Everything You Need To Know:
The R.I.C.E. Method
The R.I.C.E. Method is a relatively common approach to easing foot and ankle pain. Doctors usually recommend the R.I.C.E. method for patients at home who have suffered a recent injury such as a sprain, strain, bruise, contusion, or Achilles tendon rupture. Some medical approaches become outdated and today, that is what our specialists at PediFix are going to explore. For more information on what the R.I.C.E. method is, how to do it, and other important information, keep reading!
What Is The R.I.C.E. method?
The steps to the R.I.C.E. method are fairly simple:
R– Rest. Keeping the injured area still was long thought to encourage healing by preventing any interruptions with the fibrin bond. Fibrin is a protein that is used in homeostasis, the process where the blood clots to prevent flow and heal an injury. By resting an injury, you would be avoiding stress and strain and making space for healing.
I– Ice. Ice the affected area for the first 48-72 hours following an injury. The local application of cold temperatures is often used to reduce pain, limit bleeding, and reduce swelling. Apply ice for 20 minutes at a time, with a one-hour break in between.
C– Compression. The goal here is to reduce swelling and prevent hemorrhaging. Applying compression to an area can also reduce exudate, fluid, and cells that leak out of organs or blood vessels during inflammation, which could reduce the amount of scar tissue that develops.
The orthopedic specialists at The Center of Orthopedic and Neurosurgical Care located in Bend, Oregan shares an informative “How-To” video so you can see the R.I.C.E. Method applied to an acute injury visually. To view the video, simply click on the “How-To” video link!
When To Use R.I.C.E. protocol?
The R.I.C.E. method is a treatment recommended for soft tissue injuries such as sprains, strains, bruises, or contusions, but has been shown to support the recovery process in conditions such as an Achilles tendon rupture, or part of a plantar fasciitis treatment plan. Performing the R.I.C.E. method can begin as soon as you notice any pain or discomfort, and can be used as often as needed while you heal from your injury. It is recommended that the R.I.C.E. protocol is used within 48 hours of an initial injury. Put simply, it is recommended to try to stay off your feet as much as possible, avoid high-impact activities, and ice regularly while you heal. If you plan on doing a lot of walking or you notice swelling, tape your feet or wear compression socks! Taking care of your feet with the R.I.C.E. treatment method will give your body a chance to repair your damaged extremities.
Fact or Myth?
The R.I.C.E. protocol has been the preferred method of treatment for acute injuries since its origin in a 1978 publication entitled “Sports Medicine Book” by Dr. Gabe Mirkin. These guidelines have been used by coaches and healthcare providers for over four decades with the intent of expediting the recovery process of an injury and reducing inflammation.
There is an abundance of scientific evidence of other methods that can also be used to accelerate the healing of muscle, ligament, and tendon injuries that do not include extended periods of rest used in conjunction with ice, compression, and elevation. To debunk if the R.I.C.E. protocol is genuinely fact or myth, it is crucial to explore the body’s responses to injury and the effect ice, compression, elevation and, inactivity have on those processes.
Why Would The R.I.C.E. Method Not Work?
Over the years, this method has raised skepticism in the medical field, with studies suggesting that the R.I.C.E. protocol may slow down the healing process. Researchers suggest movement and heat may be better for healing than rest and ice, but very little information supports this statement.
Studies have been conducted to investigate if immobilizing injured joints after an injury leads to patients feeling increased pain and discomfort over time. A study by T.L Mehlhoff et. al examined the healing process of patients that followed immobilization protocol after an injury. 35% of patients in the study had pain when extending their elbow and 45% of patients in the study had increased residual pain up to three years after their initial injury. This study is a clear indication that immobilization of injured joints led to patients feeling discomfort and pain over time.
Another study done by Bayer et. al. found similar results.
This study was done in a population of 50 athletes with over half of this population having a thigh injury and just under half having a calf injury. Randomly selected, some of the athletes in the study were instructed to begin remobilization injuries two days after the injury, while the remaining athletes remobilized nine days after the injury. After one year of remission, the athletes in the study had a follow-up appointment. It was found that those who began to introduce movement into their rehabilitation routines sooner after injury (in two days rather than nine days after injury) had a shorter recovery time until they had a full return to sports. This study could also be another indication that immobilization of injuries can cause more pain and discomfort in patients over time. This study suggests that some movement after an injury is beneficial to returning that area to full mobility.
The Body’s Response To Injury
The pain that many patients experience post-injury, may be due to sensory neuropeptides in blood vessels. This is a common response from the body when the healing process from an injury is interrupted. In a study by Bring et. al examining an Achilles tendon rupture in a rat model, it was found that the rats that had mobility after an injury had a much higher regeneration rate in their tissues. This caused their injury to heal quicker than those that did not introduce mobility after an injury. This study suggests that without proper healing (mobilization of an injury), the sensory neuropeptides in our blood vessels can become “over-sensitive”. This sensitivity can result in a perceived increase in pain, further suggesting that immobilizing injuries after an incident can decrease the mechanical steps necessary for recovery and decrease pain.
Is the R.I.C.E. method outdated?
The R.I.C.E. method may simply be outdated for what we know about the importance of mobilization for soft tissue injuries but not necessarily outdated as an important step in injury recovery. To make a full and timely recovery, the injured area must be mechanically loaded to promote healing on a molecular level that translates to a full recovery and full range of motion with limited pain. Further studies should be done to determine how soon after an injury it is beneficial for patients to begin loading and moving their injured sites, as well as studies that show how much loading is optimal long term.
Athlete and Celebrity Experiences With The R.I.C.E. method
Track athlete Lynn Williams won a bronze medal in the 1984 Olympics despite suffering a foot stress fracture in the Olympic build-up. Dr. Clement had advised Lynn to run in water, and then to gradually transition back to running on land six weeks before the games. This was the same rehabilitation prescribed to Donovan Bailey in 1998 when he was recovering from a repaired Achilles tendon rupture. His surgeon Dr. Galea is quoted as: “We had him in the water right away, and by ten weeks he was jogging”. A year later, Bailey surprised the world by running 100 meters, yet again, in under ten seconds.
Are you interested in finding the best products for your at-home R.I.C.E. method protocol kit? Look no further! Our specialists at PediFix® offer a variety of ankle sprain treatment and prevention products, along with other products that effectively minimize stress in the lower extremities and prevent future injuries. Convenient ordering and guaranteed satisfaction, find your favorite foot and ankle products on our website:
Pro Tip: Wearing proper footwear and shoe inserts, such as heel stabilizers and heel supports can take excess stress off of your lower extremities and, prevent future injuries.
If you have tried the RICE method but see no improvement, or if you are unable to put any weight on the injured area within two days of an injury, you should seek medical attention. If you have questions about how our products can support you, please call 1-800- PEDIFIX (733-4349) to learn more. Our product specialists are ready to support your needs!