Hi all

Here is a little brain teaser, which relates to the management of sports injuries. I have for a while now been questioning the effectiveness of RICE in acute injuries and would like to add this to the forum to see what the reaction is. I believe it is comparing logic and common sense and human physiology to theretical practice. I may be wrong, but then.....

Some of the answers in some threads have mentioned RICE in the initial phases. I have a few things which might make you think about this differently. Although it is widely held that this is an acceptible approach to use for acute injuries, I feel we may be missing the point here. Theoretically ice reduces swelling, inflammation and pain, restricts blood flow to reduce bruising, however, this is theory, and yes these are the effects of applying ice to the body. But why would we want to starve an injured area of a natural blood flow for anything up to an hour. Inflammation, swelling, pain, bruising are all natural part of the injury process, BUT THEY ARE ALSO NATURAL PARTS OF THE HEALING PROCESS! Without these the brain will never know for sure the injury occured. So reducing these inputs can severely diminish the body's ability to repair itself. Where is the research to prove RICE helps the repair process or shortens the recovery period of an injury? I have not seen any, just as I have not seen any regarding ice baths! It is a SYMPTOMATIC APPROACH, not treatment approach. The ironic thing is that if injured and left to its own devices the body responds with vasodilatation in the injured area, NOT vasoconstriction, which goes against anything we have been told. So if the body itself increases the blood flow to the area, why are we shutting it down? For repair to begin the body needs platelets, red and white blood cells in the area, so it makes sense to increase the amount of blood in the area, but this takes place almost immediately, yet if we restrict blood flow, this cannot happen. Bruising will eventually stop as blood vessels repair quite quickly, so we should not worry about that and swelling is from damaged cells...they cannot get any more damaged and only have a certain amount of fluid in them.

In my opinion we should focus more on trying to influence more blood to the area, not away from it. This can be done by using small doses of ice (10 secs at a time, removed until the skin warms up again), below the injured area if possible to stimulate flow THROUGH the injured area, not around it which is what happens with orthodox icing.

My opinion: RICE...rest, yes. Ice, NO!

What do you think?