03/07/2022 by Michael Fink, CMT
RICE or METH for Injury Recovery?
Ditch the RICE and get on the METH method for injuries.
The long held stance that we should only be using cold therapy when dealing with injuries is outdated.
Let's talk about it...
As far back as I can remember, the go-to method of healing a sprained ankle (or any other musculoskeletal injury) has been based on the RICE method: Rest, Ice, Compression, Elevation. it all just made sense because it helped reduce pain. If theres there’s no pain then it must be helping me, right? Not necessarily. Let me highlight how RICE may not necessarily be the best protocol to abide by.
The "i" in RICE reduces blood flow to the area. Yes, ice will numb the area and help with the pain but it is also limiting the blood flow and thus limiting the healing properties the blood brings with it. The increased blood flow to an injured area is a huge part in the repair process, bringing the healing and breaking down and taking away the materials that are no longer serving us in the healing process. Our bodies are amazing systems with the capability to fix themselves quite effectivly.
I choose METH
Get your mind out the gutter. M.E.T.H. stands for Movement, Elevation, Traction, Heat. It may seem odd to use a protocol that seems to go against the method we've used for years. Apply heat rahter than ice? Yes. Movement instead of resting? 100%. But it does not mean we disregard everything that RICE advocates for — we’re still going to elevate your injury at times to control blood flow, instead of reducing it.
M is for Movement
We have got to get some movement back to the injured area.. Let’s say you’ve sprained your ankle — the attention will be toward establishing comfortable flexion and extension in the joint, to get back to the normal range it will go through when weight-bearing again. Work within your own pain scale as you begin reintroducing weight-bearing movement into your system. Listen to your body, if it becomes unbearable to weight bare then elevate and move it little by little in this position, but if it's not painful and just uncomfortable then work within your pain scale. Trust your body’s ability to adapt and challenge it.
E is for Elivate
Whenever you're resting (maybe watching your stories on streaming), elevate your sprained ankle rahter than letting it rest on the ground. Remember that elevating for too long at one time can lead to an excess in swelling, so when elevating, I suggest utilizing the position to incorporate some small movements, by practicing writing out the alphabet with your foot (a simple introduction to moving your ankle again).
Tis for Traction
This is along the same lines as Movement, to encourage more range of motion and further the rate of blood flow to your injured area. This can be applied by a Healthcare Professional or can be done by yourself with the help of a band, towel, t-shirt etc. by draping it over the foot to add some slight resistance, but should not be taken beyond your own pain threashhold. It will assist in reducing stiffness, pain, and swelling but shouldn’t induce pain so challenge yourself if it only feels uncomfortable — but don’t push past intense pain.
H is for Heat
Heat and ice can both alter your levels of pain and induce blood flow instead of limiting it. However, the same principle applies to heat in that it shouldn’t be applied for extensive periods. So don’t apply for more than 30 minutes and keep the temperature mild, to prevent burning and damaging your skin.
METH or RICE, what's better?
It is important to strike a balance between RICE and METH, which will be dictated by the level of your particular injury. Again to use the ankle sprain example, if you can't move your ankle without being in intense pain, then perhapse rest for a few days. Ice could help reduce your levels of pain temporarily, which is ihelpful to you at that moment. But if the pain is more mild then start to move, apply a mild heat and gradually expose yourself to larger amounts of load on the area and progress yourself slowly. Personally, if your injury is acute enough I would tend toward METH, but if you’re in 10/10 pain then maybe RICE could help you for the first 2-3 days.
Hope this helps.