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Forget the R.I.C.E Method: Part 2 of 3

RICE Method

In the first post in this series, I highlighted the pitfalls of the R.I.C.E Method for sports injuries and soft-tissue recovery. One thing I failed to do, though, is thoroughly breakdown the effects of inflammation. Inflammation and swelling are a normal part of the tissue healing process, so any aim, strategy or magical healing spray which “reduces” or “eliminates” swelling oftentimes is a cause for concern in my mind. I expand a little more in detail and ask additional clarifying questions in this post, which focuses heavily on the role of inflammation in the body after an injury.

Be sure to read all the way to the end to see what natural recommendations I make for properly reducing inflammation in the body for optimal health and wellness.

5 Natural methods to reduce swelling after an injury (other than movement!)

  1. 1
    Dairy-free for 30 days.
  2. 2
    Gluten-free for 30 days
  3. 3
    Increase magnesium intake
  4. 4
    Drink ½ Body Weight in ounces of water
  5. 5
    Sleep 1+ hour more each night (TRUST ME!)

Let’s break each one of these strategies down a bit further…

method 1

What does going dairy-free do for swelling?

Since swelling inside of the injured tissues is a byproduct of the inflammatory pathway, it is important to note this process can either be expedited or delayed. But the next logical question should be: Do we want to delay the inflammatory process after an injury?

If you’ve read my earlier blog in this series (if not, no worries, you can read it HERE), you’ll know how I am not a fan of icing after an injury. Ice certainly delays and reduces the amount of swelling after an injury has occurred.

In order to unpack this even more, we must travel down to the cellular level. When an injury occurs the following inflammatory mediators immediately increase in the body:

  • PGE2 (prostaglandin 2)
  • Cytokines (IL-1, IL-6, TNF)
  • Histamine
  • TGF-Beta (an important inflammatory mediator to remember!)
  • Fibrinogen/fibrin
  • Hydrogen ions (thereby making the area acidic)

In acute injuries, the inflammatory pathway kicks on immediately and continuously until the nervous system signals to cease. This occurs when peripheral nerves communicate with the spinal cord and then on to the higher levels of the brain, such as the anterolateral system (ALS) that the protective chemical mediators are no longer needed.

If too much signal intensity is broadcast via the nervous system (and for too long), a persistent inflammatory response can become the new “normal”. This results in a low grade, constant influx of a powerful chemical mediator called Substance P. When released from peripheral nociceptors, Substance P acts to further release more inflammatory mediators into the area to perpetuate the inflammatory process. This doom loop continues, as long as you are constantly feeding the nervous system a pro-inflammatory nutritional intake, such as dairy. Dairy is not the enemy here, and some people should continue to consume dairy products. My warning simply comes from the effects dairy has on the inflammatory pathway. If you consume a lot of dairy products, expect a higher than normal amount of Substance P to be released, which perpetuates the inflammatory process and excites nociceptors, which leads to more Substance P to be released and on and on the doom loop goes.

method 2

Going Gluten-Free to Reduce Inflammation:

Can going gluten free reduce inflammation?

We have been tracking the effects of gluten, especially the protein within gluten - gliadin, for quite some time now in clinical practice. The research world has looked at a variety of other proteins in wheat which might also trigger a serious inflammatory cascade.

One such protein is amylase-trypsin inhibitors (ATI). This protein has been shown to spike both the inflammatory pathway and the global immune response. This is one reason why going gluten-free before surgery can potentially reduce your post-operative swelling significantly.

Just as an aside, on a purely anecdotal basis, a close friend of mine tore his ACL while playing professional soccer in Australia. He returned home for surgery and post-op rehabilitation. He went gluten-free leading up to his surgery and the doctors were astounded at how little post-op swelling he had. To this day, he still credits going gluten-free as a major contributor to his successful recovery from the operation.

method 3

Increase Magnesium Intake

According to Hyde and Gengenbach, magnesium is the second most abundant intracellular cation next to potassium, and is a cofactor in more than 300 metabolic reactions. Other words, magnesium is basically involved in every metabolic pathway.

For example, connective tissue relies on a healthy supply of magnesium. Tissue such as elastin, glycoproteins, proteoglycans, and collagen all depend on magnesium for proper healing.

Magnesium deficiencies have been linked to depression, fibromyalgia, and myofascial pain syndrome (MPS). It appears the United States possesses one of the lowest baseline magnesium levels in the world since 1900. An inadequate intake of magnesium has been shown to be pro-inflammatory.

Researchers Weglicki and Phillips found that feeding rats a magnesium-deficiency diet increased their Substance P levels within 5 days. Substance P is a biomarker for the pro-inflammatory state.

Again, not to bore you with biochemical details here, but you could literally (not figuratively) eat your way through the healing journey by avoiding dairy and gluten and increasing your magnesium intake. See? No ice needed.

method 4

Drink ½ Your Body Weight In Ounces of Water Daily

This one will take some math, so get out your phones (I almost said calculator, but everyone just uses their phones these days, right?!).

If a person is tall, enjoys soccer (especially Liverpool FC), his favorite human is Mary Kate, and he just so happens to weigh… let’s say 185 pounds (because he actually weighs 185 pounds). Here’s how this gets all worked out:

185/2= 92.5 ounces of water each day, which equates to ~6 16oz bottles of water.

In a counter-intuitive way, drinking more water helps reduce soft-tissue swelling. Here’s how that’s even possible: When you are dehydrated, your body acts to retain as much water as possible to the vital cells functioning. When you are hydrated, the swelling goes down safely because of the sheer volume and motion of the fluid dynamics in the body. Most notably, the lymphatic system, when triggered by muscle contractions, picks up a significant amount of tasks of reducing swelling. This can only happen if you are hydrated!

method 5

Get an extra hour of sleep each night

This one might come as a surprise, but sleep has been the best kept secret for professional and high-achievers. It has been said that LeBron James slept 12 hours a day (not consecutively) during the Los Angeles Lakers' run to the NBA Championship in 2020.

If you, like many of our patients, are in need of some ideas, tips and strategies to sleep more soundly and for longer, I would highly recommend you listen to this interview I had a few years ago with Jason Silvernail, PT. Jason outlines the exact strategy high performance individuals and high achievers do every day to sleep soundly. Here’s a hint: They establish a routine!

When our sleep is irregular, we rely heavily of caffeine and adrenaline. Both are useful resources in which we can use to accomplish large amount of tasks and activities - for a period of time! Once we hit our threshold and the adrenaline and caffeine ware off, we are left with these pro-inflammatory chemical mediators. We know that too little sleep causes an immediate influx of prostaglandins and proinflammatory cytokines. Similarly to dietary triggers, too little sleep triggers the same pro-inflammatory pathway in the body. It’s also a doom loop, whereby too little sleep causes an increase in inflammation, which causes an increased sensitivity to nociceptors, which causes difficulty sleeping. Some patients have even reported a condition known as hyperalgesia, where even the feeling of the bedsheets at night causes a massive increase in pain and discomfort.

Now, there is good news!

The Anti-Inflammatory Checklist

  • Magnesium - As previously mentioned, magnesium is vital in the process of reducing swelling and a whole host of other reactions in the body. This specific brand REALLY helps the Earl Family sleep well each night.
  • Omega-3 Fatty Acid (Fish Oil) Omega-3 fatty acids (fish oil) has been shown to mirror the effects of NSAIDs in the treatment of arthritis. Omega-fish oil supplements appear to be a safer alternative to NSAIDs for treatment of nonsurgical neck or back pain.
  • Juice Plus - Everyone in our family takes the chewables, with the exception of Mary Kate, who takes the capsules.

Do This Next:

  • Share this blog with someone you know who would find this information useful.
  • Text our office if you are interested in ordering any of the Anti-inflammatory products mentioned in the blog - Call/text: (630) 765-0575
  • Keep an eye out in your inbox next month for the 3rd Installment in our 3-part blog series.

Dedicated to restoring your health.

Dr. Alex Earl, DC DACRB



Alex Earl

Alex Earl

Alex Earl, DC - Chiropractic Physician - Dr. Earl helps people of all ages remain active, strong and able to participate in the activities they love. Aside from Active Health & Restoration, Alex is a clinical instructor for Midwest Rehabilitation Institute, along with a few other professional educational organizations across the country. He is a Diplomate in Clinical Rehabilitation through the American Chiropractic Board of Rehabilitation (ACRB). Dr. Earl earned his Doctor of Chiropractic (DC) degree from National University of Health Sciences in 2015. He is currently a resident in West Chicago, IL with his beautiful wife, and four (perfect) children. In his spare time, Alex coaches high school soccer.
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