M.E.A.T. vs R.I.C.E.
From the desk of Kristen Lutz, LCMT, MS...
This isn’t a post about food. We’re talking about the method used when treating musculoskeletal and connective tissue injuries.
You may have heard of the R.I.C.E. method. It involves a sequence of Rest, Ice, Compression and Elevation. There’s been some discussion in the rehabilitation and manual therapy world as to the effectiveness of this method as a go-to treatment for all acute injuries. We are going to focus on muscle-tendon strains vs. ligament sprains. Just to clear up semantics, you strain a muscle and you sprain a ligament. Either way there is injury and we want to figure out the most effective way to promote healing.
In comes the M.E.A.T.. Erik Dalton, PhD, Founder of the Freedom from Pain Institute, and international lecturer and trainer in Myoskeletal Alignment Therapy, after doing extensive research, has come up with an alternative to R.I.C.E.. M.E.A.T.involves Movement, Exercise, Analgesic and Treatment. Movement is needed for the injured area immediately after the injury to prevent adhesions, increase circulation, and stabilize the joint and surrounding muscular and connective tissue. Exercise should start gradually following the acute stage to strengthen and stabilize the injured area. Analgesic is the use of medications, natural (such as Traumeel) or pharmaceutical, to decrease pain but not suppress the inflammatory response, which is crucial to healing. Treatment includes muscle and connective tissue balancing and functional retraining to prevent recurrence of muscle guarding and improve motor control.
We want to first know if we are dealing with a muscle-tendon strain or ligament sprain. Then we want to consider not necessarily stopping the use of ice immediately following an injury, but take another look at the approach after that time. Will continuing to ice hinder the ability of your body to heal? Why should we consider making changes? Here is what has led to the shift from R.I.C.E. to M.E.A.T.:
- Research regarding clinical effectiveness of ice/cryotherapy is significantly lacking.
- Since ligaments have essentially no blood vessels (avascular) to deliver nutrients for repair, it relies on the diffusion of nutrients from the joint itself. Icing decreases the blood supply the area, therefore there will be less chance for the tissues to heal.
- Ice slows down the metabolism of the cells of the tissue, therefore slowing down the healing process.
So, what should you do?
- Whenever you have a significant soft tissue injury, seek the guidance of a qualified medical professional. You will need to know if it is a muscle-tendon strain or ligament sprain and of course, rule out a fracture, separation or dislocation.
- Always follow up with a manual therapist (i.e. massage therapist, physical therapist, chiropractor) to discuss treatment of the injured area. You may start to feel OK after the first few days, but left without treatment can lead to problems down the road.
- Inflammation is your body’s way to protect and heal injured tissues. In some cases, inflammation can speed up healing, but too much can slow that process down. Discuss both icing and heating options with the medical practitioner you are working with. If they haven’t heard of M.E.A.T., discuss it with them. A good practitioner is always willing to look into evidence-based approaches.
Still not sure about changing your approach? Cardiologists use to recommend weeks of bed rest for patients who suffered from a heart attack. That is no longer the case. Patients are up and out of bed within the first 24 hours and begin a progressive cardiac exercise rehabilitation program. Medical practices and standards of care change. Practitioners know more today than they did yesterday. And a good practitioner is always willing to throw out old techniques to make room for newer ones.
Why R.I.C.E. when you can M.E.A.T. with an OMBE practitioner today? Pun FULLY intended.
Kristen Lutz, LCMT, MS | Licensed Massage Therapist
Kristen Lutz, a Nationally Certified Licensed Massage Therapist, is a graduate of Cortiva Institute - Boston (formerly Muscular Therapy Institute) in Watertown, MA. As a member of the American Massage Therapy Association (AMTA) and Massachusetts Chapter of the AMTA, her work is centered upon supporting clients in achieving optimal health and well being through listening and understanding individual needs . She integrates various massage techniques into each personalized session. These techniques include Swedish (relaxation), deep tissue, sports massage, orthopedic massage, neuromuscular (trigger point) therapy, and myofascial release along with stretching, range of motion, and breath work. She is currently training to be certified in Advanced Orthopedic Massage. Having completed the Usui Method Reiki II Certification, clients can benefit from the integration of energy work and balancing along with massage therapy.
Clients benefit from Kristen's approach that each client is unique and no one treatment is alike. This customized approach leads to a more effective treatment. Kristen, a New England native, has been living in Boston for the past seven years. She graduated with a B.S. in Exercise and Sport Sciences from Colby-Sawyer College in New London, NH while playing collegiate women's volleyball. She continued with her education and graduated with a M.S. in Clinical Exercise Physiology from Northeastern University in Boston, MA and has worked in the health and wellness field as an exercise physiologist.