M.E.A.T. Is Better Than R.I.C.E.! - Resting an Injured Limb Slows Recovery
Noel Peterson, N.D.
The Journal of Family Practice ( Sept. 2004, pg. 706-712) published a study which compared the common practice of immobilization vs. the uncommon practice of mobilization after joint injuries. The authors reviewed existing studies and found that resting, splinting, and casting of injured limbs or joints delays recovery, and mobilization speeds recovery. Specifically the study concluded that, compared to rest: 1. Early mobilization decreases pain, swelling, and stiffness in the short term without any long term cosmetic or radiologic deformity. Six and 12 month follow-ups also confirm the advantages of early mobilization, including better range of motion. 2. Patients return to work sooner and usually prefer early mobilization. 3. Rest is an overused treatment for limb injury, and the medical profession errs too conservatively on the side of immobilization. Systematic review of all upper and lower limb injuries, including fractures, consistently found in favor of early mobilization.
Rest is part of the so-called "R.I.C.E." protocol (Rest, Ice, Compression, Elevation). R.I.C.E. has been the standard approach of coaches and doctors for decades, and only recently have we begun to understand how R.I.C.E. can interrupt the natural course of healing.
M.E.A.T: Insuring the best clinical outcome.
Mobilization, Exercise, Analgesia, and Treatment (M.E.A.T.) insures the best clinical outcome. When our patients have injuries, we want them to recover as quickly as possible, so we encourage them to use the injured area to the maximum safe level. In almost all cases, we want them to use moist heat, not ice, to speed healing. Heat enhances circulation and repair, unlike ice which constricts blood flow and inhibits the necessary healing response. We want our patients to use mild compression, bromelain and elevation to control swelling.
We recommend analgesic pain medication-not anti-inflammatory drugs-if needed so patients can exercise with comfort. We want them to mobilize the joint, exercise and strengthen the muscles that provide stability to the joint. We want our patients to get specific treatment and help from their personal trainer, their chiropractor, masseuse, physical therapist, and when necessary, their surgeon. We want them to see us for definitive care, including trigger point injection, myofascial release. We want them to have Prolotherapy to repair weakened and unstable joints, tendons, and ligaments. And most of all we want them to stick with it, keep it strong, stay active, and enjoy life.