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Why do you need to elevate an injured body part above your heart?

It’s common practice to raise an injured body part higher than the heart, as part of the RICE protocol, which stands for Rest, Ice, Compression and Elevation. But have you ever stopped to question why an injury should be elevated?

Reduce swelling

As we all know from our own experience, an injury leads to swelling, as the body attempts to protect the area which has been injured. Much like a form of human ‘bubble wrap’, swelling creates extra padding for the damaged tissues, preventing the risk of any further injuries occurring. But just because that is the body’s default mechanism for dealing with damaged tissue, it doesn’t necessarily make it a desirable process for the body’s long-term health prospects.

Any injury, whether it leads to blood loss or not, damages blood vessels. Severing an artery may create a dramatic effect, as blood is pumped out with great force, but even a minor injury causes damage to capillaries, which leak small amounts of blood into the surrounding tissues, creating bruising. In both circumstances, your response should be the same - to elevate the damaged area above the level of the heart. This is because it introduces the element of gravity into the equation, and as a fluid, blood will always take the path of least resistance.

You can see this effect for yourself simply by undertaking an easy experiment. Raise one hand above your head and keep it there for a minute or two, whilst allowing your other arm to relax at your side. It won’t take very long for you to feel a ‘pins and needles’ sensation in your raised arm, as a lack of blood flow prevents oxygen from reaching your fingers. Now lower your arm, and take a look at both of your hands: you’ll find that the skin on the fingers and hand of your raised arm look much more pale than on the arm which remained at your side. This is clear evidence that your raised arm didn’t receive the same levels of oxygenated blood as your lowered arm.

Keeping blood from the area

So why would you want to lessen the blood flow to a damaged limb in the first place? Isn’t blood good for injuries, helping them to heal faster? Looked at in that light, it can seem counterproductive, but doctors have been recommending this course of action for a long time, and for very good reasons.

Obviously, where an injury has caused a wound that is bleeding heavily, raising the affected limb is absolutely essential to prevent severe blood loss. If too much blood is lost from the body, the patient is liable to go into shock, which could have fatal consequences, so any arterial injuries should be raised as high as possible above the level of the heart as a matter of extreme urgency. Never try to remove any foreign bodies, such as glass, from the wound as this could lead to serious consequences. Instead, apply compression and keep the limb elevated until medical professionals can take charge.

For sprains, strains and suspected breaks or fractures to the bone, you should still employ the same method of raising the affected limb. This restricts blood flow to the area, helping to limit the swelling that occurs and potentially leading to a much more favourable outcome in the long run. Although some degree of swelling is unavoidable, too much can slow down the healing process, quite apart from the fact that it can be extremely uncomfortable and debilitating.

Left untreated, inflammation can even lead to more swelling, as the damaged tissues try everything that they can to protect themselves. Simply raising the affected body part encourages fluid build-up to reduce, which makes the site of the injury less painful.

Use ice and compression to speed healing It’s important to rest a damaged limb to limit any damage, and to prevent further injuries, and keeping the area raised is a good reminder not to start using the limb again for the time being. At the same time, there are other things that can be done to reduce swelling, including using ice on the affected area to encourage healing. Ice causes the blood vessels to constrict, limiting the flow of blood to the area. Ice also causes cellular activity to reduce, which further reduces any swelling. You can use a dedicated ice pack or cooling system, or just use a bag of ice straight from the freezer, although you should wrap it in a clean tea towel or cloth to prevent the ice from damaging the skin’s cells, which can occur if very cold products are placed directly onto the skin. If there’s no ice to be found, you can easily improvise with a packet of frozen peas or something similar. Apply the ice packs for around 20 minutes at a time, at regular intervals, to encourage healing and reduce the swelling.

Add compression through the use of elastic bandages to further reduce swelling, although it’s important to keep checking on the bandage to make sure that it isn’t too tight, as this will lead to further trauma to the affected area. Anti-inflammatory drugs, such as NSAIDs can be helpful at this stage too, particularly if there is a lot of pain associated with the injury.

Although rest is strongly advised, it’s important not to avoid using the affected limb completely, although how quickly you can start using it should always be confirmed by a medical professional, if possible. Complete inactivity can be as harmful as too much exercise, so be guided by professional advice about when and how to start exercising again.