Clinicians are supposed to be evidence-based, but we’re not. We are sheep that follow the herd. Or, as a friend of mine from the University of Illinois often says “follow the Sacred Cows”. I am just as guilty. We go through the same mundane and antiquated treatment protocols that we always have. We don’t want to change our ways because that is what we are comfortable doing and that is what our patient expects. It takes a global paradigm shift in order for us change how we practice. Can a paradigm shift finally be underway in how we treat inflammation?
As followers, I knew our mindset toward ice and anti-inflammatory medication would only change if mainstream media started sharing the data. Now, this is just one story, but it is in the New York Times. Perhaps more articles like this will reach the public. Better yet, perhaps stories like this can appear on TV, like Dr. Oz or GMA. For now, I am just happy it’s finally being shared with the public and I look forward to more. A change will be coming folks. Below is a link to the NY Times article, with the best line saying: “There’s a reason for the inflammation” in the body after exercise, she says. “It’s part of the regenerative process and not a bad thing.” Continue reading →
If you know me, you are aware of my anti-ice stance. The ice debate continues to heat up. As peer-reviewed data continues to pour in, the evidence for the use of ice to treat musculoskeletal injury still lacks. I’ve written about ice many times, but many of my anti-ice articles are science-y and focused around one topic. I wanted to do something different this time. I wanted to keep it short, sweet and comprehensive. So, I bring you 10 reasons why we shouldn’t ice injuries. Continue reading →
“Coaches have used my “RICE” guideline for decades, but now it appears that both Ice and complete Rest may delay healing, instead of helping.” – Gabe Mirkin, MD, March 2014
In 1978, Gabe Mirkin, MD coined the term RICE. Health care practitioners to laypersons are quick to recognize RICE as the ‘gold standard’ treatment option following injury. Followers of my blog know my stance against ice and now there is support from the physician who coined the term. Yes, the very same physician, Dr. Gabe Mirkin, who coined RICE, is now taking a step back. I reached out to Dr. Mirkin and asked for permission to share his story. As you will read below in Dr. Mirkin’s full post, the lack of evidence for cryotherapy is something we must listen to.
In July I posted a blog discussing The Overuse of Cryotherapy. The controversy surrounding the topic made it one of the most popular blogs I’ve written. What is surprising to me is that a controversy exists at all. Why, where, and when did this notion of anti-inflammation start? Ice, compression, elevation and NSAIDs are so commonplace that suggesting otherwise is laughable to most. Enter an Athletic Training Room or Physical Therapy Clinic nearly all clients are receiving some type of anti-inflammatory treatment (ice, compression, massage, NSAIDs, biophysical modalities, etc). I evaluated a client the other day and asked what are you doing currently – “Well, I am taking anti-inflammatories and icing.” Why do you want to get rid of inflammation and swelling? I ask this question for both chronic and acute injury!