In our YogaDork Ed series we seek to shed light on anatomy and safe practices in yoga and in our bodies. Today’s article addresses the best options when recovering safely from injury.
by Maya Talisa, Certified Yoga Tune Up Instructor
To ice, or not to ice? This is a question recently being discussed regularly among many athletic trainers, physical therapists, and many movement specialists. When I first started hearing about this debate my initial (totally uninformed) thought was “Why not ice? Icing to reduce swelling and pain is a good thing, right?” From my studies, I learned this is not necessarily true. Let’s take a look at an ankle sprain, a common injury for yogis and non-yogis alike, as an example of the effectiveness of icing after an injury.
Typically when you sprain your ankle, you misstep in a way so that you suddenly invert your foot. This causes the ligaments on the lateral (outside) side of your ankle to be overstretched or partially torn, depending on the severity. The ligaments most commonly affected are anterior talofibular ligament, calcaneofibular ligament, and the posterior talofibular ligament (shown in the image). Symptoms can include pain, swelling due to excess fluids in the tissues, and redness. So what do you do now? Do you R.I.C.E? Or M.E.A.T?
R.I.C.E (rest, ice, compress, and elevate), was coined in 1978 and has since then been considered the best practice in treating soft tissue or ligament sprains. M.E.A.T. (move, exercise, analgesics, and treatment) was coined as an alternative treatment option for injuries. While there is no sufficient research comparing the two treatments, it is clear that each result in extremely different physiological responses. As you can see in the table, R.I.C.E reduces the speed of recovery due to decreased blood flow, immune response, range of motion and overall healing while M.E.A.T, increases those same responses leading to a shortened recovery time.
Despite these findings, don’t be quick to chuck the R.I.C.E routine out the window. It has been suggested that when dealing with a muscle injury, R.I.C.E may be beneficial in preventing compartment syndrome, an increase in pressure in the fascial sheath of muscle caused by excess swelling. This can decrease oxygen and increases the pH balance, which may cause permanent tissue damage in the long run.
Due to the limited circulation already present in ligaments, it is suggested that the M.E.A.T. method is a more appropriate approach when treating ligamentous injuries. Dr. Ross Hauser from Care Medical Rehabilitation Services Inc. found that “for each 10 degree Celsius change in the temperature, there is a more than two-fold increase in the cell metabolism. In other words, in order to increase cell metabolic rate by more than 100 percent, the temperature of the tissue must increase by 10 degrees.” Therefore, a regimen like M.E.A.T., which increases blood flow, collagen formation, and complete healing, seems to be the way to go with ligament injuries.
When recovering from a sprained ankle, whether you decide to use the R.I.C.E or M.E.A.T method (or a combination of the two), the next question is how to speed recovery back to full functionality and performance. After a sprain, ankle range of motion may be impaired, which can lead to issues with normal walking movements, and possible re-injury. Therapeutic exercise to restore ROM of the ankle after injury has been shown to speed recovery compared to immobilization. One such therapeutic exercise is to use YTU Therapy Balls to clean up the soft tissue area below your outside ankle bone. This area can develop scar tissue if not mobilized properly after injury, potentially causing limited ankle range of motion.
Jill Miller and Dr. Kelly Starrett have a great video about the importance of regaining range of motion in the ankle regardless if you are recovering from injury. You may be surprised at your improved range of motion from this short ankle ball buster!
Check out Jill and Dr. Kelly’s latest project, Treat While You Train for more therapy ball techniques to clear up tension throughout the body.
- “Why Ice Delays Recovery.” Dr. Gabe Mirkin on Health Fitness and Nutrition. N.p., n.d. Web. 20 July 2014.
- “Sports Injuries- RICE: Why We Do Not Recommend It.” Dr. Ross Hauser on Caring Medical and Rehabilitation Services (2010).
- Kaminski TW, Hertel J, Amendola N, et al. National Athletic Trainers’ Association position statement: conservative management and preventing of ankle sprains in athletes. J Athl Train. 2013;48:528-545
- Denegar CR, Hertel J, Fonseca J. The effect of lateral ankle sprain on dorsiflexion range of motion, posterior talar glide, and joint laxity. J Orthop Sports Phys Ther. 2002;32(4):166–173.
Maya Talisa, MPH UCLA, 200 E-RYT, collaborates with coaches to work with individual athletes and teams to enhance mobility, flexibility, and performance as a means to reduce injuries. As co-founder of RAW Sports Yoga: A Real Athletes Workout, she is dedicated to preparing athletes to reach their ultimate potential.