Spraining your ankle or knee will typically result in the same advice: take a couple of days of rest, compression, and elevation, and you’re on the path to a quick recovery. The RICE process is rarely deviated from, and is the standard when it comes to these sprain injuries.
Some doctors are questioning the clever acronym, including a doctor who coined the term himself, and whether the ‘rest’ or ‘ice’ components are needed.
Before any do-it-yourself repairs, you need to determine if you need a doctor first. “If you can’t walk more than three steps, you need to see a doctor as soon as possible to protect yourself from further injury,” says A. Lynn Millar, author of the American College of Sports Medicine’s patient guide to sprains and strains.
For injuries that’re more minor, with manageable pain and swelling, Consumer Reports’ experts have made the following amendments:
Forget Complete Rest
The old wisdom to healing injuries was to completely stop any activity until the painful area healed. New research debunks that advice: it’s far more beneficial process to practice light exercise 48-72 hours post-injury. A review by the National Athletic Trainers’ Association studied various therapies for ankle sprains, and gave top marks to early movement in the recuperation process.
“By contracting and relaxing a joint, you improve blood flow, which improves healing,” Millar explains.
The same study also found balance exercises were key in reducing the rate of re-injury, one of the common reoccurring issues of any sprain.
Gabe Mirkin, author of “The Sports Medicine Book,” originally coined RICE, advocating icing immediately after a sprain would reduce pain and inflammation.
Since publishing his findings in 1978, he’s changed his stance. After reviewing his research, he now believes icing is a deterrent to healing, impeding blood flow that brings healing to the cells. “Ice doesn’t increase healing — it delays it,” Mirkin says, and the NATA study backs him up: It gave icing a grade of C.
Unless the pain is blistering, Mirkin says to forgo the entire icing method completely.
According to the NATA study, you’d be better off with over-the-counter nonsteroidal anti-inflammatory medication such as ibuprofen (Advil, Motrin IB and generic) or naproxen (Aleve and generic). Like ice (again, if you need it), these meds should only be taken in the first 24-48 after injury, as they’ll slow down recovery through oppressing inflammation.
What Remains the Same
Consumer Reports’ experts still advocate compression and elevation from the original RICE recommendations. Wrapping a mild strain or sprain in a bandage is still acceptable to reduce swelling. Once it subsides however, the injury should be left unwrapped; otherwise it’ll be susceptible to long-term issues like osteoarthritis. Swelling can be managed through elevation as well, keeping the injured limb propped up by a pillow throughout the day and into the night.
CR’s ratings of prescription drugs, treatments, and healthy-living products can all be found at ConsumerReports.org/Health.