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Surprising New Evidence About Recovering from Acute Injuries
You sprain your ankle, and it’s bad. I mean, rolling- around -on the -ground -can’t -put- weight -on -it bad. The ankle starts to swell almost immediately, and within hours, it’s purplish, hot and really swollen. Ouch. If this has happened to you, you are not alone. Acute ankle sprains are among the most common joint injuries in active people.
Most of us have heard of RICE: the gold standard for recovery. Rest, Ice, Compress, Elevate. The only problem is that, most recent research shows that these measures alone don’t get you better faster than if you did nothing (the control group).
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.
EXERCISE: The research strongly supports exercises for regaining motion and strength as well as restoring the joint’s ability to react to perturbation. Improving balance and proprioception is crucial for returning to activities without getting hurt again. The key to a full recovery is the right exercise at the right time.
One critical skill as you recover from an ankle injury is regaining your ability to stabilize from the ankle as you move the rest of your body. This might be one exercise to get good at later in your rehab.
Ankle sprains are common, and so are recurrent ankle sprains. Without the proper attention, they can lead to chronic ankle instability. This is not to scare you; this is just to tell you that RICE will only take you so far. The rest of the journey to full function will involve some PT where we help you get moving, get stronger, and get more confident that you can heal- that you will heal. Let us guide you to fully functional movement without pain, one step at a time.
Boulder County has extended its mandate on facial coverings through the first week in June. The public health order requires face coverings be worn, regardless of vaccination status or group size in health care and gym settings. Since your safety is a priority, please continue to wear your mask while in the clinic, even if you are fully vaccinated. Thanks for your cooperation.