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Back You are here: Home Sports Other Meat, Rice And When To ICE
Monday, 01 February 2010 22:07

Meat, Rice And When To ICE

Sorry to disappoint those of you who thought that this was a dietary segment, it will however provide you with some food for thought. Many of my patients ask me when they should apply ice to an injury, and when they should use heat, and I thought now would be a good time to address this topic.

The RICE technique is commonly regarded as the gold standard for the management of acute sports injuries. It has been around forever, and is used to treat all injuries, attempting to aid and speed up recovery.

Let's break down each component:

Rest- Once injured, continuing to play increases the damage, so it is important to stop play immediately. Depending on the severity of the injury, you may also be advised to immobilize the injury.

Ice- this has a duel purpose. The first is for pain relief, as the cold desensitizes the nerve endings to relieve pain. The second is to constrict the blood vessels to control swelling.

Compression- this is the physical application of pressure in an attempt to reduce or control swelling.

Elevation- lifting the injured area above the level heart helps the flow of blood back to the heart and thus reducing swelling.

In summary, RICE serves to limit further damage and reduce pain and swelling.

 

A group of sports practitioners recently re-evaluated the RICE technique, concluding that while RICE is great for muscular injuries, it is not ideal for the management of tendon and ligament injuries.

Their argument:

Rest- too much immobilization weakens structures and slows down the healing process in terms of strengthening of scar tissue.

Ice- is excellent at constricting blood vessels, but blood flow is needed to bring in healing cells and remove damaged cells. They also believe that by bringing down the temperature you decrease the cell's metabolism, and thus its ability to heal.

Compression- stopping a component of the natural healing process will slow the entire healing process down.

Elevation- used to aid flow of blood away from the injury site. As mentioned in the previous points it is counter-productive to the healing process.

They have subsequently come up with an alternative- MEAT

Movement is supposed to increase healthy blood flow to the injured area, and also reduce swelling.

Exercise will increase the strength of the injured structures.

Analgesics are prescribed for pain relief as an alternative for ice.

Treatment will help to stimulate healing and speed up the recovery process.

So what do we do?

My opinion is that moderation and timing is the key. We need a combination both the RICE and MEAT technique.

We need to immediately Rest from activity so as not to cause further tissue damage, but not immobilize for longer than required, as research tells us that this weakens the tissue structures. Movement and Exercise are necessary components of recovery, but they must be introduced at the appropriate time, and progressed in the correct manor. Ice, as mentioned before, is great at relieving pain and decreasing blood flow. And although we don't want to slow down the healing process, we do want to 'control' the inflammatory process. In the first 72 hours, icing periodically (3-4 rimes daily) for short periods (4-5 minutes), may keep the swelling, inflammation and pain within reasonable limits, without jeopardizing the healing process.

Compression is not applied to cut off the entire blood supply to the injured area, but rather to minimize the amount of swelling. Periodic Elevation helps aid blood return to the heart, which reduces pooling of blood at the injury site. With regards to Analgesia, your treating physician can prescribe a wide variety of pain relieving medication, depending on the severity of the injury.

Treatment involves techniques and modalities such as ultrasound therapy, joint and soft tissue mobilization and progressive strengthening. If any of this doesn't make sense, don't panic; go see a trained professional the next time you get injured. Not only will they walk you through the entire process, but they will also help speed up your recovery time.

The only thing that we didn't touch on was heat. The wrong time to use heat is during the early stages of the injury, and after exercising, as this may increase the swelling and prolong the inflammatory process. Introducing heat at the appropriate time however will help increase healthy blood flow to the area and to stimulate healing. You may want to do this in the morning, or before you train, rehab, or get treatment.

The human body has an amazing ability to heal itself, but we need to work with it, and not against it.

 

JASON HIEMSTRA

Physiotherapist

Sharks Academy Medical Centre