R.I.C.E vs. M.E.A.T

For many years, the R.I.C.E protocol has been the benchmark for nursing musculoskeletal sprains and strains (Quick reminder : muscles get strained and ligaments get sprained). It involves Resting the injured area immediately and embarking on treatment. This prevents reuse of the affected area and minimizes the risk of further injury. A big part of the treatment is Icing the affected area several times a day, usually no more than 20 minutes. Compression of the area is the next step and involves keeping the injured muscle or joint as immobilized as possible via bandages and compression garments (sleeves and stockings). The primary objective of icing and compression is to reduce swelling. The final step is Elevation of the injured area to promote and restore blood flow. R.I.C.E has proven to be an effective method for a number of years and is still utilized today by many physical therapists, strength coaches and personal trainers on their clients.

In recent years, a new alternative called M.E.A.T (Movement, Exercise, Analgesic, Treatment) has emerged and is threatening to replace R.I.C.E. Many of the current research and finding on M.E.A.T conclude that it is a more effective method for treating musculoskeletal injuries and here’s why:

Movement: Upon injuring a muscle, our natural instincts is to limit movement as much as possible. The M.E.A.T protocol suggests otherwise. Movement promotes fluid distribution towards and away from the affected area. Tissues of muscles must contract in order for this to happen. For example, an individual nursing a knee sprain can focus on the eccentric phase of the leg extension machine while a runner with an ankle sprain can use calf raises to circulate fluid to the muscles around their knees and ankles. Movements also prevents adhesion (when fascia sticks together and becomes wound up) which is common in musculoskeletal injuries. The bottom line is an injured muscle or joint can still move.

Exercise: This is a piggyback of Movement. Strengthening the muscles of and around an injured area sends fluid and blood to the surrounding muscles. Exercise selection is paramount and must be approached carefully. Because the affected area won’t be 100 percent, modifications and regression of strength training exercises should be called upon if required. This is basically the rehabilitation phase.

Analgesic: This requires the use of over-the-counter and prescription medications to relieve pain associated with an injury. Acute pain can initially make the healing and recovery process more challenging. NSAIDs like Tylenol and Aleve can be used in the early stages but should be discontinued down the stretch. Though they reduce inflammation, too much reduction isn’t good because inflammation is a vital process injured muscles and joints must go through in order to be healed. Keep in mind that too much consumption of NSAIDs can harm the liver so keep the dosage at a minimum. Other analgesic methods include acupuncture and the use of topical agents.

Treatment: This final phase includes lean tissue functional training and balance work to restore strength, mobility and stability in the injured area. It can also include the use of both cold and heat in the early stages of the injury. Keep in mind that cold reduces swelling while heat restores and promote blood flow. Both are crucial in the treatment of musculoskeletal injuries.

In application of both R.I.C.E and M.E.A.T, consider the following:

  • R.I.C.E still has a place in pain management but it should mostly be utilized during the early phase of the injury when the pain is acute.
  • M.E.A.T should ultimately make up the majority of the recovery.
  • New research shows icing may not be as impactful on joints as thought to be. Ligaments have no blood vessels to transport nutrients to surrounding cells and since cooling slows down metabolism and blood flow, it can actually delay recovery of the tissue. As a rule of thumb, apply ice only to a swollen joint no more than 20 minutes, no more than three times a day for no more than 2 days.
  • In some rare cases, inflammation can actually speak up recovery because it is the body’s natural defensive mechanism against injury. The marines have a saying that “pain is weakness leaving the body” which is basically the point here. Some individuals have to go go through and feel the pain during the early part of an injury in order for it to heal.
  • To prevent frostbites, never apply ice directly on the skin. Instead use towels and protective insulating materials to wrap the ice around the injured area. Many health stores like Rite Aid and Duane Reade sell insulated icing wraps.
  • If you’re still in doubt which method to use, talk to your doctor or a licensed fitness professional.

Simple ways to fix muscle aches and pains

I can almost certainly say with conviction that virtually every person I know has some type of body ache, discomfort, pain and/or inflammation. The fact of that matter is as impactful as exercise is on the body, it inevitably won’t prevent us from experiencing some sort of muscle ache or pain at some point in our lives. For the majority of us, the stress and demands of life, work, school, companionships, family time and even gym time will ultimately fatigue the body and cause it to function less optimally in most cases.

How many times have you or someone you know felt a back ache, shoulder tightness or hip discomfort and wondered where it came from? That’s because when muscles are stressed repeatedly via strength training, home chores, manual labor, prolonged seating to name a few, the deep fascia of muscle fibers (innermost muscles tissue that surround bones, nerves and blood vessels) become wound and tangled up and begins to limit movements which can affect range of motion. On the contrary, superficial fibers are what we stretch on the surface and body of the skin like a basic lying hamstring stretch for example.

Here are 4 ways to to permanently fix and cure your aches and pains:

1. Soft Tissue Work: If you don’t already include soft tissue work in your exercise program, you ought to. Foam rollers, lacrosse/tennis ball and deep tissue massages make up this elite category. I believe it is one of the most underestimated areas of body care and maintenance. Soft tissue work can be unpleasant. In fact, it isn’t pleasant at all. If you’ve ever used a foam roller or lacrosse/tennis ball on your self, you know the feeling I’m referring to. Though painful and uncomfortable, soft tissue work allows collagen fibers of those deep fascia to untangle and loosen up, thus promoting efficient blood flow in muscles. This in turn translates into warmer and more relaxed muscles and better mobility in the joints.

2. Stretching: We all need to stretch more. It’s as simple and blunt as that. It’s quite alarming how many seasoned fitness enthusiasts lack adequate flexibility (Don’t worry, I’m one of them!). Part of the problem is that when it comes to relieving stress and endorphins kicking in, stretching pales in comparison to traditional strength training and just ins’t considered “fun”. As a result, many of us do it infrequently and when we do, it’s quick and fast. Here’s the thing: Stretching may not yield the benefits of a barbell squat or bench press, it is a vital component for movement patterns. To move efficiently and effectively, we must stretch. Tendons connect muscles to bone so in order for a joint to function well, the muscles around it must be stretched. Passive and PNF stretching are the best types and can be done anytime. While it’s important to stretch the entire body, emphasis should be placed mostly on tight muscles.

3. Corrective Exercise Training: This has been one of the most controversial areas of fitness over the last several years. By definition, corrective exercise training is the fixing of imbalances, weaknesses and muscle pain via traditional and nontraditional methods of training. It has become a staple in many training programs and a mainstream component of fitness. Corrective exercises were originally designed to fix and correct muscular imbalances that affect movement patterns, fix injury-related pain and alleviate chronic muscle tightness.

I’m all for using corrective exercises when warranted. However, it appears many exercise enthusiasts & fitness professionals today design their programs strictly around corrective exercise and that bothers me. If the underlying issue has been corrected, why keep correcting? If you’re unable to hinge low enough in a squat, strengthening and activating your hip external rotators and stretching your hamstrings & adductors should be part of the corrective remedy. Once those areas are addressed, it’s time to squat. Many people continue to utilize corrective training even after the problem is addressed. I’m a proponent of corrective exercise training and I believe it has a place in fitness. But it shouldn’t be overused and definitely shouldn’t make up an an entire workout program. Regardless of the individual or training goals and objectives, compound movements should always take precedence. They’ve been tried and tested over time.

4. Progressively Overloading: Most of us know in order to continue to see results and yield dividends, we must continually add new challenges to out workouts, whether it be more resistance, less rest between sets, more sets and/or more reps. However some of us overload too soon, not allowing the body to adapt to the early demands. Progressive Overload, gradually adding resistance to strength exercises, must be approached steadily. Going from bench pressing 100 pounds in week 1 to 150 pounds in week 2 may be too much of an overload. The central nervous system gets a shock each time we exercise, which forces the muscles of the body to respond by getting strong and growing. However if the shock goes from a mild state to a more severe state, the joints and muscles panic at the arrival of an unexpected tension and that usually causes injury. Think of it as a first time driver who goes from driving at 55 mph in week 1 to all of a sudden 85 mph in the second week. It’s very likely that new driver will be not be comfortable at 85 mph in only his/her 2nd week of driving and may lose control of his/her vehicle. Whether you’re a newbie in the gym or a seasoned lifter who took a month off, always start with a mild to moderate intensity and progressively and wisely overload.