With the exception of fracture and other serious injuries that warrant immobilization, the benefits of movement can never be ignored. First, movement in itself is the basis of physical activities, which helps boost physical health, including the processes that are involved in injury repair and healing. Movement increases blood and oxygen flow, which are both important for healing. When it comes to treating acute soft tissue injuries, the RICE protocol seems to be the most popularly used method, but this, however, contradicts the basic premise of movement.
We’ve always been told of the use of the RICE if we hurt our ankle, and we’re probably be putting an ice pack on it, wrapping it, and elevating it, thinking that these will help with the injury. We’re practically not sure about it, but we continue to follow this principle.
The R.I.C.E. protocol is designed to reduce the inflammation following an acute injury, and so reduce the blood flow. Inflammation begins with a decrease in blood flow to create a clot and control the bleeding but later proceeds with an increase to commence repair. And there is where the conflict begins.
TO FULLY ASSESS WHETHER THESE STEPS CAN ACTUALLY HELP WITH THE HEALING PROCESS OR NOT, IT’S IMPORTANT TO UNDERSTAND THE PHYSIOLOGICAL PROCESS THAT ARE INVOLVED INJURY, FROM THE MOMENT OF TRAUMA THROUGH THE RECOVERY…
Injury recovery involves three phases of inflammatory, repair, and remodeling. It’s a sequence of events where one must occur before proceeding to the next, which means that inflammation must be successfully completed before the injury can undergo the repair process, which must also be completed before the remodeling phase can take place.
Inflammation is the body’s defense mechanism and aims at protecting the injured tissue from aggravating while preparing it for repair. It begins with a period of vasoconstriction or the narrowing of the blood vessels, restricting the blood flow and allowing blood clot to form to prevent excess blood loss. After which, vasodilation occurs as the blood vessels dilate to provide oxygen-rich blood to the area. Certain cells enter the damage area to carry out their specific functions. Neutrophils prevents infection, while macrophages clears the area of dead cells and bacteria and produce growth factors essential for tissue repair, regeneration, and fibrosis. The waste products produced by cells are drained by the lymphatic system, which requires muscle contractions for propulsion. Once excess fluid is drained, the repair process begins. New blood vessels are formed to provide additional supply of oxygen and nutrients and new tissues are developed to form the structural foundation for tissue reconstruction. Following these processes, tissue remodeling is initiated to reinforce the newly formed tissue, and the recovery process has completed.
The R.I.C.E. is a lot about preventing swelling, but swelling naturally occurs as new blood and nutrients come in.
The M.E.A.T. incorporates movement in the protocol. It emphasizes the importance of maintaining joint range of motion and muscle strength through early mobilization.
Inflammation sets the stage for healing. Regardless of the stage of recovery and severity of injury, the healing process takes off from inflammation While rest is necessary to prevent further injury and to allow the inflammatory process to take place, early mobilization is just as important to prevent adverse effects of immobilization. Both conditions are important, and it’s just a matter of timing and prioritization.
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