If you just sprained your ankle, you know first hand that it is a very painful and debilitating injury. Sure, it’s not as bad as an ACL tear in your knee, but it can be pretty serious. It will swell to the size of a softball and bruise pretty badly. You may not even be able to walk on it, because it just hurts too much. By the next day, if you don’t do anything, it will continue to swell up even more and become significantly more stiff. That is because your body is trying to protect the area from further injury. So, it makes it immobile. The irony is that if you do nothing for your ankle besides rest and ice, your sprained ankle could take months to heal and you may continue to have pain for a very long time. And some people choose to do nothing. We think that is a huge mistake. The body just does not heal very well with 100% pure rest. Muscles, ligaments and joints respond much better to rehab treatments. So, even though it may seem to be the opposite of what seems safe and normal, the research is very clear on the issue of rest versus rehab.
But, I digress. You just sprained your poor ankle… what do you do first? Well, there are two sprained ankle treatment options available to you. The first is called R.I.C.E. It suggests you should rest and ice your ankle, keep some compression like a wrap on it and keep it elevated. It suggests you should continue to do this until you are healed. The second option is known as H.E.M. This ankle treatment suggests you should ice your ankle for the first 2 days, but also use more active rehab techniques including some very specific exercises, stretches and a few other healing methods. In short, one is non-active and the other is active. Which one works better? Let’s take a closer look…
Actually for the first 48 hours, there are some similarities withe R.I.C.E. and H.E.M. They both suggest you should ice and elevate your ankle. But, after the first 48 hours, these two methods differ dramatically. In other words, H.E.M. suggests ice for 2 days and R.I.C.E. suggests ice until you are fully healed. The reason for the ice is easy… icing helps contain and reduce swelling in and around the ankle. So, why does H.E.M. say to stop after 2 days?
Well, new research has shown very clearly that ice is only effective for containing and reducing swelling for the first 48 hours. After that, it has not been shown to be clinically effective at reducing swelling. Knowing that, H.E.M. suggests you move onto other healing techniques that have been shown to continue being extremely effective. But, R.I.C.E. suggests simply continuing to ice and rest.
In addition, R.I.C.E. also suggests you continue to rest until the ankle is healed. The is probably the biggest fundamental difference with H.E.M. Although H.E.M. does suggest rest as an important component of the healing process, this treatment does not suggest rest alone. Instead, it promotes an active rehab program that entails a number of unique stretches and exercises as well as a few other effective healing techniques. However, just as in R.I.C.E., you will still be resting your ankle most of the time, since, when you are not doing the rehab in H.E.M., you will be resting. So, the main difference is that H.E.M. believes that active rehab is absolutely necessary for a quick and full recovery versus rest alone.
Again, which one is better? Pure rest or rest and exercise? Again, the research suggests there is usually extensive ligament damage in an ankle sprain. Especially in a grade II or III sprain where the ligaments can completely tear or rupture. In a bad ankle sprain, scar tissue will develop as well as some neuromuscular damage (the ability for the brain to communicate with the ligaments in the ankle) as well as general ligament weakness and stiffness. In other words, there is a lot of damage.
We know that rest cannot strengthen the ankle and it cannot improve range of motion. And since we know that scar tissue develops in and around the ankle, we also know that left by itself, the ankle will actually become LESS mobile and WEAKER over time. That is the main concern with pure rest. In contrast, H.E.M. goes about teaching you how to fully heal all this damage with a wide variety of exercises, stretches and other valuable techniques. Experts agree that rest alone cannot remove or break up scar tissue, nor can it heal neuromuscular damage or improve range of motion or strength. That is why H.E.M. has such an advantage over R.I.C.E. in the recovery process.
In the end, the best indicator of a good sprained ankle treatment is how fast and well it works in the real world. And according to thousands of people who have used H.E.M., they are walking normally again and without pain in about a week or less. And according to people who use R.I.C.E., the average healing time is about 4-8 weeks. This would suggest that the body does react much better to the active rehab treatment versus the non-active one.
And, in our opinion, even more important than the actual healing time of the ankle is the fact that people who use H.E.M. are at a much lower risk of re-injury than those who just used R.I.C.E. Of course, this makes sense when you consider that the people who rehab their ankles with H.E.M. have done a number of stretches and exercises to strengthen and protect their ankles while those using pure rest have weaker and tighter ankles which are more susceptible to injury.