Sunday, May 25, 2008

Is MICE Better Than RICE for Injuries?

RICE or MICE, which is better?

From this great little post by Jiu-Jitsu Sensei Lori O'Connell on her recovery from hip flexor pull:

Conventional wisdom when it came to muscle and joint recovery used to be RICE (Rest, Ice, Compression, Elevation). But recently it has been found that immobilizing an injury (unless it's a fracture, torn muscle or your doctor advises you to) shuts the muscle down and restricts blood flow. Instead, modern medical research is suggesting that moving the muscle and encouraging blood flow to oxygenate the area and flush out metabolic waste helps you heal faster. Now many doctors are saying that RICE should be used only for the first 24-48 hours of the injury after which MICE should be used. In this acronym, "movement" replaces "rest."

I feel that all coaches and instructors should have basic or advanced knowledge of first aid CPR, and recovery from injuries that may be experienced in athletic training or competition. For those that do, the RICE acronym is well known. From Sports Medicine's RICE page:

The R.I.C.E. Method of Acute Injury Treatment Includes:

  • Rest: Resting is important immediately after injury for two reasons. First, rest is vital to protect the injured muscle, tendon, ligament or other tissue from further injury. Second, your body needs to rest so it has the energy it needs to heal itself most effectively.
  • Ice: Use ice bags, cold packs or even a bag of frozen peas wrapped in a thin towel to provide cold to the injured area. Cold can provide short-term pain relief. It also limits swelling by reducing blood flow to the injured area. Keep in mind, though, that you should never leave ice on an injury for more than 15-20 minutes at a time. Longer exposure can damage your skin. The best rule is to apply cold compresses for 15 minutes and then leave them off for at least 20 minutes. (Read The Proper Use of ICE).
  • Compression: Compression limits swelling, which slows down healing. Some people notice pain relief from compression as well. An easy way to compress the area of the injury is to wrap an ACE bandage over it. If you feel throbbing, or if the wrap just feels too tight, remove the bandage and re-wrap the area so the bandage is a little looser.
  • Elevation: Elevating an injury reduces swelling. It's most effective when the injured area is raised above the level of the heart. For example, if you injure an ankle, try lying on your bed with your foot propped on one or two pillows.

So what is MICE? According to O'Connell's post, it was recommended that after following the RICE treatment for the first 48 hours or so, that she basically keep things moving. Gentle stretching and conditioning were prescribed. The Google excerpt of "Sport and Exercise Medicine for Pharmacists" By Steven B. Kayne recommends letting pain be the guide - it should be uncomfortable, but not painful.

Great find by Sensei O'Connell, unfortunate that it took injury to bring it to light.

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Bob Patterson said...

How odd. Dojo Rat has something he call D.I.C.E.


His seems to work with anything at least 30 proof.

Nathan Teodoro said...

I think DR is starting on the embalming well prior to his time. He's going to look remarkable!

Colin Wee said...

I understand that ice is to be used only to alleviate the initial swelling. From what I understand, heat can be applied after 48-72 hours to help in the healing process.