The R.I.C.E. Protocol – Lets Revisit Part 1

How many times have you rolled an ankle, fell on your shoulder, or strained your knee and you do one of the following:

  • Call your primary care doctor asking for advice on what to do
  • Skipped the primary care doctor and just grab an ice pack out of freezer


Well both options likely end up having you Rest, Ice, Compress, Elevate. or more commonly known as the “R.I.C.E” Protocol. The R.I.C.E Protocol is used for a wide-ranging degree of various musculoskeletal injuries. Anything from a strained foot tendon to a minor ligamentous sprain. And quite frankly, that’s an outdated system. While I cannot speak at the professional levels, athletic training staffs in high school and smaller college programs still standby it.

I can understand why programs continue to use the protocol, in theory each part of the protocol has its merits from a common sense perspective.

Rest – not doing activity can allow for the injured tissue to heal.
Ice – when there is an injury to the tissue, the damaged tissue will swell, get red, and become warm (all the signs of inflammation), so the ice theoretically is applied to slow down the inflammation process
Compression – edema and swelling occurs when the tissue is damaged, compression is suppose to prevent toe swelling and help reduce the inflammation process through constriction of the vascular supply. Inflammation is going to occur and some swelling is inevitable.
Elevation – designed to reduce swelling by helping with vascular flow away from the area or site of damage.

Inflammation following an injury is not a bad thing. Inflammation is the body’s way of healing himself. It’s a naturally occurring process! Why try to prevent it.

Many businesses have developed out of the “RICE” Protocol.

CEP, 2X-U, CW-X, Hyperice, Normatec.

Some of the more popular compression companies, now have designed performance-based compression wear.

Hyperice and Normatec have capitalized on compression and ice to help reduce inflammation to help with the recovery process.

But to the point, its an outdated system to helping athletes return to the field following injury. While it can be helpful, there has been a shift with forward thinking practitioners (athletic trainers, chiropractors, physical therapists, and some medical doctors) that a better solution to getting athletes to return to the field is by being active in the recovery process instead of being passive.

Thus a new acronym was born: M.E.A.T (Movement, Exercise, Analgesics, Treatments). Which is more in line of what I do now. I think compression and icing can be a part of the treatment. Because it can be valuable supplementary tool, just not the primary portion. Musculoskeletal injuries are a part of everyday activity and training. It’s a risk you take with any activity to do. My take if you were being active when you injured yourself, it’s best to be active in your return to sport.


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