise is a soft tissue injury that involves the skin and nearby tissues following a blow or other forces that break a
blood vessel close to the surface of the body. Bruising may be seen with either a sprain or strain.
Symptoms and signs – Not all may be present
• pain at the site of the injury, often severe with a sprain or strain
• loss of power in the injured area, especially with a sprained joint
• swelling of injured area
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TAPS Approval No.:
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Types of Soft Tissue Injuries
Soft Tissues
There are three classifications of soft tissues – Muscles, tendons and ligaments
Muscles
Damage to muscles can be direct or indirect. When the demand on the muscle is greater than the strength of the
structure then a tear can occur. These injuries are graded according to the amount of damage done.
1. 1st degree = Strain A small number of muscle fibres are damaged
2. 2nd degree = Partial rupture Up to 50% of the muscle is damaged
3. 3rd degree = Complete rupture The muscle is completely torn
Tendon Injury
As with the muscle injury, tendon injury has been classified into three grades:
1. Primary There is inflammation and swelling in the tendon = Tendonitis
2. Secondary There may be a partial tear of the tendon causing pain and weakness
3. Tertiary There is complete rupture of the tendon. There may be little pain but
complete loss of function e.g. Ruptured Achilles tendon.
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TAPS Approval No.:
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Source: Nexcare™ Sports Medicine Prevention and Management of
Injuries brochure.

trademarks of 3M.
Types of Soft Tissue Injuries
Ligaments
Ligaments are usually damaged by significant external force, e.g. a tackle in rugby or a netball player standing on
another player’s foot and rolling their ankle. The function of the ligament is to stabilise the joint.
Again there are three grades of damage:
1. 1st degree = Strain A small number of ligament fibres are damaged. There is
usually some swelling and pain on stretch.
2. 2nd degree = Partial tear Up to 50% of the ligament is damaged. There is greater
pain and swelling.
1. 3rd degree = Complete rupture The entire ligament is torn. There may be less pain but
significant swelling and loss of function.
0800 436 435
TAPS Approval No.:
PP5543
Injuries brochure.

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Management of Acute Soft Tissue Sports Injuries
The aim of acute soft tissue sports injuries is to prevent further damage, reduce initial
swelling (and later assist in the removal of swelling), to ease pain, and to prevent loss
of joint range of motion.
Consequently, it is well recognised in New Zealand to follow the RICER regime:
Cease sporting activity. Rest affected part/limb
Apply ice pack to injury. Utilise cotton cover to prevent ice burn.
Keep ice on injury for 20 minutes every two hours for the first 48
hours
Reduces bleeding/swelling and provides support for injured part.
Use an elastic or compression bandage and a padded dressing
but ensure the bandage is not too tight
Ideally above the level of the person’s heart. Helps reduce
bleeding/swelling.
Refer the injured person to a suitably qualified medical
professional
The information provided is not intended as a substitute for appropriate medical advice and management. All injuries
should be assessed and diagnosed by a qualified medical professional.
0800 436 435
TAPS Approval No.:
PP5543
COMPRESSION
REFERRAL
ELEVATION
REST
ICE

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Management of Acute Soft Tissue Sports Injuries
The first 48 hours are vital in the
management of any soft tissue injury.
Appropriate management here can
prevent excessive time spent on the
sideline.
The RICER regime should be used for
all ligament strains, muscle strains,
haematomas¹ and in fact any bumps
and bruises that occur through sporting
pursuits.
The information provided is not intended as a substitute for appropriate
medical advice and management. All injuries should be assessed and
diagnosed by a qualified medical professional.
0800 436 435
TAPS Approval No.:
PP5543
With
RICER
Without
RICER
Ligament repair with and without RICER management and
early mobilisation
Injuries brochure.
¹Haematoma refers to a collection of blood outside of the blood
vessels, which gathers in body tissues. Most commonly apparent
as bruising to the skin.

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Management of Acute Soft Tissue Sports Injuries: How? and Why?
REST
How? There is a need to reduce movement to allow time to assess the injury.
Why? By resting the injured limb, the blood flow to the area is reduced. This will help to reduce
the
bleeding, swelling and subsequent pain and allow time for assessment.
ICE
How? Usual methods are: Crushed ice in a wet towel, Immersion in icy water, Nexcare™ Cold
packs.
Apply for 20 minutes, every 2-4 hours for the first 48 hours.
Caution: Do not apply the ice directly to the skin as it can create a burn. Do not apply to
people with circulatory problems. Children have a low tolerance to ice.*
Why? Ice helps to reduce the inflammatory response to the injury, reduce pain and muscle
spasm.
*Always read the instructions and use strictly as directed. The information provided is not intended as a substitute for appropriate medical advice and
management. All injuries should be assessed and diagnosed by a qualified medical professional.
0800 436 435
TAPS Approval No.:
PP5543
Injuries brochure.

trademarks of 3M.
Management of Acute Soft Tissue Sports Injuries: How? and Why?
COMPRESSION
How? Apply Nexcare™ No Hurt Self-Adherent Wrap* or a crepe bandage over an area larger
than the injured area. You will need to take the compression bandage off to ice regularly,
but this will also give you the chance to keep adjusting the compression. This is a most
important step, as compression will reduce more of the swelling from injury than the ice
alone.
Why? Compression reduces the bleeding and swelling and provides support for the injured part.
ELEVATION
How? Raise the injured part above the level of the heart whenever possible. This is especially
important with lower limb injuries.
Why? This along with compression helps to reduce bleeding and encourages the fluid to be
returned to the heart for recirculation. It also helps to reduce pain.
0800 436 435
TAPS Approval No.:
PP5543
Injuries brochure.

trademarks of 3M.
Management of Acute Soft Tissue Sports Injuries: How? and
Why?
REFERRAL
How? Refer the injured person to a suitably qualified person as soon as practicable;
Doctor,
Physiotherapist, A& E Centre, St. Johns etc.
Why? To ascertain the extent of the injury and gain expert advice on ongoing
investigations
(X-ray, surgery) and management.
0800 436 435
TAPS Approval No.:
PP5543
Injuries brochure.

trademarks of 3M.
Nexcare™ Reusable Hot / Cold Packs
Product Information – Nexcare™ Reusable Cold / Hot Pack
Cooling ice or soothing heat. Ideal for pain and swelling caused by bruises
and sprains and for soothing muscle aches and stiffness. Comes with a cloth
cover (to protect from heat scald or freezer burn), with elastic strap to secure
the pack in place. Keep in freezer or heat in microwave or gently boiling water.
Use for sprains, strains and bruising
Pack size: 1x Gel Cold / Hot Pack 100mm x 250mm + Protective Cover
Product Information – Nexcare™ Reusable Cold Pack
A soft, gel filled pillow that chills in your freezer to an ice cold temperature. Can
be used on any part of the body. Stores conveniently in home freezer,
remaining pliable and easy to use.
Use for sprains, strains and bruising
Pack size: 1x Gel Cold / Hot Pack 100mm x 250mm + Protective Cover
Always read the instructions and use strictly as directed. The information provided is not intended as a substitute for appropriate medical advice and
0800 436 435
TAPS Approval No.:
PP5543

trademarks of 3M.
Nexcare™ No Hurt Wrap & Crepe Bandages
Product Information – Nexcare™ No Hurt Wrap
A breathable, self-adherent, elastic support wrap that sticks to itself – not to skin. Stays
in place, maintains self-adhesive strength when wet and leaves no residue on the skin.
Hand tearable, hypoallergenic and latex free.
Use for lightweight compression or support, sensitive or fragile skin applications,
securing dressings or devices in place
Roll size: 25mm x 2m, 50mm x 4m, 75mm x 2m (approximately 4.5m stretched)
Product Information – Nexcare™ Crepe Bandages
Gentle, medium weight bandage for light bandaging and compression. Comfortable, light
stretch for easy application. Can be secured using clips provided or an adhesive tape.
Use for sprain and strain injuries and adhering dressings
Roll size: 50mm x 1.6m, 75mm x 1.6m, 100mm x 1.6m (approximately 4m stretched)
Always read the instructions and use strictly as directed. The information provided is not intended as a substitute for appropriate medical advice and
0800 436 435
TAPS Approval No.:
PP5543

RICER Soft Tissue Injury Management

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