I find myths and misconceptions intriguing and pondering how they came to exist and why they still endure. Big Ben brings to mind the giant London clock, but the alliterative moniker actually refers to the bell inside the tower which houses the oversized timepiece. The Immaculate Conception is often assumed to refer to a Christian savior’s birth, but it is actually used to describe Mary being born without the stain of Original Sin. Peruse may be the word most mangled from its original meaning. It is often thought to mean skimming a manuscript when it instead is defined as to pour over it thoroughly.
The world of health has its share of myths as well, to include the idea that a sprain should be iced. The twisting of lower ligaments is are among the most common medical misfortunes, meaning a million people or more each year are likely tending to it the wrong way.
The SkepDoc, Harriett Hall, reviewed Dr. Paul Offit’s book Overkill, which focuses on medical myths, most specifically on supposed cures. Per Hall, a frigid fix came to be associated with ankle in 1978 when Dr. Gabe Mirkin wrote a book about sports-related injuries in which he recommended ice along with rest, compression, and elevation, forming the acronym RICE. But Hall wrote that these ideas stemmed from “intuition rather than evidence.”
Since then, research and studies have consistently shown that icing does nothing to speed recovery. Hall cited a 2012 Dutch review of eleven studies which found no evidence to support the RICE hypothesis. In fact, the regiment could even aggravate the injury. What did work, researchers found, was early movement.
A 2013 Taiwanese study showed that strenuous exercise damaged muscle tissue by causing increased creatine kinase levels and myoglobin in the blood. The supposed cure, ice, led to even higher levels of such damage. Further, patients treated with ice experienced more fatigue.
Offit wrote the key to healing is inflammation. While painful, inflammation increases blood flow, which transports immune cells to the damaged body part. Also, warmth can be applied and gentle ankle exercises can be done without weight-bearing.
Conversely, anything that decreases blood flow will lengthen the time of healing. And rest, ice, compression, and elevation all cause this decrease; so everything traditionally recommended for ankle sprain recovery actually makes them worse. To his credit, Mirkin now says RICE is the wrong way to go. So if you twist an ankle while walking up the stairs to see the Big Ben bell because you were perusing a tourist guide, go with heat and moderate activity instead of their opposite numbers.