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The popular expression R. I. C. E. is no longer the best advice!!

Matthew Goodemote PT
Dec 11, 2016
3 min read

Ankle Sprains

Ankle injuries are one of the most common injuries in basketball. There is no way to prevent all injuries but there are things you can do to tell minimize the recovery IF/WHEN an athlete rolls his ankle. You can contact Matthew Goodemote PT for screening at 518-332-4614 or goodemotept@gmail.com

Back in 1978, in The Sports Medicine Book, Dr. Gabe Mirkin coined the term RICE (Rest, Ice, Compression, Elevation). Since then, icing has been the standard treatment for injuries and sore muscles due to its ability to relieve pain immediately in a cost-effective manner.

I read a newsletter from Dr. Mirkin, the creator of RICE, and noticed a paradigm shift... Mirkin published an article that directly debunked his own theory and exposed the lack of benefits that come from icing injured tissue.

"Coaches have used my RICE guideline for decades, but now it appears that both ice and complete rest may delay healing, instead of helping," Dr. Mirkin wrote.

Mobilize

Mobilization, when possible, is crucial to the recovery process. If you have sprains, strains, pulls, bumps and bruises. Try to keep the region as mobile as possible by taking the nearest joint(s) through its full range of motion to the best of your ability.

Activate

When Mobility is too painful or simply impossible, activation is a great next step. Activation can be manual where the muscle around the joint is precisely triggered by hand to promote activation. This is best performed by a physical therapist and can be taught to someone able to help at home.

If that is too painful, try another activation technique in Physical Therapy like the TENS Unit, which stimulates surrounding muscles without causing direct pain.

It is also important to begin using the foot and ankle as normal as possible and making sure no new issues come from walking with a limp.

Compress

The only remaining letter of Dr. Mirkin's RICE is the C... The C, for compression, is here to stay.

Ideally, you want to compress the area and mobilize it while it is compressed. A simple ankle wrap or ace bandage will make a big difference in recovery.

Elevation:

I also recommend elevation...but elevation as high as you can lift the foot...just prop it up as high as you can. On the back of the couch or exercise ball works.

Hydrate

Water is essential for nearly every function of the human body. Dehydration can increase joint pain, muscle soreness and slow down the lymphatic process. Staying hydrated will ensure that everything is functioning properly.

Make sure you are getting water when you're injured, I recommend adding up to 24 ounces to whatever total you usually aim for.

Observe

Observation is the last (but not least) step to the MACHO system. Your body gives you continual feedback during the recovery process. It's your job to observe and react to it.

How does the affected area feel?

Are you still in pain?
Has the issue become worse?
Are you feeling the repair process take place?
Is there bruising?
Is your inflammation decreasing on its own?

Value the feedback from your body and use it to your advantage by taking measures toward rehabilitation of the injury and plans for future injury prevention.

Recover Function:

As the ankle improves practicing standing on one foot for balance is crucial for recovery. The ankle sprain impairs our “proprioceptive” response...which is our bodies way of telling where it is in space...and crucial for when we have an injury to a joint.

In summary the priorities are:

1. Reduce/prevent swelling

2. Restore any lost motion

3. Restore proprioception