To ice, or not to ice? This is a question that is being discussed regularly among many athletic trainers, physical therapists, and other specialists, including Yoga Tune Up® Instructors. When I first heard about this debate my initial (totally uninformed) thought was “Why not ice?” Icing to reduce swelling and pain is a good thing, right? From my studies, I learned this is not necessarily true. Let’s take a look at an ankle sprain, a common injury for yogis and non-yogis alike, as an example of the effectiveness of icing after an injury.
Typically when you sprain your ankle, you misstep in a way so that you suddenly invert your foot. This causes the ligaments on the lateral side of your ankle to be overstretched or partially torn, depending on the severity. The ligaments most commonly affected are anterior talofibular ligament, calcaneofibular ligament, and the posterior talofibular ligament (shown in the image). Symptoms can include pain, swelling due to excess fluids in the tissues, and redness. So now what do you do? Do you R.I.C.E? Or M.E.A.T?
R.I.C.E (rest, ice, compress, and elevate), was coined in 1978 and has since then been considered the best practice in treating soft tissue or ligament sprains (Mirkin, 2014). M.E.A.T. (move, exercise, analgesics, and treatment) was coined as an alternative treatment option for injuries.
While there is no sufficient research comparing the two treatments, it is clear that each result in extremely different physiological responses. As you can see in the table to the right, R.I.C.E reduces the speed of recovery due to decreased blood flow, immune response, range of motion and overall healing while M.E.A.T, increases those same responses leading to a shortened recovery time.
Despite these findings, don’t be quick to chuck the R.I.C.E routine out the window. It has been suggested that when dealing with a muscle injury, R.I.C.E may be beneficial in preventing compartment syndrome, an increase in pressure in the fascial sheath of muscle caused by excess swelling (Hauser, 2014). This can decrease oxygen and increases the pH balance, which may cause permanent tissue damage in the long run (Hauser, 2014).
Due to the limited circulation already present in ligaments, it is suggested that the M.E.A.T. method is a more appropriate approach when treating ligamentous injuries. Dr. Ross Hauser from Care Medical Rehabilitation Services Inc. found that “for each 10 degree Celsius change in the temperature, there is a more than two-fold increase in the cell metabolism. In other words, in order to increase cell metabolic rate by more than 100 percent, the temperature of the tissue must increase by 10 degrees.” Therefore a regimen like M.E.A.T., which increases blood flow, collagen formation, and complete healing, seems to be the way to go with ligament injuries.
So which do you pick? R.I.C.E? M.E.A.T? Both? No matter what direction you decide to go, Yoga Tune Up® is here to facilitate the healing process. Tune in on Friday for my favorite YTU techniques to improve ankle range of motion!
1. “Why Ice Delays Recovery.” Dr. Gabe Mirkin on Health Fitness and Nutrition. N.p., n.d. Web. 20 July 2014. <http://drmirkin.com/fitness/why-ice-delays-recovery.html>.
2. “Sports Injuries- RICE: Why We Do Not Recommend It.” Dr. Ross Hauser on Caring Medical and Rehabilitation Services (2010). <http://www.caringmedical.com/symptoms/meatvsrice.asp>