R.I.C.E. or M.E.A.T. ??

[MEB]

So, I was at the doctors yesterday and she did some work on my bad ankle and then we got talking about a possible treatment for it. Anyway, when I got back to work I did some goggling and came across this.

http://www.prolotherapy.org/strains-sprains.asp

I've always been told that you treat a sprain with rest, ice, etc. I've never heard of the MEAT treatment. Maybe this is why is why my ankle has not healed? Who knows, just thought it was kind of interesting.

-MEB

 

[Kevin Rooney]

There are some interesting articles on Prolotherapy out there (Google-land) as well, including one at Wikipedia. In theory it sounds plausible, but it appears that not enough studies have been done to prove/disprove that approach conclusively, nor for what types of injuries/conditions.

 

[Gris]

Common sense...

dictates that if it is a SEVERE sprain R.I.C.E. is in order, at least for a while. BUT... as a FORMER athlete, I am a big believer in M.E.A.T. as soon as possible, as (regardless of soft tissue healing times) it prevents unwanted scar tissue buildup and thus promotes proper range of motion, etc.

 

[Tom Rankin]

dictates that if it is a SEVERE sprain R.I.C.E. is in order, at least for a while. BUT... as a FORMER athlete, I am a big believer in M.E.A.T. as soon as possible, as (regardless of soft tissue healing times) it prevents unwanted scar tissue buildup and thus promotes proper range of motion, etc.

I've always been told/read that cold is ok for up to 48 hours, but after that, go with heat.

 

[SAR-EMT40]

I've always been told/read that cold is ok for up to 48 hours, but after that, go with heat.

Yep. This is the treatment we have always used. The RICE is to minimize soft tissue injury especially swelling by preventing (slowing) blood flow into the area for the first 48 hours. After that the risk of swelling has passed and heat is used later to improve blood flow and promote healing after the risk of swelling has diminshed. This is also why it is important to treat with RICE as soon as possible after the injury. After about 8 hours the use of RICE is pretty much of no use. If I remember correct 80% of the swelling happens in the first 4 to 8 hour and slowly start to get less over the next 40 hours. RICE as soon as you can after the injury.


MEB, sorry to hear your ankle is not healing well. Don't forget that sprains often take longer to heal than breaks. I know, I had a bad sprain when I was in High School. It sometime still gives me problems. What is the problem with yours and how long has it been now?

Keith

 

[albee]

What if you are a vegetarian?

I would recommend the T.O.F.U. method - Theapeutic Outdoor Flexibility Unlimited.

 

[Tim Seaver]

N.I.C.E. or M.E.A.N. is the real question!

And we all know the answer to that.

 

[blacknblue]

You do want the cold initially to prevent swelling, but after sleeping on it, getting some movement and heat will help restore the injury. Of course, when they say "exercise," you mostly want to work on range of movement, not going for a death march or "pushing through the pain," which will only exacerbate the injury. (And boy, do I know about that...)

Swimming and biking are great ways (depending on the exact injury) to work on range of motion without likelihood of exacerbating an injury.

 

[DougPaul]

http://www.prolotherapy.org/strains-sprains.asp

I've always been told that you treat a sprain with rest, ice, etc. I've never heard of the MEAT treatment. Maybe this is why is why my ankle has not healed? Who knows, just thought it was kind of interesting.

IMO, the prolotherapy stuff raises a red flag. Looks to me like someone is trying to sell something...

The RICE part looks reasonable and is in general agreement with Wilkerson. (The ice should be applied for only about 15 min at a time and compression should be gentle.) According to Wilkerson, heat "may be useful, but should not be applied until three days after the injury. Motion and use may speed recovery, but only when resumed after the intial swelling and hemorrhage have subsided."

Ref: Wilkerson, James A., "Medicine for Mountaineering", 5th ed.

I personally have found leaving the pressure bandage on for extended periods to be very helpful. However, the pressure must be very gentle. If it begins to itch or becomes uncomfortable after a while (typ several hours) it is too tight. (Most people wrap the bandage too tightly.) Use a figure-8 wrap for an ankle.

A sprain can also permanently stretch ligaments and make the ankle looser and more prone to future sprains. You should probably avoid light-weight hiking boots and stick to above-the-ankle boots with some ankle support.

Good luck with it.

Doug

PS. My PT told me that they are now using the acronym "PRICE" = Protect + RICE. Somehow, the "P" part seems a bit obvious...

 

[drewski]

N.I.C.E. or M.E.A.N. is the real question!

And we all know the answer to that.

nice first,mean second

 

[David Metsky]

Here's an overview of Prolotherapy that I found on Quackwatch, my favorite online resource for investigating medical care ideas I'm unfamiliar with.

 

[Kevin Rooney]

Here's an overview of Prolotherapy that I found on Quackwatch, my favorite online resource for investigating medical care ideas I'm unfamiliar with.

I'd be a little cautious to label it quackery.

Look at all the medical misadventures of late in the pharmaceutical industry - drugs which are rushed onto the market supported with sketchy research, and medical papers released that purport to prove or disprove some drug or therapy which are themselves based upon analyzing research papers. There was an interesting article recently (US News & World Report?) which explained how suspect some of these methodologies are, and why reports are frequently released which contradict each other.

Personally, I'm exceptionally skeptical of 'new' drugs and treatment therapies, and the more potential $$ to be made the more skeptical I am. And I pay little attention to therapies which pathologize aging processes, like menopause, or create new diseases like 'restless leg syndrome'.

Is it quackery? Maybe? Maybe not. A truly competent MD will tell you that only about 40% of the drugs on the market (the type requiring an RX) have value which few dispute. When I read about all the snake oil remedies that were peddled 100 and 200 years, I wonder how many of today's medications will be regarded as snake oil 100 years in the future.

In any case, I think it's good to be skeptical, and not be too quick to pass judgment -

 

[David Metsky]

Sorry if I wasn't clear, I don't assume things that are referenced on Quackwatch are necessarily quackery, and the link I posted doesn't suggest that. It's just a good tool for investigating things that aren't quite mainstream. Some are therapies that are supported by evidence, some are unproven, and some are pure quackery.

Having never heard of prolotherapy, this is how I went about evaluating it. I haven't read enough to come to any conclusions. Sorry if my post was misleading.

 

[John H Swanson]

I always thought RICE meant Really Intense Competitive Exercise.

No wonder I take a long time to heal.