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RICE- End Of An Ice Age

June 9, 2014, 7:17 a.m.
Posts: 26382
Joined: Aug. 14, 2005

http://stoneathleticmedicine.com/2014/04/rice-the-end-of-an-ice-age/

www.thisiswhy.co.uk

www.teamnfi.blogspot.com/

June 9, 2014, 8:53 a.m.
Posts: 2099
Joined: April 22, 2006

I've been following the argument on my cousins facebook page. He operates a training center for wilderness first aid training and is also a paramedic in Hamilton.

Although they say METH (movement elevation traction heat) is the new RICE he points out that there isn't a lot of evidence either way so it hasn't made itself into their curriculum at the school.

RICE has the ability to make people feel better and as he puts it. "In a wilderness setting this isn't a bad thing." The consensus among the teachers at the facility though is that METH is a better practice although it is not an EBM (Evidence Based medicine) technique. They look forward to seeing more research done into it but many of them still employ the technique personally.

Personally I've always felt that a regiment of basic stretching after a soft tissue injury works great and usually lessens my need for prescription pain killers (which I hate taking).

June 9, 2014, 9:01 a.m.
Posts: 16286
Joined: Nov. 20, 2002

FFS …

RICE is a first aid treatment and is never meant to be used beyond the first 24-48 hours after injury. It aids in minimizing swelling and aggravation but is not considered part of the healing or recovery process.

It is not a treatment regime. Apples and oranges.

When one person suffers from a delusion, it is called insanity.

When many people suffer from a delusion, it is called religion.

June 9, 2014, 9:09 a.m.
Posts: 14532
Joined: Nov. 20, 2002

I use ice baths (beer cooler full of snow [HTML_REMOVED] water)for my feet after big ski touring days on advice of a sports physio buddy, no question it works IME

June 9, 2014, 10:43 a.m.
Posts: 456
Joined: Nov. 23, 2002

i see the debate that this guy josh stone is bringing forward is against the overuse of ice - which i agree with. it is not against the inital use of RICE therapy. you'll see this if you read through his entire blog post and particularly Dr. Mirkin's statement at the end:

"My Recommendations

If you are injured, stop exercising immediately. If the pain is severe, if you are unable to move or if you are confused or lose even momentary consciousness, you should be checked to see if you require emergency medical attention. Open wounds should be cleaned and checked. If possible, elevate the injured part to use gravity to help minimize swelling. A person experienced in treating sports injuries should determine that no bones are broken and that movement will not increase damage. If the injury is limited to muscles or other soft tissue, a doctor, trainer or coach may apply a compression bandage. Since applying ice to an injury has been shown to reduce pain, it is acceptable to cool an injured part for short periods soon after the injury occurs. You could apply the ice for up to 10 minutes, remove it for 20 minutes, and repeat the 10 minute application once or twice. There is no reason to apply ice more than six hours after you have injured yourself."

you'll see that RICE is still good to use right after an acute injury takes place.

the worst thing for the injury rehab cycle is too much rest and/or lack of movement. depending on the severity of the injury, after the short initial rice phase (less than 30min IMO) a return to movement should happen asap. this follows as one of the main reasons to use rice in the first place:

1. limits the level of swelling and immobilization of the affected tissues and joints due to the initial injury and from post injury rehab

2. limits the amount of pain due to the initial injury, post injury swelling and post injury rehab

both of these points are critical in allowing a timely return to full or close to full ROM post injury. the reason for this is that the swelling from an untreated soft tissue injury can increase the healing time due to the immobilization and associated pain of the affected area from scar tissue. if there is little to no blood flow to an area healing takes place at a very short rate and unfortunately this is the undesired after affect of the initial swelling reaction.

once the initial injury has been treated with RICE a combination if heat, limited ROM exercises/activities and alternating heat/ice therapies should be use. the combination of heat/ROM/ice or heat/ice creates a blood pumping action that brings fresh blood into the affected area and carries away waste products from then affected area. this helps in the prevention of scar tissue which greatly helps maintain ROM and imo is the most critical factor in ensuring a quick and full return to activity.

in short:

initial treatment - first 4-12 hours:

1. RICE for 30min immediately after a soft tissue injury to prevent excessive swelling
2. light ROM activities (loaded or unloaded) on a regular basis to prevent joint immobilization (scar tissue buildup from firbin

follow up treatment first thing after waking and as required

3. heat therapy to introduce blood flow to the affected area and to loosen up the affected area
4. ROM activities followed by short ice cycle
5. heat/ice cycles as possible/required to create a blood pumping action
6. massage to help maintain mobility in the injured area

mobility and blood flow = nutrients and healing

if you're interested in some reading on the soft tissue repair cycle check this out:
http://www.electrotherapy.org/modality/soft-tissue-repair-and-healing-review

I'm not a human in real life, I just play one on the internet. 

June 9, 2014, 11:54 a.m.
Posts: 7707
Joined: Sept. 11, 2003

^^^ He said it …

June 9, 2014, 12:36 p.m.
Posts: 14532
Joined: Nov. 20, 2002

My sportsphysio bud from auz told me he would immerse entire pro rugby players in ice bath the day after a game for as long as they could take it

June 9, 2014, 1:01 p.m.
Posts: 7707
Joined: Sept. 11, 2003

My sportsphysio bud from auz told me he would immerse entire pro rugby players in ice bath the day after a game for as long as they could take it

Ice bath recovery to speed up recovery from muscle and joint aches [HTML_REMOVED] pains is the best, as I can personally attest to. You stay in longer if you have beers by the tub to drink. So beer a must-have if you want to recover properly. Have done it many times. Even horse trainers know to hose down a horses legs with cold water after each race.

June 9, 2014, 1:34 p.m.
Posts: 26382
Joined: Aug. 14, 2005

Ice bath recovery to speed up recovery from muscle and joint aches [HTML_REMOVED] pains is the best, as I can personally attest to. You stay in longer if you have beers by the tub to drink. So beer a must-have if you want to recover properly. Have done it many times. Even horse trainers know to hose down a horses legs with cold water after each race.

Done it with cold showers as well.

www.thisiswhy.co.uk

www.teamnfi.blogspot.com/

June 9, 2014, 1:37 p.m.
Posts: 532
Joined: Jan. 31, 2005

Done it with cold showers as well.

I wonder if this is effective because it's a relatively short exposure to cold, which is enough to force out one round of healing fluids to allow a fresh dose to come in?

There's nothing better than an Orangina after cheating death with Digger.

June 9, 2014, 5:36 p.m.
Posts: 11418
Joined: June 4, 2008

I do contrast baths whenever I can. Super cold for as long as you can do it, then jump in a hot tub/shower. Repeat a bunch of times.

Back on the original topic, I came across this and considered purchasing it. Somewhere in there is the creator of the product talking a lot about RICE and how it's shit.

http://marcpro.com/

June 9, 2014, 7:17 p.m.
Posts: 14532
Joined: Nov. 20, 2002

That Site wants to sell you a 649$ muscle stimulator and I couldn't easily find anything in there about RICE

I just fill up a beer cooler with snow from the deck with my aviy shovel for free

June 9, 2014, 7:56 p.m.
Posts: 26382
Joined: Aug. 14, 2005

That Site wants to sell you a 649$ muscle stimulator and I couldn't easily find anything in there about RICE

I just fill up a beer cooler with snow from the deck with my aviy shovel for free

In summer the nearest stream or lake works well to.

www.thisiswhy.co.uk

www.teamnfi.blogspot.com/

June 22, 2014, 3:04 a.m.
Posts: 12804
Joined: Nov. 24, 2002

I wonder if this is effective because it's a relatively short exposure to cold, which is enough to force out one round of healing fluids to allow a fresh dose to come in?

A c0lleague at work studied Sports Science and he said that he once read a study that compared hot/cold treatment after a workout, once group was subjected to cold shoers only, the other group was subjected to hot/cold showers. He said that the group with only the cold showers had a better ability to workout again as the other group. He told me that the scientists looked on the chemical and cellular level as well, but were not really able to pinpoint any scientific reason for the improvement.

If I meet him tomorrow I can ask him about more background, greater detail.

Last year I was in the Alps for riding and rode a lot everyday, I took a hot/cold showerfor a few minutes everyday after I came back to the hotel and was not really sore the next day, not even after a 120 km death march ride through the high alpine.

"You don't learn from experience. You learn from reflecting on the experience."
- Kristen Ulmer

June 22, 2014, 7:35 a.m.
Posts: 7707
Joined: Sept. 11, 2003

Physio told me that the contrast bath cycles of constriction (cold) followed by expansion (hot) of blood vessels capillaries seems to reduce inflammation speed up healing and recovery. I don't know if there is any demonstrated/proven physiological repair effect, but I've been exposed to this before both in recovery (endurance events) and for rehab (tissue and muscle injury) and I can say that I feel great immediately after the bath cycles and it seems to much improve joint mobility, at least temporarily.

From my experience, I concede that it is possible that there is no physiological repair ocurring, but the temporary relief you get may gives you a psychological boost (a huge part of recovery) in your belief that healing is going on.

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