by: Kevin Rebman, Chief Myotherapist, NREMT
We’ve all heard it before when we’ve twisted an ankle or banged a knee: RICE—Rest, Ice, Compression, and Elevation. However, according to its creator, Dr. Gabe Mirkin, this is an outdated treatment method.
At Return to Play Institute, we embrace the latest advancements in injury recovery therapy so our clients receive the most effective care. We tailor our approach to help you heal faster and get back to doing what you love.
Why RICE No Longer Works for Injuries
“For decades, coaches have followed my ‘RICE’ guideline, but recent findings show that both ice and complete rest might slow down healing rather than support it.” – Gabe Mirkin, MD, March.
RICE has four components, and here’s why it doesn’t work:
Rest
Initially, people believed that rest played a vital role in injury recovery. The common practice involved avoiding activity, taking a break for several days or weeks, and then returning to regular routines. However, prolonged rest can hinder recovery. Instead, carefully reintroducing movement to the injured area is beneficial. This gradual approach helps maintain flexibility, prevents excessive scar tissue buildup, and keeps the affected area from becoming stiff.
Ice
Ice serves as an effective tool for relieving pain and managing swelling in the short term. In the past, recommendations suggested applying ice for 48–72 hours after an injury, but modern approaches advocate for brief applications. Short-term icing helps alleviate discomfort and minimize swelling, while prolonged use can constrict blood and lymph vessels, reducing the flow of nutrients essential for the body’s natural healing process.
Compression
Compression supports swelling management and contributes to the healing process by addressing secondary cell damage. Swelling plays a vital role in the body’s natural recovery, and allowing fluid flow around the injured area promotes faster and more effective healing.
Elevation
Elevation aims to reduce swelling by using gravity to minimize arterial pressure and assist venous blood flow back to the heart. However, in healthy individuals, gravity does not significantly affect fluid flow to the extent that it would impact healing. Hence, elevation is largely unnecessary in most cases.
What to Do Instead of RICE
in Injury Recovery
If RICE is outdated, what should you do? Here’s a revised approach:
For Acute Trauma
When dealing with acute trauma—injuries that occur suddenly, like sprains, bruises, or muscle strains—it’s important to take immediate action to prevent further damage. While RICE traditionally recommended prolonged rest and icing, modern approaches suggest:
- Use Ice Briefly: Ice can still be helpful for immediate pain relief and to control initial swelling. Apply ice for 10-15 minutes, then remove it for the same amount of time. Repeat as needed during the first 24 hours.
- Splinting or Bracing: Splinting or bracing supports the injured area by stabilizing it and reducing the risk of additional harm. This approach is especially beneficial for joints such as the ankles or wrists.
For Healing Injuries
As injuries begin to heal, the focus shifts to restoring movement and preventing complications such as stiffness or excessive scar tissue:
- Gradual Mobilization: Begin moving the affected area gently as soon as the acute pain decreases. This approach promotes a healthy range of motion and reduces the likelihood of scar tissue forming, which might otherwise limit movement.
- Ice as Needed: Continue to use ice if there is residual pain or swelling after activity. However, the emphasis should be on controlled movement rather than extended periods of icing.
For Muscle Spasms or Cramps
Muscle spasms and cramps often result from overuse, dehydration, or strain. Addressing these conditions calls for a unique approach:
- Apply Heat: Heat promotes blood flow, helping to relax tight muscles and ease discomfort, making it an effective treatment for muscle spasms, unlike acute trauma.
- Gentle Friction: Massaging the affected area with gentle pressure can help generate internal heat and relieve tension, promoting faster relaxation and recovery.
For All Injuries
Regardless of the type of injury, protecting the area during recovery is crucial to avoiding re-injury:
- Bracing or Taping: Use appropriate support to stabilize the injury if you plan to return to physical activity. White athletic tape offers rigid support for joints, while kinesiology tape provides flexible support that can also assist with muscle function and circulation.
- When in Doubt, Rest: If you’re unsure whether it’s safe to resume activity, it’s better to err on the side of caution. Pushing through pain can lead to more significant injuries and longer recovery times.
By following these updated guidelines, individuals can support their body’s natural healing processes more effectively, reduce recovery time, and prevent long-term complications.
The Value of Corrective Massage
in Injury Recovery Therapy
Incorporating corrective massage into your injury recovery plan can significantly enhance your healing process. A session with a skilled therapist offers a hands-on approach to addressing the specific needs of your body, going beyond the surface to facilitate deeper recovery. Here’s how corrective massage can make a difference:
Reduction in Edema (Swelling)
Edema, or swelling, is a natural response to injury, where fluid accumulates around the affected area. While some swelling is beneficial for healing, excessive edema can slow recovery and increase discomfort. Corrective massage uses techniques like lymphatic drainage to encourage the movement of fluids, reducing swelling and promoting faster healing.
Minimization of Scar Tissue Buildup
When tissues are injured, the body produces collagen to repair the damage, which can lead to scar tissue formation. Excessive scar tissue can restrict movement and lead to chronic pain. Corrective massage helps break down this scar tissue, maintaining the flexibility of muscles and joints and preventing long-term complications.
Release of Tension in Damaged Muscles
Injuries often cause muscles to tighten or spasm as a protective response, which can result in further discomfort and limit mobility. An experienced and skilled massage therapist can apply targeted pressure to release tension, improve muscle elasticity, and restore normal function, aiding in a smoother recovery.
Treatment of Compensating Muscles
When one part of the body is injured, other muscles often compensate to take over its functions, which can lead to imbalances and new areas of strain. Corrective massage addresses these compensating muscles so that the entire body is aligned and functioning properly, reducing the risk of additional injuries.
Psychological Benefits
An injury affects both the body and the mind. Pain and limited movement can cause frustration, anxiety, and even sadness. Massage therapy offers a calming experience that helps relieve stress and promotes relaxation. This mental relief supports the healing process, as maintaining a positive mindset plays a key role in recovery.
At Return to Play Institute, our therapists focus on helping you recover and perform at your highest level. Whether you’re recovering from an injury or aiming to improve your overall performance, our corrective massage sessions support your body’s natural healing process, helping you return to peak condition.
Frequently Asked Questions
What Is Injury Recovery Therapy?
Injury Recovery Therapy encompasses various treatments and practices designed to aid the body’s natural healing process following an injury. It focuses on reducing pain, restoring function, and preventing further injury.
Is Ice Still Useful in Injury Recovery Therapy?
Yes, ice is still useful in injury recovery therapy, but only for short-term pain relief and swelling reduction immediately after an injury. Prolonged use of ice can hinder the healing process by restricting blood flow.
How Soon Should I Start Moving an Injured Joint?
Start moving an injured joint gently as soon as the pain subsides to prevent stiffness and excessive scar tissue formation. However, it’s essential to avoid overexertion and further injury.
Can Massage Really Help in Injury Recovery?
Yes, (corrective) massage can really help in injury recovery by reducing swelling, minimizing scar tissue, relieving muscle tension, and supporting psychological recovery from an injury.
Should I Use Heat or Ice for a Muscle Spasm?
You should use heat for muscle spasms. Heat is typically more effective for muscle spasms as it promotes blood flow and helps relax the muscles, whereas ice is more suitable for reducing acute pain and swelling.
Advanced Injury Recovery Solutions
As we move beyond the outdated RICE method, adopting more effective techniques in injury recovery therapy can make a difference in the healing process. At Return to Play Institute, we focus on the latest advancements in injury recovery therapy to support your healing journey. We create personalized therapy programs to support your recovery, improve mobility, and help you return to the activities you enjoy. Begin your journey toward a healthier, more active lifestyle by scheduling an appointment with us today.
Call Return to Play Institute Today!
Return to Play Institute, LLC
5275 Edina Industrial Blvd, #210, Edina, MN 55439
(763) 270-9330
