RICE: Yes or No

[physiomitch]

Sorry, please read this after the above reply.

Just a further point on use of hot or cold in general. We need to keep aware of what is termed 'reciprocal blood flows'. This means we have a closed vascular system with a set volume of blood, and thus the body regulates the pressures to maintain a a balanced internal environment. Now if ice is applied to the skin, the surface blood vessels constrict, but to maintain even blood pressure, blood vessels somewhere else will have to dilate. This is known as reciprocal blood flow. So icing an injured area causing constriction will mean initially muscle vessels will compensate by dilating, but the longer the ice is applied, the deeper the compensation will become. Thus blood can actually be diverted away from and around an injured area to maintain good pressure and flow rate.

The converse with heat; this causes dilatation in the skin meaning there has to be constriction somewhere else. Examples of reciprocal blood flows are: between the skin and underlying muscles, between internal and external carotid arteries, between skin and gut, and importantly between paravertebral skin and spinal cord (can be harmful using cold or ice on the back resulting in congestion in the spinal cord).

Another reason maybe not to use ice for so long? Ideally we want to maximise blood flow RATE to allow the body to initiate the healing process. Interesting to note how acupuncture practitioners in the east treat acute injuries...they needle around the injured area (trapping the Dragon), essentially causing MORE injury, enhancing the body's processes, not stagnating them.

Pete