RICE or METH for running injuries?

Staying healthy is a delicate balance, and sometimes minor injuries plague the training block.

Most of triathlon injuries occur during training for running. It makes sense: that’s where impact and load are highest.

PMC found that “most injuries reported occurred during running (45 per –92 per cent)”, with far fewer in cycling and swimming.

RICE and METH are two acronyms that help remind athletes how to speed up recovery from acute running injuries.

Being injured doesn’t necessarily mean you have to scrap your race plans; by using elements of these approaches, you can, in most cases, get back to training. Everyone has an opinion on which is better, but the differences between them need not be as polarizing as they’ve been made out to be.

RICE: rest, ice, compression, elevation

RICE was the first of the two methods to become mainstream.

Rest is the first step and arguably the most important in recovery. You’ll need to (temporarily) stop your activity so you can assess your injury’s severity (possibly with the help of a sports medicine doctor or physiotherapist and start to heal.

Ice is recommended for pain and swelling. Ice constricts blood vessels, which helps reduce swelling and relieve pain. If you’ve picked up an injury such as shin splints during your long run, you should apply ice within 48 hours, and for not more than 15-20 minutes at a time. Make sure to wrap the ice (or ice pack) in a cloth to protect your skin.

Compression controls swelling and provides support to stabilize ankle sprains or muscle strains. It also supports blood flow to the affected area. You could use a tensor bandage, compression sleeve or compression socks, depending on the location of the injury.

Elevation of the affected limb or body part above heart level helps to drain fluid, reducing inflammation and swelling and helping reduce pain. This can be effective when treating runner’s knee or any other inflammation-related injury.

METH: movement, elevation, traction, heat

More recently, medical experts have suggested the METH approach, which, depending on the injury, may be more appropriate.

Some form of gentle movement (such as walking or cycling) is generally preferred over complete rest. Gentle movements on a hamstring strain, for example, can keep your muscles loose and prevent stiffness from immobility. It’s important to keep intensity levels very low so as not to risk worsening the injury.

Elevation is common to both methods. Elevating the affected limb or body part above heart level helps reduce swelling and inflammation.

Traction encourages healing by decompressing the joint. By gently stretching and pulling away from the affected area, you stretch the soft tissue, which helps restore mobility. (A physiotherapist or registered massage therapist may be able to do this more effectively than you can on your own.)

Heat is the main difference between METH and RICE. Applying heat for 20 minutes encourages, rather than restricts, blood flow to the injured area, and speeds up the healing process. This can also help relax muscle spasms or cramps. On the other hand, too much heat can induce inflammation, so heat should be applied no more than every 40 to 60 minutes.

Which is better?

One is not necessarily better than the other. The best approach is to use elements of both. RICE and METH are really just ways to remember best recovery practices. Sometimes, rotating between elements of each is the best approach.

RICE is most effective within the first 24 to 48 hours of recovery, since it helps reduce pain and inflammation. METH is best suited to your extended recovery, 48 hours after the injury. METH promotes active recovery and increased blood flow, making it easier for your body to heal. Don’t forget about strength training during recovery; strength exercises can prevent injury and support your rehabilitation.

If you experience substantial pain for longer than a day or two, or if it gets worse, you should seek medical attention.