We have always been taught for many decades that whenever an injury occurs sudden or onset we must “ICE” it. But what does it actually do? Is it best to rest the injured muscle? What does our body actually need for best management of an injured muscle during the healing phase?
Dr. Mirkin who originally developed the RICE acronym- Rest, Ice, Compression, and Elevation have always been the gold standard for treating injuries. But now even he has changed his outlook. The new line of thinking has caused extensive debate among experts who have relied on RICE for many years.
Let’s look at the different interventions that involves ICE- “RICE”, “POLICE” (Protection, Optimal loading, Ice, Compression and Elevation AND “PRICE”
Ice has been the standard injury treatment for sore muscles and injuries. Why? It relieves pain, swelling, and inflammation. When we apply ice we cause vasoconstriction and decrease the core temperature of the tissue aimed at decreasing the swelling and inflammation. Now all of this sounds good and like the best treatment for an injured muscle, but is it really? Current research shows that inflammation is the body’s first physical response to repairing tissue, and without it healing does not happen.
How does this come into play? Our body has its own defence mechanism system that when it has been attacked or even if it detects a potential threat it helps to fight against that threat. Our bodies will initially respond with a reaction of swelling. Despite what we’ve always believed that swelling is a bad sign for tissue healing research has showed us that it is neither good nor bad. Swelling is a build-up of fluid that will leave the body. It helps to protect the soft tissue structures and immobilise the injured muscle. When we ICE the injury we are actually contradicting what the body is trying to do post-injury and delaying the healing process.
When is ICE then effective for an injured muscle?
As a Physiotherapist I have found that it is best to ICE and injured muscle up to 6 hours post injury for short time periods (less than 5 minutes. it would be better to create a flushing effect by applying heat for 2 minutes, then ice for 30 seconds x10 to improve circulation of the muscle. By not applying ICE to the injury we see that the injury takes less time to heal when the body is assisting to do what’s it’s always been trying to do. Thus Ice isn’t completely thrown away but using it for the right reasons is important.
So what do we do then after an injury occur?
MEAT- No, this “MEAT” is not that type that we put on the fire and braai or a spelling error suggesting that we should “meet” -up but it is the best protocol that I’ve found works for a patient that injured his or her muscle.
The acronym MEAT stands for the following:
M- Movement: this helps to move fluid by relying on the lymph system and activating a muscle contraction to and from the injured muscle. This movement is under a small amount of stress but not keeping the injured area immobile.
E- Exercises: this encourages the growth and further strengthening of tissues to help increase circulation to an injured area. This however is best prescribed by your physiotherapist.
A- Analgesia: NSAIDs should be avoided after an injury. Why? NSAIDs reduce inflammation and inflammation is as discussed earlier an important critical step to healing. Other tools such acupuncture, dry needling, massage and deep breathing.
T- Therapy: This is best prescribed by your physiotherapist that will help speed up the healing process through exercises. As always said and believed motion is lotion to the joints.
I have always believed and seen in clinical practice how a patient can really benefit from the MEAT protocol. It is important to understand and respect the body’s healing phases and to provide the best optimal treatment for our patients. The above principles are good guidelines to help treating an injury but we should always treat each patient as an individual and adapt accordingly.
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