We’ve all heard it before when we’ve twisted an ankle or banged a knee: RICE – Rest, Ice, Compression, and Elevation. It’s an outdated recipe for treating injuries (so says the inventor of the treatment and acronym). Unless there is something broken or bleeding, RICE should not be used. Let me explain.
RICE has four components and here’s why it does not work.
“Coaches have used my “RICE” guideline for decadt now it appears that both Ice and complete Rest may delay healing, instead of helping.”
Gabe Mirkin, MD, March
- REST – When RICE was conceived, it was thought rest was a good idea for injury recovery. Stay off it, rest up for a few days or weeks, then it should be good to go! Well, rest is probably the worst thing to heal an injury. Now, don’t jump right back into the game and injure it further rather, gradually increase the use of the injured tissue to keep it from collecting huge amounts of collagen (scar tissue) and stiffening up.
- ICE – A great pain killer, but that’s it! Previously, it was suggested ice be applied to an injury for 48-72 hours. That’s three days, which is way too long. Heat was forbidden too, but times have changed. Today, if injured, go ahead, use ice for pain relief and to reduce some of the swelling (edema). Use a few handfuls of ice in a bag, 10-minutes on and 10-minutes off. When the ice is melted, you are done with ice. Your body’s natural healing process is inhibited by ice because it constricts blood and lymph vessels when needed most – to bring healing fluids to an injury.
COMPRESSION – It was thought that compression would stop the swelling of the injured area and help with healing and prevent secondary cell damage from swelling. However, as mentioned in the Ice section, that swelling is helping heal your injury! Prevent the normal fluid flow around the injured area and the body’s normal healing process is being inhibited.- ELEVATION – There is no medical benefit for elevating an injury. Even the original intent, using gravity to help minimize arterial pressure and assist venous blood flow back to the heart, does not really make sense. If, in a relatively healthy person, gravity easily interferes with fluid flow within the body, then every time we get out of bed, our ankles would swell, and we would pass out! But we don’t.
So, what do we do if RICE is no more? The simple answer is:
- For acute trauma which is not broken (bones) or bleeding (punctures, lacerations, etc.), use ice to minimize the pain and splint/brace the injury as needed.
- For injuries beginning to heal such as sprains, strains, and minor muscle tears,
- If a joint sprain or muscle strain, ice if needed, then gradually start working the joint to keep the tissues from stiffening and scaring.
- If a muscle spasm or cramp, consider heat to encourage fluid flow to the area and relaxation of the muscle. Gentle friction to the area can also be used to help generate some internal heat.
For all injuries, brace or tape the injury to avoid repeated injury, if you decide to train or compete the next day. Remember, use white athletic tape for bracing, kinesiology tape for myofascial needs. When in doubt, sit it out!
Don’t Forget the Corrective Massage!
Lastly, make an appointment with a corrective massage therapist (like us)! Along with healing quicker, expect to see some of these benefits:
- Reduction in edema (swelling),
- Minimizing scar tissue build-up,
- Releasing tension in damaged muscles,
- Ensuring compensating muscles are also treated.
Psychologically, massage also helps your brain recover from the physical injury, too.
At RTPI, we’d be happy to answer any questions related to your injury or recovery. Contact us for a free consultation.
