RICE vs MEAT: The fastest road to recovery

For decades, the prescription for any type of soft tissue injury has been RICE – rest, ice, compression, and elevation. And often the use of NSAIDs like Ibuprofen was encouraged alongside. The goal of the RICE method and Ibuprofen is to decrease inflammation and manage pain. These may seem logical, but by digging deeper we find that this may not be the fastest method to healing.ankle-clipart-Sprained_Ankle_Picture

First, why so much focus on decreasing inflammation? That would assume that the body’s natural reaction – inflaming the location in question – was wrong and somehow bad. In fact, inflammation may be exactly what the injured area needs. Early stages of inflammation are influenced by the immune system protecting the site from further injury and controlling the potential for infection. Subsequent inflammation helps to re-grow the damaged tissues and encourage the healing process. So stopping inflammation may actual slow the healing process.

More recently the prescription to encourage fast healing is MEAT – movement, exercise, analgesics, and treatment.

MEAT: Early movement is being used in medicine in many more places because of its contribution to healing. Movement increases circulation which allows the body to remove waste and deliver nutrients required for healing. Movement can also encourage healing by placing a small amount of stress on the area to which the body can respond. In addition, movement can help prevent  adhesions and scar tissue from forming, which will prevent future mobility. Movement should be attempted very carefully, however. Move only up to the point of pain and stop. Let pain be your guide. We don’t want to cause additional injury. An example of movement for an ankle injury would be drawing the alphabet with your toes in the air.

EXERCISE: As mobility returns, small bouts of exercise can be introduced to continue to promote blood flow and healing. Here again stress on the area signals the body to grow. Exercises for the ankle might include some work with an exercise band.

ANALGESICS: Studies have shown that too much pain may actually delay healing. Plus we don’t want to deal with pain all day. Analgesics like Tylenol can help reduce pain without the inflammation suppression of NSAIDs. But they should be used sparingly as they do put stress on the liver. Pain reduction is particularly important before bed. Sleep is prime time for healing and if you aren’t getting a deep sleep then you aren’t healing.

TREATMENT: Treatment is a broad category and depends largely on the injury. Treatments are best prescribed by a PT or specialist doctor to best address the injury. However, contrast baths are often incredibly helpful and an easy form of treatment. In contrast baths you alternate between ice cold and hot applications in order to promote blood flow to the area, thus speeding healing. Other treatments may include ART, Graston, and other traditional therapies.

In addition to the above, I find is wise to assist the body in any way possible with its healing duties. Glucosamine and Chondroitin have long been used to assist in soft tissue and joint repair. These substances are actually building blocks of tissue. Proteolytic enzymes have also been shown to assist with pain management and with recovery. Turmeric, specifically the substance curcumin, has been shown to have anti-inflammatory and antioxidant properties, both useful in injury situations. One supplement that has all of these substances in one supplement is Hammer Tissue Rejuvenator (15% off link).  I used this myself with great success while healing from a bad ankle sprain.

Why then does your doctor still use RICE? Well, your doctor is most concerned with getting you out of pain and avoiding your return to him with more issues. RICE delivers on that goal. But if your goal is to get back running as quickly as possible, MEAT will serve you better.

So while RICE has a focus on reducing pain and making the patient more comfortable, MEAT is directed to the fastest recovery time. Now, immediately after an injury, it is wise to stay off the affected area and ice may contribute to pain management without medication, so the RICE protocol certainly can have its place. But as movement becomes possible the protocol should shift to MEAT.

Still unsure? Do a quick search yourself on RICE vs MEAT and you’ll find plenty of research. Here is just one medical source discussing this issue and includes plenty of studies listed at the bottom. http://www.caringmedical.com/sports-injuries/rice-why-we-do-not-recommend-it/. Best of luck on your recovery!


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Improving Running Speed – The Secret of Cadence

Within all of the swirling talk of minimalist shoes, barefoot running, and Chi, there has been a constant that seems to have flown under the radar. One common thread in all of the latest running theories is the importance of a high running cadence. It just might be that no matter what shoes you wear or how you train or what you eat, simply increasing your cadence could provide the greatest immediate benefits in both increased performance and decreased injury rate.

I was first introduced to the magic of high cadence while studying the Pose running method. Pose suggests that a cadence of 180 steps per minute is ideal because it allows you to benefit from the natural elasticity in your tendons. Think of your feet as being basketballs. When a basketball hits the ground, it stays for a specific amount of time before rebounding back up. When you run with a low cadence, you are basically holding your foot on the ground when it naturally wants to “bounce” off and rise again. In order to get your foot off the ground, you then need to push off the ground. This cadence is also recommended by Chi Running and a number of other running schools.fast running cadence form

Running coach Jack Daniels first talked about the importance of cadence after studying the elite runners at the 1984 Olympics. He found that all of the elite runners had a cadence of at least 180. Gebrselassie has been identified as running as high as 240 steps at the end of a 10k! In addition to the benefits of elasticity, a quick cadence provides some other benefits.

In order to reach that turnover speed, you need to shorten your stride, thus reducing the over-striding and heel striking that exemplifies poor form. These quick, soft steps also decreases the forces on the body, reducing injury rates. Finally, quick turnover increases forward momentum. Just think about the logic of trying to run fast by putting your foot out in front of you and absorbing the energy into your legs. It simply doesn’t make sense. An article at iRunFar called Improving Running Economy goes into more detail on the physics and benefits.

So if we assume that a fast cadence is ideal, how do we get there? I have found a few good resources to help you increase cadence. The first is a short and simple article by the shoe company Altra that describes a loose protocol to increase cadence. Runner’s World also recently posted an article on improving cadence that goes into a bit more detail. But the best resource I have found, and the one that I have used with good success myself, is a series of videos and exercises at CrossfitEndurance. The videos below give a weekly progression to help you learn the 180 cadence. There is tons more information and running drills on the CFE running page.

Week 1
Week 2
Week 3
Week 4
Week 5
Week 6

A useful tool for any of these exercises is a metronome or candence app for your phone or an inexpensive digital metronome.

Certainly it can be difficult to increase your turnover, especially if you have a slow, over-striding style. However, the benefits of this one simple change can be incredible. The higher cadence will actually take less effort, improve your forward momentum, decrease injuries, and increase speed. And if you are a trail runner, you already understand the importance of taking shorter steps on technical terrain. The exercises required to make this improvement require only minimal time during each workout, are low effort, and can even be done while you watch TV. Clearly benefits like this, at low cost, are worth exploring for yourself.

Questions? Thoughts? Comments? Start the discussion below!

Running Injury Rehab Guides

Are you suffering from a running injury? Or do you have some lingering pain that affects your running? Or you must at least know a runner that is dealing with an injury. According to the American Academy of Physical Medicine and Rehabilitation, nearly 70% of runners will become injured (ref).plantar fasciitis

The smart folks at E3 Training Solutions have published a list of Basic Rehab Guides for Common Running Injuries. It covers everything from IT band to plantar fasciitis to shin splints to knee pain. What I love most about these guides is that they take a more holistic approach to truly rehabilitating the area. They are not just concerned with getting the pain to stop, but with making the physical changes necessary to prevent, or at least greatly decrease, the chances of the injury recurring.

Each guide includes stretches, mobility exercises, and strength exercises. Most of the steps include a video so you can see exactly how to do the exercise. Very little equipment is necessary for most of the guides, though you may need a lacrosse ball, medicine ball, or exercise band.

Bookmark that guide and please share this article with your running friends; most of them probably need this information right now! Be a good friend and help them out.

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Planning Your Race Schedule for Optimum Performance

If you want to maximize your performance, enjoyment, and fun racing trails and ultras this year, you can’t afford to just wing-it. Your racing schedule must take into account which races that important to you, focused training, adequate recovery, race preparation, and race registration. The simple spreadsheet template provided below will help you schedule all of your races for the year, make sure you don’t miss a registration deadline, and prepare you to do your best when it counts.

The first step to planning your racing season is to get specific about your goals. What do you specifically want to accomplish this year? Are you aiming to complete a longer distance race, like a marathon, 50k, or 50 mile ultra? Do you intend to make the transition into trail running? Maybe you just want to put up some faster times, or place in your age group. Get specific about your goals before you start planning your schedule.

Online Race Listings
Trail Animals/NE Ultra Race Calendar
Cool Running Race Search
Trail Runner Magazine Race Calendar
Ultrarunning Race Calendar

With your goal in place, you can browse the local race calendar and pick out the races where your goals will be met. Your most important races of the year we’ll call you’re A races. You will probably only have a few A races on your schedule. These are the races that you are going to focus on with your training, tapering, and racing effort. You can’t do that kind of effort every week, so you have to be selective about choosing these races.

After the A races are chosen, you can pick some B races. These races will be opportunities for you to tune-up for you’re a races. They are great chances for you to see how your training has prepared you, test your racing gear, nutrition, hydration strategy, and pacing. You will likely give these races 100%, but you probably won’t include a full pre-race taper.

Finally, in the spaces that are left on the calendar, you can choose a handful of fun races. These may be races that aren’t really in your goal discipline. For example, if you are a trail ultrarunner, you might choose a local 5k road race or a half-marathon trail run. These races will satisfy your competitive spirit, but in a more relaxed environment.

ultra race calendar

With your races selected, I recommend putting them all in a simple spreadsheet. You are welcome to download the spreadsheet I am using to plan my racing this year. In addition to columns for the basic race information like name, date, and location, I have some other useful stats. I list not only the distances that the race offers (many offer more than one distance), but also the distance I expect to race. This allows me to see if I am planning a reasonable increase in racing distance over the year. With my desire to get into 50k and 50 milers this year, I can’t really expect to run those distances in my first couple of races. I also list when registration is expected to open for a race, and whether I have registered. With many ultras and trail races allowing only a limited number of participants, I want to make sure I register quickly so I don’t get shut-out. Finally, I color-code each race so I know if I am registered, plan to register, or don’t plan to race. It’s good to have races on my list even if I don’t plan to race them as my schedule may change.

With your schedule now in-place, you can make sure you don’t have any problematic conflicts. For example, you want to make sure you have adequate time before you’re a races to taper and adequate time to recover. You also shouldn’t have many A or B races on back-to-back weekends, as your performance will likely suffer.

Feel free to download my sample racing schedule sheet and use it for your own planning. Let me know how it works for you, and if you make any improvements. And most importantly, see you on the trails this season!