Can the HEALS Protocol Replace the RICE System for Treating Injuries?

Please take a moment to read the footnotes.

Elevation, Compression, Ice, and Rest. The majority of people are familiar with or have used the R.I.C.E. protocol. Doctors and other medical experts worldwide prescribe it. According to science, R.I.C.E. is useless and may even have the opposite impact. It must be changed. RICE simply adds to the strain on a nation's public health system as its population ages and becomes less active.

RICE was created in 1978 by Dr Gabe Mirkin. In 2015 (to his massive credit) he withdrew support for his own system! One of his statements:

Subsequent research shows that rest and ice can actually delay recovery. Mild movement helps tissue to heal faster, and the application of cold suppresses the immune responses that start and hasten recovery. Icing does help suppress pain, but athletes are usually far more interested in returning as quickly as possible to the playing field. So, today, RICE is not the preferred treatment for an acute athletic injury.

It is not simply true for athletes; it applies to all people. Scientists are amazing people. Knowledge is advanced because they are glad to refute their own views. Gabe, you have my admiration. We would live in a cosy little paradigm if only international politics and industry could adopt this strategy.

As is often the case with media hyperbole, people accept the first piece of information that they come across to be true, and it grows, endures, and eventually becomes the "truth". Long before the digital media revolution, in 1962, stories about ice being a cure were published. So that was it. For fifty years, we have been guided along a road that is obviously illogical and incorrect, yet we have never questioned it.

The medical community needs more dumbbells not pills!

Let's quickly review the RICE protocol:

Rest

Rest does have a purpose, especially in cases of severe injuries where avoiding it may not be feasible. But following an injury to one, exercising other uninjured body parts will actually hasten healing—both directly and indirectly. For many mild injuries, it is completely useless.

Ice

When was the last time that cooling something accelerated a chemical or biological reaction? Still, if you want to generate some ice, it's extremely helpful! Fighters and boxers who are experiencing ocular closure may get relief from swelling by using ice. It was most likely noticed here for the first time. In other words, it's helpful for people or other carbon-based organisms that like to sportfully crush each other's brains.

Look at all those organisms flourishing in the ice cold!

A note on Inflammation V Swelling

An essential first step in the healing process is inflammation. Without it, healing will not take place. Consider it the ultra bandage of nature. It's wonderful and intricate. Why would you wish to cut it down? It would be similar to taking off a plaster while still bleeding. Do not confuse swelling with anything else. One of the byproducts of inflammation's healing processes is swelling. White blood cells, blood vessel dilatation, healing proteins, and other processes all require room to function. Waste from inflammation also need room. Ice can harm tissue in addition to reducing the efficiency of inflammation and, consequently, healing. Unless the edoema is totally impeding mobility, is potentially fatal, stemming from an autoimmune disease, or something comparable that causes unnecessary swelling then PLEASE avoid doing it!

A note about painkillers like NSAIDs

Since NSAIDs like ibuprofen lessen inflammation in a manner akin to that of ice, I believe they are detrimental to the healing process. Worse still, they lessen pain. It's crucial to feel pain so you can avoid overusing the wounded area. It is advisable to save them for patients with more severe pain or conditions such as rheumatoid arthritis or lupus, which are hyperactive inflammatory disorders.

Compression

When I describe the data as anecdotal and sparse, I am being generous. Kindly proceed! The sole benefit is the placebo effect.

Elevation

Once more, no evidence to support elevation. A total waste of precious recuperation time.

No matter how much I rest it always hurts. Don't rest then.

Alternatives

There are some. The M.E.A.T system is decently effective, especially compared to RICE.

My general injury protocol H.E.A.L.S. is outlined here. People with conditions such as lupus, EDS, rheumatoid arthritis, etc., are not supposed to use it. Some parts of this technique, though, might still be advantageous for these circumstances. Although I am not a medical professional, I would want to collaborate with medical communities worldwide to abandon the R.I.C.E. procedure.

H.E.A.L.S.

Health

Exercise

Activities

Lifetime

Sleep

Health

Evaluate the patient's physical activity levels both now and in the past, as well as their current health. Next, what led to the damage.

The tip of the iceberg is prevention. Put simply, your chances of suffering an injury in the first place are lower the more fit you are overall. The more fit you are, the faster you will heal if you do have an injury. "I am a very fit runner, cyclist, or weight lifter, but my knees are hurting and I keep getting recurring pains here and there" is a common counter tactic used by fitness fanatics. This will occur because the subjects' "fitness regime" is not varied enough. Peak fitness cannot be attained by a single sport or discipline.

Since the patient's only activity is cycling, it's possible that they are an elite rider who has hurt their knee. The following patient is a 78-year-old who has never exercised in their life and has always had sore knees as a result of their extreme inactivity and weak bones, muscles, and connective tissue. They suffered back and wrist injuries when they fell due to their knees. Extremely distinct situations that RICE will obstruct rather than resolve. Determining what workout each of them needs to perform is not too difficult.

Exercise

All patients should be informed and encouraged to exercise because it is the only way to heal and/or prevent recurrence. Additionally, mention how waiting too long can make an injury worse or result in other damage to other parts of the body. Urge them to exert more effort in their pain-free areas and somewhat less in their sore ones when they exercise. even if it's only light, easy movement. Make sure the patient is not afraid. The'rest' component of medicine has contributed to some of the apprehension. "Active stretching" should be promoted. Discourage the use of conventional stretching. Contrary to common assumption, stretching might worsen the condition by weakening the muscle or connective tissue. If they truly feel the need to extend, they should wait until after a reasonable amount of aerobic exercise.

Even if I had limitless resources, I would struggle to finish a book on the therapeutic effects of exercise on ailments. Here are a few of the principal advantages.

1) Increased blood flow to the wounded area expedites healing by bringing in more healing agents and expelling more waste.

2) Growth hormone (HGH) in humans rises. HGH can rise with any type of exercise, regardless of age. High intensity training is particularly effective. HGH is an extremely powerful growth and repair hormone.

3) Exercise also releases noradrenaline, insulin-like growth factor (IGF), brain-derived neurotrophic factor (BDNF), and testosterone, which all speed up the healing process.

4) The body uses exercise to control cortisol. Inflammation is less effective when cortisol is present.

5) The body as a whole and the area around the injury will gain muscle strength. This will undoubtedly help avoid recurrence. It will also lessen the chance of getting hurt again or improve your odds of surviving an accident or fall, etc.

6) An overall improvement in cardiovascular fitness boosts immunological function, stamina, and metabolic activity, all of which operate as indirect drivers of repair speed.

7) Heat shock protein activation (See my article on heat shock proteins - coming soon).

Activities

See if the patient's regular activities on a day-to-day basis could hinder or help with their recuperation. Urge the patient to quickly and fearlessly resume their regular exercise levels. On the wounded area, they might need to refrain from doing repetitive actions, though. Feel sympathy for them as well. They might be a single parent, a self-employed carpet fitter in need of the money, or they might have a knee ailment that will require them to give up a hobby for a while. Find remedies for the person's physical and mental wellness. I would recommend knee protectors and frequent breaks for the carpet installer, as well as approaching charity to provide practical assistance to single parents. The enthusiast might have to consider their mental health and find a new temporary hobby. Etc.

Lifetime

Inform the patient that lifelong participation in a variety of regular exercise is necessary. It is the only method that has been shown to lessen or eliminate their injury's recurrence. Remind them that failing to strengthen the affected area will increase the likelihood of additional injuries.

This is not what most people want to hear. They request a bandage, medication, or massage. People must understand that none of these will be effective. The secret to greater motivation is education.

Hmm little ones need lots of sleep! Growth and repair baby!

Sleep

Tell the patient that the only form of rest that has been shown to have therapeutic effects is sleep. In addition, the patient should be instructed to make sure their beds and pillows are comfortable and to avoid sleeping positions that can impede the healing of injuries. I personally try to get good sleep just as much as I do workouts! When you sleep every day, a significant amount of HGH is released. Consider it a "active repair" rest.

A rework of the healthcare system?

Really, every surgery requires one or two more exercise physiologists/motivators. It's crucial to update medical degrees to reflect the most recent findings in exercise physiology and psychology as a preventative and therapeutic measure.

My recent injury experience

I was involved in a high-speed car accident at the beginning of 2021. A vehicle ran into the side of my car after failing to stop. I have injuries to my chest, pelvis, and spine. I was forced to care for two children and a baby on my own right away, so I had to keep going. It was terrible, but it certainly was beneficial. I also started training every day right away. I concentrated on the places where I could train pain-free and gave my most wounded areas some extra attention to help them heal as soon as possible. I have a long way to go before I fully heal, but I am well ahead of the game. Most likely years. It's probable that I would never fully heal if I were given a RICE prescription.

I was informed that I might have had more serious spinal damage if I had not been as fit as I was prior to the collision. Fitness as a preventive measure may have saved my life!

If you want to help me make the HEALS system standard, please contact me.

Footnote

Please do not use my protocol without first seeking medical advice. This protocol is merely a suggestion right now, but it will eventually become the foundation of my plan to replace RICE. Despite the fact that I support it wholeheartedly from a scientific, financial, and psychological standpoint as well as to improve everyone's wellbeing without receiving compensation for myself. But it's just getting started!

Please contact me directly for media enquiries, academic enquiries, questions and links to research paper's. Thank you! ©️ 2021 Dan Raynham.