Let’s explore what’s new about RICE and evidence around helping you recover in the fastest way possible.
REST and ELEVATION: You do realize you are reading something written by a physical therapist who thinks movement is key to recovery, right? With a severe ankle sprain, immobilization may be indicated for 10 days max, but for most, early movement is critical. So, elevation is good between exercise sessions, emphasis on between exercise sessions. Rest, yes, but again, it’s not the way to get better, it’s just a way to take a breather.
ICE: Ice can and should be used if it makes putting weight on the ankle easier. The key is to get moving, and if ice makes that possible, measured use is good. But, there’s a potential down side of icing: You want your body’s own immune system to help you heal. You want immune cells to go to the injury and start cleaning up – at first increasing inflammation, but eventually secreting growth factors and substances that help cells make a new blood supply. The final step is adding anti-inflammatory substances from the immune system. Without that initial inflammation and the subsequent steps, an injury may not heal as quickly or as well.
While ice restricts blood supply thereby reducing swelling and pain, it also impedes immune cell migration and thus may interfere with core parts of healing. So, if you can continue to put weight on the ankle and start moving it, less ice is better in the long run.
COMPRESSION: Having support around the ankle with bracing or taping can speed the return to normal weight bearing, which is strongly supported by research. Additionally, a brace that you can wear when you return to sport can help prevent another ankle sprain. It’s an important step for early movement.
MANUAL THERAPY: Joint mobilization, lymph drainage and soft tissue work all help restore joint motion and function and research gives these two thumbs up.