Why the R.I.C.E. Method Doesn't Work

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The R.I.C.E. method, coined by Dr. Gabe Mirkin in his best-selling book The SportsMedicine Book (1978), has been touted as the end-all be-all of muscle injury treatment and recovery methods for the past several decades. R.I.C.E. stands for Rest, Ice, Compression, and Elevation. It is so pervasive that despite current scientific and medical studies showing the detrimental effects this method has on healing, you will still find most doctors and sports professionals recommending it as a viable treatment.

Disclaimer: Always consult a doctor for any serious injuries. This blog is intended for reference/educational purposes, not to diagnose or treat medical conditions. Sources are hyperlinked.

Rest

For the acute stage of injury, rest is important. Continuing to push through your physical task when in pain is ignoring your body's message that something is wrong. Immediately stop what you are doing and take rest. For mild injury this may only be a few minutes, for more severe injury it may be longer. Intense sensation and mild discomfort are normal when building muscle and flexibility, however acute pain is not normal and should be heeded as a warning of injury. Where rest doesn't work is when it is prolonged or excessive unnecessarily. Bed-rest is especially detrimental to recovery as it inhibits circulation among other healing mechanisms in the body. After the initial acute stage of injury, movement and exercise should be introduced slowly to restore proper circulation and blood flow which carries nutrients to the injured tissue and encourages lymphatic drainage of metabolic waste. Movement will also help regain range of movement and prevent scar tissue from building up around the injury. Exercise should be used to start strengthening the muscle again. There is a mental component that comes into play when immobilising the injury for too long. You might experience inhibition in moving the affected area if you wait too long before introducing recovery movements and physical therapy.

Ice

Ice is perhaps the most pervasive injury recovery treatment recommended by professionals today. Let me start by saying this; swelling and inflammation is the bodies natural response to injury. A recent study published by The Journal of The Federation of American Societies for Experimental Biology showed evidence that inflammation is actually beneficial and in fact necessary for tissue recovery. That's because in the study, researchers discovered a hormone being produced in great amounts by inflammatory cells, called insulin-like growth factor 1 or IGF-1 which increases the rate of muscle regeneration and greatly improves muscle repair. Previous ( and current ) opinion of professionals is that reducing swelling encourages healing, however the results of this study contradict that notion. It was found that the application of ice and the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen inhibits the body from delivering this healing hormone (and therefore inhibits proper healing ).

Ice has also been shown to reduce muscle strength, power, and endurance. It affects the way your nerves function and although this may relieve pain temporarily it will affect the healing process greatly. It also constricts blood vessels, restricts blood flow preventing vital nutrients, oxygen, and other healing properties from reaching the area.

According to professionals, Ice can be applied briefly for short periods to manage pain.

Compression and Elevation

Compression and Elevation fall into the same category as Ice. They reduce swelling and blood flow to the injury and therefore should be considered as detrimental to the healing process.

In terms of compression or immobilization, protection should be the main theme here. Focus on protecting the injured area while it heals, this includes removing it from the cause of injury, seeking out proper treatment, and not engaging in any activity that might exacerbate the injury,

The use of NSAID's have also been shown time and again to inhibit healing.

So what IS the best method for recovering from a muscle, tendon, or ligament tissue injury? I have discovered a method called M.E.A.T. that seems to make the most sense. M.E.A.T. stands for:

Movement

As I mentioned above, movement should be introduced after the acute stage of injury when pain and swelling has significantly subsided. movement should be gentle but consistent. Things like gentle stretching have also been shown to be effective. This is as opposed to total immobilization which has been shown to be less effective in long-term healing.

Exercise

Including targeted strengthening exercises will increase blood flow to the affected area, strengthen the muscle, as well as help to prevent build up of scar tissue.

Analgesics

Medication to relieve pain can be administered in moderation, but you should avoid the use of NSAID's especially since prolonged use of these can lead to stomach ulcers and other gastrointestinal stress, not to mention that they have been shown to inhibit muscle repair as stated above. Some people have found the use of Epsom salts or Arnica (homoeopathic treatment) to have healing effects, and some people use topical analgesics to relieve pain.

Treatment

Various treatments that have been shown to be effective in healing muscle/tendon injuries are: massage therapy, taping, acupuncture, alternate ice/heat in short periods during acute phase, and physical therapies.

Remember that in extreme cases for serious tears and injuries one should always consult a doctor. If you are having other symptoms such as fever, vomiting, dizziness, please seek out emergency medical care.