: RICE versus METH introduction Now that we are in full swing of the fall sports season, there will be a plethora of injuries that need to be evaluated and treated during sideline management.
: RICE versus METH introduction Now that we are in full swing of the fall sports season, there will be a plethora of injuries that need to be evaluated and treated during sideline management. The most common modality used for acute injuries is ice. This has been common practice for decades.
More recently, the RICE (Rest, Ice, Compression Elevation) has come under some scrutiny. Some providers are electing for METH (mobilization, elevation, traction and heat). Gabe Mirkin, a physician and former assistant professor at the University of Maryland , first used the acronym RICE as a way to treat an injury.
However recently more and more people, and in fact Dr Mirkin himself, have started to question whether or not RICE is the best way to deal with an injury. “Nobody believes in rest anymore,” Dr Mirkin says. “You can get a hip replacement and you’re on the bike 12 hours after surgery.” As for ice, “there is no data to show that ice does anything more than block pain,” he says.
“And there is data that shows it delays healing.” These opinions were cited in his own blog. When disruptions form in tissues, the body responds with three sequenced phases of recovery: inflammation, repair, and remodeling. This sequence means that the process of inflammation must successfully occur in order for the body to shift its focus to the repair phase which must also be completed before proceeding to the remodeling phase.
The magnitude of the inflammatory response is dependent upon the severity of the trauma, as well as the degree of vascularization of the tissue. Inflammation is the first phase of a three-phase sequence of tissue repair, while swelling is “the accumulation of waste at the end of the inflammatory process that is not yet evacuated” Inflammation is not an undesired outcome that needs to be reduced or delayed, but rather an instantaneous defense mechanism with the primary objective of controlling the extent of cell injury and preparing the tissue for the process of repair. As noted by Leadbetter, “inflammation can occur without healing, but healing cannot occur without inflammation.
If you are experiencing symptoms that may be related to acute injuries: rice verses meth, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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