Apologies for the outburst, but stop doing this.
This is an acronym that has persisted throughout time when it comes to injuries. For the uninitiated it stands for
R – Rest
I – Ice
C – Compression
E – Elevation
In recent years this particular acronym has come under fire by many that work in the realm of human performance. To put it bluntly, RICE is an antiquated term and in my opinion a lazy rehabilitation prescription. Many of us, when we experience an injury, want to get back to how we were performing before the injury occured – RICE isn’t the most optimal way to accomplish this task.
While RICE can potentially be useful in certain scenarios it has fallen behind more practical measures.
So, get back in the game using some of these strategies.
GET BACK TO MOVEMENT – SOONER RATHER THAN LATER
I have a little bit of a problem with the first letter in RICE – rest. Oftentimes when we go to the doctor or physical therapist the first thing they recommend is for us to rest our ailing joints, muscles or whatever the case may be.
For transparency sake; we’re talking about minor issues such as a minor muscle pull, swollen joints, and other nicks of that nature. Of course, if you ruptured a muscle, joint, or ligament then you need to seek a medical professional – hopefully that goes without saying.
Back to the original point, if you have a minor injury you need to get back to moving. There is a tried and true statement that says “use it or lose it.” Our bodies tend to operate in this fashion. If we experience an injury then we subsequently experience inflammation, swelling and pain. These mechanisms make movement seem like an unwelcome solution to our problem. But if we don’t move, our body doesn’t see much need to bring that injured area back up to snuff.
Injuries occur when our workload outpaces our body’s capacity to handle that workload. When we overfill our capacity cup our bodies do not see much reason to try and reach that same level of output because that’s what got us injured in the first place.
Think about it, have you ever injured your shoulder or knee and that one side never seemed to catch up to the other non-injured side? Do you have a “good leg” or “good side?” You’re experiencing that down regulation in output due to prior injury.
Movement is medicine, especially when it comes to injured soft tissue. So, the “rest” portion of RICE can be a little misleading.
CROSS EDUCATION PHENOMENON
This is one of the cooler phenomena in human physiology. Like I said earlier, when you experience an injury you will ultimately experience a down regulation of output in that muscle group.
You’ve lost horsepower.
That loss of horsepower stems from our nervous system. There’s been a degradation in neural drive to that affected muscle.
But what if I told you that, we can work around that? Even if the injured site is completely compromised.
Cross education speaks to nervous systems plasticity when dealing with injury. If we simply train the opposite side we can slow the degradation of the injured tissue.
Imagine you’ve injured your shoulder. SLAP tear, a pretty brutal one but your other side is completely fine.
If we begin to train that contralateral (opposite) side we can stave off how fast we lose output on the weakened side. This is thought to originate from increased neural drive from the depleted side since our extremities share similar regions within our brain.
There’s not a ton of evidence (yet) to suggest that hormonal or increased cross sectional area of the injured muscle contributes as well. I’d say it’s fair to suggest that hormonal output plays a role in holding onto old gains – that’s just my unsubstantiated opinion.
Pretty cool, right?
It is common practice to have clients or patients ice their injured areas to help reduce inflammation and numb pain. Outside of this though there isn’t much of a reason to ice. Icing an area can help with pain management but it doesn’t help in the way of healing the injured tissue or restoring movement capacity.
In fact, you’re reducing blood flow to that injured area. Blood is a nutrient stream and is the main contributor to healing tissue. Why would we reduce blood flow to an area that needs more nutrients for repair?
A better alternative in my opinion would be a contrast bath – mixing equal time between hot and cold temperatures – because of the artificial pump that’s created. Switching between hot and cold baths can aid in lymphatic drainage which is important for recovery.
I’m also a fan of hot baths by themselves as well due to the fact that it can increase systemic circulation. Which is important for joints that have a hard time getting adequate circulation such as the ankle.
I’m a huge fan of compression as a passive means of recovery. When we compress an area of our body we increase the temperature at that area and we mitigate the level of swelling. We also add a layer of support for the joint or muscle.
An effective strategy when using compression can be to wear compression garments on active recovery days between bouts of strenuous activity or if you’re injured wearing something during your return-to-play protocols is also a good option.
Be sure to add movement while wearing compression tools or garments because you won’t benefit much if you wear the garment alone – remember movement is medicine.
The premise behind elevation is to increase blood flow back to the heart. Our heart recycles our blood and with an elevation strategy we’re trying to recycle the damaged materials lingering within the blood.
I try to elevate or hang from something everyday in order to decompress and replenish. When combined with things such as box breathing, elevation can be a quality maintenance maneuver.
CONCLUSION AND A BONUS
There you have it, RICE “debunked.”
Some aspects of RICE are great but to put a bow on it I’d say tread lightly with the first two letters. Of course, the best practice is to train properly to prepare your body for the demands of the gym, sport or whatever comes down the pike.
But injuries are a part of the process so the best we can do is mitigate future occurrences.