Reconciling the Recommendations of the American College of Sports Medicine (ACSM) and the National Academy of Sciences’ (NAS) recommendations for treating sports injuries is a topic that has been debated since it was first published in 2001.1 While there are many opinions on both sides,2–4 the consensus seems to be that ACSM’s guidelines are sound and NAS’s guidelines do not provide any evidence to support their use.5
The rationale behind these two organizations’ positions is based on different theories:
ACSM’s Position: “Sports injuries are preventable with proper training, technique, and equipment.”6
NASH Position: “There is no scientific evidence that suggests that specific exercises or techniques improve performance beyond what would occur under noncontact conditions.”7
Both organizations have produced reports which address the issue of sports injuries.8–11 Both reports were peer reviewed and published in reputable medical journals.12–14 These reports contain numerous studies, but they all have one thing in common: They did not prove that any particular exercise or technique is better than another.
In fact, some of the most compelling evidence against the effectiveness of specific exercises comes from research conducted at Harvard University.15 While some of the NAS report’s conclusions are questionable, one thing that is not questionable is its statement that there is no evidence to suggest that exercises or techniques improve performance beyond what would occur under non-contact conditions.
While the reports contain numerous studies, they all have one thing in common: They did not prove that any particular exercise or technique is better than another.
The Argument Against RICE
While not intended to be a treatment option, the RICE acronym has become widely accepted as a method for reducing pain and inflammation from an injury and as a way to increase an individual’s likelihood of healing quickly. As a result, it is included with other common treatment methods such as rest, massage, and elevation.
However, there is no evidence that any of these treatments actually help speed up the healing process. In fact, RICE has been shown to be less effective than many other options.
There is no evidence that any of these [common treatment] methods actually help speed up the healing process.
The idea behind RICE is to reduce swelling and pain in an effort to allow an athlete to continue training or competing with a reduced risk of further injury. While this seems like a good idea at first, it does not take into account some very important factors involved in healing injuries.
The first problem with RICE is that it does not distinguish between different types of injuries and their potential complications. Each injury is different and may heal at a different rate, therefore the treatment for each injury should be different as well.
Some injuries—such as strains and sprains—are fairly straight forward. Ligaments and tendons can be easily damaged by overstretching or overloading.
When this happens, them become inflamed which causes pain and reduces mobility. Fortunately, this type of injury can usually heal itself with a little time off from activity. This is why RICE is most commonly used for treating these types of injuries.
The RICE method has also been proven to be less effective than other treatment options.
However, other injuries are not as easy to treat. Torn muscles, tendons, and ligaments require more specialized treatment in order to heal properly.
Muscles and ligaments do not heal well when stretched too far. This is why it is important to allow for proper healing time after an injury has occurred. Unfortunately, this is not possible in the case of sports where athletes need to be at their best on a regular basis.
The second problem with RICE is that it does not address why these injuries occur in the first place. Once an injury has occurred, it is important to treat the actual problem, which is often muscle imbalances or tendonitis.
Both of these imbalances can be the direct result of an improper training program. In these cases, RICE is not only useless, but may actually slow down the healing process by failing to address the root of the problem.
RICE and sports medicine in general tends to rely on pharmaceutical drugs and steroid injections too much. While these drugs may provide short-term relief, they often cause more problems in the long term and fail to solve the issues that lead to these types of injuries.
These drugs also have many potentially dangerous side-effects which can be very serious and even life-threatening. Steroid injections are especially dangerous since they put an extra strain on the liver and other vital organs.
In some cases, this can cause serious liver damage or even cancer.
Prevention Is The Best Medicine
When it comes to sports injuries, the best treatment is to prevent them in the first place. This involves proper training regimens and correct form when performing athletic movements.
For most amateur and professional athletes, trainers and coaches are necessary to help prevent injuries from occurring.
Another important aspect of preventing sports injuries is nutrition. Making sure that you are eating a nutritious diet rich in antioxidants may help to lessen the negative effects of free radicals which can lead to accelerated aging and disease.
Supplements can also help to provide the nutrients your body needs in order to stay healthy and prevent injury.
One of the most important things you can do to prevent sports-related injuries is to warm-up properly before engaging in athletic activity. Warming up helps to prepare your muscles for physical activity and also helps avoid injury by preventing muscles, tendons, and ligaments from being stretched too far.
Stretching is an important part of warming up. It also helps to strengthen the muscles and improve range of motion, which is also beneficial in preventing injuries.
Sources & references used in this article:
Rethinking the Use of Cryotherapy by B Druvenga – bocatc.org
Motherhood and work–life balance in the National Collegiate Athletic Association Division I setting: Mentors and the female athletic trainer by CM Eason, SM Mazerolle… – Journal of athletic …, 2014 – meridian.allenpress.com
Campus Involvement and Alcohol and Marijuana Use: Reconsidering Social Bond Theory by S Carter – 2016 – search.proquest.com
Sports medicine conflicts: Team physicians vs. athlete-patients by SP Calandrillo – . Louis ULJ, 2005 – HeinOnline
Revisiting autologous platelets as an adjuvant in macular hole repair: chronic macular holes without prone positioning by KG Kapoor, AN Khan, BC Tieu… – … Surgery, Lasers and …, 2012 – healio.com