An Updated Approach Recovering From an Injury

Sprains and strains are some of the most common injuries people suffer through all age ranges. There is no way to prevent all injuries but there are things you can do to minimize the recovery if/when it happens. The popular expression R. I. C. E. is no longer the best advice! Back in 1978, in The Sports Medicine Book, Dr. Gabe Mirkin coined the term RICE which stands for Rest Ice Compression Elevation Dr. Mirkin, the creator of RICE, published an article that directly debunked his own theory and exposed the lack of benefits that come from icing injured tissue. Dr. Mirkin went on to say: “Coaches have used my RICE guideline for decades, but now it appears that both ice and complete rest may delay healing, instead of helping.” Like Dr. Mirkin I have changed my view on using ice. Rather than use ice I recommend compression. There are several reasons for my recommendation including: 1. You can wear the compression for hours. 2. It minimizes swelling accumulation 3. It encourages blood flow which brings the ingredients for healing and encourages the removal of debris from the injury. Ice is not something that you can use for hours. In fact, the typical recommendation is 20 minutes at a time. It’s difficult to stay mobile while icing but using compression allows you to be active. I encourage my patients to wear compression as often as they can and to move often as well. Ice slows blood flow but does not reduce swelling. In the early stages, ice may have an effect on minimizing the swelling, but once there is swelling ice does not reduce it. Ice does slow blood flow to the area but if slowing blood flow does not mean reduce swelling. And, it’s not always the best strategy to reduce blood flow if you are trying to get the swelling to move and when trying to encourage healing. Ice is an analgesic and can reduce pain levels so I am not totally against it, I just don’t think it works as well as compression and therefore if I was choosing the “most” effective strategy I would choose compression. Resting is no longer considered the most effective strategy for a rapid recovery either. For years, I recommended movement rather than rest because in rehabilitation the thing I have found to help people more than anything else it restoring mobility. This applies to joints and soft tissue (i.e., muscles) One of the things I emphasize most in the beginning is restoring a patient’s motion. I often prioritize it above pain control because I have found improving mobility leads to less pain and the sooner we restore mobility the more rapid the recovery. Rather than REST, Dr. Mirkin recommends MOBILIZE. Mirkin says, “Mobilization, when possible, is crucial to the recovery process. If you have sprains, strains, pulls, bumps and bruises, try to keep the region as mobile as possible by taking the nearest joint(s) through its full range of motion to the best of your ability.” When mobility is too painful or simply impossible, activation is a great next step. Activation can be manual where the muscle around the joint is precisely triggered by hand to promote activation. At my clinic, manual therapy is used in conjunction with all other forms of rehabilitation. The results of manual practices for improving function rapidly are unmistakable. This is best performed by a physical therapist or other medical practitioner including Chiropractors and Massage Therapist and can be taught to someone able to help at home. If that is too painful, try another activation technique in Physical Therapy like the TENS Unit, which stimulates surrounding muscles without causing direct pain. The only remaining letters of Dr. Mirkin’s RICE is the C and E. The C, for compression, is here to stay. Ideally, you want to compress the area and mobilize it while it is compressed. This was my point earlier because compression can be worn for hours and has more impact than icing for a few minutes at a time. A simple wrap or ace bandage will make a big difference in recovery. I often recommend compression sleeves and in some cases compression garments. I also recommend elevation...but elevation as high as you can. For example, if you injure your ankle or foot, I recommend propping the foot up as high as you can. On the back of the couch or exercise ball works. After injury, it is important to hydrate the body. Water is essential for nearly every function of the human body. Dehydration can increase joint pain, muscle soreness and slow down the lymphatic process. Staying hydrated will ensure that everything is functioning properly. Make sure you are getting water when you’re injured. I recommend adding up to 24 ounces to whatever total you usually aim for. Observation is the last (but not least) step. Your body gives you continual feedback during the recovery process. It’s your job to observe and react to it. How does the affected area feel? • Are you still in pain? • Has the issue become worse? • Is there bruising? • Is your inflammation decreasing on its own? Learn to listen to the feedback your body provides you and use it to your advantage rehabilitating the injury. Follow the recommendations above and you will start your rehabilitation on the right path to a quick recovery. It is important to remember that the body is working to heal and ignoring symptoms does NOT help the process go faster. Too often patients think something should get better and by ignoring it actually makes the condition last longer. If you have any questions or would like to be assessed for your injury, you can contact Matthew Goodemote PT for screening at 518-332-4614 or This email address is being protected from spambots. You need JavaScript enabled to view it.