Is RICE a thing of the past?

One of the things I get asked about a lot is RICE – rest, ice, compression and elevation. We grew up with the knowledge of if something hurts RICE, but current research finds that this practice may actually cause more harm than good.

In the past, if you sustained an injury, the first thing you were told was to rest the site of injury, apply ice to the site, apply compression to the site via an ace wrap or something similar and elevate the site.  While at times this still applies, it should not be considered the go-to anymore.  New studies are suggesting that instead of resting and icing an injury, we should continue to move and use the muscles surrounding the site of injury to heal it.

For example, if you sprain your ankle, one of the first things to do is to apply the RICE principle.  But while you are doing this at night, you should be gently performing exercises to return the range of motion to normal, maintain strength and ligament proprioception, which allows the ligaments to help the joint function properly. But just because RICE has been refuted in new literature, that doesn't mean the "no pain, no gain" motto is the way to go either. It is also important to note here that if you have become injured, you should not develop a strategy on your own to move the site and maintain strength and stability, you should consult your medical professional because you could wind up hurting yourself even more.

Something that people often fail to understand is that if there is pain, taking time off does not fix the pain.  Most often you will limp following an ankle sprain.  This limping will cause problems in you hip, knee and lower back.  Stopping and resting will allow your muscles to become weaker and your ligaments will forget how to work properly.

Something you can do if you find yourself in this position are gentle range of motion exercises to help you return to walking as soon as possible.  Gently move in the range of motion that feels uncomfortable but not unbearably painful.  Do this many times throughout the day.  Each time you move it, try to move it a little further, if you cannot, that's ok but try each time to move it a little further

Another exercise is weight shifting, as shown in the video below.  Stand with your hands on a table so you can put most of the weight through your arms, and slowly put weight onto the foot, accepting as much as you can and then shifting back off of it.  Each time, try to put more weight on the foot.  Eventually, as you begin to feel better, start practicing single leg standing.  There are other exercises that the video shows that can be done as the pain subsides.  Then, at night or after performing the exercises, you can apply the RICE principle.

It is important to understand where your pain is coming form in order to follow the proper course of treatment. For example, if you go for a run and you start feeling pain in your knee, RICE will not help you.  While applying ice may help with pain, it will not solve the underlying problem.  Knee pain is most often not coming from the knee; it could be issues at the hip or ankle that is causing the pain.  Again in this case, doing gentle range of motion exercises, putting weight on the leg by weight shifting, doing body weight exercises will help heal the injury and return you to normal activity, without any long term issues.

It is also important to understand that swelling is not a bad thing.  Many people get upset that there is swelling but this just means that there is good blood being brought to the area to help heal the site.  Doing exercises with certain muscle groups can help pull the swelling out of the area but will not get rid of it completely (but that's ok).

Understanding where and when RICE is applicable is key to understanding when to use it.  Most often, it can be more beneficial to keep the injured area moving in order to improve healing time but make sure that you consult with your health care professional before trying any exercises.

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