Whenever we strain or sprain a muscle, we immediately start applying R.I.C.E (rest, ice, compression, and elevation), but is that the right thing to do?
The RICE and PRICE (protection, ice, compression, and elevation) practice came from good old medical guess work and reasoning more than actual research studies. The new studies are showing that these regimens are not the best way to speed your way back to doing what you love to do.
Let’s start with the protection and rest portion. There was a study completed in 1994 by Oregon Health and Science University. The study took 82 people with sprained ankles and divided them into two groups one group had their ankle immobilized for 10 days and then began exercises to increase mobility. The other group wrapped their ankle for two days and then began the same program. The second group was back to doing their thing much faster: 57% back to it, where the immobilization group was only at 13%.
Complete rest is not the best option for many sprains, but be smart. If you can walk on it, take it easy, but don’t completely stop. Let pain be your guide. If the pain gets worse stop. If the pain is higher than a 2.5 on a one to five scale tone it down so it’s only a two. You may have to give it 48-72 hours before you can begin, but doing some activity is better than doing nothing. It’s called active rest.
Okay so the total rest or complete protection of the joint isn’t a good thing. What about the ICE? There’s no research that shows it actually reduces swelling. It only delays it. It is a good pain reliever and the theory was that if there is less pain you’re going to be able to move it sooner. The problem is it is delaying recovery by delaying the inevitable swelling. It also delays a hormone called IGF-1, which is key in repairing damaged tissues.
And compression? Well, there’s not research, but the doctors know it reduces swelling and if swelling is down, you are able to move your joint better and sooner. Elevation to reduce swelling? Um no. It may reduce it while it’s elevated, but as soon as you put it down the swelling returns.
So what do we do? A.R.I.T.A.: active rest is the answer. Implement active rest. Start with some basic mobility exercises while keeping your pain level down. It doesn’t have to be pain free. Do things that keep the joint mobile but don’t hurt to do. Sometimes it’s the side to side strain that causes pain but forward and back is fine.
You can’t let the muscles sit idle because they tighten up and atrophy. Scar tissue builds up which will then impact the movement of tendons and muscles for a long time if not forever. Continuing motion of the joint/muscle ensures the healing process will begin and be effective.