Have you or a family member ever been injured and been told to ice the injured area on and off for several days? This is extremely popular advice, but few stop to think of the validity of it. Dr. Gabe Mirkin coined RICE (Rest, Ice, Compression, Elevation) in the 1970s, but has since found that this method may not be the most beneficial after all. Of course, the type and extent of the injury will affect the treatment plan, but as a general rule, RICE is no longer the way to go. Instead, other methods have been found to be more beneficial.
First, let's start with the Rest portion of RICE. Before we dive into when rest should or shouldn't be emphasized, it should be noted that an accurate diagnosis of the injury is the most important first step. It's important to know what's injured and to what extent. Depending on the conclusion, the next question should be, "Is this joint supposed to be mobile or stable?" A good example of this question at work is when a patient comes into the office with a sprained ankle. The ankle is a mobile joint, so immobilizing it can actually cause more harm. The faster mobility can be restored, the better an injury is likely to heal.
Next, we address Ice. What if we told you that your skin has more of an effect on the icepack than the icepack has on the injury? Sounds silly, right? Well, evidence shows that the icepack is really only cooling off the skin and this can also cause more harm than healing. Why? The cold temperature on the skin causes blood capillary restriction, which in theory is good for it, but it also slows the blood flow out of the injured area, which reduces inflammation. This inflammation is the body's perfect response to an injury so we should focus on encouraging inflammation to accelerate healing.
When it comes to compression and elevation, the effects of these "remedies" have extremely mixed results, so it's important to have the severity of the injury confirmed so we can know how much inflammation will be beneficial.
These concepts are still being thoroughly researched. According to a Journal of Athletic Training article, "Evidence that some type of immediate posttraumatic mobilization is beneficial in the treatment of acute ankle sprains is moderate. Evidence that ice provides no effect in the treatment of acute ankle sprains is limited." As time passes, more and more doctors are looking into the effects of RICE on injuries, though it proves to be difficult since you can't provide a "placebo" version of icing an injury.
For those that do try to start moving the injured area as quickly as possible, they may think that any kind of movement is beneficial. However, it's important to make sure you're not just moving, but moving correctly. The concept of moving well and moving fast is what often gets athletes back on the field as quickly as possible.
One of the things we like to focus on in the office is not treating the symptom, but rather treating the cause. With an injury, the weakest part in the chain will "break." This break isn't always solely because of unexpected force or impact but could be attributed to that area breaking down slowly over time. When you move incorrectly, it can create these weak points, which will need to be remedied and strengthened to reduce the chances of a recurring injury.
Sometimes injuries just happen and it's important to have this information stored in your brain so you know what to do next time you or a loved one gets injured. If you recently got injured, please give us a call at 678-494-9668 so we can get you back to normal as soon as possible!