Is RICE Good for You?
RICE is the acronym for Rest, Ice, Compression and Elevation. It is the common prescription for an acute injury.
Unfortunately, while this approach may seem to make sense, in many cases, it is counterproductive and can possible adversely affect recovery and/or predispose one to chronic problems.
Another approach involves manual stimulation to mechanically load the injured tissue.
The effect of mechanical load on soft tissue is receiving a lot of attention in the rehab community, especially among those involved with fascial research.
Research shows that soft-tissue mechanical loading, including exercise, manual muscle treatments such as fascial release, stretching techniques, acupuncture and instrument-assisted soft-tissue mobilization methods, all affect the cells called fibroblasts.
Fibroblasts are considered the most important cells in the extra-cellular matrix (ECM). The ECM is the extra-cellular part of tissue that provides structural support to the cells, in addition to performing various other important functions.
It is the defining feature of connective tissue. The repair, regeneration and maintenance of soft tissue take place in the ECM.
Fibroblasts synthesize essential substances such as collagen, elastin and proteoglycans. They have the ability to act as mechanotranducers, meaning they are able to detect biophysical strain such as compression, torque, shear and fluid flow, and in response, create a mechanochemical response.
Manual fascial techniques (e.g. cross friction massage and gua sha) can stimulate fibroblasts, resulting in an anti-inflammatory response and positive clinical outcomes.
Injuries strain fibroblasts and fascia in negative ways, while controlled manual muscle treatments strain fibroblasts in curative ways.
Light fascial-release technique can have an anti-inflammatory effect on acute conditions, while a deeper manual loading may be more beneficial for chronic tissue injuries.
Inflammation is often regarded as a bad thing, hence the common practice of prescribing anti-inflammatory medications (NSAIDs) and using ice.
NSAIDs can block the healing of an injury by disrupting the inflammatory process and inhibiting fibroblastic activity and collagen formation. They also have numerous side effects.
Inflammation is how the body heals. If you stop this process, injuries either heel poorly or not at all.
Mechanically loading a tissue through soft-tissue mobilization leads to an increase in fibroblasts and the re-creation of an inflammatory process.
This healing cascade enhances the supply of blood and nutrients to the region, aiding in healthy collagen deposition and soft tissue repair.
Increasing fibroblasts is an essential way of producing clinical results – it facilitates healing.