DISCLAIMER: PLEASE BE AWARE I AM NOT A QUALIFIED PHYSICIAN. This article represents only thoughts and opinions from personal experience. Always visit a professional medical expert if injured. DO NOT ATTEMPT THESE PRACTICES YOURSELF WITHOUT PROFESSIONAL MEDICAL SUPPORT!!!!

In the introduction to this story I recalled a trip to the island of Koh Samui [thai for motorcycle heaven] and how an absurd but relatively minor accident lead to a grade III high ankle sprain and left me stranded on a beach in Thailand.

Here you can see some of the damage done....
WARNING!!! EXTREME CONTENT PROCEED WITH CAUTION!! ;P

I was so lucky though. Surrounded by amazing, caring people (including my best and a number of local islanders who came to my aid) the accident actually didn't but a damper on the holiday and just meant I had to spend more time on the beach. Indeed, some of the activities we had planned wouldn't be possible but I worked through a lot of the pain and only visited the hospital once for a quick X-ray. This, by the way, was also something amazing I experienced in Thailand. The healthcare system is very fairly priced (at least relative to what I was used to!). I didn't have health insurance but all my medical bills came to less than $100 including an X-ray, pain medication, antibiotics (for the gash in my arm and knee) and dressings. And none of the stress of dealing with insurance pay out for cover which would have cost me about the same anyway.

(Please note: I DO ALWAYS RECOMMEND you get the appropriate insurance cover you need when travelling. ALWAYS!)

And best of all, the food in Thailand in amazing and this made me very happy....and they also which Dunkin Donuts which are pretty novel to us Brits....

So despite the agony of my ankle and my inability to walk at more than a few meters unassisted we were still having a blast in Thailand. The story of HARM versus RICE though goes a little further back. I used to play international level American football when I was a bit younger and minor ankle sprains were a common injury to me.

I always managed to play through with them by using excessive amounts of taped ankle supports and analgesics. I found though that this never fixed the problem. I kept spraining them regardless when I took the supports off.

At the time I had a bit interest in medical research. At the time I was writing a dissertation on chronic back pain drug delivery and previously had a lot of experiences dealing with my own injuries with the aid of physios and sports scientist. But one day I discovered a book titled "Don't ice that ankle sprain!" by Dick Hartzell.

It proposed that the traditional ackronym of RICE (or now sometimes extended to PRICE), was actually an outdated medical theory which was used to treat inflammation and pain but delayed recovery. Instead, it preached the F.A.S.T method to recovery using a combination of mobility and strengthening exercises. Before we understand how F.A.S.T works we need to look at RICE and way it has become so ingrained (no pun intended) in normal sports physio practice.

RICE

           R - Rest
           I  - Ice
          C  - Compression
          E  - Elevation 

Why RICE is recommended?

Along with protection, the RICE method encapsulates a treatment system used primary to reduce inflammation and pain. In turn this should allow the patient and physician to address the extent of the damage and begin rehabilitation exercises.
Rest is recommended for apparently obvious reasons. Keeping the ankle immobilised should prevent further damage. Ice reduces swelling by restricted the flow of blood along with compression and elevation which also prevent blood from gathering where the damage has occurred.

This method works because the patient feels less pain, the injury appears to be heal quicker and mobility exercises should be able to commence quicker. And for the most part it works. However in the next part of this series, I will discuss the F.A.S.T method and also HARM, which should be avoided but if it's not how it's still going to be okay as I chug beer, get a Thai massage on my swollen lump and bake in the sweltering heat of South-east Asia.

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