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Monday, September 27, 2021

Treatment for Acute Injuries: Remember P.R.I.C.E.

PRICE therapy


Here I will use an Ankle Sprain as an example of Acute Injury needing PRICE.

Following an Ankle Sprain, it is important to create a pain free environment. The keys components have been taught in High School and College Health Classes forever.








    Protection is always a start so that the injury does not re-occur in the days, weeks, and months following the acute episode. The rule of thumb is that the second sprain is always worse than the first. Braces, like those worn after an ankle sprain, are needed until the surrounding muscles get strong again. However, a type of shoe, an orthotic, a pad, some tape, a splint, can also be part of the protection to give crucial “protected weight bearing”. Here an orthotic to stabilize the arch is used to protect the injured posterior tibial tendon which supports the arch. With the orthotic device in place, the injured tendon does not have to work as hard and can mend faster.

Orthotic device used to center the heel in a pronated foot.


    Rest is a four lettered word to most athletes, but crucial in minimizing the re-aggravation of the ankle. Rest is created by whatever it takes to make the ankle pain free. This may be crutches, removable cast, ankle brace, limited activity, and/or completely getting off the foot involved. I tell the patients that we must use Activity Modification principles, but never use the R word!! The first 4 days after a sprain is the most crucial time to chill out. Yet, since no one can really be sure 100% of the time what is wrong, the first 2 to 3 weeks following a sprain should be relatively pain free.


    Ice for 96 hours following a sprain is crucial. Other Anti-Inflammatory Measures are also helpful. Yet, ice is used for months and months in a typical sprain, it is just knowing when to use it that is important. You use it constantly after activity, or for 4 straight days after any flare-up.


Compression is also crucial to move swelling out of the swollen area. The product seen below is of Tubigrip, but a common substitute is an Ace Wrap.

The secret to compression is to put more compression below and less compression above the ankle. This may require some tape of some type to hold on the wrap above the ankle. Make sure this tape is not wrapped all the way around and possibly cut off the circulation.


Elevation of the foot and ankle even 1 inch off the floor is very beneficial. As long as it is comfortable, and as long as there is swelling, try to elevate the foot and ankle as much as possible. Super Elevation once a day for 30 minutes is very important. Super Elevation is where you lie on the floor and elevate your foot on the wall or couch 3 feet above your heart. Combine this with compression and gentle non painful range of motion of the ankle and the swelling will improve  greatly.

The above is from my book "Secrets to Keep Moving". I hope you will read it to learn how I practice podiatry.

My wife, Patty, and I just got back from a great week in South Lake Tahoe. We had some excitement with an experience with a nearby bear. The sunset was glorious, but the orange/red glow is from the Wildfire nearby! Sad!

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.