RICE (rest, ice, compression, elevation) has always been the treatment of choice for soft tissue injuries and pain since this term was first coined during 1978. The method is used to relieve pain by curbing inflammation in the affected area.
However, during March, the person who coined the term said that the suppression of the inflammatory response to exercise could cause healing to be delayed.
Dr Gabe Mirkin said that inflammation plays an important role as it is the first stage of healing. Icing suppresses one of the hormones that arrive early during the process of triggering the inflammatory response. He said it does not mean that you will not heal if you make use of RICE, but it will delay the healing process.
This announcement comes years after physical therapists and scientists eliminated cryotherapy as an effective tool for managing soft tissue injuries. The director of athletic training at the University of Delaware and lead author of the position statement on ankle sprain treatment, Dr Tom Kaminski, said the inflammatory process should not be interrupted.
So, does this imply that you should stop using ice for pain relief?
The use of RICE for pain management is fine if you are a non-competitive athlete as the recovery delay of half a day is not very important.
However, according to Mirkin, competitive athletes should return to play as soon as possible and should not make use of anti-inflammatories or use ice. He said they should not be resting or should only rest for around 24 hours.
He added that healing will be increased if there is movement. This means that if your leg hurts because you have gone running, you should go for a stroll to keep the blood and all its healing agents flowing to the damaged muscles.
Anti-inflammatories, like RICE, delay the healing process. However, unlike RICE, there are long-term effects to using them regularly. It has been found that anti-inflammatories may actually increase exercise-induced inflammation to a point where it may cause damage to tissues rather than repairing them.
A professor of health and exercise science at Appalachian State University, Dr David Nieman, said chronic ibuprofen users often have cell damage in their intestines, particularly in the colon. He said this allows bacteria to escape into the bloodstream in small amounts, which boosts the inflammatory response.
Dr Nieman said rather than popping pills, the best method of avoidance of excess inflammation and pain during endurance racing and exercise is to fuel up correctly. He said you should eat carbs, around 30 to 60 grams per hour, or half a banana every 15 to 30 minutes.
When you are not training, he recommends consuming plenty of fruit and vegetables, as they contain flavonoids. He said that tissues which contain high flavonoid levels help the body with the protection against oxidative stress and inflammation, which we can all suffer from. He added that it will improve the natural defences of the body.
Image Credit: Emily Allen