S1E1 - RICE: Leave it in the pantry…
We’re kicking off the first season with a look at one of the fundamentals of basic first aid…soft tissue injuries. We breakdown the pathophysiology of sprains and strains at the tissue level, take a quick trip back to the 70’s to find the origins of the long-standing RICER treatment guidelines, and venture into the emerging evidence that’s shaping contemporary practice.
In 1978, the Harvard-trained physician Dr Gabe Mirkin, co-published the “Sportsmedicine Book”, introducing the world to RICE (rest, ice, compression and elevation). In 2015 Dr Mirkin amended his position on soft tissue injuries after emerging evidence suggested that suppressing inflammation (primarily through the routine use of ice), may be leading to slow and impaired healing.
For a broad overview of the history, pathophysiology and controversy, check out this article in The Sport Journal.
Further reading:
Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. Am J Sports Med. 2004 Jan-Feb;32(1):251-61. doi: 10.1177/0363546503260757. PMID: 14754753.
R.I.C.E. may not be all its cooked up to be for injury rehabilitation…
van den Bekerom MP, Struijs PA, Blankevoort L, Welling L, van Dijk CN, Kerkhoffs GM. What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults? J Athl Train. 2012 Jul-Aug;47(4):435-43. doi: 10.4085/1062-6050-47.4.14. PMID: 22889660; PMCID: PMC3396304.
Acute Ankle Sprain Management: An Umbrella Review of Systematic Reviews
Gaddi D, Mosca A, Piatti M, Munegato D, Catalano M, Di Lorenzo G, Turati M, Zanchi N, Piscitelli D, Chui K, Zatti G, Bigoni M. Acute Ankle Sprain Management: An Umbrella Review of Systematic Reviews. Front Med (Lausanne). 2022 Jul 7;9:868474. doi: 10.3389/fmed.2022.868474. PMID: 35872766; PMCID: PMC9301067.