Teaching Moment:

I sprained my ankle today running in a workout. Most people go right to the R.I.C.E. (Rest, Ice, Compress, Elevate) strategy when they sprain an ankle or sustain an injury.

If your goal is to HEAL FASTER and return to the gym and/or quality of life ASAP, then the R.I. of R.I.C.E. is NOT a good strategy.

Rest (assuming no fracture) and Ice slow healing. Yes, Ice does decrease pain (for a short period) by numbing nerves, but it also slows healing by causing blood vessels to constrict. This means that the swelling and inflammation (which are causing the pain along with tissue damage) remain in the injured area (especially when paired with Rest).

To speed healing you want to C.H.E.M. (copyright Dr. Bartemus): Compress, Heat, Elevate, Move.

Compress with an ACE bandage or my favorite tool from MobilityWOD.com, Voodoo Floss.

While Compressed, you want to Move for a couple reasons:

1. Moving will Move swelling and inflammation out of the injured area via lymphatics and venous circulation.

2. Moving will cause the body to heal/lay down new tissue along lines of stress/normal range of motion.  Rest causes the new tissue to be laid down in a disorganized fashion, which results in poor function.

3. Moving also stimulates the nerves that communicate Movement to the brain. These nerves send signals to the brain at speeds that would make any race car driver jealous; thereby out competing the slower pain nerves signals to the brain, as well as inhibiting pain signals at the spinal cord level.

Heat augments the benefits of Movement by causing blood vessels to open up (vasodilation). This increases the Movement of swelling and inflammation away from the damaged area and increases the Movement of white blood cells and healing factors to the area.

Elevation of the injured area (my ankle in this case) above the level of the heart uses gravity to increase Movement of swelling and inflammation away from the injured area, especially when the area is being Compressed. To really create synergy while Compressing, Heating, and Elevating (and therefore likely sitting/laying still), add Movement by putting a TENS or e-stim unit on the area and turning it up enough to create passive Movement (make the muscles jump).

In conclusion, to heal faster get rid of R.I.C.E. and use C.H.E.M.!

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