Is it RICE or is it MEAT?

Ice, ice baby! That has always been the go-to treatment for acute injuries, but these days is it the right way to treat acute injuries? After a basketball game, someone has sprained their ankle, they were told to rest, ice, compress, and elevate (R.I.C.E).

Specifically, R.I.C.E. has been the protocol for ankle sprains, strains, or other acute injuries to reduce pain and swell as quickly as possible. Rest is the first element in R.I.C.E. and avoiding any stress or movement of the injured site benefits the healing process. Ice is the next step and includes any form of cold therapy. Icing for 15-20 minutes every 2-3 hours is recommended. Decreasing temperature helps reduce pain, limit bleeding, and reduces swelling. Compression also helps reduce swelling and prevents hemorrhaging using an ace wrap or compression sleeve.

Lastly, elevating the injured area decreases the pressure in the surrounding blood vessels limiting bleeding and help reduce swelling. So in a nutshell. R.I.C.E is used to decrease blood flow and reduce swelling.

A more recent trend in treating acute injuries is M.E.A.T. with the acronym of movement, exercise, analgesics, and treatment. M.E.A.T. increases the blood flow to injured areas to enhance the healing. Injuries to structures that have limited blood supply like ligaments, tendons, and cartilage are hindered by the R.I.C.E. principle by reducing the blood flow thus prolonging the healing process.

Movement means maintaining the range of motion of the injured part because the more you move the quicker you heal. Movement moves fluid to and from the injured site. The movement also helps reduce the formation of scar tissue.

E is for exercise and this encourages circulation by bringing in fresh blood and removing the damaged tissue. To aggressive exercise may damage the newly formed tissue so target specific exercises can be prescribed.

A is for analgesics for pain. Non-steroidal anti-inflammatories have been used exclusively, and reduce inflammation although is critical to healing. Evidence shows that NSAIDs can inhibit healing. Tylenol or acetaminophen can reduce pain without inhibiting healing. Nutritional supplements are also an option.

T is for treatment and this can be a broad spectrum of modalities. Contrast soaks between hot water and ice water can be done, ultrasound and acupuncture are options. Injections of platelet-rich plasma or Traumeel, an all-natural product can be done. Steroid injections should be avoided. Newer technology treatments such as extracorporeal shockwave therapy or laser are options. 

What’s all this mean? Ask most health professionals what to do after a sprained ankle, and the most common answer is R.I.C.E. Whether your injury is acute or chronic, knowing how to treat it is essential. R.I.C.E. certainly has its place, and most people will lean on that concept, but M.E.A.T. has certainly gained traction in the medical field as a better alternative to reduce inflammation and promote healing. Studies have shown that with ankle sprains, early mobilization had less pain and returned to activity sooner compared to a group that was immobilized. Many practitioners recommend R.I.C.E. for the acute phase for the first 2-3 days then incorporate M.E.A.T. after that. Times have changed in how acute injuries are treated, as well as advances in medicine, so don’t get left behind!