We’ve all been there; You sprain an ankle or strain a muscle and you revert to the tried and true management technique – R.I.C.E. RICE stands for Rest, Ice, Compression and Elevation and it’s very common advice among athletic trainers/PT’s and doctors, but did you know it has very little proven research to back its effectiveness?
R.I.C.E has remained in our toolbox for its perceived effectiveness in managing pain, swelling and inflammation. It’s true, icing does provide an analgesic effect and there is evidence to prove it. It also helps reduce the inflammatory response (more on this later). Similarly, resting an injured limb is a common sense move to avoid further aggravating it.
With more recent research, we’ve learned more about the importance of the inflammation and immune response that occurs with an acute injury. When we suffer an injury, the body releases neutrophils, macrophages and growth factor which jump start the muscle and tissue healing and repair process. Applying ice to an injury can blunt this response and can lead to a slower overall recovery.
For years, physical therapists and surgeons have pushed for early movement after an injury. RICE promotes prolonged rest after an injury which isn’t always the most effective move. Evidence has shown time and again that early movement promotes faster healing and adaption of injured tissues, helps the lymphatic system clear excessive swelling, reduces atrophy and muscle stiffness. This is not to say that you shouldn’t utilize rest at all – Resting an injured muscle due to high levels of pain is still appropriate. It’s simply finding the right balance of early movement while still protecting the healing tissues. Your physical therapist can help guide you through this, as it different person to person.
Over the past few years, researchers have worked to find a more appropriate acronym to encompass a proper recovery. We are fans of the acronym PEACE & LOVE, which was introduced by the British Journal of Sports Medicine in 2019. Granted, the acronym lacks the simplicity that RICE did but proper recovery isn’t always simple. PEACE & LOVE ties in much of what we’ve learned in recent years, including the avoidance of anti inflammatories, a more defined rest period and management of the subacute phase of the injury.
While icing is no longer in favor, it can still be a tool to utilize. When pain levels are very high, utilizing ice in shorter periods of time can perhaps limit the negative effects. There’s still much to learn and guidelines will continue to evolve. In the meantime, next time you find yourself with a minor injury, try some Peace & Love!
Our new office will be open to patients on January 2nd, 2023
Please contact us at evan@altiusnj.com or at (201) 391-8932 for more details!