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R.I.C.E. is wrong?

Original Post
AWinters · · NH · Joined Apr 2007 · Points: 5,120

Anyone that practices the R.I.C.E. method after an injury should watch this video. Very interesting information here. Pay no attention to the cross-fit meat heads, Dr. Gary Reinl knows his stuff.

youtube.com/watch?v=0UmJVgE…

rock-fencer · · Columbia, SC · Joined Dec 2009 · Points: 265

might want to include the link !

AWinters · · NH · Joined Apr 2007 · Points: 5,120

haha, might help...

Past User · · Unknown Hometown · Joined Nov 2007 · Points: 1,069

was this the link?

youtube.com/watch?v=0UmJVgE…

AWinters · · NH · Joined Apr 2007 · Points: 5,120
phildenigris · · Poughkeepsie, NY · Joined Dec 2013 · Points: 0

Before you make up your mind, you should read this:

startingstrength.com/articl…

I personally don't buy the hype with this, but I also believe that ice is used too often.

EDIT: Gary Reinl is not a doctor, nor does he have a doctorate. I don't think he has any qualifications beyond a bachelors degree. It doesn't mean he's wrong, but he was misrepresented in the original post. He also sells stim units, so he's more than a little bit biased.

K-Tanz · · Phoenix, AZ · Joined Sep 2010 · Points: 211

Rest Ice Coffee Explosion.....right?

AWinters · · NH · Joined Apr 2007 · Points: 5,120

Thank you for the read, I'm anxious to get thru it. To ice or not to ice...?

Past User · · Unknown Hometown · Joined Nov 2007 · Points: 1,069

Enjoyed the video.

For what it is worth, I took a 35 foot groundfall onto ice while climbing in NY in 2010. Rock broke and my gear ripped. I believe the diagnosis was a Type II talur neck fracture with massive comminusion of the talo-tibial and sub-talur joints. I also fractured my tibial malleolus. Each and every expert ortho (from NY and beyond) told me I needed to fuse the joint and I would never walk normally again. I ignored every one of them and started seeing a Chinese doctor in Manhattan. One of the first things he told me was "ice is for dead bodies". He prescribed me an herbal decoction with age old "blood nurishers" "blood movers" and "chi movers" I drank it twice a day and he altered the formula every visit (every two weeks) based on on his evaluations of my sympotoms (heart pulse, lung pulse, liver, and others). I never had sugery, never once iced my ankle, and it is still improving to this day 3.5 years later.

Strange? It still is to me too.

Bapgar 1 · · Out of the Loop · Joined Oct 2007 · Points: 90

Bheller, if you don't mind me asking I'm curious if the practitioner you saw also used acupuncture as part of your overall treatment?
If so was it something that he did every time you saw him or only occasionally?
Thanks,
BA

Aerili · · Los Alamos, NM · Joined Mar 2007 · Points: 1,875
phildenigris wrote:I personally don't buy the hype with this
Thanks for the link, phil. I agree.

A while ago, I asked a PT friend his thoughts on this stuff coming out as I did not really feel it to reflect my professional or personal experience using ice (or my athletic training and physiology education on the "why" of ice), but I did not have time to look at cryotherapy research just for my own interest. I will post part of his response.

"I thought the article was interesting, and also a bit...shortsighted? Reactionary?

The inflammatory/proliferation/healing cascade is pretty well characterized, but there are some things which remain a bit open to interpretation. A similar question was asked of the department dean way back when I was in school. The concept is: "if the body heals by inflammation sending chemical signals to begin fibroblast proliferation, why do we have these physical agents (ie cold packs, e-stim, ultrasound, etc.) to try to get rid of the inflammation?

Indeed, why? I have long believed that chemical anti-inflammatories (NSAIDS in particular) potentially interfere with the healing process, and that research supports this, especially in healing of bone.

What about cold therapies though? I don't think the research is so clear as the writer makes it sound.

What about the 68 year old lady in subacute rehab, s/p total knee replacement? If she does not elevate and ice after therapy, she will (probably) be so swollen, stiff, and angry tomorrow that she will refuse therapy. She will be at risk for arthrofibrosis because she will not move. Remaining stationary hurts less, so she remains immobile. Her knee will NEVER function properly if arthrofibrosis sets in. The exact same occurs in athletes who undergo ACL repair. You have about two weeks to regain full extension or you will (statistically speaking) likely never get full extension back. You must reduce inflammation in order to improve ROM, and encourage full participation.

Perhaps you remember a Buffalo Bills tight end, Kevin Everett. He suffered a C3-C4 fracture dislocation which would paralyze him, but due to a remarkable and very new and experimental technique, he was spared from total quadriplegia:

'Until September 11, Everett remained on a respirator, but was able to breathe on his own while it was briefly turned off. Cappuccino described Everett's respiratory risks as among the issues he described as "life-threatening" as well as how techniques, such as intravenous methods to reduce Everett's body temperature in an attempt to reduce the swelling, were performed in order to make operation easier.'

Remember that inflammation has many negative impacts, in addition to the positive ones. Coronary artery disease is (apparently) largely caused by inflammation. Rheumatoid arthritis. Ankylosing spondylitis."


For the record, I have had improved recoveries from injuries with both chemical and physical anti-inflammatories. This was evident because I was not able to move forward in the rehab process prior to using them.
Taylor-B. · · Valdez, AK · Joined Oct 2009 · Points: 3,186

Watch out for compartment syndrome;)

slim · · Unknown Hometown · Joined Dec 2004 · Points: 1,103

i have always had good results with ice. a video from some nut job probably isn't going to stop me from icing.

marty funkhouser · · Unknown Hometown · Joined Dec 2007 · Points: 20

Remember, there is a big difference when comparing inflammation in a muscle belly and inflammation of and surrounding a joint. There are many instances of the latter negatively affecting one' s ultimate recovery due to altered mechanics and neural recruitment patterns.

Scott Robertson · · Portland, OR · Joined Jun 2002 · Points: 110

Read about this awhile back. I think ice has its place, and not icing has its place.

But I can't deny that I feel a whole lot better after a 50k if I ice bath post race. I'm going to keep icing, but I think there's some validity in the not-icing arguments.

Damienn Nicodemi · · nevada city, ca · Joined Jan 2013 · Points: 76

I ice my nuts twice a day. Its like male birth control.

Mike Belu · · Chicago, IL · Joined Jun 2012 · Points: 135

Have you seen what a crossfit "pull-up" looks like?

youtube.com/watch?v=tAZaHzd…

I'll stick to my archaic style pull-ups, and ice when I feel like it.

marty funkhouser · · Unknown Hometown · Joined Dec 2007 · Points: 20

Crossfit is akin to flailing up a warmup climb, resting at every bolt, z-clipping, and falling at the anchors with the rope behind your leg and your coach saying, 'Good form. Now do 30 more just like that for time'.

Colin Kubarych · · Phoenix, AZ · Joined Dec 2010 · Points: 0
jeff lebowski wrote:Crossfit is akin to flailing up a warmup climb, resting at every bolt, z-clipping, and falling at the anchors with the rope behind your leg and your coach saying, 'Good form. Now do 30 more just like that for time'.
WIN
Past User · · Unknown Hometown · Joined Nov 2007 · Points: 1,069
Brent Apgar wrote:Bheller, if you don't mind me asking I'm curious if the practitioner you saw also used acupuncture as part of your overall treatment? If so was it something that he did every time you saw him or only occasionally? Thanks, BA
Yes, occasionally acupuncture too.
Guideline #1: Don't be a jerk.

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