How you treat an acute injury can affect how long the injury takes to recover. Doing the right thing in the acute phase (the first 72 hours) could be the difference between making the start line or missing the event. The acute phase of any injury is a vital time to manage the injury correctly as this kick starts the healing process and can speed up recovery.
The RICE principle for injury management is well known and has been the recommended management for acute soft tissue injury. This means:
R – Rest from aggravating activities.
I – Ice for 15-20 minutes, every 2-3 hours.
C – Compression of the affected joint or muscle with a compression bandage or tape.
E – Elevation of the affected limb.
However, there have been a number of studies published of late that suggest the MEAT principle is a more effective way to manage some soft tissue injury, notably ligament, tendon and cartilage injuries. These tissues are known to have a poor blood supply as compared to muscle. While RICE is still recommended for muscle injury, some researchers are now advocating for MEAT with tendons and ligaments. The MEAT principle is based around increasing circulation and bringing more blood supply to the injured tissue. MEAT stands for:
M – Movement. This should be controlled and within the limits of pain. It has been shown to promote blood flow to the affected area. It also helps to stimulate correct scar tissue formation.
E – Exercise. Pain free, well prescribed exercise helps to maintain an overall fitness base. Exercise promotes blood circulation and generally makes us feel better. An example is continuing with upper body strengthening after an ankle sprain.
A – Analgesia or pain relief. Taking some pain relief, as advised by your pharmacist or GP, can help to decrease pain allowing you to move easier. It also allows you to function with normal tasks a lot easier which can help speed up recovery
T – Treatment. It is advised that you seek treatment from a medical professional immediately as they can advise on the correct form of treatment.
So which is right treatment?
Both RICE and MEAT have a place in soft tissue injury healing. If you have an acute muscle strain, then RICE is still the best early treatment for you. However, if your injury is to a ligament or tendon it may be that MEAT is a more effective early management strategy.
It is important to note that there has not been any good research comparing the two types of acute injury management. If you suffer an acute injury and are not sure what tissue you have injured (muscle vs tendon or ligament) my advice would be to stick to RICE. Allowing the pain and swelling associated with acute injury to settle somewhat over the first 24 hours at least, followed by early controlled movement to stimulate effective scar formation and encourage blood flow, still seems to be the most accepted form of acute injury management.
Got an acute injury? Not sure what to do? Contact your local Motus Health Physiotherapist who can advise you on the ideal management plan for your injury.
ABOUT THE AUTHOR: Hayden Thom is a physiotherapist based at Sportsmed. Hayden has a strong clinical interest in sports rehabilitation, and currently works with University of Canterbury Rugby. Hayden is also our resident IT expert being one of the designers of Recoup, an application for training and recovery