Better Rehabilitation, Faster Recovery
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RICE is so WRONG?!

September 4th 2019 in Rehabilitation

We’ve heard it time and time again. When you have a sprain: Rest it. Ice it. Wrap it. Elevate it. This is also known as the RICE method – Rest, Ice, Compress, Elevate. You have long heard it from your doctor, nurses, trainers, and friends, but did you know that this method might be wrong in a lot of cases?

But RICE is Changing

Based on the latest research, we now know that the key to healing is blood flow. Icing, compression, rest, and elevation have the opposite effect. Ice causes numbness because the body doesn't want to lose heat to the outside and shunts blood away from the area where ice is applied. Compression restricts blood flow by applying outside pressure to the tissues. Rest reduces blood flow by remaining immobile. Elevation reduces the pressure of the blood with gravity.

How Do Sprains Heal?

While methods like rest and compression keep the sprain numb to the pain of recovery, they might also cause recovery to take longer. Our bodies have to break down damaged cells and rebuild. The process of healing begins almost immediately after the injury occurs and is categorized by three phases. These are:

  • Hemostasis/inflammation phase
  • Reparative phase
  • Remodeling and maturation phase
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Healing Phase 1 – Initial Inflammation

  • 1. The body initiates processes to form blood clots in the injured area and begin acute inflammation.
  • 2. Fluid from blood vessels leaks into the surrounding tissue and triggers the characteristic signs of acute inflammation and injury: redness, swelling, and warmth.
  • 3. During this time, white blood cells are attracted to the area through chemical signals.
  • 4. Local nerve cells are also triggered during this process and work to send pain signals to the spinal cord and brain.
  • 5. At the end of the period, cells known as monocytes arrive and work to clean up dead cells and any foreign matter at the site of the injury.

The inflammatory period in the healing process can last several days.

Healing Phase 2 – Rebuild & Repair

  • 1. Platelets in the blood release chemicals that help initiate the longer-term processes of healing that occur during the reparative phase.
  • 2. These chemicals attract cells to the site of the injury.
  • 3. These cells begin the process of rebuilding by producing the cells that make up the extracellular barrier, as well as large amounts of collagen that make up scar tissue.

The length of time and success of this reparative process depends largely on the location and severity of the injury.

For reference, in an ankle tendon that has been injured through a sprain, this repair process can take up to six weeks.

Healing Phase 3 – Remodeling & Strength Training

  • 1. The muscles around the injured area should be challenged with strength training.
  • 2. Stressing the muscles and connective tissues stimulates growth and improved function.

The final remodeling phase of healing may last several weeks, months or even years.

In the process of healing an ankle tendon the original tissue used to heal the injury begins as very fibrous and then transforms to a stronger scar tissue during the final remodeling phase.

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Until all three phases are complete, the tendon or injured area may be easily re-injured. The tissue used during the repair is simply not as strong as it was originally and may never be. In some cases, this can contribute to chronic instability of the joint. At other times, acute injury can evolve into a chronic low-level inflammation causing unresolved pain and irritation in the area.

By promoting the right kind of controlled blood flow and rehabilitation, we might be able to improve upon the process. Which leads us to the question:

How should we promote healing the right way?

This is where MIO and the METH method come in.

The METH Method – Movement, Elevation, Traction, and Heat

METH is an acronym for Movement, Elevation, Traction, and Heat. This method doesn’t cut off blood flow to injured areas, which puts you at risk for additional injury due to decreased sensation in the area.

Movement is to get some range of motion back in the injured area. MIO focuses on the third phase of recovery by applying the right strengthening and stretching exercises to the effected joint using wearable technology and AI built into our MIO App.

Elevate the injury when you are resting. Feel free to put your sprained ankle on a chair instead of letting it rest on the ground while you sit at your desk. Left on its own, your injury will swell more than you want it to.

Traction is a method used by physical therapists to encourage healing. It involves gently pulling on the joint. Have someone apply a little traction to your foot in the case of an ankle sprain. In the case of a wrist sprain, you can pull traction yourself by grabbing something solid (like a metal guardrail) and pulling back to elongate your wrist. The amount of traction should be as little as possible to get relief. Don't pull longer than a few seconds and release slowly.

Heat encourages blood flow rather than stifling it. Just like with ice, don't overdo it. Heat shouldn't be applied for more than 30 minutes at a time and it doesn't need to be very hot. Don't burn yourself.

At MIO, we focus on using wearable technologies to better physical therapy and rehabilitation. Learn more about how our MIO sensors can help you recover faster, better, and cheaper on our website. Or contact us directly with any questions.