The Issues with “RICE” After an Injury
5 min read
Humans are not as fragile as we think and the recovery process is not as complicated as most providers make it seem. Following catchy acronyms may help, but recovery ultimately comes down to proper judgment. RICE is a concept that has been introduced to the youth athlete and their parents for decades. Rest, Ice, Compression, and Elevation has long been thought of as the universal treatment of an injury in the acute stage (0-72 hours following injury). Although nothing is inherently wrong with “RICE”, none of its components in isolation is likely to make or break recovery.
WHY IS THIS IMPORTANT?
In reality, icing is not going to move the needle on tissue damage itself but can instead serve as an effective means of reducing pain to allow for the re-introduction of movement. Ice as a means to decrease pain to reintroduce movement is beneficial. However icing to the point of immobility for hours on end is detrimental. Too much emphasis is often placed on resting and icing which ultimately keeps you out of the activities you love for longer than is otherwise needed. It's time you learn these basic principles of recovery so you can bounce back faster from your aches and pains to maintain your performance in the activities you love.
What is the natural healing process?
Following an injury the body undergoes a natural healing response, also known as inflammation. This process often brings redness, swelling, and warmth to the area, all of which often brings misguided concern. In reality, these are signs that the desirable, natural healing process is occurring!
The most common locations of inflammation that often results in pain or limited function.
How Does “RICE” Hinder the Natural Healing Process?
Rest: people often “rest” way too much. Too much rest reduces blood flow and causes swelling to accumulate, both of which negatively impacts healing. Unless movement is causing a sharp increase in pain, keep things moving as much as possible.
ICE: Ice doesn’t magically heal the injured tissue itself or reduce deep inflammation, however research still shows a perceived decrease in pain, therefore we suggest using it to make reintroducing movement easier. Again, movement is key in facilitating the circulation of blood and managing swelling, therefore use ice as a means to reintroduce movement. Ice as needed if you feel it helps, but don’t sit around and ice to the point of immobility.
COMPRESS: Most compression sleeves don’t provide enough compression to deeper tissues to meaningfully influence blood flow/swelling. Compression is not going to make or break your recovery.
ELEVATE: We encourage elevation to allow gravity to contribute to the circulation. But again, elevation to the point of prolonged immobility is counterproductive.
Takeaway
Ultimately, begin increasing weight bearing through the injured area as tolerated, using pain as your marker. Begin restoring normal movements and focus on avoiding compensations to protect the injured area as this often increases stress elsewhere. If you too are second guessing aspects of your recovery, give us a call or shoot us a message if you have any questions regarding your acute stages of recovery, we would be happy to help!
References
Christensen, L., Arnesen, C. E., Möller, S., & Hyldig, N. (2021). The effect of compression therapy on post-surgical swelling and pain after total knee arthroplasty. International journal of orthopaedic and trauma nursing, 41, 100815. https://doi.org/10.1016/j.ijotn.2020.100815
Van den Bekerom, M. P., Struijs, P. A., Blankevoort, L., Welling, L., van Dijk, C. N., & Kerkhoffs, G. M. (2012). What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?. Journal of athletic training, 47(4), 435–443. https://doi.org/10.4085/1062-6050-47.4.14
https://manualpt.com/the-ins-and-outs-of-inflammation/
