The RICE method.

Rest. Ice. Compression. Elevation.

How muscle, bone, joint and tissue injuries have been treated for over 40 years.

But recent research shows that rest and ice may actually slow recovery.

Dr Gabe Mirkin is the dude that popularised RICE in 1978. And he’s since changed his mind about it…

Because with more evidence, we have a better understanding of what’s going on.

See, 3 things need to happen to repair damaged tissue.

1. 🩸 Inflammation
2. 🪡 Repair
3. 🔨 Remodelling
   

Inflammation gets a bad rap.

But for acute injuries, it’s an essential part of the recovery process.

Inflammation is our immune response.

When we get injured, our immune system immediately floods the affected area with white blood cells. Which start to repair the tissue.

A good thing.

What we don’t want is swelling.

Inflammation and swelling are not the same.

We get swelling when these white blood cells don’t get cleared out quick enough.

Swelling is uncomfortable, for one. But it can also tighten up our tissues.

No good.

🧊 So why does ice slow recovery?

The inflammation process causes vasodilation (widening of blood vessels).

Which increases blood flow. And floods the injury with white blood cells.

But icing an injury causes vasoconstriction (tightening of blood vessels).

Which slows this inflammation process. And so, can slow recovery.

✍️  Note, ice does help with pain. But athletes are usually more worried about getting back out there.

Everyday athlete? Your call.

🩼  What about rest?

Our lymphatic system is in charge of reducing swelling.

It’s a one-way drainage system that clears the waste from the inflammation process.

But it only kicks into gear when our muscles contract.

So movement (without pain) actually promotes blood flow, clears the waste and reduces swelling.‍

‍

🤕 Compression and elevation?

Compression and elevation both help clear waste and reduce swelling. So we can keep them going.

💊 Anti-inflammatories like ibuprofen and diclofenac (Voltaren) have become common prescriptions too.

But again, for acute injuries we want inflammation. And as the name suggests, anti-inflams slow it.

They mask pain. So can be useful if you need to push through on a one-off. But pain (from injury) is usually a signal we need to listen to.

So if RICE is out the window, what are we running now?

A handful of other solutions have been thrown around. And while I’m far from qualified, there’s one that makes the most sense to me based on the research:

PEACE

• 🩼 Protection (from pain) – avoid activities and movements that increase pain‍
• 🙋 Elevation – elevate the injury above the heart as often as possible
• ❌ Avoid (anti-inflammatories and ice) – both slow inflammation‍
• 🤕 Compression – use elastic, tape or compression gear
• 🎓 Education – See a good therapist, learn more about the injury, its management and using an active rehab approach
  

It makes sense to me. But I realise this may be a hard one to swallow after a lifetime of RICE.

Your call.