R.I.C.E. stands for Rest, Ice, Compression, and Elevation. These steps can be used at home to treat hematoma on your arms and legs and should be practiced on a daily basis for the best results. Try to apply R.I.C.E. as soon as you develop the hematoma for optimal recovery and healing. Make sure you rest the affected area during the first 24–72 hours of developing the hematoma. This will prevent any further bleeding and allow the area to heal. Some physicians recommend that you rest a lower limb that has hematoma, such as your leg, for at least 48 hours. The duration of the rest period is dependent on the extent of the hematoma. Apply an ice pack wrapped in a towel, or perform an ice massage on the affected limb. This will decrease the pain and swelling of the hematoma.  To apply an ice massage, freeze a plastic foam cup of water. Hold the cup and place a cloth or paper towel over the affected limb, then apply ice. Never apply ice or an ice pack directly to skin, as this increases risk for a thermal burn or frostbite. After the first 48 hours, you can use a heated compress, such as a heating pad or a very warm washcloth, two to three times a day, to help your body reabsorb the blood from the hematoma. Use a compression wrap or a compressive elastic bandage over the hematoma until it appears less swollen. You can find compression wraps and compressive elastic bandages at your local drugstore or pharmacy.  You should maintain compression on the area for at least two to seven days. Make sure the compression bandage is on properly and it is snug, but not cutting off blood circulation to the limb. A wrap that cuts off circulation will trigger throbbing in the area or skin color changes such as becoming deeper purple or blanching entirely. This will help to reduce the pain and swelling. Raise the affected limb above the level of your heart on a chair or a stack of pillows. This medication will help with the pain and swelling you may experience as the hematoma heals.  Ibuprofen (Advil, Motrin) is a very effective pain reliever and anti-inflammatory medication. Follow the dosage instructions on the bottle and take no more than two pills at a time. Repeat this dosage every four to six hours. Naproxen sodium (Aleve) is another anti-inflammatory medication. You can take this medication every 12 hours as needed for pain and swelling. Acetaminophen (Tylenol) is an effective pain reliever that can be used to ease any discomfort or pain. If you have a bleeding disorder, avoid taking non-steroidal anti-inflammatory (NSAID) drugs, including aspirin, as these medications can interfere with blood platelets and prolong your bleeding. If you have a hematoma on your arm, leg, or hand, you should do diligent home treatment and be patient as the blood reabsorbs into your body. After a few months, the hematoma should fade on its own and the pain should subside.

Summary: Do R.I.C.E. Rest the limb with the hematoma. Ice the area for 20 minutes, several times a day, for the first 48 hours. Compress the hematoma to reduce any swelling. Elevate the affected area. Take an over-the-counter pain reliever or anti-inflammatory medication. Wait a few months for the hematoma to subside.


Choose a domino set with a double-12 for a 13-hand game; choose the double-9 set for a 10-hand game. From whichever set you choose, remove the highest double-sided tile before you move on to shuffling. In Mexican Train, the game starts with the highest double-sided tile in the middle of the table. Each hand after that starts with the double-sided tile that is one number less than the one preceding it: the first hand starts with the double-12, the second hand starts with the double-11, the third hand starts with the double-10, and so on. Lay out all of the tiles and flip them so they are pip-side down. Thoroughly mix them up by hand. Because there are so many rounds played in Mexican Train, have players take turns flipping and shuffling the tiles. After you draw your tiles, set them up in front of you on their sides so you can see what you have, but try your best to keep them hidden from your neighbors. You can play Mexican train with up to 8 people if you have a double-12 set. If you have a double-9 set, you can play with only 2 to 4 people. Follow this breakdown to determine how many tiles each person should take:  Double-12: 2 to 3 players take 16 tiles each; 4 players take 15 tiles each; 5 players take 14 tiles each; 6 players take 12 tiles each; 7 players take 10 tiles each; 8 players take 9 tiles each. Double-9: 2 players take 15 tiles each; 3 players take 13 tiles each; 4 players take 10 tiles each. If on any given turn you don't have a domino in your hand that can be played on either the Mexican train or your personal train, draw one tile from the train yard. If that tile can be played, play it. If not, it gets added to your hand and the turn passes on to the next player.  The “train yard” is also sometimes called the “bone pile.” Keep the tiles in the train yard face down. After drawing tiles for your hand and creating the train yard, it's finally time for gameplay to begin! There are sets you can buy that include a little stand for the starter tile, which you're welcome to use if you have it. If not, simply place the double-12 or double-9 tile into the center of the playing space.  This starter tile is often referred to as the “engine tile.” Everyone can play off of the engine tile, though each person's personal train coming off of that engine tile isn't fair game to other players unless there is a marker on it, which appears when a player isn't able to take their turn. Whoever goes first can lay down a tile only if they have one that matches the denomination of the engine tile. For example, if the engine tile is a double-12, then you must lay down a tile that has 12 pips on one side or the other. The 12-pip side needs to be laid down so it is connected to the double-12 engine tile. The exception to the 1-tile per turn rule is if you lay down a double tile, meaning that the pips on each side of the tile are the same. If you lay down a double tile, take a second turn immediately and lay down an additional tile. Once a player has laid down all the tiles in their hand, that particular round is over. Keep score on a piece of paper; have each player with tiles left in their hand add up the total number of pips. Add this figure beneath their name on the scoresheet. The goal is to have the lowest number at the end of all the rounds.  A set of double-12 dominoes will have 13 rounds, and a set of double-9 dominoes will have 10 rounds. The only other way a round can end is if the entire train yard has been depleted and no one can make a move. In that case, everyone tallies up the pips left in their hand and those figures get added to the score sheet. Each new round is started with the engine tile that is one number lower than the one used in the previous hand (double-9 for the first hand, double-8 for the second hand, double-7 for the third, and so on). The blank double is the last engine you will use before the end of the game (blank tiles can only be matched with tiles that also have a blank side). The already-used double tiles just get mixed back in with the other tiles when you shuffle between rounds.
Summary: Pull out the double-12 or double-9 domino from the set. Shuffle the remaining dominoes facedown on the table in front of you. Have each player draw their cards from the shuffled tiles. Put the remaining tiles into the “train yard” to draw from on future turns. Set the double domino in the center of the table to begin play. Pick someone to start and take turns clockwise around the table. Win a hand by being the first to lay down all of your dominoes. Continue playing and keeping score until all the double tiles are used.