PECH rule

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The PITCH control ( P housing, E is, C ompression, H ochlagern) summarizes the treatment measures of muscle and joint injuries to the damage to be kept as low as possible. In English-speaking countries one speaks of RICE ( rest, ice, compression, elevation ).


These measures can be carried out immediately by the patient or a helping layperson, but they are not a final treatment or therapy, but the preliminary first aid for a minor injury.


The actuation should be stopped immediately after the injury . The affected part of the body should be immobilized and further stress avoided.


By cooling the affected part of the body with suitable coolants, a narrowing of the blood vessels is achieved. Bleeding and swelling are reduced. The metabolism in the tissue is slowed down by the cooling , which means that tissue damage spreads more slowly. The cold also relieves the pain in the affected body region.

There are different recommendations for the duration of the cooling. When cooling with ice (e.g. with an ice pack ) , it is often advised to avoid direct skin contact by placing fabric underneath and to interrupt cooling periods by taking breaks.


Applying a compression bandage immediately will slow the expansion of bleeding and swelling. The bandage should be applied with an elastic bandage, such as an adaptive compression bandage or zinc glue bandage . If necessary, a piece of fabric can be used; a tight sock is sufficient for the ankle to begin with.


The injured part of the body should be elevated, if possible above heart level. This improves the return of the blood or reduces the actual static blood pressure at the injury. The swelling and the pain associated with it will decrease. Less blood penetrates the surrounding tissue.


The PECH rule, and cooling in particular, is unsuitable for treating muscle spasms , although P (ause) and H (ochicken) can help relieve pain and regenerate.

Individual evidence

  1. The PECH rule at Techniker Krankenkasse