top of page
Search

For injuries, use my HEALS protocol, to replace the ineffective and damaging RICE system.

Updated: Aug 8


Injury. It is time to replace the ineffective RICE system. Use my HEALS system instead.

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


Rest, Ice, Compression, Elevation. Most people have heard of or experienced the R.I.C.E. protocol. It is prescribed by doctors and health professionals the world over. Scientifically R.I.C.E. is ineffective and can actually have the opposite effect. It needs to be replaced. With an ageing and inactive population RICE only increases the burden on a countries public health service.


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.


The statement applies to all humans not just athletes. Scientists can be awesome. They are happy to disprove their own theories therefore advancing knowledge. I applaud you Gabe. If only global politics and business could follow this lead, we would reside in a cosy little paradigm.


As is the way with media hype, the first bit of information that enters people's minds is taken as the truth, and it snowballs, persists and becomes the "truth". In 1962, long before the digital media revolution, ice as a healer hit the press. That was that. We have been led down a path for 50 years, never questioning what is clearly illogical, and we now know is wrong.

Injury. It is time to replace the ineffective RICE system. Use my HEALS system instead.
The medical community needs more dumbbells not pills!

Let's take a quick look at the RICE protocol:

Rest

Yes, obviously rest has its uses, especially in severe injury where rest may be unavoidable. However, in the overwhelming majority of injury cases, there is no proven benefit. When one part of the body is injured a person can still train other parts, this will actually indirectly and directly increase the healing rate.


Ice

Since when has chilling something speeded up a chemical or biochemical reaction? It is however, very useful, if you want to make some ice! Using ice to reduce swelling might help boxers/fighters who's eyes are closing up. This is where it was probably first observed. So basically it's useful for humans or other carbon based lifeforms who enjoy bashing each other's brains in for sport.

Injury. It is time to replace the ineffective RICE system. Use my HEALS system instead.
Look at all those organisms flourishing in the ice cold!

Inflammation V Swelling


Inflammation is an ESSENTIAL first stage of healing. Healing will not happen without it. Think of it as nature's ultra bandage. It's complex and amazing. Why would you want to reduce it? It would be like removing a plaster while you are still bleeding. Swelling is NOT the same thing so do not be confused. Swelling is a side effect of the healing processes of inflammation. Healing proteins, white blood cells and blood vessel dilation etc. all need space to work. Inflammation also produces waste which takes up space. Ice not only reduces the effectiveness of inflammation, and therefore healing, but can also cause damage to tissue. Unless the swelling is completely hindering movement, is life threatening or caused by an auto immune or similar disease that causes unnecessary swelling then PLEASE avoid doing it!


A note about painkillers like NSAIDs

NSAIDs like ibuprofen are similar to ice in that they reduce inflamation so I consider these bad for recovery. Even worse they reduce pain. Pain is important so that you know not to overuse the injured area. They are better reserved for people with overactive inflammatory diseases like lupus or rheumatoid arthritis.


Compression

I am being generous when I say that the data is anecdotal and sparse. Please move along!

Injury. It is time to replace the ineffective RICE system. Use my HEALS system instead.
Get up and keep moving! Also stop wearing pointless straps and compression.

Placebo effect is the only positive outcome.


Elevation

Again no supportive data for elevation. A complete waste of valuable healing time.


Injury. It is time to replace the ineffective RICE system. Use my HEALS system instead.
No matter how much I rest it always hurts. Don't rest then.

Alternatives

There are some. The M.E.A.T system is decent and actually effective especially compared to RICE.


My protocol set out below is for general injury. It is not intended for people with illnesses like rheumatoid arthritis, lupus, EDS etc. However, aspects of this protocol may still benefit these conditions.


H.E.A.L.S.

I propose my own system. H.E.A.L.S.


Health

Exercise

Activities

Lifetime

Sleep


Health

Assess the patients current health, also their current and historic physical activity levels. Then what has caused the injury.


Prevention is the top of the tree. Simply put the more all-round fit you are the less likely you are to get an injury in the first place. If you do get injured, the fitter you are, the quicker you will recover. A classic counter made by fitness fanatics is "I am a very fit runner, cyclist or weight lifter, but my knees are hurting and I keep getting recurring pains here and there". This will be due to a lack of variation in the subjects "fitness regime". No single sport or discipline trains for true peak fitness.


The patient might be an elite cyclist that has injured their knee, because all they do is cycle. The next patient is a 78 year old who has never exercised in their life and has always got painful knees, because they are completely inactive and their muscles, connective tissue and bones are weak. They have fallen over because of their knees and it has injured their wrist and back. Very different scenarios that RICE will not fix, but will hinder. The exercise they both need to do is pretty easy to ascertain.


Exercise

Encourage and educate all patients that exercise is the only route to recovery and/or no recurrence. Also explain that if an injury is left for too long it may get worse or cause other injuries around the body. Encourage people to exercise harder in the areas that do not hurt and a little in the areas that do. Even if it's simple gentle moment. Make sure the patient has no fear. The fear, to a certain degree, has been caused by the 'rest' aspect of medicine. 'Active stretching' is to be encouraged. Discourage traditional stretching. Contrary to popular belief stretching will weaken the muscle or connective tissue and possibly aggravate it further. If they really feel the need to stretch it must only be after a reasonable amount of aerobic exercise.


Injury. It is time to replace the ineffective RICE system. Use my HEALS system instead.

Even with unlimited wealth I would struggle to complete a book about the healing effects of exercise on injuries. I have listed some of the main benefits.


1) Blood flow to the injured area increases therefore speeding up recovery by supplying more healing agents and removing more waste products.

2) Human Growth Hormone (HGH) increase. Any exercise at any age can increase HGH. High intensity training massively so. HGH is an incredible growth and repair hormone.

3) Other hormones released through exercise that increase healing rates are: noradrenaline, insulin-like growth factor (IGF), brain-derived neurotrophic factor (BDNF) and testosterone.

4) Exercise regulates cortisol in the body. Cortisol reduces the effectiveness of inflammation.

5) Muscle strength will increase around the injury site and whole body. This will obviously prevent recurrence. Also it will prevent further injury or increase the chances of surviving a fall or accident etc.

6) Overall increase in aerobic fitness indirectly contributes to repair speed through: increased metabolic activity, immune response and increased stamina.

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

Activities

Find out if the patients day to day normal activities might exacerbate or aid recovery. Encourage the patient to return to normal activity levels as soon as possible without fear. However they may need to avoid repetitive action on the injured area. Also empathise with them. They may have a knee injury, and they are a self employed carpet fitter who needs the money, a single parent or they may have a hobby that they will have to resist doing for a while. Find both physical and mental health solutions for the individual. I would suggest: knee pads and regular breaks for the carpet fitter, approach charities for the single parent to get some hands on help. The hobbyist may need to think about their mind and find a new temporary hobby. Etc.


Lifetime

Explain to the patient that regular varied exercise needs to be for their lifetime. It is the only proven way to reduce or remove a recurrence of their injury. Also remind them of the increased chance of further injury if they do not strengthen the injured area.


Most people do not want to hear this. They want to be given a pill, bandage or a massage. It is essential that people know that none of these will work. Education is the key to increased motivation.


Injury. It is time to replace the ineffective RICE system. Use my HEALS system instead.
Hmm little ones need lots of sleep! Growth and repair baby!

Sleep

Explain to the patient that sleep is the only way to rest with proven healing benefits. The patient also needs to be made aware of avoiding sleeping positions that could inhibit injury repair, and make sure that mattresses and pillows are adequate.

Sleeping well is something I personally work at as much as exercise! You release high amounts of HGH during your daily sleep. Think of it is an 'active repair' rest.


A rework of the healthcare system?

Every surgery really needs one or two less doctors and one or two more exercise physiologists/motivators. Also getting medical degrees up to scratch with the latest research in exercise physiology and psychology as a healing aid and a preventative is essential.


My recent injury experience

On February 27th 2021 I was in a high speed car accident. A driver ignored a give way and ploughed into the side of my car. I have suffered spinal, pelvic and chest injuries. I had to look after 2 kids and a baby straight away on my own so I had no choice but to keep moving. It was hellish but it undoubtedly helped. I also immediately started training every day. I focused on the areas I could train without pain a little focus on the areas where I was most injured so they could heal as quickly as possible. It will take me a long time to fully recover, but I am significantly ahead of the game. Probably years. If I was prescribed RICE it's possible I would never recover for my whole life.


I was told that if I was not as fit as I was, going into the crash, that I may have ended up with more severe spinal injuries. Prevention through fitness has potentially saved my life!


I'm currently working on a NHS cost-savings analysis that I will add to this article when I can.


Please contact me for further information. If you would like to help me make the HEALS system standard please message me. Thank you for reading!

2,498 views0 comments

Recent Posts

See All
bottom of page