Kelly Starrett on RICE

Kelly Starrett, together with Gary Reinl put out a lengthy video about R.I.C.E..

On first sight, it all seems to make sense and caters to your intuition. Increasing circulation = good; restricting nutrient flow & shutting down the signals between muscles and nerves = bad.

Don’t get me wrong, if you need to make something numb, ice is great. As Mr. Reinl points out, “Yes, (making something numb is good) if the short-term goal is pain control and the prevention of the body’s normal cellular and vascular response to injury.”

But I don’t have the knowledge to judge whether the information provided here is accurate.

Well, I hope it is not just to help selling this $650 Marc Pro device.

What’s the saying, “Extraordinary claims require extraordinary evidence”.

Here are some of the points mentioned:

on Resting – you need a little bit of stress to increase circulation, immobilization reduces the lymphatic system’s effectiveness
on Icing – causes a back flow creates more congestion (causes the fluid in the lymphatic vessels to backflow), no study says it works, shuts down the signal between the muscles and the nerves
focus more on Compression instead, wrap it up instead to avoid swelling

I know there are a bunch of PTs and MDs reading this. Please, leave your thoughts in the comments.

Thanks to Edwin for bringing this to my attention.

Update: Justin chimes in on the discussion. After looking at the cited papers he says that it’s entirely inconclusive and that Kelly’s claims are premature.

In another post he explains how you should use icing.

Injury occurs. Ice it. Compress it. Elevate it. After day one, start figuring out how you can apply progressive stress via movement. After rehab, it is okay to ice. Otherwise, try to compress and elevate the injury as much as possible. Rinse and repeat, but ween off of the icing (since it will eventually not do much other than numb the pain after the early stages).

BobChase

Nice find Gregor. I found some additional info on Clarence Bass’ site regarding lymph. It seems to jive with what this guy is saying: http://www.cbass.com/lymph.htm
- GregorATG
  
  Asked a PT friend and he assured me that lymph drainage stuff is nothing new, just as the electro therapy thingy. She said it just not that well known in the general public, which seems accurate.
  
  Time to change this.
MikeH

While the lymphatic system is important, it is by far secondary to the blood in terms of circulating nutrients, wastes, and blood gases, as well as reabsorbing inflammatory fluid. The heart circulates 5L/min, but the lymphatics bring milliliters of fluid back to the blood per minute. The lymphatics are really just a backup system.

He is correct that icing has no evidence behind it, and is likely counterproductive.
Chad

I’d be really interested to see a follow up post on this to see if anyone has tried the Marc Pro and what they thought of it. $650 is a lot to drop on something you’re not sure about. I can think of quite a few medical devices I could pick up for less that have more research supporting them.