Whether you have heard or not, the R.I.C.E. protocol turns out to be not worth it’s salt.
The letters stand for rest, ice, compress, and elevate if you’re not familiar. What I can guarantee you’re familiar with is what this protocol is used for: musculoskeletal injuries or soft-tissue injuries. Your standard sprained ankles, awkward arm landings, and even contact injuries all receive the attention of this protocol.
Well, unfortunately for us who have been adhering to this for years, we’ve been wasting our time. The founder of the method, Dr. Gabe Mirkin, came out with a blog post that announced he essentially just made it up while he was writing a sports-medicine book.
Now he is a licensed doctor and he used his experience to make informed decisions regarding this method, but it’s important to understand that he literally made it up.
He wanted something that would be catchy for the book he was writing and my gosh, did he stumble upon something catchy. People all over the world have been wedded to this method almost like nothing else I’ve ever seen before.
Try twisting your ankle and not having someone tell you to immediately ice it, go home and rest, make sure you elevate it, and maybe put an ACE wrap on it.
Obey the R.I.C.E. is the message.
But that was over 30 years ago. With his article from 2015, he stated that he no longer abides by his previous recommendations to patients.
“Coaches have used my “RICE” guideline for decades, but now it appears that both Ice and complete Rest may delay healing, instead of helping.” — Dr. Gabe Mirkin
Let this be a warning of how most medical advice comes to be. If health professionals can market it to the general public the right way, they’ll have a hit just like Dr. Mirkin did this time. There is trust built into their professional titles and that goes a long way when people are seeking an answer to their problem.
Another great example of this is the “8x8 rule” — drink eight 8-ounce glasses of water per day. Robert Roy Britt points out in his article that this “rule” is not a rule at all, in fact, it’s based on no science that anyone is aware of. These pseudo-scientific soundbites or abbreviations are often catchy enough for people to grasp and repeat to each other.
Take everything with a grain of salt, no matter how many people repeat it like gospel. Medical and scientific advances are always being made and things are being disproven all the time.
In many ways, the falsifiable nature of it actually makes it great. It is a pursuit of truth, not of personal opinion.
We are so wedded to this method, however, that my girlfriend’s sister-in-law, who is a nurse, willingly plays along with it while knowing better.
The sister-in-law’s daughter got hit in the lip while playing not too long ago, and mom ran to get ice and applied it to her daughter’s face immediately.
My girlfriend, having heard me talk about how this method had been recanted, asked if she was aware that icing is useless for recovery. The mother (sister-in-law) knew, responding without hesitation, but merely shrugged as if to say “but this is just what we do.”
I was amazed to hear this. Maybe I shouldn’t be because this is what most people would do.
There’s a reason Dr. Mirkin recanted in 2015 and the general population still has absolutely no clue, despite there being plenty of other people online documenting this tremendous breakthrough.
It’s much less a problem of awareness and more a problem of embedded beliefs.
We must admit, we’re not very good at updating our belief systems. I’ve told several people since I’ve learned of this information and they’re simply not interested.
Despite knowing that I research topics like this religiously and have the proof to show for it, they have no reason to change their mind. It feels scary to do so because you’re going against the grain, even though going with the grain was actually incorrect the whole time.
I sprained my ankle a couple months ago while playing soccer. Lucky for me, I had recently gotten a whiff of Dr. Mirkin’s article so I was able to hobble home and check back in with the internet’s new recommendations for me.
I decided to completely avoid the R.I.C.E. method and instead pursue a new one: active recovery.
Long story short, my ankle healed faster than ever before, and I’ve had a lot of sprained ankles.
Exactly two weeks to the day later, I was playing soccer again.
From a massively inflamed, purple and blue ankle to an almost fully functional ankle once again. I played that next match carefully of course, but the general takeaway is this:
“The body is meant to self-repair, not self-destruct.” — Gary Reinl
Gary Reinl is a professional athletic trainer who is known as the “anti-ice man.” He’s been telling athletes to stop icing for years.
His book, ‘Iced!’, details why icing injuries is a bad idea and he managed to get none other than Dr. Gabe Mirkin to write a foreword for it.
Reinl’s advice can be summarized as such:
Don’t be too alarmed by inflammation or pain, the body has an ingenious plan to clean it all up.
Muscle activation around the injured area pushes the inflamed waste through the body and into the lymphatic system so it can be disposed of.
Inflammation is natural and it occurs because of the accumulation of waste from the injury and from the fluid that the body has sent to clean up the mess.
The pain is the body’s alert system that tells you which movements are harmful. None of this is meant to be numbed, it’s all intentional.
The reason I healed myself with active recovery is because of Gary Reinl’s advice. He has cited this study on more than one occasion as being an unbiased one and not “bogus” like he has called others.
From that same study:
“One of the most important concepts in orthopaedics in this century is the understanding that loading accelerates healing of bone, fibrous tissue, and skeletal muscle…patients with musculoskeletal injuries and those who have recently undergone surgery are now being treated with controlled physical activity that loads their healing tissues.”
“Loading,” so it is called, is the key ingredient here and the main component the R.I.C.E. method is missing.
It is imperative to activate the muscles in and around the site of the injury to heal it in a timely fashion. It is the only way the body can shuttle waste into the lymphatic system for disposal and the only way the body recovers.
From now on, take your R.I.C.E. with a grain of salt.
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