Life is hard, start with just 5 things first.
You sprain your ankle out on a hike with your family. Your first thought and the advice people will give you will likely be the RICE (rest, ice, compress, elevate) method. This is the tried and true, salt of the earth, go-to treatment for any type of acute musculoskeletal injury. How did RICE become so well known, and is it as effective as we think it is?
RICE was developed by Dr. Gabe Mirkin in his 1978 book, The Sports Medicine Book and has gained popularity steadily ever since1. Dr. Mirkin developed this treatment as a way of reducing inflammation with the goal of allowing you to return to activity as soon as possible. RICE does seem to reduce pain, inflammation, and swelling for those with acute injuries, but as we learn more about this modality, there is evidence to suggest that RICE may slow and potentially stunt the natural healing process1. Dr. Mirkin has even changed his stance on RICE, instead favoring early movement after injury and limiting icing to a short period of time after an acute injury, less than 10 minutes at a time and within 6 hours of the injury1
New studies have begun to show that RICE treatments can impede healing by inhibiting the release of growth factors, blunting the function of the immune system as well as blocking inflammation2–4. Although RICE is effective at reducing pain temporarily, the method also reduces blood flow to the site. Adequate blood flow to the site of injury is vital to healing; blood brings oxygen, nutrients, vitamins, and minerals to the area of injury. Inhibiting this process can slow down and even stop the healing, compromising the integrity of the tissue.
What can we do when we experience musculoskeletal injury? Our goal is to elicit a positive inflammatory response, stimulate the growth factors, and bring more nutrient-dense blood flow to the site of injury. The goal is to get you back to doing what you love as safely and as soon as possible, and to ensure that your healing is true and sustainable. Alternatives to RICE that are effective include: acupuncture, low-level laser, active rest, functional/therapeutic movements, and injection therapies5, 7, 8-10. All of these therapies can help to improve the inflammatory response in a positive way. Through these methods, your sprained ankle/shoulder/wrist/etc will heal quickly and regain strength; allowing you the freedom you had before.
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