Hey I appreciate the posts.
On the NSAIDS I agree. I already posted similar things on that. They are right after the first aid part.
However I don't agree at this time on the RICE regimen. I did extensive reasearch and it is still the most widely excepted method. I am aware of the studies you posted but they are only a first step. The studies are theorizing that this initial decrease in blood flow and it's associated slow down in cell metabolism would point to slower healing in the long run. But the body of evidence does not show this.
The point of icing and immobilization is only an initial step. Pain relief is not really the goal although that is a side effect. Heck heat actually relieves pain also but that would be very detrimental. The idea is to slow down bleeding into the area and reduce swelling. Pain relief is not the purpose of it and in some case ice may cause more pain in which case it should be discontinued. Most of the writers and texts, including my own doctor, are aware of some of the speculation regarding this but they base their recommendations on the widest body of evidence. And for right now RICE seems to lead to much better outcomes.
It could well be that some of this may be proven to be a bad idea in certain cases. But right now, for this thread, I went by the most widely accepted practices. As more research is done and the medical community in general endorses a differnet practice then I would be the first one on board. RICE is only intial first aid, though, and ice certainly shouldn't be used very long. The first page goes into it in detail and there is not need to repeat it here.
The stuff on NSAIDS, as I said, I agree with, but the stuff on RICE I don't think represents current thinking in general. Experience with RICE seems to disagree with those researchers theories about it and recovery times are reduced, not lengthened.
With all that said, the reasearch was on sprains. Although doctors still routinely prescribe ice for sprains I don't think it is a universally good idea. Because ligaments have a very small blood supply compared to muscles. So reducing blood flow even more could very well be a bad idea. But that doesn't mean that RICE is out the window for all injuries. And even with sprains, swelling slows down healing. And ice is very effective at reducing swelling. But things can and will change...its just the prevaling opinion. It means we have to recognize the difference between muscles, tendons, and ligaments. I know there is a knew thing called M.E.A.T. that people are talking about in regards to certain injuries. I will do some more reserch and see if I can find new info on this. Meanwhile if you find more please let us know, IRON.
From what reading I've done on it, including writings about the stuff you just posted, I noticed a certain exxageration about what RICE actually entailed. The authors seem to be implying that ice is used for extensive periods which it defintiely should not be. Also immobilization is exaggerated and you get horror stories about the effects of it. But that is long term mobilization. Read what I have and it should be clear that I am only speaking of INITIAL immobilization following an acute injury to prevent further damage. Walking around in a sling for weaks because you pulled a tendon is a VERY bad idea, no doubt. I see the points about ligament injuries. But RICE is first aid, not long term treatment. It is still standard emergency room procedure and the idea is to reduce incipient damage, only being appropriate for the first 1 to 3 days.
I haven't ventured to far into the meat thing. But the first two letters stand for movement and excercise. Look at the first aid page. Movement and excercise are prominently discussed. But telling someone that if they sprain their ankle they should immediately start excercising it? Of course not. Should they immobilize it and walk with a cane for weeks on end. Heck no! I hope I made that abundantly clear and when people have recommended it or said they were going to do that I have told them in no uncertain terms it is a big no no. But lets not throw out the baby with the bath water
First aid is first aid. Rehab is rehab. One doesn't replace the other.