Debunking Injury Prevention and Treatment Myths

By Sondra Forsyth

By Sondra Forsyth

If you’re a regular exerciser, you probably take care to stretch before your workout or your run. Also, if you’ve ever sprained your ankle while at the gym or wrenched your knee because you fell, chances are you knew enough to follow the long-standing treatment recommendation called RICE – an acronym for Rest, Ice, Compression, Elevation. You filled a plastic bag with ice, put the bag on the affected area, held the bag in place with a tightly wrapped Ace bandage, propped your leg up higher than your hip, and stayed that way for 15 or twenty minutes. Then during a two-hour break, you were careful not to use the injured joint. You hopped around or used a cane if you have one. Then you repeated the RICE procedure. Beyond that, you didn’t exercise again for at least 72 hours if not longer.

You were following two of the gold standard pieces of advice about preventing and treating injuries. Unfortunately, those gospels of sports medicine are in fact all wrong. Here’s the current thinking:

Stretching Before Exercise Is Bad for You

A recent study done at Austin State University in Texas and published in The Journal of Strength and Conditioning Research showed that static stretching is counterproductive. A second article by Croatian researchers published in The Scandinavian Journal of Medicine and Science in Sports corroborated that finding. Both studies concluded that pre-exercise static stretching not only doesn’t help but in fact impairs subsequent performance. Static stretching, which is standard practice for weekend warriors and elite athletes alike, involves holding a stretched position for at least 45 seconds and probably 90 seconds or more. Yet the Croatian researchers found that stretched muscles are 5.5% less strong. Not only that, but muscle power – which is defined as the ability to produce force during contractions – dips by about 2 percent after static stretching. Simply put, your performance after static stretching is going to be worse instead of better.

On the other hand, as the Texas researchers proved, an “active dynamic warm-up (AD) with resistance machines (i.e., leg extension/leg flexion) and free weights (i.e., barbell squat)” is valuable. For the record, ballet dancers have always begun their barre work with the equivalent of an  “activedynamic warm-up”. Static stretching doesn’t happen until about a half and hour into a ballet class. I’m a lifelong ballet dancer and former balet teacher so I was heartened to know that we’ve had it right all along!

RICE Is Wrong

Unfortunately though, dancers have sworn by RICE all this time right along with athletes. Every dance studio has ice and ace bandages at the ready so that the minute somebody gets hurt, the cold therapy can be put to work. That has been going on ever since 1978 when Gabe Mirkin M.D. coined the term RICE. Now Dr. Mirkin himself is denouncing the practice. In a post on his blog, he wrote that a study from the Cleveland Clinic shows that “applying ice to reduce swelling, actually delays healing by preventing the body from releasing IGF-1 (Insulin-like Growth Factor-1), a hormone that helps heal damaged tissue.” The Cleveland study was published in the journal Federation of American Societies for Experimental Biology.

Mirkin also currently advises injured people not to be completely inactive but to do some in light exercise in order to stimulate muscle repair. A new acronym has been coned: MCE. That stands for Move Safely, Compress, Elevate. There’s no ice – or “cryotherapy” — in the recommendation. Mirkin does say you can use ice for maybe ten minutes right after an injury but that icing after six hours have elapsed is pointless. The reason for using ice was to reduce inflammation but Dr. Nick DiNubile, Editor-in-Chief of The Physician And Sports Medicine Journal is quoted on the web site MobilityWOD.com as saying to renowned physical therapist Kelley Starrett, “Seriously, do you honestly believe that your body’s natural inflammatory response is a mistake?”

Now you know the new mantras for safer and more productive workouts plus faster healing if you’re ever injured. (P.S. Good for you for leading an active lifestyle. That’s one of the best anti-aging strategies you could ever employ!)

Sondra Forsyth is Co-Editor-in-Chief of ThirdAge.com. She is a National Magazine Award winner with scores of major magazine bylines and twelve books to her credit. Her most recent book is “Candida Cleanse: The 21-Day Diet to Beat Yeast and Feel Your Best”. Sondra was Executive Editor at “Ladies’ Home Journal,” Features Editor at “Cosmopolitan,” and Articles Editor at “Bride’s.” A former ballerina, she founded Ballet Ambassadors, an arts-in-education company in New York City, and served as Artistic Director for 16 years.