9/30/2022
Many athletes will most likely be familiar with the R.I.C.E treatment. It stands for Rest, Ice, Compress, and Elevate. It is a really useful technique to use whenever one experiences an injury. R.I.C.E can help with soft tissue injuries like sprains, twisted ankles, pulled muscles, bruises, etc. It is best when one follows R.I.C.E immediately after sustaining an injury for best results. Now lets break it down! Rest is needed so that the injured tissues can begin to relax and become less tense. Resting also helps with reducing the disruption of 'fragile fibrin bond' which is one of the first processes of healing. Ice has several benefits, it is a type of general cryotherapy, it reduces any bleeding within the tissues and induces vasoconstriction. The cooler temperature also helps with feeling less pain in the general area. The goal of compression is to reduce any swelling and stop hemorrhage. Edema is caused by the exudation of fluid from the damaged capillaries into the tissues and compression helps with reducing this process. Finally, elevation lowers the pressure of the injured area and prevents/reduces bleeding tissues in the injured area. Elevation also encourages the drainage of the exudate through the lymph vessels and limits edema (swelling caused by trapped fluids in the tissues/body). The idea of R.I.C.E relates to our lectures with the idea of pressures, tissues, and blood flow through the body. By using gravity, compression, cryotherapy, and rest, we can allow our bodies to heal to the best of their ability by providing the best environment.
Source:
Michel P.J. van den Bekerom, Peter A.A. Struijs, Leendert Blankevoort, Lieke Welling, C. Niek van Dijk, Gino M.M.J. Kerkhoffs; What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults?. J Athl Train 1 July 2012; 47 (4): 435–443. doi: https://doi.org/10.4085/1062-6050-47.4.14
Hey Fernando, I really enjoyed reading your blog post. I've always used the RICE technique after an injury and it's nice to finally know why it helps. However, there's recently been some controversy surrounding this technique. Dr. Gabe Mirkin (Sports Doctor who created RICE technique in 1978) stated in 2015 that ice and complete rest may actually delay the injury healing process. Ice reduces swelling (by limiting blood supply), however it is this swelling that helps with the healing process. Meanwhile, rest can make it more difficult for the body drain the waste products from the damaged site. However, researchers and Dr. Mirkin also agreed that RICE is a good technique in some specific situations. Overall, I think the RICE technique requires some more research in order to determine if it truly aids in the injury healing process.
ReplyDeletesources:
https://www1.racgp.org.au/newsgp/clinical/is-it-time-to-rethink-rice-for-soft-tissue-injurie
https://www.drmirkin.com/fitness/why-ice-delays-recovery.html
https://thesportjournal.org/article/the-r-i-c-e-protocol-is-a-myth-a-review-and-recommendations/
I agree with Bella comment because I read an article about the cons of this method during the healing process. For example, it can reduce blood flow. When you rest, you are basically immobile and don't move around much and this as a result limit the blood flow throughout the body that is important for healing. Compression can limit the amount of blood flow you can get to the injury area. Compression is good when your'e moving around but when your'e immobile on bed rest, it could limit the blood flow as well as compress blood vessels into the injured area. And ice, your body is more working as a feedback loop to help protect you from the cold rather than doing any healing. I think that this method is effective acute healing like for inflammation or swelling but for longer term healing, it could cause more harm than good like limiting blood flow and can cause build up. Like Bella mentioned, it definitely needs more research to truly under the effectiveness of this method. Otherwise, nice blog, it's a fun reading!
ReplyDeletehttps://www.verywellhealth.com/why-you-shouldnt-do-rice-for-sprains-4144771
This post was very interesting as I have also been instructed on various occasions to always remember to R.I.C.E. It had been engrained in me so much so that I would always tell my family members to R.I.C.E even at the smallest injuries. It was interesting to read specifically about how it works as I had never thought about that prior. It would be interesting to look into what the most effective R.I.C.E method would be in regards to time and type of rest, ice, compression and elevation needed. In a study from Van den Bekerom 2012, length and type of compression could not be fully be supported due to lack of evidence as well as no improvement after a single ice treatment. So, I agree with you that further studies may be needed to test the efficacy of this treatment but also to test more specifically for which modes of R.I.C.E are the most beneficial in the short and long terms.
ReplyDeletevan den Bekerom MP, Struijs PA, Blankevoort L, Welling L, van Dijk CN, Kerkhoffs GM. What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults? J Athl Train. 2012 Jul-Aug;47(4):435-43. doi: 10.4085/1062-6050-47.4.14. PMID: 22889660; PMCID: PMC3396304.
It is interesting to see the lasting effects of Gabe Mirkin's R.I.C.E. protocol from 1978. Gabe Mirkin himself has refuted his claims that rest, ice, compression, and elevation is the most effective method in treating an injury. The protocol still has little evidence to support its claim and health care providers are still recommending the R.I.C.E. protocol. New studies emerging are testing methods that are in direct contrast to R.I.CE. by introducing mobilization of the affected area early in the treatment process (Tran and McCormack, 2020). In a study conducted in animal models, icing an injured muscle disrupted macrophage recruitment and decreased myogenic precursor cells, both slowing down the regeneration of muscle tissue (Miyazaki et al., 2022). Over 40 years after R.I.C.E. was coined and the scientific community is still researching to find the best method for treating an injury.
ReplyDeleteTran, K., & McCormack, S. (2020). Exercise for the Treatment of Ankle Sprain: A Review of Clinical Effectiveness and Guidelines. Canadian Agency for Drugs and Technologies in Health.
Miyazaki, A., Kawashima, M., Nagata, I., Miyoshi, M., Miyakawa, M., Sugiyama, M., Sakuraya, T., Sonomura, T., & Arakawa, T. (2022). Icing after skeletal muscle injury decreases M1 macrophage accumulation and TNF-α expression during the early phase of muscle regeneration in rats. Histochemistry and cell biology, 10.1007/s00418-022-02143-8. Advance online publication. https://doi.org/10.1007/s00418-022-02143-8